Details of a Researcher - Yamada, Yoshitake

Papers - Yamada, Yoshitake

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【押さえておきたい呼吸器疾患の画像診断Case-based review】多発結節,粒状影(粟粒影)の鑑別　健常者に発症した肺結節

池田織人, 山田祥岳, 杉浦弘明, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 303 - 303 2024.02

ISSN 0285-0524

【押さえておきたい呼吸器疾患の画像診断Case-based review】びまん性すりガラス影の鑑別　重症肺炎に合併した両肺びまん性すりガラス影

八木文子, 杉浦弘明, 山田祥岳, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 312 - 313 2024.02

ISSN 0285-0524

【押さえておきたい呼吸器疾患の画像診断Case-based review】びまん性すりガラス影の鑑別　薬剤使用後に出現した肺野陰影

八木文子, 杉浦弘明, 山田祥岳, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 306 - 307 2024.02

ISSN 0285-0524

【押さえておきたい呼吸器疾患の画像診断Case-based review】びまん性すりガラス影の鑑別　肺野のごくわずかなすりガラス影にFDG集積や肝脾腫を伴った症例

八木文子, 杉浦弘明, 山田祥岳, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 308 - 309 2024.02

ISSN 0285-0524

【押さえておきたい呼吸器疾患の画像診断Case-based review】びまん性すりガラス影の鑑別　強皮症に出現したすりガラス影

八木文子, 杉浦弘明, 山田祥岳, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 310 - 311 2024.02

ISSN 0285-0524

【押さえておきたい呼吸器疾患の画像診断Case-based review】びまん性すりガラス影の鑑別　免疫低下状態で出現したびまん性のすりガラス影

八木文子, 杉浦弘明, 山田祥岳, 陣崎雅弘

画像診断 ((株)Gakken) 44 ( 3 ) 304 - 305 2024.02

ISSN 0285-0524

Epicardial adipose tissue measured from analysis of adipose tissue area using chest CT imaging is the best potential predictor of COVID-19 severity.

Takahiro Fukushima, Tomoki Maetani, Shotaro Chubachi, Naoya Tanabe, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Takashi Shimada, Shuhei Azekawa, Shiro Otake, Kensuke Nakagawara, Mayuko Watase, 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

Metabolism: clinical and experimental (Metabolism: Clinical and Experimental) 150 155715 - 155715 2024.01

Accepted, ISSN 0026-0495

BACKGROUND: Computed tomography (CT) imaging is widely used for diagnosing and determining the severity of coronavirus disease 2019 (COVID-19). Chest CT imaging can be used to calculate the epicardial adipose tissue (EAT) and upper abdominal visceral adipose tissue (Abd-VAT) areas. The EAT is the main source of inflammatory cytokines involved in chest inflammatory diseases; thus, the EAT area might be a more useful severity predictor than the Abd-VAT area for COVID-19. However, to the best of our knowledge, there are no large-scale reports that sufficiently consider this issue. In addition, there are no reports on the characteristics of patients with normal body mass index (BMI) and high adipose tissue. AIM: The purpose of this study was to analyze whether the EAT area, among various adipose tissues, was the most associated factor with COVID-19 severity. Using a multicenter COVID-19 patient database, we analyzed the associations of chest subcutaneous, chest visceral, abdominal subcutaneous, and Abd-VAT areas with COVID-19 outcomes. In addition, the clinical significance of central obesity, commonly disregarded by BMI, was examined. METHODS: This retrospective cohort study evaluated patients with COVID-19 aged ≥18 years In Japan. Data including from chest CT images collected between February 2020 and October 2022 in four hospitals of the Japan COVID-19 Task Force were analyzed. Patient characteristics and COVID-19 severity were compared according to the adipose tissue areas (chest and abdominal subcutaneous adipose tissue [Chest-SAT and Abd-SAT], EAT, and Abd-VAT) calculated from chest CT images. RESULTS: We included 1077 patients in the analysis. Patients with risk factors of severe COVID-19 such as old age, male sex, and comorbidities had significantly higher areas of EAT and Abd-VAT. High EAT area but not high Abd-VAT area was significantly associated with COVID-19 severity (adjusted odds ratio (aOR): 2.66, 95 % confidence interval [CI]: 1.19-5.93). There was no strong correlation between BMI and VAT. Patients with high VAT area accounted for 40.7 % of the non-obesity population (BMI < 25 kg/m2). High EAT area was also significantly associated with COVID-19 severity in the non-obesity population (aOR: 2.50, 95 % CI: 1.17-5.34). CONCLUSIONS: Our study indicated that VAT is significantly associated with COVID-19 severity and that EAT is the best potential predictor for risk stratification in COVID-19 among adipose tissue areas. Body composition assessment using EAT is an appropriate marker for identifying obesity patients overlooked by BMI. Considering the next pandemic of the global health crisis, our findings open new avenues for implementing appropriate body composition assessments based on CT imaging.

