研究者業績

外山 宏

トヤマ ヒロシ  (hiroshi toyama)

基本情報

所属
藤田医科大学 医学部 医学科 放射線医学 教授 (特命教授)
学位
医学博士(1990年3月 藤田医科大学)

連絡先
htoyamafujita-hu.ac.jp
J-GLOBAL ID
200901090746938010
researchmap会員ID
1000102544

論文

 152
  • Hirotaka Ikeda, Yoshiharu Ohno, Kaori Yamamoto, Kazuhiro Murayama, Masato Ikedo, Masao Yui, Yunosuke Kumazawa, Yurika Shimamura, Yui Takagi, Yuhei Nakagaki, Satomu Hanamatsu, Yuki Obama, Takahiro Ueda, Hiroyuki Nagata, Yoshiyuki Ozawa, Akiyoshi Iwase, Hiroshi Toyama
    Cancers 16(9) 2024年4月28日  
    BACKGROUND: Diffusion-weighted images (DWI) obtained by echo-planar imaging (EPI) are frequently degraded by susceptibility artifacts. It has been suggested that DWI obtained by fast advanced spin-echo (FASE) or reconstructed with deep learning reconstruction (DLR) could be useful for image quality improvements. The purpose of this investigation using in vitro and in vivo studies was to determine the influence of sequence difference and of DLR for DWI on image quality, apparent diffusion coefficient (ADC) evaluation, and differentiation of malignant from benign head and neck tumors. METHODS: For the in vitro study, a DWI phantom was scanned by FASE and EPI sequences and reconstructed with and without DLR. Each ADC within the phantom for each DWI was then assessed and correlated for each measured ADC and standard value by Spearman's rank correlation analysis. For the in vivo study, DWIs obtained by EPI and FASE sequences were also obtained for head and neck tumor patients. Signal-to-noise ratio (SNR) and ADC were then determined based on ROI measurements, while SNR of tumors and ADC were compared between all DWI data sets by means of Tukey's Honest Significant Difference test. RESULTS: For the in vitro study, all correlations between measured ADC and standard reference were significant and excellent (0.92 ≤ ρ ≤ 0.99, p < 0.0001). For the in vivo study, the SNR of FASE with DLR was significantly higher than that of FASE without DLR (p = 0.02), while ADC values for benign and malignant tumors showed significant differences between each sequence with and without DLR (p < 0.05). CONCLUSION: In comparison with EPI sequence, FASE sequence and DLR can improve image quality and distortion of DWIs without significantly influencing ADC measurements or differentiation capability of malignant from benign head and neck tumors.
  • 服部 秀計, 坂口 英林, 成瀬 寛之, 高木 玲香, 大下 悠樹, 寺本 篤司, 太田 誠一郎, 花松 智武, 渡邉 あゆみ, 大野 良治, 外山 宏, 山上 潤一, 安田 あゆ子, 小林 茂樹
    Japanese Journal of Radiology 42(Suppl.) 25-25 2024年2月  
  • Hiroyuki Nagata, Yoshiharu Ohno, Takeshi Yoshikawa, Kaori Yamamoto, Maiko Shinohara, Masato Ikedo, Masao Yui, Takahiro Matsuyama, Tomoki Takahashi, Shuji Bando, Minami Furuta, Takahiro Ueda, Yoshiyuki Ozawa, Hiroshi Toyama
    Magnetic resonance imaging 2024年2月1日  
    PURPOSE: The purpose of this study was to determine the utility of compressed sensing (CS) with deep learning reconstruction (DLR) for improving spatial resolution, image quality and focal liver lesion detection on high-resolution contrast-enhanced T1-weighted imaging (HR-CE-T1WI) obtained by CS with DLR as compared with conventional CE-T1WI with parallel imaging (PI). METHODS: Seventy-seven participants with focal liver lesions underwent conventional CE-T1WI with PI and HR-CE-T1WI, surgical resection, transarterial chemoembolization, and radiofrequency ablation, followed by histopathological or >2-year follow-up examinations in our hospital. Signal-to-noise ratios (SNRs) of liver, spleen and kidney were calculated for each patient, after which each SNR was compared by means of paired t-test. To compare focal lesion detection capabilities of the two methods, a 5-point visual scoring system was adopted for a per lesion basis analysis. Jackknife free-response receiver operating characteristic (JAFROC) analysis was then performed, while sensitivity and false positive rates (/data set) for consensus assessment of the two methods were also compared by using McNemar's test or the signed rank test. RESULTS: Each SNR of HR-CE-T1WI was significantly higher than that of conventional CE-T1WI with PI (p < 0.05). Sensitivities for consensus assessment showed that HR-CE-MRI had significantly higher sensitivity than conventional CE-T1WI with PI (p = 0.004). Moreover, there were significantly fewer FP/cases for HR-CE-T1WI than for conventional CE-T1WI with PI (p = 0.04). CONCLUSION: CS with DLR are useful for improving spatial resolution, image quality and focal liver lesion detection capability of Gd-EOB-DTPA enhanced 3D T1WI without any need for longer breath-holding time.
  • Minami Furuta, Hirotaka Ikeda, Satomu Hanamatsu, Kaori Yamamoto, Maiko Shinohara, Masato Ikedo, Masao Yui, Hiroyuki Nagata, Masahiko Nomura, Takahiro Ueda, Yoshiyuki Ozawa, Hiroshi Toyama, Yoshiharu Ohno
    European journal of radiology 171 111289-111289 2024年1月6日  
    PURPOSE: The purpose of this in vivo study was to determine the effect of reverse encoding direction (RDC) on apparent diffusion coefficient (ADC) measurements and its efficacy for improving image quality and diagnostic performance for differentiating malignant from benign tumors on head and neck diffusion-weighted imaging (DWI). METHODS: Forty-eight patients with head and neck tumors underwent DWI with and without RDC and pathological examinations. Their tumors were then divided into two groups: malignant (n = 21) and benign (n = 27). To determine the utility of RDC for DWI, the difference in the deformation ratio (DR) between DWI and T2-weighted images of each tumor was determined for each tumor area. To compare ADC measurement accuracy of DWIs with and without RDC for each patient, ADC values for tumors and spinal cord were determined by using ROI measurements. To compare DR and ADC between two methods, Student's t-tests were performed. Then, ADC values were compared between malignant and benign tumors by Student's t-test on each DWI. Finally, sensitivity, specificity and accuracy were compared by means of McNemar's test. RESULTS: DR of DWI with RDC was significantly smaller than that without RDC (p < 0.0001). There were significant differences in ADC between malignant and benign lesions on each DWI (p < 0.05). However, there were no significant difference of diagnostic accuracy between the two DWIs (p > 0.05). CONCLUSION: RDC can improve image quality and distortion of DWI and may have potential for more accurate ADC evaluation and differentiation of malignant from benign head and neck tumors.
  • 服部 秀計, 池田 裕隆, 花松 智武, 高木 悠衣, 島村 宥里佳, 熊澤 佑之介, 中垣 勇平, 石田 小百合, 高橋 知樹, 坂東 周治, 大島 夕佳, 古田 みなみ, 高橋 和也, 濱渕 菜邑, 久永 隆治, 坂口 英林, 成瀬 寛之, 大野 良治, 外山 宏
    総合健診 51(1) 199-199 2024年1月  

