研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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Clinical Efficiency of an Artificial Intelligence-Based 3D-Angiography for Visualization of Cerebral Aneurysm: Comparison with the Conventional Method 査読有り国際誌

Ishikawa, K; Izumi, T; Nishihori, M; Imaizumi, T; Goto, S; Suzuki, K; Yokoyama, K; Kanamori, F; Uda, K; Araki, Y; Saito, R

CLINICAL NEURORADIOLOGY 33 巻 ( 4 ) 頁： 1143 - 1150 2023年12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 Neuroradiology

Purpose: Artificial intelligence (AI)-based three-dimensional angiography (3D-A) was reported to demonstrate visualization of cerebral vasculature equivalent to that of three-dimensional digital subtraction angiography (3D-DSA). However, the applicability and efficacy of the AI-based 3D‑A algorithm have not yet been investigated for 3D-DSA micro imaging. In this study, we evaluated the usefulness of the AI-based 3D‑A in 3D-DSA micro imaging. Materials and Methods: The 3D-DSA micro datasets of 20 consecutive patients with cerebral aneurysm (CA) were reconstructed with 3D-DSA and 3D‑A. Three reviewers compared 3D-DSA and 3D‑A in terms of qualitative parameters (degrees of visualization of CA and the anterior choroidal artery [AChA]) and quantitative parameters (aneurysm diameter, neck diameter, parent vessel diameter, and visible length of AChA). Results: Qualitative evaluation of diagnostic potential revealed that visualization of CA and the proximal to middle parts of the AChA with 3D‑A was equal to that with conventional 3D-DSA; in contrast, visualization of the distal part of the AChA was lower with 3D‑A than with 3D-DSA. Further, regarding quantitative evaluation, the aneurysm diameter, neck diameter, and parent vessel diameter were comparable between 3D‑A and 3D-DSA; in contrast, the visible length of the AChA was lower with 3D‑A than with 3D-DSA. Conclusions: The AI-based 3D‑A technique is feasible and evaluable visualization of cerebral vasculature with respect to quantitative and qualitative parameters in 3D-DSA micro imaging. However, the 3D‑A technique offers lower visualization of such as the distal portion of the AChA than 3D-DSA.

DOI： 10.1007/s00062-023-01325-8

Lateral Lumbar Interbody Fusion within Three-level for Patients with Neurological Symptoms due to Vertebral Fragility Fractures in the Lumbar Spine 査読有り Open Access

Nagashima, Y; Nishimura, Y; Kanemura, T; Hata, N; Satake, K; Akahori, S; Ishii, M; Anei, T; Akayasu, M; Saito, R

NEUROLOGIA MEDICO-CHIRURGICA 63 巻 ( 12 ) 頁： 548 - 554 2023年12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：Neurologia Medico-Chirurgica

There is a lack of agreement on whether minimally invasive lateral lumbar intervertebral fusion (LLIF) is a suitable treatment option for vertebral fragility fractures (VFFs). Hence, we sought to evaluate the efficacy and safety of LLIF in the management of VFF with neurological deficits in the lumbar spine. Between April 2015 and March 2020, we conducted a retrospective observational study of patients with VFF treated with three-level or less LLIF. The participants had previously received conservative treatment but had not been able to control their neurological symptoms. To assess the outcomes of the LLIF procedures, the patients were followed up for a minimum of 1 year. Clinical and radiological results, which include the timing and location of the bony fusion, were analyzed. The study involved 19 patients with 23 vertebral fracture levels. The residual height of the fractured vertebra was found to be 57.0 ± 12.3% of the height of the adjacent level. The mean Japanese Orthopedic Association score significantly improved postoperatively. Postoperative radiological parameters were significantly maintained at 1 year, and lumbar lordosis was maintained at the last follow-up (45.0 ± 26.7). In total 31 LLIF levels, bone fusion was observed in four levels at 6 months postoperatively, in 16 levels at 1 year, and in 23 levels at the last follow-up. The facet joint had the highest bony fusion location. LLIF within three levels can be safely performed in certain VFF cases with sufficient residual vertebral height.

