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.

Background/Aims: The precise incidence of symptomatic uncomplicated diverticular disease (SUDD) and its effects on the quality of life (QOL) remain unclear, particularly in Asian patients with right-sided SUDD. We assess the prevalence of SUDD and its impact on QOL in a real-world population. Methods: Five institutional cohorts of patients who received outpatient treatment for unexplained abdominal symptoms from January 15, 2020 to March 31, 2022, were included. All patients underwent colonoscopy. SUDD was defined as the presence of recurrent abdominal symptoms, particularly pain in the lower right or left quadrant lasting > 24 hours in patients with diverticulosis at the site of pain. The 36-item short-form health survey was used to assess QOL. Results: Diverticula were identified in 108 of 361 patients. Among these 108 patients, 31% had SUDD, which was right-sided in 39% of cases.Of the 50 patients with right-sided diverticula, 36% had SUDD, as did 15 of 35 patients with left-sided diverticula (43%). Among the 33 patients with SUDD, diverticula were right-sided, left-sided, and bilateral in 39%, 45%, and 15% of patients, respectively. Diarrhea was more frequent in the SUDD group than in the non-SUDD group. Patients with SUDD had significantly lower physical, mental, and role/social component scores than those without SUDD. Conclusions It is important to recognize that patients with SUDD account for as high as 31% of outpatients with unexplained abdominal symptoms; these patients have diarrhea and a low QOL. The presence of right-sided SUDD was characteristic of Asian patients.

Background/Aims: Natural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients. Methods: From October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course. Results: Forty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2 , 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care. Conclusion CIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.

Humans ; Heart Failure/drug therapy* ; Diabetes Mellitus, Type 2/drug therapy* ; Glucose ; Sodium

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

A 66-year-old, postmenopausal woman was referred to our hospital because of abnormal breast cancer screening results. A tumor was found in the upper outer part of the left breast. Biopsy revealed papillotubular carcinoma, ER (Allred score total score [TS] 3 = proportion score [PS] 2 + intensity score [IS] 1), PgR (Allred score TS 3 = PS 2 + IS 1), HER2 (2+), fluorescent in situ hybridization 1.1 (negative), and Ki-67 labeling index 15%. In diagnostic imaging, the tumor size was 35 mm. The diagnosis was T2N0M0 Stage IIA, luminal B-like breast cancer. First, letrozole 2.5 mg/day was administered as preoperative hormone therapy. After 2 months of treatment with letrozole, the tumor size had increased to 44 mm and preoperative hormone therapy was discontinued. She was started on preoperative chemotherapy (4 courses of epirubicin plus cyclophsphamide followed by 4 courses of triweekly docetaxel). The tumor size decreased, becoming undetectable. After these preoperative treatments, nipple-sparing mastectomy, sentinel lymph node biopsy, and breast reconstruction with a primary latissimus dorsi flap were performed. As of 3 years and 6 months after the operation, there has been no recurrence. At first, preoperative hormone therapy is performed for Luminal B-like breast cancer as in this case, if the response is insufficient, preoperative chemotherapy after hormone therapy may be a therapeutic option.