Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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Bilateral upper lobe Pneumocystis pneumonia during aerosolized pentamidine prophylaxis

Ohara Y., Asakura T., Ueda S., Yamada Y., Ishii M., Betsuyaku T.

QJM (QJM) 111 ( 5 ) 337 - 338 2018.05

ISSN 14602725

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Quantitative and qualitative evaluation of hybrid iterative reconstruction, with and without noise power spectrum models: A phantom study.

Minamishima K, Sugisawa K, Yamada Y, Jinzaki M

Journal of applied clinical medical physics (Journal of Applied Clinical Medical Physics) 19 ( 3 ) 318 - 325 2018.05

ISSN 1526-9914

© 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine. The purpose of this phantom study was to investigate the feasibility of dose reduction with hybrid iterative reconstruction, with and without a noise power spectrum (NPS) model, using both quantitative and qualitative evaluations. Standard dose (SD), three-quarter dose (TQD), and half-dose (HD) of radiation were used. Images were reconstructed with filtered back projection (FBP), adaptive iterative dose reduction 3D (AIDR 3D) (MILD, STR), and AIDR 3D enhanced (eAIDR 3D) (eMILD, eSTR). An NPS analysis, task-based modulation transfer function (MTFtask) analysis, and comparisons of low-contrast detectability and image texture were performed. Although the eAIDR 3D had a higher NPS value in the high-frequency range and improved image texture and resolution as compared with AIDR 3D at the same radiation dose and iteration levels, it yielded higher noise than AIDR 3D. Additionally, although there was no statistically significant difference between SD-FBP and the TQD series in the comparison of the mean area under the curve (AUC), the mean AUC was statistically significantly different between SD-FBP and the HD series. NPS values in the high-frequency range, 10% MTFtask values, low-contrast detectability, and image textures of TQD-eMILD were comparable to those of SD-FBP. Our findings suggested that using eMILD can reduce the radiation dose by 25%, while potentially maintaining diagnostic performance, spatial resolution, and image texture; this could support selecting the appropriate protocol in a clinical setting.

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Value of a Computer-aided Detection System Based on Chest Tomosynthesis Imaging for the Detection of Pulmonary Nodules.

Yamada Y, Shiomi E, Hashimoto M, Abe T, Matsusako M, Saida Y, Ogawa K

Radiology (Radiology) 287 ( 1 ) 333 - 339 2018.04

ISSN 0033-8419

© 2017 RSNA. Purpose: To assess the value of a computer-Aided detection (CAD) system for the detection of pulmonary nodules on chest tomosynthesis images. Materials and Methods: Fifty patients with and 50 without pulmonary nodules underwent both chest tomosynthesis and multidetector computed tomography (CT) on the same day. Fifteen observers (five interns and residents, five chest radiologists, and five abdominal radiologists) independently evaluated tomosynthesis images of 100 patients for the presence of pulmonary nodules in a blinded and randomized manner, first without CAD, then with the inclusion of CAD marks. Multidetector CT images served as the reference standard. Free-response receiver operating characteristic analysis was used for the statistical analysis. Results: The pooled diagnostic performance of 15 observers was significantly better with CAD than without CAD (figure of merit [FOM], 0.74 vs 0.71, respectively; P = .02). The average true-positive fraction and false-positive rate per all cases with CAD were 0.56 and 0.26, respectively, whereas those without CAD were 0.47 and 0.20, respectively. Subanalysis showed that the diagnostic performance of interns and residents was significantly better with CAD than without CAD (FOM, 0.70 vs 0.62, respectively; P = .001), whereas for chest radiologists and abdominal radiologists, the FOM with CAD values were greater but not significantly: 0.80 versus 0.78 (P = .38) and 0.74 versus 0.73 (P = .65), respectively. Conclusion: CAD significantly improved diagnostic performance in the detection of pulmonary nodules on chest tomosynthesis images for interns and residents, but provided minimal benefit for chest radiologists and abdominal radiologists.

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Distance Between the Distal Rectal Pouch and Perineum in Neonates of Low-Birth Weight With Imperforate Anus.

