1
|
Kuyama N, Takashio S, Oguni T, Yamamoto M, Hirakawa K, Ishii M, Hanatani S, Oda S, Matsuzawa Y, Usuku H, Yamamoto E, Hirai T, Ueda M, Tsujita K. Cardiac Biomarker Change at 1 Year After Tafamidis Treatment and Clinical Outcomes in Patients With Transthyretin Amyloid Cardiomyopathy. J Am Heart Assoc 2024; 13:e034518. [PMID: 38761073 DOI: 10.1161/jaha.124.034518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Although tafamidis treatment improves prognosis in patients with wild-type transthyretin amyloid cardiomyopathy, an optimal surrogate marker monitoring its therapeutic effect remains unclear. This study investigated the association between changes in cardiac biomarkers, high-sensitivity cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) during the first year after tafamidis treatment and clinical outcomes. METHODS AND RESULTS In 101 patients with wild-type transthyretin amyloid cardiomyopathy receiving tafamidis at our institution, change in cardiac biomarkers from baseline to 1 year after tafamidis administration and its association with composite outcomes (composite of all-cause death and hospitalization attributable to heart failure) was assessed. During the follow-up period (median, 17 months), 16 (16%) patients experienced composite outcomes. The hs-cTnT level significantly decreased at 1 year after tafamidis treatment, unlike the BNP level. The frequencies of increased hs-cTnT and BNP levels were significantly higher in those with composite outcomes than in those without (44% versus 15%; P=0.01). Kaplan-Meier survival analysis showed that patients in whom both hs-cTnT and BNP levels increased at 1 year after tafamidis had a higher probability of composite outcomes compared with those with decreased hs-cTnT and BNP levels (log-rank P<0.01). Cox regression analysis identified increased hs-cTnT and BNP levels at 1 year after tafamidis administration as an independent predictor of higher cumulative risk of composite outcomes. CONCLUSIONS Deterioration in cardiac biomarkers during the first year after tafamidis treatment predicted a worse prognosis, suggesting the utility of serial assessment of cardiac biomarkers for monitoring the therapeutic response to tafamidis in patients with wild-type transthyretin amyloid cardiomyopathy.
Collapse
Affiliation(s)
- Naoto Kuyama
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Tetsuya Oguni
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Masahiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
- Department of Medical Information Science, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Yasushi Matsuzawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan
- Faculty of Life Sciences, Center for Metabolic Regulation of Healthy Aging Kumamoto University Kumamoto Japan
| |
Collapse
|
2
|
Emoto T, Kidoh M, Oda S, Sakabe D, Morita K, Hatemura M, Nakaura T, Nagayama Y, Inoue T, Funama Y, Takashio S, Tsujita K, Hirai T. Diagnostic performance of unenhanced electrocardiogram-gated cardiac CT for detecting myocardial edema. Medicine (Baltimore) 2024; 103:e38295. [PMID: 38758838 PMCID: PMC11098205 DOI: 10.1097/md.0000000000038295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/26/2024] [Indexed: 05/19/2024] Open
Abstract
To assess the diagnostic performance of unenhanced electrocardiogram (ECG)-gated cardiac computed tomography (CT) for detecting myocardial edema, using MRI T2 mapping as the reference standard. This retrospective study protocol was approved by our institutional review board, which waived the requirement for written informed consent. Between December 2017 to February 2019, consecutive patients who had undergone T2 mapping for myocardial tissue characterization were identified. We excluded patients who did not undergo unenhanced ECG-gated cardiac CT within 3 months from MRI T2 mapping or who had poor CT image quality. All patients underwent unenhanced ECG-gated cardiac CT with an axial scan using a third-generation, 320 × 0.5 mm detector-row CT unit. Two radiologists together drew regions of interest (ROIs) in the interventricular septum on the unenhanced ECG-gated cardiac CT images. Using T2 mapping as the reference standard, the diagnostic performance of unenhanced cardiac CT for detecting myocardial edema was evaluated by using the area under the receiver operating characteristic curve with sensitivity and specificity. Youden index was used to find an optimal sensitivity-specificity cutoff point. A cardiovascular radiologist independently performed the measurements, and interobserver reliability was assessed using intraclass correlation coefficients for CT value measurements. A P value of <.05 was considered statistically significant. We included 257 patients who had undergone MRI T2 mapping. Of the 257 patients, 35 patients underwent unenhanced ECG-gated cardiac CT. One patient was excluded from the study because of poor CT image quality. Finally, 34 patients (23 men; age 64.7 ± 14.6 years) comprised our study group. Using T2 mapping, we identified myocardial edema in 19 patients. Mean CT and T2 values for 34 patients were 46.3 ± 2.7 Hounsfield unit and 49.0 ± 4.9 ms, respectively. Mean CT values moderately correlated with mean T2 values (Rho = -0.41; P < .05). Mean CT values provided a sensitivity of 63.2% and a specificity of 93.3% for detecting myocardial edema, with a cutoff value of ≤45.0 Hounsfield unit (area under the receiver operating characteristic curve = 0.77; P < .01). Inter-observer reproducibility in measuring mean CT values was excellent (intraclass correlation coefficient = 0.93; [95% confidence interval: 0.86, 0.96]). Myocardial edema could be detected by CT value of myocardium in unenhanced ECG-gated cardiac CT.
Collapse
Affiliation(s)
- Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Daisuke Sakabe
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Kosuke Morita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Masahiro Hatemura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Taihei Inoue
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Chuo-ku, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Chuo-ku, Kumamoto, Japan
| |
Collapse
|
3
|
Oguni T, Takashio S, Kuyama N, Hirakawa K, Hanatani S, Oike F, Usuku H, Matsuzawa Y, Kidoh M, Oda S, Yamamoto E, Ueda M, Hirai T, Tsujita K. Clinical characteristics of patients with high extracellular volume fraction evaluated by cardiac computed tomography for coronary artery evaluation. Eur Heart J Open 2024; 4:oeae036. [PMID: 38751455 PMCID: PMC11095558 DOI: 10.1093/ehjopen/oeae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
Aims This study aims to evaluate the distribution of extracellular volume fraction detected via computed tomography, clinical characteristics of high extracellular volume fraction detected via computed tomography, and the rate of incidental detection of cardiac amyloidosis in patients undergoing cardiac computed tomography for coronary artery evaluation. Methods and results This study included 874 consecutive patients (mean age, 74.4 ± 7.1 years; men, 65%), comprising men aged ≥60 years and women aged ≥70 years, who had undergone cardiac computed tomography between January 2020 and September 2022. The mean extracellular volume fraction detected via computed tomography was 29.7 ± 5.2%, and 108 patients (12.4%) had an extracellular volume fraction detected via computed tomography of ≥35%. Older age (75.9 ± 8.2 years vs. 74.2 ± 6.9 years; P = 0.042), male sex (75.9% vs. 63.0%; P = 0.007), impaired left ventricular ejection fraction, increased high-sensitivity cardiac troponin T and B-type natriuretic peptide levels, and increased left ventricular thickness showed significant associations with an extracellular volume fraction detected via computed tomography of ≥35%. Cardiac amyloidosis was diagnosed incidentally in 15 patients based on an increase in extracellular volume fraction detected via computed tomography. The prevalence of cardiac amyloidosis was 1.7% (15/874) and 14.3% (15/105) in the entire study population and in patients with an extracellular volume fraction detected via computed tomography of ≥35%, respectively. An increase in the extracellular volume fraction detected via computed tomography was suggestive of cardiac amyloidosis. Conclusion Elevated extracellular volume fraction detected via computed tomography, associated with elevated cardiac biomarker levels and myocardial structural changes, may lead to the incidental diagnosis of cardiac amyloidosis.
Collapse
Affiliation(s)
- Tetsuya Oguni
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Naoto Kuyama
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Yasushi Matsuzawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, 860-8556 Kumamoto, Japan
- Center of Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
4
|
Nagayama Y, Hayashi H, Taguchi N, Yoshida R, Harai R, Kidoh M, Oda S, Nakaura T, Hirai T. Diagnostic performance of hepatic CT and chemical-shift MRI to discriminate lipid-poor adrenal adenomas from hepatocellular carcinoma metastases. Abdom Radiol (NY) 2024; 49:1626-1637. [PMID: 38456897 DOI: 10.1007/s00261-024-04228-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To evaluate the diagnostic performance of multiphase hepatic CT parameters (non-contrast attenuation, absolute and relative washout ratios [APW and RPW, respectively], and relative enhancement ratio [RER]) and chemical-shift MRI (CS-MRI) for discriminating lipid-poor adrenal adenomas (with non-contrast CT attenuation > 10 HU) from metastases in patients with hepatocellular carcinoma (HCC). METHODS This retrospective study included HCC patients with lipid-poor adrenal lesions who underwent multiphase hepatic CT between January 2010 and December 2021. For each adrenal lesion, non-contrast attenuation, APW, RPW, RER, and signal-intensity index (SI-index) were measured. Each parameter was compared between adenomas and metastases. The area under the receiver operating characteristic curves (AUCs) and sensitivities to achieve 100% specificity for adenoma diagnoses were determined. RESULTS 104 HCC patients (78 men; mean age, 71.8 ± 9.6 years) with 63 adenomas and 48 metastases were identified; CS-MRI was performed in 66 patients with 49 adenomas and 21 metastases within one year of CT. Lipid-poor adenomas showed lower non-contrast attenuation (22.9 ± 7.1 vs. 37.9 ± 9.4 HU) and higher APW (40.5% ± 12.8% vs. 23.7% ± 17.4%), RPW (30.0% ± 10.2% vs. 12.4% ± 9.6%), RER (329% ± 152% vs. 111% ± 43.0%), and SI-index (43.3 ± 20.7 vs. 10.8 ± 13.4) than HCC metastases (all p < .001). AUC for non-contrast attenuation, APW, RPW, RER, and SI-index were 0.894, 0.786, 0.904, 0.969, and 0.902, respectively. The sensitivities to achieve 100% specificity were 7.9%, 25.4%, 30.2%, 63.5%, and 24.5%, respectively. Combined RER and APW achieved the highest sensitivity of 73.0%. CONCLUSION Multiphase hepatic CT allows for better discrimination between lipid-poor adrenal adenomas and metastases relative to CS-MRI, especially when combined with RER and washout parameters.
Collapse
Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Narumi Taguchi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Ryuya Yoshida
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Ryota Harai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
5
|
Hayashi H, Kiyosue H, Tamura Y, Ueda H, Yonemura M, Sasaki G, Hokamura M, Ishiuchi S, Kanaya H, Uetani H, Oda S, Kawanaka K, Hirai T. Transarterial Embolization of Renal Arteriovenous Malformations: Treatment Outcomes According to Angiographic Classification. J Vasc Interv Radiol 2024:S1051-0443(24)00246-X. [PMID: 38537737 DOI: 10.1016/j.jvir.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 05/20/2024] Open
Abstract
PURPOSE To assess the different adjunctive catheter techniques required to achieve complete occlusion of renal arteriovenous malformations (rAVMs) of different angioarchitectural types. MATERIALS AND METHODS Overall, data on 18 patients with rAVM (Type 1, n = 7; Type 2, n = 2; Type 3, n = 9; mean age, 53.8 years) who underwent 25 procedures between 2011 and 2022 were reviewed. The clinical presentations, endovascular techniques, arteriovenous malformation (AVM) occlusion rate, adverse events (including the incidence of renal infarction), and clinical symptoms and outcomes (including recurrence/increase of AVM) were analyzed according to the Cho-Do angioarchitectural classification. Posttreatment renal infarction was classified as no infarction, small infarction (<12.5%), medium infarction (12.5%-25%), and large infarction (>25%) using contrast-enhanced computed tomography or magnetic resonance imaging. RESULTS Hematuria and heart failure were presenting symptoms in 10 and 2 patients, respectively. The embolic materials used were as follows: Type 1 rAVM, coils alone or with n-butyl-2-cyanoacrylate (nBCA); Type 2 rAVM, nBCA alone or with coils; and Type 3 rAVMs, nBCA alone. Fourteen patients underwent adjunctive catheter techniques, including flow control with a balloon catheter and multiple microcatheter placement, alone or in combination. Immediate postprocedural angiography revealed complete occlusion in 15 patients (83%) and marked regression of rAVM in 3 (17%). Small asymptomatic renal infarctions were observed in 6 patients with Type 3 rAVMs without any decrease in renal function. No major adverse events were observed. All symptomatic patients experienced symptom resolution. Recurrence/increase of rAVM was not observed during the mean 32-month follow-up period (range, 2-120 months). CONCLUSIONS Transarterial embolization using adjunctive catheter techniques according to angioarchitectural types can be an effective treatment for rAVMs.
Collapse
Affiliation(s)
- Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Hiro Kiyosue
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshitaka Tamura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Ueda
- Department of Diagnostic Radiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Mari Yonemura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Goh Sasaki
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masamichi Hokamura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Soichiro Ishiuchi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Kanaya
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Kawanaka
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
6
|
Inoue H, Kuroda JI, Uetani H, Matsuyama T, Kaku Y, Shinojima N, Hirai T, Mukasa A. Postoperative disappearance of leptomeningeal enhancement around the brainstem in glioblastoma. Neuroradiology 2024; 66:325-332. [PMID: 38200284 DOI: 10.1007/s00234-023-03275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Leptomeningeal enhancement (LME) suggests leptomeningeal dissemination (LMD) of tumor cells, which is a complication of end-stage glioblastoma, and is associated with a poor prognosis. However, magnetic resonance imaging (MRI) occasionally indicates the disappearance of peri-brainstem LME after surgical resection of glioblastoma. Since preoperative LMD may affect treatment indications, we aimed to analyze the clinical significance of preoperative LME of the brainstem in glioblastoma. METHODS We retrospectively collected clinical and radiological data from consecutive patients with glioblastoma and preoperative LME of the brainstem, who were treated at our hospital between 2017 and 2020. RESULTS Among 112 patients with glioblastoma, nine (8%) showed preoperative LME of the brainstem. In comparison with tumors without LME, tumor size was significantly associated with the preoperative LME of the brainstem (p = 0.016). In addition, there was a trend toward significance for a relationship between deep tumor location and preoperative LME of the brainstem (p = 0.058). Notably, among six patients who underwent surgical resection for glioblastoma with LME of the brainstem, four showed significant radiological disappearance of the LME on postoperative MRI. This suggests that the LME did not result from LMD in these cases. Moreover, these four patients lived longer than would be expected from the presence of LMD. However, this LME disappearance was not observed after biopsy or chemoradiotherapy. CONCLUSIONS These findings suggest that preoperative LME does not necessarily indicate the presence of untreatable LMD; moreover, LME may disappear after surgical tumor resection. Thus, transient preoperative LME could be attributed to other mechanisms, including impaired venous flow due to intratumoral arteriovenous shunts, which can be resolved by reducing the tumor burden.
