Faculty Profiles - NAGANAWA, Shinji

Papers - NAGANAWA, Shinji

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Perilymphatic enhancement and endolymphatic hydrops: MRI findings and clinical associations Reviewed Open Access

Masumi Kobayashi, Tadao Yoshida, Yukari Fukunaga, Daisuke Hara, Shinji Naganawa, Michihiko Sone

LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY Vol. 9 ( 5 ) page： e1312 2024.10

Decreased diffusivity along the perivascular space and cerebral hemodynamic disturbance in adult moyamoya disease Reviewed Open Access

Shoko Hara, Junko Kikuta, Kaito Takabayashi, Koji Kamagata, Shihori Hayashi, Motoki Inaji, Yoji Tanaka, Masaaki Hori, Kenji Ishii, Tadashi Nariai, Toshiaki Taoka, Shinji Naganawa, Shigeki Aoki, Taketoshi Maehara

Journal of Cerebral Blood Flow & Metabolism Vol. 44 ( 10 ) page： 1787 - 1800 2024.10

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Moyamoya disease (MMD) causes cerebral arterial stenosis and hemodynamic disturbance, the latter of which may disrupt glymphatic system activity, the waste clearance system. We evaluated 46 adult patients with MMD and 33 age- and sex-matched controls using diffusivity along the perivascular space (ALPS) measured with diffusion tensor imaging (ALPS index), which may partly reflect glymphatic system activity, and multishell diffusion MRI to generate freewater maps. Twenty-three patients were also evaluated via <sup>15</sup>O-gas positron emission tomography (PET), and all patients underwent cognitive tests. Compared to controls, patients (38.4 (13.2) years old, 35 females) had lower ALPS indices in the left and right hemispheres (1.94 (0.27) vs. 1.65 (0.25) and 1.94 (0.22) vs. 1.65 (0.19), P < 0.001). While the right ALPS index showed no correlation, the left ALPS index was correlated with parenchymal freewater ( ρ = −0.47, P < 0.001); perfusion measured with PET (cerebral blood flow, ρ = 0.70, P < 0.001; mean transit time, ρ = −0.60, P = 0.003; and oxygen extraction fraction, ρ = −0.52, P = 0.003); and cognitive tests (trail making test part B for executive function; ρ = −0.37, P = 0.01). Adult patients with MMD may exhibit decreased glymphatic system activity, which is correlated with the degree of hemodynamic disturbance, increased interstitial freewater, and cognitive dysfunction, but further investigation is needed.

DOI： 10.1177/0271678X241245492

Web of Science

PubMed

Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/0271678X241245492

Correlation of Endolysmphatic Duct Signal Intensity With Clinical Features in Otological Diseases Reviewed Open Access

Kosumo Matsui, Tadao Yoshida, Satofumi Sugimoto, Masumi Kobayashi, Shinji Naganawa, Michihiko Sone

OTOLOGY & NEUROTOLOGY Vol. 45 ( 9 ) page： e624 - e629 2024.10

Response to letter to the editor from Dr. Muhammed Said Beşler: 'the accuracy of large language models in RANZCR's clinical radiology exam sample questions'. Reviewed

Takeshi Nakaura, Shinji Naganawa

Japanese journal of radiology Vol. 42 ( 9 ) page： 1081 - 1082 2024.9

Imaging evaluation and volumetric measurement of the space surrounding the diploic veins. Reviewed

Rei Nakamichi, Toshiaki Taoka, Rintaro Ito, Tadao Yoshida, Michihiko Sone, Shinji Naganawa

