Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Togao Osamu Last modified date:2020.07.03

Associate Professor / Radiology Center / Faculty of Medical Sciences


Papers
1. K. Nakamura, N. Shikama, Osamu Togao, S. Sasaki, A. Shinoda, N. Kunitake, M. Kimura, T. Watanabe, Tomonari Sasaki, H. Terashima, K. Masuda, The effects of polaprezinc on radiation-induced taste alterations, Journal of JASTRO, 13, 2, 79-82, 2001.01, The effects of polaprezinc (an insoluble zinc complex of L-carnosine) on taste abnormalities were investigated in 22 patients receiving radiation therapy to head and neck malignancies. The total doses to the tongue were 25.5-46.0 Gy (mean, 37.9 Gy). All patients received 75 mg of polaprezinc two times a day with an interval of 0-1,561 days (mean, 305.3 days) after the completion of radiation therapy. The duration of the drug administration was 25-353 days (mean, 96.9 days). Twenty patients (90.9%) were aware of an improvement of a partial or complete loss of taste. Polaprezinc is effective in improving loss of taste after radiation therapy..
2. Osamu Togao, K. Hasuo, N. Takahashi, Y. Hishiki, N. Harada, H. Yoshinaga, N. Masaki, A case report; rapid expansion of a pseudoaneurysm secondary to chronic pancreatitis, Japanese Journal of Clinical Radiology, 48, 5, 660-663, 2003.01, Formation of peripancreatic pseudoaneurysm is a well-known complication of the chronic pancreatitis. Wall of pseudoaneurysm is very fragile and prone to rupture, which can be fatal. Recently, transcatheter embolization of pseudoaneurysm has been used as the first line treatment with successful results. In most cases, embolization is performed early in the course, and temporal evolution is rarely documented. We report a case of pseudoaneurysm originating from the dorsal pancreatic artery, which developed secondary to chronic pancreatitis. The pseudoaneurysm rapidly enlarged in 8 days to 4cm. We successfully embolized the peudoaneurysm using micro-coil system..
3. Osamu Togao, Futoshi Mihara, Takashi Yoshiura, Atsuo Tanaka, Yasuo Kuwabara, Takato Morioka, Toshio Matsushima, Tomio Sasaki, Hiroshi Honda, Prevalence of stenoocclusive lesions in the renal and abdominal arteries in moyamoya disease, American Journal of Roentgenology, 10.2214/ajr.183.1.1830119, 183, 1, 119-122, 2004.01, OBJECTIVE. The extracranial involvement of moyamoya disease has been reported in several studies. The main purpose of this study was to determine the prevalence of stenoocclusive lesions in the renal and major abdominal arteries in moyamoya disease. MATERIALS AND METHODS. Abdominal angiography was performed in 73 patients with idiopathic moyamoya disease. The findings of abdominal angiography were retrospectively reviewed for the presence and appearance of stenosis in the renal and other major abdominal arteries. RESULTS. Four (5%) of 73 patients presented with unilateral renal artery stenosis. Three patients had moderate stenosis, and one patient had mild stenosis. In the three patients with moderate stenosis, the renal artery stenosis was located in the proximal region of the main branch. Two patients (3%) with moderate stenosis of the unilateral renal artery had renovascular hypertension. No statistically significant differences were observed in age, sex, and the cerebral angiographic stage between patients with and without renal artery stenosis. No stenosis was found in the abdominal aorta or celiac, superior mesenteric, common hepatic, splenic, and proximal common iliac arteries. No occlusions were found in any abdominal arteries. CONCLUSION. The prevalence of renal artery stenosis in patients with moyamoya disease was 5% (4/73). Involvement of the proximal region of the renal artery was dominant. No stenosis was found in other abdominal arteries..
4. Atsuo Tanaka, Futoshi Mihara, Takashi Yoshiura, Osamu Togao, Yasuo Kuwabara, Yoshihiro Natori, Tomio Sasaki, Hiroshi Honda, Differentiation of cavernous hemangioma from schwannoma of the orbit
A dynamic MRI study, American Journal of Roentgenology, 10.2214/ajr.183.6.01831799, 183, 6, 1799-1804, 2004.01, OBJECTIVE. The purpose of this study was to determine the capability of dynamic contrast MRI to differentiate hemangioma from schwannoma of the orbit. MATERIALS AND METHODS. Sixteen patients (three males and 13 females; mean age, 39 ± 17.3 [SD] years; age range, 10-71 years) with unilateral orbital tumors, including eight cavernous hemangiomas and eight schwannomas, were examined. In addition to conventional MRI, we performed a dynamic contrast study (fast spin-echo sequence, 20-sec interval) after bolus administration of the contrast material (gadopentetate dimeglumine, 0.1 mmol/kg). We evaluated the features of the contrast enhancement spread pattern and the tumors' time-intensity curves. RESULTS. In the early phase, all the hemangiomas started the enhancement from one point or portion, although all the schwannomas started the enhancement from a wide area. The difference in the contrast-enhancement spread pattern features between the two types of tumors was statistically significant (p < 0.0001). The gradient of the time-intensity curve did not show a significant difference. CONCLUSION. Hemangioma and schwannoma of the orbit can be differentiated by the contrast-enhancement spread pattern on dynamic MRI..
5. Osamu Togao, Futoshi Mihara, Takashi Yoshiura, Tomoyuki Noguchi, Yasuo Kuwabara, Kengo Yoshimitsu, Hiroshi Honda, Percutaneous vertebroplasty in the treatment of pain caused by metastatic tumor., Fukuoka igaku zasshi = Hukuoka acta medica, 96, 4, 93-99, 2005.01, Percutaneous vertebroplasty is a radiologically guided therapeutic procedure that consists of percutaneous injection of polymethylmetacrylate (PMMA) into pathologic vertebral bodies. It is a minimally invasive procedure that is effective in the treatment of pain resulting from bone metastasis. This procedure has the advantage of providing rapid pain relief and spinal stabilization. A patient with severe, aggressive pain from metastatic lumbar spinal tumor of thyroid follicular carcinoma is presented herein. Despite treatment with analgesic agents, external beam radiation therapy, radioiodine therapy, and posterior fusion surgery, the pain reemerged and progressed. After percutaneous vertebroplasty, definite pain relief was achieved. Vertebroplasty would be useful as an additional or alternative pain relief method in patients with metastatic vertebral tumors..
6. Takashi Yoshiura, Futoshi Mihara, Atsuo Tanaka, Osamu Togao, Takayuki Taniwaki, Akiko Nakagawa, Tomohiro Nakao, Tomoyuki Noguchi, Yasuo Kuwabara, Hiroshi Honda, Age-related structural changes in the young adult brain shown by magnetic resonance diffusion tensor imaging, Academic Radiology, 10.1016/j.acra.2004.12.015, 12, 3, 268-275, 2005.01, Rationale and Objective. Structure of the brain is generally thought to remain stationary over the course of young adulthood. However, there is some evidence that microstructural changes of the brain do occur during this period. Magnetic resonance diffusion tensor imaging (DTI) provides quantitative measures of structural changes in the brain. We used DTI to detect possible age-related structural changes in the brains of young adults. Materials and Methods. Twenty-five healthy adults in their 20s and 30s were studied using DTI. Maps of mean diffusivity and fractional anisotropy (FA) were created for subsequent histogram and region-of-interest analyses, and the results were correlated with the respective ages of the subjects. Results. The histogram analysis revealed a significant increase in the mean FA value (r = 0.407, P <. 05) and a significant decrease in FA peak height (r = -0.578, P <. 002) with increasing age. No age-related changes were observed in indices derived from mean diffusivity maps. Region-of-interest analysis showed no focal white matter regions with significant FA change. Conclusion. Quantitative DTI revealed age-related structural changes in the brains of young adults. Changes on FA histograms observed in this study were considered to be related to changes in the relative volumes of gray and white matter and may represent maturational changes..
