Details of a Researcher - Jinzaki, Masahiro

Papers - Jinzaki, Masahiro

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Interventional therapeutic strategy for hemoptysis originating from infectious pulmonary artery pseudoaneurysms

Tsukada Jitsuro, Hasegawa Ichiro, Torikai Hideyuki, Sayama Koichi, Jinzaki Masahiro, Narimatsu Yoshiaki

Journal of Vascular and Interventional Radiology 26 ( 7 ) 1046 - 1051.e1 2015.07

Research paper (scientific journal), Joint Work, ISSN 1051-0443

This study reports 6 cases of hemoptysis originating from infectious pulmonary artery pseudoaneurysms (PAPs). Selective pulmonary angiography revealed PAPs in 5 cases, and segmental pulmonary artery embolization was performed using coils and gelatin sponge particles. Systemic arterial embolization also was performed in 5 cases because of inadequate initial control or for shunts from systemic to pulmonary arteries. At a median follow-up time of 9 months (range, 25 d to 25 mo), no recurrence occurred, although 2 patients died of respiratory failure. Segmental artery embolization combined with systemic artery embolization may be useful in patients with hemoptysis secondary to PAPs.

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Interventional therapeutic strategy for hemoptysis originating from infectious pulmonary artery pseudoaneurysms.

Tsukada J, Hasegawa I, Torikai H, Sayama K, Jinzaki M, Narimatsu Y.

Journal of Vascular and Interventional Radiology (Elsevier) 26 ( 7 ) 1046 - 1051 2015.07

Research paper (scientific journal), Joint Work

This study reports 6 cases of hemoptysis originating from infectious pulmonary artery pseudoaneurysms (PAPs). Selective pulmonary angiography revealed PAPs in 5 cases, and segmental pulmonary artery embolization was performed using coils and gelatin sponge particles. Systemic arterial embolization also was performed in 5 cases because of inadequate initial control or for shunts from systemic to pulmonary arteries. At a median follow-up time of 9 months (range, 25 d to 25 mo), no recurrence occurred, although 2 patients died of respiratory failure. Segmental artery embolization combined with systemic artery embolization may be useful in patients with hemoptysis secondary to PAPs.

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特集知っておきたい循環器疾患のCT・MRI(1)-心臓・頸部血管疾患Case Review- 心臓　FFR測定

山田祥岳, 陣崎雅弘, 山田稔

画像診断 (学研メディカル秀潤社) 35 ( 8 ) 980 - 981 2015.06

ISSN 0285-0524

Usefulness of 3D SPECT/CT fusion image in CTEPH

Kawakami Takashi, Kataoka Masaharu, Nakahara Tadaki, Yamada Yoshitake, Takei Makoto, Jinzaki Masahiro, Fukuda Keiichi

International Journal of Cardiology 194 39 - 40 2015.06

Research paper (scientific journal), Joint Work, ISSN 0167-5273

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Direct assessment of 3D foot bone kinematics using biplanar X-ray fluoroscopy and an automatic model registration method.

Ito K, Hosoda K, Shimizu M, Ikemoto S, Kume S, Nagura T, Imanishi N, Aiso S, Jinzaki M, Ogihara N.

Journal of Foot and Ankle Research (Biomed Central) 8 21 2015.06

Research paper (scientific journal), Joint Work

BACKGROUND:

Quantifying detailed 3-dimensional (3D) kinematics of the foot in contact with the ground during locomotion is crucial for understanding the biomechanical functions of the complex musculoskeletal structure of the foot. Biplanar X-ray fluoroscopic systems and model-based registration techniques have recently been employed to capture and visualise 3D foot bone movements in vivo, but such techniques have generally been performed manually. In the present study, we developed an automatic model-registration method with biplanar fluoroscopy for accurate measurement of 3D movements of the skeletal foot.

METHODS:

Three-dimensional surface models of foot bones were generated prior to motion measurement based on computed tomography. The bone models generated were then registered to biplanar fluoroscopic images in a frame-by-frame manner using an optimisation technique, to maximise similarity measures between occluding contours of the bone surface models with edge-enhanced fluoroscopic images, while avoiding mutual penetration of bones. A template-matching method was also introduced to estimate the amount of bone translation and rotation prior to automatic registration.

