Differentiation of radicular cysts and radicular granulomas via texture analysis of multi-slice computed tomography images

OBJECTIVES

This study aimed to establish a method for differentiating radicular cysts from granulomas via texture analysis (TA) of multi-slice computed tomography (CT) images.

METHODS

A total of 222 lesions with multi-slice computed tomography images acquired at our hospital between 2013 and 2022 that were pathologically diagnosed were included in this study. Cases of contrast-enhanced images, severe metallic artifacts, and lesions that were not sufficiently large to be analyzed were excluded. The images were chronologically divided into a training group and a validation group. The radiological characteristics were determined. Subsequently, a TA was performed. Pyradiomics software was used for the TA of three-dimensionally segmented volumes extracted from 2-mm slice thickness images with a soft-tissue algorithm. Features that differed significantly between the two lesions in the training group were extracted and used to create machine-learning models. The discriminative ability of these models was evaluated in the validation group using receiver operating characteristic curve analysis.

RESULTS

A total of 131 lesions, comprising 28 radicular cysts and 103 granulomas, were analyzed. Forty-three texture features that exhibited significant variations were extracted. A support vector machine and decision tree model, with areas under the curves of 0.829 and 0.803, respectively, were created. These models showed high discriminative abilities, even for the validation group, with areas under the curve of 0.727 and 0.701, respectively. Both models showed superior performance compared with that of the models based on radiographic findings.

CONCLUSION

Discriminatory models were established for the TA of radicular cysts and granulomas using CT images.

Potential of preoperative fluorodeoxyglucose-positron emission tomography/computed tomography to diagnose contralateral lymph node metastases in patients with oral cancer

OBJECTIVE

To establish a decision tree using preoperative PET/computed tomography (CT) parameters for detecting contralateral lymph node metastasis (CLNM) in oral cancer patients.

METHODS

In total, 140 patients with a confirmed histopathological diagnosis of oral carcinoma showed fluorodeoxyglucose accumulation of contralateral lymph nodes in PET images. Of 260 lymph nodes, eight were metastatic. We compared metastatic and non-metastatic nodes using Fisher-Freeman-Halton exact and Fisher's exact and Mann-Whitney U tests. The diagnostic performance was analyzed using receiver operating characteristic curves. We established a decision tree using exhaustive chi-squared automatic interaction detection algorithm.

RESULTS

Five PET/CT parameters were significantly different between metastatic and non-metastatic nodes: the longest ( P  = 0.015) and shortest ( P  = 0.023) diameter, and the maximum standardized uptake values (SUVmax) of the contralateral node ( P  = 0.030), primary tumor ( P  < 0.001), and ipsilateral node ( P  < 0.001). The area under the curves of SUVmax of the primary tumor (0.887), ipsilateral node (0.886), and longest diameter (0.752) were the largest and these three parameters were used as predictive criteria in the decision tree. The accuracy of the decision tree was 97.7% with 100% sensitivity and 97.6% specificity.

CONCLUSION

Preoperative PET/CT imaging with a decision tree has the potential to diagnose CLNM in patients with oral cancer.

Magnetic resonance imaging of methotrexate-related lymphoproliferative disorder with a chief complaint of oral symptoms

OBJECTIVES

To determine the magnetic resonance imaging (MRI) features of methotrexate-related lymphoproliferative disorder (MTX-LPD) in the oral cavity of a patient with a chief complaint of oral symptoms.

METHODS

We included six patients who visited our hospital between November 2014 and November 2019, histopathologically diagnosed with MTX-LPD. All images were examined using 3 T MRI and reviewed by two radiologists.

RESULTS

Masses were detected in five cases; all masses demonstrated signal hypointensity and homogeneous signal hyperintensity on T1- and T2-weighted images with fat suppression. Homogeneous enhancement with fat suppression was evident on post-contrast T1-weighted imaging. We performed dynamic contrast-enhanced MRI in three cases and observed early enhancement with a low washout ratio pattern in all cases. Four patients underwent diffusion-weighted MRI and revealed low mean apparent diffusion coefficient (ADC) of 0.57 (range 0.5-0.65) × 10^-3 mm²/s.

