Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Shingo Baba Last modified date:2021.08.02

Associate Professor / Department of Radiology / Radiology Center / Kyushu University Hospital


Papers
1. Yugawa, K., Itoh, S., Iseda, N., Kurihara, T., Kitamura, Y., Toshima, T., Harada, N., Kohashi, K., Baba, S., Ishigami, K., Oda, Y., Yoshizumi, T. & Mori, M., Obesity is a risk factor for intrahepatic cholangiocarcinoma progression associated with alterations of metabolic activity and immune status, Scientific reports., 11, 1, 5845-5845, 2021.05.
2. Kikuchi, K., Togao, O., Yamashita, K., Momosaka, D., Nakayama, T., Kitamura, Y., Kikuchi, Y., Baba, S., Sagiyama, K., Ishimatsu, K., Kamei, R., Mukae, N., Iihara, K., Suzuki, S. O., Iwaki, T. & Hiwatashi, A, Diagnostic accuracy for the epileptogenic zone detection in focal epilepsy could be higher in FDG-PET/MRI than in FDG-PET/CT, European Radiology., 31, 5, 2915-2922, 2021.05.
3. Itoh, S., Yoshizumi, T., Kitamura, Y., Yugawa, K., Iseda, N., Shimagaki, T., Nagao, Y., Toshima, T., Harada, N., Kohashi, K., Baba, S., Ishigami, K., Oda, Y. & Mori, M., Impact of Metabolic Activity in Hepatocellular Carcinoma: Association with Immune Status and Vascular Formation, Hepatology Communications., https://doi.org/10.1002/hep4.1715, 2021.04.
4. Kazuo Kubota · Noriko Tanaka · Yoko Miyata · Hiroshi Ohtsu · Tadaki Nakahara · Setsu Sakamoto ·Takashi Kudo · Yoshihiro Nishiyama · Ukihide Tateishi · Koji Murakami · Yuji Nakamoto · Yasuyuki Taki ·Tomohiro Kaneta · Joji Kawabe · Shigeki Nagamachi · Tsuyoshi Kawano · Jun Hatazawa ·Youichi Mizutani · Shingo Baba · Kazukuni Kirii · Kunihiko Yokoyama · Terue Okamura ·Masashi Kameyama · Ryogo Minamimoto · Junwa Kunimatsu · On Kato · Hiroyuki Yamashita ·Hiroshi Kaneko · Satoshi Kutsuna · Norio Ohmagari · Akiyoshi Hagiwara · Yoshimi Kikuchi ·Masao Kobayakawa, Comparison of 18F-FDG PET/CT and 67Ga-SPECT for the diagnosis of fever of unknown origin: a multicenter prospective study in Japan, Annals of Nuclear Medicine, 35, 1, 31-46, 2021.05.
5. Akihiko Takahashi, Keita Funada, Kazuhiko Himuro, Shingo Baba and Masayuki Sasaki, Impact of Collimator on DaT-SPECT Imaging: Monte Carlo Simulation Study, Radiology and Medical Diagnostic Imaging, 10.31487/j.RDI.2019.04.06, 2020.01.
6. Sakiko Shimizu Handa, Shingo Baba, Kenichiro Yamashita, Mari Nishizaka, Shinichi Ando, The Severity of Obstructive Sleep Apnea Syndrome Cannot Predict the Accumulation of Brain Amyloid imaging with [11C]-Pittsburgh compound B PET Computed Tomography in Patients with a Normal Cognitive Function, Ann Nucl Med, 33, 7, 541-544, 2019.07.
7. Yuji Tsutsui, Shinichi Awamoto, Kazuhiko Himuro, Toyoyuki Kato, Shingo Baba, Masayuki Sasaki, Evaluating and comparing the image quality and quantification accuracy of SiPM-PET/CT and PMT-PET/CT, Annals of Nuclear Medicine, 34, 10, 725-735, 2020.10.
8. Yoshiyuki Kitamura, Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Masayuki Sasaki, Takeshi Kamitani, Yuhki Koga, Naonori Kawakubo, Toshiharu Matsuura, Kousei Ishigami, 123 I metaiodobenzylguanidine (MIBG) uptake predicts early relapse of neuroblastoma using semi-quantitative SPECT/CT analysis, Annals of Nuclear Medicine, 10.1007/s12149-021-01595-7., 35, 5, 549-556, 2021.03, Objective: 123I metaiodobenzylguanidine (MIBG) scintigraphy is a useful tool for the diagnosis of neuroblastoma (NB). MIBG uptake is correlated with norepinephrine transporter expression; hence, it is expected that high-MIBG tumors would be more highly differentiated and have a better prognosis than those with lower expression. We have introduced a method of assessing MIBG accumulation semi-quantitatively using SPECT/CT fusion images. The purpose of this study was to evaluate the relationship of 123I MIBG uptake measured by semi-quantitative values of SPECT/CT and early relapse of NB.
Methods: We studied the cases of 11 patients (5 males and 6 females, age 5-65 months, median age 20 months) with histopathologically proven NB between April 2010 and March 2015. The early-relapse group was defined as patients who had relapsed within 3 years after the first 123I MIBG SPECT/CT exam. Other patients were classified as the delay-relapse group. Uptake of MIBG was evaluated using the count ratio of tumor and muscles. T/Mmax and T/Mmean were defined as follows: T/Mmax = max count of tumor/max count of muscle, T/Mmean = mean count of tumor/mean count of muscle.
Results: The average T/Mmean values of the early-relapse group and delay-relapse group were 2.65 ± 0.58 and 7.66 ± 2.68, respectively. The T/Mmean values of the early-relapse group were significantly lower than those of delay-relapse group (p < 0.05). The average T/Mmax of the early-relapse group and delay-relapse group were 8.86 ± 3.22 and 16.20 ± 1.97, respectively. There was no significant difference in T/Mmax values between the two groups.
Conclusions: Low 123I MIBG uptake using semi-quantitative SPECT/CT analysis was correlated with early relapse of NB.
Keywords: 123I MIBG; Neuroblastoma; Pediatric; SPECT/CT; Semi-quantitative analysis..
9. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshio Matsuo, Yuichiro Kubo, Shinji Ogawa, Tokujiro Yano, Masayuki Sasaki, Hiroshi Honda, A case of pulmonary choriocarcinoma metastasis with unusual FDG-PET and CT findings
Correlation with pathology, Annals of Nuclear Medicine, 10.1007/s12149-012-0644-x, 26, 10, 835-839, 2012.08, A 26-year-old female who had had a hydatidiform mole at 20 years of age showed high levels of serum human chorionic gonadotropin. Because pelvic ultrasound did not show any gestational sac in her uterus, she was suspected to have had an extrauterine pregnancy and a spontaneous abortion. About 6 months later, a pulmonary nodule in the patient's right upper lung field was found on a routine chest X-ray film. Contrast- enhanced CT scans revealed a solitary lobulated nodule 2.0 × 1.3 × 3.0 cm in diameter in the S2 segment of the right lung. CT suggested a vessel malformation. Positron emission tomography using 2-deoxy-2-[18F]fluoro-d-glucose (FDG-PET) was performed and showed weak FDG accumulation (SUVmax = 2.0) in the nodule, which did not positively indicate malignancy. Because a follow-up CT showed a rapid increase in the size of the nodule, partial resection of S2 segment in the right upper lobe was performed. The histopathological diagnosis was a metastasis from choriocarcinoma. The tumor consisted largely of necrosis and hemorrhage, and it was considered to be a major cause of the unusual FDG-PET and CT findings..
10. Tomoyoshi Takenaka, Tokujiro Yano, Yosuke Morodomi, Kensaku Ito, Naoko Miura, Daigo Kawano, Fumihiro Shoji, Shingo Baba, Koichiro Abe, Hiroshi Honda, Yoshihiko Maehara, Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography, Surgery today, 10.1007/s00595-012-0277-7, 42, 10, 934-939, 2012.10, Purpose We developed a method for predicting truenegative lymph node metastases in clinical IA non-small lung cancer (NSCLC) by the combined evaluation of computed tomography (CT), 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) findings and the maximum standardized uptake value (SUVmax) of primary tumors. Methods The subjects of this study were 94 patients with clinical stage IA NSCLC who underwent both preoperative CT and FDG-PET. We analyzed the relationship between the SUVmax of primary tumors and various clinicopathological factors to find the best method available for assessing true-negative lymph node metastasis. Results The pathological stages were IA (n = 80), IB (n = 4), IIA (n = 5), IIIA (n = 4), and IV (n = 1). Pathologic lymph node metastasis was recognized in nine patients and the SUVmax of these tumors ranged from 3.3 to 20.3. A SUVmax of 3.0 was defined as the cut-off point and patients were dichotomized according to this point. Tumors with SUVmax of 3.0 or less were associated with a significantly lower incidence of pleural and vascular invasion and were characterized by the degree of differentiation. Conclusion The SUVmax of primary tumors reflects the grade of malignancy; therefore, the combined evaluation of FDG-PET/CT findings with the SUVmax of primary tumors may help predict lymph node metastasis negativity..
11. Akiko Shinmura, Koichiro Abe, Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Fumiko Yasukawa, Hiromaro Kiryu, Masayuki Sasaki, Masutaka Furue, Hiroshi Honda, FDG PET/CT findings in acquired perforating dermatosis., Clinical nuclear medicine, 37, 10, 997-1000, 2012.10, ABSTRACT: Acquired perforating dermatosis (APD) is an uncommon cutaneous perforating disorder. We report a patient on hemodialysis who developed skin eruption and jaundice. He underwent FDG PET/CT under suspicion of biliary malignancies. PET/CT showed no significant abnormal uptake except of multiple FDG-avid nodules in the skin. The eruption he had was histopathologically diagnosed as APD by skin biopsy. His case suggests that APD should be considered as a differential diagnosis when multiple cutaneous FDG accumulations are found in a patient on hemodialysis. To the best of our knowledge, this is the first report showing the FDG PET/CT findings of APD..
12. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Hirofumi Sawamoto, Yoshitaka Tanabe, Masayuki Sasaki, Hiroshi Honda, Incremental diagnostic value of SPECT/CT with 131I scintigraphy after radioiodine therapy in patients with well-differentiated thyroid carcinoma, Radiology, 10.1148/radiol.12112108, 265, 3, 902-909, 2012.11, Purpose: To retrospectively determine the incremental diagnostic value of adding single photon emission computed tomography/ computed tomography (SPECT/CT) to whole-body scintigraphy with iodine 131 (131I) compared with scintigraphy alone after radioiodine therapy in patients with well-differentiated thyroid carcinoma. Materials and Methods: This retrospective study was institutional review board approved; written informed consent was waived. The study included 147 patients (94 female, 53 male patients; mean age, 51 years) with well-differentiated thyroid carcinoma treated with radioiodine therapy between October 2009 and August 2010. Whole-body scintigraphy and SPECT/CT were performed on the same day in all patients receiving radioiodine therapy. Each radioactive focus at whole-body scintigraphy was classified as positive or equivocal with respect to thyroid bed, lymph node, and distant metastasis uptake. Differences between whole-body scintigraphy and SPECT/CT findings were assessed with the generalized McNemar test. Results: At SPECT/CT, origin was clearly determined of all five "hot spots" in the thyroid bed (remnant thyroid tissue or metastatic lymph node) that were judged as equivocal at wholebody scintigraphy. Interpretation of 24 (22.2%) of 108 radioactive foci for lymph node metastases was changed with SPECT/CT (P < .0001). One of 85 foci that were thought to be positive findings at whole-body scintigraphy turned out to be a negative finding (false-positive finding), and 13 and seven of 20 equivocal foci at whole-body scintigraphy were positive and negative findings, respectively, after adding SPECT/CT findings. Three false-negative findings at whole-body scintigraphy were corrected with SPECT/CT. For the detection of distant metastasis, the interpretations of 21 (40%) of 52 foci were corrected with SPECT/CT (P < .0001). One of 32 foci thought to be a positive finding at whole-body scintigraphy was a negative finding, and 11 and nine of 20 equivocal foci at whole-body scintigraphy were positive and negative findings, respectively, after SPECT/CT. At a patient-based analysis, SPECT/CT findings helped change the clinical staging in nine (6.1%) of 147 patients and therapeutic planning in three (2.0%) of 147 patients. Conclusion: SPECT/CT improved detection and localization of 131I accumulation in lymph node metastases and distant metastases, compared with whole-body scintigraphy..
13. Go Akamatsu, Kaori Ishikawa, Katsuhiko Mitsumoto, Takafumi Taniguchi, Nobuyoshi Ohya, Shingo Baba, Koichiro Abe, Masayuki Sasaki, Improvement in PET/CT image quality with a combination of point-spread function and time-of-flight in relation to reconstruction parameters, Journal of Nuclear Medicine, 10.2967/jnumed.112.103861, 53, 11, 1716-1722, 2012.11, The aim of this study was to investigate the effects of the pointspread function (PSF) and time-of-flight (TOF) on improving 18FFDG PET/CT images in relation to reconstruction parameters and noise-equivalent counts (NEC). Methods: This study consisted of a phantom study and a retrospective analysis of 39 consecutive patients who underwent clinical 18F-FDG PET/CT. The body phantom of the National Electrical Manufacturers Association and International Electrotechnical Commission with a 10-mm-diameter sphere was filled with an 18F-FDG solution with a 4:1 radioactivity ratio compared with the background. The PET data were reconstructed with the baseline ordered-subsets expectation maximization (OSEM) algorithm, with the OSEM+PSF model, with the OSEM+TOF model, and with the OSEM+PSF+TOF model. We evaluated image quality by visual assessment, the signal-to-noise ratio of the 10-mm sphere (SNR10 mm), the contrast of the 10-mm sphere, and the coefficient of variance in the phantom study and then determined the optimal reconstruction parameters. We also examined the effects of PSF and TOF on the quality of clinical images using the signal-to-noise ratio in the liver (SNRliver) in relation to the NEC in the liver (ENCliver). Results: In the phantom study, the SNR10 mm was the highest for the OSEM+PSF+TOF model, and the highest value was obtained at iteration 2 for algorithms with the TOF and at iteration 3 for those without the TOF. In terms of a postsmoothing filter full width at half maximum (FWHM), the high SNR 10 mm was obtained with no filtering or was smaller than 2 mm for algorithms with PSF and was 4-6 mm for those without PSF. The balance between the contrast recovery and noise is different for algorithms with either PSF or TOF. A combination of PSF and TOF improved SNR10 mm, contrast, and coefficient of variance, especially with a small-FWHM gaussian filter. In the clinical study, the SNRliver of the low- ENCliver group in the OSEM+PSF+TOF model was compared with that of the high-ENCliver group in conventional OSEM. The PSF+TOF improved the SNRliver by about 24.9% ± 9.81%. Conclusion: A combination of PSF and TOF clearly improves image quality, whereas optimization of the reconstruction parameters is necessary to obtain the best performance for PSF or TOF. Furthermore, this combination has the potential to provide good image quality with either lower activity or shorter acquisition time, thus improving patient comfort and reducing the radiation burden. COPYRIGHT.
14. Yasuhiro Maruoka, Michinobu Nagao, Koichiro Abe, Shingo Baba, Takuro Isoda, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Quantification of heterogeneity on 201Tl Gated SPECT
Evaluation of coronary artery disease, Clinical nuclear medicine, 10.1097/RLU.0b013e3182638e46, 38, 1, e7-e12, 2013.01, PURPOSE: The purpose of this study was to propose a new index that quantifies the heterogeneity of myocardial uptake on gated myocardial perfusion SPECT (GMPS) with Tl and investigate its utility in diagnosing multivessel coronary artery disease (CAD). METHODS: In 51 patients with CAD, adenosine-stress Tl GMPS and coronary angiography (CAG) were performed. On the basis of the American Heart Association's 17-segment model, segmental percentage uptake on stress, and redistribution images of GMPS were measured at end-systole and end-diastole. The coefficient of variance (CV) of 17 segmental percentage uptake for each patient was used as an estimate of the heterogeneity of myocardial uptake. According to the results of CAG, patients were divided into insignificant coronary artery stenosis (insignificant-CAD), single-vessel CAD, and multivessel CAD groups. The differences in CV among the 3 groups were analyzed by 1-way analysis of variance and Tukey-Kramer test. The diagnostic capability for multivessel CAD was analyzed using the receiver operating characteristics (ROC) curve analysis. RESULTS: Stress end-diastolic CV for patients with multivessel CAD [mean (SD), 18.1% (3.5%)] was significantly greater than that for single-vessel CAD [12.8% (2.9%), P < 0.0001] and insignificant-CAD [10.1% (0.9%), P < 0.0001]. Stress end-systolic CV for patients with multivessel CAD [23.4% (5.2%)] was significantly greater than that for insignificant-CAD [16.5% (4.1%), P = 0.002], whereas there was no difference between single-vessel [20.9% (6.1%)] and multivessel CAD. Using an optimal cutoff of stress end-diastolic CV diagnosed multivessel CAD with a sensitivity of 84%, a specificity of 92%, an accuracy of 88%, and an area under the curve of 0.89. CONCLUSIONS: The heterogeneity of myocardial percentage uptake on Tl GMPS was correlated with the severity of CAD. Stress end-diastolic CV value is a candidate index for differentiating patients with multivessel CAD from single-vessel CAD and insignificant-CAD..
15. Ko Higuchi, Michinobu Nagao, Yoshio Matsuo, Takeshi Kamitani, Masato Yonezawa, Mikako Jinnouchi, Yuzo Yamasaki, Koichiro Abe, Shingo Baba, Yasushi Mukai, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Evaluation of chronic ischemic heart disease with myocardial perfusion and regional contraction analysis by contrast-enhanced 256-MSCT, Japanese Journal of Radiology, 10.1007/s11604-012-0159-3, 31, 2, 123-132, 2013.02, Purpose: To investigate myocardial viability in chronic ischemic heart disease by myocardial perfusion and regional contraction analysis using 256-slice MSCT coronary angiography (CCTA). Methods: In 30 patients with prior myocardial infarction (MI), CCTA with retrospective ECG-gating and stress-redistribution thallium-201 SPECT were performed. Using the same raw data as used for CCTA, myocardial perfusion imaging (CT-MPI) was reconstructed at four phases during the cardiac cycle. Mean myocardial attenuation and wall thickness at end-systole and end-diastole were measured in the MI areas depicted by SPECT, and they were compared between viable and non-viable segments categorized by SPECT. Results: End-systolic thickness was significantly greater for viable than for non-viable segments (12.0 ± 3.2 vs. 9.6 ± 3.5 mm, p = 0.0017). There was no difference in end-diastolic thickness. Myocardial attenuation was significantly higher for viable than for non-viable segments in the subendocardium (62 ± 13 vs. 70 ± 11 HU, p = 0.003) and the epicardium (65 ± 13 vs. 80 ± 15 HU, p = 0.0002). Conclusion: The systolic wall thinning and epicardial low-attenuation areas were the indicative findings of CT-MPI for non-viable segments in the prior MI..
16. Shingo Baba, Koichiro Abe, Takuro Isoda, Yasuhiro Maruoka, Masayuki Sasaki, Hiroshi Honda, Impact of FDG-PET/CT in the management of lymphoma, Annals of Nuclear Medicine, 10.1007/s12149-011-0549-0, 25, 10, 701-716, 2011.12, Since the introduction of 67Gallium-citrate 30 years ago, nuclear medicine has played an important role in the evaluation of malignant lymphoma. During that time, several radiotracers were evaluated as potential alternatives for the diagnosis of lymphoma, but the introduction of 18F-fluorodeoxyglucose PET (FDG-PET) marked a major turning point. FDG-PET took over most of the role of gallium, and is now an essential tool in the diagnosis of lymphoma. FDG-PET is increasingly being used for assessment of the tumor staging prior to treatment, for evaluating the response to treatment, and for monitoring the early reactions to therapy to predict the final outcome. FDG-PET has been shown to have more accurate diagnostic capability than conventional CT and MRI for distinguishing the tumor necrosis and residual masses frequently seen after therapy in lymphoma patients without any clinical and biochemical manifestation. Malignant lymphoma is the first disease for which FDG-PET was adopted as a tool for response assessment in the international standard criteria. However, lymphoma does not always display a clear high uptake, and there are some pitfalls in assessing the response to therapy. This review will highlight the most important applications of FDG-PET in lymphoma, focusing on the advantages and pitfalls of this imaging, and past and ongoing efforts to standardize the use of FDG-PET, particularly in response to assessment and therapy monitoring..
17. Katsuhiko Mitsumoto, Koichiro Abe, Yuichi Sakaguchi, Tiejiao Zhang, Yosuke Tachiya, Nobuyoshi Ohya, Shingo Baba, Masayuki Sasaki, Determination of the optimal acquisition protocol of breath-hold PET/CT for the diagnosis of thoracic lesions, Nuclear Medicine Communications, 10.1097/MNM.0b013e32834bbda7, 32, 12, 1148-1154, 2011.12, Objective: The aim of this study was to determine the optimal acquisition scan protocol for deep inspiration breath-hold (BH) fluoro-2-deoxy-D-glucose positron emission tomography (PET) for the examination of thoracic lesions. Methods: We studied 32 thoracic lesions in 21 patients. Whole-body PET/computed tomography (CT) scanning with free breathing (FB) was performed for 3 min per bed position, followed by a BH-CT and five BH-PET for 20 s each. Summed BH images with total acquisition times of 40, 60, 80 and 100 s were generated (BH×2, BH×3, BH×4 and BH×5, respectively). The displacements between PET and CT images, the lesion volume of the PET image, the maximum standardized uptake value (SUVmax) and the quality of the PET image were assessed in relation to the clinical characteristics of each patient and the summation of the BH-PET images. Results: BH-PET decreased the tumor volume significantly (FB: 7.23±9.70 cm3, BH×5: 4.71±5.14 cm3, P<0.01) and increased the SUVmax (FB: 6.27±5.41, BH×5: 7.53±6.28, P<0.01). The displacement between the PET and CT images was improved significantly in the BH scans (FB: 0.77±0.53 cm, BH×5: 0.36±0.24 cm, P<0.01). In addition, aging and lung function of patients influenced the reproducibility of BH-PET. The summed BH-PET images, obtained by summation of three or more BH-PET images (total acquisition time of 60 s or more), achieved good image quality. Conclusion: BH-PET/CT improved the misregistration between PET and CT images and increased the SUVmax of thoracic lesions. The recommended number of BH-PET images for summation with 20 s of acquisition time is three or more..
18. Masato Yonezawa, K. Higuchi, Y. Yamazaki, M. Jinnouchi, Y. Maruoka, T. Isoda, T. Kamitani, S. Baba, Y. Matsuo, K. Abe, H. Honda, Coronary stenosis severity assessed by 256-slice MDCT angiography in comparison with stress myocardial perfusion imaging, Japanese Journal of Clinical Radiology, 57, 1, 136-141, 2012.01, We evaluated the feasibility of 256-slice MDCT for detecting coronary artery stenosis without beta blocker premedication, and assessed the diagnostic accuracy of MDCT for detecting myocardial ischemia by 201Tl SPECT. Fifty-three patients underwent both coronary CT angiography and stress myocardial perfusion SPECT. All coronary arteries were assessable with appropriate image quality. MDCT revealed high specificity, but only half of stenotic lesion by MDCT revealed ischemia on SPECT..
19. Yuichi Sakaguchi, Noriko Mizoguchi, Tatsuya Mitsumoto, Katsuhiko Mitsumoto, Kazuhiko Himuro, Nobuyoshi Ohya, Koichiro Kaneko, Shingo Baba, Koichiro Abe, Yoshihiko Onizuka, Masayuki Sasaki, A simple table lookup method for PET/CT partial volume correction using a point-spread function in diagnosing lymph node metastasis, Annals of Nuclear Medicine, 10.1007/s12149-010-0401-y, 24, 8, 585-591, 2010.10, Objective: We evaluated the partial volume effect in PET/CT images and developed a simple correction method to address this problem. Methods: Six spheres and the background in the phantom were filled with F-18 and we thus obtained 4 different sphere-to-background (SB) ratios. Thirty-nine cervical lymph nodes in 7 patients with papillary thyroid carcinoma (15 malignant and 24 benign) were also examined as a preliminary clinical study. First, we developed recovery coefficient (RC) curves normalized to the maximum counts of the 37-mm sphere. Next, we developed a correction table to determine the true SB ratio using three parameters, including the maximum counts of both the sphere and background and the lesion diameter, by modifying the approximation formula of the RC curves including the point-spread function correction. The full width at half maximum in this formula is estimated with the function of the SB ratio. Results: In the phantom study, a size-dependent underestimation of the radioactivity was observed. The degree of decline of RC was influenced by the SB ratio. In preliminary clinical examination, the difference in the SUV max between malignant and benign LNs thus became more prominent after the correction. The PV correction slightly improved the diagnostic accuracy from 95 to 100%. Conclusions: We developed a simple table lookup correction method for the partial volume effect of PET/CT. This new method is considered to be clinically useful for the diagnosis of cervical LN metastasis. Further examination with a greater number of subjects is required to corroborate its clinical usefulness..
20. Yoshiko Tashima, Koichiro Abe, Yoshio Matsuo, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Hiroshi Honda, Pulmonary tumor thrombotic microangiopathy FDG-PET/CT findings, Clinical nuclear medicine, 10.1097/RLU.0b013e3181966f5c, 34, 3, 175-177, 2009.03, Pulmonary tumor thrombotic microangiopathy (PTTM) is his- topathologically characterized by proliferation of intimal myofibroblasts in the small pulmonary arterioles, induced by tumor microemboli. Patients develop rapidly progressive and severe cardiopulmonary failure, and the clinical course of this disease is fatal. Conventional radiologic findings are often minimal or nonspecific, making diagnosis difficult before death. We report 2-(F-18)-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) images of PTTM, which illustrate the characteristic findings of this clinical entity. FDG-PET can be helpful for the diagnosis of PTTM..
21. Koichiro Abe, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Shuji Sakai, Ichiro Yoshino, Hiroshi Honda, Diagnostic and prognostic values of FDG-PET in patients with non-small cell lung cancer, Clinical Imaging, 10.1016/j.clinimag.2008.06.032, 33, 2, 90-95, 2009.03, Purpose: The aim of this study was to address the efficacy of 2-[F-18]-Fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in the staging of non-small cell lung cancer (NSCLC) and in prognostic prediction in patients with NSCLC. Methods: Forty-four patients (26 males, 18 females) were analyzed. Results: Accurate staging was obtained by addition of FDG-PET. Multivariate analysis indicated that the standardized uptake value of the primary tumor was the most significant prognostic factor for disease-free survival (P=.0073). Conclusion: FDG-PET is useful for the diagnosis of NSCLC and for prognostic prediction in patients with NSCLC..
22. Yoshiko Tashima, Koichiro Abe, Yoshio Matsuo, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Hiroshi Honda, Pulmonary tumor thrombotic microangiopathy FDG-PET/CT findings, Clinical nuclear medicine, 10.1097/RLU.0b013e3181966f5c, 34, 3, 175-177, 2009.03, Pulmonary tumor thrombotic microangiopathy (PTTM) is his- topathologically characterized by proliferation of intimal myofibroblasts in the small pulmonary arterioles, induced by tumor microemboli. Patients develop rapidly progressive and severe cardiopulmonary failure, and the clinical course of this disease is fatal. Conventional radiologic findings are often minimal or nonspecific, making diagnosis difficult before death. We report 2-(F-18)-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) images of PTTM, which illustrate the characteristic findings of this clinical entity. FDG-PET can be helpful for the diagnosis of PTTM..
23. Koichiro Abe, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Shuji Sakai, Ichiro Yoshino, Hiroshi Honda, Diagnostic and prognostic values of FDG-PET in patients with non-small cell lung cancer, Clinical Imaging, 10.1016/j.clinimag.2008.06.032, 33, 2, 90-95, 2009.03, Purpose: The aim of this study was to address the efficacy of 2-[F-18]-Fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in the staging of non-small cell lung cancer (NSCLC) and in prognostic prediction in patients with NSCLC. Methods: Forty-four patients (26 males, 18 females) were analyzed. Results: Accurate staging was obtained by addition of FDG-PET. Multivariate analysis indicated that the standardized uptake value of the primary tumor was the most significant prognostic factor for disease-free survival (P=.0073). Conclusion: FDG-PET is useful for the diagnosis of NSCLC and for prognostic prediction in patients with NSCLC..
