Faculty Profiles - NAGANAWA, Shinji

From FDG and beyond: the evolving potential of nuclear medicine. Reviewed

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

Annals of nuclear medicine Vol. 37 ( 11 ) page： 583 - 595 2023.11

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

The radiopharmaceutical 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) has been dominantly used in positron emission tomography (PET) scans for over 20 years, and due to its vast utility its applications have expanded and are continuing to expand into oncology, neurology, cardiology, and infectious/inflammatory diseases. More recently, the addition of artificial intelligence (AI) has enhanced nuclear medicine diagnosis and imaging with FDG-PET, and new radiopharmaceuticals such as prostate-specific membrane antigen (PSMA) and fibroblast activation protein inhibitor (FAPI) have emerged. Nuclear medicine therapy using agents such as [177Lu]-dotatate surpasses conventional treatments in terms of efficacy and side effects. This article reviews recently established evidence of FDG and non-FDG drugs and anticipates the future trajectory of nuclear medicine.

DOI： 10.1007/s12149-023-01865-6

Diffusivity Along the Perivascular Space is Decreased and Related to Hypoperfusion in Adult Moyamoya disease Reviewed

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

in press (https://www.researchsquare.com/article/rs-3411760/v1) 2023.10

Multisite harmonization of diffusion tensor image analysis along the perivascular space using the COMBined Association Test. Reviewed Open Access

Yuya Saito, Koji Kamagata, Christina Andica, Toshiaki Taoka, Rukeye Tuerxun, Wataru Uchida, Kaito Takabayashi, Mana Owaki, Seina Yoshida, Keigo Yamazaki, Shinji Naganawa, Shigeki Aoki

Japanese journal of radiology Vol. 41 ( 10 ) page： 1072 - 1083 2023.10

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

PURPOSE: This multisite study aimed to use the COMBined Association Test (COMBAT), a harmonization technique that uses regression of covariates with an empirical Bayesian framework, to harmonize diffusion tensor image analysis along the perivascular space (DTI-ALPS) variations caused by scanner, site, and protocol differences. MATERIALS AND METHODS: This study included multisite diffusion magnetic resonance imaging (dMRI) data of 45 patients with Alzheimer's disease (AD) and 82 cognitively normal (CN) participants from the AD neuroimaging initiative database. The dMRI data were obtained with two b values (0 and 1000 s/mm2) from 27 institutions and three different 3-Tesla MRI scanners (two vendors). The ALPS index was calculated from multisite dMRI data, and COMBAT was used to harmonize the factors causing site variations. Welch's t test was used, Cohen's d was calculated to compare the difference in the ALPS index between AD and CN before and after harmonization, and Pearson's correlation coefficient was calculated to assess the relationships between the ALPS index and the cognitive score, [18F] fluorodeoxyglucose (FDG)-positron emission tomography (PET), and [18F] florbetapir (AV45)-PET standardized uptake value ratios (SUVRs). RESULTS: COMBAT harmonized scanner differences and increased Cohen's d of the left and right ALPS indexes between AD and CN from 0.288 to 0.438 and 0.328 to 0.480, respectively. The ALPS indexes were significantly different between AD and CN after harmonization (P < 0.05) but not before it. Moreover, Pearson's correlation coefficients between the ALPS index and cognitive score, FDG-PET, and AV45-PET SUVRs were higher after harmonization than before it. CONCLUSION: This study demonstrates the application of COMBAT harmonization to eliminate between-scanner, site, and protocol variations in the ALPS index calculated from DTI-ALPS using dMRI and possibly facilitate the use of the ALPS index in multi-center studies.

