OBJECTIVE: To assess the performance of adaptive statistical iterative reconstruction (ASIR)-applied ultra-low-dose CT (ULDCT) in detecting small lung nodules. MATERIALS AND METHODS: Thirty patients underwent both ULDCT and standard dose CT (SCT). After determining the reference standard nodules, five observers, blinded to the reference standard reading results, independently evaluated SCT and both subsets of ASIR- and filtered back projection (FBP)-driven ULDCT images. Data assessed by observers were compared statistically. RESULTS: Converted effective doses in SCT and ULDCT were 2.81 +/- 0.92 and 0.17 +/- 0.02 mSv, respectively. A total of 114 lung nodules were detected on SCT as a standard reference. There was no statistically significant difference in sensitivity between ASIR-driven ULDCT and SCT for three out of the five observers (p = 0.678, 0.735, < 0.01, 0.038, and < 0.868 for observers 1, 2, 3, 4, and 5, respectively). The sensitivity of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT in three out of the five observers (p < 0.01 for three observers, and p = 0.064 and 0.146 for two observers). In jackknife alternative free-response receiver operating characteristic analysis, the mean values of figure-of-merit (FOM) for FBP, ASIR-driven ULDCT, and SCT were 0.682, 0.772, and 0.821, respectively, and there were no significant differences in FOM values between ASIR-driven ULDCT and SCT (p = 0.11), but the FOM value of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT and SCT (p = 0.01 and 0.00). CONCLUSION: Adaptive statistical iterative reconstruction-driven ULDCT delivering a radiation dose of only 0.17 mSv offers acceptable sensitivity in nodule detection compared with SCT and has better performance than FBP-driven ULDCT.
Adult ; Aged ; Female ; Humans ; Lung/pathology/*radiography ; Lung Neoplasms/*radiography/secondary ; Male ; Middle Aged ; ROC Curve ; Radiation Dosage ; Radiographic Image Enhancement ; Radiographic Image Interpretation, Computer-Assisted ; Rectal Neoplasms/pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Anastomotic stenosis of the colon is not an uncommon finding; however, its frequency varies from one study to another. Traditionally, postoperative colonic stenosis is managed surgically. However, endoscopic therapy has recently become the preferred treatment modality over traditional surgery. Good short-term success has been achieved with use of endoscopic balloon dilation; however, restenosis may occur over time in 14% to 25% of patients. The current report showed the effectiveness and usefulness of an insulated-tip knife (IT-knife) for electrocautery therapy of a patient with symptomatic anastomotic colonic stenosis.
Aged ; Colonoscopy ; Constriction, Pathologic/*therapy ; Electrocoagulation/instrumentation/*methods ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/radiography/*surgery ; Sigmoid Neoplasms/radiography/*surgery ; Tomography, X-Ray Computed

OBJECTIVETo assess the effect of preoperative long course radiotherapy (RT) on anastomotic leakage (AL) after low anterior resection(LAR) for rectal cancer.

METHODSMedline, EMBASE, China National Knowledge Infrastructure,the Cochrane Library databases and other databases were searched for relevant studies. Correlation between preoperative long course RT and AL after LAR for rectal cancer was examined. Review Manager 5.2 software was used to pool raw data and test the heterogeneity of existing studies and to calculate the incorporated odds ratio (OR) and 95% confidence interval (95%CI). Finally, forest plots and funnel plots were created to allow for visual comparison of the results or the effect of publication bias.

RESULTSA total of 881 studies were identified and 10 studies (n=7829) were eligible for the meta-analysis, including 2581 cases of preoperative RT, and 5248 cases of surgery alone without RT. There was no significant difference in anastomotic leakage rate between the two groups (OR:1.17, 95%CI:0.98-1.39, P=0.09).

CONCLUSIONSPreoperative long course RT did not increase the risk of postoperative AL after LAR in patients with rectal cancer.

Anastomotic Leak ; etiology ; Humans ; Postoperative Complications ; etiology ; Preoperative Care ; Radiography ; Rectal Neoplasms ; diagnostic imaging ; surgery

Recently, treatment strategy of rectal cancer has changed dramatically. The application of total mesorectal excision (TME) and preoperative chemoradiation therapy (PCRT) has become standard procedure for locoregional and locally advanced rectal cancer, respectively. For the planning of patient-specific therapy, both functional and morphological radiologic evaluation as well as multidisciplinary approach is essential. In other words, the needs for more accurate T- and N-staging and assessment of circumferential resection margin, both before and after PCRT, are increasing rapidly. Although so far there is no consensus on the role of diagnostic imaging (endorectal ultrasound, CT, MRI) in the evaluation of rectal cancer patient, MRI with diffusion-weighted image is emerging as an essential imaging modality, especially in the assessment of tumor response and depiction of complete remission after PCRT. In this review, we intended to demonstrate the present diagnostic role of various imaging modalities in tumor assessment of locally advanced rectal cancer before and after PCRT, with the introduction of new emerging imaging tool.
Chemoradiotherapy ; Humans ; Magnetic Resonance Imaging ; Neoplasm Staging ; Preoperative Care ; Rectal Neoplasms/*radiography/therapy/ultrasonography ; Tomography, X-Ray Computed

