Faculty Profiles - NAKAMURA Shota

Coarse-to-fine cascade framework for cross-modality super-resolution on clinical / micro CT dataset

ASO Visual Abstract: Pleural Invasion Depth of Disseminated Nodules in Patients with Stage IVa or Recurrent Thymoma: Assessment, Curative Impact, and Surgical Outcomes. International journal

Shota Nakamura, Hisashi Tateyama, Keita Nakanishi, Tomoshi Sugiyama, Yuka Kadomatsu, Harushi Ueno, Masaki Goto, Naoki Ozeki, Takayuki Fukui, Kohei Yokoi, Toyofumi F Chen-Yoshikawa

Annals of surgical oncology Vol. 29 ( 3 ) page： 1838 - 1838 2022.3

Tong Zheng, Hirohisa Oda, Yuichiro Hayashi, Shota Nakamura, Masaki Mori, Hirotsugu Takabatake, Hiroshi Natori, Masahiro Oda, Kensaku Mori

MEDICAL IMAGING 2022: IMAGE PROCESSING Vol. 12032 2022

Language：English Publishing type：Research paper (international conference proceedings) Publisher：SPIE-INT SOC OPTICAL ENGINEERING

This paper proposes a super-resolution (SR) method, for performing SR of medical images, training on a newly-built lung clinical CT / micro CT specimen dataset. High-resolution (HR) medical images always come at longer scanning time or heavier patient burden. Thus performing SR of low-resolution (LR) medical images for obtaining HR images is an optional approach. Conventional SR methods are always trained on bicubic downsampled images (LR) / original images (HR) image pairs. However, in medical imaging, LR medical images and HR images are commonly obtained from different imaging devices, causing registration between LR and HR images having low precision and LR-HR image pairs do not match each other perfectly. Since conventional SR methods need perfectly matched LR-HR images, low precision of registration results in conventional SR methods' unsatisfactory performance in medical imaging. To tackle this problem, we need to propose an SR method considering the modality difference and registration error between HR-LR medical images. In this paper, we propose a coarse-to-fine cascade framework for performing SR of medical images. First, we design a coarse SR network to translate LR medical images into coarse SR images, training on poorly-aligned LR-HR images. Next, we utilize a fully convolutional network (FCN) to perform fine SR (translate coarse SR images to fine SR images). We conducted experiments using a newly-built clinical / micro CT lung specimen dataset. Experimental results illustrated that our method obtained PSNR of 27.30 and SSIM of 0.75, higher than the conventional supervised method of PSNR 19.08 and SSIM 0.63.

DOI： 10.1117/12.2611311

A STING inhibitor suppresses EBV-induced B cell transformation and lymphomagenesis

Miyagi, S; Watanabe, T; Hara, Y; Arata, M; Uddin, MK; Mantoku, K; Sago, K; Yanagi, Y; Suzuki, T; Al Masud, HMA; Kawada, J; Nakamura, S; Miyake, Y; Sato, Y; Murata, T; Kimura, H

CANCER SCIENCE Vol. 112 ( 12 ) page： 5088 - 5099 2021.12

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

Epstein-Barr virus-associated lymphoproliferative disease (EBV-LPD) is frequently fatal. Innate immunity plays a key role in protecting against pathogens and cancers. The stimulator of interferon genes (STING) is regarded as a key adaptor protein allowing DNA sensors recognizing exogenous cytosolic DNA to activate the type I interferon signaling cascade. In terms of EBV tumorigenicity, the role of STING remains elusive. Here we showed that treatment with the STING inhibitor, C-176, suppressed EBV-induced transformation in peripheral blood mononuclear cells. In an EBV-LPD mouse model, C-176 treatment also inhibited tumor formation and prolonged survival. Treatment with B cells alone did not affect EBV transformation, but suppression of EBV-induced transformation was observed in the presence of T cells. Even without direct B cell-T cell contact in a transwell system, the inhibitor reduced the transformation activity, indicating that intercellular communication by humoral factors was critical to prevent EBV-induced transformation. These findings suggest that inhibition of STING signaling pathway with C-176 could be a new therapeutic target of EBV-LPD.

