AIM： To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer. METHODS： From 2003 to 2009, 7 patients with paraaortic lymph no...AIM： To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer. METHODS： From 2003 to 2009, 7 patients with paraaortic lymph node recurrence （1-3 lesions） from colorectal cancer were treated with stereotactic body radiotherapy. Total gross tumor volumes ranged from 4 to 40 mL. The doses were escalated from 36 Gy/patient to 51 Gy/patient and were delivered in 3 fractions. RESULTS： One and 3 year overall survival rates were 100% and 71.4%, respectively, and median survival was 37 mo. Grade IV intestinal obstruction was reported in 1 of 7 patients. This patient received 48 Gy in 3 fractions with a maximum point dose to the intestine of 53 Gy and V45Gy = 3.6 mL. However, 6 patients received an intestinal maximum point dose of 〈 51 Gy and V45Gy of 〈 1 mL, and did not develop any severe complications. CONCLUSION： This pilot study suggests selected paraaortic lymph node recurrence （1-3 closed lesions） that failed to respond to chemotherapy can be potentially salvaged by stereotactic body radiotherapy.展开更多
AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists...AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS:The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716,respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05). CONCLUSION:The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes.展开更多
AIM： To compare the diagnostic accuracy of computed tomography （CT） and positron emission tomography （PET） for the preoperative detection of paraaortic lymph node （PAN） metastasis in patients with intra- abdomi...AIM： To compare the diagnostic accuracy of computed tomography （CT） and positron emission tomography （PET） for the preoperative detection of paraaortic lymph node （PAN） metastasis in patients with intra- abdominal malignancies. METHODS： Sixty-six patients with intra-abdominal malignancies who underwent both CT and PET before lymphadenectomy were included in this study. Histopathologicaliy, 13 patients had metastatic PAN, while 53 had non-metastatic PAN. The CT criteria for metastasis were： short diameter ：）f 〉 8 mm, Iobular or irregular shape, and/or combined ancillary findings, including necrosis, conglomeration, vessel encasement, and infiltration. The PET criterion was positive fluorodeoxyglucose （FDG） uptake. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, and accuracy of both modalities were compared with the pathologic findings, and the false positive and false negative cases with both CT and PET were analyzed.RESULTS： The sensitivity, specificity, PPV, NPV, and accuracy of CT were 61.5%, 84.9%, 50%, 90% and 80.3%, respectively. For PET, the percentages were 46.2%, 100%, 100%, 88.3%, and 89.4%. Additionally, there were 8 false positive CT cases （8/53, 15.1%） and zero false positive PET cases. Of the 13 metastatic PANs, there were 5 false negative CT scans （38.5%） and 7 （53.9%） false negative PET scans.CONCLUSION： For detecting PAN metastasis, CT is more sensitive than PET, while PET is more specific.展开更多
基金Supported by The National Nuclear Research and Development Program of the Ministry of Education,Science and Technology,South Korea
文摘AIM： To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer. METHODS： From 2003 to 2009, 7 patients with paraaortic lymph node recurrence （1-3 lesions） from colorectal cancer were treated with stereotactic body radiotherapy. Total gross tumor volumes ranged from 4 to 40 mL. The doses were escalated from 36 Gy/patient to 51 Gy/patient and were delivered in 3 fractions. RESULTS： One and 3 year overall survival rates were 100% and 71.4%, respectively, and median survival was 37 mo. Grade IV intestinal obstruction was reported in 1 of 7 patients. This patient received 48 Gy in 3 fractions with a maximum point dose to the intestine of 53 Gy and V45Gy = 3.6 mL. However, 6 patients received an intestinal maximum point dose of 〈 51 Gy and V45Gy of 〈 1 mL, and did not develop any severe complications. CONCLUSION： This pilot study suggests selected paraaortic lymph node recurrence （1-3 closed lesions） that failed to respond to chemotherapy can be potentially salvaged by stereotactic body radiotherapy.
文摘AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS:The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716,respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05). CONCLUSION:The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes.
文摘AIM： To compare the diagnostic accuracy of computed tomography （CT） and positron emission tomography （PET） for the preoperative detection of paraaortic lymph node （PAN） metastasis in patients with intra- abdominal malignancies. METHODS： Sixty-six patients with intra-abdominal malignancies who underwent both CT and PET before lymphadenectomy were included in this study. Histopathologicaliy, 13 patients had metastatic PAN, while 53 had non-metastatic PAN. The CT criteria for metastasis were： short diameter ：）f 〉 8 mm, Iobular or irregular shape, and/or combined ancillary findings, including necrosis, conglomeration, vessel encasement, and infiltration. The PET criterion was positive fluorodeoxyglucose （FDG） uptake. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, and accuracy of both modalities were compared with the pathologic findings, and the false positive and false negative cases with both CT and PET were analyzed.RESULTS： The sensitivity, specificity, PPV, NPV, and accuracy of CT were 61.5%, 84.9%, 50%, 90% and 80.3%, respectively. For PET, the percentages were 46.2%, 100%, 100%, 88.3%, and 89.4%. Additionally, there were 8 false positive CT cases （8/53, 15.1%） and zero false positive PET cases. Of the 13 metastatic PANs, there were 5 false negative CT scans （38.5%） and 7 （53.9%） false negative PET scans.CONCLUSION： For detecting PAN metastasis, CT is more sensitive than PET, while PET is more specific.
