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Biomedical subjects

Seiki Hamada

Publications and source records attributed to Seiki Hamada.

At least 19 recordsLinked to original sources

Computer-assisted lung nodule volumetry from multi-detector row CT: influence of image reconstruction parameters.

PURPOSE: To investigate differences in volumetric measurement of pulmonary nodules caused by changing the reconstruction parameters for multi-detector row CT. MATERIALS AND METHODS: Thirty-nine pulmonary nodules less than 2 cm in diameter were examined by multi-slice CT. All nodules were solid, and located in the peripheral part of the lungs. The resultant 48 parameters images were reconstructed by changing slice thickness (1.25, 2.5, 3.75, or 5 mm), field of view (FOV: 10, 20, or 30 cm), algorithm (high-spatial frequency algorithm or low-spatial frequency algorithm) and reconstruction interval (reconstruction with 50% overlapping of the reconstructed slices or non-overlapping reconstruction). Volumetric measurements were calculated using commercially available software. The differences between nodule volumes were analyzed by the Kruskal-Wallis test and the Wilcoxon Signed-Ranks test. RESULTS: The diameter of the nodules was 8.7+/-2.7 mm on average, ranging from 4.3 to 16.4mm. Pulmonary nodule volume did not change significantly with changes in slice thickness or FOV (p>0.05), but was significantly larger with the high-spatial frequency algorithm than the low-spatial frequency algorithm (p<0.05), except for one reconstruction parameter. The volumes determined by non-overlapping reconstruction were significantly larger than those of overlapping reconstruction (p<0.05), except for a 1.25 mm thickness with 10 cm FOV with the high-spatial frequency algorithm, and 5mm thickness. The maximum difference in measured volume was 16% on average between the 1.25 mm slice thickness/10 cm FOV/high-spatial frequency algorithm parameters and overlapping reconstruction. CONCLUSION: Volumetric measurements of pulmonary nodules differ with changes in the reconstruction parameters, with a tendency toward larger volumes in high-spatial frequency algorithm and non-overlapping reconstruction compared to the low-spatial frequency algorithm and overlapping reconstruction.

Adolescent↗

Usual interstitial pneumonia and chronic idiopathic interstitial pneumonia: analysis of CT appearance in 92 patients.

PURPOSE: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic interstitial pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual interstitial pneumonia (UIP) with univariate and multivariate analyses. MATERIALS AND METHODS: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific interstitial pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) (n = 11), desquamative interstitial pneumonia (DIP) (n = 15), or lymphoid interstitial pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. RESULTS: Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). CONCLUSION: UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

Adult↗

Computational flow dynamics in abdominal aortic aneurysm using multislice computed tomography.

Following the introduction of a new multislice computed tomography (MSCT) scanner, it has become possible to produce high-speed CT angiography (CTA), the preferred method for imaging in emergent abdominal vascular conditions. Unlike catheter angiography, multislice CTA not only depicts the vessels but also allows perfusion in adjacent organs to be assessed. To make the most effective diagnostic use of multi-detector row CTA and three-dimensional image post-processing, radiologists must be familiar with the optimal CTA protocols and the typical CT findings in various emergent vascular conditions using computational flow dynamics (CFD). This article describes a technical approach to estimating the blood flow state of human abdominal aortic aneurysms (AAA) in more detail by constructing realistic three-dimensional (3D) vessel models using CFD methods, focusing on pre- and postoperative cases.

Aged↗

Evaluation of coronary artery bypass grafts using multidetector-row CT with Japanese patients.

PURPOSE: To evaluate the patency of coronary artery bypass grafting (CABG) with multidetector-row computed tomography (MDCT) in Japanese patients, who have narrower coronary arteries than Caucasians. MATERIALS AND METHODS: Nineteen patients (12 men and 7 women, mean age: 63 +/- 12 years) with 33 coronary bypass grafts were examined with three-dimensional volume rendering (3D-VR) and curved multiplanar reconstruction (MPR) of MDCT. All grafts were compared with those obtained with selective graft angiography. RESULTS: For the 19 patients with 33 grafts, the overall sensitivity and specificity, compared with those for selective bypass angiography, were 96.7% and 100%, respectively. CONCLUSION: The patency of CABG in Japanese patients can be effectively evaluated with 3D-VR and curved MPR of MDCT.

Angiography↗

Evaluation of the usefulness of color digital summation radiography in temporally sequential digital radiographs: a phantom study.

