Details of a Researcher - Jinzaki, Masahiro

Papers - Jinzaki, Masahiro

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New classification of renal angiomyolipoma

Jinzaki Masahiro

Japanese Journal of Clinical Radiology (Japanese Journal of Clinical Radiology) 60 ( 8 ) 991 - 999 2015

Research paper (scientific journal), Joint Work, ISSN 0009-9252

Angiomyolipoma (AML) is the most common benign solid renal neoplasm observed in clinical practice. Once thought to be a hamartoma, this neoplasm now considered among the family of PEComa. We recently provided a new radiological classification of AMLs that helps physicians understand the recent development and variety of its pathology, imaging features and its management. AMLs are divided into triphasic benign AML and epithelioid AML with malignant potential. Triphasic benign AMLs are consisted of classic AML which can be diagnosed by the detection of fat on imaging, and fat poor AML which can not. A hyperat-tenuating appearance on unenhanced CT and a T2-hypointense appearance at MRI both correspond to the smooth muscle component, are important diagnostic clues to the types of AMLs that contain few or no fat cells.

循環器・大動脈領域におけるAquilion ONE/ViSION Editionの有用性.

JINZAKI MASAHIRO

INNERVISION. 30 86 - 87 2015

Retroperitoneal low-flow vascular malformations

Akita Hirotaka, Yamada Yoshitake, Ito Yoshiaki, Mikami Shuji, Sugiura Hiroaki, Okuda Shigeo, Jinzaki Masahiro

Abdominal Imaging 40 ( 6 ) 1713 - 1720 2014.12

Research paper (scientific journal), Joint Work, ISSN 0942-8925

Purpose: To evaluate the MRI findings of retroperitoneal low-flow vascular malformations (RLVMs) correlated with histopathological findings. Methods: Two radiologists reviewed the MRI findings of 4 RLVMs (3 with capillary malformations and 1 with a venous malformation). First, they evaluated the visibility, signal intensities, and signal homogeneity of each lesion on non-fat-suppressed breath-hold T2-weighted single-shot fast spin-echo (non-FS SSFSE) images and fat-suppressed T2-weighted fast spin-echo (FS T2-weighted FSE) images. Second, the kinetic patterns and the internal enhancement patterns were analyzed for each lesion on multi-phasic contrast-enhanced (CE) images. After these image analyses, the MRI findings were correlated with the histopathological findings. Result: Histopathologically, the 4 RLVMs did not exhibit remarkable degeneration and were present in the retroperitoneal fat tissue without clear capsules. On the non-FS SSFSE images, 3 of the 4 RLVMs could not be discriminated from the surrounding retroperitoneal fat tissue (invisible), and the remaining lesion was barely visible with an indistinct margin. On the FS T2-weighted FSE images, however, all the RLVMs were clearly visualized as homogeneous high-signal intensities. On the multi-phasic CE images, all the capillary malformations exhibited fast enhancement, while a venous malformation showed slow enhancement. Furthermore, the RLVMs tended to exhibit a centripetal filling pattern. Conclusion: The RLVMs blended in with the surrounding retroperitoneal fat tissue on non-FS SSFSE images, like phantoms, whereas they were clearly visualized on FS T2-weighted FSE images. On multi-phasic CE images, the RLVMs tended to exhibit a centripetal filling pattern. These imaging features may be useful diagnostic clues for RLVMs.

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Pericardial endoscopy-guided left atrial appendage ligation

Kimura Takehiro, Takatsuki Seiji, Miyoshi Shunichiro, Katsumata Yoshinori, Nishiyama Takahiko, Nishiyama Nobuhiro, Tanimoto Yoko, Aizawa Yoshiyasu, Jinzaki Masahiro, Fukuda Keiichi

Circulation: Cardiovascular Interventions (Circulation: Cardiovascular Interventions) 7 ( 6 ) 844 - 850 2014.12

