研究者データベース

神島 保(カミシマ タモツ)
保健科学研究院 保健科学部門 医用生体理工学分野
教授

基本情報

所属

  • 保健科学研究院 保健科学部門 医用生体理工学分野

職名

  • 教授

学位

  • 博士(医学)(北海道大学)

ホームページURL

J-Global ID

研究キーワード

  • 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   

研究分野

  • ライフサイエンス / 膠原病、アレルギー内科学
  • ライフサイエンス / 放射線科学

職歴

  • 2012年 - 2013年 北海道大学 大学院・保健科学研究院 教授

研究活動情報

論文

  • Motoshi Fujimori, Koichi Murakami, Hiroyuki Sugimori, Yutong Lu, Kenneth Sutherland, Nozomi Oki, Takatoshi Aoki, Tamotsu Kamishima
    Journal of Magnetic Resonance Imaging 50 4 1199 - 1206 2019年10月01日 [査読有り][通常論文]
     
    © 2019 International Society for Magnetic Resonance in Medicine 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 (rS = –0.385, P < 0.001, rS = –0.458, P < 0.0001, respectively), but not with the f and D* values (rS = –0.010, P = 0.936, rS = –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.
  • Fukae J, Tanimura K, Isobe M, Kitano A, Henmi M, Nakai M, Aoki Y, Sakamoto F, Narita A, Ito T, Mitsuzaki A, Matsuhashi M, Shimizu M, Kamishima T, Atsumi T, Koike T
    International journal of rheumatic diseases 21 10 1809 - 1814 2018年10月 [査読有り][通常論文]
  • Yuto Kobayashi, Tamotsu Kamishima, Hiroyuki Sugimori, Shota Ichikawa, Atsushi Noguchi, Michihito Kono, Toshitake Iiyama, Kenneth Sutherland, Tatsuya Atsumi
    Journal of Magnetic Resonance Imaging 48 3 687 - 694 2018年09月 [査読有り][通常論文]
     
    © 2018 International Society for Magnetic Resonance in Medicine 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;48:687–694.
  • Funakoshi T, Momma D, Matsui Y, Kamishima T, Matsui Y, Kawamura D, Nagano Y, Iwasaki N
    The American journal of sports medicine 46 8 1943 - 1951 2018年07月 [査読有り][通常論文]
  • Taichi Okino, Tamotsu Kamishima, Kenneth Lee Sutherland, Jun Fukae, Akihiro Narita, Shota Ichikawa, Kazuhide Tanimura
    Acta Radiologica 59 4 460 - 467 2018年04月01日 [査読有り][通常論文]
     
    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.
  • Takahiro Onuma, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda
    Quantitative Imaging in Medicine and Surgery 8 1 25 - 31 2018年02月01日 [査読有り][通常論文]
     
    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 preoperative 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 signifcant 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.
  • Motoshi Fujimori, Tamotsu Kamishima, Masaru Kato, Yumika Seno, Kenneth Sutherland, Hiroyuki Sugimori, Mutsumi Nishida, Tatsuya Atsumi
    British Journal of Radiology 91 1086 20170748  2018年 [査読有り][通常論文]
     
    © 2018 The Authors. Published by the British Institute of Radiology. 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.
  • Kazuki Kato, Tamotsu Kamishima, Eiji Kondo, Tomohiro Onodera, Shota Ichikawa
    Radiological Physics and Technology 10 4 431 - 438 2017年12月01日 [査読有り][通常論文]
     
    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.
  • Ryosuke Sakano, Katsumi Saito, Tamotsu Kamishima, Mutsumi Nishida, Tatsunori Horie, Atsushi Noguchi, Michihito Kono, Kenneth Sutherland, Tatsuya Atsumi
    ACTA RADIOLOGICA 58 10 1238 - 1244 2017年10月 [査読有り][通常論文]
     
    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.
  • 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 2017年10月 [査読有り][通常論文]
     
    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.
  • 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 2017年06月 [査読有り][通常論文]
     