24. Shingo Baba, Mitsuaki Tatsumi, Takayoshi Ishimori, David L. Liliein, James M. Engles, Richard L. Wahl, Effect of nicotine and ephedrine on the accumulation of 18F-FDG in brown adipose tissue, Journal of Nuclear Medicine, 10.2967/jnumed.106.039065, 48, 6, 981-986, 2007.06, This study evaluated the effect of various β-adrenergic agonists on 18F-FDG uptake in brown adipose tissue (BAT) in rats using ex vivo biodistribution studies. Methods: Caffeine (10 mg/kg of body weight, n = 4), ephedrine (5 mg/kg of body weight, n = 4), nicotine (0.8 mg/kg of body weight, n = 9), or a mixture of nicotine and ephedrine (0.8 mg/kg of body weight and 5 mg/kg of body weight, respectively, n = 9) was injected into the peritoneal cavity of female Lewis rats 30 min before intravenous 18F-FDG injection. One hour after injection of 18F-FDG, the animals were sacrificed, and BAT, other major organs, and blood were extracted. The biodistribution results were compared with body temperature data. Results: In the rats injected with nicotine or ephedrine, the mean uptake of 18F-FDG, in percentage injected dose (%ID)/(g of interscapular BAT) x (kg of body weight), was significantly increased (7.9-fold for nicotine and 3.7-fold for ephedrine), compared to the control rats. Nicotine had the strongest effect on 18F-FDG uptake in BAT. Caffeine increased BAT uptake slightly, but this increase did not reach statistical significance. The combination of nicotine and ephedrine increased the uptake 12.0-fold, compared with control rats; more than either nicotine or ephedrine alone. Uptake of 18F-FDG in most other major organs did not change significantly. The effect of nicotine was blocked by prior injection of β-adrenergic antagonists. A transient decrease in body temperature was observed in the nicotine-injected group, and this effect was canceled by prior injection of β-adrenergic antagonists. No significant change in baseline temperature was seen before or after β-adrenergic agonist injection. Conclusion: Nicotine caused a greater increase in 18F-FDG uptake in BAT than did other interventions, and the effect was increased when nicotine was combined with ephedrine. The effect of nicotine was completely blocked by prior injection of β-adrenergic antagonists, indicating that β-adrenergic agonists increase the metabolism of BAT. These preclinical data suggest that patients should avoid nicotine and ephedrine before undergoing 18F-FDG PET to minimize 18F-FDG uptake in BAT..
25. Shingo Baba, Steve Y. Cho, Zhaohui Ye, Linzhao Cheng, James M. Engles, Richard L. Wahl, How reproducible is bioluminescent imaging of tumor cell growth? Single time point versus the dynamic measurement approach, Molecular Imaging, 10.2310/7290.2007.00031, 6, 5, 315-322, 2007.09, To determine the most robust and reproducible parameters for noninvasively estimating tumor cell burden in a murine model, we used real-time in vivo bioluminescent imaging to assess the growth kinetics and dissemination of luciferase-transfected Raji B-cell lymphoma. Bioluminescent signals were acquired every minute for 40 minutes after luciferin injection every other day post-tumor injection. The total 40-minute area under the curve (AUC) of photon intensity (photons/second) was calculated and compared with simplified fixed time point observations (every 5 minutes from 5 to 40 minutes after substrate injection). There was substantial variability in the shape of the time signal intensity curves at different stages of tumor growth in both the intravenous and subcutaneous models. The coefficient of variance in the AUC was 0.27 (intravenous) and 0.36 (subcutaneous) as values determined by fitting the curve, whereas the 20-minute time point measurement varied at 0.29 (intravenous) and 0.37 (subcutaneous). In both the subcutaneous and intravenous models, single time point measurements at 20 minutes had the highest correlation value with AUC. This simplified single time point measurement appears appropriate to estimate the total tumor burden in this model, but the substantial variance at each measurement must be considered in experimental designs..
26. Shingo Baba, James M. Engles, David L. Huso, Takayoshi Ishimori, Richard L. Wahl, Comparison of uptake of multiple clinical radiotracers into brown adipose tissue under cold-stimulated and nonstimulated conditions, Journal of Nuclear Medicine, 10.2967/jnumed.107.041715, 48, 10, 1715-1723, 2007.10, Our objective was to determine whether multiple clinically useful radiotracers accumulate in brown adipose tissue (BAT) and to assess their uptake in rats kept at room temperature or exposed to a cold environment. Methods: The following radiotracers were injected intravenously into groups of 6 female Wistar rats: 201Tl-chloride (TlCl), 123I- metaiodobenzylguanidine (MIBG), 99mTc-sestamibi (MIBI), 18F- or 3H-FDG, 3H-L-methionine, and 3H-thymidine. BAT-stimulated animals were maintained at 4°C for 4 h before tracer injection, whereas control animals were kept at approximately 22.5°C. The animals were sacrificed at 20-60 min after tracer injection, and BAT, major organs, and blood were extracted, weighed, and measured for radioactivity. The localization of uncoupling protein-1, glucose transporter-1, and norepinephrine transporter was evaluated with immunohistochemical staining in both groups. Results: We determined the percentage injected dose (%ID) per gram of each radiotracer in interscapular BAT, normalized to blood %ID/g. In control animals, this uptake ratio (6SD) was 8.44 ± 3.39 for 201TlCl, 9.77 ± 6.06 for 123IMIBG, 37.30 ± 14.42 for 99mTc-MIBI, 5.47 ± 4.44 for 18F- or 3H-FDG, 1.93 ± 0.87 for 3H-L-methionine, and 1.22 ± 0.74 for 3Hthymidine. Compared with uptake at room temperature, uptake after exposure to cold increased 26.4-fold (P < 0.01) for 18F- or 3H-FDG and increased significantly (P < 0.05) for 201Tl (2.04-fold), 123I-MIBG (3.25-fold), and 3H-L-methionine (3.11-fold). Immunohistochemical staining revealed increased glucose transporter-1 and norepinephrine transporter expression in BAT cell membranes and blood vessels after exposure to cold, whereas uncoupling protein-1 was expressed in the cytoplasm under both control and cold-stimulated conditions. Conclusion: BAT uptake of 18F- or 3H-FDG, 123I-MIBG, and 3H-L-methionine was significantly increased over the control state by exposure to cold. Increased uptake of 201TlCl relative to blood in cold-stimulated BAT suggests that blood flow in BAT is increased by exposure to cold. The greater increased uptake with 18F- or 3H-FDG, 123I-MIBG, and 3H-L-methionine, and the immunohistostaining findings, suggest that other factors in addition to blood flow (e.g., increased metabolism, increased transport, or metabolic trapping of the tracers) are involved in cold-stimulated BAT activation. Knowledge that high uptake in BAT may possibly be observed on clinical scans using several radiotracers, especially after patients are exposed to the cold, may lead to more accurate interpretation of clinical studies..
27. Cathrine Jespersgaard, Lars Allan Larsen, Shingo Baba, Yoji Kukita, Tomoko Tahira, Michael Christiansen, Jens Vuust, Kenshi Hayashi, Paal Skytt Andersen, Optimization of capillary array electrophoresis single-strand conformation polymorphism analysis for routine molecular diagnostics, ELECTROPHORESIS, 10.1002/elps.200600095, 27, 19, 3816-3822, 2006.10, Mutation screening is widely used for molecular diagnostics of inherited disorders. Furthermore, it is anticipated that the present and future identification of genetic risk factors for complex disorders will increase the need for high-throughput mutation screening technologies. Capillary array electrophoresis (CAE) SSCP analysis is a low-cost, automated method with a high throughput and high reproducibility. Thus, the method fulfills many of the demands to be met for application in routine molecular diagnostics. However, the need for performing the electrophoresis at three temperatures between 18°C and 35°C for achievement of high sensitivity is a disadvantage of the method. Using a panel of 185 mutant samples, we have analyzed the effect of sample purification, sample medium and separation matrix on the sensitivity of CAE-SSCP analysis to optimize the method for molecular diagnostic use. We observed different effects from sample purification and sample medium at different electrophoresis temperatures, probably reflecting the complex interplay between sequence composition, electrophoresis conditions and sensitivity in SSCP analysis. The effect on assay sensitivity from three different polymers was tested using a single electrophoresis temperature of 27°C. The data suggest that a sensitivity of 98-99% can be obtained using a 10% long chain poly-N,N-dimethylacrylamide polymer..
28. Tomoko Tahira, Shingo Baba, Koichiro Higasa, Yoji Kukita, Yutaka Suzuki, Sumio Sugano, Kenshi Hayashi, dbQSNP
A database of SNPs in human promoter regions with allele frequency information determined by single-strand conformation polymorphism-based methods, Human mutation, 10.1002/humu.20196, 26, 2, 69-77, 2005.08, We present a database, dbQSNP (http://qsnp.gen.kyushu-u.ac.jp/), that provides sequence and allele frequency information for single-nucleotide polymorphisms (SNPs) located in the promoter regions of human genes, which were defined by the 5′ ends of full-length cDNA clones. We searched for the SNPs in these regions by sequencing or single-strand conformation polymorphism (SSCP) analysis. The allele frequencies of the identified SNPs in two ethnic groups were quantified by SSCP analyses of pooled DNA samples. The accuracy of our estimation is supported by strong correlations between the frequencies in our data and those in other databases for the same ethnic groups. The frequencies vary considerably between the two ethnic groups studied, suggesting the need for population-based collections and allele frequency determination of SNPs, in, e.g., association studies of diseases. We show profiles of SNP densities that are characteristic of transcription start site regions. A fraction of the SNPs revealed a significantly different allele frequency between the groups, suggesting differential selection of the genes involved..
29. Koichiro Kaneko, Yasuo Kuwabara, Masayuki Sasaki, Hirofumi Koga, Koichiro Abe, Shingo Baba, Kazutaka Hayashi, Hiroshi Honda, Validation of quantitative accuracy of the post-injection transmission-based and transmissionless attenuation correction techniques in neurological fdg-pet, Nuclear Medicine Communications, 10.1097/00006231-200411000-00005, 25, 11, 1095-1102, 2004.11, We evaluated the quantitative accuracy of the post-injection transmission-based segmented attenuation correction (SAC) technique and transmissionless calculated attenuation correction (CAC) technique in both 2D and 3D scanning for the brain, and compared the results with those obtained using the pre-injection transmission-based measured attenuation correction (MAC) technique, which is generally accepted as the ‘gold standard’..
30. Koichiro Abe, Masayuki Sasaki, Yasuo Kuwabara, Hirofumi Koga, Shingo Baba, Kazutaka Hayashi, Naoki Takahashi, Hiroshi Honda, Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer, Annals of Nuclear Medicine, 10.1007/BF02985050, 19, 7, 573-579, 2005.01, Objective: Bone is one of the most common sites of metastasis in breast cancer patients. Although bone scintigraphy is widely used to detect metastatic breast cancer, the usefulness of 18FDG-PET for detecting bone metastasis has not been clearly evaluated. The purpose of this study was to compare the diagnostic accuracy of 18FDG-PET with bone scintigraphy in detecting bone metastasis in breast cancer patients. Methods: Forty-four women aged 35 to 81 years (mean, 56 years) with breast cancer were examined in this study. Both 18FDG-PET and bone scintigraphy were performed for each patient with 0-69 day intervals (mean, 11.5 days). The results of each image interpretation were compared retrospectively. Whole-body bones were classified into 9 anatomical regions. Metastases were confirmed at 45/187 regions in 14 patients by bone biopsy or clinical follow-up including other imaging techniques for a period of at least 6 months afterwards. Results: On a region basis, the sensitivity, specificity, and accuracy of 18FDG-PET were 84%, 99% and 95%, respectively. Although these results were comparable to those of bone scintigraphy, the combination of 18FDG-PET and bone scintigraphy improved the sensitivity (98%) and accuracy (97%) of detection. False negative lesions of bone scintigraphy were mostly bone marrow metastases and those of 18FDG-PET were mostly osteoblastic metastases. 18FDG-PET was superior to bone scintigraphy in the detection of osteolytic lesions (92% vs. 73%), but inferior in the detection of osteoblastic lesions (74% vs. 95%). Conclusions: This study shows that 18FDG-PET tends to be superior to bone scintigraphy in the detection of osteolytic lesions, but inferior in the detection of osteoblastic lesions. 18FDG-PET should play a complementary role in detecting bone metastasis with bone scintigraphy..
31. Koichiro Abe, Masayuki Sasaki, Yasuo Kuwabara, Hirofumi Koga, Shingo Baba, Koichiro Kaneko, Kazutaka Hayashi, Yoshiyuki Shioyama, Tatsuro Tajiri, Sachiyo Suita, Hiroshi Honda, Extraosseous accumulation of 99mTc-HMDP to radiation nephropathy, mimicking recurrent neuroblastoma, Annals of Nuclear Medicine, 10.1007/BF02986333, 19, 1, 35-40, 2005.02, Objective: The aim of this study is to clarify the period of extraosseous accumulation of 99mTc-hydroxymethylenediphosphonate (HMDP) to radiation nephropathy mimicking recurrent or remnant neuroblastoma in the pararenal region. Methods: We reviewed five neuroblastoma and one ganglioneuroblastoma patients (2 boys and 4 girls aged 1-9 years) who underwent 99mTc-HMDP bone scintigraphies periodically before and after radiation therapy. Results: Increased renal uptake coincident with the radiation port appeared in 5 of 6 patients from O to 3 months (mean 1.7 months), and persisted up to 7 months after the completion of radiotherapy. Renal uptake of 99mTc-HMDP was gradually decreased, and eventually became accumulation defects in 5 of 6 patients from 6 to 17 months (mean 8.9 months) after radiotherapy. Conclusion: When extraosseous accumulation is found after radiation therapy in neuroblastoma patients, radiation nephropathy would be a candidate in the differential diagnosis besides recurrent or remnant tumor..
32. Shingo Baba, Y. Kukita, K. Higasa, T. Tahira, K. Hayashi, Single-stranded conformational polymorphism analysis using automated capillary array electrophoresis apparatuses, BioTechniques, 34, 4, 746-750, 2003.04, We describe a new environment of a single-stranded conformational polymorphism (SSCP) analysis using automated capillary array sequencers (e.g., ABI PRISm® 3100 and 3700). In this environment, electrophoretic conditions, settings for instrument management, and software for data analysis are adjusted for SSCP analysis. Highly reproducible results are obtained with this new system, and fragments with mutations and/or polymorphisms in different capillaries or different runs can be reliably detected. The relative peak heights between alleles are quantitative and reproducible between runs, and so allele frequencies of single nucleotide polymorphisms can be accurately estimated by a pooled DNA strategy. The method allows unattended, low-cost, and quantitative SSCP analysis using instruments that are widely accessible..
33. Yoji Kukita, Koichiro Higasa, Shingo Baba, Michihiro Nakamura, Sachi Manago, Akari Suzuki, Tomoko Tahira, Kenshi Hayashi, A single-strand conformation polymorphism method for the large-scale analysis of mutations/polymorphisms using capillary array electrophoresis, ELECTROPHORESIS, 10.1002/1522-2683(200207)23:14<2259::AID-ELPS2259>3.0.CO;2-8, 23, 14, 2259-2266, 2002.07, We present a high-throughput single-strand conformation polymorphism (SSCP) method, performed on a commercially available capillary array DNA sequencer. We tested various sieving matrices and electrophoretic conditions, using 51 DNA fragments which included 45 fragments carrying only one single nucleotide polymorphism (SNP), 4 fragments having two SNPs and 2 fragments with insertion or deletion. Resolution of alleles was improved by increasing concentrations of both sieving matrices and buffers, and all examined polymorphisms of DNA fragments were detected, most of them (45 fragments) as clearly split allele peaks in heterozygotes. Allele frequencies of SNPs can be estimated accurately by determining the relative amounts of alleles in pooled DNA. In this method, the turn-around time for the analysis of 96 samples is less than 3 h. These results demonstrate that capillary array-based SSCP is an efficient and accurate technique for the large-scale quantitative analysis of mutations/polymorphisms..
34. Yoji Kukita, Sachi Manago, Shingo Baba, Kenshi Hayashi, Hemi-stranded SSCP analysis of SNPs in short sequence-tagged sites, BioTechniques, 33, 5, 1118-1121, 2002.11.
35. Koichiro Higasa, Yoji Kukita, Shingo Baba, Kenshi Hayashi, Software for machine-independent quantitative interpretation of SSCP in capillary array electrophoresis (QUISCA), BioTechniques, 33, 6, 1342-1348, 2002.12, PCR single-stranded conformational polymorphism (SSCP) analysis is a simple and rapid electrophoretic technique for the sensitive detection of sequence variants of PCR products. Here we describe a cross-platform program package, quantitative interpretation of SSCP in capillary array (QUISCA), which allows semi-automated quantitative detection of sequence variants separated by multicolor fluorescence-based SSCP electrophoresis using various capillary array apparatus. The program, together with the QUISCAview as a graphical user interface, takes trace data in ASCII format and processes them with three modules: signal denoising/baseline subtraction, color-matrix construction/application, and calibration of peak positions between multiple capillary runs using internal standard peaks. QUISCA is compatible with data from various widely used capillary array sequencers and is suitable not only for finding or typing SNPs in individual DNAs but also for the accurate estimation of the allele frequencies of many SNPs using a pooled DNA strategy. QUISCA can also serve as a versatile core program for various fragment analyses..
36. Ryo Murayama, Akihiro Nishie, Tomoyuki Hida, Shingo Baba, Junichi Inokuchi, Yoshinao Oda, Hiroshi Honda, Uptake of 18F-FDG in Adrenal Adenomas Is Associated with Unenhanced CT Value and Constituent Cells, Clinical nuclear medicine, 10.1097/RLU.0000000000002759, 44, 12, 943-948, 2019.12, Purpose The purposes of this study were to investigate the correlation between unenhanced CT attenuation values and 18F-FDG uptake in adrenal adenomas, and to clarify the mechanism of FDG uptake in adrenal adenomas based on immunohistochemical findings. Materials and Methods In 57 adrenal adenomas, the correlation between SUVmax on 18F-FDG PET and unenhanced CT attenuation was retrospectively investigated. In the 11 surgically resected nodules, the clear cell ratio (CCR) and expression levels of glucose transporters (GLUTs) 1 to 4 were pathologically evaluated. The GLUT expression levels were scored at 0 to 3 points for each transporter, and the sum of these expression levels was defined as the GLUT score. The relationships between CCR and either the CT attenuation number or SUVmax, and between the GLUT score and each of the CT attenutation value, SUVmax, or CCR were evaluated. Results There was a significant positive correlation between SUVmax and the CT attenuation value for the group of 57 adenomas (R = 0.44, P = 0.0007). For the 11 surgically resected cases, there was a nonsignificant trend of negative correlation between SUVmax and CCR (R = 0.57, P = 0.06). There was a significant positive correlation between GLUT score and CT attenuation value (R = 0.68, P = 0.02), and a significant negative correlation between GLUT score and CCR (R = 0.60, P = 0.003). Conclusions Adrenal adenomas composed of many compact cells or having high attenuation on unenhanced CT showed high FDG uptake. FDG uptake of adrenal adenomas may depend on the constituent cells..
37. Yoshihiro Matsumoto, Akira Matsunobu, Kenichi Kawaguchi, Mistumasa Hayashida, Keiichiro Iida, Hirokazu Saiwai, Seiji Okada, Makoto Endo, Nokitaka Setsu, Toshifumi Fujiwara, Shingo Baba, Satoshi Nomoto, Yasuharu Nakashima, Clinical results of carbon-ion radiotherapy with separation surgery for primary spine/paraspinal sarcomas, International Journal of Clinical Oncology, 10.1007/s10147-019-01505-y, 24, 11, 1490-1497, 2019.11, Purpose: To evaluate the clinical outcome of combination of carbon-ion radiotherapy with separation surgery (CIRT-SS) in patients with primary spinal/paraspinal sarcoma (PSPS) and epidural spinal cord compression (ESCC). Methods: CIRT-SS was performed in 11 consecutive patients. Patients treated in the primary and salvage settings were categorized into Group A (n = 8) and Group B (n = 3), respectively. Clinical results and imaging findings were collected, with a particular focus on ESCC grade, treatment-associated adverse events (AEs), and the locoregional control (LRC) rate and overall survival (OS). Results: The median follow-up period from the start of CIRT-SS was 25 months (7–57 months). ESCC was improved by SS in all cases. No patients exhibited radiation-induced myelopathy (RIM), but three developed Grade 3 vertebral compression fracture (VCF) during follow-up. Locoregional recurrences were observed in four patients [Group A: 1 (12.5%), Group B: 3 (100%)]. Over the entire follow-up period, three patients developed distant metastases and two patients died. The 2-year LRC rate and OS were 70% and 80%, respectively. Conclusion: CIRT-SS in the primary setting achieved acceptable LRC and OS without RIM in patients with PSPS and with ESCC. VCF was the most frequent AE associated with CIRT-SS..
38. Shinji Amakusa, Koki Matsuoka, Shingo Baba, Tsuyoshi Yoshida, Masayuki Sasaki, Differences in edge artifacts between 68Ga- And 18F-PET images reconstructed using point spread function correction, Nuclear medicine communications, 10.1097/MNM.0000000000001079, 40, 11, 1166-1173, 2019.11, Objective Edge artifacts have been reported on in relation to 18F-PET using point spread function correction algorithms. The positron range of 68Ga is longer than 18F, and this difference is thought to result in different edge artifacts. The purpose of this study is to clarify the difference in edge artifacts in PET images using point spread function correction in 68Ga- and 18F-PET. Methods We used a National Electrical Manufacturers Association International Electrotechnical Commission body phantom. The phantom was filled severally with 68Ga and 18F solution. The PET data were obtained over a 90 minutes period using a True Point Biograph 16 scanner. The images were then reconstructed with the ordered subset expectation maximization with point spread function correction. The phantom image analyses were performed by a visual assessment of the PET images and profiles, and an absolute recovery coefficient, which was the ratio of the maximum radioactivity of any given hot sphere to its true radioactivity. Results The ring-like edge artifacts of 68Ga-PET were less prominent than those in 18F-PET. The relative radioactivity profiles of 68Ga-PET showed low overshoots of the maximum radioactivity although high overshoots did appear in 18F-PET. The absolute recovery coefficients of 68Ga-PET were smaller than those of 18F-PET. Conclusion The edge artifacts of 68Ga-PET were less prominent than those of 18F-PET, and their overshoots were smaller. The difference in the positron range between 68Ga and 18F may possibly result in the difference in edge artifacts of images reconstructed using the point spread function correction algorithm..
39. Yoshihiro Nishiyama, Seigo Kinuya, Takashi Kato, Daiki Kayano, Shuhei Sato, Manabu Tashiro, Mitsuaki Tatsumi, Teisuke Hashimoto, Shingo Baba, Kenji Hirata, Mana Yoshimura, Hiroto Yoneyama, Nuclear medicine practice in Japan
a report of the eighth nationwide survey in 2017, Annals of Nuclear Medicine, 10.1007/s12149-019-01382-5, 33, 10, 725-732, 2019.10, Objective: Subcommittee on Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every 5 years since 1982 to survey contemporary nuclear medicine practice and its changes over the years. Methods: The subcommittee sent questionnaires, including the number and category of examinations as well as the kind and dose of the radiopharmaceuticals during the 30 days of June 2017, to all nuclear medicine institutes. The total numbers for the year 2017 were then estimated. Results: A total of 1132 institutes responded to the survey, including 351 PET centers. The recovery rate was 90.6%. The number of gamma cameras installed was 1332 in total, with 7.0% decrease in 5 years. Dual-head cameras and hybrid SPECT/CT scanners accounted for 88.2 and 23.6%, respectively. The number of single-photon tracer studies in 2017 was 1.08 million which means a decrease in 5.7% in 5 years and 23.6% in 10 years. All but neurotransmitter system, sentinel lymph node, and liver scintigraphy decreased. Bone scintigraphy was a leading examination (32.3%), followed by myocardial scintigraphy (24.1%) and cerebral perfusion study (18.0%) in order. SPECT studies showed an increase from 47.2% to 63.5%. PET centers have also increased from 295 to 389, as compared to the last survey. The 112 PET centers have installed one or two in-house cyclotrons. PET studies showed 24.5% increase in 5 years, with oncology accounting for 88.9%. 18F-FDG accounted for 98.2% (630,570 examinations). PET examinations using 11C-methionine have decreased, with 2440 examinations in 2017. PET examinations using 13N-NH3 have been increasing, with 2363 examinations in 2017. The number of PET studies using 11C-PIB was 904. 131I-radioiodine targeted therapies showed an increase in 5 years (23.1%), including 4487 patients for thyroid cancer. Out-patient thyroid bed ablation therapy with 1,110 MBq of 131I accounted for 36.6% of cancer patients. The number of admission rooms increased from 135 to 157 in 5 years. The number of 223Ra targeted therapies for castration-resistant metastatic prostate cancer was 1194 patients. Conclusions: Single-photon examinations showed a continuous tendency toward a decline in the survey. In contrast, the number of hybrid SPECT/CT scanner examinations has increased. PET/CT study and radionuclide targeted therapy have steadily increased..
40. Akira Maebatake, Keishin Morita, Go Akamatsu, Yuji Tsutsui, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, The influence of minimal misalignment on the repeatability of PET images examined by the repositioning of point sources, Journal of nuclear medicine technology, 10.2967/jnmt.118.208835, 47, 1, 55-59, 2019.03, We aimed to evaluate the influence of minimal misalignment of a hot spot on the repeatability of PET images using repositioning of point sources. Methods: Point sources with an inner diameter of 1 mm were made with 1 μL of 18 F solution. Seven point sources were placed on the x-axis in the field of view. For fixed-position imaging, PET data were acquired for 10 min 5 times serially. For variable-position imaging, PET data were acquired for 10 min each with the point sources placed at 0, ±0.5, and ±1.0 mm in the x-axis direction. The data were reconstructed using ordered-subsets expectation maximization (OSEM) and OSEM plus point-spread function (PSF). The image matrix was 128 x 128, 200 x 200, 256 x 256, 400 x 400, and 512 x 512 pixels. The normalized maximum count (rMax), the coefficient of variance (CV max ), and the full width at half maximum were analyzed. Results: The hot spots on OSEM images far from the center became faint and broad, whereas those on OSEM1PSF images became small and dense. Although rMax was overestimated at the 5-cm position on OSEM images, rMax at other positions was overestimated on OSEM+PSF images with a matrix of at least 256 x 256. rMax showed a similar pattern in fixed- and variable-position images. CV max in fixed-position OSEM images was less than 2%, irrespective of matrix size. In contrast, CV max in variable-position images was higher than in fixed-position images. CV max was higher for OSEM+PSF images than for OSEM images. The full width at half maximum increased at positions far from the center on OSEM images but was stable at all positions on OSEM+PSF images. Conclusion: The repeatability of the small hot spot was affected by the minimal misalignment, especially on OSEM+PSF images. Precise positioning is necessary if PET is to be used as a biomarker. Professionals should recognize that PSF correction worsens the repeatability of the small hot spot although improving the spatial resolution of PET images..
41. Sakiko Shimizu Handa, Shingo Baba, kenichiro yamashita, Mari Nishizaka, Shinichi Ando, The severity of obstructive sleep apnea syndrome cannot predict the accumulation of brain amyloid by imaging with [11C]-Pittsburgh compound B PET computed tomography in patients with a normal cognitive function, Annals of Nuclear Medicine, 10.1007/s12149-019-01349-6, 2019.01, Objective: Disturbed sleep due to obstructive sleep apnea syndrome (OSAS) might accelerate amyloidβ (Aβ) deposition, which can be a crucial factor in Alzheimer’s disease. We studied Aβ deposition in untreated OSAS patients with normal cognition. Method: We performed polysomnography (PSG) and Aβ imaging with [
11
C]-Pittsburgh compound B PET computed tomography (
11
C-PiB PET CT) in 14 untreated OSAS patients (apnea–hypopnea index: 43.8 ± 26.3/h). Results: The abnormal accumulation of enhanced
11
C-PiB PET was observed only one patient with severe, but not the most severe. Conclusions: The OSAS severity alone may not predict Aβ deposition in OSAS patients with normal cognition..
42. Akihiko Takahashi, Shingo Baba, Masayuki Sasaki, Assessment of collimators in radium-223 imaging with channelized Hotelling observer
a simulation study, Annals of Nuclear Medicine, 10.1007/s12149-018-1286-4, 32, 10, 649-657, 2018.12, Objective: Radium-223 (
223
Ra) is used in unsealed radionuclide therapy for metastatic bone tumors. The aim of this study is to apply a computational model observer to
223
Ra planar images, and to assess the performance of collimators in
223
Ra imaging. Methods: The
223
Ra planar images were created via an in-house Monte Carlo simulation code using HEXAGON and NAI modules. The phantom was a National Electrical Manufacturers Association body phantom with a hot sphere. The concentration of the background was 55 Bq/mL, and the sphere was approximately 1.5–20 times that of the background concentration. The acquisition time was 10 min. The photopeaks (and the energy window) were 84 (full width of energy window: 20%), 154 (15%), and 270 keV (10%). Each 40 images, with and without hot concentration, were applied to a three-channel difference-of-Gaussian channelized Hotelling observer (CHO), and the signal-to-noise ratio (SNR) of the hot region was calculated. The images were examined using five different collimators: two low-energy general-purpose (LEGP), two medium-energy general-purpose (MEGP), and one high-energy general-purpose (HEGP) collimators. Results: The SNR value was linearly proportional to the contrast of the hot region for all collimators and energy windows. The images of the 84-keV energy window with the MEGP collimator that have thicker septa and larger holes produced the highest SNR value. The SNR values of two LEGP collimators were approximately half of the MEGP collimators. The HEGP collimator was halfway between the MEGP and LEGP. Similar characteristics were observed for other energy windows (154, 270 keV). The SNR value of images captured via the 270-keV energy window was larger than 154-keV, although the sensitivity of the 270-keV energy window is lower than 154-keV. The results suggested a positive correlation between the SNR value and the fraction of unscattered photons. Conclusions: The SNR value of CHO reflected the performance of collimators and was available to assess and quantitatively evaluate the collimator performance in
223
Ra imaging. The SNR value depends on the magnitudes of unscattered photon count and the fraction of unscattered photon count. Consequently, in this study, MEGP collimators performed better than LEGP and HEGP collimators for
223
Ra imaging..
