Publishing type：Research paper (scientific journal)  

C型肝炎による肝硬変患者20例を対象に、ソホスブビル/ベルパタスビル(SOF/VEL)12週間コースの安全性と有効性について検討した。治療後24週目に持続的ウイルス学的効果(SVR)を達成した患者(SVR24)において、テクネチウム(Tc)-99m-ガラクトシルヒト血清アルブミンシンチグラフィーによる肝細胞受容体指数(LHL15)と血液クリアランス指数(HH15)の変化、一過性エラストグラフィによる肝硬度測定(LSM)、肝静脈圧較差(HVPG)について検討した。直腸静脈瘤出血により1例が治療を中止し、19例が治療を完遂した。SVR24は17例(89%)で達成された。LHL15の中央値は治療前の0.72からSVR24後には0.82に増加し(p=0.012)、HH15の中央値は治療前の0.82からSVR24後には0.76に減少した(p=0.010)。LSM≧20kPaの患者の割合は治療前90%であり、SVR24後も90%であった。重症門脈圧亢進症(HVPG≧12mmHgと定義)の割合は、治療前の92%からSVR24後には58%に減少した(p=0.046)。治療前からSVR24後までにHVPGが減少した患者は、HVPGが増加した患者よりも治療前の脾臓容積が小さかった(中央値、252対537mL、p=0.028)。C型肝炎に関連した非代償性肝硬変患者において、SOF/VEL治療によりSVR24を達成することで、肝細胞機能と門脈圧亢進症の改善が期待できることが短期間の追跡調査により示された。

Publishing type：Research paper (scientific journal)  

骨シンチグラムの市販後データセットを用いて、ホットスポット検出サポートシステムの微調整を行う前と後にシミュレーションを行い、調整に影響した因子を統計学的に検出した。5病院のデータセットを用いて市販前のシステムを作成し、他の病院からのデータセットを加えてシステムの微調整を行った。市販前と市販後の微調整システムを用いて市販後データを得、微調整前後の偽陽性と偽陰性の画素数の差を求めた。共分散構造分析にて四つの可能性がある因子と変化した解析結果の関係を解析した。画像のコントラストと画像あたりのホットスポットの画素数が解析結果に影響する主な因子であった。市販後データセットを用いた微調整システムが適切であったかを決定する条件も検出された。この試験結果は、人工知能システムの連続学習の効果的なデザインに役立つと考えられた。

Publishing type：Research paper (scientific journal)  

<p>In this study, we performed simulations for bone scintigrams before and after a hot spot detection support system was fine-tuned using a postmarket dataset, and statistically identified the factors that affect the changes in performance. Datasets from five hospitals were used to train the premarket system, and the dataset from another hospital was added to fine-tune the system. We applied the premarket and postmarket fine-tuned systems to postmarket test data and computed the difference in the number of pixels of false positives and false negatives before and after fine-tuning. Structural equation modeling was used to analyze the relationship between the four possible factors and performance changes. The experimental results indicated that the image contrast and number of pixels of hot spots per image were the main factors affecting the performance. In addition, we identified the conditions for determining whether fine-tuning the system using postmarket datasets is appropriate. The experimental findings from this study will be useful for deriving an effective design scheme for continuous learning in artificial intelligence systems.</p>

DOI： 10.14326/abe.12.51

Publishing type：Research paper (scientific journal)  

<p><i>Purpose</i>: The purpose of this study was to develop software for smooth dose management based on the Japan diagnostic reference levels (DRLs 2020) in the field of nuclear medicine. <i>Method</i>: Using the programming language Visual Basic for Applications (VBA), we implemented a function for calculating actual doses, a function for comparing doses at one’s own facility with those of DRLs 2020, a function for calculating appropriate doses for pediatric nuclear medicine examinations, and so on. In addition, we evaluated actual doses before and after the software implementation. <i>Result</i>: The software enabled easy calculation of actual doses and comparison with DRLs 2020 for smooth dose management. Furthermore, we were able to use the results of dose evaluation to determine the dosage at our facility and to use them as a reference for optimization. <i>Conclusion</i>: In the field of nuclear medicine, it is possible to manage doses in accordance with DRLs 2020 by introducing own software into our clinical practice.</p>

DOI： 10.6009/jjrt.2022-1298

PubMed

Publishing type：Research paper (scientific journal)  

核医学領域における診断参考レベル(Japan Diagnostic Reference Level 2020:DRLs2020)に基づいた円滑な線量管理を可能とするソフトウェアを開発するとともに、ソフトウェアを臨床に導入する前、導入した後における実投与量の評価を行った。プログラミング言語VisualBasic for Applications(VBA)を用いて、実投与量計算機能、自施設とDRLs2020の比較機能、小児核医学検査の適正投与量計算機能等を実装した。開発したソフトウェアはGUI上に各機能のプログラムを展開するボタンを配置したことにより、操作に不慣れな者でも簡便かつ直観的に操作可能であった。実投与量計算機能では使用する放射性核種あるいは放射性医薬品の種類を選択し、検定時の放射能、検定時刻、投与時刻を入力しOKボタンを押すことで、投与時刻における放射能を算出することを可能とした。小児核医学検査の適正投与量計算機能に関しては、GUI画面上で検査種類と患者体重を入力しOKボタンを押すことで、体重を基準とした適正投与量の算出を可能とした。

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.dmpk.2022.100449

PubMed

Publishing type：Research paper (scientific journal)  

肝胆道系輸送の定量評価のためのPETプローブとして[18F]ピタバスタチン([18F]PTV)を開発し、健常者を対象に臨床PET試験を行った。リファンピシン前投与あり/なしの条件下でPETプローブの薬物動態特性を調べた。リファンピシン前投与は肝臓におけるプローブの最高濃度および胆汁排泄を対照のそれぞれ52%および34%に低下させた。リファンピシン前投与は肝取り込みクリアランスを顕著に低下させ、胆汁排泄クリアランスを軽度低下させた。以上より、[18F]PTVは肝胆道系の取り込み/排出トランスポーターの活性を臨床的に調べるためのプローブとして有用と考えられた。

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s12149-022-01726-8

PubMed

Publishing type：Research paper (scientific journal)  

副甲状腺機能亢進症患者の早期相ならびに後期相の99mTc-MIBIシンチグラフィー画像から副甲状腺腺腫を検出するため、深層学習(DL)をベースとしたモデルをそれぞれ開発し、検証した。DLモデルの学習データセットには患者192例(男性47例、女性145例、平均年齢64±13歳)から検出された165腺腫を選択し、検証データセットには、患者45例(男性8例、女性37例、平均年齢67±12歳)から検出された30腺腫とした。画像は2010年6月～2019年3月までの期間内に著者等の医療施設で、シンチグラフィーと超音波検査を受けた患者から収集し、試験データセットには、患者44例(男性6例、女性38例、平均年齢67±12歳)から検出された30腺腫を用いて解析した。その結果、初期相モデルによるシンチグラムでは病変をベースとした感度は82%[95%CI 72-92%]、1画像当りの平均偽陽性数(mFPI)は0.44で、後期相モデルではそれぞれ83%[95%CI 73-92%]、0.31であった。これらの所見から、99mTc-MIBIシンチグラフィー画像を用いて、本DLモデルを適用することにより、高感度に副甲状腺腺腫が検出されることが確認された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1159/000522046

PubMed

Publishing type：Research paper (scientific journal)  

In two patients who received potassium iodide after discontinuing thiamazole and propylthiouracil for Graves' disease due to adverse reactions, ^99mTc thyroid scintigraphy performed prior to ¹³¹I administration after discontinuing potassium iodide and a 2-week low-iodine diet revealed RI accumulation in the thyroid gland was almost nonexistent. Blood free Thyroxine (fT4) were abnormally high and thyroid stimulating hormone (TSH) levels were abnormally low in both cases. Both patients were subsequently treated with 500 MBq of ¹³¹I. 24 hours later ¹³¹I scintigraphy showed ¹³¹I obvious accumulation in both thyroid lobes in both patients. Usually, the uptake functions of ¹³¹I are markedly higher than those of ^99mTc and thyroid uptake of ^99mTc is released within hours, while the ¹³¹I uptake increases over time. Discordances between ^99mTc and ¹³¹I uptake may reflect these differences.

DOI： 10.32291/nmj.4.0_5

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s11548-021-02488-w

PubMed

Publishing type：Research paper (scientific journal)  

【目的】2020年現在、全国的に統一された漢方医学教育のカリキュラムが存在せず、各大学で独自に卒前・卒後教育を行っているのが現状で、初期研修医の漢方教育に対する状況を知ることは重要である。【方法】初期研修医対象の「研修医の明日に役立つ実践セミナー」で2014年度から2020年度まで合計5回、漢方の講演会を行ったが、前4回は大学に参集する座学講義型式、2020年はWEB講義型式であった。その際初期研修医の漢方に対する状況を問うため行ったアンケートを座学講義群、WEB講義群に別け比較した。【結果】座学講義には、比較的漢方に関心の高い初期研修医が集まり、WEB講義は参加が容易で、参加者も増加した。両群に共通することは、初期研修医のおかれている卒後漢方教育の環境は、あまり「良好」とはいえず、その中で3割程度が「よくわからない」状況で漢方薬を定期的に処方し、今後自分の臨床に漢方を取り入れる必要は7割が感じているということであった。【結論】初期研修医に対するさらなる漢方医学の学習機会を設けることが重要であるが、そのためには、研修環境に依存しないWEB講義を活用すべきであると考えられた。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.clinimag.2020.12.016

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1111/cpf.12703

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s12149-020-01533-z

PubMed

Publishing type：Research paper (scientific journal)  

不明熱(FUO)の診断で重要となる病変部位同定に向け、18F-FDG PET/CT検査と68Ga-SPECT検査の感度を比較するため、国内医療施設17施設による多施設前向き研究を実施した。2014年10月～2017年9月までの期間内に、本研究参加施設に登録された患者のうち、1週間以内に2回以上腋窩温で38.0℃以上認められ、2週間以上にわたり反復する症状を呈した患者149例のうち、18F-FDG PET/CT検査と68Ga-SPECT検査を受けた128例を選択し、最終的に確定診断が得られた患者92例(男性43例、女性49例、年齢21～87歳)を解析対象とした。FUOの原因分類を行ったところ、非感染性炎症が52例、感染症が31例、悪性腫瘍が6例、その他3例に分けられ、18F-FDG PET/CT検査の感度は45%で、68Ga-SPECT検査の25%(95%CI 15.5-37.5%)に比べ、有意に高かった。また、18F-FDG PET/CT検査では、グレード分類G2/G3分布比においても検出高率が91%と、68Ga-SPECT検査の57%に比べ、有意に高い検出率であった。以上の結果から、FUO原因の最終診断で、最も重要となる病変部位同定において、18F-FDG PET/CT検査による感度は68Ga-SPECT検査に比べ、有意に優れていることが明らかにされた。

Publishing type：Research paper (scientific journal)  

DOI： 10.2174/1573405616666200528153453

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.3390/ijms21124443

PubMed

Publishing type：Research paper (scientific journal)  

抑肝散を内服することで冷えのぼせや頭痛、悪寒、発汗などの症状を発現した症例を経験したので報告する。症例は70歳代の女性、開胸術後疼痛症候群と肩こりで通院中、他科で処方されたエスシタロプラムが原因と思われるセロトニン症候群のため入院となった。鎮痛目的で投与した抑肝散を内服後、冷えのぼせ症状、頭痛、発汗、興奮が再燃した。内服中止後ただちに症状は軽快し、抑肝散による副作用と思われた。抑肝散を処方する場合には、セロトニン過剰症状が発現する可能性があることを念頭に置く必要がある。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.5005/jp-journals-10003-1352

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s11548-019-02105-x

PubMed

Publishing type：Research paper (scientific journal)  

アルツハイマー病(AD)6名、軽度認知障害(MCI)2名、健常者12名を対象に、PiB及びPBB3-PETでアミロイドベータ(Aβ)とタウの集積を測定し、臨床ステージングへの有用性を調査した。その結果、PBB3-PETで2例がステージI-II、1例がIII-IV、3例がV-VIを示し、PiB-PETで全例がステージCであった。PBB3ステージングと疾患期間は正の相関を認め、PiBステージ進行に従いMMSEは低下する傾向を認めた。海馬傍回を含む全AD特性領域でPBB3-、PiB-SUVRはADが健常者と比べ有意に高かった。MMSE低下はPBB3およびPiB増加と相関した。MMSE低下の始まりと共にPBB3が増加し、PiB増加はMMSEが高い時点でも既に観察された。アミロイドは最も早いステージにおいて既に集積していることが示された。結論として、PBB3はADステージ決定に有用と考えられた。

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s11548-020-02119-w

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1038/s41409-019-0537-x

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.18885/ci.0000000111

Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ncn3.12366

Publishing type：Research paper (scientific journal)  

A man in his 70s underwent FDG-PET 6 months after Covid-19 pneumonia was cured. The cure was confirmed with a negative polymerase chain reaction (PCR) test. At the time of PET examination, CRP was 0.06 mg / dL, WBC number was 6300 / μL, which indicates no inflammatory reaction was observed, and no obvious symptoms such as fever were observed. CT images of FDG-PET / CT showed ground glass opacities (GGO) on the right lung S6. In FDG-PET images, moderate FDG abnormal accumulation were observed in the same area, and the Standardized uptake value (SUV) max was 3.0. Many investigators reports abnormal high FDG uptake by active Covid-19 pneumonia. It should be noted that abnormal FDG accumulation by GGOs may continue to be observed after healing.