    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.
  • Katsuya Hatano, Tamotsu Kamishima, Kenneth Sutherland, Masaru Kato, Ikuma Nakagawa, Shota Ichikawa, Keisuke Kawauchi, Shota Saitou, Masaya Mukai
    RHEUMATOLOGY INTERNATIONAL 37 2 189 - 195 2017年02月 [査読有り][通常論文]
     
    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.
  • Taro Sakashita, Tamotsu Kamishima, Hiroyuki Sugimori, Minghui Tang, Atsushi Noguchi, Michihito Kono, Kenneth Sutherland, Tatsuya Atsumi
    MAGNETIC RESONANCE IN MEDICAL SCIENCES 16 1 78 - 83 2017年 [査読有り][通常論文]
     
    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.
  • 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 2017年 [査読有り][通常論文]
     
    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.
  • 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 2017年 [査読有り][通常論文]
     
    Objectives: To preliminarily evaluate the feasibility of maintenance therapy with reduced dose of intravenous abatacept (ABT) to 250mg/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 125kg. Enrolled patients were maintained with intravenous monthly ABT at a reduced dose of 250mg/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.
  • Yuki Wada, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda
    BRITISH JOURNAL OF RADIOLOGY 90 1072 20160938  2017年 [査読有り][通常論文]
     
    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 nosarcopenia 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.
  • Motoshi Fujimori, Satoko Nakamura, Kiminori Hasegawa, Kunihiro Ikeno, Shota Ichikawa, Kenneth Sutherland, Tamotsu Kamishima
    BRITISH JOURNAL OF RADIOLOGY 90 1077 20170167  2017年 [査読有り][通常論文]
     
    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 T-1 weighted 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 (r(s)=-0.469, p < 0.05) and RS (r(s)= -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.
  • Yusuke Noumura, Tamotsu Kamishima, Kenneth Sutherland, Hideho Nishimura
    BRITISH JOURNAL OF RADIOLOGY 90 1077 20170253  2017年 [査読有り][通常論文]
     
    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 3 cm 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.
  • Katsumi Saito, Asami Abe, Tamotsu Kamishima, Hajime Ishikawa, Kunihiko Wakaki, Akihiro Ishizu
    RHEUMATOLOGY INTERNATIONAL 36 12 1689 - 1690 2016年12月 [査読有り][通常論文]
  • Yuichiro Matsui, Tadanao Funakoshi, Hideyuki Kobayashi, Tomoko Mitsuhashi, Tamotsu Kamishima, Norimasa Iwasaki
    BMC MUSCULOSKELETAL DISORDERS 17 130  2016年03月 [査読有り][通常論文]
     
    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.
  • Yohei Ono, Tamotsu Kamishima, Nobutoshi Yasojima, Kenichi Tamura, Kaori Tsutsumi
    Radiological Physics and Technology 9 1 6 - 14 2016年01月01日 [査読有り][通常論文]
     
    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.
  • Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Takanobu Okubo, Kou Katayama
    RHEUMATOLOGY INTERNATIONAL 36 1 101 - 108 2016年01月 [査読有り][通常論文]
     
    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.
  • 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 2016年01月 [査読有り][通常論文]
     
    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.
  • Shota Ichikawa, Tamotsu Kamishima, Kenneth Sutherland, Takanobu Okubo, Kou Katayama
    BRITISH JOURNAL OF RADIOLOGY 89 1057 20150403  2016年 [査読有り][通常論文]
     
    Objective: To investigate the validity of a computerbased 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 computerbased 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.
  • Taro Sakashita, Tamotsu Kamishima, Yuto Kobayashi, Hiroyuki Sugimori, Minghui Tang, Kenneth Sutherland, Atsushi Noguchi, Michihito Kono, Tatsuya Atsumi
    BRITISH JOURNAL OF RADIOLOGY 89 1061 20151000  2016年 [査読有り][通常論文]
     
    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.
  • Yohei Ono, Rina Kashihara, Nobutoshi Yasojima, Hideki Kasahara, Yuka Shimizu, Kenichi Tamura, Kaori Tsutsumi, Kenneth Sutherland, Takao Koike, Tamotsu Kamishima
    BRITISH JOURNAL OF RADIOLOGY 89 1062 20150967  2016年 [査読有り][通常論文]
     