43. Hideaki Yahata, Hiroaki Kobayashi, Kenzo Sonoda, Keisuke Kodama, hiroshi yagi, Masafumi Yasunaga, Tatsuhiro Ogami, Ichiro Onoyama, Kaneki Eisuke, Okugawa Kaoru, Shingo Baba, Takuro Isoda, Yoshihiro Ohishi, Yoshinao Oda, Kiyoko Kato, Prognostic outcome and complications of sentinel lymph node navigation surgery for early-stage cervical cancer, International Journal of Clinical Oncology, 10.1007/s10147-018-1327-y, 23, 6, 1167-1172, 2018.12, Background: To evaluate the prognostic outcome and surgical complications in patients with early-stage cervical cancer who underwent sentinel node navigation surgery (SNNS) for hysterectomy or trachelectomy. Methods: A total of 139 patients who underwent SNNS using 99mTc phytate between 2009 and 2015 were evaluated. No further lymph node dissection was performed when intraoperative analysis of the sentinel lymph nodes (SLNs) was negative for metastasis. We compared the surgical complications between the SNNS group and 67 matched patients who underwent pelvic lymph node dissection (PLND) after SLN mapping between 2003 and 2008. We also examined the clinical outcomes in the SNNS group. Results: The mean number of detected SLNs was 2.5 per patient. Fourteen of the 139 patients in the SNNS group underwent PLND based on the intraoperative SLN results. The amount of blood loss, the operative time, and the number of perioperative complications were significantly less in the SNNS group than in the matched PLND group. There was no recurrence during a follow-up period ranging from 2 to 88 months (median 40 months) in the SNNS group. Conclusions: Using SNNS for early-stage cervical cancer is safe and effective and does not increase the recurrence rate. A future multicenter trial is warranted..
44. Naoki Hashimoto, Keishin Morita, Yuji Tsutsui, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, Time-of-flight information improved the detectability of subcentimeter spheres using a clinical PET/CT scanner, Journal of nuclear medicine technology, 10.2967/jnmt.117.204735, 46, 3, 268-273, 2018.09, Recent advancements in clinical PET/CT scanners have improved the detectability of small lesions. However, the ideal reconstruction parameters for detecting small lesions have not yet been sufficiently clarified. The purpose of this study was to investigate the detectability of subcentimeter spheres using a clinical PET/CT scanner. Methods: We used a clinical PET/CT scanner to obtain the data of a National Electrical Manufacturers Association body phantom consisting of 6 small spheres (inner diameters, 4.0, 5.0, 6.2, 7.9, 10, and 37 mm) containing 18F solution. The background activity was 2.65 kBq/mL, and the sphere-to-background ratio was 8. The PET data obtained for 2 and 120 min were reconstructed using ordered-subsets expectation maximization (OSEM), OSEM 1 point-spread function (PSF), and OSEM 1 time-of-flight (TOF) with voxel sizes of 2.04 × 2.04 × 2.00 mm (2-mm voxels) and 4.07 × 4.07 × 3.99 mm (4-mm voxels). A gaussian filter was not used. The image quality was evaluated by visual assessment, as well as by physical assessment of the detectability index and recovery coefficients. Results: According to the visual assessment, the detectability of the spheres improved using TOF and a longer acquisition. Using the OSEM1TOF model, the smallest visually detected spheres were 5 mm in diameter with a 120-min acquisition and 6 mm in diameter with a 2-min acquisition. According to physical assessment, the detectability of spheres 10 mm or smaller using the OSEM1TOF image was superior to that using the OSEM image. In addition, the detectability of each hot sphere and recovery coefficient with 2-mm voxels was superior to that with 4-mm voxels. Although OSEM1PSF images showed less background noise, detectability and the recovery coefficient were not improved for spheres 8 mm or smaller. Conclusion: The TOF model with 2-mm voxels improved the detectability of subcentimeter hot spheres on a clinical PET/CT scanner..
45. Naoki Hashimoto, Keishin Morita, Yuji Tsutsui, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, Time-of-flight information improved the detectability of sub-centimeter sphere using clinical positron emission tomography/computed tomography scanner, Journal of Nuclear Medicine Technology, 10.2967/jnmt.117.204735, 2018.03, Recent advancements in clinical PET/CT scanners have improved the detectability of small lesions. However, the ideal reconstruction parameters for detecting small lesions have not yet been sufficiently clarified. The purpose of this study was to investigate the detectability of the sub-centimeter spheres using a clinical PET/CT scanner. Methods: We used a Biograph mCT scanner to obtain the data of a NEMA body phantom consisting of 6 small spheres ( inner diameters: 4.0, 5.0, 6.2, 7.9, 10 and 37 mm ) containing 18F solution. The background activity was 2.65 kBq/mL and the sphere-to-background ratio was 8. The PET data obtained for 2 and 120 minutes were reconstructed using on ordered subsets expectation maximization (OSEM) algorithm, OSEM + point-spread-function (PSF) model and OSEM + time-of-flight (TOF) model with the voxel sizes of 2.04 × 2.04 × 2.00 mm (2-mm voxel reconstruction) and 4.07 × 4.07 × 3.99 mm (4-mm voxel reconstruction). A Gaussian filter was not used. The image quality was evaluated by a visual assessment, as well as by a physical assessment of the detectability index and recovery coefficients. Results: According to the visual assessment, the detectability of the spheres improved using TOF and a longer acquisition time. Using the OSEM+TOF model, the smallest visually detected spheres were 5 mm in diameter with 120-minute acquisition, and 6 mm in diameter with 2-minutes acquisition, respectively. According to physical assessment, the detectability of 10-mm or smaller spheres in diameter using the OSEM+TOF image was superior to those on the OSEM image. In addition, the detectability of each hot sphere (DI) and recovery coefficient (RC) with 2-mm voxel reconstruction were superior to those with 4-mm voxel reconstruction. Although OSEM+PSF image showed improvement of background noise, the detectability and the recovery coefficient was not improved for 8 mm or small diameter spheres. Conclusion: The TOF model with 2-mm voxel reconstruction improved the detectability of sub-centimeter hot spheres in clinical PET/CT scanner..
46. Kenzo Sonoda, Hideaki Yahata, Okugawa Kaoru, Kaneki Eisuke, Tatsuhiro Ogami, Masafumi Yasunaga, Shingo Baba, Yoshinao Oda, Hiroshi Honda, Kiyoko Kato, Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer, Oncology, 10.1159/000484049, 94, 2, 92-98, 2018.02, Background and Objectives: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. Methods: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned. Results: All patients could be evaluated for SLNs; a total of 610 SLNs were analyzed. Although the specificity of both imprint cytology and frozen-section examination was 100.0%, the sensitivity was only 58.6 and 65.5%, respectively. The diagnostic sensitivity was higher in 2-mm slices along the short axis than on bisection along the longitudinal axis. Imprint cytology correctly diagnosed 2 patients who had false-negative results on frozen section. The nature of the metastatic foci that caused an intraoperative false-negative diagnosis was either micrometastasis or isolated tumor cells. Conclusions: The accuracy of intraoperative SLN diagnosis requires improvement, especially when small metastatic foci are present..
47. Yuhki Koga, Shingo Baba, Reiji Fukano, Katsumasa Nakamura, Toshinori Soejima, Naoko Maeda, Shosuke Sunami, Junichi Ueyama, Tetsuo Mitsui, Takeshi Mori, Tomoo Osumi, Masahiro Sekimizu, Kentaro Ohki, Fumiko Tanaka, Michi Kamei, Naoto Fujita, Tetsuya Mori, Akiko M. Saito, Akiko Kada, Ryoji Kobayashi, The effect of interim FDG-PET-guided response-adapted therapy in pediatric patients with hodgkin's lymphoma (HL-14)
Protocol for a phase II study, Acta medica Okayama, 72, 4, 437-440, 2018.01, This trial enrolls patients with untreated Hodgkin's lymphoma aged<20 years at diagnosis and examines the effects of omitting radiation therapy if the FDG-positron emission tomography (PET) findings after two completed cycles of combination chemotherapy are negative. It thereby aims to determine whether patients who truly require radiation therapy can be identified by FDG-PET. If so, this modality could be used to omit radiation therapy for all other patients, decreasing the risk of serious long-term complications without affecting survival rates. The outcomes of patients for whom FDG-PET is used to assess early treatment response will also be determined..
48. Yuji Tsutsui, Shinichi Awamoto, Kazuhiko Himuro, Yoshiyuki Umezu, Shingo Baba, Masayuki Sasaki, Characteristics of Smoothing Filters to Achieve the Guideline Recommended Positron Emission Tomography Image without Harmonization, Asia Oceania journal of nuclear medicine & biology, 10.22038/aojnmb.2017.26684.1186, 6, 1, 15-23, 2018, Objectives: The aim of this study is to examine the effect of different smoothing filters on the image quality and SUVmax to achieve the guideline recommended positron emission tomography (PET) image without harmonization.
Methods: We used a Biograph mCT PET scanner. A National Electrical Manufacturers Association (NEMA) the International Electrotechnical Commission (IEC) body phantom was filled with 18F solution with a background activity of 2.65 kBq/mL and a sphere-to-background ratio of 4. PET images obtained with the Biograph mCT PET scanner were reconstructed using the ordered subsets-expectation maximization (OSEM) algorithm with time-of-flight (TOF) models (iteration, 2; subset, 21); smoothing filters including the Gaussian, Butterworth, Hamming, Hann, Parzen, and Shepp-Logan filters with various full width at half maximum (FWHM) values (1-15 mm) were applied. The image quality was physically assessed according to the percent contrast (QH,10), background variability (N10), standardized uptake value (SUV), and recovery coefficient (RC). The results were compared with the guideline recommended range proposed by the Japanese Society of Nuclear Medicine and the Japanese Society of Nuclear Medicine Technology. The PET digital phantom was developed from the digital reference object (DRO) of the NEMA IEC body phantom smoothed using a Gaussian filter with a 10-mm FWHM and defined as the reference image. The difference in the SUV between the PET image and the reference image was evaluated according to the root mean squared error (RMSE).
Results: The FWHMs of the Gaussian, Butterworth, Hamming, Hann, Parzen, and Shepp-Logan filters that satisfied the image quality of the FDG-PET/CT standardization guideline criteria were 8-12 mm, 9-11 mm, 9-13 mm, 10-13 mm, 9-11 mm, and 12-15 mm, respectively. The FWHMs of the Gaussian, Butterworth, Hamming, Hann, Parzen, and Shepp-Logan filters that provided the smallest RMSE between the PET images and the 3D digital phantom were 7 mm, 8 mm, 8 mm, 8 mm, 7 mm, and 11 mm, respectively.
Conclusion: The suitable FWHM for image quality or SUVmax depends on the type of smoothing filter that is applied..
49. Akihiko Takahashi, Kazuhiko Himuro, Shingo Baba, Yasuo Yamashita, Masayuki Sasaki, Comparison of TOF-PET and Bremsstrahlung SPECT Images of Yttrium-90
A Monte Carlo Simulation Study, Asia Oceania journal of nuclear medicine & biology, 10.22038/aojnmb.2017.9673, 6, 1, 24-31, 2018, Objectives: Yttrium-90 (90Y) is a beta particle nuclide used in targeted radionuclide therapy which is available to both single-photon emission computed tomography (SPECT) and time-of-flight (TOF) positron emission tomography (PET) imaging. The purpose of this study was to assess the image quality of PET and Bremsstrahlung SPECT by simulating PET and SPECT images of 90Y using Monte Carlo simulation codes under the same conditions and to compare them.
Methods: In-house Monte Carlo codes, MCEP-PET and MCEP-SPECT, were employed to simulate images. The phantom was a torso-shaped phantom containing six hot spheres of various sizes. The background concentrations of 90Y were set to 50, 100, 150, and 200 kBq/mL, and the concentrations of the hot spheres were 10, 20, and 40 times of those of the background concentrations. The acquisition time was set to 30 min, and the simulated sinogram data were reconstructed using the ordered subset expectation maximization method. The contrast recovery coefficient (CRC) and contrast-to-noise ratio (CNR) were employed to evaluate the image qualities.
Results: The CRC values of SPECT images were less than 40%, while those of PET images were more than 40% when the hot sphere was larger than 20 mm in diameter. The CNR values of PET images of hot spheres of diameter smaller than 20 mm were larger than those of SPECT images. The CNR values mostly exceeded 4, which is a criterion to evaluate the discernibility of hot areas. In the case of SPECT, hot spheres of diameter smaller than 20 mm were not discernable. On the contrary, the CNR values of PET images decreased to the level of SPECT, in the case of low concentration.
Conclusion: In almost all the cases examined in this investigation, the quantitative indexes of TOF-PET 90Y images were better than those of Bremsstrahlung SPECT images. However, the superiority of PET image became critical in the case of low activity concentrations..
50. TAKURO ISODA, Shingo Baba, Yasuhiro Maruoka, Kitamura Yoshiyuki, Keiichiro Tahara, Masayuki Sasaki, Hiroshi Honda, Influence of the Different Primary Cancers and Different Types of Bone Metastasis on the Lesion-based Artificial Neural Network Value Calculated by a Computer-aided Diagnostic System,BONENAVI, on Bone Scintigraphy Images, Asia Ocean J Nucl Med Biol., 8, 1, 49-55, 2017.12.
51. Kitamura Yoshiyuki, Shingo Baba, TAKURO ISODA, Yasuhiro Maruoka, Satoshi Kawanami, Kazuhiko Himuro, Masayuki Sasaki, Hiroshi Honda, The Efficiency of Respiratory-gated 18F-FDG PET/CT in Lung
Adenocarcinoma: Amplitude-gating Versus Phase-gating Methods
, Asia Ocean J Nucl Med Biol., 5, 1, 30-36, 2017.12.
52. Kazufumi Kikuchi, Hiwatashi Akio, Osamu Togao, Koji Yamashita, Ryo Somehara, Ryotaro Kamei, Shingo Baba, hiroo yamaguchi, Jun-Ichi Kira, Hiroshi Honda, Structural changes in Parkinson’s disease
voxel-based morphometry and diffusion tensor imaging analyses based on 123I-MIBG uptake, European Radiology, 10.1007/s00330-017-4941-6, 27, 12, 5073-5079, 2017.12, Objective: Patients with Parkinson’s disease (PD) may exhibit symptoms of sympathetic dysfunction that can be measured using 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. We investigated the relationship between microstructural brain changes and 123I-MIBG uptake in patients with PD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) analyses. Methods: This retrospective study included 24 patients with PD who underwent 3 T magnetic resonance imaging and 123I-MIBG scintigraphy. They were divided into two groups: 12 MIBG-positive and 12 MIBG-negative cases (10 men and 14 women; age range: 60–81 years, corrected for gender and age). The heart/mediastinum count (H/M) ratio was calculated on anterior planar 123I-MIBG images obtained 4 h post-injection. VBM and DTI were performed to detect structural differences between these two groups. Results: Patients with low H/M ratio had significantly reduced brain volume at the right inferior frontal gyrus (uncorrected p < 0.0001, K > 90). Patients with low H/M ratios also exhibited significantly lower fractional anisotropy than those with high H/M ratios (p < 0.05) at the left anterior thalamic radiation, the left inferior fronto-occipital fasciculus, the left superior longitudinal fasciculus, and the left uncinate fasciculus. Conclusions: VBM and DTI may reveal microstructural changes related to the degree of 123I-MIBG uptake in patients with PD. Key Points: • Advanced MRI methods may detect brain damage more precisely. • Voxel-based morphometry can detect grey matter changes in Parkinson’s disease. • Diffusion tensor imaging can detect white matter changes in Parkinson’s disease..
53. Kazuki Takada, Gouji Toyokawa, Tatsuro Okamoto, Shingo Baba, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Takaki Akamine, Shinkichi Takamori, Masakazu Katsura, Fumihiro Shoji, Hiroshi Honda, Yoshinao Oda, Yoshihiko Maehara, Metabolic characteristics of programmed cell death-ligand 1-expressing lung cancer on 18F-fluorodeoxyglucose positron emission tomography/computed tomography, Cancer Medicine, 10.1002/cam4.1215, 6, 11, 2552-2561, 2017.11, Programmed cell death-1 (PD-1) and programmed cell death-ligand 1 (PD-L1) have been identified as novel targets of immunotherapy of lung cancer. In present study, we evaluated the metabolic characteristics of lung cancer by using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) with regard to PD-L1 protein expression. PD-L1 protein expression was evaluated by immunohistochemistry with the antibody clone SP142 in 579 surgically resected primary lung cancer patients. Cases with less than 5% tumor membrane staining were considered negative. We examined the association between the frequency of PD-L1 protein expression and the maximum standardized uptake value (SUVmax) in preoperative 18F-FDG PET/CT. The cut-off values for SUVmax were determined by receiver operating characteristic curve analyses. The SUVmax was significantly higher in nonsmall cell lung cancer (NSCLC) patients with PD-L1 protein expression compared with those without PD-L1 protein expression (P < 0.0001). However, there was no correlation between SUVmax and PD-L1 protein expression in patients with neuroendocrine tumors (P = 0.6545). Multivariate analysis revealed that smoking, the presence of pleural invasion, and high SUVmax were independent predictors of PD-L1 positivity. PD-L1-expressing NSCLC had a high glucose metabolism. The SUVmax in preoperative 18F-FDG PET/CT was a predictor of PD-L1 protein expression in patients with NSCLC..
54. Yasuhiro Maruoka, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Koichiro Abe, Masayuki Sasaki, Horoshi Honda, A functional scoring system based on salivary gland scintigraphy for evaluating salivary gland dysfunction secondary to 131I therapy in patients with differentiated thyroid carcinoma, Journal of Clinical and Diagnostic Research, 10.7860/JCDR/2017/27340.10431, 11, 8, TC23-TC28, 2017.08, Introduction: Radioiodine therapy with 131I (131I therapy) after total or near-total thyroidectomy has been established as an effective treatment for Differentiated Thyroid Carcinoma (DTC), but can induce dry mouth symptoms by salivary gland damage and impair the patients’ quality of life. Aim: To propose a functional scoring system based on Salivary Gland Scintigraphy (SGS) findings that evaluates development of salivary gland dysfunction secondary to 131I therapy in patients with DTC. Materials and Methods: This retrospective study evaluated the records of 279 DTC patients who underwent SGS after one or more round(s) of 131I therapy, using 370 MBqof 99mTc-pertechnetate. The SGS results were assessed using a novel functional scoring system in the Parotid Glands (PGs) and Submandibular Glands (SMGs) according to visual evaluations based on a three-point uptake score, Washout Rate (%WR) score after lemon-juice stimulation, and functional score. The scores were compared among pretreatment, low-dose (<10 GBq), and high-dose (>10 GBq) groups and among pretreatment, symptom-positive, and symptom-negative groups. Risk factors for dry mouth were analyzed by univariate and multivariate logistic regression analyses. Results: Dry mouth symptoms developed in 15.4% of the DTC patients after 131I therapy. The three-point uptake, %WR, and functional scores in both the PG and SMG were statistically significant between low-dose and high-dose groups, and between symptom-positive and symptom-negative groups. The PG/SMG functional scores were independent risk factors for dry mouth (odds ratio, 0.03 and 0.0007 respectively). Conclusion: SGS-based PG and SMG functional scores were effective biomarkers to objectively evaluate salivary gland dysfunction, with the high strength of association with dry mouth symptoms..
55. Yukihide Minoda, Kazumasa Yamamura, Kazutaka Sugimoto, Shigekazu Mizokawa, Shingo Baba, Hiroaki Nakamura, Detection of bone defects around zirconium component after total knee arthroplasty, Knee, 10.1016/j.knee.2017.04.020, 24, 4, 844-850, 2017.08, BACKGROUND: It is difficult to detect bone defects caused by loosening or osteolysis around the femoral component after total knee arthroplasty (TKA) because the thick metal hinders visualization of bone defects. Previous reports have shown that tomosynthesis, a novel tomographic technique, is advantageous over fluoroscopically guided plain radiography, computed tomography (CT) and magnetic resonance imaging (MRI) for the early detection of bone defects around a conventional cobalt-chromium alloy component. However, there have been no reports on a zirconium component. The purpose of this study was to examine the sensitivity and specificity of the detection of bone defects around a zirconium component using fluoroscopically guided plain radiography, tomosynthesis, CT and MRI.
METHODS: Six zirconium femoral components were implanted in pig knees. Two were cemented without any bone defects. Two were cemented with cystic defects. Two were cemented with four-millimeter-thick defects between the bone cement and the bone. Defects were filled with agarose gel. Eight orthopedic surgeons examined the fluoroscopically guided plain radiography, tomosynthesis, CT and MRI images. Sensitivity and specificity of each method were analyzed.
RESULTS: No bone defects were detected with plain radiography. The sensitivity and specificity of tomosynthesis were 21.9% and 36.8%, respectively. The sensitivity and specificity of CT were 15.1% and 33.0%, respectively. The sensitivity and specificity of MRI were 84.4% and 86.6%, respectively.
CONCLUSIONS: For the detection of bone defects around a zirconium component after TKA, MRI is advantageous over fluoroscopically guided plain radiography, tomography and CT, in terms of sensitivity and specificity..
56. Yasuhiro Maruoka, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Koichiro Abe, Masayuki Sasaki, Hiroshi Honda, Association between volumetric analysis of lung metastases on F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography and short-term progression after i-131 therapy for differentiated thyroid carcinoma, Indian Journal of Nuclear Medicine, 10.4103/ijnm.IJNM_43_17, 32, 3, 167-172, 2017.07, Purpose: Lung metastases (LMs) and their radioiodine uptake affect prognosis in patients with differentiated thyroid carcinoma (DTC). We herein investigate the value of metabolic tumor volume (MTV) in LMs on positron emission tomography/computed tomography (PET/CT) using 2-[F-18]-fluoro-2-deoxy-D-glucose (F-18 FDG PET/CT) in predicting short-term progression after initial I-131 therapy in DTC patients. Materials and Methods: We retrospectively evaluated 111 DTC patients with LMs. Diagnostic CT and I-131 scintigraphy were performed within 1 week of I-131 therapy. Maximum standardized uptake value (SUVmax) and total MTV (MTVtotal) were compared between patients with I-131-positive and I-131-negative LMs and between patients with and without short-term progression. Correlation analyses were performed between F-18 FDG PET/CT parameters and thyroglobulin (TG) level, and predictive factors for short-term progression were analyzed by logistic regression and receiver operating characteristic curve analysis.Results: Patients with short-term progression had significantly higher SUVmax and MTVtotal than those without. TG levels were significantly correlated with SUVmax (r = 0.21) and MTVtotal (r = 0.51) after I-131 therapy. MTVtotal showed significant association (χ2 = 16.5, odds ratio = 0.02) with short-term progression after initial I-131 therapy and had the highest predictive value of all the putative risk factors. Conclusions: MTVtotal in LMs on F-18 FDG PET/CT is an independent predictive factor with a high predictive value for short-term progression of DTC after initial I-131 therapy. It is recommended that F-18 FDG PET/CT be performed before planning therapy during the evaluation of DTC patients with LM..
57. Toshioh Fujibuchi, Takatoshi Toyoda, Shingo Baba, Yoshiyuki Umezu, Isao Komiya, Masayuki Sasaki, Hiroshi Honda, Evaluation of the distribution of activation inside a compact medical cyclotron, Applied Radiation and Isotopes, 10.1016/j.apradiso.2017.02.045, 124, 27-31, 2017.06, The distribution of activation inside a compact medical cyclotron was evaluated by measuring 1 cm dose equivalent rates and γ-ray spectra. Analysis of the distribution of activation showed high activation at the deflector and the magnetic channel. Radionuclides 60Co, 57Co, 65Zn, and 54Mn were detected. Different radionuclides were generated from different components of the cyclotron, and low-activity radionuclides could be detected under low-background-radiation conditions..
58. Gouji Toyokawa, Kazuki Takada, Tatsuro Okamoto, Satoshi Kawanami, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Masakazu Katsura, Yuichi Yamada, Fumihiro Shoji, Shingo Baba, Takeshi Kamitani, Yoshinao Oda, Hiroshi Honda, Yoshihiko Maehara, Relevance Between Programmed Death Ligand 1 and Radiologic Invasiveness in Pathologic Stage I Lung Adenocarcinoma, Annals of Thoracic Surgery, 10.1016/j.athoracsur.2016.12.025, 103, 6, 1750-1757, 2017.06, Background Programmed death ligand 1 (PD-L1) was reported to predict the response of immunotherapy; however, the association between PD-L1 expression and radiologic and pathologic features has yet to be elucidated. Methods In all, 292 patients with resected pathologic stage I adenocarcinoma were analyzed for PD-L1 expression by immunohistochemistry and evaluated to determine the association between PD-L1 expression and the radiologic/pathologic invasiveness. Specifically, the radiologic invasiveness and noninvasiveness were determined based on the consolidation/tumor ratio, with a cutoff value of 0.25 by thin-section computed tomography. Results Among 292 patients, 47 (16.1%) were positive for PD-L1 expression; the remaining 245 patients (83.9%) were negative for PD-L1 expression. Fisher's exact test demonstrated that PD-L1 expression was significantly associated with a higher consolidation/tumor ratio (p = 0.029) and higher maximum standardized uptake value (p = 0.004). The mean values of consolidation/tumor ratio and maximum standardized uptake in patients with and without PD-L1 expression were 0.845 ± 0.052 and 7.241 ± 0.795, and 0.607 ± 0.023 and 3.60 ± 0.364, respectively (p < 0.001 and p < 0.001, respectively). Among 47 adenocarcinomas harboring PD-L1 expression, the frequencies of PD-L1 expression for consolidation/tumor ratios of 0, 0.1 to 0.25, 0.26 to 0.5, and 0.51 or more were 6.4%, 2.1%, 4.3%, and 87.2%, respectively (p = 0.007). Pathologically, PD-L1 was identified exclusively only in more invasive subtypes, not in less invasive ones, such as atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant ones (p < 0.001). Conclusions Expression of PD-L1 was significantly associated with radiologic/pathologic invasive adenocarcinomas. This study provides the first evidence of the radiologic and pathologic invasiveness in resected pathologic stage I adenocarcinoma with PD-L1 expression..
59. Yasuhiro Maruoka, Michinobu Nagao, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Yuzo Yamazaki, Koichiro Abe, Masayuki Sasaki, Kotaro Abe, Hiroshi Honda, Three-dimensional fractal analysis of 99m Tc-MAA SPECT images in chronic thromboembolic pulmonary hypertension for evaluation of response to balloon pulmonary angioplasty
Association with pulmonary arterial pressure, Nuclear Medicine Communications, 10.1097/MNM.0000000000000673, 38, 6, 480-486, 2017.05, Objective Balloon pulmonary angioplasty (BPA) is used for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but its effect cannot be evaluated noninvasively. We devised a noninvasive quantitative index of response to BPA using three-dimensional fractal analysis (3D-FA) of technetium-99m-macroaggregated albumin (99m Tc-MAA) single-photon emission computed tomography (SPECT). Patients and methods Forty CTEPH patients who underwent pulmonary perfusion scintigraphy and mean pulmonary arterial pressure (mPAP) measurement by right heart catheterization before and after BPA were studied. The total uptake volume (TUV) in bilateral lungs was determined from maximum intensity projection 99m Tc-MAA SPECT images. Fractal dimension was assessed by 3D-FA. Parameters were compared before and after BPA, and between patients with post-BPA mPAP more than 30 mmHg and less than or equal to 30 mmHg. Receiver operating characteristic analysis was carried out. Results BPA significantly improved TUV (595±204-885±214 ml, P<0.001) and reduced the laterality of uptake (238±147-135±131 ml, P<0.001). Patients with poor therapeutic response (post-BPA mPAP≥30 mmHg, n=16) showed a significantly smaller TUV increase (P=0.044) and a significantly greater post-BPA fractal dimension (P<0.001) than the low-mPAP group. Fractal dimension correlated with mPAP values before and after BPA (P=0.013 and 0.001, respectively). A post-BPA fractal dimension threshold of 2.4 distinguished between BPA success and failure with 75% sensitivity, 79% specificity, 78% accuracy, and area under the curve of 0.85. Conclusion 3D-FA using 99m Tc-MAA SPECT pulmonary perfusion scintigraphy enables a noninvasive evaluation of the response of CTEPH patients to BPA..