Japanese journal of radiology Vol. 42 ( 9 ) page： 953 - 961 2024.9

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

PURPOSE: The diploic veins have been suggested to be involved in the excretion of cerebrospinal fluid and intracranial waste products; however, to date, there have been no reports evaluating the space surrounding the diploic veins. Therefore, we aimed to visualize the distribution of gadolinium-based contrast agent (GBCA) in the space surrounding the diploic veins and to evaluate the spatial characteristics. MATERIALS AND METHODS: Ninety-eight participants (aged 14-84 years) were scanned 4 h after intravenous GBCA injection at Nagoya University Hospital between April 2021 and December 2022. The volume of the space surrounding the diploic veins where the GBCA was distributed was measured using contrast-enhanced T1-weighted images with the application of three-axis motion-sensitized driven equilibrium. The parasagittal dura (PSD) volume adjacent to the superior sagittal sinus was also measured using the same images. Both volumes were corrected for intracranial volume. The correlation between age and the corrected volume was examined using Spearman's rank correlation coefficient; the relationship between the corrected volume and sex was assessed using the Mann-Whitney U test. RESULTS: A significant weak negative correlation was observed between the volume of the space surrounding the diploic veins and age (r = -0.330, p < 0.001). Furthermore, there was a significant weak positive correlation between the PSD volume and age (r = 0.385, p < 0.001). Both volumes were significantly greater in men than in women. There was no correlation between the volume of the space surrounding the diploic veins and the volume of the PSD. CONCLUSION: The volume of the space surrounding the diploic veins was measurable and, in contrast to the volume of the PSD, was greater in younger participants. This space may be related to intracranial excretory mechanisms and immune responses during youth, requiring further research.

DOI： 10.1007/s11604-024-01572-w

Web of Science

PubMed

Overview of Target-Oriented Project Group United for Nippon (TOP GUN): fostering interdisciplinary collaboration among young researchers in radiology on timely topics. Reviewed

Koji Kamagata, Shinji Naganawa

Japanese journal of radiology Vol. 42 ( 9 ) page： 935 - 936 2024.9

Recent trends in AI applications for pelvic MRI: a comprehensive review Reviewed

Takahiro Tsuboyama, Masahiro Yanagawa, Tomoyuki Fujioka, Shohei Fujita, Daiju Ueda, Rintaro Ito, Akira Yamada, Yasutaka Fushimi, Fuminari Tatsugami, Takeshi Nakaura, Taiki Nozaki, Koji Kamagata, Yusuke Matsui, Kenji Hirata, Noriyuki Fujima, Mariko Kawamura, Shinji Naganawa

La radiologia medica Vol. 129 ( 9 ) page： 1369 - 1381 2024.9

Possible causes of vertigo attacks in Meniere's disease Reviewed

Tsutomu Nakashima, Shinji Naganawa, Tadao Yoshida, Michihiko Sone

MEDICAL HYPOTHESES Vol. 189 2024.8

The impact of large language models on radiology: a guide for radiologists on the latest innovations in AI. Reviewed

Takeshi Nakaura, Rintaro Ito, Daiju Ueda, Taiki Nozaki, Yasutaka Fushimi, Yusuke Matsui, Masahiro Yanagawa, Akira Yamada, Takahiro Tsuboyama, Noriyuki Fujima, Fuminari Tatsugami, Kenji Hirata, Shohei Fujita, Koji Kamagata, Tomoyuki Fujioka, Mariko Kawamura, Shinji Naganawa

Japanese journal of radiology Vol. 42 ( 7 ) page： 685 - 696 2024.7

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

The advent of Deep Learning (DL) has significantly propelled the field of diagnostic radiology forward by enhancing image analysis and interpretation. The introduction of the Transformer architecture, followed by the development of Large Language Models (LLMs), has further revolutionized this domain. LLMs now possess the potential to automate and refine the radiology workflow, extending from report generation to assistance in diagnostics and patient care. The integration of multimodal technology with LLMs could potentially leapfrog these applications to unprecedented levels.However, LLMs come with unresolved challenges such as information hallucinations and biases, which can affect clinical reliability. Despite these issues, the legislative and guideline frameworks have yet to catch up with technological advancements. Radiologists must acquire a thorough understanding of these technologies to leverage LLMs' potential to the fullest while maintaining medical safety and ethics. This review aims to aid in that endeavor.

DOI： 10.1007/s11604-024-01552-0

Web of Science

PubMed

Evaluation of alterations in interstitial fluid dynamics in cases of whole-brain radiation using the diffusion-weighted image analysis along the perivascular space method. Reviewed International journal

Toshiaki Taoka, Rintaro Ito, Rei Nakamichi, Toshiki Nakane, Mariko Kawamura, Shunichi Ishihara, Kazushige Ichikawa, Hisashi Kawai, Shinji Naganawa

