Faculty Profiles - IWANO, Shingo

Papers - IWANO, Shingo

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Predictive factors for the outcomes of initial I-131 low-dose ablation therapy to Japanese patients with differentiated thyroid cancer Reviewed

Shinji Ito, Shingo Iwano, Katsuhiko Kato, Shinji Naganawa

Annals of Nuclear Medicine Vol. 32 ( 6 ) page： 418 - 424 2018.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Tokyo

Objective: To identify prognostic factors associated with a low-iodine diet (LID) and the amount of remnant thyroid tissue in Japanese patients with differentiated thyroid cancer (DTC) who received initial I-131 remnant ablation (RAI) using a fixed low dose of I-131 (1110 MBq). Patients and methods: In this prospective study, we enrolled 45 patients. Patients were classified into a self-managed LID group and a strict LID group. We measured the urinary iodine concentration on the day of RAI after patients consumed LID for 2 weeks. Thyroid-stimulating hormone-induced thyroglobulin (Tg) levels and I-131 uptake by the remnant thyroid tissue were also evaluated. A response-evaluation whole-body scan (WBS) was performed 6–8 months after RAI to determine the outcome of the therapy. Results: Post-LID urinary iodine levels of the strict LID group tended to be lower than those of the self-managed LID group. Twenty-five cases (56%) showed absence of uptake, whereas 20 cases (44%) showed residual uptake on the response-evaluation WBS. There were no significant differences between “absence” and “residual” groups in urinary iodine concentrations and Tg levels (p = 0.253 and p = 0.234, respectively). However, significant differences were observed in I-131 uptake by the thyroid bed (p = 0.035). Conclusions: For patients following the current Japanese method of a 2-week LID, the urinary iodine concentration was not a predictive factor for the successful outcome of RAI. In contrast, low I-131 uptake by the thyroid bed, revealed by the scintigram after RAI, may serve as a favorable predictive factor.

DOI： 10.1007/s12149-018-1261-0

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Scopus

PubMed

Computer-aided Volumetry of Part-Solid Lung Cancers by Using CT: Solid Component Size Predicts Prognosis. Reviewed International journal

Shinichiro Kamiya, Shingo Iwano, Hiroyasu Umakoshi, Rintaro Ito, Hironori Shimamoto, Shota Nakamura, Shinji Naganawa

Radiology Vol. 287 ( 3 ) page： 1030 - 1040 2018.6

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

Purpose To investigate the relationship between the postoperative prognosis of patients with part-solid non-small cell lung cancer and the solid component size acquired by using three-dimensional (3D) volumetry software on multidetector computed tomographic (CT) images. Materials and Methods A retrospective study by using preoperative multidetector CT data with 0.5-mm section thickness, clinical records, and pathologic reports of 96 patients with primary subsolid non-small cell lung cancer (47 men and 49 women; mean age ± standard deviation, 66 years ± 8) were reviewed. Two radiologists measured the two-dimensional (2D) maximal solid size of each nodule on an axial image (hereafter, 2D MSSA), the 3D maximal solid size on multiplanar reconstructed images (hereafter, 3D MSSMPR), and the 3D solid volume of greater than 0 HU (hereafter, 3D SV0HU) within each nodule. The correlations between the postoperative recurrence and the effects of clinical and pathologic characteristics, 2D MSSA, 3D MSSMPR, and 3D SV0HU as prognostic imaging biomarkers were assessed by using a Cox proportional hazards model. Results For the prediction of postoperative recurrence, the area under the receiver operating characteristics curve was 0.796 (95% confidence interval: 0.692, 0.900) for 2D MSSA, 0.776 (95% confidence interval: 0.667, 0.886) for 3D MSSMPR, and 0.835 (95% confidence interval: 0.749, 0.922) for 3D SV0HU. The optimal cutoff value for 3D SV0HU for predicting tumor recurrence was 0.54 cm3, with a sensitivity of 0.933 (95% confidence interval: 0.679, 0.998) and a specificity of 0.716 (95% confidence interval: 0.605, 0.811) for the recurrence. Significant predictive factors for disease-free survival were 3D SV0HU greater than or equal to 0.54 cm3 (hazard ratio, 6.61; P = .001) and lymphatic and/or vascular invasion derived from histopathologic analysis (hazard ratio, 2.96; P = .040). Conclusion The measurement of 3D SV0HU predicted the postoperative prognosis of patients with part-solid lung cancer more accurately than did 2D MSSA and 3D MSSMPR. © RSNA, 2018.