DOI： 10.32291/nmj.2.0_15

CiNii Article

Publishing type：Research paper (scientific journal)  

A 70-year-old patient who underwent ¹³¹I radioiodine remnant ablation at our hospital after thyroid cancer had undergone total thyroidectomy and received ¹³¹ I scintillation 10 days after administration. A whole body image of ¹³¹I scintigraphy showed abnormal accumulation in the left precordial region. Although no metastasis was observed in the chest CT at the time of the first visit, the possibility of metastasis cannot be ruled out, and the abnormal accumulation disappeared in the additional SPECT image. The patient was wearing a face mask, and it was removed during the whole body scan and placed in a chest pocket. A radiological technologist who noticed the face mask removed it during SPECT imaging.
When the mask was imaged with a scinti camera, an abnormal distribution thought to be ¹³¹I was observed.
Since the epidemic of coronavirus infection, most people have started to wear face masks regularly. Even if the patient taking the ¹³¹I scintigraphy has the face mask removed, it is necessary to confirm the presence and location of the face mask before imaging.

DOI： 10.32291/nmj.2.0_10

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.18888/rp.0000001089

CiNii Article

Publishing type：Research paper (scientific journal)  

認知症診断目的にTc-99m ECDによる脳血流SPECTを施行した意味性認知症(SD)の3例を報告した。症例1は50歳代女性で、前医にてアルツハイマー型認知症と診断された。脳血流シンチグラフィでは頭頂葉、左側側頭葉下部に、easy Z score Imaging System(eZIS)では後部帯状回・楔前部、左側側頭葉に血流低下を認めた。症例2は60歳代男性で、改訂長谷川式簡易知能評価スケール(HDS-R)は0点、Mini-Mental State Examination(MMSE)は0点であった。脳血流シンチグラフィでは両側前頭・側頭葉に、eZISでは左側優位に両側前頭・側頭葉に血流分布不均一と血流低下を認めた。症例3は70歳代男性で、HDS-Rは23点、MMSEは28点であった。脳血流シンチグラフィでは左側側頭葉に、eZISでは左側やや優位に両側側頭葉に血流低下を認めた。全例、MRIで左側優位に側頭葉の萎縮を認め、問診にて語義失語を認めたためSDと診断し、症例3は症状の悪化に伴い側頭葉の血流低下の増悪を認めた。

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

本報告では,前後面のラベルを同時に入力可能なbutterfly型のfully convolutional network(FCN)を用いた骨シンチグラム上の骨格認識処理の改良について報告する.提案手法では,従来の手法により認識された前後面の骨格ラベルと確率マップの画像,および,骨格の正解ラベルを用いてFCNの学習を行う.この学習済みネットワークに未知症例に対する従来の前後面の骨格認識ラベルを入力することで,ラベルに含まれる誤りを訂正する.本稿では,提案手法を実際の246症例に対する従来手法による骨格認識ラベルに適用した結果について示し,提案手法の有効性や限界について議論する.(著者抄録)

Publishing type：Research paper (scientific journal)  

本報告では,前後面のラベルを同時に入力可能なbutterfly型のfully convolutional network(FCN)を用いた骨シンチグラム上の骨格認識処理の改良について報告する.提案手法では,従来の手法により認識された前後面の骨格ラベルと確率マップの画像,および,骨格の正解ラベルを用いてFCNの学習を行う.この学習済みネットワークに未知症例に対する従来の前後面の骨格認識ラベルを入力することで,ラベルに含まれる誤りを訂正する.本稿では,提案手法を実際の246症例に対する従来手法による骨格認識ラベルに適用した結果について示し,提案手法の有効性や限界について議論する.(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s40981-019-0243-0

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

BACKGROUND: The purpose of this study was to retrospectively evaluate the usefulness of pretreatment positron emission tomography (PET) using metabolic tumor volume (MTV) of the primary tumor and lymph nodes in advanced hypopharyngeal cancer. METHODS: From June 2007 to December 2015, consecutive patients with advanced hypopharyngeal cancer who underwent PET and were treated with definitive radiation therapy were retrospectively reviewed. RESULTS: A total of 61 patients were eligible for this study. On multivariate analysis, MTV of the primary tumor (MTV-T) was significantly related to the local control rate and overall survival (OS) (P = .036 and .012, respectively). In patients with lower MTV-T, MTV of metastatic lymph nodes (MTV-N) was significantly related to disease-specific survival and OS (P = .012 and .017, respectively). CONCLUSION: MTV-T is a significant predictor in patients with advanced hypopharyngeal cancer, and MTV-N is also significant in patients with lower MTV-T.

DOI： 10.1002/hed.25429

PubMed

Publishing type：Research paper (scientific journal)  

A 74-year-old man underwent lung scintigraphy to rule out pulmonary embolism. Planar images revealed an abnormal midline uptake of ^99mTc macroaggregated albumin (MAA), which localized to several thoracic vertebrae, as revealed by single photon emission computed tomography / computed tomography. Contrast-enhanced computed tomography demonstrated stenosis of the left brachiocephalic vein for median sternotomy. By vascular stenosis, vessels to the vertebrae developed as a collateral pathway. Additionally, ^99mTc MAA was administered from the left median cubital vein in this patient.

DOI： 10.32291/nmj.1.0_1

CiNii Article

Publishing type：Research paper (scientific journal)  

症例は79歳女性で、重症の僧帽弁狭窄症に罹患しており僧帽弁置換術のため入院となった。患者には消化管疾患の徴候または履歴は無かった。僧帽弁の置換術中、経胸壁心エコー検査および経食道心エコー(TEE)検査を施行し、僧帽弁狭窄の他に左心房の拡大(径98×69mm)と左心室腔狭小が示された。術中、外傷を避けるためTEE検査は間欠的に施行した。手術時間は519分で、TEEプローブを抜去後に経鼻胃管チューブの挿入が円滑に行われた。患者の循環器系の状態は順調に改善したが、術後5日目に胃管チューブを通じた経腸栄養を開始した直後に腹痛を訴え始め、さらには低酸素血症と重度の低血圧も発症した。術後6日目にCTを緊急施行したところ、食道胃接合部の近位に穿孔が存在し胃管チューブはその穿孔を通って縦隔と腹腔の内部まで迷入していることが判明した。腹腔鏡下で外科的修復術を施行した。穿孔は食道胃接合部から5cm上方にあり、その大きさは約2cmであった。その修復術の約2ヵ月後に施行したバリウム試験では未だ少量の漏洩が認められたが術後72日目には消退した。術後125日目に養護施設へ転院となった。後に三次元CT画像を構築して解析した結果、損傷が生じてもおかしくないほど食道が並外れてねじれていたことが判明した。

Publishing type：Research paper (scientific journal)  

A 3-year-old girl was hospitalized for examining the lower leg edema. The blood examination revealed TP (3.6 g/dL), Alb (1.7 g/dL), and hypoproteinemia. In addition, ^99mTc-HSA-D scintigraphy was performed to ascertain the presence of protein leakage from the intestinal tract. Although a diffuse RI distribution in the left lower quadrant was observed in a 1-h image, the movement of the RI distribution to the right lower quadrant was observed in the 6-h image acquired after the meal. Furthermore, the colon was being illustrated in the 24-h image. We confirmed the existence of protein leakage from the small intestinal mucosa. On interviewing the mother regarding the usual dietary content, it was found that approximately 800 mL of milk was fed to the patient per day. An allergy test revealed milk allergy, which was diagnosed as a series of protein-losing gastroenteropathy caused by excessive milk consumption.

DOI： 10.32291/nmj.1.0_7

CiNii Article

Publishing type：Research paper (scientific journal)  

In bone scintigraphy, bone scan index (BSI) has recently been shown to be useful for quantitative assessment of bone metastasis in patients with prostate cancer. We report our experience with the use of a new BSI analysis software for technetium-99m hydroxymethylene diphosphonate ^99mTc-HMDP) bone scanning.
Deep learning is accomplished using a database of identified bone anatomy structures of 246 patients, and accordingly, the skeleton is classified into 12 segments: skull, sternum, cervical spine, thoracic spine, lumbar spine, sacrum, clavicle, scapula, humerus, ribs, pelvis, and femur.
It also identifies abnormal accumulation through deep learning using a database of identified sites of abnormal accumulation in 896 patients with prostate cancer as supervised data. Each bone area in the 12 segments is calculated for each patient, and the local BSI is calculated from the area of each bone metastasis in each segment. The sum of local BSI is defined as BSI, and the number of bone metastases is defined as the number of hot spots.
The analysis was performed on a 64-bit Windows 10 personal computer with Intel® CoreTMi7-8550U and 16.0 GB RAM. The time required for analyzing bone scintigraphy for a patient was approximately 20 seconds.
Some cases actually used are presented in the text.

DOI： 10.32291/nmj.1.0_28

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.2174/1874120701913010055

Publishing type：Research paper (scientific journal)  

DOI： 10.18888/rp.0000000712

CiNii Article

Publishing type：Research paper (scientific journal)  

症例は40歳代女性で、骨痛と考えられる腰痛で受診した。高ALP血症、低リン血症を認めた。線維芽細胞増殖因子23(FGF-23)高値で、FGF-23関連低リン血症による骨軟化症と診断した。FGF-23産生腫瘍の検索目的にソマトスタチン受容体シンチグラフィ(SRS)を施行した。SRSにて早期相では明らかな異常集積を認めなかった。後期相では頭部正中にRI異常集積が出現した。頭部MRIではて蝶形骨洞にT1強調低信号、T2強調高信号を呈し、造影T1強調像で増強される腫瘤を認めた。画像所見から、蝶形骨洞の腫瘍がFGF-23産生腫瘍と考え、腫瘍摘出術を施行した。病理診断でphosphaturic mesenchymal tumorと診断した。ALPは術後から低下し、半年後には正常化した。その後、再発はみられず、順調に経過している。

Publishing type：Research paper (scientific journal)  

症例は40歳代女性で、骨痛と考えられる腰痛で受診した。高ALP血症、低リン血症を認めた。線維芽細胞増殖因子23(FGF-23)高値で、FGF-23関連低リン血症による骨軟化症と診断した。FGF-23産生腫瘍の検索目的にソマトスタチン受容体シンチグラフィ(SRS)を施行した。SRSにて早期相では明らかな異常集積を認めなかった。後期相では頭部正中にRI異常集積が出現した。頭部MRIではて蝶形骨洞にT1強調低信号、T2強調高信号を呈し、造影T1強調像で増強される腫瘤を認めた。画像所見から、蝶形骨洞の腫瘍がFGF-23産生腫瘍と考え、腫瘍摘出術を施行した。病理診断でphosphaturic mesenchymal tumorと診断した。ALPは術後から低下し、半年後には正常化した。その後、再発はみられず、順調に経過している。

Publishing type：Research paper (scientific journal)  

DOI： 10.1182/blood-2018-99-110517

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10072-018-3477-0

PubMed

Publishing type：Research paper (scientific journal)  

Tc-99m-galactosyl human serum albumin (GSA) scintigraphy is used to assess the hepatic functional reserve, and allows for visual assessment of the residual hepatocyte distribution on single-photon emission computed tomography/computed tomography (SPECT/CT) images. The association between heterogeneous liver uptake of Tc-99m-GSA and liver fibrosis remains to be studied in detail. We analyzed this association.Fifty-one patients with chronic hepatobiliary disease undergoing a Tc-99m-GSA scintigraphy were included in this study. The receptor (LHL15) and blood clearance (HH15) indexes (the uptake ratios of the liver and heart) were obtained from dynamic planar images. The liver uptake count maximum-to-mean ratio (LUC Max/Mean) was calculated from single-photon emission computed tomography/computed tomography (SPECT/CT) images as an indicator of the Tc-99m-GSA liver uptake heterogeneity. We assessed the relationship between these quantified values and liver fibrosis.There were 30 Child-Pugh classification grade A patients, 16 grade B patients, and 5 grade C patients. Among the 30 patients whose liver histopathology was evaluable, those with advanced liver fibrosis (F2-4) had a lower LHL15 than those with mild liver fibrosis (F0-1) (median, 0.90 vs. 0.92, P=.04), and a higher LUC Max/Mean (median, 1.80 vs. 1.70, P=.02). The multivariate analysis identified platelets (P=.04) and the LUC Max/Mean (P=.04) as contributing factors of advanced liver fibrosis.These findings suggest that Tc-99m-GSA SPECT/CT can be used not only to assess the hepatic functional reserve, but also to evaluate a degree of liver fibrosis.

