PubMed Health⌕ Search

Biomedical subjects

Ichiro Hasegawa

Publications and source records attributed to Ichiro Hasegawa.

10 recordsLinked to original sources

Architecture of authorization mechanism for medical data sharing on the grid.

Data security is becoming increasingly important as the Grid matures. The advances of the Grid have allowed scientists and researchers to build a data grid where they can share and exchange research-related data and information. In reality, however, these specialists do not benefit enough from this data grid. The reason is that the current Grid does not have sufficiently robust and flexible data security. We investigate a medical data-sharing environment where medical doctors and scientists can securely share clinical and medical research data. We show medical data sharing that takes advantage of PERMIS, or an RBAC-based authorization system that achieves XML element level access control. We also describe the lessons learnt in designing the environment as well as a comparison with other existing authorization mechanisms.

Computer Security↗

Mixture distribution analysis of a computer assisted diagnostic method for the evaluation of pulmonary nodules on computed tomography scan.

RATIONALE AND OBJECTIVES: To compare the effectiveness of a new computational scheme for pulmonary nodule detection in computed tomography images against human observers. MATERIALS AND METHODS: The study involved evaluation of 81 potential nodules by four radiologists. Each radiologist separately evaluated the potential nodules and provided a confidence level for the presence of pulmonary nodules. Their performance was compared with that of the new computational scheme by mixture distribution analysis. RESULTS: Mixture distribution analysis of the results of the four radiologists demonstrated a relative proportion agreement of 0.84. The kappa statistic was used to compare the agreement of the computational scheme with the results of the four radiologists. A kappa value of .65 (se = .11) was shown to be significantly different from chance (P = .99). CONCLUSION: The new computational scheme correlates well with the radiologists' subjective rankings of pulmonary nodules on computed tomography scans and may prove a useful tool in the evaluation of algorithms for the screening and diagnosis of lung cancer.

Humans↗

Bronchial artery dilatation on MDCT scans of patients with acute pulmonary embolism: comparison with chronic or recurrent pulmonary embolism.

OBJECTIVE: The purpose of our study was to compare the bronchial arteries of patients with acute pulmonary embolism with those of patients with chronic or recurrent pulmonary embolism. MATERIALS AND METHODS: Twenty-seven patients with acute pulmonary embolism and 14 patients with chronic or recurrent pulmonary embolism were retrospectively identified from 700 consecutive patients with suspected pulmonary embolism. The case data for the patients were assessed by two thoracic radiologists whose final judgments were reached by consensus. On the MDCT pulmonary angiograms obtained in these patients, the bronchial arteries were assessed by finding enhancing, small, round or curvilinear structures within the mediastinum and tracing their paths along the bilateral main bronchi. Bronchial arteries with a diameter greater than 1.5 mm were considered to be dilated. RESULTS: The diameters of the bronchial arteries in the group with chronic or recurrent pulmonary embolism were significantly larger than diameters of the bronchial arteries in the group with acute pulmonary embolism (p = 0.0002). Dilatation of bronchial arteries was observed in two of the 27 patients with acute pulmonary embolism and in seven of 14 patients with chronic or recurrent pulmonary embolism. This difference was statistically significant (p = 0.004). No dilated bronchial arteries were seen in patients who had acute pulmonary embolism but had no a history of deep venous thrombosis. CONCLUSION: Acute pulmonary embolism did not appear to cause dilatation of bronchial arteries, whereas chronic or recurrent pulmonary embolism was frequently associated with dilated bronchial arteries. In patients in whom the distinction between acute and chronic or recurrent pulmonary embolism on MDCT pulmonary angiography is clinically unclear and in whom the bronchial arteries are dilated, a diagnosis of chronic or recurrent pulmonary embolism should be favored.

Acute Disease↗

Pulmonary hilar lymph nodes in lung cancer: assessment with 3D-dynamic contrast-enhanced MR imaging.