60. Yoshihiro Matsumoto, Shingo Baba, Makoto Endo, Nokitaka Setsu, Keiichiro Iida, Jun-Ichi Fukushi, Kenichi Kawaguchi, Seiji Okada, Hirofumi Bekki, Takuro Isoda, Yoshiyuki Kitamura, Hiroshi Honda, Yasuharu Nakashima, Metabolic Tumor Volume by (18)F-FDG PET/CT Can Predict the Clinical Outcome of Primary Malignant Spine/Spinal Tumors, BioMed Research International, 10.1155/2017/8132676, 2017, 8132676, 2017, BACKGROUND AND PURPOSE: Primary malignant spine/spinal tumors (PMSTs) are rare and life-threatening diseases. In this study, we demonstrated the advantage of volume-based (18)F-FDG PET/CT metabolic parameter, metabolic tumor volume (MTV), for assessing the aggressiveness of PMSTs.
MATERIALS AND METHODS: We retrospectively reviewed 27 patients with PMSTs and calculated SUVmax, MTV, and total lesion glycolysis (TLG) to compare their accuracy in predicting progression-free survival (PFS) and overall survival (OS) by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were used to compare the reliability of the metabolic parameters and various clinical factors.
RESULTS: MTV exhibited greater accuracy than SUVmax or TLG. The cut-off values for PFS and OS derived from the AUC data were MTV 45 ml and 83 ml and TLG 250 SUV⁎ml and 257 SUV⁎ml, respectively. MTV above cut-off value, but not TLG, was identified as significant prognostic factor for PFS by log-lank test (p = 0.04). In addition, MTV was the only significant predictive factors for PFS and OS in the multivariate analysis.
CONCLUSIONS: MTV was a more accurate predictor of PFS and OS in PMSTs compared to TLG or SUVmax and helped decision-making for guiding rational treatment options..
61. Yuji Tsutsui, Shinichi Awamoto, Kazuhiko Himuro, Yoshiyuki Umezu, Shingo Baba, Masayuki Sasaki, Edge Artifacts in Point Spread Function-based PET Reconstruction in Relation to Object Size and Reconstruction Parameters, Asia Oceania journal of nuclear medicine & biology, 10.22038/aojnmb.2017.8802, 5, 2, 134-143, 2017, OBJECTIVES: We evaluated edge artifacts in relation to phantom diameter and reconstruction parameters in point spread function (PSF)-based positron emission tomography (PET) image reconstruction.
METHODS: PET data were acquired from an original cone-shaped phantom filled with 18F solution (21.9 kBq/mL) for 10 min using a Biograph mCT scanner. The images were reconstructed using the baseline ordered subsets expectation maximization (OSEM) algorithm and the OSEM with PSF correction model. The reconstruction parameters included a pixel size of 1.0, 2.0, or 3.0 mm, 1-12 iterations, 24 subsets, and a full width at half maximum (FWHM) of the post-filter Gaussian filter of 1.0, 2.0, or 3.0 mm. We compared both the maximum recovery coefficient (RCmax) and the mean recovery coefficient (RCmean) in the phantom at different diameters.
RESULTS: The OSEM images had no edge artifacts, but the OSEM with PSF images had a dense edge delineating the hot phantom at diameters 10 mm or more and a dense spot at the center at diameters of 8 mm or less. The dense edge was clearly observed on images with a small pixel size, a Gaussian filter with a small FWHM, and a high number of iterations. At a phantom diameter of 6-7 mm, the RCmax for the OSEM and OSEM with PSF images was 60% and 140%, respectively (pixel size: 1.0 mm; FWHM of the Gaussian filter: 2.0 mm; iterations: 2). The RCmean of the OSEM with PSF images did not exceed 100%.
CONCLUSION: PSF-based image reconstruction resulted in edge artifacts, the degree of which depends on the pixel size, number of iterations, FWHM of the Gaussian filter, and object size..
62. Hiroaki Shiba, Akihiko Takahashi, Shingo Baba, Kazuhiko Himuro, Yasuo Yamashita, Masayuki Sasaki, Analysis of the influence of 111In on 90Y-bremsstrahlung SPECT based on Monte Carlo simulation, Annals of Nuclear Medicine, 10.1007/s12149-016-1112-9, 30, 10, 675-681, 2016.12, Objective: 90Y-ibritumomab tiuxetan (Zevalin) which is used for the treatment of malignant lymphomas can be used for SPECT imaging based on bremsstrahlung from 90Y beta particles. However, gamma rays emitted by 111In, which is administered to evaluate the indication for the treatment, contaminate the 90Y bremsstrahlung images. Our objective is to investigate the influence of 111In on the 90Y SPECT images using Monte Carlo simulation. Methods: We used an in-house developed simulation code for the Monte Carlo simulation of electrons and photons (MCEP). Two hot spheres with diameters of 40 mm were put in an elliptical phantom. Both spheres (“sphere 1” and “sphere 2”) were filled with 90Y and 111In mixed solutions. The activities of 90Y in sphere 1 and sphere 2 were 241 and 394 kBq/mL, respectively, and the ones of 111In were 8.14 and 13.3 kBq/mL, respectively. The background activity of 90Y was 38.6 kBq/mL, whereas that of 111In was 1.30 kBq/mL; moreover, the acquisition time was 30 min. Two energy windows were used: one is 90–190 keV included the 111In photopeak; the other is 90–160 keV. To evaluate the quality of the SPECT images, the contrast recovery coefficient (CRC) and the constant noise ratio (CNR) of the SPECT images were derived. Results: For the energy window between 90 and 160 keV, the 111In count was 74 % of the total. In that case, the CRC values were 30.1 and 30.7 % for “sphere 1” and “sphere 2”, respectively, whereas the CNR values were 6.8 and 12.1, respectively. For the energy window between 90 and 190 keV, the 111In count reached 85 % of the total count. The CRC and CNR values were 38.6 and 40.0 % and 10.6 and 19.4, respectively. Conclusions: Our simulation study revealed that the cross talk between 111In and 90Y in SPECT imaging is rather serious. Even for the energy window excluding the 111In photopeak, the count ratio of 90Y was less than 30 % of the total. However, the influence of 111In on 90Y-SPECT imaging cannot be ignored, and the count ratio because of 111In is important to estimate the density of 90Y..
63. Yamashita Koji, Hiwatashi Akio, Osamu Togao, Kazuhumi Kikuchi, Kitamura Yoshiyuki, Masahiro Mizoguchi, Koji Yoshimoto, DAISUKE KUGA, Shingo Baba, TAKURO ISODA, Koji Iihara, Toru Iwaki, Hiroshi Honda, Diagnostic utility of intravoxel incoherent motion mr imaging in differentiating primary central nervous system lymphoma from glioblastoma multiforme, J Magn Reson Imaging., 44, 5, 1256-1261, 2016.11.
64. Koji Yamashita, Hiwatashi Akio, Osamu Togao, kazufumi kikuchi, Yoshiyuki Kitamura, Masahiro Mizoguchi, Koji Yoshimoto, Daisuke Kuga, Satoshi Suzuki, Shingo Baba, Takuro Isoda, Toru Iwaki, Koji Iihara, Hiroshi Honda, Diagnostic utility of intravoxel incoherent motion mr imaging in differentiating primary central nervous system lymphoma from glioblastoma multiforme, Journal of Magnetic Resonance Imaging, 10.1002/jmri.25261, 44, 5, 1256-1261, 2016.11, Purpose: To evaluate the diagnostic performance of intravoxel incoherent motion (IVIM) MR imaging and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in differentiating primary central nervous system lymphoma (PCNSL) from glioblastoma multiforme (GBM). Materials and Methods: Fifty patients, 17 with PCNSL and 33 with GBM, were retrospectively studied. From the 3 Tesla IVIM data, the perfusion fraction (f) and diffusion coefficient (D) were obtained. In addition, the maximum standard uptake value (SUVmax) was obtained from the FDG-PET data. Each of the three parameters was compared between PCNSL and GBM using Mann-Whitney U-test. The performance in discriminating between PCNSL and GBM was evaluated using receiver-operating characteristics analysis and area-under-the-curve (AUC) values for the three parameters. Results: The fmax and Dmin values were significantly higher in GBM than in PCNSL (P < 0.01 and P < 0.0001, respectively). In addition, the SUVmax value was significantly lower in GBM than in PCNSL (P < 0.0005). The AUC values for fmax, Dmin, and SUVmax were 0.756, 0.905, and 0.857, respectively. The combination of the fmax and Dmin increased the diagnostic performance (AUC = 0.936) of fmax (P < 0.05), but this value was not significantly different from the values for Dmin (P = 0.30). Conclusion: IVIM-MR imaging noninvasively provides useful quantitative information in distinguishing between PCNSL and GBM. J. Magn. Reson. Imaging 2016;44:1256–1261..
65. TAKURO ISODA, Shingo Baba, Yasuhiro Maruoka, Kitamura Yoshiyuki, Keiichiro Tahara, Masayuki Sasaki, Hiroshi Honda, Impact of patient age on the iodine/FDG "flip-flop" phenomenon in lung metastasis from thyroid cancer., Ann Nucl Med. , 30, 8, 518-524, 2016.10.
66. Takuro Isoda, Shingo Baba, Yasuhiro Maruoka, Yoshiyuki Kitamura, Keiichiro Tahara, Masayuki Sasaki, Hiroshi Honda, Impact of patient age on the iodine/FDG “flip-flop” phenomenon in lung metastasis from thyroid cancer, Annals of Nuclear Medicine, 10.1007/s12149-016-1104-9, 30, 8, 518-524, 2016.10, Objectives: Radioiodine therapy is an effective treatment for lung metastasis from thyroid cancer. However, cases of lung metastasis without iodine uptake are often encountered. In such cases, FDG accumulation in lung lesions is often observed. There is a reverse relationship between iodine and FDG accumulation in thyroid cancer lesions, the so-called “flip-flop” phenomenon. The aim of this study was to assess the relationship between patient age and the occurrence of the flip-flop phenomenon. Methods: Eighty-six patients who underwent radioiodine therapy for lung metastasis were studied retrospectively (age 17–73 years; median 60 years; males:females 22:64). We compared the clinical data and imaging findings (size and FDG uptake of lung nodules) between patients with (n = 44) and without (n = 42) iodine uptake in lung metastasis. Results: Significantly more young patients showed iodine accumulation in lung metastasis than old patients (p = 0.0025). Lung metastases with larger size or greater FDG uptake showed no iodine uptake more frequently with significant difference (p = 0.015 and <0.001, respectively). Among patients with FDG uptake in the lung metastasis, 57.1 % of young patients (<60 years) and 24.3 % of the old patients (≥60 years) showed iodine uptake (p = 0.0029). Conclusions: Higher patient age and lung nodules with large size or FDG accumulation are negative factors for iodine accumulation in lung metastases from thyroid cancer. In addition, our results show that young patients have a greater likelihood of iodine uptake even when FDG accumulates in lung metastasis, in contrast to old patients..
67. Toshiki Takeshita, Keishin Morita, Yuji Tsutsui, Daisuke Kidera, Shohei Mikasa, Akira Maebatake, Go Akamatsu, Miwa Kenta, Shingo Baba, Masayuki Sasaki, The influence of respiratory motion on the cumulative SUV-volume histogram and fractal analyses of intratumoral heterogeneity in PET/CT imaging., Ann Nucl Med, 30, 6, 393-399, 2016.07.
68. Akira Maebatake, Ayaka Imamura, Yui Kodera, Yasuo Yamashita, Kazuhiro Himuro, Shingo Baba, Miwa Kenta, Masayuki Sasaki, Evaluation of Iterative Reconstruction Method and Attenuation Correction in Brain Dopamine Transporter SPECT Using an Anthropomorphic Striatal Phantom., Asia Ocean J Nucl Med Biol., 4, 2, 72-80, 2016.07.
69. Toshiki Takeshita, Keishin Morita, Yuji Tsutsui, Daisuke Kidera, Shohei Mikasa, Akira Maebatake, Go Akamatsu, Kenta Miwa, Shingo Baba, Masayuki Sasaki, The influence of respiratory motion on the cumulative SUV-volume histogram and fractal analyses of intratumoral heterogeneity in PET/CT imaging, Annals of Nuclear Medicine, 10.1007/s12149-016-1071-1, 30, 6, 393-399, 2016.07, Objective: The purpose of this study was to investigate the influence of respiratory motion on the evaluation of the intratumoral heterogeneity of FDG uptake using cumulative SUV-volume histogram (CSH) and fractal analyses. Methods: We used an NEMA IEC body phantom with a homogeneous hot sphere phantom (HO) and two heterogeneous hot sphere phantoms (HE1 and HE2). The background radioactivity of 18F in the NEMA phantom was 5.3 kBq/mL. The ratio of radioactivity was 4:2:1 for the HO and the outer rims of the HE1 and HE2 phantoms, the inner cores of the HE1 and HE2 phantoms, and background, respectively. Respiratory motion was simulated using a motion table with an amplitude of 2 cm. PET/CT data were acquired using Biograph mCT in motionless and moving conditions. The PET images were analyzed by both CSH and fractal analyses. The area under the CSH (AUC-CSH) and the fractal dimension (FD) was used as quantitative metrics. Results: In motionless conditions, the AUC-CSHs of the HO (0.80), HE1 (0.75) and HE2 (0.65) phantoms were different. They did not differ in moving conditions (HO, 0.63; HE1, 0.65; HE2, 0.60). The FD of the HO phantom (0.77) was smaller than the FDs of the HE1 (1.71) and HE2 (1.98) phantoms in motionless conditions; however, the FDs of the HO (1.99) and HE1 (2.19) phantoms were not different from each other and were smaller than that of the HE2 (3.73) phantom in moving conditions. Conclusion: Respiratory motion affected the results of the CSH and fractal analyses for the evaluation of the heterogeneity of the PET/CT images. The influence of respiratory motion was considered to vary depending on the object size..
70. Akihiko Takahashi, Miwa Kenta, Shingo Baba, Masayuki Sasaki, A Monte Carlo study on 223Ra imaging for unsealed radionuclide therapy, Medical Physics, 43, 6, 2965-2974, 2016.06.
71. Akihiko Takahashi, Kenta Miwa, Masayuki Sasaki, Shingo Baba, A Monte Carlo study on 223Ra imaging for unsealed radionuclide therapy, Medical Physics, 10.1118/1.4948682, 43, 6, 2965-2974, 2016.06, Purpose: Radium-223 (223Ra), an α-emitting radionuclide, is used in unsealed radionuclide therapy for metastatic bone tumors. The demand for qualitative 223Ra imaging is growing to optimize dosimetry. The authors simulated 223Ra imaging using an in-house Monte Carlo simulation code and investigated the feasibility and utility of 223Ra imaging. Methods: The Monte Carlo code comprises two modules, HEXAGON and NAI. The HEXAGON code simulates the photon and electron interactions in the tissues and collimator, and the NAI code simulates the response of the NaI detector system. A 3D numeric phantom created using computed tomography images of a chest phantom was installed in the HEXAGON code. 223Ra accumulated in a part of the spine, and three x-rays and 19 γ rays between 80 and 450 keV were selected as the emitted photons. To evaluate the quality of the 223Ra imaging, the authors also simulated technetium-99m (99mTc) imaging under the same conditions and compared the results. Results: The sensitivities of the three photopeaks were 147 counts per unit of source activity (cps MBq-1; photopeak: 84 keV, full width of energy window: 20%), 166 cps MBq-1 (154 keV, 15%), and 158 cps MBq-1 (270 keV, 10%) for a low-energy general-purpose (LEGP) collimator, and those for the medium-energy general-purpose (MEGP) collimator were 33, 13, and 8.0 cps MBq-1, respectively. In the case of 99mTc, the sensitivity was 55 cps MBq-1 (141 keV, 20%) for LEGP and 52 cps MBq-1 for MEGP. The fractions of unscattered photons of the total photons reflecting the image quality were 0.09 (84 keV), 0.03 (154 keV), and 0.02 (270 keV) for the LEGP collimator and 0.41, 0.25, and 0.50 for the MEGP collimator, respectively. Conversely, this fraction was approximately 0.65 for the simulated 99mTc imaging. The sensitivity with the LEGP collimator appeared very high. However, almost all of the counts were because of photons that penetrated or were scattered in the collimator; therefore, the proportions of unscattered photons were small. Conclusions: Their simulation study revealed that the most promising scheme for 223Ra imaging is an 84-keV window using an MEGP collimator. The sensitivity of the photopeaks above 100 keV is too low for 223Ra imaging. A comparison of the fractions of unscattered photons reveals that the sensitivity and image quality are approximately two-thirds of those for 99mTc imaging..
72. Michinobu Nagao, Yuzo Yamazaki, Kamitani Takeshi, Satoshi Kawanami, Koji Sagiyama, Torahiko Yamanouchi, Yamato Shimomiya, Tetsuya Matoba, Yasushi Mukai, Keita Odashiro, Shingo Baba, Yasuhiro Maruoka, Kitamura Yoshiyuki, Akihiro Nishie, Hiroshi Honda, Quantification of coronary flow using dynamic angiography with 320-detector row CT and motion coherence image processing: Detection of ischemia for intermediate coronary stenosis., Eur J Radiol., 85, 5, 996-1003, 2016.05.
73. Michinobu Nagao, Yuzo Yamasaki, Takeshi Kamitani, Satoshi Kawanami, Koji Sagiyama, Torahiko Yamanouchi, Yamato Shimomiya, Tetsuya Matoba, Yasushi Mukai, Keita Odashiro, Shingo Baba, Yasuhiro Maruoka, Yoshiyuki Kitamura, Akihiro Nishie, Hiroshi Honda, Quantification of coronary flow using dynamic angiography with 320-detector row CT and motion coherence image processing
Detection of ischemia for intermediate coronary stenosis, European Journal of Radiology, 10.1016/j.ejrad.2016.02.027, 85, 5, 996-1003, 2016.05, Objectives Anatomical coronary stenosis is not always indicative of functional stenosis, particularly for intermediate coronary lesions. The purpose of this study is to propose a new method for quantifying coronary flow using dynamic CT angiography for the whole heart (heart-DCT) and investigate its ability for detecting ischemia from intermediate coronary stenosis. Methods Participants comprised 36 patients with coronary artery disease who underwent heart-DCT using 320-detector CT with tube voltage of 80 kV and myocardial perfusion scintigraphy (MPS). Heart-DCT was continuously performed at mid-diastole throughout 15-25 cardiac cycles with prospective ECG-gating after bolus injection of contrast media (12-24 ml). Dynamic datasets were computed into 90-100 data sets by motion coherence image processing (MCIP). Next, time-density curves (TDCs) for coronary arteries with a diameter >3 mm were automatically calculated for all phases using MCIP. On the basis of the maximum slope method, coronary flow index (CFI) was defined as the ratio of the maximum upslope of coronary artery attenuation to the upslope of ascending aorta attenuation on the TDC, and was used to quantify coronary flow. CFIs for the proximal and distal sites of coronary arteries with mild-to-moderate stenosis were calculated. Coronary territories were categorized as non-ischemic or ischemic by MPS. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff for CFI to detect ischemia. Results Distal CFI was significantly lower for ischemia (0.26 ± 0.08) than for non-ischemia (0.50 ± 0.17, p < 0.0001). No significant difference in proximal CFI was seen between ischemia (0.55 ± 0.23) and non-ischemia (0.62 ± 0.24). ROC analysis revealed 0.39 as the optimal cutoff for distal CFI to detect ischemia, with C-statistics of 0.91, 100% sensitivity, and 75% specificity. Conclusions This novel imaging technique allows coronary flow quantification using heart-DCT. Distal CFI can detect myocardial ischemia derived from intermediate coronary stenosis..
74. Koji Sagiyama, Yuji Watanabe, Ryotaro Kamei, Shingo Baba, Hiroshi Honda, Comparison of positron emission tomography diffusion-weighted imaging (PET/DWI) registration quality in a PET/MR scanner: Zoomed DWI vs. Conventional DWI., J Magn Reson Imaging, 43, 4, 853-858, 2016.04.
75. Koji Sagiyama, Yuji Watanabe, Ryotaro Kamei, Daiki Shinyama, Shingo Baba, Hiroshi Honda, An improved MR sequence for attenuation correction in PET/MR hybrid imaging., J Magn Reson Imaging, 43, 4, 853-858, 2016.04.
76. Koji Sagiyama, Yuji Watanabe, Ryotaro Kamei, Daiki Shinyama, Shingo Baba, Hiroshi Honda, An improved MR sequence for attenuation correction in PET/MR hybrid imaging, Magnetic Resonance Imaging, 10.1016/j.mri.2015.10.037, 34, 3, 345-352, 2016.04, The aim of this study was to investigate the effects of MR parameters on tissue segmentation and determine the optimal MR sequence for attenuation correction in PET/MR hybrid imaging. Eight healthy volunteers were examined using a PET/MR hybrid scanner with six three-dimensional turbo-field-echo sequences for attenuation correction by modifying the echo time, k-space trajectory in the phase-encoding direction, and image contrast. MR images for attenuation correction were obtained from six MR sequences in each session; each volunteer underwent four sessions. Two radiologists assessed the attenuation correction maps generated from the MR images with respect to segmentation errors and ghost artifacts on a five-point scale, and the scores were decided by consensus. Segmentation accuracy and reproducibility were compared. Multiple regression analysis was performed to determine the effects of each MR parameter. The two three-dimensional turbo-field-echo sequences with an in-phase echo time and radial k-space sampling showed the highest total scores for segmentation accuracy, with a high reproducibility. In multiple regression analysis, the score with the shortest echo time (-3.44, P < 0.0001) and Cartesian sampling in the anterior/posterior phase-encoding direction (-2.72, P = 0.002) was significantly lower than that with in-phase echo time and Cartesian sampling in the right/left phase-encoding direction. Radial k-space sampling provided a significantly higher score (+. 5.08, P < 0.0001) compared with Cartesian sampling. Furthermore, radial sampling improved intrasubject variations in the segmentation score (-8.28%, P = 0.002). Image contrast had no significant effect on the total score or reproducibility. These results suggest that three-dimensional turbo-field-echo MR sequences with an in-phase echo time and radial k-space sampling provide improved MR-based attenuation correction maps..
77. Koji Sagiyama, Yuji Watanabe, Ryotaro Kamei, Shingo Baba, Hiroshi Honda, Comparison of positron emission tomography diffusion-weighted imaging (PET/DWI) registration quality in a PET/MR scanner
Zoomed DWI vs. Conventional DWI, Journal of Magnetic Resonance Imaging, 10.1002/jmri.25059, 43, 4, 853-858, 2016.04, Purpose To compare zoomed diffusion-weighted imaging (z-DWI) with reduced field of view (FOV) by spatially selective radiofrequency pulses and conventional echo planar imaging (EPI) DWI (c-DWI) with regard to registration quality using positron emission tomography / magnetic resonance (PET/MR) in patients with malignant tumors. Materials and Methods Fludeoxyglucose (18F) PET imaging, c-DWI, and z-DWI were conducted simultaneously in 21 patients with known or suspected malignancy using a PET/MR system. A fusion image showing the largest tumor area was generated for analysis. Registration accuracy between PET and DWI was assessed based on the area of maximum overlap and central point displacement of the tumor. EPI factor, echo time (TE), matching area, and displacement were compared between c-DWI and z-DWI by paired t-test. Agreement of apparent diffusion coefficient (ADC) acquired by the two sequences were also assessed with linear regression s and Bland-Altman plot analysis. Results Thirty-two lesions were detected on both PET and DWI (mean size 536.3 ± 471.8 mm2). At least one lesion was found in all subjects. In all cases, EPI factor was smaller with z-DWI than c-DWI (43.1 ± 15.6 vs. 62.0 ± 10.0, P < 0.0001), and TE was also shorter for z-DWI (53.6 ± 3.6 msec vs. 65.2 ± 3.6 msec, P < 0.0001). Registration accuracy was better with z-DWI in 30 of 32 lesions (93.8%), and both average matching area and central point displacement were significantly improved (79.8 ± 18.1% vs. 61.8 ± 22.9%, P < 0.0001 and 3.92 ± 2.69 mm vs. 7.51 ± 4.07 mm, P < 0.0001). ADC values calculated with c-DWI and z-DWI showed good agreement. Conclusion Zoomed DWI reduces image distortion and provides better registration accuracy with PET images..
78. Akira Maebatake, Go Akamatsu, Kenta Miwa, Yuji Tsutsui, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, Relationship between the image quality and noise-equivalent-count in time-of-flight positron emission tomography., Ann Nucl Med, 30, 1, 68-74, 2016.01.
79. Isao Komiya, Yoshiyuki Umezu, Toshioh Fujibuchi, Kazumasa Nakamura, Shingo Baba, Hiroshi Honda, Decontamination of the Activation Product Based on a Legal Revision of the Cyclotron Vault Room on the Non-self-shield Compact Medical Cyclotron, Nihon Hoshasen Gijutsu Gakkai zasshi, 10.6009/jjrt.2016_JSRT_72.10.989, 72, 10, 989-998, 2016.01, The non-self-shield compact medical cyclotron and the cyclotron vault room were in operation for 27 years. They have now been decommissioned. We efficiently implemented a technique to identify an activation product in the cyclotron vault room. Firstly, the distribution of radioactive concentrations in the concrete of the cyclotron vault room was estimated by calculation from the record of the cyclotron operation. Secondly, the comparison of calculated results with an actual measurement was performed using a NaI scintillation survey meter and a high-purity germanium detector. The calculated values were overestimated as compared to the values measured using the NaI scintillation survey meter and the high-purity germanium detector. However, it could limit the decontamination area. By simulating the activation range, we were able to minimize the concrete core sampling. Finally, the appropriate range of radioactivated area in the cyclotron vault room was decontaminated based on the results of the calculation. After decontamination, the radioactive concentration was below the detection limit value in all areas inside the cyclotron vault room. By these procedures, the decommissioning process of the cyclotron vault room was more efficiently performed..
80. Akira Maebatake, Go Akamatsu, Kenta Miwa, Yuji Tsutsui, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, Relationship between the image quality and noise-equivalent count in time-of-flight positron emission tomography, Annals of Nuclear Medicine, 10.1007/s12149-015-1032-0, 30, 1, 68-74, 2016.01, Objective: The aim of this study was to investigate the relationship between the NEC and TOF-PET image quality. Methods: The National Electrical Manufactures Association and International Electrical Commission (NEMA IEC) body phantom with a 10-mm diameter sphere was filled with an 18F-FDG solution with a 4:1 radioactivity ratio. The PET data were acquired in the three-dimensional list mode for 20 min. We created frame data ranging from 1 to 5 min acquisition time, which were then reconstructed using the baseline ordered-subsets expectation maximization (OSEM), the OSEM + point spread function (PSF) algorithm, OSEM + time-of-flight (TOF) algorithm and OSEM + PSF + TOF algorithm. The PET images were analyzed according to the noise-equivalent count (NEC), the coefficients of variance of the background (CVBG), the maximum count (CVmax) and the contrast (CVCONT). The results were compared with the recommended value according to the guidelines for the oncology FDG-PET/CT protocol. Results: The NEC was higher than the recommended value at 3 min or longer acquisition time. The CVBG lower than 15 % were obtained at 3 min acquisition time without TOF and at 2 min acquisition time with TOF. The CVBG of 10 % or lower were obtained at 5 min or longer acquisition time without TOF and at 4 min or longer acquisition time with TOF. Both the CVmax and CVCONT lower than 10 % were obtained at 3 min or longer acquisition time without TOF and at 1 min acquisition or longer with TOF. No particular relationships were observed between the frame number and degree of the variation in the image quality. The CVCONT significantly correlated with the NEC for the data reconstructed without TOF information, while there were no significant correlations between these useful metrics for the data reconstructed with TOF. Conclusion: This study demonstrated that the NEC is not a useful metric for the evaluation of the image quality on TOF-PET images..
81. Yabuuchi H, Yoshio Matsuo, Koichiro Abe, Shingo Baba, Sunami Shunya, Kamitani Takeshi, Masato Yonezawa, Yuzo Yamasaki, Satoshi Kawanami, Michihiro Nagao, Tatsuro Okamoto, Kohashi K, Yamamoto H, Kumagai R, Yamada Y, Hotokebuchi Y, Taguchi T, Iwa, Katsumasa Nakamura, Masayuki Sasaki, Hiroshi Honda, Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT., Clin Radiol, 70, 11, 1289-1298, 2015.11.
