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Fujimoto K, Shiinoki T, Kawazoe Y, Yuasa Y, Mukaidani W, Manabe Y, Kajima M, Tanaka H. Biomechanical imaging biomarker during chemoradiotherapy predicts treatment response in head and neck squamous cell carcinoma. Phys Med Biol 2024; 69:055033. [PMID: 38359451 DOI: 10.1088/1361-6560/ad29b9] [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: 06/23/2023] [Accepted: 02/15/2024] [Indexed: 02/17/2024]
Abstract
Objective. For response-adapted adaptive radiotherapy (R-ART), promising biomarkers are needed to predict post-radiotherapy (post-RT) responses using routine clinical information obtained during RT. In this study, a patient-specific biomechanical model (BM) of the head and neck squamous cell carcinoma (HNSCC) was proposed using the pre-RT maximum standardized uptake value (SUVmax) of18F-fluorodeoxyglucose (FDG) and tumor structural changes during RT as evaluated using computed tomography (CT). In addition, we evaluated the predictive performance of BM-driven imaging biomarkers for the treatment response of patients with HNSCC who underwent concurrent chemoradiotherapy (CCRT).Approach. Patients with histologically confirmed HNSCC treated with definitive CCRT were enrolled in this study. All patients underwent CT two times as follows: before the start of RT (pre-RT) and 3 weeks after the start of RT (mid-RT). Among these patients, 67 patients who underwent positron emission tomography/CT during the pre-RT period were included in the final analysis. The locoregional control (LC), progression-free survival (PFS), and overall survival (OS) prediction performances of whole tumor stress change (TS) between pre- and mid-RT computed using BM were assessed using univariate, multivariate, and Kaplan-Meier survival curve analyses, respectively. Furthermore, performance was compared with the pre and post-RT SUVmax, tumor volume reduction rate (TVRR) during RT, and other clinical prognostic factors.Main results. For both univariate, multivariate, and survival curve analyses, the significant prognostic factors were as follows (p< 0.05): TS and TVRR for LC; TS and pre-RT FDG-SUVmaxfor PFS; and TS only for OS. In addition, for 2 year LC, PFS, and OS prediction, TS showed a comparable predictive performance to post-RT FDG-SUVmax.Significance. BM-driven TS is an effective prognostic factor for tumor treatment response after CCRT. The proposed method can be a feasible functional imaging biomarker that can be acquired during RT using only routine clinical data and may provide useful information for decision-making during R-ART.
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Affiliation(s)
- Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yusuke Kawazoe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Yuki Yuasa
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Wataru Mukaidani
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Yuki Manabe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
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Fujimoto K, Ueno M, Etoh S, Shimodozono M. Combined repetitive facilitative exercise under continuous neuromuscular electrical stimulation and task-oriented training for hemiplegic upper extremity during convalescent phase after stroke: before-and-after feasibility trial. Front Neurol 2024; 15:1356732. [PMID: 38456153 PMCID: PMC10919145 DOI: 10.3389/fneur.2024.1356732] [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] [Received: 12/16/2023] [Accepted: 01/30/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Whereas repetitive facilitative exercise (RFE) affects primarily recovery of motor impairment after stroke, task-oriented training (TOT) focuses on facilitating daily use of the affected upper extremity. However, feasibility of combined RFE and TOT has not been reported. We originated "task-oriented RFE," as a new combination therapy for patients with hemiplegic upper extremity after subacute stroke, to examine its feasibility in convalescent rehabilitation wards. Methods This is a before-and-after pilot study. Eight patients with hemiplegic upper extremity after subacute stroke received the task-oriented RFE program for 6 weeks at 80 min per day (20-60 min of TOT applied after 60-20 min of RFE under continuous neuromuscular electrical stimulation) in a convalescent rehabilitation ward. In the current program, we introduced the Aid for Decision-making in Occupation Choice (ADOC) iPad application as a goal-setting method for determining tasks. Feasibility was assessed with adherence to the protocol, adverse events in response to the intervention, and preliminary efficacy. Motor functions, amount of use and quality of movement in the hemiparetic upper extremity, and satisfaction of the patients were evaluated with Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the motor activity log (MAL) for the amount of use (AOU) and quality of movement (QOM) of the paralyzed hand, and ADOC. Results All participants accomplished the program, which was implemented as originally planned; neither nonattendance nor an adverse event occurred during the study. Favorable outcomes were obtained with all measures; mean changes in FMA, ARAT in the dominant hand, MAL-AOU, and MAL-QOM were greater than minimal clinically important differences. Mean changes in ADOC were greater than the minimal detectable change. Discussion The task-oriented RFE program was safe, well-tolerated, beneficial, and feasible within 80 min a day of occupational therapy, which means also within the procedural constraints of the Japanese health insurance system during the convalescent phase. Future studies are warranted to examine whether combined RFE and TOT enhances the efficacies of each program alone.
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Affiliation(s)
- Koya Fujimoto
- Department of Rehabilitation, Kirishima Sugiyasu Hospital, Kirishima, Kagoshima, Japan
| | - Makoto Ueno
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Seiji Etoh
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Megumi Shimodozono
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Tanaka H, Ono T, Ueda K, Karita M, Manabe Y, Kajima M, Sera T, Fujimoto K, Yuasa Y, Shiinoki T. Deep inspiration breath hold real-time tumor-tracking radiation therapy (DBRT) as a novel stereotactic body radiation therapy approach for lung tumors. Sci Rep 2024; 14:2400. [PMID: 38287139 PMCID: PMC10825222 DOI: 10.1038/s41598-024-53020-4] [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: 06/26/2023] [Accepted: 01/25/2024] [Indexed: 01/31/2024] Open
Abstract
Radiotherapy with deep inspiration breath hold (DIBH) reduces doses to the lungs and organs at risk. The stability of breath holding and reproducibility of tumor location are higher during expiration than during inspiration; therefore, we developed an irradiation method combining DIBH and real-time tumor-tracking radiotherapy (RTRT) (DBRT). Nine patients were enrolled in this study. Fiducial markers were placed near tumors using bronchoscopy. Treatment planning computed tomography (CT) was performed thrice during DIBH, assisted by spirometer-based device. Each CT scan was fused using fiducial markers. Gross tumor volume (GTV) was contoured for each dataset and summed to create GTVsum; adding a 5-mm margin around GTVsum generated the planning target volume. The prescribed dose was mainly 42 Gy in four fractions. The treatment plan was created using DIBH CT (DBRT-plan), with a similar treatment plan created for expiratory CT for cases for which DBRT could not be performed (conv-plan). Vx defined as the volume of the lung received x Gy, and the mean lung dose, V20, V10, and V5 were evaluated. DBRT was completed in all patients. Mean dose, V20, and V10 were significantly lower in the DBRT-plan than in the conv-plan (all p = 0.003). Mean rates of decrease for mean dose, V20, and V10 were 14.0%, 27.6%, and 19.1%, respectively. No significant difference was observed in V5. We developed DBRT, a stereotactic body radiation therapy performed with the DIBH technique; it combines a spirometer-based breath-hold support system with an RTRT system. All patients who underwent DBRT completed the procedure without any technical or mechanical complications. This is a promising methodology that may significantly reduce lung doses.
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Affiliation(s)
- Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan.
| | - Taiki Ono
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Kazushi Ueda
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Masako Karita
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Yuki Manabe
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Tatsuhiro Sera
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan
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Manabe Y, Shiinoki T, Fujimoto K, Ueda K, Karita M, Ono T, Kajima M, Tanaka H. Intra- and inter-fractional variations of tumors with fiducial markers measured using respiratory-correlated computed tomography images for respiratory gated lung stereotactic body radiation therapy. J Appl Clin Med Phys 2024:e14280. [PMID: 38252745 DOI: 10.1002/acm2.14280] [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: 10/22/2023] [Revised: 10/22/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE This study evaluated the intra- and inter-fractional variation of tumors with fiducial markers (FMs), relative to the tumor-FM distance, to establish how close an FM should be inserted for respiratory-gated stereotactic body radiation therapy (RG-SBRT). METHODS Forty-five lung tumors treated with RG-SBRT were enrolled. End-expiratory computed tomography (CT) (CTplan ) and four-dimensional-CT (4D-CT) scans were obtained for planning. End-expiratory CT (CTfr ) scanning was performed before each fraction. The FMs were divided into two groups based on the median tumor-FM distance in the CTplan (Dp ). For the intra-fractional variation, the correlations between the corresponding tumor and FM intra-fractional motions, defined as the centroid coordinates of those in each 0-90% phase, with the 50% phase of 4D-CT as the origin, were calculated in the left-right, anterior-posterior, and superior-inferior directions. Furthermore, the maximum difference in the tumor-FM distance in each phase of 4D-CT scan, based on those in the 50% phase of 4D-CT scan (Dmax ), was obtained. Inter-fractional variation was defined as the maximum distance between the tumors in CTplan and CTfr , when the CT scans were fused based on each FM or vertebra. RESULTS The median Dp was 26.1 mm. While FM intra-fractional motions were significantly and strongly correlated with the tumor intra-fractional motions in only anterior-posterior and superior-inferior directions for the Dp > 26 mm group, they were significantly and strongly correlated in all directions for the Dp ≤ 26 mm group. In all directions, Dmax values of the Dp ≤ 26 mm group were lower than those of the Dp > 26 mm group. The inter-fractional variations based on the Dp ≤ 26 mm were smaller than those on the Dp > 26 mm and on the vertebra in all directions. CONCLUSIONS Regarding intra- and inter-fractional variation, FMs for Dp ≤ 26 mm can increase the accuracy for RG-SBRT.
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Affiliation(s)
- Yuki Manabe
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Kazushi Ueda
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Masako Karita
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Taiki Ono
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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Tanaka H, Karita M, Ueda K, Ono T, Kajima M, Manabe Y, Fujimoto K, Yuasa Y, Shiinoki T. Differences in Radiosensitivity According to EGFR Mutation Status in Non-Small Cell Lung Cancer: A Clinical and In Vitro Study. J Pers Med 2023; 14:25. [PMID: 38248726 PMCID: PMC10820530 DOI: 10.3390/jpm14010025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/16/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Unlike drug selection, radiation parameters (field, dose) are not based on driver gene mutations in patients with metastatic non-small cell lung cancer (NSCLC). This study aimed to compare radiosensitivity in NSCLC with and without EGFR driver gene mutations using clinical and in vitro data. The clinical study included 42 patients who underwent whole-brain radiotherapy for brain metastases from NSCLC; of these, 13 patients had EGFR mutation-positive tumors. The Kaplan-Meier method was used to calculate the cranial control rate without intracranial recurrence. In the in vitro study, colony formation and double-strand DNA breaks were examined in two EGFR mutation-negative and three EGFR mutation-positive NSCLC-derived cell lines. Colony formation was assessed 14 days after irradiation with 0 (control), 2, 4, or 8 Gy. DNA double-strand breaks were evaluated 0.5 and 24 h after irradiation. EGFR mutation-positive patients had a significantly better cranial control rates than EGFR mutation-negative patients (p = 0.021). EGFR mutation-positive cells formed significantly fewer colonies after irradiation with 2 or 4 Gy than EGFR mutation-negative cells (p = 0.002, respectively) and had significantly more DNA double-strand breaks at 24 h after irradiation (p < 0.001). Both clinical and in vitro data suggest that EGFR mutation-positive NSCLC is radiosensitive.
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Affiliation(s)
- Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube 755-8505, Yamagcuhi, Japan (K.F.); (T.S.)