MISC

 109
  • 小澤良之, 小澤良之, 高橋知樹, 外山宏, 大野良治, 大野良治
    臨床画像 39 2023年  
  • 大野良治, 大野良治, 大島夕佳, 古田みなみ, 濱渕菜邑, 花松智武, 小濱佑樹, 永田紘之, 植田高弘, 池田裕隆, 村山和宏, 小澤良之, 外山宏
    映像情報Medical 54(14) 2022年  
  • 吉岡哲志, 日江井祐介, 加藤久幸, 楯谷一郎, 藤井直子, 外山宏, 片田和広
    日本耳鼻咽喉科学会会報 123(4) 2020年  
  • 河合 秀樹, 皿井 正義, 加藤 靖周, 成瀬 寛之, 渡邉 あゆみ, 松山 貴裕, 森本 紳一郎, 外山 宏, 尾崎 行男
    日本サルコイドーシス/肉芽腫性疾患学会雑誌 39(1-2) 59-64 2019年10月  
    我々は心臓サルコイドーシス疑いの74例において,「2016年版心臓サルコイドーシスの診療ガイドライン」における組織診断・臨床診断を真として,FDG-PET/CTの診断精度を検討した.さらにFDG-PET/CTと同時期に心臓造影MRIを施行した33例において,ガドリニウム造影剤を用いた遅延造影(LGE)所見を検討した.全74例中31例が本症の診断基準を満たし,38例が診断基準を満たさず,残り5例は心限局性サ症の疑診例であった.診断基準を満たした31例を真とすると,FDGPET/CTによる感度,特異度,正診率,陽性的中率,陰性的中率は,それぞれ90%,87%,88%,85%,92%であった.心臓造影MRIを同時期に施行した33例において,FDG-PET/CT陽性の20例中16例でLGE陽性,FDG-PET/CT陰性の13例中8例でLGE陽性であった.心サ症疑い患者におけるFDG-PET/CTの診断精度は非常に良好であった.さらに心臓MRIの遅延造影所見を加えることは,本症の活動性や線維化の診断に有用であった.(著者抄録)
  • 河合 秀樹, 皿井 正義, 加藤 靖周, 成瀬 寛之, 渡邉 あゆみ, 松山 貴裕, 元山 貞子, 森本 紳一郎, 外山 宏, 尾崎 行男
    核医学 56(Suppl.) S137-S137 2019年10月  
  • 河合 秀樹, 皿井 正義, 加藤 靖周, 成瀬 寛之, 渡邉 あゆみ, 松山 貴裕, 森本 紳一郎, 外山 宏, 尾崎 行男
    日本心臓核医学会ニュースレター 21(2) 123-123 2019年6月  
  • 岡田佑介, 岡田佑介, 岩田香織, 加藤隆司, 木村泰之, 木澤剛, 中村昭範, 服部英幸, 乾好貴, 外山宏, 石井一成, 石井賢二, 千田道雄, 松田博史, 伊藤健吾, 岩坪威
    核医学(Web) 55(1) 14(J‐STAGE)-14 2018年12月  
  • 乾 好貴, 市原 隆, 宇野 正樹, 伊藤 健吾, 加藤 克彦, 岡沢 秀彦, 西堀 弘記, 市川 泰崇, 山崎 孝浩, 外山 宏
    核医学 55(Suppl.) S156-S156 2018年11月  
  • 植田 高弘, 小林 茂樹, 市川 亮子, 中川 満, 安岡 知香, 外山 宏
    日本医学放射線学会秋季臨床大会抄録集 54回 S467-S468 2018年9月  
  • 村山和宏, 山城慧, 安倍雅人, 片田和広, 外山宏
    日本神経放射線学会プログラム・抄録集 47th 2018年  
  • 西山悠也, 長谷川光広, 我那覇司, 村山和宏, 早川基治, 外山宏, 片田和広, 廣瀬雄一
    日本脳腫瘍の外科学会プログラム・抄録集 23rd 2018年  
  • 松山貴裕, 太田誠一朗, 藤井直子, 乾好貴, 塚本徹哉, 磯部一郎, 辻岡勝美, 長尾静子, 小林茂樹, 外山宏
    オートプシー・イメージング学会学術総会プログラム・抄録集 16th 44 2018年  
  • 皿井正義, 加藤靖周, 石黒雅伸, 宮島桂一, 永原康臣, 河合秀樹, 菊川薫, 元山貞子, 外山宏, 尾崎行男
    臨床放射線 62(13) 1805‐1810 2017年12月10日  
  • 外山 宏, 渡邉 公憲, 石黒 雅伸, 寺本 篤司, 市原 隆, Li Deyan, Yun Dong, Hong Miao, Jun Bao, Yuan Zhibin, Yoh Noriaki, Kai Mototora
    映像情報medical : a monthly journal of medical imaging and information 49(11) 2-7 2017年10月  
  • 永田 紘之, 村山 和宏, 早川 基治, 加藤 良一, 藤井 直子, 齊藤 泰男, 藤井 健二, 片田 和広, 外山 宏
    映像情報medical : a monthly journal of medical imaging and information 49(8) 130-135 2017年7月  
  • Yoshitaka Inui, Takashi Ichihara, Masaki Uno, Masanobu Ishiguro, Seiichiro Ota, Kengo Ito, Takahiro Yamazaki, Katsuhiko Kato, Hajime Sakuma, Hidehiko Okazawa, Hiroshi Toyama
    JOURNAL OF NUCLEAR MEDICINE 58 2017年5月  
  • 伊藤 正之, 伊藤 文隆, 林 真也, 深見 直彦, 白木 良一, 岡本 昌隆, 外山 宏, 小林 英敏
    臨床放射線 62(4) 589-594 2017年4月  
  • 鱸成隆, 村山和宏, 外山宏, 三宅未紗, 三浦浩樹, 河村吉紀, 石原尚子, 吉川哲史
    Japanese Journal of Radiology 35(Supplement) 25-25 2017年2月25日  
  • 石黒雅伸, 石黒雅伸, 片岡由美, 片岡由美, 宇野正樹, 豊田昭博, 菊川薫, 乾好貴, 太田誠一朗, 外山宏, 市原隆, 市原隆
    核医学(Web) 54(Supplement) 2017年  
  • 松山貴裕, 藤井直子, 乾好貴, 塚本徹哉, 磯部一郎, 辻岡勝美, 長尾静子, 竹中章倫, 小林茂樹, 外山宏
    オートプシー・イメージング学会学術総会プログラム・抄録集 15th 2017年  
  • 岩崎 仁, 高橋 和男, 林 宏樹, 小出 滋久, 長谷川 みどり, 伊藤 泰平, 剣持 敬, 佐々木 ひと美, 日下 守, 白木 良一, 夏目 貴弘, 市原 隆, 外山 宏, 湯澤 由紀夫
    日本腎臓学会誌 58(3) 310-310 2016年5月  