CONCLUSIONS

We reported on the imaging characteristics of six rare cases of MTX-LPD in the oral cavity. Homogeneous hyperintensity on fat-suppressed T2-weighted images and low ADC values are possible features of MTX-LPD. Moreover, MTX-LPD can be differentiated from other carcinomas in the oral cavity.

Primordial odontogenic tumor occurred in the maxilla with unique calcifications and its crucial points for differential diagnosis

Primordial odontogenic tumor (POT) is a newly classified, mixed epithelial and mesenchymal odontogenic tumor, with only 17 reported cases to date. Herein, we report a case of POT that occurred in the right maxilla of a 10-year-old boy and reveal unique features in comparison with those previously reported. Radiologically, the lesion presented as a well-defined, unilocular radiolucency with notable radiopaque foci on the periphery. Microscopically, the tumor was mainly composed of dental papilla-like myxoid fibrous connective tissue, largely surrounded by non-keratinized squamous epithelium with numerous calcified particles, and partly enclosed by inner enamel epithelium-like columnar cells and enamel organ-like structures accompanied with cuboidal and/or stellate reticulum-like cells. Immunohistochemically, the epithelium tested positive for cytokeratin 14 and 19. Moreover, amelogenin and ameloblastin, matrix proteins relating to enamel formation, were positive in the covering epithelium. The tumor was enucleated as a whole, and no recurrence was recorded thereafter. Although the presence of numerous calcified particles was unique, we diagnosed this lesion as POT based on the above-described features. Furthermore, we emphasize the importance of the differential diagnosis of POT and other odontogenic tumors that resemble corresponding tooth germ components.

Effective combination of 3 imaging modalities in differentiating between malignant and benign palatal lesions

OBJECTIVE

The aim of this study was to evaluate whether computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) can effectively differentiate between malignant and benign palatal lesions.

STUDY DESIGN

In total, 59 patients with palatal lesions (32 malignant and 27 benign), who underwent CT, MRI, and/or PET/CT imaging examinations and had histopathological diagnoses, were divided into an analysis group (n = 46) and a validation group (n = 13). Bone changes adjacent to the lesion, MRI signal intensity, apparent diffusion coefficient (ADC), time to peak enhancement (T_peak), and maximum standardized uptake values (SUV_max) were evaluated in the analysis group. Diagnostic performance was individually assessed for each parameter for differentiating between malignant and benign lesions. A diagnostic decision tree was constructed by using useful parameters and its accuracy tested in the validation group.

RESULTS

The frequency distribution of bone change types and T_peak differed significantly between malignant and benign lesions. The ADC of malignant lymphoma was significantly lower than that of other lesions. The other parameters did not distinguish between lesion types. The accuracy of the decision tree, constructed by using bone change types, ADC, and T_peak, was 87.5%.

CONCLUSIONS

Bone change types, ADC values, and T_peak are useful for differentiating between malignant and benign palatal lesions.

Quantitative evaluation of artefact reduction from metallic dental materials in short tau inversion recovery imaging: efficacy of syngo WARP at 3.0 tesla

OBJECTIVES

To evaluate the effects of syngo WARP on reducing metal artefacts from dental materials.

METHODS

Short tau inversion recovery (STIR) with syngo WARP [a dedicated metal artefact reduction sequence in combination with view-angle-tilting (VAT)] was performed using phantoms of three dental alloys: cobalt-chromium (Co-Cr), nickel-chromium (Ni-Cr), and titanium (Ti). Artefact volumes and reduction ratios of black, white and overall artefacts in the standard STIR and syngo WARP images with several different parameter settings were quantified according to standards of the American Society for Testing and Materials F2119-07. In all sequences, the artefact volumes and reduction ratios were compared. The modulation transfer function (MTF) and contrast-to-noise ratio (CNR) were also measured for evaluation of image quality.

