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井上 純子医学部附属病院 放射線診断・IVR科助教
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■ 論文- 2026年07月, European journal of nuclear medicine and molecular imaging, 53(9) (9), 5462 - 5474, 英語, 国際誌研究論文（学術雑誌）
- OBJECTIVES: We aimed to explore the diagnostic efficacy of whole-body dynamic (WBD) acquisition using [18F]-Fluorodeoxyglucose-positron-emission-tomography/computed-tomography ([18F]FDG-PET/CT) for the assessment of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) compared with the standard static PET/CT. METHODS: Twenty-five patients with suspected GCA and/or PMR were prospectively enrolled in this single-center study. WBD PET imaging was performed before treatment using a standard PET/CT scanner with a multibed multipass dynamic whole-body acquisition approach (dPET). Reconstructed datasets were used to generate metabolic rate of [18F]FDG (MRFDG) images based on standard Patlak analysis. In case of pathologic FDG uptake, VOIs placed in vessel walls and joints were used for quantitation and definition of the target-to-background ratio (TBR): uptake in VOIs of vessel walls and joints (maximum values), to VOIs in blood pool (GCA), or to VOIs in normal muscles (PMR) (mean values). The final diagnosis based on the available imaging and laboratory results (except dPET), served as the standard of reference. RESULTS: Seventeen of the 25 patients (68%) showed pathologic FDG uptake, of which 5 (20%) were finally diagnosed with GCA alone, 6 (24%) with PMR alone, and another 6 (24%) with both conditions. TBR difference between dPET and static PET was significant in both diseases(GCA P<0.003, PMR P<0.003), and TBRs of dPET and static PET were significantly higher in both diseases compared with the healthy controls. CONCLUSIONS: WBD [18F]FDG-PET/CT provided a significantly higher TBR in patients with GCA and PMR compared with standard static PET imaging. WBD [18F]FDG-PET/CT may potentially enhance the diagnostic accuracy in detecting GCA and PMR.2026年06月, Clinical nuclear medicine, 51(6) (6), 459 - 463, 英語, 国際誌研究論文（学術雑誌）
- OBJECTIVE: In positron emission tomography (PET)/magnetic resonance imaging (MRI), attenuation correction (AC) for PET of the head is achieved by MRI data to generate pseudo-computed tomography (CT) images. However, for the torso, AC becomes more challenging due to the complexity of separating bone components. Additionally, generating accurate MRI-based CT using deep learning poses significant difficulties for the chest, primarily because perfectly paired MRI and CT training data are hard to obtain owing to respiratory motion and body movements. We previously demonstrated that MRI-to-CT conversion can be achieved without deformation, even using unsupervised learning for zero echo time (ZTE) MRI and CT data from different individuals. Building on this foundation, our study aims to apply this approach to AC in chest PET/MRI and assess their quantitative accuracy, reproducibility, and external validity. METHODS: The datasets used included (1) training dataset (unpaired ZTE MRI and CT of PET/CT, n = 360 and 500, respectively); (2) test dataset (paired PET/MRI and PET/CT, n = 25 and 25, respectively); (3) repeatability assessment dataset (repeated PET/MRI, n = 15 × 2 scans for the same patient); and (4) external validation dataset (paired MRI component of PET/MRI and CT, n = 30 and 30, respectively, acquired at another institution). Unpaired training data were used to train the deep learning model of pseudo-CT generation from ZTE. The accuracy, repeatability, and reproducibility of the PET/MRI scans using ZTE- and deep learning-based AC (MRACZTE) were evaluated based on the similarity of the histograms and the mean standardized uptake value (SUVmean) of physiological background of bone and liver. RESULTS: The histogram correlation coefficients between MRACZTE and the AC map based on the CT (CTAC) for the spine were significantly higher than those between conventional AC (MRACDixon) and CTAC. Additionally, bone SUVmean obtained using MRACZTE showed reduced bias relative to CTAC compared with MRACDixon. This method proved to be reproducible on each patient level and robust against external validation. CONCLUSIONS: Unsupervised learning with unpaired ZTE and CT data enabled pseudo-CT generation with bone components that closely matched CT-based attenuation maps. Integration into MR-based attenuation correction resulted in stable physiological uptake measurements in chest PET/MRI, supporting the feasibility of this approach.2026年05月, Annals of nuclear medicine, 英語, 国内誌研究論文（学術雑誌）
