研究者紹介システム

村上 卓道
ムラカミ タカミチ
大学院医学研究科 医科学専攻
教授
医学
Last Updated :2022/08/11

研究者情報

所属

  • 【主配置】

    大学院医学研究科 医科学専攻
  • 【配置】

    医学部 医学科, 未来医工学研究開発センター, 医学部附属病院, 医学部附属病院 放射線診断・IVR科, 医学部附属病院 放射線部

学位

  • 医学博士, 大阪大学

授業科目

ジャンル

  • 医療・健康 / 臨床医学
  • 医療・健康 / がん治療

コメントテーマ

  • 放射線診断
  • AI画像診断
  • 肝がん
  • IVR治療

研究活動

研究キーワード

  • 肝腫瘍治療
  • 造影剤
  • MRI
  • CT
  • dynamic CT/MR study
  • 腹部
  • 4D CT and MR imaging
  • Dual energy CT
  • MRガイド下集束超音波治療
  • 肝機能診断
  • 腹部領域のdynamic CT/MR study
  • 放射線科学
  • Radiology

研究分野

  • ライフサイエンス / 放射線科学

委員歴

  • 2013年 - 現在, 日本放射線腫瘍学会, 放射線治療専門医制度委員
  • 2013年 - 現在, 大阪がん予防検診センター, がん予防対策基金研究助成金選考委員
  • 2001年 - 現在, 日本血管造影,インターベンショナルラジオロジー学会, 評議員, 日本血管造影,インターベンショナルラジオロジー学会
  • 2000年 - 現在, 日本医学学放射線学会, 評議員、代議員、画像診断ガイドライン委員、専門医認定委員、造影剤安全性委員、JIRA標準化活動審議委員, 日本医学学放射線学会
  • 1998年 - 現在, 日本核磁気共鳴医学会, 評議員, 日本核磁気共鳴医学会
  • - 現在, Advanced CT・MR研究会, 幹事
  • - 現在, JIRA基準委員, 幹事
  • - 現在, 日本腹部造影エコー・ドプラ診断研究会, 世話人
  • - 現在, 日本肝癌研究会, プログラム委員、取扱規約委員
  • - 現在, 日本臨床腫瘍学会, がん薬物療法専門医制度委員会、専門医審査部会、試験問題検討小委員
  • - 現在, 日本肝臓学会, 肝癌診療ガイドライン改訂委員会、倫理委員会
  • - 現在, 大阪府医療人キャリアセンター, 運営協議会委員
  • - 現在, 大阪地方裁判所, 専門委員

受賞

  • 2018年11月 北米放射線学会(RSNA), CERTIFICATE OF MERIT AWARD, "New and Updated Topics in Targeted Therapies for the Treatment of Advanced and Metastatic Renal Cell Carcinoma: What Radiologists Should Know"

    Yoshiko Ueno, Tsutomu Tamada, Satoru Takahashi, Keitaro Sofue, Utaru Tanaka, Takamichi Murakami

    アメリカ合衆国

    国内外の国際的学術賞

  • 2004年 御園生賞

    日本国

  • 1997年 北米放射線学会(Certificate of Merit of RSNA)

  • 1996年 腹部CT.MR2学会大賞(Maguma Can Load of SBCT)

  • 1996年 北米放射線学会(RSNA): Certificate of Merit賞受賞

  • 1996年 Society of Computed Body Tomography and Magnetic Resonance: Cum Laude賞受賞

  • 1991年 北米放射線学会(Certificate of Merit of RSNA)

  • 1991年 北米放射線学会(Certificate of Merit of RSNA)

  • 1991年 北米放射線学会(RSNA): Certificate of Merit賞受賞

論文

  • Tahara J, Nogami M, Inukai J, Tachibana M, Zeng F, Ueno Y, Murakami T

    2021年11月, Japanese Archive of cases conference of clinical nuclear medicine, 3, 9 - 17

  • Koji Sasaki, Takuya Okada, Masato Yamaguchi, Masashi Tajiri, Mostafa Ahmed, Tomoyuki Gentsu, Eisuke Ueshima, Keitaro Sofue, Koji Sugimoto, Takamichi Murakami

    PURPOSE: The purpose is to investigate the major and minor complications of the pancreas after transcatheter arterial embolization (TAE) using n-butyl-2-cyanoacrylate (NBCA) for bleeding from pancreatic arteries. MATERIALS AND METHODS: Thirty-three patients who underwent TAE using NBCA for acute bleeding from pancreatic arteries and their parent arteries followed by contrast-enhanced computed tomography (CE-CT) were evaluated retrospectively. Complications and risk factors were assessed using Mann-Whitney U test or Fisher's exact test for the univariate analysis. Patients' characteristic, embolized artery, procedure details, and clinical outcomes were examined as possible risk factors. RESULTS: TAE was performed successfully in all patients. Minor pancreatic complications occurred in 10 patients (30%), including acute mild pancreatitis (n = 4) and focal lack of pancreatic parenchymal enhancement on CE-CT without pancreatitis (n = 6). No cases of major pancreatic complications, such as moderate/severe pancreatitis, were reported. Embolized artery was the only significant risk factor. The rate of complications per embolized artery were 15% (three out of 20 patients) in the arteries of the pancreatic head and 54% (seven out of 13 patients) in the arteries of pancreatic body and tail (p = 0.025). CONCLUSION: TAE using NBCA for acute bleeding from pancreatic arteries is efficacious and safe. Mild pancreatic complications were observed more frequently in case of embolization of the pancreatic body and tail region than the pancreatic head.

    2021年10月06日, Japanese journal of radiology, 英語, 国内誌

    研究論文(学術雑誌)

  • Ueno Y, Tamada T, Sofue K, Murakami T

    For assessing a cancer treatment, and for detecting and characterizing cancer, Diffusion-weighted imaging (DWI) is commonly used. The key in DWI's use extracranially has been due to the emergence of of high-gradient amplitude and multichannel coils, parallelimaging, and echo-planar imaging. The benefit has been fewer motion artefacts and high-quality prostate images.Recently, new techniques have been developed to improve the signal-to-noise ratio of DWI with fewer artefacts, allowing an increase in spatial resolution. For apparent diffusion coefficient quantification, non-Gaussian diffusion models have been proposed as additional tools for prostate cancer detection and evaluation of its aggressiveness. More recently, radiomics and machine learning for prostate magnetic resonance imaging have emerged as novel techniques for the non-invasive characterisation of prostate cancer. This review presents recent developments in prostate DWI and discusses its potential use in clinical practice.

    2021年09月19日, The British journal of radiology[Epub ahead of print], 20210653 - 20210653, 英語, 国際誌

    研究論文(学術雑誌)

  • Kazuhiro Kitajima, Takako Kihara, Yusuke Kawanaka, Junko Takahama, Yoshiko Ueno, Takamichi Murakami, Kotaro Yoshida, Fumi Kato, Akiko Takahata, Yoshihiko Fukukura, Jiro Munechika, Yasunari Fujinaga, Takeru Fukunaga, Masahiro Tanabe, Yuichiro Kanie, Ayumu Kido, Tsutomu Tamada, Rika Yoshida, Yuki Kamishima, Koichiro Yamakado

    PURPOSE: This study aimed to examine MRI features and staging of neuroendocrine carcinoma (NEC) of the endometrium and evaluate survival. METHODS: Clinical data, pathological, and preoperative pelvic MRI findings in 22 patients with histologically surgery-proven endometrial NEC were retrospectively reviewed. Tumors were pure NEC (n = 10) or mixed histotype (n = 12), with 13 large and nine small cell type. RESULTS: International Federation of Gynecology and Obstetrics (FIGO) staging was I, II, III, and IV in 6, 2, 12, and 2 patients, respectively. In 13 (76.4%) of 17 patients with pathological deep myometrial invasion, MRI showed abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with loss of normal uterine architecture. All tumors had restricted diffusion (apparent diffusion coefficient map low signal intensity, diffusion weighted imaging high signal intensity). Accuracy of T staging by MRI for all cases was 81.8%, with reference to pathology staging, while patient-based sensitivity, specificity, and accuracy for detecting metastatic pelvic lymph nodes was 60.0%, 100%, and 77.8%, respectively. Two intrapelvic peritoneal dissemination cases were detected by MRI. During follow-up (mean 30.4, range 3.3-138.4 months), 16 patients (72.7%) experienced recurrence and 12 (54.5%) died of disease. Two-year disease-free and overall survival rates for FIGO I, II, III, and IV were 66.7% and 83.3%, 50% and 100%, 10% and 33.3%, and 0% and 0%, respectively. CONCLUSION: Abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with normal uterine architecture loss and obvious restricted diffusion throughout the tumor are suggestive features of endometrial NEC. Pelvic MRI is reliable for intrapelvic staging of affected patients.

    2021年09月01日, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 20 (3), 236 - 244, 英語, 国内誌

    研究論文(学術雑誌)

  • Takamichi Murakami, Keitaro Sofue, Masatoshi Hori

    Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA; Gadoxetic acid; Gadoxetate disodium) is a hepatocyte-specific MR contrast agent. It acts as an extracellular contrast agent in the early phase after intravenous injection, and then is taken up by hepatocytes later. Using this contrast agent, we can evaluate the hemodynamics of the liver and liver tumors, and can therefore improve the detection and characterization of hepatocellular carcinoma (HCC). Gd-EOB-DTPA helps in the more accurate detection of hypervascular HCC than by other agents. In addition, Gd-EOB-DTPA can detect hypovascular HCC, which is an early stage of the multi-stage carcinogenesis, with a low signal in the hepatobiliary phase. In addition to tumor detection and characterization, Gd-EOB-DTPA contrast-enhanced MR imaging can be applied for liver function evaluation and prognoses evaluation. Thus, Gd-EOB-DTPA plays an important role in the diagnosis of HCC. However, we have to employ optimal imaging techniques to improve the diagnostic ability. In this review, we aimed to discuss the characteristics of the contrast media, optimal imaging techniques, diagnosis, and applications.

    2021年08月21日, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 英語, 国内誌

    研究論文(学術雑誌)

  • Masaki Kaibori, Kengo Yoshii, Kosuke Kashiwabara, Takashi Kokudo, Kiyoshi Hasegawa, Namiki Izumi, Takamichi Murakami, Masatoshi Kudo, Shuichiro Shiina, Michiie Sakamoto, Osamu Nakashima, Yutaka Matsuyama, Susumu Eguchi, Tatsuya Yamashita, Tadatoshi Takayama, Norihiro Kokudo, Shoji Kubo

    AIM: We reviewed the data of a nationwide follow-up survey to determine the impact of hepatitis C virus (HCV) infection on the outcomes of hepatectomy for mass-forming (MF) type, and combined mass-forming and periductal infiltrating (MF + PI) type intrahepatic cholangiocarcinoma (ICC). METHODS: In total, 956 patients with ICC who underwent curative hepatic resection were included in this cohort study, and patients were classified according to virus status. Patients were classified according to virus status as follows: HCV-related ICC (n = 138, 14.4%), hepatitis B virus (HBV)-related ICC (n = 43, 4.5%) and non-virus-related ICC (n = 775, 81.1%). To control for variables, we used 1:1 propensity score-matching to compare outcomes after surgery between HCV-related (n = 102) and non-virus-related ICC cases (n = 102). RESULTS: We successfully matched HCV-related and non-virus-related ICC cases with similar liver function and tumor characteristics. Patients with HCV-related ICC had significantly shorter recurrence-free survival (hazard ratio 0.62, 95% confidence interval 0.42-0.92, p = 0.016) and overall survival (hazard ratio: 0.57, 95% confidence interval: 0.37-0.88, p = 0.011) than patients with non-virus-related ICC. Cox proportional hazard analysis showed that HCV-related ICC offered a worse prognosis than non-virus-related ICC. CONCLUSIONS: HCV infection increases the risk of recurrence and worsens overall survival in patients after curative resection for MF and combined MF + PI type ICC.

    2021年08月, Hepatology research : the official journal of the Japan Society of Hepatology, 51 (8), 890 - 901, 英語, 国際誌

    研究論文(学術雑誌)

  • Sasaki K, Okada T, Yamaguchi M, Ahmed M, Gentsu T, Ueshima E, Sofue K, Tanimura K, Yamada H, Sugimoto K, Murakami T

    PURPOSE: To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) for intractable postpartum hemorrhage (PPH) due to genital tract trauma (GTT) after vaginal delivery. METHODS: We evaluated 27 patients who underwent TAE for intractable PPH due to GTT after vaginal delivery at our institution between January 2008 and December 2020. Patients were divided into two groups according to TAE procedure; TAE performed as close as possible to the bleeding point, at least more peripherally than the second branch of the anterior division of the internal iliac artery, was defined as superselective TAE (S-TAE). TAE performed from the proximal segment of the internal iliac artery was defined as proximal TAE (P-TAE). Patient characteristics, pre-procedural contrast-enhanced computed tomography (CE-CT), procedure details, technical/clinical success, and complications were evaluated separately for the S-TAE and P-TAE groups. RESULTS: The combined technical/clinical success rate was 92%. No major procedure-related complications were seen (mean follow-up: 6.12 ± 3.93 days). The combined technical/clinical success rate of S-TAE was 100% and of P-TAE was 67% (p = 0.04). S-TAE was performed more frequently in patients with pre-procedural CE-CT (p = 0.01) and use of permanent embolic materials (p = 0.003). CONCLUSION: S-TAE is safe and effective for intractable PPH due to GTT. Pre-procedural CE-CT may be useful for detecting the culprit artery and be helpful in performing S-TAE.

    2021年07月24日, Emergency radiology[Epub ahead of print], 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Yasuyo Urase, Yoshiko Ueno, Tsutomu Tamada, Keitaro Sofue, Satoru Takahashi, Nobuyuki Hinata, Kenichi Harada, Masato Fujisawa, Takamichi Murakami

    OBJECTIVE: To evaluate the interreader agreement and diagnostic performance of the Prostate Imaging Reporting and Data System (PI-RADS) v. 2.1, in comparison with v. 2. METHODS: Institutional review board approval was obtained for this retrospective study. 77 consecutive patients who underwent a prostate multiparametric magnetic resonance imaging at 3.0 T before radical prostatectomy were included. Four radiologists (two experienced uroradiologists and two inexperienced radiologists) independently scored eight regions [six peripheral zones (PZ) and two transition zones (TZ)] using v. 2.1 and v. 2. Interreader agreement was assessed using κ statistics. To evaluate diagnostic performance for clinically significant prostate cancer (csPC), area under the curve (AUC) was estimated. RESULTS: 228 regions were pathologically diagnosed as positive for csPC. With a cut-off ≥3, the agreement among all readers was better with v. 2.1 than v. 2 in TZ, PZ, or both zones combined (κ-value: TZ, 0.509 vs 0.414; PZ, 0.686 vs 0.568; both zones combined, 0.644 vs 0.531). With a cut-off ≥4, the agreement among all readers was also better with v. 2.1 than v. 2 in the PZ or both zones combined (κ-value: PZ, 0.761 vs 0.701; both zones combined, 0.756 vs 0.709). For all readers, AUC with v. 2.1 was higher than with v. 2 (TZ, 0.826-0.907 vs 0.788-0.856; PZ, 0.857-0.919 vs 0.853-0.902). CONCLUSION: Our study suggests that the PI-RADS v. 2.1 could improve the interreader agreement and might contribute to improved diagnostic performance compared with v. 2. ADVANCES IN KNOWLEDGE: PI-RADS v. 2.1 has a potential to improve interreader variability and diagnostic performance among radiologists with different levels of expertise.

    2021年07月08日, The British journal of radiology, 20201434 - 20201434, 英語, 国際誌

    研究論文(学術雑誌)

  • Mostafa Hamada, Eisuke Ueshima, Takeaki Ishihara, Yutaka Koide, Takuya Okada, Hiroki Horinouchi, Jun Ishida, Hiroshi Mayahara, Koji Sasaki, Tomoyuki Gentsu, Keitaro Sofue, Masato Yamaguchi, Ryohei Sasaki, Koji Sugimoto, Takamichi Murakami

    Background Technological developments have led to an increased usage of external-body radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may be required later in patients treated with RT because of the high recurrence rate and multinodular presentation of HCC. However, despite the risk of liver function impairment, the cumulative liver damage correlated with TACE following a hepatic RT has not been adequately assessed. Purpose To evaluate the feasibility of TACE following RT for HCC. Materials and methods Sixty-seven patients with HCC who underwent TACE after RT were retrospectively evaluated between 2012 and 2018. We assessed increases in Child–Turcotte–Pugh (CTP) by ≥2 points at 1 month, the incidence of major complications, survival duration, and short-term mortality within 6 months after TACE. Furthermore, we evaluated the predictive factors for liver function impairment and short-term mortality. Results Eight patients experienced a CTP increase ≥2 points at 1 month. There were no cases of liver abscesses or bilomas. Nine patients died within 6 months following TACE. The mean liver dose (MLD) was a significant predictor of liver function impairment at 1 month ( p = 0.042). Low liver functional reserve, distant metastasis ( p = 0.037), MLD ( p = 0.046), TACE type ( p = 0.025), and TACE within 3 months following RT ( p = 0.007) were significant predictors of short-term mortality. Conclusions Despite the feasibility of TACE following RT, clinicians should pay attention to impaired pretreatment liver function, following high dose RT, and the short duration between RT and TACE.

    SAGE Publications, 2021年07月, Acta Radiologica Open, 10 (7), 205846012110349 - 205846012110349

    研究論文(学術雑誌)

  • Kazuhiro Kitajima, Hidetoshi Matsuo, Atsushi Kono, Kozo Kuribayashi, Takashi Kijima, Masaki Hashimoto, Seiki Hasegawa, Takamichi Murakami, Koichiro Yamakado

    Impact Journals, LLC, 2021年06月08日, Oncotarget, 12 (12), 1187 - 1196

    研究論文(学術雑誌)

  • Masatoshi Kudo, Yusuke Kawamura, Kiyoshi Hasegawa, Ryosuke Tateishi, Kazuya Kariyama, Shuichiro Shiina, Hidenori Toyoda, Yasuharu Imai, Atsushi Hiraoka, Masafumi Ikeda, Namiki Izumi, Michihisa Moriguchi, Sadahisa Ogasawara, Yasunori Minami, Kazuomi Ueshima, Takamichi Murakami, Shiro Miyayama, Osamu Nakashima, Hirohisa Yano, Michiie Sakamoto, Etsuro Hatano, Mitsuo Shimada, Norihiro Kokudo, Satoshi Mochida, Tetsuo Takehara

    The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other's work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.

    2021年06月, Liver cancer, 10 (3), 181 - 223, 英語, 国際誌

    研究論文(学術雑誌)

  • 工藤正俊, 泉 並木, 久保正二, 國土典宏, 坂元亨宇, 椎名秀一朗, 高山忠利, 建石良介, 中島 収, 村上卓道, 松山 裕, 高橋 新, 宮田裕章, 田村利恵, 上妻智子, 日本肝癌研究会追跡調査委員会

    (一社)日本肝臓学会, 2021年05月, 肝臓, 62 (5), 251 - 299, 日本語

  • Kawaguchi Y, Hasegawa K, Hagiwara Y, Bellis M.D, Famularo S, Panettieri E, Matsuyama Y, Tateishi R, Ichikawa T, Kokudo T, Izumi N, Kubo S, Sakamoto M, Shiina S, Takayama T, Nakashima O, Murakami T, Vauthey J.N, Giuliante F, Carlis L.D, Romano F, Ruzzenente A, Guglielmi A, Kudo M, Kokudo N

    INTRODUCTION: Most studies predicting survival after resection, transarterial chemoembolization (TACE), and ablation analyzed diameter and number of hepatocellular carcinomas (HCCs) as dichotomous variables, resulting in an underestimation of risk variation. We aimed to develop and validate a new prognostic model for patients with HCC using largest diameter and number of HCCs as continuous variables. METHODS: The prognostic model was developed using data from patients undergoing resection, TACE, and ablation in 645 Japanese institutions. The model results were shown after balanced using the inverse probability of treatment-weighted analysis and were externally validated in an international multi-institution cohort. RESULTS: Of 77,268 patients, 43,904 patients, including 15,313 (34.9%) undergoing liver resection, 13,375 (30.5%) undergoing TACE, and 15,216 (34.7%) undergoing ablation, met the inclusion criteria. Our model (http://www.u-tokyo-hbp-transplant-surgery.jp/about/calculation.html) showed that the 5-year overall survival (OS) in patients with HCC undergoing these procedures decreased with progressive incremental increases in diameter and number of HCCs. For patients undergoing resection, the inverse probability of treatment-weighted-adjusted 5-year OS probabilities were 10%-20% higher compared with patients undergoing TACE for 1-6 HCC lesions <10 cm and were also 10%-20% higher compared with patients undergoing ablation when the HCC diameter was 2-3 cm. For patients undergoing resection and TACE, the model performed well in the external cohort. DISCUSSION: Our novel prognostic model performed well in predicting OS after resection and TACE for HCC and demonstrated that resection may have a survival benefit over TACE and ablation based on the diameter and number of HCCs.

    2021年04月21日, The American journal of gastroenterology[Epub ahead of print], 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Kojita Y, Matsuo H, Kanda T, Nishio M, Sofue K, Nogami M, Kono AK, Hori M, Murakami T

    OBJECTIVES: To evaluate a deep learning model for predicting gestational age from fetal brain MRI acquired after the first trimester in comparison to biparietal diameter (BPD). MATERIALS AND METHODS: Our Institutional Review Board approved this retrospective study, and a total of 184 T2-weighted MRI acquisitions from 184 fetuses (mean gestational age: 29.4 weeks) who underwent MRI between January 2014 and June 2019 were included. The reference standard gestational age was based on the last menstruation and ultrasonography measurements in the first trimester. The deep learning model was trained with T2-weighted images from 126 training cases and 29 validation cases. The remaining 29 cases were used as test data, with fetal age estimated by both the model and BPD measurement. The relationship between the estimated gestational age and the reference standard was evaluated with Lin's concordance correlation coefficient (ρc) and a Bland-Altman plot. The ρc was assessed with McBride's definition. RESULTS: The ρc of the model prediction was substantial (ρc = 0.964), but the ρc of the BPD prediction was moderate (ρc = 0.920). Both the model and BPD predictions had greater differences from the reference standard at increasing gestational age. However, the upper limit of the model's prediction (2.45 weeks) was significantly shorter than that of BPD (5.62 weeks). CONCLUSIONS: Deep learning can accurately predict gestational age from fetal brain MR acquired after the first trimester. KEY POINTS: • The prediction of gestational age using ultrasound is accurate in the first trimester but becomes inaccurate as gestational age increases. • Deep learning can accurately predict gestational age from fetal brain MRI acquired in the second and third trimester. • Prediction of gestational age by deep learning may have benefits for prenatal care in pregnancies that are underserved during the first trimester.

    2021年04月14日, European radiology[Epub ahead of print], 31 (6), 3775 - 3782, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Kudo M, Izumi N, Kokudo N, Sakamoto M, Shiina S, Takayama T, Tateishi R, Nakashima O, Murakami T, Matsuyama Y, Takahashi A, Miyata H, Kudo S

    In the 21st Nationwide Follow-up Survey of Primary Liver Cancer in Japan, data from 22,134 new patients and 41,956 previously followed patients were compiled from 546 institutions over a 2-year period from 1 January 2010 to 31 December 2011. Basic statistics compiled for patients newly registered in the 21st survey were cause of death, medical history, clinical diagnosis, imaging diagnosis, treatment-related factors, pathological diagnosis, recurrence status, and autopsy findings. Compared with the previous 20th survey, the population of patients with hepatocellular carcinoma (HCC) was older at the time of clinical diagnosis, had more female patients, had more patients with non-B non-C HCC, had smaller tumor diameter, and was more frequently treated with hepatectomy and with radiofrequency ablation. Cumulative survival rates were calculated for HCC, intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma (combined HCC and intrahepatic cholangiocarcinoma) by treatment type and background characteristics for patients newly registered between 1998 and 2011 whose final outcome was survival or death (excluding unknown). Cumulative survival rates for HCC were calculated by dividing patients by combinations of background factors (number of tumors, tumor diameter, and Child-Pugh grade) and by treatment type (hepatectomy, local ablation therapy, transcatheter arterial chemoembolization, and hepatic arterial infusion chemotherapy). The same values were also calculated according to registration date by dividing patients newly registered between 1978 and 2011 into four time-period groups. The data obtained from this nationwide follow-up survey are expected to contribute to advancing clinical research and treatment of primary liver cancer.

    Wiley, 2021年04月, Hepatology Research, 51 (4), 355 - 405, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Masakatsu Tsurusaki, Keitaro Sofue, Hiromitsu Onishi, Satoshi Goshima, Atsushi Higaki, Hiroyoshi Isoda, Hiroki Haradome, Kazunari Ishii, Takamichi Murakami

    2021年04月, Japanese journal of radiology, 39 (4), 405 - 405, 英語, 国内誌

  • 【肝内胆管癌の診断と治療】肝内胆管癌のスクリーニングと診断指針

    杉本勝俊, 糸井隆夫, 南 康範, 工藤正俊, 藤永康成, 角谷眞澄, 村上卓道

    (有)科学評論社, 2021年04月, 消化器・肝臓内科, 9 (4), 417 - 421, 日本語

  • 【肝内胆管癌の診断と治療】肝内胆管癌の画像診断

    藤永康成, 南 康範, 杉本勝俊, 糸井隆夫, 工藤正俊, 村上卓道, 角谷眞澄

    (有)科学評論社, 2021年04月, 消化器・肝臓内科, 9 (4), 422 - 428, 日本語

  • 祖父江慶太郎, 上嶋英介, 村上卓道, 矢部慎二, 辻田有志, 山口 尊, 上野嘉子, 堀 雅敏

    <文献概要>本特別企画に選出いただいたテーマは,第56回日本医学放射線学会秋季臨床大会で講演した内容である。肝細胞癌診断における造影CTの位置付けとその画像所見の成り立ち,診断能向上における最近の研究についてまとめたものであり,主に放射線科診断専門医資格取得前後の若い先生方を対象とした内容となっている。

    (株)メジカルビュー社, 2021年04月, 臨床画像, 37 (4), 490 - 497, 日本語

  • Nogami M, Zeng F, Inukai J, Watanabe Y, Nishio M, Kanda T, Ueno Y R, Sofue K, Kono A K, Hori M, Ohnishi A, Kubo K, Kurimoto T, Murakami T

    Purpose To retrospectively assess the repeatability of physiological F-18 labeled fluorodeoxyglucose (FDG) uptake in the skin on positron emission tomography/magnetic resonance imaging (PET/MRI) and explore its regional distribution and relationship with sex and age. Methods Out of 562 examinations with normal FDG distribution on whole-body PET/MRI, 74 repeated examinations were evaluated to assess the repeatability and regional distribution of physiological skin uptake. Furthermore, 224 examinations were evaluated to compare differences in the uptake due to sex and age. Skin segmentation on PET was performed as body-surface contouring on an MR-based attenuation correction map using an off-line reconstruction software. Bland–Altman plots were created for the repeatability assessment. Kruskal–Wallis test was performed to compare the maximum standardized uptake value (SUVmax) with regional distribution, age, and sex. Results The limits of agreement for the difference in SUVmean and SUVmax of the skin were less than 30%. The highest SUVmax was observed in the face (3.09±1.04), followed by the scalp (2.07±0.53). The SUVmax in the face of boys aged 0–9 years and 10–20 years (1.33±0.64 and 2.05±1.00, respectively) and girls aged 0–9 years (0.98±0.38) was significantly lower than that of men aged ≥20 years and girls aged ≥10 years (p<0.001). In women, the SUVmax of the face (2.31±0.71) of ≥70-year-olds was significantly lower than that of 30–39-year-olds (3.83±0.82) (p<0.05). Conclusion PET/MRI enabled the quantitative analysis of skin FDG uptake with repeatability. The degree of physiological FDG uptake in the skin was the highest in the face and varied between sexes. Although attention to differences in body habitus between age groups is needed, skin FDG uptake also depended on age.

    Public Library of Science (PLoS), 2021年03月26日, PLOS ONE, 16 (3), e0249304 - e0249304

    [査読有り]

    研究論文(学術雑誌)

  • Yasunori Minami, Tomohiro Minami, Kazuomi Ueshima, Yukinobu Yagyu, Masakatsu Tsurusaki, Takuya Okada, Masatoshi Hori, Masatoshi Kudo, Takamichi Murakami

    Background: We investigate the feasibility of image fusion application for ablative margin assessment in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) and possible causes for a wrong initial evaluation of technical success through a side-by-side comparison. Methods: A total of 467 patients with 1100 HCCs who underwent RFA were reviewed retrospectively. Seventeen patients developed local tumor progressions (LTPs) (median size, 1.0 cm) despite initial judgments of successful ablation referring to contrast-enhanced images obtained in the 24 h after ablation. The ablative margins were reevaluated radiologically by overlaying fused images pre- and post-ablation. Results: The initial categorizations of the 17 LTPs had been grade A (absolutely curative) (n = 5) and grade B (relatively curative) (n = 12); however, the reevaluation altered the response categories to eight grade C (margin-zero ablation) and nine grade D (existence of residual HCC). LTP occurred in eight patients re-graded as C within 4 to 30.3 months (median, 14.3) and in nine patients re-graded as D within 2.4 to 6.7 months (median, 4.2) (p = 0.006). Periablational hyperemia enhancements concealed all nine HCCs reevaluated as grade D. Conclusion: Side-by-side comparisons carry a risk of misleading diagnoses for LTP of HCC. Overlay fused imaging technology can be used to evaluate HCC ablative margin with high accuracy.

    MDPI AG, 2021年03月23日, Cancers, 13 (6), 1460 - 1460

    研究論文(学術雑誌)

  • Isao Numoto, Masakatsu Tsurusaki, Teruyoshi Oda, Yukinobu Yagyu, Kazunari Ishii, Takamichi Murakami

    The authors are sorry to report that the overall survival reported in their recently published paper was incorrect [...].

    2021年03月15日, Cancers, 13 (6), 英語, 国際誌

  • Maruyama K, Okada T, Ueha T, Isohashi K, Ikeda H, Kanai Y, Sasaki K, Gentsu T, Ueshima E, Sofue K, Nogami M, Yamaguchi M, Sugimoto K, Sakai Y, Hatazawa J, Murakami T

    Carbon dioxide (CO2) treatment is reported to have an antitumor effect owing to the improvement in intratumoral hypoxia. Previous studies were based on histological analysis alone. In the present study, the improvement in intratumoral hypoxia by percutaneous CO2 treatment in vivo was determined using 18F-fluoromisonidazole positron emission tomography-computed tomography (18F-FMISO PET-CT) images. Twelve Japanese nude mice underwent implantation of LM8 tumor cells in the dorsal subcutaneous area 2 weeks before percutaneous CO2 treatment and 18F-FMISO PET-CT scans. Immediately after intravenous injection of 18F-FMISO, CO2 and room air were administered transcutaneously in the CO2-treated group (n=6) and a control group (n=6), respectively; each treatment was performed for 10 minutes. PET-CT was performed 2 h after administration of 18F-FMISO. 18F-FMISO tumor uptake was quantitatively evaluated using the maximum standardized uptake value (SUVmax), tumor-to-liver ratio (TLR), tumor-to-muscle ratio (TMR), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Mean ± standard error of the mean (SEM) of the tumor volume was not significantly different between the two groups (CO2-treated group, 1.178±0.450 cm3; control group, 1.368±0.295 cm3; P=0.485). Mean ± SEM of SUVmax, TLR, MTV (cm3) and TLG were significantly lower in the CO2-treated group compared with the control group (0.880±0.095 vs. 1.253±0.071, P=0.015; 1.063±0.147361 vs. 1.455±0.078, P=0.041; 0.353±0.139 vs. 1.569±0.438, P=0.015; 0.182±0.070 vs. 1.028±0.338, P=0.015), respectively. TMR was not significantly different between the two groups (4.520±0.503 vs. 5.504±0.310; P=0.240). In conclusion, 18F-FMISO PET revealed that percutaneous CO2 treatment improved intratumoral hypoxia in vivo. This technique enables assessment of the therapeutic effect in CO2 treatment by imaging, and may contribute to its clinical application.

    2021年03月, Oncology letters, 21 (3), 207 - 207, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Ito J, Nogami M, Morita Y, Sakaguchi K, Komada H, Hirota Y, Sugawara K, Tomori Y, Zeng F, Murakami T, Ogawa W

    AIM: To investigate the relationships between various clinical variables and the metformin-induced accumulation of fluorodeoxyglucose (FDG) in the intestine, with distinction between the intestinal wall and lumen, in individuals with type 2 diabetes who were receiving metformin treatment and underwent 18 F-labelled FDG ([18 F]FDG) positron emission tomography (PET)-MRI. MATERIALS AND METHODS: We evaluated intestinal accumulation of [18 F]FDG with both subjective (a five-point visual scale determined by two experienced radiologists) and objective analyses (measurement of the maximum standardized uptake value [SUVmax ]) in 26 individuals with type 2 diabetes who were receiving metformin and underwent [18 F]FDG PET-MRI. [18 F]FDG accumulation within the intestinal wall was discriminated from that in the lumen on the basis of SUVmax . RESULTS: SUVmax for the large intestine was correlated with blood glucose level (BG) and metformin dose, but not with age, body mass index, HbA1c level or estimated glomerular filtration rate (eGFR). SUVmax for the small intestine was not correlated with any of these variables. Visual scale analysis yielded essentially similar results. Metformin dose and eGFR were correlated with SUVmax for the wall and lumen of the large intestine, whereas BG was correlated with that for the wall. Multivariable analysis identified metformin dose as an explanatory factor for SUVmax in the wall and lumen of the large intestine after adjustment for potential confounders including BG and eGFR. CONCLUSIONS: Metformin dose is an independent determinant of [18 F]FDG accumulation in the wall and lumen of the large intestine in individuals treated with this drug.

    Wiley, 2021年03月, Diabetes Obesity and Metabolism, 23 (3), 692 - 699, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 西岡 瑛子, 上野 嘉子, 村上 卓道

    <Point!>・転移性卵巣腫瘍と原発性卵巣腫瘍はそれぞれ患者の予後や治療方針が異なるため、これらの鑑別は臨床的意義が高く、画像検査は非侵襲的診断法として重要な役割を果たす。しかし転移性卵巣腫瘍はその原発巣によって病理学的特徴が異なり、様々な形態を呈しうる。・原発巣により一定の傾向はあるものの、転移性卵巣腫瘍の画像所見は原発性卵巣腫瘍とオーバーラップする点が多い。術前診断は困難な場合も多く、画像所見や臨床所見などを総合的に考える必要がある。・本稿では一般的な転移性卵巣腫瘍の画像的特徴とともに、原発巣ごとのポイントや鑑別を要する原発性卵巣腫瘍についてまとめた。(著者抄録)

    (株)診断と治療社, 2021年03月, 産科と婦人科, 88 (Suppl.), 384 - 392, 日本語

  • Koh DM, Ba-Ssalamah A, Brancatelli G, Fananapazir G, Fiel MI, Goshima S, Ju SH, Kartalis N, Kudo M, Lee JM, Murakami T, Seidensticker M, Sirlin CB, Tan CH, Wang J, Yoon JH, Zeng M, Zhou J, Taouli B

    OBJECTIVES: The 9th International Forum for Liver Magnetic Resonance Imaging (MRI) was held in Singapore in September 2019, bringing together radiologists and allied specialists to discuss the latest developments in and formulate consensus statements for liver MRI, including the applications of gadoxetic acid-enhanced imaging. METHODS: As at previous Liver Forums, the meeting was held over 2 days. Presentations by the faculty on days 1 and 2 and breakout group discussions on day 1 were followed by delegate voting on consensus statements presented on day 2. Presentations and discussions centered on two main meeting themes relating to the use of gadoxetic acid-enhanced MRI in primary liver cancer and metastatic liver disease. RESULTS AND CONCLUSIONS: Gadoxetic acid-enhanced MRI offers the ability to monitor response to systemic therapy and to assist in pre-surgical/pre-interventional planning in liver metastases. In hepatocellular carcinoma, gadoxetic acid-enhanced MRI provides precise staging information for accurate treatment decision-making and follow-up post therapy. Gadoxetic acid-enhanced MRI also has potential, currently investigational, indications for the functional assessment of the liver and the biliary system. Additional voting sessions at the Liver Forum debated the role of multidisciplinary care in the management of patients with liver disease, evidence to support the use of abbreviated imaging protocols, and the importance of standardizing nomenclature in international guidelines in order to increase the sharing of scientific data and improve the communication between centers. KEY POINTS: • Gadoxetic acid-enhanced MRI is the preferred imaging method for pre-surgical or pre-interventional planning for liver metastases after systemic therapy. • Gadoxetic acid-enhanced MRI provides accurate staging of HCC before and after treatment with locoregional/biologic therapies. • Abbreviated protocols for gadoxetic acid-enhanced MRI offer potential time and cost savings, but more evidence is necessary. The use of gadoxetic acid-enhanced MRI for the assessment of liver and biliary function is under active investigation.

    2021年02月01日, European radiology[Epub ahead of print], 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Oe K, Zeng F, Fukui T, Nogami M, Murakami T, Matsumoto T, Kuroda R, Niikura T

    BACKGROUND: Recently, a standardized uptake value (SUV) has been used to evaluate bone single-photon emission computed tomography (SPECT). The aim of this study was to investigate quantitative SPECT imaging of uninfected nonunion to compare hypertrophic nonunion and non-hypertrophic nonunion using volume-based parameters. METHODS: We evaluated 23 patients with uninfected nonunion who underwent SPECT acquisition 3 h after an injection of 99mTc-hydroxymethylene diphosphonate or 99mTc-methylene diphosphonate from April 2014 to November 2019. We reconstructed the acquired data and performed voxel-based quantitative analysis using the GI-BONE software. Quantitative parameters, maximum SUV (SUVmax), peak SUV (SUVpeak), and mean SUV (SUVmean) in the high and low uptake areas of nonunion were compared between hypertrophic nonunion and non-hypertrophic nonunion. The contralateral limb was used as a control, and the ratios of the quantitative parameters were calculated. RESULTS: The values for the quantitative parameters (high uptake area/low uptake area, respectively), SUVmax control ratio (12.13 ± 4.95/6.44 ± 4.71), SUVpeak control ratio (11.65 ± 4.58/6.45 ± 4.64), and SUVmean control ratio (11.94 ± 5.03/6.28 ± 4.95) for hypertrophic nonunion were higher than those for non-hypertrophic nonunion (7.82 ± 4.76/3.41 ± 2.09 (p = 0.065/0.12), 7.56 ± 4.51/3.61 ± 2.23 (p = 0.065/0.22), and 7.59 ± 5.18/3.05 ± 1.91 (p = 0.076/0.23)). CONCLUSIONS: SUVmax, SUVpeak, and SUVmean control ratios obtained from bone SPECT images can quantitatively evaluate the biological activity of nonunions and may be an effective evaluation method for treatment decisions, especially the necessity of autologous bone grafting.

    2021年02月, Journal of orthopaedic surgery and research, 16 (1), 125 - 125, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Aoki T, Kubota K, Kubo S, Eguchi S, Izumi N, Kokudo N, Sakamoto M, Shiina S, Takayama T, Nakashima O, Matsuyama Y, Murakami T, Kudo M

    BACKGROUND: Non-curative (debulking) hepatic resection for hepatocellular carcinoma (HCC) is occasionally applied for selected cases with bulky tumors or for oncologic emergency cases; however, the clinical usefulness of this procedure has not yet been fully evaluated. The aim of the present study was to evaluate the patient outcomes of non-curative hepatic resections for HCC using data from bi-annual nationwide surveys conducted in Japan. METHOD: Data of 1084 non-curative hepatic resections for HCC were collected. The patient outcomes were compared with those of curative resections, transcatheter arterial chemoembolization (TACE), and hepatic arterial infusion chemotherapy (HAIC). RESULTS: Patient survival after the non-curative resection was poorer than that after curative resection (P < 0.001) and was especially dismal in cases with extrahepatic tumor spread (lymph node metastasis, peritoneal seeding, or distant metastasis). As compared to cases receiving TACE without surgery, non-curative resections for multiple intrahepatic tumors were applied to cases with advanced tumors with good liver functional reserve. The survival outcomes were significantly more favorable in the TACE group, but the results became similar after propensity score matching of the patients. The survival outcome of patients receiving non-curative resections was better than that of cases treated by HAIC, with median survival times of 26.0 months and 10.0 months, respectively. CONCLUSION: The indications for non-curative hepatic resection in patients with HCC should be judged cautiously, especially in patients with extrahepatic tumor spread. This treatment approach may be beneficial for selected patients with intermediate- or advanced-stage HCC limited in liver and with good liver functional reserve.

    2021年02月, World journal of surgery, 45 (2), 607 - 614, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Tsurusaki M, Sofue K, Onishi H, Goshima S, Higaki A, Isoda H, Haradome H, Ishii K, Murakami T

    PURPOSE: To identify predictive factors for truncation artifacts (TAs) in the arterial phase of Gd-EOB-DTPA-enhanced MRI in a multicenter study in Japan. MATERIALS AND METHODS: Data on patient factors (age, sex, weight, presence of viral hepatitis, and other conditions) and imaging parameters (e.g., triggering, voxel size, matrix, k-space ordering, acquisition time, reduction factor, flip angle, fat suppression, field strength, injection rate, and saline volume) were obtained. Univariate and multivariate analyses were performed to investigate the correlation of these parameters. RESULTS: We evaluated 1444 patients from 43 institutions who were scanned using GE, Siemens, Philips, or Toshiba MRI equipment (501, 354, 349, and 240 patients, respectively). The total incidence of TAs was 12.5% (17.2, 3.6, 15.7, and 12.1%, respectively). The matrix [odds ratio (OR) 0.13], flip angle (OR 5.77), use of fat suppression (OR 0.106), and field strength (OR 0.092) used in the Philips equipment significantly increased the incidence of TAs in MRI examination. CONCLUSIONS: The incidence of TAs in the arterial phase is influenced by several patient factors and imaging parameters. Especially, Siemens and Toshiba equipment had a significantly lower frequency of TAs. This indicates that such vendor-specific technology used in the dynamic sequence may have a TA-resistant effect.

    Springer Science and Business Media LLC, 2021年02月, Japanese journal of radiology, 39 (2), 165 - 177, 英語, 国内誌

    研究論文(学術雑誌)

  • Tsurusaki M, Sofue K, Hori M, Sasaki K, Ishii K, Murakami T, Kudo M

    Dual-energy computed tomography (DECT) is an imaging technique based on data acquisition at two different energy settings. Recent advances in CT have allowed data acquisitions and simultaneous analyses of X-rays at two energy levels, and have resulted in novel developments in the field of abdominal imaging. The use of low and high X-ray tube voltages in DECT provide fused images that improve the detection of liver tumors owing to the higher contrast-to-noise ratio (CNR) of the tumor compared with the liver. The use of contrast agents in CT scanning improves image quality by enhancing the CNR and signal-to-noise ratio while reducing beam-hardening artifacts. DECT can improve detection and characterization of hepatic abnormalities, including mass lesions. The technique can also be used for the diagnosis of steatosis and iron overload. This article reviews and illustrates the different applications of DECT in liver imaging.

    2021年01月22日, Diagnostics (Basel, Switzerland), 11 (2), 161 - 161, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • CT or MRI CT、MRIどっちを依頼?(No.10) 肝 超音波検査で肝に腫瘤が疑われた

    祖父江 慶太郎, 村上 卓道

    (公社)日本医師会, 2021年01月, 日本医師会雑誌, 149 (10), 1808 - 1809, 日本語

  • Horinouchi H, Ueshima E, Sofue K, Komatsu S, Okada T, Yamaguchi M, Fukumoto T, Sugimoto K, Murakami T

    BACKGROUND: Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. CASE PRESENTATION: A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal-external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. CONCLUSIONS: Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

    2020年12月, Surgical case reports, 6 (1), 304 - 304, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Matsuo H, Nishio M, Kanda T, Kojita Y, Kono A, Hori M, Teshima M, Otsuki N, Nibu K, Murakami T

    Abstract We hypothesized that, in discrimination between benign and malignant parotid gland tumors, high diagnostic accuracy could be obtained with a small amount of imbalanced data when anomaly detection (AD) was combined with deep leaning (DL) model and the L2-constrained softmax loss. The purpose of this study was to evaluate whether the proposed method was more accurate than other commonly used DL or AD methods. Magnetic resonance (MR) images of 245 parotid tumors (22.5% malignant) were retrospectively collected. We evaluated the diagnostic accuracy of the proposed method (VGG16-based DL and AD) and that of classification models using conventional DL and AD methods. A radiologist also evaluated the MR images. ROC and precision-recall (PR) analyses were performed, and the area under the curve (AUC) was calculated. In terms of diagnostic performance, the VGG16-based model with the L2-constrained softmax loss and AD (local outlier factor) outperformed conventional DL and AD methods and a radiologist (ROC-AUC = 0.86 and PR-ROC = 0.77). The proposed method could discriminate between benign and malignant parotid tumors in MR images even when only a small amount of data with imbalanced distribution is available.

    Springer Science and Business Media LLC, 2020年12月, Scientific Reports, 10 (1), 19388 - 19388, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Nishio M, Noguchi S, Matsuo H, Murakami T

    Abstract This study aimed to develop and validate computer-aided diagnosis (CXDx) system for classification between COVID-19 pneumonia, non-COVID-19 pneumonia, and the healthy on chest X-ray (CXR) images. From two public datasets, 1248 CXR images were obtained, which included 215, 533, and 500 CXR images of COVID-19 pneumonia patients, non-COVID-19 pneumonia patients, and the healthy samples, respectively. The proposed CADx system utilized VGG16 as a pre-trained model and combination of conventional method and mixup as data augmentation methods. Other types of pre-trained models were compared with the VGG16-based model. Single type or no data augmentation methods were also evaluated. Splitting of training/validation/test sets was used when building and evaluating the CADx system. Three-category accuracy was evaluated for test set with 125 CXR images. The three-category accuracy of the CAD system was 83.6% between COVID-19 pneumonia, non-COVID-19 pneumonia, and the healthy. Sensitivity for COVID-19 pneumonia was more than 90%. The combination of conventional method and mixup was more useful than single type or no data augmentation method. In conclusion, this study was able to create an accurate CADx system for the 3-category classification. Source code of our CADx system is available as open source for COVID-19 research.

    Springer Science and Business Media LLC, 2020年12月, Scientific Reports, 10 (1), 17532

    [査読有り]

    研究論文(学術雑誌)

  • Akamine Y, Ueda Y, Ueno Y, Sofue K, Murakami T, Yoneyama M, Obara M, Cautere MV

    PURPOSE: Hierarchical clustering (HC), an unsupervised machine learning (ML) technique, was applied to multi-parametric MR (mp-MR) for prostate cancer (PCa). The aim of this study is to demonstrate HC can diagnose PCa in a straightforward interpretable way, in contrast to deep learning (DL) techniques. METHODS: HC was constructed using mp-MR including intravoxel incoherent motion, diffusion kurtosis imaging, and dynamic contrast-enhanced MRI from 40 tumor and normal tissues in peripheral zone (PZ) and 23 tumor and normal tissues in transition zone (TZ). HC model was optimized by assessing the combinations of several dissimilarity and linkage methods. Goodness of HC model was validated by internal methods. RESULTS: Accuracy for differentiating tumor and normal tissue by optimal HC model was 96.3% in PZ and 97.8% in TZ, comparable to current clinical standards. Relationship between input (DWI and permeability parameters) and output (tumor and normal tissue cluster) was shown by heat maps, consistent with literature. CONCLUSION: HC can accurately differentiate PCa and normal tissue, comparable to state-of-the-art diffusion based parameters. Contrary to DL techniques, HC is an operator-independent ML technique producing results that can be interpreted such that the results can be knowledgeably judged.

    Elsevier BV, 2020年12月, Magnetic Resonance Imaging, 74, 90 - 95, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 工藤 正俊, 泉 並木, 久保 正二, 國土 典宏, 坂元 亨宇, 椎名 秀一朗, 高山 忠利, 建石 良介, 中島 収, 村上 卓道, 松山 裕, 高橋 新, 宮田 裕章, 田村 利恵, 上妻 智子, 日本肝癌研究会追跡調査委員会

    第21回全国原発性肝癌追跡調査においては、546施設から2010年1月1日から2011年12月31日までの2年間の22,134例の新規症例と41,956例の追跡症例が集計された。基礎統計は、第21回新規登録症例を対象として死因、既往歴、臨床診断、画像診断、治療法別の各因子、病理診断、再発、剖検についてまとめた。第20回調査と比較し、肝細胞癌における臨床診断時の高齢化、女性の増加、非B非C肝癌の増加、腫瘍径の縮小の傾向が、治療においては切除の割合の増加、局所療法におけるラジオ波焼灼療法の増加が認められた。1998年から2011年まで新規登録症例の中で最終予後が生存または死亡となった症例(不明を除く)について肝細胞癌、肝内胆管癌、混合型肝癌の治療法別、背景因子別累積生存率を算出した。肝細胞癌については腫瘍個数、腫瘍径、肝障害度、Child-Pugh分類を組み合わせることにより背景因子を揃えて、治療法別(肝切除、局所療法、肝動脈塞栓療法(TACE))、肝動注化学療法の累積生存率を算出し、また、1978年から2011年までの新規登録症例を4期に分け、累積生存率を算出した。新規登録症例数は経時的に増加し、肝細胞癌の予後の改善が著しいことが明らかとなった。本追跡調査が原発性肝癌の研究および診療の進歩に役立つことを期待する。(著者抄録)

    (一社)日本肝臓学会, 2020年12月, 肝臓, 61 (12), 645 - 691, 日本語

  • 肺病変に関するPET/MRIにおけるZero-TE法の診断能について

    Zeng Feibi, 野上 宗伸, 犬養 純子, 上野 嘉子, 神田 知紀, 祖父江 慶太郎, 久保 和広, 栗本 貴子, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S155 - S155, 英語

  • 胸部PET/MRIの吸収補正 別症例のCTを用いてZTEから偽CTを深層学習により作成する検討

    野上 宗伸, 松尾 秀俊, 西尾 瑞穂, 曽 菲比, 犬養 純子, Wiesinger Florian, Kaushik Sandeep, 栗本 貴子, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S157 - S157, 英語

  • 悪性腫瘍の全身FDG PET/MRIにおけるBSREMを用いた高速撮像と診断能の検討

    犬養 純子, 野上 宗伸, 曽 菲比, 渡邊 慶明, 西尾 瑞穂, 神田 知紀, 祖父江 慶太郎, 河野 敦, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S174 - S174, 日本語

  • 急性上腸間膜動脈閉塞症のIVR 塞栓症と動脈解離

    小出 裕, 松代 啓吾, 丸山 晃司, 川崎 竜太, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S67 - S67, 日本語

  • 治療適応の基準を満たさない腎血管筋脂肪腫の破裂

    元津 倫幸, 山口 雅人, 佐々木 康二, Hamada M.A.S., 上嶋 英介, 岡田 卓也, 祖父江 慶太郎, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S144 - S144, 日本語

  • 腹部人工血管置換術後遠隔期に被覆瘤外への出血に対し経動脈的塞栓術を行った2例

    松代 啓吾, 川崎 竜太, 小出 裕, 丸山 晃司, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S145 - S145, 日本語

  • 外傷性上腕動脈損傷に対しステント留置術を施行した1例

    伊崎 健太, 木下 知恵子, 酒井 英郎, 池田 覚, 佐野 秀, 当广 美樹, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S147 - S147, 日本語

  • 孤立性上腸間膜動脈解離に対しステント留置術を行った難渋例

    小出 裕, 松代 啓吾, 丸山 晃司, 川崎 竜太, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S147 - S147, 日本語

  • 中咽頭腫瘍として発症したGiant cell tumor of tendon sheath

    小路田 泰之, 神田 知紀, 村上 卓道

    (公社)日本医学放射線学会, 2020年10月, 日本医学放射線学会秋季臨床大会抄録集, 56回, S134 - S134, 日本語

  • 肺病変に関するPET/MRIにおけるZero-TE法の診断能について

    Zeng Feibi, 野上 宗伸, 犬養 純子, 上野 嘉子, 神田 知紀, 祖父江 慶太郎, 久保 和広, 栗本 貴子, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S155 - S155, 英語

  • 悪性腫瘍の全身FDG PET/MRIにおけるBSREMを用いた高速撮像と診断能の検討

    犬養 純子, 野上 宗伸, 曽 菲比, 渡邊 慶明, 西尾 瑞穂, 神田 知紀, 祖父江 慶太郎, 河野 敦, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S174 - S174, 日本語

  • 胸部PET/MRIの吸収補正 別症例のCTを用いてZTEから偽CTを深層学習により作成する検討

    野上 宗伸, 松尾 秀俊, 西尾 瑞穂, 曽 菲比, 犬養 純子, Wiesinger Florian, Kaushik Sandeep, 栗本 貴子, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2020年10月, 核医学, 57 (Suppl.), S157 - S157, 英語

  • Numoto I, Tsurusaki M, Oda T, Yagyu Y, Ishii K, Murakami T

    PURPOSE: To evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for pseudoaneurysms occurring secondary to pancreatitis or because of leakage of pancreatic juice after pancreatectomy. MATERIALS AND METHODS: This retrospective study included 42 consecutive patients (38 males and 4 females; mean age, 60 years; range, 33-80 years) who underwent TAE for bleeding visceral artery pseudoaneurysms between March 2004 and December 2018. The technical and clinical success rates, incidence of recurrent bleeding, complications, including pancreatitis, and overall survival after TAE were evaluated. RESULTS: Of the 42 enrolled patients, 23 had bleeding due to a complication of pancreatectomy and 19 had bleeding as a complication of pancreatitis. TAE with N-butyl cyanoacrylate (NBCA) or NBCA plus microcoils recurrent bleeding or inability to control bleeding was 15.8% (3 of 19) following TAE with NBCA and 17.4% (4 of 23) following TAE with coils. No clinically significant ischemic events of the pancreas or duodenum were observed in the embolized areas. Serum amylase did not increase compared with the initial levels after any of the procedures. At 30 days after TAE, 32 patients were alive. CONCLUSION: TAE has a high success rate for the management of hemorrhage, with few complications. The procedure appears to be safe and effective for pseudoaneurysms associated with either pancreatitis or pancreatectomy.

    2020年09月23日, Cancers, 12 (10), 2733 - 2733, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Tsujita Y, Sofue K, Komatsu S, Yamaguchi T, Ueshima E, Ueno Y, Kanda T, Okada T, Nogami M, Yamaguchi M, Tsurusaki M, Hori M, Fukumoto T, Murakami T

    PURPOSE: Accurate prediction of post-hepatectomy liver failure (PHLF) is important in advanced hepatocellular carcinoma (HCC). We aimed to retrospectively evaluate the utility of gadoxetic acid-enhanced MRI for predicting PHLF in patients who underwent anatomic hepatectomy for HCC with portal vein invasion. METHODS: Forty-one patients (32 men, 9 women) were included. Hepatobiliary-phase MR images were acquired 20 min after injection of gadoxetic acid using a 3D fat-suppressed T1-weighted spoiled gradient-echo sequence. Liver-spleen ratio (LSR), remnant hepatocellular uptake index (rHUI), and HUI were calculated. The severity of PHLF was defined according to the International Study Group of Liver Surgery. Differences in LSR between the resected liver and the remnant liver, and HUI and rHUI/HUI between no/mild and severe PHLF were compared using the Wilcoxon signed-rank test and Wilcoxon rank-sum test, respectively. Univariate and multivariate logistic regression analyses were performed to identify predictors of severe PHLF. Areas under the receiver operating characteristic curves (AUCs) of rHUI and rHUI/HUI were calculated for predicting severe PHLF. RESULTS: Nine patients developed severe PHLF. LSR of the remnant liver was significantly higher than that of the resected liver (P < 0.001). Severe PHLF demonstrated significantly lower rHUI (P < 0.001) and rHUI/HUI (P < 0.001) compared with no/mild PHLF. Multivariate logistic regression analysis showed that decreased rHUI (P = 0.012, AUC=0.885) and rHUI/HUI (P = 0.002, AUC=0.852) were independent predictors of severe PHLF. CONCLUSION: Gadoxetic acid-enhanced MRI can be a promising noninvasive examination for assessing global and regional liver function, allowing estimation of the functional liver remnant and accurate prediction of severe PHLF before hepatic resection.

    2020年09月, European journal of radiology, 130, 109189 - 109189, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Yamada Y, Masuda A, Sofue K, Murakami T, Kodama Y

    Background and Aims: Imaging tools for predicting pancreatic atrophy after steroid therapy in autoimmune pancreatitis (AIP) have not been established. As delayed equilibrium-phase contrast enhancement in computed tomography (CE-CT) may reflect interstitial fibrosis, we evaluated the ability of equilibrium-phase CT imaging for predicting pancreatic atrophy. Methods: Forty-six steroid-treated AIP patients who underwent contrast-enhanced CT at our university hospital were included in this retrospective study. CT attenuation (Hounsfield units [HU]) values in noncontrast images (NC) and equilibrium-phase images (EP) and the differences in HU values between NC and EP images (SUB) were measured. Pancreatic volume was measured in CE-CT before (Volpre) and after (Volpost) steroid therapy. The volume reduction rate was calculated. The relationships of CT values with pancreatic atrophy, Volpost, volume reduction rate, and diabetes exacerbation were investigated. Results: CT values in the EP and SUB images before steroid therapy were associated with pancreatic atrophy after steroid therapy (atrophy vs nonatrophy 114.5 ± 12.8 vs 99.5 ± 11.1, P = 0.0002; 70.9 ± 14.72 vs 57.2 ± 13.1, P = 0.003, respectively), but CT values in NC images were not (P = 0.42). CT values in EP and SUB images before steroid therapy were correlated with Volpost (EP images r = -0.70, P = 0.002; SUB images r = -0.68, P = 0.03) and volume reduction rate after steroid therapy (EP images: r = -0.55, P < 0.0001; SUB images r = -0.45, P = 0.002). Diabetes exacerbation was associated with higher EP and SUB values (P = 0.009 and P = 0.04, respectively). Conclusion: Equilibrium-phase contrast CT imaging may facilitate prediction of pancreatic atrophy after steroid therapy in AIP.

    2020年08月, JGH open : an open access journal of gastroenterology and hepatology, 4 (4), 677 - 683, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 液体塞栓物質(NBCA)を極める! エキスパートへの道 膵領域の急性出血に対するNBCAを用いた動脈塞栓術の検討

    佐々木 康二, 岡田 卓也, 山口 雅人, Hamada Mostafa, 元津 倫幸, 上嶋 英介, 祖父江 慶太郎, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 122 - 122, 日本語

  • 骨転移疼痛に対する集学的治療 -この痛みをどう治療するか- 骨転移に対する骨セメント治療 経皮的椎体形成術の適応を考える

    岡田 卓也, 佐々木 康二, Hamada M.A.S., 元津 倫幸, 上嶋 英介, 祖父江 慶太郎, 山口 雅人, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 131 - 131, 日本語

  • 大動脈解離に対するIVR 大動脈解離に対するIVRの現況と課題

    山口 雅人, 岡田 卓也, 佐々木 康二, 元津 倫幸, 上嶋 英介, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 133 - 133, 日本語

  • ドセタキセル含浸薬剤溶出性ビーズの基礎的検討

    谷 龍一郎, 岡田 卓也, 上嶋 英介, 篠原 正和, 元津 倫幸, 佐々木 康二, Hamada M.A.S, 祖父江 慶太郎, 山口 雅人, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 282 - 282, 日本語

  • アンギオ室での急変対応におけるチーム医療 ハートフルチームビルディング

    小出 裕, 山口 雅人, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 136 - 136, 日本語

  • EVAR後の瘤径拡大例に対するトラネキサム酸投与の有用性

    松代 啓吾, 川崎 竜太, 丸山 晃司, 小出 裕, 野村 佳克, 山口 雅人, 岡田 卓也, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 166 - 166, 日本語

  • 腎動脈瘤に対しバイアバーンを留置した1例

    伊崎 健太, 木下 知恵子, 池田 覚, 酒井 英郎, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2020年08月, 日本インターベンショナルラジオロジー学会雑誌, 35 (Suppl.), 252 - 253, 日本語

  • 骨転移の痛みのマネージメント 脊椎転移に対する経皮的椎体形成術の適応について考える

    岡田 卓也, 佐々木 康二, 角谷 賢一朗, 宮脇 大輔, 酒井 良忠, 坂下 明大, 今村 善宣, 山口 雅人, 杉本 幸司, 村上 卓道

    (NPO)日本緩和医療学会, 2020年08月, Palliative Care Research, 15 (Suppl.), S37 - S37, 日本語

  • Ueno Y, Tamada T, Takeuchi M, Sofue K, Takahashi S, Kamishima Y, Urase Y, Kido A, Hinata N, Harada K, Fujisawa M, Miyaji Y, Murakami T

    American Roentgen Ray Society, 2020年07月, American Journal of Roentgenology[Epub ahead of print]

    [査読有り]

    研究論文(学術雑誌)

  • Morita Y, Nogami M, Sakaguchi K, Okada Y, Hirota Y, Sugawara K, Tamori Y, Zeng F, Murakami T, Ogawa W

    OBJECTIVE: Positron emission tomography (PET)-computed tomography has revealed that metformin promotes the intestinal accumulation of [18F]fluorodeoxyglucose (FDG), a nonmetabolizable glucose derivative. It has remained unknown, however, whether this accumulation occurs in the wall or intraluminal space of the intestine. We here addressed this question with the use of [18F]FDG PET-MRI, a recently developed imaging method with increased accuracy of registration and high soft-tissue contrast. RESEARCH DESIGN AND METHODS: Among 244 individuals with type 2 diabetes who underwent PET-MRI, we extracted 24 pairs of subjects matched for age, BMI, and HbA1c level who were receiving treatment with metformin (metformin group) or were not (control group). We evaluated accumulation of [18F]FDG in different portions of the intestine with both a visual scale and measurement of maximum standardized uptake value (SUVmax), and such accumulation within the intestinal wall or lumen was discriminated on the basis of SUVmax. RESULTS: SUVmax of the jejunum, ileum, and right or left hemicolon was greater in the metformin group than in the control group. [18F]FDG accumulation in the ileum and right or left hemicolon, as assessed with the visual scale, was also greater in the metformin group. SUVmax for the intraluminal space of the ileum and right or left hemicolon, but not that for the intestinal wall, was greater in the metformin group than in the control group. CONCLUSIONS: Metformin treatment was associated with increased accumulation of [18F]FDG in the intraluminal space of the intestine, suggesting that this drug promotes the transport of glucose from the circulation into stool.

    2020年07月, Diabetes Care, 43 (7), 1 - 7, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Yasuyo Urase, Mizuho Nishio, Yoshiko Ueno, Atsushi K. Kono, Keitaro Sofue, Tomonori Kanda, Takaki Maeda, Munenobu Nogami, Masatoshi Hori, Takamichi Murakami

    The usefulness of sparse-sampling CT with deep learning-based reconstruction for detection of metastasis of malignant ovarian tumors was evaluated. We obtained contrast-enhanced CT images (n = 141) of ovarian cancers from a public database, whose images were randomly divided into 71 training, 20 validation, and 50 test cases. Sparse-sampling CT images were calculated slice-by-slice by software simulation. Two deep-learning models for deep learning-based reconstruction were evaluated: Residual Encoder-Decoder Convolutional Neural Network (RED-CNN) and deeper U-net. For 50 test cases, we evaluated the peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) as quantitative measures. Two radiologists independently performed a qualitative evaluation for the following points: entire CT image quality; visibility of the iliac artery; and visibility of peritoneal dissemination, liver metastasis, and lymph node metastasis. Wilcoxon signed-rank test and McNemar test were used to compare image quality and metastasis detectability between the two models, respectively. The mean PSNR and SSIM performed better with deeper U-net over RED-CNN. For all items of the visual evaluation, deeper U-net scored significantly better than RED-CNN. The metastasis detectability with deeper U-net was more than 95%. Sparse-sampling CT with deep learning-based reconstruction proved useful in detecting metastasis of malignant ovarian tumors and might contribute to reducing overall CT-radiation exposure.

    MDPI AG, 2020年06月28日, Applied Sciences, 10 (13), 4446 - 4446

    研究論文(学術雑誌)

  • Horinouchi H, Okada T, Yamaguchi M, Maruyama K, Sasaki K, Gentsu T, Ueshima E, Sofue K, Kawasaki R, Nomura Y, Omura A, Okada K, Sugimoto K, Murakami T

    PURPOSE: To evaluate the mid-term outcomes of transarterial embolization (TAE) for type II endoleak after endovascular abdominal aortic aneurysm repair (EVAR) and investigate the predictors of sac enlargement after embolization. MATERIALS AND METHODS: We conducted a retrospective analysis of 55 patients [48 men and 7 women, median age 79.0 (interquartile ranges 74-82) years] who underwent TAE for type II endoleak from 2010 to 2018. The aneurysmal sac enlargement, endoleaks, aneurysm-related adverse event rate, and reintervention rate were evaluated. Patients' characteristics and clinical factors were evaluated for their association with sac enlargement. RESULTS: Fifty-five patients underwent TAE with technical success and were subsequently followed for a median of 636 (interquartile ranges 446-1292) days. The freedom from sac enlargement rates at 1, 3, and 5 years was 73.2%, 32.0%, and 26.7%, respectively. After initial TAE, the recurrent type II, delayed type I, and occult type III endoleak were identified in 39 (71%), 5 (9%), and 3 (5%) patients, respectively. Although a patient had aorto-duodenal fistula, there was no aneurysm-related death. The freedom from reintervention rates was 84.6%, 35.7%, and 17.0%, respectively. In the multivariate analysis, sac diameter > 55 mm at initial TAE (hazard ratios, 3.23; 95% confidence intervals, 1.22-8.58; P < 0.05) was a significant predictor of sac enlargement. CONCLUSION: TAE for type II endoleak was not effective in preventing sac enlargement, and reinterventions were required among the mid-term follow-up. The sac diameter > 55 mm at initial TAE was a significant predictor of sac enlargement.

    2020年05月, Cardiovascular and interventional radiology, 43 (5), 696 - 705, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Horinouchi H, Sofue K, Nishii T, Maruyama K, Sasaki K, Gentsu T, Ueshima E, Okada T, Yamaguchi M, Sugimoto K, Murakami T

    PURPOSE: To assess the utility of whole-aorta CT angiography (CTA) with 15 mL contrast material (CM) on time-resolved imaging for endovascular abdominal aortic repair (EVAR). METHODS: Twenty-six patients with a high-risk of post-contrast acute kidney injury (PC-AKI) underwent CTA with 15 mL CM using temporal maximum intensity projection (tMIP-CTA) generated from time-resolved imaging. The aortoiliac CT values were measured. Two observers measured the arterial diameters in unenhanced CT and tMIP-CTA images, and image quality was evaluated on a 5-point scale. The presence of the accessory renal artery, inferior mesenteric artery (IMA) occlusion, and instructions for use (IFU) of EVAR were evaluated. RESULTS: CT examinations were successfully performed, and no patients developed PC-AKI. The mean CT values of the whole aorta were 267.5 ± 51.4 HU, which gradually decreased according to the distal levels of the aorta. Bland-Altman analysis revealed excellent agreement for the external arterial diameter measurements between unenhanced CT and tMIP-CTA. Excellent interobserver agreement was achieved for the measurements of the external (ICCs, 0.910-0.992) and internal arterial diameters (ICCs, 0.895-0.993). Excellent or good overall image quality was achieved in 24 (92 %) patients. The presence of the accessory renal artery, IMA occlusion and the assessment of IFU were in 100 % agreement. Multivariate analysis revealed aortic volume as the most significant independent factor associated with strong aortic enhancement (p = 0.004). CONCLUSIONS: Whole-aorta tMIP-CTA on time-resolved imaging is useful for maintaining contrast enhancement and image quality for EVAR planning, and can substantially reduce the amount of CM.

    2020年05月, European journal of radiology, 126, 108861 - 108861, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Zeng F, Nogami M, Ueno Y R, Kanda T, Sofue K, Kubo K, Kurimoto T, Murakami T

    OBJECTIVES: This study aimed to evaluate the diagnostic performance of the lung zero-echo time (ZTE) sequence in FDG PET/MRI for detection and differentiation of lung lesions in oncologic patients in comparison with conventional two-point Dixon-based MR imaging. METHODS: In this single-institution retrospective study approved by the institutional review board, 209 patients with malignancies (97 men and 112 women; age range, 17-89 years; mean age, 66.5 ± 12.9 years) underwent 18F-FDG PET/MRI between August 2017 and August 2018, with diagnostic Dixon and ZTE under respiratory gating acquired simultaneously with PET. Image analysis was performed for PET/Dixon and PET/ZTE fused images by two readers to assess the detectability and differentiation of lung lesions. The reference standard was pathological findings and/or the data from a chest CT. The detection and differentiation abilities were evaluated for all lesions and subgroups divided by lesion size and maximum standardized uptake value (SUVmax). RESULTS: Based on the reference standard, 227 lung lesions were identified in 113 patients. The detectability of PET/ZTE was significantly better than that of PET/Dixon for overall lesions, lesions with a SUVmax less than 3.0 and lesions smaller than 4 mm (p < 0.01). The diagnostic performance of PET/ZTE was significantly better than that of PET/Dixon for overall lesions and lesions smaller than 4 mm (p < 0.01). CONCLUSIONS: ZTE can improve diagnostic performance in the detection and differentiation of both FDG-avid and non-FDG-avid lung lesions smaller than 4 mm in size, yielding a promising tool to enhance the utility of FDG PET/MRI in oncology patients with lung lesions. KEY POINTS: • The detection rate of PET/ZTE for lesions with a SUVmax of less than 1.0 was significantly better than that of PET/Dixon. • The performance for differentiation of PET/ZTE for lesions that were even smaller than 4 mm in size were significantly better than that of PET/Dixon. • Inter-rater agreement of PET/ZTE for the differentiation of lesions less than 4 mm in size was substantial and better than that of PET/Dixon.

    2020年04月16日, European Radiology, 30 (9), 4995 - 5003, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Tai K, Komatsu S, Sofue K, Kido M, Tanaka M, Kuramitsu K, Awazu M, Gon H, Tsugawa D, Yanagimoto H, Toyama H, Murakami S, Murakami T, Fukumoto T

    BACKGROUND: Although total tumour volume (TTV) may have prognostic value for hepatic resection in certain solid cancers, its importance in colorectal liver metastases (CRLM) remains unexplored. This study investigated its prognostic value in patients with resectable CRLM. METHOD: This was a retrospective review of patients who underwent hepatic resection for CRLM between 2008 and 2017 in a single institution. TTV was measured from CT images using three-dimensional construction software; cut-off values were determined using receiver operating characteristic (ROC) curve analyses. Potential prognostic factors, overall survival (OS) and recurrence-free survival (RFS) were determined using multivariable and Kaplan-Meier analyses. RESULTS: Some 94 patients were included. TTV cut-off values for OS and RFS were 100 and 10 ml respectively. Right colonic primary tumours, primary lymph node metastasis and bilobar liver metastasis were included in the multivariable analysis of OS; a TTV of 100 ml or above was independently associated with poorer OS (hazard ratio (HR) 6·34, 95 per cent c.i. 2·08 to 17·90; P = 0·002). Right colonic primary tumours and primary lymph node metastasis were included in the RFS analysis; a TTV of 10 ml or more independently predicted poorer RFS (HR 1·90, 1·12 to 3·57; P = 0·017). The 5-year OS rate for a TTV of 100 ml or more was 41 per cent, compared with 67 per cent for a TTV below 100 ml (P = 0·006). Corresponding RFS rates with TTV of 10 ml or more, or less than 10 ml, were 14 and 58 per cent respectively (P = 0·009). A TTV of at least 100 ml conferred a higher rate of unresectable initial recurrences (12 of 15, 80 per cent) after initial hepatic resection. CONCLUSION: TTV was associated with RFS and OS after initial hepatic resection for CRLM; TTV of 100 ml or above was associated with a higher rate of unresectable recurrence.

    2020年04月11日, BJS open, 4 (3), 456 - 466, 英語, 国際誌

    [査読有り]

  • Sofue K, Onoda M, Tsurusaki M, Morimoto D, Yada N, Kudo M, Murakami T

    BACKGROUND: Differentiation between inflammation and fibrosis is an important clinical distinction in patients with chronic liver disease, which has been difficult so far with MR elastography. PURPOSE: To investigate whether dual-frequency MR elastography can estimate necroinflammation of the liver and improve diagnostic performance for the staging of liver fibrosis. STUDY TYPE: Retrospective. SUBJECTS: In all, 30 patients (14 males, 16 females) with chronic liver disease. FIELD STRENGTH/SEQUENCE: 1.5T/dual-frequency MR elastography at 60-Hz and 80-Hz vibration frequencies. [Correction added on November 12, 2019, after first online publication: The field strength in the preceding sentence was corrected.] ASSESSMENT: Necroinflammation activity and fibrosis were assessed using the METAVIR scoring system. Stiffness values at 60-Hz (G60-Hz ) and 80-Hz (G80-Hz ) were obtained with an MR elastogram. The difference value between G80-Hz and G60-Hz (ΔG) was calculated. Four values (G60-Hz , G80-Hz , G60-Hz - ΔG, and G80-Hz  + ΔG) were generated to estimate necroinflammation and fibrosis. STATISTICAL TESTS: The ΔG were correlated with necroinflammation activity grade and fibrosis stage using Spearman's rank correlation. Diagnostic performance of the four values for necroinflammation activity grade and fibrous stage was assessed by using area under the receiver operating characteristic curve (AUC). RESULTS: The mean value of G80-Hz (6.23 ± 3.67 kPa) was significantly higher than that of G60-Hz (5.27 ± 3.14 kPa) (P < 0.0001). The ΔG demonstrated a strong correlation with necroinflammation grade (ρ = 0.625, P < 0.001) and no correlation with fibrosis stage (ρ = 0.306, P = 0.113). The AUC of the G80-Hz and G80-Hz  + ΔG showed higher accuracy for necroinflammation, and optimal cutoff values yielded better discrimination of ≥A1, ≥A2, and = A3. The AUC demonstrated that all the generated values had high diagnostic performance (≥0.87 for all) for fibrosis. DATA CONCLUSION: Dual-frequency MR elastography shows potential in estimating necroinflammation of the liver and may improve diagnostic performance for staging liver fibrosis. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1053-1064.

    2020年04月, Journal of magnetic resonance imaging : JMRI, 51 (4), 1053 - 1064, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Komatsu S, Yano Y, Sofue K, Kido M, Tanaka M, Kuramitsu K, Awazu M, Gon H, Yamamoto A, Yanagimoto H, Toyama H, Kodama Y, Murakami T, Fukumoto T

    BACKGROUND: The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC). METHODS: The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients. RESULTS: Of the study subjects, 37 patients had Child-Pugh class A (CPA) liver function, and 14 patients had Child-Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1-2 months, or 2-3 months (p = 0.2368, 0.9368, and 0.9293). CONCLUSION: The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.

    2020年03月29日, HPB : the official journal of the International Hepato Pancreato Biliary Association[Epub ahead of print], 22 (10), 1450 - 1456, 英語, 国際誌

    研究論文(学術雑誌)

  • 線維軟骨塞栓症が疑われた若年者脊髄梗塞の1例

    藤原 康弘, 神田 知紀, 上野 嘉子, 岡田 卓也, 祖父江 慶太郎, 前田 隆樹, 野上 宗伸, 山口 雅人, 杉本 幸司, 村上 卓道, 大塚 喜久

    (公社)日本医学放射線学会, 2020年02月, Japanese Journal of Radiology, 38 (Suppl.), 40 - 40, 日本語

    [査読有り]

  • Kanda T, Miyazaki A, Zeng F, Ueno Y, Sofue K, Maeda T, Nogami M, Kitajima K, Murakami T

    The optic nerve is morphologically classified as a peripheral nerve, but histologically it shares characteristics with the central nerves. Diseases that affect vision and the optic nerve are many and varied: optic neuritis, demyelination (multiple sclerosis, acute disseminated encephalomyelitis, neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein antibody-related disorders), drugs, collagen disease, vasculitis, infection, trauma, vascular abnormalities, tumours, and non-tumoural masses. In this review, we summarise the magnetic resonance imaging findings for various pathological conditions that cause deterioration in visual acuity.

    INT SCIENTIFIC INFORMATION INC, 2020年02月, Polich Journal of Radiology, 85, e67 - e81, 英語

    [査読有り]

  • Kozuki R, Kono A, Tanaka C, Tahara J, Inukai J, Feibi Z, Nogami M, Yoneda K, Akashi K, Murakami T

    2020年02月, Japanese Archive of cases conference of clinical nuclear medicine, 2, 1 - 9

    [査読有り]

  • Hamada MAS, Okada T, Yamaguchi M, Gotake Y, Okada K, Sugimoto K, Murakami T

    2020年02月, Interventional Radiology, 5 (1), 19 - 22, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Zech CJ, Ba-Ssalamah A, Berg T, Chandarana H, Chau GY, Grazioli L, Kim MJ, Lee JM, Merkle EM, Murakami T, Ricke J, B Sirlin C, Song B, Taouli B, Yoshimitsu K, Koh DM

    OBJECTIVES: The 8th International Forum for Liver Magnetic Resonance Imaging (MRI), held in Basel, Switzerland, in October 2017, brought together clinical and academic radiologists from around the world to discuss developments in and reach consensus on key issues in the field of gadoxetic acid-enhanced liver MRI since the previous Forum held in 2013. METHODS: Two main themes in liver MRI were considered in detail at the Forum: the use of gadoxetic acid for contrast-enhanced MRI in patients with liver cirrhosis and the technical performance of gadoxetic acid-enhanced liver MRI, both opportunities and challenges. This article summarises the expert presentations and the delegate voting on consensus statements discussed at the Forum. RESULTS AND CONCLUSIONS: It was concluded that gadoxetic acid-enhanced MRI has higher sensitivity for the diagnosis of hepatocellular carcinoma (HCC), when compared with multidetector CT, by utilising features of hyperenhancement in the arterial phase and hypointensity in the hepatobiliary phase (HBP). Recent HCC management guidelines recognise an increasing role for gadoxetic acid-enhanced MRI in early diagnosis and monitoring post-resection. Additional research is needed to define the role of HBP in predicting microvascular invasion, to better define washout during the transitional phase in gadoxetic acid-enhanced MRI for HCC diagnosis, and to reduce the artefacts encountered in the arterial phase. Technical developments are being directed to shortening the MRI protocol for reducing time and patient discomfort and toward utilising faster imaging and non-Cartesian free-breathing approaches that have the potential to improve multiphasic dynamic imaging. KEY POINTS: • Gadoxetic acid-enhanced MRI provides higher diagnostic sensitivity than CT for diagnosing HCC. • Gadoxetic acid-enhanced MRI has roles in early-HCC diagnosis and monitoring post-resection response. • Faster imaging and free-breathing approaches have potential to improve multiphasic dynamic imaging.

    2020年01月, European Radiology, 30 (1), 370 - 382, 英語, 国際誌

    [査読有り]

  • Ueshima E, Nishiofuku H, Takaki H, Hirata Y, Kodama H, Tanaka T, Kichikawa K, Yamakado K, Okada T, Sofue K, Yamaguchi M, Sugimoto K, Murakami T

    Introduction: The underlying mechanism involved in the recurrence of hepatoma after hepatic arterial embolization (HAE) is not adequately examined. An immunosuppressive cytokine, transforming growth factor β1 (TGF-β1), can lead to tumor progression and is affected by hypoxia in various cancers. The study aimed to assess the effect of HAE on the expression of TGF-β1 in a rat hepatoma model. Methods: Sprague-Dawley rats bearing N1S1 hepatoma cells underwent HAE (HAE group, n = 5) or sham treatment (sham group, n = 4). The animals were euthanized at 48 h, and liver tissues were harvested. Immunohistochemistry (IHC) and quantitative polymerase chain reaction (qPCR) were performed to compare the expression of TGF-β1 and hypoxia-inducible factor 1α (HIF-1α) between the HAE and sham groups. In vitro experiments with the N1S1 cell line were also performed under normoxic (21% O2) or hypoxic (1% O2) conditions for 48 h, and the expression of TGF-β1 and HIF-1α was assessed with western blotting and enzyme-linked immunosorbent assay. Statistical data comparisons were performed by Student t test. Results: IHC showed that both the TGF-β1-positive and HIF-1α-positive tumor peripheral areas were larger in the HAE group (6.59 ± 2.49 and 10.26 ± 4.14%; p < 0.001, respectively) than in the sham group (0.34 ± 0.41 and 0.40 ± 0.84% respectively). Similarly, qPCR showed that the mRNA expression levels of TGF-β1 and HIF-1α were higher (1.95 ± 0.38-fold and 1.62 ± 0.37-fold; p < 0.001 and p = 0.002, respectively) in the HAE group than those in the sham group. TGF-β1 expression was suppressed when HIF-1α inhibitors were added (p = 0.001), and HIF-1α expression was upregulated when exogenous TGF-β1 was added (p = 0.033) in N1S1 cells. Conclusion: HAE enhanced local TGF-β1 expression in a rat hepatoma model. In vitro experiments suggest that HAE-induced hypoxic stress may trigger the interdependent expression of TGF-β1 and HIF-1α.

    2020年01月, Liver cancer, 9 (1), 63 - 72, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Isaka Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanebe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Koshi E, Kosugi T, Yasuda Y

    2020年01月, Japanese journal of radiology, 38 (1), 3 - 46, 英語, 国内誌

    [査読有り]

    研究論文(学術雑誌)

  • Maruyama K, Sofue K, Horinouchi H, Okada T, Ueshima E, Gentsu T, Sasaki K, Yamaguchi M, Sugimoto K, Murakami T

    OBJECTIVE: The aim of this study was to assess the utility of 70-kilovoltage-peak (kVp) contrast-enhanced computed tomography (CECT) for visualization and identification of the right adrenal vein (RAV) in comparison with that of conventional 120-kVp CECT. METHODS: This retrospective study included patients who underwent adrenal venous sampling with concurrent biphasic 120-kVp (120-kVp group, n = 43) or 70-kVp (70-kVp group, n = 47) CECT. Signal-to-noise ratios, contrast-to-noise ratios, longitudinal lengths, conspicuity scores, RAV detection rates, and size-specific dose estimates were compared between the 2 groups. RESULTS: In comparison with the 120-kVp group, the 70-kVp group had significantly higher signal-to-noise and contrast-to-noise ratios (P < 0.001-P = 0.033), greater longitudinal lengths (P < 0.001-P = 0.002), superior conspicuity scores for the RAV (P < 0.001), higher RAV detection rates (P = 0.015-P = 0.033), and lower size-specific dose estimates (P < 0.001). CONCLUSIONS: Seventy-kilovoltage-peak CECT has advantages over conventional 120-kVp CECT and is potentially useful for noninvasive assessment of the precise anatomy of the RAV.

    2020年01月, J Comput Assist Tomogr, 44 (1), 153 - 159

    [査読有り]

    研究論文(学術雑誌)

  • Kudo M, Izumi N, Kubo S, Kokudo N, Sakamoto M, Shiina S, Tateishi R, Nakashima O, Murakami T, Matsuyama Y, Takahashi A, Miyata H, Takayama T

    In the 20th Nationwide Follow-up Survey of Primary Liver Cancer in Japan, data from 21 075 new patients and 40 769 previously followed patients were compiled from 544 institutions over a 2-year period from 1 January 2008 to 31 December 2009. Compared with the previous 19th survey, the population of patients with hepatocellular carcinoma (HCC) was older at the time of clinical diagnosis, included more female patients, included more patients with non-B non-C HCC, had smaller tumor diameters and more frequently received radiofrequency ablation as local ablation therapy. Cumulative survival rates were calculated for HCC, intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma (combined HCC and intrahepatic cholangiocarcinoma) by treatment type and by background characteristics for patients newly registered between 1998 and 2009 whose final outcome was survival or death. Cumulative survival rates for HCC were calculated by dividing patients by combinations of background factors (number of tumors, tumor diameter, and Child-Pugh grade) and by treatment types (hepatectomy, local ablation therapy, and transcatheter arterial chemoembolization). Cumulative survival rates and median overall survival in patients treated by resection, transcatheter arterial chemoembolization, and local ablation therapy were calculated. The same values were also calculated by the registration date by dividing patients newly registered between 1978 and 2009 into four time period groups . The results of the analysis show that the prognosis of HCC is improving dramatically. It is expected that the data obtained from this nationwide follow-up survey will contribute to advancing clinical research, including the design of clinical trials, as well as the treatment strategy of primary liver cancer in the clinical practice setting.

    2020年01月, Hepatology research : the official journal of the Japan Society of Hepatology, 50 (1), 15 - 46, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Aoki T, Kubota K, Hasegawa K, Kubo S, Izumi N, Kokudo N, Sakamoto M, Shiina S, Takayama T, Nakashima O, Matsuyama Y, Murakami T, Kudo M

    BACKGROUND: The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non-anatomical resection for solitary HCC. METHODS: Data from patients with solitary HCC who had undergone non-anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence-free survival associated with the surgical margin status and width were evaluated in the two groups. RESULTS: A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0-mm surgical margin was associated with poorer overall and recurrence-free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome. CONCLUSION: Anatomical resection with a negative 0-mm surgical margin may be acceptable. Non-anatomical resection with a negative 0-mm margin was associated with a less favourable survival outcome.

    2020年01月, The British journal of surgery, 107 (1), 113 - 120, 英語, 国際誌

    [査読有り]

  • Isaki Y, Hayashi H, Aonuma K, Horio M, Terada Y, Doi K, Fujigaki Y, Yasuda H, Sato T, Fujikura T, Kuwatsuru R, Toei H, Murakami R, Saito Y, Hirayama A, Murohara T, Sato A, Ishii H, Takayama T, Watanabe M, Awai K, Oda S, Murakami T, Yagyu Y, Joki N, Komatsu Y, Miyauchi T, Ito Y, Miyazawa R, Kanno Y, Ogawa T, Koshi E, Kosugi T, Yasuda Y

    2019年11月, Circulation journal : official journal of the Japanese Circulation Society, 83 (12), 2572 - 2607, 英語, 国内誌

    [査読有り]

    研究論文(学術雑誌)

  • Kokudo N, Takemura N, Hasegawa K, Takayama T, Kubo S, Shimada M, Nagano H, Hatano E, Izumi N, Kaneko S, Kudo M, Iijima H, Genda T, Tateishi R, Torimura T, Igaki H, Kobayashi S, Sakurai H, Murakami T, Watadani T, Matsuyama Y

    The fourth version of Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development, and Evaluation system, which was published in October 2017 in Japanese. New or revised recommendations were described, herein, with a special reference to the surveillance, diagnostic, and treatment algorithms.

    2019年10月, Hepatology Research, 49 (10), 1109 - 1113, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 全身PET/MRI撮像における高速化への試み BSREM再構成における指摘β値の検討

    野上 宗伸, 曽 菲比, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2019年10月, 核医学, 56 (Suppl.), S166 - S166, 英語

    [査読有り]

  • 当院における脾動脈瘤に対する動脈塞栓術の治療成績

    岡田 卓也, 佐々木 康二, Hamada Mostafa, 堀之内 宏樹, 元津 倫幸, 上嶋 英介, 祖父江 慶太郎, 山口 雅人, 杉本 幸司, 村上 卓道

    (一社)日本脈管学会, 2019年10月, 脈管学, 59 (Suppl.), S140 - S140, 日本語

    [査読有り]

  • Iliac Branch Endoprosthesisを用いたステントグラフト内挿術の初期成績

    元津 倫幸, 山口 雅人, Hamada Mostafa, 佐々木 康二, 堀之内 宏樹, 上嶋 英介, 岡田 卓也, 祖父江 慶太郎, 後竹 康子, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次, 杉本 幸司, 村上 卓道

    (一社)日本脈管学会, 2019年10月, 脈管学, 59 (Suppl.), S175 - S175, 日本語

    [査読有り]

  • 腎障害患者におけるヨード造影剤使用に関するガイドライン2018

    猪阪 善隆, 林 宏光, 青沼 和隆, 斎藤 能彦, 平山 篤志, 室原 豊明, 桑鶴 良平, 粟井 和夫, 村上 卓道, 菅野 義彦, 小松 康宏, 藤垣 嘉秀, 堀尾 勝, 佐藤 明, 高山 忠輝, 渡邉 真言, 石井 秀樹, 村上 隆介, 柳生 行伸, 藤榮 博史, 尾田 済太郎, 寺田 典生, 安田 日出夫, 常喜 信彦, 小川 智也, 林 宏樹, 藤倉 知行, 佐藤 太一, 土井 研人, 宮内 隆政, 伊藤 雄伍, 宮沢 亮, 古志 衣里, 小杉 智規, 安田 宜成, 興梠 征典, 鳴海 善文, 対馬 義人, 木村 剛, 玉木 長良, 島袋 朋子, 「腎障害患者におけるヨード造影剤使用に関するガイドライン」作成委員会, 日本腎臓学会, 日本医学放射線学会, 日本循環器学会

    (一社)日本腎臓学会, 2019年10月, 日本腎臓学会誌, 61 (7), 933 - 1081, 日本語

  • Kudo M, Ikeda M, Ueshima K, Sakamoto M, Shiina S, Tateishi R, Hasegawa K, Furuse J, Miyayama S, Murakami T, Yamashita T, Kokudo N

    Response Evaluation Criteria in Solid Tumors (RECIST) is inappropriate to assess the direct effects of treatment on hepatocellular carcinoma (HCC) by locoregional therapies, such as radiofrequency ablation and transarterial chemoembolization. Therefore, establishment of response evaluation criteria solely devoted to HCC is needed in clinical practice, as well as in clinical trials of HCC treatment, such as systemic therapies, which cause necrosis of the tumor. Response Evaluation Criteria in Cancer of the Liver (RECICL) was revised in 2019 by the Liver Cancer Study Group of Japan based on the 2015 version of RECICL, which was commonly used in Japan. The major revised points of the RECICL 2019 are as follows: (i) CEA and CA19-9 have been newly added as tumor markers that should be recorded for use as criteria in the response evaluation for intrahepatic cholangiocarcinoma; (ii) the criteria now state that the details of molecular targeted therapy should be specified; and (iii) specific methods for overall evaluation are now described. Also, as an assessment of overall TE4 requires that TE4 is achieved in all nodules (even non-target lesions), the same calculation methods described above are used. We hope this new treatment response criteria, RECICL, proposed by the Liver Cancer Study Group of Japan will benefit the HCC treatment response evaluation in the setting of daily clinical practice and clinical trials as well, not only in Japan, but also internationally.

    2019年09月, Hepatology Research, 49 (9), 981 - 989, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 直腸静脈瘤に対して上直腸静脈直接穿刺法で塞栓術を行った1例

    元津 倫幸, 岡田 卓也, 小出 裕, 佐々木 康二, Hamada M.A.S., 堀之内 宏樹, 谷 龍一郎, 上嶋 英介, 祖父江 慶太郎, 山口 雅人, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2019年09月, 日本インターベンショナルラジオロジー学会雑誌, 34 (1), 79 - 79, 日本語

    [査読有り]

  • 奇静脈弓経由でカテーテル塞栓術を施行し得た食道静脈瘤の1例

    岡崎 仁志, 伊崎 健太, 木下 知恵子, 酒井 英郎, 白川 裕, 尹 聖哲, 杉本 幸司, 村上 卓道

    (公社)日本医学放射線学会, 2019年09月, 日本医学放射線学会秋季臨床大会抄録集, 55回, S515 - S515, 日本語

  • 特発性孤立性SMA解離に対するステント留置直後に遠位閉塞をきたした1例

    木下 めぐ美, 川崎 竜太, 丸山 晃司, 清家 翔平, 野村 佳克, 長谷川 翔大, 辻本 貴紀, 松森 正術, 村上 博久, 田中 裕史, 向原 伸彦, 杉本 幸司, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2019年09月, 日本インターベンショナルラジオロジー学会雑誌, 34 (1), 81 - 81, 日本語

  • Ueno Y, Takeuchi M, Tamada T, Sofue K, Takahashi S, Kamishima Y, Hinata N, Harada K, Fujisawa M, Murakami T

    A Vesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric magnetic resonance imaging (mp-MRI) was developed to provide accurate information for the diagnosis of muscle-invasive bladder cancers (MIBCs). In this study we evaluated the interobserver agreement and diagnostic performance of VI-RADS. We retrospectively evaluated data for 74 consecutive patients with bladder cancer who had undergone mp-MRI before transurethral resection in a single institution from January 2010 to August 2018. Five readers assessed the probability of the presence of MIBC using VI-RADS scores. The interobserver agreement was assessed by measuring intraclass correlation coefficients (ICCs). Receiver operating characteristic (ROC) analysis was used to evaluate the MIBC diagnostic performance. The area under the ROC curve (AUC) was estimated for ordinal score assessments. Our study demonstrated that interobserver agreement was excellent among five readers (ICC 0.85, 95% confidence interval 0.80-0.89) and the diagnostic performance of VI-RADS was represented as a pooled AUC of 0.90 (95% confidence interval 0.87-0.93). PATIENT SUMMARY: We evaluated the interobserver agreement and diagnostic performance of a new scoring system based on magnetic resonance imaging called a Vesical Imaging-Reporting and Data System (VI-RADS) for muscle-invasive bladder cancer. Our results indicate that VI-RADS is suitable as a comprehensive tool for appropriate treatment planning for patients with bladder cancer.