DOI： 10.2176/jns-nmc.2023-0064

Endoscopic debulking canalization for optic pathway glioma with obstructive hydrocephalus 査読有り国際誌

Takeuchi, K; Ohka, F; Nagata, Y; Ito, E; Harada, H; Saito, R

CHILDS NERVOUS SYSTEM 39 巻 ( 12 ) 頁： 3421 - 3425 2023年12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：Child's Nervous System

Optic pathway gliomas (OPGs) are benign tumors that can stop growing or even shrink. In recent years, surgical resection has not been considered the first-line treatment because of its high risk of complications. Chemotherapy is the mainstay of treatment for growing OPGs. Surgical treatment for OPGs with obstructive hydrocephalus is required. Ventriculoperitoneal shunting is effective for all types of hydrocephalus. However, long-term management is required, especially in pediatric cases, and there is a risk of shunt-related complications over a long lifespan. Debulking surgery for OPGs allows us to avoid shunt placement by creating a waterway and releasing the hydrocephalus. To reduce the surgical risk and invasiveness, we used an endoscopic canalization technique with a small-diameter cylinder. In this article, we present a case of endoscopic canalization of an obstructive hydrocephalus caused by OPGs in a 14-year-old female to illustrate our surgical technique. (Trial registration Registry name and number: Efficacy and safety of the neuro-endoscopic treatment for brain tumors (2019–0254)).

DOI： 10.1007/s00381-023-06053-5

Deep learning based identification of pituitary adenoma on surgical endoscopic images: a pilot study 査読有り

Fuse, Y; Takeuchi, K; Hashimoto, N; Nagata, Y; Takagi, Y; Nagatani, T; Takeuchi, I; Saito, R

NEUROSURGICAL REVIEW 46 巻 ( 1 ) 頁： 291 2023年11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：Neurosurgical Review

Accurate tumor identification during surgical excision is necessary for neurosurgeons to determine the extent of resection without damaging the surrounding tissues. No conventional technologies have achieved reliable performance for pituitary adenomas. This study proposes a deep learning approach using intraoperative endoscopic images to discriminate pituitary adenomas from non-tumorous tissue inside the sella turcica. Static images were extracted from 50 intraoperative videos of patients with pituitary adenomas. All patients underwent endoscopic transsphenoidal surgery with a 4 K ultrahigh-definition endoscope. The tumor and non-tumorous tissue within the sella turcica were delineated on static images. Using intraoperative images, we developed and validated deep learning models to identify tumorous tissue. Model performance was evaluated using a fivefold per-patient methodology. As a proof-of-concept, the model’s predictions were pathologically cross-referenced with a medical professional’s diagnosis using the intraoperative images of a prospectively enrolled patient. In total, 605 static images were obtained. Among the cropped 117,223 patches, 58,088 were labeled as tumors, while the remaining 59,135 were labeled as non-tumorous tissues. The evaluation of the image dataset revealed that the wide-ResNet model had the highest accuracy of 0.768, with an F1 score of 0.766. A preliminary evaluation on one patient indicated alignment between the ground truth set by neurosurgeons, the model’s predictions, and histopathological findings. Our deep learning algorithm has a positive tumor discrimination performance in intraoperative 4-K endoscopic images in patients with pituitary adenomas.

DOI： 10.1007/s10143-023-02196-w

その他リンク： https://link.springer.com/article/10.1007/s10143-023-02196-w/fulltext.html

Difference of coil distribution made by finishing coils in large size aneurysm model with radiolucent coils 査読有り

Matsuno, H; Izumi, T; Nishihori, M; Goto, S; Araki, Y; Yokoyama, K; Uda, K; Saito, R

NAGOYA JOURNAL OF MEDICAL SCIENCE 85 巻 ( 4 ) 頁： 725 - 732 2023年11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：Nagoya Journal of Medical Science

