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Ninomiya K, Arimura H, Yoshitake T, Hirose TA, Shioyama Y. Synergistic combination of a topologically invariant imaging signature and a biomarker for the accurate prediction of symptomatic radiation pneumonitis before stereotactic ablative radiotherapy for lung cancer: A retrospective analysis. PLoS One 2022; 17:e0263292. [PMID: 35100322 PMCID: PMC8803154 DOI: 10.1371/journal.pone.0263292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/18/2022] [Indexed: 12/25/2022] Open
Abstract
Objectives We aimed to explore the synergistic combination of a topologically invariant Betti number (BN)-based signature and a biomarker for the accurate prediction of symptomatic (grade ≥2) radiation-induced pneumonitis (RP+) before stereotactic ablative radiotherapy (SABR) for lung cancer. Methods A total of 272 SABR cases with early-stage non-small cell lung cancer were chosen for this study. The occurrence of RP+ was predicted using a support vector machine (SVM) model trained with the combined features of the BN-based signature extracted from planning computed tomography (pCT) images and a pretreatment biomarker, serum Krebs von den Lungen-6 (BN+KL-6 model). In all, 242 (20 RP+ and 222 RP–(grade 1)) and 30 cases (8 RP+ and 22 RP–) were used for training and testing the model, respectively. The BN-based features were extracted from BN maps that characterize topologically invariant heterogeneous traits of potential RP+ lung regions on pCT images by applying histogram- and texture-based feature calculations to the maps. The SVM models were built to predict RP+ patients with a BN signature that was constructed based on the least absolute shrinkage and selection operator logistic regression model. The evaluation of the prediction models was performed based on the area under the receiver operating characteristic curves (AUCs) and accuracy in the test. The performance of the BN+KL-6 model was compared to the performance based on the BN, conventional original pCT, and wavelet decomposition (WD) models. Results The test AUCs obtained for the BN+KL-6, BN, pCT, and WD models were 0.825, 0.807, 0.642, and 0.545, respectively. The accuracies of the BN+KL-6, BN, pCT, and WD models were found to be 0.724, 0.708, 0.591, and 0.534, respectively. Conclusion This study demonstrated the comprehensive performance of the BN+KL-6 model for the prediction of potential RP+ patients before SABR for lung cancer.
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Affiliation(s)
- Kenta Ninomiya
- Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Hidetaka Arimura
- Faculty of Medical Sciences, Division of Medical Quantum Science, Department of Health Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
- * E-mail: (HA); (TY)
| | - Tadamasa Yoshitake
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
- * E-mail: (HA); (TY)
| | - Taka-aki Hirose
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, Higashi-ku, Fukuoka, Japan
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Murakami Y, Nakano M, Yoshida M, Hirashima H, Nakamura F, Fukunaga J, Hirose TA, Yoshioka Y, Oguchi M, Hirata H. Possibility of chest wall dose reduction using volumetric-modulated arc therapy (VMAT) in radiation-induced rib fracture cases: comparison with stereotactic body radiation therapy (SBRT). J Radiat Res 2018; 59:327-332. [PMID: 29800456 PMCID: PMC5967448 DOI: 10.1093/jrr/rry012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/07/2017] [Indexed: 05/21/2023]
Abstract
The present study compares dosimetric parameters between volumetric-modulated arc therapy (VMAT) and 3D conformal radiation therapy (3D-CRT) in lung tumors adjacent to the chest wall treated with stereotactic body radiation therapy (SBRT). The study focused on the radiation dose to the chest wall of 16 patients who had developed radiation-induced rib fractures (RIRF) after SBRT using 3D-CRT. The targets in all patients were partially overlapping with the fractured ribs, and the median overlapping rib-PTV distance was 0.4 cm. Stereotactic body radiation therapy was re-planned for all patients. The prescribed dose was 48 Gy in four fractions to cover at least 95% of the planning target volume (PTV). Evaluated dosimetric factors included D98% and the conformation number (CN) of the PTV, the D2cm3, V40 and V30 of the fractured ribs, the V30 of the chest wall, and the Dmean, V20 and V5 of the lung. A comparison of 3D-CRT with the VMAT plan for PTV revealed that CN was significantly improved in the VMAT plan, whereas D98% did not significantly differ between the two plans. Regarding organs at risk (OARs), the D2cm3, V40 and V30 of fractured ribs, the V30 of the chest wall, and the Dmean, V20 and V5 of the lung, were significantly decreased in the VMAT plan. We concluded that the dose to OARs such as ribs and chest wall could be reduced with improved target conformity using VMAT instead of 3D-CRT for SBRT to treat peripheral lung tumors.