82. Hidetake Yabuuchi, Y. Matsuo, Kotaro Abe, Shingo Baba, S. Sunami, Takeshi Kamitani, M. Yonezawa, Yuzo Yamasaki, Satoshi Kawanami, M. Nagao, Tatsuro Okamoto, K. Nakamura, Hidetaka Yamamoto, Masayuki Sasaki, Hiroshi Honda, Anterior mediastinal solid tumours in adults
Characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT, Clinical Radiology, 10.1016/j.crad.2015.07.004, 70, 11, 1289-1298, 2015.11, Aim To find significant parameters to characterise anterior mediastinal solid tumours in adults using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI), and combined 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). Materials and methods Forty-eight histologically confirmed anterior mediastinal solid tumours in 48 patients (24 men, 24 women; age range 21-83 years, mean 50.7 years) were examined. The parameters analysed were maximal diameter, presence of capsule/septa on T2-weighted images, time-signal intensity curves (TICs), apparent diffusion coefficient (ADC), and maximum standardised uptake value (SUVmax). Also examined was whether any differences between histological types could be seen in these parameters. In a validation study, 42 anterior mediastinal solid tumours in 42 patients were examined consecutively. Results The washout pattern on TIC was seen only in thymic epithelial tumours (20/32). SUVmax of lymphoma (mean, 17.9), malignant germ cell tumours (14.2), and thymic carcinomas (15.6) were significantly higher than that of thymomas (6.1). The mean maximal diameter of thymic epithelial tumours was significantly smaller than that of lymphomas (p<0.01) and malignant germ cell tumours (p<0.05). The validation study also yielded high accuracy (38/42, 91%) in differentiation among the anterior mediastinal solid tumours. Conclusion The SUVmax, TIC pattern on DCE-MRI, and maximal diameter might be useful to differentiate anterior mediastinal solid tumours in adults..
83. Yuki Bekki, Yasue Kimura, Masaru Morita, Yoko Zaitsu, Hiroshi Saeki, Tatsuro Okamoto, Eiji Oki, Shingo Baba, Yoshinao Oda, Yoshihiko Maehara, Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions
A report of two cases, Esophagus, 10.1007/s10388-014-0454-4, 12, 3, 322-326, 2015.07, Hilar lymph node metastasis of esophageal cancer is considered to be a distant metastasis and is not indicated for surgical resection. However, its diagnosis is difficult when accompanied by inflammatory diseases such as sarcoidosis. We report two patients with esophageal cancer accompanied by bilateral hilar lymphadenopathy or accumulation on [18F]-fluorodeoxyglucose positron emission tomography-computed tomography. The first patient underwent surgery because the enlarged bilateral hilar lymph nodes were considered to be nonmalignant lesions owing to superficial carcinoma and symmetric distribution of the hilar lymph nodes. The second patient received chemotherapy, which caused the main tumor to shrink and decreased [18F]-fluorodeoxyglucose uptake. However, chemotherapy did not affect the hilar lymphadenopathy, which suggests that it was caused by reactive changes rather than metastasis. In both cases, esophagectomy and histological findings revealed that the hilar nodes were caused by sarcoid-like reactions. These findings profoundly influenced our treatment decisions for these patients..
84. Yuki Bekki, Yasue Kimura, Masaru Morita, Yoko Zaitsu, Hiroshi Saeki, Tatsuro Okamoto, Eiji Oki, Shingo Baba, Yoshinao Oda, Yoshihiko Maehara, Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions
a report of two cases, Esophagus, 10.1007/s10388-014-0454-4, 12, 3, 322-326, 2015.07, Hilar lymph node metastasis of esophageal cancer is considered to be a distant metastasis and is not indicated for surgical resection. However, its diagnosis is difficult when accompanied by inflammatory diseases such as sarcoidosis. We report two patients with esophageal cancer accompanied by bilateral hilar lymphadenopathy or accumulation on [18F]-fluorodeoxyglucose positron emission tomography–computed tomography. The first patient underwent surgery because the enlarged bilateral hilar lymph nodes were considered to be nonmalignant lesions owing to superficial carcinoma and symmetric distribution of the hilar lymph nodes. The second patient received chemotherapy, which caused the main tumor to shrink and decreased [18F]-fluorodeoxyglucose uptake. However, chemotherapy did not affect the hilar lymphadenopathy, which suggests that it was caused by reactive changes rather than metastasis. In both cases, esophagectomy and histological findings revealed that the hilar nodes were caused by sarcoid-like reactions. These findings profoundly influenced our treatment decisions for these patients..
85. Yoko Takashima, Takeshi Kamitani, Satoshi Kawanami, Michinobu Nagao, Masato Yonezawa, Yuzo Yamasaki, Shingo Baba, Hidetake Yabuuchi, Tomoyuki Hida, Kenichi Kouhashi, Katsuya Nakamura, Hiromichi Sonoda, Yoshinao Oda, Hiroshi Honda, Mediastinal paraganglioma, Japanese Journal of Radiology, 10.1007/s11604-015-0436-z, 33, 7, 433-436, 2015.07, We present a case of mediastinal paraganglioma with radiologic–pathologic correlation. A 48-year-old woman was found incidentally to have a middle mediastinal mass on CT. The mass showed iso-signal intensity compared to that of muscle on T1-weighted images and high signal intensity on T2-weighted images. The lesion showed intermediate intensity on diffusion-weighted imaging, and its apparent diffusion coefficient was 1.72 × 10−3 mm2/s. A contrast-enhanced dynamic study revealed a rapid peak and washout enhancement pattern. 18F-FDG-PET revealed abnormal uptake in the mediastinal tumor with a maximal standardized uptake value of 7.88. 123I-meta-iodobenzylguanidine scintigraphy also showed abnormal uptake in the tumor. These findings corresponded to the hypervascularity, rich stroma, low nuclear/cytoplasmic ratio, and nest-forming proliferation of tumor cells with positive neuroendocrine markers..
86. Yasuo Tsuda, Masaru Morita, Hiroshi Saeki, Ando Koji, Ida Satoshi, Yasue kimura, Eiji Oki, TAKEFUMI OHGA, Tetsuya Kusumoto, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshihiko Maehara, Esophagectomy-related thoracic duct injury detected by lymphoscintigraphy with 99m Tc-diethylenetriamine pentaacetic acid-human serum albumin: report of a case
, Surgery Today , 45, 4, 517-521, 2015.04.
87. Akihiko Takahashi, Himuro kazuhiko, Yasuo Yamashita, Isao Komiya, Shingo Baba, Masayuki Sasaki, Monte Carlo simulation of PET and SPECT imaging of 90Y., Med Phys., 10.1118/1.4915545., Apr;42, 4, 1926-1935, 2015.04.
88. Akihiko Takahashi, Kazuhiko Himuro, Yasuo Yamashita, Isao Komiya, Shingo Baba, Masayuki Sasaki, Monte Carlo simulation of PET and SPECT imaging of 90Y, Medical Physics, 10.1118/1.4915545, 42, 4, 1926-1935, 2015.04, Purpose: Yittrium-90 (90Y) is traditionally thought of as a pure beta emitter, and is used in targeted radionuclide therapy, with imaging performed using bremsstrahlung single-photon emission computed tomography (SPECT).However, because 90Yalso emits positrons through internal pair production with a very small branching ratio, positron emission tomography (PET) imaging is also available. Because of the insufficient image quality of 90Y bremsstrahlung SPECT, PET imaging has been suggested as an alternative. In this paper, the authors present the Monte Carlo-based simulation-reconstruction framework for 90Yto comprehensively analyze the PET and SPECT imaging techniques and to quantitatively consider the disadvantages associated with them. Methods: Our PET and SPECT simulation modules were developed using Monte Carlo simulation of Electrons and Photons (MCEP), developed by Dr. S. Uehara. PET code (MCEP-PET) generates a sinogram, and reconstructs the tomography image using a time-of-flight ordered subset expectation maximization (TOF-OSEM) algorithm with attenuation compensation. To evaluate MCEP-PET, simulated results of 18F PET imaging were compared with the experimental results. The results confirmed that MCEP-PET can simulate the experimental results very well. The SPECT code (MCEP-SPECT) models the collimator and NaI detector system, and generates the projection images and projection data. To save the computational time, the authors adopt the prerecorded 90Y bremsstrahlung photon data calculated by MCEP. The projection data are also reconstructed using the OSEM algorithm. The authors simulated PET and SPECT images of a water phantom containing six hot spheres filled with different concentrations of 90Y without background activity. The amount of activity was 163 MBq, with an acquisition time of 40 min. Results: The simulated 90Y-PET image accurately simulated the experimental results. PET image is visually superior to SPECT image because of the lowbackground noise. The simulation reveals that the detected photon number in SPECT is comparable to that of PET, but the large fraction (approximately 75%) of scattered and penetration photons contaminates SPECT image. The lower limit of 90Y detection in SPECT image was approximately 200 kBq/ml, while that in PET image was approximately 100 kBq/ml. Conclusions: By comparing the background noise level and the image concentration profile of both the techniques, PET image quality was determined to be superior to that of bremsstrahlung SPECT. The developed simulation codes will be very useful in the future investigations of PET and bremsstrahlung SPECT imaging of 90Y..
89. Akira Maebatake, Maho Sato, Ruriko Kagami, Yasuo Yamashita, Isao Komiya, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, An anthropomorphic phantom study of brain dopamine transporter SPECT images obtained using different SPECT/CT devices and collimators., J Nucl Med Technol, 43, 1, 41-46, 2015.03.
90. Tadamasa Yoshitake, Katsumasa Nakamura, Yoshiyuki Shioyama, Tomonari Sasaki, Ohga Saiji, Makoto Shinoto, kotaro terashima, Kaori Asai, Yoshio Matsuo, Shingo Baba, Hiroshi Honda, Stereotactic body radiation therapy for primary lung cancers clinically diagnosed without pathological confirmation: a single-institution experience, Int J Clin Oncol, 20, 1, 53-58, 2015.02.
91. Michinobu Nagao, Shingo Baba, Masato Yonezawa, Yuzo Yamasaki, Takeshi Kamitani, Takuro Isoda, Satoshi Kawanami, Yasuhiro Maruoka, Yoshiyuki Kitamura, Abe Kohtaro, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy., The International Journal of Cardiovascular Imaging , 31, 2, 399-407, 2015.02.
92. Yoshiyuki Kitamura, Takayama Yukihisa, Akihiro Nishie, Asayama Yoshiki, Yasuhiro Ushijima, Fujita Nobuhiro, Koichiro Morita, Shingo Baba, yuichiro kubo, Ken Shirabe, Hiroshi Honda, Inflammatory Pseudotumor-like Follicular Dendritic Cell Tumor of the Spleen: Case Report and Review of the Literature., Magn Reson Med Sci., 2463/mrms.2014-0052, 2015.02.
93. Michinobu Nagao, Shingo Baba, Masato Yonezawa, Yuzo Yamasaki, Takeshi Kamitani, Takuro Isoda, Satoshi Kawanami, Yasuhiro Maruoka, Yoshiyuki Kitamura, Kotaro Abe, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy, International Journal of Cardiovascular Imaging, 10.1007/s10554-014-0562-1, 31, 2, 399-407, 2015.02, Iron deficiency and cardiac sympathetic impairment play a role in the worsening of heart failure, and these two conditions may be linked. The present study aimed to clarify the relationship between myocardial iron deficiency, cardiac sympathetic activity, and major adverse cardiac events (MACE) in patients with dilated cardiomyopathy (DCM). Cardiac T2* MRI for iron deficiency and 123I-Metaiodobenzylguanidine (MIBG) imaging for cardiac sympathetic activity were performed in 46 patients with DCM. Myocardial T2* value (M-T2*) was calculated by fitting signal intensity data for mid-left ventricular septum to a decay curve using 3-Tesla scanner. 123I-MIBG washout rate (MIBG-WR) was calculated using a polar-map technique with tomographic data. We analyze the ability of M-T2* and MIBG-WR to predict MACE. MIBG-WR and M-T2* were significantly greater in DCM patients with MACE than in patients without MACE. Receiver-operating-characteristics curve analysis showed that the optimal MIBG-WR and M-T2* thresholds of 35 % and 28.1 ms, and the two combination predict MACE with C-statics of 0.69, 0.73, and 0.82, respectively. Patients with MIBG-WR <35 % and M-T2* <28.1 ms had significantly lower event-free rates than those with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (log-rank value = 4.35, p < 0.05). Cox hazard regression analysis showed that χ2 and the hazard ratio were 3.99 and 2.15 for development of MACE in patients with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (p < 0.05). Iron deficiency, expressed by a high M-T2*, and MIBG-WR were both independent predictors of MACE in patients with DCM. The two combination was a more powerful predictor of MACE than either parameter alone..
94. Takafumi Taniguchi, Go Akamatsu, Yukiko Kasahara, Katsuhiko Mitsumoto, Shingo Baba, Yuji Tsutsui, Kazuhiko Himuro, Shohei Mikasa, Daisuke Kidera, Masayuki Sasaki, Improvement in PET/CT image quality in overweight patients with PSF and TOF.
, Annals of Nuclear Medicine , 29, 1, 71-77, 2015.01.
95. Takafumi Taniguchi, Go Akamatsu, Yukiko Kasahara, Katsuhiko Mitsumoto, Shingo Baba, Yuji Tsutsui, Kazuhiko Himuro, Shohei Mikasa, Daisuke Kidera, Masayuki Sasaki, Distribution of residual long-lived radioactivity in the inner concrete walls of a compact medical cyclotron vault room
, Annals of Nuclear Medicine , 29, 1, 84-90, 2015.01.
96. Akira Maebatake, Maho Sato, Ruriko Kagami, Yasuo Yamashita, Isao Komiya, Kazuhiko Himuro, Shingo Baba, Masayuki Sasaki, An Anthropomorphic Phantom Study of Brain Dopamine Transporter SPECT Images Obtained Using Different SPECT/CT Devices and Collimators, Journal of nuclear medicine technology, 10.2967/jnmt.114.149401, 43, 1, 41-46, 2015.01, The aim of this study was to evaluate differences in dopamine transporter SPECT images among different SPECT/CT devices and to determine the most appropriate region of interest (ROI) for semiquantitative evaluation. Methods: An anthropomorphic striatal phantom was filled with 123I solutions of different striatumto- background radioactivity ratios. Data were acquired using 2 SPECT/CT devices equipped with low- to medium-energy generalpurpose and low-energy high-resolution (LEHR) collimators. The SPECT images were reconstructed by filtered backprojection with both attenuation and scatter correction and then were analyzed using specific binding ratio (SBR). The most appropriate of 7 ROI types was determined, and we then compared the linearity and recovery of SBR among the different SPECT/CT devices and collimators. Results: The linearity of SBR was excellent for all types of ROIs. The ROI contouring the striatum based on the CT images showed the best recovery of SBR using mean activity in the striatal ROI (SBRmean) (47.8%). For this ROI, the recovery of SBRmean for SPECT/CT with a LEHR collimator with thick septa and a long hole length was 61.6%- significantly higher than that of other devices. Conclusion: The ROI contouring the striatum based on CT images was considered appropriate for evaluating dopamine transporter SPECT/CT. Among the different SPECT/CT devices, an LEHR collimator designed for 123II imaging is recommended..
97. Toshioh Fujibuchi, Akihiro Nohtomi, Shingo Baba, Masayuki Sasaki, Isao Komiya, Yoshiyuki Umedzu, Hiroshi Honda, Distribution of residual long-lived radioactivity in the inner concrete walls of a compact medical cyclotron vault room, Annals of Nuclear Medicine, 10.1007/s12149-014-0918-6, 29, 1, 84-90, 2015.01, Methods: Cylindrical concrete cores 5 cm in diameter and 10 cm in length were bored from the concrete wall, ceiling and floor. Core boring was performed at 18 points. The gamma-ray spectrum of each sample was measured using a high-purity germanium detector. The degree of activation of the concrete in the cyclotron vault room was analyzed, and the range and tendency toward activation in the vault room were examined.
Objective: Compact medical cyclotrons have been set up to generate the nuclides necessary for positron emission tomography. In accelerator facilities, neutrons activate the concrete used to construct the vault room; this activation increases with the use of an accelerator. The activation causes a substantial radioactive waste management problem when facilities are decommissioned. In the present study, several concrete cores from the walls, ceiling and floor of a compact medical cyclotron vault room were samples 2 years after the termination of operations, and the radioactivity concentrations of radionuclides were estimated.
Results: 60Co and 152Eu were identified by gamma-ray spectrometry of the concrete samples. 152Eu and 60Co are produced principally from the stable isotopes of europium and cobalt by neutron capture reactions. The radioactivity concentration did not vary much between the surface of the concrete and at a depth of 10 cm. Although the radioactivity concentration near the target was higher than the clearance level for radioactive waste indicated in IAEA RS-G-1.7, the mean radioactivity concentration in the walls and floor was lower than the clearance level.
Conclusion: The radioactivity concentration of the inner concrete wall of the medical cyclotron vault room was not uniform. The areas exceeding the clearance level were in the vicinity of the target, but most of the building did not exceed the clearance levels..
98. Yasuo Tsuda, Masaru Morita, Hiroshi Saeki, Kouji Andou, Satoshi Ida, Yasue Kimura, Eiji Oki, Takefumi Ohga, Tetsuya Kusumoto, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshihiko Maehara, Esophagectomy-related thoracic duct injury detected by lymphoscintigraphy with 99mTc-diethylenetriamine pentaacetic acid-human serum albumin
report of a case, Surgery today, 10.1007/s00595-014-0968-3, 45, 4, 517-521, 2015.01, Chylothorax is an uncommon but potentially life-threatening complication of esophagectomy. A 72-year-old man underwent thoracoscopy-assisted subtotal esophagectomy and reconstruction with a gastric tube, through a retrosternal route, after preoperative chemoradiotherapy. Chylothorax was detected after starting enteral feeding on postoperative day (POD) 7. Despite conservative therapy such as fasting, total parenteral nutrition, and octreotide administration, massive fluid drainage continued. On POD 19, lymphoscintigraphy with 99mTc-diethylenetriamine pentaacetic acid-human serum albumin (HSA-D) was performed and the site of leakage was detected at the level of the fourth thoracic vertebra. On POD 23, the thoracic duct was ligated, following which the volume of chylothorax decreased. Lymphoscintigraphy 12 days after the reoperation showed no leakage from the thoracic duct. We recommend lymphoscintigraphy with 99mTc-HSA-D for locating the chyle leakage site and helping decide about the operative indication..
99. Takafumi Taniguchi, Go Akamatsu, Yukiko Kasahara, Katsuhiko Mitsumoto, Shingo Baba, Yuji Tsutsui, Kazuhiko Himuro, Shohei Mikasa, Daisuke Kidera, Masayuki Sasaki, Improvement in PET/CT image quality in overweight patients with PSF and TOF, Annals of Nuclear Medicine, 10.1007/s12149-014-0912-z, 29, 1, 71-77, 2015.01, Methods: This study consisted of a phantom study and a clinical study. The NEMA IEC body phantom and a 40 cm diameter large phantom (LG phantom) simulating an overweight patient were used in this study. Both phantoms were filled with 18F solution with a sphere to background ratio of 4:1. The PET data were reconstructed with the baseline ordered-subsets expectation maximization (OSEM) algorithm, with the OSEM + PSF model, with the OSEM + TOF model and with the OSEM + PSF + TOF model. The clinical study was a retrospective analysis of 66 patients who underwent 18F-FDG PET/CT. The image quality was evaluated using the background variability (coefficient of variance, CVphantom and CVliver) and the contrast (CONTHOT and SNR).
Results: In phantom study, the CVphantom of the LG phantom was higher than that of the NEMA phantom. The PSF decreased the CVphantom of the LG phantom to the NEMA phantom level. The TOF information accelerated the CVphantom plateau earlier. The best relationship between the CVphantom and the CONTHOT was observed for the OSEM + PSF + TOF. In clinical study, the combination of PSF and TOF decreased the CVliver for overweight patients to that for normal weight patients while it increased the SNR similarly between two patient groups.
Conclusion: The combination of the PSF and TOF correction improved the image quality of the LG phantom and overweight patients.
Objective: The aim of this study was to evaluate the effect of the point spread function (PSF) and time of flight (TOF) on PET/CT images of overweight patients in relation to the iteration number and the acquisition time..
100. Yoshiyuki Kitamura, Yukihisa Takayama, Akihiro Nishie, Yoshiki Asayama, yasuhiro ushijima, nobuhiro fujita, Koichirou Morita, Shingo Baba, yuichiro kubo, Ken Shirabe, Hiroshi Honda, Inflammatory pseudotumor-like follicular dendritic cell tumor of the spleen
Case report and review of the literature, Magnetic Resonance in Medical Sciences, 10.2463/mrms.2014-0052, 14, 4, 347-354, 2015.01, A 74-year-old woman underwent contrast-enhanced (CE) computed tomography (CT) that revealed an enlarging splenic lesion. This splenic tumor was suspected as metastasis because the patient had been diagnosed with right breast cancer with lung and right axillary lymph node metastases 4 years earlier and had undergone surgery and hormone therapy at another hospital. T2-weighted imaging of magnetic resonance (MR) imaging demonstrated the tumor with slightly high intensity with a rim of low intensity at the margin. On dynamic contrast-enhanced (DCE)-MR imaging after intravenous administration of gadolinium diethylenetriamine pentaacetic acid, delayed enhancement was observed in the center and margin of the tumor. On positron emission tomography with 2-deoxy-2-[18F] fluoro-Dglucose (FDG) integrated with CT, the tumor showed high FDG uptake. Splenic metastasis was considered based on the imaging findings, lack of inflammation on laboratory data, and clinical course, so she underwent splenectomy. Histopathologically, the tumor was encapsulated by a fibrous structure, which was depicted as the rim at the tumor margin on T2-weighted imaging and DCE-MR imaging. Immunohistochemical study allowed the diagnosis of inflammatory pseudotumor (IPT)-like follicular dendritic cell tumor (FDCT). FDCT is a primary neoplasm of lymph nodes that shows features of follicular dendritic cell differentiation, and it is rare at the spleen. Differential diagnosis is difficult between IPTlike FDCT and similar splenic tumors, such as IPT, splenic metastases, hamartoma and hemangioma. However, in addition to the enhancement pattern within a tumor on DCEMR imaging, detection of the capsular-like rim on MR imaging might aid the diagnosis of splenic IPT-like FDCT..
101. Tadamasa Yoshitake, Katsumasa Nakamura, Yoshiyuki Shioyama, Tomonari Sasaki, Ohga Saiji, Makoto Shinoto, Kotaro Terashima, Kaori Asai, Keiji Matsumoto, Yoshio Matsuo, Shingo Baba, Hiroshi Honda, Stereotactic body radiation therapy for primary lung cancers clinically diagnosed without pathological confirmation
a single-institution experience, International Journal of Clinical Oncology, 10.1007/s10147-014-0698-y, 20, 1, 53-58, 2015.01, Background: Pathological diagnosis of small lung lesions is sometimes difficult in medically inoperable patients. The purpose of this study was to evaluate the adverse events and the outcomes of stereotactic body radiation therapy (SBRT) for lung lesions which were clinically diagnosed as primary lung cancer without pathological confirmation. Methods: Between April 2003 and April 2011, 88 patients with small lung lesions which were clinically diagnosed as primary lung cancer were treated with SBRT. The median tumor size was 19 mm (range 8–40 mm). The radiation dose was 48 Gy in four fractions in all patients. The median follow-up was 23 months (range 6–91 months). Results: Recurrence was observed in 13 patients. The local control rate, progression-free survival rate, and overall survival rate at 3 years were 90, 67, and 80 %, respectively. Two patients (2.3 %) had Grade 2 radiation pneumonitis, and six patients (6.8 %) had Grade 2 rib fractures. There were no adverse events of Grade 3 or greater. Conclusions: SBRT appears to be a safe and effective treatment option for small lung lesions that are clinically diagnosed as primary lung cancer without pathological confirmation..
102. Katsumasa Nakamura, Ohga Saiji, Tomonari Sasaki, Shingo Baba, Hiroshi Honda, [Targeted radionuclide therapy for castration-resistant prostate cancer], Nihon rinsho. Japanese journal of clinical medicine, 72, 12, 2181-2185, 2014.12, Although patients with castration-resistant prostate cancer frequently have metastases to the bone, they have a relatively favorable prognosis. Therefore, it is important to keep or improve the level of patient's quality of life. The use of strontium-89 for the management of the pain from bone metastasis was approved in 2007 in Japan. A new bone-targeting radiopharmaceuticals using radium-223 is also promising, because a randomized trial showed an overall survival advantage of radium-223 in prostate patients with bone metastases. In this review, we summarize the role of targeted radionuclide therapy for castration-resistant prostate cancer, focusing on strontium-89 and radium-223..
103. Takaaki Nakashima, Yukihisa Takayama, Akihiro Nishie, Asayama Yoshiki, Shingo Baba, Youichi Yamashita, Ken Shirabe, Yuichiro Kubo, Tomoyuki Hida, Hiroshi Honda, Hepatocellular adenoma showing high uptake of 18F-fluorodeoxyglucose (FDG) via an increased expression of glucose transporter 2 (GLUT-2)
, Clinical Imaging, 38, 6, 888-891, 2014.11.
104. Yuji Tsutsui, Daisuke Kidera, Takafumi Taniguchi, Go Akamatsu, Isao Komiya, Yoshiyuki Umezu, Yoshiyuki Kitamura, Shingo Baba, Masayuki Sasaki, Accuracy of amplitude-based respiratory gating for PET/CT in irregular respirations
, Annals of Nuclear Medicine, 28, 8, 770-779, 2014.10.
105. Katsumasa Nakamura, Ohga Saiji, Tomonari Sasaki, Shingo Baba, Hiroshi Honda, Targeted radionuclide therapy for castration-resistant prostate cancer.

, Japanese journal of clinical medicine, 72, 21, 2181-2185, 2014.10.
106. Yuji Tsutsui, Daisuke Kidera, Takafumi Taniguchi, Go Akamatsu, Isao Komiya, Yoshiyuki Umezu, Yoshiyuki Kitamura, Shingo Baba, Masayuki Sasaki, Accuracy of amplitude-based respiratory gating for PET/CT in irregular respirations, Annals of Nuclear Medicine, 10.1007/s12149-014-0870-5, 28, 8, 770-779, 2014.10, Objective: We evaluated the accuracy of amplitude gating PET (AG-PET) compared with phase gating PET (PG-PET) in relation to respiratory motion patterns based on a phantom analysis.
Method: We used a NEMA IEC body phantom filled with an 18F solution with a 4:1 sphere-to-background radioactivity ratio (12.6 and 2.97 kBq/mL). PET/CT scans were acquired in a motionless and moving state on a Biograph mCT. The respiratory movements were simulated by four different waveform patterns consisting of ideal breathing, breathing with a pause period, breathing with a variable amplitude and breathing with a changing baseline. AG-PET selects the narrow bandwidth containing 20 % of the respiratory cycle. PG-PET was reconstructed with five gates. The image quality was physically assessed using the percent contrast (QH,10mm), background variability (N10mm) recovery coefficient (RC), and sphere volumes.
Result: In regular motion patterns with ideal breathing and breathing with a pause period, the QH,10mm, RC and sphere volumes were not different between AG-PET and PG-PET. In the variable amplitude pattern, the QH,10mm of AG-PET was higher than that of PG-PET (35.8 vs 28.2 %), the RC of AG-PET was higher than that of PG-PET and sphere volume of AG-PET was smaller than that of PG-PET (6.4 vs 8.6 mL). In the changing baseline pattern, the QH,10mm of AG-PET was higher than that of PG-PET (42.4 vs 16.7 %), the RC of AG-PET was higher than that of PG-PET and sphere volume of AG-PET was smaller than that of PG-PET (6.2 vs 9.8 mL). The N10mm did not differ between AG-PET and PG-PET, irrespective of the motion pattern.
Conclusion: Amplitude gating PET is considered to be more accurate than phase gating PET for examining unstable respiratory motion patterns, such as those involving a variable amplitude or changing baseline..
107. Shingo Baba, Takuro Isoda, Y. Maruoka, Yoshiyuki Kitamura, Hiroshi Honda, Masayuki Sasaki, Role of FDG-PET for the treatment strategy of malignant lymphoma, Japanese Journal of Clinical Radiology, 59, 10, 1292-1301, 2014.10, FDG-PET is increasingly being used for assessment of the staging, for evaluating the response to treatment, and for monitoring the reactions to therapy in malignant lymphoma. This review will highlight the most important applications of FDG-PET in lymphoma, focusing on the advantages and pitfalls of this imaging, and past and ongoing efforts to standardize the use of FDG-PET, particularly in response to assessment and therapy monitoring..