DOI： 10.1097/MD.0000000000011765

PubMed

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DOI： 10.1016/j.eucr.2018.04.005

PubMed

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Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Various positron emission tomography (PET) probes have been developed to assess in vivo activities in humans of drug transporters, which aid in the prediction of pharmacokinetic properties of drugs and the impact of drug-drug interactions. We developed a new PET probe, sodium (3R, 5R)-3, 5-dihydroxy-7-((1S, 2S, 6S, 8S)-6-hydroxy-2-methyl-8- ((1-[11C]-(E)-2-methyl-but-2-enoyl) oxy) -1, 2, 6, 7, 8, 8a-hexahydronaphthalen-1-yl) heptanoate ([11C]DPV), and demonstrated its usefulness for the quantitative investigation of Oatps (gene symbol SLCO) and Mrp2 (gene symbol ABCC2) in rats. To further analyze the species differences and verify the pharmacokinetic parameters in humans, serial PET scanning of the abdominal region with [11C]DPV was performed in six healthy volunteers with and without an OATP1Bs and MRP2 inhibitor, rifampicin (600 mg, oral), in a crossover fashion. After intravenous injection, [11C]DPV rapidly distributed to the liver and kidney followed by secretion into the bile and urine. Rifampicin significantly reduced the liver distribution of [11C]DPV 3-fold, resulting in a 7.5-fold reduced amount of excretion into the bile and the delayed elimination of [11C]DPV from the blood circulation. The hepatic uptake clearance (CLuptake, liver) and canalicular efflux clearance (CLint, bile) of [11C]DPV (544 ± 204 and 10.2 ± 3.5 µl/min per gram liver, respectively) in humans were lower than the previously reported corresponding parameters in rats (1800 and 298 µl/min per gram liver, respectively) (Shingaki et al., 2013). Furthermore, rifampicin treatment significantly reduced CLuptake, liver and CLint, bile by 58% and 44%, respectively. These results suggest that PET imaging with [11C]DPV is an effective tool for quantitatively characterizing the OATP1Bs and MRP2 functions in the human hepatobiliary transport system.

DOI： 10.1124/dmd.118.080408

PubMed

Publishing type：Research paper (scientific journal)  

Tc-99m-MAA scintigraphy was performed in a patient with pulmonary hypertension to confirm the presence of a Right-to-LEFT (R-L) shunt due to the pulmonary Arteriovenous (AV) fistula. Both planar imaging and SPECT/CT showed multiple decreased or increased RI accumulation in both lung fields, and the R-L shunt ratio was high, indicating the presence of an R-L shunt. We considered that the decreased RI accumulated lesions were caused by pulmonary hypertension due to the pulmonary AV fistula. Osler-Weber-Rendu syndrome was proposed and genetic diagnosis was done. However, we speculated that the increased RI accumulated lesions were attributable to localized bleeding or a venous telangiectasia around the pulmonary AV fistula.

DOI： 10.2174/1573405612666161018111353

Publishing type：Research paper (scientific journal)  

<p>A high-resolution display panel comes to practical use, but the resolution of the indicated contents does not change. The up-sampling processing is applied to indication of the low-resolution contents. In the up-sampling process, the super resolution enables an up-sampling process which estimates information of high frequency components lost by sampling while analyzing input images is noticed. In this paper, we aimed at reconstructing an image of normal resolution in which the influence of statistical noise is reduced by applying super resolution after down-sampling processing is applied to positron emission tomography (PET) image with many statistical noises. To evaluate the noise reduction effect, we compared it with the Gaussian filter which is frequently used to reduce the influence of the statistical noise of the PET image. A 3D Hoffman brain phantom was used to evaluate objectively by peak signal-to-noise ratio and power spectral density. The objective index of the PET image applying super resolution is positive results, suggesting the possibility of being useful as compared with the conventional method.</p>

DOI： 10.6009/jjrt.2018_JSRT_74.7.653

PubMed

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.18888/rp.0000000215

CiNii Article

Publishing type：Research paper (scientific journal)  

腎臓の炎症性疾患の鑑別におけるガリウムシンチグラフィSPECT/CTの有用性を検討した。ガリウムシンチグラフィSPECT/CTを行った41例(男19例、女22例、平均年齢62歳)を対象とした。腎生検で腎臓の炎症性疾患と診断された11例(腎炎群)と非腎炎群30例について、腎、肝右葉、椎体、右腸腰筋の平均SPECT/CT値から求めた腎/肝比、腎/椎体比、腎/腸腰筋比を比較した結果、腎炎群では非腎炎群よりもeGFRが有意に低く、腎/椎体比、腎/腸腰筋比は有意に高かった。また、ROCカーブから求めたcut-off値を用いて指標の有用性を検討した結果、腎/肝比、腎/椎体比よりも腎/腸腰筋比の指標が有用であった。腎臓の炎症性疾患の鑑別にあたっては、ガリウムシンチグラフィSPECT/CTを用いることでより精度の高い検査が可能になることが示唆された。

Publishing type：Research paper (scientific journal)  

副甲状腺機能亢進症(HPT)の検出におけるTc-99m-MIBI副甲状腺シンチグラフィーにおけるSPECT/CTの有用性を超音波検査(US)と比較した。2012年6月～2013年12月にHPTが疑われた患者108例(男性20例、女性88例、平均64歳)を後ろ向きに調査した。Tc-99m-MIBI 600MBq投与3時間後にSPECT/CTを施行し、視覚的に評価した。病理診断を基準とし、SPECT/CTとUSの感度を比較した。原発性副甲状腺機能亢進症(PHPT)は83例で、そのうち腺腫は76例(76結節)、過形成は7例(21結節)であった。続発性副甲状腺機能亢進症(SHPT)は25例、過形成のみで25例(80結節)であった。SPECT/CTの感度はPHPT、SHPT、腺腫、過形成でそれぞれ87、88、89、39%、USの感度はそれぞれ83、88、86、60%であり、過形成でのみ有意差が見られた。異所性腺腫は11例で、いずれもSPECT/CTで検出でき、そのうち10結節がSPECT/CTでのみ検出できた。

Publishing type：Research paper (scientific journal)  

腎臓の炎症性疾患の鑑別におけるガリウムシンチグラフィSPECT/CTの有用性を検討した。ガリウムシンチグラフィSPECT/CTを行った41例(男19例、女22例、平均年齢62歳)を対象とした。腎生検で腎臓の炎症性疾患と診断された11例(腎炎群)と非腎炎群30例について、腎、肝右葉、椎体、右腸腰筋の平均SPECT/CT値から求めた腎/肝比、腎/椎体比、腎/腸腰筋比を比較した結果、腎炎群では非腎炎群よりもeGFRが有意に低く、腎/椎体比、腎/腸腰筋比は有意に高かった。また、ROCカーブから求めたcut-off値を用いて指標の有用性を検討した結果、腎/肝比、腎/椎体比よりも腎/腸腰筋比の指標が有用であった。腎臓の炎症性疾患の鑑別にあたっては、ガリウムシンチグラフィSPECT/CTを用いることでより精度の高い検査が可能になることが示唆された。

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DOI： 10.1016/j.jns.2017.08.2879

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DOI： 10.1016/j.jns.2017.08.2883

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DOI： 10.4103/1450-1147.215493

PubMed

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DOI： 10.1016/j.jvir.2016.11.092

PubMed

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DOI： 10.1016/j.ivir.2016.11.092

Publishing type：Research paper (scientific journal)  

<p><i>Purpose</i>: The N-Isopropyl-p-[123I] Iodoamphetamine (¹²³I-IMP) SPECT imaging reduces the image quality and quantitative accuracy due to scatter and septal penetration occurred by radioactive uptake from outside of the field of view such as the lungs. We evaluated the influence of scatter and septal penetration using phantom-simulated radioactivity from outside of the field of view, and subsequently compared the effect of scatter and septal penetration corrections between the simulation-based effective scatter source estimation (ESSE) method and the multi-window method (ellipse approximation method). <i>Methods</i>: We used the phantom filled with 10 and 25 kBq/mL for the brain and lung parts corresponding to radioactive concentration in the clinical study. The SPECT images were acquired with and without lung phantom using low-energy high-resolution (LEHR) and cardiac high-resolution (CHR) collimators. We quantitatively evaluated a brain phantom by count analysis and coefficient of variation as reference data without lung phantom simulated the radioactivity from outside of the field of view, and compared between two scatter corrections by each collimator. <i>Results</i>: The brain count in cerebral base with the ESSE method using LEHR collimator was higher than that of the ellipse approximation method. The whole brain count with the ellipse approximation method using CHR collimator shows 28.8% lower than the ESSE method, so that it suggests that the ellipse approximation method for LEHR collimator and the ESSE method for CHR collimator was close to reference counts. The coefficient of variation of the ESSE method was lower than that of the ellipse approximation method for both two collimators. <i>Conclusions</i>: It was possible to correct the scatter and penetration from outside the field of view with high accuracy, by using the ellipse approximation method with LEHR collimator and the ESSE method with CHR collimator.</p>

DOI： 10.6009/jjrt.2017_JSRT_73.10.1028

CiNii Article

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DOI： 10.1155/2017/7956726

PubMed

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PubMed

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DOI： 10.18888/j01565.2017096478

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レビー小体型認知症(DLB)の診断に苦慮した認知症の3例を経験した。症例1は82歳女性で、物忘れが多くなり、金銭管理ができなくなった。99mTc-ECD脳血流SPECTでは、両側大脳半球の血流分布は不均一で脳萎縮が疑われた。eZISでは両側帯状回の一部に有意な血流低下がみられた。DLBと診断し、内服加療となった。症例2は68歳男性で、抑うつ状態が強くなり、妄想的言動や奇異行動がみられるようになった。幻視、妄想を訴え、パーキンソン症状もみられた。99mTc-ECD脳血流SPECTでは両側前頭葉の血流が不均一に低下していた。eZISでは両側後部帯状回・楔前部に有意な血流低下がみられた。両側大脳半球の血流も低下していた。幻覚、妄想は内服にて軽快した。軽度認知機能障害、双極性障害と診断した。症例3は80歳女性で、自宅でも幻視を認めるようになった。99mTc-ECD脳血流SPECTでは右上部前頭葉や頭頂葉の血流が不均一で、同部の萎縮が疑われた。左側頭葉にも血流低下がみられ、萎縮が疑われた。eZISでは両側帯状回・楔前部に有意な血流低下がみられた。DLBの前駆状態が疑われた。幻視は内服にて軽快した。

Publishing type：Research paper (scientific journal)  

レビー小体型認知症(DLB)の診断に苦慮した認知症の3例を経験した。症例1は82歳女性で、物忘れが多くなり、金銭管理ができなくなった。99mTc-ECD脳血流SPECTでは、両側大脳半球の血流分布は不均一で脳萎縮が疑われた。eZISでは両側帯状回の一部に有意な血流低下がみられた。DLBと診断し、内服加療となった。症例2は68歳男性で、抑うつ状態が強くなり、妄想的言動や奇異行動がみられるようになった。幻視、妄想を訴え、パーキンソン症状もみられた。99mTc-ECD脳血流SPECTでは両側前頭葉の血流が不均一に低下していた。eZISでは両側後部帯状回・楔前部に有意な血流低下がみられた。両側大脳半球の血流も低下していた。幻覚、妄想は内服にて軽快した。軽度認知機能障害、双極性障害と診断した。症例3は80歳女性で、自宅でも幻視を認めるようになった。99mTc-ECD脳血流SPECTでは右上部前頭葉や頭頂葉の血流が不均一で、同部の萎縮が疑われた。左側頭葉にも血流低下がみられ、萎縮が疑われた。eZISでは両側帯状回・楔前部に有意な血流低下がみられた。DLBの前駆状態が疑われた。幻視は内服にて軽快した。

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PubMed

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PubMed

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DOI： 10.1155/2016/6374584

PubMed

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Publishing type：Research paper (scientific journal)  

Background: The relationship between medial temporal lobe atrophy (MTA) and cognitive impairment in patients with dementia with Lewy bodies (DLB) remains unclear. We examined this relationship using voxel-based specific regional analysis system for Alzheimer disease (VSRAD) advance software, which allowed us to quantify the degree of MTA on images obtained from magnetic resonance imaging (MRI) scans.
Methods: Thirty-seven patients diagnosed with DLB were recruited and scanned with a 1.5 Tesla MRI scanner. All MRI data were analyzed using VSRAD advance. The target volume of interest (VOI) included the entire region of the entorhinal cortex, hippocampus, and amygdala. The degree of MTA was obtained from the averaged positive z-score (Z score) on the target VOI, with higher scores indicating more severe MTA. Mini-Mental State Examination (MMSE) and the Revised Hasegawa Dementia Scale (HDS-R), which strengthened the measures of memory and language more than MMSE, were used to assess the presence of cognitive impairment.
Results: A negative correlation was found between the Z score and MMSE total scores or the HDS-R total scores. A stepwise multiple regression analysis performed to adjust the covariate effects of sex, age, the onset age of the disease, duration of DLB, years of education, and donepezil treatment showed that the HDS-R total scores were independently associated with the Z score, whereas MMSE total scores were not.
Conclusions: These results suggest that MTA is related to cognitive impairment in patients with DLB, particularly the regions of orientation, immediate and delayed recall, and word fluency.

