慶應義塾研究者情報データベース

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• Pearls and pitfalls in imaging of axial spondyloarthritis for rheumatologists

  Nozaki T., Tsujioka Y., Sugimoto H., Yamada Y., Yamada M., Yokoyama Y., Fujishiro H., Nimura A., Tsuzaki J., Hase M., Okada M., Kaneko Y., Jinzaki M.

  Modern Rheumatology 35 （ 4 ） 612 - 625 2025年07月

  ISSN  14397595

  　概要を見る

  This review provides key insights into sacroiliitis imaging, covering anatomy, imaging techniques, and interpretation. It focuses on normal physiological changes in young to middle-aged women, children, and the elderly that can resemble sacroiliitis. We emphasize the importance of distinguishing between active and structural lesions, as highlighted in the recent ASAS-SPARTAN standardized magnetic resonance imaging protocol. Physicians should be aware that bone marrow oedema signals on magnetic resonance imaging, a hallmark of active inflammation in axial spondyloarthritis, can also be observed in young to middle-aged women, especially postpartum, even without spondyloarthritis. Paediatric sacroiliac joints may show changes mimicking inflammation due to ongoing bone growth. Furthermore, degenerative changes in the sacroiliac joint are common with advancing age and can be mistaken for sacroiliitis or interpreted as structural changes. The presence of accessory sacroiliac joints, prone to degeneration, further complicates diagnosis. Accurate interpretation requires considering these normal variations to avoid misdiagnosing spondyloarthritis. Collaboration between clinicians and radiologists is crucial, especially when encountering atypical or clinically inconsistent findings. Japan College of Rheumatology 2025. Published by Oxford University Press.

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• Chronological changes in etiology, pathological and imaging findings in primary liver cancer from 2001 to 2020

  Tsuzaki J., Ueno A., Masugi Y., Tamura M., Yamazaki S., Matsuda K., Kurebayashi Y., Sakai H., Yokoyama Y., Abe Y., Hayashi K., Hasegawa Y., Yagi H., Kitago M., Jinzaki M., Sakamoto M.

  Japanese Journal of Clinical Oncology 55 （ 4 ） 362 - 371 2025年04月

  ISSN  03682811

  　概要を見る

  Purpose: To achieve a historical perspective, the chronological changes in primary liver cancer over a 20-year period were investigated at a single institution, focusing on shifts in etiology and the impact on imaging and pathological findings using The Liver Imaging Reporting and Data System. Materials and methods: A retrospective study of surgically resected primary liver cancer in 680 patients from 2001 to 2020 resulted in 434 patients with 482 nodules being analyzed. Dynamic contrast-enhanced computed tomography imaging and the Liver Imaging Reporting and Data System 2018 classification were employed. Two pathologists and two radiologists independently evaluated specimens and images. Results: This study highlighted a significant decline in cases of viral hepatitis and cirrhosis in primary liver cancer patients but an increase in intrahepatic cholangiocarcinoma and scirrhous hepatocellular carcinoma. Notably, there was a rise in non-viral hepatitis cases, potentially pointing toward an increase in steatohepatitic hepatocellular carcinoma cases in the future. Intrahepatic cholangiocarcinoma, scirrhous hepatocellular carcinoma and steatohepatitic hepatocellular carcinoma tumors exhibited slightly different distributions in the Liver Imaging Reporting and Data System classification compared with ordinary hepatocellular carcinoma, which may reflect the presence of fibrosis and lipid in tumor parenchyma. Conclusions: Consistent with past reports, this study demonstrated the emergence of primary liver cancer against a backdrop of non-viral and non-cirrhotic liver. Liver Imaging Reporting and Data System has been consistently useful in diagnosing primary liver cancer; however, among the histological subtypes of hepatocellular carcinoma, an increase is anticipated in scirrhous hepatocellular carcinoma and steatohepatitic hepatocellular carcinoma, which may present imaging findings different from those of ordinary hepatocellular carcinoma. This development may necessitate a reevaluation of the current approach for diagnosing and treating hepatocellular carcinoma based solely on imaging.

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• Clinical Impact of Neoadjuvant Therapy for Resectable Pancreatic Ductal Adenocarcinoma: A Single-Center Retrospective Study

  Shimane G., Kitago M., Yagi H., Abe Y., Hasegawa Y., Hori S., Tanaka M., Tsuzaki J., Yokoyama Y., Masugi Y., Takemura R., Kitagawa Y.

  Annals of Surgical Oncology 32 （ 4 ） 2830 - 2840 2025年04月

  ISSN  10689265

  　概要を見る

  Background: Neoadjuvant therapy is recommended for treating resectable pancreatic ductal adenocarcinoma (PDAC); however, its appropriate use in patients with resectable PDAC remains debatable. Objective: This study aimed to identify independent poor prognostic factors and evaluate the clinical significance of neoadjuvant therapy in patients with resectable PDAC. Methods: We retrospectively reviewed consecutive patients diagnosed with resectable PDAC at our institute between January 2003 and December 2022. We analyzed poor prognostic factors at the time of diagnosis in patients who underwent upfront surgery using the Cox proportional hazards model for overall survival (OS). The prognostic score was calculated by adding the individual prognostic factor scores. Results: Overall, 359 patients were included in this study, with 308 patients undergoing upfront surgery and the remaining 51 patients receiving neoadjuvant therapy. The R0 resection rate was significantly higher in the neoadjuvant therapy group (70.6%) than in the upfront surgery group (64.0%). Multivariate analysis in the upfront surgery group revealed the following independent poor prognostic factors: tumor size ≥ 35 mm, serum albumin level ≤.5 g/dL, neutrophil-to-lymphocyte ratio ≥ 3.5, carbohydrate antigen 19-9 level ≥ 250 U/mL, and Duke pancreatic monoclonal antigen type 2 level ≥ 750 U/mL. Among patients with prognostic scores of 0–1 (n = 263), the intention-to-treat OS did not significantly differ between the neoadjuvant therapy and upfront surgery groups. Among those patients with a prognostic score of ≥ 2 (n = 96), the neoadjuvant therapy group had significantly longer intention-to-treat OS than the upfront surgery group. Conclusions: Prognostic score-based stratification can help identify patients who could benefit from neoadjuvant therapy.