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【循環器診療に大きく寄与する心臓CT/MRI】大動脈弁狭窄症に対するTAVI/TAVRにおける術前CT評価

山田祥岳, 山田稔, 松本俊亮, 横山陽一, 鈴木達也, 津崎盾哉, 橋本正弘, 中原健裕, 陣崎雅弘

日独医報 (バイエル薬品(株)) 67 77 - 94 2024.01

ISSN 0912-0351

Predictive modeling of submarining risk in car occupants based on pelvis angle and lap belt positioning.

Yuya Takeuchi, Yoshihiko Tanaka, Toshiharu Azuma, Yuqing Zhao, Koji Mizuno, Minoru Yamada, Yoichi Yokoyama, Yoshitake Yamada, Masahiro Jinzaki

Traffic injury prevention (Traffic Injury Prevention) 25 ( 2 ) 147 - 155 2024

Accepted, ISSN 1538-9588

OBJECTIVE: The engagement of the lap belt with the pelvis is critical for occupant safety during vehicle frontal crashes to prevent occupant submarining. This study aims to develop a predictive model for submarining risk based on anthropometric parameters and lap belt positioning using finite element (FE) analyses. METHODS: FE analyses were conducted using human body models representing various body shapes (a 50th percentile male, low and high BMI males, and a 5th percentile female) in three seated postures (standard, reclined, and slouched). The lap belt-ASIS overlap and the belt-pelvis angle were used as key parameters for predicting submarining risk. A logistic regression analysis was utilized to correlate submarining occurrence with the initial values of these two parameters at the beginning of impact. Subsequently, this submarining prediction model was applied to computer tomography (CT) measurements of human subjects in different seated postures (upright, reclined, and slouched), and submarining risks were calculated based on the developed model. RESULTS: FE simulations indicated that submarining was more likely to occur as the initial belt-pelvis angle approached zero and there was a smaller initial belt-ASIS overlap. The logistic regression analysis demonstrated that the initial belt-pelvis angle and belt-ASIS overlap were statistically significant for predicting submarining risk. The derived model effectively distinguished submarining occurrence based on the initial values of these two parameters. The application of the submarining model to CT measurements of human subjects showed that submarining risk was lower in the order of upright, slouched, and reclined postures. In the reclined posture, the high submarining risk was attributed to a small belt-ASIS overlap and a rearward-tilted pelvis angle; whereas in the slouched posture, the risk was mostly associated with a rearward-tilted pelvis angle. CONCLUSIONS: The submarining prediction model was developed based on the belt-pelvis angle and the belt-ASIS overlap. This predictive model may help to design restraint systems for various body types and seated postures of occupants.

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The influence of seated postures and anthropometry on lap belt fit in vehicle occupants: A 3D computed tomography study.

