Publications by authors named "Shuhei Sato"

78 Publications

Nuclear medicine practice in Japan: a report of the eighth nationwide survey in 2017.

Ann Nucl Med 2019 Oct 24;33(10):725-732. Epub 2019 Jun 24.

Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan.

Objective: Subcommittee on Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every 5 years since 1982 to survey contemporary nuclear medicine practice and its changes over the years.

Methods: The subcommittee sent questionnaires, including the number and category of examinations as well as the kind and dose of the radiopharmaceuticals during the 30 days of June 2017, to all nuclear medicine institutes. The total numbers for the year 2017 were then estimated.

Results: A total of 1132 institutes responded to the survey, including 351 PET centers. The recovery rate was 90.6%. The number of gamma cameras installed was 1332 in total, with 7.0% decrease in 5 years. Dual-head cameras and hybrid SPECT/CT scanners accounted for 88.2 and 23.6%, respectively. The number of single-photon tracer studies in 2017 was 1.08 million which means a decrease in 5.7% in 5 years and 23.6% in 10 years. All but neurotransmitter system, sentinel lymph node, and liver scintigraphy decreased. Bone scintigraphy was a leading examination (32.3%), followed by myocardial scintigraphy (24.1%) and cerebral perfusion study (18.0%) in order. SPECT studies showed an increase from 47.2% to 63.5%. PET centers have also increased from 295 to 389, as compared to the last survey. The 112 PET centers have installed one or two in-house cyclotrons. PET studies showed 24.5% increase in 5 years, with oncology accounting for 88.9%. F-FDG accounted for 98.2% (630,570 examinations). PET examinations using C-methionine have decreased, with 2440 examinations in 2017. PET examinations using N-NH have been increasing, with 2363 examinations in 2017. The number of PET studies using C-PIB was 904. I-radioiodine targeted therapies showed an increase in 5 years (23.1%), including 4487 patients for thyroid cancer. Out-patient thyroid bed ablation therapy with 1,110 MBq of I accounted for 36.6% of cancer patients. The number of admission rooms increased from 135 to 157 in 5 years. The number of Ra targeted therapies for castration-resistant metastatic prostate cancer was 1194 patients.

Conclusions: Single-photon examinations showed a continuous tendency toward a decline in the survey. In contrast, the number of hybrid SPECT/CT scanner examinations has increased. PET/CT study and radionuclide targeted therapy have steadily increased.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12149-019-01382-5DOI Listing
October 2019

Image Evaluation of Free-breathing Navigator Echo and Triggered Cardiac-gated Delayed Myocardial Enhancement Magnetic Resonance Imaging in Sedated Infants.

Acta Med Okayama 2018 Jun;72(3):267-273

Graduate School of Health Sciences, Okayama University, Okayama 700-8558,

We validated a navigator-echo-triggered sequence that drives magnetization before cardiac-gated inversion recovery T1 turbo field echo acquisition, in the sedated free-breathing pediatric population. Cardiac magnetic resonance imaging was performed on sedated infants with single ventricle. We calculated the signal-to-noise ratios and contrast-to-noise ratios of 2 groups of images obtained using respiratory triggering with and without navigator echo. All images were then visually assessed by 2 observers. The signal-to-noise ratio and the contrast-to-noise ratio were significantly higher with than without navigator echo (p<0.01; p<0.05). The visual assessment scores were also consistently better with than without navigator echo (p<0.01). Free-breathing navigator echo was found to have the advantage of decreasing the motion artifact caused by respiration. Cardiacgated inversion recovery T1 turbo field echo sequence for free-breathing navigator-echo-triggered respiration allows for the acquisition, in sedated infants, of diagnostic images whose quality exceeds that of the non-navigator-echo-triggered alternative.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18926/AMO/56072DOI Listing
June 2018

Verbal or Visual Memory Score and Regional Cerebral Blood Flow in Alzheimer Disease.

Dement Geriatr Cogn Dis Extra 2018 Jan-Apr;8(1):1-11. Epub 2018 Jan 23.

aDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Objective: Among many cognitive function deficits, memory impairment is an initial and cardinal symptom in Alzheimer disease (AD). In most cases, verbal and visual memory scores correlate highly, but in some cases the deficit of verbal or visual memory is very different from that of the other memory. In this study, we examined the neural substrates of verbal and visual memory in patients with AD.

Methods: One hundred eighty-eight consecutive patients with AD were recruited from outpatient units. Verbal and visual memory scores were evaluated using the Wechsler Memory Scale - revised. The patients underwent brain SPECT with Tc-ethylcysteinate dimer.

Results: After removing the effects of age, sex, education, and Mini-Mental State Examination scores, correlation analysis showed a significant correlation of verbal memory scores to regional cerebral blood flow (rCBF) in the bilateral cingulate gyrus and left precuneus. Similarly, a significant correlation of visual memory scores to rCBF was found in the right precuneus and right cingulate gyrus.

Conclusion: The posterior medial cortices (PMC) are very important areas in episodic memory among patients with mild AD. Verbal memory is more closely related to the both sides of the PMC, while visual memory is more closely related to the right PMC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000486093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836286PMC
January 2018

Utility of second-generation single-energy metal artifact reduction in helical lung computed tomography for patients with pulmonary arteriovenous malformation after coil embolization.

Jpn J Radiol 2018 Apr 10;36(4):285-294. Epub 2018 Feb 10.

Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama-city, 700-8558, Okayama, Japan.

Purpose: The quality of images acquired using single-energy metal artifact reduction (SEMAR) on helical lung computed tomography (CT) in patients with pulmonary arteriovenous malformation (PAVM) after coil embolization was retrospectively evaluated.

Materials And Methods: CT images were reconstructed with and without SEMAR. Twenty-seven lesions [20 patients (2 males, 18 females), mean age 61.2 ± 11.0 years; number of embolization coils, 9.8 ± 5.0] on contrast-enhanced CT and 18 lesions of non-enhanced lung CT concurrently performed were evaluated. Regions of interest were positioned around the coils and mean standard deviation value was compared as noise index. Two radiologists visually evaluated metallic coil artifacts using a four-point scale: 4 = minimal; 3 = mild; 2 = strong; 1 = extensive.

