研究者詳細 - 陣崎　雅弘

論文 - 陣崎　雅弘

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特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 骨軟部　脂肪性腫瘍

松本俊亮, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 9 ） 914 - 915 2016年07月

ISSN 0285-0524

特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 血管　限局性大動脈解離

塚田実郎, 中塚誠之, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 9 ） 926 - 927 2016年07月

ISSN 0285-0524

特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 肝胆膵脾　脾腫瘤

松本俊亮, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 9 ） 886 - 887 2016年07月

ISSN 0285-0524

特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 泌尿器　嚢胞性小腎腫瘍

秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 9 ） 890 - 891 2016年07月

ISSN 0285-0524

特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 泌尿器　副腎腺腫

小黒草太, 陣崎雅弘, 宮下和季, 栗原勲

画像診断（学研メディカル秀潤社） 36 （ 9 ） 888 - 889 2016年07月

ISSN 0285-0524

特集画像でみかける偶発的所見のマネジメント　−あなたならどう書く?− 泌尿器　充実性小腎腫瘍

秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 9 ） 892 - 893 2016年07月

ISSN 0285-0524

特集胸部画像診断-症状や身体所見からのアプローチ呼吸器症状からみた胸部画像診断呼吸困難慢性血栓塞栓性肺高血圧症,肺水腫,急性呼吸窮迫症候群

杉浦弘明, 陣崎雅弘

medicina （株式会社医学書院） 53 （ 8 ） 1192 - 1194 2016年07月

ISSN 0025-7699

Comparison of the diagnostic accuracy of FBP, ASiR, and MBIR reconstruction during CT angiography in the evaluation of a vessel phantom with calcified stenosis in a distal superficial femoral artery in a cadaver extremity

Tsukada J., Yamada M., Yamada Y., Yamazaki S., Imanishi N., Tamura K., Hashimoto M., Nakatsuka S., Jinzaki M.

Medicine (United States) （Medicine (United States)） 95 （ 27 ） e4127 2016年07月

研究論文（学術雑誌）, 共著, ISSN 00257974

Purpose: To investigate whether adaptive statistical iterative reconstruction (ASiR) or model-based iterative reconstruction (MBIR) improves the diagnostic performance of computed tomography angiography (CTA) for small-vessel calcified lesions relative to filtered back projection (FBP) using cadaver extremities and a calcified stenosis phantom. Methods: A cadaver was used in accordance with our institutional regulations, and a calcified stenosis phantom simulating 4 grades of stenosis was prepared. The phantom was inserted within the distal superficial femoral artery of the cadaver leg. Ten CT images per reconstruction type and stenosis grade were acquired using a 64-slice multidetector-row CTA. As an objective measurement, the first and second derivatives of the CT value function profiles were calculated. As a subjective measurement, 2 blinded reviewers measured the stenosis ratio using a quantitative scale. The Wilcoxon rank-sum test was used to evaluate the data. Results: Objective measurements of both 25% and 50% stenosis differed significantly (P < 0.01) between MBIR (25/50%: 25.80/50.30 ± 3.88/3.86%) and FBP (25/50%: 35.60/83.80 ± 3.44/26.10%), whereas significant differences were not observed between ASiR and FBP. Reviewer 2's subjective measurements of 25% stenosis differed significantly (P < 0.01) between MBIR (35.13 ± 3.25%) and ASiR (40.89 ± 3.14%), and the measurements of 50% stenosis differed significantly (P < 0.01) between MBIR (reviewers 1/2, 62.36/54.78 ± 2.78/4.96%) and FBP (reviewers 1/2, 62.36/74.84 ± 2.78/18.10%). Significant differences in the subjective measurements were not observed between ASiR and FBP. Conclusion: MBIR improves the diagnostic performance of CTA for small-vessel calcified lesions relative to FBP.

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Optimal HMPAO α value for Lassen’s correction algorithm obscured by statistical noise

Kameyama M., Murakami K., Jinzaki M.