Research paper (scientific journal), Joint Work, ISSN 1941-7640

Background-Approaches for closing the left atrial appendage (LAA) have been developed for stroke prevention. However, the prevailing maneuvers require an open-chest surgery, intravascular access, or transseptal puncture. We evaluated the feasibility and safety of pericardial endoscopy-guided LAA ligation in a canine model. Methods and Results-We used a total of 8 canines and computed tomography was performed before the procedures. After a double percutaneous pericardiocentesis, a transurethral rigid endoscope was inserted into the pericardial space. The ENDOLOOP ligature was advanced to the ostium of the LAA by counter pulling the tip of the LAA with forceps. After confirming the positioning guided by transesophageal echocardiography, the ligature was securely tightened. Acute success was evaluated by transesophageal echocardiography and chronic success was evaluated by blood testing, computed tomography, and transesophageal echocardiography. The LAA ligation was safely achieved in all canines without major complications. One month after the ligation, the ligated LAA was replaced by fibrotic tissue, and both the transesophageal echocardiography and computed tomographic images revealed no residual shunt. There was only a localized adhesion of the pericardium, where the original LAA was located, without the need for antibiotic or steroid administration. The postprocedural internal surface of the ligated LAA was smooth by virtue of intimal growth. Blood tests showed a slight elevation of the inflammatory markers, but this normalized spontaneously. Conclusions-Pericardial endoscopy-guided LAA ligation could provide an alternative, minimally invasive, and feasible solution for LAA closure that does not require vascular access or a transseptal puncture.

Visualization of the right adrenal vein using CT during right inferior phrenic arteriography in hepatocellular carcinoma patients

Oguro Sota, Nakatsuka Seishi, Jinzaki Masahiro, Misu Manabu, Yashiro Hideki, Hashimoto Subaru, Kuribayashi Sachio

Japanese Journal of Radiology (Japanese Journal of Radiology) 32 ( 11 ) 630 - 636 2014.11

Research paper (scientific journal), Joint Work, ISSN 1867-1071

Objective: The objective of this retrospective study was to determine the frequency of right adrenal vein identification by computed tomography (CT) during right inferior phrenic arteriography (CTRIPA) and to describe the spectrum of anatomic variations of the right adrenal vein.Materials and methods: CTRIPA performed on 104 patients treated with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma in our hospital between August 2007 and July 2013 were reviewed. The right adrenal vein on CTRIPA images was evaluated for degree of visualization, anatomic variation, anatomic features, vessel direction, and length. CTRIPA images were compared with dynamic CT before TACE.Results: Partial or entire enhancement of the adrenal gland was obtained in 101 patients. The right adrenal vein was detected using CTRIPA in 97 % (98/101) of patients, which was significantly higher than detection using dynamic multidetector CT (MDCT) [77 % (78/101)]. Vessel length and diameter averaged 8.5 ± 3.8 and 1.6 ± 0.5 mm, respectively. CTRIPA also showed venous drainage into the right capsular renal vein in nine patients.Conclusion: Almost all right adrenal veins were visualized using CTRIPA; the detection rate was significantly higher on CTRIPA than on MDCT before TACE.

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Successful second attempt multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation for an octogenarian with hypertrophic obstructive cardiomyopathy

Maekawa Yuichiro, Jinzaki Masahiro, Anzai Atsushi, Tsuruta Hikaru, Matsumura Keisuke, Yamada Yoshitake, Tabei Ryota, Kawakami Takashi, Hayashida Kentaro, Yuasa Shinsuke, Murata Mitsushige, Suzuki Masahiro, Kuribayashi Sachio, Fukuda Keiichi

International Journal of Cardiology (International Journal of Cardiology) 176 ( 3 ) e131 - e132 2014.10

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

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A Multi-Institutional Validation of the Prognostic Value of the Neutrophil-to-Lymphocyte Ratio for Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy

Tanaka Nobuyuki, Kikuchi Eiji, Kanao Kent, Matsumoto Kazuhiro, Shirotake Suguru, Miyazaki Yasumasa, Kobayashi Hiroaki, Kaneko Gou, Hagiwara Masayuki, Ide Hiroki, Obata Jun, Hoshino Katsura, Hayakawa Nozomi, Kosaka Takeo, Hara Satoshi, Oyama Masafumi, Momma Tetsuo, Nakajima Yosuke, Jinzaki Masahiro, Oya Mototsugu

Annals of Surgical Oncology (Annals of Surgical Oncology) 21 ( 12 ) 4041 - 4048 2014.10

