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Takada M, Yoshimura M, Kawaguchi K, Kotake T, Uozumi R, Kataoka M, Koyama T, Kato H, Yoshibayashi H, Suwa H, Tsuji W, Yamashiro H, Kataoka T, Ishiguro H, Tokumasu R, Honda M, Yamashita R, Yonezawa A, Himoto Y, Onishi N, Parida L, Morita S, Toi M. Abstract P3-09-07: A multicenter phase Ib/II study for evaluating safety and efficacy of Nivolumab in combination with radiation therapy in patients with HER2-negative metastatic breast cancer (KBCRN-B-002 trial). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p3-09-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: In metastatic breast cancer, Overall Response Rate (ORR) for checkpoint inhibitor monotherapy has been limited. Since Radiation Therapy (RT) stimulates anti-cancer immune responses, we evaluated safety and efficacy of a combinatorial therapy of RT with Nivolumab (a Programmed cell death protein 1 (PD-1) inhibitor) on HER2-negative metastatic breast cancer patients in a multicenter and non-randomized phase Ib/II study. PATIENTS AND METHODS: Patients with HER2-negative breast cancer, measurable metastasis (RECIST1.1) and at least one bone metastasis requiring radiation therapy were enrolled. The patients were divided into two cohorts, A and B. Cohort A constitutes estrogen and/or progesterone receptor-positive breast cancer patients that had 1 or 2 lines of endocrine therapy for the metastatic disease. Cohort B constitutes triple negative breast cancer patients that had two or more lines of chemotherapy for metastatic disease and anthracycline and taxane treatment for any disease setting. Single fraction RT of 8 Gy was delivered on day 0. Patients received 3 mg/kg Nivolumab intravenously every 2 weeks from day 1 until the disease progressed. Combined use of endocrine therapy of the physician’s choice was allowed in Cohort A. Primary endpoints were safety and ORR (RECIST1.1) in phase Ib and phase II, respectively. Secondary endpoints were Duration of Response (DOR), Disease Control Rate (DCR) and Progression-Free Survival (PFS). For translational research, we integrated time series multi-omics data that are correlated with Tumor Immune Microenvironment (TIME) to identify novel drug sensitivity-associated signatures using machine learning method. The multi-omics data included data from RNAseq, DNAseq, mass cytometry (CyTOF), multiple cytokines, human leukocyte antigen, radiomics, drug concentrations, tuberculin reaction using Peripheral Blood Mononuclear Cells (PBMCs), serum, plasma, imaging and Formalin-Fixed Paraffin-Embedded (FFPE) samples. RESULTS: 31 patients were enrolled from Jan 2017 to Nov 2018 and 29 patients (18 in Cohort A and 11 in Cohort B) were included in the full analysis set. While seven patients in Cohort A had received 1 or 2 lines of chemotherapy earlier for the metastatic disease, eight patients in Cohort B received three or more lines of chemotherapy. Dose limiting toxicities were not observed in phase Ib. In Cohort A, the ORR was 11.1% (90% with a Confidence Interval (CI) of 3.7-28.6). The best overall responses were: Partial Response (PR) in 2 patients (11.1%), Stable Disease (SD) in 11 patients (61.1%) and Progressive Disease (PD) in 5 patients (27.8%). In Cohort B, ORR was 0% as none of the patients responded to the treatment. The best overall responses were: SD in 4 patients (36.4%), PD in 6 patients (54.5%) and one patient (9.1%) was not evaluated (NE). While the DCR for Cohorts A and B were 72.2% (90% CI: 52.9-85.8) and 36.4% (90% CI: 17.5-60.6), respectively, the median PFS were 4 months (95% CI: 2.1-5.5 months) and 2 months (95% CI: 1.2-4.0 months), respectively. Common toxicities were mild; including 3 patients in Cohort A (16.7%) and 2 patients in Cohort B (18.2%) that experienced grade 3 or 4 toxicity. There were no deaths due to adverse effects. Furthermore, our integrated analysis identified novel candidates for drug sensitivity-associated signatures. CONCLUSIONS: The combination of RT and Nivolumab had a manageable safety profile and demonstrated clinically significant disease control outside the RT fields. Periodic abscopal response data and multi-omics data are also presented. (UMIN: UMIN000026046; ClinicalTrials.gov: NCT03430479).
