※一部利用できない機能があります
| 1.
論文 |
論文
|
Imamura, S. ; Kobayashi, Junji ; Sakasegawa, S. ; Nohara, Atsushi ; Nakajima, Kenichi ; Kawashiri, Masa-aki ; Inazu, Akihiro ; Yamagishi, Masakazu ; Koizumi, Junji ; Mabuchi, Hiroshi ; 小林, 淳二 ; 野原, 淳 ; 中嶋, 憲一 ; 川尻, 剛照 ; 稲津, 明広 ; 山岸, 正和 ; 小泉, 順二 ; 馬渕, 宏
概要:
金沢大学医薬保健研究域医学系<br />The objective of this study was to establish a hepatic lipase (HL) assay method that can be applied
…
to automatic clinical analyzers. Seventy-four hyperlipidemic subjects (men/women 45/29) were recruited. Lipase activity was assayed measuring the increase in absorbance at 546 nm due to quinonediimine dye production. Reaction mixture R-1 contained 50 mM Tris-HCl (pH 9.5), 0.5 mM glycerol-1,2-dioleate, 0.4% (unless otherwise noted) polyoxyethylenenonylphenylether, 3 mM ATP, 3 mM MgCl2, 1.5 mM CaCl2, monoacylglycerol-specific lipase, glycerol kinase, glycerol-3-phosphate oxidase, 0.075% N,N-bis-(4-sulfobutyl)-3-methylaniline-2 Na, peroxidase, ascorbic acid oxidase. Reaction mixture R-2 contained 50 mM Tris-HCl (pH9.5), 0.15% 4-aminoantypirine. Automated assay for activity was performed with a Model 7080 Hitachi analyzer. In the lipase assay, 160 μl of R-1 was incubated at 37°C with 3 μl of samples for 5 min, and 80 μl of R-2 was added. Within-run coefficient of variations was 0.9-1.0%. Calibration curve of lipase activity was linear (r = 0.999) between 0 and 320 U/l. Analytical recoveries of purified HL added to plasma were 96.6-99.8%. HL activity in postheparin plasma measured in this method had a closer correlation with HL mass by a sandwich ELISA (r = 0.888, P , 0.0001) than those in the conventional method using [ 14C-]triolein (r = 0.730, P < 0.0001). This assay method for HL activity can be applied to an automatic clinical analyzer. Copyright © 2007 by the American Society for Biochemistry and Molecular Biology, Inc.
続きを見る
|
||||
| 2.
論文 |
論文
|
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
…
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
続きを見る
|
||||
| 3.
論文 |
論文
|
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
…
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
続きを見る
|
||||
| 4.
論文 |
論文
|
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
…
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.
続きを見る
|
||||
| 5.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, Tsunehiko
概要:
The multicenter Japanese-Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS), which involved 117 institutions and 4,629 patients, was the first attempt to quantify cardiac events and survival using
…
stress-rest-gated single-photon emission computed tomography myocardial perfusion images (MPI) and QGS software in Japan. A 3-year follow-up study showed a relatively lower incidence of hard events than in the USA and some European countries, but a similar role of perfusion and left ventricular (LV) function. A low event risk with normal MPI and a higher incidence of major cardiac events in patients with large perfusion defects and LV dysfunction were defined. MPI was useful even among patients with proven coronary artery stenosis. The association between diabetes and chronic kidney disease (CKD) was an important predictor of cardiac events and the risk was evaluated using new software and risk charts. Additional studies were extended to include asymptomatic diabetes (J-ACCESS 2) and CKD (J-ACCESS 3). Because risk estimation is linked to the national healthcare system and clinical practice, optimal risk stratification and guidance for therapeutic strategies are recommended. (Circ J 2012; 76: 1313-1321)
続きを見る
|
||||
| 6.
論文 |
論文
|
Nakajima, Kenichi
概要:
金沢大学医薬保健研究域医学系
|
||||
| 7.
論文 |
論文
|
Nakajima, Kenichi ; Inaki, Anri ; Hiramatsu, Takashi ; Hasegawa, Minoru ; Fujimoto, Manabu ; Takehara, Kazuhiko ; Kinuya, Seigo
概要:
金沢大学医薬保健研究域医学系<br />Objectives: Esophageal complications are common in patients with systemic sclerosis (SSc). The relat
…
ionship between gastroesophageal reflux (GER) symptoms and dysmotility was examined in endoscopically confirmed patients suspected of having reflux esophagitis. Methods: A total of 32 patients with limited and diffuse type SSc (lSSc, dSSc) were examined based on a structured questionnaire score (QS) of GER symptoms, retention fraction of esophageal scintigraphy at 90 s (R90) and gastric emptying time. Results: The QS was significantly higher in the reflux esophagitis group than in the non-esophagitis group (5.4 ± 3.5, 1.4 ± 2.9, P = 0.003). When the non-esophagitis group was further divided into lSSc and dSSc groups, R90 was higher in the reflux esophagitis group (31 ± 18%) and the non-esophagitis group with dSSc (34 ± 32%) than in the non-esophagitis group with lSSc (8 ± 3%, P = 0.02). Both high R90 ≥ 15% and QS ≥ 4 indicated reflux esophagitis. Conversely, both normal R90 and QS indicated no reflux esophagitis. Conclusion: A combination of esophageal scintigraphy and structured questionnaire demonstrated different aspects of esophageal dysfunction, namely dysmotility and GER. Patients with high QS and dysmotility may be indicated for further evaluation including endoscopic examination and medical treatment. © 2009 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 8.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, T.
概要:
金沢大学医薬保健研究域医学系
|
||||
| 9.
論文 |
論文
|
Okuda, Koichi ; Nakajima, Kenichi ; Motomura, Nobutoku ; Kubota, Masahiro ; Yamaki, Noriyasu ; Maeda, Hisato ; Matsuo, Shinro ; Kinuya, Seigo
概要:
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
…
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.
続きを見る
|
||||
| 10.
論文 |
論文
|
Nakajima, Kenichi ; Kumita, Shinichiro ; Ishida, Yoshio ; Momose, Mitsuru ; Hashimoto, Jun ; Morita, Koichi ; Taki, Junichi ; Yamashina, Shohei ; Maruno, Hirotaka ; Ogawa, Masami ; Kubota, Masahiro ; Takahashi, Munehiro ; Odagawa, Tetsuro ; Yokozuka, Koichi
概要:
金沢大学大学院医学系研究科がん制御学
|
||||
| 11.
論文 |
論文
|
Nakajima, Kenichi ; Higuchi, Takahiro ; Taki, Junichi ; Kawano, Masaya ; Tonami, Norihisa
概要:
金沢大学大学院医学系研究科<br />Gated myocardial perfusion SPECT has been used to calculate ejection fraction (EF) and end-diastolic
…
volume (EDV) and has correlated well with conventional methods. However, the comparative accuracy of and correlations across various types of gated SPECT software are not well understood. Methods: Mathematic phantoms of cylindric-hemispheric hybrid models, ranging in volume from 34 to 266 mL, were generated. The clinical cases consisted of 30 patients who participated in a radionuclide angiography and gated blood-pool (GBP) study in addition to undergoing 99mTc-sestamibi gated SPECT. Four kinds of software, Quantitative Gated SPECT (QGS), the Emory Cardiac Toolbox (ECT), 4D-MSPECT, and Perfusion and Functional Analysis for Gated SPECT (pFAST) were used to compute EF and EDV, and the results were analyzed by multiple comparisons tests. Patients were classified into 4 groups (i.e., no defect, small defect, large defect, and small heart) so that factors affecting variation could be analyzed. Results: In mathematic models ≥74 mL, volume error was within ±15%, whereas for a small volume (34 mL), QGS and 4D-MSPECT underestimated the volume and pFAST overestimated it. The respective intra- and interobserver reproducibility of the results was good for QGS (r=0.99 and 1.00), ECT (r=0.98 and 0.98), and 4D-MSPECT (r=0.98 and 0.98) and fair for pFAST (r=0.88 and 0.85). The correlation coefficient for EF between gated SPECT and the GBP study was 0.82, 0.78, 0.69, and 0.84 for QGS, ECT, 4D-MSPECT, and pFAST, respectively. The correlation coefficient for EDV between gated SPECT and the GBP study was 0.88, 0.89, 0.85, and 0.90, respectively. Although good correlation was observed among the 4 software packages, QGS, ECT, and 4D-MSPECT overestimated EF in patients with small hearts, and pFAST overestimated the true volume in patients with large perfusion defects. Correlation coefficients among the 4 kinds of software were 0.80-0.95 for EF and 0.89-0.98 for EDV. Conclusion: All 4 software programs showed good correlation between EF or EDV and the GBP study. Good correlation was observed also between each pair of quantification methods. However, because each method has unique characteristics that depend on its specific algorithm and thus behaves differently in the various patient subgroups, the methods should not be used interchangeably.
続きを見る
|
||||
| 12.
論文 |
論文
|
Terai, Hidenobu ; Shimizu, Masami ; Ino, Hidekazu ; Yamaguchi, Masato ; Uchiyama, Katsuharu ; Oe, Kotaro ; Nakajima, Kenichi ; Taki, Junichi ; Kawano, Masaya ; Mabuchi, Hiroshi
概要:
金沢大学大学院医学系研究科<br />Left ventricular (LV) systolic function in hypertrophic cardiomyopathy (HCM) is usually normal. Late
…
in the disease, however, LV systolic dysfunction and dilatation are recognized. Although abnormalities in cardiac sympathetic nerve activity in patients with HCM have been demonstrated using 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, the changes of cardiac sympathetic nerve activity throughout the clinical course from typical to end-stage HCM are unclear. The objective of this study was to evaluate the relationship between abnormalities on 123I-MIBG myocardial scintigraphy and pathophysiologic changes in patients with HCM. Methods: We performed 123I-MIBG scintigraphy on 46 patients with HCM and 18 age-matched control subjects. The patients were categorized into 3 groups: 28 patients with normal LV systolic function (group A), 9 patients with LV systolic dysfunction (group B), and 9 patients with LV systolic dysfunction and dilatation (group C). With planar 123I-MIBG imaging, the heart-to-mediastinum ratio for early and delayed acquisitions and the washout rate were calculated. With SPECT, polar maps of the LV myocardium were divided into 20 segments. The regional uptake and washout rate were calculated from semiquantitative 20-segment bull's-eye analysis. Results: The early uptake was significantly lower in group C than in the control group (P < 0.01). The washout rate was progressively higher in group A, group B, and group C (P < 0.01). Reduced regional early uptake was found in 2.9 ± 3.4 (group A), 4.1 ± 4.7 (group B), and 7.4 ± 4.3 (group C) segments, respectively. In group C, regional early uptake was significantly reduced, predominantly in the interventricular septal wall, and regional washout rate was increased in the apex and lateral wall. Conclusion: These results suggest that cardiac sympathetic nerve abnormalities in patients with HCM may advance with development of LV systolic dysfunction and dilatation and that 123I-MIBG myocardial scintigraphy may be a useful tool for the evaluation of pathophysiologic changes in HCM.
続きを見る
|
||||
| 13.
論文 |
論文
|
Shimizu, Masami ; Ino, Hidekazu ; Yamaguchi, Masato ; Terai, Hidenobu ; Hayashi, Kenshi ; Nakajima, Kenichi ; Taki, Junichi ; Mabuchi, Hiroshi
概要:
金沢大学大学院医学系研究科<br />Cardiac sympathetic nerve activity is changed in patients with hypertrophic cardiomyopathy (HCM). How
…
ever, the relationship between heterogeneity of this activity and systolic left ventricular dysfunction in patients with HCM is not well established. This study was performed to evaluate the sympathetic nerve activity in various cardiac regions and to investigate the relationship between cardiac dysfunction and heterogeneity of the cardiac sympathetic nerve activity in patients with HCM. Methods: Cardiac sympathetic nerve activity was evaluated in 25 patients with HCM and 10 control subjects using planar imaging and SPECT by 123l-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. With planar 123I-MIBG imaging, the heart-to-mediastinum activity ratios (H/M), at early (20 min) and delayed (3 h) acquisition, and the washout rate were calculated. Polar maps of the left ventricular myocardium were divided into 20 segments, and the dispersion (maximal to minimal values) and SD of uptake and the washout rate in 20 segments were calculated. Results: The early H/M did not differ between the 2 groups. The delayed H/M was significantly lower and the washout rate of the whole heart was significantly higher in the HCM group than those in the control group. In patients with HCM, the delayed H/M, early uptake dispersion, and SD of early uptake showed good correlation with the left ventricular end-diastolic and end-systolic dimensions and the percentage of fractional shortening. A stepwise regression analysis revealed that the SD of early uptake was a powerful determinant for the percentage of fractional shortening in patients with HCM. Conclusion: These results suggest that the heterogeneity of regional cardiac sympathetic nerve activity may be correlated with cardiac dysfunction in patients with HCM.
