Papers - Yamada, Yoshitake

Size of the Tonsil on Ultrasound in Children Without Tonsil-Associated Symptoms.

Hosokawa T, Yamada Y, Takahashi H, Tanami Y, Sato Y, Hosokawa M, Oguma E

Ultrasound quarterly  2019.05

ISSN  0894-8771

• Access to Document (DOI)

Comparison of diagnostic accuracy for fistulae at ultrasound and voiding cystourethrogram in neonates with anorectal malformation.

Hosokawa T, Yamada Y, Tanami Y, Sato Y, Ishimaru T, Tanaka Y, Kawashima H, Oguma E

Pediatric radiology (Pediatric Radiology)  49 ( 5 ) 609 - 616 2019.05

ISSN  0301-0449

　View Summary

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Background: Recently, it has been reported that anorectal malformation with rectourethral fistula in male neonates can be managed by primary neonatal reconstruction without colostomy. To prevent urethral injury during anorectoplasty, the fistula’s location is important. To date, the use of voiding cystourethrograms to determine the presence and location of fistulas in neonates with anorectal malformations has not been studied. Objective: To compare the accuracy of ultrasound (US) and voiding cystourethrogram for determining the presence and location of fistulas in neonates with anorectal malformation. Materials and methods: We included 21 male neonates with anorectal malformation with rectourethral fistula (n=16), rectovesical fistula (n=1) or no fistula (n=4) who underwent US and voiding cystourethrogram preoperatively on the day of surgery. Fistula imaging was classified into three grades (0–2), and grades 1–2 were considered fistula positive. We compared the imaging-based location of the fistula with surgical findings. Results: US performed significantly better than voiding cystourethrogram for determining the presence of fistulas (area under the receiver operating characteristic curve, 0.90 vs. 0.71, respectively; P=0.044) (diagnostic accuracy 85.7%, 95% confidence interval [95% CI] 63.7–97.0% and 52.4%, 95% CI 29.8–74.3%, respectively). In cases with fistulas detected by either modality, the accuracy of locating the fistula by US was 50.0% (95% CI 24.7–75.3%) and by voiding cystourethrogram was 100% (95% CI: 59.0–100%). Conclusion: US accurately detected, but did not accurately locate, fistulas in neonates with anorectal malformation. When planning primary neonatal reconstruction of anorectal malformation without colostomy, voiding cystourethrogram could provide additional information about fistula location.

• Access to Document (DOI)

【治療関連肺障害の画像診断】免疫チェックポイント阻害剤による肺障害の画像診断

杉浦 弘明, 南 康大, 山田 祥岳, 陣崎 雅弘

臨床放射線 (金原出版(株))  64 ( 6 ) 777 - 786 2019.05

ISSN  0009-9252

Associations Between Sonographic Findings and Operative Time of Transumbilical Laparoscopic-Assisted Appendectomy for Acute Appendicitis in Children.

Hosokawa T, Yamada Y, Tanami Y, Sato Y, Ishimaru T, Kawashima H, Oguma E

AJR. American journal of roentgenology (American Journal of Roentgenology)  213 ( 1 ) 1 - 9 2019.04

ISSN  0361-803X

　View Summary

© American Roentgen Ray Society OBJECTIVE. The purpose of this study is to evaluate the association between sonographic findings and the operative time of transumbilical laparoscopic-assisted appendectomy (TULAA) for appendicitis in children. MATERIALS AND METHODS. We included 131 children who underwent ultrasound within 24 hours before TULAA. We evaluated the associations between operative time and patients’ demographics, as well as the following sonographic findings: maximum outer wall diameter of the appendix, appendicolith, ascites (not echogenic), echogenic ascites, abscess formation, increased intraabdominal fat echo in the right lower quadrant (RLQ; 3-point scale), and the location of the appendix (three locations). The results were analyzed using simple linear regression or the t test and a multiple liner regression model. RESULTS. The mean (± SD) patient age was 9.50 ± 2.92 years (range, 3–15 years), and the mean operative time was 73.04 ± 36.56 minutes (range, 25–210 minutes). Univariate analysis showed that higher body mass index, greater maximum outer wall diameter of the appendix, higher grade of intraabdominal fat echo in the RLQ, presence of appendicolith, presence of echogenic ascites, abscess formation, and location of the appendix in the pelvis were associated with increased operative time. Multivariate analysis found that abscess formation and higher grade of increased intraabdominal fat echo in the RLQ were independently associated with operative time (both p < 0.05). CONCLUSION. Preoperative sonographic findings of abscess formation and increased intraabdominal fat echo in the RLQ were factors independently associated with prolonged operative time for TULAA. On the basis of these sonographic findings, surgeons may predict additional surgical procedures, including abscess aspiration or adhesiolysis, and operative time before beginning the operation.