Citation Format: Masahiro Takada, Michio Yoshimura, Kosuke Kawaguchi, Takeshi Kotake, Ryuji Uozumi, Masako Kataoka, Takahiko Koyama, Hironori Kato, Hiroshi Yoshibayashi, Hirofumi Suwa, Wakako Tsuji, Hiroyasu Yamashiro, Tatsuki Kataoka, Hiroshi Ishiguro, Reitaro Tokumasu, Maya Honda, Rikiya Yamashita, Atsushi Yonezawa, Yuki Himoto, Natsuko Onishi, Laxmi Parida, Satoshi Morita, Masakazu Toi. A multicenter phase Ib/II study for evaluating safety and efficacy of Nivolumab in combination with radiation therapy in patients with HER2-negative metastatic breast cancer (KBCRN-B-002 trial) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-09-07.
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Ogihara K, Kikuchi E, Okabe T, Hattori S, Yamashita R, Yoshimine S, Shirotake S, Matsumoto K, Mizuno R, Hara S, Oyama M, Niwakawa M, Oya M. Neutrophil-to-lymphocyte ratio is a useful biomarker for predicting worse clinical outcome in chemo-resistant urothelial carcinoma patients treated with pembrolizumab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz425.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Golia Pernicka JS, Gagniere J, Chakraborty J, Yamashita R, Nardo L, Creasy JM, Petkovska I, Do RRK, Bates DDB, Paroder V, Gonen M, Weiser MR, Simpson AL, Gollub MJ. Radiomics-based prediction of microsatellite instability in colorectal cancer at initial computed tomography evaluation. Abdom Radiol (NY) 2019; 44:3755-3763. [PMID: 31250180 PMCID: PMC6824954 DOI: 10.1007/s00261-019-02117-w] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To predict microsatellite instability (MSI) status of colon cancer on preoperative CT imaging using radiomic analysis. METHODS This retrospective study involved radiomic analysis of preoperative CT imaging of patients who underwent resection of stage II-III colon cancer from 2004 to 2012. A radiologist blinded to MSI status manually segmented the tumor region on CT images. 254 Intensity-based radiomic features were extracted from the tumor region. Three prediction models were developed with (1) only clinical features, (2) only radiomic features, and (3) "combined" clinical and radiomic features. Patients were randomly separated into training (n = 139) and test (n = 59) sets. The model was constructed from training data only; the test set was reserved for validation only. Model performance was evaluated using AUC, sensitivity, specificity, PPV, and NPV. RESULTS Of the total 198 patients, 134 (68%) patients had microsatellite stable tumors and 64 (32%) patients had MSI tumors. The combined model performed slightly better than the other models, predicting MSI with an AUC of 0.80 for the training set and 0.79 for the test set (specificity = 96.8% and 92.5%, respectively), whereas the model with only clinical features achieved an AUC of 0.74 and the model with only radiomic features achieved an AUC of 0.76. The model with clinical features alone had the lowest specificity (70%) compared with the model with radiomic features alone (95%) and the combined model (92.5%). CONCLUSIONS Preoperative prediction of MSI status via radiomic analysis of preoperative CT adds specificity to clinical assessment and could contribute to personalized treatment selection.
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Yamashita R, Perrin T, Chakraborty J, Chou JF, Horvat N, Koszalka MA, Midya A, Gonen M, Allen P, Jarnagin WR, Simpson AL, Do RKG. Radiomic feature reproducibility in contrast-enhanced CT of the pancreas is affected by variabilities in scan parameters and manual segmentation. Eur Radiol 2019; 30:195-205. [PMID: 31392481 DOI: 10.1007/s00330-019-06381-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/07/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aims to measure the reproducibility of radiomic features in pancreatic parenchyma and ductal adenocarcinomas (PDAC) in patients who underwent consecutive contrast-enhanced computed tomography (CECT) scans. METHODS In this IRB-approved and HIPAA-compliant retrospective study, 37 pairs of scans from 37 unique patients who underwent CECTs within a 2-week interval were included in the analysis of the reproducibility of features derived from pancreatic parenchyma, and a subset of 18 pairs of scans were further analyzed for the reproducibility of features derived from PDAC. In each patient, pancreatic parenchyma and pancreatic tumor (when present) were manually segmented by two radiologists independently. A total of 266 radiomic features were extracted from the pancreatic parenchyma and tumor region and also the volume and diameter of the tumor. The concordance correlation coefficient (CCC) was calculated to assess feature reproducibility for each patient in three scenarios: (1) different radiologists, same CECT; (2) same radiologist, different CECTs; and (3) different radiologists, different CECTs. RESULTS Among pancreatic parenchyma-derived features, using a threshold of CCC > 0.90, 58/266 (21.8%) and 48/266 (18.1%) features met the threshold for scenario 1, 14/266 (5.3%) and 15/266 (5.6%) for scenario 2, and 14/266 (5.3%) and 10/266 (3.8%) for scenario 3. Among pancreatic tumor-derived features, 11/268 (4.1%) and 17/268 (6.3%) features met the threshold for scenario 1, 1/268 (0.4%) and 5/268 (1.9%) features met the threshold for scenario 2, and no features for scenario 3 met the threshold, respectively. CONCLUSIONS Variations between CECT scans affected radiomic feature reproducibility to a greater extent than variation in segmentation. A smaller number of pancreatic tumor-derived radiomic features were reproducible compared with pancreatic parenchyma-derived radiomic features under the same conditions. KEY POINTS • For pancreatic-derived radiomic features from contrast-enhanced CT (CECT), fewer than 25% are reproducible (with a threshold of CCC < 0.9) in a clinical heterogeneous dataset. • Variations between CECT scans affected the number of reproducible radiomic features to a greater extent than variations in radiologist segmentation. • A smaller number of pancreatic tumor-derived radiomic features were reproducible compared with pancreatic parenchyma-derived radiomic features under the same conditions.