NMR in biomedicine Vol. 37 ( 7 ) page： e5030 2024.7

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

In the current study, we assessed changes in interstitial fluid dynamics resulting after whole-brain radiotherapy using the diffusion-weighted image analysis along the perivascular space (DWI-ALPS) method, which is a simplified variation of the diffusion tensor image ALPS (DTI-ALPS) method using diffusion-weighted imaging (DWI) with orthogonal motion-probing gradients (MPGs). This retrospective study included 47 image sets from 22 patients who underwent whole-brain radiotherapy for brain tumors. The data for the normal control group comprised 105 image sets from 105 participants with no pathological changes. DWI was performed with the three MPGs applied in an orthogonal direction to the imaging plane, and apparent diffusion coefficient images for the x-, y-, and z-axes were retrospectively generated. The ALPS index was calculated to quantify interstitial fluid dynamics. The independent t-test was used to compare the ALPS index between normal controls and patients who underwent whole-brain radiotherapy. Patients were compared in all age groups and individual age groups (20-39, 40-59, and 60-84 years). We also examined the correlation between biologically equivalent doses (BEDs) and the ALPS index, as well as the correlation between white matter hyperintensity and the ALPS index. In the comparison of all age groups, the ALPS index was significantly lower (p < 0.001) in the postradiation group (1.32 ± 0.16) than in the control group (1.44 ± 0.17), suggesting that interstitial fluid dynamics were altered in patients following whole-brain radiotherapy. Significant age group differences were found (40-59 years: p < 0.01; 60-84 years: p < 0.001), along with a weak negative correlation between BEDs (r = -0.19) and significant correlations between white matter hyperintensity and the ALPS index (r = -0.46 for periventricular white matter, r = -0.38 for deep white matter). It was concluded that the ALPS method using DWI with orthogonal MPGs suggest alteration in interstitial fluid dynamics in patients after whole-brain radiotherapy. Further systematic prospective studies are required to investigate their association with cognitive symptoms.

DOI： 10.1002/nbm.5030

Web of Science

PubMed

Palliative radiotherapy for painful non-bone lesions in patients with advanced cancer: a single center retrospective study Reviewed

Yurika Shindo, Yutaro Koide, Naoya Nagai, Tomoki Kitagawa, Takahiro Aoyama, Hidetoshi Shimizu, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira, Shunichi Ishihara, Shinji Naganawa

JAPANESE JOURNAL OF RADIOLOGY Vol. 42 ( 6 ) page： 656 - 661 2024.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Purpose

This retrospective study aimed to assess the efficacy and safety of palliative radiotherapy for painful non-bone lesions in patients with advanced cancer.

Materials and methods

We enrolled patients with painful non-bone lesions who underwent conventional palliative radiotherapy between September 2018 and September 2022. The treatment targets included primary tumor lesions, lymph node metastases, non-bone hematogenous metastases, and other lesions. The primary endpoint was the overall pain response rate in evaluable patients, determined based on the International Consensus Pain Response Endpoint criteria. The secondary endpoints included overall survival, pain recurrence, and adverse events.

Results

Of the 420 screened patients, 142 received palliative radiotherapy for painful non-bone lesions, and 112 were evaluable. A pain response was achieved in 67 patients (60%) of the 112 evaluable patients within a median of 1.2 months. Among these patients, 25 exhibited complete response, 42 partial response, 18 indeterminate response, and 27 pain progression. The median survival time was 5.5 months, recorded at a median follow-up of 6.0 months, during which 67 patients died. Multivariate analysis identified poor performance status scores of 2–4, opioid use, and re-irradiation as independent factors associated with a reduced likelihood of achieving a pain response. Pain recurrence occurred in 18 patients over a median of 4.1 months. Seventeen patients had grade 1–2 adverse events, while none experienced grade 3 or higher toxicity.

Conclusion

Palliative radiotherapy can potentially be a safe and well-tolerated modality for managing painful non-bone lesions, with a low rate of adverse events.