• Access to Document (DOI)

Time-resolved quantitative evaluation of diaphragmatic motion during forced breathing in a health screening cohort in a standing position: Dynamic chest phrenicography.

Hida T, Yamada Y, Ueyama M, Araki T, Nishino M, Kurosaki A, Jinzaki M, Honda H, Hatabu H, Kudoh S

European journal of radiology (European Journal of Radiology)  113   59 - 65 2019.04

ISSN  0720-048X

　View Summary

© 2019 The Authors Objective: To assess diaphragmatic motion during forced breathing in a health screening center cohort by time-resolved quantitative analysis using dynamic chest radiography and demonstrate the characteristics and associations with demographics and pulmonary function of participants. Materials and methods: This prospective study includes 174 volunteers (99 males; median 57, range 36–93 years old) that underwent dynamic chest radiography with a flat panel detector system during forced breathing in a standing position. We automatically tracked and recorded the positions of the top of the diaphragms and the excursions on images of each participant and calculated peak motion speeds based on the data. We investigated the associations with demographics and pulmonary function statistically. Results: The average excursions of the diaphragms during forced breathing were 49.1 ± 17.0 mm (right; mean ± standard deviation) and 52.1 ± 15.9 mm (left). The peak motion speeds were 26.7 ± 10.0 mm/s (right) and 32.2 ± 12.4 mm/s (left) in the inspiratory phase and 22.1 ± 12.7 mm/s (right) and 24.3 ± 10.3 mm/s (left) in the expiratory phase. Excursions and peak motion speeds of the left diaphragm were significantly greater than the right. Higher body mass index (BMI) and vital capacity (VC) were associated with greater excursions and faster peak motion speeds of the diaphragms. Conclusions: Time-resolved quantitative analysis of the diaphragms with dynamic chest radiography demonstrated the characteristics of diaphragmatic motion during forced breathing in a health screening cohort. Higher BMI and VC were associated with excursions and peak motion speeds of the diaphragms.

• Access to Document (DOI)

The relationship between the morphological axis and the kinematic axis of the proximal radius.

Oki S, Inaba N, Matsumura N, Iwamoto T, Yamada Y, Jinzaki M, Nagura T

Surgical and radiologic anatomy : SRA (Surgical and Radiologic Anatomy)  41 ( 4 ) 423 - 429 2019.04

ISSN  0930-1038

　View Summary

© 2018, Springer-Verlag France SAS, part of Springer Nature. Purpose: Surgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT). Methods: Ten healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated. Results: The rotation axis of the forearm was positioned on the radial head 0.0 mm radial and 0.4 mm posterior to the center of the radial head proximally and 2.0 mm radial and 1.2 mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%). Conclusion: Forearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause “rattling motion” of the radial head after reduction procedures.

• Access to Document (DOI)

【マルチモダリティによるCardiac Imaging 2019[臨床編]個別化循環器診療のフロンティア:進化し続ける心臓画像診断】CTのベネフィット&ポテンシャル　TAVI術前CT

山田 祥岳, 山田 稔, 松本 俊亮, 中原 健裕, 鈴木 達也, 橋本 正弘, 林田 健太郎, 陣崎 雅弘

INNERVISION ((株)インナービジョン)  34 ( 5 ) 21 - 25 2019.04

ISSN  0913-8919

A rare case of unroofed coronary sinus with a secundum atrial septal defect incidentally detected by computed tomography.

