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Last Updated :2024/11/04

研究者情報

マスター

アカウント（マスター）

  • 氏名

    渡邊　史郎(ワタナベ　シロウ), ワタナベ　シロウ

所属（マスター）

  • 北海道大学病院

所属（マスター）

  • 北海道大学病院

独自項目

syllabus

  • 2021, 基本医学総論, Basic Principles of Medicine, 修士課程, 医学院, 画像診断、CT、MRI、PET、SPECT、血管造影、超音波、IVR、RI内用療法
  • 2021, 核医学, Nuclear Medicine, 学士課程, 医学部, 画像診断　PET　SPECT　IVR　画像定量化　アイソトープ治療

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プロフィール情報

学位

  • 医学博士（2017年03月 北海道大学）

プロフィール情報

  • 姓

    渡邊

  • 名

    史郎

  • ID各種

    201801016008717755

業績リスト

研究分野

  • ライフサイエンス / 放射線科学

論文

  • Naoto Wakabayashi, Shiro Watanabe, Takashige Abe, Junki Takenaka, Kenji Hirata, Rina Kimura, Keita Sakamoto, Nobuo Shinohara, Kohsuke Kudo
    Annals of nuclear medicine 38 7 553 - 562 2024年07月 
    OBJECTIVE: To investigate the incidence of adverse events (AEs) following single and multiple administrations of I-131 metaiodobenzylguanidine (MIBG) therapy for inoperable pheochromocytomas and paragangliomas (PPGLs). METHODS: A single-center retrospective study was conducted on patients with inoperable PPGLs who underwent I-131 MIBG therapy between January 2000 and December 2020. A total of 28 patients with available electronic medical records were included. The treatment consisted of a single intravenous administration of 150 mCi (5.55 GBq) of I-131 MIBG. We evaluated the first MIBG treatment and repeated MIBG treatments performed within 200 days of the previous treatment. AEs for each treatment were evaluated using CTCAE version 4.0, and the statistical analysis was conducted at a significance level of p < 0.05. Objective response based on RECIST 1.1 criteria and biochemical response based on urinary catecholamines were assessed. RESULTS: The study included a total of 63 administrations, consisting of 28 single administrations (SAs), including the first administration for all 28 cases, and 35 multiple administrations (MAs), which included the second or later administrations. Hematological AEs were evaluable for 23 SAs and 29 MAs. Grade 3 or higher leukopenia occurred in 9.8% of all administrations, and Grade 3 or higher lymphopenia in 23.5%; both were manageable through observation. There were no significant differences in clinical AE Grades 1-2 (p = 0.32), hematological AE Grades 1-2 (p = 0.22), or hematological AE Grades 3-4 (p = 0.12) between MAs and SAs. Statistical analysis for each type of AE revealed significant increases in leukopenia (p < 0.01) and lymphopenia (p = 0.04). No significant difference in anemia, thrombocytopenia, or neutropenia was observed between MAs and SAs. There was no significant increase in the incidence rate of Grade 3 or higher hematological AEs for any of the parameters. The objective response rate was 0% for SAs and 36% for MAs. Biochemical response rates were 18% for SAs and 67% for MAs. CONCLUSION: In I-131 MIBG therapy for PPGLs, multiple administrations significantly increased only Grade 1 or 2 lymphopenia and leukopenia compared to single administration.
  • 血液維持透析患者の甲状腺癌に対して放射性ヨウ素内用療法を施行した1例
    江口 みな, 上田 雄翔, 中沢 大悟, 西尾 妙織, 竹中 淳規, 渡邊 史郎, 平田 健司, 村田 裕宣, 千葉 裕基, 武貞 敬介, 篠原 信雄
    日本透析医学会雑誌 57 Suppl.1 479 - 479 (一社)日本透析医学会 2024年05月
  • Kuroshima T, Kitagawa Y, Sato J, Watanabe S, Asaka T, Abe T, Harada H, Hirata K, Kuge Y
    Odontologgy PMID: 38703257 2024年05月 [査読有り]
  • 切除不能/転移性PPGLにおけるI-131 MIBG治療後シンチグラフィーで非集積病変を有する患者の予測因子に関する検討
    竹中 淳規, 渡邊 史郎, 安部 崇重, 土川 貴裕, 竹内 啓, 平田 健司, 木村 理奈, 若林 直人, 篠原 信雄, 工藤 與亮
    日本内分泌外科学会雑誌 41 Suppl.1 S202 - S202 (一社)日本内分泌外科学会 2024年04月
  • Sunburst appearanceを呈する頭蓋骨腫瘤を契機に発見された神経芽腫の1例
    北川 悠, 竹中 淳規, 渡邊 史郎, 平田 健司, 内山 裕子, 木村 理奈, 中川 純一, 池辺 洋平, 工藤 與亮, 長谷河 昌孝, 澤井 彩織, 寺下 友佳代, 杉山 未奈子, 平林 真介, 長 祐子, 真部 淳
    Japanese Journal of Radiology 42 Suppl. 5 - 5 (公社)日本医学放射線学会 2024年02月
  • Shiro Watanabe, Kenji Hirata, Keiichi Magota, Junki Takenaka, Naoto Wakabayashi, Daiki Shinyama, Koichi Yasuda, Akihiro Homma, Kohsuke Kudo
    Annals of nuclear medicine 2023年11月09日 
    OBJECTIVE: Silicon photomultiplier-based positron emission tomography/computed tomography (SiPM-PET/CT) has the superior spatial resolution to conventional PET/CT (cPET/CT). This head-to-head comparison study compared the images of physiological 18F-fluorodeoxyglucose (FDG) accumulation in small-volume structures between SiPM-PET/CT and cPET/CT in patients scanned with both modalities, and we investigated whether the thresholds that are reported to be useful for differentiating physiological accumulations from malignant lesions can also be applied to SiPM-PET/CT. METHODS: We enrolled 21 consecutive patients with head and neck malignancies who underwent whole-body FDG-PET/CT for initial staging or a follow-up evaluation (October 2020 to March 2022). After being injected with FDG, all patients underwent PET acquisition on both Vereos PET-CT and Gemini TF64 PET-CT systems (both Philips Healthcare) in random order. For each patient, the maximum standardized uptake value (SUVmax) was measured in the pituitary gland, esophagogastric junction (EGJ), adrenal glands, lumbar enlargement of the spinal cord, and epididymis. We measured the liver SUVmean and the blood pool SUVmean to calculate the target-to-liver ratio (TLR) and the target-to-blood ratio (TBR), respectively. Between-groups differences in each variable were examined by a paired t-test. We also investigated whether there were cases of target uptake greater than the reported threshold for distinguishing pathological from physiological accumulations. RESULTS: Data were available for 19 patients. Ten patients were in Group 1, i.e., the patients who underwent SiPM-PET first, and the remaining nine patients who underwent cPET first were in Group 2. In the SiPM-PET results, the SUVmax of all targets was significantly higher than that obtained by cPET in all patients, and this tendency was also observed when the patients were divided into Groups 1/2. The TLRs of all targets were significantly higher in SiPM-PET than in cPET in all patients, and SiPM-PET also showed significantly higher TBRs for all targets except the EGJ (p = 0.052). CONCLUSIONS: The physiological uptake in the small structures studied herein showed high accumulation on SiPM-PET. Our results also suggest that the thresholds reported for cPET to distinguish pathological accumulations likely lead to false-positive findings in SIPM-PET evaluations.
  • 腫瘍性骨軟化症における111Inペンテトレオチドを用いたソマトスタチン受容体シンチグラフィにてSPECT-CTが有用であった一例
    平野 佑亮, 平田 健司, 渡邊 史郎, 竹中 淳規, 孫田 惠一, 宗像 大和, 前田 佑介
    北海道放射線技術雑誌 95 39 - 39 (公社)日本放射線技術学会-北海道支部 2023年11月
  • Junki Takenaka, Kenji Hirata, Shiro Watanabe, Masahiko Takahata, Kohsuke Kudo
    Clinical nuclear medicine 48 11 e523-e525  2023年11月01日 
    MRI revealed a thoracic vertebrae lesion in a 40-year-old woman with back pain. She was referred to our institution; MRI demonstrated a mass from the second to the fifth thoracic vertebra and compression fractures. CT revealed a splenic mass, multiple pulmonary nodules, and low-density masses in the liver. 18 F-FDG PET/CT showed increased uptake (SUV max , 10.6) in the peripheral rim of the thoracic vertebra mass, with central parts showing lower uptake than the peripheral rim. The splenic mass exhibited increased accumulation (SUV max , 4.8). The thoracic spine lesion was fixed; a biopsy was performed. Alveolar echinococcosis was confirmed immunologically. Alveolar echinococcosis can present with bone lesions. It must be differentiated from malignancy.
  • Junki Takenaka, Shiro Watanabe, Takashige Abe, Takahiro Tsuchikawa, Satoshi Takeuchi, Kenji Hirata, Rina Kimura, Naoto Wakabayashi, Nobuo Shinohara, Kohsuke Kudo
    Neuroendocrinology 2023年09月19日 
    Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours that produce catecholamines. [131I] MIBG-avid unresectable or metastatic PPGLs are treated with [131I] MIBG therapy. A high metabolic tumour volume (MTV) and total lesion glycolysis (TLG) can be poor prognostic factors. Therefore, we evaluated the metabolic responses to [131I] MIBG therapy with respect to other clinical factors.A retrospective study was performed on a series of 20 patients who underwent FDG-PET before and after [131I] MIBG therapy. We administered a single dose comprising 5.5 GBq of [131I] MIBG. Semi-quantitative parameters (SUVmax, MTV, and TLG) were calculated using the liver SUV (mean + 3SD) as a threshold on Metavol software. The semi-quantitative FDG-PET parameters for determining response were complete response , partial remission, stable disease, and progressive disease (PD). We divided our study participants into the PD and non-PD groups and compared the overall survival between the two groups. Subsequently, we evaluated the relationships between metabolic response and age, sex, tumour type, metastatic site, chemotherapy or external radiation history, and 24-hour urine catecholamine levels by univariate logistic regression analyses. Both MTV-based and TLG-based criteria for PD vs. non-PD were significant prognostic factors (p = 0.014). However, treatment response as evaluated based on the SUVmax was not a significant predictor. Higher urinary dopamine levels were associated with poor metabolic response as assessed by MTV and TLG. The other clinical parameters were non-significant. Poor metabolic response (measured with MTV and TLG) to [131I] MIBG therapy in unresectable or metastatic PPGLs was related to shorter OS. The poor metabolic response can be predicted using the urinary dopamine level.
  • Satoshi Takeuchi, Kenji Hirata, Keiichi Magota, Shiro Watanabe, Rika Moku, Akihiko Shiiya, Jun Taguchi, Shin Ariga, Tomohiro Goda, Yoshihito Ohhara, Takurou Noguchi, Yasushi Shimizu, Ichiro Kinoshita, Rio Honma, Yasushi Tsuji, Akihiro Homma, Hirotoshi Dosaka-Akita
    EJNMMI research 13 1 69 - 69 2023年07月17日 
    BACKGROUND: Lenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes. RESULTS: This was a prospective, nonrandomised, multicentre study. Patients with pathologically confirmed differentiated thyroid carcinoma (DTC) and lesions refractory to radioiodine treatment were eligible for inclusion. Patients were treated with 24 mg lenvatinib as the initial dose and underwent PET/CT examination 1 week after treatment initiation. Contrast-enhanced CT was scheduled at least 4 weeks later as the gold standard for evaluation. The primary endpoint was to evaluate the discrimination power of maximum standardised uptake value (SUVmax) obtained by PET/CT compared to that obtained by contrast-enhanced CT. Evaluation was performed using the area under the receiver operating characteristic (ROC-AUC) curve. Twenty-one patients were included in this analysis. Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.714 for SUVmax after 1 week of lenvatinib treatment. The best cut-off value for the treatment response for SUVmax was 15.211. The sensitivity and specificity of this cut-off value were 0.583 and 0.857, respectively. The median progression-free survival was 26.3 months in patients with an under-cut-off value and 19.7 months in patients with an over-cut-off value (P = 0.078). CONCLUSIONS: The therapeutic effects of lenvatinib were detected earlier than those of CT because of decreased FDG uptake on PET/CT. PET/CT examination 1 week after the initiation of lenvatinib treatment may predict treatment outcomes in patients with DTC. TRIAL REGISTRATION: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (number UMIN000022592) on 6 June, 2016.