- PURPOSE: Currently, no standardized anatomic magnetic resonance (MR) imaging protocol exists for detecting parathyroid adenomas. We analyzed various MR pulse sequences to evaluate their performance in visualizing histopathologically confirmed parathyroid adenomas in patients with primary hyperparathyroidism (pHPT) undergoing [18F]fluorocholine positron emission tomography (PET)/MR. METHODS: This retrospective study included 128 adenomas in 110 patients with biochemically confirmed pHPT who underwent [18F]fluorocholine PET/MR at our institution between December 2020 and October 2023. Two radiologists independently characterized the lesions (as upper pole, lower pole, or ectopic adenomas). Surgical reports and histopathology served as reference standard. Lesion conspicuity, delineation, and size were compared on axial T1-weighted fast spin echo sequence (T1w FSE) and axial T2-weighted iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) sequence with water image reconstruction (T2w FSE flex water). Interreader agreement was determined using Cohen's kappa; differences were analyzed using Wilcoxon signed-rank test. RESULTS: Parathyroid adenomas had significantly higher conspicuity, superior delineation, and were larger (p < 0.001) on T2w FSE flex water images compared to T1w FSE images. While these differences were maintained in the subgroup analysis for upper and lower pole adenomas, ectopic adenomas were of similar size on both MR pulse sequences (p = 0.646). CONCLUSION: T2w FSE flex water offers significantly better visualization of parathyroid adenomas compared to T1w FSE, especially in orthotopic lesions. These results support the targeted use of such a limited MR protocol as part of PET/MR in the preoperative assessment of patients with pHPT.2026年04月, Nuclear medicine and molecular imaging, 60(2) (2), 121 - 130, 英語, 国際誌研究論文（学術雑誌）
- Parathyroid carcinoma (PC) is an exceedingly rare endocrine malignancy, accounting for less than 1% of all primary hyperparathyroidism (pHPT) cases. It typically presents with pronounced hypercalcemia and markedly elevated parathyroid hormone (PTH) levels. Accurate imaging plays a pivotal role in diagnosis, staging, surgical planning, and long-term surveillance, although differentiating PC from benign disease on imaging remains a significant challenge. A multimodal imaging strategy combining cervical ultrasonography (US) and nuclear medicine techniques provides high sensitivity for lesion detection. Ultrasonography with advanced detective flow imaging allows detailed anatomical assessment and evaluation of vascular patterns of the primary tumor. [99mTc]Tc-methoxyisobutylisonitrile ([99mTc]Tc-MIBI) scintigraphy frequently demonstrates prolonged tracer retention in PC, while [18F]fluorocholine positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance (PET/MR) imaging have shown superior performance for detecting both primary tumors and metastatic disease due to its higher spatial resolution and higher molecular sensitivity. [18F]FDG PET serves as an adjunct modality for identifying aggressive, metabolically active lesions. Emerging radiotracers such as [18F]-fibroblast activation protein inhibitor ([18F]FAPI) and [68Ga]Ga-trivehexin have shown potential in cases where initial imaging is inconclusive. Theranostic strategies that integrate molecular imaging with targeted radioligand therapy may transform PC management by enabling personalized treatment approaches tailored to each tumor's biological and imaging characteristics. This review aims to evaluate available imaging modalities for PC diagnosis and provide guidance for their clinical application.2025年12月, Life (Basel, Switzerland), 15(12) (12), 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: Accurate preoperative localization of parathyroid adenomas is crucial in managing primary hyperparathyroidism (pHPT). Although [18F]Fluorocholine PET/CT and PET/MR have shown superior sensitivity over conventional imaging, distinguishing upper from lower pole adenomas remains challenging due to the invisibility of the recurrent laryngeal nerve. This study introduces the "tracheal bisecting line" (TBL), a novel anatomical landmark on axial PET/MR images, to aid in polarity differentiation. METHODS: This retrospective study included 110 patients (128 adenomas) with biochemically confirmed pHPT who underwent [18F]Fluorocholine PET/MR at the University Hospital Zurich between December 2020 and October 2023. Adenomas were classified as upper (posterior to the TBL), lower (anterior), with mid-TBL cases (neither anterior nor posterior) treated as upper per default, according to evidence from surgical