RESULTS:

We analysed 3D skeletal movements of a cadaver foot mobilized by a robotic gait simulator. The 3D kinematics of the calcaneus, talus, navicular and cuboid in the stance phase of the gait were successfully reconstructed and quantified using the proposed model-registration method. The accuracy of bone registration was evaluated as 0.27 ± 0.19 mm and 0.24 ± 0.19° (mean ± standard deviation) in translation and rotation, respectively, under static conditions, and 0.36 ± 0.19 mm and 0.42 ± 0.30° in translation and rotation, respectively, under dynamic conditions.

CONCLUSIONS:

The measurement was confirmed to be sufficiently accurate for actual analysis of foot kinematics. The proposed method may serve as an effective tool for understanding the biomechanical function of the human foot during locomotion.

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Direct assessment of 3D foot bone kinematics using biplanar X-ray fluoroscopy and an automatic model registration method

Ito Kohta, Hosoda Koh, Shimizu Masahiro, Ikemoto Shuhei, Kume Shinnosuke, Nagura Takeo, Imanishi Nobuaki, Aiso Sadakazu, Jinzaki Masahiro, Ogihara Naomichi

Journal of Foot and Ankle Research 8 ( 1 ) 2015.06

Research paper (scientific journal), Joint Work

Background: Quantifying detailed 3-dimensional (3D) kinematics of the foot in contact with the ground during locomotion is crucial for understanding the biomechanical functions of the complex musculoskeletal structure of the foot. Biplanar X-ray fluoroscopic systems and model-based registration techniques have recently been employed to capture and visualise 3D foot bone movements in vivo, but such techniques have generally been performed manually. In the present study, we developed an automatic model-registration method with biplanar fluoroscopy for accurate measurement of 3D movements of the skeletal foot. Methods: Three-dimensional surface models of foot bones were generated prior to motion measurement based on computed tomography. The bone models generated were then registered to biplanar fluoroscopic images in a frame-by-frame manner using an optimisation technique, to maximise similarity measures between occluding contours of the bone surface models with edge-enhanced fluoroscopic images, while avoiding mutual penetration of bones. A template-matching method was also introduced to estimate the amount of bone translation and rotation prior to automatic registration. Results: We analysed 3D skeletal movements of a cadaver foot mobilized by a robotic gait simulator. The 3D kinematics of the calcaneus, talus, navicular and cuboid in the stance phase of the gait were successfully reconstructed and quantified using the proposed model-registration method. The accuracy of bone registration was evaluated as 0.27 ± 0.19 mm and 0.24 ± 0.19° (mean ± standard deviation) in translation and rotation, respectively, under static conditions, and 0.36 ± 0.19 mm and 0.42 ± 0.30° in translation and rotation, respectively, under dynamic conditions. Conclusions: The measurement was confirmed to be sufficiently accurate for actual analysis of foot kinematics. The proposed method may serve as an effective tool for understanding the biomechanical function of the human foot during locomotion.

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CT dose reduction for visceral adipose tissue measurement

Yamada Yoshitake, Jinzaki Masahiro, Niijima Yuki, Hashimoto Masahiro, Yamada Minoru, Abe Takayuki, Kuribayashi Sachio

American Journal of Roentgenology 204 ( 6 ) W677 - W683 2015.06

Research paper (scientific journal), Joint Work, ISSN 0361-803X

OBJECTIVE. The objective of our study was to evaluate the effects of radiation dose reduction and the reconstruction algorithm used-filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), or model-based iterative reconstruction (MBIR)-on the measurement of abdominal visceral fat using CT. SUBJECTS AND METHODS. Standard-dose and low-dose abdominal CT examinations were performed simultaneously with automatic exposure control in 59 patients; the noise index for a 5-mm slice thickness was 12 for routine-dose CT and 24 for low-dose CT. The routine-dose CT images were reconstructed using FBP (reference standard), and the low-dose CT images were reconstructed using FBP, ASIR (so-called hybrid iterative reconstruction [IR]), and MBIR (so-called pure IR). In the 236 image series obtained, the visceral fat area was measured. Data were analyzed by the Pearson correlation coefficient test and a Bland-Altman difference analysis. RESULTS. The radiation dose of the low-dose abdominal CT examinations was 73.0% (mean) lower than that of routine-dose CT examinations. Excellent correlations were observed between the visceral fat areas measured on the routine-dose FBP images and those measured on the low-dose FBP, low-dose ASIR, and low-dose MBIR images (r = 0.998, 0.998, and 0.998, respectively; p < 0.001). A Bland-Altman difference analysis revealed excellent agreements, with mean biases of-0.47,-0.41, and 0.18 cm2 for the visceral fat area between the routine-dose FBP images and the low-dose FBP, low-dose ASIR, and low-dose MBIR images, respectively. CONCLUSION. A 73.0% reduction of the radiation dose would be possible in CT for the measurement of the abdominal visceral fat regardless of which reconstruction algorithm is used (i.e., FBP, hybrid IR, or pure IR).