続きを見る
|
||||
| 14.
論文 |
論文
|
Taki, Junichi ; Fujino, Susumu ; Nakajima, Kenichi ; Matsunari, Ichiro ; Okazaki, Hideaki ; Saga, Takashi ; Bunko, Hisashi ; Tonami, Norihisa
概要:
金沢大学大学院医学系研究科<br />The aim of the study was to investigate the increase in myocardial 99mTc-methoxyisobutylisonitrile (s
…
estamibi) retention in humans during pharmacologic vasodilation. Methods: For calculation of the increase in 99mTc-sestamibi retention during hyperemia, baseline and adenosine triphosphate (ATP)-induced hyperemic stress sestamibi studies were performed using a same-day rest-stress protocol. On the injection of sestamibi, left ventricular dynamic data were obtained for 90 s. The increase in sestamibi retention from baseline to hyperemia was calculated by the formula Cmh(t) ∫01 Cbb(τ)dτ/Cmb(t) ∫01 Cbh(τ)dτ, where Cmh(t) and Cmb(t) are myocardial counts on the tomographic image, and Cbb(τ) and Cbh(τ) are the left ventricular blood-pool counts during the first transit of sestamibi at baseline and during hyperemia, respectively. Coronary flow increase during intravenous ATP stress was measured using intracoronary Doppler flow guide wire and compared with the scintigraphic results of 28 measurements in 22 patients. Results: Sestamibi retention increased as coronary flow velocity increased but plateaued at >2.5-3 times baseline flow velocity. The relationship between the increase in sestamibi retention (Y) and the increase in flow (X) is expressed as follows: Y = 0.44 + 0.60X - 0.068X2 (r = 0.82). Conclusion: In humans, the increase in 99mTc-sestamibi myocardial retention underestimates coronary flow reserve, particularly at high flow rates. Knowledge of these tracer retention characteristics will contribute to a more comprehensive understanding of the manner and interpretation of stress sestamibi imaging.
続きを見る
|
||||
| 15.
論文 |
論文
|
Taki, Junichi ; Higuchi, Takahiro ; Kawashima, Atsuhiro ; Tait, Jonathan F. ; Kinuya, Seigo ; Muramori, Akira ; Matsunari, Ichiro ; Nakajima, Kenichi ; Tonami, Norihisa ; Strauss, H. William
概要:
金沢大学大学院医学系研究科<br />There is increasing evidence that cell death after myocardial ischemia and reperfusion may begin as a
…
poptosis rather than necrosis. To determine the time course, location, and extent of this process, we studied groups of rats after a 20-min interval of coronary occlusion and reperfusion. METHODS: After thoracotomy, the left coronary artery was occluded for 20 min. After release and before study, groups of animals were allowed to recover for various intervals: 0.5 h (n = 6), 1.5 h (n = 7), 6 h (n = 7), 1 d (n = 8), 3 d (n = 8), or 2 wk (n = 5). At the time of study, the rats were injected with 99mTc-annexin V (80-150 MBq). One hour later, to verify the area at risk, 201Tl (0.74 MBq) was injected intravenously just after the left coronary artery reocclusion and the rats were sacrificed 1 min later. Dual-tracer autoradiography was performed to assess 99mTc-annexin V uptake and the area at risk. RESULTS: Extensive 99mTc-annexin V uptake was observed in the mid myocardium after 0.5-1.5 h of reperfusion. The area of annexin uptake had expanded in the subendocardial and subepicardial layers at 6 h after reperfusion and then gradually lessened over 3 d. At 0.5 and 1.5 h of reperfusion, 99mTc-annexin V uptake ratios were 7.36 +/- 2.95 and 6.34 +/- 2.24 (mean +/- SD), respectively. The uptake ratios gradually decreased at 6 h, 1 d, 3 d, and 2 wk after reperfusion (4.65 +/- 1.93, 3.27 +/- 0.92 [P < 0.01 vs. 0.5 h], 1.84 +/- 0.55 [P < 0.001 vs. 0.5 h, P < 0.005 vs. 1.5 h], and 1.65 +/- 0.31 [P < 0.001 vs. 0.5 h, P < 0.005 vs. 1.5 h], respectively). CONCLUSION: These data indicate that annexin binding commences soon after ischemia and reperfusion in the mid myocardium within the area at risk and expands to include the subendocardial and subepicardial layers at 6 h after reperfusion, followed by gradual reduction of activity over 3 d.
続きを見る
|
||||
| 16.
論文 |
論文
|
Taki, Junichi ; Higuchi, Takahiro ; Nakajima, Kenichi ; Matsunari, Ichiro ; Hwang, Eui-Hyo ; Bunko, Hisashi ; Kawasuji, Michio ; Watanabe, Go ; Tonami, Norihisa
概要:
金沢大学大学院医学系研究科<br />Abnormal septal motion after coronary artery bypass graft surgery (CABG) is a common finding. This st
…
udy was undertaken to investigate the change in various global and regional ventricular function parameters measured by gated myocardial perfusion SPECT after surgery and to determine which quantitative parameter of WT and WM is more appropriate for the evaluation of regional cardiac function, especially in the septum of patients with CABG. Methods: Before and 3 to 5 wk after CABG (all patients underwent at least 1 bypass grafting to the left anterior descending coronary artery), 35 patients (28 men, 7 women) underwent gated SPECT using 99mTc-methoxyisobutylisonitrile. Quantitative global and regional ventricular functional analysis was performed using quantitative gated SPECT software. Results: Global ejection fraction did not change (59.3% ± 16.0% to 60.5% ± 14.5%, P = 0.24). However, end-diastolic and end-systolic volumes lessened significantly after CABG (81.4 ± 37.3 mL to 68.9 ± 28.9 mL, P < 0.0001, and 38.1 ± 33.1 mL to 30.4 ± 23.0 mL, P < 0.005, respectively). As global function parameters, the changes in both total WM (r = 0.88) and WT (r = 0.86) correlated well with the change in ejection fraction after surgery. Segmental analysis showed a significant postoperative increase in relative tracer uptake in the anterior, anteroseptal, inferoseptal, and inferior walls and in the apex. Segmental wall motion (WM) deteriorated in the anteroseptal, inferoseptal, and mid anterior walls. On the other hand, anterolateral, inferolateral, and inferior WM increased. As a whole, these WM changes showed a reduction in septal motion associated with a concomitant increase in lateral motion after surgery. Segmental wall thickening, however, did not decrease in septal areas and did not increase in the lateral wall and correlated with percentage tracer uptake (r = 0.69) better than WM did (r = 0.30) after CABG. Conclusion: In patients with CABG, postoperative WM analysis by gated SPECT underestimated septal motion and overestimated lateral motion because of exaggerated systolic anteromedial cardiac translation. Therefore, wall thickening analysis would be recommended for the evaluation of postoperative cardiac function
続きを見る
|
||||
| 17.
論文 |
論文
|
Higuchi, Takahiro ; Taki, Junichi ; Nakajima, Kenichi ; Kinuya, Seigo ; Namura, Masanobu ; Tonami, Norihisa
概要:
金沢大学大学院医学系研究科<br />Serial changes in fatty acid metabolism or use associated with acute ischemia and reperfusion were ex
…
amined in rat hearts. Methods: Male Wistar rats were subjected to occlusion of the left coronary artery for 20 min followed by reperfusion. After release of the occlusion, groups of animals were allowed to recover for intervals of 20 min (n = 9), 1 d (n = 9), 3 d (n = 6), 7 d (n = 6), or 30 d (n = 6). Hearts were excised 15-20 min after injection of 0.74 MBq of 125I-15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) and 14.8 MBq of 201TI. One minute before resection, the left coronary artery was reoccluded and 185 MBq of 99mTc-sestamibi were injected to document the area at risk. Triple-tracer autoradiography was performed to assess tracer uptake. Uptake ratios of BMIPP and 201TI in the area at risk were calculated on the basis of the count density in the lesion divided by that in the normally perfused area. Results: 201TI uptake did not change throughout the observation period (P = 0.25). In contrast, BMIPP uptake increased early in the acute phase (20 min and 1 d), decreased during the sub-acute phase (7 d), and subsequently recovered in the chronic phase (30 d). Conclusion: The present investigation clearly illustrated that BMIPP uptake is higher than 201TI uptake in the acute phase, that BMIPP uptake is lower than 201TI uptake in the subacute phase, and that BMIPP uptake and 201TI uptake are similar in the chronic phase. These results yield data essential to the precise interpretation of BMIPP images.
続きを見る
|
||||
| 18.
論文 |
論文
|
Nakajima, Kenichi ; Matsubara, Kosuke ; Ishikawa, Takahiro ; Motomura, Nobutoku ; Maeda, Ryo ; Akhter, Nasima ; Okuda, Koichi ; Taki, Junichi ; Kinuya, Seigo
概要:
金沢大学大学院医学系研究科がん制御学
|
||||
| 19.
論文 |
論文
|
Nakajima, Kenichi ; Taki, Junichi ; Kawano, Masaya ; Higuchi, Takahiro ; Sato, Shinichi ; Nishijima, Chihiro ; Takehara, Kazuhiko ; Tonami, Norihisa
概要:
金沢大学大学院<br />Diagnosis of cardiac involvement is important for the management of patients with systemic sclerosis (SSc).
…
This study was undertaken to determine the significance of gated myocardial perfusion SPECT in patients with SSc and whether diastolic function measured by gated SPECT is an early sign of cardiac complications. Methods: Thirty-four patients with SSc and 16 control patients were studied using exercise nongated and resting gated myocardial perfusion SPECT. The SSc was classified by the modified Rodnan total skin score (TSS) into high-TSS (score ≥ 10; n = 18) and low-TSS (score < 10; n = 16) groups. Gated SPECT was performed using 99mTc-methoxyisobutyl-isonitrile with 16 frames per cardiac cycle and quantitatively analyzed by QGS software and Fourier filtering of the volume curve. The parameters of ejection fraction (EF), peak filling rate (PFR), one-third mean filling rate, and time to PFR (TPFR) were calculated. Results: A slight perfusion abnormality was observed in four and five patients in the low-TSS and high-TSS groups, respectively (not statistically significant). A decreased resting EF less than 55% was found in no and two patients in the low-TSS and high-TSS groups, respectively. TPFR was 166 ± 22, 168 ± 38, and 216 ± 82 ms (P = 0.05, high-TSS group versus low-TSS group; P = 0.04, control group versus high-TSS group) and TPFR/R-R interval was 0.18 ± 0.02, 0.19 ± 0.04, and 0.26 ± 0.09 (P = 0.01, high-TSS group versus low-TSS group; P = 0.005, control group versus high-TSS group) for the control, low-TSS, and high-TSS groups, respectively. Conclusion: Diastolic function can be evaluated by gated myocardial perfusion SPECT. Significant diastolic abnormalities were shown even in patients with normal perfusion and systolic function and were related to the severity of SSc.
続きを見る
|
||||
| 20.
論文 |
論文
|
Nakajima, Kenichi ; Kusuoka, Hideo ; Nishimura, Shigeyuki ; Yamashina, Akira ; Nishimura, Tsunehiko
概要:
金沢大学大学院医学系研究科がん制御学<br />Purpose: Quantitative gated single-photon emission computed tomography (SPECT) is known to have
…
high accuracy and precision for measurement of the principal cardiac functional parameters. We hypothesised that normal values for EF and LV volumes may differ among nationalities, and that optimal threshold values specific to the study population are required. Methods: Among 4,670 consecutively registered patients for a J-ACCESS (Japanese investigation regarding prognosis based on gated SPECT) study from 117 hospitals, a total of 268 (149 women, 119 men) were selected who had no baseline cardiac diseases and had experienced no cardiac events during the preceding 3-year period. A gated SPECT study was performed with 99mTc-tetrofosmin and analysed with Cedars Sinai Medical Center's quantitative gated SPECT (QGS) software. The results in respect of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV), and EDV, ESV and SV normalised by body surface area (EDVI, ESVI and SVI), were calculated and summarised to obtain normal limits. Results: EF for women and men was 74 ± 9% and 63 ± 7%, respectively (p < 0.0001). EDV, ESV and SV were significantly smaller in women than in men. Based on multiple regressions for linear models, the primary and secondary predictors of EF, EDVI, ESVI were gender and age. By stepwise multiple regression analysis, a statistically significant third predictor for EDV, ESV, SV and SVI was body weight. No colinearity was found between age and body weight. Important factors for the studied Japanese population included a high incidence of small hearts in women and the relatively advanced age of the population (the mean age ±SD was 64.1 ± 10.0 years for women and 60.9 ± 11.7 years for men). Conclusion: EF and volumes determined by gated SPECT with QGS were significantly affected by gender and age, with body weight as a third predictor for volumes. Moreover, the normal limits were so specific for the population studied that standards appropriate for the study in question should be utilised. © 2007 Springer-Verlag.