Results: Noise index was significantly improved with SEMAR versus without SEMAR (median [interquartile range]; 194.4 [161.6-211.9] Hounsfield units [HU] vs. 243.9 [220.4-286.0] HU; p < 0.001). Visual score was significantly improved with SEMAR versus without SEMAR (Reader 1, 3 [3] vs.1 [1]; Reader 2, 3 [3] vs.1 [1]; p < 0.001). Significant differences were similarly demonstrated on lung CT (p < 0.001).

Conclusion: SEMAR provided clear chest CT images in patients who underwent PAVM coil embolization.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-018-0723-6DOI Listing
April 2018

Evaluating Low-kV Dual-source CT Angiography by High-pitch Spiral Acquisition and Iterative Reconstruction in Pediatric Congenital Heart Disease Patients.

Acta Med Okayama 2017 Oct;71(5):407-412

Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,

We retrospectively evaluated the qualities of pediatric cardiovascular dual-source computed tomography (DSCT) images reconstructed by sinogram-affirmed iterative reconstruction (SAFIRE) and filtered back projection (FBP). We analyzed the cases of 287 congenital heart disease (CHD) patients < 5 years old, referred to our department in August 2013-March 2015. We divided them into two groups according to tube voltage (70 kVp, n=147; 80 kVp, n=140). All images were acquired by a CARE kV system and reconstructed by FBP and SAFIRE. The attenuation, noise, and signal-to-noise ratio (SNR) at each region of the heart and great vessels were measured. The volume CT dose index and dose-length product values were recorded. Compared to FBP, reconstruction by SAFIRE showed that the attenuation volume was significantly lower by 0.4% except for the ascending aorta (p<0.05), the noise value was lower by about 20% (p<0.05), and the SNR was higher by approx. 25% (p<0.05). The radiation dose in the 70 kVp group was significantly lower than that in the 80 kVp group. No significant differences in SNR were observed between the patient groups. DSCT image acquisition with SAFIRE using the CARE kV system results in low image noise and radiation dose in pediatric patients with CHD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18926/AMO/55438DOI Listing
October 2017

Image Quality of Coronary Arteries on Non-electrocardiography-gated High-Pitch Dual-Source Computed Tomography in Children with Congenital Heart Disease.

Pediatr Cardiol 2017 Oct 8;38(7):1393-1399. Epub 2017 Jul 8.

Department of Radiology, Okayama University Medical School, 2-5-1 Kitaku Shikatacho, Okayama, 700-8558, Japan.

This study aimed to evaluate image quality of coronary artery imaging on non-electrocardiography (ECG)-gated high-pitch dual-source computed tomography (DSCT) in children with congenital heart disease (CHD) and to assess factors affecting image quality. We retrospectively reviewed the records of 142 children with CHD who underwent non-ECG-gated high-pitch DSCT. The subjective image quality of the proximal coronary segments was graded using a five-point scale. A score <3 represented a non-diagnostic image. Age, body weight, and heart rate were compared between the two groups: patients with good diagnostic image quality in all four segments and patients with at least one segment with non-diagnostic image quality. Predictors of image quality were assessed by multivariate logistic regression, including age, body weight, and heart rate. Four-hundred-fifty-seven of the 568 segments (80.5%) had diagnostic image quality. Patients with non-diagnostic segments were significantly younger (21.6 ± 25.5 months), had lower body weight (7.82 ± 5.00 kg), and a faster heart rate (123 ± 23.7 beats/min) (each p < 0.05) than patients with diagnostic image quality in all four segments (30.6 ± 20.7 months, 10.3 ± 4.00 kg, and 113 ± 21.6 beats/min, respectively; each p < 0.05). The multivariate logistic regression revealed that body weight (odds ratio 1.228; p = 0.029) was a significant predictor of image quality. Non-ECG-gated high-pitch DSCT provided adequate image quality of the proximal coronary segments in children with CHD. Lower body weight was a factor that led to poorer image quality of the coronary arteries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00246-017-1675-9DOI Listing
October 2017

Diagnostic Value of Dual-time-point F-18 FDG PET/CT and Chest CT for the Prediction of Thymic Epithelial Neoplasms.

Acta Med Okayama 2017 Apr;71(2):105-112

Department of Radiology, Okayama University Hospital, Okayama 700-8558,

We retrospectively assessed the dual-time-point (DTP) F-18 FDG PET/CT findings of thymic epithelial neoplasms (TENs) and investigated the diagnostic capacity of PET/CT compared to that of CT for predicting carcinoma. We calculated the ratio of the standardized uptake value of the tumor and that of the aortic arch (T/M ratio) for both the 90-min early scan and the 2-h delayed scan in 56 TEN patients. We used a multivariate logistic regression (MLR) analysis to estimate the CT features of carcinoma. We compared the diagnostic capacities of PET/CT and chest CT using receiver operating characteristic (ROC) analyses. The ROC curve revealed that the appropriate cut-off T/M ratio value for the highest accuracy was 2.39 with 75.0% accuracy. The area under the curve (AUC) was 0.855. The statistical analyses for DTP scans of 35 TEN patients demonstrated 74.3% accuracy and 0.838 AUC for the early scan versus 82.9% and 0.825 for the delayed scan. The MLR analysis indicated that mediastinal fat infiltration was a predictor of carcinoma. The ROC curve obtained for the model yielded an AUC of 0.853. Delayed scanning could improve the diagnostic capacity for carcinoma. The T/M ratio and mediastinal fat infiltration are predictive of carcinoma with moderate diagnostic accuracy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18926/AMO/54978DOI Listing
April 2017

Evaluation of Urinary Stone Composition and Differentiation between Urinary Stones and Phleboliths Using Single-source Dual-energy Computed Tomography.

