Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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屋代香絵, 山田祥岳, 津崎盾哉, 池田織人, 新妻雄介, 山田実加, 城谷良太, 真杉洋平, 上野彰久, 田中真之, 平田賢郎, 陣崎雅弘

臨床放射線 (金原出版(株)) 70 ( 4 ) 559 - 566 2025.07

ISSN 0009-9252

Interstitielle Lungenerkrankungen im Kindesalter: Aktuelles Verständnis von Klassifikation und bildgebenden Befunden

Yuko Tsujioka, Gen Nishimura, Eugene Nishi, Tatsuo Kono, Taiki Nozaki, Masahiro Hashimoto, Yoshitake Yamada, Masahiro Jinzaki

Kompass Pneumologie 2025.06

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Future Applications of Cardiothoracic CT.

Mark L Schiebler, Masahiro Jinzaki, Masahiro Yanagawa, Amir Pourmorteza, Yoshitake Yamada, Yoko Kato, Noriaki Wada, Cornelia Schaefer-Prokop, Vincent Dousset, Noriyuki Tomiyama, Mathias Prokop, João A Lima, Hiroto Hatabu

Radiology 315 ( 3 ) e240085 2025.06

Accepted, ISSN 0033-8419

Radiologists are witnessing astonishing innovation and advancement of CT technologies and their clinical applications. This review highlights how photon-counting CT (PCCT), upright CT, and artificial intelligence (AI) may impact cardiothoracic CT applications for imaging and diagnosis. PCCT relies on new detectors that can bin the separate photon energies and allow for lower radiation dose and better spatial resolution. The clinical applications of PCCT in the coronary arteries are becoming the new standard for cardiac CT imaging. New upright CT has shown the benefits of imaging in the upright position and offers new insight into how the upright position affects biomechanics and physiology. Four-dimensional CT, which can be used to directly image perfusion, is challenging MRI and MR angiography for primacy in this area. The burgeoning role of AI and informatics is changing the way radiologists interpret and report many imaging examinations. The future is bright and promises lower radiation and intravenous contrast agent doses and higher spatial resolution, and will further incorporate deep learning to improve the effectiveness of CT.

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Imaging of the umbilicus.

Fumiko Yagi, Hirotaka Akita, Yoshitake Yamada, Masahiro Jinzaki

Abdominal radiology (New York) 50 ( 12 ) 6201 - 6213 2025.05

Accepted, ISSN 2366004X

The umbilicus is a scar of the umbilical cord containing various embryonic remnants that can lead to postnatal diseases. It is the collection point for blood and lymphatic flow and other structures. Hence, various diseases and conditions can occur. In this review, we aimed to categorize umbilical diseases based on the embryonic remnants, including urachal remnants, omphalomesenteric duct anomalies, and complications of the umbilical arteries and veins. The urachus, formed from the allantois, can result in anomalies such as patent urachus and urachal cysts, with infections being the most common complication. Radiologists must note that urachal carcinoma is a rare complication presenting with characteristic imaging findings. The omphalomesenteric duct can lead to Meckel's diverticulum, the most prevalent gastrointestinal anomaly. In addition, obliterated umbilical arteries and veins can cause various conditions, including hernias and abscesses. This review also summarizes the umbilical ring lesions, such as gastroschisis and omphalocele, and iatrogenic lesions associated with laparoscopic procedures and catheter placement. Imaging techniques such as ultrasound, computed tomography, and magnetic resonance imaging are crucial for diagnosing and managing these conditions. Understanding the embryological basis and imaging features of umbilical diseases is vital for timely diagnosis and treatment.