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Yuasa Y, Shiinoki T, Fujimoto K, Tanaka H. Pseudo dual-energy CT-derived iodine mapping using single-energy CT data based on a convolution neural network. BJR Open 2023; 5:20220059. [PMID: 37942496 PMCID: PMC10630979 DOI: 10.1259/bjro.20220059] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/12/2023] [Accepted: 08/02/2023] [Indexed: 11/10/2023] Open
Abstract
Objective The objectives of this study are: (1) to develop a convolutional neural network model that yields pseudo high-energy CT (CTpseudo_high) from simple image processed low-energy CT (CTlow) images, and (2) to create a pseudo iodine map (IMpseudo) and pseudo virtual non-contrast (VNCpseudo) images for thoracic and abdominal regions. Methods Eighty patients who underwent dual-energy CT (DECT) examinations were enrolled. The data obtained from 55, 5, and 20 patients were used for training, validation, and testing, respectively. The ResUnet model was used for image generation model and was trained using CTlow and high-energy CT (CThigh) images. The proposed model performance was evaluated by calculating the CT values, image noise, mean absolute errors (MAEs), and histogram intersections (HIs). Results The mean difference in the CT values between CTpseudo_high and CThigh images were less than 6 Hounsfield unit (HU) for all evaluating patients. The image noise of CTpseudo_high was significantly lower than that of CThigh. The mean MAEs was less than 15 HU, and HIs were almost 1.000 for all the patients. The evaluation metrics of IM and VNC exhibited the same tendency as that of the comparison between CTpseudo_high and CThigh images. Conclusions Our results indicated that the proposed model enables to obtain the DECT images and material-specific images from only single-energy CT images. Advances in knowledges We constructed the CNN-based model which can generate pseudo DECT image and DECT-derived material-specific image using only simple image-processed CTlow images for the thoracic and abdominal regions.
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Affiliation(s)
- Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
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Tanaka H, Karita M, Ueda K, Ono T, Manabe Y, Kajima M, Fujimoto K, Yuasa Y, Shiinoki T. Difference in Radiosensitivity Depending on the Presence and Absence of EGFR Mutations: Clinical and In Vitro Analyses. Int J Radiat Oncol Biol Phys 2023; 117:e63. [PMID: 37785880 DOI: 10.1016/j.ijrobp.2023.06.785] [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) For stage IV non-small cell lung cancer (NSCLC), the treatment drug is selected based on the gene mutation status. However, the dose or field of radiation therapy is not change based on the genetic status. We evaluated both clinical and in vitro data, showing that the presence or absence of epidermal growth factor receptor (EGFR) mutations affects radiosensitivity in patients with brain metastases (BM) from NSCLC. MATERIALS/METHODS Patients with BM from NSCLC who received whole brain radiotherapy (WBRT) were enrolled in this study. Patient characteristics are shown in the Table. EGFR mutations were observed in 13 (31.0%) patients. The prescribed dose was 30 Gy in 10 fractions (85.7%). The A549, VMRC-LCD, NCI-H1975, and HCC4006 cell lines were used for the in vitro study. EGFR mutation was negative in A549 and VMRC-LCD and positive in NCI-H1975 (exon21) and HCC4006 (exon19). After irradiation of these cell lines with 0, 2, 4, and 8 Gy, a colony formation assay was performed. DNA double-strand breaks (DSBs) were assessed 30 min and 24 h after 4 Gy irradiation using γH2AX. RESULTS The median follow-up period was 4 months (range, 1-35). Intracranial recurrence was observed in 14 (33.3%) patients during the follow-up period. Thirty-nine (92.9%) patients died during the follow-up period. Patients with EGFR mutation-positive tumors had significantly better intracranial control rates than those with EGFR mutation-negative tumors (p = 0.0213). A similar tendency was observed in the analysis conducted, except for the cases in which tyrosine kinase inhibitor (TKI) was administered after WBRT. In the EGFR mutation-positive group, no significant difference was observed between patients who received TKI after WBRT and those who did not (p = 0.527). In the colony formation assay, EGFR mutation-positive cell lines showed a significantly lower number of colonies formed after irradiation with 2 and 4 Gy than mutation-negative cell lines (p = 0.00018 and 0.0000291, respectively). EGFR mutation-positive cell lines had significantly more DNA-DSBs remaining 24 h after irradiation than mutation-negative cell lines (p = 0.0000000312). CONCLUSION Our data suggest that patients with EGFR mutation-positive NSCLC are more radiosensitive than those with negative EGFR mutations.
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Affiliation(s)
- H Tanaka
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - M Karita
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - K Ueda
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - T Ono
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - Y Manabe
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - M Kajima
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - K Fujimoto
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - Y Yuasa
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - T Shiinoki
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
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Tanaka H, Ueda K, Karita M, Ono T, Kajima M, Manabe Y, Sera T, Fujimoto K, Yuasa Y, Shiinoki T. Deep-Inspiration Breath-Hold Stereotactic Body Radiation Therapy by Combining Spirometer-Guided Breath-Hold and a Real-Time Tumor Tracking System: A Novel Approach. Int J Radiat Oncol Biol Phys 2023; 117:e63-e64. [PMID: 37785881 DOI: 10.1016/j.ijrobp.2023.06.786] [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) There are several methods used against respiratory motion (RM). Expiratory breath-hold (BH) is considered more stable and reproducible than inspiratory BH; therefore, BH with spirometry is often used for expiration. The real-time tumor tracking radiotherapy (RTRT) system is a highly effective method for reducing the margin of RM. This system ambushes and irradiates tumors during the expiratory phase when tumors move slowly. Although these methods usually involve expiration, it is advantageous to expand the lungs with inspiration to reduce the risk of adverse events. Here, we developed a new approach of performing stereotactic body radiation therapy (SBRT) under deep-inspiration BH (DIBH) by combining these two methods. MATERIALS/METHODS Lung tumors with respiratory motion ≥ 1 cm were included. Three or four fiducial markers were placed near the tumor via bronchoscopy. DIBH CT (CT-IN) was performed under the guidance of spirometer. The PTV was obtained by adding a 5-mm margin to the GTV delineated on CT-IN. The prescribed dose was 42 Gy in four fractions for the D95 of the PTV. An error of 2.0 mm around the planned position of the fiducial marker on CT-IN was permitted along each orthogonal axis as a gating box. In preparation for cases in which the reproducibility of DIBH is low and treatment cannot be performed, light expiration BH CT (CT-EX) was also performed, and a radiotherapy plan was prepared for the conventional RTRT system so that it could be switched at any time. Lung volumes and doses (mean dose, V20 Gy, V10 Gy, and V5 Gy) on CT-EX and CT-IN were compared. RESULTS Five patients underwent SBRT with DIBH, and all completed the planned irradiation course. The median treatment time per fraction was 27.86 min (range, 25.5-40.6). Four tumors were located in the left lower lobe and one in the right lower lobe. The median volume of PTV was 12.4 (range, 5.2-26.2) mL. The lung volumes and doses on CT-EX and CT-IN are shown in the Table. The lung volume on CT-IN was 1.6 times larger than that on CT-EX. The PTV-to-lung ratio on CT-IN was significantly lower than that on CT-EX. V20 Gy and V10 Gy on CT-IN were significantly lower than those on CT-EX. CONCLUSION SBRT with DIBH was achieved by combining the spirometer and RTRT system. This can help to eliminate concerns about reproducibility and high-speed tumor movement during inspiration, which are weaknesses of spirometer-guided breath-hold and the RTRT system, respectively, while ensuring the accuracy of the RTRT system. DIBH SBRT is a promising method that can reduce lung dose.
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Affiliation(s)
- H Tanaka
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - K Ueda
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - M Karita
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - T Ono
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - M Kajima
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - Y Manabe
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - T Sera
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - K Fujimoto
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - Y Yuasa
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
| | - T Shiinoki
- Yamaguchi University Graduate School of Medicine, Department of Radiation Oncology, Ube, Japan
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Shiinoki T, Fujimoto K, Kawazoe Y, Yuasa Y, Kajima M, Manabe Y, Hirano T, Matsunaga K, Tanaka H. Assessing four-dimensional CT stress maps derived from patient-specific biomechanical models of the lung with pulmonary function test data in lung cancer patients. Br J Radiol 2023; 96:20221149. [PMID: 37393529 PMCID: PMC10461275 DOI: 10.1259/bjr.20221149] [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] [Received: 12/07/2022] [Revised: 05/23/2023] [Accepted: 06/12/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVE This study aims to retrospectively compare the stress map of the lung with pulmonary function test (PFT) results in lung cancer patients and to evaluate the potential of the stress map as an imaging biomarker for chronic obstructive pulmonary disease (COPD). METHODS 25 lung cancer patients with pre-treatment four-dimensional CT (4DCT) and PFT data were retrospectively analysed. PFT metrics were used to diagnose obstructive lung disease. For each patient, forced expiratory volume in 1 s (FEV1 % predicted) and the ratio of FEV1 and forced vital capacity (FEV1/FVC) were recorded. 4DCT and biomechanical model-deformable image registration (BM-DIR) were used to obtain the lung stress map. The relationship between the mean of the total lung stress and PFT data was evaluated, and the COPD classification grade was also evaluated. RESULTS The mean values of the total lung stress and FEV1 % predicted showed a significant strong correlation [R = 0.833, (p < 0.001)]. The mean values and FEV1/FVC showed a significant strong correlation [R = 0.805, (p < 0.001)]. For the total lung stress, the area under the curve and the optimal cut-off value were 0.94 and 510.8 Pa for the classification of normal or abnormal lung function, respectively. CONCLUSION This study has demonstrated the potential of lung stress maps based on BM-DIR to accurately assess lung function by comparing them with PFT data. ADVANCES IN KNOWLEDGE The derivation of stress map directly from 4DCT is novel method. The BM-DIR-based lung stress map can provide an accurate assessment of lung function.
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Affiliation(s)
- Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yusuke Kawazoe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yuki Manabe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
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Tanaka H, Ueda K, Karita M, Ono T, Manabe Y, Kajima M, Fujimoto K, Yuasa Y, Shiinoki T. Immune Checkpoint Inhibitors after Radiation Therapy Improve Overall Survival Rates in Patients with Stage IV Lung Cancer. Cancers (Basel) 2023; 15:4260. [PMID: 37686535 PMCID: PMC10486712 DOI: 10.3390/cancers15174260] [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: 07/22/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
This exploratory and retrospective study aimed to evaluate whether there is a difference in the overall survival (OS) rates of patients with stage IV lung cancer who underwent radiation therapy (RT) depending on the presence or absence of immune checkpoint inhibitors (ICIs) and the timing of their use. Eighty patients with histologically confirmed stage IV lung cancer were enrolled, and ICIs were administered to thirty (37.5%). ICIs were administered before RT and after RT in 11 and 20 patients, respectively. The median follow-up period was 6 (range: 1-37) months. Patients treated with ICIs had significantly better OS rates than those not treated with ICIs (p < 0.001). The 6-month OS rates in patients treated with and without ICIs were 76.3% and 34.5%, respectively. The group that received ICI therapy after RT had a significantly better OS rate than the group that received ICI therapy prior to RT (6-month OS: 94.7% vs. 40.0%, p < 0.001). In the multivariate analysis, performance status (0-1 vs. 2-4) and ICI use after RT were significant factors for OS (p = 0.032 and p < 0.001, respectively). Our results suggest that ICI administration after RT may prolong the OS of patients with stage IV lung cancer.
