Japanese Journal of Radiology

PURPOSE: We developed a heart atlas for breast radiation therapy and evaluated the influence of education on intra and inter-observer similarity, and cardiac dose reporting. MATERIALS AND METHODS: The data of 16 left breast cancer patients were analyzed. Eight observers delineated heart and cardiac subunits [left (LCA) and right (RCA) coronary arteries, left anterior descending artery (LAD), bilateral atrium and ventricles] before the education. A radiologist and radiation oncologist developed the atlas and delineated the gold standard (GS) volumes...

Hepatocellular carcinoma (HCC) is heterogeneous in terms of its biological nature. Various factors related to its biological nature, including size, multifocality, macroscopic morphology, grade of differentiation, macro/microvascular invasion, bile duct invasion, intra-tumoral fat and molecular factors, and their value as prognostic imaging biomarkers have been reported. And recently, genome-based molecular HCC classification correlated with clinical outcome has been elucidated. The imaging biomarkers suggesting a less aggressive nature of HCC are smaller size, solitary tumor, smooth margin suggesting small nodular type with indistinct margin and simple nodular type with distinct margin, capsule, imaging biomarkers predicting early or well-differentiated grade, intra-tumoral fat detection, and low fluorodeoxyglucose (FDG) accumulation...

PURPOSE: To evaluate the efficacy of thoracic endovascular aortic repair (TEVAR) for ruptured acute type B aortic dissection (r-ATBAD). MATERIALS AND METHODS: The study included 18 patients (15 men and 3 women) who underwent TEVAR for r-ATBAD in two institutions between 1997 and 2017. The mean patient age was 74 ± 10 years. The false lumen was patent in 13 patients (72%) and was mostly thrombosed in 5 patients (28%). Three patients had malperfusion of aortic branches...

PURPOSE: Diagnostic and neurosurgical procedures require the precise localization of small intracranial arteries, but this may be difficult using conventional computed tomography angiography (CTA). This study was conducted to evaluate the quality of CTA images acquired using a prototype ultra-high-resolution computed tomography (U-HRCT) system compared with those acquired using a conventional computed tomography (C-CT) system. MATERIALS AND METHODS: From July through September 2015, 10 adult patients (6 women and 4 men) previously scanned by C-CT were examined using U-HRCT to locate and assess cerebral aneurysms...

Deep learning has caused a third boom of artificial intelligence and great changes of diagnostic medical imaging systems such as radiology, pathology, retinal imaging, dermatology inspection, and endoscopic diagnosis will be expected in the near future. However, various attempts and new methods of deep learning have been proposed in recent years, and their progress is extremely fast. Therefore, at the initial stage when medical artificial intelligence papers were published, the artificial intelligence technology itself may be old technology or well-known general-purpose common technology...

PURPOSE: To assess the safety and efficacy of transarterial embolization (TAE) and to evaluate the utility of contrast-enhanced computed tomography (CE-CT) for life-threatening spontaneous retroperitoneal hemorrhage (SRH). METHODS: Nineteen patients underwent TAE following CE-CT for life-threatening SRH. CE-CT and angiographic findings, technical successes, and clinical successes were evaluated. The diagnostic performance of CE-CT for the detection of active bleeding arteries was also assessed by two independent readers...

PURPOSE: To identify predictive factors for local control of locally advanced esophageal cancer by chemoradiotherapy, the relationship between clinical features, including macroscopic tumor type, and treatment outcome was analyzed in 83 patients. MATERIALS AND METHODS: Macroscopic tumor type was defined by endoscopy as follows: type 1: protruding type; type 2: ulcerative and localized type; type 3: ulcerative and infiltrative type; type 4: diffusely infiltrative type; and type 5: unclassifiable type...

PURPOSE: We assessed differences in gross tumor volumes (GTVs) for pancreatic cancer between respiratory-ungated positron emission tomography (3D-PET) and contrast-enhanced four-dimensional computed tomography (CE-4DCT). MATERIALS AND METHODS: We evaluated the GTVs in 21 patients. The sum of the GTVs, which was individually delineated by observers 1 and 2 on the CE-4DCT images from all respiratory phases, was used as GTV-4DCT. The GTVs on the 3D-PET images were extracted with three thresholds: 20%, 30%, and 40% of maximum activity concentration (GTV-n%)...

PURPOSE: To evaluate the frequency, characteristics, and clinical significance of transient hyperintensity foci on T1-weighted images (T1WI) in acute disseminated encephalomyelitis (ADEM). MATERIALS AND METHODS: Patients diagnosed with ADEM underwent MR studies at the time of disease onset and every 3 months or more often thereafter. The frequency and appearance timing of abnormal signals including T1WI and their morphological characteristics were evaluated. Relations between patient symptoms and abnormal signals on MRI were also evaluated...

PURPOSE: To determine the utility of mean standardized uptake value (SUVmean ) of whole liver measured by 99m Tc-GSA SPECT/CT fusion imaging, for evaluation of liver fibrosis. MATERIALS AND METHODS: Eighty-six patients who underwent hepatectomy were enrolled, and were classified into the non-fibrosis or fibrosis group based on the pathological findings in the resected liver specimen. Univariate and multivariate analyses were performed between the two groups on four blood biochemical indices (albumin, total bilirubin, platelet count, and prothrombin time activity) and two 99m Tc-GSA scintigraphy-derived liver function indices (LHL15 and SUVmean ) to evaluate the independent predictive value for severe fibrosis...