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

Ultrasound quarterly (Ultrasound Quarterly) 34 ( 1 ) 18 - 22 2018.03

ISSN 0894-8771

© 2018 Wolters Kluwer Health, Inc. All rights reserved. This study was to evaluate the correlation between birth weight and the distance between distal rectal pouch and perineum (P-P distance) and to determine a cutoff value for P-P distance to diagnose low-type imperforate anus in neonates with low-birth weight (LBW). We included 15 neonates with LBW (mean weight, 2012 ± 470 g; range, 906-2452 g) and imperforate anus (surgically confirmed: 11 low type and 3/1 intermediate/high type), who underwent ultrasonography on the day after birth. Type of imperforate anus was defined based on the International Classification of Anorectal Anomalies. The P-P distances on ultrasonograms were measured. Pearson correlation coefficient test and receiver operating characteristic curve were used for statistical analyses. Among all 15 neonates, nonsignificant correlation was observed between the birth weight and P-P distance (r = 0.36; P = 0.18). Mean P-P distance was 9.0 ± 6.6 mm (range, 1.0-24.0 mm) in all neonates, 5.7 ± 2.8 mm (range, 1.0-11.0 mm) in the 11 neonates with low-type imperforate anus, and 18.3 ± 9.1 mm (range, 14.0-24.0 mm) in the 4 neonates with intermediate-/high-type imperforate anus. Using cutoff P-P distance of 12.5 mm, sensitivity and specificity for diagnosis of low-type imperforate anus were 100% (11/11) and 100% (4/4), respectively. In conclusion, nonsignificant correlation was observed between P-P distance and birth weight, and cutoff P-P distance to diagnose low-type imperforate anus was 12.5 mm. Despite the very small sample size in our study, and only 4 neonates with intermediate-/high-type imperforate anus, these findings are important because surgical management whether transperineal anoplasty or diverting colostomy is decided based on the type of imperforate anus, and P-P distance to diagnose the type of imperforate anus was feasible even in neonates with LBW.

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【シリーズ新潮流-The Next Step of Imaging Technology<Vol.8>Dual Energy Imagingの可能性　新たな価値をもたらすDECTの技術的特徴から臨床的有用性まで】Dual Energy Imagingの原理と特徴　Dual energy imagingの技術と撮影法

山田祥岳, 山田稔, 横山陽一, 岡村哲平, 陣崎雅弘

INNERVISION ((株)インナービジョン) 33 ( 3 ) 6 - 9 2018.02

ISSN 0913-8919

dual energy CTとは、管電圧の異なる2種類のX線で撮影する技術である。近年、CTメーカー各社が独自のdual energy CTの技術開発を進めており、臨床現場での認知・普及も進みつつある。CT画像は、被写体のX線減弱の情報を、水を基準としたCT値として可視化するものであるが、通常のCTでは多色エネルギーのX線を使用しているため、X線が被写体を通過する過程で低エネルギーの成分が吸収され、高エネルギーの成分が残る「ビームハードニング効果」が起こり、アーチファクトの原因となる。また、「線減弱係数」は「質量減弱係数」×「密度」で表され、「質量減弱係数」は本来物質固有の数値だが、撮影対象の密度状態によって、異なる物質のCT値が同じになる場合がある。X線エネルギーによるCT値の変化は物質に固有であることから、2種類の管電圧でCTを撮影することで、物質弁別(material decomposition)を行うことが可能となる(図1)。また、2種類のX線のデータを処理することで、さまざまなエネルギーの単色X線画像を仮想的に合成することが可能である。これにより、前述のビームハードニング効果を減弱させることができる。そのほか、dual energy CT撮影で得られる画像情報に、仮想単純画像、実効原子番号画像、電子密度画像などがある。本稿では、dual energy CTの解析方法、撮影法、原理と取得できる画像について解説する。(著者抄録)

Image quality of virtual monochromatic images obtained using 320-detector row CT: A phantom study evaluating the effects of iterative reconstruction and body size

