Details of a Researcher - Jinzaki, Masahiro

Papers - Jinzaki, Masahiro

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特集 AI と心臓病診療日常診療への可能性を探る診る1 AI 総論

橋本正弘, 陣崎雅弘

Heart View (メジカルビュー社) 25 ( 11 ) 1016 - 1019 2021.11

ISSN 1342-6591

Portal Vein Damage after DEB-TACE and Lipiodol-TACE: Based on Evaluation by Computed Tomography during Arterial Portography

Tamura Masashi, Nakatsuka Seishi, Torikai Hideyuki, Misu Manabu, Tsukada Jitsuro, Tamura Kentaro, Ito Nobutake, Inoue Masanori, Yashiro Hideki, Jinzaki Masahiro

Interventional Radiology (Japanese Society of Interventional Radiology) 6 ( 3 ) 93 - 101 2021.11

Purpose: To reveal the effect of drug-eluting beads transarterial chemoembolization and Lipiodol transarterial chemoembolization on portal perfusion, and to identify factors predisposing portal vein damage after transarterial chemoembolization, based on evaluation by computed tomography during arterial portography.Material and Methods: This retrospective cohort analysis included 49 patients with hepatocellular carcinoma who underwent transarterial chemoembolization and preprocedural/follow-up computed tomography during arterial portography between October 2013 and April 2015. The preprocedural and follow-up computed tomography during arterial portography were compared to identify the following new changes suggestive of portal vein damage in the follow-up computed tomography during arterial portography: small perfusion defects, large perfusion defects, and narrowing/disappearance or portal vein obstruction. The frequency of portal vein damage after drug-eluting beads transarterial chemoembolization and Lipiodol transarterial chemoembolization was calculated, and relationships between portal vein damage and clinical variables were analyzed. Finally, a multivariate logistic regression analysis with adjustments for potentially confounding factors was performed to identify factors predisposing portal vein damage.Results: The analysis included 24 patients who underwent drug-eluting beads transarterial chemoembolization and 25 who underwent Lipiodol transarterial chemoembolization. Emergence of small perfusion defects and narrowing/disappearance or obstruction of portal vein were observed at a significantly higher frequency following drug-eluting beads transarterial chemoembolization than following Lipiodol transarterial chemoembolization (70.8% [17/24] vs. 20% [5/25]; p < 0.001; 41.7% [10/24] vs. 12% [3/25]; p = 0.019). Drug-eluting beads transarterial chemoembolization and selectivity of transarterial chemoembolization (selective [<subsegmental], segmental or lobar) were significantly associated with portal vein damage (p < 0.001 and p = 0.016, respectively). However, multivariate logistic regression analysis identified drug-eluting beads transarterial chemoembolization as a significant independent predictor of portal vein damage (odds ratio: 34.95; 95% confidence interval: 1.137-1073.99; p = 0.042).Conclusions: Portal vein damage occurred at a significantly higher frequency following drug-eluting beads transarterial chemoembolization than following Lipiodol transarterial chemoembolization, and drug-eluting beads transarterial chemoembolization was an independent predictor of portal vein damage after transarterial chemoembolization.

Prognostic value of noninvasive combined anatomic/functional assessment by cardiac CT in patients with suspected coronary artery disease — Comparison with invasive coronary angiography and nuclear myocardial perfusion imaging for the five-year-follow up of the CORE320 multicenter study: Combined CTA/CTP for Long-Term Patient Outcome

Dewey M., Rochitte C.E., Ostovaneh M.R., Chen M.Y., George R.T., Niinuma H., Kitagawa K., Laham R., Kofoed K., Nomura C., Sakuma H., Yoshioka K., Mehra V.C., Jinzaki M., Kuribayashi S., Laule M., Paul N., Scholte A.J., Cerci R., Hoe J., Tan S.Y., Rybicki F.J., Matheson M.B., Vavere A.L., Arai A.E., Miller J.M., Cox C., Brinker J., Clouse M.E., Di Carli M., Lima J.A.C., Arbab-Zadeh A.

