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Computers 15(2) 115-115 2026年2月8日In lung cytology, screeners and pathologists examine many cells in cytological specimens and describe their corresponding imaging findings. To support this process, our previous study proposed an image-finding generation model based on convolutional neural networks and a transformer architecture. However, further improvements are required to enhance the accuracy of these findings. In this study, we developed a cytology-specific image-finding generation model using a vision transformer and open-source large language models. In the proposed method, a vision transformer pretrained on large-scale image datasets and multiple open-source large language models was introduced and connected through an original projection layer. Experimental validation using 1059 cytological images demonstrated that the proposed model achieved favorable scores on language-based evaluation metrics and good classification performance when cells were classified based on the generated findings. These results indicate that a task-specific model is an effective approach for generating imaging findings in lung cytology.
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Respiratory Investigation 64(1) 101335-101335 2026年1月
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Computers 14(11) 489-489 2025年11月9日In the diagnosis of lung cancer, imaging findings of lung nodules are essential for benign and malignant classifications. Although numerous studies have investigated the classification of lung nodules, no method has been proposed for obtaining detailed imaging findings. This study aimed to develop a novel method for generating image findings and classifying benign and malignant nodules in chest computed tomography (CT) images using vision–language models. In this study, we collected chest CT images of 77 patients diagnosed with either benign or malignant tumors at Fujita Health University Hospital. For these images, we cropped the regions of interest around the nodules, and a pulmonologist provided the corresponding image findings. We used vision–language models for image captioning to generate image findings. The findings generated by these two models were grammatically correct, with no deviations in notation, as expected from the image findings. Moreover, the descriptions of benign and malignant characteristics were accurately obtained. The bootstrapping language–image pretraining (BLIP) base model achieved an accuracy of 79.2% in classifying nodules, and the bilingual evaluation understudy-4 score for agreement with physician findings was 0.561. These results suggest that the proposed method may be effective for classifying and generating lung nodule findings.
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Fujita medical journal 11(3) 121-128 2025年8月OBJECTIVES: To develop a comprehensive machine learning model incorporating various clinical factors, including frailty and comorbidities, to predict 30-day readmission and mortality risk in patients with chronic obstructive pulmonary disease (COPD). METHODS: This retrospective cohort study used electronic health records (EHR) from Fujita Health University Hospital (2004-2019) for 1294 patients with COPD and 3499 hospitalization or death events. The EHR contained longitudinal patient data (demographics, diagnoses, test results, clinical records). We developed two eXtreme Gradient Boosting models, the comprehensive Top64 and practical 11-feature models. We compared these with the Comorbidity, Obstruction, Dyspnea, and Previous Exacerbations index (CODEX) model, a widely used tool for predicting hospital readmission or death in patients with COPD. The area under the receiver operating characteristic curve (AUC) with 95% confidence interval (CI), sensitivity, and specificity were used to evaluate the model performance. RESULTS: The Top64 (AUC: 0.769, 95% CI: 0.747-0.791) and practical 11-feature (AUC: 0.746, 95% CI: 0.730-0.762) models performed better than the CODEX model (AUC: 0.587, 95% CI: 0.563-0.611). The Top64 model showed 0.978 sensitivity and 0.341 specificity, and the practical 11-feature model achieved 0.955 sensitivity and 0.361 specificity. The calibration curves showed good agreement between the observed and predicted results for both models. CONCLUSIONS: A machine learning approach based on clinical data readily available from the EHR performed better than existing models in predicting 30-day readmission and mortality risks in patients with COPD. A comprehensive risk prediction tool may enhance individualized care strategies and improve patient outcomes in COPD management.
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Respirology case reports 13(5) e70157 2025年5月Bronchoscopic lung volume reduction (BLVR) with endobronchial valves is an established treatment for selected patients with advanced emphysema. A 74-year-old male patient with chronic obstructive pulmonary disease and severe dyspnea was scheduled to undergo BLVR targeting the right middle lobe bronchus based on high-resolution CT findings, which showed severe emphysematous changes with hyperinflation and fissure completeness of 98% in the right middle lobe. The physician conducted preoperative virtual reality (VR)-assisted planning using the patient's imaging data, enabling comprehensive visualisation of the bronchial tree, airway measurements, and procedural simulation. The Chartis system confirmed a 'no flow' pattern, supporting the absence of collateral ventilation. During the procedure, a size 5.5 valve was placed in the right B4/5 bronchus following VR and intraoperative assessments. The patient remained stable postoperatively without complications. VR enhanced procedural planning by improving airway assessment, optimising valve sizing, and reducing cognitive load, leading to increased efficiency and operator confidence. Further research is warranted to validate the utility of VR in bronchoscopic interventions.