Okamura, Teppei, Yamada, Yoshitake, Yamada, Minoru, Yamazaki, Akihisa, Shiraga, Nobuyuki, Jinzaki, Masahiro

EUROPEAN JOURNAL OF RADIOLOGY (European Journal of Radiology) 95 212 - 221 2017.10

Research paper (scientific journal), Accepted, ISSN 0720-048X

© 2017 Elsevier B.V. Objectives To compare the image quality between virtual monochromatic spectral (VMS) images obtained using 320-row detector CT and polychromatic 120-kVp images reconstructed with or without iterative reconstruction using various phantom sizes. Materials and methods Torso phantoms simulating three patient sizes and containing four syringes filled with water or different contrast media (5, 10, 15 mgI/mL15 mgI/ml) were used. The phantoms were scanned using dual-energy (80/135-kVp) and single-energy (120-kVp) protocols at different settings (20 mGy, 12 mGy, and 6 mGy). VMS images were generated at 1-keV intervals (range, 35–135 keV). Both the VMS images and the single-energy 120-kVp images were reconstructed using filtered back projection (FBP) and adaptive iterative dose reduction 3D (AIDR-3D). The signal-to-noise ratio (SNR), and the contrast-to-noise ratio (CNR) were assessed. Results Using FBP reconstruction, the SNR and CNR of the VMS images were lower than or similar to those of the 120-kVp images for most dose settings. Using AIDR-3D reconstruction, however, the 70-keV VMS images had higher SNRs and CNRs than the 120-kVp images at most settings. Conclusions The image quality of VMS images with FBP reconstruction tended to be lower than that of the 120-kVp images. With the use of AIDR-3D, however, approximately 70-keV VMS images had a higher image quality than the 120-kVp images.

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Diagnostic Accuracy of Sonography for Detection of a Fistula on the Birth Day in Neonates With an Imperforate Anus: Comparison of Diagnostic Performance Between Suprapubic and Perineal Approaches.

Takahiro Hosokawa, Yoshitake Yamada, Yutaka Tanami, Shinya Hattori, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Mayumi Hosokawa, Eiji Oguma

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (Journal of Ultrasound in Medicine) 36 ( 10 ) 1989 - 1995 2017.10

Accepted, ISSN 0278-4297

© 2017 by the American Institute of Ultrasound in Medicine. Objectives: To evaluate the diagnostic accuracy of sonography for detection of an internal fistula on the birth day in neonates with an imperforate anus and to compare the diagnostic performance between the suprapubic and perineal approaches. Methods: We included 46 neonates with an imperforate anus (29 low type and 17 intermediate/high type) who underwent sonography by both the suprapubic and perineal approaches on the birth day. Thirty-nine neonates had internal fistulas, and 12 did not, as surgically proven. Two blinded radiologists evaluated the suprapubic and perineal sonograms for the presence of the internal fistula in consensus. A final diagnosis of the internal fistula was determined on the basis of the findings of both approaches. A receiver operating characteristic analysis was used to compare the diagnostic performance for detection of an internal fistula between the suprapubic and perineal approaches. Results: The sensitivity, specificity, and accuracy of the final diagnosis based on the findings of suprapubic, perineal, and both approaches were 52.9%, 79.4%, and 79.4%; 75.5%, 75.5%, and 75.5%; and 58.7%, 78.3%, and 78.3%, respectively. The diagnostic performance of the perineal approach was significantly better than that of the suprapubic approach (P <.0001). Conclusions: The diagnostic accuracy of sonography for detection of an internal fistula on the birth day exceeded 75% in neonates with an imperforate anus, and sonography on the birth day is feasible. The perineal approach had superior diagnostic performance over the suprapubic approach. Thus, when evaluating an internal fistula by sonography, we recommend using the perineal approach in addition to the suprapubic approach.

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Sonography for an Imperforate Anus: Approach, Timing of the Examination, and Evaluation of the Type of Imperforate Anus and Associated Anomalies.