続きを見る
|
||||
| 21.
論文 |
論文
|
Okuda, Koichi ; Nakajima, Kenichi ; Hosoya, Tetsuo ; Ishikawa, Takehiro ; Konishi, Takahiro ; Matsubara, Kosuke ; Matsuo, Shinro ; Kinuya, Seigo
概要:
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 (
…
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.
続きを見る
|
||||
| 22.
論文 |
論文
|
Kahara, Toshio ; Nakajima, Kenichi ; Takahashi, Kozo ; Iwaki, Noriko ; Michigishi, Takatoshi ; Usuda, Rika
概要:
金沢大学医薬保健研究域医学系
|
||||
| 23.
論文 |
論文
|
Nakajima, Kenichi ; Nagara, Tamaki ; Kuwabara, Yoichi ; Kawano, Masaya ; Matsunari, Ichiro ; Taki, Junichi ; Nishimura, Shigeyuki ; Yamashina, Akira ; Ishida, Yoshio ; Tomoike, Hitonobu
概要:
金沢大学医薬保健研究域医学系<br />Backgrounds: Prediction of left ventricular functional recovery is important after myocardial infarc
…
tion. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. Methods: A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99mTc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments. Results: Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p < 0.0001 for non-gated; 64 ± 16% and 51 ± 17% for ES percent uptake, p < 0.0001). The area under the curve of receiver operating characteristics curve for non-gated percent uptake, ES percent uptake, end-diastolic percent uptake and visual perfusion defect score was 0.70, 0.71, 0.61, and 0.56, respectively. Sensitivity and specificity of percent uptake were 68% and 64% for non-gated map and 80% and 52% for ES percent uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES percent uptake values. Conclusion: Segmental 99mTc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study. © 2008 Springer-Verlag.
続きを見る
|
||||
| 24.
論文 |
論文
|
Nakajima, Kenichi ; Matsuo, Shinro ; Kawano, Masaya ; Matsumoto, Naoya ; Hashimoto, Jun ; Yoshinaga, Keiichiro ; Taki, Junichi ; Okuda, Koichi
概要:
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
…
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.
続きを見る
|
||||
| 25.
論文 |
論文
|
Nakajima, Kenichi ; Yamasaki, Yoshimitsu ; Kusuoka, Hideo ; Izumi, Tohru ; Kashiwagi, Atsunori ; Kawamori, Ryuzo ; Shimamoto, Kazuaki ; Yamada, Nobuhiro ; Nishimura, Tsunehiko
概要:
金沢大学医薬保健研究域医学系<br />Purpose Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfusi
…
on imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. Methods A total of 506 asymptomatic patients ≥50 years of age who had carotid artery maximum intima-media thickness ≥1.1 mm, urinary albumin excretion of ≥30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Results Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0–3, 4–8, 9–13, and ≥14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. Conclusion The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients.
続きを見る
|
||||
| 26.
論文 |
論文
|
Yamashita, Shozo ; Yokoyama, Kunihiko ; Onoguchi, Masahisa ; Yamamoto, Haruki ; Hiko, Shigeaki ; Horita, Akihiro ; Nakajima, Kenichi
概要:
Objectives: Deep-inspiration breath-hold (DIBH) PET/CT with short-time acquisition and respiratory-gated (RG) PET/CT are
…
performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. Methods: In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. Results: In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. Conclusion: DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used. © 2013 The Author(s).<br />In Press / 発行後1年より全文を公開
続きを見る
|
||||
| 27.
論文 |
論文
|
Nakajima, Kenichi ; Kusuoka, Hideo ; Nishimura, Shigeyuki ; Yamashina, Akira ; Nishimura, Tsunehiko
概要:
金沢大学医薬保健研究域医学系<br />Objective: To determine the prognostic value of myocardial ischemia, function and coronary risk fact
…
ors on total and hard cardiac events using myocardial perfusion imaging in a Japanese population. Methods: A prospective cohort study was performed in 117 Japanese hospitals, each with a nuclear cardiology facility. A total of 4,031 patients with suspected or confirmed ischemic heart disease were registered. The patients were followed up for a year to investigate total and hard events, and those who had any events were followed up for 3 years to evaluate subsequent hard events. A stress-rest gated myocardial perfusion study was performed with 99mTc-tetrofosmin using gated single-photon emission computed tomography (SPECT) and analyzed by semi-quantitative scores. Results: During the 1-year follow-up period, 263 (6.5%) patients had total events comprising all-cause death, non-fatal myocardial infarction (MI), heart failure, unstable angina, angina pectoris and coronary revascularization. Cardiac death occurred in 23 patients (0.6%) and non-fatal MI in 11 (0.3%). Among patients with ejection fraction (EF) of <45% and a summed difference score (SDS) of ≥2, 18.7% (2.4% for cardiac death and 0.6% for non-fatal MI) experienced total events compared with 3.9% (0.3% for cardiac death and 0.2% for non-fatal MI; P < 0.0001) of those with EF ≥ 45% and SDS < 2. Multivariate analysis identified EF, SDS, age, history of revascularization and diabetes as significant predictors of all events, while the significant predictors were age and EF for hard events. When the patients who had heart failure in the first year were followed up, 9 of 41 (22.0%) experienced cardiac death in the subsequent 3-year follow-up period. Conclusions: Myocardial ischemia defined by SDS and ventricular function were the main predictors of total events despite the relatively low incidence of hard events in this Japanese population. In patients with cardiac events in a year, closer attention should be paid to subsequent hard events particularly in patients with heart failure. © 2009 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 28.
論文 |
論文
|
Nakajima, Kenichi
概要:
金沢大学医薬保健研究域医学系<br />Myocardial normal databases for stress myocardial perfusion study have been created by the Japanese
…
Society of Nuclear Medicine Working Group. The databases comprised gender-, camera rotation range- and radiopharmaceutical-specific data-sets from multiple institutions, and normal database files were created for installation in common nuclear cardiology software. Based on the electrocardiography-gated single-photon emission computed tomography (SPECT), left ventricular function, including ventricular volumes, systolic and diastolic functions and systolic wall thickening were also analyzed. Normal databases for fatty acid imaging using 123I-beta-methyl-iodophenyl-pentadecanoic acid and sympathetic imaging using 123I-meta-iodobenzylguanidine were also examined. This review provides lists and overviews of normal values for myocardial SPECT and ventricular function in a Japanese population. The population-specific approach is a key factor for proper diagnostic and prognostic evaluation. © 2010 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 29.
論文 |
論文
|
Nakajima, Kenichi ; Matsuo, Shinro ; Hasegawa, Minoru ; Kinuya, Seigo ; Takehara, Kazuhiko
概要:
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
…
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.
続きを見る
|
||||
| 30.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, Tsunehiko
概要:
金沢大學医薬保健研究域医学系<br />Cardiac diseases are one of the major causes of death both in Western countries and in Japan. Based
…
on various clinical information, identification of myocardial ischemia and contractile function plays a major role in predicting serious cardiac events of death and acute coronary syndromes. Currently, myocardial perfusion imaging provides both kinds of information, and clinical follow-up studies have been performed in the U.S., Europe and Japan. Due to our involvement in a Japanese multi-center prognostic study, we have found similarities and differences between Western and Japanese populations. The most important predictors of cardiac events are myocardial perfusion abnormality and ventricular function. The importance of diabetes and chronic kidney disease should be also emphasized. The trends of cardiovascular events should be carefully investigated because of westernized diets and lifestyles in addition to current progress of therapeutic strategy.
続きを見る
|
||||
| 31.
論文 |
論文
|
Nakajima, Kenichi ; Yamasaki, Yoshimitsu ; Kusuoka, Hideo ; Izumi, Tohru ; Kashiwagi, Atsunori ; Kawamori, Ryuzo ; Shimamoto, Kazuaki ; Yamada, Nobuhiro ; Nishimura, Tsunehiko
概要:
金沢大学医薬保健研究域医学系<br />Purpose: Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfus
…
ion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. Methods: A total of 506 asymptomatic patients ≥50 years of age who had carotid artery maximum intima-media thickness ≥1.1 mm, urinary albumin excretion of ≥30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Results: Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0-3, 4-8, 9-13, and ≥14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. Conclusion: The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients. © 2009 Springer-Verlag.
続きを見る
|
||||
| 32.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Nyström, Karin ; Richter, Jens ; Minarik, David ; Wakabayashi, Hiroshi ; Matsuo, Shinro ; Kinuya, Seigo ; Edenbrandt, Lars
概要:
Purpose In patients with a small heart, defined as an end-systolic volume (ESV) of ≤20 mL calculated using the Quantitat
…
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.
続きを見る
|
||||
| 33.
論文 |
論文
|
Nakajima, Kenichi ; Takeishi, Yasuchika ; Matsuo, Shinro ; Yamasaki, Yoshimitsu ; Nishimura, Tsunehiko
概要:
Purpose: Patients with metabolic syndrome (MetS) have potentially higher risk for cardiovascular events. The aim of this
…
study was to evaluate the effect of MetS on cardiac events in type-2 diabetic patients asymptomatic for coronary artery disease (CAD) in a Japanese population. Methods: A total of 485 patients from a J-ACCESS-2 investigation with stress-gated myocardial perfusion imaging (MPI) and quantitative-gated MPI analysis were examined. Cardiovascular hard events (cardiac death and acute coronary syndrome) and total events during a 3-year follow-up were analyzed. Results: The MetS group (n = 229) had higher incidence of hypertension, dyslipidemia, and ventricular dilatation than the non-MetS group (n = 256). The hard events were 8 and 12 for the MetS and non-MetS groups (P = n.s.), and total events were 31 and 31 for each of these groups, respectively (P = n.s.). Significant variables related to total cardiovascular events included age, current smoking, insulin use, total cholesterol, ejection fraction, summed stress score ≥ 9, and summed difference score ≥ 2. Cox proportional hazard analysis and Kaplan-Meier survival analysis showed that only the summed stress score was related to total events (P = .01), and the presence and the number of items for MetS criteria were not. Conclusion: In patients with type 2 diabetes asymptomatic for CAD, cardiovascular events and ischemia are as common in diabetic patients without MetS as in those with MetS. A high MPI defect score is related to total events including cardiac and cerebrovascular events. © 2012 American Society of Nuclear Cardiology.
続きを見る
|
||||
| 34.
論文 |
論文
|
Nakajima, Kenichi ; Hasegawa, Minoru ; Inaki, Anri ; Wakabayashi, Hiroshi ; Hosoya, Tetsuo ; Takahara, Kazuhiko ; Kinuya, Seigo
概要:
金沢大学医薬保健研究域医学系<br />Purpose: Esophageal complication is common in systemic sclerosis (SSc), but scintigraphic transit pa
…
tterns based on each subtype have not been understood well. The aim of this study was to develop a new algorithm for integrating a dynamic esophageal transit study and to apply the method to patients with SSc. Methods: A total of 40 patients suspected of having SSc were examined by a dynamic esophageal transit study. The subtypes included 32 with definite SSc (15 limited cutaneous type and 17 diffuse cutaneous type) and 8 with probable SSc. The serial esophageal images were shifted and summed to a functional image (sliding sum image) and compared to a conventional condensed image analysis. Esophageal retention fraction at 90 s (R90) and half-time (T1/2) of transit were also measured. Results: The four patterns of the sliding sum image and condensed image agreed in all patients. Abnormal retention patterns were observed in none of the 8 (0%) patients with the probable SSc and in 15 of 32 (47%) patients with definite SSc (p = 0.014). The severity of scleroderma assessed by modified Rodnan skin thickness score correlated with that of esophageal retention R90 (p = 0.04). Conclusion: The sliding sum image is a simple and effective method for integrating esophageal transit. Patients with definite SSc and severe scleroderma had significantly higher retention patterns, while probable SSc patients showed no esophageal dysmotility. © 2011 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 35.