DOI： 10.1111/cas.15152

Commentary: Paving the way with visualization of the invisible craftsmanship. International journal

Shota Nakamura, Toyofumi F Chen-Yoshikawa

JTCVS open Vol. 8 page： 664 - 665 2021.12

Diagnostic utility of metabolic parameters on FDG PET/CT for lymph node metastasis in patients with cN2 non-small cell lung cancer. International journal

Keita Nakanishi, Shota Nakamura, Tomoshi Sugiyama, Yuka Kadomatsu, Harushi Ueno, Masaki Goto, Naoki Ozeki, Takayuki Fukui, Shingo Iwano, Toyofumi Fengshi Chen-Yoshikawa

BMC cancer Vol. 21 ( 1 ) page： 983 - 983 2021.9

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

BACKGROUND: The aim of this study was to assess the diagnostic utility of metabolic parameters on fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) for predicting lymph node (LN) metastasis in patients with cN2 non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed patients who underwent surgery for cN2 NSCLC between 2007 and 2020. Those who had clinically diagnosed positive hilar and mediastinal LNs by routine CT and PET/CT imaging were investigated. To measure the metabolic parameters of LNs, the data according to maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN-to-primary tumor ratio of SUVmax (LPR) were examined. The diagnosis of each retrieved LN was confirmed based on histopathological examination of surgical tissue specimens. Receiver operating characteristics (ROC) curves with area under the curve (AUC) calculations and multivariate analysis by logistic regression were performed. RESULTS: Forty-five patients with 84 clinically diagnosed positive hilar or mediastinal LNs were enrolled in the present study. Of the 84 LNs, 63 LNs were pathologically proven as positive (75%). The SUVmax, MTV, TLG, and LPR of LN metastasis were significantly higher than those of benign nodes. In the ROC analysis, the AUC value of LPR [AUC, 0.776; 95% confidence interval (CI), 0.640-0.913] was higher than that of LN SUVmax (AUC, 0.753; 95% CI, 0.626-0.880) or LN TLG3.5 (AUC, 0.746; 95% CI, 0.607-0.885). Using the optimal LPR cutoff value of 0.47, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.1, 66.7, 88.3, 58.3, and 79.8%, respectively. Multivariate analysis by logistic regression showed that LPR was an independent predictor for LN metastasis (odds ratio, 6.45; 95% CI, 1.785-23.301; P = 0.004). In the subgroup analysis of adenocarcinoma patients (n = 18; 32 LNs), TLG3.5 was a better predictor (AUC, 0.816; 95% CI, 0.639-0.985) than LPR (AUC, 0.792; 95% CI, 0.599-0.986) or LN SUVmax (AUC, 0.792; 95% CI, 0.625-0.959). CONCLUSIONS: Our findings suggest that LPR on FDG-PET is a useful predictor for LN metastasis in patients with cN2 NSCLC. TLG can be a good predictor for LN metastasis in patients with adenocarcinoma.

DOI： 10.1186/s12885-021-08688-6

Differential impacts of postoperative complications on patients' survival in completely resected non-small-cell lung cancer.

Yuka Kadomatsu, Hideki Tsubouchi, Keita Nakanishi, Tomoshi Sugiyama, Harushi Ueno, Masaki Goto, Naoki Ozeki, Shota Nakamura, Takayuki Fukui, Toyofumi Fengshi Chen-Yoshikawa

General thoracic and cardiovascular surgery Vol. 69 ( 9 ) page： 1283 - 1290 2021.9

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

OBJECTIVE: The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. METHODS: Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan-Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. RESULTS: Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41-4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70-2.70). CONCLUSIONS: Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.

DOI： 10.1007/s11748-021-01619-z

Cognitive-behavioral family therapy as psychoeducation for adolescents with high-functioning autism spectrum disorders: Aware and Care for my Autistic Traits (ACAT) program study protocol for a pragmatic multisite randomized controlled trial

Oshima F., William M., Takahashi N., Tsuchiyagaito A., Kuwabara H., Shiina A., Seto M., Hongo M., Iwama Y., Hirano Y., Sutoh C., Taguchi K., Yoshida T., Kawasaki Y., Ozawa Y., Masuya J., Sato N., Nakamura S., Kuno M., Takahashi J., Ohtani T., Matsuzawa D., Inada N., Kuroda M., Ando M., Hori A., Nakagawa A., Shimizu E.