Collapse
Affiliation(s)
- Hirotaka Inoue
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Jun-Ichiro Kuroda
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan.
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Tomohiko Matsuyama
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto City, Kumamoto, Japan
| | - Yasuyuki Kaku
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan.
| |
Collapse
|
7
|
Tamaishi Y, Tanaka H, Hirai T, Hiramatsu SI, Takakura S, Magawa S, Tanaka K, Kondo E, Iwamoto T, Ikeda T. Safety and dose-finding trial of tadalafil administered for fetus in labor: A phase I clinical study. J Obstet Gynaecol Res 2024; 50:448-455. [PMID: 38165071 DOI: 10.1111/jog.15871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
AIM This study aimed to investigate the safety and efficacy of tadalafil in protecting the fetus from hypoxic stress caused by repeated labor pains during delivery and preventing fetal hypoxic-ischemic encephalopathy. METHODS The study used a three-case cohort approach. Three patients were administered 10 mg tadalafil and monitored for serious adverse events. In the absence of serious tadalafil-associated adverse events as assessed by the Safety Evaluation Committee, three new patients were added to the study and treated with 20 mg/dose. The blood levels of tadalafil were recorded before and after 2, 4, 8, and 12 h of administration and 2 h after delivery. RESULTS A total of seven patients were enrolled, and after excluding one patient who delivered before 37 weeks, tadalafil was administered to six patients. Maternal adverse events were considered acceptable from the maternal perspective, with grade 1 headache, anorexia, and myalgia and no obstetrical complications after delivery at both doses. No serious neonatal adverse events were associated with tadalafil. Tadalafil blood levels remained stable at both doses. In addition, the level of soluble fms-like tyrosine kinase-1 did not alter, while that of the placental growth factor differed significantly before and after tadalafil administration. CONCLUSIONS The study confirmed the safety of tadalafil administration during delivery for both mothers and newborns. The stable tadalafil blood levels confirmed the efficacy of the tested administration regime at 12 h interval. These findings would assist in conducting phase II trials to further verify the optimal dose and safety of tadalafil.
Collapse
Affiliation(s)
- Yuya Tamaishi
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | | | | | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| |
Collapse
|
8
|
Hirai T, Aoyama T, Tsuji Y, Itoh T, Matsumoto Y, Iwamoto T. Kinetic-pharmacodynamic model of warfarin for prothrombin time-international normalized ratio in Japanese patients. Br J Clin Pharmacol 2024; 90:828-836. [PMID: 37953511 DOI: 10.1111/bcp.15967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/10/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023] Open
Abstract
AIMS Genotype-guided dosing algorithms can explain about half of the interindividual variability in prothrombin time-international normalized ratio (PT-INR) under warfarin treatment. This study aimed to refine a published kinetic-pharmacodynamic model and guide warfarin dosage for an optimal PT-INR based on renal function. METHODS Using a retrospective cohort of adult patients (>20 years) who were administered warfarin and underwent PT-INR measurements, we refined the kinetic-pharmacodynamic model with age and the genotypes of cytochrome P450 2C9 and vitamin K epoxide reductase complex subunit 1 using the PRIOR subroutine in the nonlinear-mixed-effect modelling programme. We searched the significant covariates for parameters, such as the dose rate for 50% inhibition of coagulation (EDR50 ), using a stepwise forward and backward method. Monte Carlo simulation determined a required daily dose of warfarin with a target range of PT-INR (2.0-3.0 or 1.6-2.6) based on the significant covariates. RESULTS A total of 350 patients with 2762 PT-INR measurements were enrolled (estimated glomerular filtration rate [eGFR]: 47.5 [range: 2.6-199.0] mL/min/1.73 m2 ). The final kinetic-pharmacodynamic model showed that the EDR50 changed power functionally with body surface area, serum albumin level and eGFR. Monte Carlo simulation revealed that a lower daily dose of warfarin was required to attain the target PT-INR range as eGFR decreased. CONCLUSIONS Model-informed precision dosing of warfarin is a valuable approach for estimating its dosage in patients with renal impairment.
Collapse
Affiliation(s)
- Toshinori Hirai
- Department of Pharmacy, Mie University Hospital, Faculty of Medicine, Mie University, Tsu, Mie, Japan
| | - Takahiko Aoyama
- Laboratory of Clinical Pharmacometrics, School of Pharmacy, Nihon University, Funabashi, Chiba, Japan
| | - Yasuhiro Tsuji
- Laboratory of Clinical Pharmacometrics, School of Pharmacy, Nihon University, Funabashi, Chiba, Japan
| | - Toshimasa Itoh
- Department of Pharmacy, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Yoshiaki Matsumoto
- Laboratory of Clinical Pharmacometrics, School of Pharmacy, Nihon University, Funabashi, Chiba, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Faculty of Medicine, Mie University, Tsu, Mie, Japan
| |
Collapse
|
9
|
Yamaguchi S, Oda S, Kidoh M, Hayashi H, Takashio S, Usuku H, Nagayama Y, Nakaura T, Tsujita K, Hirai T, Aoki T. Cardiac MRI T1 and T2 Mapping as a Quantitative Imaging Biomarker in Transthyretin Amyloid Cardiomyopathy. Acad Radiol 2024; 31:514-522. [PMID: 37775448 DOI: 10.1016/j.acra.2023.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess the utility of cardiac magnetic resonance imaging (MRI) T1 and T2 mapping as quantitative imaging biomarkers in transthyretin amyloid cardiomyopathy (ATTR-CM). MATERIALS AND METHODS This study retrospectively evaluated 74 patients with confirmed wild-type ATTR-CM who underwent cardiac MRI, 99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy, and echocardiography. We assessed the quantitative disease parameters, for example, left ventricular ejection fraction (LVEF), and global longitudinal strain (GLS) by echocardiography, native T1, extracellular volume fraction (ECV), and native T2 value by cardiac MRI, heart-to-contralateral ratio (H/CL) by 99mTc-PYP, and high-sensitive cardiac troponin T. Myocardial native T2 of ≥50 ms was defined as myocardial edema. Correlations between the disease's quantitative parameters were evaluated, and the ECV was compared to other parameters in ATTR-CM with/without myocardial edema. RESULTS ECV in all patients with ATTR-CM revealed a strong correlation with native T1 (r = 0.62), a moderate correlation with hs-TnT (r = 0.59), LVEF (r = -0.48), GLS (r = 0.58), and H/CL (r = 0.48). Correlations between ECV and other quantitative parameters decreased in ATTR-CM with myocardial edema except for H/CL. Meanwhile, the correlations increased in ATTR-CM without myocardial edema. CONCLUSION The presence of myocardial edema affected the interpretation of ECV assessment, although ECV can be a comprehensive imaging biomarker for ATTR-CM. ECV showed a significant correlation with various quantitative disease parameters and can be a reliable disease monitoring marker in patients with ATTR-CM when myocardial edema was excluded.
Collapse
Affiliation(s)
- Shinpei Yamaguchi
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan (S.Y., T.A.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.).
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan (S.T., H.U., K.T.)
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University,1-1-1 Honjo, Chuo-ku, Kumamoto, Japan (S.Y., S.O., M.K., H.H., Y.N., T.N., T.H.)
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan (S.Y., T.A.)
| |
Collapse
|
10
|
Shinojima N, Yano S, Uchida D, Mizukami N, Mabe H, Kawashima J, Igata M, Kondo T, Uetani H, Yamamoto T, Uekawa K, Hide T, Mikami Y, Hirai T, Mukasa A. Long-term outcomes of multidisciplinary treatment combining surgery and stereotactic radiotherapy with Novalis for craniopharyngioma. J Clin Neurosci 2024; 120:138-146. [PMID: 38244528 DOI: 10.1016/j.jocn.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
Craniopharyngiomas are difficult to resect completely, recurrence is frequent, and hypothalamic/pituitary function may be affected after surgery. Therefore, the ideal treatment for craniopharyngiomas is local control with preservation of hypothalamic and pituitary functions. The purpose of this study is to retrospectively evaluate the long-term efficacy and adverse events of stereotactic radiotherapy (SRT) with Novalis for craniopharyngioma. This study included 23 patients with craniopharyngiomas who underwent surgery between 2006 and 2021 and underwent SRT as their first irradiation after surgery. The median post-irradiation observation period was 88 months, with the overall survival rates of 100 % at 10 years and 85.7 % at 20 years. One patient died of adrenal insufficiency 12 years after irradiation. The local control rate of the cystic component was 91.3 % at 5 years, 83.0 % at 15 years, with no increase in the solid component. No delayed impairment of visual or pituitary function due to irradiation was observed. No new hypothalamic dysfunction was observed after radiation therapy. No delayed adverse events such as brain necrosis, cerebral artery stenosis, cerebral infarction, or secondary brain tumors were also observed. SRT was safe and effective over the long term in patients irradiated in childhood as well as adults, with no local recurrence or adverse events. We believe that surgical planning for craniopharyngioma with stereotactic radiotherapy in mind is effective in maintaining a good prognosis and quality of life.
Collapse
Affiliation(s)
- Naoki Shinojima
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
| | - Shigetoshi Yano
- Minamifukuoka Neurosurgical Hospital, Fukuoka 811-1313, Japan
| | - Daichi Uchida
- Kumamoto Radiosurgery Clinic, Kumamoto 862-0941, Japan
| | | | - Hiroyo Mabe
- Department of Pediatrics, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Junji Kawashima
- Department of Diabetes, Metabolism and Endocrinology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Motoyuki Igata
- Department of Diabetes, Metabolism and Endocrinology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Tatsuya Kondo
- Department of Diabetes, Metabolism and Endocrinology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Takahiro Yamamoto
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Ken Uekawa
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Takuichiro Hide
- Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| |
Collapse
|
11
|
Hokamura M, Uetani H, Nakaura T, Matsuo K, Morita K, Nagayama Y, Kidoh M, Yamashita Y, Ueda M, Mukasa A, Hirai T. Exploring the impact of super-resolution deep learning on MR angiography image quality. Neuroradiology 2024; 66:217-226. [PMID: 38148334 DOI: 10.1007/s00234-023-03271-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE The aim of this study is to assess the effect of super-resolution deep learning-based reconstruction (SR-DLR), which uses k-space properties, on image quality of intracranial time-of-flight (TOF) magnetic resonance angiography (MRA) at 3 T. METHODS This retrospective study involved 35 patients who underwent intracranial TOF-MRA using a 3-T MRI system with SR-DLR based on k-space properties in October and November 2022. We reconstructed MRA with SR-DLR (matrix = 1008 × 1008) and MRA without SR-DLR (matrix = 336 × 336). We measured the signal-to-noise ratio (SNR), contrast, and contrast-to-noise ratio (CNR) in the basilar artery (BA) and the anterior cerebral artery (ACA) and the sharpness of the posterior cerebral artery (PCA) using the slope of the signal intensity profile curve at the half-peak points. Two radiologists evaluated image noise, artifacts, contrast, sharpness, and overall image quality of the two image types using a 4-point scale. We compared quantitative and qualitative scores between images with and without SR-DLR using the Wilcoxon signed-rank test. RESULTS The SNRs, contrasts, and CNRs were all significantly higher in images with SR-DLR than those without SR-DLR (p < 0.001). The slope was significantly greater in images with SR-DLR than those without SR-DLR (p < 0.001). The qualitative scores in MRAs with SR-DLR were all significantly higher than MRAs without SR-DLR (p < 0.001). CONCLUSION SR-DLR with k-space properties can offer the benefits of increased spatial resolution without the associated drawbacks of longer scan times and reduced SNR and CNR in intracranial MRA.
Collapse
Affiliation(s)
- Masamichi Hokamura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan.
| | - Kensei Matsuo
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Kosuke Morita
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Yuichi Yamashita
- Canon Medical Systems Corporation, 70-1, Yanagi-cho, Saiwai-ku, Kawasaki-shi, Kanagawa, 212-0015, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| |
Collapse
|
12
|
Nakaura T, Yoshida N, Kobayashi N, Shiraishi K, Nagayama Y, Uetani H, Kidoh M, Hokamura M, Funama Y, Hirai T. Preliminary assessment of automated radiology report generation with generative pre-trained transformers: comparing results to radiologist-generated reports. Jpn J Radiol 2024; 42:190-200. [PMID: 37713022 PMCID: PMC10811038 DOI: 10.1007/s11604-023-01487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE In this preliminary study, we aimed to evaluate the potential of the generative pre-trained transformer (GPT) series for generating radiology reports from concise imaging findings and compare its performance with radiologist-generated reports. METHODS This retrospective study involved 28 patients who underwent computed tomography (CT) scans and had a diagnosed disease with typical imaging findings. Radiology reports were generated using GPT-2, GPT-3.5, and GPT-4 based on the patient's age, gender, disease site, and imaging findings. We calculated the top-1, top-5 accuracy, and mean average precision (MAP) of differential diagnoses for GPT-2, GPT-3.5, GPT-4, and radiologists. Two board-certified radiologists evaluated the grammar and readability, image findings, impression, differential diagnosis, and overall quality of all reports using a 4-point scale. RESULTS Top-1 and Top-5 accuracies for the different diagnoses were highest for radiologists, followed by GPT-4, GPT-3.5, and GPT-2, in that order (Top-1: 1.00, 0.54, 0.54, and 0.21, respectively; Top-5: 1.00, 0.96, 0.89, and 0.54, respectively). There were no significant differences in qualitative scores about grammar and readability, image findings, and overall quality between radiologists and GPT-3.5 or GPT-4 (p > 0.05). However, qualitative scores of the GPT series in impression and differential diagnosis scores were significantly lower than those of radiologists (p < 0.05). CONCLUSIONS Our preliminary study suggests that GPT-3.5 and GPT-4 have the possibility to generate radiology reports with high readability and reasonable image findings from very short keywords; however, concerns persist regarding the accuracy of impressions and differential diagnoses, thereby requiring verification by radiologists.
Collapse
Affiliation(s)
- Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan.
| | - Naofumi Yoshida
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Naoki Kobayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Kaori Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Masamichi Hokamura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan
| |
Collapse
|
13
|
Hayashi H, Oda S, Kidoh M, Anai M, Hirakawa K, Takashio S, Yamamoto E, Takamure H, Moriguchi N, Tsujita K, Hirai T. Pulmonary arterial hypertension associated with portal hypertension: Noninvasive comprehensive assessment using computed tomography. Radiol Case Rep 2024; 19:671-674. [PMID: 38111546 PMCID: PMC10726335 DOI: 10.1016/j.radcr.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/02/2023] [Accepted: 11/05/2023] [Indexed: 12/20/2023] Open
Abstract
Pulmonary arterial hypertension associated with portal hypertension, known as portopulmonary hypertension (PoPH) is one of the important and serious pulmonary complications in patients with portal hypertension. Although there are a large number of patients with portal hypertension due to mainly liver cirrhosis, the number of cases diagnosed with PoPH are far fewer because the causes of dyspnea in patients with cirrhosis are diverse and the disease entity of PoPH is poorly recognized by clinicians. We report here the case with PoPH suggested and assessed comprehensively by dual energy computed tomography (CT) including high-resolution pulmonary CT angiography, pulmonary perfusion imaging, myocardial late iodine enhancement imaging, and myocardial extracellular volume analysis. This refined CT imaging protocol can be used in conjunction with standard chest evaluation and offers a practical and useful approach for the noninvasive "one-stop shop" evaluation of PoPH.
