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BackgroundTo evaluate the feasibility of the use and continuation of sentinel lymph node navigation surgery (SNNS) as an alternative to pelvic lymph node dissection (PLND) for patients with preoperatively estimated stage IA endometrial cancer.MethodsThis retrospective study selected the electronic medical records of all patients who had received CT scans and MRI imaging before surgery from April 1, 2009 to March 31, 2021. Sentinel lymph nodes (SLNs) were detected by administrating 99mTc-phytate and/or indocyanine green into the cervix, and the clinical outcomes of the patients who underwent SNNS or PLND were evaluated. Furthermore, in case of nodal recurrence, a new procedure to determine whether the facility should continue with SNNS or not was developed that compares the maximum likelihood hypothesis and an alternative one based on recurrence rates.ResultsAmong 137 patients, SLN biopsies with ultrastaging were performed on 91 patients. The SLN detection rate was 95.6%. Over a 59-month median observation period, no statistically significant differences were shown in overall survival, disease-specific survival and disease-free survival between the SNNS and PLND groups when introducing the propensity score method (p-values: 0.06, 0.153, and 0.625, respectively). Our procedure demonstrated that, in our department without recurrence up to the 65th attempt, it was possible to continue SNNS if a recurrence occurs at the 66th attempt.ConclusionThis study suggests the validity of SNNS as an alternative to PLND. Even in the absence of evidence from randomized controlled trials, we can confirm the validity of continuing SNNS using our procedure.

Objective To compare the visibility of circumscribed masses on digital breast tomosynthesis (DBT) images and 2D mammograms and determine the usefulness of DBT for differentiation between benign and malignant circumscribed masses. Methods Seventy-one (19 malignant and 52 benign) mammographic well-circumscribed masses were included. Visibility of the masses and halo signs on DBT images were retrospectively compared with 2D mammograms. The effects of mammographic breast density on mass visibility were also evaluated. Results For DBT, 83% were superior and 17% were equivalent in visibility of the masses to that of 2D, and superiority of DBT was significantly enhanced in the high breast density group compared with the low breast density group (91% vs 68%, respectively, p = 0.016). Three lesions were only detected on DBT. There was no significant difference in the superiority of DBT for lesion visibility between malignant and benign masses. The halo sign was detected in 58% lesions on DBT and in 4% on 2D ( p < 0.001). Conclusion Circumscribed masses were better visualized on DBT than on 2D mammograms, particularly in high-density breasts. The halo sign often appeared on DBT and gave a clearer mass margin. However, circumscribed masses on DBT are not assured of being benign. Key Points • Circumscribed masses were better visualized on breast tomosynthesis than on 2D mammography. • Tomosynthesis visualized circumscribed masses better than 2D for all breast density categories. • Halo signs often appeared on tomosynthesis and contributed to detect circumscribed margins. • Circumscribed masses on tomosynthesis images are not assured of being benign lesions.

PurposeTo retrospectively assess the accuracy of magnetic resonance imaging (MRI) in predicting dentate line invasion in low rectal cancer.Materials and methodsEighty-one patients with primary rectal cancer were assessed by dynamic contrast-enhanced MRI. The location of the dentate line was assessed on MRI in 27 patients with upper-mid rectal cancer. Two observers independently evaluated the distance between the distal tumor edge and the MRI-defined dentate line in 54 patients with low rectal cancer, and the imaging and histological findings were compared.ResultsThe MRI-defined dentate line was 24.0 ± 3.8 mm above the anal verge in patients with upper-mid rectal cancer. The dentate line invasion status agreed with the histological findings in 49/54 (91%) patients (κ = 0.72 [95% CI 0.50–0.95]) for observer 1, and in 51/54 (94%) patients (κ = 0.83 [0.65–1.00]) for observer 2 in patients with low rectal cancer. Interobserver agreement was good (κ = 0.83 [0.65–1.00]). The MRI-derived distance between the distal tumor edge and the dentate line had significant correlation with the histological distance (r = 0.86 for reader 1 and 0.75 for observer 2).ConclusionMRI demonstrates high accuracy in predicting dentate line invasion in low rectal cancer.

Prediction of the peak discharge of debris flow is one of the most important factors in mitigating debris flow disasters. Currently, empirical methods based on the relationship between the peak discharge and total debris flow volume (magnitude) for many debris flow events are used to estimate peak discharge for planning or designing debris flow countermeasures in Japan. In order to estimate the peak discharge of debris flow with high accuracy, the debris flow monitoring sensors with load cell and pressure sensor (hereafter referred to as a DFLP system), was installed to evaluate various characteristics during floods involving debris flows at Kamikamihorizawa Creek. During the debris flow that occurred on August 29, 2019 at Kamikamihorizawa Creek, seven surges corresponding to debris flow events were monitored by the DFLP system for a 20-minute period. Based on the relationship between the peak discharge and magnitude, the observation data of Kamikamihorizawa Creek, Illgraben and Schipfenbach has been added to previous data from the literature and the relationship has been updated. The peak discharge and magnitude of debris flow on August 29, 2019 at Kamikamihorizawa Creek exhibited distributions similar to past observation data, which shows that the relationship between peak discharge and magnitude follows a similar trend.

