Faculty Profiles - NAGANAWA, Shinji

【脳脊髄液動態のすべて】脳脊髄液による老廃物のクリアランス glymphaticシステム Reviewed

早期声門癌に対するS-1併用化学放射線療法の長期成績

高瀬裕樹, 伊藤善之, 木村香菜, 岡田徹, 久保田誠司, 川村麻里子, 中原理絵, 大家祐実, 香西由加, 長縄慎二, 藤本保志, 曾根三千彦

Japanese Journal of Radiology Vol. 36 ( Suppl. ) page： 22 - 22 2018.2

胸壁並行断面CTを用いた間質性肺炎の経時的評価

馬越弘泰, 岩野信吾, 伊藤倫太郎, 島本宏矩, 長縄慎二

Japanese Journal of Radiology Vol. 36 ( Suppl. ) page： 19 - 19 2018.2

非小細胞肺癌の局所浸潤性の予測に関する造影dual energy CTとFDG-PET/CTの比較

伊藤倫太郎, 岩野信吾, 島本宏矩, 馬越弘泰, 伊藤信嗣, 長縄慎二, 加藤克彦

Japanese Journal of Radiology Vol. 36 ( Suppl. ) page： 20 - 20 2018.2

田岡俊昭, 長縄慎二

画像診断 Vol. 38 ( 3 ) page： 268 - 276 2018.2

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)Gakken

glymphaticシステムは頭蓋内の脳脊髄液,脳内の間質液を含む循環に関連した1つのコンセプトであり,脳実質内の老廃物を洗い出すシステムとして広く受け入れられるようになりつつある.その一方で,以前から提唱されている細小動脈壁の排出路を介したシステムとの関連も含めて,この仮説に関して不明な点も多く,現時点で多くの議論がある.(著者抄録)

DOI： 10.15105/gz.0000000353

Other Link： https://search.jamas.or.jp/default/link?pub_year=2018&ichushi_jid=J00235&link_issn=&doc_id=20180226160007&doc_link_id=10.15105%2FGZ.0000000353&url=https%3A%2F%2Fdoi.org%2F10.15105%2FGZ.0000000353&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Relationship between Contrast Enhancement of the Perivascular Space in the Basal Ganglia and Endolymphatic Volume Ratio. Reviewed Open Access

Toshio Ohashi, Shinji Naganawa, Toshio Katagiri, Kayao Kuno

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 17 ( 1 ) page： 67 - 72 2018.1

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: We routinely obtain the endolymphatic hydrops (EH) image using heavily T2-weighted three dimensional-fluid attenuated inversion recovery (hT2w-3D-FLAIR) imaging at 4 hours after intravenous administration of a single-dose of gadolinium-based contrast media (IV-SD-GBCM). While repeating the examination, we speculated that the contrast enhancement of the perivascular space (PVS) in the basal ganglia might be related to the degree of EH. Therefore, the purpose of this study was to investigate the relationship between the endolymphatic volume ratio (%ELvolume) and the signal intensity of the PVS (SI-PVS). MATERIALS AND METHODS: In 20 patients with a suspicion of EH, a heavily T2-weighted 3D-turbo spin echo sequence for MR cisternography (MRC) and an hT2w-3D-FLAIR as a positive perilymph image (PPI) were obtained at 4 hours after IV-SD-GBCM. The %ELvolume of the cochlea and the vestibule were measured on the previously reported HYDROPS2-Mi2 image. The PVS in the basal ganglia was segmented on MRC using a region-growing method. The PVS regions were copied and pasted onto the PPI, and the SI-PVS was measured. The larger value of the right and the left ears was employed as the %ELvolume, and the weighted average of both sides was employed as the SI-PVS. The correlation between the %ELvolume and the SI-PVS was evaluated. RESULT: There was a strong negative linear correlation between the %ELvolume of the cochlea and the SI-PVS (r = -0.743, P < 0.001); however, there was no significant correlation between the %ELvolume of the vestibule and the SI-PVS (r = -0.267, P = 0.256). CONCLUSION: There was a strong negative correlation between the cochlear %ELvolume and the SI-PVS. Contrast enhancement of PVS might be a biomarker of EH.