Collapse
Affiliation(s)
- Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Miki Anai
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hiroto Takamure
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naoya Moriguchi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
14
|
Hayashi H, Oda S, Kidoh M, Yamaguchi S, Yoshimura F, Takashio S, Usuku H, Nagayama Y, Nakaura T, Ueda M, Tsujita K, Hirai T. Myocardial extracellular volume quantification in cardiac amyloidosis: a comparative study between cardiac computed tomography and magnetic resonance imaging. Eur Radiol 2024; 34:1016-1025. [PMID: 37597032 DOI: 10.1007/s00330-023-10129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES Myocardial extracellular volume (ECV) on computed tomography (CT), an alternative to cardiac magnetic resonance (CMR), has significant practical clinical advantages. However, the consistency between ECVs quantified via CT and CMR in cardiac amyloidosis (CA) has not been investigated sufficiently. Therefore, the current study investigated the application of CT-ECV in CA with CMR-ECV as the reference standard. METHODS We retrospectively evaluated 31 patients with CA who underwent cardiac CT and CMR. Pearson correlation analysis was performed to investigate correlations between CT-ECV and CMR-ECV at each segment. Further, correlations between ECV and clinical parameters were assessed. RESULTS There were no significant differences in the mean global ECVs between CT scan and CMR (51.3% ± 10.2% vs 50.0% ± 10.5%). CT-ECV was correlated with CMR-ECV at the septal (r = 0.88), lateral (r = 0.80), inferior (r = 0.79), anterior (r = 0.77) segments, and global (r = 0.87). In both CT and CMR, the ECV had a weak to strong correlation with high-sensitivity cardiac troponin T level, a moderate correlation with global longitudinal strain, and an inverse correlation with left ventricular ejection fraction. Further, the septal ECV and global ECV had a slightly higher correlation with the clinical parameters. CONCLUSIONS Cardiac CT can quantify myocardial ECV and yield results comparable to CMR in patients with CA. Moreover, a significant correlation between CT-ECV and clinical parameters was observed. Thus, CT-ECV can be an imaging biomarker and alternative to CMR-ECV. CLINICAL RELEVANCE STATEMENT Cardiac CT can quantify myocardial ECV and yield results comparable to CMR in patients with CA, and CT-ECV can be used clinically as an imaging biomarker and alternative to CMR-ECV. KEY POINTS • A significant correlation was found between CT myocardial extracellular volume and cardiac MR myocardial extracellular volume in patients with cardiac amyloidosis. • In CT and cardiac MR, the myocardial extracellular volume correlated well with high-sensitivity cardiac troponin T level, global longitudinal strain, and left ventricular ejection fraction. • CT myocardial extracellular volume can be an imaging biomarker and alternative to cardiac MR myocardial extracellular volume.
Collapse
Affiliation(s)
- Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Shinpei Yamaguchi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Fumihiro Yoshimura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
15
|
Kobayashi N, Masuda T, Nakaura T, Shiraishi K, Uetani H, Nagayama Y, Kidoh M, Funama Y, Hirai T. The Feasibility of Using a Deep Learning-Based Model to Determine Cardiac Computed Tomographic Contrast Dose. J Comput Assist Tomogr 2024; 48:85-91. [PMID: 37531644 DOI: 10.1097/rct.0000000000001532] [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: 08/04/2023]
Abstract
PURPOSE This study aimed to predict contrast effects in cardiac computed tomography (CT) from CT localizer radiographs using a deep learning (DL) model and to compare the prediction performance of the DL model with that of conventional models based on patients' physical size. METHODS This retrospective study included 473 (256 men and 217 women) cardiac CT scans between May 2014 and August 2017. We developed and evaluated DL models that predict milligrams of iodine per enhancement of the aorta from CT localizer radiographs. To assess the model performance, we calculated and compared Pearson correlation coefficient ( r ) between the actual iodine dose that was necessary to obtain a contrast effect of 1 HU (iodine dose per contrast effect [IDCE]) and IDCE predicted by DL, body weight, lean body weight, and body surface area of patients. RESULTS The model was tested on 52 cases for the male group (mean [SD] age, 63.7 ± 11.4) and 44 cases for the female group (mean [SD] age, 69.8 ± 11.6). Correlation coefficients between the actual and predicted IDCE were 0.607 for the male group and 0.412 for the female group, which were higher than the correlation coefficients between the actual IDCE and body weight (0.539 for male, 0.290 for female), lean body weight (0.563 for male, 0.352 for female), and body surface area (0.587 for male, 0.349 for female). CONCLUSIONS The performance for predicting contrast effects by analyzing CT localizer radiographs with the DL model was at least comparable with conventional methods using the patient's body size, notwithstanding that no additional measurements other than CT localizer radiographs were required.
Collapse
Affiliation(s)
- Naoki Kobayashi
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | - Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima
| | - Takeshi Nakaura
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | - Kaori Shiraishi
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | - Hiroyuki Uetani
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | - Yasunori Nagayama
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | - Masafumi Kidoh
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| | | | - Toshinori Hirai
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University1, Kumamoto
| |
Collapse
|
16
|
Harada K, Shinojima N, Yamamoto H, Itoyama M, Uchida D, Dekita Y, Miyamaru S, Uetani H, Orita Y, Mikami Y, Nosaka K, Hirai T, Mukasa A. A Rare Case of Adult Poorly Differentiated Chordoma of the Skull Base With Rapid Progression and Systemic Metastasis: A Review of the Literature. Cureus 2024; 16:e51605. [PMID: 38173946 PMCID: PMC10764176 DOI: 10.7759/cureus.51605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 01/05/2024] Open
Abstract
Chordoma is a rare tumor that arises from chordal tissue during fetal life. Recently, the concept of poorly differentiated chordoma, a subtype of chordoma characterized by loss of SMARCB1/INI1 with a poorer prognosis than conventional chordomas, was established. It predominantly occurs in children and is rare in adults. Here, we report a rare adult case of poorly differentiated chordoma of the skull base with a unique course that rapidly systemically metastasized and had the shortest survival time of any adult chordoma reported to date. The patient was a 32-year-old male with a chief complaint of diplopia. MRI showed a widespread neoplastic lesion with the clivus as the main locus. Endoscopic extended transsphenoidal tumor resection was performed. Pathological findings showed that the tumor was malignant, and immunohistochemistry revealed a Ki-67 labeling index of 80%, diffusely positive brachyury, and loss of INI1 expression. The final diagnosis was poorly differentiated chordoma. Postoperatively, the residual tumor in the right cavernous sinus showed rapid growth. The patient was promptly treated with gamma knife three fractions. The residual tumor regressed, but the tumor developed systemic metastasis in a short period, and the patient died seven months after diagnosis. This report of a rapidly progressing and fatal adult poorly differentiated chordoma shows the highest Ki-67 labeling index reported to date. Prompt multidisciplinary treatment should be considered when the Ki-67 labeling index is high.
Collapse
Affiliation(s)
- Keisuke Harada
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Naoki Shinojima
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Haruaki Yamamoto
- Department of Neurosurgery, Saiseikai Kumamoto Hospital, Kumamoto, JPN
| | - Mai Itoyama
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Daichi Uchida
- Department of Radiosurgery, Kumamoto Radiosurgery Clinic, Kumamoto, JPN
| | - Yuji Dekita
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Satoru Miyamaru
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, JPN
| | - Yorihisa Orita
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto, JPN
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, JPN
| | - Kisato Nosaka
- Department of Cancer Treatment Center, Kumamoto University Hospital, Kumamoto, JPN
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University Hospital, Kumamoto, JPN
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, JPN
| | - Akitake Mukasa
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, JPN
| |
Collapse
|
17
|
Nagayama Y, Emoto T, Kato Y, Kidoh M, Oda S, Sakabe D, Funama Y, Nakaura T, Hayashi H, Takada S, Uchimura R, Hatemura M, Tsujita K, Hirai T. Improving image quality with super-resolution deep-learning-based reconstruction in coronary CT angiography. Eur Radiol 2023; 33:8488-8500. [PMID: 37432405 DOI: 10.1007/s00330-023-09888-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To evaluate the effect of super-resolution deep-learning-based reconstruction (SR-DLR) on the image quality of coronary CT angiography (CCTA). METHODS Forty-one patients who underwent CCTA using a 320-row scanner were retrospectively included. Images were reconstructed with hybrid (HIR), model-based iterative reconstruction (MBIR), normal-resolution deep-learning-based reconstruction (NR-DLR), and SR-DLR algorithms. For each image series, image noise, and contrast-to-noise ratio (CNR) at the left main trunk, right coronary artery, left anterior descending artery, and left circumflex artery were quantified. Blooming artifacts from calcified plaques were measured. Image sharpness, noise magnitude, noise texture, edge smoothness, overall quality, and delineation of the coronary wall, calcified and noncalcified plaques, cardiac muscle, and valves were subjectively ranked on a 4-point scale (1, worst; 4, best). The quantitative parameters and subjective scores were compared among the four reconstructions. Task-based image quality was assessed with a physical evaluation phantom. The detectability index for the objects simulating the coronary lumen, calcified plaques, and noncalcified plaques was calculated from the noise power spectrum (NPS) and task-based transfer function (TTF). RESULTS SR-DLR yielded significantly lower image noise and blooming artifacts with higher CNR than HIR, MBIR, and NR-DLR (all p < 0.001). The best subjective scores for all the evaluation criteria were attained with SR-DLR, with significant differences from all other reconstructions (p < 0.001). In the phantom study, SR-DLR provided the highest NPS average frequency, TTF50%, and detectability for all task objects. CONCLUSION SR-DLR considerably improved the subjective and objective image qualities and object detectability of CCTA relative to HIR, MBIR, and NR-DLR algorithms. CLINICAL RELEVANCE STATEMENT The novel SR-DLR algorithm has the potential to facilitate accurate assessment of coronary artery disease on CCTA by providing excellent image quality in terms of spatial resolution, noise characteristics, and object detectability. KEY POINTS • SR-DLR designed for CCTA improved image sharpness, noise property, and delineation of cardiac structures with reduced blooming artifacts from calcified plaques relative to HIR, MBIR, and NR-DLR. • In the task-based image-quality assessments, SR-DLR yielded better spatial resolution, noise property, and detectability for objects simulating the coronary lumen, coronary calcifications, and noncalcified plaques than other reconstruction techniques. • The image reconstruction times of SR-DLR were shorter than those of MBIR, potentially serving as a novel standard-of-care reconstruction technique for CCTA performed on a 320-row CT scanner.
Collapse
Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yuki Kato
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Sentaro Takada
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Ryutaro Uchimura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masahiro Hatemura
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
18
|
Sambommatsu Y, Hirukawa K, Shimata K, Honda M, Sakurai Y, Ishii M, Ibuki S, Isono K, Irie T, Kawabata S, Hirao H, Sugawara Y, Tamura Y, Ikeda O, Hirai T, Inomata Y, Morinaga J, Hibi T. Hepatic venous outflow obstruction after adult living donor liver transplantation. Liver Transpl 2023; 29:1292-1303. [PMID: 37540170 DOI: 10.1097/lvt.0000000000000234] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023]
Abstract
Hepatic venous outflow obstruction (HVOO) is a rare but critical vascular complication after adult living donor liver transplantation. We categorized HVOOs according to their morphology (anastomotic stenosis, kinking, and intrahepatic stenosis) and onset (early-onset < 3 mo vs. late-onset ≥ 3 mo). Overall, 16/324 (4.9%) patients developed HVOO between 2000 and 2020. Fifteen patients underwent interventional radiology. Of the 16 hepatic venous anastomoses within these 15 patients, 12 were anastomotic stenosis, 2 were kinking, and 2 were intrahepatic stenoses. All of the kinking and intrahepatic stenoses required stent placement, but most of the anastomotic stenoses (11/12, 92%) were successfully managed with balloon angioplasty, which avoided stent placement. Graft survival tended to be worse for patients with late-onset HVOO than early-onset HVOO (40% vs. 69.3% at 5 y, p = 0.162) despite successful interventional radiology. In conclusion, repeat balloon angioplasty can be considered for simple anastomotic stenosis, but stent placement is recommended for kinking or intrahepatic stenosis. Close follow-up is recommended in patients with late-onset HVOO even after successful treatment.
Collapse
Affiliation(s)
- Yuzuru Sambommatsu
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kazuya Hirukawa
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Keita Shimata
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masaki Honda
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yuto Sakurai
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masatsugu Ishii
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Sho Ibuki
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kaori Isono
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Tomoaki Irie
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Seiichi Kawabata
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Hiroki Hirao
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yasuhiko Sugawara
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yoshitaka Tamura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Osamu Ikeda
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | | | - Jun Morinaga
- Department of Clinical Investigation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| |
Collapse
|
19
|
Morita K, Uetani H, Nakaura T, Yoneyama M, Nagayama Y, Kidoh M, Shinojima N, Hamasaki T, Mukasa A, Hirai T. Accelerating TOF-MRA: The impact of the combined use of compressed sensitivity encoding and spiral imaging. Magn Reson Imaging 2023; 103:28-36. [PMID: 37406743 DOI: 10.1016/j.mri.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE To evaluate the image quality of the combined technique of compressed sensitivity encoding (CS) and spiral imaging in time-of-flight magnetic resonance angiography (TOF-MRA), which is approximately 2.5 times faster than conventional methods. METHODS Twenty volunteers underwent four TOF-MRA sequences: sensitivity encoding (SENSE) with acceleration factor of 4 (acquisition time: 4:55 min), CS with acceleration factor of 10.9, and spiral and CS-spiral (both 1:55 min). A quantitative image analysis (signal-to-noise ratio [SNR], contrast, and full width at half maximum [FWHM] edge criterion measurements) was performed on four TOF sequences. For qualitative image analysis, two board-certified radiologists evaluated the overall depiction of the proximal, intermediate, and distal branches in CS, spiral, and CS-spiral images using SENSE as a reference. RESULTS The SNR of BA in spiral and CS-spiral imaging was significantly lower than that in SENSE (p = 0.009). The contrasts of ACA and BA in CS-spiral were significantly higher and those in spiral were significantly lower than those in SENSE (p < 0.001). The FWHM in the CS image was significantly higher than that of SENSE; however, no significant differences were observed between the spiral or CS-spiral and SENSE. In qualitative analysis, the depiction of proximal vascular branches was significantly impaired in spiral than in others and that of distal vascular branches was significantly impaired in CS than in others (p < 0.001). CONCLUSIONS In TOF-MRA, which is approximately 2.5 times faster than conventional methods, the combined use of CS and spiral imaging demonstrated an improvement in image quality compared to either CS or spiral imaging alone. SUMMARY STATEMENT The image quality of Compressed SENSE and spiral imaging is particularly poor in the proximal and distal vascular branches, respectively at an extremely high acceleration factor; however, CS-spiral provided stable image quality in all regions as compared with the SENSE technique.