DOI： 10.1148/radiol.2018172319

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PubMed

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

Thin-section computed tomography-determined usual interstitial pneumonia pattern affects the decision-making process for resection in newly diagnosed lung cancer patients: a retrospective study. Reviewed

Hashimoto N, Ando A, Iwano S, Sakamoto K, Okachi S, Matsuzaki A, Okada Y, Wakai K, Yokoi K, Hasegawa Y

BMC pulmonary medicine Vol. 18 ( 1 ) page： 2 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

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 2018.1

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

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PubMed

A comparative analysis of dual-phase dual-energy CT and FDG-PET/CT for the prediction of histopathological invasiveness of non-small cell lung cancer. Reviewed International journal

Rintaro Ito, Shingo Iwano, Hironori Shimamoto, Hiroyasu Umakoshi, Koji Kawaguchi, Shinji Ito, Katsuhiko Kato, Shinji Naganawa

European journal of radiology Vol. 95 page： 186 - 191 2017.10

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

PURPOSE: To compare dual-phase dual-energy CT (DE-CT) with FDG-PET/CT for predicting histopathological locoregional invasiveness of non-small cell lung cancers (NSCLCs). MATERIALS AND METHODS: We selected 63 consecutive patients with NSCLC lesions (37 males, 26 females; age range, 44-85 years; mean age, 69 years) who were evaluated preoperatively by both DE-CT and PET/CT at our institution. Postoperative microscopic invasiveness (lymphatic permeation, vascular invasion, and/or pleural involvement) was reviewed, and we defined locoregionally invasive tumors as those that had at least one positive finding of microscopic invasiveness. DE-CT scanning in the arterial and delayed phases was performed after injection of iodinated contrast media using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation of primary tumors in the arterial and delayed phases was quantified automatically using "syngo Dual Energy Lung Nodules" application software, and the ratio of arterial phase to delayed phase enhancement (A/D ratio) was calculated. The A/D ratio and SUVmax on PET/CT were evaluated with respect to postoperative invasiveness by univariate logistic regression analysis. RESULTS: The A/D ratio was significantly correlated with lymphatic permeation, vascular invasion, and pleural involvement (p=0.011, p=0.021, and p=0.010, respectively). In contrast, the SUVmax was significantly correlated with pleural involvement (p=0.020) but not with lymphatic permeation or vascular invasion (p=0.088 and p=0.100, respectively). In the subgroup of patients with lesion diameters ≤2cm, the A/D ratio was significantly correlated with locoregional invasiveness (p=0.040), while the SUVmax was not (p=0.121). CONCLUSION: For the prediction of microscopic invasiveness of NSCLCs, the diagnostic performance of dual-phase DE-CT may be comparable to that of FDG-PET/CT.

DOI： 10.1016/j.ejrad.2017.08.010

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PubMed

Automated mediastinal lymph node detection from CT volumes based on intensity targeted radial structure tensor analysis Reviewed

Hirohisa Oda, Kanwal K. Bhatia, Masahiro Oda, Takayuki Kitasaka, Shingo Iwano, Hirotoshi Homma, Hirotsugu Takabatake, Masaki Mori, Hiroshi Natori, Julia A. Schnabel, Kensaku Mori