MISC
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Chest 158(2) 797-807 2020年3月4日BACKGROUND: Infectious complications after endobronchial ultrasound-guided transbronchial biopsy with a guide sheath (EBUS-GS-TBB) are serious in that they may delay or change scheduled subsequent therapy. The aim of this study was to identify risk factors for infection after EBUS-GS-TBB. RESEARCH QUESTION: ▪▪▪ STUDY DESIGN AND METHODS: We retrospectively reviewed the medical records of 1,045 consecutive patients who had undergone EBUS-GS-TBB for peripheral lung lesions between January 2013 and December 2017 at Fujita Health University Hospital. We evaluated the following risk factors for infectious complications after EBUS-GS-TBB: relevant patient characteristics (age and comorbidities), lesion size, CT scan features of target lesion (intratumoral low-density areas [LDAs] and cavitation), stenosis of responsible bronchus observed by bronchoscopy, and laboratory data before EBUS-GS-TBB (WBC count and C-reactive protein concentration). RESULTS: Forty-seven of the study patients developed infectious complications (24 with pneumonia, 14 with intratumoral infection, three with lung abscess, three with pleuritis, and three with empyema), among whom the complication caused a delay in cancer treatment in 13 patients, cancellation of cancer treatment in seven patients, and death in three patients. Multivariate analysis showed that cavitation (P = .007), intratumoral LDAs (P < .001), and stenosis of responsible bronchus observed by bronchoscopy (P < .001) were significantly associated with infectious complications after EBUS-GS-TBB. Prophylactic antibiotics had been administered to 13 patients in the infection group. Propensity matched analysis could not show significant benefit of prophylactic antibiotics in preventing post-EBUS-GS-TBB infections. INTERPRETATION: Cavitation, LDAs for CT scan features of target lesions, and stenosis of responsible bronchus observed by bronchoscopy are risk factors of post-EBUS-GS-TBB infection. In the cohort, prophylactic antibiotics failed to prevent infectious complications.
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BMC pulmonary medicine 19(1) 194-194 2019年11月1日BACKGROUND: Myeloperoxidase anti-neutrophil cytoplasmic antibody-related nephritis (MPO-ANCA nephritis) is occasionally accompanied by lung abnormalities such as pulmonary fibrosis. However, the clinical features of pulmonary fibrosis in patients with MPO-ANCA nephritis have not been well documented. This study was performed to compare the prognosis of a usual interstitial pneumonia (UIP) pattern of lung fibrosis in patients with MPO-ANCA nephritis with the prognosis of idiopathic pulmonary fibrosis (IPF). METHODS: We retrospectively reviewed the medical records of 126 patients with MPO-ANCA nephritis and identified 31 with a UIP pattern of lung fibrosis on high-resolution or thin-slice computed tomography (CT). We compared the characteristics and prognosis of these patients with those of 32 patients with IPF. In 18 patients from both groups, we assessed and compared the decline in lung volume over time using three-dimensional (3D) CT images reconstructed from thin-section CT data. RESULTS: The numbers of male and female patients were nearly equal among patients with MPO-ANCA nephritis exhibiting a UIP pattern; in contrast, significant male dominancy was observed among patients with IPF (p = 0.0021). Significantly fewer smokers were present among the patients with MPO-ANCA nephritis with a UIP pattern than among those with IPF (p = 0.0062). There was no significant difference in the median survival time between patients with MPO-ANCA nephritis with a UIP pattern (50.8 months) and IPF (55.8 months; p = 0.65). All patients with IPF in this cohort received antifibrotic therapy (pirfenidone or nintedanib). Almost half of the deaths that occurred in patients with MPO-ANCA nephritis with a UIP pattern were caused by non-respiratory-related events, whereas most deaths in patients with IPF were caused by respiratory failure such as acute exacerbation. In the 3D CT lung volume analyses, the rate of decline in lung volume was equivalent in both groups. CONCLUSIONS: MPO-ANCA nephritis with a UIP pattern on CT may have an unfavorable prognosis equivalent to that of IPF with a UIP pattern treated with antifibrotic agents.
書籍等出版物
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79共同研究・競争的資金等の研究課題
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日本学術振興会 科学研究費助成事業 2025年4月 - 2028年3月
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日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2022年4月 - 2025年3月
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日本学術振興会 科学研究費助成事業 2021年4月 - 2024年3月
その他教育活動上特記すべき事項
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件名第48回医学教育ワークショップ終了年月日2013/08/18概要「臨床実習学習成果の設定」に参加した。