Acta Med Okayama 2017 Apr;71(2):91-96

Department of Radiology, Okayama Medical Center, Okayama 701-1192,

The aim of this study was to investigate the utility of single-source dual-energy computed tomography (SS-DECT) composition analysis in characterizing different types of urinary stones and differentiating them from phleboliths. This study included 29 patients with urinary stones who were scheduled for surgery. All patients were scanned, first using single-energy computed tomography acquisition and then DECT acquisition on SS-DECT. Dual-energy data were archived to a Gemstone spectral imaging (GSI) viewer (GE Healthcare, Milwaukee, WI, USA). Hounsfield units (HU) and effective atomic numbers (Zeff) were estimated using the GSI viewer. The results of dual-energy analysis were compared with the biochemical constitution of the stones. The chemical analysis determined that the stones included 32 calcium-based, 6 cystine and 1 struvite stone. Both HU and Zeff values were helpful in differentiating calcium-based stones from cystine and struvite stones and phleboliths. The Zeff values of phleboliths were significantly higher than those for struvite and cystine stones, whereas it was difficult to distinguish phleboliths from struvite and cystine stones using the HU values. Composition analysis using SS-DECT is helpful for distinguishing urinary stone types and discriminating phleboliths from urinary stones. Zeff values may be more useful than HU values for differentiating urinary stones from phleboliths.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18926/AMO/54976DOI Listing
April 2017

Imaging of the temporal bone in children using low-dose 320-row area detector computed tomography.

J Med Imaging Radiat Oncol 2017 Aug 27;61(4):489-493. Epub 2017 Feb 27.

Department of Radiology, Okayama University Medical School, Okayama, Japan.

Introduction: The aim of this study was to compare the image quality obtained using low-dose and standard-dose 320-row temporal bone computed tomography (CT) in paediatric patients.

Methods: Thirteen low-dose CT (120 kV/50 mAs) and nine standard-dose CT (120 kV/100 mAs) images from children up to 5 years of age were compared for their image quality. The noise and signal-to-noise ratio for bone, fat and air were measured. Two observers assessed the overall image quality and ability to visualize 14 small anatomic structures using a 5-point scale, with a score of 3-5 indicating imaging of diagnostic quality.

Results: Noise was significantly higher and the signal-to-noise ratio was significantly lower with low-dose CT. Although the overall image quality and visibility of several structures on low-dose CT were significantly reduced when compared with standard-dose CT, all the image quality scores were 3 or >3. The dose-length products for low-dose CT and standard-dose CT were 59.6 mGy·cm and 119.3 mGy·cm, respectively.

Conclusion: Low-dose CT of the temporal bone using 320-row CT provides images of diagnostic quality for assessment of middle and inner ear anatomy, similar to that provided by the standard-dose protocol, in spite of increased image noise.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1754-9485.12596DOI Listing
August 2017

Intracoronary Cardiac Progenitor Cells in Single Ventricle Physiology: The PERSEUS (Cardiac Progenitor Cell Infusion to Treat Univentricular Heart Disease) Randomized Phase 2 Trial.

Circ Res 2017 Mar 4;120(7):1162-1173. Epub 2017 Jan 4.

From the Departments of Cardiovascular Surgery (S.I., D.O., T.G., N.H., J.K., Y. Kuroko, Y. Kotani, S.A., S.K., S. Sano), Pediatrics (S.O., T.E., M.K., Y. Kurita, K.H., Y.F., K.B.), Anesthesiology and Resuscitology (T.I.), and Radiology (S. Sato), Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan; and Regenerative Medicine, Center for Innovative Clinical Medicine, Okayama University Hospital, Japan (H.O.).

Rationale: Patients with single ventricle physiology are at high risk of mortality resulting from ventricular dysfunction. The preliminary results of the phase 1 trial showed that cardiosphere-derived cells (CDCs) may be effective against congenital heart failure.

Objective: To determine whether intracoronary delivery of autologous CDCs improves cardiac function in patients with single ventricle physiology.

Methods And Results: We conducted a phase 2 randomized controlled study to assign in a 1:1 ratio 41 patients who had single ventricle physiology undergoing stage 2 or 3 palliation to receive intracoronary infusion of CDCs 4 to 9 weeks after surgery or staged reconstruction alone (study A). The primary outcome measure was to assess improvement in cardiac function at 3-month follow-up. Four months after palliation, controls had an alternative option to receive late CDC infusion on request (study B). Secondary outcomes included ventricular function, heart failure status, somatic growth, and health-related quality of life after a 12-month observation. At 3 months, the absolute changes in ventricular function were significantly greater in the CDC-treated group than in the controls (+6.4% [SD, 5.5] versus +1.3% [SD, 3.7]; =0.003). In study B, a late CDC infusion in 17 controls increased the ventricular function at 3 months compared with that at baseline (38.8% [SD, 7.7] versus 34.8% [SD, 7.4]; <0.0001). At 1 year, overall CDC infusion was associated with improved ventricular function (41.4% [SD, 6.6] versus 35.0% [SD, 8.2]; <0.0001) and volumes (<0.001), somatic growth (<0.0001) with increased trophic factors production, such as insulin-like growth factor-1 and hepatocyte growth factor, and quality of life, along with a reduced heart failure status (<0.0001) and cardiac fibrosis (=0.014) relative to baseline.

Conclusions: Intracoronary infusion of CDCs after staged palliation favorably affected cardiac function by reverse remodeling in patients with single ventricle physiology. This impact may improve heart failure status, somatic growth, and quality of life in patients and reduce parenting stress for their families.

Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01829750.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCRESAHA.116.310253DOI Listing
March 2017

Measurement of epicardial fat thickness by transthoracic echocardiography for predicting high-risk coronary artery plaques.

Heart Vessels 2016 Nov 1;31(11):1758-1766. Epub 2016 Feb 1.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.

