Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare the lesion detectability of hypovascular liver metastases between 70-keV and 40-keV images from dual energy-computed tomography (CT) reconstructed with deep-learning image reconstruction (DLIR). METHODS: This multi-institutional, retrospective study included adult patients both pre- and post-treatment for gastrointestinal adenocarcinoma. All patients underwent contrast-enhanced CT with reconstruction at 40-keV and 70-keV. Liver metastases were confirmed using gadoxetic acid-enhanced magnetic resonance imaging. Four radiologists independently assessed lesion conspicuity (per-patient and per-lesion) using a 5-point scale. A radiologic technologist measured image noise, tumor-to-liver contrast, and contrast-to-noise ratio (CNR). Quantitative and qualitative results were compared between 70-keV and 40-keV images. RESULTS: The study included 138 patients (mean age, 69 ± 12 years; 80 men) with 208 liver metastases. Seventy-one patients had liver metastases, while 67 did not. Primary cancer sites included 68 cases of pancreas, 50 colorectal, 12 stomach, and 8 gallbladder/bile duct. No significant difference in per-patient lesion detectability was found between 70-keV images (sensitivity, 71.8-90.1%; specificity, 61.2-85.1%; accuracy, 73.9-79.7%) and 40-keV images (sensitivity, 76.1-90.1%; specificity, 53.7-82.1%; accuracy, 71.7-79.0%) (p = 0.18-> 0.99). Similarly, no significant difference in per-lesion lesion detectability was observed between 70-keV (sensitivity, 67.3-82.2%) and 40-keV images (sensitivity, 68.8-81.7%) (p = 0.20-> 0.99). However, Image noise was significantly higher at 40 keV, along with greater tumor-to-liver contrast and CNRs for both hepatic parenchyma and tumors (p < 0.01). CONCLUSION: There was no significant difference in hypovascular liver metastases detectability between 70-keV and 40-keV images using the DLIR technology.

DOI： 10.1007/s00261-025-05151-z

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp.2025-0055

Language：Japanese  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

Objectives

This study aimed to compare 3-minute delayed phase images with 5-minute delayed phase images for quantifying hepatic extracellular volume fraction (ECV) using dual-energy computed tomography (CT).

Methods

Between January 2020 and July 2022, eighty consecutive patients with chronic liver disease (45 men and 35 women, mean age: 69.3 ± 10.4 years) were included in this study cohort. All patients underwent both 3- and 5-minute delayed phase CT scans for assessing focal liver lesions. ECV value was calculated by the iodine densities of the hepatic parenchyma and aorta, and compared between in each phase. Correlations between ECV values in each phase with the albumin–bilirubin (ALBI) score and grade, fibrosis-4 index (Fib-4), and clinical fibrosis stage were statistically analyzed.

Results

No significant difference was found in ECV values between the 3- and 5-minute delayed phase images (p = 0.056). The ratio of ECV values for 3-minute to 5-minute delayed phase images was 0.984 ± 0.078, ranging from 0.85 to 1.16. The ECV calculated on 3- and 5-minute delayed phase images showed strong and moderate correlations with ALBI grade (Spearman’s ρ; 0.763 and 0.724, respectively) and ALBI score (Spearman’s ρ; 0.707 and 0.668, respectively), and also showed moderate correlations with Fib-4 (Spearman’s ρ; 0.548 and 0.543, respectively) and clinical fibrosis stage (Spearman’s ρ; 0.468 and 0.435, respectively).

Conclusion

Three-minute delayed phase images were found to be equivalent to 5-minute delayed phase images for the calculation of ECV.

DOI： 10.1093/bjr/tqaf081

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

Abstract

Advancements in computed tomography (CT) technology, particularly the emergence of dual-energy CT (DE-CT) and photon-counting detector CT (PCD-CT), can improve detection, characterization, and treatment monitoring of focal liver lesions. DE-CT, through its ability to differentiate tissues with similar densities and produce diverse datasets, has enhanced lesion visibility and diagnostic precision. PCD-CT further advances imaging with superior spatial resolution and material decomposition capabilities, offering potential for complex diagnostic scenarios. This review aimed to highlight the role of CT in hepatic imaging and its application to focal liver lesions.

DE-CT improves lesion detectability using low-energy virtual monochromatic images, which enhance iodine contrast and reduce radiation and contrast agent doses. It also facilitates treatment response evaluation after locoregional therapies for hepatocellular carcinoma by quantifying biomarkers, such as the extracellular volume fraction. This review underscores the transformative impact of DE-CT and PCD-CT on liver imaging, emphasizing their complementary roles alongside magnetic resonance imaging. These innovations have paved the way for more precise diagnostics, improved treatment planning, and enhanced patient outcomes in the management of liver diseases.

DOI： 10.1097/rli.0000000000001187

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Immune-related pneumonitis (irP) is a severe immune-related adverse event that can occur after treatment with immune checkpoint inhibitors (ICIs); accurate monitoring and early diagnosis are crucial. Serum Krebs von den Lungen-6 (KL-6) and surfactant protein-D (SP-D) are used to diagnose and monitor the disease activity of various types of interstitial lung disease. This study evaluated the usefulness of KL-6 and SP-D for diagnosing irP in cancer patients receiving ICIs. PATIENTS AND METHODS: This retrospective observational study included cancer patients treated with more than two cycles of ICIs from September 2014 to October 2023. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic utility of KL-6 and SP-D. RESULTS: Of the 724 cancer patients, 631 were included in the analysis, and 64 developed irP. The ROC analysis showed that KL-6 and SP-D had areas under the curve of 0.803 and 0.845, respectively. Serum KL-6 ≥ 500 U/mL had a sensitivity of 65.6% and a specificity of 83.4% for the diagnosis of irP, while SP-D ≥ 110 ng/mL had a sensitivity of 66.7% and a specificity of 88.6%. Combining both KL-6 ≥ 500 U/mL and SP-D ≥ 110 ng/mL resulted in a specificity of 96.6%, with a sensitivity of 46.7%. Combining either KL-6 ≥ 500 U/mL or SP-D ≥ 110 ng/mL resulted in a sensitivity of 85.0%, with a specificity of 75.5%. SP-D levels were significantly associated with irP severity, while KL-6 levels were not. CONCLUSIONS: Serum KL-6 and SP-D are useful for diagnosing irP in cancer patients receiving ICIs.

DOI： 10.1016/j.resinv.2025.02.005

PubMed

Authorship：Lead author   Language：Japanese  

Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：Japanese   Publisher：(公社)日本医学放射線学会  

Authorship：Lead author   Language：Japanese  

Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Purpose

To evaluate the effect of deep learning reconstruction (DLR) on vascular depiction, tumor enhancement, and image quality of computed tomography hepatic arteriography (CTHA) images acquired during transcatheter arterial chemoembolization (TACE).

Methods

Institutional review board approval was obtained. Twenty-seven patients (18 men and 9 women, mean age, 75.7 years) who underwent CTHA immediately before TACE were enrolled. All images were reconstructed using three reconstruction algorithms: hybrid-iterative reconstruction (hybrid-IR), DLR with mild strength (DLR-M), and DLR with strong strength (DLR-S). Vascular depiction, tumor enhancement, feeder visualization, and image quality of CTHA were quantitatively and qualitatively assessed by two radiologists and compared between the three reconstruction algorithms.

Results

The mean signal-to-noise ratios (SNR) of sub-segmental arteries and sub-sub-segmental arteries, and the contrast-to-noise ratio (CNR) of tumors, were significantly higher on DLR-S than on DLR-M and hybrid-IR (P &lt; 0.001). The mean qualitative score for sharpness of sub-segmental and sub-sub-segmental arteries was significantly better on DLR-S than on DLR-M and hybrid-IR (P &lt; 0.001). There was no significant difference in the feeder artery detection rate of automated feeder artery detection software among three reconstruction algorithms (P = 0.102). The contrast, continuity, and confidence level of feeder artery detection was significantly better on DLR-S than on DLR-M (P = 0.013, 0.005, and 0.001) and hybrid-IR (P &lt; 0.001, P = 0.002, and P &lt; 0.001). The weighted kappa values between two readers for qualitative scores of feeder artery visualization were 0.807–0.874. The mean qualitative scores for sharpness, granulation, and diagnostic acceptability of CTHA were better on DLR-S than on DLR-M and hybrid-IR (P &lt; 0.001).

Conclusions

DLR significantly improved the SNR of small hepatic arteries, the CNR of tumor, and feeder artery visualization on CTHA images. DLR-S seems to be better suited to routine CTHA in TACE than does hybrid-IR.

DOI： 10.1007/s11604-024-01614-3

PubMed

Other Link： https://link.springer.com/article/10.1007/s11604-024-01614-3/fulltext.html

Language：English   Publisher：(公社)日本医学放射線学会  

Language：English   Publishing type：Research paper (scientific journal)  

Obtaining an imaging diagnosis of various hepatobiliary and pancreatic disorders caused by certain drugs can often be challenging. Familiarity with these conditions may improve diagnostic accuracy and patient management. This review aimed to describe the imaging findings of drug-associated hepatobiliary and pancreatic disorders and identify suggestions for obtaining a correct diagnosis. We focused on relatively common disorders or those that can present with characteristic imaging findings, such as drug-induced acute hepatitis, sinusoidal obstruction syndrome, focal nodular hyperplasia-like lesions, hepatocellular adenoma, pseudocirrhosis, chemotherapy-associated steatohepatitis, amiodarone deposition in the liver, secondary iron overload, drug-induced pancreatitis, pancreatic enlargement after epoprostenol therapy, ceftriaxone-associated gallbladder pseudolithiasis, immune-related adverse events, and methotrexate-associated lymphoproliferative disorders.

DOI： 10.1007/s11604-023-01505-z

PubMed

Language：English   Publisher：(公社)日本医学放射線学会  

Language：English   Publisher：(公社)日本医学放射線学会  

Language：Japanese  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publisher：(公社)日本医学放射線学会  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

Since its introduction in the worldwide medical market, gadoxetic acid has attracted considerable interest. The year 2023 marks the 15th anniversary of the introduction of gadoxetic acid in Japan. Gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI) is the predominantly performed contrast MRI examination for the liver. Its most essential characteristic, namely, the hepatobiliary phase, revolutionized the clinical management of liver disease. Gadoxetic acid-enhanced MRI is currently the most efficient method for focal liver lesion detection and analysis. Meta-analyses demonstrated its excellent effectiveness for the diagnosis of hepatocellular carcinoma and liver metastases. Owing to the extensive usage of gadoxetic acid, a hepatobiliary phase hypointense nodule without arterial phase hyperenhancement is well documented. The existence of such nodules may be a sign of hypervascular hepatocellular carcinoma in nodules and other areas in the liver. Apart from its role in tumor identification and characterization, GA-MRI can help assess response to therapy and liver fibrosis. Therefore, it is proposed to use gadoxetic acid as the first option for MRI of the liver in the majority of patients. The efficacy of gadoxetic acid surpasses its disadvantages, rendering this contrast agent the preferred choice for routine MRI of the liver. The clinical use of GA-MRI is discussed in this review article.

