Objective: To evaluate outcomes of palliative surgery for malignant bowel obstruction (MBO) and identify factors associated with postoperative survival. Methods: We retrospectively reviewed 27 patients who underwent palliative surgery for MBO between April 2014 and March 2023. Clinical data including symptom relief, oral intake, discharge status, and overall survival (OS) were analyzed. Results: Median age was 70 years; 23 patients were Stage IV. Primary tumors included colon-rectum (15), stomach (6), pancreas (2), and others (4). Peritoneal dissemination was present in 18 cases. Median preoperative Palliative Prognostic Index (PPI) was 3.0. Postoperative symptom relief was achieved in 96.3%, oral intake in 81.5%, and discharge in 51.9%. Median OS was 118 days. Peritoneal dissemination and oral intake status were significantly associated with OS; sex, age, and PPI were not. Conclusion: Palliative surgery may improve outcomes such as symptom relief, oral intake, discharge to preferred care settings, and survival. These findings support its role in advance care planning and enhancing quality of life in patients with terminal cancer.

Objective: To elucidate the magnetic resonance imaging (MRI) characteristics for distinguishing solitary fibrous tumors (SFTs) from desmoid tumors (DTs). Materials and Methods: A retrospective study of 66 consecutive patients with histopathologically proven SFT (n = 34; 13 males and 21 females; mean age, 52.0 ± 17.1 years) or DT (n = 32; 11 males and 21 females; mean age, 39.0 ± 21.3 years) was conducted. The two groups were quantitatively compared in terms of the size, signal intensity ratio (SIR), and apparent diffusion coefficient value. For qualitative analysis, the tumor location, boundary, shape, internal uniformity, predominant signal intensity, T1-weighted images (T1WI) characteristics (hyperintense area), T2-weighted images (T2WI) characteristics (hypointense area, marked hyperintense area, flow void, band sign, and yin-yang sign), and contrast-enhanced T1WI characteristics (unenhanced area and degree of enhancement) were compared between the two groups. Multiple stepwise logistic regression analyses were conducted to distinguish between the SFT and DT. Results: T1 (P = 0.010) and T2 (P = 0.026) SIRs were higher in SFTs than in DTs. Hyperintense areas on T1WI (P < 0.001), marked hyperintense areas on T2WI (P = 0.025), and flow void (P = 0.025) were more frequently noted in SFTs. On T1WI, the solid component predominantly revealed hyperintensity in SFTs and isointensity in DTs (P < 0.001). Indistinct tumor boundary (P < 0.001), hypointense area on T2WI (P < 0.001), and band sign (P < 0.001) were more frequently observed in DTs. Multiple stepwise logistic regression analysis revealed that the hyperintense area on T1WI (odds ratio favoring SFT, 12.80, P = 0.002) and band sign (odds ratio favoring DT, 0.03; P < 0.001) were independent predictors. Conclusion MRI characteristics can help distinguish SFT from DT. The presence of a hyperintense area relative to the skeletal muscle on T1WI in SFTs and the band sign on T2WI in DTs are important MRI features.

Objective: To elucidate the magnetic resonance imaging (MRI) characteristics for distinguishing solitary fibrous tumors (SFTs) from desmoid tumors (DTs). Materials and Methods: A retrospective study of 66 consecutive patients with histopathologically proven SFT (n = 34; 13 males and 21 females; mean age, 52.0 ± 17.1 years) or DT (n = 32; 11 males and 21 females; mean age, 39.0 ± 21.3 years) was conducted. The two groups were quantitatively compared in terms of the size, signal intensity ratio (SIR), and apparent diffusion coefficient value. For qualitative analysis, the tumor location, boundary, shape, internal uniformity, predominant signal intensity, T1-weighted images (T1WI) characteristics (hyperintense area), T2-weighted images (T2WI) characteristics (hypointense area, marked hyperintense area, flow void, band sign, and yin-yang sign), and contrast-enhanced T1WI characteristics (unenhanced area and degree of enhancement) were compared between the two groups. Multiple stepwise logistic regression analyses were conducted to distinguish between the SFT and DT. Results: T1 (P = 0.010) and T2 (P = 0.026) SIRs were higher in SFTs than in DTs. Hyperintense areas on T1WI (P < 0.001), marked hyperintense areas on T2WI (P = 0.025), and flow void (P = 0.025) were more frequently noted in SFTs. On T1WI, the solid component predominantly revealed hyperintensity in SFTs and isointensity in DTs (P < 0.001). Indistinct tumor boundary (P < 0.001), hypointense area on T2WI (P < 0.001), and band sign (P < 0.001) were more frequently observed in DTs. Multiple stepwise logistic regression analysis revealed that the hyperintense area on T1WI (odds ratio favoring SFT, 12.80, P = 0.002) and band sign (odds ratio favoring DT, 0.03; P < 0.001) were independent predictors. Conclusion MRI characteristics can help distinguish SFT from DT. The presence of a hyperintense area relative to the skeletal muscle on T1WI in SFTs and the band sign on T2WI in DTs are important MRI features.