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Affiliation(s)
- Yu Murakami
- Division of Medical Quantum Sciences, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
- Corresponding author. Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. Tel: +81-3-3520-0111; Fax: +81-3-3570-0141;
| | - Masahiro Nakano
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Masahiro Yoshida
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Hideaki Hirashima
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Fumiya Nakamura
- Division of Medical Quantum Sciences, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junichi Fukunaga
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Taka-aki Hirose
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuo Yoshioka
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Masahiko Oguchi
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Hideki Hirata
- Division of Medical Quantum Sciences, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Shibayama Y, Arimura H, Hirose TA, Nakamoto T, Sasaki T, Ohga S, Matsushita N, Umezu Y, Nakamura Y, Honda H. Investigation of interfractional shape variations based on statistical point distribution model for prostate cancer radiation therapy. Med Phys 2017; 44:1837-1845. [DOI: 10.1002/mp.12217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 02/15/2017] [Accepted: 03/02/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Yusuke Shibayama
- Department of Medical Technology; Kyushu University Hospital; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Hidetaka Arimura
- Faculty of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Taka-aki Hirose
- Graduate School of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Takahiro Nakamoto
- Graduate School of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
- Japan Society for the Promotion of Science; 8, Ichiban-cho, Chiyoda-ku Tokyo 102-8472 Japan
| | - Tomonari Sasaki
- Faculty of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Saiji Ohga
- Faculty of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Norimasa Matsushita
- Division of Clinical Radiology Service; Kyoto University Hospital; 54, Kawaharacho, Shogoin, Sakyo-ku Kyoto 606-8507 Japan
| | - Yoshiyuki Umezu
- Department of Medical Technology; Kyushu University Hospital; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Yasuhiko Nakamura
- Department of Medical Technology; Kyushu University Hospital; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
| | - Hiroshi Honda
- Faculty of Medical Sciences; Kyushu University; 3-1-1, Maidashi, Higashi-ku Fukuoka 812-8582 Japan
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Nakamoto T, Arimura H, Nakamura K, Shioyama Y, Hirose TA, Umezu Y, Nakamura Y, Honda H, Hirata H. WE-AB-303-07: Computational Monitoring Framework of Four-Dimensional Dose Distributions During Treatment Time Based On a 2D/3D Registration with Adaptive Transformation Parameters in Lung Stereotactic Body Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4925872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hirashima H, Umezu Y, Fukunaga J, Hirose T, Nagata H, Mohri I, Nakamura K, Hirata H. [Effect of prostate matching on dose distribution by on board imager kV-CBCT image]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2015; 71:222-229. [PMID: 25797665 DOI: 10.6009/jjrt.2015_jsrt_71.3.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effect of prostate matching on dose distribution using kilovolt cone beam computed tomography (kV-CBCT) with image guided radiation therapy for prostate cancer. MATERIALS AND METHOD Sixteen prostate cancer patients were treated with intensity modulated radiation therapy to 76 Gy at 2 Gy per fraction in 38 fractions. Daily target localization was performed using "bone matching" and "prostate matching" based on planning CT and kV-CBCT. Prostate dose coverage was assessed by the proportion of the CTV fully encompassed by 95%, 98% isodose lines, and mean dose lines. As for rectal and bladder, dose coverage was assessed by volumes which received 40 Gy, 60 Gy, 70 Gy, 75 Gy and mean dose at treatment. And we calculated the tumor control probability (TCP) and normal tissue complication probability (NTCP), accordingly. They were compared to the bone and prostate matching image. RESULT Our study found an improvement in dose usage in CTV and bladder which enabled us to compare the bone matching image and the prostate matching image. However, it did not improve dose usage in the rectal. Then we chose patients who were a large shift from bone matching image to prostate matching image. As a result, rectal dose and NTCP were reduced. DISCUSSION Prostate matching is useful and safe when compared to bone matching because of improving CTV dose usage and reducing dose rectal and bladder.