Journal of Cardiovascular Computed Tomography (Journal of Cardiovascular Computed Tomography) 15 ( 6 ) 485 - 491 2021.11

ISSN 19345925

Background: Few data exist on long-term outcome in patients undergoing combined coronary CT angiography (CTA) and myocardial CT perfusion imaging (CTP) as well as invasive coronary angiography (ICA) and single photon emission tomography (SPECT). Methods: At 16 centers, 381 patients were followed for major adverse cardiac events (MACE) for the CORE320 study. All patients underwent coronary CTA, CTP, and SPECT before ICA within 60 days. Prognostic performance according binary results (normal/abnormal) was assessed by 5-year major cardiovascular events (MACE) free survival and area under the receiver-operating-characteristic curve (AUC). Results: Follow up beyond 2-years was available in 323 patients. MACE-free survival rate was greater among patients with normal combined CTA-CTP findings compared to ICA-SPECT: 85 vs. 80% (95% confidence interval [CI] for difference 0.1, 11.3) though event-free survival time was similar (4.54 vs. 4.37 years, 95% CI for difference: -0.03, 0.36). Abnormal results by combined CTA-CTP was associated with 3.83 years event-free survival vs. 3.66 years after abnormal combined ICA-SPECT (95% CI for difference: -0.05, 0.39). Predicting MACE by AUC also was similar: 65 vs. 65 (difference 0.1; 95% CI -4.6, 4.9). When MACE was restricted to cardiovascular death, myocardial infarction, or stroke, AUC for CTA-CTP was 71 vs. 60 by ICA-SPECT (difference 11.2; 95% CI -1.0, 19.7). Conclusions: Combined CTA-CTP evaluation yields at least equal 5-year prognostic information as combined ICA-SPECT assessment in patients presenting with suspected coronary artery disease. Noninvasive cardiac CT assessment may eliminate the need for diagnostic cardiac catheterization in many patients. Clinical trial registration: NCT00934037.

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Anatomic and diagnostic considerations of facial mobility for understanding the effectiveness of facial massage: A pilot study

Okuda I., Yamada M., Yamada Y., Yokoyama Y., Kampan N., Akita K., Jinzaki M.

Skin Research and Technology (Skin Research and Technology) 27 ( 6 ) 1057 - 1063 2021.11

ISSN 0909752X

Background: The effectiveness of facial massage is often explained by the resulting increases in the blood and lymphatic flow. However, it is difficult to explain the lifting effect on the cheeks. The aim of this study was to analyze facial mobility to further current understanding of the effectiveness of facial massage. Materials and Methods: Two kinds of analytical methods were designed using a cadaveric head as well as advanced computed tomography (CT). The cadaveric face was divided into three sections, and three different colors of ink were injected into each section. It was kept in a supine position for 24 hours, and the ink distribution was observed. Upright and supine CT examinations were performed on six healthy adult volunteers. The images of both were superimposed by a three-dimensional image analysis system, and changes in facial contours were analyzed. Results: The three colors of ink spread craniocaudally and were distributed differently from the gravitational vector. When both CT images were superimposed, two distinct lines were formed, which represented overlapping of the facial contours due to the two different CT images. These lines were found to correspond to the border of each color of the ink. Conclusion: Focusing on the mobility of the face, the soft tissue of the face had vertical mobility, and it was speculated that this mobility is involved in the effectiveness of facial massage. Our results could provide useful information for cosmetic treatment and contribute to the collection of scientific knowledge for anti-aging medicine.

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Difference in the airway luminal area between the standing and supine positions using upright and conventional computed tomography

Matsumoto S., Yamada Y., Yamada M., Chubachi S., Yokoyama Y., Matsuoka S., Tanabe A., Niijima Y., Murata M., Fukunaga K., Jinzaki M.