108. Takuro Isoda, Shingo Baba, Yasuhiro Maruoka, Yoshiyuki Kitamura, Akihiro Nishie, Hiroshi Honda, Nabothian Cyst a Predominant Cause of False-Positive Iodine Uptake in Uterus:Comparison of SPECT/CT and Pelvic MRI
, Clin Nucl Med, 39, 8, 680-684, 2014.08.
109. Koichiro Abe, Tomonori Yoshikai, Shingo Baba, Takuro Isoda, Hiroshi Honda, PET/CT Findings in Acute Gastric Anisakiasis, Clin Nucl Med., 39, 6, 340-342, 2014.06.
110. Yohei Mano, Shinichi Aishima, Yuichiro Kubo, Yuki Tanaka, Takeshi Motomura, Takeo Toshima, Ken Shirabe, Shingo Baba, Yoshihiko Maehara, Yoshinao Oda, Correlation between biological marker expression and fluorine-18 fluorodeoxyglucose uptake in hepatocellular carcinoma, Am J Clin Pathol, 142, 3, 391-397, 2014.06.
111. Koichiro Abe, Tomonori Yoshikai, Shingo Baba, Takuro Isoda, Hiroshi Honda, PET/CT findings in acute gastric anisakiasis, Clinical Nuclear Medicine, 10.1097/RLU.0b013e3182a23d17, 39, 6, e340-e342, 2014.06, Acute gastric anisakiasis is caused by the consumption of raw or undercooked fish containing Anisakis larvae. Although several reports have demonstrated the CT features of acute gastric anisakiasis, little is known about the FDG PET/CT findings. We report a 59-year-old woman who underwent FDG PET/CT and was finally diagnosed as having acute gastric anisakiasis. The PET/CT demonstrated focal FDG accumulation in the fornix of the gastric wall and lymph nodes in the lesser curvature and paraaortic regions..
112. Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Yoshiyuki Kitamura, Masayuki Sasaki, Tsuyoshi Yoshida, Hiroshi Honda, Diagnostic and prognostic value of pretreatment SUV in 18F-FDG/ PET in breast cancer
Comparison with apparent diffusion coefficient from diffusion-weighted MR imaging, Journal of Nuclear Medicine, 10.2967/jnumed.113.129395, 55, 5, 736-742, 2014.05, In oncology, the apparent diffusion coefficient (ADC) measured by diffusion-weighted MR imaging (DWI) and the standardized uptake value (SUV) from 18F-FDG PET have similar clinical applications. The purpose of this study was to assess the correlation between the ADC and SUV and compare their potential in the diagnosis and prediction of prognosis in breast tumors. Methods: Seventy-nine female patients (age range, 19-69 y; average, 49.1 y) with 83 pathologically proven breast tumors were recruited. The diagnoses consisted of 70 malignant breast tumors (65 cases of invasive ductal carcinoma, 1 of medullary carcinoma, 1 of mucinous carcinoma, 1 of squamous cell carcinoma, and 2 of micropapillary carcinoma) and 13 benign breast tumors (4 cases of fibroadenoma, 4 of mastopathy, 3 of adenosis with atypia, and 2 of benign phyllodes tumor). All patients underwent mammary gland MR imaging with DWI and 18F-FDG PET within a 2-wk interval. The patients' ADCs and SUVs were measured within the tumor by DWI and 18F-FDG PET, respectively. For the malignant tumors, we evaluated the relationships among ADC, SUV, histopathologic appearance, and long-term prognosis. Results: A significant difference (P < 0.05) was observed in both parameters (ADC and SUV) between the benign and malignant breast tumors, and the difference was more significant when we introduced a new parameter, SUV/ADC. There was a weak inverse correlation between ADC and SUV (r = -0.36; P = 0.06) among the total tumors; however, this correlation was not significant within the group of malignant tumors. High SUV was found to correlate with larger tumor size, higher nuclear grade, and the triple-negative hormonal receptor profile. High ADC was revealed to be correlated with negative progesterone receptor and positive human epidermal growth factor receptor 2 profile. Higher SUVs also showed a correlation with poor prognosis. No correlation was seen between ADC and prognosis. Conclusion: Both SUV and ADC are helpful parameters in differentiating benign from malignant breast tumors. The use of SUV and ADC in combination may help in the diagnosis because of their inverse relationship. High preoperative SUV was associated with poor prognosis, but the contribution of ADC to prognosis prediction was small..
113. Akira Monji, Keisuke Motomura, Yoshito Mizoguchi, Tomoyuki Ohara, Shingo Baba, Takashi Yoshiura, Shigenobu Kanba, A Case of Late-Onset Bipolar Disorder With Severely Abnormal Behavior and Neuroimaging Observations Very Similar to Those of Frontotemporal Dementia , J Neuropsychiatry Clin Neurosci, 26, 1, pp e35-pp e35, 2014.04.
114. Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Yoshiyuki Kitamura, Tuyoshi Yoshida, Masayuki Sasaki, Hiroshi Honda, Diagnostic and prognostic value of pretreatment SUV in 18F-FDG/PET in breast cancer: comparison with ADC from diffusion-weighted MRI, J Nucl Med, 55, 5, 736-742, 2014.03.
115. Yohei Mano, Shinichi Aishima, yuichiro kubo, Yuki Tanaka, Takashi Motomura, Takeo Toshima, Ken Shirabe, Shingo Baba, Yoshihiko Maehara, Yoshinao Oda, Correlation between biological marker expression and fluorine-18 fluorodeoxyglucose uptake in hepatocellular carcinoma, American Journal of Clinical Pathology, 10.1309/AJCPG8AFJ5NRKLLM, 142, 3, 391-397, 2014.01, Objectives: This study investigated the association between several biological markers and fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with hepatocellular carcinoma.
Methods: Forty-two patients with hepatocellular carcinoma who underwent FDG positron emission tomography were included in the study. Tumor sections were immunohistochemically stained for phosphorylated signal transducer and activator of transcription 3 (pSTAT3), hypoxia-inducible factor 1α (HIF1α), glucose transporter 1 (GLUT1), GLUT2, GLUT3, and GLUT4.
Results: The high standardized uptake value (SUV) group showed larger tumor size, more frequent vascular invasion, and poorer differentiation compared with the low SUV group. The high SUV group also showed significantly higher immunohistochemical expression of pSTAT3, HIF1α, and GLUT1. The GLUT1 high-expression group showed higher α-fetoprotein (a tumor marker) and poorer differentiation than did the GLUT1 low-expression group.
Conclusions: Our study indicates that FDG uptake is associated with the expression of pSTAT3, HIF1α, and GLUT1 in hepatocellular carcinoma. The expression of these proteins shows a correlation with poor differentiation and vascular invasion..
116. Takaaki Nakashima, Yukihisa Takayama, Akihiro Nishie, Yoshiki Asayama, Shingo Baba, Youichi Yamashita, Ken Shirabe, yuichiro kubo, Tomoyuki Hida, Hiroshi Honda, Hepatocellular adenoma showing high uptake of 18F-fluorodeoxyglucose (FDG) via an increased expression of glucose transporter 2 (GLUT-2), Clinical Imaging, 10.1016/j.clinimag.2014.06.005, 38, 6, 888-891, 2014.01, Hepatocellular adenoma (HCA) is a benign liver neoplasm composed of hepatocytes. We experienced HCA demonstrating a high uptake of 18F-fluorodeoxyglucose (FDG) on positron emission tomography-computed tomography, mimicking a malignant tumor. The mechanism underlying the uptake of FDG has not been identified. Here, we discuss that an enhancement of glucose metabolism via an increased expression of glucose transporter 2 may have a role in the high uptake of FDG shown by HCAs..
117. Go Akamatsu, Katsuhiko Mitsumoto, Takafumi Taniguchi, Yuji Tsutsui, Shingo Baba, Masayuki Sasaki, Influences of point-spread function and time-of-flight reconstructions on standardized uptake value of lymph node metastases in FDG-PET, European Journal of Radiology, 10.1016/j.ejrad.2013.09.030, 83, 1, 226-230, 2014.01, Purpose The purpose of this study was to investigate the effects of point-spread function (PSF) and time-of-flight (TOF) on the standardized uptake value (SUV) of lymph node metastasis in FDG-PET/CT. Materials and methods This study evaluated 41 lymph node metastases in 15 patients who had undergone 18F-FDG PET/CT. The lesion diameters were 2.5 cm or less. The mean short-axis diameter of the lymph nodes was 10.5 ± 3.7 mm (range 4.6-22.8 mm). The PET data were reconstructed with baseline OSEM algorithm, with OSEM + PSF, with OSEM + TOF and with OSEM + PSF + TOF. A semi-quantitative analysis was performed using the maximum and mean SUV of lymph node metastases (SUV max and SUVmean) and mean SUV of normal lung tissue (SUVlung). We also evaluated image quality using the signal-to-noise ratio in the liver (SNRliver). Results Both PSF and TOF increased the SUV of lymph node metastases. The combination of PSF and TOF increased the SUVmax by 43.3% and the SUVmean by 31.6% compared with conventional OSEM. By contrast, the SUVlung was not influenced by PSF and TOF. TOF significantly improved the SNRliver. Conclusion PSF and TOF both increased the SUV of lymph node metastases. Although PSF and TOF are considered to improve small-lesion detectability, it is important to be aware that PSF and TOF influence the accuracy of quantitative measurements..
118. Takuro Isoda, Shingo Baba, Yasuhiro Maruoka, Yoshiyuki Kitamura, Akihiro Nishie, Masayuki Sasaki, Hiroshi Honda, Nabothian Cyst a predominant cause of false-positive iodine uptake in Uterus
Comparison of SPECT/CT and Pelvic MRI, Clinical Nuclear Medicine, 10.1097/RLU.0000000000000504, 39, 8, 680-684, 2014.01, PURPOSE: Many cases of unexpected radioiodine uptake have been reported, including physiological uptake in healthy tissue and in both benign and malignant nonthyroidal lesions. However, iodine uptake in the uterus has not been well assessed. In this article, we systemically analyzed iodine uptake in the uterus and identified the site in which uptake occurred. MATERIALS AND METHODS: Seventy-six female patients who underwent SPECT/CT from neck to pelvis were included in this study; 5 patients with uterine uptake received pelvic MRI. Iodine uptake in the uterus was diagnosed with SPECT/CT and compared with the findings of the MRI. Serum TSH level, administered dose of iodine-131 and number of radioiodine therapies were compared between the 2 groups with and without iodine uptake in the uterus. RESULTS: Twenty (26.3%) of 76 patients showed iodine uptake in the uterine cervix on SPECT/CT. It was difficult to distinguish the uptake in the uterus from that in the urinary bladder or rectum using only planar images. The patients with the uterine uptake were younger than those without (median age, 46.5 vs. 62, P = 0.011). There were no significant differences in serum TSH level, administered dose of iodine-131, or number of radioiodine therapies between the 2 groups. In all instances of the 5 patients who underwent pelvic MRI, iodine uptake in the uteri was located in nabothian cysts. CONCLUSION: Iodine uptake in the uterus is frequently found if pelvic SPECT/CT is performed. Nabothian cysts are a predominant cause of iodine uptake in the uterine cervix..
119. Takuro Isoda, Shingo Baba, Yasuhiro Maruoka, Yoshiyuki Kitamura, Akihiro Nishie, Masayuki Sasaki, Hiroshi Honda, Nabothian Cyst a predominant cause of false-positive iodine uptake in Uterus
Comparison of SPECT/CT and Pelvic MRI, Clinical Nuclear Medicine, 10.1097/RLU.0000000000000504, 39, 8, 680-684, 2014.01, PURPOSE: Many cases of unexpected radioiodine uptake have been reported, including physiological uptake in healthy tissue and in both benign and malignant nonthyroidal lesions. However, iodine uptake in the uterus has not been well assessed. In this article, we systemically analyzed iodine uptake in the uterus and identified the site in which uptake occurred. MATERIALS AND METHODS: Seventy-six female patients who underwent SPECT/CT from neck to pelvis were included in this study; 5 patients with uterine uptake received pelvic MRI. Iodine uptake in the uterus was diagnosed with SPECT/CT and compared with the findings of the MRI. Serum TSH level, administered dose of iodine-131 and number of radioiodine therapies were compared between the 2 groups with and without iodine uptake in the uterus. RESULTS: Twenty (26.3%) of 76 patients showed iodine uptake in the uterine cervix on SPECT/CT. It was difficult to distinguish the uptake in the uterus from that in the urinary bladder or rectum using only planar images. The patients with the uterine uptake were younger than those without (median age, 46.5 vs. 62, P = 0.011). There were no significant differences in serum TSH level, administered dose of iodine-131, or number of radioiodine therapies between the 2 groups. In all instances of the 5 patients who underwent pelvic MRI, iodine uptake in the uteri was located in nabothian cysts. CONCLUSION: Iodine uptake in the uterus is frequently found if pelvic SPECT/CT is performed. Nabothian cysts are a predominant cause of iodine uptake in the uterine cervix..
120. Akira Monji, Keisuke Motomura, Yoshito Mizoguchi, Tomoyuki Ohara, Shingo Baba, Takashi Yoshiura, Shigenobu Kanba, A case of late-onset bipolar disorder with severely abnormal behavior and neuroimaging observations very similar to those of frontotemporal dementia, Journal of Neuropsychiatry and Clinical Neurosciences, 10.1176/appi.neuropsych.13020031, 26, 1, 2014.
121. M. Nagao, S. Kawanami, Shingo Baba, M. Yonezawa, Yuzo Yamasaki, Takeshi Kamitani, Takuro Isoda, Y. Maruoka, N. Kitamura, Hiroshi Honda, Fusion of cardiac nuclear medicine and MRI
New insight in cardiomyopathy, Japanese Journal of Clinical Radiology, 59, 13, 1812-1820, 2014, Here we propose the fusion imaging of myocardial SPECT/PET and MRI, and demonstrate new insights in dilated cardiomyopathy (DCM) and cardiac sarcoidosis. In DCM, impaired cardiac sympathetic activity expressed by MIBG scintigraphy was associated with spatial dyssynchrony obtained from tagging MRI. Myocardial T2 value and MIBG uptake were independents predictors of major cardiac adverse events in DCM. Fusion image of late gadolinium enhanced MRI and FDG-PET helps to differentiate cardiac sarcoidosis from myocarditis and DCM. Myocardial thickening and T2 high intensity on MRI and high myocardial uptake on FDG-PET were often seen in non-responder to steroid therapy in cardiac sarcoidosis..
122. Akira Monji, Keisuke Motomura, Yoshito Mizoguchi, Tomoyuki Ohara, Shingo Baba, Takashi Yoshiura, Shigenobu Kanba, A case of late-onset bipolar disorder with severely abnormal behavior and neuroimaging observations very similar to those of frontotemporal dementia, Journal of Neuropsychiatry and Clinical Neurosciences, 10.1176/appi.neuropsych.13020031, 26, 1, 2014.
123. M. Nagao, S. Kawanami, Shingo Baba, M. Yonezawa, Yuzo Yamasaki, Takeshi Kamitani, Takuro Isoda, Y. Maruoka, N. Kitamura, Hiroshi Honda, Fusion of cardiac nuclear medicine and MRI
New insight in cardiomyopathy, Japanese Journal of Clinical Radiology, 59, 13, 1812-1820, 2014, Here we propose the fusion imaging of myocardial SPECT/PET and MRI, and demonstrate new insights in dilated cardiomyopathy (DCM) and cardiac sarcoidosis. In DCM, impaired cardiac sympathetic activity expressed by MIBG scintigraphy was associated with spatial dyssynchrony obtained from tagging MRI. Myocardial T2 value and MIBG uptake were independents predictors of major cardiac adverse events in DCM. Fusion image of late gadolinium enhanced MRI and FDG-PET helps to differentiate cardiac sarcoidosis from myocarditis and DCM. Myocardial thickening and T2 high intensity on MRI and high myocardial uptake on FDG-PET were often seen in non-responder to steroid therapy in cardiac sarcoidosis..
124. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshiyuki Kiramura, Go Akamatsu, Masayuki Sasaki, Hiroshi Honda, Usefulness of partial volume effect-corrected F-18 FDG PET/CT for predicting I-131 accumulation in the metastatic lymph nodes of patients with thyroid carcinoma., Ann Nucl Med, 27, 10, 873-879, 2013.12, PURPOSE:
The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC).

METHODS:
Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared.

RESULTS:
For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001).

CONCLUSION:
PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT..
125. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Noriko Mizoguchi, Go Akamatsu, Masayuki Sasaki, Hiroshi Honda, Usefulness of partial volume effect-corrected F-18 FDG PET/CT for predicting I-131 accumulation in the metastatic lymph nodes of patients with thyroid carcinoma, Annals of Nuclear Medicine, 10.1007/s12149-013-0767-8, 27, 10, 873-879, 2013.12, Purpose: The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC). Methods: Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared. Results: For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001). Conclusion: PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT..
126. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Noriko Mizoguchi, Go Akamatsu, Masayuki Sasaki, Hiroshi Honda, Usefulness of partial volume effect-corrected F-18 FDG PET/CT for predicting I-131 accumulation in the metastatic lymph nodes of patients with thyroid carcinoma, Annals of Nuclear Medicine, 10.1007/s12149-013-0767-8, 27, 10, 873-879, 2013.12, Purpose: The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC). Methods: Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared. Results: For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001). Conclusion: PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT..
127. Kazushige Atsumi, Katsumasa Nakamura, Koichiro Abe, Masakazu Hirakawa, Yoshiyuki Shioyama, Tomonari Sasaki, Shingo Baba, Takuro Isoda, Ohga Saiji, Tadamasa Yoshitake, Makoto Shinoto, Kaori Asai, Hiroshi Honda, Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer, Journal of radiation research, 10.1093/jrr/rrt021, 54, 5, 890-898, 2013.09, The purpose of this study was to assess the efficacy of 18F-fluoro-2-deoxy-glucose uptake positron emission tomography (FDG-PET) for the prediction of outcome in definitive chemoradiotherapy (CRT) for esophageal cancer. We enrolled 56 patients with esophageal cancer treated with definitive CRT and examined by FDG-PET before treatment. We examined the correlation of the maximum standardized uptake value (SUVmax) in FDG-PET of the primary tumor with overall survival (OS), progression-free survival (PFS), local control (LC) and response of the primary tumor. After definitive CRT, 30 patients had a clinical complete response (CR), making the CR rate 54%. For all 56 patients, the 2-year OS rate, PFS rate and LC rates were 64%, 38% and 51%, respectively. We divided the patients into two groups according to SUVmax: SUVmax < 10 (low-SUV) and <10 (high-SUV). The 2-year OS rates in the low- and high-SUV groups were 100% and 41%, the PFS rates were 73% and 19%, the LC rates were 71% and 39%, and the CR rates were 100% and 32%, respectively. A univariate analysis revealed significant differences between the low- and high-SUV group in OS, PFS, LC and response (P = 0.0005, 0.0002, 0.048, and <0.0001, respectively). SUVmax and T stage were significantly associated with OS, PFS, LC and response. A multivariate analysis showed significant differences between the SUVmax <10 and ≥10 groups in overall survival and response (P < 0.05). Our result suggests that the SUVmax in FDG-PET of the primary tumor before treatment may have prognostic value for esophageal cancer..
128. Kazushige Atsumi, Katsumasa Nakamura, Koichiro Abe, Masakazu Hirakawa, Yoshiyuki Shioyama, Tomonari Sasaki, Shingo Baba, Takuro Isoda, Ohga Saiji, Tadamasa Yoshitake, Makoto Shinoto, Kaori Asai, Hiroshi Honda, Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer, Journal of radiation research, 10.1093/jrr/rrt021, 54, 5, 890-898, 2013.09, The purpose of this study was to assess the efficacy of 18F-fluoro-2-deoxy-glucose uptake positron emission tomography (FDG-PET) for the prediction of outcome in definitive chemoradiotherapy (CRT) for esophageal cancer. We enrolled 56 patients with esophageal cancer treated with definitive CRT and examined by FDG-PET before treatment. We examined the correlation of the maximum standardized uptake value (SUVmax) in FDG-PET of the primary tumor with overall survival (OS), progression-free survival (PFS), local control (LC) and response of the primary tumor. After definitive CRT, 30 patients had a clinical complete response (CR), making the CR rate 54%. For all 56 patients, the 2-year OS rate, PFS rate and LC rates were 64%, 38% and 51%, respectively. We divided the patients into two groups according to SUVmax: SUVmax < 10 (low-SUV) and <10 (high-SUV). The 2-year OS rates in the low- and high-SUV groups were 100% and 41%, the PFS rates were 73% and 19%, the LC rates were 71% and 39%, and the CR rates were 100% and 32%, respectively. A univariate analysis revealed significant differences between the low- and high-SUV group in OS, PFS, LC and response (P = 0.0005, 0.0002, 0.048, and <0.0001, respectively). SUVmax and T stage were significantly associated with OS, PFS, LC and response. A multivariate analysis showed significant differences between the SUVmax <10 and ≥10 groups in overall survival and response (P < 0.05). Our result suggests that the SUVmax in FDG-PET of the primary tumor before treatment may have prognostic value for esophageal cancer..
129. Masato Yonezawa, Michinobu Nagao, Koichiro Abe, Yoshio Matsuo, Shingo Baba, Takeshi Kamitani, Takuro Isoda, Yasuhiro Maruoka, Mikako Jinnouchi, Yuzo Yamasaki, Kotaro Abe, Taiki Higo, Takashi Yoshiura, Hiroshi Honda, Relationship between impaired cardiac sympathetic activity and spatial dyssynchrony in patients with non-ischemic heart failure
Assessment by MIBG scintigraphy and tagged MRI, Journal of Nuclear Cardiology, 10.1007/s12350-013-9715-1, 20, 4, 600-608, 2013.08, Background: Impairment of cardiac sympathetic activity has various detrimental effects on cardiac function. The purpose was to investigate the relationship between left ventricular (LV) dyssynchrony and cardiac sympathetic activity in non-ischemic heart failure (HF). Methods: Twenty-seven patients with non-ischemic HF were enrolled. Cardiac sympathetic activity was assessed by heart-to-mediastinum ratio (H/M ratio) on 123I- Metaiodobenzylguanidine scintigraphy. LV dyssynchrony was assessed by cross-correlation analysis of time curves of myocardial circumferential strains delivered from cine-tagging MR images. Temporal dyssynchrony was defined as contraction delay between septal and lateral segments >110 milliseconds. Spatial dyssynchrony was defined as the negative value of the maximum correlation for the two strain time curves. Results: H/M ratio was significantly lower for patients with spatial dyssynchrony compared to patients without (1.8 ± 0.3 vs 2.1 ± 0.3, P <.05). There was no difference between patients with and without temporal dyssynchrony (2.0 ± 0.2 vs 2.0 ± 0.3). The incidence of spatial dyssynchrony was significantly higher in patients with H/M ratio <2.0 than those whose ratios were ≥2.0 (75% vs 20%, P =.001). There was no difference in the incidence of temporal dyssynchrony between the two groups (17% vs 20%). Conclusion: Impairment of cardiac sympathetic activity was found to be associated with spatial dyssynchrony in patients with non-ischemic HF..
130. Masato Yonezawa, Michinobu Nagao, Koichiro Abe, Yoshio Matsuo, Shingo Baba, Takeshi Kamitani, Takuro Isoda, Yasuhiro Maruoka, Mikako Jinnouchi, Yuzo Yamasaki, Kotaro Abe, Taiki Higo, Takashi Yoshiura, Hiroshi Honda, Relationship between impaired cardiac sympathetic activity and spatial dyssynchrony in patients with non-ischemic heart failure
Assessment by MIBG scintigraphy and tagged MRI, Journal of Nuclear Cardiology, 10.1007/s12350-013-9715-1, 20, 4, 600-608, 2013.08, Background: Impairment of cardiac sympathetic activity has various detrimental effects on cardiac function. The purpose was to investigate the relationship between left ventricular (LV) dyssynchrony and cardiac sympathetic activity in non-ischemic heart failure (HF). Methods: Twenty-seven patients with non-ischemic HF were enrolled. Cardiac sympathetic activity was assessed by heart-to-mediastinum ratio (H/M ratio) on 123I- Metaiodobenzylguanidine scintigraphy. LV dyssynchrony was assessed by cross-correlation analysis of time curves of myocardial circumferential strains delivered from cine-tagging MR images. Temporal dyssynchrony was defined as contraction delay between septal and lateral segments >110 milliseconds. Spatial dyssynchrony was defined as the negative value of the maximum correlation for the two strain time curves. Results: H/M ratio was significantly lower for patients with spatial dyssynchrony compared to patients without (1.8 ± 0.3 vs 2.1 ± 0.3, P <.05). There was no difference between patients with and without temporal dyssynchrony (2.0 ± 0.2 vs 2.0 ± 0.3). The incidence of spatial dyssynchrony was significantly higher in patients with H/M ratio <2.0 than those whose ratios were ≥2.0 (75% vs 20%, P =.001). There was no difference in the incidence of temporal dyssynchrony between the two groups (17% vs 20%). Conclusion: Impairment of cardiac sympathetic activity was found to be associated with spatial dyssynchrony in patients with non-ischemic HF..
131. Go Akamatsu, Katsuhiko Mitsumoto, Kaori Ishikawa, Takafumi Taniguchi, Nobuyoshi Ohya, Shingo Baba, Koichiro Abe, Masayuki Sasaki, Benefits of point-spread function and time of flight for PET/CT image quality in relation to the body mass index and injected dose, Clinical Nuclear Medicine, 10.1097/RLU.0b013e31828da3bd, 38, 6, 407-412, 2013.06, : The PET image quality of overweight patients and patients who receive low injected doses deteriorates because of increases in statistical noise. The purpose of this study was to investigate the benefits of the point-spread function (PSF) and time-of-flight (TOF) for PET/CT image quality in such patients. METHODS: The PET images were reconstructed using the baseline ordered-subsets expectation-maximization algorithm (OSEM), OSEM + PSF, OSEM + TOF, and OSEM + PSF + TOF. In the phantom study, we used a National Electrical Manufacturers Association body phantom with different radioactivity concentrations and analyzed image quality using the coefficient of variance in the background (CVphantom). In the clinical study, we retrospectively studied 39 patients who underwent clinical F-FDG PET/CT. The patients were classified into groups based on body mass index and injected dose. Image quality was evaluated using the CV in the liver (CVliver). RESULTS: In the phantom study, PSF and TOF improved the CVphantom, especially in low-activity models. Among all of the reconstructions, the best CVphantom was obtained with OSEM + PSF + TOF. In the clinical study, the CVliver of the low-dose group with OSEM + PSF + TOF was comparable to that of the high-dose group with conventional OSEM. CONCLUSIONS: Point-spread function and TOF improved PET/CT image quality for overweight patients who received a lower injected dose. Therefore, the use of PSF and TOF is suggested to maintain the image quality of such patients without extending scanning times. It is greatly beneficial to obtain sufficient image quality for larger patients, especially in delivery institutions where the injection dose cannot be easily increased..
132. Go Akamatsu, Katsuhiko Mitsumoto, Kaori Ishikawa, Takafumi Taniguchi, Nobuyoshi Ohya, Shingo Baba, Koichiro Abe, Masayuki Sasaki, Benefits of point-spread function and time of flight for PET/CT image quality in relation to the body mass index and injected dose, Clinical Nuclear Medicine, 10.1097/RLU.0b013e31828da3bd, 38, 6, 407-412, 2013.06, : The PET image quality of overweight patients and patients who receive low injected doses deteriorates because of increases in statistical noise. The purpose of this study was to investigate the benefits of the point-spread function (PSF) and time-of-flight (TOF) for PET/CT image quality in such patients. METHODS: The PET images were reconstructed using the baseline ordered-subsets expectation-maximization algorithm (OSEM), OSEM + PSF, OSEM + TOF, and OSEM + PSF + TOF. In the phantom study, we used a National Electrical Manufacturers Association body phantom with different radioactivity concentrations and analyzed image quality using the coefficient of variance in the background (CVphantom). In the clinical study, we retrospectively studied 39 patients who underwent clinical F-FDG PET/CT. The patients were classified into groups based on body mass index and injected dose. Image quality was evaluated using the CV in the liver (CVliver). RESULTS: In the phantom study, PSF and TOF improved the CVphantom, especially in low-activity models. Among all of the reconstructions, the best CVphantom was obtained with OSEM + PSF + TOF. In the clinical study, the CVliver of the low-dose group with OSEM + PSF + TOF was comparable to that of the high-dose group with conventional OSEM. CONCLUSIONS: Point-spread function and TOF improved PET/CT image quality for overweight patients who received a lower injected dose. Therefore, the use of PSF and TOF is suggested to maintain the image quality of such patients without extending scanning times. It is greatly beneficial to obtain sufficient image quality for larger patients, especially in delivery institutions where the injection dose cannot be easily increased..