Research paper (scientific journal), Joint Work, ISSN 1068-9265

Background: To externally validate the prognostic impact of preoperative neutrophil–lymphocyte ratio (pre-NLR) in patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU).Methods: A total of 665 patients from 12 institutions were included. The median follow-up was 28 months. Associations between pre-NLR level and outcome were assessed using multivariate analysis. A pre-NLR level of >3.0 was defined as elevated.Results: Pre-NLR levels were elevated in 184 patients (27.7 %), and pre-NLR elevation was significantly associated with worse pathological features such as tumor grade 3, advanced pT stage, positive lymphovascular invasion (LVI), and lymph node involvement in RNU specimens. The 5-year recurrence-free and cancer-specific survival rates were 57.0 % (p < 0.001) and 60.2 % (p < 0.001), respectively, in patients with elevated pre-NLR, and 69.2 and 77.3 %, respectively, in their counterparts. Multivariate analysis showed that elevated pre-NLR was an independent risk factor for predicting subsequent disease recurrence (p = 0.037; hazard ratio (HR) 1.38) and cancer-specific mortality (p = 0.036;, HR 1.47), although the addition of pre-NLR slightly improved the accuracies of the base model for predicting both disease recurrence and cancer-specific mortality to 79.8 % (p = 0.041) and 83.0 % (p = 0.039), respectively (gain in predictive accuracy: 0.2 and 0.1 %, respectively).Conclusion: This multi-institutional study revealed that elevated pre-NLR was significantly associated with worse pathological features such as tumor grade 3, advanced pT stage, positive LVI, and lymph node involvement in RNU specimens, and elevated pre-NLR was an independent risk factor of disease recurrence and cancer-specific mortality in UTUC patients treated with RNU.

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Abdominal CT

Yamada Yoshitake, Jinzaki Masahiro, Hosokawa Takahiro, Tanami Yutaka, Abe Takayuki, Kuribayashi Sachio

European journal of radiology (European Journal of Radiology) 83 ( 10 ) 1715 - 1722 2014.10

Research paper (scientific journal), Joint Work, ISSN 0720048X

OBJECTIVES: To compare quantitative and subjective image quality between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp imaging performed during the same abdominal computed tomography (CT) examination.MATERIALS AND METHODS: Our institutional review board approved this prospective study; each participant provided written informed consent. 51 patients underwent sequential fast kVp-switching dual-energy (80/140 kVp, volume CT dose index: 12.7 mGy) and single-energy (120-kVp, 12.7 mGy) abdominal enhanced CT over an 8 cm scan length with a random acquisition order and a 4.3-s interval. VMS images with filtered back projection (VMS-FBP) and adaptive statistical iterative reconstruction (so-called hybrid IR) (VMS-ASIR) (at 70 keV), as well as 120-kVp images with FBP (120-kVp-FBP) and ASIR (120-kVp-ASIR), were generated from dual-energy and single-energy CT data, respectively. The objective image noises, signal-to-noise ratios and contrast-to-noise ratios of the liver, kidney, pancreas, spleen, portal vein and aorta, and the lesion-to-liver and lesion-to-kidney contrast-to-noise ratios were measured. Two radiologists independently and blindly assessed the subjective image quality. The results were analyzed using the paired t-test, Wilcoxon signed rank sum test and mixed-effects model with Bonferroni correction.RESULTS: VMS-ASIR images were superior to 120-kVp-FBP, 120-kVp-ASIR and VMS-FBP images for all the quantitative assessments and the subjective overall image quality (all P<0.001), while VMS-FBP images were superior to 120-kVp-FBP and 120-kVp-ASIR images (all P<0.004).CONCLUSIONS: VMS images at 70 keV have a higher image quality than 120-kVp images, regardless of the application of hybrid IR. Hybrid IR can further improve the image quality of VMS imaging.