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• Vessels encapsulating tumor clusters contribute to the intratumor heterogeneity of HCC on Gd-EOB-DTPA-enhanced MRI

  Matsuda K., Ueno A., Tsuzaki J., Kurebayashi Y., Masugi Y., Yamazaki K., Tamura M., Abe Y., Hasegawa Y., Kitago M., Jinzaki M., Sakamoto M.

  Hepatology Communications 9 （ 1 ）  2024年12月

  　概要を見る

  Background: Vessels encapsulating tumor clusters (VETC) pattern is tumor vasculature of HCC and is a predictor of prognosis and therapeutic efficacy. Recent radiological studies have demonstrated the predictability of VETC from preoperative images, but the mechanisms of image formation are not elucidated. This study aims to determine the relationship between VETC and intratumor heterogeneity in Gd-EOB-DTPA-enhanced magnetic resonance imaging (EOB-MRI) and to provide its pathological evidence. Methods: Radiologists visually classified preoperative arterial- and hepatobiliary-phase EOB-MRI images of 204 surgically resected HCCs into patterns based on heterogeneity and signal intensity; these classifications were validated using texture analysis. Single and multiplex immunohistochemistry for CD34, h-caldesmon, and OATP1B3 were performed to evaluate VETC, arterial vessel density (AVD), and OATP1B3 expression. Recurrence-free survival was assessed using the generalized Wilcoxon test. The contribution of clinicoradiological factors to the prediction of VETC was evaluated by random forest and least absolute shrinkage and selection operator regression. Results: VETC was frequently found in tumors with arterial-phase heterogeneous hyper-enhancement patterns and in tumors with hepatobiliary-phase heterogeneous hyperintense/isointense patterns (HBP-Hetero). AVD and OATP1B3 expression positively correlated with signal intensity in the arterial and hepatobiliary phases, respectively. Intratumor spatial analysis revealed that AVD and OATP1B3 expression were lower in VETC regions than in tumor regions without VETC. Patients with HBP-Hetero tumors had shorter recurrence-free survival. Machine learning models highlighted the importance of serum PIVKA-II, tumor size, and enhancement pattern of arterial and hepatobiliary phase for VETC prediction. Conclusions: VETC is associated with local reductions of both AVD and OATP1B3 expression, likely contributing to heterogeneous enhancement patterns in EOB-MRI. Evaluation of the arterial and hepatobiliary phases of EOB-MRI would enhance the predictability of VETC.

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• Venous Malformation in the Anterior Mediastinum

  Hiroto Sakai, Ichiro Hasegawa, Junya Tsuzaki, Saori Okamoto, Tadayoshi Kurata

  Cureus 2024年04月

  筆頭著者, 最終著者,  ISSN  2168-8184

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• 特集 腹部の最新画像情報2025 胆管内乳頭状腫瘍:原発性硬化性胆管炎の経過中に肝破裂と腹膜播種を起こした1例

  屋代 香絵, 山田 祥岳, 津崎 盾哉, 池田 織人, 新妻 雄介, 山田 実加, 城谷 良太, 真杉 洋平, 上野 彰久, 田中 真之, 平田 賢郎, 陣崎 雅弘

  臨床放射線 （金原出版）  70 （ 4 ） 559 - 566 2025年07月

  ISSN  0009-9252

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• 生体肝移植後胆汁瘻に対しGun-sight technique変法によるSharp-recanalizationにて内外瘻化し得た一例

  大崎 奈々, 田村 全, 渡邉 剛央, 宮澤 あずみ, 間崎 光, 山本 洋輔, 小川 遼, 古後 斗冴, 古川 裕二, 津崎 盾哉, 吉川 裕紀, 塚田 実郎, 井上 政則, 陣崎 雅弘, 中塚 誠之

  日本医学放射線学会秋季臨床大会抄録集 （(公社)日本医学放射線学会）  60回   S447 - S447 2024年09月

  ISSN  0048-0428

• Swan-Ganzカテーテルによる肺動脈損傷に対してコイル塞栓を施行した一例

  間崎 光, 田村 全, 大崎 奈々, 津崎 盾哉, 塚田 実郎, 井上 政則, 中塚 誠之, 陣崎 雅弘

  日本医学放射線学会秋季臨床大会抄録集 （(公社)日本医学放射線学会）  60回   S500 - S500 2024年09月

  ISSN  0048-0428

• 画像診断と病理　非定型肝嚢胞

  津崎 盾哉, 陣崎 雅弘, 野村 塁

  画像診断 （(株)Gakken）  44 （ 10 ） 988 - 989 2024年08月

  ISSN  0285-0524

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• カテーテル挿入下4D-CTAで責任血管を同定し得た特発性腎出血の一例

  城谷 良太, 田村 全, 山本 洋輔, 古川 裕二, 古後 斗冴, 宮林 真未奈, 津崎 盾哉, 塚田 実郎, 井上 正則, 中塚 誠之, 陣崎 雅弘

  日本インターベンショナルラジオロジー学会雑誌 （(一社)日本インターベンショナルラジオロジー学会）  39 （ Suppl. ） 224 - 224 2024年04月

  ISSN  1340-4520

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