Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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Free-breathing Three-dimensional MR Cholangiopancreatography Using Centric k-space Encoding Improved Gallbladder Visualization: A Prospective Study

Junya Tsuzaki, Taiki Nozaki, Daiki Ito, Tetsushi Habe, Sayaka Miyazaki, Manabu Arai, Manabu Hase, Hiroki Sakata, Ryo Tsukada, Yoshitake Yamada, Masahiro Jinzaki

Magnetic Resonance in Medical Sciences 2026.02

Accepted, ISSN 1347-3182

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Three-dimensional analysis of shoulder hand-behind-back motion in patients with frozen shoulder

Takafumi Niwa, Noboru Matsumura, Yuki Yoshida, Yoichi Yokoyama, Minoru Yamada, Yoshitake Yamada, Takeo Nagura, Masaya Nakamura, Masahiro Jinzaki

Journal of Shoulder and Elbow Surgery 2026.02

Accepted, ISSN 1058-2746

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Comparison of supine and upright postures in carbon ion radiotherapy for pancreatic cancer: An in silico planning study.

Nomura Y, Inaniwa T, Isozaki T, Kurosaki H, Shinoto M, Yamada Y, Yamada M, Yokoyama Y, Mizuno H, Yonai S, Iwata Y, Takeda A, Ishikawa H, Jinzaki M

Medical physics 53 ( 2 ) e70325 2026.02

ISSN 0094-2405

Background: Conducting carbon ion radiotherapy (CIRT) in upright posture has several technical advantages over that in conventional supine posture for pancreatic cancer treatment. However, few studies have investigated effects of upright positioning on anatomy and CIRT dose distributions. Purpose: This study compared anatomy and dose distributions in CIRT for pancreatic cancer between supine and upright postures. Methods: Fourteen pairs of computed tomography (CT) images obtained from asymptomatic volunteers in these postures were analyzed. Clinical target volume (CTV), organs-at-risk (OARs), and gastrointestinal gas contours were delineated within a planning volume for each CT image, and a CIRT dose distribution was calculated. The anatomical differences between these postures were evaluated by comparing volumes and 3D rendered images of the contours, while the dosimetric differences were assessed with 12 dosimetric metrics. Moreover, a proximal overlap volume of the OARs and possible change in water-equivalent path length due to gastrointestinal gas were calculated for all coplanar beam angles to compare ranges of applicable beam angles and potential range uncertainty between these postures. Results: The bowel contour volumes in the upright posture were more than 46% smaller than those in the supine posture because the bowel was shifted. The upright posture provided a smaller dose to the bowel and higher dose coverage to the CTV than the supine posture. The possible water-equivalent path length changes due to the stomach and duodenum gas decreased at most beam angles in the upright posture. Conclusions: The upright CIRT had several anatomical and dosimetric advantages for pancreatic cancer treatment over conventional supine CIRT. This technique will be useful in applying the patient-specific beam angle arrangement and precise dose delivery with reduced range uncertainty.

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Three-dimensional in vivo kinematics of the subtalar joint during weight-bearing standing on coronal-wedge surfaces using upright computed tomography.

Naomichi Ogihara, Hiroyuki Seki, Asahi Sujino, Akimasa Ito, Yuka Matsumoto, Gen Suwa, Takeo Nagura, Yoichi Yokoyama, Minoru Yamada, Yoshitake Yamada, Masahiro Jinzaki

Gait & posture 123 110021 - 110021 2026.01

Accepted, ISSN 0966-6362

BACKGROUND: The human subtalar joint is crucial for bipedal posture and locomotion, providing stability, adaptability, and force dissipation. While its kinematics have been studied, most research has been under non-weight-bearing conditions, leaving its function under physiological loading unclear. RESEARCH QUESTION: What is the three-dimensional kinematics of the human subtalar joint during weight-bearing postures, as quantified by the helical axis? METHODS: This study analyzed three-dimensional in vivo subtalar joint kinematics during weight-bearing using upright CT. Fifteen healthy elderly adults (11 females, 4 males; mean age: 64.9 ± 5.0 years) underwent CT scans in neutral, inverted, and everted postures using 10° coronal wedges. Kinematics were quantified via helical axis representation relative to two talar coordinate systems: the foot longitudinal axis and the talus principal axis. RESULTS: The helical axis ran obliquely from anterior-medial-dorsal to posterior-lateral-plantar, with inclination and deviation angles of 22.4° ± 9.6° and 35.2° ± 5.6° in the former system, and 36.5° ± 10.7° and 12.0° ± 7.1° in the latter. Rotation along the axis was 9.9° ± 3.8°, with minimal translation (0.5 ± 0.5 mm). SIGNIFICANCE: These findings suggest subtalar joint movement is more constrained under weight-bearing conditions than in non-weight-bearing studies. This study underscores the importance of weight-bearing analyses for clinical applications and understanding human foot adaptations for bipedalism.

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Quantitative airway evaluation using supine and upright computed tomography in patients with non-cystic fibrosis bronchiectasis and nontuberculous mycobacterial pulmonary disease.