Trials Vol. 21 ( 1 ) 2020.9

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

Background: One aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents. Methods: This multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording. Discussion: It is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD. Trial registration: UMIN Register 000029851. Registered on January 06, 2018

DOI： 10.1186/s13063-020-04750-z

ASO Author Reflections: KCNJ15 Expression and Malignant Behavior of Esophageal Squamous Cell Carcinoma

Commentary: Local chemotherapy with nanoparticles: A ray of light in the dark? Reviewed International journal

Shota Nakamura, Toyofumi F. Chen-Yoshikawa

Journal of Thoracic and Cardiovascular Surgery Vol. 160 ( 3 ) page： E169 - E170 2020.9

Nakamura, S; Kanda, M; Kodera, Y

ANNALS OF SURGICAL ONCOLOGY Vol. 27 ( 7 ) page： 2569 - 2570 2020.7

Current trends in thoracic surgery

Toyofumi F. Chen-Yoshikawa, Takayuki Fukui, Shota Nakamura, Toshinari Ito, Yuka Kadomatsu, Hideki Tsubouchi, Harushi Ueno, Tomoshi Sugiyama, Masaki Goto, Shunsuke Mori, Naoki Ozeki, Shuhei Hakiri, Koji Kawaguchi

Nagoya Journal of Medical Science Vol. 82 ( 2 ) page： 161 - 174 2020.5

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

© 2020 Nagoya University. Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, imageguided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and ex vivo lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

DOI： 10.18999/nagjms.82.2.161

Clinical application of a surgical navigation system based on virtual thoracoscopy for lung cancer patients: Real time visualization of area of lung cancer before induction therapy and optimal resection line for obtaining a safe surgical margin during surgery Reviewed International journal

Shota Nakamura, Yuichiro Hayashi, Koji Kawaguchi, Takayuki Fukui, Shuhei Hakiri, Naoki Ozeki, Shunsuke Mori, Masaki Goto, Kensaku Mori, Kohei Yokoi

Journal of Thoracic Disease Vol. 12 ( 3 ) page： 672 - 679 2020.3

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

© Journal of Thoracic Disease. All rights reserved. Background: We have developed a surgical navigation system that presents virtual thoracoscopic images using computed tomography (CT) image data, as if you are observing intra-thoracic cavity in synchronization with the real thoracoscopic view. Using this system, we made it possible to simultaneously visualize the ‘area of lung cancer before induction therapy’ and the ‘optimal resection line for obtaining a safe surgical margin’ as a virtual thoracoscopic view. We applied this navigation system in the clinical setting in operations for lung cancer patients with chest wall invasion after induction chemoradiotherapy. Methods: The proposed surgical navigation system consisted of a three-dimensional (3D) positional tracker and a virtual thoracoscopy system. The 3D positional tracker was used to recognize the positional information of the real thoracoscope. The virtual thoracoscopy system generated virtual thoracoscopic views based on CT image data. Combined with these two technologies, patient-to-image registration was performed in two patients, and the results generated a virtual thoracoscopic view that was synchronized with the real thoracoscopic view. Results: The operations were started with video-assisted thoracic surgery (VATS), and the navigation system was activated at the same time. The virtual thoracoscopic view was synchronized with the real thoracoscopic view, which also simultaneously indicated the ‘area of lung cancer before induction therapy’ and the ‘optimal resection lines for obtaining a safe surgical margin’. We marked the optimal lines using an electric scalpel, and then performed lobectomy and chest wall resection with a sufficient surgical margin using these landmarks. Pathological examinations confirmed that the surgical margin was negative. No complications related to the navigation system were encountered during or after the procedures. Conclusions: Using this proposed navigation system, we could obtain a ‘CT-derived virtual intrathoracic 3D view of the patient’ that was aligned with the thoracoscopic view during surgery. The accurate identification of areas of cancer invasion before induction therapy using this system might be a useful for determining optimal surgical resection lines.

DOI： 10.21037/jtd.2019.12.108

Clinicopathologic Features of Thymoma With the Expression of Programmed Death Ligand 1 Reviewed

12mの階段昇段時間年齢と肺癌手術後運動機能低下

尾関直樹, 福井高幸, 中村彰太, 羽切周平, 森俊輔, 後藤真輝, 杉山燈人, 坪内秀樹, 永谷元基, 井上貴行, 水野陽太, 川口晃司

肺癌 Vol. 59 ( 6 ) page： 712 - 712 2019.11

Multimodality therapy for thymoma patients with pleural dissemination.