Journal of Medical Imaging Vol. 4 ( 4 ) page： 044502 2017.10

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

This paper presents a local intensity structure analysis based on an intensity targeted radial structure tensor (ITRST) and the blob-like structure enhancement filter based on it (ITRST filter) for the mediastinal lymph node detection algorithm from chest computed tomography (CT) volumes. Although the filter based on radial structure tensor analysis (RST filter) based on conventional RST analysis can be utilized to detect lymph nodes, some lymph nodes adjacent to regions with extremely high or low intensities cannot be detected. Therefore, we propose the ITRST filter, which integrates the prior knowledge on detection target intensity range into the RST filter. Our lymph node detection algorithm consists of two steps: (1) obtaining candidate regions using the ITRST filter and (2) removing false positives (FPs) using the support vector machine classifier. We evaluated lymph node detection performance of the ITRST filter on 47 contrast-enhanced chest CT volumes and compared it with the RST and Hessian filters. The detection rate of the ITRST filter was 84.2% with 9.1 FPs/volume for lymph nodes whose short axis was at least 10 mm, which outperformed the RST and Hessian filters.

DOI： 10.1117/1.JMI.4.4.044502

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Quantitative evaluation of interstitial pneumonia using 3D-curved high-resolution CT imaging parallel to the chest wall: A pilot study. Reviewed International journal

Hiroyasu Umakoshi, Shingo Iwano, Tsutomu Inoue, Yuanzhong Li, Shinji Naganawa

PloS one Vol. 12 ( 9 ) page： e0185532 2017.9

Language：English

OBJECTIVES: To quantify the imaging findings of patients with interstitial pneumonia (IP) and emphysema using three-dimensional curved high-resolution computed tomography (3D-cHRCT) at a constant depth from the chest wall, and compare the results to visual assessment of IP and each patient's diffusing capacity of the lungs for carbon monoxide (DLco). METHODS: We retrospectively reviewed the axial CT findings and pulmonary function test results of 95 patients with lung cancer (72 men and 23 women, aged 45-84 years) with or without IP, as follows: non-IP (n = 47), mild IP (n = 31), and moderate IP (n = 17). The 3D-cHRCT images of the lung at a 1-cm depth from the chest wall were reconstructed automatically using original software; total area (TA), high-attenuation area (HAA) >-500 HU, and low-attenuation area (LAA) <-950 HU were calculated on a workstation. The %HAA and %LAA were calculated as follows: [Formula: see text], and [Formula: see text]. RESULTS: The %HAA and %LAA respective values were 3.2±0.9 and 27.7±8.2, 3.9±1.2 and 27.6±5.9, and 6.9±2.2 and 25.4±8.7 in non-IP, mild IP, and moderate IP patients, respectively. There were significant differences in %HAA between the 3 groups of patients (P<0.001), but no differences in %LAA (P = 0.558). Multiple linear regression analysis revealed that %HAA and %LAA were negatively correlated with predicted DLco (standard partial regression coefficient [b*] = -0.453, P<0.001; b* = -0.447, P<0.001, respectively). CONCLUSIONS: The %HAA and %LAA values computed using 3D-cHRCT were significantly correlated with DLco and may be important quantitative parameters for both IP and emphysema.

DOI： 10.1371/journal.pone.0185532

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PubMed

Dual Energy CTによる小型肺癌の造影評価

島本宏矩, 岩野信吾, 馬越弘泰, 伊藤倫太郎, 長縄慎二

Japanese Journal of Radiology Vol. 35 ( Suppl. ) page： 34 - 34 2017.2

FDG-PETによる非小細胞肺癌の予後予測因子の検討 SUVmaxと体積を考慮した指標の比較

伊藤信嗣, 岩野信吾, 伊藤倫太郎, 長縄慎二, 加藤克彦

核医学 Vol. 54 ( 1 ) page： 565 - 565 2017.2

ドパミントランスポータシンチグラフィにおける解析ソフトの有用性に関する研究

松澤伸一郎, 加藤克彦, 国本啓太, 本田将之, 椋本竜斗, 小田川哲郎, 阿部真治, 藤田尚利, 櫻木庸博, 伊藤信嗣, 伊藤倫太郎, 岩野信吾, 長縄慎二

核医学 Vol. 54 ( 1 ) page： 663 - 663 2017.2

胸壁並行断面CTを用いた間質性肺炎の定量的評価

馬越弘泰, 岩野信吾, 伊藤倫太郎, 長縄慎二

Japanese Journal of Radiology Vol. 35 ( Suppl. ) page： 34 - 34 2017.2

Thoracic Temporal Subtraction Three Dimensional Computed Tomography (3D-CT): Screening for Vertebral Metastases of Primary Lung Cancers. Reviewed International journal