Masanori Kaji, Takanori Asakura, Yoshitake Yamada, Hiromu Tanaka, Ho Namkoong, Shotaro Chubachi, Minoru Yamada, Takuya Ozawa, Yoichi Yokoyama, Shin Iizuka, Keiichi Narita, Genta Nagao, Ryoichi Kato, Naoki Fukunaga, Shunsuke Nakamura, Shuhei Azekawa, Sayaka Miyazaki, Kensuke Nakagawara, Hirofumi Kamata, Richard C Boucher, Koichi Fukunaga, Naoki Hasegawa, Masahiro Jinzaki

European journal of radiology 195 112626 - 112626 2025.12

Accepted, ISSN 0720-048X

INTRODUCTION: Bronchiectasis, closely associated with nontuberculous mycobacterial pulmonary disease (NTM-PD), exhibits unevenly distributed lesions, yet their spatial features remain unclear. We hypothesized that upright CT, which may better depict distal airways due to gravity-induced lung expansion, might more accurately reflect disease severity and its relationship with pulmonary function tests (PFTs). METHODS: In this prospective study, twenty patients underwent low-dose inspiratory and expiratory CT scans in standing and supine positions. Airways were segmented with Vincent® software and classified as bronchiectatic or non-bronchiectatic. Generation-specific quantitative CT (QCT) parameters, including inspiratory airway total area (ITA), inspiratory airway lumen area (ILA), wall thickness, and wall area percentage (WA%), were measured and correlated with PFTs. RESULTS: Bronchiectatic lesions were primarily identified in the 8th-10th generation airways (anatomically the 7th-9th generations), the transition from distal bronchi to proximal bronchioles. Standing CT detected more distal airways than supine CT. Mixed-effect models revealed significantly larger ITA and higher WA% in bronchiectatic airways (8th-10th generations) on standing CT. In non-bronchiectatic airways (trachea to 6th generation), ITA and ILA were significantly larger in the standing position, except for the main bronchus ITA. ITA, ILA, and WA% were moderate to strongly correlated with %FVC, %FEV1, and FEF25-75%, reflecting airway obstruction, with stronger correlations in the standing position. ITA in bronchiectatic airways was moderately negatively correlated with diffusing capacity of the lungs for carbon monoxide, indicating potential alveolar disease. CONCLUSION: Upright CT offers useful structural biomarkers associated with airflow limitation and possible alveolar impairment in bronchiectasis with NTM-PD. REGISTRATION: University Hospital Medical Information Network (UMIN 000026587). URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000030456.

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Integrated assessment of total airway count and pneumonia volume on chest computed tomography as a prognostic biomarker for coronavirus disease.

Kensuke Nakagawara, Naoya Tanabe, Shotaro Chubachi, Tomoki Maetani, Yusuke Shiraishi, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Takashi Shimada, Shuhei Azekawa, Shiro Otake, Takahiro Fukushima, Mayuko Watase, Hideki Terai, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Yoshitake Yamada, Masahiro Jinzaki, Toyohiro Hirai, Yukinori Okada, Ryuji Koike, Makoto Ishii, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga

European radiology 2025.12

Accepted, ISSN 0938-7994

OBJECTIVES: The clinical relevance of computed tomography (CT)-based airway tree structure is unclear. Herein, we used artificial intelligence to segment the airway tree and pneumonia regions, measuring total airway count (TAC) and pneumonia volume to examine whether their combination is more closely associated with clinical outcomes in patients with coronavirus disease (COVID-19) than pneumonia volume alone. MATERIALS AND METHODS: We examined clinical data and chest CT from 781 hospitalized COVID-19 patients in a multicenter retrospective cohort in Japan, focusing on the percentage of critical outcomes (high-flow oxygen, invasive mechanical ventilation, or death). Additionally, 197 patients were followed up for 3 months to monitor TAC and pneumonia volume. RESULTS: Critical outcomes were observed in 63 (8.8%) patients, with higher TAC in those patients. Patients were divided into four groups based on cutoff values of 17.6% for pneumonia volume percent and 255 for TAC: Group A (low TAC, low pneumonia volume), Group B (high TAC, low pneumonia volume), Group C (low TAC, high pneumonia volume), and Group D (high TAC, high pneumonia volume). Group D had the worst outcomes, highest levels of inflammation, fibrosis markers, and complications, as well as a significantly higher risk of critical outcomes after adjusting for age, body mass index, sex, total lung volume and comorbidities. In the 3-month longitudinal analysis, pneumonia volume, but not TAC, improved in critical cases. CONCLUSIONS: The integrated assessment of TAC and pneumonia volume effectively predicted critical outcomes in COVID-19 patients and may be useful for various respiratory diseases, including infectious or interstitial pneumonia. KEY POINTS: Question Total airway counts (TAC) on computed tomography (CT) scan is associated with respiratory disease progression, but clinical relevance of CT-based airway tree structure is unclear. Findings The integrated assessment of TAC and pneumonia volume effectively predicted critical outcomes in COVID-19 patients. Clinical relevance This metric can potentially be applied to various respiratory diseases, including infectious or interstitial pneumonia.

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Elevated 18F-FDG uptake in non-metastatic lymph nodes of POLE-mutated endometrial cancer on PET/CT.

