Diagnostic Imaging and Interventional radiology (IVR) Research on
With respect to diagnostic imaging (1) angiography and plain radiography (barium contrast, cholangiography, etc.), studies using angiography, the earliest being held, followed by (2) Nuclear Medicine, (3) CT, (4 ) ultrasonography, (5) have been studied using MRI. The various imaging improves the diagnostic accuracy of various diseases, it is determined that the effect becomes more accurate treatment planning and proper treatment, many have contributed to the advancement of medical listening. In addition, angiography and ultrasound technology, Interventional radiology is a minimally invasive treatment applied to MRI and CT (IVR) has been well done.
Angiography and plain radiography, angiography studies using
Since the late 1960s, T. Osawa (Jichi Medical School professor later), Shigeru Shibata, Minoru Morita, Kazuo Miyasaka, and imaging findings of various diseases Hidetoshi Takei et al conducted a study of diagnostic accuracy and usefulness. As featured on our laboratory research at the time, space research and spinal angiography, arteriography may be mentioned in the study of thyroid disease. Also, in the 1980s, but Kazuo Suzaki, by continuously recording the video disk angiography, quantitative method was developed for functional testing of the cervical esophagus hypopharynx swallowing.
Since the 1970s, positive 從 Kodate, K. Ito et al, using nuclear medicine, thyroid disorders, parathyroid disorders, bone disorders, including research conducted pulmonary blood flow and renal blood flow. In 1983, nuclear medicine courses were opened, he became the first professor of the subject was an assistant professor of radiology at the time Kodate positive.
A dedicated CT scanner head in 1976 and 1981 Hokkaido University Hospital was established in the whole-body CT scanners. CT is a cross-sectional tomographic images obtained of the body, and has emerged as a revolutionary diagnostic equipment and can identify lesions and normal tissue. In CT, and time did not know well what is depicted and how various diseases, CT findings of various diseases, the timing of imaging and the use of contrast agents suitable hemodynamics of liver tumors by dynamic CT evaluation for comparison with such imaging findings and histopathology were carried out extensively studied.Since the late 1970s, Kazuo Miyasaka, Hidetoshi Takei, Satoru Abe et al, using CT has been conducting research regarding the central nervous system disorders. In particular, conduct vigorous research on spinal disorders, cervical spine disease, ossification of posterior longitudinal ligament was clearly the contrast between imaging findings and pathological findings such as spinal-axial subluxation. From the 1980s about the disease of the abdomen from the chest, Nobuyuki Fujita, went to study with CT. In 1996, the culmination of experience and research results to it, Nobuyuki Fujita, “a diagnostic abdominal CT,” wrote a textbook that has become a widely read among doctors.
In the 1990s, and Hiroyuki Yoshikawa, delayed side effects of non-ionic contrast agent used in testing CT, was studied in Obihiro Hospital. This side effect is delayed, resulting in 8%, revealed that the side effects more frequently than immediate.
Since 2000, the introduction of multi-slice CT, has dramatically improved resolution and time resolution of the body axis direction of CT. Also became easier to obtain three-dimensional image in the human body. Akira Kudo given these showed that the anterior spinal artery can be imaged with multi-slice CT. Yuya Onodera et al conducted a study of the virtual bronchial endoscopy using CT data. This enables the simulation of bronchial endoscopy, endoscopic bronchial smooth the actual procedure, and had to make it more accurate. In addition, the diagnosis not only form, which also features diagnostic studies using CT, giving Akira Kudoh, S. Jiang et al temple, make the study of cerebral blood flow analysis using CT, cerebral blood volume in cerebral blood flow developed a method to calculate more precisely. Akira Kudo given, as well as further improvements in the analytical method, cerebral blood flow analysis software to develop more accurate, and available on the Internet.