Clinical Anatomy (Clinical Anatomy) 34 ( 8 ) 1150 - 1156 2021.11

ISSN 08973806

No clinical studies to date have compared the airway luminal area between supine and standing positions. Our aim was therefore to compare the airway luminal area between these two positions on computed tomography (CT) and to determine its correlation with forced expiratory volume in 1 s (FEV1). Thirty-two asymptomatic volunteers underwent both conventional (supine position) and upright (standing position) CT during deep inspiration breath-holding. Pulmonary function tests were conducted on the same day. We measured the airway luminal area on CT in each position. Paired t-tests and Pearson's correlation coefficients were used for statistical analysis. The average luminal areas of the trachea, right and left main bronchi, and average third-generation airway were greater in the standing than the supine position by 3.4%, 6.1%, 5.5%, and 5.2%, respectively. The correlation coefficients between airway luminal areas and FEV1 tended to be higher in the standing than the supine position; this correlation was highest for the average third-generation airway (r = 0.70, P < 0.0001). The airway luminal areas of the trachea, bilateral main bronchi, and average third-generation airway were greater in the standing than the supine position. The average third-generation airway area in the standing position had the highest correlation with FEV1.

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特別寄稿日本初の放射線科医藤浪剛一と草創期の放射線医学

陣崎雅弘, 茂松直之

画像診断 (学研メディカル秀潤社) 41 ( 13 ) 1429 - 1433 2021.10

ISSN 0285-0524

Diagnostic value of texture analysis of apparent diffusion coefficient maps for differentiating fat-poor angiomyolipoma from non-clear-cell renal cell carcinoma

Arita Y., Yoshida S., Kwee T.C., Akita H., Okuda S., Iwaita Y., Mukai K., Matsumoto S., Ueda R., Ishii R., Mizuno R., Fujii Y., Oya M., Jinzaki M.

European Journal of Radiology (European Journal of Radiology) 143 2021.10

ISSN 0720048X

Purpose: To investigate the feasibility of texture analysis of apparent diffusion coefficient (ADC) maps for differentiating fat-poor angiomyolipomas (fpAMLs) from non-clear-cell renal cell carcinomas (non-ccRCCs). Methods: In this bi-institutional study, we included two consecutive cohorts from different institutions with pathologically confirmed solid renal masses: 67 patients (fpAML = 46; non-ccRCC = 21) for model development and 39 (fpAML = 24; non-ccRCC = 15) for validation. Patients underwent preoperative magnetic resonance imaging (MRI), including diffusion-weighted imaging. We extracted 45 texture features using a software with volumes of interest on ADC maps. Receiver operating characteristic curve analysis was performed to compare the diagnostic performance between the random forest (RF) model (derived from extracted texture features) and conventional subjective evaluation using computed tomography and MRI by radiologists. Results: RF analysis revealed that grey-level zone length matrix long-zone high grey-level emphasis was the dominant texture feature for diagnosing fpAML. The area under the curve (AUC) of the RF model to distinguish fpAMLs from non-ccRCCs was not significantly different between the validation and development cohorts (p = .19). In the validation cohort, the AUC of the RF model was similar to that of board-certified radiologists (p = .46) and significantly higher than that of radiology residents (p = .03). Conclusions: Texture analysis of ADC maps demonstrated similar diagnostic performance to that of board-certified radiologists for discriminating between fpAMLs and non-ccRCCs. Diagnostic performances in the development and validation cohorts were comparable despite using data from different imaging device manufacturers and institutions.

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深層学習を用いた超音波画像における腎嚢胞の計測補助機能の開発

金内友里恵, 橋本正弘, 東田直樹, Haque Hasnine, 陣崎雅弘, 榊原康文

日本医用画像工学会大会予稿集 ((一社)日本医用画像工学会) 40回 304 - 308 2021.10

超音波検査において,臓器や腫瘍の計測のために2点1組の計測マーカーが付与される.計測マーカーに基づいて対象所見の位置やサイズが計測される.本研究は腹部超音波検査における計測マーカーの付与をサポートすることを目的として,深層学習を用いた超音波画像における計測補助機能の開発を行なった.対象は,超音波検査の中でも計測頻度の高い腎嚢胞とした.慶應義塾大学病院で2019年1月から2020年5月に撮影された腹部超音波画像170,538枚のうち,腎嚢胞が計測されている2,664枚を使用して,画像を入力すると計測マーカーの位置を表すdistance mapを予測するようにモデルを訓練した.モデルはUNet++を用いた.出力されたdistance mapから決定した計測マーカーの位置について,座標誤差を用いて予測精度を評価したところ,平均8.13mm,中央値4.63mmという結果になった.(著者抄録)