Yoshihiko Tanaka, Houtatsu Shu, Yuqing Zhao, Koji Mizuno, Minoru Yamada, Yoichi Yokoyama, Yoshitake Yamada, Masahiro Jinzaki

Traffic injury prevention (Traffic Injury Prevention) 25 ( 3 ) 454 - 462 2024

Accepted, ISSN 1538-9588

OBJECTIVE: In vehicle frontal collisions, it is crucial that the lap belt is designed to engage with the anterior superior iliac spine (ASIS) of occupants for a reliable restraint. This study aims to understand the influence of different seated postures on the geometrical relationship of the seat belt and the pelvis for various occupants using 3D upright and supine computed tomography (CT) systems. METHODS: The 3D shapes of bones and soft tissues around the pelvis were acquired through a CT scan for 30 participants. They were seated in a rigid seat equipped with a lap belt simulating the front seat of a small car, and wore a lap belt in three seated postures: upright, slouched and reclined. Parameters related to the likelihood of submarining occurrences, such as belt-ASIS overlap (an index for assessing the potential engagement of the lap belt with the ASIS) and the belt-pelvis angle (the difference between the belt angle and the normal direction of the anterior edge of the ilium) were compared. RESULTS: It was observed that the pelvis angle tilted rearward as the hip point was positioned forward and seatback angle increased. This can be seen in the slouched and reclined posture. The belt-pelvis angle was comparable between the slouched and the reclined postures, and was closer to zero (indicating that the lap belt path is closer to perpendicular to the anterior edge of the ilium) compared to the upright posture. In contrast, the belt-ASIS overlap increased with an increasing flesh margin of the ASIS and shallower belt angle. This suggests that the belt-pelvis angle is influenced by the seated posture whereas the belt-ASIS overlap is dependent more on an individual's anthropometry. The plot of belt-pelvis angle and belt-ASIS overlap exhibited significant variability among participants. CONCLUSIONS: The belt-pelvis angle and the belt-ASIS overlap of individuals will provide valuable information for understanding the current belt-fit location and predicting submarining occurrences for individuals in various postures when designing restraint systems.

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Possible Pannus Formation After Transcatheter Aortic Valve Replacement With Self-Expandable Valves.

Juri Iwata, Kentaro Hayashida, Akiyoshi Kajino, Shingo Sakata, Toshinobu Ryuzaki, Hikaru Tsuruta, Yoshitake Yamada, Masahiro Jinzaki, Hideyuki Shimizu, Masaki Ieda

JACC. Asia 5 ( 2 ) 315 - 317 2024

Accepted

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Association Between Renal Sinus Fat and Cardiometabolic and Renin-Angiotensin System Parameters in Primary Aldosteronism.

Ryunosuke Mitsuno, Kenji Kaneko, Toshifumi Nakamura, Daiki Kojima, Yosuke Mizutani, Tatsuhiko Azegami, Shintaro Yamaguchi, Yoshitake Yamada, Masahiro Jinzaki, Kenichiro Kinouchi, Jun Yoshino, Kaori Hayashi

Journal of the Endocrine Society (Journal of the Endocrine Society) 8 ( 1 ) bvad154 2023.12

Accepted

CONTEXT: Renal sinus fat (RSF) accumulation is associated with cardiometabolic diseases, such as obesity, diabetes, hypertension, and chronic kidney disease. However, clinical implications of RSF in primary aldosteronism (PA) remain unclear. OBJECTIVE: We aimed to investigate relationships between RSF volume and key cardiometabolic and renin-angiotensin system (RAS) parameters in PA patients and clarify the differences in these relationships between unilateral and bilateral subtypes. METHODS: We analyzed data obtained from well-characterized PA patients that involved 45 unilateral (median age: 52 years; 42.2% men) and 92 bilateral patients (51 years; 42.4% men). RESULTS: RSF volume normalized by renal volume (RSF%) was greater in the unilateral group than in the bilateral group (P < .05). RSF% was greater in men than in women (P < .05). RSF% positively correlated with parameters related to cardiometabolic risk, including age, body mass index, visceral fat volume, creatinine, triglycerides/high-density lipoprotein cholesterol ratio, uric acid, fasting glucose, and C-reactive protein regardless of PA subtypes (all P < .05). Intriguingly, RSF% positively correlated with plasma aldosterone concentration (PAC), aldosterone-to-renin ratio, and intact parathyroid hormone (iPTH) (all P < .05) in bilateral patients but did not correlate with RAS parameters and even showed an opposite trend in unilateral patients. In subgroup analyses by sex, these distinctions became more evident in women. After adjustment for potential confounders, RSF% remained positively correlated with PAC and iPTH in bilateral patients. CONCLUSION: Our results indicate that RSF accumulation is involved in cardiometabolic dysfunction associated with PA. However, there were distinct correlations between RSF volume and RAS parameters according to sex and PA subtypes.