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Affiliation(s)
- Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube 755-8505, Yamaguchi, Japan
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11
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Kawazoe Y, Shiinoki T, Fujimoto K, Yuasa Y, Hirano T, Matsunaga K, Tanaka H. Investigation of the combination of intratumoral and peritumoral radiomic signatures for predicting epidermal growth factor receptor mutation in lung adenocarcinoma. J Appl Clin Med Phys 2023:e13980. [DOI: 10.1002/acm2.13980] [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] [Received: 01/19/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Affiliation(s)
- Yusuke Kawazoe
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Japan
| | - Koya Fujimoto
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Japan
| | - Yuki Yuasa
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease Graduate School of Medicine Yamaguchi University Ube Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease Graduate School of Medicine Yamaguchi University Ube Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University Ube Japan
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Kawazoe Y, Shiinoki T, Fujimoto K, Yuasa Y, Hirano T, Matsunaga K, Tanaka H. Comparison of the radiomics-based predictive models using machine learning and nomogram for epidermal growth factor receptor mutation status and subtypes in lung adenocarcinoma. Phys Eng Sci Med 2023; 46:395-403. [PMID: 36787023 DOI: 10.1007/s13246-023-01232-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
The purpose of this study is to develop the predictive models for epidermal growth factor receptor (EGFR) mutation status and subtypes [exon 21-point mutation (L858R) and exon 19 deletion mutation (19Del)] and evaluate their clinical usefulness. Total 172 patients with lung adenocarcinoma were retrospectively analyzed. The analysis of variance and the least absolute shrinkage were used for feature selection from plain computed tomography images. Then, radiomic score (rad-score) was calculated for the training and test cohorts. Two machine learning (ML) models with 5-fold were applied to construct the predictive models with rad-score, clinical features, and the combination of rad-score and clinical features. The nomogram was developed using rad-score and clinical features. The prediction performance was evaluated by the area under the receiver operating characteristic curve (AUC). Finally, decision curve analysis (DCA) was performed using the best ML and nomogram models. In the test cohorts, the AUC of the best ML and the nomogram model were 0.73 (95% confidence interval, 0.59-0.87) and 0.79 (0.65-0.92) in the EGFR mutation groups, 0.83 (0.67-0.99) and 0.85 (0.72-0.97) in the L858R mutation groups, as well as 0.77 (0.58-0.97) and 0.77 (0.60-0.95) in the 19Del groups. The DCA showed that the nomogram models have comparable results with ML models. We constructed two predictive models for EGFR mutation status and subtypes. The nomogram models had comparable results to the ML models. Because the superiority of the performance of ML and nomogram models varied depending on the prediction groups, appropriate model selection is necessary.
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Affiliation(s)
- Yusuke Kawazoe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan.
| | - Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
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13
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Fujimoto K. [8. Overview of Deformable Image Registration for Clinical Applications]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:78-83. [PMID: 36682782 DOI: 10.6009/jjrt.2023-2136] [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] [Indexed: 01/20/2023]
Affiliation(s)
- Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University
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Morizawa Y, Satoh H, Arai M, Iwasa S, Sato A, Fujimoto K. Association Between Nonadherence and Transient Hyperuricemia in Pediatric Kidney Transplantation. Transplant Proc 2023; 55:129-133. [PMID: 36581508 DOI: 10.1016/j.transproceed.2022.09.033] [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: 05/13/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nonadherence among pediatric transplant recipients is a significant problem that reduces graft survival and leads to poor kidney graft outcomes. It is, however, extremely difficult to detect during a regular follow-up. This study, therefore, aimed to investigate the risk factors involved in nonadherence, focusing on unexplained transient hyperuricemia in pediatric kidney transplant (KTx) recipients at a single pediatric center. METHODS This retrospective study included 167 patients who underwent KTx at our pediatric center. A Cox proportional hazards analysis was performed to evaluate the risk of nonadherence using the following factors: age, sex, body mass index SD score, transient hyperuricemia, hypertension, and follow-up period. RESULTS Nonadherence was identified in 19 patients (11%), with the average (SD) age and post-KTx duration at diagnosis being 17.21 (4.73) years and 79.21 (38.77) months, respectively. Thirty-four patients (20%) were diagnosed with transient hyperuricemia at a median of 14 months after KTx. On multivariate Cox regression analysis, transient hyperuricemia was the only independent risk factor for nonadherence after KTx. CONCLUSIONS Transient hyperuricemia was identified as one of the risk factors for nonadherence after KTx; therefore, careful monitoring for transient hyperuricemia may allow early detection of nonadherence.
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Affiliation(s)
- Y Morizawa
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Department of Urology, Nara Medical University, Kashihara, Nara, Japan.
| | - H Satoh
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - M Arai
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - S Iwasa
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - A Sato
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - K Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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Kajima M, Ono T, Manabe Y, Fujimoto K, Shiinoki T, Tanaka H. Prognostic Role of Systemic Inflammation Response Index for Cervical Cancer Patients Treated with Definitive Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee JL, Keam B, Kanesvaran R, Yamamoto Y, Su WP, Chiang PH, Lin CC, Sassa N, Nishimura K, Fujimoto K, Chang PH, Kim M, Fukasawa S, Yokoyama M, Enokida H, Xu J, Homet Moreno B, Imai K, Nishiyama H, Rha S. 136MO Efficacy and safety of pembrolizumab (pembro) monotherapy in East Asian patients (pts) with urothelial carcinoma (UC) in KEYNOTE-045 or KEYNOTE-052. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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17
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Fujimoto K, Shiinoki T, Yuasa Y, Kawazoe Y, Yamane M, Sera T, Tanaka H. Assessing liver fibrosis distribution through liver elasticity estimates obtained using a biomechanical model of respiratory motion with magnetic resonance elastography. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac7d35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/29/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. This study aimed to produce a three-dimensional liver elasticity map using the finite element method (FEM) and respiration-induced motion captured by T1-weighted magnetic resonance images (FEM-E-map) and to evaluate whether FEM-E-maps can be an imaging biomarker comparable to magnetic resonance elastography (MRE) for assessing the distribution and severity of liver fibrosis. Approach. We enrolled 14 patients who underwent MRI and MRE. T1-weighted MR images were acquired during shallow inspiration and expiration breath-holding, and the displacement vector field (DVF) between two images was calculated using deformable image registration. FEM-E-maps were constructed using FEM and DVF. First, three Poisson’s ratio settings (0.45, 0.49, and 0.499995) were validated and optimized to minimize the difference in liver elasticity between the FEM-E-map and MRE. Then, the whole and regional liver elasticity values estimated using FEM-E-maps were compared with those obtained from MRE using Pearson’s correlation coefficients. Spearman rank correlations and chi-square histograms were used to compare the voxel-level elasticity distribution. Main results. The optimal Poisson’s ratio was 0.49. Whole liver elasticity estimated using FEM-E-maps was strongly correlated with that measured using MRE (r = 0.96). For regional liver elasticity, the correlation was 0.84 for the right lobe and 0.82 for the left lobe. Spearman analysis revealed a moderate correlation for the voxel-level elasticity distribution between FEM-E-maps and MRE (0.61 ± 0.10). The small chi-square distances between the two histograms (0.11 ± 0.07) indicated good agreement. Significance. FEM-E-maps represent a potential imaging biomarker for visualizing the distribution of liver fibrosis using only T1-weighted images obtained with a common MR scanner, without any additional examination or special elastography equipment. However, additional studies including comparisons with biopsy findings are required to verify the reliability of this method for clinical application.
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Fujimoto K, Fujii K, Kanamori T, Murai K, Tomura T, Tsutsumi R, Teramoto T, Nonaka Y, Sakaue H, Matsuo Y, Murayama N. Randomized, double-blind, crossover, placebo-controlled clinical trial to evaluate the effects of chicken hot water extract on insulin secretion. Eur Rev Med Pharmacol Sci 2022; 26:2422-2430. [PMID: 35442497 DOI: 10.26355/eurrev_202204_28476] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Essence of chicken (EOC), a hot water extract of chicken, is widely consumed in Southeast Asia as a beverage. EOC has an inhibitory effect on the elevation of blood glucose levels and a secretagogue effect on insulin. However, the mechanism by which EOC promotes insulin secretion is unknown. We aimed to verify the postprandial hyperglycemic inhibitory effect and the insulin secretory effect of EOC in healthy adults under appropriate placebo settings. In addition, we aimed to understand the mechanism underlying the insulin secretory effect of EOC. PATIENTS AND METHODS Thirty-four healthy Japanese adults were fed 68 mL of EOC or control food, followed by 200 g of cooked rice. Blood glucose and plasma insulin levels were measured at 30, 45, 60, 90, and 120 min after the participants ate cooked rice. The trial had a randomized, double-blind, crossover, placebo-controlled design. RESULTS The ingestion of EOC induced an increase in the maximum blood concentration (Cmax) of insulin and shortened the time required to reach the maximum blood concentration following rice consumption. Ingestion of the test beverage resulted in a significantly higher insulinogenic index than that obtained after ingestion of the control beverage. No side effects were observed in this study. Mechanistic experiments revealed that EOC stimulated significant (p < 0.05) secretion of GLP-1 from NCI-H716 human intestinal L cells at 0.1, 1, and 10 mg/mL. CONCLUSIONS Consuming EOC when eating rice supports pancreatic function. Daily consumption of EOC could elevate the early-phase insulin response; therefore, it could prevent diabetes in Asians with low insulin secretion.
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Affiliation(s)
- K Fujimoto
- Research Institute, Suntory Global Innovation Center Limited, Kyoto, Japan.
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19
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Shiinoki T, Fujimoto K, Kawazoe Y, Yuasa Y, Kajima M, Manabe Y, Ono T, Hirano T, Matsunaga K, Tanaka H. Predicting programmed death-ligand 1 expression level in non-small cell lung cancer using a combination of peritumoral and intratumoral radiomic features on computed tomography. Biomed Phys Eng Express 2022; 8. [PMID: 35051908 DOI: 10.1088/2057-1976/ac4d43] [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: 12/03/2021] [Accepted: 01/20/2022] [Indexed: 12/24/2022]
Abstract
In this study, we investigated the possibility of predicting expression levels of programmed death-ligand 1 (PD-L1) using radiomic features of intratumoral and peritumoral tumors on computed tomography (CT) images. We retrospectively analyzed 161 patients with non-small cell lung cancer. We extracted radiomics features for intratumoral and peritumoral regions on CT images. The null importance, least absolute shrinkage, and selection operator model were used to select the optimized feature subset to build the prediction models for the PD-L1 expression level. LightGBM with five-fold cross-validation was used to construct the prediction model and evaluate the receiver operating characteristics. The corresponding area under the curve (AUC) was calculated for the training and testing cohorts. The proportion of ambiguously clustered pairs was calculated based on consensus clustering to evaluate the validity of the selected features. In addition, Radscore was calculated for the training and test cohorts. For expression level of PD-L1 above 1%, prediction models that included radiomic features from the intratumoral region and a combination of radiomic features from intratumoral and peritumoral regions yielded an AUC of 0.83 and 0.87 and 0.64 and 0.74 in the training and test cohorts, respectively. In contrast, the models above 50% prediction yielded an AUC of 0.80, 0.97, and 0.74, 0.83, respectively. The selected features were divided into two subgroups based on PD-L1 expression levels ≥ 50% or ≥ 1%. Radscore was statistically higher for subgroup one than subgroup two when radiomic features for intratumoral and peritumoral regions were combined. We constructed a predictive model for PD-L1 expression level using CT images. The model using a combination of intratumoral and peritumoral radiomic features had a higher accuracy than the model with only intratumoral radiomic features.