DOI： 10.1007/s11604-024-01536-0

Web of Science

PubMed

Other Link： https://link.springer.com/article/10.1007/s11604-024-01536-0/fulltext.html

Efficacy of 100 hz sound stimulation on saccular dysfunction in meniere's disease Reviewed Open Access

Michihiko Sone, Nobutaka Ohgami, Naomi Katayama, Masumi Kobayashi, Yishuo Gu, Keming Tong, Tadao Yoshida, Shinji Naganawa, Masashi Kato

ACTA OTO-LARYNGOLOGICA Vol. 144 ( 4 ) page： 272 - 276 2024.4

Development of automatic generation system for lung nodule finding descriptions. Reviewed International journal Open Access

Yohei Momoki, Akimichi Ichinose, Keigo Nakamura, Shingo Iwano, Shinichiro Kamiya, Keiichiro Yamada, Shinji Naganawa

PloS one Vol. 19 ( 3 ) page： e0300325 2024.3

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

Worldwide, lung cancer is the leading cause of cancer-related deaths. To manage lung nodules, radiologists observe computed tomography images, review various imaging findings, and record these in radiology reports. The report contents should be of high quality and uniform regardless of the radiologist. Here, we propose an artificial intelligence system that automatically generates descriptions related to lung nodules in computed tomography images. Our system consists of an image recognition method for extracting contents-namely, bronchopulmonary segments and nodule characteristics from images-and a natural language processing method to generate fluent descriptions. To verify our system's clinical usefulness, we conducted an experiment in which two radiologists created nodule descriptions of findings using our system. Through our system, the similarity of the described contents between the two radiologists (p = 0.001) and the comprehensiveness of the contents (p = 0.025) improved, while the accuracy did not significantly deteriorate (p = 0.484).

DOI： 10.1371/journal.pone.0300325

Open Access

Web of Science

PubMed

Assessing interstitial fluid dynamics in type 2 diabetes mellitus and prediabetes cases through diffusion tensor imaging analysis along the perivascular space Reviewed

Rukeye Tuerxun, Koji Kamagata, Yuya Saito, Christina Andica, Kaito Takabayashi, Wataru Uchida, Seina Yoshida, Junko Kikuta, Hiroki Tabata, Hitoshi Naito, Yuki Someya, Hideyoshi Kaga, Mari Miyata, Toshiaki Akashi, Akihiko Wada, Toshiaki Taoka, Shinji Naganawa, Yoshifumi Tamura, Hirotaka Watada, Ryuzo Kawamori, Shigeki Aoki

Frontiers in Aging Neuroscience Vol. 16 page： 1362457 2024.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Frontiers Media SA

Background and purpose

Glymphatic system in type 2 diabetes mellitus (T2DM) but not in the prodrome, prediabetes (Pre-DM) was investigated using diffusion tensor image analysis along the perivascular space (DTI-ALPS). Association between glymphatic system and insulin resistance of prominent characteristic in T2DM and Pre-DM between is yet elucidated. Therefore, this study delves into the interstitial fluid dynamics using the DTI-ALPS in both Pre-DM and T2DM and association with insulin resistance.

Materials and methods

In our cross-sectional study, we assessed 70 elderly individuals from the Bunkyo Health Study, which included 22 with Pre-DM, 18 with T2DM, and 33 healthy controls with normal glucose metabolism (NGM). We utilized the general linear model (GLM) to evaluate the ALPS index based on DTI-ALPS across these groups, considering variables like sex, age, intracranial volume, years of education, anamnesis of hypertension and hyperlipidemia, and the total Fazekas scale. Furthermore, we have explored the relationship between the ALPS index and insulin resistance, as measured by the homeostasis model assessment of insulin resistance (HOMA-IR) using GLM and the same set of covariates.

Results

In the T2DM group, the ALPS index demonstrated a reduction compared with the NGM group [family-wise error (FWE)-corrected p &lt; 0.001; Cohen's d = −1.32]. Similarly, the Pre-DM group had a lower ALPS index than the NGM group (FWE-corrected p &lt; 0.001; Cohen's d = −1.04). However, there was no significant disparity between the T2DM and Pre-DM groups (FWE-corrected p = 1.00; Cohen's d = −0.63). A negative correlation was observed between the ALPS index and HOMA-IR in the combined T2DM and Pre-DM groups (partial correlation coefficient r = −0.35, p &lt; 0.005).

Conclusion

The ALPS index significantly decreased in both the pre-DM and T2DM groups and showed a correlated with insulin resistance. This indicated that changes in interstitial fluid dynamics are associated with insulin resistance.