RESULTS

In standard STIR, the overall artefact volume of Co-Cr was markedly larger than those of Ni-Cr and Ti. All types of artefacts tended to be reduced with increasing receiver bandwidth (rBW) and VAT. The effect of artefact reduction tended to be more obvious in the axial plane than in the sagittal plane. Compared with standard STIR, syngo WARP with a matrix of 384 × 384, receiver bandwidth of 620 Hz/pixel, and VAT of 100 % in the axial plane obtained reduction effects of 30 % (white artefacts), 45 % (black artefacts), and 38 % (overall artefacts) although MTF and CNR decreased by 30 and 22 % compared with those of standard STIR, respectively.

CONCLUSIONS

syngo WARP for STIR can effectively reduce metal artefacts from dental materials.

Diagnostic abilities of 3T MRI for assessing mandibular invasion of squamous cell carcinoma in the oral cavity: comparison with 64-row multidetector CT

OBJECTIVES

To evaluate the diagnostic accuracies of 3T MRI in evaluating mandibular invasion of squamous cell carcinoma (SCC) in the oral cavity and to compare those with that of multidetector CT (MDCT).

METHODS

41 cases with oral SCC examined by both 3T MRI and MDCT prior to surgery were included in this study. Intravenous contrast medium was administered in all examinations. Images were evaluated for the presence or absence of mandibular invasion and mandibular canal involvement by the tumour. For MRI, both two-dimensional (2D) fast spin echo (FSE) and three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) images were used for the evaluation. For MDCT, dental CT cross-sectional images were rused. The results were correlated with histopathological findings, and sensitivity and specificity of each imaging technique were calculated.DMFR prrof.

RESULTS

Histopathologically, 32 of 41 cases had mandibular invasion and 10 cases had mandibular canal involvement. For mandibular invasion, all three imaging techniques showed sensitivities of 100%. However, the specificities of 2D FSE (56%) and 3D VIBE (78%) were lower than that of MDCT (89%), although the differences were not significant. For mandibular canal involvement, whereas the sensitivities of all three imaging techniques were 100%, the specificities of 2D FSE, 3D VIBE and MDCT were 54, 62 and 85%, respectively. The specificity of 2D FSE was significantlylower than that of MDCT (P < 0.017).

CONCLUSIONS

In the evaluation of mandibular invasion, 3T MRI was not as accurate as MDCT. In particular, 2D FSE sequences showed significantly lower specificity than MDCT in evaluating the extent of mandibular invasion. The use of 3D VIBE sequence slightly improved the low specificity of 2D FSE sequences.

Spatial resolution measurements by Radia diagnostic software with SEDENTEXCT image quality phantom in cone beam CT for dental use

OBJECTIVES

We aimed to employ the Radia diagnostic software with the safety and efficacy of a new emerging dental X-ray modality (SEDENTEXCT) image quality (IQ) phantom in CT, and to evaluate its validity.

METHODS

The SEDENTEXCT IQ phantom and Radia diagnostic software were employed. The phantom was scanned using one medical full-body CT and two dentomaxillofacial cone beam CTs. The obtained images were imported to the Radia software, and the spatial resolution outputs were evaluated. The oversampling method was employed using our original wire phantom as a reference. The resultant modulation transfer function (MTF) curves were compared. The null hypothesis was that MTF curves generated using both methods would be in agreement. One-way analysis of variance tests were applied to the f50 and f10 values from the MTF curves. The f10 values were subjectively confirmed by observing the line pair modules.

RESULTS

The Radia software reported the MTF curves on the xy-plane of the CT scans, but could not return f50 and f10 values on the z-axis. The null hypothesis concerning the reported MTF curves on the xy-plane was rejected. There were significant differences between the results of the Radia software and our reference method, except for f10 values in CS9300. These findings were consistent with our line pair observations.

CONCLUSIONS

We evaluated the validity of the Radia software with the SEDENTEXCT IQ phantom. The data provided were semi-automatic, albeit with problems and statistically different from our reference. We hope the manufacturer will overcome these limitations.