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Affiliation(s)
- Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Koya Fujimoto
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Yusuke Kawazoe
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Yuki Yuasa
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Miki Kajima
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Yuki Manabe
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Taiki Ono
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University, Minamikogushi 1-1-1, Ube, Yamaguchi, 7558505, JAPAN
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Tanaka H, Ono T, Takano H, Manabe Y, Kajima M, Fujimoto K, Yuasa Y, Shiinoki T, Yamaji Y, Matsunaga K, Matsuo M. Monocyte-to-Lymphocyte Ratio is a Significant Prognostic Factor for Patients With Non-Small Cell Lung Cancer Who Treated By Stereotactic Body Radiation Therapy: A Multi Institutional Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Tanaka H, Ono T, Manabe Y, Kajima M, Fujimoto K, Yuasa Y, Shiinoki T, Yamaji Y, Matsunaga K. Anemia is a Prognostic Factor for Overall Survival Rate in Patients with Non-Small Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy. Cancer Manag Res 2021; 13:7447-7453. [PMID: 34611438 PMCID: PMC8485919 DOI: 10.2147/cmar.s336044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/25/2021] [Accepted: 09/22/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose Anemia has been associated with poor prognosis in patients with cancer across several cancer types. It has been identified as a prognostic factor in patients with non-small cell lung cancer (NSCLC) who have undergone surgery or chemoradiotherapy. However, there are only a few reports that have evaluated the prognostic significance of anemia in patients with NSCLC undergoing stereotactic body radiation therapy (SBRT). Patients and Methods A total of 77 patients were enrolled in this study. The pretreatment hemoglobin (Hb) levels, within 2 weeks before SBRT, were available for all patients. The median age of the participants (56 men, 21 women) was 80 (range, 50–90) years. The median Hb level was 12.8 (range, 7.8–18.3) g/dL. The median follow-up period was 24 (range, 1–87) months. Results Local recurrence was observed in 8 (10.4%) cases during the follow-up period. The 1- and 2-year local control (LC) rates were 94.8% and 86.4%, respectively. Seventeen (22.1%) patients died during the follow-up period. The 1- and 2-year overall survival (OS) rates were 93.1% and 85.2%, respectively. Univariate analysis identified anemia and body mass index as significant prognostic factors for predicting OS. On multivariate analysis, anemia was confirmed to be the only significant factor (p = 0.02469). Conclusion Our data suggest that anemia is a prognostic factor for predicting the OS rate in patients with early-stage NSCLC treated with SBRT.
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Affiliation(s)
- Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Taiki Ono
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yuki Manabe
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Terashima T, Higashibeppu Y, Yamashita T, Sakata Y, Azuma M, Fujimoto K, Munakata H, Ishii M, Kaneko S. 954P Comparison of medical costs and outcome between hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Makarov SN, Wartman WA, Noetscher GM, Fujimoto K, Zaidi T, Burnham EH, Daneshzand M, Nummenmaa A. Degree of improving TMS focality through a geometrically stable solution of an inverse TMS problem. Neuroimage 2021; 241:118437. [PMID: 34332043 PMCID: PMC8561647 DOI: 10.1016/j.neuroimage.2021.118437] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/10/2021] [Accepted: 07/27/2021] [Indexed: 10/31/2022] Open
Abstract
The Transcranial Magnetic Stimulation (TMS) inverse problem (TMS-IP) investigated in this study aims to focus the TMS induced electric field close to a specified target point defined on the gray matter interface in the M1HAND area while otherwise minimizing it. The goal of the study is to numerically evaluate the degree of improvement of the TMS-IP solutions relative to the well-known sulcus-aligned mapping (a projection approach with the 90∘ local sulcal angle). In total, 1536 individual TMS-IP solutions have been analyzed for multiple target points and multiple subjects using the boundary element fast multipole method (BEM-FMM) as the forward solver. Our results show that the optimal TMS inverse-problem solutions improve the focality - reduce the size of the field "hot spot" and its deviation from the target - by approximately 21-33% on average for all considered subjects, all observation points, two distinct coil types, two segmentation types, two intracortical observation surfaces under study, and three tested values of the field threshold. The inverse-problem solutions with the maximized focality simultaneously improve the TMS mapping resolution (differentiation between neighbor targets separated by approximately 10 mm) although this improvement is quite modest. Coil position/orientation and conductivity uncertainties have been included into consideration as the corresponding de-focalization factors. The present results will change when the levels of uncertainties change. Our results also indicate that the accuracy of the head segmentation critically influences the expected TMS-IP performance.
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Affiliation(s)
- S N Makarov
- Electrical and Computer Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115 USA.
| | - W A Wartman
- Electrical and Computer Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - G M Noetscher
- Electrical and Computer Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - K Fujimoto
- Center for Devices and Radiological Health (CDRH), FDA, Silver Spring, MD 20993 USA
| | - T Zaidi
- Center for Devices and Radiological Health (CDRH), FDA, Silver Spring, MD 20993 USA
| | - E H Burnham
- Electrical and Computer Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - M Daneshzand
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - A Nummenmaa
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115 USA
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Kaga T, Noda Y, Fujimoto K, Suto T, Kawai N, Miyoshi T, Hyodo F, Matsuo M. Deep-learning-based image reconstruction in dynamic contrast-enhanced abdominal CT: image quality and lesion detection among reconstruction strength levels. Clin Radiol 2021; 76:710.e15-710.e24. [PMID: 33879322 DOI: 10.1016/j.crad.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the use of deep-learning-based image reconstruction (DLIR) algorithms in dynamic contrast-enhanced computed tomography (CT) of the abdomen, and to compare the image quality and lesion conspicuity among the reconstruction strength levels. MATERIALS AND METHODS This prospective study included 59 patients with 373 hepatic lesions who underwent dynamic contrast-enhanced CT of the abdomen. All images were reconstructed using four reconstruction algorithms, including 40% adaptive statistical iterative reconstruction-Veo (ASiR-V) and DLIR at low, medium, and high-strength levels (DLIR-L, DLIR-M, and DLIR-H, respectively). The signal-to-noise ratio (SNR) of the abdominal aorta, portal vein, liver, pancreas, and spleen and the lesion-to-liver contrast-to-noise ratio (CNR) were calculated and compared among the four reconstruction algorithms. The diagnostic acceptability was qualitatively assessed and compared among the four reconstruction algorithms and the conspicuity of hepatic lesions was compared between <5 and ≥5 mm lesions. RESULTS The SNR of each anatomical structure (p<0.0001) and CNR (p<0.0001) were significantly higher in DLIR-H than the other reconstruction algorithms. Diagnostic acceptability was significantly better in DLIR-M than the other reconstruction algorithms (p<0.0001). The conspicuity of hepatic lesions was highest when using 40% ASiR-V and tended to lessen as the reconstruction strength level was getting higher in DLIR, especially in <5 mm lesions; however, all hepatic lesions could be detected. CONCLUSIONS DLIR improved the SNR, CNR, and image quality compared with 40% ASiR-V, while making it possible to decrease lesion conspicuity using higher reconstruction strength.
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Affiliation(s)
- T Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Y Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - K Fujimoto
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - T Suto
- Department of Radiology, Gifu Municipal Hospital, Gifu, Japan
| | - N Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - T Miyoshi
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - F Hyodo
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
| | - M Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
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Fujimoto K, Shiinoki T, Yuasa Y, Tanaka H. Estimation of liver elasticity using the finite element method and four-dimensional computed tomography images as a biomarker of liver fibrosis. Med Phys 2021; 48:1286-1298. [PMID: 33449406 DOI: 10.1002/mp.14723] [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: 05/15/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Current radiotherapy planning procedures are generally designed based on anatomical information only and use computed tomography (CT) images that do not incorporate organ-functional information. In this study, we developed a method for estimating liver elasticity using the finite element method (FEM) and four-dimensional CT (4DCT) images acquired during radiotherapy planning, and we subsequently evaluated its feasibility as a biomarker for liver fibrosis. MATERIALS AND METHODS Twenty patients who underwent 4DCT and ultrasound-based transient elastography (UTE) were enrolled. All patients had chronic liver disease or cirrhosis. Liver elasticity measurements of the UTE were performed on the right lobe of the patient's liver in 20 patients. The serum biomarkers of the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) were available in 18 of the 20 total patients, which were measured within 1 week after undergoing 4DCT. The displacement between the 4DCT images obtained at the endpoints of exhalation and inspiration was determined using the actual (via deformable image registration) and simulated (via FEM) respiration-induced displacement. The elasticity of each element of the liver model was optimized by minimizing the error between the actual and simulated respiration-induced displacement. Then, each patient's estimated liver elasticity was defined as the mean Young's modulus of the liver's right lobe and that of the whole liver using the estimated elasticity map. The estimated liver elasticity was evaluated for correlations with the elasticity obtained via UTE and with two serum biomarkers (APRI and FIB-4). RESULTS The mean ± standard deviation (SD) of the errors between the actual and simulated respiration-induced displacement in the liver model was 0.54 ± 0.33 mm. The estimated liver's right lobe elasticity was statistically significantly correlated with the UTE (r = 0.87, P < 0.001). Furthermore, the estimated whole liver elasticity was statistically significantly correlated with the UTE (r = 0.84, P < 0.001), APRI score (r = 0.62, P = 0.005), and FIB-4 score (r = 0.54, P = 0.021). CONCLUSION In this study, liver elasticity was estimated through FEM-based simulation and actual respiratory-induced liver displacement obtained from 4DCT images. Furthermore, we assessed that the estimated elasticity of the liver's right lobe was strongly correlated with the UTE. Therefore, the estimated elasticity has the potential to be a feasible imaging biomarker for assessing liver fibrosis using only 4DCT images without additional inspection or equipment costs. Because our results were derived from a limited sample of 20 patients, it is necessary to evaluate the accuracy of elasticity estimation for each liver segment on larger groups of biopsied patients to utilize liver elasticity information for radiotherapy planning.
