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Comparison of X-ray, Endoscopy and Biopsy Examinations for the Diagnosis of Early Gastric Cancer
HIKOO SHIRAKABE, M.D., HISAO HAYAKAWA, M.D., YUJI ITAI, M.D., NORIYUKI TAKEDA, M.D. and TOZO HOSOI, M.D.
Department of Internal Medicine, Juntendo University, School of Medicine Tokyo
Received October 18, 1972; a comparative and retrospective study of X-ray, endoscopy and biopsy examinations was made on 63 lesions in 58 early gastric cancer cases. The initial X-ray examination detected abnormalities in 86% of the lesions, regardless of their diagnosis at that time, and the first endoscopy following the initial X-ray examination detected another 9%. Qualitatively, 32% were diagnosed as malignant as a result of the first X-ray examination, while 59% were diagnosed as malignant as a result of the first endoscopy. In other words, the first endoscopy diagnosed another 27% of lesions as malignant, including the discovery of 9% of lesions overlooked in the first X-ray examination. This is the merit of the first endoscopy. The collective diagnosis of detailed X-ray examination and endoscopy confirmed 85.7% as malignant. There was little difference in the results of the detailed X-ray examination, endoscopy and biopsy, in as much as biopsy was really necessary for only 10% (6/60) of lesions, aside from the 52 lesions diagnosed as malignant before biopsy. The role of biopsy should not be overestimated. X-ray and endoscopic examinations should be performed correctly with due care in order to evaluate the essential merit of biopsy.
Modern imaging of Crohn's disease using bowel ultrasound
Fabrizio Parente, MD *, Salvatore Greco, MD, Mirko Molteni, MD, Andrea Anderloni, MD, Giovanni Maconi, MD, Gabriele Bianchi Porro, MD
Department and Chair of Gastroenterology, L. Sacco University Hospital, Milan, Italy
Technological advancement of ultrasound (US) equipments and understanding of bowel appearances with high resolution US during the last decade has led to consideration of this imaging procedure as an important tool for inflammatory bowel diseases assessment. In particular, Crohn's disease (CD) for its pathologic characteristics (that is, inflammatory infiltration of the entire bowel wall with possible extension to the surrounding mesentery) is the disease entity which has mainly taken advantage from this non-invasive, radiation-free technique. Beside correctly defining anatomic location and extension of CD lesions within the bowel in the majority of cases, US also shows perigut abnormalities and may demonstrate complications such as fistulas and abscesses. With the help of Power Doppler function, some additional information may be obtained about the local activity of the disease which is particularly useful in the presence of strictures. New US technologies (such as those using intravenous bolus contrast agents or oral no absorbable anechoic solutions) may further improve diagnostic capability of US in this context, thus probably revolution the diagnostic approach to this disease in the near future, particularly during follow-up in CD of the small bowel.
· Advanced Instrumentation Technology
Office of Biological and Environmental Research (BER) Advanced Instrumentation Technology (formerly Advanced Biomedical Technology) supports multidisciplinary, multi-institutional projects that address high-risk medical instrumentation technology problems. The research ultimately will lead to the development of medical instruments and techniques that can be transferred to the National Institutes of Health or industry for further development. AIT supports basic engineering research that utilizes the unique resources and expertise at DOE National Laboratories to develop innovative medical technology. Recent research has focused in three areas.
- Artificial Retina — Research to develop an implantable microelectronic retinal device that restores useful vision to people blinded by retinal diseases.
- Awake Animal Imaging Instrumentation — Research will create scanners to image biochemical processes in the body even when the patient is moving.
- Adapting Astronomy to Ophthalomology (completed) — Optics used in astronomy are helping scientists discover new ways to diagnose eye diseases and correct vision.
· Medical Imaging Instrumentation
BER's Medical Imaging Instrumentation program supports research projects to provide accurate and clear images of biochemical activities by developing sensitive detectors and scanning equipment and the advanced data acquisition and image processing methods necessary to support these next-generation detectors.
Nuclear Medicine Instrumentation
Special imaging systems called positron emission tomography (PET) and single-photon emission computed tomography (SPECT) scanners produce 3-dimensional images. In SPECT, a gantry rotates one or more detectors around the body to acquire many image projections. PET scanners usually surround the body with a stationary ring of detectors. PET and SPECT were first conceived by BER scientists in the 1950s.
PET and SPECT are used to study blood flow and metabolic activity in body organs. Images may show nervous system abnormalities, cancers, or other damaged tissue.
Magnetic Resonance Imaging (MRI) Instrumentation
MRI distinguishes harmful tissue (such as tumors or stroke damage) from normal tissue by creating 2- or 3-D images using magnetic fields and non-ionizing radiation. These images can be developed with a variety of orientations and contrasts for better detection of abnormal tissue. Also known as magnetic resonance tomography (MRT) or nuclear magnetic resonance imaging (NMRI).
A Light-Sharing Approach to High Resolution 3-D Gamma-Ray Detection for Positron Emission Tomography
Principal Investigator: Paul Vaska
Institution: Brookhaven National Laboratory
Project Term: 10/01/2006 - 09/30/2007
High-Field Magnetic Resonance Imaging
Principal Investigator: David Schlyer
Institution: Brookhaven National Laboratory
Project Term: 10/01/2004 - 09/30/2007
Molecular Imaging in Neuroscience
Principal Investigator: Gene-Jack Wang
Institution: Brookhaven National Laboratory
Project Term: 10/01/2004 - 09/30/2007