Prognostic Value of Metabolic Tumor Volume Measured by (18)F-FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery.

PURPOSE: We assessed the prognostic value of metabolic tumor volume (MTV) measured using(18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0 ± 8.8years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake value (SUVpeak) and MTV of the target lesion, including primary HNSCC andmetastatic cervical lymph nodes, were measured from FDG PET/CT images. We compared SUVpeak, MTV, and clinicopathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease-free survival (DFS) and overall survival (OS). RESULTS: On the initial FDG PET/CT scans, the median SUVpeak was 7.8 (range, 1.8-19.0) and MTV was17.0 cm(3) (range, 0.1-131.0 cm(3)). The estimated 2-year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUVpeak 6.2 and MTV 20.7 cm(3) were the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (p < 0.05). CONCLUSION: The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy.

Osteonecrosis Mimicking Bone Metastasis in Femoral Head on (18)F-FDG PET/CT: A Case Report.

A 77-year-old woman underwent chemotherapy, radiotherapy, and brachytherapy for cervical cancer 9 years ago. On a follow-up (18)F-fluorodeoxyglucose (FDG) PET/CT image, focal FDG uptake was noted in a focal osteolytic lesion in the right femoral head. During magnetic resonance imaging, this lesion showed subchondral dark-signal-intensity rim on T1-weighted image and double line sign on T2-weighted image, suggestive of osteonecrosis. The lesion was pathologically confirmed as osteonecrosis after surgery. This case demonstrates that osteonecrosis of the femoral head may demonstrate focal FDG uptake mimicking bone metastasis.

Acute obstructive cholangitis after transarterial chemoembolization: the effect of percutaneous transhepatic removal of tumor fragment.

Acute obstructive cholangitis due to the migration of necrotized tumor fragment is a rare complication occurring after a transarterial chemoembolization. The percutaneous tumor removal procedure following percutaneous transhepatic biliary drainage is an appropriate treatment over endoscopic removal for the relief of acute cholangitis in this case. Following this serial management, no invasive hepatocellular carcinoma of the bile duct recurred after two years of follow-up.

Discrimination of metastatic from acute osteoporotic compression spinal fractures with MR imaging.

A study was performed to determine which magnetic resonance (MR) imaging findings are useful in discrimination between metastatic compression fractures and acute osteoporotic compression fractures of the spine. The MR imaging findings in 27 patients with metastatic compression fractures and 55 patients with acute osteoporotic compression fractures were compared by using the chi(2) test. MR imaging findings suggestive of metastatic compression fractures were as follows: a convex posterior border of the vertebral body, abnormal signal intensity of the pedicle or posterior element, an epidural mass, an encasing epidural mass, a focal paraspinal mass, and other spinal metastases. MR imaging findings suggestive of acute osteoporotic compression fractures were as follows: a low-signal-intensity band on T1- and T2-weighted images, spared normal bone marrow signal intensity of the vertebral body, retropulsion of a posterior bone fragment, and multiple compression fractures. The signal intensity on fast spin-echo T2-weighted images obtained without fat suppression played little role in distinguishing between metastatic compression fractures and acute osteoporotic compression fractures.

Researcher contributions and fulfillment of ICMJE authorship criteria: analysis of author contribution lists in research articles with multiple authors published in radiology. International Committee of Medical Journal Editors.

PURPOSE: To determine the number of researchers who fulfill the International Committee of Medical Journal Editors (ICMJE) authorship criteria and to evaluate individual contributions. MATERIALS AND METHODS: The author contribution lists of Radiology articles published between 1998 and 2000 with at least three authors were reviewed. The fulfillment of ICMJE criteria for authorship and the contribution percentage were assessed according to each researcher's position in the byline and nationality (American vs international), number of researchers per article, and year of publication. RESULTS: Sixty-eight percent of researchers fulfilled the ICMJE authorship criteria. Position in the byline indicated a significant difference in fulfillment (P <.001): 98.9% and 85.3% for the first and second authors, respectively, and 52.8% and 66.5% for the middle and last authors, respectively. American researchers had a higher percentage (78%) of fulfillment than did international researchers (57%) (P <.001). Fulfillment decreased as the number of authors per article increased (P <.001), although there was no significant change throughout 1998-2000. The mean contribution percentages decreased greatly from first to second to last to middle authors. American researchers had a significantly larger mean contribution percentage than did international researchers. Of the total 6,686 researchers, 2,316 (35%) contributed to one or two categories. This rate was higher for middle and international authors. CONCLUSION: The 68% fulfillment of criteria for authorship was closely related to the large number of researchers contributing to one category or to categories belonging to the same ICMJE criterion.

Meniscal tear configurations: categorization with MR imaging.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of MR imaging for categorizing the configuration of meniscal tears of the knee. MATERIALS AND METHODS: Fast spin-echo MR images obtained at 1.5 T from 110 patients who had meniscal tears identified at arthroscopy were retrospectively and independently classified by two reviewers into five configurations: horizontal, longitudinal, radial, oblique, and complex. MR imaging categorization was compared with arthroscopic results as the standard of reference. Data were also analyzed with longitudinal and oblique tears combined because these usually are reparable, and with horizontal, radial, and complex tears combined because these usually are not reparable. Interobserver and intraobserver agreements were calculated using kappa coefficients. RESULTS: At arthroscopy, meniscal tears were categorized as horizontal (n = 44), longitudinal (n = 34), complex (n = 22), radial (n = 11), and oblique (n = 5). Sensitivity, specificity, and accuracy of each reviewer for the reparable tears were 82%, 92%, and 89%; and 59%, 97%, and 84%, respectively. Interobserver agreements were fair between reviewer 1 and the first and second interpretations of reviewer 2 (kappa = 0.25, p < 0.005; and kappa = 0.21, p < 0.05, respectively). Intraobserver agreement was substantial (kappa = 0.71, p < 0.001). CONCLUSION: MR imaging was accurate for predicting reparable meniscal tears and was sensitive for the determination of nonreparable tears.