DOI： 10.1097/RLI.0000000000000990

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：Japanese  

Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND OBJECTIVE: The lung immune prognostic index (LIPI), a simple index calculated from the blood lactate dehydrogenase level and derived neutrophil-to-lymphocyte ratio, is thought to be associated with host immune status. However, the utility of LIPI in patients with idiopathic interstitial pneumonias (IIPs) is unknown. METHODS: In this multicentre, retrospective, observational study, an association between LIPI and the survival of patients with IIPs was evaluated. RESULTS: Exploratory and validation cohorts consisting of 460 and 414 patients with IIPs, respectively, were included (159 and 159 patients had idiopathic pulmonary fibrosis [IPF], and 301 and 255 had non-IPF, respectively). In the exploratory cohort, patients with IPF and a low LIPI had significantly better survival than those with a high LIPI (median of 5.6 years vs. 3.9 years, p = 0.016). The predictive ability of LIPI for the survival of patients with IPF was validated in the validation cohort (median of 8.5 years vs. 4.4 years, p = 0.003). In a multivariate Cox proportional hazard analysis, LIPI was selected as an independent predictive factor for the survival of IPF patients. There was no significant association between LIPI and survival of non-IPF patients in the exploratory and validation cohorts. CONCLUSION: The LIPI was a predictive factor for the survival of patients with IPF and could aid the management of IPF.

DOI： 10.1111/resp.14621

PubMed

Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

AIM: To determine risk factors associated with hepatocellular carcinoma (HCC) development following direct-acting antiviral (DAA) therapy. METHODS: We enrolled patients with chronic hepatitis C who underwent direct-acting antiviral therapy and achieved sustained virologic response at 12 weeks between 2012 and 2018. Subsequently, patients were followed up. The primary endpoint was the development of HCC or the date of the last follow up when the absence of HCC was confirmed. Uni- and multivariate Cox proportional hazards models were used to identify factors contributing to HCC development, including gadoxetic acid-enhanced magnetic resonance imaging findings. The cumulative incidence rates of HCC development were calculated using the Kaplan-Meier method, and differences between groups were assessed using the log-rank test. RESULTS: The final study cohort comprised 482 patients (median age 70.5 years; 242 men). The median follow-up period was 36.8 months. Among 482 patients, 96 developed HCC (19.9%). The 1-, 3-, and 5-year cumulative rates of HCC development were 4.9%, 18.6%, and 30.5%, respectively. Multivariate analysis revealed that age, male sex, history of HCC, and hepatobiliary phase hypointense nodules without arterial phase hyperenhancement were independent risk factors significantly associated with HCC development (p < 0.001-0.04). The highest risk group included patients with both a history of HCC and the presence of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement (the 1- and 3-year cumulative HCC development rates were 14.2% and 62.2%, respectively). CONCLUSION: History of HCC and presence of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement were strong risk factors for HCC development following direct-acting antiviral therapy.

DOI： 10.1111/hepr.13964

PubMed

Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To assess inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein (TIV) from bland thrombus on gadoxetic acid-enhanced magnetic resonance imaging (Gx-MRI). Secondarily, to determine whether a multi-feature model improves accuracy compared to LI-RADS. METHODS: We retrospectively identified consecutive patients at risk for hepatocellular carcinoma with venous occlusion(s) reported on Gx-MRI. Five radiologists independently classified each occlusion as TIV or bland thrombus using the LI-RADS TIV criterion (enhancing soft tissue in vein). They also evaluated imaging features suggestive of TIV or bland thrombus. Intra-class correlation coefficient (ICC) was calculated for individual features. A multi-feature model was developed based on consensus scores of features with > 5% consensus prevalence and > 0.40 ICC. Sensitivity and specificity of the LI-RADS criterion and of the cross-validated multi-feature model were compared. RESULTS: Ninety-eight patients with 103 venous occlusions (58 TIV, 45 bland thrombus) were included. The LI-RADS criterion provided 0.63 ICC and, depending on the reader, 0.62-0.93 sensitivity and 0.87-1.00 specificity. Five other features had > 5% consensus prevalence and > 0.40 ICC, including three LI-RADS suggestive features and two non-LI-RADS features. The optimal multi-feature model incorporated the LI-RADS criterion and one LI-RADS suggestive feature (occluded or obscured vein contiguous with malignant parenchymal mass). After cross-validation, the multi-feature model did not improve sensitivity or specificity compared to the LI-RADS criterion (P = 0.23 and 0.25, respectively). CONCLUSION: Using Gx-MRI, the LI-RADS criterion for TIV provides substantial inter-observer agreement, variable sensitivity, and high specificity for differentiating TIV from bland thrombus. A cross-validated multi-feature model did not improve diagnostic performance.

DOI： 10.1007/s00261-023-03964-4

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: There has been no prospective trial for treatment of immune-related pneumonitis (irP) occurred after immune checkpoint inhibitors (ICIs). METHODS: In this single-arm phase II study, patients with cancer with grade ≥2 irP received oral prednisolone (1 mg/kg/day), tapered over 6 weeks. The primary endpoint was a pneumonitis control rate at 6 weeks from the start of the study treatment, defined as complete disappearance or partial improvement of irP in high-resolution CT of the chest. RESULTS: Among 57 patients enrolled, 56 were included in the final analysis. The most frequent cause of irP was single ICI therapy (51.8%), followed by combination with chemotherapy plus ICI (39.3%). Thirty-five (62.5%) patients had grade 2 irP and 21 (37.5%) had grade ≥3. Fifty-one (91.1%) patients completed the study treatment while 5 discontinued the study treatment because of relapse of irP (n=1), death from cancer (n=1), occurrence of immune-related hepatitis (n=1), extension of the treatment duration more than 6 weeks (n=1), and attending physician's decision (n=1). Six weeks after the start of the study treatment, 16 (28.5%) patients demonstrated complete recovery from irP, 35 (62.5%) had a partial improvement in irP, 1 (1.8%) had a relapse of irP, and 4 (7.1%) were not evaluable. The pneumonitis control rate at 6 weeks was 91.1% (95% CI, 80.7% to 96.1%). Twelve weeks after the start of the study treatment, 5 (8.9%), 27 (48.2%), and 15 (26.8%) patients demonstrated complete recovery, partial improvement, and relapse, respectively, and 9 (16.1%) were not evaluable. The pneumonitis control rate at 12 weeks was 57.1% (95% CI, 44.1% to 69.2%). During the observation period, 18 (32.1%) patients experienced a relapse of irP, and of those, 17 received re-treatment with corticosteroids. Grade ≥3 adverse events occurred in 10 (17.9%) patients, in which hyperglycemia was most frequent (n=6). There was no treatment-related death. CONCLUSIONS: In this first prospective study for irP, prednisolone at 1 mg/kg/day, tapered over 6 weeks, demonstrated a promising clinical benefit and manageable toxicity, suggesting a potential treatment option for irP. TRIAL REGISTRATION NUMBER: jRCT: 1041190029.

DOI： 10.1136/jitc-2023-007056

PubMed

Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Acute exacerbation of idiopathic interstitial pneumonias (AE-IIPs) induces permanent pulmonary dysfunction and is potentially lethal. The unpredictable occurrence of AE-IIPs remains an important clinical issue in the management of IIPs. METHODS: In this multicentre, retrospective, observational study, a predictive score for AE-IIPs was designed using clinical factors based on multivariate Fine-Gray analysis in patients with IIPs. RESULTS: Based on multivariate Fine-Gray analysis in an exploratory cohort of 487 patients with IIPs, the predictive score for AE-IIPs was determined as follows: 1 point each was added for honeycombing on high-resolution computed tomography (H), age >75 years (A) and lactate dehydrogenase level >222 U·L-1 (L); the total score ranged from 0 to 3 (HAL score). The HAL score discriminated the risk of AE-IIPs with a C-index of 0.62 (95% CI 0.56-0.67); this discrimination was verified in a validation cohort of 402 patients with IIPs with a C-index of 0.67 (95% CI 0.60-0.73). In a combined cohort, the estimated cumulative risks for AE-IIPs at 1, 2, 3, 5 and 10 years were 1.9%, 3.5%, 5.1%, 7.7% and 12.9%, respectively, in the total score 0 group; 4.7%, 8.3%, 12.0%, 17.7% and 28.4%, respectively, in the total score 1 group; and 8.0%, 14.2%, 19.7%, 28.7% and 43.0%, respectively, in the total score ≥2 group. Subgroup analysis revealed that the HAL score was applicable to patients with and without idiopathic pulmonary fibrosis. CONCLUSIONS: The HAL score discriminated the risk of AE-IIPs and could aid in the management of IIPs.

DOI： 10.1183/13993003.01634-2022

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare the quality of dynamic imaging between stack-of-stars acquisition without breath-holding (DISCO-Star) and the breath-holding method (Cartesian LAVA and DISCO). METHODS: This retrospective study was conducted between October 2019 and February 2020. Two radiologists performed visual assessments of respiratory motion or pulsation artifacts, streak artifacts, liver edge sharpness, and overall image quality using a 5-point scale for two datasets: Dataset 1 (n = 107), patients with Cartesian LAVA and DISCO-Star; Dataset 2 (n = 41), patients with DISCO and DISCO-Star at different time points. Diagnosable image quality was defined as ≥ 3 points in overall image quality. Whether the scan timing of the arterial phase (AP) was appropriate was evaluated, and results between the pulse sequences were compared. In cases of inappropriate scan timing in the DISCO-Star group, retrospective reconstruction with a high frame rate (80 phases, 3 s/phase) was added. RESULTS: The overall image quality of Cartesian LAVA was better than that of DISCO-Star in AP. However, noninferiority was shown in the ratio of diagnosable images between Cartesian LAVA and DISCO-Star in AP. There was no significant difference in the ratio of appropriate scan timing between DISCO-Star and Cartesian LAVA; however, the ratio of appropriate scan timing in DISCO-Star with high frame rate reconstruction was significantly higher than that in Cartesian LAVA in both readers. Overall image quality scores between DISCO and DISCO-Star were not significantly different in AP. There was no significant difference in the ratio of appropriate scan timing between DISCO-Star with high frame rate reconstruction and DISCO in both readers. CONCLUSION: The use of DISCO-Star with high frame rate reconstruction is a good solution to obtain appropriate AP scan timing compared with Cartesian LAVA. DISCO-Star showed equivalent image quality in all phases and in the ratio of appropriate AP scan timing compared with DISCO.