Shingo Iwano, Rintaro Ito, Hiroyasu Umakoshi, Takatoshi Karino, Tsutomu Inoue, Yuanzhong Li, Shinji Naganawa

PloS one Vol. 12 ( 1 ) page： e0170309 2017.1

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

PURPOSE: We developed an original, computer-aided diagnosis (CAD) software that subtracts the initial thoracic vertebral three-dimensional computed tomography (3D-CT) image from the follow-up 3D-CT image. The aim of this study was to investigate the efficacy of this CAD software during screening for vertebral metastases on follow-up CT images of primary lung cancer patients. MATERIALS AND METHODS: The interpretation experiment included 30 sets of follow-up CT scans in primary lung cancer patients and was performed by two readers (readers A and B), who each had 2.5 years' experience reading CT images. In 395 vertebrae from C6 to L3, 46 vertebral metastases were identified as follows: osteolytic metastases (n = 17), osteoblastic metastases (n = 14), combined osteolytic and osteoblastic metastases (n = 6), and pathological fractures (n = 9). Thirty-six lesions were in the anterior component (vertebral body), and 10 lesions were in the posterior component (vertebral arch, transverse process, and spinous process). The area under the curve (AUC) by receiver operating characteristic (ROC) curve analysis and the sensitivity and specificity for detecting vertebral metastases were compared with and without CAD for each observer. RESULTS: Reader A detected 47 abnormalities on CT images without CAD, and 33 of them were true-positive metastatic lesions. Using CAD, reader A detected 57 abnormalities, and 38 were true positives. The sensitivity increased from 0.717 to 0.826, and on ROC curve analysis, AUC with CAD was significantly higher than that without CAD (0.849 vs. 0.902, p = 0.021). Reader B detected 40 abnormalities on CT images without CAD, and 36 of them were true-positive metastatic lesions. Using CAD, reader B detected 44 abnormalities, and 39 were true positives. The sensitivity increased from 0.783 to 0.848, and AUC with CAD was nonsignificantly higher than that without CAD (0.889 vs. 0.910, p = 0.341). Both readers detected more osteolytic and osteoblastic metastases with CAD than without CAD. CONCLUSION: Our temporal 3D-CT subtraction CAD software easily detected vertebral metastases on the follow-up CT images of lung cancer patients regardless of the osteolytic or osteoblastic nature of the lesions.

DOI： 10.1371/journal.pone.0170309

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PubMed

Hessian-assisted supervoxel: Structure-oriented voxel clustering and application to mediastinal lymph node detection from CT volumes Reviewed

Hirohisa Oda, Kanwal K. Bhatia, Masahiro Oda, Takayuki Kitasaka, Shingo Iwano, Hirotoshi Homma, Hirotsugu Takabatake, Masaki Mori, Hiroshi Natori, Julia A. Schnabel, Kensaku Mori

Progress in Biomedical Optics and Imaging - Proceedings of SPIE Vol. 10134 2017

Language：English Publishing type：Research paper (international conference proceedings) Publisher：SPIE

In this paper, we propose a novel supervoxel segmentation method designed for mediastinal lymph node by embedding Hessian-based feature extraction. Starting from a popular supervoxel segmentation method, SLIC, which computes supervoxels by minimising differences of intensity and distance, we overcome this method's limitation of merging neighboring regions with similar intensity by introducing Hessian-based feature analysis into the supervoxel formation. We call this structure-oriented voxel clustering, which allows more accurate division into distinct regions having blob-, line- or sheet-like structures. This way, different tissue types in chest CT volumes can be segmented individually, even if neighboring tissues have similar intensity or are of non- spherical extent. We demonstrate the performance of the Hessian-assisted supervoxel technique by applying it to mediastinal lymph node detection in 47 chest CT volumes, resulting in false positive reductions from lymph node candidate regions. 89 % of lymph nodes whose short axis is at least 10 mm could be detected with 5.9 false positives per case using our method, compared to our previous method having 83 % of detection rate with 6.4 false positives per case.