論文 |
論文
|
Nakajima, Kenichi ; Matsuo, Shinro ; Okuda, Koichi ; Wakabayashi, Hiroshi ; Tsukamoto, Kazumasa ; Nishimura, Tsunehiko
概要:
Background:Myocardial perfusion imaging (MPI) has been used to estimate cardiac event risk. The aim of the present study
…
is to achieve stable risk estimation based on perfusion scoring and a multi-center prognostic database. Methods and Results:Multivariate logistic regression analysis was performed to estimate cardiac event risk based on a J-ACCESS study. A stress-MPI was performed in 45 patients with coronary artery disease (CAD) and in 25 non-CAD patients. Perfusion defect scoring of summed stress score (SSS) was performed by 5 methods: (1) visual scoring; (2) automatic scoring of 3 short-axis and 1 vertical long-axis slices; (3) visual modification of Method 2; (4) automatic polar map scoring based on a Japanese multi-center database; and (5) visual modification of Method 4. Agreement of SSS between 2 observers was good (r=0.87-0.97). Agreement of estimated cardiac event risk between observers and among 5 methods was very good (r=0.99-1.00). Regarding diagnostic accuracy for CAD, Method 5 showed optimal diagnostic yields (sensitivity 84%, accuracy 77%). Conclusions:Estimation of cardiac event risk in conjunction with polar map segmentation and common normal databases resulted in stable risk values, and might be used for risk stratification in patients suspected of having CAD. © All rights are reserved to the Japanese Circulation Society.
続きを見る
|
||||
| 36.
論文 |
論文
|
Okuda, Koichi ; Nakajima, Kenichi ; Hosoya, Tetsuo ; Ishikawa, Takehiro ; Matsuo, Shinro ; Kawano, Masaya ; Taki, Junichi ; Kinuya, Seigo
概要:
Objective: We have developed freeware package for automatically quantifying myocardial perfusion and 123I-labeled radiop
…
harmaceutical single-photon emission computed tomography (SPECT), which is called "cardioBull". We aim to evaluate diagnostic performance of the detection of coronary artery disease (CAD) on the developed software in comparison with commercially available software package [Quantitative Perfusion SPECT (QPS)]. Methods: Stress-rest 99mTc-sestamibi myocardial perfusion SPECT was performed in 36 patients with CAD and 35 control patients. A ≥75% stenosis in the coronary artery was identified by coronary angiography in the CAD group. Segmental perfusion defect score was automatically calculated by both cardioBull and QPS software. Summed stress score (SSS) was obtained to detect CAD by the receiver operator characteristic (ROC) analysis. Areas under the ROC curves (AUC) were calculated in patient-based and coronary-based analyses. Results: Mean SSSs showed no significant difference between cardioBull and QPS (6.0 ± 7.1 vs. 5.6 ± 7.0). The AUC for cardioBull was equivalent to that for QPS (0.91 ± 0.04 vs. 0.87 ± 0.04, p = n.s.). Sensitivity, specificity, and accuracy for cardioBull were 89, 74, and 82%, respectively. For the regional detection of CAD, the AUC showed largest value in left anterior descending coronary artery (LAD) territory (0.86 ± 0.06 for cardioBull, 0.87 ± 0.06 for QPS, p = n.s.). Sensitivity, specificity and accuracy of cardioBull were 70, 88, and 83% for the LAD; 91, 62, and 66% for the left circumflex coronary artery (LCx); and 78, 69, and 70% for the right coronary artery (RCA), respectively. Conclusions: The AUC, sensitivity, specificity and accuracy for the detection of CAD showed high diagnostic performance on the developed software. In addition, the developed software provided comparable diagnostic performance to the commercially available software package. © 2011 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 37.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Matsuo, Shinro ; Yoshita, Mitsuhiro ; Taki, Junichi ; Yamada, Masahito ; Kinuya, Seigo
概要:
Purpose: This study was performed to demonstrate that the results obtained with a calibration phantom could be used as a
…
tool for standardizing measurement of heart to mediastinum (H/M) ratio in cardiac metaiodobenzylguanidine (MIBG) imaging. Methods: Images of the phantom containing 123I-MIBG were acquired on the cameras in 10 hospitals (11 camera types) to determine the relationship between H/M ratios using different collimators: low-energy (LE) and medium-energy (ME)/low-medium-energy (LME) collimators. The effect of standardization on the ME-comparable H/M ratio was examined in two settings: a Japanese standard MIBG database (n = 62) and multicentre studies (n = 49). In a multicentre study, probable Alzheimer's disease (AD, n = 18) and probable dementia with Lewy bodies (DLB, n = 31) were studied and standardized by the calibration phantom method. Results: Linear regression equations between LE and ME collimators were obtained for the phantom study in all institutions. When the H/M ratio with an LE collimator was corrected based upon the calibration phantom, the corrected values were comparable to those obtained using ME collimators. The standard database also exhibited a normal distribution after standardization as determined by skewness and goodness-of-fit test. A mixture of the populations by LE and ME collimators showed significant separation of AD and DLB groups (F ratio = 24.9 for the late H/M), but the corrected values resulted in higher F ratios for both early and late H/M (F ratio = 34.9 for the late H/M). Conclusion: Standardization of H/M ratios by the heart-chest calibration phantom method is feasible among different collimator types. This method could be practically used for multicentre comparison of H/M ratios. © 2011 Springer-Verlag.
続きを見る
|
||||
| 38.
論文 |
論文
|
Okuda, Koichi ; Nakajima, Kenichi ; Matsuo, Shinro ; Wakabayashi, Hiroshi ; Taki, Junichi ; Kinuya, Seigo
概要:
Objectives: Decreases in apical and apex activities - namely, 'apical thinning' - are a well-known phenomenon in attenua
…
tion-corrected (AC) myocardial perfusion. The aim of this study was to compare actual myocardial thickness derived from a multidetector-row computed tomography with AC myocardial perfusion count from a hybrid single-photon emission computed tomography/computed tomography to investigate the cause of apical thinning. Methods: We enrolled 21 participants with a low likelihood of coronary artery disease (mean age 65±21 years, 13 men) from 185 consecutive patients and 11 healthy volunteers, who independently underwent Tc-sestamibi single-photon emission computed tomography/computed tomography and 64-slice multidetector-row computed tomography scans. AC and non-AC myocardial perfusion counts and thickness were measured on the basis of a 17-segment model and averaged at the apex, apical, mid, and basal walls. Results: Myocardial thickness at the apex was significantly thinner than that at the apical and mid walls (5.1±1.3, 7.3±1.3, and 9.9±2.4 mm, respectively; P<0.005). AC count at the apex was significantly lower than that at the apical and mid regions (76.0±5.5, 82.8±4.7, and 85.6±3.8, respectively; P<0.002). Moderate relationship was observed between myocardial thickness and AC count (y=-10.5+0.22x, r=0.54, P<0.0001. No relationship was found between thickness and non-AC count (r=0.16, P=0.263). Conclusion: The low apex and apical counts were caused by anatomical thinning of the myocardium in AC myocardial perfusion imaging. Attenuation correction provided an accurate relationship between myocardial count and thickness because of the partial volume effect. © 2011 Wolters Kluwer Health | Lippincott Williams and Wilkins.
続きを見る
|
||||
| 39.
論文 |
論文
|
Nakajima, Kenichi ; Matsuo, Shinro ; Okuyama, Chio ; Hatta, Tsuguru ; Tsukamoto, Kazumasa ; Nishimura, Shigeyuki ; Yamashina, Akira ; Kusuoka, Hideo ; Nishimura, Tsunehiko
概要:
Background: Cardiac event risk is estimated using quantitative gated myocardial perfusion imaging (MPI) and clinical bac
…
kground in patients with ischemic heart disease. The aim of the present study was to calculate major cardiac event risk and tabulate it in the Heart Risk Table for clinical use of risk stratification. Methods and Results: Multivariate logistic regression was performed based on a multicenter prognostic database (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated Single-photon emission computed tomography [J-ACCESS investigation]) using MPI (n=2,395). The risk of major cardiac events (cardiac death, non-fatal myocardial infarction and heart failure requiring hospitalization) was estimated using age, ejection fraction (EF), estimated glomerular filtration rate (eGFR) and presence of diabetes mellitus (DM). Age-matched standard eGFR was determined in 77 subjects. Major cardiac event risk was calculated using the equation: risk (%/3 years)=1/(1+Exp(-(-4.699-0.0151×eGFR+0.7998×DM+0.0582×age+0.697×SSS-0.0359×EF))×100, where SSS refers to summed stress scores. Risk was determined without eGFR (the initial version) and using the present formula with eGFR (revised version), with consistent results. DM and chronic kidney disease were major determinants of cardiac events. Conclusions: Cardiac event risk was estimated using MPI defect score and left ventricular EF in conjunction with eGFR and the presence of DM. The risk table might be used for risk evaluation in Japanese patients undergoing MPI. (Circ J 2012; 76: 168-175)
続きを見る
|
||||
| 40.
論文 |
論文
|
Nakajima, Kenichi ; Nakajima, Yasuo ; Horikoshi, Hiroyuki ; Ueno, Munehisa ; Wakabayashi, Hiroshi ; Shiga, Tohru ; Yoshimura, Mana ; Ohtake, Eiji ; Sugawara, Yoshifumi ; Matsuyama, Hideyasu ; Edenbrandt, Lars
概要:
Background Artificial neural network (ANN)-based bone scan index (BSI), a marker of the amount of bone metastasis, has b
…
een shown to enhance diagnostic accuracy and reproducibility but is potentially affected by training databases. The aims of this study were to revise the software using a large number of Japanese databases and to validate its diagnostic accuracy compared with the original Swedish training database. Methods The BSI was calculated with EXINIbone (EB; EXINI Diagnostics) using the Swedish training database (n = 789). The software using Japanese training databases from a single institution (BONENAVI version 1, BN1, n = 904) and the revised version from nine institutions (version 2, BN2, n = 1,532) were compared. The diagnostic accuracy was validated with another 503 multi-center bone scans including patients with prostate (n = 207), breast (n = 166), and other cancer types. The ANN value (probability of abnormality) and BSI were calculated. Receiver operating characteristic (ROC) and net reclassification improvement (NRI) analyses were performed. Results The ROC analysis based on the ANN value showed significant improvement from EB to BN1 and BN2. In men (n = 296), the area under the curve (AUC) was 0.877 for EB, 0.912 for BN1 (p = not significant (ns) vs. EB) and 0.934 for BN2 (p = 0.007 vs. EB). In women (n = 207), the AUC was 0.831 for EB, 0.910 for BN1 (p = 0.016 vs. EB), and 0.932 for BN2 (p < 0.0001 vs. EB). The optimum sensitivity and specificity based on BN2 was 90% and 84% for men and 93% and 85% for women. In patients with prostate cancer, the AUC was equally high with EB, BN1, and BN2 (0.939, 0.949, and 0.957, p = ns). In patients with breast cancer, the AUC was improved from EB (0.847) to BN1 (0.910, p = ns) and BN2 (0.924, p = 0.039). The NRI using ANN between EB and BN1 was 17.7% (p = 0.0042), and that between EB and BN2 was 29.6% (p < 0.0001). With respect to BSI, the NRI analysis showed downward reclassification with total NRI of 31.9% (p < 0.0001). Conclusion In the software for calculating BSI, the multi-institutional database significantly improved identification of bone metastasis compared with the original database, indicating the importance of a sufficient number of training databases including various types of cancers. © 2013 Nakajima et al.
