Researcher Profile and Settings

Affiliation

• Faculty of Health Sciences　Health Sciences　Biomedical Science and Engineering

Job Title

• Professor

URL

https://kaken.nii.ac.jp/d/r/10399868.ja.html

J-Global ID

• 201501009192801225

Research Interests

• 校正   超音波   関節リウマチ   放射線治療   動体追跡放射線治療   画像誘導放射線治療   電子線トラック解析   核医学診断技術   非線形最適化   モンテカルロ法   体幹部定位放射線照射   プラスチック検出器   炎症性発癌   スポットスキャン   低酸素細胞   量子線シミュレーション   

Research Areas

• Life sciences / Allergies and connective tissue disease
• Life sciences / Radiology

Educational Organization

•  Bachelor's degree program　Departments of Health Sciences, School of Medicine
•  Master's degree program　Graduate School of Health Sciences
•  Doctoral (PhD) degree program　Graduate School of Health Sciences

Academic & Professional Experience

• 2012 - 2013 Hokkaido University

Research Activities

Published Papers

• A deep registration method for accurate quantification of joint space narrowing progression in rheumatoid arthritis.

  Haolin Wang, Yafei Ou, Wanxuan Fang, Prasoon Ambalathankandy, Naoto Goto, Gen Ota, Taichi Okino, Jun Fukae, Kenneth Sutherland, Masayuki Ikebe, Tamotsu Kamishima

  Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society 108 102273 - 102273 2023/09 

  Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that leads to progressive articular destruction and severe disability. Joint space narrowing (JSN) has been regarded as an important indicator for RA progression and has received significant attention. Radiology plays a crucial role in the diagnosis and monitoring of RA through the assessment of joint space. A new framework for monitoring joint space by quantifying joint space narrowing (JSN) progression through image registration in radiographic images has emerged as a promising research direction. This framework offers the advantage of high accuracy; however, challenges still exist in reducing mismatches and improving reliability. In this work, we utilize a deep intra-subject rigid registration network to automatically quantify JSN progression in the early stages of RA. In our experiments, the mean-square error of the Euclidean distance between the moving and fixed images was 0.0031, the standard deviation was 0.0661 mm and the mismatching rate was 0.48%. Our method achieves sub-pixel level accuracy, surpassing manual measurements significantly. The proposed method is robust to noise, rotation and scaling of joints. Moreover, it provides misalignment visualization, which can assist radiologists and rheumatologists in assessing the reliability of quantification, exhibiting potential for future clinical applications. As a result, we are optimistic that our proposed method will make a significant contribution to the automatic quantification of JSN progression in RA. Code is available at https://github.com/pokeblow/Deep-Registration-QJSN-Finger.git.
• A deep registration method for accurate quantification of joint space narrowing progression in rheumatoid arthritis

  Haolin Wang, Yafei Ou, Wanxuan Fang, Prasoon Ambalathankandy, Naoto Goto, Gen Ota, Taichi Okino, Jun Fukae, Kenneth Sutherland, Masayuki Ikebe, Tamotsu Kamishima

  Computerized Medical Imaging and Graphics 108 102273 - 102273 0895-6111 2023/09
• Fully automatic software for detecting radiographic joint space narrowing progression in rheumatoid arthritis: phantom study and comparison with visual assessment

  Taichi Okino, Yafei Ou, Masayuki Ikebe, Kenichi Tamura, Kenneth Sutherland, Jun Fukae, Kazuhide Tanimura, Tamotsu Kamishima

  JAPANESE JOURNAL OF RADIOLOGY 41 (5) 510 - 520 1867-1071 2023/05 

  Purpose We have developed an in-house software equipped with partial image phase-only correlation (PIPOC) which can automatically quantify radiographic joint space narrowing (JSN) progression. The purpose of this study was to evaluate the software in phantom and clinical assessments. Materials and methods In the phantom assessment, the software's performance on radiographic images was compared to the joint space width (JSW) difference using a micrometer as ground truth. A phantom simulating a finger joint was scanned underwater. In the clinical assessment, 15 RA patients were included. The software measured the radiological progression of the finger joints between baseline and the 52nd week. The cases were also evaluated with the Genant-modified Sharp score (GSS), a conventional visual scoring method. We also quantitatively assessed these joints' synovial vascularity (SV) on power Doppler ultrasonography (0, 8, 20 and 52 weeks). Results In the phantom assessment, the PIPOC software could detect changes in JSN with a smallest detectable difference of 0.044 mm at 0.1 mm intervals. In the clinical assessment, the JSW change of the joints with GSS progression detected by the software was significantly greater than those without GSS progression (p = 0.004). The JSW change of joints with positive SV at baseline was significantly higher than those with negative SV (p = 0.024). Conclusion Our in-house software equipped with PIPOC can automatically and quantitatively detect slight radiographic changes of JSW in clinically inactive RA patients.
• Fully automatic software for detecting radiographic joint space narrowing progression in rheumatoid arthritis: phantom study and comparison with visual assessment.

  Taichi Okino, Yafei Ou, Masayuki Ikebe, Kenichi Tamura, Kenneth Sutherland, Jun Fukae, Kazuhide Tanimura, Tamotsu Kamishima

  Japanese journal of radiology 41 (5) 510 - 520 2023/05 

  PURPOSE: We have developed an in-house software equipped with partial image phase-only correlation (PIPOC) which can automatically quantify radiographic joint space narrowing (JSN) progression. The purpose of this study was to evaluate the software in phantom and clinical assessments. MATERIALS AND METHODS: In the phantom assessment, the software's performance on radiographic images was compared to the joint space width (JSW) difference using a micrometer as ground truth. A phantom simulating a finger joint was scanned underwater. In the clinical assessment, 15 RA patients were included. The software measured the radiological progression of the finger joints between baseline and the 52nd week. The cases were also evaluated with the Genant-modified Sharp score (GSS), a conventional visual scoring method. We also quantitatively assessed these joints' synovial vascularity (SV) on power Doppler ultrasonography (0, 8, 20 and 52 weeks). RESULTS: In the phantom assessment, the PIPOC software could detect changes in JSN with a smallest detectable difference of 0.044 mm at 0.1 mm intervals. In the clinical assessment, the JSW change of the joints with GSS progression detected by the software was significantly greater than those without GSS progression (p = 0.004). The JSW change of joints with positive SV at baseline was significantly higher than those with negative SV (p = 0.024). CONCLUSION: Our in-house software equipped with PIPOC can automatically and quantitatively detect slight radiographic changes of JSW in clinically inactive RA patients.
• Automatic Quantification of Enhancing Pannus of the Rheumatoid Hand using Machine Learning in DCE-MRI(タイトル和訳中)

  Fang Wanxuan, Mao Yijun, An Yujie, Sugimori Hiroyuki, Kiuch Shinji, Kamishima Tamotsu

  日本医学放射線学会学術集会抄録集 82回 S194 - S194 0048-0428 2023/03
• Rheumatoid Arthritis Synovitis Segmentation Based on Unsupervised Learning and Time-intensity Curve Signal Data on Dynamic Contrast Enhaced MRI(タイトル和訳中)

  Mao Yijun, Fang Wanxuan, An Yujie, Sugimori Hiroyuki, Kiuch Shinji, Kamishima Tamotsu

  日本放射線技術学会総会学術大会予稿集 79回 322 - 322 1884-7846 2023/03
• A Sub-Pixel Accurate Quantification of Joint Space Narrowing Progression in Rheumatoid Arthritis

  Yafei Ou, Prasoon Ambalathankandy, Ryunosuke Furuya, Seiya Kawada, Tianyu Zeng, Yujie An, Tamotsu Kamishima, Kenichi Tamura, Masayuki Ikebe

  IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS 27 (1) 53 - 64 2168-2194 2023/01 

  Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects peripheral synovial joints, like fingers, wrists and feet. Radiology plays a critical role in the diagnosis and monitoring of RA. Limited by the current spatial resolution of radiographic imaging, joint space narrowing (JSN) progression of RA for the same reason above can be less than one pixel per year with universal spatial resolution. Insensitive monitoring of JSN can hinder the radiologist/rheumatologist from making a proper and timely clinical judgment. In this paper, we propose a novel and sensitive method that we call partial image phase-only correlation which aims to automatically quantify JSN progression in the early RA. The majority of the current literature utilizes the mean error, root-mean-square deviation and standard deviation to report the accuracy at pixel level. Our work measures JSN progression between a baseline and its follow-up finger joint images by using the phase spectrum in the frequency domain. Using this study, the mean error can be reduced to 0.0130 mm when applied to phantom radiographs with ground truth, and 0.0519 mm standard deviation for clinical radiography. With the sub-pixel accuracy far beyond usual manual measurements, we are optimistic that the proposed work is a promising scheme for automatically quantifying JSN progression.
• A Sub-Pixel Accurate Quantification of Joint Space Narrowing Progression in Rheumatoid Arthritis.

  Yafei Ou, Prasoon Ambalathankandy, Ryunosuke Furuya, Seiya Kawada, Tianyu Zeng, Yujie An, Tamotsu Kamishima, Kenichi Tamura, Masayuki Ikebe

  IEEE journal of biomedical and health informatics 27 (1) 53 - 64 2023/01 

  Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects peripheral synovial joints, like fingers, wrists and feet. Radiology plays a critical role in the diagnosis and monitoring of RA. Limited by the current spatial resolution of radiographic imaging, joint space narrowing (JSN) progression of RA for the same reason above can be less than one pixel per year with universal spatial resolution. Insensitive monitoring of JSN can hinder the radiologist/rheumatologist from making a proper and timely clinical judgment. In this paper, we propose a novel and sensitive method that we call partial image phase-only correlation which aims to automatically quantify JSN progression in the early RA. The majority of the current literature utilizes the mean error, root-mean-square deviation and standard deviation to report the accuracy at pixel level. Our work measures JSN progression between a baseline and its follow-up finger joint images by using the phase spectrum in the frequency domain. Using this study, the mean error can be reduced to 0.0130 mm when applied to phantom radiographs with ground truth, and 0.0519 mm standard deviation for clinical radiography. With the sub-pixel accuracy far beyond usual manual measurements, we are optimistic that the proposed work is a promising scheme for automatically quantifying JSN progression.
• 関節リウマチ患者の滑膜炎を自動で抽出するソフトウエアの開発 手のダイナミックMRIを用いた検討(Toward Development of Software Application that can Automatically Demonstrate the Distribution of Pannus in Rheumatoid Hand using Dynamic MRI Dataset)

  Fang Wanxuan, An Yujie, Sugimori Hiroyuki, Kiuchi Shinji, Kamishima Tamotsu

  日本医学放射線学会学術集会抄録集 81回 S210 - S210 0048-0428 2022/03
• Feasibility of an Ultrasound-Based Method for Measuring Talar Displacement during the Anterior Drawer Stress Test Using a Telos Device: A Preliminary Study.

  Kaori Tsutsumi, Utayo Nakaya, Yuta Koshino, Mari Tateno, Kazuhisa Matsumoto, Mai Tanaka, Mika Yokoyama, Tatsunori Horie, Mina Samukawa, Tamotsu Kamishima, Harukazu Tohyama

  International journal of environmental research and public health 19 (4) 2022/02/18 [Refereed]
   

  This study was conducted to measured talar displacement using ultrasound during an anterior drawer test (ADT) with a Telos device. Five adults (3 men and 2 women; 8 ankles; mean age: 23.2 y) with a history of ankle sprain and eight adults (5 men and 3 women; 16 ankles; mean age: 22.1 y) without a history of ankle sprain were recruited into a history of ankle sprain (HAS) and a control group, respectively. Talar displacement was observed in response to load forces applied by a Telos device during the ultrasound stress imaging test. The ultrasound probe was placed 5 mm inside from the center of the Achilles tendon on the posterior ankle along the direction of the major axis. The inter-rater reliability for the present method was classified as good and excellent (ICC(2,2) = 0.858 and 0.957 at 120 N and 150 N, respectively) in the control group and excellent (ICC(2,2) = 0.940 and 0.905 at 120 N and 150 N, respectively) in the HAS group, according to specific intraclass correlation coefficient values. We found that talar displacement during the ADT was lower in the HAS group than in the control group. Analysis of the receiver operating characteristic curve revealed that the quantitative ultrasound-based ADT using a Telos device was superior to the X-ray-based test in detecting reduced ankle joint mobility during the ADT (area under the curve of 0.905 and 0.726 at a force of 150 N using ultrasound-based and X-ray-based tests, respectively). Further investigation is needed; nevertheless, this preliminary study suggests that the ultrasound-based quantitative ADT using a Telos device might detect talar displacement more sensitively than the conventional stress X-ray.
• 肝臓のMR弾性造影に関する半自動化定量ソフトウエアの結果の妥当性と再現性に関する研究(Validation and Reproducibility Study on Semi-automatic Quantification Software for MR Elastography of the Liver)

  Katsuumi Yuri, Kamishima Tamotsu, Sugimori Hiroyuki, Shimamura Tsuyoshi, Kawamura Norio, Takeda Hiroshi

  日本放射線技術学会総会学術大会予稿集 77回 248 - 249 1884-7846 2021/03
• Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring.

  Aimi Taguchi, Shun Shishido, Yafei Ou, Masayuki Ikebe, Tianyu Zeng, Wanxuan Fang, Koichi Murakami, Toshikazu Ueda, Nobutoshi Yasojima, Keitaro Sato, Kenichi Tamura, Kenneth Sutherland, Nozomi Oki, Ko Chiba, Kazuyuki Minowa, Masataka Uetani, Tamotsu Kamishima

  Journal of digital imaging 34 (1) 96 - 104 2020/12/02 

  Several visual scoring methods are currently used to assess progression of rheumatoid arthritis (RA) on radiography. However, they are limited by its subjectivity and insufficient sensitivity. We have developed an original measurement system which uses a technique called phase-only correlation (POC). The purpose of this study is to validate the system by using a phantom simulating the joint of RA patients.A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. The phantom was scanned with radiography, 320 multi detector CT (MDCT), high-resolution peripheral quantitative CT (HR-pQCT), cone beam CT (CBCT), and tomosynthesis. The width was adjusted to the average size of a women's metacarpophalangeal joint, from 1.2 to 2.2 mm with increments of 0.1 mm and 0.01 mm. Radiographical images were analyzed by the POC-based system and manual method, and images from various tomographical modalities were measured via the automatic margin detection method. Correlation coefficients between true JSW difference and measured JSW difference were all strong at 0.1 mm intervals with radiography (POC-based system and manual method), CBCT, 320MDCT, HR-pQCT, and tomosynthesis. At 0.01 mm intervals, radiography (POC-based system), 320MDCT, and HR-pQCT had strong correlations, while radiography (manual method) and CBCT had low correlations, and tomosynthesis had no statistically significant correlation. The smallest detectable changes for radiography (POC-based system), radiography (manual method), 320MDCT, HR-pQCT, CBCT, and tomosynthesis were 0.020 mm, 0.041 mm, 0.076 mm, 0.077 mm, 0.057 mm, and 0.087 mm, respectively. We conclude that radiography analyzed with the POC-based system might sensitively detect minute joint space changes of the finger joint.
• Validation of Fully Automatic Quantitative Software for Finger Joint Space Narrowing Progression for Rheumatoid Arthritis Patients.

  Chiaki Narisawa, Kenneth Sutherland, Yutong Lu, Akira Furusaki, Akira Sagawa, Tamotsu Kamishima

  Journal of digital imaging 33 (6) 1387 - 1392 2020/12 

  In rheumatoid arthritis (RA), the radiographic progression of joint space narrowing (JSN) is evaluated using visual assessments. However, those methods are complicated and time-consuming. We developed an automatic system that can detect joint locations and compute the joint space difference index (JSDI), which was defined as the chronological change in JSN between two radiographs. The purpose of this study was to establish the validity of the software that automatically evaluates the temporal change of JSN. This study consisted of 39 patients with RA. All patients were treated with tocilizumab and underwent hand radiography (left and right hand separately) at 0, 6, and 12 months. The JSN was evaluated using mTSS (modified Total Sharp Score) by one musculoskeletal radiologist as well as our automatic system. Software measurement showed that JSDI between 0 and 12 months was significantly higher than that between 0 and 6 months (p < 0.01). While, there was no significant difference in mTSS between 0, 6, and 12 months. The group with higher disease activity at 0 months had significantly higher JSDI between 0 and 6 months than that with lower disease activity (p = 0.02). The automatic software can evaluate JSN progression of RA patients in the finger joint on X-ray.
• Fibroma of tendon sheath of the hand in a 3-year-old boy: a case report.

  Hiroki Shibayama, Yuichiro Matsui, Daisuke Kawamura, Atsushi Urita, Chikako Ishii, Tamotsu Kamishima, Mutsumi Nishida, Ai Shimizu, Norimasa Iwasaki

  BMC musculoskeletal disorders 21 (1) 732 - 732 2020/11/10 

  BACKGROUND: Fibroma of tendon sheath (FTS) is a rare benign soft tissue tumor that often occurs in the upper extremities. It manifests as a slow-growing mass, often without tenderness or spontaneous pain. FTS occurs most commonly in people aged 20-40 years and is extremely rare in young children. Because FTS presents with atypical physical and imaging findings, it might be misdiagnosed as another soft tissue tumor such as a ganglion cyst or tenosynovial giant cell tumor (TSGCT). Although marginal resection is usually performed, a high rate of local recurrence is reported. CASE PRESENTATION: A boy aged 3 years and 1 month visited our outpatient clinic with a complaint of a mass of the left hand. An elastic hard mass approximately 20 mm in diameter could be palpated on the volar side of his left little finger. This mass was initially diagnosed as a ganglion cyst at another hospital. Ultrasonography revealed a well-circumscribed hypoechoic mass with internal heterogeneity on the flexor tendon. On magnetic resonance imaging (MRI), the mass showed iso signal intensity to muscle on T1-weighted images, and homogeneously low signal intensity to muscle on T2-weighted images. The mass was peripherally enhanced after contrast administration. FTS was initially suspected as the diagnosis on the basis of these imaging features. Because of the limited range of motion of his little finger, surgery was performed when he was 4 years old. Histopathological findings indicated the mass was well-circumscribed and contained scattered spindle cells embedded in a prominent collagenous matrix. The spindle cells contained elongated and cytologically bland nuclei with a fine chromatin pattern. Nuclear pleomorphism and multinucleated giant cells were not observed. On the basis of these findings, we made a diagnosis of FTS. One year after surgery, no signs of local recurrence were observed. CONCLUSIONS: We experienced an extremely rare case of FTS in the hand of a 3-year-old child. We especially recommend ultrasonography for hand tumors of young children to diagnose or eliminate ganglion cysts. MRI helped differentially diagnose FTS from TSGCT. Although marginal resection can be performed as a treatment, great care should be taken postoperatively because FTS has a high possibility of local recurrence.
• Processes that enable public health professionals to organize preventive care support groups.

  Miki Oichi, Tamotsu Kamishima, Michiyo Hirano

  Public health nursing (Boston, Mass.) 37 (6) 880 - 888 2020/11 

  OBJECTIVES: This study examines the structure of the process that public health professionals (PHPs) use to organize preventive care groups for older adults and the elements that strengthen this process. DESIGN AND SAMPLE: The study was conducted using a quantitative descriptive design. Anonymous self-administered questionnaires were distributed by mail to 919 PHPs, including nurses and social workers employed by local governments in a Japanese prefecture, who facilitated recreational groups for older adults for the purposes of preventive care. Measures Items related to the process and the awareness of support were based on previous research. The process structure was examined using exploratory factor analysis, while multiple logistic regression analysis was used to study strengthening elements. RESULTS: The process yielded six factors (encouraging clarity with respect to the group's activity policy; creating connections with other resources; fostering independence; encouraging activity evaluation; creating relationships with group members; understanding the strengths and weaknesses of communities and individuals) with a total of 23 items. Two of three indicators of awareness of support were significantly related to the process. CONCLUSIONS: Understanding the importance of strengthening elements might improve support groups for older adults.
• Fully automatic quantitative software for assessment of minute finger joint space narrowing progression on radiographs: evaluation in rheumatoid arthritis patients with long-term sustained clinical low disease activity.

  Kazuki Kato, Kenneth Sutherland, Yuki Tanaka, Masaru Kato, Jun Fukae, Kazuhide Tanimura, Tamotsu Kamishima

  Japanese journal of radiology 38 (10) 979 - 986 2020/10 

  PURPOSE: Rheumatoid arthritis (RA) causes joint space narrowing (JSN) as a form of joint destruction. We developed an automatic system that can detect joint locations and compute the joint space difference index (JSDI), which was defined as the chronological change in JSN between two radiographs. This study aims to evaluate the application of "machine vision" for radiographic image of the finger joints. MATERIALS AND METHODS: Fifteen RA patients with long-term sustained clinical low disease activity were recruited. All patients underwent hand radiography and power Doppler ultrasonography (PDUS). The JSN was evaluated using the Genant-modified Sharp scoring (GSS) method and the automatic system. Synovial vascularity (SV) was assessed quantitatively using ultrasonography. RESULTS: There were no significant differences in the JSDI between the joints with JSN and those without JSN on GSS (p = 0.052). The JSDI of the joints with SV was significantly higher than those without SV (p = 0.043). The JSDI of the no therapeutic response group was significantly higher than those of the response group (p < 0.001). CONCLUSION: Our software can automatically evaluate temporal changes of JSN, which might free rheumatologists / radiologists from the burden of scoring hand radiography.
• Non-tuberculosis Mycobacterium Tenosynovitis with Rice Bodies in a Patient with Systemic Lupus Erythematosus.

  Yuichiro Fujieda, Keita Ninagawa, Yuichiro Matsui, Michihiro Kono, Tamotsu Kamishima, Norimasa Iwasaki, Tatsuya Atsumi

  Internal medicine (Tokyo, Japan) 59 (18) 2317 - 2320 2020/09/15 

  Infectious disease with various presentations in systemic lupus erythematosus often resembles lupus flare. A 37-year-old woman presented with a swollen left index finger that had not resolved, despite 7 years of immunosuppressive treatment. MRI showed rice-body formation in the flexor tendon sheath and tenosynovectomy demonstrated chronic synovitis with epithelioid granuloma. A mycobacterial culture confirmed invasive mycobacterial tenosynovitis due to Mycobacterium chelonae. The patient was treated with moxifloxacin and clarithromycin and completely recovered.
• Relationship between Upper Body Posture Angle and Vertebral Body Posture Angle in Lateral Flexion and Rotation Posture

  Yoshio TSUCHIYA, Takayuki TANAKA, Tamotsu KAMISHIMA

  Advanced Biomedical Engineering 9 181 - 188 2020/09 [Refereed][Not invited]
   

  Lumbar loading causes increased intervertebral pressure and is an important factor in low back pain. However, it is difficult to quantitatively judge the actions that affect lumbar load and the magnitude of lumbar load increase. Low back pain occurs not only in the workplace but also during activities of daily living. Therefore, it is necessary to investigate the factors inducing low back pain by measuring movements in various planes and determining the magnitude of the lumbar load. Accordingly, the lumbar spine should be examined during various movements. Several studies have examined vertebral bodies in the anteflexion posture. However, the relationship between body flexion angle and vertebral body angle during lateral flexion and rotation remains unknown. In this study, we proposed an estimation method for changes in vertebral body angle during lateral flexion and rotation in the lumbosacral region using a wearable sensor system we previously developed. The accuracy of the proposed estimation method was evaluated and demonstrated using X-ray images.
• Editorial for "Clinical Potential of UTE-MRI for Assessing the COVID-19: Patient- and Lesion-Based Comparative Analysis".

  Tamotsu Kamishima, Yujie An, Wanxuan Fang, Yutong Lu

  Journal of magnetic resonance imaging : JMRI 52 (3) 956 - 957 2020/09
• Fluvastatin prevents the development of arthritis in env-pX rats via up-regulation of Rho GTPase-activating protein 12.

  Shun Tanimura, Mutsumi Nishida, Tatsunori Horie, Tamotsu Kamishima, Hitomi Matsumoto, Yutaka Morimura, Yuka Nishibata, Sakiko Masuda, Daigo Nakazawa, Utano Tomaru, Tatsuya Atsumi, Akihiro Ishizu

  Experimental and molecular pathology 115 104454 - 104454 2020/08 

  The pleiotropic effects of statins, including an antiarthritic potential, have been noted. This study aimed to determine the efficacy of statins on rheumatoid arthritis (RA) and clarify how statins affect its pathogenesis. Fluvastatin (500 μg/kg/day) or vehicle was given per os to env-pX rats, which carry the human T-cell leukemia virus type I env-pX gene and spontaneously develop destructive arthritis mimicking RA, for 30 days. Blood sampling and ultrasonography (US) of the ankle joints were conducted on days 0, 10, 20, and 30. On day 30, all rats were euthanized, and the ankle joints were subjected to histological analysis. To clarify how fluvastatin affects the pathogenesis of RA, comprehensive serum exosomal microRNA (miRNA) analysis was performed. Gene expression in the primary culture of synovial fibroblasts derived from arthritic rat and human and non-arthritic rat periarticular tissues was determined quantitatively by real-time reverse transcription-polymerase chain reaction (RT-PCR). As a result, the development of arthritis in env-pX rats was significantly suppressed by fluvastatin, which was evident from the viewpoints of serology, US imaging, and histology. Comprehensive serum exosomal miRNA analysis suggested that the expression of Rho GTPase-activating protein 12 (Arhgap12) was decreased in arthritic env-pX rats but increased with the administration of fluvastatin. Corresponding results were obtained by quantitative RT- PCR using primary culture of synovial fibroblasts. The collective findings suggest that fluvastatin prevents the development of arthritis in env-pX rats via the up-regulation of ARHGAP12. This study suggests that ARHGAP12 can be a possible therapeutic target of RA.
• 肝臓のMRエラストグラフィにおける閾値によるSemi-automatic Quantification Softwareの検証研究(Validation Study on Semi-automatic Quantification Software by Threshold Value for MR Elastography of the Liver)

  Katsuumi Yuri, Kamishima Tamotsu, Sugimori Hiroyuki, Shimamura Tsuyoshi, Kawamura Norio, Takeda Hiroshi

  日本放射線技術学会総会学術大会予稿集 76回 318 - 319 1884-7846 2020/03
• Quick and accurate selection of hand images among radiographs from various body parts using deep learning.

  Kohei Fujiwara, Wanxuan Fang, Taichi Okino, Kenneth Sutherland, Akira Furusaki, Akira Sagawa, Tamotsu Kamishima

  Journal of X-ray science and technology 28 (6) 1199 - 1206 2020 

  BACKGROUND: Although rheumatoid arthritis (RA) causes destruction of articular cartilage, early treatment significantly improves symptoms and delays progression. It is important to detect subtle damage for an early diagnosis. Recent software programs are comparable with the conventional human scoring method regarding detectability of the radiographic progression of RA. Thus, automatic and accurate selection of relevant images (e.g. hand images) among radiographic images of various body parts is necessary for serial analysis on a large scale. OBJECTIVE: In this study we examined whether deep learning can select target images from a large number of stored images retrieved from a picture archiving and communication system (PACS) including miscellaneous body parts of patients. METHODS: We selected 1,047 X-ray images including various body parts and divided them into two groups: 841 images for training and 206 images for testing. The training images were augmented and used to train a convolutional neural network (CNN) consisting of 4 convolution layers, 2 pooling layers and 2 fully connected layers. After training, we created software to classify the test images and examined the accuracy. RESULTS: The image extraction accuracy was 0.952 and 0.979 for unilateral hand and both hands, respectively. In addition, all 206 test images were perfectly classified into unilateral hand, both hands, and the others. CONCLUSIONS: Deep learning showed promise to enable efficiently automatic selection of target X-ray images of RA patients.
• Computed diffusion-weighted imaging for differentiating synovial proliferation from joint effusion in hand arthritis.

  Yuki Tanaka, Motoshi Fujimori, Koichi Murakami, Hiroyuki Sugimori, Nozomi Oki, Takatoshi Aoki, Tamotsu Kamishima

  Rheumatology international 39 (12) 2111 - 2118 0172-8172 2019/12 [Refereed][Not invited]
   

  The objective of this study is to investigate computed DWI (cDWI) as an alternative method to contrast-enhanced MRI in comparison with directory measured DWI (mDWI) and apparent diffusion coefficient (ADC) for differentiating synovial proliferation from joint effusion. Nine patients suspected with RA (5 women) were included in this study. A radiologist identified region of interest (ROI) based on STIR, and evaluated using a 5-point grading scale of 0 (fluid) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. cDWI was synthesized for b values from 1000 to 2000 at 200 s/mm2 intervals using the combination of b values at mDWI. In addition to ADC values, contrast ratios were calculated using signal intensity for each ROI on the mDWI and cDWI. Visual assessment by a radiologist was conducted between pairs of STIR image and mDWI or cDWI. ROI grades were most significantly correlated with cDWI2000 based on b values of 400-1000 s/mm2 (rs = 0.405, p < 0.01). The area under the curve of cDWI2000 based on b values of 400-1000 s/mm2 (0.762) was larger than that of ADC values (0.570-0.608) when comparing low versus high contrast enhancement grades. Both cDWI1800 (200-1000) and cDWI2000 (400-1000) demonstrated high sensitivity and specificity in visual assessment (84.6% and 66.7%, respectively). The cDWI2000 based on b values of 400-1000 s/mm2 may be useful for noninvasive differentiation of synovial proliferation from joint effusion in hand arthritis.
• Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof-of-concept study.