Shoji S, Kanazawa H, Yamada Y, Jinzaki M, Fukuda K

Journal of cardiovascular computed tomography (Journal of Cardiovascular Computed Tomography)   2019.03

ISSN  1934-5925

• Access to Document (DOI)

Decreased and slower diaphragmatic motion during forced breathing in severe COPD patients: Time-resolved quantitative analysis using dynamic chest radiography with a flat panel detector system.

Hida T, Yamada Y, Ueyama M, Araki T, Nishino M, Kurosaki A, Jinzaki M, Honda H, Hatabu H, Kudoh S

European journal of radiology (European Journal of Radiology)  112   28 - 36 2019.03

ISSN  0720-048X

　View Summary

© 2019 Elsevier B.V. Objective: To assess the diaphragmatic motion in chronic obstructive pulmonary disease (COPD) patients during forced breathing by time-resolved quantitative analysis using dynamic chest radiography and to demonstrate the characteristics and the difference from that in normal subjects. Materials and methods: Thirty-one COPD patients and a matched control of 31 normal subjects on age, sex, height, and weight, who underwent chest radiographs during forced breathing using dynamic chest radiography, were included in this study. COPD patients were classified based on the criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (GOLD 1, n = 3; GOLD 2, n = 12; GOLD 3, n = 13; GOLD 4, n = 3). We measured excursions and peak motion speeds of the diaphragms for each participant. We compared the results among GOLD 1/2, GOLD 3/4 groups and normal subjects and investigated associations between the data, and participants’ demographics, or pulmonary function. Results: The excursions of bilateral diaphragms were significantly decreased in the GOLD 3/4 group relative to normal subjects (right, 39.8 ± 15.3 mm vs. 52.7 ± 15.1 mm, P = 0.030; left, 43.7 ± 14.0 mm vs. 56.9 ± 15.5 mm, P = 0.017; mean ± standard deviation) and the GOLD 1/2 group (right, 39.8 ± 15.3 mm vs. 54.4 ± 16.7 mm, P = 0.036; left, 43.7 ± 14.0 mm vs. 60.5 ± 13.9 mm, P = 0.008). The peak motion speeds of the left diaphragm in the inspiratory phase were slower in the GOLD 1/2 group than in normal subjects (24.5 ± 8.0 mm/s vs. 33.6 ± 14.0 mm/s, P = 0.038), and in the GOLD 3/4 group than in normal subjects (25.6 ± 6.8 mm/s vs. 33.6 ± 14.0 mm/s, P = 0.067). The excursions of the diaphragms showed correlation with VC, %VC, and FEV 1 , while the peak motion speeds showed no significant correlation with pulmonary function tests. Conclusions: Time-resolved quantitative analysis of diaphragms with dynamic chest radiography indicated differences in diaphragmatic motion between COPD groups and normal subjects during forced breathing. The excursions of the diaphragms during forced breathing were significantly lower in the GOLD 3/4 group than those in the GOLD 1/2 group and normal subjects.

• Access to Document (DOI)

Predictors of prognosis in children with portal venous gas detected by ultrasound.

Hosokawa T, Yamada Y, Tanami Y, Sato Y, Hosokawa M, Oguma E

Medical ultrasonography (Medical Ultrasonography)  21 ( 1 ) 30 - 36 2019.02

ISSN  1844-4172

　View Summary

© 2019 Societatea Romana de Ultrasonografie in Medicina si Biologie. All Rights Reserved. Aims: To evaluate ultrasound findings in order to determine potential predictors of prognosis in pediatric patients with portal venous gas (PVG) detected by ultrasound. Materials and methods: Thirty-nine children were included and divided into two groups: benign PVG (n=24) and life-threatening PVG (n=15; 6 surgical interventions and 9 deaths). Possible predictors, i.e., the location of PVG in the liver, the distribution of intestinal pneumatosis, ascites and free air were compared between the two groups. Results: A significant difference was noted between the two groups in terms of the distribution of intestinal pneumatosis (limited to the large bowel, benign vs life-threatening = 60.9% (14/23):21.4% (3/14), p=0.040), the absence of ascites (benign vs life-threatening = 79.1% (19/24):40.0% (6/15), p=0.019) and patient age (benign vs life-threatening = 52.5±65.3 months vs 19.7±44.0 months, p=0.019). No significant difference was observed in the location of PVG in the liver, the presence of free air, and sex between the two groups. Conclusions: In pediatric patients with PVG, including various ages and underlying diseases, intestinal pneumatosis limited to the large bowel and absence of ascites were predictors of a benign prognosis. However, despite the presence of these predictors, some patients with PVG required surgical intervention, thereby suggesting that the cause of PVG, such as necrotizing enterocolitis, volvulus, or pancreatitis, must be also carefully evaluated.