No abstract available.
Diagnosis, Differential ; Endosonography ; Female ; Humans ; Incidental Findings ; *Intestinal Mucosa/pathology/radiography/surgery ; Intestinal Polyps/*diagnosis/pathology/radiography/surgery ; Middle Aged ; Neoplasms, Fibroepithelial/*diagnosis/pathology/radiography/surgery ; Predictive Value of Tests ; Rectal Neoplasms/*diagnosis/pathology/radiography/surgery ; Tomography, X-Ray Computed

Rectal syphilis, known as a great masquerader, can be difficult to diagnose because of its variable symptoms. Gastroenterologists should be aware of the possibility of rectal syphilis when confronted with anorectal ulcers, and should gather a detailed history about sexual preferences and practices, including homosexuality. We report a case of primary rectal syphilis mimicking rectal cancer on radiologic imaging. In this report, we described the clinical, endoscopic, and radiologic features of this rare case.
Humans ; Male ; Middle Aged ; Rectal Diseases/*diagnosis/pathology/radiography ; Rectal Neoplasms/*pathology/radiography ; Syphilis/*diagnosis/pathology/radiography

Multiple primary malignancy was reported firstly by Billroth in 1889. Recently, multiple primary malignancies are considered to increase due to improved survival rate of cancer patients, advanced diagnostic tools, and increased use of chemotherapy and radiotherapy. In Korea, several cases of triple primary malignancies were reported. However, four primary malignancies in gastro-intestinal tract was rarely reported. Recently, we experienced a 70 year-old male who was diagnosed with metachronous four primary malignancies in rectum, ascending colon, stomach, and ampulla of Vater. We report this rare case of metachronous four primary malignancies with a review of literature.
Adenocarcinoma/*diagnosis/pathology/surgery ; Adenocarcinoma, Mucinous/diagnosis/surgery ; Aged ; Ampulla of Vater/*pathology ; Colonic Neoplasms/diagnosis/surgery ; Common Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Gastrointestinal Neoplasms/*diagnosis/pathology/radiography ; Humans ; Male ; Neoplasms, Second Primary/*diagnosis/pathology ; Rectal Neoplasms/diagnosis/surgery ; Stomach Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

Anorectum is a rare location for malignant lymphoma. Involvement of is rare even for the lymphoma associated with acquired immune deficiency syndrome (AIDS), and AIDS has a relatively increased frequency of anorectal lymphoma. Most lymphomas in AIDS patients are of a B-cell origin, and T-cell lymphoma of the gastrointestinal tract is extremely rare. We report here on a case of anorectal and gastric peripheral T-cell lymphoma, unspecified (PTCLu) in a non-AIDS patient. A previously healthy 29-year-old man presented with hematochezia and tenesmus that he had suffered with for the previous 2 months. Sigmoidoscopy showed anal and rectal submucosal tumor. Multiple round-shaped, flat and elevated lesions were noted on the gastric antrum and body as well. He underwent excisional biopsy for the anal mass and the diagnosis was PTCLu. Biopsies of the gastric lesions gave the same diagnosis. There was no lymphoma involved in the bone marrow. At admission, no antibodies against human immunodeficiency virus were detected. He underwent systemic chemotherapy and upfront autologous stem cell transplantation.
Tomography, X-Ray Computed ; Stomach Neoplasms/*pathology/radiography ; Sigmoidoscopy ; Rectal Neoplasms/*pathology/radiography ; Male ; Lymphoma, T-Cell, Peripheral/*pathology/radiography ; Humans ; Gastroscopy ; Follow-Up Studies ; Diagnosis, Differential ; Biopsy ; Adult ; Acquired Immunodeficiency Syndrome/*diagnosis

No abstract availble.
Aged ; Humans ; Liver Neoplasms/radiography/*radionuclide imaging/*secondary ; Male ; Neoplasm Recurrence, Local/*radionuclide imaging ; *Positron-Emission Tomography ; Rectal Neoplasms/pathology/*radionuclide imaging ; Sigmoidoscopes

No abstract availble
Antimetabolites, Antineoplastic/*adverse effects/therapeutic use ; Colon/pathology/radiography ; Colonoscopy ; Enterocolitis, Pseudomembranous/diagnosis/*etiology ; Fluorouracil/*adverse effects/therapeutic use ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/*drug therapy ; Tomography, X-Ray Computed