PURPOSE: We performed 3D-dynamic MRI on patients with primary lung cancer to identify its usefulness for detecting hilar adenopathy shown at surgery. METHODS AND MATERIALS: 30 consecutive patients with peripheral lung cancer underwent preoperative 3D-dynamic Gd-DTPA-enhanced MRI. Two thoracic radiologists blinded to histopathologic findings reviewed those studies independently for hilar adenopathy visualization. The results were correlated with surgical and histopathologic findings. Interreader agreement for the detection of hilar adenopathy was assessed by means of the kappa statistic. RESULTS: Dynamic MRI demonstrated hilar adenopathy, with or without metastasis revealed at surgery, in all of 15 patients. Adenopathy without metastasis was shown in four patients. Dynamic MRI also revealed metastatic adenopathy in 11 of 12 patients with pathologically proven metastasis. There was only one case with lymph node metastasis that did not have adenopathy either on MRI or even at surgery. The diagnostic accuracy of dynamic MRI for adenopathy with or without metastases revealed at surgery were as follows; sensitivity, 100%; specificity, 100%; positive predictive value, 100%; and negative predictive value, 100%, respectively. The diagnostic accuracy of dynamic MRI for hilar lymph nodes metastasis were as follows; sensitivity, 92%; specificity, 78%; positive predictive value, 73%; and negative predictive value, 93%. Interreader agreement was substantial (kappa=0.73) for detection of hilar adenopathy. CONCLUSION: Hilar adenopathy on 3D-dynamic MRI correlated well with that of surgical finding on patients with primary lung cancer. It may have the potential to make an accurate preoperative evaluation of hilar lymph node metastasis from lung cancer.

Adenocarcinoma↗

Voxelwise mapping of magnetic resonance ventilation-perfusion ratio in a porcine model by multimodality registration: technical note.

RATIONALE AND OBJECTIVES: The purpose of this study was to demonstrate the construction of voxelwise ventilation-perfusion (V/Q) ratio maps in a porcine model by nonrigidly aligning the respective ventilation and perfusion images using a multimodality registration algorithm. MATERIALS AND METHODS: The first-pass contrast agent technique for a blood flow map and 3He used for ventilation imaging were performed using a normal porcine model. The registered 3He-ventilation image was then aligned to the blood flow map using a multimodality registration algorithm. The voxelwise V/Q ratios were calculated by dividing the registered 3He-ventilation image by the blood flow map. The V/Q ratios were also semi-logarithmically scatter-plotted against the number of voxels. RESULTS: From perfusion magnetic resonance images, a voxel-by-voxel blood flow map was produced. Registered 3He ventilation image was successfully obtained as well as V/Q ratio map. Plots of the V/Q ratios obtained by this registration approach were similar to the logarithmic normal distribution. CONCLUSION: Registration of MR perfusion and ventilation images can potentially enable quantitative evaluation of regional pulmonary function and thus yield deeper insight into the physiology and pathophysiology of the lung.

Animals↗

Characterization of regional pulmonary mechanics from serial magnetic resonance imaging data.

RATIONALE AND OBJECTIVES: The aim of this study was to investigate a method for quantifying lung motion from the registration of successive images in serial magnetic resonance imaging acquisitions during normal respiration. MATERIALS AND METHODS: Estimates of pulmonary motion were obtained by summing the normalized cross-correlation over serially acquired lung images to identify corresponding locations between the images. The estimated motions were modeled as deformations of an elastic body and thus reflect to a first order approximation the true physical behavior of lung parenchyma. The Lagrangian strain, derived from the calculated motion fields, were used to quantify the tissue deformation induced in the lung over the serial acquisition. RESULTS: The method was validated on a magnetic resonance imaging study, for which breath-hold images were acquired of a healthy volunteer at different phases of the respiratory cycle. Regional parenchymal strain was observed to be oriented toward the pulmonary hilum, with strain magnitude maximal at the midcycle of the expiratory phase. CONCLUSION: In vivo magnetic resonance imaging quantification of lung motion holds the potential of providing a new diagnostic dimension in the assessment of pulmonary function, augmenting the information provided by studies of ventilation and perfusion.

Adult↗

2003 AUR Memorial Award. Dynamic expiratory volumetric CT imaging of the central airways: comparison of standard-dose and low-dose techniques.