DOI： 10.1117/12.2254782

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Scopus

Planning video-assisted thoracic surgery segmentectomy using three dimensional computed tomography angiography and bronchography with a virtual safety margin. Reviewed

Iwano S

Journal of visualized surgery Vol. 3 page： 82 2017

Visualization of Middle Ear Ossicles in Elder Subjects with Ultra-short Echo Time MR Imaging Reviewed

Shinji Naganawa, Toshiki Nakane, Hisashi Kawai, Toshiaki Taoka, Kojiro Suzuki, Shingo Iwano, Hiroko Satake, David Grodzki

MAGNETIC RESONANCE IN MEDICAL SCIENCES Vol. 16 ( 2 ) page： 93 - 97 2017

Language：English Publishing type：Research paper (scientific journal) Publisher：JPN SOC MAGNETIC RESONANCE MEDICINE

Purpose: To evaluate the visualization of middle ear ossicles by ultra-short echo time magnetic resonance (MR) imaging at 3T in subjects over 50 years old.
Materials and Methods: Sixty ears from 30 elder patients that underwent surgical or interventional treatment for neurovascular diseases were included (ages: 50-82, median age: 65; 10 men, 20 women). Patients received follow-up MR imaging including routine T1-and T2-weighted images, time-of-flight MR angiography, and ultra-short echo time imaging (PETRA, pointwise encoding time reduction with radial acquisition). All patients underwent computed tomography (CT) angiography before treatment. Thin-section source CT images were correlated with PETRA images. Scan parameters for PETRA were: TR 3.13, TE 0.07, flip angle 6 degrees, 0.83 x 0.83 x 0.83 mm resolution, 3 min 43 s scan time. Two radiologists retrospectively evaluated the visibility of each ossicular structure as positive or negative using PETRA images. The structures evaluated included the head of the malleus, manubrium of the malleus, body of the incus, long process of the incus, and the stapes. Signal intensity of the ossicles was classified as: between labyrinthine fluid and air, similar to labyrinthine fluid, between labyrinthine fluid and cerebellar parenchyma, or higher than cerebellar parenchyma.
Results: In all ears, the body of the incus was visible. The head of the malleus was visualized in 36/60 ears. The manubrium of the malleus and long process of the incus was visualized in 1/60 and 4/60 ears, respectively. The stapes were not visualized in any ear. Signal intensity of the visible structures was between labyrinthine fluid and air in all ears.
Conclusion: The body of the incus was consistently visualized with intensity between air and labyrinthine fluid on PETRA images in aged subjects. Poor visualization of the manubrium of the malleus, long process of the incus, and the stapes limits clinical significance of middle ear imaging with current PETRA methods.

DOI： 10.2463/mrms.mp.2015-0171

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Evaluation of locoregional invasiveness of small-sized non-small cell lung cancers by enhanced dual-energy computed tomography Reviewed

Shimamoto H, Iwano S, Umakoshi H, Kawaguchi K, Naganawa S

Cancer Imaging Vol. 16 ( 1 ) page： 18 2016.7

Respiratory mechanics measured by forced oscillation technique in rheumatoid arthritis-related pulmonary abnormalities: frequency-dependence, heterogeneity and effects of smoking Reviewed

Sokai R, Ito S, Iwano S, Uchida A, Aso H, Kondo M, Ishiguro N, Kojima T, Hasegawa, Y

Springerplus Vol. 5 page： 335 2016.4

Correlation between FDG-PET/CT findings and solid type non-small cell cancer prognostic factors: are there differences between adenocarcinoma and squamous cell carcinoma? Reviewed

Ito R, Iwano S, Kishimoto M, Ito S, Kato K, Naganawa S.

Ann Nucl Med Vol. 29 ( 10 ) page： 897-905 2015.9

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Papers - IWANO, Shingo