Maho Kurihara, Yu Iwabuchi, Yoshitake Yamada, Atsushi Shimizu, Takuma Yoshimura, Kensuke Sakai, Tatsuyuki Chiyoda, Kohei Nakamura, Hiroshi Nishihara, Wataru Yamagami, Masahiro Jinzaki

European journal of radiology 195 112620 - 112620 2025.12

Accepted, ISSN 0720-048X

PURPOSE: DNA polymerase epsilon (POLE) exonuclease domain-mutated endometrial cancer (EC) is associated with a favorable prognosis and significant immune cell infiltration. Cancers with significant immune cell infiltration often exhibit higher maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT). This study aimed to evaluate the correlation between POLE status and FDG-PET/CT imaging in patients with EC. METHODS: This retrospective study enrolled 102 patients (mean age, 56.2 ± 11.8 years) with EC who underwent preoperative FDG-PET/CT between July 2018 and August 2023. Patients were categorized into molecular subtypes based on molecular profiling. SUVmax of the primary tumor and lymph nodes was measured, and correlations with molecular subtypes were examined. RESULTS: The SUVmax in the primary tumor of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (mean ± SD, 13.21 ± 4.78 vs 9.82 ± 3.78; p = 0.001). Multiple regression analysis showed that POLE status was associated with SUVmax in primary tumors (B = 2.30, p = 0.031). The SUVmax in non-metastatic lymph nodes of POLE-mutated ECs was higher than that in non-POLE-mutated ECs (median SUVmax, 1.31 [IQR, 1.05-2.21] vs. 1.06 [IQR, 0.91-1.20]; p = 0.003). Multiple regression analysis revealed that POLE status was the only factor associated with SUVmax in non-metastatic lymph nodes (B = 0.339, p = 0.046), while age, BMI, blood glucose level, histological type, and primary tumor size showed no significant association. CONCLUSION: Patients with POLE-mutated EC exhibit high SUVmax in primary tumors and also tend to show elevated uptake in non-metastatic lymph nodes.

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Consolidation-to-ground-glass opacity ratio on chest CT as a prognostic marker for critical outcomes in COVID-19: a retrospective cohort study.

Hiromu Tanaka, Naoya Tanabe, Shotaro Chubachi, Tomoki Maetani, Yusuke Shiraishi, Ho Namkoong, Takanori Asakura, Takashi Shimada, Shuhei Azekawa, Shiro Otake, Kensuke Nakagawara, Takahiro Fukushima, Mayuko Watase, Hideki Terai, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Yoshitake Yamada, Masahiro Jinzaki, Toyohiro Hirai, Yukinori Okada, Ryuji Koike, Makoto Ishii, Naoki Hasegawa, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga

BMC pulmonary medicine 25 ( 1 ) 550 - 550 2025.12

Accepted

BACKGROUND: Computed tomography (CT)-based quantification of coronavirus disease 2019 (COVID-19) pneumonia is widely performed, and total pneumonia volume, ground-glass opacity (GGO), and consolidation affect disease severity. However, there is insufficient information on how consolidation to GGO (C/G) ratio correlates with clinical characteristics including disease severity and complications in COVID-19 patients. METHODS: This retrospective cohort study included 1,194 hospitalized patients with COVID-19 from four member hospitals of the Japan COVID-19 Task Force. Critical outcomes were defined as conditions requiring high-flow oxygen or invasive mechanical ventilation, or death. Patients were divided into two groups based on %pneumonia (percentage of pneumonia volume divided by total lung volume) using receiver operating characteristic curve, and those with high %pneumonia were further divided into two groups based on C/G ratio. Critical outcomes and complications were then compared between high and low C/G ratio groups. RESULTS: The optimal cutoff value of %pneumonia to predict critical outcomes was 17.1%, classifying the included patients into low (Group 1, n = 900) and high (n = 294) %pneumonia groups. The optimal cutoff value of C/G ratio was 0.202, classifying patients in the high %pneumonia group into two groups: low (Group 2, n = 192) and high C/G (Group 3, n = 102) ratio groups. The incidence of critical outcomes was stair-step high in all three groups (2.1%, 21.4%, and 37.3%, respectively). Multivariable analysis revealed an independent relationship between C/G ratio and critical outcomes from other known risk factors (adjusted odds ratio: 1.92, 95% confidential interval: 1.03-3.59, P = 0.040). Group 3 also showed significantly higher serum C-reactive protein (Group 1: 2.96 mg/dL, Group 2: 8.90 mg/dL, Group 3: 11.4 mg/dL) and procalcitonin (Group 1: 0.16 ng/mL, Group 2: 0.25 ng/mL, Group 3: 1.19 ng/mL) levels and incidence of bacterial infection (Group 1: 5.6%, Group 2: 10.4%, Group 3: 20.3%), compared with other groups. CONCLUSIONS: CT-density analysis of COVID-19 pneumonia in a large patient population showed that C/G ratio was a significant predictor of critical outcomes and useful for prognosis evaluation.

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Diaphragmatic curvature analysis using dynamic digital radiography.