    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.
  • Takahiro Onuma, Tamotsu Kamishima, Tsukasa Sasaki, Motomichi Sakata
    Radiological Physics and Technology 8 2 312 - 319 2015年07月23日 [査読有り][通常論文]
     
    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).
  • Masayuki Nakahara, Manabu Ito, Naoya Hattori, Keiichi Magota, Masahiko Takahata, Ken Nagahama, Hideki Sudo, Tamotsu Kamishima, Nagara Tamaki, Norimasa Iwasaki
    ACTA RADIOLOGICA 56 7 829 - 836 2015年07月 [査読有り][通常論文]
     
    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.
  • 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 2015年01月 [査読有り][通常論文]
     
    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.
  • Ryosuke Sakano, Tamotsu Kamishima, Mutsumi Nishida, Tatsunori Horie
    Radiological Physics and Technology 8 1 120 - 124 2015年 [査読有り][通常論文]
     
    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.
  • Yoshio Tsuchiya, Takashi Kusaka, Takayuki Tanaka, Yoshikazu Matsuo, Makoto Oda, Tsukasa Sasaki, Tamotsu Kamishima, Masanori Yamanaka
    2015 37TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC) 2015 3909 - 3912 2015年 [査読有り][通常論文]
     
    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.
  • 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 53 9 1608 - 1612 2014年09月 [査読有り][通常論文]
     
    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.
  • 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 66 3 523 - 532 2014年03月 [査読有り][通常論文]
     
    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 (beta = 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.
  • Susumu Moriya, Yukio Miki, Tamotsu Kamishima, Tosiaki Miyati, Mitsunori Kanagaki, Yukako Matsuno, Tsuneo Yokobayashi
    European Journal of Radiology 82 9 1458 - 1462 2013年09月 [査読有り][通常論文]
     
    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 1.5 T and 3.0 T. Materials and methods T1-weighted images were obtained with CHESS using 1.5 T and 3.0 T 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 1.5 T, the mean evaluation score was 1.55 for images obtained without rice pads and 3.50 for images obtained with rice pads. At 3.0 T, 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 1.5 T and 3.0 T. Rice pads are therefore useful with at 1.5 T and 3.0 T, which are currently becoming more widely used. © 2013 Elsevier Ireland Ltd.
  • 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 52 3 523 - 528 2013年03月 [査読有り][通常論文]
     
    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; ext-link-type="uri" xlink:href="http://www.umin.ac.jp/ctr/" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.umin.ac.jp/ctr/; UMIN000004476.
  • Atsushi Urita, Norimasa Iwasaki, Makoto Kondo, Yasuhiko Nishio, Tamotsu Kamishima, Akio Minami
    Journal of Hand Surgery 38 3 498 - 503 2013年03月 [査読有り][通常論文]
     
    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. Type of study/level of evidence: Therapeutic I. © 2013 American Society for Surgery of the Hand.
  • Kamishima T, Kato M, Atsumi T, Koike T, Onodera Y, Terae S
    Clinical and experimental rheumatology 31 1 154  2013年01月 [査読有り][通常論文]
  • Susumu Moriya, Yukio Miki, Tamotsu Kamishima, Mitsunori Kanagaki, Tsuneo Yokobayashi, Mitsunori Ishikawa
    EUROPEAN JOURNAL OF RADIOLOGY 81 9 2318 - 2322 2012年09月 [査読有り][通常論文]
     
    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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
  • Tomohiro Onodera, Tokifumi Majima, Norimasa Iwasaki, Tamotsu Kamishima, Yasuhiko Kasahara, Akio Minami
    INTERNATIONAL ORTHOPAEDICS 36 9 1871 - 1876 2012年09月 [査読有り][通常論文]
     
