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OKAJIMA Kaoru

    Kindai University Nara Hospital　Professor/General Manager
Last Updated :2024/04/23

Researcher Information

Degree

  • (BLANK)（Kyoto University）

J-Global ID

Research Interests

  • 放射線腫瘍学   Radiation Oncology   

Research Areas

  • Life sciences / Radiology

Education

  •        - 1992  Kyoto University  医学研究科  内科系
  •        - 1992  Kyoto University  Graduate School, Division of Medicine
  •        - 1985  Kyoto University  Faculty of Medicine  Department of Medical Science
  •        - 1985  Kyoto University  Faculty of Medicine

Association Memberships

  • American Society for Radiation Oncology   日本放射線腫瘍学会   Radiologicel Society of North America   日本医学放射線学会   日本核医学会   日本消化器内視鏡学会   

Published Papers

  • yasuo oguma; Makoto Hosono; Kaoru Okajima; Eri Inoue; Kiyoshi Nakamatsu; Hiroshi Doi; Tomohiro Matsuura; Masahiro Inada; Takuya Uehara; Yutaro Wada; Aritoshi Ri; Yutaka Yamamoto; Kazuhiro Yoshimura; Hirotsugu Uemura; Yasumasa Nishimura
    Radiation 2022/09
  • Eri Inoue; Kaoru Okajima; Hiroshi Doi; Kouhei Fukuda; Yasuo Oguma; Aritoshi Ri; Daisuke Nishikawa; Katsunari Yane; Tomohiro Matsuura; Yasumasa Nishimura
    Acta Oto-Laryngologica Informa UK Limited 141 (11) 1022 - 1026 0001-6489 2021/11 [Refereed]
     
    BACKGROUND: Hypothyroidism is a common adverse event after radiotherapy for head and neck tumors and the incidence need to be re-evaluated because of using intensity-modulated radiotherapy (IMRT). AIMS/OBJECTIVES: Confirm the dose-volume effect of IMRT for pharyngeal cancer on hypothyroidism. MATERIALS AND METHODS: This was a retrospective analysis of patients underwent IMRT for pharyngeal cancer from June 2011 to May 2018. Patients were classified into group A (thyroid stimulating hormone (TSH) <5μU/ml), group B (5< =TSH < 10), and group C (10< =TSH) based on TSH over 36 months post-radiation. Radiation dose, thyroid volume, and the proportion of the thyroid that received X Gy or greater (Vx) were measured. RESULTS: Fifty-two patients were included in this work. Hypothyroidism developed in 33/52 (63%) patients, 13 in group B and 20 in group C. The mean radiation dose to the thyroid was 49.4 Gy and the median time until hypothyroidism was 39 months after irradiation. Hypothyroidism was significantly related to neck dissection (ND) and radiation dose to the thyroid. Patients whose thyroid received 45 Gy or more (V45) >67% had a significantly higher incidence of hypothyroidism. CONCLUSIONS AND SIGNIFICANCE: Patients with pharyngeal cancer who had ND and V45 to the thyroid >67% are at risk of hypothyroidism.
  • Shuichi Fukuda; Kaoru Okajima; Kaoru Okada; Kohei Fukuda; Tomoko Wakasa; Tomoyuki Tsujimoto; Atsushi Gakuhara; Hideo Tomihara; Katsuya Ohta; Kotaro Kitani; Kazuhiko Hashimoto; Hajime Ishikawa; Jin-Ichi Hida; Masao Yukawa; Yoshio Ohta; Masatoshi Inoue
    Molecular and Clinical Oncology Spandidos Publications 15 (1) 2049-9450 2021/05
  • 対側乳腺のマンモグラフィー微細石灰化で発見された対側乳腺リンパ管転移の1例
    湯川 真生; 岡嶋 馨; 橋本 和彦; 井上 雅智; 若狭 朋子; 太田 善夫
    日本乳癌学会総会プログラム抄録集 (一社)日本乳癌学会 28回 325 - 325 2020/10
  • Hodaka Numasaki; Teruki Teshima; Yutaka Ando; Keizo Akuta; Hiroshi Ikeda; Kaoru Okajima; Tomoyasu Kumano; Tomonari Sasaki; Kenji Sekiguchi; Masao Tago; Atsuro Terahara; Katsumasa Nakamura; Tetsuo Nishimura; Kazuhiko Ogawa
    Journal of radiation research 61 (1) 146 - 160 2020/01 
    This paper describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From March 2013 to August 2016, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2012. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 213 000 and 251 000, respectively. Additionally, the estimated cancer incidence was 865 238 cases with ~24.6% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 864), telecobalt (n = 0), Gamma Knife (n = 44), 60Co remote afterloading system (RALS; n = 23) and 192Ir RALS (n = 130). The LINAC system used dual-energy functions in 651 units, 3D conformal radiotherapy functions in 759 and intensity-modulated radiotherapy (IMRT) functions in 466. There were 792 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists, 1061.6 full-time equivalent (FTE) radiation oncologists, 2124.2 FTE radiotherapy technologists, 181.3 FTE medical physicists, 170.9 FTE radiotherapy quality managers and 841.5 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2012.
  • 塩野 裕之; 楠本 英則; 櫻井 禎子; 岡部 崇記; 明石 雄策; 松浦 知弘; 岡嶋 馨
    肺癌 (NPO)日本肺癌学会 57 (5) 489 - 489 0386-9628 2017/09
  • Hasegawa H; Ashikaga R; Okajima K; Wakayama T; Miyoshi M; Nishimura Y; Murakami T
    Jpn J Radiol 35 (8) 463 - 471 2017/08 [Refereed]
  • G-CSF産生食道扁平上皮癌脈絡膜転移の1例
    福田 周一; 藤原 由規; 三島 弘; 若狭 朋子; 花本 仁; 湯川 真生; 岡嶋 馨; 太田 善夫; 井上 雅智
    日本食道学会学術集会プログラム・抄録集 (NPO)日本食道学会 71回 P58 - 1 2017/06
  • Shuichi Fukuda; Yoshinori Fujiwara; Hiroshi Mishima; Tomoko Wakasa; Hitoshi Hanamoto; Keisuke Inoue; Kotaro Kitani; Hajime Ishikawa; Masanori Tsujie; Masao Yukawa; Kaoru Okajima; Yoshio Ohta; Masatoshi Inoue
    Clinical Case Reports Wiley 5 (4) 419 - 424 2050-0904 2017/04
  • Tomofumi Misaka; Makoto Hosono; Takashi Kudo; Takamichi Ito; Tsutomu Syomura; Masanobu Uemura; Kaoru Okajima
    ANNALS OF NUCLEAR MEDICINE SPRINGER 31 (3) 235 - 244 0914-7187 2017/04 [Refereed]
     