DOI： 10.2463/mrms.mp.2017-0001

Gadolinium-based Contrast Media, Cerebrospinal Fluid and the Glymphatic System: Possible Mechanisms for the Deposition of Gadolinium in the Brain. Reviewed Open Access

Toshiaki Taoka, Shinji Naganawa

Magn Reson Med Sci. 2018.1

FDG PET/CT Overcomes Discordance Between Clinical and Pathologic TNM Classification of Small-size Primary Lung Cancer: Influence on Postoperative Prognosis. Reviewed International journal Open Access

Hiroyasu Umakoshi, Shingo Iwano, Kohei Yokoi, Shinji Ito, Rintaro Ito, Koji Kawaguchi, Takayuki Fukui, Shinji Naganawa

Clinical lung cancer Vol. 19 ( 1 ) page： e37-e45 - e45 2018.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: We aimed to determine the concordance between the clinical stage (c-stage) and pathologic stage (p-stage) for patients with small-size lung cancer. Additionally we searched for prognostic factors other than the TNM stage. PATIENTS AND METHODS: We retrospectively reviewed the preoperative multidetector computed tomography (CT) and positron emission tomography/CT reports, surgical records, and pathologic reports of patients with primary lung cancer ≤ 3 cm. The Union for International Cancer Control TNM seventh edition classification of c-stage and p-stage were compared. The tumors were classified into multiple subgroups by concordance or discordance between the c-stage and p-stage. Disease-free survival (DFS) was assessed using survival analysis to assess the tumor characteristics that were predictive of prognosis. RESULTS: A total of 289 surgically resected primary lung cancers were evaluated. The concordance between c-stage and p-stage was 65.4%, with moderate reproducibility (kappa coefficient, 0.467). The upstaging rate from c-stage I to p-stage II-IV was 9.4%, and these patients had significantly worse DFS than those with a concordant stage I classification (P < .001). The main reason for upstaging was an underestimation of metastases to the hilar lymph nodes (n = 7) or mediastinal lymph nodes (n = 11). A multivariate Cox proportional hazards model showed that the significant predictive factors for DFS were p-stage (hazard ratio, 1.342; P = .003) and maximum standardized uptake value on positron emission tomography/CT (hazard ratio, 12.162; P = .001). CONCLUSION: The concordance rate between c-stage and p-stage for small primary lung cancers had moderate reproducibility. Discordance between c-stage I and p-stage II-IV significantly affected DFS. The maximum standardized uptake value of the primary lesion was an independent prognostic factor, and combining it with c-stage might improve the prediction of therapeutic outcomes.

DOI： 10.1016/j.cllc.2017.05.021

Differences in Signal Intensity and Enhancement on MR Images of the Perivascular Spaces in the Basal Ganglia versus Those in White Matter Open Access

Naganawa Shinji, Nakane Toshiki, Kawai Hisashi, Taoka Toshiaki

MAGNETIC RESONANCE IN MEDICAL SCIENCES Vol. 17 ( 4 ) page： 301-307 2018

Clinical MR imaging of endolymphatic hydrops: Updates on scanning methods, image processing and interpretation. Reviewed

Shinji Naganwa

Solutions in Contrast Imaging. Vol. 9 ( 5 ) page： 1-5 2018

Dosimetric feasibility of using tungsten-based functional paper for flexible chest wall protectors in intraoperative electron radiotherapy for breast cancer. Reviewed International journal Open Access

Takeshi Kamomae, Hajime Monzen, Mariko Kawamura, Kuniyasu Okudaira, Takayoshi Nakaya, Takashi Mukoyama, Yoshikazu Miyake, Yoshitomo Ishihara, Yoshiyuki Itoh, Shinji Naganawa

