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Optimum scanning protocol for the assessnert of cervicallymph metastases in patients with oral cancer using helical computed tomography

Research Project

Project/Area Number 13671965
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field 病態科学系歯学(含放射線系歯学)
Research InstitutionNiigata University

Principal Investigator

HAYASHI Takafimi  Niigata University, Graduate School of Medical and Dental Sciences, Professor, 大学院・医歯学総合研究科, 教授 (80198845)

Co-Investigator(Kenkyū-buntansha) KATSURA Kouji  Niigata University, Medical and Dental Hospital, Lecturer, 医歯学総合病院, 講師 (30283021)
TAIRA Shuhzou  Niigata University, Graduate School of Medical and Dental Sciences, Assistant, 大学院・医歯学総合研究科, 助手 (70313525)
Project Period (FY) 2001 – 2004
Project Status Completed (Fiscal Year 2004)
Budget Amount *help
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2004: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 2003: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 2002: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2001: ¥1,600,000 (Direct Cost: ¥1,600,000)
Keywordsoral cancer / cervical lymph node metastases / helical CT / intravenous contrast enhancement / optimum scanning protocol / keratinization / high density area / superior cervical ganglion / らせん走査CT / 口腔顎顔面領域 / 悪性腫瘍 / 転移判定基準 / 紡錘形結節状構造 / 舌癌 / 造影前CT / hyperdense area / 角質変性 / らせん操作型CT / 三次元表示 / volume rendering画像 / MPR画像 / 画像再構成間隔
Research Abstract

1.Optimum scanning protocol :
Non-contrast 3 mm thickness conventional scans are taken parallel to Reid's base line (the anthropologic base line) followed by contrast helical scans. Using a power injector, contrast material (300mgI/mL) is administered at a rate of 1-1.5 mL/s. Helical scanning of a primary lesion and cervical lymph nodes is started 45 seconds after the initiation of contrast infusion. The scan data are acquired using a collimation of 3 mm and a table speed of 3 mm/s (pitch 1/s), and reformatted into 1 mm interval axial images. Delayed 3 mm thickness non-helical scan in also performed 3 minutes after the initiation of contrast infusion.
2.Additional interpretation :
1)In order to demonstrate the utility of the three-dimensional volumetric visualization of subsequent cervical lymph node metastases in patients with tongue carcinoma, a volume rendering visualization system was used. Ten metastatic nodes of 10 patients were found with repeated ultrasonography performed at an in … More terval of at least one month and, if possible, every two weeks. All of the metastatic nodes were detected on CT taken after sonographic examination and were distinctly demonstrated on the volume rendering three-dimensional images obtained with CT data. It is suggested that three-dimensional images reconstructed with CT data provide the accurate anatomical location of non-palpable metastatic nodes detected with repeated ultrasonography.
2)We presented the high density area(HDA) within the metastatic regional lymph nodes observed on non-contrast CT in two patients with stage I or II tongue carcinoma during a follow-up period. The density of HDAs was an attenuation value of more than approximately 70 Hounsfield units or more. One patient had a level I node and the other had a level II node. Contest CT failed to detect the HDAs within the nodes. Histopathological examination revealed that HDAs were strongly correlated with the area of marked keratinization of metastatic foci. HDAs might be overlooked if only contrast CT was used. The clinician should be aware of non-contrast CT as well as contrast CT on investigating lymph node metastases at an early stage in patients with stage I or II tongue carcinoma during the follow-up period.
3)In older to distinguish benign from malignant nodules within the dissected neck area in patients with oral cancer during a follow-up period, we retrospectively evaluate the frequency and the characteristic findings of fusiform-shaped nodule along the internal carotid artery observed on the follow-up sonography. Fifty-two patients with oral cancer, who underwent radical neck dissections, were enrolled in this study. After neck dissection, every patient was examined repeatedly with sonography during a follow-up period at an interval of one month. CT and/or MRI were performed when clinically required. Any patient with recurrent neck mass was excluded from this study. In the 52 patients, fusiform-shaped nodule was observed in 10 patients (19%) on the follow-up sonography. The nodule was homogenously hypoechoic and the margin of the nodule was well-demarcated except for the upper end. Hyperechoic core was clearly observed in every nodule, which showed a fatty density on post-contrast CT. On post-contrast MRI, the nodule enhanced markedly and the core showed hypointensity on fat saturated images. In conclusion, it was suggested that the fusiform-shaped nodule observed on the follow-up sonography within the dissected neck area might be the superior cervical ganglion of sympathetic trunk. However, further studies were needed to disclose the true character of the nodule. Less