  • 山之内 和広, 外山 宏, 藤井 直子, 岡本 直樹, 長谷川 みどり, 湯澤 由紀夫, 杉山 敏
    Japanese Journal of Radiology 34(Suppl.) 36-36 2016年2月  
  • Ryoichi Shiroki, Naohiko Fukami, Kosuke Fukaya, Mamoru Kusaka, Takahiro Natsume, Takashi Ichihara, Hiroshi Toyama
    INTERNATIONAL JOURNAL OF UROLOGY 23(2) 122-131 2016年2月  
    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2), we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy will be more frequently carried out as a safe, effective and minimally-invasive nephron-sparing surgery procedure.
  • 植田 高弘, 村山 和宏, 鱸 成隆, 外山 宏
    Japanese Journal of Radiology 34(Suppl.) 28-28 2016年2月  
  • 村山 和宏, 鱸 成隆, 大家 祐実, 植田 高弘, 小森 雅子, 外山 宏, 片田 和広
    Japanese Journal of Radiology 34(Suppl.) 29-29 2016年2月  
  • 野村 昌彦, 赤松 北斗, 村山 和宏, 植田 高弘, 鱸 成隆, 外山 宏, 内海 俊明
    Japanese Journal of Radiology 34(Suppl.) 29-29 2016年2月  
  • 村山 和宏, 福場 崇, 植田 高弘, 池戸 雅人, 二宮 綾子, 片田 和広, 外山 宏
    映像情報Medical 47(14) 83-87 2015年12月  
  • 村山 和宏, 早川 基治, 鱸 成隆, 植田 高弘, 片田 和広, 外山 宏
    日独医報 60(2) 159-170 2015年11月  
  • 志村 正博, 石原 慎, 伊東 昌広, 浅野 之夫, 津田 一樹, 越智 隆之, 清水 謙太郎, 林 千紘, 赤松 北斗, 花岡 良太, 加藤 良一, 外山 宏, 堀口 明彦
    日本臨床外科学会雑誌 76(10) 2605-2605 2015年10月  
  • 岡本 直樹, 佐藤 和一, 長谷川 みどり, 山之内 和広, 外山 宏, 大橋 篤, 中井 滋, 藤井 直子, 杉山 敏, 湯澤 由紀夫
    日本透析医学会雑誌 48(Suppl.1) 943-943 2015年5月  
  • 岡本 直樹, 佐藤 和一, 長谷川 みどり, 山之内 和広, 外山 宏, 鈴木 敦詞, 大橋 篤, 中井 滋, 藤井 直子, 杉山 敏, 上西 一弘, 湯澤 由紀夫
    日本腎臓学会誌 57(3) 588-588 2015年4月  
  • 太田誠一朗, 外山宏, 宇野正樹, 石黒雅伸, 夏目貴弘, 横山須美, 市原隆
    臨床放射線 60(2) 304-310 2015年2月  査読有り
  • 服部 秀計, 植田 高弘, 山之内 和広, 太田 誠一郎, 菊川 薫, 外山 宏, 岡澤 光芝, 林 正道, 今泉 和良
    Japanese Journal of Radiology 33(Suppl.) 56-56 2015年2月  
  • 永田紘之, 渡邉あゆみ, 服部秀計, 齋藤泰男, 山之内和広, 赤松北斗, 片岡由美, 小林正尚, 村山和宏, 加藤良一, 辻岡勝美, 井田義宏, 藤井直子, 片田和広, 外山宏
    日本医学放射線学会秋季臨床大会抄録集 51st 2015年  
  • 鱸成隆, 村山和宏, 三宅未紗, 三浦浩樹, 河村吉紀, 石原尚子, 吉川哲史, 外山宏
    日本神経放射線学会プログラム・抄録集 44th 202 2015年  
  • Seigo Kinuya, Yasuo Kuwabara, Kentaro Inoue, Setsu Sakamoto, Eku Shimosegawa, Keiko Takeoka, Yoshihiro Takeda, Hiroshi Toyama, Yasuo Niio, Yoshihiro Nishiyama, Keiichiro Yoshinaga, Mana Yoshimura
    ANNALS OF NUCLEAR MEDICINE 28(10) 1032-1038 2014年12月  査読有り
    The Subcommittee on the Survey of Nuclear Medical 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. 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 2012, to all the nuclear medicine institutes. The total numbers for the year 2012 were then estimated. A total of 1,167 institutes responded to the survey, including the 14 in vitro assay institutes and 266 PET centers. The recovery rate was 92 %. The number of gamma cameras installed was 1,425 in total, with 9 % decrease in 5 years. Dual-head cameras and hybrid SPECT/CT scanners accounted for 84 and 10.5 %, respectively. The number of single-photon tracer studies in 2012 was 1.15 million which means decrease in 19 % in 5 years and 29 % in 10 years. All but cerebral perfusion study and sentinel lymphoscintigraphy have decreased. Bone scintigraphy was a leading examination (38.7 %), followed by cardiac