Takahiro Hosokawa, Yoshitake Yamada, Yutaka Tanami, Shinya Hattori, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Mayumi Hsokawa, Eiji Oguma

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine) 36 ( 9 ) 1747 - 1758 2017.09

Accepted, ISSN 0278-4297

© 2017 by the American Institute of Ultrasound in Medicine. This systematic review outlines the role of sonography in an imperforate anus. The diagnostic performance for type of imperforate anus is superior on the day after birth than that on the day of birth by using the pouch-perineum distance. Three approaches can be used (suprapubic, infracoccygeal, and perineal). The pouch-perineum distance, fistula location, and relationship between the puborectalis muscle and distal rectal pouch are useful for classifying the type of imperforate anus. However, the pouch-perineum distance measured has an overlap between the low and high/intermediate types of imperforate anus. Sonography can be useful for some of the associated anomalies and helpful for surgeons in some cases.

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The MUC5B promoter polymorphism is associated with specific interstitial lung abnormality subtypes

Putman, Rachel K., Gudmundsson, Gunnar, Araki, Tetsuro, Nishino, Mizuki, Sigurdsson, Sigurdur, Gudmundsson, Elias F., Eiriksdottir, Gudny, Aspelund, Thor, Ross, James C., Estepar, Raul San Jose, Miller, Ezra R., Yamada, Yoshitake, Yanagawa, Masahiro, Tomiyama, Noriyuki, Launer, Lenore J., Harris, Tamara B., El-Chemaly, Souheil, Raby, Benjamin A., Cho, Michael H., Rosas, Ivan O., Washko, George R., Schwartz, David A., Silverman, Edwin K., Gudnason, Vilmundur, Hatabu, Hiroto, Hunninghake, Gary M.

EUROPEAN RESPIRATORY JOURNAL (European Respiratory Journal) 50 ( 3 ) 1989 - 1995 2017.09

Research paper (scientific journal), Accepted, ISSN 0903-1936

© ERS 2017. The MUC5B promoter polymorphism (rs35705950) has been associated with interstitial lung abnormalities (ILA) in white participants from the general population; whether these findings are replicated and influenced by the ILA subtype is not known. We evaluated the associations between the MUC5B genotype and ILA in cohorts with extensive imaging characterisation. We performed ILA phenotyping and MUC5B promoter genotyping in 5308 and 9292 participants from the AGES-Reykjavik and COPDGene cohorts, respectively. We found that ILA was present in 7% of participants from the AGES-Reykjavik, 8% of non-Hispanic white participants from COPDGene and 7% of African-American participants from COPDGene. Although the MUC5B genotype was strongly associated (after correction for multiple testing) with ILA (OR 2.1, 95% CI 1.8-2.4, p=1×10-26), there was evidence of significant heterogeneity between cohorts (I2=81%). When narrowed to specific radiologic subtypes, (e.g. subpleural ILA), the MUC5B genotype remained strongly associated (OR 2.6, 95% CI 2.2-3.1, p=1×10-30) with minimal heterogeneity (I2=0%). Although there was no evidence that the MUC5B genotype influenced survival, there was evidence that MUC5B genotype improved risk prediction for possible usual interstitial pneumonia (UIP) or a UIP pattern in non-Hispanic white populations. The MUC5B promoter polymorphism is strongly associated with ILA and specific radiologic subtypes of ILA, with varying degrees of heterogeneity in the underlying populations.

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The efficacy, safety and feasibility of inhaled amikacin for the treatment of refractory non-tuberculous mycobacterial lung diseases

Kazuma Yagi, Makoto Ishii, Ho Namkoong, Takahiro Asami, Osamu Iketani, Takanori Asakura, Shoji Suzuki, Satoshi Okamori, Hiroaki Sugiura, Yoshitake Yamada, Tomoyasu Nishimura, Hirofumi Kamata, Hiroshi Fujiwara, Yohei Funatsu, Yoshifumi Uwamino, Tomoko Betsuyaku, Naoki Hasegawa

EUROPEAN RESPIRATORY JOURNAL 50 2017.09

ISSN 0903-1936

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The efficacy, safety, and feasibility of inhaled amikacin for the treatment of difficult-to-treat non-tuberculous mycobacterial lung diseases