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Hamdi I, Buntinx G, Poizat O, Delbaere S, Perrier A, Yamashita R, Muraoka KI, Takeshita M, Aloïse S. Unraveling ultrafast dynamics of the photoswitchable bridged dithienylethenes under structural constraints. Phys Chem Chem Phys 2019; 21:6407-6414. [PMID: 30839028 DOI: 10.1039/c8cp07100d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The excited state dynamics of constrained photochromic benzodithienylethenes were addressed by considering the bridging with polyether chains (from x = 4 to 6 units) at the ortho and meta positions of the aryl group, named DTE-ox and DTE-mx, via time-resolved absorption spectroscopy supported with (TD)-DFT calculations. The photochromic parameters and geometrical structures of these series are discussed. A novel photocyclization pathway via a triplet state, evidenced recently (Hamdi et al., Phys. Chem. Chem. Phys., 2016, 18, 28091-28100), is largely dependent on the length and the position of the polyether chain. For the first time, by comparing the two series, we revealed, for the DTE-ox series, an interconversion not only in the ground state but also between the triplet states of the anti-parallel and parallel open form conformers.
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Gounder MM, Mahoney MR, Van Tine BA, Ravi V, Attia S, Deshpande HA, Gupta AA, Milhem MM, Conry RM, Movva S, Pishvaian MJ, Riedel RF, Sabagh T, Tap WD, Horvat N, Basch E, Schwartz LH, Maki RG, Agaram NP, Lefkowitz RA, Mazaheri Y, Yamashita R, Wright JJ, Dueck AC, Schwartz GK. Sorafenib for Advanced and Refractory Desmoid Tumors. N Engl J Med 2018; 379:2417-2428. [PMID: 30575484 PMCID: PMC6447029 DOI: 10.1056/nejmoa1805052] [Citation(s) in RCA: 250] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Desmoid tumors (also referred to as aggressive fibromatosis) are connective tissue neoplasms that can arise in any anatomical location and infiltrate the mesentery, neurovascular structures, and visceral organs. There is no standard of care. METHODS In this double-blind, phase 3 trial, we randomly assigned 87 patients with progressive, symptomatic, or recurrent desmoid tumors to receive either sorafenib (400-mg tablet once daily) or matching placebo. Crossover to the sorafenib group was permitted for patients in the placebo group who had disease progression. The primary end point was investigator-assessed progression-free survival; rates of objective response and adverse events were also evaluated. RESULTS With a median follow-up of 27.2 months, the 2-year progression-free survival rate was 81% (95% confidence interval [CI], 69 to 96) in the sorafenib group and 36% (95% CI, 22 to 57) in the placebo group (hazard ratio for progression or death, 0.13; 95% CI, 0.05 to 0.31; P<0.001). Before crossover, the objective response rate was 33% (95% CI, 20 to 48) in the sorafenib group and 20% (95% CI, 8 to 38) in the placebo group. The median time to an objective response among patients who had a response was 9.6 months (interquartile range, 6.6 to 16.7) in the sorafenib group and 13.3 months (interquartile range, 11.2 to 31.1) in the placebo group. The objective responses are ongoing. Among patients who received sorafenib, the most frequently reported adverse events were grade 1 or 2 events of rash (73%), fatigue (67%), hypertension (55%), and diarrhea (51%). CONCLUSIONS Among patients with progressive, refractory, or symptomatic desmoid tumors, sorafenib significantly prolonged progression-free survival and induced durable responses. (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT02066181 .).