    Objective The association between left ventricular (LV) dyssynchrony parameters, given by phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), and acquisition orbits is unclear. The aim of this study was to assess the dependence of LV dyssynchrony parameters on acquisition orbits. Methods Ninety-nine patients who underwent Tl-201-gated SPECT MPI were categorized into minor hypoperfusion or major hypoperfusion groups. Forty-four patients who underwent Tc-99m-tetrofosmin-gated SPECT MPI were categorized into minor hypoperfusion or major hypoperfusion groups. The major hypoperfusion group with Tl-201 was divided into inferior or non-inferior wall hypoperfusion subgroups, and anteroseptal or non-anteroseptal wall hypoperfusion subgroups. Gated SPECT MPI data over a 360A degrees acquisition orbit (360A degrees images) and a 180A degrees acquisition orbit (180A degrees images) were reconstructed, and histogram bandwidth (HBW) and phase standard deviation (PSD) were compared. Results Between 360A degrees and 180A degrees images with Tl-201, there were significant differences in HBW and PSD both globally (HBW 34.8 +/- 16.6 vs. 29.1 +/- 10.2; PSD 8.8 +/- 4.9 vs. 7.0 +/- 2.3, p < 0.05 for both) and in the inferior wall (HBW 29.5 +/- 15.5 vs. 23.3 +/- 9.0; PSD 7.6 +/- 4.6 vs. 5.6 +/- 2.4, p < 0.001 for both) in the major hypoperfusion group, and also in the inferior wall in all subgroups of the major hypoperfusion group. In contrast, no segment had any significant differences in HBW or PSD between 360A degrees and 180A degrees images with Tc-99m. Conclusion Differences in acquisition orbit had a significant influence on HBW and PSD with Tl-201-gated SPECT MPI in the inferior wall in patients with major hypoperfusion myocardium.
  • 副腎に発生した平滑筋肉腫の1例
    高橋 一肇; 松浦 知弘; 長谷川 博一; 藤原 一央; 岡嶋 馨; 若狭 朋子; 上島 成也
    Japanese Journal of Radiology (公社)日本医学放射線学会 35 (Suppl.) 43 - 43 1867-1071 2017/02
  • Nobuo Kashiwagi; Takamichi Murakami; Katsuyuki Nakanishi; Osamu Maenishi; Kaoru Okajima; Hiroto Takahashi; Mio Sakai; Yasuhiko Tomita; Kyoichi Terao; Noriyuki Tomiyama
    Acta Radiologica 54 (5) 511 - 515 0284-1851 2013/06 
    Background: Although pleomorphic adenomas account for over 90% of all benign submandibular gland tumors, the imaging features of submandibular pleomorphic adenomas have not been reported in a large number of cases. Purpose: To assess the conventional magnetic resonance imaging (MRI) findings for predicting the submandibular pleomorphic adenoma. Material and Methods: MR studies of 42 pleomorphic adenomas and 28 other types of tumor were reviewed. MR images were assessed for the presence of hyperintense areas on T2-weighted images (first sign), a well-defined margin (second sign), and presence of crescent-shaped compression of the ipsilateral normal submandibular gland (third sign). Results: For identifying submandibular pleomorphic adenoma, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.6%, 50.0%, 74.5%, 93.3%, and 78.6% for the first sign, 95.2%, 46.4% 72.7%, 86.7%, and 75.7% for the second sign, and 23.8%, 100%, 86.7%, 46.7%, and 54.3% for the third sign, respectively. Combining the first and second findings achieved to 85.7% specificity and 90.9% accuracy. Conclusion: Although non-specific, submandibular pleomorphic adenomas usually have hyperintense areas on T2-weighted images and well-defined margins. In addition, crescent-shaped compression of the ipsilateral normal gland seems to represent a highly specific sign.
  • Okajima K; Ishikawa K; Matsuura T; Tatebe H; Fujiwara K; Hiroi K; Hasegawa H; Nishimura Y
    Int J Clin Oncol 18 (6) 1078 - 1084 2013 [Refereed]
     
    BACKGROUND: New treatment strategies for prostate cancer have recently been developed, but multiple malignancies remain a major concern. The aim of this study was to evaluate the characteristics of multiple malignancies and to analyze the risk of secondary malignancies after radiotherapy for prostate cancer. METHODS: From 2000 to 2011, 150 patients with prostate cancer were treated with curative radiotherapy in our department. Patient age range was 54-92 years (median, 70 years), and the follow-up period was 4-142 months (median, 48 months). The incidence of multiple primary cancers was compared with the estimated incidence. RESULTS: A total of 147 patients (98 %) survived more than 12 months (12-142 months; median, 48 months); 20/150 patients (13 %) died within 10 years. Cause of death was recurrent prostate cancer in 11 patients, other primary malignancies in 7 patients, and cardiovascular disease in 2 patients. Multiple primary cancers were present in 26 of 150 patients (17 %), including 16 subsequent malignancies (11 %) with latent periods of 13-83 months (median, 43 months). The subsequent non-prostate malignancies were lung cancer in 4 patients, urinary bladder or ureter cancer in 4, stomach cancer in 3, malignant lymphoma in 2, and other in 3. Analysis of the observed incidence of secondary malignancies compared with the estimated incidence in the general population revealed a higher incidence of ureter cancer and malignant lymphoma. CONCLUSION: Close attention should be paid to secondary malignancies after radiotherapy for prostate cancer, including malignancies occurring within 5 years, which could be attributable to radiotherapy.
  • The Usefullness of Conventional MR imaging in Establishing the Daiagnosis of Submandibular Pleomorphic Adenoma.
    柏木 伸夫; 高橋 洋人; 前西 修; 岡嶋 馨; 村上 卓道; 石井 一成; 中西 克之
    2012/11
  • 岡嶋 馨; 太田 善夫
    BRAIN and NERVE: 神経研究の進歩 (株)医学書院 64 (10) 1151 - 1157 1881-6096 2012/10 
    脳腫瘍の画像診断は主にMRIを用いて行われ、その手法は現在までにほぼ確立されている。その診断は腫瘍の存在や組織型の鑑別のみでなく、腫瘍の進展範囲や悪性度を予測して治療方法に応用することまでにも貢献している。高悪性度星状細胞腫のみを対象に、典型例の画像診断と病理組織像・臨床症状との関連を考察した。星状細胞の組織分類、高悪性度星状細胞腫の画像所見、画像所見と臨床症状、自覚症状とその他の因子との関連、腫瘍の進展範囲と放射線治療、腫瘍の多様性について述べた。
  • 孤立性線維性腫瘍の1例
    松浦 知弘; 長谷川 博一; 松久保 裕子; 廣井 啓二; 岡嶋 馨; 藤原 由規; 木村 浩基; 太田 善夫
    Japanese Journal of Radiology (公社)日本医学放射線学会 30 (Suppl.I) 54 - 54 1867-1071 2012/02
  • 転移性脳腫瘍に対する全脳照射の初期効果 腫瘍径との相関
    松浦 知弘; 岩田 裕樹; 廣井 啓二; 建部 仁志; 荒木 哲朗; 長谷川 博一; 西田 千嘉子; 岡嶋 馨
    日本医学放射線学会学術集会抄録集 (公社)日本医学放射線学会 71回 S189 - S189 0048-0428 2012/02
  • 岩間 密; 藤原 由規; 佐藤 克明; 木村 浩基; 井上 啓介; 池田 光憲; 木谷 光太郎; 中山 剛之; 村田 賢; 湯川 真生; 岡嶋 馨; 太田 善夫; 井上 雅智
    癌と化学療法 (株)癌と化学療法社 38 (12) 2090 - 2092 0385-0684 2011/11 
    背景:本邦におけるTNM cStage II・III食道癌に対する術前化学放射線療法(chemoradiation therapy:CRT)の適応は、いまだ不明確である。術前CRT症例と根治的CRT症例を比較し、TNM cStage II・III症例におけるCRTの意義について検討した。対象:TNM cStage II・III食道扁平上皮癌30例。A群(術前CRT)12例、B群(根治的CRT)18例。結果B群はA群に比べ高齢症例が有意であった。A群手術合併症;肺炎16.6%、縫合不全33.3%、反回神経麻痺8.3%。手術関連死亡は認めず。CRT奏効率(CR+PR);A群75%、B群88.9%(p=0.32)。生存期間中央値;A群17.4ヵ月、B群12.6ヵ月(p=0.18)。結語:術前CRT症例は手術安全性に問題はなく、根治的CRTも比較的安全に施行された。両群間の生存率に差は認めず、根治的CRTは臓器温存面から切除可能食道癌の治療選択肢の一つのオプションになり得ると考えられる。(著者抄録)
  • 木谷 光太郎; 岡嶋 馨; 佐藤 克明; 磯野 小百合; 木村 浩基; 池田 光憲; 井上 啓介; 岩間 密; 辻江 正徳; 中山 剛之; 藤原 由規; 村田 賢; 湯川 真生; 太田 善夫; 井上 雅智
    癌と化学療法 (株)癌と化学療法社 38 (12) 2122 - 2124 0385-0684 2011/11 
    局所進行下部直腸癌5症例に対してS-1併用術前化学放射線療法(CRT)を施行し、安全性と治療成績について検討した。術前CRTとして化学療法は、S-1 80 mg/m2 14日投薬7日休薬14日投薬を行い、放射線療法は1.8Gy/dayで5回/週、計45Gy照射(ともに計35日間)とした。術前CRT終了後、6〜8週間後に手術を施行した。手術は原発巣切除+両側側方郭清を施行した。術前CRTによる病理組織学的な奏効率60%(3例ともGrade 2)、側方リンパ節転移症例は0例であった。有害事象は全例で認めたがgrade 2以下であり、全例術前CRTを完遂できた。術後合併症は、創感染2例、縫合不全1例であった。S-1併用術前CRTは、副作用も軽微で安全に施行できた。今後は、この結果を基に第II相試験を開始している。(著者抄録)
  • 胎児MRI 知っておくべき疾患
    長谷川 博一; 岡嶋 馨; 西田 千嘉子; 廣井 啓二; 荒木 哲郎; 松浦 知弘; 岩田 裕樹
    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 47回 S537 - S537 0048-0428 2011/09
  • 同時多発肺癌(6病変)の1切除例
    武本 智樹; 池田 直樹; 塩野 裕之; 明石 雄策; 尾崎 智博; 寺嶋 応顕; 植田 勲人; 田村 孝雄; 岡嶋 馨; 太田 善夫; 中川 勝裕
    肺癌 (NPO)日本肺癌学会 51 (4) 296 - 297 0386-9628 2011/08
  • 木谷 光太郎; 岡嶋 馨; 木村 浩基; 池田 光憲; 井上 啓介; 岩間 密; 中山 剛之; 藤原 由規; 村田 賢; 湯川 真生; 石川 一樹; 太田 善夫; 井上 雅智
    癌と化学療法 (株)癌と化学療法社 37 (12) 2635 - 2637 0385-0684 2010/11 
    症例は80歳、女性。体重減少を主訴に前医を受診し、精査にて局所進行下部直腸癌と診断され当科に紹介された。腫瘍は腟後壁と尾骨への浸潤が疑われ骨盤腔内を埋め尽くすものがあり、切除不能と判断しS-1併用化学放射線療法(CRT)を施行した(S-1 80mg/m2、RT1.8Gy×25回、計45Gy)。CRTにより腫瘍縮小効果が得られたため、手術を施行した。超低位前方切除術(D3郭清)、回腸人工肛門造設術を施行し、肛門温存が可能であった。組織学的治療効果はGrade 2であった。術前CRTによる副作用はgrade 1の白血球減少のみであった。局所進行直腸癌に対するCRTは、欧米では標準治療であり、局所制御効果が期待できる。本邦でも局所進行直腸癌症例では治癒切除率を向上させるとされており、今後大規模な臨床試験での検証が求められる。(著者抄録)
  • Kotaro Kitani; Kaoru Okajima; Hiroki Kimura; Mitsunori Ikeda; Keisuke Inoue; Mitsuru Iwama; Tsuyoshi Nakayama; Yoshinori Fujiwara; Masaru Murata; Masao Yukawa; Kazuki Ishikawa; Yoshio Ota; Masatoshi Inoue
    Japanese Journal of Cancer and Chemotherapy Japanese Journal of Cancer and Chemotherapy Publishers Inc. 37 (12) 2635 - 2637 0385-0684 2010 [Refereed]
     