• Access to Document (DOI)

Impact of a combination of quantitative indices representing uptake intensity, shape, and asymmetry in DAT SPECT using machine learning: comparison of different volume of interest settings.

Iwabuchi Y, Nakahara T, Kameyama M, Yamada Y, Hashimoto M, Matsusaka Y, Osada T, Ito D, Tabuchi H, Jinzaki M

EJNMMI research (EJNMMI Research)  9 ( 1 ) 7 2019.01

ISSN  2191-219X

　View Summary

© 2019, The Author(s). Background: We sought to assess the machine learning-based combined diagnostic accuracy of three types of quantitative indices obtained using dopamine transporter single-photon emission computed tomography (DAT SPECT)—specific binding ratio (SBR), putamen-to-caudate ratio (PCR)/fractal dimension (FD), and asymmetry index (AI)—for parkinsonian syndrome (PS). We also aimed to compare the effect of two different types of volume of interest (VOI) settings from commercially available software packages DaTQUANT (Q) and DaTView (V) on diagnostic accuracy. Methods: Seventy-one patients with PS and 40 without PS (NPS) were enrolled. Using SPECT images obtained from these patients, three quantitative indices were calculated at two different VOI settings each. SBR-Q, PCR-Q, and AI-Q were derived using the VOI settings from DaTQUANT, whereas SBR-V, FD-V, and AI-V were derived using those from DaTView. We compared the diagnostic value of these six indices for PS. We incorporated a support vector machine (SVM) classifier for assessing the combined accuracy of the three indices (SVM-Q: combination of SBR-Q, PCR-Q, and AI-Q; SVM-V: combination of SBR-V, FD-V, and AI-V). A Mann-Whitney U test and receiver-operating characteristics (ROC) analysis were used for statistical analyses. Results: ROC analyses demonstrated that the areas under the curve (AUC) for SBR-Q, PCR-Q, AI-Q, SBR-V, FD-V, and AI-V were 0.978, 0.837, 0.802, 0.906, 0.972, and 0.829, respectively. On comparing the corresponding quantitative indices between the two types of VOI settings, SBR-Q performed better than SBR-V (p = 0.006), whereas FD-V performed better than PCR-Q (p = 0.0003). No significant difference was observed between AI-Q and AI-V (p = 0.56). The AUCs for SVM-Q and SVM-V were 0.988 and 0.994, respectively; the two different VOI settings displayed no significant differences in terms of diagnostic accuracy (p = 0.48). Conclusion: The combination of the three indices obtained using the SVM classifier improved the diagnostic performance for PS; this performance did not differ based on the VOI settings and software used.

• Access to Document (DOI)

Quantitative assessment of erector spinae muscles in patients with Mycobacterium avium complex lung disease.

Asakura T, Yamada Y, Suzuki S, Namkoong H, Okamori S, Kusumoto T, Niijima Y, Ozaki A, Hashimoto M, Yagi K, Kamata H, Funatsu Y, Ishii M, Jinzaki M, Betsuyaku T, Hasegawa N