133. Ko Higuchi, Michinobu Nagao, Yoshio Matsuo, Takeshi Kamitani, Masato Yonezawa, Mikako Jinnouchi, Yuzo Yamasaki, Koichiro Abe, Shingo Baba, Yasushi Mukai, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Evaluation of chronic ischemic heart disease with myocardial perfusion and regional contraction analysis by contrast-enhanced 256-MSCT, Japanese Journal of Radiology, 10.1007/s11604-012-0159-3, 31, 2, 123-132, 2013.02, Purpose: To investigate myocardial viability in chronic ischemic heart disease by myocardial perfusion and regional contraction analysis using 256-slice MSCT coronary angiography (CCTA). Methods: In 30 patients with prior myocardial infarction (MI), CCTA with retrospective ECG-gating and stress-redistribution thallium-201 SPECT were performed. Using the same raw data as used for CCTA, myocardial perfusion imaging (CT-MPI) was reconstructed at four phases during the cardiac cycle. Mean myocardial attenuation and wall thickness at end-systole and end-diastole were measured in the MI areas depicted by SPECT, and they were compared between viable and non-viable segments categorized by SPECT. Results: End-systolic thickness was significantly greater for viable than for non-viable segments (12.0 ± 3.2 vs. 9.6 ± 3.5 mm, p = 0.0017). There was no difference in end-diastolic thickness. Myocardial attenuation was significantly higher for viable than for non-viable segments in the subendocardium (62 ± 13 vs. 70 ± 11 HU, p = 0.003) and the epicardium (65 ± 13 vs. 80 ± 15 HU, p = 0.0002). Conclusion: The systolic wall thinning and epicardial low-attenuation areas were the indicative findings of CT-MPI for non-viable segments in the prior MI..
134. Ko Higuchi, Michinobu Nagao, Yoshio Matsuo, Takeshi Kamitani, Masato Yonezawa, Mikako Jinnouchi, Yuzo Yamasaki, Koichiro Abe, Shingo Baba, Yasushi Mukai, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Evaluation of chronic ischemic heart disease with myocardial perfusion and regional contraction analysis by contrast-enhanced 256-MSCT, Japanese Journal of Radiology, 10.1007/s11604-012-0159-3, 31, 2, 123-132, 2013.02, Purpose: To investigate myocardial viability in chronic ischemic heart disease by myocardial perfusion and regional contraction analysis using 256-slice MSCT coronary angiography (CCTA). Methods: In 30 patients with prior myocardial infarction (MI), CCTA with retrospective ECG-gating and stress-redistribution thallium-201 SPECT were performed. Using the same raw data as used for CCTA, myocardial perfusion imaging (CT-MPI) was reconstructed at four phases during the cardiac cycle. Mean myocardial attenuation and wall thickness at end-systole and end-diastole were measured in the MI areas depicted by SPECT, and they were compared between viable and non-viable segments categorized by SPECT. Results: End-systolic thickness was significantly greater for viable than for non-viable segments (12.0 ± 3.2 vs. 9.6 ± 3.5 mm, p = 0.0017). There was no difference in end-diastolic thickness. Myocardial attenuation was significantly higher for viable than for non-viable segments in the subendocardium (62 ± 13 vs. 70 ± 11 HU, p = 0.003) and the epicardium (65 ± 13 vs. 80 ± 15 HU, p = 0.0002). Conclusion: The systolic wall thinning and epicardial low-attenuation areas were the indicative findings of CT-MPI for non-viable segments in the prior MI..
135. Go Akamatsu, Katsuhiko Mitsumoto, Takahumi Taniguchi, Shingo Baba, Masayuki Sasaki, Influences of point-spread function and time-of-flight reconstructions on standardized uptake value of lymph node metastases in FDG-PET., Eur J Radiol., 83, 1, 226-230, 2013.01, Purpose
The purpose of this study was to investigate the effects of point-spread function (PSF) and time-of-flight (TOF) on the standardized uptake value (SUV) of lymph node metastasis in FDG-PET/CT.

Materials and methods
This study evaluated 41 lymph node metastases in 15 patients who had undergone 18F-FDG PET/CT. The lesion diameters were 2.5 cm or less. The mean short-axis diameter of the lymph nodes was 10.5 ± 3.7 mm (range 4.6–22.8 mm). The PET data were reconstructed with baseline OSEM algorithm, with OSEM + PSF, with OSEM + TOF and with OSEM + PSF + TOF. A semi-quantitative analysis was performed using the maximum and mean SUV of lymph node metastases (SUVmax and SUVmean) and mean SUV of normal lung tissue (SUVlung). We also evaluated image quality using the signal-to-noise ratio in the liver (SNRliver).

Results
Both PSF and TOF increased the SUV of lymph node metastases. The combination of PSF and TOF increased the SUVmax by 43.3% and the SUVmean by 31.6% compared with conventional OSEM. By contrast, the SUVlung was not influenced by PSF and TOF. TOF significantly improved the SNRliver.

Conclusion
PSF and TOF both increased the SUV of lymph node metastases. Although PSF and TOF are considered to improve small-lesion detectability, it is important to be aware that PSF and TOF influence the accuracy of quantitative measurements..
136. Shuichi Isomura, Akira Monji, Kensuke Sasaki, Shingo Baba, Toshiaki Onitsuka, Tomoyuki Ohara, Yoshito Mizoguchi, Takahiro Kato, Hideki Horikawa, Yoshihiro Seki, Shigenobu Kanba, FTD with catatonia-like signs that temporarily resolved with zolpidem, Neurology: Clinical Practice, 10.1212/CPJ.0b013e318296f263, 3, 4, 354-357, 2013.01.
137. Yasuhiro Maruoka, Michinobu Nagao, Koichiro Abe, Shingo Baba, Takuro Isoda, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Quantification of heterogeneity on 201Tl Gated SPECT
Evaluation of coronary artery disease, Clinical Nuclear Medicine, 10.1097/RLU.0b013e3182638e46, 38, 1, 2013.01, PURPOSE: The purpose of this study was to propose a new index that quantifies the heterogeneity of myocardial uptake on gated myocardial perfusion SPECT (GMPS) with Tl and investigate its utility in diagnosing multivessel coronary artery disease (CAD). METHODS: In 51 patients with CAD, adenosine-stress Tl GMPS and coronary angiography (CAG) were performed. On the basis of the American Heart Association's 17-segment model, segmental percentage uptake on stress, and redistribution images of GMPS were measured at end-systole and end-diastole. The coefficient of variance (CV) of 17 segmental percentage uptake for each patient was used as an estimate of the heterogeneity of myocardial uptake. According to the results of CAG, patients were divided into insignificant coronary artery stenosis (insignificant-CAD), single-vessel CAD, and multivessel CAD groups. The differences in CV among the 3 groups were analyzed by 1-way analysis of variance and Tukey-Kramer test. The diagnostic capability for multivessel CAD was analyzed using the receiver operating characteristics (ROC) curve analysis. RESULTS: Stress end-diastolic CV for patients with multivessel CAD [mean (SD), 18.1% (3.5%)] was significantly greater than that for single-vessel CAD [12.8% (2.9%), P < 0.0001] and insignificant-CAD [10.1% (0.9%), P < 0.0001]. Stress end-systolic CV for patients with multivessel CAD [23.4% (5.2%)] was significantly greater than that for insignificant-CAD [16.5% (4.1%), P = 0.002], whereas there was no difference between single-vessel [20.9% (6.1%)] and multivessel CAD. Using an optimal cutoff of stress end-diastolic CV diagnosed multivessel CAD with a sensitivity of 84%, a specificity of 92%, an accuracy of 88%, and an area under the curve of 0.89. CONCLUSIONS: The heterogeneity of myocardial percentage uptake on Tl GMPS was correlated with the severity of CAD. Stress end-diastolic CV value is a candidate index for differentiating patients with multivessel CAD from single-vessel CAD and insignificant-CAD..
138. Shuichi Isomura, Akira Monji, Kensuke Sasaki, Shingo Baba, Toshiaki Onitsuka, Tomoyuki Ohara, Yoshito Mizoguchi, Takahiro Kato, Hideki Horikawa, Yoshihiro Seki, Shigenobu Kanba, FTD with catatonia-like signs that temporarily resolved with zolpidem, Neurology: Clinical Practice, 10.1212/CPJ.0b013e318296f263, 3, 4, 354-357, 2013.01.
139. Yasuhiro Maruoka, Michinobu Nagao, Koichiro Abe, Shingo Baba, Takuro Isoda, Taiki Higo, Kenji Sunagawa, Hiroshi Honda, Quantification of heterogeneity on 201Tl Gated SPECT
Evaluation of coronary artery disease, Clinical Nuclear Medicine, 10.1097/RLU.0b013e3182638e46, 38, 1, 2013.01, PURPOSE: The purpose of this study was to propose a new index that quantifies the heterogeneity of myocardial uptake on gated myocardial perfusion SPECT (GMPS) with Tl and investigate its utility in diagnosing multivessel coronary artery disease (CAD). METHODS: In 51 patients with CAD, adenosine-stress Tl GMPS and coronary angiography (CAG) were performed. On the basis of the American Heart Association's 17-segment model, segmental percentage uptake on stress, and redistribution images of GMPS were measured at end-systole and end-diastole. The coefficient of variance (CV) of 17 segmental percentage uptake for each patient was used as an estimate of the heterogeneity of myocardial uptake. According to the results of CAG, patients were divided into insignificant coronary artery stenosis (insignificant-CAD), single-vessel CAD, and multivessel CAD groups. The differences in CV among the 3 groups were analyzed by 1-way analysis of variance and Tukey-Kramer test. The diagnostic capability for multivessel CAD was analyzed using the receiver operating characteristics (ROC) curve analysis. RESULTS: Stress end-diastolic CV for patients with multivessel CAD [mean (SD), 18.1% (3.5%)] was significantly greater than that for single-vessel CAD [12.8% (2.9%), P < 0.0001] and insignificant-CAD [10.1% (0.9%), P < 0.0001]. Stress end-systolic CV for patients with multivessel CAD [23.4% (5.2%)] was significantly greater than that for insignificant-CAD [16.5% (4.1%), P = 0.002], whereas there was no difference between single-vessel [20.9% (6.1%)] and multivessel CAD. Using an optimal cutoff of stress end-diastolic CV diagnosed multivessel CAD with a sensitivity of 84%, a specificity of 92%, an accuracy of 88%, and an area under the curve of 0.89. CONCLUSIONS: The heterogeneity of myocardial percentage uptake on Tl GMPS was correlated with the severity of CAD. Stress end-diastolic CV value is a candidate index for differentiating patients with multivessel CAD from single-vessel CAD and insignificant-CAD..
140. Go Akamatsu, Kaori Ishikawa, Katsuhiko Mitsumoto, Takafumi Taniguchi, Nobuyoshi Ohya, Shingo Baba, Koichiro Abe, Masayuki Sasaki, Improvement in PET/CT image quality with a combination of point-spread function and time-of-flight in relation to reconstruction parameters, Journal of Nuclear Medicine, 10.2967/jnumed.112.103861, 53, 11, 1716-1722, 2012.11, The aim of this study was to investigate the effects of the pointspread function (PSF) and time-of-flight (TOF) on improving 18FFDG PET/CT images in relation to reconstruction parameters and noise-equivalent counts (NEC). Methods: This study consisted of a phantom study and a retrospective analysis of 39 consecutive patients who underwent clinical 18F-FDG PET/CT. The body phantom of the National Electrical Manufacturers Association and International Electrotechnical Commission with a 10-mm-diameter sphere was filled with an 18F-FDG solution with a 4:1 radioactivity ratio compared with the background. The PET data were reconstructed with the baseline ordered-subsets expectation maximization (OSEM) algorithm, with the OSEM+PSF model, with the OSEM+TOF model, and with the OSEM+PSF+TOF model. We evaluated image quality by visual assessment, the signal-to-noise ratio of the 10-mm sphere (SNR10 mm), the contrast of the 10-mm sphere, and the coefficient of variance in the phantom study and then determined the optimal reconstruction parameters. We also examined the effects of PSF and TOF on the quality of clinical images using the signal-to-noise ratio in the liver (SNRliver) in relation to the NEC in the liver (ENCliver). Results: In the phantom study, the SNR10 mm was the highest for the OSEM+PSF+TOF model, and the highest value was obtained at iteration 2 for algorithms with the TOF and at iteration 3 for those without the TOF. In terms of a postsmoothing filter full width at half maximum (FWHM), the high SNR 10 mm was obtained with no filtering or was smaller than 2 mm for algorithms with PSF and was 4-6 mm for those without PSF. The balance between the contrast recovery and noise is different for algorithms with either PSF or TOF. A combination of PSF and TOF improved SNR10 mm, contrast, and coefficient of variance, especially with a small-FWHM gaussian filter. In the clinical study, the SNRliver of the low- ENCliver group in the OSEM+PSF+TOF model was compared with that of the high-ENCliver group in conventional OSEM. The PSF+TOF improved the SNRliver by about 24.9% ± 9.81%. Conclusion: A combination of PSF and TOF clearly improves image quality, whereas optimization of the reconstruction parameters is necessary to obtain the best performance for PSF or TOF. Furthermore, this combination has the potential to provide good image quality with either lower activity or shorter acquisition time, thus improving patient comfort and reducing the radiation burden. COPYRIGHT.
141. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Hirofumi Sawamoto, Yoshitaka Tanabe, Masayuki Sasaki, Hiroshi Honda, Incremental diagnostic value of SPECT/CT with 131I scintigraphy after radioiodine therapy in patients with well-differentiated thyroid carcinoma, Radiology, 10.1148/radiol.12112108, 265, 3, 902-909, 2012.11, Purpose: To retrospectively determine the incremental diagnostic value of adding single photon emission computed tomography/ computed tomography (SPECT/CT) to whole-body scintigraphy with iodine 131 (131I) compared with scintigraphy alone after radioiodine therapy in patients with well-differentiated thyroid carcinoma. Materials and Methods: This retrospective study was institutional review board approved; written informed consent was waived. The study included 147 patients (94 female, 53 male patients; mean age, 51 years) with well-differentiated thyroid carcinoma treated with radioiodine therapy between October 2009 and August 2010. Whole-body scintigraphy and SPECT/CT were performed on the same day in all patients receiving radioiodine therapy. Each radioactive focus at whole-body scintigraphy was classified as positive or equivocal with respect to thyroid bed, lymph node, and distant metastasis uptake. Differences between whole-body scintigraphy and SPECT/CT findings were assessed with the generalized McNemar test. Results: At SPECT/CT, origin was clearly determined of all five "hot spots" in the thyroid bed (remnant thyroid tissue or metastatic lymph node) that were judged as equivocal at wholebody scintigraphy. Interpretation of 24 (22.2%) of 108 radioactive foci for lymph node metastases was changed with SPECT/CT (P < .0001). One of 85 foci that were thought to be positive findings at whole-body scintigraphy turned out to be a negative finding (false-positive finding), and 13 and seven of 20 equivocal foci at whole-body scintigraphy were positive and negative findings, respectively, after adding SPECT/CT findings. Three false-negative findings at whole-body scintigraphy were corrected with SPECT/CT. For the detection of distant metastasis, the interpretations of 21 (40%) of 52 foci were corrected with SPECT/CT (P < .0001). One of 32 foci thought to be a positive finding at whole-body scintigraphy was a negative finding, and 11 and nine of 20 equivocal foci at whole-body scintigraphy were positive and negative findings, respectively, after SPECT/CT. At a patient-based analysis, SPECT/CT findings helped change the clinical staging in nine (6.1%) of 147 patients and therapeutic planning in three (2.0%) of 147 patients. Conclusion: SPECT/CT improved detection and localization of 131I accumulation in lymph node metastases and distant metastases, compared with whole-body scintigraphy..
142. Tomoyoshi Takenaka, Tokujiro Yano, Yosuke Morodomi, Kensaku Ito, Naoko Miura, Daigo Kawano, Fumihiro Shoji, Shingo Baba, Koichiro Abe, Hiroshi Honda, Yoshihiko Maehara, Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography, Surgery today, 10.1007/s00595-012-0277-7, 42, 10, 934-939, 2012.10, Purpose We developed a method for predicting truenegative lymph node metastases in clinical IA non-small lung cancer (NSCLC) by the combined evaluation of computed tomography (CT), 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) findings and the maximum standardized uptake value (SUVmax) of primary tumors. Methods The subjects of this study were 94 patients with clinical stage IA NSCLC who underwent both preoperative CT and FDG-PET. We analyzed the relationship between the SUVmax of primary tumors and various clinicopathological factors to find the best method available for assessing true-negative lymph node metastasis. Results The pathological stages were IA (n = 80), IB (n = 4), IIA (n = 5), IIIA (n = 4), and IV (n = 1). Pathologic lymph node metastasis was recognized in nine patients and the SUVmax of these tumors ranged from 3.3 to 20.3. A SUVmax of 3.0 was defined as the cut-off point and patients were dichotomized according to this point. Tumors with SUVmax of 3.0 or less were associated with a significantly lower incidence of pleural and vascular invasion and were characterized by the degree of differentiation. Conclusion The SUVmax of primary tumors reflects the grade of malignancy; therefore, the combined evaluation of FDG-PET/CT findings with the SUVmax of primary tumors may help predict lymph node metastasis negativity..
143. Yasuhiro Maruoka, Koichiro Abe, Shingo Baba, Takuro Isoda, Yoshio Matsuo, yuichiro kubo, Shinji Ogawa, Tokujiro Yano, Masayuki Sasaki, Hiroshi Honda, A case of pulmonary choriocarcinoma metastasis with unusual FDG-PET and CT findings
Correlation with pathology, Annals of Nuclear Medicine, 10.1007/s12149-012-0644-x, 26, 10, 835-839, 2012.08, A 26-year-old female who had had a hydatidiform mole at 20 years of age showed high levels of serum human chorionic gonadotropin. Because pelvic ultrasound did not show any gestational sac in her uterus, she was suspected to have had an extrauterine pregnancy and a spontaneous abortion. About 6 months later, a pulmonary nodule in the patient's right upper lung field was found on a routine chest X-ray film. Contrast- enhanced CT scans revealed a solitary lobulated nodule 2.0 × 1.3 × 3.0 cm in diameter in the S2 segment of the right lung. CT suggested a vessel malformation. Positron emission tomography using 2-deoxy-2-[18F]fluoro-d-glucose (FDG-PET) was performed and showed weak FDG accumulation (SUVmax = 2.0) in the nodule, which did not positively indicate malignancy. Because a follow-up CT showed a rapid increase in the size of the nodule, partial resection of S2 segment in the right upper lobe was performed. The histopathological diagnosis was a metastasis from choriocarcinoma. The tumor consisted largely of necrosis and hemorrhage, and it was considered to be a major cause of the unusual FDG-PET and CT findings..
144. Masato Yonezawa, K. Higuchi, Yuzo Yamasaki, M. Jinnouchi, Y. Maruoka, Takuro Isoda, Takeshi Kamitani, Shingo Baba, Y. Matsuo, K. Abe, Hiroshi Honda, Coronary stenosis severity assessed by 256-slice MDCT angiography in comparison with stress myocardial perfusion imaging, Japanese Journal of Clinical Radiology, 57, 1, 136-141, 2012.01, We evaluated the feasibility of 256-slice MDCT for detecting coronary artery stenosis without beta blocker premedication, and assessed the diagnostic accuracy of MDCT for detecting myocardial ischemia by 201Tl SPECT. Fifty-three patients underwent both coronary CT angiography and stress myocardial perfusion SPECT. All coronary arteries were assessable with appropriate image quality. MDCT revealed high specificity, but only half of stenotic lesion by MDCT revealed ischemia on SPECT..
145. Akiko Shinmura, Koichiro Abe, Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Fumiko Yasukawa, Hiromaro Kiryu, Masayuki Sasaki, Masutaka Furue, Hiroshi Honda, FDG PET/CT findings in acquired perforating dermatosis., Clinical nuclear medicine, 37, 10, 997-1000, 2012.01, ABSTRACT: Acquired perforating dermatosis (APD) is an uncommon cutaneous perforating disorder. We report a patient on hemodialysis who developed skin eruption and jaundice. He underwent FDG PET/CT under suspicion of biliary malignancies. PET/CT showed no significant abnormal uptake except of multiple FDG-avid nodules in the skin. The eruption he had was histopathologically diagnosed as APD by skin biopsy. His case suggests that APD should be considered as a differential diagnosis when multiple cutaneous FDG accumulations are found in a patient on hemodialysis. To the best of our knowledge, this is the first report showing the FDG PET/CT findings of APD..
146. Katsuhiko Mitsumoto, Koichiro Abe, Yuichi Sakaguchi, Tiejiao Zhang, Yosuke Tachiya, Nobuyoshi Ohya, Shingo Baba, Masayuki Sasaki, Determination of the optimal acquisition protocol of breath-hold PET/CT for the diagnosis of thoracic lesions, Nuclear Medicine Communications, 10.1097/MNM.0b013e32834bbda7, 32, 12, 1148-1154, 2011.12, Objective: The aim of this study was to determine the optimal acquisition scan protocol for deep inspiration breath-hold (BH) fluoro-2-deoxy-D-glucose positron emission tomography (PET) for the examination of thoracic lesions. Methods: We studied 32 thoracic lesions in 21 patients. Whole-body PET/computed tomography (CT) scanning with free breathing (FB) was performed for 3 min per bed position, followed by a BH-CT and five BH-PET for 20 s each. Summed BH images with total acquisition times of 40, 60, 80 and 100 s were generated (BH×2, BH×3, BH×4 and BH×5, respectively). The displacements between PET and CT images, the lesion volume of the PET image, the maximum standardized uptake value (SUVmax) and the quality of the PET image were assessed in relation to the clinical characteristics of each patient and the summation of the BH-PET images. Results: BH-PET decreased the tumor volume significantly (FB: 7.23±9.70 cm3, BH×5: 4.71±5.14 cm3, P<0.01) and increased the SUVmax (FB: 6.27±5.41, BH×5: 7.53±6.28, P<0.01). The displacement between the PET and CT images was improved significantly in the BH scans (FB: 0.77±0.53 cm, BH×5: 0.36±0.24 cm, P<0.01). In addition, aging and lung function of patients influenced the reproducibility of BH-PET. The summed BH-PET images, obtained by summation of three or more BH-PET images (total acquisition time of 60 s or more), achieved good image quality. Conclusion: BH-PET/CT improved the misregistration between PET and CT images and increased the SUVmax of thoracic lesions. The recommended number of BH-PET images for summation with 20 s of acquisition time is three or more..
147. Shingo Baba, Koichiro Abe, Takuro Isoda, Yasuhiro Maruoka, Masayuki Sasaki, Hiroshi Honda, Impact of FDG-PET/CT in the management of lymphoma, Annals of Nuclear Medicine, 10.1007/s12149-011-0549-0, 25, 10, 701-716, 2011.12, Since the introduction of 67Gallium-citrate 30 years ago, nuclear medicine has played an important role in the evaluation of malignant lymphoma. During that time, several radiotracers were evaluated as potential alternatives for the diagnosis of lymphoma, but the introduction of 18F-fluorodeoxyglucose PET (FDG-PET) marked a major turning point. FDG-PET took over most of the role of gallium, and is now an essential tool in the diagnosis of lymphoma. FDG-PET is increasingly being used for assessment of the tumor staging prior to treatment, for evaluating the response to treatment, and for monitoring the early reactions to therapy to predict the final outcome. FDG-PET has been shown to have more accurate diagnostic capability than conventional CT and MRI for distinguishing the tumor necrosis and residual masses frequently seen after therapy in lymphoma patients without any clinical and biochemical manifestation. Malignant lymphoma is the first disease for which FDG-PET was adopted as a tool for response assessment in the international standard criteria. However, lymphoma does not always display a clear high uptake, and there are some pitfalls in assessing the response to therapy. This review will highlight the most important applications of FDG-PET in lymphoma, focusing on the advantages and pitfalls of this imaging, and past and ongoing efforts to standardize the use of FDG-PET, particularly in response to assessment and therapy monitoring..
148. Yuichi Sakaguchi, Noriko Mizoguchi, Tatsuya Mitsumoto, Katsuhiko Mitsumoto, Kazuhiko Himuro, Nobuyoshi Ohya, Koichiro Kaneko, Shingo Baba, Koichiro Abe, Yoshihiko Onizuka, Masayuki Sasaki, A simple table lookup method for PET/CT partial volume correction using a point-spread function in diagnosing lymph node metastasis, Annals of Nuclear Medicine, 10.1007/s12149-010-0401-y, 24, 8, 585-591, 2010.10, Objective: We evaluated the partial volume effect in PET/CT images and developed a simple correction method to address this problem. Methods: Six spheres and the background in the phantom were filled with F-18 and we thus obtained 4 different sphere-to-background (SB) ratios. Thirty-nine cervical lymph nodes in 7 patients with papillary thyroid carcinoma (15 malignant and 24 benign) were also examined as a preliminary clinical study. First, we developed recovery coefficient (RC) curves normalized to the maximum counts of the 37-mm sphere. Next, we developed a correction table to determine the true SB ratio using three parameters, including the maximum counts of both the sphere and background and the lesion diameter, by modifying the approximation formula of the RC curves including the point-spread function correction. The full width at half maximum in this formula is estimated with the function of the SB ratio. Results: In the phantom study, a size-dependent underestimation of the radioactivity was observed. The degree of decline of RC was influenced by the SB ratio. In preliminary clinical examination, the difference in the SUV max between malignant and benign LNs thus became more prominent after the correction. The PV correction slightly improved the diagnostic accuracy from 95 to 100%. Conclusions: We developed a simple table lookup correction method for the partial volume effect of PET/CT. This new method is considered to be clinically useful for the diagnosis of cervical LN metastasis. Further examination with a greater number of subjects is required to corroborate its clinical usefulness..
149. Shingo Baba, Heather A. Jacene, James M. Engles, Hiroshi Honda, Richard L. Wahl, CT Hounsfield Units of Brown Adipose Tissue Increase with Activation: Preclinical and Clinical Studies, J Nucl Med. , vol51, 2, 246-25-, 2010.02.
150. Shingo Baba, Heather A. Jacene, James M. Engles, Hiroshi Honda, Richard L. Wahl, CT Hounsfield units of brown adipose tissue increase with activation
preclinical and clinical studies, Journal of Nuclear Medicine, 10.2967/jnumed.109.068775, 51, 2, 246-250, 2010.02, Brown adipose tissue (BAT) densities assessed as CT Hounsfield units (HUs) were evaluated in a rodent model and in patients to determine whether HUs changed in relation to BAT activity. Methods: Serial 18F-FDG PET/CT was performed on rats under both room temperature control conditions and after 4 h of cold-stimulation, which is known to activate BAT. The maximum standardized uptake values and CT HUs of BAT were measured, and tissues were examined in the laboratory. Image records from cancer patients who underwent PET/CT were reviewed, and 23 patients were identified who displayed both high and low 18F-FDG uptake into BAT on serial 18F-FDG PET/CT scans. The maximum standardized uptake values and CT HUs of BAT were compared in these scans. Results: The mean (±SD) CT HUs of cold-activated BAT (-12.4 ± 22.4) were significantly higher than those (-27.9 ± 9.6) of the controls in the rat model. The CT HUs of BAT (-71.6 ± 18.0) in the patients with high 18F-FDG uptake were significantly higher than those (-104.4 ± 16.8) of the patients with low 18F-FDG uptake . A decrease in relative lipid content is seen in activated BAT in rats on histology. Conclusion: The CT HUs of BAT increased in activated conditions in both animals and patients, likely because of lipid consumption by activated BAT..
151. Koichiro Kaneko, Koichiro Abe, Shingo Baba, Yoshitaka Tanabe, Hidetake Yabuuchi, Masamitsu Hatakenaka, Masayuki Sasaki, Hiroshi Honda, Can calcification predict 131I accumulation on metastatic lymph nodes in papillary thyroid carcinoma patients receiving 131I therapy? Comparison of CT, 131I WBS and 18F-FDG PET/CT, European Radiology, 10.1007/s00330-009-1557-5, 20, 2, 477-483, 2010.02, Objective: The aim of this study was to clarify the predictive significance of nodal calcification in terms of the therapeutic option of 131I therapy in papillary thyroid carcinoma (PTC) patients. Methods: We reviewed 19 computed tomography (CT) examinations of PTC patients on receiving 131I therapy for the presence of nodal calcification, and compared the 131I whole-body scintigraphy and 18F-2-fluoro-2-deoxy- D-glucose (FDG) positron emission tomography (PET)/CT findings. The metastatic lymph nodes (mLNs) were divided into three groups: A, those with calcification; B, those without calcification but belonging to patients who had calcified mLNs; C, those without calcification and belonging to patients who had no calcified mLNs. The incidences of 131I accumulation and maximum standardised uptake values (SUV max) in the three groups were compared. Results: A total of 70 mLNs were evaluated. Twelve mLNs belonged to group A, 13 to group B and 45 to group C. The incidences of 131I accumulation were significantly higher in groups A (100%) and B (100%) than in group C (11.1%) (p<0.0001 for both). The SUVmax was significantly lower in groups A (4.1±1.9) and B (3.9±1.4) than in group C (7.1±4.4) (p=0.01, p=0.002, respectively). Conclusions: Our results indicated that calcification in mLNs related to the ability of 131I accumulation and less dedifferentiation..