Transformerベースのモデルを用いた肺領域における所見文からの疾患名抽出

岡崎真治, 林雄一郎, 小田昌宏, 橋本正弘, 陣崎雅弘, 明石敏昭, 青木茂樹, 森健策

日本医用画像工学会大会予稿集 ((一社)日本医用画像工学会) 40回 199 - 202 2021.10

本稿では,TransformerベースのBERTモデルを用いた肺領域における所見文の疾患分類を行う方法を提案する.これは疾患名が付与された画像データセット構築の初期検討である.画像処理において,一般的には機械学習モデルの性能向上のため多くの学習データが必要である.しかし,医用画像のアノテーションには膨大な手間がかかる問題がある.そこで,放射線科医がCT画像の診断結果から作成し,患者の状態を詳細に記載している所見文を利用する.本研究では疾患名が付与された画像データセット構築の初期検討として,TransformerベースのモデルでFine-tuningを行い,肺領域において4クラス分類を行った.肺領域における400例の疾患分類実験によりMacro-F1で79.4%となった.(著者抄録)

The efficacy of transarterial embolization for postpartum hemorrhage complicated with disseminated intravascular coagulation: A single‐center experience

Ochiai D., Nakatsuka S., Abe Y., Ikenoue S., Kasuga Y., Inoue M., Jinzaki M., Tanaka M.

Journal of Clinical Medicine (Journal of Clinical Medicine) 10 ( 18 ) 2021.09

Indications for the use of transarterial embolization (TAE) for postpartum hemorrhage (PPH) have been established. However, the efficacy of TAE for PPH complicated by disseminated intravascular coagulation (DIC) remains controversial. In this study, we investigated the efficacy of TAE for PPH complicated by DIC. A database review was conducted to identify patients who were treated with TAE for PPH at our hospital. TAE was performed in 41 patients during the study period. Effective hemostasis was achieved in all cases, but additional procedures, such as reembolization or hysterectomy, were required in five patients (12.2%). The typical causes of PPH included uterine atony (18 cases), placenta previa (15 cases), amniotic fluid embolism (DIC‐type) (11 cases), and placenta accreta spectrum (10 cases). The mean blood loss was 3836 mL. The mean obstetrical DIC and the International Society on Thrombosis and Hemostasis DIC scores were 7.9 and 2.6, respectively. The efficacy of hemostasis was comparable between patients with and without DIC. However, the complete success rate of TAE was lower in patients with DIC as the condition worsened than that in non‐DIC patients. Overall, TAE is effective as a minimally invasive treatment for PPH complicated by DIC.

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特集 CT 再入門- 新技術で何がわかる?- 3. 面検出器CTの活用　2 頭部全体の血流評価

長谷学, 堤啓, 藤原広和, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 938 - 939 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 序説

陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 919 - 919 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 6. 立位CTの活用　3 骨盤臓器脱

横山陽一, 山田祥岳, 山田稔, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 1010 - 1011 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 6. 立位CTの活用　2 鼠径ヘルニア

山田祥岳, 山田稔, 横山陽一, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 1008 - 1009 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 6. 立位CTの活用　1 脊椎すべり症

山田祥岳, 山田稔, 横山陽一, 名倉武雄, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 1006 - 1007 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 5. Dual energy CTの活用　5 肺塞栓症

田村全, 山田祥岳, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 984 - 985 2021.07

ISSN 0285-0524

特集 CT 再入門- 新技術で何がわかる?- 3. 面検出器CTの活用　9 関節動態

山田稔, 山田祥岳, 横山陽一, 石井和典, 名倉武雄, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 9 ) 952 - 953 2021.07

ISSN 0285-0524

Evaluation of Dynamic Carpal Arch Stability following Carpal Tunnel Release Using Four-Dimensional Computed Tomography

Kimura H., Sato K., Matsumura N., Suzuki T., Iwamoto T., Ohori K., Yamada Y., Matsumoto M., Nakamura M., Jinzaki M., Nagura T.