studies (29.4 %) and cerebral perfusion study (18.5 %) in order. SPECT studies showed an increase from 42.3 to 47.2 %. PET centers have also increased from 212 to 295, as compared to the last survey. The 135 PET centers have installed one or two in-house cyclotrons. PET studies showed 25.5 % increase in 5 years, with oncology accounting for 96.3 %. F-18-FDG accounted for 98.2 % (505,990 examinations). PET examinations using C-11-methionine have been increasing, with 3,352 examinations in 2012. The number of new PET studies using C-11-PIB PET was 695. I-131-radioiodine targeted therapies showed an increase, including 3,644 patients (53.6 %) for thyroid cancer and 4,889 patients (17.9 %) for hyperthyroidism. Out-patient thyroid bed ablation therapy with 30 mCi of I-131 accounted for 21.0 % of cancer patients. The number of admission rooms decreased from 158 to 135 in 5 years. In vitro radioassays have been declining continuously since 1992, with the number of studies of 9.0 million in 2012. 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 in the oncology field and radionuclide targeted therapy have steadily increased.
  • 石原 慎, 伊東 昌広, 浅野 之夫, 津田 一樹, 志村 正博, 清水 謙太郎, 越智 隆之, 林 千紘, 加藤 良一, 花岡 良太, 赤松 北斗, 外山 宏, 堀口 明彦
    胆と膵 35(10) 893-896 2014年10月  
    膵・胆管合流異常の診断基準は、2013年9月に改訂された。その診断基準に、画像診断として、EUSまたはmultidetector-row CT(MD-CT)のmulti-planar reconstruction (MPR)像などで、膵管と胆管が十二指腸壁外で合流することを確認する項目が新設された。MD-CTは、造影剤アレルギーがある場合、腎機能が不良の場合は施行できない欠点はあるが、EUSのごとく術者の技量に左右されないことや同時に癌の精査が行える利点がある。自験例27例の検討では、MD-CTにて全例で膵・胆管合流異常の診断が可能であった。既報告では、その診断率は小児例では19.6%、成人例では58.3〜100.0%であり、成人例では診断率は満足できる報告もある。MD-CTにて膵・胆管合流異常の診断は可能であるが、日本膵・胆管合流異常研究会による合流形式分類のc型のように、複雑な合流形式をとるものには、術式の立案のためERCPを追加で行う必要がある。(著者抄録)
  • 鱸 成隆, 村山 和宏, 三宅 未紗, 三浦 浩樹, 河村 吉紀, 石原 尚子, 吉川 哲史, 外山 宏
    日本医学放射線学会秋季臨床大会抄録集 50回 S657-S657 2014年9月  
  • Yuichi Kimura, Takashi Yamada, Nobuya Hashizume, Masahiko Nomura, Seiichiro Ota, Keishi Kitamura, Hiroshi Toyama
    JOURNAL OF NUCLEAR MEDICINE 55 2014年5月  
  • 服部秀計, 伊藤文隆, 大家祐実, 外山宏, 小林英敏, 片田和広, 丸山高広, 日下守, 白木良一, 彦坂祐紀子, 齊藤泰紀, 宇野正樹, 澤井剛, 江上和宏, 加藤正直, 石黒雅伸, 武藤晃一, 横山須美, 市原隆
    Jpn J Radiol 32(Supplement) 27 2014年2月  査読有り
  • Seiichiro Ota, Masaki Uno, Masaki Kato, Masanobu Ishiguro, Takahiro Natsume, Kaoru Kikukawa, Masanori Tadokoro, Takashi Ichihara, Hiroshi Toyama
    ANNALS OF NUCLEAR MEDICINE 28(2) 112-119 2014年2月  査読有り
    Strontium-89 chloride (Sr-89) bremsstrahlung single photon emission computed tomography (SPECT) imaging was evaluated for detecting more detailed whole body Sr-89 distribution. Sr-89 bremsstrahlung whole body planar and merged SPECT images were acquired using two-detector SPECT system. Energy window A (100 keV +/- A 50 %) for planar imaging and energy window A plus adjacent energy window B (300 keV +/- A 50 %) for SPECT imaging were set on the continuous spectrum. Thirteen patients with multiple bone metastases were evaluated. Bone metastases can be detected with Tc-99m-HMDP whole body