  Motoshi Fujimori, Koichi Murakami, Hiroyuki Sugimori, Yutong Lu, Kenneth Sutherland, Nozomi Oki, Takatoshi Aoki, Tamotsu Kamishima

  Journal of magnetic resonance imaging : JMRI 50 (4) 1199 - 1206 1053-1807 2019/10 [Refereed][Not invited]
   

  BACKGROUND: Postcontrast-enhanced MRI is currently the reference standard for synovial proliferation in rheumatoid arthritis (RA). However, the technique is somewhat invasive due to the use of gadolinium contrast agents, which may cause severe adverse/side effects. Intravoxel incoherent motion (IVIM) simultaneously permits quantification of perfusion as well as diffusion using a single imaging scan. PURPOSE/HYPOTHESIS: To test the capability of IVIM MRI for noninvasive discrimination of synovial proliferation in hand arthritis. STUDY TYPE: Prospective. SUBJECTS: Seven suspected RA patients (three women and four men; mean age, 61 years; range, 26-74 years). FIELD STRENGTH/SEQUENCE: 3 T/short tau inversion recovery (STIR), IVIM, postcontrast-enhanced MRI. ASSESSMENT: Region of interest (ROI) was identified based on STIR. Contrast-enhanced MRI was evaluated using a 5-point grading scale of 0 (water) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. For each ROI, we calculated the apparent diffusion coefficient (ADC) and IVIM parameters (molecular diffusion coefficient [D], perfusion fraction [f], and perfusion-related diffusion coefficient [D*]). These parameters were subsequently compared with ROI contrast enhancement grades. STATISTICAL TESTS: Spearman's rank correlation test and a receiver operating characteristic (ROC) curve. RESULTS: A total of 90 ROIs of suspected synovial proliferation and/or joint effusion were identified. ROI grades were correlated with ADC and D values (r S = -0.385, P < 0.001, r S = -0.458, P < 0.0001, respectively), but not with the f and D* values (r S = -0.010, P = 0.936, r S = -0.084, P = 0.505, respectively). The area under the curves (AUCs) of D values (0.708-0.888, P = 0.002-0.0002) were slightly larger than those of ADC values (0.692-0.791, P = 0.013-0.001) when comparing low- vs. high-contrast enhancement grades. DATA CONCLUSION: The IVIM parameter D and ADC may be useful for the noninvasive identification of synovial proliferation in hand arthritis. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:1199-1206.
• 肝臓のMR Elastography検査におけるスライス位置の検討

  勝海 友里, 神島 保, 杉森 博行, 嶋村 剛, 川村 典生, 武田 宏司

  日本放射線技術学会雑誌 (公社)日本放射線技術学会 75 (9) 1056 - 1056 0369-4305 2019/09
• Quantitative power Doppler signal assessment in the subchondral bone region of the metacarpophalangeal joint is an effective predictor of radiographic progression in the hand of rheumatoid arthritis: a pilot study.

  Motoshi Fujimori, Tamotsu Kamishima, Akihiro Narita, Mihoko Henmi, Masaru Kato, Kenneth Sutherland, Mutsumi Nishida, Yuki Tanaka, Lu Yutong, Kazuhide Tanimura, Tatsuya Atsumi

  Rheumatology international 39 (8) 1413 - 1421 2019/08 

  Ultrasonography is useful for assessment of synovitis in the hand of rheumatoid arthritis (RA) patients. The aim of this study was to investigate the predictive value of the quantitative power Doppler (PD) signal assessment in the subchondral bone region of the metacarpophalangeal (MCP) joint in patients with RA showing radiographic progression of the hand by comparing with those of previously reported scoring systems. Twenty-two patients (20 women) with RA who underwent power Doppler ultrasonography (PDUS) of the bilateral one to five MCP joints at baseline were included in the study. Radiography of both hands was performed at baseline and at 1 year. PDUS of the synovial space was evaluated according to semi-quantitative scoring (0-3) and quantitative measurement (0-100%). The PD signal in the subchondral bone region was qualitatively (0, 1) and quantitatively (mm2) assessed. The performance of PDUS assessment was compared using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and the risk ratio (RR). As a predictor for radiographic progression, the quantitative PD signal assessment in the subchondral bone region (AUC = 0.842, p < 0.01) was equivalent to quantitative vascularity (AUC = 0.817, p < 0.05) and semi-quantitative scoring (AUC = 0.754, p < 0.05). As for the RR of the PD signal in the subchondral bone region for radiographic progression, the quantitative PD signal assessment was 5.40 (p < 0.01), whereas the qualitative PD signal assessment was 1.60 (p = 0.204). Quantitative PD signal assessment in the subchondral bone region can predict radiographic progression in the hand of RA patients.
• Detection of Increased Vascular Signal in Arthritis-Prone Rats Without Joint Swelling Using Superb Microvascular Imaging Ultrasonography.

  Tatsunori Horie, Mutsumi Nishida, Shun Tanimura, Tamotsu Kamishima, Erika Tamai, Yutaka Morimura, Yuka Nishibata, Sakiko Masuda, Daigo Nakazawa, Utano Tomaru, Tatsuya Atsumi, Akihiro Ishizu

  Ultrasound in medicine & biology 45 (8) 2086 - 2093 0301-5629 2019/08 [Refereed][Not invited]
   

  This study aimed to determine whether ultrasonography (US) can detect increased vascular signal in the synovial tissue before overt synovitis in rheumatoid arthritis (RA). Env-pX rats that spontaneously develop RA-like synovitis were used. Ankle joints of 15 pre-morbid env-pX rats were observed with power Doppler and superb microvascular imaging (SMI) using an ultrahigh-frequency (8-24 MHz) probe. Signal values were counted as the number of pixels. The total number of vessels and vessel area in the synovial tissue were histologically evaluated. Dilated vessels were determined from the mean value of synovial vessels in three wild-type rats. In all env-pX rats, apparent synovial proliferation was not observed. However, vasodilation was evident. Only SMI values were significantly correlated with the number of dilated vessels (r = 0.585, p = 0.022) but not with the total number of vessels. US with SMI using ultrahigh-frequency probe can detect increased vascular signal in the synovial tissue of arthritis-prone rats.
• Detection of Fine Radiographic Progression in Finger Joint Space Narrowing Beyond Human Eyes: Phantom Experiment and Clinical Study with Rheumatoid Arthritis Patients.

  Kazuki Kato, Nobutoshi Yasojima, Kenichi Tamura, Shota Ichikawa, Kenneth Sutherland, Masaru Kato, Jun Fukae, Kazuhide Tanimura, Yuki Tanaka, Taichi Okino, Yutong Lu, Tamotsu Kamishima

  Scientific reports 9 (1) 8526 - 8526 2019/06/12 

  The visual assessment of joint space narrowing (JSN) on radiographs of rheumatoid arthritis (RA) patients such as the Genant-modified Sharp score (GSS) is widely accepted but limited by its subjectivity and insufficient sensitivity. We developed a software application which can assess JSN quantitatively using a temporal subtraction technique for radiographs, in which the chronological change in JSN between two radiographs was defined as the joint space difference index (JSDI). The aim of this study is to prove the superiority of the software in terms of detecting fine radiographic progression in finger JSN over human observers. A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. We compared the smallest detectable changes in JSW between the JSDI and visual assessment using phantom images. In a clinical study, 222 finger joints without interval score change on GSS in 15 RA patients were examined. We compared the JSDI between joints with and without synovial vascularity (SV) on power Doppler ultrasonography during the follow-up period. True JSW difference was correlated with JSDI for JSW differences ranging from 0.10 to 1.00 mm at increments of 0.10 mm (R2 = 0.986 and P < 0.001). Rheumatologists were difficult to detect JSW difference of 0.30 mm or less. The JSDI of finger joints with SV was significantly higher than those without SV (P = 0.030). The software can detect fine differences in JSW that are visually unrecognizable.
• 軟骨下骨領域におけるパワードプラ血流信号の定量評価 関節破壊の予後予測

  藤森 元嗣, 田中 悠貴, Lu Yutong, 勝海 友里, 中川 紗良, 神島 保, 成田 明宏, 邉見 美穂子, 谷村 一秀, 加藤 将, 渥美 達也, Sutherland Kenneth, 西田 睦

  北海道医学雑誌 北海道医学会 94 (1) 58 - 59 0367-6102 2019/05
• 関節リウマチにおける滑膜増殖評価:IVIM MRI

  藤森元嗣, LU Yutong, 藤原滉平, 村上公一, 杉森博之, 神島保, SUTHERLAND Kenneth, 大木望, 青木隆敏

  北海道医学雑誌 94 (1) 57‐58  0367-6102 2019/05 [Refereed][Not invited]
  
• 肝MRエラストグラフィーの半自動定量化ソフトウェアに関する検証研究(Validation Study on Semi-Automatic Quantification Software for MR Elastography of the Liver)

  Katsuumi Yuri, Kamishima Tamotsu, Sugimori Hiroyuki, Shimamura Tsuyoshi, Kawamura Norio, Takeda Hiroshi

  日本放射線技術学会総会学術大会予稿集 75回 211 - 212 1884-7846 2019/03
• 幼児の手指に発生した腱鞘線維腫(Fibroma of the Tendon Sheath)の1例

  石井 智佳子, 松井 雄一郎, 河村 太介, 瓜田 淳, 新井 隆太, 岩崎 倫政, 神島 保, 岩井 孝仁, 西田 睦, 清水 亜衣

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 61 (137th suppl) 41 - 41 1343-3873 2019
• 全自動解析ソフトウェアによるリウマチ患者の関節裂隙狭小化進行評価

  田中 悠貴, 近藤 麻菜, 市川 翔太, 神島 保, 高橋 英治, 古崎 章, 天崎 吉晴

  北海道医学雑誌 北海道医学会 93 (2) 123 - 123 0367-6102 2018/11
• 関節リウマチの関節破壊進行予測におけるパワードプラ超音波検査の定量的評価の有用性

  瀬野 結実香, 勝海 友里, 藤森 元嗣, 堀江 達則, 西田 睦, 神島 保, 加藤 將, 保田 晋助, 渥美 達也

  北海道医学雑誌 北海道医学会 93 (2) 123 - 123 0367-6102 2018/11
• Active synovitis in the presence of osteitis predicts residual synovitis in patients with rheumatoid arthritis with a clinical response to treatment.

  Jun Fukae, Kazuhide Tanimura, Masato Isobe, Akemi Kitano, Mihoko Henmi, Maria Nakai, Yuko Aoki, Fumihiko Sakamoto, Akihiro Narita, Takeya Ito, Akio Mitsuzaki, Megumi Matsuhashi, Masato Shimizu, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  International journal of rheumatic diseases 21 (10) 1809 - 1814 1756-1841 2018/10 [Refereed][Not invited]
   

  AIM: To clarify the relationship between active synovitis/osteitis and subsequent residual synovitis (R-synovitis) in patients with rheumatoid arthritis (RA). METHODS: Three hundred and twenty finger joints of 16 patients with active RA at baseline (Disease Activity Score with 28 joints - erythrocyte sedimentation rate > 3.2) who subsequently achieved clinical low disease activity or remission afterwards were analyzed. Synovial vascularity (SV) was assessed according to a semi-quantitative ultrasound score (grades 0-3). Active synovitis was defined by SV positivity at baseline. R-synovitis was defined by the presence of grade > 2 SV at the 24th week. Osteitis was detected by magnetic resonance imaging (MRI) at baseline as trabecular bone lesions with water content and indistinct margins. RESULTS: Ultrasonography detected active synovitis in 116 joints at baseline. Forty-seven joints had R-synovitis at the 24th week. MRI detected osteitis in 12 joints at baseline. The presence of active synovitis with osteitis at baseline was significantly correlated with R-synovitis at the 24th week. CONCLUSIONS: Active synovitis in the presence of osteitis predicted R-synovitis regardless of whether there was a clinical improvement in RA.
• Autologous Osteochondral Mosaicplasty for Centrally and Laterally Located, Advanced Capitellar Osteochondritis Dissecans in Teenage Athletes: Clinical Outcomes, Radiography, and Magnetic Resonance Imaging Findings.

  Tadanao Funakoshi, Daisuke Momma, Yuki Matsui, Tamotsu Kamishima, Yuichiro Matsui, Daisuke Kawamura, Yusuke Nagano, Norimasa Iwasaki

  The American journal of sports medicine 46 (8) 1943 - 1951 0363-5465 2018/07 [Refereed][Not invited]
   

  BACKGROUND: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear. PURPOSE: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months). RESULTS: Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up ( P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation. CONCLUSION: Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.
• Composite assessment of power Doppler ultrasonography and MRI in rheumatoid arthritis: a pilot study of predictive value in radiographic progression after one year.

  Motoshi Fujimori, Tamotsu Kamishima, Masaru Kato, Yumika Seno, Kenneth Sutherland, Hiroyuki Sugimori, Mutsumi Nishida, Tatsuya Atsumi

  The British journal of radiology 91 (1086) 20170748 - 20170748 0007-1285 2018/06 [Refereed][Not invited]
   

  OBJECTIVE: Power Doppler ultrasonography (PDUS) and MRI are independently useful to predict structural damage in patients with rheumatoid arthritis (RA). We hypothesize that there is a complementary relationship between these modalities. The aim of this study is, therefore, to investigate the usefulness of the predictive value of composite assessment of PDUS and contrast-enhanced MRI in radiographic outcomes in patients with RA. METHODS: 20 patients (17 females and 3 males) with RA on disease-modifying antirheumatic drugs underwent PDUS and MRI of both hands at baseline. Radiography of the bilateral hands was performed at baseline and at 1 year. Articular synovitis on PDUS was evaluated according to quantitative measurement. Synovitis, bone marrow edema and bone erosion were scored according to the RA MRI scoring method. The changes of joint space narrowing and bone erosion on radiograph were assessed by the Sharp/van der Heijde method. We applied t-statistics to combine the assessment of quantitative PDUS with semiquantitative MRI. RESULTS: Structural damage progression for radiography was not correlated with any evaluations for MRI, while it showed significant correlation with synovitis on PDUS (rs = 0.597, p = 0.005). The composite assessment of both modalities (synovitis for PDUS and bone marrow edema for MRI) was correlated with structural damage progression on radiograph (rs = 0.792, p < 0.0001). CONCLUSION: Composite assessment of PDUS and MRI may have a stronger predictive value in radiographic progression than PDUS or MRI alone in RA. Advances in knowledge: Composite assessment of PDUS and MRI may be an effective predictor of structural damage in RA.
• Radiographic temporal subtraction analysis can detect finger joint space narrowing progression in rheumatoid arthritis with clinical low disease activity.

  Taichi Okino, Tamotsu Kamishima, Kenneth Lee Sutherland, Jun Fukae, Akihiro Narita, Shota Ichikawa, Kazuhide Tanimura

  Acta radiologica (Stockholm, Sweden : 1987) 59 (4) 460 - 467 1600-0455 2018/04 [Refereed][Not invited]
   

  Background Recent papers suggest that finger joints with positive synovial vascularity (SV) assessed by ultrasonography under clinical low disease activity (CLDA) in rheumatoid arthritis (RA) patients may cause joint space narrowing (JSN) progression. Purpose To investigate the performance of a computer-based method by directly comparing with the conventional scoring method in terms of the detectability of JSN progression in hand radiography of RA patients with CLDA. Material and Methods Fifteen RA patients (13 women, 2 men) with long-term sustained CLDA of >2 years were included. Radiological progression of finger joints was measured or scored using the computer-based method which can detect JSN progression between two radiographic images as the joint space difference index (JSDI), as well as the Genant-modified Sharp score (GSS). We also quantitatively assessed SV of these joints using ultrasonography. Results Out of 270 joints, we targeted 259 finger joints after excluding nine damaged joints (four ankylosis, three complete luxation, and two subluxation) and two improved joints according to the GSS results. The JSDI of finger joints with JSN progression was significantly higher than those without JSN progression ( P = 0.018). The JSDI of finger joints with ultrasonographic SV was significantly higher than those without ultrasonographic SV ( P = 0.004). Progression in JSDI showed stronger associations with ultrasonographic SV than progression in GSS (odds ratio [95% confidence interval]: 7.19 [3.37-15.36] versus 5.84 [2.76-12.33]). Conclusion The computer-based method was comparable to the conventional scoring method regarding the detectability of JSN progression in RA patients with CLDA.
• 超音波とMRIの複合的評価は生物学的疾患修飾性抗リウマチ薬(bDMARDs)を投与中の関節リウマチにおけるX線上の関節破壊の予測能を改善する(Composite Assessment of Ultrasonography and MRI Improves the Prognostic Power of Joint Destruction on Radiograph in Rheumatoid Arthritis on Biological Disease-modifying Antirheumatic Drugs(bDMARDs))

  Fujimori Motoshi, Kamishima Tamotsu, Seno Yumika, Sugimori Hiroyuki, Nishida Mutsumi, Atsumi Tatsuya

  日本放射線技術学会総会学術大会予稿集 74回 231 - 232 1884-7846 2018/03
• リウマチ性疾患の画像2:関節エコーその他 超高周波プローブを用いたSuperb Micro-vascular Imagingによる超音波検査でのラット足関節の早期関節炎診断

  西田 睦, 谷村 瞬, 神島 保, 西端 友香, 益田 紗季子, 中沢 大悟, 外丸 詩野, 渥美 達也, 石津 明洋

  日本リウマチ学会総会・学術集会プログラム・抄録集 (一社)日本リウマチ学会 62回 485 - 485 2018/03
• スタチンの関節炎抑制効果とその機序の解明

  谷村 瞬, 西田 睦, 神島 保, 西端 友香, 益田 紗季子, 中沢 大悟, 外丸 詩野, 渥美 達也, 石津 明洋

  日本リウマチ学会総会・学術集会プログラム・抄録集 (一社)日本リウマチ学会 62回 778 - 778 2018/03
• Quantification of hand synovitis in rheumatoid arthritis: Arterial mask subtraction reinforced with mutual information can improve accuracy of pixel-by-pixel time-intensity curve shape analysis in dynamic MRI.

  Yuto Kobayashi, Tamotsu Kamishima, Hiroyuki Sugimori, Shota Ichikawa, Atsushi Noguchi, Michihito Kono, Toshitake Iiyama, Kenneth Sutherland, Tatsuya Atsumi

  Journal of magnetic resonance imaging : JMRI 48 (3) 687 - 694 1053-1807 2018/03/01 [Refereed][Not invited]
   

  BACKGROUND: Synovitis, which is a hallmark of rheumatoid arthritis (RA), needs to be precisely quantified to determine the treatment plan. Time-intensity curve (TIC) shape analysis is an objective assessment method for characterizing the pixels as artery, inflamed synovium, or other tissues using dynamic contrast-enhanced MRI (DCE-MRI). PURPOSE/HYPOTHESIS: To assess the feasibility of our original arterial mask subtraction method (AMSM) with mutual information (MI) for quantification of synovitis in RA. STUDY TYPE: Prospective study. SUBJECTS: Ten RA patients (nine women and one man; mean age, 56.8 years; range, 38-67 years). FIELD STRENGTH/SEQUENCE: 3T/DCE-MRI. ASSESSMENT: After optimization of TIC shape analysis to the hand region, a combination of TIC shape analysis and AMSM was applied to synovial quantification. The MI between pre- and postcontrast images was utilized to determine the arterial mask phase objectively, which was compared with human subjective selection. The volume of objectively measured synovitis by software was compared with that of manual outlining by an experienced radiologist. Simple TIC shape analysis and TIC shape analysis combined with AMSM were compared in slices without synovitis according to subjective evaluation. STATISTICAL TESTS: Pearson's correlation coefficient, paired t-test and intraclass correlation coefficient (ICC). RESULTS: TIC shape analysis was successfully optimized in the hand region with a correlation coefficient of 0.725 (P < 0.01) with the results of manual assessment regarded as ground truth. Objective selection utilizing MI had substantial agreement (ICC = 0.734) with subjective selection. Correlation of synovial volumetry in combination with TIC shape analysis and AMSM with manual assessment was excellent (r = 0.922, P < 0.01). In addition, negative predictive ability in slices without synovitis pixels was significantly increased (P < 0.01). DATA CONCLUSIONS: The combination of TIC shape analysis and image subtraction reinforced with MI can accurately quantify synovitis of RA in the hand by eliminating arterial pixels. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
• Longitudinal CT study of sarcopenia due to hepatic failure after living donor liver transplantation.

  Takahiro Onuma, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda

  Quantitative imaging in medicine and surgery 8 (1) 25 - 31 2223-4306 2018/02 [Refereed][Not invited]
   

  Background: The quantity and quality of skeletal muscle have been observed to be closely related with post-transplantation mortality in patients undergoing living donor liver transplantation (LDLT). However, the effect of LDLT on skeletal muscle has not been thoroughly investigated. The aim of this study was to investigate the change of trunk muscle mass and adiposity in recipients of LDLT. Methods: The study population included LDLT recipients at Hokkaido University Hospital who underwent pre- and post-operative computed tomography (CT) scans (31 recipients; 14 males, and 17 females). The cross-sectional area of the dorsal muscle group at the 12th thoracic vertebra (Th12) was measured with the dorsal muscle group mass index (DMGMI), while the psoas muscle at the upper border of 4th lumber vertebra (L4) was measured with the psoas muscle mass index (PMI). Muscle adiposity of the dorsal muscle group was also measured with the intramuscular adipose tissue content (IMAC). For these data, the correlation between pre-operative values and follow-up changes (post-operative values minus pre-operative values) were analyzed. Each sex was evaluated separately. Results: A statistically significant correlation was detected between pre-operative values and follow-up differences in DMGMI for both sexes (male: r=-0.675, P=0.008; female: r=-0.687, P=0.002) and in PMI for both sexes (males: r=-0.739, P=0.003; females: r=-0.641, P=0.006). The correlation of pre-operative values and follow-up differences for IMAC was not statistically significant with r=0.132 (P=0.700) and r=-0.498 (P=0.071) for males and females, respectively. Conclusions: Improvement of sarcopenia in recipients of LDLT can be demonstrated regardless of sex using volumetric CT.
• Quantitative knee cartilage measurement at MR imaging of patients with anterior cruciate ligament tear.

  Kazuki Kato, Tamotsu Kamishima, Eiji Kondo, Tomohiro Onodera, Shota Ichikawa

  Radiological physics and technology 10 (4) 431 - 438 1865-0341 2017/12 [Refereed][Not invited]
   

  In previous studies, numerous approaches were proposed that assess knee cartilage volume quantitatively using 3D magnetic resonance (MR) imaging. However, the clinical use of these approaches is limited because 3D MR is prone to metal artifacts in postoperative cases. Our purpose in this study was to validate a method for knee cartilage volume quantification using conventional MR imaging in patients who underwent anterior cruciate ligament (ACL) reconstruction surgery. The study included 16 patients who underwent MR imaging before and 1 year after ACL reconstruction surgery. Knee cartilage volumes were measured by our computer-based method with the use of T1-weighted sagittal images. We classified the cartilage into eight regions and made comparisons between preoperative and postoperative cartilage volumes in each region. There was a significant difference between preoperative and postoperative cartilage volumes with regard to medial posterior weight-bearing, medial posterior, lateral posterior weight-bearing, and lateral posterior portions (p = 0.006, 0.023, 0.017 and 0.002, respectively). These results were consistent with the previous studies showing that knee cartilage loss occurs frequently in these portions due to an anterior subluxation of the tibia accompanied by ACL tear. With our method, knee cartilage volumes could be measured quantitatively with conventional MR imaging in patients who underwent ACL reconstruction surgery.
• Effectiveness of whole-body magnetic resonance imaging for the efficacy of biologic anti-rheumatic drugs in patients with rheumatoid arthritis: A retrospective pilot study.

  Michihito Kono, Tamotsu Kamishima, Shinsuke Yasuda, Keita Sakamoto, Sawako Abe, Atsushi Noguchi, Toshiyuki Watanabe, Yuka Shimizu, Kenji Oku, Toshiyuki Bohgaki, Olga Amengual, Tetsuya Horita, Tatsuya Atsumi

  Modern rheumatology 27 (6) 953 - 960 1439-7595 2017/11 [Refereed][Not invited]
   

  OBJECTIVES: To evaluate the scoring of whole-body magnetic resonance imaging (WBMRI) for efficacy assessment in rheumatoid arthritis (RA) patients receiving biological disease-modifying anti-rheumatic drugs (bDMARDs). METHODS: Thirty consecutive RA patients receiving bDMARDs were included in this retrospective study. Contrast WBMRI was performed before and 1 year after bDMARDs initiation. RESULTS: At baseline, mean age was 57.1 years and mean disease duration was 3.0 years. Median disease activity score in 28 joints improved from 5.1 to 2.1. Treatment with bDMARDs improved mean whole-body synovitis score from 31.2 to 23.2 and median whole-body bone-edema score from 11 to 3. Whole-body bone-erosion score improved in seven patients and deteriorated in 17 patients. Logistic regression analysis identified whole-body synovitis score as a poor prognostic factor for whole-body bone-erosion progression. Bone-edema score in individual bones was identified as a poor prognostic factor for the progression of bone-erosion. Changes in hand synovitis score correlated with those of other joints, but neither changes in bone-edema nor erosion score of hands correlated with those of other joints in WBMRI. CONCLUSIONS: WBMRI scoring may be a novel useful tool to evaluate the efficacy of anti-rheumatic drugs, as well as a potential predictor of joint prognosis, in patients with RA.
• Maintenance treatment using abatacept with dose reduction after achievement of low disease activity in patients with rheumatoid arthritis (MATADOR) - A prospective, multicenter, single arm pilot clinical trial.

  Shinsuke Yasuda, Kazumasa Ohmura, Hiroshi Kanazawa, Takashi Kurita, Yujiro Kon, Tomonori Ishii, Yuichiro Fujieda, Satoshi Jodo, Kazuhide Tanimura, Michio Minami, Tomomasa Izumiyama, Takumi Matsumoto, Yoshiharu Amasaki, Yoko Suzuki, Hideki Kasahara, Naofumi Yamauchi, Masaru Kato, Tamotsu Kamishima, Akito Tsutsumi, Hiromitsu Takemori, Takao Koike, Tatsuya Atsumi

  Modern rheumatology 27 (6) 930 - 937 1439-7595 2017/11 [Refereed][Not invited]
   

  OBJECTIVES: To preliminarily evaluate the feasibility of maintenance therapy with reduced dose of intravenous abatacept (ABT) to 250 mg/body/month after achieving remission or low disease activity (LDA). PATIENTS AND METHODS: RA patients treated with ABT at 13 sites were enrolled in this prospective interventional pilot study during the period between March 2013 and March 2015. Inclusion criteria were (1) age at 20 years or older, (2) under treatment with monthly intravenous ABT at approved doses, (3) DAS28-CRP lower than 2.7 at least for 6 months, (4) agreed to join this trial with written informed consent and (5) body weight under 125 kg. Enrolled patients were maintained with intravenous monthly ABT at a reduced dose of 250 mg/body (MATADOR protocol). The primary end point was the proportion of the patients continued with MATADOR protocol at week 48. MATADOR protocol was discontinued upon disease flare or other reasons such as patients' request or severe adverse event (AE). Disease activities and structural changes were also evaluated. RESULTS: Fifty-three patients fulfilled the entry criteria and were followed for 1-year. MATADOR protocol was continued for 1-year in 43 (81%) of the evaluated patients. Three patients experienced severe AEs. Mean DAS28-CRP and remission rate were 1.56 and 88% when ABT reduced and 1.80 and 81% at 1-year, respectively. Structural remission was achieved in 34 out of 42 evaluated patients. CONCLUSIONS: Reduced dose of intravenous ABT was proposed as a feasible choice for maintenance therapy for RA after achievement of remission/LDA, although further randomized trials would be awaited.
• Power Doppler signal calibration in the finger joint between two models of ultrasound machine: a pilot study using a phantom and joints in patients with rheumatoid arthritis.