  • Sunburst appearanceを呈する頭蓋骨腫瘤を契機に発見された神経芽腫の1例
    北川 悠, 竹中 淳規, 渡邊 史郎, 平田 健司, 内山 裕子, 木村 理奈, 中川 純一, 池辺 洋平, 長谷河 昌孝, 澤井 彩織, 寺下 友佳代, 杉山 未奈子, 平林 真介, 長 祐子, 山口 秀, 真部 淳, 工藤 與亮
    北海道放射線医学雑誌 3 33 - 36 (NPO)メディカルイメージラボ 2023年03月 
    症例は9歳女児。左頭部腫瘤を主訴に近医を受診し、頭部CTで左前頭骨にsunburst appearanceを呈する腫瘤性病変を指摘され、その他にも右頭頂骨と左下顎頭に骨病変を認めた。体幹部造影CTを施行したところ、後縦隔の胸椎椎体前方から左側にかけて巨大な軟部腫瘤を認めた。血清神経特異エノラーゼ(NSE)や尿中バニリルマンデル酸(VMA)/ホモバニリン酸(HVA)が高値であり、神経芽腫が第一に疑われた。123I-MIBGシンチグラフィを施行したところ、後縦隔腫瘤のほか頭蓋骨を含めた全身骨にも集積が見られ、神経芽腫とその骨転移が疑われた。頭蓋骨腫瘤の生検術により神経芽腫の診断が確定した。神経芽腫は小児期に発生する頭蓋外の固形悪性腫瘍の中で最も頻度が高い。転移性頭蓋骨腫瘍がsunburst appearanceを呈することは比較的稀であるが、小児では神経芽腫の転移でしばしば経験される。神経芽腫の骨転移の部位として、頭蓋骨は頻度が高く、小児においてsunburst appearanceを呈し多発する頭蓋骨腫瘤を見た場合には神経芽腫の骨転移を考慮する必要がある。(著者抄録)
  • MIP類似アルゴリズムによるFDG-PET体表画像の有用性
    平田 健司, 木村 理奈, 唐 明輝, 渡邊 史郎, 竹中 淳規, 若林 直人, 杉森 博行, 吉村 高明, 工藤 與亮
    核医学 60 Suppl. S208 - S208 (一社)日本核医学会 2023年
  • SRCNNを用いた短時間収集PET画像の画質改善モデルの開発と定量性評価
    遠藤 大輝, 吉村 高明, 唐 明輝, 杉森 博行, 長谷川 淳, 小亀 翔揮, 孫田 惠一, 木村 理奈, 渡邊 史郎, 平田 健司, 工藤 與亮
    核医学 60 Suppl. S209 - S209 (一社)日本核医学会 2023年
  • 褐色細胞腫・傍神経節腫に対するI-131MIBG治療の単回投与と複数回投与での有害事象発生率の検討
    若林 直人, 渡邊 史郎, 安部 崇重, 竹中 淳規, 平田 健司, 篠原 信雄, 工藤 與亮
    核医学 60 Suppl. S216 - S216 (一社)日本核医学会 2023年
  • Junki Takenaka, Kenji Hirata, Shiro Watanabe, Hideaki Shiraishi, Kohsuke Kudo
    Asia Oceania journal of nuclear medicine & biology 11 1 93 - 96 2023年 
    A 2-year-old girl started to wobble without any specific triggers, so the patient was admitted to our hospital's pediatric department. The entire cerebellum showed severe atrophy on MRI and much lower uptake than that in the cerebral cortex on perfusion SPECT. The diagnosis of opsoclonus-myoclonus syndrome (OMS) was suspected. MRI visualized a small mass behind the inferior vena cava. Although its uptake on I-123 MIBG scintigraphy was inconclusive, the mass was surgically removed, and the diagnosis of neuroblastoma was pathologically confirmed. OMS is one of the paraneoplastic neurological syndromes with cerebellar ataxia, myoclonus of the trunk and extremities, and opsoclonus as its main symptoms. Approximately 50% of children cases with OMS are associated with neuroblastoma. The prognosis for neuroblastoma itself with OMS is relatively good, but the neurological prognosis is very poor. If there is decreased blood flow in the cerebellum of an infant, it may be necessary to search for neuroblastoma.
  • MIP類似アルゴリズムによるFDG-PET体表画像の有用性
    平田 健司, 木村 理奈, 唐 明輝, 渡邊 史郎, 竹中 淳規, 若林 直人, 杉森 博行, 吉村 高明, 工藤 與亮
    核医学 60 Suppl. S208 - S208 (一社)日本核医学会 2023年
  • SRCNNを用いた短時間収集PET画像の画質改善モデルの開発と定量性評価
    遠藤 大輝, 吉村 高明, 唐 明輝, 杉森 博行, 長谷川 淳, 小亀 翔揮, 孫田 惠一, 木村 理奈, 渡邊 史郎, 平田 健司, 工藤 與亮
    核医学 60 Suppl. S209 - S209 (一社)日本核医学会 2023年
  • Tsubasa Kunieda, Ren Togo, Noriko Nishioka, Yukie Shimizu, Shiro Watanabe, Kenji Hirata, Keisuke Maeda, Takahiro Ogawa 0001, Kohsuke Kudo, Miki Haseyama
    ICCE-Taiwan 165 - 166 2023年
  • Junki Takenaka, Shiro Watanabe, Takashige Abe, Kenji Hirata, Yuko Uchiyama, Rina Kimura, Nobuo Shinohara, Kohsuke Kudo
    Annals of nuclear medicine 2022年10月27日 
    OBJECTIVE: Pheochromocytomas and paragangliomas (PPGLs) are rare tumors arising from the neural crest cells that form the sympathetic and parasympathetic nervous systems. Radiotherapy with [131I]metaiodobenzylguanidine (MIBG) is recommended for unresectable PPGLs. We investigated the usefulness of the metabolic tumor volume (MTV) and total lesion glycolysis (TLG) derived from [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting the prognosis of patients with unresectable PPGL(s) before receiving [131I]MIBG therapy. PATIENTS AND METHODS: We retrospectively analyzed the cases of 25 patients with unresectable PPGLs treated with [131I]MIBG at our hospital between 2001 and 2020. The MTV and TLG were measured in reference to liver accumulation. We divided the patients into two groups based on median values for the maximum standardized uptake value (SUVmax), MTV, and TLG, and evaluated between-group differences using log-rank tests. Cox proportional hazards models were used to determine whether there were significant differences in prognosis with respect to tumor type (pheochromocytoma vs. paraganglioma), site of metastasis, age, past treatment (chemotherapy, external radiation or [131I]MIBG treatment before the current [131I]MIBG treatment), urinary catecholamine, SUVmax, MTV, and TLG. RESULTS: The median follow-up time was 42 months (range 2-136 months). The median overall survival was 63 months. The overall survival (OS) was significantly shorter in the high-MTV group (log-rank test, p = 0.049) and the high-TLG group (p = 0.049), with no significant difference between the high- and low-SUVmax groups (p = 0.19). Likewise, there was no significant difference in prognosis according to pheochromocytoma or paraganglioma, metastasis location, age, or prior chemotherapy. A history of external radiation before [131I]MIBG treatment was associated with a significantly worse prognosis (hazard ration [HR] = 7.95, p = 0.0018). Urinary adrenaline and noradrenaline were not significant prognostic factors (p = 0.70, p = 0.25, respectively), but urinary dopamine did predict a worse outcome (p = 0.022). There was no increased risk of death for higher SUVmax or TLG (p = 0.63 and 0.057, respectively), but higher MTV did predict a worse outcome (HR = 7.27, p = 0.029). CONCLUSION: High MTV and high TLG were significantly associated with a poor prognosis after [131I]MIBG therapy for PPGLs. Other treatment strategies for such patients may need to be explored.
  • Haruki Narita, Junki Takenaka, Shiro Watanabe, Takashige Abe, Kohsuke Kudo
    Clinical nuclear medicine 47 9 e591-e593  2022年09月01日 
    A 49-year-old Japanese man had a chief complaint of left hypochondrium pain, and a CT scan revealed a mass in the left retroperitoneal space. CT and MRI scans revealed a hemorrhagic component and surrounding fibrous tissues. FDG PET/CT images showed increased uptake in the peripheral rim of the mass, indicating a malignant tumor. The SUV max was 7.6. We surgically resected the mass. The pathological examination confirmed the diagnosis of chronic expanding hematoma. It is difficult to differentiate CEH from malignant tumors on imaging; this should be recognized as a diagnostic pitfall.
  • AIによる肝臓セグメンテーションの性能評価と肝臓体積の経時的変化
    木村 理奈, 平田 健司, 常田 慧徳, 竹中 淳規, 渡邊 史郎, 阿保 大介, 工藤 與亮
    日本医学放射線学会秋季臨床大会抄録集 59回 S403 - S403 (公社)日本医学放射線学会 2022年09月
  • Shiro Watanabe, Shozo Okamoto, Kazumasa Akikawa, Noriyuki Miyamoto, Miyuki Okamura-Kawasaki, Yuko Uchiyama, Junki Takenaka, Takuya Toyonaga, Kenji Hirata, Kohsuke Kudo
    Annals of nuclear medicine 2022年08月16日 
    OBJECTIVE: Radioactive iodine (RAI) therapy is a useful treatment for Graves' disease (GD). Most RAI sessions administer ≤ 500 MBq of iodine (I)-131. Sometimes patients require repeated RAI, often for longer periods of remission. We investigated the characteristics of patients for whom high dose (mostly 1110 MBq of I-131) RAI was effective as RAI therapy for GD. METHODS: We retrospectively analyzed the cases of 79 patients who underwent RAI for GD in a multicenter setting. We divided the patients into two groups based on the I-131 dose administered: the low dose (LD) group who received ≤ 500 MBq (n = 44) and the high dose (HD) group who received > 500 MBq (n = 35). The therapeutic effect was defined as achieving remission and reaching the point of participating in thyroid hormone replacement therapy within 1 year after RAI. We compared the LD and HD groups' remission rates and conducted a multivariate logistic regression analysis of predictive factors for remission. In a simulation, using the formula for predicting the probability of remission obtained from the analysis results, we estimated how much the remission rate would change if the I-131 dose is increased from 500 to 1110 MBq. RESULTS: The mean ± standard deviation I-131 dose administered in the LD group was 480 ± 6 MBq, and that of the HD group was 1054 ± 265 MBq. Thirty-five patients (80%) in the LD group and 26 patients (74%) in the HD group achieved remission; this difference in the remission rate was not significant. The multivariate analysis results demonstrated that the absorbed dose and thyroid-stimulating antibody (TSAb) were independent predictors of remission. Seven patients (8.9%) showed an increased probability of remission from < 50% to > 50% when the higher RAI dose was applied (1110 MBq instead of 500 MBq). The thyroid volume and TSAb values in these patients were relatively large at 54.7 ± 34.2 mL and 1378.4 ± 586.3%, respectively. CONCLUSION: Although the overall remission rate was not significantly different between the patients who received high- or low-dose I-131, treatment with high-dose RAI may improve the probability of remission in patients with a massive thyroid volume and/or high-TSAb Graves' disease.
  • バセドウ病に対するHigh dose I-131治療による治療効果の改善
    渡邊 史郎, 岡本 祥三, 秋川 和聖, 内山 裕子, 竹中 淳規, 平田 健司, 工藤 與亮
    核医学 59 Suppl. S463 - S463 (一社)日本核医学会 2022年08月
  • Takaaki Yoshimura, Atsushi Hasegawa, Shoki Kogame, Keiichi Magota, Rina Kimura, Shiro Watanabe, Kenji Hirata, Hiroyuki Sugimori
    Diagnostics 12 4 872 - 872 2022年03月31日 
    In positron emission tomography (PET) imaging, image quality correlates with the injected [18F]-fluorodeoxyglucose (FDG) dose and acquisition time. If image quality improves from short-acquisition PET images via the super-resolution (SR) deep learning technique, it is possible to reduce the injected FDG dose. Therefore, the aim of this study was to clarify whether the SR deep learning technique could improve the image quality of the 50%-acquisition-time image to the level of that of the 100%-acquisition-time image. One-hundred-and-eight adult patients were enrolled in this retrospective observational study. The supervised data were divided into nine subsets for nested cross-validation. The mean peak signal-to-noise ratio and structural similarity in the SR-PET image were 31.3 dB and 0.931, respectively. The mean opinion scores of the 50% PET image, SR-PET image, and 100% PET image were 3.41, 3.96, and 4.23 for the lung level, 3.31, 3.80, and 4.27 for the liver level, and 3.08, 3.67, and 3.94 for the bowel level, respectively. Thus, the SR-PET image was more similar to the 100% PET image and subjectively improved the image quality, as compared to the 50% PET image. The use of the SR deep-learning technique can reduce the injected FDG dose and thus lower radiation exposure.
  • 肺癌の再発・転移が疑われた後縦隔FDG陽性病変の診断に骨髄シンチグラフィが有用であった一例
    眞島 隆成, 竹中 淳規, 渡邊 史郎, 内山 裕子, 木村 理奈, 榊原 純, 平田 健司, 工藤 與亮
    北海道放射線医学雑誌 2 29 - 33 (NPO)メディカルイメージラボ 2022年03月 
    後縦隔傍脊椎部に発生した髄外造血の一例を経験したので報告する。症例は70歳代男性。原発性肺癌の術後経過観察中に胸部CTにて第5/6胸椎腹側に軟部腫瘤の出現を指摘され、その後も腫瘤は増大傾向を示した。18F-FDG PET/CTでの集積亢進も認め、術後再発や転移性腫瘍、その他悪性リンパ腫や神経原性腫瘍等が鑑別となったが、画像経過からは腫瘤は経時的な増大とともに形態の変化も認めていた。この経過からは髄外造血が疑われたが、病変の局在としてはやや非典型であった。診断目的に気管支鏡下または外科的生検も検討されたが、出血リスクの高い髄外造血の除外のためインジウム(111In)シンチグラフィを施行したところ、腫瘤に一致したインジウムの集積を認め、髄外造血と診断した。その後も経過観察し、腫瘤は自然消退した。髄外造血は肝臓、脾臓、リンパ節などにみられるが、胸腔内、なかでも後縦隔の傍脊椎領域にも発生する。後縦隔傍脊椎部に腫瘤を認めた場合には髄外造血を念頭に置く必要があり、骨髄シンチグラフィにより侵襲的検査を回避可能な場合がある。(著者抄録)
  • Anri Inaki, Tohru Shiga, Yoshito Tsushima, Megumi Jinguji, Hiroshi Wakabayashi, Daiki Kayano, Norihito Akatani, Takafumi Yamase, Yuji Kunita, Satoru Watanabe, Tomo Hiromasa, Hiroshi Mori, Kenji Hirata, Shiro Watanabe, Tetsuya Higuchi, Hiroyasu Tomonaga, Seigo Kinuya
    Annals of Nuclear Medicine 36 3 267 - 278 2022年03月 [査読有り]
     