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CT during arteriography to visualize the right adrenal vein for adrenal venous sampling

Oguro Sota, Nakatsuka Seishi, Yashiro Hideki, Hashimoto Subaru, Miyashita Kazutoshi, Kurihara Isao, Itoh Hiroshi, Jinzaki Masahiro

Journal of Vascular and Interventional Radiology 26 ( 6 ) 910 - 914 2015.06

Research paper (scientific journal), Joint Work, ISSN 1051-0443

The present report describes 6 cases of adrenal venous sampling (AVS) in patients who underwent computed tomography (CT) during arteriography because cannulation of right adrenal veins was otherwise difficult. CT was performed during arteriography to obtain information on the location and direction of the right adrenal vein. Two right adrenal veins were visualized in 1 case. The right central adrenal vein was not visualized in 1 case owing to an injury from a previous unsuccessful AVS procedure, but the right renal capsular vein was well visualized. CT during arteriography could contribute to a high AVS success rate.

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CT during Arteriography to Visualize the Right Adrenal Vein for Adrenal Venous Sampling.

Oguro S, Nakatsuka S, Yashiro H, Hashimoto S, Miyashita K, Kurihara I, Itoh H, Jinzaki M.

26 ( 6 ) 910 - 914 2015.06

Research paper (scientific journal), Joint Work

The present report describes 6 cases of adrenal venous sampling (AVS) in patients who underwent computed tomography (CT) during arteriography because cannulation of right adrenal veins was otherwise difficult. CT was performed during arteriography to obtain information on the location and direction of the right adrenal vein. Two right adrenal veins were visualized in 1 case. The right central adrenal vein was not visualized in 1 case owing to an injury from a previous unsuccessful AVS procedure, but the right renal capsular vein was well visualized. CT during arteriography could contribute to a high AVS success rate.

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特集腫瘍に対する分子標的療法の現状と画像評価序説

陣崎雅弘

画像診断 (学研メディカル秀潤社) 35 ( 7 ) 763 - 763 2015.05

ISSN 0285-0524

Renal cyst pseudoenhancement

Yamada Yoshitake, Yamada Minoru, Sugisawa Koichi, Akita Hirotaka, Shiomi Eisuke, Abe Takayuki, Okuda Shigeo, Jinzaki Masahiro

Medicine (United States) (Medicine (United States)) 94 ( 15 ) 2015.04

Research paper (scientific journal), Joint Work, ISSN 0025-7974

The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59-85 years; mean age, 73.2±5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0±14.7mm [range, 4-61mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0Hounsfield units [HU]; 95% confidence interval, 2.6-7.4/3.6-8.4HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8HU; 95% confidence interval, 9.8-14.5/10.4-15.1/9.4-14.2HU) (all P<.001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images.

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Evaluation of velopharyngeal closure by 4D imaging using 320-detector-row computed tomography

Sakamoto Yoshiaki, Soga Shigeyoshi, Jinzaki Masahiro, Yamada Yoshitake, Ogata Hisao, Kishi Kazuo

Journal of Plastic, Reconstructive and Aesthetic Surgery (Journal of Plastic, Reconstructive and Aesthetic Surgery) 68 ( 4 ) 479 - 484 2015.04