Epicardial adipose tissue (EAT) volume is reported to be associated with coronary plaques. We evaluated whether non-invasive measurement of EAT thickness by echocardiography can predict high-risk coronary plaque characteristics determined independently by coronary computed tomography (CT) angiography. We enrolled 406 patients (mean age 63 years, 57 % male) referred for 64-slice CT. EAT was measured on the right ventricle free wall from a parasternal long-axis view at the end of systole. High-risk coronary plaques were defined as low-density plaques (<30 Hounsfield units) with positive remodeling (remodeling index >1.05). Patients were divided into thin or thick EAT groups using a cutoff value derived from receiver operator characteristic curve analysis for discriminating high-risk plaques. The receiver operator characteristic cutoff value was 5.8 mm with a sensitivity of 83 % and specificity of 64 % (area under the curve 0.77, 95 % confidence interval 0.70-0.83, p < 0.01). Compared with the thin EAT group, the thick EAT group had a high prevalence of low-density plaques (4 vs. 24 %, p < 0.01), positive remodeling (39 vs. 60 %, p < 0.01), and high-risk plaques (3 vs. 17 %, p < 0.01). Multiple logistic analysis revealed that thick EAT was a significant predictor of high-risk plaques (odds ratio 7.98, 95 % confidence interval 2.77-22.98, p < 0.01) after adjustment for covariates, including conventional risk factors, visceral adipose tissue area, and medications. The measurement of EAT thickness by echocardiography may provide a non-invasive option for predicting high-risk coronary plaques.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00380-016-0802-5DOI Listing
November 2016

Small bowel neoplasms: enhancement patterns and differentiation using post-contrast multiphasic multidetector CT.

Abdom Radiol (NY) 2017 03;42(3):794-801

Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Purpose: The purpose of the present study was to analyze the enhancement patterns of small bowel neoplasms on post-contrast multiphasic multidetector CT and to assess the diagnostic capacity for differentiating five tumor types.

Methods: We performed a retrospective study of data on 92 small bowel neoplasms. The neoplasms were categorized into five groups according to pathology findings, not imaging findings (23 adenocarcinomas; 22 lymphomas; 19 metastases; 18 gastrointestinal stromal tumors [GIST]; 10 neuroendocrine tumors [NET]).

Results: GIST and NET demonstrated a hypervascular pattern in the multiphasic dynamic study. Adenocarcinoma and lymphoma showed a delayed enhancement pattern. Metastasis was classified as an intermediate enhancement pattern. The receiver operating characteristic analyses revealed that attenuation thresholds could be set with acceptable accuracies for most of the small bowel neoplasms.

Conclusions: Multiphasic dynamic studies may have the potential to improve the diagnostic capacity of multidetector CT for small bowel neoplasms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00261-016-0945-yDOI Listing
March 2017

Thallium-201 Uptake of Giant Cell Tumor: One Step Toward the Differential Diagnosis to Atypically Presenting Osteosarcoma.

AJR Am J Roentgenol 2017 Jan 11;208(1):171-179. Epub 2016 Oct 11.

2 Department of Radiology, Okayama University Hospital, Okayama City, Okayama, Japan.

Objective: The radiologic differential diagnosis of giant cell tumors (GCTs) is challenging because there is a risk of misdiagnosis of GCTs as malignant lesions such as atypically presenting osteosarcomas (OSs). This study aims to assess the feasibility of Tl scintigraphy for the differential diagnosis of GCT and atypical OS.

Materials And Methods: Thallium-201 scintigraphy scans obtained between January 2006 and October 2015 of patients with histologically proven GCT (23 patients [male-to-female ratio, 15:8]; median age, 33.0 years; age range, 20-61 years) and patients with atypically presenting OS (20 patients [male-to-female ratio, 11:9]; median age, 30.0 years; age range, 12-69 years) were retrospectively reviewed. Morphologic classification of osseous lesions was performed on radiographs and CT scans. The Tl scintigraphy-based tumor-to-background contrast (TBC) and washout rate (WR) were calculated on early phase and delayed phase scans. The laboratory parameters lactate dehydrogenase (LDH), C-reactive protein (CRP), and alkaline phosphatase were obtained. Statistical significance was estimated using the Mann-Whitney U test. Cutoff values were calculated for early phase TBC and delayed phase TBC.

Results: Twenty-two of 23 GCTs were detected on the initial radiographs, whereas only six of 20 atypical OSs were detected on the initial radiographs. The early phase TBC was increased in GCT (median, 2.59; range, 0.51-12.26) compared with atypical OS (median, 1.68; range, 0.90-6.45) (p = 0.07). The delayed phase TBC was increased in GCT (median, 1.65; range, 0.22-5.26) compared with atypical OS (median, 0.96; range, 0.39-3.76) (p = 0.02). The median WR was not significantly decreased in GCT. The cutoff value for the early phase TBC was 3.90, and the cutoff value for the delayed phase TBC was 1.64; these cutoff values for early and delayed phase TBC yielded a sensitivity of 80.0% and a specificity of 47.8% and 52.2% respectively. Serum LDH (mean: atypical OS vs GCT, 215.5 vs 170.5 U/L, respectively; p = 0.01), alkaline phosphatase (median: 355.0 vs 252.0 U/L; p = 0.03), and CRP (median: 0.21 vs 0.09 mg/dL; p = 0.04) values were significantly increased in atypical OS compared with GCT.

Conclusion: The intense Tl uptake of GCT in combination with laboratory OS biomarkers facilitate the differential diagnosis of GCT and atypically presenting OS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2214/AJR.16.16359DOI Listing
January 2017

Positive affect and regional cerebral blood flow in Alzheimer's disease.

Psychiatry Res Neuroimaging 2016 Oct 13;256:15-20. Epub 2016 Sep 13.

Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.

Quality of life (QOL) has been recently recognized as the central purpose of healthcare, and positive affect is one of the core dimension of QOL. However, positive affect among patients with dementia or Alzheimer's disease (AD) has not received much attention in the medical research field. One hundred sixteen consecutive patients with AD were recruited from the outpatient units of the Memory Clinic of Okayama University Hospital. The positive affect score was evaluated using the positive affect domain of the Quality of Life questionnaire for Dementia (QOL-D). Patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. Positive affect scores were inversely related to apathy scores, subjective depressive scores, and delusion scores. After removing the effects of age, sex, duration of education, and cognitive function, positive affect scores showed a significant correlation with regional cerebral blood flow in the left premotor and superior frontal gyri. The left premotor and superior frontal area is significantly involved in the pathogenesis of the decrease of positive affect in AD. Apathy and depression are closely related to the prefrontal area in AD, and they may affect the relationship between positive affect and the left prefrontal area.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pscychresns.2016.09.003DOI Listing
October 2016

Coronary lesion characteristics with mismatch between fractional flow reserve derived from CT and invasive catheterization in clinical practice.