    Abstract Objective In this phase II study, we aimed to investigate the efficacy and safety of single-dose [131I]meta-iodobenzylguanidine (131I-mIBG) therapy in patients with refractory pheochromocytoma and paraganglioma (PPGL). Patients and methods This study was designed as an open-label, single-arm, multi-center, phase II clinical trial. The enrolled patients were administered 7.4 GBq of 131I-mIBG. Its efficacy was evaluated 12 and 24 weeks later, and its safety was monitored continuously until the end of the study. We evaluated the biochemical response rate as the primary endpoint using the one-sided exact binomial test based on the null hypothesis (≤ 5%). Results Seventeen patients were enrolled in this study, of which 16 were treated. The biochemical response rate (≥ 50% decrease in urinary catecholamines) was 23.5% (90% confidence interval: 8.5–46.1%, p = 0.009). The radiographic response rates, determined with CT/MRI according to the response evaluation criteria in solid tumors (RECIST) version 1.1 and 123I-mIBG scintigraphy were 5.9% (0.3%–25.0%) and 29.4% (12.4%–52.2%), respectively. The most frequent non-hematologic treatment-emergent adverse events (TEAEs) were gastrointestinal symptoms including nausea, appetite loss, and constipation, which were, together, observed in 15 of 16 patients. Hematologic TEAEs up to grade 3 were observed in 14 of 16 patients. No grade 4 or higher TEAEs were observed. All patients had experienced at least one TEAE, but no fatal or irreversible TEAEs were observed. Conclusion A single dose 131I-mIBG therapy was well tolerated by patients with PPGL, and statistically significantly reduced catecholamine levels compared to the threshold response rate, which may lead to an improved prognosis for these patients.
  • 超解像深層学習を用いたPET検査における被ばく線量低減に向けた検討
    長谷川 淳, 吉村 高明, 孫田 恵一, 木村 理奈, 渡邊 史郎, 平田 健司
    日本放射線技術学会総会学術大会予稿集 78回 160 - 160 (公社)日本放射線技術学会 2022年03月
  • Anri Inaki, Tohru Shiga, Yoshito Tsushima, Megumi Jinguji, Hiroshi Wakabayashi, Daiki Kayano, Norihito Akatani, Takafumi Yamase, Yuji Kunita, Satoru Watanabe, Tomo Hiromasa, Hiroshi Mori, Kenji Hirata, Shiro Watanabe, Tetsuya Higuchi, Hiroyasu Tomonaga, Seigo Kinuya
    Annals of nuclear medicine 36 3 267 - 278 2022年03月 
    OBJECTIVE: In this phase II study, we aimed to investigate the efficacy and safety of single-dose [131I]meta-iodobenzylguanidine (131I-mIBG) therapy in patients with refractory pheochromocytoma and paraganglioma (PPGL). PATIENTS AND METHODS: This study was designed as an open-label, single-arm, multi-center, phase II clinical trial. The enrolled patients were administered 7.4 GBq of 131I-mIBG. Its efficacy was evaluated 12 and 24 weeks later, and its safety was monitored continuously until the end of the study. We evaluated the biochemical response rate as the primary endpoint using the one-sided exact binomial test based on the null hypothesis (≤ 5%). RESULTS: Seventeen patients were enrolled in this study, of which 16 were treated. The biochemical response rate (≥ 50% decrease in urinary catecholamines) was 23.5% (90% confidence interval: 8.5-46.1%, p = 0.009). The radiographic response rates, determined with CT/MRI according to the response evaluation criteria in solid tumors (RECIST) version 1.1 and 123I-mIBG scintigraphy were 5.9% (0.3%-25.0%) and 29.4% (12.4%-52.2%), respectively. The most frequent non-hematologic treatment-emergent adverse events (TEAEs) were gastrointestinal symptoms including nausea, appetite loss, and constipation, which were, together, observed in 15 of 16 patients. Hematologic TEAEs up to grade 3 were observed in 14 of 16 patients. No grade 4 or higher TEAEs were observed. All patients had experienced at least one TEAE, but no fatal or irreversible TEAEs were observed. CONCLUSION: A single dose 131I-mIBG therapy was well tolerated by patients with PPGL, and statistically significantly reduced catecholamine levels compared to the threshold response rate, which may lead to an improved prognosis for these patients.
  • Tsubasa Kunieda, Ren Togo, Noriko Nishioka, Yukie Shimizu, Shiro Watanabe, Kenji Hirata, Keisuke Maeda, Takahiro Ogawa 0001, Kohsuke Kudo, Miki Haseyama
    GCCE 137 - 138 2022年
  • SiPM-PET/CT装置を用いた冠動脈18F-FDG集積の再現性評価
    渡邊 史郎, 納谷 昌直, 孫田 恵一, 真鍋 治, 新山 大樹, 平田 健司, 内山 裕子, 竹中 淳規, 工藤 與亮
    核医学 58 Suppl. S210 - S210 (一社)日本核医学会 2021年10月
  • FDG-PET/CTのレポート上のSUVmaxを利用して解剖学用語を機械学習させる検討
    平田 健司, 渡邊 史郎, 内山 裕子, 竹中 淳規, 木村 理奈, 眞島 隆成, 孫田 恵一, 工藤 與亮
    核医学 58 Suppl. S225 - S225 (一社)日本核医学会 2021年10月
  • Yuko Uchiyama, Kenji Hirata, Shiro Watanabe, Shozo Okamoto, Tohru Shiga, Kazufumi Okada, Yoichi M. Ito, Kohsuke Kudo
    Annals of Nuclear Medicine 35 11 1223 - 1231 2021年08月11日 [査読有り]
     
    BACKGROUND: Although patients with differentiated thyroid cancer (DTC) generally have a good prognosis, patients with a large metabolic tumor volume (MTV) on FDG-PET may experience poor clinical courses. We measured organ-based MTVs and tested its prognostic performance in comparison to conventional MTV (cMTV). METHODS: We retrospectively analyzed the cases of 280 patients who received their first I-131 therapy in 2003-2014 at our hospital and showed an FDG-avid metastatic lesion. We randomly divided the patients into training (n = 190) and validation (n = 90) datasets. We classified the MTVs as MTVneck-node, MTVdistant-node, MTVlung, MTVbone, and MTVother-organs and tested with/without dichotomization vis-à-vis overall survival (OS). Based on the estimated weighting coefficients of the organ-based MTVs, we propose a new index: the adjusted whole-body MTV (aMTV). Using the validation dataset, we compared the aMTV with cMTV for predicting OS. RESULTS: In a univariate analysis, MTVdistant-node and MTVother-organs were more strongly correlated with the OS than the dichotomized forms, whereas the dichotomized forms of MTVneck-node, MTVlung, and MTVbone were more strongly correlated with OS than the continuous variables. The aMTV was thus expressed as 0.69 × dic(MTVneck-node) + 0.02 × MTVdistant-node + 1.05 × dic(MTVlung) + 1.58 × dic(MTVbone) + 0.01 × MTVother-organs, where dic(x) represents 0 or 1 based on the optimized cut-off. In the model evaluation using the validation group, aMTV was a significant predictor of OS with a higher c-index (0.7676) than cMTV (0.7218). CONCLUSION: In DTC patients with FDG-avid metastasis before I-131 therapy, all organ-based MTVs were significant predictors of prognosis. As the aMTV outperformed the cMTV for predicting prognoses, we recommend measuring the MTV on an organ basis.
  • 巨大乳腺腺筋上皮腫の1例 MRI所見を中心に
    竹中 淳規, 加藤 扶美, 富岡 伸元, 桑原 健, 渡邊 史郎, 坂井 亙, 鈴木 宏明, 高橋 將人, 南部 敏和, 工藤 與亮
    北海道放射線医学雑誌 1 12 - 17 (NPO)メディカルイメージラボ 2021年03月 
    症例は50歳代女性。右乳房腫瘤を主訴に前医を受診し、生検で腺筋上皮腫が疑われ、当院乳腺外科受診。MRIでは右乳腺をほぼ置換する腫瘤を認め、早期濃染と洗い出しを示し、嚢胞変性を疑う造影不良域を認めた。拡散強調像で軽度高信号を示し、ADC値は1.264×10^-3mm2/secであった。周囲に小腫瘤やnon-mass enhancementを多数認めた。MRI上、悪性を否定できず、右乳房全摘術が施行された。組織像では腺筋上皮腫と考えられ、明らかな悪性とする異型は認めなかった。主腫瘤の周囲には連続性の不明瞭な腫瘤や不整形病変も見られMRIでの分布に概ね一致していた。乳腺腺筋上皮腫は組織学的に腺上皮細胞と筋上皮細胞がともに増殖を示す極めて稀な良性腫瘍で、画像所見は非特異的で、術前診断は難しい。外科的に切除されるが、局所再発しやすい為、十分なマージンが必要となる。本症例のように腫瘍が広範に存在し、不連続な分布を呈する場合もあり、MRIで病変の範囲を評価することが重要である。(著者抄録)
  • Kazutaka Harashima, Shiro Watanabe, Nanase Okazaki, Daisuke Endo, Yuko Uchiyama, Fumi Kato, Kenji Hirata, Kohsuke Kudo
    Asia Oceania journal of nuclear medicine & biology 9 2 183 - 187 2021年 [査読有り]
     