    The patient was an 80-year-old woman who was diagnosed with locally advanced low rectal cancer. It was unresectable and we performed chemoradiotherapy combined with S-1 (S-1 80 mg/m2, RT 1.8 Gy × 25, total 45 Gy). An effective reduction of primary region resulted in curative resection (super low anterior resection, D3 lymph node dissection, covering ileostomy) with preserving the anal sphincter. Histopathologically, therapeutic efficacy was Grade 2. Preoperative chemoradiation has been a standard therapy in Western countries and would control local recurrence. This case indicated that CRT could improve a rate of curative resection in patients with locally advanced rectal carcinomas.
  • 臀部、外陰部に発生した皮膚腫瘍の2例
    澤本 学; 熊本 貴之; 柳下 晃一; 山田 秀和; 岡嶋 馨
    日本皮膚科学会雑誌 (公社)日本皮膚科学会 118 (6) 1128 - 1129 0021-499X 2008/05
  • Kiyoshi Nakamatsu; Minoru Suzuki; Yasumasa Nishimura; Shuichi Kanamori; Ryuta Koike; Toru Shibata; Naoya Shintani; Masahiko Okumura; Kaoru Okajima; Fumiharu Akai
    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY SPRINGER JAPAN KK 13 (1) 48 - 53 1341-9625 2008/02 
    Background. The aim of this article is to report the treatment outcomes, toxicities, and dosimetric feasibility of our simultaneous- boost intensity-modulated radiotherapy ( SIB-IMRT) protocol. Methods. Thirteen patients with malignant gliomas treated between December 2000 and September 2004 were enrolled in this study. Two planning target volumes ( PTVs) were defined in the present study. Our IMRT regimen delivered 70 Gy/ 28 fractions ( fr)/ daily; 2.5 Gy to the gross tumor volume ( GTV) with a 0.5-cm margin, defined as the PTV-G, and 56 Gy/ 28 fr/ daily, with 2.0 Gy to the surrounding edema, defined as the planning target volume annulus ( PTV-a). Eleven of the 13 patients received one or two courses of nimustine hydrochloride ( ACNU) ( 100 mg/ m(2)) and vincristine ( 1.2 mg/ body) and interferon-beta ( 3 x 10(6) units) three times weekly during the period of radiotherapy. Adjuvant chemotherapy, ACNU ( 100 mg/ m2) and vincristine ( 1.2 mg/ body), was repeated every 6 weeks and interferon-beta was repeated every 2 weeks. The treatment outcomes, toxicity, and dosimetric feasibility were assessed. Results. All the patients experienced tumor recurrence. The median progression- free survival times for patients with grade III tumors and glioblastome were 7.5 and 8.0 months, respectively. The 1- year and 2- year overall survival rates for all the patients were 77% and 31%, respectively. Four patients experienced acute grade 1/ 2 toxicities during the treatment. No late toxicity related to radiotherapy has been seen. Analyses with dose- volume histograms confirmed excellent conformity of dose distributions in the two target volumes, PTV- G and PTV- a, with the sparing of organs at risk. Conclusion. Our IMRT regimen did not prevent tumor progression. However, the ability of IMRT to deliver highly conformative doses to two contiguous targets, GTV and the surrounding edema, justifies its application to malignant gliomas.
  • C Nishida; K Okajima; T Kudo; T Yamamoto; R Hattori; Y Nishimura
    ANNALS OF NUCLEAR MEDICINE JAPANESE SOCIETY NUCLEAR MEDICINE 19 (8) 647 - 653 0914-7187 2005/12 
    Objective: To examine whether we could predict myocardial ischemia. when coronary artery calcification is detected by non-gated multidetector CT in patients with suspected ischemic heart disease. Methods: Eighty-three patients suspected of having ischemic heart disease (55 men, 28 women; age range 36-83 years; mean age 68 years) underwent multidetector CT and Tl-201 single photon emission computed tomography. Prediction of myocardial ischemia by coronary arterial calcification detected on CT was evaluated by comparing the coronary artery territories that showed calcification with the area of myocardial ischemia determined by SPECT. The sensitivity, specificity, positive predictive value, and negative predictive value of multidetector CT for predicting myocardial ischemia were calculated. Coronary angiography was also examined and compared with multidetector CT. Risk factors, including hypertension, smoking, hyperlipidemia, diabetes, and family history, were compared for evidence of coronary artery calcification detected by multidetector CT and myocardial ischemia detected by thallium nuclear scans. Results: For analysis by patients, the sensitivity, specificity, positive predictive value, and negative predictive value of coronary artery calcification for myocardial ischemia detection were 65, 63, 56, and 71%, respectively. Similarly, for analysis by coronary arterial territories, those values were 56, 77, 41 and 86%, respectively. Coronary stenosis on CAG was also related to the ischemia determined by SPECT and calcification on multicletector CT. Ischemia was better influenced by risk factors than was coronary arterial calcification. Conclusions: For analysis by coronary arterial territories, the specificity and negative predictive value of coronary arterial calcification seen by multicletector CT are relatively high.
  • OKAJIMA KAORU
    Japanese Journal of Radiological Technology Japanese Society of Radiological Technology 61 (5) 608 - 610 0369-4305 2005/05 
    1999年より実用している、近畿大学奈良病院のフィルムレスシステムの使用経験を報告した。
  • Minoru Suzuki; Kiyoshi Nakamatsu; Shuichi Kanamori; Kaoru Okajima; Masahiko Okumura; Yasumasa Nishimura
    International Journal of Clinical Oncology 9 (6) 491 - 497 1341-9625 2004/12 
    Background. Intensity-modulated radiotherapy (IMRT) can deliver different doses to two target volumes with high conformity. The purpose of the present study was to compare outcomes provided by two different optimization methods, overlapping structure-based and non-overlapping structure-based methods, for simultaneous integrated boost (SIB)-IMRT for malignant gliomas. Methods. Treatment plans for three glioblastomas and one anaplastic astrocytoma were analyzed in the present study. The planning protocol was to deliver 70 Gy/28 fractions (fr) to the gross tumor volume (GTV) and 56 Gy/28 fr to the surrounding edema. Two different optimization methods were tested for optimizing dose distribution to the GTV and the surrounding edema. One method was the "including method", an overlapping structure-based (GTV and the clinical target volume [CTV]) optimization method. The other method was the "annulus method", a non-overlapping structure-based (GTV and the subtracted volume) optimization method. Dosimetric indexes derived from dose-volume histograms (DVHs) were used for the analysis. Results. There was no significant difference between the two methods in the mean doses of the target volumes and the doses delivered to the 5% or 95% target volumes (D05 or D95). The mean dose to the brain by the including method was significantly higher than that delivered by the annulus method (P = 0.0001). The D05 of the brain showed no significant difference between the two methods. Conclusion. The two optimization methods provided comparable dose distributions within the target volumes and normal brain.
  • Kumamoto Takayuki; Sugihara Kazuko; Yamada Hidekazu; Okajima Hajime
    Hifu no kagaku Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association 3 (6) 563 - 566 2004/10 
    The patient was an 85-year-old man who developed itchy erythema in the left temporal region in September 2001. Since part of the erythema showed the development of erosion and crust, the patient initially consulted our department on October 26, 2002. The initial examination revealed erythema measuring 6.7×4.2 cm with crust in the left temporal region. Based on the results of biopsy, the patient was diagnosed as having solar keratosis. Considering the advanced age, a history of myocardial infarction, and other risk factors such as complications of heart failure, electron beam therapy was selected to avoid the risk of surgery. The total irradiation dose was 45 Gy (3.0 Gy × 15 times), and the tumor disappeared without showing any severe side effect. Currently, 19 months after the treatment, and there is no tumor recurrence.
  • 電子線療法が有効であった日光角化症の1例
    熊本 貴之; 杉原 和子; 山田 秀和; 岡嶋 馨
    皮膚の科学 日本皮膚科学会-大阪地方会・京滋地方会 2 (5) 473 - 473 1347-1813 2003/10
  • T Mizowaki; K Okajima; Y Nagata; M Mitsumori; Y Nishimura; K Shoji; R Asato; M Hiraoka
    AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS LIPPINCOTT WILLIAMS & WILKINS 26 (2) 155 - 158 0277-3732 2003/04 
    Eighty-one patients with nondisseminated nasopharyngeal carcinoma consecutively treated between January 1977 and December 1998 were analyzed to evaluate whether a concurrent adjunction of low-dose cisplatin enhances the outcome of definitive radiotherapy. Ninety-eight percent (n = 79) of the cases were ranked as stage III/IV according to the 1987 Union International Contre le Cancer staging criteria. Patients treated before 1987 and treated after 1988 were mainly managed by radiotherapy alone (historical group: n = 48) and concurrent chemoradiotherapy with relatively low-dose cisplatin (CCRT group: n = 33), respectively. The locoregional failure-free survival rate of the CCRT group was significantly better than that of the historical group (72.8% vs. 35.9% at 5 years, p = 0.0041). However, multivariate analysis identified only the total dose and the T-stage as significant independent factors for locoregional control. No difference was observed on overall, disease-specific, and distant failure-free survival between the two groups. The results of the present study suggest that concurrent adjunction of low-dose cisplatin will not improve the outcome of definitive radiotherapy for nasopharyngeal carcinoma. Full-dose concurrent chemoradiotherapy, as well as the appropriate dose escalation for better locoregional. control, will be mandatory to achieve better survival.
  • T Mizowaki; K Okajima; Y Nagata; M Mitsumori; Y Nishimura; K Shoji; R Asato; M Hiraoka
    AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS LIPPINCOTT WILLIAMS & WILKINS 26 (2) 155 - 158 0277-3732 2003/04 
    Eighty-one patients with nondisseminated nasopharyngeal carcinoma consecutively treated between January 1977 and December 1998 were analyzed to evaluate whether a concurrent adjunction of low-dose cisplatin enhances the outcome of definitive radiotherapy. Ninety-eight percent (n = 79) of the cases were ranked as stage III/IV according to the 1987 Union International Contre le Cancer staging criteria. Patients treated before 1987 and treated after 1988 were mainly managed by radiotherapy alone (historical group: n = 48) and concurrent chemoradiotherapy with relatively low-dose cisplatin (CCRT group: n = 33), respectively. The locoregional failure-free survival rate of the CCRT group was significantly better than that of the historical group (72.8% vs. 35.9% at 5 years, p = 0.0041). However, multivariate analysis identified only the total dose and the T-stage as significant independent factors for locoregional control. No difference was observed on overall, disease-specific, and distant failure-free survival between the two groups. The results of the present study suggest that concurrent adjunction of low-dose cisplatin will not improve the outcome of definitive radiotherapy for nasopharyngeal carcinoma. Full-dose concurrent chemoradiotherapy, as well as the appropriate dose escalation for better locoregional. control, will be mandatory to achieve better survival.
  • 大割 貢; 米倉 竹夫; 廣岡 慎治; 小角 卓也; 吉林 宗夫; 三崎 泰志; 廣田 正志; 岡嶋 馨; 山本 敬; 西田 千嘉子; 太田 善夫
    Pharma Medica Pharma Medica (株)メディカルレビュー社 20 (8) 242 - 246 0289-5803 2002/08 
    2歳男児.MRI検査で胸部大動脈から左肺下葉への異常流入血管を認め,胸部レントゲン及び造影CT検査で左肺下葉の肺動静脈の拡張を認めた.しかし,その他の肺病変は認められず,肺分画症が強く疑われ,更に,心臓超音波検査で左心負荷を認めたため胸腔鏡補助下左肺下葉切除術を施行した.異常血管は,肺靱帯頭側の胸部大動脈より分岐し,径8mmの太さで長さは2cmあり,肺門部の尾側より肺内に流入していた.左肺下葉の肺動脈は欠損し,A6のみ左肺上葉の肺動脈より分岐していた.肺切除分画の病理所見では肺実質内に手術操作に伴うと思われる小出血像を認めた.術後経過は良好で,術後10日目に退院した
  • Filmless Radiology System at Nara Hospital, Kinki University
    岡嶋 馨; 山本 敬; 西田 千嘉子; 西村 恭昌
    Radiology Frontier メディカルレビュー社 4 (2) 105 - 109 2001/05 
    近畿大学奈良病院において全国にさきがけて実用稼動している、放射線部フィルムレスシステムの現状を報告した。
  • T Mizowaki; Y Nagata; K Okajima; M Kokubo; Y Negoro; N Araki; M Hiraoka
    RADIOTHERAPY AND ONCOLOGY ELSEVIER SCI IRELAND LTD 57 (2) 237 - 242 0167-8140 2000/11 
    Background and purpose: Image distortion is one of the major drawbacks of magnetic resonance (MR) imaging for use in radiotherapy treatment planning (RTTP). In this study, the reproducibility of MR imaging distortion was evaluated by repeated phantom measurements. Materials and methods: A grid-pattern acrylic phantom was scanned with a 0.2-Tesla permanent magnetic unit. We repeated a series of scans three times to evaluate the reproducibility of the distortion. In each series, co-ordinates at 432 intersections of the grid were measured for both T1- and T2-weighted spin-echo (SE) pulse sequences. Positional displacements and their variations at the intersections were calculated. Results: Averages of the displacements were distributed between 1.58 and 1.74 mm, and maximum values (MAX) between 12.6 and 15.0 mm. Within 120 mm of the image center, the average values ranged from 0.73 to 0.80 mm, and from 3.4 to 5.0 mm for MAX. The absolute values of the positional variations among three series were distributed between 0.41 and 0.88 mm for average values, and between 1.4 and 4.5 mm for MAX. Conclusions: The positional variations were mostly within 3 pixels, and most of the positional displacements within the radius of 120 mm of the image center were 2 mm or less. Therefore, it will be possible to use this MR system in RTTP under limited situations, although careful applications are required for RTTP of the body. The development of a computer program to correct image distortion is expected. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.
  • R J Griffin; K Okajima; A Ogawa; C W Song
    International journal of radiation biology 75 (10) 1299 - 306 0955-3002 1999/10 
    PURPOSE: To test the individual and combined effects of local mild temperature hyperthermia (MTH) at 41.5 degrees C for 60 min and carbogen breathing on tumour radiosensitivity. MATERIALS AND METHODS: The FSall fibrosarcoma of C3H mice and the SCK mammary carcinoma of A/J mice were used. The effect of various treatments on tumour cell survival was determined using the in vivo/in vitro tumour excision assay, and the radiobiological hypoxic fraction was calculated. The tumour radiation sensitivity was tested with the tumour growth delay assay. RESULTS: The radiobiological hypoxic cell fraction (HF) in control FSall and SCK tumours was 0.45 and 0.78, respectively, and these values decreased to 0.12 in FSall tumours and 0.22 in SCK tumours when determined immediately after the tumours were treated with MTH. The HF was 0.32 in FSall tumours and 0.33 in SCK tumours after carbogen breathing was applied. When tumours were treated with MTH and the animals breathed carbogen the HF decreased to 0.03-0.04 in both FSall and SCK tumours. MTH treatment alone had only a small effect on tumour growth, but MTH treatment applied before irradiating the tumours significantly increased the radiation-induced tumour growth delay. Carbogen breathing modestly improved the radiation-induced tumour growth delay while the combination of MTH treatment and carbogen breathing caused the largest increase in radiation-induced tumour growth delay. CONCLUSIONS: MTH treatment alone and combined with carbogen breathing substantially increased the tumour radiation response probably through an increase in the tumour oxygenation status.
  • M Yamamoto; Y Nagata; K Okajima; T Ishigaki; R Murata; T Mizowaki; M Kokubo; N Hiraoka
    RADIOTHERAPY AND ONCOLOGY ELSEVIER SCI IRELAND LTD 50 (2) 151 - 156 0167-8140 1999/02 [Refereed]
     