Nakamura S, Kawaguchi K, Fukui T, Hakiri S, Ozeki N, Mori S, Goto M, Hashimoto K, Ito T, Yokoi K

General thoracic and cardiovascular surgery 2019.2

Shuhei Hakiri, Takayuki Fukui, Shunsuke Mori, Koji Kawaguchi, Shota Nakamura, Naoki Ozeki, Taketo Kato, Masaki Goto, Yasushi Yatabe, Kohei Yokoi

Annals of Thoracic Surgery Vol. 107 ( 2 ) page： 418 - 424 2019.2

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

© 2019 The Society of Thoracic Surgeons Background: Programmed death ligand 1 (PD-L1) is reportedly expressed in various malignancies and is considered a prognostic factor. We attempted to reveal the usefulness of the PD-L1 expression as a prognostic factor in patients with thymoma. Methods: Eighty-one patients with thymoma who underwent surgical resection between 2004 and 2015 were retrospectively reviewed. The PD-L1 expression was evaluated by immunohistochemistry and stratified by the proportion of positive tumor cells. Strong membranous reactivity of the PD-L1 antibody in 1% or more of tumor cells was considered “positive.” The association between the PD-L1 expression and the clinicopathologic features was investigated. Results: The PD-L1 expression was positive in 22 patients (27%) and negative in 59 patients (73%). The PD-L1 positivity was significantly associated with type B2 and B3 thymoma (p < 0.001) and stage III and IV disease (p = 0.048). In addition, PD-L1 positive tumors showed a significantly higher maximum standardized uptake value than PD-L1 negative tumors (p = 0.026). The 5-year disease-free survival rate was 82% in PD-L1 positive patients and 88% in PD-L1 negative patients, showing no significant difference (p = 0.57). Furthermore, PD-L1 positivity was not an independent prognostic factor for the disease-free survival on a Cox proportional hazards analysis (p = 0.59). Conclusions: A strong expression of PD-L1 in thymoma was significantly associated with type B2 and B3 and higher pathologic stages. In addition, PD-L1 positivity was associated with an increased maximum standardized uptake value of the tumor. However, patients with PD-L1 positive thymomas did not show a significantly worse prognosis than patients with PD-L1 negative tumors.

DOI： 10.1016/j.athoracsur.2018.08.037

Clinicopathological features of thymoma with the expression of programmed death-ligand 1

Hakiri, S; Fukui, T; Mori, S; Kawaguchi, K; Nakamura, S; Ozeki, N; Kato, T; Goto, M; Yatabe, Y; Yokoi, K

ANNALS OF ONCOLOGY Vol. 29 2018.10

A bilateral approach to extended thymectomy using the da Vinci Surgical System for patients with myasthenia gravis Reviewed International journal

Koji Kawaguchi, Takayuki Fukui, Shota Nakamura, Tetsuo Taniguchi, Kohei Yokoi

Surgery Today Vol. 48 ( 2 ) page： 195 - 199 2018.2

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

© 2017, Springer Japan KK. Purpose: We adopted a bilateral approach to complete robotic extended thymectomy with the excision of the pericardial fat tissue from both sides and analyzed the initial outcomes. Methods: The patient cart was docked first from the left shoulder side. After dissection of the thymus and right pericardial fat tissue, the cart was temporarily rolled out, and the bed was rotated approximately 90° clockwise. The cart was then re-docked from the right-side shoulder, and extended thymectomy was performed via the left-side approach. The outcomes were compared with four cases of unilateral approach performed for mediastinal tumor in the same term. Results: Four patients with myasthenia gravis (two of whom had stage I thymoma) underwent extended thymectomy by the bilateral approach. The mean operative time was 288 min, and the console time was 146 min in the right side and 67 min in the left side. The resected thymus and surrounding adipose tissue were almost symmetrical, in contrast with those obtained via the unilateral approach. No remarkable events were noted. Conclusion: Bilateral extended thymectomy for myasthenia gravis patients was safe and reasonable based on the initial outcomes.

DOI： 10.1007/s00595-017-1567-x

Computer-aided Volumetry of Part-solid lung cancers by Using cT: Solid component size predicts prognosis International journal

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

Radiology Vol. 287 ( 3 ) page： 1030 - 1040 2018

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

© RSNA, 2018 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 A retrospective study by using preoperative multidetector Methods: 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 6 standard deviation, 66 years 6 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.

DOI： 10.1148/radiol.2018172319