Annual Report 2023

Department of Diagnostic Radiology

Masahiko Kusumoto, Miyuki Sone, Nachiko Uchiyama, Hirokazu Watanabe, Mototaka Miyake, Shunsuke Sugawara, Kimiteru Ito, Yuko Kubo, Chihiro Ito, Sachiko Nakano, Nao Kikkawa, Shintaro Kimura, Sawako Kaku, Takumi Oshima, Mizuki Ozawa, Rakuhei Nakama, Tomoya Tanishima, Shou Murakami

Introduction

 The Department of Diagnostic Radiology provides a wide range of modalities, including interventional radiology (IR), general radiology, computed tomography (CT), magnetic resonance imaging (MRI), mammography, and nuclear medicine imaging (Table 1).

Table 1. Number of Examination per Modality

 In 2014, we launched the Interventional Radiology Center to facilitate the widespread proliferation of IR in Japan and to provide various IR treatments for patients referred from other hospitals or clinics.

 We seek individuals with outstanding leadership capabilities, proven academic and administrative experience, a vision to build and sustain programs at the forefront of imaging research, and a commitment to clinical experience.

The Team and What We Do

 In 2023, a total of 14 board-certified radiologists, 3 non-board-certified radiologists and one physician performed routine radiological diagnosis, including IR procedures. We provided a total of 79,859 radiological diagnoses, the details of which are shown in Table 1. Furthermore, we implemented artificial intelligence software for diagnostic support in interpreting radiological images. In the Interventional Radiology (IR) Center, we used four hybrid angio-CT machines and various diagnostic equipment to provide local anticancer treatments (cryotherapy, radiofrequency ablation, microwave coagulation, arterial chemoembolization, etc.) and palliative treatments (drainage, nerve block, bone cement, ascites shunt, etc.). The number of procedures was 8,026 in FY 2023 (Table 2). An outpatient practice was started, including implantation or removal of the central venous port.

Research Activities

 The CT colonography (CTC) has been successfully introduced as an effective option for preoperative staging and colorectal screening in our center. Approximately 700 patients and/or candidates were examined in 2023. We are developing artificial intelligence software for colorectal tumors, including flat lesions. The primary purpose of our CTC research work is to conduct a multicenter trial to establish evidence regarding fully digitalized CTC for a colorectal screening system in Japan.

 A multi-tracer consisting of F-18 FDG, and Cu-64 ATSM PET/CT imaging has been investigated for the treatment of patients with cancer to improve the sensitivity and specificity of detecting tumor sites or tumor characteristics. F-18 FDG PET allows us to calculate the glucose metabolic rate of the tumor site and to predict the treatment response in patients treated with immune checkpoint inhibitors. Cu-64 ATSM PET/CT has been conducted in over 16 patients with brain tumor through the clinical research. In addition, PET/MRI has been applied to more than 1000 cases of cancer patients per year and proved itself to be a powerful tool for managing malignancy.

 For cancer treatment using radioisotope, internal radiotherapy was carried out using radioactive iodine (I-131) chloride, Zevalin, Lutathera, Xofigo, and Raiatt.

 In the "Public/Private R&D Investment Strategic Expansion PrograM (PRISM)" project for the development of artificial intelligence to accelerate the creation of new drugs, we provided 2,000 chest CT images and diagnostic reports to build an integrated database for lung cancer treatment. We have also developed an annotation tool for radiological images to efficiently develop deep learning models.

 We have investigated the efficacy of ultra-high-resolution computed tomography (U-HRCT) developed in the NCC. The research topics related to U-HRCT include staging and evaluating the treatment efficacy of head and neck cancers, diagnostic accuracy of biliary and pancreatic cancers, and strategy to improve the detection of small pancreatic cancers. In addition, we have started developing texture analysis and artificial intelligence for the detection and characterization of pancreatic tumors.

 We performed single-center studies of image-guided biopsy, sedation for ablation, gastrointestinal decompression by transesophageal gastric tube, and antithrombotic therapy after venous stenting. In addition, we continued to develop simulation software for transarterial and ablation procedures.

Clinical Trials

 We have led a multi-institutional cooperative study group of interventional radiology (JIVROSG: Japan Interventional Radiology in Oncology Study Group) as a steering organization of 115 participating institutions. Currently, two clinical trials are ongoing.

 In the nuclear medicine field, one clinical trial is ongoing: a phase I study evaluating the safety of Cu-64 ATSM for brain tumors. We also started developing another phase I study protocol of a new clinical trial evaluating the safety of Cu64 NCAB PET/CT for pancreatic cancer.

Education

 The clinical education and training of young radiologists is an important part of our department’s activities. Educational opportunities for domestic and overseas physicians have been provided. Following the expansion of the indications for RFA, we accepted trainees for obtaining certification to perform RFA.