Imaging findings of childhood B-cell lymphoblastic lymphoma in the mental region: a case report

Lymphoblastic lymphoma (LBL) is an uncommon neoplasm that accounts for about 5% of all non-Hodgkin's lymphomas. Approximately 90% of LBLs are of immature T-cell lineage, with B-cell lymphoblastic lymphoma (B-LBL) accounting for only about 10%. Owing to infrequency, the clinicopathological features and the imaging findings of B-LBL are not well defined. LBLs frequently affect extranodal sites. The most common site is the skin, followed by the bone, and the head and neck region is rarely involved. We report herein a case of childhood B-LBL occurring in the mental region, with emphasis on the findings of several imaging studies, including contrast-enhanced CT, MRI and fluorodeoxyglucose-positron emission tomography/CT.

Resolution characteristics of optical coherence tomography for dental use

OBJECTIVES

The purpose of this study was to clarify the resolution characteristics of optical coherence tomography (OCT) for dental use.

METHODS

Two types of swept-source optical coherence tomography machines were employed in this study. To clarify their resolution characteristics, we newly developed a glass chart device with a ladder pattern of wavelengths, which ranged from 4 × 2 μm to 1024 × 2 μm, as well as a star-target pattern, a grid pattern and a spatial frequency response pattern. The resolving powers and characteristics of the OCTs were subjectively evaluated.

RESULTS

The Santec OCT-2000^™ (Santec Co., Komaki, Japan) had a resolving power of 64 μm in both the horizontal X and vertical Y directions, while the OCT from Yoshida had a resolving power of 64 μm in the horizontal X direction and 128 µm in the vertical Y direction. The resolving power of the depth Z direction could not be obtained from this study. With the Yoshida OCT, the star-target pattern seemed to be non-symmetrical, owing to an edge enhancement effect, which was revealed when the ladder patterns were placed in a horizontal direction.

CONCLUSIONS

This study successfully clarified the resolution characteristics of two types of OCTs. The obtained data may be useful for diagnostic purposes, and the glass chart device used in this study may be useful for OCT quality assurance programmes.

Differentiating benign and malignant salivary gland tumours: diagnostic criteria and the accuracy of dynamic contrast-enhanced MRI with high temporal resolution

OBJECTIVE

To determine the optimal diagnostic criterion of dynamic contrast-enhanced MRI (DCE-MRI) for predicting salivary gland malignancy using a dynamic sequence with high temporal resolution, as well as the accuracy of this technique.

METHODS

The DCE-MRI findings of 98 salivary gland tumours (74 benign and 24 malignant) were reviewed. MR images were sequentially obtained at 5-s intervals for 370 s. Two parameters, peak time and washout ratio (WR) were determined from the time-signal intensity curve. The optimal thresholds of these parameters for differentiating benign and malignant tumours were determined, along with the diagnostic accuracy of the criterion using these thresholds.

RESULTS

A peak time of 150 s and a WR of 30% were identified as optimal thresholds. As the criterion for malignancy, the combination of peak time <150 s and WR <30% provided a sensitivity of 79% (19/24), specificity of 95% (70/74) and an overall accuracy of 91% (89/98). Three of the five false-negative cases were malignant lymphomas of the parotid gland.

CONCLUSION

Peak time <150 s with WR <30% comprised the optimal diagnostic criterion in predicting salivary gland malignancy, providing a sensitivity of 79% and specificity of 95%. The use of high temporal resolution might improve the accuracy of DCE-MRI.

ADVANCES IN KNOWLEDGE

Although several studies have reported the usefulness of DCE-MRI in the differential diagnosis of salivary gland tumours, the specific diagnostic criteria employed have differed widely. We determined the optimal criterion and its accuracy using a dynamic sequence with high temporal resolution.

Imaging findings of benign peripheral nerve sheath tumor in jaw

OBJECTIVE

The aim of this study was to investigate the imaging characteristics of peripheral nerve sheath tumors (PNSTs) in the jaw.

STUDY DESIGN

Imaging studies of 6 patients were retrospectively reviewed. Conventional radiography, computed tomography, and magnetic resonance imaging were performed in all patients.