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Perrin T, Midya A, Yamashita R, Chakraborty J, Saidon T, Jarnagin WR, Gonen M, Simpson AL, Do RKG. Short-term reproducibility of radiomic features in liver parenchyma and liver malignancies on contrast-enhanced CT imaging. Abdom Radiol (NY) 2018; 43:3271-3278. [PMID: 29730738 DOI: 10.1007/s00261-018-1600-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the short-term reproducibility of radiomic features in liver parenchyma and liver cancers in patients who underwent consecutive contrast-enhanced CT (CECT) with intravenous iodinated contrast within 2 weeks by chance. METHODS The Institutional Review Board approved this HIPAA-compliant retrospective study and waived the requirement for patients' informed consent. Patients were included if they had a liver malignancy (liver metastasis, n = 22, intrahepatic cholangiocarcinoma, n = 10, and hepatocellular carcinoma, n = 6), had two consecutive CECT within 14 days, and had no prior or intervening therapy. Liver tumors and liver parenchyma were segmented and radiomic features (n = 254) were extracted. The number of reproducible features (with concordance correlation coefficients > 0.9) was calculated for patient subgroups with different variations in contrast injection rate and pixel resolution. RESULTS The number of reproducible radiomic features decreased with increasing variations in contrast injection rate and pixel resolution. When including all CECTs with injection rates differences of less than 15% vs. up to 50%, 63/254 vs. 0/254 features were reproducible for liver parenchyma and 68/254 vs. 50/254 features were reproducible for malignancies. When including all CT with pixel resolution differences of 0-5% or 0-15%, 20/254 vs. 0/254 features were reproducible for liver parenchyma; 34/254 liver malignancy features were reproducible with pixel differences up to 15%. CONCLUSION A greater number of liver malignancy radiomic features were reproducible compared to liver parenchyma features, but the proportion of reproducible features decreased with increasing variations in contrast injection rates and pixel resolution.
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Ito K, Teng R, Schöder H, Humm JL, Ni A, Michaud L, Nakajima R, Yamashita R, Wolchok JD, Weber WA. 18F-FDG PET/CT for Monitoring of Ipilimumab Therapy in Patients with Metastatic Melanoma. J Nucl Med 2018; 60:335-341. [PMID: 30413661 DOI: 10.2967/jnumed.118.213652] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/17/2019] [Indexed: 12/29/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) are now commonly used to treat patients with metastatic malignant melanoma. Although concerns have been raised that the inflammatory response induced by ICIs may limit the ability of 18F-FDG PET/CT to assess tumor response, systematic analyses on the use of 18F-FDG PET/CT in this setting are mostly lacking. Thus, we set out to evaluate the association between tumor response on 18F-FDG PET/CT and prognosis in patients with metastatic malignant melanoma treated with ipilimumab. Methods: We analyzed 60 consecutive patients with metastatic melanoma who underwent 18F-FDG PET/CT scans both before and after treatment to evaluate treatment response after completion of ipilimumab therapy. Tumor response was assessed by the change in the sum of SULpeak (voxels with the highest average SUL [SUV normalized to lean body mass]) of up to 5 lesions according to PERCIST5. New lesions on PET that appeared suggestive of metastases were considered progressive metabolic disease (PMD). Because immunotherapy may cause new inflammatory lesions that are detectable on 18F-FDG PET/CT, we also evaluated an immunotherapy-modified response classification (imPERCIST5). In this classification, new lesions do not define PMD per se; rather, PMD requires an increase in the sum of SULpeak by 30%. The correlation between tumor response according to these 3 definitions and overall survival (OS) was evaluated and compared with known prognostic factors. Results: In responders and nonresponders, the 2-y OS was 66% versus 29% for imPERCIST5 (P = 0.003). After multivariate analysis, imPERCIST5 remained prognostic (hazard ratio, 3.853; 95% confidence interval, 1.498-9.911; P = 0.005). New sites of focal 18F-FDG uptake occurred more often in patients with PMD (n = 24) by imPERCIST5 than in those with stable metabolic disease (n = 7) or partial metabolic response (n = 4). In patients with partial metabolic response, 2 of 4 isolated new lesions regressed spontaneously during follow-up. Conclusion: In patients with metastatic melanoma treated with ipilimumab, tumor response according to PERCIST was associated with OS. Our data suggest that PMD should not be defined by the appearance of new lesions, but rather by an increase in the sum of SULpeak.