Research paper (scientific journal), Joint Work, ISSN 1748-6815

Objective Current imaging techniques for velopharyngeal closure (VPC) evaluation are two-dimensional, static, or distressing, thus necessitating multiple procedures to understand this three-dimensional and dynamic area. We validated the use of a novel four-dimensional (4D) computed tomography (CT) technique for the morphological and kinematic evaluation of VPC in cleft palate patients based on dynamic volume scanning with 320-detector-row CT. Methods Five patients aged 4-10 years (40% males) with persistent velopharyngeal insufficiency post palatoplasty underwent conventional tests (cephalometry and video-nasal endoscopy) and 4D-CT. For each patient, complete multiplanar reconstruction, 4D airway CT, and 4D-CT endoscopy data for all scanning phases were compared with cephalometric and video-nasal endoscopy data. The movements of the velum and posterior pharyngeal walls were graded by each modality. Results 4D airway CT revealed higher anatomical detail than cephalometry, additionally providing dynamic images. 4D-CT endoscopy and video-nasal endoscopy were in agreement for all patients regarding the patterns of VPC, with complete visualization of VPC in five versus one patient, respectively. 4D airway CT and cephalometry showed a discrepancy in one case, wherein grading by cephalometry was overestimated. 4D-CT was also useful in determining the width and length of a proposed pharyngeal flap. The examination time (mean ± standard deviation (SD), seconds), including patient preparation time, was 224 ± 73, 492 ± 145, and 718 ± 123 for cephalometric radiographs, CT, and video-nasal endoscopy, respectively. The mean estimated radiation dose during 4D-CT was 4.44 ± 1.64 mSv. Conclusions 4D-CT provides detailed morphological and kinematic analysis of VPC and may offer advantages over conventional procedures.

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How does visceral obesity affect surgical performance in laparoscopic radical nephrectomy?

Yuge Kazuyuki, Miyajima Akira, Jinzaki Masahiro, Kaneko Gou, Hagiwara Masayuki, Hasegawa Masanori, Takeda Toshikazu, Kikuchi Eiji, Nakagawa Ken, Oya Mototsugu

Japanese Journal of Clinical Oncology (Japanese Journal of Clinical Oncology) 45 ( 4 ) 373 - 377 2015.04

Research paper (scientific journal), Joint Work, ISSN 0368-2811

Objective: In a previous study, we described the relationship between operating time and obesity, particularly visceral obesity, in laparoscopic surgery. Operating time in laparoscopic surgery is affected by the experience and technique of the surgeon. Here, we investigated whether a difference in the surgeon's experience affects the operating time for laparoscopic radical nephrectomy in patients with visceral obesity. Methods: From January 2006 to February 2012, 167 laparoscopic radical nephrectomies were performed at our institution. Visceral fat areawas measured at the level of the umbilicus using computed tomography. A visceral fat area ≥ 100 cm2 was used as the definition of visceral obesity. All laparoscopic radical nephrectomies were performed by six surgeons. Two of the six surgeons perform 50 cases or more laparoscopic surgeries every year and they were defined as the expert group. We analyzed the relationships between clinical findings, methods, surgeon experience, body mass index or visceral fat area and operating time. Results: The expert and non-expert surgeons performed 77 and 90 laparoscopic radical nephrectomies, respectively, and the median operating timewas 167.0 ± 44.0 and 227.5 ± 60.6 min. Twenty-five patients underwent laparoendoscopic single-site nephrectomy by the expert surgeons. For all surgeons, visceral obesity was a significant factor for prolonged operating time. Multivariate analysis showed that visceral obesity and clinical T stage were independent risk factors for prolonged operating time for the non-expert surgeons [P = 0.004, hazard ratio (HR):5.15, P = 0.037, HR:10.41]. However, for the expert surgeons, clinical T stage was the only independent risk factor for prolonged operating time (P = 0.039, HR:4.33). Conclusion: Visceral obesity was a factor of prolonged operating time in laparoscopic radical nephrectomy. The non-expert surgeons were particularly affected by visceral obesity.

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Lack of Association between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population

Tanami Yutaka, Jinzaki Masahiro, Kishi Satoru, Matheson Matthew, Vavere Andrea L., Rochitte Carlos E., Dewey Marc, Chen Marcus Y., Clouse Melvin E., Cox Christopher, Kuribayashi Sachio, Lima Joao A C, Arbab-Zadeh Armin

Circulation: Cardiovascular Imaging (Circulation: Cardiovascular Imaging) 8 ( 3 ) 2015.03