    Although 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is an established method for the staging of malignancies, benign lesions (e.g, active inflammatory lesions) often show increased metabolic activity. Herpes zoster is the clinical manifestation of the activation and replication of dormant varicella-zoster virus (VZV) in individuals with decreased cell-mediated immunity. Although the diagnosis of herpes zoster is clinical, it is sometimes observed incidentally during imaging for another disease. We describe the case of a 67-year-old Japanese female patient diagnosed with cervical cancer in whom FDG-PET/CT revealed herpes zoster manifestations: hypermetabolic cutaneous lesions in the buttock and pelvic lymph node involvement. The resected lymph nodes showed no malignant lesions but revealed lymphoid follicle formation, probably related to viral infection. There has been no report comparing FDG-PET findings of lymph nodes with histologic findings; the present findings are compatible with a clinically VZV-induced inflammatory reaction in regional lymph nodes, which increased FDG accumulation. Active infection with VZV displays increased FDG uptake in regional lymph nodes and may lead to incorrect malignant disease management in oncology. Misdiagnoses can be avoided by a careful interpretation by experienced nuclear medicine physicians as well as proper clinical evaluation.
  • Keisuke Kawauchi, Sho Furuya, Kenji Hirata, Chietsugu Katoh, Osamu Manabe, Kentaro Kobayashi, Shiro Watanabe, Tohru Shiga
    BMC Cancer 20 1 2020年12月 [査読有り]
     
    Abstract Background As the number of PET/CT scanners increases and FDG PET/CT becomes a common imaging modality for oncology, the demands for automated detection systems on artificial intelligence (AI) to prevent human oversight and misdiagnosis are rapidly growing. We aimed to develop a convolutional neural network (CNN)-based system that can classify whole-body FDG PET as 1) benign, 2) malignant or 3) equivocal. Methods This retrospective study investigated 3485 sequential patients with malignant or suspected malignant disease, who underwent whole-body FDG PET/CT at our institute. All the cases were classified into the 3 categories by a nuclear medicine physician. A residual network (ResNet)-based CNN architecture was built for classifying patients into the 3 categories. In addition, we performed a region-based analysis of CNN (head-and-neck, chest, abdomen, and pelvic region). Results There were 1280 (37%), 1450 (42%), and 755 (22%) patients classified as benign, malignant and equivocal, respectively. In the patient-based analysis, CNN predicted benign, malignant and equivocal images with 99.4, 99.4, and 87.5% accuracy, respectively. In region-based analysis, the prediction was correct with the probability of 97.3% (head-and-neck), 96.6% (chest), 92.8% (abdomen) and 99.6% (pelvic region), respectively. Conclusion The CNN-based system reliably classified FDG PET images into 3 categories, indicating that it could be helpful for physicians as a double-checking system to prevent oversight and misdiagnosis.
  • Shiro Watanabe, Ken-Ichi Nishijima, Shozo Okamoto, Keiichi Magota, Kenji Hirata, Takuya Toyonaga, Tohru Shiga, Yuji Kuge, Nagara Tamaki
    Annals of nuclear medicine 34 8 595 - 599 2020年05月02日 [査読有り][通常論文]
     
    OBJECTIVE: We evaluated the radiation dosage, biodistribution, human safety, and tolerability of the injection of a single dose of [123I] 5-iodo-6-[(2-iminoimidazolidinyl)methyl]uracil (IIMU), a new radiotracer targeting thymidine phosphorylase (TP), in healthy volunteers. METHODS: Potential participants were tested at our hospital to confirm their eligibility. Two healthy male adults passed the screening tests. They were injected with 56 and 111 MBq of [123I]IIMU, respectively. Safety assessments were performed before and at 1, 3, 6, 9, 24, 48 h, and 1-week post-injection. Whole-body emission scans were conducted at 1, 3, 6, 24, and 48 h post-injection. Regions of interest were manually drawn to enclose the entire body at each time point, identifying high-uptake organs to obtain the time-activity curves. Urine and blood samples were collected at 1, 2, 3, 4, 5, 6, 9, 24, and 48 h post-injection. The radiation dose for each organ and the effective doses were estimated using OLINDA/EXM 1.1 software. RESULTS: No adverse events were observed as of the follow-up visit > 1-week post-injection. In both subjects, the highest uptake of [123I]IIMU occurred in the liver, with peak injected activity (%IA) values of 17.7% and 15.1%, respectively. The second highest uptake was in the thyroid (0.35% and 0.66% IA). The %IA decreased gradually toward the end of the study (48 h) in all organs except the liver and thyroid. By the end of the study, 52.5% and 51.5% of the injected activity of [123I]IIMU had been excreted via the subjects' renal systems. The estimated mean effective doses of [123I]IIMU were 9.19 μSv/MBq and 10.1 μSv/MBq, respectively. CONCLUSION: In this preliminary study, [123I]IIMU was safely administered to healthy adults, and its potential clinical use in TP imaging was revealed.
  • Shiro Watanabe, Tetsuya Inoue, Shozo Okamoto, Keiichi Magota, Ayumi Takayanagi, Jun Sakakibara-Konishi, Norio Katoh, Kenji Hirata, Osamu Manabe, Takuya Toyonaga, Yuji Kuge, Hiroki Shirato, Nagara Tamaki, Tohru Shiga
    EJNMMI research 9 1 104 - 104 2019年12月04日 [査読有り][通常論文]
     
    BACKGROUND: We investigated the prognostic predictive value of the combination of fluorodeoxyglucose (FDG)- and fluoromisonidazole (FMISO)-PET in patients with non-small cell lung carcinoma (NSCLC) treated with stereotactic body radiation therapy (SBRT). PATIENTS AND METHODS: We prospectively examined patients with pathologically proven NSCLC; all underwent FDG and FMISO PET/CT scans before SBRT. PET images were acquired using a whole-body time-of-flight PET-CT scanner with respiratory gating. We classified them into recurrent and non-recurrent groups based on their clinical follow-ups and compared the groups' tumor diameters and PET parameters (i.e., maximum of the standardized uptake value (SUVmax), metabolic tumor volume, tumor-to-muscle ratio, and tumor-to-blood ratio). We performed univariate analysis to evaluate the impact of the PET variables on the patients' progression-free survival (PFS). We divided the patients by thresholds of FDG SUVmax and FMISO SUVmax obtained from receiver operating characteristic analysis for assessment of recurrence rate and PFS. RESULTS: Thirty-two NSCLC patients (19 male and 13 females; median age, 83 years) were enrolled. All received SBRT. At the study endpoint, 23 patients (71.9%) were non-recurrent and nine patients (28.1%) had recurrent disease. Significant between-group differences were observed in tumor diameter and all the PET parameters, demonstrating that those were significant predictors of the recurrence in all patients. In the 22 patients with tumors > 2 cm, tumor diameter and FDG SUVmax were not significant predictors. Thirty-two patients were divided into three patterns from the thresholds of FDG SUVmax (6.81) and FMISO SUVmax (1.89); A, low FDG and low FMISO (n = 14); B, high FDG and low FMISO (n = 8); C, high FDG and high FMISO (n = 10). No pattern A patient experienced tumor recurrence, whereas two pattern B patients (25%) and seven pattern C patients (70%) exhibited recurrence. A Kaplan-Meier analysis of all patients revealed a significant difference in PFS between patterns A and B (p = 0.013) and between patterns A and C (p < 0.001). In the tumors > 2 cm patients, significant differences in PFS were demonstrated between pattern A and C patients (p = 0.002). CONCLUSION: The combination of FDG- and FMISO-PET can identify patients with a baseline risk of recurrence and indicate whether additional therapy might be performed to improve survival.
  • MRI上、悪性が疑われた巨大乳腺腺筋上皮腫の1例
    竹中 淳規, 加藤 扶美, 坂井 亙, 木村 輔, 渡邉 史郎, 鈴木 純, 富岡 伸元, 桑原 健, 鈴木 宏明, 南部 敏和
    日本医学放射線学会秋季臨床大会抄録集 55回 S472 - S472 (公社)日本医学放射線学会 2019年09月
  • Watanabe S, Shiga T, Hirata K, Magota K, Okamoto S, Toyonaga T, Higashikawa K, Yasui H, Kobayashi J, Nishijima KI, Iseki K, Matsumoto H, Kuge Y, Tamaki N
    EJNMMI research 9 1 60 - 60 2019年07月 [査読有り][通常論文]
     
    BACKGROUND: To facilitate hypoxia imaging in a clinical setting, we developed 1-(2,2-dihydroxymethyl-3-[18F]-fluoropropyl)-2-nitroimidazole ([18F]DiFA) as a new tracer that targets tumor hypoxia with its lower lipophilicity and efficient radiosynthesis. Here, we evaluated the radiation dosage, biodistribution, human safety, tolerability, and early elimination after the injection of [18F]DiFA in healthy subjects, and we performed a preliminary clinical study of patients with malignant tumors in a comparison with [18F]fluoromisonidazole ([18F]FMISO). RESULTS: The single administration of [18F]DiFA in 8 healthy male adults caused neither adverse events nor abnormal clinical findings. Dynamic and sequential whole-body scans showed that [18F]DiFA was rapidly cleared from all of the organs via the hepatobiliary and urinary systems. The whole-body mean effective dose of [18F]DiFA estimated by using the medical internal radiation dose (MIRD) schema with organ level internal dose assessment/exponential modeling (OLINDA/EXM) computer software 1.1 was 14.4 ± 0.7 μSv/MBq. Among the organs, the urinary bladder received the largest absorbed dose (94.7 ± 13.6 μSv/MBq). The mean absorbed doses of the other organs were equal to or less than those from other hypoxia tracers. The excretion of radioactivity via the urinary system was very rapid, reaching 86.4 ± 7.1% of the administered dose. For the preliminary clinical study, seven patients were subjected to [18F]FMISO and [18F]DiFA positron emission tomography (PET) at 48-h intervals to compare the two tracers' diagnostic ability for tumor hypoxia. The results of the tumor hypoxia evaluation by [18F]DiFA PET at 1 h and 2 h were not significantly different from those obtained with [18F]FMISO PET at 4 h ([18F]DiFA at 1 h, p = 0.32; [18F]DiFA at 2 h, p = 0.08). Moreover, [18F]DiFA PET at both 1 h (k = 0.68) and 2 h (k = 1.00) showed better inter-observer reproducibility than [18F]FMISO PET at 4 h (k = 0.59). CONCLUSION: [18F]DiFA is well tolerated, and its radiation dose is comparable to those of other hypoxia tracers. [18F]DiFA is very rapidly cleared via the urinary system. [18F]DiFA PET generated comparable images to [18F]FMISO PET in hypoxia imaging with shorter waiting time, demonstrating the promising potential of [18F]DiFA PET for hypoxia imaging and for a multicenter trial.
  • Osamu Manabe, Markus Kroenke, Tadao Aikawa, Atsuto Murayama, Masanao Naya, Atsuro Masuda, Noriko Oyama-Manabe, Kenji Hirata, Shiro Watanabe, Tohru Shiga, Chietsugu Katoh, Nagara Tamaki
    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 26 3 909 - 918 2019年06月 [査読有り][通常論文]
     
    OBJECTIVE: FDG PET/CT plays a significant role in the diagnosis of inflammatory heart diseases and cardiac tumors. We attempted to determine the optimal FDG uptake threshold for volume-based analyses and to evaluate the relationship between the myocardial physiological uptake volume in FDG PET and several clinical factors. METHODS: A total of 190 patients were retrospectively analyzed. The cardiac metabolic volume (CMV) was defined as a volume within the boundary determined by a threshold (SUVmean of blood pool × 1.5). RESULTS: The SUVmean of the blood pool measured in the descending aorta (DA) (r = 0.86, intraclass correlation coefficient [ICC] = 0.93, P < 0.0001) and that in the left ventricle (LV) cavity (r = 0.87, ICC = 0.90, P < 0.0001) showed high inter-operator reproducibility. However, the SUVmean in the LV cavity showed a significant correlation with the CMV (P = 0.0002, r = 0.26). The CMV in the patients who fasted < 18 hours were significantly higher (49.7  ±  73.2 vs. 18.0  ±  53.8 mL, P = 0.0013) compared to the patients with > 18-hour fasting. The multivariate analysis demonstrated that only the fasting period > 18 hours was independently associated with CMV = 0. CONCLUSION: Our findings revealed that the DA is suitable to decide the threshold for the volume-based analysis. The fasting time was significantly associated with the cardiac FDG uptake.
  • Keisuke Kawauchi, Kenji Hirata, Chietsugu Katoh, Seiya Ichikawa, Osamu Manabe, Kentaro Kobayashi, Shiro Watanabe, Sho Furuya, Tohru Shiga
    Scientific reports 9 1 7192 - 7192 2019年05月10日 [査読有り][通常論文]
     