DOI： 10.3389/fnagi.2024.1362457

Web of Science

PubMed

Clinical significance of posterior expansion of the utricular endolymphatic space Reviewed Open Access

Hideyuki Kaida, Tadao Yoshida, Satofumi Sugimoto, Masumi Kobayashi, Shinji Naganawa, Michihiko Sone

ACTA OTO-LARYNGOLOGICA Vol. 144 ( 2 ) page： 107 - 111 2024.2

Current Understanding of the Anatomy, Physiology, and Magnetic Resonance Imaging of Neurofluids: Update From the 2022 "ISMRM Imaging Neurofluids Study group" Workshop in Rome. Reviewed International journal Open Access

Nivedita Agarwal, Laura D Lewis, Lydiane Hirschler, Leonardo Rivera Rivera, Shinji Naganawa, Swati Rane Levendovszky, Geir Ringstad, Marijan Klarica, Joanna Wardlaw, Costantino Iadecola, Cheryl Hawkes, Roxana Octavia Carare, Jack Wells, Erik N T P Bakker, Vartan Kurtcuoglu, Lynne Bilston, Maiken Nedergaard, Yuki Mori, Marcus Stoodley, Noam Alperin, Mony de Leon, Matthias J P van Osch

Journal of magnetic resonance imaging : JMRI Vol. 59 ( 2 ) page： 431 - 449 2024.2

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

Neurofluids is a term introduced to define all fluids in the brain and spine such as blood, cerebrospinal fluid, and interstitial fluid. Neuroscientists in the past millennium have steadily identified the several different fluid environments in the brain and spine that interact in a synchronized harmonious manner to assure a healthy microenvironment required for optimal neuroglial function. Neuroanatomists and biochemists have provided an incredible wealth of evidence revealing the anatomy of perivascular spaces, meninges and glia and their role in drainage of neuronal waste products. Human studies have been limited due to the restricted availability of noninvasive imaging modalities that can provide a high spatiotemporal depiction of the brain neurofluids. Therefore, animal studies have been key in advancing our knowledge of the temporal and spatial dynamics of fluids, for example, by injecting tracers with different molecular weights. Such studies have sparked interest to identify possible disruptions to neurofluids dynamics in human diseases such as small vessel disease, cerebral amyloid angiopathy, and dementia. However, key differences between rodent and human physiology should be considered when extrapolating these findings to understand the human brain. An increasing armamentarium of noninvasive MRI techniques is being built to identify markers of altered drainage pathways. During the three-day workshop organized by the International Society of Magnetic Resonance in Medicine that was held in Rome in September 2022, several of these concepts were discussed by a distinguished international faculty to lay the basis of what is known and where we still lack evidence. We envision that in the next decade, MRI will allow imaging of the physiology of neurofluid dynamics and drainage pathways in the human brain to identify true pathological processes underlying disease and to discover new avenues for early diagnoses and treatments including drug delivery. Evidence level: 1 Technical Efficacy: Stage 3.

DOI： 10.1002/jmri.28759

Open Access

Web of Science

PubMed

Improvement of vertigo symptoms and acoustic power absorbance in cases with endolymphatic hydrops Reviewed Open Access

Masumi Kobayashi, Tadao Yoshida, Yukari Fukunaga, Daisuke Hara, Satofumi Sugimoto, Shinji Naganawa, Michihiko Sone

LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY Vol. 9 ( 1 ) page： e1210 2024.2

Revolutionizing radiation therapy: the role of AI in clinical practice Reviewed

Mariko Kawamura, Takeshi Kamomae, Masahiro Yanagawa, Koji Kamagata, Shohei Fujita, Daiju Ueda, Yusuke Matsui, Yasutaka Fushimi, Tomoyuki Fujioka, Taiki Nozaki, Akira Yamada, Kenji Hirata, Rintaro Ito, Noriyuki Fujima, Fuminari Tatsugami, Takeshi Nakaura, Takahiro Tsuboyama, Shinji Naganawa

Journal of Radiation Research Vol. 65 ( 1 ) page： 1 - 9 2024.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

