研究者詳細 - 伊藤　倫太郎

論文 - 伊藤　倫太郎

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FDG PET/CT Overcomes Discordance Between Clinical and Pathologic TNM Classification of Small-size Primary Lung Cancer: Influence on Postoperative Prognosis 査読有り国際誌

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

CLINICAL LUNG CANCER 19 巻 ( 1 ) 頁： E37 - E45 2018年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Clinical Lung Cancer

We reviewed the concordance between the clinical stage and pathologic stage for primary lung cancer. We evaluated 289 surgically resected lung cancers ≤ 3 cm. Multivariate survival analysis showed that the significant predictive factors for postoperative disease-free survival were pathologic stage and the maximum standardized uptake value (SUVmax) of primary lesions. Combining SUVmax with clinical stage might improve the prediction of therapeutic outcomes. 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 査読有り国際誌

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

EUROPEAN JOURNAL OF RADIOLOGY 95 巻頁： 186 - 191 2017年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：European Journal of Radiology

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 ≤2 cm, 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

Thoracic Temporal Subtraction Three Dimensional Computed Tomography (3D-CT): Screening for Vertebral Metastases of Primary Lung Cancers 査読有り国際誌

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

PLOS ONE 12 巻 ( 1 ) 頁： e0170309 2017年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：PLoS ONE

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 truepositive 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 truepositive 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

Web of Science

Scopus

PubMed

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

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

Annals of nuclear medicine 29 巻 ( 10 ) 頁： 897-905 2015年12月

Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation. 査読有り

Iwano S, Ito R, Umakoshi H, Ito S, Naganawa S

The British journal of radiology 88 巻 ( 1055 ) 頁： 20150224 2015年

Prognostic evaluations of small size lung cancers by 18F-FDG PET/CT and thin-section CT. 査読有り

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

Lung cancer (Amsterdam, Netherlands) 86 巻 ( 2 ) 頁： 180-4 2014年11月

Prediction of pathologic prognostic factors in patients with lung adenocarcinomas: comparison of thin-section computed tomography and positron emission tomography/computed tomography. 査読有り

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

Cancer imaging : the official publication of the International Cancer Imaging Society 14 巻頁： 3 2014年4月

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論文 - 伊藤　倫太郎