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Anatomical cardiac and electrocardiographic axes correlate in both upright and supine positions: an upright/supine CT study.

Togo Norimatsu, Takehiro Nakahara, Yoshitake Yamada, Yoichi Yokoyama, Minoru Yamada, Keiichi Narita, Masahiro Jinzaki

Scientific reports (Scientific Reports) 13 ( 1 ) 18170 - 18170 2023.10

Accepted

The correlation between the anatomical cardiac and electrocardiographic axes has been discussed for several years. Using upright computed tomography, this study aimed to reveal the relationship between the anatomical cardiac and electrocardiographic axes in both the supine and upright positions. Upright CT and standard supine CT were performed for healthy volunteers, following electrocardiography in both upright and supine position. On CT images, the coordinates of apex, the center of aortic valve (AV) and mitral valve (MV) were recorded, and the vectors and angles were calculated. Subcutaneous and visceral fat volume were semi-automatically calculated in a workstation. From a total 190 volunteers, 41 males were performed electrocardiography and included for this study. The QRS and anatomical axes (AV-apex and MV-apex axis) were significantly correlated in both supine and upright positions, while the angle of the AV-apex to Z axis was the most correlated (supine: r = - 0.54, p = 0.0002, upright: r = - 0.47, p = 0.0020). The anatomical axis moved in the dorsal and caudal directions from the supine to upright position. Multiple regression analysis revealed that the anatomical axis from the AV-apex to the Z-axis was determined according to age, body height, subcutaneous and visceral fat volumes.

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Clinical utilization of artificial intelligence-based COVID-19 pneumonia quantification using chest computed tomography - a multicenter retrospective cohort study in Japan.

Hiromu Tanaka, Tomoki Maetani, Shotaro Chubachi, Naoya Tanabe, Yusuke Shiraishi, Takanori Asakura, Ho Namkoong, 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

Respiratory research (Respiratory Research) 24 ( 1 ) 241 - 241 2023.10

Accepted, ISSN 1465-9921

BACKGROUND: Computed tomography (CT) imaging and artificial intelligence (AI)-based analyses have aided in the diagnosis and prediction of the severity of COVID-19. However, the potential of AI-based CT quantification of pneumonia in assessing patients with COVID-19 has not yet been fully explored. This study aimed to investigate the potential of AI-based CT quantification of COVID-19 pneumonia to predict the critical outcomes and clinical characteristics of patients with residual lung lesions. METHODS: This retrospective cohort study included 1,200 hospitalized patients with COVID-19 from four hospitals. The incidence of critical outcomes (requiring the support of high-flow oxygen or invasive mechanical ventilation or death) and complications during hospitalization (bacterial infection, renal failure, heart failure, thromboembolism, and liver dysfunction) was compared between the groups of pneumonia with high/low-percentage lung lesions, based on AI-based CT quantification. Additionally, 198 patients underwent CT scans 3 months after admission to analyze prognostic factors for residual lung lesions. RESULTS: The pneumonia group with a high percentage of lung lesions (N = 400) had a higher incidence of critical outcomes and complications during hospitalization than the low percentage group (N = 800). Multivariable analysis demonstrated that AI-based CT quantification of pneumonia was independently associated with critical outcomes (adjusted odds ratio [aOR] 10.5, 95% confidence interval [CI] 5.59-19.7), as well as with oxygen requirement (aOR 6.35, 95% CI 4.60-8.76), IMV requirement (aOR 7.73, 95% CI 2.52-23.7), and mortality rate (aOR 6.46, 95% CI 1.87-22.3). Among patients with follow-up CT scans (N = 198), the multivariable analysis revealed that the pneumonia group with a high percentage of lung lesions on admission (aOR 4.74, 95% CI 2.36-9.52), older age (aOR 2.53, 95% CI 1.16-5.51), female sex (aOR 2.41, 95% CI 1.13-5.11), and medical history of hypertension (aOR 2.22, 95% CI 1.09-4.50) independently predicted persistent residual lung lesions. CONCLUSIONS: AI-based CT quantification of pneumonia provides valuable information beyond qualitative evaluation by physicians, enabling the prediction of critical outcomes and residual lung lesions in patients with COVID-19.