    Patient misidentification in imaging examinations has become a serious problem in clinical settings. Such misidentification could be prevented if patient characteristics such as sex, age, and body weight could be predicted based on an image of the patient, with an alert issued when a mismatch between the predicted and actual patient characteristic is detected. Here, we tested a simple convolutional neural network (CNN)-based system that predicts patient sex from FDG PET-CT images. This retrospective study included 6,462 consecutive patients who underwent whole-body FDG PET-CT at our institute. The CNN system was used for classifying these patients by sex. Seventy percent of the randomly selected images were used to train and validate the system; the remaining 30% were used for testing. The training process was repeated five times to calculate the system's accuracy. When images for the testing were given to the learned CNN model, the sex of 99% of the patients was correctly categorized. We then performed an image-masking simulation to investigate the body parts that are significant for patient classification. The image-masking simulation indicated the pelvic region as the most important feature for classification. Finally, we showed that the system was also able to predict age and body weight. Our findings demonstrate that a CNN-based system would be effective to predict the sex of patients, with or without age and body weight prediction, and thereby prevent patient misidentification in clinical settings.
  • Kroenke M, Hirata K, Gafita A, Watanabe S, Okamoto S, Magota K, Shiga T, Kuge Y, Tamaki N
    PloS one 14 2 e0213111  2019年 [査読有り][通常論文]
     
    BACKGROUND: Hypoxia can induce radiation resistance and is an independent prognostic marker for outcome in head and neck cancer. As 18F-FMISO (FMISO), a hypoxia tracer for PET, is far less common than 18F-FDG (FDG) and two separate PET scans result in doubled cost and radiation exposure to the patient, we aimed to predict hypoxia from FDG PET with new techniques of voxel based analysis and texture analysis. METHODS: Thirty-eight patients with head-and-neck cancer underwent consecutive FDG and FMISO PET scans before any treatment. ROIs enclosing the primary cancer were compared in a voxel-by-voxel manner between FDG and FMISO PET. Tumour hypoxia was defined as the volume with a tumour-to-muscle ratio (TMR) > 1.25 in the FMISO PET and hypermetabolic volume was defined as >50% SUVmax in the FDG PET. The concordance rate was defined as percentage of voxels within the tumour which were both hypermetabolic and hypoxic. 38 different texture analysis (TA) parameters were computed based on the ROIs and correlated with presence of hypoxia. RESULTS: Within the hypoxic tumour regions, the FDG uptake was twice as high as in the non-hypoxic tumour regions (SUVmean 10.9 vs. 5.4; p<0.001). A moderate correlation between FDG and FMISO uptake was found by a voxel-by-voxel comparison (r = 0.664 p<0.001). The average concordance rate was 25% (± 22%). Entropy was the TA parameter showing the highest correlation with hypoxia (r = 0.524 p<0.001). CONCLUSION: FDG uptake was higher in hypoxic tumour regions than in non-hypoxic regions as expected by tumour biology. A moderate correlation between FDG and FMISO PET was found by voxel-based analysis. TA yielded similar results in FDG and FMISO PET. However, it may not be possible to predict tumour hypoxia even with the help of texture analysis.
  • FMISO-PETによる心臓サルコイドーシス病変の評価
    古家 翔, 真鍋 治, 大平 洋, 納谷 昌直, 相川 忠夫, 小梁川 和宏, 渡邊 史郎, 小林 健太郎, 平田 健司, 志賀 哲, 真鍋 徳子
    核医学 55 Suppl. S233 - S233 (一社)日本核医学会 2018年11月 [査読有り][通常論文]
  • Strategy to develop convolutional neural network-based classifier for diagnosis of whole-body FDG PET images
    Keisuke Kawauchi, Kenji Hirata, Seiya Ichikawa, Osamu Manabe, Kentaro Kobayashi, Shiro Watanabe, Miki Haseyama, Takahiro Ogawa, Ren Togo, Tohru Shiga, Chietsugu Katoh
    Society of Nuclear Medicine and Molecular Imaging Annual Meeting (SNMMI) 2018年06月 [査読有り][通常論文]
  • J. Sato, Y. Kitagawa, S. Watanabe, T. Asaka, N. Ohga, K. Hirata, T. Shiga, A. Satoh, N. Tamaki
    International Journal of Oral and Maxillofacial Surgery 47 5 553 - 560 2018年05月01日 [査読有り][通常論文]
     
    Tumour hypoxia can be detected by 18F-fluoromisonidazole positron emission tomography (FMISO-PET). Few studies have assessed the relationships of new PET parameters, including hypoxic volume (HV), metabolic tumour volume (MTV), and total lesion glycolysis (TLG), with 5-year survival of patients treated surgically for oral squamous cell carcinoma (OSCC). This study evaluated the relationships between these PET parameters and 5-year survival in OSCC patients. Twenty-three patients (age 42–84 years 15 male, eight female) with OSCC underwent FMISO- and 18F-fluoro-2-deoxyglucose (FDG)-PET computed tomography before surgery. All of them underwent radical surgery and were followed up for more than 5 years. The FDG-PET maximum standardized uptake value (SUVmax), HV, MTV, and TLG were measured. The ability of PET parameters to predict disease-free survival (DFS) and loco-regional recurrence (LR) was evaluated using receiver operating characteristic curve analysis. During the follow-up period, five of the 23 patients (22%) died and six (26%) experienced LR. Although FDG-PET SUVmax was not significantly associated with DFS or LR, HV correlated significantly with both DFS and LR. TLG, but not MTV, was significantly associated with DFS however neither MTV nor TLG was related significantly to LR. In conclusion, tumour HV may predict outcomes in patients with OSCC.
  • Kazuhito Yoshikawa, Makiko Onodera-Kyan, Yoshimasa Kitagawa, Akira Satoh, Jun Sato, Tetsuya Kitamura, Tohru Shiga, Shiro Watanabe, Nagara Tamaki
    Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 30 4 319 - 323 2018年 [査読無し][通常論文]
     
    Objective: FDG-PET has been shown useful in the staging of malignant lymphoma (ML) and in evaluating treatment outcomes. Serum concentration of soluble interleukin-2 receptor (sIL-2R) has also been shown prognostic in patients with MLs. This study analyzed the clinical possibility of baseline FDG-PET parameters, such as maximum standardized uptake values (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and serum sIL-2R and lactate dehydrogenase (LDH) concentrations, as prognostic variables in patients with oral and neck non-Hodgkin's lymphoma (NHL). Methods: Baseline FDG-PET parameters and serum protein concentrations were correlated with 2-year prognosis in 12 patients with oral and neck NHL. The optimal cutoff values for FDG SUVmax, serum sIL-2R and LDH were determined by receiver operating characteristics analyses. Results: At 2-year follow up, seven patients remained alive (good prognosis), and five had died (poor prognosis). The median FDG SUVmax was significantly higher in the poor than in the good prognosis groups (P = 0.04), but serum sIL-2R concentrations did not differ significantly between the two groups (P = 0.09). Baseline MTV and TLG were significantly higher in patients with poor than with good prognosis (P = 0.02 each). Serum LDH levels was significantly higher in patients with poor than with good prognosis (P = 0.01). Univariate logistic regression analysis showed significant correlations between FDG SUVmax and patient prognosis (P = 0.04, odds ratio, 23.4). Conclusion: Comprehensive evaluation of baseline FDG SUVmax may have possibility for predicting the prognosis of patients with oral and neck NHLs.
  • Jun Sato, Yoshimasa Kitagawa, Shiro Watanabe, Takuya Asaka, Noritaka Ohga, Kenji Hirata, Shozo Okamoto, Tohru Shiga, Masanobu Shindoh, Yuji Kuge, Nagara Tamaki
    ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY 124 3 261 - 270 2017年09月 [査読有り][通常論文]
     
    Objective. Hypoxia is a common feature and prognostic factor in cancer. F-18-fluoromisonidazole (FMISO) positron emission tomography (PET) can detect tumor hypoxia noninvasively. The aim of this study was to assess the correlations between FMISO-PET and F-18-fluorodexyglucose (FDG)-PET parameters with cell proliferation and hypoxia in patients with oral squamous cell carcinoma (OSCC). Study Design. Twenty-three preoperative patients with OSCC were included. The tumor/muscle ratio (TMR) of FMISO-PET, the maximum standardized uptake values (SUVmax) of FDG-PET, metabolic tumor volume, and total lesion glycolysis were measured. Ki-67 and hypoxia-inducible factor-1 alpha (HIF-1 alpha) expression was immunohistochemically evaluated. Results. FMISO TMR (P = .003) and FDG SUVmax (P = .04) were significantly higher in patients with high expression of Ki-67 compared with those with low expression of Ki-67. FMISO TMR (P = .006) and FDG SUVmax (P = .01) were also significantly higher in patients with HIF-1 alpha expression than in those without HIF-1 alpha expression. Metabolic tumor volume was not significantly related to either Ki-67 or HIF-1 alpha expression. Multivariate analysis showed that FMISO TMR was independently predictive of Ki-67 (P = .002; odds ratio 31.1) and HIF-1 alpha (P = .049; odds ratio 10.5) expression. Conclusions. FMISO-PET showed significant relationships with Ki-67 and HIF-1 alpha expression, which are key features of cell proliferation and hypoxia in OSCC.
  • Yukiko Nishikawa, Koichi Yasuda, Shozo Okamoto, Yoichi M. Ito, Rikiya Onimaru, Tohru Shiga, Kazuhiko Tsuchiya, Shiro Watanabe, Wataru Takeuchi, Yuji Kuge, Hao Peng, Nagara Tamaki, Hiroki Shirato
    RADIATION ONCOLOGY 12 1 148  2017年09月 [査読有り][通常論文]
     
    Background: Hypoxic cancer cells are thought to be radioresistant and could impact local recurrence after radiotherapy (RT). One of the major hypoxic imaging modalities is [F-18] fluoromisonidazole positron emission tomography (FMISO-PET). High FMISO uptake before RT could indicate radioresistant sites and might be associated with future local recurrence. The predictive value of FMISO-PET for intra-tumoral recurrence regions was evaluated using high-resolution semiconductor detectors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). Methods: Nine patients with local recurrence and 12 patients without local recurrence for more than 3 years were included in this study. These patients received homogeneous and standard doses of radiation to the primary tumor irrespective of FMISO uptake. The FMISO-PET image before RT was examined via a voxel-based analysis, which focused on the relationship between the degree of FMISO uptake and recurrence region. Results: In the pretreatment FMISO-PET images, the tumor-to-muscle ratio (TMR) of FMISO in the voxels of the tumor recurrence region was significantly higher than that of the non-recurrence region (p < 0.0001). In the recurrent patient group, a TMR value of 1.37 (95% CI: 1.36-1.39) corresponded to a recurrence rate of 30%, the odds ratio was 5.18 (4.87-5.51), and the area under the curve (AUC) of the receiver operating characteristic curve was 0.613. In all 21 patients, a TMR value of 2.42 (2.36-2.49) corresponded to an estimated recurrence rate of 30%, and the AUC was only 0.591. Conclusions: The uptake of FMISO in the recurrent region was significantly higher than that in the non-recurrent region. However, the predictive value of FMISO-PET before IMRT is not sufficient for up-front dose escalation for the intra-tumoral high-uptake region of FMISO. Because of the higher mean TMR of the recurrence region, a new hypoxic imaging method is needed to improve the sensitivity and specificity for hypoxia.
  • Shiro Watanabe, Tohru Shiga, Kenji Hirata, Tetsuya Inoue, Shozo Okamoto, Takuya Toyonaga, Keiichi Magota, Ken-ichi Nishijima, Yuji Kuge, Nagara Tamaki
    JOURNAL OF NUCLEAR MEDICINE 58 2017年05月 [査読有り][通常論文]
  • Takuya Toyonaga, Tohru Shiga, Kenji Hirata, Shigeru Yamaguchi, Wataru Takeuchi, Kohsuke Kudo, Keiichi Magota, Osamu Manabe, Kentaro Kobayashi, Shiro Watanabe, Yuji Kuge, Nagara Tamaki
    JOURNAL OF NUCLEAR MEDICINE 58 2017年05月 [査読有り][通常論文]
  • Takuya Toyonaga, Shigeru Yamaguchi, Kenji Hirata, Kentaro Kobayashi, Osamu Manabe, Shiro Watanabe, Shunsuke Terasaka, Hiroyuki Kobayashi, Naoya Hattori, Tohru Shiga, Yuji Kuge, Shinya Tanaka, Yoichi M Ito, Nagara Tamaki
    European journal of nuclear medicine and molecular imaging 44 4 611 - 619 2017年04月 [査読有り][通常論文]
     