RESULTS

A fusiform lesion continuous with the nerve was observed in 2 cases, with the tumor arising within the inferior alveolar canal. In the other 4 cases, with the tumor arising outside the canal, the tumor had protruded and eroded into the bone. Protrusion was also present in 1 of the 2 cases, with the tumor arising within the canal. A target or fascicular sign was observed each in 1 case.

CONCLUSIONS

A fusiform lesion continuous with the nerve and a target or fascicular sign was only present in a few cases. The PNSTs, however, showed a tendency to protrude into the bone.

A clinicoradiological study of odontogenic carcinomas and their impact on clinical diagnosis

OBJECTIVES

To investigate the clinical and radiological characteristics of odontogenic carcinomas (OCs) and evaluate their impact on early clinical diagnosis.

METHODS

The clinical and radiological features of all patients with OCs in our pathology record from January 1988 to December 2009 were retrospectively reviewed. The impact on a tentative diagnosis before final histological examination of clinical, panoramic and CT features was investigated.

RESULTS

Of 474 cases with malignant jaw tumours, 417 (88%) were gingival squamous cell carcinomas (SCCs) and 27 (6%) were OCs. The average age of the patients with OCs was significantly lower than that of those with gingival SCCs. 20 OCs were in the mandible and 7 were in the maxilla. 22 OC patients (81%) had pain and/or swelling as an initial symptom of the disease. Although the majority of OCs showed irregularly contoured radiolucency, one-third of the cases showed cyst-like radiolucency totally or partially surrounded by a sclerotic rim on panoramic radiography. Permeative or gross cortical bone destruction and mass extension outside the jaw bone were found on CT and a diagnosis of malignant tumour was more common. Mass extension outside the cortex had a significant influence on malignant diagnosis. However, 22% of the patients were still clinically diagnosed as having osteomyelitis after CT.

CONCLUSIONS

Although CT was useful to obtain a diagnosis of malignant tumour in OC patients, 22% of patients were clinically diagnosed as having osteomyelitis even after CT. When an osteomyelitis case is resistant to conventional therapy and gross bone destruction and/or mass extension is found on CT, a histopathological examination should be done.

USPIO-enhanced MRI of highly invasive and highly metastasizing transplanted human squamous cell carcinoma: an experimental study

OBJECTIVE

The aim of this study was to investigate the signal intensity characteristics of highly invasive and highly metastasizing transplanted human squamous cell carcinoma using ultra-small super-paramagnetic iron oxide (USPIO)-enhanced MRI and to correlate them with USPIO distribution to tumour components revealed by histological examination.

METHODS

13 nude mice with transplanted human squamous cell carcinoma in the oral cavity were imaged before and 24 hours after intravenous administration of USPIO. The difference in signal intensity between pre-contrast and post-contrast MR images was visually evaluated. For quantitative analysis, signal intensity within a region of interest was measured. Histological findings were correlated with MR findings. The approximate USPIO concentration was evaluated using USPIO phantoms.

RESULTS

Seven tumours had an area showing signal intensity increase on post-contrast T₁ weighted images. Histopathologically, six of those tumours contained a small amount of iron particles in the stroma. The USPIO concentration was presumed low. Two tumours had an area showing signal intensity decrease on post-contrast T₁ and T₂ weighted images. The areas had a large amount of iron particles in the stroma and the USPIO concentration was presumed high. There was a minimal amount of iron particles in tumour parenchymal cells.

CONCLUSIONS

The amount of USPIO accumulation into tumour stroma was considered to affect MR signal intensity. A small amount increases T₁ weighted signal intensity, whereas a large amount decreases T₁ and T₂ weighted intensity. The USPIO accumulation into the tumour parenchyma was not thought to affect MR signal intensity.

Bifid mandibular canal: confirmation of limited cone beam CT findings by gross anatomical and histological investigations

OBJECTIVES

The aims of this study were (1) to assess the validity of limited cone beam CT (CBCT) in detecting the distribution of bifid mandibular canals in the retromolar region by comparing its findings with those of panoramic radiography and spiral CT imaging, and (2) to confirm the contents of such canals depicted on limited CBCT images by using gross anatomical and histological methods.