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Affiliation(s)
- Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8535, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8535, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8535, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8535, Japan
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Shiinoki T, Fujii F, Yuasa Y, Nonomura T, Fujimoto K, Sera T, Tanaka H. Analysis of dosimetric impact of intrafraction translation and rotation during respiratory‐gated stereotactic body radiotherapy with real‐time tumor monitoring of the lung using a novel six degrees‐of‐freedom robotic moving phantom. Med Phys 2020; 47:3870-3881. [DOI: 10.1002/mp.14369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Takehiro Shiinoki
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University 1‐1‐1 Minamikogushi Ube Yamaguchi755‐8505Japan
| | - Fumitake Fujii
- Department of Mechanical Engineering Graduate School of Science and Technology for Innovation Yamaguchi University 2‐16‐1 Tokiwadai Ube Yamaguchi755‐8611Japan
| | - Yuki Yuasa
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University 1‐1‐1 Minamikogushi Ube Yamaguchi755‐8505Japan
| | - Tatsuki Nonomura
- Department of Mechanical Engineering Graduate School of Science and Technology for Innovation Yamaguchi University 2‐16‐1 Tokiwadai Ube Yamaguchi755‐8611Japan
| | - Koya Fujimoto
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University 1‐1‐1 Minamikogushi Ube Yamaguchi755‐8505Japan
| | - Tatsuhiro Sera
- Department of Radiological Technology Yamaguchi University Hospital 1‐1‐1 Minamikogushi Ube Yamaguchi755‐8505Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology Graduate School of Medicine Yamaguchi University 1‐1‐1 Minamikogushi Ube Yamaguchi755‐8505Japan
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Tanaka N, Nakai Y, Asakawa I, Miyake M, Anai S, Hasegawa M, Fujimoto K. The oncologic outcomes of low-dose-rate brachytherapy for prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33523-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Miyake M, Marugami N, Hori S, Nishimura N, Owari T, Itami Y, Nakai Y, Tanaka N, Fujimoto K. Dynamic contrast-enhanced magnetic resonance imaging can improve diagnostic accuracy of detecting bladder carcinoma in situ in combination with photodynamic diagnosis? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Miyake M, Marugami N, Fujiwara Y, Komura K, Inamoto T, Azuma H, Matsumoto H, Matsuyama H, Nishimura N, Hori S, Owari T, Itami Y, Nakai Y, Fujimoto K. Down-grading of ipsilateral hydronephrosis by neoadjuvant chemotherapy is associated with better oncological outcomes after radical nephroureterectomy in patients with ureteral cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Fujimoto K, Uwano I, Sasaki M, Oshida S, Tsutsui S, Yanagihara W, Fujiwara S, Kobayashi M, Kubo Y, Yoshida K, Terasaki K, Ogasawara K. Acetazolamide-Loaded Dynamic 7T MR Quantitative Susceptibility Mapping in Major Cerebral Artery Steno-Occlusive Disease: Comparison with PET. AJNR Am J Neuroradiol 2020; 41:785-791. [PMID: 32299799 DOI: 10.3174/ajnr.a6508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/01/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Dynamic changes in cerebrovascular reactivity after acetazolamide administration vary markedly among patients with major cerebral arterial steno-occlusive disease. MR quantitative susceptibility mapping can dynamically quantify the cerebral magnetic susceptibility. The purpose of this study was to determine whether dynamic changes in susceptibility after administration of acetazolamide on 7T quantitative susceptibility mapping are associated with pre-existing states of CBV and the cerebral metabolic rate of oxygen in the cerebral hemispheres with major cerebral arterial steno-occlusive disease. MATERIALS AND METHODS Sixty-five patients underwent 7T MR imaging at baseline and at 5, 10, 15, and 20 minutes after acetazolamide administration. Differences between the susceptibility of venous structures and surrounding brain tissue were calculated in the quantitative susceptibility mapping images. Susceptibility differences at 5, 10, 15, and 20 minutes after acetazolamide administration relative to baseline were calculated in 97 cerebral hemispheres with major cerebral arterial steno-occlusive disease. CBV and the cerebral metabolic rate of oxygen were also calculated using 15O-gas PET in the resting state. RESULTS Dynamic changes of susceptibility after acetazolamide administration were classified into 3 patterns: abnormally increasing 5 or 10 minutes after acetazolamide administration; abnormally decreasing within 20 minutes after acetazolamide administration; and remaining unchanged after acetazolamide administration. CBV was significantly greater in the first pattern than in the latter 2. The cerebral metabolic rate of oxygen differed significantly in descending order from the first to middle to last pattern. CONCLUSIONS Dynamic changes of susceptibility after acetazolamide administration on 7T MR quantitative susceptibility mapping are associated with pre-existing states of CBV and the cerebral metabolic rate of oxygen in major cerebral arterial steno-occlusive disease.
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Affiliation(s)
- K Fujimoto
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - I Uwano
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., M.S.)
| | - M Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., M.S.)
| | - S Oshida
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - S Tsutsui
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - W Yanagihara
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - S Fujiwara
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - M Kobayashi
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - Y Kubo
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - K Yoshida
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.)
| | - K Terasaki
- Cyclotron Research Center (K.T.), Iwate Medical University School of Medicine, Morioka, Japan
| | - K Ogasawara
- From the Department of Neurosurgery (K.F., S.O., S.T., W.Y., S.F., M.K., Y.K., K.Y., K.O.),
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Shiinoki T, Fujii F, Fujimoto K, Yuasa Y, Sera T. A novel dynamic robotic moving phantom system for patient-specific quality assurance in real-time tumor-tracking radiotherapy. J Appl Clin Med Phys 2020; 21:16-28. [PMID: 32281265 PMCID: PMC7386190 DOI: 10.1002/acm2.12876] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 12/29/2020] [Accepted: 03/10/2020] [Indexed: 12/25/2022] Open
Abstract
In this study, we assess a developed novel dynamic moving phantom system that can reproduce patient three-dimensional (3D) tumor motion and patient anatomy, and perform patient-specific quality assurance (QA) of respiratory-gated radiotherapy using SyncTraX. Three patients with lung cancer were enrolled in a study. 3D printing technology was adopted to obtain individualized lung phantoms using CT images. A water-equivalent phantom (WEP) with the 3D-printed plate lung phantom was set at the tip of the robotic arm. The log file that recorded the 3D positions of the lung tumor was used as the input to the dynamic robotic moving phantom. The WEP was driven to track 3D respiratory motion. Respiratory-gated radiotherapy was performed for driving the WEP. The tracking accuracy was calculated as the differences between the actual and measured positions. For the absolute dose and dose distribution, the differences between the planned and measured doses were calculated. The differences between the planned and measured absolute doses were <1.0% at the isocenter and <4.0% for the lung region. The gamma pass ratios of γ3 mm/3% and γ2 mm/2% under the conditions of gating and no-gating were 99.9 ± 0.1% and 90.1 ± 8.5%, and 97.5 ± 0.9% and 68.6 ± 17.8%, respectively, for all the patients. Furthermore, for all the patients, the mean ± SD of the root mean square values of the positional error were 0.11 ± 0.04 mm, 0.33 ± 0.04 mm, and 0.20 ± 0.04 mm in the LR, AP, and SI directions, respectively. Finally, we showed that patient-specific QA of respiratory-gated radiotherapy using SyncTraX can be performed under realistic conditions using the moving phantom.
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Affiliation(s)
- Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Fumitake Fujii
- Department of Mechanical Engineering, Graduate School of Science and Technology for innovation, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Tatsuhiro Sera
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Yamaguchi, Japan
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Fukui Y, Yamamoto K, Yamamoto T, Fujimoto K. Tuning of particle indentation by surface modification of polymer particles and substrates. Colloids Surf A Physicochem Eng Asp 2020. [DOI: 10.1016/j.colsurfa.2019.124380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yuasa Y, Shiinoki T, Onizuka R, Fujimoto K. Estimation of effective imaging dose and excess absolute risk of secondary cancer incidence for four-dimensional cone-beam computed tomography acquisition. J Appl Clin Med Phys 2019; 20:57-68. [PMID: 31593377 PMCID: PMC6839364 DOI: 10.1002/acm2.12741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 09/02/2019] [Accepted: 09/15/2019] [Indexed: 12/25/2022] Open
Abstract
This study was conducted to estimate the organ equivalent dose and effective imaging dose for four-dimensional cone-beam computed tomography (4D-CBCT) using a Monte Carlo simulation, and to evaluate the excess absolute risk (EAR) of secondary cancer incidence. The EGSnrc/BEAMnrc were used to simulate the on-board imager (OBI) from the TrueBeam linear accelerator. Specifically, the OBI was modeled based on the percent depth dose and the off-center ratio was measured using a three-dimensional (3D) water phantom. For clinical cases, 15 lung and liver cancer patients were simulated using the EGSnrc/DOSXYZnrc. The mean absorbed doses to the lung, stomach, bone marrow, esophagus, liver, thyroid, bone surface, skin, adrenal glands, gallbladder, heart, intestine, kidney, pancreas and spleen, were quantified using a treatment planning system, and the equivalent doses to each organ were calculated. Subsequently, the effective dose was calculated as the weighted sum of the equivalent dose, and the EAR of the secondary cancer incidence was determined for each organ with the use of the biologic effects of ionizing radiation (BEIR) VII model. The effective doses were 3.9 ± 0.5, 15.7 ± 2.0, and 7.3 ± 0.9 mSv, for the lung, and 4.2 ± 0.6, 16.7 ± 2.4, and 7.8 ± 1.1 mSv, for the liver in the respective cases of the 3D-CBCT (thorax, pelvis) and 4D-CBCT modes. The lung EARs for males and females were 7.3 and 10.7 cases per million person-years, whereas the liver EARs were 9.9 and 4.5 cases per million person-years. The EAR increased with increasing time since radiation exposure. In clinical studies, we should use 4D-CBCT based on consideration of the effective dose and EAR of secondary cancer incidence.
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Affiliation(s)
- Yuki Yuasa
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Takehiro Shiinoki
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
| | - Ryota Onizuka
- Department of Radiological TechnologyYamaguchi University HospitalUbeYamaguchiJapan
| | - Koya Fujimoto
- Department of Radiation OncologyGraduate School of MedicineYamaguchi UniversityUbeYamaguchiJapan
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Sato R, Sakamoto K, Yamashita T, Nagamatsu S, Motozato K, Sueta D, Oshima S, Nakako K, Fujimoto K, Shimomura H, Tsunoda R, Hokimoto S, Kaikita K, Tsujita K. 3285Impact of intravascular ultrasound-guided percutaneous coronary intervention in patients with diabetes mellitus and chronic kidney disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Several studies have shown favorable results using IVUS-guided PCI. Nevertheless, patient background in which use of IVUS is effective is not well elucidated. Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) tend to have complex coronary artery lesions. We sought to assess the impact of IVUS guidance on clinical outcomes in these patients.
Methods
Kumamoto Intervention Conference Study is a multicenter registry which has enrolled consecutive patients who underwent PCI in 16 centers in Japan. Between August 2008 and March 2014, 11,195 consecutive patients were enrolled in this registry. To elucidate the efficacy of IVUS usage in DM and CKD patients, 10,822 consecutive subjects with 1-year follow-up data were analyzed. In this patient population, 69.2% (n=7,493) of patients were treated with IVUS-guided PCI. Patients were divided into 4 groups: the No Risk Group, the DM only Group, the CKD only Group, and the DM+CKD Group.
Results
Maximum stent diameter, post dilatation rate, usage of distal protection device, and rotational atherectomy rate were significantly higher in the IVUS-guided PCI patients in all 4 groups. 1-year MACE (cardiovascular death, non-fatal myocardial infarction, and MI with stent thrombosis) was significantly lower in the IVUS-guided PCI patients than angiography-guided PCI patients in each subset, except for the No Risk Group. In contrast to angiography-guided PCI patients, there were no significant differences among the 4 groups as regards 1-year MACE in the IVUS-guided PCI patients except for the DM+CKD Group. In multiple regression analysis, IVUS usage was an independent negative predictor for 1-year MACE in the DM only Group (HR=0.374, 95% CI 0.194–0.719, p=0.003) and in the CKD only Group (HR=0.604, 95% CI 0.379–0.962, p=0.010). When the No Risk Group was used as a reference, the HR has increased according to increased risk factors in the angiography-guided PCI patients, but such tendency was not necessarily observed in the IVUS-guided PCI patients (Table).