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泌尿器疾患のガイドライン-診療の流れと画像検査の位置づけ- 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) 34 ( 12 ) 1285 - 1295 2014.09

ISSN 0285-0524

Feasibility of coronary artery calcium scoring on virtual unenhanced images derived from single-source fast kVp-switching dual-energy coronary CT angiography

Yamada Yoshitake, Jinzaki Masahiro, Okamura Teppei, Yamada Minoru, Tanami Yutaka, Abe Takayuki, Kuribayashi Sachio

Journal of Cardiovascular Computed Tomography (Journal of Cardiovascular Computed Tomography) 8 ( 5 ) 391 - 400 2014.09

Research paper (scientific journal), Joint Work, ISSN 1934-5925

Background: Dual-energy CT technology enables acquisition of virtual unenhanced (VUE) images from contrast-enhanced scans. Objective: To assess the feasibility of coronary artery calcium (CAC) scoring on VUE images derived from fast kVp-switching dual-energy coronary CT angiography. Methods: Twenty-seven patients underwent true noncontrast CAC-scoring CT followed by routine single-energy (120-kVp) and fast kVp-switching dual-energy coronary CT angiography, in a random acquisition order on the same day. We calculated the CAC scores on true noncontrast and VUE images. The image noises and the signal-to-noise and contrast-to-noise ratios of the aorta and coronary arteries were measured on both the single-energy coronary CT angiography images and dual-energy coronary CT angiography images (70 keV virtual monochromatic spectral images). The Pearson correlation coefficient test and paired t test were used for statistical analysis. Results: Excellent correlation was observed between the CAC scores on the true noncontrast and those on the VUE images (. r = 0.88; P <001). Compared with single-energy coronary CT angiography, dual-energy coronary CT angiography showed significantly reduced image noise and increased signal-to-noise and contrast-to-noise ratios in all regions (all P <001). The effective dose of dual-energy coronary CT angiography (4.3 ± 0.3 mSv) was significantly lower than that of true noncontrast CAC-scoring CT plus single-energy coronary CT angiography (5.4 ± 0.7 mSv; P <0001). Conclusions: Excellent correlation was observed between the CAC scores on the VUE images and true noncontrast images. Thus, fast kVp-switching dual-energy coronary CT angiography could allow prediction of the true CAC scores, potentially reducing the total radiation exposure and image acquisition time by obviating the need for true noncontrast CAC-scoring CT.

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Utility of the reverse wire technique in multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation

Maekawa Yuichiro, Jinzaki Masahiro, Anzai Atsushi, Matsumura Keisuke, Tsuruta Hikaru, Kawakami Takashi, Hayashida Kentaro, Yuasa Shinsuke, Murata Mitsushige, Suzuki Masahiro, Kuribayashi Sachio, Fukuda Keiichi

International Journal of Cardiology (International Journal of Cardiology) 173 ( 3 ) 2014.05

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

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放射線科医が診断すべき日常診療で迷う症例 (第11章)泌尿器　腎・上部尿路・膀胱・副腎で迷う症例の鑑別

陣崎雅弘, 秋田大宇, 谷本伸弘

画像診断 (学研メディカル秀潤社) 34 ( 4 ) s212 - s221 2014.03

ISSN 0285-0524

Multidetector computed tomography-guided percutaneous transluminal septal myocardial ablation in a Noonan syndrome patient with hypertrophic obstructive cardiomyopathy

Maekawa Yuichiro, Jinzaki Masahiro, Tsuruta Hikaru, Yamada Yoshitake, Kishino Yoshikazu, Kawakami Takashi, Hayashida Kentaro, Yuasa Shinsuke, Murata Mitsushige, Kawamura Akio, Sano Motoaki, Kuribayashi Sachio, Fukuda Keiichi

International Journal of Cardiology (International Journal of Cardiology) 172 ( 1 ) 2014.03

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

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Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy

Tanaka Nobuyuki, Kikuchi Eiji, Kanao Kent, Matsumoto Kazuhiro, Kobayashi Hiroaki, Ide Hiroki, Miyazaki Yasumasa, Obata Jun, Hoshino Katsura, Shirotake Suguru, Akita Hirotaka, Kosaka Takeo, Miyajima Akira, Momma Tetsuo, Nakagawa Ken, Hasegawa Shintaro, Nakajima Yosuke, Jinzaki Masahiro, Oya Mototsugu

Annals of Surgical Oncology (Annals of Surgical Oncology) 21 ( 3 ) 1038 - 1045 2014.03