    2019年07月, European urology, 76 (1), 54 - 56, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Maruyama K, Sofue K, Okada T, Koide Y, Ueshima E, Iguchi G, Tani R, Gentsu T, Horinouchi H, Sasaki K, Yamaguchi M, Sugimoto K, Murakami T

    PURPOSE: To evaluate the advantages of intraprocedural CT during adrenal venous sampling (AVS) to confirm accurate catheterization of the right adrenal vein (RAV). MATERIALS AND METHODS: This single-institution study included 106 patients (mean age 52.4 years; range 28-74 years) with primary aldosteronism who performed contrast-enhanced CT (CECT) before AVS following AVS between January 2011 and March 2018. After catheterization of the RAV under fluoroscopic guidance, unenhanced CT images were obtained to confirm catheter position on unified CT angiography system. Catheter repositioning was performed when the catheter was inaccurately positioned. Venography findings were classified into two groups: (1) presumably cannulated in the RAV (presumed RAV group) and (2) obscured visualization of the RAV because of collateral vessels (obscured RAV group). Success rates of AVS were compared using Fisher's exact test. RESULTS: The overall success of AVS was achieved in 104 patients (98.1%). Catheter was deviated into the IVC during intraprocedural CT in four patients. Fourteen patients (14.0%) required catheter repositioning by intraprocedural CT images, and accurate catheterization in the RAV was eventually accomplished. The success rate of AVS was significantly higher in the presumed RAV group (90.1% [73/81]) than that in the obscured RAV group (68.4% [13/19]) (p = 0.024). If intraprocedural CT was not acquired during AVS, the success rate of AVS would have been significantly lower (84.9% [90/106]) compared with that use of intraprocedural CT (98.1% [104/106]) (p < 0.001). CONCLUSIONS: Intraprocedural unenhanced CT by referring to the preprocedural CECT before AVS enables the confirmation of accurate catheterization of the RAV. LEVEL OF EVIDENCE: Level 4, case series.

    2019年04月, Cardiovascular and interventional radiology, 42 (4), 542 - 551, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Zeng F, Nogami M, Okunaga T, Kubo K, Murakami T

    2019年04月, Japanese Archive, Cases Conference of Clinical Nuclear Medicine (NMJ), 1, 13 - 16, 英語

    [査読有り]

    研究論文(大学,研究機関等紀要)

  • Tani R, Sofue K, Sugimoto K, Katayama N, Hamada Mostafa A.S, Maruyama K, Horinouchi H, Gentsu T, Ueshima E, Koide Y, Okada T, Yamaguchi M, Murakami T

    PURPOSE: To assess the safety and efficacy of transarterial embolization (TAE) and to evaluate the utility of contrast-enhanced computed tomography (CE-CT) for life-threatening spontaneous retroperitoneal hemorrhage (SRH). METHODS: Nineteen patients underwent TAE following CE-CT for life-threatening SRH. CE-CT and angiographic findings, technical successes, and clinical successes were evaluated. The diagnostic performance of CE-CT for the detection of active bleeding arteries was also assessed by two independent readers. RESULTS: Active extravasation of contrast material was accurately observed in 78.9‒84.2% of the patients on CE-CT. Angiograms revealed active extravasation in 37 arteries of 15 patients (78.9%), and 4 patients showed no sign of active bleeding. Sensitivity, positive predictive value, and accuracy rate of CE-CT for the detection of active bleeding vessels was 59.5%, 62.9‒71.0% and 55.6‒60.0% respectively. The successful embolization of 48 intended arteries was achieved in all the patients, including empirical TAE in four patients. Hemodynamic stabilization was achieved in 17 patients (89.5%) with a significant decrease in transfusion (p < 0.001). CONCLUSION: TAE is a technically safe and clinically effective treatment method for life-threatening SRH. CE-CT has moderate capability for accurate identification of active bleeding arteries. TAE including arteries that potentially distribute anatomic territory of the hematoma is essential.

    2019年04月, Japanese journal of radiology, 37 (4), 328 - 335, 英語, 国内誌

    [査読有り]

    研究論文(学術雑誌)

  • Gentsu T, Okada T, Yamaguchi M, Horinouchi H, Katayama N, Ueshima E, Koide Y, Sofue K, Gotake Y, Nomura Y, Tanaka H, Okita Y, Sugimoto K, Murakami T

    PURPOSE: To evaluate the incidence of type II endoleak (EL-II) and aneurysm enlargement after endovascular aneurysm repair (EVAR) using the Endurant stent graft in patients with abdominal aortic aneurysm (AAA) with occluded inferior mesenteric artery (IMA). MATERIALS AND METHODS: Between 2012 and 2017, 103 patients who underwent EVAR using the Endurant stent graft for AAA with occluded IMA (50 patients with prophylactic embolized IMA and 53 with spontaneous occluded IMA) were retrospectively reviewed. The incidence of EL-II and aneurysm enlargement was evaluated. Predictive factors for persistent EL-II were evaluated based on patient characteristics, preprocedural anatomical characteristics, intraprocedural details, and postprocedural complications. RESULTS: Incidence rates of early EL-II and persistent EL-II were 6.8% (7/103 patients) and 4.9% (5/103 patients), respectively. Aneurysm enlargement was found in 10 patients (9.7%), including all 5 patients with persistent EL-II, 3 with de novo EL-II, and 2 with no EL-II. The rates of freedom from aneurysm enlargement at 1, 2, and 3 years were 98.7%, 97.0%, and 93.1% for the group without persistent EL-II, and 80.0%, 60.0%, and 20.0% for the group with persistent EL-II (p < 0.001), respectively. The maximum aneurysm diameter (odds ratio (OR), 1.16; 95% confidence interval (CI), 1.01-1.34; p = 0.0362) and the number of patent lumbar arteries (OR, 2.72; 95% CI, 1.07-6.90; p = 0.0357) were predictive of persistent EL-II. CONCLUSIONS: The incidence of EL-II after EVAR using the Endurant stent graft for AAA with occluded IMA was low, but most early EL-II persisted and resulted in aneurysm enlargement. Level of Evidence Level 4, Case Series.

    2019年04月, Cardiovascular and interventional radiology, 42 (4), 505 - 512, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • 透析に合併したびまん性肺胞隔壁型アミロイドーシスの1例

    浜川 岳文, 松木 充, 鈴木 絢子, 土居 秀平, 沼本 勲男, 小田 晃義, 小塚 健倫, 村上 卓道

    (公社)日本医学放射線学会, 2019年02月, Japanese Journal of Radiology, 37 (Suppl.), 40 - 40, 日本語

  • Yamamuro M, Asai Y, Yamada K, Ozaki Y, Matsumoto M, Murakami T

    Springer Science and Business Media LLC, 2019年01月, Medical Biological Engineering Computing, 57 (1), 289 - 298

    [査読有り]

    研究論文(学術雑誌)

  • 曽 菲比, 野上 宗伸, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2019年, 核医学, 56 (1), 155 - 155, 日本語

  • 野上 宗伸, 曽 菲比, 久保 和広, 村上 卓道

    (一社)日本核医学会, 2019年, 核医学, 56 (1), 155 - 155, 日本語

  • Sofue K, Itoh T, Takahashi S, Schmidt B, Shimada R, Negi N, Sugimura K, Murakami T

    2018年11月, Investigative Radiology, 53 (11), 673 - 680, 英語

    [査読有り][招待有り]

    研究論文(学術雑誌)

  • Motosugi U, Murakami T, Lee JM, Fowler KJ, Heiken JP, Sirlin CB, LI-RADS HBA Working Group

    2018年11月, J Magn Reson Imaging, 48 (5), 1169 - 1171

    [査読有り]

  • Sofue K, Tsurusaki M, Mileto A, Hyodo T, Sasaki K, Nishi T, Chikugo T, Yada N, Kudo M, Sugimura K, Murakami T

    AIM: To investigate whether iodine density measurements from contrast-enhanced dual-energy computed tomography (CT) data can non-invasively stage liver fibrosis. METHODS: This single-center, prospective study was approved by our IRB with written informed consent. Forty-seven consecutive patients (26 men and 21 women; mean age, 63.1 years) with chronic liver disease underwent contrast-enhanced dual-energy CT of the liver (non-contrast, arterial, portal venous, and equilibrium phase images), followed by liver biopsy. Iodine density of liver and aorta were obtained by two independent observers. Iodine uptake of the liver (Δ Liver), representing the difference in iodine density between equilibrium phase and non-contrast images, was calculated and normalized by aorta (Δ Liver/Aorta). We accounted for contrast agent distribution volume by using hematocrit level. Accuracy of iodine density measurements for staging liver fibrosis was assessed by using receiver operating characteristic (ROC) curves. Multivariate linear regression analysis was used to assess the impact of independent variables (liver fibrosis stage and patient-related confounders) on iodine uptake. RESULTS: The Δ Liver/Aorta significantly increased and moderately correlated with METAVIR liver fibrosis stage (ρ = 0.645, P < 0.001). Areas under the ROC curve ranged from 0.795 to 0.855 for discriminating each liver fibrosis score (≥F1-F4). METAVIR fibrosis stage was the most significant independent factor associated with Δ Liver (P = 0.005) and Δ Liver/Aorta (P < 0.001). CONCLUSION: Hepatic extracellular volume fraction with contrast-enhanced dual-energy CT can non-invasively stage liver fibrosis in chronic liver diseases. This technique could prove useful for monitoring disease progression and treatment response, potentially reducing the need for liver biopsy.

    2018年11月, Hepatology Research, 48 (12), 1008 - 1019, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Ueno YR, Tamada T, Takahashi S, Tanaka U, Sofue K, Kanda T, Nogami M, Ohno Y, Hinata N, Fujisawa M, Murakami T

    2018年09月, Korean J Radiol, 19 (5), 832 - 837, 英語

    [査読有り][招待有り]

    研究論文(学術雑誌)

  • Tsurusaki M, Oda T, Sofue K, Numoto I, Yagyu Y, Kashiwagi N, Murakami T

    British Institute of Radiology, 2018年09月, The British Journal of Radiology, 91 (1092), ePub ahead of print - 20180124, 英語

    [査読有り][招待有り]

    研究論文(学術雑誌)

  • Kanda T, Wakabayashi Y, Zeng F, Ueno Y, Sofue K, Maeda T, Nogami M, Murakami T

    2018年09月, Jpn J Radiol, 36 (9), 519 - 527, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 縦隔発生の骨外性骨肉腫の一例

    岸田 雄治, 大野 良治, 関 紳一郎, 神保 直江, 伊藤 智雄, 田中 雄悟, 真庭 謙昌, 村上 卓道

    (公社)日本医学放射線学会, 2018年09月, 日本医学放射線学会秋季臨床大会抄録集, 54回, S523 - S523, 日本語

    [査読有り]

  • Hayato Kaida, Koichi Azuma, Akihiko Kawahara, Eiji Sadashima, Satoshi Hattori, Shinzo Takamori, Jun Akiba, Kiminori Fujimoto, Axel Rominger, Takamichi Murakami, Kazunari Ishii, Masatoshi Ishibashi

    Introduction: To assess the correlation among 18F-FDG uptake, Glut1, pStat1 and pStat3, and to investigate the relationship between the prognosis and 18F-FDG uptake and these molecular markers in surgically resected non-small cell lung cancer (NSCLC) patients. Results: Knockdown of Glut1 led to a significant increase in pStat1 expression. Glut1 expression positively correlated with the SUVmax, SUVmean, and TLG significantly (P<0.001). pStat3 expression negatively correlated with all PET parameters significantly (P<0.001). pStat1 had positive weak correlations with the SUVmax and SUVmean. All PET parameters and Glut1 were significantly associated with DFS (P<0.05). TLG, MTV, Glut1 and pStat1 were significantly associated with OS (P<0.05). Conclusion: pStat3 and Glut1 may be associated with 18F-FDG uptake mechanism. TLG, MTV, and Glut1 may be independent prognostic factors. Methods: The SUVmax, SUVmean, MTV and TLG of primary lesions were calculated in 140 patients. The expressions of Glut1 and Stat pathway proteins in NSCLC cell lines were examined by immune blots. Excised tumor tissue was analyzed by immunohistochemistry. OS and DFS were evaluated by the Kaplan-Meier method. The difference in survival between subgroups was analyzed by log-rank test. The prognostic significance of clinicopathological, molecular and PET parameters was assessed by Cox proportional hazard regression analysis.

    2018年08月10日, Oncotarget, 9 (62), 31971 - 31984, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Yuichi Wakabayashi, Ryuichi Takahashi, Tomonori Kanda, Feibi Zeng, Munenobu Nogami, Kazunari Ishii, Takamichi Murakami

    PURPOSE: We developed a new analytical method to quantify the dopamine transporter (DAT) radiation dose in the striatum on [123I] FP-CIT single-photon emission computed tomography (SPECT). This method is based on the dopamine transporter standardized uptake value (DaTSUV). The purpose of this study was to compare DaTSUV with the classical specific binding ratio (SBR) in the discrimination of dopaminergic neurodegenerative diseases (dNDD) from non-dNDD. METHOD: Seventy-seven consecutive patients who underwent DaTscan were included. Patients were divided into a dNDD group (n = 44; 24 men, 20 women; median age 73 years) and a non-dNDD group (n = 33; 14 men, 19 women; median age 75 years) based on their clinical diagnoses. The relationship between each method was evaluated by Pearson's correlation coefficient. Differences in SBR and DaTSUV in each group were evaluated by t test. Pairwise comparison of receiver operating characteristic (ROC) curve analysis was performed to compare the discriminating abilities of each method according to the standard error of the area under the curve (AUC). A value of p < 0.05 was considered statistically significant. RESULT: There was a significant strong correlation between DaTSUV and SBR (r = 0.910 [95% CI = 0.862-0.942], p < 0.001). The dNDD group showed significantly lower SBR (3.48 [1.25-7.91] vs 6.58 [3.81-11.1], p < 0.001) and DaTSUV (4.91 [1.59-13.6] vs 8.61 [2.29-15.6], p < 0.001) than the non-dNDD group. The discriminating ability of SBR (AUC = 0.918) was significantly higher than that of DaTSUV (AUC = 0.838, p = 0.0176). CONCLUSION: DaTSUV has a good correlation with SBR, but it could not exceed SBR for discriminating dNDD from non-dNDD.

    2018年08月, Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 39 (8), 1401 - 1407, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Nobuo Kashiwagi, Shin Ichi Nakatsuka, Takamichi Murakami, Eisuke Enoki, Kazuhiro Yamamoto, Katsuyuki Nakanishi, Takaaki Chikugo, Yoshitaka Kurisu, Masatomo Kimura, Tomoko Hyodo, Akio Tsukabe, Takahide Kakigi, Yasuhiko Tomita, Kazunari Ishii, Yoshifumi Narumi, Yukinobu Yagyu, Noriyuki Tomiyama

    OBJECTIVES: To report MR imaging features of mammary analogue secretory carcinoma (MASC) and acinic cell carcinoma (AciCC) of the salivary gland based on the latest version of the World Health Organization (WHO) 2017 classification of head and neck tumours. METHODS: MR images in 4 patients with MASC and 4 with AciCC were reviewed for margin characteristics, the presence of pathological cervical nodes, the presence of a cystic component and interface between cystic and solid component, signal intensity of the cystic components on T1 weighted images, and signal intensity of the solid component on T1 and T2 weighted images. RESULTS: All the MASCs and AciCCs had well-defined boundaries, and 1 AciCC had pathological nodes. All 4 MASCs presented as predominantly cystic tumours with papillary projection of the solid component. All 4 AciCCs presented as solid tumours. The signal intensity of the cystic components on T1 weighted images was entirely hyperintense in 2, and partly hyperintense demonstrating fluid-fluid level in 2. In all the MASCs, the signal intensity of the solid components on T1 weighted images was intermediate. In the AciCCs, the signal intensity of the solid components on T1 weighted images was high in 2 tumours and intermediate in 2. The signal intensity of the solid components on T2 weighted images varied from low to high in both MSACs and AciCCs. CONCLUSIONS: All 4 MASCs had a large cystic component, including areas of high signal intensity on T1 weighted images. The solid component appeared as a papillary projection into the cystic component. All 4 AciCCs presented as solid tumours, 2 of which showed high signal intensity on T1 weighted images.

    2018年07月, Dento maxillo facial radiology, 47 (5), 20170218 - 20170218, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Julia Sauerbeck, Kazunari Ishii, Chisa Hosokawa, Hayato Kaida, Franziska T Scheiwein, Kohei Hanaoka, Axel Rominger, Matthias Brendel, Peter Bartenstein, Takamichi Murakami

    PURPOSE: In subjects with amyloid deposition, striatal accumulation of 11C-Pittsburgh compound B (PiB) demonstrated by positron emission tomography (PET) is related to the stage of Alzheimer's disease (AD). In this study, we investigated the correlation between striatal and cortical non-displaceable binding potential (BPND). METHODS: Seventy-three subjects who complained of cognitive disturbance underwent dynamic PiB-PET studies and showed positive PiB accumulation were retrospectively selected. These subjects included 34 AD, 26 mild cognitive impairment, 2 frontotemporal lobar degeneration, 2 Parkinson's disease, 5 dementia with Lewy bodies, and 4 undefined diagnosis patients. Individual BPND images were produced from the dynamic data of the PiB-PET study, and voxel-based analyses were performed to estimate the correlations between striatal and other regional cortical BPND measures. RESULTS: There were highly significant correlations between striatal and prefrontal BPND, with the highest correlation being demonstrated in left Brodmann area 11. We found that almost all of the high cortical BPND values correlated with striatal BPND values, with the exception of the occipital cortex with low correlation. CONCLUSION: Our study demonstrated positive correlations in amyloid deposits between the striatum and other cortical areas with functional and anatomical links. The amyloid distribution in the brain is not random, but spreads following the functional and anatomical connections.

    2018年07月, Annals of nuclear medicine, 32 (6), 398 - 403, 英語, 国内誌

    [査読有り]

    研究論文(学術雑誌)

  • Sofue K, Itoh T, Takahashi S, Schmidt B, Shimada R, Negi N, Sugimura K, Murakami T

    2018年06月, Investigative Radilogy, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Feibi Zeng, Munenobu Nogami, Taiichiro Shirai, Yoh Zen, Takamichi Murakami

    Iron overload is a major complication in blood transfusion procedures. This report presents a case of malignant lymphoma, in which the findings of bone marrow involvement were discordant between 18F-FDG PET imaging studies and MRI with diffusion-weighted imaging studies. In this case, the PET imaging studies were positive for malignant lymphoma, whereas the MRI studies were negative. Iron deposition in the reticuloendothelial system due to posttransfusion iron overload was considered to be the cause of the decrease in signal intensity on diffusion-weighted imaging, resulting in a false-negative finding on MRI.

    Lippincott Williams and Wilkins, 2018年05月01日, Clinical Nuclear Medicine, 43 (5), 361 - 362, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasunori Minami, Tomohiro Minami, Satoru Hagiwara, Hiroshi Ida, Kazuomi Ueshima, Naoshi Nishida, Takamichi Murakami, Masatoshi Kudo

    Objectives: To assess the clinical feasibility of US-US image overlay fusion with evaluation of the ablative margin in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods: Fifty-three patients with 68 HCCs measuring 0.9–4.0 cm who underwent RFA guided by US-US overlay image fusion were included in this retrospective study. By an overlay of pre-/postoperative US, the tumor image could be projected onto the ablative hyperechoic zone. Therefore, the ablative margin three-dimensionally could be shown during the RFA procedure. US-US image overlay was compared to dynamic CT a few days after RFA for assessment of early treatment response. Accuracy of graded response was calculated, and the performance of US-US image overlay fusion was compared with that of CT using a Kappa agreement test. Results: Technically effective ablation was achieved in a single session, and 59 HCCs (86.8 %) succeeded in obtaining a 5-mm margin on CT. The response with US-US image overlay correctly predicted early CT evaluation with an accuracy of 92.6 % (63/68) (k = 0.67 95 % CI: 0.39–0.95). Conclusion: US-US image overlay fusion can be proposed as a feasible guidance in RFA with a safety margin and predicts early response of treatment assessment with high accuracy. Key points: • US-US image overlay fusion visualizes the ablative margin during RFA procedure. • Visualizing the margin during the procedure can prompt immediate complementary treatment. • US image fusion correlates with the results of early evaluation CT.

    Springer Verlag, 2018年05月01日, European Radiology, 28 (5), 1986 - 1993, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hayato Kaida, Koichi Azuma, Uhi Toh, Akihiko Kawahara, Eiji Sadashima, Satoshi Hattori, Jun Akiba, Nobuhiro Tahara, Axel Rominger, Kazunari Ishii, Takamichi Murakami, Masatoshi Ishibashi

    Objective: To assess the correlations between dual-phase uorine-18 uorodeoxyglucose (18F-FDG) uptake and clinicopathological and immunohistochemical prognostic factors in patients with surgically resected breast cancer stage I-III. Subjects and Methods: We retrospectively analyzed the cases of 105 patients. We calculated the maximum standardized uptake value (SUVmax) at 85min (SUV1), SUVmax at 125min (SUV2) and the retention index [RI]. Spearman's rank correlation test, the Kruskal-Wallis test and receiver operating characteristic (ROC) analysis were performed to assess the association between 18F-FDG uptake and the clinicopathological and immunohistochemical factors: glucose transporter-1 (Glut-1), estrogen receptor alpha (ERα), ERβ, progesterone receptor (PR), human epidermal growth factor 2 (Her2), mammalian target of rapamycin (mTOR), and P70S6kinase (P70S6). Results: The SUV1 and SUV2 values were correlated with Glut-1, pathological tumor size, ERα negativity, and pathological stage (all P values were < 0.05), but not with mTOR, P70S6, ERβ, PR, Her2 or other factors. The SUV1 and SUV2 in the triple negative subtype were signi-cantly higher than those of the hormone receptor-positive subtype (P< 0.05). The RI was associated with pathological tumor size alone. In the ROC analysis of Glut-1, the areas under the curve for SUV1 and SUV2 were signicantly larger than for RI (SUV1, P=0.032, SUV2, P=0.022). Conclusion: Glucose transporter-1, estrogen receptor alpha negativity and nuclear grade might affect the high 18F-FDG uptake in breast cancer. The SUVmax might be more useful than the RI for predicting the Glut-1 expression and the aggressiveness of breast cancer.

    P.Ziti and Co, 2018年01月01日, Hellenic Journal of Nuclear Medicine, 21 (1), 35 - 42, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Kaida H, Ishii K, Hanada S, Tohda Y, Murakami T

    A 78-year-old man had fever, persistent wheezing, and serum C-reactive protein elevation. Malignant lymphoma was suspected because of mediastinal lymph nodes swelling on CT and soluble interleukin 2 receptor elevation. Symmetric F-18-FDG uptake in the tracheobronchial tree and bilateral auricles was observed on PET/CT. He was finally diagnosed as having relapsing polychondritis by auricular cartilage biopsy. F-18-FDG PET/CT may have crucial role in evaluating the extent of inflammation and deciding the biopsy site of relapsing polychondritis.

    LIPPINCOTT WILLIAMS & WILKINS, 2018年01月, Clinical Nuclear Medicine, 43 (1), 25 - 27, 英語

    [査読有り]

  • Fukui H, Kashiwagi N, Murakami T, Watanabe Y, Hyodo T, Ishii K, Yamakawa M, Takahashi H, Tomiyama N

    The infraorbital canal (IOC), which runs in the roof of the maxillary sinus, is a useful anatomical landmark for the infraorbital nerve (ION) on computed tomography (CT) images. Enlargement of the IOC on CT images is thought to be a pathological state that usually affects the ION. However, we have frequently observed enlargement of the IOC in patients with a history of radical surgery of the maxillary sinus: so-called Caldwell-Luc (CL) surgery. In this study, the size of the IOC of the maxillary sinus was compared between patients with a history of CL surgery (post-CL IOCs) and those with no history of CL surgery (control IOCs). A total of 347 consecutive patients who underwent facial CT from January 2014 to October 2014 for various indications were evaluated. After excluding groove-type IOCs and IOCs with pathological lesions that could affect their diameters, 47 post-CL IOCs in 26 patients were finally compared with 504 control IOCs in 252 patients. To evaluate IOC size, the short-axis diameter of the IOC was measured on a reconstructed coronal image at the level of the posterior pole of the eyeball. The short-axis diameters of the post-CL IOCs and control IOCs were 3.0 +/- 0.6 and 1.4 +/- 0.3 mm, respectively (p < 0.005). The short-axis diameters of post-CL IOCs are significantly enlarged (approximately double the diameter) compared to those of control IOCs.

    SPRINGER, 2017年09月, Jpn J Radiol, 35 (9), 532 - 538, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Volumetric parameterを用いた食道癌切除患者の予後因子の検討

    甲斐田 勇人, 石井 一成, 細川 知紗, 柳生 行伸, 任 誠雲, 兵頭 朋子, 山田 穣, 細野 眞, 安田 卓司, 村上 卓道

    (一社)日本核医学会, 2017年09月, 核医学, 54 (Suppl.), S193 - S193, 日本語

  • Hasegawa H, Ashikaga R, Okajima K, Wakayama T, Miyoshi M, Nishimura Y, Murakami T

    Purpose This study aimed to compare the detectability of neoplastic lesion enhancement after gadolinium-based contrast media injection in three-dimensional T1-weighted black blood Cube (3D-T1W BB Cube) and three-dimensional T1-weighted fast spoiled gradient-echo (3D-T1W fast SPGR) images obtained with 1.5-T magnetic resonance imaging (MRI). Materials and methods Phantom and clinical studies were performed to compare the lesion detectability and contrast ratio (CR) between 3D-T1W BB Cube and 3D-T1W fast SPGR pulse sequences. Results In the phantom study, the CRs for 3D-T1W BB Cube and 3D-T1W fast SPGR were equivalent at low gadolinium concentrations (0.125-1.25 mmol/l). In the clinical study, the detectability in the two modalities was similar for enhanced lesions >= 5 mm, but was significantly better in 3D-T1W BB Cube for lesions <5 mm (p = 0.011). Similarly, the CRs in both modalities were similar for lesions >= 5 mm (0.66 +/- 0.36 vs. 0.56 +/- 0.30, p = 0.153), but significantly lower in 3D-T1W BB Cube images for lesions <5 mm ( 0.29 +/- 0.19 vs. 0.39 +/- 0.21, p = 0.006). Conclusions Contrast 3D-T1W BB Cube imaging appears more sensitive than 3D-T1W fast SPGR imaging for detecting neoplastic lesion enhancement in the clinical setting using a 1.5-T MRI scanner, particularly for lesions <5 mm in diameter.

    SPRINGER, 2017年08月, Jpa J Radiol, 35 (8), 463 - 471, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Shimomura K, Araki F, Kono Y, Asai Y, Murakami T, Hyodo T, Okamura M, Matsumoto K, Monzen H, Nishimura Y

    The purpose of this study was to obtain the fraction by weight of the elemental composition and mass density of a humanoid tissue phantom that includes lung tissue, soft tissue, and bone tissue, by using dual energy computed tomography (DECT). The fraction by weight and the mass density for tissue-equivalent materials were calculated by means of a least-squares method with a linear attenuation coefficient, using monochromatic photon energies of 10-140keV, as obtained from DECT. The accuracy of calculated values for the fractions by weight of H (hydrogen), C (carbon), N (nitrogen), and O (oxygen) as verified by comparing the values with those that were analyzed using the combustion technique. The fraction by weight for other elements was confirmed by comparing with the analyzed values by means of energy dispersive photon spectroscopy. The calculated mass densities for each tissue were compared with those that were obtained by dividing the weight by volume. The calculated values of the fraction by weight that were obtained by means of DECT had differences of 1.9%, 9.2%, 6.6%, 7.8%, 0.8%, and 0.2% at a maximum for H, C, N, O, P (phosphorus), and Ca (calcium), respectively, from the reference values analyzed by the combustion technique and energy dispersive photon spectroscopy. The difference in the mass density for tissue was 0.011g/cm3 at a maximum. This study demonstrated the fraction by weight and the mass density of the humanoid tissue-equivalent materials that were calculated by means of DECT were expected high accuracy.

    2017年07月, Phys Med, 39, 59 - 66, 英語, 国際誌

    [査読有り]

    研究論文(学術雑誌)

  • Masafumi Toguchi, Masakatsu Tsurusaki, Norihisa Yada, Keitaro Sofue, Tomoko Hyodo, Minori Onoda, Isao Numoto, Mitsuru Matsuki, Izumi Imaoka, Masatoshi Kudo, Takamichi Murakami

    Purpose: To evaluate the quantitative measurement of liver stiffness (LS), compare the diagnostic performance of magnetic resonance elastography (MRE) and ultrasound-based transient elastography (TE), and evaluate two different MRE-based LS measurement methods. Methods: Between October 2013 and January 2015, 116 consecutive patients with chronic liver disease underwent MRE to measure LS (kilopascals; kPa). Of the 116 patients, 51 patients underwent both TE and liver biopsy, and the interval between the liver biopsy and both the MRE and TE was less than 90 days. MRE-derived LS values were measured on the anterior segment of the right lobe (single small round regions of interest per slice; srROIs) and whole right lobe of the liver (free hand region of interest; fhROI), and these values were correlated with pathological fibrosis grades and diagnostic performance. Results: Pathological fibrosis stage was significantly correlated with srROIs (r = 0.87, p < 0.001), fhROI (r = 0.80, p < 0.001), and TE (r = 0.73, p < 0.001). For detection of significant fibrosis (>= F2), advanced fibrosis (>= F3), and cirrhosis, the area under the curve (AUC) associated with the srROIs was largest, and there was a significant difference between srROIs and TE (0.93 vs. 0.82, p = 0.006), srROIs and fhROI (0.93 vs. 0.89, p = 0.04) for detection of >= F2. For advanced fibrosis and cirrhosis detection, AUCs were not significant (0.92-0.96). Conclusions: MRE and TE detected liver fibrosis with comparable accuracy. In particular, the srROIs method was effective for detecting of significant fibrosis.

    SPRINGER, 2017年06月, ABDOMINAL RADIOLOGY, 42 (6), 1659 - 1666, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Wakabayashi Y, Ishii K, Hosokawa C, Hyodo T, Kaida H, Yamada M, Yagyu Y, Tsurusaki M, Kozuka T, Sugimura K, Murakami T

    2017年05月, Kobe J Med Sci, 62 (5), E136 - E141

    [査読有り]

  • Nobuyuki Asato, Masakatsu Tsurusaki, Keitaro Sofue, Yoko Hieda, Takashi Katsube, Kazuhiro Kitajima, Takamichi Murakami

    Purpose To evaluate the diagnostic efficacy of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) vs. contrast-enhanced computed tomography (CE-CT) in the detection of liver metastasis in colorectal carcinoma patients. Materials and methods One-hundred fifty-eight consecutive patients with histopathologically confirmed colorectal carcinoma underwent EOB-MRI and CE-CT; 68 patients had 105 surgically confirmed liver metastases. Diagnostic analyses were performed according to sensitivity and positive predictive value (PPV) for liver metastasis detection in combined arterial- and hepatocyte-phase images vs. CE-CT by three readers blinded to clinical data. Diagnostic accuracy and sensitivity were evaluated using the alternative free-response receiver operating characteristic method. Results The overall sensitivity of EOB-MRI (91.4%) was significantly higher than that of CE-CT (80.9%, p < 0.001); the higher sensitivity of EOB-MRI was observed especially in smaller-sized lesions (73.3 vs. 56.0% for lesions <= 1 cm; 91.9 vs. 80.8% for lesions > 1 cm and <= 2 cm; 99.2 vs. 95.7% for lesions > 2 cm). EOB-MRI showed a significantly greater area under the receiver operating characteristic curve (Az value = 0.970) compared with CE-CT (Az value = 0.899, p < 0.01). Conclusion EOB-MRI provided higher detectability for liver metastases, especially for smaller-sized lesions, than CE-CT in patients with colorectal carcinoma.

    SPRINGER, 2017年04月, JAPANESE JOURNAL OF RADIOLOGY, 35 (4), 197 - 205, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomoko Hyodo, Norihisa Yada, Masatoshi Hori, Osamu Maenishi, Peter Lamb, Kosuke Sasaki, Minori Onoda, Masatoshi Kudo, Teruhito Mochizuki, Takamichi Murakami

    Purpose: To assess the clinical accuracy and reproducibility of liver fat quantification with the multimaterial decomposition (MMD) algorithm, comparing the performance of MMD with that of magnetic resonance (MR) spectroscopy by using liver biopsy as the reference standard. Materials and Methods: This prospective study was approved by the institutional ethics committee, and patients provided written informed consent. Thirty-three patients suspected of having hepatic steatosis underwent non-contrast material-enhanced and triple-phase dynamic contrast-enhanced dual-energy computed tomography (CT) (80 and 140 kVp) and single-voxel proton MR spectroscopy within 30 days before liver biopsy. Percentage fat volume fraction (FVF) images were generated by using the MMD algorithm on dual-energy CT data to measure hepatic fat content. FVFs determined by using dual-energy CT and percentage fat fractions (FFs) determined by using MR spectroscopy were compared with histologic steatosis grade (0-3, as defined by the nonalcoholic fatty liver disease activity score system) by using Jonck-heere-Terpstra trend tests and were compared with each other by using Bland-Altman analysis. Real non-contrast-enhanced FVFs were compared with triple-phase contrast-enhanced FVFs to determine the reproducibility of MMD by using Bland-Altman analyses. Results: Both dual-energy CT FVF and MR spectroscopy FF increased with increasing histologic steatosis grade (trend test, P <.001 for each). The Bland-Altman plot of dual-energy CT FVF and MR spectroscopy FF revealed a proportional bias, as indicated by the significant positive slope of the line regressing the difference on the average (P < .001). The 95% limits of agreement for the differences between real non-contrast- enhanced and contrast-enhanced FVFs were not greater than about 2%. Conclusion: The MMD algorithm quantifying hepatic fat in dual-energy CT images is accurate and reproducible across imaging phases. (C) RSNA, 2017

    RADIOLOGICAL SOC NORTH AMERICA, 2017年04月, RADIOLOGY, 283 (1), 108 - 118, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasunori Minami, Masahiro Takita, Masakatsu Tsurusaki, Yukinobu Yagyu, Kazuomi Ueshima, Takamichi Murakami, Masatoshi Kudo

    AimTo investigate whether plain cone-beam computed tomography (CT) immediately after conventional transcatheter arterial chemoembolization (c-TACE) can help to predict tumor response semiquantitatively in patients with hepatocellular carcinoma (HCC). MethodsAnalysis was carried out retrospectively on 262 targeted HCCs in 169 patients treated with c-TACE. Dynamic CT was performed at baseline and 1-4months after c-TACE. Receiver-operating characteristic curve analysis was undertaken to evaluate whether voxel values of cone-beam CT could predict a complete response and to identify the cut-off value. Final tumor response assessment and early prediction using the retention pattern of iodized oil, the cut-off value of the density, and the combination of the cut-off density value and retention pattern of iodized oil in HCCs on postprocedural cone-beam CT were compared. ResultsComplete response was obtained in 72.9% of lesions. According to the pattern of iodized oil uptake, the sensitivity, specificity, and accuracy for predicting complete response were 85.9%, 70.4%, and 81.7%, respectively by excellent uptake on cone-beam CT. The area under the curve was 0.86 with the optimal cut-off at a voxel value of 200.13. According to not only the density but also the homogeneity of iodized oil retention, the sensitivity, specificity, and accuracy values for predicting complete response were 86.4%, 95.8%, and 88.9%, respectively. The predictive accuracy was significantly better than that of the pattern of iodized oil retention only (P=0.019). ConclusionThe combination of density and visual estimate of homogeneity is superior to either alone in predicting tumor response of c-TACE in HCC patients.

    WILEY, 2017年03月, HEPATOLOGY RESEARCH, 47 (3), E113 - E119, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masafumi Toguchi, Masakatsu Tsurusaki, Isao Numoto, Syojiro Hidaka, Miho Yamakawa, Nobuyuki Asato, SungWoon Im, Yukinobu Yagyu, Mitsuru Matsuki, Yoshifumi Takeyama, Takamichi Murakami

    To evaluate the feasibility and safety of the Amplatzer vascular plug (AVP) for preoperative common hepatic embolization (CHA) before distal pancreatectomy with en bloc celiac axis resection (DP-CAR) to redistribute blood flow to the stomach and liver via the superior mesenteric artery (SMA). Four patients (3 males, 1 female; median age 69 years) with locally advanced pancreatic body cancer underwent preoperative CHA embolization with AVP. After embolization, SMA arteriography was performed to confirm the alteration of blood flow from the SMA to the proper hepatic artery. In three of four patients, technical successes were achieved with sufficient margin from the origin of gastroduodenal artery. In one patient, the margin was less than 5 mm, although surgery was successfully performed without any problem. Eventually, all patients underwent the DP-CAR without arterial reconstruction or liver ischemia. AVP application is feasible and safe as an embolic procedure for preoperative CHA embolization of DP-CAR.

    SPRINGER, 2017年03月, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 40 (3), 445 - 449, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomoko Hyodo, Masatoshi Hori, Peter Lamb, Kosuke Sasaki, Tetsuya Wakayama, Yasutaka Chiba, Teruhito Mochizuki, Takamichi Murakami

    Purpose: To assess the ability of fast-kilovolt-peak switching dualenergy computed tomography (CT) by using the multimaterial decomposition (MMD) algorithm to quantify liver fat. Materials and Methods: Fifteen syringes that contained various proportions of swine liver obtained from an abattoir, lard in food products, and iron (saccharated ferric oxide) were prepared. Approval of this study by the animal care and use committee was not required. Solid cylindrical phantoms that consisted of a polyurethane epoxy resin 20 and 30 cm in diameter that held the syringes were scanned with dual-and single-energy 64-section multidetector CT. CT attenuation on single-energy CT images (in Hounsfield units) and MMD-derived fat volume fraction (FVF; dual-energy CT FVF) were obtained for each syringe, as were magnetic resonance (MR) spectroscopy measurements by using a 1.5-T imager (fat fraction [ FF] of MR spectroscopy). Reference values of FVF (FVF ref) were determined by using the Soxhlet method. Iron concentrations were determined by inductively coupled plasma optical emission spectroscopy and divided into three ranges (0 mg per 100 g, 48.1-55.9 mg per 100 g, and 92.6-103.0 mg per 100 g). Statistical analysis included Spearman rank correlation and analysis of covariance. Results: Both dual-energy CT FVF (rho = 0.97; P < .001) and CT attenuation on single-energy CT images (rho = 20.97; P < .001) correlated significantly with FVF ref for phantoms without iron. Phantom size had a significant effect on dual-energy CT FVF after controlling for FVF ref (P < .001). The regression slopes for CT attenuation on single-energy CT images in 20-and 30-cm-diameter phantoms differed significantly (P = .015). In sections with higher iron concentrations, the linear coefficients of dual-energy CT FVF decreased and those of MR spectroscopy FF increased (P < .001). Conclusion: Dual-energy CT FVF allows for direct quantification of fat content in units of volume percent. Dual-energy CT FVF was larger in 30-cm than in 20-cm phantoms, though the effect of object size on fat estimation was less than that of CT attenuation on single-energy CT images. In the presence of iron, dual-energy CT FVF led to underestimateion of FVFref to a lesser degree than FF of MR spectroscopy led to overestimation of FVFref. (C) RSNA, 2016

    RADIOLOGICAL SOC NORTH AMERICA, 2017年02月, RADIOLOGY, 282 (2), 381 - 389, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Nobuo Kashiwagi, Eisuke Enoki, Chisa Hosokawa, Kenta Sakaguchi, Takamichi Murakami

    LIPPINCOTT WILLIAMS & WILKINS, 2017年02月, CLINICAL NUCLEAR MEDICINE, 42 (2), 131 - 132, 英語

    [査読有り]

  • H. Takahashi, K. Ishii, N. Kashiwagi, Y. Watanabe, H. Tanaka, T. Murakami, N. Tomiyama

    AIM: To evaluate the performance of apparent diffusion coefficient (ADC) mapping compared with voxel-based morphometry and to demonstrate the clinical usefulness of ADC mapping in the diagnosis of Alzheimer's disease (AD). MATERIALS AND METHODS: The study population comprised 31 patients with AD (group A) and 24 patients without dementia (group B) who underwent three-dimensional (3D) T1weighted imaging (WI) and two- dimensional (2D) echo-planar diffusion-weighted imaging (DWI) at 3 T. The volume and ADC of the regional grey matter (GM) in the bilateral hippocampi, precunei, and the anterior and posterior cingulate gyri were calculated using a voxelbased method for automatic segmentation of brain structures. The significance of intergroup differences in each volume and ADC of all regional GM was tested using analysis of variance (ANOVA) with Bonferroni correction. Intergroup regional GM differences in each volume and ADC were evaluated using statistical parametric mapping (SPM). RESULTS: In group A, the volumes of the precunei (mean value: group A/B = 18.93/21.48 cm(3)) and the anterior cingulate gyri (mean value: group A/B = 6.1/7.81 cm(3)) were significantly less than in group B (p < 0.05). The ADC in group A was significantly larger than that in group B in the bilateral hippocampi (mean value: group A/B = right 1020.79x10(6)/ 877.23x10(-6) mm(2)/s; left 1072.89x10(-6)/900.2x10(-6) mm(2)/s) and posterior cingulate gyri (mean value: group A/B = 1006.77x10-(6)/876.88x10(-6) mm(2)/s; p < 0.05). SPM showed that the areas of increased ADC were more extensive than the areas of decreased volume in the bilateral hippocampi, precunei, and posterior cingulate gyri in group A, compared with those in group B (p < 0.001). CONCLUSION: Evaluation of ADC mapping can quantify changes in brain water diffusivity and may improve the performance of automatic morphometric diagnosis of AD. 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

    W B SAUNDERS CO LTD, 2017年02月, CLINICAL RADIOLOGY, 72 (2), 108 - 115, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 捻転を呈した漿膜下子宮筋腫の2例

    浜川 岳文, 松木 充, 沼本 勲男, 小田 晃義, 福井 秀行, 兵頭 朋子, 任 誠雲, 柳生 行伸, 今岡 いずみ, 鶴崎 正勝, 石井 一成, 村上 卓道

    日本画像医学会, 2017年02月, Japanese Journal of Diagnostic Imaging, 35 (1), 96 - 96, 日本語

  • ANCA関連腎炎に合併した縦隔線維症の1例

    日高 正二朗, 小塚 健倫, 浜川 岳文, 福井 秀行, 渡口 真史, 山田 穣, 任 誠雲, 柏木 伸夫, 細川 知紗, 鶴崎 正勝, 今岡 いずみ, 松木 充, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2017年02月, Japanese Journal of Radiology, 35 (Suppl.), 48 - 48, 日本語

  • 膀胱子宮内膜症の経過を追った2例

    沼本 勲男, 今岡 いずみ, 若林 雄一, 藤谷 哲也, 山川 美穂, 兵頭 朋子, 甲斐田 勇人, 柳生 行伸, 熊野 正士, 鶴崎 正勝, 松木 充, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2017年02月, Japanese Journal of Radiology, 35 (Suppl.), 49 - 49, 日本語

  • 上顎洞術後変化としての眼窩下管拡大

    福井 秀行, 柏木 伸夫, 任 誠雲, 甲斐田 勇人, 柳生 行伸, 小塚 健倫, 細川 知紗, 熊野 正士, 鶴崎 正勝, 松木 充, 今岡 いずみ, 石井 一成, 細野 眞, 村上 卓道

    (公社)日本医学放射線学会, 2017年02月, Japanese Journal of Radiology, 35 (Suppl.), 54 - 54, 日本語

  • Yasuharu Imai, Kazuhiro Katayama, Masatoshi Hori, Takayuki Yakushijin, Kenji Fujimoto, Toshifumi Itoh, Takumi Igura, Mitsuru Sakakibara, Manabu Takamura, Masakatsu Tsurusaki, Hiroto Takahashi, Katsuyuki Nakanishi, Noriaki Usuki, Koh Tsuji, Hiroshi Ohashi, Tonsok Kim, Tetsuo Takehara, Takamichi Murakami

    Background: We prospectively compared the efficacy of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) with that of dynamic multidetector computed tomography (MDCT) for detection of recurrent hypervascular hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Methods: Institutional review board approval and written informed consent were obtained for this multicenter study. Ninety-seven HCC patients treated with curative RFA underwent both Gd-EOB-DTPA-enhanced MRI and dynamic MDCT every 3-4 months. HCC diagnosis was made based on the typical enhancement pattern of HCC on MRI and/or CT by on-site consensus reading. Two blinded observers independently assessed image datasets to compare diagnostic accuracy, sensitivity, specificity, and the areas under the receiver operating characteristic curve (AUROC). Results: Recurrence was observed in 48 of 97 patients. Among these, 22 were diagnosed by both Gd-EOB-DTPA-enhanced MRI and MDCT; the remainder were diagnosed by only one of these 2 modalities. Recurrence was diagnosed in more patients by Gd-EOB-DTPA-enhanced MRI than by MDCT (44 vs. 26 patients, p < 0.001). Patient-based analysis revealed that the accuracy, sensitivity, and AUROC of Gd-EOB-DTPA-enhanced MRI were significantly higher than those of MDCT for both observers (p < 0.005). The AUROC of Gd-EOB-DTPA-enhanced MRI and MDCT was 0.95 and 0.76 for observer 1 and 0.90 and 0.74 for observer 2, respectively. The. values for MRI and MDCT were 0.83 and 0.70, respectively. Conclusions: Compared with dynamic MDCT, Gd-EOB-DTPA-enhanced MRI had higher diagnostic accuracy and sensitivity for detection of recurrent hypervascular HCC and may be a better tool for following patients after RFA. (C) 2017 S. Karger AG, Basel

    KARGER, 2017年, LIVER CANCER, 6 (4), 349 - 359, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Aerosol deposition of inhaled corticosteroids/long-acting Ɓ2-agonists in the peripheral airways of patients with asthma using functional respiratory imaging, a novel imaging technolog.

    Iwanaga T, Kozuka T, Nakanishi J, Yamada K, Nishiyama O, Sano H, Murakami T, Tohda Y

    2017年, Pulm Ther (in press)

    [査読有り]

  • Okada M, Murakami T, Kuwatsuru R, Nakamura Y, Isoda H, Goshima S, Hanaoka R, Haradome H, Shinagawa Y, Kitao A, Fujinaga Y, Marugami N, Yuki M, Ichikawa T, Higaki A, Hori M, Fujii S, Matsui O

    Purpose: To identify biochemical factors associated with liver enhancement over time on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) images and predict the optimal time point of the hepatobiliary phase in various clinical settings. Materials and Methods: This study was approved by the institutional review boards, and written informed consent was obtained from the 1903 patients enrolled. Simple and multiple logistic regression analyses were performed to investigate the biochemical factors associated with liver-to-spleen contrast (LSC) of at least 1.5 in the hepatobiliary phase. Changes in LSC and lesion-to-liver contrast (LLC) of lesions over time (at 5, 10, 15, and 20 minutes) were investigated with a linear mixed-effects model in patients and lesions. For LSC, the optimal cutoff value was determined with receiver operating characteristic analysis of the most significant variable. Differences in LSC and LLC were analyzed in various clinical settings. Results: Ultimately, 1870 patients were evaluated, as 33 were excluded according to study criteria. Prothrombin (PT) activity, total bilirubin level (P=.020), and total cholesterol level (P=.005) were significantly associated with LSC of at least 1.5 at 20 minutes, and PT activity was identified as the most significant factor (odds ratio, 1.271; 95% confidence interval: 1.109, 1.455; P=.001). LSC of at least 1.5 at 20 minutes with PT activity of at least 86.9% and less than 86.9% occurred in 555 of 626 patients (88.6%) and 388 of 575 patients (67.5%), respectively. Satisfactory liver enhancement at 20 minutes was significantly more likely to be achieved by patients with hepatitis B virus than by those with hepatitis C virus (P<.001) and by patients with metastasis than by those with hepatocellular carcinoma (P<.001). No significant difference in LLC was observed in patients examined at 1.5 and 3.0 T (P=.133). Conclusion: Hepatic enhancement is significantly associated with PT activity, total bilirubin level, and total cholesterol level. PT activity of at least 86.9% could be used to shorten examination times at Gd-EOB-DTPA-enhanced MR imaging. (C) RSNA, 2016

    RADIOLOGICAL SOC NORTH AMERICA, 2016年11月, Radiology, 281 (2), 474 - 483, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hayato Kaida, Koichi Azuma, Akihiko Kawahara, Masafumi Yasunaga, Yuhei Kitasato, Satoshi Hattori, Tomoki Taira, Hiroki Ureshino, Masayoshi Kage, Kazunari Ishii, Takamichi Murakami, Masatoshi Ishibashi

    Purpose: We examined whether fluorine-18 fluorodeoxyglucose (FDG) uptake is related to the mammalian target of rapamycin (mTOR) signal pathway and its related proteins in pancreatic cancer patients. Methods: We retrospectively studied 53 pancreatic cancer patients who underwent FDG positron emission tomography (PET) or FDG PET/CT, and complete curative surgical resection. The SUV max, the tumor to nontumor activity of pancreas [T/N (P)] ratio and the T/N of liver [T/N (L)] ratio were calculated. The expressions of glucose transporter-1( Glut-1) and mTOR pathway proteins in pancreas cell lines were examined by immune blots. Excised tumor tissue was analyzed by immunohistochemistry using monoclonal antibodies for Glut-1, epidermal growth factor receptor (EGFR), mTOR, p70S6kinase (p70S6) and S6 ribosomal protein (S6). Results: The expressions of Glut-1, EGFR and p70S6 were significantly correlated with the SUV max, T/N (P) ratio and T/N (L) ratio. The expressions of mTOR and S6 were not correlated with all parameters. The expression of Glut-1 was positively correlated with the expressions of EGFR and p70S6, but not with mTOR or S6. S6 was positively correlated with p70S6. Conclusions: Glut-1, EGFR and p70S6 expressions are associated with the FDG uptake mechanism of pancreatic cancer. FDG uptake may predict the levels of EGFR and p70S6 expressions, and FDG uptake reflects glucose metabolism and cancer progression. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2016年10月, EUROPEAN JOURNAL OF RADIOLOGY, 85 (10), 1804 - 1810, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 薬剤動態に基づいたアミロイドイメージングに対する雑音低減アルゴリズム

    木村 裕一, 藤井 康介, 山田 誉大, 細川 知紗, 坂田 宗之, 石井 一成, 村上 卓道

    (一社)日本核医学会, 2016年10月, 核医学, 53 (Suppl.), S277 - S277, 日本語

  • 非小細胞肺癌のFDG集積とGlut-1、pStat-1、pStat-3での予後因子の検討

    甲斐田 勇人, 東 公一, 河原 明彦, 服部 聡, 倉田 精二, 高森 信三, 藤本 公則, 鹿毛 政義, 石井 一成, 村上 卓道, 石橋 正敏

    (一社)日本核医学会, 2016年10月, 核医学, 53 (Suppl.), S283 - S283, 日本語

  • 逐次近似応用再構成法が超急性期脳梗塞CT画像におけるZスコアマッピングに与える影響

    渡邊 翔太, 坂口 健太, 細野 眞, 石井 一成, 村上 卓道, 市川 勝弘

    (公社)日本放射線技術学会, 2016年09月, 日本放射線技術学会雑誌, 72 (9), 813 - 813, 日本語

  • 松木 充, 浜川 岳文, 小田 晃義, 沼本 勲男, 福井 秀行, 任 誠雲, 柳生 行伸, 村上 卓道

    (株)学研メディカル秀潤社, 2016年09月, 画像診断, 36 (12), 1171 - 1183, 日本語

  • Masakatsu Tsurusaki, Keitaro Sofue, Takamichi Murakami

    A variety of imaging techniques, including ultrasonography (US), multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography combined with CT scan (PET/CT), are available for diagnosis and treatment planning in liver metastasis. Contrast-enhanced MDCT is a relatively non-invasive, widely available and standardized method for hepatic work-up. Gadoxetic acid (gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid; EOB Primovist (R)]) is a recently developed liver-specific hepatobiliary MR contrast agent that offers both dynamic imaging as well as liver-specific static hepatocyte imaging, referred to as the hepatobiliary phase. Following contrast injection, this technique reveals dynamic vascular phases (arterial, portal venous and delayed phases), in addition to the hepatobiliary phase upon uptake by functional hepatocytes. The overall sensitivity of gadoxetic acid-enhanced MRI was significantly higher than that of contrast-enhanced CT. Specifically, the higher sensitivity of gadoxetic acid-enhanced MRI was observed in lesions smaller than 1cm in diameter. Gadoxetic acid-enhanced MRI is considered an extremely useful tool for the diagnosis of liver metastases. Future studies will focus on diagnostic algorithms involving combinations of modalities such as MRI, MDCT and/or F-18-fluorodeoxyglucose PET/CT, which may impact the treatment plan for these patients.

    WILEY, 2016年08月, HEPATOLOGY RESEARCH, 46 (9), 853 - 861, 英語

    [査読有り]

  • 仰臥位と腹臥位CTの重力差による動的評価とCT値による客観評価を用いた進行食道癌における新しい大動脈壁浸潤評価法

    田中 裕美子, 白石 治, 熊野 正士, 曽我部 俊介, 岩間 密, 安田 篤, 新海 政幸, 今野 元博, 今本 治彦, 村上 卓道, 奥野 清隆, 安田 卓司

    切除困難な局所進行食道癌cT4(大動脈)も化学療法(ChT)/化学放射線療法(CRT)の進歩に伴い治癒切除率が向上し、より精度の高い深達度診断が求められている。我々は通常の仰臥位CTでのcT4診断(Picus角(PA)≧90度)に加え、重力差を利用した腹臥位CTとの比較による動的評価法を考案し、その有用性を検討した。対象は初診時仰臥位造影CTでcT3以深の食道癌22例(cT3/T4=17/5)35測定、全例ChT/CRTを先行し18例で手術を施行。腫瘍-大動脈壁間距離(T-A D)とPAを仰/腹CTで測定し、最終深達度(fT4=R1、2、fT3.5=R0 and著明な瘢痕化(+)、fT3=R0 and瘢痕化(-)、非手術例はEUS所見)と比較した。全35測定の平均後縦隔前後径(下縦隔)は仰/腹の順に12.3/26.0mmで、PA<60度(21測定)の平均T-A DとPAは3.0/4.4mm、23.2/16度と腹臥位で距離は延長し角度は縮小した(p<0.05)。治療前PA≧60度の10例はfT3/T3.5/T4=5/2/3。fT3は腹臥位で全例PAは減少しT-A Dも3/5例で延長、fT3.5はいずれかが不変、fT4は両方不変であった。以上より、仰/腹CTにおけるT-A D/PAの比較はT3(両方変化)、T3.5(いずれか不変)、T4(両方不変)を鑑別できる可能性が示唆された。(著者抄録)

    近畿大学医学会, 2016年06月, 近畿大学医学雑誌, 41 (1-2), 27 - 38, 日本語

  • Masafumi Toguchi, Mitsuru Matsuki, Isao Numoto, Masakatsu Tsurusaki, Izumi Imaoka, Kazunari Ishii, Rikiya Yamashita, Yuki Inada, Shuichi Monzawa, Hisato Kobayashi, Takamichi Murakami

    There are three types of breast cancer recurrence which can occur after initial treatment: local, regional, and distant. Distant metastases are more frequent than local and regional recurrences. It usually occurs several years after the primary breast cancer, although it is sometimes diagnosed at the same time as the primary breast cancer. Although the common distant metastases are bone, lung and liver, breast cancer has the potential to metastasize to almost any region of the body. Early detection and treatment of distant metastases improves the prognosis, therefore radiologists and clinicians should recognize the possibility of metastasis from breast cancer and grasp the imaging characteristics. In this report, we demonstrate the imaging characteristics of metastases from breast cancer to uncommon sites.

    SPRINGER, 2016年06月, JAPANESE JOURNAL OF RADIOLOGY, 34 (6), 400 - 408, 英語

    [査読有り]

  • 仰臥位と腹臥位CTにおける重力差とCT値による客観評価を用いた新しい進行食道癌大動脈浸潤の評価の有用性

    田中 裕美子, 白石 治, 熊野 正士, 曽我部 俊介, 岩間 密, 安田 篤, 新海 政幸, 今野 元博, 今本 治彦, 村上 卓道, 安田 卓司

    (一社)日本外科学会, 2016年04月, 日本外科学会定期学術集会抄録集, 116回, OP - 2, 日本語

  • Takeshi Miyata, Masayuki Kitano, Shunsuke Omoto, Kumpei Kadosaka, Ken Kamata, Hajime Imai, Hiroki Sakamoto, Naoshi Nisida, Yogesh Harwani, Takamichi Murakami, Yoshifumi Takeyama, Yasutaka Chiba, Masatoshi Kudo

    AIM: To assess the usefulness of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for lymph node metastasis in pancreatobiliary carcinoma. METHODS: All patients suspected of pancreatobiliary carcinoma with visible lymph nodes after standard EUS between June, 2009 and January, 2012 were enrolled. In the primary analysis, patients with successful EUS-fine needle aspiration (FNA) were included. The lymph nodes were assessed by several standard EUS variables (short and long axis lengths, shape, edge characteristic and echogenicity), color Doppler EUS variable [central intranodal blood vessel (CIV) presence] and CH-EUS variable (heterogeneous/homogeneous enhancement patterns). The diagnostic accuracy relative to EUS-FNA was calculated. In the second analysis, N-stage diagnostic accuracy of CH-EUS was compared with EUS-FNA in patients who underwent surgical resection. RESULTS: One hundred and nine patients (143 lymph nodes) fulfilled the criteria. The short axis cutoff >= 13 mm predicted malignancy with a sensitivity and specificity of 72% and 85%, respectively. These values were 72% and 63% for the long axis cut-off >= 20 mm, 62% and 75% for the round shape variable, 81% and 30% for the sharp edge variable, 66% and 61% for the hypoechogenicity variable, 70% and 72% for the CIV-absent variable, and 83% and 91% for the heterogeneous CH-EUS-enhancement variable, respectively. CH-EUS was more accurate than standard and color Doppler EUS, except the short axis cut-off. Notably, three patients excluded because of EUS-FNA failure were correctly N-staged by CH-EUS. CONCLUSION: CH-EUS complements standard and color Doppler EUS and EUS-FNA for assessment of lymph node metastases.

    BAISHIDENG PUBLISHING GROUP INC, 2016年03月, WORLD JOURNAL OF GASTROENTEROLOGY, 22 (12), 3381 - 3391, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yoshito Tsushima, Tsuneo Ishiguchi, Takamichi Murakami, Hiromitsu Hayashi, Katsumi Hayakawa, Kunihiko Fukuda, Yukunori Korogi, Hideharu Sugimoto, Yasuo Takehara, Yoshifumi Narumi, Yasuaki Arai, Ryohei Kuwatsuru, Kengo Yoshimitsu, Kazuo Awai, Masayuki Kanematsu, Ryo Takagi

    To help establish consensus on the safe use of contrast media in Japan. Questionnaires were sent to accredited teaching hospitals with radiology residency programs. The reply rate was 45.4 % (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6 %, respectively, and dehydration in 73.9 %. As preventive actions, intravenous hydration (89.1 %) and reduction of iodinated contrast media dose (86.9 %) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6 %, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6 %. A renal function test was always (63.5 % in iodinated; 65.7 % in gadolinium) or almost always (23.1; 19.8 %) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6 %). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed. Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patientsE1/4 eGFR. Preventive actions against NSF and AAR still lacked consensus.

    SPRINGER, 2016年02月, JAPANESE JOURNAL OF RADIOLOGY, 34 (2), 130 - 139, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tatsuo Inoue, Tomoko Hyodo, Keiko Korenaga, Takamichi Murakami, Yasuharu Imai, Atsushi Higaki, Takeshi Suda, Toru Takano, Kennichi Miyoshi, Masahiko Koda, Hironori Tanaka, Hiroko Iijima, Hironori Ochi, Masashi Hirooka, Kazushi Numata, Masatoshi Kudo

    Background It remains unknown whether Kupffer-phase images in Sonazoid-enhanced ultrasonography (US) can be used to predict hypervascularization of borderline lesions. Therefore, we aimed to clarify whether Kupffer-phase images in Sonazoid-enhanced ultrasonography can predict subsequent hypervascularization in hypovascular borderline lesions detected on hepatobiliary-phase gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (GdEOB-DTPA)-enhanced magnetic resonance imaging. Methods From January 2008 to March 2012, 616 low-intensity hypovascular nodules were detected in hepatobiliary-phase images of Gd-EOB-DTPA-enhanced MRI at nine institutions. Among these, 167 nodules, which were confirmed as hypovascular by Gd-EOB-DTPA-enhanced MRI and Sonazoid-enhanced US, were evaluated in this study. Potential hypervascularization factors were selected based on their clinical significance and the results of previous reports. The Kaplan-Meier model and log-rank test were used for univariate analysis and the Cox regression model was used for multivariate analysis. Results The cumulative incidence of hypervascularization of borderline lesions was 18, 37, and 43 % at 1, 2, and 3 years, respectively. Univariate analyses showed that tumor size (p = 0.0012) and hypoperfusion on Kupffer-phase images in Sonazoid-enhanced US (p = 0.004) were associated with hypervascularization of the tumor. Multivariate analysis showed that tumor size [HR: 1.086, 95 % confidence interval = 1.027-1.148, p = 0.004] and hypo perfusion on Kupffer-phase images [HR: 3.684, 95 % confidence interval = 1.798-7.546, p = 0.0004] were significantly different. Conclusions Kupffer-phase images in Sonazoid-enhanced US and tumor diameter can predict hypervascularization of hypointense borderline lesions detected on hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI.

    SPRINGER JAPAN KK, 2016年02月, JOURNAL OF GASTROENTEROLOGY, 51 (2), 144 - 152, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 上顎洞術後変化としての眼窩下管拡大

    福井 秀行, 柏木 伸夫, 任 誠雲, 甲斐田 勇人, 柳生 行伸, 小塚 健倫, 細川 知紗, 熊野 正士, 鶴崎 正勝, 松木 充, 今岡 いずみ, 細野 眞, 石井 一成, 村上 卓道

    日本画像医学会, 2016年02月, Japanese Journal of Diagnostic Imaging, 34 (1), 116 - 116, 日本語

  • IgG4関連疾患によると思われる冠動脈病変の1例

    千葉 輝明, 松木 充, 今岡 いずみ, 熊野 正士, 小塚 健倫, 柏木 伸夫, 柳生 行伸, 足利 竜一朗, 鶴崎 正勝, 石井 一成, 村上 卓道, 平野 豊, 樋野 尚一

    (公社)日本医学放射線学会, 2016年02月, Japanese Journal of Radiology, 34 (Suppl.), 55 - 55, 日本語

  • 当院における胃粘膜下腫瘍に対する18F-FDG PET検査

    沼本 勲男, 松木 充, 福井 秀行, 若林 雄一, 渡口 真史, 千葉 輝明, 山田 穣, 柏木 伸夫, 細川 知紗, 小塚 健倫, 細野 眞, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2016年02月, Japanese Journal of Radiology, 34 (Suppl.), 56 - 56, 日本語

  • Masatoshi Kudo, Kazuomi Ueshima, Shoji Kubo, Michiie Sakamoto, Masatoshi Tanaka, Iwao Ikai, Junji Furuse, Takamichi Murakami, Masumi Kadoya, Norihiro Kokudo

    The Response Evaluation Criteria in Solid Tumors (RECIST) is inappropriate to assess the direct effects of treatment on hepatocellular carcinoma (HCC) by locoregional therapies such as radiofrequency ablation (RFA) and transarterial chemoembolization (TACE). Therefore, establishment of response evaluation criteria solely devoted to HCC is needed urgently in clinical practice as well as in clinical trials of HCC treatment, such as molecular-targeted therapies, which cause necrosis of the tumor. The Response Evaluation Criteria in Cancer of the Liver (RECICL) was revised in 2015 by the Liver Cancer Study Group of Japan based on the 2009 version of RECICL, which was commonly used in Japan. Major revised points of the RECICL 2015 is to define the target lesions of two lesions per organ or three lesions per liver, up to a maximum of five lesions. The second revised point is that setting the timing at which the overall treatment response has been changed. The third point is that the definition of treatment effect 1 has been changed to more than 50% tumor enlargement, excluding the area of necrosis after treatment. Overall evaluation of treatment response has been amended to make it possible to evaluate the overall response including extrahepatic lesions by systemic therapy, which is similar to RECIST ormodified RECIST. We hope this new treatment response criteria, RECICL, proposed by the Liver Cancer Study Group of Japan will benefit HCC treatment response evaluation in the setting of daily clinical practice and clinical trials, not only in Japan, but also internationally.

    WILEY, 2016年01月, HEPATOLOGY RESEARCH, 46 (1), 3 - 9, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasuyuki Yamashita, Sadayuki Murayama, Masahiro Okada, Yoshiyuki Watanabe, Masako Kataoka, Yasushi Kaji, Keiko Imamura, Yasuo Takehara, Hiromitsu Hayashi, Kazuko Ohno, Kazuo Awai, Toshinori Hirai, Kazuyuki Kojima, Shuji Sakai, Naofumi Matsunaga, Takamichi Murakami, Kengo Yoshimitsu, Toshifumi Gabata, Kenji Matsuzaki, Eriko Tohno, Yasuhiro Kawahara, Takeo Nakayama, Shuichi Monzawa, Satoru Takahashi

    Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on "showing evidence and suggestions in the form of clinical questions (CQs)" concerning clinically encountered questions and "describing routine imaging techniques presently considered to be standards to guarantee the quality of imaging examinations". In so doing, we adhered to the basic principles of assuming the readers to be "radiologists specializing in diagnostic imaging", "simultaneously respecting the global standards and attending to the situation in Japan", and "making the guidelines consistent with those of other scientific societies related to imaging". As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form of CQs. In this sense, the guidelines are considered to reflect the abilities of diagnostic radiologists in Japan. The contents of the guidelines are essential knowledge for radiologists, but we believe that they are also of use to general clinicians and clinical radiological technicians. While the number and contents of CQs are still insufficient, and while chapters such as those on imaging in children and emergency imaging need to be supplemented, the guidelines will be serially improved through future revisions. Lastly, we would like to extend our sincere thanks to the 153 members of the drafting committee who authored the guidelines, 12 committee chairpersons who coordinated their efforts, six members of the secretariat, and affiliates of related scientific societies who performed external evaluation.

    SPRINGER, 2016年01月, JAPANESE JOURNAL OF RADIOLOGY, 34 (1), 43 - 79, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masakatsu Tsurusaki, Keitaro Sofue, Hiroyoshi Isoda, Masahiro Okada, Kazuhiro Kitajima, Takamichi Murakami

    Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgical candidates. The study was approved by the institutional review boards at each of four centers. Patients scheduled to undergo multiphasic CT, gadoxetic acid-enhanced MRI, and liver surgery were prospectively included in this study. The diagnostic abilities of MRI and CT were evaluated and compared on the basis of sensitivity and positive predictive value for detection of and differentiation between HCCs and benign lesions. Fifty-four patients with 83 histopathologically confirmed HCCs were included in the study. Combined interpretation of the dynamic and hepatobiliary phases of gadoxetic acid-enhanced MRI showed statistically higher sensitivity for lesion detection (83 %) than did interpretation of multiphasic MDCT images (70 %; p < 0.001). The mean area under each alternative free-response receiver operating characteristics curve was significantly higher for MR images (0.927) than for CT images (0.864, p < 0.01). The sensitivity for preoperative detection of HCCs was higher for gadoxetic acid-enhanced MRI than for multiphasic MDCT imaging.

    SPRINGER JAPAN KK, 2016年01月, JOURNAL OF GASTROENTEROLOGY, 51 (1), 71 - 79, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tetsuro Araki, Mizuki Nishino, Wei Gao, Josee Dupuis, Gary M. Hunninghake, Takamichi Murakami, George R. Washko, George T. O'Connor, Hiroto Hatabu

    To investigate CT appearance and size of the thymus in association with participant characteristics. 2540 supposedly healthy participants (mean age 58.9 years, 51 % female) were evaluated for the CT appearance of thymic glands with four-point scores (according to the ratio of fat and soft tissue), size and morphology. These were correlated with participants' age, sex, BMI and smoking history. Of 2540 participants, 1869 (74 %) showed complete fatty replacement of the thymus (Score 0), 463 (18 %) predominantly fatty attenuation (Score 1), 172 (7 %) half fatty and half soft-tissue attenuation (Score 2) and 36 (1 %) solid thymic gland with predominantly soft-tissue attenuation (Score 3). Female participants showed less fatty degeneration of the thymus with higher thymic scores within age 40-69 years (P < 0.001). Participants with lower thymic scores showed higher BMI (P < 0.001) and were more likely to be former smokers (P < 0.001) with higher pack-years (P = 0.04). Visual assessment with four-point thymic scores revealed a sex difference in the fatty degeneration of the thymus with age. Women show significantly higher thymic scores, suggesting less fat content of the thymus, during age 40-69 years. Cigarette smoking and high BMI are associated with advanced fatty replacement of the thymus. aEuro cent 74 % of participants (mean age 58.9 years) demonstrated complete fatty thymus. aEuro cent Women show less fatty thymus compared to men at ages 40-69 years. aEuro cent Smoking and high BMI are associated with advanced fatty degeneration in thymus.

    SPRINGER, 2016年01月, EUROPEAN RADIOLOGY, 26 (1), 15 - 24, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Minami Y, Takita M, Tsurusaki M, Yagyu Y, Ueshima K, Murakami T, Kudo M

    2016年, Hepatol Res (in press)

    [査読有り]

  • Nobuo Kashiwagi, Takamichi Murakami, Masafumi Toguchi, Katsuyuki Nakanishi, Shojiro Hidaka, Hideyuki Fukui, Masatomo Kimura, Mutsukazu Kitano, Noriyuki Tomiyama

    Objectives: To present and characterize CT and MR imaging findings of metastases to the parotid nodes. Methods: CT (n=10) and MR (n=11) images from 14 patients with metastases to the parotid nodes were reviewed. The primary tumour sites were the ocular adnexa in five patients, facial skin in four patients, upper aerodigestive tract in four patients and thyroid gland in one patient. CT and MR images were evaluated with emphasis on the size and number of parotid tumours, their location in the parotid gland, the presence of associated clinically pathological cervical nodes or previous history of cervical node metastasis, margin characteristics and the presence of central necrosis. Results: A total of 18 tumours were identified in 14 patients, with an average maximal cross-sectional diameter of 19mm (7-44 mm). 12 patients had a single parotid tumour and 2 patients had unilateral multiple tumours; 12 tumours in 10 patients were located in the parotid tail, 6 tumours in 4 patients were located in the superficial lobe and no tumour was noted in the deep lobe. In the superficial lobe, four of six tumours were located in the pretragal area. Three of nine patients whose primary sites were the ocular adnexa or skin had associated clinically pathological cervical nodes. None of these patients had a previous history of cervical node metastasis. All five patients with other primary sites had associated pathological cervical nodes or a history of such. 11 tumours had well-defined margins and 7 tumours had ill-defined margins. Post-contrast images showed central necrosis in 2 of 11 tumours. Conclusions: Metastases to the parotid nodes tend to present as solitary parotid masses with two preferential sites.

    BRITISH INST RADIOLOGY, 2016年, DENTOMAXILLOFACIAL RADIOLOGY, 45 (8), 英語

    [査読有り]

    研究論文(学術雑誌)

  • Sakaguchi K, Hosono M, Imamura T, Takahara N, Hayashi M, Yakushiji Y, Ishii K, Murakami T

    2016年, EJNMMI Physics (in press)

    [査読有り]

  • Yuki Makino, Yasuharu Imai, Takumi Igura, Sachiyo Kogita, Yoshiyuki Sawai, Kazuto Fukuda, Takayuki Iwamoto, Junya Okabe, Manabu Takamura, Norihiko Fujita, Masatoshi Hori, Tetsuo Takehara, Masatoshi Kudo, Takamichi Murakami

    Background and Aims: Extracted-overlay fusion imaging is a novel computed tomography/magnetic resonance-ultrasonography (CT/MR-US) imaging technique in which a target tumor with a virtual ablative margin is extracted from CT/MR volume data and synchronously overlaid on US images. We investigated the applicability of the technique to intraoperative evaluation of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods: This retrospective study analyzed 85 HCCs treated with RFA using extracted-overlay fusion imaging for guidance and evaluation. To perform RFA, an electrode was inserted targeting the tumor and a virtual 5-mm ablative margin overlaid on the US image. Following ablation, contrast-enhanced US (CEUS) was performed to assess the ablative margin, and the minimal ablative margins were categorized into three groups: (I) margin <0 mm (protrusion), (II) margin 0 to <5 mm, and (III) margin >= 5 mm. Margin assessment was based on the positional relationship between the overlaid tumor plus margin and the perfusion defect of the ablation zone. Tumors in group I underwent repeat ablation until they were in groups II or III. The final classifications were compared with those obtained by retrospectively created fusion images of pre- and post-RFA CT or MR imaging (CT-CT/MR-MR fusion imaging). Results: Treatment evaluation was impossible using CEUS in six HCCs because the tumors were located far below the body surface. Of the remaining 79 HCCs, the categorizations of minimal ablative margins between CEUS extracted-overlay fusion imaging and CT-CT/MR-MR fusion imaging were in agreement for 72 tumors (91.1%) (Cohen's quadratic-weighted kappa coefficient 0.66, good agreement, p<0.01). Conclusions: Extracted-overlay fusion imaging combined with CEUS is feasible for the evaluation of RFA and enables intraoperative treatment evaluation without the need to perform contrast-enhanced CT. Copyright (C) 2016 S. Karger AG, Basel

    KARGER, 2016年, LIVER CANCER, 5 (4), 269 - 279, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Mika Yamamuro, Kanako Yamada, Yoshiyuki Asai, Koji Yamada, Yoshiaki Ozaki, Masao Matsumoto, Takamichi Murakami

    Mammography, the most effective early breast cancer detection technique, is associated with the risk of missed lesions in dense breasts, and excessive X-ray exposure. Accurate estimations of glandularity and radiation dose are important during screening. We propose a novel, inexpensive method for accurate glandularity quantification using pixel values in clinical digital mammograms and X-ray exposure spectra. Glandularities were calculated for 314 mammograms in Japanese women, and the Dance formula c-factor was applied to estimate breast doses. To investigate the relationship between breast thickness and missed lesions, images were classified into four categories based on the rate of missed lesions, and correlated with breast thickness. Glandularity decreased with increasing compressed breast thickness, indicating that commonly used breast doses (assumed 50% glandularity) significantly overestimate thin breasts and underestimate thick breasts. The missed lesion rate was higher for thinner compressed breast thicknesses. Accurate glandularity estimation could thus promote individualized screening mammography.

    SPRINGER INT PUBLISHING AG, 2016年, BREAST IMAGING, IWDM 2016, 9699, 377 - 384, 英語

    [査読有り]

    研究論文(国際会議プロシーディングス)

  • Chisa Hosokawa, Kazunari Ishii, Yuichi Kimura, Tomoko Hyodo, Makoto Hosono, Kenta Sakaguchi, Kimio Usami, Kenji Shimamoto, Yuzuru Yamazoe, Takamichi Murakami

    The goal of this study was to clarify whether binding potential (BP) images using C-11-Pittsburgh compound B (C-11-PiB) and dynamic PET can reliably detect cortical amyloid deposits for patients whose C-11-PiB PET static images are ambiguous and whether visual ratings are affected by white matter retention. Methods: Static and BP images were constructed for 85 consecutive patients with cognitive impairment after C-11-PiB dynamic PET. Cortical uptake was visually assessed as positive, negative, or equivocal for both types of images. Quantitatively, the standardized uptake value ratio (SUVR) from the static image, the nondisplaceable BP from the dynamic image for mean gray matter uptake, and the ratio of gray matter uptake to white matter retention were compared among C-11-PiB-positive, C-11-PiB-equivocal, and C-11-PiB-negative groups. Results: Forty-three scans were visually assessed as C-11-PiB-positive in both the static and the BP images. Ten scans were C-11-PiB-equivocal in the static images. In 8 of them, the BP images were C-11-PiB-positive, whereas the other 2 were C-11-PiB-equivocal. Thirty-two scans were assessed as C-11-PiB-negative in the static images. In the BP images, 4 were C-11-PiB-positive and 2 were C-11-PiB-equivocal. The mean gray matter uptake of C-11-PiB in SUVR and nondisplaceable BP, respectively, showed statistically significant differences among the C-11-PiB-positive, C-11-PiB-equivocal, and C-11-PiB-negative groups. The ratio of gray matter uptake to white matter retention was lower in the BP images than static images from the C-11-PiB-negative and C-11-PiB-equivocal groups, whereas it was higher in the C-11-PiB-positive group. Conclusion: C-11-PiB PET BP images can clarify visual interpretation of clinical static C-11-PiB-equivocal images by reducing the interference of nonspecific white matter retention. We conclude that C-11-PiB-equivocal PET findings on static images reflect cortical amyloid deposits, which can be verified using BP images. Furthermore, quantitative assessments, such as SUVR and nondisplaceable BP, are of no use for correctly rating equivocal visual findings.

    SOC NUCLEAR MEDICINE INC, 2015年12月, JOURNAL OF NUCLEAR MEDICINE, 56 (12), 1910 - 1915, 英語

    [査読有り]

    研究論文(学術雑誌)

  • SungWoon Im, Ryuichiro Ashikaga, Yukinobu Yagyu, Tetsuya Wakayama, Mitsuharu Miyoshi, Tomoko Hyodo, Izumi Imaoka, Seishi Kumano, Kazunari Ishii, Takamichi Murakami

    The purpose of this study was to investigate the usefulness of T1W black-blood Cube (BB Cube) and T1W BB Cube fluid-attenuated inversion recovery (BB Cube-FLAIR) sequences for contrast-enhanced brain imaging, by evaluating flow-related artefacts, detectability, and contrast ratio (CR) of intracranial lesions among these sequences and T1W-SE. Phantom studies were performed to determine the optimal parameters of BB Cube and BB Cube-FLAIR. A clinical study in 23 patients with intracranial lesions was performed to evaluate the usefulness of these two sequences for the diagnosis of intracranial lesions compared with the conventional 2D T1W-SE sequence. The phantom study revealed that the optimal parameters for contrast-enhanced T1W imaging were TR/TE = 500 ms/minimum in BB Cube and TR/TE/TI = 600 ms/minimum/300 ms in BB Cube-FLAIR imaging. In the clinical study, the degree of flow-related artefacts was significantly lower in BB Cube and BB Cube-FLAIR than in T1W-SE. Regarding tumour detection, BB Cube showed the best detectability; however, there were no significant differences in CR among the sequences. At 1.5 T, contrast-enhanced BB Cube was a better imaging sequence for detecting brain lesions than T1W-SE or BB Cube-FLAIR. aEuro cent Cube is a single-slab 3D FSE imaging sequence. aEuro cent We applied a black-blood (BB) imaging technique to T1W Cube. aEuro cent At 1.5 T, contrast-enhanced T1W BB Cube was valuable for detecting brain lesions.

    SPRINGER, 2015年11月, EUROPEAN RADIOLOGY, 25 (11), 3175 - 3186, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 甲斐田 勇人, 石井 一成, 村上 卓道, 田原 宣広, 本多 亮博, 福本 義弘, 石橋 正敏

    (一社)日本核医学会, 2015年11月, 核医学, 52 (4), 403 - 403, 日本語

  • Kazushi Numata, Hiroyuki Fukuda, Hiromi Nihonmatsu, Masaaki Kondo, Akito Nozaki, Makoto Chuma, Manabu Morimoto, Takashi Oshima, Masahiro Okada, Takamichi Murakami, Shigeo Takebayashi, Shin Maeda, Yoshiaki Inayama, Masayuki Nakano, Katsuaki Tanaka

    We evaluated the use of tumor vessel patterns observed during arterial-phase contrast-enhanced ultrasonography (US) to differentiate regenerative nodules (RN) from early hepatocellular carcinoma (HCC) or high-grade dysplastic nodules (HGDN) in patients with chronic liver disease. Pathologically confirmed lesions (83 early HCC, 6 HGDN, and 13 RN with mean maximal diameters of 15.4, 15.3, and 16.2 mm, respectively) were enrolled in this retrospective study. We performed contrast-enhanced US using a perflubutane-based contrast agent. We then classified the tumor vessels observed during the arterial phase of contrast-enhanced US into two patterns: peripheral vessels (centripetal pattern) and central vessels (centrifugal pattern). Eighty-one (97.6%) of the 83 early HCC exhibited various enhancement patterns (hypovascular, 44.6%; isovascular, 25.3%; and hypervascular, 27.7%) and a peripheral vessel pattern, while the remaining 2 lesions (2.4%) exhibited hypovascular enhancement and a central vessel pattern. All 6 HGDN lesions were hypovascular with a peripheral vessel pattern. Twelve (92.3%) of the 13 RN were hypovascular with a central vessel pattern, and the remaining one (7.7%) was hypervascular with a central vessel pattern. When lesions exhibiting a central vessel pattern during arterial-phase contrast-enhanced US were diagnosed as RN, the sensitivity, specificity, and accuracy of these diagnoses were 100%, 97.8%, and 98.0%, respectively. The tumor vessel patterns observed during arterial-phase contrast-enhanced US may be useful for differentiating RN from early HCC or HGDN in patients with chronic liver disease.

    SPRINGER, 2015年10月, ABDOMINAL IMAGING, 40 (7), 2372 - 2383, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 膵癌のFDG集積とmTOR関連マーカーとの相関性に関する分子病理学的検討

    甲斐田 勇人, 東 公一, 河原 明彦, 安永 昌史, 服部 聡, 倉田 精二, 廣瀬 靖光, 鹿毛 政義, 石井 一成, 村上 卓道, 石橋 正敏

    (一社)日本核医学会, 2015年09月, 核医学, 52 (3), 248 - 248, 日本語

  • PiB陰性例の18F-FDG PETによる脳代謝分布の検討

    細川 知紗, 石井 一成, 若林 雄一, 兵頭 朋子, 花田 一志, 甲斐田 勇人, 細野 眞, 木村 裕一, 村上 卓道

    (一社)日本核医学会, 2015年09月, 核医学, 52 (3), 262 - 262, 日本語

  • アミロイドイメージングにおける組織放射能時間曲線に対するパターン認識による参照領域設定アルゴリズム

    木村 裕一, 山田 誉大, 細川 知紗, 石井 一成, 村上 卓道

    (一社)日本核医学会, 2015年09月, 核医学, 52 (3), 293 - 293, 日本語

  • 超急性期脳梗塞症例に対する頭部単純CT画像を用いたコンピューター支援診断システムの開発

    渡邊 翔太, 坂口 健太, 細野 眞, 石井 一成, 村上 卓道

    (公社)日本放射線技術学会, 2015年09月, 日本放射線技術学会雑誌, 71 (9), 896 - 896, 日本語

  • 上腸間膜静脈血栓症による急性腸管虚血に対しTIPSを施行した1例

    沼本 勲男, 鶴崎 正勝, 柳生 行伸, 渡口 真史, 山川 美帆, 任 誠雲, 松木 充, 村上 卓道, 萩原 智, 工藤 正俊, 吉藤 竹仁, 船内 正憲

    (一社)日本インターベンショナルラジオロジー学会, 2015年09月, IVR: Interventional Radiology, 30 (3), 283 - 283, 日本語

  • Tetsuro Araki, Mizuki Nishino, Oscar E. Zazueta, Wei Gao, Josee Dupuis, Yuka Okajima, Jeanne C. Latourelle, Ivan O. Rosas, Takamichi Murakami, George T. O'Connor, George R. Washko, Gary M. Hunninghake, Hiroto Hatabu

    Objective: To investigate the prevalence and distribution of paraseptal emphysema on chest CT images in the Framingham Heart Study (FHS) population, and assess its impact on pulmonary function. Also pursued was the association with interstitial lung abnormalities. Materials and methods: We assessed 2633 participants in the FHS for paraseptal emphysema on chest CT. Characteristics of the participants, including age, sex, smoking status, clinical symptoms, and results of pulmonary function tests, were compared between those with and without paraseptal emphysema. The association between paraseptal emphysema and interstitial lung abnormalities was investigated. Results: Of the 2633 participants, 86 (3%) had pure paraseptal emphysema (defined as paraseptal emphysema with no other subtypes of emphysema other than paraseptal emphysema or a very few centrilobular emphysema involved) in at least one lung zone. The upper zone of the lungs was almost always involved. Compared to the participants without paraseptal emphysema, those with pure paraseptal emphysema were significantly older, and were more frequently male and smokers (mean 64 years, 71% male, mean 36 pack-years, P < 0.001) and had significantly decreased FEV1/FVC% (P = 0.002), and diffusion capacity of carbon monoxide (DLCO) (P = 0.002). There was a significant association between pure paraseptal emphysema and interstitial lung abnormalities (P < 0.001). Conclusions: The prevalence of pure paraseptal emphysema was 3% in the FHS population, predominantly affects the upper lung zone, and contributes to decreased pulmonary function. Cigarette smoking, aging, and male gender were the factors associated with the presence of paraseptal emphysema. Significant association between paraseptal emphysema and interstitial lung abnormalities was observed. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2015年07月, EUROPEAN JOURNAL OF RADIOLOGY, 84 (7), 1413 - 1418, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 肝細胞癌の診断・治療の最前線 ダイナミックCT・MRI診断

    村上卓道, 朝戸信行, 熊野正士, 鶴﨑正勝

    2015年06月, 消化器外科, 38 (6), 877 - 886

    [査読有り]

  • Nobuo Kashiwagi, Takashi Fujii, Kinji Nishiyama, Katsuyuki Nakanishi, Noriyuki Tomiyama, Yukinobu Yagyu, Masakatsu Tsurusaki, Mutsukazu Kitano, Takamichi Murakami

    A case of advanced parotid cancer in which long-term control was achieved by superselective intra-arterial cisplatin infusion with concomitant radiotherapy is reported. A 63-year-old woman with parotid squamous cell carcinoma was referred to our hospital. Magnetic resonance images revealed extraparotid extension of the tumor, indicating that complete resection would be difficult. Consequently, intra-arterial cisplatin infusion with concomitant radiotherapy was planned as an alternative therapy. Superselective intra-arterial infusion of cisplatin (100 mg/m(2)) was performed six times, at intervals of 7-9 days. The arteries chosen for superselective infusion were the posterior auricular artery, the transverse facial artery and the intrinsic parotid artery originating directly from the external carotid artery. Concurrently, external radiotherapy of a total of 50 Gy in 25 fractions was also performed. The patient achieved a complete response and has remained free of disease recurrence 5 years after treatment. Intra-arterial cisplatin infusion with concomitant radiotherapy can be a practical option for patients with unresectable parotid squamous cell carcinoma.

    OXFORD UNIV PRESS, 2015年04月, JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 45 (4), 378 - 380, 英語

    [査読有り]

    研究論文(学術雑誌)

  • NAFLDにおけるDual energy CTを用いた肝脂肪変性定量評価の有用

    岡部 純弥, 澤井 良之, 福田 和人, 井倉 技, 小来田 幸世, 今井 康陽, 磯谷 圭介, 米澤 稔, 藤田 典彦, 兵頭 朋子, 辻川 華子, 阿部 時也, 橋口 明典, 坂元 亨宇, 村上 卓道

    (一社)日本肝臓学会, 2015年04月, 肝臓, 56 (Suppl.1), A359 - A359, 日本語

  • 膵頭十二指腸切除後膵液瘻に対する予測因子としての内臓脂肪量測定の有用性

    荒木麻利子, 松本正孝, 中多靖幸, 亀井敬子, 石川 原, 中居卓也, 村上卓道, 竹山宣典

    2015年03月, 近畿大学医学雑誌, 39 (3), 125 - 132

  • Minori Onoda, Tomoko Hyodo, Takamichi Murakami, Masahiro Okada, Tatsuro Uto, Masatoshi Hori, Tosiaki Miyati

    Objective: To compare signal intensity (SI) correction using scale and rescale slopes with SI correction using SIs of spleen and muscle for quantifying multiphase hepatic contrast enhancement with Gd-EOB-DTPA by assessing their correlation with T-1 values generated from Look-Locker turbo-field-echo (LL-TFE) sequence data (ER-T-1). Materials and methods: Thirty patients underwent Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in this prospective clinical study. For each patient, breath-hold T-1-weighted fat-suppressed three-dimensional (3D) gradient echo sequences (e-THRIVE) were acquired before and 2 (first phase), 10 (second phase), and 20 min (third phase) after intravenous Gd-EOB-DTPA. Look-Locker turbo-fieldecho (LL-TFE) sequences were acquired before and 1.5 (first phase), 8 (second phase), and 18 min (third phase) postcontrast. The liver parenchyma enhancement ratios (ER) of each phase were calculated using the SI from e-THRIVE sequences (ER-SI) and the T-1 values generated from LL-TFE sequence data (ER-T-1) respectively. ER-SIs were calculated in three ways: (1) comparing with splenic SI (ER-SI-s), (2) comparing with muscle SI (ER-SI-m), (3) using scale and rescale slopes obtained from DICOM headers (ER-SI-c), to eliminate the effects of receiver gain and scaling. For each of the first, second and third phases, correlation and agreement were assessed between each ER-SI and ER-T-1. Results: In the first phase, all ER-SIs correlated weakly with ER-Ti. In the second and third phases, ER-SI-c showed a stronger linear correlation with ER-Ti (r(2) =0.71-0.72, p <0.01) than did ER-SI-s (r(2) =0.37-0.39, p <0.01) or ER-SI-m (r(2) =0.30-0.41, p <0.01). Conclusion: SI correction using scale and rescale slopes from DICOM data is the most acceptable algorithm for evaluating delayed-phase Gd-EOB-DTPA hepatic enhancement. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2015年03月, EUROPEAN JOURNAL OF RADIOLOGY, 84 (3), 339 - 345, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Norihiro Kokudo, Kiyoshi Hasegawa, Masaaki Akahane, Hiroshi Igaki, Namiki Izumi, Takafumi Ichida, Shinji Uemoto, Shuichi Kaneko, Seiji Kawasaki, Yonson Ku, Masatoshi Kudo, Shoji Kubo, Tadatoshi Takayama, Ryosuke Tateishi, Takashi Fukuda, Osamu Matsui, Yutaka Matsuyama, Takamichi Murakami, Shigeki Arii, Masatoshi Okazaki, Masatoshi Makuuchi

    The 3rd version of Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine, which was published in October 2013 in Japanese. Here, we briefly describe new or changed recommendations with a special reference to the two algorithms for surveillance, diagnosis, and treatment.