Since the late 1980s, researchers have also used the ultrasound imaging tests. Qing et clove, by manual compression, found that decreased echogenicity of the liver hemangioma. Since the 2000s, Professor Kazuo Miyasaka, a graduate student Shan little Tang, Categorization of wave Doppler for portal blood flow in the graft after liver transplantation most living under the guidance of assistant Tadashi Shimizu, occlusion waveform and arterial examined the relationship between liver function provided a precise indicator of cardiovascular complications after transplantation. In addition, graduate students indicated that strong red ultrasound imaging is useful in evaluation of renal tumors after freezing treatment. Currently, doing Usefulness of ultrasound contrast agents in various diseases.
The MRI machine in 1988, was established in Hokkaido University Hospital. MRI, compared with CT, without radiation, has the advantage of high soft tissue contrast. The high soft tissue contrast, and identification of lesions and normal tissue, it is easier than CT. Also, the ability to direct imaging of any fault plane was a great advantage when compared to the advent of CT MRI. As when appearing CT, MRI findings of the study was conducted on a variety of diseases. Initially, the research is performed actively on the findings, particularly MRI images of brain and spinal cord disease, reported the MRI findings of various diseases. Gradually came to be actively conducted research in many disease sites.In the 2000s, Yoshinori Kodama et al noted, we analyzed the MRI findings of Lactococcus Ekino liver disease, elucidate its characteristics. Moreover, not only shape diagnostics, diagnostic studies were also performed using functional MRI. In the 1990s, Jiang et S. Temple, cine-using MRI, with Chiari type 1 malformation with syringomyelia is found that the increased beating of the upper and lower medulla and cerebellar tonsils. In the 2000s, but they give Akira Kudo, quietness flow rate of the internal jugular vein, changes in breathing, has announced that it affects the signals of MRI.
Techniques used for angiography, vascular IVR from within the blood vessels to treat, CT and ultrasound, non treated to reach the lesion directly from the body using an MRI-table are divided into vascular IVR. Since the 1970s, Minoru Morita, Kazuo Miyasaka, Hidetoshi Takei, Satoru Abe, Masahiro Shinohara, Kiyoshi clove, Hiroya Saito et al have been working. In the 2000s, the English ear Endo showed the usefulness of three-dimensional image reconstruction by rotational DSA in abdominal area Tadashi Shimizu et al. This makes it possible to quantify and confirm the precision of complex vascular anatomy, a more accurate vascular IVR, was safe to do so. In addition, research has also frozen the percutaneous treatment, a graduate student from the strong relationship between histopathology and Zhu MRI images of kidneys after freezing treatment, Daisuke Abo is a graduate of the existence of apoptosis after treatment of frozen kidney Edge shown. In addition, the results of the treatment they freeze 作原 Yusuke guided percutaneous MRI of uterine fibroids, compared with other treatments, fibroids shrink rate is high, indicating that less pain during treatment. Liver tumors, kidney tumors, such as promising as a treatment for uterine fibroids.Currently, Ministry of Health Cancer Research Grant “Research on the standardization of procedures and the adaptation of the IVR in the treatment of cancer” in the team, “clinical trial phase I / II for the first percutaneous radiofrequency coagulation therapy for lung tumors,” “uterine artery embolization using gelatin sponge for symptomatic uterine fibroids (Uterine artery embolization: UAE) clinical trial phase I / II of the information, “” hepatic artery chemoembolization for hepatic arterial infusion of cisplatin for hepatocellular carcinoma phase I / II of the “,” A Phase II Trial of Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma with Epirubicin / Doxorubicin-Lipiodol Emulsion and Gelatin Particles “participated in a multicenter study, to establish evidence-based IVR has contributed.