  Ryosuke Sakano, Katsumi Saito, Tamotsu Kamishima, Mutsumi Nishida, Tatsunori Horie, Atsushi Noguchi, Michihito Kono, Kenneth Sutherland, Tatsuya Atsumi

  Acta radiologica (Stockholm, Sweden : 1987) 58 (10) 1238 - 1244 0284-1851 2017/10 [Refereed][Not invited]
   

  Background Despite the advantages of ultrasound (US) in the management of rheumatoid arthritis (RA) patients, power Doppler (PD) US may be highly dependent on the type of US machine used. Purpose To present a method to calibrate the PD signal of two models of US machines by use of a flow phantom and finger joints of patients with RA. Material and Methods For the phantom study, the PD signal count was measured in the flow phantom perfusing blood mimicking fluid at various injection rates and pulse repetition frequencies (PRFs). The quantitative PD index was calculated with ImageJ. For the clinical study, the second and third metacarpophalangeal joints of five consecutive patients with RA were examined. The quantitative PD index was measured at various PRFs by use of two models of machine (the same models as the phantom study). Results For the phantom and clinical studies, negative correlations were found between the PRF and the quantitative PD index when the flow velocity was constant and positive correlations between flow velocity and the quantitative PD index at constant PRF. There was a significant difference in the depiction performance of synovial blood flow between the two models, which can be calibrated by adjusting the PRF values derived from the phantom study in each model. Conclusion Signal calibration of pannus vascularity between US machines may be possible by adjusting the PRF value according to flow phantom data. Different US machines can thus provide equivalent examination results concerning the pannus vascularity.
• Computer-Based Radiographic Quantification of Joint Space Narrowing Progression Using Sequential Hand Radiographs: Validation Study in Rheumatoid Arthritis Patients from Multiple Institutions.

  Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Jun Fukae, Kou Katayama, Yuko Aoki, Takanobu Okubo, Taichi Okino, Takahiko Kaneda, Satoshi Takagi, Kazuhide Tanimura

  Journal of digital imaging 30 (5) 648 - 656 0897-1889 2017/10 [Refereed][Not invited]
   

  We have developed a refined computer-based method to detect joint space narrowing (JSN) progression with the joint space narrowing progression index (JSNPI) by superimposing sequential hand radiographs. The purpose of this study is to assess the validity of a computer-based method using images obtained from multiple institutions in rheumatoid arthritis (RA) patients. Sequential hand radiographs of 42 patients (37 females and 5 males) with RA from two institutions were analyzed by a computer-based method and visual scoring systems as a standard of reference. The JSNPI above the smallest detectable difference (SDD) defined JSN progression on the joint level. The sensitivity and specificity of the computer-based method for JSN progression was calculated using the SDD and a receiver operating characteristic (ROC) curve. Out of 314 metacarpophalangeal joints, 34 joints progressed based on the SDD, while 11 joints widened. Twenty-one joints progressed in the computer-based method, 11 joints in the scoring systems, and 13 joints in both methods. Based on the SDD, we found lower sensitivity and higher specificity with 54.2 and 92.8%, respectively. At the most discriminant cutoff point according to the ROC curve, the sensitivity and specificity was 70.8 and 81.7%, respectively. The proposed computer-based method provides quantitative measurement of JSN progression using sequential hand radiographs and may be a useful tool in follow-up assessment of joint damage in RA patients.
• 関節リウマチ患者の関節腔狭隘化を定量的に評価するためのcomputer-based temporal subtraction法(Quantitative Assessment of Joint Space Narrowing Progression in the Feet of Rheumatoid Arthritis Patients Using a Computer-based Temporal Subtraction Method)

  田中 悠貴, 千葉 拓貴, 神島 保, 市川 翔太, 沖野 太一, 深江 淳, 青木 悠子, 谷村 一秀

  日本放射線技術学会雑誌 73 (9) 832 - 832 0369-4305 2017/09
• Superb micro-vascular imaging法のシグナル強度と関節内血管径の関係性 関節リウマチの実験動物モデル(Relationship between Superb Micro-vascular Imaging Signal Quantity and Vessel Diameter in the Joints: Experimental Animal Models of Rheumatoid Arthritis)

  玉井 絵里香, 神島 保, 森村 豊, 堀江 達則, 谷村 瞬, 西田 睦, 石津 明洋, 外丸 詩野

  日本放射線技術学会雑誌 73 (9) 855 - 855 0369-4305 2017/09
• Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

  Motoshi Fujimori, Satoko Nakamura, Kiminori Hasegawa, Kunihiro Ikeno, Shota Ichikawa, Kenneth Sutherland, Tamotsu Kamishima

  The British journal of radiology 90 (1077) 20170167 - 20170167 0007-1285 2017/08 [Refereed][Not invited]
   

  OBJECTIVE: To quantify wrist cartilage using contrast MRI and compare with the extent of adjacent synovitis and bone marrow edema (BME) in patients with rheumatoid arthritis (RA). METHODS: 18 patients with RA underwent post-contrast fat-suppressed T1weighted coronal imaging. Cartilage area at the centre of the scaphoid-capitate and radius-scaphoid joints was measured by in-house developed software. We defined cartilage as the pixels with signal intensity between two thresholds (lower: 0.4, 0.5 and 0.6 times the muscle signal, upper: 0.9, 1.0, 1.1, 1.2 and 1.3 times the muscle signal). We investigated the association of cartilage loss with synovitis and BME score derived from RA MRI scoring system. RESULTS: Cartilage area was correlated with BME score when thresholds were adequately set with lower threshold at 0.6 times the muscle signal and upper threshold at 1.2 times the muscle signal for both SC (rs=-0.469, p < 0.05) and RS (rs=-0.486, p < 0.05) joints, while it showed no significant correlation with synovitis score at any thresholds. CONCLUSION: Our software can accurately quantify cartilage in the wrist and BME associated with cartilage loss in patients with RA. Advances in knowledge: Our software can quantify cartilage using conventional MR images of the wrist. BME is associated with cartilage loss in RA patients.
• Visceral adipose tissue area measurement at a single level: can it represent visceral adipose tissue volume?

  Yusuke Noumura, Tamotsu Kamishima, Kenneth Sutherland, Hideho Nishimura

  The British journal of radiology 90 (1077) 20170253 - 20170253 0007-1285 2017/08 [Refereed][Not invited]
   

  OBJECTIVE: Measurement of visceral adipose tissue (VAT) needs to be accurate and sensitive to change for risk monitoring. The purpose of this study is to determine the CT slice location where VAT area can best reflect changes in VAT volume and body weight. METHODS: 60 plain abdominal CT images from 30 males [mean age (range) 51 (41-68) years, mean body weight (range) 71.1 (101.9-50.9) kg] who underwent workplace screenings twice within a 1-year interval were evaluated. Automatically calculated and manually corrected areas of the VAT of various scan levels using "freeform curve" region of interest on CT were recorded and compared with body weight changes. RESULTS: The strongest correlations of VAT area with VAT volume and body weight changes were shown in a slice 3 cm above the lower margin of L3 with r values of 0.853 and 0.902, respectively. CONCLUSION: VAT area measurement at a single level 3 cm above the lower margin of the L3 vertebra is feasible and can reflect changes in VAT volume and body weight. Advances in knowledge: As VAT area at a CT slice 3cm above the lower margin of L3 can best reflect interval changes in VAT volume and body weight, VAT area measurement should be selected at this location.
• Semi-Automated Quantification of Finger Joint Space Narrowing Using Tomosynthesis in Patients with Rheumatoid Arthritis.

  Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Hideki Kasahara, Yuka Shimizu, Motoshi Fujimori, Nobutoshi Yasojima, Yohei Ono, Takahiko Kaneda, Takao Koike

  Journal of digital imaging 30 (3) 369 - 375 0897-1889 2017/06 [Refereed][Not invited]
   

  The purpose of the study is to validate the semi-automated method using tomosynthesis images for the assessment of finger joint space narrowing (JSN) in patients with rheumatoid arthritis (RA), by using the semi-quantitative scoring method as the reference standard. Twenty patients (14 females and 6 males) with RA were included in this retrospective study. All patients underwent radiography and tomosynthesis of the bilateral hand and wrist. Two rheumatologists and a radiologist independently scored JSN with two modalities according to the Sharp/van der Heijde score. Two observers independently measured joint space width on tomosynthesis images using an in-house semi-automated method. More joints with JSN were revealed with tomosynthesis score (243 joints) and the semi-automated method (215 joints) than with radiography (120 joints), and the associations between tomosynthesis scores and radiography scores were demonstrated (P < 0.001). There was significant, negative correlation between measured joint space width and tomosynthesis scores with r = -0.606 (P < 0.001) in metacarpophalangeal joints and r = -0.518 (P < 0.001) in proximal interphalangeal joints. Inter-observer and intra-observer agreement of the semi-automated method using tomosynthesis images was in almost perfect agreement with intra-class correlation coefficient (ICC) values of 0.964 and 0.963, respectively. The semi-automated method using tomosynthesis images provided sensitive, quantitative, and reproducible measurement of finger joint space in patients with RA.
• Pre-operative volume rather than area of skeletal muscle is a better predictor for post-operative risks for respiratory complications in living-donor liver transplantation.

  Yuki Wada, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda

  The British journal of radiology 90 (1072) 20160938 - 20160938 0007-1285 2017/04 [Refereed][Not invited]
   

  OBJECTIVE: To demonstrate the superiority of total psoas volume (TPV) over total psoas area (TPA) in terms of predicting post-operative complications in living-donor liver transplantation (LDLT). METHODS: The TPA and TPV were assessed in 32 recipients who underwent CT before LDLT. The TPA was measured using an axial CT image at the level of the upper margin of the fourth lumbar vertebral body. The TPV was calculated using all the CT images from the muscle origin through the level of the pubic symphysis. Patients were divided into a sarcopenia group and no-sarcopenia group based on the medians of normalized TPA (nTPA) and normalized TPV (nTPV). We calculated the odds ratio (OR) of post-operative respiratory complications in relation to nTPA and nTPV, respectively. RESULTS: Out of 32 recipients, 17 recipients experienced at least 1 post-operative respiratory complication. The OR for males according to nTPV [OR = 15.00, 95% confidence interval (CI) = 1.03-218.31; p = 0.031] was higher than that for nTPA (OR = 3.33, 95% CI = 0.36-30.70; p = 0.280). The OR for females according to nTPV (OR = 4.00, 95% CI = 0.56-28.40; p = 0.16) was the same as that for nTPA (OR = 4.00, 95% CI = 0.56-28.40; p = 0.16). CONCLUSION: Pre-operative volume of the skeletal muscle might be a better predictor for post-operative risks in LDLT recipients than pre-operative area of the skeletal muscle. Advances in knowledge: Post-operative risks for respiratory complications in LDLT recipients might be evaluated more accurately by using TPV instead of TPA.
• 関節リウマチにおける手の滑膜炎定量のためのダイナミック造影強調MRIを用いた簡易的なアプローチ 完全自動化した全画素の分析(Simplified Approach to Quantification for Hand Synovitis in Rheumatoid Arthritis Using Dynamic Contrast Enhanced MRI: Full-Automatic Pixel-By-Pixel Analysis)

  Kobayashi Yuto, Kamishima Tamotsu, Ichikawa Shota, Sugimori Hiroyuki, Noguchi Atsushi, Kono Michihito, Atsumi Tatsuya

  日本放射線技術学会総会学術大会予稿集 73回 178 - 179 1884-7846 2017/03
• 関節リウマチの治療 用法・用量・スイッチ・無効・減量・中止 アバタセプト減量による関節リウマチ維持療法 北海道・東北地域での多施設前向き介入試験

  保田 晋助, 大村 一将, 金澤 洋, 栗田 崇史, 近 祐次郎, 石井 智徳, 藤枝 雄一郎, 浄土 智, 谷村 一秀, 三浪 三千男, 泉山 朋政, 松本 巧, 天崎 吉晴, 鈴木 陽子, 笠原 英樹, 山内 尚文, 加藤 将, 神島 保, 堤 明人, 竹森 弘光, 小池 隆夫, 渥美 達也

  日本リウマチ学会総会・学術集会プログラム・抄録集 (一社)日本リウマチ学会 61回 565 - 565 2017/03 [Refereed][Not invited]
  
• A reliability study using computer-based analysis of finger joint space narrowing in rheumatoid arthritis patients.

  Katsuya Hatano, Tamotsu Kamishima, Kenneth Sutherland, Masaru Kato, Ikuma Nakagawa, Shota Ichikawa, Keisuke Kawauchi, Shota Saitou, Masaya Mukai

  Rheumatology international 37 (2) 189 - 195 0172-8172 2017/02 [Refereed][Not invited]
   

  The joint space difference index (JSDI) is a newly developed radiographic index which can quantitatively assess joint space narrowing progression of rheumatoid arthritis (RA) patients by using an image subtraction method on a computer. The aim of this study was to investigate the reliability of this method by non-experts utilizing RA image evaluation. Four non-experts assessed JSDI for radiographic images of 510 metacarpophalangeal joints from 51 RA patients twice with an interval of more than 2 weeks. Two rheumatologists and one radiologist as well as the four non-experts examined the joints by using the Sharp-van der Heijde Scoring (SHS) method. The radiologist and four non-experts repeated the scoring with an interval of more than 2 weeks. We calculated intra-/inter-observer reliability using the intra-class correlation coefficients (ICC) for JSDI and SHS scoring, respectively. The intra-/inter-observer reliabilities for the computer-based method were almost perfect (inter-observer ICC, 0.966-0.983; intra-observer ICC, 0.954-0.996). Contrary to this, intra-/inter-observer reliability for SHS by experts was moderate to almost perfect (inter-observer ICC, 0.556-0.849; intra-observer ICC, 0.589-0.839). The results suggest that our computer-based method has high reliability to detect finger joint space narrowing progression in RA patients.
• Pixel-by-Pixel Arterial Spin Labeling Blood Flow Pattern Variation Analysis for Discrimination of Rheumatoid Synovitis: A Pilot Study.

  Taro Sakashita, Tamotsu Kamishima, Hiroyuki Sugimori, Minghui Tang, Atsushi Noguchi, Michihito Kono, Kenneth Sutherland, Tatsuya Atsumi

  Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine 16 (1) 78 - 83 1347-3182 2017/01/10 [Refereed][Not invited]
   

  We examined the capability of a gray-scale arterial spin labeling blood flow pattern variation (BFPV) map with two different post labeling delay (PLD) times to discriminate pannus in patients with rheumatoid arthritis (RA) at 3T. There was a statistically significant difference in the BFPV values between artery, pannus, and surrounding tissue. Furthermore, the color-coded BFPV map was able to accurately distinguish pannus from other tissues. These results suggest this approach may be capable of identifying pannus noninvasively.
• Relationship between power Doppler grade and the pathological blood vessel features in long-standing rheumatoid arthritis.

  Katsumi Saito, Asami Abe, Tamotsu Kamishima, Hajime Ishikawa, Kunihiko Wakaki, Akihiro Ishizu

  Rheumatology international 36 (12) 1689 - 1690 0172-8172 2016/12 [Refereed][Not invited]
  
• One-year maintenance with routine assessment of patient index data 3-based remission may inhibit radiographic progression in patients with rheumatoid arthritis treated with routine clinical therapy: A retrospective comparison of radiographic outcome and its prognostic factors between maintained remissions with patient-reported outcome index and physician-oriented disease activity indices.

  Kou Katayama, Takanobu Okubo, Toshikazu Sato, Kiyomi Kamiya, Richio Fukai, Satomi Abe, Hiroshi Ito, Yuichi Makino, Tamotsu Kamishima

  Modern rheumatology 26 (6) 817 - 827 1439-7595 2016/11 [Refereed][Not invited]
   

  OBJECTIVES: We investigated whether the maintenance of routine assessment of patient index data 3 (RAPID3) remission for one year (RAPID3-MR) may predict good radiographic outcomes. We also compared radiographic progression to prognostic factors among patients with RAPID3-MR, with the maintenance of clinical disease activity index remission for one year (CDAI-MR) or with the maintenance of 28 joint count disease activity score remission for one year (DAS28-MR). METHODS: Of 1220 patients with available clinical data, 92 with RAPID3-MR, 80 with RAPID3-NMR (not satisfying RAPID3-MR), 45 with CDAI-MR, and 75 with DAS28-MR were retrospectively investigated. CDAI and DAS28 for clinical outcomes and the modified total Sharp score (mTSS) for radiographic joint damage were investigated for at least one year. RESULTS: RAPID3, CDAI, DAS28, and their categories remained unchanged or significantly improved in RAPID3-MR patients but significantly deteriorated in RAPID3-NMR patients. The mean annual ΔmTSS was significantly lower in RAPID3-MR patients (0.12 ± 0.55) than in RAPID3-NMR patients (0.54 ± 1.27) (p = 0.025). There was no significant difference among RAPID3-MR patients, CDAI-MR patients (0.06 ± 0.85), and DAS28-MR patients (0.11 ± 0.89). The baseline mTSS (p = 0.038) and monotherapy with nonbiological disease-modifying antirheumatic drugs (p = 0.033) were good prognostic factors in RAPID3-MR patients. CONCLUSIONS: One-year RAPID3 remission maintenance may predict good radiographic outcomes.
• Tomosynthesis can facilitate accurate measurement of joint space width under the condition of the oblique incidence of X-rays in patients with rheumatoid arthritis.

  Yohei Ono, Rina Kashihara, Nobutoshi Yasojima, Hideki Kasahara, Yuka Shimizu, Kenichi Tamura, Kaori Tsutsumi, Kenneth Sutherland, Takao Koike, Tamotsu Kamishima

  The British journal of radiology 89 (1062) 20150967 - 20150967 0007-1285 2016/06 [Refereed][Not invited]
   

  OBJECTIVE: Accurate evaluation of joint space width (JSW) is important in the assessment of rheumatoid arthritis (RA). In clinical radiography of bilateral hands, the oblique incidence of X-rays is unavoidable, which may cause perceptional or measurement error of JSW. The objective of this study was to examine whether tomosynthesis, a recently developed modality, can facilitate a more accurate evaluation of JSW than radiography under the condition of oblique incidence of X-rays. METHODS: We investigated quantitative errors derived from the oblique incidence of X-rays by imaging phantoms simulating various finger joint spaces using radiographs and tomosynthesis images. We then compared the qualitative results of the modified total Sharp score of a total of 320 joints from 20 patients with RA between these modalities. RESULTS: A quantitative error was prominent when the location of the phantom was shifted along the JSW direction. Modified total Sharp scores of tomosynthesis images were significantly higher than those of radiography, that is to say JSW was regarded as narrower in tomosynthesis than in radiography when finger joints were located where the oblique incidence of X-rays is expected in the JSW direction. CONCLUSION: Tomosynthesis can facilitate accurate evaluation of JSW in finger joints of patients with RA, even with oblique incidence of X-rays. ADVANCES IN KNOWLEDGE: Accurate evaluation of JSW is necessary for the management of patients with RA. Through phantom and clinical studies, we demonstrate that tomosynthesis may achieve more accurate evaluation of JSW.
• Bizarre parosteal osteochondromatous proliferation (Nora's lesion) affecting the distal end of the ulna: a case report.

  Yuichiro Matsui, Tadanao Funakoshi, Hideyuki Kobayashi, Tomoko Mitsuhashi, Tamotsu Kamishima, Norimasa Iwasaki

  BMC musculoskeletal disorders 17 130 - 130 1471-2474 2016/03/16 [Refereed][Not invited]
   

  BACKGROUND: Bizarre parosteal osteochondromatous proliferation (BPOP), first described by Nora et al. in 1983 and therefore termed "Nora's lesion", is a rare lesion that occurs in the short bones of the hands and feet and eventually presents as a parosteal mass. Reports of BPOP in the long bones are very rare. A benign disease, BPOP does not become malignant, although a high rate of recurrence following surgical resection is reported. Because of its atypical imaging findings and histopathological appearance, a BPOP might be misdiagnosed as a malignant tumor such as an osteochondroma with malignant transformation, a parosteal osteosarcoma, or a periosteal osteosarcoma. CASE PRESENTATION: A 58-year-old woman complained of left ulnar wrist pain at the time of her initial presentation. Plain x-rays showed ectopic calcifications in and around the distal radioulnar joint, which supported the diagnosis of subacute arthritis with hydroxyapatite crystal deposition. She was initially given a wrist brace and directed to follow-up, but her persistent pain required the administration of corticosteroid injections into the distal radioulnar joint. Increasing ulnar wrist joint pain and limited forearm pronation and wrist flexion necessitated computed tomography and contrast-enhanced magnetic resonance imaging. BPOP was diagnosed based on the preoperative imaging studies, and a resection of the lesion was performed along with the decortication of the underlying the cortical bone to reduce recurrence rates. The diagnosis of BPOP was confirmed by pathologic examination. Two years after surgery, the patient has no subsequent pain complaints and an improved range of motion. CONCLUSIONS: BPOP affecting the distal end of the ulna is exceedingly rare. Because BPOP was diagnosed primarily based upon preoperative imaging findings in our patient, decortication of the underlying cortical bone was performed to reduce recurrence rates. Further careful follow-up in these patients is essential, despite the non-recurrence of the lesion.
• MRI of the wrist and fingers

  KAMISHIMA Tamotsu

  Medical Imaging and Information Sciences 医用画像情報学会 33 (1) 4 - 7 0910-1543 2016 

  Current magnetic resonance imaging （MRI） techniques and high‐quality coil system can provide exquisite anatomic detail of the wrist and fingers. They present a valuable tool for assessment and characterization of traumatic injuries to small structures, various arthropathies, and neoplastic processes. As imaging quality continues to improve, the clinical significance of MRI of this field becomes more apparent in the evaluation and management of these entities.
• A proposal of lumbosacral load wearable sensor and lumbosacral alignment estimation based on X-ray image

  土谷圭央, 日下聖, 田中孝之, 松尾祥和, 小田まこと, 笹木工, 神島保, 山中正紀

  日本機械学会論文集(Web) 一般社団法人 日本機械学会 82 (843) ROMBUNNO.16‐00072(J‐STAGE) - 00072-16-00072 2187-9761 2016 [Refereed][Not invited]
   

  <p>Anteflexion of the spine is essential for many physical activities of daily living. However, this motion places the lumbar disks because it generats heavy load due to changes in the shape of the lumbar spine and can lead to low back pain. In older to reduce low back pain, here we proposed a wearable sensor system configuration that can estimate lumbosacral alignment and lumbar load by measuring the shape of the lumbar skin when the lumbosacral alignment changes. The shape of the lumbar skin and posture angle are measured by using curvature sensors and accelerometers. In addition, the system must be constructed in consideration of the physique, in order to absorb in a variety of human. We proposed this system by measuring the body parameters of anteflexion and studied the change in dimensions of the lumbar spine from changes in posture. By extracting the dimensions of the lumbosacral spine in X-ray images, the attitude angle, body surface area and the dimensions of the lumbosacral spine have relevance. The lumbosacral dimensions calibration method was developed by using that relation. Lumbosacral alignment estimation considering the difference in physiques is developed, and lumbosacral spine alignment was to improve the estimation accuracy. The proposed method could improve accuracy lumbosacral alignment estimation.</p>
• A Calibration Method for Interbody Distance in Lumbosacral Alignment Estimation.

  Yoshio Tsuchiya, Takashi Kusaka, Takayuki Tanaka, Yoshikazu Matsuo, Makoto Oda, Tsukasa Sasaki, Tamotsu Kamishima, Masanori Yamanaka

  Intelligent Robotics and Applications - 9th International Conference, ICIRA 2016, Tokyo, Japan, August 22-24, 2016, Proceedings, Part II Springer 200 - 210 2016 [Refereed][Not invited]
  
• Detection and measurement of rheumatoid bone and joint lesions of fingers by tomosynthesis: a phantom study for reconstruction filter setting optimization.

  Yohei Ono, Tamotsu Kamishima, Nobutoshi Yasojima, Kenichi Tamura, Kaori Tsutsumi

  Radiological physics and technology 9 (1) 6 - 14 1865-0341 2016/01 [Refereed][Not invited]
   

  Rheumatoid arthritis (RA) is a systemic disease that is caused by autoimmunity. RA causes synovial proliferation, which may result in bone erosion and joint space narrowing in the affected joint. Tomosynthesis is a promising modality which may detect early bone lesions such as small bone erosion and slight joint space narrowing. Nevertheless, so far, the optimal reconstruction filter for detection of early bone lesions of fingers on tomosynthesis has not yet been known. Our purpose in this study was to determine an optimal reconstruction filter setting by using a bone phantom. We obtained images of a cylindrical phantom with holes simulating bone erosions (diameters of 0.6, 0.8, 1.0, 1.2, and 1.4 mm) and joint spaces by aligning two phantoms (space widths from 0.5 to 5.0 mm with 0.5 mm intervals), examining six reconstruction filters by using tomosynthesis. We carried out an accuracy test of the bone erosion size and joint space width, done by one radiological technologist, and a test to assess the visibility of bone erosion, done by five radiological technologists. No statistically significant difference was observed in the measured bone erosion size and joint space width among all of the reconstruction filters. In the visibility assessment test, reconstruction filters of Thickness+- and Thickness-- were among the best statistically in all characteristics except the signal-to-noise ratio. The Thickness+- and Thickness-- reconstruction filter may be optimal for evaluation of RA bone lesions of small joints in tomosynthesis.
• Performance of computer-based analysis using temporal subtraction to assess joint space narrowing progression in rheumatoid patients.

  Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Takanobu Okubo, Kou Katayama

  Rheumatology international 36 (1) 101 - 8 0172-8172 2016/01 [Refereed][Not invited]
   

  Our computer-based method can detect the chronological change in joint space width between baseline and follow-up images as the joint space difference index (JSDI). The aim of this study was to verify the sensitivity and specificity of our computer-based method in assessment of joint space narrowing progression in rheumatoid patients. Twenty-seven patients (24 women and 3 men) with rheumatoid arthritis underwent radiography of the bilateral hand at baseline and at 1 year. The joint space narrowing (JSN) of a total of 252 metacarpophalangeal (MCP) joints and 229 carpal joints was assessed by our computer-based method, setting the Sharp/van der Heijde method as the gold standard. We constructed a receiver operating characteristic curve by using the Sharp/van der Heijde method as the gold standard and set the optimal cutoff on JSDI for MCP, carpal, and MCP/carpal joints. We then calculated the sensitivity and specificity for each cutoff in assessment of JSN progression. At the most discriminant cutoff, the sensitivity and specificity of the computer-based method for MCP joints was 78.6 versus 85.3 %, respectively (AUC = 0.837; P < 0.001). Carpal joints revealed a lower sensitivity and specificity with 64.7 and 86.8 % (AUC = 0.775; P < 0.001). Furthermore, the sensitivity and specificity for MCP/carpal joints was 71.0 versus 83.6 %, respectively (AUC = 0.778; P < 0.001). The computer-based method presented a reliable assessment of JSN progression with high sensitivity and specificity and may be useful in follow-up assessment of the joint damage in rheumatoid patients.
• Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis.

  Kei Ikeda, Akihiro Narita, Michihiro Ogasawara, Shigeru Ohno, Yutaka Kawahito, Atsushi Kawakami, Hiromu Ito, Isao Matsushita, Takeshi Suzuki, Kenta Misaki, Takehisa Ogura, Tamotsu Kamishima, Yohei Seto, Ryuichi Nakahara, Atsushi Kaneko, Takayuki Nakamura, Mihoko Henmi, Jun Fukae, Keiichiro Nishida, Takayuki Sumida, Takao Koike

  Modern rheumatology 26 (1) 9 - 14 1439-7595 2016 [Refereed][Not invited]
   

  INTRODUCTION: We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples. METHODS: We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography. RESULTS: Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (≥ 80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus. CONCLUSIONS: Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.
• Radiographic quantifications of joint space narrowing progression by computer-based approach using temporal subtraction in rheumatoid wrist.

  Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Takanobu Okubo, Kou Katayama

  The British journal of radiology 89 (1057) 20150403 - 20150403 0007-1285 2016 [Refereed][Not invited]
   

  OBJECTIVE: To investigate the validity of a computer-based method using temporal subtraction in carpal joints of patients with rheumatoid arthritis (RA), which can detect the difference in joint space between two images with the joint space difference index (JSDI). METHODS: The study consisted of 43 patients with RA (39 females and 4 males) who underwent radiography at baseline and at 1-year follow-up. The joint space narrowing (JSN) of carpal joints on bilateral hand radiographs was assessed by our computer-based method, using the Sharp/van der Heijde method as the standard of reference. We compared the JSDI of joints with JSN progression in the follow-up period with that of those without JSN progression. In addition, we examined whether there is a significant difference in JSDI in terms of laterality or topology of the joint. RESULTS: The JSDI of joints with JSN progression was significantly higher than that of those without JSN progression (Mann-Whitney U test, p < 0.001). There was no statistically significant difference in the JSDI between the left and right carpal joints, which was analysed for five different joints altogether and each joint separately (Mann-Whitney U test, p > 0.05). There was statistically significant difference in JSDI among different joints (Kruskal-Wallis test, p = 0.003). CONCLUSION: These results suggest that our computer-based method may be useful to recognize the JSN progression on radiographs of rheumatoid wrists. ADVANCES IN KNOWLEDGE: The computer-based temporal subtraction method can detect the JSN progression in the wrist, which is the single most commonly involved site in RA.
• Accurate quantitative assessment of synovitis in rheumatoid arthritis using pixel-by-pixel, time-intensity curve shape analysis.

