PURPOSE: To investigate the relationship of spinal osteophytes to vertebral bone mineral density (BMD) and to spinal fracture. MATERIALS AND METHODS: This relationship was investigated in 203 men. Integral BMD was measured with dual x-ray absorptiometry, and both cortical and trabecular BMD were measured with quantitative computed tomography (QCT). RESULTS: Trabecular BMD was found to decrease with age in subjects with and without large osteophytes, while cortical and integral BMD decreased with age only in subjects without large osteophytes. Trabecular BMD in men without fracture was significantly higher than in those with fracture (P < .05 for BMD measured with single-energy QCT), while there was no significant difference between these groups in cortical or integral BMD. CONCLUSION: Measurement of trabecular BMD with QCT provides information useful in detection of age-related bone loss and of fracture in men with and without osteophytes.
Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.
Purpose: Intensity modulated radiation therapy (IMRT) is characterized by a relatively long period for beam exposure and consequently the risk for unnecessary exposure to non-targeted organs, mainly due to the scattered radiation, should be considered. The puposes of this study are to measure the absorbed dose of the peripheral organs during helical IMRT using a fluorescent glass dosimeter. Materials and Methods: In this research, we took lung cancer as a model and measured the absorbed dose of the peripheral organs during helical IMRT using a fluorescent glass dosimeter. The planning target volume (PTV) dose of 95% was set to be 5 Gy in the phantom. Results and Discussion: The highest exposure dose was observed for the breasts, which were on the PTV trajectory, with the left and right breasts receiving doses of 227.94 mGy and 371.90 mGy, respectively. The exposure doses of the left and right lenses were 3.13 mGy for the left lens and 3.22 mGy for the right lens. An exponential dose reduction to the distance from PTV was confirmed. Our data suggest that the doses for peripheral organs were acceptable in lung cancer case based on past literature search. However, the use of custom blocks for the eyes should be considered to prevent possible late occurance of cataract.
Our purpose was to investigate the MR features of the lacrimal glands in patients with Sjögren's syndrome. Using MR imaging, we examined 58 lacrimal glands in 29 women with Sjögren's syndrome and 150 lacrimal glands in 75 female control subjects. The patients ranged in age from 21 to 76 years, and the control subjects ranged in age from 0 to 78 years. We analyzed the thicknesses and internal signal intensity patterns of the lacrimal glands and compared the results with lacrimal flow rates using Schirmer's test. On the basis of the profile of normal age-related decreases in lacrimal gland thickness that we obtained from our control subjects, we categorized the lacrimal glands in the patients with Sjögren's syndrome as hypertrophic (7.8 +/- 0.8 mm), normal-sized (4.8 +/- 1.2 mm), or atrophic (2.4 +/- 0.5 mm). The patients had slower lacrimal flow rates than did the control subjects. Atrophic lacrimal glands had slower lacrimal flow rates (1.8 +/- 1.2 mm/5 min) than did normal-sized (5.2 +/- 2.8 mm/5 min) and hypertrophic (4.3 +/- 2.6 mm/5 min) glands. Normal-sized lacrimal glands with homogeneous MR features had faster lacrimal flow rates (7.6 +/- 2.2 mm/5 min) than did normal-sized glands with heterogeneous MR features (4.0 +/- 2.4 mm/5 min). Fat suppression studies showed that fat deposition was accelerated in the lacrimal glands of patients with Sjögren's syndrome. These results suggest that change in size associated with accelerated fat deposition may be the characteristic MR feature of lacrimal glands affected by Sjögren's syndrome. Thus, MR imaging could be a useful tool for assessment of the extent of lacrimal gland involvement in patients with Sjögren's syndrome.
Adult T-cell leukemia-lymphoma (ATLL) is caused by human T-cell lymphotrophic virus I (HTLV-I) infection. Among ATLL cases, 70% of patients present with leukemia and the remaining patients present with lymphoma. Hand osteolysis in the patients with ATLL is considered as paraneoplastic syndrome and caused by parathyroid hormone-related peptide (PTHrP) released from tumor cells. Radiographic features are similar to hyperparathyroidism, but the distribution of osteolysis in hands appears to be slightly different with the authors’ experiences. The objective of this study was to identify radiographic characteristics of hand osteolysis associated with ATLL. We included six ATLL patients (5 men and 1 woman; age range, 45-71 years). All the patients presented with acute leukemia, and three were associated with hypercalcemia and pain in various locations including hands. Patterns of osteolysis on hand radiographs were evaluated and recorded independently by three musculoskeletal radiologists. We analyzed the distribution of the bone resorption in the ray distribution of the hand, finger predilection, and the difference between the ulnar and radial sides. The bone resorption was characterized by frequent involvement of the distal and proximal phalanges, predilection of ring fingers and prominent involvement on the ulnar side, compared with frequent involvement of proximal and middle phalanges, index and middle fingers, and on the radial side in the bone resorption of typical hyperparathyroidism. Such distribution may be a characteristic feature of hand osteolysis in patients with ATLL. The present findings are helpful for physicians to differentiate PTHrP-mediated osteolysis in ATLL from parathyroid hormone-mediated hyperparathyroidism.