planar and merged SPECT images and compared with Sr-89 bremsstrahlung whole body planar and merged SPECT images. Based on the location of metastatic lesions seen as hot spots on Tc-99m-HMDP images as a reference, the hot spots on Sr-89 bremsstrahlung images were divided into the same bone parts as Tc-99m-HMDP images (a total of 35 parts in the whole body), and the number of hot spots were counted. We also evaluated the incidence of extra-osseous uptakes in the intestine on Sr-89 bremsstrahlung whole body planar images. A total of 195 bone metastatic lesions were detected in both Tc-99m-HMDP whole body planar and merged SPECT images. Detection of hot spot lesions in Sr-89 merged SPECT images (127 of 195; 66 %) was more frequent than in Sr-89 whole body planar images (108 of 195; 56 %), based on metastatic bone lesions in Tc-99m-HMDP whole body planar and merged SPECT images. A large intestinal Sr-89 accumulation was detected in 5 of the 13 patients (38 %). Sr-89 bremsstrahlung-merged SPECT imaging could be more useful for detailed detection of whole body Sr-89 distribution than planar imaging. Intestinal Sr-89 accumulation due to Sr-89 physiologic excretion was detected in feces for 4 days after tracer injection.
  • 外山宏
    画像診断 34(3) 251 2014年  
  • Masanao Kobayashi, Yasuki Asada, Kosuke Matsubara, Yuta Matsunaga, Ai Kawaguchi, Kazuhiro Katada, Hiroshi Toyama, Kichiro Koshida, Shouichi Suzuki
    JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS 15(5) 246-256 2014年  査読有り
    We modified the Imaging Performance Assessment of CT scanners (ImPACT) to evaluate the organ doses and the effective dose based on the International Commission on Radiological Protection (ICRP) Publication 110 reference male/female phantom with the Aquilion ONE ViSION Edition scanner. To select the new CT scanner, the measurement results of the CTDI100, c and CTDI100, p for the 160 (head) and the 320 (body) mm polymethylmethacrylate phantoms, respectively, were entered on the Excel worksheet. To compute the organ doses and effective dose of the ICRP reference male/female phantom, the conversion factors obtained by comparison between the organ doses of different types of phantom were applied. The organ doses and the effective dose were almost identical for the ICRP reference male/female and modified ImPACT. The results of this study showed that, with the dose assessment of the ImPACT, the difference in sex influences only testes and ovaries. Because the MIRD-5 phantom represents a partially hermaphrodite adult, the phantom has the dimensions of the male reference man including testes, ovaries, and uterus but no female breasts, whereas the ICRP male/female phantom includes whole-body male and female anatomies based on high-resolution anatomical datasets. The conversion factors can be used to estimate the doses of a male and a female accurately, and efficient dose assessment can be performed with the modified ImPACT.
