ABSTRACT
PURPOSE: The aim of this study was to prospectively investigate the clinical impact of image fusion of computed tomography (CT) and single photon emission computed tomography (SPECT) diagnostics in head and neck cancer adjacent or fixed to bony maxillofacial structures. PROCEDURES: Computer-based manual image fusion has been applied in 74 patients with suspected malignancies in the oromaxillofacial region following CT and SPECT. Afterward, image fusion was compared to separate evaluation of CT and SPECT and visual coregistration with histopathological results serving as control. RESULTS: In nine out of 74 patients, image fusion achieved more precise anatomical findings regarding tumor dimension than simultaneous evaluation of CT and SPECT, but there was no improvement of identification of bone infiltration. CONCLUSION: Manual image fusion of CT and SPECT does not improve identification of bone infiltration compared to simultaneous evaluation. Though particularly in complex anatomical regions, a fixed preoperative diagnostic algorithm in image registration lead to a more precise evaluation and treatment of head and neck malignancies.
Subject(s)
Facial Neoplasms/diagnostic imaging , Facial Neoplasms/therapy , Maxillofacial Abnormalities/diagnostic imaging , Maxillofacial Abnormalities/therapy , Technetium Tc 99m Medronate , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Adult , Aged , Facial Neoplasms/pathology , Female , Humans , Intraoperative Care , Male , Maxillofacial Abnormalities/pathology , Middle Aged , Preoperative CareABSTRACT
The purpose of this study was to evaluate the impact of various iodine contrast concentrations on image quality in computed tomography (CT) perfusion studies. Twenty-one patients with suspicion of cerebral ischemia underwent perfusion CT using two different iodine contrast concentrations: 11 patients received iomeprol 300 (iodine concentration: 300 mg/ml ) while ten received the same volume of iomeprol 400 (iodine concentration: 400 mg/ml). Scan parameters were kept constant for both groups. Maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) were calculated from two adjacent slices. Quantitative comparisons were based on measurements of the maximum enhancement [Hounsfield units (HU)] and signal-to-noise index (SNI) on CBF, CBV, and TTP images. Determinations of grey-to-white-matter delineation for each iodine concentration were performed by two blinded readers. Only data from the non-ischemic hemispheres were considered. Both maximum enhancement and SNI values were higher after iomeprol 400, resulting in significantly better image quality in areas of low perfusion. No noteworthy differences were found for normal values of CBF, CBV, and TTP. Qualitative assessment of grey/white matter contrast on CBF and CBV maps revealed better performance for iomeprol 400. For brain perfusion studies, highly concentrated contrast media such as iomeprol 400 is superior to iomeprol 300.
Subject(s)
Brain Ischemia/diagnostic imaging , Cerebrovascular Circulation , Contrast Media/administration & dosage , Iopamidol/analogs & derivatives , Tomography, X-Ray Computed , Double-Blind Method , Female , Humans , Iopamidol/administration & dosage , Male , Middle AgedABSTRACT
OBJECTIVE: The aim of this study was to evaluate the benefit of image fusion of CT (computertomography) and bone SPECT (single photon emission computed tomography) in diagnosis of head and neck cancer. METHODS AND PATIENTS: Computer based image fusion has been applied in 39 patients with suspected cancer in the oromaxillofacial region following CT and SPECT without any further hazard for the patients. Afterwards image fusion was set in comparision to simultaneously evaluation of CT and SPECT and histological findings. RESULTS: In 5 out of 39 patients SPECT/CT image fusion obtained more precise anatomical findings in tumour expansion than simultaneously evaluation of CT and SPECT. CONCLUSION: For planning of surgical and radiation therapy of oral and maxillofacial cancer, image fusion of CT/SPECT provides efficient and plastical diagnostic imaging. Particularly in complex anatomical regions like maxilla or base of the skull image fusion could be an additional device, if simultaneous evaluation of CT and SPECT is not clear.
Subject(s)
Image Enhancement , Image Processing, Computer-Assisted , Jaw Neoplasms/diagnosis , Mouth Neoplasms/diagnosis , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Female , Humans , Jaw Neoplasms/radiotherapy , Jaw Neoplasms/surgery , Male , Middle Aged , Mouth Neoplasms/radiotherapy , Mouth Neoplasms/surgery , Patient Care Planning , Sensitivity and SpecificityABSTRACT
This case report deals with a patient who was readmitted with a bilateral submandibular swelling after having received primary surgery due to gastric adenocarcinoma 6 months before. After bilateral submandibulectomy both glands were diagnosed histopathologically as metastasis of adenocarcinoma. This is the rare case of a submandibular gland metastasis and the first case of a bilateral synchronous submandibular gland metastasis from gastric carcinoma.
