Annual Report 2019
Department of Radiological Technology
I. Radiological Diagnosis
Tomohiko Aso, Kanyu Ihara, Toshihiro Ishihara, Hirobumi Nagasawa, Chieko Nagashima, Takahiro Miyoshi, Toshimitsu Utsuno, Naoya Ikeno, Hiromi Suzuki, Takatsugu Magara, Atsushi Shishido, Makoto Mimatsu, Jun Torii, Yasutake Ishikawa, Noriko Nishikawa, Akiko Nagoshi, Manabu Kimura, Kenta Hiroi, Hiroki Miyazaki, Yoshihiro Mizumachi, Yusuke Miyamoto, Yuya Kanai, Tatsuya Horita, Ryo Kawana, Yusuke Wakatsuki, Ikuya Ishii, Yuto Tanaka, Gyoko To, Seiya Mochizuki, Nao Ozaki, Masae Fujisawa, Motoi Nagata, Yuhei Shimizu, Shuhei Kamikaji, Yuta Miyamae, Akira Yoshida, Seiya Sato, Aya Shimoike, Madoka Nanao, Satoru Kanzawa, Miku Kousaka, Chihiro Muto, Midori Nonaka, Shinnosuke Ishikawa, Masahiro Mizuki, Shunya Oguri, Ken Shimizu, Satsuki Watanabe, Kouki Fukushi
Introduction
This department has a wide range of radiological modalities, namely, interventional radiology (IR), general X-rays, computed tomography (CT), magnetic resonance imaging (MRI), mammography, and nuclear medicine (NM). Serving as a teaching hospital, we put a considerable effort into education. We accept students, visitors, and trainees from around the world. We also attend academic congresses around the world.
The Team and What We Do
1. General X-rays
Using the examination photography manual and the education manual that were unified last year, we focused our efforts on newcomer education.
We also newly developed a multi-purpose X-ray fluoroscopy system that integrates a general radiography system and a fluoroscopy system, announced the results, and started clinical operation.
In the Mammography Department, we obtained the mammography screening facility image certification
.2. Computed Tomography (CT)
We used the new dual-energy CT and ultra-high-resolution CT to provide virtual monochromatic images and iodine maps with additional information and clinical images with excellent resolution. In addition, through joint research with a company, we reported a new image reconstruction technology that applies deep learning technology.
3. Magnetic Resonance Imaging (MRI)
We have improved the image quality by introducing a new MRI device.
We chose a more detailed contrast medium that matched each patient’s weight and kidney function. We were able to shorten the number of waiting days for reservations by changing the reservation plan.
4. Interventional Radiology (IR)
We advanced the accuracy improvement of the 3D workstation and development of new applications in collaboration with a company, and presented at the academic society about the usefulness of the automated tumor-feeder detection system.
5. Fluoroscopy
We are working on human resource development of staff who can respond to inspections. We gave a conference presentation on CT colonography (CTC) tagging.
6. Endoscopy
We held a study session about exposure, and we worked to control and reduce the exposure of the endoscopic center staff. We continued collaborative research on 3D mapping using C-arm X-ray fluoroscopy. In addition, we conducted research presentations for improving mapping functions. We also presented at the European Congress of Radiology (ECR).
7. Nuclear Medicine (NM)
Continuing from last year, we carried out joint research and domestic research presentations on human resource development and the installation of an aseptic isolator for pharmaceutical products so as to cope with the increase in the number of PET-MRI examinations.
With the increase in demand for radionuclide therapy, we increased the number of acceptances for existing radionuclide therapy in collaboration with doctors. In addition, we are conducting contract research on new and ongoing radionuclide therapy Phase I clinical trials and phantom imaging accompanying clinical trials.
Research activities
1) In collaboration with Konica Minolta Co., Ltd., we developed a plan to evaluate the detectability of dynamic observation of nodules in the lung field by dynamic X-ray imaging. This year, we developed a chest dynamic phantom and demonstrated that dynamic chest X-ray imaging can obtain images at a dose lower than the total dose of chest X-ray and improve nodule recognition.
2) In collaboration with Nemoto Kyorindo Co., Ltd., we developed a barcode reading system for CT contrast medium syringes and verified the accuracy of the system. In the future, we will standardize the safety of CT contrast medium syringe IC tags.
3) In collaboration with FUJIFILM Medical Solutions Co., Ltd., for dose management, we have developed a reading method for Optical Character Recognition (OCR) processing that reads optical characters from captured images of radiological medical equipment that does not support dose information output.
Education
1) We continuously participated in training sessions hosted by the Ministry of Health, Labour and Welfare and the National Hospital Organization, etc. and workshops of various certification organizations.