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Yamashita R, Nishio M, Do RKG, Togashi K. Convolutional neural networks: an overview and application in radiology. Insights Imaging 2018; 9:611-629. [PMID: 29934920 PMCID: PMC6108980 DOI: 10.1007/s13244-018-0639-9] [Citation(s) in RCA: 958] [Impact Index Per Article: 159.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 04/24/2018] [Accepted: 05/28/2018] [Indexed: 02/06/2023] Open
Abstract
Abstract Convolutional neural network (CNN), a class of artificial neural networks that has become dominant in various computer vision tasks, is attracting interest across a variety of domains, including radiology. CNN is designed to automatically and adaptively learn spatial hierarchies of features through backpropagation by using multiple building blocks, such as convolution layers, pooling layers, and fully connected layers. This review article offers a perspective on the basic concepts of CNN and its application to various radiological tasks, and discusses its challenges and future directions in the field of radiology. Two challenges in applying CNN to radiological tasks, small dataset and overfitting, will also be covered in this article, as well as techniques to minimize them. Being familiar with the concepts and advantages, as well as limitations, of CNN is essential to leverage its potential in diagnostic radiology, with the goal of augmenting the performance of radiologists and improving patient care. Key Points • Convolutional neural network is a class of deep learning methods which has become dominant in various computer vision tasks and is attracting interest across a variety of domains, including radiology. • Convolutional neural network is composed of multiple building blocks, such as convolution layers, pooling layers, and fully connected layers, and is designed to automatically and adaptively learn spatial hierarchies of features through a backpropagation algorithm. • Familiarity with the concepts and advantages, as well as limitations, of convolutional neural network is essential to leverage its potential to improve radiologist performance and, eventually, patient care.
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Shirasaki N, Matsushita T, Matsui Y, Yamashita R. Evaluation of the suitability of a plant virus, pepper mild mottle virus, as a surrogate of human enteric viruses for assessment of the efficacy of coagulation-rapid sand filtration to remove those viruses. WATER RESEARCH 2018; 129:460-469. [PMID: 29182907 DOI: 10.1016/j.watres.2017.11.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 05/03/2023]
Abstract
Here, we evaluated the removal of three representative human enteric viruses - adenovirus (AdV) type 40, coxsackievirus (CV) B5, and hepatitis A virus (HAV) IB - and one surrogate of human caliciviruses - murine norovirus (MNV) type 1 - by coagulation-rapid sand filtration, using water samples from eight water sources for drinking water treatment plants in Japan. The removal ratios of a plant virus (pepper mild mottle virus; PMMoV) and two bacteriophages (MS2 and φX174) were compared with the removal ratios of human enteric viruses to assess the suitability of PMMoV, MS2, and φX174 as surrogates for human enteric viruses. The removal ratios of AdV, CV, HAV, and MNV, evaluated via the real-time polymerase chain reaction (PCR) method, were 0.8-2.5-log10 when commercially available polyaluminum chloride (PACl, basicity 1.5) and virgin silica sand were used as the coagulant and filter medium, respectively. The type of coagulant affected the virus removal efficiency, but the age of silica sand used in the rapid sand filtration did not. Coagulation-rapid sand filtration with non-sulfated, high-basicity PACls (basicity 2.1 or 2.5) removed viruses more efficiently than the other aluminum-based coagulants. The removal ratios of MS2 were sometimes higher than those of the three human enteric viruses and MNV, whereas the removal ratios of φX174 tended to be smaller than those of the three human enteric viruses and MNV. In contrast, the removal ratios of PMMoV were similar to and strongly correlated with those of the three human enteric viruses and MNV. Thus, PMMoV appears to be a suitable surrogate for human enteric viruses for the assessment of the efficacy of coagulation-rapid sand filtration to remove viruses.
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Furuta A, Isoda H, Ohno T, Ono A, Yamashita R, Arizono S, Kido A, Sakashita N, Togashi K. Left Gastric Vein Visualization with Hepatopetal Flow Information in Healthy Subjects Using Non-Contrast-Enhanced Magnetic Resonance Angiography with Balanced Steady-State Free-Precession Sequence and Time-Spatial Labeling Inversion Pulse. Korean J Radiol 2018; 19:32-39. [PMID: 29353997 PMCID: PMC5768503 DOI: 10.3348/kjr.2018.19.1.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/23/2017] [Indexed: 11/17/2022] Open
Abstract
Objective To selectively visualize the left gastric vein (LGV) with hepatopetal flow information by non-contrast-enhanced magnetic resonance angiography under a hypothesis that change in the LGV flow direction can predict the development of esophageal varices; and to optimize the acquisition protocol in healthy subjects. Materials and Methods Respiratory-gated three-dimensional balanced steady-state free-precession scans were conducted on 31 healthy subjects using two methods (A and B) for visualizing the LGV with hepatopetal flow. In method A, two time-spatial labeling inversion pulses (Time-SLIP) were placed on the whole abdomen and the area from the gastric fornix to the upper body, excluding the LGV area. In method B, nonselective inversion recovery pulse was used and one Time-SLIP was placed on the esophagogastric junction. The detectability and consistency of LGV were evaluated using the two methods and ultrasonography (US). Results Left gastric veins by method A, B, and US were detected in 30 (97%), 24 (77%), and 23 (74%) subjects, respectively. LGV flow by US was hepatopetal in 22 subjects and stagnant in one subject. All hepatopetal LGVs by US coincided with the visualized vessels in both methods. One subject with non-visualized LGV in method A showed stagnant LGV by US. Conclusion Hepatopetal LGV could be selectively visualized by method A in healthy subjects.