In the Otoishi River, a tributary on right side of the Akatani River in the Chikugo River basin, a large amount of sediment and woody debris were deposited on riverbed due to the sediment disaster caused by the heavy rainfall in northern part of Kyushu Region on 5th to 6th July in 2017. As one of countermeasures to control the outflow of sediment and woody debris to the Akatani River, a sand pocket is planned with the sabo dam with large conduit parts and the log broom works. In this study, hydraulic model test and flume test were carried out to obtain knowledges for design of the sand pocket. Iron bars are installed vertically at the upstream front of the large conduit parts for capturing sediment and logs, and those intervals are desirable to be set in consideration of sediment diameter and sediment movement without the dam. Besides, it is necessary to consider capturing function and flow characteristics such as shockwave when the log broom works is planned in setting of layout and dimensions.

The present study proposes a method to estimate sediment runoff by introducing a dam function of the relationship between inflow sediment and sediment runoff through a slit dam. The model can process rainfall runoff, sediment yield and runoff of a mountainous basin, and the model is applied to the upper reaches of the Joganji River basin, which is known for its huge amount of sediment runoff and intense bed variation because of the sediment yield caused by the earthquake in 1858. The performance of the calculations of sediment control of the slit dam is evaluated by the model. The result indicates that sediment deposition is significantly changed by sediment runoff. The proposed method can be expected to evaluate sediment transport with sabo dams on a basin scale.

The re-movement of sediment and woody debris in torrents after huge sediment transport in the past could cause new flood and sediment disasters due to heavy rainfall events. However, it is not clear how re-movement of logs effects on bed variations such as bars and river channel divergence. In present study, hydraulic model tests were carried out referring to the magnitude of floods, that was over the plan size, in Tottabetsu River basin in August in 2016. These tests include different magnitudes of flood, suppling logs from bed/side bank erosion, and existence of sabo facilities. The key results were as follows: The presence of logs by bed/side bank erosions influences on the patterns of flows and sediment transport, because deposition of logs affects formation of bars. Difference of the magnitudes of the floods affects the activeness of the interaction between logs and sediment transport. In additions, the locations and slits of the sabo dam need to consider hydraulic conditions and characteristics of woody debris for appropriate control of sediment and woody debris.

Since 2010, numerous debris flows have occurred on Sakura-jima Island due to rainfall events that occurred after extensive ash deposition associated with volcanic activity. The study area included the Nojiri and Arimura rivers in the southwestern and southeastern parts of Sakura-jima, respectively. Debris flow monitoring systems consisting of loadcell and pressure sensor (DFLP) were installed to evaluate characteristics of moving weight and so on during debris flows. The systems were installed at the Arimura River No. 3 sabo dam in June in 2012 and at the Nojiri River No. 1 sabo dam in 2014. In addition, LVP (Load, Vibration and Pressure) sensors consisting of loadcells and accelerometers for measuring vibration and pressure were installed on the riverbed for debris flow detection. Modified LVP systems were installed at the Nojiri River No. 7 sabo dam in February in 2015, and at the Arimura River No. 3 sabo dam in October in 2016. Interesting characteristics of debris flows were obtained by the DFLP and LVP systems. The findings showed that the sediment concentrations of both the coarse and the suspended and liquid phases could be estimated by the DFLP systems, and several patterns of debris flows were observed by the LVP systems.

Primary hepatic lymphoma (PHL) is a rare form of non-Hodgkin lymphoma primarily affecting the liver. We present a case of an 84-year-old man diagnosed with PHL, incidentally detected during abdominal ultrasonography. The ultrasonography showed a hypoechoic nodule. When examined by CEUS, the nodule showed hyperenhancement in the arterial phase and hypoenhancement in the portal and late phases. Conversely, CECT demonstrated hypoenhancement through all the phases. The patient declined a tumor biopsy and opted for follow-up care. Ten months later, the lobular mass had increased from 15 mm to 65 mm, presenting as hypoechogenic and demonstrating the “vessel-penetrating sign” on color Doppler imaging. CEUS revealed reticulated enhancement, indicating intratumoral vessels. The mass displayed hypoattenuation on plain CT, hypointensity in T1-weighted images, and hyperintensity in T2-weighted images and exhibited significant restriction in diffusion-weighted images. Both CECT and contrast-enhanced MRI exhibited hypoenhancement. The patient underwent a partial hepatic segmentectomy, and the mass was pathologically diagnosed as a diffuse large B-cell lymphoma. Subsequent postoperative radiological examinations revealed no other lesions, confirming the diagnosis of PHL. Our report highlights specific ultrasonographic signs of PHL observed from an early stage and presents a review of the relevant literature.

We report a case of uterine adenomatoid tumor (AT) with regional lymph node involvement in a 49-year-old woman. Magnetic resonance imaging revealed an aggregated cystic mass in the posterior uterine wall with partial protrusion of the tumor outside the uterus, and cystic masses of same characteristics in the bilateral obturator and right common iliac lymph nodes. FDG PET/CT revealed no significant FDG uptake in the uterine and lymph node lesions. Taking possible lymph node metastasis into consideration, hysterectomy and lymph node biopsy were performed and it revealed AT of the uterus and the lymph nodes histopathologically.