Objective: To elucidate the magnetic resonance imaging (MRI) characteristics for distinguishing solitary fibrous tumors (SFTs) from desmoid tumors (DTs). Materials and Methods: A retrospective study of 66 consecutive patients with histopathologically proven SFT (n = 34; 13 males and 21 females; mean age, 52.0 ± 17.1 years) or DT (n = 32; 11 males and 21 females; mean age, 39.0 ± 21.3 years) was conducted. The two groups were quantitatively compared in terms of the size, signal intensity ratio (SIR), and apparent diffusion coefficient value. For qualitative analysis, the tumor location, boundary, shape, internal uniformity, predominant signal intensity, T1-weighted images (T1WI) characteristics (hyperintense area), T2-weighted images (T2WI) characteristics (hypointense area, marked hyperintense area, flow void, band sign, and yin-yang sign), and contrast-enhanced T1WI characteristics (unenhanced area and degree of enhancement) were compared between the two groups. Multiple stepwise logistic regression analyses were conducted to distinguish between the SFT and DT. Results: T1 (P = 0.010) and T2 (P = 0.026) SIRs were higher in SFTs than in DTs. Hyperintense areas on T1WI (P < 0.001), marked hyperintense areas on T2WI (P = 0.025), and flow void (P = 0.025) were more frequently noted in SFTs. On T1WI, the solid component predominantly revealed hyperintensity in SFTs and isointensity in DTs (P < 0.001). Indistinct tumor boundary (P < 0.001), hypointense area on T2WI (P < 0.001), and band sign (P < 0.001) were more frequently observed in DTs. Multiple stepwise logistic regression analysis revealed that the hyperintense area on T1WI (odds ratio favoring SFT, 12.80, P = 0.002) and band sign (odds ratio favoring DT, 0.03; P < 0.001) were independent predictors. Conclusion MRI characteristics can help distinguish SFT from DT. The presence of a hyperintense area relative to the skeletal muscle on T1WI in SFTs and the band sign on T2WI in DTs are important MRI features.

Objective: To elucidate the magnetic resonance imaging (MRI) characteristics for distinguishing solitary fibrous tumors (SFTs) from desmoid tumors (DTs). Materials and Methods: A retrospective study of 66 consecutive patients with histopathologically proven SFT (n = 34; 13 males and 21 females; mean age, 52.0 ± 17.1 years) or DT (n = 32; 11 males and 21 females; mean age, 39.0 ± 21.3 years) was conducted. The two groups were quantitatively compared in terms of the size, signal intensity ratio (SIR), and apparent diffusion coefficient value. For qualitative analysis, the tumor location, boundary, shape, internal uniformity, predominant signal intensity, T1-weighted images (T1WI) characteristics (hyperintense area), T2-weighted images (T2WI) characteristics (hypointense area, marked hyperintense area, flow void, band sign, and yin-yang sign), and contrast-enhanced T1WI characteristics (unenhanced area and degree of enhancement) were compared between the two groups. Multiple stepwise logistic regression analyses were conducted to distinguish between the SFT and DT. Results: T1 (P = 0.010) and T2 (P = 0.026) SIRs were higher in SFTs than in DTs. Hyperintense areas on T1WI (P < 0.001), marked hyperintense areas on T2WI (P = 0.025), and flow void (P = 0.025) were more frequently noted in SFTs. On T1WI, the solid component predominantly revealed hyperintensity in SFTs and isointensity in DTs (P < 0.001). Indistinct tumor boundary (P < 0.001), hypointense area on T2WI (P < 0.001), and band sign (P < 0.001) were more frequently observed in DTs. Multiple stepwise logistic regression analysis revealed that the hyperintense area on T1WI (odds ratio favoring SFT, 12.80, P = 0.002) and band sign (odds ratio favoring DT, 0.03; P < 0.001) were independent predictors. Conclusion MRI characteristics can help distinguish SFT from DT. The presence of a hyperintense area relative to the skeletal muscle on T1WI in SFTs and the band sign on T2WI in DTs are important MRI features.