  Taro Sakashita, Tamotsu Kamishima, Yuto Kobayashi, Hiroyuki Sugimori, Minghui Tang, Kenneth Sutherland, Atsushi Noguchi, Michihito Kono, Tatsuya Atsumi

  The British journal of radiology 89 (1061) 20151000 - 20151000 0007-1285 2016 [Refereed][Not invited]
   

  OBJECTIVE: To improve on the reproducibility and sensitivity of the assessment of patients with rheumatoid arthritis (RA), two semi-automated measurement methods of the area of enhancing pannus (AEP), based on thresholding (AEP_THRES) and pixel-by-pixel time-intensity curve analysis (AEP_TIC), were evaluated as an alternative for the gold-standard manual contouring method (AEP_MANUAL). METHODS: 8 patients (7 females and 1 male) with RA of the wrist or finger joints participated in the study. A three-dimensional contrast-enhanced dynamic sequence was used at 3 T. After identifying the most relevant time-intensity curve (TIC) shape in terms of synovitis by comparing with the synovitis score using the RA-MRI scoring system, three different approaches for measuring the AEP were performed. Spearman's test of rank correlation was used to compare AEPs via two semi-automated methods (AEP_THRES and AEP_TIC) against manual segmentation (AEP_MANUAL) in the entire hand region as well as the wrist and the finger regions. RESULTS: The TIC shape of "washout after fast initial enhancement" had excellent correlation with synovitis score (r = 0.809). The correlation coefficient between AEP_TIC and AEP_MANUAL was evaluated to be better than that of AEP_THRES and AEP_MANUAL in the wrist region (AEP_THRES: r = 0.716, AEP_TIC: r = 0.815), whereas these were of comparable accuracy for the entire hand and the finger regions. CONCLUSION: This study suggests that TIC analysis may be an alternative to manual contouring for pannus quantification and provides important clinical information of the extent of the disease in patients with RA. ADVANCES IN KNOWLEDGE: TIC shape analysis can be applied for new quantitative assessment for RA synovitis in the wrist.
• リウマチ超音波検査機器に関するアンケート調査報告

  齋藤 克己, 神島 保, 坂野 稜典, 堀江 達則, 西田 睦, 成田 明宏, 谷村 一秀, 小池 隆夫

  北海道医学雑誌 北海道医学会 90 (2) 144 - 144 0367-6102 2015/11
• 18F-FDG-PET/CT better localizes active spinal infection than MRI for successful minimally invasive surgery.

  Masayuki Nakahara, Manabu Ito, Naoya Hattori, Keiichi Magota, Masahiko Takahata, Ken Nagahama, Hideki Sudo, Tamotsu Kamishima, Nagara Tamaki, Norimasa Iwasaki

  Acta radiologica (Stockholm, Sweden : 1987) 56 (7) 829 - 36 0284-1851 2015/07 [Refereed][Not invited]
   

  BACKGROUND: Surgical debridement is often required to treat spinal infections. Successful surgery requires accurate localization of the active infections, however, current imaging technique still requires surgeons' experience to narrow the surgical fields to achieve less invasive procedures. PURPOSE: To investigate the use of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for successful surgical planning. MATERIAL AND METHODS: Nine patients with suspected spinal infection underwent magnetic resonance imaging (MRI) and FDG-PET/CT before surgery to locate active foci of infections. The spinal structures were divided into seven compartments at each intervertebral disc level for a total of 315 compartments investigated. The same classification system was used to design operating fields for histological correlation. RESULTS: FDG-PET/CT diagnosed fewer compartments as active infection (34 compartments, 10.8%) than MRI (62 compartments, 19.7%, P  = 0.002). Surgical exploration was performed in 49 compartments, and demonstrated active infection in 25 compartments. The sensitivity / specificity of FDG-PET/CT was 100% / 79%, respectively, which was superior to those of MRI, 76% / 42%. Foci of active infection showed hypermetabolic activity with a SUVmax of 7.1 ± 2.6 (range, 3.0-12.7). Receiver operating characteristic (ROC) analysis indicated an optimal threshold for active spinal infection at a SUVmax of 4.2, corresponding to a sensitivity of 90.3% and specificity of 91.2%. CONCLUSION: FDG-PET/CT demonstrated limited areas of abnormality allowing accurate delineation, and is thus useful to narrow the surgical fields. Since overall diagnostic accuracy of FDG-PET/CT was superior to that of MRI, FDG-PET/CT is a useful technique to narrow the surgical field for successful less invasive surgery.
• Absolute reliability of adipose tissue volume measurement by computed tomography: application of low-dose scan and minimal detectable change--a phantom study.

  Takahiro Onuma, Tamotsu Kamishima, Tsukasa Sasaki, Motomichi Sakata

  Radiological physics and technology 8 (2) 312 - 9 1865-0341 2015/07 [Refereed][Not invited]
   

  Metabolic syndrome increases the risk of developing diabetes and cardiovascular disease, particularly heart failure. Abdominal obesity is commonly assessed by measurement of the waist circumference, which exhibits a positive correlation with the visceral fat area measured on computed tomography (CT). CT is an excellent technique for measurement of cross-sectional areas of adipose tissue, but the exposure to ionizing radiation limits broad and repeated application in healthy subjects. Our purpose in this study was to determine the reliability of low-dose CT for abdominal fat quantification as compared with a standard CT protocol. A phantom was scanned by use of changes in the volume of vegetable oil, simulating visceral and subcutaneous adipose tissue, and by changes in the tube current-time products (25-300 mAs). We measured the volume of vegetable oil for each mAs value, and we calculated the minimal detectable change (MDC) in the volume by making repeated measurements. The measured volume of vegetable oil at 50 mAs and higher was not significantly different (p > 0.05), but that at 25 mAs was significantly different (p < 0.001), from that at 300 mAs. The MDC was less than 0.4 ml regardless of the mAs value at all mAs values assessed. We suggest that the adipose tissue volume is determined accurately by CT at 50 mAs (75 % reduction of radiation exposure compared with the standard dose).
• 腱板付着部の血流よりみた腱板断裂の成因とその治癒過程

  船越 忠直, 西田 睦, 神島 保, 瓜田 淳, 末永 直樹, 岩崎 倫政

  日本整形外科学会雑誌 (公社)日本整形外科学会 89 (2) S434 - S434 0021-5325 2015/03
• リウマチ性滑膜炎の描出 従来型のコントラスト造影MRIに対する二重標識後待ち時間(PLD)測定を利用したASL画像分析法の利点(Depiction of Rheumatoid Synovitis: Advantage of ASL Imaging Analysis Using Dual Post Labeling Delay(PLD) Settings Over Conventional Contrast Enhanced MRI)

  Sakashita Taro, Kamishima Tamotsu, Sugimori Hiroyuki, Tou Meiki, Noguchi Atsushi, Kono Michihito, Atsumi Tatsuya

  日本放射線技術学会総会学術大会予稿集 71回 185 - 185 1884-7846 2015/02
• 関節リウマチ診療におけるパワードプラ超音波検査の機種間差 PRF設定と滑膜血流描出能の関係

  坂野 稜典, 神島 保, 西田 睦, 堀江 達則

  超音波医学 (公社)日本超音波医学会 42 (1) 94 - 94 1346-1176 2015/01
• Bilateral breast MRI by use of dual-source parallel radiofrequency excitation and image-based shimming at 3 Tesla: improvement in homogeneity on fat-suppression imaging.

  Kinya Ishizaka, Fumi Kato, Satoshi Terae, Suzuko Mito, Noriko Oyama-Manabe, Tamotsu Kamishima, Mitsuhiro Nakanishi, Hiroyuki Sugimori, Hiroyuki Hamaguchi, Hiroki Shirato

  Radiological physics and technology 8 (1) 4 - 12 1865-0333 2015/01 [Refereed][Not invited]
   

  In this study, we aimed to compare fat-suppression homogeneity on breast MR imaging by using dual-source parallel radiofrequency excitation and image-based shimming (DS-IBS) with single-source radiofrequency excitation with volume shim (SS-Vol) at 3 Tesla. Twenty patients were included. Axial three-dimensional T1-weighted turbo-field-echo breast images with DS-IBS and SS-Vol were obtained. Fat suppression was scored with four grade points. The contrast of the pectoral muscle and the fat in each breast area was obtained in the head medial, head lateral, foot medial, and foot lateral areas. The axillary space was calculated and compared between DS-IBS and SS-Vol. The average DS-IBS score was significantly higher than that of SS-Vol. The mean contrasts of fat in the foot lateral areas and axillary spaces on DS-IBS images were significantly higher than on SS-Vol images.
• Power Doppler signal calibration between ultrasound machines by use of a capillary-flow phantom for pannus vascularity in rheumatoid finger joints: a basic study.

  Ryosuke Sakano, Tamotsu Kamishima, Mutsumi Nishida, Tatsunori Horie

  Radiological physics and technology 8 (1) 120 - 4 1865-0341 2015/01 [Refereed][Not invited]
   

  Ultrasound allows the detection and grading of inflammation in rheumatology. Despite these advantages of ultrasound in the management of rheumatoid patients, it is well known that there are significant machine-to-machine disagreements regarding signal quantification. In this study, we tried to calibrate the power Doppler (PD) signal of two models of ultrasound machines by using a capillary-flow phantom. After flow velocity analysis in the perfusion cartridge at various injection rates (0.1-0.5 ml/s), we measured the signal count in the perfusion cartridge at various injection rates and pulse repetition frequencies (PRFs) by using PD, perfusing an ultrasound micro-bubble contrast agent diluted with normal saline simulating human blood. By use of the data from two models of ultrasound machines, Aplio 500 (Toshiba) and Avius (Hitachi Aloka), the quantitative PD (QPD) index [the summation of the colored pixels in a 1 cm × 1 cm rectangular region of interest (ROI)] was calculated via Image J (internet free software). We found a positive correlation between the injection rate and the flow velocity. In Aplio 500 and Avius, we found negative correlations between the PRF and the QPD index when the flow velocity was constant, and a positive correlation between flow velocity and the QPD index at constant PRF. The equation for the relationship of the PRF between Aplio 500 and Avius was: y = 0.023x + 0.36 [y = PRF of Avius (kHz), x = PRF of Aplio 500 (kHz)]. Our results suggested that the signal calibration of various models of ultrasound machines is possible by adjustment of the PRF setting.
• Calibration method for lumbosacral dimensions in wearable sensor system of lumbar alignment.

  Yoshio Tsuchiya, Takashi Kusaka, Takayuki Tanaka, Yoshikazu Matsuo, Makoto Oda, Tsukasa Sasaki, Tamotsu Kamishima, Masanori Yamanaka

  Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference 2015 3909 - 12 1557-170X 2015 [Refereed][Not invited]
   

  Anteflexion of the spine is essential for many physical activities in everyday life. However, this motion places the lumbar disks under heavy load due to changes in the shape of the lumbar spine and can lead to low back pain. With the aim of reducing low back pain, here we developed a wearable sensor system that can estimate lumbosacral alignment and lumbar load by measuring the shape of the lumbar skin when the lumbosacral alignment changes. In addition, we used this system to measure the parameters of anteflexion and studied the change in dimensions of the lumbar spine from changes in posture. By determining the dimensions of the lumbosacral spine on an X-ray image, a lumbosacral dimensions calibration method based on body surface area and height was developed. By using this method, lumbosacral alignment and lumbar load could be accurately estimated using the wearable sensor system.
• Efficacy of Tocilizumab in Patients with Rheumatoid Arthritis: Sequential Evaluation Using Whole-Body Magnetic Resonance Imaging.

  Michihito Kono, Shinsuke Yasuda, Kazumasa Ohmura, Tomoko Fukui, Sanae Shimamura, Ikuma Nakagawa, Atsushi Noguchi, Haruki Shida, Toshiyuki Watanabe, Yuka Shimizu, Takashi Kurita, Kenji Oku, Toshiyuki Bohgaki, Olga Amengual, Tetsuya Horita, Keita Sakamoto, Tamotsu Kamishima, Tatsuya Atsumi

  ARTHRITIS & RHEUMATOLOGY 66 S518 - S518 2326-5191 2014/10 [Refereed][Not invited]
  
• 単純X線写真におけるリウマチ患者の関節裂隙狭小化の変化 経時差分技術を用いた検討

  佐々木 亮祐, 神島 保, 市川 翔太, Sutherland Kenneth, 大久保 学宣, 片山 耕

  日本放射線技術学会雑誌 (公社)日本放射線技術学会 70 (9) 1054 - 1054 0369-4305 2014/09
• 単純X線写真に対する経時差分技術を用いたリウマチ患者の関節裂隙狭小化評価 手根部関節への応用

  市川 翔太, 神島 保, 佐々木 亮祐, Sutherland Kenneth, 大久保 学宣, 片山 耕

  日本放射線技術学会雑誌 (公社)日本放射線技術学会 70 (9) 1054 - 1055 0369-4305 2014/09
• 手関節のリウマチ滑膜炎におけるPixel-by-Pixel TIC解析

  坂下 太郎, 神島 保, 杉森 博行, 唐 明輝, 河野 通仁, 渥美 達也

  日本放射線技術学会雑誌 (公社)日本放射線技術学会 70 (9) 965 - 965 0369-4305 2014/09
• Structural deterioration of finger joints with ultrasonographic synovitis in rheumatoid arthritis patients with clinical low disease activity.

  Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Takeya Ito, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Rheumatology (Oxford, England) 53 (9) 1608 - 12 1462-0324 2014/09 [Refereed][Not invited]
   

  OBJECTIVE: In this study we investigated the relationship between synovial vascularity (SV) and structural alteration of finger joints in patients with RA and long-term sustained clinical low disease activity (CLDA). METHODS: RA patients with CLDA of >2 years (minimum 1 year of CLDA for study entry plus 1 year of observation) were analysed. Quantitative SV values were sequentially measured in each finger joint using power Doppler ultrasonography (0, 8, 20 and 52 weeks). Radiological progression of local finger joints was evaluated according to the Genant-modified Sharp score (0-52 weeks). RESULTS: Of the 25 patients enrolled, 15 patients were finally analysed after excluding 10 patients who failed to maintain CLDA during the observational period. Changes in radiological progression of MCP and PIP joints with positive SV were significantly greater than those in joints with negative SV. Joint space narrowing (JSN) was strongly related to structural alteration of finger joints. In joints with positive SV, changes in structural alteration did not relate to total SV values, which reflect total exposure to inflammation in an observational period. CONCLUSION: Even in patients with a long period of CLDA, finger joints with positive SV showed structural alteration, especially in the progression of JSN. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry, http://www.umin.ac.jp/ctr/, UMIN000007305.
• 毛細血管ファントムを用いた超音波装置機器間のパワードプラ信号校正 パンヌス血流評価結果の機種間差低減を目指して

  坂野 稜典, 神島 保, 堀江 達則, 西田 睦

  北海道医学雑誌 北海道医学会 89 (1) 94 - 94 0367-6102 2014/05
• 多時相造影MRIのTIC解析を用いた滑膜炎抽出

  小野 雅人, 神島 保, 杉森 博行, 唐 明輝, 河野 通仁, 渥美 達也

  北海道医学雑誌 北海道医学会 89 (1) 93 - 93 0367-6102 2014/05
• Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint: identification of the components that are reliable and influential on the global assessment of the whole joint.

  Kei Ikeda, Yohei Seto, Akihiro Narita, Atsushi Kawakami, Yutaka Kawahito, Hiromu Ito, Isao Matsushita, Shigeru Ohno, Keiichiro Nishida, Takeshi Suzuki, Atsushi Kaneko, Michihiro Ogasawara, Jun Fukae, Mihoko Henmi, Takayuki Sumida, Tamotsu Kamishima, Takao Koike

  Arthritis & rheumatology (Hoboken, N.J.) 66 (3) 523 - 32 2326-5191 2014/03 [Refereed][Not invited]
   

  OBJECTIVE: The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA). METHODS: US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis. RESULTS: A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P < 0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantially influence the global assessment of synovial inflammation (β = 0.06). CONCLUSION: The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.
• Lingering fat signals with CHESS in simultaneous imaging of both hands can be improved with rice pads in both 1.5T and 3.0T.

  Susumu Moriya, Yukio Miki, Tamotsu Kamishima, Tosiaki Miyati, Mitsunori Kanagaki, Yukako Matsuno, Tsuneo Yokobayashi

  European journal of radiology 82 (9) 1458 - 62 0720-048X 2013/09 [Refereed][Not invited]
   

  OBJECTIVES: To investigate whether rice pads can eliminate lingering fat signals of the complex surface shape of both hands that occur with chemical shift selective (CHESS) at 1.5T and 3.0T. MATERIALS AND METHODS: T1-weighted images were obtained with CHESS using 1.5T and 3.0T systems. The same imaging parameters were used with and without rice pads on the coronal plane of both hands in 10 healthy volunteers. The fat-suppression effects were classified into four categories and scored for images, and visual evaluations were performed by one radiologist and one radiologic technologist. RESULTS: At 1.5T, the mean evaluation score was 1.55 for images obtained without rice pads and 3.50 for images obtained with rice pads. At 3.0T, the mean evaluation score was 1.10 for images obtained without rice pads and 3.20 for images obtained with rice pads. With both systems, images obtained with the rice pads showed significantly better fat suppression effects than images obtained without rice pads (P<0.0001, P<0.0001). CONCLUSIONS: It was confirmed that lingering fat signals are eliminated and good fat-suppressed images are obtained with the use of rice pads at 1.5T and 3.0T. Rice pads are therefore useful with at 1.5T and 3.0T, which are currently becoming more widely used.
• CT osteoabsorptiometry法を用いた野球選手肘関節における応力分布解析

  門間太輔, 岩崎倫政, 大泉直美, 中土裕樹, 船越忠直, 神島保, 但野茂, 三浪明男

  北海道整形災害外科学会雑誌 54 (2) 162 - 166 1343-3873 2013/03 [Refereed][Not invited]
  
• Positive synovial vascularity in patients with low disease activity indicates smouldering inflammation leading to joint damage in rheumatoid arthritis: time-integrated joint inflammation estimated by synovial vascularity in each finger joint.

  Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Takeya Ito, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Rheumatology (Oxford, England) 52 (3) 523 - 8 1462-0324 2013/03 [Refereed][Not invited]
   

  OBJECTIVE: To investigate the relationship between synovial vascularity and joint damage progression in each finger joint of patients with RA under low disease activity during treatment with biologic agents. METHODS: We studied 310 MCP and 310 PIP joints of 31 patients with active RA who were administered adalimumab (ADA) or tocilizumab (TCZ). Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at weeks 8, 20 and 40. Synovial vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and at week 50. RESULTS: Composite scores of the DAS with 28 joints and the Simplified Disease Activity Index (SDAI) were significantly decreased from baseline to week 8, being sustained at a low level by biologic agents during the observational period. MCP and PIP joints with positive synovial vascularity after week 8 showed more subsequent joint damage progression than joints without synovial vascularity throughout the follow-up. The changes in radiographic progression in these joints were independent of the sum of synovial vascularity from baseline to week 40 or the occasional occurrence of positive synovial vascularity. CONCLUSION: Smouldering inflammation reflected by positive synovial vascularity under low disease activity was linked to joint damage. The damage progressed irrespective of the severity of positive synovial vascularity. Even with a favourable overall therapeutic response, monitoring of synovial vascularity has the potential to provide useful joint information to tailor treatment strategies. Trial registration. University Hospital Medical Information Network Clinical Trials Registry; http://www.umin.ac.jp/ctr/; UMIN000004476.
• Effect of low-intensity pulsed ultrasound on bone healing at osteotomy sites after forearm bone shortening.

  Atsushi Urita, Norimasa Iwasaki, Makoto Kondo, Yasuhiko Nishio, Tamotsu Kamishima, Akio Minami

  The Journal of hand surgery 38 (3) 498 - 503 0363-5023 2013/03 [Refereed][Not invited]
   

  PURPOSE: To test the hypothesis that low-intensity pulsed ultrasound (LIPUS) may accelerate healing at osteotomy sites after forearm bone shortening osteotomies. METHODS: In this prospective study, we enrolled 27 patients who underwent ulnar shortening osteotomy for ulnar impaction syndrome or radial shortening osteotomy for Kienböck disease. We randomized limbs to be treated with LIPUS (14 osteotomies, LIPUS group) or without LIPUS (13 osteotomies, control group). At 1 week postoperatively, patients in the LIPUS group received once-daily 20-minute LIPUS treatments that continued until at least 12 weeks postoperatively. At 2, 4, 6, 8, 12, 16, and 24 weeks postoperatively, we assessed union of the osteotomy site to determine the time to union using 4 projections of x-rays. RESULTS: In this study, all osteotomies achieved complete union. The mean times to complete cortical union were 57 days in the LIPUS group and 76 days in the control group. Regarding endosteal union, the mean times were 121 days in the LIPUS group and 148 days in the control group. The LIPUS group had significantly reduced times for both types of union. CONCLUSIONS: Application of LIPUS shortened the time to cortical union by 27%, and to endosteal union by 18%. Our results indicate that LIPUS accelerated bone healing after we performed forearm bone shortening osteotomies. This may provide earlier return to activity and work for patients undergoing forearm osteotomies.
• Association of Renal Volume with the Degree of Aortic Contrast Enhancement in Abdominal CT

  Muto NS, Kamishima T, Sasaki T, Terae S, Tha KK, Shirato H, Bae KT

  Advances in Computed Tomography 2 55 - 62 2013 [Refereed][Not invited]
  
• Contrast-enhanced whole body joint MR Imaging in rheumatoid patients on tumour necrosis factor-alpha agents: a pilot study to evaluate novel scoring system for MR synovitis

  T. Kamishima, M. Kato, T. Atsumi, T. Koike, Y. Onodera, S. Terae

  CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 31 (1) 154 - 154 0392-856X 2013/01 [Refereed][Not invited]
  
• Fat-suppressed MR images of both hands obtained using CHESS can be improved by rice pads.

  Susumu Moriya, Yukio Miki, Tamotsu Kamishima, Mitsunori Kanagaki, Tsuneo Yokobayashi, Mitsunori Ishikawa

  European journal of radiology 81 (9) 2318 - 22 0720-048X 2012/09 [Refereed][Not invited]
   

  When chemical shift selective (CHESS) imaging is used with magnetic resonance imaging (MRI) for simultaneous imaging of both hands for the evaluation of rheumatoid arthritis, the fat suppression effect is poor. We investigated whether these fat-suppressed images using CHESS could be improved with the use of rice pads. T1-weighted images were obtained with CHESS and the same imaging parameters were used with and without rice pads on the coronal plane of both hands in 10 healthy volunteers. Patients were placed in a prone position with both hands extended overhead. The fat-suppression effect was classified into four categories and scored for both sets of images, and visual assessments were made by one radiologist and one radiologic technologist. The evaluation score was 1.1 for the images made without rice pads, and 3.2 for the images made with rice pads. The fat suppression effect was thus significantly better in the images made using rice pads (P<0.0001). Lingering fat signals disappeared almost completely in images of both hands using CHESS with rice pads, and it was confirmed that the images were improved and had good fat suppression. More accurate evaluation of inflammatory sites that occur in rheumatoid arthritis may thus be possible, promising better diagnostic accuracy.
• Long-term stress distribution patterns of the ankle joint in varus knee alignment assessed by computed tomography osteoabsorptiometry.

  Tomohiro Onodera, Tokifumi Majima, Norimasa Iwasaki, Tamotsu Kamishima, Yasuhiko Kasahara, Akio Minami

  International orthopaedics 36 (9) 1871 - 6 0341-2695 2012/09 [Refereed][Not invited]
   

  PURPOSE: The stress distribution of an ankle under various physiological conditions is important for long-term survival of total ankle arthroplasty. The aim of this study was to measure subchondral bone density across the distal tibial joint surface in patients with malalignment/instability of the lower limb. METHODS: We evaluated subchondral bone density across the distal tibial joint in patients with malalignment/instability of the knee by computed tomography (CT) osteoabsorptiometry from ten ankles as controls and from 27 ankles with varus deformity/instability of the knee. The quantitative analysis focused on the location of the high-density area at the articular surface, to determine the resultant long-term stress on the ankle joint. RESULTS: The area of maximum density of subchondral bone was located in the medial part in all subjects. The pattern of maximum density in the anterolateral area showed stepwise increases with the development of varus deformity/instability of the knee. CONCLUSIONS: Our results should prove helpful for designing new prostheses and determining clinical indications for total ankle arthroplasty.
• Alterations in stress distribution patterns through the forearm joint surface of the elbow in baseball players assessed using computed tomography osteoabsorptiometry.

  Daisuke Momma, Norimasa Iwasaki, Naomi Oizumi, Kazuhiro Fujisaki, Tadanao Funakoshi, Yuichiro Abe, Tamotsu Kamishima, Shigeru Tadano, Akio Minami

  Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 17 (3) 253 - 60 0949-2658 2012/05 [Refereed][Not invited]
   

  BACKGROUND: The distribution of subchondral bone density well reflects long-term resultant stress acting on an articular surface in living joints. Consequently, a measurement of the distribution pattern can determine the stress distribution across the elbow joint surface under long-term loading conditions of baseball pitching. Our purpose was to elucidate the characteristic alterations in the distribution pattern of subchondral bone density across the forearm bones of the elbow with pitching activities. The hypothesis is that pitching activities would change the stress distribution in living subjects. METHODS: The analysis was performed using computed tomography (CT) images obtained from the dominant elbow of ten nonthrowing athletes (control group), ten college baseball fielders (fielder group), and ten college baseball pitchers (pitcher group). The distribution pattern of subchondral bone density through the articular surface of the proximal radius and ulna bones was assessed using CT osteoabsorptiometry. RESULTS: The maximum density area was located in the posterior part of the trochlea notch in all study participants. This maximum density area was significantly increased in the baseball groups compared with that in the control group. The pitcher group also showed a significant distribution of the maximum density area in the anterior part of the radial head. CONCLUSION: Our analysis indicates that pitching activities increase actual stress on the articular surface not only in the posterior part of the trochlea notch but also in the anterior part of the radial head. The stress across the elbow may be expanded from the ulnohumeral to the radiohumeral joint by repetitive pitching activities in living subjects.
• Distribution of bone mineral density at osteochondral donor sites in the patellofemoral joint among baseball players and controls.

  Kinya Nishida, Norimasa Iwasaki, Kazuhiro Fujisaki, Tadanao Funakoshi, Tamotsu Kamishima, Shigeru Tadano, Akio Minami

  The American journal of sports medicine 40 (4) 909 - 14 0363-5465 2012/04 [Refereed][Not invited]
   

  BACKGROUND: To theoretically minimize complications of osteochondral graft harvest from the knee, grafts should be obtained from the site of lowest stress distribution across the joint. HYPOTHESIS: Long-term stress distribution over the patellofemoral (PF) joint surface is not equal in athletes. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Measurement of subchondral bone density can determine long-term resultant stress acting on an articular surface in living joints. Our analysis was performed using computed tomography (CT) image data obtained from bilateral knees of 10 college baseball fielders (fielder group) and 10 college baseball pitchers (pitcher group) and 2 control groups, including 10 college soccer players (soccer group) and 10 nonathletes (nonathlete group). The distribution pattern of subchondral bone density throughout the articular surface of the PF joint was assessed using the CT osteoabsorptiometry method. The quantitative analysis focused on the location of the low-density area at the articular surface to assess potential osteochondral donor sites. RESULTS: All participants in the pitcher and fielder groups demonstrated a low-density area widely distributed in the proximal part of the lateral trochlea. On the other hand, a high-density area was located in the distal part of the lateral notch, of the medial notch, and of the medial trochlea. No apparent differences in the distribution pattern were found between the baseball groups and the control groups. CONCLUSION: Our analysis, based on CT osteoabsorptiometry, indicates that the proximal lateral trochlea of the distal femur has the highest percentage area of low bone density at the PF joint level in donor knees of baseball players, soccer players, and nonathlete controls. CLINICAL RELEVANCE: From a biomechanical viewpoint, the proximal lateral trochlea is the optimal site for harvesting osteochondral grafts in performing mosaicplasty for baseball players. This selection for the donor site may minimize postoperative PF joint symptoms.
• A retrospective evaluation of magnetic resonance imaging effectiveness on capitellar osteochondritis dissecans among overhead athletes.

