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図書
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edited by Shinro Matsuo
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論文
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Shibutani, Takayuki ; Onoguchi, Masahisa ; Yoneyama, Hiroto ; Konishi, Takahiro ; Matsuo, Shinro ; Nakajima, Kenichi ; 澁谷, 孝行 ; 松尾, 信郎 ; 中嶋, 憲一
概要:
金沢大学医薬保健研究域保健学系<br />ObjectivesAlthough the utility of IQ-SPECT imaging using 99mTc and 201Tl myocardial perfusion SPECT
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has been reported, 123I-labeled myocardial SPECT has not been fully evaluated. We determined the characteristics and utility of 123I IQ-SPECT imaging compared with conventional SPECT (C-SPECT).MethodsTwo myocardial phantom patterns were used to simulate normal myocardium and myocardial infarction. SPECT acquisition was performed using a hybrid dual-head SPECT/CT system equipped with a SMARTZOOM collimator for IQ-SPECT or a low-medium energy general purpose collimator for C-SPECT. Projection data were reconstructed using ordered subset expectation maximization with depth-dependent 3-dimensional resolution recovery for C-SPECT and ordered subset conjugate gradient minimizer method for IQ-SPECT. Three types of myocardial image were created; namely, no correction (NC), with attenuation correction (AC), and with both attenuation and scatter corrections (ACSC). Five observers visually scored the homogeneity of normal myocardium and defect severity of the myocardium with inferior defects by a five-point scale: homogeneity scores (5 = homogeneous to 1 = inhomogeneous) and defect scores (5 = excellent to 1 = poor). We also created a 17-segment polar map and quantitatively assessed segmental %uptake using a myocardial phantom with normal findings and defects.ResultsThe average visual homogeneity scores of the IQ-SPECT with NC and ACSC were significantly higher than that of C-SPECT, whereas the average visual defect scores of IQ-SPECT with AC and ACSC were significantly lower. The %uptake of all segments for IQ-SPECT with NC was significantly higher than that of C-SPECT. Furthermore, the subtraction of %uptake for C-SPECT and IQ-SPECT was the largest in inferior wall, which was approximately 10.1%, 14.7% and 14.4% for NC, AC and ACSC, respectively. The median % uptake values of the inferior wall with defect areas for C-SPECT and IQ-SPECT were 46.9% and 50.7% with NC, 59.8% and 69.2% with AC, and 54.7% and 66.5% with ACSC, respectively.Conclusion123I IQ-SPECT imaging significantly improved the attenuation artifact compared with C-SPECT imaging. Although the defect detectability of IQ-SPECT was inferior to that of C-SPECT, 123I IQ-SPECT images with NC and ACSC met the criteria for defect detectability. Use of 123I IQ-SPECT is suitable for routine examinations.<br />Embargo Period 12 months
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論文
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Shibutani, Takayuki ; Nakajima, Kenichi ; Wakabayashi, Hiroshi ; Mori, Hiroshi ; Matsuo, Shinro ; Yoneyama, Hiroto ; Konishi, Takahiro ; Okuda, Koichi ; Onoguchi, Masahisa ; Kinuya, Seigo ; 澁谷, 孝行 ; 中嶋, 憲一 ; 若林, 大志 ; 松尾, 信郎 ; 米山, 寛人 ; 小野口, 昌久 ; 絹谷, 清剛
概要:
金沢大学医薬保健研究域保健学系<br />ObjectivesThe patient-based diagnosis with an artificial neural network (ANN) has shown potential u
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tility for the detection of coronary artery disease; however, the region-based accuracy of the detected regions has not been fully evaluated. The aim of this study was to demonstrate the accuracy of all detected regions compared with expert interpretation.\nMethodsA total of 109 abnormal regions including 33 regions with stress defects and 76 regions with ischemia were examined, which were derived from 21 patients who underwent myocardial perfusion SPECT within 45 days of coronary angiography. The gray and color scale images, a polar map of stress, rest and difference, and left ventricular function were displayed on the monitor to score the extent and severity of stress defect and ischemia. Two experienced nuclear medicine physicians (Observers A and B) scored the abnormality with a 4-point scale and draw abnormal regions on a polar map. The gold standard was determined by the final judgment of normal or abnormal by the consensus of two other independent expert nuclear cardiologists, and was compared with the stress defect and ischemia derived from ANN.\nResultsThe concordance rate of ANN to the gold standard was higher than that of two observers. Furthermore, the κ coefficient indicated moderate to substantial agreement for stress defect and slight to the fair agreement for ischemia. The area under the curve (AUC) of ANN was the highest for both stress defect and ischemia; in particular, the ANN of ischemia showed significantly higher AUC than Observer A (p = 0.005). The ANN of stress defect showed higher specificity compared with two observers, while the ANN of ischemia showed higher sensitivity. Consequently, the accuracy of ANN showed the highest in this study.\nConclusionThe ANN-based regional diagnosis showed a high concordance rate with the gold standard and comparable or even higher than the interpretation by nuclear medicine physicians.<br />Embargo Period 12 months
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論文
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Matsuo, Shinro
概要:
金沢大学附属病院核医学診療科
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Akhter, Nasima ; Nakajima, Kenichi ; Okuda, Koichi ; Matsuo, Shinro ; Yoneyama, Tatsuya ; Taki, Junichi ; Kinuya, Seigo
概要:
金沢大学医薬保健研究域医学系<br />Purpose: Gated single-photon emission computed tomography (SPECT) imaging of myocardium by 99mTc and