DOI： 10.2463/mrms.mp.2021-0143

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

MRI is widely used in clinical practice for detecting liver diseases. Since the introduction of gadoxetic acid, MRI has become the most effective modality for the detection and characterization of focal liver lesions. According to previous meta-analyses, the area under the receiver operating characteristic curve (AUROC) was 0.97-0.99 for the diagnosis of small hepatocellular carcinoma (≥ 2 cm) by gadoxetic-acid-enhanced MRI. Moreover, the AUROC for the diagnosis of colorectal liver metastases was significantly high (0.98). Despite gadoxetic acid's drawbacks, its clinical utility outweighs them, making it the contrast agent of choice in routine liver MRIs. Moreover, clinically, liver MRI has become more prevalent for a quantitative assessment. Liver fibrosis can be evaluated using MR elastography; whereas, hepatic steatosis and iron overload can be evaluated using proton density fat fraction, with high accuracy and reproducibility. This article reviewed the usefulness of liver MRI, which can be a comprehensive imaging modality in clinical practice.

DOI： 10.2463/mrms.rev.2022-0100

PubMed

Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

DOI： 10.2463/jjmrm.2023-1801

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: In transthyretin cardiac amyloidosis (ATTR-CA), 99mTc-pyrophosphate myocardial scintigraphy (99mTc-PYP) is a diagnostic tool that utilizes visual and quantitative evaluation. However, false positive cases can occur because of tracer accumulation in the blood. We investigated the effectiveness of the heart-to-mediastinum (H/M) ratio of 99mTc-PYP in ATTR-CA diagnosis. METHODS: We retrospectively included 164 patients who underwent 99mTc-PYP single-photon emission computed tomography/computed tomography between March 2019 and January 2022. The diagnostic accuracy of ATTR-CA was examined by the heart-to-contralateral lung (H/CL) and H/M ratio calculated at 3 hours post-tracer administration. RESULTS: After the exclusion of patients who did not undergo endomyocardial biopsy, 30 patients (15 each with ATTR-CA and without ATTR-CA) were included. The receiver operating characteristic curve used to distinguish ATTR-CA from non-ATTR-CA patients revealed an area under the curve of 0.986 and 0.943, respectively. A H/M ratio of > 1.41 identified ATTR-CA patients with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100, 93.3, 93.3, and 100%, respectively. Conversely, an H/CL ratio of > 1.3 identified ATTR-CA patients with 100% sensitivity, 40.0% specificity, 62.5% PPV, and 100% NPV. CONCLUSION: The H/M ratio obtained at 3 hours post-injection has the potential to be a novel indicator for ATTR-CA.

DOI： 10.1007/s12350-022-03180-5

PubMed

Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: This study aims to identify the hallmarks of gadoxetate disodium-enhanced magnetic resonance imaging distinguishing hepatocellular carcinoma (HCC) from hypervascular liver metastases (HLMs). Methods: Between January 2008 and October 2020, among patients who underwent gadoxetate disodium-enhanced MRI, those who met the following criteria were retrospectively included: without chronic hepatitis or liver stiffness ≤ 2.5 kPa on magnetic resonance elastography or F0/F1 on pathological assessment. Two blinded radiologists reviewed the imaging findings to judge the presence or absence of the enhancing capsule, nonperipheral washout, corona enhancement, hypointensity in the transitional/hepatobiliary phase (HBP), hyperintensity on T2-weighted/diffusion-weighted imaging (DWI), mosaic architecture, and blood products/fat in mass. The lesion-to-liver signal intensity ratios in HBP and DWI were also calculated. Univariate and multivariate analyses were performed to identify the imaging hallmarks distinguishing HCC from HLM. Interobserver agreement was calculated using kappa values and intraclass correlation coefficients (ICCs). Results: The final study cohort comprised 72 lesions in 44 patients (mean age, 65.0±11.9 years). Univariate analysis revealed higher frequencies of the following features in HCC than in HLM (P < .10): nonperipheral washout, corona enhancement, transitional phase hypointensity, mosaic architecture, and fat in mass (P = .002-.073). Multivariate analysis revealed that nonperipheral washout and mosaic architecture favored the diagnosis of HCC over that of HLM with odds ratios of 7.66 and 14.6, respectively (P = .038 and .029, respectively). The interobserver agreement for each item was moderate or substantial (kappa or ICC = .447-.792). Conclusion: Peripheral washout and mosaic architecture may be reliable imaging hallmarks for distinguishing HCC from HLM.

DOI： 10.1177/08465371221085516

PubMed

Language：English   Publisher：(公社)日本医学放射線学会  

Language：Japanese  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Gynaecologic emergencies include diseases resulting from adnexal and uterine disorders. Some emergencies are life threatening; however, they often have non-specific symptoms and physical findings. Thus, imaging diagnosis is important for evaluating these conditions. The first-choice modality for obstetrics and gynaecology is ultrasonography; however, some cases require computed tomography (CT) and magnetic resonance imaging (MRI) for correct diagnosis. Treatment options for gynaecologic emergencies vary from conservative therapy to emergency surgery, thus a correct diagnosis is critical. The purpose of this article is to describe notable CT and MRI findings of gynaecologic emergencies, which will help emergency department physicians arrive at the correct diagnosis and thus facilitate optimal treatment for patients.

DOI： 10.1111/1754-9485.13450

PubMed

Language：Japanese  

Language：Japanese   Publisher：(一社)日本核医学会  

Language：Japanese   Publisher：(一社)日本核医学会  

Language：English   Publishing type：Research paper (scientific journal)  

Computed tomography (CT) is an imaging modality that provides otherwise unobtainable information in the diagnostic workup for acute abdomen. The patient's clinical history, physical examination, and laboratory findings are essential for a correct diagnosis; however, some diagnoses are difficult to establish. Although contrast-enhanced CT is the preferred diagnostic tool and provides invaluable information, using only post-contrast images can lead to misdiagnoses. Unenhanced CT images are more useful than post-contrast images for detecting high-attenuation lesions or materials because surrounding tissues also show high attenuation on post-contrast images. Unenhanced CT often provides key imaging findings for a correct diagnosis; hence, the purpose of this article is to describe CT findings in acute abdomen with high-attenuation lesions in the gastrointestinal tract.

DOI： 10.4103/SINGAPOREMEDJ.SMJ-2021-101

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.11622/smedj.2022079

PubMed

Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To evaluate the diagnostic performance of MRI-based radiomics model for differentiating phyllodes tumors of the breast from fibroadenomas. METHODS: This retrospective study included 88 patients (32 with phyllodes tumors and 56 with fibroadenomas) who underwent MRI. Radiomic features were extracted from T2-weighted image, pre-contrast T1-weighted image, and the first-phase and late-phase dynamic contrast-enhanced MRIs. To create stable machine learning models and balanced classes, data augmentation was performed. A least absolute shrinkage and selection operator (LASSO) regression was performed to select features and build the radiomics model. A radiological model was constructed from conventional MRI features evaluated by radiologists. A combined model was constructed using both radiomics features and radiological features. Machine learning classifications were done using support vector machine, extreme gradient boosting, and random forest. The area under the receiver operating characteristic (ROC) curve (AUC) was computed to assess the performance of each model. RESULTS: Among 1070 features, the LASSO logistic regression selected 35 features. Among three machine learning classifiers, support vector machine had the best performance. Compared to the radiological model (AUC: 0.77 ± 0.11), the radiomics model (AUC: 0.96 ± 0.04) and combined model (0.97 ± 0.03) had significantly improved AUC values (both p < 0.01) in the validation set. The combined model had a relatively higher AUC than that of the radiomics model in the validation set, but this was not significantly different (p = 0.391). CONCLUSIONS: Radiomics analysis based on MRI showed promise for discriminating phyllodes tumors from fibroadenomas. KEY POINTS: • The radiomics model and the combined model were superior to the radiological model for differentiating phyllodes tumors from fibroadenomas. • The SVM classifier performed best in the current study. • MRI-based radiomics model could help accurately differentiate phyllodes tumors from fibroadenomas.

DOI： 10.1007/s00330-021-08510-8

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.imu.2022.101030

Scopus

Language：Japanese  

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11405/nisshoshi.119.1055

PubMed

Language：Japanese   Publisher：(一社)日本核医学会  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

PURPOSE: To evaluate the feasibility of folded image training strategy (FITS) and the quality of images reconstructed using the improved model-based deep learning (iMoDL) network trained with FITS (FITS-iMoDL) for abdominal MR imaging. METHODS: This retrospective study included abdominal 3D T1-weighted images of 122 patients. In the experimental analyses, peak SNR (PSNR) and structure similarity index (SSIM) of images reconstructed with FITS-iMoDL were compared with those with the following reconstruction methods: conventional model-based deep learning (conv-MoDL), MoDL trained with FITS (FITS-MoDL), total variation regularized compressed sensing (CS), and parallel imaging (CG-SENSE). In the clinical analysis, SNR and image contrast were measured on the reference, FITS-iMoDL, and CS images. Three radiologists evaluated the image quality using a 5-point scale to determine the mean opinion score (MOS). RESULTS: The PSNR of FITS-iMoDL was significantly higher than that of FITS-MoDL, conv-MoDL, CS, and CG-SENSE (P < 0.001). The SSIM of FITS-iMoDL was significantly higher than those of the others (P < 0.001), except for FITS-MoDL (P = 0.056). In the clinical analysis, the SNR of FITS-iMoDL was significantly higher than that of the reference and CS (P < 0.0001). Image contrast was equivalent within an equivalence margin of 10% among these three image sets (P < 0.0001). MOS was significantly improved in FITS-iMoDL (P < 0.001) compared with CS images in terms of liver edge and vessels conspicuity, lesion depiction, artifacts, blurring, and overall image quality. CONCLUSION: The proposed method, FITS-iMoDL, allowed a deeper MoDL reconstruction network without increasing memory consumption and improved image quality on abdominal 3D T1-weighted imaging compared with CS images.