This review provides an overview of the application of artificial intelligence (AI) in radiation therapy (RT) from a radiation oncologist’s perspective. Over the years, advances in diagnostic imaging have significantly improved the efficiency and effectiveness of radiotherapy. The introduction of AI has further optimized the segmentation of tumors and organs at risk, thereby saving considerable time for radiation oncologists. AI has also been utilized in treatment planning and optimization, reducing the planning time from several days to minutes or even seconds. Knowledge-based treatment planning and deep learning techniques have been employed to produce treatment plans comparable to those generated by humans. Additionally, AI has potential applications in quality control and assurance of treatment plans, optimization of image-guided RT and monitoring of mobile tumors during treatment. Prognostic evaluation and prediction using AI have been increasingly explored, with radiomics being a prominent area of research. The future of AI in radiation oncology offers the potential to establish treatment standardization by minimizing inter-observer differences in segmentation and improving dose adequacy evaluation. RT standardization through AI may have global implications, providing world-standard treatment even in resource-limited settings. However, there are challenges in accumulating big data, including patient background information and correlating treatment plans with disease outcomes. Although challenges remain, ongoing research and the integration of AI technology hold promise for further advancements in radiation oncology.

DOI： 10.1093/jrr/rrad090

Web of Science

PubMed

Fairness of artificial intelligence in healthcare: review and recommendations Reviewed

Daiju Ueda, Taichi Kakinuma, Shohei Fujita, Koji Kamagata, Yasutaka Fushimi, Rintaro Ito, Yusuke Matsui, Taiki Nozaki, Takeshi Nakaura, Noriyuki Fujima, Fuminari Tatsugami, Masahiro Yanagawa, Kenji Hirata, Akira Yamada, Takahiro Tsuboyama, Mariko Kawamura, Tomoyuki Fujioka, Shinji Naganawa

Japanese Journal of Radiology Vol. 42 ( 1 ) page： 3 - 15 2024.1

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

In this review, we address the issue of fairness in the clinical integration of artificial intelligence (AI) in the medical field. As the clinical adoption of deep learning algorithms, a subfield of AI, progresses, concerns have arisen regarding the impact of AI biases and discrimination on patient health. This review aims to provide a comprehensive overview of concerns associated with AI fairness; discuss strategies to mitigate AI biases; and emphasize the need for cooperation among physicians, AI researchers, AI developers, policymakers, and patients to ensure equitable AI integration. First, we define and introduce the concept of fairness in AI applications in healthcare and radiology, emphasizing the benefits and challenges of incorporating AI into clinical practice. Next, we delve into concerns regarding fairness in healthcare, addressing the various causes of biases in AI and potential concerns such as misdiagnosis, unequal access to treatment, and ethical considerations. We then outline strategies for addressing fairness, such as the importance of diverse and representative data and algorithm audits. Additionally, we discuss ethical and legal considerations such as data privacy, responsibility, accountability, transparency, and explainability in AI. Finally, we present the Fairness of Artificial Intelligence Recommendations in healthcare (FAIR) statement to offer best practices. Through these efforts, we aim to provide a foundation for discussing the responsible and equitable implementation and deployment of AI in healthcare.

DOI： 10.1007/s11604-023-01474-3

Web of Science

Scopus

PubMed

The Glymphatic System in Humans: Investigations With Magnetic Resonance Imaging. Reviewed International journal

Shinji Naganawa, Toshiaki Taoka, Rintaro Ito, Mariko Kawamura

Investigative radiology Vol. 59 ( 1 ) page： 1 - 12 2024.1

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

The concept of the glymphatic system was proposed more than a decade ago as a mechanism for interstitial fluid flow and waste removal in the central nervous system. The function of the glymphatic system has been shown to be particularly activated during sleep. Dysfunction of the glymphatic system has been implicated in several neurodegenerative diseases. Noninvasive in vivo imaging of the glymphatic system is expected to be useful in elucidating the pathophysiology of these diseases. Currently, magnetic resonance imaging is the most commonly used technique to evaluate the glymphatic system in humans, and a large number of studies have been reported. This review provides a comprehensive overview of investigations of the human glymphatic system function using magnetic resonance imaging. The studies can be divided into 3 categories, including imaging without gadolinium-based contrast agents (GBCAs), imaging with intrathecal administration of GBCAs, and imaging with intravenous administration of GBCAs. The purpose of these studies has been to examine not only the interstitial fluid movement in the brain parenchyma, but also the fluid dynamics in the perivascular and subarachnoid spaces, as well as the parasagittal dura and meningeal lymphatics. Recent research has even extended to include the glymphatic system of the eye and the inner ear. This review serves as an important update and a useful guide for future research directions.

DOI： 10.1097/RLI.0000000000000969

Web of Science

PubMed

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Papers - NAGANAWA, Shinji