Annals of Nuclear Medicine （Annals of Nuclear Medicine） 30 （ 6 ） 445 - 449 2016年07月

研究論文（学術雑誌）, 共著, ISSN 09147187

Objective: [99mTc] d,l-hexamethyl-propyeneamine oxime (99mTc-HMPAO), a brain perfusion tracer, suffers significant underestimation of regional cerebral blood flow (rCBF). Lassen et al. developed their linearization algorithm to correct the influence of back-diffusion of the tracer, and proposed their parameter α as 1.5. Based on mathematical modeling and literature review, recently, a new α value of 0.5 has been proposed for Lassen’s correction algorithm for 99mTc-HMPAO, although correction using the old α value of 1.5 was confirmed to be sufficient. Inugami et al. reported that linearization correction gives a stable correlation coefficient over a wide range of α. Our hypotheses are that statistical noise is the source of the stable correlation coefficient presented by them and that the robustness of the correlation coefficient is the reason why many studies confirmed the value of α as 1.5. Methods: Statistical noise was added in silico to the count, whose relationship with flow was α = 0.5. Then, the count was corrected by Lassen’s linearization algorithm with a variety of α. Results: This study confirmed the hypothesis that smaller α values (strong correction) increase the noise at high flow values, leading to nominal increases in correlation coefficient as α decreases. Conclusion: Despite this, adoption of the new, smaller α value of 0.5 would be more useful clinically in regaining the contrast between low-flow and high-flow areas of the brain.

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今月の主題新しい小腸・大腸画像診断─現状と将来展望主題 PET/CT

村上康二, 岩渕雄, 中原理紀, 緒方雄史, 片桐真理, 松坂陽至, 伊藤一成, 陣崎雅弘

胃と腸（株式会社医学書院） 51 （ 7 ） 909 - 916 2016年06月

ISSN 0536-2180

特集膠原病と類縁疾患の肺病変急性・亜急性経過の間質性肺炎

杉浦弘明, 陣崎雅弘

画像診断（学研メディカル秀潤社） 36 （ 8 ） 743 - 753 2016年06月

ISSN 0285-0524

CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

Matsumoto S., Yamada Y., Hashimoto M., Okamura T., Yamada M., Yashima F., Hayashida K., Fukuda K., Jinzaki M.

European Radiology （European Radiology） 27 （ 5 ） 1963 - 1970 2016年04月

研究論文（学術雑誌）, 共著, ISSN 09387994

Objectives: To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD). Methods: Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time × weight [kg] × 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard. Results: The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV). Conclusions: CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD. Key Points: • TAVI-planning CT using variable helical pitch (VHP) scanning is useful. • The average volume of contrast material was 38.7 ± 8.5 mL. • The average attenuations of all the arteries were >400 HU. • This CT had a high sensitivity and NPV for excluding obstructive CAD.

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Radiation-dose-lowering effects of landiolol hydrochloride in coronary angiography using computed tomography (DELIGHT): A prospective multicenter study

Kido T., Mochizuki T., Hirano M., Yamada Y., Tanaka R., Kanzaki S., Higashi M., Jinzaki M., Yoshioka K., Kuribayashi S.

Circulation Journal （Circulation Journal） 80 （ 5 ） 1225 - 1231 2016年04月

研究論文（学術雑誌）, 共著, ISSN 13469843

Background: Controlling and decreasing the heart rate (HR) of patients during coronary computed tomography angiography (CCTA) is necessary to reduce radiation exposure and improve image quality. This prospective multicenter study aimed to investigate whether HR control with landiolol hydrochloride is useful for reducing radiation exposure during CCTA. Methods and Results: We investigated 219 patients with suspected ischemic heart disease whose pretest HRs were 50–80 beats/min. We measured the HR before and after administration of landiolol hydrochloride and compared the estimated exposure inferred from the HR before administration of landiolol hydrochloride with the actual dose. After administration of landiolol hydrochloride, the mean HR (59.9 ± 6.4 beats/min) at the time of CCTA was significantly lower than before administration (69.3 ± 7.3 beats/min; P<0.001); 80% of the patients had controlled HRs at ≤65 beats/min. HR and blood pressure of all the patients recovered after the scan. The mean radiation dose in all patients was approximately 50% derived from the inferred dose before use of landiolol hydrochloride (4.5 ± 3.2 vs. 9.0 ± 3.7 mSv; P<0.001). There were no adverse events during this study. Conclusions: The use of landiolol hydrochloride during CCTA was safe and resulted in approximately 50% decrease in radiation exposure dose, suggesting the clinical usefulness of this drug.