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Affiliation(s)
- Hideaki Hirashima
- Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University
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Nakamoto T, Arimura H, Nakamura K, Shioyama Y, Mizoguchi A, Hirose TA, Honda H, Umezu Y, Nakamura Y, Hirata H. A computerized framework for monitoring four-dimensional dose distributions during stereotactic body radiation therapy using a portal dose image-based 2D/3D registration approach. Comput Med Imaging Graph 2015; 40:1-12. [DOI: 10.1016/j.compmedimag.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 12/31/2022]
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Fukunaga J, Arimura H, Umezu Y, Ohishi A, Hirose TA. [Investigation of the influence of metal markers on dose distributions and dose evaluation indices in intensity modulated radiation therapy plans for prostate cancer]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:1429-1438. [PMID: 25672448 DOI: 10.6009/jjrt.2014_jsrt_70.12.1429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this study was to evaluate the influence of metal markers on dose distributions and dose evaluation indices in intensity modulated radiation therapy (IMRT) plans for prostate cancer. The dose distribution calculation in the prostate IMRT was performed in a virtual phantom with and without insertion of the metal markers. The deviations of Dmax, Dmin, homogeneity index (HI), Dmean, D2, D98, and D95 of clinical target volume (CTV) and planning target volume (PTV) were obtained for estimation of the influence on the dose evaluation indices. Analytical anisotropic algorithm (AAA) and Acuros external beam (AXB) algorithms were employed for calculating the dose distributions. There were no deviations in any dose evaluation indices in dose distributions calculated by using AAA, whereas the maximum deviations for CTV and PTV by using AXB were +7.93% and +6.43% for Dmax, -16.61% and -1.77% for Dmin, +29.46% and +8.34% for HI, +0.15% and +0.02% for Dmean, +1.50% and +0.24% for D2, respectively. Additional data were -0.20% in D98 (CTV) and -0.27% in D95 (PTV). This study suggests that local dose changes, which were produced around metal markers, affected dose distributions and the dose evaluation indices.
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Affiliation(s)
- Junichi Fukunaga
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital
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Matsumoto Y, Umezu Y, Fujibuchi T, Noguchi Y, Fukunaga J, Kimura T, Hirano N, Hirose T, Sonoda S, Matsumoto R. [Verification of the protective effect of a testicular shield in postoperative radiotherapy for seminoma]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:883-887. [PMID: 25242597 DOI: 10.6009/jjrt.2014_jsrt_70.9.883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In postoperative radiotherapy for seminoma, control of the testicular absorbed dose is important, since exposure of the testis can lead to temporary or permanent infertility. In this case, instead of using a dog-leg-shaped field, treatment using a field focused near the aorta was provided in several disease stages of seminoma. However, the precise need for testicular shielding during treatment and dose of testis exposure was not clear. We examined these questions by measuring the testicular absorbed dose with and without a testicular shield using two clinical treatment plans and a phantom. The distance from the testis phantom and the lower end of the irradiation field was varied. Where the total dose for the tumor was 20 Gy, the testicular absorbed dose was below 0.1 Gy, the threshold dose for temporary infertility. At this dosage, the distance between the testis phantom and the edge of the irradiation field was 14.6 cm without the shield and 9.99 cm with the shield. Using a testes shield, it was thus possible to reduce the dose by 58.5%.