We conducted a study to understand the characteristics of the finishing coils to select the appropriate coil for the final stage of embolization. Consequently, experimental embolization was performed on a 10 mm spherical silicone aneurysm filled with radiolucent coils, which simulated a volume embolization ratio of 20%. Nine different coils (i-ED complex ∞ SilkySoft, SilkySoft, ExtraSoft, V-Trak HyperSoft helical, Barricade 10 complex finishing, Optima complex 10 soft, Target 360 Ultra, Galaxy G3 mini, and Axium prime 3D ExtraSoft) were analyzed six times at random. After each coil insertion, indices that include area, Feret diameter, circularity, and centroid center of mass were calculated using biplane x-ray images. Furthermore, these data were analyzed using the spring constant k, which represents the stiffness of the coil. In multiple comparisons, a significant difference was observed in the area analysis. The i-ED complex ∞ SilkySoft was more widespread than Target 360 Ultra (p < 0.05). However, no significant differences were observed in the other indices. The spring constant k value of Target 360 Ultra was 2.5 times larger than that of the i-ED complex ∞ SilkySoft, and it negatively correlated with the area index rather than with the other indices. Notably, it was suggested that the smaller the spring constant k, the wider the distribution of the finishing coils. Although there was little difference between the coils, some coils had characteristics suggesting that good embolization could be expected using appropriate finishing coils.

DOI： 10.18999/nagjms.85.4.725

DISSECTING THE INTRA- AND INTER-TUMORAL HETEROGENEITY UNDERLYING GLIOBLASTOMA PATHOGENESIS UTILIZING MULTI-OMICS ANALYSIS

Nakashima, T; Funakoshi, Y; Yajima, H; Yamamoto, R; Sugihara, Y; Nambu, S; Arakawa, Y; Tanaka, S; Ishida, J; Saito, R; Hanaya, R; Yoshimoto, K; Narita, Y; Suzuki, H

NEURO-ONCOLOGY 25 巻 2023年11月

INTRA-OPERATIVE ANALYSES OF GENETIC ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM TUMORS USING RAPID QUANTITATIVE PCR DEVICE

Ohka, F, Maeda, S, Yamaguchi, J, Shimizu, H, Motomura, K, Takeuchi, K, Nagata, Y, Nishikawa, T, Kibe, Y, Takido, Y, Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

DISSECTING THE INTRA- AND INTER-TUMORAL HETEROGENEITY UNDERLYING GLIOBLASTOMA PATHOGENESIS UTILIZING MULTI-OMICS ANALYSIS

Nakashima, T, Funakoshi, Y, Yajima, H, Yamamoto, R, Sugihara, Y, Nambu, S, Arakawa, Y, Tanaka, S, Ishida, J, Saito, R, Hanaya, R, Yoshimoto, K, Narita, Y, Suzuki, H

NEURO-ONCOLOGY 25 巻 2023年11月

ESTABLISHMENT OF ORGANOID MODELS OF PATIENT-DERIVED GH-PRODUCING PITUITARY ADENOMA

Maeda, S, Ohka, F, Kanamori, F, Okumura, Y, Takeuchi, K, Nagata, Y, Motomura, K, Yamaguchi, J, Kibe, Y, Harada, H, Shimizu, H, Takido, Y, Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

GLIOBLASTOMA, IDH-WILDTYPE WITHOUT KEY MOLECULAR FEATURES

Saito, R, Motomura, K, Ohka, F, Yamaguchi, J, Maeda, S, Nishikawa, T, Mizutani, K, Kibe, Y, Shimizu, H, Takido, Y

NEURO-ONCOLOGY 25 巻 2023年11月

IMAGING FEATURES AND CONSIDERATION OF PROGRESSION PATTERN OF DIFFUSE HEMISPHERIC GLIOMAS, H3 G34-MUTANT

Kibe, Y, Ohka, F, Motomura, K, Aoki, K, Maeda, S, Yamaguchi, J, Shimizu, H, Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

Epileptogenic zone in Broca's area is resectable under awake surgery in accordance with the hodotopic framework: A case report 査読有り

Suzuki, T; Ishizaki, T; Maesawa, S; Hashida, M; Mutoh, M; Ito, Y; Tanei, T; Saito, R

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 112 巻頁： 84 - 87 2023年11月

Minor Suture Fusion is Associated With Chiari Malformation in Nonsyndromic Craniosynostosis 査読有り国際誌 Open Access

Mizutani, K; Kurimoto, M; Nagakura, M; Nawashiro, T; Nagai, T; Aoki, K; Kato, M; Saito, R

JOURNAL OF CRANIOFACIAL SURGERY 34 巻 ( 8 ) 頁： 2308 - 2312 2023年11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：Journal of Craniofacial Surgery