Collapse
Affiliation(s)
- Kosuke Morita
- Department of Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan.
| | | | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Tadashi Hamasaki
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, Japan
| |
Collapse
|
20
|
Matsuo K, Nakaura T, Morita K, Uetani H, Nagayama Y, Kidoh M, Hokamura M, Yamashita Y, Shinoda K, Ueda M, Mukasa A, Hirai T. Feasibility study of super-resolution deep learning-based reconstruction using k-space data in brain diffusion-weighted images. Neuroradiology 2023; 65:1619-1629. [PMID: 37673835 DOI: 10.1007/s00234-023-03212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE The purpose of this study is to evaluate the influence of super-resolution deep learning-based reconstruction (SR-DLR), which utilizes k-space data, on the quality of images and the quantitation of the apparent diffusion coefficient (ADC) for diffusion-weighted images (DWI) in brain magnetic resonance imaging (MRI). METHODS A retrospective analysis was performed on 34 patients who had undergone DWI using a 3 T MRI system with SR-DLR reconstruction based on k-space data in August 2022. DWI was reconstructed with SR-DLR (Matrix = 684 × 684) and without SR-DLR (Matrix = 228 × 228). Measurements were made of the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) in white matter (WM) and grey matter (GM), and the full width at half maximum (FWHM) of the septum pellucidum. Two radiologists assessed image noise, contrast, artifacts, blur, and the overall quality of three image types using a four-point scale. Quantitative and qualitative scores between images with and without SR-DLR were compared using the Wilcoxon signed-rank test. RESULTS Images with SR-DLR showed significantly higher SNRs and CNRs than those without SR-DLR (p < 0.001). No statistically significant variances were found in the apparent diffusion coefficients (ADCs) in WM and GM between images with and without SR-DLR (ADC in WM, p = 0.945; ADC in GM, p = 0.235). Moreover, the FWHM without SR-DLR was notably lower compared to that with SR-DLR (p < 0.001). CONCLUSION SR-DLR has the potential to augment the quality of DWI in DL MRI scans without significantly impacting ADC quantitation.
Collapse
Affiliation(s)
- Kensei Matsuo
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan.
| | - Kosuke Morita
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| | - Masamichi Hokamura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| | - Yuichi Yamashita
- Canon Medical Systems Corporation, 70-1, Yanagi, Saiwai, Kawasaki, Kanagawa, 212-0015, Japan
| | - Kensuke Shinoda
- MRI Systems Division, Canon Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi, 324-8550, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Chuo, Kumamoto, 860-8556, Japan
| |
Collapse
|
21
|
Uetani H, Kitajima M, Ohmori Y, Morita K, Yamashita Y, Kaku Y, Nakaura T, Sasao A, Sasaki G, Ishiuchi S, Mukasa A, Hirai T. Intracranial aneurysms treated with stent-assisted coil embolization: evaluation with four-dimensional ultrashort-TE MR angiography. Eur Radiol 2023; 33:7923-7933. [PMID: 37284863 DOI: 10.1007/s00330-023-09755-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/23/2023] [Accepted: 03/10/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES As a novel follow-up method for intracranial aneurysms treated with stent-assisted coil embolization (SACE), we developed four-dimensional magnetic resonance angiography (MRA) with minimized acoustic noise utilizing ultrashort-echo time (4D mUTE-MRA). We aimed to assess whether 4D mUTE-MRA is useful for the evaluation of intracranial aneurysms treated with SACE. METHODS This study included 31 consecutive patients with intracranial aneurysm treated with SACE who underwent 4D mUTE-MRA at 3 T and digital subtraction angiography (DSA). For 4D mUTE-MRA, five dynamic MRA images with a spatial resolution of 0.5 × 0.5 × 0.5 mm3 were obtained every 200 ms. Two readers independently reviewed the 4D mUTE-MRA images to evaluate the aneurysm occlusion status (total occlusion, residual neck, and residual aneurysm) and the flow in the stent using a 4-point scale (from 1 [not visible] to 4 [excellent]). The interobserver and intermodality agreement was assessed using κ statistics. RESULTS On DSA images, 10 aneurysms were classified as total occlusion, 14 as residual neck, and 7 as residual aneurysm. In terms of aneurysm occlusion status, the intermodality and interobserver agreement was excellent (κ = 0.92 and κ = 0.96, respectively). For the flow in the stents on 4D mUTE-MRA, the mean score was significantly higher for single stents than multiple stents (p < .001) and for open-cell type stents than closed-cell type (p < .01). CONCLUSIONS 4D mUTE-MRA is a useful tool with a high spatial and temporal resolution for the evaluation of intracranial aneurysms treated with SACE. KEY POINTS • In the evaluation of intracranial aneurysms treated with SACE on 4D mUTE-MRA and DSA, the intermodality and interobserver agreement in aneurysm occlusion status was excellent. • 4D mUTE-MRA shows good to excellent visualization of flow in the stents, especially for cases treated with a single or open-cell stent. • 4D mUTE-MRA can provide hemodynamic information related to embolized aneurysms and the distal arteries to stented parent arteries.
Collapse
Affiliation(s)
- Hiroyuki Uetani
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan.
| | - Mika Kitajima
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Yuki Ohmori
- Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Kosuke Morita
- Central Radiology Section, Kumamoto University Hospital, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Yuichi Yamashita
- Canon Medical Systems Corporation, MRI Sales Department, Sales Engineer Group, 70-1, Yanagi-cho, Saiwai-ku, Kawasaki, Kanagawa, 212-0015, Japan
| | - Yasuyuki Kaku
- Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Takeshi Nakaura
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Akira Sasao
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
- Joint Research Course of Imaging Dynamics Applied Medicine, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Goh Sasaki
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Soichiro Ishiuchi
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| | - Toshinori Hirai
- Departments of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuou-ku, Kumamoto, Japan
| |
Collapse
|
22
|
Shiraishi K, Nakaura T, Uetani H, Nagayama Y, Kidoh M, Kobayashi N, Morita K, Yamahita Y, Tanaka Y, Baba H, Hirai T. Deep learning-based reconstruction and 3D hybrid profile order technique for MRCP at 3T: evaluation of image quality and acquisition time. Eur Radiol 2023; 33:7585-7594. [PMID: 37178197 DOI: 10.1007/s00330-023-09703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To evaluate the image quality of the 3D hybrid profile order technique and deep-learning-based reconstruction (DLR) for 3D magnetic resonance cholangiopancreatography (MRCP) within a single breath-hold (BH) at 3 T magnetic resonance imaging (MRI). METHODS This retrospective study included 32 patients with biliary and pancreatic disorders. BH images were reconstructed with and without DLR. The signal-to-noise ratio (SNR), contrast, contrast-to-noise ratio (CNR) between the common bile duct (CBD) and periductal tissues, and full width at half maximum (FWHM) of CBD on 3D-MRCP were evaluated quantitatively. Two radiologists scored image noise, contrast, artifacts, blur, and overall image quality of the three image types using a 4-point scale. Quantitative and qualitative scores were compared using the Friedman test and post hoc Nemenyi test. RESULTS The SNR and CNR were not significantly different when under respiratory gating- and BH-MRCP without DLR. However, they were significantly higher under BH with DLR than under respiratory gating (SNR, p = 0.013; CNR, p = 0.027). The contrast and FWHM of MRCP under BH with and without DLR were lower than those under respiratory gating (contrast, p < 0.001; FWHM, p = 0.015). Qualitative scores for noise, blur, and overall image quality were higher under BH with DLR than those under respiratory gating (blur, p = 0.003; overall, p = 0.008). CONCLUSIONS The combination of the 3D hybrid profile order technique and DLR is useful for MRCP within a single BH and does not lead to the deterioration of image quality and space resolution at 3 T MRI. CLINICAL RELEVANCE STATEMENT Considering its advantages, this sequence might become the standard protocol for MRCP in clinical practice, at least at 3.0 T. KEY POINTS • The 3D hybrid profile order can achieve MRCP within a single breath-hold without a decrease in spatial resolution. • The DLR significantly improved the CNR and SNR of BH-MRCP. • The 3D hybrid profile order technique with DLR reduces the deterioration of image quality in MRCP within a single breath-hold.
Collapse
Affiliation(s)
- Kaori Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan.
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Naoki Kobayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Kosuke Morita
- Department of Radiology, Kumamoto University Hospital, Kumamoto, Japan, Honjo 1-1-1, Kumamoto, Japan
| | - Yuichi Yamahita
- Canon Medical Systems Corporation, 70-1, Yanagi-Cho, Saiwai-Ku, Kawasaki-Shi, Kanagawa, 212-0015, Japan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| |
Collapse
|
23
|
Nagayama Y, Emoto T, Hayashi H, Kidoh M, Oda S, Nakaura T, Sakabe D, Funama Y, Tabata N, Ishii M, Yamanaga K, Fujisue K, Takashio S, Yamamoto E, Tsujita K, Hirai T. Coronary Stent Evaluation by CTA: Image Quality Comparison Between Super-Resolution Deep Learning Reconstruction and Other Reconstruction Algorithms. AJR Am J Roentgenol 2023; 221:599-610. [PMID: 37377362 DOI: 10.2214/ajr.23.29506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND. A super-resolution deep learning reconstruction (SR-DLR) algorithm may provide better image sharpness than earlier reconstruction algorithms and thereby improve coronary stent assessment on coronary CTA. OBJECTIVE. The purpose of our study was to compare SR-DLR and other reconstruction algorithms in terms of image quality measures related to coronary stent evaluation in patients undergoing coronary CTA. METHODS. This retrospective study included patients with at least one coronary artery stent who underwent coronary CTA between January 2020 and December 2020. Examinations were performed using a 320-row normal-resolution scanner and were reconstructed with hybrid iterative reconstruction (HIR), model-based iterative reconstruction (MBIR), normal-resolution deep learning reconstruction (NR-DLR), and SR-DLR algorithms. Quantitative image quality measures were determined. Two radiologists independently reviewed images to rank the four reconstructions (4-point scale: 1 = worst reconstruction, 4 = best reconstruction) for qualitative measures and to score diagnostic confidence (5-point scale: score ≥ 3 indicating an assessable stent). The assessability rate was calculated for stents with a diameter of 3.0 mm or less. RESULTS. The sample included 24 patients (18 men, six women; mean age, 72.5 ± 9.8 [SD] years), with 51 stents. SR-DLR, in comparison with the other reconstructions, yielded lower stent-related blooming artifacts (median, 40.3 vs 53.4-58.2), stent-induced attenuation increase ratio (0.17 vs 0.27-0.31), and quantitative image noise (18.1 vs 20.9-30.4 HU) and higher in-stent lumen diameter (2.4 vs 1.7-1.9 mm), stent strut sharpness (327 vs 147-210 ΔHU/mm), and CNR (30.0 vs 16.0-25.6) (all p < .001). For both observers, all ranked measures (image sharpness; image noise; noise texture; delineation of stent strut, in-stent lumen, coronary artery wall, and calcified plaque surrounding the stent) and diagnostic confidence showed a higher score for SR-DLR (median, 4.0 for all features) than for the other reconstructions (range, 1.0-3.0) (all p < .001). The assessability rate for stents with a diameter of 3.0 mm or less (n = 37) was higher for SR-DLR (86.5% for observer 1 and 89.2% for observer 2) than for HIR (35.1% and 43.2%), MBIR (59.5% and 62.2%), and NR-DLR (62.2% and 64.9%) (all p < .05). CONCLUSION. SR-DLR yielded improved delineation of the stent strut and in-stent lumen, with better image sharpness and less image noise and blooming artifacts, in comparison with HIR, MBIR, and NR-DLR. CLINICAL IMPACT. SR-DLR may facilitate coronary stent assessment on a 320-row normal-resolution scanner, particularly for small-diameter stents.
Collapse
Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenshi Yamanaga
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| |
Collapse
|
24
|
Toya R, Matsuyama T, Saito T, Fukugawa Y, Shiraishi S, Murakami D, Orita Y, Hirai T, Oya N. Prevalence and Risk Factors for Retropharyngeal and Retro-Styloid Lymph Node Metastasis in Hypopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e630. [PMID: 37785883 DOI: 10.1016/j.ijrobp.2023.06.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We evaluated the prevalence and identified the risk factors for retropharyngeal and retro-styloid lymph node metastasis (LNM) in patients with hypopharyngeal carcinoma (HPC). This was achieved using a combination of MR and FDG-PET/CT images. MATERIALS/METHODS Two board-certified radiation oncologists, who experienced 16 and 18 years in the diagnosis and treatment of head and neck cancers retrospectively reviewed pretreatment FDG-PET/CT images and contrast-enhanced thin-slice CT and MR images of 155 patients with HPC who underwent radiotherapy. Observers assessed these images without prior knowledge of the patient's clinical information and disagreements were resolved by consensus. The radiological diagnostic criteria for lateral retropharyngeal LNM (RPLNM) and retro-styloid LNM (RSLNM) were a short-axis diameter of ≥5 mm and/or necrosis and/or abnormal FDG uptake. Any visible medial RPLN was defined as LNM. RESULTS RPLNM was confirmed in 20 (13%) patients. Of these, 10 (6%) had ipsilateral RPLNM, 5 (3%) had contralateral RPLNM, and 5 (3%) had bilateral RPLNM. No patients were diagnosed with medial RPLNM. Fisher's exact test revealed tumor site (p = 0.006), T category (p = 0.049), and cervical LNM (p < 0.001) to be significantly associated with RPLNM. Logistic regression analysis revealed posterior wall (PW) tumors (odds ratio [OR]: 4.128, 95% confidence interval [CI]: 1.339-12.727; p = 0.014) and bilateral or contralateral cervical LNM (OR: 11.577, 95% CI: 2.135-62.789; p = 0.005) to be significantly correlated with RPLNM. The RPLNM was found in 9 (32%) of the 28 patients with PW tumors. Of these 9 patients, 2 (7%) had ipsilateral RPLNM, 3 (11%) had contralateral RPLNM, and 4 (14%) had bilateral RPLNM. Fisher's exact test revealed the PW tumors to be significantly associated with contralateral RPLNM (p < 0.001). Retro-styloid LNM (RSLNM) was confirmed in two (1%) patients, both of whom had ipsilateral RSLNM with lymph nodes (LNs) of ≥15 mm in the upper limit of ipsilateral level II. Fisher's exact test revealed the LN of ≥15 mm in the upper limit of ipsilateral level II to be significantly associated with ipsilateral RSLNM (p = 0.001). CONCLUSION The RPLNM was identified in 13% of patients with HPC. The PW tumors and bilateral or contralateral cervical LNM were risk factors for RPLNM; particularly, PW tumors were a specific risk factor for contralateral RPLNM. Although the RSLNM was rare, LNs of ≥15 mm in the upper limit of ipsilateral level II were a risk factor for ipsilateral RSLNM.