7. Tomohiro Nakao, Akiko Nakagawa, Takashi Yoshiura, Eriko Nakatani, Maiko Nabeyama, Chika Yoshizato, Akiko Kudoh, Kyoko Tada, Kazuko Yoshioka, Midori Kawamoto, Osamu Togao, Shigenobu Kanba, Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement
A functional magnetic resonance imaging study, Biological Psychiatry, 10.1016/j.biopsych.2004.12.039, 57, 8, 901-910, 2005.04, Background: Functional neuroimaging studies have implicated hyperactivity of the frontal cortex in obsessive-compulsive disorder (OCD); however, relationships between abnormal brain activity, clinical improvement, and neuropsychological function have not been clarified in OCD. To clarify the pathophysiology of this disorder, regional changes in brain function were examined during administration of cognitive and symptom provocation tasks in patients with OCD before and after treatment. Methods: Ten outpatients with OCD participated in the study. Functional magnetic resonance imaging (fMRI) was performed before and after treatment. Stroop and symptom provocation tasks were administered during fMRI. Each patient was randomly allocated to receive either pharmacotherapy with fluvoxamine 200 mg/day (n = 4) or behavior therapy (n = 6) for 12 weeks. Results: After 12-week treatment, mean (± SD) total score on the Yale-Brown Obsessive-Compulsive Scale decreased from 29.00 ± 3.59 to 14.60 ± 9.22, representing symptomatic improvement from moderate to mild. After symptom improvement, symptom provocation-related activation in the orbitofrontal, dorsolateral-prefrontal, and anterior cingulate cortices decreased. Conversely, Stroop task-related activation in the parietal cortex and cerebellum increased. Conclusions: After improvement of OCD with either fluvoxamine or behavioral therapy, hyperactivation of the frontal lobe related to a symptom-provocative state decreases, and posterior brain activity related to action-monitoring function increases..
8. Takashi Yoshiura, Futoshi Mihara, Atsuo Tanaka, Tomoyuki Noguchi, Osamu Togao, Yasuo Kuwabara, Hiroshi Honda, Novel method to estimate and display cerebral cortical degeneration using diffusion-weighted magnetic resonance imaging, Magnetic Resonance in Medicine, 10.1002/mrm.20558, 54, 2, 455-459, 2005.08, Previous studies have shown that diffusion-weighted imaging (DWI) is useful for detecting microstructural degradation of neuronal tissue in neurodegenerative diseases. Mapping of cortical degeneration by DWI is potentially useful, but is extremely difficult, mainly because of the partial volume effect resulting from the surrounding cerebrospinal fluid (CSF). In this study a novel method to map and display the cortical damage in neurodegenerative diseases using DWI is proposed. Instead of measuring the cortical diffusivity, the diffusivity of white matter directly beneath the cortex, where neuronal fibers enter or exit the overlying cortex, was measured and mapped onto the cortical surface. The map was viewed in a form of three-dimensional (3D) rendering. Patients with Alzheimer's disease (AD) showed cortical damage in the temporal and parietal cortices, and a patient with frontotemporal dementia showed damage in the frontal lobe, consistent with the typical topographical distribution of histopathological cortical damage in each of these diseases. The results suggest that subcortical diffusivity closely reflects cortical damage, and that the current mapping technique is a promising tool for evaluating neurodegenerative diseases..
9. Futoshi Mihara, Takashi Yoshiura, Tomoyuki Noguchi, Osamu Togao, Takato Morioka, Tomio Sasaki, Hiroshi Honda, A method to reduce saline and heparin in intraoperative cerebral angiography
A preliminary report, Radiation Medicine - Medical Imaging and Radiation Oncology, 23, 8, 588-589, 2005.12, Purpose: To reduce saline and heparin in continuous catheter perfusion in intraoperative cerebral angiography, a method using a syringe pump was tried. Materials and Methods: Ten patients with brain arteriovenous malformation (AVM) underwent intraoperative cerebral angiography. Seven internal carotid arteries (ICAs) and six vertebral arteries (VAs) were catheterized in these patients. Continuous catheter perfusion was performed at a low rate of 3 mL/hr with saline containing 8,000 units of heparin per liter using a syringe pump. Results: Mean duration of catheter perfusion was 8.3±4.0 hrs (range, 3.0 to 15.7 hrs). Mean volume of saline was 25.0±11.9 mL (range, 9 to 47 mL) per catheter. Mean dosage of heparin was 200.0±94.9 units (range, 72 to 376 units) per catheter. No complications due to intraoperative angiography were observed in this trial. Conclusion: Reduction of the saline volume and heparin dosage was possible in intraoperative cerebral angiography by the continuous perfusion of a small amount of high-concentration heparinized saline using a syringe pump..
10. Osamu Togao, Futoshi Mihara, T. Yoshiura, A. Tanaka, T. Noguchi, Y. Kuwabara, K. Kaneko, T. Matsushima, Hiroshi Honda, Cerebral hemodynamics in moyamoya disease
Correlation between perfusion-weighted MR imaging and cerebral angiography, American Journal of Neuroradiology, 27, 2, 391-397, 2006.02, BACKGROUND AND PURPOSE: In Moyamoya disease, the relationship between cerebral hemodynamics and angiographic findings has not been fully evaluated. The purpose of this study is to evaluate hemodynamics in Moyamoya disease with perfusion-weighted MR imaging (PWI) and cerebral angiography. METHODS: Twenty patients with Moyamoya disease were the subjects. Mean transit time (MTT) derived from PWI was calculated in the medial frontal lobes, the posterior frontal lobes, the occipital lobes, and the basal ganglia. From the angiographies, we classified the degrees of internal carotid artery (ICA) and posterior cerebral artery (PCA) stenoses as well as the degrees of Moyamoya vessels and leptomeningeal anastomosis (LMA). MTT in each region was compared with the angiographic findings. RESULTS: MTT positively correlated with the degree of ICA stenosis in the medial frontal (P < .01), posterior frontal (P < .001), and occipital (P < .001) lobes, as well as in the basal ganglia (P < .001). MTT correlated with the degree of PCA stenosis in the medial frontal (P < .001), posterior frontal (P < .001), and occipital (P < .001) lobes, as well as in the basal ganglia (P < .001 ). MTT correlated with the degree of Moyamoya vessels in the medial frontal (P < .05) and posterior frontal (P < .01) lobes. A multivariate analysis revealed that ICA and PCA stenoses and Moyamoya vessels were independent factors that prolonged MTT. CONCLUSION: Both ICA and PCA stenoses may influence overall cerebral perfusion in Moyamoya disease. The development of Moyamoya vessels may indicate hemodynamic impairment..
11. Takayuki Taniwaki, Akira Okayama, Takashi Yoshiura, Osamu Togao, Yasuhiko Nakamura, Takao Yamasaki, Katsuya Ogata, Hiroshi Shigeto, Yasumasa Ohyagi, Jun-Ichi Kira, Shozo Tobimatsu, Functional network of the basal ganglia and cerebellar motor loops in vivo
Different activation patterns between self-initiated and externally triggered movements, NeuroImage, 10.1016/j.neuroimage.2005.12.032, 31, 2, 745-753, 2006.06, The basal ganglia and cerebellar loops are known to participate differently in self-initiated (SI) and externally triggered (ET) movements. However, no previous neuroimaging studies have illustrated functional organization of these loops in vivo. Here, we aimed to functionally visualize these loops during motor execution using functional magnetic resonance imaging (fMRI) with structural equation modeling (SEM). Twelve normal subjects (24-29 years old) were scanned while performing five different frequencies of sequential left finger movements using either SI or ET movements. Random effect analysis combined with a parametric approach revealed a significant positive linear dependence of cerebral activation upon movement rate in the right Put, GPi, VL, SMC and SMA during SI tasks. During ET tasks, significant positive linear relationships were found in the right SMC, VPL, left CB and DN, whereas tendency for linear relationships was seen in the right PMv. SEM further showed significant interactions within the right basal ganglia-thalamo-motor loop during SI tasks. In contrast, there were significant interactions within the entire right cerebral hemisphere-left cerebellar loop involving CB, DN, VPL, PMv and SMC during ET tasks. Therefore, our modeling approach enabled identification of different contributions of the motor loops of basal ganglia and cerebellum to SI and ET tasks during motor execution..