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原発性アルドステロン症における腎周囲脂肪蓄積の臨床的意義の検証

満野竜ノ介, 中村俊文, 金子賢司, 児島大輝, 中村健吾, 水谷洋佑, 山田祥岳, 陣崎雅弘, 畔上達彦, 神田武志, 木内謙一郎, 吉野純, 林香

日本内分泌学会雑誌 ((一社)日本内分泌学会) 101 ( Suppl.Update ) 42 - 44 2025.05

ISSN 0029-0661

原発性アルドステロン症患者81例のCT画像から腎周囲脂肪(PAT)容量を計測し、心代謝疾患の危険因子やミネラルコルチコイド受容体拮抗薬による治療開始後初期の腎機能の変化との関連について検討した。その結果、%PAT(腎周囲脂肪容量-内臓脂肪容量比)は原発性アルドステロン症の診断時のbody mass index(BMI)、血清クレアチニン濃度、eGFR値、血清尿酸濃度、血清中性脂肪濃度などの心代謝疾患の危険因子と有意な相関関係を認めた。年齢、性別、BMI、病型・局在などの交絡因子で調整した線形重回帰分析でも、PATの蓄積はミネラルコルチコイド受容体拮抗薬による治療開始後初期の腎機能低下と有意に相関した。原発性アルドステロン症において、PAT蓄積は心代謝機能障害およびミネラルコルチコイド受容体拮抗薬による治療開始後初期の腎機能低下に関与することが示唆された。

Simulation Study of Upright Prostate Radiation Therapy: Comparison of Upright and Supine Anatomy and Dose-Volumetric Factors.

Kohei Oguma, Yoshitake Yamada, Naoyoshi Koike, Junichi Fukada, Minoru Yamada, Yoichi Yokoyama, Atsuya Takeda, Naoyuki Shigematsu, Masahiro Jinzaki

Practical radiation oncology 15 ( 5 ) 497 - 508 2025.04

Accepted, ISSN 1879-8500

PURPOSE: This study aimed to assess the feasibility of upright radiation therapy for prostate cancer, compared to conventional supine radiation therapy, by quantitatively evaluating anatomic changes and their dosimetric impact through treatment planning simulations based on paired upright and supine positioning computed tomography (CT) images. METHODS AND MATERIALS: This study compared pelvic organ anatomies and dose distributions, in hypothetical prostate cancer patients, between upright and supine prostate radiation therapy using paired CT images from asymptomatic volunteers. Anatomic changes in pelvic organ position, shape, volume, and rectal gas were quantitatively evaluated. Prostate radiation therapy was simulated on these CT images for volumetric modulated arc therapy with a prescribed dose of 60 Gy in 20 fractions. Dosimetric comparisons were performed using dose-volume histogram parameters based on a clinical protocol. RESULTS: Fifty-one asymptomatic volunteers were registered. Compared to the supine position, pelvic organs in the upright position moved inferiorly (prostate: 2.8 mm ± 5.2, rectum: 2.9 mm ± 5.8, bladder: 3.7 mm ± 6.9, bowel: 25.2 mm ± 18.6; all P < .001). Rectal gas moved superiorly (4.8 mm ± 11.9; P = .004) and posteriorly (10.7 mm ± 23.5; P = .008). All dose-volume histogram parameters met the dose constraints, and the dose distributions of the upright and supine plans were clinically comparable in terms of organ-at-risk sparing and target coverage (P > .05). In some cases, the rectum curved more posteriorly in the upright position, allowing better sparing of high-dose areas, and the bladder moved inferiorly while expanding in the anterior-posterior direction in the upright position, preventing the small bowel from dropping into the radiation field. CONCLUSIONS: Our treatment planning simulation showed that upright radiation therapy for prostate cancer is feasible with a dose distribution comparable to that of conventional supine radiation therapy, despite significant anatomic changes in pelvic organ positioning between the upright and supine patient positions.

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Long-Term Impact of Early Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Implantation.

Juri Iwata, Kentaro Hayashida, Ryo Arita, Tomonari Moriizumi, Akiyoshi Kajino, Shingo Sakata, Toshinobu Ryuzaki, Keitaro Shinada, Hikaru Tsuruta, Yoshitake Yamada, Jungo Kato, Tatsuo Takahashi, Masataka Yamazaki, Masahiro Jinzaki, Hideyuki Shimizu, Masaki Ieda

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 105 ( 5 ) 1161 - 1170 2025.04