  Norimasa Iwasaki, Tamotsu Kamishima, Hiroyuki Kato, Tadanao Funakoshi, Akio Minami

  The American journal of sports medicine 40 (3) 624 - 30 0363-5465 2012/03 [Refereed][Not invited]
   

  BACKGROUND: Magnetic resonance imaging (MRI) has been widely used to characterize osteochondritis dissecans (OCD) lesions. However, the usefulness of MRI for predicting fragment stability in OCD of the humeral capitellum (capitellar OCD) remains unclear. HYPOTHESIS: Preoperative MRI cannot accurately diagnose fragment instability of capitellar OCD in overhead athletes. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 1. METHODS: Twenty-seven male overhead athletes who had undergone surgery for capitellar OCD were included in the study. A single senior musculoskeletal radiologist blindly reviewed preoperative MRI of these OCD lesions. The radiologist reported the presence or absence of each of the 4 MRI signs indicating fragment instability as described by De Smet et al. The lesions were also classified according to the MRI staging system of Dipaola et al for characterizing the lesions. Intraoperative assessment of fragment stability was used as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for fragment instability as assessed by MRI. RESULTS: According to the MRI criteria by De Smet et al and the Dipaola et al staging system, 21 (78%) and 20 (74%) lesions were defined as unstable, respectively. The obtained results yielded a sensitivity of 89% and a specificity of 44% for diagnosing fragment instability using the De Smet et al MRI criteria and a sensitivity of 83% and a specificity of 44% using the Dipaola et al MRI staging system. The PPV and NPV for fragment instability were 76% and 67% using the De Smet et al criteria and 75% and 57% according to the Dipaola et al staging system, respectively. The overall correlation rate of Dipaola et al MRI and intraoperative stages was 41%. CONCLUSION: Preoperative MRI cannot precisely diagnose fragment instability of capitellar OCD that requires operative treatments in overhead athletes. Especially, MRI indicating stable lesions is considered not to be useful in predicting intraoperative instability of capitellar OCD in this study population.
• Usefulness of portography and contrast-enhanced computed tomography to predict the embolized area in percutaneous transhepatic portal vein embolization with absolute ethanol under temporary balloon occlusion

  Hasegawa Y, Abo D, Sakuhara Y, Kato F, Kamishima T, Shimizu T, Ito YM, Terae S, Shirato H

  Japanese Journal of Radiology 30 (1) 53 - 61 1867-1071 2012/01 [Refereed][Not invited]
   

  PURPOSE: To assess the usefulness of portography and contrast-enhanced computed tomography (CECT) for predicting the embolized area after the first injection of absolute ethanol (AE) in right portal vein embolization (RPVE). MATERIALS AND METHODS: Portograms were retrospectively reviewed in 50 patients (30 men and 20 women, mean age 65 years) who had undergone percutaneous transhepatic RPVE with AE under temporary balloon occlusion (TBO) between February 2002 and October 2009. The enhancement pattern before embolization and the embolization pattern after the first AE injection were analyzed by portography. The angles of portal branches against the horizontal plane were measured in 48 patients using pre-treatment CECT. RESULTS: The enhancement pattern was not consistent with the embolization pattern in 35 patients (p < 0.001). When the anterior branch angles were divided into two groups at -5°, 0°, 10°, and 15°, the frequency of the posterior-branch-dominant embolization pattern was higher in the more negatively angled group (p = 0.002-0.041). CONCLUSION: The distribution of AE is different from that of contrast medium in percutaneous transhepatic RPVE under TBO. The pre-treatment measurement of the angles of portal branches against the horizontal plane on CECT is suggested to be useful for predicting the embolized area.
• In vivo vascularity alterations in repaired rotator cuffs determined by contrast-enhanced ultrasound.

  Tadanao Funakoshi, Norimasa Iwasaki, Tamotsu Kamishima, Mutsumi Nishida, Yoichi Ito, Kinya Nishida, Makoto Motomiya, Naoki Suenaga, Akio Minami

  The American journal of sports medicine 39 (12) 2640 - 6 0363-5465 2011/12 [Refereed][Not invited]
   

  BACKGROUND: The alterations in blood flow after rotator cuff repair remain unclear. Visualization of vascular patterns could clarify basic and clinical investigations. PURPOSE: To assess longitudinal blood flow inside the repaired cuff and the surrounding tissue after rotator cuff repair, using contrast-enhanced ultrasonography. STUDY DESIGN: Descriptive laboratory study. METHODS: Fifteen patients (7 men and 8 women; mean age, 65.0 ± 9.8 years) consented to participate. The patients underwent an ultrasound scan before and 1, 2, and 3 months after surgery. Enhanced ultrasound images were recorded for 1 minute after intravenous injection of contrast reagent. Four regions of interest inside the cuff and 2 regions in the anchor hole and subacromial bursa were superimposed on the obtained images. Calculated areas under the time-intensity curves were expressed in acoustic units (AU). RESULTS: We found area-dependent differences in patterns of alteration and magnitude of blood flow inside the repaired cuff and peritendinous tissues. Vascularity in the articular distal and bursal distal region of the repaired cuff at 1 month postoperatively increased significantly compared with that at the preoperative baseline (76 vs 5 AU, P = .0037; 92 vs 7 AU, P = .043). The vascularity peaked at 1 month after surgery in the bursal area within the cuff but at 2 months in the articular area. The vascularity in the articular proximal region of the repaired cuff was significantly lower than that in the bursal proximal (P = .0046), bursal distal (P = .0183), and articular distal regions (P = .0163) 1 month after surgery. CONCLUSION: Enhancement patterns in intratendinous tissue increased at 1 or 2 months postoperatively and decreased at 3 months. We found area-dependent differences in enhancement patterns inside the repaired cuff and peritendinous tissue. CLINICAL RELEVANCE: Visualization of vascularization using contrast-enhanced ultrasound could help in deciding on an appropriate repair technique or on the form of postoperative rehabilitation after rotator cuff repair.
• Identification and further differentiation of subendocardial and transmural myocardial infarction by fast strain-encoded (SENC) magnetic resonance imaging at 3.0 Tesla.

  Noriko Oyama-Manabe, Naoki Ishimori, Hiroyuki Sugimori, Marc Van Cauteren, Kohsuke Kudo, Osamu Manabe, Tomoyuki Okuaki, Tamotsu Kamishima, Yoichi M Ito, Hiroyuki Tsutsui, Khin Khin Tha, Satoshi Terae, Hiroki Shirato

  European radiology 21 (11) 2362 - 8 0938-7994 2011/11 [Refereed][Not invited]
   

  OBJECTIVES: To investigate whether subendocardial and transmural myocardial infarction can be identified and differentiated using the peak circumferential and longitudinal strains measured by fast strain-encoded (SENC). METHODS: Nineteen patients with ischemic heart diseases underwent imaging with fast SENC and late gadolinium enhancement (LGE) MRI at 3 T. Fast SENC measurements were performed in three short-axis slices (basal, mid-ventricular and apical levels) and one long-axis view (four-chamber) to assess peak longitudinal and circumferential systolic strains. RESULTS: All patients showed myocardial infarction with an average of 7 positive LGE segments. A total of 304 segments for longitudinal strains (LS) and 114 segments for circumferential strains (CS) could be analysed. Positive LGE segments showed lower peak CS and LS compared with the no LGE segments (P < 0.0001 for both). Segments with subendocardial infarction showed reduced CS and LS compared with the no LGE segments (P < 0.0001 for both). There was a significant difference in CS between subendocardial and transmural infarct segments (P = 0.03), but no significant difference in LS between them (P = 0.64). CONCLUSIONS: Fast SENC can identify old myocardial infarction and differentiate subendocardial from transmural infarction.
• Power Doppler signal calibration using capillary phantom for pannus vascularity in rheumatoid finger joint: a pilot study

  T. Kamishima, M. Nishida, T. Horie, A. Narita, A. Sagawa, M. Henmi, H. Shirato, S. Terae

  CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 29 (6) 1057 - 1057 0392-856X 2011/11 [Refereed][Not invited]
  
• Radiographic prognosis of finger joint damage predicted by early alteration in synovial vascularity in patients with rheumatoid arthritis: Potential utility of power doppler sonography in clinical practice

  Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Takeya Ito, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Arthritis Care and Research 63 (9) 1247 - 1253 2151-4658 2011/09 [Refereed][Not invited]
   

  Objective To investigate the relationship between synovial vascularity and progression of structural bone damage in each finger joint in patients with rheumatoid arthritis (RA) and to demonstrate synovial vascularity as a potential therapeutic marker. Methods We studied 250 metacarpophalangeal (MCP) and 250 proximal interphalangeal (PIP) joints of 25 patients with active RA who were administered adalimumab or tocilizumab. Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at the fourth and eighth weeks. Synovial vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and the twentieth week. Results Clinical indices such as the 28-joint Disease Activity Score, the Clinical Disease Activity Index, and the Simplified Disease Activity Index were significantly decreased by biologic agents. The MCP and PIP joints with no response in synovial vascularity between baseline and the eighth week (vascularity improvement of ≤70% at the eighth week) showed a higher risk of radiographic progression compared with responsive joints (vascularity improvement of > 70% at the eighth week relative risk 2.33-9). Radiographic progression at the twentieth week was significantly lower in responsive joints than in nonresponsive joints. Conclusion The improvement of synovial vascularity following treatment with biologic agents led to suppression of radiographic progression of RA in each finger joint. The alteration in synovial vascularity numerically reflected therapeutic efficacy. Using vascularity as a marker to determine the most suitable therapeutic approach would be beneficial for patients with active RA. Copyright © 2011 by the American College of Rheumatology.
• Radiographic prognosis of finger joint damage predicted by early alteration in synovial vascularity in patients with rheumatoid arthritis: Potential utility of power doppler sonography in clinical practice.

  Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Takeya Ito, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Arthritis care & research 63 (9) 1247 - 53 2151-464X 2011/09 [Refereed][Not invited]
   

  OBJECTIVE: To investigate the relationship between synovial vascularity and progression of structural bone damage in each finger joint in patients with rheumatoid arthritis (RA) and to demonstrate synovial vascularity as a potential therapeutic marker. METHODS: We studied 250 metacarpophalangeal (MCP) and 250 proximal interphalangeal (PIP) joints of 25 patients with active RA who were administered adalimumab or tocilizumab. Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at the fourth and eighth weeks. Synovial vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and the twentieth week. RESULTS: Clinical indices such as the 28-joint Disease Activity Score, the Clinical Disease Activity Index, and the Simplified Disease Activity Index were significantly decreased by biologic agents. The MCP and PIP joints with no response in synovial vascularity between baseline and the eighth week (vascularity improvement of ≤70% at the eighth week) showed a higher risk of radiographic progression compared with responsive joints (vascularity improvement of >70% at the eighth week; relative risk 2.33-9). Radiographic progression at the twentieth week was significantly lower in responsive joints than in nonresponsive joints. CONCLUSION: The improvement of synovial vascularity following treatment with biologic agents led to suppression of radiographic progression of RA in each finger joint. The alteration in synovial vascularity numerically reflected therapeutic efficacy. Using vascularity as a marker to determine the most suitable therapeutic approach would be beneficial for patients with active RA.
• 画像診断技術の進歩とその臨床的革新への可能性 造影超音波検査による腱板治癒過程における血行動態の変化

  船越 忠直, 岩崎 倫政, 西田 欽也, 本宮 真, 神島 保, 西田 睦, 末永 直樹, 三浪 明男

  日本整形外科学会雑誌 (公社)日本整形外科学会 85 (8) S1061 - S1061 0021-5325 2011/08
• Rapid estimation of split renal function in kidney donors using software developed for computed tomographic renal volumetry.

  Fumi Kato, Tamotsu Kamishima, Ken Morita, Natalia S Muto, Syozou Okamoto, Tokuhiko Omatsu, Noriko Oyama, Satoshi Terae, Kakuko Kanegae, Katsuya Nonomura, Hiroki Shirato

  European journal of radiology 79 (1) 15 - 20 0720-048X 2011/07 [Refereed][Not invited]
   

  PURPOSE: To evaluate the speed and precision of split renal volume (SRV) measurement, which is the ratio of unilateral renal volume to bilateral renal volume, using a newly developed software for computed tomographic (CT) volumetry and to investigate the usefulness of SRV for the estimation of split renal function (SRF) in kidney donors. METHOD: Both dynamic CT and renal scintigraphy in 28 adult potential living renal donors were the subjects of this study. We calculated SRV using the newly developed volumetric software built into a PACS viewer (n-SRV), and compared it with SRV calculated using a conventional workstation, ZIOSOFT (z-SRV). The correlation with split renal function (SRF) using (99m)Tc-DMSA scintigraphy was also investigated. RESULTS: The time required for volumetry of bilateral kidneys with the newly developed software (16.7±3.9s) was significantly shorter than that of the workstation (102.6±38.9s, p<0.0001). The results of n-SRV (49.7±4.0%) were highly consistent with those of z-SRV (49.9±3.6%), with a mean discrepancy of 0.12±0.84%. The SRF also agreed well with the n-SRV, with a mean discrepancy of 0.25±1.65%. The dominant side determined by SRF and n-SRV showed agreement in 26 of 28 cases (92.9%). CONCLUSION: The newly developed software for CT volumetry was more rapid than the conventional workstation volumetry and just as accurate, and was suggested to be useful for the estimation of SRF and thus the dominant side in kidney donors.
• Computed tomography osteoabsorptiometry alterations in stress distribution patterns through the wrist after radial shortening osteotomy for Kienböck disease.

  Hikaru Makabe, Norimasa Iwasaki, Tamotsu Kamishima, Naomi Oizumi, Shigeru Tadano, Akio Minami

  The Journal of hand surgery 36 (7) 1158 - 64 0363-5023 2011/07 [Refereed][Not invited]
   

  PURPOSE: The distribution pattern of subchondral bone density is considered to closely reflect the stress distribution across a joint under physiological loading conditions. Our purpose was to determine alterations in the distribution pattern of subchondral bone density across the distal articular surfaces of the radius and the ulna in patients with Kienböck disease after radial shortening. METHODS: We collected preoperative and postoperative computed tomography (CT) image data from 7 wrists of 7 patients who had undergone radial shortening for Kienböck disease. We measured the distribution of subchondral bone density through the distal articular surface of the radius and the ulna using a CT osteoabsorptiometry method. The obtained data were quantitatively assessed by calculating the high-density area ratio of the entire radiocarpal joint surface, scaphoid fossa, lunate fossa, and distal ulnar surface. RESULTS: At the mean postoperative period of 27 months, the mean high-density area ratio in the entire distal articular surface of the radius significantly decreased from 0.413 preoperatively to 0.141 postoperatively. The postoperative value in each fossa demonstrated a significant reduction from 0.253 to 0.096 in the scaphoid fossa and from 0.160 to 0.045 in the lunate fossa. No significant alteration in the value was found in the distal ulna at follow-up. CONCLUSIONS: Our CT osteoabsorptiometry analysis suggests that the distribution of subchondral bone density in both scaphoid and lunate fossae notably decreases after radial shortening. This indicates that radial shortening unloads the lunate by reducing the actual stress across the distal articular surface of the radius in subjects with Kienböck disease. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
• Monitoring anti-interleukin 6 receptor antibody treatment for rheumatoid arthritis by quantitative magnetic resonance imaging of the hand and power Doppler ultrasonography of the finger.

  Tamotsu Kamishima, Kazuhide Tanimura, Masato Shimizu, Megumi Matsuhashi, Jun Fukae, Yujiro Kon, Hiromi Hagiwara, Akihiro Narita, Yuko Aoki, Naoki Kosaka, Tatsuya Atsumi, Hiroki Shirato, Satoshi Terae

  Skeletal radiology 40 (6) 745 - 55 0364-2348 2011/06 [Refereed][Not invited]
   

  OBJECTIVES: To compare quantitative magnetic resonance imaging (MRI) and power Doppler ultrasonography (PDUS) with conventional measures of disease activity in rheumatoid arthritis (RA) patients treated with the anti-interleukin 6 (anti-IL 6) receptor antibody tocilizumab in terms of responsiveness at a few months to disease activity and ability to predict structural damage at 1 year. METHODS: A cohort of patients with RA (n = 29) was evaluated clinically including disease activity score 28 (DAS28) and by semiquantitative (SQ-) and quantitative (Q-) PDUS (bilateral metacarpophalangeal joints) and MRI (one hand and wrist) at initiation of treatment with anti-IL 6 receptor antibody agents and after 2 and 5 months. Conventional radiography for both hands and wrists was performed at baseline and at 12 months. Responsiveness was assessed by standardized response means (SRM). Areas under the curve (AUC) for measures at baseline, 2 and 5 months were correlated with structural damage at 1 year. RESULTS: Among the laboratory and clinical parameters, DAS28-ESR was the most responsive with a large effect size of SRM. Structural damage progressions for radiography and MR erosion were correlated with AUC of MR bone erosion and Q-PDUS, respectively. CONCLUSIONS: In the evaluation of disease activity in RA patients in the first few months after starting anti-IL 6 receptor antibody tocilizumab treatment, the semiquantitative MR bone erosion score of the hand and quantitative value for power Doppler signal in the finger joint were both responsive and predictive of structural damage progression at 1 year.
• Relationship between diseased lung tissues on computed tomography and motion of fiducial marker near lung cancer.

  Yuya Onodera, Noriko Nishioka, Koichi Yasuda, Noriyuki Fujima, Mylin Torres, Tamotsu Kamishima, Noriko Ooyama, Rikiya Onimaru, Satoshi Terae, Satoshi Ooizumi, Masaharu Nishimura, Hiroki Shirato

  International journal of radiation oncology, biology, physics 79 (5) 1408 - 13 1879-355X 2011/04/01 [Refereed][Not invited]
   

  PURPOSE: For lung cancer patients with poor pulmonary function because of emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before undergoing stereotactic body radiotherapy. METHODS AND MATERIALS: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography scans in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy. The relationships between the computed tomography findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Of the 71 patients, 30 had normal pulmonary function, and 29 had obstructive pulmonary dysfunction (forced expiratory volume in 1 s/forced vital capacity ratio of <70%), 6 patients had constrictive dysfunction (percentage of vital capacity <80%), and 16 had mixed dysfunction. RESULTS: The upper region was associated with smaller tumor motion, as expected (p = .0004), and the presence of fibrosis (p = .088) and pleural tumor contact (p = .086) were weakly associated with tumor motion. The presence of fibrotic changes in the lung tissue was associated with smaller tumor motion in the upper region (p <.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. CONCLUSION: Tumors in the upper lung region with fibrotic changes have smaller motion than those in the upper region of the lungs without fibrotic changes. The tumor motion in the lower lung region was not significantly different between patients with and without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion.
• Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function.

  Natalia Sayuri Muto, Tamotsu Kamishima, Ardene A Harris, Fumi Kato, Yuya Onodera, Satoshi Terae, Hiroki Shirato

  European journal of radiology 78 (1) 151 - 6 0720-048X 2011/04 [Refereed][Not invited]
   

  PURPOSE: To evaluate the relationship between renal cortical volume, measured by an automatic contouring software, with body mass index (BMI), age and renal function. MATERIALS AND METHODS: The study was performed in accordance to the institutional guidelines at our hospital. Sixty-four patients (34 men, 30 women), aged 19 to 79 years had their CT scans for diagnosis or follow-up of hepatocellular carcinoma retrospectively examined by a computer workstation using a software that automatically contours the renal cortex and the renal parenchyma. Body mass index and estimated glomerular filtration rate (eGFR) were calculated based on data collected. Statistical analysis was done using the Student t-test, multiple regression analysis, and intraclass correlation coefficient (ICC). RESULTS: The ICC for total renal and renal cortical volumes were 0.98 and 0.99, respectively. Renal volume measurements yielded a mean cortical volume of 105.8cm(3)±28.4SD, mean total volume of 153cm(3)±39SD and mean medullary volume of 47.8cm(3)±19.5SD. The correlation between body weight/height/BMI and both total renal and cortical volumes presented r=0.6, 0.6 and 0.4, respectively, p<0.05, while the correlation between renal cortex and age was r=-0.3, p<0.05. eGFR showed correlation with renal cortical volume r=0.6, p<0.05. CONCLUSION: This study demonstrated that renal cortical volume had a moderate positive relationship with BMI, moderate negative relationship with age, and a strong positive relationship with the renal function, and provided a new method to routinely produce volumetric assessment of the kidney.
• RELATIONSHIP BETWEEN DISEASED LUNG TISSUES ON COMPUTED TOMOGRAPHY AND MOTION OF FIDUCIAL MARKER NEAR LUNG CANCER

  Yuya Onodera, Noriko Nishoka, Koichi Yasuda, Noriyuki Fujima, Mylin Torres, Tamotsu Kamishima, Noriko Ooyama, Rikiya Onimaru, Satoshi Terae, Satoshi Ooizumi, Masaharu Nishimura, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 79 (5) 1408 - 1413 0360-3016 2011/04 [Refereed][Not invited]
   

  Purpose: For lung cancer patients with poor pulmonary function because of emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before undergoing stereotactic body radiotherapy. Methods and Materials: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography scans in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy. The relationships between the computed tomography findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Of the 71 patients, 30 had normal pulmonary function, and 29 had obstructive pulmonary dysfunction (forced expiratory volume in 1 s/forced vital capacity ratio of < 70%), 6 patients had constrictive dysfunction (percentage of vital capacity < 80%), and 16 had mixed dysfunction. Results: The upper region was associated with smaller tumor motion, as expected (p = .0004), and the presence of fibrosis (p = .088) and pleural tumor contact (p = .086) were weakly associated with tumor motion. The presence of fibrotic changes in the lung tissue was associated with smaller tumor motion in the upper region (p <.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. Conclusion: Tumors in the upper lung region with fibrotic changes have smaller motion than those in the upper region of the lungs without fibrotic changes. The tumor motion in the lower lung region was not significantly different between patients with and without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion. (C) 2011 Elsevier Inc.
• 肩腱板断裂治癒過程における血行動態 新規造影剤を用いた超音波検査

  船越 忠直, 岩崎 倫政, 西田 睦, 神島 保, 三浪 明男

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 52 (2) 357 - 358 1343-3873 2011/03
• 造影超音波検査による肩腱板断裂治癒過程における血行動態の変化

  船越 忠直, 岩崎 倫政, 神島 保, 西田 睦, 西田 欽也, 本宮 真, 河村 大介, 松本 大, 永野 裕介, 三浪 明男, 末永 直樹

  日本整形外科学会雑誌 (公社)日本整形外科学会 85 (3) S347 - S347 0021-5325 2011/03
• Long-term stress distribution patterns across the elbow joint in baseball players assessed by computed tomography osteoabsorptiometry.

  Daisuke Momma, Norimasa Iwasaki, Naomi Oizumi, Hiroki Nakatsuchi, Tadanao Funakoshi, Tamotsu Kamishima, Shigeru Tadano, Akio Minami

  The American journal of sports medicine 39 (2) 336 - 41 0363-5465 2011/02 [Refereed][Not invited]
   

  BACKGROUND: The distribution pattern of subchondral bone density is considered to highly reflect the stress distribution across a joint under long-term physiologic loading conditions. Therefore, the biomechanical characteristics over the elbow joint surface under long-term loading conditions of baseball pitching can be determined by a measurement of the distribution pattern. HYPOTHESIS: Stress distribution over the elbow joint surface alters with long-term pitching activities. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Computed tomography (CT) imaging data from the dominant elbow of 10 nonthrowing athletes, 10 college baseball fielders, and 10 college baseball pitchers were collected for the current analysis. The distribution of subchondral bone density through the distal articular surface of the humerus was measured using a CT osteoabsorptiometry method. The quantitative analysis of the obtained data focused on location and size of the maximum density area at the articular surface. RESULTS: The maximum density area of subchondral bone across the articular surface of the distal humerus was located in the posterior part of the trochlea in all subjects. This maximum density area was significantly increased in the pitcher group, compared with that in other groups. Additionally, the pitcher group demonstrated a significant distribution of the maximum density area in the anterior part of the capitellum. CONCLUSION: The results indicate that actual stress across the elbow is concentrated in the posterior part of the trochlea in humans. Baseball pitching may produce excessive or repetitive stress against not only this part, but also the anterior part of the capitellum. The majority of osteochondritis dissecans lesions affecting the elbow are found in the anterior part of the capitellum in throwing athletes. The results may support an important role of mechanical conditions in the cause of elbow osteochondritis dissecans.
• The incidence and mechanism of sunitinib-induced thyroid atrophy in patients with metastatic renal cell carcinoma

  N. Shinohara, M. Takahashi, T. Kamishima, H. Ikushima, N. Otsuka, A. Ishizu, C. Shimizu, H. Kanayama, K. Nonomura

  BRITISH JOURNAL OF CANCER 104 (2) 241 - 247 0007-0920 2011/01 [Refereed][Not invited]
   

  BACKGROUND: To elucidate the incidence and mechanisms of sunitinib-induced thyroid atrophy, we investigated serial volumetric and functional changes, and evaluated histological changes of the thyroid gland in metastatic renal cell carcinoma patients who received sunitinib. METHODS: Thyroid volume (by computed tomography volumetry) and thyroid function were measured at baseline, during the treatment, and at post-treatment periods. Histological evaluation of the thyroid gland was performed in four autopsied patients. RESULTS: The median reduction rate in thyroid volume at last evaluation during sunitinib treatment was 30% in all 17 patients. The incidence of hypothyroidism during sunitinib treatment was significantly higher in the high reduction rate group (n - 8; more than 50% reduction in volume) than in the low reduction rate group (n 9; less than 50% reduction in volume). Half of the patients in the high reduction rate group exhibited a transient thyroid-stimulating hormone suppression, suggesting thyrotoxicosis during sunitinib treatment. Histological evaluation demonstrated atrophy of thyroid follicles and degeneration of follicular epithelial cells without critical diminution of vascular volume in the thyroid gland. CONCLUSION: Thyroid atrophy is frequently observed following sunitinib treatment and may be brought about by sunitinib-induced thyrotoxicosis or the direct effects of sunitinib that lead to degeneration of thyroid follicular cells. British Journal of Cancer (2011) 104, 241-247. doi: 10.1038/sj.bjc.6606029 www.bjcancer.com Published online 14 December 2010 (C) 2011 Cancer Research UK
• Simplified approach to MR image quantification of the rheumatoid wrist: a pilot study.

  Tamotsu Kamishima, Kazuhide Tanimura, Yuko Aoki, Naoki Kosaka, Masato Shimizu, Megumi Matsuhashi, Jun Fukae, Yujiro Kon, Satoshi Terae, Hiroki Shirato

  Skeletal radiology 40 (1) 65 - 74 0364-2348 2011/01 [Refereed][Not invited]
   

  OBJECTIVES: To determine an optimal threshold in a simplified 3D-based volumetry of abnormal signals in rheumatoid wrists utilizing contrast and non-contrast MR data, and investigate the feasibility and reliability of this method. MATERIALS AND METHODS: MR images of bilateral hands of 15 active rheumatoid patients were assessed before and 5 months after the initiation of tocilizumab infusion protocol. The volumes of abnormal signals were measured on STIR and post-contrast fat-suppressed T1-weighted images. Three-dimensional volume rendering of the images was used for segmentation of the wrist by an MR technologist and a radiologist. Volumetric data were obtained with variable thresholding (1, 1.25, 1.5, 1.75, and 2 times the muscle signal), and were compared to clinical data and semiquantitative MR scoring (RAMRIS) of the wrist. Intra- and interobserver variability and time needed for volumetry measurements were assessed. RESULTS: The volumetric data correlated favorably with clinical parameters almost throughout the pre-determined thresholds. Interval differences in volumetric data correlated favorably with those of RAMRIS when the threshold was set at more than 1.5 times the muscle signal. The repeatability index was lower than the average of the interval differences in volumetric data when the threshold was set at 1.5-1.75 for STIR data. Intra- and interobserver variability for volumetry was 0.79-0.84. The time required for volumetry was shorter than that for RAMRIS. CONCLUSIONS: These results suggest that a simplified MR volumetric data acquisition may provide gross estimates of disease activity when the threshold is set properly. Such estimation can be achieved quickly by non-imaging specialists and without contrast administration.
• In vivo visualization of vascular patterns of rotator cuff tears using contrast-enhanced ultrasound.