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Nomura T, Kabashima K, Yamashita R, Kogame T. 500 The lymphokine signatures of angiomatoid fibrous histiocytoma revealed by immunohistochemistry. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ono A, Arizono S, Fujimoto K, Akasaka T, Yamashita R, Furuta A, Isoda H, Togashi K. Non-contrast-enhanced 3D MR portography within a breath-hold using compressed sensing acceleration: A prospective noninferiority study. Magn Reson Imaging 2017; 43:42-47. [PMID: 28688951 DOI: 10.1016/j.mri.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/22/2017] [Accepted: 07/02/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate images of non-contrast-enhanced 3D MR portography within a breath-hold (BH) using compressed sensing (CS) compared to standard respiratory-triggered (RT) sequences. MATERIALS AND METHODS Fifty-nine healthy volunteers underwent MR portography using two sequences of balanced steady-state free-precession (bSSFP) with time-spatial labeling inversion pulses (Time-SLIP): BH bSSFP-CS and RT bSSFP. Two radiologists independently scored the diagnostic acceptability to delineate the portal branches (MPV: main portal vein; RPV: right portal vein; LPV: left portal vein; RPPV: right posterior portal vein; and P4 and P8: portal branch of segment 4 and segment 8, respectively) and the overall image quality on a four-point scale. We assessed noninferiority of BH bSSFP-CS to RT bSSFP. For quantitative analysis, vessel-to-liver contrast (Cv-l) was calculated in MPV, RPV and LPV. RESULTS BH bSSFP sequence was successfully performed with a 30-second acquisition time. The diagnostic acceptability scores of BH bSSFP-CS compared with RT bSSFP were statistically noninferior: MPV (95% CI for score difference of Reader 1 and Reader 2, respectively: [-0.16, 0.06], [-0.05, 0.02]), RPV ([-0.00, 0.11], [-0.01, 0.08]), LPV ([-0.03, 0.10], [-0.10, 0.03]), RPPV ([-0.03, 0.10], [-0.05, 0.05]), P4 ([-0.13, 0.34], [-0.28, 0.21]) and P8 ([-0.21, 0.11], [-0.25, -0.02]). However, the overall image quality of BH bSSFP-CS did not show noninferiority ([-0.61, -0.24], [-0.54, -0.17]). Cv-l values were significantly lower in BH bSSFP-CS (P<0.001). CONCLUSION CS enabled non-contrast-enhanced 3D bSSFP MR portography to be performed within a BH while maintaining noninferior diagnostic acceptability compared to standard RT bSSFP MR portography.
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Yamashita R, Yamaoka T, Nishitai R, Isoda H, Taura K, Arizono S, Furuta A, Ohno T, Ono A, Togashi K. Portal vein branching order helps in the recognition of anomalous right-sided round ligament: common features and variations in portal vein anatomy. Abdom Radiol (NY) 2017; 42:1832-1838. [PMID: 28389788 DOI: 10.1007/s00261-017-1128-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This study aimed to evaluate the common features and variations of portal vein anatomy in right-sided round ligament (RSRL), which can help propose a method to detect and diagnose this anomaly. METHODS In this retrospective study of 14 patients with RSRL, the branching order of the portal tree was analyzed, with special focus on the relationship between the dorsal branch of the right anterior segmental portal vein (PA-D) and the lateral segmental portal vein (PLL), to determine the common features. The configuration of the portal vein from the main portal trunk to the right umbilical portion (RUP), the inclination of the RUP, and the number and thickness of the ramifications branching from the right anterior segmental portal vein (PA) were evaluated for variations. RESULTS In all subjects, the diverging point of the PA-D was constantly distal to that of the PLL. The portal vein configuration was I- and Z-shaped in nine and five subjects, respectively. The RUP was tilted to the right in all subjects. In Z-shaped subjects, the portal trunk between the branching point of the right posterior segmental portal vein and that of the PLL was tilted to the left in one subject and was almost parallel to the vertical plane in four subjects. Multiple ramifications were radially distributed from the PA in eight subjects, whereas one predominant PA-D branched from the PA in six subjects. CONCLUSIONS Based on the diverging points of the PA-D and PLL, we proposed a three-step method for the detection and diagnosis of RSRL.