Physics in medicine and biology Vol. 63 ( 1 ) page： 015006 - 015006 2017.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Intraoperative electron radiotherapy (IOERT), which is an accelerated partial breast irradiation method, has been used for early-stage breast cancer treatment. In IOERT, a protective disk is inserted behind the target volume to minimize the dose received by normal tissues. However, to use such a disk, the surgical incision must be larger than the field size because the disk is manufactured from stiff and unyielding materials. In this study, the applicability of newly developed tungsten-based functional paper (TFP) was assessed as an alternative to the existing protective disk. The radiation-shielding performance of the TFP was verified through experimental measurements and Monte Carlo simulations. Percentage depth dose curves and lateral dose profiles with and without TFPs were measured and simulated on a dedicated IOERT accelerator. The number of piled-up TFPs was changed from 1 to 40. In the experimental measurements, the relative doses at the exit plane of the TFPs for 9 MeV were 42.7%, 9.2%, 0.2%, and 0.1% with 10, 20, 30, and 40 TFPs, respectively, whereas those for 12 MeV were 63.6%, 27.1%, 8.6%, and 0.2% with 10, 20, 30, and 40 TFPs, respectively. Slight dose enhancements caused by backscatter radiation from the TFPs were observed at the entrance plane of the TFPs at both beam energies. The results of the Monte Carlo simulation indicated the same tendency as the experimental measurements. Based on the experimental and simulated results, the radiation-shielding performances of 30 TFPs for 9 MeV and 40 TFPs for 12 MeV were confirmed to be acceptable and close to those of the existing protective disk. The findings of this study suggest the feasibility of using TFPs as flexible chest wall protectors in IOERT for breast cancer treatment.

DOI： 10.1088/1361-6560/aa96cf

An unbiased data-driven age-related structural brain parcellation for the identification of intrinsic brain volume changes over the adult lifespan. Reviewed

Epifanio Bagarinao, Hirohisa Watanabe, Satoshi Maesawa, Daisuke Mori, Kazuhiro Hara, Kazuya Kawabata, Noritaka Yoneyama, Reiko Ohdake, Kazunori Imai, Michihito Masuda, Takamasa Yokoi, Aya Ogura, Toshihiko Wakabayashi, Masafumi Kuzuya, NorioOzaki, Minoru Hoshiyama, Haruo Isoda, Shinji Naganawa, Gen Sobue

Neuroimage ( 169 ) page： 134-144 2017.12

Three-dimensional printer-generated patient-specific phantom for artificial in vivo dosimetry in radiotherapy quality assurance. Reviewed International journal Open Access

Takeshi Kamomae, Hidetoshi Shimizu, Takayoshi Nakaya, Kuniyasu Okudaira, Takahiro Aoyama, Hiroshi Oguchi, Masataka Komori, Mariko Kawamura, Kazuhiro Ohtakara, Hajime Monzen, Yoshiyuki Itoh, Shinji Naganawa

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) Vol. 44 page： 205 - 211 2017.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Pretreatment intensity-modulated radiotherapy quality assurance is performed using simple rectangular or cylindrical phantoms; thus, the dosimetric errors caused by complex patient-specific anatomy are absent in the evaluation objects. In this study, we construct a system for generating patient-specific three-dimensional (3D)-printed phantoms for radiotherapy dosimetry. An anthropomorphic head phantom containing the bone and hollow of the paranasal sinus is scanned by computed tomography (CT). Based on surface rendering data, a patient-specific phantom is formed using a fused-deposition-modeling-based 3D printer, with a polylactic acid filament as the printing material. Radiophotoluminescence glass dosimeters can be inserted in the 3D-printed phantom. The phantom shape, CT value, and absorbed doses are compared between the actual and 3D-printed phantoms. The shape difference between the actual and printed phantoms is less than 1 mm except in the bottom surface region. The average CT value of the infill region in the 3D-printed phantom is -6 ± 18 Hounsfield units (HU) and that of the vertical shell region is 126 ± 18 HU. When the same plans were irradiated, the dose differences were generally less than 2%. These results demonstrate the feasibility of the 3D-printed phantom for artificial in vivo dosimetry in radiotherapy quality assurance.