DOI： 10.1177/0891988715590210

PubMed

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Aims: To elucidate the role of cerebral serotonin neurotransmission in visceral perception in functional dyspepsia (FD), we observationally examined the regional expression level of the serotonin transporter (SERT) and its correlation with clinical symptoms.
Main methods: FD patients (Rome III criteria; N = 9, age range: 36-76 years) and healthy controls (N = 8, age range: 25-61 years) participated in this study. Positron emission tomography scanning with [C-11] N, N-dimethyl-2-(2-amino-4-cyanophenylthio) benzylamine ([11C] DASB), which binds specifically to SERT, was used to quantify the binding potential (BPND) of [11C] DASB in the midbrain, thalamus, caudate, putamen, amygdala, and hippocampus with reference to co-registered magnetic resonance images. Clinical symptoms were assessed using the Gastrointestinal Symptoms Rating Scale (GSRS). Self-Rating Depression Scale (SDS), and State-Trait Anxiety Inventory (STAI).
Key findings: BPND of the midbrain (P = 0.041) and thalamus (P = 0.031) was higher in FD patients than in controls. The BPND values in the midbrain correlated with total GSRS (r = 0.663, P = 0.004) and abdominal pain (r = 0.419, P = 0.047) scores. Its values in the thalamus correlated with total GSRS (r = 0.423, P = 0.044), abdominal pain (r = 0.502, P = 0.022), and indigestion (r = 0.476, P = 0.028) scores. Its value in the hippocampus correlated with abdominal pain and state-STAI scores (r = 0.528, P = 0.017; r = 0.428, P = 0.043).
Significance: Up-regulation of the SERT level in the midbrain and thalamus may underlie the pathogenesis of FD such as abdominal and psychological symptoms via a brain-gut interaction. (C) 2015 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.lfs.2015.07.023

PubMed

Publishing type：Research paper (scientific journal)  

骨シンチグラム上の転移などの異常集積の特徴は人体内の部位によって異なる。そのため、解剖構造(頭蓋骨、肋骨、骨盤などの器官)の情報は異常集積の診断において重要な役割を果たす。本報告では、マルチアトラス法による骨シンチグラム全身像上の人体の解剖構造の自動認識処理を提案する。この処理では、まず、骨シンチグラムと解剖構造を手入力したラベル画像の組(アトラスと呼ぶ)を複数用意したデータベースを用意する。次に、入力画像に対してデータベース内の全シンチグラムを位置合わせし、同じ変形場を用いてラベル画像を変形させる。さらに、変形後のラベルを器官ごとに重ね合わせ、入力画像と位置合わせ後のシンチグラムとの間の類似度に基づく重み付き多数決により画素単位で認識結果を得る。本報告では、提案法を実際の77症例から撮影した前面と後面のシンチグラム画像に適用して性能を評価した結果について示し、有効性について議論する。(著者抄録)

Publishing type：Research paper (scientific journal)  

骨シンチグラム上の転移などの異常集積の診断には長い経験が必要であり、医師間でも診断がばらつくこともある難しい問題である。本稿では、異常集積の検出支援のための第一ステップとして、転移や骨折などの異常集積や、注射漏れなどによる集積を検出する処理を開発したので報告する。具体的には、原画像と濃度値の正規化後の画像に対して、集積の特徴を強調するために集中度フィルタ、ガウシアンフィルタ、ヘシアンフィルタを適用し、それらの出力に対する閾値処理を弱分類器とするMadaBoostにより、各画素が注目する異常集積などであるか否かを判定する処理を開発した。また、本研究室で開発している解剖構造の認識結果を利用した異常集積の判定処理も開発し、実際の71症例の骨シンチグラム全身像(前面画像)に適用して性能を評価した。本報告では適用結果を示し、提案する処理の有効性について考察する。(著者抄録)

Publishing type：Research paper (scientific journal)  

骨シンチグラム上の転移などの異常集積の診断には長い経験が必要であり、医師間でも診断がばらつくこともある難しい問題である。本稿では、異常集積の検出支援のための第一ステップとして、転移や骨折などの異常集積や、注射漏れなどによる集積を検出する処理を開発したので報告する。具体的には、原画像と濃度値の正規化後の画像に対して、集積の特徴を強調するために集中度フィルタ、ガウシアンフィルタ、ヘシアンフィルタを適用し、それらの出力に対する閾値処理を弱分類器とするMadaBoostにより、各画素が注目する異常集積などであるか否かを判定する処理を開発した。また、本研究室で開発している解剖構造の認識結果を利用した異常集積の判定処理も開発し、実際の71症例の骨シンチグラム全身像(前面画像)に適用して性能を評価した。本報告では適用結果を示し、提案する処理の有効性について考察する。(著者抄録)

Publishing type：Research paper (scientific journal)  

骨シンチグラム上の転移などの異常集積の特徴は人体内の部位によって異なる。そのため、解剖構造(頭蓋骨、肋骨、骨盤などの器官)の情報は異常集積の診断において重要な役割を果たす。本報告では、マルチアトラス法による骨シンチグラム全身像上の人体の解剖構造の自動認識処理を提案する。この処理では、まず、骨シンチグラムと解剖構造を手入力したラベル画像の組(アトラスと呼ぶ)を複数用意したデータベースを用意する。次に、入力画像に対してデータベース内の全シンチグラムを位置合わせし、同じ変形場を用いてラベル画像を変形させる。さらに、変形後のラベルを器官ごとに重ね合わせ、入力画像と位置合わせ後のシンチグラムとの間の類似度に基づく重み付き多数決により画素単位で認識結果を得る。本報告では、提案法を実際の77症例から撮影した前面と後面のシンチグラム画像に適用して性能を評価した結果について示し、有効性について議論する。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1097/RLU.0000000000000574

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

The functions of genes involved in idiopathic portal hypertension (IPH) remain unidentified. The present study was undertaken to identify the functions of genes expressed in blood samples from patients with IPH through comprehensive analysis of gene expression using DNA microarrays. The data were compared with data from healthy individuals to explore the functions of genes showing increased or decreased expression in patients with IPH. In cluster analysis, no dominant probe group was shown to differ between patients with IPH and healthy controls. In functional annotation analysis using the Database for Annotation Visualization and Integrated Discovery tool, clusters showing dysfunction in patients with IPH involved gene terms related to the immune system. Analysis using network-based pathways revealed decreased expression of adenosine deaminase, ectonucleoside triphosphate diphosphohydrolase 4, ATP-binding cassette, subfamily C, member 1, transforming growth factor-beta, and prostaglandin E receptor 2; increased expression of cytochrome P450, family 4, subfamily F, polypeptide 3, and glutathione peroxidase 3; and abnormalities in the immune system, nucleic acid metabolism, arachidonic acid/leukotriene pathways, and biological processes. These results suggested that IPH involved compromised function of immunocompetent cells and that such dysfunction may be associated with abnormalities in nucleic acid metabolism and arachidonic acid/leukotriene-related synthesis/metabolism.

DOI： 10.1155/2015/349215

PubMed

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

We report a 47-year-old man in whom 99mTc human serum albumin diethylene-triamine-pentaacetic acid protein-losing scintigraphy, performed with SPECT/CT, was useful for diagnosing Ménétrier disease. Planar images taken 1 and 3 hours after radioactive isotope injection yielded a suspicion that the stomach was the site of protein loss in this case. However, the protein loss from the stomach was precisely diagnosed after SPECT/CT was performed
this helped to diagnose Ménétrier disease.

DOI： 10.1097/RLU.0000000000000411

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Background and Aim: 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) may detect primary lesions (PLs) and extrahepatic metastases (EHMs) only in advanced hepatocellular carcinoma (HCC) patients. We investigated the requirement of PET and the optimal timing of PET scanning for accurate staging and treatment planning. Methods: We conducted a retrospective investigation of 64 HCC patients who underwent PET (median age, 74 years
male/female, 41/23
etiology, 46 hepatitis C virus/4 hepatitis B virus/4 alcoholic/10 others). To determine the best timing for PET examinations, we analyzed PET result-based recommended treatment changes and characteristics of patients with FDG-avid PLs or EHMs. Results: FDG-avid PLs were detected by PET in 22 patients (34%): 18 with hypervascular PL, 11 with serum α-fetoprotein levels ≥200ng/mL, and 11 beyond Milan criteria. EHMs were detected in 21 patients (33%: lymph nodes, 8
lung, 5
abdominal wall, 4
bone, 3
other organs, 4 [including overlapping]). Recommended treatments changed for 16 patients (25%) because of Barcelona Clinic Liver Cancer stage increases based on PET scanning. In multivariate analyses, serum α-fetoprotein levels ≥200ng/mL and beyond Milan criteria were independent factors for FDG-avid PLs and a maximum standardized uptake value (SUVmax) of PLs of ≥4.0 was an independent factor for FDG-avid EHMs (P=0.002, 0.008, and 0.045, respectively). Conclusions: PET allows detection of HCC spread in patients with elevated serum α-fetoprotein levels or those beyond Milan criteria and detects EHMs in patients with PLs with high SUVmax values. Optimally timed PET scans can complement conventional imaging for accurate staging and treatment strategy determination. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

DOI： 10.1111/jgh.12611

PubMed

Publishing type：Research paper (scientific journal)  

Purpose: Gastrointestinal (GI) bleeding scintigraphy in combination with single-photon emission computed tomography/computed tomography (SPECT/CT) remains to be studied in detail. This study aimed to examine the diagnostic ability of this tool. Methods: GI bleeding scintigraphy using 99mTc-human serum albumin-diethylenetriaminepentaacetic acid was performed for 38 patients with suspected GI bleeding. Twenty-four patients were diagnosed using planar images alone (planar group) and 14 patients were diagnosed using planar images and additional SPECT/CT images (planar + SPECT/CT group). The diagnostic ability of each method was analyzed. Results: GI bleeding was observed in 20 of the 38 patients. For the existence of GI bleeding, planar images alone showed a sensitivity of 70%, specificity of 93%, positive predictive value (PPV) of 88%, negative predictive value (NPV) of 81%, and an overall accuracy of 83%, whereas planar images + SPECT/CT showed a sensitivity of 100%, specificity of 75%, PPV of 91%, NPV of 100%, and an overall accuracy of 93%. The source of bleeding was accurately diagnosed in 50% in the planar group and 78% in the planar + SPECT/CT group. In the planar + SPECT/CT group, 44% of the evaluable patients showed correct localization of the source of GI bleeding by additional SPECT/CT images, although planar images only showed incorrect localization. Conclusion: GI bleeding scintigraphy in combination with SPECT/CT is a noninvasive and useful tool for the examination of GI bleeding. © 2014 Springer Science+Business Media.

DOI： 10.1007/s00261-014-0111-3

PubMed

Publishing type：Research paper (scientific journal)  

A database is an important factor in the statistical analysis of myocardial scintigraphy. Our aim in this study was to verify the validity of the threshold method using phantoms and to create a clinical database using this method. Since this method involves artificially excluding a low count area on a polar map, we created a myocardial phantom with defects. Then, we applied this method to the construction of a control database (CDB) for which we used stress-rest scans of 152 male and 52 female Japanese patients. The clinical relevance of this database was investigated by comparison of the values between the CDB and a Japanese normal database. In the study evaluation, we mainly used the summed extent score (SES) and a severity map (severity). Data from the phantom with defects demonstrated that the threshold method could compensate for defective areas, enabling the use of data for the creation of the CDB. Comparison of the CDB with the Japanese normal database showed a good relationship with respect to the SES and severity (Initial post-stress: SES: r = 0.978
severity: r = 0.997, Redistribution: SES: r = 0.944
severity: r = 0.993). The threshold method facilitates the effective creation of a database by use of clinical data. This enables individual institutions to build their own databases, taking into account differences in collection and processing conditions between institutions as well as the characteristics of individual equipment. © 2014 Japanese Society of Radiological Technology and Japan Society of Medical Physics.

DOI： 10.1007/s12194-014-0271-4

PubMed

Publishing type：Research paper (scientific journal)  

心筋シンチグラフィーのためのコントロールデータベース(CDB)の作製におけるファントムを用いる閾値法の有用性について検討した。本法を用いて、日本人の男性患者152人および女性患者52人のストレス-レストスキャンに用いるCDBを構築した。このデータベースの臨床的関連をCDBおよび日本のノーマルデータベースの値の比較により調べ、合計エクステントスコア(SES)および重篤度マップを中心に評価した。欠損をもつファントムからのデータから、本法によって欠損領域が補償されて、CDBの構築のためにデータ利用が可能になることが示された。CDBを日本のノーマルデータベースと比較したところ、SESと重篤度に関して良好な相関が認められた。本法により臨床データを用いたCDBの効果的な構築が促進され、これにより個々の施設において独自のデータベースを構築することが可能になることが示された。

Publishing type：Research paper (scientific journal)  

心筋シンチグラフィーのためのコントロールデータベース(CDB)の作製におけるファントムを用いる閾値法の有用性について検討した。本法を用いて、日本人の男性患者152人および女性患者52人のストレス-レストスキャンに用いるCDBを構築した。このデータベースの臨床的関連をCDBおよび日本のノーマルデータベースの値の比較により調べ、合計エクステントスコア(SES)および重篤度マップを中心に評価した。欠損をもつファントムからのデータから、本法によって欠損領域が補償されて、CDBの構築のためにデータ利用が可能になることが示された。CDBを日本のノーマルデータベースと比較したところ、SESと重篤度に関して良好な相関が認められた。本法により臨床データを用いたCDBの効果的な構築が促進され、これにより個々の施設において独自のデータベースを構築することが可能になることが示された。

Publishing type：Research paper (scientific journal)  