PURPOSE: The purpose of this study was to assess the usefulness of color digital summation radiography (CDSR) for detection of nodules on chest radiographs by observers with different levels of experience. MATERIALS AND METHODS: A total of 30 radiographs of chest phantoms with abnormalities and 30 normal ones were arranged at random. Set A was conventional radiographs only. Set B consisted of both conventional radiographs and CDSR images, which were colored with magenta. Five chest radiologists and five residents evaluated both image sets on a TFT monitor. The observers were asked to rate each image set using a continuous rating scale. The reading time for each set was also recorded. RESULTS: In set A, the performance of chest radiologists was significantly superior to that of the residents (P < 0.05). However, in set B, there was no significant difference in the performance of the chest radiologists and the residents. In both observer groups, the mean reading time per case in set B was significantly shorter than that in set A (P < 0.01). CONCLUSION: By using CDSR, the detection capability of observers with little experience improves and is comparable to that of experienced observers. Moreover, the reading time becomes much shorter using CDSR.

Color↗

MR imaging of thymic epithelial tumors: correlation with World Health Organization classification.

PURPOSE: The aim of this study was to determine magnetic resonance imaging (MRI) features of various subtypes of thymic epithelial tumors based on the World Health Organization classification. MATERIALS AND METHODS: The study included 64 patients with histologically proven thymic epithelial tumors. Two observers evaluated the MRI findings in terms of tumor size, contour, lobulation, shape, homogeneity, the presence of intratumor high- and low-signal foci, enhancement degree and pattern, the presence of capsule and septum, and associated mediastinal lymphadenopathy and pleural effusion. RESULTS: Type A tumors were more likely to have a smooth contour, round shape, distinct capsule, and smaller size compared to any other type of thymic epithelial tumor. Thymic carcinomas demonstrated a higher prevalence of low-signal foci within the mass on T2-weighted images and mediastinal lymphadenopathy than any other types. The frequency of heterogeneous intensity on T2-weighted images increased from type A tumors to thymic carcinomas. CONCLUSION: The presence of a smooth contour, round shape, and capsule is highly suggestive of a type A tumor. Foci of low signal intensity in the mass on T2-weighted images and mediastinal lymphadenopathy are highly suggestive of thymic carcinomas.

Adult↗

Evaluation of usefulness of color digital summation radiography for solitary pulmonary nodules on chest radiographs.

PURPOSE: The aim of this study was to evaluate the usefulness of novel color digital summation radiography (CDSR) for detecting solitary pulmonary nodules on chest radiographs by observers with different levels of experience. MATERIALS AND METHODS: A total of 30 healthy controls and 30 patients with newly detected solitary pulmonary nodules were evaluated. Six radiologists and five residents evaluated three image sets: set A, current and prior radiographs only; set B, set A with temporal subtraction images; and set C, set A with CDSR. The observers were asked to rate each image set using a continuous rating scale. In addition, the reading time required for each set was recorded. RESULTS: The radiologists showed no significant differences in the mean A(z) value between set A, set B, and set C. However, the residents showed significant differences between set A and set B and between set A and set C. In addition, for set B and set C, the mean reading time per case of all readers was significantly shorter than that for set A. CONCLUSION: The detection capability of observers with little experience is comparable to that of experienced observers when reading radiographs with temporal subtraction images or with CDSR. The usefulness of CDSR is comparable to that of temporal subtraction.

Clinical Competence↗

Air microbubbles as MR susceptibility contrast agent at 1.5 Tesla.

Air microbubbles have been investigated recently at high magnetic field strength (2 Tesla or greater) as potential MR susceptibility contrast agents. We used a phantom to measure their susceptibility at 1.5 T to clarify their usefulness for this purpose. The phantom, filled with fresh Levovist suspension at 4 different doses (67 to 125 mg/mL), was continuously scanned with a gradient-echo technique at a temporal resolution of 10 s. The transverse relaxation increase (R2*) by microbubbles demonstrated a time course of exponential decay at each dose (time-constant, 39 to 57 s). The dependency of R2* on microbubble volume fraction was linear, with a slope of 89 s-1 per percentage microbubble volume fraction. Our study represents the first step towards applying microbubbles as susceptibility contrast agents at 1.5 T.

Air↗

Usefulness of three-dimensional multidetector-row CT images for preoperative evaluation of tumor extension in primary breast cancer patients.