    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. 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. 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. Our results should prove helpful for designing new prostheses and determining clinical indications for total ankle arthroplasty.
  • Daisuke Momma, Norimasa Iwasaki, Naomi Oizumi, Kazuhiro Fujisaki, Tadanao Funakoshi, Yuichiro Abe, Tamotsu Kamishima, Shigeru Tadano, Akio Minami
    JOURNAL OF ORTHOPAEDIC SCIENCE 17 3 253 - 260 2012年05月 [査読有り][通常論文]
     
    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. 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. 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. 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.
  • Kinya Nishida, Norimasa Iwasaki, Kazuhiro Fujisaki, Tadanao Funakoshi, Tamotsu Kamishima, Shigeru Tadano, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 40 4 909 - 914 2012年04月 [査読有り][通常論文]
     
    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.
  • Norimasa Iwasaki, Tamotsu Kamishima, Hiroyuki Kato, Tadanao Funakoshi, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 40 3 624 - 630 2012年03月 [査読有り][通常論文]
     
    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.
  • Tadanao Funakoshi, Norimasa Iwasaki, Tamotsu Kamishima, Mutsumi Nishida, Yoichi Ito, Kinya Nishida, Makoto Motomiya, Naoki Suenaga, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 39 12 2640 - 2646 2011年12月 [査読有り][通常論文]
     
    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.
  • 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 2011年11月 [査読有り][通常論文]
     
    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.
  • Kamishima T, Nishida M, Horie T, Narita A, Sagawa A, Henmi M, Shirato H, Terae S
    Clinical and experimental rheumatology 29 6 1057  2011年11月 [査読有り][通常論文]
  • 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 - 1253 2011年09月 [査読有り][通常論文]
     
    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.
  • 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 2011年07月 [査読有り][通常論文]
     
    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 99mTc-DMSA scintigraphy was also investigated. Results: The time required for volumetry of bilateral kidneys with the newly developed software (16.7 +/- 3.9 s) was significantly shorter than that of the workstation (102.6 +/- 38.9 s, 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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
  • Makabe H, Iwasaki N, Kamishima T, Oizumi N, Tadano S, Minami A
    The Journal of hand surgery 36A 7 1158 - 1164 2011年07月 [査読有り][通常論文]
     
    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 Kienbock 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 Kienbock 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 Kienbock disease. (J Hand Surg 2011;36A:1158-1164. Copyright (C) 2011 by the American Society for Surgery of the Hand. All rights reserved.)
  • 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 - 755 2011年06月 [査読有り][通常論文]
     
    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. 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. 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. 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.
  • Natalia Sayuri Muto, Tamotsu Kamishima, Ardene A. Harris, Fumi Kato, Yuya Onodera, Satoshi Terae, Hiroki Shirato
    EUROPEAN JOURNAL OF RADIOLOGY 78 1 151 - 156 2011年04月 [査読有り][通常論文]
     
    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 105.8 cm(3) +/- 28.4 SD, mean total volume of 153 cm(3) +/- 39 SD and mean medullary volume of 47.8 cm(3) +/- 19.5 SD. 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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
  • 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 2011年04月 [査読有り][通常論文]
     
    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.
  • Daisuke Mommma, Norimasa Iwasaki, Naomi Oizumi, Hiroki Nakatsuchi, Tadanao Funakoshi, Tamotsu Kamishima, Shigeru Tadano, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 39 2 336 - 341 2011年02月 [査読有り][通常論文]
     
    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.
  • 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 2011年01月 [査読有り][通常論文]
     
    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. 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. 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. 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.
  • Tadanao Funakoshi, Norimasa Iwasaki, Tamotsu Kamishima, Mutsumi Nishida, Yoichi Ito, Makoto Kondo, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 38 12 2464 - 2471 2010年12月 [査読有り][通常論文]
     
    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.
  • Norimasa Iwasaki, Shintarou Yamane, Kinya Nishida, Tatsuya Masuko, Tadanao Funakoshi, Tamotsu Kamishima, Akio Minami
    JOURNAL OF SHOULDER AND ELBOW SURGERY 19 8 E1 - E6 2010年12月 [査読有り][通常論文]
  • Tamotsu Kamishima, Yuichiro Fujieda, Tatsuya Atsumi, Rie Mimura, Takao Koike, Satoshi Terae, Hiroki Shirato
    AMERICAN JOURNAL OF ROENTGENOLOGY 195 4 W287 - W292 2010年10月 [査読有り][通常論文]
     