12. T. Noguchi, Futoshi Mihara, T. Yoshiura, Osamu Togao, K. Atsumi, T. Matsuura, T. Kuroiwa, Hiroshi Honda, MR imaging of human herpesvirus-6 encephalopathy after hematopoietic stem cell transplantation in adults, American Journal of Neuroradiology, 27, 10, 2191-2195, 2006.11, BACKGROUND AND PURPOSE: Human herpesvirus-6 (HHV-6)-associated encephalopathy tends to develop in immunocompromised patients. Neurologic symptoms, such as disorientation, short-term memory loss, convulsion, coma, and hypopnea could occur, but they may be nonspecific. We retrospectively reviewed MR images of 6 adults with HHV-6-associated encephalopathy to study characteristic imaging findings that could be useful in making the diagnosis. MATERIALS AND METHODS: Between 2003 and 2005, we encountered 6 cases of HHV-6-associated encephalopathy (3 men and 3 women; age range, 36-55 years) in 3 hospitals. The diagnosis was made clinically according to the neurologic symptoms accompanied by high-level copies of HHV-6 DNA in CSF or peripheral blood by quantitative polymerase chain reaction without the detection of any other infectious pathogen. RESULTS: All 6 patients had abnormal hippocampus/amygdala findings on presentation, and no other regions were involved. In the early period (0-2 days from onset), abnormal high signal intensity on fluid-attenuated inversion recovery (FLAIR) imaging (2 of 3, 67%) and on diffusion-weighted images accompanied by apparent diffusion coefficient (ADC) reduction (2 of 2, 100%) were observed. In the middle period (3-30 days), abnormal low signal intensity on T1-weighted images (5 of 6, 83%) and abnormal high signal intensity on T2-weighted images (4 of 6, 67%) and FLAIR (5 of 6, 83%) were confirmed. In the late period (> 30 days), we saw the resolution of signal intensity abnormalities and the appearance of atrophic change (4 of 4, 100%) of the affected regions. CONCLUSION: HHV-6-associated encephalopathy in adults tends to affect the mesial temporal lobe. MR imaging is useful for detecting HHV-6 encephalopathy and distinguishing it from the other diseases of the central nervous system in immunocompromised patients..
13. Takashi Yoshiura, Futoshi Mihara, Hiroshi Koga, Tomoyuki Noguchi, Osamu Togao, Yasumasa Ohyagi, Koji Ogomori, Atsushi Ichimiya, Shigenobu Kanba, Hiroshi Honda, Cerebral White Matter Degeneration in Frontotemporal Dementia Detected by Diffusion-Weighted Magnetic Resonance Imaging, Academic Radiology, 10.1016/j.acra.2006.08.009, 13, 11, 1373-1378, 2006.11, Rationale and Objective: Brain tissue damage in frontotemporal dementia (FTD) has never been systematically studied using diffusion-weighted imaging (DWI). We studied FTD patients using DWI to determine whether microstructural changes in white matter can be detected in vivo. Materials and Methods: Thirteen FTD patients and 15 aged healthy subjects were studied. Mean diffusivity (MD) abnormalities in 28 white matter regions were visually evaluated. In addition, MD values in 10 white matter regions relative to that in the ipsilateral postcentral gyrus were measured. The results were compared between healthy subjects and FTD patients. Results: The visual rating resulted in a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, right orbitofrontal gyrus, bilateral anterior temporal lobes, and left middle temporal lobe (P < .01, respectively). Relative MD comparison revealed a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, bilateral orbitofrontal gyri, and bilateral anterior temporal lobes (P < .05 after Bonferroni correction, respectively). Conclusion: Our results demonstrated white matter MD abnormalities in FTD patients. It was suggested that the observed white matter MD abnormalities are secondary to damage in the overlying cortex..
14. Takashi Yoshiura, Futoshi Mihara, Hiroshi Koga, Yasumasa Ohyagi, Tomoyuki Noguchi, Osamu Togao, Koji Ogomori, Katsue Miyoshi, Takao Yamasaki, Koichiro Kaneko, Atsushi Ichimiya, Shigenobu Kanba, Hiroshi Honda, Mapping of Subcortical White Matter Abnormality in Alzheimer's Disease Using Diffusion-Weighted Magnetic Resonance Imaging, Academic Radiology, 10.1016/j.acra.2006.09.042, 13, 12, 1460-1464, 2006.12, Rationale and Objectives: White matter (WM) abnormality in Alzheimer's disease (AD) has been less well characterized than cortical damage. We studied the spatial distribution of the subcortical WM abnormality using diffusion-weighted magnetic resonance imaging (DWI). Materials and Methods: Twenty-one AD patients and seven healthy, elderly subjects were included. DWIs were obtained using a cerebrospinal fluid (CSF)-nulled pulse sequence to reduce the partial volume contamination of CSF signal. Diffusivity in the subcortical WM voxels was mapped onto the cortical surface using original software so that the spatial distribution of subcortical WM damage, which was visualized as an area of increased diffusivity, could be viewed in a three-dimensional map. The damages in the lateral surface of the bilateral cerebral hemispheres were visually evaluated, and severities of the damages in five brain regions were compared with each other. In addition, the severity of the damage in each region was correlated with patient's mini-mental state examination (MMSE) score. Results: In both hemispheres, clear sparing of the pericentral regions and predominant involvement of the parietal and temporal regions were revealed with statistical significance (P < .05, respectively). Marginal correlation (P < .05 uncorrected for multiple comparisons) was observed between the damage severity in the bilateral frontal and right temporal regions and patient's MMSE score. Conclusion: We demonstrated a subcortical WM abnormality over the parietal and temporal regions with clear sparing of the pericentral region using our mapping method, which supported the hypothesis that the subcortical WM abnormality in AD originates in Wallerian degeneration..
15. Hiwatashi Akio, Takashi Yoshiura, Tomoyuki Noguchi, Osamu Togao, Koji Yamashita, Hiroshi Honda, Percutaneous vertebroplasty, Fukuoka igaku zasshi = Hukuoka acta medica, 98, 9, 337-345, 2007.01.
16. Tomoyuki Noguchi, Takashi Yoshiura, Shuichi Oguri, Hiwatashi Akio, Osamu Togao, Koji Yamashita, Eiki Nagao, Junji Murakami, Futoshi Mihara, Hiroshi Honda, Intraarterial therapy for acute ischemic stroke
investigation of prognostic factors., Fukuoka igaku zasshi = Hukuoka acta medica, 98, 8, 320-328, 2007.01, BACKGROUND: Intraarterial therapy (IAT) for acute cerebral infarction has been proven to be profitable. However, the criteria for the indications, the choice of the thrombolytic agents, and the use of adjunctive agents are controversial. We retrospectively analyzed the prognostic factors of IAT. MATERIALS AND METHODS: From 1994 to 2003, 28 patients underwent IAT due to middle cerebral artery occlusion (17 women and 11 men; median age, 69 years old). We evaluated the following prognostic parameters: institution of treatment, degree of paralysis at visit, size of high-intensity area on diffusion-weighted images, dose of intraarterial urokinase administration, elapsed time from symptom onset to completion of IAT, presence of penetration of embolus by microcatheter and microguidewire, recanalization after IAT, intracranial hemorrhage (ICH) within 24 hours after IAT, and intravenous heparin administration after IAT. The outcome was evaluated at discharge and was classified into the following categories according to the modified Rankin Scale: independence (0 to 2), dependence (3 to 5), and death (6). RESULTS: Seven patients were judged to be independent, 16 patients were judged to be dependent, and five patients died. Patients with recanalization after IAT had a better outcome than those without (p < 0.05); patients with intracranial hemorrhage had a worse outcome than those without (p < 0.05); and patients with intravenous heparin administration after IAT had a better outcome in activities of daily living than those without (p < 0.05). CONCLUSION: In addition to ICH and recanalization, our results suggested that intravenous heparin administration after IAT had a favorable effect on patient outcome..
17. Koji Yamashita, Tomoyuki Noguchi, Futoshi Mihara, Takashi Yoshiura, Osamu Togao, Hiroshi Yoshikawa, Hiroshi Honda, An intraorbital wooden foreign body
Description of a case and a variety of CT appearances, Emergency Radiology, 10.1007/s10140-007-0597-x, 14, 1, 41-43, 2007.05, We present a case report in which a 4-year-old girl was involved in a fall that resulted in an injury of the right orbita. The girl kept a chopstick in her right hand that got into the right orbita due to this accident. Only a fraction remained in the orbita; the residual chopstick got lost. Hence, the substance of the chopstick was unknown. Computed tomography (CT) revealed a foreign body in the right orbita, but ophthalmologists had initially no indication of intervention. Further course according to the follow-up CT showed an increase of Hounsfield units (HU). These findings led to the assumption that the foreign body was made of wood. Through this, the ophthalmologists performed an evacuation. Motivated by these clinical results, we created an experimental setup that could demonstrate changes of HU in different coated chopsticks. It is concluded that wooden foreign bodies can display a variety of CT appearances depending on materials, types, coating, and time-course..