    Purpose: To assess errors resulting from manual transfer of contour information for three-dimensional (3-D) target reconstruction, and to determine variations in target volume delineation of brain tumours by different radiation oncologists. Materials and methods: Images of 18 patients with intracranial astrocytomas were used for retrospective treatment planning by five radiation oncologists. In this study, the target outline was delineated on sequential CT slices by an experienced radiation oncologist. Thereafter, the target outline was manually reconstructed by five radiation oncologists onto an A-P or lateral scout film. The same target outline was also reconstructed as a projection using the Beam's-eye view capability on a CT simulator unit. The two target outlines were compared by encompassing each shape with the smallest rectangle. The manually-reconstructed radiation field was termed 'Field manually established on X-ray film (F-X)', and the automatically-established field was termed 'Field established by CT simulator (F-CT)'. In a second part of this study, four radiation oncologists defined contours from contrast enhanced CT images of nine patients with intracranial astrocytomas. The CT images of these nine cases included five pre-operative cases and four post-operative cases. Both gross tumour volume (GTV) and clinical target volume (CTV) were outlined on sequential CT slices. The target outlines for the four radiation oncologists were compared by identifying the smallest rectangular field surrounding the projection of these contours. The field established by each radiation oncologist was termed 'Field of target volume (F-TV)', and the overlapping portion of the four F-TVs for each case was termed 'Overlapped field of the target volume (Fo-TV)'. Results: The average distance between the isocentres of F-X and F-CT was 0.6 +/- 0.4 cm (mean +/- SD). The average ratio of the area of FX divided by the area of F-CT was 1.04 +/- 0.12. The area of F-X was wider than the area of F-CT for four of the five oncologists. The ratio of the area of F-TV divided by the area of Fo-TV was calculated. The average ratio was relatively greater for CTV (2.07 in pre-operative cases and 2.11 in post-operative cases) than for GTV (1.12 in pre-operative cases and 1.41 in post-operative cases). Among radiation oncologists, variations in the delineation of GTV were smaller than those of CTV. Conclusions: When using an X-ray simulator in treatment planning, errors resulting from the manual transfer of CT contour information to planar radiographs must be considered. When computer techniques are used to project contours onto radiographs errors resulting from individual variations when performing the contouring must be considered. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.
  • Nagata Y; Okajima K; Kokubo M; Kanamori S; Fujiwara K; Mizowaki T; Sasai K; Hiraoka M; Kataoka N; Konishi I
    American journal of clinical oncology 1 22 97 - 102 0277-3732 1999/02 [Refereed]
  • Yasumasa Nishimura; Yoshihiko Yokoe; Yasushi Nagata; Kaoru Okajima; Mitsuo Nishida; Masahiro Hiraoka
    International Journal of Clinical Oncology 3 (6) 351 - 356 1341-9625 1998/12 [Refereed]
     