Collapse
Affiliation(s)
- R Toya
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan; Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - T Matsuyama
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - T Saito
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Fukugawa
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - S Shiraishi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - D Murakami
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Orita
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - T Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - N Oya
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
25
|
Kokubo M, Kishi N, Matsuo Y, Ogura M, Araki N, Fujii K, Okumura S, Nakamatsu K, Kishi T, Atsuta T, Sakamoto T, Otsu S, Katagiri T, Narabayashi M, Fujishiro S, Iizuka Y, Ozasa H, Hirai T, Mizowaki T. Major Cardiovascular Events after Chemoradiotherapy with or without Durvalumab in Patients with Stage III Non-Small Cell Lung Cancer: Supplementary Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e30-e31. [PMID: 37785096 DOI: 10.1016/j.ijrobp.2023.06.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) RTOG 0617 showed that cardiac events are relatively common after high-dose thoracic radiotherapy. The aim of this study was to investigate the incidence and risk of major cardiovascular events (MACE) after concurrent chemoradiotherapy (CCRT) with or without durvalumab in patients with stage III non-small cell lung cancer (NSCLC) using the data from a multi-institutional study in Japan. MATERIALS/METHODS Patients who received CCRT for stage III NSCLC between July 2018 and July 2019 were enrolled in a multi-institutional study in Japan. MACE was defined as follows: symptomatic pericardial effusion, acute coronary syndrome, pericarditis, significant arrhythmia, and heart failure. The cumulative incidence of MACE, accounting for death as a competing risk, was calculated. Pre-existing coronary heart disease (CHD) included coronary artery disease, congestive heart failure, peripheral vascular disease, stroke, and extensive coronary artery calcification. The association between patient/treatment-related factors and MACE was assessed by multivariate analysis. RESULTS Among 178 patients with a median follow-up period of 42.5 months, 13 patients developed MACEs. The 3-year cumulative incidence of MACE was 6.9% (95% confidence interval [CI], 4.0-11.9%). Univariate analysis showed that female sex and mean heart dose (MHD) were marginally associated (3-year cumulative incidence, male 5.6% vs. female 12.1%; P = 0.12; MHD ≥ 6.3 Gy 4.8% vs. < 6.3 Gy 9.1%; P = 0.13), and pre-existing CHD was significantly associated with an increased risk of MACE (no CHD 4.3% vs. CHD 16.8%; P = 0.026). Consolidation durvalumab was not associated with an increased risk of MACE (no durvalumab 5.2% vs. durvalumab 7.4%; P = 0.89). Multivariate analysis showed that pre-existing CHD was significantly associated with MACE (hazard ratio, 4.22; 95% CI, 1.30-13.7; P = 0.016). CONCLUSION The incidence of MACE based on the real-world data in Japan was lower than previously reported. Pre-existing CHD was associated with an increased risk of MACE after CCRT in patients with stage III NSCLC, whereas the administration of consolidation durvalumab was not associated with an increased risk of MACE.
Collapse
Affiliation(s)
- M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Ogura
- Department of Radiation Oncology, Kishiwada City Hospital, Kishiwada, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Fujii
- Department of Radiation Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - S Okumura
- Department of Radiation Oncology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - K Nakamatsu
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, Osaka, Japan
| | - T Atsuta
- Department of Radiology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Otsu
- Department of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan
| | - T Katagiri
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - M Narabayashi
- Department of Radiology, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - S Fujishiro
- Department of Radiation Oncology, Shinko Hospital, Kobe, Japan
| | - Y Iizuka
- Department of Radiation Oncology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - H Ozasa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
26
|
Kishi N, Matsuo Y, Ogura M, Kokubo M, Araki N, Fujii K, Okumura S, Nakamatsu K, Kishi T, Atsuta T, Sakamoto T, Otsu S, Katagiri T, Narabayashi M, Fujishiro S, Iizuka Y, Ozasa H, Hirai T, Mizowaki T. Real-World Study of Overall Survival in Patients with Stage III Non-Small Cell Lung Cancer Treated with Chemoradiotherapy with or without Durvalumab and an Exploratory Analysis of Effective Radiation Dose to the Immune Cells. Int J Radiat Oncol Biol Phys 2023; 117:e29-e30. [PMID: 37785070 DOI: 10.1016/j.ijrobp.2023.06.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate the real-world data on overall survival (OS) in patients with stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT) with or without consolidation durvalumab, and to perform an exploratory analysis on effective radiation dose to the immune cells (EDIC). MATERIALS/METHODS In our multi-institutional retrospective study, patients who received CCRT between July 2018 and July 2019 for stage III NSCLC in Japan were investigated. EDIC was estimated using mean lung dose, mean heart dose, body volume, body mean dose, and body weight, as reported in the secondary analysis of RTOG 0617. The cut-off value of EDIC was calculated using the maximally selected log-rank statistics. RESULTS One hundred and seventy-eight patients were eligible for the analysis (136 patients, CCRT with consolidation durvalumab [CCRT+D] cohort; 42 patients, CCRT cohort). The median follow-up period was 42.5 months. Three-year OS rates were 59.8% in the overall cohort: 60.5% in the CCRT+D cohort, and 58.0% in the CCRT cohort with no significant difference (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.45-1.27; P = 0.29). Univariate analysis showed that ECOG-PS, smoking history, histology, EGFR mutational status, gross tumor volume and EDIC were significantly associated with OS. Multivariate analysis showed that ECOG-PS 2, gross tumor volume ≥ 57 cm3 and EDIC ≥ 4.4 Gy were associated with poor OS. Among 21 EGFR-mutated patients, 3 year-OS rates were 64.7% in the CCRT+D cohort and 100% in the CCRT cohort, while 3 year-OS rates were 68.8% and 58.7% among 90 EGFR wild-type patients. Three-year OS rates were 64.6% and 47.6% for EDIC < 4.4 Gy and EDIC ≥ 4.4 Gy in the overall cohort (HR, 1.82; 95% CI, 1.14-2.90; P = 0.015). In the subgroup analysis, 66.3% vs. 44.4% in the CCRT+D cohort (HR, 2.01; 95% CI, 1.17-3.47; P = 0.016), and 59.0% vs. 56.1% in the CCRT cohort (HR, 1.20; 95% CI, 0.48-3.01; P = 0.70), respectively. CONCLUSION Our real-world data in Japan showed that there was no significant difference in OS between the CCRT+D cohort and the CCRT cohort. High EDIC could be a risk for poor OS in patients treated with CCRT and consolidation durvalumab compared with those treated with CCRT.
Collapse
Affiliation(s)
- N Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Matsuo
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Ogura
- Department of Radiation Oncology, Kishiwada City Hospital, Kishiwada, Japan
| | - M Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Fujii
- Department of Radiation Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - S Okumura
- Department of Radiation Oncology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - K Nakamatsu
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, Osaka, Japan
| | - T Atsuta
- Department of Radiology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - T Sakamoto
- Department of Radiation Oncology, Kyoto Katsura Hospital, Kyoto, Japan
| | - S Otsu
- Department of Radiation Oncology, Kyoto City Hospital, Kyoto, Japan
| | - T Katagiri
- Department of Radiation Oncology, Tenri Hospital, Tenri, Japan
| | - M Narabayashi
- Department of Radiology, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - S Fujishiro
- Department of Radiation Oncology, Shinko Hospital, Kobe, Japan
| | - Y Iizuka
- Department of Radiation Oncology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - H Ozasa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
27
|
Yoshimura F, Oda S, Kidoh M, Hayashi H, Yonemura M, Miyazaki S, Takashio S, Kuramoto Y, Asano Y, Tsujita K, Hirai T. Cardiac Magnetic Resonance Imaging Findings in Filamin C Variant-Associated Arrhythmogenic Left Ventricular Cardiomyopathy. Circ J 2023; 87:1403. [PMID: 37635079 DOI: 10.1253/circj.cj-23-0480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Fumihiro Yoshimura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Mari Yonemura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Shuhei Miyazaki
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Yuki Kuramoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshihiro Asano
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
- Department of Genomic Medicine, National Cerebral and Cardiovascular Center
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| |
Collapse
|
28
|
Fukunaga K, Fujiwara Y, Enzaki M, Komi M, Hirai T, Azuma M. [Usefulness of Voxel-Based Quantification (VBQ) Smoothing in Relaxation Time Mapping]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:913-922. [PMID: 37544734 DOI: 10.6009/jjrt.2023-1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE Voxel-based quantification (VBQ) smoothing is a technique used to smooth quantitative parametric maps in the Montreal Neurological Institute standard space. Although VBQ smoothing could suppress changes in quantitative values at tissue boundaries, its effectiveness on relaxation time (T1 and T2 values and proton density PD) maps has not been investigated. The purpose of this study was to clarify the usefulness of VBQ smoothing in relaxation time mapping. METHOD T1 and T2 values and PD maps of the brains of 20 healthy participants were obtained using a two-dimensional multi-dynamic multi-echo sequence. VBQ and Gaussian smoothing were applied to the relaxation time maps by varying the kernel size by 1 mm from 1 to 6 mm. Changes in relaxation time before and after VBQ and Gaussian smoothing for the putamen, caudate nucleus, substantia nigra, and corpus callosum on the relaxation time maps were evaluated. RESULT The changes in relaxation time after VBQ smoothing application were smaller than those in that after Gaussian smoothing application. Although the differences in the relaxation time for all tissues before and after VBQ and Gaussian smoothing applications increased with increasing kernel size for all relaxation times for both methods, the changes in the relaxation time for VBQ smoothing were smaller than those in that for Gaussian smoothing. CONCLUSION VBQ smoothing can suppress the change in the relaxation time on the boundary of the tissue and is thus a useful smoothing technique in relaxation time mapping.
Collapse
Affiliation(s)
- Kota Fukunaga
- Graduate School of Health Sciences, Kumamoto University
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University
| | | | | | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Medicine, Kumamoto University
| | - Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki
| |
Collapse
|
29
|
Hirai T, Kondo Y, Sakazaki Y, Seki A, Ishitsuka Y, Iwamoto T. Drug-drug interaction signals between loop diuretics and teicoplanin during acute kidney injury evaluated using Japanese spontaneous adverse drug event reports. Sci Rep 2023; 13:13989. [PMID: 37633977 PMCID: PMC10460414 DOI: 10.1038/s41598-023-41095-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023] Open
Abstract
Teicoplanin can cause acute kidney injury, but little is known about the risk of acute kidney injury when teicoplanin is co-administered with loop diuretics (a powerful diuresis), which can alter renal hemodynamics and glomerular filtration rate. We performed a signal detection analysis using a Japanese adverse event database to determine the additive impact of loop diuretics on acute kidney injury associated with teicoplanin. The dataset originated between April 2004 and August 2022. Disproportionality analysis was performed to detect the signals for acute kidney injury (the Standardized MedDRA Query) when co-administered teicoplanin or vancomycin (a positive control) with individual diuretics, including loop diuretics. Multivariate logistic regression analysis was tested to estimate the adjusted reporting odds ratio (aROR) and 95% confidence interval (95% CI). There were 147 and 515 events of acute kidney injury associated with teicoplanin and vancomycin, respectively. A significant positive signal for acute kidney injury when teicoplanin was co-administered with loop diuretics was present (aROR 4.83, 95% CI 3.52-6.61, p < 0.0001). Contrastingly, no significant signals were observed when vancomycin was co-administered with any diuretics. These findings suggest that co-administered loop diuretics may have an unfavorable effect on acute kidney injury while undertaking teicoplanin but not vancomycin.
Collapse
Affiliation(s)
- Toshinori Hirai
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Yuki Kondo
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oehonmachi, Chuo-ku, Kumamoto, Kumamoto, 862-0973, Japan
| | - Yuka Sakazaki
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oehonmachi, Chuo-ku, Kumamoto, Kumamoto, 862-0973, Japan
| | - Ayaka Seki
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oehonmachi, Chuo-ku, Kumamoto, Kumamoto, 862-0973, Japan
| | - Yoichi Ishitsuka
- Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oehonmachi, Chuo-ku, Kumamoto, Kumamoto, 862-0973, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| |
Collapse
|
30
|
Toya R, Matsuyama T, Saito T, Fukugawa Y, Watakabe T, Shiraishi S, Murakami D, Orita Y, Hirai T, Oya N. Prevalence and risk factors for retropharyngeal and retro-styloid lymph node metastasis in hypopharyngeal carcinoma. Radiat Oncol 2023; 18:134. [PMID: 37568173 PMCID: PMC10422770 DOI: 10.1186/s13014-023-02322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND We evaluated the prevalence and identified the risk factors for retropharyngeal and retro-styloid lymph node metastasis (LNM) in patients with hypopharyngeal carcinoma (HPC). This was achieved using a combination of magnetic resonance (MR) and [18 F]-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) images. METHODS Two board-certified radiation oncologists retrospectively reviewed pretreatment FDG-PET/CT images and contrast-enhanced thin-slice CT and MR images of 155 patients with HPC who underwent radiotherapy. Fisher's exact tests and logistic regression analyses were performed to assess the risk factors for LNM. RESULTS Retropharyngeal LNM (RPLNM) was confirmed in 20 (13%) patients. Posterior wall (PW) tumors (odds ratio [OR]: 4.128, 95% confidence interval [CI]: 1.339-12.727; p = 0.014) and bilateral or contralateral cervical LNM (OR: 11.577, 95% CI: 2.135-62.789; p = 0.005) were significantly correlated with RPLNM. The RPLNM was found in 9 (32%) of the 28 patients with PW tumors. Of these 9 patients, 2 (7%) had ipsilateral RPLNM, 3 (11%) had contralateral RPLNM, and 4 (14%) had bilateral RPLNM. The PW tumors were significantly associated with contralateral RPLNM (p < 0.001). Retro-styloid LNM (RSLNM) was confirmed in two (1%) patients, both of whom had ipsilateral RSLNM with lymph nodes (LNs) of ≥ 15 mm in the upper limit of ipsilateral level II. A significant association was found between LNs of ≥ 15 mm in the upper limit of ipsilateral level II and ipsilateral RSLNM (p = 0.001). CONCLUSIONS The RPLNM was identified in 13% of patients with HPC. The PW tumors and bilateral or contralateral cervical LNM were risk factors for RPLNM; particularly, PW tumors were a specific risk factor for contralateral RPLNM. Although the RSLNM was rare, LNs of ≥ 15 mm in the upper limit of ipsilateral level II were a risk factor for ipsilateral RSLNM.