    WILEY-BLACKWELL, 2015年02月, HEPATOLOGY RESEARCH, 45 (2), 123 - 127, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Takamichi Murakami, Norihisa Yada, Kazushi Numata, Minori Onoda, Tomoko Hyodo, Tatsuo Inoue, Kazunari Ishii, Masatoshi Kudo

    PurposeTo compare four imaging approaches in cirrhotic estimation; pre-enhancement T1 relaxation time (T1RT), reduction rate (RR) of T1RT, signal-based liver-to-muscle ratio (L/M ratio) on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), and liver stiffness measurement (LSM) of US elastography. Materials and MethodsConsecutive 58 patients with chronic liver diseases who underwent both Gd-EOB-DTPA-enhanced MRI and FibroScan were analyzed. Four imaging approaches were evaluated by fibrosis score from liver biopsy and receiver operating characteristic (ROC) analysis. ResultsRR was found to be inversely correlated with LSM (r=-0.65). RR decreased with degree of fibrosis (F0-F1, 58.56.2%, versus F2-F3-F4, 48.8 +/- 11.7%, P=0.010, F0-F1-F2, 58.2 +/- 6.2% versus F3-F4, 45.5 +/- 12.3%, P=0.010 and F0-F1, 58.5 +/- 6.2%, versus F2-F3, 52.1 +/- 12.0%, P=0.0038). LSM increased with degree of fibrosis (F0-F1, 5.4 +/- 2.2 kPa versus F2-F3-F3, 19.3 +/- 15.5 kPa, P=0.0011 and F0-F1-F2, 6.8 +/- 3.6 kPa versus F3-F4, 23.8 +/- 17.1 kPa, P=0.0029 and F0-F1, 5.4 +/- 2.2 kPa, versus F2-F3, 11.4 +/- 7.2 kPa, P=0.0098). Area under ROC curves were 0.83 (F3-F4), 0.72 (F2-F3-F4), 0.68 (F2-F3) for RR and 0.83 (F3-F4), 0.88 (F2-F3-F4), 0.81 (F2-F3) for LSM in discriminating between patients with fibrosis. ConclusionThe capability by LSM was better than those by RR of T1RT, pre-enhancement T1RT, and L/M ratio to differentiate F2, but LSM and RR of T1RT showed the same value to differentiate F3. J. Magn. Reson. Imaging 2015;41:329-338.(c) 2013 Wiley Periodicals, Inc.

    WILEY-BLACKWELL, 2015年02月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 41 (2), 329 - 338, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Chisa Hosokawa, Kazunari Ishii, Tomoko Hyodo, Kenta Sakaguchi, Kimio Usami, Kenji Shimamoto, Yuzuru Yamazoe, Makoto Hosono, Kazushi Hanada, Masami Ueda, Kazuma Saigo, Takamichi Murakami

    We have encountered occasional equivocal findings when assessing cerebral cortical amyloid retention with C-11-Pittsburgh compound B (PiB) PET. We investigated the diagnostic significance of equivocal PiB PET findings. This retrospective study included 101 consecutive patients complaining of cognitive disorders (30 Alzheimer's disease, 25 mild cognitive impairment, 8 Lewy body disease, 7 frontotemporal lobar degeneration, 31 others) who underwent both C-11-PiB PET and F-18-fluorodeoxy-d-glucose (FDG) PET. We visually classified PiB-positive, PiB-equivocal or PiB-negative ratings according to cortical uptake. For quantitative assessments of PiB PET, standard uptake values referred to cerebellar cortex (SUVR) were calculated in regional template volume of interests (frontal, temporoparietal, precuneus/posterior cingulate cortex, cerebral white matter and cerebellar cortex). The results of visual assessment were compared with the regional and mean cortical SUVRs and cortical-to-white matter ratio of PiB uptake, as well as clinical and FDG PET findings. Among the 101 scans, 41 were PiB negative, 11 were PiB equivocal, and 49 were rated PiB positive in the visual assessments. The mean cortical SUVR and cortical-to-white matter ratio were 0.97 +/- A 0.07 and 0.57 +/- A 0.21 in PiB-negative, 1.51 +/- A 0.17 and 0.75 +/- A 0.06 in PiB equivocal and 2.10 +/- A 0.33 and 0.97 +/- A 0.11 in PiB-positive group, respectively. Nine of 11 subjects with PiB-equivocal findings had cognitive impairments and FDG distribution compatible with Alzheimer's disease or dementia with Lewy bodies. We considered equivocal visual findings on PiB PET equivalent to PiB-positive with slight cortical uptake. In addition, slight cortical amyloid deposits were considered to cause cerebral metabolic abnormality and cognitive impairment. Although mean cortical SUVR was more sensitive than visual assessment because of low cortical-to-white matter contrast due to non-specific accumulation in white matter, it is important not to overlook small amounts of cortical uptake of PiB in visual inspection for exact diagnosis.

    SPRINGER, 2015年02月, ANNALS OF NUCLEAR MEDICINE, 29 (2), 164 - 169, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tetsuro Araki, Mizuki Nishino, Wei Gao, Josée Dupuis, George R. Washko, Gary M. Hunninghake, Takamichi Murakami, George T. O'Connor, Hiroto Hatabu

    Purpose: To investigate the prevalence and CT image characteristics of anterior mediastinal masses in a population-based cohort and their association with the demographics of the participants. Materials and methods: Chest CT scans of 2571 Framingham Heart Study participants (mean age 58.9 years, 51% female) were evaluated by two board-certified radiologists with expertise in thoracic imaging for the presence of anterior mediastinal masses, their shape, contour, location, invasion of adjacent structures, fat content, and calcification. For participants with anterior mediastinal masses, a previous cardiac CT scan was reviewed for interval size change of the masses, when available. The demographics of the participants were studied for any association with the presence of anterior mediastinal masses. Results: Of 2571, 23 participants (0.9%, 95% CI: 0.6-1.3) had anterior mediastinal masses on CT. The most common CT characteristics were oval shape, lobular contour, and midline location, showing soft tissue density (median 32.1. HU). Fat content was detected in a few cases (9%, 2/23). Six out of eight masses with available prior cardiac CT scans demonstrated an interval growth over a median period of 6.5 years. No risk factors for anterior mediastinal masses were detected among participants' demographics, including age, sex, BMI, and cigarette smoking. Conclusions: The prevalence of anterior mediastinal masses is 0.9% in the Framingham Heart Study. Those masses may increase in size when observed over 5-7 years. Investigation of clinical significance in incidentally found anterior mediastinal masses with a longer period of follow-up would be necessary.

    Elsevier Ltd, 2015年01月08日, European Journal of Radiology Open, 2, 26 - 31, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yuki Makino, Yasuharu Imai, Takumi Igura, Masatoshi Hori, Kazuto Fukuda, Yoshiyuki Sawai, Sachiyo Kogita, Norihiko Fujita, Tetsuo Takehara, Takamichi Murakami

    To assess the feasibility of fusion of pre- and post-ablation gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) to evaluate the effects of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), compared with similarly fused CT images This retrospective study included 67 patients with 92 HCCs treated with RFA. Fusion images of pre- and post-RFA dynamic CT, and pre- and post-RFA Gd-EOB-DTPA-MRI were created, using a rigid registration method. The minimal ablative margin measured on fusion imaging was categorized into three groups: (1) tumor protruding outside the ablation zone boundary, (2) ablative margin 0-< 5.0 mm beyond the tumor boundary, and (3) ablative margin a parts per thousand yen5.0 mm beyond the tumor boundary. The categorization of minimal ablative margins was compared between CT and MR fusion images. In 57 (62.0%) HCCs, treatment evaluation was possible both on CT and MR fusion images, and the overall agreement between them for the categorization of minimal ablative margin was good (kappa coefficient = 0.676, P < 0.01). MR fusion imaging enabled treatment evaluation in a significantly larger number of HCCs than CT fusion imaging (86/92 [93.5%] vs. 62/92 [67.4%], P < 0.05). Fusion of pre- and post-ablation Gd-EOB-DTPA-MRI is feasible for treatment evaluation after RFA. It may enable accurate treatment evaluation in cases where CT fusion imaging is not helpful.

    SPRINGER, 2015年01月, ABDOMINAL IMAGING, 40 (1), 102 - 111, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Kazunari Ishii, Chisa Hosokawa, Tomoko Hyodo, Kenta Sakaguchi, Kimio Usami, Kenji Shimamoto, Makoto Hosono, Yuzuru Yamazoe, Takamichi Murakami

    There is evidence that some cases of patients with dementia with Lewy bodies (DLB) can demonstrate Alzheimer disease (AD) like reduced glucose metabolism without amyloid deposition. The aim of this study was to clarify whether regional hypometabolism is related to amyloid deposits in the DLB brain and measure the degree of regional hypometabolism. Ten consecutive subjects with DLB and 10 AD patients who underwent both Pittsburgh compound B (PiB)-PET and F-18-fluoro-2-deoxyglucose (FDG)-PET were included in this study. Regional standardized uptake value ratio (SUVR)s normalised to cerebellar cortices were calculated in the FDG- and PiB-PET images. All AD patients and five DLB patients showed amyloid deposits (PiB positive). In the DLB group the parietotemporal and occipital metabolism were significantly lower than those in the AD group but there was no difference between the posterior cingulate hypometabolism between DLB and AD groups. There were no differences in regional glucose metabolism between PiB positive and negative DLB patients. In the DLB brain, it is suggested that decreased regional glucose metabolism is unrelated to amyloid deposits, although the hypometabolic area overlaps with the AD hypometabolic area and the degree of parietotemporal and occipital hypometabolism in DLB brain is much larger than that in AD brain.

    SPRINGER, 2015年01月, ANNALS OF NUCLEAR MEDICINE, 29 (1), 78 - 83, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasunori Minami, Tomohiro Minami, Hirokazu Chishina, Tadaaki Arizumi, Masahiro Takita, Satoshi Kitai, Norihisa Yada, Satoru Hagiwara, Masakatsu Tsurusaki, Yukinobu Yagyu, Kazuomi Ueshima, Naoshi Nishida, Takamichi Murakami, Masatoshi Kudo

    Objective: To investigate whether balloon-occluded transcatheter arterial chemoembolization (b-TACE) can produce a more dense accumulation of iodized oil in various stages of hepatocellular carcinoma (HCC), from single to uncountable, to overcome inferior local control. Materials and Methods: We studied 27 patients with HCC, including single to uncountable multiple lesions, who underwent b-TACE between August 2013 and April 2015. Dynamic CT was performed at baseline and 1-3 months after b-TACE. The treatment effect (TE) after b-TACE was evaluated using the Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan. Results: In the countable HCC group, contrast-enhanced CT demonstrated RECICL TE4 in 43.8% (14/32), TE3 in 12.5% (4/32), TE2 in 37.5% (12/32), and TEl in 6.3% (2/32) of patients. For the TACE-naive cohort, the objective response rate was 52.9%. The objective response rate was 60% for the previously lACE-treated cohort. In the uncountable multiple HCC group, the objective response rate was 0% (0/10), with progressive disease in 90% (9/10) of patients. Conclusion: Our observations suggested that b-TACE did not reduce the efficacy of retreatment for HCC with an insufficient outcome from conventional TACE, but it could not improve the efficacy of treatment for uncountable multiple HCCs. (C) 2015 S. Karger AG, Basel

    KARGER, 2015年, ONCOLOGY, 89 (Suppl2), 27 - 32, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Chiun Hsu, Bang-Bin Chen, Chien-Hung Chen, Ming-Chih Ho, Jason Chia-Hsien Cheng, Norihiro Kokudo, Takamichi Murakami, Winnie Yeo, Jinsil Seong, Ji-Dong Jia, Kwan-Hyub Han, Ann-Lii Cheng

    A key mission of the Asia-Pacific Primary Liver Cancer Expert (APPLE) Association is to ensure a coherent view for management of hepatocellular carcinoma (HCC) and to advance new treatment for this difficult disease. At the 5th APPLE meeting, held in July 2014 in Taipei, Taiwan, an APPLE consensus development program was established to facilitate discussion among experts in the Asia-Pacific region on pertinent issues for HCC management, including (1) surgery for intermediate/advanced-stage disease, (2) prevention of HCC recurrence after curative treatment, (3) optimizing imaging diagnosis, (4) radiotherapy: current practice and future clinical trials, and (5) the role of cytotoxic chemotherapy. A pre-congress questionnaire was undertaken with the consensus development committee members to help understand the current practice patterns for HCC in the Asia-Pacific region and to identify issues relating to optimal patient care and further clinical trials for which consensus needs to be developed. In this report, the results of the questionnaire are presented, and the pertinent issues identified by each consensus group for further discussion and consensus development are summarized. Copyright (C) 2015 S. Karger AG, Basel

    KARGER, 2015年, LIVER CANCER, 4 (2), 96 - 105, 英語

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    研究論文(学術雑誌)

  • Yasunori Minami, Takamichi Murakami, Masayuki Kitano, Toshiharu Sakurai, Naoshi Nishida, Masatoshi Kudo

    Cone-beam CT (CBCT) is generated during a rotational sweep of the C-arm around the patient, and can be a valuable imaging technique, providing in situ cross-sectional imaging. It is easy to evaluate the morphologic characteristics of hepatic arteries from multiple views with the use of various reconstruction techniques, such as maximum intensity projection (MIP) and volume rendering. CBCTangiography is capable of providing more information than the standard 2-dimensional angiography in visualizing hepatocellular carcinomas (HCCs) and targeting tumors though precise microcatheter placement in close proximity to HCCs. It can also be useful in evaluating treatment success at the time of the procedure. It is anticipated that CBCT could reduce radiation exposure, the overall procedure time and contrast material use because it allows immediate feedback for an efficient angiographic procedure. Therefore, CBCT angiography is an exciting technology with the potential to significantly impact the practice of interventional radiology. The purpose of this article is to provide a review of the principles, clinical applications and technique of CBCT angiography for HCC treatment. (C) 2015 S. Karger AG, Basel

    KARGER, 2015年, DIGESTIVE DISEASES, 33 (6), 759 - 764, 英語

    [査読有り]

  • Bang-Bin Chen, Takamichi Murakami, Tiffany Ting-Fang Shih, Michiie Sakamoto, Osamu Matsui, Byung-Ihn Choi, Myeong-Jin Kim, Jeong Min Lee, Ren-jie Yang, Meng-Su Zeng, Ran-Chou Chen, Ja-Der Liang

    Current novel imaging techniques in the diagnosis of hepatocellular carcinoma (HCC), with the latest evidence in this field, was discussed at the Asia-Pacific Primary Liver Cancer Expert (APPLE) meeting held in Taipei, Taiwan, in July 2014. Based on their expertise in a specific area of research, the novel imaging group comprised 12 participants from Japan, South Korea, Taiwan, and China and it included 10 abdominal radiologists, one hepatologist, and one pathologist. The expert participants discussed topics related to HCC imaging that were divided into four categories: (i) detection method, (ii) diagnostic method, (iii) evaluation method, and (iv) functional method. Consensus was reached on 10 statements; specific comments on each statement were provided to explain the rationale for the voting results and to suggest future research directions. Copyright (C) 2015 S. Karger AG, Basel

    KARGER, 2015年, LIVER CANCER, 4 (4), 215 - 227, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masakatsu Tsurusaki, Takamichi Murakami

    Transcatheter arterial chemoembolization (TACE) is performed worldwide for patients with intermediate-stage hepatocellular carcinoma (HCC). TACE has produced survival advantages in two randomized controlled trials and a meta-analysis, and is currently the mainstay of treatment for this stage of HCC. However, there are currently no global guidelines regarding the dose, choice or combination of cytotoxic agents for TACE; therefore, it is difficult to compare data from different TACE studies. In Japan, most of the TACE procedures have been based on iodized oil as conventional TACE, utilizing the microembolic and drug-carrying characteristic of iodized oil. Superselective TACE with lipiodol is the primary TACE procedure that has reported satisfactory levels of local control associated with a lower risk of complications. Conversely, TACE performed using drug-eluting beads has been widely used in western countries, and this has shown similar tumor response and median survival compared to conventional TACE. Moreover, the combination of TACE and molecular targeted agents is now ongoing to evaluate the synergistic effect. In this review, the indication, technical issues, and complications of TACE are reviewed. Copyright (C) 2015 S. Karger AG, Basel

    KARGER, 2015年, LIVER CANCER, 4 (3), 165 - 175, 英語

    [査読有り]

  • Yukinobu Yagyu, Masakatsu Tsurusaki, Kazutoshi Kamiyama, Hajime Kitagaki, Takamichi Murakami

    To evaluate the feasibility and technical aspects of transcatheter arterial chemoembolization (TACE) for non-resectable hepatocellular carcinoma (HCC) using a 3.5-French (Fr) catheter system. This study included 328 consecutive cases of HCC among 232 patients who underwent TACE procedures using both a 3.5-Fr catheter system and a microcatheter fitted to a 3.5-Fr system between April 2009 and November 2011. We assessed the ability to reach the catheter into the proper hepatic artery (PHA), main hepatic branch, segmental artery, and subsegmental or sub-subsegmental artery. The feasibility was rated according to the following factors: (1) the number of arteries that could be used to reach the target artery/total number of procedures using the 3.5-Fr system, (2) the rate of successful completion of the procedures without changing over to the 4-Fr system and (3) the reasons for changing over the 4-Fr system. TACE of the PHA (27 sessions), RHA/LHA (103 sessions), segmental (31 sessions), or subsegmental/sub-subsegmental arteries (162 sessions) was performed. The rate of successfully reaching the target artery using the 3.5-Fr system was 93% (306/328 sessions). We were unable to reach the target artery in 22 sessions, including 11/8/3 procedures targeting the sub-subsegmental artery, subsegmental artery, and RHA/LHA, respectively. We changed over to the 4-Fr system in six sessions; therefore, the rate of successful completion of the procedures without changing over to the 4-Fr system was 98% (322/328 sessions). TACE of the target artery can be successfully performed using the 3.5-Fr system in most patients with HCC.

    SPRINGER, 2014年12月, ABDOMINAL IMAGING, 39 (6), 1304 - 1308, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 若林 雄一, 石井 一成, 河内 崇, 細川 知紗, 山川 美帆, 兵頭 朋子, 任 誠雲, 鶴崎 正勝, 足利 竜一郎, 松木 充, 細野 眞, 北村 登, 村上 卓道

    (一社)日本核医学会, 2014年11月, 核医学, 51 (4), 438 - 439, 日本語

  • Keitaro Sofue, Masakatsu Tsurusaki, Takamichi Murakami, Shunsuke Onoe, Hiroyuki Tokue, Kentaro Shibamoto, Yasuaki Arai, Kazuro Sugimura

    To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy. A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated. Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients. The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients. aEuro cent Accurate preoperative imaging is essential for surgical planning and successful hepatic resection. aEuro cent Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases. aEuro cent EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.

    SPRINGER, 2014年10月, EUROPEAN RADIOLOGY, 24 (10), 2532 - 2539, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 軽症アルツハイマー病の18F-FDG PETと11C-PiB PET検査の経時的画像変化の検討

    細川 知紗, 石井 一成, 兵頭 朋子, 坂口 健太, 宇佐美 公男, 若林 雄一, 鶴崎 正勝, 松木 充, 細野 眞, 村上 卓道

    (一社)日本核医学会, 2014年09月, 核医学, 51 (3), 284 - 284, 日本語

  • Masahiro Okada, Tetsuya Wakayama, Norihisa Yada, Tomoko Hyodo, Kazushi Numata, Yuki Kagawa, Daisuke Nishiyama, Keizo Miyakoshi, Takamichi Murakami

    To investigate optimal flip angle (FA) of three-dimensional fat-suppressed T1-weighted image on Gd-EOB-DTPA-enhanced MRI. Forty-five patients with 35 hepatocellular carcinomas (HCCs) and 16 liver metastases (METs) were investigated. Signal-to-noise ratio (SNR), tumor-to-liver contrast (TLC) of HCC and MET, visual image quality (IQ) and lesion conspicuity (LeCo) were evaluated at hepatobiliary phase with different FAs (FA15A degrees-30A degrees-45A degrees-60A degrees in 13 patients, FA5A degrees-10A degrees-15A degrees-20A degrees-25A degrees in 32 patients). TLC gradually showed better in range from FA15A degrees to FA60A degrees and FA5A degrees to FA25A degrees, but SNRs gradually decreased. SNR and TLC-MET at FA15A degrees were significantly better than those at FA45A degrees and FA60A degrees. SNR at FA10A degrees was significantly higher than at FA5A degrees, FA20A degrees, and FA25A degrees. TLC-HCC and TLC-MET at FA5A degrees were inferior to other FAs. IQs and LeCos at FA15A degrees and FA30A degrees were superior to those at FA45A degrees and FA60A degrees. IQs at FA5A degrees and FA25A degrees were significantly lower than those at FA10A degrees-20A degrees, although LeCos for HCC and MET at FA25A degrees were superior to those at FA5A degrees-20A degrees. FA ranging from 10A degrees to 20A degrees is suitable for hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI, to image HCC and MET.

    SPRINGER, 2014年08月, ABDOMINAL IMAGING, 39 (4), 694 - 701, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hideko Ohama, Yasuharu Imai, Osamu Nakashima, Sachiyo Kogita, Manabu Takamura, Masatoshi Hori, Yasushi Seki, Yoshiyuki Sawai, Takumi Igura, Kazuto Fukuda, Yuki Makino, Osakuni Morimoto, Masahiko Ohsawa, Michiie Sakamoto, Takamichi Murakami

    Little is known about the difference in enhancement patterns of hepatocellular carcinoma (HCC) during multistep hepatocarcinogenesis between the post-vascular phase of Sonazoid-enhanced ultrasonography (SEUS) and hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI, as well as uptakes of Sonazoid and Gd-EOB-DTPA by HCC. Seventy patients with 73 histologically proven HCCs (33 hypovascular well-differentiated HCCs and 40 progressed HCCs) and 9 dysplastic nodules (DNs) were enrolled. Enhancement patterns of the lesions on the post-vascular phase of SEUS and hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI were evaluated. Uptakes of Sonazoid and Gd-EOB-DTPA were assessed by Sonazoid enhancement index and EOB enhancement ratio in relation to immunohistochemistry of CD68 and organic anion transporting polypeptide 8 (OATP8), respectively. On the post-vascular phase of SEUS, none of the 9 DNs and 3 of 33 hypovascular well-differentiated HCCs (9 %) were hypoechoic, whereas 3 of 9 DNs (33 %) and 31 of 33 hypovascular well-differentiated HCCs (94 %) showed hypointensity on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. Of 31 progressed HCCs, 95 and 93 % were hypoechoic and hypointense on the post-vascular phase of SEUS and hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI, respectively. Sonazoid enhancement indexes decreased in progressed HCCs, correlating with lower Kupffer cell numbers (P < 0.001). EOB enhancement ratios decreased in hypovascular well-differentiated and progressed HCCs, as OATP8 expression declined (P < 0.001). In stepwise hepatocarcinogenesis, uptake of Sonazoid starts decreasing later than that of Gd-EOB-DTPA. Although signal reductions on the post-vascular phase of SEUS or hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI suggest HCC, hypoechoic appearance on the post-vascular phase of SEUS might be HCC-specific, particularly progressed HCC.

    SPRINGER JAPAN KK, 2014年06月, JOURNAL OF GASTROENTEROLOGY, 49 (6), 1081 - 1093, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Comparison between SUV and BP images acquired using 11C-PIB PET: Questionable PIB accumulation in SUV images

    Chisa Hosokawa, Kazunari Ishii, Yuichi Kimura, Kenta Sakaguchi, Makoto Hosono, Takamichi Murakami

    SOC NUCLEAR MEDICINE INC, 2014年05月, JOURNAL OF NUCLEAR MEDICINE, 55, 英語

    [査読有り]

  • H. Takahashi, K. Ishii, C. Hosokawa, T. Hyodo, N. Kashiwagi, M. Matsuki, R. Ashikaga, T. Murakami

    BACKGROUND AND PURPOSE: Alzheimer disease is the most common neurodegenerative disorder with dementia, and a practical and economic biomarker for diagnosis of Alzheimer disease is needed. Three-dimensional arterial spin-labeling, with its high signal-to-noise ratio, enables measurement of cerebral blood flow precisely without any extrinsic tracers. We evaluated the performance of 3D arterial spin-labeling compared with SPECT, and demonstrated the 3D arterial spin-labeled imaging characteristics in the diagnosis of Alzheimer disease. MATERIALS AND METHODS: This study included 68 patients with clinically suspected Alzheimer disease who underwent both 3D arterial spin-labeling and SPECT imaging. Two readers independently assessed both images. Kendall W coefficients of concordance (K) were computed, and receiver operating characteristic analyses were performed for each reader. The differences between the images in regional perfusion distribution were evaluated by means of statistical parametric mapping, and the incidence of hypoperfusion of the cerebral watershed area, referred to as "borderzone sign" in the 3D arterial spin-labeled images, was determined. RESULTS: Readers showed K = 0.82/0.73 for SPECT/3D arterial spin-labeled imaging, and the respective areas under the receiver operating characteristic curve were 0.82/0.69 for reader 1 and 0.80/0.69 for reader 2. Statistical parametric mapping showed that the perisylvian and medial parieto-occipital perfusion in the arterial spin-labeled images was significantly higher than that in the SPECT images. Borderzone sign was observed on 3D arterial spin-labeling in 70% of patients misdiagnosed with Alzheimer disease. CONCLUSIONS: The diagnostic performance of 3D arterial spin-labeling and SPECT for Alzheimer disease was almost equivalent. Three-dimensional arterial spin-labeled imaging was more influenced by hemodynamic factors than was SPECT imaging.

    AMER SOC NEURORADIOLOGY, 2014年05月, AMERICAN JOURNAL OF NEURORADIOLOGY, 35 (5), 906 - 911, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hiroto Takahashi, Masahiro Okada, Tomoko Hyodo, Syojiro Hidaka, Yuki Kagawa, Mitsuru Matsuki, Masakatsu Tsurusaki, Takamichi Murakami

    Purpose: To investigate whether low-dose dynamic CT of the liver with iterative reconstruction can reduce both the radiation dose and the amount of contrast medium. Materials and methods: This study was approved by our institutional review board. 113 patients were randomly assigned to one of two groups. Group A/group B (fifty-eight/fifty-five patients) underwent liver dynamic CT at 120/100 kV, with 0/40% adaptive statistical iterative reconstruction (ASIR), with a contrast dose of 600/480 mg I/kg, respectively. Radiation exposure was estimated based on the manufacturer's phantom data. The enhancement value of the hepatic parenchyma, vessels and the tumor-to-liver contrast of hepatocellular carcinomas (HCCs) were compared between two groups. Two readers independently assessed the CT images of the hepatic parenchyma and HCCs. Results: The mean CT dose indices: 6.38/4.04 mGy, the dose-length products: 194.54/124.57 mGy cm, for group A/group B. The mean enhancement value of the hepatic parenchyma and the tumor-to-liver contrast of HCCs with diameters greater than 1 cm in the post-contrast all phases did not differ significantly between two groups (P > 0.05). The enhancement values of vessels in group B were significantly higher than that in group A in the delayed phases (P < 0.05). Two reader's confidence levels for the hepatic parenchyma in the delayed phases and HCCs did not differ significantly between the groups (P > 0.05). Conclusions: Low-dose dynamic CT with ASIR can reduce both the radiation dose and the amount of contrast medium without image quality degradation, compared to conventional dynamic CT without ASIR. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2014年04月, EUROPEAN JOURNAL OF RADIOLOGY, 83 (4), 684 - 691, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 多発結節影を呈した肺アミロイドーシスの1例

    日高 正二朗, 小塚 健倫, 柳生 行伸, 柏木 伸夫, 今岡 いずみ, 松木 充, 足利 竜一朗, 細野 眞, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2014年02月, Japanese Journal of Radiology, 32 (Suppl.), 39 - 39, 日本語

  • 蠕動運動の月経周期による変化を観察した双角子宮の1例

    荒木 哲朗, 今岡 いずみ, 日高 正二朗, 岡田 真広, 柳生 行伸, 松木 充, 足利 竜一朗, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2014年02月, Japanese Journal of Radiology, 32 (Suppl.), 40 - 40, 日本語

  • 腫瘤形成した慢性唾液腺炎のFDG-PET/CT所見

    細川 知紗, 柏木 伸夫, 松久保 祐子, 山田 穣, 任 誠雲, 兵頭 朋子, 高橋 洋人, 柳生 行伸, 岡田 真広, 小塚 健倫, 今岡 いずみ, 鶴崎 正勝, 松木 充, 足利 竜一郎, 細野 眞, 石井 一成, 村上 卓道, 筑後 雅章

    (公社)日本医学放射線学会, 2014年02月, Japanese Journal of Radiology, 32 (Suppl.), 45 - 45, 日本語

  • Masahiro Okada, Takamichi Murakami

    Computed tomography (CT) is essential for the diagnosis of liver tumors. In the CT criteria of hypervascular hepatocellular carcinoma (HCC), the diagnosis is based on hemodynamic findings, such as arterial enhancement, followed by washout in the portal-venous and/or equilibrium phase. In this chapter, typical and atypical findings (HCC mimickers) of HCC on CT and current diagnostic techniques to image HCC were stated.

    Springer US, 2014年01月01日, Abdomen and Thoracic Imaging: An Engineering and Clinical Perspective, 317 - 346, 英語

    [査読有り]

    論文集(書籍)内論文

  • MR imaging of hydrogel scleral buckle as a late complication after retinal detachment surgery

    Ashikaga R, Im S, Yagyu Y, Abe K, Ono Y, Matsumoto C, Murakami T

    2014年01月, Acta Med Kinki Univ, 38 (2), 111 - 113

  • Masakatsu Tsurusaki, Masahiko Okada, Hiroyuki Kuroda, Mitsuru Matsuki, Kazunari Ishii, Takamichi Murakami

    Positron emission tomography (PET) is widely available and its application with 2-[F-18] fluoro-2-deoxy-D-glucose (F-18-FDG) in oncology has become one of the standard imaging modalities in diagnosing and staging of tumors, and monitoring the therapeutic efficacy in hepatic malignancies. Recently, investigators have measured glucose utilization in liver tumors using F-18-FDG and positron emission tomography/computer tomography (PET/CT) in order to establish a diagnosis of tumors, assess their biologic characteristics and predict therapeutic effects on hepatic malignancies. The PET/CT with F-18-FDG may further enhance the hepatic malignancy diagnostic algorithm by accurate diagnosis, staging, restaging and evaluating its biological characteristics, which can benefit the patients suffering from primary and metastatic hepatic tumors such as hepatocellular carcinoma (HCC), cholangiocarcinoma (CCC), and metastatic liver tumor.

    SPRINGER JAPAN KK, 2014年01月, JOURNAL OF GASTROENTEROLOGY, 49 (1), 46 - 56, 英語

    [査読有り]

  • H. Takahashi, N. Kashiwagi, T. Chikugo, K. Nakanishi, Y. Tomita, T. Murakami

    AIM: To report the magnetic resonance imaging (MRI) and corresponding histopathological features of squamous cell carcinoma (SCC) originating in the parotid gland. MATERIALS AND METHODS: The MRI images of seven patients with histopathologically proven SCC originating in the parotid gland were reviewed retrospectively, with an emphasis on tumour size, shape, contour definition, extraparotid infiltration, signal characteristics, and the presence of central necrosis. These were correlated with the microscopic findings of the surgical specimens. RESULTS: The tumours ranged in size from 3.9-7 cm (mean 4.7 cm). All tumours had an ill-defined margin with extraparotid infiltration, which seemed to reflect the invasive growth of the tumour cells on histopathological examination. The solid portions of the tumours showed predominantly low to intermediate signal intensities on T2-weighted images, which seemed to reflect the high cellularity, intercellular bridges, and/or keratin pearl formation observed at histopathological examination. Five of the seven tumours had central necrosis. CONCLUSION: A relatively large tumour with central necrosis is a useful imaging feature of SCCs originating in the parotid gland, in addition to the well-recognized indicators of parotid malignancy, such as an ill-defined margin, extraparotid infiltration, and low to intermediate signal intensity on T2-weighted images. (C) 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

    W B SAUNDERS CO LTD, 2014年01月, CLINICAL RADIOLOGY, 69 (1), 41 - 44, 英語

    研究論文(学術雑誌)

  • Ken Kamata, Masayuki Kitano, Masatoshi Kudo, Hiroki Sakamoto, Kumpei Kadosaka, Takeshi Miyata, Hajime Imai, Kiyoshi Maekawa, Takaaki Chikugo, Masashi Kumano, Tomoko Hyodo, Takamichi Murakami, Yasutaka Chiba, Yoshifumi Takeyama

    Background and study aims: Pancreatic ductal adenocarcinomas (PDAC) sometimes arise in patients with intraductal papillary mucinous neoplasms (IPMNs). This study examined the incidence of PDACs concomitant to or derived from branch duct IPMNs. The usefulness of endoscopic ultrasonography (EUS) relative to other imaging methods for detecting these tumors was also assessed. Patients and methods: This retrospective study used data from clinical records and imaging studies that were collected prospectively. During 2001-2009, 167 consecutive patients with IPMNs underwent EUS, ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). The 102 patients whose branch duct IPMNs lacked mural nodules/symptoms and thus did not qualify for resection were followed up by semiannual EUS and annual ultrasonography, CT, and MRI. The sensitivity and specificity with which the four modalities detected IPMN-derived and -concomitant PDACs at the first examination and throughout the study period were evaluated. The rate of PDAC development during follow-up was analyzed by the Kaplan-Meier method. Results: A total of 17 IPMN-derived and 11 IPMN-concomitant PDACs were diagnosed at the first examination. Lesions that did not qualify for resection or chemotherapy were followed up for a median of 42 months. Seven IPMN-concomitant PDACs and no IPMN-derived PDACs were detected during follow-up. The 3- and 5-year rates of IPMN-concomitant PDAC development were 4.0% and 8.8%, respectively. At the first examination, EUS was superior to other imaging modalities in terms of IPMN-derived and -concomitant PDAC detection. Throughout the study period, including follow-up, EUS was significantly better at detecting IPMN-concomitant PDACs than the other modalities. Conclusions: IPMN-concomitant PDACs are quite often found at diagnosis and during follow-up.EUS examination of the whole pancreas plays an important role in the management of IPMNs as it allows the early detection of these small invasive carcinomas.

    GEORG THIEME VERLAG KG, 2014年01月, ENDOSCOPY, 46 (1), 22 - 29, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Ken Kamata, Masayuki Kitano, Masatoshi Kudo, Hiroki Sakamoto, Kumpei Kadosaka, Takeshi Miyata, Hajime Imai, Kiyoshi Maekawa, Takaaki Chikugo, Masashi Kumano, Tomoko Hyodo, Takamichi Murakami, Yasutaka Chiba, Yoshifumi Takeyama

    Georg Thieme Verlag, 2014年, Endoscopy, 46 (4), 358, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masashi Kono, Tatsuo Inoue, Masatoshi Kudo, Hirokazu Chishina, Tadaaki Arizumi, Masahiro Takita, Satoshi Kitai, Norihisa Yada, Satoru Hagiwara, Yasunori Minami, Kazuorni Ueshima, Naoshi Nishida, Takamichi Murakami

    Objective:The purpose of this study was to evaluate the risk factors for local recurrence with radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) measuring <= 2 cm. Methods: This study involved 234 patients with 274 HCCs measuring cm who had undergone RFA as the initial treatment. The mean tumor diameter was 1.478 cm. The median follow-up period was 829 days. We evaluated the post-RFA cumulative local recurrence rate and analyzed the risk factors contributing to clinical outcomes. Results: Cumulative local recurrence rates were 9, 19 and 19% at 1,2 and 3 years, respectively. Among the 145 cases with a complete safety margin (SM) after RFA, only 4 developed local tumor recurrence and the cumulative rates of local tumor recurrence at 1, 2 and 3 years were 2, 3 and 3%, respectively. Among the 129 cases with incomplete SM, local tumor recurrence developed in 34 and the cumulative rates of local tumor progression at 1, 2 and 3 years were 14, 36 and 36%, respectively. In multivariate analysis, significant risk factors were tumor location (liver surface), irregular gross type and SM <5 mm. Conclusion: Even with HCC measuring cm, location and gross type of tumor should be carefully evaluated before RFA is performed. (C) 2014 S. Karger AG, Basel

    KARGER, 2014年, DIGESTIVE DISEASES, 32 (6), 670 - 677, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Murakami T, Tsurusaki M, Hyodo T, Imai Y

    Informa UK Limited, 2014年, Journal of Hepatocellular Carcinoma, 1, 101 - 108

    [査読有り]

    研究論文(学術雑誌)

  • Takamichi Murakami, Masakatsu Tsurusaki

    Most liver tumors are benign and hypervascular, and it is important to avoid unnecessary interventions for benign lesions. This review describes the typical and atypical imaging features of common hypervascular benign liver tumors and outlines a general approach to distinguishing between benign and malignant hepatic lesions. There are many types of benign liver tumors that need to be differentiated from hepatocellular carcinoma (HCC). Therefore, it is very important to know the imaging characteristics of benign tumors. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging is helpful in diagnosing hypervascular pseudotumors, focal nodular hyperplasia, and nodular lesions associated with alcohol-induced hepatitis. There are also some hypervascular malignant tumors, such as cholangiocarcinoma, cholangiolocellular carcinoma, mixed type tumors, and metastatic liver tumors, which also required differentiation from HCC. Copyright (C) 2014 S. Karger AG, Basel

    KARGER, 2014年, LIVER CANCER, 3 (2), 85 - 96, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasunori Minami, Yukinobu Yagyu, Takamichi Murakami, Masatoshi Kudo

    Purpose: New tracking navigation imaging software was used to evaluate the usefulness of three dimensional (3D) CT angiography for transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Materials and Methods: Fifty-two patients with 73 HCCs were enrolled in this study retrospectively. Rotational angiography was performed from the hepatic artery for evaluation of the tumor feeding vessels. Arteries feeding the tumor were traced automatically by adjusting the region of interest around the targeted tumor on axial and coronal images using tracking navigation imaging with 3D cone-beam CT angiography. Results: Using final selective angiographic findings as the gold standard, the detection of feeding vessels was 90.4% (66/73) for tracking navigation imaging and 50.7% (37/73) for celiac trunk angiography. This difference was statistically significant (Wilcoxon rank sum test, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of feeding arteries were 97.1% (66/68), 80.0% (4/5), 98.5% (66/67), and 66.7% (4/6), respectively. The kappa coefficient had a value of 0.638 (95% CI: 0.471-0.805), which is considered to indicate a good degree of agreement. With the as-sistance of tracking navigation imaging, the disease control rate of TACE for HCC was 67.3% (35/52) according to the modified Response Evaluation Criteria in Solid Tumors. During follow- up periods of 1-11 months, 10 patients (19.2%) remained cancer-free after TACE. Conclusion: Tracking navigation imaging with 3D cone-beam CT angiography should be useful for TACE in HCC patients with complicated feeding arteries. Copyright (C) 2014 S. Karger AG, Basel

    KARGER, 2014年, LIVER CANCER, 3 (1), 53 - 61, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yuko Matsukubo, Nobuo Kashiwagi, Masanobu Uemura, Sachiyo Tatsumi, Hiroto Takahashi, Tomoko Hyodo, Noriyuki Tomiyama, Ryuichiro Ashikaga, Kazunari Ishii, Takamichi Murakami

    Introduction: The aim of this study was to investigate the prevalence of intravertebral pneumatocyst (IVP) of the cervical spine by age group, compared with that of intradiscal vacuum (IDV). Methods: We investigated 500 consecutive patients who underwent cervical computed tomography (CT) from May 2012 to May2013 for various indications. CT datasets were assessed for the presence of IVPs and IDVs with stratification by age. Results: IVPs of the cervical spine were detected in 8 % (7 of 86 subjects) of patients in their forties or below, 30 % (23 of 75) in their fifties, 49 % (67 of 136) in their sixties, 55 % (76 of 137) in their seventies, and 60 % (40 of 66) in their eighties or over. IDVs of the cervical spine were detected in 6, 25, 48, 54, and 57 %, respectively. Coexistence of both phenomena was identified in 4, 17, 33, 40, and 43 %, respectively. Conclusion: IVPs of the cervical spine are a common incidental finding, increasing in prevalence with age and more common than IDV in all age groups. © 2013 Springer-Verlag Berlin Heidelberg.

    11, 2013年11月, Neuroradiology, 55 (11), 1341 - 1344, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 細川 知紗, 石井 一成, 木村 裕一, 兵頭 朋子, 坂口 健太, 宇佐美 公男, 細野 眞, 村上 卓道

    (一社)日本核医学会, 2013年11月, 核医学, 50 (4), 327 - 327, 日本語

  • Yuki Kagawa, Masahiro Okada, Yukinobu Yagyu, Seishi Kumano, Masayuki Kanematsu, Masayuki Kudo, Takamichi Murakami

    Background: A new multiphasic fast imaging technique, known as volume helical shuttle technique, is a breakthrough for liver imaging that offers new clinical opportunities in dynamic blood flow studies. This technique enables virtually real-time hemodynamics assessment by shuttling the patient cradle back and forth during serial scanning. Purpose: To determine optimal scan timing of hepatic arterial-phase imaging for detecting hypervascular hepatocellular carcinoma (HCC) with maximum tumor-to-liver contrast by volume helical shuttle technique. Material and Methods: One hundred and one hypervascular HCCs in 50 patients were prospectively studied by 64-channel multidetector-row computed tomography (MDCT) with multiphasic fast imaging technique. Contrast medium containing 600 mg iodine per kg body weight was intravenously injected for 30 s. Six seconds after the contrast arrival in the abdominal aorta detected with bolus tracking, serial 12-phase imaging of the whole liver was performed during 24-s breath-holding with multiphasic fast imaging technique during arterial phase. By placing regions of interest in the abdominal aorta, portal vein, liver parenchyma, and hypervascular HCCs on the multiphase images, time-density curves of anatomical regions and HCCs were composed. Timing of maximum tumor-to-liver contrast after the contrast arrival in the abdominal aorta was determined. Results: For the detection of hypervascular HCC at arterial phase, mean time and value of maximum tumor-to-liver contrast after the contrast arrival were 21 s and 38.0 HU, respectively. Conclusion: Optimal delay time for the hepatic arterial-phase imaging maximizing the contrast enhancement of hypervascular HCCs was 21 s after arrival of contrast medium in the abdominal aorta.

    ROYAL SOC MEDICINE PRESS LTD, 2013年10月, ACTA RADIOLOGICA, 54 (8), 843 - 850, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Mitsuru Matsuki, Takamichi Murakami, Hiroshi Juri, Shushi Yoshikawa, Yoshifumi Narumi

    Background: While CT is widely used in medical practice, a substantial source of radiation exposure is associated with an increased lifetime risk of cancer. Therefore, concerns to dose reduction in CT examinations are increasing and an iterative reconstruction algorithm, which allow for dose reduction by compensating image noise in the image reconstruction, has been developed. Purpose: To investigate the performance of low-dose abdominal CT using adaptive iterative dose reduction 3D (AIDR 3D) compared to routine-dose CT using filtered back projection (FBP). Material and Methods: Fifty-eight patients underwent both routine-dose CT scans using FBP and low-dose CT scans using AIDR 3D in the abdomen. The image noise levels, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) of the aorta, portal vein, liver, and pancreas were measured and compared in both scans. Visual evaluations were performed. The volume CT dose index (CTDIvol) was measured. Results: Image noise levels on low-dose CT images using AIDR 3D were significantly lower than, or not significantly different from, routine-dose CT images using FBP in reviewing the data on the basis of all patients and the three BMI groups. SNRs and CNRs on low-dose CT images using AIDR 3D were significantly higher than, or not significantly different from, routine-dose CT images using FBP in reviewing the data on the basis of all patients and the three BMI groups. In visual evaluation of the images, there were no statistically significant differences between the scans in all organs independently of BMI. The average CTDIvol at routine-dose and low dose CT was 21.4 and 10.8 mGy, respectively. Conclusion: Low-dose abdominal CT using AIDR 3D allows for approximately 50% reduction in radiation dose without a degradation of image quality compared to routine-dose CT using FBP independently of BMI.

    SAGE PUBLICATIONS LTD, 2013年10月, ACTA RADIOLOGICA, 54 (8), 869 - 875, 英語

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    研究論文(学術雑誌)

  • Yuki Makino, Yasuharu Imai, Takumi Igura, Masatoshi Hori, Kazuto Fukuda, Yoshiyuki Sawai, Sachiyo Kogita, Hideko Ohama, Yasushi Matsumoto, Masanori Nakahara, Shinichiro Zushi, Masanori Kurokawa, Keisuke Isotani, Manabu Takamura, Norihiko Fujita, Takamichi Murakami

    Aim: To demonstrate the usefulness of the computed tomography (CT) fusion imaging for the evaluation of treatment effect of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods: Eighty-five patients with 94 HCC with complete ablation judged on conventional side-by-side interpretation of pre-RFA and post-RFA CT at the time of RFA were included in this retrospective study. CT data was retrospectively used to create fusion images of pre-RFA and post-RFA CT using automatic rigid registration and manual correction referring to intrahepatic structures and hepatic contours around a tumor. Clinical factors including a minimal ablative margin (MAM) measured on fusion images were examined to prove risk factors for local tumor progression (LTP). Results: LTP was observed in 13 (13.8%) tumors with a median follow up of 21.0 months (range, 2-75). The mean MAM on the fusion image was 1.4 +/- 3.1mm and 23 tumors (24.5%) were judged to be protruding from the ablation zone. Multivariate analysis revealed that protruding from the ablation zone was the only significant factor for LTP (hazard ratio, 7.09; 95% confidential interval, 2.26-22.3; P<0.001). Conclusion: Some HCC were assessed as incomplete ablation on the CT fusion images, although considered completely ablated on side-by-side images at the time of treatment, and incomplete ablation was revealed to be the only independent risk factor for LTP. The CT fusion imaging enables quantitative and accurate evaluation of treatment effect of RFA.

    WILEY-BLACKWELL, 2013年09月, HEPATOLOGY RESEARCH, 43 (9), 950 - 958, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomoaki Ichikawa, Masahiro Okada, Hiroshi Kondo, Hironobu Sou, Takamichi Murakami, Masayuki Kanematsu, Shushi Yoshikawa, Kazuhito Shiosakai, Akiko Hayakawa, Kazuo Awai, Kengo Yoshimitsu, Yasuyuki Yamashita

    Rationale and Objectives: To determine the recommended iodine dose of contrast material (CM) for hepatic arterial-dominant phase (HAP) and hepatic parenchymal phase (HPP) imaging to assess hypervascular hepatocellular carcinoma (HCC). Materials and Methods: This was a prospective study including 348 patients with hypervascular HCC in 77 hospitals as a postmarketing surveillance to investigate the effects of body weight-tailored dose of CM (300 mgl/mL of iohexol) for hepatic multiphasic contrast-enhanced multidetector-row computed tomography imaging. Informed consent was obtained from all patients who were enrolled. The tumor-to-liver contrast (TLC) of HAP images was assessed qualitatively (QL-TLC) and quantitatively (QT-TLC [HU]; computed tomography [CT] value of tumor-CT value of hepatic parenchyma). Minimal and sufficient QT-TLC were defined as CT values corresponding to the median and 75% of QL-TLC assigned with "good," respectively. The recommended iodine dose was estimated by the relationship between iodine dose (mgl/kg) and QT-TLC. Results: There was a good correlation between QL-TLC and QT-TLC. The recommended iodine dose of CM for HAP imaging was considered to be in the range of 567-647 mgl/kg based on minimal (33.7 HU) and sufficient QT-TLC (40.9 HU). Meanwhile, the recommended dose of CM for HPP imaging was 572 mgl/kg as a dose that gives hepatic enhancement more than 50 HU during HPP imaging. Conclusions: The recommended iodine dose of CM for HAP and HPP imaging may be different, being 567-647 mgl/kg and 572 mgl/kg, respectively, in assessing hypervascular HCC.

    ELSEVIER SCIENCE INC, 2013年09月, ACADEMIC RADIOLOGY, 20 (9), 1130 - 1136, 英語

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    研究論文(学術雑誌)

  • 細川 知紗, 石井 一成, 木村 裕一, 兵頭 朋子, 細野 眞, 坂口 健太, 宇佐美 公男, 村上 卓道

    (一社)日本核医学会, 2013年09月, 核医学, 50 (3), S182 - S182, 日本語

  • Masatoshi Hori, Tonsok Kim, Hiromitsu Onishi, Izumi Imaoka, Yuki Kagawa, Takamichi Murakami, Atsushi Nakamoto, Takashi Ueguchi, Mitsuaki Tatsumi, Takayuki Enomoto, Tadashi Kimura, Noriyuki Tomiyama

    To prospectively assess the efficacy of 3-T magnetic resonance (MR) imaging using the three-dimensional turbo spin-echo T2-weighted and diffusion-weighted technique (3D-TSE/DW) compared with that of conventional imaging using the two-dimensional turbo spin-echo T2-weighted and dynamic contrast-enhanced technique (2D-TSE/DCE) for the preoperative staging of endometrial cancer, with pathological analysis as the reference standard. Seventy-one women with endometrial cancer underwent MR imaging using 3D-TSE/DW (b = 1,000 s/mm(2)) and 2D-TSE/DCE. Two radiologists independently assessed the two imaging sets. Accuracy, sensitivity, and specificity for staging were analysed with the McNemar test; the areas under the receiver operating characteristic curve (Az) were compared with a univariate z-score test. The results for assessing deep myometrial invasion, accuracy, sensitivity, specificity and Az, respectively, were as follows: 3D-TSE/DW-observer 1, 87 %, 95 %, 85 % and 0.96; observer 2, 92 %, 84 %, 94 % and 0.95; 2D-TSE/DCE-observer 1, 80 %, 79 %, 81 % and 0.89; observer 2, 86 %, 84 %, 87 % and 0.86. Most of the values were higher with 3D-TSE/DW without significant differences (P > 0.12). For assessing cervical stromal invasion, there were no significant differences in those values for both observers (P > 0.6). Accuracy of 3D-TSE/DW was at least equivalent to that of the conventional technique for the preoperative assessment of endometrial cancer.

    SPRINGER, 2013年08月, EUROPEAN RADIOLOGY, 23 (8), 2296 - 2305, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Christoph J. Zech, Carlo Bartolozzi, Paulette Bioulac-Sage, Pierce K. Chow, Alejandro Forner, Luigi Grazioli, Alexander Huppertz, Herve Laumonier, Jeong Min Lee, Takamichi Murakami, Jens Ricke, Claude B. Sirlin

    OBJECTIVE. This article reviews topics discussed during the Fifth International Forum for Liver MRI (with a focus on gadoxetic acid-enhanced MRI), which was held in Munich, Germany, in September 2011. CONCLUSION. Growing evidence shows that gadoxetic acid-enhanced MRI has high sensitivity and specificity for diagnosing liver tumors. Hepatobiliary phase imaging adds new information for the characterization of borderline lesions. However, there is a need to develop standardized criteria for interpretation of gadoxetic acid-enhanced MRI in patients with cirrhosis or other risk factors for hepatocellular carcinoma. © American Roentgen Ray Society.

    1, 2013年07月, American Journal of Roentgenology, 201 (1), 97 - 107, 英語

    [査読有り]

  • Rieko Okada, Takeshi Okuda, Naoki Nakano, Kazuhiko Nishimatsu, Hiroyuki Fukushima, Minori Onoda, Toshiho Otsuki, Kazunari Ishii, Takamichi Murakami, Amami Kato

    The aim of this study was to identify the location associated with primitive sentence processing. Processing related to generation and comprehension of sentences ("sentence processing") is postulated to be largely divided into syntactic processing (processing related to the formation of sentences and to verb reflection and particles) and verb information (argument structure and thematic role). Numerous lesion studies and functional brain imaging studies on unimpaired individuals have suggested that the left inferior frontal gyrus (IFG) is involved in syntactic processing. In addition, some studies have reported that the area from the left parietal lobe to the posterior superior temporal gyrus is involved in processing information such as argument structure and thematic role. However, studies on sentence processing using functional brain imaging have used complex sentences as tasks, raising the possibility that the results show the demands on not only language processing, but also on working memory. To clarify the brain areas involved in basic sentence processing in human language, there is a need to examine tasks involved in sentence processing that assume more primitive processing with minimal demands on working memory. The present study used sentence-completion tasks in the Japanese language that include basic sentence processing. The results showed activation in the left IFG and left parietal lobe, suggesting that these areas are involved in sentence processing. We then investigated the proportion of patients showing impaired sentence processing from among patients with aphasia and a lesion in the left IFG or from the parietal lobe to the posterior superior temporal gyrus. Four of 5 patients (80%) with lesions mostly in the left IFG showed impaired sentence processing, suggesting that this site plays a critical role in sentence processing. Of the 4 patients with lesions mostly in the area from the left parietal lobe to the posterior superior temporal gyrus, 1 patient (25%) showed impaired sentence processing. Unlike the other 3 subjects, this subject exhibited impaired recalling of verbs. This area is mainly involved in lexical-semantics and the present results suggest that verb information within that field became impaired, in turn causing impaired sentence processing. (C) 2013 Elsevier Ltd. All rights reserved.

    PERGAMON-ELSEVIER SCIENCE LTD, 2013年07月, JOURNAL OF NEUROLINGUISTICS, 26 (4), 470 - 478, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Nobuo Kashiwagi, Takamichi Murakami, Katsuyuki Nakanishi, Osamu Maenishi, Kaoru Okajima, Hiroto Takahashi, Mio Sakai, Yasuhiko Tomita, Kyoichi Terao, Noriyuki Tomiyama

    Background: Although pleomorphic adenomas account for over 90% of all benign submandibular gland tumors, the imaging features of submandibular pleomorphic adenomas have not been reported in a large number of cases. Purpose: To assess the conventional magnetic resonance imaging (MRI) findings for predicting the submandibular pleomorphic adenoma. Material and Methods: MR studies of 42 pleomorphic adenomas and 28 other types of tumor were reviewed. MR images were assessed for the presence of hyperintense areas on T2-weighted images (first sign), a well-defined margin (second sign), and presence of crescent-shaped compression of the ipsilateral normal submandibular gland (third sign). Results: For identifying submandibular pleomorphic adenoma, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.6%, 50.0%, 74.5%, 93.3%, and 78.6% for the first sign, 95.2%, 46.4% 72.7%, 86.7%, and 75.7% for the second sign, and 23.8%, 100%, 86.7%, 46.7%, and 54.3% for the third sign, respectively. Combining the first and second findings achieved to 85.7% specificity and 90.9% accuracy. Conclusion: Although non-specific, submandibular pleomorphic adenomas usually have hyperintense areas on T2-weighted images and well-defined margins. In addition, crescent-shaped compression of the ipsilateral normal gland seems to represent a highly specific sign.

    2013年06月, Acta Radiologica, 54 (5), 511 - 515, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takashi Katsube, Masahiro Okada, Seishi Kumano, Izumi Imaoka, Yuki Kagawa, Masatoshi Hori, Kazunari Ishii, Noboru Tanigawa, Yasuharu Imai, Masatoshi Kudo, Takamichi Murakami

    2013年06月, European Journal of Radiology, 82 (6), 1039, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomoko Hyodo, Takamichi Murakami, Yasuharu Imai, Masahiro Okada, Masatoshi Hori, Yuki Kagawa, Sachiyo Kogita, Seishi Kumano, Masatoshi Kudo, Teruhito Mochizuki

    Purpose: To identify patient characteristics and magnetic resonance (MR) imaging findings associated with subsequent hypervascularization in hypovascular nodules that show hypointensity on hepatobiliary phase gadoxetic acid-enhanced MR images in patients with chronic liver diseases. Materials and Methods: Institutional review board approval was obtained, and informed consent was waived. At multiple follow-up gadoxetic acid-enhanced MR imaging examinations of 68 patients, 160 hypovascular nodules were retrospectively reviewed. A Cox regression model for hypervascularization was developed to explore the association of baseline characteristics, including patient factors (Child-Pugh classification, etiology of liver disease, history of local therapy for hepatocellular carcinoma [HCC], and coexistence of hypervascular HCC) and MR imaging findings (fat content, signal intensity on T2-weighted images, and nodule size). In addition, the growth rate was calculated as the reciprocal of tumor volume doubling time to investigate its relationship with subsequent hypervascularization by using receiver operating characteristic and Kaplan-Meier analyses. Results: The prevalence of subsequent hypervascularization was 31% (50 of 160 nodules). Independent Cox multivariable predictors of increased risk of hypervascularization were hyperintensity on T2-weighted images (hazard ratio [HR] = 8.7; 95% confidence interval [CI]: 3.6, 20.8), previous local therapy for hypervascular HCC (HR = 5.0; 95% CI: 1.8, 13.6), Child-Pugh B cirrhosis (HR = 3.6; 95% CI: 1.4, 9.5) and coexistence of hypervascular HCC (HR = 2.0; 95% CI: 1.0, 3.8). The mean growth rate was significantly higher in nodules that showed subsequent hypervascularization than in those without hypervascularization. Kaplan-Meier analysis based on the receiver operating characteristic cutoff level (1.8 x 10(-3)/day [tumor volume doubling time, 542 days]) showed that nodules with a higher growth rate had a significantly higher incidence of hypervascularization (P = 5.2 x 10(-8), log-rank test). Conclusion: Hyperintensity on T2-weighted images is an independent and strong risk factor at baseline for subsequent hypervascularization in hypovascular nodules in patients with chronic liver disease. Tumor volume doubling time of less than 542 days was associated with a high rate of subsequent hypervascularization. (C)RSNA, 2013

    RADIOLOGICAL SOC NORTH AMERICA, 2013年02月, RADIOLOGY, 266 (2), 480 - 490, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 3次元ボリュームCT画像データと肝自動抽出ソフトウェアを用いた肝容積測定

    堀 雅敏, 金 東石, 大西 裕満, 中本 篤, 富山 憲幸, 小林 省吾, 丸橋 繁, 永野 浩昭, 村上 卓道

    (公社)日本医学放射線学会, 2013年02月, 日本医学放射線学会学術集会抄録集, 72回, S285 - S285, 日本語

    [査読有り]

  • 大腿四頭筋血腫の経過で隣接骨の皮質過形成をきたした1例

    森田 敬裕, 柏木 伸夫, 兵頭 朋子, 柳生 行伸, 小塚 健倫, 熊野 正士, 今岡 いずみ, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2013年02月, Japanese Journal of Radiology, 31 (Suppl.I), 47 - 47, 日本語

  • 外傷性神経腫の1例

    藤谷 哲也, 柏木 伸夫, 今岡 いずみ, 熊野 正士, 石井 一成, 足利 竜一朗, 村上 卓道, 前西 修, 楠原 廣久, 磯貝 典孝

    (公社)日本医学放射線学会, 2013年02月, Japanese Journal of Radiology, 31 (Suppl.I), 53 - 53, 日本語

  • Dual-energy CTによる肝脂肪定量 ファントム実験によるsingle-energy CTおよびMRSとの比較

    兵頭 朋子, 岡田 真広, 工藤 正幸, 鶴崎 正勝, 足利 竜一朗, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2013年02月, 日本医学放射線学会学術集会抄録集, 72回, S251 - S251, 日本語

  • Yuki Makino, Yasuharu Imai, Hideko Ohama, Takumi Igura, Sachiyo Kogita, Yoshiyuki Sawai, Kazuto Fukuda, Manabu Takamura, Hiroshi Ohashi, Takamichi Murakami

    Objectives: To investigate the usefulness of the ultrasonography (US) fusion imaging system for radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods: Since the US fusion imaging system became available in 2010, we have conducted RFA with this system in all cases. The characteristics of 75 patients with 120 HCCs and 89 patients with 123 HCCs who underwent RFA before the introduction of this system (period A) and after it (period B), respectively, were retrospectively compared. Results: Significant difference in the characteristics of the patients and HCCs between the two periods was found only in the proportion of HCCs with poor conspicuity on grayscale US treated with RFA (1.7%, 2/120 for period A vs. 15.4%, 19/123 for period B, p < 0.01). Among the 19 HCCs with poor conspicuity on grayscale US for period B, 5 and 9 HCCs were identified on grayscale US and contrast-enhanced US, respectively, by the use of the US fusion imaging system, whereas the 5 remaining undetectable HCCs were treated by using the system in conjunction with reference images displayed side-by-side with grayscale US. Conclusion: Since the introduction of the US fusion imaging system, it has become possible to perform RFA for HCCs with poor conspicuity on grayscale US. Copyright (C) 2013 S. Karger AG, Basel

    KARGER, 2013年, ONCOLOGY, 84, 44 - 50, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Hiroshi Kondo, Hironobu Sou, Takamichi Murakami, Masayuki Kanematsu, Tomoaki Ichikawa, Shushi Yoshikawa, Kazuhito Shiosakai, Akiko Hayakawa, Kazuo Awai, Kengo Yoshimitsu, Yasuyuki Yamashita

    Purpose: To investigate four different contrast protocols to detect hypervascular hepatocellular carcinoma (HCC) most adaptable for patients at any body weight (BW) in clinical practice. Materials and methods: A post-marketing surveillance of liver dynamic CT was prospectively performed by four different protocols in 415 patients: Protocol-A, BW-tailored dose of contrast media (CM: iohexol 300 mgI/mL), fixed injection duration (30s), fixed scan timing at arterial phase (AP); Protocol-B, BW-tailored dose of CM, fixed injection duration (30s), by bolus tracking; Protocol-C, BW-tailored dose of CM, fixed injection flow rate, by bolus tracking; Protocol-D, 100 mL constant of CM at any BW, fixed scan timing. Scan timing and tumor conspicuity at AP was scored qualitatively. The quantitative CT values of aorta and tumor liver contrast (TLC) were obtained. Results: The qualitative rate assessed "good" as scan timing of AP in Protocol-C was significantly lower than those in Protocols A and D (difference: 16.6%, 17.4%, P = 0.0069, P = 0.0140, respectively). Scatter plot of Protocol-D (R-2 = 0.1283) at AP showed significant inverse relationship between TLC and BW (P = 0.0053), although not significant in Protocols A, B, C. Conclusion: In patients with higher BW, protocols of BW-tailored dose of CM and/or fixed injection duration have no dependence on BW to diagnose hypervascular HCCs.

    SPRINGER INTERNATIONAL PUBLISHING AG, 2013年, SPRINGERPLUS, 2 (2), 367 - 378, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tatsuo Inoue, Tomoko Hyodo, Takamichi Murakami, Yukihisa Takayama, Akihiro Nishie, Atsushi Higaki, Keiko Korenaga, Azusa Sakamoto, Yukio Osaki, Hiroshi Aikata, Kazuaki Chayama, Takeshi Suda, Toru Takano, Kennichi Miyoshi, Masahiko Koda, Kazushi Numata, Hironori Tanaka, Hiroko Iijima, Hironori Ochi, Masashi Hirooka, Yasuharu Imai, Masatoshi Kudo

    Objective: We aimed to investigate the natural outcome of nonhypervascular lesions detected in the hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI by performing a longitudinal study retrospectively enrolled in a nationwide manner. Methods: Between February 2008 and March 2011, 224 patients with 504 nodules that were diagnosed as nonhypervascular by imaging were recruited from institutions that participated in the present study. We examined the natural outcome of nonhypervascular lesions and evaluated the risk factors. Results: Of the 504 nodules, 173 (34.3%) showed hypervascular transformation. The overall cumulative incidence of hypervascular transformation was 14.9% at 12 months and 45.8% at 24 months. Multivariate analysis using the Cox regression model revealed previous treatment history for hepatocellular carcinoma (HCC relative risk = 1.498 p = 0.036, 95% CI 1.03-2.19) and hyperintensity on T2-weighted images (relative risk = 1.724 p = 0.015, 95% CI 1.11-2.67) were identified as independent factors for hypervascular transformation. Conclusions: Patients who have a previous treatment history for HCC and with hypointense nodules showing hyperintensity on T2-weighted images need careful follow-up because of the high incidence of hypervascular transformation.

    S. Karger AG, 2013年, Digestive Diseases, 31 (5-6), 472 - 479, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yuki Makino, Yasuharu Imai, Takumi Igura, Sachiyo Kogita, Yoshiyuki Sawai, Kazuto Fukuda, Masatoshi Hori, Masatoshi Kudo, Takamichi Murakami

    Objectives: We developed a novel technique of the extracted-overlay function in CT/MR-ultrasonography (US) fusion imaging for radiofrequency ablation (RFA), in which only a tumor extracted from CT/MR images with a virtual ablative margin of arbitrary thickness is overlaid on US. The usefulness of this function is investigated in this preliminary report. Methods: The volume data of the extracted tumor with a virtual ablative margin were created on an image-processing workstation, and transported into a US unit equipped with a CT/MR-US fusion imaging system. After the positional registration of US and transported images, the extracted tumor with an ablative margin could be overlaid on US. In RFA, using this function, an electrode was inserted targeting the overlaid tumor with an ablative safety margin of 5 mm on US, and the treatment effect was evaluated by dynamic CT. Treatment results of 23 consecutive hepatocellular carcinomas (HCCs) that underwent RFA using this function were retrospectively analyzed. Results: Complete tumor ablation was achieved in 22 (95.7%) and 1 (4.3%) HCCs in 1 and 2 treatment sessions, respectively. Conclusions: Due to the visualization of an extracted tumor with an ablative safety margin on a US image, even during and after ablation, this function is useful for treatment planning and guidance of RFA. (C) 2013 S. Karger AG, Basel

    KARGER, 2013年, DIGESTIVE DISEASES, 31 (5-6), 485 - 489, 英語

    [査読有り]

    研究論文(学術雑誌)

  • ダイナミックマルチスライスCTにおける多血性肝細胞癌検出に最適な造影剤量の検討

    藤谷哲也, 熊野正士, 村上卓道

    2012年11月, 近畿大学医学雑誌, 37 (3,4), 155 - 162

  • The Usefullness of Conventional MR imaging in Establishing the Daiagnosis of Submandibular Pleomorphic Adenoma.

    柏木伸夫, 高橋洋人, 前西 修, 岡嶋 馨, 村上卓道, 石井一成, 中西克之

    2012年11月

  • Seishi Kumano, Masahiro Okada, Taro Shimono, Masatomo Kuwabara, Yukinobu Yagyu, Izumi Imaoka, Ryuichiro Ashikaga, Kazunari Ishii, Takamichi Murakami

    Purpose: The purpose of this study was to evaluate the accuracy of T-staging of gastric cancer by air-filling multidetector-row CT (air-MDCT) compared with water-filling MDCT (hydro-MDCT). Materials and methods: One hundred fifteen patients with histologically diagnosed gastric cancer were included in this study. Fifty-eight patients underwent air-MDCT, and the remaining 57 had hydro-MDCT using a 64-channel scanner. Based on the volumetric data of contrast-enhanced MDCT obtained about 75 s after intravenously injecting 525 mg iodine per kilogram patients weight (525 mgI/kg) nonionic contrast material at the rate of 2 ml/s, oblique coronal and oblique sagittal multi-planar reformatted images perpendicular to the stomach wall, including the tumor, were reconstructed on a workstation. Mural invasion of gastric cancer into the gastric wall, as visualized by CT, was classified according to the TNM classification, and the results of T-staging by MDCT were compared with those by pathologic analysis after surgery. Results: Correct assessment of T-staging by air-CT was achieved in 48 of 58 patients (83%), and that by hydro-MDCT was 49 of 57 patients (86%). The sensitivity, specificity, and accuracy of the technique in determining the invasion of serosa were 88%, 93%, and 91% for air-CT and 83%, 95%, and 91% for hydro-CT. There were no significant differences between hydro-MDCT and air-MDCT in sensitivity (P = 0.73), specificity (P = 0.71) and accuracy (P = 0.98). Conclusion: Air-MDCT is a very valuable tool in T-staging of gastric cancer as well as hydro-MDCT. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2012年11月, EUROPEAN JOURNAL OF RADIOLOGY, 81 (11), 2953 - 2960, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tetsuya Fujigai, Seishi Kumano, Masahiro Okada, Tomoko Hyodo, Izumi Imaoka, Yukinobu Yagyu, Ryuichiro Ashikaga, Kazunari Ishii, Takamichi Murakami

    Purpose: The purpose of this study is to prospectively investigate the optimal dose of contrast medium for the depiction of hypervascular hepatocellular carcinoma (HCC) during the hepatic arterial phase (HAP), portal venous phase (PVP) and delayed phase (DP) of dynamic MDCT. Materials and methods: The study included 128 patients, out of these patients, 36 patients were found to have 56 hypervascular HCCs. Sixty-three patients were assigned to receive a dose of 525 mgI/kg with protocol A, and 62 received a dose of 630 mgI/kg with protocol B. Measurements of the attenuation values of the abdominal aorta, portal vein, hepatic vein, hepatic parenchyma and HCC during the HAP, PVP and DP were taken. Tumor-liver contrast (TLC) was calculated from the attenuation value of the hepatic parenchyma and HCC. Results: The aortic attenuation value with protocol B (351, 166, and 132 HU) was significantly higher than that with protocol A (313, 153, and 120 HU) during all the phases, (P < 0.01 for all phases). The hepatic enhancement from unenhanced baseline with protocol B (25.2, 63.6, 50.6 HU) was significantly higher than that with protocol A (20.2, 55.1 and 43.0 HU) during all the phases, (P < 0.01 for all phases). The TLC with protocol B (37.4, -11.8 and -13.6 HU) was significantly higher than that with protocol A (28.0, -9.8 and -12.1 HU) during HAP (P = 0.042). Conclusion: The administration of 630 mgI/kg of body weight depicts hypervascular HCC more clearly during HAP and shows sufficient hepatic enhancement of 50 HU during DP. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2012年11月, EUROPEAN JOURNAL OF RADIOLOGY, 81 (11), 2978 - 2983, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 脳血管性認知症のcilostazol投与前後における脳血流変化の検討

    花田 一志, 細野 眞, 辻井 農亜, 船津 浩二, 明石 浩幸, 原田 毅, 三川 和歌子, 池田 真優子, 白川 治, 村上 卓道

    日本臨床精神神経薬理学会・日本神経精神薬理学会, 2012年10月, 日本臨床精神神経薬理学会・日本神経精神薬理学会合同年会プログラム・抄録集, 22回・42回, 146 - 146, 日本語

    [査読有り]

  • 【年齢別特徴をふまえた脳神経画像診断-小児から成人まで-】感染症

    松木 充, 藤谷 哲也, 松久保 祐子, 高橋 洋人, 柏木 伸夫, 足利 竜一郎, 石井 一成, 村上 卓道

    (株)学研メディカル秀潤社, 2012年10月, 画像診断, 32 (13), 1252 - 1267, 日本語

  • Tatsuo Inoue, Masatoshi Kudo, Mina Komuta, Sosuke Hayaishi, Taisuke Ueda, Masahiro Takita, Satoshi Kitai, Kinuyo Hatanaka, Norihisa Yada, Satoru Hagiwara, Hobyung Chung, Toshiharu Sakurai, Kazuomi Ueshima, Michiie Sakamoto, Osamu Maenishi, Tomoko Hyodo, Masahiro Okada, Seishi Kumano, Takamichi Murakami

    We aimed to evaluate gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the detection of hepatocellular carcinomas (HCCs) and dysplastic nodules (DNs) compared with dynamic multi-detector row computed tomography (MDCT), and to discriminate between HCCs and DNs. Eighty-six nodules diagnosed as HCC or DNs were retrospectively investigated. Gd-EOB-DTPA-enhanced MRI and dynamic MDCT were compared with respect to their diagnostic ability for hypervascular HCCs and detection sensitivity for hypovascular tumors. The ability of hepatobiliary images of Gd-EOB-DTPA-enhanced MRI to discriminate between these nodules was assessed. We also calculated the EOB enhancement ratio of the tumors. For hypervascular HCCs, the diagnostic ability of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of MDCT for tumors less than 2 cm (p = 0.048). There was no difference in the detection of hypervascular HCCs between hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI (43/45: 96%) and dynamic MDCT (40/45: 89%), whereas the detection sensitivity of hypovascular tumors by Gd-EOB-DTPA-enhanced MRI was significantly higher than that by dynamic MDCT (39/41: 95% vs. 25/41: 61%, p = 0.001). EOB enhancement ratios were decreased in parallel with the degree of differentiation in DNs and HCCs, although there was no difference between DNs and hypovascular well-differentiated HCCs. The diagnostic ability of Gd-EOB-DTPA-enhanced MRI for hypervascular HCCs less than 2 cm was significantly higher than that of MDCT. For hypovascular tumors, the detection sensitivity of hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of dynamic Gd-EOB-DTPA-enhanced MRI and dynamic MDCT. It was difficult to distinguish between DNs and hypovascular well-differentiated HCCs based on the EOB enhancement ratio.

    SPRINGER JAPAN KK, 2012年09月, JOURNAL OF GASTROENTEROLOGY, 47 (9), 1036 - 1047, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 兵頭 朋子, 岡田 真広, 矢田 典久, 前西 修, 香川 祐毅, 任 誠雲, 柏木 伸夫, 柳生 行伸, 今岡 いずみ, 松木 充, 足利 竜一朗, 石井 一成, 工藤 正俊, 村上 卓道

    近畿大学医学会, 2012年09月, 近畿大学医学雑誌, 37 (3-4), 18A - 18A, 日本語

  • T. Hyodo, S. Kumano, F. Kushihata, M. Okada, M. Hirata, T. Tsuda, Y. Takada, T. Mochizuki, T. Murakami

    Recent developments in imaging technology have enabled CT and MR cholangiopancreatography (MRCP) to provide minimally invasive alternatives to endoscopic retrograde cholangiopancreatography for the pre- and post-operative assessment of biliary disease. This article describes anatomical variants of the biliary tree with surgical significance, followed by comparison of CT and MR cholangiographies. Drip infusion cholangiography with CT (DIC-CT) enables high-resolution three-dimensional anatomical representation of very small bile ducts (e. g. aberrant branches, the caudate branch and the cystic duct), which are potential causes of surgical complications. The disadvantages of DIC-CT include the possibility of adverse reactions to biliary contrast media and insufficient depiction of bile ducts caused by liver dysfunction or obstructive jaundice. Conventional MRCP is a standard, non-invasive method for evaluating the biliary tree. MRCP provides useful information, especially regarding the extrahepatic bile ducts and dilated intrahepatic bile ducts. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRCP may facilitate the evaluation of biliary structure and excretory function. Understanding the characteristics of each type of cholangiography is important to ensure sufficient perioperative evaluation of the biliary system.

    BRITISH INST RADIOLOGY, 2012年07月, BRITISH JOURNAL OF RADIOLOGY, 85 (1015), 887 - 896, 英語

    [査読有り]

  • Takashi Katsube, Masahiro Okada, Seishi Kumano, Izumi Imaoka, Yuki Kagawa, Masatoshi Hori, Kazunari Ishii, Noboru Tanigawa, Yasuharu Imai, Masatoshi Kudo, Takamichi Murakami

    Purpose: To investigate the usefulness of T2* mapping of liver on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for estimating liver function. Materials and methods: 33 patients were classified into 3 groups as follows: normal liver function (NLF) (n = 7); mild liver damage (MLD) (n = 16) with Child-Pugh A; severe liver damage (SLD) (n = 10) with Child-Pugh B. T2*-weighted gradient-echo (T2* W-GRE) and T1-weighted gradient-echo (T1W-GRE) images were obtained before and after Gd-EOB-DTPA administration (3, 8, 13, and 18 min; 5, 10,15, and 20 min; respectively). T2* mapping of liver was calculated from T2* W-GRE, then T2* values of liver and T2* reduction rates of T2* value between pre-and post-contrast enhancement were measured. The increase rates of liver-to-muscle signal intensity (LMS) ratio on T1W-GRE between pre-and post-contrast enhancement were calculated. Results: T2* values on pre-and post-contrast showed no significant differences among three groups. Significant differences in T2* reduction rates were found among groups, and those of LCB were lower than those of other groups (NLF: MLD: SLD, 3.8: 6.0: 0.6% at 3 min, 8.2: 10.3: 1.0% at 8 min, 10.7: 11.5: 1.2% at 13 min, and 16.1: 13.2: 3.5% at 18 min, respectively) (P < 0.05). Significant differences in increase rates of LMS ratio on T1W-GRE were identified (NLF: MLD: SLD, 1.53: 1.46: 1.35 at 5 min, 1.68: 1.64: 1.37 at 10 min, 1.79: 1.76: 1.44 at 15 min, and 1.89: 1.78: 1.49 at 20 min, respectively). Conclusion: T2* reduction rate and increase rate of LMS ratio on T1W-GRE may allow us estimation of liver function according to Child-Pugh score. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2012年07月, EUROPEAN JOURNAL OF RADIOLOGY, 81 (7), 1460 - 1464, 英語

    [査読有り]

    研究論文(学術雑誌)

  • N. Kashiwagi, K. Dote, K. Kawano, Y. Tomita, T. Murakami, K. Nakanishi, Y. Araki, K. Mori, N. Tomiyama

    Objective: The aim of this study was to correlate the MRI appearance and pathological findings in each grade of the mucoepidermoid carcinoma (MEC) of the parotid gland. Methods: We reviewed surgically proven MECs of parotid glands in 20 patients. Pathologically, 5 tumours were high-grade, 3 were intermediate and 12 were low-grade. MR images were evaluated with emphasis on signal intensities on T-2 weighted images, margin characteristics and lymph node metastasis, correlating these with pathological features. Results: Among the high-grade MECs, four out of five tumours showed inhomogeneous low to intermediate signal intensity on T-2 weighted images, reflecting high cellularity. All tumours had an ill-defined margin, reflecting invasive tumour growth. Among the intermediate-grade MECs, all three tumours showed intermediate signal intensity on T-2 weighted images and two tumours had an ill-defined margin. Among the low-grade MECs, 11 of the 12 tumours had a hyperintense area on T-2 weighted images because of the existence of abundant mucin secreting cells. Seven tumours had an ill-defined margin, reflecting peritumoural inflammatory changes rather than invasive tumour growth. Lymph node metastasis was seen in three high-grade MECs. Conclusion: MECs of the parotid gland show variable MRI findings reflecting their histological nature, which seems to have certain tendencies depending on the tumour grade.

    BRITISH INST RADIOLOGY, 2012年06月, BRITISH JOURNAL OF RADIOLOGY, 85 (1014), 709 - 713, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Kazunari Ishii, Kazushi Numata, Tomoko Hyodo, Seishi Kumano, Masayuki Kitano, Masatoshi Kudo, Takamichi Murakami

    BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hepatocytes. The purpose of this study was to investigate the relation between liver and biliary enhancement in patients with or without liver dysfunction, and to compare the tumor-to-liver contrast in these patients. METHODS: Forty patients [group 1: normal liver and Child-Pugh class A in 20 patients, group 2: Child-Pugh class B in 18 patients and Child-Pugh C in 2] were evaluated. All patients underwent MR imaging of the liver using a 1.5-Tesla system. T1-weighted 3D images were obtained at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA injection. The relation between group 3 (total bilirubin <1.8 mg/dL) and group 4 (total bilirubin >= 1.8 mg/dL) was investigated at 20 minutes. Liver and biliary signals were measured, and compared between groups 1 and 2 or groups 3 and 4. Tumor-to-liver ratio was also evaluated between groups 1 and 2. Scheffes post-hoc test after two-way repeated-measures ANOVA and Pearson's correlation test were used for statistical analysis. RESULTS: Liver enhancement showed significant difference at all time points between groups 1 and 2. Biliary enhancement did not show a significant difference between groups 1 and 2 at 5 minutes, but did at 10, 15 and 20 minutes. At 20 minutes, significant differences between groups 3 and 4 were seen for liver and biliary enhancement. At all time points, liver enhancement correlated with biliary enhancement in both groups. At 5 minutes and 20 minutes, statistical differences between groups 1 and 2 were seen for tumor-to-liver ratio. CONCLUSIONS: The degree of biliary enhancement has a close correlation to that of liver enhancement. It is especially important that insufficient liver enhancement causes lower tumor-to-liver contrast in the hepatobiliary phase of Gd-EOB-DTPA.

    ZHEJIANG UNIV SCH MEDICINE, 2012年06月, HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL, 11 (3), 307 - 313, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Izumi Imaoka, Takayuki Nakatsuka, Tetsuro Araki, Takashi Katsube, Masahiro Okada, Seishi Kumano, Kazunari Ishii, Ryuichiro Ashikaga, Tomoyuki Okuaki, Marc Van Cauteren, Takamichi Murakami

    Background: Previous literature demonstrated that the T2* value of the uterine junctional zone was lower than that of peripheral myometrium by using BOLD MR imaging. We expect T2* mapping image may add more information to T2-weighted images of the uterine myometrium. Purpose: To evaluate whether T2* mapping software would reproduce the result of previous report, and to apply the software to benign uterine diseases. Material and Methods: Five healthy volunteers and 19 patients clinically suspected of having benign pelvic disease were imaged using a 1.5T MR system. All women were of reproductive age, and all provided informed consent. Sagittal T2* images using a multishot EPI sequence were obtained. T2* values were calculated and color T2* maps reconstructed using a T2* fitting tool. Results: The uterine zones could be identified in all 24 examinations on the T2* maps. In addition, a thin "4th zone" was seen between the endometrium and the JZ (junctional zone) in 19 of 24 examinations. The T2* value of JZ was significantly lower than that of peripheral myometrium (PM) (P < 0.001). No significant difference in the T2* value of the JZ or of PM was noted between normal uterus and uterus with leiomyomas and/or adenomyosis. Conclusion: A quantitative T2* map can easily be obtained using the PRIDE software T2* fitting tool, and the software reproduces the result from previous report. T2* value of the junctional zone was lower than that of peripheral myometrium regardless of having benign myometrial diseases.

    ROYAL SOC MEDICINE PRESS LTD, 2012年05月, ACTA RADIOLOGICA, 53 (4), 473 - 477, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hiromitsu Onishi, Tonsok Kim, Yasuharu Imai, Masatoshi Hori, Hiroaki Nagano, Yasuhiro Nakaya, Takahiro Tsuboyama, Atsushi Nakamoto, Mitsuaki Tatsumi, Seishi Kumano, Masahiro Okada, Manabu Takamura, Kenichi Wakasa, Noriyuki Tomiyama, Takamichi Murakami

    To retrospectively compare the accuracy of detection of hypervascular hepatocellular carcinoma (HCC) by multiphasic multidetector CT and by gadoxetate disodium-enhanced MR imaging. After ethical approval, we analysed a total of 73 hypervascular HCC lesions from 31 patients suspected of having HCC, who underwent both gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT. Five blinded observers independently reviewed CT images, as well as dynamic MR images alone and combined with hepatobiliary phase MR images. Diagnostic accuracy (Az values), sensitivities and positive predictive values were compared by using the Scheffe post hoc test. The mean Az value for dynamic and hepatobiliary phase MR combined (0.81) or dynamic MR images alone (0.78) was significantly higher than that for CT images (0.67, P < 0.001, 0.005, respectively). The mean sensitivity of the combined MR images (0.67) was significantly higher than that of dynamic MR alone (0.52, P < 0.05) or CT images (0.44, P < 0.05). The mean positive predictive values were 0.96, 0.95 and 0.94, for CT, dynamic MR alone and combined MR images, respectively. Compared with multiphasic multidetector CT, gadoxetate disodium-enhanced MR imaging combining dynamic and hepatobiliary phase images results in significantly improved sensitivity and diagnostic accuracy for detection of hypervascular HCC. aEuro cent Gadoxetate disodium is a new liver-specific MR imaging contrast agent. Gadoxetate disodium-enhanced MRI helps the assessment of patients with liver disease. aEuro cent It showed high diagnostic accuracy for the detection of hepatocellular carcinoma.

    SPRINGER, 2012年04月, EUROPEAN RADIOLOGY, 22 (4), 845 - 854, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Kazunari Ishii, Kohei Hanaoka, Masahiro Okada, Seishi Kumano, Yoshihiro Komeya, Norio Tsuchiya, Makoto Hosono, Takamichi Murakami

    The aim of this study was to elucidate the regional differences between brain perfusion single photon emission computed tomography (SPECT) images reconstructed with a uniform attenuation correction using Chang's method (AC-Chang) and a non-uniform attenuation correction with CT using SPECT/CT (AC-CT). SPECT images of a phantom with and without head holder were obtained, and reconstructed images of AC-Chang and AC-CT were compared. Twenty-eight consecutive patients with brain disease examined by SPECT/CT brain perfusion imaging were selected, and images were reconstructed with AC-Chang and AC-CT. The AC-Chang and AC-CT reconstructed images were then compared by voxel-based analysis using three-dimensional stereotactic surface projections. Counts in the frontal area of the AC-Chang phantom image with head holder were higher than those in the posterior area. Counts in the frontal area of the AC-Chang clinical images were significantly higher than those in the AC-CT images, while the counts in the margin of the frontal lobe and posterior margin of the parietal, occipital cortices and cerebellum of the AC-Chang images were significantly lower. Relative frontal perfusion was 5.0% higher and relative cerebellar perfusion was 4.6% lower in the AC-Chang images relative to the AC-CT images, on average. We demonstrated the frontal dominant hyper-perfusion and parieto-occipital and cerebellar hypo-perfusion in brain SPECT images reconstructed with AC-Chang compared to those reconstructed with AC-CT. We suggest that to obtain an accurate attenuation-corrected brain perfusion SPECT image, attenuation correction by Chang's method is inadequate.

    SPRINGER, 2012年04月, ANNALS OF NUCLEAR MEDICINE, 26 (3), 241 - 247, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yoshifumi Nakauchi, Yoshitaka Iwanaga, Shinichiro Ikuta, Masayuki Kudo, Kazuhiro Kobuke, Takamichi Murakami, Shunichi Miyazaki

    Objective To assess the feasibility of quantitative myocardial perfusion imaging (MPI) in acute myocardial infarction (AMI), using multi-row detector CT (MDCT) with a model-based deconvolution method. Design, setting, patients and interventions Fifteen normal subjects with normal coronary arteries and 26 patients with AMI after reperfusion therapy underwent MPI with MDCT. Perfusion parameters: tissue blood flow (TBF), tissue blood volume (TBV) and mean transit time (MTT) were obtained and compared with clinical parameters, angiography and single-photon emission CT (SPECT) data. Furthermore, the MPI data were compared with data from myocardial magnetic resonance (MR) in 10 subjects. Results The TBF and TBV of infarcted myocardium were significantly lower than those of non-infarcted areas (TBF, 51.96 +/- 19.42 vs 108.84 +/- 13.29 ml/100 g/min, p<0.01; TBV, 4.47 +/- 2.23 vs 9.79 +/- 2.58 ml/100 g, p<0.01). The MTT of infarcted areas did not differ from that of non-infarcted areas. The defect areas on TBV colour maps were significantly associated with peak creatine kinase level, QRS score and SPECT defect score. The ratio of TBF or TBV in the epicardial to endocardial side was significantly higher in infarct myocardium with good collateral circulation than in myocardium with poor/no collateral circulation (p<0.01 for both). The TBF measurements with CT- and MR-MPI were in good agreement by linear regression analysis (R=0.55, p<0.01). Conclusions This study demonstrated that MDCT perfusion imaging with deconvolution analysis could quantitatively detect myocardial perfusion abnormalities in patients with AMI and may provide the basis for the non-invasive and quantitative assessment of myocardial infarction.

    B M J PUBLISHING GROUP, 2012年04月, HEART, 98 (7), 566 - 572, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Nobuo Kashiwagi, Takamichi Murakami, Takaaki Chikugo, Yasuhiko Tomita, Kiyoshi Kawano, Katsuyuki Nakanishi, Kazunori Mori, Noriyuki Tomiyama

    Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare aggressive epithelial malignancy arising from a primary or recurrent benign mixed tumor. Only a few case reports describing the radiologic features of CXPA have been published. Purpose: To describe and characterize the magnetic resonance (MR) imaging findings of CXPA in the parotid gland and correlate them with pathologic findings. Material and Methods: The MR images of surgically proven CXPA in the parotid gland of five men and five women ranging in age from 28 to 75 years (mean 52 years) were retrospectively reviewed. All MR images were evaluated with emphasis on the size, margin characteristics, extraparotid infiltration, the presence of an encapsulated component, and signal intensity on T2-weighted or short-inversion-time inversion recovery (STIR) images. Results: The average maximal diameter was 4.3 cm. All 10 tumors had ill-defined boundaries, and seven tumors showed extraparotid infiltration, reflecting invasive growth of the malignant component identified on histological examination. Eight tumors had a round encapsulated component and seven of those signal intensities were a mixture of hypo- and hyperintensity on T2-weighted or STIR images. Histological correlation of these components revealed fibrously encapsulated tumors containing hyalinization and myxoid tissue, suggesting degenerated pleomorphic adenoma. Invasive malignant components had non-specific and various signal intensities. Conclusion: An invasive parotid mass co-existing with a round encapsulated component is suggestive of carcinoma ex pleomorphic adenoma.

    ROYAL SOC MEDICINE PRESS LTD, 2012年04月, ACTA RADIOLOGICA, 53 (3), 303 - 306, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomomaro Etoh, Yoh Watanabe, Izumi Imaoka, Takamichi Murakami, Hiroshi Hoshiai

    We report a rare case of adenomyoma localized only in the left fallopian tube mimicking tubal malignant tumor. A 45-year-old woman presented with mild pelvic pain, dysmenorrhea and left adnexal mass. Magnetic resonance imaging showed a solid tumor, suspected primary cancer of the fallopian tube, and serum carbohydrate antigen 125 was elevated to 72 U/mL (normal; 035). At surgery, the tumor was revealed as a left fallopian tube tumor without torsion. Postoperative histopathology showed that the tumor included bundle-like growing non-atypical leiomyoma cells and ectopic normal endometrium accompanied with endometrial stroma and we diagnosed primary adenomyoma of the left fallopian tube. Adenomyoma localized only in the fallopian tube is a rare entity and it can occur only in the fallopian tube.

    WILEY-BLACKWELL, 2012年04月, JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 38 (4), 721 - 723, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 肝腫瘍造影超音波過去5年の総括と今後の展望 肝細胞癌診断におけるSonazoid造影USの有用性についてEOB造影MRIとの比較

    小来田 幸世, 今井 康陽, 大濱 日出子, 福田 和人, 井倉 技, 澤井 良之, 関 康, 中島 収, 村上 卓道

    (公社)日本超音波医学会, 2012年04月, 超音波医学, 39 (Suppl.), S238 - S238, 日本語

  • Masaru Kubota, Takamichi Murakami, Hiroaki Nagano, Hidetoshi Eguchi, Shigeru Marubashi, Shogo Kobayashi, Hiroshi Wada, Masahiro Tanemura, Keizo Dono, Shoji Nakamori, Masato Sakon, Morito Monden, Masaki Mori, Yuichiro Doki

    BACKGROUND AND AIMS: The purpose of this prospective study was to demonstrate the ability to measure pancreatic tumor tissue blood flow (TBF) with a noninvasive method using xenon inhalation computed tomography (xenon-CT) and to correlate TBF with histological features, particularly microvascular density (MVD). METHODS: TBFs of pancreatic tumors in 14 consecutive patients were measured by means of xenon-CT at diagnosis and following therapy. Serial abdominal CT scans were obtained before and after inhalation of nonradioactive xenon gas. TBF was calculated using the Fick principle. Furthermore, intratumoral microvessels were stained with anti-CD34 monoclonal antibodies before being quantified by light microscopy (×200). We evaluated MVD based on CD34 expression and correlated it with TBF. RESULTS: The quantitative TBF of pancreatic tumors measured by xenon CT ranged from 22.3 to 111.4 ml/min/100 g (mean ± SD, 59.6 ± 43.9 ml/min/100 g). High correlation (r = 0.885, P < 0.001) was observed between TBF and intratumoral MVD. CONCLUSION: Xenon-CT is feasible in patients with pancreatic tumors and is able to accurately estimate MVD noninvasively.