    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.
  • Ardene Harris, Tamotsu Kamishima, Hong Yi Hao, Fumi Kato, Tokuhiko Omatsu, Yuya Onodera, Satoshi Terae, Hiroki Shirato
    EUROPEAN JOURNAL OF RADIOLOGY 75 1 E97 - E101 2010年07月 [査読有り][通常論文]
     
    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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
  • 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 - 465 2010年05月 [査読有り][通常論文]
     
    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. 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. 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. 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.
  • 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 - 663 2010年05月 [査読有り][通常論文]
     
    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.
  • 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 2010年05月 [査読有り][通常論文]
     
    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. © 2010 Japan Radiological Society.
  • Tokifumi Majima, Tamotsu Kamishima, Kouichi Susuda
    BMC Sports Science, Medicine and Rehabilitation 1 1 6  2009年12月 [査読有り][通常論文]
  • Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 37 12 2349 - 2354 2009年12月 [査読有り][通常論文]
     
    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.
  • Jun Fukae, Masato Shimizu, Yujiro Kon, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Takao Koike
    MODERN RHEUMATOLOGY 19 5 502 - 506 2009年10月 [査読有り][通常論文]
     
    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.
  • 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 - 332 2009年10月 [査読有り][通常論文]
     
    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.
  • 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 2009年06月 [査読有り][通常論文]
     
    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. © 2009 Japan Radiological Society.
  • Tamotsu Kamishima, Kazuhide Tanimura, Mihoko Henmi, Akihiro Narita, Fumihiko Sakamoto, Satoshi Terae, Hiroki Shirato
    SKELETAL RADIOLOGY 38 5 467 - 472 2009年05月 [査読有り][通常論文]
     
    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. 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. 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). 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.
  • Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Naoki Suenaga, Akio Minami
    AMERICAN JOURNAL OF SPORTS MEDICINE 35 12 2096 - 2100 2007年12月 [査読有り][通常論文]
     
    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.
  • Kamishima T
    Radiation medicine 23 4 277 - 282 2005年06月 [査読有り][通常論文]
     
    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.
  • Oyama N, Oyama N, Yokoshiki H, Kamishima T, Nambu T, Tsutsui H, Miyasaka K
    Circulation journal : official journal of the Japanese Circulation Society 69 4 466 - 470 2005年04月 [査読有り][通常論文]
  • Maruyama R, Kamishima T, Shiiya N, Asano T, Matsuzaki K, Miyasaka K, Yasuda K
    The Annals of thoracic surgery 76 4 1308  2003年10月 [査読有り][通常論文]
  • H Kato, N Iwasaki, A Minami, T Kamishima
    JOURNAL OF HAND SURGERY-AMERICAN VOLUME 28A 1 44 - 47 2003年01月 [査読有り][通常論文]
     
    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.
  • H Awaya, DG Mitchell, T Kamishima, G Holland, K Ito, T Matsumoto
    RADIOLOGY 224 3 769 - 774 2002年09月 [査読有り][通常論文]
     
    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 foe 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 74.20%, 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. (C) RSNA, 2002.
  • Jeong YY, Mitchell DG, Kamishima T
    AJR. American journal of roentgenology 178 6 1327 - 1334 2002年06月 [査読有り][通常論文]
  • Y Kodama, T Shimizu, H Endo, S Hige, T Kamishima, GA Holland, N Miyamoto, K Miyasaka
    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 25 2 137 - 140 2002年03月 [査読有り][通常論文]
     
    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.