Heart Vessels 2017 Apr 13;32(4):390-398. Epub 2016 Sep 13.

Department of Cardiovascular Medicine, Okayama University Hospital, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.

High diagnostic performance of noninvasive fractional flow reserve computed from CT (FFR-CT) was recently reported in prospective multicenter trials. The aims of this study were to evaluate the diagnostic accuracy of FFR-CT in clinical practice and to examine the lesion characteristics showing a mismatch between FFR-CT and invasive FFR. A total of 20 patients (29 vessels) with suspected coronary artery disease were included. All patients underwent invasive coronary angiography and invasive FFR according to coronary artery CT angiography (CCTA) findings. The same raw data used for CCTA were used to evaluate FFR-CT. Results from FFR-CT were compared with invasively measured FFR. A positive ischemia was defined as FFR <0.80. Analyses from three vessels in two patients were not evaluated because of severe calcification or motion artifacts. The diagnostic accuracy, sensitivity, and specificity of FFR-CT per-vessel basis were 81, 100, and 69 %, respectively. To find the reason for mismatch in positive ischemia, lesion characteristics determined with CCTA were compared between the matched group and the mismatched group. A significant difference in bifurcation lesions with positive remodeling was observed between the matched group and the mismatched group (p < 0.01). The high sensitivity of FFR-CT may provide an additional support to the use of CCTA, although particular attention should be paid when using FFR-CT in bifurcation lesions with positive remodeling.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00380-016-0892-0DOI Listing
April 2017

A Case of Focal Bone Marrow Reconversion Mimicking Bone Metastasis: The Value of 111Indium Chloride.

Acta Med Okayama 2016 Aug;70(4):285-9

Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,

We present a case of a 66-year-old man with esophageal carcinoma. 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for evaluating distant metastasis and staging revealed 18F-FDG uptake in the third lumbar vertebra and other vertebrae. Magnetic resonance imaging could not differentiate bone metastases from benign bone lesions. We considered the possibility of bone marrow reconversion. 111Indium chloride (111In-Cl3) scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) revealed erythroid bone marrow components in the bone lesions. The diagnosis of bone marrow reconversion was pathologically confirmed by a bone biopsy of the third lumbar vertebra. The patient underwent esophagectomy and has remained disease-free in the 2 years since. To the best of our knowledge, this is the first report to describe the usefulness of 111In-Cl3 with SPECT/CT for the diagnosis of bone marrow reconversion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18926/AMO/54505DOI Listing
August 2016

Ankle muscle coactivation and its relationship with ankle joint kinematics and kinetics during gait in hemiplegic patients after stroke.

Somatosens Mot Res 2016 06 18;33(2):79-85. Epub 2016 May 18.

a Department of Physical Therapy , Kyoto University , Kyoto , Japan ;

Introduction: Increased ankle muscle coactivation during gait is a compensation strategy for enhancing postural stability in patients after stroke. However, no previous studies have demonstrated that increased ankle muscle coactivation influenced ankle joint movements during gait in patients after stroke.

Purpose: To investigate the relationship between ankle muscle coactivation and ankle joint movements in hemiplegic patients after stroke.

Methods: Seventeen patients after stroke participated. The coactivation index (CoI) at the ankle joint was calculated separately for the first and second double support (DS1 and DS2, respectively) and single support (SS) phases on the paretic and non-paretic sides during gait using surface electromyography. Simultaneously, three-dimensional motion analysis was performed to measure the peak values of the ankle joint angle, moment, and power in the sagittal plane. Ground reaction forces (GRFs) of the anterior and posterior components and centers of pressure (COPs) trajectory ranges and velocities were also measured.

Results: The CoI during the SS phase on the paretic side was negatively related to ankle dorsiflexion angle, ankle plantarflexion moment, ankle joint power generation, and COP velocity on the paretic side. Furthermore, the CoI during the DS2 phase on both sides was negatively related to anterior GRF amplitude on each side.

Conclusion: Increased ankle muscle coactivation is related to decreased ankle joint movement during the SS phase on the paretic side to enhance joint stiffness and compensate for stance limb instability, which may be useful for patients who have paretic instability during the stance phase after stroke.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08990220.2016.1178636DOI Listing
June 2016

Chronic interstitial pneumonia in young patients undergoing lung transplantation or autopsy: clinico-radiologic-pathologic observations from a single institution.

Jpn J Radiol 2016 Jul 11;34(7):515-22. Epub 2016 May 11.

Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Purpose: To retrospectively evaluate high-resolution computed tomography (HRCT) findings and clinical diagnoses of chronic interstitial pneumonia (IP) with a poor prognosis in young patients (≤50 years).

Materials And Methods: HRCT images of 8 men and 7 women (mean age 34.8 years) obtained before lung transplantation or autopsy were reviewed. After reviewing whole lung specimens and pathologic diagnoses, all patients were clinically diagnosed according to the 2010 idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP) consensus statement.

Results: HRCT images revealed intralobular reticular opacity, air cysts, ground glass opacity, traction bronchiectasis, and interlobular septal thickening. Intralobular reticular opacity was the most extensive finding. Abnormal findings existed predominantly in both the peripheral and lower lung zones in only 1 patient. Classifications of HRCT patterns were "UIP" (n = 2), "inconsistent with UIP" (n = 11), and "indeterminate UIP" (n = 2). Multidisciplinary diagnoses were "IPF/UIP" (n = 1), "possible IPF/UIP" (n = 1), "IP with connective tissue disease" (n = 7), "fibrotic nonspecific IP" (n = 1), and "unclassified IP" (n = 5).

Conclusion: The most extensive HRCT finding was intralobular reticular opacity. Most HRCT images differed from typical IPF/UIP, and IPF/UIP was uncommon in young patients with chronic IP with a poor prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11604-016-0551-5DOI Listing
July 2016

Exploratory analysis of textual data from the Mother and Child Handbook using the text-mining method: Relationships with maternal traits and post-partum depression.

J Obstet Gynaecol Res 2016 Jun 2;42(6):655-60. Epub 2016 Mar 2.

Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan.

Aim: The aim of the present study was to examine the possibility of screening apprehensive pregnant women and mothers at risk for post-partum depression from an analysis of the textual data in the Mother and Child Handbook by using the text-mining method.