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disease characterized by chronic, profound, disabling, and unexplained fatigue. Although it is hypothesized that brain inflammation is involved in the pathophysiology of CFS/ME, there is no direct evidence of neuroinflammation in patients with CFS/ME. Activation of microglia or astrocytes is related to neuroinflammation. 11C-(R)-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl) -3-isoquinoline-carboxamide (11C-(R)-PK11195) is a ligand of PET for a translocator protein that is expressedby activatedmicrogliaor astrocytes. We used 11C-(R)-PK11195 and PET to investigate the existence of neuroinflammation in CFS/ME patients. Methods: Nine CFS/ME patients and 10 healthy controls underwent 11C-(R)-PK11195 PET and completed questionnaires about fatigue, fatigue sensation, cognitive impairments, pain, and depression. To measure the density of translocator protein, nondisplaceable binding potential (BPND) values were determined using linear graphical analysis with the cerebellum as a reference region. Results: The BPND values of 11C-(R)-PK11195 in the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons were 45%-199% higher in CFS/ME patients than in healthy controls. In CFS/ME patients, the BP ND values of 11C-(R)-PK11195 in the amygdala, thalamus, and midbrain positively correlated with cognitive impairment score, the BP ND values in the cingulate cortex and thalamus positively correlated with pain score, and the BPND value in the hippocampus positively correlated with depression score. Conclusion: Neuroinflammation is present inwidespread brain areas in CFS/MEpatients and was associated with the severity of neuropsychologic symptoms. Evaluation of neuroinflammation in CFS/ME patients may be essential for understanding the core pathophysiology and for developing objective diagnostic criteria and effective medical treatments. Copyright © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

DOI： 10.2967/jnumed.113.131045

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Background:Congenital portosystemic shunt (CPSS) has the potential to cause hepatic encephalopathy and thus needs long-term follow-up, but an effective follow-up method has not yet been established. We aimed to evaluate the importance of per-rectal portal scintigraphy (PRPS) for long-term follow-up of CPSS.Methods:We retrospectively examined shunt severity time course in patients (median: 9.6 y, range: 5.2-16.6 y) with intrahepatic (n = 3) or extrahepatic (n = 3) CPSS by using blood tests, ultrasonography or computed tomography, and PRPS. Per-rectal portal shunt index (cutoff: 10%) was calculated by PRPS.Results:PRPS demonstrated that the initial shunt index was reduced in all intrahepatic cases (from 39.7 ± 9.8% (mean ± SD) to 14.6 ± 4.7%) and all extrahepatic cases (from 46.2 ± 10.9 to 27.5 ± 12.6%) during the follow-up period. However, ultrasonography and computed tomography disclosed different shunt diameter time courses between intrahepatic and extrahepatic CPSSs. Initial shunt diameter (5.8 ± 3.5 mm) reduced to 2.0 ± 0.3 mm in intrahepatic cases, but the initial diameter (6.3 ± 0.7 mm) increased to 10.6 ± 1.0 mm in extrahepatic cases. All patients had elevated serum total bile acid or ammonia levels at initial screening, but these blood parameters were insufficient to assess shunt severity because the values fluctuate.Conclusion:PRPS can track changes in the shunt severity of CPSS and is more reliable than ultrasonography and computed tomography in patients with extrahepatic CPSS. Copyright © 2014 International Pediatric Research Foundation, Inc.

DOI： 10.1038/pr.2014.11

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Summary: Aim: Delayed gastric emptying, including gastroparesis, is a common complication in diabetes mellitus. The association between delayed gastric emptying and overall diabetic complications remains to be studied in detail. We analysed this association. Methods: We performed gastric emptying scintigraphy of 99mTc-diethylenetriaminepentaacetic acid in 34 patients with diabetes to measure the gastric emptying half-times (T1/2) of the whole stomach (WS), proximal stomach (PS) and distal stomach (DS). We assessed T1/2, diabetic-related factors and complications. Results: The prevalence of autonomic neuropathy was higher in the group with delayed T1/2 of the WS than in the normal group. Analysis of intima-media thickness (IMT) and ankle brachial pressure index (ABI), which are risk indicators for vascular disorder, showed that IMT of the carotid bulb was greater in the group with delayed T1/2 of the WS than in the normal group (2·41 mm [1·50-2·81] versus 1·40 mm [0·81-2·08], P = 0·015). T1/2 of the WS correlated positively with IMT of the carotid bulb (r = 0·391, P = 0·027) and negatively with ABI (r = -0·389, P = 0·028). These correlations were mainly attributed to PS and were the same in patients without autonomic neuropathy. In seven of nine patients who received scintigraphy again after diabetic treatment, glycosylated haemoglobin (HbA1c) levels decreased and T1/2 of the WS shortened compared with before treatment. Conclusion: Vascular disorder, among other cofactors such as autonomic neuropathy, could be involved in the pathophysiology of delayed gastric emptying. Medium- to long-term glycaemic control was associated with gastric emptying. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley &amp
Sons Ltd.

DOI： 10.1111/cpf.12079

PubMed

Publishing type：Research paper (scientific journal)  

術前画像所見から適切な手術戦略を立てるため、原発性副甲状腺機能亢進症(pHPT)の病変箇所の確定におけるテクネチウムセスタミビ(99mTc-MIBI)SPECT/CTの有効性を99mTc-MIBIプラナースキャンおよび超音波(US)スキャンの有効性と比較した。副甲状腺摘出術で単一の腺腫が認められたpHPT患者61名(平均63.5±12.5歳、男性9名、女性52名)を対象に、術前画像検査の結果について有効性を評価した。USスキャン(n=61)により56例、プラナースキャン(n=61)により52例、SPECT/CT(n=52)により46例に病変が検出された。病変の正確な位置が確定された割合は、USスキャン、プラナースキャン、SPECT/CTの単一モダリティーでそれぞれ77.0%、75.4%、88.5%であり、USスキャンとプラナースキャンの組み合わせ(n=42)およびUSスキャンとSPECT/CTの組み合わせ(n=37)でそれぞれ90.5%および100%であった。以上の結果から、USスキャンと99mTc-MIBI SPECT/CTによる画像診断の結果の一致により術前に高い信頼性で病変位置が確定できることが示唆された。

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

縦隔における異所性副甲状腺機能亢進性病変の低侵襲性集中切除において、術中ラジオナビゲーションの適用を試み、その意義を評価した。異所性縦隔副甲状腺機能亢進を呈する症例5例に対して、術中ラジオナビゲーション手術を施行した。MIBI(methoxyisobutylisonitrile)-SPECTを用いて、外科的アプローチを計画した。99mTc-MIBI(11.1MBq/kg)を手術の2時間前に投与し、術中に携帯式ガンマ線プローブを用いて病変の放射活性を検出した。大動脈弓に認められた2病変を、左胸腔鏡下切除により摘出した。気管分岐部に認められた他の2病変には、右開胸術によるアプローチを適用した。ラジオガイド下で、隠れた2つの腺腫を隣接リンパ節と共に一括切除した。動脈管索に位置する他の病変は胸骨分割により切除した。切除された全病変で放射活性の蓄積が検出され、術野の放射活性は減少した。

Publishing type：Research paper (scientific journal)  

Purpose: Surgical removal of a mediastinal ectopic parathyroid is always challenging. We attempted to apply intraoperative radio-guided navigation for the minimally invasive focused removal of ectopic hyperparathyroid lesions in the mediastinum, and evaluated its significance. Methods: Five cases with ectopic mediastinal hyperfunctioning parathyroid were treated by intraoperative radio-guided navigation surgery. MIBI (methoxyisobutylisonitrile)-SPECT (single-photon emission computed tomography) was used to plan the surgical approach. 99mTc-MIBI (11.1 MBq/kg) was administered 2 h before surgery, and a handheld gamma probe was used intraoperatively to detect radioactivity in the lesion. Results: Two lesions found on the aortic arch were excised by left thoracoscopic resection. Two other lesions on the tracheal bifurcation were approached by right thoracotomy. We could remove two hidden adenomas by en bloc resection with the adjacent lymph nodes under radio-guidance. Another lesion, located at the ligamentum arteriosum, was excised with sternal division. Accumulations of radioactivity were identified in all lesions removed, with decreased radioactivity in the surgical field. Conclusions: Intraoperative radio-guided navigation is a useful tool for the focused removal of an ectopic mediastinal parathyroid by providing instant feedback to help guide the surgeon, while also providing precise localization of lesions. © 2013 Springer Japan.

DOI： 10.1007/s00595-013-0547-z

PubMed

Publishing type：Research paper (scientific journal)  

縦隔における異所性副甲状腺機能亢進性病変の低侵襲性集中切除において、術中ラジオナビゲーションの適用を試み、その意義を評価した。異所性縦隔副甲状腺機能亢進を呈する症例5例に対して、術中ラジオナビゲーション手術を施行した。MIBI(methoxyisobutylisonitrile)-SPECTを用いて、外科的アプローチを計画した。99mTc-MIBI(11.1MBq/kg)を手術の2時間前に投与し、術中に携帯式ガンマ線プローブを用いて病変の放射活性を検出した。大動脈弓に認められた2病変を、左胸腔鏡下切除により摘出した。気管分岐部に認められた他の2病変には、右開胸術によるアプローチを適用した。ラジオガイド下で、隠れた2つの腺腫を隣接リンパ節と共に一括切除した。動脈管索に位置する他の病変は胸骨分割により切除した。切除された全病変で放射活性の蓄積が検出され、術野の放射活性は減少した。

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

We evaluated the efficacy of technetium-sestamibi (^99m Tc-MIBI) SPECT/CT for planning parathyroidectomy in cases with primary hyperparathyroidism (pHPT), comparing with planar scintigraphy and ultrasound (US), in an aim to establish the proper surgical strategy according to the preoperative imaging studies. A retrospective review of consecutive 75 pHPT patients who had been operated on was conducted. The results of preoperative imaging modalities and the operative finding were analyzed. Seven cases were found to have multiple hyperplastic glands, and no responsible gland was found in three cases. Four cases underwent only US scan for preoperative imaging. Remaining 61 cases were found to have single adenoma, and were included in the evaluation of localization imaging. US scan, ^99m Tc-MIBI planar scan and ^99mTc-MIBI SPECT/CT showed accurate localization in 77.0% (47/61), 75.4% (46/61) and 88.5% (46/52) of the evaluable cases, respectively. US and ^99m Tc-MIBI planar scan demonstrated consistent result in 42 cases (68.9%), and those cases showed accurate localization in 90.5% (38/42). When both US and ^99m Tc-MIBI SPECT/CT was consistent, all 37 lesions had been correctly indicated. No clinico-pathological features were suggested to influence in demonstrating the localization, other than only ^99m Tc-MIBI SPECT/CT exhibited 100% sensitivity in ectopic glands. Combination of US and ^99m Tc-MIBI SPECT/CT certainly contributes to the planning of minimally invasive operation in cases with pHPT by indicating correct localization of single adenoma.

DOI： 10.1507/endocrj.EJ13-0292

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.18973/nuclearmedicinejsrt.68.0_13

CiNii Article

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

骨シンチグラフィ画像で総カウント数800、400、100カウントの元画像と平滑化フィルタ適用の処理画像を平均二乗平方根誤差(RMSE)とパワースペクトル密度(PSD)を用いて2000カウントの目標画像と比較した。目標画像に対するRMSE値は元画像:0.083～0.018、ガウシアンフィルタ:0.028～0.016、バイラテラルフィルタ:0.026～0.013であり、処理画像の目標画像に対するRMSE値は元画像のそれより低値を示し、バイラテラルフィルタではガウシアンフィルタより低値であった。処理画像のPSDは全周波数帯で目標画像のPSDに対し低値を示した。処理画像の最適な全分散値はバイラテラルフィルタ:0.53～1.45とガウシアンフィルタ:0.43～1.10より大きかった。バイラテラルフィルタの最適な空間分散値は0.52～1.37、画素分散値は0.13～0.41であった。二次元で各分散値のなす角は平均0.25radianであり、空間分散値は全分散値の0.97倍、画素分散値は0.25倍であった。

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

骨シンチグラフィ画像で総カウント数800、400、100カウントの元画像と平滑化フィルタ適用の処理画像を平均二乗平方根誤差(RMSE)とパワースペクトル密度(PSD)を用いて2000カウントの目標画像と比較した。目標画像に対するRMSE値は元画像:0.083〜0.018、ガウシアンフィルタ:0.028〜0.016、バイラテラルフィルタ:0.026〜0.013であり、処理画像の目標画像に対するRMSE値は元画像のそれより低値を示し、バイラテラルフィルタではガウシアンフィルタより低値であった。処理画像のPSDは全周波数帯で目標画像のPSDに対し低値を示した。処理画像の最適な全分散値はバイラテラルフィルタ:0.53〜1.45とガウシアンフィルタ:0.43〜1.10より大きかった。バイラテラルフィルタの最適な空間分散値は0.52〜1.37、画素分散値は0.13〜0.41であった。二次元で各分散値のなす角は平均0.25radianであり、空間分散値は全分散値の0.97倍、画素分散値は0.25倍であった。

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Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

PubMed

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Publishing type：Research paper (scientific journal)  

The aim of this study is to improve the image quality using a post process rather than a correction process at acquisition time. We used a smoothing filter that is widely used on a compact digital camera. Especially for nuclear medicine, when we use a short acquisition time, we will get images that have a large increase in statistical noise. For those images, we validated the efficiency of the smoothing filter by assessing two characteristic parameters. In addition, we defined the best smoothing filter parameters to get stable images that reduced the influence of statistical noise.

DOI： 10.6009/jjrt.2013_JSRT_69.12.1363

CiNii Article

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We describe the case of chylothorax after esophagectomy for esophageal carcinoma. Lymphoscintigraphy with Tc-99m-human serum albumin- diethylenetriaminepentaacetic acid showed an abnormal radioisotope accumulation on the left side of the thoracic duct. Single-photon emission computed tomography (SPECT) combined with computed tomography (CT) revealed a hot spot directly on the site at, which the thoracic duct was ligated during surgery, which was the suggested site of chyle leakage. We emphasize that lymphoscintigraphy with SPECT/CT is very useful tool for accurately identifying the site of the chyle leakage.