  • Tatsuo Banno, Ryoichi Kato, Ryota Hanaoka, Hokuto Akamatsu, Kan Kaneko, Hiroshi Toyama
    Open Medical Imaging Journal 8(1) 8-21 2014年  査読有り
    When performing endovascular aortic repair (EVAR) procedures, clinicians sometimes encounter cases in which the indications for EVAR are beyond the instruction for use (IFU). In EVAR, proximal neck fixation is the most important factor. This report describes several techniques and tips for EVAR in cases presenting with a difficult short neck or angled neck, especially when using the Gore Excluder®. Endo-wedge techniques (EWT), including non-sheath-assisted EWT with sheath-assisted strategies, are presented. We describe the scrum technique, which is a special procedure that is only feasible when using the Gore Excluder®. In this technique, intentional wire bending around the proximal neck portion occurs by pushing from both sides of the guidewire. This technique is applicable in cases with a sharply angled neck. The scrum with EWT is a more precise strategy for cases with a short or angled neck. Other troublesome cases include limb occlusion caused by weak points in the Gore Excluder® body and legs. The very rare complication of stent-graft collapse is also reviewed. © Banno et al.
  • 南一幸, 横山須美, 田所匡典, 鈴木昇一, 石黒雅伸, 加藤正基, 沖田洋右, 豊田昭博, 宇野正樹, 内藤愛子, 渡邊公憲, 辻本正和, 大野智之, 古谷勇一郎, 外山宏, 菊川薫, 乾好貴, 太田誠一朗, 木澤剛, 野村昌彦, 片田和広
    核医学 50(4) 312 2013年11月  査読有り
  • Yuichi Kimura, Chie Seki, Nobuya Hashizume, Takashi Yamada, Hidekatsu Wakizaka, Takahiro Nishimoto, Kentaro Hatano, Keishi Kitamura, Hiroshi Toyama, Iwao Kanno
    PHYSICS IN MEDICINE AND BIOLOGY 58(22) 7889-7903 2013年11月  査読有り
    This study aimed to develop a new system, named CD-Well, for mouse PET dynamic study. CD-Well allows the determination of time-activity curves (TACs) for arterial whole blood and plasma using 2-3 mu L of blood per sample; the minute sample size is ideal for studies in small animals. The system has the following merits: (1) measures volume and radioactivity of whole blood and plasma separately; (2) allows measurements at 10 s intervals to capture initial rapid changes in the TAC; and (3) is compact and easy to handle, minimizes blood loss from sampling, and delay and dispersion of the TAC. CD-Well has 36 U-shaped channels. A drop of blood is sampled into the opening of the channel and stored there. After serial sampling is completed, CD-Well is centrifuged and scanned using a flatbed scanner to define the regions of plasma and blood cells. The length measured is converted to volume because the channels have a precise and uniform cross section. Then, CD-Well is exposed to an imaging plate to measure radioactivity. Finally, radioactivity concentrations are computed. We evaluated the performance of CD-Well in in vitro measurement and in vivo F-18-fluorodeoxyglucose and [C-11] 2-carbomethoxy-3 beta-(4-fluorophenyl) tropane studies. In in vitro evaluation, per cent