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Post-Traumatic Pulmonary Hematoma Presenting as Multiple Ring-shaped Spherical Nodules.

Orito Ikeda, Kunihiko Shimizu, Yoshitake Yamada, Hiroaki Sugiura, Miki Takahashi, Tokuhiro Kimura, Hideaki Suzuki, Kozo Sato, Masahiro Jinzaki

American journal of respiratory and critical care medicine (American Journal of Respiratory and Critical Care Medicine) 208 ( 11 ) 1227 - 1230 2023.09

Accepted, ISSN 1073-449X

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Pre-existing Interstitial Lung Abnormalities and Immune Checkpoint Inhibitor-Related Pneumonitis in Solid Tumors: A Retrospective Analysis.

Kohei Horiuchi, Shinnosuke Ikemura, Takashi Sato, Keitaro Shimozaki, Satoshi Okamori, Yoshitake Yamada, Yoichi Yokoyama, Masahiro Hashimoto, Masahiro Jinzaki, Ikuko Hirai, Takeru Funakoshi, Ryuichi Mizuno, Mototsugu Oya, Kenro Hirata, Yasuo Hamamoto, Hideki Terai, Hiroyuki Yasuda, Ichiro Kawada, Kenzo Soejima, Koichi Fukunaga

The oncologist (Oncologist) 29 ( 1 ) e108 - e117 2023.08

Accepted, ISSN 1083-7159

BACKGROUND: Immune checkpoint inhibitors (ICIs) have demonstrated efficacy over previous cytotoxic chemotherapies in clinical trials among various tumors. Despite their favorable outcomes, they are associated with a unique set of toxicities termed as immune-related adverse events (irAEs). Among the toxicities, ICI-related pneumonitis has poor outcomes with little understanding of its risk factors. This retrospective study aimed to investigate whether pre-existing interstitial lung abnormality (ILA) is a potential risk factor for ICI-related pneumonitis. MATERIALS AND METHODS: Patients with non-small cell lung cancer, malignant melanoma, renal cell carcinoma, and gastric cancer, who was administered either nivolumab, pembrolizumab, or atezolizumab between September 2014 and January 2019 were retrospectively reviewed. Information on baseline characteristics, computed tomography findings before administration of ICIs, clinical outcomes, and irAEs were collected from their medical records. Pre-existing ILA was categorized based on previous studies. RESULTS: Two-hundred-nine patients with a median age of 68 years were included and 23 (11.0%) developed ICI-related pneumonitis. While smoking history and ICI agents were associated with ICI-related pneumonitis (P = .005 and .044, respectively), the categories of ILA were not associated with ICI-related pneumonitis (P = .428). None of the features of lung abnormalities were also associated with ICI-related pneumonitis. Multivariate logistic analysis indicated that smoking history was the only significant predictor of ICI-related pneumonitis (P = .028). CONCLUSION: This retrospective study did not demonstrate statistically significant association between pre-existing ILA and ICI-related pneumonitis, nor an association between radiologic features of ILA and ICI-related pneumonitis. Smoking history was independently associated with ICI-related pneumonitis. Further research is warranted for further understanding of the risk factors of ICI-related pneumonitis.

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Impact of patient characteristic factors on the dynamics of liver glucose metabolism: Evaluation of multiparametric imaging with dynamic whole-body 18 F-fluorodeoxyglucose-positron emission tomography.