Accepted, ISSN 1522-1946

BACKGROUND: Hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) detected on multidetector computed tomography (MDCT) is considered leaflet thrombosis. However, its impact on long-term clinical outcomes remains unclear. This study aimed to investigate the impact of early HALT detection after TAVI on long-term clinical outcomes and structural valve deterioration beyond 6 years. METHODS: Of the 672 consecutive patients who underwent TAVI between 2013 and 2018, 448 were treated with either SAPIEN XT or SAPIEN 3 and underwent MDCT analysis within 30 days after TAVI. MDCT results and echocardiographic data were analyzed annually. RESULTS: HALT was detected in 68 (15.2%) of 448 eligible patients within 30 days after TAVI. No significant difference in effective orifice area was observed by echocardiography within 30 days after TAVI between the HALT and the non-HALT groups in SAPIEN XT (HALT vs. non-HALT: 1.62 ± 0.66 cm2 vs. 1.72 ± 0.43 cm2; p = 0.26) and in SAPIEN 3 (1.42 ± 0.35 cm2 vs. 1.45 ± 0.34 cm2; p = 0.63). No significant differences in all-cause mortality (52.9% vs. 60.0%; hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.83-1.70; p = 0.3), stroke incidence (5.9% vs. 7.1%; HR: 1.06; 95% CI: 0.08-13.7; p = 0.97), heart failure rehospitalization (10.3% vs. 15.0%; HR: 2.3; 95% CI: 0.89-5.99; p = 0.09), and structural valve deterioration (14.7% vs. 17.9%; HR: 0.89; 95% CI: 0.45-1.73; p = 0.73) were observed between the HALT and the non-HALT groups during the median follow-up of 1872 (interquartile range; 1203-2468) days. CONCLUSIONS: HALT within 30 days was not associated with clinical outcomes or hemodynamic performance during long-term follow-up.

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Imaging findings of thyroid diseases in children.

Yuko Tsujioka, Yoshitake Yamada, Tomonobu Hasegawa, Masahiro Hashimoto, Masahiro Jinzaki

Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology 34 ( 2 ) 89 - 104 2025.04

Accepted, ISSN 0918-5739

We review the imaging findings in pediatric thyroid diseases that necessitate prompt diagnosis and timely medical intervention. Congenital hypothyroidism particularly represents a critical pediatric emergency. Ultrasonography stands as the primary modality for accurately assessing thyroid morphology and identifying thyroid dysgenesis. 123I-scintigraphy mirrors iodine metabolism and thyroid hormone synthesis, and the concurrent application of perchlorate (perchloride discharge test) elucidates the pathogenesis of thyroid dyshormonogenesis. Nonetheless, radioiodine scintigraphy has seen limited utilization due to the intricacies of pre-test preparation. 99mTc-pertechnetate scintigraphy demonstrates high sensitivity in delineating thyroid tissues with minimal radiation exposure, facilitating the diagnosis of thyroid dysgenesis. Additionally, we have included brief insights on the imaging characteristics of central hypothyroidism, thyroiditis, and thyroid masses.

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Simultaneous quantification of lower limb skeletal posture and ground reaction forces using upright computed tomography: Potential implications for osteoarthritis assessment and treatment.

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

Journal of biomechanics 183 112630 - 112630 2025.04

Accepted, ISSN 0021-9290

Understanding the transmission of forces through the joints of the lower limb under weight-bearing conditions is critical for assessing the progression of knee and ankle osteoarthritis, as well as for developing effective surgical and preventive strategies. This study presents the first simultaneous quantification of three-dimensional skeletal posture and ground reaction force vectors during quiet standing, utilizing upright computed tomography and a custom-made force plate. We constructed the force plate using two six-axis force sensors, and the coordinate system of the CT was aligned with that of the force plate using metal spheres attached to the edges of the force plate. This system enabled precise measurement of ground reaction force vectors relative to the skeletal posture. The present study demonstrated that the load-bearing axis (the line connecting the femoral head center to the midpoint of the distal tibial plafond) in healthy subjects during quiet standing is not identical to the actual line of force application. The analysis revealed that the force vectors generally pass slightly medioposterior to the femoral head center. By providing a detailed view of how force is transmitted through the lower limb joints, this system potentially offers new insights into joint loading patterns that possibly contribute to osteoarthritis development.