Takuya Hino, Akinori Tsunomori, Noriaki Wada, Akinori Hata, Taiki Fukuda, Yusei Nakamura, Yoshitake Yamada, Tomoyuki Hida, Mizuki Nishino, Masako Ueyama, Atsuko Kurosaki, Takeshi Kubo, Shoji Kudoh, Kousei Ishigami, Hiroto Hatabu

European journal of radiology open 15 100676 - 100676 2025.12

Accepted, ISSN 2352-0477

PURPOSE: To investigate area under diaphragm (AUD) obtained by dynamic digital radiography (DDR) for the differentiation between normal subjects and chronic obstructive pulmonary disease (COPD) patients. METHODS: This retrospective study included healthy volunteers and COPD patients recruited from 2009 to 2014 at Fukujuji Hospital, who received DDR and pulmonary functional test. AUD was defined as an area under a hemidiaphragm and above the line connecting the ipsilateral costophrenic angle to the top of the hemidiaphragm on DDR image. AUD in full inspiration minus AUD in full expiration (ΔAUD) was also calculated. The diaphragmatic surface was demarcated manually on DDR image to calculate AUD. Three-group comparison of AUD and ΔAUD among normal, mild COPD, and severe COPD subjects was tested with one-way analysis of variance, followed by multiple comparison with Tukey-Kramer method. The diagnostic accuracy of COPD by ΔAUD was assessed using receiver-operating-characteristics (ROC) curve. RESULTS: Sixty-eight participants (36 men, 29 COPD patients) were enrolled. AUD in full inspiration was larger in healthy volunteers than in COPD patients (right, p < 0.001; left, p = 0.02). ΔAUD were different in the three-group comparison (right, normal, 208.7 ± 184.6 mm2, mild COPD, -18.1 ± 117.5 mm2, severe COPD -97.5 ± 150.0 mm2, p < 0.001; left, normal, 254.9 ± 131.5 mm2, mild COPD, -12.5 ± 136.5 mm2, severe COPD, -100.7 ± 134.1 mm2, p < 0.001). ROC curve showed high diagnostic performance of COPD by unilateral ΔAUD (right, area-under curve 0.942; left, area-under-curve 0.965). CONCLUSION: The value of ΔAUD was smaller according to the severity of COPD. ΔAUD can be helpful in distinguishing healthy subjects from COPD patients.

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Effects of perirenal fat accumulation on cardiometabolic and renal functions and mineralocorticoid receptor activation in primary aldosteronism.

Ryunosuke Mitsuno, Toshifumi Nakamura, Kengo Nakamura, Kenji Kaneko, Daiki Kojima, Yosuke Mizutani, Yoshitake Yamada, Masahiro Jinzaki, Tatsuhiko Azegami, Takeshi Kanda, Kenichiro Kinouchi, Hiroshi Itoh, Jun Yoshino, Kaori Hayashi

Hypertension research : official journal of the Japanese Society of Hypertension 48 ( 12 ) 3244 - 3256 2025.12

Accepted, ISSN 0916-9636

Perirenal fat (PRF), an ectopic fat depot lying adjacent to kidneys, is a risk factor for cardiometabolic and renal dysfunctions in patients with obesity and type 2 diabetes. We aimed to investigate the involvement of PRF in the pathophysiology and treatment of primary aldosteronism (PA). To this end, we measured PRF volume by abdominal CT and evaluated the relationships among PRF volume, cardiometabolic and renin-angiotensin-aldosterone system (RAAS) parameters, and therapeutic response to mineralocorticoid receptor antagonist (MRA) treatment in well-phenotyped PA patients. In addition, we evaluated the effects of MRA treatment on inflammation and fibrosis, potential downstream targets of MR signaling, by analyzing PRF obtained from obese (db/db) mice. PRF volume (PRF%) and visceral fat volume (VFV) were associated with various cardiometabolic and renal risk markers and RAAS parameters, such as body mass index, creatinine, triglyceride, high-density lipoprotein cholesterol, uric acid, fasting glucose, C-reactive protein, 24-h urine aldosterone, and 24-h urine normetanephrine (all P < 0.05). PRF%, but not VFV, positively correlated with changes in systolic and diastolic blood pressure and initial estimated glomerular filtration rate (eGFR) fall following MRA treatment after adjusting for confounders (all P < 0.05). In addition, MRA treatment decreased PRF expression of markers of macrophage infiltration and fibrosis in db/db mice (all P < 0.05). In conclusion, our results suggest that PRF accumulation is involved in the mechanisms linking MR activation to cardiometabolic and renal dysfunctions in PA patients. Moreover, PRF could be not only a prognostic factor but also a new therapeutic target for MRA-resistant hypertension.

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Adipose-Muscle Crosstalk in COPD Cachexia: Early Adipose Atrophy Drives Subsequent Muscle Wasting.