PURPOSE: Rice cakes have not been recognized as a cause of small bowel obstruction (SBO) worldwide. We compared clinical and CT findings of rice cake SBO versus SBO due to bezoars, the most common cause of food-induced SBO. METHODS: Twenty-four patients with rice cake SBO (n = 17) or bezoar SBO (n = 7) were retrospectively evaluated for clinical findings and the following multi-detector CT (MDCT) features: identification of the transition zone, presence of intraluminal lesions, degree of obstruction, and length and attenuation of obstructing materials...

Many surgical procedures are used for the treatment of lung, heart, and mediastinal diseases. The techniques can result in postoperative complications. The nature of these complications differs according to the duration of thoracic surgery and the onset of the complication. The complications occurring within 1 month and more than 1 month generally considered as early and late complications, respectively. Chest radiographs and CT scans obtained in patients who have undergone thoracic surgery show normal changes during the surgical procedure and diverse postsurgical complications...

OBJECTIVE: The purpose of this study was to investigate whether the origins and courses of the coronary arteries could be better assessed using ECG-gated dual-source computed tomography (CT) than with echocardiography in neonates with transposition of the great arteries (TGA). METHODS: A total of 17 neonates within 14 days old who underwent both echocardiography and retrospective ECG-gated coronary CT angiography were retrospectively reviewed. The patients were sedated and intubated during CT examinations, and CT images were obtained with a breath-hold...

OBJECTIVE: To evaluate the effectiveness of two orthogonal topograms on radiation dose and image quality (IQ) associated with topogram-based automatic tube voltage selection (ATVS) for lung CT scanning. METHODS: Thirty-seven patients were enrolled in this study. At baseline, only an anteroposterior topogram was obtained and at follow-up, both anteroposterior and lateral topograms were performed. ATVS was turned on during all scans. Objective and subjective IQ evaluations were performed and compared; tube voltage and radiation dose of each scan were noted and analyzed...

PURPOSE: To clarify clinicopathological features of false-negative clinically significant prostate cancer (csPC) at multiparametric prostate MRI (mpMRI). METHODS: 95 patients with 139 csPC undergoing 3T mpMRI before radical prostatectomy were included. Two radiologists were independently evaluated mpMR images using PI-RADS v2. Clinicopathological findings were compared between (a) detectable and undetectable lesions using overall mpMRI criteria (o-mpMRI criteria) and (b) lesions with early enhancement effect (EEE) and lesions without EEE at DCE-MRI...

PURPOSE: To investigate the effectiveness of postmortem computed tomography in the diagnosis of drowning, focusing on the comparison of fresh water and salt water cases using three-dimensionally (3D) reconstructed data. MATERIALS AND METHODS: We examined features of drowning in 25 fresh water drowning cases (FWDCs; 13 men, 12 women; mean age 73.1 years; range 43-95 years), and compared these with 12 salt water drowning cases (SWDCs; 5 men, 7 women; mean age 66...

PURPOSE: To evaluate the incidence and changes in the pleuroparenchymal fibroelastosis (PPFE)-like lesions on chest CT in routine clinical practice. MATERIALS AND METHODS: This study included 1284 patients who underwent chest CT in 2011 at a hospital. The incidence of PPFE-like lesions and their correlation with age, body mass index, and concomitant pulmonary findings were assessed. Moreover, predictors of lesion progression were evaluated on follow-up. The ethical review board waived the requirement of informed consent for the retrospective review of patient records...

The "democratization of AI" is progressing, and it is becoming an era when anyone can utilize AI. What kind of radiologists are new generation radiologists suitable for the AI era? The first is maintaining a broad perspective regarding healthcare in its entirety. Next, it is necessary to study the basic knowledge and latest information concerning AI and possess the latest knowledge concerning modalities such as CT/MRI and imaging information systems. Finally, it is important for radiologists to not forget the viewpoint of patient-centered healthcare...

PURPOSE: To clarify the long-term outcomes of breast calcifications after stereotactic vacuum-assisted breast biopsy (SVAB) and to develop strategy after SVAB. METHODS: Subject comprised 594 patients with 615 calcifications who underwent SVAB. 371 (60.3%) lesions were diagnosed as benign, 38 (6.2%) as indeterminate, and 206 (33.5%) as malignant. We retrospectively reviewed post-biopsy courses of non-malignant lesions which were followed. A histopathological review was performed for false negatives to clarify the reasons...

PURPOSE: To test the tagging efficacy, patient acceptability, and accuracy of computed tomographic colonography (CTC) with a reduced dose of laxative using a novel barium sulfate (BaSO4 ) contrast agent. MATERIALS AND METHODS: CTC followed by optical colonoscopy (OC) was performed on 73 patients with positive results in fecal occult blood tests. They were administrated a BaSO4 suspension and a magnesium citrate solution for bowel preparation. Patients completed a questionnaire about the acceptability of bowel preparation...