続きを見る
|
||||
| 41.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, Tsunehiko
概要:
The multicenter Japanese-Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS), which involved 117 institutions and 4,629 patients, was the first attempt to quantify cardiac events and survival using
…
stress-rest-gated single-photon emission computed tomography myocardial perfusion images (MPI) and QGS software in Japan. A 3-year follow-up study showed a relatively lower incidence of hard events than in the USA and some European countries, but a similar role of perfusion and left ventricular (LV) function. A low event risk with normal MPI and a higher incidence of major cardiac events in patients with large perfusion defects and LV dysfunction were defined. MPI was useful even among patients with proven coronary artery stenosis. The association between diabetes and chronic kidney disease (CKD) was an important predictor of cardiac events and the risk was evaluated using new software and risk charts. Additional studies were extended to include asymptomatic diabetes (J-ACCESS 2) and CKD (J-ACCESS 3). Because risk estimation is linked to the national healthcare system and clinical practice, optimal risk stratification and guidance for therapeutic strategies are recommended. (Circ J 2012; 76: 1313-1321)
続きを見る
|
||||
| 42.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Matsuo, Shinro
概要:
Purpose: This study was performed to demonstrate that the results obtained with a calibration phantom could be used as a
…
tool for standardizing measurement of heart to mediastinum (H/M) ratio in cardiac metaiodobenzylguanidine (MIBG) imaging. Methods: Images of the phantom containing 123I-MIBG were acquired on the cameras in 10 hospitals (11 camera types) to determine the relationship between H/M ratios using different collimators: low-energy (LE) and mediumenergy (ME)/low-medium-energy (LME) collimators. The effect of standardization on the ME-comparable H/M ratio was examined in two settings: a Japanese standard MIBG database (n=62) and multicentre studies (n=49). In a multicentre study, probable Alzheimer's disease (AD, n=18) and probable dementia with Lewy bodies (DLB, n=31) were studied and standardized by the calibration phantom method. Results: Linear regression equations between LE and ME collimators were obtained for the phantom study in all institutions. When the H/M ratio with an LE collimator wascorrected based upon the calibration phantom, the corrected values were comparable to those obtained using ME collimators. The standard database also exhibited a normal distribution after standardization as determined by skewness and goodness-of-fit test. A mixture of the populations by LE and ME collimators showed significant separation of AD and DLB groups (F ratio=24.9 for the late H/M), but the corrected values resulted in higher F ratios for both early and late H/M (F ratio=34.9 for the late H/M). Conclusion: Standardization of H/M ratios by the heartchest calibration phantom method is feasible among different collimator types. This method could be practically used for multicentre comparison of H/M ratios. © Springer-Verlag 2011.
続きを見る
|
||||
| 43.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, Tsunehiko
概要:
The multicenter Japanese-Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS), which involved 117 institutions and 4,629 patients, was the first attempt to quantify cardiac events and survival using
…
stress-rest-gated single-photon emission computed tomography myocardial perfusion images (MPI) and QGS software in Japan. A 3-year follow-up study showed a relatively lower incidence of hard events than in the USA and some European countries, but a similar role of perfusion and left ventricular (LV) function. A low event risk with normal MPI and a higher incidence of major cardiac events in patients with large perfusion defects and LV dysfunction were defined. MPI was useful even among patients with proven coronary artery stenosis. The association between diabetes and chronic kidney disease (CKD) was an important predictor of cardiac events and the risk was evaluated using new software and risk charts. Additional studies were extended to include asymptomatic diabetes (J-ACCESS 2) and CKD (J-ACCESS 3). Because risk estimation is linked to the national healthcare system and clinical practice, optimal risk stratification and guidance for therapeutic strategies are recommended.
続きを見る
|
||||
| 44.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Nyström, Karin ; Richter, Jens ; Minarik, David ; Wakabayashi, Hiroshi ; Matsuo, Shinro ; Kinuya, Seigo ; Edenbrandt, Lars
概要:
Purpose: In patients with a small heart, defined as an end-systolic volume (ESV) of ≤20 mL calculated using the Quantita
…
tive 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. © 2013 The Author(s).
続きを見る
|
||||
| 45.
論文 |
論文
|
Nakajima, Kenichi ; Nakata, Tomoaki ; Yamada, Takahisa ; Yamashina, Shohei ; Momose, Mitsuru ; Kasama, Shu ; Matsui, Toshiki ; Matsuo, Shinro ; Travin, Mark I. ; Jacobson, Arnold F.
概要:
Purpose Prediction of mortality risk is important in the management of chronic heart failure (CHF). The aim of this stud
…
y was to create a prediction model for 5-year cardiac death including assessment of cardiac sympathetic innervation using data from a multicenter cohort study in Japan. Methods The original pooled database consisted of cohort studies from six sites in Japan. A total of 933 CHF patients who underwent 123I-metaiodobenzylguanidine (MIBG) imaging and whose 5-year outcomes were known were selected from this database. The late MIBG heart-to-mediastinum ratio (HMR) was used for quantification of cardiac uptake. Cox proportional hazard and logistic regression analyses were used to select appropriate variables for predicting 5-year cardiac mortality. The formula for predicting 5-year mortality was created using a logistic regression model. Results During the 5-year follow-up, 205 patients (22 %) died of a cardiac event including heart failure death, sudden cardiac death and fatal acute myocardial infarction (64 %, 30 % and 6 %, respectively). Multivariate logistic analysis selected four parameters, including New York Heart Association (NYHA) functional class, age, gender and left ventricular ejection fraction, without HMR (model 1) and five parameters with the addition of HMR (model 2). The net reclassification improvement analysis for all subjects was 13.8 % (p < 0.0001) by including HMR and its inclusion was most effective in the downward reclassification of low-risk patients. Nomograms for predicting 5-year cardiac mortality were created from the five-parameter regression model. Conclusion Cardiac MIBG imaging had a significant additive value for predicting cardiac mortality. The prediction formula and nomograms can be used for risk stratifying in patients with CHF. © 2014 The Author(s).<br />Article in press<br />This article has Supplemental materrial and methods.
続きを見る
|
||||
| 46.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Yoshimura, Mana ; Matsuo, Shinro ; Wakabayashi, Hiroshi ; Imanishi, Yasuhiro ; Kinuya, Seigo
概要:
Background The heart-to-mediastinum ratio (HMR) of 123I-metaiodobenzylguanidine (MIBG) showed variations among instituti
…
ons and needs to be standardized among various scinticamera-collimator combinations. Methods A total of 225 phantom experiments were performed in 84 institutions to calculate cross-calibration coefficients of HMR. Based on phantom studies, a conversion coefficient for each camera-collimator system was created, including low-energy (LE, n = 125) and a medium-energy (ME, n = 100) collimators. An average conversion coefficient from the most common ME group was used to calculate the standard HMR. In clinical MIBG studies (n = 52) from three institutions, HMRs were standardized from both LE- and ME-type collimators and classified into risk groups of <1.60, 1.60-2.19, and ≥2.20. Results The average conversion coefficients from the individual camera-collimator condition to the mathematically calculated reference HMR ranged from 0.55 to 0.75 for LE groups and from 0.83 to 0.95 for ME groups. The conversion coefficient of 0.88 was used to unify HMRs from all acquisition conditions. Using the standardized HMR, clinical studies (n = 52) showed good agreement between LE and ME types regarding three risk groups (κ = 0.83, P < .0001, complete agreement in 90%, 42% of the patients reclassified into the same risk group). Conclusion By using the reference HMR and conversion coefficients for the system, HMRs with various conditions can be converted to the standard HMRs in a range of normal to low HMRs.
続きを見る
|
||||
| 47.
論文 |
論文
|
Nakajima, Kenichi ; Matsuo, Shinro ; Wakabayashi, Hiroshi ; Yokoyama, Kunihiko ; Bunko, Hisashi ; Okuda, Koichi ; Kinuya, Seigo ; Nyström, Karin ; Edenbrandt, Lars
概要:
Background:The purpose of this study was to apply an artificial neural network (ANN) in patients with coronary artery di
…
sease (CAD) and to characterize its diagnostic ability compared with conventional visual and quantitative methods in myocardial perfusion imaging (MPI).Methods and Results:A total of 106 patients with CAD were studied with MPI, including multiple vessel disease (49%), history of myocardial infarction (27%) and coronary intervention (30%). The ANN detected abnormal areas with a probability of stress defect and ischemia. The consensus diagnosis based on expert interpretation and coronary stenosis was used as the gold standard. The left ventricular ANN value was higher in the stress-defect group than in the no-defect group (0.92±0.11 vs. 0.25±0.32, P<0.0001) and higher in the ischemia group than in the no-ischemia group (0.70±0.40 vs. 0.004±0.032, P<0.0001). Receiver-operating characteristics curve analysis showed comparable diagnostic accuracy between ANN and the scoring methods (0.971 vs. 0.980 for stress defect, and 0.882 vs. 0.937 for ischemia, both P=NS). The relationship between the ANN and defect scores was non-linear, with the ANN rapidly increased in ranges of summed stress score of 2–7 and summed defect score of 2–4.Conclusions:Although the diagnostic ability of ANN was similar to that of conventional scoring methods, the ANN could provide a different viewpoint for judging abnormality, and thus is a promising method for evaluating abnormality in MPI. (Circ J 2015; 79: 1549–1556)
続きを見る
|
||||
| 48.
論文 |
論文
|
Nakajima, Kenichi ; Jacobson, Arnold F.
概要:
Since the advent of 123I-meta-iodobenzylguanidine（MIBG）in 1990s, it has been widely used in clinical practice in Japan.
…
Based on the wide range of clinical applications, 123I MIBG is now incorporated in Japanese Circulation Society)s guidelines of nuclear cardiology. The major role of 123I MIBG has been in determination of severity and prognostic evaluation of heart failure. In addition, assessment of the treatment by various types of medications has been the second major role of 123 I MIBG imaging. Compared with the conventional clinical parameters of heart failure, additive values of 123I MIBG depend on how it reflects the patient condition more accurately, and how it relates to improvement in the patient outcome. 123 I MIBG is also now available for cardiac imaging in the USA and Europe. Unified methodology and further studies focusing on clinical decision-making are the next required steps to document MIBG utility.
続きを見る
|
||||
| 49.
論文 |
論文
|
Nakajima, Kenichi ; Nakata, Tomoaki
概要:
Cardiac neuroimaging with (123)I-metaiodobenzylguanidine ((123)I-MIBG) has been officially used in clinical practice in
…
Japan since 1992. The nuclear cardiology guidelines of the Japanese Circulation Society, revised in 2010, recommended cardiac (123)I-MIBG imaging for the management of heart failure (HF) patients, particularly for the assessment of HF severity and prognosis of HF patients. Consensus in North American and European countries regarding incorporation into clinical practice, however, has not been established yet. This article summarizes 22 y of clinical applications in Japan of (123)I-MIBG imaging in the field of cardiology; these applications are reflected in cardiology guidelines, including recent methodologic advances. A standardized cardiac (123)I-MIBG parameter, the heart-to-mediastinum ratio (HMR), is the basis for clinical decision making and enables common use of parameters beyond differences in institutions and studies. Several clinical studies unanimously demonstrated its potent independent roles in prognosis evaluation and risk stratification irrespective of HF etiologies. An HMR of less than 1.6-1.8 and an accelerated washout rate are recognized as high-risk indicators of pump failure death, sudden cardiac death, and fatal arrhythmias and have independent and incremental prognostic values together with known clinical variables, such as left ventricular ejection fraction and brain natriuretic peptide. Another possible use of this imaging technique is the selection of therapeutic strategy, such as pharmacologic treatment and nonpharmacologic treatment with an implantable cardioverter-defibrillator or cardiac resynchronization device; however, this possibility remains to be investigated. Recent multiple-cohort database analyses definitively demonstrated that patients who were at low risk for lethal events and who were defined by an HMR of greater than 2.0 on (123)I-MIBG studies had a good long-term prognosis. Future investigations of cardiac (123)I-MIBG imaging will contribute to better risk stratification of low-risk and high-risk populations, to the establishment of cost-effective use of this imaging technique for the management of HF patients, and to worldwide acceptance of this imaging technique in clinical cardiology practice. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
続きを見る
|
||||
| 50.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Nakata, Tomoaki
概要:
Background:Although there are several known prognostic determinants in heart failure (HF), individual risk profiles can
…
vary, in particular between ischemic and non-ischemic HF background. This study investigated the difference in prognostic efficacy of cardiac 123I-meta-iodobenzylguanidine (MIBG) imaging between the 2 etiologies.Methods and Results:All 1,322 patients with HF were enrolled and followed up at most after 10 years. The HF patients were divided into 2 groups: an ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis. During 10 years of follow-up, 296 (22.4%) of 1,322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. On multivariate Cox proportional hazards analysis using categorized variables, in the ischemic group, delayed heart-to-mediastinum ratio (HMR; P<0.0001), age (P=0.0002) and LVEF (P=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (P<0.0001), NYHA class (P<0.0001) and age (P<0.0001) were significant determinants of lethal outcome.Conclusions:Cardiac MIBG imaging has nearly identical prognostic value in both ischemic and non-ischemic HF, independent of cause of cardiac death. (Circ J 2016; 80: 435–441)
続きを見る
|
||||
| 51.
論文 |
論文
|
Nakajima, Kenichi ; Okuda, Koichi ; Matsuo, Shinro ; Agostini, Denis
概要:
Embargo Period 12 months
|
||||
| 52.