18. Takayuki Taniwaki, Akira Okayama, Takashi Yoshiura, Osamu Togao, Yasuhiko Nakamura, Takao Yamasaki, Katsuya Ogata, Hiroshi Shigeto, Yasumasa Ohyagi, Jun-Ichi Kira, Shozo Tobimatsu, Age-related alterations of the functional interactions within the basal ganglia and cerebellar motor loops in vivo, NeuroImage, 10.1016/j.neuroimage.2007.04.027, 36, 4, 1263-1276, 2007.07, Aging may alter the motor functions of the basal ganglia and cerebellum; however, no previous neuroimaging study has investigated the effect of aging on the functional connectivity of the motor loops involving these structures. Recently, using fMRI with a parametric approach and structural equation modeling (SEM), we demonstrated a significant functional interaction within the basal ganglia-thalamo-motor (BGTM) loop during self-initiated (SI) finger movement in young normal subjects, whereas cerebro-cerebellar (CC) loop was mainly involved during externally triggered (ET) movement. We applied this method to 12 normal aged subjects (53-72 years old) in order to study the effect of age on BGTM and CC loops. Compared with the functional connectivity seen in young subjects, SEM showed decreased connectivity in BGTM loops during SI task, decreased interaction in the CC loop during ET task, and increased connectivity within motor cortices and between hemispheres during both types of tasks. These results suggest an age-related decline of cortico-subcortical connectivity with increased interactions between motor cortices. Aging effects on SI and ET movements are probably caused by functional alterations within BGTM and CC loops..
19. Tomoyuki Noguchi, Takashi Yoshiura, Hiwatashi Akio, Osamu Togao, Koji Yamashita, Kouji Kobayashi, Futoshi Mihara, Hiroshi Honda, Quantitative Perfusion Imaging with Pulsed Arterial Spin Labeling
A phantom study, Magnetic Resonance in Medical Sciences, 10.2463/mrms.6.91, 6, 2, 91-97, 2007.12, Purpose: Pulsed arterial spin labeling (PASL) is a magnetic resonance (MR) method for measuring cerebral blood flow. Although several validation studies for PASL in animals and humans have been reported, no reports have detailed the fundamental study of PASL using a flow phantom. We compared the true and theoretical flow rates in a flow phantom to confirm the analytical validity of quantitative perfusion imaging with Q2TIPS sequence. Methods: We built a flow phantom consisting of a 40-mm diameter plastic syringe filled with plastic beads and small plastic tubes 4 mm in diameter. Gd-DTPA-doped 8L water solution (0.1 mM) was circulated between the syringe and a tank through a plastic tube by a constant flow pump while the flow rate was adjusted between 0 and 2.61 cm/s. Q2TIPS sequence parameters were TI
1
= 50 ms and TI
2
= 1400 ms. Five imaging slices of 50 subtraction images were acquired sequentially in a distal-to-proximal direction using a single-shot echo planar imaging (EPI) technique. The theoretical flow rate calculated based upon the previously reported kinetic model for Q2TIPS was compared with the true flow rate. Results: A good linear relationship was observed between the theoretical, F', and true flow rates, F, in a flow rate range of 1.43 to 1.95 cm/s (F = 1.024-F- 1.915, R2 = 0.902). The ratio of theoretical to true flow rate was 92 (+/-) 4%. Conclusion: Flow rate was quantified with reasonable accuracy when the entire amount of labeled bolus within the phantom could be recovered. Our experiment confirmed the analytical validity of Q2TIPS and suggested that blood flow measurement may be feasible using the Q2TIPS pulse sequence and kinetic model of the PASL equation..
20. Takuya Hino, Osamu Togao, Hiwatashi Akio, Koji Yamashita, kazufumi kikuchi, Daichi Momosaka, Hiroshi Honda, Clinical efficacy of simplified intravoxel incoherent motion imaging using three b-values for differentiating high- and low-grade gliomas, PloS one, 10.1371/journal.pone.0209796, 13, 12, 2018.12, In this study, we evaluated the efficacy of intravoxel incoherent motion (IVIM)-derived parameters calculated with three b-values in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs) by comparing those calculated with multiple b-values. Ten patients with LGG (ages 35.1±12.1 yrs; 4 males, 6 females) and 21 patients with HGG (ages 60.6±19.1 yrs; 10 males, 11 females) who underwent subsequent surgical resections were examined with both IVIM imaging and histopathological analysis. The IVIM diffusion-weighted imaging was conducted using a single-shot echo planar sequence with 13 b-factors (0, 10, 20, 30, 50, 80, 100, 200, 300, 400, 600, 800, and 1000 sec/mm
2
) at 3T. In the conventional IVIM analysis, the perfusion fraction (f) and true diffusion coefficient (D) were calculated by biexponential fitting model with 13 b-values. In the simplified method with the selected three b-values (0, 300, and 1000 sec/mm
2
), D simply corresponds to the slope of a straight line passing through two logarithmic signal intensities (SIs) at the b-values of 300 and 1000 s/mm
2
, and f corresponds to the difference between the intercept of this line and SI at the b-value of 0 sec/mm
2
. The maximum f (f-max) and minimum D (D-min) was measured in each tumor. The f-max values calculated with three b-values (12.8±5.9%) were significantly lower than those with 13 b-values (17.3±7.5%, p<0.0001), but a good correlation and agreement were observed between these sets of f-max values (r = 0.79, ICC = 0.87). In the IVIM imaging with both three and 13 b-values, the HGGs showed significantly higher f-max values compared to the LGGs (p<0.001, respectively). The D-min values calculated with three b-values (1.06±0.31 ×10
−3
mm
2
/sec) was not different from those with 13 b-values (1.07±0.33 ×10
−3
mm
2
/sec), and an excellent correlation and agreement were found between them (r = 0.99, ICC = 0.99). The simplified IVIM imaging using three b-values can efficiently differentiate HGGs and LGGs..
21. Tatsuhiro Wada, Chiaki Tokunaga, Osamu Togao, Ryohei Funatsu, Yasuo Yamashita, Kouji Kobayashi, Masami Yoneyama, Hiroshi Honda, Visualization of cerebrospinal fluid dynamics using multi-spin echo acquisition cine imaging (MUSACI), Magnetic Resonance in Medicine, 10.1002/mrm.27394, 81, 1, 331-341, 2019.01, Purpose: To evaluate the visualization of CSF dynamics using the novel method multi-spin echo acquisition cine imaging (MUSACI). Methods: MUSACI is based on multi-echo volume isotropic turbo spin-echo acquisition (VISTA) with pulse gating. MUSACI images were acquired in 11 healthy volunteers (7 men, 4 women; age range, 24–46 y, mean age, 31.9 ± 5.51 y). We compared the CSF signal intensities (SIs) at multiple values of the effective echo time (TE
eff
) at the lateral ventricle, the foramen of Monro, the third ventricle, and the fourth ventricle. We compared the CSF SI changes in MUSACI at multiple TE
eff
and the mean velocities in phase contrast (PC) at each trigger delay at the foramen of Monro, the third ventricle, and the fourth ventricle. Results: The anterograde CSF motion from the aqueduct to the fourth ventricle, the retrograde motion from the aqueduct to the third ventricle, and the retrograde motion from the foramen of Monro to the lateral ventricle were observed with MUSACI. The CSF SIs at each TE
eff
in the foramen of Monro, the third ventricle, and the fourth ventricle were significantly lower than that at each TE
eff
in the lateral ventricle (P < 0.05). The CSF SI in MUSACI changed with the TE
eff
, and the CSF movements were observed at each trigger delay in PC. Conclusion: MUSACI can provide both high-resolution anatomical detail of the CSF passageways and physiologic information regarding CSF dynamics in a single scan..
22. Hiwatashi Akio, Osamu Togao, Koji Yamashita, kazufumi kikuchi, Daichi Momosaka, Hiroshi Nakatake, Ryo Yamasaki, Hidenori Ogata, Masami Yoneyama, Jun-Ichi Kira, Hiroshi Honda, Simultaneous MR neurography and apparent T2 mapping in brachial plexus
Evaluation of patients with chronic inflammatory demyelinating polyradiculoneuropathy, Magnetic Resonance Imaging, 10.1016/j.mri.2018.09.025, 55, 112-117, 2019.01, Purpose: MR neurography is known to be useful to evaluate nerve pathology. The purpose of this study was to evaluate the usefulness of simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) to distinguish patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from healthy subjects. Materials and methods: This retrospective study included 13 patients with CIDP and five healthy subjects from 2015 to 2017. The T2 relaxation time and the size of the cervical ganglia and roots of the brachial plexus were measured. Statistical analyses were performed with the Mann-Whitney U test and receiver operating characteristics (ROC) analysis. Results: The T2 relaxation times of the ganglia and roots were longer in patients with CIDP (119.31 ± 35.53 msec and 111.15 ± 33.82 msec) than in healthy subjects (101.42 ± 26.42 msec and 85.29 ± 13.22 msec, P = 0.0007 and P < 0.0001, respectively). The sizes of the ganglia and the roots were larger in patients with CIDP (6.25 ± 1.56 mm and 4.37 ± 1.71 mm) than in healthy subjects (5.59 ± 1.08 mm and 3.50 ± 0.62 mm, P = 0.0114 and P = 0.0014, respectively). ROC analysis revealed that T2 relaxation time of the roots was best at distinguishing CIDP patients from healthy subjects (the area under the curve = 0.748). Conclusion: Patients with CIDP could be distinguished from healthy subjects using simultaneous apparent T2 mapping and neurography with SHINKEI..