DOI： 10.2463/mrms.mp.2021-0103

PubMed

Language：Japanese  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.11622/smedj.2021226

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: According to LI-RADS, a major discriminating feature between hepatocellular carcinoma (HCC) and non-HCC malignancies is the subtype of arterial phase hyperenhancement (APHE). The aim of this study was to investigate whether APHE subtypes are consistent across multi-arterial phase (mHAP) MRI acquisitions while evaluating reader agreement. Secondarily, we investigated factors that may affect reader agreement for APHE subtype. METHODS: In this retrospective study, consecutive patients with liver cirrhosis and focal observations who underwent mHAP were included. Five radiologists reviewed MR images in 2 reading sessions. In reading session 1, individual AP series were reviewed and scored for presence of APHE and subtype. In reading session 2, readers scored observations' major and ancillary features and LI-RADS category in the complete MRI examination. Reader agreement was calculated using Fleiss' kappa for binary outcomes and Kendall's coefficient of concordance for LI-RADS categories. Univariate mixed effects logistic regressions were performed to investigate factors affecting agreement. RESULTS: In total, 61 patients with 77 focal observations were analyzed. Of observations unanimously scored as having APHE, 27.7% showed both rim and nonrim subtypes on mHAP. Inter-reader agreement for APHE subtype ranged from 0.49 (95% CI: 0.33, 0.64) to 0.57 (95% CI: 0.40, 0.74) between reading sessions. Observation size had a trend level effect on rim APHE agreement (p = 0.052). CONCLUSION: Approximately 1/3 of observations demonstrated inconsistent APHE subtype during mHAP acquisition. Small lesions were particularly challenging. Further guidance on APHE subtype classification, especially when applied to mHAP, could be a focus of LI-RADS refinement. KEY POINTS: • In a cohort of patients at risk for HCC, 28% of the observations showed inconsistent arterial phase hyperenhancement (APHE) subtypes (rim and nonrim) on multi-arterial phase imaging according to the majority score of 5 independent readers. • Inconsistent APHE subtypes may challenge reliable imaging diagnosis, i.e., LI-RADS categorization, of focal liver observations in patients at risk for HCC.

DOI： 10.1007/s00330-021-07924-8

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND. Acute exacerbation (AE) is a life-threatening complication of inter-stitial pneumonia (IP). Thoracic surgery may trigger AE. OBJECTIVE. The purpose of this study is to explore the role of preoperative CT findings in predicting postoperative AE in patients with IP and lung cancer. METHODS. This retrospective case-control study included patients from 22 institutions who had IP and underwent thoracic surgery for lung cancer. AE was diagnosed on the basis of symptoms and imaging findings noted within 30 days after surgery and the absence of alternate causes. For each patient with AE, two control patients without AE were identified. After exclusions, the study included 92 patients (78 men and 14 women; 31 with AE [the AE group] and 61 without AE [the no-AE group]; mean age, 72 years). Two radiologists independently reviewed preoperative thin-slice CT examinations for pulmonary findings and resolved differences by consensus. The AE and no-AE groups were compared using the Fisher exact and Mann-Whitney U tests. Multivariable logistic regression was performed. Interreader agreement was assessed by kappa coefficients. RESULTS. A total of 94% of patients in the AE group underwent segmentectomy or other surgery that was more extensive than wedge resection versus 75% in the no-AE group (p = .046). The usual IP pattern was present in 58% of the AE group versus 74% of the no-AE group (p = .16). According to subjective visual scoring, the mean (± SD) ground-glass opacity (GGO) extent was 6.3 ± 5.4 in the AE group versus 3.9 ± 3.8 in the no-AE group (p = .03), and the mean consolidation extent was 0.5 ± 1.2 in the AE group versus 0.1 ± 0.3 in the no-AE group (p = .009). Mean pulmonary trunk diameter was 28 ± 4 mm in the AE group versus 26 ± 3 mm in the no-AE group (p = .02). In a model of CT features only, independent predictors of AE (p < .05) were GGO extent (odds ratio [OR], 2.8), consolidation extent (OR, 9.4), and pulmonary trunk diameter (OR, 4.2); this model achieved an AUC of 0.75, a PPV of 71%, and an NPV of 77% for AE. When CT and clinical variables were combined, undergoing segmentectomy or more extensive surgery also independently predicted AE (OR, 8.2; p = .02). CONCLUSION. The presence of GGO, consolidation, and pulmonary trunk enlargement on preoperative CT predicts AE in patients with IP who are undergoing lung cancer surgery. CLINICAL IMPACT. Patients with IP and lung cancer should be carefully managed when predictive CT features are present. Wedge resection, if possible, may help reduce the risk of AE in these patients. TRIAL REGISTRATION. University Hospital Medical Information Clinical Trial Registry UMIN000029661.

DOI： 10.2214/AJR.21.25499

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Hepatocellular carcinoma (HCC) is a malignancy with variable biologic aggressiveness based on the tumor grade, presence or absence of vascular invasion, and pathologic and molecular classification. Knowledge and understanding of the prognostic implications of different pathologic and molecular phenotypes of HCC are emerging, with therapeutics that promise to provide improved outcomes in what otherwise remains a lethal cancer. Imaging has a central role in diagnosis of HCC. However, to date, the imaging algorithms do not incorporate prognostic features or subclassification of HCC according to its biologic aggressiveness. Emerging data suggest that some imaging features and further radiologic, pathologic, or radiologic-molecular phenotypes may allow prediction of the prognosis of patients with HCC. An invited commentary by Bashir is available online. Online supplemental material is available for this article. ©RSNA, 2021.

DOI： 10.1148/rg.2021210009

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To evaluate the diagnostic performance and image quality of the low-tube voltage and low-contrast medium dose protocol for hepatic dynamic CT. METHODS: This retrospective study was conducted between January and May 2018. All patients underwent hepatic dynamic CT using one of the two protocols: tube voltage, 80 kVp and contrast dose, 370   mgI/kg with hybrid iterative reconstruction or tube voltage, 120 kVp and contrast dose, 600  mgI/kg with filtered back projection. Two radiologists independently scored lesion conspicuity and image quality. Another radiologist measured the CT numbers of abdominal organs, muscles, and hepatocellular carcinoma (HCC) in each phase. Lesion detectability, HCC diagnostic ability, and image quality of the arterial phase were compared between the two protocols using the non-inferiority test. CT numbers and HCC-to-liver contrast were compared between the protocols using the Mann-Whitney U test. RESULTS: 424 patients (70.5 ± 10.1 years) were evaluated. The 80-kVp protocol showed non-inferiority in lesion detectability and diagnostic ability for HCC (sensitivity, 85.7-89.3%; specificity, 96.3-98.6%) compared with the 120-kVp protocol (sensitivity, 91.0-93.3%; specificity, 93.6-97.3%) (p < 0.001-0.038). The ratio of fair image quality in the 80-kVp protocol also showed non-inferiority compared with that in the 120-kVp protocol in assessments by both readers (p < 0.001). HCC-to-liver contrast showed no significant differences for all phases (p = 0.309-0.705) between the two protocols. CONCLUSION: The 80-kVp protocol with hybrid iterative reconstruction for hepatic dynamic CT can decrease iodine doses while maintaining diagnostic performance and image quality compared with the 120-kVp protocol. ADVANCES IN KNOWLEDGE: The 80- and 120-kVp protocols showed equivalent hepatic lesion detectability, diagnostic ability for HCC, image quality, and HCC-to-liver contrast.The 80-kVp protocol showed a 38.3% reduction in iodine dose compared with the 120-kVp protocol.

DOI： 10.1259/bjr.20210601

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

There are various diseases of the gallbladder and cystic duct, and imaging diagnosis is challenging for the rare among them. However, some rare diseases show characteristic imaging findings or patient history; therefore, familiarity with the imaging presentation of rare diseases may improve diagnostic accuracy and patient management. The purpose of this article is to describe the imaging findings of rare diseases of the gallbladder and cystic duct and identify their pathological correlations with these diseases.

DOI： 10.3348/kjr.2020.1479

PubMed

Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To assess the feasibility of a CNN-based liver registration algorithm to generate difference maps for visual display of spatiotemporal changes in liver PDFF, without needing manual annotations. METHODS: This retrospective exploratory study included 25 patients with suspected or confirmed NAFLD, who underwent PDFF-MRI at two time points at our institution. PDFF difference maps were generated by applying a CNN-based liver registration algorithm, then subtracting follow-up from baseline PDFF maps. The difference maps were post-processed by smoothing (5 cm2 round kernel) and applying a categorical color scale. Two fellowship-trained abdominal radiologists and one radiology resident independently reviewed difference maps to visually determine segmental PDFF change. Their visual assessment was compared with manual ROI-based measurements of each Couinaud segment and whole liver PDFF using intraclass correlation (ICC) and Bland-Altman analysis. Inter-reader agreement for visual assessment was calculated (ICC). RESULTS: The mean patient age was 49 years (12 males). Baseline and follow-up PDFF ranged from 2.0 to 35.3% and 3.5 to 32.0%, respectively. PDFF changes ranged from - 20.4 to 14.1%. ICCs against the manual reference exceeded 0.95 for each reader, except for segment 2 (2 readers ICC = 0.86-0.91) and segment 4a (reader 3 ICC = 0.94). Bland-Altman limits of agreement were within 5% across all three readers. Inter-reader agreement for visually assessed PDFF change (whole liver and segmental) was excellent (ICCs > 0.96), except for segment 2 (ICC = 0.93). CONCLUSIONS: Visual assessment of liver segmental PDFF changes using a CNN-generated difference map strongly agreed with manual estimates performed by an expert reader and yielded high inter-reader agreement. KEY POINTS: • Visual assessment of longitudinal changes in quantitative liver MRI can be performed using a CNN-generated difference map and yields strong agreement with manual estimates performed by expert readers.

DOI： 10.1007/s00330-020-07649-0

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

AIMS: To evaluate the association between contrast patterns on gadoxetic acid-enhanced hepatobiliary phase (HBP) MR images and transporter expression in surgically resected hypovascular hepatocellular nodules including early hepatocellular carcinomas (HCCs). METHODS: Forty-two hypovascular hepatic nodules and 43 hypervascular HCCs as a control were included in this retrospective study. Contrast of the nodules on HBP images was graded as hypo-, iso-, or hyperintense. Histopathological assessment was performed in the context of multistep hepatocarcinogenesis. Immunohistochemical staining of organic anion transporter 1B3 (OATP1B3) and multidrug resistance protein 2 (MRP2) was performed. Cramer's coefficient was used to determine the linear relationship between contrast grades and transporter expression, and the Cochran-Armitage trend test was used to determine the relationship between transporter expression and progression of multistep hepatocarcinogenesis. RESULTS: Moderate linear relationships between contrast grades and OATP1B3 expression were observed for both hypo- and hypervascular nodules. OATP1B3 expression was negatively correlated with the progression of multistep hepatocarcinogenesis. MRP2 expression was not associated with the contrast grades or histopathological results. CONCLUSION: OATP1B3 expression was associated with contrast grades of hepatocellular nodules observed in HBP image of gadoxetic acid-enhanced MRI in the hypovascular hepatocellular nodules and was negatively correlated with hepatocarcinogenesis.