Studies on the PACS
Goro Irie (second professor) and colleagues, PACS (Picture Archiving and Communication System) conducted the study, which related to image compression, image transmission, such as the quality of research conducted on the monitor. In 1988, Hokkaido University Hospital introduced to the world’s first hospital-wide PACS, FCR (Fuji Computed Radiography) active in the introduction of digitized images of most of the radiation caused by the Hokkaido University Hospital. Its time was revolutionary system. However, the speed of computer processing power and transmission networks of the time, the PACS was insufficient for a large, PACS was not popular for a while. In recent years, high performance and speed of the computer network transmission, hospital-wide PACS becomes possible, around 2005, Hokkaido University Hospital is running a full hospital-wide PACS, filmless was. In recent years, hospitals have been increasing around the world to introduce the PACS, the hospital system is aimed at Hokkaido University in the late 1980s, finally became a reality.
Remote imaging (teleradiology) Studies on
As the popularity of new imaging equipment such as MRI and CT, were rapidly increasing demand for medical diagnostic radiology. Meanwhile, hospitals have full-time radiologists diagnostician has been limited to some hospitals. In particular, Hokkaido has been scattered by each hospital in the vast land area. Therefore, the transmission of radiology images to diagnose medical, diagnostic imaging is performed, the transmission system to respond to the results of the original hospital, ie, remote imaging (teleradiology) was considered necessary to introduce. Goro Irie, Kazuo Miyasaka et al, between the Hospital and Hokkaido University Hospital and School Nakashibetsu in 1988 and began an attempt to distance using a phone line diagnostic imaging. Transmission rate at the time of the telephone line is 9600bps, the image transmission was inadequate. Therefore, image compression is required and a high compression ratio, this study helped in PACS. Later, the introduction of ISDN, the transmission speed is improved. Using this, the Central CI Clinic, City Hospital Ebetsu was initiated between the remote image diagnosis Kutchan Hospital. Leveraging the expertise of those in April 2002, a medical venture from Hokkaido University, Medical Image Laboratory (MIL) was established in the city of Sapporo. Belonging to the radiologist, such as radiology and nuclear medicine departments of the Hokkaido University Hospital, more than 60 medical institutions in the province that provide support services to remote imaging.
Radiation therapy research
Studies on optimization of dose distribution
The theme of our many years of therapy department of radiology, the pursuit of optimum dose distribution in time and space. Professor Wakabayashi first, based on biochemical studies of indirect effects, the optimal time and space (four dimensions) in order to achieve a dose distribution in intracavitary radiation therapy, and then filling in the world to remote high dose rate intracavitary irradiation the first commercial, if a small volume, split levels (units per dose) can be found to be in treatment, intracavitary irradiation was possible extraneous. 30 years later, the same treatment has become a worldwide standard.The pursuit of optimal temporal and spatial dose distribution, the second generation attempts at teaching bays external beam photon, a prospective study conducted in the 1970s for small short-term fractionated radiotherapy, made the announcement. A high amount of one wire leads to a higher incidence of late effects spinal cord at doses the same total, fractionated radiotherapy at least short term, only available for small irradiation volume, vital organs such as the spinal cord is a precision showed that it is important to reduce the radiation dose as much as possible with a fixed law. In all they contain, such as pelvic organ irradiation Nouchi important, increasing the amount can not be shown in one line. Based on this, fixtures on the head and neck radiotherapy (shells) were first commercialized in Japan for use in all cases.
In the 1980s, has spread the image CT · MRI, and is available early for radiotherapy with high precision, which on the basis of experience, and radiotherapy in 1987 in collaboration with Kyoto University from Associate Professor Tsujii CT system was developed for the plan. Currently, using a device similar to a treatment facility for almost all developed countries.
The Hokkaido University School of Medicine contributed to the most recent radiation therapy field, which cerebral stereotactic radiotherapy has evolved since the early 1990s. Same treatment, in a small volume, small split in a way that irradiation using high precision locking device, located on the extension of the Research Professor Wakabayashi above creek. Is mainly clay and an assistant professor since 1993, has developed a brain stereotactic irradiation dose unit. On that basis, cerebral arteriovenous malformations, metastatic brain tumors with gamma knife similar, fractionation by adding acoustic schwannoma in spinal arteriovenous malformation, more like the outcome, and patients gathered from across the country The. Respect for fractionated stereotactic radiotherapy linear accelerator is also visitors from abroad, has been quoted in many papers research paper textbooks.