Collapse
Affiliation(s)
- Ryo Toya
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Tomohiko Matsuyama
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tetsuo Saito
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshiyuki Fukugawa
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahiro Watakabe
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinya Shiraishi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daizo Murakami
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yorihisa Orita
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
31
|
Shinogi Y, Hirai T, Ishibashi M, Ino K, Tawara I, Iwamoto T. Drug interactions of tacrolimus with letermovir and azole antifungals following hematopoietic stem cell transplantation: A retrospective observational analysis. Pharmacol Res Perspect 2023; 11:e01120. [PMID: 37530504 PMCID: PMC10395274 DOI: 10.1002/prp2.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
Tacrolimus interacts with letermovir and azole antifungals, whereas letermovir has nonuniform effects on the pharmacokinetics of azole antifungals. We retrospectively investigated the interaction of tacrolimus (continuous infusion) with letermovir considering co-administered azole antifungals in adult hematopoietic stem cell transplantation patients. The extent of intraindividual variation in the ratio of tacrolimus concentration to dose normalized by body weight (C/D ratio) was investigated. The correlation between the C/D ratio and estimated glomerular filtration rate (eGFR) was analyzed. In 35 patients (795 points), the C/D ratio was higher in the tacrolimus plus letermovir period than in the tacrolimus alone period (1234.7 [566.2-2721.0] ng/mL/mg/kg vs. 564.4 [245.3-1861.3] ng/mL/mg/kg, p < .001). This trend was observed when co-administered with azole antifungals (n = 30, 1285.5 [662.7-2506.7] ng/mL/mg/kg vs. 547.1 [245.3-1861.3] ng/mL/mg/kg, p < .001), but not without azole antifungals (n = 5, 809.9 [566.2-1573.3] ng/mL/mg/kg vs. 616.1 [350.6-979.8] ng/mL/mg/kg, p = .125). For patients co-administered fluconazole, the tacrolimus C/D ratio increased in patients with letermovir than those without letermovir (n = 28, 1215.0 [662.7-2506.7] ng/mL/mg/kg vs. 529.9 [245.3-1654.4] ng/mL/mg/kg, p < .001). Tacrolimus C/D ratio did not correlate with eGFR under letermovir and fluconazole administrations (y = 0.1x + 1307.1, r = .008, p = .968). Close blood concentration monitoring of intravenous tacrolimus is required when patients administered letermovir and azole antifungals.
Collapse
Affiliation(s)
- Yuri Shinogi
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| | - Toshinori Hirai
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| | - Miki Ishibashi
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| | - Kazuko Ino
- Department of Hematology and Oncology, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| | - Isao Tawara
- Department of Hematology and Oncology, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, Tsu, Mie, Japan
| |
Collapse
|
32
|
Chihiro S, Hirai T, Kaneda M, Okamoto A, Kato H, Tanaka K, Kondo E, Ikeda T, Iwamoto T. Factors for the development of anemia in patients with newly introduced olaparib: A retrospective case-control study. Medicine (Baltimore) 2023; 102:e34123. [PMID: 37505180 PMCID: PMC10378826 DOI: 10.1097/md.0000000000034123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023] Open
Abstract
Anemia is the most common dose-limiting toxicity of olaparib. However, few studies have analyzed the clinical features of olaparib-induced anemia. This study investigated the clinical features of olaparib-induced anemia. Additionally, the role of folate or vitamin B12 in olaparib-induced anemia was examined. This retrospective case-control study included patients who received olaparib at Mie University Hospital between January 2018 and December 2020. Data were collected between initiation of olaparib and discontinuation of olaparib or till December 2021. We investigated the development of grade ≥ 3 anemia during olaparib administration for at least 1 year. We examined patients with grade ≥ 3 anemia considering the mean corpuscular volume (MCV), its association with gastrointestinal events and cumulative dose of carboplatin. For the sub-study analysis, data on patients treated with olaparib for ovarian or endometrial cancer were collected to evaluate the Common Terminology Criteria for Adverse Events (CTCAE) or monthly changes in folate or vitamin B12 levels from baseline to 3 months after olaparib initiation. These data were collected between initiation of olaparib and discontinuation of olaparib or till November 2022. Patients with no data on folic acid or vitamin B12 levels were excluded from the sub-study. In the main study, 40 patients were included. Eighteen patients (45%) developed grade ≥ 3 anemia, and all patients discontinued treatment (94%) or reduced olaparib dose (67%) after developing anemia. Among the patients with grade ≥ 3 anemia, 9 (50%) exhibited macrocytic anemia and 15 (83%) had previously received carboplatin. The incidence of grade ≥ 2 dysgeusia was significantly higher in patients with grade ≥ 3 anemia (P = .034). Moreover, the cumulative dose of previously administered carboplatin was higher in patients who had 3 episodes of anemia (P = .102). In sub-study, 12 had data on folic acid and vitamin B12 levels. Sub-study analysis showed that none fulfilled the criteria for deficiency of folate or vitamin B12, while 3 developed grade 3 anemia. This study revealed that olaparib-induced anemia frequently occurs as macrocytic and normocytic erythroblastic anemia without folate or vitamin B12 deficiencies. A high cumulative dose of previously administered carboplatin and dysgeusia may be associated with olaparib-induced anemia.
Collapse
Affiliation(s)
| | | | - Michiko Kaneda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | | | - Hideo Kato
- Department of Pharmacy, Mie University Hospital, Mie, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan
| |
Collapse
|
33
|
Nakano Y, Inokuchi Y, Hayama T, Hirai T, Nishiyama M, Sueyasu Y, Yokoo K. Exploration of the optimal GS-441524 trough concentration for treating COVID-19. Int J Antimicrob Agents 2023:106892. [PMID: 37339712 DOI: 10.1016/j.ijantimicag.2023.106892] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES Remdesivir (RDV) is the cornerstone for treating coronavirus disease 2019 (COVID-19). The active metabolite of RDV, GS-441524 (a nucleoside analog), has high inter-individual variability in plasma concentration; however, its concentration-response relationship is still unclear. This study investigated the target GS-441524 trough concentration for symptom improvement in COVID-19 pneumonia. METHODS This single-center, retrospective, observational study included COVID-19 pneumonia patients (≥15 years) who were administered RDV for ≥3 days from May 2020 to August 2021 at Saiseikai Futsukaichi Hospital. To determine the cut-off value of GS-441524 trough concentration on day 3, the achievement of the National Institute of Allergy and Infectious Disease Ordinal Scale (NIAID-OS) ≤3 after RDV administration was evaluated using the cumulative incidence function (CIF) with the Gray test and time-dependent receiver operating characteristic (ROC) analysis. Multivariate logistic regression analysis was performed to determine the factors influencing GS-441524 target trough concentrations. RESULTS Our analysis comprised 59 patients. The CIF revealed that GS-441524 trough concentration ≥70 ng/mL was associated with the achievement of NIAID-OS ≤3 (p = 0.047), which was significant based on the time-dependent ROC analysis. Factors influencing GS-441524 trough concentration ≥70 ng/mL included a decrease in eGFR (adjusted odds ratio [aOR] 0.96, 95% confidence interval [95% CI] 0.92-0.99, p = 0.027) and BMI ≥25 kg/m2 (aOR 0.26, 95% CI 0.07-0.86, p = 0.031). CONCLUSION GS-441524 trough concentration ≥70 ng/mL is a predictor of efficacy in COVID-19 pneumonia. The presence of lower eGFR or BMI ≥25 kg/m2 was associated with achieving GS-441524 trough concentration ≥70 ng/mL.
Collapse
Affiliation(s)
- Yuki Nakano
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka, 818-0023, Japan.
| | - Yoko Inokuchi
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka, 818-0023, Japan
| | - Tadashi Hayama
- Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma, Johnan, Fukuoka, 810-0180, Japan
| | - Toshinori Hirai
- Department of Pharmacy, Mie University Hospital, Faculty of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Mamoru Nishiyama
- Department of Respiratory Medicine, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka, Japan, 818-0023, Japan
| | - Yoshiko Sueyasu
- Department of Respiratory Medicine, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka, Japan, 818-0023, Japan
| | - Kenjo Yokoo
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino, Fukuoka, 818-0023, Japan
| |
Collapse
|
34
|
Funama Y, Nakaura T, Hasegawa A, Sakabe D, Oda S, Kidoh M, Nagayama Y, Hirai T. Noise power spectrum properties of deep learning-based reconstruction and iterative reconstruction algorithms: Phantom and clinical study. Eur J Radiol 2023; 165:110914. [PMID: 37295358 DOI: 10.1016/j.ejrad.2023.110914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE To compare the noise power spectrum (NPS) properties and perform a qualitative analysis of hybrid iterative reconstruction (IR), model-based IR (MBIR), and deep learning-based reconstruction (DLR) at a similar noise level in clinical study and compare these outcomes with those in phantom study. METHODS A Catphan phantom with an external body ring was used in the phantom study. In the clinical study, computed tomography (CT) examination data of 34 patients were reviewed. NPS was calculated from DLR, hybrid IR, and MBIR images. The noise magnitude ratio (NMR) and the central frequency ratio (CFR) were calculated from DLR, hybrid IR, and MBIR images relative to filtered back-projection images using NPS. Clinical images were independently reviewed by two radiologists. RESULTS In the phantom study, DLR with a mild level had a similar noise level as hybrid IR and MBIR with strong levels. In the clinical study, DLR with a mild level had a similar noise level as hybrid IR with standard and MBIR with strong levels. The NMR and CFR were 0.40 and 0.76 for DLR, 0.42 and 0.55 for hybrid IR, and 0.48 and 0.62 for MBIR. The visual inspection of the clinical DLR image was superior to that of the hybrid IR and MBIR images. CONCLUSION Deep learning-based reconstruction improves overall image quality with substantial noise reduction while maintaining image noise texture compared with the CT reconstruction techniques.
Collapse
Affiliation(s)
- Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Akira Hasegawa
- Department of Radiological Technology, National Cancer Center Japan, Tokyo, Japan; AlgoMedica, Inc., Sunnyvale, CA, USA
| | - Daisuke Sakabe
- Department of Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
35
|
Fukunaga K, Enzaki M, Komi M, Azuma M, Hirai T, Fujiwara Y. [Evaluation of the Accuracy of Relaxation Time Measurements Using 3D-QALAS at 3.0 T MRI and Comparison with 2D-MDME]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023:2023-1343. [PMID: 37211403 DOI: 10.6009/jjrt.2023-1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Three-dimensional (3D) quantification using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse (QALAS) is a quantitative sequence used to measure relaxation times. The accuracy of the relaxation time measurement of 3D-QALAS at 3.0 T and the bias of 3D-QALAS have not yet been assessed. The purpose of this study was to clarify the accuracy of the relaxation time measurements using 3D-QALAS at 3.0 T MRI. METHODS The accuracy of the T1 and T2 values for 3D-QALAS was evaluated using a phantom. Subsequently, the T1 and T2 values and proton density of the brain parenchyma in healthy subjects were measured using 3D-QALAS and compared with those of 2D multi-dynamic multi-echo (MDME). RESULTS In the phantom study, the average T1 value of 3D-QALAS was 8.3% prolonged than that for conventional inversion recovery spin-echo; the average T2 value for 3D-QALAS was 18.4% shorter than that for multi-echo spin-echo. The in vivo assessment showed that the mean T1 and T2 values and PD for 3D-QALAS were prolonged by 5.3%, shortened by 9.6%, and increased by 7.0%, respectively, compared with those for 2D-MDME. CONCLUSION Although 3D-QALAS at 3.0 T has high accuracy T1 value, which is less than 1000 ms, the T1 value could be overestimated for tissues with it longer than that T1 value. The T2 value for 3D-QALAS could be underestimated for tissues with T2 values, and this tendency increases with longer T2 values.
Collapse
Affiliation(s)
- Kota Fukunaga
- Graduate School of Health Sciences, Kumamoto University
| | | | | | - Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Medicine, Kumamoto University
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University
| |
Collapse
|
36
|
Nagayama Y, Hirai T. Diagnostic Performance of Contrast-Enhanced Dual-Energy CT Metrics for Differentiating Adrenal Adenomas From Nonadenomas Can Be Affected by Inclusion Criteria. AJR Am J Roentgenol 2023:1. [PMID: 37134208 DOI: 10.2214/ajr.23.29073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Yasunori Nagayama
- Graduate School of Medical Sciences, Kumamoto University Kumamoto, Japan,
| | - Toshinori Hirai
- Graduate School of Medical Sciences, Kumamoto University Kumamoto, Japan
| |
Collapse
|
37
|
Nagayama Y, Iwashita K, Maruyama N, Uetani H, Goto M, Sakabe D, Emoto T, Nakato K, Shigematsu S, Kato Y, Takada S, Kidoh M, Oda S, Nakaura T, Hatemura M, Ueda M, Mukasa A, Hirai T. Deep learning-based reconstruction can improve the image quality of low radiation dose head CT. Eur Radiol 2023; 33:3253-3265. [PMID: 36973431 DOI: 10.1007/s00330-023-09559-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/06/2022] [Accepted: 02/06/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To evaluate the image quality of deep learning-based reconstruction (DLR), model-based (MBIR), and hybrid iterative reconstruction (HIR) algorithms for lower-dose (LD) unenhanced head CT and compare it with those of standard-dose (STD) HIR images. METHODS This retrospective study included 114 patients who underwent unenhanced head CT using the STD (n = 57) or LD (n = 57) protocol on a 320-row CT. STD images were reconstructed with HIR; LD images were reconstructed with HIR (LD-HIR), MBIR (LD-MBIR), and DLR (LD-DLR). The image noise, gray and white matter (GM-WM) contrast, and contrast-to-noise ratio (CNR) at the basal ganglia and posterior fossa levels were quantified. The noise magnitude, noise texture, GM-WM contrast, image sharpness, streak artifact, and subjective acceptability were independently scored by three radiologists (1 = worst, 5 = best). The lesion conspicuity of LD-HIR, LD-MBIR, and LD-DLR was ranked through side-by-side assessments (1 = worst, 3 = best). Reconstruction times of three algorithms were measured. RESULTS The effective dose of LD was 25% lower than that of STD. Lower image noise, higher GM-WM contrast, and higher CNR were observed in LD-DLR and LD-MBIR than those in STD (all, p ≤ 0.035). Compared with STD, the noise texture, image sharpness, and subjective acceptability were inferior for LD-MBIR and superior for LD-DLR (all, p < 0.001). The lesion conspicuity of LD-DLR (2.9 ± 0.2) was higher than that of HIR (1.2 ± 0.3) and MBIR (1.8 ± 0.4) (all, p < 0.001). Reconstruction times of HIR, MBIR, and DLR were 11 ± 1, 319 ± 17, and 24 ± 1 s, respectively. CONCLUSION DLR can enhance the image quality of head CT while preserving low radiation dose level and short reconstruction time. KEY POINTS • For unenhanced head CT, DLR reduced the image noise and improved the GM-WM contrast and lesion delineation without sacrificing the natural noise texture and image sharpness relative to HIR. • The subjective and objective image quality of DLR was better than that of HIR even at 25% reduced dose without considerably increasing the image reconstruction times (24 s vs. 11 s). • Despite the strong noise reduction and improved GM-WM contrast performance, MBIR degraded the noise texture, sharpness, and subjective acceptance with prolonged reconstruction times relative to HIR, potentially hampering its feasibility.