Methods: Uncomplicated pregnant women (n = 58) were divided into two groups according to State-Trait Anxiety Inventory grade (high trait [group I, n = 21] and low trait [group II, n = 37]) or Edinburgh Postnatal Depression Scale score (high score [group III, n = 15] and low score [group IV, n = 43]). An exploratory analysis of the textual data from the Maternal and Child Handbook was conducted using the text-mining method with the Word Miner software program. A comparison of the 'structure elements' was made between the two groups.

Results: The number of structure elements extracted by separated words from text data was 20 004 and the number of structure elements with a threshold of 2 or more as an initial value was 1168. Fifteen key words related to maternal anxiety, and six key words related to post-partum depression were extracted.

Conclusion: The text-mining method is useful for the exploratory analysis of textual data obtained from pregnant woman, and this screening method has been suggested to be useful for apprehensive pregnant women and mothers at risk for post-partum depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jog.12971DOI Listing
June 2016

Diagnostic Performance of First-Pass Myocardial Perfusion Imaging without Stress with Computed Tomography (CT) Compared with Coronary CT Angiography Alone, with Fractional Flow Reserve as the Reference Standard.

PLoS One 2016 19;11(2):e0149170. Epub 2016 Feb 19.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Coronary computed tomography angiography (CCTA) in combination with first-pass CT myocardial perfusion imaging (MPI) has a better diagnostic performance than CCTA alone, compared with invasive coronary angiography as the reference standard. The aim of this study was to investigate the additional diagnostic value of first-pass CT-MPI without stress for detecting hemodynamic significance of coronary stenosis, compared with invasive fractional flow reserve (FFR). We recruited 53 patients with suspected coronary artery disease undergoing both CCTA and first-pass CT-MPI without stress and invasive FFR, and 75 vessels were analyzed. We used the same raw data for CCTA and CT-MPI. First-pass CT-MPI was reconstructed by examining the diastolic signal densities as a bull's eye map. Invasive FFR <0.8 was considered as positive. On per-vessel analysis, the area under the receiver operating characteristic curve for CCTA plus first-pass CT-MPI and CCTA alone was 0.81 (0.73-0.90) and 0.70 (0.61-0.81), respectively (P = 0.036). CCTA plus first-pass CT-MPI without stress showed 0.73 sensitivity, 0.74 specificity, 0.53 positive predictive value, and 0.87 negative predictive value for detecting hemodynamically significant coronary stenosis. First-pass CT-MPI without stress correctly reclassified 38% of CCTA false-positive vessels as true negative. First-pass CT-MPI without stress combined with CCTA demonstrated excellent diagnostic accuracy, compared with invasive FFR as the reference standard. This technique could complement CCTA for diagnosis of coronary artery disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149170PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764509PMC
July 2016

Criteria for radiologic diagnosis of hypochondroplasia in neonates.

Pediatr Radiol 2016 Apr 11;46(4):513-8. Epub 2016 Feb 11.

Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chu-Ou-Ku, Niigata, 951-8510, Japan.

Background: A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period.

Objective: To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia.

Materials And Methods: This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora.

Results: Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6.

Conclusion: Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00247-015-3518-2DOI Listing
April 2016

Image Quality of Coronary Computed Tomography Angiography with 320-Row Area Detector Computed Tomography in Children with Congenital Heart Disease.

Pediatr Cardiol 2016 Mar 12;37(3):497-503. Epub 2015 Nov 12.

Department of Radiology, Okayama University Medical School, 2-5-1 Kitaku Shikatacho, Okayama, 700-8558, Japan.

The objective of this study was to assess factors affecting image quality of 320-row computed tomography angiography (CTA) of coronary arteries in children with congenital heart disease (CHD). We retrospectively reviewed 28 children up to 3 years of age with CHD who underwent prospective electrocardiography (ECG)-gated 320-row CTA with iterative reconstruction. We assessed image quality of proximal coronary artery segments using a five-point scale. Age, body weight, average heart rate, and heart rate variability were recorded and compared between two groups: patients with good diagnostic image quality in all four coronary artery segments and patients with at least one coronary artery segment with nondiagnostic image quality. Altogether, 96 of 112 segments (85.7 %) had diagnostic-quality images. Patients with nondiagnostic segments were significantly younger (10.0 ± 11.6 months) and had lower body weight (5.9 ± 2.9 kg) (each p < 0.05) than patients with diagnostic image quality of all four segments (20.6 ± 13.8 months and 8.4 ± 2.5 kg, respectively; each p < 0.05). Differences in heart rate and heart rate variability between the two imaging groups were not significant. Receiver operating characteristic analyses for predicting patients with nondiagnostic image quality revealed an optimal body weight cutoff of ≤5.6 kg and an optimal age cutoff of ≤12.5 months. Prospective ECG-gated 320-row CTA with iterative reconstruction provided feasible image quality of coronary arteries in children with CHD. Younger age and lower body weight were factors that led to poorer image quality of coronary arteries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00246-015-1305-3DOI Listing
March 2016

Predicting pleural invasion using HRCT and 18F-FDG PET/CT in lung adenocarcinoma with pleural contact.

Ann Nucl Med 2015 Nov 5;29(9):757-65. Epub 2015 Jul 5.

Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 700-8558, Japan.

Objective: To evaluate the relevance of high-resolution computed tomography (HRCT) findings and fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake for risk stratification of visceral pleural invasion by lung adenocarcinoma.

Methods: The HRCT findings and (18)F-FDG uptake for lung adenocarcinomas with pleural contact on CT were retrospectively analyzed in 208 consecutive patients (94 females and 114 males; median age, 69.0 years) between January 2009 and December 2013, with institutional review board approval. The HRCT findings and maximum standardized uptake value (SUV max) were recorded for each patient. Multivariate logistic regression was used for statistical analysis, and subgroup analysis stratified for whole tumor size ≤ 3 cm was also performed.