DOI： 10.1007/s11604-023-01432-z

New trend in artificial intelligence-based assistive technology for thoracic imaging. Reviewed International journal Open Access

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

La Radiologia medica Vol. 128 ( 10 ) page： 1236 - 1249 2023.10

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

Although there is no solid agreement for artificial intelligence (AI), it refers to a computer system with intelligence similar to that of humans. Deep learning appeared in 2006, and more than 10 years have passed since the third AI boom was triggered by improvements in computing power, algorithm development, and the use of big data. In recent years, the application and development of AI technology in the medical field have intensified internationally. There is no doubt that AI will be used in clinical practice to assist in diagnostic imaging in the future. In qualitative diagnosis, it is desirable to develop an explainable AI that at least represents the basis of the diagnostic process. However, it must be kept in mind that AI is a physician-assistant system, and the final decision should be made by the physician while understanding the limitations of AI. The aim of this article is to review the application of AI technology in diagnostic imaging from PubMed database while particularly focusing on diagnostic imaging in thorax such as lesion detection and qualitative diagnosis in order to help radiologists and clinicians to become more familiar with AI in thorax.

DOI： 10.1007/s11547-023-01691-w

MOGADのGlymphatic systemのDTI-ALPSを用いた解析 Reviewed

宮地真由, 富沢雄二, 星野泰延, コッス・ダビデ, 萩原彰文, 鎌形康司, 関根永久, 高林海斗, 田岡俊昭, 仲谷元, 横山和正, 長縄慎二, 青木茂樹, 服部信孝

臨床神経学 Vol. 63 ( Suppl. ) page： S275 - S275 2023.9

A Brain Morphometry Study with Across-Site Harmonization Using a ComBat-Generalized Additive Model in Children and Adolescents. Reviewed International journal Open Access

Tadashi Shiohama, Norihide Maikusa, Masahiro Kawaguchi, Jun Natsume, Yoshiyuki Hirano, Keito Saito, Jun-Ichi Takanashi, Jacob Levman, Emi Takahashi, Koji Matsumoto, Hajime Yokota, Shinya Hattori, Keita Tsujimura, Daisuke Sawada, Tomoko Uchida, Tomozumi Takatani, Katsunori Fujii, Shinji Naganawa, Noriko Sato, Hiromichi Hamada

Diagnostics (Basel, Switzerland) Vol. 13 ( 17 ) 2023.9

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

Regional anatomical structures of the brain are intimately connected to functions corresponding to specific regions and the temporospatial pattern of genetic expression and their functions from the fetal period to old age. Therefore, quantitative brain morphometry has often been employed in neuroscience investigations, while controlling for the scanner effect of the scanner is a critical issue for ensuring accuracy in brain morphometric studies of rare orphan diseases due to the lack of normal reference values available for multicenter studies. This study aimed to provide across-site normal reference values of global and regional brain volumes for each sex and age group in children and adolescents. We collected magnetic resonance imaging (MRI) examinations of 846 neurotypical participants aged 6.0-17.9 years (339 male and 507 female participants) from 5 institutions comprising healthy volunteers or neurotypical patients without neurological disorders, neuropsychological disorders, or epilepsy. Regional-based analysis using the CIVET 2.1.0. pipeline provided regional brain volumes, and the measurements were across-site combined using ComBat-GAM harmonization. The normal reference values of global and regional brain volumes and lateral indices in our study could be helpful for evaluating the characteristics of the brain morphology of each individual in a clinical setting and investigating the brain morphology of ultra-rare diseases.

DOI： 10.3390/diagnostics13172774

Four-dimensional Flow MRI Assessment of Portal Hemodynamics and Hepatic Regeneration after Portal Vein Embolization. Reviewed International journal Open Access

Ryota Hyodo, Yasuo Takehara, Takashi Mizuno, Kazushige Ichikawa, Ryota Horiguchi, Shoji Kawakatsu, Takashi Mizuno, Tomoki Ebata, Shinji Naganawa, Ning Jin, Yoshito Ichiba