Takashi Shimada, Shotaro Chubachi, Keisuke Nishikawa, Tetsuya Arai, Hideto Iizuka, Shiro Otake, Kaori Sakurai, Junko Hamamoto, Mamoru Sasaki, Tomoki Maetani, Naoya Tanabe, Katsunori Masaki, Hiroki Kabata, Jun Miyata, Yoshitake Yamada, Masahiro Jinzaki, Hidetoshi Nakamura, Koichiro Asano, Koichi Fukunaga

Journal of cachexia, sarcopenia and muscle 16 ( 6 ) e70154 2025.12

Accepted, ISSN 2190-5991

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is frequently associated with cachexia, leading to poor prognoses and reduced quality of life. However, the mechanisms underlying adipose tissue atrophy, its pathological significance and its interaction with skeletal muscle remain poorly understood. We hypothesised that adipose tissue atrophy precedes muscle wasting in COPD-associated cachexia, and muscle atrophy progresses through adipose-muscle crosstalk. METHODS: We analysed chest computed tomography scans of 185 patients with COPD to quantify the cross-sectional areas of the pectoralis muscle (PM), subcutaneous adipose tissue (SAT) and epicardial adipose tissue (EAT), and the percentage of low attenuation area (LAA%) as an index of emphysema. To elucidate the pathophysiological mechanisms underlying cachexia in COPD, we performed histological and molecular analyses of the lung, muscle and adipose tissues over time in a cigarette smoke-induced emphysema mouse model. Further, we used an in vitro culture system of differentiated adipocytes (3T3-L1) and myotubes (C2C12) to study the effects of cigarette smoke extract (CSE) on adipose-muscle interaction. RESULTS: In patients with COPD, the areas of PM, SAT and EAT all demonstrated significant negative correlations with LAA%; notably, PM and EAT were independently associated with the extent of emphysematous changes. In the smoke-exposed murine model, adipose tissue atrophy was observed after 1 month of exposure, accompanied by increased expressions of IL-6 and IL-1β, macrophage infiltration and the upregulation of the lipolytic enzymes ATGL and HSL. The adipose atrophy had further progressed after 3 months of exposure, and the high expression of UCP1 was sustained, which suggested the browning of adipose tissue. Conversely, muscle atrophy was not evident at 1 month but became apparent after 3 months, coinciding with emphysema development. This was associated with the downregulation of the myogenic markers MyoD and Myogenin and the upregulation of the muscle degradation marker Atrogin-1. In vitro experiments revealed that CSE exposure reduced lipid droplet content and induced IL-6 and IL-1β expressions in adipocytes. Conditioned media from CSE-treated adipocytes triggered myotube atrophy and downregulated MyoD and Myogenin but upregulated Atrogin-1. CONCLUSIONS: Our findings indicate that cigarette smoke-induced adipose tissue atrophy precedes muscle wasting, and alterations in adipose tissue may contribute to muscle atrophy progression. Adipose tissue dysfunction may be implicated in the development of cachexia in patients with COPD, highlighting its potential as a therapeutic target.

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Intraabdominal fat-free volume, but not fat volume, predicts the development of peritonitis in patients on peritoneal dialysis: a retrospective cohort study

Ryunosuke Mitsuno, Kohkichi Morimoto, Kenji Kaneko, Daiki Kojima, Toshifumi Nakamura, Takashin Nakayama, Eriko Yoshida Hama, Shun Tonomura, Yoshitake Yamada, Masahiro Jinzaki, Kiyotaka Uchiyama, Naoki Washida, Takeshi Kanda, Tatsuhiko Azegami, Tadashi Yoshida, Jun Yoshino, Kaori Hayashi

Renal Replacement Therapy (Springer Science and Business Media LLC) 11 ( 1 ) 2025.12

Abstract

Introduction

Increased intraabdominal fat volume (IAFV) is associated with systemic inflammation and various cardiometabolic diseases. However, the clinical implication of IAFV in patients on peritoneal dialysis (PD) is unclear. In addition, the association of intraabdominal fat-free volume (IAFFV), which could mainly reflect the volume of visceral organs that serve as a potential source of inflammatory uremic toxins, with PD-associated clinical outcomes remains unknown.

Methods

We retrospectively measured IAFV and IAFFV in the 108 patients on PD using abdominal computed tomography at initiation of PD. The participants were followed up until PD cessation, death, or study completion. We investigated the relationships between IAFV and IAFFV and the risks of peritonitis and PD discontinuation (defined by a composite endpoint of death or transfer to hemodialysis).

Results

The median follow-up period was 46 (interquartile range 24–82) months. The baseline obesity-related traits significantly (P < 0.05) differed between high-IAFV (≥ 2935 cm3) and low-IAFV (< 2935 cm3) groups. However, the log-rank tests found no differences in the incidence of peritonitis and PD discontinuation between groups. In contrast, both peritonitis-free survival and time on PD therapy were shorter in high-IAFFV (≥ 4796 cm3) group than in low-IAFFV (< 4796 cm3) group (all P < 0.05). In the Cox regression models, IAFFV remained a strong risk factor for peritonitis even after adjusting for confounders (hazard ratio: 2.16, 95% confidence interval: 1.07–4.38).

Conclusions

We demonstrate that IAFFV is an independent risk factor of peritonitis in patients o nPD. Additional studies are needed to identify specific intraabdominal component(s) involved in the pathogenesis of PD-associated adverse events.

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CT-based phenotyping of COVID-19: cluster analysis of pulmonary and extrapulmonary imaging markers from a multicentre retrospective cohort study.