2) In addition to participating in in-hospital conferences organized by each department, a radiological technologist conference was held to improve specialized knowledge and improve skills.
3) We are continuously engaged in human resource exchanges between The University of Tokyo Hospital and Kyoto University Hospital.
4) We accept many visits from and undertake training and clinical training for domestic radiological technologist schools and countries around the world.
Future prospects
1) To prevent infection by COVID-19, etc., we will verify the antibacterial effects of alcohol and silver-based antibacterial preparations.
2) We will conduct research to provide dose information to patients using a dose management system.
3) We will develop a dose management system for obtaining injection information for nuclear medicine drugs online from an automatic injection device. Then, we will conduct verification research on optimization of medical exposure protection and improvement of work efficiency.
II. Radiological Oncology
Tomohiko Aso, Shouichi Katsuta, Tomonori Goka, Ako Aikawa, Toshimitsu Sofue, Miyuki Murata, Yosihiro Shibata, Minoru Hamada, Tatsuya Sakasai, Akira Yoshida, Junichi Kuwahara, Keita Kaga, Yuuki Miura, Rie Ishikawa, Daisuke Fujiyama, Nao Ozaki, Yuuya Hisaki, Masae Fujisawa, Yuuhei Shimizu, Madoka Nanao, Hironori Murakami, Chihiro Kuroki, Shuto Amanuma, Kazuki Takasou, Hiroki Tsunoda, Hiroko Sugaya
Introduction
This section is equipped with four Linear Accelerators (LINAC) and CyberKnife and MRIdian systems, which support Intensity Modulated Radiation Therapy (IMRT), Stereotactic Radiation Therapy (SRT) and Image-guided Radiation therapy (IGRT). An Image Guided Brachytherapy system is also utilized.
The Team and What We Do
1) We updated one linear accelerator to the latest model that includes the highly precise positioning support system (ExacTrac) and aimed to strengthen our radiotherapy facility continuously with compatible machines.
2) The MRI-guided adaptive radiotherapy system (MRIdian) was used for eight patients on average per month. Online adaptive treatment, the highest-level radiation therapy technique, was carried out 154 times on all patients including ones for in-hospital clinical trials.
3) 37 total body irradiation (TBI) procedures for bone marrow transplantations and one total skin electron beam therapy (TSEBT) procedure were performed.
4) To prevent COVID-19, we reinforced the infection precautions and managed the business continuity plan.
5) We took steps about the protection of specific radioisotopes to comply with the Act on Prevention of Radiation Hazards due to Radioisotopes.
6) Joint development related to the application of sensing systems started with Computer System Technology Co., Ltd.
7) Joint research with ITOCHU Corporation on quality control and construction of treatment workflow for the MRIdian adaptive radiotherapy system was completed at the end of fiscal 2019.
8) A dual energy imaging method with a 320-detector row CT system was examined to improve the accuracy of radiotherapy.
Research activities
1) In regard to the MRIdian system, we produced verification results of changes in dose distribution in the magnetic field, development of quality control phantoms, inspection of intra-fractional organ motion and development of MRI imaging techniques.
Clinical trials
1) We were engaged in a clinical study of brachytherapy using alpha particle emitting radioisotopes below the lower limit of the regulations.
2) We were engaged in a clinical study of boron neutron capture therapy (BNCT).
Education
1) We had staff rotations among modalities according to our educational programs.
2) We made a post concurrently appointed to a radiotherapy quality manager to aim for deeper understanding of the radiation therapy planning and quality control.
3) We accepted many visitors and trainees from all around Japan.
4) We accepted many students learning Radiological Science in Japanese universities and Yuanpei University in Taiwan.
5) We reviewed and improved our workflow through comprehensive training about the radiotherapy processes.
Future prospects
1) We will verify the specifications of a 3D/2D-sensing system that will ensure compliance with the Act on Prevention of Radiation Hazards due to Radioisotopes.
2) For the BNCT system, we will work together to complete the clinical trials and achieve early clinical use.
3) For the MRIdian system, we will establish an efficient quality control system and education system, and will contribute to spreading safe treatment.
4) The MRIdian system should change its radiation source from 60-cobalt to a LINAC system to aim for advanced features.
5) To provide stable treatment conditions, we must plan to replace the LINAC used over 10 years to a new system supporting higher precision and adaptive radiation therapy.
6) We will cooperate with the clinical trials performed in the Department of Radiation Oncology.
List of papers published in 2019
Journal
1. Miyamae Y, Akimoto M, Sasaki M, Fujimoto T, Yano S, Nakamura M. Variation in target volume and centroid position due to breath holding during four-dimensional computed tomography scanning: A phantom study. J Appl Clin Med Phys, 21:11-17, 2020