Kai Tonda, Yu Iwabuchi, Tohru Shiga, Yoshiki Owaki, Arashi Fujita, Takehiro Nakahara, Ryosuke Sakurai, Atsushi Shimizu, Yoshitake Yamada, Masahiro Okada, Masahiro Jinzaki

Diabetes, obesity & metabolism (Diabetes, Obesity and Metabolism) 25 ( 12 ) 3521 - 3528 2023.08

Accepted, ISSN 1462-8902

AIMS: To assess the impact of various patient characteristics on the dynamics of liver glucose metabolism using automated multiparametric imaging with whole-body dynamic 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET). MATERIALS AND METHODS: We retrospectively enrolled 540 patients who underwent whole-body dynamic FDG-PET. Three quantitative indices representing hepatic glucose metabolism [mean standardized uptake value normalized by lean body mass (SULmean), metabolic glucose rate (kinetic index) and distribution volume (DV)] were measured from multiparametric PET images produced automatically based on the Patlak plot model. Patient characteristics including age, sex, body mass index, fasting time, blood glucose level, and the presence of diabetes mellitus (DM) or hepatic steatosis (HS) were collected. We examined the correlations between the characteristic factors and three quantitative indices using multiple regression analysis. RESULTS: The success rate of kinetic analysis using multiparametric PET imaging was 93.3% (504/540). Hepatic SULmean was significantly correlated with age (p < .001), sex (p < .001) and blood glucose level (p = .002). DV was significantly correlated with age (p = .033), sex (p < .001), body mass index (p = .002), fasting time (p = .043) and the presence of HS (p = .002). The kinetic index was significantly correlated with age (p < .001) and sex (p = .004). In the comparison of the healthy, DM and HS groups, patients with DM had a significantly increased SULmean, whereas patients with HS had a significantly decreased DV. CONCLUSIONS: Our results showed that liver glucose metabolism was influenced by various patient characteristic factors. Multiparametric FDG-PET imaging can be used to analyse the kinetics of liver glucose metabolism in routine clinical practice.

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Extra-articular location of the three-dimensional mechanical axis in advanced knee osteoarthritis: an upright computed tomography study.

Ryo Sasaki, Kazuya Kaneda, Yoshitake Yamada, Yasuo Niki, Masaya Nakamura, Takeo Nagura, Masahiro Jinzaki

Japanese journal of radiology (Japanese Journal of Radiology) 41 ( 12 ) 1405 - 1413 2023.07

Accepted, ISSN 1867-1071

PURPOSE: One of the most widely used benchmarks of lower-limb alignment is the mechanical axis (MA), which passes through the centers of the femoral head and the ankle in the weight-bearing position. However, where the MA passes through three-dimensionally (3D) is unclear. We investigated the MA in 3D (3D-MA) in knee osteoarthritis (OA) using upright computed tomography (CT). MATERIALS AND METHODS: This study included 66 varus OA knees from 38 patients [age 70.0 (64.8-77.0) years; median (interquartile range)]. The 3D-MA was determined using upright CT data and compared among Kellgren-Lawrence (KL) grades. Further, correlations between the 3D-MA and other parameters were evaluated. RESULTS: The 3D-MA was located at 5.3 (1.3-14.4)% medially and 7.1 (0.7-15.3)% posteriorly on the tibial plateau in KL-1, and was translated medioposteriorly with increased KL grade. The 3D-MA in KL-3 [30.6 (22.6-42.6)% medially and 50.9 (45.8-80.2)% posteriorly] and KL-4 [56.7 (48.5-62.9)% medially and 92.3 (50.2-127.1)% posteriorly] was located extra-articularly. The mediolateral position of the 3D-MA correlated with the femorotibial angle [correlation coefficient (CC) = - 0.85, p < 0.001], and the anteroposterior position of the 3D-MA correlated with the knee flexion angle (CC = - 0.93, p < 0.001). CONCLUSION: Our analysis demonstrated that the 3D-MA in low-grade OA knees passes slightly medial and posterior to the knee center, and the 3D-MA is translated medioposteriorly with the progression of knee OA. Further, the 3D-MA is translated medially with varus progression and posteriorly with the progression of knee flexion contracture.