    3, 2012年03月, Digestive diseases and sciences, 57 (3), 801 - 5, 英語, 国際誌

    [査読有り]

  • EOB造影MRIとSonazoid造影USを用いた肝細胞癌の検出と分化度診断

    大濱 日出子, 今井 康陽, 小来田 幸世, 福田 和人, 井倉 技, 澤井 良之, 牧野 祐紀, 関 康, 森本 修邦, 高村 学, 竹内 真, 中島 収, 村上 卓道

    (一財)日本消化器病学会, 2012年03月, 日本消化器病学会雑誌, 109 (臨増総会), A272 - A272, 日本語

  • Masayuki Kitano, Masatoshi Kudo, Kenji Yamao, Tadayuki Takagi, Hiroki Sakamoto, Takamitsu Komaki, Ken Kamata, Hajime Imai, Yasutaka Chiba, Masahiro Okada, Takamichi Murakami, Yoshifumi Takeyama

    OBJECTIVES: Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS), a novel technology, visualizes parenchymal perfusion in the pancreas. This study prospectively evaluated how accurately CH-EUS characterizes pancreatic lesions and compared its diagnostic ability with that of contrast-enhanced multidetector-row computed tomography (MDCT) and endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). METHODS: A total of 277 consecutive patients with pancreatic solid lesions that were detected by conventional EUS underwent CH-EUS for evaluation of vascularity. After infusing an ultrasound contrast, CH-EUS was performed by using an echoendoscope and a specific mode for contrast harmonic imaging. On the basis of the intensity of enhancement, the lesions were categorized into four patterns: nonenhancement, hypoenhancement, isoenhancement, and hyperenhancement. For comparison, all patients underwent MDCT. The ability of CH-EUS to differentiate ductal carcinomas from the other solid tumors, particularly small lesions (<= 2 cm in diameter) was assessed, and compared with the differentiating abilities of MDCT and EUS-FNA. RESULTS: In terms of reading the CH-EUS images, the kappa-coefficient of the interobserver agreement test was 0.94 (P<0.001). CH-EUS-depicted hypoenhancement diagnosed ductal carcinomas with a sensitivity and specificity of 95.1% (95% confidence interval (CI) 92.7-96.7%) and 89.0% (95% CI 83.0-93.1%), respectively. For diagnosing small carcinomas by CH-EUS, the sensitivity and specificity were 91.2% (95% CI 82.5-95.1%) and 94.4% (95% CI 86.2-98.1%), respectively. CH-EUS-depicted hypervascular enhancement diagnosed neuroendocrine tumors with a sensitivity and specificity of 78.9% (95% CI 61.4-89.7%) and 98.7% (95% CI 96.7-98.8%), respectively. Although CH-EUS and MDCT did not differ significantly in diagnostic ability with regard to all lesions, CH-EUS was superior to MDCT in diagnosing small (<= 2 cm) carcinomas (P<0.05). In 12 neoplasms that MDCT failed to detect, 7 ductal carcinomas and 2 neuroendocrine tumors had hypoenhancement and hyperenhancement on CH-EUS, respectively. When CH-EUS was combined with EUS-FNA, the sensitivity of EUS-FNA increased from 92.2 to 100%. CONCLUSIONS: CH-EUS is useful for characterizing conventional EUS-detected solid pancreatic lesions. EUS equipped with contrast harmonic imaging may play an important role in the characterization of small tumors that other imaging methods fail to depict and may improve the diagnostic yield of EUS-FNA.

    NATURE PUBLISHING GROUP, 2012年02月, AMERICAN JOURNAL OF GASTROENTEROLOGY, 107 (2), 303 - 310, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Naoto Hayasaka, Nobuo Nagai, Naoyuki Kawao, Atsuko Niwa, Yoshichika Yoshioka, Yuki Mori, Hiroshi Shigeta, Nobuo Kashiwagi, Masaaki Miyazawa, Takao Satou, Hideaki Higashino, Osamu Matsuo, Takamichi Murakami

    Background: There is an increasing need for animal disease models for pathophysiological research and efficient drug screening. However, one of the technical barriers to the effective use of the models is the difficulty of non-invasive and sequential monitoring of the same animals. Micro-CT is a powerful tool for serial diagnostic imaging of animal models. However, soft tissue contrast resolution, particularly in the brain, is insufficient for detailed analysis, unlike the current applications of CT in the clinical arena. We address the soft tissue contrast resolution issue in this report. Methodology: We performed contrast-enhanced CT (CECT) on mouse models of experimental cerebral infarction and hepatic ischemia. Pathological changes in each lesion were quantified for two weeks by measuring the lesion volume or the ratio of high attenuation area (%HAA), indicative of increased vascular permeability. We also compared brain images of stroke rats and ischemic mice acquired with micro-CT to those acquired with 11.7-T micro-MRI. Histopathological analysis was performed to confirm the diagnosis by CECT. Principal Findings: In the models of cerebral infarction, vascular permeability was increased from three days through one week after surgical initiation, which was also confirmed by Evans blue dye leakage. Measurement of volume and %HAA of the liver lesions demonstrated differences in the recovery process between mice with distinct genetic backgrounds. Comparison of CT and MR images acquired from the same stroke rats or ischemic mice indicated that accuracy of volumetric measurement, as well as spatial and contrast resolutions of CT images, was comparable to that obtained with MRI. The imaging results were also consistent with the histological data. Conclusions: This study demonstrates that the CECT scanning method is useful in rodents for both quantitative and qualitative evaluations of pathologic lesions in tissues/organs including the brain, and is also suitable for longitudinal observation of the same animals.

    PUBLIC LIBRARY SCIENCE, 2012年02月, PLOS ONE, 7 (2), e32342, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 慢性GVHDに伴う舌papillomatosisから発生した舌癌の1例

    加藤 里枝子, 勝部 敬, 下野 太郎, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2012年02月, Japanese Journal of Radiology, 30 (Suppl.I), 41 - 41, 日本語

  • Gd-EOB-DTPA造影MRIでの肝機能評価の試み T1 Mapping法を用いて

    勝部 敬, 岡田 真広, 熊野 正士, 藤谷 哲也, 森田 敬裕, 今岡 いずみ, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2012年02月, Japanese Journal of Radiology, 30 (Suppl.I), 43 - 43, 日本語

  • 高速多相撮像を用いた多血性肝細胞癌の最適撮像時間の検討

    香川 祐毅, 岡田 真広, 柳生 行伸, 小塚 健倫, 熊野 正士, 今岡 いずみ, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2012年02月, Japanese Journal of Radiology, 30 (Suppl.I), 47 - 47, 日本語

  • Dual energy CTを用いた肝脂肪の定量評価 ファントム実験と初期臨床経験

    兵頭 朋子, 岡田 真広, 矢田 典久, 工藤 正幸, 香川 祐毅, 熊野 正士, 石井 一成, 工藤 正俊, 村上 卓道

    (公社)日本医学放射線学会, 2012年02月, 日本医学放射線学会学術集会抄録集, 71回, S272 - S272, 日本語

  • ASIRを用いた低電圧肝Dynamic-CTによる被曝低減と造影剤量低減に関する報告

    日高 正二朗, 高橋 洋人, 岡田 真広, 兵頭 朋子, 香川 祐毅, 今岡 いずみ, 石井 一成, 足利 竜一朗, 工藤 正俊, 村上 卓道

    (公社)日本医学放射線学会, 2012年02月, 日本医学放射線学会学術集会抄録集, 71回, S273 - S273, 日本語

  • Yoh Watanabe, Hidekatsu Nakai, Izumi Imaoka, Takamichi Murakami, Hiroshi Hoshiai

    Carcinoma meningitis with uterine cervical cancer is an extremely rare event. We present the clinicopathologic characteristics and diagnostic imaging findings of a patient with advanced small-cell neuroendocrine carcinoma of the cervix who had developed carcinoma meningitis during systematic chemotherapy.

    WILEY-BLACKWELL, 2012年01月, JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 38 (1), 336 - 339, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takamichi Murakami, Masahiro Okada, Tomoko Hyodo

    Detection, characterization, staging, and treatment monitoring are major roles of diagnostic imaging of liver cancers. Developments in multidetector-row computed tomography (MDCT) technology have increased the spatial and temporal resolution of CT to allow more precise evaluation of the hemodynamics of liver tumors and improve the diagnostic accuracy of dynamic MDCT. The high spatial and temporal resolutions of dynamic MDCT enable us to reconstruct 3-dimensional (3D) images that are very useful for pretreatment evaluation. Dynamic MR imaging with fast 3D T-1-weighted gradient echo imaging sequence using nonspecific contrast medium can be highly sensitive for detecting hypervascular HCC. However, the use of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), a contrast medium specific to hepatic tissue, offers greater diagnostic ability and, so, has become essential to liver imaging. MR imaging with Gd-EOB-DTPA may replace CT during hepatic arteriography and CT during arterioportography.

    JPN SOC MAGNETIC RESONANCE IN MEDICINE, 2012年, MAGNETIC RESONANCE IN MEDICAL SCIENCES, 11 (2), 75 - 81, 英語

    [査読有り]

  • Yuki Makino, Yasuharu Imai, Takumi Igura, Hideko Ohama, Sachiyo Kogita, Yoshiyuki Sawai, Kazuto Fukuda, Hiroshi Ohashi, Takamichi Murakami

    A multimodality fusion imaging system has been introduced for the clinical practice of diagnosis and treatment of hepatocellular carcinoma (HCC), especially for loco-regional treatment. An ultrasonography (US) fusion imaging system can provide a side-by-side display of real-time US images and any cross-sectional images of multiplanar reconstruction of CT or MRI that synchronize real-time US. The US fusion imaging system enables us to perform radiofrequency ablation (RFA) for HCCs difficult to detect on conventional US safely. Besides, we can evaluate the treatment effects of RFA easily at the bedside by combining the contrast-enhanced US and the US fusion imaging system. Fusion images of pre- and post-RFA CT have been utilized for the assessment of the treatment effects of RFA. Although the treatment effects of RFA have been conventionally evaluated, comparing pre- and post-RFA CT side-by-side, the evaluation tends to be in-accurate. On CT fusion images, the tumor and the ablation zone are overlaid and we can grasp the positional relation easily, leading to quantitative and more accurate evaluation. The multi modality fusion imaging system has become quite an important tool for loco-regional treatment of HCC because of its usefulness for both the guidance during the RFA procedure and the evaluation of its treatment effects. Copyright (C) 2012 S. Karger AG, Basel

    KARGER, 2012年, DIGESTIVE DISEASES, 30 (6), 580 - 587, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hiromitsu Onishi, Takamichi Murakami, Tonsok Kim, Masatoshi Hori, Keigo Osuga, Mitsuaki Tatsumi, Hiroki Higashihara, Noboru Maeda, Takahiro Tsuboyama, Atsushi Nakamoto, Kaname Tomoda, Noriyuki Tomiyama

    Purpose: To investigate the validity of determining the contrast medium dose based on body surface area (BSA) for the abdominal contrast-enhanced multi-detector row CT comparing with determining based on body weight (BW). Materials and methods: Institutional review committee approval was obtained. In this retrospective study, 191 patients those underwent abdominal contrast-enhanced multi-detector row CT were enrolled. All patients received 96 mL of 320 mg I/mL contrast medium at the rate of 3.2 mL. The iodine dose required to enhance 1 HU of the aorta at the arterial phase and that of liver parenchyma at portal venous phase per BSA were calculated (EU(BSA)) and evaluated the relationship with BSA. Those per BW were also calculated (EU(BW)) and evaluated. Estimated enhancement values (EEVs) of the aorta and liver parenchyma with two protocols for dose decision based on BSA and BW were calculated and patient-to-patient variability was compared between two protocols using the Levene test. Results: The mean of EU(BSA) and EU(BW) were 0.0621 g I/m(2)/HU and 0.00178 g I/kg/HU for the aorta, and 0.342 g I/m(2)/HU and 0.00978 g I/kg/HU for the liver parenchyma, respectively. In the aortic enhancement, EU(BSA) was almost constant regardless of BSA, and the mean absolute deviation of the EEV with the BSA protocol was significantly lower than that with the BW protocol (P < .001), although there was no significant difference between two protocols in the hepatic parenchymal enhancement (P = .92). Conclusion: For the aortic enhancement, determining the contrast medium dose based on BSA was considered to improve patient-to-patient enhancement variability. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2011年12月, EUROPEAN JOURNAL OF RADIOLOGY, 80 (3), 643 - 647, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 兵頭 朋子, 岡田 真広, 香川 祐毅, 熊野 正士, 任 誠雲, 柏木 伸夫, 柳生 行伸, 今岡 いずみ, 足利 竜一朗, 石井 一成, 工藤 正俊, 村上 卓道

    近畿大学医学会, 2011年12月, 近畿大学医学雑誌, 36 (3-4), 13A - 13A, 日本語

  • 今井 康陽, 井倉 技, 小来田 幸世, 澤井 良之, 大濱 日出子, 牧野 祐紀, 福田 和人, 黒川 正典, 森本 修邦, 関 康, 高村 学, 村上 卓道

    (株)医薬情報研究所, 2011年12月, 新薬と臨牀, 60 (12), 2519 - 2519, 日本語

  • 柏木伸夫, 村上卓道, 筑後孝章

    2011年09月, ACTA Radiol, 52 (9), 951 - 953

  • 米矢 吉宏, 細野 眞, 土屋 典生, 熊野 正士, 山田 譲, 任 誠雲, 柳生 行伸, 石井 一成, 足利 竜一朗, 西村 恭昌, 村上 卓道

    (一社)日本核医学会, 2011年09月, 核医学, 48 (3), S272 - S272, 日本語

  • Masahiro Okada, Takashi Katsube, Seishi Kumano, Yuki Kagawa, Tetsuro Araki, Natsuko Tsuda, Tomoyuki Okuaki, Izumi Imaoka, Noboru Tanigawa, Kazunari Ishii, Takamichi Murakami

    Background: Non-invasive MR imaging is expected to be used for accurate diagnosis and quantification of non-alcoholic steatohepatitis (NASH), because NASH is a progressive fatty liver disease. New MR techniques, such as fat fraction ratio (FFR) and T2* value measurement, have attracted an increasing attention, because those techniques can measure quantitative parameters of fibrosis, fat and iron deposition in the liver. Purpose: To investigate the potential of FFR and T2* value in NASH with pre-enhancement, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) or super-paramagnetic iron oxide (SPIO)-enhanced MRI. Material and Methods: Twenty-eight rats were divided equally into four groups (one control group and three NASH groups). All rats underwent unenhanced, Gd-EOB-DTPA, and SPIO-enhanced MRI. The T2* value of the liver was measured for each image sequence, and then changes in T2* values before and after each injection were analyzed using Dunnett's test. The reduction rate of T2* value before and 13 min after injection of Gd-EOB-DTPA or SPIO was analyzed using Mann-Whitney's U test. Moreover, FFR of the liver was measured before enhancement, and the relationship between fat fraction and the calculated fat area percentage on a pathological specimen was examined using Spearman's correlation test. Results: On pre-enhancement, FFR and T2* value were 26.0% +/- 12.0% and 21.5 +/- 4.2 ms for all NASH groups, and 0.9% +/- 0.5% and 30.8 +/- -5.5 ms for control, respectively. Both FFR and T2* values were significantly different between the NASH and control groups. The reduction rate of T2* value was significantly lower in the NASH groups than in the control group on SPIO-enhanced MRI, though there was no significant difference on Gd-EOB-DTPA-enhanced MRI. FFR was correlated with the calculated fat area percentage for the pathological specimen. Conclusion: Pre-enhancement FFR, T2* value measurement and reduction rate of T2* value on SPIO-enhanced MRI may help estimate the progress of liver fat deposition and fibrosis in NASH.

    ROYAL SOC MEDICINE PRESS LTD, 2011年07月, ACTA RADIOLOGICA, 52 (6), 658 - 664, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Tonsok Kim, Takamichi Murakami

    The purpose of this article is to explain the role of advanced liver CT imaging, including perfusion CT, dual-energy CT, and volume helical shuttle (VHS) scanning, with regard to its clinical applications. Perfusion CT is a promising method for calculating hepatic blood flow and portal blood flow, including microcirculation, using a color-encoded display of parameters obtained from the liver time-density curve, with iodine contrast agent. Tumor angiogenesis and assessment of the response to antiangiogenesis treatment (e.g., Sorafenib) can be analyzed by perfusion CT of the liver. VHS scan has very high temporal resolution due to the reciprocating movement employed during scanning, enabling the acquisition of 24 scans of the whole liver in the arterial dominant phase during a 40-s breath hold, and a reduction in radiation dose. Dual-energy CT enables differentiation of materials and tissues based on their CT density values, using two different energy spectra. This method includes a low tube voltage CT technique that increases the contrast enhancement of vascular structures while simultaneously reducing radiation dose. Images obtained at the preferred settings of low tube voltage and high tube current, with dose reduction in the hepatic arterial phase, are useful for detecting hypervascular hepatocellular carcinoma.

    SPRINGER, 2011年06月, ABDOMINAL IMAGING, 36 (3), 273 - 281, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takashi Katsube, Masahiro Okada, Seishi Kumano, Masatoshi Hori, Izumi Imaoka, Kazunari Ishii, Masatoshi Kudo, Hajime Kitagaki, Takamichi Murakami

    Objectives: To investigate the ability of T1 mapping of liver on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging for the estimation of liver function. Materials and Methods: Local institutional review board approved this study. Ninety-one patients (64 men, 27 women; mean age, 67.4 years) were classified into 4 groups as follows: normal liver function (NLF), n = 16; chronic hepatitis (CH), n = 38; liver cirrhosis with Child-Pugh A (LCA), n = 20; and liver cirrhosis with Child-Pugh B (LCB), n = 17. Look-Locker sequences (single slice multiphase imaging using gradient-echo sequence with inversion recovery pulse) were obtained before and at 3, 8, 13, and 18 minutes after Gd-EOB-DTPA administration. T1 mapping of liver parenchyma was calculated from the Look-Locker sequence. T1 relaxation time of liver and reduction rate of T1 relaxation time between pre- and postcontrast enhancement were measured. The Bonferroni t test was used for comparisons between the 4 groups. Results: Precontrast T1 relaxation times were significantly longer for LCA and LCB than for NLF, and that of LCB was longer than that of chronic hepatitis (P < 0.05). Postcontrast T1 relaxation times were significantly longer for LCB than for other groups at all time points. Those of LCA were longer than those of NLF at all time points. Reduction rates were significantly lower for LCB than for the other groups at >= 8 minutes. Conclusions: Evaluation of hepatic uptake of Gd-EOB-DTPA using T1 mapping of liver parenchyma can help estimate liver function.

    LIPPINCOTT WILLIAMS & WILKINS, 2011年04月, INVESTIGATIVE RADIOLOGY, 46 (4), 277 - 283, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yuki Kagawa, Masahiro Okada, Seishi Kumano, Takashi Katsube, Izumi Imaoka, Noboru Tanigawa, Kazunari Ishii, Masatoshi Kudo, Takamichi Murakami

    Purpose: To investigate optimal delay time of hepatic arterial phase in Gadoxetate-enhanced MR for detecting hypervascular hepatocellular carcinoma (HCC). Materials and Methods: Forty-five patients with 85 hypervascular HCCs and 9 patients with 16 hypervascular HCCs underwent Gadoxetate-and Gd-DTPA-enhanced MR at 1.5 Tesla (T) system, respectively. All HCCs were analyzed 10-38 s after injection using a time-resolved dynamic MR sequence with keyhole data sampling. Seven sequential phase images (1 phase 4 s) were obtained during a single breath hold of 28 s. Time-intensity curves of the abdominal aorta, liver parenchyma, and HCC were obtained, then aortic contrast arrival time, time of peak HCC enhancement, duration time of HCC and aortic enhancement, and time delay from aortic contrast arrival to peak enhancement of HCC were measured. Results: Aortic contrast arrival time was 15.1 +/- 2.9 s, time of peak HCC enhancement 29.9 +/- 4.6 s, duration time of HCC enhancement 17.4 +/- 6.4 s postinjection of Gadoxetate. Duration of aortic enhancement (23.6 +/- 3.5 s) of Gadoxetate-enhanced MR was significantly less than that of Gd-DTPA-enhanced MR (26.3 +/- 2.8 s) (P < 0.0059). Conclusion: Peak enhancement time of HCC on Gadoxetate-enhanced MR imaging occurred at 14.6 +/- 4.6 s after aortic contrast arrival.

    WILEY-BLACKWELL, 2011年04月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 33 (4), 864 - 872, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Naoto Hayasaka, Kazuyuki Aoki, Saori Kinoshita, Shoutaroh Yamaguchi, John K. Wakefield, Sachiyo Tsuji-Kawahara, Kazumasa Horikawa, Hiroshi Ikegami, Shigeharu Wakana, Takamichi Murakami, Ram Ramabhadran, Masaaki Miyazawa, Shigenobu Shibata

    Regulators of G protein signaling (RGS) are a multi-functional protein family, which functions in part as GTPase-activating proteins (GAPs) of G protein alpha-subunits to terminate G protein signaling. Previous studies have demonstrated that the Rgs16 transcripts exhibit robust circadian rhythms both in the suprachiasmatic nucleus (SCN), the master circadian light-entrainable oscillator (LEO) of the hypothalamus, and in the liver. To investigate the role of RGS16 in the circadian clock in vivo, we generated two independent transgenic mouse lines using lentiviral vectors expressing short hairpin RNA (shRNA) targeting the Rgs16 mRNA. The knockdown mice demonstrated significantly shorter free-running period of locomotor activity rhythms and reduced total activity as compared to the wild-type siblings. In addition, when feeding was restricted during the daytime, food-entrainable oscillator (FEO)-driven elevated food-anticipatory activity (FAA) observed prior to the scheduled feeding time was significantly attenuated in the knockdown mice. Whereas the restricted feeding phase-advanced the rhythmic expression of the Per2 clock gene in liver and thalamus in the wild-type animals, the above phase shift was not observed in the knockdown mice. This is the first in vivo demonstration that a common regulator of G protein signaling is involved in the two separate, but interactive circadian timing systems, LEO and FEO. The present study also suggests that liver and/or thalamus regulate the food-entrained circadian behavior through G protein-mediated signal transduction pathway(s).

    PUBLIC LIBRARY SCIENCE, 2011年03月, PLOS ONE, 6 (3), 1 - 7, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Gd-EOB-DTPA造影MRIにおけるHCCのT1値の経時的変化について T1 mappingを用いた定量的な検討

    森田 敬裕, 熊野 正士, 岡田 真広, 兵頭 朋子, 柏木 伸夫, 柳生 行伸, 今岡 いずみ, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2011年02月, 日本医学放射線学会学術集会抄録集, 70回, S275 - S276, 日本語

  • SSFSE像におけるHCCに対するEOB造影の経時的影響 1.5Tと3.0Tの比較

    荒木 哲朗, 岡田 真広, 熊野 正士, 柳生 行伸, 柏木 伸夫, 小塚 健倫, 今岡 いずみ, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2011年02月, 日本医学放射線学会学術集会抄録集, 70回, S276 - S276, 日本語

  • Gd-EOB-DTPA造影MRI肝細胞相で検出された慢性障害肝の乏血性結節 多血化の危険因子

    兵頭 朋子, 岡田 真広, 香川 祐毅, 熊野 正士, 堀 雅敏, 石井 一成, 今井 康陽, 望月 輝一, 工藤 正俊, 村上 卓道

    (公社)日本医学放射線学会, 2011年02月, 日本医学放射線学会学術集会抄録集, 70回, S342 - S343, 日本語

  • 減弱を考慮した副腎皮質アドステロール摂取率の簡易的な算出方法

    大塚 正和, 花岡 宏平, 宇佐美 公男, 澄田 貢, 石井 一成, 村上 卓道, 細野 眞

    (公社)日本放射線技術学会, 2011年02月, 日本放射線技術学会総会学術大会予稿集, 67回, 320 - 320, 日本語

  • 坂口 健太, 高田 裕史, 宇佐美 公男, 米矢 吉宏, 土屋 典生, 熊野 正士, 細野 眞, 花岡 宏平, 大塚 正和, 井上 亮, 新谷 祐子, 吉田 修平, 森元 英夫, 宇都 辰郎, 澄田 貢, 柿木 崇秀, 柳生 行伸, 石井 一成, 足利 竜一郎, 村上 卓道

    (一社)日本核医学会, 2011年02月, 核医学, 48 (1), 63 - 64, 日本語

  • 収集時間の減少が123I-IMP脳血流SPECT/CT検査に与える影響について

    花岡 宏平, 坂口 健太, 大塚 正和, 澄田 貢, 石井 一成, 村上 卓道, 細野 眞

    (公社)日本放射線技術学会, 2011年02月, 日本放射線技術学会総会学術大会予稿集, 67回, 251 - 251, 日本語

  • 高速多相撮像を用いた多血性肝細胞癌の最適な撮像時間の検討

    香川祐毅, 岡田真広, 村上卓道

    2011年01月, 近大医学雑誌, 36 (1), 19 - 24

  • 照射野外固定の卵巣病変およびその機能性変化

    香川 祐毅, 今岡 いずみ, 加藤 里枝子, 安藤 里奈, 桑原 雅知, 岡田 真広, 熊野 正士, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2011年01月, Japanese Journal of Radiology, 29 (Suppl.I), 57 - 57, 日本語

  • Alaboudy A, Inoue T, Hatanaka K, Chung H, Hyodo T, Kumano S, Murakami T, Moustafa EF, Kudo M

    Objective: To clarify the diagnostic ability of combining imaging methods to diagnose hepatocellular carcinoma (HCC) using Sonazoid (R)-enhanced ultrasound (US), gadolinium diethylene-triamine-pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CECT). Methods: A total of 32 patients who underwent surgical resection for HCC were studied. Sonazoid-enhanced US, Gd-EOB-DTPA MRI, CECT, and intraoperative contrast-enhanced ultrasonography were done for all patients. The definitive diagnosis of HCC in those patients was based on histopathological confirmation. Results: A total of 50 histologically proven HCCs were obtained from 32 patients; their mean (+/-SD) age was 68.3 years +/-8.1. The mean (+/-SD) nodule size was 2.6 cm +/- 1.9. Twenty percent were well-differentiated HCC, 64% were moderately differentiated HCC, 10% were poorly differentiated HCC, 4% were combined HCC and CCC, and 2% were HCC with severe necrosis. The overall diagnostic sensitivity of CEUS, CECT, and Gd-EOB-DTPA MRI was 72, 74, and 86%, respectively; however, there was no significant difference between the three imaging modalities in diagnosing typical HCC (p = 0.092). When combining the diagnostic ability of the different imaging modalities, the diagnostic sensitivity of Sonazoid-enhanced US and Gd-EOB-DTPA MRI was 90%, while addition of Sonazoid-enhanced US to CECT and CECT to Gd-EOB-DTPA MRI had a sensitivity of 82 and 88%, respectively. There was no significant difference between the three imaging combinations (p = 0.970). Conclusion: Sonazoid-enhanced US and Gd-EOB-DTPA MRI can be confidently used in daily clinical practice for the management of HCC. Copyright (C) 2011 S. Karger AG, Basel

    KARGER, 2011年, Oncology, 81 (Suppl 1), 66 - 72, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takamichi Murakami, Yasuharu Imai, Masahiro Okada, Tomoko Hyodo, Won-Jae Lee, Myeong-Jin Kim, Tonsok Kim, Byung Ihn Choi

    Detection, characterization, staging, and treatment monitoring are major roles in imaging diagnosis in liver cancers. Contrast-enhanced ultrasonography (CEUS) using micro-bubble contrast agents has expanded the role of US in the detection and diagnosis of liver nodules in patients at high risk of hepatocellular carcinoma (HCC). CEUS provides an accurate differentiation between benign and malignant liver nodules, which is critical for adequate management of HCC and is also useful for guidance of percutaneous local therapy of HCC and postprocedure monitoring of the therapeutic response. The technology of multidetector-row computed tomography (MDCT) has increased spatial and temporal resolutions of computed tomography (CT). It has made possible a more precise evaluation of the hemodynamics of liver tumor, and the diagnostic accuracy of dynamic MDCT has improved. Perfusion CT can measure tissue perfusion parameters quantitatively and can assess segmental hepatic function. Dynamic MDCT with high spatial and temporal resolution enables us to reconstruct 3- and 4-dimensional imaging, which is very useful for pretreatment evaluation. Dual-energy CT makes possible the differentiation of materials and tissues in images obtained based on the differences in iodine and water densities. Monochromatic images, which can be reconstructed by dual-energy CT data, provide some improvement in contrast and show a higher contrast-to-noise ratio for hypervascular HCCs. Dynamic magnetic resonance imaging with fast imaging sequence of 3-dimensional Fourier transformation T(1)-weighted gradient echo and nonspecific contrast medium can show high detection sensitivity of hypervascular HCC. However, the hepatic tissue-specific contrast medium, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid, has become an essential contrast medium for liver imaging because of its higher diagnostic ability. It may replace CT during hepatic arteriography and during arterioportography. Copyright (C) 2011 S. Karger AG, Basel

    KARGER, 2011年, ONCOLOGY, 81, 86 - 99, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Sachiyo Kogita, Yasuharu Imai, Masahiro Okada, Tonsok Kim, Hiromitsu Onishi, Manabu Takamura, Kazuto Fukuda, Takumi Igura, Yoshiyuki Sawai, Osakuni Morimoto, Masatoshi Hori, Hiroaki Nagano, Kenichi Wakasa, Norio Hayashi, Takamichi Murakami

    To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow. Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography. Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 +/- 0.14) and well, moderately and poorly differentiated HCCs (0.79 +/- 0.19, 0.60 +/- 0.27, 0.49 +/- 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs. Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs.

    SPRINGER, 2010年10月, EUROPEAN RADIOLOGY, 20 (10), 2405 - 2413, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Yasuharu Imai, Tonsok Kim, Sachiyo Kogita, Manabu Takamura, Seishi Kumano, Hiromitsu Onishi, Masatoshi Hori, Kazuto Fukuda, Norio Hayashi, Kenichi Wakasa, Michiie Sakamoto, Takamichi Murakami

    Purpose: To compare enhancenent patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) between gadoxetate- and ferucarbotran-enhanced MRI. Materials and Methods: Patients recruited from ultrasound surveillance for HCC in chronic liver diseases were enrolled in this prospective study approved by institutional review board. Thirty-six patients with 37 histologically proven HCC, including 22 well-differentiated HCCs (wHCC), 15 moderately to poorly differentiated HCCs (mpHCCs), and 4 DNs, underwent gadoxetate-enhanced and ferucarbotran-enhanced MRI. We compared hepatobiliary phase image of gadoxetate-enhanced MRI with ferucarbotran-enhanced MR image regarding signal intensity of HCC and DN relative to surrounding liver parenchyma. We calculated contrast ratios between tumor and liver on pre-enhancement, hepatobiliary phase of gadoxetate-enhanced MRI and ferucarbotran-enhanced MRI. Results: On ferucarbotran-enhanced MRI, all mpHCCs showed hyper-intensity, while 14 wHCCs (14/22; 63%) showed iso-intensity. On hepatobiliary phase of gadoxetate-enhanced MRI, 13 mpHCCs (13/15; 86%) and 20 wHCCs (20/22; 91%) showed hypo-intensity. Two DNs and the other two showed iso- and hypo-intensity, respectively, on gadoxetate-enhanced MRI, whereas all DNs revealed iso-intensity on ferucarbotran-enhanced MRI. Gadoxetate-postcontrast ratio was significantly lower than ferucarbotran-postcontrast ratio in wHCC (P = 0.015). Conclusion: The uptake function of hepatocytes that are targeted by gadoxetate is more sensitive than that of Kupffer cells targeted by ferucarbotran in stepwise hepatocarcinogenesis.

    JOHN WILEY & SONS INC, 2010年10月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 32 (4), 903 - 913, 英語

    [査読有り]

    研究論文(学術雑誌)

  • RI標識モノクローナル抗体療法におけるIn-Zevalin、FDGの腫瘍集積と奏効の関係について

    花岡 宏平, 細野 眞, 米矢 吉宏, 土屋 典生, 山添 譲, 宇佐美 公男, 澄田 貢, 石井 一成, 村上 卓道

    (一社)日本核医学会, 2010年09月, 核医学, 47 (3), 432 - 432, 日本語

  • Estimation of Liver Function Using T1 Mapping on Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid-enhanced Magnetic Resonance Imaging.

    Katsube T, Okada M, Kumano S, Hori M, Imaoka I, Ishii K, Kudo M, Kitagaki H, Murakami T

    Lippincott Williams & Wilkins, 2010年08月28日, Invest Radiol, 46, 277 - 283, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Norihide Sato, Kazunari Ishii, Kaname Matsumura, Makoto Hosono, Takamichi Murakami

    Malignant lymphoma is the most common form of hematologic cancer, yet because of advanced methods of assessment, the traditional histology-based classification of lymphoma is insufficient for understanding lymphoma imaging. Still, radiologists should be familiar with the imaging findings in lymphoma. Integrated positron emission tomography (PET) computed tomography (CT) allows improved diagnostic accuracy, and uptake of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) can help predict response during treatment. The sensitivity and specificity of FDG PET are superior to those of gallium 67 scintigraphy in all but indolent lymphoma. Both magnetic resonance (MR) imaging and CT allow excellent assessment of bone texture, but FDG PET is superior in demonstrating bone marrow metabolic activity. Thus, FDG PET is important in both the primary diagnosis and the evaluation of therapy in lymphoma. It may be difficult to determine whether residual abnormalities seen after the completion of chemotherapy radiation therapy represent residual tumor or fibrotic tissue, but PET/CT may allow more accurate diagnosis than MR imaging or CT, thereby helping identify patients who require more intensive treatment. Some diagnostic pitfalls are encountered at FDG PET. However, anatomic CT helps localize and define disease and avoid these potential pitfalls. (c) RSNA, 2010 . radiographics.rsna.org

    RADIOLOGICAL SOC NORTH AMERICA, 2010年07月, RADIOGRAPHICS, 30 (4), 939 - 960, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takamichi Murakami

    5, 2010年05月, Journal of Japanese Society of Gastroenterology, 107 (5), 693 - 702, 日本語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Takeshi Isoda, Seishi Kumano, Yuki Kagawa, Tetsuro Araki, Hiromitsu Onishi, Masatoshi Hori, Tonsok Kim, Yasuyuki Motokui, Takeshi Wada, Takamichi Murakami

    Kupffer cell imaging is a powerful tool for the detection of liver cancer. This diagnostic procedure depends on the faculty of the reticuloendothelial system (RES) which takes up foreign bodies, including small particles. The current study aimed to develop a novel RES targeting liposomal contrast agent that functionalized with serine or mannose, the moiety specifically binding to a corresponding receptor on phagocytic cells. Liposomes loaded with non-ionic X-ray contrast media, lohexol, were prepared by supercritical carbon dioxide reverse-phase evaporation method and were intravenously injected to healthy rabbits in order to evaluate the liver parenchymal enhancement in X-ray computed tomography (CT). From 10 to 40 min after injection, the mean enhancement value of the liver parenchyma approached 45 and 34 Hounsfield units (HU) when serine-modified iodinated liposomal contrast agent (ILCA) and mannose-modified ILCA were applied, respectively. The tumor-to-liver contrast values were also evaluated after the administration of the prepared ILCA to rabbits with VX-2 carcinoma. For serine-modified ILCA, tumor-to-liver contrast was 82 HU at 1 min and >24 HU at 10-40 min; for mannose-modified ILCA, the values were 58 HU at 0.5 min and >21 HU at 10-40 min. These vales estimated from the region of intrest and the imaging figures of liver indicate the potential of ILCA for clinical use. Copyright (C) 2010 John Wiley & Sons, Ltd.

    WILEY-HINDAWI, 2010年05月, CONTRAST MEDIA & MOLECULAR IMAGING, 5 (3), 140 - 146, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tomoaki Ichikawa, Kazuhiro Saito, Naoki Yoshioka, Akihiro Tanimoto, Takehiko Gokan, Yasuo Takehara, Takeshi Kamura, Toshifumi Gabata, Takamichi Murakami, Katsuyoshi Ito, Shinji Hirohashi, Akihiro Nishie, Yoko Saito, Hiroaki Onaya, Ryohei Kuwatsuru, Atsuko Morimoto, Koji Ueda, Masayo Kurauchi, Josy Breuer

    Objectives: To prospectively evaluate the safety and efficacy of combined unenhanced and gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging compared with unenhanced MR imaging and triphasic contrast-enhanced spiral computed tomography (CT) for the detection and characterization of focal liver lesions. Materials and Methods: The study was reviewed and approved by the institutional review board at each of the 15 centers involved in the study, and informed written consent was given by all patients. In total, 178 patients with suspected focal hepatic lesions (based, in most patients, on CT, tumor marker and ultrasound examinations) underwent combined MR imaging with a single, rapid injection of Gd-EOB-DTPA 0.025 mmol/kg, including T1-weighted dynamic and delayed MR images 20 to 40 minutes postinjection. Triphasic contrast-enhanced CT, the comparator examination, was performed within 4 weeks of MR imaging. Standard of references (SOR) were resection histopathology and intraoperative ultrasonography, or combined CT during arterial portography and CT hepatic arteriography; in cases where, although the major lesions were treated, some lesion(s) were not treated, follow-up superparamagnetic iron oxide-enhanced MR imaging was additionally performed. All images were assessed for differences in lesion detection and characterization (specific lesion type) by on-site readers and 3, blinded (off-site) reviewers. All adverse events (AEs) occurring within 72 hours after Gd-EOB-DTPA administration were reported. Results: Overall, 9.6% of patients who received Gd-EOB-DTPA reported 21 drug-related AEs. A total of 151 patients were included in the efficacy analysis. Combined MR imaging showed statistically higher sensitivity in lesion detection (67.5%-79.5%) than unenhanced MR imaging (46.5%-59.1%; P < 0.05 for all). Combined MR imaging also showed higher sensitivity in lesion detection than CT (61.1%-73.0%), with the results being statistically significant (P < 0.05) for on-site readers and 2 of 3 blinded readers. Higher sensitivity in lesion detection with combined MR imaging compared with CT was also clearly demonstrated in the following subgroups: lesions with a diameter <= 20 mm (lesions <= 10 mm: 38.0%-55.4% vs. 26.1%-47.3%, respectively; lesions 10-20 mm: 71.1%-87.3% vs. 65.7%-78.4%, respectively); in cirrhotic patients (64.5%-75.4% vs. 54.5%-70.3%, respectively); and in patients with hepatocellular carcinoma (66.6%-78.6% vs. 59.1%-71.6%, respectively). Combined MR imaging demonstrated a higher proportion of correctly characterized lesions (50.5%-72.1%) than unenhanced MR imaging (30.2%-50.0%; P < 0.05 for all), whereas there were no significant differences compared with CT (49.0%-68.1%), except for one blinded reader (P < 0.05). Conclusion: In this study, hepatocyte-specific Gd-EOB-DTPA was shown to be safe and to improve the detection and characterization of focal hepatic lesions compared with unenhanced MR imaging. When compared with spiral CT, Gd-EOB-DTPA enhanced MRI seems to be beneficial especially for the detection for smaller lesions or hepatocellular carcinoma underlying cirrhotic liver.

    LIPPINCOTT WILLIAMS & WILKINS, 2010年03月, INVESTIGATIVE RADIOLOGY, 45 (3), 133 - 141, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Akihiro Kuriu, Taro Shimono, Masatomo Kuwabara, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    We report a case of fourth ventricular mixed germ cell tumor (GCT) in a 20-year-old man. Neuroradiological investigations revealed a fourth ventricular hemorrhagic tumor with adipose tissue. We suspected mixed GCT because adipose tissue was seen preoperatively, but mixed GCT occurring after childhood in this location has not previously been reported. We describe herein the imaging findings for mixed GCT and discuss the differential diagnoses of fourth ventricular tumors with adipose tissue. © 2010 Japan Radiological Society.

    2, 2010年02月, Japanese Journal of Radiology, 28 (2), 166 - 168, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 多血性肝細胞癌におけるGd-EOB-DTPA造影ダイナミックMRIの診断能 造影ダイナミックCTとの比較

    大西 裕満, 村上 卓道, 今井 康陽, 金 東石, 堀 雅敏, 坪山 尚寛, 中本 篤, 中矢 泰裕, 高村 学, 熊野 正士

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S243 - S243, 日本語

    [査読有り]

  • Akihiro Kuriu, Taro Shimono, Masatomo Kuwabara, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    We report a case of fourth ventricular mixed germ cell tumor (GCT) in a 20-year-old man. Neuroradiological investigations revealed a fourth ventricular hemorrhagic tumor with adipose tissue. We suspected mixed GCT because adipose tissue was seen preoperatively, but mixed GCT occurring after childhood in this location has not previously been reported. We describe herein the imaging findings for mixed GCT and discuss the differential diagnoses of fourth ventricular tumors with adipose tissue.

    SPRINGER, 2010年02月, JAPANESE JOURNAL OF RADIOLOGY, 28 (2), 166 - 168, 英語

    [査読有り]

    研究論文(学術雑誌)

  • MRIおよびCTを用いた画像的肝機能評価

    岡田 真広, 熊野 正士, 勝部 敬, 香川 祐毅, 栗生 明博, 今岡 いずみ, 石井 一成, 今井 康陽, 工藤 正俊, 村上 卓道

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S134 - S134, 日本語

  • SPECT/CTによる脳血流SPECTの減弱補正効果

    栗生 明博, 石井 一成, 米谷 吉宏, 柳生 行伸, 熊野 正士, 足利 竜一朗, 細野 眞, 村上 卓道

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S183 - S184, 日本語

  • 油性造影剤マイオジールの頭蓋内MRI所見についての検討

    下野 太郎, 足利 竜一朗, 柳生 行伸, 桑原 雅知, 勝部 敬, 栗生 明博, 石井 一成, 村上 卓道

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S206 - S206, 日本語

  • 3T MRI高分解能画像による正常子宮の蠕動評価

    安藤 理奈, 今岡 いずみ, 香川 祐毅, 加藤 里枝子, 柳生 行伸, 岡田 真広, 熊野 正士, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S274 - S275, 日本語

  • Gd-EOB-DTPA造影MRIと肝機能評価 T1 Mapping法を用いて

    勝部 敬, 岡田 真広, 熊野 正士, 香川 祐毅, 栗生 明博, 奥秋 知幸, 今岡 いずみ, 石井 一成, 足利 竜一朗, 村上 卓道

    (公社)日本医学放射線学会, 2010年02月, 日本医学放射線学会学術集会抄録集, 69回, S293 - S293, 日本語

  • Hiroki Higashihara, Takamichi Murakami, Tonsok Kim, Masatoshi Hori, Hiromitsu Onishi, Saki Nakata, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura

    Purpose: To evaluate ability of ferucarbotran-enhanced MR imaging (MRI) in differentiating metastases from nonsolid benign lesions of the liver according to signal-intensity characteristics. Materials and methods: Sixty-six consecutive patients, who had 138 focal hepatic lesions (26 cysts, 11 hemangiomas,and 101 metastases), underwent ferucarbotran-enhanced MRI. The signal-intensity pattern of each kind of lesion relative to the liver parenchyma on ferucarbotran-enhanced T2* and heavily T1-weighted gradient-echo images were assessed and categorized into the following three categories: high-intensity and iso-intensity, respectively (category A), high and low (category B), and iso- and low-intensity (category C). For category B, lesions were subdivided into two groups based on single-shot half-Fourier RARE images: category B1 (not significantly high-intensity) and category B2 (significantly high-intensity). Results: Category A had 11 hemangiomas and 2 metastatic tumors, category B1 had 97 metastatic tumors, category B2 had 2 metastatic tumors and 9 cysts, and category C had 17 cysts. When a tumor with a signal intensity of category A was considered to be hemangioma, category Ell metastasis, and category B2 and C cyst, the diagnostic accuracy for differentiating these lesions was 97% (134/138). Conclusion: The combination of signal-intensity pattern on ferucarbotran-enhanced T2*- and heavily T1-weighted gradient-echo MRI has ability to differentiate liver metastases from nonsolid benign lesions. However, T2-weighted single-shot half-Fourier RARE imaging should also be employed to achieve better performance. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2010年01月, EUROPEAN JOURNAL OF RADIOLOGY, 73 (1), 125 - 130, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Natsuko Tsuda, Masahiro Okada, Takamichi Murakami

    Purpose: We investigated whether the gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI was useful for nonalcoholic steatohepatitis (NASH) staging based on the severity of liver fibrosis. Materials and methods: Twenty-one male Sprague-Dawley rats aged 7 weeks, weighing about 150 g in NASH group were fed a choline-deficient diet for 4, 7 or 10 weeks, and seven rats in the control group were fed a standard diet (n = 7). After the feeding period, the rats were subjected to contrast-enhanced MRI (2D-FLASH; TR/TE = 101/2.9 ms, flip angle 90 degrees). Gd-DTPA (0.1 mmol Gd/kg) and Gd-EOB-DTPA (0.025 mmol Gd/kg) were injected at 24-h intervals, and the speed of contrast injection was 1 mL/s. Signal intensities of the liver were measured and the relative enhancement (RE), the time of maximum RE (T(max)) and elimination half-life of RE (T(1/2)) in the liver were compared. The fibrosis rate (%) was calculated with the following formula: fibrosis/whole area x 100. Results: The fibrosis rates of each group were as follows: 0.52, 0.79, 2.84, and 0.50% (4, 7, 10 weeks and control groups). The fibrosis rate of the 10 weeks group was significantly higher than the control and 4 or 7 weeks groups. Although there was no difference between the T(max) and T(1/2) of each group after Gd-DTPA injection, the T(max) and T(1/2) of the 10 weeks group were significantly prolonged in comparison with the control and 4 or 7 weeks groups after Gd-EOB-DTPA injection (p < 0.01). There was a significant correlation between the fibrosis rate and T(max) or T(1/2) after Gd-EOB-DTPA injection (r = 0.90 or 0.97). Conclusion: It was possible to assess the progress of liver fibrosis in NASH by evaluating the signal intensity-time course on Gd-EOB-DTPA-enhanced MRI. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2010年01月, EUROPEAN JOURNAL OF RADIOLOGY, 73 (1), 137 - 142, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 64列多列化CTを用いた新しい定量的心筋灌流イメージング法

    中内祥文, 岩永善高, 生田新一郎, 村上卓道

    2010年, 近畿大学医学雑誌, 35 (3,4)

  • 三次元CT画像を用いた冠動脈の起始異常および開口部起始位置の解剖学的調査

    工藤正幸, 村上卓道

    2010年, 近畿大学医学雑誌, 35 (3,4), 177 - 184

  • MR cholangiopancreatography at 3.0 T: Intra-individual comparative study with MR cholangiopancreatography at 1.5 T for clinical patients.

    大西裕満, 村上卓道, 金 東石

    2010年, Invest Radiol, 44, 559 - 565

  • A. Okada, Y. Morita, H. Fukunishi, K. Takeichi, T. Murakami

    Objectives To describe the learning curve effect of magnetic resonance-guided focused ultrasound surgery (MRgFUS) on the outcomes of patients treated for uterine fibroids in four centers in Japan. Methods The extent of fibroid ablation (often used to measure treatment success) was evaluated using the non-perfused volume (NPV) ratio in 287 Japanese patients. The patients were divided into two equal groups according to the chronological treatment time and results were compared between these groups to estimate the learning curve effect. Results were also compared with published data from clinical trials. Results The NPV ratio increased chronologically, from 39.3% to 54.0% (P < 0.001), indicating increasing effectiveness of the treatment with experience. The mean NPV ratios for the entire patient population were over double that of previous clinical trials 46.6% vs. 21.9%; P < 0.001). No serious complications were reported. Conclusion The learning process and accumulation of data on MRgFUS enable the optimization of treatments in order to safely achieve large NPV ratios and sustained clinical benefit. Copyright (C) 2009 ISUOG. Published by John Wiley & Sons, Ltd.

    JOHN WILEY & SONS LTD, 2009年11月, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 34 (5), 579 - 583, 英語

    研究論文(学術雑誌)

  • Akihiro Tanimoto, Jeong Min Lee, Takamichi Murakami, Alexander Huppertz, Masatoshi Kudo, Luigi Grazioli

    Discussion at the 2nd Forum for Liver MRI: The International Primovist (R) User Meeting on the use of the hepatocyte-specific contrast agent gadolinium-ethoxybenzyl-diethylene triamine penta-acetic acid (Gd-EOB-DTPA) is reported. Changes to the currently recommended Gd-EOB-DTPA imaging protocol were identified that can reduce the overall examination time. The potential benefits of 3-T MR imaging using Gd-EOB-DTPA have yet to be fully explored. Data show that Gd-EOB-DTPA-enhanced MRI allows identification of liver lesions and provides a differential diagnosis of hepatocellular nodules in the non-cirrhotic and cirrhotic liver, based on vascularity, during the dynamic arterial, portal-venous and late phases, and during the hepatocytespecific phase. Current European, American and Japanese guidelines for the diagnosis of hepatocellular carcinoma need to take into account the recent rapid advances in liver imaging. Based on published clinical trials and the experience of the attendees in the use of Gd-EOB-DTPA in liver imaging, a new simplified, non-invasive diagnostic algorithm was proposed that would be applicable to both Eastern and Western clinical practice in the evaluation of hepatocarcinogenesis and hepatocellular carcinoma. Preliminary clinical experience suggests that Gd-EOB-DTPA may also provide an innovative and cost-effective one-stop approach for staging rectal cancer using whole-body imaging.

    SPRINGER, 2009年10月, EUROPEAN RADIOLOGY, 19 (5), S975 - S989, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hiromitsu Onishi, Tonsok Kim, Masatoshi Hori, Takamichi Murakami, Mitsuaki Tatsumi, Yasuhiro Nakaya, Atsushi Nakamoto, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura

    Objectives: To prospectively evaluate the image quality and diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) at 3.0 T compared with that at 1.5 T used for patients. Materials and Methods: This study was approved by our institutional review board, and informed consent was obtained from all patients. Three-dimensional MRCP with both a 1.5-T system and a 3.0-T system was administered to 33 consecutive patients suspected of having biliary and/or pancreatic diseases. For 3-dimensional MRCP imaging, a respiratory-triggered Fast Recovery Fast Spin Echo sequence with the parallel imaging technique was used for both systems. The spatial resolution at 1.5 T was matched to that at 3.0 T, and matrix size was 512 X 160, field of view (FOV) 36 X 36 cm, slice thickness 2 mm, and the number of slices ranged from 44 to 54. Repetition time varied according to the patients' respiratory cycles, which ranged from 3000 milliseconds to 6000 milliseconds, and effective echo time, ranging from 391 milliseconds to 482 milliseconds, was automatically determined by the systems. Contrast of imaging of the common bile duct versus that of the periductal tissue was quantitatively evaluated. The image quality for homogeneity of signal intensity, image noise, susceptibility artifacts, and overall imaging quality and diagnostic accuracy for stenoses of bile and main pancreatic ducts and for pancreatic cystic lesions were qualitatively evaluated. The results for 1.5- and 3.0-T were then compared statistically, by using the paired t test for quantitative evaluation of contrast between the common bile duct and the periductal tissue, the Wilcoxon signed rank test for visual evaluation of the image quality, and the McNemar chi(2) test for evaluation of sensitivity and specificity for diagnostic purposes. A P value of less than 0.05 was considered to indicate a statistically significant difference. Results: Contrast of the common bile duct versus that of the periductal tissue at 3.0 T was superior to that at 1.5 T (P < 0.001). In the visual evaluation, image quality at 3.0 T was superior to that at 1.5 T for evaluation of image noise (P < 0.001), overall image quality (P < 0.001), and delineation of intrahepatic bile ducts (P < 0.01) and the main pancreatic duct (P < 0.05), whereas there were no significant differences in homogeneity of signal intensity and in susceptibility artifacts. The diagnostic accuracy for 3.0 T was approximately equivalent to that for 1.5 T. Conclusion: Our results for patients with biliary and pancreatic diseases demonstrate a marked improvement in contrast of the common bile duct versus that of the periductal tissue and image quality including image noise at 3.0 T compared by 1.5 T when identical spatial resolution configuration were used. The results suggest that 3.0 T may allow higher spatial resolution and offer promise for improved diagnosis in MRCP, although further investigations using optimize scan parameters will be needed before its full potential can be achieved.

    LIPPINCOTT WILLIAMS & WILKINS, 2009年09月, INVESTIGATIVE RADIOLOGY, 44 (9), 559 - 565, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masatoshi Hori, Tonsok Kim, Takamichi Murakami, Izumi Imaoka, Hiromitsu Onishi, Atsushi Nakamoto, Yasuhiro Nakaya, Kaname Tomoda, Tateki Tsutsui, Takayuki Enomoto, Tadashi Kimura, Hironobu Nakamura

    Purpose: To prospectively compare magnetic resonance imaging (MRI) at 3.0 T and 1.5 T in the same patients for preoperative evaluation of endometrial carcinoma. Materials and Methods: Thirty consecutive patients with endometrial carcinoma underwent MRI at both 3.0 T and 1.5 T as well as surgery. Quantitative and qualitative analyses were performed. Two radiologists independently evaluated images. MR findings were compared with surgicopathologic findings. Results: Image homogeneity of T2-weighted images at 3.0 T was significantly inferior to that at 1.5 T (P = 0.007). The scores of image homogeneity and susceptibility artifacts were not significantly different between 3.0 T gadolinium-enhanced imaging and 1.5 T imaging (P = 0.09 and 0.36). Kappa statistics showed good interobserver agreement between the two radiologists for local-regional staging on T2-weighted images (kappa>0.6). The area under the receiver operating characteristic curve (Az) values for T2-weighted imaging in terms of myometrial invasion, cervical invasion, and lymph node metastases were 0.88 (3.0 T) versus 0.91 (1.5 T), 0.84 versus 0.83, and 0.94 versus 0.95 for reader 1, respectively. There were no significant differences between imaging at 3.0 T and at 1.5 T in Az values for either reader (P > 0.35). Conclusion: 3.0 T MRI is an equivalent imaging modality to 1.5 T imaging for presurgical evaluation of endometrial carcinoma, although not significantly superior to 1.5 T imaging.

    JOHN WILEY & SONS INC, 2009年09月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 30 (3), 621 - 630, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 統計的逐次近似法の割合を変化させたCT画像の物理評価

    小西 達朗, 黒川 敏昭, 多田 佳司, 上村 正信, 山田 浩司, 坂口 健太, 村上 卓道, 工藤 正幸

    (公社)日本放射線技術学会, 2009年09月, 日本放射線技術学会雑誌, 65 (9), 1298 - 1298, 日本語

  • Seishi Kumano, Masahiko Uemura, Toyoaki Haraikawa, Masaaki Hirata, Keiichi Kikuchi, Tonsok Kim, Masahiro Okada, Teruhito Mochizuki, Takamichi Murakami

    Purpose. The aim of this study was to evaluate the efficacy of double arterial phase dynamic magnetic resonance imaging (MRI) with the sensitivity encoding technique (SENSE dynamic MRI) for detection of hypervascular hepatocellular carcinoma (HCC) in comparison with double arterial phase dynamic multidetector-row helical computed tomography (dynamic MDCT). Materials and methods. A total of 28 patients with 66 hypervascular HCCs underwent both double arterial SENSE dynamic MRI and dynamic MDCT. The diagnosis of HCC was based on surgical resection (n = 7), biopsy (n = 10), or a combination of CT during arterial portography (CTAP), CT during hepatic arteriography (CTA), and/or the 6-month follow-up CT (n = 49). Based on alternative-free response receiving operating characteristic (ROC) analysis, the diagnostic performance for detecting HCC was compared between double arterial phase SENSE dynamic MRI and double arterial phase dynamic MDCT. Results. The mean sensitivity, positive predictive value, and mean A(z) values for hypervascular HCCs were 72%, 80%, and 0.79, respectively, for SENSE dynamic MRI and 66%, 92%, and 0.78, respectively, for dynamic MDCT. The mean sensitivity for double arterial phase SENSE dynamic MRI was higher than that for double arterial phase dynamic MDCT, but the difference was not statistically significant. Conclusion. Double arterial phase SENSE dynamic MRI is as valuable as double arterial phase dynamic MDCT for detecting hypervascular HCCs.

    SPRINGER, 2009年07月, JAPANESE JOURNAL OF RADIOLOGY, 27 (6), 229 - 236, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hiromitsu Onishi, Norikazu Masuda, Kayo Takechi, Takahiro Nakayama, Masayuki Tatsuta, Naoki Mihara, Manabu Takamura, Yutaka Inoue, Keiko Kuriyama, Yoshikazu Kotsuma, Hiroshi Furukawa, Takamichi Murakami, Hironobu Nakamura

    Rationale and Objectives. The aim of this study was to evaluate the breast cancer diagnostic capability of "dual-side readout" computed radiography-based mammography (DRCRM) with a 50-mu m pixel size compared to that of conventional film-screen mammography (FSM). Materials and Methods. Thirty patients who were scheduled for surgical treatment for breast cancer and 10 normal volunteers were enrolled. All 30 patients underwent surgical treatment, and breast cancer was proved histopathologically. Twenty-eight patients had 35 invasive carcinomas, and the remaining two had ductal carcinomas in situ. Each of the 40 women underwent both DRCRM and FSM (with double exposure and the same view, without removing compression). Three observers retrospectively interpreted the mammograms independently and evaluated and rated masses and class categories. The accuracy of the detection of masses was evaluated with alternative free-response receiver-operating characteristic analysis. Sensitivity for the detection of masses and of cancers was also evaluated. Results. The mean areas under the alternative free-response receiver-operating characteristic curves in the detection of the masses were 0.88 for DRCRM and 0.91 for FSM (P = .08). The corresponding values for mean sensitivity for the detection of masses were 0.74 and 0.77 (P = .48) and those for the detection of cancers 0.79 and 0.84 (P = .20). Conclusion. No significant differences were observed between DRCRM and FSM for diagnosis of breast cancers.

    ELSEVIER SCIENCE INC, 2009年07月, ACADEMIC RADIOLOGY, 16 (7), 836 - 841, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Taro Shimono, Yoshihiro Komeya, Rina Ando, Yuki Kagawa, Takashi Katsube, Masatomo Kuwabara, Yukinobu Yagyu, Seishi Kumano, Izumi Imaoka, Norio Tsuchiya, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    To investigate whether integrated fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) can differentiate benign from adrenal malignant lesions on the basis of maximum standardized uptake value (SUV(max)), tumor/liver (T/L) SUV(max) ratio, and CT attenuation value (Hounsfield Units; HU) of unenhanced CT obtained from FDG-PET/CT data. We studied 30 patients with 35 adrenal lesions (16 adrenal benign lesions, size 16 +/- A 5 mm, in 15 patients; and 19 adrenal malignant lesions, 24 +/- A 12 mm, in 15 patients) who had confirmed primary malignancies (lung cancer in 23 patients, lymphoma in 2, esophageal cancer in 2, hypopharyngeal cancer in 1, prostate cancer in 1, and 1 patient in whom lesions were detected at cancer screening). All patients underwent PET/CT at 1 h post FDG injection. Diagnosis of adrenal malignant lesions was based on interval growth or reduction after chemotherapy. An adrenal mass that remained unchanged for over 1 year was the standard used to diagnose adrenal benign lesions. Values of FDG uptake and CT attenuation were measured by placing volumetric regions of interest over PET/CT images. Adrenal uptake of SUV(max) a parts per thousand yen 2.5 was considered to indicate a malignant lesion; SUV(max) < 2.5 was considered to indicate a benign lesion. In further analysis, 1.8 was employed as the threshold for the T/L SUV(max) ratio. Unenhanced CT obtained from PET/CT data was considered positive for adrenal malignant lesions based on a CT attenuation value a parts per thousand yen 10 HU; lesions with a value < 10 HU were considered adrenal benign lesions. Mann-Whitney's U test was used for statistical analyses. SUV(max) in adrenal malignant lesions (7.4 +/- A 3.5) was higher than that in adrenal benign lesions (2.1 +/- A 0.5, p < 0.05). The CT attenuation value of adrenal malignant lesions (27.6 +/- A 11.9 HU) was higher than that of adrenal benign lesions (10.1 +/- A 12.3 HU, p < 0.05). In differentiating between adrenal benign and malignant lesions, a CT threshold of 10 HU corresponded to a sensitivity of 57%, specificity of 94%, accuracy of 74%, positive predictive value of 92% and negative predictive value of 65%. An SUV(max) cut-off value of 2.5 corresponded to a sensitivity of 89%, specificity of 94%, accuracy of 91%, positive predictive value of 94% and negative predictive value of 88%. The T/L SUV(max) ratio was 1.0 +/- A 0.2 for adrenal benign lesions and 4.5 +/- A 3.0 for adrenal malignant lesions. And T/L SUV(max) ratio cut-off value of 1.8 corresponded to a sensitivity of 85%, specificity of 100%, accuracy of 91%, positive predictive value of 100% and negative predictive value of 83%. FDG-PET/CT with additional SUV(max) analysis improves the diagnostic accuracy of adrenal lesions in cancer patients.

    SPRINGER, 2009年06月, ANNALS OF NUCLEAR MEDICINE, 23 (4), 349 - 354, 英語

    研究論文(学術雑誌)

  • Masahiro Okada, Taro Shimono, Yoshihiro Komeya, Rina Ando, Yuki Kagawa, Takashi Katsube, Masatomo Kuwabara, Yukinobu Yagyu, Seishi Kumano, Izumi Imaoka, Norio Tsuchiya, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    To investigate whether integrated fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) can differentiate benign from adrenal malignant lesions on the basis of maximum standardized uptake value (SUV(max)), tumor/liver (T/L) SUV(max) ratio, and CT attenuation value (Hounsfield Units; HU) of unenhanced CT obtained from FDG-PET/CT data. We studied 30 patients with 35 adrenal lesions (16 adrenal benign lesions, size 16 +/- A 5 mm, in 15 patients; and 19 adrenal malignant lesions, 24 +/- A 12 mm, in 15 patients) who had confirmed primary malignancies (lung cancer in 23 patients, lymphoma in 2, esophageal cancer in 2, hypopharyngeal cancer in 1, prostate cancer in 1, and 1 patient in whom lesions were detected at cancer screening). All patients underwent PET/CT at 1 h post FDG injection. Diagnosis of adrenal malignant lesions was based on interval growth or reduction after chemotherapy. An adrenal mass that remained unchanged for over 1 year was the standard used to diagnose adrenal benign lesions. Values of FDG uptake and CT attenuation were measured by placing volumetric regions of interest over PET/CT images. Adrenal uptake of SUV(max) a parts per thousand yen 2.5 was considered to indicate a malignant lesion; SUV(max) < 2.5 was considered to indicate a benign lesion. In further analysis, 1.8 was employed as the threshold for the T/L SUV(max) ratio. Unenhanced CT obtained from PET/CT data was considered positive for adrenal malignant lesions based on a CT attenuation value a parts per thousand yen 10 HU; lesions with a value < 10 HU were considered adrenal benign lesions. Mann-Whitney's U test was used for statistical analyses. SUV(max) in adrenal malignant lesions (7.4 +/- A 3.5) was higher than that in adrenal benign lesions (2.1 +/- A 0.5, p < 0.05). The CT attenuation value of adrenal malignant lesions (27.6 +/- A 11.9 HU) was higher than that of adrenal benign lesions (10.1 +/- A 12.3 HU, p < 0.05). In differentiating between adrenal benign and malignant lesions, a CT threshold of 10 HU corresponded to a sensitivity of 57%, specificity of 94%, accuracy of 74%, positive predictive value of 92% and negative predictive value of 65%. An SUV(max) cut-off value of 2.5 corresponded to a sensitivity of 89%, specificity of 94%, accuracy of 91%, positive predictive value of 94% and negative predictive value of 88%. The T/L SUV(max) ratio was 1.0 +/- A 0.2 for adrenal benign lesions and 4.5 +/- A 3.0 for adrenal malignant lesions. And T/L SUV(max) ratio cut-off value of 1.8 corresponded to a sensitivity of 85%, specificity of 100%, accuracy of 91%, positive predictive value of 100% and negative predictive value of 83%. FDG-PET/CT with additional SUV(max) analysis improves the diagnostic accuracy of adrenal lesions in cancer patients.

    SPRINGER, 2009年06月, ANNALS OF NUCLEAR MEDICINE, 23 (4), 349 - 354, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tatsushige Iwamoto, Yoshihiro Takasugi, Kenji Hiramatsu, Yoshihisa Koga, Tatsuo Konishi, Kensuke Kozuka, Takamichi Murakami

    The incidence of a tracheal bronchus-that is, a congenitally abnormal bronchus originating from the trachea or main bronchi-is 0.1%-2%. Serious hypoxia and atelectasis can develop in such patients with intubation and one-lung ventilation. We experienced a remarkable decrease in peripheral oxygen saturation (Sp(O2)) and a rise in airway pressure during placement of a double-lumen endobronchial tube in a patient with patent ductus arteriosus and tracheal bronchus. Substitution of the double-lumen tube with a bronchial blocker tube provided secure isolation of the lung intraoperatively. A type I tracheal bronchus and segmental tracheal stenosis were identified on postoperative three-dimensional (3D) computed tomographic (CT) images. Preoperative examination of chest X-rays, CT images, and preoperative tracheal 3D images should preempt such complications and assist in securing safe and optimal one-lung ventilation.

    SPRINGER JAPAN KK, 2009年05月, JOURNAL OF ANESTHESIA, 23 (2), 260 - 265, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masatoshi Hori, Tonsok Kim, Takamichi Murakami, Izumi Imaoka, Hiromitsu Onishi, Kaname Tomoda, Tateki Tsutsui, Takayuki Enomoto, Tadashi Kimura, Hironobu Nakamura

    Purpose: To prospectively evaluate the efficacy of 3.0-T magnetic resonance (MR) imaging in the preoperative staging of cervical carcinoma compared with that at 1.5-T imaging, with surgery and pathologic analysis as the reference standards. Materials and Methods: Institutional review board approval and informed consent were obtained. Thirty-one consecutive patients (age range, 27-71 years; mean age, 51.1 years) underwent 3.0-and 1.5-T MR imaging. Quantitative and qualitative analyses were performed. Two radiologists independently evaluated images in terms of local-regional staging. MR findings were compared with surgicopathologic findings. Results: Mean tumor signal-to-noise ratios, mean cervical stroma signal-to-noise ratios, and mean tumor-to-cervical stroma contrast-to-noise ratios at 3.0-T imaging were significantly higher than those at 1.5-T imaging (P = 9.1 x 10(-6), P = 1.8 x 10(-6), and P = .008, respectively). Image homogeneity at 3.0-T imaging was significantly inferior to that at 1.5-T imaging (P = .005). There were no significant differences in terms of the degree of susceptibility artifacts. Interobserver agreement between the two radiologists for local-regional staging was good or excellent (kappa = 0.65-0.89). Sensitivity, specificity, and area under the receiver operating characteristic curve for radiologist 1 in the evaluation of parametrial invasion were (a) 75% for both 3.0-and 1.5-T imaging, (b) 70% for both 3.0-and 1.5-T imaging, and (c) 0.82 for 3.0-T imaging and 0.85 for 1.5-T imaging, respectively. Corresponding values for vaginal invasion were (a) 67% for both 3.0-and 1.5-T imaging, (b) 68% for 3.0-T imaging and 72% for 1.5-T imaging, and (c) 0.62 for 3.0-T imaging and 0.67 for 1.5-T imaging, respectively. Corresponding values for lymph node metastases were (a) 57% for both 3.0-and 1.5-T imaging, (b) 83% for 3.0-T imaging and 88% for 1.5-T imaging, and (c) 0.72 for 3.0-T imaging and 0.78 for 1.5-T imaging, respectively. Neither radiologist noted significant differences between values obtained with 3.0-T imaging and those obtained with 1.5-T imaging (P > .5 for all comparison pairs). Conclusion: In this study, 3.0-T MR imaging was characterized by high diagnostic accuracy in the presurgical evaluation of patients with cervical carcinoma, although 3.0-T imaging was not significantly superior to 1.5-T imaging. (c) RSNA, 2009

    RADIOLOGICAL SOC NORTH AMERICA, 2009年04月, RADIOLOGY, 251 (1), 96 - 104, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Taro Shimono, Makoto Hosono, Ryuichiro Ashikaga, Seishi Kumano, Izumi Imaoka, Yukinobu Yagyu, Masahiro Okada, Masatomo Kuwabara, Takamichi Murakami

    We have occasionally seen ring-shaped lateral ventricular nodules < 1 cm in diameter during routine brain magnetic resonance imaging (MRI). We investigated retrospectively clinical and MRI findings of the nodules. Review of radiological records was performed for 39,607 patients who underwent brain MRI between January 2001 and April 2008. Nodules were assessed for number, location, shape, and signal intensity, which was determined based on the range of signal intensity from gray to white matter on T1- and T2-weighted imaging. Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI), contrast enhancement characteristics, and serial MRI changes of nodules were assessed when available. Nine of 39,607 patients (0.023%) showed the nodules. No symptoms associated with the nodules. Among the nine patients, 11 nodules were identified (one nodule in seven patients (77.8%) and two nodules in two patients (22.2%)). Location was limited to the roof of the body for six nodules (54.5%) and the frontal horn for five patients (45.5%). All nodules (100%) were round and isointense on T1- and T2-weighted imaging. On FLAIR imaging of eight nodules, six (75%) were hyperintense, and two (25%) were isointense. On DWI of seven nodules, all nodules (100%) were isointense. None of seven nodules (0%) examined using postcontrast MRI showed enhancement. None of eight nodules (0%) examined using serial MRI (range, 4-60 months) showed changes in morphology over time. These nodules were incidentally encountered and shared similar MRI features. Although pathological confirmation was lacking in our cases, these nodules may be of nonaggressive nature.

    SPRINGER, 2009年03月, NEURORADIOLOGY, 51 (3), 145 - 150, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tonsok Kim, Takamichi Murakami, Masatoshi Hori, Hiromitsu Onishi, Kaname Tomoda, Hironobu Nakamura

    Purpose: To compare 3.0T and 1.5T MR systems in terms of the effect of superparamagnetic iron oxide (SPIO) on tumor-to-liver contrast in 12*-weighted gradient-echo MRI. Materials and Methods: SPIO-enhanced gradient-echo MR images of the liver with four different TEs (3, 5.3, 6.5, and 8.5 msec) were obtained by means of 1.5T and 3.0T systems. Quantitative analyses of relative signal intensities (SIs) and relative tumor contrast and qualitative analyses of image quality and lesion conspicuity of the liver were performed in 22 patients, 16 of whom had malignant liver tumors. Results: With both 1.5T and 3.0T, at TE = 8.4 msec, the relative SI of liver and relative tumor contrast were significantly (P < 0. 0 1) lower and higher, respectively. than that for any of the other TEs. There were no significant differences in the relative SI of the liver, relative tumor contrast, image quality, and tumor conspicuity for the same TE between the 1.5T and 3.0T systems. Conclusion: Our results showed that the effect of SPIO on tumor-to-liver contrast at T2*-weighted gradient-echo imaging was similar for the 1.5T and 3.0T systems, and that the 8.4-msec TE was optimal of the four TEs used in this study at 3.0T.

    JOHN WILEY & SONS INC, 2009年03月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 29 (3), 595 - 600, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 勝部 敬, 下野太郎, 村上卓道

    小脳萎縮を呈したNeuroacanthocytosisの兄弟例を報告した。

    AMER SOC NEURORADIOLOGY, 2009年02月, AJNR Am J Neuroradiol, 30 (2), 386 - 388, 英語

    研究論文(学術雑誌)

  • 非造影の3テスラMRIにおける肝悪性腫瘍の検出能 1.5テスラMRIとの比較

    大西 裕満, 金 東石, 堀 雅敏, 村上 卓道, 巽 光朗, 中矢 泰裕, 中本 篤, 坪山 尚寛, 友田 要, 中村 仁信

    (公社)日本医学放射線学会, 2009年02月, 日本医学放射線学会学術集会抄録集, 68回, S344 - S344, 日本語

    [査読有り]

  • Recovery Coefficient(RC)-SUV部分容積効果補正による肺癌リンパ節転移の評価

    米矢 吉宏, 細野 眞, 花岡 宏平, 宇佐美 公男, 高田 裕史, 坂口 健太, 岡田 真広, 土屋 典生, 香川 祐毅, 村上 卓道

    (公社)日本医学放射線学会, 2009年02月, 日本医学放射線学会学術集会抄録集, 68回, S318 - S318, 日本語

  • 大西裕満, 村上 卓道, 金東石

    Purpose: To prospectively investigate, by means of a pre-and postexamination questionnaire, the types and frequency of adverse reactions to ferucarbotran (Resovist), a superparamagnetic iron oxide (SPIO) contrast agent. Materials and Methods: This study was approved by the ethics committee of each of the institutions involved, and all patients gave written informed consent. One questionnaire asking about baseline symptoms before the injection of ferucarbotran, and one about adverse events over a period of seven days after injection were given to 315 patients who under-went ferucarbotran-enhanced magnetic resonance imaging (MRI) of the liver at several institutions. The data for baseline symptoms were used for reference to exclude false-positive adverse reactions and were also compared with the adverse event data to determine with McNemar's chi-squared test the incidence of each symptom. Results: Before MR examination, 249 clinical symptoms were reported by 102 of 315 patients (32.4%). After the injection of ferucarbotran, 169 adverse events were observed in 78 patients (24.8%). Eventually, 70 adverse events occurring in 45 patients (14.3%) were judged to be adverse reactions to ferucarbotran, defined as possibly or definitely ferucarbotran -related events. All reactions were of mild intensity. Conclusion: Ferucarbotran can be considered safe for clinical use in liver MRI.

    JOHN WILEY & SONS INC, 2009年01月, JOURNAL OF MAGNETIC RESONANCE IMAGING(in press)., 29 (1), 106 - 111, 英語

    研究論文(学術雑誌)

  • Hiromitsu Onishi, Takamichi Murakami, Tonsok Kim, Masatoshi Hori, Shinji Hirohashi, Mitsuru Matsuki, Yoshifumi Narumi, Yasuharu Imai, Kousuke Sakurai, Hironobu Nakamura

    Purpose: To prospectively investigate, by means of a pre-and postexamination questionnaire, the types and frequency of adverse reactions to ferucarbotran (Resovist), a superparamagnetic iron oxide (SPIO) contrast agent. Materials and Methods: This study was approved by the ethics committee of each of the institutions involved, and all patients gave written informed consent. One questionnaire asking about baseline symptoms before the injection of ferucarbotran, and one about adverse events over a period of seven days after injection were given to 315 patients who under-went ferucarbotran-enhanced magnetic resonance imaging (MRI) of the liver at several institutions. The data for baseline symptoms were used for reference to exclude false-positive adverse reactions and were also compared with the adverse event data to determine with McNemar's chi-squared test the incidence of each symptom. Results: Before MR examination, 249 clinical symptoms were reported by 102 of 315 patients (32.4%). After the injection of ferucarbotran, 169 adverse events were observed in 78 patients (24.8%). Eventually, 70 adverse events occurring in 45 patients (14.3%) were judged to be adverse reactions to ferucarbotran, defined as possibly or definitely ferucarbotran -related events. All reactions were of mild intensity. Conclusion: Ferucarbotran can be considered safe for clinical use in liver MRI.

    JOHN WILEY & SONS INC, 2009年01月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 29 (1), 106 - 111, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Takamichi Murakami, Seishi Kumano, Masatomo Kuwabara, Taro Shimono, Makoto Hosono, Hitoshi Shiozaki

    To assess whether integrated fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can improve the diagnostic accuracy of metastatic regional lymph nodes (LNs) in esophageal cancer compared with contrast enhanced CT (CECT). We examined 180 consecutive patients with esophageal cancer by integrated PET/CT between April 2006 and March 2007. Eighteen patients (M:F 14:4) underwent radical esophagectomy after evaluations by PET/CT and CECT of 5-7-mm-thick slices 70-80 s after injection. Regional LNs of esophageal cancer were retrospectively reviewed on CECT images by two blinded evaluators on the basis of the following cutoff sizes: 7 mm for all regional LNs (Protocol A), 10 mm for paratracheal LNs (Protocol B), and 7 mm for others. In addition, the maximum standardized uptake value (SUVmax) on PET/CT was evaluated for positive uptake by LNs. Of 210 LNs excised at surgery, 25 were positive and 185 were negative for metastasis at pathology. The PET/CT images identified 15 true-positive and 184 truenegative LNs, whereas CECT identified 15 true positives and 176 true negatives in Protocol A, and 14 true positives and 180 true negative in Protocol B. The sensitivity, specificity, accuracy, positive, and negative predictive values of PET/CT were respectively 60.0%, 99.5%, 94.8%, 93.8%, and 94.8%, whereas those of CECT were 60.0%, 95.1%, 91.0%, 62.5%, and 94.6% (Protocol A) and 56.0%, 97.3%, 92.4%, 73.7%, and 94.2% (Protocol B). A comparison of the two CECT protocols revealed fewer false-positive LNs in Protocol B, but slightly lower sensitivity in Protocol B than in Protocol A. Substantial numbers of false-positive LNs were determined by CECT in the paratracheal regions (6 of 9, 66.7%) and CECT revealed central necrosis in 4 of 15 (26.7%) true-positive LNs > 1.8 cm. The mean SUVmax on PET/CT was 2.9 (range 1.7-5.5) in true-positive LNs. The smallest LN metastasis detectable by PET/CT was 6 mm. Integrated PET/CT improves the PPV of regional LNs when compared with CECT.

    SPRINGER, 2009年01月, ANNALS OF NUCLEAR MEDICINE, 23 (1), 73 - 80, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 多段階発癌・早期肝細胞癌の画像診断と病理・病態-c.MRI・SPIP造影MRI-

    熊野正士, 村上卓道, 今井康陽

    2009年, 画像診断, 29 (6), 584 - 590

  • Gd-EOB-DTPAの登場による肝画像診断におけるMRIの役割と可能性

    岡田真広, 熊野正士, 香川祐毅, 勝部 敬, 今岡いずみ, 工藤正俊, 村上卓道, 今井康陽

    2009年, 日獨医報, 54, 80 - 93

  • RFA治療後の肝細胞癌再発症例

    村上卓道, 岡田真広, 中居卓也, 工藤正俊

    2009年, EOB-PrimovistR Enhanced MRI Practical Report EOB-PrimovistR Enhanced MRI Practical Report, 1, 1 - 4

  • 熊野正士, 柳生行伸, 村上卓道

    2009年, 肝胆膵画像, 11, 63 - 68

  • MRI T2強調像にて低信号を呈した卵巣粘液嚢胞腺癌の1例

    桑原雅知, 今岡いずみ, 村上卓道

    2009年, 画像診断アトラス, 14, 72 - 73

  • 村上卓道, 岡田真広, 熊野正士

    2009年, 肝胆膵画像, 11 (5), 539 - 551

  • 新しい早期肝細胞がんの診断法-Gd-EOB-DTPA造影MRI

    今井康陽, 岡田真広, 村上卓道

    2009年, 日本医師会雑誌, 138 (6), 1106

  • 肝癌の診断 肝臓perfusion CT.

    南 康範, 工藤 正俊, 村上 卓道

    2009年, 日本臨床, 67, 342 - 345

  • MDCTは肝癌の診断に有用か?

    熊野正士, 村上卓道

    中外医学社, 2009年, 現場の疑問に答える 肝臓病診療Q&A, 202 - 205

  • 肝臓:肝臓の画像診断

    岡田真広, 村上卓道, 沼田和司

    2009年, Annual Review 消化器

  • OOKP(歯根部利用人工角膜)手術後のCT像

    桑原 雅知, 下野 太郎, 勝部 敬, 藤谷 哲也, 松久保 祐子, 足利 竜一朗, 細野 眞, 村上 卓道, 福田 昌彦, 濱田 傑

    (公社)日本医学放射線学会, 2008年09月, 日本医学放射線学会秋季臨床大会抄録集, 44回, S500 - S500, 日本語

  • 米矢 吉宏, 細野 眞, 花岡 宏平, 宇佐美 公男, 高田 裕史, 坂口 健太, 岡田 真広, 土屋 典生, 香川 祐毅, 任 誠雲, 村上 卓道

    (一社)日本核医学会, 2008年09月, 核医学, 45 (3), S205 - S205, 日本語

  • Masatomo Kuwabara, Taro Shimono, Mami Toyomasu, Mitsuaki Shioyama, Yoshiyuki Mitsui, Eiji Yoshinaga, Akira Kawada, Makoto Hosono, Takamichi Murakami, Susumu Kusunoki

    Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation of cartilage in multiple sites of the body, including the auricles. Central nervous system involvement appears rare. We encountered a case of relapsing polychondritis with encephalitis that could be diagnosed by the unique appearance of the auricle with signal hyperintensity on diffusion-weighted magnetic resonance imaging.

    SPRINGER, 2008年08月, RADIATION MEDICINE, 26 (7), 438 - 441, 英語

    研究論文(学術雑誌)

  • 桑原 雅知, 下野 太郎, 村上 卓道

    Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation of cartilage in multiple sites of the body, including the auricles. Central nervous system involvement appears rare. We encountered a case of relapsing polychondritis with encephalitis that could be diagnosed by the unique appearance of the auricle with signal hyperintensity on diffusion-weighted magnetic resonance imaging.

    SPRINGER, 2008年08月, Radiat Med, 26 (7), 438 - 441, 英語

    研究論文(学術雑誌)

  • Masatomo Kuwabara, Taro Shimono, Mami Toyomasu, Mitsuaki Shioyama, Yoshiyuki Mitsui, Eiji Yoshinaga, Akira Kawada, Makoto Hosono, Takamichi Murakami, Susumu Kusunoki

    Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation of cartilage in multiple sites of the body, including the auricles. Central nervous system involvement appears rare. We encountered a case of relapsing polychondritis with encephalitis that could be diagnosed by the unique appearance of the auricle with signal hyperintensity on diffusion-weighted magnetic resonance imaging. © 2008 Japan Radiological Society.

    7, 2008年08月, Radiation Medicine - Medical Imaging and Radiation Oncology, 26 (7), 438 - 441, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Teruaki Yoh, Makoto Hosono, Yoshihiro Komeya, Sung-Woon Im, Ryuichiro Ashikaga, Taro Shimono, Norio Tsuchiya, Masahiro Okada, Kazushi Hanada, Yukinobu Yagyu, Yasumasa Nishimura, Takamichi Murakami

    Objective The objective of our study was to evaluate diagnostic ability and features of quantitative indices of three modalities: uptake rate on norcholesterol scintigraphy, computed tomography (CT) attenuation value, and fat suppression on chemical-shift magnetic resonance imaging (MRI) for characterizing adrenal adenomas. Methods Image findings of norcholesterol scintigraphy, CT, and MRI were reviewed for 78 patients with functioning (n = 48) or nonfunctioning (n = 30) adrenal masses. The norcholesterol uptake rate, attenuation value on unenhanced CT, and suppression on in-phase to opposed-phase MRI were measured for adrenal masses. Results The norcholesterol uptake rate, CT attenuation value, and MR suppression index showed the sensitivity of 60%, 82%, and 100%, respectively, for functioning adenomas of < 2.0 cm, and 96%, 79%, and 67%, respectively, for those of >= 2.0 cm. A statistically significant correlation was observed between size and norcholesterol uptake, and between CT attenuation value and MR suppression index. Regarding norcholesterol uptake, the adenoma-to-contralateral gland ratio was significantly higher in cortisol releasing than in aldosterone-releasing adenomas. Conclusions The norcholesterol uptake rate was reliable for characterization of adenomas among adrenal masses of >= 2.0 cm. CT attenuation value and MR suppression index were well correlated with each other, and were useful regardless of mass size.

    SPRINGER, 2008年07月, ANNALS OF NUCLEAR MEDICINE, 22 (6), 513 - 519, 英語

    研究論文(学術雑誌)

  • Teruaki Yoh, Makoto Hosono, Yoshihiro Komeya, Sung-Woon Im, Ryuichiro Ashikaga, Taro Shimono, Norio Tsuchiya, Masahiro Okada, Kazushi Hanada, Yukinobu Yagyu, Yasumasa Nishimura, Takamichi Murakami

    Objective The objective of our study was to evaluate diagnostic ability and features of quantitative indices of three modalities: uptake rate on norcholesterol scintigraphy, computed tomography (CT) attenuation value, and fat suppression on chemical-shift magnetic resonance imaging (MRI) for characterizing adrenal adenomas. Methods Image findings of norcholesterol scintigraphy, CT, and MRI were reviewed for 78 patients with functioning (n = 48) or nonfunctioning (n = 30) adrenal masses. The norcholesterol uptake rate, attenuation value on unenhanced CT, and suppression on in-phase to opposed-phase MRI were measured for adrenal masses. Results The norcholesterol uptake rate, CT attenuation value, and MR suppression index showed the sensitivity of 60%, 82%, and 100%, respectively, for functioning adenomas of < 2.0 cm, and 96%, 79%, and 67%, respectively, for those of >= 2.0 cm. A statistically significant correlation was observed between size and norcholesterol uptake, and between CT attenuation value and MR suppression index. Regarding norcholesterol uptake, the adenoma-to-contralateral gland ratio was significantly higher in cortisol releasing than in aldosterone-releasing adenomas. Conclusions The norcholesterol uptake rate was reliable for characterization of adenomas among adrenal masses of >= 2.0 cm. CT attenuation value and MR suppression index were well correlated with each other, and were useful regardless of mass size.

    SPRINGER, 2008年07月, ANNALS OF NUCLEAR MEDICINE, 22 (6), 513 - 519, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Takamichi Murakami, Seishi Kumano, Izumi Imaoka, Taro Shimono, Ryuichiro Ashikaga, Makoto Hosono

    OBJECTIVE. The purpose of our study was to evaluate whether simultaneous injection into cubital veins bilaterally at one half of the standard injection rate achieves similar hepatic and aortic enhancement on MDCT as the conventional injection rate into a single cubital vein. MATERIALS AND METHODS. Thirty-two patients underwent multiphase MDCT because they were suspected of having a hepatic tumor. Patients were assigned to one of the following two groups: group A, 100 mL of 370 mg I/mL of contrast medium injected into a unilateral cubital vein (one-route) via a 20-gauge cannula at a rate of 4 mL/s; or group B, 50 mL of contrast medium injected into the cubital veins bilaterally (two-route) via 24-gauge cannulas at 2 mL/s. Peak contrast enhancement of the liver and abdominal aorta for groups A and B was measured using regions of interest and compared; arrival time of the contrast media was also compared using a bolus-tracking system. Analysis was performed using Wilcoxon's signed rank test. RESULTS. Peak aortic enhancement of groups A and B was 367 +/- 67 H and 361 +/- 113 H (p = 0.61, not significant), respectively, and peak hepatic enhancement of groups A and B was 56 +/- 11 H and 56 +/- 16 H (p = 0.88, not significant), respectively. Mean arrival time to the aorta of group B (19.4 +/- 3.4 seconds) was significantly later compared with that of group A (15.5 +/- 3.5 seconds) (p = 0.005). CONCLUSION. The slower two-route injection produced the same aortic and hepatic enhancement as the faster one-route method with faster injection, but the arrival time of the contrast medium was later using the two-route method.

    AMER ROENTGEN RAY SOC, 2008年06月, AMERICAN JOURNAL OF ROENTGENOLOGY, 190 (6), W323 - W326, 英語

    研究論文(学術雑誌)

  • Takatoshi Kitada, Takamichi Murakami, Noriyoshi Kuzushita, Kaori Minamitani, Kazuya Nakajo, Keigo Osuga, Eiji Miyoshi, Hironobu Nakamura, Bunichiro Kishino, Shinji Tamura, Norio Hayashi

    Aim: Real-time virtual sonography (RVS) can synchronize B-mode ultrasound (US) images with multiplanar reconstruction (MPR)-computed tomography (CT) images on the same screen in real time. The purpose of this study was to evaluate the effectiveness of RVS for radiofrequency ablation therapy (RFA) of hepatocellular carcinomas (HCC) in which it was difficult to identify contours or margins by B-mode US. Methods: Sixty-three consecutive patients with a solitary HCC of less than 3.5 cm in diameter were enrolled in this study. Thirty-nine patients with HCC clearly detectable by B-mode US underwent conventional RFA, while the remaining 24 with obscure tumor lesions underwent RVS-guided RFA. A follow-up study of RFA treatment was performed every 3 months using enhanced CT imaging of the arterial and portal phase (at least 24 months). The accuracy of needle insertion was confirmed by measuring the gap between the needle insertion line and the center of the tumor from MPR-CT images. Results: The local recurrence rate of the RVS-guided RFA group was similar to that of the conventional RFA group (8.3% vs 7.7%), despite the difficulty of detecting tumor lesions in the former group. The mean gap between the needle insertion line and the center of the tumor was 1.6 mm (0-3.2 mm) in eight patients treated with RVS-guided RFA. Conclusion: RVS-guided RFA can be useful for treating HCC that are difficult to detect by B-mode US.

    WILEY-BLACKWELL, 2008年06月, HEPATOLOGY RESEARCH, 38 (6), 565 - 571, 英語

    研究論文(学術雑誌)

  • Takatoshi Kitada, Takamichi Murakami, Noriyoshi Kuzushita, Kaori Minamitani, Kazuya Nakajo, Keigo Osuga, Eiji Miyoshi, Hironobu Nakamura, Bunichiro Kishino, Shinji Tamura, Norio Hayashi

    Aim: Real-time virtual sonography (RVS) can synchronize B-mode ultrasound (US) images with multiplanar reconstruction (MPR)-computed tomography (CT) images on the same screen in real time. The purpose of this study was to evaluate the effectiveness of RVS for radiofrequency ablation therapy (RFA) of hepatocellular carcinomas (HCC) in which it was difficult to identify contours or margins by B-mode US. Methods: Sixty-three consecutive patients with a solitary HCC of less than 3.5 cm in diameter were enrolled in this study. Thirty-nine patients with HCC clearly detectable by B-mode US underwent conventional RFA, while the remaining 24 with obscure tumor lesions underwent RVS-guided RFA. A follow-up study of RFA treatment was performed every 3 months using enhanced CT imaging of the arterial and portal phase (at least 24 months). The accuracy of needle insertion was confirmed by measuring the gap between the needle insertion line and the center of the tumor from MPR-CT images. Results: The local recurrence rate of the RVS-guided RFA group was similar to that of the conventional RFA group (8.3% vs 7.7%), despite the difficulty of detecting tumor lesions in the former group. The mean gap between the needle insertion line and the center of the tumor was 1.6 mm (0-3.2 mm) in eight patients treated with RVS-guided RFA. Conclusion: RVS-guided RFA can be useful for treating HCC that are difficult to detect by B-mode US.

    WILEY-BLACKWELL, 2008年06月, HEPATOLOGY RESEARCH, 38 (6), 565 - 571, 英語

    研究論文(学術雑誌)

  • 無水エタノールによる腎動脈塞栓術が著効した低形成腎による腎性高血圧の1女児例

    田端信忠, 伊豆亜加音, 井上智弘, 岡田 満, 篠原 徹, 任 誠雲, 坪山尚寛, 栁生行伸, 村上卓道, 竹村 司

    腎低形成による腎性高血圧に対して、腎機能廃絶を目的とした無水エタノールによる腎動脈塞栓術を実施したが、開腹することなく低侵襲的であり、腎摘除術に比する効果が得られた。症例の適応条件を充分に考慮することで、腎摘除術に代わる治療法であると考えられた。

    2008年06月, 小児高血圧研究会誌, 5 (1)

  • Takatoshi Kitada, Takamichi Murakami, Noriyoshi Kuzushita, Kaori Minamitani, Kazuya Nakajo, Keigo Osuga, Eiji Miyoshi, Hironobu Nakamura, Bunichiro Kishino, Shinji Tamura, Norio Hayashi

    Aim: Real-time virtual sonography (RVS) can synchronize B-mode ultrasound (US) images with multiplanar reconstruction (MPR)-computed tomography (CT) images on the same screen in real time. The purpose of this study was to evaluate the effectiveness of RVS for radiofrequency ablation therapy (RFA) of hepatocellular carcinomas (HCC) in which it was difficult to identify contours or margins by B-mode US. Methods: Sixty-three consecutive patients with a solitary HCC of less than 3.5 cm in diameter were enrolled in this study. Thirty-nine patients with HCC clearly detectable by B-mode US underwent conventional RFA, while the remaining 24 with obscure tumor lesions underwent RVS-guided RFA. A follow-up study of RFA treatment was performed every 3 months using enhanced CT imaging of the arterial and portal phase (at least 24 months). The accuracy of needle insertion was confirmed by measuring the gap between the needle insertion line and the center of the tumor from MPR-CT images. Results: The local recurrence rate of the RVS-guided RFA group was similar to that of the conventional RFA group (8.3% vs 7.7%), despite the difficulty of detecting tumor lesions in the former group. The mean gap between the needle insertion line and the center of the tumor was 1.6 mm (0-3.2 mm) in eight patients treated with RVS-guided RFA. Conclusion: RVS-guided RFA can be useful for treating HCC that are difficult to detect by B-mode US.