    PURPOSE: Metabolic activity and hypoxia are both important factors characterizing tumor aggressiveness. Here, we used F-18 fluoromisonidazole (FMISO) and F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) to define metabolically active hypoxic volume, and investigate its clinical significance in relation to progression free survival (PFS) and overall survival (OS) in glioblastoma patients. EXPERIMENTAL DESIGN: Glioblastoma patients (n = 32) underwent FMISO PET, FDG PET, and magnetic resonance imaging (MRI) before surgical intervention. FDG and FMISO PET images were coregistered with gadolinium-enhanced T1-weighted MR images. Volume of interest (VOI) of gross tumor volume (GTV) was manually created to enclose the entire gadolinium-positive areas. The FMISO tumor-to-normal region ratio (TNR) and FDG TNR were calculated in a voxel-by-voxel manner. For calculating TNR, standardized uptake value (SUV) was divided by averaged SUV of normal references. Contralateral frontal and parietal cortices were used as the reference region for FDG, whereas the cerebellar cortex was used as the reference region for FMISO. FDG-positive was defined as the FDG TNR ≥1.0, and FMISO-positive was defined as FMISO TNR ≥1.3. Hypoxia volume (HV) was defined as the volume of FMISO-positive and metabolic tumor volume in hypoxia (hMTV) was the volume of FMISO/FDG double-positive. The total lesion glycolysis in hypoxia (hTLG) was hMTV × FDG SUVmean. The extent of resection (EOR) involving cytoreduction surgery was volumetric change based on planimetry methods using MRI. These factors were tested for correlation with patient prognosis. RESULTS: All tumor lesions were FMISO-positive and FDG-positive. Univariate analysis indicated that hMTV, hTLG, and EOR were significantly correlated with PFS (p = 0.007, p = 0.04, and p = 0.01, respectively) and that hMTV, hTLG, and EOR were also significantly correlated with OS (p = 0.0028, p = 0.037, and p = 0.014, respectively). In contrast, none of FDG TNR, FMISO TNR, GTV, HV, patients' age, or Karnofsky performance scale (KPS) was significantly correlated with PSF or OS. The hMTV and hTLG were found to be independent factors affecting PFS and OS on multivariate analysis. CONCLUSIONS: We introduced hMTV and hTLG using FDG and FMISO PET to define metabolically active hypoxic volume. Univariate and multivariate analyses demonstrated that both hMTV and hTLG are significant predictors for PFS and OS in glioblastoma patients.
  • Osamu Manabe, Kenji Hirata, Okamoto Shozo, Tohru Shiga, Yuko Uchiyama, Kentaro Kobayashi, Shiro Watanabe, Takuya Toyonaga, Hisaya Kikuchi, Noriko Oyama-Manabe, Nagara Tamaki
    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 24 1 329 - 331 2017年02月 [査読有り][通常論文]
     
    18F-fluoromisonidazole (FMISO) is a positron emission tomography (PET) tracer that accumulates in hypoxic tissues. We here present a case of suspected cardiac sarcoidosis which was detected with increased FMISO uptake.
  • Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Shiro Watanabe, Kenji Hirata, Ken-ichi Nishijima, Keiichi Magota, Katsuhiko Kasai, Rikiya Onimaru, Kazuhiko Tuchiya, Yuji Kuge, Hiroki Shirato, Nagara Tamaki
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 43 12 2147 - 2154 2016年11月 [査読有り][通常論文]
     
    The purpose of this study was to prospectively investigate reoxygenation in the early phase of fractionated radiotherapy and serial changes of tumoricidal effects associated with intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer (HNC) using F-18 fluoromisonidazole (FMISO) PET and F-18 fluorodeoxyglucose (FDG) PET. Patients with untreated HNC underwent FMISO-PET and FDG-PET studies prospectively. A PET evaluation was conducted before each IMRT (Pre-IMRT), during IMRT (at 30 Gy/15 fr) (Inter-IMRT), and after completion of IMRT (70 Gy/35 fr) (Post-IMRT). FMISO-PET images were scanned by a PET/CT scanner at 4 h after the FMISO injection. We quantitatively analyzed the FMISO-PET images of the primary lesion using the maximum standardized uptake (SUVmax) and tumor-to-muscle ratio (TMR). The hypoxic volume (HV) was calculated as an index of tumor hypoxia, and was defined as the volume when the TMR was aeyen 1.25. Each FDG-PET scan was started 1 h after injection. The SUVmax and metabolic tumor volume (MTV) values obtained by FDG-PET were analyzed. Twenty patients finished the complete PET study protocol. At Pre-IMRT, 19 patients had tumor hypoxia in the primary tumor. In ten patients, the tumor hypoxia disappeared at Inter-IMRT. Another seven patients showed the disappearance of tumor hypoxia at Post-IMRT. Two patients showed tumor hypoxia at Post-IMRT. The FMISO-PET results showed that the reduction rates of both SUVmax and TMR from Pre-IMRT to Inter-IMRT were significantly higher than the corresponding reductions from Inter-IMRT to Post-IMRT (SUVmax: 27 % vs. 10 %, p = 0.025; TMR: 26 % vs. 12 %, p = 0.048). The reduction rate of SUVmax in FDG-PET from Pre-IMRT to Inter-IMRT was similar to that from Inter-IMRT to Post-IMRT (47 % vs. 48 %, p = 0.778). The reduction rate of the HV in FMISO-PET from Pre-IMRT to Inter-IMRT tended to be larger than that from Inter-IMRT to Post-IMRT (63 % vs. 40 %, p = 0.490). Conversely, the reduction rate of the MTV in FDG-PET from Pre-IMRT to Inter-IMRT was lower than that from Inter-IMRT to Post-IMRT (47 % vs. 74 %, p = 0.003). Both the intensity and the volume of tumor hypoxia rapidly decreased in the early phase of radiotherapy, indicating reoxygenation of the tumor hypoxia. In contrast, the FDG uptake declined gradually with the course of radiotherapy, indicating that the tumoricidal effect continues over the entire course of radiation treatment.
  • Shiro Watanabe, Osamu Manabe, Kenji Hirata, Noriko Oyama-Manabe, Naoya Hattori, Yasuka Kikuchi, Kentaro Kobayashi, Takuya Toyonaga, Nagara Tamaki
    BMC cancer 16 635 - 635 2016年08月15日 [査読有り][通常論文]
     
    BACKGROUND: Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a benign lymphoid proliferation or malignant lymphoma in patients who have been treated with MTX. MTX withdrawal and observation for a short period should be considered in the initial management of patients who develop LPD while on MTX therapy. Here we evaluated the diagnostic accuracy and predictive value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for MTX-LPD. METHODS: We retrospectively investigated the cases of 15 patients clinically suspected of having MTX-LPD. A total of 324 anatomic regions (207 nodal and 117 extranodal regions) were assessed by (18)F-FDG PET/CT and by multi-detector row CT (MDCT). Each anatomic region was classified as either malignant or benign. The uptake of (18)F-FDG was assessed semi-quantitatively with the standardized uptake value maximum (SUVmax), the whole-body metabolic tumor volume (WBMTV), and the whole-body total lesion glycolysis (WBTLG) in order to investigate predictive factors of spontaneous regression after the withdrawal of MTX. RESULTS: MTX-LPD lesions were observed in 92/324 (28.4 %) regions. (18)F-FDG PET/CT showed 90.2 % sensitivity, 97.4 % specificity, and 95.4 % accuracy, values which were significantly higher than those of MDCT (59.8, 94.8, and 84.9 %, respectively. p < 0.002). After the withdrawal of MTX, 9/15 patients (60.0 %) achieved complete response (CR). The SUVmax, WBMTV and WBTLG values of the CR patients were 9.2 (range 2.8-47.1), 44.3 (range 0-362.6) ml, 181.8 (range 0-2180.9) ml, respectively, which were not significantly different from those of the non-CR patients: 10.6 (range 0-24.9), 15.7 (range 0-250.1) ml, and 97.4 (range 0-1052.1) ml. CONCLUSIONS: Although (18)F-FDG PET/CT was a useful tool to detect MTX-LPD lesions, none of the (18)F-FDG PET parameters before the withdrawal of MTX could be used to predict CR after the withdrawal of MTX.
  • Takuya Toyonaga, Kenji Hirata, Shigeru Yamaguchi, Kanako C Hatanaka, Sayaka Yuzawa, Osamu Manabe, Kentaro Kobayashi, Shiro Watanabe, Tohru Shiga, Shunsuke Terasaka, Hiroyuki Kobayashi, Yuji Kuge, Nagara Tamaki
    European journal of nuclear medicine and molecular imaging 43 8 1469 - 76 2016年07月 [査読有り][通常論文]
     
    PURPOSE: Tumor necrosis is one of the indicators of tumor aggressiveness. (18)F-fluoromisonidazole (FMISO) is the most widely used positron emission tomography (PET) tracer to evaluate severe hypoxia in vivo. Because severe hypoxia causes necrosis, we hypothesized that intratumoral necrosis can be detected by FMISO PET in brain tumors regardless of their histopathology. We applied FMISO PET to various types of brain tumors before tumor resection and evaluated the correlation between histopathological necrosis and FMISO uptake. METHODS: This study included 59 brain tumor patients who underwent FMISO PET/computed tomography before any treatments. According to the pathological diagnosis, the brain tumors were divided into three groups: astrocytomas (group 1), neuroepithelial tumors except for astrocytomas (group 2), and others (group 3). Two experienced neuropathologists evaluated the presence of necrosis in consensus. FMISO uptake in the tumor was evaluated visually and semi-quantitatively using the tumor-to-normal cerebellum ratio (TNR). RESULTS: In visual analyses, 26/27 cases in the FMISO-positive group presented with necrosis, whereas 28/32 cases in the FMISO-negative group did not show necrosis. Mean TNRs with and without necrosis were 3.49 ± 0.97 and 1.43 ± 0.42 (p < 0.00001) in group 1, 2.91 ± 0.83 and 1.44 ± 0.20 (p < 0.005) in group 2, and 2.63 ± 1.16 and 1.35 ± 0.23 (p < 0.05) in group 3, respectively. Using a cut-off value of TNR = 1.67, which was calculated by normal reference regions of interest, we could predict necrosis with sensitivity, specificity, and accuracy of 96.7, 93.1, and 94.9 %, respectively. CONCLUSIONS: FMISO uptake within the lesion indicated the presence of histological micro-necrosis. When we used a TNR of 1.67 as the cut-off value, intratumoral micro-necrosis was sufficiently predictable. Because the presence of necrosis implies a poor prognosis, our results suggest that FMISO PET could provide important information for treatment decisions or surgical strategies of any type of brain tumor.
  • Jun Sato, Takeshi Kuroshima, Mayumi Wada, Akira Satoh, Shiro Watanabe, Shozo Okamoto, Tohru Shiga, Nagara Tamaki, Yoshimasa Kitagawa
    ODONTOLOGY 104 2 239 - 243 2016年05月 [査読有り][通常論文]
     