Yagi Kazuma, Ishii Makoto, Namkoong Ho, Asami Takahiro, Iketani Osamu, Asakura Takanori, Suzuki Shoji, Sugiura Hiroaki, Yamada Yoshitake, Nishimura Tomoyasu, Fujiwara Hiroshi, Funatsu Yohei, Uwamino Yoshifumi, Kamo Tetsuro, Tasaka Sadatomo, Betsuyaku Tomoko, Hasegawa Naoki

BMC Infectious Diseases (BMC Infectious Diseases) 17 ( 1 ) 558 - 558 2017.08

Accepted, ISSN 1471-2334

Background: In multidrug regimens, including an intravenous aminoglycoside (e.g. amikacin [AMK]) is recommended for difficult-to-treat non-tuberculous mycobacterial (NTM) lung diseases. We aimed to evaluate the efficacy, safety, and feasibility of inhaled AMK therapy in patients with difficult-to-treat NTM lung diseases in a retrospective chart review. Methods: The study population consisted of patients with NTM lung diseases who received combination therapy, including inhaled AMK therapy, at Keio University Hospital (Tokyo, Japan), from January 2014 through May 2016. A total of 26 cases, consisting of 23 Mycobacterium avium complex (MAC) and three Mycobacterium abscessus complex (MABC) infections cases, were included in this study. The efficacy, safety, and feasibility of inhaled AMK therapy were retrospectively investigated. The Research Ethics Committee of Keio University Hospital approved this study, and informed consent was obtained from all patients. Results: All 26 patients were culture-positive at enrolment. Twenty-three of the 26 patients (88.5%), including 21/23 MAC patients (91.3%) and 2/3 MABC patients (66.7%), were administered inhaled AMK therapy for >3months. The proportion of patients who had clinical symptoms, including, cough and sputum, declined after inhalation AMK therapy. Ten of the 23 patients (43.5%) who received AMK inhalation, including 8/21 MAC (38.1%) and 2/2 MABC patients (100%), showed sputum conversion, defined as at least three consecutive negative sputum cultures. Seven of the 23 patients, including, 5/21 MAC and 2/2 MABC patients, showed improvements in high-resolution computed tomography imaging of the chest. In addition, the serum AMK trough levels before the second inhalation were <1.2μg/mL in all 26 patients, with no occurrence of severe adverse events, such as renal toxicity. One patient (3.8%) experienced auditory toxicity, in the form of tinnitus. However, this symptom was reversible, after temporary interruption of AMK, the patient was able to safely resume the therapy. Conclusions: Inhaled AMK therapy is an effective and feasible therapy for difficult-to-treat NTM lung disease.

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Comparison of Diagnostic Accuracy for the Low-Type Imperforate Anus Between Prone Cross-Table Radiography and Sonography.

Takahiro Hosokawa, Mayumi Hosokawa, Yutaka Tanami, Shinya Hattori, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Eiji Oguma, Yoshitake Yamada

Accepted, ISSN 0278-4297

© 2017 by the American Institute of Ultrasound in Medicine. OBJECTIVES: To compare the diagnostic accuracy for the low-type imperforate anus between prone cross-table radiography and sonography.METHODS: We included 20 neonates with imperforate anus: 13 with a surgically proven low type and 7 with an intermediate or high type. The distance between the distal rectal pouch and the perineum (pouch-perineum distance) was measured by both sonography and prone cross-table radiography. A previously established pouch-perineum distance of 10 mm was used as the cutoff for diagnosis of a low-type imperforate anus. The fistula location was also determined with sonography. We then compared the diagnostic accuracy of the imaging methods for a low-type imperforate anus using the cutoff value of the pouch-perineum distance alone and both the cutoff value of the pouch-perineum distance and fistula location. The McNemar test was used for statistical analysis.RESULTS: With the use of only the pouch-perineum distance, the diagnostic accuracy for the low-type imperforate anus based on sonographic measurements was comparable with the accuracy achieved by prone cross-table radiographic measurements (60.0% [12 of 20] versus 45.0% [9 of 20]; P = .625). With the use of the pouch-perineum distance and fistula location, the diagnostic accuracy of sonography was significantly better than the accuracy of prone cross-table radiography (90.0% [18 of 20] versus 45% [9 of 20]; P = .012).CONCLUSIONS: The diagnostic accuracy of sonography for the low-type imperforate anus based on both the pouch-perineum distance and fistula location is better than that of prone cross-table radiography. If the pouch-perineum distance on prone cross-table radiography is greater than 10 mm, a sonographic examination to determine the fistula location could be recommended.