Collapse
Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Koya Iwashita
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Natsuki Maruyama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Makoto Goto
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Kengo Nakato
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Shinsuke Shigematsu
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Yuki Kato
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Sentaro Takada
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Masahiro Hatemura
- Department of Central Radiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
38
|
Hirai T, Abe O, Nakamura M, Inui S, Uetani H, Ueda M, Azuma M. Brain structural changes in patients with chronic methylmercury poisoning in Minamata. Brain Res 2023; 1805:148278. [PMID: 36775085 DOI: 10.1016/j.brainres.2023.148278] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/22/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Exploratory whole-brain studies in patients suffering from methylmercury (MeHg) poisoning have not been conducted. We aimed to evaluate the neuroanatomical differences between patients with chronic MeHg poisoning and healthy volunteers via magnetic resonance (MR) imaging. Patients included in this case-control study were divided into three categories based on whether MeHg exposure occurred in utero, under 15 years of age, or over 15 years of age, as fetal-, pediatric-, and adult-type patients, respectively. This study analyzed MR imaging data from 10 patients each of fetal, pediatric, and adult types of chronic MeHg poisoning in Minamata and corresponding 53, 37, and 15 age- and sex-matched healthy volunteers. Whole-brain voxel-based morphometry (VBM) analysis was used to determine the volumetric gray and white matter (GM and WM) differences in patients with chronic MeHg poisoning. Compared to healthy individuals, VBM revealed a significant reduction in GM in the cerebellar and calcarine areas in pediatric- and adult-type cases and in the thalamus of fetal-type cases. A significant reduction in WM volume was also noted in the cerebral and the cerebellar regions, especially in pediatric-type cases. Patients with chronic MeHg poisoning develop structural differences in the GM of the calcarine, the cerebellum, and the thalamus and in the WM of the cerebrum and cerebellum. These changes can appear, depending on the timing of MeHg exposure.
Collapse
Affiliation(s)
- Toshinori Hirai
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masaaki Nakamura
- Department of Clinical Medicine, National Institute for Minamata Disease, Minamata, Japan
| | - Shohei Inui
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mitsuharu Ueda
- Department of Neurology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| |
Collapse
|
39
|
Kidoh M, Oda S, Takashio S, Kawano Y, Hayashi H, Morita K, Emoto T, Shigematsu S, Yoshimura F, Nakaura T, Nagayama Y, Matsuoka M, Ueda M, Tsujita K, Hirai T. Cardiac MRI-derived Extracellular Volume Fraction versus Myocardium-to-Lumen R1 Ratio at Postcontrast T1 Mapping for Detecting Cardiac Amyloidosis. Radiol Cardiothorac Imaging 2023; 5:e220327. [PMID: 37124644 PMCID: PMC10141336 DOI: 10.1148/ryct.220327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/02/2023]
Abstract
Purpose To evaluate the diagnostic performance of myocardium-to-lumen R1 (1/T1) ratio on postcontrast T1 maps for the detection of cardiac amyloidosis in a large patient sample. Materials and Methods This retrospective study included consecutive patients who underwent MRI-derived extracellular volume fraction (MRI ECV) analysis between March 2017 and July 2021 because of known or suspected heart failure or cardiomyopathy. Pre- and postcontrast T1 maps were generated using the modified Look-Locker inversion recovery sequence. Diagnostic performances of MRI ECV and myocardium-to-lumen R1 ratio on postcontrast T1 maps (a simplified index not requiring a native T1 map and hematocrit level data) for detecting cardiac amyloidosis were evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Results Of 352 patients (mean age, 63 years ± 16 [SD]; 235 men), 136 had cardiac amyloidosis. MRI ECV showed 89.0% (121 of 136; 95% CI: 82%, 94%) sensitivity and 98.6% (213 of 216; 95% CI: 96%, 100%) specificity for helping detect cardiac amyloidosis (cutoff value of 40% [AUC, 0.99 {95% CI: 0.97, 1.00}; P < .001]). Postcontrast myocardium-to-lumen R1 ratio showed 92.6% (126 of 136; 95% CI: 89%, 96%) sensitivity and 93.1% (201 of 216; 95% CI: 89%, 96%) specificity (cutoff value of 0.84 [AUC, 0.98 {95% CI: 0.95, 0.99}; P < .001]). There was no evidence of a difference in AUCs for each parameter (P = .10). Conclusion Postcontrast myocardium-to-lumen R1 ratio showed excellent diagnostic performance comparable to that of MRI ECV in the detection of cardiac amyloidosis.Keywords: MR Imaging, Cardiac, Heart, Cardiomyopathies Supplemental material is available for this article. © RSNA, 2023.
Collapse
|
40
|
Hirai T, Bao L, Barabash V, Carrat R, Chappuis P, Eaton R, Edwards P, Escourbiac F, Gicquel S, Komarov V, Merola M, Raffray R, Chen J, Wang K, Gervash A, Makhankov A, Arkhipov N, Safronov V. Hypervapotron heat sinks in ITER plasma-facing components—Process qualifications and production control toward series production. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
41
|
Shiraishi C, Hirai T, Fujita S, Dohi K, Iwamoto T. Variations in prothrombin time-international normalized ratio caused by drug-drug interaction in patients receiving warfarin: A retrospective observational study. Int J Clin Pharmacol Ther 2023; 61:139-147. [PMID: 36633369 DOI: 10.5414/cp204306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Drug-drug interactions between warfarin and cytochrome P450 (CYP) 2C9 inhibitors and inducers are well known. Few studies have clarified the clinical impact of CYP2C9 inhibitors and inducers on warfarin therapy. Here, we evaluated the clinical impact of CYP2C9-mediated interactions on the pharmacodynamics of warfarin. MATERIALS AND METHODS This retrospective observational study enrolled patients who received warfarin between 2008 and 2020 at Mie University Hospital. We defined prothrombin time-international normalized ratio/daily warfarin dose (PT-INR/dose) as the primary outcome and conducted a multiple linear regression analysis to clarify the factors that affected the primary outcome. Additionally, we examined the clinical features of patients who received CYP2C9 inducers. RESULTS Out of 1,393 patients, 17 (1.2%) received carbamazepine, rifampicin, phenobarbital, or phenytoin as CYP2C9 inducers. Multiple linear regression analysis indicated that age, body mass index (BMI), serum albumin (Alb), estimated glomerular filtration rate (eGFR), and CYP2C9 inducers were associated with PT-INR/dose. The multiple regression equation was as follows: PT-INR/dose = 1.590 + 0.004 × age - 0.020 × BMI - 0.141 × Alb - 0.001 × eGFR - 0.149 × (if concomitant use of CYP2C9 inducers) (adjusted coefficient of determination = 0.106, Akaike information criterion = 267.3, p < 0.001). In patients receiving CYP2C9 inducers, lower PT-INR/dose values were observed regardless of co-administered CYP2C9 inhibitors. CONCLUSION In addition to age, BMI, Alb, and eGFR, concomitant use of CYP2C9 inducers should be considered when adjusting the warfarin dose and PT-INR.
Collapse
|
42
|
Hirai T, Ueda S, Ogura T, Katayama K, Dohi K, Hosohata K, Aoyama T, Matsumoto Y, Iwamoto T. Hyperkalemia by eplerenone or esaxerenone in the presence or absence of clarithromycin in hypertensive patients: a retrospective observational cohort study. J Hypertens 2023; 41:580-586. [PMID: 36655800 DOI: 10.1097/hjh.0000000000003372] [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: 01/20/2023]
Abstract
OBJECTIVE Mineralocorticoid receptor antagonists (MRAs), eplerenone and esaxerenone, cause hyperkalemia dose-dependently. We investigated the cytochrome P450 3A4-mediated drug-drug interaction between the MRAs and clarithromycin. METHODS This retrospective observational study included adult hypertensive patients with MRA plus clarithromycin or MRA alone with a propensity score matching (1:1). The difference in serum potassium level (ΔK, maximum level - baseline level) between groups was compared using the Mann-Whitney U -test. Linear regression analysis was used to detect variables that correlated with ΔK in patients with MRA plus clarithromycin. RESULTS After propensity score matching (each nine patients), serum potassium level was elevated after treatment with MRA plus clarithromycin [4.3 (3.5 to 5.1) meq/l to 4.9 (4.0 to 5.5) meq/l, P = 0.0234] and MRA alone [4.3 (4.0 to 4.7) meq/l to 4.6 (4.4 to 5.2) meq/l, P = 0.0469]. Although there was no significant difference in ΔK between groups [MRA plus clarithromycin: 0.5 (0.1 to 1.1) meq/l vs. MRA alone: 0.3 (0.1 to 1.2) meq/l, P = 0.7231], ΔK was significantly higher in esaxerenone plus clarithromycin than in esaxerenone alone [0.6 (0.5 to 1.1) meq/l vs. 0.1 (0.1 to 0.2) meq/l, P = 0.0495]. Conversely, clarithromycin did not show a significant effect on ΔK in patients with eplerenone [0.4 (-0.2 to 1.2) meq/l vs. 0.8 (0.1 to 1.3) meq/l, P = 0.5745]. A positive correlation was found between ΔK and age in patients with MRA plus clarithromycin ( y = 0.03 × x - 1.38, r = 0.71, P = 0.0336). CONCLUSION The drug-drug interaction between MRAs and clarithromycin was evident, particularly in esaxerenone. Serum potassium levels should be closely monitored in older patients.
Collapse
Affiliation(s)
| | - Shun Ueda
- Department of Pharmacy, Faculty of Medicine
| | | | | | - Kaoru Dohi
- Department of Cardiology, Faculty of Medicine, Mie University Hospital, Mie University, Edobashi, Tsu, Mie
| | - Keiko Hosohata
- Education and Research Center for Clinical Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka
| | - Takahiko Aoyama
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Nihon University, Funabashi, Chiba, Japan
| | - Yoshiaki Matsumoto
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Nihon University, Funabashi, Chiba, Japan
| | | |
Collapse
|
43
|
Shiraishi K, Nakaura T, Uetani H, Nagayama Y, Kidoh M, Kobayashi N, Morita K, Yamahita Y, Miyamoto T, Hirai T. Combination Use of Compressed Sensing and Deep Learning for Shoulder Magnetic Resonance Imaging With Various Sequences. J Comput Assist Tomogr 2023; 47:277-283. [PMID: 36944152 DOI: 10.1097/rct.0000000000001418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE For compressed sensing (CS) to become widely used in routine magnetic resonance imaging (MRI), it is essential to improve image quality. This study aimed to evaluate the usefulness of combining CS and deep learning-based reconstruction (DLR) for various sequences in shoulder MRI. METHODS This retrospective study included 37 consecutive patients who underwent undersampled shoulder MRIs, including T1-weighted (T1WI), T2-weighted (T2WI), and fat-saturation T2-weighted (FS-T2WI) images. Images were reconstructed using the conventional wavelet-based denoising method (wavelet method) and a combination of wavelet and DLR-based denoising methods (hybrid-DLR method) for each sequence. The signal-to-noise ratio and contrast-to-noise ratio of the bone, muscle, and fat and the full width at half maximum of the shoulder joint were compared between the 2 image types. In addition, 2 board-certified radiologists scored the image noise, contrast, sharpness, artifacts, and overall image quality of the 2 image types on a 4-point scale. RESULTS The signal-to-noise ratios and contrast-to-noise ratios of the bone, muscle, and fat in T1WI, T2WI, and FS-T2WI obtained from the hybrid-DLR method were significantly higher than those of the conventional wavelet method (P < 0.001). However, there were no significant differences in the full width at half maximum of the shoulder joint in any of the sequences (P > 0.05). Furthermore, in all sequences, the mean scores of the image noise, sharpness, artifacts, and overall image quality were significantly higher in the hybrid-DLR method than in the wavelet method (P < 0.001), but there were no significant differences in contrast among the sequences (P > 0.05). CONCLUSIONS The DLR denoising method can improve the image quality of CS in T1-weighted images, T2-weighted images, and fat-saturation T2-weighted images of the shoulder compared with the wavelet denoising method alone.
Collapse
Affiliation(s)
- Kaori Shiraishi
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Takeshi Nakaura
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Hiroyuki Uetani
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Yasunori Nagayama
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Masafumi Kidoh
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Naoki Kobayashi
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Kosuke Morita
- Department of Radiology, Kumamoto University Hospital, Kumamoto
| | | | - Takeshi Miyamoto
- Department of Orthopaedicsurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- From the Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| |
Collapse
|
44
|
Masuda T, Nakaura T, Funama Y, Sato T, Nagayama Y, Kidoh M, Yoshida M, Arao S, Ono A, Hiratsuka J, Hirai T, Awai K. Can Machine Learning Identify the Intravenous Contrast Dose and Injection Rate Needed for Optimal Enhancement on Dynamic Liver Computed Tomography? J Comput Assist Tomogr 2023; Publish Ahead of Print:00004728-990000000-00168. [PMID: 37380150 DOI: 10.1097/rct.0000000000001468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES This study aimed to investigate whether machine learning (ML) is useful for predicting the contrast material (CM) dose required to obtain a clinically optimal contrast enhancement in hepatic dynamic computed tomography (CT). METHODS We trained and evaluated ensemble ML regressors to predict the CM doses needed for optimal enhancement in hepatic dynamic CT using 236 patients for a training data set and 94 patients for a test data set. After the ML training, we randomly divided using the ML-based (n = 100) and the body weight (BW)-based protocols (n = 100) by the prospective trial. The BW protocol was performed using routine protocol (600 mg/kg of iodine) by the prospective trial. The CT numbers of the abdominal aorta and hepatic parenchyma, CM dose, and injection rate were compared between each protocol using the paired t test. Equivalence tests were performed with equivalent margins of 100 and 20 Hounsfield units for the aorta and liver, respectively. RESULTS The CM dose and injection rate for the ML and BW protocols were 112.3 mL and 3.7 mL/s, and 118.0 mL and 3.9 mL/s (P < 0.05). There were no significant differences in the CT numbers of the abdominal aorta and hepatic parenchyma between the 2 protocols (P = 0.20 and 0.45). The 95% confidence interval for the difference in the CT number of the abdominal aorta and hepatic parenchyma between 2 protocols was within the range of predetermined equivalence margins. CONCLUSIONS Machine learning is useful for predicting the CM dose and injection rate required to obtain the optimal clinical contrast enhancement for hepatic dynamic CT without reducing the CT number of the abdominal aorta and hepatic parenchyma.