METHODS

Bilateral bifid mandibular canals of a Japanese cadaver were investigated. The canals depicted on panoramic radiography, spiral CT and limited CBCT images were compared. Cross-sectional limited CBCT images of these canals were compared with gross anatomical sections of the mandible and their contents were confirmed histologically.

RESULTS

The spiral CT and limited CBCT images showed the bilateral bifid mandibular canals in the retromolar region whereas the panoramic radiographs indicated the presence of only the left bifid mandibular canal. The canal distribution was more distinct in the limited CBCT images than in the spiral CT images and the cross-sectional limited CBCT images were consistent with the gross anatomical sections. Histologically, the canals contained several nerve bundles and arteries among which the largest nerve and artery were of a similar size.

CONCLUSION

Limited CBCT is valuable for assessing the distribution of bifid mandibular canals. It is clinically significant to accurately localize a bifid mandibular canal of the retromolar region because it contains a nerve bundle and artery.

Usefulness of cone beam computed tomography in temporomandibular joints with soft tissue pathology

OBJECTIVE

the aim of the study was to evaluate the usefulness of cone beam CT (CBCT) in temporomandibular joints (TMJs) with soft tissue pathology.

METHODS

106 TMJs of 55 patients with temporomandibular disorder (TMD) were examined by MRI and CBCT. MR images were used for the evaluation of disc displacement, disc deformity, joint effusion and obscurity of temporal posterior attachment (TPA). CBCT images were evaluated for the presence or absence of osseous abnormalities. The chi(2) test was used to analyse the association between MRI and CBCT findings.

RESULTS

MRI of 106 TMJs revealed disc displacement, disc deformity, joint effusion and obscurity of the TPA in 68, 73, 28 and 27 joints, respectively. Of the 68 TMJs with disc displacement, anterior disc displacement without reduction (ADDWR) was seen most frequently (47/68). CBCT imaging found 65 TMJs were characterized by the presence of osseous abnormalities and were significantly associated with disc deformity and ADDWR (P < 0.05). There was no statistically significant association between the presence of joint effusion and obscurity of TPA and TMJ osseous abnormalities.

CONCLUSIONS

TMD patients with confirmed ADDWR or disc deformity on MRI are at risk of having osseous abnormalities in the TMJ and further examination with CBCT is recommended.

Bifid mandibular canals: cone beam computed tomography evaluation

OBJECTIVES

For surgical procedures involving the posterior mandible, it is important to be familiar with the details of the bifid mandibular canal. To our knowledge, there have been no systematic studies evaluating the bifid mandibular canal using sectional imaging. The purpose of this study is to evaluate the incidence and configuration of the bifid mandibular canal using cone beam CT.

METHODS

252 patients (301 mandible sides) underwent cone beam CT between October 2004 and September 2005 and were included in this study. The cone beam CT images were evaluated for the presence and configuration of the bifid mandibular canal. The patterns of bifurcation were classified into four types according to the classification of Nortjé et al (Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg 1977; 15: 55-63). The diameter of the accessory canal was classified into two categories: 50% or more and less than 50% of the diameter of the main mandibular canal.

RESULTS

Of the 301 subjects, 47 (15.6%) demonstrated a bifid mandibular canal. They were Type I in 2, Type II in 40, Type III in 0, and Type IV in 5 cases. The diameter of the accessory canal was greater than or equal to 50% of the main canal in 23, and less than 50% in 24 cases.

CONCLUSIONS

On the basis of the cone beam CT, a bifid mandibular canal was found in 15.6% of cases, a markedly higher proportion than found in previous reports using panoramic images. Cone beam CT is considered a suitable modality for detailed evaluation of bifid mandibular canals.

Differentiation between superficial and deep lobe parotid tumors by magnetic resonance imaging: usefulness of the parotid duct criterion

BACKGROUND

The location of a parotid tumor affects the choice of surgery, and there is a risk of damaging the facial nerve during surgery. Thus, differentiation between superficial and deep lobe parotid tumors is important for appropriate surgical planning.