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立位・臥位CTにより肺容積の体位性変化を評価できた横隔膜ヘルニアの1例

杉野功祐, 鈴木嵩弘, 山田祥岳, 横山陽一, 山田稔, 大久保祐, 政井恭兵, 加勢田馨, 菱田智之, 朝倉啓介, 陣崎雅弘

日本呼吸器外科学会雑誌 ((一社)日本呼吸器外科学会) 39 ( 3 ) P31 - 7 2025.04

ISSN 0919-0945

Pearls and pitfalls in imaging of axial spondyloarthritis for rheumatologists.

Taiki Nozaki, Yuko Tsujioka, Hideharu Sugimoto, Yoshitake Yamada, Minoru Yamada, Youichi Yokoyama, Hitomi Fujishiro, Akimoto Nimura, Junya Tsuzaki, Manabu Hase, Masato Okada, Yuko Kaneko, Masahiro Jinzaki

Modern rheumatology 35 ( 4 ) 612 - 625 2025.03

Accepted, ISSN 1439-7595

This review provides key insights into sacroiliitis imaging, covering anatomy, imaging techniques, and interpretation. It focuses on normal physiological changes in young to middle-aged women, children, and the elderly that can resemble sacroiliitis. We emphasize the importance of distinguishing between active and structural lesions, as highlighted in the recent ASAS-SPARTAN standardized magnetic resonance imaging protocol. Physicians should be aware that bone marrow oedema signals on magnetic resonance imaging, a hallmark of active inflammation in axial spondyloarthritis, can also be observed in young to middle-aged women, especially postpartum, even without spondyloarthritis. Paediatric sacroiliac joints may show changes mimicking inflammation due to ongoing bone growth. Furthermore, degenerative changes in the sacroiliac joint are common with advancing age and can be mistaken for sacroiliitis or interpreted as structural changes. The presence of accessory sacroiliac joints, prone to degeneration, further complicates diagnosis. Accurate interpretation requires considering these normal variations to avoid misdiagnosing spondyloarthritis. Collaboration between clinicians and radiologists is crucial, especially when encountering atypical or clinically inconsistent findings.

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Exploring the pathophysiology of anemia in COPD: Insights from chest CT and longitudinal clinical data.

Aya Takizawa, Takashi Shimada, Shotaro Chubachi, Tetsuya Arai, Akira Miyakawa, Hideto Iizuka, Shiro Otake, Kaori Sakurai, Naoya Tanabe, Yoshitake Yamada, Masahiro Jinzaki, Hidetoshi Nakamura, Koichiro Asano, Koichi Fukunaga

Respiratory medicine 240 108046 - 108046 2025.03

Accepted, ISSN 0954-6111

BACKGROUND: Although anemia has been associated with chronic obstructive pulmonary disease (COPD) severity, the underlying risk factors, such as chest imaging indicators, remain poorly understood. In this study, we aimed to investigate the relationship between anemia and clinical features, including pulmonary and extrapulmonary indicators on chest computed tomography (CT), and to clarify the pathophysiology of anemia in COPD. METHODS: A total of 400 patients with COPD were prospectively followed for 3 years. Anemia was defined as hemoglobin <13 g/dl in males and <12 g/dl in females. Patients were categorized into the anemia and non-anemia groups, and their clinical characteristics were compared. RESULTS: The anemia group exhibited lower percentage of predicted forced expiratory volume in 1 s (%FEV1) and body mass index (BMI) measurements, worse COPD assessment test (CAT) scores, and more frequent exacerbations. Imaging revealed more severe emphysema, lower cross-sectional areas of the pectoralis and erector spinae muscles, decreased subcutaneous fat, and more severe coronary artery calcification in this group. Additionally, echocardiography demonstrated a higher prevalence of pulmonary hypertension and reduced left ventricular ejection fraction in patients with anemia. Three-year longitudinal data analysis further showed that declining hemoglobin levels correlated with the worsening of nutritional status, a deterioration in bone mineral density (BMD), and an increase in CAT scores. CONCLUSION: Anemia in COPD is a multifactorial comorbidity resulting in emphysema, decreased fat and muscle mass, and reduced BMD.

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Discrepancies in long-leg alignment and knee joint line obliquity between two- and three-dimensional measurements under weight-bearing conditions: Effects on coronal plane alignment of the knee classification.