    WILEY-BLACKWELL, 2008年06月, HEPATOLOGY RESEARCH, 38 (6), 565 - 571, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masahiro Okada, Takamichi Murakami, Seishi Kumano, Izumi Imaoka, Taro Shimono, Ryuichiro Ashikaga, Makoto Hosono

    OBJECTIVE. The purpose of our study was to evaluate whether simultaneous injection into cubital veins bilaterally at one half of the standard injection rate achieves similar hepatic and aortic enhancement on MDCT as the conventional injection rate into a single cubital vein. MATERIALS AND METHODS. Thirty-two patients underwent multiphase MDCT because they were suspected of having a hepatic tumor. Patients were assigned to one of the following two groups: group A, 100 mL of 370 mg I/mL of contrast medium injected into a unilateral cubital vein (one-route) via a 20-gauge cannula at a rate of 4 mL/s; or group B, 50 mL of contrast medium injected into the cubital veins bilaterally (two-route) via 24-gauge cannulas at 2 mL/s. Peak contrast enhancement of the liver and abdominal aorta for groups A and B was measured using regions of interest and compared; arrival time of the contrast media was also compared using a bolus-tracking system. Analysis was performed using Wilcoxon's signed rank test. RESULTS. Peak aortic enhancement of groups A and B was 367 +/- 67 H and 361 +/- 113 H (p = 0.61, not significant), respectively, and peak hepatic enhancement of groups A and B was 56 +/- 11 H and 56 +/- 16 H (p = 0.88, not significant), respectively. Mean arrival time to the aorta of group B (19.4 +/- 3.4 seconds) was significantly later compared with that of group A (15.5 +/- 3.5 seconds) (p = 0.005). CONCLUSION. The slower two-route injection produced the same aortic and hepatic enhancement as the faster one-route method with faster injection, but the arrival time of the contrast medium was later using the two-route method.

    AMER ROENTGEN RAY SOC, 2008年06月, AMERICAN JOURNAL OF ROENTGENOLOGY, 190 (6), W323 - W326, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 香川 祐毅, 細野 眞, 米矢 吉宏, 岡田 真広, 土屋 典生, 花岡 宏平, 宇佐美 公男, 高田 裕史, 坂口 健太, 葉 輝明, 任 誠雲, 柳生 行伸, 足利 竜一朗, 村上 卓道

    ファントム実験で得られた回復係数(RCs)を用い、部分容積効果の影響を受けやすいリンパ節のStandardized uptake values(SUV)補正を行うことで、肺癌および食道癌での縦隔リンパ節転移の診断能が向上するか検討した。肺癌においても食道癌においても、リンパ節転移の診断には、ROC解析でsizeよりもSUVmaxとcSUVmaxでの評価の方が大きなAzを示し、高い診断能を有した。SUVmaxとcSUVmaxの比較では、補正によりAzがやや低下し、小病変の低いSUVmaxが過大に補正されて診断能を損なった可能性があった。食道癌の転移陽性リンパ節は肺癌の転移陽性リンパ節に比してsizeが小さく、SUVmaxが低い傾向があり、腫瘍ごとにリンパ節転移のsize、SUVmaxについて指標を設定する必要が考えられた。

    産業開発機構(株), 2008年06月, 映像情報Medical, 40 (6), 618 - 619, 日本語

  • Koji Mikami, Takamichi Murakami, Atsuya Okada, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura

    Purpose. The aim of this study was to assess the feasibility and effectiveness of magnetic resonance ( MRI)-guided focused ultrasound ( MRIgFUS) ablation for uterine fibroids and to identify the candidates for this treatment. Materials and methods. A total of 48 patients with a symptomatic uterine fibroid underwent MRIgFUS. The percent ablation volume was calculated, and the patients' characteristics and the MR imaging features of the fibroids that might predict the effect of this treatment were assessed. Changes in the symptoms related to the uterine fibroid were assessed at 6 and 12 months. Results. The planned target zone were successfully treated in 32 patients with bulk-related and menstrual symptoms but unsuccessfully treated in the remaining 16 patients. These 16 patients were obese or their uterine fibroid showed heterogeneous high signal intensity on T2-weighted images. The 32 successfully treated patients were followed up for 6 months. At the 6-month follow-up, bulk-related and menstrual symptoms were diminished in 60% and 51% of patients, respectively. Among them, 17 patients were followed up for 12 months, and 9 of them who showed alleviation of bulk-related symptoms at 6 months had further improvement. The mean percent ablation volume of those nine patients was 51%. In 5 ( 33%) of the 15 patients with alleviation of menstrual symptoms at 6 months, the symptoms became worse at 12 months. There was a significant difference in the mean percent ablation volume between patients with alleviation of menstrual symptoms and those without ( 54% vs. 37%; P = 0.03). Conclusion. MRIgFUS ablation is a safe, effective treatment for nonobese patients with symptomatic fibroids that show low signal intensity on T2-weighted images. Ablation of more than 50% of the fibroid volume may be needed with a short-term follow-up.

    SPRINGER, 2008年05月, RADIATION MEDICINE, 26 (4), 198 - 205, 英語

    研究論文(学術雑誌)

  • 第7章 治療効果の評価と追加治療:CTによる治療効果評価:

    岡田 真広, 村上 卓道

    中山書店, 2008年05月, 大﨑住夫編 肝癌ラジオ波凝固療法の実践テクニック, 220 - 228

  • 第6章 RFAの新しい展開:HIFU臨床開発の現況

    村上 卓道

    中山書店, 2008年05月, 大﨑住夫編 肝癌ラジオ波凝固療法の実践テクニック, 203

  • Koji Mikami, Takamichi Murakami, Atsuya Okada, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura

    Purpose. The aim of this study was to assess the feasibility and effectiveness of magnetic resonance (MRI)-guided focused ultrasound (MRIgFUS) ablation for uterine fibroids and to identify the candidates for this treatment. Materials and methods. A total of 48 patients with a symptomatic uterine fibroid underwent MRIgFUS. The percent ablation volume was calculated, and the patients' characteristics and the MR imaging features of the fibroids that might predict the effect of this treatment were assessed. Changes in the symptoms related to the uterine fibroid were assessed at 6 and 12 months. Results. The planned target zone were successfully treated in 32 patients with bulk-related and menstrual symptoms but unsuccessfully treated in the remaining 16 patients. These 16 patients were obese or their uterine fibroid showed heterogeneous high signal intensity on T2-weighted images. The 32 successfully treated patients were followed up for 6 months. At the 6-month follow-up, bulk-related and menstrual symptoms were diminished in 60% and 51% of patients, respectively. Among them, 17 patients were followed up for 12 months, and 9 of them who showed alleviation of bulk-related symptoms at 6 months had further improvement. The mean percent ablation volume of those nine patients was 51%. In 5 (33%) of the 15 patients with alleviation of menstrual symptoms at 6 months, the symptoms became worse at 12 months. There was a significant difference in the mean percent ablation volume between patients with alleviation of menstrual symptoms and those without (54% vs. 37% P = 0.03). Conclusion. MRIgFUS ablation is a safe, effective treatment for nonobese patients with symptomatic fibroids that show low signal intensity on T2-weighted images. Ablation of more than 50% of the fibroid volume may be needed with a short-term follow-up. © 2008 Japan Radiological Society.

    4, 2008年05月, Radiation Medicine - Medical Imaging and Radiation Oncology, 26 (4), 198 - 205, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Hot Spot Tracking for Focused Ultrasound Surgery of Liver using Filtered Venography

    D. Kokuryo, E. Kumamoto, A. Okada, T. Murakami, S. Fujii, T. Kaihara, K. Kuroda

    2008年05月, Proc. 16th ISMRM Scientific Meeting and Exhibition, 1229 - 1229, 英語

    [査読有り]

    研究論文(国際会議プロシーディングス)

  • Taro Shimono, Takahiro Tsuboyama, Masatomo Kuwabara, Sung-woon Im, Yukinobu Yagyu, Izumi Imaoka, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    Purpose. Motion artifact is problematic in the diagnosis of Creutzfeldt-Jakob disease (CJD) because of dementia. The purpose was to compare the occurrence of this artifact between a diffusion-weighted (DW) magnetic resonance ( MR) imaging sequence and conventional sequences. Materials and methods. Ten MR examinations comprising T2- weighted, T1- weighted, DW, and fl uidattenuated inversion recovery imaging in seven CJD patients were retrospectively evaluated. The occurrence of motion artifacts on each sequence were assessed, and the examination was classifi ed into four groups as follows: group A, motion artifact not revealed on DW imaging but revealed on one or more other sequences; group B, revealed on DW imaging and one or more other sequences; group C, not revealed on any sequences; and group D, revealed on DW imaging but not on any other sequences. Results. The 10 MR examinations were classifi ed as eight group A ( 80%), one B ( 10%), one C ( 10%), and zero D ( 0%). Conclusion. Motion artifacts are likely to occur in any conventional imaging sequences in CJD, but the fastimaging ability of DW imaging can reduce this artifact. The combination of an absence of motion artifact on DW imaging and the presence on conventional sequences may be one of the frequent fi ndings of CJD.

    SPRINGER, 2008年04月, RADIATION MEDICINE, 26 (3), 151 - 155, 英語

    研究論文(学術雑誌)

  • Taro Shimono, Takahiro Tsuboyama, Masatomo Kuwabara, Sung-Woon Im, Yukinobu Yagyu, Izumi Imaoka, Ryuichiro Ashikaga, Makoto Hosono, Takamichi Murakami

    Purpose. Motion artifact is problematic in the diagnosis of Creutzfeldt-Jakob disease (CJD) because of dementia. The purpose was to compare the occurrence of this artifact between a diffusion-weighted (DW) magnetic resonance (MR) imaging sequence and conventional sequences. Materials and methods. Ten MR examinations comprising T2-weighted, T1-weighted, DW, and fluid-attenuated inversion recovery imaging in seven CJD patients were retrospectively evaluated. The occurrence of motion artifacts on each sequence were assessed, and the examination was classified into four groups as follows: group A, motion artifact not revealed on DW imaging but revealed on one or more other sequences group B, revealed on DW imaging and one or more other sequences group C, not revealed on any sequences and group D, revealed on DW imaging but not on any other sequences. Results. The 10 MR examinations were classified as eight group A (80%), one B (10%), one C (10%), and zero D (0%). Conclusion. Motion artifacts are likely to occur in any conventional imaging sequences in CJD, but the fast-imaging ability of DW imaging can reduce this artifact. The combination of an absence of motion artifact on DW imaging and the presence on conventional sequences may be one of the frequent findings of CJD. © 2008 Japan Radiological Society.

    3, 2008年04月, Radiation Medicine - Medical Imaging and Radiation Oncology, 26 (3), 151 - 155, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 大動脈解離後に発症した下腸間膜動脈領域の虚血性腸炎

    任 誠雲, 下野 太郎, 柳生 行伸, 清水 利栄, 葉 輝明, 坪山 尚寛, 桑原 雅知, 小塚 健倫, 今岡 いずみ, 足利 竜一朗, 村上 卓道, 米矢 吉宏, 土屋 典生, 岡田 真広, 細野 眞, 井上 剛裕, 梅原 泰, 土手 健作

    (公社)日本医学放射線学会, 2008年04月, Radiation Medicine, 26 (Suppl.I), 47 - 47, 日本語

  • 卵巣腫瘤との鑑別が困難であった限局性腹膜偽粘液腫の1例

    清水 利栄, 今岡 いずみ, 下野 太郎, 桑原 雅知, 小塚 健倫, 葉 輝明, 任 誠雲, 坪山 尚寛, 柳生 行伸, 熊野 正士, 足利 竜一朗, 村上 卓道, 米矢 吉宏, 土屋 典生, 岡田 真広, 細野 眞

    (公社)日本医学放射線学会, 2008年04月, Radiation Medicine, 26 (Suppl.I), 50 - 50, 日本語

  • Azzam A. Khankan, Takamichi Murakami, Hiromitsu Onishi, Masaki Matsushita, Riccardo Iannaccone, Yoshiko Aoki, Takeshi Tono, Tonsok Kim, Masatoshi Hori, Keigo Osuga, Roberto Passariello, Hironobu Nakamura

    Purpose: To determine the usefulness of nonenhanced T1-weighted spoiled gradient-recalled acquisition in the steady-state (SPGR) MRI in the early assessment of the efficacy of radio frequency (RF) therapy for hepatocellular carcinoma (HCC). Materials and Methods: A total of 23 patients with 28 HCC nodules treated with percutaneous RF ablation underwent nonenhanced MRI within two days after the RF procedure and contrast-enhanced computed tomography (CT) one week after. MR assessment of ablation efficacy according to the concentric zonal pattern on T1-weighted SPGR imaging was compared with the one-week CT and presence of local recurrence by means of follow-up study for 12 months or more. Results: In 18 of 28 ablated nodules, SPGR images revealed a central hyperintense zone covering the entire tumor, CT showed a nonenhanced area covering the entire tumor, and no local recurrence was demonstrated in the follow-up studies. In nine of 28 nodules, the central hyperintense zone did not cover the entire tumor; and local recurrence was demonstrated in three nodules. In the remaining one nodule, no signal change was seen in the treated area on SPGR images and CT showed the presence of residual viable tumor. Conclusion: Nonenhanced T1-weighted MRI was considered useful for early assessment of the efficacy of RF therapy for HCC.

    JOHN WILEY & SONS INC, 2008年03月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 27 (3), 546 - 551, 英語

    研究論文(学術雑誌)

  • Azzam A. Khankan, Takamichi Murakami, Hiromitsu Onishi, Masaki Matsushita, Riccardo Iannaccone, Yoshiko Aoki, Takeshi Tono, Tonsok Kim, Masatoshi Hori, Keigo Osuga, Roberto Passariello, Hironobu Nakamura

    Purpose: To determine the usefulness of nonenhanced T1-weighted spoiled gradient-recalled acquisition in the steady-state (SPGR) MRI in the early assessment of the efficacy of radio frequency (RF) therapy for hepatocellular carcinoma (HCC). Materials and Methods: A total of 23 patients with 28 HCC nodules treated with percutaneous RF ablation underwent nonenhanced MRI within two days after the RF procedure and contrast-enhanced computed tomography (CT) one week after. MR assessment of ablation efficacy according to the concentric zonal pattern on T1-weighted SPGR imaging was compared with the one-week CT and presence of local recurrence by means of follow-up study for 12 months or more. Results: In 18 of 28 ablated nodules, SPGR images revealed a central hyperintense zone covering the entire tumor, CT showed a nonenhanced area covering the entire tumor, and no local recurrence was demonstrated in the follow-up studies. In nine of 28 nodules, the central hyperintense zone did not cover the entire tumor; and local recurrence was demonstrated in three nodules. In the remaining one nodule, no signal change was seen in the treated area on SPGR images and CT showed the presence of residual viable tumor. Conclusion: Nonenhanced T1-weighted MRI was considered useful for early assessment of the efficacy of RF therapy for HCC.

    JOHN WILEY & SONS INC, 2008年03月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 27 (3), 546 - 551, 英語

    研究論文(学術雑誌)

  • Azzam A. Khankan, Takamichi Murakami, Hiromitsu Onishi, Masaki Matsushita, Riccardo Iannaccone, Yoshiko Aoki, Takeshi Tono, Tonsok Kim, Masatoshi Hori, Keigo Osuga, Roberto Passariello, Hironobu Nakamura

    Purpose: To determine the usefulness of nonenhanced T1-weighted spoiled gradient-recalled acquisition in the steady-state (SPGR) MRI in the early assessment of the efficacy of radio frequency (RF) therapy for hepatocellular carcinoma (HCC). Materials and Methods: A total of 23 patients with 28 HCC nodules treated with percutaneous RF ablation underwent nonenhanced MRI within two days after the RF procedure and contrast-enhanced computed tomography (CT) one week after. MR assessment of ablation efficacy according to the concentric zonal pattern on T1-weighted SPGR imaging was compared with the one-week CT and presence of local recurrence by means of follow-up study for 12 months or more. Results: In 18 of 28 ablated nodules, SPGR images revealed a central hyperintense zone covering the entire tumor, CT showed a nonenhanced area covering the entire tumor, and no local recurrence was demonstrated in the follow-up studies. In nine of 28 nodules, the central hyperintense zone did not cover the entire tumor; and local recurrence was demonstrated in three nodules. In the remaining one nodule, no signal change was seen in the treated area on SPGR images and CT showed the presence of residual viable tumor. Conclusion: Nonenhanced T1-weighted MRI was considered useful for early assessment of the efficacy of RF therapy for HCC.

    JOHN WILEY & SONS INC, 2008年03月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 27 (3), 546 - 551, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Yasuharu Imai, Takamichi Murakami, Masatoshi Hori, Kazuto Fukuda, Tonsok Kim, Taro Marukawa, Hisashi Abe, Masatomo Kuwabara, Hiromitu Onishi, Kyo Tsuda, Yoshiyuki Sawai, Masanori Kurokawa, Norio Hayashi, Morito Monden, Hironobu Nakamura

    Aim: Recently, many diagnostic modalities have been developed for the detection of hepatocellular carcinoma (HCC). Of these, a less invasive and more accurate diagnostic procedure is desirable. This study was undertaken to compare combined dynamic multidetector row helical computerized tomography (MDCT) and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) with combined CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) for the detection of hypervascular HCC. Methods: Forty-eight patients with 56 pathologically proved hypervascular HCCs (less than 5.0 cm in diameter) underwent dynamic MDCT and SPIO-enhanced MRI, as well as CTHA and CTAP. The images were reviewed by four independent and blinded readers on a tumor-by-tumor basis. Results: The mean areas under alternative-free response receiver operating characteristic curve (Az) for combined dynamic MDCT and SPIO-enhanced MRI (IV set) and combinedCTHA and CTAP (IA set) were comparable (0.948 and 0.969, respectively, P > 0.05), although the Az value of the IV set was significantly lower than that of the IA set in HCCs smaller than or equal to 1.5 cm (0.867 and 0.937, respectively, P = 0.033). The mean sensitivity and positive predictive value of the IV set were similar to those of the IA set. Conclusions: Combined dynamic MDCT and SPIO-enhanced MRI showed a diagnostic accuracy comparable to intra-arterial contrast-enhanced CT (CTHA and CTAP) for hypervascular HCC, and may be a useful diagnostic option prior to curative treatments of hypervascular HCC, although a limitation exists in detecting HCCs smaller than or equal to 1.5 cm.

    BLACKWELL PUBLISHING, 2008年02月, HEPATOLOGY RESEARCH, 38 (2), 147 - 158, 英語

    研究論文(学術雑誌)

  • Yasuharu Imai, Takamichi Murakami, Masatoshi Hori, Kazuto Fukuda, Tonsok Kim, Taro Marukawa, Hisashi Abe, Masatomo Kuwabara, Hiromitu Onishi, Kyo Tsuda, Yoshiyuki Sawai, Masanori Kurokawa, Norio Hayashi, Morito Monden, Hironobu Nakamura

    Aim: Recently, many diagnostic modalities have been developed for the detection of hepatocellular carcinoma (HCC). Of these, a less invasive and more accurate diagnostic procedure is desirable. This study was undertaken to compare combined dynamic multidetector row helical computerized tomography (MDCT) and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) with combined CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) for the detection of hypervascular HCC. Methods: Forty-eight patients with 56 pathologically proved hypervascular HCCs (less than 5.0 cm in diameter) underwent dynamic MDCT and SPIO-enhanced MRI, as well as CTHA and CTAP. The images were reviewed by four independent and blinded readers on a tumor-by-tumor basis. Results: The mean areas under alternative-free response receiver operating characteristic curve (Az) for combined dynamic MDCT and SPIO-enhanced MRI (IV set) and combinedCTHA and CTAP (IA set) were comparable (0.948 and 0.969, respectively, P > 0.05), although the Az value of the IV set was significantly lower than that of the IA set in HCCs smaller than or equal to 1.5 cm (0.867 and 0.937, respectively, P = 0.033). The mean sensitivity and positive predictive value of the IV set were similar to those of the IA set. Conclusions: Combined dynamic MDCT and SPIO-enhanced MRI showed a diagnostic accuracy comparable to intra-arterial contrast-enhanced CT (CTHA and CTAP) for hypervascular HCC, and may be a useful diagnostic option prior to curative treatments of hypervascular HCC, although a limitation exists in detecting HCCs smaller than or equal to 1.5 cm.

    BLACKWELL PUBLISHING, 2008年02月, HEPATOLOGY RESEARCH, 38 (2), 147 - 158, 英語

    研究論文(学術雑誌)

  • Yasuharu Imai, Takamichi Murakami, Masatoshi Hori, Kazuto Fukuda, Tonsok Kim, Taro Marukawa, Hisashi Abe, Masatomo Kuwabara, Hiromitu Onishi, Kyo Tsuda, Yoshiyuki Sawai, Masanori Kurokawa, Norio Hayashi, Morito Monden, Hironobu Nakamura

    Aim: Recently, many diagnostic modalities have been developed for the detection of hepatocellular carcinoma (HCC). Of these, a less invasive and more accurate diagnostic procedure is desirable. This study was undertaken to compare combined dynamic multidetector row helical computerized tomography (MDCT) and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) with combined CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) for the detection of hypervascular HCC. Methods: Forty-eight patients with 56 pathologically proved hypervascular HCCs (less than 5.0 cm in diameter) underwent dynamic MDCT and SPIO-enhanced MRI, as well as CTHA and CTAP. The images were reviewed by four independent and blinded readers on a tumor-by-tumor basis. Results: The mean areas under alternative-free response receiver operating characteristic curve (Az) for combined dynamic MDCT and SPIO-enhanced MRI (IV set) and combinedCTHA and CTAP (IA set) were comparable (0.948 and 0.969, respectively, P > 0.05), although the Az value of the IV set was significantly lower than that of the IA set in HCCs smaller than or equal to 1.5 cm (0.867 and 0.937, respectively, P = 0.033). The mean sensitivity and positive predictive value of the IV set were similar to those of the IA set. Conclusions: Combined dynamic MDCT and SPIO-enhanced MRI showed a diagnostic accuracy comparable to intra-arterial contrast-enhanced CT (CTHA and CTAP) for hypervascular HCC, and may be a useful diagnostic option prior to curative treatments of hypervascular HCC, although a limitation exists in detecting HCCs smaller than or equal to 1.5 cm.

    BLACKWELL PUBLISHING, 2008年02月, HEPATOLOGY RESEARCH, 38 (2), 147 - 158, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 原発性肺癌のリンパ節転移の評価におけるrecovery coefficient(RC) SUV補正の有用性

    米矢 吉宏, 細野 眞, 花岡 宏平, 宇佐見 公男, 高田 裕史, 坂口 健太, 岡田 真広, 土屋 典生, 香川 祐毅, 村上 卓道

    (公社)日本医学放射線学会, 2008年02月, 日本医学放射線学会学術集会抄録集, 67回, S376 - S376, 日本語

  • T2* fitting toolによる子宮筋層と子宮良性病変の評価

    今岡 いずみ, 坪山 尚寛, 柳生 行伸, 下野 太郎, 熊野 正士, 村上 卓道, 奥秋 知幸, 小山 望

    (公社)日本医学放射線学会, 2008年02月, 日本医学放射線学会学術集会抄録集, 67回, S213 - S213, 日本語

  • 転移性肝がんの診断【近畿大学医学部附属病院】

    岡田 真広, 熊野 正士, 畑中 絹世, 工藤 正俊, 村上 卓道

    2008年, INNEVISION INNEVISION, 23, 6 - 11

  • 腎癌摘出後14年目に生じた膵転移に対してPET-CTとDynamic CTを施行した1例 腎癌の遠隔転移におけるPET-CTの役割

    松久保祐子, 岡田 真広, 村上 卓道

    2008年, 核医学症例検討会症例集, 29, 15 - 16

  • 岡田 真広, 熊野 正士, 村上 卓道

    2008年, 肝胆膵画像, 10, 25 - 33

  • びまん性肝疾患・脾

    金 東石, 村上 卓道

    メディカルサイエンスインターナショナル, 2008年, 腹部のMRI, 5 - 44

  • 腎癌の遠隔転移におけるPET-CTの役割

    松久保祐子, 岡田 真広, 村上 卓道

    2008年, 核医学症例検討会症例集, 29, 15 - 16

  • 診断に苦慮した上衣腫の2例

    荒木哲朗, 下野 太郎, 村上 卓道

    2008年, 臨床放射線, 53, 1141 - 1145

  • 肝臓ダイナミックCTにおけるイオメプロール350mgl/mLの投与方法および投与量に関する検討(臨床第Ⅱ/Ⅲ相試験)-体重比用量群と固定用量群との多施設共同ランダム化比較試験-

    粟井和夫, 村上 卓道, 山下康行

    2008年, 臨床医薬, 24, 575 - 597

  • 転移性肝がんの診断

    岡田 真広, 熊野 正士, 村上 卓道

    2008年, Innervison Innervison, 23 (5), 6 - 11

  • Takahiro Tsuboyama, Izumi Imaoka, Taro Shimono, Takayuki Nakatsuka, Ryuichiro Ashikaga, Tomoyuki Okuaki, Nozomu Koyama, Takamichi Murakami

    Purpose: We evaluated the ability of the PRESTO (principles of echo shifting with a train of observations) technique to reveal small veins and microbleeds in the human brain. Materials and Methods: In an experimental study, we calculated contrast-to-noise ratio (CNR) between a cerebral parenchymal phantom and human venous blood using 3 sequences of 3-dimensional (3D)-PRESTO, 3D-gradient recalled echo (GRE), and 3D-GRE echo-planar imaging (EPI). Then, we examined 7 healthy volunteers and 5 patients with venous angiomas or traumatic brain injuries using the 3D-PRESTO technique. In volunteer studies, MR venographies were reconstructed from 10-mm, 15-mm, and 20-mm thickness data using the minimum-intensity-projection (MinIP) technique. Three radiologists identified deep brain venous anatomy and counted the visible left medullary veins. In clinical studies, we evaluated the lesion conspicuity of small venous diseases and microbleeds. Results: In the phantom study, 3D-PRESTO showed the highest CNR. In all volunteer studies, the deep brain venous anatomy was readily identified in the MinIP images at each thickness. The mean numbers of counted left medullary veins were 5.1 for 10 mm, 5.9 for 15 mm, and 6.7 for 20 mm in the MinIP images. The difference was significant between 10-mm and 20-mm MinIP images (P=0.02). In patient studies, abnormal small veins and microbleeds were clearly revealed. Conclusion: High-resolution MR venography using 3D-PRESTO technique can clearly depict small veins and microbleeds in the human brain.

    2, 2008年, Magnetic Resonance in Medical Sciences, 7 (2), 73 - 77, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Motoko Nishiura, Takeshi Johkoh, Shuji Yamamoto, Osamu Honda, Takenori Kozuka, Mitsuhiro Koyama, Noriyuki Tomiyama, Seiki Hamada, Takamichi Murakami, Takashi Matsumoto, Yoshifumi Narumi, Hironobu Nakamura

    Purpose. The aim of this study was to evaluate the decreasing of cardiac motion artifact and whether the extent of ground-glass attenuation of idiopathic pulmonary fibrosis (IPF) was accurately assessed by electrocardiography (ECG)-triggered high-resolution computed tomography (HRCT) by 0.5-s/rotation multidetector-row CT (MDCT). Materials and methods. ECG-triggered HRCT were scanned at the end-diastolic phase by a MDCT scanner with the following scan parameters axial four-slice mode, 0.5 mm collimation, 0.5-s/rotation, 120 kVp, 200 mA/rotation, high-frequency algorithm, and half reconstruction. In 42 patients with IPF, both conventional HRCT (ECG gating(-), full reconstruction) and ECG-triggered HRCT were performed at the same levels (10-mm intervals) with the above scan parameters. The correlation between percent diffusion of carbon monoxide of the lung (%DLCO) and the mean extent of ground-glass attenuation on both conventional HRCT and ECG-triggered HRCT was evaluated with the Spearman rank correlation coefficient test. Results. The correlation between %DLCO and the mean extent of ground-glass attenuation on ECG-triggered HRCT (observer A: r = -0.790, P < 0.0001 observer B: r = -0.710, P < 0.0001) was superior to that on conventional HRCT (observer A: r = -0.395, P < 0.05 observer B: r = -0.577, P = 0.002) for both observers. Conclusion. ECG-triggered HRCT by 0.5 s/rotation MDCT can reduce the cardiac motion artifact and is useful for evaluating the extent of ground-glass attenuation of IPF. © 2007 Japan Radiological Society.

    2007年12月, Radiation Medicine - Medical Imaging and Radiation Oncology, 25 (10), 523 - 528, 英語

    研究論文(学術雑誌)

  • Hirokazu Uyama, Hiroaki Nagano, Hideji Nakamura, Takamichi Murakami, Hironobu Nakamura, Morito Monden, Norio Hayashi

    Background: Patients with advanced hepatocellular carcinoma (HCC) need an effective treatment modality because of the poor prognosis of the disease. From an in vitro study, beta-interferon (IFN-beta) has been reported to enhance the antiproliferative effects of doxorubicin on HCC cell lines. In the present study, we investigated the therapeutic effects of combined IFN-beta and doxorubicin intra-arterial injection therapy on patients with advanced HCC. Methods: IFN-beta (3 MIU) and doxorubicin (10 mg/bodyweight) were given by one-shot intra-arterial injection through an arterial port to patients with advanced HCC. One treatment course consisted of three intra-arterial injections per week for 4 weeks. Three courses were conducted and evaluation was done monthly. Results: Eleven patients with advanced HCC were treated with combined IFN-beta and doxorubicin. One patient enteredcomplete remission (CR), seven patients were evaluated as having stable disease (SD) and three as having progressive disease (PD). The mean overall survival was 10 months. The mean survival for CR and SD patients was 15 months, and that for PD patients was 6 months (P = 0.0464, log-rank test). Decrease of serum total bilirubin was observed for all patients. Conclusion: Combined IFN-beta and doxorubicin intra-arterial therapy offers an effective chemotherapy option for patients with advanced HCC by improving liver function and having tolerable side-effects.

    BLACKWELL PUBLISHING, 2007年12月, HEPATOLOGY RESEARCH, 37 (12), 1018 - 1025, 英語

    研究論文(学術雑誌)

  • Hirokazu Uyama, Hiroaki Nagano, Hideji Nakamura, Takamichi Murakami, Hironobu Nakamura, Morito Monden, Norio Hayashi

    Background: Patients with advanced hepatocellular carcinoma (HCC) need an effective treatment modality because of the poor prognosis of the disease. From an in vitro study, beta-interferon (IFN-beta) has been reported to enhance the antiproliferative effects of doxorubicin on HCC cell lines. In the present study, we investigated the therapeutic effects of combined IFN-beta and doxorubicin intra-arterial injection therapy on patients with advanced HCC. Methods: IFN-beta (3 MIU) and doxorubicin (10 mg/bodyweight) were given by one-shot intra-arterial injection through an arterial port to patients with advanced HCC. One treatment course consisted of three intra-arterial injections per week for 4 weeks. Three courses were conducted and evaluation was done monthly. Results: Eleven patients with advanced HCC were treated with combined IFN-beta and doxorubicin. One patient enteredcomplete remission (CR), seven patients were evaluated as having stable disease (SD) and three as having progressive disease (PD). The mean overall survival was 10 months. The mean survival for CR and SD patients was 15 months, and that for PD patients was 6 months (P = 0.0464, log-rank test). Decrease of serum total bilirubin was observed for all patients. Conclusion: Combined IFN-beta and doxorubicin intra-arterial therapy offers an effective chemotherapy option for patients with advanced HCC by improving liver function and having tolerable side-effects.

    BLACKWELL PUBLISHING, 2007年12月, HEPATOLOGY RESEARCH, 37 (12), 1018 - 1025, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Motoko Nishiura, Takeshi Johkoh, Shuji Yamamoto, Osamu Honda, Takenori Kozuka, Mitsuhiro Koyama, Noriyuki Tomiyama, Seiki Hamada, Takamichi Murakami, Takashi Matsumoto, Yoshifumi Narumi, Hironobu Nakamura

    Purpose. The aim of this study was to evaluate the decreasing of cardiac motion artifact and whether the extent of ground-glass attenuation of idiopathic pulmonary fibrosis (IPF) was accurately assessed by electrocardiography (ECG)-triggered high-resolution computed tomography (HRCT) by 0.5-s/rotation multidetector-row CT (MDCT). Materials and methods. ECG-triggered HRCT were scanned at the end-diastolic phase by a MDCT scanner with the following scan parameters axial four-slice mode, 0.5 mm collimation, 0.5-s/rotation, 120 kVp, 200 mA/rotation, high-frequency algorithm, and half reconstruction. In 42 patients with IPF, both conventional HRCT (ECG gating(-), full reconstruction) and ECG-triggered HRCT were performed at the same levels (10-mm intervals) with the above scan parameters. The correlation between percent diffusion of carbon monoxide of the lung (%DLCO) and the mean extent of ground-glass attenuation on both conventional HRCT and ECG-triggered HRCT was evaluated with the Spearman rank correlation coefficient test. Results. The correlation between %DLCO and the mean extent of ground-glass attenuation on ECG-triggered HRCT (observer A: r = -0.790, P < 0.0001 observer B: r = -0.710, P < 0.0001) was superior to that on conventional HRCT (observer A: r = -0.395, P < 0.05 observer B: r = -0.577, P = 0.002) for both observers. Conclusion. ECG-triggered HRCT by 0.5 s/rotation MDCT can reduce the cardiac motion artifact and is useful for evaluating the extent of ground-glass attenuation of IPF. © 2007 Japan Radiological Society.

    10, 2007年12月, Radiation Medicine - Medical Imaging and Radiation Oncology, 25 (10), 523 - 528, 英語

    [査読有り]

    研究論文(学術雑誌)

  • recovery coefficient(RC)に基づくSUV補正を用いた肺癌リンパ節転移の評価

    米矢 吉宏, 細野 眞, 花岡 宏平, 宇佐見 公男, 高田 裕史, 坂口 健太, 任 誠雲, 土屋 典生, 岡田 真広, 葉 輝明, 村上 卓道

    (一社)日本核医学会, 2007年10月, 核医学, 44 (3), 287 - 287, 日本語

  • 腎血管性高血圧患者に対して腎動脈塞栓術が著効した1例

    任 誠雲, 柳生 行伸, 桑原 雅知, 坪山 尚寛, 下野 太郎, 清水 利栄, 小塚 健倫, 今岡 いずみ, 熊野 正士, 葉 輝明, 細野 眞, 土屋 典生, 岡田 真広, 米矢 吉宏, 村上 卓道, 竹村 司

    (一社)日本インターベンショナルラジオロジー学会, 2007年10月, IVR: Interventional Radiology, 22 (4), 495 - 495, 日本語

  • [Advancement of the imaging for hepatic malignancies].

    Kumano S, Okada M, Imaoka I, Shimono T, Hosono M, Murakami T

    9, 2007年09月, Gan to kagaku ryoho. Cancer & chemotherapy, 34, 1357 - 1360

    [査読有り]

  • Riccardo Iannaccone, Francesca Piacentini, Takamichi Murakami, Valerie Paradis, Jacques Belghiti, Masatoshi Hori, Tonsok Kim, Francois Durand, Kenichi Wakasa, Morito Monden, Hironobu Nakamura, Roberto Passariello, Valerie Vilgrain

    Purpose: To retrospectively evaluate the clinical, pathologic, and helical computed tomographic ( CT) and magnetic resonance ( MR) imaging findings of hepatocellular carcinoma ( HCC) in patients with nonalcoholic fatty liver disease ( NAFLD). Materials and Methods: Institutional review board approval was obtained for this study; the need for patient informed consent was waived. Clinical, pathologic, and imaging findings were retrospectively evaluated in 22 men ( mean age, 64.5 years) with HCC and NAFLD. Helical CT and MR images were reviewed for morphologic features such as tumor size, margins, necrosis, and degree of enhancement. Results: Obesity, diabetes, and hypertension were common findings and were observed in 12 ( 55%), 14 ( 64%), and 13 ( 59%) of the 22 patients, respectively. The serum alpha-fetoprotein level was elevated in eight patients ( 36%). All patients had pathologic evidence of NAFLD. HCC was well-differentiated in seven patients, moderately differentiated in 11, and poorly differentiated in four. Large tumors ( mean diameter, 8.4 cm) were depicted at CT and/or MR imaging in all patients. Twenty-one patients had a solitary or dominant mass. At imaging, tumor margins were well defined in 17 patients, with a smooth surface in 17, and there was evidence of a tumor capsule in 15. Necrosis was depicted in 16 patients. There was no evidence of calcifications, central scar, fat, or abdominal lymphadenopathy. CT was performed in 20 patients. HCC was hypoattenuating on unenhanced CT scans in 14 patients, heterogeneously hyperattenuating in the arterial phase in 20, and hypoattenuating in the portal phase in 14. MR imaging was performed in 16 patients. HCC was hyperintense compared with liver parenchyma at T2-weighted MR imaging in all 16 patients, hypointense at T1-weighted imaging in 14, heterogeneously hyperintense at arterial phase T1-weighted imaging in 16, and hypointense at portal phase T1-weighted imaging in 14. Conclusion: HCC in patients with NAFLD is more likely to manifest as a large solitary or dominant mass characterized by smooth and possibly encapsulated margins, necrosis, and hyper-vascularity. (c) RSNA, 2007.

    RADIOLOGICAL SOC NORTH AMERICA, 2007年05月, RADIOLOGY, 243 (2), 422 - 430, 英語

    研究論文(学術雑誌)

  • Riccardo Iannaccone, Francesca Piacentini, Takamichi Murakami, Valerie Paradis, Jacques Belghiti, Masatoshi Hori, Tonsok Kim, Francois Durand, Kenichi Wakasa, Morito Monden, Hironobu Nakamura, Roberto Passariello, Valerie Vilgrain

    Purpose: To retrospectively evaluate the clinical, pathologic, and helical computed tomographic ( CT) and magnetic resonance ( MR) imaging findings of hepatocellular carcinoma ( HCC) in patients with nonalcoholic fatty liver disease ( NAFLD). Materials and Methods: Institutional review board approval was obtained for this study; the need for patient informed consent was waived. Clinical, pathologic, and imaging findings were retrospectively evaluated in 22 men ( mean age, 64.5 years) with HCC and NAFLD. Helical CT and MR images were reviewed for morphologic features such as tumor size, margins, necrosis, and degree of enhancement. Results: Obesity, diabetes, and hypertension were common findings and were observed in 12 ( 55%), 14 ( 64%), and 13 ( 59%) of the 22 patients, respectively. The serum alpha-fetoprotein level was elevated in eight patients ( 36%). All patients had pathologic evidence of NAFLD. HCC was well-differentiated in seven patients, moderately differentiated in 11, and poorly differentiated in four. Large tumors ( mean diameter, 8.4 cm) were depicted at CT and/or MR imaging in all patients. Twenty-one patients had a solitary or dominant mass. At imaging, tumor margins were well defined in 17 patients, with a smooth surface in 17, and there was evidence of a tumor capsule in 15. Necrosis was depicted in 16 patients. There was no evidence of calcifications, central scar, fat, or abdominal lymphadenopathy. CT was performed in 20 patients. HCC was hypoattenuating on unenhanced CT scans in 14 patients, heterogeneously hyperattenuating in the arterial phase in 20, and hypoattenuating in the portal phase in 14. MR imaging was performed in 16 patients. HCC was hyperintense compared with liver parenchyma at T2-weighted MR imaging in all 16 patients, hypointense at T1-weighted imaging in 14, heterogeneously hyperintense at arterial phase T1-weighted imaging in 16, and hypointense at portal phase T1-weighted imaging in 14. Conclusion: HCC in patients with NAFLD is more likely to manifest as a large solitary or dominant mass characterized by smooth and possibly encapsulated margins, necrosis, and hyper-vascularity. (c) RSNA, 2007.

    RADIOLOGICAL SOC NORTH AMERICA, 2007年05月, RADIOLOGY, 243 (2), 422 - 430, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Daniele Marin, Riccardo Iannaccone, Andrea Laghi, Carlo Catalano, Takamichi Murakami, Masatoshi Hori, Tonsok Kim, Roberto Passariello

    Purpose: To intraindividually compare the enhancement pattern of focal nodular hyperplasia (FNH) after dynamic administration of two bolus-injectable liver-specific MR contrast agents, ferucarbotran and gadobenate dimeglumine. Materials and Methods: A total of 19 patients with 24 FNHs underwent gadobenate dimeglumine- and ferucarbotran-enhanced MRI during the hepatic arterial-dominant phase (HAP; 25 seconds), the portal-venous phase (PVP; 60 seconds), and the equilibrium phase (EP; 180 seconds). Hepatospecific phases were acquired on T1-weighted images 120 minutes after gadobenate dimeglumine administration, and on T2-weighted images 10 minutes after ferucarbotran administration. Lesion enhancement was independently analyzed by two observers. The kappa statistic was determined to evaluate the agreement between the enhancement patterns of the lesions. Results: On gadobenate dimeglumine- enhanced MR images during HAP, PVP, and EP, FNHs were: hyperintense (24/20/13); isointense (0/4/11); and hypointense (0/0/0). On ferucarbotran-enhanced MR images during HAP, PVP, and EP, FNHs were: hyperintense (2/0/0); isointense (16/9/14); and hypointense (6/15/10). Overall, poor agreement between both contrast agents was observed. During the hepatospecific phases, most (20/24; 83%) FNHs showed a typical enhancement pattern during the delayed hepatospecific phase. Conclusion: The dynamic enhancement pattern of FNHs is significantly different between gadobenate: dimeglumine- and ferucarbotran-enhanced MRI. With respect to hepatospecific phase, the majority of FNHs showed a typical behavior on both contrast agents.

    JOHN WILEY & SONS INC, 2007年04月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 25 (4), 775 - 782, 英語

    研究論文(学術雑誌)

  • 肝がんと闘う. 世界に冠たる日本の診療.

    工藤 正俊, 村上 卓道

    22: 1

    2007年04月, INNERVISION INNERVISION, 22 (4), 1 - 2

  • Kazuhiko Hashimoto, Takamichi Murakami, Keizo Dono, Masatoshi Hori, Tonsok Kim, Masayuki Kudo, Shigeru Marubashi, Atsushi Miyamoto, Yutaka Takeda, Hiroaki Nagano, Koji Umeshita, Hironobu Nakamura, Morito Monden

    The purpose of this study was to compare measurements of hepatic tissue blood flow (TBF) calculated by xenon and perfusion CT. Seven patients with normal liver and eight with chronic liver disease underwent both xenon and perfusion CT. During xenon CT examinations, serial abdominal CT scans were obtained every minute before and during 4 min of nonradioactive 25% (v/v) xenon gas inhalation and 5 min of administration of oxygen-rich air. Hepatic arterial and portal venous TBF were measured separately with a special imaging system using the Kety-Schmidt expression based on the Fick principle (AZ-7000W; Anzai Medical Co.). The hepatic arterial fraction (HAF) was calculated as follows: [hepatic arterial TBF/(hepatic arterial TBF + portal venous TBF)]. During perfusion CT examinations, total hepatic TBF and HAF were also calculated from the enhanced CT cine image data on a workstation using a commercially available software package based on a deconvolution algorithm (CT Perfusion 3 GE Healthcare, USA). Total hepatic TBF measured by xenon and perfusion CT was 82.9 +/- 15 and 82.8 +/- 18 ml/min/100 g, respectively. The measured values by the two techniques showed a significant correlation (R-2 = 0.657, P < 0.05). HAF measured by xenon and perfusion CT was 26.6 +/- 11 and 21.8 +/- 13%, respectively. The measured values by the two techniques also showed a significant correlation (R-2 = 0.869, P < 0.05). We conclude that there was a good correlation between hepatic TBF quantified by xenon CT and perfusion CT.

    SPRINGER, 2007年04月, DIGESTIVE DISEASES AND SCIENCES, 52 (4), 943 - 949, 英語

    研究論文(学術雑誌)

  • Natsuko Tsuda, Masahiro Okada, Takamichi Murakami

    RATIONALE AND OBJECTIVES: To investigate the potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for the differential diagnosis of nonalcoholic steatohepatitis (NASH) and fatty liver (FL). METHODS: Twenty-one male rats were divided into 3 groups. Seven rats in the NASH group were fed a choline-deficient diet for 10 weeks, and the 7 rats in the FL group were fed a standard diet also containing 1% (wt/wt) orotic acid for 4 weeks. As a control, 7 rats were fed a standard diet. After the feeding period, all rats were subjected to contrast-enhanced dynamic and delayed MRI with a 2D-FLASH technique. Gd-DTPA (0.1 mmol Gd/kg) and Gd-EOB-DTPA (0.025 mmol Gd/kg) were injected into the tail vein at 24-hour intervals. Signal intensities of the liver were measured for each MR image and the relative enhancement (RE) was calculated. In addition, the time of maximum RE (Tmax) and the half-life of RE (T1/2) in liver were compared. After MRI, the liver was histologically analyzed to evaluate steatosis, hepatitis, and fibrosis. RESULTS: Diffuse macrovesicular steatosis and severe fibrosis were observed in the NASH group, whereas diffuse microvesicular steatosis and rare fibrosis were observed in the FL group. Immediately after the Gd-DTPA injection, the RE in the liver of each group temporarily increased, and thereafter, rapid RE reduction was observed. However, a continuous increase and subsequent slow reduction of RE were induced after the Gd-EOB-DTPA injection. Although there was no difference between the Tmax and T1/2 of each group after the Gd-DTPA injection, Tmax and T1/2 of the NASH group were significantly prolonged in comparison with FL and control groups after the Gd-EOB-DTPA injection (P < 0.01). CONCLUSIONS: It was possible to differentiate NASH and FL by evaluating the SI time course on Gd-EOB-DTPA enhanced MRI. © 2007 Lippincott Williams & Wilkins, Inc.

    2007年04月, Investigative Radiology, 42 (4), 242 - 247, 英語

    研究論文(学術雑誌)

  • Kazuhiko Hashimoto, Takamichi Murakami, Keizo Dono, Masatoshi Hori, Tonsok Kim, Masayuki Kudo, Shigeru Marubashi, Atsushi Miyamoto, Yutaka Takeda, Hiroaki Nagano, Koji Umeshita, Hironobu Nakamura, Morito Monden

    The purpose of this study was to compare measurements of hepatic tissue blood flow (TBF) calculated by xenon and perfusion CT. Seven patients with normal liver and eight with chronic liver disease underwent both xenon and perfusion CT. During xenon CT examinations, serial abdominal CT scans were obtained every minute before and during 4 min of nonradioactive 25% (v/v) xenon gas inhalation and 5 min of administration of oxygen-rich air. Hepatic arterial and portal venous TBF were measured separately with a special imaging system using the Kety-Schmidt expression based on the Fick principle (AZ-7000W; Anzai Medical Co.). The hepatic arterial fraction (HAF) was calculated as follows: [hepatic arterial TBF/(hepatic arterial TBF + portal venous TBF)]. During perfusion CT examinations, total hepatic TBF and HAF were also calculated from the enhanced CT cine image data on a workstation using a commercially available software package based on a deconvolution algorithm (CT Perfusion 3 GE Healthcare, USA). Total hepatic TBF measured by xenon and perfusion CT was 82.9 +/- 15 and 82.8 +/- 18 ml/min/100 g, respectively. The measured values by the two techniques showed a significant correlation (R-2 = 0.657, P < 0.05). HAF measured by xenon and perfusion CT was 26.6 +/- 11 and 21.8 +/- 13%, respectively. The measured values by the two techniques also showed a significant correlation (R-2 = 0.869, P < 0.05). We conclude that there was a good correlation between hepatic TBF quantified by xenon CT and perfusion CT.

    SPRINGER, 2007年04月, DIGESTIVE DISEASES AND SCIENCES, 52 (4), 943 - 949, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Daniele Marin, Riccardo Iannaccone, Andrea Laghi, Carlo Catalano, Takamichi Murakami, Masatoshi Hori, Tonsok Kim, Roberto Passariello

    Purpose: To intraindividually compare the enhancement pattern of focal nodular hyperplasia (FNH) after dynamic administration of two bolus-injectable liver-specific MR contrast agents, ferucarbotran and gadobenate dimeglumine. Materials and Methods: A total of 19 patients with 24 FNHs underwent gadobenate dimeglumine- and ferucarbotran-enhanced MRI during the hepatic arterial-dominant phase (HAP; 25 seconds), the portal-venous phase (PVP; 60 seconds), and the equilibrium phase (EP; 180 seconds). Hepatospecific phases were acquired on T1-weighted images 120 minutes after gadobenate dimeglumine administration, and on T2-weighted images 10 minutes after ferucarbotran administration. Lesion enhancement was independently analyzed by two observers. The kappa statistic was determined to evaluate the agreement between the enhancement patterns of the lesions. Results: On gadobenate dimeglumine- enhanced MR images during HAP, PVP, and EP, FNHs were: hyperintense (24/20/13); isointense (0/4/11); and hypointense (0/0/0). On ferucarbotran-enhanced MR images during HAP, PVP, and EP, FNHs were: hyperintense (2/0/0); isointense (16/9/14); and hypointense (6/15/10). Overall, poor agreement between both contrast agents was observed. During the hepatospecific phases, most (20/24; 83%) FNHs showed a typical enhancement pattern during the delayed hepatospecific phase. Conclusion: The dynamic enhancement pattern of FNHs is significantly different between gadobenate: dimeglumine- and ferucarbotran-enhanced MRI. With respect to hepatospecific phase, the majority of FNHs showed a typical behavior on both contrast agents.

    JOHN WILEY & SONS INC, 2007年04月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 25 (4), 775 - 782, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Natsuko Tsuda, Masahiro Okada, Takamichi Murakami

    Rationale and Objectives: To investigate the potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for the differential diagnosis of nonalcoholic steatohepatitis (NASH) and fatty liver (FL). Methods: Twenty-one male rats were divided into 3 groups. Seven rats in the NASH group were fed a choline-deficient diet for 10 weeks, and the 7 rats in the FL group were fed a standard diet also containing 1% (wt/wt) orotic acid for 4 weeks. As a control, 7 rats were fed a standard diet. After the feeding period, all rats were subjected to contrast-enhanced dynamic and delayed MRI with a 2D-FLASH technique. Gd-DTPA (0.1 mmol Gd/kg) and Gd-EOB-DTPA (0.025 mmol Gd/kg) were injected into the tail vein at 24-hour intervals. Signal intensities of the liver were measured for each MR image and the relative enhancement (RE) was calculated. In addition, the time of maximum RE (T-max) and the half-life of RE (T-1/2) in liver were compared. After MRI, the liver was histologically analyzed to evaluate steatosis, hepatitis, and fibrosis. Results: Diffuse macrovesicular steatosis and severe fibrosis were observed in the NASH group, whereas diffuse microvesicular steatosis and rare fibrosis were observed in the FL group. Immediately after the Gd-DTPA injection, the RE in the liver of each group temporarily increased, and thereafter, rapid RE reduction was observed. However, a continuous increase and subsequent slow reduction of RE were induced after the Gd-EOB-DTPA injection. Although there was no difference between the T-max and T-1/2 of each group after the Gd-DTPA injection, T-max and T-1/2 of the NASH group were significantly prolonged in comparison with FL and control groups after the Gd-EOB-DTPA injection (P < 0.01). Conclusions: It was possible to differentiate NASH and FL by evaluating the SI time course on Gd-EOB-DTPA enhanced MRI.

    LIPPINCOTT WILLIAMS & WILKINS, 2007年04月, INVESTIGATIVE RADIOLOGY, 42 (4), 242 - 247, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 肝門部胆管癌術後に生じた門脈狭窄に対して門脈ステント留置を行った1例

    児玉 彩, 柳生 行伸, 桑原 雅知, 任 誠雲, 米矢 吉宏, 土屋 典生, 岡田 真広, 坪山 尚寛, 葉 輝明, 清水 利栄, 小塚 健倫, 今岡 いずみ, 下野 太郎, 足利 竜一朗, 細野 眞, 村上 卓道

    (一社)日本インターベンショナルラジオロジー学会, 2007年04月, IVR: Interventional Radiology, 22 (2), 266 - 266, 日本語

  • S. Takahashi, M. Takamura, S. Yamamoto, M. Kudo, Y. Narumi, T. Murakami, H. Nakamura

    Purpose: To determine the effects of detector configuration, as well as vessel orientation, on the depiction accuracy of arterial stenosis using four-channel multidetector-row helical computed tomography (MDCT) angiography in vitro. Material and Methods: Five acrylic vessel phantoms (3 mm in diameter with 25 or 50% stenosis, or 5 mm with 25, 50, or 75% stenosis) were scanned with a four-channel MDCT scanner at five vessel orientations (0, 30, 45, 60, and 90 to the z-axis) using 4 x 1.25, 2.5, 3.75, and 5.0-mm detector configurations at beam pitches of 0.75 and 1.5. The percentage of stenosis was calculated by the ratio of the full width at half maximum for stenotic and non-stenotic portions of the phantom, and compared to the actual known values. Results: A detector configuration of 4 x 1.25 mm provided good reproducibility, as well as high accuracy for assessing vessel stenosis, while a 4 x 2.5-mm or wider detector configuration caused underestimations of stenosis. Although the phantoms perpendicular to the z-axis were underestimated, the errors were kept in clinically acceptable ranges using the 4 x 1.25-mm detector configuration. Conclusion: Four-channel MDCT accurately discerns stenosis for vessel phantoms of 3 or 5 mm in diameter at any orientation when using a detector configuration of 4 x 1.25 mm.

    TAYLOR & FRANCIS LTD, 2007年03月, ACTA RADIOLOGICA, 48 (2), 173 - 179, 英語

    研究論文(学術雑誌)

  • クロイツフェルト・ヤコブ病(CJD)のMRI診断において詳細な読影をする前に可能性を想起できるか?

    下野 太郎, 坪山 尚寛, 桑原 雅知, 任 誠雲, 柳生 行伸, 今岡 いずみ, 小塚 健倫, 足利 竜一朗, 細野 眞, 村上 卓道

    (公社)日本医学放射線学会, 2007年02月, 日本医学放射線学会学術集会抄録集, 66回, S306 - S307, 日本語

  • Seishi Kumano, Takaharu Tsuda, Hiroaki Tanaka, Masaaki Hirata, Tonsok Kim, Takamichi Murakami, Eiji Sugihara, Hisashi Abe, Hirotaka Yamashita, Nobuaki Kobayashi, Teruhito Mochizuki

    PURPOSE: The purpose of this study was to evaluate the efficacy of 3-dimensional computed tomographic angiography (3D CTA) using 16-channel multidetector-row helical computed tomography (MDCT) in the preoperative visualization of laparoscopic gastrectomy for early gastric cancer. MATERIALS AND METHODS: Twenty consecutive patients with early gastric cancer who underwent computed tomographic (CT) examination using 16-channel MDCT (0.625 mm x 16) before surgery were included in this study. At a rate of 4 mL/s, 2 mL/kg of 300 mg I/mL contrast material was intravenously injected. Timing for arterial phase scanning was determined by using a test bolus injection. Portal phase imaging was performed 70 seconds after the start of bolus injection. By using volume rendering and maximum intensity projection techniques, 3D CT angiograms of perigastric vessels were reconstructed from CT images of 0.625-mm thickness on computer workstations. RESULTS: In all cases, the left gastric artery (LGA) and the right gastric artery were correctly identified on 3D CTA, and the left gastric vein was also depicted on 3D CTA in all cases. In 2 cases, the aberrant left hepatic artery from LGA was correctly identified on 3D CTA. In 1 case, the accessory LGA from the left hepatic artery was correctly identified on 3D CTA. The variations of the veins included the left gastric vein flowing into the portal vein in 10 cases: the splenic vein in 9 and the junction of the portal and splenic veins in 1. CONCLUSIONS: A 3D CTA reconstructed from 16-channel MDCT images clearly revealed perigastric vascular anatomy in all cases, which is important for laparoscopic gastrectomy. Three-dimensional CTA is useful for the preoperative visualization of laparoscopic gastrectomy. © 2007 Lippincott Williams & Wilkins, Inc.

    2007年01月, Journal of Computer Assisted Tomography, 31 (1), 93 - 97, 英語

    研究論文(学術雑誌)

  • Seishi Kumano, Takaharu Tsuda, Hiroaki Tanaka, Masaaki Hirata, Tonsok Kim, Takamichi Murakami, Eiji Sugihara, Hisashi Abe, Hirotaka Yamashita, Nobuaki Kobayashi, Teruhito Mochizuki

    Purpose: The purpose of this study was to evaluate the efficacy of 3-dimensional computed tomographic angiography (3D CTA) using 16-channel multidetector-row helical computed tomography (MDCT) in the preoperative visualization of laparoscopic gastrectomy for early gastric cancer. Materials and Methods: Twenty consecutive patients with early gastric cancer who underwent computed tomographic (CT) examination using 16-channel MDCT (0.625 mm x 16) before surgery were included in this study. At a rate of 4 mL/s, 2 mL/kg of 300 mg I/mL contrast material was intravenously injected. Timing for arterial phase scanning was determined by using a test bolus injection. Portal phase imaging was performed 70 seconds after the start of bolus injection. By using volume rendering and maximum intensity projection techniques, 31) CT angiograms of perigastric vessels were reconstructed from CT images of 0.625-mm thickness on computer workstations. Results: In all cases, the left gastric artery (LGA) and the right gastric artery were correctly identified on 3D CTA, and the left gastric vein was also depicted on 3D CTA in all cases. In 2 cases, the aberrant left hepatic artery from LGA was correctly identified on 3D CTA. In I case, the accessory LGA from the left hepatic artery was correctly identified on 3D CTA. The variations of the veins included the left gastric vein flowing into the portal vein in 10 cases: the splenic vein in 9 and the junction of the portal and splenic veins in 1. Conclusions: A 3D CTA reconstructed from 16-channel MDCT images clearly revealed perigastric vascular anatomy in all cases, which is important for laparoscopic gastrectomy. Three-dimensional CTA is useful for the preoperative visualization of laparoscopic gastrectomy.

    LIPPINCOTT WILLIAMS & WILKINS, 2007年01月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 31 (1), 93 - 97, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Katsuyuki Nakanishi, Midori Kobayashi, Kazunori Nakaguchi, Miyaji Kyakuno, Nobuyuki Hashimoto, Hiromitsu Onishi, Noboru Maeda, Saki Nakata, Masatomo Kuwabara, Takamichi Murakami, Hironobu Nakamura

    Purpose: We assessed the diagnostic value of whole body magnetic resonance (MR) imaging (WB-MRI) using diFfusion-weighted images (DWI) for detecting bone metastasis and compared it with that of skeletal scintigraphy (SS). Materials and Methods: Thirty patients with malignancies (breast cancer, 17 patients prostate cancer, 9 and one patient each, thyroid cancer, liposarcoma, leiomyosarcoma, and extraskeletal Ewing sarcoma) underwent both WB-MRI and SS to detect bone metastasis. All patients were followed more than 6 months by MR imaging, SS, or computed tomographic (CT) examination. For WB-MRI, patients were placed in feet rest supine position with table-top extender and quadrature body coil. We acquired DWI (axial plane from lower neck to proximal femur) (single shot short TI inversion-recovery [STIR]: repetition time [TR] 6243/echo time [TE] 59/inversion time [TI] 180 ms b value: 600 s/mm2 5-mm slice thickness 112×112 matrix), T1-weighted fast spin echo (T1WI), and STIR (sagittal plane of total spine images and coronal plane of whole body images) images. Four blinded readers independently and separately interpreted images of combined MR sequences of Twister (session 1) and T1WI+STIR+DWI (session 2). Results: In 10 of 30 patients, we detected a total of 52 metastatic bone lesions in the other 20, follow-up examinations conformed no metastatic bone lesions. For these 52 lesions, for session 2, the mean sensitivity was 96z and the positive predictive value (PPV) was 98z. Those values were superior to those of session 1 (sensitivity: 88z PPV: 95z) and those of SS (sensitivity: 96z PPV: 94z). Conclusion: WB-MRI that included DWI was useful for detecting bone metastasis.

    2007年, Magnetic Resonance in Medical Sciences, 6 (3), 147 - 155, 英語

    研究論文(学術雑誌)

  • MR撮像法の臨床応用脂肪抑制法の原理

    中塚 隆之, 西松 和彦, 村上 卓道

    2007年, 日独医報, 52, 371 - 388

  • TAGEにおける抗癌剤:併用する抗癌剤よその効果

    前田 登, 村上 卓道, 大須賀慶悟

    2007年, 肝胆膵, 55 (5), 805 - 812

  • 卵巣腫瘍と鑑別が困難であった限局性腹膜偽粘液腫の一例

    清水利栄, 今岡 いずみ, 下野 太郎, 葉輝明, 任 誠雲, 坪山尚寛, 足利 竜一朗, 村上 卓道

    2007年, 臨床放射線, 52, 700 - 703

  • Katsuyuki Nakanishi, Midori Kobayashi, Kazunori Nakaguchi, Miyaji Kyakuno, Nobuyuki Hashimoto, Hiromitsu Onishi, Noboru Maeda, Saki Nakata, Masatomo Kuwabara, Takamichi Murakami, Hironobu Nakamura

    Purpose: We assessed the diagnostic value of whole body magnetic resonance (MR) imaging (WB-MRI) using diFfusion-weighted images (DWI) for detecting bone metastasis and compared it with that of skeletal scintigraphy (SS). Materials and Methods: Thirty patients with malignancies (breast cancer, 17 patients prostate cancer, 9 and one patient each, thyroid cancer, liposarcoma, leiomyosarcoma, and extraskeletal Ewing sarcoma) underwent both WB-MRI and SS to detect bone metastasis. All patients were followed more than 6 months by MR imaging, SS, or computed tomographic (CT) examination. For WB-MRI, patients were placed in feet rest supine position with table-top extender and quadrature body coil. We acquired DWI (axial plane from lower neck to proximal femur) (single shot short TI inversion-recovery [STIR]: repetition time [TR] 6243/echo time [TE] 59/inversion time [TI] 180 ms b value: 600 s/mm2 5-mm slice thickness 112×112 matrix), T1-weighted fast spin echo (T1WI), and STIR (sagittal plane of total spine images and coronal plane of whole body images) images. Four blinded readers independently and separately interpreted images of combined MR sequences of Twister (session 1) and T1WI+STIR+DWI (session 2). Results: In 10 of 30 patients, we detected a total of 52 metastatic bone lesions in the other 20, follow-up examinations conformed no metastatic bone lesions. For these 52 lesions, for session 2, the mean sensitivity was 96z and the positive predictive value (PPV) was 98z. Those values were superior to those of session 1 (sensitivity: 88z PPV: 95z) and those of SS (sensitivity: 96z PPV: 94z). Conclusion: WB-MRI that included DWI was useful for detecting bone metastasis.

    3, 2007年, Magnetic Resonance in Medical Sciences, 6 (3), 147 - 155, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tonsok Kim, Takamichi Murakami, Satoru Takahashi, Masatoshi Hori, Shirou Takahara, Naotsugu Ichimaru, Akihiko Okuyama, Yoshifumi Narumi, Hironobu Nakamura

    Purpose. The purpose of this study was to clarify and compare the accuracy of contrast-enhanced computed tomography (CT) angiography using multidetector-row helical CT (MDCT angiography) and gadolinium-enhanced MR angiography using three-dimensional Fourier transformation gradient-echo sequence (3D MR angiography) for preoperative evaluation of renal arteries in living renal donors. Materials and methods. A total of 42 living renal donor candidates underwent both MDCT angiography and 3D MR angiography before digital subtraction angiography (DSA). Each MDCT angiogram and 3D MR angiogram was prospectively interpreted, and the findings were compared with the DSA results. Results. MDCT angiography identified all of the 12 supernumerary arteries detected by DSA, whereas 3D MR angiography identified only 8. MDCT angiography identified all of the 19 proximal arterial branches detected by DSA, whereas 3D MR angiography identified only 16. Conclusion. A more accurate depiction of renal arteries in living renal donors can be achieved with MDCT angiography than with 3D MR angiography. © Japan Radiological Society 2006.

    2006年11月, Radiation Medicine - Medical Imaging and Radiation Oncology, 24 (9), 617 - 624, 英語

    研究論文(学術雑誌)

  • Taishi Hata, Masataka Ikeda, Shoji Nakamori, Rei Suzuki, Tonsok Kim, Masayoshi Yasui, Ichiro Takemasa, Masakazu Ikenaga, Hirofumi Yamamoto, Masayuki Ohue, Takamichi Murakami, Mitsugu Sekimoto, Masato Sakon, Morito Monden

    The aim of the study was to evaluate the usefulness of serial lung perfusion scintigraphy prospectively using single-photon emission computed tomographic image (SPECT) in screening for pulmonary embolism (PE) after elective surgery for gastrointestinal malignancy. PE was examined pre- and postoperatively with SPECT. Diagnosis of PE was based on segmental perfusion defect visualization in at least two of three planes on a SPECT image compared with preoperative SPECT images. Final diagnosis was determined by detection of embolus with multidetector helical CT (MDCT). No perioperative anticoagulant was used. Thirty-four patients were enrolled. One patient was excluded because of thrombophilia. In preoperative scans, nonsegmental defects were detected in 11 and a segmental defect in 1 patient, who was then diagnosed as PE preoperatively. Among 21 patients with normal preoperative SPECT, 2 had nonsegmental and 5 had segmental defects postoperatively. Among 11 patients with nonsegmental preoperative SPECT, 7 had nonsegmental and 4 had segmental defects postoperatively. Postoperative segmental defects were differentiated by their shape only and there was no need to compare pre- and postoperative SPECT. MDCT confirmed four patients with PE among nine with segmental defects postoperatively. Our results of screening for PE by visualization at least two planes of SPECT images suggest that postoperative SPECT scan is suitable for the diagnosis of postoperative PE.

    SPRINGER, 2006年11月, DIGESTIVE DISEASES AND SCIENCES, 51 (11), 2073 - 2080, 英語

    研究論文(学術雑誌)

  • Taishi Hata, Masataka Ikeda, Shoji Nakamori, Rei Suzuki, Tonsok Kim, Masayoshi Yasui, Ichiro Takemasa, Masakazu Ikenaga, Hirofumi Yamamoto, Masayuki Ohue, Takamichi Murakami, Mitsugu Sekimoto, Masato Sakon, Morito Monden

    The aim of the study was to evaluate the usefulness of serial lung perfusion scintigraphy prospectively using single-photon emission computed tomographic image (SPECT) in screening for pulmonary embolism (PE) after elective surgery for gastrointestinal malignancy. PE was examined pre- and postoperatively with SPECT. Diagnosis of PE was based on segmental perfusion defect visualization in at least two of three planes on a SPECT image compared with preoperative SPECT images. Final diagnosis was determined by detection of embolus with multidetector helical CT (MDCT). No perioperative anticoagulant was used. Thirty-four patients were enrolled. One patient was excluded because of thrombophilia. In preoperative scans, nonsegmental defects were detected in 11 and a segmental defect in 1 patient, who was then diagnosed as PE preoperatively. Among 21 patients with normal preoperative SPECT, 2 had nonsegmental and 5 had segmental defects postoperatively. Among 11 patients with nonsegmental preoperative SPECT, 7 had nonsegmental and 4 had segmental defects postoperatively. Postoperative segmental defects were differentiated by their shape only and there was no need to compare pre- and postoperative SPECT. MDCT confirmed four patients with PE among nine with segmental defects postoperatively. Our results of screening for PE by visualization at least two planes of SPECT images suggest that postoperative SPECT scan is suitable for the diagnosis of postoperative PE.

    SPRINGER, 2006年11月, DIGESTIVE DISEASES AND SCIENCES, 51 (11), 2073 - 2080, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Tonsok Kim, Takamichi Murakami, Satoru Takahashi, Masatoshi Hori, Shirou Takahara, Naotsugu Ichimaru, Akihiko Okuyama, Yoshifumi Narumi, Hironobu Nakamura

    Purpose. The purpose of this study was to clarify and compare the accuracy of contrast-enhanced computed tomography (CT) angiography using multidetector-row helical CT (MDCT angiography) and gadolinium-enhanced MR angiography using three-dimensional Fourier transformation gradient-echo sequence (3D MR angiography) for preoperative evaluation of renal arteries in living renal donors. Materials and methods. A total of 42 living renal donor candidates underwent both MDCT angiography and 3D MR angiography before digital subtraction angiography (DSA). Each MDCT angiogram and 3D MR angiogram was prospectively interpreted, and the findings were compared with the DSA results. Results. MDCT angiography identified all of the 12 supernumerary arteries detected by DSA, whereas 3D MR angiography identified only 8. MDCT angiography identified all of the 19 proximal arterial branches detected by DSA, whereas 3D MR angiography identified only 16. Conclusion. A more accurate depiction of renal arteries in living renal donors can be achieved with MDCT angiography than with 3D MR angiography. © Japan Radiological Society 2006.

    9, 2006年11月, Radiation Medicine - Medical Imaging and Radiation Oncology, 24 (9), 617 - 624, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Carlos Valls, Ricardo Iannacconne, Esther Alba, Takamichi Murakami, Masatoshi Hori, Roberto Passariello, Valerie Vilgrain

    The purpose of this article is to provide an update on imaging techniques useful for detection and characterization of fat in the liver. Imaging findings of liver steatosis, both diffuse steatosis and focal fatty change, as well as focal fatty sparing, are presented. In addition, we will review computed tomography (CT) and magnetic resonance (MR) findings of focal liver lesions with fatty metamorphosis, including hepatocellular carcinoma, hepatocellular adenoma, focal nodular hyperplasia, angiomyolipoma, lipoma, and metastases.

    SPRINGER, 2006年10月, EUROPEAN RADIOLOGY, 16 (10), 2292 - 2308, 英語

    研究論文(学術雑誌)

  • Carlos Valls, Ricardo Iannacconne, Esther Alba, Takamichi Murakami, Masatoshi Hori, Roberto Passariello, Valerie Vilgrain

    The purpose of this article is to provide an update on imaging techniques useful for detection and characterization of fat in the liver. Imaging findings of liver steatosis, both diffuse steatosis and focal fatty change, as well as focal fatty sparing, are presented. In addition, we will review computed tomography (CT) and magnetic resonance (MR) findings of focal liver lesions with fatty metamorphosis, including hepatocellular carcinoma, hepatocellular adenoma, focal nodular hyperplasia, angiomyolipoma, lipoma, and metastases.

    SPRINGER, 2006年10月, EUROPEAN RADIOLOGY, 16 (10), 2292 - 2308, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Assessment of the severity of liver disease and fibrotic change: The usefulness of hepatic CT perfusion imaging

    Kazuhiko Hashimoto, Takamichi Murakami, Keizo Dono, Masatoshi Hori, Tonsok Kim, Masayuki Kudo, Shigeru Marubashi, Atsushi Miyamoto, Yutaka Takeda, Hiroaki Nagano, Koji Umeshita, Hironobu Nakamura, Morito Monden

    This study assessed the utility of CT perfusion for quantitative assessment of liver function and fibrosis. Tissue blood flow (TBF), tissue blood volume (TBV), mean transit time (MTT) and hepatic arterial fraction (HAF) were measured with CT perfusion using the deconvolution algorithm in 38 patients with chronic liver diseases and 10 patients without liver disease. Using Child-Pugh classification, 21 patients were classified as Child A, 10 as Child B, and 7 as Child C. In 20 patients, the degree of fibrosis was quantitated in surgically-resected specimens and compared with the perfusion parameters. The mean TBF, TBV, MTT and HAF of patients without liver disease were 103.9 +/- 18 ml/min/100 g, 12.5 +/- 2.0 ml/100 g, 11.1 +/- 1.6 sec and 18.4 +/- 5.6%, respectively (+/- SD). The mean TBF of patients with Child A, B and C were 95.1 +/- 24, 86.7 +/- 29 and 75.5 +/- 6.5 ml/min/100 g, respectively. TBF tended to decrease with the severity of chronic liver disease. The mean HAF of patients with Child A, B and C were 18.6 +/- 8.3, 29.8 +/- 11.2 and 40.2 +/- 11.1%, respectively. HAF of patients without liver disease was significantly different from those of Child B and C (p < 0.05, each). However, there were no significant differences in TBV and MTT between each groups. HAF correlated significantly with the degree of fibrosis (R-2-0.588, p < 0.05). Our results showed that parameters of CT perfusion correlated significantly with the severity of liver fibrosis and cirrhosis. Quantitative measurement of hepatic tissue blood flow by CT perfusion is useful for evaluation of the severity of disease and fibrotic change.

    PROFESSOR D A SPANDIDOS, 2006年10月, ONCOLOGY REPORTS, 16 (4), 677 - 683, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Real-time Virtual Sonography(RVS)ガイド下ラジオ波焼灼療法(RFA)の有用性についての検討

    北田 学利, 村上 卓道, 葛下 典由, 松田 高明, 南谷 かおり, 中条 和也, 大須賀 慶吾, 三善 英知, 中村 仁信, 岸野 文一郎, 田村 信司, 林 紀夫

    (一社)日本肝臓学会, 2006年09月, 肝臓, 47 (Suppl.2), A455 - A455, 日本語

  • Assessment of the severity of liver disease and fibrotic change: The usefulness of hepatic CT perfusion imaging.

    橋本和彦, 村上 卓道

    2006年08月, Oncology Reports, 16, 677 - 683

  • Automated segmentation of liver from 3D CT images

    Amir H. Foruzan, Reza A. Zoroofi, Yoshinobu Sato, Masatoshi Hori, Takamichi Murakami, Hironobu Nakamura, Shinichi Tamura

    Liver automatic segmentation is very valuable for corresponding quantitative evaluations Automatic segmentation of liver using CT images is difficult due to similar intensity with respect to its surrounding tissues, poor in-plane and inter-plane resolutions, and partial volume effect. In this research, we propose a hybrid approach as follows. We generate color CT images using a heuristic transfer function followed by estimating the liver regions of the color images by a wavelet based texture based approach. We then calculate the cross correlation of the histogram of the liver with a small windows within each slice and finalize the liver mask by employing a level set algorithm. The proposed algorithm is not sensitive to the shape, size and gray scales of the liver. The success of the techniques in the presence of the available randomly selected data set is around 90%.

    SPRINGER HEIDELBERG, 2006年06月, INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY, 1, 71 - 73, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Keigo Osuga, Koji Mikami, Hiroki Higashihara, Noboru Maeda, Takahiro Tsuboyama, Masatomo Kuwabara, Hiromitsu Onishi, Masatoshi Hori, Tonsok Kim, Kaname Tomoda, Takamichi Murakami, Hironobu Nakamura

    Transcatheter embolotherapy (TCE), a common procedure for interventional radiologists, comprises transcatheter delivery of embolic agents into target vessels in order to eliminate lesions or lesion-associated symptoms. Good knowledge of delivery catheters and embolic agents is essential to optimize embolization techniques and to obtain the desired therapeutic outcomes. In this review, we describe the principles and techniques of TCE for peripheral arterial and venous lesions featuring visceral aneurysms, peripheral and pulmonary arteriovenous malformations (AVMs), and varicoceles. © 2006 Japan Radiological Society.

    4, 2006年05月, Radiation Medicine - Medical Imaging and Radiation Oncology, 24 (4), 309 - 314, 英語

    [査読有り]

  • N Tanigawa, A Komemushi, S Kariya, H Kojima, Y Shomura, K Ikeda, N Omura, T Murakami, S Sawada

    Purpose: To prospectively investigate the relationship between initial clinical response and bone marrow edema pattern on preprocedural magnetic resonance (MR) images in vertebral bodies selected For percutaneous vertebroplasty (PVP). Materials and Institutional review board approval and written informed Methods: consent were obtained. PVP was performed for osteoporotic compression fractures in 80 consecutive patients (mean age. 72.4 years: range. 44-85 years : 67 women and 14 men: 157 vertebrae). Patients were divided into three groups according to the proportion of the vertebra in which the bone marrow edema pattern was observed on sagittal MR images: group 1.50% or more of the vertebra; group 2, less than 50%; group 3. no edema pattern observed. By using Wilcoxon rank sum test, Fisher exact test.. and Wilcoxon signed rank test. groups were examined for differences in treatment efficacy, which was defined as the difference between preprocedural and postprocedural pain as assessed by means Of visual analog scale (VAS) score at 1-3 days after PVP. Results: Forty-four patients were assigned to group 1, 14 to group 2, and 22 to group 3. No significant difference was seen between the groups with respect to age. sex. number of treated vertebrae, or preprocedural VAS score. In group 1, VAS score decreased from 7.5 before the procedure to 2.9 after (improvement of 4.6). In group 2. the score decreased front 6.8 to 3.1 (improvement. or 3.7). fit group 3, the score decreased from 7.0 to 4.3 (improvement of 2.7). Improvement was significantly greater in group than in group 3 (P <.005). Conclusion: PVP resulted in significantly greater clinical improvement in patients with an extensive bone marrow edema pattern than it) those without this pattern. (c) RSNA, 2006.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年04月, RADIOLOGY, 239 (1), 195 - 200, 英語

    研究論文(学術雑誌)

  • H Onishi, T Murakami, T Kim, M Hori, R Iannaccone, M Kuwabara, H Abe, S Nakata, K Osuga, K Tomoda, R Passariello, H Nakamura

    Purpose: To retrospectively compare the accuracy in detection of hepatic metastases among contrast material-enhanced multi-detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging. Material and Methods: The ethics committee did not require its approval or informed consent for this retrospective study, which was compliant with Declaration of Helsinki principles. Data in 38 patients (22 men, 16 women; mean age, 64.5 years: range, 35-78 years) suspected of having hepatic metastases who underwent both contrast-enhanced CT and SPIO-enhanced MR imaging were retrospectively analyzed. Twenty-one of the 38 patients had 61 metastases. Seventeen of the 61 metastases were confirmed histologically; the remaining 44 metastases were defined with imaging follow-up. At MR imaging, SPIO-enhanced heavily T1-weighted images, T2*-weighted gradient echo images, and T2-weighted fast spin-echo images were evaluated. Contrast-enhanced multi-detector row CT images obtained in the portal phase were evaluated. Four blinded observers independently reviewed CT images, MR images. Diagnostic accuracy was evaluated by using the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values were also analyzed with the Fisher protected least significant difference test and generalized estimating equations. Results: The mean area under the AFROC curve for the combined approach (0.70) was significantly higher than that for SPIO-enhanced MR imaging alone (0.58. P < .05, Fisher protected least significant difference test), and there was no significant difference between each of them and that for contrast-enhanced CT alone (0.66). For all lesions, the mean sensitivity of combined imaging (0.59) was significantly higher than that of CT (0.48) or MR imaging (0.43) alone (P < .05, Fisher protected least significant difference test and generalized estimating equations). For all lesions, the mean positive predictive values were 0.82, 0.89, and 0.81, for combined MR and CT, CT alone, and MR alone, respectively. Conclusion: The addition of SPIO-enhanced MR imaging to contrast-enhanced multi-detector row CT (ie, combined analysis of SPIO-enhanced MR images and contrast-enhanced CT images) can improve sensitivity in the detection of hepatic metastases, although this improvement in sensitivity was not significant at AFROC analysis. (c) RSNA 2006.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年04月, RADIOLOGY, 239 (1), 131 - 138, 英語

    研究論文(学術雑誌)

  • Masatomo Kuwabara, Yoshifumi Narumi, Satoru Takahashi, Yoshinobu Sato, Tonsok Kim, Takamichi Murakami, Hironobu Nakamura

    Purpose. The aim of this study was to evaluate the correlation between the renal artery cross-sectional area measured by multidetector computed tomography (MDCT) and the nephrogram area calculated by renal arteriography in potential living renal donors with duplicated renal arteries. Materials and methods. Medical records of 18 patients with duplicated renal arteries who underwent both MDCT angiography and renal arteriography between 2001 and 2003 were retrospectively reviewed. All 20 kidneys were evaluated. Renal artery cross-sectional areas were measured using the workstation to which the CT data were transferred the nephrogram areas on the digitized angiographic images were calculated using public domain software. Bland-Altman analysis was performed to compare the cross-sectional area ratio of the accessory arteries to the main renal arteries, with the ratios obtained from the nephrogram areas calculated from the arteriograms. Results. The mean cross-sectional areas of the accessory and main renal arteries were 6.78 and 20.9 mm2, respectively. The ratio of the nephrogram areas calculated from the arteriograms ranged from 0.094 to 0.809. Bland-Altman analysis showed no significant difference. Conclusion. It is possible to predict the supply volume of accessory renal arteries by measuring the cross-sectional area of the accessory and main renal arteries in potential living renal donors. © 2006 Japan Radiological Society.

    2006年04月, Radiation Medicine - Medical Imaging and Radiation Oncology, 24 (3), 195 - 201, 英語

    研究論文(学術雑誌)

  • M Hori, T Murakami, T Kim, R Iannaccone, H Abe, H Onishi, K Tomoda, C Catalano, R Passariello, H Nakamura

    Purpose: To investigate the role of ferucarbotran-enhanced. dynamic MR imaging using multishot spin-echo echo-planar sequence in the evaluation of hemodynamics of focal hepatic lesions. Materials and Methods: Sixty-three focal hepatic lesions (24 benign and 39 malignant) from 53 consecutive patients who underwent both ferucarbotran-enhanced MR imaging and dynamic computed tomography (CT) were included fit this study. MR imaging was performed with a 1.5-T scanner with a phased-array coil. T2-weighted multishot spin-echo echo-planar sequences (TR/TE = 1714-2813/80 msec) were obtained during a single breathhold before and 15, 60, 120, 180, and 600 seconds after intravenous injection of ferucarbotran. The enhancement patterns of lesions were classified into three categories by a study coordinator on the basis of dynamic CT images as hypervascular, hypovascular. and hemangioma type. The study coordinator created mean contrast-to-noise ratio of lesions vs. time curves for each enhancement pattern for quantitative analyses. Moreover, three radiologists separately and blindly reviewed MR images. and then assigned three confidence scores for the three enhancement patterns to each lesion. Sensitivity. specificity, and receiver operating characteristic analyses were performed. Results: Quantitative analyses showed characteristic enhancement Curves for each enhancement pattern. Mean sensitivities/specificities were 0.816/0.882, 0.897/0.863, and 0.800/0.989 for hypervascular, hypovascular, and hemangioma types, respectively. Mean areas under the receiver operating characteristic curve were 0.886 for hypervascular type and 0.913 for hypovascular type. Conclusion: Ferucarbotran-enhanced dynamic MR imaging can be used to successfully characterize the hemodynamics of focal hepatic lesions.

    JOHN WILEY & SONS INC, 2006年04月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 23 (4), 509 - 519, 英語

    研究論文(学術雑誌)

  • H Onishi, T Murakami, T Kim, M Hori, R Iannaccone, M Kuwabara, H Abe, S Nakata, K Osuga, K Tomoda, R Passariello, H Nakamura

    Purpose: To retrospectively compare the accuracy in detection of hepatic metastases among contrast material-enhanced multi-detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging. Material and Methods: The ethics committee did not require its approval or informed consent for this retrospective study, which was compliant with Declaration of Helsinki principles. Data in 38 patients (22 men, 16 women; mean age, 64.5 years: range, 35-78 years) suspected of having hepatic metastases who underwent both contrast-enhanced CT and SPIO-enhanced MR imaging were retrospectively analyzed. Twenty-one of the 38 patients had 61 metastases. Seventeen of the 61 metastases were confirmed histologically; the remaining 44 metastases were defined with imaging follow-up. At MR imaging, SPIO-enhanced heavily T1-weighted images, T2*-weighted gradient echo images, and T2-weighted fast spin-echo images were evaluated. Contrast-enhanced multi-detector row CT images obtained in the portal phase were evaluated. Four blinded observers independently reviewed CT images, MR images. Diagnostic accuracy was evaluated by using the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values were also analyzed with the Fisher protected least significant difference test and generalized estimating equations. Results: The mean area under the AFROC curve for the combined approach (0.70) was significantly higher than that for SPIO-enhanced MR imaging alone (0.58. P < .05, Fisher protected least significant difference test), and there was no significant difference between each of them and that for contrast-enhanced CT alone (0.66). For all lesions, the mean sensitivity of combined imaging (0.59) was significantly higher than that of CT (0.48) or MR imaging (0.43) alone (P < .05, Fisher protected least significant difference test and generalized estimating equations). For all lesions, the mean positive predictive values were 0.82, 0.89, and 0.81, for combined MR and CT, CT alone, and MR alone, respectively. Conclusion: The addition of SPIO-enhanced MR imaging to contrast-enhanced multi-detector row CT (ie, combined analysis of SPIO-enhanced MR images and contrast-enhanced CT images) can improve sensitivity in the detection of hepatic metastases, although this improvement in sensitivity was not significant at AFROC analysis. (c) RSNA 2006.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年04月, RADIOLOGY, 239 (1), 131 - 138, 英語

    [査読有り]

    研究論文(学術雑誌)

  • N Tanigawa, A Komemushi, S Kariya, H Kojima, Y Shomura, K Ikeda, N Omura, T Murakami, S Sawada

    Purpose: To prospectively investigate the relationship between initial clinical response and bone marrow edema pattern on preprocedural magnetic resonance (MR) images in vertebral bodies selected For percutaneous vertebroplasty (PVP). Materials and Institutional review board approval and written informed Methods: consent were obtained. PVP was performed for osteoporotic compression fractures in 80 consecutive patients (mean age. 72.4 years: range. 44-85 years : 67 women and 14 men: 157 vertebrae). Patients were divided into three groups according to the proportion of the vertebra in which the bone marrow edema pattern was observed on sagittal MR images: group 1.50% or more of the vertebra; group 2, less than 50%; group 3. no edema pattern observed. By using Wilcoxon rank sum test, Fisher exact test.. and Wilcoxon signed rank test. groups were examined for differences in treatment efficacy, which was defined as the difference between preprocedural and postprocedural pain as assessed by means Of visual analog scale (VAS) score at 1-3 days after PVP. Results: Forty-four patients were assigned to group 1, 14 to group 2, and 22 to group 3. No significant difference was seen between the groups with respect to age. sex. number of treated vertebrae, or preprocedural VAS score. In group 1, VAS score decreased from 7.5 before the procedure to 2.9 after (improvement of 4.6). In group 2. the score decreased front 6.8 to 3.1 (improvement. or 3.7). fit group 3, the score decreased from 7.0 to 4.3 (improvement of 2.7). Improvement was significantly greater in group than in group 3 (P <.005). Conclusion: PVP resulted in significantly greater clinical improvement in patients with an extensive bone marrow edema pattern than it) those without this pattern. (c) RSNA, 2006.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年04月, RADIOLOGY, 239 (1), 195 - 200, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M Hori, T Murakami, T Kim, R Iannaccone, H Abe, H Onishi, K Tomoda, C Catalano, R Passariello, H Nakamura

    Purpose: To investigate the role of ferucarbotran-enhanced. dynamic MR imaging using multishot spin-echo echo-planar sequence in the evaluation of hemodynamics of focal hepatic lesions. Materials and Methods: Sixty-three focal hepatic lesions (24 benign and 39 malignant) from 53 consecutive patients who underwent both ferucarbotran-enhanced MR imaging and dynamic computed tomography (CT) were included fit this study. MR imaging was performed with a 1.5-T scanner with a phased-array coil. T2-weighted multishot spin-echo echo-planar sequences (TR/TE = 1714-2813/80 msec) were obtained during a single breathhold before and 15, 60, 120, 180, and 600 seconds after intravenous injection of ferucarbotran. The enhancement patterns of lesions were classified into three categories by a study coordinator on the basis of dynamic CT images as hypervascular, hypovascular. and hemangioma type. The study coordinator created mean contrast-to-noise ratio of lesions vs. time curves for each enhancement pattern for quantitative analyses. Moreover, three radiologists separately and blindly reviewed MR images. and then assigned three confidence scores for the three enhancement patterns to each lesion. Sensitivity. specificity, and receiver operating characteristic analyses were performed. Results: Quantitative analyses showed characteristic enhancement Curves for each enhancement pattern. Mean sensitivities/specificities were 0.816/0.882, 0.897/0.863, and 0.800/0.989 for hypervascular, hypovascular, and hemangioma types, respectively. Mean areas under the receiver operating characteristic curve were 0.886 for hypervascular type and 0.913 for hypovascular type. Conclusion: Ferucarbotran-enhanced dynamic MR imaging can be used to successfully characterize the hemodynamics of focal hepatic lesions.

    JOHN WILEY & SONS INC, 2006年04月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 23 (4), 509 - 519, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masatomo Kuwabara, Yoshifumi Narumi, Satoru Takahashi, Yoshinobu Sato, Tonsok Kim, Takamichi Murakami, Hironobu Nakamura

    Purpose. The aim of this study was to evaluate the correlation between the renal artery cross-sectional area measured by multidetector computed tomography (MDCT) and the nephrogram area calculated by renal arteriography in potential living renal donors with duplicated renal arteries. Materials and methods. Medical records of 18 patients with duplicated renal arteries who underwent both MDCT angiography and renal arteriography between 2001 and 2003 were retrospectively reviewed. All 20 kidneys were evaluated. Renal artery cross-sectional areas were measured using the workstation to which the CT data were transferred the nephrogram areas on the digitized angiographic images were calculated using public domain software. Bland-Altman analysis was performed to compare the cross-sectional area ratio of the accessory arteries to the main renal arteries, with the ratios obtained from the nephrogram areas calculated from the arteriograms. Results. The mean cross-sectional areas of the accessory and main renal arteries were 6.78 and 20.9 mm2, respectively. The ratio of the nephrogram areas calculated from the arteriograms ranged from 0.094 to 0.809. Bland-Altman analysis showed no significant difference. Conclusion. It is possible to predict the supply volume of accessory renal arteries by measuring the cross-sectional area of the accessory and main renal arteries in potential living renal donors. © 2006 Japan Radiological Society.

    3, 2006年04月, Radiation Medicine - Medical Imaging and Radiation Oncology, 24 (3), 195 - 201, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Usefulness of the real-time virtual sonography on radiofrequency ablation of heparocellular carcinomas

    Takatoshi Kitada, Takamichi Murakami, Takaaki Matsuda, Kaori Minamitani, Kosuke Sakurai, Keigo Osuga, Noriyoshi Kuzushita, E. J. Miyoshi, Shinji Tamura, Hironobu Nakamura, Norio Hayashi, Bunichiro Kishino

    W B SAUNDERS CO-ELSEVIER INC, 2006年04月, GASTROENTEROLOGY, 130 (4), A775 - A775, 英語

    [査読有り]

  • 肝癌治療におけるReal-time Virtual Sonography(RVS)の有用性

    北田 学利, 村上 卓道, 松田 高明, 中城 和也, 南谷 かおり, 桜井 康介, 大須賀 慶吾, 三善 英知, 田村 信司, 中村 仁信, 林 紀夫, 岸野 文一郎

    (一社)日本肝臓学会, 2006年04月, 肝臓, 47 (Suppl.1), A67 - A67, 日本語

  • T Murakami, H Onishi, K Mikami, R Iannaccone, MP Federle, T Kim, M Hori, A Okada, T Marukawa, H Higashihara, R Passariello, H Nakamura

    Objective: To find the optimal scan timing for early arterial phase hepatic CT with adequate arterial enhancement after the aortic contrast arrival. Methods: Sixty patients were divided randomly into three groups, each of which received 2.0 mL/kg of the 300 mgI/mL contrast medium with an injection duration of 30 seconds (Group A, mean rate 3.6 mL/sec); of 25 seconds (13, 4.6 mL/sec); of 30 seconds (3.6 mL/sec) followed by a saline chaser (C). Results: After the contrast arrival, aortic enhancement increased rapidly for 6-15 seconds (mean, 10 seconds) to the initial peak enhancement in all groups, and then, increased moderately to the maximum aortic enhancement over the following 19, 13, and 21 seconds, respectively. The mean maximum aortic enhancement in Group B (392 HU) and C (360 HU) were significantly higher than that in A (326 HU), respectively. The difference between the initial and maximum aortic enhancement was less than 50 HU. Conclusion: The optimal timing of the early arterial phase for hepatic CT arteriography is 10-15 seconds after the aortic arrival.

    LIPPINCOTT WILLIAMS & WILKINS, 2006年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 30 (2), 206 - 211, 英語

    研究論文(学術雑誌)

  • T Murakami, H Onishi, K Mikami, R Iannaccone, MP Federle, T Kim, M Hori, A Okada, T Marukawa, H Higashihara, R Passariello, H Nakamura

    Objective: To find the optimal scan timing for early arterial phase hepatic CT with adequate arterial enhancement after the aortic contrast arrival. Methods: Sixty patients were divided randomly into three groups, each of which received 2.0 mL/kg of the 300 mgI/mL contrast medium with an injection duration of 30 seconds (Group A, mean rate 3.6 mL/sec); of 25 seconds (13, 4.6 mL/sec); of 30 seconds (3.6 mL/sec) followed by a saline chaser (C). Results: After the contrast arrival, aortic enhancement increased rapidly for 6-15 seconds (mean, 10 seconds) to the initial peak enhancement in all groups, and then, increased moderately to the maximum aortic enhancement over the following 19, 13, and 21 seconds, respectively. The mean maximum aortic enhancement in Group B (392 HU) and C (360 HU) were significantly higher than that in A (326 HU), respectively. The difference between the initial and maximum aortic enhancement was less than 50 HU. Conclusion: The optimal timing of the early arterial phase for hepatic CT arteriography is 10-15 seconds after the aortic arrival.