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腎嚢胞のCT画像に生じるpseudoenhancement effectの抑制に関わる撮影条件の検討　連続X線と仮想単色X線、画像再構成法、およびビーム幅の違いにおけるファントム検証

杉澤浩一, 市川勝弘, 南島一也, 長谷川雅一, 山田祥岳, 陣崎雅弘

日本放射線技術学会雑誌 ((公社)日本放射線技術学会) 73 ( 8 ) 636 - 645 2017.08

ISSN 0369-4305

診断に難渋した播種性ヒストプラズマ症の一例

栗原真帆, 杉浦弘明, 南康大, 松本俊亮, 山田祥岳, 蔵本純子, 川田一郎, 別役智子, 陣崎雅弘

日本医学放射線学会秋季臨床大会抄録集 ((公社)日本医学放射線学会) 53回 S523 - S523 2017.08

ISSN 0048-0428

Difference in the craniocaudal gradient of the maximum pixel value change rate between chronic obstructive pulmonary disease patients and normal subjects using sub-mGy dynamic chest radiography with a flat panel detector system

Yamada Yoshitake, Ueyama Masako, Abe Takehiko, Araki Tetsuro, Abe Takayuki, Nishino Mizuki, Jinzaki Masahiro, Hatabu Hiroto, Kudoh Shoji

European Journal of Radiology (European Journal of Radiology) 92 37 - 44 2017.07

Accepted, ISSN 0720-048X

Objectives To compare the craniocaudal gradients of the maximum pixel value change rate (MPCR) during tidal breathing between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography. Materials and methods This prospective study was approved by the institutional review board and all participants provided written informed consent. Forty-three COPD patients (mean age, 71.6 ± 8.7 years) and 47 normal subjects (non-smoker healthy volunteers) (mean age, 54.8 ± 9.8 years) underwent sequential chest radiographs during tidal breathing in a standing position using dynamic chest radiography with a flat panel detector system. We evaluated the craniocaudal gradient of MPCR. The results were analyzed using an unpaired t-test and the Tukey–Kramer method. Results The craniocaudal gradients of MPCR in COPD patients were significantly lower than those in normal subjects (right inspiratory phase, 75.5 ± 48.1 vs. 108.9 ± 42.0 s⁻¹ cm⁻¹, P < 0.001; right expiratory phase, 66.4 ± 40.6 vs. 89.8 ± 31.6 s⁻¹ cm⁻¹, P = 0.003; left inspiratory phase, 75.5 ± 48.2 vs. 108.2 ± 47.2 s⁻¹ cm⁻¹, P = 0.002; left expiratory phase, 60.9 ± 38.2 vs. 84.3 ± 29.5 s⁻¹ cm⁻¹, P = 0.002). No significant differences in height, weight, or BMI were observed between COPD and normal groups. In the sub-analysis, the gradients in severe COPD patients (global initiative for chronic obstructive lung disease [GOLD] 3 or 4, n = 26) were significantly lower than those in mild COPD patients (GOLD 1 or 2, n = 17) for both right and left inspiratory/expiratory phases (all P ≤ 0.005). Conclusions A decrease of the craniocaudal gradient of MPCR was observed in COPD patients. The craniocaudal gradient was lower in severe COPD patients than in mild COPD patients.