PURPOSE

To evaluate the usefulness of using the parotid duct, in addition to the retromandibular vein, for differentiating between superficial and deep lobe parotid tumors on MR images.

MATERIAL AND METHODS

Magnetic resonance images of 42 parotid tumors in 40 patients were reviewed to determine whether the tumor was located in the superficial or deep lobe. In each case, the retromandibular vein and the parotid duct were used to locate the tumor. The parotid duct was only used in cases where the tumor and the duct were visualized on the same image.

RESULTS

Using the retromandibular vein criterion, 71% of deep lobe and 86% of superficial lobe tumors were correctly diagnosed, providing an accuracy of 81%. However, the accuracy achieved when using the parotid duct criterion was 100%, although it could be applied to only 28 of the 42 cases. Based on these results, we defined the following diagnostic method: the parotid duct criterion is first applied, and for cases in which it cannot be applied, the retromandibular vein criterion is used. The accuracy of this method was 88%, which was better than that achieved using the retromandibular vein criterion alone.

CONCLUSION

The parotid duct criterion is useful for determining the location of parotid tumors. Combining the parotid duct criterion with the retromandibular vein criterion might improve the diagnostic accuracy of parotid tumor location compared to using the latter criterion alone.

MRI findings of temporomandibular joints with disk perforation

OBJECTIVE

To investigate magnetic resonance imaging (MRI) findings of temporomandibular joints (TMJs) with disk perforation.

STUDY DESIGN

Thirty-one TMJs (31 patients) with disk perforation, 37 TMJs (34 patients) with anterior disk displacement and no disk perforation, and 22 asymptomatic TMJs of 11 volunteers were examined by MRI. The presence or absence of disk perforation was confirmed by TMJ arthrography. The MR images were evaluated for the presence or absence of disk deformity, disk displacement, condylar bone changes and joint effusion and for visualization of the temporal posterior attachment (TPA) of the posterior disk attachment. Those findings were compared among the 3 groups.

RESULTS

The incidences of anterior disk displacement and condylar bone changes in the patients group with disk perforation were significantly higher than in asymptomatic volunteers. Disk deformity and obscurity of TPA were significantly more frequent in the patient group with disk perforation than in the other 2 groups.

CONCLUSION

In addition to disk deformity, TPA obscurity was considered to be one of the characteristic MRI findings of TMJs with disk perforation.

Evidence that basal activity, but not transactivation, of the epidermal growth factor receptor tyrosine kinase is required for insulin-like growth factor I-induced activation of extracellular signal-regulated kinase in oral carcinoma cells

IGF-I receptor (IGF-IR) is involved in numerous biological functions via its major downstream signaling molecules, extracellular signal-regulated kinase (ERK) and phosphatidylinositol 3'-kinase/Akt. The IGF-I-induced activation of ERK, but not that of Akt, is reportedly mediated by the transactivation of the epidermal growth factor receptor (EGFR) tyrosine kinase (TK). The mechanism for the EGFR-TK-dependent activation, however, still remains largely unknown. We found that an oral carcinoma cell line overexpressing EGFR, Ca9-22, exhibited IGF-I-induced activation of both Akt and ERK, but that only the latter was significantly decreased by a specific inhibitor of EGFR-TK, tyrphostin AG1478. In this report we provide evidence for the existence in this cell line of a novel mechanism by which IGF-I induces ERK activation in a manner that is dependent on the basal level of EGFR-TK activity, but is independent of receptor transactivation. In addition, we show that c-Raf kinase is likely to be a key regulator of this mechanism. The elucidation of such a unique mechanism involving cross-talk between EGFR and heterologous receptors may shed additional light on the clinical use of EGFR-TK inhibitors in antitumor therapies.

Bioconversion studies in cultured cells of Corydalis species

Structural analysis of the metabolites of dopamine and salsolinol in cultured cells of Corydalis species was carried out using the combination of LC-MS and LC-NMR techniques. Metabolic pathways were clarified without the need to isolate the individual metabolites.