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Yamashita R, Isoda H, Arizono S, Ono A, Onishi N, Furuta A, Togashi K. Non-contrast-enhanced magnetic resonance venography using magnetization-prepared rapid gradient-echo (MPRAGE) in the preoperative evaluation of living liver donor candidates: Comparison with conventional computed tomography venography. Eur J Radiol 2017; 90:89-96. [DOI: 10.1016/j.ejrad.2017.02.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/16/2017] [Indexed: 11/25/2022]
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Yamashita R, Isoda H, Arizono S, Furuta A, Ohno T, Ono A, Murata K, Togashi K. Selective visualization of pelvic splanchnic nerve and pelvic plexus using readout-segmented echo-planar diffusion-weighted magnetic resonance neurography: A preliminary study in healthy male volunteers. Eur J Radiol 2017; 86:52-57. [DOI: 10.1016/j.ejrad.2016.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/21/2016] [Accepted: 10/27/2016] [Indexed: 02/02/2023]
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Nagase T, Yamashita R, Lee JG. PM-01Electron-Irradiation-Induced Structural Changes at Pt/SiOxInterfaces at 773 K. Microscopy (Oxf) 2016. [DOI: 10.1093/jmicro/dfw064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Saka Y, Taniguchi Y, Nagahara Y, Yamashita R, Karasawa M, Naruse T, Watanabe Y. Rapidly progressive lupus nephritis associated with golimumab in a patient with systemic lupus erythematosus and rheumatoid arthritis. Lupus 2016; 26:447-448. [PMID: 27510604 DOI: 10.1177/0961203316662724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ohno T, Isoda H, Furuta A, Arizono S, Yamashita R, Ono A, Togashi K. Usefulness of breath-hold inversion recovery-prepared T1-weighted two-dimensional gradient echo sequence for detection of hepatocellular carcinoma in Gd-EOB-DTPA-enhanced MR imaging. Clin Imaging 2016; 40:997-1003. [PMID: 27295329 DOI: 10.1016/j.clinimag.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/11/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
The aim is to evaluate the diagnostic performance and the added value of breath-hold inversion recovery-prepared T1-weighted two-dimensional gradient echo (IR-2D-GRE) sequence for detection of hepatocellular carcinoma (HCC) in patients with insufficient liver parenchymal enhancement during the hepatobiliary phase (HBP) of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Seventeen patients with a quantitative liver-to-spleen contrast ratio of ≤1.5 on HBP images and 36 HCCs were included. Liver-to-lesion contrast ratios on HBP images obtained with IR-2D-GRE sequence were significantly higher than those with three-dimensional gradient echo sequence. The addition of IR-2D-GRE sequence during HBP of Gd-EOB-DTPA-enhanced MRI yielded higher diagnostic accuracy and improved sensitivity.
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Kawahara S, Isoda H, Fujimoto K, Shimizu H, Furuta A, Arizono S, Ohno T, Yamashita R, Ono A, Togashi K. Additional benefit of computed diffusion-weighted imaging for detection of hepatic metastases at 1.5T. Clin Imaging 2016; 40:481-5. [DOI: 10.1016/j.clinimag.2015.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 12/27/2022]
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Toguchi M, Matsuki M, Numoto I, Tsurusaki M, Imaoka I, Ishii K, Yamashita R, Inada Y, Monzawa S, Kobayashi H, Murakami T. Imaging of metastases from breast cancer to uncommon sites: a pictorial review. Jpn J Radiol 2016; 34:400-8. [PMID: 27059215 DOI: 10.1007/s11604-016-0541-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/17/2016] [Indexed: 01/22/2023]
Abstract
There are three types of breast cancer recurrence which can occur after initial treatment: local, regional, and distant. Distant metastases are more frequent than local and regional recurrences. It usually occurs several years after the primary breast cancer, although it is sometimes diagnosed at the same time as the primary breast cancer. Although the common distant metastases are bone, lung and liver, breast cancer has the potential to metastasize to almost any region of the body. Early detection and treatment of distant metastases improves the prognosis, therefore radiologists and clinicians should recognize the possibility of metastasis from breast cancer and grasp the imaging characteristics. In this report, we demonstrate the imaging characteristics of metastases from breast cancer to uncommon sites.