differences (mean +/- SE) from manual measurement were 4.4 +/- 3.6% for whole blood and 4.0 +/- 3.5% for plasma across the typical range of radioactivity measured in mouse dynamic study. In in vivo studies, reasonable TACs were obtained. The peaks were captured well, and the time courses coincided well with the TAC derived from PET imaging of the heart chamber. The total blood loss was less than 200 mu L, which had no physiological effect on the mice. CD-Well demonstrates satisfactory performance, and is useful for mouse PET dynamic study.
  • 白川誠二, 後田智也, 橋本洋志, 田所匡典, 宇野正樹, 辻本正和, 石黒雅伸, 外山宏
    核医学技術 33(4) 367-376 2013年10月  
  • 桑原 康雄, 絹谷 清剛, 井上 健太郎, 坂本 攝, 下瀬川 恵久, 竹岡 啓子, 竹田 芳弘, 外山 宏, 新尾 泰男, 西山 佳宏, 吉永 恵一郎, 吉村 真奈, 日本アイソトープ協会医学, 薬学部会全国核医学診療実態調査専門委員会
    Radioisotopes 62(8) 545-608 2013年8月  
    1982年から5年ごとに各時代の核医学診療の実態を把握するため、「全国核医学診療実態調査」を実施してきたが、2012年6月に第7回調査を過去6回の調査と同様の方法で実施し、過去の調査結果と比較し報告した。核医学診療を行っている1274施設全てに調査票を送付した。回答があったのは1167施設で回答回収率は91.6%と前回同様90%を超える高い数値であった。全核医学施設は全体として調査開始から横ばいかやや増加の傾向にあるが、インビボ検査の施設は5年前に比べ減少した。検査件数は前回より減少傾向にあったが今回更に27万件/年(19%)減少した。一方、PET検査に関しては前回ほどの伸びはなかったが施設内で4割、検査数では16万件増加した。非密封RI治療に関しても新規薬剤を含め全体で6割、治療件数で4000件増加した。インビトロ検査に関しては減少が続き、実施施設数は1/3になったが、検査件数の減少は3割に留まった。CTやMRIなどの診断技術の進歩により、検査の枠組みが変化すると共に核医学の中でもインビボ検査からPET検査、核医学診断からRI内用療法への重心のシフトが明らかになった。
  • Kazuhiro Yamanouchi, Hiroshi Toyama, Takahiro Maruyama, Kiyotaka Hoshinaga, Kazuhiro Katada
    CLINICAL NUCLEAR MEDICINE 38(7) 543-545 2013年7月  
    We report here a case of rupture of a substitute urinary bladder due to a relapse of bladder cancer detected incidentally on a bone scan. The radionuclides used in bone scans accumulate in the bone and are excreted in the urine. Incidental detection of rupture of a substitute urinary bladder may lead to appropriate intermediate neobladder repair.
  • Yumi Oie, Yasunori Saito, Masanao Kato, Fumitaka Ito, Hidekazu Hattori, Hiroshi Toyama, Hidetoshi Kobayashi, Kazuhiro Katada
    RADIATION ONCOLOGY 8 56 2013年3月  査読有り
    Background: Radiation pneumonitis (RP) and organizing pneumonia (OP) are the two main types of lung damage that can occur after lung irradiation. The goal of this study was to evaluate the relationship between RP and OP after irradiation for breast cancer. Methods: Four hundred and twenty-eight patients who underwent radiotherapy for breast cancer were identified. The whole breast was irradiated with two tangential photon beams. Chest computed tomography (CT) scan were performed when patients showed any symptoms that were suspicious for pneumonitis. Results: Five patients (1.2%) were diagnosed with OP. All five patients showed ground glass opacities and consolidation of the border of the lesion of RP in the radiation fields. Infiltration of OP spread from the site of RP to the hilum of the ipsilateral lung. Between RP and OP, a free region space (FRS) could be detected. Conclusions: OP is closely related to RP. All OP lesions developed near the site of RP.