    Background. With the availability of a high-dose-rate (HDR) remote afterloading device, a Phase I/II protocol was initiated at our institution to assess the toxicity and efficacy of HDR intracavitary brachytherapy, using molds, in the treatment of squamous cell carcinomas of the oral cavity. Methods. Eight patients with squamous cell carcinoma of the oral cavity were treated by the technique. The primary sites of the tumors were the buccal mucosa, oral floor, and gingiva. Two of the buccal mucosal cancers were located in the retromolar trigon. For each patient, a customized mould was fabricated, in which two to four afterloading catheters were placed for an 192Ir HDR source. Four to seven fractions of 3-4 Gy, 5 mm below the mould surface, were given following external radiation therapy of 40-60 Gy/2 Gy. The total dose of HDR brachytherapy ranged from 16 to 28 Gy. Results. Although a good initial complete response rate of 7/8 (88%) was achieved, there was local recurrence in four of these seven patients. Both of the retromolar trigon tumors showed marginal recurrence. No serious (e.g., ulcer or bone exposure) late radiation damage has been observed thus far in the follow up period of 15-57 months. Conclusions. High-dose-rate brachytherapy using the mold technique seems a safe and useful method for selected early and superficial oral cavity cancer. However, it is not indicated for thick tumors and/or tumors located in the retromolar trigon.
  • RJ Griffin; K Okajima; CW Song
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS PERGAMON-ELSEVIER SCIENCE LTD 42 (4) 865 - 869 0360-3016 1998/11 [Refereed]
     
    Purpose: To determine the most effective combination of carbogen breathing with mild temperature hyperthermia (MTH) to increase the oxygenation and radiation response in murine tumors, Methods and Materials: MTH at 41,5 degrees C for 60 min was applied by immersion of the tumor in a precisely controlled water bath. The tumor pO(2) was measured with a polarographic microelectrode. The radiation response of the tumor was determined using the in vivolin vitro assay for surviving tumor cells. Results: In the FSaII fibrosarcoma the median pO(2) increased from a control value of 6.5 +/- 0.5 mm Hg to 16.6 +/- 1.1 mm Hg immediately after MTH and was 10.9 +/- 1.3 mm Hg 24 h later. Carbogen breathing for 5 min increased the FSaII pO(2) to 19.9 +/- 2.1 mm Hg. Carbogen breathing for 5 min beginning immediately after MTH increased the median pO(2) more than 5 times to 35.4 +/- 3.8 mm Hg. This combined treatment also substantially increased the response of the tumors to a radiation exposure of 20 Gy, In another tumor model, the SCK mammary carcinoma, MTH treatment increased the median pO(2) from the control level of 4.4 +/- 0.2 mm Hg to 12.6 +/- 1.2 mm Hg, and it returned to 4.3 +/- 0.3 mm Hg 24 h later, Carbogen breathing for 5 min increased the SCK tumor pO(2) to 17.1 +/- 1.4 mm Hg. The median SCK pO(2) was increased about 7 times to 31.2 +/- 4.2 mm Hg when MTH was followed immediately with carbogen breathing for 5 min. The radiation response was also markedly increased by this combination, When the animals breathed carbogen for 15 or 30 min, the pO(2) and radiosensitivity in both tumor types either remained the same or was lower than that after 5 min of breathing, In addition, both FSaII and SCK tumors were radiosensitized 24 h after MTH treatment alone or with 5 min of carbogen breathing. Conclusions: A shorter carbogen breathing time immediately after MTH causes the most tumor radiosensitization, The results of this study also demonstrate that MTH increases radiosensitivity with and without carbogen breathing up to 24 h after the mild hyperthermia treatment. (C) 1998 Elsevier Science Inc.
  • Y Nagata; K Fujiwara; K Okajima; M Mitsumori; T Mizowaki; N Ohya; M Hiraoka; M Abe; K Ohura; S Wataya
    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY SPRINGER VERLAG 21 (3) 205 - 207 0174-1551 1998/05 [Refereed]
     