Future Prospects

 The Department of Diagnostic Radiology strives for excellence in clinical care, education, and research. Our goal is to provide outstanding patient-centered radiology services and to establish evidence in this area. Future challenges include the development of AI software for medical imaging, thereby promoting the active role of the Interventional Radiology Center opened in 2014 and facilitating imaging as biomarkers for personalized cancer treatments, such as molecular-targeted agents for theranostics, immunotherapy, and boron neutron capture therapy. We will continuously aim at (i) providing high-quality/high-speed clinical care with IR for patients both in and outside the hospital, (ii) promoting the clinical and academic education for young physicians, and (iii) enhancing the utilization and accessibility of IR in the field of oncology in Japan. Furthermore, we will collaborate on the MIRAI (Minimally-Invasive Revolutionary treatments with Advanced Intelligence) project in NCCH to develop innovative medical equipment and devices.

List of papers published in 2023

Journal

1. Akamine T, Nakagawa K, Ito K, Watanabe H, Yotsukura M, Yoshida Y, Yatabe Y, Kusumoto M, Watanabe SI. Impact of (18)F-FDG PET on TNM Staging and Prognosis in Thymic Epithelial Tumors. Annals of surgical oncology, 31:192-200, 2024

2. Kobayashi K, Gu L, Hataya R, Mizuno T, Miyake M, Watanabe H, Takahashi M, Takamizawa Y, Yoshida Y, Nakamura S, Kouno N, Bolatkan A, Kurose Y, Harada T, Hamamoto R. Sketch-based semantic retrieval of medical images. Medical image analysis, 92:103060, 2024

3. Sugawara H, Kikkawa N, Ito K, Watanabe H, Kaku S, Akai H, Abe O, Watanabe SI, Yatabe Y, Kusumoto M. Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer. The British journal of radiology, 97:462-468, 2024

4. Suzuki H, Kawata Y, Aokage K, Matsumoto Y, Sugiura T, Tanabe N, Nakano Y, Tsuchida T, Kusumoto M, Marumo K, Kaneko M, Niki N. Aorta and main pulmonary artery segmentation using stacked U-Net and localization on non-contrast-enhanced computed tomography images. Medical physics, 51:1232-1243, 2024

5. Yamashige D, Hijioka S, Nagashio Y, Maruki Y, Fukuda S, Yagi S, Okamoto K, Hara H, Hagiwara Y, Agarie D, Takasaki T, Chatto M, Ohba A, Kondo S, Morizane C, Ueno H, Sone M, Saito Y, Okusaka T. Incidence and factors associated with stent dysfunction and pancreatitis after gastroduodenal stenting for malignant gastric outlet obstruction. Endoscopy international open, 12:E367-E376, 2024

6. Sugitani A, Ogawa A, Yoshida H, Kobayashi-Kato M, Kikkawa N, Tanase Y, Uno M, Ishikawa M, Kato T. Ovarian Mesonephric-Like Adenocarcinoma With Recurrent Liver Metastases: A Case Report with Analysis of Therapeutic Molecular Targets. International journal of surgical pathology, 32:578-585, 2024

7. Kubo T, Sone M, Sugawara S, Kusumoto M, Arakawa A, Ogawa C, Suzuki S, Arai Y, Abe O. Technical Feasibility and Safety of Central Venous Ports for Intravenous Chemotherapy in Infants With Retinoblastoma: A Retrospective Study. Cureus, 16:e52231, 2024

8. Baba T, Kusumoto M, Kato T, Kurihara Y, Sasaki S, Oikado K, Saito Y, Endo M, Fujiwara Y, Kenmotsu H, Sata M, Takano T, Kato K, Hirata K, Katagiri T, Saito H, Kuwano K. Correction to: Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan. International journal of clinical oncology, 29:78-79, 2024

9. Kato T, Tsukamoto S, Miyake M, Kudose Y, Takamizawa Y, Moritani K, Daiko H, Kanemitsu Y. Prognostic impact of extramural venous invasion detected by contrast-enhanced CT colonography in colon cancer. BJS open, 8:zrad121, 2024

10. Sone M, Yasunaga H, Osawa M, Takeguchi Y, Han A, Akiyama N, Kamiya M, Woodhams R, Yoshimatsu R, Nakatsuka A, Kakeda S, Takase K, Mimura H, Yamakado K. Impact of Work Environment on Job Satisfaction among Interventional Radiologists in Japan: A Cross-sectional Study. Interventional radiology (Higashimatsuyama-shi (Japan), 9:13-19, 2024

11. Onishi Y, Shimizu H, Kimura S, Oka S, Kawahara S, Uza N, Isoda H, Nakamoto Y. Transcatheter Arterial Embolization for Bleeding Caused by Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Case Series. Cureus, 16:e55025, 2024