Results: Multivariate analysis showed that SUV max [odds ratio (OR) 1.09, 95 % confidence interval (CI) 1.02-1.16, P = 0.014] and obtuse angle (OR 4.14, 95 % CI 1.97-8.74, P < 0.001) were significant independent predictors for visceral pleural invasion. Receiver operating characteristic (ROC) analysis showed that, compared with the multivariate models [area under the curve (Az) 0.819-0.829], SUV max alone (Az 0.815) was useful in predicting visceral pleural invasion. In the subgroup analysis, multivariate analysis showed that SUV max (OR 1.29, 95 % CI 1.12-1.50, P = 0.001) and contact length with the pleura (OR 1.13, 95 % CI 1.05-1.22, P = 0.001) were significant independent predictors for visceral pleural invasion. ROC analysis showed that SUV max alone (Az 0.844) showed similar diagnostic performance to the multivariate models (Az 0.845-0.857).

Conclusions: SUV max alone and multivariate models including SUV max are useful for the prediction of visceral pleural invasion by lung adenocarcinoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12149-015-0999-xDOI Listing
November 2015

Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT.

PLoS One 2015 30;10(6):e0131138. Epub 2015 Jun 30.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Background: Nonalcoholic fatty liver disease is associated with a risk of coronary artery disease (e.g., diabetes mellitus, dyslipidemia, metabolic syndrome). We evaluated whether nonalcoholic hepatic steatosis is associated with high-risk plaques as assessed by multidetector computed tomography (CT).

Methods: This retrospective study involved 414 participants suspected of having coronary artery disease. Nonalcoholic hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 and the presence and appropriate characteristics of coronary-artery plaques as assessed by coronary CT angiography. High-risk plaques were identified, as were low-density plaques, positive remodeling, and spotty calcification.

Results: Compared with patients who did not have nonalcoholic hepatic steatosis, patients with nonalcoholic hepatic steatosis had more low-density plaques (21% vs. 44%, p<0.01), positive remodeling (41% vs. 58%, p = 0.01), and spotty calcification (12% vs. 36%, p<0.01). The number of high-risk plaques in patients with nonalcoholic hepatic steatosis was greater than in those without nonalcoholic hepatic steatosis (p<0.01). Patients with nonalcoholic hepatic steatosis were more likely to have high-risk plaques than were those with only an elevated level of visceral adipose tissue (≥86 cm2; 35% vs. 16%, p<0.01). Multivariate analyses that included nonalcoholic hepatic steatosis, amount of visceral adipose tissue, and the presence/absence of traditional risk factors demonstrated that nonalcoholic hepatic steatosis was an independent predictor of high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94-9.07, p<0.01).

Conclusions: Diagnosis of nonalcoholic hepatic steatosis may be of value when assessing the risk of coronary artery disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0131138PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488355PMC
April 2016

Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT.

J Cardiovasc Comput Tomogr 2015 Jul-Aug;9(4):354-61. Epub 2015 May 1.

Department of Radiology, Okayama University Hospital, Okayama, Japan.

Background: Cardiac CT is an excellent tool for evaluating the anatomy of a secundum atrial septal defect (ASD). However, a comprehensive assessment of its usefulness, including measurement of the pulmonary to systemic blood flow ratio in secundum ASD patients, has not been performed.

Objective: Therefore, this study was designed to evaluate the usefulness of CT for assessing the hemodynamics of secundum ASD in adults compared with transesophageal echocardiography (TEE), transthoracic echocardiography, and invasive catheterization.

Methods: Fifty adult patients with secundum ASD were enrolled. Cardiac CT scans (128-slice multidetector CT instrument) were acquired. These were followed by 2-dimensional reconstruction of the secundum ASDs to determine the defect size, the rim length between the outer edge of the defect, and the pulmonary to systemic blood flow (Qp/Qs) ratio.

Results: The maximum sizes of the secundum ASDs derived from CT and TEE studies were comparable (21.2 ± 8.0 vs. 20.0 ± 7.3 mm; P = .41; r = 0.960; P < .001). The rim lengths for the aortic, mitral, and tricuspid valves; the inferior vena cava; and posterior atrium were also comparable between CT and TEE measurements. The mean Qp/Qs ratio that was derived from CT measurements was comparable with that found by invasive catheterization (2.3 ± 0.7 vs. 2.3 ± 0.8; P = .73; r = 0.786; P < .001).

Conclusion: Cardiac CT is feasible for assessing pathology and the severity of secundum ASD in adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcct.2015.04.007DOI Listing
March 2016

Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions.

Ann Nucl Med 2015 Oct 3;29(8):674-81. Epub 2015 Jun 3.

Department of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, Okayama, 700-8558, Japan.

Objective: This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions.

Methods: Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann-Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions.

Results: There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging.

Conclusions: 201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12149-015-0990-6DOI Listing
October 2015

Both a visual and a semiquantitative analysis for differentiating benign from malignant chondrogenic bone tumors using Tc-99m (V) DMSA scintigraphy: a prospective study.

Nucl Med Commun 2015 Aug;36(8):802-7

Departments of aRadiology bPathology, Okayama University Hospital Departments of cMedical Materials for Musculoskeletal Reconstruction dOrthopaedic Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.

Objective: The aims of this prospective study were to assess the relationship between tumor aggressiveness and Tc-99m (V) dimercaptosuccinic acid (DMSA) uptake in chondrogenic bone tumors and the value of Tc-99m (V) DMSA scintigraphy for differentiating benign from malignant tumors.

Methods: Twenty-four patients with chondrogenic tumors (19 benign and five malignant) underwent Tc-99m DMSA (V) scintigraphy. Radiopharmaceutical uptake was classified using a three-point scale to allow a visual-only analysis, and a tumor-to-background contrast (TBC) was computed using regions of interest to provide a semiquantitative analysis. Spearman's correlation coefficient was used to assess the correlation between tumor aggressiveness and TBC. The difference in TBC between benign and malignant tumors was analyzed with the Mann-Whitney U-test. An appropriate cutoff value of TBC was chosen for the diagnosis of malignancy of a tumor using receiver operating characteristic analysis.