Risk Stratification of DM and CKD Variable IVUS-Guided PCI Angiography-Guided PCI HR 95% CI P HR 95% CI P The No Risk Group Reference – – Reference – – vs. the DM only Group 0.627 0.321–1.227 0.173 2.036 1.090–3.804 0.026 vs. the CKD only Group 1.334 0.795–2.237 0.275 2.730 1.541–4.836 0.001 vs. the DM+CKD Group 2.114 1.287–3.474 0.014 2.225 1.160–4.266 0.016
Conclusion
The efficacy of IVUS usage as regards 1-year MACE was confirmed in DM and CKD patients, but not observed in patients without them or in the combination of DM and CKD patients.
Acknowledgement/Funding
None
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Affiliation(s)
- R Sato
- Kumamoto University, Kumamoto, Japan
| | | | | | | | | | - D Sueta
- Kumamoto University, Kumamoto, Japan
| | - S Oshima
- Kumamoto Central Hospital, Department of Cardiology, Kumamoto, Japan
| | - K Nakako
- Saiseikai Kumamoto Hospital, Department of Cardiology, Kumamoto, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Department of Cardiology, Kumamoto, Japan
| | - H Shimomura
- Tokusyukai Hospital, Department of Cardiology, Fukuoka, Japan
| | - R Tsunoda
- Kumamoto Red Cross Hospital, Department of cardiology, Kumamoto, Japan
| | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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Motozato K, Sakamoto K, Nakao K, Fujimoto K, Miyao Y, Shimomura H, Tsunoda R, Sato R, Nagamatsu S, Yamashita T, Kaikita K, Tsujita K. P5480Impact of Silent Myocardial Ischemia on One Year Mortality after Successful Coronary Intervention: Data from Japanese Multicenter (KICS) Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0434] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Under the awareness of appropriate use criteria, the significance of PCI for the patients with silent myocardial ischemia (SMI) decreases. On the other hand, the prognoses of SMI patients have been reported to be equivalent to those of symptomatic effort angina pectoris (EAP) patients. We aimed to clarify the prognosis of SMI after PCI and elucidate the factors influencing the mortality.
Methods
The Kumamoto Intervention Conference Study is multicenter registry enrolling consecutive patients undergoing PCI in 16 centers in Japan. Overall, 17,688 consecutive patients were enrolled during April 2008 to March 2017. To compare the clinical events between SMI and EAP, 8,278 subjects, excluding acute coronary syndrome, post successful PCI were enrolled with 1-year follow-up data.
Results
In this study, 2,071 patients were classified as SMI and 6,207 patients were EAP. Male, lower body mass index (BMI), diabetes, chronic kidney disease (CKD), smoking habits, prior myocardial infarction (MI), composite of cerebrovascular disease and composite of peripheral arterial disease were all significantly higher in the SMI group. Although nonfatal MI and stent thrombosisduring 12-monthswere comparable between the 2 groups, all-cause mortality and cardiac death during 12-months were significantly higher in the SMI group than in the EAP group (3.9% vs 1.8%, p<0.001, 1.4% vs 0.5%, p<0.001, respectively). On the other hand, Repeat Revascularization rate during 12-months was significantly lower in the SMI group than in the EAP group (15.7% vs 19.5%, p<0.001).Kaplan-Meier analysis for cardiac death showed a significant difference between the 2 groups (Figure). In a multiple logistic regression analysis, in addition to lower BMI and CKD, SMI was an independent predictor for cardiac death. Even after adjustment by propensity-score matching with predictive factors for cardiac event, SMI showed a higher cardiac death rate compared with EAP (1.4% vs 0.5%, p=0.004), and it remained as a significant predictor.
Conclusion
In this study, SMI itself was associated with higher mortality after PCI. Strict follow-up and assessment of residual ischemia should be necessary for SMI patients.
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Affiliation(s)
- K Motozato
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - Y Miyao
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | | | - R Tsunoda
- Kumamoto Red Cross Hospital, Kumamoto, Japan
| | - R Sato
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Nagamatsu
- Kumamoto University Hospital, Kumamoto, Japan
| | - T Yamashita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
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Soeda T, Ishihara M, Fujino F, Ogawa H, Nakao K, Yasuda S, Noguchi T, Ozaki Y, Suwa S, Fujimoto K, Nakama Y, Morita T, Shimizu W, Hirohata A, Saito Y. P5502Comparison of clinical characteristics and prognosis between non-octogenarians and octogenarians with cardiac troponin positive acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0452] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Cardiac troponin (cTn) is the preferred biomarker for the diagnosis of acute myocardial infarction (AMI). Octogenarians who presented cTn positive AMI are not usually recruited in clinical trials. Therefore, their clinical characteristics and prognosis are rarely investigated.
Objective
To study the characteristics and prognosis in octogenarians who presented cTn positive AMI.
Methods and results
The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective and multicenter registry. A total of 3,283 consecutive AMI patients who were diagnosed by cTn-based criteria were included. The patients were divided into non-octogenarians (n=2,593) and octogenarians (n=690). Compared with non- octogenarians, octogenarians showed significantly lower incidence of diabetes mellitus (37.6% and 31.9%, p=0.006) and dyslipidemia (53.6% and 45.6%, p<0.001), and significantly higher incidence of hypertension (64.1% and 75.3%, p<0.001) and chronic kidney disease (38.7% and 68.7%, p<0.001). Octogenarians showed significantly longer onset to door time (p<0.001) and longer door to device time (p<0.001). Though, compared with non-octogenarians, octogenarians showed lower peak CK (2,506 and 1,926, p<0.001), LVEF was significantly lower in octogenarians (54.6% and 52.6%, p=0.005). The presentation of AMI was different between the two group. The incidence of ST-segment elevation MI (STEMI) was 70.7% in non-octogenarians and 62.0% in octogenarians. Non-STEMI with CK elevation and without CK elevation were 16.2% and 13.1% in non- octogenarians, and 20.9% and 17.1% in octogenarians. In-hospital mortality was higher in octogenarians (4.7% and 13.2%, P<0.001). Especially, octogenarians with STEMI and non-STEMI with CK elevation showed the highest in-hospital mortality. And octogenarians without CK elevation showed similar in hospital mortality with non-octogenarians with STEMI (Figure).
Conclusions
J-MINUET showed the poor prognosis of octogenarians who were diagnosed as AMI based on cTn.
Acknowledgement/Funding
None
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Affiliation(s)
- T Soeda
- Nara Medical University, Cardiovascular medicine, Kashihara, Japan
| | - M Ishihara
- Hyogo College of Medicine, Division of Coronary Artery Disease, Nishinomiya, Japan
| | - F Fujino
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Ozaki
- Fujita Health University, Cardiology, Toyoake, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - Y Nakama
- Hiroshima City Hospital, Hiroshima, Japan
| | - T Morita
- Osaka General Medical Center, Osaka, Japan
| | | | - A Hirohata
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Y Saito
- Nara Medical University, Cardiovascular medicine, Kashihara, Japan
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Yamashita T, Sakamoto K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Suwa S, Fujimoto K, Okura H, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M. P3392Potential of imaging-guided PCI for event suppression in Japanese acute myocardial infarction patients: J-MINUET substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0268] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) has been widely used in clinical settings. Although favorable results of imaging-guided percutaneous coronary intervention (PCI) compared with angio-guided PCI were observed in several studies, impacts of institutional-based usage frequency, about imaging-guided PCI, have not been well elucidated.
Methods
To elucidate the impact of imaging-guided PCI and the effects of frequency of its usage, we analyzed data of the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET). This was a prospective and multicenter registry consisting of 3,283 AMI patients, who were hospitalized within 48 hours of onset from July 2012 to March 2014. Clinical follow-up data was obtained for 3 years. In this sub-study, a total of 2,788 patients who underwent urgent PCI having detailed procedural information were enrolled. We analyzed the differences of utilization rates of imaging-guided PCI among the participating institutions and the impacts for the clinical events. The participating institutions were divided into 3 groups by the frequency of IVUS usage: low frequency institutions: under 50%; moderate frequency institutions: 50% to 90%; and, high frequency institutions: over 90%.
Results
In this cohort registry, patients were enrolled from 28 institutions. The utilization rate of coronary imaging varied widely depending on each institution from 15.4% to 100% (mean 85.7%±24.3, median 97.4%). When the institutions were divided into 3 groups by the frequency of intravascular imaging usage, four low frequency institutions enrolled 295 patients, five moderate frequency institutions enrolled 624 patients, and 19 high frequency institutions enrolled 1,491 patients. Although the incidence of MACE (death, MI, stroke, cardiac failure, or revascularization for unstable angina) decreased stepwise (33.2%, 23.7%, and 19.7%) (gray bar in the Figure), the event rates of the imaging-guided PCI cases among the 3 groups were comparable (21.6%, 21.9%, and 19.6%) (white bar in the Figure). On the other hand, a gradual event reduction between the 3 groups was observed in the angio-guided PCI cases (black bar in the Figure). In comparison of MACE rate between imaging-guided and angio-guided PCI, there were statistically significant differences in the low frequency and moderate frequency institutions (p=0.001 and p=0.012, respectively). In contrast, comparable event rates were observed in the high frequency institutions (p=0.441).
MACE rate by imaging usage frequency
Conclusions
In Japanese ACS patients treated with imaging-guided PCI, better suppression of clinical events during 3-year was found in the institutions with the more frequent use of intravascular imaging, mainly due to stepwise event suppression in the cases of angio-guided PCI. On the other hand, the clinical benefit of coronary imaging was obtained independently of the frequency of use and its experience.
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Affiliation(s)
- T Yamashita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - J Ako
- Kitasato University, tokyo, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Suwa
- Juntendo University, Tokyo, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - H Okura
- Gifu Universiry, Gifu, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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Sakama M, Fujimoto K, Inoue K, Fukushi M, Imajyo Y, Fukuhara T, Matsuura M, Yajima T, Endo M, Fujisawa M, Matsumoto-Kawaguchi E. FEASIBILITY STUDY ON THE FUSION OF PHITS SIMULATIONS AND THE DLNN ALGORITHM FOR A NEW QUANTITATIVE METHOD OF IN-SITU MULTIPLE-CHANNEL DEPTH DISTRIBUTION SPECTROMETRY. Radiat Prot Dosimetry 2019; 184:328-333. [PMID: 31038704 DOI: 10.1093/rpd/ncz093] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We have recently have developed an in-situ multiple-channel depth distribution spectrometer (DDS) that can easily acquire on-site measurements of the depth distribution of specific radioactivities of Cs-134 and Cs-137 underground. Despite considerable improvements in the hardware developed for this device, the quantitative method for determining of radioactivities with this DDS device cannot yet achieve satisfactory performance for practical use. For example, this method cannot discriminate each γ-ray spectra of Cs-134 and Cs-137 acquired by the 20 thallium-doped caesium iodine CsI(Tl) scintillation crystal detectors of the DDS device from corresponding depth levels of underground soil. Therefore, we have applied deep learning neural network (DLNN) as a novel radiation measurement technique to discriminate the spectra and to determine the specific radioactivities of Cs-134 and Cs-137. We have developed model soil layers on a virtual space in Monte-Carlo based PHITS simulations and transported γ-ray radiation generated from a particular single soil layer or multiple layers as radiation sources; next, we performed PHITS calculations of those specific radioactivity measurements for each soil layer using DDS device based on machine learning via the DLNN algorithm. In this study, we obtained informative results regarding the feasibility of the proposal innovative radiation measurement method for further practical use in on-site applications.