特集大腸癌肝転移-最新の治療ストラテジー総論大腸癌肝転移の画像診断

上野彰久, 陣崎雅弘

臨床外科（株式会社医学書院） 71 （ 4 ） 393 - 403 2016年04月

ISSN 0386-9857

Role of computed tomography urography in the clinical evaluation of upper tract urothelial carcinoma

Jinzaki M., Kikuchi E., Akita H., Sugiura H., Shinmoto H., Oya M.

International Journal of Urology （International Journal of Urology） 23 （ 4 ） 284 - 298 2016年04月

研究論文（学術雑誌）, 共著, ISSN 09198172

Intravenous urography has been widely used for the evaluation of upper tract urothelial carcinoma. However, computed tomography urography presently has a higher diagnostic accuracy for upper tract urothelial carcinoma (94.2-99.6%) than intravenous urography (80.8-84.9%), and has replaced intravenous urography as the first-line imaging test for investigating patients with a high risk of upper tract urothelial carcinoma. Although the detection rate for bladder tumors using standard computed tomography urography is not yet high enough to replace cystoscopy, the addition of a 60- to 80-s delayed scan after the administration of contrast material for the whole pelvis improves the detection rate. A drawback to computed tomography urography is the higher radiation dose of 15-35 mSv, compared with a mean effective dose of 5-10 mSv for intravenous urography. Among several approaches to reducing the radiation dose, the use of an iterative reconstruction algorithm is most likely to become an effective solution because of its simplicity. One advantage of computed tomography urography over intravenous urography is its ability to reliably differentiate between upper tract urothelial carcinoma and calculi or blood clots. Computed tomography urography also shows characteristic findings of other benign conditions. These findings, in combination with negative cytology, are very important diagnostic clues for avoiding an unnecessary nephroureterectomy. For the clinical staging, a recent study has reported the high diagnostic accuracy of computed tomography urography with respect to ≥pT3 tumors. The present review shows the current status of computed tomography urography for the evaluation of upper tract urothelial carcinoma.

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Application of q-space diffusion MRI for the visualization of white matter

Fujiyoshi K., Hikishima K., Nakahara J., Tsuji O., Hata J., Konomi T., Nagai T., Shibata S., Kaneko S., Iwanami A., Momoshima S., Takahashi S., Jinzaki M., Suzuki N., Toyama Y., Nakamura M., Okano H.

Journal of Neuroscience （Journal of Neuroscience） 36 （ 9 ） 2796 - 2808 2016年03月

研究論文（学術雑誌）, 共著, ISSN 02706474

White matter abnormalities in the CNS have been reported recently in various neurological and psychiatric disorders. Quantitation of non-Gaussianity for water diffusion by q-space diffusional MRI (QSI) renders biological diffusion barriers such as myelin sheaths; however, the time-consuming nature of this method hinders its clinical application. In the current study, we aimed to refine QSI protocols to enable their clinical application and to visualize myelin signals in a clinical setting. For this purpose, animal studies were first performed to optimize the acquisition protocol of a non-Gaussian QSI metric. The heat map of standardized kurtosis values derived from optimal QSI (myelin map) was then created. Histological validation of the myelin map was performed in myelin-deficient mice and in a nonhuman primate by monitoring its variation during demyelination and remyelination after chemical spinal cord injury. The results demonstrated that it was sensitive enough to depict dysmyelination, demyelination, and remyelination in animal models. Finally, its utility in clinical practice was assessed by a pilot clinical study in a selected group of patients with multiple sclerosis (MS). The human myelin map could be obtained within 10 min with a 3 T MR scanner. Use of the myelin map was practical for visualizing white matter and it sensitively detected reappearance of myelin signals after demyelination, possibly reflecting remyelination inMSpatients. Our results together suggest that the myelin map, a kurtosis-related heat map obtainable with time-saving QSI, may be a novel and clinically useful means of visualizing myelin in the human CNS.