    LIPPINCOTT WILLIAMS & WILKINS, 2006年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 30 (2), 206 - 211, 英語

    [査読有り]

    研究論文(学術雑誌)

  • GISTのイマチニブ治療に対する耐性・再進行の診断 CTとPETの比較

    金 東石, 坪山 尚寛, 村上 卓道, 堀 雅敏, 大西 裕満, 友田 要, 西田 俊朗, 中村 仁信

    (公社)日本医学放射線学会, 2006年02月, 日本医学放射線学会学術集会抄録集, 65回, S298 - S298, 日本語

  • T Yasumoto, T Murakami, H Yamamoto, M Hori, R Iannaccone, T Kim, H Abe, M Kuwabara, K Yamasaki, N Kikkawa, H Arimoto, R Passariello, H Nakamura

    OBJECTIVE. The objective of our study was to assess the value of two-way interpretation (i.e., from rectum to cecum and vice versa) compared with one-way interpretation (i.e., from rectum to cecum only) in terms of polyp detection and interpretation time on MDCT colonography. MATERIALS AND METHODS. Fifty consecutive patients underwent both CT colonography and conventional colonoscopy. Three radiologists independently analyzed the CT colonographic examinations of each patient using a primary 3D method. All examinations were analyzed using two techniques: navigation from rectum to cecum only (one-way) and navigation from rectum to cecum and vice versa (two-way). Sensitivity and positive predictive value were calculated on both a per-polyp basis and a per-patient basis. Alternative free-response receiver operating characteristic (ROC) curve analysis was estimated, and image interpretation time was documented. RESULTS. One hundred fifty-five polyps were depicted in 45 patients by colonoscopy. The mean sensitivity of CT colonography for polyp detection with two-way (88.4%) was significantly superior to that with one-way (78.1%) (p < 0.01). The mean positive predictive value of each observer with one-way was 66.7%, whereas that with two-way was 65.8%. The mean area under the alternative free-response ROC curve (A(z) value) with two-way (0.827) was higher than that with one-way (0.816), but there was not a statistically significant difference. The average interpretation time of each observer with two-way (39 min) was statistically significantly longer than that with one-way (25 min) (p < 0.01). CONCLUSION. When using a primary 3D interpretation technique at CT colonography, complete 3D navigation from rectum to cecum and from cecum to rectum is mandatory to maximize polyp detection. The image interpretation time for two-way interpretation is statistically significantly longer than that with one-way interpretation.

    AMER ROENTGEN RAY SOC, 2006年01月, AMERICAN JOURNAL OF ROENTGENOLOGY, 186 (1), 85 - 89, 英語

    研究論文(学術雑誌)

  • S Kumano, T Murakami, T Kim, M Hori, R Iannaccone, S Nakata, H Onishi, K Osuga, K Tomoda, C Catalano, H Nakamura

    PURPOSE: To evaluate retrospectively the accuracy of multi-detector row computed tomography (CT) in the assessment of serosal invasion in patients with gastric cancer. MATERIALS AND METHODS: The Ethics Committee does not require approval or informed consent for retrospective studies. Forty-one consecutive patients (24 men, 17 women; mean age, 68 years) with gastric cancer were included in this study. All patients were given 600 mL of tap water to drink and were positioned prone or supine on the scanning table. The detector row configuration included four detector rows, a section thickness of 1.25 mm, a pitch of 6, and a reconstruction interval of 0.63 mm. Transverse and multiplanar reconstruction images were simultaneously evaluated by two independent observers to assess the depth of tumor invasion in the gastric wall (ie, T stage). T staging at multi-detector row CT was compared with T staging at histologic evaluation (reference standard), which was performed by means of surgical or histologic examination of the resected specimen. We also calculated the sensitivity, specificity, and accuracy of multi-detector row CT for each observer in the assessment of serosal invasion. RESULTS: Analysis of interobserver agreement showed substantial or almost perfect agreement (nonweighted kappa value of 0.78 and weighted kappa value of 0.85). Correct assessment of gastric wall invasion was 80% and 85% for observers 1 and 2, respectively. The sensitivity, specificity, and accuracy of multi-detector row CT in the assessment of serosal invasion were 90%, 95%, and 93%, respectively, for observer 1 and 80%, 97%, and 93%, respectively, for observer 2. Overstaging occurred in six patients, and understaging occurred in five patients. All understaged tumors were scirrhous subtype gastric cancer. CONCLUSION: Multi-detector row CT scanning of patients with gastric cancer gave 93% accuracy in the assessment of serosal invasion in patients with gastric cancer. (c) RSNA, 2005.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年01月, RADIOLOGY, 237 (3), 961 - 966, 英語

    研究論文(学術雑誌)

  • S Kumano, T Murakami, T Kim, M Hori, R Iannaccone, S Nakata, H Onishi, K Osuga, K Tomoda, C Catalano, H Nakamura

    PURPOSE: To evaluate retrospectively the accuracy of multi-detector row computed tomography (CT) in the assessment of serosal invasion in patients with gastric cancer. MATERIALS AND METHODS: The Ethics Committee does not require approval or informed consent for retrospective studies. Forty-one consecutive patients (24 men, 17 women; mean age, 68 years) with gastric cancer were included in this study. All patients were given 600 mL of tap water to drink and were positioned prone or supine on the scanning table. The detector row configuration included four detector rows, a section thickness of 1.25 mm, a pitch of 6, and a reconstruction interval of 0.63 mm. Transverse and multiplanar reconstruction images were simultaneously evaluated by two independent observers to assess the depth of tumor invasion in the gastric wall (ie, T stage). T staging at multi-detector row CT was compared with T staging at histologic evaluation (reference standard), which was performed by means of surgical or histologic examination of the resected specimen. We also calculated the sensitivity, specificity, and accuracy of multi-detector row CT for each observer in the assessment of serosal invasion. RESULTS: Analysis of interobserver agreement showed substantial or almost perfect agreement (nonweighted kappa value of 0.78 and weighted kappa value of 0.85). Correct assessment of gastric wall invasion was 80% and 85% for observers 1 and 2, respectively. The sensitivity, specificity, and accuracy of multi-detector row CT in the assessment of serosal invasion were 90%, 95%, and 93%, respectively, for observer 1 and 80%, 97%, and 93%, respectively, for observer 2. Overstaging occurred in six patients, and understaging occurred in five patients. All understaged tumors were scirrhous subtype gastric cancer. CONCLUSION: Multi-detector row CT scanning of patients with gastric cancer gave 93% accuracy in the assessment of serosal invasion in patients with gastric cancer. (c) RSNA, 2005.

    RADIOLOGICAL SOC NORTH AMERICA, 2006年01月, RADIOLOGY, 237 (3), 961 - 966, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Yasumoto, T Murakami, H Yamamoto, M Hori, R Iannaccone, T Kim, H Abe, M Kuwabara, K Yamasaki, N Kikkawa, H Arimoto, R Passariello, H Nakamura

    OBJECTIVE. The objective of our study was to assess the value of two-way interpretation (i.e., from rectum to cecum and vice versa) compared with one-way interpretation (i.e., from rectum to cecum only) in terms of polyp detection and interpretation time on MDCT colonography. MATERIALS AND METHODS. Fifty consecutive patients underwent both CT colonography and conventional colonoscopy. Three radiologists independently analyzed the CT colonographic examinations of each patient using a primary 3D method. All examinations were analyzed using two techniques: navigation from rectum to cecum only (one-way) and navigation from rectum to cecum and vice versa (two-way). Sensitivity and positive predictive value were calculated on both a per-polyp basis and a per-patient basis. Alternative free-response receiver operating characteristic (ROC) curve analysis was estimated, and image interpretation time was documented. RESULTS. One hundred fifty-five polyps were depicted in 45 patients by colonoscopy. The mean sensitivity of CT colonography for polyp detection with two-way (88.4%) was significantly superior to that with one-way (78.1%) (p < 0.01). The mean positive predictive value of each observer with one-way was 66.7%, whereas that with two-way was 65.8%. The mean area under the alternative free-response ROC curve (A(z) value) with two-way (0.827) was higher than that with one-way (0.816), but there was not a statistically significant difference. The average interpretation time of each observer with two-way (39 min) was statistically significantly longer than that with one-way (25 min) (p < 0.01). CONCLUSION. When using a primary 3D interpretation technique at CT colonography, complete 3D navigation from rectum to cecum and from cecum to rectum is mandatory to maximize polyp detection. The image interpretation time for two-way interpretation is statistically significantly longer than that with one-way interpretation.

    AMER ROENTGEN RAY SOC, 2006年01月, AMERICAN JOURNAL OF ROENTGENOLOGY, 186 (1), 85 - 89, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masatoshi Hori, Tonsok Kim, Takamichi Murakami, Hiromitsu Onishi, Naohiro Tsuboyama, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura, Masaya Hirano, Atsushi Nozaki

    A tetrahedral gradient diffusion sequence for body imaging for a 1.5T scanner was implemented, and we compared the quality of images acquired with the new technique and with the conventional orthogonal technique. Image quality was better using the tetrahedral technique in terms of signal homogeneity in the right liver lobe and signal loss artifact in the left lobe, and the technique was considered useful for magnetic resonance imaging in the upper abdomen.

    2006年, Magnetic Resonance in Medical Sciences, 5 (4), 201 - 206, 英語

    研究論文(学術雑誌)

  • Atsuya Okada, Takamichi Murakami, Koji Mikami, Hiromitsu Onishi, Noboru Tanigawa, Taro Marukawa, Hironobu Nakamura

    Focused ultrasound surgery (FUS) is a method of noninvasive focal thermal ablation. Temperature-sensitive phase-difference magnetic resonance (MR) imaging allows monitoring of the focal point and measurement of tissue temperature elevation in real time, ensuring delivery of a therapeutic dose. A newly developed respiratory monitoring system enables us to track liver tumors, which move with respiration. We report our initial experience using MR-guided FUS with respiratory gating in successfully treating a hepatocellular carcinoma 15 mm in diameter.

    2006年, Magnetic Resonance in Medical Sciences, 5 (3), 167 - 171, 英語

    研究論文(学術雑誌)

  • Atsuya Okada, Takamichi Murakami, Koji Mikami, Hiromitsu Onishi, Noboru Tanigawa, Taro Marukawa, Hironobu Nakamura

    Focused ultrasound surgery (FUS) is a method of noninvasive focal thermal ablation. Temperature-sensitive phase-difference magnetic resonance (MR) imaging allows monitoring of the focal point and measurement of tissue temperature elevation in real time, ensuring delivery of a therapeutic dose. A newly developed respiratory monitoring system enables us to track liver tumors, which move with respiration. We report our initial experience using MR-guided FUS with respiratory gating in successfully treating a hepatocellular carcinoma 15 mm in diameter.

    3, 2006年, Magnetic Resonance in Medical Sciences, 5 (3), 167 - 171, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Masatoshi Hori, Tonsok Kim, Takamichi Murakami, Hiromitsu Onishi, Naohiro Tsuboyama, Keigo Osuga, Kaname Tomoda, Hironobu Nakamura, Masaya Hirano, Atsushi Nozaki

    A tetrahedral gradient diffusion sequence for body imaging for a 1.5T scanner was implemented, and we compared the quality of images acquired with the new technique and with the conventional orthogonal technique. Image quality was better using the tetrahedral technique in terms of signal homogeneity in the right liver lobe and signal loss artifact in the left lobe, and the technique was considered useful for magnetic resonance imaging in the upper abdomen.

    4, 2006年, Magnetic Resonance in Medical Sciences, 5 (4), 201 - 206, 英語

    [査読有り]

    研究論文(学術雑誌)

  • R Iannaccone, C Catalano, F Mangiapane, T Murakami, A Lamazza, E Fiori, A Schillaci, D Marin, Nofroni, I, M Hori, R Passariello

    PURPOSE: To prospectively evaluate the diagnostic accuracy of low-radiation-close computed tomographic (CT) colonography for detection of colorectal polyps by using two sequential colonoscopies, with the second colonoscopy as the reference standard. MATERIALS AND METHODS: The study was local ethics committee approved, and all patients gave written informed consent. Colonographic images were acquired by using a low-dose multi-detector row CT protocol (effective milliampere-second setting, 10 mAs). Three observers interpreted the CT colonographic data separately and independently by using a two-dimensional technique. Initial conventional colonoscopy was performed by an endoscopist unaware of the CT colonographic findings. Second colonoscopy performed within 2 weeks by a colonoscopist aware of both the CT colonographic and the initial colonoscopic findings served as the reference standard. The sensitivities of CT colonography and initial colonoscopy were calculated on a per-polyp and a per-patient basis. Specificities and positive and negative predictive values also were calculated on a per-patient basis. RESULTS: Eighty-eight patients underwent CT colonography and initial conventional colonoscopy on the same day. Per-polyp sensitivities were 62% and 83% for CT colonography and initial colonoscopy, respectively. Sensitivities for detection of polyps 6 mm in diameter or larger were 86% and 84% for CT colonography and initial colonoscopy, respectively. Initial colonoscopy failed to depict 16 polyps, six of which were correctly detected with CT colonography. For identification of patients with polyps 6 mm in diameter or larger, CT colonography and initial colonoscopy, respectively, had sensitivities of 84% and 90%, specificities of 82% and 100%, positive predictive values of 70% and 100%, and negative predictive values of 91% and 95%. CONCLUSION: Low-dose CT colonography compares favorably with colonoscopy for detection of colorectal polyps 6 mm in diameter or larger, with markedly decreased performance for detection of polyps 5 mm in diameter or smaller. (c) RSNA, 2005.

    RADIOLOGICAL SOC NORTH AMERICA, 2005年12月, RADIOLOGY, 237 (3), 927 - 937, 英語

    研究論文(学術雑誌)

  • R Iannaccone, C Catalano, F Mangiapane, T Murakami, A Lamazza, E Fiori, A Schillaci, D Marin, Nofroni, I, M Hori, R Passariello

    PURPOSE: To prospectively evaluate the diagnostic accuracy of low-radiation-close computed tomographic (CT) colonography for detection of colorectal polyps by using two sequential colonoscopies, with the second colonoscopy as the reference standard. MATERIALS AND METHODS: The study was local ethics committee approved, and all patients gave written informed consent. Colonographic images were acquired by using a low-dose multi-detector row CT protocol (effective milliampere-second setting, 10 mAs). Three observers interpreted the CT colonographic data separately and independently by using a two-dimensional technique. Initial conventional colonoscopy was performed by an endoscopist unaware of the CT colonographic findings. Second colonoscopy performed within 2 weeks by a colonoscopist aware of both the CT colonographic and the initial colonoscopic findings served as the reference standard. The sensitivities of CT colonography and initial colonoscopy were calculated on a per-polyp and a per-patient basis. Specificities and positive and negative predictive values also were calculated on a per-patient basis. RESULTS: Eighty-eight patients underwent CT colonography and initial conventional colonoscopy on the same day. Per-polyp sensitivities were 62% and 83% for CT colonography and initial colonoscopy, respectively. Sensitivities for detection of polyps 6 mm in diameter or larger were 86% and 84% for CT colonography and initial colonoscopy, respectively. Initial colonoscopy failed to depict 16 polyps, six of which were correctly detected with CT colonography. For identification of patients with polyps 6 mm in diameter or larger, CT colonography and initial colonoscopy, respectively, had sensitivities of 84% and 90%, specificities of 82% and 100%, positive predictive values of 70% and 100%, and negative predictive values of 91% and 95%. CONCLUSION: Low-dose CT colonography compares favorably with colonoscopy for detection of colorectal polyps 6 mm in diameter or larger, with markedly decreased performance for detection of polyps 5 mm in diameter or smaller. (c) RSNA, 2005.

    RADIOLOGICAL SOC NORTH AMERICA, 2005年12月, RADIOLOGY, 237 (3), 927 - 937, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Prospective respiratory-triggered multidetector row CT (MDCT) for abdominal examinations: Initial experience with a prototype

    Markus Fahrni, Takamichi Murakami, Masatoshi Hori, Tonsok Kim, Toru Matsumura, Masayuki Kudo, Shigeru Sase, Kaname Tomoda, Hironobu Nakamura

    Purpose: To develop a prototype for prospective respiratory-triggered multidetector row computed tomography (MDCT) for abdominal examinations and to assess its feasibility. Materials and Methods: The prototype consisted of the following components: an MDCT unit, personal computer (PC), and a respiratory motion detector in the form of a wearable belt with sensors to measure differences in pressure caused by breathing excursions. The registered signals were processed by the PC. The abdominal MDCT images of 10 healthy volunteers were obtained with an incremental axial technique in the expiration phase during normal breathing. Multiplanar reformations (MPR) were then performed. On the basis of the precision of these reconstructions, two radiologists then assessed the accuracy and applicability of the system. Results: Coronal and sagittal MPR images from these prospective respiratory-gated examinations were found to be accurate. In particular, the continuity of borders and surfaces of scanned organs proved the exactness of the previously acquired respiration-correlated axial source images. Conclusion: This prototype is feasible to perform prospective respiratory-triggered abdominal MDCT examinations during normal respiration without breathhold. This system may be useful for patients with reduced compliance in holding their breath.

    2005年11月, Radiation Medicine - Medical Imaging and Radiation Oncology, 23 (7), 528 - 531, 英語

    研究論文(学術雑誌)

  • S Hayashi, K Dono, J Shimizu, T Murakami, M Takamura, T Kim, M Hori, ZH Lu, H Nagano, S Nakamori, M Sakon, H Nakamura, M Monden

    Background. A new Xenon computed tomography (CT) system was developed to measure both hepatic arterial and portal venous tissue blood flow (HATBF/ PVTBF) non-invasively. Despite its clinical trial, the effect of prostaglandin El (PGE1) on hepatic hemodynamics is not well investigated. In a rabbit model, we evaluated the accuracy of this system by comparing it with the electromagnetic blood flowmeter (EMBF), the pharmacological effect of PGE1 on the fractional hepatic hemodynamics. Materials and methods. Seven NZW-rabbits were used. Serial abdominal CT scan was obtained every min before and during the 4 min inhalation of the Xenon gas, followed by 5 min administration of oxygen air. From these images, HATBF and PVTBF were separately calculated with a special new imaging system. We also used EMBF during laparotomy, and directly measured the hepatic arterial and portal venous flow with or without PGE1 administration. Results. Xenon CT showed HATBF of 18.4 +/- 4.5 (ml/min/100 g) and PVTBF of 69.4 +/- 15.0, was almost identical with those of EMBF (19.8 +/- 5.7 and 67.2 +/- 19.1, respectively). After PGE1 administration, Xenon CT showed 22.9 +/- 4.6 and 76.5 +/- 20.5, while those with EMBF were 21.0 +/- 6.5 and 84.7 +/- 21.6, respectively. There were significant correlations (P < 0.01) in total HTBF, HATBF, and PVTBF between results of Xenon CT and EMBF. Conclusions. Xenon CT with a newly developed imaging system enables us to measure the fractional hepatic tissue blood flow in rabbits, differentially and accurately. Venous administration of PGE1 increased total hepatic blood flow, mainly affecting the portal blood flow. (c) 2005 Elsevier Inc. All rights reserved.

    ACADEMIC PRESS INC ELSEVIER SCIENCE, 2005年11月, JOURNAL OF SURGICAL RESEARCH, 129 (1), 24 - 30, 英語

    研究論文(学術雑誌)

  • S Hayashi, K Dono, J Shimizu, T Murakami, M Takamura, T Kim, M Hori, ZH Lu, H Nagano, S Nakamori, M Sakon, H Nakamura, M Monden

    Background. A new Xenon computed tomography (CT) system was developed to measure both hepatic arterial and portal venous tissue blood flow (HATBF/ PVTBF) non-invasively. Despite its clinical trial, the effect of prostaglandin El (PGE1) on hepatic hemodynamics is not well investigated. In a rabbit model, we evaluated the accuracy of this system by comparing it with the electromagnetic blood flowmeter (EMBF), the pharmacological effect of PGE1 on the fractional hepatic hemodynamics. Materials and methods. Seven NZW-rabbits were used. Serial abdominal CT scan was obtained every min before and during the 4 min inhalation of the Xenon gas, followed by 5 min administration of oxygen air. From these images, HATBF and PVTBF were separately calculated with a special new imaging system. We also used EMBF during laparotomy, and directly measured the hepatic arterial and portal venous flow with or without PGE1 administration. Results. Xenon CT showed HATBF of 18.4 +/- 4.5 (ml/min/100 g) and PVTBF of 69.4 +/- 15.0, was almost identical with those of EMBF (19.8 +/- 5.7 and 67.2 +/- 19.1, respectively). After PGE1 administration, Xenon CT showed 22.9 +/- 4.6 and 76.5 +/- 20.5, while those with EMBF were 21.0 +/- 6.5 and 84.7 +/- 21.6, respectively. There were significant correlations (P < 0.01) in total HTBF, HATBF, and PVTBF between results of Xenon CT and EMBF. Conclusions. Xenon CT with a newly developed imaging system enables us to measure the fractional hepatic tissue blood flow in rabbits, differentially and accurately. Venous administration of PGE1 increased total hepatic blood flow, mainly affecting the portal blood flow. (c) 2005 Elsevier Inc. All rights reserved.

    ACADEMIC PRESS INC ELSEVIER SCIENCE, 2005年11月, JOURNAL OF SURGICAL RESEARCH, 129 (1), 24 - 30, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Prospective respiratory-triggered multidetector row CT (MDCT) for abdominal examinations: Initial experience with a prototype

    Markus Fahrni, Takamichi Murakami, Masatoshi Hori, Tonsok Kim, Toru Matsumura, Masayuki Kudo, Shigeru Sase, Kaname Tomoda, Hironobu Nakamura

    Purpose: To develop a prototype for prospective respiratory-triggered multidetector row computed tomography (MDCT) for abdominal examinations and to assess its feasibility. Materials and Methods: The prototype consisted of the following components: an MDCT unit, personal computer (PC), and a respiratory motion detector in the form of a wearable belt with sensors to measure differences in pressure caused by breathing excursions. The registered signals were processed by the PC. The abdominal MDCT images of 10 healthy volunteers were obtained with an incremental axial technique in the expiration phase during normal breathing. Multiplanar reformations (MPR) were then performed. On the basis of the precision of these reconstructions, two radiologists then assessed the accuracy and applicability of the system. Results: Coronal and sagittal MPR images from these prospective respiratory-gated examinations were found to be accurate. In particular, the continuity of borders and surfaces of scanned organs proved the exactness of the previously acquired respiration-correlated axial source images. Conclusion: This prototype is feasible to perform prospective respiratory-triggered abdominal MDCT examinations during normal respiration without breathhold. This system may be useful for patients with reduced compliance in holding their breath.

    7, 2005年11月, Radiation Medicine - Medical Imaging and Radiation Oncology, 23 (7), 528 - 531, 英語

    [査読有り]

    研究論文(学術雑誌)

  • [Radiofrequency ablation for hepatocellular carcinoma and liver metastases].

    Yasumoto T, Murakami T, Katsumoto Y, Hashimoto T, Noda S, Murata K, Kinuta M, Nakamura H

    11, 2005年10月, Gan to kagaku ryoho. Cancer & chemotherapy, 32, 1596 - 1599

    [査読有り]

  • [Successful treatment of combined intraarterial (5-fluorouracil and adriamycin and cisplatin) infusion chemotherapy for advanced hepatocellular carcinoma with multiple intrahepatic metastases and/or portal vein thrombosis--two case reports].

    Kato H, Nagano H, Ota H, Nakamura M, Wada H, Yoshioka S, Noda T, Bazarragchaa D, Marubashi S, Miyamoto A, Takeda Y, Umeshita K, Dono K, Murakami T, Nakamura H, Monden M

    11, 2005年10月, Gan to kagaku ryoho. Cancer & chemotherapy, 32, 1842 - 1845

    [査読有り]

  • Quantitative tissue blood flow evaluation of pancreatic tumor: Comparison between xenon CT technique and perfusion CT technique based on deconvolution analysis

    Hisashi Abe, Takamichi Murakami, Masaru Kubota, Tonsok Kim, Masatoshi Hori, Masayuki Kudo, Kazuhiko Hashimoto, Shoji Nakamori, Keizo Dono, Kaname Tomoda, Morito Monden, Hironobu Nakamura

    Purpose: There has been one report that tissue blood flow (TBF) quantification with xenon CT was effective in predicting the therapeutic response to an anticancer drug in pancreatic cancer. The purpose of this study was to evaluate the correlation between the TBF of pancreatic tumors calculated with xenon CT and those with perfusion CT, in order to evaluate whether perfusion CT could replace xenon CT. Materials and Methods: Nine patients with pathologically proved pancreatic tumors who underwent both xenon CT and perfusion CT were included. Results: Quantitative TBF of pancreatic tumors measured by perfusion CT ranged from 22.1 to 196.2 ml/min/100 g (mean±SD, 52.6±54.8 ml/min/100 g). In contrast, those obtained by xenon CT ranged from 10.3 to 173.6 ml/min/100 g (mean±SD, 47.9±49.4 ml/min/100 g). There was a good linear correlation between xenon CT and perfusion CT (y=0.8537x+2.48, R2=0.895: p< 0.05). Conclusion: The TBF of pancreatic tumors measured by xenon CT and perfusion CT techniques showed a close linear correlation. We can expect that perfusion CT based on the deconvolution algorithm may replace xenon CT to predict the effect of pancreatic tumor treatment with anticancer drugs.

    2005年08月, Radiation Medicine - Medical Imaging and Radiation Oncology, 23 (5), 364 - 370, 英語

    研究論文(学術雑誌)

  • Quantitative tissue blood flow evaluation of pancreatic tumor: Comparison between xenon CT technique and perfusion CT technique based on deconvolution analysis

    Hisashi Abe, Takamichi Murakami, Masaru Kubota, Tonsok Kim, Masatoshi Hori, Masayuki Kudo, Kazuhiko Hashimoto, Shoji Nakamori, Keizo Dono, Kaname Tomoda, Morito Monden, Hironobu Nakamura

    Purpose: There has been one report that tissue blood flow (TBF) quantification with xenon CT was effective in predicting the therapeutic response to an anticancer drug in pancreatic cancer. The purpose of this study was to evaluate the correlation between the TBF of pancreatic tumors calculated with xenon CT and those with perfusion CT, in order to evaluate whether perfusion CT could replace xenon CT. Materials and Methods: Nine patients with pathologically proved pancreatic tumors who underwent both xenon CT and perfusion CT were included. Results: Quantitative TBF of pancreatic tumors measured by perfusion CT ranged from 22.1 to 196.2 ml/min/100 g (mean±SD, 52.6±54.8 ml/min/100 g). In contrast, those obtained by xenon CT ranged from 10.3 to 173.6 ml/min/100 g (mean±SD, 47.9±49.4 ml/min/100 g). There was a good linear correlation between xenon CT and perfusion CT (y=0.8537x+2.48, R2=0.895: p< 0.05). Conclusion: The TBF of pancreatic tumors measured by xenon CT and perfusion CT techniques showed a close linear correlation. We can expect that perfusion CT based on the deconvolution algorithm may replace xenon CT to predict the effect of pancreatic tumor treatment with anticancer drugs.

    5, 2005年08月, Radiation Medicine - Medical Imaging and Radiation Oncology, 23 (5), 364 - 370, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Murakami, M Takamura, T Kim, M Hori, MP Federle, H Onishi, K Tomoda, H Nakamura

    Rationale and objectives: The purpose of this study is to assess the diagnostic impact of double phase computed tomography during hepatic arteriography for hepatocellular carcinoma. Materials and methods: 118 hepatocellular carcinomas in 73 cirrhotic patients who underwent double phase computed tomography during hepatic arteriography were enrolled in this study. Double phase computed tomography during hepatic arteriography consisted of computed tomography images obtained at 5-10 s (first phase) and 40-50 s (second phase) after the initiation of an intraarterial administration of 40-60 ml of contrast medium through the hepatic artery. Diagnostic accuracy of the first phase computed tomography during hepatic arteriography alone and double phase computed tomography during hepatic arteriography images for hepatocellular carcinoma were separately analyzed by three blinded readers independently. Alternative-free response receiver operating characteristic curves were constructed to compare each set of computed tomography during hepatic arteriography images. Results: The detection sensitivity of the double phase CTHA for HCC (mean, 83.1%) was significantly higher than that of the first phase CTHA alone (mean, 73.4%) (P < 0.01). Moreover. the positive predictive value of the double phase CTHA (mean, 93.7%) was higher than that of the first phase CTHA alone (87.4%). The area under the AFROC curve (Az value) of the double phase CTHA (mean, 0.88) was significantly higher than that of the first phase CTHA alone (mean, 0.77) (P < 0.05). Conclusions: Double phase computed tomography during hepatic arteriography can improve the diagnostic accuracy of hepatocellular carcinoma. © 2004 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2005年05月, EUROPEAN JOURNAL OF RADIOLOGY, 54 (2), 246 - 252, 英語

    研究論文(学術雑誌)

  • T Murakami, M Takamura, T Kim, M Hori, MP Federle, H Onishi, K Tomoda, H Nakamura

    Rationale and objectives: The purpose of this study is to assess the diagnostic impact of double phase computed tomography during hepatic arteriography for hepatocellular carcinoma. Materials and methods: 118 hepatocellular carcinomas in 73 cirrhotic patients who underwent double phase computed tomography during hepatic arteriography were enrolled in this study. Double phase computed tomography during hepatic arteriography consisted of computed tomography images obtained at 5-10 s (first phase) and 40-50 s (second phase) after the initiation of an intraarterial administration of 40-60 ml of contrast medium through the hepatic artery. Diagnostic accuracy of the first phase computed tomography during hepatic arteriography alone and double phase computed tomography during hepatic arteriography images for hepatocellular carcinoma were separately analyzed by three blinded readers independently. Alternative-free response receiver operating characteristic curves were constructed to compare each set of computed tomography during hepatic arteriography images. Results: The detection sensitivity of the double phase CTHA for HCC (mean, 83.1%) was significantly higher than that of the first phase CTHA alone (mean, 73.4%) (P < 0.01). Moreover. the positive predictive value of the double phase CTHA (mean, 93.7%) was higher than that of the first phase CTHA alone (87.4%). The area under the AFROC curve (Az value) of the double phase CTHA (mean, 0.88) was significantly higher than that of the first phase CTHA alone (mean, 0.77) (P < 0.05). Conclusions: Double phase computed tomography during hepatic arteriography can improve the diagnostic accuracy of hepatocellular carcinoma. © 2004 Elsevier Ireland Ltd. All rights reserved.

    ELSEVIER IRELAND LTD, 2005年05月, EUROPEAN JOURNAL OF RADIOLOGY, 54 (2), 246 - 252, 英語

    [査読有り]

    研究論文(学術雑誌)

  • R Iannaccone, A Laghi, C Catalano, P Rossi, F Mangiapane, T Murakami, M Hori, F Piacentini, Nofroni, I, R Passariello

    PURPOSE: To determine, by using multi-detector row helical computed tomography (CT), the added value of obtaining unenhanced and delayed phase scans in addition to biphasic (hepatic arterial and portal venous phases) scans in the detection of hepatocellular carcinoma (HCC) in patients with cirrhosis. MATERIALS AND METHODS: Local ethical committee approval and patient consent were obtained. One hundred ninety-five patients (129 men, 66 women; mean age, 61 years; age range, 39-78 years) with 250 HCCs underwent multi-detector row helical CT of the liver. A quadruple-phase protocol that included unenhanced, hepatic arterial, portal venous, and delayed phases was performed. Analysis of images from hepatic arterial and portal venous phases combined, hepatic arterial and portal venous phases with the unenhanced phase, hepatic arterial and portal venous phases with the delayed phase, and all phases combined was performed separately by three independent radiologists. Relative sensitivity, positive predictive value, and area under the receiver operating characteristic curve (A,) were calculated for each reading session. RESULTS: Mean sensitivity and positive predictive values, respectively, for HCC detection were 88.8% (666 of 750 readings) and 97.8% (666 of 681 readings) for the combined hepatic arterial and portal venous phases, 89.2% (669 of 750 readings) and 97.8% (669 of 684 readings) for hepatic arterial and portal venous phases with the unenhanced phase, 92.8% (696 of 750 readings) and 97.3% (696 of 715 readings) for hepatic arterial and portal venous phases with the delayed phase, and 92.8% (696 of 750 readings) and 97.3% (696 of 715 readings) for all four phases combined. The reading sessions in which delayed phase images were available for interpretation showed significantly (P <.05) superior sensitivity and A, values. CONCLUSION: Unenhanced phase images are not effective for HCC detection. Because of the significant increase in HCC detection, a delayed phase can be a useful adjunct to biphasic CT in patients at risk for developing HCC.

    RADIOLOGICAL SOC NORTH AMERICA, 2005年02月, RADIOLOGY, 234 (2), 460 - 467, 英語

    研究論文(学術雑誌)

  • R Iannaccone, A Laghi, C Catalano, P Rossi, F Mangiapane, T Murakami, M Hori, F Piacentini, Nofroni, I, R Passariello

    PURPOSE: To determine, by using multi-detector row helical computed tomography (CT), the added value of obtaining unenhanced and delayed phase scans in addition to biphasic (hepatic arterial and portal venous phases) scans in the detection of hepatocellular carcinoma (HCC) in patients with cirrhosis. MATERIALS AND METHODS: Local ethical committee approval and patient consent were obtained. One hundred ninety-five patients (129 men, 66 women; mean age, 61 years; age range, 39-78 years) with 250 HCCs underwent multi-detector row helical CT of the liver. A quadruple-phase protocol that included unenhanced, hepatic arterial, portal venous, and delayed phases was performed. Analysis of images from hepatic arterial and portal venous phases combined, hepatic arterial and portal venous phases with the unenhanced phase, hepatic arterial and portal venous phases with the delayed phase, and all phases combined was performed separately by three independent radiologists. Relative sensitivity, positive predictive value, and area under the receiver operating characteristic curve (A,) were calculated for each reading session. RESULTS: Mean sensitivity and positive predictive values, respectively, for HCC detection were 88.8% (666 of 750 readings) and 97.8% (666 of 681 readings) for the combined hepatic arterial and portal venous phases, 89.2% (669 of 750 readings) and 97.8% (669 of 684 readings) for hepatic arterial and portal venous phases with the unenhanced phase, 92.8% (696 of 750 readings) and 97.3% (696 of 715 readings) for hepatic arterial and portal venous phases with the delayed phase, and 92.8% (696 of 750 readings) and 97.3% (696 of 715 readings) for all four phases combined. The reading sessions in which delayed phase images were available for interpretation showed significantly (P <.05) superior sensitivity and A, values. CONCLUSION: Unenhanced phase images are not effective for HCC detection. Because of the significant increase in HCC detection, a delayed phase can be a useful adjunct to biphasic CT in patients at risk for developing HCC.

    RADIOLOGICAL SOC NORTH AMERICA, 2005年02月, RADIOLOGY, 234 (2), 460 - 467, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 子宮筋腫に対するMRIガイド集束超音波治療における拡散強調画像の有用性

    礒橋 佳也子, 岡田 篤哉, 丸川 太朗, 三上 恒治, 村上 卓道, 中村 仁信, Keserci Bilgin

    (公社)日本医学放射線学会, 2005年02月, 日本医学放射線学会学術集会抄録集, 64回, S380 - S380, 日本語

  • 子宮筋腫に対するMRガイド下集束超音波治療の有用性

    岡田 篤哉, 丸川 太朗, 礒橋 佳也子, 三上 恒治, 村上 卓道, 中村 仁信, Keserci Bilgin

    (公社)日本医学放射線学会, 2005年02月, 日本医学放射線学会学術集会抄録集, 64回, S381 - S381, 日本語

  • 5-FU, CDDP, Adriamucin (FAP)による肝動注化学療法が著効した進行肝細胞癌の2例

    加藤 仁, 村上 卓道

    2005年, 癌と化学療法, 32, 1842 - 1845

  • GDAコイル法におけるマイクロネスター・コイルの有用性

    大須賀 慶悟, 村上 卓道

    留置法として側孔付カテーテルを胃十二指腸動脈(GDA)に留置するGDAコイル法におけるマイクロネスター・コイル(MNC)の有用性について留置工夫も含めて検討した.切除不能肝胆道系悪性腫瘍に対してMNCを用いてGDAコイル法を施行した25例を対象とした.プッシュ法で52個,フラッシュ法で5個,合計57個のMNCをGDAに留置した.全コイルで留置は成功した.14例計17個で側枝アンカー法による留置を行い,膵・十二指腸枝の効率的な側枝塞栓が得られた.MNC留置直後の造影では,いずれもほぼ即時的な血管閉塞を認めた.MNCの位置は血管内で安定し,近位側への逸脱や末梢への移動・迷入は認めなかった.1週間後のポート造影では,全例でGDAの再開通を認めなかった

    (一社)日本インターベンショナルラジオロジー学会, 2005年, IVR会誌, 20 (4), 406 - 410, 日本語

  • 血管塞栓用マイクロネスター・コイルの使用経験

    大須賀 慶悟, 村上 卓道

    マイクロネスター・コイル(MNC)は,主に肺動静脈奇形(AVM)や精索静脈瘤で使われているが,動脈での用途も広い.そこで,MNCを動脈で臨床試用した.症例1(65歳女).右腎AVMに対してMNCを留置した.塞栓直後の腎動脈造影で,AVMの描出は完全に消失し,健常部はほぼ温存された.1年後の造影CTでは静脈瘤の血栓化と縮小を認めており完治と考えられた.症例2(58歳男).門脈浸潤を伴う肝細胞癌に対して,GDAコイル法により動注用カテーテルを留置した.総肝動脈造影では,胃十二指腸動脈(GDA)は比較的太くてまっすぐな走行を示した.MNCでGDAの塞栓を行った.塞栓直後の血管造影にてGDAの閉塞を認めた.1週間後のポート造影でもGDAの再開通は認めなかった

    (一社)日本インターベンショナルラジオロジー学会, 2005年, IVR会誌, 20 (3), 285 - 288, 日本語

  • [Hepatic arterial infusion chemotherapy (HAIC)--hepatocellular carcinoma].

    Osuga K, Murakami T, Nakata S, Tomoda K, Nagano H, Monden M, Nakamura H

    13, 2004年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 31, 2114 - 2117

    [査読有り]

  • Original report. Hepatic nodular lesions associated with abnormal development of the portal vein.

    T Kim, T Murakami, E Sugihara, M Hori, K Wakasa, H Nakamura

    OBJECTIVE. We reviewed the medical records including pathologic descriptions, CT images, MR images, and digital subtraction angiograms of three patients with hepatic lesions that were associated with abnormal development of the portal vein-patent ductus venosus or congenital absence of the portal vein-to clarify the imaging characteristics of these abnormalities. CONCLUSION. Two-phase helical CT and MRI, including MR angiography and dynamic studies, are useful for the diagnosis of patent ductus venosus and congenital absence of the portal vein. MRI may more effectively reveal hepatic lesions than two-phase helical CT under such abnormal conditions in which the liver has only the arterial but not the portal blood supply.

    AMER ROENTGEN RAY SOC, 2004年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 183 (5), 1333 - 1338, 英語

    研究論文(学術雑誌)

  • R Iannaccone, A Laghi, C Catalano, F Mangiapane, A Lamazza, A Schillaci, G Sinibaldi, T Murakami, P Sammartino, M Hori, F Piacentini, Nofroni, I, Stipa, V, R Passariello

    Aims: We prospectively compared the performance of low-dose multidetector computed tomographic colonography (CTC) without cathartic preparation with that of colonoscopy for the detection of colorectal polyps. Methods: A total of 203 patients underwent low-dose CTC without cathartic preparation followed by colonoscopy. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. No subtraction of tagged feces was performed. Colonoscopy was performed 3-7 days after CTC. Three readers interpreted the CTC examinations separately and independently using a primary 2-dimensional approach using multiplanar reconstructions and 3-dimensional images for further characterization. Colonoscopy with segmental unblinding was used as reference standard. The sensitivity of CTC was calculated both on a per-polyp and a per-patient basis. For the latter, specificity, positive predictive values, and negative predictive values were also calculated. Results: CTC had an average sensitivity of 95.5% (95% confidence interval [CI], 92.1%99%) for the identification of colorectal polyps greater than or equal to8 mm. With regard to per-patient analysis, CTC yielded an average sensitivity of 89.9% (95% CI, 86%-93.7%), an average specificity of 92.2% (95% CI, 89.5%94.9%), an average positive predictive value of 88% (95% CI, 83.3%-91.5%), and an average negative predictive value of 93.5% (95% CI, 90.9%-96%). Interobserver agreement was high on a per-polyp basis (K statistic range, .61-.74) and high to excellent on a per-patient basis (K statistic range, .79-.91). Conclusions: Low-dose multidetector CTC without cathartic preparation compares favorably with colonoscopy for the detection of colorectal polyps.

    W B SAUNDERS CO, 2004年11月, GASTROENTEROLOGY, 127 (5), 1300 - 1311, 英語

    研究論文(学術雑誌)

  • T Kim, T Murakami, E Sugihara, M Hori, K Wakasa, H Nakamura

    OBJECTIVE. We reviewed the medical records including pathologic descriptions, CT images, MR images, and digital subtraction angiograms of three patients with hepatic lesions that were associated with abnormal development of the portal vein-patent ductus venosus or congenital absence of the portal vein-to clarify the imaging characteristics of these abnormalities. CONCLUSION. Two-phase helical CT and MRI, including MR angiography and dynamic studies, are useful for the diagnosis of patent ductus venosus and congenital absence of the portal vein. MRI may more effectively reveal hepatic lesions than two-phase helical CT under such abnormal conditions in which the liver has only the arterial but not the portal blood supply.

    AMER ROENTGEN RAY SOC, 2004年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 183 (5), 1333 - 1338, 英語

    [査読有り]

    研究論文(学術雑誌)

  • R Iannaccone, A Laghi, C Catalano, F Mangiapane, A Lamazza, A Schillaci, G Sinibaldi, T Murakami, P Sammartino, M Hori, F Piacentini, Nofroni, I, Stipa, V, R Passariello

    Aims: We prospectively compared the performance of low-dose multidetector computed tomographic colonography (CTC) without cathartic preparation with that of colonoscopy for the detection of colorectal polyps. Methods: A total of 203 patients underwent low-dose CTC without cathartic preparation followed by colonoscopy. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. No subtraction of tagged feces was performed. Colonoscopy was performed 3-7 days after CTC. Three readers interpreted the CTC examinations separately and independently using a primary 2-dimensional approach using multiplanar reconstructions and 3-dimensional images for further characterization. Colonoscopy with segmental unblinding was used as reference standard. The sensitivity of CTC was calculated both on a per-polyp and a per-patient basis. For the latter, specificity, positive predictive values, and negative predictive values were also calculated. Results: CTC had an average sensitivity of 95.5% (95% confidence interval [CI], 92.1%99%) for the identification of colorectal polyps greater than or equal to8 mm. With regard to per-patient analysis, CTC yielded an average sensitivity of 89.9% (95% CI, 86%-93.7%), an average specificity of 92.2% (95% CI, 89.5%94.9%), an average positive predictive value of 88% (95% CI, 83.3%-91.5%), and an average negative predictive value of 93.5% (95% CI, 90.9%-96%). Interobserver agreement was high on a per-polyp basis (K statistic range, .61-.74) and high to excellent on a per-patient basis (K statistic range, .79-.91). Conclusions: Low-dose multidetector CTC without cathartic preparation compares favorably with colonoscopy for the detection of colorectal polyps.

    W B SAUNDERS CO, 2004年11月, GASTROENTEROLOGY, 127 (5), 1300 - 1311, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Embolic effects of superabsorbent polymer microspheres in rabbit renal model: Comparison with tris-acryl gelatin microspheres and polyvinyl alcohol

    Azzam Anwar Khankan, Keigo Osuga, Shinichi Hori, Eiichi Morii, Takamichi Murakami, Hironobu Nakamura

    Purpose: We have developed a spherical embolic agent, superabsorbent polymer microspheres (SAP-MS). The aim of this study was to examine the embolic effects of SAP-MS in comparison with polyvinyl alcohol (PVA) particles and tris-acryl gelatin microsphere (Embosphere Microsphere EM) in a rabbit renal model. Materials and Methods: The right kidneys of nine rabbits were embolized with the given agents: PVA (180-300 μm) (n=3), EM (100-300 μm) (n=3), and SAP-MS (106-150 μm) (n=3). The embolized kidneys were evaluated by angiography and histology after one week. Results: Renal artery occlusion and prominent coagulative necrosis were confirmed regardless of agent. PVA aggregated in the proximal vessels with tiny fragments migrating into glomeruli. Both EM and SAP-MS traveled distally up to the interlobular artery level, and a single particle achieved cross-sectional vessel occlusion. SAP-MS was markedly swollen, deformed, and conformed to the vessel lumen compared with the constantly spherical EM. Mild perivascular reaction was seen with both microspheres. Conclusion: SAP-MS resulted in targeted end-organ infarction in the rabbit renal model and showed different mechanical properties from other agents.

    6, 2004年11月, Radiation Medicine - Medical Imaging and Radiation Oncology, 22 (6), 384 - 390, 英語

    [査読有り]

    研究論文(学術雑誌)

  • H Onishi, M Matsushita, T Murakami, T Tono, S Okamoto, Y Aoki, R Iannaccone, M Hori, T Kim, K Osuga, K Tomoda, R Passariello, H Nakamura

    Rationale and Objectives. The purpose of this study was to evaluate the utility of magnetic resonance (MR) imaging for indicating the extent of true tissue necrosis of the liver after radiofrequency (RF) ablation in comparison with histopathologic findings in dog models and an autopsy case. Materials and Methods. RF ablation of the liver parenchyma was performed on three dogs under general anesthesia. MR appearances of the RF-ablated regions on T1-weighted fast-low angle shot (FLASH; repetition time/echo time [TR/TE]/flip angle: 120/3.8/70), T2-weighted turbo spin echo (3000/80/echo train = 25) and contrast-enhanced T1-weighted images were compared with histopathologic findings. An autopsy case with hepatocellular carcinoma was also enrolled in this study. Results. All ablated regions showed three zones on T1-weighted FLASH images: a central zone with low intensity, a broad hyperintense middle zone, and a surrounding hypointense band. The central and middle zones corresponded to the degrees of coagulation necrosis observed during histopathologic examination, whereas no viable cells were seen in these zones during the microscopic examination using nicotinamide adenine dinucleotide diaphorase stain. The surrounding hypointense band corresponded to sinusoidal congestion in the acute phase and to fibrotic change in the subacute phase. Conclusion. MR imaging using the FLASH sequence can accurately determine the extent of the necrotic area after RF ablation.

    ASSOC UNIV RADIOLOGISTS, 2004年10月, ACADEMIC RADIOLOGY, 11 (10), 1180 - 1189, 英語

    研究論文(学術雑誌)

  • H Onishi, M Matsushita, T Murakami, T Tono, S Okamoto, Y Aoki, R Iannaccone, M Hori, T Kim, K Osuga, K Tomoda, R Passariello, H Nakamura

    Rationale and Objectives. The purpose of this study was to evaluate the utility of magnetic resonance (MR) imaging for indicating the extent of true tissue necrosis of the liver after radiofrequency (RF) ablation in comparison with histopathologic findings in dog models and an autopsy case. Materials and Methods. RF ablation of the liver parenchyma was performed on three dogs under general anesthesia. MR appearances of the RF-ablated regions on T1-weighted fast-low angle shot (FLASH; repetition time/echo time [TR/TE]/flip angle: 120/3.8/70), T2-weighted turbo spin echo (3000/80/echo train = 25) and contrast-enhanced T1-weighted images were compared with histopathologic findings. An autopsy case with hepatocellular carcinoma was also enrolled in this study. Results. All ablated regions showed three zones on T1-weighted FLASH images: a central zone with low intensity, a broad hyperintense middle zone, and a surrounding hypointense band. The central and middle zones corresponded to the degrees of coagulation necrosis observed during histopathologic examination, whereas no viable cells were seen in these zones during the microscopic examination using nicotinamide adenine dinucleotide diaphorase stain. The surrounding hypointense band corresponded to sinusoidal congestion in the acute phase and to fibrotic change in the subacute phase. Conclusion. MR imaging using the FLASH sequence can accurately determine the extent of the necrotic area after RF ablation.

    ASSOC UNIV RADIOLOGISTS, 2004年10月, ACADEMIC RADIOLOGY, 11 (10), 1180 - 1189, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Murakami, M Hori, T Kim, K Hashimoto, K Dono, S Hayashi, E Sugihara, H Nagano, S Sase, M Sakon, M Monden, H Nakamura

    Objective: The purpose of this study was to separately measure the arterial and portal venous tissue blood flow (TBF) of hepatocellular carcinoma (HCC) with a noninvasive method using xenon inhalation CT (xenon-CT) and to differentiate between well-differentiated HCCs and moderately and poorly differentiated HCCs. Materials and Methods: Total, arterial and portal venous TBFs of 38 surgically proven HCC nodules from 38 patients were measured by means of xenon-CT. Serial abdominal CT scans were obtained before and after inhalation of nonradioactive xenon gas. TBF was computed using the Fick principle, after which the correlation between TBF and pathologic features of the tumors was determined. Results: Total, arterial, and portal venous TBFs of HCC were 125.7 +/- 59.9 mL/min/100g, 102.5 +/- 37.3, and 22.2 +/- 11.4, respectively, and the corresponding findings for hepatic parenchyma were 67.3 +/- 13.1, 25.2 +/- 9.6, and 42.4 +/- 11.0. Total and arterial TBFs of HCC were significantly higher than those of the hepatic parenchyma (P < 0.01), whereas portal venous TBF of HCC was significantly lower than that of hepatic parenchyma (P < 0.01). Arterial TBF of moderately or poorly differentiated HCC (120.4 +/- 38.2) was significantly higher than that of well-differentiated HCC (60.4 +/- 43.5) (P < 0.01). Conclusions: Arterial and portal venous TBFs of HCC could be measured separately, noninvasively, and safely with xenon-CT. Correlation between TBF and pathologic features of tumors indicate that xenon-CT can be used to differentiate between well-differentiated HCCs and moderately and poorly differentiated HCCs.

    LIPPINCOTT WILLIAMS & WILKINS, 2004年04月, INVESTIGATIVE RADIOLOGY, 39 (4), 210 - 215, 英語

    研究論文(学術雑誌)

  • S Goshima, M Kanematsu, M Matsuo, T Murakami, M Hori, M Takamura, H Kondo, N Kako, N Moriyama, H Nakamura, H Hoshi

    The purpose of our study was to assess whether respiratory-triggered multishot fast spin echo (MS-FSE) and breath-hold half-Fourier single-shot fast spin echo (SS-FSE) images, in addition to breath-hold T-2*-weighted gradient recalled echo (GRE) images, increase observer performance in the detection of malignant hepatic tumors with ferumoxide-enhanced magnetic resonance (MR) imaging. Ferumoxide-enhanced MR images obtained from 48 patients with 83 malignant hepatic tumors were retrospectively reviewed by three independent off-site readers. In the first image review, GRE images alone were reviewed. Then, MS-FSE images were added for the first combination review. Finally, SS-FSE images were added for the second combination review. Observer performances were tested by McNemar's test and receiver-operating-characteristic analysis for the clustered data. Sensitivity for hepatocellular carcinomas, metastases, and malignant hepatic tumors overall was significantly (p < 0.05) higher with GRE and MS-FSE combined and GRE, MS-FSE and SS-FSE combined than with GRE alone. For metastases, the Az value was significantly (p < 0.05) higher with GRE and MS-FSE combined, and GRE, MS-FSE and SS-FSE combined than with GRE alone. We confirmed the incremental value of ferumoxide-enhanced MR imaging by obtaining MS-FSE and SS-FSE images in addition to GRE images in the detection of malignant hepatic tumors. (C) 2004 Elsevier Inc. All rights reserved.

    ELSEVIER SCIENCE INC, 2004年04月, MAGNETIC RESONANCE IMAGING, 22 (3), 379 - 388, 英語

    研究論文(学術雑誌)

  • T Murakami, M Hori, T Kim, K Hashimoto, K Dono, S Hayashi, E Sugihara, H Nagano, S Sase, M Sakon, M Monden, H Nakamura

    Objective: The purpose of this study was to separately measure the arterial and portal venous tissue blood flow (TBF) of hepatocellular carcinoma (HCC) with a noninvasive method using xenon inhalation CT (xenon-CT) and to differentiate between well-differentiated HCCs and moderately and poorly differentiated HCCs. Materials and Methods: Total, arterial and portal venous TBFs of 38 surgically proven HCC nodules from 38 patients were measured by means of xenon-CT. Serial abdominal CT scans were obtained before and after inhalation of nonradioactive xenon gas. TBF was computed using the Fick principle, after which the correlation between TBF and pathologic features of the tumors was determined. Results: Total, arterial, and portal venous TBFs of HCC were 125.7 +/- 59.9 mL/min/100g, 102.5 +/- 37.3, and 22.2 +/- 11.4, respectively, and the corresponding findings for hepatic parenchyma were 67.3 +/- 13.1, 25.2 +/- 9.6, and 42.4 +/- 11.0. Total and arterial TBFs of HCC were significantly higher than those of the hepatic parenchyma (P < 0.01), whereas portal venous TBF of HCC was significantly lower than that of hepatic parenchyma (P < 0.01). Arterial TBF of moderately or poorly differentiated HCC (120.4 +/- 38.2) was significantly higher than that of well-differentiated HCC (60.4 +/- 43.5) (P < 0.01). Conclusions: Arterial and portal venous TBFs of HCC could be measured separately, noninvasively, and safely with xenon-CT. Correlation between TBF and pathologic features of tumors indicate that xenon-CT can be used to differentiate between well-differentiated HCCs and moderately and poorly differentiated HCCs.

    LIPPINCOTT WILLIAMS & WILKINS, 2004年04月, INVESTIGATIVE RADIOLOGY, 39 (4), 210 - 215, 英語

    [査読有り]

    研究論文(学術雑誌)

  • S Goshima, M Kanematsu, M Matsuo, T Murakami, M Hori, M Takamura, H Kondo, N Kako, N Moriyama, H Nakamura, H Hoshi

    The purpose of our study was to assess whether respiratory-triggered multishot fast spin echo (MS-FSE) and breath-hold half-Fourier single-shot fast spin echo (SS-FSE) images, in addition to breath-hold T-2*-weighted gradient recalled echo (GRE) images, increase observer performance in the detection of malignant hepatic tumors with ferumoxide-enhanced magnetic resonance (MR) imaging. Ferumoxide-enhanced MR images obtained from 48 patients with 83 malignant hepatic tumors were retrospectively reviewed by three independent off-site readers. In the first image review, GRE images alone were reviewed. Then, MS-FSE images were added for the first combination review. Finally, SS-FSE images were added for the second combination review. Observer performances were tested by McNemar's test and receiver-operating-characteristic analysis for the clustered data. Sensitivity for hepatocellular carcinomas, metastases, and malignant hepatic tumors overall was significantly (p < 0.05) higher with GRE and MS-FSE combined and GRE, MS-FSE and SS-FSE combined than with GRE alone. For metastases, the Az value was significantly (p < 0.05) higher with GRE and MS-FSE combined, and GRE, MS-FSE and SS-FSE combined than with GRE alone. We confirmed the incremental value of ferumoxide-enhanced MR imaging by obtaining MS-FSE and SS-FSE images in addition to GRE images in the detection of malignant hepatic tumors. (C) 2004 Elsevier Inc. All rights reserved.

    ELSEVIER SCIENCE INC, 2004年04月, MAGNETIC RESONANCE IMAGING, 22 (3), 379 - 388, 英語

    [査読有り]

    研究論文(学術雑誌)

  • S Kobayashi, M Hori, K Dono, H Nagano, K Umeshita, S Nakamori, M Sakon, K Osuga, K Umetani, T Murakami, H Nakamura, M Monden

    Background/Aims: The aim of this study was to visualize hepatic microvessels (less than 100 mum in diameter) in vivo, which could not be visualized by conventional X-ray angiography, by using synchrotron radiation (ultra-bright and monochromatic X-ray). Methods: Five female Balb/c nu/nu mice were used. To investigate the hepatic microvessels under nearly physiologic conditions, we performed in vivo aortography under anesthesia with 370 mgI/ml nonionic iodine contrast medium using monochromatic 17-keV X-rays generated by a synchrotron. Images were captured with a pixel matrix size of 1024 x 1024 at a rate of 30 pictures/s. The field of view was 7 mm x 7 mm and thus the pixel size was approximately 7 mum. Captured images were evaluated both qualitatively and quantitatively. Results: Small hepatic arterial and portal venous branches of the liver were visualized separately during one sequential aortogram. The minimum diameter of the vessels observed was approximately 20 mum, and the vessels which ran parallel to the hepatic artery were observed and it seemed to be intrahepatic peribiliary arterial plexus. Conclusions: Our new experimental model would be useful for visualization of changes in the hepatic microcirculation under nearly physiologic conditions. (C) 2003 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

    ELSEVIER SCIENCE BV, 2004年03月, JOURNAL OF HEPATOLOGY, 40 (3), 405 - 408, 英語

    研究論文(学術雑誌)

  • S Kobayashi, M Hori, K Dono, H Nagano, K Umeshita, S Nakamori, M Sakon, K Osuga, K Umetani, T Murakami, H Nakamura, M Monden

    Background/Aims: The aim of this study was to visualize hepatic microvessels (less than 100 mum in diameter) in vivo, which could not be visualized by conventional X-ray angiography, by using synchrotron radiation (ultra-bright and monochromatic X-ray). Methods: Five female Balb/c nu/nu mice were used. To investigate the hepatic microvessels under nearly physiologic conditions, we performed in vivo aortography under anesthesia with 370 mgI/ml nonionic iodine contrast medium using monochromatic 17-keV X-rays generated by a synchrotron. Images were captured with a pixel matrix size of 1024 x 1024 at a rate of 30 pictures/s. The field of view was 7 mm x 7 mm and thus the pixel size was approximately 7 mum. Captured images were evaluated both qualitatively and quantitatively. Results: Small hepatic arterial and portal venous branches of the liver were visualized separately during one sequential aortogram. The minimum diameter of the vessels observed was approximately 20 mum, and the vessels which ran parallel to the hepatic artery were observed and it seemed to be intrahepatic peribiliary arterial plexus. Conclusions: Our new experimental model would be useful for visualization of changes in the hepatic microcirculation under nearly physiologic conditions. (C) 2003 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

    ELSEVIER SCIENCE BV, 2004年03月, JOURNAL OF HEPATOLOGY, 40 (3), 405 - 408, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Efficacy of multi-slice helical CT venography for the diagnosis of deep venous thrombosis: Comparison with venous sonography

    Tonsok Kim, Takamichi Murakami, Masatoshi Hori, Seishi Kumano, Masato Sakon, Hironobu Nakamura

    Objective: The purpose of this study was to assess the efficacy of contrast enhanced multislice helical CT (MSCT) venography for the diagnosis of deep venous thrombosis (DVT) in comparison with venous sonography. Materials and Methods: MSCT was used to obtain contiguous, 5-mm thick axial CT images from the diaphragm to the ankles of 27 patients after intravenous injection of contrast material. These patients were clinically suspected of having DVT. The same patients underwent venous sonography before CT examination. The detectability of DVT with MSCT venography was compared with that with venous sonography. Results: MSCT venography detected DVT in 21 patients, but venous sonography did so in only 17. MSCT venography detected DVT missed by venous sonography in five patients, while venous sonography detected DVT missed by MSCT venography in one patient. Conclusion: MSCT venography can be expected to make a valuable contribution to the diagnosis of DVT and to the prophylaxis of pulmonary embolism.

    2, 2004年03月, Radiation Medicine - Medical Imaging and Radiation Oncology, 22 (2), 77 - 81, 英語

    [査読有り]

    研究論文(学術雑誌)

  • S Takahashi, T Murakami, M Takamura, T Kim, M Hori, Y Narumi, H Nakamura

    Purpose: To evaluate the usefulness of half-dose contrast-enhanced magnetic resonance (MR) angiography for depicting the abdominal aorta and its major branches. Materials and Methods: A total of 72 consecutive patients were randomly assigned to one of four groups that underwent MR angiography after receiving different concentrations (original or diluted to 50%) and total amounts (single or half-dose) of gadolinium chelate injected at different rates (1 or 0.5 mL/second). The signal-to-noise ratio (SNR) and contrast-to-noise ratio, (CNR) of the abdominal aorta and of the common and external iliac arteries were calculated, and two blinded readers rated the respective image qualities. Results: The SNR and CNR of the abdominal aorta and the common iliac artery in the 0.5 mL/second groups were statistically significantly lower than those in the 1 mL/second groups. The differences in overall image quality across the four groups were not statistically significant. Conclusion: Half-dose MR angiography using diluted contrast medium injected at a rate of 1 mL/second depicted the abdominal aorta and its branches as clearly as using a full single dose.

    JOHN WILEY & SONS INC, 2004年02月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 19 (2), 194 - 201, 英語

    研究論文(学術雑誌)

  • S Takahashi, T Murakami, M Takamura, T Kim, M Hori, Y Narumi, H Nakamura

    Purpose: To evaluate the usefulness of half-dose contrast-enhanced magnetic resonance (MR) angiography for depicting the abdominal aorta and its major branches. Materials and Methods: A total of 72 consecutive patients were randomly assigned to one of four groups that underwent MR angiography after receiving different concentrations (original or diluted to 50%) and total amounts (single or half-dose) of gadolinium chelate injected at different rates (1 or 0.5 mL/second). The signal-to-noise ratio (SNR) and contrast-to-noise ratio, (CNR) of the abdominal aorta and of the common and external iliac arteries were calculated, and two blinded readers rated the respective image qualities. Results: The SNR and CNR of the abdominal aorta and the common iliac artery in the 0.5 mL/second groups were statistically significantly lower than those in the 1 mL/second groups. The differences in overall image quality across the four groups were not statistically significant. Conclusion: Half-dose MR angiography using diluted contrast medium injected at a rate of 1 mL/second depicted the abdominal aorta and its branches as clearly as using a full single dose.

    JOHN WILEY & SONS INC, 2004年02月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 19 (2), 194 - 201, 英語

    [査読有り]

    研究論文(学術雑誌)

  • S Takiguchi, M Sekimoto, Y Fujiwara, T Yasuda, M Yano, M Hod, T Murakami, H Nakamura, M Monden

    Background: Laparoscopic extended lymph node dissection for gastric cancer is difficult to perform because it requires dissection with preservation of vessels. Therefore, an intraoperative navigation system for the angioarchitecture would be helpful. Recent enhanced volume-rendering, computed tomography (CT) can produce clear intra:luminal three-dimensional (3D) images. This advanced radiological technology can provide 3D angiographic images reconstructed in the same view as would be observed from a laparoscope inserted into the abdominal cavity. We report our experience with laparoscopic gastrectomy with radical lymph node dissection using this advanced radiological technology. Methods: 3D CT angiographic images from the celiac axis to the proper hepatic artery were reconstructed in two ways preoperatively. The first was only 3D angiographic images that were reconstructed as the laparoscopic view (LapView 3D CT angiography). The second was LapView 3D CT angiography with images of the body of the pancreas, which was more useful for intraoperative navigation in comprehensing anatomy. Two monitors were placed over the shoulder of the patient during surgery. One monitor, which was controlled by the image mixer, projected the laparoscopic images with picture in picture of 3D CT angiographic images. The surgeon performed the surgery with reference to this monitor during lymph node dissection. Results: 3D angiographic CT clearly showed all vessels of interest in laparoscopic lymph node dissection for gastric cancer in 10 cases. The anatomy of vessels appeared as if looking beyond visible surface. LapView 3D CT angiography was useful for laparoscopic navigation surgery.

    SPRINGER-VERLAG, 2004年01月, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 18 (1), 106 - 110, 英語

    研究論文(学術雑誌)

  • T Sasaki, T Hasegawa, T Kimura, A Okada, T Murakami, T Sugiura, K Ohsuga

    Background: For giant gastric varices in association with portal hypertension, endoscopic treatment often is difficult. Although balloon-occluded retrograde transvenous obliteration (B-RTO) has been performed successfully in adult cirrhotic patients, there has been no report in pediatric patients. Methods: A 10-year-old girl with biliary atresia (BA) who had been free of jaundice after hepatic portoenterostomy was detected to have isolated gastric fundal varices by routine endoscopy. They gradually enlarged up to 4 cm in diameter, showing a tense appearance, so prophylactic treatment was conducted. Magnetic resonance angiography showed the blood flow of the varices mainly drained by a large gastrorenal shunt. A balloon catheter was introduced into the gastrorenal shunt via the femoral vein and was inflated to occlude the outflow of the varices. Five percent ethanolamine oleate was injected into the varices, and the outflow occlusion was kept for more than 30 minutes. Extensive thrombosis was achieved by an additional embolotherapy after 17 months. Throughout the course, the patient has been doing well without bleeding or worsening of the liver function tests. Conclusions: B-RTO for isolated gastric fundal varices has been performed safely in a pediatric patient and seems effective in reducing the variceal size and tension. (C) 2004 Elsevier Inc. All rights reserved.

    W B SAUNDERS CO, 2004年01月, JOURNAL OF PEDIATRIC SURGERY, 39 (1), 130 - 132, 英語

    研究論文(学術雑誌)

  • Detection of malignant hepatic tumors with ferumoxides-enhanced MRI: Comparison of five gradient-recalled echo sequences with different TEs

    M Matsuo, M Kanematsu, K Itoh, T Murakami, Y Maetani, H Kondo, S Goshima, N Kako, H Hoshi, J Konishi, N Moriyama, H Nakamura

    OBJECTIVE. The purpose of our study was to compare the detectability of malignant hepatic tumors on ferumoxides -enhanced MRI using five gradient-recalled echo sequences at different TEs. MATERIALS AND METHODS. Ferumoxides-enhanced MRIs obtained in 31 patients with 50 malignant hepatic tumors (33 hepatocellular carcinomas, 17 metastases) were reviewed retrospectively by three independent offsite radiologists. T1-weighted gradient-recalled echo images with TEs of 1.4 and 4.2 msec; T2*-weighted gradient-recalled echo images with TEs of 6, 8, and 10 msec; and T2-weighted fast spin-echo images of livers were randomly reviewed on a segment-by-segment basis. Observer performance was tested using the McNemar test and receiver operating characteristic analysis for the clustered data. Lesion-to-liver contrast-to-noise ratio was also assessed. RESULTS. Mean lesion-to-liver contrast-to-noise ratios were negative and lower with gradient-recalled echo at 1.4 msec than with the other sequences. Sensitivity was higher (P < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (75-83%) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (46-48%), and was higher (p < 0.05) with gradient-recalled echo sequence at 8 msec (83%) than with gradient-recalled echo at 6 msec and fast spin-echo sequences (75-78%). Specificity was comparably high with all sequences (95-98%). The area under the receiver operating characteristic curve (A,) was greater (p < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (A(Z) = 0.91-0.93) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (A(z) = 0.82-0.85). CONCLUSION. In the detection of malignant hepatic tumors, gradient-recalled echo sequences at 8 msec showed the highest sensitivity and had an Az value and lesion-to-liver contrast-to-noise ratio comparable with values from gradient-recalled echo sequences at 6 and 10 msec and fast spin-echo sequences.

    AMER ROENTGEN RAY SOC, 2004年01月, AMERICAN JOURNAL OF ROENTGENOLOGY, 182 (1), 235 - 242, 英語

    研究論文(学術雑誌)

  • M Matsuo, M Kanematsu, K Itoh, T Murakami, Y Maetani, H Kondo, S Goshima, N Kako, H Hoshi, J Konishi, N Moriyama, H Nakamura

    OBJECTIVE. The purpose of our study was to compare the detectability of malignant hepatic tumors on ferumoxides -enhanced MRI using five gradient-recalled echo sequences at different TEs. MATERIALS AND METHODS. Ferumoxides-enhanced MRIs obtained in 31 patients with 50 malignant hepatic tumors (33 hepatocellular carcinomas, 17 metastases) were reviewed retrospectively by three independent offsite radiologists. T1-weighted gradient-recalled echo images with TEs of 1.4 and 4.2 msec; T2*-weighted gradient-recalled echo images with TEs of 6, 8, and 10 msec; and T2-weighted fast spin-echo images of livers were randomly reviewed on a segment-by-segment basis. Observer performance was tested using the McNemar test and receiver operating characteristic analysis for the clustered data. Lesion-to-liver contrast-to-noise ratio was also assessed. RESULTS. Mean lesion-to-liver contrast-to-noise ratios were negative and lower with gradient-recalled echo at 1.4 msec than with the other sequences. Sensitivity was higher (P < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (75-83%) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (46-48%), and was higher (p < 0.05) with gradient-recalled echo sequence at 8 msec (83%) than with gradient-recalled echo at 6 msec and fast spin-echo sequences (75-78%). Specificity was comparably high with all sequences (95-98%). The area under the receiver operating characteristic curve (A,) was greater (p < 0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (A(Z) = 0.91-0.93) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (A(z) = 0.82-0.85). CONCLUSION. In the detection of malignant hepatic tumors, gradient-recalled echo sequences at 8 msec showed the highest sensitivity and had an Az value and lesion-to-liver contrast-to-noise ratio comparable with values from gradient-recalled echo sequences at 6 and 10 msec and fast spin-echo sequences.

    AMER ROENTGEN RAY SOC, 2004年01月, AMERICAN JOURNAL OF ROENTGENOLOGY, 182 (1), 235 - 242, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Sasaki, T Hasegawa, T Kimura, A Okada, T Murakami, T Sugiura, K Ohsuga

    Background: For giant gastric varices in association with portal hypertension, endoscopic treatment often is difficult. Although balloon-occluded retrograde transvenous obliteration (B-RTO) has been performed successfully in adult cirrhotic patients, there has been no report in pediatric patients. Methods: A 10-year-old girl with biliary atresia (BA) who had been free of jaundice after hepatic portoenterostomy was detected to have isolated gastric fundal varices by routine endoscopy. They gradually enlarged up to 4 cm in diameter, showing a tense appearance, so prophylactic treatment was conducted. Magnetic resonance angiography showed the blood flow of the varices mainly drained by a large gastrorenal shunt. A balloon catheter was introduced into the gastrorenal shunt via the femoral vein and was inflated to occlude the outflow of the varices. Five percent ethanolamine oleate was injected into the varices, and the outflow occlusion was kept for more than 30 minutes. Extensive thrombosis was achieved by an additional embolotherapy after 17 months. Throughout the course, the patient has been doing well without bleeding or worsening of the liver function tests. Conclusions: B-RTO for isolated gastric fundal varices has been performed safely in a pediatric patient and seems effective in reducing the variceal size and tension. (C) 2004 Elsevier Inc. All rights reserved.

    W B SAUNDERS CO, 2004年01月, JOURNAL OF PEDIATRIC SURGERY, 39 (1), 130 - 132, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 井上 隆弘, 村上 卓道

    2004年, 肝臓, 45 (9), 499 - 504

  • MRI造影剤Gd-EOB-DTPA/SH L 569Bシリンジ製剤の有用性に関する評価

    村上 卓道, 中村仁信

    2004年, 新薬と臨床, 53, 1162 - 1172

  • Embolic effects of superabsorbent polymer microspheres in rabbit renal model: comparison with tris-acryl gelatin microspheres and polyvinyl alcohol.

    Khankan AA, 村上 卓道

    2004年, Radiat Med, 2, 384 - 390

  • Efficacy of multi-slice helical CT venography for the diagnosis of deep venous thrombosis. Comparison with venous sonography.

    金 東石, 村上 卓道

    2004年, Radiat Med, 22, 77 - 81

  • M Hori, T Murakami, T Kim, K Tomoda, H Nakamura

    Computed tomography (CT) and magnetic resonance imaging (MRI) are useful for detection and characterization of liver tumors, and widely used in clinical practice. By using dynamic CT and MRI with extracellular contrast material or MRI with liver-specific contrast material, we can investigate the morphological, hemodynamical and functional nature of focal hepatic lesions. Tumors often show characteristic findings on CT and MRI. Thus, we can correctly establish a diagnosis of liver tumors based on those findings. In this article, we describe the role of CT scan and MRI in the differentiation of liver tumors as well as presenting some typical CT and MR images. Copyright (C) 2004 S. Karger AG, Basel.

    KARGER, 2004年, DIGESTIVE DISEASES, 22 (1), 39 - 55, 英語

    [査読有り]

  • T Murakami, M Hori, T Kim, S Kawata, H Abe, H Nakamura

    It is important to diagnose hepatocellular carcinoma (HCC) correctly and in early stage, because viral hepatitis and liver cirrhosis are often complicated by HCC. Non-contrast and enhanced CT and MRI are very useful to visualize and diagnose HCC objectively. Especially, CT and MR imaging with dynamic study is essential to diagnose HCC, because it is usually hypervascular. Dynamic CT and MR study also improve differential diagnosis in the characterization of the tumor. However, to perform useful dynamic study, it is necessary to use a CT unit which can make a helical scan, or a MR system with fast imaging technique available that can obtain more than 15 slices within a single breath hold. Tissue specific contrast medium, such as superparamagnetic iron oxide that is available only on MRI, is also useful for diagnosis of HCC. Copyright (C) 2004 S. Karger AG, Basel.

    KARGER, 2004年, INTERVIROLOGY, 47 (3-5), 209 - 226, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T. Hashimoto, H. Nakamura, S. Hori, K. Tomoda, T. Mitani, T. Murakami, T. Kozuka, M. Monden, K. Wakasa, M. Sakurai

    Two patients with mixed hepatocellular and cholangiocellular carcinoma underwent partial hepatectomy after magnetic resonance (MR) imaging. Correlation is made with the histopathologic manifestations. In both cases the tumors showed relative low signal intensities on T1-weighted spin-echo (SE) images and high signal intensities on T2-weighted SE images. Dynamic MR imaging showed the enhancement from the periphery of the tumor to the inner area gradually and the enhancement continued into the delayed phase. With both cases fibrosis was marked in the inner area of the tumor compared to the peripheral area. The extent and degree of fibrotic tissue is considered to reflect the enhancement on dynamic MR imaging. © 1994 Springer-Verlag New York Inc.

    Springer-Verlag, 2004年, Abdominal Imaging, 19 (5), 430 - 432, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Murakami, T Kim, M Hori, MP Federle

    RADIOLOGICAL SOC NORTH AMERICA, 2003年12月, RADIOLOGY, 229 (3), 931 - 932, 英語

  • J Masumoto, Y Sato, M Hori, T Murakami, T Johkoh, H Nakamura, S Tamura

    A similarity measure for nonrigid volume registration with known joint distribution of a targeted tissue is developed to process tissue slide at the boundaries between the targeted and non-targeted tissues. Pre-segmentation of the targeted tissue is unnecessary. This measure is applied to registering volumes acquired at different time-phases in dynamic CT scans of the liver using contrast materials and can be derived for the case where only the joint distribution of the targeted tissue is known. The similarity measure is formulated as a likelihood by introducing a concept termed 'exclusivity condition' and embedded into a cost function for nonrigid registration to be combined with the smoothness term. In addition, a practical method for estimating the joint distribution of the liver from unregistered clinical CT data is described. We demonstrate experimentally that tissue slide is effectively processed by this proposed measure using simulated dynamic CT data generated from a software phantom and clinical CT data of eight patients. (C) 2003 Elsevier B.V. All rights reserved.

    ELSEVIER SCIENCE BV, 2003年12月, MEDICAL IMAGE ANALYSIS, 7 (4), 553 - 564, 英語

    研究論文(学術雑誌)

  • J Masumoto, Y Sato, M Hori, T Murakami, T Johkoh, H Nakamura, S Tamura

    A similarity measure for nonrigid volume registration with known joint distribution of a targeted tissue is developed to process tissue slide at the boundaries between the targeted and non-targeted tissues. Pre-segmentation of the targeted tissue is unnecessary. This measure is applied to registering volumes acquired at different time-phases in dynamic CT scans of the liver using contrast materials and can be derived for the case where only the joint distribution of the targeted tissue is known. The similarity measure is formulated as a likelihood by introducing a concept termed 'exclusivity condition' and embedded into a cost function for nonrigid registration to be combined with the smoothness term. In addition, a practical method for estimating the joint distribution of the liver from unregistered clinical CT data is described. We demonstrate experimentally that tissue slide is effectively processed by this proposed measure using simulated dynamic CT data generated from a software phantom and clinical CT data of eight patients. (C) 2003 Elsevier B.V. All rights reserved.

    ELSEVIER SCIENCE BV, 2003年12月, MEDICAL IMAGE ANALYSIS, 7 (4), 553 - 564, 英語

    [査読有り]

    研究論文(学術雑誌)

  • J Masumoto, Y Sato, M Hori, T Murakami, T Johkoh, H Nakamura, S Tamura

    A similarity measure for nonrigid volume registration with known joint distribution of a targeted tissue is developed to process tissue slide at the boundaries between the targeted and non-targeted tissues. Pre-segmentation of the targeted tissue is unnecessary. This measure is applied to registering volumes acquired at different time-phases in dynamic CT scans of the liver using contrast materials and can be derived for the case where only the joint distribution of the targeted tissue is known. The similarity measure is formulated as a likelihood by introducing a concept termed 'exclusivity condition' and embedded into a cost function for nonrigid registration to be combined with the smoothness term. In addition, a practical method for estimating the joint distribution of the liver from unregistered clinical CT data is described. We demonstrate experimentally that tissue slide is effectively processed by this proposed measure using simulated dynamic CT data generated from a software phantom and clinical CT data of eight patients. (C) 2003 Elsevier B.V. All rights reserved.

    ELSEVIER SCIENCE BV, 2003年12月, MEDICAL IMAGE ANALYSIS, 7 (4), 553 - 564, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Murakami, T Kim, M Hori, MP Federle

    RADIOLOGICAL SOC NORTH AMERICA, 2003年12月, RADIOLOGY, 229 (3), 931 - 932, 英語

    [査読有り]

  • Dose investigation of superparamagnetic iron oxide (SPIO) SH U 555 A in liver MR imaging

    Hirohashi Shinji, Ichikawa Tomoaki, Tanimoto Akihiro, Isobe Yoshinori, Hachiya Junichi, Saito Kazuhiro, Isoda Hiroyoshi, Nishimura Hiroshi, Kuwatsuru Ryohei, Gokan Takehiko, Murakami Takamichi, Nakano Shigeyuki, Seriu Taku

    SH U 555 A, a new superparamagnetic iron oxide(SPIO)contrast agent for liver MR imaging, was investigated in terms of safety and efficacy. Eighty-four patients with suspected malignant liver tumor were randomly allocated to two groups: the L dose group (8 μmol Fe/kg) and H dose group (12 μmol Fe/kg). Efficacy was qualitatively evaluated through blinded reading of the MR images. Assessment of the images revealed no consistent differences between the L and H dose groups. During the 3- to 4-day observation period, a total of 16 adverse events were observed in 11 patients: 8 patients in the L dose group and 3 patients in the H dose group. Nasal bleeding occurred in 2 of these cases in the H dose group 2 and 4 days, respectively, after injection. Although patients in the H dose group showed a significantly larger transient decrease in Coagulation Factor XI at 4-6 hr post-injection (p. i.) than patients in the L dose group, analysis of covariance revealed an estimated 6.5% difference. There was no prolongation of APTT or change in Factor XI at 72-96 hr p. i. Because there were no clinically significant differences between the L and H doses, both were considered to be safe and effective.

    9, 2003年11月25日, Nippon Acta Radiologica, 63 (9), 539 - 550, 日本語

    [査読有り]

    研究論文(学術雑誌)

  • Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions

    S Kumano, T Murakami, T Kim, M Hori, A Okada, T Sugiura, Y Noguchi, S Kawata, K Tomoda, H Nakamura

    OBJECTIVE. We evaluated the ability of superparamagnetic iron oxide (SPIO)-enhanced MRI to differentiate solid metastatic tumors and nonsolid benign lesions by clarifying the characteristic signal-intensity pattern of each lesion on SPIO-enhanced T2-weighted and heavily T1-weighted gradient-echo images. MATERIALS AND METHODS. SPIO-enhanced MRI was performed using a 1.5-T system in 33 consecutive patients without cirrhosis who had 81 focal hepatic lesions (42 cysts, 13 hemangiomas, 26 metastatic tumors). The relative signal intensity of lesions on SPIO-enhanced heavily T1- and T2-weighted gradient-echo images was classified into one of the following three categories: high intensity, isointensity, or low intensity relative to the surrounding liver parenchyma. The diagnostic accuracy for differentiating solid metastatic tumors from nonsolid benign lesions (cysts or hemangiomas) was determined. RESULTS. A combination of the relative signal intensity of the lesion on T2- and heavily T1-weighted gradient-echo images could be classified into the following five categories: high intensity and high intensity (category 1), high intensity and isointensity (category 2), high intensity and low intensity (category 3), isointensity and isointensity (category 4), and isointensity and low intensity (category 5). According to these categories, category 1 contained two hemangiomas, category 2 had 11 hemangiomas, category 3 had 25 metastatic tumors and two cysts, category 4 had three cysts, and category 5 had 37 cysts and one metastatic tumor. When a tumor with a relative signal intensity of categories I or 2 was considered to be a hemangioma (category 3 metastatic tumors and categories 4 and 5 cysts), diagnostic accuracy for characterizing such hepatic lesions was 96% (78/81). CONCLUSION. When evaluating metastatic liver tumors on SPIO-enhanced MRI, we recommend that heavily T1- and T2-weighted gradient-echo images be obtained with our parameters to exclude hemangiomas or cysts.

    AMER ROENTGEN RAY SOC, 2003年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 181 (5), 1335 - 1339, 英語

    研究論文(学術雑誌)

  • S Kumano, T Murakami, T Kim, M Hori, A Okada, T Sugiura, Y Noguchi, S Kawata, K Tomoda, H Nakamura

    OBJECTIVE. We evaluated the ability of superparamagnetic iron oxide (SPIO)-enhanced MRI to differentiate solid metastatic tumors and nonsolid benign lesions by clarifying the characteristic signal-intensity pattern of each lesion on SPIO-enhanced T2-weighted and heavily T1-weighted gradient-echo images. MATERIALS AND METHODS. SPIO-enhanced MRI was performed using a 1.5-T system in 33 consecutive patients without cirrhosis who had 81 focal hepatic lesions (42 cysts, 13 hemangiomas, 26 metastatic tumors). The relative signal intensity of lesions on SPIO-enhanced heavily T1- and T2-weighted gradient-echo images was classified into one of the following three categories: high intensity, isointensity, or low intensity relative to the surrounding liver parenchyma. The diagnostic accuracy for differentiating solid metastatic tumors from nonsolid benign lesions (cysts or hemangiomas) was determined. RESULTS. A combination of the relative signal intensity of the lesion on T2- and heavily T1-weighted gradient-echo images could be classified into the following five categories: high intensity and high intensity (category 1), high intensity and isointensity (category 2), high intensity and low intensity (category 3), isointensity and isointensity (category 4), and isointensity and low intensity (category 5). According to these categories, category 1 contained two hemangiomas, category 2 had 11 hemangiomas, category 3 had 25 metastatic tumors and two cysts, category 4 had three cysts, and category 5 had 37 cysts and one metastatic tumor. When a tumor with a relative signal intensity of categories I or 2 was considered to be a hemangioma (category 3 metastatic tumors and categories 4 and 5 cysts), diagnostic accuracy for characterizing such hepatic lesions was 96% (78/81). CONCLUSION. When evaluating metastatic liver tumors on SPIO-enhanced MRI, we recommend that heavily T1- and T2-weighted gradient-echo images be obtained with our parameters to exclude hemangiomas or cysts.

    AMER ROENTGEN RAY SOC, 2003年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 181 (5), 1335 - 1339, 英語

    [査読有り]

    研究論文(学術雑誌)

  • [A case of successful treatment of advanced hepatocellular carcinoma with tumor thrombi in the major portal branches and inferior vena cava with combined intraarterial 5-fluorouracil, adriamycin and cisplatin therapy].

    Ota H, Nagano H, Sakon M, Yamamoto T, Nakamura M, Marubashi S, Miyamoto A, Dono K, Umeshita K, Nakamori S, Murakami T, Nakamura H, Monden M

    11, 2003年10月, Gan to kagaku ryoho. Cancer & chemotherapy, 30, 1673 - 1677

    [査読有り]

  • Abdominal applications of multislice CT

    Kim Tonsok, Murakami Takamichi, Nakamura Hironobu

    Multislice helical CT has made it possible to obtain thinner images with wider coverage at a higher speed in comparison with single-slice helical CT and has improved temporal and spatial resolution. The higher speed available with multislice CT has enabled double arterial phase imaging of the liver and both arterial and pancreatic phase imaging of the pancreas in a single breath-hold. Just as multislice CT has improved the diagnoses of hepatic tumors and pancreatic tumors, it has also improved the quality of three-dimensional imaging, such as multiplanar reformation and CT angiography, by its thinner images. CT angiography is replacing conventional angiography for presurgical evaluation.

    8, 2003年08月25日, Nippon Acta Radiologica, 63 (8), 369 - 377, 日本語

    [査読有り]

    研究論文(学術雑誌)

  • J Shimizu, H Oka, K Dono, M Sakon, M Takamura, T Murakami, S Hayashi, H Nagano, S Nakamori, K Umeshita, S Sase, M Gotoh, K Wakasa, H Nakamura, M Monden

    The aim of this study was to quantitatively measure tissue blood flow (TBF) in hepatocellular carcinoma (HCC) by a noninvasive method using xenon (Xe) inhalation/CT scans and to correlate the measured TBF with histological features. TBF was measured in HCC with xenon-enhanced CT (xenon/CT) in 20 patients. In 15 patients with HCC diagnosed as hypervascular tumors by conventional CT, TBF of the tumors was significantly higher than that of noncancerous liver tissue (151.1 +/- 20 vs 42.6 +/- 20 ml/min/100 g). Histologically, these tumors were diagnosed as moderately-to-poorly differentiated HCC. In contrast, in five patients with hypovascular HCC, TBF of HCC was almost comparable to that of the noncancerous regions (45.3 +/- 6 vs 48.3 +/- 6 ml/min/100 g). All these tumors were well-differentiated HCC. In conclusions, the measured values of TBF correlate with the clinicopathologic features of liver tumors and nontumorous liver tissue in patients with HCC.

    KLUWER ACADEMIC/PLENUM PUBL, 2003年08月, DIGESTIVE DISEASES AND SCIENCES, 48 (8), 1510 - 1516, 英語

    研究論文(学術雑誌)

  • T Murakami, T Kim, S Kawata, M Kanematsu, MP Federle, M Hori, A Okada, S Kumano, E Sugihara, K Tomoda, H Nakamura

    Purpose: We evaluated the optimal timing of arterial phase imaging for detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multi detector-row helical computed tomography. Materials and Methods: Forty-nine patients with 90 hypervascular hepatocellular carcinomas (3 to 50 mm in diameter; mean, 18.7 mm) under-went triple arterial phase imaging of the whole liver using a multidetector-row helical computed tomography. At 20 seconds, 30 seconds, and 40 seconds after intravenous administration of 100 mL of 300 mgI/mL of nonionic contrast medium at a rate of 4 mL/s, early, middle, and late arterial phase images were obtained serially during a single breath-hold with an interscan delay of 5 seconds. Detector-row configurations of 4 mm x 4, scan pitch of 5.5, and scan time of 5 seconds for each phase were used. Forty prospective reconstruction images of 5-mm thickness for each phase were obtained. The images from each phase were interpreted separately for detection of hypervascular hepatocellular carcinoma by 3 observers independently who were unaware of tumor burden in the liver. Sensitivity, positive predictive value, and area under the receiver operating characteristic curve values for each arterial phase were calculated and compared statistically. Results: The mean sensitivity and positive predictive values for hypervascular hepatocellular carcinoma diagnosis of blind readers were 37% and 87% for the early arterial phase, 73% and 85% for the middle arterial phase, and 49% and 81% for the late arterial phase, respectively. The middle arterial phase imaging showed significantly superior sensitivity compared with the early and late arterial phase for detecting hepatocellular carcinoma (P < 0.05). Mean area under the receiver operating characteristic curve value of the middle arterial phase imaging (0.84) was significantly higher that that of the early (0.56) or late arterial phase (0.62; P < 0.05). Conclusion: If a single arterial phase is used for diagnosis of hypervascular hepatocellular carcinoma, the middle phase (delay time of 30 seconds) is optimal.

    LIPPINCOTT WILLIAMS & WILKINS, 2003年08月, INVESTIGATIVE RADIOLOGY, 38 (8), 497 - 503, 英語

    研究論文(学術雑誌)

  • Jun Masumoto, Masatoshi Hori, Yoshinobu Sato, Takamichi Murakami, Takeshi Johkoh, Hironobu Nakamura, Shinichi Tamura

    With practical applications of multislice CT, high-speed imaging has drastically become possible in recent years as compared with the past and imaging the liver twice during the time a patient holds his breath once has become possible in liver CT imaging using contrast media. Thus, three-dimensional images of two time phases differing in the circulatory state of a contrast medium are obtainable without positional discrepancies. The authors propose an automated liver area extracting (segmenting) method using three-dimensional CT images of two time phases of a contrast medium for extracting the shape of the liver. This method first constructs a two-dimensional characteristic (feature) space having the CT values of time phases on each axis from the three-dimensional images of a two time phase portion imaged immediately after and 10-plus seconds after the infusion of a contrast medium. The method extracts areas showing changes in the contrast medium corresponding to the liver in this space and generates images with the liver region emphasized using these. The method then determines the liver region by performing opening and closing procedures on the liver area-emphasized images generated. Finally, it determines the liver region by a three-dimensional component connecting procedure using geometric shape characteristics of the blood vessels, tumors, and so on. The efficacy of using images of two time phases simultaneously has been verified by applying the proposed method to nine cases. © 2003 Wiley Periodicals, Inc.

    2003年08月, Systems and Computers in Japan, 34 (9), 71 - 82, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Murakami, T Kim, S Kawata, M Kanematsu, MP Federle, M Hori, A Okada, S Kumano, E Sugihara, K Tomoda, H Nakamura

    Purpose: We evaluated the optimal timing of arterial phase imaging for detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multi detector-row helical computed tomography. Materials and Methods: Forty-nine patients with 90 hypervascular hepatocellular carcinomas (3 to 50 mm in diameter; mean, 18.7 mm) under-went triple arterial phase imaging of the whole liver using a multidetector-row helical computed tomography. At 20 seconds, 30 seconds, and 40 seconds after intravenous administration of 100 mL of 300 mgI/mL of nonionic contrast medium at a rate of 4 mL/s, early, middle, and late arterial phase images were obtained serially during a single breath-hold with an interscan delay of 5 seconds. Detector-row configurations of 4 mm x 4, scan pitch of 5.5, and scan time of 5 seconds for each phase were used. Forty prospective reconstruction images of 5-mm thickness for each phase were obtained. The images from each phase were interpreted separately for detection of hypervascular hepatocellular carcinoma by 3 observers independently who were unaware of tumor burden in the liver. Sensitivity, positive predictive value, and area under the receiver operating characteristic curve values for each arterial phase were calculated and compared statistically. Results: The mean sensitivity and positive predictive values for hypervascular hepatocellular carcinoma diagnosis of blind readers were 37% and 87% for the early arterial phase, 73% and 85% for the middle arterial phase, and 49% and 81% for the late arterial phase, respectively. The middle arterial phase imaging showed significantly superior sensitivity compared with the early and late arterial phase for detecting hepatocellular carcinoma (P < 0.05). Mean area under the receiver operating characteristic curve value of the middle arterial phase imaging (0.84) was significantly higher that that of the early (0.56) or late arterial phase (0.62; P < 0.05). Conclusion: If a single arterial phase is used for diagnosis of hypervascular hepatocellular carcinoma, the middle phase (delay time of 30 seconds) is optimal.