Research paper (scientific journal), Joint Work, ISSN 1068-9265

Purpose: To investigate the site-specific pattern of disease recurrence and/or metastasis and the associated patient outcomes after radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods: A total of 733 patients with UTUC from a retrospective multi-institutional cohort were included, with a median follow-up of 34 months. Associated patient outcomes were analyzed by multivariate analysis. To evaluate the influence of primary tumor location, we divided it into four areas: renal pelvis, and upper, middle, and lower ureter. Results: A total of 218 patients experienced disease recurrence, with the majority of relapses occurring within the first 3 years. Cumulative incidence rates of first disease recurrence at 1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients, 38.5 % developed distant recurrence; 17.4 % experienced both local and distant recurrences; and 44.0 % developed isolated local recurrence. The predominant sites of distant metastasis were lung, liver, and bone. Multivariate analysis revealed that the prevalence of local recurrence and lung metastasis was significantly associated, with primary tumor location being independent of other clinicopathological variables. Lower/middle ureter tumors had a higher rate of local recurrence in the pelvic cavity, and renal pelvic tumors had a higher prevalence of distant relapse in the lungs. Similar results were obtained when rerunning the data set by excluding patients who received adjuvant chemotherapy (n = 131). Conclusions: This multi-institutional study provided a detailed picture of metastatic behavior after RNU, and primary tumor locations were associated with unique patterns of metastatic spread in UTUC patients. © 2013 Society of Surgical Oncology.

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The predictive value of positive urine cytology for outcomes following radical nephroureterectomy in patients with primary upper tract urothelial carcinoma

Tanaka Nobuyuki, Kikuchi Eiji, Kanao Kent, Matsumoto Kazuhiro, Shirotake Suguru, Kobayashi Hiroaki, Miyazaki Yasumasa, Ide Hiroki, Obata Jun, Hoshino Katsura, Hayakawa Nozomi, Kosaka Takeo, Oyama Masafumi, Miyajima Akira, Momma Tetsuo, Nakagawa Ken, Jinzaki Masahiro, Nakajima Yosuke, Oya Mototsugu

Urologic Oncology: Seminars and Original Investigations (Urologic Oncology: Seminars and Original Investigations) 32 ( 1 ) 48.e19 - 48.e26 2014.01

Research paper (scientific journal), Joint Work, ISSN 1078-1439

Background and objective: Few studies have addressed the predictive value of positive urine cytology for prognosis in patients with upper tract urothelial carcinoma (UTUC). We investigated whether the status of preoperative urine cytology could provide additional prognostic information following radical nephroureterectomy (RNU). Materials and methods: The study included 474 patients with primary nonmetastatic UTUC (pTa-4N0M0) from a retrospective multi-institutional cohort. The median follow-up period was 35 months. Associations between the status of urine cytologic evaluation and outcomes were analyzed using multivariate Cox regression models. Urine cytology was evaluated preoperatively using voided samples. Disease recurrence was defined as any relapse in nonbladder lesions and was coded separately from intravesical recurrence. Results: Positive urine cytology was detected in 184 patients (38.8%) preoperatively. Disease recurrence occurred in 127 patients, while intravesical recurrence occurred in 219 patients; 83 patients died of UTUC during follow-up. Kaplan-Meier analysis revealed that only the incidence of intravesical recurrence was significantly associated with the status of urine cytologic evaluation (P = 0.024); the intravesical recurrence-free survival rates at 1 and 3 years following RNU were 61.4% and 46.2% in patients with positive urine cytology and 71.1% and 51.6% in their counterparts, respectively. Multivariate analysis showed that gender (hazard ratio [HR] = 1.74, 95% confidence interval [CI]; 1.28-2.43), tumor multifocality in RNU specimens (HR = 1.64, 95% CI; 1.09-2.47), and positive urine cytology (HR = 1.41, 95% CI; 1.08-1.85) were independent risk factors for subsequent intravesical recurrence. Conclusions: The results showed the prognostic value of positive urine cytology in patients with primary UTUC, and preoperative positive urine cytology may be associated with a significant increase in the prevalence of intravesical recurrence following RNU. © 2014 Elsevier Inc.