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Affiliation(s)
- M Sakama
- Department of Radiation Science and Technology, Division of Radiological Sciences, Institute of Biomedical Sciences, Tokushima University, Kuramoto-cho Tokushima, Japan
| | - K Fujimoto
- Faculty of Engineering and Design, Kagawa University, Hayashi-cho 2217-20, Takamatsu City, Kagawa, Japan
| | - K Inoue
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Higashi-Ogu 7-2-10, Arakawa City, Tokyo, Japan
| | - M Fukushi
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Higashi-Ogu 7-2-10, Arakawa City, Tokyo, Japan
| | - Y Imajyo
- Advanced Fusion Technology (AFT), Co., Ltd., Sotokanda 5-6-3, Chiyoda-ku, Tokyo, Japan
| | - T Fukuhara
- Advanced Fusion Technology (AFT), Co., Ltd., Sotokanda 5-6-3, Chiyoda-ku, Tokyo, Japan
| | - M Matsuura
- CLEAR-PULSE, Co., Ltd., Chuo 6-25-17, Ota-ku, Tokyo, Japan
| | - T Yajima
- Advanced Fusion Technology (AFT), Co., Ltd., Sotokanda 5-6-3, Chiyoda-ku, Tokyo, Japan
| | - M Endo
- Advanced Fusion Technology (AFT), Co., Ltd., Sotokanda 5-6-3, Chiyoda-ku, Tokyo, Japan
| | - M Fujisawa
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Higashi-Ogu 7-2-10, Arakawa City, Tokyo, Japan
| | - E Matsumoto-Kawaguchi
- Department of Radiation Science and Technology, Division of Radiological Sciences, Institute of Biomedical Sciences, Tokushima University, Kuramoto-cho Tokushima, Japan
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Motozato K, Sakamoto K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Suwa S, Fujimoto K, Nakama Y, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M. P1954Prognostic value of the CHADS2 score for adverse cardiovascular events in acute myocardial infarction patients without atrial fibrillation: J-MINUET Substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0701] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The CHADS2score has mainly been used to predict the likelihood of cerebrovascular accidents in patients with atrial fibrillation. However, increasing attention is being paid to this scoring system for risk stratification of patients with coronary artery disease. We investigated the value of the CHADS2 score in predicting cardiovascular events in Japanese acute myocardial infarction (AMI) patients without atrial fibrillation.
Methods
To elucidate the prognostic value of CHADS2score in AMI patients, we analysed data of the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET). This was a prospective and multicenter registry consisting of 3,283 AMI patients, who were hospitalized within 48-hours of onset from July 2012 to March 2014. We calculated the CHADS2 scores for 3,044 patients without clinical evidence of atrial fibrillation. The presence of heart failure was substituted by Killip classification>2 on admission. Clinical follow-up data was obtained for 3 years. In addition to the in-hospital mortality,we evaluated cardiovascular events, defined as all cause deathor non-fatal MI during 3-year follow up periods.
Results
In this study, enrolled patients were classified into low- (point 0–1), intermediate- (point 2–3), and high-score (point 4–6) groups by calculating CHADS2 score. Overall patients with low, intermediate and high score were divided into 1,395, 1,393 and 256 patients, respectively. In-hospital mortality among low, intermediate, and high score groups were 2.8%, 7.4% and 14.8%, respectively (P<0.001). The incidence of cardiovascular eventsamong low, intermediate, and high score groups were 7.8%, 16.3%, 29.3%, respectively (P<0.001). Kaplan-Meier analysis showed a significant difference between the groups (Figure). The event rates were significantly higher in both high score and intermediate score group than in low score group (P<0.001). Multivariate Cox hazard analysis identified CHADS2 score (per 1 point) as an independent predictor of cardiovascular events in addition to chronic kidney disease and lower body mass index. (hazard ratio, 1.344; 95% CI, 1.239–1.459; P<0.001). Among the factors constituting CHADS2 score, heart failure and age were identified as independent predictors for in-hospital mortality. With respect to the cardiovascular event during 3 years, heart failure, age, and previous stroke were revealed as significant independent predictors.
Conclusion
This large cohort study indicated that the CHADS2 score is useful for the prediction of in-hospital mortality and the cardiovascular events during 3-year follow up in Japanese AMI patients without atrial fibrillation.
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Affiliation(s)
- K Motozato
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Sakamoto
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University Hospital, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - J Ako
- Kitasato University, Sagamihara, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Kumamoto, Japan
| | - Y Nakama
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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Hashimoto T, Ako J, Nakao K, Ozaki Y, Kimura K, Noguchi T, Suwa S, Fujimoto K, Nakama Y, Morita T, Shimizu W, Saito Y, Hirohata A, Ogawa H, Ishihara M. P3406Validation of atherothrombotic risk score for secondary prevention in patients with acute myocardial infarction: the J-MINUET study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0281] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention and CREDO-Kyoto Thrombotic Risk Score are contemporary secondary prevention risk scoring systems. However, these scoring systems have not been validated in other populations.
Purpose
The aim of this study was to validate of the TIMI Risk Score for Secondary Prevention and CREDO-Kyoto Thrombotic Risk Score in patients in the early phase of acute myocardial infarction (AMI).
Methods
The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry conducted in 28 Japanese medical institutions. We enrolled 3,283 consecutive patients with AMI who were admitted to participating institutions within 48 hours of symptom onset between July 2012 and May 2014. Among them, 3,070 patients were included in this study after excluding 213 patients who died in the hospital. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI and non-fatal stroke. The patients were stratified by the TIMI Risk Score for Secondary Prevention and CREDO-Kyoto Thrombotic Risk Score.
Results
At the 3-year follow-up, the primary endpoint had occurred in 337 patients (11.0%). All-cause death, non-fatal MI and non-fatal stroke had occurred in 177 (5.8%), 80 (2.6%) and 80 (2.6%) patients, respectively. TIMI Risk Score for Secondary Prevention and CREDO-Kyoto Thrombotic Risk Score showed a graded association with the composite of all-cause death, non-fatal MI and non-fatal stroke at 3 years in the J-MINUET population (Figure).
Validation of atherothrombotic risk
Conclusions
TIMI Risk Score for Secondary Prevention and CREDO-Kyoto Thrombotic Risk Score were shown to be applicable to the patients in the early phase of AMI.
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Affiliation(s)
- T Hashimoto
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital Cardiovascular Center, Division of Cardiology, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center, Yokohama, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Izunokuni, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Department of Cardiology, Kumamoto, Japan
| | - Y Nakama
- Hiroshima City Hiroshima Citizens Hospital, Department of Cardiology, Hiroshima, Japan
| | - T Morita
- Osaka General Medical Center, Division of Cardiology, Osaka, Japan
| | - W Shimizu
- Nippon Medical School, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Saito
- Nara Medical University, Department of Cardiovascular Medicine, Kashihara, Japan
| | - A Hirohata
- The Sakakibara Heart Institute of Okayama, Department of Cardiovascular Medicine, Okayama, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Ishihara
- Hyogo College of Medicine, Division of Cardiovascular Medicine, Hyogo, Japan
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Kanda K, Fujimoto K, Mochizuki R, Ishida K, Lee B. Development and validation of the comprehensive assessment scale for chemotherapy-induced peripheral neuropathy in survivors of cancer. BMC Cancer 2019; 19:904. [PMID: 31506070 PMCID: PMC6734590 DOI: 10.1186/s12885-019-6113-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/23/2018] [Accepted: 08/30/2019] [Indexed: 12/13/2022] Open
Abstract
Background Appropriate assessment is essential for the management of chemotherapy-induced peripheral neuropathy (CIPN), an intractable symptom that cannot yet be palliated, which is high on the list of causes of distress for cancer patients. However, objective assessment by medical staff makes it easy to underestimate the symptoms and effects of CIPN in cancer survivors. As a result, divergence from subjective evaluation of cancer survivors is a significant problem. Therefore, there is an urgent need to develop a subjective scale with high accuracy and applicability that reflects the experiences of cancer patients. We developed a comprehensive assessment scale for CIPN in cancer survivors, named the Comprehensive Assessment Scale for Chemotherapy-Induced Peripheral Neuropathy in Survivors of Cancer (CAS-CIPN), and demonstrated its reliability and validity. Methods We developed a questionnaire based on qualitative studies of peripheral neuropathy in Japanese cancer patients and literature review. Twelve cancer experts confirmed the content validity of the questionnaire. A draft version comprising 40 items was finalized by a pilot test on 100 subjects. The participants in the present study were 327 Japanese cancer survivors. Construct validity was determined by factor analysis, and internal validity by confirmation factor analysis and Cronbach’s α. Results Factor analysis showed that the structure consisted of 15 items in four dimensions: “Threatened interference in daily life by negative feelings”, “Impaired hand fine motor skills”, “Confidence in choice of treatment/management,” and “Dysesthesia of the palms and soles.” The CAS-CIPN internal consistency reliability was 0.826, and the reliability coefficient calculated using the Spearman-Brown formula [q = 2r/(1 + r)] was 0.713, confirming high internal consistency and stability. Scores on this scale were strongly correlated with Gynecologic Oncology Group-Neurotoxicity scores (r = 0.714, p < 0.01), confirming its criterion-related validity. Conclusions The CAS-CIPN is an assessment tool with high reliability and validity for the comprehensive evaluation of CIPN in cancer survivors. The CAS-CIPN is simple to use, and can be used by medical professionals for appropriate situational assessment and intervention.
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Affiliation(s)
- K Kanda
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaoruimachi, Takasakishi, Gunma, 370-0033, Japan.
| | - K Fujimoto
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaoruimachi, Takasakishi, Gunma, 370-0033, Japan
| | - R Mochizuki
- The Jikei University School of Medicine, School of Nursing, 8-3-1, Kokuryocho, Chofu, Tokyo, 182-8570, Japan
| | - K Ishida
- Niigata College of Nursing, 240 Shinnancho, Joetsu, Nigata, 943-0147, Japan
| | - B Lee
- Department of Occupation, Gunma University Graduate School of Health Sciences, 3-39-22, Showamachi, Maebashi, Gunma, 371-8514, Japan
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Fujimoto K, Shiinoki T, Yuasa Y, Onizuka R, Yamane M. Evaluation of the effects of motion mitigation strategies on respiration-induced motion in each pancreatic region using cine-magnetic resonance imaging. J Appl Clin Med Phys 2019; 20:42-50. [PMID: 31385418 PMCID: PMC6753735 DOI: 10.1002/acm2.12693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/25/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 01/09/2023] Open
Abstract
Purpose This study aimed to quantify the respiration‐induced motion in each pancreatic region during motion mitigation strategies and to characterize the correlations between this motion and that of the surrogate signals in cine‐magnetic resonance imaging (MRI). We also aimed to evaluate the effects of these motion mitigation strategies in each pancreatic region. Methods Sagittal and coronal two‐dimensional cine‐MR images were obtained in 11 healthy volunteers, eight of whom also underwent imaging with abdominal compression (AC). For each pancreatic region, the magnitude of pancreatic motion with and without motion mitigation and the positional error between the actual and predicted pancreas motion based on surrogate signals were evaluated. Results The magnitude of pancreatic motion with and without AC in the left–right (LR) and superior–inferior (SI) directions varied depending on the pancreatic region. In respiratory gating (RG) assessments based on a surrogate signal, although the correlation was reasonable, the positional error was large in the pancreatic tail region. Furthermore, motion mitigation in the anterior‐posterior and SI directions with RG was more effective than was that with AC in the head region. Conclusions This study revealed pancreatic region‐dependent variations in respiration‐induced motion and their effects on motion mitigation outcomes during AC or RG. The magnitude of pancreatic motion with or without AC and the magnitude of the positional error with RG varied depending on the pancreatic region. Therefore, during radiation therapy for pancreatic cancer, it is important to consider that the effects of motion mitigation during AC or RG may differ depending on the pancreatic region.