    LIPPINCOTT WILLIAMS & WILKINS, 2003年08月, INVESTIGATIVE RADIOLOGY, 38 (8), 497 - 503, 英語

    [査読有り]

    研究論文(学術雑誌)

  • J Shimizu, H Oka, K Dono, M Sakon, M Takamura, T Murakami, S Hayashi, H Nagano, S Nakamori, K Umeshita, S Sase, M Gotoh, K Wakasa, H Nakamura, M Monden

    The aim of this study was to quantitatively measure tissue blood flow (TBF) in hepatocellular carcinoma (HCC) by a noninvasive method using xenon (Xe) inhalation/CT scans and to correlate the measured TBF with histological features. TBF was measured in HCC with xenon-enhanced CT (xenon/CT) in 20 patients. In 15 patients with HCC diagnosed as hypervascular tumors by conventional CT, TBF of the tumors was significantly higher than that of noncancerous liver tissue (151.1 +/- 20 vs 42.6 +/- 20 ml/min/100 g). Histologically, these tumors were diagnosed as moderately-to-poorly differentiated HCC. In contrast, in five patients with hypovascular HCC, TBF of HCC was almost comparable to that of the noncancerous regions (45.3 +/- 6 vs 48.3 +/- 6 ml/min/100 g). All these tumors were well-differentiated HCC. In conclusions, the measured values of TBF correlate with the clinicopathologic features of liver tumors and nontumorous liver tissue in patients with HCC.

    KLUWER ACADEMIC/PLENUM PUBL, 2003年08月, DIGESTIVE DISEASES AND SCIENCES, 48 (8), 1510 - 1516, 英語

    [査読有り]

    研究論文(学術雑誌)

  • AA Khankan, M Maeda, K Osuga, T Murakami, H Nakamura

    We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.

    SPRINGER-VERLAG, 2003年03月, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 26 (2), 186 - 188, 英語

    研究論文(学術雑誌)

  • E Sugihara, T Murakami, T Kim, M Hori, M Takamura, S Kawata, A Okada, AA Khankan, K Tomoda, H Nakamura

    Purpose: The technique of double-phase echo chemical shift gradient-echo magnetic resonance (MR) imaging with the fast low-angle shot sequence (double-echo FLASH) provides in-phase and opposed-phase (double-phase) images simultaneously. The purpose of this study was to assess whether the dynamic study with a combination of in-phase and opposed-phase (double-phase) echo images improves the detectability of hypervascular hepatocellular carcinoma (HCC) compared with that with either in-phase or opposed-phase images alone. Method: Thirty-seven patients with 107 hypervascular HCCs who underwent the whole-liver double-phase echo dynamic MR imaging were enrolled in the study. Three radiologists blindly read in-phase images alone, opposed-phase images alone, and then double-phase images together. Sensitivity and positive predictive values as well as the areas below the alternative-free response receiver operating characteristic curve (Az values) for each imaging technique were calculated and compared statistically. Results: The mean sensitivity, positive predictive values, and Az values for hypervascular HCCs were 51%, 77%, and 0.52 for in-phase imaging; 55%, 86%, and 0.58 for opposed-phase imaging; and 57%, 84%, and 0.63 for double-phase imaging, respectively. The mean sensitivity for opposed-phase imaging was significantly higher than that for in-phase imaging (P < 0.05), and the mean sensitivity for double-phase imaging was higher than that for in-phase imaging (P < 0.01). The mean Az value for the double-phase imaging was significantly higher than that for in-phase imaging (P < 0.01). Conclusion: Dynamic MR imaging with double-phase images was recommended for the detection of hypervascular HCC.

    LIPPINCOTT WILLIAMS & WILKINS, 2003年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 27 (2), 110 - 116, 英語

    研究論文(学術雑誌)

  • AA Khankan, M Maeda, K Osuga, T Murakami, H Nakamura

    We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.

    SPRINGER-VERLAG, 2003年03月, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 26 (2), 186 - 188, 英語

    [査読有り]

    研究論文(学術雑誌)

  • E Sugihara, T Murakami, T Kim, M Hori, M Takamura, S Kawata, A Okada, AA Khankan, K Tomoda, H Nakamura

    Purpose: The technique of double-phase echo chemical shift gradient-echo magnetic resonance (MR) imaging with the fast low-angle shot sequence (double-echo FLASH) provides in-phase and opposed-phase (double-phase) images simultaneously. The purpose of this study was to assess whether the dynamic study with a combination of in-phase and opposed-phase (double-phase) echo images improves the detectability of hypervascular hepatocellular carcinoma (HCC) compared with that with either in-phase or opposed-phase images alone. Method: Thirty-seven patients with 107 hypervascular HCCs who underwent the whole-liver double-phase echo dynamic MR imaging were enrolled in the study. Three radiologists blindly read in-phase images alone, opposed-phase images alone, and then double-phase images together. Sensitivity and positive predictive values as well as the areas below the alternative-free response receiver operating characteristic curve (Az values) for each imaging technique were calculated and compared statistically. Results: The mean sensitivity, positive predictive values, and Az values for hypervascular HCCs were 51%, 77%, and 0.52 for in-phase imaging; 55%, 86%, and 0.58 for opposed-phase imaging; and 57%, 84%, and 0.63 for double-phase imaging, respectively. The mean sensitivity for opposed-phase imaging was significantly higher than that for in-phase imaging (P < 0.05), and the mean sensitivity for double-phase imaging was higher than that for in-phase imaging (P < 0.01). The mean Az value for the double-phase imaging was significantly higher than that for in-phase imaging (P < 0.01). Conclusion: Dynamic MR imaging with double-phase images was recommended for the detection of hypervascular HCC.

    LIPPINCOTT WILLIAMS & WILKINS, 2003年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 27 (2), 110 - 116, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Esophageal varices: Diagnosis with gadolinium-enhanced MR imaging of the liver for patients with chronic liver damage

    M Matsuo, M Kanematsu, T Kim, M Hori, M Takamura, T Murakami, H Kondo, N Moriyama, H Nakamura, H Hoshi

    OBJECTIVE. The purpose of our study was to evaluate the value of gadolinium-enhanced MR imaging of the liver in the detection and grading of esophageal varices in patients with chronic liver damage. MATERIALS AND METHODS. Three independent off-site radiologists retrospectively reviewed MR images of the liver obtained in 72 patients with chronic liver damage, including 49 patients with untreated esophageal varices. All patients had undergone gastrointestinal endoscopy within 2 weeks of MR imaging. Both MR and endoscopic images were reviewed to determine whether esophageal varices were present and, if so, to determine the grade of the varices. Observer performances were tested with reciever operating characteristic curve analysis using the jackknife dispersion test. Correlations between the grades of the varices determined using MR images and those determined using endoscopic images were tested. RESULTS. Sensitivity for detection of esophageal varices was significantly (p < 0.01) higher for the combination of unenhanced and gadolinium-enhanced MR images (81%) than for the unenhanced MR images alone (51%). The receiver operating characteristic curve analysis (area under the curve, [A(z)]) showed that performance using the combination of the unenhanced and gadolinium-enhanced MR images (A(z) = 0.641) was superior to that using unenhanced MR images alone (A(z) = 0.586). A statistically significant positive correlation (p < 0.05) was found between the grades determined using MR imaging and the grades determined using endoscopy. CONCLUSION. Our results suggest the potential value of diagnosing the presence and grade of esophageal varices on MR imaging of the liver for patients with chronic liver damage. Gadolinium-enhanced MR imaging may increase the potential value.

    AMER ROENTGEN RAY SOC, 2003年02月, AMERICAN JOURNAL OF ROENTGENOLOGY, 180 (2), 461 - 466, 英語

    研究論文(学術雑誌)

  • Detection of hepatocellular carcinoma: Comparison of dynamic MR imaging with dynamic double arterial phase helical CT

    Y Noguchi, T Murakami, T Kim, M Hori, K Osuga, S Kawata, S Kumano, A Okada, T Sugiura, H Nakamura

    OBJECTIVE. Three-dimensional (313) Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and fat suppression developed for abdominal imaging, including MR angiography, can show enhanced areas clearly. The purpose of this study was to evaluate the efficacy of dynamic MR imaging with the pulse sequences for the detection of hypervascular hepatocellular carcinoma by comparing it with that of dynamic helical CT with double arterial phase imaging. SUBJECTS AND METHODS. Fifty-three patients with 103 hypervascular hepatocellular carcinoma nodules who underwent both dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and dynamic helical CT with double arterial phase imaging were enrolled in the study. For dynamic MR imaging, unenhanced, arterial, portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 sec, respectively, after injection of gadopentetate dimeglumine. Three observers independently interpreted the images obtained with each technique in a blinded manner and in random order. RESULTS. Mean sensitivity and positive predictive values of CT for hypervascular hepatocellular carcinoma (66% and 97%, respectively) were higher than those of MR imaging (63% and 96%, respectively), but there was no significant difference in detecting sensitivity among the observers (p < 0.05). CT and MR imaging were complementary, with some tumors undetected by CT but revealed on MR imaging. There was also no significant difference in A(z) values between CT (0.74) and MR imaging (0.71) (p < 0.05). CONCLUSION. Dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse is recommended to improve the detection of hypervascular hepatocellular carcinoma nodules in addition to the use of dynamic helical CT with double arterial phase imaging.

    AMER ROENTGEN RAY SOC, 2003年02月, AMERICAN JOURNAL OF ROENTGENOLOGY, 180 (2), 455 - 460, 英語

    研究論文(学術雑誌)

  • Y Noguchi, T Murakami, T Kim, M Hori, K Osuga, S Kawata, S Kumano, A Okada, T Sugiura, H Nakamura

    OBJECTIVE. Three-dimensional (313) Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and fat suppression developed for abdominal imaging, including MR angiography, can show enhanced areas clearly. The purpose of this study was to evaluate the efficacy of dynamic MR imaging with the pulse sequences for the detection of hypervascular hepatocellular carcinoma by comparing it with that of dynamic helical CT with double arterial phase imaging. SUBJECTS AND METHODS. Fifty-three patients with 103 hypervascular hepatocellular carcinoma nodules who underwent both dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and dynamic helical CT with double arterial phase imaging were enrolled in the study. For dynamic MR imaging, unenhanced, arterial, portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 sec, respectively, after injection of gadopentetate dimeglumine. Three observers independently interpreted the images obtained with each technique in a blinded manner and in random order. RESULTS. Mean sensitivity and positive predictive values of CT for hypervascular hepatocellular carcinoma (66% and 97%, respectively) were higher than those of MR imaging (63% and 96%, respectively), but there was no significant difference in detecting sensitivity among the observers (p < 0.05). CT and MR imaging were complementary, with some tumors undetected by CT but revealed on MR imaging. There was also no significant difference in A(z) values between CT (0.74) and MR imaging (0.71) (p < 0.05). CONCLUSION. Dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse is recommended to improve the detection of hypervascular hepatocellular carcinoma nodules in addition to the use of dynamic helical CT with double arterial phase imaging.

    AMER ROENTGEN RAY SOC, 2003年02月, AMERICAN JOURNAL OF ROENTGENOLOGY, 180 (2), 455 - 460, 英語

    [査読有り]

  • M Matsuo, M Kanematsu, T Kim, M Hori, M Takamura, T Murakami, H Kondo, N Moriyama, H Nakamura, H Hoshi

    OBJECTIVE. The purpose of our study was to evaluate the value of gadolinium-enhanced MR imaging of the liver in the detection and grading of esophageal varices in patients with chronic liver damage. MATERIALS AND METHODS. Three independent off-site radiologists retrospectively reviewed MR images of the liver obtained in 72 patients with chronic liver damage, including 49 patients with untreated esophageal varices. All patients had undergone gastrointestinal endoscopy within 2 weeks of MR imaging. Both MR and endoscopic images were reviewed to determine whether esophageal varices were present and, if so, to determine the grade of the varices. Observer performances were tested with reciever operating characteristic curve analysis using the jackknife dispersion test. Correlations between the grades of the varices determined using MR images and those determined using endoscopic images were tested. RESULTS. Sensitivity for detection of esophageal varices was significantly (p < 0.01) higher for the combination of unenhanced and gadolinium-enhanced MR images (81%) than for the unenhanced MR images alone (51%). The receiver operating characteristic curve analysis (area under the curve, [A(z)]) showed that performance using the combination of the unenhanced and gadolinium-enhanced MR images (A(z) = 0.641) was superior to that using unenhanced MR images alone (A(z) = 0.586). A statistically significant positive correlation (p < 0.05) was found between the grades determined using MR imaging and the grades determined using endoscopy. CONCLUSION. Our results suggest the potential value of diagnosing the presence and grade of esophageal varices on MR imaging of the liver for patients with chronic liver damage. Gadolinium-enhanced MR imaging may increase the potential value.

    AMER ROENTGEN RAY SOC, 2003年02月, AMERICAN JOURNAL OF ROENTGENOLOGY, 180 (2), 461 - 466, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 非剛体レジストレーションを適用した多時相腹部造影CT画像からの肝臓領域自動抽出法

    桝本潤, 村上 卓道

    2003年, コンピュータ支援画像診断学会論文誌, 7, 1 - 10

  • 5-FU,CDDP,Adriamycinの3剤併用動注療法によりCRが得られた進行肝細胞癌(Vp4,Vv3,IM3)の1例

    太田英夫, 村上 卓道

    2003年, 癌と化学療法, 30, 1673 - 1677

  • 超常磁性体酸化鉄製剤SH U 555AのMRI肝臓造影における用量検討

    廣橋伸治, 村上 卓道

    2003年, 日本医放会誌, 63, 539 - 550

  • Yumi Noguchi, Takamichi Murakami, Tonsok Kim, Masatoshi Hori, Keigo Osuga, Syuji Kawata, Atsuya Okada, Takashi Sugiura, Kaname Tomoda, Yoshifumi Narumi, Hironobu Nakamura

    Purpose: The technique of double-echo chemical shift gradient echo magnetic resonance imaging (MRI) with the fast low-angle shot (double-echo FLASH) sequence provides in-phase and opposed-phase images in a single breath hold. The purpose of this study was to evaluate the efficacy of dynamic MRI with double-echo FLASH imaging for the detection of hypervascular hepatocellular carcinoma by comparing it with dynamic helical computed tomography (CT) imaging with double arterial phase. Materials and Methods: Twenty-nine patients with 67 hypervascular hepatocellular carcinoma nodules who underwent both dynamic MRI with double-echo FLASH imaging (repetition time/echo time/flip angle: 160/3.6, 7.0/80c) and dynamic helical CT imaging with double arterial phase were enrolled in the study. For dynamic MRI, precontrast, arterial, portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 seconds, respectively, after intravenous injection of 0.1 mmol/kg of gadopentetate dimeglumine at a rate of 2 ml/s. For dynamic CT imaging, quadraphase images, including early arterial, late arterial, portal venous, and equilibrium phases, were obtained serially approximately 20, 30, 70, and 180 seconds, respectively, after intravenous administration of 2 ml/kg of 300 mgI/ml of nonionic contrast medium at a rate of 5 ml/s. Three masked observers independently interpreted images obtained with each technique in random order, separately and without patient identifiers. Sensitivity and positive predictive values as well as the area below the alternative-free response receiver operating characteristic curve (Az) for each imaging technique were calculated and compared statistically. Results: Mean sensitivity and positive predictive values of MRI for hypervascular hepatocellular carcinoma were 48% and 94%, respectively, and those of CT imaging were 47% and 91%, respectively. In 11 (38%) of the 29 patients, at least one observer judged dynamic MRI to be superior, whereas in 5 patients (17%), dynamic CT was judged to be superior. There was no significant difference in the sensitivity and positive predictive values between these techniques (p > 0.05). There was no significant difference either in mean Az values between CT (0.55) and MRI (0.57) (p = 0.61). Conclusion: Dynamic MRI with double-echo FLASH imaging can detect hypervascular hepatocellular carcinoma as well as dynamic helical CT imaging with double arterial phase.

    2002年11月, Journal of Computer Assisted Tomography, 26 (6), 981 - 987, 英語

    研究論文(学術雑誌)

  • Embolization of high flow arteriovenous malformations: Experience with use of superabsorbent polymer microspheres

    K Osuga, S Hori, H Kitayoshi, AA Khankan, A Okada, T Sugiura, T Murakami, K Hosokawa, H Nakamura

    PURPOSE: To determine efficacy, safety, and requirements for adjunctive embolization or surgery in the treatment of symptomatic arteriovenous malformations (AVMs) with superabsorbent polymer microsphere (SAP-MS) particles. MATERIALS AND METHODS: SAP-MS particles (sodium acrylate and vinyl alcohol copolymer) are nonbiodegradable spheres with a precisely calibrated diameter. SAP-MS particles swell by absorbing fluids and become soft and deformable. Twenty-five patients (16 men, nine women; mean age, 32 y; range 12-66 y) with symptomatic facial (n = 5), upper- (n = 8) and lower- (n = 12) extremity AVMs were treated primarily (n = 23) or preoperatively (n = 2) by transarterial embolization (TAE) treatment with use of SAP-MS particles. Direct puncture embolization (DPE; n = 4) and/or surgical intervention (n = 5; ie, skin graft, resection, or amputation) were required. Surgical specimens from the resected (n = 2) and the amputated (n = 2) patients were evaluated histologically. Follow-up study, including clinical findings and imaging studies, was performed at intervals ranging from 3 months to 1 year. Clinical outcome was evaluated retrospectively, depending on the subjective improvement of symptoms and signs, according to the medical records. RESULTS: Seventy-two TAEs (range, 1-11; mean, 2.8) and 12 DPEs (range, 1-3; mean, 2.4) were performed during the mean follow-up period of 38 months (range, 7-110 mo). Twenty patients (80%) experienced symptom improvement by embolotherapy alone (n = 17) or in combination with surgery (n = 3). One lip and two finger AVMs were totally removed by surgical excision or amputation after TAE treatment. In diffuse upper- (n = 1) and lower- (n = 1) extremity AVMs, the symptoms were uncontrolled. No nerve injury or skin necrosis was observed after TAE treatment with SAP-MS particles. Mucosal necrosis was induced by DPE with ethanol in one patient. Histologically, SAP-MS particles penetrated intralesional vessels and conformed to the vessel lumen, resulting in tight vessel occlusion. Minimal perivascular reaction was observed. CONCLUSION: SAP-MS particles were used safely in TAE treatment of AVM. TAE treatment with use of SAP-MS particles was suitable for certain symptomatic AVMs, but diffuse AVMs remain a challenge and a combination of alternative methods will be necessary for further strategy.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年11月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (11), 1125 - 1133, 英語

    研究論文(学術雑誌)

  • Embolization of high flow arteriovenous malformations: Experience with use of superabsorbent polymer microspheres

    K Osuga, S Hori, H Kitayoshi, AA Khankan, A Okada, T Sugiura, T Murakami, K Hosokawa, H Nakamura

    PURPOSE: To determine efficacy, safety, and requirements for adjunctive embolization or surgery in the treatment of symptomatic arteriovenous malformations (AVMs) with superabsorbent polymer microsphere (SAP-MS) particles. MATERIALS AND METHODS: SAP-MS particles (sodium acrylate and vinyl alcohol copolymer) are nonbiodegradable spheres with a precisely calibrated diameter. SAP-MS particles swell by absorbing fluids and become soft and deformable. Twenty-five patients (16 men, nine women; mean age, 32 y; range 12-66 y) with symptomatic facial (n = 5), upper- (n = 8) and lower- (n = 12) extremity AVMs were treated primarily (n = 23) or preoperatively (n = 2) by transarterial embolization (TAE) treatment with use of SAP-MS particles. Direct puncture embolization (DPE; n = 4) and/or surgical intervention (n = 5; ie, skin graft, resection, or amputation) were required. Surgical specimens from the resected (n = 2) and the amputated (n = 2) patients were evaluated histologically. Follow-up study, including clinical findings and imaging studies, was performed at intervals ranging from 3 months to 1 year. Clinical outcome was evaluated retrospectively, depending on the subjective improvement of symptoms and signs, according to the medical records. RESULTS: Seventy-two TAEs (range, 1-11; mean, 2.8) and 12 DPEs (range, 1-3; mean, 2.4) were performed during the mean follow-up period of 38 months (range, 7-110 mo). Twenty patients (80%) experienced symptom improvement by embolotherapy alone (n = 17) or in combination with surgery (n = 3). One lip and two finger AVMs were totally removed by surgical excision or amputation after TAE treatment. In diffuse upper- (n = 1) and lower- (n = 1) extremity AVMs, the symptoms were uncontrolled. No nerve injury or skin necrosis was observed after TAE treatment with SAP-MS particles. Mucosal necrosis was induced by DPE with ethanol in one patient. Histologically, SAP-MS particles penetrated intralesional vessels and conformed to the vessel lumen, resulting in tight vessel occlusion. Minimal perivascular reaction was observed. CONCLUSION: SAP-MS particles were used safely in TAE treatment of AVM. TAE treatment with use of SAP-MS particles was suitable for certain symptomatic AVMs, but diffuse AVMs remain a challenge and a combination of alternative methods will be necessary for further strategy.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年11月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (11), 1125 - 1133, 英語

    [査読有り]

    研究論文(学術雑誌)

  • [A case of postoperative multiple hepatic metastasis from gastric cancer successfully treated by percutaneous microwave coagulation therapy and hepatic arterial infusion chemotherapy].

    Yamamoto T, Nagano H, Sakon M, Yasuda T, Takemoto H, Tsujino T, Ota H, Dono K, Umeshita K, Nakamori S, Yano M, Osuga K, Murakami T, Nakamura H, Monden M

    12, 2002年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 29, 2429 - 2432

    [査読有り]

  • Y Noguchi, T Murakami, T Kim, M Hori, K Osuga, S Kawata, A Okada, T Sugiura, K Tomoda, Y Narumi, H Nakamura

    Purpose: The technique of double-echo chemical shift gradient echo magnetic resonance imaging (MRI) With the fast low-angle shot (double-echo FLASH) sequence provides in-phase and opposed-phase images in a single breath hold. The purpose of this study was to evaluate the efficacy of dynamic MRI with double-echo FLASH imaging for the detection of hypervascular hepatocellular carcinoma by comparing it With dynamic helical computed tomography (CT) imaging With double arterial phase. Materials and Methods: Twenty-nine patients with 67 hypervascular hepatocellular carcinoma nodules Who underwent both dynamic MRI with double-echo FLASH imaging (repetition time/echo time/flip angle: 160/3.6, 7.0/80degrees) and dynamic helical CT imaging with double arterial phase were enrolled in the study. For dynamic MRI, precontrast, arterial. portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 seconds, respectively, after intravenous injection of 0.1 mmol/kg of gadopentetate dimeglumine at a rate of 2 ml/s. For dynamic CT imaging, quadraphase images, including early arterial, late arterial, portal venous, and equilibrium phases, were obtained serially approximately 20, 30, 70, and 180 seconds, respectively, after intravenous administration of 2 ml/kg of 300 mgl/ml of nonionic contrast medium at a rate of 5 ml/s. Three masked observers independently interpreted images obtained With each technique in random order, separately and without patient identifiers. Sensitivity and positive predictive values as well as the area below the alternative-free response receiver operating characteristic curve (Az) for each imaging technique were calculated and compared statistically. Results: Mean sensitivity and positive predictive values of MRI for hypervascular hepatocellular carcinoma Were 48% and 94%, respectively, and those of CT imaging were 47% and 91%, respectively. In 11 (38%) of the 29 patients, at least one observer judged dynamic MRI to be superior, whereas in 5 patients (17%), dynamic CT was judged to be superior. There was no significant difference in the sensitivity and positive predictive values between these techniques (p > 0.05). There was no significant difference either in mean Az values between CT (0.55) and MRI (0.57) (p = 0.61). Conclusion: Dynamic MRI with double-echo FLASH imaging can detect hypervascular hepatocellular carcinoma as well as dynamic helical CT imaging with double arterial phase.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 26 (6), 981 - 987, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M Hori, T Murakami, T Kim, K Tsuda, S Takahashi, A Okada, M Takamura, H Nakamura

    Purpose: The purpose of this study was to compare the diagnostic performance of superparamagnetic iron oxide (SPIO)-enhanced MRI for the detection of hypervascular hepatocellular carcinoma (HCC) with dynamic helical CT. Methods: SPIO-enhanced MR and dynamic helical CT images obtained from 41 patients with 52 hypervascular HCCs (5-130 mm; mean, 27 mm) were retrospectively analyzed. MRI were obtained with 1.5 T scanners using T2-weighted and proton density-weighted spin-echo (or fast spin-echo) sequences for all cases and a T2*-weighted gradient echo sequence for 36 cases. Four blinded observers reviewed images independently. Diagnostic accuracy was evaluated using alternative-free response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values (PPV) were also evaluated. Results: The areas under the AFROC curves for each observer were greater for MR than for CT (means, 0.81 and 0.76; p < 0.05). The mean sensitivities for MR and CT were 0.75 and 0.71, respectively (p = 0.13). The mean PPVs were 0.83 and 0.79 (p = 0.21). Conclusion: SPIO-enhanced MRI showed slightly better diagnostic performance than dynamic helical CT for the detection of hypervascular HCCs.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年09月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 26 (5), 701 - 710, 英語

    研究論文(学術雑誌)

  • Transarterial embolization for large hepatocellular carcinoma with use of superabsorbent polymer microspheres: Initial experience

    K Osuga, AA Khankan, S Hori, A Okada, T Sugiura, M Maeda, H Nagano, A Yamada, T Murakami, H Nakamura

    The authors report the initial experience with transarterial embolization of large hepatocellular carcinoma (HCC) with use of superabsorbent polymer microsphere (SAP-MS) particles. Six patients with nine HCCs (mean diameter, 8.2 cm) underwent 10 embolization procedures. Two patients underwent surgery later. In follow-up, tumor necrosis, postembolization syndrome, and laboratory data were assessed. Complete necrosis in three nodules, nearly complete necrosis in three nodules, and partial necrosis in three nodules were observed. Histologically, SAP-MS occluded intratumoral vessels tightly without ischemic damage of normal hepatic tissue. Postprocedural pain was minimal. No deterioration of liver function occurred. Our initial experience suggests that embolization with use of SAP-MS leads to extensive tumor necrosis of large nodular HCC, sparing use of chemotherapeutic agents.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年09月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (9), 929 - 934, 英語

    研究論文(学術雑誌)

  • Transarterial embolization for large hepatocellular carcinoma with use of superabsorbent polymer microspheres: Initial experience

    K Osuga, AA Khankan, S Hori, A Okada, T Sugiura, M Maeda, H Nagano, A Yamada, T Murakami, H Nakamura

    The authors report the initial experience with transarterial embolization of large hepatocellular carcinoma (HCC) with use of superabsorbent polymer microsphere (SAP-MS) particles. Six patients with nine HCCs (mean diameter, 8.2 cm) underwent 10 embolization procedures. Two patients underwent surgery later. In follow-up, tumor necrosis, postembolization syndrome, and laboratory data were assessed. Complete necrosis in three nodules, nearly complete necrosis in three nodules, and partial necrosis in three nodules were observed. Histologically, SAP-MS occluded intratumoral vessels tightly without ischemic damage of normal hepatic tissue. Postprocedural pain was minimal. No deterioration of liver function occurred. Our initial experience suggests that embolization with use of SAP-MS leads to extensive tumor necrosis of large nodular HCC, sparing use of chemotherapeutic agents.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年09月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (9), 929 - 934, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M Hori, T Murakami, T Kim, K Tsuda, S Takahashi, A Okada, M Takamura, H Nakamura

    Purpose: The purpose of this study was to compare the diagnostic performance of superparamagnetic iron oxide (SPIO)-enhanced MRI for the detection of hypervascular hepatocellular carcinoma (HCC) with dynamic helical CT. Methods: SPIO-enhanced MR and dynamic helical CT images obtained from 41 patients with 52 hypervascular HCCs (5-130 mm; mean, 27 mm) were retrospectively analyzed. MRI were obtained with 1.5 T scanners using T2-weighted and proton density-weighted spin-echo (or fast spin-echo) sequences for all cases and a T2*-weighted gradient echo sequence for 36 cases. Four blinded observers reviewed images independently. Diagnostic accuracy was evaluated using alternative-free response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values (PPV) were also evaluated. Results: The areas under the AFROC curves for each observer were greater for MR than for CT (means, 0.81 and 0.76; p < 0.05). The mean sensitivities for MR and CT were 0.75 and 0.71, respectively (p = 0.13). The mean PPVs were 0.83 and 0.79 (p = 0.21). Conclusion: SPIO-enhanced MRI showed slightly better diagnostic performance than dynamic helical CT for the detection of hypervascular HCCs.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年09月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 26 (5), 701 - 710, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Multidetector CT: Diagnostic impact of slice thickness on detection of hypervascular hepatocellular carcinoma

    S Kawata, T Murakami, T Kim, M Hori, MP Federle, S Kumano, E Sugihara, S Makino, H Nakamura, M Kudo

    OBJECTIVE. The objective of our study was to evaluate the diagnostic impact of varying slice thickness on multidetector CT to optimize detection of hypervascular hepatocellular carcinoma. MATERIALS AND METHODS. Forty-three patients with 87 hypervascular hepatocellular carcinomas (diameter: range, 3-80 mm; mean, 22 mm) and 19 patients with either chronic hepatitis or liver cirrhosis and without hepatocellular carcinoma who had undergone early arterial and late arterial phase imaging of the entire liver on multidetector CT were retrospectively enrolled in this study. The detector row configuration was 2.5 x 4 mm, the pitch was 6, and the scanning time was 10.5 sec for each phase. All patients received contrast medium (2 mL/kg of body weight) at a rate of 5 mL/sec; the mean scanning delay for the early arterial phase was 19.0 sec, and the mean delay for the late arterial phase was 34.5 sec. Eighty 2.5-mm-thick reconstruction images, forty 5-mm-thick reconstruction images, and twenty-six 7.5-mm-thick reconstruction images were obtained for each phase. Each image set was interpreted separately by three observers to detect hypervascular hepatocellular carcinoma by viewing images on a workstation monitor. Sensitivity, positive predictive value, and area under the receiver operating characteristic curve (A(z)) were calculated. We used retrospectively excellent follow-up and imaging or pathologic proof as the gold standard. RESULTS. The mean sensitivity and positive predictive value for hypervascular hepatocellular carcinoma were 76% and 69% on 2.5-mm images, 73% and 69% on 5-mm, images, and 67% and 76% on 7.5-mm images, respectively. No significant difference in sensitivity among the images was detected, except by one observer who reported a significant difference in the sensitivity between 2.5- and 7.5-mm images (p < 0.05) and between 5- and 7.5-mm images (p < 0.05). The mean A(z) values were 0.79, 0.80, and 0.78 for 2.5-, 5-, and 7.5-mm images, respectively. No significant difference in A(z) values among the images obtained with different slice thicknesses was detected. CONCLUSION. For multidetector CT identification of hypervascular hepatocellular carcinoma, we found little or no advantage in reducing slice thickness to less than 5 mm.

    AMER ROENTGEN RAY SOC, 2002年07月, AMERICAN JOURNAL OF ROENTGENOLOGY, 179 (1), 61 - 66, 英語

    研究論文(学術雑誌)

  • S Kawata, T Murakami, T Kim, M Hori, MP Federle, S Kumano, E Sugihara, S Makino, H Nakamura, M Kudo

    OBJECTIVE. The objective of our study was to evaluate the diagnostic impact of varying slice thickness on multidetector CT to optimize detection of hypervascular hepatocellular carcinoma. MATERIALS AND METHODS. Forty-three patients with 87 hypervascular hepatocellular carcinomas (diameter: range, 3-80 mm; mean, 22 mm) and 19 patients with either chronic hepatitis or liver cirrhosis and without hepatocellular carcinoma who had undergone early arterial and late arterial phase imaging of the entire liver on multidetector CT were retrospectively enrolled in this study. The detector row configuration was 2.5 x 4 mm, the pitch was 6, and the scanning time was 10.5 sec for each phase. All patients received contrast medium (2 mL/kg of body weight) at a rate of 5 mL/sec; the mean scanning delay for the early arterial phase was 19.0 sec, and the mean delay for the late arterial phase was 34.5 sec. Eighty 2.5-mm-thick reconstruction images, forty 5-mm-thick reconstruction images, and twenty-six 7.5-mm-thick reconstruction images were obtained for each phase. Each image set was interpreted separately by three observers to detect hypervascular hepatocellular carcinoma by viewing images on a workstation monitor. Sensitivity, positive predictive value, and area under the receiver operating characteristic curve (A(z)) were calculated. We used retrospectively excellent follow-up and imaging or pathologic proof as the gold standard. RESULTS. The mean sensitivity and positive predictive value for hypervascular hepatocellular carcinoma were 76% and 69% on 2.5-mm images, 73% and 69% on 5-mm, images, and 67% and 76% on 7.5-mm images, respectively. No significant difference in sensitivity among the images was detected, except by one observer who reported a significant difference in the sensitivity between 2.5- and 7.5-mm images (p < 0.05) and between 5- and 7.5-mm images (p < 0.05). The mean A(z) values were 0.79, 0.80, and 0.78 for 2.5-, 5-, and 7.5-mm images, respectively. No significant difference in A(z) values among the images obtained with different slice thicknesses was detected. CONCLUSION. For multidetector CT identification of hypervascular hepatocellular carcinoma, we found little or no advantage in reducing slice thickness to less than 5 mm.

    AMER ROENTGEN RAY SOC, 2002年07月, AMERICAN JOURNAL OF ROENTGENOLOGY, 179 (1), 61 - 66, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Small hypervascular hepatocellular carcinoma revealed by double arterial phase CT performed with single breath-hold scanning and automatic bolus tracking

    T Kim, T Murakami, M Hori, M Takamura, S Takahashi, A Okada, S Kawata, M Cruz, MP Federle, H Nakamura

    OBJECTIVE. The purpose of this study was to evaluate the usefulness of double arterial phase CT for the detection of small hypervascular hepatocellular carcinomas, using an automated bolus-tracking technique to initiate the hepatic arterial phase CT. MATERIALS AND METHODS. Double arterial and late phase contrast-enhanced helical CT scans were obtained on 287 consecutive patients suspected of having hepatocellular carcinoma. These included 56 patients with 90 small (less than or equal to3 cm) hepatocellular carcinomas and 50 patients with no hepatocellular carcinomas. CT scans of these patients were interpreted by three reviewers. The first arterial phase scan was initiated automatically 10 sec after the bolus-tracking program detected the threshold enhancement of 50 H in the abdominal aorta. Three. reviewers interpreted the late phase CT scans in combination with the first, second, or both hepatic arterial phases. Measures of the reviewers detection of hepatocellular carcinoma included analysis of interobserver variation, sensitivity, specificity, and area under receiver operating characteristic curve (A(z)). RESULTS. The time elapsed from bolus initiation to threshold aortic enhancement ranged from 10 to 24 sec (mean, 13 see), resulting in initiation of the first arterial phase CT scan from 20 to 34 see (mean, 23 see). The combination of late phase CT and both first and second arterial phase images showed significantly better performance than the combination of the late phase and either the first or second arterial phases, although the difference was most evident in comparison with the combination of second arterial and late phases. CONCLUSION. An automated bolus-tracking program can be used to optimize the timing of hepatic arterial phase CT. Multiphasic CT performed using this technique is useful in detection of small hepatocellular carcinoma.

    AMER ROENTGEN RAY SOC, 2002年04月, AMERICAN JOURNAL OF ROENTGENOLOGY, 178 (4), 899 - 904, 英語

    研究論文(学術雑誌)

  • T Kim, T Murakami, M Hori, M Takamura, S Takahashi, A Okada, S Kawata, M Cruz, MP Federle, H Nakamura

    OBJECTIVE. The purpose of this study was to evaluate the usefulness of double arterial phase CT for the detection of small hypervascular hepatocellular carcinomas, using an automated bolus-tracking technique to initiate the hepatic arterial phase CT. MATERIALS AND METHODS. Double arterial and late phase contrast-enhanced helical CT scans were obtained on 287 consecutive patients suspected of having hepatocellular carcinoma. These included 56 patients with 90 small (less than or equal to3 cm) hepatocellular carcinomas and 50 patients with no hepatocellular carcinomas. CT scans of these patients were interpreted by three reviewers. The first arterial phase scan was initiated automatically 10 sec after the bolus-tracking program detected the threshold enhancement of 50 H in the abdominal aorta. Three. reviewers interpreted the late phase CT scans in combination with the first, second, or both hepatic arterial phases. Measures of the reviewers detection of hepatocellular carcinoma included analysis of interobserver variation, sensitivity, specificity, and area under receiver operating characteristic curve (A(z)). RESULTS. The time elapsed from bolus initiation to threshold aortic enhancement ranged from 10 to 24 sec (mean, 13 see), resulting in initiation of the first arterial phase CT scan from 20 to 34 see (mean, 23 see). The combination of late phase CT and both first and second arterial phase images showed significantly better performance than the combination of the late phase and either the first or second arterial phases, although the difference was most evident in comparison with the combination of second arterial and late phases. CONCLUSION. An automated bolus-tracking program can be used to optimize the timing of hepatic arterial phase CT. Multiphasic CT performed using this technique is useful in detection of small hepatocellular carcinoma.

    AMER ROENTGEN RAY SOC, 2002年04月, AMERICAN JOURNAL OF ROENTGENOLOGY, 178 (4), 899 - 904, 英語

    [査読有り]

    研究論文(学術雑誌)

  • H Yoshimura, T Murakami, T Kim, H Nakamura, N Hirabuki, M Sakon, K Wakasa, Y Inoue

    We report two cases of angiomyolipoma of the liver, where small amounts of fat on computed tomography, magnetic resonance imaging, and angiography made distinguishing this tumor from other hypervascular tumors difficult. Recognizing the imaging features of no capsule, hypervascularity of the tumor including the fat component, and early venous drainage may be helpful for correctly diagnosing angiomyolipoma of the liver.

    SPRINGER-VERLAG, 2002年03月, ABDOMINAL IMAGING, 27 (2), 184 - 187, 英語

    研究論文(学術雑誌)

  • Percutaneous microwave tumor coagulation for hepatocellular carcinomas with interruption of segmental hepatic blood flow

    T Ishida, T Murakami, T Shibata, Y Inoue, M Takamura, T Niinobu, T Sato, H Nakamura

    PURPOSE: To assess the effect of hepatic artery occlusion with or without hepatic venous outflow interruption on coagulation diameter during percutaneous microwave coagulation therapy (PMCT) for hepatocellular carcinoma (HCC) by a prospective and randomized trial. MATERIALS AND METHODS: Thirty-one patients with 36 HCCs (10-38 mm in diameter) were randomly separated into two treatment groups as follows: group 1 (14 tumors in 14 patients) was treated with PMCT in conjunction with both segmental hepatic artery embolization with gelatin sponge particles and temporary interruption of hepatic venous flow by means of a 6-F balloon catheter to reduce the portal venous flow; group 2 (22 tumors in 17 patients) was treated with PMCT with segmental hepatic artery embolization only. PMCT under ultrasound (US) guidance was performed with 2,450 MHz of microwave frequency at 40-60 W and a needle applicator 1.6 mm in diameter. The coagulated area was measured at the maximum diameter perpendicular to the needle tract on enhanced computed tomography (CT) performed immediately after PMCT. The local effect of the treatment was evaluated by follow-up enhanced CT (6-33 mo). RESULTS: Patients in group I had a significantly larger coagulation area (mean +/- SD = 42.9 mm +/- 8.3), with coagulation times of 5.3 min +/- 1.4, than patients in group 2 (32.6 mm +/- 8.0), with coagulation times of 4.2 min +/- 1.3 (P <.05). Follow-up enhanced CT showed no local enhancement of the tumor, indicating complete necrosis and no local recurrence, except for four tumors. There were no major complications after PMCT except liver abscess that developed after PMCT in one patient with pneumobilia. CONCLUSIONS: PMCT with combined hepatic arterial embolization and temporary hepatic venous flow interruption can coagulate significantly larger volumes of tumor than PMCT with only hepatic arterial embolization.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年02月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (2), 185 - 191, 英語

    研究論文(学術雑誌)

  • Percutaneous microwave tumor coagulation for hepatocellular carcinomas with interruption of segmental hepatic blood flow

    T Ishida, T Murakami, T Shibata, Y Inoue, M Takamura, T Niinobu, T Sato, H Nakamura

    PURPOSE: To assess the effect of hepatic artery occlusion with or without hepatic venous outflow interruption on coagulation diameter during percutaneous microwave coagulation therapy (PMCT) for hepatocellular carcinoma (HCC) by a prospective and randomized trial. MATERIALS AND METHODS: Thirty-one patients with 36 HCCs (10-38 mm in diameter) were randomly separated into two treatment groups as follows: group 1 (14 tumors in 14 patients) was treated with PMCT in conjunction with both segmental hepatic artery embolization with gelatin sponge particles and temporary interruption of hepatic venous flow by means of a 6-F balloon catheter to reduce the portal venous flow; group 2 (22 tumors in 17 patients) was treated with PMCT with segmental hepatic artery embolization only. PMCT under ultrasound (US) guidance was performed with 2,450 MHz of microwave frequency at 40-60 W and a needle applicator 1.6 mm in diameter. The coagulated area was measured at the maximum diameter perpendicular to the needle tract on enhanced computed tomography (CT) performed immediately after PMCT. The local effect of the treatment was evaluated by follow-up enhanced CT (6-33 mo). RESULTS: Patients in group I had a significantly larger coagulation area (mean +/- SD = 42.9 mm +/- 8.3), with coagulation times of 5.3 min +/- 1.4, than patients in group 2 (32.6 mm +/- 8.0), with coagulation times of 4.2 min +/- 1.3 (P <.05). Follow-up enhanced CT showed no local enhancement of the tumor, indicating complete necrosis and no local recurrence, except for four tumors. There were no major complications after PMCT except liver abscess that developed after PMCT in one patient with pneumobilia. CONCLUSIONS: PMCT with combined hepatic arterial embolization and temporary hepatic venous flow interruption can coagulate significantly larger volumes of tumor than PMCT with only hepatic arterial embolization.

    LIPPINCOTT WILLIAMS & WILKINS, 2002年02月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 13 (2), 185 - 191, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Intrahepatic recurrences of hepatocellular carcinoma after hepatectomy - Analysis based on tumor hemodynamics

    M Sakon, H Nagano, S Nakamori, K Dono, K Umeshita, T Murakami, H Nakamura, M Monden

    Hypothesis: Surgical margin, ie, the area of possible local intrahepatic metastasis, is controversial in hepatectomy for hepatocellular carcinoma. Design: The blood drainage area of turner was identified preoperatively by abdominal helical computed tomographic scan under hepatic arteriography and excised as surgical margin. The specimens were pathologically examined on the basis of the corresponding computed tomographic images. Setting: University hospital Patients: From June 2, 1997, to April 24, 2000, 67 patients with hepatocellular carcinoma who underwent curative hepatic resection. Main Outcome Measure: Intrahepatic recurrence. Results: Blood drainage area of tumor could be classified into the following types. The marginal type (drainage into the peritumorous area) was frequent (50 cases) and excised mostly by nonanatomic, limited resection. Portal vein type (drainage into the portal branches) was less common (12 cases) and resected mostly by anatomically systematic hepatectomy. The remaining 5 cases were of the hypovascular type and underwent limited resection. Multiple nodules were frequently found inside the drainage area (4 of 8 cases) and were moderate or poorly differentiated hepatocellular carcinoma, consistent with intrahepatic metastasis. Solitary nodules were mostly outside the drainage area (11 of 12 cases) and contained well-differentiated hepatocellular carcinoma (7 of 10 cases), suggesting multicentric carcinogenesis. Intrahepatic recurrences were commonly found in bilateral or contralateral lobes (17 of 19 cases) and divided into 2 groups with a few (less than or equal to4) and multiple ( E:8) recurrent nodules. Conclusions: Surgical margin varied according to tumor hemodynamics. Tumor recurrences may result not only from multicentric carcinogenesis but also from intrahepatic metastasis via systemic circulation.

    AMER MEDICAL ASSOC, 2002年01月, ARCHIVES OF SURGERY, 137 (1), 94 - 99, 英語

    研究論文(学術雑誌)

  • Multi-detector row helical CT angiography of hepatic vessels: Depiction with dual-arterial phase acquisition during single breath hold

    S Takahashi, T Murakami, M Takamura, T Kim, M Hori, Y Narumi, H Nakamura, M Kudo

    PURPOSE: To determine by using multi-detector row computed tomography (CT), in a triphasic hepatic dynamic study, which included single breath-hold dual-arterial phase acquisition, the accuracy and frequency of visualization of the small hepatic arterial and portal venous anatomy with angiographic correlation. MATERIALS AND METHODS: In 62 patients, pre- and postcontrast triphasic helical CT were performed by using a multi-detector row CT scanner, with 2.5-mm detector row collimation, at a pitch of 6. The first and second arterial phases were performed during a single breath hold. One reader, blinded to the results of the angiography, reviewed the first arterial phase images on a cine display to assess hepatic arterial anatomy. Visualization of the portal vein and its branches was assessed by using second arterial and portal venous phase images. RESULTS: Major arterial trunks (celiac, hepatic, superior mesenteric, and left gastric) were depicted in all cases. Visualization of small arteries was as follows: right and left hepatic, 62 (100%) of 62; middle hepatic, 52 (87%) of 60; cystic, 47 (90%) of 52; right gastric, 50 (89%) of 56; and right and left inferior phrenic, 57 (92%) and 55 (89%) of 62 respectively Subsegmental or more peripheral branches of the portal vein were depicted in 83% of cases during the second arterial phase and in 96% during the portal phase. There was no difference in degree of visualization in these two phases. CONCLUSION: Multi-detector row CT angiography was able to depict the hepatic vascular anatomy.

    RADIOLOGICAL SOC NORTH AMERICA, 2002年01月, RADIOLOGY, 222 (1), 81 - 88, 英語

    研究論文(学術雑誌)

  • S Takahashi, T Murakami, M Takamura, T Kim, M Hori, Y Narumi, H Nakamura, M Kudo

    PURPOSE: To determine by using multi-detector row computed tomography (CT), in a triphasic hepatic dynamic study, which included single breath-hold dual-arterial phase acquisition, the accuracy and frequency of visualization of the small hepatic arterial and portal venous anatomy with angiographic correlation. MATERIALS AND METHODS: In 62 patients, pre- and postcontrast triphasic helical CT were performed by using a multi-detector row CT scanner, with 2.5-mm detector row collimation, at a pitch of 6. The first and second arterial phases were performed during a single breath hold. One reader, blinded to the results of the angiography, reviewed the first arterial phase images on a cine display to assess hepatic arterial anatomy. Visualization of the portal vein and its branches was assessed by using second arterial and portal venous phase images. RESULTS: Major arterial trunks (celiac, hepatic, superior mesenteric, and left gastric) were depicted in all cases. Visualization of small arteries was as follows: right and left hepatic, 62 (100%) of 62; middle hepatic, 52 (87%) of 60; cystic, 47 (90%) of 52; right gastric, 50 (89%) of 56; and right and left inferior phrenic, 57 (92%) and 55 (89%) of 62 respectively Subsegmental or more peripheral branches of the portal vein were depicted in 83% of cases during the second arterial phase and in 96% during the portal phase. There was no difference in degree of visualization in these two phases. CONCLUSION: Multi-detector row CT angiography was able to depict the hepatic vascular anatomy.

    RADIOLOGICAL SOC NORTH AMERICA, 2002年01月, RADIOLOGY, 222 (1), 81 - 88, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Intrahepatic recurrences of hepatocellular carcinoma after hepatectomy - Analysis based on tumor hemodynamics

    M Sakon, H Nagano, S Nakamori, K Dono, K Umeshita, T Murakami, H Nakamura, M Monden

    Hypothesis: Surgical margin, ie, the area of possible local intrahepatic metastasis, is controversial in hepatectomy for hepatocellular carcinoma. Design: The blood drainage area of turner was identified preoperatively by abdominal helical computed tomographic scan under hepatic arteriography and excised as surgical margin. The specimens were pathologically examined on the basis of the corresponding computed tomographic images. Setting: University hospital Patients: From June 2, 1997, to April 24, 2000, 67 patients with hepatocellular carcinoma who underwent curative hepatic resection. Main Outcome Measure: Intrahepatic recurrence. Results: Blood drainage area of tumor could be classified into the following types. The marginal type (drainage into the peritumorous area) was frequent (50 cases) and excised mostly by nonanatomic, limited resection. Portal vein type (drainage into the portal branches) was less common (12 cases) and resected mostly by anatomically systematic hepatectomy. The remaining 5 cases were of the hypovascular type and underwent limited resection. Multiple nodules were frequently found inside the drainage area (4 of 8 cases) and were moderate or poorly differentiated hepatocellular carcinoma, consistent with intrahepatic metastasis. Solitary nodules were mostly outside the drainage area (11 of 12 cases) and contained well-differentiated hepatocellular carcinoma (7 of 10 cases), suggesting multicentric carcinogenesis. Intrahepatic recurrences were commonly found in bilateral or contralateral lobes (17 of 19 cases) and divided into 2 groups with a few (less than or equal to4) and multiple ( E:8) recurrent nodules. Conclusions: Surgical margin varied according to tumor hemodynamics. Tumor recurrences may result not only from multicentric carcinogenesis but also from intrahepatic metastasis via systemic circulation.

    AMER MEDICAL ASSOC, 2002年01月, ARCHIVES OF SURGERY, 137 (1), 94 - 99, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 経皮的マイクロターゼ凝固療法および5-FU, Adriamycin, Cisplatin肝動注化学療法が奏効した胃癌術後肝転移の1例

    山本為義, 村上 卓道

    2002年, 癌と化学療法, 29, 2439 - 2432

  • マルチスライスCTによる腹部領域における低濃度製剤の有用性:240mgI/ml製剤によるCT angiography

    河田修治, 村上 卓道

    2002年, 映像情報, 34, 900 - 904

  • Osakuni Morimoto, Hiroaki Nagano, Masato Sakon, Hidetoshi Eguchi, Atsushi Miyamoto, Motoi Kondo, Isao Arai, Tameyoshi Yamamoto, Keizo Dono, Koji Umeshita, Manabu Takamura, Takamichi Murakami, Shoji Nakamori, Hironobu Nakamura, Morito Monden

    We report the case of a liver abscess associated with microwave coagulation therapy (MCT). A 67-year-old man underwent a pylorus-preserving pancreatoduodenectomy for bile duct cancer in August 1998. In June 1999, abdominal computed tomography (CT) showed three low-density areas in his liver. With a diagnosis of multiple metastatic liver tumors, we applied MCT to each liver tumor. The patient presented with fever after therapy. Abdominal CT showed a hepatic abscess, which was treated by percutaneous transhepatic abscess drainage under ultrasonography. A bacteriological examination of the pus material revealed the presence of Enterococcus faecalis and Candida albicans. Treatment resulted in a rapid resolution of symptoms. Our case indicated that care should be exercised in using MCT for the treatment of liver tumors in patients who have undergone reconstructive surgery of the biliary tract.

    2002年, Surgery today, 32 (5), 454 - 7, 英語, 国内誌

  • High dose rate endovascular brachytherapy in aorto-iliac lesion for the prevention of restenosis

    Hideya Yamazaki, Kaname Tomoda, Hiroya Shiomi, Munehiro Maeda, Shuji Kawata, Atsuya Okada, Takamichi Murakami, Hironobu Nakamura, Eiichi Tanaka, Takehiro Inoue, Toshihiko Inoue

    This study examined the applicability of endovascular brachytherapy to larger del arteries such as the abdominal aorta and iliac artery. Endovascular brachytherapy using an Ir-192 HDR source was administered 11 times to nine patients who had undergone percutaneous transluminal angioplasty (PTA) between 1995 and 1999. The follow-up lasted 13 to 55 months after treatment (median, 24 months). Eight of the 11 lesions have been controlled so far. Although one case developed thrombus inside the stent five months later, recanalization was achieved by means of retreatment. One patient who underwent low-dose irradiation (6 Gy) without stent implantation showed restenosis five months after treatment. We used a centering catheter that did not block the blood stream for exact centering of the radiation source in larger vessels such as the abdominal aorta. Although endovascular brachytherapy is a promising and safe procedure, careful follow-up is needed to detect untoward reactions such as thrombosis.

    2002年, Radiation Medicine - Medical Imaging and Radiation Oncology, 20 (1), 25 - 32, 英語

    研究論文(学術雑誌)

  • Jun Masumoto, Yoshinobu Sato, Masatoshi Hori, Takamichi Murakami, Takeshi Johkoh, Hironobu Nakamura, Shinichi Tamura

    Springer, 2002年, Medical Image Computing and Computer-Assisted Intervention - MICCAI 2002, 5th International Conference, Tokyo, Japan, September 25-28, 2002, Proceedings, Part II, 493 - 500

    [査読有り]

  • High dose rate endovascular brachytherapy in aorto-iliac lesion for the prevention of restenosis

    Hideya Yamazaki, Kaname Tomoda, Hiroya Shiomi, Munehiro Maeda, Shuji Kawata, Atsuya Okada, Takamichi Murakami, Hironobu Nakamura, Eiichi Tanaka, Takehiro Inoue, Toshihiko Inoue

    This study examined the applicability of endovascular brachytherapy to larger del arteries such as the abdominal aorta and iliac artery. Endovascular brachytherapy using an Ir-192 HDR source was administered 11 times to nine patients who had undergone percutaneous transluminal angioplasty (PTA) between 1995 and 1999. The follow-up lasted 13 to 55 months after treatment (median, 24 months). Eight of the 11 lesions have been controlled so far. Although one case developed thrombus inside the stent five months later, recanalization was achieved by means of retreatment. One patient who underwent low-dose irradiation (6 Gy) without stent implantation showed restenosis five months after treatment. We used a centering catheter that did not block the blood stream for exact centering of the radiation source in larger vessels such as the abdominal aorta. Although endovascular brachytherapy is a promising and safe procedure, careful follow-up is needed to detect untoward reactions such as thrombosis.

    1, 2002年, Radiation Medicine - Medical Imaging and Radiation Oncology, 20 (1), 25 - 32, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Osakuni Morimoto, Hiroaki Nagano, Masato Sakon, Hidetoshi Eguchi, Atsushi Miyamoto, Motoi Kondo, Isao Arai, Tameyoshi Yamamoto, Keizo Dono, Koji Umeshita, Manabu Takamura, Takamichi Murakami, Shoji Nakamori, Hironobu Nakamura, Morito Monden

    We report the case of a liver abscess associated with microwave coagulation therapy (MCT). A 67-year-old man underwent a pylorus-preserving pancreatoduodenectomy for bile duct cancer in August 1998. In June 1999, abdominal computed tomography (CT) showed three low-density areas in his liver. With a diagnosis of multiple metastatic liver tumors, we applied MCT to each liver tumor. The patient presented with fever after therapy. Abdominal CT showed a hepatic abscess, which was treated by percutaneous transhepatic abscess drainage under ultrasonography. A bacteriological examination of the pus material revealed the presence of Enterococcus faecalis and Candida albicans. Treatment resulted in a rapid resolution of symptoms. Our case indicated that care should be exercised in using MCT for the treatment of liver tumors in patients who have undergone reconstructive surgery of the biliary tract.

    5, 2002年, Surgery today, 32 (5), 454 - 7, 英語, 国内誌

    [査読有り]

  • Masatoshi Hori, Takamichi Murakami, Tonsok Kim, Hironobu Nakamura

    Both computed tomography arterial portography (CTAP) and CT hepatic arteriography (CTHA) are CT techniques with angiographic assistance. The detection sensitivity of these techniques is high because marked lesion contrast can be obtained using direct delivery of contrast materials to the liver parenchyma or the tumors. The use of CTAP and CTHA may improve therapeutic results after transarterial embolization therapy for hepatocellular carcinomas because of their high diagnostic accuracy. Findings on CTAP or CTHA can sometimes help characterize the hepatic focal lesions. Thus, CTAP and CTHA are frequently performed as pretreatment examinations, although they are invasive compared to intravenous (IV) contrast-enhanced CT or magnetic resonance imaging. However, there are some potential pitfalls, such as nontumorous perfusion abnormalities. CTAP and CTHA are less effective for evaluation of patients with cirrhosis and portal hypertension. This article presents a current overview of CTAP and CTHA technique for diagnosis of hepatic neoplasms. Copyright 2002, Elsevier Science (USA). All rights reserved.

    W.B. Saunders, 2002年, Techniques in Vascular and Interventional Radiology, 5 (3), 164 - 169, 英語

    [査読有り]

  • Usefulness of newly developed interactive multiplanar reconstruction viewer for large amount of image sets by multidetector-row CT: evaluation of invasion to surrounding organs of esophageal carcinoma

    T Johkoh, S Yamamoto, T Murakami, M Hori, O Honda, T Kozuka, M Koyama, M Tsubamoto, S Hamada, Y Narum, H Nakamura

    SPRINGER-VERLAG BERLIN, 2002年, CARS 2002: COMPUTER ASSISTED RADIOLOGY AND SURGERY, PROCEEDINGS, 1025 - 1025, 英語

    [査読有り]

    研究論文(国際会議プロシーディングス)

  • R Kuwatsuru, M Kadoya, K Ohtomo, A Tanimoto, S Hirohashi, T Murakami, Y Tanaka, K Yoshikawa, H Katayama

    RATIONALE AND OBJECTIVES. To compare gadobenate dimeglumine (Gd-BOPTA) with gadopentetate dimeglumine (Gd-DTPA) for magnetic resonance imaging of the liver. METHODS. The contrast agent Gd-BOPTA or Gd-DTPA was administered at a dose of 0.1 mmol/kg to 257 patients suspected of having malignant liver tumors. Dynamic phase images, spin-echo images obtained within 10 minutes of injection, and delayed images obtained 40 to 120 minutes after injection were acquired. All postcontrast images were compared with unenhanced TI-weighted and T2-weighted images obtained immediately before injection. A full safety assessment was performed. RESULTS. The contrast efficacy for dynamic phase imaging was moderately or markedly improved in 90.9% (110/121) and 87.9% (109/124) of patients for Gd-BOPTA and Gd-DTPA, respectively. At 40 to 120 minutes after injection, the corresponding improvements were 21.7% (26/120) and 11.6% (14/121) for spin-echo sequences and 44.5% (53/119) and 19.0% (23/121) for breath-hold gradient-echo sequences, respectively. The differences at 40 to 120 minutes after injection were statistically significant (P < 0.02). Increased information at 40 to 120 minutes after injection compared with information acquired within 10 minutes of injection was available for 24.0% (29/121) of patients with Gd-BOPTA and for 14.5% (18/124) of patients with Gd-DTPA (P < 0.03). Adverse events were seen in 4.7% (6/128) and 1.6% (2/127) of patients receiving Gd-BOPTA and Gd-DTPA, respectively. The difference was not statistically significant. CONCLUSIONS. The efficacy of Gd-BOPTA is equivalent to that of Gd-DTPA for liver imaging during the dynamic phase and superior during the delayed (40-120 minutes) phase of contrast enhancement. Both agents are safe for use in magnetic resonance imaging of the liver.

    LIPPINCOTT WILLIAMS & WILKINS, 2001年11月, INVESTIGATIVE RADIOLOGY, 36 (11), 632 - 641, 英語

    研究論文(学術雑誌)

  • Pancreatic mass due to chronic pancreatitis: Correlation of CT and MR imaging features with pathologic findings

    T Kim, T Murakami, M Takamura, M Hori, S Takahashi, S Nakamori, M Sakon, Y Tanji, K Wakasa, H Nakamura

    OBJECTIVE. The purpose of this study was to identify helical CT and MR imaging features of pancreatic masses (focal enlargement) due to chronic pancreatitis and their correlation with pathologic findings. CONCLUSION. When histologic fibrosis is uniformly present through the pancreas in patients with chronic pancreatitis, there is no demarcation of masses due to chronic pancreatitis. When there is a greater degree of histologic fibrosis in the masslike part of the pancreas. the mass is often demarcated from the remaining pancreas, and the enhancement pattern on two-phase helical CT and dynamic gadolinium-enhanced MR imaging mimics that of pancreatic adenocarcinoma.

    AMER ROENTGEN RAY SOC, 2001年08月, AMERICAN JOURNAL OF ROENTGENOLOGY, 177 (2), 367 - 371, 英語

    研究論文(学術雑誌)

  • MR cholangiography with volume rendering: Receiver operating characteristic curve analysis in patients with choledocholithiasis

    H Kondo, M Kanematsu, Y Shiratori, K Itoh, T Murakami, M Hori, Yasuda, I, M Matsuo, H Nakamura, H Hoshi, H Moriwaki

    OBJECTIVE. The purpose of our study was to compare observer performances for the diagnosis of choledocholithiasis using MR cholangiography with volume-rendered, maximum-intensity-projection, and thick-section half-Fourier rapid acquisition with relaxation enhancement sequences. MATERIALS AND METHODS. The images from three types of MR cholangiography performed on 43 patients with biliary calculi were retrospectively analyzed. Image review was conducted for two anatomic compartments (upper biliary tract and common bile duct). A total of 86 compartments, including 19 with bile duct calculi, were reviewed by three independent off-site gastrointestinal radiologists. Observer performance was determined by receiver operating characteristic curve analysis, image quality was subjectively judged by three radiologists. RESULTS. Sensitivity was higher with volume-rendered MR cholangiography (58%) than with thick-section (54%, not significant) and maximum-intensity-projection MR cholangiography (47%, p < 0.07). Specificity was higher with volume-rendered MR cholangiography (92%) than with thick-section (86%, p < 0.03) and maximum-intensity-projection MR cholangiography (88%, not significant). Accuracy was higher with volume-rendered MR cholangiography (84%) than with thick-section and maximum-intensity-projection MR cholangiography (79% for both, not significant). Observer performance with volume-rendered MR cholangiography (A(z) = 0.791-0.952) was batter than that with thick-section (A(z) = 0.722-0.834) and maximum-intensity-projection MR cholangiography (A(z) = 0.771-0.87). Image quality was better with maximum-intensity-projection MR cholaniography and thick-section MR cholangiography than with volume-rendered MR cholangiography (p < 0.0001). CONCLUSION. Observer performance with volume-rendered MR cholangiography was better than th at with maximum-intensity-projection and thick-section MR cholangiography for the diagnosis of choledocholithiasis. Volume rendering may be an efficient technique for the reconstruction of MR cholangiography.

    AMER ROENTGEN RAY SOC, 2001年05月, AMERICAN JOURNAL OF ROENTGENOLOGY, 176 (5), 1183 - 1189, 英語

    研究論文(学術雑誌)

  • Microwave coagulation therapy with interruption of hepatic blood in- or outflow: An experimental study

    M Takamura, T Murakami, T Shibata, T Ishida, T Niinobu, S Kawata, J Shimizu, T Kim, M Monden, H Nakamura

    PURPOSE: To determine how interruption of hepatic blood in- or outflow affects the coagulation diameter of microwave coagulation therapy (MCT) in the liver. MATERIALS AND METHODS: Laparotomic MCT at 60 W for 1 minute was performed in 11 Landrace pigs. MCT was performed under six different conditions: without occlusion (Group N; in seven lobes of seven pigs); with occlusion of the hepatic artery (Group A; in five lobes of five pigs); with occlusion of the portal vein (Group P;in five lobes of five pigs); with occlusion of the hepatic artery and portal vein (Group AP; in six lobes of six pigs); with occlusion of the hepatic vein (Group V; in five lobes of four pigs); and with occlusion of the hepatic artery and vein (Group AV; in seven lobes of seven pigs). The maximum diameters for each group were compared. RESULTS: The coagulation diameters (mean +/- SD) were 8.5 mm +/- 2.0, 10.0 mm +/- 1.6, 14.3 mm +/- 2.5, 14.4 mm +/- 2.4, 13.0 mm +/- 0.8, and 14.4 mm +/- 1.5 for Groups N, A, P,AP, V, and AV, respectively. The coagulation diameters for groups P, AP, V, and AV were statistically larger than those for groups N and A (P < .05). There was no significant difference between the coagulation diameters of Groups P, AP, V, and AV. CONCLUSION: The coagulation diameter depends mainly on the portal venous flow. In addition of direct interruption of the portal vein, interruption of the hepatic vein can also result in a substantial increase in the coagulation diameter.

    LIPPINCOTT WILLIAMS & WILKINS, 2001年05月, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 12 (5), 619 - 622, 英語

    研究論文(学術雑誌)

  • Hypervascular hepatocellular carcinoma: Detection with double arterial phase multi-detector row helical CT

    T Murakami, T Kim, M Takamura, M Hori, S Takahashi, MP Federle, K Tsuda, K Osuga, S Kawata, H Nakamura, M Kudo

    PURPOSE: To assess whether double arterial phase imaging with multi-detector row helical computed tomography improves detection of hypervascular hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Fifty-one patients with 96 hypervascular HCCs underwent double arterial phase imaging of the entire liver. At measured delay after intravenous administration of 2 mL/kg of contrast medium at a rate of 5 mL/sec, the early and late arterial phase images were obtained serially during a single breath hold with interscan delay of 5.0 seconds. Detector row configuration of 2.5 x 4 mm, pitch of 6, and scanning time of 10.5 seconds for each phase were used. Forty 5-mm-thick reconstruction images were obtained for each phase. Each image set was interpreted separately by three observers, who were unaware of tumor burden in the liver, to detect hypervascular HCC. Sensitivity, positive predictive value, and area below the receiver operating characteristic curve (A(z)) for early and late arterial phases separately and together were calculated. RESULTS: Mean sensitivity and positive predictive value for hypervascular HCC were 54% and 85% for the early arterial phase, 78% and 83% for the late arterial phase, and 86% and 92% for the double arterial phase, respectively. Double arterial phase imaging showed significantly superior sensitivity compared with early or late arterial phase imaging alone for detecting HCC (P < .05). The mean A(z) value for double arterial phase was significantly higher than that for early or late arterial phase imaging alone (P < .05). Double arterial phase imaging showed the lowest number of false-positive lesions. CONCLUSION: Double arterial phase imaging is recommended to improve detection of hypervascular HCCs and reduce false-positive lesions.

    RADIOLOGICAL SOC NORTH AMER, 2001年03月, RADIOLOGY, 218 (3), 763 - 767, 英語

    研究論文(学術雑誌)

  • T Murakami, T Kim, M Takamura, J Shimizu, M Hori, K Dono, K Takachi, N Kato, T Miyazawa, M Sakon, M Monden, H Nakamura

    The purpose of this study was to investigate whether regional liver damage could be detected by means of enhanced MR imaging with a superparamagnetic iron oxide (SH U 555A) in an ischemia-reperfusion model of rat liver. Ischemic liver damage was induced in the right lobe by vascular clamping for 0 (sham), 30 (I-30), 60 (I-60), and 90 minutes (I-90), There was no significant difference in relative enhancement (RE) between the ischemic and nonischemic lobes in the sham, I-30 and I-60 groups, while RE of the ischemic lobe was significantly lower than that of its nonischemic counterpart in the I-90 group as seen on SH U 555A enhanced proton density spin echo images (P < 0.05). Histological examination revealed that iron deposits were significantly smaller in the ischemic than the nonischemic lobe in the I-90 group (P < 0.05), although there was no significant difference in the number of Kupffer cells. Our results indicate that severe regional liver damage can be evaluated by MR imaging with SH U 555A.

    KLUWER ACADEMIC/PLENUM PUBL, 2001年01月, DIGESTIVE DISEASES AND SCIENCES, 46 (1), 148 - 155, 英語

    研究論文(学術雑誌)

  • M Cruz, T Murakami, K Tsuda, H Kurachi, T Enomoto, T Kim, S Takahashi, H Nakamura

    A myxoid leiomyoma of the uterus is radiologically described. Sonography showed a large mass extending from the renal hilum to the pelvis. Enhanced computed tomography and magnetic resonance imaging findings denoted cystic and myxoid components. Magnetic resonance imaging demonstrated flow voids between the mass and the uterus, indicating likely origin from the uterus. Exploratory laparotomy showed a huge leiomyomatous mass.

    SPRINGER-VERLAG, 2001年01月, ABDOMINAL IMAGING, 26 (1), 98 - 101, 英語

    研究論文(学術雑誌)

  • 門脈内腫瘍 (Vp3)を伴う肝細胞癌に対しTAEを施行し3年以上の長期生存を得た1例

    山本為義, 村上 卓道

    2001年, 癌と化学療法, 28, 1718 - 1723

  • マルチスライスCT画像からの肝臓領域自動抽出

    桝本 潤, 村上 卓道

    2001年, 信学論, (9), 2150 - 2161

  • S Takahashi, T Kim, T Murakami, A Okada, M Hori, Y Narumi, H Nakamura

    To assess the ability of gadolinium enhancement to suppress the overlapping vessel signals that diminish the image quality of magnetic resonance cholangiopancreatography (MRCP), we obtained MRCP before and after intravenous injection of gadolinium. Signal intensity ratio of the common bile duct to the main pancreatic duct was significantly improved after the injection of contrast media. The image quality of the postcontrast MRCP was better than that of the precontrast one.

    SPRINGER-VERLAG, 2000年09月, ABDOMINAL IMAGING, 25 (5), 511 - 513, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M Matsuo, M Kanematsu, T Murakami, T Kim, M Hori, H Kondo, H Nakamura, H Hoshi

    The purpose of our study was to evaluate the supplementary value of breath-hold fat-suppressed T2-weighted magnetic resonance (MR) imaging with half-Fourier single-shot fast spin-echo (SE) or multishot SE echoplanar (EP) sequences combined with respiratory-triggered fat-suppressed fast SE T2-weighted MR imaging for detection and characterization of focal hepatic lesions. MR images in 42 patients with 82 solid, malignant and 77 nonsolid. benign lesions were analyzed. Image review was conducted on a segment-by-segment basis; in all, 333 liver segments were reviewed separately for solid and nonsolid lesions by three Independent radiologists. For solid lesions. observer performance with receiver-operating-characteristic (ROC) analysis in one radiologist and specificity in another significantly Improved after adding single-shot fast SE Images. For nonsolid lesions, observer performance with ROC analysis in one radiologist and specificity in another significantly improved after adding single-shot fast SE images. Combining breath-hold half-Fourier single-shot fast SE imaging with respiratory-triggered fast SE imaging may be recommended for improved detection and characterization of focal hepatic lesions. (C) 2000 Wiley-Liss, Inc.

    JOHN WILEY & SONS INC, 2000年09月, JOURNAL OF MAGNETIC RESONANCE IMAGING, 12 (3), 444 - 452, 英語

    [査読有り]

    研究論文(学術雑誌)

  • X線CT画像からの肝腫瘤自動抽出の検討

    桝本 潤, 堀 雅敏, 佐藤 嘉伸, 村上 卓道, 上甲 剛, 中村 仁信, 田村 進一

    2000年06月, 信学論 (D-II), 日本語

    [査読有り]

    研究論文(学術雑誌)

  • 木村 拓也, 長谷川 利路, 大植 孝治, 帆足 孝也, 岡田 正, 村上 卓道, 中村 健治

    (一社)日本小児外科学会, 2000年05月, 日本小児外科学会雑誌, 36 (3), 568 - 568, 日本語

  • Takashi Shibata, Takamichi Murakami, Norio Ogata

    BACKGROUND. Although percutaneous microwave coagulation is relatively noninvasive therapy for patients with hepatic tumors, coagulation of tumors is sometimes incomplete and local recurrence occurs. The authors hypothesized that the cause of incomplete coagulation was a cooling effect in surrounding hepatic blood flow. To prove this hypothesis and to improve the efficacy of this therapy, they interrupted hepatic blood flow during the treatment and measured the amount of tumor tissue coagulated by microwave. METHODS. The authors first performed an animal experiment on pigs. After laparotomy, the liver of an anesthetized pig was coagulated by microwave with or without interruption of hepatic blood flow the interruption was achieved by squeezing hepatic blood vessels. Next, the authors applied the microwave coagulation percutaneously to 25 human patients with primary or metastatic carcinoma in the liver with or without intraoperative temporary interruption of hepatic blood flow the interruption was achieved by inflating balloon catheters inserted in the hepatic blood vessels through femoral vessels. RESULTS. The greatest dimension of area of normal liver tissue coagulated by microwave with blood flow interruption was significantly (P < 0.001) larger (18.8 ± 1.0 mm, n = 4) than without it (9.8 ± 1.7 mm, n = 4) in the experiment with pigs. In human hepatic tumors, the greatest dimension of the area coagulated by microwave with blood flow interruption was also significantly (P < 0.001) larger (41.1 ± 9.3 mm, n = 14) than without it (26.9 ± 8.5 mm, n = 11). The local recurrence rate of the tumor during a period of 6 months after the treatment was lower (P < 0.05) with blood flow interruption (7%) than without it (45%). CONCLUSIONS. Intraoperative interruption of hepatic blood flow increases the areas of primary and metastatic hepatic tumors coagulated by microwave. It is expected to increase the efficacy of percutaneous microwave coagulation therapy for patients with hepatic tumors.

    2000年01月15日, Cancer, 88 (2), 302 - 311, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Helical CT imaging of gastric cancer: Normal wall appearance and the potential for staging

    K. Kadowaki, T. Murakami, H. Yoshioka, T. Kim, S. Takahashi, K. Tomoda, Y. Narumi, H. Nakamura

    Purpose: To evaluate the CT appearance of the normal gastric wall and the effectiveness of contrast enhanced helical CT for T-staging of gastric cancer. Methods: For the basic experiment, two resected stomachs with gastric cancer were filled with water and examined by helical CT imaging. For the clinical study, 59 consecutive patients with gastric cancer who had received preoperative helical CT examination and had also been operated on were entered in this study. Helical CT images were evaluated independently by three radiologists without knowledge of histological staging results. Results: The basic examination of a histopathological correlation with CT images revealed that the inner layer with high attenuation corresponded to the mucosa and the muscular layer of the mucosa, the middle layer with low attenuation to the submucosal layer consisting of coarse tissues and containing fatty tissues, and the outer layer with slightly high attenuation to the proper muscle with serosa. The clinical study revealed that the rate of correct diagnosis through consensus reading was 66.1%. Conclusion: The entire stomach with a well-stained mucosa can be visualized by contrast enhanced helical CT. However, T-staging of gastric cancer by helical CT did not appear to improve the accuracy of staging.

    2000年, Radiation Medicine - Medical Imaging and Radiation Oncology, 18 (1), 47 - 54, 英語

    [査読有り]

    研究論文(学術雑誌)

  • MR imaging of mesenteric hemangioma: A case report

    M. Takamura, T. Murakami, H. Kurachi, T. Kim, T. Enomoto, Y. Narumi, H. Nakamura

    A 62-year-old woman presented with a mobile abdominal palpable mass. She underwent MR examination twice. Because of the mobility of the mass, it was out of the field of view on the first MR examination. The second MR examination detected the mass, which showed heterogeneous signal intensity including low and high intensity on T2-weighted spin echo images. The mass, which was cavernous hemangioma with old hemorrhage, was difficult to differentiate from fibroma or thecoma of the ovary or subserosal leiomyoma of the uterus.

    2000年, Radiation Medicine - Medical Imaging and Radiation Oncology, 18 (1), 67 - 69, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Scintigraphic and MR perfusion imaging in preoperative evaluation for lung volume reduction surgery: Pilot study results

    T. Johkoh, N. L. Muller, P. V. Kavanagh, Y. Cartier, J. R. Mayo, N. Tomiyama, T. Murakami, H. Naito, H. Nakamura, H. Moriya

    Purpose: To compare MR perfusion imaging with perfusion scintigraphy in the evaluation of patients with pulmonary emphysema being considered for lung volume reduction surgery. Patients and Methods: Six patients with pulmonary emphysema and two normal individuals were evaluated by MR perfusion imaging, perfusion scintigraphy, and selective bilateral pulmonary angiography. MR images were obtained with an enhanced fast gradient recalled echo with three-dimensional Fourier transformation technique (efgre 3D) (6.3/1.3 flip angle, 30° field of view, 45-48 cm matrix, 256x160). The presence or absence of perfusion defects in each segment was evaluated by two independent observers. Results: Using angiography as the gold standard, the sensitivity, specificity, and accuracy of MR perfusion imaging in detecting focal perfusion abnormalities were 90%, 87%, and 89%, respectively, while those of perfusion scintigraphy were 71%, 76%, and 71%, respectively. The diagnostic accuracy of MR perfusion imaging was significantly higher than that of scintigrapy (p< 0.001, McNemar test). There was good agreement between two observers for MR perfusion imaging (kappa statistic, 0.66) and only moderate agreement for perfusion scintigraphy (kappa statistic, 0.51). Conclusion: MR perfusion imaging is superior to perfusion scintigraphy in the evaluation of pulmonary parenchymal perfusion in patients with pulmonary emphysema.

    2000年, Radiation Medicine - Medical Imaging and Radiation Oncology, 18 (5), 277 - 281, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Takuya Kimura, Toshimichi Hasegawa, Takaharu Oue, Takaya Hoashi, Takamichi Murakami, Kenji Nakamura, Akira Okada

    Although transjugular intrahepatic portosystemic shunt (TIPS) is widely accepted in adults, there have been few successful reports in infants. The authors describe a 2-year-old boy with postoperative biliary atresia who underwent TIPS for uncontrollable lower intestinal bleeding and achieved hemostasis. Massive melena developed, which was not controlled by conservative therapy and devascularization. A shunt was created between the right hepatic vein and the right portal vein with a 6- x 50-mm Wallstent. After TIPS, the porto-systemic pressure gradient decreased from 15 to 11 mm Hg, and collaterals markedly reduced. He has not had recurrent bleeding for over 7 months. TIPS may be a technically feasible and effective treatment to control intestinal bleeding in infants. However, further experience and long-term follow-up will be required. Copyright (C) 2000 by W.B. Saunders Company.

    2000年, Journal of Pediatric Surgery, 35 (11), 1597 - 1599, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Clinical late phase II trials of MultiHance (R) (Gd-BOPTA) for the magnetic resonance imaging of liver tumors in Japan

    R Kuwatsuru, M Kadoya, K Ohtomo, A Tanimoto, S Hirohashi, T Murakami, Y Tanaka, K Yoshikawa, H Katayama

    Objective: The purpose of the study was to evaluate the safety and efficacy of Gd-BOPTA for liver imaging and to determine the most appropriate clinical dose to administer. Methods: Gd-BOPTA was administered at a dose of 0.05 (group A), 0.1 (group B), or 0.2 (group C) mmol/kg to 201 patients suspected of having malignant liver tumors who had been referred for magnetic resonance imaging. Dynamic phase images (T1-weighted gradient echo sequences obtained during breath-hold), images obtained within 10 min of Gd-BOPTA injection (spin echo images) and delayed images obtained at 40-120 min after Gd-BOPTA injection (T1-weighted spin echo and gradient echo sequences during breath-hold) were acquired. All post-contrast images were compared with pre-contrast images (T1- and T2-weighted sequences) obtained immediately prior to Gd-BOPTA administration. Safety was assessed in terms of the incidence of adverse events. Results: The contrast efficacy for the dynamic study was classified as (+++) in 39.7% (27/68), 55.4% (36/65), and 47.0% (31/66) for groups A, B, and C, respectively. The contrast efficacy within 10 min of the injection was classified as (+++) in 7.6% (5/66); 16.9% (11/65), and 12.5% (8/64) for groups A, B, and C, respectively. The contrast efficacy at 40-120 min post-injection was classified as (+++) in 4.4% (3/68), 21.5% (14/65), and 20.0% (13/65) for groups A, B, and C, respectively with significant differences noted between groups A and B and groups A and C. As regards safety, the overall incidence of adverse reactions was 3.5% (7/199). Conclusion: Gd-BOPTA is a safe and efficacious contrast agent for use in both dynamic phase imaging and delayed (40-120 min) static imaging. A dose of 0.1 mmol/kg Gd-BOPTA appears to be the ideal dose for use in liver imaging in Japan.

    LIPPINCOTT WILLIAMS & WILKINS, 1999年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 23, S65 - S74, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Kim, T Murakami, S Takahashi, M Hori, M Sakon, S Nakamori, K Wakasa, H Nakamura

    We present two cases of ductal adenocarcinoma of the pancreas with intratumoral calcification. The two cases indicate two different etiologies for intratumoral calcification in ductal adenocarcinoma. Thus, the possibility of adenocarcinoma should be considered when a tumor with intratumoral calcification is found, although the incidence of intratumoral calcification in the ductal adenocarcinoma of the pancreas remains rare.

    SPRINGER VERLAG, 1999年11月, ABDOMINAL IMAGING, 24 (6), 610 - 613, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Detection of hepatocellular carcinoma: Comparison of low- and high-spatial-resolution dynamic MR images

    M Kanematsu, H Hoshi, T Murakami, K Itoh, M Hori, H Kondo, H Nakamura

    OBJECTIVE, The purpose of our study was to compare the diagnostic performance of low- and high-spatial-resolution gadolinium chelate-enhanced triphasic dynamic gradient-recalled echo (GRE) MR images in the detection of hepatocellular carcinoma. MATERIALS AND METHODS. Triphasic dynamic MR images obtained with low (256 x 128) and high (512 x 224) image matrices in 28 patients with 65 hepatocellular carcinomas (HCCs) were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 215 liver segments, including 56 segments with tumor burden, were reviewed for the presence of HCC by three independent radiologists. Detectability was evaluated with relative sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Image quality was evaluated with rank order analysis. RESULTS. Relative sensitivity was statistically significantly better with high-spatial-resolution images than with low-spatial-resolution images (p < .005). Relative specificity was statistically significantly better with low-spatial-resolution images than with high-spatial-resolution images (p < .001). Diagnostic accuracy determined by ROC curve analysis was marginally higher with high-spatial-resolution (area under ROC curve [A(z)] = .97) than with low-spatial-resolution (A(z) = .94, p < .09) images. Image quality was statistically significantly better with high-spatial-resolution images (p < .005). CONCLUSION. High-spatial-resolution dynamic CURE images were superior to low-spatial-resolution images in sensitivity of detecting HCC and in image quality. Triphasic dynamic GRE imaging in the screening and follow-up programs of patients with suspected HCC should be performed using high image matrices.

    AMER ROENTGEN RAY SOC, 1999年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 173 (5), 1207 - 1212, 英語

    [査読有り]

    研究論文(学術雑誌)

  • T Obi, T Murakami, M Takatsu, S Kusunoki, M Serizawa, K Mizoguchi, R Koike, Y Nishimura

    A previously reported patient presenting sensory-dominant neuropathy with antiganglioside antibodies, bound preferentially to polysialogangliosides including GD1b, was autopsied. While axonal degeneration was predominant in the sural nerve, many demyelinated fibers were present in the spinal roots. Dorsal roots had undergone significant damage. These pathological findings were well correlated with the electrophysiological results showing decreased F-wave conduction velocities and conduction blocks in motor nerves and decreased or absent sensory action potentials in sensory nerves, with distribution of GD1b in nerve tissues such as dorsal root ganglia and paranodal myelin in the ventral and dorsal roots. (C) 1999 John Wiley & Sons, Inc.

    JOHN WILEY & SONS INC, 1999年10月, MUSCLE & NERVE, 22 (10), 1426 - 1431, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Evaluation of gadobenate dimeglumine in hepatocellular carcinoma: Results from phase II and phase III clinical trials in Japan

    A Tanimoto, R Kuwatsuru, M Kadoya, K Ohtomo, S Hirohashi, T Murakami, K Hiramatsu, K Yoshikawa, H Katayama

    To evaluate the clinical efficacy of gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance imaging for hepatocellular carcinoma (HCC), we reviewed the results of clinical phase II and III trials in Japan. Gd-BOPTA was administered at a dose of 0.1 mmol/kg to 139 patients who were suspected to have HCC. Dynamic phase images (breath-hold T1-weighted gradient echo [GRE)], spin-echo (SE) images obtained within 10 minutes of injection, and delayed breath-hold GRE images obtained 40-120 minutes after injection were evaluated, All post-contrast images were compared with T1- and Ta-weighted pre-contrast images. The contrast efficacy for the dynamic study was classified as (+++) or (++) in 92.1% (128/139), in 43.1% (59/ 137) with SE within 10 minutes of injection, and in 43.2% (60/139) with breath-hold GRE at delayed phase, The increase in lesion-liver contrast-to-noise ratio was best at the arterial phase of dynamic breath-hold GRE. Liver signal-to-noise ratio showed a mean 52.3% increase in delayed phase, Additional information at delayed phase compared with images acquired within 10 minutes of injection (including the dynamic study) was classified as (+++) or (++) in 28.1% (39/139), With regard to safety, the overall incidence of adverse reactions was 5.0% (7/141) of the patients who were suspected to have HCC, all of whom recovered within 12 hours without any sequelae, No clinically important changes were observed in the blood and urine laboratory tests. It was concluded that Gd-BOPTA was well tolerated and effective in both dynamic study and delayed static imaging for the diagnosis of HCC. (C) 1999 Wiley-Liss, Inc.

    JOHN WILEY & SONS INC, 1999年09月, JMRI-JOURNAL OF MAGNETIC RESONANCE IMAGING, 10 (3), 450 - 460, 英語

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    研究論文(学術雑誌)

  • Optimal phases of dynamic CT for detecting hepatocellular carcinoma: evaluation of unenhanced and triple-phase images

    T Kim, T Murakami, S Takahashi, K Tsuda, K Tomoda, Y Narumi, H Oi, M Sakon, H Nakamura

    Background: To determine the optimal phases of dynamic computed tomography (CT) for detecting hepatocellular carcinoma (HCC). Methods: Fifty-two patients with 85 HCC Modules were examined by means of unenhanced and triple-phase CT images of the whole liver. The time for obtaining the arterial-phase images was 25-55 s after intravenous bolus injection of contrast material, the time for obtaining the portal venous-phase images was 65-100 s, and the time for obtaining late-phase images was 145 s to 4 min. Detectability of the HCC nodules for all phases was statistically compared. Results: The detection rates for the arterial- and late-phase images were significantly higher than for the unenhanced and portal venous-phase images (p < 0.01). The combination of arterial- and late-phase images showed the same number of HCC nodules in the same number of patients as did the combination of unenhanced and triple-phase images. Conclusion: The combination of the arterial- and late-phase imagings was best for detecting HCC nodules.

    SPRINGER VERLAG, 1999年09月, ABDOMINAL IMAGING, 24 (5), 473 - 480, 英語

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    研究論文(学術雑誌)

  • Diffusion-weighted single-shot echoplanar MR imaging for liver disease

    T Kim, T Murakami, S Takahashi, M Hori, K Tsuda, H Nakamura

    OBJECTIVE. The aims of this study were to determine apparent diffusion coefficients (ADCs) of the abdominal organs and liver lesions, to determine the effect of the magnitude of b values on the ADCs, and to determine whether measured ADCs of liver tumors help differentiate benign from malignant lesions. SUBJECTS AND METHODS. Six healthy volunteers and 126 patients were examined with diffusion-weighted single shot echoplanar imaging using multiple b values (maximum, 846 sec/mm(2)). The ADCs of the liver, spleen, kidney, 49 malignant liver lesions (33 hepatocellular carcinomas, 15 metastatic liver tumors, and one cholangiocellular carcinoma), and 30 benign lesions (17 cysts, 12 hemangiomas, and one angiomyolipoma) were calculated. RESULTS. The ADCs of the abdominal organs and liver lesions showed smaller values when calculated with the greater maximum b values. The ADCs of the benign lesions calculated with all the b values of less than 850 sec/mm(2) (2.49 +/- 1.39 x 10(-3) mm(2)/sec) were significantly (p = .0024) greater than those of the malignant lesions (1.01 +/- 0.38 x 10(-3) mm(2)/sec). When the maximum b value is 846 sec/mm(2), use of a threshold ADC of 1.6 x 10(-3) mm(2)/sec would result in a sensitivity of 98% and a specificity of 80% for differentiation of malignant liver lesions from benign lesions. CONCLUSION. Measurement of ADC has good potential for characterizing liver lesions, but the calculated ADCs could be affected by the magnitude of the maximum b value.

    AMER ROENTGEN RAY SOC, 1999年08月, AMERICAN JOURNAL OF ROENTGENOLOGY, 173 (2), 393 - 398, 英語

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    研究論文(学術雑誌)

  • Evaluation of regional liver function by gadolinium-EOB-DTPA-enhanced MR imaging

    J Shimizu, K Dono, M Gotoh, Y Hasuike, T Kim, T Murakami, M Sakon, K Umeshita, H Nagano, S Nakamori, N Kato, T Miyazawa, H Nakamura, M Monden

    We evaluated the role of magnetic resonance (MR) imaging with gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA), in estimating regional liver function in a rat ischemia-reperfusion model. Ischemic liver damage was induced in the right lobe by vascular clamping for 0 (sham), 30 (I-30), 60 (I-60), and 90 min (I-90 group). The ischemic lobes in the I-60 and I-90 groups was clearly visualized as a high intensity area in the T1 images at late phase of Gd-EOB-DTPA enhancement, Moreover, the T1/2 of signal intensity in ischemic lobes significantly correlated with the duration of vascular clamping. We also observed significant correlation between T1/2 and ATP concentration in the liver tissue (r = -0.719, P = 0.04). Our results indicate that MR imaging with Gd-EOB-DTPA is useful for evaluation of regional liver function in rats.

    KLUWER ACADEMIC/PLENUM PUBL, 1999年07月, DIGESTIVE DISEASES AND SCIENCES, 44 (7), 1330 - 1337, 英語

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    研究論文(学術雑誌)

  • Pancreatic CT imaging: Effects of different injection rates and doses of contrast material

    T Kim, T Murakami, S Takahashi, A Okada, M Hori, Y Narumi, H Nakamura

    PURPOSE: To assess the effects of the intravenous injection rate and dose of contrast material on pancreatic computed tomography (CT). MATERIALS AND METHODS: A total of 126 patients were divided at random into four groups with different injection rates and doses. Groups 1 and 2 underwent injection of 2 mt per kilogram of body weight of 300 mg of iodine per milliliter of contrast material, and groups 3 and 4 underwent injection of 1.5 mL/kg. The injection rate was 5 mL/sec for groups 1 and 3 and 3 mL/sec for groups 2 and 4. Single-level serial CT scanning was performed at the level of the pancreatic head, and the pancreatic enhancement value was calculated. RESULTS: The maximum pancreatic enhancement value was 99 HU +/- 18 (mean +/- SD) for group 1, 90 HU +/- 18 for group 2, 86 HU +/- 15 for group 3, and 74 HU +/- 13 for group 4. There were significant differences in the maximum pancreatic enhancement value between groups 1 and 2 (P =.045), between groups 3 and 4 (P =.001), between groups 1 and 3 (P =.016), and between groups 2 and 4 (P =.001). CONCLUSION: Both a higher dose and a faster injection rate increased the maximum pancreatic enhancement value.

    RADIOLOGICAL SOC NORTH AMER, 1999年07月, RADIOLOGY, 212 (1), 219 - 225, 英語

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    研究論文(学術雑誌)

  • M Kanematsu, H Hoshi, T Murakami, K Itoh, M Hori, Y Inaba, H Kondo, R Yokoyama, H Nakamura

    The purpose of our study was to compare the diagnostic accuracy of fat-suppressed T2-weighted magnetic resonance (MR) images obtained with conventional spin-echo (SE), respiratory-triggered fast SE, and breath-hold multishot SE echoplanar (EP) sequences for the detection of hepatocellular carcinoma and metastases. Images obtained with the three sequences in 17 patients (15 with cirrhosis) with 31 hepatocellular carcinomas and 14 patients with 45 metastases were retrospectively analyzed, Image review was conducted on a segment-by-segment basis; in all, 248 liver segments were reviewed separately and independently for detection of solid, malignant lesions. Diagnostic accuracy was evaluated with receiver-operating-characteristic (ROC) curve analysis, Diagnostic accuracy for hepatocellular carcinoma as determined by ROC curve analysis was better by a statistically significant amount for conventional SE (Az = 0.95) images when compared with respiratory-triggered fast SE (Az = 0.83, P < 0.05) and breath-hold multishot SE EP (Az = 0.80, P < 0.05) images, Conventional SE MR sequences should not be replaced with respiratory-triggered fast SE or breath-hold multishot SE EP sequences for T2-weighted MR imaging of patients with hepatocellular carcinoma in cirrhosis, unless sufficient contrast-enhanced dynamic MR imaging Is subsequently performed. J. Magn. Reson. Imaging 1999; 10:25-32, 1999. (C) 1999 Wiley-Liss, Inc.