DOI： 10.1016/j.ejrad.2021.109669

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp-2019-0122

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00330-020-07006-1

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To determine imaging hallmarks for distinguishing intrahepatic mass-forming biliary carcinomas (IMBCs) from hepatocellular carcinoma (HCC) and to validate their diagnostic ability using Bayesian statistics. METHODS: Study 1 retrospectively identified clinical and imaging hallmarks that distinguish IMBCs (n = 41) from HCC (n = 247) using computed tomography (CT) and magnetic resonance imaging (MRI). Study 2 retrospectively assessed the diagnostic ability of these hallmarks to distinguish IMBCs (n = 37) from HCC (n = 111) using Bayesian statistics with images obtained from a different institution. We also assessed the diagnostic ability of the hallmarks in the patient subgroup with high diagnostic confidence (≥ 80% of post-test probability). Two radiologists independently evaluated the imaging findings in studies 1 and 2. RESULTS: In study 1, arterial phase peritumoral parenchymal enhancement on CT/MRI, delayed enhancement on CT/MRI, diffusion-weighted imaging peripheral hyperintensity, and bile duct dilatation were hallmarks indicating IMBCs, whereas chronic liver disease, non-rim arterial phase hyperenhancement on CT/MRI, enhancing capsule on CT/MRI, and opposed-phase signal drop were hallmarks indicating HCC (p = 0.001-0.04). In study 2, Bayesian statistics-based post-test probability combining all hallmark features had a diagnostic accuracy of 89.2% (132/148) in distinguishing IMBCs from HCC for both readers. In the high diagnostic confidence subgroup (n = 120 and n = 124 for readers 1 and 2, respectively), the accuracy improved (95.0% (114/120) and 93.5% (116/124) for readers 1 and 2, respectively). CONCLUSIONS: Combined interpretation of CT and MRI to identify hallmark features is useful in discriminating IMBCs from HCCs. High post-test probability by Bayesian statistics allows for a more reliable non-invasive diagnosis. KEY POINTS: • Combined interpretation of CT and MRI to identify hallmark features was useful in discriminating intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma. • Bayesian method-based post-test probability combining all hallmark features determined in study 1 showed high (> 90%) sensitivity and specificity for distinguishing intrahepatic mass-forming biliary carcinomas from hepatocellular carcinoma. • If the post-test probability or the confidence was ≥ 80% when combining the imaging features of CT and MRI, the high specificity of > 95% was achieved without any loss of sensitivity to distinguish hepatocellular carcinoma from intrahepatic mass-forming biliary carcinomas.

DOI： 10.1007/s00330-020-06972-w

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To investigate neuroendocrine carcinoma (NEC) of the uterine cervix cases for MRI features and staging, as well as pathological correlations and survival. RESULTS: FIGO was I in 42, II in 14, III in 1, and IV in 5 patients. T2-weighted MRI showed homogeneous slightly high signal intensity and obvious restricted diffusion (ADC map, low intensity; DWI, high intensity) throughout the tumor in most cases, and mild enhancement in two-thirds. In 50 patients who underwent a radical hysterectomy and lymphadenectomy without neoadjuvant chemotherapy (NAC), intrapelvic T staging by MRI overall accuracy was 88.0% with reference to pathology staging, while patient-based sensitivity, specificity, and accuracy for metastatic pelvic lymph node detection was 38.5%, 100%, and 83.3%, respectively. During a mean follow-up period of 45.6 months (range 4.3-151.0 months), 28 patients (45.2%) experienced recurrence and 24 (38.7%) died. Three-year progression-free and overall survival rates for FIGO I, II, III, and IV were 64.3% and 80.9%, 50% and 64.3%, 0% and 0%, and 0% and 0%, respectively. MATERIALS AND METHODS: Sixty-two patients with histologically surgery-proven uterine cervical NEC were enrolled. Twelve received NAC. Clinical data, pathological findings, and pretreatment pelvic MRI findings were retrospectively reviewed. Thirty-two tumors were pure NEC and 30 mixed with other histotypes. The NECs were small cell type (41), large cell type (18), or a mixture of both (3). CONCLUSIONS: Homogeneous lesion texture with obvious restricted diffusion throughout the tumor are features suggestive of cervical NEC. Our findings show that MRI is reliable for T staging of cervical NEC.

DOI： 10.18632/oncotarget.27613

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare computed diffusion-weighted imaging (cDWI) feasibility with that of directly acquired DWI for visualizing pancreatic ductal adenocarcinoma (PDAC) and focal autoimmune pancreatitis (AIP). METHODS: From April 2012 to January 2017, 135 patients with PDAC (n = 111) or focal AIP (n = 24) were retrospectively enrolled. They underwent DWI with b-values of 0, 500, and 1000 s/mm2. From DWI0 and DWI1000, we generated cDWIs with targeted b-values of 1500, 2000, and 3000 s/mm2. The lesions' signal intensities, image quality, signal intensity ratio (SIR) of lesions and pancreatic parenchyma to spinal cord, and lesion-to-pancreatic parenchyma contrast ratio (CR) were compared among the five DWI protocols (DWI500, DWI1000, cDWI1500, cDWI2000, and cDWI3000). SIR was analyzed by receiver operating characteristic (ROC) analyses. RESULTS: DWI500, DWI1000, and cDWI1500 had higher image quality than cDWI2000 and cDWI3000 (P < 0.001). The incidence of clear hyperintense PDAC was highest on cDWI2000, followed by cDWI1500, and cDWI3000 (P < 0.001-0.002), while the incidence of clear hyperintense AIP was higher on DWI1000, cDWI1500, and cDWI2000 than on DWI500 and cDWI3000 (P = 0.001-0.022). SIRs decreased whereas CRs increased as the b-value increased, for both PDAC and AIP. The area under the ROC curve (AUC) of SIRlesion was significantly lower on cDWI1500 than on cDWI2000 and cDWI3000 (P < 0.001). CONCLUSION: cDWI1500 or cDWI2000 generated from b-values of 0 and 1000 s/mm2 were the most effective for visualizing PDAC and focal AIP; however, the SIRlesion AUC was significantly lower on cDWI1500 than on cDWI2000 and cDWI3000.

DOI： 10.1007/s00261-020-02695-0

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To investigate whether shortened acquisition or multiple arterial phase acquisition improves image quality of the arterial phase compared with conventional protocol. METHODS: This retrospective study was approved by the relevant Institutional Review Board. A total of 615 consecutive patients who underwent gadoxetate disodium-enhanced MRI including one of the following three sequences in three different periods were included: (i) conventional liver acquisition with volume acceleration (LAVA) (between October 2014 and January 2015, n = 149), (ii) Turbo-LAVA (between March and August 2016, n = 216), and (iii) differential sub-sampling with Cartesian ordering (DISCO) (between January and September 2015, n = 250). We monitored the respiratory bellows waveform during breath holding for each patient and recorded breath-hold fidelity of the patients. Two radiologists independently evaluated the degree of respiratory artifact and scan timing on the arterial phase and compared them between the three protocols (i.e., conventional LAVA, Turbo-LAVA, and DISCO), with conventional LAVA as control. RESULTS: The ratio of patients with breath-hold failure was not significantly different among the three protocols (P = 0.6340 and 0.1085). Respiratory artifact was significantly lower in DISCO than in conventional LAVA (P = 0.0424), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.2593). The ratio of adequate scan timing and diagnosable image defined as no or mild artifact and adequate scan timing were higher in DISCO than in conventional LAVA (P = 0.0025 and 0.0019), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.0780 and 0.0657). CONCLUSION: Compared with conventional protocol, multiple arterial phase acquisition (DISCO) obtained a higher number of diagnosable images by reducing respiratory motion artifact and optimizing the scan timing of arterial phase.

DOI： 10.2463/mrms.mp.2020-0064

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Post-contrast liver magnetic resonance imaging is typically performed with breath-hold 3D gradient echo sequences. However, breath-holding for >10 s is difficult for some patients. In this study, we compared the quality of hepatobiliary phase (HBP) imaging without breath-holding using the prototype pulse sequences stack-of-stars liver acquisition with volume acceleration (LAVA) (LAVA Star) with or without navigator echoes (LAVA Starnavi+ and LAVA Starnavi-) and Cartesian LAVA with navigator echoes (Cartesian LAVAnavi+). METHODS: Seventy-two patients were included in this single-center, retrospective, cross-sectional study. HBP imaging using the three LAVA sequences (Cartesian LAVAnavi+, LAVA Starnavi-, and LAVA Starnavi+) without breath-holding was performed for all patients using a 3T magnetic resonance system. Two independent radiologists qualitatively analyzed (overall image quality, liver edge sharpness, hepatic vein clarity, streak artifacts, and respiratory motion/pulsation artifacts) HBP images taken by the three sequences using a five-point scale. Quantitative evaluations were also performed by calculating the liver-to-spleen, -lesion, and -portal vein (PV) signal intensity ratios. The results were compared between the three sequences using the Friedman test. RESULTS: LAVA Starnavi+ showed the best image quality and hepatic vein clarity (P < 0.0001). LAVA Starnavi- showed the lowest image quality (P < 0.0001-0.0106). LAVA Starnavi+ images showed fewer streak artifacts than LAVA Starnavi- images (P < 0.0001), while Cartesian LAVAnavi+ images showed no streak artifacts. Cartesian LAVAnavi+ images showed stronger respiratory motion/pulsation artifacts than the others (P < 0.0001). LAVA Starnavi- images showed the highest liver-to-spleen ratios (P < 0.0001-0.0005). Cartesian LAVAnavi+ images showed the lowest liver-to-lesion and -PV ratios (P < 0.0001-0.0108). CONCLUSION: In terms of image quality, the combination of stack-of-stars acquisition and navigator echoes is the best for HBP imaging without breath-holding.

DOI： 10.2463/mrms.mp.2019-0030

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To identify gadoxetate disodium-enhanced MRI features distinguishing hepatic IPT from CLM. METHODS: From February 2008 to December 2019, 162 lesions (IPT, n = 31 and CLM, n = 131) from 94 patients (mean age 65.1 ± 12.2 years; 65 men and 29 women) were retrospectively assessed for the presence or absence of obscure boundary, rim enhancement on arterial phase (AP), persistent rim enhancement during AP to transitional phase (TP), blood vessel penetration, peritumoral parenchymal enhancement on AP, peritumoral parenchymal hypointensity on hepatobiliary phase (HBP), peritumoral parenchymal hyperintensity on T2-weighted imaging (T2WI), biliary dilatation, central hypointensity with a relatively hyperintense periphery on HBP, peripheral hyperintensity on diffusion-weighted imaging (DWI) and T2WI, and lesion to liver signal intensity ratio (SIRlesion/liver) on HBP and DWI. Relevant features for differentiating between ITP and CLM were identified by univariate and multivariate analyses. RESULTS: Univariate analysis revealed significantly higher frequencies of the following features in IPT than CLM: younger age, obscure boundary, blood vessel penetration, central hypointensity with a relatively hyperintense periphery on HBP, higher SIRlesion/liver on HBP, and lower SIRlesion/liver on DWI (P < 0.001‒0.035). Rim enhancement on AP and persistent rim enhancement during AP to TP were significantly more common in CLM than in IPT (P ≤ 0.001). Multivariate analysis revealed that a central hypointensity with a relatively peripheral hyperintensity on HBP, higher SIRlesion/liver on HBP, and lower SIRlesion/liver on DWI were predictive of IPT (P = 0.003‒0.039). CONCLUSION: Central hypointensity with a relatively peripheral hyperintensity on HBP and SIRlesion/liver on HBP and DWI may be reliable gadoxetate disodium-enhanced MRI features for distinguishing IPT from CLM.