  Tadanao Funakoshi, Norimasa Iwasaki, Tamotsu Kamishima, Mutsumi Nishida, Yoichi Ito, Makoto Kondo, Akio Minami

  The American journal of sports medicine 38 (12) 2464 - 71 0363-5465 2010/12 [Refereed][Not invited]
   

  BACKGROUND: Hypoxia and decreased blood supply have been proposed as risks for tendon rupture. Visualization of the vascularity of intact and torn rotator cuffs would be useful for improving treatments for rotator cuff tear. PURPOSE: To assess vascularity inside a tendon or an adjacent rotator cuff insertion point in patients differing in age and extent of damage to the tendon. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Ten volunteers (all men) and 15 patients (10 men, 5 women) consented to participate in the study. Contrast agent for enhanced ultrasound was injected intravenously. Enhanced ultrasound images of the torn cuff and the contralateral shoulder were recorded for 1 minute. Four small regions of interest, the articular and bursal sides of the tendon and the medial and lateral sides of the bursa, were studied in all shoulders. RESULTS: There was a significant decrease in blood flow in the intratendinous region in elderly subjects compared with young subjects, but age had no effect on blood flow in bursal tissue. Blood flow in ruptured rotator cuffs did not differ from that in intact rotator cuffs. The intraclass correlation coefficient for intraobserver reproducibility was 0.82 (95% confidence interval: 0.77-0.86). CONCLUSIONS: The findings of this investigation were the hypovascular pattern in intratendinous tissue compared with the subacromial bursa, the age-related decrease in intratendinous vascularity, and the hypovascular pattern in the tendon, regardless of rupture of the tendon. Clarification of vascular patterns inside or around the torn ends of a rotator cuff will assist in the development of successful treatments for torn rotator cuffs.
• Transplantation of tissue-engineered cartilage for the treatment of osteochondritis dissecans in the elbow: outcomes over a four-year follow-up in two patients.

  Norimasa Iwasaki, Shintarou Yamane, Kinya Nishida, Tatsuya Masuko, Tadanao Funakoshi, Tamotsu Kamishima, Akio Minami

  Journal of shoulder and elbow surgery 19 (8) e1-6 - E6 1058-2746 2010/12 [Refereed][Not invited]
  
• Contrast-enhanced whole-body joint MRI in patients with unclassified arthritis who develop early rheumatoid arthritis within 2 years: feasibility study and correlation with MRI findings of the hands.

  Tamotsu Kamishima, Yuichiro Fujieda, Tatsuya Atsumi, Rie Mimura, Takao Koike, Satoshi Terae, Hiroki Shirato

  AJR. American journal of roentgenology 195 (4) W287-92 - W292 0361-803X 2010/10 [Refereed][Not invited]
   

  OBJECTIVE: The purpose of this article is to examine the feasibility of whole-body joint MRI for detecting systemic joint synovitis and for analyzing the relationship between the hands and systemic joint involvement in patients with unclassified arthritis who later develop early rheumatoid arthritis (RA). MATERIALS AND METHODS: The study included 17 patients (five men and 12 women; median age, 65 years [range, 38-77 years]; median symptom duration, 3 months [range, 1-6 months]). MRI of the systemic joints was performed for patients with unclassified arthritis without radiographic evidence of RA and who were diagnosed as having RA according to 1987 revised classification criteria within 2 years. RESULTS: The chosen 4-point scale for image quality was moderate to excellent. MRI findings of systemic joints were in accordance with joint swelling and tenderness (chi-square test, p < 0.0001). Sixty percent (45/75) of hand joints and 67% (12/18) of systemic joints other than hands showed MR synovitis without swelling. With regard to the correlation of MRI findings between hands and joints other than hands, there was a statistically significant positive correlation in the joint count (r = 0.5514 and p = 0.0218) and semiquantitative value of hand synovitis (r = 0.5382 and p = 0.0258). CONCLUSION: Whole-body joint MRI in early RA is feasible in terms of image quality and agreement with the results of clinical examination. MRI may be more sensitive for depicting synovitis-positive joints than clinical examination. Estimation of the systemic burden of synovitis detected by MRI may be possible via MRI of the hands.
• 肩腱板断裂に対する新規造影剤を用いた超音波検査の有用性

  船越 忠直, 神島 保, 西田 睦, 近藤 真, 岩崎 倫政, 三浪 明男

  北海道整形災害外科学会雑誌 北海道整形災害外科学会 52 (1) 134 - 135 1343-3873 2010/08
• 肩腱板断裂治癒過程における血行動態 新規造影剤を用いた超音波検査

  船越 忠直, 岩崎 倫政, 西田 欽也, 本宮 真, 神島 保, 西田 睦, 末永 直樹, 三浪 明男

  日本整形外科学会雑誌 (公社)日本整形外科学会 84 (8) S1191 - S1191 0021-5325 2010/08
• Splenic volume measurements on computed tomography utilizing automatically contouring software and its relationship with age, gender, and anthropometric parameters.

  Ardene Harris, Tamotsu Kamishima, Hong Yi Hao, Fumi Kato, Tokuhiko Omatsu, Yuya Onodera, Satoshi Terae, Hiroki Shirato

  European journal of radiology 75 (1) e97-101 - E101 0720-048X 2010/07 [Refereed][Not invited]
   

  OBJECTIVE: The present research was conducted to establish the normal splenic volume in adults using a novel and fast technique. The relationship between splenic volume and age, gender, and anthropometric parameters was also examined. MATERIALS AND METHODS: The splenic volume was measured in 230 consecutive patients who underwent computed tomography (CT) scans for various indications. Patients with conditions that have known effect on the spleen size were not included in this study. A new technique using volumetric software to automatically contour the spleen in each CT slice and quickly calculate splenic volume was employed. Inter- and intra-observer variability were also examined. RESULTS: The average splenic volume of all the subjects was 127.4+/-62.9 cm(3), ranging from 22 to 417 cm(3). The splenic volume (S) correlated with age (A) (r=-0.33, p<0.0001), body weight (W) (r=0.35, p<0.0001), body mass index (r=0.24, p<0.0001) and body surface area (BSA) (r=0.31, p<0.0001). The age-adjusted splenic volume index correlated with gender (p=0.0089). The formulae S=W[6.47A(-0.31)] and S=BSA[278A(-0.36)] were derived and can be used to estimate the splenic volume. Inter- and intra-observer variability were 6.4+/-9.8% and 2.8+/-3.5% respectively. CONCLUSION: Of the anthropometric parameters, the splenic volume was most closely linked to body weight. The automatically contouring software as well as formulae can be used to obtain the volume of the spleen in regular practice.
• Change of synovial vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis: Comparative study of a novel quantitative score with a semiquantitative score

  Jun Fukae, Yujiro Kon, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Arthritis Care and Research 62 (5) 657 - 663 2151-4658 2010/05 [Refereed][Not invited]
   

  Objective. To investigate the relationship between synovial vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA). Methods. We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial vascularity was evaluated according to both quantitative and semiquantitative methods. Results. Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial vascularity and radiographic change in single MCP or PIP joints, the level of vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of vascularity in response to DMARDs, defined as the percentage change in vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial vascularity in a single finger joint. Conclusion. The change of synovial vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA. © 2010, American College of Rheumatology.
• Extramedullary plasmacytoma involving perirenal space accompanied by extramedullary hematopoiesis and amyloid deposition

  Rie Mimura, Tamotsu Kamishima, Kanako C. Kubota, Fumihito Nakano, Ichiro Yabe, Hidenao Sasaki, Satoru Maruyama, Nobuo Shinohara, Ardene A. Harris, Hironori Haga, Hiroki Shirato, Satoshi Terae

  JAPANESE JOURNAL OF RADIOLOGY 28 (4) 309 - 313 1867-108X 2010/05 [Refereed][Not invited]
   

  A 62-year-old man was referred to us after unsuccessful treatment of bilateral weakness in his upper and lower extremities with paresthesia in both lower extremities. Computed tomography (CT) revealed soft tissue masses in the left kidney along the capsule and paraaortic region that were of relatively low attenuation with accompanying granular calcifications. Pathological diagnosis of the biopsy specimen was extramedullary plasmacytoma accompanied by extramedullary hematopoiesis and amyloid deposition. Although the CT findings correlated well with the pathological results, the case was extremely atypical for extramedullary plasmacytoma in respect to location and the accompaniment with extramedullary hematopoiesis.
• Semi-quantitative analysis of rheumatoid finger joint synovitis using power Doppler ultrasonography: when to perform follow-up study after treatment consisting mainly of antitumor necrosis factor alpha agent.

  Tamotsu Kamishima, Akira Sagawa, Kazuhide Tanimura, Masato Shimizu, Megumi Matsuhashi, Masahide Shinohara, Hiromi Hagiwara, Mihoko Henmi, Akihiro Narita, Satoshi Terae, Hiroki Shirato

  Skeletal radiology 39 (5) 457 - 65 0364-2348 2010/05 [Refereed][Not invited]
   

  PURPOSE: To determine the timing for follow-up study of power Doppler ultrasonography (PDUS) by evaluating the response of finger joint synovitis in patients with rheumatoid arthritis (RA) to treatment including infliximab, an antitumor necrosis factor alpha agent. METHODS AND MATERIALS: Bilateral second/third metacarpo-phalangeal (MCP) joints and second proximal inter-phalangeal (PIP) joints (total of six joints) in 21 patients (18 women and three men; median age 53 years) with chronic active RA were assessed by PDUS before and after 2 weeks, 6 weeks, 14 weeks, 30 weeks, 38 weeks, 46 weeks, and 54 weeks of infliximab infusion. Pulse Doppler settings were standardized for each patient and optimized for the detection of synovial blood flow by adjustment of color gain, pulse repetition, and flow optimization. Power Doppler signal was graded for each joint [joint grade for power Doppler (JGPD) signals], and the sum of the grades of six joints was defined as the PDUS index [joint index for power Doppler signals (JIPD)] at each visit. PDUS and clinical parameters [28-joint disease activity score (DAS28), health assessment questionnaire, and C-reactive protein (CRP) level] were independently assessed and compared with baseline values. The American College of Rheumatology (ACR) core set responders and non-responders at week 54 were compared for clinical parameters and PDUS index at each visit. RESULTS: Fourteen patients completed the planned treatment for 1 year, while six patients dropped out for various reasons and one died suddenly. PDUS was performed a total of 146 times on 467 joints. DAS28 was assessed 127 times. Both DAS28 and JIPD had decreased at the follow-up. Comparative analysis between DAS28 and PDUS was available 125 times. The transverse correlation between the PDUS index and DAS28 was not significant throughout the follow-up period. When responders and non-responders were discriminated at week 54, a logistic regression model for the binary endpoint of responder vs non-responder, with PDUS index as explanatory variable at time point 0, and follow-up revealed statistical significance from week 38 and on. CONCLUSION: PDUS reflected infliximab's effect on pannus vascular signals; this effect was observed as early as 2 weeks after treatment had begun. Also, the responders to treatment at 54 weeks tended to have fewer JIPD than non-responders in the follow-up period. PDUS may be performed at week 38 or later to foresee the response to the treatment at week 54.
• Change of synovial vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis: comparative study of a novel quantitative score with a semiquantitative score.

  Jun Fukae, Yujiro Kon, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike

  Arthritis care & research 62 (5) 657 - 63 2151-464X 2010/05 [Refereed][Not invited]
   

  OBJECTIVE: To investigate the relationship between synovial vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA). METHODS: We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial vascularity was evaluated according to both quantitative and semiquantitative methods. RESULTS: Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial vascularity and radiographic change in single MCP or PIP joints, the level of vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of vascularity in response to DMARDs, defined as the percentage change in vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial vascularity in a single finger joint. CONCLUSION: The change of synovial vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA.
• Extramedullary plasmacytoma involving perirenal space accompanied by extramedullary hematopoiesis and amyloid deposition.

  Rie Mimura, Tamotsu Kamishima, Kanako C Kubota, Fumihito Nakano, Ichiro Yabe, Hidenao Sasaki, Satoru Maruyama, Nobuo Shinohara, Ardene A Harris, Hironori Haga, Hiroki Shirato, Satoshi Terae

  Japanese journal of radiology 28 (4) 309 - 13 1867-1071 2010/05 [Refereed][Not invited]
   

  A 62-year-old man was referred to us after unsuccessful treatment of bilateral weakness in his upper and lower extremities with paresthesia in both lower extremities. Computed tomography (CT) revealed soft tissue masses in the left kidney along the capsule and paraaortic region that were of relatively low attenuation with accompanying granular calcifications. Pathological diagnosis of the biopsy specimen was extramedullary plasmacytoma accompanied by extramedullary hematopoiesis and amyloid deposition. Although the CT findings correlated well with the pathological results, the case was extremely atypical for extramedullary plasmacytoma in respect to location and the accompaniment with extramedullary hematopoiesis.
• 造影超音波による関節リウマチの活動性評価

  神島 保, 西田 睦, 渥美 達也

  IVR: Interventional Radiology (一社)日本インターベンショナルラジオロジー学会 25 (1) 109 - 109 1340-4520 2010/01
• Sequential alterations in magnetic resonance imaging findings after autologous osteochondral mosaicplasty for young athletes with osteochondritis dissecans of the humeral capitellum.

  Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Akio Minami

  The American journal of sports medicine 37 (12) 2349 - 54 0363-5465 2009/12 [Refereed][Not invited]
   

  BACKGROUND: The goal of osteochondral mosaicplasty (mosaicplasty) against osteochondritis dissecans of the humeral capitellum (capitellar OCD) is to allow patients to return to their sports activities without functional disturbance of the affected elbow. Consequently, the rehabilitation protocol and the interval before returning to sports activities must be established. Although surgeons need this type of data for establishing sequential alterations of grafts in the elbow, no such data have been published. HYPOTHESIS: The findings of magnetic resonance imaging (MRI) improve with increasing time after mosaicplasty for capitellar OCD. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Ten young male athletes with advanced lesions of capitellar OCD, treated with mosaicplasties, underwent MRI scans at 3, 6, and 12 months, postoperatively. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to the capitellar lesion. The MRI findings were semiquantitatively assessed according to the scoring system of Henderson et al (4, normal; 16, no repair). RESULTS: At 12 months, all patients returned to their competitive level of sports without any disturbances of the operated elbow. Fluid surrounding the graft was found in all patients at 3 months and 4 patients at 6 months. The grafts were all well seated within the recipient sites, with no MRI evidence of graft loosening at 12 months. The overall MRI scores significantly improved from 3 to 12 months. CONCLUSION: The MRI findings indicate that the graft incorporation to the surrounding tissues occurs around or after 6 months, postoperatively. This finding suggests that rehabilitation precautions be taken for up to 6 months after mosaicplasty for young athletes with capitellar OCD.
• Intravenous pyogenic granuloma of the finger.

  Tamotsu Kamishima, Akiko Hasegawa, Kanako C Kubota, Naomi Oizumi, Norimasa Iwasaki, Akio Minami, Satoru Sasaki, Yuhei Yamamoto, Tokuhiko Omatsu, Yuya Onodera, Satoshi Terae, Hiroki Shirato

  Japanese journal of radiology 27 (8) 328 - 32 1867-1071 2009/10 [Refereed][Not invited]
   

  Intravenous pyogenic granuloma is a rare solitary form of lobular capillary hemangioma that usually occurs in the veins of the neck and upper extremities. We report two cases of intravenous pyogenic granuloma localized in the finger, giving details of the magnetic resonance imaging (MRI) findings. These two cases had similar locations in fingers and identical MRI findings. The differential diagnoses of this rare entity are also discussed.
• Alveolar hydatid disease of the adrenal gland: computed tomography and magnetic resonance imaging findings

  Tamotsu Kamishima, Toru Harabayashi, Syuhei Ishikawa, Kanako C. Kubota, Katsuya Nonomura, Tokuhiko Omatsu, Yuya Onodera, Hiroki Shirato, Satoshi Terae

  JAPANESE JOURNAL OF RADIOLOGY 27 (5) 225 - 228 1867-108X 2009/06 [Refereed][Not invited]
   

  Echinococcosis is a parasitic infection of humans caused by the larval stage of the tapeworm Echinococcus. Primary alveolar echinococcosis of the adrenal gland is rare. We report a case of alveolar hydatid disease of the adrenal gland that presented as a multiloculated cystic mass without calcification. The lesion was purely cystic in nature, suggesting that it was at an early stage of development.
• Alveolar hydatid disease of the adrenal gland: computed tomography and magnetic resonance imaging findings.

  Tamotsu Kamishima, Toru Harabayashi, Syuhei Ishikawa, Kanako C Kubota, Katsuya Nonomura, Tokuhiko Omatsu, Yuya Onodera, Hiroki Shirato, Satoshi Terae

  Japanese journal of radiology 27 (5) 225 - 8 1867-1071 2009/06 [Refereed][Not invited]
   

  Echinococcosis is a parasitic infection of humans caused by the larval stage of the tapeworm Echinococcus. Primary alveolar echinococcosis of the adrenal gland is rare. We report a case of alveolar hydatid disease of the adrenal gland that presented as a multiloculated cystic mass without calcification. The lesion was purely cystic in nature, suggesting that it was at an early stage of development.
• Power Doppler ultrasound of rheumatoid synovitis: quantification of vascular signal and analysis of interobserver variability.

  Tamotsu Kamishima, Kazuhide Tanimura, Mihoko Henmi, Akihiro Narita, Fumihiko Sakamoto, Satoshi Terae, Hiroki Shirato

  Skeletal radiology 38 (5) 467 - 72 0364-2348 2009/05 [Refereed][Not invited]
   

  OBJECTIVE: The objective of this study was to assess interobserver uncertainties in power Doppler (PD) examination of the fingers of patients with rheumatoid arthritis (RA), by separating the source of the discrepancy into (1) acquisition of the images and (2) criteria for assessment of the images. MATERIALS AND METHODS: Twenty patients who had been diagnosed with RA were enrolled in this study. Ultrasound examinations were performed by one inexperienced and two experienced sonographers. Interobserver variation was measured using a conventional semiquantitative image grading scale. Interobserver variation of the quantitative PD (QPD) index (the summation of the colored pixels in a region of interest) was also assessed. RESULTS: The agreement was higher between the two experienced sonographers (kappa value of 0.8) than between experienced and inexperienced sonographers (kappa value, 0.6-0.7) in the semiquantitative image grading scale. Results suggest that the difference in the assessment on the image grading scale was due more to the difference in the acquisition of the images than to variations in the grading criteria between sonographers. An excellent relationship was noted between the image grading scale and the QPD index for Doppler signal with a Spearman's coefficient of rank correlation of 0.83 (P < 0.0001). CONCLUSIONS: Interobserver discrepancies in the image grading and QPD index methods were due more to the difference in the acquisition of the image than to the grading criteria used. The QPD index seems to be as reliable as the image grading scale with reasonable interobserver agreement between experienced sonographers.
• Synovial chondromatosis originating from the synovium of the anterior cruciate ligament: a case report.

  Tokifumi Majima, Tamotsu Kamishima, Kouichi Susuda

  Sports medicine, arthroscopy, rehabilitation, therapy & technology : SMARTT 1 (1) 6 - 6 2009/04/23 [Refereed][Not invited]
   

  A case of synovial chondromatosis originating from the synovium of the anterior cruciate ligament (ACL) resulting in a mechanical block to knee extension is reported. A 36-year-old man complained of a restricted range of left-knee motion and pain when walking. Plain roentgenograms showed normal appearance, however, magnetic resonance imaging showed intensity changes in the ACL. Arthroscopically, numerous small free bodies were observed. Proliferation of synovium and cartilaginous tissues were identified around the ACL. There were no significant findings in the synovium except around the ACL. The synovium around the ACL was resected and free bodies were washed out. This is the first report of synovial chondromatosis originating from the synovium of the ACL.
• RA患者における手関節造影MRIを用いた炎症性滑膜定量による生物学的製剤の効果判定

  神島 保, 堀田 哲也, 大友 耕太郎, 藤枝 雄一郎, 片岡 浩, 保田 晋助, 加藤 将, 渥美 達也, 小池 隆夫

  日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 (一社)日本リウマチ学会 53回・18回 397 - 397 2009/03
• Screening for rheumatoid arthritis with finger joint power Doppler ultrasonography: quantification of conventional power Doppler ultrasonographic scoring.

  Jun Fukae, Masato Shimizu, Yujiro Kon, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Takao Koike

  Modern rheumatology 19 (5) 502 - 6 1439-7595 2009 [Refereed][Not invited]
   

  Power Doppler ultrasonography (PD-US) has proved to be a useful technique to measure synovial vascularity due to its capability to provide data that can be used to evaluate the level of joint inflammation and assess rheumatoid arthritis (RA). We have developed a novel PD-US finger joint scoring method that introduces quantitative measurements into the conventional PD-US assessment method. A comparison of the two methods revealed that our novel PD-US method strongly correlates with the conventional method in terms of RA assessment. We performed finger joint PD-US on 69 patients with RA and 70 patients who had multiple joint pain but showed no evidence of inflammatory diseases (non-inflammatory disease, NI) and measured the synovial vascularity of the metacarpophalangeal joints 1-5 and proximal interphalangeal (PIP) joints 1-5 for each patient. We analyzed the data with receiver operating characteristic analysis and, based on the results for the total vascularity of 20 finger joints, defined a cut-off value of 36% as discriminating between RA and NI. This cut-off value was found to be a valuable tool in screening for RA. We conclude that our finger joint PD-US scoring system is both useful and applicable for diagnosing RA.
• CT/MRIにて確定診断に至らなかった結節に対する造影超音波(CEUS)の位置づけ

  西田 睦, 増田 香織, 佐藤 恵美, 溝口 恵美, 小野寺 祐也, 尾松 徳彦, 神島 保, 加藤 扶美, 加賀 早苗, 井上 真美子, 横山 しのぶ, 鈴木 春樹, 清水 力, 松野 一彦, 玉木 長良, 白土 博樹

  超音波医学 (公社)日本超音波医学会 35 (4) 463 - 463 1346-1176 2008/07
• 全身造影MRIによる関節リウマチの画像診断

  神島 保, 白土 博樹, 保田 晋介, 堀田 哲也, 渥美 達也, 小池 隆夫

  Radiation Medicine (公社)日本医学放射線学会 26 (Suppl.I) 11 - 11 0288-2043 2008/04
• Donor site evaluation after autologous osteochondral mosaicplasty for cartilaginous lesions of the elbow joint.

  Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Naoki Suenaga, Akio Minami

  The American journal of sports medicine 35 (12) 2096 - 100 0363-5465 2007/12 [Refereed][Not invited]
   

  BACKGROUND: One significant disadvantage of autologous osteochondral mosaicplasty (mosaicplasty) is the harvesting of osteochondral grafts from the normal articular area of the knee joint. However, the effect of harvesting grafts on knee function remains unclear. PURPOSE: To clarify the functional effects on the donor knee of harvesting osteochondral grafts and to perform magnetic resonance imaging evaluation of donor site repair after mosaicplasty for capitellar osteochondritis dissecans in young athletes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eleven male competitive athletes with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to osteochondral defects in the capitellum. Assessment at a mean follow-up of 26 months included local findings of the donor knees, a Lysholm knee scoring scale, International Knee Documentation Committee standard evaluation form, and magnetic resonance imaging evaluation. RESULTS: All patients returned to a competitive level of their previous sports without any donor site disturbances. Based on the Lysholm knee score and International Knee Documentation Committee evaluation form, all knees were graded as excellent and normal, respectively. The magnetic resonance imaging showed 50% to 100% defect fill in 6 of 9 patients and normal or nearly normal signals in 4 patients at the donor sites. CONCLUSION: No adverse effects of osteochondral graft harvest on donor knee function were found after mosaicplasty for capitellar osteochondritis dissecans in young athletes. However, magnetic resonance imaging indicates that the donor site is resurfaced with fibrous tissue.
• 関節リウマチの画像診断 非造影関節エコーによる関節リウマチの関節炎評価

  櫻井 典之, 深江 淳, 渥美 達也, 酒井 良江, 堀田 哲也, 保田 晋助, 神島 保, 小池 隆夫

  日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 (一社)日本リウマチ学会 50回・15回 132 - 132 2006/03
• Chemical shift MR images of the parotid gland in Sjögren's syndrome utilizing low-field MR system comparison with MR sialography and salivary secretion function.

  Tamotsu Kamishima

  Radiation medicine 23 (4) 277 - 82 0288-2043 2005/06 [Refereed][Not invited]
   

  PURPOSE: To compare chemical shift imaging and MR sialography in patients with Sjögren's syndrome utilizing a low (0.3 Tesla) magnetic field. METHODS: We retrospectively evaluated 8 controls (16 glands) and 30 patients (60 glands) with parotitis of Sjögren's syndrome. MR images were obtained with a 0.3 Tesla system (HITACHI MRP-7000, Hitachi, Ltd., Tokyo, Japan) with a coil for the temporomandibular joint. MR sialography was graded according to the grading system established for conventional sialography. The signal decrease rate between in- and opposed-phase images, and the standard deviation (S.D.) of the parotid parenchymal signal in opposed-phase images were measured. RESULTS: MR sialography and chemical shift images were obtained in 38 and 46 glands, respectively. MR sialography was graded as 0 in 15, 1 in 12, 2 in 4, and 3 in 5 glands. The mean signal decrease rate in in/opposed phase was 37.6%, and the mean S.D. of the parotid parenchymal signal in the opposed-phase images was 655.9. The salivary secretion function was related to heterogeneity on opposed phase (r=-0.3) but not to MR sialography grading. CONCLUSION: Heterogeneity on opposed-phase images assessable with a low-field magnet system may be a useful parameter to add in the evaluation of Sjögren's parotitis.
• Detection of amiodarone-induced pulmonary toxicity in supine and prone positions: high-resolution computed tomography study.

  Noriko Oyama, Naotsugu Oyama, Hisashi Yokoshiki, Tamotsu Kamishima, Toshikazu Nambu, Hiroyuki Tsutsui, Kazuo Miyasaka

  Circulation journal : official journal of the Japanese Circulation Society 69 (4) 466 - 70 1346-9843 2005/04 [Refereed][Not invited]
   

  BACKGROUND: The aim of the present study was to describe the effectiveness and feasibility of high-resolution computed tomography (HRCT) in patients in supine and prone positions to detect amiodarone-induced pulmonary toxicity (APT). With regard to the possible differential diagnosis, our second goal was to emphasize the clinical value of HRCT with the patients in supine and prone positions compared with other paraclinical tests. METHODS AND RESULTS: Thoracic HRCT taken in both positions for 23 patients who were administrated amiodarone were prospectively evaluated in the current study. High-resolution computed tomography scans obtained with the patient in a prone position were helpful in differentiating dependent opacity from lung disease in 11 out of 23 patients. In another 4 patients, HRCT scans obtained with the patient in a prone position were useful in confirming the presence of subtle ground-glass opacities, considered as APT. Combination of HRCT in supine and prone positions provided a more reproducible method for evaluating the global extent of APT than other paraclinical tests. CONCLUSIONS: High-resolution computed tomography used in prone positions as well as a supine position could be an effective technique for reducing false-positive results in detection of APT and preventing the clinically serious pulmonary adverse effects by amiodanone.
• MDCT scan visualizes the Adamkiewicz artery.

  Ryushi Maruyama, Tamotsu Kamishima, Norihiko Shiiya, Takeshi Asano, Kenji Matsuzaki, Kazuo Miyasaka, Keishu Yasuda

  The Annals of thoracic surgery 76 (4) 1308 - 1308 0003-4975 2003/10 [Refereed][Not invited]
  
• Acute posterior interosseous nerve palsy caused by septic arthritis of the elbow: a case report.

  Hiroyuki Kato, Norimasa Iwasaki, Akio Minami, Tamotsu Kamishima

  The Journal of hand surgery 28 (1) 44 - 7 0363-5023 2003/01 [Refereed][Not invited]
   

  A rare case of acute posterior interosseous nerve palsy caused by septic elbow arthritis is reported. The nerve was compressed beneath the arcade of Frohse by hypertrophied synovium and joint fluid at the anterior aspect of the radial neck. Decompression of the nerve, synovectomy, and irrigation of the elbow joint were done. effective. Six months after the surgery the nerve palsy had recovered completely. Two years after surgery there was no recurrence of the infection or nerve palsy.
• Cirrhosis: modified caudate-right lobe ratio.