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201Tl is used extensively to measure quantitative cardiac functional parameters. However, factors affecting normal values for myocardial functional parameters and population-specific standards have not yet been established. The aim of the study was to determine the effect of sex, radiotracer, rotation angles and frame rates on resting myocardial wall thickening (WT) and to develop a Japanese standard of normal values for WT. Methods: Data from a total of 202 patients with low possibility of having cardiac problems were collected from nine hospitals throughout Japan. Patients were divided into five groups according to study protocol, and WT was evaluated according to the 17-segment and four-region (basal, mid and apical regions and the apex) polar map distribution. Result: WT was generally higher in women than in men irrespective of the use of radiotracers, rotation angles or frame rates, and the difference was highly significant in the mid and apical regions. In any protocol used, resting myocardial thickening in the apex was higher than in the mid and apical regions, and thickening was lowest in the basal region, suggesting heterogeneous regional myocardial thickening (%) in normal subjects. Different rotation angles showed no significant change on WT, but different frame rates and tracers showed significant WT change in both sexes. Percent thickening of the myocardium was significantly higher in imaging by 99mTc-labelled tracers than in 201Tl. Conclusion: Sex, radiotracers and frame rates had a significant effect on myocardial thickening, and the importance of population-specific standards should be emphasized. A normal database can serve as a standard for gated SPECT evaluation of myocardial thickening in a Japanese population and might be applicable to Asian populations having a similar physique. © 2008 Springer-Verlag.<br />This article has not been published yet.
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論文
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Okuda, Koichi ; Nakajima, Kenichi ; Motomura, Nobutoku ; Kubota, Masahiro ; Yamaki, Noriyasu ; Maeda, Hisato ; Matsuo, Shinro ; Kinuya, Seigo
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金沢大学医薬保健研究域<br />Objective: Segmentation with scatter and photopeak window data using attenuation correction (SSPAC) met
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hod can provide a patient-specific non-uniform attenuation coefficient map only by using photopeak and scatter images without X-ray computed tomography (CT). The purpose of this study is to evaluate the performance of attenuation correction (AC) by the SSPAC method on normal myocardial perfusion database. Methods: A total of 32 sets of exercise-rest myocardial images with Tc-99 m-sestamibi were acquired in both photopeak (140 keV ± 10%) and scatter (7% of lower side of the photopeak window) energy windows. Myocardial perfusion databases by the SSPAC method and non-AC (NC) were created from 15 female and 17 male subjects with low likelihood of cardiac disease using quantitative perfusion SPECT software. Segmental myocardial counts of a 17-segment model from these databases were compared on the basis of paired t test. Results: AC average myocardial perfusion count was significantly higher than that in NC in the septal and inferior regions (P < 0.02). On the contrary, AC average count was significantly lower in the anterolateral and apical regions (P < 0.01). Coefficient variation of the AC count in the mid, apical and apex regions was lower than that of NC. Conclusions: The SSPAC method can improve average myocardial perfusion uptake in the septal and inferior regions and provide uniform distribution of myocardial perfusion. The SSPAC method could be a practical method of attenuation correction without X-ray CT. © 2009 The Japanese Society of Nuclear Medicine.
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論文
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Okuda, Koichi ; Nakajima, Kenichi ; Hosoya, Tetsuo ; Ishikawa, Takehiro ; Konishi, Takahiro ; Matsubara, Kosuke ; Matsuo, Shinro ; Kinuya, Seigo
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金沢大学医薬保健研究域医学系<br />Background: We have developed novel software for semi-automatically measuring heart-to-mediastinum (
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H/M) ratio in cardiac Iodine-123 (123I)-labeled meta-iodobenzylguanidine (MIBG) imaging. Our aim is to improve the reproducibility of the H/M ratio using the semi-automated method as opposed to the manual method. Methods and Results: The software algorithm automatically determined the mediastinal region of interest (ROI) using information from 123I-MIBG uptake of the heart, lung, liver, and thyroid after a cardiac circular ROI was manually set. A total of 37 patients who underwent both early and delayed 123I-MIBG imaging was retrospectively selected. The heart-to-mediastinum (H/M) ratios were calculated by both semi-automated and manual methods and assessed for the intra- and inter-observer variability. All H/M ratios were classified into three groups: normal, slight abnormality, and severe abnormality. The H/M ratios with the new method were higher than those obtained manually (P<.001). In the test-retest reliability, the intra-class correlation coefficient from the semi-automated method showed excellent reproducibility for early (0.99) and delayed (0.99) imaging. The Bland-Altman plots demonstrated better agreement using the semi-automated method (a range of 95% limits -0.11 to 0.10) than that in the manual method (-0.34 to 0.27). The inter-observer agreement was also good using the semi-automated method (κ = 0.866). Conclusions: The H/M ratio using the semi-automated method showed high reproducibility in both early and delayed imaging. © 2010 American Society of Nuclear Cardiology.