Respiratory medicine (Respiratory Medicine)  145   66 - 72 2018.12

ISSN  0954-6111

　View Summary

© 2018 Elsevier Ltd Background and objective: No reports exist regarding skeletal muscle involvement in patients with Mycobacterium avium complex lung disease (MAC-LD). The cross-sectional area of the erector spinae muscles (ESMCSA) reflects physical activity and can be assessed by computed tomography (CT). We investigated the relationship between ESMCSA and physiological parameters and prognosis in MAC-LD patients. Material and methods: In this prospective observational study, the ESMCSA was measured on single-slice axial CT images. MAC-LD patients and sex- and age-matched controls (non-MAC-LD participants) were evaluated. We evaluated the relationship between the ESMCSA and physiological parameters and prognosis. Results: A total of 260 patients (209 female; median age, 69 years; 190 with nodular/bronchiectatic disease; 74 with cavitary lesions) were enrolled. The ESMCSA was not different between MAC-LD patients and controls. In MAC-LD patients, the ESMCSA was significantly associated with age, body mass index (BMI), pulmonary function, CT severity, and health-related quality of life (HRQL). Multivariate Cox proportional hazards analyses revealed that an ESMCSA < −1 standard derivation (hazards ratio [HR], 2.76; P = 0.047) was significantly associated with all-cause mortality, along with BMI < 18.5 kg/m2 (HR, 3.67; P = 0.02) and presence of cavitary lesions (HR, 5.84; P = 0.001). However, the ESMCSA was not significantly associated with all-cause mortality when current treatment status, % predicted functional vital capacity, and forced expiratory volume in 1 s were added to the analyses. Conclusions: Although the prognostic impact was limited, ESMCSA was significantly associated with HRQL and prognostic physiological parameters, such as BMI and pulmonary function.

• Access to Document (DOI)

Comparison Between the Pouch-Perineum Distance in Neonates With a Low-Type Anorectal Malformation With and Without an Opened Fistula: Pitfall of Measuring the Pouch-Perineum Distance on Sonography.

Hosokawa T, Takahashi H, Tanami Y, Sato Y, Tanaka Y, Kawashima H, Hosokawa M, Oguma E, Yamada Y

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (Journal of Ultrasound in Medicine)  37 ( 12 ) 2797 - 2802 2018.12

ISSN  0278-4297

　View Summary

© 2018 by the American Institute of Ultrasound in Medicine. Objective—An anorectal malformation (ARM) in neonates requires urgent surgery, with the type of surgery being dependent on the type of malformation (low, intermediate, or high). Distal rectal pouch and perineum (pouch-perineum) distance is reported to be useful for differentiating the type of ARM; however, the impact of an opened fistula on pouch-perineum distance is not well known. The purpose of this study was to evaluate the difference in pouch-perineum distance between neonates with a low-type ARM with and without an opened fistula. Methods—We included 24 neonates with low-type ARM who underwent sonography before surgery. Eight neonates already had an opened fistula before sonography, and 16 did not. The pouch-perineum distance was measured using the perineal approach. Mann-Whitney U and Spearman’s correlation coefficient tests were used for statistical analysis. Results—The mean pouch-perineum distance in all neonates with a low-type ARM was 8.3 ± 2.9 mm. The pouch-perineum distance was substantially longer for an ARM with than without an opened fistula (10.6 ± 3.4 mm vs. 7.1 ± 1.7 mm; P =.02). No appreciable correlation was identified between the pouch-perineum distance and the postnatal day of examination (ρ =-.23, P =.26) or birth weight (ρ =.15, P =.47). Conclusion—The pouch-perineum distance is substantially longer in neonates with an ARM with an opened fistula than in those without an opened fistula. Caution should be exercised by the sonographic examiner in evaluating pouch-perineum distance in neonates with an opened fistula to prevent an incorrect surgical procedure based on misdiagnosis of the type of ARM.

• Access to Document (DOI)

Genomic Comparison With Supercentenarians Identifies RNF213 as a Risk Gene for Pulmonary Arterial Hypertension.

Suzuki H, Kataoka M, Hiraide T, Aimi Y, Yamada Y, Katsumata Y, Chiba T, Kanekura K, Isobe S, Sato Y, Satoh T, Gamou S, Fukuda K, Kosaki K

Circulation. Genomic and precision medicine (Circulation. Genomic and precision medicine)  11 ( 12 ) e002317 2018.12

Joint Work, Accepted,  ISSN  2574-8300

• Access to Document (DOI)

Optimal Timing of the First Barium Swallow Examination for Diagnosis of Pyriform Sinus Fistula.