Report

(5 results)
  • 2004 Annual Research Report   Final Research Report Summary
  • 2003 Annual Research Report
  • 2002 Annual Research Report
  • 2001 Annual Research Report
  • Research Products

    (10 results)

All 2004 2003 2001 Other

All Journal Article (7 results) Publications (3 results)

  • [Journal Article] 頸部郭清術後に認められる内頸動脈に沿った紡錘形結節状構造の画像所見2004

    • Author(s)
      林 孝文
    • Journal Title

      頭頸部癌 30

      Pages: 630-634

    • NAID

      10014246468

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Journal Article] Fusiform-shaped nodule along the internal carotid artery demonstrated on the follow-up sonography within the dissected neck area in patients with oral cancer.2004

    • Author(s)
      Hayashi T.
    • Journal Title

      Journal of Head and Neck Cancer vol.30

      Pages: 630-634

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Journal Article] 頸部郭清術後に認められる内頸動脈に沿った紡錘形結節状構造の画像所見2004

    • Author(s)
      林 孝文
    • Journal Title

      頭頸部癌 30・4

      Pages: 630-634

    • NAID

      10014246468

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Non-contrast-enhanced CT findings of high attenuation within metastatic cervical lymph nodes in patients with stage I or II tongue carcinoma during a follow-up period2003

    • Author(s)
      Hayashi T
    • Journal Title

      AJNR Am J Neuroradiol 24

      Pages: 1330-1333

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Journal Article] Non-contrast-enhanced CT findings of high attenuation within metastatic cervical lymph nodes in patients with stage I or II tongue carcinoma during a follow-up period.2003

    • Author(s)
      Hayashi T.
    • Journal Title

      AJNR Am J Neuroradiol vol.24

      Pages: 1330-1333

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Journal Article] CTデータによるvolume rendering法を利用した舌癌後発頚部転移リンパ節の三次元表示の試み-USによる経過観察の支援-2001

    • Author(s)
      林 孝文
    • Journal Title

      歯科放射線 41

      Pages: 240-244

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Journal Article] Three-dimensional volumetric visualization of subsequent cervical lymphnode metastases in patients with tongue carcinoma using CT data ; a diagnostic aid for repeated follow-up ultrasonography2001

    • Author(s)
      Hayashi T.
    • Journal Title

      Dental Radiology vol.41

      Pages: 240-244

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2004 Final Research Report Summary
  • [Publications] Hayashi T, Tanaka R, Taira S, Koyama J, Katsura K, Kobayashi F: "Non-contrast-enhanced CT findings of high attenuation within metastatic cervical lymph nodes in patients with stage I or II tongue carcinoma during a follow-up period"AJNR Am J Neuroradiol. 24・7. 1330-1333 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Takafumi HAYASHI, et al.: "The high density area on non-contrast CT within metastatic cervical lymph nodes in patients with stage I or II tongue carcinoma during a follow-up period"AJNR Am J Neuroradiol. (掲載予定). (2003)

    • Related Report
      2002 Annual Research Report
  • [Publications] 林 孝文: "CTデータによるvolume rendering法を利用した舌癌後発頚部転移リンパ節の三次元表示の試み-USによる経過観察の支援-"歯科放射線. 41巻4号. 240-244 (2001)

    • Related Report
      2001 Annual Research Report

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Published: 2001-04-01   Modified: 2016-04-21  

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