Research paper (scientific journal), Joint Work, ISSN 1941-9651

Background-Epicardial fat may play a role in the pathogenesis of coronary artery disease (CAD). We explored the relationship of epicardial fat volume (EFV) with the presence and severity of CAD or myocardial perfusion abnormalities in a diverse, symptomatic patient population. Methods and Results-Patients (n=380) with known or suspected CAD who underwent 320-detector row computed tomographic angiography, nuclear stress perfusion imaging, and clinically driven invasive coronary angiography for the CORE320 international study were included. EFV was defined as adipose tissue within the pericardial borders as assessed by computed tomography using semiautomatic software. We used linear and logistic regression models to assess the relationship of EFV with coronary calcium score, stenosis severity by quantitative coronary angiography, and myocardial perfusion abnormalities by single photon emission computed tomography (SPECT). Median EFV among patients (median age, 62.6 years) was 102 cm3 (interquartile range: 53). A coronary calcium score of ≥1 was present in 83% of patients. Fifty-nine percent of patients had ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography, and 49% had abnormal myocardial perfusion results by SPECT. There were no significant associations between EFV and coronary artery calcium scanning, presence severity of ≥50% stenosis by quantitative coronary angiography, or abnormal myocardial perfusion by SPECT. Conclusions-In a diverse population of symptomatic patients referred for invasive coronary angiography, we did not find associations of EFV with the presence and severity of CAD or with myocardial perfusion abnormalities. The clinical significance of quantifying EFV remains uncertain but may relate to the pathophysiology of acute coronary events rather than the presence of atherosclerotic disease.

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Visceral obesity is associated with better recurrence-free survival after curative surgery for Japanese patients with localized clear cell renal cell carcinoma

Kaneko Gou, Miyajima Akira, Yuge Kazuyuki, Yazawa Satoshi, Mizuno Ryuichi, Kikuchi Eiji, Jinzaki Masahiro, Oya Mototsugu

Japanese Journal of Clinical Oncology (Japanese Journal of Clinical Oncology) 45 ( 2 ) 210 - 216 2015.02

Research paper (scientific journal), Joint Work, ISSN 0368-2811

Objective: To investigate the prognostic significance of visceral obesity to predict recurrence after curative surgery for Japanese patients with localized renal cell carcinoma. Methods: The data of 285 patients who underwent curative surgery for localized renal cell carcinoma were retrospectively reviewed. Median follow-up was 36.7 months. The association between visceral obesity and recurrence-free survival rate was evaluated using the Kaplan-Meier method and Cox regression models. Visceral fat area at the level of the umbilicus measured using pre-operative computed tomography was used as an index of visceral obesity. Results: Twenty-nine patients (10.2%) experienced recurrence. Five-year recurrence-free survival rates were 91.3% in high visceral fat area group (≥120 cm2) and 76.9% in low visceral fat area group (<120 cm²) (P = 0.037); however, visceral fat area was not an independent predictor of recurrence- free survival in multivariate analysis. In the patients with clear cell renal cell carcinoma, 28 patients (11.6%) experienced recurrence. Five-year recurrence-free survival rates were 88.7% in high visceral fat area group and 71.0% in low visceral fat area group (P = 0.043), and visceral fat area was an independent predictor of recurrence-free survival (hazard ratio: 1.974, P = 0.042) as well as C-reactive protein, Fuhrman nuclear grade, tumor size and microvascular invasion. In patients with organ confined clear cell renal cell carcinoma in particular, visceral fat area was also a useful and independent predictor of recurrence-free survival (hazard ratio: 2.807, P = 0.038). Body mass index was not useful in either cohort. Conclusions: High visceral fat area was a positive predictive biomarker for better recurrence-free survival after curative surgeries for localized clear cell renal cell carcinomas; however, body mass index was not a predictor.

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Thrombus in acute aortic dissection with atrial fibrillation

Shiraishi Yasuyuki, Kohno Takashi, Egashira Toru, Maekawa Yuichiro, Yamada Yoshitake, Yoshitake Akihiro, Shimizu Hideyuki, Sano Motoaki, Jinzaki Masahiro, Fukuda Keiichi

The American journal of emergency medicine (American Journal of Emergency Medicine) 33 ( 2 ) 308.e3 - 308.e4 2015.02

Research paper (scientific journal), Joint Work, ISSN 07356757

Type B acute aortic dissection (AAD) is often successfully managed with medical therapy, with a lower mortality rate, compared with type A AAD. Although the number of AAD patients complicated with atrial fibrillation (AF) has increased, reflecting an aging society, there have only been a few reports regarding the association of AAD and AF. Furthermore, there is no consensus on anticoagulation therapy in ADD patients complicated with AF, despite the importance of anticoagulation therapy in AF treatment. Here, we discuss a 79-year-old man with type B AAD and chronic AF complicated with the rapid left atrial appendage (LAA) thrombus formation after discontinuation of anticoagulation therapy. Emergent contrast-enhanced computed tomography revealed type B AAD with a partially thrombosed false lumen from the bifurcation of the aorta and the left subclavian artery to above the diaphragm. Ulcer-like projection was observed in the proximal thrombosed false lumen. Ten days after discontinuation of anticoagulation therapy, LAA thrombus was detected on contrast-enhanced computed tomography, which was not observed on admission. After anticoagulation therapy was resumed, the LAA thrombus disappeared,but the partially thrombosed false lumen was enlarged. The second discontinuation of anticoagulation therapy stabilized the dissected aorta and did not cause recurrence of LAA thrombus. In conclusion,clinicians need to balance the prevention of LAA thrombus formation with the complete thrombosis of a false lumen in patients with AAD and AF.