  Hitomi Awaya, Donald G Mitchell, Tamotsu Kamishima, George Holland, Katsuyoshi Ito, Tsuneo Matsumoto

  Radiology 224 (3) 769 - 74 0033-8419 2002/09 [Refereed][Not invited]
   

  PURPOSE: To determine whether a modified caudate-right lobe ratio (C/RL) with use of the right portal vein to set the lateral boundary (C/RL-r) is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is the previously described C/RL with use of the main portal vein to set the lateral boundary (C/RL-m). MATERIALS AND METHODS: Two hundred thirty-six patients (121 with pathologically proved cirrhosis and 115 without history of chronic hepatic diseases) underwent magnetic resonance (MR) imaging. Two independent observers measured C/RL-r and compared it with C/RL-m. Results were compared by using receiver operating characteristic (ROC) curves and accuracy measures at various thresholds. RESULTS: The area below the ROC curve was greater for C/RL-r (0.797) than for C/RL-m (0.731; P =.040). By using a C/RL-r greater than 0.90, the sensitivity, specificity, and accuracy for the MR imaging diagnosis of cirrhosis were 71.7%, 77.4%, and 74.2%, respectively. The highest accuracy of the C/RL-m was 65.7%, when the C/RL-m was greater than 0.55. Interobserver agreement was statistically confirmed for both measurements by using kappa analysis. Significant differences were found among the three Child-Pugh classes by using C/RL-r (P =.0105) but not by using C/RL-m. CONCLUSION: C/RL-r is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is C/RL-m.
• Small (<20 mm) enhancing hepatic nodules seen on arterial phase MR imaging of the cirrhotic liver: clinical implications.

  Yong Yeon Jeong, Donald G Mitchell, Tamotsu Kamishima

  AJR. American journal of roentgenology 178 (6) 1327 - 34 0361-803X 2002/06 [Refereed][Not invited]
   

  OBJECTIVE: To determine the significance in patients with cirrhosis of small (<20 mm) hepatic nodules that show no hyperintensity on T2-weighted MR images but that enhance during arterial phase MR imaging, we reviewed the cases of patients with such nodules. MATERIALS AND METHODS: Our review of radiology reports yielded 68 nodules in 40 patients with cirrhosis that showed no hyperintensity on T2-weighted MR images but had rapid enhancement during arterial phase MR imaging after administration of a gadolinium contrast agent. Thirty-four patients (60 nodules) had multiple follow-up MR imaging examinations (range of length of follow-up, 1-72 months; average length of follow-up, 15 months 2 weeks). The final diagnosis of the nodule was determined by pathology reports or after at least 2 years of follow-up to ensure nodule stability and, therefore, benignity. Two radiologists independently reviewed MR images of the nodules, noting the size, signal intensity on T1- or T2-weighted images, and homogeneity of contrast enhancement. RESULTS: Nine (13%) of the 68 nodules were hepatocellular carcinomas (HCCs). The size of nodules on the first MR examination was between 4 and 20 mm (mean size, 9.5 mm). No significant correlation between the diagnosis of HCC and nodule signal intensity (p = 0.48) or contrast enhancement homogeneity (p = 0.56) on first MR examination was found. Positive predictive value (PPV) and negative predictive value (NPV) for diagnosing HCC on the basis of nodule growth were 100% and 98%, respectively. For diagnosing HCC on the basis of a change in nodule signal intensity, the PPV was 60% and the NPV was 91%. For diagnosing HCC on the basis of a change of enhancement homogeneity, the PPV was 63%, and the NPV was 94%. CONCLUSION: A finding of growth in small, early-enhancing nodules in patients with cirrhosis is highly predictive of HCC. When small nodules are observed on a single examination, close follow-up of the patient appears appropriate.
• Spontaneous rupture of hepatocellular carcinoma supplied by the right renal capsular artery treated by transcatheter arterial embolization

  Y Kodama, T Shimizu, H Endo, S Hige, T Kamishima, GA Holland, N Miyamoto, K Miyasaka

  CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 25 (2) 137 - 140 0174-1551 2002/03 [Refereed][Not invited]
   

  We present a case of spontaneous rupture of hepatocellular carcinoma (HCC) with poor liver function which was treated by transcatheter arterial embolization (TAE). The patient's bilirubin value was 3.8 mg/dL. The tumor was fed by the right renal capsular artery according to selective arteriography. It was subsequently treated by TAE. With successful TAE, no hepatic failure was related to the treatment. We believe that if tumors are fed only by extrahepatic collateral vessels, TAE may be an effective treatment even in patients with poor liver function.
• Elbow synovial fold syndrome: MR imaging findings

  H Awaya, ME Schweitzer, SA Feng, T Kamishima, PJ Marone, S Farooki, DJ Trudell, P Haghighi, DL Resnick

  AMERICAN JOURNAL OF ROENTGENOLOGY 177 (6) 1377 - 1381 0361-803X 2001/12 [Refereed][Not invited]
   

  OBJECTIVE. We describe the anatomy and MR imaging appearance of elbow plicae. MATERIALS AND METHODS. First. five cadavers were evaluated by sectioning and using MR arthrography for evidence of normal or prominent synovial folds to determine the potential origin of elbow plicae. Next, 164 consecutive MR images were evaluated to determine the frequency of the plicae in a clinical population. Last, we retrospectively studied a selected group of eight patients who underwent preoperative MR imaging and in whom enlarged synovial folds were confirmed at surgery. RESULTS. In the cadavers, the synovial fold appeared to originate from the synovium adjacent to a posterior fat pad. In the clinical population, half the patients showed a synovial fold at the same location; however, most folds were less than or equal to 2 tnm in thickness. The eight patients presented clinically with symptoms mimicking an intraarticular body. The synovial fold in symptomatic patients was seen posteriorly just above the olecranon and averaged 3 mm in thickness. CONCLUSION. A synovial fold extending from the posterior fat pad in the elbow is a frequent finding on MR imaging. In a subgroup of patients, plicae, when thickened, may present clinically as a locking elbow. However, overlap exists between the thicknesses of symptomatic and asymptomatic plicae.
• Rapid MR imaging detection of renal cysts: Age-based standards

  AB Nascimento, DG Mitchell, XM Zhang, T Kamishima, L Parker, GA Holland

  RADIOLOGY 221 (3) 628 - 632 0033-8419 2001/12 [Refereed][Not invited]
   

  PURPOSE: To establish age-based standards for renal cysts depicted at magnetic resonance (MR) imaging and to compare these standards with existing standards for ultrasonography (US). MATERIALS AND METHODS: Three radiologists reviewed subsecond T2-weighted single-shot fast spin-echo kidney MR imaging findings in 528 patients (248 men, 280 women) selected from consecutive abdominal MR studies without regard to clinical indication. Age, sex, and number and diameter of cysts were noted. Results were analyzed with nonparametric tests and were compared with published US results. RESULTS: Men (mean, 2.0; 95% Cl: 1.5, 2.5) had more renal cysts than women (mean, 1.2; 95% Cl: 0.9, 1.5) (P < .001). Number and diameter of cysts increased with age (P < .001). Of 528 patients, 330 (62.5%) had at least one renal cyst, and 315 (59.7%) had cysts of 10 mm or less. MR imaging findings were comparable to published US criteria for type 1 autosomal dominant polycystic kidney disease (ADPKD) if only cysts larger than 1 cm were considered: Only one subject in the group of 18-29-year-old subjects had at least two renal cysts, and five of 493 subjects aged 30-59 years had at least two cysts in each kidney. CONCLUSION: Compared with reported US results, MR imaging depicted an increased number of simple renal cysts in healthy individuals because of its increased sensitivity for cysts smaller than 1 cm. If only simple renal cysts larger than 1 cm are considered, US criteria for type 1 ADPKD can be applied to MR imaging.
• Utilization of "used" vials: Cost-effective technique for MR arthrography

  T Kamishima, ME Schweitzer, H Awaya, D Abraham

  JOURNAL OF MAGNETIC RESONANCE IMAGING 12 (6) 953 - 955 1053-1807 2000/12 [Refereed][Not invited]
   

  Because full vials of commercially available MR arthrographic contrast are expensive, we hypothesized that the small residual contrast in a "used" vial would be adequate for MR arthrography. After sterility testing and quantity analysis of the residual contrast in 28 vials, this method was successfully used in 10 patients. (C) 2000 Wiley-Liss, Inc.
• MR imaging of bilateral renal malacoplakia after liver transplantation

  T Kamishima, K Ito, H Awaya, DG Mitchell

  AMERICAN JOURNAL OF ROENTGENOLOGY 175 (3) 919 - 920 0361-803X 2000/09 [Refereed][Not invited]
  
• 生体部分肝移植におけるVascular IVRの経験

  作原 祐介, 児玉 芳尚, 立石 宇貴秀, 神島 保, 清水 匡, 宮坂 和男

  日本医学放射線学会雑誌 (公社)日本医学放射線学会 60 (3) 113 - 113 0048-0428 2000/02
• 自己免疫性肝硬変に合併した多発AVFの治療経験

  立石 宇貴秀, 作原 祐介, 児玉 芳尚, 神島 保, 清水 匡, 宮坂 和男

  日本医学放射線学会雑誌 (公社)日本医学放射線学会 60 (3) 113 - 113 0048-0428 2000/02

Books etc

• 関節のMRI

  上谷, 雅孝, 青木, 隆敏, 神島, 保, 江原, 茂, 杉本, 英治, 福田, 国彦 
  メディカル・サイエンス・インターナショナル 2020/12 (ISBN: 9784815701871) xviii, 682p
• MR撮像のポジショニングとテクニック : フルカラーCGで学ぶ

  杉森, 博行, 神島, 保 
  メジカルビュー社 2019/08 (ISBN: 9784758319348) xii, 234p
• フルカラーCGで学ぶX線撮影のポジショニングとテクニック

  杉森, 博行, 神島, 保 
  メジカルビュー社 2018/01 (ISBN: 9784758319072) xv, 231p
• 関節リウマチの画像診断 : 診断の基本から鑑別診断まで

  杉本, 英治, 神島, 保 
  メディカル・サイエンス・インターナショナル 2017/09 (ISBN: 9784895928946) xi, 353p
• 骨軟部画像診断スタンダード = Standards for musculoskeletal imaging

  青木, 純, 青木, 隆敏, 上谷, 雅孝, 江原, 茂, 神島, 保, 杉本, 英治, 福田, 国彦, 藤本, 肇 
  メディカル・サイエンス・インターナショナル 2014/12 (ISBN: 9784895927949) xi, 386p
• 骨軟部の超音波診断 : リウマチの早期診断のために

  Martino, Fabio, Silvestri, Enzo, Grassi, Walter, Garlaschi, G. (Giacomo), 神島, 保, 佐川, 昭 
  丸善出版 2012/06 (ISBN: 9784621063316) xi, 204p
• 手のリウマチの画像診断

  Garlaschi, G. (Giacomo), Silvestri, Enzo, Satragno, Luigi, Cimmino, Marco Amedeo, 佐川, 昭, 神島, 保, シュプリンガージャパン 
  丸善出版 2012/06 (ISBN: 9784621064085) vi, 118p

MISC

• Optimization of Automatic In-house Software for Detecting the Joint Destruction in RA Patients Using Reliability Index

  OKINO Taichi, OKINO Taichi, OU Yafei, IKEBE Masayuki, SAGAWA Akira, KATO Masaru, ATSUMI Tatsuya, KAMISHIMA Tamotsu  日本医学物理学会学術大会報文集  123rd-  2022
• Optimization of Automatic In-house Software for Detecting the Joint Destruction in RA Patients Using Reliability Index

  OKINO Taichi, OKINO Taichi, OU Yafei, IKEBE Masayuki, SAGAWA Akira, KATO Masaru, ATSUMI Tatsuya, KAMISHIMA Tamotsu  日本放射線技術学会総会学術大会予稿集  78th-  2022
• Application of Reliability Index to POC Analysis for Detection of Finger JSN Progression in RA

  AN Yujie, KAWADA Seiya, OU Yafei, IKEBE Masayuki, FURUSAKI Akira, SAGAWA Akira, KAMISHIMA Tamotsu  日本医学放射線学会総会抄録集  81st-  2022
• Automatic Partial Image Phase Only Correlation Analysis Can Detect Radiographic Finger Joint Space Narrowing in Rheumatoid Arthritis

  OKINO Taichi, OU Yafei, IKEBE Masayuki, FUKAE Jun, TANIMURA Kazuhide, KAMISHIMA Tamotsu  日本医学物理学会学術大会報文集  121st-  2021
• Pitfall of Phase Only Correlation (POC) Analysis in Detection of Radiographic Finger Joint Space Narrowing in Rheumatoid Arthritis

  AN Yujie, ZENG Tianyu, OU Yafei, IKEBE Masayuki, FURUSAKI Akira, SAGAWA Akira, KAMISHIMA Tamotsu  日本医学放射線学会総会抄録集  80th-  2021
• Automatic Partial Image Phase Only Correlation Analysis Can Detect Radiographic Finger Joint Space Narrowing in Rheumatoid Arthritis

  OKINO Taichi, OU Yafei, IKEBE Masayuki, FUKAE Jun, TANIMURA Kazuhide, KAMISHIMA Tamotsu  日本放射線技術学会総会学術大会予稿集  77th-  2021
• Convolutional neural network for classification of two-dimensional array images generated from clinical information may support diagnosis of rheumatoid arthritis.

  Jun Fukae, Masato Isobe, Toshiyuki Hattori, Yuichiro Fujieda, Michihiro Kono, Nobuya Abe, Akemi Kitano, Akihiro Narita, Mihoko Henmi, Fumihiko Sakamoto, Yuko Aoki, Takeya Ito, Akio Mitsuzaki, Megumi Matsuhashi, Masato Shimizu, Kazuhide Tanimura, Kenneth Sutherland, Tamotsu Kamishima, Tatsuya Atsumi, Takao Koike  Scientific reports  10-  (1)  5648  -5648  2020/03/27  [Not refereed][Not invited]
   

  This research aimed to study the application of deep learning to the diagnosis of rheumatoid arthritis (RA). Definite criteria or direct markers for diagnosing RA are lacking. Rheumatologists diagnose RA according to an integrated assessment based on scientific evidence and clinical experience. Our novel idea was to convert various clinical information from patients into simple two-dimensional images and then use them to fine-tune a convolutional neural network (CNN) to classify RA or nonRA. We semi-quantitatively converted each type of clinical information to four coloured square images and arranged them as one image for each patient. One rheumatologist modified each patient's clinical information to increase learning data. In total, 1037 images (252 RA, 785 nonRA) were used to fine-tune a pretrained CNN with transfer learning. For clinical data (10 RA, 40 nonRA), which were independent of the learning data and were used as testing data, we compared the classification ability of the fine-tuned CNN with that of three expert rheumatologists. Our simple system could potentially support RA diagnosis and therefore might be useful for screening RA in both specialised hospitals and general clinics. This study paves the way to enabling deep learning in the diagnosis of RA.
• Quantitative Assement of Joint Space in Phantom Simulating Small Joint: Validity of Radiography Using Phase Only Correlation (POC) in Comparison with High Performance CTs

  TAGUCHI Aimi, SHISHIDO Shun, OU Yafei, YASOJIMA Nobutoshi, TAMURA Kenichi, IKEBE Masayuki, KAMISHIMA Tamotsu  日本放射線技術学会総会学術大会予稿集  76th-  2020
• Comparison between Radiography and Tomosynthesis in Detectability for a Minute Change of Finger Joint Space Narrowing: POC Analysis of Phantom in Water Tank

  ZENG Tianyu, KONDO Mana, YASOJIMA Nobutoshi, TAMURA Kenichi, OU Yafei, IKEBE Masayuki, KAMISHIMA Tamotsu  日本放射線技術学会総会学術大会予稿集  76th-  2020
• Automatic Finger Joint Space Narrowing Analysis by Phase Only Correlation (POC) in Rheumatoid Patients

  OKINO Taichi, OU Yafei, IKEBE Masayuki, FUKAE Jun, TANIMURA Kazuhide, KAMISHIMA Tamotsu  日本放射線技術学会総会学術大会予稿集  76th-  2020
• Automatic Finger Joint Space Narrowing Analysis by Phase Only Correlation (POC) in Rheumatoid Patients

  OKINO Taichi, OU Yafei, IKEBE Masayuki, FUKAE Jun, TANIMURA Kazuhide, KAMISHIMA Tamotsu  日本医学物理学会学術大会報文集  119th-  2020
• Quantitative Assessment of Joint Space in Phantom Simulating Small Joint: Validity of Radiography Using Phase Only Correlation (POC) in Comparison with High Performance CTs

  TAGUCHI Aimi, SHISHIDO Shun, OU Yafei, YASOJIMA Nobutoshi, TAMURA Kenichi, IKEBE Masayuki, KAMISHIMA Tamotsu  日本医学物理学会学術大会報文集  119th-  2020
• Comparison between Radiography and Tomosynthesis in Detectability for a Minute Change of Finger Joint Space Narrowing: POC Analysis of Phantom in Water Tank

  ZENG Tianyu, KONDO Mana, YASOJIMA Nobutoshi, TAMURA Kenichi, OU Yafei, IKEBE Masayuki, KAMISHIMA Tamotsu  日本医学物理学会学術大会報文集  119th-  2020
• MRIで米粒体を認めた全身性エリテマトーデス患者の非結核性抗酸菌性腱鞘滑膜炎の1例

  蜷川慶太, 藤枝雄一郎, 松井雄一郎, 神島保, 麻生邦之, 佐藤太貴, 河野通仁, 加藤将, 奥健志, OLGA Amengual, 保田晋助, 岩崎倫政, 渥美達也  日本臨床免疫学会総会プログラム・抄録集  47th-  2019
• 人の目とソフトウェアにおける関節リウマチ患者の微小関節裂隙狭小化の検出能の比較

  加藤一樹, 本郷七瀬, 八十嶋伸敏, 田村賢一, 市川翔太, SUTHERLAND Kenneth, 神島保  北海道医学雑誌  94-  (1)  2019
• リウマチ性疾患の画像2:関節エコーその他 超高周波プローブを用いたSuperb Micro-vascular Imagingによる超音波検査でのラット足関節の早期関節炎診断

  西田 睦, 谷村 瞬, 神島 保, 西端 友香, 益田 紗季子, 中沢 大悟, 外丸 詩野, 渥美 達也, 石津 明洋  日本リウマチ学会総会・学術集会プログラム・抄録集  62回-  485  -485  2018/03  [Not refereed][Not invited]
  
• スタチンの関節炎抑制効果とその機序の解明

  谷村 瞬, 西田 睦, 神島 保, 西端 友香, 益田 紗季子, 中沢 大悟, 外丸 詩野, 渥美 達也, 石津 明洋  日本リウマチ学会総会・学術集会プログラム・抄録集  62回-  778  -778  2018/03  [Not refereed][Not invited]
  
• ダイナミックMRIによる手関節リウマチ滑膜炎の定量化

  小林勇渡, 田口愛望, 杉森博之, 神島保, 市川翔太, SUTHERLAND Kenneth, 野口淳史, 河野通仁, 渥美達也  北海道医学雑誌  93-  (2)  2018
• 全自動解析ソフトウェアによるリウマチ患者の関節裂隙狭小化進行評価

  田中悠貴, 近藤麻菜, 市川翔太, 神島保, 高橋英治, 古崎章, 天崎吉晴  北海道医学雑誌  93-  (2)  2018
• スタチンの関節炎抑制効果と機序の検討

  谷村瞬, 渥美達也, 西田睦, 堀江達則, 神島保, 玉井絵里香, 森村豊, 西端友香, 益田紗季子, 石津明洋, 外丸詩野  北海道医学雑誌  93-  (2)  2018
• 関節リウマチにおける造影ダイナミックMRIを用いた滑膜炎定量評価

  小林 勇渡, 市川 翔太, 神島 保, 杉森 博行, 野口 淳史, 河野 通仁, 渥美 達也  北海道医学雑誌  92-  (2)  108  -109  2017/11  [Not refereed][Not invited]
  
• Assessment of Knee Cartilage Volume Using an Original Software for Conventional MRI(和訳中)

  宍戸 駿, 神島 保, 加藤 一樹, 市川 翔太, 近藤 英司, 小野寺 智洋  日本放射線技術学会雑誌  73-  (9)  867  -867  2017/09  [Not refereed][Not invited]
  
• 従来型MRIに対応した独自のソフトウエアを用いた膝軟骨体積の評価(Assessment of Knee Cartilage Volume Using an Original Software for Conventional MRI)

  宍戸 駿, 神島 保, 加藤 一樹, 市川 翔太, 近藤 英司, 小野寺 智洋  日本放射線技術学会雑誌  73-  (9)  867  -867  2017/09  [Not refereed][Not invited]
  
• X線画像解析に基づく腰部3次元動作と腰仙椎アライメントとの関係

  土谷圭央, 日下聖, 田中孝之, 松尾祥和, 小田まこと, 笹木工, 神島保, 山中正紀  日本機械学会ロボティクス・メカトロニクス講演会講演論文集(CD-ROM)  2017-  ROMBUNNO.2P2‐J06  2017/05/09  [Not refereed][Not invited]
  
• 関節リウマチ患者の関節裂隙狭小化進行評価を可能にするオリジナルソフトウェア開発-非専門医による再現性の調査-

  波多野克哉, 市川翔太, 神島保, 加藤將, 中川育磨, 渥美達也, 齋藤翔太, 川内敬介, SUTHERLAND Kenneth, 貴志孝行, 寺江聡, 向井正也  北海道医学雑誌  92-  (2)  2017
• スタチン製剤の関節炎抑制効果と機序の検討

  谷村瞬, 渥美達也, 西田睦, 堀江達則, 神島保, 齋藤克己, 西端友香, 益田紗季子, 石津明洋, 外丸詩野  北海道医学雑誌  92-  (2)  2017
• 知っておきたい関節リウマチの診断から治療まで MRIの有用性

  保田晋助, 神島保  診断と治療  104-  (12)  1525‐1529  2016/12/01  [Not refereed][Not invited]
  
• ウェアラブルセンサシステムを用いた腰部負荷推定のための腰仙部寸法校正法

  土谷圭央, 日下聖, 田中孝之, 松尾祥和, 小田まこと, 笹木工, 神島保, 山中正紀  計測自動制御学会システム・情報部門学術講演会講演論文集(CD-ROM)  2015-  ROMBUNNO.SS18-5(O1-2)  2015/11/18  [Not refereed][Not invited]
  
• 1P1-X04 Lumbosacral dimensions correction method for wearable lumbar load estimation system

  Tsuchiya Yoshio, KUSAKA Takashi, TANAKA Takayuki, MATSUO Yoshikazu, ODA Makoto, SASAKI Tsukasa, KAMISIMA Tamotsu, YAMANAKA Masanori  ロボティクス・メカトロニクス講演会講演概要集  2015-  "1P1  -X04(1)"-"1P1-X04(4)"  2015/05/17  

  This study is aimed to developed of wearable sensor system, and propose an estimation method of lumbosacral alignment and lumbar load caused by changes in posture. Obtains the lumbosacral size from the X-ray image, the lumbosacral size calibration method is developed using the body surface area and height. Using these method, and confirm lumbosacral alignment estimation accuracy and the lumbar load estimation accuracy.
• Usefulness of whole-body MRI for the evaluation of patients with rheumatoid arthritis on biological agents

  KONO Michihito, KONO Michihito, YASUDA Shinsuke, OHMURA Kazumasa, SHIMAMURA Sanae, NOGUCHI Atsushi, NAKAGAWA Ikuma, SHIDA Haruki, WATANABE Toshiyuki, SHIMIZU Yuka, OKU Kenji, BOHGAKI Toshiyuki, AMENGUAL Olga, HORITA Tetsuya, KAMISHIMA Tamotsu, ATSUMI Tatsuya  日本リウマチ学会総会・学術集会プログラム・抄録集  59th-  2015
• スポーツ選手における膝蓋大腿関節応力分布の解析―mosaicplastyにおける骨軟骨柱ドナー部位選択のために―

  西田欽也, 岩崎倫政, 藤崎和弘, 船越忠直, 神島保, 但野茂, 三浪明男  北海道整形災害外科学会雑誌  55-  (2)  187  -192  2014/03/25  [Not refereed][Not invited]
  
• 単純X線写真に対する経時差分技術を用いたリウマチ患者の関節裂隙狭小化評価-手根部関節への応用

  市川翔太, 神島保, 佐々木亮祐, SUTHERLAND Kenneth, 大久保学宣, 片山耕  日本放射線技術学会雑誌  70-  (9)  2014
• 単純X線写真におけるリウマチ患者の関節裂隙狭小化の変化-経時差分技術を用いた検討

  佐々木亮祐, 神島保, 市川翔太, SUTHERLAND Kenneth, 大久保学宣, 片山耕  日本放射線技術学会雑誌  70-  (9)  2014
• 手関節のリウマチ滑膜炎におけるPixel-by-Pixel TIC解析

  坂下太郎, 神島保, 杉森博行, 唐明輝, 河野通仁, 渥美達也  日本放射線技術学会雑誌  70-  (9)  2014
• 多時相造影MRIのTIC解析を用いた滑膜炎抽出

  小野雅人, 神島保, 杉森博行, 唐明輝, 河野通仁, 渥美達也  北海道医学雑誌  89-  (1)  2014
• Imaging for the Assessment of Chronic Osteomyelitis ::The Efficacy of Magnetic Resonance Imaging

  Fujii Miki, Terashi Hiroto, Kamishima Tamotsu, Nagata Shuji, Aoki Takatoshi, Yasuda Hiroshi  Jpn. J. Surg. Wound Care  5-  (3)  108  -117  2014  [Not refereed][Not invited]
   

  Adequate debridement combined with antibiotics is very important to treat chronic sternal osteomyelitis. Although Magnetic Resonance Imaging (MRI) has been recognized as an effective imaging tool for the assessment of osteomyelitis, the difference in the wound healing process is still unclear. We report the characteristics of MRI in two patients with chronic sternal osteomyelitis. Marrow replacement by low signal intensity on T1-weighted images and corresponding high signal intensity on STIR images is characteristic of osteomyelitis. However, these signals decreased over the course of the wound healing process. In the case of a dead bone, the signal became unclear because of insufficient fluid.<BR> In conclusion, although the present study included a limited number of subjects, it demonstrated that, in chronic sternal wounds, osteomyelitis can be reliably detected by MRI. The change of image corresponded to the wound healing process.
• 超音波装置を用いた足関節に対する前方引き出し負荷と移動距離計測の試み

  中谷 詩世, 福良 沙霧, 寒川 美奈, 神島 保, 遠山 晴一, 堤 香織  北海道放射線技術雑誌  (75)  116  -116  2013/10  [Not refereed][Not invited]
  
• 関節リウマチの滑膜血流評価のための超音波用毛細血管ファントムの検討

  神島 保, 西田 睦, 堀江 達則, 坂野 稜典, 成田 明宏, 逸見 美穂子, 谷村 一秀, 佐川 昭, 白土 博樹, 寺江 聡  北海道醫學雜誌 = Acta medica Hokkaidonensia  88-  (2)  2013/04/01  [Not refereed][Not invited]
  
• DIAGNOSTIC SENSITIVITY FOR HEPATOCELLULAR CARCINOMA WITH GD-EOB-DTPA-ENHANCED LIVER MRI AND SONAZOID CONTRAST-ENHANCED ULTRASOUND: COMPARISON WITH 64-SLICE MULTIDETECTOR HELICAL CT

  J. Ma, Y. Onodera, M. Nishida, T. Kamishima, H. Shirato, W. Loo  EUROPEAN JOURNAL OF CANCER  49-  S1  -S2  2013/03  [Not refereed][Not invited]
  
• 感染症の治療戦略 感染症の画像診断

  神島保, 真鍋治, 寺江聡, 玉木長良  整形・災害外科  55-  (6)  717-723  2012/05/01  [Not refereed][Not invited]
  
• 高機能ゲルを応用した自然再生羊膝軟骨のMR画像評価

  神島保, 寺江聡, 白土博樹, 北村信人, 安田和則  Jpn J Radiol  30-  (Supplement 1)  10  2012/02/25  [Not refereed][Not invited]
  
• 関節リウマチの全身関節造影MR診断—段階的滑膜炎評価の試み

  神島保, 寺江聡, 白土博樹, 加藤将, 藤枝雄一郎, 渥美達也, 小池隆夫  Jpn J Radiol  30-  (Supplement 1)  2  2012/02/25  [Not refereed][Not invited]
  
• 末梢TFCC断裂のMR診断

  神島保, 寺江聡, 白土博樹, 岩崎倫政, 三浪明男  Jpn J Radiol  30-  (Supplement 1)  2  2012/02/25  [Not refereed][Not invited]
  
• 超音波による関節リウマチの炎症性滑膜定量評価—機種間キャリブレーションに関する毛細血管フアントムを用いた基礎的検討

  神島保, 寺江聡, 白土博樹, 堀江達則, 西田睦  Jpn J Radiol  30-  (Supplement 1)  10  2012/02/25  [Not refereed][Not invited]
  
• Long-term stress distribution patterns across the elbow joint in baseball players assessed by computed tomography osteoabsorptiometry (vol 39, pg 336, 2011)