The trunk is about the disease, unlike the brain, it is necessary to control the movement in the cardiac effects of intestinal peristalsis breathing, I knew it must be synchronized with the movement of the tumor treatment. In 1999, an associate professor from the clay, the company developed in collaboration with the motion tracking system irradiation, while confirming the three-dimensional location of tumor lesions per 0.03 seconds, the moment came to be irradiated as planned this position was possible. Rated the same treatment at home and abroad, has attracted attention.
The initial opening of the classroom studies, the indirect effect of radiation research, to pursue a number of inexplicable phenomena caused by radiation, incorporating the development of cell biology, has been developed. 1970 and transplanted tumors in animals makes it possible to examine the effect of radiation on it, just the reaction of cells to ecosystems Rubeku know, have studied the immunological effects of exposure to systemic .Miyamoto is a small dose total body irradiation assistant in the 1980s showed that tumor growth delay effect.
In the 1990s, became the theme for our school that has not been applied to understanding radiation biology molecular biological techniques so far. Hashimoto is a graduate student small dose total body irradiation, by inducing a cellular immune control of numerous factors, showed that the potential to reduce metastasis. Healed of cancer after radiation, why are you living back to its original form. For example, a “tumor of the nose is healed then returns to the shape of the nose.” Seeking behavior of this group clay assistant professor, graduate students Omatsu, the fundamental mechanisms that are involved found that the HOX gene involved in morphogenesis. Higher research students to study the effects of radiation on the heart, and molecular biological study on the effects of fine capillaries.
To examine the radiosensitivity of tumor cells has an important role to optimize radiation therapy. Nishioka et al assistant, and molecular biological techniques applied to tumor cells, pursuing the relationship between radiosensitivity and apoptosis. Tsuchiya graduate students to study the role of the p53 tumor suppressor gene in brain tumors, apoptosis in the brain are thin Glioblastoma relationship with radiosensitivity, suggesting that strongly involved in the irreversible arrest stage G0.
Digitization of information
Treatment of electronic patient information is that the world began prior to 1970, Professor Irie. Its philosophy is carried over to now, 30 years from 1970, what the treatment of patients with radiation therapy, treatment results, stored in a database such as survival, patient survival has helped in the analysis.From 1980, all electronic storage is now the image of the patient information is now being stored electronically matched photo management CT / MRI / treatment plan for all patients were treated in the hospital. This made it possible to determine the best dose, including the activity of the tumor as well as forms for the various images.
Furthermore, research assistant professor in 1998, Professor Miyasaka clay, have been using images digitized information consultation to other hospital patients treated with radiation. Three domestic locations will enable radiation treatment planning in one location and distance of South Korea, the emergency radiation treatment, 90% of patients able to walk and spinal paralysis that could become bedridden, has attracted the attention of the world. In addition, in order to simplify the work of the ward nurses, nursing support system was developed. It is through trial and error since the 1980s, in 1997 in conjunction with the hospital information system, is attracting attention from abroad as the most successful examples, from 1998 developed into a full hospital-wide nursing system.
Using functional imaging in radiation treatment planning to
K. Nishioka et al, with the cooperation of nuclear medicine courses from Dr. Eriko Tsukamoto, FDG in head and neck tumors? And conducting research in radiation treatment planning for the PET, has gained a high reputation in international conferences. Aoyama et al, with the cooperation of Dr. Kyosuke Kamata from neurosurgery, radiation treatment planning have been using magnetoencephalography and functional MRI images. They should have shown the direction of future development of radiation therapy, becoming a leading data presented at the Academy with a focus on U.S. domestic and international.