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Incidental spade-shaped FDG uptake in the left ventricular apex suggests apical hypertrophic cardiomyopathy

Katagiri, Mari, Nakahara, Tadaki, Murata, Mitsushige, Ogata, Yuji, Matsusaka, Yohji, Iwabuchi, Yu, Yamada, Yoshitake, Fukuda, Keiichi, Jinzaki, Masahiro

ANNALS OF NUCLEAR MEDICINE (Annals of Nuclear Medicine) 31 ( 5 ) 399 - 406 2017.06

Research paper (scientific journal), Accepted, ISSN 0914-7187

© 2017, The Japanese Society of Nuclear Medicine. Purpose: Apical wall thickening with an “ace-of-spades” configuration is a unique sign of apical hypertrophic cardiomyopathy (AHCM). We investigated spade-shaped FDG uptake around the left ventricular apex (SSUA) incidentally found in routine oncological FDG PET. Methods: Cases showing SSUA were selected based on retrospective review. The pattern or intensity of SSUA was compared with the results of electrocardiogram (ECG), echocardiography, and stress myocardial perfusion SPECT. The diagnosis of ACHM was based on the presence of giant negative T wave in ECG, thickness of spade-shaped hypertrophy in the apex in echocardiography, and increased tracer uptake in the apex in rest SPECT. Results: Among the 34 patients in 36 PET scans showing SSUA, SSUA was weak in 17 and intense in 17. There were isolated SSUA (n = 29) and SSUA with diffuse or other focal left ventricular uptake (n = 5). Three patients with the latter uptake pattern turned out to have coexistence of AHCM and asymmetric septal hypertrophy. Of the 16 SSUA-positive patients who underwent echocardiography, 13 (81%) were diagnosed as AHCM and the remaining 3 were regarded as borderline AHCM (apical wall thickness, 14–15 mm). There were 16 patients with SSUA who also underwent PET scans after the study period among which 11 (69%) had persistent SSUA in the follow-up PET. In the remaining 5, follow-up PET scans showed diffuse left ventricular uptake and SSUA was barely visible. The intensity of SSUA was significantly or marginally associated with giant negative T wave (p < 0.01), apical asynergy (p = 0.08), and impaired coronary flow reserve (p < 0.05). There were no other factors correlated with the pattern or intensity of SSUA. Conclusion: SSUA incidentally found in oncological FDG PET appeared to be associated with AHCM, especially in ischemic conditions. The moderate repeatability of SSUA was probably due to obscurity by physiological uptake.

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Evaluation of the Normal Tonsils in Pediatric Patients with Ultrasonography

Hosokawa Takahiro, Yamada Yoshitake, Tanami Yutaka, Hattori Shinya, Sato Yumiko, Hosokawa Mayumi, Oguma Eiji

Journal of Ultrasound in Medicine (Journal of Ultrasound in Medicine) 36 ( 5 ) 1029 - 1036 2017.05

Accepted, ISSN 0278-4297

Objectives: To evaluate how well the tonsils can be viewed, in addition to echogenicity, using ultrasound, and to compare these results between children younger and older than the age of 3. Methods: We evaluated the tonsils of 99 patients (72.0 ± 59.1 months) by ultrasound. Ultrasound scans of both the left and right side, in both the transverse and longitudinal planes, were obtained. Images were scored with one of four grades according to how well the tonsil border could be distinguished, 0 being the worst and 3 being the best. Grades 2 or 3 (>50% of the tonsil border was detectable) in both tonsils, in either the transverse or longitudinal image, were considered "evaluable." Echogenicity was designated as imperceptible, low echoic, or striated in appearance. Statistical analysis was performed using the Mann-Whitney U test. Results: Bilateral tonsils were evaluable in 96.0% (96/99) of cases. The mean grades were 2.44 ± 0.65/2.03 ± 0.68 in the right transverse/longitudinal images, and 2.40 ± 0.59/2.12 ± 0.73 in the left transverse/longitudinal images. The grades in children older than the age of 3 were significantly higher than those in younger patients (all P <.05). Echogenicity classification on the right and left side revealed a striated appearance in 97.0% (96/99) and 90.0% (89/99) of cases, respectively. Conclusions: The tonsils of almost all pediatric patients could be evaluated by ultrasound, particularly for patients older than 3 years. Additionally, a striated pattern of the tonsils was observed in most cases.