DOI： 10.4103/0972-3919.112749

PubMed

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F-18 FDG PET/CT has been widely used to diagnose primary tumors and lymph node metastases and to evaluate the response of head and neck squamous cell carcinoma (HNSCC) to therapy. The advantage of using PET/CT is that this combination allows metabolic information to be precisely overlapped with anatomical information, thereby improving the identification of sites with an abnormal accumulation of F-18 FDG. The role of FDG PET/CT in the therapeutic evaluation (such as in treatment planning, the therapeutic response, and the surveillance and examination of HNSCC patients) is discussed in this manuscript. When evaluating the post-treatment outcome via FDG PET/CT, it is important to exclude the posttreatment inflammation-related increase in glucose metabolism in lymph nodes, salivary gland, muscles, and soft tissues. The influence of inflammation can be eliminated if PET/CT is performed after 12 weeks, by which time posttreatment inflammation subsides. Further, FDG PET/CT affords a high negative predictive value. Based on the results of an FDG PET/CT test, some invasive tests that are performed to detect recurrence can be omitted. © Japan Radiological Society 2012.

DOI： 10.1007/s11604-012-0076-5

PubMed

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Background: and Objectives Gastroparesis, a gastrointestinal autonomic neuropathy, is a common adverse reaction in chronic hepatitis C (CHC) patients receiving interferon therapy. Current therapeutic options are limited. We evaluated the efficacy of mosapride for IFN-induced gastroparesis. Methods Twenty-four consecutive CHC patients were randomly assigned to either the control group, which received pegylated interferon α-2b at 1.5 μg/kg/week and ribavirin at 600-1,000 mg/day, depending on body weight (PegIFN/RBV), or the mosapride group, which received PegIFN/RBV plus mosapride at 15 mg/person/day. The solid-phase gastric emptying half-times (T1/2) of the total, proximal, and distal stomach (scintigraphy) and digestive symptoms (questionnaire) were measured within one week before and four weeks after initiation of the assigned therapy. The test meal comprised a 200-g pancake containing Tc-99m diethylenetriamine pentaacetic acid. Results: In the control group, after PegIFN/RBV initiation, a significant increase was observed in the total T1/2 (before: 84.0 ± 22.1 min versus after: 100.8 ± 28.9 min, P = 0.03), the distal T1/2 (before: 95.3 ± 32.2 min versus after: 115.3 ± 41.4 min, P = 0.03), and digestive symptom score (before: 3.2 ± 1.4 versus after: 8.1 ± 4.8, P = 0.02)
proximal T1/2 change was not significant. In the mosapride group, no significant delays were observed in the total, proximal, and distal T1/2 values
the change in symptom scores was not significant. Conclusions: Mosapride improved total and distal gastric motility in IFN-induced gastroparesis, and consequently relieved symptoms. © Springer Science+Business Media, LLC 2012.

DOI： 10.1007/s10620-012-2085-8

PubMed

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Background/Aims: We previously found that some cases of clinically diagnosed Alzheimer's disease (AD) were rated as Pittsburgh compound B (PiB) negative by amyloid imaging (i.e. cases of PiB-negative dementia). The present study was designed to analyze the clinical features of PiB-negative dementia patients in detail. Methods: Of the 64 cases of clinically diagnosed AD, 14 were rated PiB negative. Eleven of these were further analyzed using CSF biomarker levels and findings from MRI, FDG-PET, 123I-MIBG myocardial scintigraphy and voxel-based morphometry (VBM). Results: When examined by 123I-MIBG myocardial scintigraphy, the heart/mediastinum ratio was significantly higher in the PiB-negative dementia group than in the dementia with Lewy bodies (DLB) group. Analyses of CSF biomarkers and MRI and FDG-PET findings suggested argyrophilic grain disease (AGD) in 3 cases, frontotemporal lobar degeneration (FTLD) in 3 cases, neurofibrillary tangle-predominant dementia (NFTD) in 1 case, and AD in 2 cases. In the VBM data analysis, the PiB-positive AD group showed significant atrophy of both hippocampi compared with the healthy control group, while the PiB-negative dementia group presented with significant atrophy of the left precuneus. Conclusion: PiB-negative dementia is unlikely to include DLB, while it most likely includes diseases of tauopathy, such as FTLD, AGD and NFTD. A better understanding of PiB-negative dementia is expected to further improve the accuracy of the clinical AD diagnosis. Copyright © 2012 S. Karger AG, Basel.

DOI： 10.1159/000341577

PubMed

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Publishing type：Research paper (scientific journal)  

DOI： 10.11477/mf.1428100470

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CiNii Article

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Publishing type：Research paper (scientific journal)  

Fluorodeoxyglucose (FDG), which allows the evaluation of glucose metabolism, is widely used for tumor diagnosis using positron emission tomography (PET). FDG-PET, which is used for the diagnosis of intrahepatic tumor lesions, shows high FDG accumulation in cholangiocellular carcinoma (CCC) and metastatic liver cancer. FDG-PET shows high FDG accumulation in moderately or poorly differentiated hepatocellular carcinoma (HCC) and is useful for the diagnosis of extrahepatic HCC metastases and recurrences. However, because the imaging method frequently shows low FDG accumulation in well-differentiated HCC, it is not very useful for that diagnosis. For the diagnosis of well-differentiated HCC, F-18 fluorocholine for evaluation of phospholipid metabolism and C-11 acetate for evaluation of free fatty acid metabolism are useful in the diagnosis of that HCC. It is expected that the combination of these PET agents will enhance the diagnostic performance of FDG-PET for HCC in the future. The problem of a lack of anatomical information is being resolved with the development of the use of PET in combination with computed tomography or magnetic resonance imaging. For the problem of low resolution, PET devices using semiconductors have been developed. © 2011 The Japan Society of Hepatology.

DOI： 10.1111/j.1872-034X.2011.00819.x

PubMed

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PubMed

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アルツハイマー型認知症(DAT)に対するdonepezilの効果について関心領域(ROI)分析を用いて評価する際の、fluorine-18-fluorodeoxyglucose(FDG)-positron emission tomography(PET)の有用性について検討した。Diagnostic and Statistical Manual of Mental Disorders第4版(DSM-IV)に従ってDATと診断された外来患者11名を対象とした。Donepezil治療の開始前と投薬12週後にFDG-PETを受けた。認知変化はAlzheimer's disease Assessment Scale cognitive subscale日本版(ADAS-Jcog)を用いて測定し、その結果に基づいてグループを応答者と非応答者に分けた。脳のグルコース代謝を調べるためにFDG-PETを用い、脳の各葉に設定したROIのFDG取込みを測定した。治療前の取込みに対する治療後の取込みの比を求めた。応答者では前頭葉、側頭葉、後頭葉、頭頂葉、側頭頭頂葉における平均比率はそれぞれ2.18、1.62、1.15、1.12、1.09であった。前頭葉と後頭葉において応答者と非応答者の間に有意差が見られた。これらの所見からFDG-PETはdonepezilへの反応のモニター評価に有用であると思われた。

Publishing type：Research paper (scientific journal)  

アルツハイマー型認知症(DAT)に対するdonepezilの効果について関心領域(ROI)分析を用いて評価する際の、fluorine-18-fluorodeoxyglucose(FDG)-positron emission tomography(PET)の有用性について検討した。Diagnostic and Statistical Manual of Mental Disorders第4版(DSM-IV)に従ってDATと診断された外来患者11名を対象とした。Donepezil治療の開始前と投薬12週後にFDG-PETを受けた。認知変化はAlzheimer's disease Assessment Scale cognitive subscale日本版(ADAS-Jcog)を用いて測定し、その結果に基づいてグループを応答者と非応答者に分けた。脳のグルコース代謝を調べるためにFDG-PETを用い、脳の各葉に設定したROIのFDG取込みを測定した。治療前の取込みに対する治療後の取込みの比を求めた。応答者では前頭葉、側頭葉、後頭葉、頭頂葉、側頭頭頂葉における平均比率はそれぞれ2.18、1.62、1.15、1.12、1.09であった。前頭葉と後頭葉において応答者と非応答者の間に有意差が見られた。これらの所見からFDG-PETはdonepezilへの反応のモニター評価に有用であると思われた。

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Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.neures.2011.07.862

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Publishing type：Research paper (scientific journal)  

Aims: Depressive symptoms are common in patients with dementia of Alzheimer type (DAT) and contribute to clinical morbidity. Previous studies have suggested that hypoperfusion in the prefrontal cortex and anterior cingulate gyrus are involved in the pathophysiology of depression in DAT. Using 3-D stereotactic region of interest (ROI) template (3DSRT), fully automated ROI analysis software, the purpose of the present study was to investigate the relationship between depressive symptoms and regional cerebral blood flow (rCBF) in DAT.
Methods: Technetium-99m-ethyl cysteinate dimer (99mTc-ECD) single-photon emission computed tomography (SPECT) and Japanese version of the Neuropsychiatric Inventory (NPI) were carried out in 35 patients diagnosed as having mild-moderate DAT according to DSM-IV. These patients were divided into the depressive group (D group: n = 17) and non-depressive group (ND group: n = 18) using the NPI depression items. All data from SPECT images were analyzed using 3DSRT software. On 3DSRT the perfusion ratios (rCBF of bilateral callosomarginal, precentral, central, parietal, angular, temporal, posterior cerebral, pericallosal, lenticular nucleus, thalamus and hippocampus/cerebellar hemisphere) of each segment were compared between the D group and the ND group.
Results: The perfusion ratios of the left callosomarginal segment for the D group were significantly lower (P &lt; 0.05) than those of the ND group.
Conclusions: Hypoperfusion in the left frontal cortex contributes to the expression of depressive symptoms in patients with DAT.

DOI： 10.1111/j.1440-1819.2010.02083.x

PubMed

Publishing type：Research paper (scientific journal)  

完全自動化のstereotactic region of interest(ROI)分析ソフトウェアである3D stereotactic ROI template(3DSRT)を用いて、アルツハイマー型認知症(DAT)における抑うつ症状と局所脳血流量(rCBF)との関係について検討した。DSM-IVによる軽度～中等度のDATを有すると診断された患者35例(男性10名、女性25名)について、99mTc-ECD SPECTおよび日本語版Neuropsychiatric Inventory(NPI)を実施した。NPIの抑うつ項目を用いて、患者を抑うつ群(D群、n=17)および非抑うつ群(ND群、n=18)に分類した。SPECT画像からの全データについて3DSRTを用いて解析した。3DSRTにて、各領域の灌流率(両側の脳梁縁、中心前回、中心回、頭頂部、角回、側頭部、後脳、脳梁周囲、レンズ核、視床、海馬/小脳半球のrCBF)をD群とND群で比較した。D群における左脳梁縁領域の灌流率は、ND群に比べて有意に低かった。DAT患者においては、左前頭皮質の低灌流が抑うつ症状の発現に寄与していた。

Publishing type：Research paper (scientific journal)  

完全自動化のstereotactic region of interest(ROI)分析ソフトウェアである3D stereotactic ROI template(3DSRT)を用いて、アルツハイマー型認知症(DAT)における抑うつ症状と局所脳血流量(rCBF)との関係について検討した。DSM-IVによる軽度〜中等度のDATを有すると診断された患者35例(男性10名、女性25名)について、99mTc-ECD SPECTおよび日本語版Neuropsychiatric Inventory(NPI)を実施した。NPIの抑うつ項目を用いて、患者を抑うつ群(D群、n=17)および非抑うつ群(ND群、n=18)に分類した。SPECT画像からの全データについて3DSRTを用いて解析した。3DSRTにて、各領域の灌流率(両側の脳梁縁、中心前回、中心回、頭頂部、角回、側頭部、後脳、脳梁周囲、レンズ核、視床、海馬/小脳半球のrCBF)をD群とND群で比較した。D群における左脳梁縁領域の灌流率は、ND群に比べて有意に低かった。DAT患者においては、左前頭皮質の低灌流が抑うつ症状の発現に寄与していた。

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Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Because of the chronic shortage of liver donors, hepatologists are required to prolong the liver transplant waiting period by preserving the hepatic reserve of scheduled recipients. This study examined the effectiveness of oral branched-chain amino acids (BCAAs), using outcome markers indicating pretransplant hepatic reserve. Fifty-six consecutive eligible patients with Child class A cirrhosis without major complications were randomly assigned to receive oral BCAA granules (12.45 g/day) for least 1 year or no BCAAs. Differences between groups in the Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh (CTP) score, asialoscintigraphic clearance index (Cl), and complications were examined. Of 50 remaining patients, 27 received BCAAs, and 23 received no BCAAs (mean duration, 3.2 years). The mean annual changes in the MELD score, CTP score, and asialoscintigraphic Cl were smaller in the BCAA group than in the control group (-0.06 +/- 0.23 versus 0.10 +/- 0.40, P = 0.024, 0.06 +/- 0.30 versus 0.30 +/- 0.48, P = 0.037, and 0.00 +/- 0.02 versus 0.02 +/- 0.04, P = 0.040, respectively). The mean annual changes in the serum total bilirubin and the serum albumin in the BCAA group were better preserved than those in the control group (-0.07 +/- 0.20 versus 0.12 +/- 0.18 mg/dL, P &lt; 0.001, and 0.07 +/- 0.13 versus -0.02 +/- 0.19 g/dL, P = 0.005, respectively); other laboratory variables were not significant. The incidence of overall major cirrhotic complications was lower in the BCAA group than in the control group [14.8% (4 of 27 patients) versus 30.4% (7 of 23 patients) at 3 years, P = 0.043]; only ascites was significant individually. In conclusion, early interventional oral BCAAs might prolong the liver transplant waiting period by preserving hepatic reserve in cirrhosis. Liver Transpl 15:790-797, 2009. (C) 2009 AASLD.