その他活動・業績

  • 藤井 美樹, 寺師 浩人, 神島 保, 長田 周治, 青木 隆敏, 安田 浩 創傷 5 (3) 108 -117 2014年 [査読無し][通常論文]
     
    胸骨骨髄炎の治療ではデブリドマンが重要であり,術前に壊死・感染組織の範囲を把握しておかなければならない。慢性骨髄炎に対する画像診断手段としてMRIが有用であることは知られているが,胸骨骨髄炎の治癒過程におけるMR画像の経時的変化を詳細に述べた報告はない。われわれの経験した2例の胸骨正中切開後の慢性胸骨骨髄炎患者のMR画像につき詳細を述べる。骨髄炎では,骨髄内の組織液量の増加によりT1強調像で低信号,STIR像で高信号を示す。しかし,欠損部位が肉芽に置き換わり,炎症が鎮静化すると病変部のMRI信号は低下した。また,腐骨となった場合にはMRIのみでの診断はむずかしく,撮影条件の工夫やCTの併用が必要と考えられた。
  • 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年04月01日 [査読無し][通常論文]
  • 神島 保 電子情報通信学会技術研究報告. MI, 医用画像 111 (127) 37 -40 2011年07月05日 [査読無し][通常論文]
     
    関節リウマチ(RA)は慢性の炎症性疾患で,進行すると関節破壊に至ることもある.近年,RA診療の現場では,抗リウマチ薬に加え強力な治療効果を有する薬剤(生物学的製剤)が使用可能になり,完治に近い状態まで炎症が改善する症例も経験されるようになってきた.それとともに,RAの早期治療開始のために正確な早期診断の必要性が高まっている.画像診断の長所として,定性的評価のみならず定量的評価が可能なことがあげられる.ここでは超音波とMRIのRA病変定量化の進歩につき述べる.
  • 清水 康友, 金井 理, 伊達 宏昭, 白土 博樹, 神島 保, 荻子 仁泰 精密工学会学術講演会講演論文集 2011 (0) 107 -108 2011年 [査読無し][通常論文]
     
    製品設計の為のデジタルハンドを用いた仮想エルゴノミック評価を行う際に,製品の把持や操作の為の手指の力を推定することは,この評価を合理的に行う基準として非常に有効である.本報告では,その評価を行う為の指の筋骨格の生体力学モデルを構築する為,製品把持時の指の腱,筋肉,関節表面に発揮される力を非線形最適化手法により導出する手法を提案する.更に,過去に発表された論文における実験結果と比較し,検証を行う.
  • 神島 保 日本磁気共鳴医学会雑誌 29 (4) 155 -162 2009年11月15日 [査読無し][通常論文]
  • 神島 保 日本整形外科學會雜誌 81 (11) 950 -954 2007年11月25日 [査読無し][通常論文]
  • 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年07月01日 [査読無し][通常論文]
  • 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) 2007年02月20日 [査読無し][通常論文]
  • 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) 2006年03月10日 [査読無し][通常論文]
  • 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年 [査読無し][通常論文]
  • 神島 保, 丹野 麻美, 笹木 工, 岡 美香, 孫田 恵一, 横山 英辰, 渡辺 良晴, 炭田 修身, 玉木 長良, 宮坂 和男 日本保険医学会誌 103 (2) 150 -160 2005年06月17日 [査読無し][通常論文]
     
    画像診断法はコンピュータの進歩の恩恵を受けて近年急速な進歩を遂げた。それに伴い細分化も進み,今日では放射線医学に携わる者にとっても全体像の把握は必ずしも容易ではない。今回は最近の画像診断法の進歩を主要な画像診断器機ごとに整理して述べる。超音波では造影剤の開発,三次元,四次元画像について,コンピュータ断層撮影法(CT)では脳血流・心臓への応用について,磁気共鳴イメージング(MRI)ではパラレルイメージング,全身MRI,拡散強調画像について,核医学では陽電子放出コンピュータ断層撮影(PET)について,血管造影検査では回転DSA(digital subtraction angiography),血管造影コンピュータ断層撮影法について,技術(ソフト面・ハード面)の進歩,臨床応用につき分かりやすく解説する。また,コンピュータ支援診断(CAD)の現状についても言及する。