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

Matsumoto, Shunsuke, Yamada, Yoshitake, Hashimoto, Masahiro, Okamura, Teppei, Yamada, Minoru, Yashima, Fumiaki, Hayashida, Kentaro, Fukuda, Keiichi, Jinzaki, Masahiro

EUROPEAN RADIOLOGY (European Radiology) 27 ( 5 ) 1963 - 1970 2017.05

Research paper (scientific journal), Accepted, ISSN 0938-7994

© 2016, European Society of Radiology. Objectives: To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD). Methods: Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time × weight [kg] × 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard. Results: The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV). Conclusions: CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD. Key Points: • TAVI-planning CT using variable helical pitch (VHP) scanning is useful. • The average volume of contrast material was 38.7 ± 8.5 mL. • The average attenuations of all the arteries were >400 HU. • This CT had a high sensitivity and NPV for excluding obstructive CAD.

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Impact of cavity and infiltration on pulmonary function and health-related quality of life in pulmonary Mycobacterium avium complex disease: A 3-dimensional computed tomographic analysis

Asakura, Takanori, Yamada, Yoshitake, Namkoong, Ho, Suzuki, Shoji, Niijima, Yuki, Kamata, Hirofumi, Funatsu, Yohei, Yagi, Kazuma, Okamori, Satoshi, Sugiura, Hiroaki, Ishii, Makoto, Jinzaki, Masahiro, Betsuyaku, Tomoko, Hasegawa, Naoki

RESPIRATORY MEDICINE (Respiratory Medicine) 126 9 - 16 2017.05

Research paper (scientific journal), Accepted, ISSN 0954-6111

© 2017 Elsevier Ltd Background and objectives Pulmonary Mycobacterium avium complex (pMAC) disease manifests as various types of lesions, such as infiltrates, nodules, cavities, and bronchiectasis. However, the important determinants for clinical parameters in lung involvement are poorly understood. The objective of this study was to obtain quantitative parameters by 3-dimensional CT, and investigate the relationship between these parameters and the pulmonary function tests (PFTs) and health-related quality of life. Material and methods Quantitative analysis using CT was performed in 67 pMAC patients. The relationship between new quantitative parameters for evaluating lung involvement using 3-dimensional CT and PFTs or St George's Respiratory Questionnaire (SGRQ) was evaluated. Results The ratio of infiltration to total lung volume showed significant correlation with the PFT results, especially the percent-predicted forced vital capacity (%FVC; ρ = −0.52), residual volume (ρ = −0.51), and total lung capacity (ρ = −0.59). The cavity volume was strongly correlated with the %FVC (ρ = −0.78) in the cavity group, while the ratio of infiltration to total lung volume was strongly correlated with the %FVC (ρ = −0.53) in the non-cavity group. The ratio of infiltration to total lung volume was significantly correlated with all SGRQ parameters (ρ = 0.41–0.52) in the non-cavity group. Conclusions Infiltration was an important parameter for the PFTs and SGRQ in pMAC patients according to the 3-dimensional CT analysis. Moreover, cavity volume was an important parameter of the PFTs in the cavity group. Therefore, infiltration and cavity volume are key features for the management of pMAC disease.

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Late Recoil of Balloon-expandable Transcatheter Aortic Bioprosthesis: Insights from the OCEAN-TAVI Registry

Yanagisawa, Ryo, Tanaka, Makoto, Yashima, Fumiaki, Yamada, Yoshitake, Arai, Takahide, Shimizu, Hideyuki, Jinzaki, Masahiro, Fukuda, Keiichi, Watanabe, Yusuke, Yamamoto, Masanori, Kozuma, Ken, Suzuki, Takahiko, Hayashida, Kentaro

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 69 ( 16 ) S85 - S86 2017.04

Research paper (scientific journal), ISSN 0735-1097

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