Diagnostic Radiology Division
Introduction
The Diagnostic Radiology Division is comprised of four groups, divided according to their area of concentration into the gastrointestinal tract group, the parenchymatous organs group, the nuclear medicine group, and the chest group. Over 84600 inpatient and outpatient radiographic procedures were performed in 1999. In our division, the major activities are to make a diagnosis of patients with malignant tumors using several imaging modalities and to develop new imaging techniques to improve the quality of diagnostic images. Our division has now four helical computed tomography (CT) systems, two 1.5T magnetic resonance imaging (MRI) systems, two digital subtraction angiographic (DSA) systems, three gamma-cameras, three digital radiographic (DR) systems for gastrointestinal examinations, and two mammographic systems. One DSA system is equipped with a helical CT and is referred to as an IVR-CT system. All medical images in our new hospital are digitized. Original or compression images of computed radiography (CR), digital radiography (DR), radioisotope (RI), CT, and MRI can be easily and rapidly referenced on the medical information system for research, administ-ration, and clinical expertise (MIRACLE).
Routine Activities
1. Gastrointestinal Tract Group
Two radiologists belong to this group, which carries out upper GI, barium enema, DIP, and mammography tests. Over 2650 gastrointestinal and colorectal examinations using the DR system were performed. Many early-stage malignant tumors have been detected using the double contrast method.
2. Parenchymatous Group
Five radiologists belong to this group, which performs integrated diagnostic imaging using CT, MRI, angiography, and IVR-CT for diagnosing cancer in parenchymatous organs, including the liver, pancreas, kidney, spleen, ovary, uterus, and brain. Over 16100 CT examinations, over 4100 MRI examinations, and over 827 angiographic exami-nations were performed. We are actively involved in performing interventional radiology, especially therapeutic arterial embolization combined with chemotherapy and fluoro-CT guided percutaneous ethanol injection (PEI) for treatment of hepatocellular carcinoma.
3. Nuclear Medicine Group
Two radiologists belong to this group, which conducts over 3400 scintigraphic examinations for malignant tumors annually. Of these examinations, 75% are bone scintigraphies, 15% are Ga-67 scintigraphies, and 1% are Tl-201 scintigraphies for malignant bone and soft tissue tumors. Bone scintigraphies are useful for checking bone metastasis in patients with advanced cancer.
4. Chest Group
One radiologist and two doctors from another division belong to this group, which carried out over 41000 chest radiographic examinations and over 3200 CT examinations in 1999. Helical CT examination is routinely used for the detection of lung tumors and various lung abnormalities in addition to routine chest radiographs. High-resolution CT or thin-slice CT examinations are routinely performed in the diagnosis of small peripheral bronchogenic carcinomas and other subtle abnormalities. In addition, in order to obtain a cytopathological diagnosis, fluoro-guided percu-taneous needle biopsy for various intrathoracic lesions is often performed.
5. Conferences
We have several conferences with other divisions, including preoperative gastric conferences, hepatobiliary conferences, breast conferences, chest conferences, and the like; some of the conferences are held as remote TV conferences.
Research Activities
This division has been developing medical imaging instruments with the support of the new Ten-year Strategy for Cancer Control. A computer-aided diagnosis (CAD) system for both breast cancer using Fuji Computed Radiography (FCR) mammograms and lung cancer using a helical CT has been developed. Three-dimensional displays of the brain based on CT and MR imaging data are used in planning neurosurgery. Moreover, the selection of medical treatments for pancreatic cancers based on various medical images, the cost-benefit imaging efficiency with regard to gastric and lung cancer, and the usefulness of fluoro-CT guided PEI and sub-segmental TAE for the treatment of hepatocellular carcinoma have been studied in our division with the support of Grants-in-Aid for Cancer Research from the Ministry of Health and Welfare.
Clinical Trials
1. A charged coupled device (CCR)-DR system is routinely used in gastrointestinal and colorectal barium examinations. Imaging diagnosis using a cathode ray tube (CRT) is available in this section.
2.We confirmed the usefulness of our new CAD system in the detection of breast cancer and lung cancer.
3.We confirmed the usefulness of the division's IVR-CT system not only in the treatment of liver cancer but also in the detection of pancratobiliary tumors.
4.Two sets of MRI systems were updated in our new hospital. We can now perform several new imaging methods, including functional imaging, diffusion imaging, MR-mammography, MR-angiography without contrast medium, and MR-cholangiopancreatography (MRCP). Using these methods, we can obtain new information about tumors and other abnormalities. A functional image is useful for evaluating the relationship between brain tumors and the motor area, which is valuable information when planning surgery. A diffusion image is useful for differentiating liver tumors from cysts.
5. Original or compressed images of CR, DR, RI, CT, and MRI can be easily and rapidly referenced on the MIRACLE. Some chest X-ray and MRI reports are made by using this system.
|
Number
of Patients Who Underwent Angiography and Transarterial Chemoembolization
Therapy (TACT) for Hepatocellular Carcinoma |
||||
|
Year |
No
of pts |
No
of pts with HCC |
Fresh
pts /Recurrent pts |
No
of TACT for HCC (%) |
|
1997 |
387 |
264 |
141/123 |
177 (67.0) |
|
1998 |
399 |
246 |
190/56 |
190 (77.2) |
|
1999 |
356 |
224 |
176/48 |
177 (79.0) |
|
Total |
1142 |
734 |
507/227 |
544 (74.1) |
(N. MORIYAMA)