DOI： 10.1002/lt.21758

PubMed

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CiNii Article

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We report a 60-year-old-woman with a huge intracardiac angiosarcoma in whom preoperative F-18 fluorodeoxyglucose (FDG) PET was useful for confirming malignancy of the tumor and determining whether surgery was indicated for it. Her chief complaint was dyspnea. Because she was suspected to have a huge intracardiac tumor on the basis of transthoracic echocardiographic and computed tomography (CT) findings, FDG PET was performed, and the maximum standardized uptake value (SUV) of the tumor was found to be 5.6. Because other tests and SUV level suggested a malignant cardiac tumor, surgical resection of it was attempted. On histopathological examination, the tumor was found to be an angiosarcoma. Our experience with this case indicates that, when dealing with patients suspected to have very large tumors, FDG PET is useful in examination for malignant potential and is indispensable in exploration for distant metastases.

DOI： 10.1097/RLU.0b013e318192c3e3

PubMed

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Publishing type：Research paper (scientific journal)  

We report a 60-year-old-woman with a huge intracardiac angiosarcoma in whom preoperative F-18 fluorodeoxyglucose (FDG) PET was useful for confirming malignancy of the tumor and determining whether surgery was indicated for it. Her chief complaint was dyspnea. Because she was suspected to have a huge intracardiac tumor on the basis of transthoracic echocardiographic and computed tomography (CT) findings, FDG PET was performed, and the maximum standardized uptake value (SUV) of the tumor was found to be 5.6. Because other tests and SUV level suggested a malignant cardiac tumor, surgical resection of it was attempted. On histopathological examination, the tumor was found to be an angiosarcoma. Our experience with this case indicates that, when dealing with patients suspected to have very large tumors, FDG PET is useful in examination for malignant potential and is indispensable in exploration for distant metastases.

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CiNii Article

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DOI： 10.1007/s12149-008-0208-2

PubMed

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CiNii Article

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CiNii Article

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Depressive symptoms are common in Alzheimer's disease (AD) and contribute to clinical morbidity. Previous studies have suggested that hypoperfusion in the prefrontal cortex and anterior cingulate gyrus are involved in the pathophysiology, of depression. Using the easy Z-score imaging system (eZIS), we investigated the relationship between depressive symptoms and prefrontal hypoperfusion in AD. Tc-99m-ethyl cysteinate dimer (Tc-99m-ECD)-single photon emission tomography (SPECT) and Neuropsychiatric Inventory (NPI) were performed in forty-four patients diagnosed as having Dementia of Alzheimer's type (DAT) with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). These patients were divided into the depressive group (D group: n = 26) and non-depressive group (ND group: n = 18) using NPI depression items. All data from SPECT images were analyzed using eZIS software. Scores in four regions were determined by Z-values: these regions consisted of each side of the prefrontal cortex and anterior cingulate gyrus. The mean scores between the D group and ND group were compared. The mean scores of the left prefrontal cortex in the D group were significantly higher (p &lt; 0.0125) than those in the ND group. There were no significant differences in the scores of the right prefrontal cortex and the bilateral anterior cingulate gyrus between these two groups (Mann-Whitney U-test). These findings suggest that hypoperfusion in the left prefrontal area contributes to the expression of depressive symptoms in patients with DAT. (c) 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.neulet.2008.06.053

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CiNii Article

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DOI： 10.1007/s12149-007-0101-4

PubMed

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DOI： 10.1007/s12149-007-0116-x

PubMed

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PubMed

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Background/Aims: The purpose of this study was to validate the usefulness of positron emission tomography with fluorine-18-fluoiodeoxyglucose (FDG-PET) in predicting degree of malignancy and prognosis, evaluated in terms of Japan Integrated Staging (JIS) score, in cirrhotic patients with hepatocellular carcinoma (HCC).
Methodology: FDG-PET was performed in 50 patients with HCC. The activity within regions of interest placed over tumors was measured, and standardized uptake values (SUVs) were calculated by dividing the tissue activity by injected dose of radioactivity per unit body weight. SUV ratio (SUVR) was expressed as tumor-to-nontumor ratio of SUV. Patients were allocated to 3 groups of similar size: group A, SUVR &lt;= 51.1; group B, 1.1 &lt; SUVR &lt; 1.6; and group C, 1.6 &lt;= SUVR.
Results: SUVR significantly correlated with tumor node metastasis stage score (p &lt; 0.001) or JIS score (p=0.022). Survival rate in SUVR group C Was significantly lower than that in group A (p &lt; 0.001), and close to being significantly lower than that in group B. On multivariate analysis, JIS scores 2 and &gt;= 3, SUVR group C were significantly related to survival (All p &lt; 0.05).
Conclusions: SUVR was well associated with a tumor staging which is the factor of JIS score and with survival, and indicated malignancy and prognosis of patients especially with high-grade HCC.

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PubMed

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We report a 56-year-old man who underwent monitoring of the response to chemotherapy of malignant pleural mesothelioma (MPM). ⁸F-fluoro-2-deoxy-_D-glucose positron emission tomography (FDG-PET) and computed tomography (CT) were performed prior to chemotherapy and after the first and second courses of chemotherapy. The tumor lesion exhibited shrinkage on CT and a decrease in the standardized uptake value (SUV) max after the first course of chemotherapy, but exhibited size enlargement and an increase in SUV max after the second course of chemotherapy. These findings suggest that results of quantification of metabolic response by FDG-PET are related to the objectiveresponse as determined by CT in patients with MPM.<br>

DOI： 10.2169/internalmedicine.47.1462

CiNii Article

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DOI： 10.11477/mf.1427100625

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DOI： 10.1097/RLU.0b013e318156bb67

PubMed

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Publishing type：Research paper (scientific journal)  

We report a 44-year-old-man with a biliary-gastric fistula in whom Tc-99m Sn-N-pyridoxyl-5-methyltryptophan (PMT) hepatobiliary scintigraphy was useful in determining indications for surgery. A small orifice suspected to be the opening of a biliary-gastric fistula was found on upper endoscopy, and an anatomic structure suspected to be a gastrobiliary fistula was detected on magnetic resonance cholangiopancreatography (MRCP). Tc-99m PMT hepatobiliary scintigraphy revealed continuous flow of bile into the stomach through the fistula. Flow of bile into the stomach through a fistula can cause gastric cancer, and is therefore indicated for surgical treatment. Tc-99m PMT hepatobiliary scintigraphy was useful in determining the indications for surgery.

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CiNii Article

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CiNii Article

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CiNii Article

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CiNii Article

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CiNii Article

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DOI： 10.1007/s12149-007-0008-0

PubMed

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DOI： 10.1007/s12149-007-0014-2

PubMed

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This report describes a case of secondary obsessive-compulsive disorder related to diaschisis after pontine infarction. A 71-year-old male developed obsessive images, after a pontine infarction. A brain magnetic resonance imaging scan showed a low intensity area in the right pons on T1-weighted image, while brain single photon emission computed tomography showed low cerebral blood flow in the temporal lobe as well as the pons. In this case, infarction in the pons appeared to cause dysfunction in the temporal lobe via the neural projection network, an example of so-called 'diaschisis'. This case suggests that brainstem infarction and decreased temporal lobe perfusion can lead to secondary obsessive-compulsive disorder.

DOI： 10.1111/j.1440-1819.2007.01635.x

PubMed

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CiNii Article

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DOI： 10.1007/BF03033994

PubMed

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Publishing type：Research paper (scientific journal)  

Objective: Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is sometimes used as a means of follow-up after diagnosis and treatment of cancers of the head and neck region. The present study was undertaken to evaluate the ability of FDG-PET to detect local residual tumor after treatment of laryngeal cancer. Methods: Thirty-six patients with laryngeal cancer underwent FDG-PET before and after initial treatment. Of these patients, 20 received FDG-PET before treatment and 28 received it after treatment. The relationship between standardized uptake values (SUV) and the presence or absence of local residual tumor was investigated by setting the cut-off value of the SUV using the receiver operating characteristics (ROC) curve. Results: When the pre-treatment SUV threshold for laryngeal cancer was set at 7.20, the detection of local residual tumor after treatment using FDG-PET had a sensitivity of 77.78%, specificity of 81.82%, false positive rate of 18.18%, false negative rate of 22.22%, accuracy of 80% and a p value of 0.02. When the post-treatment SUV threshold for the larynx was set at 3.35, the test had a sensitivity of 93.75%, specificity of 91.67%, false positive rate of 8.33%, false negative rate of 6.25%, accuracy of 92.86% and a p value of 0.0001. Conclusions: FDG-PET was found to be useful for determining the presence of local residual tumor after treatment of laryngeal cancer.

Publishing type：Research paper (scientific journal)  

Objective: Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is sometimes used as a means of follow-up after diagnosis and treatment of cancers of the head and neck region. The present study was undertaken to evaluate the ability of FDG-PET to detect local residual tumor after treatment of laryngeal cancer. Methods: Thirty-six patients with laryngeal cancer underwent FDG-PET before and after initial treatment. Of these patients, 20 received FDG-PET before treatment and 28 received it after treatment. The relationship between standardized uptake values (SUV) and the presence or absence of local residual tumor was investigated by setting the cut-off value of the SUV using the receiver operating characteristics (ROC) curve. Results: When the pre-treatment SUV threshold for laryngeal cancer was set at 7.20, the detection of local residual tumor after treatment using FDG-PET had a sensitivity of 77.78%, specificity of 81.82%, false positive rate of 18.18%, false negative rate of 22.22%, accuracy of 80% and a p value of 0.02. When the post-treatment SUV threshold for the larynx was set at 3.35, the test had a sensitivity of 93.75%, specificity of 91.67%, false positive rate of 8.33%, false negative rate of 6.25%, accuracy of 92.86% and a p value of 0.0001. Conclusions: FDG-PET was found to be useful for determining the presence of local residual tumor after treatment of laryngeal cancer.

Publishing type：Research paper (scientific journal)  

Objective: Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is sometimes used as a means of follow-up after diagnosis and treatment of cancers of the head and neck region. The present study was undertaken to evaluate the ability of FDG-PET to detect local residual tumor after treatment of laryngeal cancer. Methods: Thirty-six patients with laryngeal cancer underwent FDG-PET before and after initial treatment. Of these patients, 20 received FDG-PET before treatment and 28 received it after treatment. The relationship between standardized uptake values (SUV) and the presence or absence of local residual tumor was investigated by setting the cut-off value of the SUV using the receiver operating characteristics (ROC) curve. Results: When the pre-treatment SUV threshold for laryngeal cancer was set at 7.20, the detection of local residual tumor after treatment using FDG-PET had a sensitivity of 77.78%, specificity of 81.82%, false positive rate of 18.18%, false negative rate of 22.22%, accuracy of 80% and a p value of 0.02. When the post-treatment SUV threshold for the larynx was set at 3.35, the test had a sensitivity of 93.75%, specificity of 91.67%, false positive rate of 8.33%, false negative rate of 6.25%, accuracy of 92.86% and a p value of 0.0001. Conclusions: FDG-PET was found to be useful for determining the presence of local residual tumor after treatment of laryngeal cancer.

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CiNii Article

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PubMed

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CiNii Article

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DOI： 10.1007/BF02984683

PubMed

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Objective: Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). Methods: FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and SUV was calculated as an indicator of glucose metabolism. Results: Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. Conclusions: FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening.

Publishing type：Research paper (scientific journal)  

Objective: Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). Methods: FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and SUV was calculated as an indicator of glucose metabolism. Results: Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. Conclusions: FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening.

Publishing type：Research paper (scientific journal)  

Objective: Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). Methods: FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and SUV was calculated as an indicator of glucose metabolism. Results: Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. Conclusions: FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening.

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CiNii Article

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DOI： 10.1007/BF02984650

PubMed

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Publishing type：Research paper (scientific journal)  

A 53-year-old man with a history of nausea and elevated liver functions presented to our clinic. A CT scan showed a small tumor in the right lobe of the liver. Fluorine-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography confirm abnormal metabolic activity with a high standardized uptake value of 7.3 in the lesion. These findings could indicate a malignancy such as well-differentiated hepatocellular carcinoma or cholangiocarcinoma, or a benign lesion such as hepatic abscess. He was diagnosed by histopathological examination as having an epithelioid granuloma with many inflammatory cells. This is the rare report of hepatic inflammatory pseudotumor featuring markedly increased F-18-FDG uptake.

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A 53-year-old man with a history of nausea and elevated liver functions presented to our clinic. A CT scan showed a small tumor in the right lobe of the liver. Fluorine-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography confirm abnormal metabolic activity with a high standardized uptake value of 7.3 in the lesion. These findings could indicate a malignancy such as well-differentiated hepatocellular carcinoma or cholangiocarcinoma, or a benign lesion such as hepatic abscess. He was diagnosed by histopathological examination as having an epithelioid granuloma with many inflammatory cells. This is the rare report of hepatic inflammatory pseudotumor featuring markedly increased F-18-FDG uptake.