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

The Knee 53 237 - 245 2025.03

Accepted, ISSN 0968-0160

BACKGROUND: Long-leg alignment and joint line obliquity have traditionally been assessed using two-dimensional (2D) radiography, but the accuracy of this measurement has remained unclear. This study aimed to evaluate the accuracy of 2D measurements of lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) using upright three-dimensional (3D) computed tomography (CT). METHODS: This study involved 66 knees from 38 patients (34 women, four men) with knee osteoarthritis (OA), categorized by Kellgren-Lawrence (KL) grade. Patients underwent standing long-leg radiography (LLR) and upright CT. Flexion and rotation angles of the femur and tibia were measured from upright CT data, and knees were classified by coronal plane alignment of the knee (CPAK) according to 2D- and 3D-LDFA/MPTA. RESULTS: Overall, as KL grade increased, femoral external rotation and flexion increased significantly (P < 0.05). Regarding the tibia, flexion increased (P < 0.05) while rotation remained unchanged with increasing KL grade. In mild OA (KL1 or KL2), 2D-LDFA (86.5 ± 1.8°) was significantly larger than 3D-LDFA (85.0 ± 2.5°; P < 0.05), and this difference was also observed in severe OA (KL3 or KL4) (88.7 ± 2.5° vs. 87.7 ± 3.2°; P < 0.05). However, MPTA was comparable between 2D and 3D. The consistency between 2D and 3D CPAK classifications was 48.5% for the entire sample, 25.0% for mild OA, and 61.9% for severe OA. CONCLUSION: Based on 3D-LDFA/MPTA data gained from upright CT, 2D radiographic LDFA tended to be inaccurate, which may significantly affect the CPAK classification.

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Coronary Artery Calcification on Chest Computed Tomography as a Predictor of Cardiovascular Adverse Events in Patients With COVID-19 - A Multicenter Retrospective Study in Japan.

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

Circulation journal : official journal of the Japanese Circulation Society 89 ( 3 ) 373 - 381 2025.02

Accepted, ISSN 1346-9843

BACKGROUND: Coronary artery calcification (CAC) detected through chest computed tomography (CT) strongly predicts cardiovascular events in asymptomatic individuals undergoing primary prevention. Few studies with limited sample sizes have investigated the predictive value of CAC for cardiovascular complications in COVID-19. This study examined the impact of CAC on cardiovascular complications using a large-scale COVID-19 database. METHODS AND RESULTS: This multicenter retrospective cohort study used data from the Japan COVID-19 Task Force database. After exclusion based on missing information, 1,109 patients with COVID-19 were included. The Agatston score was used to evaluate CAC, dividing the population into 3 groups based on calcification degree (no, moderate, and severe CAC). The primary outcome was cardiovascular complications; the secondary outcome was critical outcomes. The severe CAC group had a higher rate of cardiovascular complications than the other groups. Multivariable analysis, considering COVID-19 severity factors, identified severe CAC as independently associated with cardiovascular complications but not with critical outcomes. Subgroup analysis revealed that, in patients without hypertension, diabetes, cardiovascular disease, or chronic kidney disease, severe CAC was significantly correlated with cardiovascular complications, whereas this association was not observed in patients with these underlying conditions. CONCLUSIONS: Patients with COVID-19 and severe CAC had increased cardiovascular complications, and identifying cardiovascular and pulmonary findings on chest CT is essential. Measuring CAC via non-electrocardiogram-gated CT helps predict patient risk.

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Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019.