experience. Two board-certified readers independently assessed the images. Surgical findings served as the reference. Inter-reader agreement was evaluated using weighted kappa statistics, and diagnostic accuracy was calculated for all adenomas and subgroups: orthotopic, non-orthotopic, and intrathyroidal. RESULTS: Among the 128 adenomas, 109 were orthotopic and 19 non-orthotopic (6 intrathyroidal). The inter-reader agreement was nearly perfect (κ = 0.99). The overall accuracy using the TBL was 0.945. The accuracy improved to 0.982 for orthotopic adenomas but decreased to 0.789 for non-orthotopic and 0.667 for intrathyroidal cases. Excluding intrathyroidal adenomas raised accuracy to 1.0 in non-orthotopic cases and 0.959 overall for non-intrathyroidal adenomas. CONCLUSIONS: The TBL is a reliable and reproducible landmark on [18F]Fluorocholine PET/MR for predicting parathyroid adenoma polarity, particularly in orthotopic and non-intrathyroidal cases. It may enhance surgical planning by improving anatomical clarity.2025年10月, Annals of nuclear medicine, 英語, 国内誌研究論文（学術雑誌）
- Histiocytic sarcoma is a malignant neoplasm of mature histiocytes that rarely involves the central nervous system. A 49-year-old man presenting with a mass filling the lumbar spinal canal underwent 18F-FDG PET/MRI. Fused PET/MRI images showed intense FDG uptake in the mass, as well as uptake in the cerebellopontine angle and cervical lymph nodes. Biopsy of the spinal lesion showed histiocytic sarcoma. This is the rare case report of PET/MRI performed for histiocytic sarcoma demonstrating changes in FDG uptake during chemotherapy. This case highlights the utility of PET imaging for evaluating the extent of lesions and treatment efficacy for histiocytic sarcoma.2025年05月, Clinical nuclear medicine, 英語, 国際誌研究論文（学術雑誌）
- (株)メジカルビュー社, 2025年01月, 臨床画像, 41(1) (1), 90 - 91, 日本語
- (株)メジカルビュー社, 2025年01月, 臨床画像, 41(1) (1), 92 - 93, 日本語
- (株)メジカルビュー社, 2025年01月, 臨床画像, 41(1) (1), 94 - 95, 日本語
- (株)メジカルビュー社, 2025年01月, 臨床画像, 41(1) (1), 96 - 97, 日本語
- PURPOSE: Minimal misregistration of fused PET and MRI images can be achieved with simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI). However, the acquisition of multiple MRI sequences during a single PET emission scan may impair fusion precision of each sequence. This study evaluated the diagnostic utility of time-synchronized PET/MRI using an MR active trigger and a Bayesian penalized likelihood reconstruction algorithm (BPL) to assess the locoregional extension of endometrial cancer. METHODS: Fifty-five patients with endometrial cancer who underwent pelvic 2-deoxy-2-[18F]fluoro-D-glucose PET/MRI were retrospectively evaluated. The PET emission time for the BPL reconstruction was determined by the MR active trigger of each MR sequence. The concordance rates of image interpretation with pathological T-staging, diagnostic performance for deep myometrial invasion (MI), and diagnostic confidence levels were evaluated by two readers and compared between time-synchronized, overlapping (conventional and simultaneous, but not time-synchronized), and sequential (not simultaneous) PET/MRI and MRI with diffusion-weighted imaging. Misregistration of the PET/MRI-fused images was determined by evaluating the differences in bladder dimensions. RESULTS: The T classification by time-synchronized PET/MRI was the most concordant with the pathological T classification for the two readers. Time-synchronized PET/MRI had a significantly higher diagnostic performance for deep MI and higher confidence level scores than overlapping PET/MRI for the novice reader (p = 0.033 and p = 0.038, respectively). The differences in bladder dimension on sequential PET/MRI were significantly larger than those on overlapping and time-synchronized PET/MRI (p <0.001). CONCLUSION: Time-synchronized PET/MRI is superior to conventional PET/MRI for assessing the locoregional extension of endometrial cancer.2024年08月, European journal of radiology, 179, 111678 - 111678, 英語, 国際誌研究論文（学術雑誌）
- (株)メジカルビュー社, 2024年02月, 臨床画像, 40(2) (2), 189 - 196, 日本語
- (公社)日本医学放射線学会, 2024年02月, Japanese Journal of Radiology, 42(Suppl.) (Suppl.), 40 - 40, 日本語術前診断が困難であった後腹膜肺分画症の1例