Shiro Otake, Naoya Tanabe, Shotaro Chubachi, Tomoki Maetani, Yusuke Shiraishi, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Takashi Shimada, Shuhei Azekawa, Kensuke Nakagawara, Takahiro Fukushima, Mayuko Watase, Hideki Terai, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Yoshitake Yamada, Masahiro Jinzaki, Toyohiro Hirai, Yukinori Okada, Ryuji Koike, Makoto Ishii, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga

Scientific reports 15 ( 1 ) 42116 - 42116 2025.11

Accepted

Coronavirus disease 2019 (COVID-19) displays a highly variable clinical course despite advancements in vaccination and antiviral therapies. Chest computed tomography (CT) has become a valuable tool for diagnosing and predicting COVID-19 severity; however, limited studies have explored integrating pulmonary and extrapulmonary CT markers to identify distinct clinical phenotypes. In this study, we aimed to evaluate the utility of cluster analysis, using quantitative pulmonary and extrapulmonary CT indicators, to classify patients with COVID-19 into distinct phenotypic clusters and assess their clinical relevance in predicting disease severity and outcomes. The primary outcome was the rate of critical outcomes (requiring high-flow oxygen therapy or invasive ventilator support or death). In this multicentre, retrospective cohort study, we analysed 1,034 patients with COVID-19 from four hospitals in Japan. Hierarchical cluster analysis was performed using age, sex, and seven imaging markers: pneumonia volume, muscle area, muscle density, subcutaneous and visceral fat indices, bone density, and coronary artery calcification score. Clinical characteristics, laboratory findings, and outcomes were compared across the identified clusters. Four distinct clusters were identified. Cluster 1 consisted of younger individuals with minimal pneumonia and favourable extrapulmonary organ markers, exhibiting the best clinical outcomes. Cluster 2 included younger patients with high pneumonia volume and visceral fat accumulation, exhibiting poor respiratory outcomes. Cluster 3 comprised older individuals with mild fat accumulation and low bone density, with intermediate severity. Cluster 4 presented the highest pneumonia volume, extensive visceral fat, and coronary artery calcification, resulting in the worst overall prognosis, including the highest mortality and in-hospital complications. Clustering based on pulmonary and extrapulmonary CT indicators enabled the precise classification of patients with COVID-19 into clinically significant subgroups with distinct outcomes. This study highlights the importance of integrating multiple imaging markers for disease phenotyping and prognosis.

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Three-dimensional simulation of wall impingement and graft bending in anatomical double-bundle ACL reconstruction using weight-bearing upright multi-detector CT.

Ryo Sasaki, Yasuo Niki, Kazuya Kaneda, Yoshitake Yamada, Kengo Harato, Shu Kobayashi, Takeo Nagura, Masaya Nakamura, Masahiro Jinzaki

The Knee 58 104277 - 104277 2025.11

Accepted, ISSN 0968-0160

PURPOSE: Graft-notch impingement and large graft bending angle (GBA) in anterior cruciate ligament reconstruction (ACLR) carry a risk of graft failure and subsequent poor postoperative outcomes. Most studies have analyzed the impingement rate and GBA using computed tomography (CT) in the supine position, but not in the standing condition. This study aimed to assess the graft impingement and GBA using upright multi-detector CT (MDCT). METHODS: We analyzed 43 knee joints of 23 healthy volunteers (women, n = 13; men, n = 10) in a single-leg standing position using an upright 320-detector-row CT. We defined the putative position of the graft tunnel in three-dimensional models and assessed the impingement rate and GBA of both the anteromedial (AMB) and posterolateral bundles (PLB). RESULT: The impingement rate for the AMB with a 6-mm graft diameter (81.4 %) was significantly higher than that for the PLB (0.7 %; P < 0.001). The modified AMB tunnel position, which connects the midpoint between the traditional AM and PL tunnel apertures of the femur to the most medial point within the tibial AM footprint, reduced the impingement rate by 14.0 % (P < 0.001). The impingement rate of the modified AMB with a 10-mm graft diameter (32.6 %) was significantly lower than that of the traditional AMB with a 6-mm graft diameter (81.4 %; P < 0.001). The GBA of the modified AMB was significantly smaller than that of the traditional AMB (P < 0.001). CONCLUSION: This study indicated high graft-notch impingement rates and large GBA for traditional AMB in the standing position, highlighting potential biomechanical challenges associated with traditional double-bundle ACLR configurations.

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Extent of pulmonary involvement on admission predicts long-term pulmonary and muscular sequelae of COVID-19: A longitudinal computed tomography study.

Takashi Shimada, Naoya Tanabe, Shotaro Chubachi, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Shuhei Azekawa, Shiro Otake, Kensuke Nakagawara, Takahiro Fukushima, Mayuko Watase, Tomoki Maetani, Yusuke Shiraishi, Hideki Terai, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Yoshitake Yamada, Masahiro Jinzaki, Toyohiro Hirai, Yukinori Okada, Ryuji Koike, Makoto Ishii, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga

Respiratory investigation 63 ( 6 ) 1215 - 1220 2025.11

Accepted, ISSN 2212-5345

BACKGROUND: Studies on the association between chest computed tomography (CT) findings of extensive pulmonary involvement and long-term pulmonary and extrapulmonary coronavirus disease 2019 (COVID-19) sequelae are lacking. This study aimed to investigate the relationship between the severity of pneumonia on admission and residual pulmonary and extrapulmonary complications at three months post-hospitalization. METHODS: Using data from the Japan COVID-19 Task Force database, we conducted quantitative analysis of CT scans of 164 patients obtained at admission and three months later. The parameters included pneumonia volume, total lung volume, and area and density of the pectoralis muscle (PM), subcutaneous and epicardial adipose tissue, and vertebral bone density. RESULTS: Patients with extensive pneumonia on admission had high residual pneumonia volumes, reduced lung volumes, and decreased area and density of PM at three months. No significant differences were observed in the adipose tissue or bone parameters. The severity of pneumonia at admission was independently associated with PM atrophy. CONCLUSIONS: CT-based quantification of pneumonia extent during the acute phase of COVID-19 may be useful in predicting long-term pulmonary sequelae and muscle wasting. This approach may allow the objective evaluation of Long COVID and facilitate the identification of potential therapeutic targets.

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Japanese Radiology 2025 Updates.

Mami Iima, Tsukasa Saida, Yoshitake Yamada, Ryo Kurokawa, Daiju Ueda, Maya Honda, Kentaro Nishioka, Rintaro Ito, Keitaro Sofue, Shinji Naganawa

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes 8465371251374557 - 8465371251374557 2025.10

Accepted, ISSN 0846-5371

This review provides a comprehensive overview of recent transformative advancements in diagnostic imaging that position Japan at the forefront of radiological innovation. We highlight pivotal innovations that enhance diagnostic capabilities and redefine clinical workflows. The article begins with upright multidetector computed tomography (MDCT), a groundbreaking technology offering novel insights into posture-dependent anatomical and physiological changes. We then explore significant progress in breast and gynecologic imaging, including advancements in artificial intelligence computer-aided (AI-CAD) synthesized mammograms, automated breast ultrasound (ABUS), and abbreviated MRI protocols. These innovations address unique regional challenges in early cancer detection. Significant innovations in abdominal radiology, spanning advanced CT (including photon-counting detector CT), accelerated MRI, and AI applications, are also discussed. The review further delves into glymphatic system research, where advanced MRI techniques, particularly DTI-ALPS, are unraveling new insights into brain waste clearance and neurological disorders. Finally, we examine the future of Japanese radiology through the lens of AI, with a focus on Large Language Models (LLMs). We discuss their growing role in diagnostic support, report generation, and information extraction, as well as important societal and ethical considerations. These collective advancements underscore Japan's dynamic contributions to radiological innovation, poised to significantly impact global healthcare practices by improving disease detection, optimizing workflows, and extending healthy life expectancy in an aging society.

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Kinematic and Kinetic Effects of 10-Degree Coronal Wedge Floors on Lower Limb Joints During Static Standing: An Upright Multidetector-Row CT Study.

Hiroyuki Seki, Naomichi Ogihara, Akimasa Ito, Asahi Sujino, Yoshitake Yamada, Minoru Yamada, Yoichi Yokoyama, Masaya Nakamura, Takeo Nagura, Masahiro Jinzaki

Foot & ankle international 46 ( 10 ) 10711007251361132 - 1202 2025.09

Accepted, ISSN 1071-1007

BACKGROUND: Coronal wedge insoles are commonly prescribed to mitigate musculoskeletal disorders, yet their static-standing kinematic and kinetic effects on lower extremity joints remain insufficiently understood. METHODS: This cross-sectional experimental study included 15 healthy older adults (mean 64.9 ± 6.0 y; 11 females, 4 males) who underwent CT imaging of the entire lower limbs during static standing. Ground reaction forces (GRFs) were simultaneously recorded using right and left force plates, with their sum equal in magnitude and opposite in direction to the body weight vector. Three floor conditions were tested: a 10-degree medial wedge, a flat surface, and a 10-degree lateral wedge. Lower limb alignment, GRF vector inclinations, projected GRF location at the height of the joint center, and external joint moments were assessed under 3 floor conditions. RESULTS: Coronal wedges altered hip and subtalar joint angles, with medial wedges inducing hindfoot supination and hip abduction, whereas lateral wedges promoted hindfoot pronation and hip internal rotation. The GRF vector was found to generally pass lateral to the tibiotalar and subtalar joints and medial to the hip joint, generating eversion and adduction moments, respectively. Notably, these moments increased on the lateral wedge but were reduced on the medial wedge. In contrast, projected GRF location at joint height remained near the knee joint center across all conditions, resulting in minimal varus/valgus knee moments. CONCLUSION: This study provides the first quantifications of the 3-dimensional GRF vector concerning joint centers during static standing; these exploratory findings warrant confirmation during gait and in symptomatic cohorts. Our study suggests that lateral wedges tend to increase external joint moments at the hip and tibiotalar. Although further investigation is needed, these mechanical effects at the hip may have potential relevance and should be considered with caution when prescribing lateral wedge insoles.

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Comparison of supine and upright postures for liver respiratory motion management in radiotherapy.