Objective: To elucidate the magnetic resonance imaging (MRI) characteristics for distinguishing solitary fibrous tumors (SFTs) from desmoid tumors (DTs). Materials and Methods: A retrospective study of 66 consecutive patients with histopathologically proven SFT (n = 34; 13 males and 21 females; mean age, 52.0 ± 17.1 years) or DT (n = 32; 11 males and 21 females; mean age, 39.0 ± 21.3 years) was conducted. The two groups were quantitatively compared in terms of the size, signal intensity ratio (SIR), and apparent diffusion coefficient value. For qualitative analysis, the tumor location, boundary, shape, internal uniformity, predominant signal intensity, T1-weighted images (T1WI) characteristics (hyperintense area), T2-weighted images (T2WI) characteristics (hypointense area, marked hyperintense area, flow void, band sign, and yin-yang sign), and contrast-enhanced T1WI characteristics (unenhanced area and degree of enhancement) were compared between the two groups. Multiple stepwise logistic regression analyses were conducted to distinguish between the SFT and DT. Results: T1 (P = 0.010) and T2 (P = 0.026) SIRs were higher in SFTs than in DTs. Hyperintense areas on T1WI (P < 0.001), marked hyperintense areas on T2WI (P = 0.025), and flow void (P = 0.025) were more frequently noted in SFTs. On T1WI, the solid component predominantly revealed hyperintensity in SFTs and isointensity in DTs (P < 0.001). Indistinct tumor boundary (P < 0.001), hypointense area on T2WI (P < 0.001), and band sign (P < 0.001) were more frequently observed in DTs. Multiple stepwise logistic regression analysis revealed that the hyperintense area on T1WI (odds ratio favoring SFT, 12.80, P = 0.002) and band sign (odds ratio favoring DT, 0.03; P < 0.001) were independent predictors. Conclusion MRI characteristics can help distinguish SFT from DT. The presence of a hyperintense area relative to the skeletal muscle on T1WI in SFTs and the band sign on T2WI in DTs are important MRI features.

Objective: To assess the noncontrast two-dimensional single-shot balanced turbo-field-echo magnetic resonance angiography (b-TFE MRA) features of the abdominal aortic aneurysm (AAA) status following endovascular aneurysm repair (EVAR) and evaluate to detect endoleaks (ELs). Materials and Methods: We examined four aortic stent-grafts in a phantom study to assess the degree of metallic artifacts. We enrolled 46 EVAR-treated patients with AAA and/or common iliac artery aneurysm who underwent both computed tomography angiography (CTA) and b-TFE MRA after EVAR. Vascular measurements on CTA and b-TFE MRA were compared, and signal intensity ratios (SIRs) of the aneurysmal sac were correlated with the size changes in the AAA after EVAR (AAA prognoses). Furthermore, we examined six feasible b-TFE MRA features for the assessment of ELs. Results: There were robust intermodality (r = 0.92–0.99) correlations and interobserver (intraclass correlation coefficient = 0.97–0.99) agreement. No significant differences were noted between SIRs and aneurysm prognoses. Moreover, “mottled high-intensity” and “creeping high-intensity with the low-band rim” were recognized as significant imaging findings suspicious for the presence of ELs (p < 0.001), whereas “no signal black spot” and “layered high-intensity area” were determined as significant for the absence of ELs (p < 0.03). Based on the two positive features, sensitivity, specificity, and accuracy for the detection of ELs were 77.3%, 91.7%, and 84.8%, respectively. Furthermore, the k values (0.40–0.88) displayed moderate-toalmost perfect agreement. Conclusion Noncontrast MRA could be a promising imaging modality for ascertaining patient follow-up after EVAR.