DOI： 10.1007/s00261-020-02575-7

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Background Diffusion-weighted (DW) MRI-based elastography has recently been proposed for noninvasive liver fibrosis staging but requires evaluation in a larger number of patients. Purpose To compare DW MRI and MR elastography for the assessment of liver fibrosis. Materials and Methods In this retrospective study, patients underwent MR elastography and DW MRI between November 2017 and April 2018. Shear modulus measured by MR elastography (μMRE) was obtained in each patient from regions of interest placed on liver stiffness maps by two independent readers. Shifted apparent diffusion coefficient (ADC) was calculated from DW MRI (b = 200 and 1500 sec/mm2) and converted to DW MRI-based virtual shear modulus (μDiff). MRI-based liver fibrosis stages were estimated from μMRE and μDiff values (F0-F4) and serum fibrosis markers were assessed. Statistical analyses included Bland-Altman plots, Bayesian prediction, and receiver operating characteristic analyses. Results Seventy-four patients (mean age, 68 years ± 9 [standard deviation]; 45 men) were evaluated. Interreader coefficient of reproducibility was 0.86 kPa for DW MRI and 1.2 kPa for MR elastography. Strong correlation between shifted ADC and μMRE was observed (r2 = 0.81; P < .001), showing high agreement between μMRE and μDiff values (mean difference, -0.02 kPa ± 0.88; P < .001). DW MRI-based fibrosis staging agreed with MR elastography-based staging in 55% of patients (41 of 74) and within one stage difference in 35% of patients (26 of 74). Binarization into insignificant (F0-F1) and significant fibrosis (F2-F4) showed agreement in 85% of patients (63 of 74; κ = 0.85). Compared with serum markers (area under the receiver operating characteristic curve [AUC], 0.50-0.69), μDiff showed better performance in discriminating fibrosis stages F0-F2 from F3-F4 (AUC, 0.79; 95% confidence interval: 0.69, 0.90), whereas serum markers showed slightly better results for F0-F1 versus F2-F4 differentiation (fibrosis stages were estimated by using MR elastography). Combining DW MRI with serum markers provided a trend toward highest discriminative performance (AUC, μDiff + aspartate aminotransferase-to-platelet radio index: F0-F1 vs F2-F4, 0.81 [95% confidence interval: 0.69, 0.93], P = .17; F0-F2 vs F3-F4, 0.83 [95% confidence interval: 0.74, 0.92], P = .07; and AUC μDiff + Fibrosis 4 score: F0-F1 vs F2-F4, 0.78 [95% confidence interval: 0.64, 0.92], P < .30; F0-F2 vs F3-F4, 0.81 [95% confidence interval: 0.71, 0.91], P = .08). Conclusion MR elastography and diffusion-weighted (DW) MRI-based estimation of liver fibrosis stage showed high agreement. DW MRI shows potential as an alternative to MR elastography for noninvasive fibrosis staging without the need for mechanical vibration setup. © RSNA, 2020 Online supplemental material is available for this article.

DOI： 10.1148/radiol.2020191498

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

To accelerate high-resolution diffusion-weighted imaging with a multi-shot echo-planar sequence, we propose an approach based on reduced averaging and deep learning. Denoising convolutional neural networks can reduce amplified noise without requiring extensive averaging, enabling shorter scan times and high image quality. The preliminary experimental results demonstrate the superior performance of the proposed denoising method over state-of-the-art methods such as the widely used block-matching and 3D filtering.

DOI： 10.2463/mrms.tn.2019-0081

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp.2019-0193

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp.2019-0193

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Fish bones are some of the most commonly ingested foreign bodies. In most cases, fish bone ingestion is asymptomatic, and the bones are expelled from the body spontaneously. Otherwise, patients with fish bone ingestion can present to the emergency department with nonspecific symptoms. Fish bones can become impacted in various part of the body. Even in cases that are initially asymptomatic after ingestion, serious complications may develop at a later stage. Computed tomography (CT) plays an important role in the diagnosis of fish bone ingestion because it is the most sensitive modality for detecting these foreign bodies. It is important to be familiar with CT findings to detect ingested fish bones and the related complications and to direct further management of the condition.

DOI： 10.1177/0846537119899198

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Meckel diverticulum is the most common and well-known congenital anomaly of the digestive system. Although most cases are asymptomatic, Meckel diverticulum can have a variety of complications, including gastrointestinal bleeding as a result of peptic ulceration, diverticulitis, and small bowel obstruction. Although the radiologic findings of these complications have been reported, they are difficult to diagnose preoperatively because Meckel diverticulum is a small entity. Computed tomography and scintigraphy play an important role in the diagnosis of Meckel diverticulum and its complications. It is important to be familiar with the radiologic features of acute abdomen due to complications of Meckel diverticulum to be able to manage the condition appropriately.

DOI： 10.1177/0846537119899537

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.26797

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To improve the quality of images obtained via dynamic contrast enhanced MRI (DCE-MRI), which contain motion artifacts and blurring using a deep learning approach. MATERIALS AND METHODS: A multi-channel convolutional neural network-based method is proposed for reducing the motion artifacts and blurring caused by respiratory motion in images obtained via DCE-MRI of the liver. The training datasets for the neural network included images with and without respiration-induced motion artifacts or blurring, and the distortions were generated by simulating the phase error in k-space. Patient studies were conducted using a multi-phase T1-weighted spoiled gradient echo sequence for the liver, which contained breath-hold failures occurring during data acquisition. The trained network was applied to the acquired images to analyze the filtering performance, and the intensities and contrast ratios before and after denoising were compared via Bland-Altman plots. RESULTS: The proposed network was found to be significantly reducing the magnitude of the artifacts and blurring induced by respiratory motion, and the contrast ratios of the images after processing via the network were consistent with those of the unprocessed images. CONCLUSION: A deep learning-based method for removing motion artifacts in images obtained via DCE-MRI of the liver was demonstrated and validated.

DOI： 10.2463/mrms.mp.2018-0156

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: MR-based metrics, including hepatobiliary phase (HBP) hypointense nodules without arterial phase hyperenhancement (APHE), and liver stiffness as measured by MR elastography are useful markers to stratify the risk of hepatocellular carcinoma (HCC) development in chronic liver disease patients. However, prospective studies are needed to clarify their utility. PURPOSE: To perform a risk analysis of HCC development in chronic liver disease patients, with a focus on MR-based biomarkers. STUDY TYPE: Prospective. SUBJECTS: Consecutive 110 cirrhotic patients (61 males, 49 females) without a history of HCC who matched the inclusion criteria. FIELD STRENGTH/SEQUENCE: 3T/3D gradient-echo T1 -weighted images and MR elastography. ASSESSMENT: Patients underwent MRI for HCC screening and attended follow-up appointments every 3 months. The primary endpoint was the development of hypervascular HCC. Patients were classified according to the presence of an HBP hypointense nodule without APHE (if present in the liver, the patient was classified in nonclean liver group; if absent, clean liver group), and stiffness value on MR elastography (soft liver, <4.0 kPa; stiff liver, ≥4.0 kPa) at the initial examination. STATISTICAL TESTS: Risk factors were identified in univariate and multivariate Cox regression models. Incidence rates of HCC development were evaluated using the Kaplan-Meier method. RESULTS: Patients were classified into clean-liver (n = 76) and nonclean-liver groups (n = 34), and into soft-liver (n = 53) and stiff-liver groups (n = 45). During the follow-up period (median, 21.0 months), 16 patients developed hypervascular HCC. Patients in the nonclean-liver group showed a higher incidence of hypervascular HCC than those in the clean-liver group (3-year HCC incidence rates: 50.4% and 5.7%, respectively; P < 0.05). A nonclean liver was independently associated with hypervascular HCC development (hazard ratio, 18.75; 95% confidence interval, 4.83-128.63; P < 0.0001), but stiff liver was not (1.91; 0.66-6.23; P = 0.23). DATA CONCLUSION: An HBP hypointense nodule without APHE observed on a gadoxetic acid-enhanced MR image is a strong indicator of subsequent development of hypervascular HCC in patients with chronic liver disease. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2020;51:389-396.

DOI： 10.1002/jmri.26760

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

The present study is aimed to clarify the utility of magnetic resonance cholangiopancreatography (MRCP) and the additional value of diffusion-weighted imaging (DWI) in diagnosing pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN).This retrospective study involved 38 patients with PDAC concomitant with IPMN and 114 patients (control) who were randomly selected from 320 patients with IPMN without PDAC and were matched with cases for magnetic resonance imaging (MRI) strength (1.5 T/3.0 T). Two radiologists reviewed the 2 MR image sets with relevant clinical information blinded, first MRCP alone and then combined MRI set including DWI. Diagnostic capability and interobserver agreement were assessed by using receiver operating characteristics curve (Az) analysis and weighted κ statistics.Az values for the 2 observers were 0.834 and 0.821 for MRCP alone and 0.964 and 0.926 for the combined MRI (P < .001 and P < .001), respectively. The sensitivity of MRCP alone was 61% (23/38), with both observers failing to diagnose PDACs located at the end of tail or away from the pancreatic duct. Meanwhile, with combined MRI, sensitivity was significantly increased for both observers (61% to 92%, P = .002; 61% to 87%, P = .004). Moreover, the interobserver agreement was higher with combined MRI (κ = 0.85) than MRCP alone (κ = 0.59).MRCP and DWI might be a superior option with a higher diagnostic capability of PDAC concomitant with IPMN than MRCP alone, especially for tumors away from the pancreatic duct.