PURPOSE: Usefulness of three dimensional (3D) multidetector-row CT (MDCT) images for preoperative evaluation of tumor extension was studied in primary breast cancer patients. METHODS: 3D-MDCT tumor images of 143 tumors in 143 patients with primary breast cancer were created with the volume rendering method. The transverse tumor size (TS) and vertical tumor size (VS) were then measured in an anterior-posterior view of the 3D-MDCT images. The pathological tumor size was determined according to a map of the tumor spread prepared by pathologists using multi-sliced (3-5 mm intervals) surgical specimens and compared with the tumor size on 3D-MDCT images. RESULTS: First, the optimal method for creating 3D-MDCT tumor images was determined for the first 40 patients (learning set), resulting in a fairly good correlation of tumor size on 3D-MDCT images with pathological tumor size (r = 0.983 for TS and r = 0.958 for VS). We then carried out a validation study on the next 103 patients (validation set). The 3D-MDCT tumor size's strong correlation with the pathological tumor size demonstrated a high rate of accuracy (r = 0.974 for TS and r = 0.977 for VS). Subset analyses according to histological type showed that correlation coefficients were r = 0.979 for TS and r = 0.981 for VS of invasive ductal carcinomas (n = 88), r = 0.948 for TS and r = 0.970 for VS of ductal carcinomas in situ (n = 10), and r = 0.984 for TS and r = 0.976 for VS of invasive lobular carcinomas (n = 5). CONCLUSION: 3D-MDCT images can assess breast cancer tumor extension highly accurately, and thus seems to be useful for planning the extent of resection in breast conserving surgery.

Adult↗

Full-size digital storage phosphor chest radiography: effect of 4K versus 2K matrix size on observer performance in detection of subtle interstitial abnormalities.

PURPOSE: To compare observer performance in the detection of subtle interstitial abnormalities on 3,520 x 3,520 (4K) matrix and 1,760 x 1,760 (2K) matrix full-size digital storage phosphor (DSP) chest radiographs. MATERIALS AND METHODS: Thirty-five 4K DSP chest radiographs with subtle interstitial abnormalities (n=27) or normal lungs (n=8) were processed with a half-band low-pass filter to produce 2K DSP radiographs. Although the actual matrix size of the 2K DSP radiographs remained 4K, the effective matrix size was reduced to 2K. Four chest radiologists independently evaluated full-sized hard-copy of the 4K and 2K DSP radiographs, and scored the presence of interstitial abnormalities for both right and left lungs on a five-point confidence scale. With findings on high-resolution computed tomography as the reference standard, observer performance was evaluated using multireader-multicase receiver operating characteristic (ROC) analysis. RESULTS: The average area under the ROC curve (Az) values for 4K and 2K DSP radiographs were 0.791+/-0.055 and 0.804+/-0.050, respectively. Both individual and averaged Az values showed no statistically significant differences (p>0.05) between 4K and 2K DSP radiographs. CONCLUSION: Observer performance in the detection of subtle interstitial abnormalities on 4K full-size DSP chest radiographs was equivalent to that on 2K full-size DSP chest radiographs.

Humans↗

Aortic compliance in patients with aortic regurgitation: evaluation with magnetic resonance imaging.

PURPOSE: To assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM valve) in patients with aortic regurgitation (AR). MATERIALS AND METHODS: Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. RESULTS: Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. CONCLUSION: Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment.

Adult↗

Voxel dimensions required for micromorphologic evaluation of ground-glass opacity on lung high-resolution CT.

PURPOSE: To clarify the appropriate voxel dimensions required for pathologic evaluation of areas with ground-glass opacity on lung high-resolution computed tomography (HRCT). MATERIALS AND METHODS: Synchrotron radiation CT (SRCT) images of autopsied lung speci-mens (n=25) that showed ground-glass opacity on HRCT were reconstructed with 12 different voxel dimensions ranging from 0.006 to 0.6 mm. The specimens were micromorphologically categorized into one of three pathologic groups: alveolar, interstitial, and mixed abnormalities. Each SRCT image was independently diagnosed as one of three pathologic groups by six chest radiologists. The diagnostic accuracy required to estimate the appropriate voxel dimensions was compared among different voxel dimensions by means of the Tukey test. RESULTS: Diagnostic accuracy with voxel dimensions less than or equal to 0.06 mm was significantly higher than that with voxel dimensions of 0.18 mm or more (p<0.01). There was, however, no significance of difference in diagnostic accuracy with voxel dimensions of less than or equal to 0.06 mm. In addition, no significant difference in diagnostic accuracy was found with voxel dimensions of 0.18 mm or more. CONCLUSION: The appropriate voxel dimensions are approximately 0.06 mm for pathologic differentiation of areas with ground-glass opacity on HRCT.

Humans↗

Mid-term results of freestyle aortic stentless bioprosthetic valve: clinical impact of quantitative analysis of in-vivo three-dimensional flow velocity profile by magnetic resonance imaging.