論文 |
論文
|
Okuda, Koichi ; Nakajima, Kenichi ; Yamada, Masato ; Wakabayashi, Hiroshi ; Ichikawa, Hajime ; Arai, Hiroyuki ; Matsuo, Shinro ; Taki, Junichi ; Hashimoto, Mitsumasa ; Kinuya, Seigo
概要:
Objective: The aim of this study was to characterize the optimal reconstruction parameters for ordered-subset expectatio
…
n maximization (OSEM) with attenuation correction, scatter correction, and depth-dependent resolution recovery (OSEMACSCRR). We assessed the optimal parameters for OSEMACSCRR in an anthropomorphic torso phantom study, and evaluated the validity of the reconstruction parameters in the groups of normal volunteers and patients with abnormal perfusion. Methods: Images of the anthropomorphic torso phantom, 9 normal volunteers and 7 patients undergoing myocardial perfusion SPECT were acquired with a SPECT/CT scanner. SPECT data comprised a 64 × 64 matrix with an acquisition pixel size of 6.6 mm. A normalized mean square error (NMSE) of the phantom image was calculated to determine both optimal OSEM update and a full width at half maximum (FWHM) of Gaussian filter. We validated the myocardial count, contrast and noise characteristic for clinical subjects derived from OSEMACSCRR processing. OSEM with depth-dependent resolution recovery (OSEMRR) and filtered back projection (FBP) were simultaneously performed to compare OSEMACSCRR. Results: The combination of OSEMACSCRR with 90-120 OSEM updates and Gaussian filter with 13.2-14.85 mm FWHM yielded low NMSE value in the phantom study. When we used OSEMACSCRR with 120 updates and Gaussian filter with 13.2 mm FWHM in the normal volunteers, myocardial contrast showed significantly higher value than that derived from 120 updates and 14.85 mm FWHM. OSEMACSCRR with the combination of 90-120 OSEM updates and 14.85 mm FWHM produced lowest % root mean square (RMS) noise. Regarding the defect contrast of patients with abnormal perfusion, OSEMACSCRR with the combination of 90-120 OSEM updates and 13.2 mm FWHM produced significantly higher value than that derived from 90-120 OSEM updates and 14.85 mm FWHM. OSEMACSCRR was superior to FBP for the % RMS noise (8.52 ± 1.08 vs. 9.55 ± 1.71, p = 0.02) and defect contrast (0.368 ± 0.061 vs. 0.327 ± 0.052, p = 0.01), respectively. Conclusions: Clinically optimized the number of OSEM updates and FWHM of Gaussian filter were (1) 120 updates and 13.2 mm, and (2) 90-120 updates and 14.85 mm on the OSEMACSCRR processing, respectively. Further assessment may be required to determine the optimal iterative reconstruction parameters in a larger patient population. © 2013 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 53.
論文 |
論文
|
Nakajima, Kenichi ; Kawano, Masaya ; Kinami, Shinichi ; Fujimura, Takashi ; Miwa, Koichi ; Tonami, Norihisa
概要:
金沢大学医学部附属病院核医学診療科<br />木南, 伸一<br />Objective: The physiology of gastrointestinal transfer function after proximal gastre
…
ctomy with bypass-tract reconstruction is not well understood. We applied a simultaneous dual-radionuclide method with a hepatobiliary imaging and gastric emptying study to evaluate physiologic alterations occurring after surgery. Methods: Nineteen patients with early gastric cancer, including 9 preoperative control patients and 10 who had proximal gastrectomy and double-tract reconstruction surgery were examined by dual-radionuclide hepatobiliary and gastric emptying studies (99mTc PMT and 111In DTPA). Retention fraction in the stomach at 3 minutes (R3) and 60 minutes (R60) and gastric emptying half-time (GET) were calculated. Bile reflux and mixture of bile and food were also evaluated. Results: The retention fractions of R3 and R60 were significantly lower in the double-tract reconstruction group than those in the preoperative group. GET differed significantly between the double-tract and preoperative groups (20.7 min ± 7.1 min and 36.2 min ± 11.0 min, p = 0.0018). The mixture of bile and food was not good in the double-tract reconstruction group (p = 0.014 vs. preoperative). Patients with a large residual stomach showed slower initial emptying (p = 0.0068) and a better mixture of bile and food (p = 0.058) compared to those with a small residual stomach. The bile reflux was not significantly increased after surgery. Conclusion: The dual-radionuclide gastrointestinal and hepatobiliary imaging was feasible and could demonstrate characteristic transit patterns of the foods and bile in the double-tract reconstruction procedure. A larger residual stomach, if possible, is desirable to provide better transfer and mixing of bile and foods.
続きを見る
|
||||
| 54.
論文 |
論文
|
Nakajima, Kenichi ; Taki, Junichi ; Yoneyama, Tatsuya ; Fukuoka, Makoto ; Kayano, Daiki ; Tonami, Norihisa
概要:
金沢大学医学部附属病院核医学診療科
|
||||
| 55.
論文 |
論文
|
Taki, Junichi ; Higuchi, Takahiro ; Kawashima, Atsuhiro ; Tait, Jonathan F. ; Muramori, Akira ; Matsunari, Ichiro ; Nakajima, Kenichi ; Vanderheyden, Jean-Luc ; Strauss, H. William
概要:
金沢大学医学部附属病院核医学診療科<br />Background: To determine whether mild to moderate ischemia that is not severe enough to induce my
…
ocardial infarction will cause myocardial cell damage or apoptosis, the 99mTc-Annexin-V (Tc-A) uptake was studied in groups of rats with various intervals of coronary occlusion and reperfusion times. Methods and Results: After left coronary artery occlusion for 15 min (n=23), 10 min (n=23), or 5min (n=12), Tc-A (80-150 MBq) was injected at 0.5, 1.5, 6, or 24 h after reperfusion. One hour later, to verify the area at risk, 201Tl (0.74 MBq) was injected just after left coronary artery re-occlusion and the rats were killed 1 min later. Dual tracer autoradiography was performed to assess Tc-A uptake and area at risk. In all 5-min occlusion and reperfusion models, no significant Tc-A uptake was observed in the area at risk. Tc-A uptake ratios in the 15-min and 10-min ischemia models were 4.46±3.16 and 2.02±0.47 (p=0.078) at 0.5 h after reperfusion, 3.49±1.78 and 1.47±0.11 (p<0.05) at 1.5h after reperfusion, 1.60±0.43 and 1.34±0.23 (p=0.24) at 6h after reperfusion, 1.50±0.33 and 1.28±0.33 (p=0.099) at 24 h after reperfusion, respectively. With 15-min ischemia, in 3 of the 5 rats there were a few micro-foci of myocardial cell degeneration and cell infiltration in less than 1% of the ischemic area at 24 h after reperfusion. No significant histological change was observed in rats with 10-min or 5-min ischemia. Conclusion: The data indicate that Tc-A binding depends on the severity of ischemia even without a significant amount of histological change or infarction.
続きを見る
|
||||
| 56.
論文 |
論文
|
Nakajima, Kenichi ; Nishimura, Tsunehiko
概要:
Purpose Inter-institution reproducibility of gated SPECT quantification based on institutional preferences was evaluated
…
. This sort of variability is crucial for a multicentre study when many hospitals are involved. Methods A total of 106 institutes participated in this study and were grouped according to their use of five workstation types. Fifteen sets of 99mTc-tetrofosmin gated projection images with normal ejection fraction (EF) (70%, group A, n=5), borderline low EF (50%, group B, n=5) and low EF with large perfusion defects (30%, group C, n=5) were prepared. The projection images were processed by QGS software in each institute based on its own routine settings. Based on 318 QGS results, the reproducibility of EF and volumes was analysed for each group and workstation. Results The reproducibility of EF was good in 14 of 15 cases, showing a standard deviation (SD) of <3.6%, and the coefficient of variance of the end-diastolic volume (EDV) was <9.3% in all cases. When the deviation from the average value was analysed, the difference between EF at each institute and the average EF of the workstation (dEF) showed an SD of 2.2–3.7% for each group. The ratio of the EDV divided by the average EDV (rEDV) showed an SD of 0.061–0.069 for each group. One case in group C that had a large anterior defect with low EF showed bimodal EF distribution in one of the five workstations. The SD of EF was workstation dependent, owing to the SPECT reconstruction conditions. Conclusion The reproducibility in EF and volumes within a workstation was good, even though the gated SPECT preferences varied. This reproducibility study supports the use of gated SPECT as a standard of ventricular function in multicentre studies.© Springer-Verlag 1999.
続きを見る
|
||||
| 57.
論文 |
論文
|
Nakajima, Kenichi ; Kawano, Masaya ; Hasegawa, Minoru ; Taki, Junichi ; Fujimoto, Manabu ; Takehara, Kazuhiko ; Tonami, Norihisa
概要:
金沢大学医学部附属病院核医学診療科<br />Background: Cardiac involvement is an important factor for the appropriate management of systemic
…
sclerosis (SSc). The possibility for detecting early myocardial damage was investigated using 99mTc methoxyisobutyliso- nitrile (MIBI) gated perfusion single photon emission computed tomography (SPECT) and 123I metaiodobenzyl-guanidine (MIBG) sympathetic imaging. Methods and Results: Twenty-three patients with SSc and 14 control subjects were studied. The severity of SSc was defined by disease type and semi-quantitative skin thickness scores. A myocardial perfusion study was performed using 99mTc MIBI exercise-rest study, and systolic and diastolic parameters were calculated from the volume curve of the gated SPECT. 123I MIBG was evaluated by segmental defects, a heart-to-mediastinum ratio and washout rate (WR). No significant exercise-induced ischemia was observed and the left ventricular ejection fraction was within normal range in patients with SSc. However, diastolic function calculated by time to peak filling (TPF) in the early diastole was significantly prolonged in SSc compared with the control group (184±35 ms, 160±25 ms, p=0.030) and more rapid MIBG WR from the myocardium (18.2±7.0% vs 11.1±4.3%, p=0.0015). Compared with the control group, the severe group with either diffuse SSc or a skin thickness score ≥10 had more prolonged TPF/RR interval than the less severe group. Both diastolic and sympathetic abnormali-ties were observed in 7 (30%) patients, and 1 abnormality in 17 (74%) patients with SSc. Conclusions: In patients with SSc, either diastolic dysfunction or sympathetic derangement, or both were observed even without induced ischemia and normal ventricular contractility. Based on these subclinical early findings, further follow-up studies are recommended.
続きを見る
|
||||
| 58.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Kinuya, Seigo ; Yamagishi, Masakazu
概要:
Objective: Takotsubo cardiomyopathy is a cardiac syndrome with an acute onset defined by chest symptoms and ST segment e
…
levation on electrocardiograms. Takotsubo cardiomyopathy is sometimes misdiagnosed as acute myocardial infarction (AMI). Therefore a non-invasive diagnostic method is needed to be established for setting up appropriate strategies. The purpose of this study was to detect myocardial metabolic abnormalities and to determine the diagnostic usefulness of 123I-beta-methy-iodophenyl pentadecanoic acid (123I-BMIPP) imaging in patients with takotsubo cardiomyopathy. Methods and results: We examined 16 patients with takotsubo cardiomyopathy and 12 with AMI in the left anterior descending artery. All patients were studied with resting 123I-BMIPP imaging. Total defect score (TDS) of 123I-BMIPP and perfusion were semi-quantitatively determined with single-photon emission computed tomography (SPECT) imaging using a 17-segment 5-point model. TDS of 123I-BMIPP were 4.8 ± 2.7 in patients with Takotsubo cardiomyopathy and 22.4 ± 10.7 in AMI. The ratio of summed BMIPP defect score of non-apical to apical segments in Takotsubo cardiomyopathy was smaller than that of the patients with AMI (0.1 ± 0.1 vs. 1.1 ± 0.7, p < 0.0001), indicating that 123I-BMIPP abnormalities were exclusively observed the in apical area. The ratio of summed perfusion defect scores of non-apical to apical segments in takotsubo cardiomyopathy did not differ significantly from that of AMI (0.52 ± 0.6 vs. 0.57 ± 0.3, p = NS). Summed BMIPP defect score in the apical area of takotsubo cardiomyopathy was larger than that of perfusion defect score (3.9 ± 2.7 vs. 1.8 ± 1.8, p = 0.04). Conclusion: Impaired metabolic metabolism exclusively in the apical region was observed by 123I-BMIPP SPECT images in takotsubo cardiomyopathy. These typical metabolic SPECT features of the disease can be utilized on differential diagnosis of takotsubo cardiomyopathy. © 2013.<br />This is the author's version of a work accepted for publication by Japanese College of Cardiology. Changes resulting from the publishing process, including peer review, editing, corrections, structural formatting and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. The definitive version has been published in Journal of Cardiology, 64 (1), pp. 49-56,2014 July, 10.1016/j.jjcc.2013.10.019
続きを見る
|
||||
| 59.