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Nagase T, Yamashita R, Lee JG. B12-O-15In Situ Observation of Pt Silicide Formation at Pt/SiOx Interface Under Electron Irradiation. Microscopy (Oxf) 2015. [DOI: 10.1093/jmicro/dfv102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shibuya K, Kinoshita K, Mizutani M, Oshima A, Yamashita R, Matsuda Y. Intraocular Ossification in the GSP/pe Chicken With Imperfect Albinism. Vet Pathol 2014; 52:688-91. [PMID: 25421422 DOI: 10.1177/0300985814559401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The eyes of 2 male and 2 female GSP/pe chickens, the imperfect albino strain, were investigated at 52 weeks of age. Aged chickens of the GSP/pe colony became blind with bilateral ocular enlargement and opaque lenses. Affected eyes (bilateral in 2 males and unilateral in 2 females) were hard and difficult to section; histologic specimens were processed after decalcification. A large portion of the posterior chamber was occupied by cancellous bone containing fibrous and cartilaginous foci. Osseous tissues developed adjacent to the choroid, and no retinal pigment epithelium (RPE) was detected between osseous tissues and the choroid. Small segments of degenerate neuronal retina were scattered in the osseous tissue. The irises and ciliary bodies were deformed by osseous tissue, and the lenses had severe cataracts. These observations suggest that the intraocular osseous tissue may be derived from RPE in the hereditary incomplete-albino strain of chickens.
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Shimizu H, Isoda H, Ohno T, Yamashita R, Kawahara S, Furuta A, Fujimoto K, Kido A, Kusahara H, Togashi K. Non-contrast-enhanced MR portography and hepatic venography with time-spatial labeling inversion pulses: comparison of imaging with the short tau inversion recovery method and the chemical shift selective method. Magn Reson Imaging 2014; 33:81-5. [PMID: 25159471 DOI: 10.1016/j.mri.2014.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 08/12/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare and evaluate images of non-contrast enhanced magnetic resonance (MR) portography and hepatic venography acquired with two different fat suppression methods, the chemical shift selective (CHESS) method and short tau inversion recovery (STIR) method. MATERIALS AND METHODS Twenty-two healthy volunteers were examined using respiratory-triggered three-dimensional true steady-state free-precession with two time-spatial labeling inversion pulses. The CHESS or STIR methods were used for fat suppression. The relative signal-to-noise ratio and contrast-to-noise ratio (CNR) were quantified, and the quality of visualization was scored. RESULTS Image acquisition was successfully conducted in all volunteers. The STIR method significantly improved the CNRs of MR portography and hepatic venography. The image quality scores of main portal vein and right portal vein were higher with the STIR method, but there were no significant differences. The image quality scores of right hepatic vein, middle hepatic vein, and left hepatic vein (LHV) were all higher, and the visualization of LHV was significantly better (p<0.05). CONCLUSION The STIR method contributes to further suppression of the background signal and improves visualization of the portal and hepatic veins. The results support using non-contrast-enhanced MR portography and hepatic venography in clinical practice.
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Furuta A, Isoda H, Yamashita R, Ohno T, Kawahara S, Shimizu H, Shibata T, Togashi K. Comparison of monopolar and bipolar diffusion weighted imaging sequences for detection of small hepatic metastases. Eur J Radiol 2014; 83:1626-30. [PMID: 24998079 DOI: 10.1016/j.ejrad.2014.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/01/2014] [Accepted: 06/02/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare monopolar (MP) and bipolar (BP) diffusion weighted imaging (DWI) in detecting small liver metastases. MATERIALS AND METHODS Eighty-eight patients underwent 3-T MRI. The signal-to-noise ratios (SNR) of the liver parenchyma and lesions, the lesion-to-liver contrast-to-noise ratios (CNR), and the detection sensitivities were compared. The lesion distortion was scored (LDS) from 4 (no distortion) to 1 (excessive distortion), dichotomised as no-distortion and distortion, and the association between detected lesions for each reader in the MP or BP DWI group and the dichotomised lesion distortion degree was assessed. RESULT Forty-six hepatic metastases were confirmed. The CNR with BP images showed significantly higher values than with MP (P=0.017). The detection sensitivities of the three readers were higher in the BP sequence than in MP, and one reader detected significantly more hepatic lesions with BP images (P=0.04). LDS was significantly improved with BP sequence (P=0.002). In the no-distortion group, excluding the MP DWI assessments of one reader, detection sensitivities were significantly higher than in the distortion group (P<0.001 and P=0.002, respectively). CONCLUSION Reduced lesion distortion improves the detection of small liver metastases, and BP is more sensitive in detecting small liver metastases than MP DWI.
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