RATIONALE AND OBJECTIVES: Investigators in this study compared standard-dose and low-dose inspiratory and expiratory computed tomographic (CT) images with regard to their usefulness for measuring the tracheal lumen in patients with or without tracheobronchomalacia (TBM). MATERIALS AND METHODS; Hospital records were reviewed to identify 10 consecutive patients with bronchoscopically proved TBM and 10 control subjects without TBM who underwent paired volumetric inspiratory and dynamic expiratory examinations with multisection CT. A low-dose (40-80 mA) technique was used for dynamic expiratory CT in 14 (70%) of the 20 subjects, and a standard dose (240-280 mA) was used in the remaining six (30%). All images were reviewed in a randomized, blinded fashion by two observers, who measured the tracheal lumen to determine the presence of TBM by consensus. The degree of confidence in measuring the tracheal lumen was graded on a four-point scale from 0(no confidence) to 3 (highest level of confidence), also by consensus of the two observers. Statistical analysis for differences in confidence level was performed with the Mann-Whitney U test. The image noise level was assessed by measuring the standard deviation of the presternal soft tissue, and statistical analysis for differences in noise level was performed with the t test. RESULTS: The level of confidence in tracheal lumen measurement was high, regardless of respiratory phase and dose (inspiratory mean, 2.9; median, 3; range, 2-3; expiratory low-dose mean, 2.6; median, 3; range, 2-3; expiratory standard-dose mean, 2.8; median, 3; range, 2-3). There was no significant difference in confidence level between standard- and low-dose techniques (P = .53). Excessive central airway collapse (expiratory reduction in cross-sectional diameter, > 50%) was seen in all 10 patients with TBM and in none of the control subjects. CONCLUSION: The acquisition of paired inspiratory and dynamic expiratory images with multisection helical CT is a promising method for diagnosing TBM. The low-dose technique performs as well as the standard-dose technique for the dynamic expiratory phase, with a similar degree of confidence for measuring the tracheal lumen.

Awards and Prizes↗

Tracheomalacia incidentally detected on CT pulmonary angiography of patients with suspected pulmonary embolism.

OBJECTIVE: The aim of this study was to determine the frequency of tracheomalacia incidentally detected on CT pulmonary angiography in patients with suspected pulmonary embolism. MATERIALS AND METHODS: CT records of 163 consecutive patients imaged with CT pulmonary angiography for suspected pulmonary embolism were retrospectively reviewed at our institution. The patients underwent CT pulmonary angiography with three different types of CT scanners. All images were visually assessed by two thoracic radiologists for excessive collapse of the trachea and the main bronchi. The cross-sectional area of the lumen at the site of maximal collapse of the airway was measured, and the percentage of luminal narrowing was calculated by comparing it with the cross-sectional area of the airway lumen at an adjacent area without collapse. We defined tracheomalacia as a 50% or greater decrease in tracheal lumen. RESULTS: Sixteen (10%) of 163 patients showed evidence of tracheomalacia (seven men, nine women; age range, 41-95 years; mean age, 72 years). The most common presenting symptom was shortness of breath, which was observed in 13 (81%) of 16 patients. Known causes of tracheomalacia were found in 15 (94%) of 16 patients, prior intubation was confirmed in 12 patients, and history of asthma or chronic obstructive pulmonary disease was observed in five patients. CONCLUSION: Tracheomalacia is a relatively common incidental finding on CT pulmonary angiography studies. The central airways, as well as pulmonary vasculature, should be reviewed carefully for clinical interpretation in patients with suspected pulmonary embolism. Paired expiratory-inspiratory CT is recommended if patients present with known causes of tracheomalacia such as prior intubation, chronic obstructive pulmonary disease, or asthma.

Adult↗

MR-pathologic correlation of lung specimens.

The aim of this study was to assess the feasibility of a new MR-pathologic correlation method utilizing a high-resolution MR technique with a 3-inch surface coil and elimination of susceptibility by replacing air in the pulmonary alveoli of lung specimens with water. Inflated cadaver lung specimens of various lung disorders were imaged using a conventional spin echo (SE) sequence in a clinical 1.5 T MR scanner. The MR images were correlated with pathologic specimens. In six out of seven specimens, MR revealed detailed images corresponding to pathological changes. MR may provide a non-invasive and non-destructive method for examining lung specimens and for image-pathologic correlation.

Cadaver↗

CT and MR in pulmonary embolism: A changing role for nuclear medicine in diagnostic strategy.

The goal of this article is to summarize current data on computed tomography (CT) and magnetic resonance (MR) in the diagnosis of acute pulmonary embolism (PE) in relation to the radionuclide ventilation perfusion scan. It is important for the nuclear medicine, CT, and MR communities to develop a shared approach to this disorder. Triage using chest radiographs appears to be a practical method for enhancing both nuclear medicine and CT/MR performance. The realization that there is no clinically available gold standard for the diagnosis of PE suggests that the imaging community should replace impractical and idealistic discussions with more realistic outcome-oriented approaches. A simplified one-step evaluation of the pulmonary arteries and the lower extremity veins for deep venous thrombus can provide a comprehensive examination for PE. CT is currently a more practical diagnostic tool, whereas MR offers a scientific probe for pulmonary physiology including the regional mapping of ventilation-perfusion relationships. Nuclear medicine, CT, and MR thus form an imaging triad for the diagnosis of acute PE.

Humans↗