論文 |
論文
|
Matsumoto, Isao ; Oda, Makoto ; Takizawa, Masaya ; Waseda, Ryuichi ; Nakajima, Kenichi ; Kawano, Masaya ; Mochizuki, Takafumi ; Ikeda, Hiroko ; Watanabe, Go
概要:
Background: This study investigated the usefulness of fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-P
…
ET) during the treatment of thymic epithelial tumors in combination with Ki-67 evaluation based on surgical cases in our department. Methods: Between November 2003 and May 2011, 39 patients with thymic epithelial tumor underwent preoperative FDG-PET. The maximum standardized uptake value (SUVmax) of each category within Masaoka stage, World Health Organization classification, tumor diameter, myasthenia gravis, and Ki-67 label index were compared. To examine risk factors for relapse, SUVmax, age, sex, and surgical radicality were investigated in addition to those items. Results: The mean SUVmax was 4.5 (range, 1.2 to 14.6) and was significantly higher for Masaoka stage IV than for I and II (all p < 0.008) and for World Health Organization classified thymic cancer compared with all other types (all p < 0.0001). Mean SUVmax revealed significantly higher values for large tumors than for small tumors (p = 0.02). Mean SUVmax was significantly higher for high Ki-67-positive samples (p = 0.0004), indicating a strong correlation between SUVmax and the Ki-67 label index (ρ = 0.77, p = 0.0001). SUVmax accurately reflected therapeutic efficacy in patients with induction therapy. Univariate analysis revealed Masaoka stages III and IV and pathologically incomplete resection as risk factors for relapse. On multivariate analysis, independent risk factors for relapse comprised only Masaoka stages III and IV. Conclusions: FDG-PET SUVmax does reflect proliferation and invasiveness of thymic epithelial tumors and can provide an index for diagnosis and treatment, although it is not a risk factor for relapse. FDG-PET is also useful for evaluating induction therapy efficacy and detecting relapse. © 2013 The Society of Thoracic Surgeons.
続きを見る
|
||||
| 60.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Okuda, Koichi ; Kinuya, Seigo
概要:
Objective: The coronary artery calcium (CAC) score and myocardial perfusion imaging can now be detected simultaneously u
…
sing a hybrid SPECT/CT camera. However, there has been little evaluation on the relationship between stress-induced ischemia and coronary artery calcification in a Japanese population. The aim of this study was to investigate the relationship between these parameters and to elucidate the diagnostic value of the CAC score as an adjunct to myocardial perfusion imaging (MPI) for the assessment of coronary artery disease (CAD) in an intermediate-risk population. Methods: We retrospectively analyzed 105 patients (63% men, mean age 71 years) with CAD or suspected CAD who underwent MPI using SPECT/CT. CAC scanning was performed using a SPECT/CT camera. Results: There was a significant difference in the CAC score between patients with ischemia (n = 42) and those without ischemia (n = 63) (1353 ± 1524 vs. 332 ± 554, p < 0.01). The frequency of ischemic MPI determined by summed difference score tended to be higher in patients with high CAC (CAC = 0; 0.8 ± 1.3 vs. CAC > 1000; 3.0 ± 2.0). Higher age is related roughly with higher CAC score with no statistical significance (r 2 = 0.1) (<60 years old; 200 ± 692, vs. >80 years old; 1258 ± 1546, ns). The location of calcification was not related to the ischemic area. In a population with a predominately intermediate likelihood of CAD, a calcium score of zero has a possibility of excluding inducible ischemia on MPI. In part, ischemic MPI is associated with a high likelihood of subclinical atherosclerosis as detected by CAC. Conclusion: Hybrid SPECT/CT might be useful for diagnostic assessment and coronary artery with known or suspected CAD. © 2011 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 61.
論文 |
論文
|
Yoneyama, Hiroto ; Tsushima, Hiroyuki ; Onoguchi, Masahisa ; Konishi, Takahiro ; Nakajima, Kenichi ; Matsuo, Shinro ; Kayano, Daiki ; Wakabayashi, Hiroshi ; Inaki, Anri ; Kinuya, Seigo
概要:
Objective: Although SPECT/CT systems have been used for sentinel lymph node (SLN) imaging, few studies have focused on o
…
ptimization of attenuation correction (AC) and scatter correction (SC). While SLNs could be detected in conventional planar images, they sometimes do not appear in SPECT/CT images. The purpose of this study was to investigate the optimal AC and SC and to improve the detectability of SLNs in examinations using SPECT/CT systems.Materials and methods: The study group consisted of 56 female patients with breast cancer. In SPECT/CT imaging, four kinds of images were created with and without AC and SC; namely, AC−SC−, AC+SC−, AC−SC+ and AC+SC+. Five nuclear medicine physicians interpreted the planar and SPECT/CT images with five grades of confidence levels (1–5). The detection rate was calculated as the number of patients whose average confidence levels of interpretation were more than 4, divided by the total number of patients.Results: The confidence level of interpretation and the detection rate provided by the planar images were 4.76 ± 0.49 and 94.6 %, respectively. In SPECT/CT imaging, the AC+SC− provided the best detection rate (confidence level of interpretation, 4.81 ± 0.38; detection rate, 98.2 %), followed by the AC−SC− (4.70 ± 0.55, 89.3 %), and the AC−SC+ (4.39 ± 1.2, 78.6 %). The lowest values were obtained for the AC+SC+ (4.36 ± 1.22, 78.6 %). Regarding the confidence levels of interpretation, significant differences were observed between AC+SC− and AC−SC−, AC+SC− and AC+SC+, AC+SC− and AC−SC+, and between planar images and AC+SC+ (P = 0.0021, 0.0009, 0.0013, and 0.0056, respectively).Conclusions: When SPECT/CT was used, AC improved the detection of SLNs. SC caused disappearance of a faint SLN in some cases and should not be performed.
続きを見る
|
||||
| 62.
論文 |
論文
|
Yoneyama, Hiroto ; Tsushima, Hiroyuki ; Onoguchi, Masahisa ; Konishi, Takahiro ; Nakajima, Kenichi ; Matsuo, Shinro ; Kayano, Daiki ; Wakabayashi, Hiroshi ; Inaki, Anri ; Kinuya, Seigo
概要:
Objective: Although SPECT/CT systems have been used for sentinel lymph node (SLN) imaging, few studies have focused on o
…
ptimization of attenuation correction (AC) and scatter correction (SC). While SLNs could be detected in conventional planar images, they sometimes do not appear in SPECT/CT images. The purpose of this study was to investigate the optimal AC and SC and to improve the detectability of SLNs in examinations using SPECT/CT systems. Materials and methods: The study group consisted of 56 female patients with breast cancer. In SPECT/CT imaging, four kinds of images were created with and without AC and SC; namely, AC−SC−, AC+SC−, AC−SC+ and AC+SC+. Five nuclear medicine physicians interpreted the planar and SPECT/CT images with five grades of confidence levels (1–5). The detection rate was calculated as the number of patients whose average confidence levels of interpretation were more than 4, divided by the total number of patients. Results: The confidence level of interpretation and the detection rate provided by the planar images were 4.76 ± 0.49 and 94.6 %, respectively. In SPECT/CT imaging, the AC+SC− provided the best detection rate (confidence level of interpretation, 4.81 ± 0.38; detection rate, 98.2 %), followed by the AC−SC− (4.70 ± 0.55, 89.3 %), and the AC−SC+ (4.39 ± 1.2, 78.6 %). The lowest values were obtained for the AC+SC+ (4.36 ± 1.22, 78.6 %). Regarding the confidence levels of interpretation, significant differences were observed between AC+SC− and AC−SC−, AC+SC− and AC+SC+, AC+SC− and AC−SC+, and between planar images and AC+SC+ (P = 0.0021, 0.0009, 0.0013, and 0.0056, respectively). Conclusions: When SPECT/CT was used, AC improved the detection of SLNs. SC caused disappearance of a faint SLN in some cases and should not be performed. © 2014, The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 63.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Onoguchi, Masahisa ; Wakabayashi, Hiroshi ; Okuda, Koichi ; Kinuya, Seigo
概要:
Objective A novel multifocal collimator, IQ-SPECT (Siemens) consists of SMARTZOOM, cardio-centric and 3D iterative SPECT
…
reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 (201Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging. Methods Forty patients (eight women, mean age of 75 years) who underwent myocardial perfusion imaging were included in the study. All patients underwent one-day protocol perfusion scan after an adenosine-stress test and at rest after administering201Tl and showed normal results. Acquisition was performed on a Symbia T6 equipped with a conventional dual-headed gamma camera system (Siemens ECAM) and with a multifocal SMARTZOOM collimator. Imaging was performed with a conventional system followed by IQ-SPECT/computed tomography (CT). Reconstruction was performed with or without X-ray CT-derived attenuation correction (AC). Two nuclear physicians blinded to clinical information interpreted all myocardial perfusion images. A semi-quantitative myocardial perfusion was analyzed by a 17-segment model with a 5-point visual scoring. The uptake of each segment was measured and left ventricular functions were analyzed by QPS software. Results IQ-SPECT provided good or excellent image quality. The quality of IQ-SPECT images without AC was similar to those of conventional LEHR study. Mid-inferior defect score (0.3 ± 0.5) in the conventional LEHR study was increased significantly in IQ-SPECT with AC (0 ± 0). IQ-SPECT with AC improved the mid-inferior decreased perfusion shown in conventional images. The apical tracer count in IQ-SPECT with AC was decreased compared to that in LEHR (0.1 ± 0.3 vs. 0.5 ± 0.7, p˂0.05). The left ventricular ejection fraction from IQ-SPECT was significantly higher than that from the LEHR collimator (p = 0.0009). Conclusion The images of IQ-SPECT acquired in a short time are equivalent to that of conventional LEHR. The results indicated that the IQ-SPECT system with AC is capable of correcting inferior artifacts with high image quality. © The Japanese Society of Nuclear Medicine 2015.
続きを見る
|
||||
| 64.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Nakata, Tomoaki
概要:
Background:Although there are several known prognostic determinants in heart failure (HF), individual risk profiles can
…
vary, in particular between ischemic and non-ischemic HF background. This study investigated the difference in prognostic efficacy of cardiac 123I-meta-iodobenzylguanidine (MIBG) imaging between the 2 etiologies.Methods and Results:All 1,322 patients with HF were enrolled and followed up at most after 10 years. The HF patients were divided into 2 groups: an ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis. During 10 years of follow-up, 296 (22.4%) of 1,322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. On multivariate Cox proportional hazards analysis using categorized variables, in the ischemic group, delayed heart-to-mediastinum ratio (HMR; P<0.0001), age (P=0.0002) and LVEF (P=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (P<0.0001), NYHA class (P<0.0001) and age (P<0.0001) were significant determinants of lethal outcome.Conclusions:Cardiac MIBG imaging has nearly identical prognostic value in both ischemic and non-ischemic HF, independent of cause of cardiac death. (Circ J 2016; 80: 435–441)<br />出版者照会後に全文公開
続きを見る
|
||||
| 65.