Collapse
Affiliation(s)
- Takanori Masuda
- From the Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto
| | - Tomoyasu Sato
- Department of Diagnostic Radiology, Tsuchiya General Hospital
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Masato Yoshida
- Department of Diagnostic Radiology, Tsuchiya General Hospital
| | - Shinichi Arao
- From the Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama
| | - Atsushi Ono
- From the Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama
| | - Junichi Hiratsuka
- From the Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
45
|
Kidoh M, Oda S, Takashio S, Hirakawa K, Kawano Y, Shiraishi S, Hayashi H, Nakaura T, Nagayama Y, Funama Y, Ueda M, Tsujita K, Hirai T. CT Extracellular Volume Fraction versus Myocardium-to-Lumen Signal Ratio for Cardiac Amyloidosis. Radiology 2023; 306:e220542. [PMID: 36255307 DOI: 10.1148/radiol.220542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Large studies on the diagnostic performance of CT-derived myocardial extracellular volume fraction (ECV) for detecting cardiac amyloidosis are lacking. A simple and practical index as a surrogate for CT ECV would be clinically useful. Purpose To compare the diagnostic performances between CT-derived myocardial ECV and myocardium-to-lumen signal ratio for the detection of cardiac amyloidosis in a large patient sample. Materials and Methods This retrospective study included patients who underwent CT ECV analysis because of suspected heart failure or cardiomyopathy between January 2018 and July 2021. CT ECV was quantified using routine pre-transcatheter aortic valve replacement planning cardiac CT, pre-atrial fibrillation ablation planning cardiac CT, or coronary CT angiography with the addition of unenhanced and delayed phase cardiac CT scans. The diagnostic performances of CT ECV and myocardium-to-lumen signal ratio in delayed phase cardiac CT (a simplified index not requiring unenhanced CT and hematocrit) for detecting cardiac amyloidosis were evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Results Of 552 patients (mean age, 69 years ± 14 [SD]; 295 men), 41 had cardiac amyloidosis. The sensitivity of CT ECV for amyloidosis was 90% (37 of 41 patients [95% CI: 77, 97]), with a specificity of 92% (472 of 511 patients [95% CI: 90, 95]) and optimal ECV cutoff value of 37% (AUC, 0.97 [95% CI: 0.96, 0.99]). The sensitivity of myocardium-to-lumen signal ratio was 88% (36 of 41 patients [95% CI: 74, 96]), with a specificity of 92% (469 of 511 patients [95% CI: 89, 94]) and optimal myocardium-to-lumen signal ratio cutoff value of 0.87 (AUC, 0.96 [95% CI: 0.94, 0.97]; P = .27 for comparison with ECV). Conclusion CT-derived myocardial extracellular volume fraction and myocardium-to-lumen signal ratio showed comparable and excellent diagnostic performance in detecting cardiac amyloidosis in a large patient sample. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Williams in this issue.
Collapse
Affiliation(s)
- Masafumi Kidoh
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seitaro Oda
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seiji Takashio
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kyoko Hirakawa
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yawara Kawano
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Shinya Shiraishi
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hidetaka Hayashi
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takeshi Nakaura
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yasunori Nagayama
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yoshinori Funama
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Mitsuharu Ueda
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kenichi Tsujita
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Toshinori Hirai
- From the Departments of Diagnostic Radiology (M.K., S.O., S.S., H.H., T.N., Y.N., T.H.), Cardiovascular Medicine (S.T., K.H., K.T.), Hematology, Rheumatology, and Infectious Disease (Y.K.), and Neurology (M.U.), Graduate School of Medical Sciences, and Department of Medical Physics, Faculty of Life Sciences (Y.F.), Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| |
Collapse
|
46
|
Goto M, Nagayama Y, Sakabe D, Emoto T, Kidoh M, Oda S, Nakaura T, Taguchi N, Funama Y, Takada S, Uchimura R, Hayashi H, Hatemura M, Kawanaka K, Hirai T. Lung-Optimized Deep-Learning-Based Reconstruction for Ultralow-Dose CT. Acad Radiol 2023; 30:431-440. [PMID: 35738988 DOI: 10.1016/j.acra.2022.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/18/2022] [Accepted: 04/30/2022] [Indexed: 01/25/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the image properties of lung-specialized deep-learning-based reconstruction (DLR) and its applicability in ultralow-dose CT (ULDCT) relative to hybrid- (HIR) and model-based iterative-reconstructions (MBIR). MATERIALS AND METHODS An anthropomorphic chest phantom was scanned on a 320-row scanner at 50-mA (low-dose-CT 1 [LDCT-1]), 25-mA (LDCT-2), and 10-mA (ULDCT). LDCT were reconstructed with HIR; ULDCT images were reconstructed with HIR (ULDCT-HIR), MBIR (ULDCT-MBIR), and DLR (ULDCT-DLR). Image noise and contrast-to-noise ratio (CNR) were quantified. With the LDCT images as reference standards, ULDCT image qualities were subjectively scored on a 5-point scale (1 = substantially inferior to LDCT-2, 3 = comparable to LDCT-2, 5 = comparable to LDCT-1). For task-based image quality analyses, a physical evaluation phantom was scanned at seven doses to achieve the noise levels equivalent to chest phantom; noise power spectrum (NPS) and task-based transfer function (TTF) were evaluated. Clinical ULDCT (10-mA) images obtained in 14 nonobese patients were reconstructed with HIR, MBIR, and DLR; the subjective acceptability was ranked. RESULTS Image noise was lower and CNR was higher in ULDCT-DLR and ULDCT-MBIR than in LDCT-1, LDCT-2, and ULDCT-HIR (p < 0.01). The overall quality of ULDCT-DLR was higher than of ULDCT-HIR and ULDCT-MBIR (p < 0.01), and almost comparable with that of LDCT-2 (mean score: 3.4 ± 0.5). DLR yielded the highest NPS peak frequency and TTF50% for high-contrast object. In clinical ULDCT images, the subjective acceptability of DLR was higher than of HIR and MBIR (p < 0.01). CONCLUSION DLR optimized for lung CT improves image quality and provides possible greater dose optimization opportunity than HIR and MBIR.
Collapse
Affiliation(s)
- Makoto Goto
- Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Daisuke Sakabe
- Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takafumi Emoto
- Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto 860-8556, Japan
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seitaro Oda
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Narumi Taguchi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto 862-0976, Japan
| | - Sentaro Takada
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Ryutaro Uchimura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hidetaka Hayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Masahiro Hatemura
- Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto 860-8556, Japan
| | - Koichi Kawanaka
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| |
Collapse
|
47
|
Nagayama Y, Hirai T. Letter to the editor on "diagnostic value of the relative enhancement ratio of the portal venous phase to unenhanced CT in the identification of lipid‑poor adrenal tumors". Abdom Radiol (NY) 2023; 48:1841-1842. [PMID: 36810706 DOI: 10.1007/s00261-023-03856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/25/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
48
|
Yokota S, Miyaso H, Hirai T, Suga K, Wakayama T, Taquahashi Y, Kitajima S. Development of a non-invasive method for testicular toxicity evaluation using a novel compact magnetic resonance imaging system. J Toxicol Sci 2023; 48:57-64. [PMID: 36725021 DOI: 10.2131/jts.48.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In non-clinical animal studies for drug discovery, histopathological evaluation is the most powerful tool to assess testicular toxicity. However, histological analysis is extremely invasive; many experimental animals are needed to evaluate changes in the pathology and anatomy of the testes over time. As an alternative, small animal magnetic resonance imaging (MRI) offers a non-invasive methodology to examine testicular toxicity without radiation. The present study demonstrated the suitability of a new, ready-to-use compact MRI platform using a high-field permanent magnet to assist with the evaluation of testicular toxicity. To validate the utility of the MRI platform, male mice were treated with busulfan (40 mg/kg, intraperitoneal injection). Twenty-eight days after treatment, both testes in busulfan-treated and control mice (n = 6/group) were non-invasively scanned in situ by MRI at 1 tesla. On a T1-weighted 3D gradient-echo MRI sequences (voxel size: 0.23 × 0.23 × 0.50 mm), the total testicular volume in busulfan-treated mice was significantly smaller than in controls. On T1-weighted images, the signal intensity of the testes was significantly higher in busulfan-treated mice than in controls. The mice were sacrificed, and the testes were isolated for histopathological analysis. The weight of the testes in busulfan-treated mice significantly decreased, similar to the results of the non-invasive analysis. Additionally, periodic acid-Schiff stain-positive effusions were observed in the interstitium of the busulfan-treated mouse testes, potentially explaining T1 shortening due to a high concentration of glycoproteinaceous content. The present data demonstrated a rapid evaluation of testicular toxicity in vivo by compact MRI.
Collapse
Affiliation(s)
- Satoshi Yokota
- Division of Cellular & Molecular Toxicology, Center for Biological Safety & Research, National Institute of Health Sciences
| | - Hidenobu Miyaso
- Department of Anatomy, Faculty of Medicine, School of Medicine, International University of Health and Welfare
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
| | - Kousuke Suga
- Division of Cellular & Molecular Toxicology, Center for Biological Safety & Research, National Institute of Health Sciences
| | - Tomohiko Wakayama
- Department of Histology, Graduate School of Medical Sciences, Kumamoto University
| | - Yuhji Taquahashi
- Division of Cellular & Molecular Toxicology, Center for Biological Safety & Research, National Institute of Health Sciences
| | - Satoshi Kitajima
- Division of Cellular & Molecular Toxicology, Center for Biological Safety & Research, National Institute of Health Sciences
| |
Collapse
|
49
|
Shiraishi C, Hirai T, Ogura T, Iwamoto T. Analysis of Clinical Factors in Olaparib-related Anemia Using Adverse Drug Event Reporting Databases. Anticancer Res 2023; 43:883-891. [PMID: 36697083 DOI: 10.21873/anticanres.16231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIM Anemia is one of the dose-limiting toxicities of olaparib. A global randomized controlled trial confirmed that anemia occurrence in Japanese was relatively high. The factors related to anemia in different nationalities remain unknown. Therefore, this study investigated the factors of olaparib-related anemia in real-world settings using an adverse event reporting system database. PATIENTS AND METHODS We used data from FDA Adverse Events Reporting System (FAERS) and Japanese Adverse Drug Event Report database (JADER) between 2018 and 2021. FAERS reports from Japan were collected to conduct subgroup analysis, which was defined as FAERS-Japan. The endpoint was the occurrence of olaparib-related anemia. Disproportionality analysis was conducted to calculate reporting odds ratio (ROR), with a confidence interval of 95%. Adjusted ROR (aROR) was calculated to control for sex differences. RESULTS In FAERS and JADER, the daily olaparib dose per body weight (DPBW) ≥12 mg/kg was associated with anemia occurrence [aROR; FAERS, 4.483 (3.009-6.680), p<0.001, FAERS-Japan, 1.834 (1.091-3.063), p=0.009, and JADER, 1.628 (1.039-2.551), p=0.034]. Furthermore, FAERS reports confirmed that females with body weight <50 kg, reports from Japan, concomitant use of drugs causing vitamin B12 deficiency, and previous platinum treatment history were associated with olaparib-related anemia. FAERS-Japan also showed that body weight <50 kg and previous platinum treatment history were associated with anemia occurrence. CONCLUSION High DPBW constitutes a significant risk of olaparib-related anemia. In addition, information on co-administration of drugs causing vitamin B12 deficiency and previous platinum treatment history is also important for the evaluation of the risk of olaparib-related anemia.
Collapse
Affiliation(s)
- Chihiro Shiraishi
- Department of Pharmacy, Mie University Hospital, Mie, Japan.,Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Toshinori Hirai
- Department of Pharmacy, Mie University Hospital, Mie, Japan.,Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Toru Ogura
- Clinical Research Support Center, Mie University Hospital, Mie, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan; .,Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| |
Collapse
|
50
|
Sakai M, Hirai T, Shitara S, Iwamoto T, Shiga T. Comparison of creatinine-based equations for estimating renal function for digoxin dose adjustment in patients with atrial fibrillation and heart failure. Pharmacol Res Perspect 2023; 11:e01050. [PMID: 36628508 PMCID: PMC9832284 DOI: 10.1002/prp2.1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/08/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to determine an appropriate equation for estimating renal function to dose regulate the serum digoxin trough concentration to a target of <0.9 ng/ml in patients with atrial fibrillation (AF) and heart failure (HF). All patients received 0.125 mg oral digoxin daily. The estimated glomerular filtration rate by the Modification of Diet in Renal Disease (eGFRMDRD ) equation deindexed based on body surface area had the highest correlation with digoxin trough concentrations (r = -0.450) compared to the Cockcroft-Gault equation (r = -0.415) or deindexed eGFR based on the Chronic Kidney Disease Epidemiology Collaboration (eGFRCKD-EPI ) equation (r = -0.416). The median digoxin trough concentrations were 0.60, 0.77, 0.97 and 1.30 ng/ml in patients with a deindexed eGFRMDRD ≥ 60, 45-59, 30-44 and < 30 ml/min, respectively. The deindexed eGFRMDRD is an appropriate equation for digoxin dose adjustment in patients with AF and HF.
Collapse
Affiliation(s)
| | - Toshinori Hirai
- Department of Clinical Pharmacology and TherapeuticsThe Jikei University School of MedicineTokyoJapan
- Department of PharmacyMie University Hospital, Faculty of Medicine, Mie UniversityTsuMieJapan
| | - Satoshi Shitara
- Department of Clinical Pharmacology and TherapeuticsThe Jikei University School of MedicineTokyoJapan
| | - Takuya Iwamoto
- Department of PharmacyMie University Hospital, Faculty of Medicine, Mie UniversityTsuMieJapan
| | - Tsuyoshi Shiga
- Department of Clinical Pharmacology and TherapeuticsThe Jikei University School of MedicineTokyoJapan
- Department of CardiologyTokyo Women's Medical UniversityTokyoJapan
| |
Collapse
|