- This study evaluated the diagnostic value of a rapid whole-body fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) approach, combining Bayesian penalised likelihood (BPL) PET with an optimised β value and abbreviated MRI (abb-MRI). The study compares the diagnostic performance of this approach with the standard PET/MRI that utilises ordered subsets expectation maximisation (OSEM) PET and standard MRI (std-MRI). The optimal β value was determined by evaluating the noise-equivalent count (NEC) phantom, background variability, contrast recovery, recovery coefficient, and visual scores (VS) for OSEM and BPL with β100-1000 at 2.5-, 1.5-, and 1.0-min scans, respectively. Clinical evaluations were conducted for NECpatient, NECdensity, liver signal-to-noise ratio (SNR), lesion maximum standardised uptake value, lesion signal-to-background ratio, lesion SNR, and VS in 49 patients. The diagnostic performance of BPL/abb-MRI was retrospectively assessed for lesion detection and differentiation in 156 patients using VS. The optimal β values were β600 for a 1.5-min scan and β700 for a 1.0-min scan. BPL/abb-MRI at these β values was equivalent to OSEM/std-MRI for a 2.5-min scan. By combining BPL with optimal β and abb-MRI, rapid whole-body PET/MRI could be achieved in ≤1.5 min per bed position, while maintaining comparable diagnostic performance to standard PET/MRI.2023年05月, Diagnostics (Basel, Switzerland), 13(11) (11), 英語, 国際誌研究論文（学術雑誌）
- (一社)日本核医学会, 2022年, 核医学, 59(1) (1), 35 - 35, 日本語深層学習を用いてZTE MRIから生成した骨による減弱補正が胸部領域のSUVに及ぼす影響
- (一社)日本核医学会, 2021年, 核医学, 58(Suppl.) (Suppl.), S198 - S198, 英語非感染性偽関節に対する骨SPECTの定量評価(Quantitative evaluation of bone SPECT for uninfected nonunion)
- 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.2021年, PloS one, 16(3) (3), e0249304, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S157 - S157, 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
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S155 - S155, 英語肺病変に関するPET/MRIにおけるZero-TE法の診断能について
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S174 - S174, 日本語悪性腫瘍の全身FDG PET/MRIにおけるBSREMを用いた高速撮像と診断能の検討
- 2020年02月, Japanese Archive of cases conference of clinical nuclear medicine, 2, 1 - 9[査読有り]
- (一社)日本核医学会, 2023年, 核医学, 60(1) (1), 38 - 39, 日本語
- (一社)日本核医学会, 2022年, 核医学, 59(1) (1), 35 - 35, 日本語
- (一社)日本核医学会, 2022年, 核医学, 59(1) (1), 37 - 37, 日本語
- (一社)日本核医学会, 2022年, 核医学, 59(1) (1), 35 - 35, 日本語
- (一社)日本核医学会, 2021年, 核医学, 58(Suppl.) (Suppl.), S196 - S196, 日本語肺転移の診断能と融合画像精度におけるZTE併用FDG PET/MRIとPET/CTとの比較
- (一社)日本核医学会, 2021年, 核医学, 58(Suppl.) (Suppl.), S196 - S196, 英語深層学習を用いたZTE MRIによる胸部PET/MRIの吸収補正に関する定量的検証
- (一社)日本核医学会, 2021年, 核医学, 58(1) (1), 79 - 79, 日本語
- (一社)日本核医学会, 2021年, 核医学, 58(1) (1), 79 - 80, 日本語
- (一社)日本核医学会, 2021年, 核医学, 58(1) (1), 80 - 80, 日本語
- (一社)日本核医学会, 2021年, 核医学, 58(Suppl.) (Suppl.), S196 - S196, 日本語肺転移の診断能と融合画像精度におけるZTE併用FDG PET/MRIとPET/CTとの比較
- (一社)日本核医学会, 2021年, 核医学, 58(Suppl.) (Suppl.), S196 - S196, 英語深層学習を用いたZTE MRIによる胸部PET/MRIの吸収補正に関する定量的検証
- A woman in her twenties with cervical cancer underwent conical resection at 13 weeks gestation. The pathological examination showed lymphatic invasion and possible positive margins. A total hysterectomy was recommended; however, the patient strongly desired continuation of the pregnancy. An FDG-PET/MRI was performed at 16 and 27 weeks gestation for cancer staging. No evidence of metastasis was observed. The patient’s cancer treatment was delayed until fetal maturity, and a scheduled cesarean section was performed at 30 weeks gestation followed by a modified radical hysterectomy, oophorectomy, and pelvic lymph node dissection with ovarian preservation. Cervical intraepithelial neoplasia was diagnosed 18 months postoperatively and was treated via vaginal wall resection at 19 months postoperatively. PET/MRI obtains PET and MR images simultaneously and the fused images provide information regarding anatomical and functional relationships. The high contrast resolution of MRI and the functional information provided by PET images render PET/MRI an ideal method for the evaluation of physiological FDG uptake by the fetus. In this study, we could follow the physiological uptake of FDG by a fetus over time during the gestational weeks by PET/MRI. The FDG uptake by the fetal brain is lower than that in the maternal brain, and the FDG uptake is similar in the left and right cardiac ventricles. In addition, the physiological uptake by the tonsilla, liver, kidneys, and bladder, is reported.Cases conference of clinical nuclear medicine (NMJ), 2021年, Japanese Archive of cases conference of clinical nuclear medicine, 3, 9 - 17, 英語
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S155 - S155, 英語肺病変に関するPET/MRIにおけるZero-TE法の診断能について
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S157 - S157, 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
- (一社)日本核医学会, 2020年10月, 核医学, 57(Suppl.) (Suppl.), S174 - S174, 日本語悪性腫瘍の全身FDG PET/MRIにおけるBSREMを用いた高速撮像と診断能の検討
- 2019年, Abstracts. Annual Symposium. Japanese Society for the Advancement of Women’s Imaging (CD-ROM), 20th筋腫分娩様の所見を呈し,術前診断が困難であった子宮平滑筋肉腫の1例