    This study describes the use of F-18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to detect a chronic odontogenic infection as the possible origin of a brain abscess (BA). A 74-year-old man with esophageal carcinoma was referred to our department to determine the origin of a BA in his oral cavity. He had no acute odontogenic infections. The BA was drained, and bacteria of the Staphylococcus milleri group were detected. Whole body FDG-PET revealed that the only sites of definite uptake of FDG were the esophageal carcinoma and the left upper maxillary region (SUVmax: 4.5). These findings suggested that the BA may have originated from a chronic periodontal infection. Six teeth with progressive chronic periodontal disease were extracted to remove the possible source of BA. These findings excluded the possibility of direct spread of bacteria from the odontogenic infectious lesion to the intracranial cavity. After extraction, there was no relapse of BA.
  • Hirata Kenji, Takeuchi Wataru, Yamaguchi Shigeru, Kobayashi Hiroyuki, Terasaka Shunsuke, Toyonaga Takuya, Watanabe Shiro, Kobayashi Kentaro, Manabe Osamu, Kobashi Keiji, Shiga Tohru, Tamaki Nagara
    JOURNAL OF NUCLEAR MEDICINE 57 2016年05月01日 [査読有り][通常論文]
  • Shiro Watanabe, Osamu Manabe, Naoya Hattori, Florian C Gaertner, Kentaro Kobayashi, Atsuro Masuda, Nagara Tamaki
    European journal of nuclear medicine and molecular imaging 41 1 184 - 184 2014年01月 [査読有り][通常論文]

MISC

  • 遠藤大輝, 吉村高明, 唐明輝, 杉森博行, 長谷川淳, 小亀翔揮, 孫田惠一, 木村理奈, 渡邊史郎, 平田健司, 工藤與亮 核医学(Web) 60 (Supplement) 2023年
  • 平田健司, 木村理奈, 唐明輝, 渡邊史郎, 竹中淳規, 若林直人, 杉森博行, 吉村高明, 工藤與亮, 平田健司, 木村理奈, 唐明輝, 渡邊史郎, 竹中淳規, 若林直人, 杉森博行, 吉村高明, 工藤與亮, 平田健司, 唐明輝, 渡邊史郎, 杉森博行, 吉村高明, 工藤與亮, 平田健司, 杉森博行, 吉村高明, 工藤與亮, 平田健司, 工藤與亮 核医学(Web) 60 (Supplement) 2023年
  • 長谷川淳, 吉村高明, 吉村高明, 孫田恵一, 木村理奈, 木村理奈, 渡邊史郎, 渡邊史郎, 平田健司, 平田健司 日本放射線技術学会総会学術大会予稿集 78th 2022年
  • 真鍋治, 渡邊史郎, 小林健太郎, 平田健司 画像診断 38 (7) 689‐694 2018年05月25日 [査読無し][通常論文]
  • 真鍋 治, 渡邊 史郎, 小林 健太郎, 平田 健司 画像診断 38 (7) 689 -694 2018年05月 [査読無し][通常論文]
     
    ＜文献概要＞メトトレキサート関連リンパ球増殖性疾患(MTX-LPD)は,メトトレキサート(MTX)投与中の患者に発生する比較的稀な疾患である.グルコース代謝が亢進している症例が多く,一度に全身を評価できるFDG PET/CT検査の有用性は高いと考えられる.関節リウマチ患者では,MTX投与中止後に関節炎が悪化することがあるため,関節および周囲リンパ節へのFDGの集積が明瞭化することがある.
  • 古家翔, 真鍋治, 大平洋, 納谷昌直, 相川忠夫, 小梁川和宏, 渡邊史郎, 小林健太郎, 平田健司, 志賀哲, 真鍋徳子 核医学(Web) 55 (Supplement) 2018年
  • T. Inoue, S. Watanabe, K. Harada, K. Yasuda, N. Katoh, S. Okamoto, T. Shiga, Y. Kuge, N. Tamaki, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 99 (2) E466 -E466 2017年10月 [査読無し][通常論文]
  • TKI時代における転移再発甲状腺分化癌の放射線治療 放射性ヨード内用療法抵抗性の判断・適切なTKIへの橋渡し 核医学の立場から
    渡邊 史郎, 内山 裕子, 岡本 祥三, 志賀 哲 日本内分泌・甲状腺外科学会雑誌 34 (Suppl.2) S224 -S224 2017年10月 [査読無し][通常論文]
  • 渡邊史郎, 内山裕子, 岡本祥三, 志賀哲 日本内分泌・甲状腺外科学会雑誌 34 (Supplement2) S224 2017年09月30日 [査読無し][通常論文]
  • CTテキスチャー解析による非小細胞肺癌の低酸素予測の可能性
    渡邊 史郎, 平田 健司, 岡本 祥三, 真鍋 治, 内山 裕子, 小林 健太郎, 豊永 拓哉, 井上 哲也, 孫田 恵一, 西嶋 剣一, 久下 裕司, 志賀 哲 核医学 54 (Suppl.) S170 -S170 2017年09月 [査読無し][通常論文]
  • 巨大甲状腺腫を伴うバセドウ病に対するI-131 30mCi 1回投与に関する検討
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    伊藤 和夫, 鐘ヶ江 香久子, 渡邊 史郎, 真鍋 治, 細川 正夫 核医学 54 (Suppl.) S188 -S188 2017年09月 [査読無し][通常論文]
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    平田 健司, 真鍋 治, 内山 裕子, 小林 健太郎, 渡邊 史郎, 豊永 拓哉, 志賀 哲 核医学 54 (Suppl.) S193 -S193 2017年09月 [査読無し][通常論文]
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    藤井 宝顕, 真鍋 治, 平田 健司, 渡邊 史郎, 真鍋 徳子, 工藤 與亮, 志賀 哲 核医学 54 (1) 652 -652 2017年02月 [査読無し][通常論文]
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    小林 健太郎, 平田 健司, 山口 秀, 寺坂 俊介, 豊永 拓哉, 内山 裕子, 渡邊 史郎, 菊地 恒矢, 志賀 哲, 玉木 長良 核医学 53 (Suppl.) S257 -S257 2016年10月 [査読無し][通常論文]
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    渡邊 史郎, 平田 健司, 志賀 哲, 豊永 拓哉, 岡本 祥三, 内山 裕子, 宗像 大和, 孫田 恵一, 志水 陽一, 西嶋 剣一, 大倉 一枝, 久下 裕司, 玉木 長良 JSMI Report 9 (2) 205 -205 2016年04月 [査読無し][通常論文]
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    真鍋 治, 吉永 敬一郎, 加藤 千恵次, 富山 勇輝, 渡邊 史郎, 菊地 恒矢, 玉木 長良 核医学 53 (1) 510 -510 2016年02月 [査読無し][通常論文]
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    渡邊 史郎 核医学 53 (1) 569 -569 2016年02月 [査読無し][通常論文]
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    伊藤 和夫, 鐘ヶ江 香久子, 渡邊 史郎, 玉木 長良 核医学 52 (4) 383 -383 2015年11月 [査読無し][通常論文]
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  • 渡邊 史郎, 岡本 祥三, 志賀 哲, 井上 哲也, 平田 健司, 孫田 恵一, 西嶋 剣一, 久下 裕司, 白土 博樹, 玉木 長良 核医学 52 (3) 294 -294 2015年09月 [査読無し][通常論文]
  • F-18 FDG PET/CTにて偽陽性を示した内翻メッケル憩室の一例
    鐘ヶ江 香久子, 伊藤 和夫, 渡邊 史郎, 小池 容史, 大橋 宏和, 久須美 貴哉, 澄川 宗祐, 武内 利直, 松本 岳士, 高橋 宏明 核医学 52 (3) 249 -249 2015年09月 [査読無し][通常論文]
  • 7年間2万例での悪性腫瘍別の平均SUV値 Reporting systemを用いた検討
    菊地 恒矢, 平田 健司, 真鍋 治, 内山 裕子, 小林 健太郎, 渡邊 史郎, 豊永 拓哉, 牧野 俊一, 富山 勇輝, 志賀 哲, 玉木 長良 核医学 52 (3) 268 -268 2015年09月 [査読無し][通常論文]
  • 乳癌の組織学的および免疫組織学的特性とFDG集積との関係
    伊藤 和夫, 鈴木 康弘, 渡邊 史郎, 鐘ヶ江 香久子, 武内 利直 核医学 52 (3) 289 -289 2015年09月 [査読無し][通常論文]
  • 乳癌骨転移診断 F-18 FDG PET/CT検査と骨スキャンとの比較
    伊藤 和夫, 鈴木 康弘, 渡邊 史郎, 鐘ヶ江 香久子 核医学 52 (3) 289 -289 2015年09月 [査読無し][通常論文]
  • 非小細胞肺癌における呼吸同期を併用したFMISO-PET/CTの低酸素定量評価についての検討
    渡邊 史郎, 岡本 祥三, 志賀 哲, 井上 哲也, 平田 健司, 孫田 恵一, 西嶋 剣一, 久下 裕司, 白土 博樹, 玉木 長良 核医学 52 (3) 294 -294 2015年09月 [査読無し][通常論文]
  • 甲状腺分化癌の転移巣のFDG-PETのSUVmaxは、I-131治療後の予後を予測できる
    内山 裕子, 岡本 祥三, ガートナー・フローリアン, 志賀 哲, 平田 健司, 真鍋 治, 小林 健太郎, 渡邊 史郎, 豊永 拓哉, 吉永 恵一郎, 玉木 長良 核医学 52 (3) 309 -309 2015年09月 [査読無し][通常論文]
  • 久須美貴哉, 坂下啓太, 三橋洋介, 澄川宗祐, 菊地健司, 吉川智宏, 佐々木邦明, 木ノ下義宏, 西田靖仙, 細川正夫, 穂刈格, 塚越洋元, 奥田博介, 渡邊史郎, 小野寺裕也, 伊藤和夫, 大内知之, 武内利直 日本大腸こう門病学会雑誌 68 (6) 455 2015年06月 [査読無し][通常論文]
  • 当院における大腸癌に対する腹腔鏡下手術の現状と展望
    久須美 貴哉, 坂下 啓太, 三橋 洋介, 澄川 宗祐, 菊地 健司, 吉川 智宏, 佐々木 邦明, 木ノ下 義宏, 西田 靖仙, 細川 正夫, 穂刈 格, 塚越 洋元, 奥田 博介, 渡邊 史郎, 小野寺 裕也, 伊藤 和夫, 大内 知之, 武内 利直 日本大腸肛門病学会雑誌 68 (6) 455 -455 2015年06月 [査読無し][通常論文]
  • Jun Sato, Yoshimasa Kitagawa, Shiro Watanabe, Shozo Okamoto, Noritaka Ohga, Takuya Asaka, Kenji Hirata, Tohru Shiga, Masanobu Shindoh, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 56 (3) 2015年05月 [査読無し][通常論文]
  • Shiro Watanabe, Osamu Manabe, Kenji Hirata, Kazuo Itoh, Miyako Myoujin, Hiroaki Takahashi, Masao Hosokawa, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 56 (3) 2015年05月 [査読無し][通常論文]
  • Watanabe Shiro, Okamoto Shozo, Shiga Tohru, Inoue Tetsuya, Hirata Kenji, Magota Keiichi, Nishijima Ken-ichi, Kuge Yuji, Shirato Hiroki, Tamaki Nagara JOURNAL OF NUCLEAR MEDICINE 56 (3) 2015年05月01日 [査読有り][通常論文]
  • 久須美貴哉, 坂下啓太, 三橋洋介, 澄川宗祐, 鯉沼潤吉, 吉川智宏, 佐々木邦明, 木ノ下義宏, 西田靖仙, 細川正夫, 奥田博介, 穂刈格, 塚越洋元, 大内知之, 武内利直, 渡邊史郎, 小野寺裕也, 伊藤和夫 日本大腸こう門病学会雑誌 68 (5) 355 2015年05月 [査読無し][通常論文]
  • 高齢者大腸癌の当院の治療の推移と現況について
    久須美 貴哉, 坂下 啓太, 三橋 洋介, 澄川 宗祐, 鯉沼 潤吉, 吉川 智宏, 佐々木 邦明, 木ノ下 義宏, 西田 靖仙, 細川 正夫, 奥田 博介, 穂刈 格, 塚越 洋元, 大内 知之, 武内 利直, 渡邊 史郎, 小野寺 裕也, 伊藤 和夫 日本大腸肛門病学会雑誌 68 (5) 355 -355 2015年05月 [査読無し][通常論文]
  • 渡邊史郎, 岡本祥三, 志賀哲, 宗像大和, 潟端純也, 内山裕子, 吉永恵一郎, 玉木長良 核医学 51 (4) 413 2014年11月30日 [査読無し][通常論文]
  • 岡本祥三, 志賀哲, 内山裕子, 渡邊史郎, 吉永恵一郎, 玉木長良 核医学 51 (4) 413 -414 2014年11月30日 [査読無し][通常論文]
  • 豊永拓哉, 服部直也, 真鍋治, 小林健太郎, 益田淳朗, 玉木長良, 渡邊史郎, 岡本孝之, 佐藤泰征, 山崎健史, 林麻子 核医学 51 (4) 420 2014年11月30日 [査読無し][通常論文]
  • 渡邊史郎, 岡本祥三, 志賀哲, 内山裕子, 玉木長良, 宗像大和, 片端純也, 吉永恵一郎 北海道医学雑誌 89 (2) 162 2014年11月01日 [査読無し][通常論文]
  • 甲状腺分化癌肺転移に対する複数のI-131内用療法後に肺線維症をきたした1例
    渡邊 史郎, 岡本 祥三, 志賀 哲, 内山 裕子, 玉木 長良, 宗像 大和, 潟端 純也, 吉永 恵一郎 北海道医学雑誌 89 (2) 162 -162 2014年11月 [査読無し][通常論文]
  • 複数回の131I内用療法後に肺線維症をきたしたと思われる1例
    渡邊 史郎, 岡本 祥三, 志賀 哲, 宗像 大和, 潟端 純也, 内山 裕子, 吉永 恵一郎, 玉木 長良 核医学 51 (4) 413 -413 2014年11月 [査読無し][通常論文]
  • 甲状腺分化癌肺転移に対する放射性ヨード内用療法後に重篤な汎血球減少を呈した1例
    岡本 祥三, 志賀 哲, 内山 裕子, 渡邊 史郎, 吉永 恵一郎, 玉木 長良 核医学 51 (4) 413 -414 2014年11月 [査読無し][通常論文]
  • Fanconi症候群に対して99mTc-DMSA腎静態シンチグラフィを施行した1例
    豊永 拓哉, 服部 直也, 真鍋 治, 小林 健太郎, 益田 淳朗, 玉木 長良, 渡邊 史郎, 岡本 孝之, 佐藤 泰征, 山崎 健史, 林 麻子 核医学 51 (4) 420 -420 2014年11月 [査読無し][通常論文]
  • S. Okamoto, T. Shiga, K. Yasuda, K. Magota, K. Kasai, S. Watanabe, Y. Kuge, H. Shirato, N. Tamaki EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 41 S196 -S196 2014年10月 [査読無し][通常論文]
  • 渡邊史郎, 真鍋治, 服部直也, 平田健司, 志賀哲, 玉木長良 核医学 51 (3) 304 2014年09月30日 [査読無し][通常論文]
  • 内山裕子, 岡本祥三, 志賀哲, 渡邊史郎, 豊永拓哉, 吉永恵一郎, 玉木長良, 荒井博史, 孫田恵一 核医学 51 (3) 306 2014年09月30日 [査読無し][通常論文]
  • 渡邊史郎, 岡本祥三, 安田耕一, 志賀哲, 孫田恵一, 葛西克彦, 久下裕司, 白土博樹, 玉木長良 核医学 51 (3) 265 -265 2014年09月30日 [査読無し][通常論文]
  • 豊永拓哉, 岡本祥三, 志賀哲, 内山裕子, 真鍋治, 小林健太郎, 益田淳朗, 渡邊史郎, 吉永恵一郎, 玉木長良 核医学 51 (3) 307 2014年09月30日 [査読無し][通常論文]
  • 内山裕子, 岡本祥三, 志賀哲, 渡邊史郎, 豊永拓哉, 吉永恵一郎, 玉木長良, 荒井博史, 孫田恵一 核医学 51 (3) 325 2014年09月30日 [査読無し][通常論文]
  • 岡本祥三, 志賀哲, 内山裕子, 渡邊史郎, 豊永拓哉, 孫田恵一, 宗像大和, 荒井博史, 吉永恵一郎, 玉木長良 核医学 51 (3) 305 2014年09月30日 [査読無し][通常論文]
  • FMISO-PETによる低酸素と糖代謝分布の相関についての検討
    渡邊 史郎, 岡本 祥三, 安田 耕一, 志賀 哲, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良 核医学 51 (3) 265 -265 2014年09月 [査読無し][通常論文]
  • 皮膚悪性黒色腫における原発巣の糖代謝を用いたリンパ節転移の存在予測
    渡邊 史郎, 真鍋 治, 服部 直也, 平田 健司, 志賀 哲, 玉木 長良 核医学 51 (3) 304 -304 2014年09月 [査読無し][通常論文]
  • Ablation目的にI-131内用療法を予定された甲状腺癌患者の転移検索の臨床的重要性
    岡本 祥三, 志賀 哲, 内山 裕子, 渡邊 史郎, 豊永 拓哉, 孫田 恵一, 宗像 大和, 荒井 博史, 吉永 恵一郎, 玉木 長良 核医学 51 (3) 305 -305 2014年09月 [査読無し][通常論文]
  • バセドウ病に対する高投与量I-131内用療法の治療効果と安全性
    内山 裕子, 岡本 祥三, 志賀 哲, 渡邊 史郎, 豊永 拓哉, 吉永 恵一郎, 玉木 長良, 荒井 博史, 孫田 恵一 核医学 51 (3) 306 -306 2014年09月 [査読無し][通常論文]
  • 甲状腺癌に対するI-131 AblationにおけるrhTSHの甲状腺ホルモン休薬と比較した治療時副作用軽減効果の検討
    豊永 拓哉, 岡本 祥三, 志賀 哲, 内山 裕子, 真鍋 治, 小林 健太郎, 益田 淳朗, 渡邊 史郎, 吉永 恵一郎, 玉木 長良 核医学 51 (3) 307 -307 2014年09月 [査読無し][通常論文]
  • 転移病変を有する甲状腺分化癌におけるFDG-PET陽性例でのSUVとI-131内用療法後の予後に関する検討
    内山 裕子, 岡本 祥三, 志賀 哲, 渡邊 史郎, 豊永 拓哉, 吉永 恵一郎, 玉木 長良, 荒井 博史, 孫田 恵一 核医学 51 (3) 325 -325 2014年09月 [査読無し][通常論文]
  • Shiro Watanabe, Osamu Manabe, Naoya Hattori, Kenji Hirata, Noriko Oyama-Manabe, Tohru Shiga, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 55 2014年05月 [査読無し][通常論文]
  • Shiro Watanabe, Osamu Manabe, Naoya Hattori, Kenji Hirata, Tohru Shiga, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 55 2014年05月 [査読無し][通常論文]
  • Watanabe Shiro, Okamoto Shozo, Shiga Tohru, Yasuda Koichi, Magota Keiichi, Kasai Katsuhiko, Kuge Yuji, Shirato Hiroki, Tamaki Nagara JOURNAL OF NUCLEAR MEDICINE 55 2014年05月 [査読有り][通常論文]
  • 豊永拓哉, 小林健太郎, 益田淳朗, 服部直也, 真鍋治, 渡邊史郎, 玉木長良 核医学 51 (1) 29 2014年02月28日 [査読無し][通常論文]
  • 感染症に対するFDG-PET/CTの有用性
    豊永 拓哉, 小林 健太郎, 益田 淳朗, 服部 直也, 真鍋 治, 渡邊 史郎, 玉木 長良 核医学 51 (1) 29 -29 2014年02月 [査読無し][通常論文]
  • 渡邊史郎, 服部直也, 真鍋治, 志賀哲, 玉木長良 核医学 50 (3) 201 2013年09月30日 [査読無し][通常論文]
  • 平田健司, 真鍋治, 小林健太郎, 渡邊史郎, 玉木長良, HUANG Sung‐Cheng 核医学 50 (3) 230 2013年09月30日 [査読無し][通常論文]
  • メトトレキサート関連リンパ腫におけるFDG-PET/CTの有用性の検討
    渡邊 史郎, 服部 直也, 真鍋 治, 志賀 哲, 玉木 長良 核医学 50 (3) S191 -S191 2013年09月 [査読無し][通常論文]
  • Whole body(WB) metabolic tumor volume(MTV)およびtotal lesion glycolysis(TLG)の計測環境の構築
    平田 健司, 真鍋 治, 小林 健太郎, 渡邊 史郎, 玉木 長良, Huang Sung-Cheng 核医学 50 (3) S220 -S220 2013年09月 [査読無し][通常論文]
  • 渡邊史郎, 真鍋治, 石尾崇, 小林健太郎, 平田健司, 服部直也, 玉木長良, 白鳥聡一, 藤本勝也, 田中淳司 核医学 49 (4) 414 2012年11月30日 [査読無し][通常論文]
  • FDG PET/CTによって病変範囲と治療効果を画像化できた皮下脂肪織炎様T細胞リンパ腫の一例
    渡邊 史郎, 真鍋 治, 石尾 崇, 小林 健太郎, 平田 健司, 服部 直也, 玉木 長良, 白鳥 聡一, 藤本 勝也, 田中 淳司 核医学 49 (4) 414 -414 2012年11月 [査読無し][通常論文]