Here, we focused on the association between minor suture fusion and Chiari malformation (CM) occurrence in nonsyndromic craniosynostosis (NSC), and evaluated how the minor suture affects the posterior cranial fossa by measuring the posterior fossa deflection angle (PFA). In this retrospective study, the clinical records of 137 patients who underwent surgery for NSC at Aichi Children's Health and Medical Center between April 2010 and May 2022 were analyzed. Clinical data from Aichi Developmental Disability Center Central Hospital was collected for 23 patients as the external validation set. Among the 137 patients, 123 were diagnosed with NSC and the remaining 14 with syndromic craniosynostosis. Of the 123 NSC patients, 23 patients presented with CM. Multivariate analysis showed that occipito-mastoid fusion was the only significant risk factor for CM (P=0.0218). Within the NSC group, CM patients had a significantly increased PFA (6.33±8.10 deg) compared with those without CM (2.76±3.29 deg, P=0.0487). Nonsyndromic craniosynostosis patients with occipito-mastoid suture fusion had a significantly increased PFA (6.50±7.60 deg) compared with those without occipito-mastoid fusion (2.60±3.23 deg, P=0.0164). In the validation cohort, occipito-mastoid suture fusion was validated as an independent risk factor for CM in univariate analysis. Minor suture fusion may cause CM associated with NSC. Chiari malformation could develop due to an increased PFA due to minor suture fusion, which causes growth disturbance in the affected side and compensatory dilation in the contralateral side within the posterior cranial fossa.

DOI： 10.1097/SCS.0000000000009552

Local Delivery of Nimustine Hydrochloride against Brain Tumors: Basic Characterization Study Open Access

Shao, XD; Saito, R; Sato, A; Okuno, S; Saigusa, D; Saito, R; Uruno, A; Osada, Y; Kanamori, M; Tominaga, T

TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 261 巻 ( 3 ) 頁： 187 - 194 2023年11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：Tohoku Journal of Experimental Medicine

Convection-enhanced delivery (CED) delivers agents directly into tumors and the surrounding parenchyma. Although a promising concept, clinical applications are often hampered by insufficient treatment efficacy. Toward developing an effective CED-based strategy for delivering drugs with proven clinical efficacy, we performed a basic characterization study to explore the locally delivered characteristics of the water soluble nitrosourea nimustine hydrochloride (ACNU). First, ACNU distribution after CED in rodent brain was studied using mass spectrometry imaging. Clearance of14C-labeled ACNU after CED in striatum was also studied. ACNU was robustly distributed in rodent brain similar to the distribution of the hydrophilic dye Evans blue after CED, and locally delivered ACNU was observed for over 24 h at the delivery site. Subsequently, to investigate the potential of ACNU to induce an immunostimulative microenvironment, Fas and transforming growth factor-β1 (TGF-β1) was assessed in vitro. We found that ACNU significantly inhibited TGF-β1 secretion and reduced Fas expression. Further, after CED of ACNU in 9L-derived intracranial tumors, the infiltration of CD4/CD8 lymphocytes in tumors was evaluated by immunofluorescence. CED of ACNU in xenografted intracranial tumors induced tumor infiltration of CD4/ CD8 lymphocytes. ACNU has a robust distribution in rodent brain by CED, and delayed clearance of the drug was observed at the local infusion site. Further, local delivery of ACNU affects the tumor microenvironment and induces immune cell migration in tumor. These characteristics make ACNU a promising agent for CED.

DOI： 10.1620/tjem.2023.J069

INTRA-OPERATIVE ANALYSES OF GENETIC ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM TUMORS USING RAPID QUANTITATIVE PCR DEVICE

Ohka, F; Maeda, S; Yamaguchi, J; Shimizu, H; Motomura, K; Takeuchi, K; Nagata, Y; Nishikawa, T; Kibe, Y; Takido, Y; Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

IMAGING FEATURES AND CONSIDERATION OF PROGRESSION PATTERN OF DIFFUSE HEMISPHERIC GLIOMAS, H3 G34-MUTANT

Kibe, Y; Ohka, F; Motomura, K; Aoki, K; Maeda, S; Yamaguchi, J; Shimizu, H; Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