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DOI： 10.11477/mf.1409100068

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CiNii Article

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CiNii Article

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PubMed

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Objective: The aim of this study is to evaluate an imaging approach using computed tomography (CT), magnetic resonance imaging (MRI), technetium-99m pertechnetate scintigraphy (99mTc pertechnetate scintigraphy), gallium-67 scintigraphy (67Ga scintigraphy) and fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET). Material and Methods: We reviewed retrospectively 59 patients with parotid masses. CT, MRI, 67Ga scintigraphy, 99mTc pertechnetate scintigraphy, and 18F-FDG PET were performed. Results: All of the benign tumors had smooth margins on CT and MRI. Patients with inflammatory lesions and malignant lesions showed well-defined margins or ill-defined margins. All Warthin's tumors showed high technetium accumulation. Many of malignant tumors showed high FDG accumulation. Both pleomorphic adenomas and Warthin's tumors showed high accumulation in some cases on 18F-FDG PET. Among 15 patients with pleomorphic adenoma, 14 patients showed marked hyperintensity relative to CSF on T2-weighted images and partial enhancement on contrast-enhanced T1-weighted images. Combination of several imaging modarity offered usefulness of differential diagnosis for parotid masses. Conclusion: An efficient combination of imaging methods may be helpful for achieve the correct diagnosis.

DOI： 10.1007/BF02489988

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CiNii Article

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CiNii Article

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DOI： 10.1007/BF02985116

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DOI： 10.1097/01.rlu.0000187611.64235.61

PubMed

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Objective: The uptake of L-methyl-C-11-methionine (MET) by gliomas is greater than that by intact tissue, making methionine very useful for evaluation of tumor extent. If the degree of malignancy of brain tumors can be evaluated by MET-PET, the usefulness of MET-PET as a means of diagnosing brain tumors will increase. Methods: We performed this study on 67 glioma patients between 3 and 69 years of age (36 males and 3 1 females). Tumors included diffuse astrocytoma, anaplastic astrocytoma, glioblastoma, ependymoma, oligodendroglioma, medulloblastoma, dysembryoplastic neuroepithelial tumor, choroid plexus papilloma, central neurocytoma, optic glioma, gliomatosis cerebri, pleomorphic xanthoastrocytoma, and ganglioglioma. Tumor activity and degree of malignancy were evaluated using Ki-67LI (LI: labeling index) and Kaplan-Meier survival curves. The correlations between methionine uptake and tumor proliferation (tumor versus contralateral gray matter ratio (T/N) and Ki-67LI) were determined for the group of all subjects. The existence of significant correlations between T/N and Ki-67LI and between SUV and Ki-67LI was determined for astrocytic tumors. Receiver operating characteristics (ROC) analysis of TIN and standardized uptake value (SUV) was performed for the group of astrocytic tumors. We also determined the ROC cut-off levels to ensure high accuracy of the analysis. Results: For the 67 cases of glioma, the degree of accumulation was variable. KI-67LI differed significantly between the high-grade group and low-grade group at T/N levels between 1.5 and 1.8 on analysis using tumor proliferative potential (p = 0.019-0.031). The prognosis differed significantly between the high-grade and low-grade groups when T/N was in the range of 1.6-1.8 (p = 0.028-0.032). The accuracy thus calculated was highest (85.7%) when T/N was 1.5 as determined by ROC analysis. Conclusions: When analysis was confined to cases of astrocytic tumor, a correlation was noted between methionine accumulation and Ki-67LI. For the astrocytic tumors, T/N ratio seemed to be more useful as a diagnostic indicator than SUV. The cut-off level of T/N ratio for distinction between high-grade and low-grade astrocytoma appears to lie between 1.5 and 1.6.

Publishing type：Research paper (scientific journal)  

Objective: The uptake of L-methyl-C-11-methionine (MET) by gliomas is greater than that by intact tissue, making methionine very useful for evaluation of tumor extent. If the degree of malignancy of brain tumors can be evaluated by MET-PET, the usefulness of MET-PET as a means of diagnosing brain tumors will increase. Methods: We performed this study on 67 glioma patients between 3 and 69 years of age (36 males and 3 1 females). Tumors included diffuse astrocytoma, anaplastic astrocytoma, glioblastoma, ependymoma, oligodendroglioma, medulloblastoma, dysembryoplastic neuroepithelial tumor, choroid plexus papilloma, central neurocytoma, optic glioma, gliomatosis cerebri, pleomorphic xanthoastrocytoma, and ganglioglioma. Tumor activity and degree of malignancy were evaluated using Ki-67LI (LI: labeling index) and Kaplan-Meier survival curves. The correlations between methionine uptake and tumor proliferation (tumor versus contralateral gray matter ratio (T/N) and Ki-67LI) were determined for the group of all subjects. The existence of significant correlations between T/N and Ki-67LI and between SUV and Ki-67LI was determined for astrocytic tumors. Receiver operating characteristics (ROC) analysis of TIN and standardized uptake value (SUV) was performed for the group of astrocytic tumors. We also determined the ROC cut-off levels to ensure high accuracy of the analysis. Results: For the 67 cases of glioma, the degree of accumulation was variable. KI-67LI differed significantly between the high-grade group and low-grade group at T/N levels between 1.5 and 1.8 on analysis using tumor proliferative potential (p = 0.019-0.031). The prognosis differed significantly between the high-grade and low-grade groups when T/N was in the range of 1.6-1.8 (p = 0.028-0.032). The accuracy thus calculated was highest (85.7%) when T/N was 1.5 as determined by ROC analysis. Conclusions: When analysis was confined to cases of astrocytic tumor, a correlation was noted between methionine accumulation and Ki-67LI. For the astrocytic tumors, T/N ratio seemed to be more useful as a diagnostic indicator than SUV. The cut-off level of T/N ratio for distinction between high-grade and low-grade astrocytoma appears to lie between 1.5 and 1.6.

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We report two cases of poorly differentiated squamous cell carcinoma of the left maxillary sinus. Both patients had a similar clinical course and similar imaging findings. However, FDG uptake by the 2 lesions was very different. The SUVs of the tumor lesions of patient I and 2 were 20.67 and 7.56, respectively. Histopathologically, hematoxylin and eosin (H&E) stained sections (X200) were packed with tumor cells, with many more inflammatory cells seen in patient 1. When dealing with cases of carcinoma of the head neck region where tumors are often accompanied by inflammation, we should bear in mind that FDG uptake by tumors is strongly influenced by the activity and timing of inflammation within the tumor lesions.

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DOI： 10.11477/mf.1405100123

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CiNii Article

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DOI： 10.1007/BF02985582

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A 76-year-old woman was admitted to our hospital with a 2-month history of increasing abdominal distension, leg edema, and dyspnea. The serum transaminase level was about twice the upper limit of normal. The CT showed no tumor. Fluorine-18 2-deoxy-2-fluoro-(D)-glucose (FDG)-positron emission tomography (PET) showed diffuse abnormal accumulation throughout the entire liver. She was diagnosed by histopathological examination as having hepatic angiosarcoma causing veno-occlusive disease (VOD). This is the first report of hepatic angiosarcoma. with FDG-PET.

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A 76-year-old woman was admitted to our hospital with a 2-month history of increasing abdominal distension, leg edema, and dyspnea. The serum transaminase level was about twice the upper limit of normal. The CT showed no tumor. Fluorine-18 2-deoxy-2-fluoro-(D)-glucose (FDG)-positron emission tomography (PET) showed diffuse abnormal accumulation throughout the entire liver. She was diagnosed by histopathological examination as having hepatic angiosarcoma causing veno-occlusive disease (VOD). This is the first report of hepatic angiosarcoma. with FDG-PET.

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DOI： 10.3748/wjg.v11.i25.3882

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DOI： 10.1097/01.rlu.0000159906.78384.5e

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The authors report unusual splenic accumulation of Tc-99m hydroxymethylene diphosphonate (HMDP) on bone scintigraphy of a patient with alcoholic cirrhosis of the liver. Laboratory studies showed hemolytic anemia and hemochromatosis resulting from alcohol abuse, both of which are thought to be related to the diffuse splenic uptake observed. When diffuse splenic accumulation by Tc-99m HMDP is seen, the existence of alcoholic hepatopathy might be considered.

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Total pages：7   Responsible for pages：7   Book type：Scholarly book

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Total pages：27   Responsible for pages：27   Book type：Scholarly book

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副甲状腺機能亢進症は,腺腫や副甲状腺癌による原発性機能亢進症と透析後に発症する過形成による二次性機能亢進症がある。それらの治療は主に外科切除であり,患者への侵襲を減らすために正確な病変の存在診断・部位診断が重要である。本稿では,副甲状腺機能亢進症における画像診断である超音波検査と99mTc-2methoxy-2methylpropylisonitrile(99mTc-MIBI)シンチグラフィ検査について長所,短所,及び診断能について説明する。近年普及しつつあるSPECT/CTの有用性についても言及した。(著者抄録)

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副甲状腺機能亢進症は,腺腫や副甲状腺癌による原発性機能亢進症と透析後に発症する過形成による二次性機能亢進症がある。それらの治療は主に外科切除であり,患者への侵襲を減らすために正確な病変の存在診断・部位診断が重要である。本稿では,副甲状腺機能亢進症における画像診断である超音波検査と99mTc-2methoxy-2methylpropylisonitrile(99mTc-MIBI)シンチグラフィ検査について長所,短所,及び診断能について説明する。近年普及しつつあるSPECT/CTの有用性についても言及した。(著者抄録)

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骨シンチの集積機序は、99mTcで標識されたビスホスホン酸が骨のハイドロキシアパタイト構成分子の無機リン酸と置換され結合することによる。骨転移は病的な骨代謝の亢進状態で、骨シンチは代謝の亢進を検出するためより骨転移を早期に検出できる。89Sr(89Sr塩化ストロンチウム)は骨転移の疼痛緩和に用いられるが、89Srは、Caと同族のアルカリ土類金属でCaと似た挙動を示し、骨転移の骨代謝の亢進した部位に集積するため、疼痛部位に骨シンチの異常集積を認めることが必要条件である。(著者抄録)

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骨シンチの集積機序は、99mTcで標識されたビスホスホン酸が骨のハイドロキシアパタイト構成分子の無機リン酸と置換され結合することによる。骨転移は病的な骨代謝の亢進状態で、骨シンチは代謝の亢進を検出するためより骨転移を早期に検出できる。89Sr(89Sr塩化ストロンチウム)は骨転移の疼痛緩和に用いられるが、89Srは、Caと同族のアルカリ土類金属でCaと似た挙動を示し、骨転移の骨代謝の亢進した部位に集積するため、疼痛部位に骨シンチの異常集積を認めることが必要条件である。(著者抄録)

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PET(positron emission tomography)は腫瘍の代謝面での評価を行うことにより,CTやMRIなど従来の画像診断に比べ治療効果を早期にとらえることができる.PETの利点は客観的指標であるSUV(standardized uptake value)を用いることにより腫瘍を数量的に評価できること,腫瘍の全身転移を評価できる点である.PETの腫瘍診断に関しては,糖代謝を評価するフルオロデオキシグルコース(FDG)が広く用いられているが,肝細胞癌の約半数において偽陰性を示す.しかしリン脂質代謝や脂肪酸代謝を反映するPET製剤を用いることによりPET陰性癌の診断が可能である.今後これらのPET製剤を組み合わせることにより,肝細胞癌に対する化学療法の効果判定にPETの果たす役割は大きくなっていくと考えられる.(著者抄録)

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

PET(positron emission tomography)は腫瘍の代謝面での評価を行うことにより,CTやMRIなど従来の画像診断に比べ治療効果を早期にとらえることができる.PETの利点は客観的指標であるSUV(standardized uptake value)を用いることにより腫瘍を数量的に評価できること,腫瘍の全身転移を評価できる点である.PETの腫瘍診断に関しては,糖代謝を評価するフルオロデオキシグルコース(FDG)が広く用いられているが,肝細胞癌の約半数において偽陰性を示す.しかしリン脂質代謝や脂肪酸代謝を反映するPET製剤を用いることによりPET陰性癌の診断が可能である.今後これらのPET製剤を組み合わせることにより,肝細胞癌に対する化学療法の効果判定にPETの果たす役割は大きくなっていくと考えられる.(著者抄録)

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Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

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FPD-CTによるSPECT/CT装置の導入における最大のメリットは、省スペース化である。従来の検査室にも、無理なく設置可能である。SPECT/CTにより、生体内の代謝がどの部位でどのように行われているかが明瞭に描画可能になった。本稿では特に有用である副甲状腺シンチ、センチネルリンパ節シンチ、I-131甲状腺シンチの3つを取り上げ、具体的にその有用性・先進性を述べる。(著者抄録)

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

FPD-CTによるSPECT/CT装置の導入における最大のメリットは、省スペース化である。従来の検査室にも、無理なく設置可能である。SPECT/CTにより、生体内の代謝がどの部位でどのように行われているかが明瞭に描画可能になった。本稿では特に有用である副甲状腺シンチ、センチネルリンパ節シンチ、I-131甲状腺シンチの3つを取り上げ、具体的にその有用性・先進性を述べる。(著者抄録)

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

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Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)