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論文
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Nakajima, Kenichi ; Matsuo, Shinro ; Kawano, Masaya ; Matsumoto, Naoya ; Hashimoto, Jun ; Yoshinaga, Keiichiro ; Taki, Junichi ; Okuda, Koichi
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金沢大学医薬保健研究域医学系<br />Purpose The Japanese Society of Nuclear Medicine (JSNM) working group has created a myocardial perfu
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sion imaging database applicable to standard acquisition protocol. The aim of this study is to validate the diagnostic accuracy of the common normal database compared with the expert interpretation of each institute. Methods Five institutions participated in this study and used different acquisition settings which included 360°/ 180° rotation, camera configuration and camera orbits. The software and its version used in each institution also varied. The working group database was applied to detect the culprit coronary territory from a total of 166 patients with coronary artery disease (CAD) and 145 patients with lowlikelihood of CAD. Results When summed stress score C4 was defined as significant abnormality, overall sensitivity, specificity and accuracy of patient-based analysis were 77, 72 and 75%, respectively, based on quantitative analysis using the common database, whereas those by institutional visual expert reading were 72, 79 and 75%, respectively. Conclusion The common database, which was created by a multi-center working group and separated between male/ female with 180/360° acquisitions, demonstrated comparable diagnostic accuracy to expert interpretation by each institute, and it may be applicable to multi-center studies.
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論文
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Nakajima, Kenichi ; Matsuo, Shinro ; Hasegawa, Minoru ; Kinuya, Seigo ; Takehara, Kazuhiko
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金沢大学医薬保健研究域医学系<br />Myocardial involvement is an important prognostic factor in patients with systemic sclerosis, and ea
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rly diagnosis and staging of the disease have been sought after. Since myocardial damage is characterized by connective tissue disease, including fibrosis and diffuse vascular lesions or microcirculation, nuclear myocardial perfusion imaging has been a promising option for evaluating myocardial damages in early stages. In addition to the conventional stress-rest perfusion imaging, the current use of quantitative electrocardiographic gated imaging has contributed to more precise evaluation of cardiac perfusion, ventricular wall motion, and diastolic function, all of which have enhanced diagnostic ability of evaluating myocardial dysfunction. Abnormal sympathetic imaging with Iodine-123 metaiodobenzylguanidine might be another option for identifying myocardial damage. This paper deals with approaches from nuclear cardiology to detect perfusion and functional abnormality as an early sign of myocardial involvement as well as possible prognostic values in patients with abnormal imaging results. The role of nuclear cardiology in the era of multiple imaging modalities is discussed.
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Nakajima, Kenichi ; Okuda, Koichi ; Nyström, Karin ; Richter, Jens ; Minarik, David ; Wakabayashi, Hiroshi ; Matsuo, Shinro ; Kinuya, Seigo ; Edenbrandt, Lars
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Purpose In patients with a small heart, defined as an end-systolic volume (ESV) of ≤20 mL calculated using the Quantitat
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ive Gated SPECT (QGS) program, underestimation of ESV and overestimation of ejection fraction (EF) using gated myocardial perfusion imaging are considered errors caused by inappropriate delineation of the left ventricle (LV). The aim of this study was to develop a new method for delineation of the LV and to evaluate it in studies using a digital phantom, normal subjects and patients. Methods The active shape-based method for LV delineation, EXINI heart (ExH), was adjusted to more accurately process small hearts. In small hearts, due to the partial volume effect and the short distance to the opposite ventricular wall, the endocardial and the epicardial surfaces are shifted in the epicardial direction depending on the midventricular volume. The adjusted method was evaluated using digital XCAT phantoms with Monte Carlo simulation (8 virtual patients), a Japanese multicentre normal database (69 patients) and consecutive Japanese patients (116 patients). The LV volumes, EF and diastolic parameters derived from ExH and QGS were compared. Results The digital phantom studies showed a mean ESV of 87 %±9 % of the true volume calculated using ExH and 22 %±18 % calculated using QGS. In the normal database, QGS gave higher EFs in women than in men (71.4±6.0 % vs. 67.2±6.0 %, p=0.0058), but ExH gave comparable EFs (70.7±4.9 % and 71.4±5 % in men and women, respectively, p=ns). QGS gave higher EFs in subjects with a small heart than in those with a normal-sized heart (74.5±5.1 % vs. 66.1±4.9 %), but ExH gave comparable values (70.0±5.9 % vs. 71.6±4.2 %, respectively, p=ns). In consecutive patients, the average EFs with QGS in patients with ESV >20 mL, 11–20 mL and ≤10 mL were 57.9 %, 71.9 % and 83.2 %, but with ExH the differences among these groups were smaller (65.2 %, 67.8 % and 71.5 %, respectively). Conclusion The volume-dependent edge correction algorithm was able to effectively reduce the effects on ESV and EF of a small heart. The uniform normal values might be applicable to both men and women and to both small and normal-sized hearts.
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