Results: Six benign tumors showed negative uptake (uptake score 0), whereas 13 benign tumors showed positive uptake (n=10 uptake score 1; n=3 uptake score 2). All chondrosarcomas showed positive uptake (n=2 uptake score 1; n=3 uptake score 2). A significant correlation was found between tumor aggressiveness and TBC. A significant difference was seen in TBC between benign and malignant tumors. With the chosen cutoff value of TBC equal to 0.611, the sensitivity was 80.0%, specificity was 78.9%, the positive predictive value was 50.0%, and the negative predictive value was 93.8%.

Conclusion: Tc-99m (V) DMSA scintigraphy may have the potential to improve diagnostic methods for detecting chondrosarcomas using visual and/or semiquantitative analyses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MNM.0000000000000328DOI Listing
August 2015

Association between coronary artery calcification and left ventricular diastolic dysfunction in elderly people.

Heart Vessels 2016 Apr 12;31(4):499-507. Epub 2015 Feb 12.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.

Coronary artery calcification (CAC) is associated with the incidence of congestive heart failure. We evaluated the association between CAC and left ventricular diastolic dysfunction (LVDD) in elderly patients without coronary artery disease. Coronary computed tomography was performed in 1,021 consecutive patients >55 years of age who were suspected of having coronary artery disease. A total of 530 patients (age, 70 ± 8 years; 56 % men) with a LV ejection fraction >50 % and without obstructive coronary artery disease and a history of coronary artery disease were included in the analysis. LVDD was defined according to a standard algorithm by echocardiography (septal e' <8, lateral e' <10, and left atrial volume index ≥34 mL/m(2)). A total of 224 of 530 patients had LVDD. CAC scores in patients with LVDD were higher than those in patients without LVDD (p < 0.01). The prevalence of LVDD in patients with CAC scores ≥400 was greater than that in patients with CAC scores of 0-9 (58 vs. 34 %, p < 0.01). After adjustment for confounding factors, the CAC score was associated with LVDD, with an odds ratio of 1.96 (95 % confidence interval: 1.11-3.43, p = 0.02) for a CAC score ≥400 compared with a CAC score of 0-9. A CAC score ≥400 was associated with LVDD in elderly patients without CAD in this population. Further prospective studies are needed to evaluate the clinical relevance of CAC as a risk of heart failure with preserved ejection fraction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00380-015-0645-5DOI Listing
April 2016

Left frontal lobe hypoperfusion and depressive symptoms in Alzheimer's disease patients taking cholinesterase inhibitors.

Psychiatry Res 2014 Dec 19;224(3):319-23. Epub 2014 Oct 19.

Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.

Depressive symptoms are common in patients with Alzheimer's disease (AD) and increase the caregiver burden. Many studies have reported dorsolateral prefrontal hypometabolism or hypoperfusion in AD patients with depressive symptoms, most of whom did not take acetylcholinesterase inhibitors (AChEI). It is not clear, however, whether a similar condition is present in patients taking AChEI medication. Fifty-seven consecutive AD patients taking AChEI were recruited at a memory clinic. Objective depressive symptoms were evaluated using the depression domain of the Neuropsychiatric Inventory (NPI-dep). All patients underwent brain single photon emission computed tomography (SPECT) with (99m)Tc-ethylcysteinate dimer, and the SPECT images were analyzed using the Statistical Parametric Mapping 8 program. No significant differences between groups with positive and negative NPI-dep scores were found with respect to age, sex, years of education, and cognitive function. Compared with patients with negative NPI-dep scores, patients with NPI-dep scores ≥1 showed significant hypoperfusion in the left middle frontal region. Our results indicate that the dorsolateral prefrontal area is significantly involved in the pathogenesis of depressive symptoms in AD patients being treated with AChEI. The area on the left side especially may be closely related to the depressive symptoms evaluated using the NPI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pscychresns.2014.10.008DOI Listing
December 2014

Intracoronary autologous cardiac progenitor cell transfer in patients with hypoplastic left heart syndrome: the TICAP prospective phase 1 controlled trial.

Circ Res 2015 Feb 17;116(4):653-64. Epub 2014 Nov 17.

From the Departments of Cardiovascular Surgery (S.I., S.T., D.O., M.O., J.K., S.A., T.K., K.Y., A.T., Y.K., S.K., S.S.), Pediatrics (S.O., T.E., M.K., K.B.), Anesthesiology and Resuscitology (T.I.), and Radiology (S.S.), Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan; and Department of Regenerative Medicine, Center for Innovative Clinical Medicine, Okayama University Hospital (H.O.), Okayama, Japan.

Rationale: Hypoplastic left heart syndrome (HLHS) remains a lethal congenital cardiac defect. Recent studies have suggested that intracoronary administration of autologous cardiosphere-derived cells (CDCs) may improve ventricular function.

Objective: The aim of this study was to test whether intracoronary delivery of CDCs is feasible and safe in patients with hypoplastic left heart syndrome.

Methods And Results: Between January 5, 2011, and January 16, 2012, 14 patients (1.8±1.5 years) were prospectively assigned to receive intracoronary infusion of autologous CDCs 33.4±8.1 days after staged procedures (n=7), followed by 7 controls with standard palliation alone. The primary end point was to assess the safety, and the secondary end point included the preliminary efficacy to verify the right ventricular ejection fraction improvements between baseline and 3 months. Manufacturing and intracoronary delivery of CDCs were feasible, and no serious adverse events were reported within the 18-month follow-up. Patients treated with CDCs showed right ventricular ejection fraction improvement from baseline to 3-month follow-up (46.9%±4.6% to 52.1%±2.4%; P=0.008). Compared with controls at 18 months, cardiac MRI analysis of CDC-treated patients showed a higher right ventricular ejection fraction (31.5%±6.8% versus 40.4%±7.6%; P=0.049), improved somatic growth (P=0.0005), reduced heart failure status (P=0.003), and lower incidence of coil occlusion for collaterals (P=0.007).

Conclusions: Intracoronary infusion of autologous CDCs seems to be feasible and safe in children with hypoplastic left heart syndrome after staged surgery. Large phase 2 trials are warranted to examine the potential effects of cardiac function improvements and the long-term benefits of clinical outcomes.

Clinical Trial Registration Url: http://www.clinicaltrials.gov. Unique identifier: NCT01273857.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCRESAHA.116.304671DOI Listing
February 2015
-->