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The time-adjusted gradual replacement injection method enables better visualization of the right heart

Nakahara Takehiro, Jinzaki Masahiro, Niwamae Nogiku, Saito Yuuichirou, Arai Masashi, Tsushima Yoshito, Kuribayashi Sachio, Kurabayashi Masahiko

Journal of Cardiovascular Computed Tomography (Journal of Cardiovascular Computed Tomography) 8 ( 2 ) 158 - 165 2014

Research paper (scientific journal), Joint Work, ISSN 1934-5925

Background: Despite the improvement of cardiac CT, right heart visualization remains challenging. Objective: We herein describe a new method, called the time-adjusted gradual replacement injection protocol. The aim of this study was to compare this protocol with the split-bolus injection protocol. Methods: Fifty-two patients who had undergone dual-source cardiac CT were retrospectively recruited. Twenty-six patients were injected by using the split-bolus injection protocol, and 26 patients were injected by using the time-adjusted gradual replacement injection protocol. For this method, we injected contrast medium for 10seconds at a flow rate of 0.07× body weight mL/s, then gradually replaced the contrast material with saline until 2 seconds before finishing the scans. The CT attenuation was measured in 4 chambers, the aorta, and the coronary arteries. The visualization of the anatomic structures and the occurrence and severity of streak artifacts were scored for the cardiac structures in the heart. For the analyses, either Welch t-test or Student t-test was performed. Results: In the right heart, the CT values and visualization scores were significantly higher in the time-adjusted replacement injection group than in the split-bolus injection group, whereas the artifact scores were comparable between the 2 groups. The CT values, visualization scores, and artifact scores of the left heart were not significantly different between the 2 groups. Conclusions: In this study, the time-adjusted gradual replacement injection protocol provided excellent attenuation for visualization of the right heart. This method may help toaccurately evaluate the right cardiac anatomy and thereby identify any potential diseases. © 2014 Society of Cardiovascular Computed Tomography.

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Surgical anatomy imaging associated with cervical cancer treatment

Nakamura Masaru, Fujii Takuma, Imanishi Nobuaki, Jinzaki Masahiro, Yamada Minoru, Kuribayashi Sachio, Aoki Daisuke

Clinical Anatomy (Clinical Anatomy) 27 ( 3 ) 503 - 510 2014

Research paper (scientific journal), Joint Work, ISSN 0897-3806

The objectives of this study were to visualize the surgical anatomical structures in the female pelvis by computed tomography and to investigate the components of the parametrium for anatomical education, radiological diagnosis, and surgical simulation. We surgically dissected fresh female cadavers maintained in precise surgical anatomic positions and examined the anatomical structures using experimental fine cell detector multislice computed tomography (FDCT) with a slice thickness of 0.3125 mm. In addition, we established a three-dimensional (3D) reconstruction model for precise observation of the surgical anatomy using Materialise's Interactive Medical Image Control System (Mimics). We evaluated two-dimensional (2D) images of the surgical anatomical structures in combination with the 3D reconstruction model. The 3D model was reconstructed from 430 serial axial pelvic CT images of a cadaver. The cardinal ligament, uterosacral ligament, paravesical space, and pararectal space were visualized on the CT images obtained from the surgically dissected part. The parametrium components were clearly distinguished on the surgically dissected side. Based on the information from the dissected side, these components on the undissected side could be distinguished as well. We recognized the parametrium components in the area extirpated during radical hysterectomy. The approach using cadavers, experimental FDCT, and 3D software provided excellent visualization of pelvic structures. High-quality images of surgical anatomical structures provide new insight regarding precise surgical anatomy in the female pelvis. The radiological information has practical usefulness for radiotherapeutic planning and surgical simulation. Copyright © 2013 Wiley Periodicals, Inc.