12. Kawauchi D, Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Omura T, Yoshida A, Kubo Y, Igaki H, Ichimura K, Narita Y. Consulting a neurosurgeon upon initial medical assessment reduces the time to the first surgery and potentially contributes to improved prognosis for glioblastoma patients. Japanese journal of clinical oncology, 53:1027-1033, 2023

13. Akamine T, Nakagawa K, Ito K, Watanabe H, Yotsukura M, Yoshida Y, Yatabe Y, Kusumoto M, Watanabe SI. Role of fluorine-18-fluorodeoxyglucose positron emission tomography in selecting candidates for a minimally invasive approach for thymic epithelial tumour resection. Interdisciplinary cardiovascular and thoracic surgery, 36:ivad082, 2023

14. Torasawa M, Horinouchi H, Yagishita S, Utsumi H, Okuda K, Takekoshi D, Ito S, Wakui H, Murata S, Kaku S, Okuma K, Matsumoto Y, Shinno Y, Okuma Y, Yoshida T, Goto Y, Yamamoto N, Araya J, Ohe Y, Fujita Y. Exploratory analysis to predict pneumonitis during durvalumab consolidation therapy for patients with locally advanced non-small cell lung cancer from proteomic profiling of circulating extracellular vesicles. Thoracic cancer, 14:2909-2923, 2023

15. Harai S, Hijioka S, Nagashio Y, Ohba A, Maruki Y, Yamashige D, Hisada Y, Yoshinari M, Kitamura H, Maehara K, Murashima Y, Kawasaki Y, Koga T, Takeshita K, Ueno H, Kondo S, Morizane C, Fukasawa M, Sone M, Saito Y, Enomoto N, Okusaka T. Comparison of 6-mm and 10-mm-diameter, fully-covered, self-expandable metallic stents for distal malignant biliary obstruction. Endoscopy international open, 11:E340-E348, 2023

16. Natsume T, Yoshida H, Nishikawa T, Kikkawa N, Naka T, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M, Kato T. Uterine Leiomyosarcoma Masquerading as a Malignant Perivascular Epithelioid Cell Tumor: A Diagnostic Challenge. International journal of surgical pathology, 31:778-784, 2023

17. Kitamura SI, Yoshida H, Kobayashi-Kato M, Kikkawa N, Tanase Y, Uno M, Ishikawa M, Kato T. Adenoid Basal Carcinoma with Adenoid Cystic Carcinoma Component of the Uterine Cervix: A Case Report and Literature Review. International journal of surgical pathology, 31:819-824, 2023

18. Matsumoto YK, Himoto Y, Nishio M, Kikkawa N, Otani S, Ito K, Yamanoi K, Kato T, Fujimoto K, Kurata Y, Moribata Y, Yoshida H, Minamiguchi S, Mandai M, Kido A, Nakamoto Y. Nodal infiltration in endometrial cancer: a prediction model using best subset regression. European radiology, 34:3375-3384, 2023

19. Fukuta T, Tanaka T, Hashimoto T, Isahaya K, Kubo Y, Yamano Y, Satomi K, Hiraoka N, Shirakawa N, Arakawa A, Ogawa C, Nishimura N, Aoki J, Ito A, Inamoto Y, Kim SW, Fukuda T. Nelarabine-induced myelopathy in patients undergoing allogeneic hematopoietic cell transplantation: a report of three cases. International journal of hematology, 117:933-940, 2023

20. Kitajima K, Igeta M, Kuyama J, Kawahara T, Suga T, Otani T, Sugawara S, Kono Y, Tamaki Y, Seko-Nitta A, Ishiwata Y, Ito K, Toriihara A, Watanabe S, Hosono M, Miyake H, Yamamoto S, Narita M, Daimon T, Yamakado K. Novel nomogram developed for determining suitability of metastatic castration-resistant prostate cancer patients to receive maximum benefit from radium-223 dichloride treatment-Japanese Ra-223 Therapy in Prostate Cancer using Bone Scan Index (J-RAP-BSI) Trial. European journal of nuclear medicine and molecular imaging, 50:1487-1498, 2023

21. Fox JJ, Mauguen A, Ito K, Gupta D, Yu A, Schindler TH, Strauss HW, Schöder H. Long-Term Prognostic Value of (82)Rb PET/CT-Determined Myocardial Perfusion and Flow Reserve in Cancer Patients. Journal of nuclear medicine, 64:791-796, 2023

22. Sato Y, Ishiyama M, Nakano S, Nakao M, Mun M, Ninomiya H, Terauchi T, Oikado K. Ringlike Peripheral Increased Iodine Concentration for the Differentiation of Primary Lung Cancer and Pulmonary Metastases on Contrast-Enhanced Dual-Energy CT. AJR. American journal of roentgenology, 220:828-837, 2023