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

Journal of cachexia, sarcopenia and muscle 16 ( 1 ) e13721 2025.02

Accepted, ISSN 2190-5991

BACKGROUND: Chest computed tomography (CT) is a valuable tool for diagnosing and predicting the severity of coronavirus disease 2019 (COVID-19) and assessing extrapulmonary organs. Reduced muscle mass and visceral fat accumulation are important features of a body composition phenotype in which obesity and muscle loss coexist, but their relationship with COVID-19 outcomes remains unclear. In this study, we aimed to investigate the association between the erector spinae muscle (ESM) to epicardial adipose tissue (EAT) ratio (ESM/EAT) on chest CT and disease severity in patients with COVID-19. METHODS: We analysed data from 1074 COVID-19 patients enrolled in the Japan COVID-19 Task Force database. The primary outcome was the rate of critical outcomes (requiring high-flow oxygen therapy, invasive ventilator support or death). The incidence of critical outcomes was compared between patients with high and low ESM/EAT ratios. RESULTS: The low ESM/EAT group (n = 353) had a higher incidence of critical outcomes (13.3% vs. 5.13%, p < 0.001) and mortality (2.55% vs. 0.69%, p = 0.019) than the high ESM/EAT group (n = 721). In multivariable analysis, the low ESM/EAT ratio was associated with critical outcomes (adjusted odds ratio [aOR] 2.11, 95% confidence interval [CI] 1.22-3.66) independently of the known COVID-19 severity factors including age, sex, body mass index (BMI), smoking history, lifestyle-related comorbidities and pneumonia volume. CONCLUSION: The low ESM/EAT ratio in COVID-19 patients can be obtained on chest CT and used to predict critical outcomes after disease onset, demonstrating the importance of detailed body composition assessments in COVID-19 practice.

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Recent trends in scientific research in chest radiology: What to do or not to do? That is the critical question in research.

Hiroto Hatabu, Masahiro Yanagawa, Yoshitake Yamada, Takuya Hino, Yuzo Yamasaki, Akinori Hata, Daiju Ueda, Yusei Nakamura, Yoshiyuki Ozawa, Masahiro Jinzaki, Yoshiharu Ohno

Japanese journal of radiology 43 ( 6 ) 883 - 902 2025.01

Accepted, ISSN 1867-1071

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Validation of musculoskeletal segmentation model with uncertainty estimation for bone and muscle assessment in hip-to-knee clinical CT images.

Mazen Soufi, Yoshito Otake, Makoto Iwasa, Keisuke Uemura, Tomoki Hakotani, Masahiro Hashimoto, Yoshitake Yamada, Minoru Yamada, Yoichi Yokoyama, Masahiro Jinzaki, Suzushi Kusano, Masaki Takao, Seiji Okada, Nobuhiko Sugano, Yoshinobu Sato

Scientific reports 15 ( 1 ) 125 - 125 2025.01

Accepted

Deep learning-based image segmentation has allowed for the fully automated, accurate, and rapid analysis of musculoskeletal (MSK) structures from medical images. However, current approaches were either applied only to 2D cross-sectional images, addressed few structures, or were validated on small datasets, which limit the application in large-scale databases. This study aimed to validate an improved deep learning model for volumetric MSK segmentation of the hip and thigh with uncertainty estimation from clinical computed tomography (CT) images. Databases of CT images from multiple manufacturers/scanners, disease status, and patient positioning were used. The segmentation accuracy, and accuracy in estimating the structures volume and density, i.e., mean HU, were evaluated. An approach for segmentation failure detection based on predictive uncertainty was also investigated. The model has improved all segmentation accuracy and structure volume/density evaluation metrics compared to a shallower baseline model with a smaller training database (N = 20). The predictive uncertainty yielded large areas under the receiver operating characteristic (AUROC) curves (AUROCs ≥ .95) in detecting inaccurate and failed segmentations. Furthermore, the study has shown an impact of the disease severity status on the model's predictive uncertainties when applied to a large-scale database. The high segmentation and muscle volume/density estimation accuracy and the high accuracy in failure detection based on the predictive uncertainty exhibited the model's reliability for analyzing individual MSK structures in large-scale CT databases.

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Resection of a Giant Middle Mediastinal Tumor Using a Transaortopulmonary Arterial Approach.

Kaito Yano, Tsutomu Ito, Keisuke Asakura, Yuriko Tanabe, Yorihiko Matsumoto, Kaoru Kaseda, Yutaka Kurebayashi, Yoshitake Yamada, Tomoyuki Hishida, Hideyuki Shimizu

Annals of thoracic surgery short reports 3 ( 4 ) 936 - 939 2025

Accepted

Surgical approaches for giant middle mediastinal tumors are challenging owing to the surrounding great vessels and vital organs. Here, we report the resection of a giant middle mediastinal tumor with feeding vessels from the coronary artery causing exertional dyspnea. Surgical resection involved a clamshell incision and temporary transection of the ascending aorta and right pulmonary artery under cardiopulmonary bypass to achieve optimal visualization. The tumor, diagnosed as unicentric Castleman disease, was safely excised with good postoperative outcomes. This method-the transaortopulmonary arterial approach-offers a favorable surgical tool for giant mediastinal tumors.