152. Shinji Ogawa, Hiroaki Kobayashi, Satoshi Amada, Hideaki Yahata, Kenzo Sonoda, Koichiro Abe, Shingo Baba, Masayuki Sasaki, Tsunehisa Kaku, Norio Wake, Sentinel node detection with 99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy, International Journal of Clinical Oncology, 10.1007/s10147-009-0010-8, 15, 1, 52-58, 2010.02, Background: If the sentinel-lymph-node (SLN) concept is valid in cervical cancer, most patients could avoid pelvic lymphadenectomy when absence of metastasis is intraoperatively confirmed in the SLN. We assessed feasibility and accuracy of SLN detection using 99mTc phytate in patients with cervical cancer. Methods: Eighty-two women with stage Ia-IIb cervical cancer enrolled in this study. All underwent hysterectomy or trachelectomy with accompanying total pelvic lymphadenectomy. On the day before surgery, we injected fluid containing 99mTc-labeled phytate subepithelially into four cervical quadrants outside the tumor. Intraoperatively, SLNs were identified as radioactive "hot nodes" by gamma probe. Systematic bilateral pelvic lymphadenectomy was performed after the hot node sampling to evaluate the predictive ability of hot nodes. Results: A total of 157 lymph nodes were detected as SLNs in 72 of 82 patients. SLN detection rate was 88%. Detection rate was 95% for the subgroups of patients with stage Ia-Ib1 disease and smaller tumor size (≤3 cm in maximal diameter). Lymph node metastasis was found in 15 patients. In 3 of them, no SLNs were detected. In the remaining 12 patients, each ipsilateral SLN contained metastasis when the pelvic lymph nodes contained metastases. Sensitivity was 100%, the false negative rate was 0%, and the negative predictive value of SLN was 100%. Conclusion: We conclude SLN detection using 99mTc-labeled phytate is satisfactory to assess pelvic nodes in patients with early cervical cancer; if validated with other research, it should be incorporated into clinical practice..
153. Koichiro Kaneko, Koichiro Abe, Shingo Baba, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Masamitsu Hatakenaka, Hiroshi Honda, Detection of residual lymph node metastases in high-risk papillary thyroid cancer patients receiving adjuvant I-131 therapy
The usefulness of F-18 FDG PET/CT, Clinical nuclear medicine, 10.1097/RLU.0b013e3181c3b737, 35, 1, 6-11, 2010.01, Objective: The aims of this retrospective study were to evaluate the incidence of residual lymph node (LN) metastases in high-risk papillary thyroid cancer (PTC) patients receiving adjuvant I-131 therapy, especially in those without I-131 accumulation, and to evaluate the clinical usefulness of F-18 FDG PET/CT to detect those lesions. Methods: The 37 PTC patients receiving adjuvant I-131 therapy were retrospectively evaluated. We examined the incidence of residual LN metastasis and compared the accumulation of F-18 FDG and I-131 in those lesions, and compared the serum thyroglobulin (Tg) levels between patients with and without residual LN metastases. Result: A total of 33 lesions were diagnosed as residual LN metastases in 9 patients. FDG accumulated in all of the lesions, but 19 lesions (57.6%) of them had no I-131 accumulation. The SUVmax was significantly higher in lesions without I-131 accumulation than in lesions with I-131 accumulation (6.6 ± 2.8 vs. 4.2 ± 1.8; P = 0.007). The serum Tg levels were significantly higher in patients with residual LN metastases than in patients without it (709.9 ± 1470.8 vs. 25.6 ± 37.1 ng/mL; P = 0.005). The incidence of residual LN metastasis was significantly higher in patients with a detectable serum Tg level than in patients without it (35.0% vs. 0%, P = 0.03). Conclusion: These results indicate that the residual LN metastasis was relatively common in high-risk PTC patients receiving adjuvant I-131 therapy whose serum Tg levels remained detectable, and those lesions often had no I-131 accumulation. FDG-PET/CT would be recommended for PTC patients with detectable serum Tg levels to detect residual LN metastases..
154. Heather A. Jacene, Sophie Leboulleux, Shingo Baba, Daniel Chatzifotiadis, Behnaz Goudarzi, Oleg Teytelbaum, Karen M. Horton, Ihab Kamel, Katarzyna J. Macura, Hua Ling Tsai, Jeanne Kowalski, Richard L. Wahl, Assessment of interobserver reproducibility in quantitative 18F-FDG PET and CT measurements of tumor response to therapy, Journal of Nuclear Medicine, 10.2967/jnumed.109.063321, 50, 11, 1760-1769, 2009.11, Our goal was to estimate and compare across different readers the reproducibility of the 18F-FDG PET standardized uptake value (SUV) and CT size measurements, and changes in those measurements, in malignant tumors before and after therapy. Methods: Fifty-two tumors in 25 patients were evaluated on 18F-FDG PET/CT scans. Maximum SUVs (SUVbw max) and CT size measurements were determined for each tumor independently on pre- and posttreatment scans by 8 different readers (4 PET, 4 CT) using routine nonautomated clinical methods. Percentage changes in SUVbw max and CT size between pre- and posttreatment scans were calculated. Interobserver reproducibility of SUVbw max, CT size, and changes in these values were described by intraclass correlation coefficients (ICCs) and estimates of variance. Results: The ICC was higher for the pretreatment, posttreatment, and percentage change in SUVbw max than the ICC for the longest CT size and the 2-dimensional CT size (before treatment, 0.93, 0.72, and 0.61, respectively; after treatment, 0.91, 0.85, and 0.45, respectively; and percentage change, 0.94, 0.70, and 0.33, respectively). The variability of SUVbw max was significantly lower than the variability of the longest CT size and the 2-dimensional CT size (mean ± SD before treatment, 6.3% ± 14.2%, 16.2% ± 17.8%, and 27.5% ± 26.7%, respectively, P ≤ 0.001; and after treatment, 18.4% ± 26.8%, 35.1% ± 47.5%, and 50.9% ± 51.4%, respectively, P ≤ 0.02). The variability of percentage change in SUVbw max (16.7% ± 36.2%) was significantly lower than that for percentage change in the longest CT size (156.3% ± 157.3%, P ≤ 0.0001) and the 2-dimensional CT size (178.4% ± 546.5%, P < 0.0001). Conclusion: The interobserver reproducibility of SUVbw max for both untreated and treated tumors and percentage change in SUVbw max are substantially higher than measurements of CT size and percentage change in CT size. Measurements of tumor metabolism by PET should be included in trials to assess response to therapy. Although PET reproducibility was high, the variability observed in analyses of identical image sets by 4 readers indicates that automated analytic tools to assess response might be helpful to further enhance reproducibility..
155. Masayuki Sasaki, Koichiro Abe, Shingo Baba, Hiroshi Sawamoto, Yoshitaka Tanabe, Application of PET-CT in the treatment of lung cancer, Gan to kagaku ryoho. Cancer & chemotherapy, 36, 8, 1271-1274, 2009.08.
156. Tashima Y, Abe K, Matsuo Y, Baba S, Kaneko K, Isoda T, Yabuuchi H, Sasaki M, Honda H, Pulmonary tumor thrombotic microangiopathy: FDG-PET/CT findings, Clin Nucl Med, 34(3):175-7,2009.03., 2009.05.
157. Abe K, Baba S, Kaneko K, Isoda T, Yabuuchi H, Sasaki M, Sakai S, Yoshino I, Honda H, Diagnostic and prognostic values of FDG-PET in patients with non-small cell lung cancer., Clin Imaging., 33(2):90-5., 2009.03.
158. Koichiro Abe, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Shuji Sakai, Ichiro Yoshino, Hiroshi Honda, Diagnostic and prognostic values of FDG-PET in patients with non-small cell lung cancer, Clinical Imaging, 10.1016/j.clinimag.2008.06.032, 33, 2, 90-95, 2009.03, Purpose: The aim of this study was to address the efficacy of 2-[F-18]-Fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in the staging of non-small cell lung cancer (NSCLC) and in prognostic prediction in patients with NSCLC. Methods: Forty-four patients (26 males, 18 females) were analyzed. Results: Accurate staging was obtained by addition of FDG-PET. Multivariate analysis indicated that the standardized uptake value of the primary tumor was the most significant prognostic factor for disease-free survival (P=.0073). Conclusion: FDG-PET is useful for the diagnosis of NSCLC and for prognostic prediction in patients with NSCLC..
159. Yoshiko Tashima, Koichiro Abe, Yoshio Matsuo, Shingo Baba, Koichiro Kaneko, Takuro Isoda, Hidetake Yabuuchi, Masayuki Sasaki, Hiroshi Honda, Pulmonary tumor thrombotic microangiopathy FDG-PET/CT findings, Clinical nuclear medicine, 10.1097/RLU.0b013e3181966f5c, 34, 3, 175-177, 2009.03, Pulmonary tumor thrombotic microangiopathy (PTTM) is his- topathologically characterized by proliferation of intimal myofibroblasts in the small pulmonary arterioles, induced by tumor microemboli. Patients develop rapidly progressive and severe cardiopulmonary failure, and the clinical course of this disease is fatal. Conventional radiologic findings are often minimal or nonspecific, making diagnosis difficult before death. We report 2-(F-18)-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) images of PTTM, which illustrate the characteristic findings of this clinical entity. FDG-PET can be helpful for the diagnosis of PTTM..
160. Shingo Baba, James M. Engles, David L. Huso, Takayoshi Takayoshi, and Richard L. Wahl, Comparative Uptake of Multiple Clinical Radiotracers into Brown Adipose Fat Tissue under Cold Stimulated and Non- stimulated Conditions, J Nucl Med., Oct;48(10):1715-23., 2007.10.
161. Shingo Baba, James M. Engles, David L. Huso, Takayoshi Ishimori, Richard L. Wahl, Comparison of uptake of multiple clinical radiotracers into brown adipose tissue under cold-stimulated and nonstimulated conditions, Journal of Nuclear Medicine, 10.2967/jnumed.107.041715, 48, 10, 1715-1723, 2007.10, Our objective was to determine whether multiple clinically useful radiotracers accumulate in brown adipose tissue (BAT) and to assess their uptake in rats kept at room temperature or exposed to a cold environment. Methods: The following radiotracers were injected intravenously into groups of 6 female Wistar rats: 201Tl-chloride (TlCl), 123I- metaiodobenzylguanidine (MIBG), 99mTc-sestamibi (MIBI), 18F- or 3H-FDG, 3H-L-methionine, and 3H-thymidine. BAT-stimulated animals were maintained at 4°C for 4 h before tracer injection, whereas control animals were kept at approximately 22.5°C. The animals were sacrificed at 20-60 min after tracer injection, and BAT, major organs, and blood were extracted, weighed, and measured for radioactivity. The localization of uncoupling protein-1, glucose transporter-1, and norepinephrine transporter was evaluated with immunohistochemical staining in both groups. Results: We determined the percentage injected dose (%ID) per gram of each radiotracer in interscapular BAT, normalized to blood %ID/g. In control animals, this uptake ratio (6SD) was 8.44 ± 3.39 for 201TlCl, 9.77 ± 6.06 for 123IMIBG, 37.30 ± 14.42 for 99mTc-MIBI, 5.47 ± 4.44 for 18F- or 3H-FDG, 1.93 ± 0.87 for 3H-L-methionine, and 1.22 ± 0.74 for 3Hthymidine. Compared with uptake at room temperature, uptake after exposure to cold increased 26.4-fold (P < 0.01) for 18F- or 3H-FDG and increased significantly (P < 0.05) for 201Tl (2.04-fold), 123I-MIBG (3.25-fold), and 3H-L-methionine (3.11-fold). Immunohistochemical staining revealed increased glucose transporter-1 and norepinephrine transporter expression in BAT cell membranes and blood vessels after exposure to cold, whereas uncoupling protein-1 was expressed in the cytoplasm under both control and cold-stimulated conditions. Conclusion: BAT uptake of 18F- or 3H-FDG, 123I-MIBG, and 3H-L-methionine was significantly increased over the control state by exposure to cold. Increased uptake of 201TlCl relative to blood in cold-stimulated BAT suggests that blood flow in BAT is increased by exposure to cold. The greater increased uptake with 18F- or 3H-FDG, 123I-MIBG, and 3H-L-methionine, and the immunohistostaining findings, suggest that other factors in addition to blood flow (e.g., increased metabolism, increased transport, or metabolic trapping of the tracers) are involved in cold-stimulated BAT activation. Knowledge that high uptake in BAT may possibly be observed on clinical scans using several radiotracers, especially after patients are exposed to the cold, may lead to more accurate interpretation of clinical studies..
162. Shingo Baba, Steve Y. Cho, Zhaohui Ye, Linzhao Cheng, James M. Engles, Richard L. Wahl, How Reproducible is Bioluminescent Imaging of Tumor Cell Growth? : Single Time Point v.s. Dynamic Measurement Approach, Molecular Imaging. , 2007 Sep-Oct;6(5):315-22., 2007.09.
163. Shingo Baba, Steve Y. Cho, Zhaohui Ye, Linzhao Cheng, James M. Engles, Richard L. Wahl, How reproducible is bioluminescent imaging of tumor cell growth? Single time point versus the dynamic measurement approach, Molecular Imaging, 10.2310/7290.2007.00031, 6, 5, 315-322, 2007.09, To determine the most robust and reproducible parameters for noninvasively estimating tumor cell burden in a murine model, we used real-time in vivo bioluminescent imaging to assess the growth kinetics and dissemination of luciferase-transfected Raji B-cell lymphoma. Bioluminescent signals were acquired every minute for 40 minutes after luciferin injection every other day post-tumor injection. The total 40-minute area under the curve (AUC) of photon intensity (photons/second) was calculated and compared with simplified fixed time point observations (every 5 minutes from 5 to 40 minutes after substrate injection). There was substantial variability in the shape of the time signal intensity curves at different stages of tumor growth in both the intravenous and subcutaneous models. The coefficient of variance in the AUC was 0.27 (intravenous) and 0.36 (subcutaneous) as values determined by fitting the curve, whereas the 20-minute time point measurement varied at 0.29 (intravenous) and 0.37 (subcutaneous). In both the subcutaneous and intravenous models, single time point measurements at 20 minutes had the highest correlation value with AUC. This simplified single time point measurement appears appropriate to estimate the total tumor burden in this model, but the substantial variance at each measurement must be considered in experimental designs..
164. Shingo Baba, Mitsuaki Tatsumi, Takayoshi Ishimori, David Lilien, James M Engles, and Richard L Wahl, Effect of Nicotine and Ephedrine on the Accumulation of FDG in Brown Adipose Fat Tissue, J Nucl Med. , 2007 Jun;48(6):981-6, 2007.06.
165. Shingo Baba, Mitsuaki Tatsumi, Takayoshi Ishimori, David L. Liliein, James M. Engles, Richard L. Wahl, Effect of nicotine and ephedrine on the accumulation of 18F-FDG in brown adipose tissue, Journal of Nuclear Medicine, 10.2967/jnumed.106.039065, 48, 6, 981-986, 2007.06, This study evaluated the effect of various β-adrenergic agonists on 18F-FDG uptake in brown adipose tissue (BAT) in rats using ex vivo biodistribution studies. Methods: Caffeine (10 mg/kg of body weight, n = 4), ephedrine (5 mg/kg of body weight, n = 4), nicotine (0.8 mg/kg of body weight, n = 9), or a mixture of nicotine and ephedrine (0.8 mg/kg of body weight and 5 mg/kg of body weight, respectively, n = 9) was injected into the peritoneal cavity of female Lewis rats 30 min before intravenous 18F-FDG injection. One hour after injection of 18F-FDG, the animals were sacrificed, and BAT, other major organs, and blood were extracted. The biodistribution results were compared with body temperature data. Results: In the rats injected with nicotine or ephedrine, the mean uptake of 18F-FDG, in percentage injected dose (%ID)/(g of interscapular BAT) x (kg of body weight), was significantly increased (7.9-fold for nicotine and 3.7-fold for ephedrine), compared to the control rats. Nicotine had the strongest effect on 18F-FDG uptake in BAT. Caffeine increased BAT uptake slightly, but this increase did not reach statistical significance. The combination of nicotine and ephedrine increased the uptake 12.0-fold, compared with control rats; more than either nicotine or ephedrine alone. Uptake of 18F-FDG in most other major organs did not change significantly. The effect of nicotine was blocked by prior injection of β-adrenergic antagonists. A transient decrease in body temperature was observed in the nicotine-injected group, and this effect was canceled by prior injection of β-adrenergic antagonists. No significant change in baseline temperature was seen before or after β-adrenergic agonist injection. Conclusion: Nicotine caused a greater increase in 18F-FDG uptake in BAT than did other interventions, and the effect was increased when nicotine was combined with ephedrine. The effect of nicotine was completely blocked by prior injection of β-adrenergic antagonists, indicating that β-adrenergic agonists increase the metabolism of BAT. These preclinical data suggest that patients should avoid nicotine and ephedrine before undergoing 18F-FDG PET to minimize 18F-FDG uptake in BAT..
166. Jespersgaard C, Larsen LA, Baba S, Kukita Y, Tahira T, Christiansen M, Vuust J, Hayashi K, Andersen PS., Optimization of capillary array electrophoresis single-strand conformation polymorphism analysis for routine molecular diagnostics., Electrophoresis., 2006 Oct;27(19):3816-22., 2006.10.
167. Cathrine Jespersgaard, Lars Allan Larsen, Shingo Baba, Yoji Kukita, Tomoko Tahira, Michael Christiansen, Jens Vuust, Kenshi Hayashi, Paal Skytt Andersen, Optimization of capillary array electrophoresis single-strand conformation polymorphism analysis for routine molecular diagnostics, ELECTROPHORESIS, 10.1002/elps.200600095, 27, 19, 3816-3822, 2006.10, Mutation screening is widely used for molecular diagnostics of inherited disorders. Furthermore, it is anticipated that the present and future identification of genetic risk factors for complex disorders will increase the need for high-throughput mutation screening technologies. Capillary array electrophoresis (CAE) SSCP analysis is a low-cost, automated method with a high throughput and high reproducibility. Thus, the method fulfills many of the demands to be met for application in routine molecular diagnostics. However, the need for performing the electrophoresis at three temperatures between 18°C and 35°C for achievement of high sensitivity is a disadvantage of the method. Using a panel of 185 mutant samples, we have analyzed the effect of sample purification, sample medium and separation matrix on the sensitivity of CAE-SSCP analysis to optimize the method for molecular diagnostic use. We observed different effects from sample purification and sample medium at different electrophoresis temperatures, probably reflecting the complex interplay between sequence composition, electrophoresis conditions and sensitivity in SSCP analysis. The effect on assay sensitivity from three different polymers was tested using a single electrophoresis temperature of 27°C. The data suggest that a sensitivity of 98-99% can be obtained using a 10% long chain poly-N,N-dimethylacrylamide polymer..
168. Abe K, Sasaki M, Kuwabara Y, Koga H, Baba S, Hayashi K, Takahashi N, Honda H, Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer, Ann Nucl Med, 10.1007/BF02985050, 19, 7, 573-579, 2005.10, 2005.10.
169. Tomoko Tahira, Shingo Baba, Koichiro Higasa, Yoji Kukita, Yutaka Suzuki, Sumio Sugano, Kenshi Hayashi, dbQSNP
A database of SNPs in human promoter regions with allele frequency information determined by single-strand conformation polymorphism-based methods, Human Mutation, 10.1002/humu.20196, 26, 2, 69-77, 2005.08, We present a database, dbQSNP (http://qsnp.gen.kyushu-u.ac.jp/), that provides sequence and allele frequency information for single-nucleotide polymorphisms (SNPs) located in the promoter regions of human genes, which were defined by the 5′ ends of full-length cDNA clones. We searched for the SNPs in these regions by sequencing or single-strand conformation polymorphism (SSCP) analysis. The allele frequencies of the identified SNPs in two ethnic groups were quantified by SSCP analyses of pooled DNA samples. The accuracy of our estimation is supported by strong correlations between the frequencies in our data and those in other databases for the same ethnic groups. The frequencies vary considerably between the two ethnic groups studied, suggesting the need for population-based collections and allele frequency determination of SNPs, in, e.g., association studies of diseases. We show profiles of SNP densities that are characteristic of transcription start site regions. A fraction of the SNPs revealed a significantly different allele frequency between the groups, suggesting differential selection of the genes involved..
170. Abe K, Sasaki M, Kuwabara Y, Koga H, Baba S, Kaneko K, Hayashi K, Shioyama Y, Tajiri T, Suita S, Honda H, Extraosseous accumulation of (99m)Tc-HMDP to radiation nephropathy, mimicking recurrent neuroblastoma., Ann Nucl Med , 10.1007/BF02986333, 19, 1, 35-40, 19(1):35-40,2005.02, 2005.02.
171. Kaneko K, Kuwabara Y, Sasaki M, Koga H, Abe K, Baba S, Hayashi K, Honda H, Validation of quantitative accuracy of the post-injection transmission-based and transmissionless attenuation correction techniques in neurological FDG-PET, Nucl Med Commun, 10.1097/00006231-200411000-00005, 25, 11, 1095-1102, 19(1):35-40,2005.02, 2004.11.
172. Shingo Baba, Y. Kukita, K. Higasa, T. Tahira, K. Hayashi, Single-stranded conformational polymorphism analysis using automated capillary array electrophoresis apparatuses, BioTechniques, 34, 4, 746-750, 2003.04, We describe a new environment of a single-stranded conformational polymorphism (SSCP) analysis using automated capillary array sequencers (e.g., ABI PRISm® 3100 and 3700). In this environment, electrophoretic conditions, settings for instrument management, and software for data analysis are adjusted for SSCP analysis. Highly reproducible results are obtained with this new system, and fragments with mutations and/or polymorphisms in different capillaries or different runs can be reliably detected. The relative peak heights between alleles are quantitative and reproducible between runs, and so allele frequencies of single nucleotide polymorphisms can be accurately estimated by a pooled DNA strategy. The method allows unattended, low-cost, and quantitative SSCP analysis using instruments that are widely accessible..
173. Koichiro Higasa, Yoji Kukita, Shingo Baba, Kenshi Hayashi, Software for machine-independent quantitative interpretation of SSCP in capillary array electrophoresis (QUISCA), BioTechniques, 33, 6, 1342-1348, 2002.12, PCR single-stranded conformational polymorphism (SSCP) analysis is a simple and rapid electrophoretic technique for the sensitive detection of sequence variants of PCR products. Here we describe a cross-platform program package, quantitative interpretation of SSCP in capillary array (QUISCA), which allows semi-automated quantitative detection of sequence variants separated by multicolor fluorescence-based SSCP electrophoresis using various capillary array apparatus. The program, together with the QUISCAview as a graphical user interface, takes trace data in ASCII format and processes them with three modules: signal denoising/baseline subtraction, color-matrix construction/application, and calibration of peak positions between multiple capillary runs using internal standard peaks. QUISCA is compatible with data from various widely used capillary array sequencers and is suitable not only for finding or typing SNPs in individual DNAs but also for the accurate estimation of the allele frequencies of many SNPs using a pooled DNA strategy. QUISCA can also serve as a versatile core program for various fragment analyses..
174. Yoji Kukita, Sachi Manago, Shingo Baba, Kenshi Hayashi, Hemi-stranded SSCP analysis of SNPs in short sequence-tagged sites, BioTechniques, 33, 5, 1118-1121, 2002.11.
175. Yoji Kukita, Koichiro Higasa, Shingo Baba, Michihiro Nakamura, Sachi Manago, Akari Suzuki, Tomoko Tahira, Kenshi Hayashi, A single-strand conformation polymorphism method for the large-scale analysis of mutations/polymorphisms using capillary array electrophoresis, Electrophoresis, 10.1002/1522-2683(200207)23:14<2259::AID-ELPS2259>3.0.CO;2-8, 23, 14, 2259-2266, 2002.07, We present a high-throughput single-strand conformation polymorphism (SSCP) method, performed on a commercially available capillary array DNA sequencer. We tested various sieving matrices and electrophoretic conditions, using 51 DNA fragments which included 45 fragments carrying only one single nucleotide polymorphism (SNP), 4 fragments having two SNPs and 2 fragments with insertion or deletion. Resolution of alleles was improved by increasing concentrations of both sieving matrices and buffers, and all examined polymorphisms of DNA fragments were detected, most of them (45 fragments) as clearly split allele peaks in heterozygotes. Allele frequencies of SNPs can be estimated accurately by determining the relative amounts of alleles in pooled DNA. In this method, the turn-around time for the analysis of 96 samples is less than 3 h. These results demonstrate that capillary array-based SSCP is an efficient and accurate technique for the large-scale quantitative analysis of mutations/polymorphisms..
176. Tomonari Sasaki, T. Tahira, A. Suzuki, K. Higasa, Y. Kukita, Shingo Baba, K. Hayashi, Precise estimation of allele frequencies of single-nucleotide polymorphisms by a quantitative SSCP analysis of pooled DNA, American journal of human genetics, 10.1086/316928, 68, 1, 214-218, 2001.01, We show that single-nucleotide polymorphisms (SNPs) of moderate to high heterozygosity (minor allele frequencies >10%) can be efficiently detected, and their allele frequencies accurately estimated, by pooling the DNA samples and applying a capillary-based SSCP analysis. In this method, alleles are separated into peaks, and their frequencies can be reliably and accurately quantified from their peak heights (SD <1.8%). We found that as many as 40% of publicly available SNPs that were analyzed by this method have widely differing allele frequency distributions among groups of different ethnicity (parents of Centre d'Etude Polymorphisme Humaine families vs. Japanese individuals). These results demonstrate the effectiveness of the present pooling method in the reevaluation of candidate SNPs that have been collected by examination of limited numbers of individuals. The method should also serve as a robust quantitative technique for studies in which a precise estimate of SNP allele frequencies is essential - for example, in linkage disequilibrium analysis..
177. Hiroyuki Irie, Hiroshi Honda, Shingo Baba, Toshiro Kuroiwa, Kengo Yoshimitsu, Tsuyoshi Tajima, Makiko Jimi, Toshihiko Sumii, Kouji Masuda, Original report. Autoimmune pancreatitis
CT and MR characteristics, American Journal of Roentgenology, 170, 5, 1323-1327, 1998.05, OBJECTIVE. Our goal was to elucidate the CT and MR imaging characteristics in patents with autoimmune pancreatitis, which is a reversible chronic pancreatitis with an autoimmune cause. CONCLUSION. On CT and MR imaging, a capsulelike rim, which is thought to correspond to an inflammatory process involving peripancreatic tissues, appears to be a characteristic finding of autoimmune pancreatitis. Also, diffuse pancreatic enlargement along with hypointensity on T1-weighted MR images and delayed enhancement on dynamic CT and MR studies are other features of this disorder..
178. Toshihiko Katafuchi, Keisuke Motomura, Shingo Baba, Kazuki Ota, Tetsuro Hori, Differential effects of tumor necrosis factor-α and -β on rat ventromedial hypothalamic neurons in vitro, American Journal of Physiology - Regulatory Integrative and Comparative Physiology, 272, 6 41-6, 1997.08, The effects of tumor necrosis factor (TNF)-α and -β on the spontaneous firing rate of ventromedial hypothalamic (VMH) neurons were examined in rat brain slice preparations. Of 89 neurons, 36 (40%) showed a decrease in the firing rate to 78.2 ± 4.0% (n = 36, mean ± SE) of the preapplication level after a bath application of 20 ng/ml (~1.2 nM) of TNF- α. This response to TNF-α still persisted in a low-Ca2+, high-Mg2+ medium. Six (7%) of the 89 neurons were excited and 47 (53%) were unaffected by TNF-α. The inhibitory responses induced by TNF-α were abolished in a solution that contained sodium salicylate (1.9 x 10-8 M). In contrast, TNF-β at a dose of 20 ng/ml (~1.1 nM) increased the firing rate to +39.2 ± 6.5% (n = 11) of the preapplication level in 11 (24.5%) of 45 VMH neurons. Two of the 45 neurons (4.5%) were inhibited and 32 (71%) were unaffected by TNF-β. The threshold concentration of TNF-α to alter the VMH neuron activity was lower than that of TNF-β. Heat-inactivated TNFs were without effect. These findings suggest that TNF-α and -β act as neuromodulators in the VMH, at least partly through prostaglandin synthesis, and differentially modulate the VMH neuron activity..