Radiology Vol. 308 ( 3 ) page： e230709 2023.9

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

Background Percutaneous transhepatic portal vein (PV) embolization (PVE) is a standard preoperative procedure for advanced biliary cancer when the future liver remnant (FLR) is insufficient, yet the effect of this procedure on portal hemodynamics is still unclear. Purpose To assess whether four-dimensional (4D) MRI flowmetry can be used to estimate FLR volume and to identify the optimal time for this measurement. Materials and Methods This prospective single-center study enrolled consecutive adult patients with biliary cancer who underwent percutaneous transhepatic PVE for the right liver between June 2020 and November 2022. Portal hemodynamics were assessed using 4D flow MRI before PVE and within 1 day (0-day group) or 3-4 days (3-day group) after PVE. FLR volume was measured using CT before PVE and after PVE but before surgery. Blood flow changes were analyzed with the Wilcoxon signed rank test, and correlations with Spearman rank correlation. Results The 0-day group included 24 participants (median age, 72 years [IQR, 69-77 years]; 17 male participants), and the 3-day group included 13 participants (median age, 71 years [IQR, 68-78 years]; eight male participants). Both groups showed increased left PV (LPV) flow rate after PVE (0-day group: from median 3.72 mL/sec [IQR, 2.83-4.55 mL/sec] to 9.48 mL/sec [IQR, 8.12-10.7 mL/sec], P < .001; 3-day group: from median 3.65 mL/sec [IQR, 2.14-3.79 mL/sec] to 8.16 mL/sec [IQR, 6.82-8.98 mL/sec], P < .001). LPV flow change correlated with FLR volume change relative to the number of days from PVE to presurgery CT only in the 3-day group (ρ = 0.62, P = .02; 0-day group, P = .11). The output of the regression equation for estimating presurgery FLR volume correlated with CT-measured volume (ρ = 0.78; P = .002). Conclusion Four-dimensional flow MRI demonstrated increased blood flow in residual portal branches 3-4 days after PVE, offering insights for estimating presurgery FLR volume. Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Roldán-Alzate and Oechtering in this issue.

DOI： 10.1148/radiol.230709

From pituitary adenoma to PitNET: it is time to discuss PitNET/pituitary adenoma. Reviewed Open Access

Yasutaka Fushimi, Toshiaki Taoka, Shinji Naganawa

Japanese journal of radiology Vol. 41 ( 8 ) page： 787 - 788 2023.8

Prognostic impact of EGFR/ALK alterations in leptomeningeal metastasis from lung adenocarcinoma treated with whole-brain radiotherapy. Reviewed International journal

Hidekazu Oyoshi, Hidenari Hirata, Yasuhiro Hirano, Sadamoto Zenda, Yuzheng Zhou, Kento Tomizawa, Takeshi Fujisawa, Masaki Nakamura, Hidehiro Hojo, Atsushi Motegi, Shun-Ichiro Kageyama, Yoshitaka Zenke, Koichi Goto, Shunichi Ishihara, Shinji Naganawa, Tetsuo Akimoto

Clinical & experimental metastasis Vol. 40 ( 5 ) page： 407 - 413 2023.7

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

The prognosis and prognostic factors of patients receiving whole-brain radiotherapy (WBRT) for leptomeningeal metastasis (LM) from lung adenocarcinoma have not been established. Particularly, the impact of EGFR mutations and ALK rearrangements on survival remains unclear. This retrospective study evaluated the prognosis and prognostic factors of patients receiving WBRT for LM. We evaluated overall survival (OS) from WBRT initiation and clinical variables in 80 consecutive patients receiving WBRT for LM from lung adenocarcinoma at our institution between June 2013 and June 2021. After a median follow-up of 5.2 (range 0.5-56.5) months, the median OS was 6.2 months (95% CI 4.4-12.4). Of the 80 patients, 51 were classified as EGFR/ALK mutant (EGFR: 44; ALK: 6; both: 1) and 29 as wild-type. The median OS was 10.4 (95% CI 5.9-20.9) versus 3.8 (95% CI 2.5-7.7) months in the EGFR/ALK-mutant versus wild-type patients (HR = 0.49, P = 0.0063). Multivariate analysis indicated that EGFR/ALK alterations (HR = 0.54, P = 0.021) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1 (HR = 0.25, P < 0.001) were independent factors associated with favorable OS. Among the patients who underwent brain MRI before and after WBRT, intracranial progression-free survival was longer in the 26 EGFR/ALK-mutant than 13 wild-type patients (HR = 0.31, P = 0.0039). Although the prognosis of patients receiving WBRT for LM remains poor, EGFR/ALK alterations and good ECOG PS may positively impact OS in those eligible for WBRT.