    Purpose: To evaluate the effect of transcatheter arterial embolization (TAE) on metastatic bone tumors in an experimental study. Methods: Fifteen Japanese white rabbits were transplanted with VX2 sarcoma cells into the iliac crest. In 10 rabbits, the arterial supply to the iliac bone tumors, internal iliac artery and iliolumbar artery were then embolized with particles of gelatin sponge. The therapeutic effect was evaluated by comparison with the natural course of control tumors in the other five rabbits. Results: After TAE, extensive necrosis, fibrosis, and vacuolization within the tumors were confirmed histologically. In the control rabbits, 19% +/- 7% of the entire tumor was found to be spontaneous tumor necrosis; in contrast, the tumors of the TAE group showed necrosis as 62% +/- 22% of the entire tumor. In one TAE group rabbit, no active tumor cell could be detected in the residual tumor. Conclusion: TAE was found to be an effective treatment for bone tumors in an experimental model.
  • Y Nagata; K Okajima; M Mitsumori; T Mizowaki; M Kokubo; Y Negoro; M Hiraoka; T Nishidai; M Abe; K Takemura; S Nishida; Y Mishina; T Arai; T Thorson; C Kazusa; H Ueshima
    CAR '98 - COMPUTER ASSISTED RADIOLOGY AND SURGERY ELSEVIER SCIENCE BV 1165 295 - 298 0531-5131 1998 [Refereed]
  • Y Nagata; M Kokubo; Y Negoro; M Mitsumori; T Mizowaki; K Okajima; M Yamamoto; K Sasai; M Hiraoka; T Nishidai; M Abe
    CAR '98 - COMPUTER ASSISTED RADIOLOGY AND SURGERY ELSEVIER SCIENCE BV 1165 520 - 525 0531-5131 1998 [Refereed]
  • R J Griffin; K Okajima; B Barrios; C W Song
    Cancer research 56 (24) 5590 - 3 0008-5472 1996/12 
    The partial pressure of oxygen (pO2) of FSaII tumors grown in the leg of C3H mice significantly improved when the tumors were heated by immersing the tumor-bearing legs in a water bath at 41.5 degrees C for 60 min. The tumor pO2 also substantially increased when the tumor-bearing mice breathed carbogen (95% O2:5% CO2). Additionally, mild hyperthermia followed by carbogen breathing further increased the tumor pO2 and increased radiation cytotoxicity as assessed by the in vivo/in vitro excision assay for surviving FSaII cells. It was concluded that mild hyperthermia in combination with carbogen breathing is potentially useful to reoxygenate radioresistant hypoxic cells and improve the radiotherapy of human tumors.
  • H Isozaki; K Okajima; E Nomura; K Fujii; S Sako; N Izumi; T Ohyama; Y Komizo; T Kitade
    Gan to kagaku ryoho. Cancer & chemotherapy 23 (10) 1275 - 83 0385-0684 1996/09 
    In order to clarify the preoperative diagnostic ability for lymph node metastasis, images from magnetic resonance imaging (MRI), computed axial tomography (CT) and ultrasonography (US) were evaluated in 200 gastric cancer patients. The long-term results of 2,000 gastric cancer patients who had undergone gastrectomy were also studied to evaluate the effectiveness of lymphadenectomy. 1) Preoperative diagnosis of lymph node metastasis: The detection rate of lymph nodes around the stomach was 34.1% in MRI, 18.7% in CT and 5.0% in US. The incidence of metastasis was over 80% when the size of lymph node imaged was 1.5 cm and over, against 25% for lymph nodes less than 1.0 cm in size. The detection rate of metastatic lymph node according to the mode of metastasis was 88% for macro-nodular type, 66% for micro-nodular type, 57% for diffuse type in MRI, 70, 41 and 15% in CT, and 38, 3, 0% in US, respectively. Therefore, MRI was most useful for detecting metastatic lymph node preoperatively. 2) Long-term results of gastric cancer with lymph node metastasis: The cumulative 5-year survival rate was 84.2% in n0, 56.1% in n1, 33.7% in n2, 16.5% in n3, and 5.1% in n4 patients. Satisfactory long-term results were obtained for n2 or less patients without serosal invasion. Moreover, by paraaortic lymph node dissection, the cumulative 5-year survival rate in n4 patients was 16.4% (27.8% for cases with radical resection). These results showed the effectiveness of lymph node dissection for gastric cancer.
  • T Mizowaki; Y Nagata; K Okajima; R Murata; M Yamamoto; M Kokubo; M Hiraoka; M Abe
    RADIOLOGY RADIOLOGICAL SOC NORTH AMER 199 (3) 855 - 860 0033-8419 1996/06 [Refereed]
     
    PURPOSE: To evaluate the geometric distortion on magnetic resonance (MR) images obtained with a permanent magnet system and determine the usefulness of MR imaging-assisted x-ray simulation in radiation therapy treatment planning (RTTP). MATERIALS AND METHODS: The authors measured the distortion on MR images of grid-pattern phantoms. MR imaging-assisted x-ray simulation was performed with skin markers in 14 patients with bone tumors. Treatment planning had already been performed with a conventional system. RESULTS: On phantom images, most of the positional displacements within a 120-mm radius from the center of the static magnetic field were less than 2 mm; larger displacements were observed in the peripheral region of the images. MR imaging was useful in the RTTP of all patients. The original radiation field was modified after MR examination in six patients. CONCLUSION: The amount of image distortion within the practical area is acceptable for RTTP. MR imaging-assisted x-ray simulation is useful for patients with bone tumors and warrants further investigation.
  • Y Nagata; K Okajima; R Murata; M Mitsumori; T Mizowaki; M Yamamoto; M Hiraoka; T Nishidai; M Nakata; M Abe; K Sugahara; H Arimura; M Hosoba; H Morisawa; C Kazusa; D Ai; M Kokubo
    International journal of radiation oncology, biology, physics 34 (5) 1105 - 11 0360-3016 1996/03 
    PURPOSE: To introduce the process of developing an integrated radiotherapy network. METHODS AND MATERIALS: We developed a new radiotherapy treatment-planning system in 1987 that we named the Computer Tomography (CT) simulator. CT images were immediately transported to multiimage monitors and to a planning computer, and treatment planning could be performed with the patient lying on the CT couch. The results of planning were used to guide a laser projector, and radiation fields were projected onto the skin of the patient. Since 1991, an integrated radiotherapy network system has been developed, which consists of a picture archiving and communicating system (PACS), a radiotherapy information database, a CT simulator, and a linear accelerator with a multileaf collimator. RESULTS: Clinical experience has been accumulated in more than 1,000 patients. Based on our 7 years of experience, we have modified several components of our original CT simulator and have developed a second generation CT simulator. A standard protocol has been developed for communication between the CT scanner, treatment planning computer, and radiotherapy apparatus using the Ethernet network. As a result, treatment planning data can be transported to the linear accelerator within 1 min after completion of treatment planning. CONCLUSION: This system enables us to make optimal use of CT information and to devise accurate three-dimensional (3D) treatment-planning programs. Our network also allows for the performance of fully computer-controlled dynamic arc conformal therapy.
  • Michihide Mitsumori; Yasushi Nagata; Yoshishige Okuno; Masashi Yamamoto; Rumi Murata; Takashi Mizowaki; Kaoru Okajima; Masahiro Hiraoka; Mitsuyuki Abe
    Journal of JASTRO 8 (2) 151 - 159 1881-9885 1996 [Refereed]
     