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Affiliation(s)
- Yoshitsugu Matsumoto
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital
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Hirose T, Umezu Y, Noguchi Y, Fukunaga J, Hirano N, Matsumoto Y, Matsumoto R. [Verification of the dose from an iridium-192 ((192)Ir) sealed source absorbed by an implantable cardioverter defibrillator (ICD) during uterine intracavitary brachytherapy]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:230-234. [PMID: 24647060 DOI: 10.6009/jjrt.2014_jsrt_70.3.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to verify the dose absorbed by an implantable cardioverter defibrillator (ICD) from an (192)Ir sealed source during uterine intracavitary brachytherapy, and to confirm its immunity to radiation effects. First, prior to treatment, the doses around the ICD position of an anthromorphic phantom were evaluated. Next, we also measured the dose at the ICD position using a fluorescent glass dosimeter and silicon diode dosimeter during the treatment of intracavitary brachytherapy of a patient implanted with an ICD. The results of the phantom study showed the dose percentage at the ICD location, 2 cm deep, to be 0.074% of the prescribed dose. The results of a treatment study similarly showed the dose, measured using a fluorescent glass dosimeter in the ICD position, to be 0.071% of the prescribed dose. During the application of the total prescribed dose, 30 Gy/5 fraction, the dose at the surface of the ICD position was estimated to be 21.2 mGy, well below the 1 Gy maximum recommended in the JASTRO guidelines. We regard dose verification and monitoring during treatment to be both necessary and useful in the treatment of individual cases.
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Affiliation(s)
- Takaaki Hirose
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital
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Tachibana M, Noguchi Y, Fukunaga J, Hirano N, Yoshidome S, Hirose T. [Influence on dose calculation by difference of dose calculation algorithms in stereotactic lung irradiation: comparison of pencil beam convolution (inhomogeneity correction: batho power law) and analytical anisotropic algorithm]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2009; 65:1064-1072. [PMID: 19721315 DOI: 10.6009/jjrt.65.1064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The monitor unit (MU) was calculated by pencil beam convolution (inhomogeneity correction algorithm: batho power law) [PBC (BPL)] which is the dose calculation algorithm based on measurement in the past in the stereotactic lung irradiation study. The recalculation was done by analytical anisotropic algorithm (AAA), which is the dose calculation algorithm based on theory data. The MU calculated by PBC (BPL) and AAA was compared for each field. In the result of the comparison of 1031 fields in 136 cases, the MU calculated by PBC (BPL) was about 2% smaller than that calculated by AAA. This depends on whether one does the calculation concerning the extension of the second electrons. In particular, the difference in the MU is influenced by the X-ray energy. With the same X-ray energy, when the irradiation field size is small, the lung pass length is long, the lung pass length percentage is large, and the CT value of the lung is low, and the difference of MU is increased.
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Tachibana M, Noguchi Y, Fukunaga J, Hirano N, Yoshidome S, Hirose T. [Comparison of dose evaluation index by pencil beam convolution and anisotropic analytical algorithm in stereotactic radiotherapy for lung cancer]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2009; 65:938-944. [PMID: 19661728 DOI: 10.6009/jjrt.65.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We previously studied dose distributions of stereotactic radiotherapy (SRT) for lung cancer. Our aim is to compare in combination pencil beam convolution with the inhomogeneity correction algorithm of Batho power low [PBC (BPL)] to the anisotropic analytical algorithm (AAA) by using the dose evaluation indexes. There were significant differences in D95, PTV mean dose, homogeneity index, and conformity index, V10, and V5. The dose distributions inside the PTV calculated by PBC (BPL) were more uniform than those of AAA. There were no significant differences in V20 and mean dose of total lung. There was no large difference for the whole lung. However, the surrounding high-dose region of PTV became smaller in AAA. The difference in dose evaluation indexes extended between PBC (BPL) and AAA that as many as low CT value of lung. When the dose calculation algorithm is changed, it is necessary to consider difference dose distributions compared with those of established practice.
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Affiliation(s)
- Masayuki Tachibana
- Department of Radiological Technology, Kyushu University Hospital, Japan
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