GLIOBLASTOMA, IDH-WILDTYPE WITHOUT KEY MOLECULAR FEATURES

Saito, R; Motomura, K; Ohka, F; Yamaguchi, J; Maeda, S; Nishikawa, T; Mizutani, K; Kibe, Y; Shimizu, H; Takido, Y

NEURO-ONCOLOGY 25 巻 2023年11月

ESTABLISHMENT OF ORGANOID MODELS OF PATIENT-DERIVED GH-PRODUCING PITUITARY ADENOMA

Maeda, S; Ohka, F; Kanamori, F; Okumura, Y; Takeuchi, K; Nagata, Y; Motomura, K; Yamaguchi, J; Kibe, Y; Harada, H; Shimizu, H; Takido, Y; Saito, R

NEURO-ONCOLOGY 25 巻 2023年11月

Higher abundance of Campylobacter in the oral microbiome of Japanese patients with moyamoya disease 査読有り Open Access

Takayanagi, K; Kanamori, F; Ishii, K; Yokoyama, K; Araki, Y; Sumitomo, M; Maeda, S; Goto, S; Ota, S; Nagata, Y; Nishihori, M; Maesawa, S; Izumi, T; Takasu, S; Saito, R

SCIENTIFIC REPORTS 13 巻 ( 1 ) 頁： 18545 2023年10月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Scientific Reports

Genetic factors alone cannot explain the pathophysiology of moyamoya disease (MMD), and environmental factors such as an immune response are thought to be involved. Oral and gut microbiomes have attracted attention as environmental factors in the pathophysiology of some vascular and autoimmune diseases. However, the relationship between MMD and these microbiomes is yet to be thoroughly investigated. This prospective case–control study aimed to compare the microbiomes of Japanese patients with MMD with those of healthy individuals to identify the specific bacteria involved in MMD. Saliva and fecal samples were collected from 16 patients with MMD who had not undergone revascularization surgery. Fifteen healthy individuals were matched for age, sex, and body mass index. The microbiomes were determined using 16S rRNA sequencing and analyzed using QIIME2. Differentially abundant microbes were identified using LEfSE and ANCOM-BC. In the oral microbiome, the two analytical methods showed that Campylobacter was more abundant in patients with MMD than in healthy individuals. Differences in the gut microbiome were smaller than those in the oral microbiome. In conclusion, the oral microbiome profiles of patients with MMD significantly differ from those of healthy individuals. Campylobacter spp. could be a substantial environmental factor in the pathophysiology of MMD.

DOI： 10.1038/s41598-023-45755-3

Development of machine learning models for predicting unfavorable functional outcomes from preoperative data in patients with chronic subdural hematomas 査読有り Open Access

Fuse, Y; Nagashima, Y; Nishiwaki, H; Ohka, F; Muramatsu, Y; Araki, Y; Nishimura, Y; Ienaga, J; Nagatani, T; Seki, Y; Watanabe, K; Ohno, K; Saito, R

SCIENTIFIC REPORTS 13 巻 ( 1 ) 頁： 16997 2023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：Scientific Reports

Chronic subdural hematoma (CSDH) often causes neurological deterioration and is treated with hematoma evacuation. This study aimed to assess the feasibility of various machine learning models to preoperatively predict the functional outcome of patients with CSDH. Data were retrospectively collected from patients who underwent CSDH surgery at two institutions: one for internal validation and the other for external validation. The poor functional outcome was defined as a modified Rankin scale score of 3–6 upon hospital discharge. The unfavorable outcome was predicted using four machine learning algorithms on an internal held-out cohort (n = 188): logistic regression, support vector machine (SVM), random forest, and light gradient boosting machine. The prediction performance of these models was also validated in an external cohort (n = 99). The area under the curve of the receiver operating characteristic curve (ROC-AUC) of each machine learning-based model was found to be high in both validations (internal: 0.906–0.925, external: 0.833–0.860). In external validation, the SVM model demonstrated the highest ROC-AUC of 0.860 and accuracy of 0.919. This study revealed the potential of machine learning algorithms in predicting unfavorable outcomes at discharge among patients with CSDH undergoing burr hole surgery.

DOI： 10.1038/s41598-023-44029-2

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