    In the radiotherapeutic clinic, color photographs are as important as radiographs because they record essential information of visible tumors. From this point of view, a radiotherapy PACS system should be able to accommodate color photographic images. Since July 1993, we have been using a digital still camera system to record tumors at the radiotherapy clinic. An image is displayed on a CRT monitor and the data is digitally stored on an inexpensive 4 mm DAT cassette tape, and a color print can be obtained in one minute. Since November 1993, we have transferred these images to an image database on a Macintosh. This has enabled us to review the changes in a patient chronologically. Although there are some points to be improved, digital photograph is useful and should be broadly used by radiotherapeutic clinics. © 1996, Japanese Society for Therapeutic Radiology and Oncology. All rights reserved.
  • Rumi Murata; Yasushi Nagata; Kaoru Okajima; Michihide Mitsumori; Takashi Mizowaki; Masashi Yamamoto; Masaki Kokubo; Takehiro Nishidai; Masahiro Hiraoka; Mitsuyuki Abe
    Journal of JASTRO 8 (2) 97 - 103 1881-9885 1996 [Refereed]
     
    An electronic portal imaging device (EPID) has been applied for clinical use at Kyoto University Hospital since 1993. The EPID is a liquid-filled ionization chamber system (PortalVision, Varian Associates). Portal images of 104 treatment fields from 93 patients were taken using a treatment beam and were verified with simulation images. The range of setup deviation was almost within 5 mm for head and neck, and pelvic fields, while within 10 mm for thoracic fields. In both a transverse direction and a longitudinal direction, the mean setup deviation was larger in thoracic fields than in head and neck, and pelvic fields. There are still some problems to be solved with this EPID system. The time taken for image acquisition is more than 6.5 seconds and the image quality is not satisfactory for accurate verification. However, the real time monitoring of patients’ position during treatment which enables quick detection of major setup errors or block placement errors is a great advantage of the EPID. The EPID will play an important role in modern radiation therapy in terms of increasing the accuracy of treatments, although further development of both hardware and software is required. © 1996, Japanese Society for Therapeutic Radiology and Oncology. All rights reserved.
  • Yasushi Nagata; Kaoru Okajima; Rumi Murata; Takashi Mizowaki; Shinji Yamamoto; Michihide Mitsumori; Yasumasa Nishimura; Masahiro Hiraoka; Takehiro Nishidai; Manabu Nakata; Mitsuyuki Abe; Yuta Shibamoto; Masaji Takahashi
    Journal of JASTRO 7 (1) 65 - 75 1881-9885 1995 [Refereed]
     
    The clinical efficacy of the CT simulator was evaluated in this study We developed a new radiotherapy treatment planning system in 1987, which we named the CT simulator. Between 1987 and 1993, we modified several components of our original simulator and we developed a second generation CT simulator in 1993. Clinical experience has been accumulated in more than 1,100 patients over 7 years. The CT simulator has enabled us to decrease complications of radiotherapy for maxillary cancer and breast cancer. Increased local control of liver cancer was obtained by combining this system with voice-gated intermittent irradiation. Recently, the CT simulator system has become more widely available in Japan, and it is now used at 29 institutions. To improve the effectiveness of the CT simulator, an integrated radiotherapy network system was developed in 1993. This network allows the rapid performance of computer-controlled dynamic are conformal therapy with a multi-leaf collimator. © 1995, Japanese Society for Therapeutic Radiology and Oncology. All rights reserved.
  • Y NAGATA; K OKAJIMA; R MURATA; M MITSUMORI; T MIZOWAKI; K TSUTSUI; K ONO; Y NISHIMURA; M HIRAOKA; T NISHIDAI; M TAKAHASHI; M ABE
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS PERGAMON-ELSEVIER SCIENCE LTD 30 (4) 979 - 983 0360-3016 1994/11 [Refereed]
     
    Purpose: The results of three-dimensional treatment planning using a computed tomography simulator were evaluated in patients with maxillary cancer. Methods and Materials: Treatment planning was done in 25 patients using an x-ray simulator and plain x-ray films (1979-1982, group 1) in 34 patients using an x-ray simulator and computed tomography films (1983-1987, group 2), in 24 patients using a computed tomography simulator (1988-1992, group 3). The number of patients with Stage IV disease increased in the order of group I to group 3. Results: The average radiation field was smallest in group 3 (66.5 cm(2)) followed by group 2 (67.4 cm(2)) and group 1 (72.9 cm(2)). A radiation dose of more than 30 Gy to the lens of the effected side was delivered to 13% of group 3, 44% of group 2, and 44% of group 1. The dose to the lens on the uneffected side was zero in 56% of group 1, 74% of group 2, and 96% of group 3. A long-term decrease in visual activity on the effected side occurred in 11% of group 3, 32% of group 2, and 44% of group 1. However, a significant increase in survival was only noted between groups I and 2, because the three population of patients were different. Conclusion: The three-dimensional treatment planning results in a better treatment than two-dimensional treatment planning as measured by complication rates and field sizes.
  • 増永慎一郎; 平岡真寛; 李 宇萍; 西村恭昌; 光森通英; 小石元紹; 岡嶋 馨; 永田 靖; 阿部光幸; 伊藤公一; 古屋克巳; 葛西晴雄; 寺川隆成; 近藤正博
    日本ハイパ?サ?ミア誌 9 115 - 124 1993 [Refereed]
  • K Okajima; Y Nagata; M Mitsumori; T Ishigaki; I Kimura; Y Nakano; K Minato; M Komori; K Sato; T Takahashi
    Radiology 183 (2) 569 - 72 0033-8419 1992/05 
    To investigate spatial resolution requirements for digitized portal images in radiation therapy, observer performance tests were performed. One hundred twenty portal images were digitized with sampling frequencies of 0.700, 0.350, and 0.175 mm for observation. Receiver operating characteristic analysis was used to determine the acceptable sampling frequency for clinical portal images. The detectability of setup errors was significantly better on the original images than on the digitized images with sampling frequencies of 0.700 mm (P = .005) and 0.350 (P = .046). Some clinical disadvantages might accrue with the use of a sampling frequency of 0.350 mm or larger.
  • K Okajima; M Nakata; S Yano; Y Nagata; I Kimura; Y Nakano; M Abe
    Radiology 181 (1) 273 - 6 0033-8419 1991/10 
    An objective and quantitative method for the evaluation of the quality of megavoltage portal images was developed by applying receiver operating characteristic analysis. On the basis of therapeutic use of portal images, setup errors were employed as "signals" in this experimental study that compared the original portal films with digitized images. Six readers observed 104 portal images of a chest phantom, half of which were "abnormal" (ie, had setup errors). Digital images (2,048 x 2,048 matrix) were enhanced by means of histogram equalization and then printed with a laser printer for observation. The readers showed a higher discrimination capacity with the digitally enhanced images, although a statistically significant improvement was not demonstrated. The present method of assessment of image quality proved to be both simple and clinically reasonable.
  • K MINATO; M KOMORI; Y NAKANO; K OKAJIMA; KIMURA, I; T TAKAHASHI; J KONISHI; M ABE; Y GOTOH; K SATO
    MEDICAL IMAGING IV : PACS SYSTEM DESIGN AND EVALUATION, PARTS 1 AND 2 SPIE - INT SOC OPTICAL ENGINEERING 1234 180 - 185 1990 [Refereed]
  • Y NAGATA; S KOHNO; T SAGA; K OKAJIMA; M HOSONO; M TAMAKI; T KANATA; A TAKABAYASHI; S MATSUDA
    COMPUTERIZED MEDICAL IMAGING AND GRAPHICS PERGAMON-ELSEVIER SCIENCE LTD 13 (5) 419 - 422 0895-6111 1989/09 [Refereed]
  • K OKAJIMA; S KOHNO; M TAMAKI; M HOSONO; M KAWAMOTO; Y NISHIYAMA; M SUGANO; T MIYAOKA
    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY SPRINGER VERLAG 12 (3) 128 - 130 0174-1551 1989/05 [Refereed]
  • Nagata Yasushi; Nakano Yoshihisa; Takahashi Masaji; Abe Mitsuyuki; Saga Tsuneo; Okajima Kaoru; Hosono Makoto; Kohno Shigene
    日本医学放射線学会雑誌 日本医学放射線学会 48 (4) 417 - 422 0048-0428 1988/04

Books etc

  • 画像からみた癌の病期分類, 画像からみた癌の病期分類 「３章 肺癌」
    岡嶋 馨; 平岡真寛 (Joint work)金芳堂 2000/04 
    病期分類の実際を画像にもとづいて詳説した。

