Shika Hoshasen
Online ISSN : 2185-6311
Print ISSN : 0389-9705
ISSN-L : 0389-9705
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  • Evaluation of Dose Constraint for Contralateral Neck in Unilateral Neck Volumetric-modulated Arc Therapy
    Takaharu Kudoh, Youji Miyamoto
    2024 Volume 63 Issue 2 Pages 47-53
    Published: 2024
    Released on J-STAGE: April 02, 2024
    DOIhttps://doi.org/10.11242/dentalradiology.63.47
    JOURNAL FREE ACCESS
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    This study aimed to estimate the prevalence and rate of contralateral neck metastasis following unilateral neck volumetric-modulated arc therapy （VMAT）, and to determine the relevant dose constraints for at-risk organs in head and neck cancer patients undergoing unilateral neck VMAT. We enrolled 33 patients with head and neck cancer who underwent unilateral neck VMAT between 2015 and 2021. The prescribed dose to the high-risk planning target volume （PTV） was 60 to 70Gy, and the dose to the low-risk PTV was 50Gy2 （biological equivalent dose of 2Gy） with simultaneous integrated boost. Four patients had contralateral neck metastasis; however, these patients were salvaged. We evaluated the dose to the at-risk organs at virtual contralateral neck VMAT treatment planning, which allowed the effective dosage of PTV in all 33 patients. The average maximum doses to the spinal cord and brain stem were 12.8Gy and 11.1Gy, respectively. The average mean dose to the ipsilateral parotid gland of previously treated unilateral neck VMAT plan was 5.0Gy. The relevant dose constraints to the spinal cord, brain stem, and ipsilateral parotid gland of the unilateral neck VMAT plan were 32.2Gy, 42.9Gy, and 21.0Gy, respectively, in our department.
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  • Three Cases of Desmoplastic Ameloblastoma
    Migiwa Kuroda, Tomomi Hanazawa, Yukiko Matsuda
    2024 Volume 63 Issue 2 Pages 54-62
    Published: 2024
    Released on J-STAGE: April 02, 2024
    DOIhttps://doi.org/10.11242/dentalradiology.63.54
    JOURNAL FREE ACCESS
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    Desmoplastic ameloblastoma （DA） is a rare pathological variant of ameloblastoma that presents characteristic radiographic findings. Herein, we report three DA cases: one occurred in the anterior portion of the maxilla, and two in the anterior portion of the mandible.
    ［Case 1］ The patient was a 61-year-old man who presented to the hospital with a primary complaint of swelling in the right incisor region of the maxilla. Panoramic radiography revealed a mixed radiolucent/radiopaque area with a partly ill-defined border. Computed tomography （CT） revealed expansion of the labial cortical bone. Root resorption was not observed. On magnetic resonance imaging, the lesion exhibited intermediate- to low-signal intensity on T1-weighted imaging, and heterogeneous high- to low-signal intensity on T2-weighted imaging.
    ［Case 2］ The patient was a 49-year-old woman who presented to the hospital with a primary complaint of swelling in the right premolar region of the mandible. Panoramic radiography revealed a mixed radiolucent/radiopaque area with a partly ill-defined border and root displacement of the first and second premolars without root resorption. CT revealed a small high-density structure in the lesion.
    ［Case 3］ The patient was a 51-year-old woman who presented to the hospital with a primary complaint of swelling in the left incisor region of the mandible. Panoramic radiography revealed a honeycomb-like radiolucent area and slight root displacement of the canine and first premolar. CT revealed a small high-density structure in the lesion.
    Biopsies were performed in all patients, and they were diagnosed with DA. Herein, we report their imaging findings and review previously reported cases of DA in Japan. DA is reported to have higher recurrence rates compared to typical ameloblastomas; therefore, imaging findings are important for determining treatment strategies.
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  • A Case of Mandibular Buccal Bifurcation Cysts with an External Dental Fistula
    Hitomi Sato, Mika Otonari-Yamamoto, Kei Nakajima, Keisuke Ohno, Hideki ...
    2024 Volume 63 Issue 2 Pages 63-69
    Published: 2024
    Released on J-STAGE: April 02, 2024
    DOIhttps://doi.org/10.11242/dentalradiology.63.63
    JOURNAL FREE ACCESS
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    Mandibular buccal bifurcation cysts （MBBCs） occur at the buccal region of the permanent mandibular first molar in children aged 4 to 14. MBBC belongs to the inflammatory collateral cysts and its frequency is approximately 35％ of inflammatory collateral cysts. Herein, we present a case of MBBCs with an external dental fistula.
    An eight-year-old boy complained of a right buccal mass and visited a nearby hospital. After performing plain CT, contrast-enhanced MRI, and blood testing, he was referred to our hospital for diagnosis and treatment. An induration was observed in the right buccal region with redness and tenderness. Blood testing showed mild inflammation.
    Panoramic radiography showed discreet U-shape radiolucencies with a sclerotic border in the bifurcation area of the bilateral mandibular first molars. CT demonstrated a soft tissue density lesion in the right buccal side of the mandible. The cystic lesion was located on the buccal aspect of the right mandibular first molars. The buccal cortical bone showed expansion and perforation accompanied by periosteal reaction. CT also revealed another cystic lesion at the same location as the right one. Gadolinium-enhanced MRI demonstrated the enhanced periphery of the cystic lesions. One and a half months after taking antibiotics, drainage occurred from the external dental fistula. CT revealed a cylindrical structure from the buccal side of the mandible to the skin. The end of the cylindrical structure flared into a funnel shape in the subcutaneous tissue. We diagnosed the bilateral mandibular cysts and external dental fistula as being related to the right cyst. Bilateral cystectomy and curettage of the fistula were performed. Histopathological findings showed MBBC. CT revealed ossification of the defective parts due to the cystectomy three months after surgery.
    Our findings suggest that CT and MRI are useful for diagnosis and follow-up for MBBCs with external dental fistula.
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