23. K. Yamashita, R. Hatae, Hiwatashi Akio, Osamu Togao, kazufumi kikuchi, D. Momosaka, Y. Yamashita, Daisuke Kuga, Nobuhiro Hata, K. Yoshimoto, S. O. Suzuki, Toru Iwaki, Koji Iihara, Hiroshi Honda, Predicting TERT promoter mutation using MR images in patients with wild-type IDH1 glioblastoma, Diagnostic and Interventional Imaging, 10.1016/j.diii.2019.02.010, 2019.01, Purpose: The purpose of this study was to identify magnetic resonance imaging (MRI) features that are associated with telomerase reverse transcriptase promoter mutation (TERTm) in glioblastoma. Materials and methods: A total of 112 patients with glioblastoma who had MRI at 1.5- or 3.0-T were retrospectively included. There were 43 patients with glioblastoma with wild-type TERT (TERTw) (22 men, 21 women; mean age, 47 ± 25 [SD] years; age range: 3–84 years) and 69 patients with glioblastoma with TERTm (34 men, 35 women; mean age 64 ± 11 [SD] years; age range, 41-–85 years). The feature vectors consist of 11 input units for two clinical parameters (age and gender) and nine MRI characteristics (tumor location, subventricular extension, cortical extension, multiplicity, enhancing volume, necrosis volume, the percentage of necrosis volume, minimum apparent diffusion coefficient [ADC] and normalized ADC). First, the diagnostic performance using univariate and multivariate logistic regression analyses was evaluated. Second, the cross-validation of the support vector machine (SVM) was performed by using leave-one-out method with 43 TERTw and 69 TERTm to evaluate the diagnostic performance. In addition, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the differentiation between TERTw and TERTm were compared between logistic regression analysis and SVM. Results: With multivariate analysis, the percentage of necrosis volume and age were significantly greater in TERTm glioblastoma than in TERTw glioblastoma. SVM allowed discriminating between TERTw glioblastoma and TERTm glioblastoma with sensitivity, specificity, PPV, NPV, and accuracy of 85.7% [60/70; 95% confidence interval (CI): 75.3–92.9%], 54.8% (23/42; 95% CI: 38.7–70.2%), 75.9% (60/79; 95% CI: 69.1–81.7%), 69.7% (23/33; 95% CI: 54.9–81.3%) and 74.1% (83/112; 95% CI: 65.0–81.9%), respectively. Conclusion: The percentage of necrosis volume and age may surrogate for predicting TERT mutation status in glioblastoma..
24. Noriaki Hirakawa, Hironori Kuga, Yoji Hirano, Jinya Sato, Naoya Oribe, Itta Nakamura, Shogo Hirano, Takefumi Ueno, Yuko Oda, Osamu Togao, Hiwatashi Akio, Hiroshi Honda, Shigenobu Kanba, Toshiaki Onitsuka, Neuroanatomical substrate of chronic psychosis in epilepsy
an MRI study, Brain Imaging and Behavior, 10.1007/s11682-019-00044-4, 2019.01, There may be different neural bases between subjects with epilepsy only (EP) and interictal chronic epilepsy psychosis (EPS). However, there have been few structural MRI studies of EPS. The current study was conducted to investigate the neural substrate of EPS. T1-weighted images were analyzed in 14 patients with EPS and 14 strictly-matched patients with EP. We conducted volume comparison in the whole brain using voxel-based morphometry (VBM). The VBM method revealed that EPS patients exhibited significantly reduced gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus compared with EP patients (adjusted p = 0.029, FDR corrected q; k = 319 voxels). For clinical correlations, there were no significant associations between psychotic symptoms and gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus. VBM analysis revealed that reduced gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus may be crucial regions for EPS..
25. Akihiro Nishie, Yoshiki Asayama, Kosei Ishigami, yasuhiro ushijima, Yukihisa Takayama, Daisuke Okamoto, nobuhiro fujita, Daisuke Tsurumaru, Osamu Togao, Koji Sagiyama, Tatsuya Manabe, Eiji Oki, yuichiro kubo, Tomoyuki Hida, Minako Hirahashi-Fujiwara, Jochen Keupp, Hiroshi Honda, Amide proton transfer imaging to predict tumor response to neoadjuvant chemotherapy in locally advanced rectal cancer, Journal of Gastroenterology and Hepatology (Australia), 10.1111/jgh.14315, 34, 1, 140-146, 2019.01, Background and Aim: The amount of proteins and peptides can be estimated with amide proton transfer (APT) imaging. Previous studies demonstrated the usefulness of APT imaging to predict tumor malignancy. We determined whether APT imaging can predict the tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced rectal cancer (LARC). Methods: Seventeen patients with LARC who underwent a pretherapeutic magnetic resonance examination including APT imaging and NAC (at least two courses) were enrolled. The APT-weighted imaging (WI) signal intensity (SI) (%) was defined as magnetization transfer ratio asymmetry (MTR
asym
) at the offset of 3.5 ppm. Each tumor was histologically evaluated for the degree of degeneration and necrosis and then classified as one of five histological Grades (0, none; 1a, less than 1/3; 1b, 1/3 to 2/3; 2, more than 2/3; 3, all). We compared the mean APTWI SIs of the tumors between the Grade 0/1a/1b (low-response group) and Grade 2/3 (high-response group) by Student's t-test. We used receiver operating characteristics curves to determine the diagnostic performance of the APTWI SI for predicting the tumor response. Results: The mean APTWI SI of the low-response group (n = 12; 3.05 ± 1.61%) was significantly higher than that of the high-response group (n = 5; 1.14 ± 1.13%) (P = 0.029). The area under the curve for predicting the tumor response using the APTWI SI was 0.87. When ≥2.75% was used as an indicator of low-response status, 75% sensitivity and 100% specificity of the APTWI SI were obtained. Conclusion: Pretherapeutic APT imaging can predict the tumor response to NAC in patients with LARC..
26. Osamu Togao, Hiwatashi Akio, Koji Yamashita, Daichi Momosaka, Makoto Obara, ataru nishimura, Koichi Arimura, Nobuhiro Hata, Koji Iihara, Marc Van Cauteren, Hiroshi Honda, Acceleration-selective arterial spin labeling MR angiography for visualization of brain arteriovenous malformations, Neuroradiology, 10.1007/s00234-019-02217-w, 2019.01, Purpose: To evaluate the performance of acceleration-selective arterial spin labeling (AccASL) MR angiography in the visualization of brain arteriovenous malformations (AVMs) in comparison with digital subtraction angiography (DSA) and time-of-flight (TOF) MR angiography. Methods: Twenty-one patients with brain AVM (mean age 31.1 ± 18.6 years; 11 males, 10 females) underwent TOF and AccASL MR angiography and DSA. Two neuroradiologists conducted an observer study for detection, nidus size, eloquence, venous drainage pattern, and Spetzler-Martin (SM) grade. The evaluations included the visualization of each AVM component with reference to DSA and assessments of contrast-to-noise ratio (CNR). The kappa statistic, repeated measures analysis of variance, Wilcoxon matched pairs test, and paired t test were used. Results: Both observers detected more AVMs with AccASL (95.2%, 90.5% for Observers 1 and 2) than with TOF (76.2% and 71.4%, respectively). The inter-modality agreement between AccASL and DSA was almost perfect for the eloquence, venous drainage pattern, and SM grade for Observer 1 and moderate for the venous drainage pattern and substantial for the eloquence and SM grade for Observer 2. The visualization scores were higher with AccASL than with TOF for the feeding artery (AccASL, 4.5 ± 1.0 vs. TOF, 3.9 ± 1.5, p = 0.0214), nidus (4.6 ± 1.1 vs. 3.2 ± 1.5, p = 0.0006), and draining vein (4.6 ± 1.0 vs. 2.2 ± 1.1, p < 0.0001), respectively. The CNRs in the nidus were higher in AccASL than in TOF (29.9 ± 16.7 vs. 20.8 ± 16.5, p = 0.0002), as in the draining vein (23.2 ± 13.0 vs. 12.6 ± 12.0, p = 0.0010), respectively. Conclusions: AccASL better visualized brain AVMs compared with TOF and was useful for grading without the use of contrast agents..