Hosokawa T, Yamada Y, Takahashi H, Tanami Y, Sato Y, Hosokawa M, Oguma E

AJR. American journal of roentgenology (American Journal of Roentgenology)  211 ( 5 ) 1122 - 1127 2018.11

ISSN  0361-803X

　View Summary

© 2018 American Roentgen Ray Society. OBJECTIVE. Observation of a sinus tract during a barium swallow examination is important for the diagnosis of pyriform sinus fistula; however, to our knowledge, no reports have existed regarding the optimal timing of the examination in relation to the onset of symptoms. The purpose of this study was to compare the timing of the examination, patient age, the number of inflammatory episodes that occurred before the examination, and the barium concentration used for examinations with true-positive results versus those with false-negative results for the diagnosis of pyriform sinus fistula. MATERIALS AND METHODS. Twenty-three children with pyriform sinus fistula were included. The timing of the examination, patient age, the number of the inflammatory episodes that occurred before examination, and the barium concentration used were compared between examinations with true-positive results and examinations with false-negative results, by use of the Mann-Whitney U test. RESULTS. The examination had true-positive results for 60.9% (14/23) of patients and false-negative results for 39.1% (9/23) of patients. The mean (± SD) interval since the onset of symptoms was significantly shorter for patients with false-negative examination results than for those with true-positive examination results (26.33 ± 21.17 days vs 48.57 ± 17.67 days; p = 0.020). By 6 weeks after the onset of symptoms, more than half of the examinations had false-negative results. No significant difference in patient age (p = 0.238) or number of previous inflammatory episodes (p = 0.431) existed between examinations with true-positive and false-negative results; however, a significant difference was noted in the mean barium concentration used (88.57% ± 31.53% vs 52.86% ± 18.68% weight/volume, respectively; p = 0.014). CONCLUSION. Barium swallow examinations with false-negative results were significantly more likely when the examination was performed soon after the onset of symptoms. Therefore, early first examinations would not be recommended for the diagnosis of pyriform sinus fistula, especially in terms of radiation exposure. A higher barium concentration may be useful.

• Access to Document (DOI)

The diagnostic accuracy of DAT SPECT using DaTQUANT software: discrimination among patients with non-Parkinsonian disease, Parkinson's disease, and atypical Parkinsonian syndromes

Iwabuchi Y., Nakahara T., Kameyama M., Yamada Y., Hashimoto M., Matsusaka Y., Jinzaki M.

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 45   S401 - S401 2018.10

ISSN  1619-7070

Ultrasound imaging of the anorectal malformation during the neonatal period: a comprehensive review.

Hosokawa T, Yamada Y, Hsokawa M, Kikuchi S, Ohira K, Tanami Y, Sato Y, Oguma E

Japanese journal of radiology (Japanese Journal of Radiology)  36 ( 10 ) 581 - 591 2018.10

ISSN  1867-1071

　View Summary

© 2018, Japan Radiological Society. Anorectal malformation (ARM) is classified as low, intermediate, or high; accurate diagnosis of the type during the early neonatal period is important to determine the appropriate initial surgical approach. This review assesses the role of ultrasound examination in the classification of ARM during the neonatal period, with a focus on landmarks on the sonogram, the approach used for sonography, and the optimal examination timing. The following three factors on the sonogram are used for the classification: location of the fistula, the distance between the distal rectal pouch and the anal dimple (perineum) (P–P distance), and the relationship between the puborectalis muscle and the distal rectal pouch. Three approaches can be used to evaluate ARM by ultrasonography, namely, suprapubic, perineal, and infracoccygeal approaches. Each approach has its own advantages and disadvantages. Optimal timing of the ultrasound examination is also important with respect to each factor to classify ARM. We have described the pitfalls of ultrasound in diagnosis of cases, namely ARM with Down syndrome (which tends to be without fistula), ARM with low birth weight, ARM with unusual location of fistula, ARM with opened fistula (where the P–P distance is unreliable), and cloacal malformation (variation of the high-type ARM).

• Access to Document (DOI)

Perfusion Defect-Concordant Progression of Unilateral Refractory Pulmonary Mycobacterium avium Complex Disease.

Asakura T, Yamada Y, Ishii M, Ebisudani T, Ueda S, Betsuyaku T, Hasegawa N

American journal of respiratory and critical care medicine (American Journal of Respiratory and Critical Care Medicine)  198 ( 6 ) 803 - 804 2018.09

ISSN  1073-449X

• Access to Document (DOI)

The added value of tomosynthesis in endoscopic retrograde cholangiography with radiography for the detection of choledocholithiasis.