Journal of Hand and Microsurgery (Journal of Hand and Microsurgery) 13 ( 3 ) 138 - 142 2021.07

ISSN 09743227

Introduction This study aimed to assess the carpal arch dynamics during active finger and wrist motion following carpal tunnel release using four-dimensional computed tomography (4D-CT). Materials and Methods Four patients who diagnosed with bilateral carpal tunnel syndrome and underwent unilateral carpal tunnel release were prospectively included. 4D-CT of the bilateral wrists during active finger and wrist motion was performed for 10 seconds at five frames per second. The distances between the tip of tuberosity of the scaphoid and the volar ridge of the pisiform (S-P distance) and volar ridge of trapezium and the tip of hook of hamate (T-H distance) were measured at each position and the values of S-P and T-H distances were compared between the postoperative and contralateral wrists. Results During finger motion, the S-P and T-H distances were not different at any position between the postoperative side and contralateral side. Conversely, S-P and T-H distances gradually increased in the postoperative wrists. The differences between the sides of S-P distance were significant, with >0 degrees of wrist extension, and differences of T-H distance were significant with >15 degrees of wrist extension. Conclusion This study demonstrated the carpal arch dynamics using 4D-CT and revealed that the carpal arch was widened with the wrist in extension after carpal tunnel release. This study suggests that the transverse carpal ligament plays an important role in maintaining carpal arch stability.

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Picked-up Knowledge from Foreign Journals 画像をリファレンスとした,循環器臨床診断における機械学習

中原健裕, 奥田茂男, 陣崎雅弘

画像診断 (学研メディカル秀潤社) 41 ( 8 ) 880 - 882 2021.06

ISSN 0285-0524

Statin therapy for patients with aortic stenosis who underwent transcatheter aortic valve implantation: A report from a Japanese multicentre registry

Yashima F., Hara M., Inohara T., Jinzaki M., Shimizu H., Fukuda K., Tanaka M., Yamamoto M., Watanabe Y., Naganuma T., Shirai S., Yamawaki M., Tada N., Yamanaka F., Mizutani K., Ueno H., Tabata M., Takagi K., Hayashida K.

BMJ Open (BMJ Open) 11 ( 6 ) 2021.06

Objective Data on statin for patients with aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI) are limited. The present study aimed to evaluate the impact of statin on midterm mortality of TAVI patients. Design Observational study. Setting This study included patients with AS from a Japanese multicentre registry who underwent TAVI. Participants The overall cohort included 2588 patients (84.4±5.2 years); majority were women (69.3%). The Society of Thoracic Surgeons risk score was 6.55% (IQR 4.55%-9.50%), the Euro II score was 3.74% (IQR 2.34%-6.02%) and the Clinical Frailty Scale score was 3.9±1.2. Interventions We classified patients based on statin at admission and identified 936 matched pairs after propensity score matching. Primary and secondary outcome measures The outcomes were all-cause and cardiovascular mortality. Results The median follow-up was 660 days. Statin at admission was associated with a significant reduction in all-cause mortality (adjusted HR (aHR) 0.76, 95% CI 0.58 to 0.99, p=0.04) and cardiovascular mortality (aHR 0.64, 95% CI 0.42 to 0.97, p=0.04). In the octogenarians, statin was associated with significantly lower all-cause mortality (aHR 0.87, 95% CI 0.75 to 0.99, p=0.04); however, the impact in the nonagenarians appeared to be lower (aHR 0.84, 95% CI 0.62 to 1.13, p=0.25). Comparing four groups according to previous coronary artery disease (CAD) and statin, there was a significant difference in all-cause mortality, and patients who did not receive statin despite previous CAD showed the worst prognosis (aHR 1.33, 95% CI 1.12 to 1.57 (patients who received statin without previous CAD as a reference), p<0.01). Conclusions Statin for TAVI patients will be beneficial even in octogenarians, but the benefits may disappear in nonagenarians. In addition, statin will be essential for TAVI patients with CAD. Further research is warranted to confirm and generalise our findings since this study has the inherent limitations of an observational study and included only Japanese patients.

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