DOI： 10.1016/j.ejmp.2017.10.005

Longitudinal up-regulation of endolymphatic hydrops in patients with Meniere's disease during medical treatment. Reviewed International journal

Munehisa Fukushima, Tadashi Kitahara, Ryohei Oya, Shiro Akahani, Hidenori Inohara, Shinji Naganawa, Noriaki Takeda

Laryngoscope investigative otolaryngology Vol. 2 ( 6 ) page： 344 - 350 2017.12

Language：English Publishing type：Research paper (scientific journal)

Objective/Hypothesis: Meniere's disease (MD) is a common inner ear disease characterized by repeated episodic vertigo, fluctuating sensorineural hearing loss, and tinnitus. Its pathology is defined as endolymphatic hydrops (EH) in the inner ear and EH has been hypothesized to correlate with the clinical symptoms of MD. We presented the dynamics of in vivo EH in MD patients during medical treatments. Study Design: Prospective, single-arm repeated measures. Methods: Eleven MD patients were enrolled. All subjects prospectively underwent gadolinium-enhanced inner ear magnetic resonance (MR) imaging and neuro-otological testing before and after medical treatment. The volume of EH was quantitatively evaluated by processing MR images. All MD patients were administered continuous medication and followed up for more than 12 months. Results: The frequency of vertigo episodes decreased in all patients and vestibular function decreased to 13-91% of the pre-treatment level. The volume ratio of post-treatment EH-to-pre-treatment EH ranged from 1.01-3.22. The total volume of pre-treatment EH was significantly correlated with cochlear symptom disease duration and the affected ear's hearing level. Conclusion: EH in MD patients developed longitudinally with deterioration of inner ear function during medical treatment. The natural course of MD may progress with development of EH at least for a certain period. Level of Evidence: 2b.

DOI： 10.1002/lio2.115

【中枢神経系の新たな疾患カテゴリーとその画像所見】Glymphaticシステム脳内の老廃物排除のための仕組み Reviewed

田岡俊昭, 長縄慎二

臨床画像 Vol. 33 ( 12 ) page： 1447 - 1458 2017.12

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)メジカルビュー社

Glymphaticシステムは頭蓋内の脳脊髄液、脳内の間質液を含む循環に関連した1つのコンセプトであり、脳脊髄液の循環に関しての新しい考え方とともに広く受け入れられるようになりつつあり、さまざまな疾患と関連している可能性が指摘されている。(著者抄録)

DOI： 10.18885/j01843.2018048070

Other Link： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J01843&link_issn=&doc_id=20171201080008&doc_link_id=%2Fap4ringc%2F2017%2F003312%2F009%2F1447-1458%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap4ringc%2F2017%2F003312%2F009%2F1447-1458%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Clinical outcomes of 125I brachytherapy with and without external-beam radiation therapy for localized prostate cancer: results from 300 patients at a single institution in Japan. Reviewed International journal

Sayo Maki, Yoshiyuki Itoh, Seiji Kubota, Tohru Okada, Rie Nakahara, Junji Ito, Mariko Kawamura, Shinji Naganawa, Yasushi Yoshino, Takashi Fujita, Masashi Kato, Momokazu Gotoh, Mitsuru Ikeda

Journal of radiation research Vol. 58 ( 6 ) page： 870 - 880 2017.11

Language：English Publishing type：Research paper (scientific journal)