  D. Momma, N. Iwasaki, N. Oizumi, H. Nakatsuchi, T. Funakoshi, T. Kamishima, S. Tadano, A. Minami  AMERICAN JOURNAL OF SPORTS MEDICINE  40-  (1)  NP4  -NP4  2012/01  [Not refereed][Not invited]
  
• Image Quantification in Rheumatology : Past, Present, and Future

  KAMISHIMA Tamotsu  IEICE technical report.  111-  (127)  37  -40  2011/07/05  [Not refereed][Not invited]
   

  Rheumatoid arthritis (RA) is a chronic inflammatory disease that often results in progressive joint destruction. The accurate assessment of joint inflammation and sensitive monitoring of disease activity in patients with RA are essential in evaluating the response to treatment and the disease outcome. Quantitative analysis in magnetic resonance imaging and US theoretically have advantages over semi-quantitative analysis in measuring the response to therapeutic agents, as the former can reflect a change in inflammatory activity more sensitively and objectively. Recent advantages in image quantification for RA will be demonstrated in this lecture.
• In vivo visualization of vascular patterns of soft tissue using contrast-enhanced ultrasound

  船越 忠直, 岩崎 倫政, 神島 保  Orthopaedic surgery and traumatology  54-  (8)  963  -968  2011/07
• Ultrasonographical assessment of the rheumatoid finger joint

  神島 保  Orthopaedic surgery and traumatology  54-  (5)  485  -489  2011/04
• 非浸潤性乳管癌の3T MRIにおける画像所見の検討

  加藤扶美, 大山徳子, 細田充主, 寺江聡, 高橋弘昌, 水戸寿々子, 石坂欣也, 小野寺祐也, 神島保, 白土博樹  日本医学放射線学会総会抄録集  70th-  S311  2011/02/28  [Not refereed][Not invited]
  
• 関節リウマチにおける手・手指MRI所見と全身MRI所見との関係

  神島保, 小野寺祐也, 寺江聡, 白土博樹, 藤枝雄一郎, 堀田哲也, 渥美達也, 小池隆夫  Jpn J Radiol  29-  (Supplement 1)  13  2011/01/25  [Not refereed][Not invited]
  
• 腎周囲腔原発形質細胞腫の1例

  森田亮, 神島保, 白土博樹, 寺江聡, 久保田佳奈子, 中野史人, 矢部一郎, 丸山覚, 三村理恵  Jpn J Radiol  29-  (Supplement 1)  3  2011/01/25  [Not refereed][Not invited]
  
• 肝ダイナミックCT後期動脈相における動脈の造影効果と単純CTから推測される腎体積との関係

  神島保, 武藤ナタリア早百合, 加藤扶美, 小野寺祐也, 寺江聡, 白土博樹, 伊藤和夫  Jpn J Radiol  29-  (Supplement 1)  9  2011/01/25  [Not refereed][Not invited]
  
• Constructing of finger biomechanical model for estimating manipulation force in digital hand

  Shimizu Yasutomo, Kanai Satoshi, Date Hiroaki, Shirato Hiroki, Kamishima Tamotsu, Ogisu Kimihiro  Proceedings of JSPE Semestrial Meeting  2011-  (0)  107  -108  2011  [Not refereed][Not invited]
   

  In the virtual ergonomic assessments for product design using a digital hand, estimating the force of hand for grasping and manipulating the product are very effective in building criteria of the reasonable assessment. In this paper, we proposed the method to derive exerted force by building construct the musculoskeletal biomechanical model of a finger, and by solving a non-linear optimization problem on the forces of finger tendons, muscles and the joint surfaces in case of grasping the product. In addition, the derived exerted forces were verified by comparing the previous experiment of results.
• 全身MRIによる関節リウマチの治療効果判定

  神島保, 尾松徳彦, 小野寺祐也, 白土博樹, 寺江聡, 堀田哲也, 渥美達也, 小池隆夫  Jpn J Radiol  28-  (Supplement 1)  14  2010/07/25  [Not refereed][Not invited]
  
• 手指のintravascular pyogenic granulomaの2例

  長谷川晶子, 神島保, 尾松徳彦, 小野寺祐也, 寺江聡, 白土博樹, 久保田加奈子  Jpn J Radiol  28-  (Supplement 1)  5  2010/07/25  [Not refereed][Not invited]
  
• 腫瘍におけるtumor doubling timeと糖代謝能の関係

  坂本圭太, 神島保, 尾松徳彦, 小野寺祐也, 白土博樹, 寺江聡, 平田健司, 玉木長良  Jpn J Radiol  28-  (Supplement 1)  12  2010/07/25  [Not refereed][Not invited]
  
• CT造影効果と腎体積の関係

  神島保, 武藤ナタリア早百合, 加藤扶美, 尾松徳彦, 小野寺祐也, ハリス アーディンA, 白土博樹, 寺江聡, 伊藤和夫  Jpn J Radiol  28-  (Supplement 1)  9  2010/07/25  [Not refereed][Not invited]
  
• 子宮筋腫核出,帝切後に子宮に発生した腫瘤の1例

  相山健, 尾松徳彦, 加藤扶美, 大山徳子, 神島保, 小野寺祐也, 寺江聡, 白土博樹, 蝦名康彦, 櫻木範明  Jpn J Radiol  28-  (Supplement 1)  5  2010/07/25  [Not refereed][Not invited]
  
• 3T MRIにおけるDCISの画像所見

  加藤扶美, 大山徳子, 高橋將人, 高橋弘昌, 細田充主, 水戸寿々子, 石坂欣也, 小野寺祐也, 神島保, 寺江聡, 白土博樹  日本乳癌学会学術総会プログラム・抄録集  18th-  562  2010/05/25  [Not refereed][Not invited]
  
• The incidence and the mechanism of sunitinib-induced thyroid atrophy in patients with metastatic renal cell carcinoma

  N. Shinohara, M. Takahashi, T. Kamishima, H. Ikushima, N. Otsuka, A. Ishizu, A. Sazawa, H. Kanayama, K. Nonomura  JOURNAL OF CLINICAL ONCOLOGY  28-  (15)  2010/05  [Not refereed][Not invited]
  
• Experimental MR imaging of zirconia ceramic joint implants at 1.5 and 3 T

  T. Kamishima, N. Kitamura, M. Amemiya, K. Ishizaka, F. Kato, K. Yasuda, H. Shirato, S. Terae  Clinical Radiology  65-  (5)  387  -390  2010/05/01  [Not refereed][Not invited]
  
• 3T乳腺MRIにおけるSplit Dynamic法の検討:Dynamic studyの途中の高分解能撮像と従来法の比較

  加藤扶美, 大山徳子, 水戸寿々子, 高橋將人, 坂元哲郎, VAN CAUTEREN Marc, 小野寺祐也, 神島保, 寺江聡, 白土博樹  日本医学放射線学会総会抄録集  69th-  S256  2010/02/28  [Not refereed][Not invited]
  
• CT/MRI (腎細胞がんの治療をめぐって) -- (見落としのない検査のために--腎細胞がんを念頭においた読影)

  神島 保  臨床腫瘍プラクティス  6-  (1)  24  -30  2010
• MR Imaging of the Rheumatoid Hand : Techniques and Application

  KAMISHIMA Tamotsu  日本磁気共鳴医学会雑誌  29-  (4)  155  -162  2009/11/15  [Not refereed][Not invited]
  
• Predominant tubulointerstitial nephritis in a patient with systemic lupus erythematosus with an emphasis on CT and MR imaging findings

  Tamotsu Kamishima, Noriko Nishioka, Hiroshi Kataoka, Jun Fukae, Tatsuya Atsumi, Ardene A. Harris, Tokuhiko Omatsu, Yuya Onodera, Satoshi Terae, Hiroki Shirato  European Journal of Radiology Extra  72-  2009/11/01  [Not refereed][Not invited]
   

  In most cases of systemic lupus erythematosus (SLE), glomerular lesions are the main renal complication. Although tubulointerstitial lesions are often associated with severe glomerular lesions, predominant or isolated tubulointerstitial injury in the presence of minimal glomerular abnormalities with SLE, so-called predominant tubulointerstitial lupus nephritis, is rare and there is no report on CT and MR imaging findings of predominant tubulointerstitial lupus nephritis. Herein, we describe the case of a 48-year-old woman with SLE who presented with acute renal deterioration attributable to acute tubulointerstitial nephritis with an emphasis on CT and MR imaging findings. CT demonstrated multiple wedge-shaped areas or streaky zones of lesser enhancement that extend from the papilla to the renal cortex. MR images revealed relatively clear corticomedullary junction with slightly irregular cortex on T1-weighted images, and wed-shaped areas of decreased signal intensity corresponding CT findings increased signal intensity in the central parenchyma on T2-weighted image. The enhancement effect was weak and delayed in the central parenchyma on dynamic MR images after bolus administration of contrast. These imaging features seemed to reflect the tubulointerstitial dysfunction and infiltration in this case. © 2009 Elsevier Ireland Ltd. All rights reserved.
• Splenic volume in systemic lupus erythematosus

  Ardene A. Harris, T. Kamishima, T. Horita, T. Atsumi, N. Fujita, T. Omatsu, Y. Onodera, S. Terae, T. Koike, H. Shirato  Lupus  18(12)-  1119  -1120  2009/10/05  [Not refereed][Not invited]
  
• 特別座談会 RA画像診断における造影MRI検査

  上谷 雅孝, 青木 隆敏, 神島 保  映像情報medical  41-  (11)  1074  -1077  2009/10
• 腎癌患者へのSunitinib投与が引き起こす甲状腺機能障害の発症機序

  篠原 信雄, 高橋 正幸, 神島 保, 生島 仁史, 大塚 紀幸, 石津 明洋, 丸山 覚, 安部 崇重, 佐澤 陽, 金山 博臣, 野々村 克也  日本癌治療学会誌  44-  (2)  456  -456  2009/09  [Not refereed][Not invited]
  
• 3.0T MRIを用いた乳房MRI撮像法(Split Dynamic法)の検討

  加藤扶美, 尾松徳彦, 小野寺祐也, 神島保, 大山徳子, 寺江聡, 白土博樹, 高橋将人, 細田充主, 高橋弘昌, 水戸寿々子, 石坂欣也, 坂元哲郎, 勝又康友, VAN CAUTEREN Marc  日本乳癌学会学術総会プログラム・抄録集  17th-  393  2009/06/11  [Not refereed][Not invited]
  
• Efficacy and thyroidal effects of sunitinib in Japanese patients with metastatic renal cell carcinoma: Hypothyroidism and thyroid atrophy as potential biomarkers for sunitinib?

  N. Shinohara, M. Takahashi, T. Kamishima, H. Ikushima, A. Sazawa, H. Kanayama, K. Nonomura  JOURNAL OF CLINICAL ONCOLOGY  27-  (15)  2009/05  [Not refereed][Not invited]
  
• 動体追跡照射時における肺腫瘍の移動距離と関連因子の検討

  小野寺祐也, 西岡典子, 鬼丸力也, 尾松徳彦, 神島保, 加藤扶美, 白土博樹  Radiat Med  27-  (Supplement 1)  1  2009/04/25  [Not refereed][Not invited]
  
• 関節リウマチの超音波による治療効果判定

  神島保, ムトウ ナタリアサユリ, 尾松徳彦, 小野寺祐也, 寺江聡, 白土博樹  Radiat Med  27-  (Supplement 1)  9  2009/04/25  [Not refereed][Not invited]
  
• 新開発のsoftwareを用いた肺腫瘍のDT計測値の再現性と妥当性評価

  坂本圭太, 神島保, 平田健司, 尾松徳彦, 小野寺祐也, 寺江聡, 玉木長良, 白土博樹  日本医学放射線学会総会抄録集  68th-  S364-S365  2009/02/28  [Not refereed][Not invited]
  
• 両手MRIにおける関節リウマチ病変定量のための最適化の試み

  神島保, 谷村一秀, 清水昌人, 松橋めぐみ, 深江淳, 近祐次郎, 青木悠子, 尾松徳彦, 寺江聡, 白土博樹  日本医学放射線学会総会抄録集  68th-  S189  2009/02/28  [Not refereed][Not invited]
  
• ダイナミックCTにおける腎体積と大動脈・肝実質増強効果の関係について

  神島保, 武藤ナタリア早百合, アーディン ハリス, 尾松徳彦, 小野寺祐也, 寺江聡, 伊藤和夫, 白土博樹  日本医学放射線学会総会抄録集  68th-  S170  2009/02/28  [Not refereed][Not invited]
  
• 心臓周囲脂肪分布の評価—体積対面積

  大山徳子, 笹木工, 水戸寿々子, 後藤大祐, 古本智夫, 小野寺祐也, 尾松徳彦, 神島保, 寺江聡, 白土博樹  日独医報  54-  (1)  74  2009/02/25  [Not refereed][Not invited]
  
• Intra-articular nodular fasciitis in the elbow joint, with an emphasis on MR imaging findings

  Noriko Nishioka, Tamotsu Kamishima, Tatsuya Masuko, Kanako C. Kubota, Miki Komatsu, Norimasa Iwasaki, Takayuki Nojima, Tomoo Itoh, Ardene A. Harris, Akio Minami, Hiroki Shirato  European Journal of Radiology Extra  69-  2009/01/01  [Not refereed][Not invited]
   

  Nodular fasciitis is a benign, usually self-limiting proliferation of myofibroblasts, arising from the fascia. In this article, a case of nodular fasciitis in the elbow joint of a 29-year-old man is presented. The nodular lesion developed from the synovial joint capsule in the elbow and histological and immunohistochemical studies revealed myofibroblastic proliferation. Only 13 cases of intra-articular nodular fasciitis have been reported in English literature. The present report describes the first case in which intra-articular nodular fasciitis occurs in the elbow joint of a patient. Additionally, magnetic resonance imaging findings of intra-articular nodular fasciitis are discussed along with a review of previous articles. © 2008 Elsevier Ireland Ltd. All rights reserved.
• パワードプラ超音波による関節リウマチ治療効果判定

  神島保, 尾松徳彦, 小野寺祐也, 寺江聡, 白土博樹  日本医学放射線学会総会抄録集  67th-  S180-S181  2008/02/28  [Not refereed][Not invited]
  
• 心臓周囲脂肪の定量—内臓脂肪の新しい指標

  大山徳子, 水戸寿々子, 笹木工, 小野寺祐也, 後藤大祐, 古本智夫, 尾松徳彦, 神島保, 寺江聡, 白土博樹  日本医学放射線学会総会抄録集  67th-  S318  2008/02/28  [Not refereed][Not invited]
  
• 新開発のCT volumetryソフトによる生体腎移植ドナーの分腎比の評価

  加藤扶美, 神島保, 森田研, 守屋禎之, 野々村克也, 白土博樹, 武藤ナタリア早百合, 小野寺祐也, 胡学斌, 寺江聡  日本医学放射線学会総会抄録集  67th-  S215  2008/02/28  [Not refereed][Not invited]
  
• Whole Body MR Imaging of Musculoskeletal Tumor

  KAMISHIMA Tamotsu  The Journal of the Japanese Orthopaedic Association  81-  (11)  950  -954  2007/11/25  [Not refereed][Not invited]
  
• スポーツ損傷のMRI : 膝関節

  神島 保, 加藤 扶美, 白〓 博樹  臨床スポーツ医学 = The journal of clinical sports medicine  24-  (7)  755  -760  2007/07/01  [Not refereed][Not invited]
  
• OP-026 MRIによる前立腺癌の診断 : A prospective study(第95回日本泌尿器科学会総会)

  出村 孝義, 日岡 隆矢, 兼田 達夫, 坂井 亙, 長谷川 貴, 西野 茂夫, 神島 保, 後藤田 裕子, 村岡 俊二  日本泌尿器科學會雜誌  98-  (2)  297  -297  2007/02/20  [Not refereed][Not invited]
  
• 造影全身MRIによる関節リウマチの評価

  神島 保, 渥美 達也, 堀田 哲也, 酒井 良江, 深江 淳, 保田 晋助, 白土 博樹, 小池 隆夫  日本医学放射線学会学術集会抄録集  66回-  S367  -S367  2007/02  [Not refereed][Not invited]
  
• APP-054 MRI-directed template biopsyによる前立腺癌の局在診断(総会賞応募ポスター,第94回日本泌尿器科学会総会)

  出村 孝義, 日岡 隆矢, 兼田 達夫, 坂井 亙, 平松 一秀, 長谷川 貴, 西野 茂夫, 神島 保, 後藤田 裕子, 村岡 俊二  日本泌尿器科學會雜誌  97-  (2)  249  -249  2006/03/10  [Not refereed][Not invited]
  
• 関節リウマチに対するインフリキシマブの造影関節エコーによる効果判定

  神島 保, 桜井 典之, 渥美 達也, 酒井 良江, 堀田 哲也, 保田 普助, 小池 隆夫, 宮坂 和男  断層映像研究会雑誌  33-  (1)  17  -17  2006/03  [Not refereed][Not invited]
  
• 関節リウマチに対するインフリキシマブの造影エコーによる効果判定

  増田 香織, 佐藤 恵美, 神島 保, 丹野 麻美, 清水 匡, 宮坂 和男  超音波検査技術抄録集  31-  (0)  203  -203  2006  [Not refereed][Not invited]
  
• Recent Advances in Diagnostic Imaging Technologies

  Kamishima Tamotsu, Tanno Asami, Sasaki Tsukasa, Oka Mika, Magota Keiichi, Yokoyama Eitatsu, Watanabe Yoshiharu, Sumita Syushin, Tamaki Nagara, Miyasaka Kazuo  The journal of the Association of Life Insurance Medicine of Japan  103-  (2)  150  -160  2005/06/17  [Not refereed][Not invited]
   

  Diagnostic imaging technologies have made rapid advances in recent years benefiting from the progress of a computer. Accompanying the advances, diagnostic imaging technologies are becoming increasingly fractionalized and it is not always easy even for the person engaged in radiology to grasp the entire figure. This study shows recent advances in diagnostic imaging technologies taking each main diagnostic imaging apparatus in order. We intelligibly explain the advances of technologies (software and hardware) and the clinical application concerning the development of contrast media and three- and four-dimensional images as to ultrasonography, the application of computed tomography (CT) to cerebral bloodstream and the heart, parallel imaging, whole body MRI and diffusion emphasized images as to magnetic resonance imaging (MRI), positron emission tomography (PET) as to nuclear medicine, and rotating digital subtraction angiography (DSA) and angiographic computed tomography as to angiography. This study also makes references to the present conditions of computer assisted diagnosis (CAD).
• Liver hemangiomas: Assessment of the change in size using CT and MRI

  GA Holland, T Kamishima, DG Mitchell, A Lall  RADIOLOGY  222-  (3)  875  -875  2002/03  [Not refereed][Not invited]
  
• Computed tomography and magnetic resonance imaging of retroperitoneal and mesenteric tumor

  Noriko Oyama, Tamotsu Kamishima, Kouzou Kubo, Daisuke Abo, Toshikazu Nambu, Chihoko Miyazaki, Donald G. Mitchell, Kazuo Miyasaka  Radiologist  9-  (6)  303  -308  2002  [Not refereed][Not invited]
   

  Because retroperitoneal and mesenteric tumors may not be found until they become huge, speculating about the site of origin of a tumor is sometimes difficult. Computed tomography and magnetic resonance imaging are the primary modalities for evaluating the spread of tumor and the location of the tumor in the retroperitoneal space or in the mesentery. Although patients with retroperitoneal and mesenteric tumors usually present with nonspecific imaging findings, visualization of calcification, a fatty component, fibrosis, necrosis, and hemorrhage can be a key to the correct diagnosis. This article reviews the imaging characteristics of several tumors involving these regions.
• MR imaging and percutaneous therapy of osteitis pubis as a stress injury of sports

  T Kamishima, ME Schweitzer, AB Bartolozzi, H Awaya  RADIOLOGY  221-  117  -117  2001/11  [Not refereed][Not invited]
  
• CT imaging of chromophobe renal cell carcinoma

  N Oyama, T Kamishima, K Kubo, C Miyazaki, Y Ogawa, T Nambu  RADIOLOGY  221-  125  -125  2001/11  [Not refereed][Not invited]
  
• MR imaging of the fetus

  Tamotsu Kamishima, Taiga Nishihori, Donald G. Mitchell, Toshikazu Nambu, Nobuyuki Fujita, Kazuo Miyasaka  Radiologist  8-  (5)  245  -253  2001  [Not refereed][Not invited]
   

  This article describes the indications, safety, and technique of fetal MR imaging, as well as the MR findings of the abnormal fetus, placenta, and surrounding tissues. MR imaging is not routinely recommended and is usually performed when obstetric ultrasound does not suffice. Single-shot sequences have minimized image degradation due to fetal movement, and the relatively short imaging provides acceptable maternal breath-hold time. Fetal CNS abnormalities described include holoprosencephaly, vein of Galen aneurysmal malformations, colpocephaly, Chiari II malformation, and encephalocele. Fetal non-CNS abnormalities described include cystic hygromas, congenital diaphragmatic hernia, omphalocele, multicystic dysplastic kidney, and sacrococcygeal teratoma. Among the miscellaneous maternal abnormalities reported are placenta accreta, dermoid cysts, and interstitial pregnancy.
• MR imaging of cysts and cystic lesions of the liver

  Tamotsu Kamishima, Taiga Nishihori, Donald G. Mitchell, Toshikazu Nambu, Nobuyuki Fujita, Kazuo Miyasaka  Radiologist  8-  (4)  175  -183  2001  [Not refereed][Not invited]
   

  This article reviews the value of MR imaging for detecting and characterizing cystic liver lesions. Recently developed sophisticated techniques of MR assessment of cysts are described, including the use of contrast-enhanced images. Loculation or nodular projections are occasionally seen in a complicated cyst. Peribiliary cysts appear as fluid adjacent to the intrahepatic portal vein. In patients with choledochal cysts, MR cholangiopancreatography can show the connection between the extrahepatic bile duct and the cystic structure. This modality also can show secondary abnormalities such as pancreaticobiliary stone and malignant tumor. Primary sclerosing cholangitis presents with dilatation of the intrahepatic bile ducts, which may mimic hepatic cysts or cystic diseases. In primary hepatic carcinoid tumor, cystic changes inside the tumor are commonly seen as increased signal intensity on T2-weighted images.
• Small (< 20 mm), early enhancing-nodules without hyperintensity on t2-weighted image in cirrhotic liver: Clinical implication on follow-up MR imaging

  Y Jeong, DG Mitchell, T Kamishima, H Kang  RADIOLOGY  217-  504  -504  2000/11  [Not refereed][Not invited]
  
• 生体部分肝移植術後症例における動静脈同時PTAの試み

  神島 保, 立石 宇貴秀, 堀尾 圭司, 市村 亘, 清水 匡, 宮坂 和男  IVR: Interventional Radiology  14-  (4)  507  -507  1999/10
• 腎血管筋脂肪腫に対する腎静脈バルーン閉塞下エタノール動脈塞栓術の試み

  立石 宇貴秀, 神島 保, 堀尾 圭司, 市村 亘, 清水 匡, 宮坂 和男  IVR: Interventional Radiology  14-  (4)  508  -508  1999/10
• 肝Nodular Regenerative Hyperplasia(NRH)の画像所見

  作原祐介, 藤田信行, 神島保, 毛利学, 岸本理和, 南部敏和  日独医報  44-  (4)  794-795  1999  [Not refereed][Not invited]
  
• Pulmonary vein and left atrial invasion by lung cancer: Assessment with contrast-enhanced three-dimensional MR angiography

  K Takahashi, T Kamishima, M Furuse, S Satoh, K Saitoh, T Aburano  RADIOLOGY  209P-  451  -451  1998/11  [Not refereed][Not invited]
  

Research Grants & Projects

• 関節リウマチ破壊性変化定量解析システムの妥当性評価

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2021/04 -2024/03 

  Author : 神島 保, 池田 啓, 渥美 達也, 池辺 将之, 田村 賢一

   

  Genant-modified Sharpスコア（GSS）などの、関節リウマチ（RA）における関節腔狭小化（JSN）のX線スコアリング法は広く受け入れられているが、評価が主観的で煩雑である。そのため、関節裂隙幅（JSW）の変化を自動的に定量化できる部分位相限定相関（PIPOC）を備えたソフトウェアを開発した。本研究の目的は、ソフトウェアを用いてトシリズマブ治療下の関節リウマチ患者のJSN進行を検討することである。 トシリズマブで治療された39名のRA患者（女性35名）を対象とした。中手指節関節および近位指節間関節のＸ線学的進行は、0ヶ月および12ヶ月のGSSに従って評価された。 被験者の均質性を確保するために、ソフトウェア分析のベースラインでGSS = 0の関節をターゲットにした。 JSN進行測定用の社内ソフトウェアの成功率は96.8％（449/464）であった。ソフトウェアで1年間に定量化された手指関節のJSW変化は、GSS進行陽性群の方が陰性群よりも有意に大きかった（p = 0.02）。 PIPOC依存ソフトウェアは、1年間のトシリズマブ治療下の追跡期間中にRA患者のJSN進行を検出できる可能性がある。
• Power Doppler signal calibration between ultrasound machines by use of a capillary-flow phantom for pannus vascularity in rheumatoid finger joints

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2012/04 -2015/03 

  Author : KAMISHIMA Tamotsu, ATSUMI Tatsuya, TERAE Satoshi, NISHIDA Mutsumi

   

  Ultrasound allows the detection and grading of inflammation in rheumatology. Despite these advantages of ultrasound in the management of rheumatoid patients, it is well known that there are significant machine-to-machine disagreements regarding signal quantification. In this study, we tried to calibrate the power Doppler (PD) signal of two models of ultrasound machines by using a capillary-flow phantom. In Aplio 500 and Avius, we found negative correlations between the PRF and the QPD index when the flow velocity was constant, and a positive correlation between flow velocity and the QPD index at constant PRF. The equation for the relationship of the PRF between Aplio 500 and Avius was: y = 0.023x + 0.36 [y = PRF of Avius (kHz), x = PRF of Aplio 500 (kHz)]. Our results suggested that the signal calibration of various models of ultrasound machines is possible by adjustment of the PRF setting.
• Basic Research for four-dimensional stereotactic radiotherapy

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2005 -2009 

  Author : SHIRATO Hiroki, KANEKO Junichi, NISHIYAMA Syusuke, KATOH Chietsugu, AOYAMA Hidefumi, SEKI Koh-ichi, ONIMARU Rikiya, NISHIOKA Takeshi, MORITA Koichi, DATE Hiroyuki, TAKADA Eiji, TOMIOKA Satoshi, KUDO Kohsude, ONODERA Yuya, KAMISHIMA Tamotsu, ONIMARU Rikiya, SHIMIZU Shinichi, SAKUHARA Yusuke, OYAMA Noriko, ABO Daisuke, TAGUCHI Hiroshi

   

  We developed a four-dimensional (4-D, space and time) focal positron emission localizer, FPEL, using two sets of BGO scintillators, photo-electric multiplier, and collimators. A narrow (5-mm in diameter) 45-MeV electron beam was controlled to irradiate a target with an accuracy of 0.1mm in 4D coordinates automatically if the amount of positron emitters at the target exceeds the threshold. A mouse model was established to irradiate the tumor in which FDG is accumulated. Using the FPEL, 45-MeV electron beam hit the tumor in mice which move in front of the beam exit with the amplitude resembling human respiration. Tumor without fiducial gold marker disappeared within a week after the irradiation. Basis for 4D stereotacic radiotherapy was established successfully.
• Interactive Radiotherapy

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2006 -2008 

  Author : SHIRATO Hiroki, HONMA Sato, TAMAKI Nagara, KUGE Yuji, DATE Hiroyuki, KIYANAGI Yoshiaki, HATAKEYAMA Masanori, KANEKO Junichi, MIZUTA Masahiro, INUBUSHI Masayuki, TADANO Shigeru, TAMURA Mamoru, HAYAKAWA Kazushige, MATSUNAGA Naofumi, ISHIKAWA Masayori, AOYAMA Hidefumi, SAKUHARA Yusuke, ONIMARU Rikiya, ABO Daisuke, OITA Masataka, KAMISHIMA Tamotsu, TERAE Satoshi, KUDO Kohsuke, ONODERA Yuya, OMATSU Tokuhiko, SHIMIZU Shinichi, NISHIMURA Takashi, SUZUKI Ryusuke, GERARD Bengua

   

  いままでの先端放射線医療に欠けていた医療機器と患者のinteractionを取り入れた放射線治療を可能にする。臓器の動き・腫瘍の照射による縮小・免疫反応などは、線量と時間に関して非線形であり、システムとしての癌・臓器の反応という概念を加えることが必要であることが示唆された。生体の相互作用を追求していく過程で、動体追跡技術は先端医療のみならず、基礎生命科学でも重要な役割を果たすことがわかった。

Educational Activities

Teaching Experience