BACKGROUND AND AIM OF THE STUDY: The study aim was to investigate the in-vivo flow profiles of a stentless aortic bioprosthetic valve by MRI flow quantification, and to identify the clinical implication of prosthesis size and implantation method. METHODS: Twenty-six patients with a Freestyle stentless aortic bioprosthetic valve were studied using three-dimensional flow velocity profile by MRI, and compared with four patients with a stented aortic bioprosthetic valve and four healthy volunteers. Flow velocity profiles were analyzed quantitatively by the hydromechanics parameter, mean to peak velocity ratio at peak systole and compared with parameters monitored echocardiographically. RESULTS: In larger-sized valves or full root implantation, flow profiles showed an optimal pattern with low gradients, a high mean to peak velocity ratio, and minimum disturbance which approximated that of a normal valve. By contrast, a subset of patients, notably with 21 mm valves and subcoronary implantation, showed suboptimal flow pattern with high gradient and low mean to peak velocity ratio which approximated that of stented valves. The mean to peak velocity ratio was more strongly related to peak velocity than to the indexed effective orifice area. CONCLUSION: Although stentless aortic bioprostheses have excellent hemodynamic performance, some patients show suboptimal results. This seems to occur more often when the subcoronary technique is used, and especially with 21-mm valves. Care must be taken when using the subcoronary technique with a 21-mm valve in patients with a small body surface area.

Adult↗

Image quality of high-resolution CT with 16-channel multidetector-row CT: comparison between helical scan and conventional step-shoot scan.

OBJECTIVE: The aim of this study was to evaluate the image quality of high-resolution CT (HRCT) reconstructed from volumetric data with 16-channel multidetector-row CT (MDCT). SUBJECTS AND METHODS: Eleven autopsy lungs that were diagnosed histopathologically were scanned by 16-channel MDCT with the step-and-shoot scan mode and three helical scan modes. Each helical mode had each size of focal spot, pitch, and time of gantry rotation. HRCT images were reconstructed from the volumetric data with each helical mode and axial sequence data. Two observers evaluated the image quality and noted the most appropriate diagnosis for each imaging. RESULTS: Visualization of abnormal structures with one helical mode was equal to those with axial mode, whereas those with the other two helical modes were inferior to those with axial mode (Wilcoxon signed rank test; p<0.0001). There was no significant difference in diagnostic efficacy between modes. CONCLUSION: The image quality of HRCT with appropriate helical mode is equal to that with axial mode and diagnostic efficacy is equal among all modes. These results may indicate that sufficient HRCT images can be obtained by only one helical scan without the addition of conventional axial scans.

Cadaver↗

Detection of pulmonary metastases with multi-detector row CT scans of 5-mm nominal section thickness: autopsy lung study.

PURPOSE: To determine the effect of changing pitch and collimation on depiction of pulmonary metastases on scans of 5-mm section thickness obtained with multi-detector row computed tomography (CT) compared with those obtained with single-detector row CT. MATERIALS AND METHODS: In five autopsy lungs, 1,013 metastatic 0.5-30.0-mm nodules were detected at helical CT with 1-mm collimation and histopathologically diagnosed as metastases. Each nodule was numbered, and its localization was recorded as the standard for subsequent studies. Four types of scans of 5-mm section thickness were obtained with multi-detector row CT and four sets of helical pitch and table speed, respectively, as follows: set A, 3:1 and 7.5 mm per rotation; set B, 6:1 and 15 mm per rotation; set C, 6:1 and 30 mm per rotation; set D, conventional and 5-mm interval. Conventional helical CT scans (set E) were obtained with 5-mm collimation at single-detector row CT. Two independent observers evaluated the five sets of CT scans. RESULTS: Acquisition times for sets A-D, respectively, were 1.9, 3.8, 7.5, and 1.5 times faster than they were for set E. The mean numbers of detected nodules were 671 (66%) in set A, 661 (65%) in set B, 678 (67%) in set C, 654 (65%) in set D, and 656 (65%) in set E; there was no significant difference in the number of detected nodules among the five sets (P =.997, McNemar test and Bonferroni equation). CONCLUSION: Regardless of varying pitch or detector collimation, multi- and single-detector row CT scans obtained with 5-mm section thickness have almost the same ability to depict pulmonary metastases and are equivalent.

Autopsy↗

Chronic cystic lung disease: diagnostic accuracy of high-resolution CT in 92 patients.