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Assessment of pulmonary function in COPD patients using dynamic digital radiography: A novel approach utilizing lung signal intensity changes during forced breathing.

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

European journal of radiology open 13 100579 - 100579 2024.12

Accepted, ISSN 2352-0477

OBJECTIVES: To investigate the association of lung signal intensity changes during forced breathing using dynamic digital radiography (DDR) with pulmonary function and disease severity in patients with chronic obstructive pulmonary disease (COPD). METHODS: This retrospective study included 46 healthy subjects and 33 COPD patients who underwent posteroanterior chest DDR examination. We collected raw signal intensity and gray-scale image data. The lung contour was extracted on the gray-scale images using our previously developed automated lung field tracking system and calculated the average of signal intensity values within the extracted lung contour on gray-scale images. Lung signal intensity changes were quantified as SImax/SImin, representing the maximum ratio of the average signal intensity in the inspiratory phase to that in the expiratory phase. We investigated the correlation between SImax/SImin and pulmonary function parameters, and differences in SImax/SImin by disease severity. RESULTS: SImax/SImin showed the highest correlation with VC (rs = 0.54, P < 0.0001), followed by FEV1 (rs = 0.44, P < 0.0001), both of which are key indicators of COPD pathophysiology. In a multivariate linear regression analysis adjusted for confounding factors, SImax/SImin was significantly lower in the severe COPD group compared to the normal group (P = 0.0004) and mild COPD group (P=0.0022), suggesting its potential usefulness in assessing COPD severity. CONCLUSION: This study suggests that the signal intensity changes of lung fields during forced breathing using DDR reflect the pathophysiology of COPD and can be a useful index in assessing pulmonary function in COPD patients, potentially improving COPD diagnosis and management.

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Thoracic posture-related morphological changes in patients with pectus excavatum versus healthy controls.

Takahiro Suzuki, Keisuke Asakura, Yoshitake Yamada, Kyohei Masai, Minoru Yamada, Yoichi Yokoyama, Yu Okubo, Kaoru Kaseda, Tomoyuki Hishida, Masahiro Jinzaki

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 66 ( 5 ) 2024.11

Accepted, ISSN 1010-7940

OBJECTIVES: Cases of severe pectus excavatum presenting with worsening cardiopulmonary symptoms in the upright position have been reported. However, the underlying mechanism remains unclear. We evaluated posture-related morphological changes of the thorax in patients with pectus excavatum. METHODS: Chest morphology was evaluated preoperatively using upright and supine computed tomography in 21 patients with pectus excavatum and 35 healthy volunteers. The minimum anterior-posterior thoracic diameter, depression depth, and Haller index on horizontal sections, as well as the T6-12 plumb line distance on sagittal sections, were compared between the two positions. RESULTS: In patients with pectus excavatum (median age, 22 years; 18 males and 3 females), the minimum anterior-posterior diameter was smaller (4.5 vs 5.1 cm, P < 0.001) and the Haller index was greater (10.1 vs 6.4, P < 0.001) in the upright position than in the supine position. The T6-T12 plumb line distance was longer in the upright position (2.4 vs 0.8 cm, P < 0.001), while the depression depth showed no significant difference. Healthy volunteers exhibited similar changes. The degree of spinal curvature increased in the upright position due to the anterior shift of the lower thoracic vertebrae, resulting in a shorter anterior-posterior diameter, irrespective of chest wall deformity. One patient with dyspnoea only in the upright position exhibited compression of the right inferior pulmonary vein only on upright computed tomography. CONCLUSIONS: The minimum anterior-posterior diameter is shorter in the upright position. This may explain the worsening of cardiopulmonary symptoms in patients with severe pectus excavatum when in an upright position. CLINICAL TRIAL NUMBER: UMIN000036438 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041519.

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