DOI： 10.1097/md.0000000000018039

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Liver alignment between series/exams is challenged by dynamic morphology or variability in patient positioning or motion. Image registration can improve image interpretation and lesion co-localization. We assessed the performance of a convolutional neural network algorithm to register cross-sectional liver imaging series and compared its performance to manual image registration. METHODS: Three hundred fourteen patients, including internal and external datasets, who underwent gadoxetate disodium-enhanced magnetic resonance imaging for clinical care from 2011 to 2018, were retrospectively selected. Automated registration was applied to all 2,663 within-patient series pairs derived from these datasets. Additionally, 100 within-patient series pairs from the internal dataset were independently manually registered by expert readers. Liver overlap, image correlation, and intra-observation distances for manual versus automated registrations were compared using paired t tests. Influence of patient demographics, imaging characteristics, and liver uptake function was evaluated using univariate and multivariate mixed models. RESULTS: Compared to the manual, automated registration produced significantly lower intra-observation distance (p < 0.001) and higher liver overlap and image correlation (p < 0.001). Intra-exam automated registration achieved 0.88 mean liver overlap and 0.44 mean image correlation for the internal dataset and 0.91 and 0.41, respectively, for the external dataset. For inter-exam registration, mean overlap was 0.81 and image correlation 0.41. Older age, female sex, greater inter-series time interval, differing uptake, and greater voxel size differences independently reduced automated registration performance (p ≤ 0.020). CONCLUSION: A fully automated algorithm accurately registered the liver within and between examinations, yielding better liver and focal observation co-localization compared to manual registration.

DOI： 10.1186/s41747-019-0120-7

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.mp-2019-0122

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.crad.2019.08.002

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Diffusion-weighted imaging (DWI) is useful for detecting and characterizing liver lesions but is sensitive to organ motion artifact, especially in the left lobe. PURPOSE: To assess the signal intensity (SI) loss in the left hepatic lobe on DWI depending on motion-proving gradient (MPG) pulse direction (preliminary study) and to evaluate the usefulness of modified signal averaging to reduce the SI loss on DWI (application study). METHODS: About 48 (preliminary) and 35 (application) patients were included. In the preliminary study, DWI with four different MPG directions, only a single MPG pulse direction (x-, y-, or z-axis) and all three directions combined (standard DWI), were reconstructed from the original data. In the application study, we examined the usefulness of the weighted averaging number of excitations (wNEX) method, in which a larger weighting factor is applied to the higher signal in pixel-by-pixel NEX signal averaging by comparing four reconstruction methods. We assumed that true signals would be the same in both lobes. The SI and apparent diffusion coefficient (ADC) ratios for the left versus right lobe were calculated by dividing the SI/ADC of the right lobe by that of the left lobe. RESULTS: In the preliminary study, the SI ratio was significantly lower on DWI using only the x-axis but was significantly higher on DWI using only the z-axis (both P < 0.0001) when compared with standard DWI. In the application study, the SI (mean, 1.15-1.17) and ADC (0.90-0.92) ratios on DWI with wNEX were closer to 1.0 than those on standard DWI (SI ratio, 1.32-1.38; ADC ratio 0.80-0.81); the differences were significant (all P < 0.0001). CONCLUSION: The MPG pulse along the z-axis caused signal loss in the left hepatic lobe. The wNEX reconstruction method effectively reduced signal loss in the left lobe on DWI.

DOI： 10.2463/mrms.mp.2018-0085

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Recent studies of adults have found an association between hyperintensity of the dentate nucleus (DN) and globus pallidus (GP) on T1 -weighted images (T1 WI) and a history of linear gadolinium-based contrast agent (GBCA) administration. Several reports have also focused on this phenomenon in pediatric patients; however, data in the current literature remains limited. PURPOSE/HYPOTHESIS: To evaluate the associations between DN and GP T1 -signal increase and previous administration of linear GBCAs in pediatric patients. STUDY TYPE: Single-center, retrospective, cross-sectional study. POPULATION: We included pediatric patients with histories of ≥5 linear GBCA (gadodiamide and gadopentetate dimeglumine) administrations (the "≥5 Linear GBCA administrations" group), 1-4 administrations (the "1-4 Linear GBCA administrations" group), and no history of GBCA administration (the "No GBCA administration" group). Each group included 42 patients. Therefore, 126 patients (male:female, 72:54; median age, 16 [range, 4-18] years) were included in this study. FIELD STRENGTH/SEQUENCE: 1.5T/ Spin-echo unenhanced T1 -weighted imaging. ASSESSMENT: Unenhanced T1 -weighted images were quantitatively analyzed by two radiologists. The DN-to-pons and GP-to-thalamus signal intensity ratios (DN-to-pons and GP-to-thalamus ratios, respectively) were compared. STATISTICAL TESTS: Wilcoxon test with the Bonferroni correction and intraclass correlation coefficients. RESULTS: The DN-to-pons ratio increased as the number of GBCA administrations increased (P < 0.0063). The GP-to-thalamus ratio of the "≥5 Linear GBCA administrations" group was significantly higher than those of the other two groups (P < 0.0001). The GP-to-thalamus ratio of the "1-4 Linear GBCA administrations" group did not differ significantly from that of the "No GBCA administration" group (P = 1.000). The DN-to-pons and GP-to-thalamus ratios' interobserver intraclass correlation coefficients were excellent (0.8236) and good (0.6738), respectively. DATA CONCLUSION: High signal intensities in the DN and GP on T1 WI were associated with previous linear GBCA administration in pediatric patients. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1046-1052.

DOI： 10.1002/jmri.26311

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To evaluate the usefulness of longitudinal observation of liver stiffness measured using magnetic resonance elastography (MRE) to stratify the risk of hepatocellular carcinoma (HCC) in patients with chronic liver disease. MATERIALS AND METHODS: We retrospectively reviewed data for 161 patients with chronic liver disease using the following inclusion criteria: two MRE examinations separated by at least a 12-month interval, no history of HCC, no development of HCC between the two examinations and availability of laboratory results. Liver stiffness was classified as low (< 3 kPa), moderate (3-4.7 kPa) or high (> 4.7 kPa). The patients were divided into three groups according to sequential changes in liver stiffness as follows: high on the first MRE (group A, n = 60), low on both MRE examinations (group C, n = 36) and other combinations (group B, n = 65). Cox analyses and Kaplan-Meier methods were used to determine the risk of developing HCC. RESULTS: Forty-seven patients (29.2%) developed HCC during follow-up (46.7% [28/60] in group A, 26.2% [17/65] in group B, and 5.6% [2/36] in group C). There was a significant difference in the rate of development of HCC between groups A (45.1%), B (26.1%) and C (12.4%) at 3 years (p = 0.0002). The independent risk factors for development of HCC were group A classification, age and a high alanine aminotransferase level (risk ratio 1.018-6.030; p = 0.0028-0.0268). CONCLUSION: Longitudinal observation of liver stiffness using MRE can stratify the risk of HCC during follow-up of chronic liver disease. KEY POINTS: • The results of MRE can stratify the risk for development of HCC during follow-up in patients with chronic liver disease. • Patients with chronic liver disease and high liver stiffness (> 4.7 kPa) on a previous MRE examination are at high risk for developing HCC, regardless of current liver stiffness. • Management of patients with chronic liver disease becomes more appropriate using longitudinally acquired two-point MRE data.

DOI： 10.1007/s00330-018-5640-7

PubMed

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

We evaluated the value of magnetic resonance elastography (MRE) for the prediction of response to magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids. Eleven patients were enrolled. A fractional change of >30% in Symptoms Severity Score (SSS) was defined as a 'substantial symptomatic improvement' at 12 months after treatment. The fractional stiffness value reduction in the patients with a substantial improvement in SSS was significantly higher than that in those without (P = 0.0446).

DOI： 10.2463/mrms.tn.2017-0103

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIM: Nab-paclitaxel plus gemcitabine (nab-P+Gem) is one of most reliable and effective regimens for borderline or unresectable pancreatic cancer (PC). However, the feasibility and clinical benefits of this regimen have never been evaluated for patients with recurrent PC after pancreatectomy. The aim of this study was to investigate the feasibility of combination therapy with nab-paclitaxel plus gemcitabine (nab-P+Gem) for patients with recurrent PC. PATIENTS AND METHODS: Twenty-two patients with recurrent PC received an intravenous infusion of nab-P (125 mg/m2) and Gem (1,000 mg/m2) on days 1, 8, and 15 of a 4-week cycle. The primary end-point of this study was completion of the 4 cycles. The secondary end-points were the safety, efficacy, and disease control rate. RESULTS: The treatment completion rate of the 4 cycles was 90.9%. The objective response rate was 13.6% and the disease control rate was 63.6%. The median progression-free survival was 7.2 months. The most common grade 3 or higher hematological toxicity was neutropenia (72.7%). There was no treatment-related death. Furthermore, the chemotherapeutic effects varied with the time of recurrence. CONCLUSION: Combination nab-P+Gem therapy was well-tolerated and effective in patients with recurrent PC.

DOI： 10.21873/anticanres.13019

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To evaluate the prognostic value of preoperative 18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with potentially resectable pancreatic cancer. METHODS: The study included 103 consecutive patients with potentially resectable pancreatic cancer who underwent preoperative FDG-PET/CT. Age, sex, blood glucose level, tumor marker levels (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9)), PET-related parameters (maximum standardized uptake value (SUVmax)), and contrast-enhanced CT-related factors (tumor size, location, enhancement pattern, and CT-based T and N factors by tumor nodes metastasis (TNM) classification) were assessed for their ability to independently predict postoperative tumor recurrence using Cox proportional hazards model. RESULTS: Median follow-up was 23.1 months. Univariate analyses revealed that SUVmax (P = 0.0004), tumor size (P = 0.0002), T factor (P = 0.0102), N factor (P = 0.0049), and CA19-9 levels (P = 0.0059) were significantly associated with disease-free survival (DFS). In multivariate analysis, SUVmax (P = 0.0163) and CA19-9 levels (P = 0.0364) independently predicted DFS. Kaplan-Meier analysis revealed that patients with low (< 2.5) SUVmax had a significantly better prognosis than those with higher SUVmax (P = 0.0006). The DFS in patients with SUVmax < 2.5 (n = 23) and SUVmax ≥ 2.5 (n = 80) was 61.9% and 9.7%, respectively, 3 years postoperatively. CONCLUSIONS: SUVmax can predict DFS in patients with resectable pancreatic cancer. A SUVmax < 2.5 heralds a better prognosis.

DOI： 10.1007/s00261-018-1647-4

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We measured the changes in the cerebrospinal fluid (CSF) flow dynamics after compression of the bilateral jugular veins using phase contrast-magnetic resonance imaging (PC-MRI). PC-MRI was performed in 10 healthy male volunteers using a 3T clinical scanner with a two-dimensional gradient echo sequence. We successfully measured the changes in CSF flow velocity using PC-MRI with and without compression of the bilateral jugular veins. The relative velocity range decreased by about 30% when the bilateral jugular veins were compressed.

DOI： 10.2463/mrms.tn.2017-0056

PubMed

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：John Wiley and Sons Inc.  

DOI： 10.1002/jmri.25868

Scopus

PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Magnetic Resonance in Medicine  

DOI： 10.2463/mrms.mp.2017-0047

Scopus

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Lippincott Williams and Wilkins  

DOI： 10.1097/RLI.0000000000000428

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：John Wiley and Sons Inc.  