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Dynamic evaluation of the sternoclavicular and acromioclavicular joints using an upright four-dimensional computed tomography.

Yuki Yoshida, Noboru Matsumura, Yoshitake Yamada, Minoru Yamada, Yoichi Yokoyama, Azusa Miyamoto, Satoshi Oki, Masaya Nakamura, Takeo Nagura, Masahiro Jinzaki

Journal of biomechanics (Journal of Biomechanics) 157 111697 - 111697 2023.06

Accepted, ISSN 0021-9290

In the analysis of the shoulder complex, the sequential changes occurring in the sternoclavicular and acromioclavicular joints during active shoulder motion are challenging to track. This study aimed to investigate the in vivo sternoclavicular and acromioclavicular joint motions during active elevation, including the sequential changes in these joint spaces using upright four-dimensional computed tomography (4DCT). Bilateral shoulders of 12 healthy volunteers upright 4DCT were obtained during active elevation similar to a "hands up" motion. The sternoclavicular and acromioclavicular rotation angles, joint distances, and closest points on the clavicle relative to the thorax and scapula were evaluated during 10°-140° of humerothoracic elevation. During humerothoracic elevation, the clavicle elevated, retracted, and rotated posteriorly relative to the thorax, whereas the scapula rotated upwardly, internally, and posteriorly relative to the clavicle. All the sternoclavicular and acromioclavicular joint rotation angles were significantly different at ≥ 30°-50° of humerothoracic elevation compared with 10° of humerothoracic elevation. The mean sternoclavicular and acromioclavicular joint distances were 2.2 ± 1.1 mm and 1.6 ± 0.9 mm, respectively. The closest points were located on the anteroinferior part of the medial and lateral clavicle in the sternoclavicular and acromioclavicular joints, respectively. Significant differences were observed in the acromioclavicular joint distance and anterior/posterior movements of the closest points in the sternoclavicular and acromioclavicular joints compared with 10° of humerothoracic elevation. Our sternoclavicular and acromioclavicular closest point results indicate that the impingement tends to occur at the anteroinferior part of the medial and lateral aspects of the clavicle and may be related to osteoarthritis.

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Three-dimensional joint surface orientation does not correlate with two-dimensional coronal joint line orientation in knee osteoarthritis: Three-dimensional analysis of upright computed tomography.

Ryo Sasaki, Yasuo Niki, Kazuya Kaneda, Yoshitake Yamada, Takeo Nagura, Masaya Nakamura, Masahiro Jinzaki

The Knee (Knee) 43 10 - 17 2023.05

Accepted, ISSN 0968-0160

BACKGROUND: Two-dimensional (2D) coronal joint line orientation on radiography under weight-bearing conditions has been widely used in evaluating knee osteoarthritis (OA). However, the effects of tibial rotation remain unknown. The present study aimed to newly define three-dimensional (3D) joint surface orientation relative to the floor as an unchangeable 3D angle unaffected by tibial rotation using upright computed tomography (CT), and to investigate correlations between 3D and 2D parameters in knee OA. METHODS: Sixty-six knees in 38 patients with varus knee OA underwent standing hip-to-ankle digital radiography and upright CT. The 2D parameters measured on radiographs included femorotibial angle (FTA), tibial joint line angle (TJLA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA). The 3D inner product angle between vectors of the tibial joint surface and the floor from CT was defined as the 3D joint surface-floor angle. RESULTS: Mean 3D joint surface-floor angle was 6.0 ± 3.6°. No correlation was identified between 3D joint surface-floor angle and 2D joint line parameters, even though FTA correlated substantially with 2D joint line parameters. No significant differences in 3D joint surface-floor angle were identified among Coronal Plane Alignment of the Knee (CPAK) types. CONCLUSIONS: The 3D joint surface orientation did not correlate with 2D coronal joint line orientation and was unaffected by CPAK classification types. This finding suggests that current 2D evaluations should be reconsidered for a better understanding of true knee joint line orientation.

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