The aim of this study was to determine the outcomes and adverse events for 300 men with prostate cancer treated with 125iodine (125I) brachytherapy with and without external-beam radiation therapy (EBRT) at a single institution in Japan. Between February 2005 and November 2011, 300 consecutive patients with clinically localized prostate cancer were treated with 125I brachytherapy at the Nagoya University Hospital. A total of 271 men were treated with implants with doses of 145 Gy, and 29 men were treated with implants with doses of 110 Gy combined with EBRT (40-50 Gy/20-25 fractions). The median patient age was 69 years (range, 53-83 years). The median follow-up period was 53 months (range, 5-99 months). According to the National Comprehensive Cancer Network risk classification, 132 men (44%) had low-risk, 147 men (29%) had intermediate-risk and 21 men (7%) had high-risk disease. The 5-year overall survival rate, biochemical relapse-free survival rate, and disease-specific survival rates were 93.5%, 97.3% and 98.5%, respectively. Two men (0.6%) died of prostate cancer and 10 men (3.3%) died of other causes. Seventeen men (5.6%) experienced Grade 2 rectal bleeding in all: 12 (41.4%) of 29 in brachytherapy with EBRT, and 5 (1.8%) of 271 in brachytherapy alone. The rates of Grade 2 and 3 genitourinary toxicity were 1.0% and 1.7%, respectively. Excellent local control was achieved at our hospital for localized prostate cancer with 125I brachytherapy with and without EBRT. Gastrointestinal and genitourinary toxicities were acceptable.

DOI： 10.1093/jrr/rrx051

The Relationship Between Endolymphatic Hydrops in the Vestibule and Low-Frequency Air-Bone Gaps. Reviewed

Satofumi Sugimoto, Tadao Yoshida, Masaaki Teranishi, Yuriko Okazaki, Shinji Naganawa, Michihiko Sone

The Laryngoscope. Vol. 28 ( 7 ) page： 1658 - 1662 2017.11

Letter to editor [Saccular measurements in routine MRI can predict hydrops in Meniele disease] by Simon F et al.

Pablo Dominguez, Shinji Naganawa

Eur Arch Otorhinolaryngol. 2017.11

Structural MRI correlates of amyotrophic lateral sclerosis progression. Reviewed International journal Open Access

Joe Senda, Naoki Atsuta, Hirohisa Watanabe, Epifanio Bagarinao, Kazunori Imai, Daichi Yokoi, Yuichi Riku, Michihito Masuda, Ryoichi Nakamura, Hazuki Watanabe, Mizuki Ito, Masahisa Katsuno, Shinji Naganawa, Gen Sobue

Journal of neurology, neurosurgery, and psychiatry Vol. 88 ( 11 ) page： 901 - 907 2017.11

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Amyotrophic lateral sclerosis (ALS) presents with varying degrees of brain degeneration that can extend beyond the corticospinal tract (CST). Furthermore, the clinical course and progression of ALS varies widely. Brain degeneration detected using structural MRI could reflect disease progression. SUBJECTS AND METHODS: On study registration, 3-Tesla volumetric MRI and diffusion tensor imaging scans were obtained at baseline in 38 healthy controls and 67 patients with sporadic ALS. Patients had Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) scores of ≥36 and did not have the chromosome 9, open reading frame 72 repeat expansion. Six months later, changes in ALSFRS-R (ΔALSFRS-R) scores were calculated and patients were grouped into three categories, namely, patients with slow progression with ΔALSFRS-R scores ≤3 (n=19), intermediate progression with ΔALSFRS-R scores =4, 5 and 6 (n=36) and rapid progression with ΔALSFRS-R scores ≥7 (n=12). We analysed voxel-based morphometry and tract-based spatial statistics among these subgroups and controls. RESULTS: In comparison with controls, patients with ALS showed grey matter atrophy and decreased fractional anisotropy beyond the motor cortex and CST, especially in the frontotemporal lobes and basal ganglia. Moreover, the degree of change was highly proportional to ΔALSFRS-R at the 6-month assessment. CONCLUSION: A more rapid disease progression and poorer functional decline were associated with greater involvement of the extra-motor cortex and basal ganglia, suggesting that the spatial extent of brain involvement can be an indicator of the progression in ALS.

DOI： 10.1136/jnnp-2016-314337