27. kenichiro yamashita, Taira Uehara, Pukovisa Prawiroharjo, Koji Yamashita, Osamu Togao, Hiwatashi Akio, Yoshihide Taniwaki, Hidetsuna Utsunomiya, Takuya Matsushita, Ryo Yamasaki, Jun-Ichi Kira, Functional connectivity change between posterior cingulate cortex and ventral attention network relates to the impairment of orientation for time in Alzheimer’s disease patients, Brain Imaging and Behavior, 10.1007/s11682-018-9860-x, 13, 1, 154-161, 2019.02, Alzheimer’s disease (AD) patients exhibit various cognitive dysfunctions, including impairment of orientation for time (OT). The brain regions underlying OT impairment remain to be elucidated. A previous single-photon emission computed tomography study has indicated hypoperfusion of the posterior cingulate cortex (PCC) in relation to deterioration of OT. In this study, we investigated whole brain functional connectivity changes of PCC using resting-state functional magnetic resonance imaging. Voxel-based functional connectivity with PCC was analyzed in OT-poor or OT-good AD patients, classified according to the mean OT scores of the Mini-Mental State Examination subscale. The connectivities of dorsal frontal lobe, and lateral parietal and lateral temporal lobes with PCC in the right hemisphere were reduced in the OT-poor AD group compared with the OT-good AD group. A subtraction connectivity map of OT score differences (OT-good minus OT-poor) revealed the right middle temporal gyrus near the temporo-parietal junction as a significantly connected region with PCC. These results suggest that the right posterior part of the middle temporal gyrus may play an important role in OT in conjunction with PCC, and that disconnection between PCC and the right ventral attention network may cause OT disturbance in AD patients..
28. Akihiro Nishie, Osamu Togao, Chihiro Tamura, Mayumi Yamato, Kazuhiro Ichikawa, Satoshi Nohara, Yoshio Ito, Naoki Kato, Satoshi Yoshise, Hiroshi Honda, In Vitro and In Vivo Detection of Drug-induced Apoptosis Using Annexin V-conjugated Ultrasmall Superparamagnetic Iron Oxide (USPIO)
A Pilot Study, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 10.2463/mrms.mp.2017-0157, 18, 2, 142-149, 2019.04, PURPOSE: To investigate the binding potential of newly developed Annexin V-conjugated ultrasmall superparamagnetic iron oxide (V-USPIO) for detection of drug-induced apoptosis in vitro and in vivo. METHODS: Apoptotic cells induced by camptothecin were incubated with or without Annexin V-USPIO at a concentration of 0.089 mmol Fe/L in vitro. T2 values of the two cell suspensions were measured by 0.47T nuclear magnetic resonance (NMR) spectrometer. Tumor-bearing mice were subjected to 1.5T MR scanner at 2 h after intraperitoneal injection of etoposide and cyclophosphamide. Following the pre-contrast T1- and T2-weighted imaging (0 h), the post-contrast scan was performed at 2, 4, 6 and 24 h after intravenous injection of Annexin V-USPIO (100 μmol Fe/kg). As a control, MRI was also obtained at 4 h after injection of USPIO without Annexin V. The ratio of tumor signal intensity (SI) on post-MRI for that on pre-MRI (Post/Pre-SI ratio) was calculated. After scanning, tumors were resected for pathological analysis to evaluate the distribution of iron and apoptotic cells. RESULTS: The suspension of apoptotic cells incubated with Annexin V-USPIO showed shorter T2 value than that without it. On T1-weighted imaging post/pre-SI ratio at 4 h after injection of Annexin V-USPIO showed 1.46, while after injection of USPIO without Annexin V was 1.17. The similar distribution of iron and apoptotic cells was observed in concordance with high signal intensity area on post-T1-weighted imaging. CONCLUSION: A newly developed Annexin V-USPIO could have the potential for detection of drug-induced apoptosis..
29. Yuta Akamine, Makoto Obara, Osamu Togao, Shuhei Shibukawa, Masami Yoneyama, Tomoyuki Okuaki, Marc Van Cauteren, Robust visualization of middle cerebral artery main trunk by enhanced acceleration-selective arterial spin labeling (eAccASL) for intracranial MRA, Magnetic Resonance in Medicine, 10.1002/mrm.27603, 81, 5, 3185-3191, 2019.05, Purpose: A new sequence for intracranial MRA is developed, named enhanced acceleration-selective arterial spin labeling (eAccASL), to improve main artery visualization at middle cerebral artery (MCA). The aim of this study is to assess the visualization improvement using eAccASL, compared with the previously developed AccASL. Methods: eAccASL and AccASL were performed in 8 healthy volunteers and images were compared between the 2 sequences. One patient with Moyamoya disease was evaluated by eAccASL and time of flight. For the volunteer images, vessel visualization was assessed by measuring the contrast-to-noise ratio between MCA M1 to M4 and white matter and by counting the peripheral arteries. Venous artifact level was assessed by measuring the contrast-to-noise ratio between the confluence of the sinuses and white matter and by evaluating cortical vein visualization. For the patient images, qualitative assessment of peripheral and collateral vessel visualization was conducted. Results: In the MCA main trunk, higher arterial signal intensity, with reduced flow void, was observed in eAccASL compared with AccASL. Contrast-to-noise ratios of M1 to M3 for eAccASL were significantly higher than those of AccASL. There was no significant difference between AccASL and eAccASL for venous artifact. Conclusion: eAccASL could produce better MCA main trunk visualization compared with AccASL, while maintaining good venous signal suppression..
30. Hiwatashi Akio, Osamu Togao, Koji Yamashita, Kazufumi Kikuchi, Ryotaro Kamei, Hiroshi Yoshikawa, Atsushi Takemura, Hiroshi Honda, Diffusivity of intraorbital lymphoma vs. inflammation
comparison of single shot turbo spin echo and multishot echo planar imaging techniques, European Radiology, 10.1007/s00330-017-4995-5, 28, 1, 325-330, 2018.01, Purpose: To compare the abilities of turbo spin-echo diffusion-weighted imaging (TSE DWI) and multi-shot echo planar DWI (MSh DWI) to discriminate orbital lymphoma from inflammatory lesions. Materials and methods: Twenty-nine patients with pathologically confirmed lymphomas and 39 patients with inflammation were imaged with a 3.0-T system. The apparent diffusion coefficient (ADC) of each lesion was measured. Signal intensities compared to normal grey matter on conventional imaging were also measured. Results: The ADCs derived from the TSE DWI of the lymphomas (0.68 ± 0.14 × 10−3 mm2/s) were significantly lower than those of the inflammation cases (1.04 ± 0.39 × 10−3 mm2/s; p < 0.001). The ADCs derived from MSh DWI could not be used to separate the lymphomas from the inflammation (1.16 ± 0.43 × 10−3 mm2/s vs. 1.36 ± 0.48 × 10−3 mm2/s; p = 0.06). Conventional sequences also could not separate the lymphomas from the inflammation (p > 0.05). The ROC analysis showed the best diagnostic performance with ADCs derived from TSE DWI (the area under the curve: AUC = 0.831) followed by ADC derived from MSh DWI (AUC = 0.633). Conclusion: The ADCs derived from TSE DWI might help to differentiate orbital lymphomas from inflammation. Key Points: • ADC of lymphoma was significantly lower than that of inflammation. • ADC derived from TSE DWI showed the best diagnostic performance. • This study was conducted by a 3-T MR scanner..
31. Hiwatashi Akio, Osamu Togao, Koji Yamashita, K. Kikuchi, D. Momosaka, Hiroshi Honda, Diffusion-weighted magnetic resonance imaging of extraocular muscles in patients with Grave's ophthalmopathy using turbo field echo with diffusion-sensitized driven-equilibrium preparation, Diagnostic and interventional imaging, 10.1016/j.diii.2018.02.007, 2018.01, Purpose: The purpose of this study was to correlate diffusivity of extraocular muscles, measured by three-dimensional turbo field echo (3DTFE) magnetic resonance (MR) imaging using diffusion-sensitized driven-equilibrium preparation, with their size and activity in patients with Grave's ophthalmopathy. Materials and methods: Twenty-three patients with Grave's ophthalmopathy were included. There were 17 women and 6 men with a mean age of 55.8 ± 12.6 (SD) years (range: 26–83 years). 3DTFE with diffusion-sensitized driven-equilibrium MR images were obtained with b-values of 0 and 500 s/mm2. The apparent diffusion coefficient (ADC) of extraocular muscles was measured on coronal reformatted MR images. Signal intensities of extraocular muscles on conventional MR images were compared to those of normal-appearing white matter, and cross-sectional areas of the muscles were also measured. The clinical activity score was also evaluated. Statistical analyses were performed with Pearson correlation and Mann-Whitney U tests. Results: On 3DTFE with diffusion-sensitized driven-equilibrium preparation, the mean ADC of the extraocular muscles was 2.23 ± 0.37 (SD) × 10−3 mm2/s (range: 1.70 × 10−3–3.11 × 10−3 mm2/s). There was a statistically significant moderate correlation between ADC and the size of the muscles (r = 0.61). There were no statistically significant correlations between ADC and signal intensity on conventional MR and the clinical activity score. Conclusion: 3DTFE with diffusion-sensitized driven-equilibrium preparation technique allows quantifying diffusivity of extraocular muscles in patients with Grave's ophthalmopathy. The diffusivity of the extraocular muscles on 3DTFE with diffusion-sensitized driven-equilibrium preparation MR images moderately correlates with their size..