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Affiliation(s)
- Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yuki Yuasa
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Ryota Onizuka
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Masatoshi Yamane
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, Japan
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43
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Ohwada G, Minakuchi S, Sato Y, Kondo H, Nomura T, Tsuboi A, Hong G, Itoh Y, Kawai Y, Kimoto S, Gunji A, Suzuki A, Suzuki T, Kimoto K, Hoshi N, Saita M, Yoneyama Y, Sato Y, Morokuma M, Okazaki J, Maeda T, Nakai K, Ichikawa T, Nagao K, Fujimoto K, Murata H, Kurogi T, Yoshida K, Nishimura M, Nishi Y, Murakami M, Hosoi T, Hamada T. Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial. JDR Clin Trans Res 2019; 5:50-61. [PMID: 30975019 DOI: 10.1177/2380084419837607] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/13/2022] Open
Abstract
INTRODUCTION Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives. OBJECTIVE This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives. METHODS Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health-related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney U test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed. RESULTS Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons (P < 0.05). Significant differences were also observed for perceived chewing ability of hard foods (P < 0.05). CONCLUSION These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ). KNOWLEDGE TRANSFER STATEMENT The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.
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Affiliation(s)
- G Ohwada
- The Japan Denture Care Society.,Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Minakuchi
- The Japan Denture Care Society.,Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Sato
- The Japan Denture Care Society.,Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Kondo
- The Japan Denture Care Society.,Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - T Nomura
- The Japan Denture Care Society.,Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - A Tsuboi
- The Japan Denture Care Society.,Division of Community Oral Health Science, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - G Hong
- The Japan Denture Care Society.,Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Y Itoh
- The Japan Denture Care Society.,Division of Aging and Geriatric Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Y Kawai
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dentistry, Nihon University, Matsudo, Japan
| | - S Kimoto
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dentistry, Nihon University, Matsudo, Japan
| | - A Gunji
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dentistry, Nihon University, Matsudo, Japan
| | - A Suzuki
- The Japan Denture Care Society.,Department of Removable Prosthodontics, Graduate School of Dentistry, Nihon University, Matsudo, Japan
| | - T Suzuki
- The Japan Denture Care Society.,Section of Oral Prosthetic Engineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Kimoto
- The Japan Denture Care Society.,Division of Prosthodontics and Oral Rehabilitation, Department of Oral Function and Restoration, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - N Hoshi
- The Japan Denture Care Society.,Division of Prosthodontics and Oral Rehabilitation, Department of Oral Function and Restoration, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - M Saita
- The Japan Denture Care Society.,Division of Prosthodontics and Oral Rehabilitation, Department of Oral Function and Restoration, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Y Yoneyama
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Y Sato
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - M Morokuma
- The Japan Denture Care Society.,Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - J Okazaki
- The Japan Denture Care Society.,Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - T Maeda
- The Japan Denture Care Society.,Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - K Nakai
- The Japan Denture Care Society.,Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - T Ichikawa
- The Japan Denture Care Society.,Department of Oral and Maxillofacial Prosthodontics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima City, Japan
| | - K Nagao
- The Japan Denture Care Society.,Department of Oral and Maxillofacial Prosthodontics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima City, Japan
| | - K Fujimoto
- The Japan Denture Care Society.,Department of Oral and Maxillofacial Prosthodontics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima City, Japan
| | - H Murata
- The Japan Denture Care Society.,Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki City, Japan
| | - T Kurogi
- The Japan Denture Care Society.,Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki City, Japan
| | - K Yoshida
- The Japan Denture Care Society.,Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki City, Japan
| | - M Nishimura
- The Japan Denture Care Society.,Department of Oral and Maxillofacial Prosthodontics, Field of Oral and Maxillofacial Rehabilitation, Course for Advanced Therapeutic, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima City, Japan
| | - Y Nishi
- The Japan Denture Care Society.,Department of Oral and Maxillofacial Prosthodontics, Field of Oral and Maxillofacial Rehabilitation, Course for Advanced Therapeutic, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima City, Japan
| | - M Murakami
- The Japan Denture Care Society.,Denture Prosthodontic Restoration, Advanced Dentistry Center, Kagoshima University Medical and Dental Hospital, Kagoshima City, Japan
| | - T Hosoi
- The Japan Denture Care Society.,School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - T Hamada
- The Japan Denture Care Society.,Hiroshima University, Hiroshima City, Japan
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Shiinoki T, Yuasa Y, Fujimoto K. PO-0921 Assessment of CT-based imaging biomarker of COPD in IGRT planning for lung cancer patient. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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45
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Shiraishi J, Nose H, Fujimoto K, Ohno T, Yamamoto T, Kanematsu N, Kodera Y, Hasegawa T, Araki F, Doi K, Kawamura S. [The Know-how Useful for Publication of Your Article in RPT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2019; 74:1197-1206. [PMID: 30344217 DOI: 10.6009/jjrt.2018_jsrt_74.10.1197] [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: 11/11/2022]
Affiliation(s)
| | - Hideo Nose
- National Defense Medical College Hospital
| | | | | | | | - Nobuyuki Kanematsu
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology
| | | | | | | | - Kunio Doi
- Editor-in-Chief of the RPT, The University of Chicago, and Gunma Prefectural College of Health Sciences
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46
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Nakao KK, Kido A, Imai T, Abiko K, Fujimoto K, Horie A, Minamiguchi S, Tanaka S, Mandai M, Togashi K. Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer. Clin Radiol 2019; 74:326.e1-326.e8. [PMID: 30771995 DOI: 10.1016/j.crad.2018.11.014] [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: 08/16/2018] [Accepted: 11/16/2018] [Indexed: 11/28/2022]
Abstract
AIM To optimise cross-sectional chest imaging usage by identifying frequency and risk factors associated with thoracic metastases in cervical cancer patients after initial definitive treatment. MATERIALS AND METHODS This study, conducted during 2004-2015, examined 361 consecutive patients with histopathologically proven cervical carcinoma with at least 1 year of follow-up. Electronic medical records and all available imaging modes were used to record and assess patient and tumour characteristics and timing of thoracic metastases. Associations with these characteristics and thoracic metastases were assessed using univariate and multivariable Cox proportional hazards modelling. RESULTS Of the 361 patients, 31 developed thoracic metastases. Multivariate regression results showed that adeno/adenosquamous carcinomas (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.06 to 5.72), other histology (HR, 5.61; 95% CI, 1.81 to 17.42), high International Federation of Gynaecology and Obstetrics (FIGO) stage (HR, 2.84; 95% CI, 1.09 to 7.37), and presence of initial intra-abdominal lymph node metastases (HR, 2.46; 95% CI, 1.02 to 5.90) were associated significantly and independently with thoracic metastases. The second analysis among the subgroup of surgical treatment identified intermediate-high risk classification of recurrence (HR, 5.12; 95% CI, 1.14 to 22.94), high FIGO stage (HR, 2.73; 95% CI, 1.05 to 7.13), and other histology (HR, 11.51; 95% CI, 3.66 to 36.19) as independent predictors of thoracic metastases. Two of the 361 and 2/313 patients with thoracic metastases who did not correspond to the conditions above were in the respective evaluation groups. CONCLUSION Assessment of negative prognostic factors for thoracic metastases might contribute to reduced need for chest cross-sectional chest computed tomography examinations.
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Affiliation(s)
- K K Nakao
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - A Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - T Imai
- Department of Clinical Biostatistics, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - K Abiko
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - K Fujimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - A Horie
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - S Minamiguchi
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - S Tanaka
- Department of Clinical Biostatistics, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - M Mandai
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - K Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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47
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Nakai Y, Tanaka N, Asakawa I, Miyake M, Anai S, Morizawa Y, Owari T, Fujii T, Hasegawa M, Fujimoto K. Assessment of the Prostate-Specific Antigen Bounce in Patients Treated with 12⁵I-Brachytherapy for Prostate Cancer and Its Correlation with Testosterone. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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48
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Morita K, Fujii T, Shimada K, Itami H, Hatakeyama K, Miyake M, Fujimoto K, Ohbayashi C. NACC1 as a target of microRNA-331-3p regulates cell proliferation in urothelial carcinoma cells. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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49
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Ito T, Matsui F, Fujimoto K, Matsuyama S, Yazawa K, Matsumoto F, Shimada K. Acquired undescended testis and possibly associated testicular torsion in children with cerebral palsy or neuromuscular disease. J Pediatr Urol 2018; 14:402-406. [PMID: 30219308 DOI: 10.1016/j.jpurol.2018.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Torsion of an undescended testis (UDT) associated with cerebral palsy (CP) and neuromuscular disease (NMD) is an uncommon condition that is not well recognized by primary care physicians or healthcare providers. OBJECTIVE The objective of this study was to highlight the clinical importance of torsion of a UDT in children with CP and NMD. MATERIALS AND METHODS Eleven children with testicular torsion of a UDT operated on at the study institute between 1991 and 2015 were identified. The records of seven children (63.6%) associated with CP or NMD were retrospectively reviewed. Clinical findings of testicular torsion were assessed along with the treatment outcome and testicular salvageability. RESULTS All seven children were not identified with a UDT by public health checkup for infant and young children. No children with CP or NMD had torsion of a descended testis during the present study period. Median age at surgery was 15 years (range, 1-20 years). The testis location was at the external inguinal ring in five patients, in the inguinal canal in one, and in the superficial inguinal pouch in one. Of the contralateral testes, four were a UDT, one was a retractile testis, and two were descended testes. Orchiectomy was performed in six patients (85.7%). In the remaining patients, the testis was preserved but became atrophic. DISCUSSION This study demonstrated that children with CP or NMD may be affected with torsion of a UDT with peak at around puberty with the poor salvage rate, even if the testes appear descended in infancy and young children. Shortcomings of this study were the retrospective design and a small series of children undergoing surgery for torsion of a UDT. CONCLUSION Pediatric urologists need to educate primary care physicians and healthcare providers in the recognition of acquired UDTs and possibly associated testicular torsion in children with CP and NMD. Genital examination should be continued regularly until adolescence in these children to detect acquired UDT. These children should be referred to pediatric urologists to promote surgery as soon as the diagnosis of acquired UDT is carried out. It is believed that it is perhaps the best approach to prevent loss of the testis in children with CP and NMD.
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Affiliation(s)
- T Ito
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - F Matsui
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan.
| | - K Fujimoto
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - S Matsuyama
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - K Yazawa
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - F Matsumoto
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - K Shimada
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
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50
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Sakamoto K, Tsujita K, Kaikita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Yasuda S, Suwa S, Fujimoto K, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M. 5072Obesity paradox outcomes after acute myocardial infarction in Japanese is due to optimal medical therapy in overweight patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5072] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Sakamoto
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Kaikita
- Kumamoto University Hospital, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - K Nakao
- Saiseikai Kumamoto Hospital, Division of Cardiology, Kumamoto, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiovascular Center, Yokohama, Japan
| | - J Ako
- Kitasato University, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Izunokuni, Japan
| | - K Fujimoto
- National Hospital Organization Kumamaoto Medical Center, Department of Cardiology, Kumamoto, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Ishihara
- Hyogo College of Medicine, Division of Coronary Artery Disease, Nishinomiya, Japan
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