教育活動情報

主要な担当授業

  • 医用画像科学特講
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
  • がん・再生医療特論
    開講年度 : 2018年
    課程区分 : 修士課程
    開講学部 : 保健科学院
    キーワード : 1)細胞・臓器へのストレス・ストレス応答(再生を含む)とそのメカニズム 2)がん発生および生物学・病態・進展、治療による影響
  • 医用画像科学特講演習
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
  • 大学院共通授業科目(一般科目):自然科学・応用科学
    開講年度 : 2018年
    課程区分 : 修士課程
    開講学部 : 大学院共通科目
    キーワード : MRI、断層撮像装置、画像診断
  • 臨床画像技術学特論
    開講年度 : 2018年
    課程区分 : 修士課程
    開講学部 : 保健科学院
    キーワード : 画像診断, 国家試験 基礎医学大要
  • 放射線技術学演習
    開講年度 : 2018年
    課程区分 : 修士課程
    開講学部 : 保健科学院
    キーワード : 放射線治療、画像診断、画像撮影・撮像技術
  • 生体情報機能解析学特講
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
    キーワード : 病原微生物、免疫エスケープ機構、アポトーシス、自己寛容機構、アレルギー疾患モデル動物、自己免疫疾患モデル動物、デジタル形態学、Image-J、質量分析、プロテオーム解析、医用放射線、超音波、MRI、細胞ストレス、制御された細胞死と臓器傷害・機能、脂肪肝・NASH
  • 生体情報機能解析学特講演習
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
    キーワード : 病原微生物、免疫エスケープ機構、アポトーシス、自己寛容機構、アレルギー疾患モデル動物、自己免疫疾患モデル動物、デジタル形態学、Image-J、質量分析、プロテオーム解析、医用放射線、超音波、MRI、細胞ストレス、制御された細胞死と臓器障害・機能、脂肪肝・NASH
  • 医用画像科学特講
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
    キーワード : 医用画像、画像診断、装置製品化、PET、陽電子消滅ガンマ線、関節疾患、耳生理機能、耳疾患、超音波法、循環機能
  • 医用画像科学特講演習
    開講年度 : 2018年
    課程区分 : 博士後期課程
    開講学部 : 保健科学院
    キーワード : 医用画像、画像診断、装置製品化、PET、陽電子消滅ガンマ線、関節疾患、耳生理機能、耳疾患、超音波法、循環機能
  • 一般臨床医学
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床医学
  • 画像解剖学演習
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 正常解剖、X線写真、CT、MRI、超音波
  • 画像診断学概論
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 画像診断、異常像、病態
  • 検査薬理学概論
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 画像診断、造影剤、体内動態、検査補助薬剤
  • 保健解剖学演習
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 正常解剖、X線写真、CT、MRI、超音波
  • 放射線防護学
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 放射線被曝、放射腺防護、放射線管理
  • 臨床画像解剖学Ⅱ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 画像診断, 国家試験 基礎医学大要
  • 臨床超音波検査学
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 超音波断層画像診断、ハーモニックイメージング、造影超音波
  • 保健解剖学実習
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 正常解剖、X線写真、CT、MRI、超音波
  • 基礎撮影技術学実習
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 一般撮影、撮影条件論、ポジショニング論、臨床画像評価
  • 放射線腫瘍学
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 放射線腫瘍学
  • 放射線防護学実習
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 放射線被曝、放射腺防護、放射線管理
  • 臨床実習Ⅰ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床実習、一般撮影、血管撮影、CT検査、超音波検査
  • 臨床実習Ⅱ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床実習、チーム医療、一次医療、二次医療、画像診断、放射線治療
  • 臨床実習Ⅲ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床実習、胸部X線撮影、上部消化管撮影、マンモグラフィ、検診、予防医学、高度先端医療
  • 臨床実習Ⅳ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床実習、核医学検査、シンチグラフィ、SPECT、PET、MR検査
  • 臨床実習Ⅴ
    開講年度 : 2018年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 臨床実習、放射線治療、治療計画、放射線治療装置、線量測定、歯科撮影、医療情報


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