Purpose: Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in stages II, III, and liver metastasis after curative resection using propensity-matched analysis. Methods: Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed. Results: There were 110 patients with stage II, 100 patients with stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with stage II and 32 pairs with stage III were identified. In the patients with stage II, overall survival (OS) and recurrence-free survival (RFS) were not significantly different for right- and left-sided colon cancers. In the patients with stage III, OS and RFS were significantly worse in right-sided colon cancer. In those with liver metastasis, OS of right-sided colon cancer was significantly worse than left-sided disease, while RFS was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer. Conclusion Sidedness of colon cancer had a significant and varied prognostic impact in patients with stage II, III, and liver metastasis after curative resection.

Objective: To assess the noncontrast two-dimensional single-shot balanced turbo-field-echo magnetic resonance angiography (b-TFE MRA) features of the abdominal aortic aneurysm (AAA) status following endovascular aneurysm repair (EVAR) and evaluate to detect endoleaks (ELs). Materials and Methods: We examined four aortic stent-grafts in a phantom study to assess the degree of metallic artifacts. We enrolled 46 EVAR-treated patients with AAA and/or common iliac artery aneurysm who underwent both computed tomography angiography (CTA) and b-TFE MRA after EVAR. Vascular measurements on CTA and b-TFE MRA were compared, and signal intensity ratios (SIRs) of the aneurysmal sac were correlated with the size changes in the AAA after EVAR (AAA prognoses). Furthermore, we examined six feasible b-TFE MRA features for the assessment of ELs. Results: There were robust intermodality (r = 0.92–0.99) correlations and interobserver (intraclass correlation coefficient = 0.97–0.99) agreement. No significant differences were noted between SIRs and aneurysm prognoses. Moreover, “mottled high-intensity” and “creeping high-intensity with the low-band rim” were recognized as significant imaging findings suspicious for the presence of ELs (p < 0.001), whereas “no signal black spot” and “layered high-intensity area” were determined as significant for the absence of ELs (p < 0.03). Based on the two positive features, sensitivity, specificity, and accuracy for the detection of ELs were 77.3%, 91.7%, and 84.8%, respectively. Furthermore, the k values (0.40–0.88) displayed moderate-toalmost perfect agreement. Conclusion Noncontrast MRA could be a promising imaging modality for ascertaining patient follow-up after EVAR.

OBJECTIVE: This study aimed to evaluate the efficacy of magnetic resonance (MR) imaging in differentiating between cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) in the head and neck region.MATERIALS AND METHODS: Among patients with cutaneous head and neck cancers, 14 with primary cBCCs and 15 with primary cSCCs with a histologic tumor height of ≥ 4 mm underwent MR examinations; the findings were then examined for correlations.RESULTS: cBCCs (71%) occurred more frequently on the nose than cSCCs (13%) (p < 0.01). The maximum diameter (23.5 ± 7.2 mm vs. 12.7 ± 4.5 mm; p < 0.01) and diameter-to-height ratio (2.8 ± 0.9 vs. 1.7 ± 0.4; p < 0.01) were significantly greater in cSCCs than in cBCCs. Superficial ulcer formation (67% vs. 21%; p < 0.05), protrusion into the subcutaneous tissue (60% vs. 21%; p < 0.05), ill-demarcated deep tumor margins (60% vs. 7%; p < 0.01), and peritumoral fat stranding (93% vs. 7%; p < 0.01) were more frequently observed in cSCCs than in cBCCs. Intratumoral T2-hyperintense foci (57% vs. 13%; p < 0.05) were more frequently observed in cBCCs than in cSCCs.CONCLUSION: cBCCs predominantly occurred on the nose with intratumoral T2-hyperintense foci, whereas cSCCs predominantly exhibited a flattened configuration, superficial ulcer formation, protrusion into the subcutaneous tissue, ill-demarcated deep tumor margin, and peritumoral fat stranding.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Nose ; Skin Neoplasms ; Subcutaneous Tissue ; Ulcer