Suyama Y, Yamada Y, Yamaguchi H, Someya G, Otsuka S, Murayama Y, Shinmoto H, Jinzaki M, Ogawa K

The British journal of radiology (British Journal of Radiology)  91 ( 1087 ) 20180115 2018.07

ISSN  0007-1285

　View Summary

© 2018 The Authors. Objective: The diagnostic performance of endoscopic retrograde cholangiography (ERC) with radiography is imperfect. We assessed the value of adding tomosynthesis to ERC with radiography for the detection of choledocholithiasis. Methods: This study included 102 consecutive patients (choledocholithiasis/non-choledocholithiasis, n = 57/45), who underwent both radiography and tomosynthesis for ERC in the same examination and were not diagnosed with malignancy. The reference standard for the existence of choledocholithiasis was confirmed by endoscopic stone extraction during ERC, intraoperative cholangiography, or follow up with magnetic resonance cholangiopancreatography (n = 78, 11, and 13, respectively). A gastroenterologist and a radiologist independently evaluated the radiographs and the combination of tomosynthesis and radiographic images in a blinded and randomised manner. Receiver operating characteristic analysis was used for statistical analysis. Results: The areas under the receiver operating characteristic curve for combined tomosynthesis and radiography were significantly higher than those for radiography alone for both readers: Reader 1/ Reader 2, 0.929/0.956 [95% confidence interval (CI), 0.861-0.965/0.890-0.983) vs 0.803/0.769 (95% confidence interval, 0.707-0.873/0.668-0.846), respectively (p = 0.0047/> 0.0001). Conclusion: Adding tomosynthesis to radiography improved the diagnostic performance of ERC for detection of choledocholithiasis. Advances in knowledge: Adding tomosynthesis to radiography improves detection of choledocholithiasis and tomosynthesis images can be obtained easily after radiographs and repeated immediately.

• Access to Document (DOI)

Quantitative evaluation of the tracer distribution in dopamine transporter SPECT for objective interpretation.

Iwabuchi Y, Nakahara T, Kameyama M, Yamada Y, Hashimoto M, Ogata Y, Matsusaka Y, Katagiri M, Itoh K, Osada T, Ito D, Tabuchi H, Jinzaki M

Annals of nuclear medicine (Annals of Nuclear Medicine)  32 ( 5 ) 363 - 371 2018.06

ISSN  0914-7187

　View Summary

© 2018, The Japanese Society of Nuclear Medicine. Purpose: Quantification of the tracer distribution would add objectivity to the visual assessments of dopamine transporter (DAT) single photon emission computed tomography (SPECT) data. Our study aimed to evaluate the diagnostic utility of fractal dimension (FD) as a quantitative indicator of tracer distribution and compared with the conventional quantitative value: specific binding ratio (SBR). We also evaluated the utility of the combined index SBR/FD (SBR divided by FD). Materials and methods: We conducted both clinical and phantom studies. In the clinical study, 150 patients including 110 patients with Parkinsonian syndrome (PS) and 40 without PS were enrolled. In the phantom study, we used a striatal phantom with the striatum chamber divided into two spaces, representing the caudate nucleus and putamen. The SBR, FD, and SBR/FD were calculated and compared between datasets for evaluating the diagnostic utility. Mann–Whitney test and receiver-operating characteristics (ROC) analysis were used for analysis. Results: ROC analysis revealed that the FD value had high diagnostic performance [the areas under the curve (AUC) = 0.943] and the combined use of SBR and FD (SBR/FD) delivered better results than the SBR alone (AUC, 0.964 vs 0.899; p < 0.001). The sensitivity, specificity, and accuracy, respectively, were 79.1, 85.0, and 80.7% with SBR, 84.5, 97.5, and 88.0% with FD, and 92.7, 87.5, and 91.3% with SBR/FD. Conclusion: Our results confirmed that the FD value is a useful diagnostic index, which reflects the tracer distribution in DAT SPECT images. The combined use of SBR and FD was more useful than either used alone.

• Access to Document (DOI)