書籍等出版物

 3

講演・口頭発表等

 117

共同研究・競争的資金等の研究課題

 27

教育内容・方法の工夫(授業評価等を含む)

 1
  • 件名
    生涯教育研修センター12階、IT学習室のPCシステムを利用した。
    開始年月日
    2008
    終了年月日
    2013
    概要
    基本的診療技能Ⅱ(実習)において、1台/1人のPCシステムを利用し、頭部、胸部、腹部CTの横断解剖の実習を行った。

作成した教科書、教材、参考書

 2
  • 件名
    Functional Cerebral SPECT and PET Imaging, 4thedition, Van Heertum RL, Tikofsky RS, Ichise M, eds.
    終了年月日
    2010
    概要
    Moya-moya disease, 310-311,Wolters Kluwer/Lippincott Williams & Wilkinsを分担執筆した。
  • 件名
    Functional Cerebral SPECT and PET Imaging. 4th edition, Van Heertum RL, Tikofsky RS, Ichise M.eds.
    終了年月日
    2010
    概要
    Herpes encephalitis, 440-441,Wolters Kluwer/Lippincott Williams & Wilkinsを分担執筆した。

教育方法・教育実践に関する発表、講演等

 3
  • 件名
    第44回日本医学教育学会大会, 横浜
    終了年月日
    2012
    概要
    若月 徹, 大槻眞嗣, 江﨑誠治, 外山 宏, 田中郁子, 菊川 薫, 鈴木茂孝,諸岡正史, 佐久間隆子, 長田明子, 石原 慎, 中島 昭, 松井俊和,辻 孝雄:藤田式PBL tutorial 第3報 PBLへのピア評価の導入について発表した。
  • 件名
    第43回日本医学教育学会大会, 広島
    終了年月日
    2011
    概要
    鈴木茂孝, 若月 徹, 大槻眞嗣, 江崎誠治, 鴨下淳一, 飯田忠行, 松井俊和,外山 宏, 田中郁子, 菊川 薫, 辻 孝雄:グループ学習での簡易的なピア評価方法の試作について発表した。
  • 件名
    第44回日本医学教育学会大会, 広島
    終了年月日
    2010
    概要
    大槻眞嗣, 松井俊和, 外山 宏, 田中郁子, 菊川 薫, 若月 徹, 江崎誠治,鈴木茂孝, 佐久間隆子, 中島 昭, 長田明子, 辻 孝雄, 小野雄一郎:藤田式PBL tutorial, the second reportについて発表した。

その他教育活動上特記すべき事項

 2
  • 件名
    第22年藤田保健衛生大学医学教育ワークショップ 
    開始年月日
    2010/04/12
    終了年月日
    2010/04/13
    概要
    医学教育ワークショップに参加した。
  • 件名
    第32年藤田保健衛生大学医学教育ワークショップ
    開始年月日
    2011/12/19
    終了年月日
    2011/12/20
    概要
    医学教育ワークショップに参加した。