論文 |
論文
|
Yoneyama, Hiroto ; Tsushima, Hiroyuki ; Onoguchi, Masahisa ; Konishi, Takahiro ; Nakajima, Kenichi ; Kinuya, Seigo
概要:
Objective: The identification of sentinel lymph nodes (SLNs) near injection sites is difficult because of scattered gamm
…
a rays. The purpose of this study was to investigate the optimal energy windows for elimination of scattered gamma rays in order to improve the detection of SLNs. Methods: The clinical study group consisted of 56 female patients with breast cancer. While the energy was centred at 140 keV with a 20% window for Tc-99m, this energy window was divided into five subwindows with every 4% in planar imaging. Regions of interest were placed on SLNs and the background, and contrast was calculated using a standard equation. The confidence levels of interpretations were evaluated using a five-grade scale. Results: The contrast provided by 145.6 keV ± 2% was the best, followed by 140 keV ± 2%, 151.2 keV ± 2%, 134.4 keV ± 2% and 128.8 keV ± 2% in that order. When 128.8 keV ± 2% and 134.4 keV ± 2% were eliminated from 140 keV ± 10% (145.6 keV ± 6%), the contrast of SLNs improved significantly. The confidence levels of interpretation and detection rate provided by the planar images with 140 keV ± 10% were 4.74 ± 0.58 and 94.8%, respectively, and those provided by 145.6 keV ± 6% were 4.94 ± 0.20 and 100%. Conclusion: Because lower energy windows contain many scattered gamma rays, upper offset energy windows, which exclude lower energy windows, improve the image contrast of SLNs near injection sites. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
続きを見る
|
||||
| 66.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Nakata, Tomoaki ; 松尾, 信郎 ; 中嶋, 憲一
概要:
Background:Although there are several known prognostic determinants in heart failure (HF), individual risk profiles can
…
vary, in particular between ischemic and non-ischemic HF background. This study investigated the difference in prognostic efficacy of cardiac 123I-meta-iodobenzylguanidine (MIBG) imaging between the 2 etiologies.Methods and Results:All 1,322 patients with HF were enrolled and followed up at most after 10 years. The HF patients were divided into 2 groups: an ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis. During 10 years of follow-up, 296 (22.4%) of 1,322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. On multivariate Cox proportional hazards analysis using categorized variables, in the ischemic group, delayed heart-to-mediastinum ratio (HMR; P<0.0001), age (P=0.0002) and LVEF (P=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (P<0.0001), NYHA class (P<0.0001) and age (P<0.0001) were significant determinants of lethal outcome.Conclusions:Cardiac MIBG imaging has nearly identical prognostic value in both ischemic and non-ischemic HF, independent of cause of cardiac death. (Circ J 2016; 80: 435–441)
続きを見る
|
||||
| 67.
論文 |
論文
|
Yoneyama, Hiroto ; Nakajima, Kenichi ; Okuda, Koichi ; Matsuo, Shinro ; Onoguchi, Masahisa ; Kinuya, Seigo ; Edenbrandt, Lars
概要:
Background: We compared two reconstruction algorisms and two cardiac functional evaluation software programs in terms of
…
their accuracy for estimating ejection fraction (EF) of small hearts (SH). Methods: The study group consisted of 66 pediatric patients. Data were reconstructed using a filtered back projection (FBP) method without the resolution correction (RC) and an iterative method based on an ordered subset expectation maximization (OSEM) algorithm with the RC. EF was evaluated using two software programs of quantitative gated single-photon emission computed tomography (SPECT) (QGS) and cardioREPO. We compared the EF of gated myocardial perfusion SPECT to echocardiographic measurement (Echo). Results: Forty-eight of 66 patients had an end-systolic volume < 20 mL which was used as the criterion for being included in the SH group, and the SH effect led to an overestimation of EF. While significant differences were observed between Echo (66.9 ± 5.0%) and QGS-FBP without RC (76.9 ± 8.4%, P < .0001), QGS-OSEM with RC (76.6 ± 8.6%, P < .0001), and cardioREPO-FBP without RC (72.1 ± 10.0%, P = .0011), no significant difference was observed between Echo and cardioREPO-OSEM with RC (67.4 ± 6.1%) in SH group. Conclusions: In pediatric gated myocardial perfusion SPECT, the SH effect can be significantly reduced when an OSEM algorithm is used with RC in combination with the specific cardioREPO algorithm. © 2016 American Society of Nuclear Cardiology<br />Embargo Period 12 months
続きを見る
|
||||
| 68.
論文 |
論文
|
Kim, Fae ; Yamada, Kazunori ; Inoue, Dai ; Nakajima, Kenichi ; Mizushima, Ichiro ; Kakuchi, Yasushi ; Fujii, Hiroshi ; Narumi, Kenta ; Matsumura, Masami ; Umehara, Hisanori ; Yamagishi, Masakazu ; Kawano, Mitsuhiro
概要:
金沢大学附属病院リウマチ・膠原病内科<br />Immunoglobulin G4 (IgG4)-related tubulointerstitial nephritis (TIN) is often accompanied by auto
…
immune pancreatitis (AIP) or chronic sclerosing dacryoadenitis and sialoadenitis. However, IgG4-related TIN without AIP or lacrimal and/or salivary gland lesions has not been well recognized. Here, we report a case of IgG4-related TIN associated with hepatic inflammatory pseudotumor without AIP or lacrimal and/or salivary gland lesions. A 58-year-old Japanese man with epigastralgia underwent contrast-enhanced computed tomography (CT), which revealed multiple low-density lesions in both kidneys and a low density hepatic mass. Laboratory tests showed an extremely high level of serum IgG4. Percutaneous renal and hepatic biopsies showed diffuse infiltration of lymphocytes and IgG4-positive plasma cells with fibrosis in both tissues. Two months after administration of oral prednisolone, both lesions decreased in size on follow-up CT, and the serum cre-atinine level also improved. No recurrence has been detected for two years with a maintenance dose of pred-nisolone. © 2011 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 69.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Okuda, Koichi ; Kawano, Masaya ; Ishikawa, Takehiro ; Hosoya, Tetsuo ; Taki, Junichi ; Kinuya, Seigo
概要:
金沢大学附属病院核医学診療科<br />Background: Although the heart-to-mediastinum (H/M) ratio in a planar image has been used for practi
…
cal quantification in 123I-metaiodobenzylguanidine (MIBG) imaging, standardization of the parameter is not yet established. We hypothesized that the value of the H/M ratio could be standardized to the various camera-collimator combinations. Methods and results: Standard phantoms consisting of the heart and mediastinum were made. A low-energy high-resolution (LEHR) collimator and a medium-energy (ME) collimator were used. We examined multi-window correction methods with 123I- dual-window (IDW) acquisition, and planar images were obtained with IDW correction and the LEHR collimator. The images were obtained using the following gamma camera systems: GCA 9300A (Toshiba, Tokyo), E.CAM Signature (Toshiba/Siemens, Tokyo) and Varicam (GE, Tokyo). Cardiac phantom studies demonstrated that contamination of the H/M count ratio was greater with the LEHR collimator and least with the ME collimator. The corrected H/M ratio with the LEHR collimator was similar to that with ME collimators. The uncorrected H/M ratio with the ME collimator was linearly related to the H/M ratio with IDW correction with the LEHR collimator. The relationship between the uncorrected H/M ratios determined with the LEHR (E.CAM) and the ME collimators was y = 0.56 x + 0.49, where y = H/M ratio with the E.CAM and x = H/M ratio with the ME collimator. The average normal values for the low-energy collimator (n=18) were 2.2±0.2 (initial H/M ratio) and 2.42±0.2 (delayed H/M ratio), and for the low/medium-energy (LME) collimator (n=14) were 2.63±0.25 (initial H/M ratio) and 2.87±0.19 (delayed H/M ratio). H/M ratios in previous clinical studies using LEHR collimators are comparable to those with ME collimators. Conclusion: The IDW-corrected H/M ratios determined with the LEHR collimator were similar to those determined with the ME collimator. This finding could make it possible to standardize the H/M ratio in planar imaging among various collimators in the clinical setting. © 2008 Springer-Verlag.
続きを見る
|
||||
| 70.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Okuda, Koichi ; Kawano, Masaya ; Ishikawa, Takehiro ; Hosoya, Tetsuo ; Taki, Junichi ; Kinuya, Seigo
概要:
金沢大学附属病院核医学診療科<br />Background: Although the heart-to-mediastinum (H/M) ratio in a planar image has been used for practi
…
cal quantification in 123I- metaiodobenzylguanidine (MIBG) imaging, standardization of the parameter is not yet established. We hypothesized that the value of the H/M ratio could be standardized to the various camera-collimator combinations. Methods and results: Standard phantoms consisting of the heart and mediastinum were made. A low-energy high-resolution (LEHR) collimator and a medium-energy (ME) collimator were used. We examined multi-window correction methods with 123I- dual-window (IDW) acquisition, and planar images were obtained with IDW correction and the LEHR collimator. The images were obtained using the following gamma camera systems: GCA 9300A (Toshiba, Tokyo), E.CAM Signature (Toshiba/Siemens, Tokyo) and Varicam (GE, Tokyo). Cardiac phantom studies demonstrated that contamination of the H/M count ratio was greater with the LEHR collimator and least with the ME collimator. The corrected H/M ratio with the LEHR collimator was similar to that with ME collimators. The uncorrected H/M ratio with the ME collimator was linearly related to the H/M ratio with IDW correction with the LEHR collimator. The relationship between the uncorrected H/M ratios determined with the LEHR (E.CAM) and the ME collimators was y = 0.56x + 0.49, where y = H/M ratio with the E.CAM and x = H/M ratio with the ME collimator. The average normal values for the low-energy collimator (n=18) were 2.2±0.2 (initial H/M ratio) and 2.42±0.2 (delayed H/M ratio), and for the low/medium-energy (LME) collimator (n=14) were 2.63±0.25 (initial H/M ratio) and 2.87±0.19 (delayed H/M ratio). H/M ratios in previous clinical studies using LEHR collimators are comparable to those with ME collimators. Conclusion: The IDW-corrected H/M ratios determined with the LEHR collimator were similar to those determined with the ME collimator. This finding could make it possible to standardize the H/M ratio in planar imaging among various collimators in the clinical setting. © 2008 Springer-Verlag.
続きを見る
|
||||
| 71.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Wakabayashi, Hiroshi ; Akhter, Nasima ; Taki, Junichi ; Okuda, Koichi ; Kinuya, Seigo
概要:
金沢大学附属病院核医学診療科<br />Background: We evaluated the relationship between computed tomography angiography (CTA) and SPECT, a
…
nd assessed to determine the clinical usefulness of the fusion image using CTA and myocardial perfusion imaging (MPI). Methods: Forty-one consecutive patients [after coronary artery bypass operation (n = 13) and suspected stenosis (n = 28)] underwent MPI and CTA. SPECT/CTA fused images were generated. Results: In total, 687 segments including bypass graft in 164 coronary arteries were analyzed. Myocardial ischemia on MPI was observed in 11 patients among 28 with CTA abnormalities, one had both ischemia and infarction, and 7 had only infarction. Segment-based analysis showed that ischemia was found in 14 segments (24%) among 59 stenoses on CTA. Forty stenotic segments (69%) were not associated with perfusion abnormality. The rest 5 stenotic segments were considered equivocal (8%). A fusion image made it possible to associate perfusion defects with its corresponding coronary artery in 4 out of 5 equivocal lesions on side-by-side analysis. Patients with incremental diagnostic information on SPECT/CTA fusion (n = 4) had significant smaller coronary diameter than that of not-improved coronary vessels (2.0 ± 0.4 vs. 3.9 ± 0.4 mm, p = 0.001). Conclusion: Cardiac fusion imaging accurately diagnosed functionally relevant coronary stenosis. SPECT/CTA fusion images in coronary artery disease may provide added diagnostic information on functional relevance of coronary artery disease. © 2009 The Japanese Society of Nuclear Medicine.
続きを見る
|
||||
| 72.
論文 |
論文
|
Matsuo, Shinro ; Nakajima, Kenichi ; Yamasaki, Yoshimitsu ; Kashiwagi, Atsunori ; Nishimura, Tsunehiko
概要:
金沢大学附属病院核医学診療科<br />Background: This study was designed to determine the clinical risk for hard events after normal sing
…
le-photon emission computed tomography (SPECT) and to identify the predictors of increased risk in asymptomatic patients with diabetes mellitus, based on a Japanese Assessment of Cardiac Events and Survival Studies by quantitative gated SPECT (J-ACCESS)-2 study. Methods and Results: A total of 513 consecutive asymptomatic patients who underwent stress 99 mTc-tetrofosmin SPECT in Japan were included in this study. Based on SPECT image and QGS data, 319 had a summed stress score ≤3, a summed difference score <2 and normal cardiac function (end-systolic volume ≤60 ml, males, ≤40 ml, females; left ventricular ejection fraction ≥49%, males, ≥50%, females). Myocardial perfusion was normal in 62% of this study population. During a 3-year follow-up, there were a total of 8 cardiac major events (2.5%): 2 cases of sudden death, 5 of acute coronary syndrome, and 1 of hospitalization because of congestive heart failure. The annual major event rate was 0.8%. Subjects undergoing coronary angiography had significantly more major events than those who did not among normal SPECT subjects (P=0.01). Kaplan-Meier analysis showed that the cardiac major events rate was very low, and subjects with normal SPECT can be considered as low risk among asymptomatic patients with diabetes. Conclusions: An excellent prognosis was associated with a normal SPECT in asymptomatic patients with diabetes, so these patients can be exempted from further invasive procedure.
続きを見る
|