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Transhepatic Arterial Approach for Successful Embolization of Hepatic Hilar Pseudoaneurysm Fed by Tortuous Collateral Vessels.

Tamura M, Nakatsuka S, Shimizu Y, Oguro S, Inoue M, Jinzaki M.

Journal of Vascular and Interventional Radiology 27 （ 5 ） 768 - 770 2016年03月

研究論文（学術雑誌）, 共著

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Significant reduction of left atrial volume concomitant with clinical improvement after percutaneous transluminal septal myocardial ablation for drug-refractory hypertrophic obstructive cardiomyopathy, and its precise detection with multidetector CT

Maekawa Y., Akita K., Tsuruta H., Yamada Y., Hayashida K., Yuasa S., Murata M., Jinzaki M., Fukuda K.

Open Heart （Open Heart） 3 （ 1 ） e000359 2016年01月

研究論文（学術雑誌）, 共著

Objective: In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. Methods: We studied a consecutive cohort of 20 patients with drug-refractory symptomatic HOCM after PTSMA. We evaluated LA volume analyses with cardiac MDCT on patients who underwent PTSMA as compared to echocardiography. Results: Before PTSMA, 75% of all patients had heart failure-associated symptoms in the New York Heart Association functional class III/IV. All patients experienced relief from heart failure-associated symptoms after PTSMA. Cardiac MDCT showed significant reduction in the index of maximum LA volume during follow-up compared to before PTSMA in the same way as in echocardiography (93.634.1 mL/m2 vs 82.635.3 mL/m2, p=0.035). A Bland-Altman plot showed small mean differences and limits of agreement in the measurements of the index of maximum LA volume before and after PTSMA between echocardiography and MDCT. Conclusions: The follow-up cardiac MDCT was a useful tool to evaluate the effectiveness of PTSMA on reduction of LA volume. Cardiac MDCT might provide comparable measurements of the LA volume in patients with drug-refractory symptomatic HOCM before and after PTSMA compared to echocardiography.

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Comparison of [(15)O] H2O Positron Emission Tomography and Functional Magnetic Resonance Imaging in Activation Studies.

Kameyama M, Murakami K, Jinzaki M

World journal of nuclear medicine 15 （ 1 ） 3 - 6 2016年01月

研究論文（学術雑誌）, 共著

[(15)O] H2O positron emission tomography (PET) has long been out of use in activation studies on the brain. Indeed, it is true that blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) has better spatial resolution and temporal resolution than PET, as well as no radiation exposure. However, PET and fMRI differ in their scope. Compared to fMRI, [(15)O] H2O PET offers advantages such as being quantifiable, less deteriorated by movement, and allowing for longitudinal studies. This article aimed to reassess the merits of PET in this context.

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"Moving left ventricular obstruction" due to stress cardiomyopathy in a patient with hypertrophic obstructive cardiomyopathy treated with percutaneous transluminal septal myocardial ablation

Akita K., Maekawa Y., Tsuruta H., Okuda S., Yanagisawa R., Kageyama T., Kawakami T., Kanazawa H., Hayashida K., Yuasa S., Murata M., Jinzaki M., Fukuda K.

International Journal of Cardiology （International Journal of Cardiology） 1 （ 202 ） 194 - 195 2016年01月

研究論文（学術雑誌）, 共著, ISSN 01675273

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陣崎　雅弘

論文 - 陣崎　雅弘