    JOHN WILEY & SONS INC, 1999年07月, JMRI-JOURNAL OF MAGNETIC RESONANCE IMAGING, 10 (1), 25 - 32, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Focal hepatic lesion detection: Comparison of four fat-suppressed T2-weighted MR imaging pulse sequences

    M Kanematsu, H Hoshi, K Itoh, T Murakami, M Hori, H Kondo, R Yokoyama, H Nakamura

    PURPOSE: To evaluate fat-suppressed T2-weighted magnetic resonance (MR) imaging with conventional spin-echo (SE), breath-hold fast SE, respiratory-triggered fast SE, and breath-hold multishot SE echo-planar sequences for the detection of focal hepatic lesions. MATERIALS AND METHODS: Fat-suppressed T2-weighted MR images obtained with the four sequences in 55 patients with 81 solid and 129 nonsolid lesions were retrospectively analyzed. Image review was conducted on a serment-by-segment basis; a total of 440 liver segments were reviewed separately for solid and nonsolid lesions by three independent radiologists. Diagnostic accuracy was evaluated with receiver operating characteristic analysis. RESULTS: The mean lesion-to-liver contrast-to-noise ratio was highest on the multishot SE echo-planar images of both solid and nonsolid lesions. Fat-suppressed respiratory-triggered fast SE images had significantly better (P < .05) or comparative detectability of both solid and nonsolid lesions compared with the other types of images. Image quality was best on the respiratory-triggered fast SE images. CONCLUSION: Fat-suppressed respiratory-triggered fast SE imaging should replace fat-suppressed conventional SE imaging as a standard T2-weighted imaging examination in the detection of focal hepatic lesions.

    RADIOLOGICAL SOC NORTH AMER, 1999年05月, RADIOLOGY, 211 (2), 363 - 371, 英語

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    研究論文(学術雑誌)

  • 時間変化情報を用いたマルチスライスCT画像からの肝臓領域の自動抽出

    桝本 潤, 佐藤 嘉伸, 堀 雅敏, 村上 卓道, 上甲 剛, 中村 仁信, 田村 進一

    1999年05月, 信学技報, 99 (427), 51 - 58, 日本語

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    研究論文(学術雑誌)

  • T Murakami, T Kim, T Sugiura, M Hori, M Takamura, K Wakasa, H Nakamura

    LIPPINCOTT WILLIAMS & WILKINS, 1999年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 23 (2), 320 - 322, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M. Kanematsu, H. Hoshi, T. Yamada, T. Murakami, T. Kim, M. Kato, R. Yokoyama, H. Nakamura

    Purpose: The purpose of this study was to assess the imaging findings of pathologically-proved small hepatic nodules 2 cm in size or smaller detected with ultrasonography in cirrhotic patients with suspected hepatocellular carcinoma (HCC). Materials and Methods: We evaluated sonographically detected 32 small hepatic nodules which were pathologically confirmed in 23 consecutive cirrhotic patients who were suspected of having HCC. Twenty-six lesions were confirmed with ultrasonographically-guided aspiration needle- core biopsy, and six with definitive surgery. Ultrasonographic examination records were retrospectively reviewed. CT, and MR images obtained with various imaging techniques were retrospectively reviewed by two radiologists in a blind fashion. Results: The 32 hepatic nodules were comprised of seven focal fatty changes, two large regenerative nodules, three low-grade dysplastic nodules, five high-grade dysplastic nodules, and fifteen HCCs. Ultrasonography showed various echogenicity for the hepatic nodules. The signal-intensity characteristics with T1-weighted spin-echo, in-phase gradient-recalled-echo, and dynamic MR imagings may be useful in distinguishing HCC from nonHCC nodules. Conclusions: Nearly half of small hepatic nodules detected with ultrasonography were nonHCC nodules. Ultrasonographic findings may not be reliable in characterizing small hepatic nodules in cirrhosis. CT and MR imaging obtained with the various techniques are still insensitive to these hepatic nodules.

    1999年01月, Abdominal Imaging, 24 (1), 47 - 55, 英語

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    研究論文(学術雑誌)

  • MRI of cervical adenocarcinoma with cystic components

    M Takamura, T Murakami, H Kurachi, Y Narumi, K Tsuda, T Enomoto, Y Murata, H Nakamura

    We encountered two cases of endocervical well-differentiated adenocarcinoma with cystic components. Magnetic resonance findings of the first case showed cystic lesion with enhanced mural nodule in the uterine cervix. The second case showed multicystic lesion in the uterine cervix. The cystic walls were thickening in the postcontrast T-weighted image. The cervical adenocarcinoma with cystic components should be added to one of differential diagnosis of the uterine cervical cystic lesion. (C) Elsevier Science Inc., 1999.

    ELSEVIER SCIENCE INC, 1999年01月, CLINICAL IMAGING, 23 (1), 40 - 43, 英語

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    研究論文(学術雑誌)

  • A case of fallopian tube carcinoma: Successful preoperative diagnosis with MR imaging

    H. Kurachi, T. Maeda, T. Murakami, K. Tsuda, Y. Narumi, H. Nakamura, A. Miyake, Y. Murata

    We report a case of fallopian tube carcinoma, successfully diagnosed preoperatively. The patient was a 64-year-old woman. Transvaginal sonography and computed tomography showed a cystic and solid tumor on the left side of the uterus, suggesting ovarian cancer. The tumor was, however, suspected to be a fallopian tube carcinoma on MR imaging. MR images showed a solid mass surrounded by a tube-shaped cystic part. At surgery, a solid and cystic tumor was found in the left fallopian tube. MR imaging may be useful to assist in the diagnosis of fallopian tube carcinoma.

    1999年, Radiation Medicine - Medical Imaging and Radiation Oncology, 17 (1), 63 - 66, 英語

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    研究論文(学術雑誌)

  • MR imaging of non-squamous vaginal tumors

    K Tsuda, T Murakami, H Kurachi, Y Narumi, T Kim, S Takahashi, K Tomoda, H Ohi, Y Murata, H Nakamura

    We reviewed the MR images and pathologic findings of five cases of primary vaginal neoplasms of non-squamous origin. Histologic types consisted one case each of adenocarcinoma, adenosarcoma, melanoma, lymphoma, and neurilemoma. Magnetic resonance imaging was found useful for evaluating the type and the extension of vaginal tumors.

    SPRINGER VERLAG, 1999年, EUROPEAN RADIOLOGY, 9 (6), 1214 - 1218, 英語

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    研究論文(学術雑誌)

  • MR imaging patterns of gadolinium retention within liver neoplasms

    MS Peterson, T Murakami, RL Baron

    Background: To determine the spectrum of appearances of gadolinium retention within cholangiocarcinoma (CCA) and other liver neoplasms. Methods: Two hundred ten patients underwent hepatic magnetic resonance imaging (MRI) at 1.5 T with precontrast T1- and T2-weighted spin-echo (SE) images and delayed Gd-DTPA- or gadoteridol-(0.1 mmol/kg) enhanced T1-weighted SE images. Postcontrast images were evaluated for lesions suspicious for tumors, and lesion signal intensity was characterized as homogeneously or heterogeneously hypo-, iso-, mildly hyper-, or markedly hyperintense to liver. Data from 94 patients with benign or malignant neoplasms are presented. Results: Imaging demonstrated 237 malignant neoplasms (121 hepatocellular carcinoma [HCC], 26 CCA, 17 colon carcinoma metastases, 73 other tumors) and 28 benign neoplasms (22 hemangioma, six focal nodular hyperplasia [FNH]). One hundred forty malignant lesions appeared as homogeneous postcontrast (29 hypointense, 75 isointense, 17 mildly hyperintense, 19 markedly hyperintense) and 97 as heterogeneous (15 isointense, 50 mildly hyperintense, 32 markedly hyperintense). Malignant lesions showing homogeneous, mildly or markedly hyperintense signal intensity postcontrast included 10 CCA, seven HCC, six epithelioid hemangioendothelioma, eight neuroendocrine tumor metastases, three adenocarcinoma metastases of unknown origin, and one breast carcinoma metastasis. Hemangiomas appeared as homogeneous postcontrast in 19 lesions (six isointense, one mildly hyperintense, 12 markedly hyperintense) and as heterogeneous in three lesions (markedly hyperintense). FNH appeared as homogeneous postcontrast in one lesion (isointense) and as heterogeneous in five lesions tone isointense, four mildly hyperintense). Conclusion: Homogeneous gadolinium retention on delayed postcontrast images of malignant hepatic neoplasms is seen in a high percentage of CCA lesions and less commonly with other neoplasms.

    SPRINGER VERLAG, 1998年11月, ABDOMINAL IMAGING, 23 (6), 592 - 599, 英語

    [査読有り]

    研究論文(学術雑誌)

  • M Hori, T Murakami, T Kim, S Takahashi, H Oi, K Tomoda, Y Narumi, H Nakamura

    Purpose: The purpose of our work was to determine the usefulness of double-phase helical CT during arterial portography (CTAP) for the detection of hypervascular hepatocellular carcinoma (HCC). Method: Eighty-four patients with 176 hypervascular HCC nodules underwent double-phase CTAP. Hypervascular HCCs were diagnosed by iodized oil CT after transcatheter arterial chemoembolization (TACE). The first-phase images were obtained 30 s after the initiation of injection of a nonionic iodinated contrast medium into the superior mesenteric artery or splenic artery, and the second-phase images were obtained after 70 s. These images were interpreted separately for detection of HCC. Results: The double-phase CTAP detected two nodules and six nodules that were missed by the first- and second-phase images, respectively. The sensitivity for hyper vascular HCC nodules was 89% for the first phase, 91% for the second phase, and 93% for the first phase and second phase combined. The double-phase CTAP showed significantly superior sensitivity to the first-phase CTAP for detecting HCC nodules (p < 0.05). However, there was no statistically significant difference between the sensitivities of the double-phase CTAP and the second-phase CTAP. The positive predictive Values of the double-phase images were inferior to those of either the first-phase or the second-phase images alone. Conclusion: Double-phase helical CTAP was found to be no better than second-phase CTAP alone for the detection of hypervascular HCC nodules.

    LIPPINCOTT WILLIAMS & WILKINS, 1998年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 22 (6), 861 - 867, 英語

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    研究論文(学術雑誌)

  • Experimental hepatic dysfunction: Evaluation by NMR imaging with Gd-EOB-DTPA

    T Murakami, TS Kim, M Gotoh, Y Hasuike, N Kato, T Miyazawa, M Monden, H Nakamura

    ASSOC UNIV RADIOLOGISTS, 1998年04月, ACADEMIC RADIOLOGY, 5, S80 - S82, 英語

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    研究論文(学術雑誌)

  • Gd-DTPA enhanced multi-shot echo-planar MRI: 転移性肝腫瘍と肝実質のコントラストの向上

    金 東石, 村上 卓道, 高橋 哲, 岡田 篤哉, 堀 雅敏, 宮原 伸浩, 友田 要, 鳴海 善文, 大井 博道, 中村 仁信

    1998年04月, 日本医放会誌, 58 (5), 235 - 237, 日本語

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    研究論文(学術雑誌)

  • Helical CT angiography of living renal donors: Comparison with 3D Fourier transformation phase contrast MRA

    K Tsuda, T Murakami, T Kim, Y Narumi, S Takahashi, K Tomoda, S Takahara, A Okuyama, H Oi, H Nakamura

    Purpose: The purpose of this study was to determine whether helical CT angiography (CTA) or MR angiography (MRA) is the optimal method to use as a preoperative examination for anatomic arterial assessment of Living renal donors. Method: Eighteen candidates to be renal donors underwent helical CTA, 3D Fourier transformation phase contrast (3D-FT-PC) MRA, and digital subtraction angiography (DSA). The CTA and MRA were interpreted separately by three readers independently, and these results were correlated with the findings of DSA. Results: DSA showed nine accessory renal arteries and 10 prehilar branches. CTA revealed seven or eight accessory renal arteries. MRA showed six or seven accessory arteries. Of 10 prehilar branches, 7-9 branches were detected with CTA and 5-8 branches with MRA. Conclusion: Helical CTA is superior to 3D-FT-PC MRA for evaluating the arterial anatomy of living renal donors.

    LIPPINCOTT WILLIAMS & WILKINS, 1998年03月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 22 (2), 186 - 193, 英語

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    研究論文(学術雑誌)

  • Sensitivity in detection of hypervascular hepatocellular carcinoma by helical CT with intra-arterial injection of contrast medium, and by helical CT and MR imaging with intravenous injection of contrast medium

    M Hori, T Murakami, H Oi, T Kim, S Takahashi, M Matsushita, K Tomoda, Y Narumi, K Kadowaki, H Nakamura

    Purpose: To determine the effectiveness of i.a, contrast-enhanced helical CT and of i.v. contrast-enhanced helical CT and MR imaging, in detecting hypervascular hepatocellular carcinoma (HCC). Material and Methods: Fifty patients with 125 hypervascular HCC nodules underwent helical CT both during arterial portography (CTAP) and during hepatic arteriography (CTHA). Helical CT and MR imaging of the entire liver with i.v, administration of contrast medium were also performed. Helical CT images were obtained at 30-33 s (arterial-phase CT) and at 5 min (equilibrium-phase CT) after the initiation of an i.v. bolus injection of contrast medium. After T1- and T2-weighted spin-echo MR imaging, gradient-echo images during breath-holding were obtained prior to and 20 s, 1 min, and 2 min after the bolus administration of 0.1 mmol/kg of gadopentetate dimeglumine (dynamic MR). The sensitivity and positive predictive value of the various techniques were evaluated and compared. Results. In terms of sensitivity for hypervascular HCC nodules of less than 1 cm in diameter, CTAP (90%) and CTHA (88%) were significantly superior to dynamic MR imaging (44%), arterial-phase CT (39%), spin-echo MR imaging (20%), and equilibrium-phase CT (7%) (p<0.001). However, there was no significant difference in the techniques with regard to the detection of lesions equal to or more than 2 cm in diameter. Conclusion: For detecting small hypervascular HCCs, helical CT with i.a. contrast enhancement is superior to helical CT and MR imaging with i.v. enhancement.

    MUNKSGAARD INT PUBL LTD, 1998年03月, ACTA RADIOLOGICA, 39 (2), 144 - 151, 英語

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    研究論文(学術雑誌)

  • MRI appearance of ruptured corpus luteum

    S. Takahashi, T. Murakami, Y. Narumi, H. Kurachi, K. Tsuda, T. Kim, K. Tomoda, H. Nakamura, Y. Murata

    A 20-year-old woman was admitted complaining of lower abdominal pain. Transabdominal ultrasound revealed a fluid collection in the pouch of Douglas and an irregularly shaped ovary with cystic lesions. Malignant cystic mass of the right ovary was highly suspected from the ultrasound findings. Transvaginal peritoneal centesis yielded a bloody fluid, but the pregnancy test was negative. On the third day of admission, menstruation began. MR examination performed four days after the initial onset of pain showed a subacute hematoma just adjacent to the right ovary, and segmental interruption of the right ovarian cortex. Based on these MR findings and the patient's history, subacute hemorrhage from the right ovarian corpus luteum was suspected, and this was confirmed with surgical exploration.

    1998年, Radiation Medicine - Medical Imaging and Radiation Oncology, 16 (6), 487 - 489, 英語

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    研究論文(学術雑誌)

  • Microwave Hepatic Tumor Coagulation Therapy during Stoppage of Hepatic Blood Flow Using Balloon Catheters

    Takamichi Murakami, Takashi Shibata, Takeshi Ishida, Tadayuki Satoh, Hironobu Nakamura

    The usefulness of microwave hepatic tumor coagulation therapy (MTC) with stoppage of hepatic blood flow using a balloon catheter was assessed. By placing a 5-French balloon catheter in a hepatic artery and 6-French balloon catheter in a hepatic vein, hepatic arterial and portal venous flow of the liver segment including the tumor was interrupted. The effects of balloon occlusion were evaluated by CT during arterial portography. MTC with stoppage of hepatic flow was performed for two patients with metastatic liver tumor 2cm in diameter. Enhanced CT obtained after MTC showed no enhancement of the tumor, indicating complete necrosis. There were no complications and the two patients were discharged within 4 days after MTC. MTC with stoppage of hepatic blood flow is effective for treatment of hepatic metastatic tumor.

    1998年, Nippon Acta Radiologica, 58 (7), 369 - 371, 日本語

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    研究論文(学術雑誌)

  • Spectrally selected efgre3d による全肝3D-Dynamic studyの有用性

    高橋 哲, 金 東石, 村上 卓道, 堀 雅敏, 岡田 篤哉, 中田 早紀, 津田 恭, 鳴海 善文, 友田 要, 大井 博道, 中村 仁信

    Three-dimensional gadolinium-enhanced dynamic MRI of whole liver using the spectrally selected enhanced fast gradient recall sequence (spec IR-efgre3d) was performed in five patients with HCC. Ten HCC nodules were confirmed by CTA, CTAP and Lipiodol CT, and all of them were detected with dynamic MRI. MIP images reconstructed from 3D gadolinium-enhanced dynamic MR studies clearly showed the main portal vein and its branches in all cases. Portal vein thrombosis was also demonstrated with the MIP images.

    1998年, 日本医放会誌, 58 (3), 99 - 101, 日本語

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    研究論文(学術雑誌)

  • CT arterial portography and CT arteriography with a triple-lumen balloon catheter

    T Murakami, H Oi, M Hori, T Kim, S Takahashi, M Matsushita, Y Narumi, H Nakamura

    Purpose: To evaluate the usefulness of the triple-lumen balloon catheter in the serial performance of CT arterial portography (CT-AP) and CT arteriography (CT-A). Material and Methods: A combined CT-AP and CT-A examination of 58 patients was carried out in which a cobra-type triple-lumen balloon catheter was used. CT-AP was performed by injecting contrast medium either into the splenic artery through a side-hole in the catheter proximal to the balloon inflated in the common hepatic artery, or into the superior mesenteric artery through an end-hole in the catheter. Then CT-A was serially performed by delivering contrast medium either to the common hepatic artery or the proper hepatic artery from the end-hole, or to the accessory right hepatic artery through a side-hole proximal to the inflated balloon. Results: Sufficient CT-APs were obtained in 53 of the 58 patients (91%), CT-A in 42 (72%), and both in 42 (72%). Incomplete CT-AP was due to technical failure or anatomical anomaly, as was incomplete CT-A. No complications were seen. Conclusion: The triple-lumen balloon catheter technique is useful and convenient in the serial performance of CT-AP and CT-A.

    MUNKSGAARD INT PUBL LTD, 1997年07月, ACTA RADIOLOGICA, 38 (4), 553 - 557, 英語

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    研究論文(学術雑誌)

  • Superparamagnetic iron oxide enhanced magnetic resonance imaging of rat liver with hepatocellular carcinoma and benign hyperplastic nodule

    T Ishida, T Murakami, N Kato, M Takahashi, T Miyazawa, K Tsuda, K Tomoda, Y Narumi, H Nakamura

    RATIONALE AND OBJECTIVES. The authors assess the potential of a new superparamagnetic iron oxide (SPIO) in grading hepatocellular carcinoma (HCC) histologically and in differentiating HCC from benign hyperplastic nodule (HPN). METHODS. Nine Wistar rats (with poorly to moderately differentiated HCC, well-differentiated HCC, and HPN) received drinking water containing N-nitrosomorpholine, and were examined by magnetic resonance imaging (4.7 tesla). Spin-echo images (repetition time/echo time, 600/24.5 mseconds) were obtained before and 15 minutes after intravenous administration of 10 mu mol Fe/kg of SH U 555A. RESULTS. poorly to moderately differentiated and well-differentiated HCC showed no significant change in signal-to-noise ratio (SNR) 15 minutes after contrast, whereas HPN showed a significant decrease in SNR. The contrast-to-noise ratio (CNR) between each kind of tumor and adjacent liver parenchyma showed a significant increase at 15 minutes after contrast. CONCLUSIONS. The SPIO discussed in this article may help to differentiate HCC from HPN, but it remains difficult to grade hepatocellular carcinoma histologically.

    LIPPINCOTT-RAVEN PUBL, 1997年05月, INVESTIGATIVE RADIOLOGY, 32 (5), 282 - 287, 英語

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    研究論文(学術雑誌)

  • Hepatocellular carcinoma patients showing long-term complete responses to chemoembolization

    T Hashimoto, H Nakamura, K Tomoda, T Murakami, K Nakanishi, K Tsuda, T Ishida, T Kim, Y Narumi

    W B SAUNDERS CO, 1997年04月, SEMINARS IN ONCOLOGY, 24 (2), 26 - 28, 英語

    [査読有り]

    研究論文(学術雑誌)

  • A case of hepatocellular carcinoma detected by dynamic CT and MRI but not digital subtraction angiography

    Atsushi Omae, Kazuhiro Katayama, Takuya Miyagi, Norihiro Enomoto, Akihiko Ito, Hirotaka Nagai, Yoshiki Ito, Hideki Hagiwara, Kiyoshi Mochizuki, Akinori Kasahara, Takamichi Murakami, Kaname Tomoda, Hironobu Nakamura, Norio Hayashi

    1997年01月, Japanese Journal of Gastroenterology, 94 (1), 56 - 61, 日本語

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    研究論文(学術雑誌)

  • Dynamic MR imaging for extraserosal invasion of advanced gastric cancer

    H Oi, M Matsushita, T Murakami, H Nakamura

    Dynamic magnetic resonance (MR) images in 37 patients with gastric cancers were obtained by a two-dimensional fast multiplanar spoiled gradient technique. The degree of tumor invasion was classified into four grades regarding a low-intensity band between the stomach and surrounding fat. Advanced gastric cancer was strongly enhanced, appearing as a thickened wall, by the contrast medium during the early to delayed phases of dynamic studies, The extent of invasion of the adjacent organs was diagnosed by the difference in enhancement between the tumor and the parenchyma, The sensitivity of extraserosal invasion was 93%, Dynamic MR diagnosis is useful for evaluating the extent of gastric carcinoma.

    SPRINGER VERLAG, 1997年01月, ABDOMINAL IMAGING, 22 (1), 35 - 40, 英語

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    研究論文(学術雑誌)

  • MR imaging of cervical carcinoma: Comparison among T2-weighted, dynamic, and postcontrast T1-weighted images with histopathological correlation

    K Tsuda, T Murakami, H Kurachi, H Ogawa, H Oi, A Miyake, Y Narumi, H Nakamura

    Background: To identify the reasons for misdiagnosis of the degree of stromal invasion by uterine cervical cancer with various magnetic resonance sequences. Methods: T2-weighted, dynamic, and postcontrast T1-weighted images were obtained in the sagittal plane in 20 patients with uterine cervical cancer, After evaluating these sequences for the degree of stromal invasion, histologic specimens were directly correlated with these images. Results: The degree of stromal invasion was correctly diagnosed in 15 of the 20 cases on T2-weighted images, in 12 on dynamic images, and in eight on postcontrast T1-weighted images. All misdiagnoses were due to overestimation. Histologically, peritumoral stroma showed inflammation or edema in two patients, whereas no histological abnormality was found in the other patients. A hyperintense rim, i.e., a peritumoral enhanced ring-shaped structure, was observed on the enhanced images of five patients. The hyperintense rim corresponded to the periphery of the tumor in three patients and to the cervical stroma in two patients. Conclusion: T2-weighted images permitted the most accurate evaluation of stromal invasion by uterine tumors. Overdiagnosis may be due to an abnormal intensity of the cervical stroma, which was observed more frequently on dynamic and postcontrast T1-weighted images than on T2-weighted images.

    SPRINGER VERLAG, 1997年01月, ABDOMINAL IMAGING, 22 (1), 103 - 107, 英語

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    研究論文(学術雑誌)

  • Overestimation ratio of hepatic lesion size on spiral CT arterial portography: An indicator of malignancy

    M. Kanematsu, H. Hoshi, T. Imaeda, T. Murakami, T. Yamada, Y. Nishigaki, Y. Nandate, R. Yokoyama, H. Nakamura

    Purpose: To assess the reliability of the size-overestimation ratio obtained from spiral CT arterial portography (CTAP) and spiral equilibrium- phase CT (EPCT) in distinguishing malignant focal hepatic lesions from benign ones. Methods: The CTAP images and EPCT images obtained five minutes after CTAP in 39 patients with focal hepatic lesions were retrospectively analyzed. Fifty-eight lesions (hepatocellular carcinoma [HCC], 33 metastasis, 10 liver cyst, 10 cavernous hemangioma, 2 adenomatous hyperplasia [AH], 2 focal nodular hyperplasia [FNH], 1) had their sizes measured on CTAP and EPCT images using the calipers on the CT console. Results: The size-overestimation ratios (CTAP/EPCT) were 1.24 ± 0.15 in HCC, 1.28 ± 0.26 in metastasis, 1.02 ± 0.23 in liver cyst, 0.98 ± 0.34 in cavernous hemangioma, 0.94 ± 0.39 in AH, and 1.00 in FNH. Mean size-overestimation ratios for benign- and malignant-lesion groups were 1.00 ± 0.37 and 1.25 ± 0.18, respectively (p < 0.0001). When a cutoff level was set at 1.05, sensitivity and specificity for malignancy were 91% and 93%, respectively. Conclusions: In comparison with EPCT, CTAP significantly overestimates the size of malignant hepatic tumors. This phenomenon may be an indicator of hepatic malignancy.

    1997年, Radiation Medicine - Medical Imaging and Radiation Oncology, 15 (5), 267 - 272, 英語

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    研究論文(学術雑誌)

  • Trial of a Detachable Y-shaped Tube with Two Valves for Serial Examinations of CT Arterial Portography and CT Hepatic Arteriography

    Takamichi Murakami, Kaname Tomoda, Tsutomu Sakamoto, Tonsok Kim, Kyo Tsuda, Satoru Takahashi, Atsuya Okada, Takashi Sugiura, Yoshifumi Narumi, Hironobu Nakamura

    In five patients with hepatocellular carcinoma, CT arterial portography (CTAP) and CT hepatic arteriography (CTHA) were performed serially by using a newly developed detachable Y-shaped tube with two valves that could be attached to a conventional angiographic sheath. Two catheters could be inserted into the conventional angiographic sheath without blood backflow by using the Y-shaped tube. One catheter could be easily and safety placed on the common or proper hepatic artery, and the other on the superior mesenteric artery. This detachable Y-shaped tube with two valves could make it easy to perform serial CTAP and CTHA examinations.

    1997年, Nippon Acta Radiologica, 57 (7), 430 - 432, 日本語

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    研究論文(学術雑誌)

  • Combined hepatocellular and cholangiocellular carcinoma

    T. Murakami, T. Kim, K. Tomoda, Y. Narumi, M. Sakon, K. Wakasa, H. Nakamura

    A patient with combined hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC) underwent partial hepatectomy, and the correlation between the pathological and radiological findings was examined retrospectively. The tumor showed hypoattenuation and hypoenhancement relative to the surrounding liver parenchyma on noncontrast and postcontrast CT, respectively. Both the HCC and CCC components of the tumor showed hypointensity and heterogeneous hyperintensity on T1- and T2-weighted spin echo images, respectively. While the HCC component of the tumor showed hyperenhancement relative to the liver parenchyma on arterial phase images of dynamic MR imaging, the CCC component showed hypoenhancement. When components with different degrees of vascularity are seen in a hepatic tumor, combined HCC and CCC should be considered.

    1997年, Radiation Medicine - Medical Imaging and Radiation Oncology, 15 (4), 243 - 246, 英語

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    研究論文(学術雑誌)

  • Spontaneous bacterial peritonitis in Cirrhosis: Enhancement of ascites on delayed MR imaging

    M. Kanematsu, H. Hoshi, T. Murakami, K. Tsuda, R. Yokoyama, H. Nakamura

    Delayed contrast enhancement of ascites in MR imaging performed in a 61- year-old cirrhotic patient who developed spontaneous bacterial peritonitis is discussed. Delayed T1-weighted spin-echo MR images after the IV injection of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) showed remarkable enhancement of ascites. The ascites showed marked elevation in total protein value and neutrophil count, establishing a diagnosis of spontaneous bacterial peritonitis. This case suggests the potency of delayed-enhancement MR imaging for the prediction of spontaneous bacterial peritonitis in cirrhotic patients.

    1997年, Radiation Medicine - Medical Imaging and Radiation Oncology, 15 (3), 185 - 187, 英語

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    研究論文(学術雑誌)

  • CT guided percutaneous microwave tumor coagulation therapy for local recurrence of rectal cancer

    T. Ishida, M. Yoshii, T. Murakami, T. Sato, T. Niinobu, T. Shibata

    Purpose: To evaluate the usefulness of the CT guided percutaneous microwave tumor coagulation (PMTC) therapy for local recurrence of rectal cancer. Materials and Methods: The CT guided PMTC was performed for two patients with local recurrence of rectal cancer. Maximum axial diameter of the tumor was 30 mm on CT images. With patients in the prone position on the CT table, a 14-gauge needle-electrode was used to penetrate the tumor under epidural and local anesthesia. PMTC was performed with an output of 60 watts for 60 seconds at a time. Effects of the PMTC were evaluated by CT images obtained three months after the therapy. Results: In both cases, there was no evidence of tumor growth on the CT images. Clinical symptoms disappeared soon after the therapy, and no major complication was observed. Conclusion: The CT guided PMTC therapy was useful for local recurrence of rectal cancer.

    1997年, Japanese Journal of Cancer and Chemotherapy, 24 (12), 1851 - 1853, 日本語

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    研究論文(学術雑誌)

  • The change of hepatic energy status after transcatheter arterial embolization (TAE) for hepatocellular carcinoma - A study using 31P-MRS

    K. Taniguchi, T. Kaminaga, M. Sakon, K. Umeshita, T. Yamada, Y. Takeda, N. Higaki, T. Aoki, H. Ohzato, Y. Hasuike, M. Gotoh, T. Murakami, H. Nakamura, M. Monden

    In six patients with hepatocellular carcinoma, adenosine triphosphate (ATP), phosphomonoester (PME), phosphoric acid (Pi), and pH were measured before and after transcatheter arterial embolization (TAE), using 31P- magnetic resonance spectroscopy (MRS). The effectiveness of TAE was judged by the extent of lipiodol accumulation within the tumor and change in serum alphafetoprotein level. The pH within the tumor decreased 2 -9 days after TAE in all the cases, and βATP/Pi ratio decreased when TAE was effective, whereas the ratio did not decrease when TAE was ineffective. The βATP/Pi ratio measured by 31P-MRS seems to be a useful, non-invasive marker of the anti-tumor effect of TAE, although further investigation is needed.

    1997年, Japanese Journal of Cancer and Chemotherapy, 24 (12), 1632 - 1634, 日本語

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    研究論文(学術雑誌)

  • Preliminary Evaluation of the Apparent Diffusion Coefficient of the Kidney with a Spiral IVIM Sequence

    Kyo Tsuda, Takamichi Murakami, Kousuke Sakurai, Koushi Harada, Tonsok Kim, Satoru Takahashi, Kaname Tomoda, Yoshifumi Narumi, Hironobu Nakamura, Masaaki Izumi, Tetsuji Tsukamoto

    We examined the usefulness of the spiral intravoxel incoherent motion (IVIM) sequence in measuring the apparent diffusion coefficient (ADC)of the kidneys. Five volunteers and five patients with chronic renal failure underwent diffusion-sensitive magnetic resonance imaging of the kidneys with the spiral IVIM sequence. The ADC values in patients with chronic renal failure were significantly lower than those in the renal cortex of volunteers. The mean value of ADC in patients with chronic renal failure was lower than that in volunteers, although there was no statistically significant difference. In volunteers, the ADC of the renal cortex was significantly higher than that of the renal medulla. The phantom study indicated that the accuracy of ADC depended on the signal to noise ratio. A spiral IVIM sequence with a high enough signal to noise ratio may be useful in evaluating renal function, especially that of the cortex.

    1997年, Nippon Acta Radiologica, 57 (1), 19 - 22, 日本語

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    研究論文(学術雑誌)

  • Hepatic malignancies: Usefulness of acquisition of multiple arterial and portal venous phase images at dynamic gadolinium-enhanced MR imaging

    MS Peterson, RL Baron, T Murakami

    PURPOSE: To determine whether liver tumor detection is increased by acquiring multiple dynamic arterial phase and portal venous phase magnetic resonance (MR) images. MATERIALS AND METHODS: Dynamic MR imaging was performed in 205 patients at 1.5 T with use of a fast spoiled gradient-echo technique (repetition time, 9-12 msec; echo time, 2.1-3.0 msec; flip angle, 30 degrees). During intravenous bolus injection of gadopentetate dimeglumine or gadoteridol (0.1 mmol/kg), nine images were acquired at each of 10-12 locations over approximately 120 seconds. The number of tumors detected on arterial phase and portal venous phase images and unenhanced T1- and T2-weighted spin-echo (SE) images was evaluated separately. Data obtained in 75 patients with proved malignancies were analyzed. RESULTS: At imaging, 220 malignant tumor nodules were depicted. At prospective review of all images, 110 hepatocellular carcinomas (HCCs) were detected: 82 (75%) on unenhanced T1-weighted SE images, 83 (75%) on unenhanced T2-weighted SE images, 92 (84%) on arterial phase images, and 76 (69%) on portal venous phase images. At prospective review, eight HCCs were detected on only arterial phase images, one on only portal venous phase images, nine on both arterial and portal venous phase images, and 11 on only unenhanced SE images. The 18 additional HCCs detected prospectively on only dynamic images increased HCC detection by 21% over prospective detection on only SE images. Detection of non-HCC tumors (including metastases) did not increase with dynamic images. CONCLUSION Acquisition of multiple dynamic arterial phase and portal venous phase images increased detection of HCC but not metastases.

    RADIOLOGICAL SOC NORTH AMER, 1996年11月, RADIOLOGY, 201 (2), 337 - 345, 英語

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    研究論文(学術雑誌)

  • Vaginal arteriovenous malformation: MR imaging

    K Matsumoto, H Kurachi, T Murakami, Y Narumi, K Tsuda, K Yoshino, H Nakamura, A Miyake

    Vaginal arteriovenous malformations (AVMs), although rare, can lead to life-threatening complications. We report the first case of a vaginal AVM whose diagnosis and follow-up were performed by magnetic resonance imaging (MRI), MRI findings of the AVM are the blood flow-related features within the tumor, such as the phase-shift artifact, paradoxical enhancement, and flow voids.

    SPRINGER VERLAG, 1996年11月, ABDOMINAL IMAGING, 21 (6), 554 - 556, 英語

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    研究論文(学術雑誌)

  • The bladder and bladder tumors: Imaging with three dimensional display of helical CT data

    Y Narumi, T Kumatani, Y Sawai, K Kuriyama, C Kuroda, S Takahashi, T Kim, K Tsuda, T Murakami, H Nakamura

    AMER ROENTGEN RAY SOC, 1996年11月, AMERICAN JOURNAL OF ROENTGENOLOGY, 167 (5), 1134 - 1135, 英語

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    研究論文(学術雑誌)

  • MR evaluation of mediopatellar plica

    K Nakanishi, M Inoue, T Ishida, T Murakami, K Tsuda, J Ikezoe, H Nakamura

    Purpose: Evaluation of the usefulness of MR imaging for diagnosing mediopatellar plica (MP) of the knee joint. Material and Methods: We prospectively examined MR images of 40 knee joints in 30 patients with symptoms. The pulse sequences were SE T1-weighted images (600/26 ms), T2-weighted images (1800/70), and FLASH images (320/15/flip angle 90 degrees). When a low-intensity band was found above the medial condyle of the femur on T1-weighted and T2-weighted MR images, we defined it as MP. We compared these MR findings with arthroscopic findings, including the SAKAKIBARA classification of MP. Results: In 29 of the 40 knee joints in which MP was arthroscopically found, 27 were correctly diagnosed as having MP on MR. In the remaining 11 without MP, 9 were correctly diagnosed by MR. Conclusion: MR images are useful not only for detecting MP but also for evaluating its extension. Our results suggest that MR imaging is useful as a screening method for detecting MP before arthroscopy.

    MUNKSGAARD INT PUBL LTD, 1996年07月, ACTA RADIOLOGICA, 37 (4), 567 - 571, 英語

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    研究論文(学術雑誌)

  • Ciliated foregut cyst in cirrhotic liver

    T Murakami, A Imai, H Nakamura, K Tsuda, T Kanai, K Wakasa

    We encountered a patient with a ciliated hepatic foregut cyst with accompanying liver cirrhosis, which was hard to distinguish from well-differentiated hepatocellular carcinoma. A lesion 2 cm in diameter was found in the subcapsular region of the medial segment of the liver. It was slightly hypoechoic on ultrasonography, of high attenuation on nonenhanced computed tomography (CT), of high intensity on T-1-weighted spin echo images of magnetic resonance imaging (MRI), and of isointensity on T-2-weighted spin echo images. It was not enhanced in the arterial phase images of MRI, and was shown as a complete perfusion defect on CT arterial portography. The cyst was enucleated and found to be filled with bloody mucinous fluid.

    SPRINGER VERLAG, 1996年06月, JOURNAL OF GASTROENTEROLOGY, 31 (3), 446 - 449, 英語

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    研究論文(学術雑誌)

  • CT and NIR imaging of abdominal liposarcoma

    T Kim, T Murakami, H Oi, K Tsuda, M Matsushita, K Tomoda, H Fukuda, H Nakamura

    OBJECTIVE. CT and MR images were reviewed to correlate the histologic subtypes of abdominal liposarcoma with the radiologic findings. SUBJECTS AND METHODS. Ten patients with liposarcoma who underwent CT or MR imaging before surgery were included in this study, CT and MR imaging findings for these patients were compared retrospectively with histologic findings. RESULTS. Major histologic subtypes found in our group of patients were five well-differentiated, three myxoid, one pleomorphic, and one round-cell liposarcomas. The well-differentiated subtype consisted of lipoma-like and/or sclerosing components. The predominant attenuation and signal intensity characteristics of the lipoma-like components on CT and MR images resembled those of fat, whereas the predominant attenuation and signal intensity characteristics of the sclerosing components resembled those of muscle. The myxoid subtype showed, on unenhanced images, predominant attenuation and signal intensity characteristics that resembled those of water; on contrast-enhanced images, this subtype showed gradual reticular enhancement. The appearance of the round-cell and pleomorphic subtypes was that of heterogeneous, nonfatty tumors, Their characteristics were indistinguishable from those of other malignant soft-tissue masses. CONCLUSION. Each histologic subtype of abdominal liposarcoma showed different CT attenuation or MR imaging signal intensity characteristics. A clear understanding of these findings should prove helpful in the diagnosis of liposarcoma.

    AMER ROENTGEN RAY SOC, 1996年04月, AMERICAN JOURNAL OF ROENTGENOLOGY, 166 (4), 829 - 833, 英語

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    研究論文(学術雑誌)

  • Value of gonadotropin-releasing hormone agonist in diagnosing peritoneal pseudocysts

    H Kurachi, T Murakami, T Maeda, K Tsuda, O Higashiguchi, H Nakamura, A Miyake

    MUNKSGAARD INT PUBL LTD, 1996年03月, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 75 (3), 294 - 297, 英語

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    研究論文(学術雑誌)

  • Dynamic MR imaging and early-phase helical CT for detecting small intrahepatic metastases of hepatocellular carcinoma

    H Oi, T Murakami, T Kim, M Matsushita, H Kishimoto, H Nakamura

    OBJECTIVE. We performed a study to evaluate the sensitivities of multislice dynamic MR imaging and early-phase helical CT as noninvasive methods for detecting small intrahepatic metastases of hepatocellular carcinomas. MATERIALS AND METHODS. Dynamic and spin-echo MR imaging and early- and delayed-phase helical CT of the liver were performed for patients with multiple hepatocellular carcinomas before transcatheter arterial chemoembolization. Forty-nine patients had 242 intrahepatic metastases less than 3 cm in diameter. Using iodized-oil CT after transcatheter arterial chemoembolization as a gold standard, the sensitivity of MR imaging for detecting intrahepatic metastases was compared with that of CT. RESULTS. Of the 242 nodules, 225 were diagnosed as hepatocellular carcinomas by iodized-oil CT. Of these, dynamic MR imaging depicted 140 nodules and early-phase CT depicted 106. The sensitivities of dynamic MR imaging and early-phase CT were significantly Superior to those of spin-echo MR imaging (p < .0001) and delayed-phase CT (p < .0001) for tumors less than 1 cm in diameter. CONCLUSION. Dynamic MR imaging and early-phase CT of the liver are the most sensitive noninvasive means of detecting small intrahepatic metastases of hepatocellular carcinomas before and after treatment.

    AMER ROENTGEN RAY SOC, 1996年02月, AMERICAN JOURNAL OF ROENTGENOLOGY, 166 (2), 369 - 374, 英語

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    研究論文(学術雑誌)

  • 3DFT-flash MR imaging of pancreatic cancer with gadopentetate dimeglumine

    T. Murakami, K. Tsuda, H. Nakamura, K. Osuga, K. Tomoda, S. Hori, M. Miyata, M. Monden, K. Wakasa

    Purpose: We evaluated the usefulness of dynamic 3-dimensional Fourier transformation (3DFT) fast low angle shot (FLASH) MR imaging using gadopentetate dimeglumine (Gd-DTPA) to assess the extent of pancreatic cancer. Material and Methods: Breath-hold 3DFT-FLASH MR images (20/4 25° flip angle 7 partitions 3-5-mm slice thickness) were obtained before the administration of 0.1 mmol/kg of Gd-DTPA, just after (early phase), and 1 and 2 min (late phases) after in 14 patients with pancreatic cancer. All patients underwent surgical removal or laparotomy. We compared the findings of T1-, T2-, and postcontrast T1-weighted spin-echo (conventional SE) and 3DFT-FLASH imaging with histologic or surgical findings. Results: Dynamic MR images could delineate the pancreatic tumors more clearly than the conventional SE images, and were useful for diagnosing vessel invasion. The contrast-to-noise ratio between the pancreatic cancer and the surrounding pancreatic parenchyma was significantly higher with the dynamic 3DFT-FLASH image than with the conventional SE images (p0.01). Conclusion: Dynamic 3DFT-FLASH MR imaging with Gd-DTPA is useful in delineating and evaluating the extent of pancreatic cancer. Copyright © Acta Radiologica 1996.

    1996年, Acta Radiologica, 37 (2), 190 - 194, 英語

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    研究論文(学術雑誌)

  • DETECTION OF HYPERVASCULAR HEPATOCELLULAR-CARCINOMA BY DYNAMIC MRI AND DYNAMIC SPIRAL CT

    T KIM, T MURAKAMI, H OI, M MATSUSHITA, H KISHIMOTO, H IGARASHI, H NAKAMURA, J OKAMURA

    Objective: Our goal was to evaluate the detectability of hypervascular hepatocellular carcinomas (HCCs) by multislice dynamic MRI and dynamic spiral CT. Materials and Methods: Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, the liver was subjected to T1- and T7-weighted SE-MRI, multislice dynamic MRI after intravenous bolus injection of Gd-DTPA, early phase imaging with spiral CT (dynamic spiral CT) after intravenous bolus injection of contrast medium (at a rate of 2 or 3 ml/s), and delayed phase CT in 64 patients with 208 HCC nodules. The detectability of HCCs by MRI and CT was evaluated retrospectively compared with CT after TACE as a gold standard. Results: The detectability of nodules <1 cm in diameter was superior with dynamic MRI (67%) and dynamic spiral CT (50%) in comparison with SE-MRI (26%) and delayed phase CT (11%) (p < 0.01). The detectability of these tumors with dynamic MRI was significantly superior to that with dynamic spiral CT using an injection rate of 2 ml/s (p < 0.01), but not significantly different from that of dynamic spiral CT using a rate of 3 ml/s. Conclusion: Dynamic MRI and dynamic spiral CT are comparable for detecting hypervascular intrahepatic metastases of HCC.

    LIPPINCOTT-RAVEN PUBL, 1995年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 19 (6), 948 - 954, 英語

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    研究論文(学術雑誌)

  • INTRAMURAL INVASION OF GASTRIC-CANCER - EVALUATION BY CT WITH WATER-FILLING METHOD

    K TSUDA, S HORI, T MURAKAMI, H NAKAMURA, K TOMODA, K NAKANISHI, H SHIOZAKI

    Objective: Our goal was to clarify the ability of CT to evaluate intramural invasion of gastric cancer. Materials and Methods: We reviewed bolus-enhanced CT images performed with orally administered 40-600 ml of water in 59 early gastric cancers and 22 advanced gastric cancers mimicking early gastric cancers macroscopically. Results: CT was able to reveal 49% of early gastric cancers and 68% of advanced gastric cancers mimicking early cancers. Twenty-seven gastric tumors were detected in two or three layered structure of wall. Morphologic features of early gastric cancers are strong enhancement without wall thickening and thickened inner layer with normal middle and outer layers. Morphologic features of early advanced gastric cancers are a thickened wall with disappeared middle and outer layers and transmural enhancement with wall thickening. If one of these features was used to predict whether the tumor was early or early advanced gastric cancer in detected cases, specificity was 93-100%, sensitivity was 7-72%, and positive predictive value was 80-100%. Conclusion: We evaluated whether the wall pattern of gastric tumors on CT can provide useful information about intramural invasion.

    LIPPINCOTT-RAVEN PUBL, 1995年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 19 (6), 941 - 947, 英語

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    研究論文(学術雑誌)

  • DETECTABILITY OF HYPERVASCULAR HEPATOCELLULAR-CARCINOMA BY ARTERIAL PHASE IMAGES OF MR AND SPIRAL CT

    T MURAKAMI, T KIM, H OI, H NAKAMURA, H IGARASHI, M MATSUSHITA, J OKAMURA, T KOZUKA

    The ability of arterial phase images of breath-hold MR imaging and spiral CT to detect hypervascular hepatocellular carcinomas (HCCs) was evaluated. Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, MR images and spiral CT during i.v. bolus injection of contrast medium (IV-MR imaging and IV-spiral CT) and spiral CT during intraarterial injection of contrast media through catheter (IA-spiral CT) of the entire liver were obtained in 24 consecutive patients with 93 HCCs. In the detection of HCCs less than 1 cm in diameter, IA-spiral CT (87.3%) was superior to IV-MR imaging (63.5%) and IV-spiral CT (54.0%) (p <0.001). There was no significant difference in detectability in any tumor size between IV-MR imaging and IV-spiral CT IA-spiral CT was the best for detecting hypervascular HCCs, and there was no significant difference between IV-MR imaging and IV-spiral CT.

    MUNKSGAARD INT PUBL LTD, 1995年07月, ACTA RADIOLOGICA, 36 (4), 372 - 376, 英語

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    研究論文(学術雑誌)

  • Cervical invasion of endometrial carcinoma - evaluation by parasagittal MR imaging

    T. Murakami, H. Kurachi, H. Nakamura, K. Tsuda, A. Miyake, K. Tomoda, S. Hori, T. Kozuka

    Twenty-seven consecutive patients were examined by T2-(1 800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma.

    1995年05月, Acta Radiologica, 36 (3), 248 - 253, 英語

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    研究論文(学術雑誌)

  • MRI OF PLACENTAL POLYPS

    H KURACHI, T MAEDA, T MURAKAMI, K TSUDA, M SAKATA, H NAKAMURA, A MIYAKE

    Objective: Placental polyp is intrauterine polypoid placental tissue retained after delivery or abortion and may cause life-threatening bleeding. We studied the value of MRI in diagnosing placental polyps. Material and Methods: Two women, 26 and 32 years old, with histologically proven placental polyp were included in this study. These patients were treated with local injections of methotrexate or transcatheter arterial embolization. The MR images before and after these treatments were studied retrospectively. Results: High intensity pedunculated masses of 3-4 cm in size were observed in the expanded uterine cavity on T2-weighted and contrast-enhanced T1-weighted SE images. Bloody contents were observed around the masses. Placental polyps were more intensely enhanced than the myometrium by the contrast media, and the enhanced T1-weighted images indicated the retained placental tissues with an adherent part to the myometrium. Magnetic resonance imaging was also useful in following up the reduction in the size of the lesions and in the blood flow after the treatments. Conclusions: Magnetic resonance imaging may be useful in diagnosing and following up placental polyps.

    LIPPINCOTT-RAVEN PUBL, 1995年05月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 19 (3), 444 - 448, 英語

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    研究論文(学術雑誌)

  • CERVICAL INVASION OF ENDOMETRIAL CARCINOMA - EVALUATION BY PARASAGITTAL MR-IMAGING

    T MURAKAMI, H KURACHI, H NAKAMURA, K TSUDA, A MIYAKE, K TOMODA, S HORI, T KOZUKA

    Twenty-seven consecutive patients were examined by T2-(1 800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma.

    MUNKSGAARD INT PUBL LTD, 1995年05月, ACTA RADIOLOGICA, 36 (3), 248 - 253, 英語

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    研究論文(学術雑誌)

  • HEPATOCELLULAR-CARCINOMA - EFFICACY OF TRANSCATHETER OILY CHEMOEMBOLIZATION IN RELATION TO MACROSCOPIC AND MICROSCOPIC PATTERNS OF TUMOR-GROWTH AMONG 100 PATIENTS WITH PARTIAL-HEPATECTOMY

    T HASHIMOTO, H NAKAMURA, S HORI, K TOMODA, K NAKANISHI, T MURAKAMI, T KOZUKA, M MONDEN, M GOTOH, C KURODA, K WAKASA, M SAKURAI

    Purpose: To evaluate the efficacy of transcatheter oily chemoembolization (TOCE) for hepatocellular carcinoma (HCC) on the basis of microscopic and macroscopic findings postembolization. Methods: HCCs ranging in size from 0.5 to 13 cm (mean 3.6 cm) were obtained from partial hepatectomies of 100 consecutive patients who had undergone TOCE between 20 and 246 days (mean 59.5 days) prior to surgery. The efficacy of TOCE was assessed on the basis of the necrotic to live cell ratio of the tumors. The microscopic pattern of tumor growth was grouped into expanding type (complete capsule formation) and replacing type (incomplete or no capsule). There were five types of macroscopic groupings: single nodule, single nodule with extranodular growth (SNE), contiguous and noncontiguous multinodular, and massive growth type. Results: Among 79 cases with the expanding type, 29 (37%) had 100% HCC necrosis, but none with 100% necrosis were in the replacing type. By macroscopic grouping, the efficacy of TOCE decreased from the single nodule type (50% of patients had 100% necrosis) to the SNE type (21%), and the other types (9%). Conclusion: TOCE appears to be most efficacious for HCC with the expanding growth pattern and HCC forming single nodules. Poor results are to be expected in HCC of replacing growth type and multinodular or massive growth types.

    SPRINGER VERLAG, 1995年03月, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 18 (2), 82 - 86, 英語

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    研究論文(学術雑誌)

  • TIME-OF-FLIGHT MR-ANGIOGRAPHY OF PORTAL SYSTEM AND COLLATERALS IN PORTAL-HYPERTENSION USING A 2-DFT FAST SPOILED GRADIENT RECALLED STEADY-STATE PRECESSION TECHNIQUE

    T MURAKAMI, H IGARASHI, H OI, M MATSUSHITA, T KIM, H KISHIMOTO, H NAKAMURA, J OKAMURA, T KOZUKA

    MR angiographic examinations were performed in 26 patients. Approximately 30 contiguous fast spoiled GRASS images (8.1/3.1/30 degrees, TR/TE/flip angle) were acquired during single breath-holding for about 35 s, and then new images were reconstructed with maximum intensity projection technique. Spoiled GRASS images (40/ 12/40) of 2 to 3 slices were taken during breath-holding for about 13 s, and these processes were repeated to obtain about 30 individual images for conventional MR angiography. The new MR angiograms were compared quantitatively and qualitatively with conventional MR angiograms with arterial portography as the gold standard. The new MR angiograms could visualize blood vessels with smooth margins, and provided almost the same anatomic information about the portal Vein and collateral vessels as the conventional MR angiograms. Contrast-to-noise ratios between the portal or hepatic Vein and liver parenchyma were significantly higher with fast spoiled GRASS images. The new MR angiograms using fast spoiled GRASS images provided useful diagnostic mapping of the collateral Venous pathways within a shorter examination time.

    MUNKSGAARD INT PUBL LTD, 1994年11月, ACTA RADIOLOGICA, 35 (6), 581 - 585, 英語

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    研究論文(学術雑誌)

  • MR-IMAGING OF MIXED HEPATOCELLULAR AND CHOLANGIOCELLULAR CARCINOMA

    T HASHIMOTO, H NAKAMURA, S HORI, K TOMODA, T MITANI, T MURAKAMI, T KOZUKA, M MONDEN, K WAKASA, M SAKURAI

    Two patients with mixed hepatocellular and cholangiocellular carcinoma underwent partial hepatectomy after magnetic resonance (MR) imaging. Correlation is made with the histopathologic manifestations. In both cases the tumors showed relative low signal intensities on T1-weighted spin-echo (SE) images and high signal intensities on T2-weighted SE images. Dynamic MR imaging showed the enhancement from the periphery of the tumor to the inner area gradually and the enhancement continued into the delayed phase. With both cases fibrosis was marked in the inner area of the tumor compared to the peripheral area. The extent and degree of fibrotic tissue is considered to reflect the enhancement on dynamic MR imaging.

    SPRINGER VERLAG, 1994年09月, ABDOMINAL IMAGING, 19 (5), 430 - 432, 英語

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    研究論文(学術雑誌)

  • TRANSTHORACIC PERCUTANEOUS ETHANOL INJECTION INTO THE LIVER

    K TOMODA, S HORI, H NAKAMURA, T HASHIMOTO, T MURAKAMI, K TSUDA, T ISHIDA, T KOZUKA

    RATIONALE AND OBJECTIVES. The feasibility of the new transthoracic approach of percutaneous ethanol injection through the lower lung to the subphrenic region of the liver was evaluated in normal rats. METHODS. Fourteen normal rats received percutaneous ethanol injection. A 22-gauge fine needle was inserted into the liver via the thoracic cage and through the lower lung parenchyma under computed tomographic (CT) guidance. After ethanol (0.1-0.2 mL) was injected, three follow-up CT scans were performed: immediately after, 1 day after, and 1 week after the initial injection. All animals were killed 1 week after injection to evaluate macroscopic changes of the diaphragm and pleura. RESULTS. No major complications were observed. Minor complications were observed in six rats; these included one pneumothorax (7%) and five band-like and streaky shadows (presumably pulmonary hemorrhages) (35%) on the CT scan obtained immediately after the procedure. However, all complications had disappeared spontaneously in the follow-up CT scan obtained 1 day after the procedure. At autopsy, no pleural changes were seen. CONCLUSIONS. This study demonstrates that percutaneous ethanol injection through the lower lung parenchyma is achievable. Although this study was performed only in normal rats, the transthoracic approach can be a complementary method of ultrasound-guided percutaneous ethanol injection for tumors in the subphrenic region of the liver. Further study will be needed in abnormal livers and then in human subjects to verify the safety and efficacy of this procedure.

    LIPPINCOTT-RAVEN PUBL, 1994年09月, INVESTIGATIVE RADIOLOGY, 29 (9), 839 - 841, 英語

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    研究論文(学術雑誌)

  • EXTRASEROSAL INVASION IN ADVANCED GASTRIC-CANCER - EVALUATION WITH MR-IMAGING

    M MATSUSHITA, H OI, T MURAKAMI, N TAKATA, T KIM, H KISHIMOTO, H NAKAMURA, S OKAMOTO, J OKAMURA

    PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging in the diagnosis of extraserosal invasion in advanced gastric cancer. MATERIALS AND METHODS: MR imaging was performed in 48 patients with advanced gastric cancer, and the results were correlated with the histopathologic findings. Images perpendicular to the gastric wall with cancer were obtained with spoiled gradient-recalled acquisition in the steady state (GRASS). The degree of serosal invasion was classified on the basis of the appearance of a low-signal-intensity band around the lesion. RESULTS: Advanced gastric cancer appeared as a thickened wall of high signal intensity after the administration of contrast material. A low-signal-intensity band disappeared or showed irregularity in the area of extraserosal invasion by the gastric cancer. The MR imaging-determined grade correlated with the histopathologic findings for 11 of 14 (79%) pT2 tumors, 23 of 24 (96%) pT3 tumors, and eight of 10 (80%) pT4 tumors. The overall accuracy was 88%. CONCLUSION: Presence of a low-signal-intensity band at MR imaging is useful for the preoperative evaluation of serosal invasion.

    RADIOLOGICAL SOC NORTH AMER, 1994年07月, RADIOLOGY, 192 (1), 87 - 91, 英語

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    研究論文(学術雑誌)

  • 5-YEAR SURVIVAL AFTER TRANSCATHETER CHEMOEMBOLIZATION FOR HEPATOCELLULAR-CARCINOMA

    H NAKAMURA, T MITANI, T MURAKAMI, T HASHIMOTO, K TSUDA, K NAKANISHI, T ISHIDA, K TOMODA, S HORI, T KOZUKA, M MONDEN, C KURODA

    The 5-year cumulative survival rate of 443 patients who underwent transcatheter chemoembolization (TCE) for non-resectable hepatocellular carcinoma (HCC) before December 1986 was 8.0%, and 29 patients survived for 5 years or more. Of these 29 patients, 25 were men and 4 were women; their mean age was 63.9 years. Macroscopic classification showed lesions of the single nodular type in 16 cases, the multiple nodular type in 10 cases, and the massive type in 3 cases; 12 of the single nodular lesions measured 5 cm or less in size. The TNM classification showed lesions of stage I in 3 cases, stage II in 14 cases, stage III in 6 cases, and stage IV in 6 cases. Lesions classified as Child A were found in 23 patients, and they were thus much more common than Child B lesions (2 patients) and Child C lesions (1 patient). The response was analyzed in relation to the use of iodized oil (Lipiodol). It was used in 215 of the patients, and the 5-year cumulative survival rate of those patients was 12.9% (23 of them survived for 5 years or more). Lipiodol was not used in 228 patients, and they showed a 5-year cumulative survival rate of 3.4%, with 6 patients surviving for 5 years or more. The 6 patients with stage III disease and the 6 with stage IV disease received Lipiodol. TCE with Lipiodol thus contributed greatly in prolonging the survival of patients with HCC complicated by intrahepatic metastases or intraportal tumor thrombi.

    SPRINGER VERLAG, 1994年02月, CANCER CHEMOTHERAPY AND PHARMACOLOGY, 33, S89 - S92, 英語

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    研究論文(学術雑誌)

  • NEW DEVELOPMENT OF TRANSARTERIAL IMMUNOEMBOLIZATION (TIE) FOR THERAPY OF HEPATOCELLULAR-CARCINOMA WITH INTRAHEPATIC METASTASES

    T KANAI, M MONDEN, M SAKON, M GOTOH, K UMESHITA, Y HASUIKE, H NAKANO, T MONDEN, T MURAKAMI, H NAKAMURA, K WAKASA, M SAKURAI, J OKAMURA, T MORI

    The prognosis of patients with multiple hepatocellular carcinoma (HCC) remains disappointing. In this study, we devised a new therapeutic modality for HCC consisting of transarterial immunoembolization (TIE) using OK-432 and fibrinogen and then analyzed the preliminary results. In the first series, we applied the treatment to 19 patients with advanced HCC who had proved to be insensitive to several previous conventional treatments. In all, 14 patients (74%) with unresected HCC have currently survived for between 2 and 16 months after TIE. The remaining 5 patients died at 17, 14, 8, 7, and 4 months after TIE. The serum levels of tumor markers decreased in all of the patients, and a marked reduction in tumor size was observed in six patients after TIE. A high fever occurred in all cases, and abdominal pain and loss of appetite were also observed after TIE. However, deterioration of liver function was negligible. After confirmation of the safety of this method, we started a second study series in which this TIE treatment was selected as the first choice. Six patients have been treated to date. All patients in this group underwent hepatic resection at 6-48 days following TIE. Histological examination of the resected specimens following TIE showed massive infiltration of mononuclear cells around tumor cell nests and lytic necrosis as well as coagulation necrosis of the main tumor and the intrahepatic metastases. In conclusion, our results indicate that TIE may be a safe and promising therapy for patients with HCC.

    SPRINGER VERLAG, 1994年02月, CANCER CHEMOTHERAPY AND PHARMACOLOGY, 33, S48 - S54, 英語

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    研究論文(学術雑誌)

  • 3DFT-FISP MRI WITH GADOPENTETATE DIMEGLUMINE IN DIFFERENTIAL-DIAGNOSIS OF SMALL LIVER-TUMORS

    H NAKAMURA, T MURAKAMI, T ISHIDA, K TSUDA, T HASHIMOTO, K NAKANISHI, T MITANI, K TOMODA, S HORI, T KOZUKA

    Objective: We assessed the value of dynamic sequential three-dimensional Fourier transformation (3DFT) MRI in differentiating various types of small liver tumors. Materials and Methods: Forty-seven patients with 65 liver masses <3 cm in size (42 hepatocellular carcinomas, 11 hemangiomas, 12 metastatic tumors) were studied by 3DFT fast imaging with steady-state precession (FISP) MRI [TR(ms)/TE(ms)/flip angle (degrees): 20/8/30]. The slab thickness was 21-35 mm, and there were seven partitions. The 3DFT-FISP MR images were obtained immediately after 0.1 mmol/kg of gadopentetate dimeglumine was administered intravenously over 2-3 s (early phase), 60 s after (late phase I), and 120 s after (late phase II). Results: Eighty-six percent of small hepatocellular carcinomas showed hyperintense enhancement relative to the surrounding liver parenchyma and iso- or hypointense enhancement with or without capsular enhancement in the late phase. Eighty-two percent of small hemangiomas showed peripheral globular enhancement in the early phase and total hyperintense or peripheral enhancement in the late phases. Ninety-two percent of the small metastatic liver tumors showed doughnut-like ring enhancement in the early phase. Conclusion: By dynamic 3DFT-FISP MRI, we were able to accurately evaluate the hemodynamics and morphological findings of each type of small liver tumor.

    LIPPINCOTT-RAVEN PUBL, 1994年01月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 18 (1), 49 - 54, 英語

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    研究論文(学術雑誌)

  • Doses of epirubicin used in oily chemoembolization of hepatocellular carcinoma

    H. Nakamura, T. Murakami, K. Tomoda, K. Nakanishi, S. Hori, H. Oi, I. Tsukaguchi, H. Watanabe, M. Masuike, Y. Inoue

    Epirubicin (EPIR), an anticancer agent, has recently been used with increasing frequency in transcatheter oily chemoembolization (TOCE) of hepatocellular carcinoma. We conducted a dose-finding study of EPIR with regard to its safety. One hundred thirty-four patients were divided into five groups according to the EPIR doses (mg/m2), Group A (< 30 mg/m2), Group B (≥30-< 40 mg/m2), Group C (≥40-< 50 mg/m2), Group D (≥50-< 60 mg/m2), and Group E (≥60 mg/m2). The number of leukocytes decreased at 2 weeks but recovered at 4 weeks with no significant differences among the groups. However, there were significantly fewer leukocytes in Group E than in Groups A to D. There were no significant differences among the groups in either the number of erythrocytes or platelets. The number of platelets tended to remain at increased levels even at 4 weeks. Liver function as represented by GOT, GPT, LDH, and total bilirubin was not aggravated, but tended to improve. GOT and LDH in Groups D and E, in particular, improved significantly at 4 weeks, probably because of the antitumor effect of TOCE. These results suggest that EPIR can be administered up to 50 mg/m2 for TOCE.

    1994年, Japanese Journal of Cancer and Chemotherapy, 21 (13), 2218 - 2221, 日本語

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    研究論文(国際会議プロシーディングス)

  • Lymphangioma of the mesentery and small intestine: A case report showing a solid tumor with a cystic component on US and CT

    K. Tsuda, T. Murakami, H. Nakamura, T. Kozuka, H. Yamanishi, M. Miyata, H. Fukuda

    We encountered a patient with multiple lymphangiomas of the mesentery and small intestine. Ultrasonography and computed tomography showed a mesenteric tumor composed of a solid component with a small cystic part. This unusual appearance made the differential diagnosis between lymphangioma and other intra-abdominal solid tumors difficult.

    1994年, Radiation Medicine - Medical Imaging and Radiation Oncology, 12 (5), 241 - 243, 英語

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    研究論文(学術雑誌)

  • DISPLAY OF MR ANGIOGRAMS - MAXIMUM INTENSITY PROJECTION VERSUS 3-DIMENSIONAL RENDERING

    T MURAKAMI, T KASHIWAGI, H NAKAMURA, K TSUDA, M AZUMA, K TOMODA, S HORI, T KOZUKA

    Objective: The purpose of this study is to clarify the most useful technique of MR imaging in demonstrating the collateral venous pathways due to portal hypertension. Subjects: Twenty-eight cirrhotic patients with collateral venous pathways due to portal hypertension and three patients without them were studied. We evaluated the detectability of collateral vessels of flow-enhanced transverse MR images by time of flight effect, projection MR angiography using the maximum intensity projection technique and three-dimensional (3D) computer graphic images, by using the arterial portography as the standard. Results: Flow-enhanced transverse MR images showed 98% of the collateral vessels detected by angiography, however, the connection of each vessel was obscure. Fully 81% of the collateral vessels were seen by projection MR angiography, and 98% of them by the 3D computer graphic images. Conclusion: The detectability of collateral vessels of 3D computer graphic imaging was better than that of the projection MR angiography and was as accurate as that of transverse MR imaging. 3D Computer graphic images provided complex anatomical information in a more easily understood fashion than either transverse MR images or projection MR angiography.

    ELSEVIER SCI IRELAND LTD, 1993年09月, EUROPEAN JOURNAL OF RADIOLOGY, 17 (2), 95 - 100, 英語

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    研究論文(学術雑誌)

  • IMAGING OF PERITONEAL PSEUDOCYSTS - VALUE OF MR-IMAGING COMPARED WITH SONOGRAPHY AND CT

    H KURACHI, T MURAKAMI, H NAKAMURA, S HORI, A MIYAKE, T KOZUKA, O TANIZAWA

    OBJECTIVE. Peritoneal pseudocysts are created when fluid arising from the ovary is trapped by peritoneal adhesions. We studied the value of MR imaging, compared with sonography and CT, for detecting these abnormalities. SUBJECTS AND METHODS. Nine women, 27 to 49 years old, who had surgically proved peritoneal pseudocysts were included in the study. All nine patients were premenopausal, and eight had a history of pelvic surgery. All patients were examined with MR imaging and sonography, and five were also examined with CT. Imaging findings were analyzed and compared with the surgical findings. RESULTS. Sonograms in all nine patients showed a thick-walled cyst that contained focal echoes indicating nodules, making it difficult to differentiate these lesions from cystic ovarian tumors. In eight of the nine patients, the fluid in the pseudocysts had low signal intensity on T1-weighted MR images and high signal intensity on T2-weighted spin-echo MR images, suggesting that the fluid was serous. The pseudocyst had an irregular shape on MR images in seven patients and on CT scans in three patients. However, MR provided more information than CT did about the nature of the fluid within the pseudocyst. CONCLUSION. Our study suggests that MR imaging is more useful than sonography and CT for determining the characteristic findings of peritoneal pseudocysts.

    AMER ROENTGEN RAY SOC, 1993年09月, AMERICAN JOURNAL OF ROENTGENOLOGY, 161 (3), 589 - 591, 英語

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    研究論文(学術雑誌)

  • DETECTION OF VIABLE TUMOR-CELLS IN HEPATOCELLULAR-CARCINOMA FOLLOWING TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION WITH IODIZED OIL - PATHOLOGICAL CORRELATION WITH DYNAMIC TURBO-FLASH MR-IMAGING WITH GD-DTPA

    T MURAKAMI, H NAKAMURA, S HORI, K TOMODA, T MITANI, K NAKANISHI, T HASHIMOTO, K TSUDA, T KOZUKA, M MONDEN, K WAKASA

    To evaluate the effect of transcatheter arterial chemoembolization (TACE) with iodized oil for hepatocellular carcinoma (HCC), dynamic turbo-fast low angle shot (turbo-FLASH) (TR/TE/flip angle/TI, 8.5/4.6/10/200) MR imaging with gadopentetate dimeglumine was performed in 10 patients with HCC after TACE with iodized oil and before partial hepatectomy. Immediately after 0.05 mmol/kg b.w. of gadopentetate dimeglumine was administered intravenously, 10 images were obtained in the first 20 s (early phase). Then, one image every 30 s from 1 to 3 min (late phase), and images at 5 min and 7 min (delayed phase) were obtained serially. In the early phase, HCC showed no enhancement in 5 patients, partial hyperintense enhancement in 4, and total hyperintense enhancement in one. Viable regions of the tumor, evaluated at histopathology, showed hyperintense enhancement relative to the surrounding liver parenchyma in the early phase, while necrotic regions showed no enhancement. Both viable and necrotic regions showed lower signal intensities than the surrounding liver parenchyma in both late and delayed phases. By using dynamic turbo-FLASH MR imaging, we were able to accurately evaluate the effect of TACE with iodized oil for HCC in 8 of the 10 patients. In 2 patients, in whom small viable cells were seen in the HCC, viable regions could not be detected with our technique. It is concluded that turbo-FLASH dynamic MR imaging was useful for evaluating the effect of TACE for HCC.

    MUNKSGAARD INT PUBL LTD, 1993年07月, ACTA RADIOLOGICA, 34 (4), 399 - 403, 英語

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    研究論文(学術雑誌)

  • ANGIOMYOLIPOMA OF THE LIVER - ULTRASOUND, CT, MR-IMAGING AND ANGIOGRAPHY

    T MURAKAMI, H NAKAMURA, S HORI, K NAKANISHI, T MITANI, T KOZUKA, Y KIMURA, M MONDEN, K WAKASA, M SAKURAI

    Angiomyolipoma, a rare benign liver tumor, was observed in a 50-year-old woman examined with US, CT, MR imaging and angiography. Dynamic studies using CT and MR imaging were valuable in differentiating the disease from hepatocellular carcinoma with fat deposits.

    MUNKSGAARD INT PUBL LTD, 1993年07月, ACTA RADIOLOGICA, 34 (4), 392 - 394, 英語

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    研究論文(学術雑誌)

  • ACALCULOUS CHOLECYSTITIS (PANNICULITIS) ASSOCIATED WITH WEBER-CHRISTIAN DISEASE

    T ISHIDA, H NAKAMURA, S HORI, T MARUKAWA, T MITANI, T MURAKAMI, M NISHIKAWA, K NAKANISHI, S MAESHIMA, M MITOMO, T KOZUKA

    Acalculous cholecystitis occurred in a patient with Weber-Christian disease. It reflected a panniculitis similar to that which developed in the orbit, abdominal cavity, and the retroperitoneal space.

    ELSEVIER SCIENCE INC, 1993年01月, CLINICAL IMAGING, 17 (1), 56 - 58, 英語

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    研究論文(学術雑誌)

  • PELIOSIS OF THE SPLEEN WITH INTRAPERITONEAL HEMORRHAGE

    K TSUDA, H NAKAMURA, T MURAKAMI, T KOZUKA, M YOSHII, K ISOZAKI, Y TSUKAHARA, M TAKAMI, M HANADA

    We encountered a patient with steroid-related peliosis of the spleen, a rare disease characterized by multiple blood-filled cavities in the splenic parenchyma, with spontaneous intraperitoneal hemorrhage. The ultrasonographic, computed tomographic, and angiographic images were compared with pathologic findings of the material obtained surgically.

    SPRINGER VERLAG, 1993年, ABDOMINAL IMAGING, 18 (3), 283 - 285, 英語

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    研究論文(学術雑誌)

  • SUBLUXATION OF THE PATELLA - EVALUATION OF PATELLAR ARTICULAR-CARTILAGE WITH MR IMAGING

    K NAKANISHI, M INOUE, K HARADA, J IKEZOE, T MURAKAMI, H NAKAMURA, T KOZUKA

    In patients with subluxation of the patella, injury of the patellar articular cartilage is frequently observed, and correct evaluation of this cartilage injury is extremely important for the management of these patients. Magnetic Resonance (MR) studies were performed on 102 patellofemoral (PF) joints of 51 patients with subluxation of the patella and 20 PF joints of 10 healthy volunteers. In 77 of the 102 PF joints with subluxation, arthroscopy and/or operation were performed. MR images were obtained with spin-echo and FLASH sequences, and para-axial images were obtained. We retrospectively analysed the MR findings of the 77 joints with special attention to the surface and thickness of the cartilage, and classified them into four grades. These MR grades were compared with the grades on arthroscopy, and the following results were obtained: MR grade 0, normal cartilage (n = 27, sensitivity 90.9%, specificity 74.2%); MR grade 1, thickening of the cartilage (n = 24, sensitivity 50%, specificity 89.1%); MR grade 2, surface irregularity of the cartilage (n = 20, sensitivity 85%, specificity 94.7%); MR grade 3, loss of the cartilage (n = 6, sensitivity 100%, specificity 100%). Although the early changes observed by arthroscopy were underestimated from the MR images, MR imaging proved to be extremely useful for evaluating moderately or advanced patellar cartilage injury.

    BRITISH INST RADIOLOGY, 1992年08月, BRITISH JOURNAL OF RADIOLOGY, 65 (776), 662 - 667, 英語

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    研究論文(学術雑誌)

  • Koh Tokunaga, Hironobu Nakamura, Taro Marukawa, Takashi Mitani, Takamichi Murakami, Masanori Nishikawa, Chikazumi Kuroda, Takahiro Kozuka

    Adrenal venous blood samples drawn before and after stimulation with adrenocorticotropic hormone (ACTH) were analysed in 32 consecutive patients with primary aldosteronism. Twenty-six patients had aldosterone-producing adenomas and six patients had bilateral hyperplasia. The ratio of higher to lower levels of aldosterone in the right and left adrenals (aldosterone ratio), aldosterone to cortisol ratio (A/C ratio), and the ratio of higher to lower levels of A/C ratio in the right and left adrenals (ratio of A/C ratios) were calculated. We used both aldosterone ratio and ratio of A/C ratios as a means of diagnosis, a ratio of 3.0 or more for unilateral adenoma, and less than 3.0 for bilateral hyperplasia. With ACTH stimulation, correct characterization of lesions increased from 91% (29 of 32) to 97% (31 of 32) by aldosterone ratio and from 84% (27 of 32) to 97% (30 of 31) by ratio of A/C ratios. Correct diagnosis of bilateral hyperplasia increased markedly from 67% (4 of 6) to 100% and 50% (3 of 6) to 83% (5 of 6) with use of each criterion. In patients with adenoma, aldosterone ratio rose in 54% (14 of 26) from the pre-stimulation levels. Before stimulation, it ranged from 1.5 to 115.9 (mean 34.8), and afterwards, from 2.1 to 1097.9 (mean 95.5). In contrast, in all patients with bilateral hyperplasia aldosterone ratio fell to less than 3.0 following stimulation with ACTH. With ACTH stimulation, aldosterone ratio increased in patients with adenoma and decreased in patients with hyperplasia. Measurement of A/C ratio is used to ensure correct access to the adrenal veins, but it was useful in only one case and aldosterone ration was a more reliable diagnostic parameter than ratio of A/C ratios in both pre-and post-ACTH stimulations. Assay of aldosterone levels and calculation of aldosterone ratios before and after ACTH stimulation were valuable in locating small adenomas in the right and left adrenal and especially in differentiating bilateral hyperplasia from adenoma. © 1992 Springer-Verlag.

    Springer-Verlag, 1992年05月, European Radiology, 2 (3), 223 - 229, 英語

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    研究論文(学術雑誌)

  • RETROPERITONEAL SCHWANNOMAS SIMULATING ADRENAL-TUMORS

    S MAESHIMA, H NAKAMURA, M NISHIKAWA, T MURAKAMI, T MITANI, T MARUKAWA, S HORI, T KOZUKA, M IRIMOTO

    Tumors in the area of the adrenal were detected by chance in two patients who underwent a regular physical check-up. On arteriography the tumors were found to be fed by the adrenal artery. The diagnosis was retroperitoneal schwannoma, but in both patients it was difficult to differentiate the schwannoma from an adrenal tumor preoperatively.

    ELSEVIER SCIENCE INC, 1992年04月, CLINICAL IMAGING, 16 (2), 121 - 124, 英語

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    研究論文(学術雑誌)

  • Dynamic MR studies of hepatocellular carcinoma with portal vein tumor thrombosis

    T. Mitani, H. Nakamura, T. Murakami, M. Nishikawa, S. Maeshima, K. Nakanishi, T. Marukawa, K. Harada, S. Hori, T. Kozuka

    1992年, Radiation Medicine - Medical Imaging and Radiation Oncology, 10 (6), 232 - 234, 英語

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    研究論文(学術雑誌)

  • Pancreatic angiography using balloon catheter occlusion and a vasoconstrictor

    H. Nakamura, S. Hori, K. Tomoda, T. Mitani, T. Murakami, T. Hashimoto, K. Nakanishi, S. Maejima, K. Tsuda, T. Kozuka, S. Sawada, S. Furui

    1992年, Radiation Medicine - Medical Imaging and Radiation Oncology, 10 (2), 48 - 49, 英語

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    研究論文(学術雑誌)

  • Stage III, IV hepatocellular carcinoma patients surviving more than five years after transcatheter chemoembolization

    H. Nakamura, T. Mitani, T. Murakami, T. Hashimoto, K. Nakanishi, S. Maeshima, K. Tsuda, K. Tomoda, S. Hori, T. Kozuka, M. Monden, C. Kuroda

    1992年, Japanese Journal of Cancer and Chemotherapy, 19 (10), 1756 - 1758, 日本語

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    研究論文(国際会議プロシーディングス)

  • SIDEROTIC NODULES IN HEPATIC CIRRHOSIS DISAPPEARING AFTER BILIARY HEMORRHAGE - MR IMAGING

    T MURAKAMI, H NAKAMURA, C KURODA, S HORI, T MARUKAWA, T KOZUKA, M MONDEN, K WAKASA

    Magnetic resonance demonstrated siderotic regenerating nodules in a patient with hepatocellular carcinoma with accompanying liver cirrhosis. The siderosis disappeared when iron deficiency anemia developed in association with biliary hemorrhage. Magnetic resonance was sensitive enough to follow changes in the siderosis. The mechanism of iron deposition in regenerating nodules that accompanied liver cirrhosis did not seem to be related to the severity of the liver damage.

    LIPPINCOTT-RAVEN PUBL, 1991年11月, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 15 (6), 1039 - 1041, 英語

    [査読有り]

    研究論文(学術雑誌)

  • N. Fujita, K. Harada, T. Murakami, Y. Akai, T. Kozuka

    The effects of to‐and‐fro pulsatile flow, i.e., an oscillatory fluid motion with no net flow, on signal intensity in gated spin‐echo magnetic resonance imaging are considered both theoretically and experimentally. On the basis of hydrodynamic principles, to‐and‐fro pulsatile flow at large Womersley numbers consists of uniform inner flow and boundary‐layer‐type flow adjacent to a tube wall. Therefore, the velocity profile is “trapezoidal” rather than parabolic at all times during the pulsation period. Contrary to the absence of phase dispersion and loss of signal within the inner flow where no velocity gradient exists, large velocity differences cause phase dispersion and, hence, loss of signal within the boundary layer, whose thickness is inversely proportional to the Womersley number. An understanding of these features of to‐and‐fro pulsatile flow provides the theoretical basis of cerebrospinal fluid flow phenomena in magnetic resonance imaging, since this type of flow exists in cerebrospinal fluid pathways. © 1990 Academic Press, Inc. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company

    1990年, Magnetic Resonance in Medicine, 15 (2), 275 - 286, 英語

    [査読有り]

    研究論文(学術雑誌)

  • Cystic adventitial disease of the popliteal artery

    K. Itoh, H. Fukuoka, A. Naitoh, M. Senba, S. Katsuta, Y. Fukuda, K. Dohi, T. Murakami

    1988年, Japanese Journal of Clinical Radiology, 33 (10), 1159 - 1161, 日本語

    [査読有り]

    研究論文(学術雑誌)

  • Tsujita Y, Sofue K, Ueshima E, Ueno Y, Hori M, Murakami T

    Viral hepatitis was previously the most common cause of chronic liver disease. However, in recent years, nonalcoholic fatty liver disease (NAFLD) cases have been increasing, especially in developed countries. NAFLD is histologically characterized by fat, fibrosis, and inflammation in the liver, eventually leading to cirrhosis and hepatocellular carcinoma. Although biopsy is the gold standard for the assessment of the liver parenchyma, quantitative evaluation methods, such as ultrasound, CT, and MRI, have been reported to have good diagnostic performances. The quantification of liver fat, fibrosis, and inflammation is expected to be clinically useful in terms of the prognosis, early intervention, and treatment response for the management of NAFLD. The aim of this review was to discuss the basics and prospects of MRI-based tissue quantifications of the liver, mainly focusing on proton density fat fraction for the quantification of fat deposition, MR elastography for the quantification of fibrosis, and multifrequency MR elastography for the evaluation of inflammation.

    2022年05月, Magn Reson Med Sci[Epub ahead of print], 英語

    [査読有り]

    研究論文(学術雑誌)

  • Nishio M, Kobayashi D, Nishioka E, Matsuo H, Urase Y, Onoue K, Ishikura R, Kitamura Y, Sakai E, Tomita M, Hamanaka A, Murakami T

    This retrospective study aimed to develop and validate a deep learning model for the classification of coronavirus disease-2019 (COVID-19) pneumonia, non-COVID-19 pneumonia, and the healthy using chest X-ray (CXR) images. One private and two public datasets of CXR images were included. The private dataset included CXR from six hospitals. A total of 14,258 and 11,253 CXR images were included in the 2 public datasets and 455 in the private dataset. A deep learning model based on EfficientNet with noisy student was constructed using the three datasets. The test set of 150 CXR images in the private dataset were evaluated by the deep learning model and six radiologists. Three-category classification accuracy and class-wise area under the curve (AUC) for each of the COVID-19 pneumonia, non-COVID-19 pneumonia, and healthy were calculated. Consensus of the six radiologists was used for calculating class-wise AUC. The three-category classification accuracy of our model was 0.8667, and those of the six radiologists ranged from 0.5667 to 0.7733. For our model and the consensus of the six radiologists, the class-wise AUC of the healthy, non-COVID-19 pneumonia, and COVID-19 pneumonia were 0.9912, 0.9492, and 0.9752 and 0.9656, 0.8654, and 0.8740, respectively. Difference of the class-wise AUC between our model and the consensus of the six radiologists was statistically significant for COVID-19 pneumonia (p value = 0.001334). Thus, an accurate model of deep learning for the three-category classification could be constructed; the diagnostic performance of our model was significantly better than that of the consensus interpretation by the six radiologists for COVID-19 pneumonia.

    2022年05月, Scientific Reports, 12, 8214, 英語

    [査読有り]

    研究論文(学術雑誌)

  • 抗Ma2抗体陽性の傍腫瘍性辺縁系脳炎の1例

    横尾 紫穂, 宮崎 亜樹, 神田 知紀, 小路田 泰之, 村上 卓道

    (公社)日本医学放射線学会, 2021年08月, 日本医学放射線学会秋季臨床大会抄録集, 57回, S391 - S391, 日本語

  • 耳管軟骨から生じたと考えられる軟骨系腫瘍の1例

    神田 知紀, 神澤 真紀, 宮崎 亜樹, 小路田 泰之, 村上 卓道

    (公社)日本医学放射線学会, 2021年08月, 日本医学放射線学会秋季臨床大会抄録集, 57回, S455 - S455, 日本語

  • Takeru Yamaguchi, Keitaro Sofue, Eisuke Ueshima, Yoshiko Ueno, Yushi Tsujita, Shinji Yabe, Sachiyo Shirakawa, Hirochika Toyama, Masatoshi Hori, Takumi Fukumoto, Takamichi Murakami

    Wiley, 2022年01月10日, Journal of Magnetic Resonance Imaging

    研究論文(学術雑誌)

  • Masatoshi Kudo, Namiki Izumi, Norihiro Kokudo, Michiie Sakamoto, Shuichiro Shiina, Tadatoshi Takayama, Ryosuke Tateishi, Osamu Nakashima, Takamichi Murakami, Yutaka Matsuyama, Arata Takahashi, Hiroaki Miyata, Shoji Kubo

    In the 22nd Nationwide Follow-up Survey of Primary Liver Cancer in Japan, data from 21 155 newly registered patients and 43 041 previously registered follow-up patients were compiled from 538 institutions over a 2-year period from January 1, 2012 to December 31, 2013. Basic statistics compiled for patients newly registered in the 22nd survey were cause of death, past medical history, clinical diagnosis, imaging diagnosis, treatment-related factors, pathologic diagnosis, recurrence status and autopsy findings. Compared with the previous 21st survey, the population of patients with hepatocellular carcinoma (HCC) was older at the time of clinical diagnosis, had more female patients, more patients with non-B non-C HCC, smaller tumor diameter and was more frequently treated with hepatectomy. Cumulative survival rates were calculated for HCC, intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma (combined HCC and intrahepatic cholangiocarcinoma) by treatment type and background characteristics for patients newly registered between 2002 and 2013 whose final outcome was survival or death. Median overall survival and cumulative survival rates for HCC were calculated by dividing patients by combinations of background factors (number of tumors, tumor diameter or Child-Pugh grade) and by treatment type (hepatectomy, radiofrequency ablation therapy, transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy and systemic therapy). The same values were also calculated according to registration date by dividing patients newly registered between 1978 and 2013 into five time period groups. The data obtained from this nationwide follow-up survey are expected to contribute to advancing clinical research and treatment of primary liver cancer worldwide.

    2022年01月, Hepatology research : the official journal of the Japan Society of Hepatology, 52 (1), 5 - 66, 英語, 国際誌

    研究論文(学術雑誌)

  • 異なる受信コイルを用いた膝関節MRIにおけるコイル特性の検討

    石田 瑞穂, 曽宮 雄一郎, 吉田 直碁, 堀井 慎太郎, 島田 隆史, 河野 淳, 日下 亜起子, 村上 卓道

    (公社)日本放射線技術学会, 2021年09月, 日本放射線技術学会雑誌, 77 (9), 1034 - 1034, 日本語

  • Dual Energy CTにおけるDeep Learning Reconstructionがヨード検出に与える影響

    坂田 裕一郎, 福富 朗世, 根宜 典之, 香川 清澄, 前林 知樹, 日下 亜起子, 河野 淳, 村上 卓道

    (公社)日本放射線技術学会, 2021年09月, 日本放射線技術学会雑誌, 77 (9), 1074 - 1074, 日本語

  • 金属アーチファクト低減法と画像再構成法の組み合わせに関する検討

    石川 和希, 香川 清澄, 根宜 典行, 日下 亜起子, 河野 淳, 村上 卓道

    (公社)日本放射線技術学会, 2021年09月, 日本放射線技術学会雑誌, 77 (9), 1115 - 1115, 日本語

  • 慢性血栓塞栓性肺高血圧症患者における、重回帰分析を用いた肺動脈平均圧推定についての検討

    高橋 真依, 松尾 秀俊, 西尾 瑞穂, 松永 卓明, 河野 淳, 谷口 悠, 平田 健一, 村上 卓道

    (公社)日本医学放射線学会, 2021年08月, 日本医学放射線学会秋季臨床大会抄録集, 57回, S400 - S400, 日本語

  • メトホルミンは消化管内腔へのFluorode-oxyglucose(FDG)排泄を促進させる

    森田 靖子, 野上 宗伸, 坂口 一彦, 岡田 裕子, 廣田 勇士, 田守 義和, 曽 菲比, 村上 卓道, 小川 渉

    (一社)日本糖尿病学会, 2020年08月, 糖尿病, 63 (Suppl.1), S - 115, 日本語

  • Yoshiko Ueno, Tsutomu Tamada, Keitaro Sofue, Yasuyo Urase, Nobuyuki Hinata, Masato Fujisawa, Takamichi Murakami

    Background: Prostate apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging have been used for evaluating prostate cancer (PCa) aggressiveness. However, the way of measuring ADC values has varied depending on the study. Purpose: To investigate inter- and intra-reader variability and diagnostic performance of three kinds of shaped 2D regions of interests (ROIs) for tumor ADC measurements in PCa. Material and Methods: Seventy-four patients with PCa undergoing 3-T MRI before surgery were included. Histologic findings from radical prostatectomy specimens were reviewed to define each patient's dominant tumor. Three readers independently measured the tumor ADCs using three different ROI methods: freehand, large-circle, and small-circles ROIs. Readers repeated measurements after 3 weeks. Bland-Altman analysis was performed to evaluate the inter- and intra-reader variability. Receiver Operating Characteristic analysis was used for assessment of tumor aggressiveness for PCa. Results: For intra-reader and inter-reader variability, the mean coefficient of repeatability for freehand ROIs, large-circle ROIs, and small-circles ROIs were as follows: 13.7%, 12.4%, and 11.5%; 9.4%, 9.7%, and 9.5%. For differentiating Gleason score (GS) = 3 + 3 from GS ≥ 3 + 4 tumors, the area under the curves were 0.90 for freehand ROIs, 0.89 for large-circle ROIs, and 0.94 small-circles ROIs (p = 0.31). Conclusion: The variations in ROI method did not have a major influence on intra-reader or inter-reader reproducibility or diagnostic performance for prostate ADC measurements.

    2022年03月, Acta radiologica open, 11 (3), 20584601221086500 - 20584601221086500, 英語, 国際誌

    研究論文(学術雑誌)

  • Keitaro Sofue, Eisuke Ueshima, Atsuhiro Masuda, Sachiyo Shirakawa, Yoh Zen, Yoshiko Ueno, Yushi Tsujita, Takeru Yamaguchi, Shinji Yabe, Takeshi Tanaka, Noriko Inomata, Hirochika Toyama, Takumi Fukumoto, Yuzo Kodama, Takamichi Murakami

    OBJECTIVE: To investigate the diagnostic performance of the extracellular volume (ECV) fraction in multiphasic contrast-enhanced computed tomography (CE-CT) for estimating histologic pancreatic fibrosis and predicting postoperative pancreatic fistula (POPF). METHODS: Eighty-five patients (49 men; mean age, 69 years) who underwent multiphasic CE-CT followed by pancreaticoduodenectomy with pancreaticojejunal anastomosis between January 2012 and December 2018 were retrospectively included. The ECV fraction was calculated from absolute enhancements of the pancreas and aorta between the precontrast and equilibrium-phase images, followed by comparisons among histologic pancreatic fibrosis grades (F0‒F3). The diagnostic performance of the ECV fraction in advanced fibrosis (F2‒F3) was evaluated using receiver operating characteristic curve analysis. Multivariate logistic regression analysis was used to evaluate the associations of the risk of POPF development with patient characteristics, histologic findings, and CT imaging parameters. RESULTS: The mean ECV fraction of the pancreas was 34.4% ± 9.5, with an excellent intrareader agreement of 0.811 and a moderate positive correlation with pancreatic fibrosis (r = 0.476; p < 0.001). The mean ECV fraction in advanced fibrosis was significantly higher than that in no/mild fibrosis (44.4% ± 10.8 vs. 31.7% ± 6.7; p < 0.001), and the area under the receiver operating characteristic curve for the diagnosis of advanced fibrosis was 0.837. Twenty-two patients (25.9%) developed clinically relevant POPF. Multivariate logistic regression analysis demonstrated that the ECV fraction was a significant predictor of POPF. CONCLUSIONS: The ECV fraction can offer quantitative information for assessing pancreatic fibrosis and POPF after pancreaticojejunal anastomosis. KEY POINTS: • There was a moderate positive correlation of the extracellular volume (ECV) fraction of the pancreas in contrast-enhanced CT with the histologic grade of pancreatic fibrosis (r = 0.476; p < 0.001). • The ECV fraction was higher in advanced fibrosis (F2‒F3) than in no/mild fibrosis (F0‒F1) (p < 0.001), with an AUC of 0.837 for detecting advanced fibrosis. • The ECV fraction was an independent risk factor for predicting subclinical (odds ratio, 0.81) and clinical (odds ratio, 0.80) postoperative pancreatic fistula.

    2022年03月, European radiology, 32 (3), 1770 - 1780, 英語, 国際誌

    研究論文(学術雑誌)

  • 島田 隆史, 祖父江 慶太郎, 上田 優, 谷 和紀子, 吉田 直碁, 堀井 慎太郎, 曽宮 雄一郎, 上野 嘉子, 日下 亜起子, 村上 卓道