Yusuke Nomura, Taku Inaniwa, Yoshitake Yamada, Minoru Yamada, Yoichi Yokoyama, Sodai Tanaka, Shunsuke Yonai, Hideyuki Mizuno, Yoshiyuki Iwata, Atsuya Takeda, Hitoshi Ishikawa, Masahiro Jinzaki

Medical physics 52 ( 9 ) e18111 2025.09

Accepted, ISSN 0094-2405

BACKGROUND: Understanding respiratory motions of liver and its surrogate organs is crucial for precise dose delivery in liver cancer radiotherapy. Although these motions have been studied for respiratory motion management in the supine posture, few studies have quantified them and evaluated their correlations in the upright posture. PURPOSE: This study quantified the respiratory motions of liver and surrogate organs and evaluated the correlations between the liver motions and surrogate signals for respiratory motion monitoring in both the supine and upright postures. METHODS: 4D dynamic volume computed tomography (CT) images were acquired from 13 asymptomatic volunteers in both supine and upright postures while free breathing. The 4D liver motions were calculated by performing deformable image registration. Subsequently, superior-inferior (SI) motion at the right diaphragm apex and anterior-posterior (AP) motion at the abdominal skin surface were obtained as surrogate signals from the 4D CT images. The average displacements and maximum magnitudes of liver motions and surrogate signals were compared between the postures. Moreover, the correlations between the liver motions and surrogate signals were evaluated based on correlation models. RESULTS: The average liver displacements from the end-exhalation along the SI, AP, and left-right directions were -6.1, 2.1, and -0.4 mm in the supine posture and -4.6, 2.5, and 0.1 mm in the upright posture, respectively. The maximum motion range along the SI direction significantly decreased from 16.3 ± 6.6 mm in the supine posture to 11.0 ± 2.7 mm in the upright posture. Similar to the supine posture, the correlation models also reproduced the liver motions with high fitting accuracy in the upright posture. CONCLUSIONS: Compared to the conventional supine posture, the liver SI motion became smaller in the upright posture while keeping evident correlations with the surrogate signals, which suggests the upright posture will allow precise dose delivery with reduced internal target margins.

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Upright multidetector CT with 320-row gantry: a technical innovation providing insights into human anatomy under gravity and potential clinical implications.

Masahiro Jinzaki, Minoru Yamada, Yoichi Yokoyama, Takehiro Nakahara, Takeo Nagura, Yoko Inamoto, Fumiko Yagi, Orito Ikeda, Mohammed Alshahri, Katsuhiro Mizutani, Yoshitake Yamada

The British journal of radiology 98 ( 1175 ) 1754 - 1765 2025.08

Accepted, ISSN 0007-1285

CT performed in the supine position has been highly effective in diagnosing organic diseases such as cancer, arteriosclerosis, and infections, significantly contributing to increased life expectancy. In an aging society, extending healthy life expectancy becomes more critical, requiring early diagnosis of functional disorders. We have led the industry-academia collaboration in developing an upright MDCT system. Although this system maintains the same physical specifications as conventional MDCT, it differs significantly in imaging configuration-allowing supine, upright, and sitting positions-and offers improved workflow while requiring only two-thirds of the installation space. Unlike conventional MDCT, it allows for the assessment of anatomical changes under gravity. It also enables the objective diagnosis and grading of functional diseases, in which findings were not apparent on conventional CT, and enable the study of the pathogenesis of functional diseases which worsen symptoms in the upright position. Furthermore, it allows for noninvasive evaluation of dynamic functions such as swallowing and voiding, which can only be assessed in standing or sitting positions.

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Distinctive features of upright CT myelography in patients with lumbar spine degenerative diseases.

Soya Kawabata, Yuki Akaike, Sota Nagai, Takaya Imai, Hiroki Takeda, Kei Ito, Shinjiro Kaneko, Kota Watanabe, Takeo Nagura, Morio Matsumoto, Masaya Nakamura, Yoshitake Yamada, Masahiro Jinzaki, Yoshiharu Ohno, Masanori Inoue, Nobuyuki Fujita

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 34 ( 10 ) 4496 - 4504 2025.08

Accepted, ISSN 0940-6719

PURPOSE: Recently, a full-body upright computed tomography (CT) scanner has been developed, which when combined with myelography, is expected to provide valuable insights into the pathology of lumbar spine degenerative diseases (LSDD). This study aims to elucidate the distinctive features of upright CT myelography (CTM) in LSDD by comparing it with supine magnetic resonance imaging (MRI). METHODS: This study included 110 patients who underwent both supine MRI and upright CTM for LSDD. The anteroposterior diameter (APD), transverse diameter (TD), and area of the dural sac were measured from L1/2 to L5/S1. Lumbar lordosis (LL) was also measured in both modalities. RESULTS: The APD of the dural sac was significantly smaller at L2/3 and L4/5, while the TD was significantly larger at L1/2 and L2/3 on upright CTM compared to supine MRI. The dural sac area was significantly larger at L1/2 and smaller at L4/5 on upright CTM. Subgroup analysis divided patients into Group I (LL greater in upright CTM, n = 56) and Group D (LL smaller in upright CTM, n = 54). The dural sac area was significantly smaller at L3/4 and L4/5 in Group I and larger at L1/2 in Group D on upright CTM. CONCLUSIONS: Changes in the APD, TD and area of the dural sac during the transition from supine to standing were markedly dependent on the intervertebral level. These parameters were also influenced by patterns of change in LL between the two positions. Upright CTM revealed diverse position-related morphological changes in the lumbar dural sac in LSDD patients.

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