共同研究・競争的資金等の研究課題

  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2024年04月 -2027年03月 
    代表者 : 渡邊 史郎, 安井 博宣, 水野 雄貴
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2022年04月 -2025年03月 
    代表者 : 加藤 千恵次, 渡邊 史郎, 孫田 惠一
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2022年04月 -2025年03月 
    代表者 : 北川 善政, 竹内 康人, 渡邊 史郎, 平田 健司, 大賀 則孝, 佐藤 淳, 犬伏 正幸
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2022年06月 -2024年03月 
    代表者 : 北川 善政, 平田 健司, 渡邊 史郎, 佐藤 淳, 浅香 卓哉, 竹内 康人, 犬伏 正幸, 網塚 憲生
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2022年04月 -2024年03月 
    代表者 : 渡邊 史郎
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2020年04月 -2023年03月 
    代表者 : 渡邊 史郎
     
    低酸素と悪性腫瘍の関連にかかわる研究は基礎から臨床まで広く注目されており、生体での低酸素イメージング剤を用いた悪性腫瘍に対する治療の予後予測評価は多数の報告がある。多くはF-18 FMISOを用いた陽電子放出断層像（PET）であるが、いずれも低酸素が疑われる病変では予後や局所制御率が不良と報告されている。しかし、免疫チェックポイント阻害薬を用いた治療に関する予後予測や治療効果予測について、低酸素イメージングによる免疫治療の評価は行われていない。免疫チェックポイント治療は高価であり、またこれまでの抗がん剤とは異なる自己免疫メカニズムをもつ特異的な副作用を引き起こす。免疫関連有害事象として知られているが、まだ不明な点も多く、不必要なADLの低下や治療のコンプライアンスを低下させる恐れもある。 非侵襲的な画像診断技術を用いて免疫治療の効果を事前に予測又は早期に判定することができれば、適切な患者選択、適切な投与回数・期間の決定、身体的負担の軽減、不要な副作用の回避、経済的な損失の抑制を実現できる可能性があり、その臨床的有用性や医療経済効果は極めて高いと言える。 本研究ではF-18 FMISO PETを用いた非侵襲的な低酸素イメージングを用いた低酸素と治療効果の病態を明らかにするものである。FMISO PETは多くの施設では利用できず、広く研究を行うことは困難である。既存のFDG-PETやCTからFMISO PETの集積や低酸素を予測することでこれらの治療前後での低酸素による病態を一般的な施設で評価することが可能となる。
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 岡本 祥三, 安井 博宣, 志賀 哲, 渡邊 史郎
     
    健常者8例を対象としたFDiFA-PETを行い、安全性の確認と、従来の低酸素PETであるFMISO-PETより短い時間で同等の低酸素評価画像を得る事を確認した。この結果は治療前の低酸素評価における患者負担の軽減を示唆する。 一方FMISO-PETで病変に集積がある患者の予後がFDG-PET単体で集積がある患者よりも悪い事を確認し、低酸素PETは予後予測に有用でこれらの患者に対する新たな治療方針の必要性が示唆された。 実験動物を用いた基礎検討も行い、FDiFAではFMISOに比較して有意に高い腫瘍筋肉比で高コントラスト像が得られ、早期に低酸素領域を描出できる事が示唆された。

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