DOI： 10.1002/jmri.25764

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1148/radiol.2017170025

Web of Science

PubMed

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)   Publisher：文光堂  

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)   Publisher：文光堂  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.25551

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PubMed

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/hep.29128

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Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)   Publisher：文光堂  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1097/RLI.0000000000000360

Web of Science

PubMed

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.25425

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PubMed

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00330-016-4423-2

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PubMed

Language：English   Publisher：(公社)日本医学放射線学会  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author,　Last author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.25182

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PubMed

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.2014-0149

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jhep.2015.08.031

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1159/000367736

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Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.24760

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.24666

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2463/mrms.2014-0150

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Language：English   Publisher：(公社)日本医学放射線学会  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.mri.2014.10.003

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.24505

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/cld.440

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1097/rct.0000000000000114

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Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：Japanese  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.24164

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PubMed

Language：Japanese  

Authorship：Lead author   Language：Japanese  

Language：Japanese  

Language：Japanese  

Authorship：Lead author   Language：Japanese  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.23930

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Authorship：Lead author   Language：Japanese  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1097/RCT.0b013e3182873799

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Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.mri.2012.08.004

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00330-012-2571-6

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author   Language：Japanese  

Language：English  

Authorship：Lead author   Language：Japanese  

Authorship：Lead author   Language：Japanese  

Authorship：Lead author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (commerce magazine)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00330-009-1467-6

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.21913

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Language：Japanese  

CiNii Books

Other Link： http://search.jamas.or.jp/link/ui/2009213196

Language：Japanese  

Total pages：544   Language：Japanese  

CiNii Books

ASIN

Language：Japanese  

Language：Japanese  

Language：English  

Language：English  

Total pages：562   Language：English  

Language：English   Book type：Scholarly book

Language：Japanese  

Total pages：冊   Language：Japanese  

CiNii Books

Language：Japanese   Book type：General book, introductory book for general audience

Language：Japanese   Book type：General book, introductory book for general audience

Total pages：414   Responsible for pages：107-114   Language：Japanese   Book type：General book, introductory book for general audience

Total pages：414   Responsible for pages：107-114   Language：Japanese   Book type：General book, introductory book for general audience

Total pages：216   Language：Japanese   Book type：General book, introductory book for general audience

Total pages：216   Language：Japanese   Book type：General book, introductory book for general audience

Event date： 2025.11 - 2025.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, Illinois   Country：United States  

Event date： 2025.11 - 2025.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, Illinois   Country：United States  

Event date： 2025.11

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：栃木（自治医科大学附属病院　放射線診断科カンファレンスルーム）   Country：Japan  

Event date： 2025.11

Language：Japanese   Presentation type：Other  

Venue：鹿児島（TKPガーデンシティ鹿児島中央３F「屋久島」）ハイブリッド開催   Country：Japan  

Event date： 2025.10

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Event date： 2025.10

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Venue：松本市（信州大学医学部附属病院　外来棟4階大会議室）   Country：Japan  

Event date： 2025.10

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Venue：名古屋（ホテルメルパルク名古屋　平安の間（２F））   Country：Japan  

Event date： 2025.10

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Venue：高知（高知パレスホテル２F「ミューズ」）   Country：Japan  

Event date： 2025.9

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：筑波（筑波大学健康医科学イノベーションセンター棟8階講堂+Zoom Webinar配信   Country：Japan  

Event date： 2025.9

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Venue：福岡（パピヨン24　2階　ガスホール）   Country：Japan  

Event date： 2025.8

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Venue：姫路（アクリエひめじ）   Country：Japan  

Event date： 2025.8

Language：Japanese   Presentation type：Other  

Venue：姫路（アクリエひめじ）   Country：Japan  

Event date： 2025.8

Language：Japanese   Presentation type：Oral presentation(general)  

Country：Japan  

Event date： 2025.8

Language：Japanese   Presentation type：Oral presentation(general)  

Country：Japan  

Event date： 2025.8

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2025.6

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Event date： 2025.5

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Event date： 2025.5

Language：English   Presentation type：Poster presentation  

Event date： 2025.5

Language：English   Presentation type：Oral presentation(invited, special)  

Event date： 2025.5

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2025.4

Language：Japanese   Presentation type：Poster presentation  

Event date： 2025.2

Language：English   Presentation type：Oral presentation(invited, special)  

Event date： 2025.1

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2024.12

Language：English   Presentation type：Oral presentation(general)  

Event date： 2024.11

Language：Japanese  

Event date： 2024.11

Language：Japanese  

Event date： 2024.11

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2024.10

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：English   Presentation type：Poster presentation  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：English   Presentation type：Poster presentation  

Language：English   Presentation type：Poster presentation  

Language：English   Presentation type：Poster presentation  

Language：English   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Poster presentation  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：English   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：English   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Language：English   Presentation type：Poster presentation  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：English   Presentation type：Symposium workshop panel(nominated)  

Event date： 2021.10

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.9

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Event date： 2021.9

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.7 - 2021.8

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.7

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.6

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.5

Language：English   Presentation type：Oral presentation(invited, special)  

Event date： 2021.5

Language：English   Presentation type：Oral presentation(general)  

Event date： 2021.4

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2021.4

Language：Japanese   Presentation type：Symposium workshop panel(nominated)  

Event date： 2021.4

Language：English   Presentation type：Symposium workshop panel(nominated)  

Event date： 2021.4

Language：English   Presentation type：Oral presentation(invited, special)  

Event date： 2021.3

Language：Japanese   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Web開催  

Event date： 2020.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Online  

Event date： 2020.11

Language：English   Presentation type：Poster presentation  

Venue：Online  

Event date： 2020.11

Language：English   Presentation type：Oral presentation(general)  

Venue：Online  

Language：English   Presentation type：Oral presentation(general)  

Venue：Online  

Language：English   Presentation type：Poster presentation  

Venue：Online  

Language：English   Presentation type：Oral presentation(general)  

Venue：Online  

Event date： 2020.9

Language：Japanese   Presentation type：Poster presentation  

Venue：Web開催  

Event date： 2020.8

Language：English   Presentation type：Oral presentation(general)  

Event date： 2020.8

Language：English   Presentation type：Oral presentation(general)  

Venue：Web  

Language：English   Presentation type：Oral presentation(general)  

Venue：Web  

Language：English   Presentation type：Oral presentation(general)  

Venue：Web  

Event date： 2020.6

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：Web 開催（Live配信）  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：Web 開催（Live配信）  

Event date： 2019.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2019.12

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Language：English   Presentation type：Oral presentation(general)  

Venue：Chicago, USA  

Event date： 2019.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：熊本  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：熊本  

Event date： 2019.9

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：熊本  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：熊本  

Event date： 2019.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：東京  

Event date： 2019.5

Language：English   Presentation type：Poster presentation  

Venue：Montreal, Canada  

Language：English   Presentation type：Poster presentation  

Venue：Montreal, Canada  

Event date： 2018.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2018.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

教育展示 Certificate of Merit award 受賞

Event date： 2018.11

Language：Japanese   Presentation type：Poster presentation  

Venue：沖縄  

Language：Japanese   Presentation type：Poster presentation  

Venue：沖縄  

Event date： 2018.11

Language：Japanese   Presentation type：Poster presentation  

Venue：神戸  

Event date： 2018.9

Language：English   Presentation type：Oral presentation(general)  

Venue：Kanazawa  

Event date： 2018.9

Language：English   Presentation type：Oral presentation(general)  

Venue：Kanazawa  

Language：English   Presentation type：Oral presentation(general)  

Venue：Kanazawa  

Event date： 2018.7

Language：Japanese   Presentation type：Oral presentation(general)  

Language：Japanese   Presentation type：Oral presentation(general)  

Event date： 2018.7

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Event date： 2018.6

Language：Japanese  

Venue：久留米  

Language：Japanese  

Venue：久留米  

Event date： 2018.6

Language：English   Presentation type：Poster presentation  

Venue：Paris, France  

Language：English   Presentation type：Poster presentation  

Venue：Paris, France  

Event date： 2018.5

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：鎌倉  

Event date： 2018.5

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：鎌倉  

Event date： 2018.5

Language：Japanese   Presentation type：Poster presentation  

Venue：鎌倉  

Language：Japanese   Presentation type：Poster presentation  

Venue：鎌倉  

Event date： 2018.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2018.4

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：横浜  

Event date： 2018.3

Language：English   Presentation type：Oral presentation(general)  

Venue：Vienna, Austria  

Language：English   Presentation type：Oral presentation(general)  

Venue：Vienna, Austria  

Event date： 2018.2

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：東京  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：東京  

Event date： 2018.2

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：福岡  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：福岡  

Event date： 2018.1

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：甲府  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：甲府  

Event date： 2017.12

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：甲府  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：甲府  

Event date： 2017.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2017.11

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Language：English   Presentation type：Poster presentation  

Venue：Chicago, USA  

Event date： 2017.10

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：山梨大学  

Language：Japanese   Presentation type：Oral presentation(invited, special)  

Venue：山梨大学  

Event date： 2017.10

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2017.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2017.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2017.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2017.9

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：宇都宮  

Event date： 2017.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：大阪  

Event date： 2017.7

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：新宿  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：新宿  

Event date： 2017.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：旭川  

Event date： 2017.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：旭川  

Event date： 2017.6

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：旭川  

Event date： 2017.6

Language：Japanese   Presentation type：Poster presentation  

Venue：旭川  

Language：Japanese   Presentation type：Poster presentation  

Venue：旭川  

Event date： 2017.6

Language：English   Presentation type：Oral presentation(general)  

Venue：Athens, Greece  

Language：English   Presentation type：Oral presentation(general)  

Venue：Athens, Greece  

Event date： 2017.4

Language：English   Presentation type：Poster presentation  

Venue：Hawaii, USA  

Event date： 2017.4

Language：English   Presentation type：Poster presentation  

Venue：Hawaii, USA  

Language：English   Presentation type：Poster presentation  

Venue：Hawaii, USA  

Event date： 2017.4

Language：English   Presentation type：Oral presentation(general)  

Venue：Hawaii, USA  

Event date： 2017.4

Language：English   Presentation type：Poster presentation  

Venue：Hawaii, USA  

Event date： 2017.4

Language：English   Presentation type：Poster presentation  

Venue：Hawaii, USA  

Event date： 2017.4

Language：English   Presentation type：Oral presentation(general)  

Venue：Hawaii, USA  

Event date： 2017.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2017.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2017.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2017.4

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Language：Japanese   Presentation type：Oral presentation(general)  

Venue：横浜  

Event date： 2017.3

Language：English   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Hawaii, USA  

Language：English   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Hawaii, USA  

Event date： 2017.3

Language：English   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Hawaii, USA  

Event date： 2017.3

Language：English   Presentation type：Public discourse, seminar, tutorial, course, lecture and others  

Venue：Hawaii, USA