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Improved renal function in a patient with hypertrophic obstructive cardiomyopathy after multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation.

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

International Journal of Cardiology (International Journal of Cardiology) 15 ( 181 ) 349 - 350 2015.02

Research paper (scientific journal), Joint Work, ISSN 01675273

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Non-invasive computed fractional flow reserve from computed tomography (Ct) for diagnosing coronary artery disease; japanese results from nxt trial (analysis of coronary blood flow using ct angiography

Miyoshi Toru, Osawa Kazuhiro, Ito Hiroshi, Kanazawa Susumu, Kimura Takeshi, Shiomi Hiroki, Kuribayashi Sachio, Jinzaki Masahiro, Kawamura Akio, Bezerra Hiram, Bezerra Hiram, Nørgaard Bjarne L.

Circulation Journal (The Japanese Circulation Society) 79 ( 2 ) 406 - 412 2015.01

Research paper (scientific journal), Joint Work, ISSN 1346-9843

Background: Recently, a non-invasive method using computational fluid dynamics to calculate vessel-specific fractional flow reserve (FFRct) from routinely acquired coronary computed tomography angiography (CTA) was described. The Analysis of Coronary Blood Flow Using CT Angiography: Next Steps (NXT) trial, which was a prospective, multicenter trial including 254 patients with suspected coronary artery disease, noted high diagnostic performance of FFRct compared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRct vs. standard stenosis quantification on coronary CTA in the Japanese subset of the NXT trial.Conclusions: FFRct has high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial.Methods and Results: A total of 57 Japanese participants were included from Okayama University (n=36), Kyoto University (n=17), and Keio University (n=4) Hospitals. Per-patient diagnostic accuracy of FFRct (74%; 95% confidence interval [CI]: 60–85%) was higher than for coronary CTA (47%; 95% CI: 34–61%, P<0.001) arising from improved specificity (63% vs. 27%, P<0.001). FFRct correctly reclassified 53% of patients and 63% of vessels with coronary CTA false positives as true negatives. When patients with Agatston score >1,000 were excluded, per-pa-tient accuracy of FFRct was 83% with a high specificity of 76%, similar to the overall NXT trial findings.

CT Dose Reduction for Visceral Adipose Tissue Measurement: Effects of Model-Based and Adaptive Statistical Iterative Reconstructions and Filtered Back Projection.

Yamada Y, Jinzaki M, Niijima Y, Hashimoto M, Yamada M, Abe T, Kuribayashi S.

American Journal of Roentgenology (American Roentgen Ray Society) 204 ( 6 ) W677 - W683 2015.01

Research paper (scientific journal), Joint Work

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Evidenced-based clinical practice guideline for upper tract urothelial carcinoma (summary--Japanese Urological Association, 2014 edition).

Oya M, Kikuchi E; Committee for Establishment of Clinical Practice Guideline for Management of Upper Tract Urothelial Carcinoma; Japanese Urological Association.

International Journal of Urology 22 ( 1 ) 3 - 13 2015.01

Research paper (scientific journal), Joint Work

Upper tract urothelial carcinoma is more rare than bladder cancer, although they are both categorized as urothelial carcinoma. Because of the low incidence, little clinical evidence is available regarding the treatment of the former. However, recently such evidence has slowly begun to accumulate. The guideline presented herein was compiled for the purpose of ensuring proper diagnosis and treatment by physicians involved in the treatment of upper tract urothelial carcinoma. We carefully selected 16 clinical questions essential for daily clinical practice and grouped them into four major categories: epidemiology, diagnosis, surgery and systemic chemotherapy/other matters. Related literature was searched using PubMed and Japan Medical Abstracts Society databases for articles published between 1987 and 2013. If the judgment was made on the basis of insufficient or inadequate evidence, the grade of recommendation was determined on the basis of committee discussions and resultant consensus statements. Here, we present a short English version of the original guideline, and overview its key clinical issues.

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