32. Keisuke Ikari, Tomohiro Nakao, Kiyotaka Nemoto, Kayo Okada, Keitaro Murayama, Shinichi Honda, Masumi Kuwano, Satoshi Yamada, Hirofumi Tomiyama, Mayumi Tomita, Osamu Togao, Hiwatashi Akio, Shigenobu Kanba, Corrigendum to “Morphologic and clinical differences between early- and late-onset obsessive-compulsive disorder
Voxel-based morphometric study” (Journal of Obsessive-Compulsive and Related Disorders (2017) (35–41)(S2211364916301580)(10.1016/j.jocrd.2017.02.005)), Journal of Obsessive-Compulsive and Related Disorders, 10.1016/j.jocrd.2017.11.005, 16, 112-113, 2018.01, We regret that Table 1 and Fig. 2 need correction. As for Table 1, we found a few critical errors. The patients' age is not 18–64 years old, correctly 17–64 years old. The patients' age of onset is not 4–38 years old, correctly 6–54 years old. The patients' duration of illness is not 0.6–42 years, correctly 0.6–51 years. As for Fig.2, several readers pointed us that it was difficult to see. So we would like to make corrections. We coloured the lines to make it distinguishable, and enlarged letters to make it more visible. We explained in footnote which line colour corresponds to which group. We attached the modified files. We are sorry to trouble you, but we hope that you will correct and replace them by the following files. We would like to apologise for any inconvenience caused..
33. Osamu Togao, Hiwatashi Akio, Makoto Obara, Koji Yamashita, Kazufumi Kikuchi, Ryotaro Kamei, ataru nishimura, Koichi Arimura, Koji Yoshimoto, Koji Iihara, Marc Van Cauteren, Hiroshi Honda, Acceleration-selective arterial spin-labeling MR angiography used to visualize distal cerebral arteries and collateral vessels in moyamoya disease, Radiology, 10.1148/radiol.2017162279, 286, 2, 611-621, 2018.02, Purpose: To evaluate and compare the performance of accelerationselective arterial spin labeling (AccASL) magnetic resonance (MR) angiography in the visualization of cerebral arteries and collateral vessels in patients with Moyamoya disease with that of time-of-flight (TOF) MR angiography, with digital subtraction angiography (DSA) as the reference standard. Materials and Methods: Thirty-six cerebral hemispheres from 22 patients with Moyamoya disease underwent TOF and AccASL MR angiography and DSA. Qualitative evaluations included imaging of the terminal internal carotid artery (ICA), distal middle cerebral arteries (MCAs), Moyamoya vessels, and leptomeningeal anastomosis (LMA) collaterals with reference to DSA. Quantitative evaluations included assessment of contrast-tonoise ratio (CNR) and number of vessels in MCA branches. The linear mixed-effect model was used to compare the two methods. Results: Mean scores for qualitative evaluation were significantly higher with AccASL angiography than with TOF angiography for imaging distal MCAs (3.9 6 0.3 [standard deviation] vs 2.9 6 1.1; P , .001), Moyamoya vessels (3.6 6 0.6 vs 2.7 6 0.9, P , .001), and LMA collaterals (3.8 6 0.6 vs 1.8 6 0.7, P , .001). Scores for steno-occlusive degree around the terminal ICAs were better with TOF angiography than with AccASL angiography (2.6 6 0.5 vs 2.4 6 0.6, P = .023). CNRs in the M4 segment were significantly higher with AccASL angiography (11.9 6 12.9, P , .001) than with TOF angiography (4.1 6 7.9). The number of vessels was significantly higher with AccASL angiography (18.3 6 5.0, P , .001) than with TOF angiography (8.9 6 4.9). The increase in the number of vessels from TOF angiography to AccASL angiography was greater in patients with severe ICA stenoocclusion (late ICA stage group, 11.4 6 4.5; early ICA stage group, 6.8 6 4.0; P = .007) and well-developed leptomeningeal anastomosis (mildly developed LMA group, 7.1 6 4.3; well-developed LMA group, 11.3 6 4.5; P = .011). Conclusion: AccASL MR angiography enables better visualization of distal cerebral arteries and collateral vessels in patients with Moyamoya disease than does TOF MR angiography, while TOF MR angiography enables better visualization of stenosis of proximal arteries. Both methods work in a mutually beneficial manner in the assessment of cerebral arteries..
34. Yukihisa Takayama, Akihiro Nishie, Osamu Togao, Yoshiki Asayama, Kosei Ishigami, yasuhiro ushijima, Daisuke Okamoto, nobuhiro fujita, Kenzo Sonoda, Tomoyuki Hida, Yoshihiro Ohishi, Jochen Keupp, Hiroshi Honda, Amide proton transfer MR imaging of endometrioid endometrial adenocarcinoma
Association with histologic grade, Radiology, 10.1148/radiol.2017170349, 286, 3, 909-917, 2018.03, Purpose: To evaluate the utility of amide proton transfer (APT) imaging in estimating histologic grades of endometrioid endometrial adenocarcinoma (EEA). Materials and The institutional review board approved this prospective Methods: study. Between June 2012 and March 2016, 32 patients with EEA underwent magnetic resonance (MR) imaging. After their surgical procedures, their EEAs were confirmed pathologically and classified into histologic grades: grade 1 (n = 11), grade 2 (n = 11), and grade 3 (n = 10). The APT signal intensities (SIs) and the mean and minimum apparent diffusion coefficients (ADCs) of the three grades were calculated and compared. Spearman rank correlation coefficient was also calculated between the APT SIs and histologic grades, and between the ADCs and histologic grades. Results: The Spearman correlation coefficient with histologic grade of the APT SIs, the mean ADC, and the minimum ADC were 0.55 (P = .001), 0.03 (P = .84), and 20.30 (P = .09), respectively. The average APT SIs and the mean and minimum ADCs were 2.2% 6 0.2 (standard deviation), 0.9 3 1023 mm2/sec 6 0.2, and 0.6 3 1023 mm2/sec 6 0.1 for grade 1; 3.2% 6 0.3, 0.8 3 1023 mm2/sec 6 0.1, and 0.5 3 1023 mm2/sec 6 0.1 for grade 2; and 3.7% 6 0.3, 0.9 3 1023 mm2/sec 6 0.1, and 0.5 3 1023 mm2/sec 6 0.1 for grade 3, respectively. The APT SIs of grade 3 EEA were significantly higher than those of grade 1 EEA (P = .01), but other pairwise comparisons did not reveal any significant differences (P = .06-.51). The mean and minimum ADCs showed no significant differences among the three histologic grades (P =.13-.51). Conclusion: The APT SI was positively correlated with the histologic grades of EEA..
35. Kazufumi Kikuchi, Hiwatashi Akio, Osamu Togao, Koji Yamashita, Ryotaro Kamei, Mika Kitajima, Masafumi Kanoto, Hiroto Takahashi, Yusuke Uchiyama, Masafumi Harada, Yuki Shinohara, Takashi Yoshiura, Yuki Wakata, Hiroshi Honda, Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas
a multicenter study in Japan, Neuroradiology, 10.1007/s00234-018-1991-7, 60, 4, 391-401, 2018.04, Purpose: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. Methods: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P <.05 was considered to indicate significance. Results: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P <.0001, P =.0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10−3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3 mm2/s) (P <.0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. Conclusion: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs..