DOI： 10.1007/s10585-023-10225-7

Comparative examination of the pons and corpus callosum as reference regions for quantitative evaluation in positron emission tomography imaging for Alzheimer’s disease using 11C-Pittsburgh Compound-B Invited Reviewed Open Access

Tomohiro Tada, Kazuhiro Hara, Naotoshi Fujita, Yoshinori Ito, Hiroshi Yamaguchi, Reiko Ohdake, Kazuya Kawabata, Aya Ogura, Toshiyasu Kato, Takamasa Yokoi, Michihito Masuda, Shinji Abe, Shinichi Miyao, Shinji Naganawa, Masahisa Katsuno, Hirohisa Watanabe, Gen Sobue, Katsuhiko Kato

Annals of Nuclear Medicine Vol. 37 ( 7 ) page： 410 - 418 2023.7

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

Abstract

Objectives

Standardised uptake value ratio (SUVR) is usually obtained by dividing the SUV of the region of interest (ROI) by that of the cerebellar cortex. Cerebellar cortex is not a valid reference in cases where amyloid β deposition or lesions are present. Only few studies have evaluated the use of other regions as references. We compared the validity of the pons and corpus callosum as reference regions for the quantitative evaluation of brain positron emission tomography (PET) using <sup>11</sup>C-PiB compared to the cerebellar cortex.

Methods

We retrospectively evaluated data from 86 subjects with or without Alzheimer’s disease (AD). All subjects underwent magnetic resonance imaging, PET imaging, and cognitive function testing. For the quantitative analysis, three-dimensional ROIs were automatically placed, and SUV and SUVR were obtained. We compared these values between AD and healthy control (HC) groups.

Results

SUVR data obtained using the pons and corpus callosum as reference regions strongly correlated with that using the cerebellar cortex. The sensitivity and specificity were high when either the pons or corpus callosum was used as the reference region. However, the SUV values of the corpus callosum were different between AD and HC (p < 0.01).

Conclusions

Our data suggest that the pons and corpus callosum might be valid reference regions.

DOI： 10.1007/s12149-023-01843-y

Other Link： https://link.springer.com/article/10.1007/s12149-023-01843-y/fulltext.html

田岡俊昭先生の2023 ISMRM Senior Fellow 受章を記念して Reviewed

長縄慎二

日本磁気共鳴医学会雑誌 Vol. 43 ( 3 ) 2023.7

Clinical applications of artificial intelligence in liver imaging Invited

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

Radiologia Medica Vol. 128 ( 6 ) page： 655 - 667 2023.6

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

This review outlines the current status and challenges of the clinical applications of artificial intelligence in liver imaging using computed tomography or magnetic resonance imaging based on a topic analysis of PubMed search results using latent Dirichlet allocation. LDA revealed that “segmentation,” “hepatocellular carcinoma and radiomics,” “metastasis,” "fibrosis," and "reconstruction" were current main topic keywords. Automatic liver segmentation technology using deep learning is beginning to assume new clinical significance as part of whole-body composition analysis. It has also been applied to the screening of large populations and the acquisition of training data for machine learning models and has resulted in the development of imaging biomarkers that have a significant impact on important clinical issues, such as the estimation of liver fibrosis, recurrence, and prognosis of malignant tumors. Deep learning reconstruction is expanding as a new technological clinical application of artificial intelligence and has shown results in reducing contrast and radiation doses. However, there is much missing evidence, such as external validation of machine learning models and the evaluation of the diagnostic performance of specific diseases using deep learning reconstruction, suggesting that the clinical application of these technologies is still in development.