23. Kashihara T, Nakayama Y, Okuma K, Takahashi A, Kaneda T, Katagiri M, Nakayama H, Kubo Y, Ito K, Nakamura S, Takahashi K, Inaba K, Murakami N, Saito T, Okamoto H, Itami J, Kusumoto M, Ohe Y, Igaki H. Impact of interstitial lung abnormality on survival after adjuvant durvalumab with chemoradiotherapy for locally advanced non-small cell lung cancer. Radiotherapy and oncology, 180:109454, 2023

24. Itou C, Arai Y, Sone M, Sugawara S, Kimura S, Onishi Y. Percutaneous Image-Guided Transesophageal Long Intestinal Tube Placement for Palliative Decompression in Advanced Cancer Patients with Unresectable Malignant Small Bowel Obstruction. Cardiovascular and interventional radiology, 46:1000-1012, 2023

25. Kitajima K, Kuyama J, Kawahara T, Suga T, Otani T, Sugawara S, Kono Y, Tamaki Y, Seko-Nitta A, Ishiwata Y, Ito K, Toriihara A, Watanabe S, Hosono M, Miyake H, Yamamoto S, Sasaki R, Narita M, Yamakado K. Assessing Therapeutic Response to Radium-223 with an Automated Bone Scan Index among Metastatic Castration-Resistant Prostate Cancer Patients: Data from Patients in the J-RAP-BSI Trial. Cancers, 15:2784, 2023

26. Asonuma K, Kobayashi T, Kikkawa N, Nakano M, Sagami S, Morikubo H, Miyatani Y, Hojo A, Fukuda T, Hibi T. Optimal Use of Serum Leucine-Rich Alpha-2 Glycoprotein as a Biomarker for Small Bowel Lesions of Crohn's Disease. Inflammatory intestinal diseases, 8:13-22, 2023

27. Hamada A, Kitajima K, Suda K, Koga T, Soh J, Kaida H, Ito K, Sekine T, Takegahara K, Daisaki H, Hashimoto M, Yoshida Y, Kabasawa T, Yamasaki T, Hirota S, Usuda J, Ishii K, Mitsudomi T. Prognostic role of preoperative fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography with an image-based harmonization technique: A multicenter retrospective study. JTCVS open, 14:502-522, 2023

28. Sugawara S, Sone M, Sakamoto N, Sofue K, Hashimoto K, Arai Y, Tokue H, Takigawa M, Mimura H, Yamanishi T, Yamagami T. Guidelines for Central Venous Port Placement and Management (Abridged Translation of the Japanese Version). Interventional radiology (Higashimatsuyama-shi (Japan), 8:105-117, 2023

29. Ozawa M, Sone M, Sugawara S, Itou C, Kimura S, Arai Y, Kusumoto M. Necessity of Prophylactic Anticoagulation Therapy Following Inferior Vena Cava Stent Placement in Patients with Cancer. Interventional radiology (Higashimatsuyama-shi (Japan), 8:70-74, 2023

30. Kaida H, Kitajima K, Sekine T, Ito K, Daisaki H, Kimura T, Sato MP, Enomoto A, Otsuki N, Ishii K. Prognostic significance of the harmonized maximum standardized uptake value of 18F-FDG-PET/CT in patients with resectable oral tongue squamous cell carcinoma: a multicenter study. Dento maxillo facial radiology, 52:20230083, 2023

31. Ozawa M, Sone M, Sugawara S, Itou C, Kimura S, Arai Y, Kusumoto M. Artificial Pneumothorax Using the Liver-Directed Approach and Seldinger's Technique: Technical Feasibility and Safety. Cureus, 15:e41423, 2023

32. Kashihara T, Mori T, Nakaichi T, Nakamura S, Ito K, Kurihara H, Kusumoto M, Itami J, Yoshimoto S, Igaki H. Correlation between L-amino acid transporter 1 expression and 4-borono-2-(18) F-fluoro-phenylalanine accumulation in humans. Cancer medicine, 12:20564-20572, 2023

33. Yoshii Y, Matsumoto H, Igarashi C, Tachibana T, Hihara F, Shinada M, Waki A, Yoshida S, Naito K, Ito K, Higashi T, Kurihara H, Ueno M. Process to Remove the Size Variants Contained in the Antibody-Chelator Complex PCTA-NCAB001 for Radiolabeling with Copper-64. Pharmaceuticals (Basel, Switzerland), 16:1341, 2023

34. Nishino M, Kusumoto M, Bankier AA, Kurihara Y, Zhang L, Rasheed Z, Meinhardt G, Arunachalam M, Taitt C, Wang Q, Powell CA. Trastuzumab Deruxtecan‒Related Interstitial Lung Disease/Pneumonitis: Computed Tomography Imaging Patterns to Guide Diagnosis and Management. JCO precision oncology, 7:e2300391, 2023