36. Kazufumi Kikuchi, Hiwatashi Akio, Osamu Togao, Koji Yamashita, Ryotaro Kamei, Koji Yoshimoto, Koji Iihara, Satoshi Suzuki, Toru Iwaki, Yuriko Suzuki, Hiroshi Honda, Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas, European Radiology, 10.1007/s00330-018-5404-4, 1-9, 2018.04, Objectives: ASL is useful in evaluating tumour blood flow and in detecting hypervascular tumours. The purpose of this study was to assess the additive value of ASL to non-contrast and contrast-enhanced (NC/CE)-T1WI for diagnosing residual or recurrent meningiomas. Methods: This retrospective study included 25 postoperative patients (20 women, 5 men; median age, 65 [32–85] years) with and 25 gender- and age-matched postoperative patients without residual or recurrent meningiomas. ASL was performed using a pseudocontinuous method. Seven independent observers (two radiology residents, two general radiologists and three neuroradiologists) participated in two reading sessions consisting of only NC/CE-T1WI (first session) or NC/CE-T1WI with ASL (second session). We evaluated the sensitivity and diagnostic performance for the detection of residual or recurrent meningiomas. The diagnostic performance was assessed using a figure of merit (FOM) calculated via jackknife free-response receiver-operating characteristics. Statistical analysis was performed with paired t tests, with a significance level of p < .05. Results: The sensitivities were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (62.1% vs. 70.7%), general radiologists (75.9% vs. 87.9%), neuroradiologists (97.7% vs. 100%) and all observers (81.3% vs. 88.2%). The FOMs were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (0.76 vs. 0.83), general radiologists (0.83 vs. 0.93), neuroradiologists (0.95 vs. 0.99) and all observers (0.86 vs. 0.93). The addition of ASL significantly improved the diagnostic parameters for all observers except neuroradiologists (p <. 05). Conclusions: ASL improved the detection rate of residual or recurrent meningiomas on NC/CE-T1WI among both radiology residents and general radiologists. Key Points: • ASL improved diagnostic performance for residual/recurrent meningioma compare to NC/CE-T1WI alone.• Diagnostic sensitivity was increased after adding ASL compared with NC/CE-T1WI.• FOM was increased after adding ASL compared with NC/CE-T1WI..
37. Osamu Togao, Hiwatashi Akio, Makoto Obara, Koji Yamashita, Daichi Momosaka, ataru nishimura, Koichi Arimura, Nobuhiro Hata, Koji Yoshimoto, Koji Iihara, Marc van Cauteren, Hiroshi Honda, 4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease
a comparison of techniques, European Radiology, 10.1007/s00330-018-5462-7, 1-11, 2018.05, Objectives: To evaluate the performance of four-dimensional pseudo-continuous arterial spin labeling (4D-pCASL)-based angiography using CENTRA-keyhole and view sharing (4D-PACK) in the visualization of flow dynamics in distal cerebral arteries and leptomeningeal anastomosis (LMA) collaterals in moyamoya disease in comparison with contrast inherent inflow-enhanced multiphase angiography (CINEMA), with reference to digital subtraction angiography (DSA). Methods: Thirty-two cerebral hemispheres from 19 patients with moyamoya disease (mean age, 29.7 ± 19.6 years; five males, 14 females) underwent both 4D-MR angiography and DSA. Qualitative evaluations included the visualization of anterograde middle cerebral artery (MCA) flow and retrograde flow via LMA collaterals with reference to DSA. Quantitative evaluations included assessments of the contrast-to-noise ratio (CNR) on these vessels. The linear mixed-effect model was used to compare the 4D-PACK and CINEMA methods. Results: The vessel visualization scores were significantly higher with 4D-PACK than with CINEMA in the visualization of anterograde flow for both Observer 1 (CINEMA, 3.53 ± 1.39; 4D-PACK, 4.53 ± 0.80; p < 0.0001) and Observer 2 (CINEMA, 3.50±1.39; 4D-PACK, 4.31 ± 0.86; p = 0.0009). The scores were higher with 4D-PACK than with CINEMA in the visualization of retrograde flow for both Observer 1 (CINEMA, 3.44 ± 1.05; 4D-PACK, 4.47 ± 0.88; p < 0.0001) and Observer 2 (CINEMA, 3.19 ± 1.20; 4D-PACK, 4.38 ± 0.91; p < 0.0001). The maximum CNR in the anterograde flow was higher in 4D-PACK (40.1 ± 16.1, p = 0.0001) than in CINEMA (27.0 ± 16.6). The maximum CNR in the retrograde flow was higher in 4D-PACK (36.1 ± 10.0, p < 0.0001) than in CINEMA (15.4 ± 8.0). Conclusions: The 4D-PACK provided better visualization and higher CNRs in distal cerebral arteries and LMA collaterals compared with CINEMA in patients with this disease. Key Points: • The 4D-PACK enables good visualization of distal cerebral arteries in moyamoya disease.• The 4D-PACK enables direct visualization of leptomeningeal collateral vessels in moyamoya disease.• Vessel visualization by 4D-PACK can be useful in assessing cerebral hemodynamics..
38. Makoto Obara, Osamu Togao, Gabriele M. Beck, Shuhei Shibukawa, Tomoyuki Okuaki, Masami Yoneyama, Masanobu Nakamura, Hiroshi Honda, Marc Van Cauteren, Non-contrast enhanced 4D intracranial MR angiography based on pseudo-continuous arterial spin labeling with the keyhole and view-sharing technique, Magnetic Resonance in Medicine, 10.1002/mrm.27074, 80, 2, 719-725, 2018.08, Purpose: 4D dynamic MR angiography (4D-MRA) using pseudo-continuous arterial spin labeling (pCASL), combined with Keyhole and View-sharing (4D-PACK) for scan acceleration, is introduced. Its validity for arterial inflow dynamics visualization was investigated through comparison with 4D-pCASL and contrast inherent inflow enhanced multiphase angiography (CINEMA). Methods: Six healthy volunteers were included in the study. The arterial transit time (ATT) in 4D-PACK was measured at multiple regions in middle cerebral artery (MCA), and Pearson's correlation coefficient with ATT in 4D-pCASL was calculated. The contrast-to-noise ratio (CNR) in 4D-PACK was measured in four MCA segments and compared with that in 4D-pCASL and CINEMA. Arterial visualization in 4D-PACK was assessed qualitatively in patients with moyamoya disease and arteriovenous malformation by comparing with CINEMA. Results: 4D-PACK achieved a 36% scan time reduction compared with 4D-pCASL. The correlation coefficient for ATT measured by 4D-pCASL and 4D-PACK was greater than 0.96. The CNR was significantly higher using 4D-PACK compared with CINEMA in the M4 segment (P < 0.01). In patient examinations, the flow in the collateral artery or draining vein was better visualized in 4D-PACK compared with CINEMA. Conclusion: 4D-PACK accelerates 4D-pCASL, shows similar inflow dynamics as 4D-pCASL and shows better peripheral visualization compared with CINEMA. Magn Reson Med 80:719–725, 2018..
39. Akihiro Nishie, Yukihisa Takayama, Yoshiki Asayama, Kosei Ishigami, yasuhiro ushijima, Daisuke Okamoto, nobuhiro fujita, Daisuke Tsurumaru, Osamu Togao, Tatsuya Manabe, Eiji Oki, Yuichiro Kubo, Tomoyuki Hida, Minako Hirahashi-Fujiwara, Jochen Keupp, Hiroshi Honda, Amide proton transfer imaging can predict tumor grade in rectal cancer, Magnetic Resonance Imaging, 10.1016/j.mri.2018.04.017, 51, 96-103, 2018.09, Purpose: To prospectively investigate the ability of amide proton transfer (APT) imaging, in comparison with that of diffusion-weighted imaging (DWI), to predict pathological factors in rectal cancer. Materials and methods: Twenty-two patients who underwent MR examination including APT imaging and DWI for evaluation of rectal cancer were enrolled. APT signal intensity (SI) was defined as the magnetization transfer asymmetry at 3.5 ppm and was mapped. An apparent diffusion coefficient (ADC) map was generated using b-values of 0, 500 and 1000 s/mm2. APT SI and ADC were calculated by placing regions-of-interest in the tumors on these maps. Pathological factors including tumor size and tumor grade were also evaluated. Average APT SIs or ADCs were compared between the two groups classified based on each pathological factor using Student's t-test. Results: The average APT SI of tumors with diameters of 5 cm or more (3.09 ± 1.41%) was significantly higher than that of tumors with diameters < 5 cm (1.83 ± 1.38%). In addition, the average APT SI of moderately differentiated adenocarcinoma (2.82 ± 1.51%) was significantly higher than that of well-differentiated adenocarcinoma (1.24 ± 0.57%). There was no difference in ADC between groups classified based on any pathological factor. Conclusion: Amide proton transfer imaging can predict tumor grade in rectal cancer..