OBJECTIVE: The objective of this study was to determine whether the various chronic cystic lung diseases can be differentiated on the basis of the pattern and distribution of abnormalities on high-resolution CT. MATERIALS AND METHODS: High-resolution CT scans in 92 patients with chronic cystic lung diseases (18 with pulmonary Langerhans cell histiocytosis, 18 with pulmonary lymphangioleiomyomatosis, 17 with usual interstitial pneumonia, 16 with lymphocytic interstitial pneumonia, 15 with emphysema, and eight with desquamative interstitial pneumonia or respiratory bronchiolitis interstitial lung disease) were retrospectively assessed by two independent observers without knowledge of the clinical or pathologic data. The observers recorded the abnormalities, the most likely diagnosis, and the degree of confidence in that diagnosis. RESULTS: The two observers made a correct first-choice diagnosis in 148 (80%) of 184 interpretations. The correct diagnosis was made in 100% of interpretations of usual interstitial pneumonia, 81% of desquamative interstitial pneumonia or respiratory bronchiolitis interstitial lung disease, 81% of lymphocytic interstitial pneumonia, 77% of emphysema, 72% of lymphangioleiomyomatosis, and 72% of Langerhans cell histiocytosis. The two observers made a diagnosis with a high degree of confidence in 105 (57%) of 184 interpretations. The confident diagnosis was correct in 98 (93%) of 105 interpretations. CONCLUSION: Although various chronic cystic lung diseases often have a characteristic appearance that allows their distinction on high-resolution CT, considerable overlap exists among the CT findings. Therefore, lung biopsy is often required for a definitive diagnosis.

Adolescent↗

Temporal subtraction for detection of solitary pulmonary nodules on chest radiographs: evaluation of a commercially available computer-aided diagnosis system.

PURPOSE: To evaluate the usefulness of a commercially available computer-aided diagnosis (CAD) system that incorporates temporal subtraction for the detection of solitary pulmonary nodules on chest radiographs by readers with different levels of experience. MATERIALS AND METHODS: Sixty pairs of chest radiographs in 30 patients with newly detected solitary pulmonary nodules and 30 normal cases, all confirmed with serial chest computed tomography (CT), were obtained from screen-film or digital radiographic systems and were digitized (spatial resolution, 0.171 mm/pixel). Temporal subtraction images were produced with an iterative image-warping technique. Five chest radiologists and five residents evaluated both image sets for solitary nodules: set A, current and prior radiographs with temporal subtraction images, and set B, current and prior radiographs only. Assessment was performed with receiver operating characteristic (ROC) analysis of the images on a monitor (pixel size, 1,280 x 1,024) equipped with the system. The reading time needed by each reader was recorded in each case. RESULTS: For the chest radiologists, no statistically significant difference was found between set A (area under the ROC curve [A(z)] = 0.934) and set B (A(z) = 0.964). For the residents, however, observer performance in set A (A(z) = 0.907) was superior to that in set B (A(z) = 0.855) (P <.05). For both groups, the mean reading time per case for set A (chest radiologists, 16.7 seconds; residents, 15.7 seconds) was significantly (P <.05) shorter than that for set B (chest radiologists, 20.4 seconds; residents, 26.2 seconds). CONCLUSION: For the detection of solitary pulmonary nodules, the CAD system with temporal subtraction can promote efficiency for established chest radiologists and improvement in accuracy for less experienced readers.

Adult↗

Temporal subtraction for the detection of hazy pulmonary opacities on chest radiography.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of temporal subtraction with a commercially available computer-assisted diagnosis system for the detection of multifocal hazy pulmonary opacities on chest radiographs, which are sometimes difficult to detect directly on chest radiographs. MATERIALS AND METHODS: Thirty healthy patients and 30 patients with new multifocal hazy pulmonary opacities that were confirmed by serial chest CT examinations were evaluated with and without temporal subtraction images. Chest radiographs were taken from either film-screen or digital radiography images and were digitized with a spatial resolution of 0.171 mm per pixel. Temporal subtraction images were produced by an iterative image-warping technique. We designed an observer performance study in which observers (six chest radiologists and four residents) indicated their confidence level for the presence or absence of hazy pulmonary opacities on two sets of images, current and previous radiographs only (set A), and current and previous radiographs with temporal subtraction images (set B). Receiver operating characteristic curves were generated. RESULTS: For chest radiologists, observer performance with set B (with temporal subtraction images; A(z) = 0.947) was superior to that with set A (without temporal subtraction images; A(z) = 0.916) (p < 0.05). For residents, no statistically significant difference was found between sets A and B. CONCLUSION: The temporal subtraction technique clearly improves diagnostic accuracy for the detection of multifocal hazy pulmonary opacities on chest radiographs, especially when the observers are experienced chest radiologists who have sufficient skill to evaluate the patient's condition as revealed on the images.

Humans↗