DOI： 10.1007/s11547-023-01638-1

Scopus

Retrospective non-inferiority study of stereotactic radiosurgery for more than ten brain metastases Reviewed

Naoya Nagai, Yutaro Koide, Yurika Shindo, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira, Shunichi Ishihara, Shinji Naganawa

Journal of Neuro-Oncology Vol. 163 ( 2 ) page： 385 - 395 2023.6

もやもや病にGlymphatic system機能不全は存在するか? DTI-ALPS indexによる評価 Reviewed Open Access

原祥子, 菊田潤子, 高林海斗, 鎌形康司, 林志保里, 稲次基希, 田中洋次, 堀正明, 石井賢二, 成相直, 田岡俊昭, 長縄慎二, 青木茂樹, 前原健寿

日本磁気共鳴医学会雑誌 Vol. 43 ( 2 ) page： 56 - 59 2023.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本磁気共鳴医学会

もやもや病のGlymphatic system(GS)について、DTI analysis along the perivascular space(DTI-ALPS index)を用いて検討した。成人もやもや病患者46名(男性13名、女性33名、平均38.4歳)と年齢、性別の合致した健常人34名(男性7名、女性27名、平均40.1歳)を対象とし、3T機でEPIシーケンスによる拡散MRIとMPRAGE法による3DT1強調像を撮影した。患者全例で認知機能検査としてTrail Making Test(TMT)を行った。もやもや病のDTI-ALPS indexは健常人より有意に低く、脳実質水成分と負の相関を示した。DTI-ALPS indexはPETのパラメータのうち、脳灌流圧の逆波である平均通過時間(MTT)と有意な負の相関を示した。遂行機能障害が強いほど点数が高くなるTMT-Bは左半球のDTI-ALPS indexと有意な負の相関を示した。もやもや病では脳循環不全の程度に応じてGS機能不全が存在し、脳実質の水成分増加を生じ、認知機能障害と関連する可能性があると考えられた。

DOI： 10.2463/jjmrm.2022-1774

もやもや病にGlymphatic system機能不全は存在するか？―DTI-ALPS indexによる評価― Reviewed

原祥子、菊田潤子、高林海斗、鎌形康司、林志保里、稲次基希、田中洋次、堀正明、石井賢二、成相直、田岡俊昭、長縄慎二、青木茂樹、前原健寿

日本磁気共鳴医学会雑誌 Vol. 43 ( 2 ) page： 56 - 59 2023.5

ALPS-indexを用いた糖尿病と糖尿病前期の病態におけるGlymphatic systemの評価 Reviewed International coauthorship Open Access

Rukeye Tuerxun、鎌形康司、Christina Andica、内田　航、斎藤勇哉、高林海斗、加賀英義、染谷由希、明石敏昭、和田昭彦、田端宏樹、内藤仁嗣、田村好史、田岡俊昭、長縄慎二、河盛隆造、綿田裕孝、青木茂樹

日本磁気共鳴医学会雑誌 Vol. 43 ( 2 ) page： 60 - 62 2023.5

Labyrinthine calcification in ears with otitis media and antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV): A report of two cases. Reviewed International journal Open Access

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

Auris, nasus, larynx Vol. 50 ( 2 ) page： 299 - 304 2023.4

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

Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV) has been proposed as a new type of otitis media. The hearing loss caused by OMAAV can be expected to improve with early detection and intervention, but if it continues to worsen and leads to deafness, it is challenging to recover the patient's hearing. When bilateral deafness occurs, cochlear implant (CI) surgery is the only way to improve hearing. Here, Case 1 showed unilateral cochlear calcification, and Case 2 showed bilateral cochlear calcification. In Case 1, CI surgery was performed on the ear lacking calcification, and in Case 2 it was performed on the ear with milder calcification. In Case 2, granulation was present from the tympanic space to the mastoid, the round window was closed, and the basal turn of the cochlea was narrowed. Such calcification of the cochlea caused by OMAAV has not been reported so far. It is essential to detect these changes by computed tomography scans at an early stage and to perform CI surgery at an appropriate time, because hearing improvements are not expected in patients who become deaf because of OMAAV.

DOI： 10.1016/j.anl.2022.01.004