Renal angiomyolipoma

Jinzaki Masahiro, Silverman Stuart G., Akita Hirotaka, Nagashima Yoji, Mikami Shuji, Oya Mototsugu

Abdominal Imaging (Abdominal Imaging) 39 ( 3 ) 588 - 604 2014

Research paper (scientific journal), Joint Work, ISSN 0942-8925

Angiomyolipoma is the most common benign solid renal neoplasm observed in clinical practice. Once thought to be a hamartoma and almost always diagnosed by the imaged-based detection of fat, angiomyolipomas are now known to consist of a heterogeneous group of neoplasms. Although all are considered perivascular epithelioid cell tumors, many display different pathology, imaging features, and clinical behavior. The importance of understanding this group of neoplasms is emphasized by the fact that many types of angiomyolipoma contain little to no fat, and despite being benign, sometimes escape a pre-operative diagnosis. These types of angiomyolipomas can all be considered when encountering a renal mass that is both hyperattenuating relative to renal parenchyma on unenhanced CT and T2-hypointense, features that reflect their predominant smooth muscle component. We review recent developments and provide a radiological classification of angiomyolipomas that helps physicians understand the various types and learn how to both diagnose and manage them. © 2014 The Author(s).

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Three-dimensional image fusion of volume rendering SPECT/CT images for evaluation of pulmonary lobe function

Nakahara T., Koga S., Katagiri M., Ogata T., Iwabuchi Y., Matsuzaka Y., Murakami K., Jinzaki M.

Japanese Journal of Clinical Radiology (Japanese Journal of Clinical Radiology) 59 ( 13 ) 1821 - 1827 2014

Research paper (scientific journal), Joint Work, ISSN 0009-9252

Evaluating pulmonary regional function using pulmonary perfusion scintigraphy is so easy that it is used in daily clinical practice. However, this may not seem suitable for prediction of post-lobectomy lung function because it is difficult to divide lobar radioactive counts from pulmonary radioactivity on planar scintigraphic images. On the other hand, pulmonary perfusion SPECT with attenuation and scatter correction may help calculate lobar perfusion of the lung. We developed a new method for assessing pulmonary lobe function using three-dimensional (3D) image fusion of volume rendering SPECT/CT images. Our study showed that lobe-to-entire lung perfusion ratio with this 3D method (%lobe3D) was reproducible between 2 observers (rs = 0.97, ICC = 0.98). In addition, there was a high correlation between %lobe3D and lobe-to-entire lung perfusion ratio with 2D method (rs=0.98-0.99). In conclusion, our proposed method provides an accurate assessment for pulmonary lobar perfusion.

Prognostic value of preoperative multiparametric magnetic resonance imaging (MRI) for predicting biochemical recurrence after radical prostatectomy

Hattori Seiya, Kosaka Takeo, Mizuno Ryuichi, Kanao Kent, Miyajima Akira, Yasumizu Yota, Yazawa Satoshi, Nagata Hirohiko, Kikuchi Eiji, Mikami Shuji, Jinzaki Masahiro, Nakagawa Ken, Tanimoto Akihiro, Oya Mototsugu

BJU International (BJU International) 113 ( 5 ) 741 - 747 2014

Research paper (scientific journal), Joint Work, ISSN 1464-4096

Objective To evaluate the suitability of preoperative multiparametric magnetic resonance imaging (MRI) positivity as a predictor of biochemical recurrence after radical prostatectomy (RP). Patients and Methods We reviewed the clinical records of patients who underwent either standard RP or laparoscopic RP between January 2005 and December 2009 at our institution. Patients who received radiotherapy or androgen deprivation therapy before surgery were excluded. A total of 314 patients met the study inclusion criteria. Cox proportional hazard regression models were used for analyses. In accordance with the criteria in the established guidelines, a radiologist scored the probability of the presence of prostate cancer using a five-point scale of diagnostic confidence level. The highest confidence level of any pulse sequence was considered as the evaluation result. Results MRI positivity was significantly associated with a high clinical stage (cT ≥ 2; P = 0.039), a high positive biopsy core rate (≥0.2; P < 0.001), a high biopsy Gleason score ([GS] ≥8; P < 0.001) and a high pathological GS (≥8; P = 0.005). Univariate analysis and multivariate analysis showed that MRI positivity was a prognostic indicator in the analysis that included only preoperative variables and also in the analysis including preoperative and pathological variables. Conclusion Multiparametric MRI positivity can independently predict biochemical recurrence after RP. © 2013 The Authors. BJU International © 2013 BJU International.

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