Conference Activities & Talks

  • A case of Wunderlich syndrome  [Not invited]
    長谷川 博一; 松久保 祐子; 松浦 知弘; 廣井 啓二; 岡嶋 馨; 石川 一樹; 三橋 洋治
    第297回日本医学放射線学会関西地方会  2011/02  大阪  第297回日本医学放射線学会関西地方会
     
    Wunderlich症候群は重複子宮の亜型であり、片側膣閉鎖と同側の腎形成不全を合併する症候群である。無治療であると子宮内膜症や卵管閉鎖をきたし不妊の原因となる。妊孕性を保持するためにはMRIによる早期診断が重要であると思われた。
  • Tumor viability of lymph node metastases from esophageal cancer treated by preoperative  [Not invited]
    石川 一樹; 岡嶋 馨; 廣井 啓二; 松浦 知弘; 西川 龍之; 西村 恭昌
    RSNA(北米放射線学会)2010  2010/12  Cicago, IL, USA  RSNA(北米放射線学会)2010
  • 食道癌放射線化学療法後の手術症例における陽性リンパ節の検討  [Not invited]
    石川 一樹; 岡嶋 馨; 長谷川 博一; 廣井 啓二; 松久保 祐子
    日本放射線腫瘍学会第22回学術大会  2009/09  京都市  日本放射線腫瘍学会第22回学術大会
  • 自己免疫性膵炎に伴うIgG4関連硬化性疾患の一例  [Not invited]
    石川 一樹; 岡嶋 馨; 長谷川 博一; 廣井 啓二
    第289回日本医学放射線学会関西地方会  2008/06  大阪市  第289回日本医学放射線学会関西地方会
  • 術前診断が困難であった肝血管筋脂肪腫の一例  [Not invited]
    村田 賢; 湯川 真生; 井上 啓介; 錦 耕平; 山口 拓也; 城田 哲哉; 真貝 竜史; 中山 剛之; 長谷川 博一; 岡嶋 馨; 太田 善夫; 井上 雅智
    第２０回 日本肝胆膵外科学会・学術集会  2008/05  山形  第２０回 日本肝胆膵外科学会・学術集会
  • 当院における外傷性肝損傷例の検討  [Not invited]
    村田 賢; 湯川 真生; 亀井 敬子; 北口 博士; 中山 剛之; 小川 稔; 芋縄 啓史; 阿部 泰志; 長谷川 博一; 岡嶋 馨; 井上 雅智
    第３１回日本外科系連合学術集会  2006/06  石川県金沢  第３１回日本外科系連合学術集会
     
    外傷性肝損傷のⅢｂ型が手術適応で迅速な対応が救命率の向上につながる
  • 肝胆膵外傷症例の検討  [Not invited]
    村田 賢; 湯川 真生; 亀井 敬子; 北口 博士; 中山 剛之; 小川 稔; 芋縄 啓史; 阿部 泰志; 長谷川 博一; 岡嶋 馨; 井上 雅智
    第18回日本肝胆膵外科関連会議・東京  2006/05  東京  第18回日本肝胆膵外科関連会議・東京
  • a case of pediatric acute abdominal pain  [Not invited]
    西川 龍之; 長谷川 博一; 西田 千嘉子; 岡嶋 馨
    奈良県医師会放射線部会  2006/01  奈良  奈良県医師会放射線部会
     
    症例は10才男児 主訴は気分不良および上腹部痛。MRI上、胆嚢の長軸の異常、胆嚢管の位置異常が見られ、胆嚢軸捻転と診断され、手術された。一般に高齢・痩身の女性に多いとされている。今回、小児男児例を軽堅したので発表した。
  • A Clinical Study of Intensity Modulated Radiotherapy (IMRT) Using the Simultaneous Integrated Boost Method for Malignant Gliomas  [Not invited]
    中松 清志; 西村 恭昌; 赤井 文治; 岡嶋 馨
    European Cancer Societies  2005/10  Paris  European Cancer Societies
  • A case of cardiac tumor  [Not invited]
    西川 龍之; 長谷川 博一; 西田 千嘉子; 岡嶋 馨
    南大阪画像カンファレンス  2005/09  大阪  南大阪画像カンファレンス
     
    症例は38歳女性。主訴は腹満。右房に約8cmの腫瘤を認めた。手術が行われmyxomaの診断を得た。 左房により好発する腫瘍であるが、右房・右室にも発生しうる。血栓・肉腫・乳頭弾性繊維腫などが鑑別にあがる。若干の文献的考察を加えた。
  • 新研修制度における画像ティーチングファイルの運用  [Not invited]
    藤島 正浩; 田村 純; 西川 龍之; 長谷川 博一; 西田 千嘉子; 山本 敬; 岡嶋 馨; 西村 恭昌
    第280回日本医学放射線学会関西地方会  2005/07  大阪府豊中市  第280回日本医学放射線学会関西地方会
     
    新研修制度が始まり、放射線科を選択する研修医は多い。当科で作成してきたティーチングファイルを研修指導に活用したので運用状況を評価する。 開院以来レポート・画像ともに電子化されているが、1999－2005年の約19万件のレポートのうち重要性のためにマークをつけたものは「教育」2426件、「要結果」2072件、「貴重」177件、「研究」164件、「稀有」154件であった。 研修内容は「教育」例を閲覧・分類してデジタル保管すること、「要結果」例を病理部で探索すること、の2点である。研修医一人１か月あたり「教育」331件「要結果」152件の未整理ファイルを処理した。研修側の利点は短期間に典型症例を閲覧することであるが、教育側の情報の整理という長所も大きい。
  • A case of pediatric lung tumor  [Not invited]
    西川 龍之; 長谷川 博一; 西田 千嘉子; 岡嶋 馨; 佐々木 隆士; 大割 貢; 小角 卓也; 米倉 竹夫; 太田 善夫
    日本放射線医学会関西地方会  2005/07  神戸  日本放射線医学会関西地方会
     
    症例は2才9ヶ月 女児。主訴は熱発および咳。急速に増大する腫瘤を右下肺に認め、中下葉切除術施行され、pleuropulmonary blastomaの病理診断を得た。予後不良な疾患であるが、迅速な外科的治療を必要とする疾患である。年少児では本疾患を念頭に置いた鑑別診断が必要である。
  • A case of pediatric Abdominal pain  [Not invited]
    西川 龍之; 長谷川 博一; 西田 千嘉子; 岡嶋 馨; 北村 則子; 小角 卓也; 米倉 竹夫
    京奈画像カンファレンス  2005/06  奈良  京奈画像カンファレンス
     
    症例は4才男児。主訴は上腹部痛および嘔吐。左記にて発症し翌日両下肢に紫斑様丘疹出現。血性下痢・血性嘔吐出現も出現した。CTを施行し胃・十二指腸の壁肥厚を認めた。American college of Reumatology の基準を満たし、アレルギ―性紫斑病と診断された。画像上は小腸の壁肥厚が多いとされるが、今回はやや異なる像を呈する症例を経験した。
  • 画像診断が困難であった原発性肝癌の一例  [Not invited]
    北口 博士; 村田 賢; 新﨑 亘; 岩﨑 拓也; 中山 剛之; 小川 稔; 湯川 真生; 井上 雅智; 山本 敬; 岡嶋 馨; 太田 善夫
    第30回日本外科系連合学会学術集会  2005/06  東京  第30回日本外科系連合学会学術集会
  • マルチスライスＣＴより作成した３Ｄ動画像による肝切除のナビゲーション  [Not invited]
    村田 賢; 湯川 真生; 北口 博士; 新﨑 亘; 岩﨑 拓也; 中山 剛之; 小川 稔; 井上 雅智; 山本 敬; 岡嶋 馨
    日本肝胆膵外科関連会議・横浜  2005/06  横浜  日本肝胆膵外科関連会議・横浜
  • 外傷性肝損傷症例の検討  [Not invited]
    村田 賢; 湯川 真生; 北口 博士; 新﨑 亘; 岩﨑 拓也; 中山 剛之; 小川 稔; 井上 雅智; 芋縄 啓史; 阿部 泰志; 山本 敬; 岡嶋 馨
    第30回日本外科系連合学会学術総会  2005/06  東京  第30回日本外科系連合学会学術総会
  • リンパ節の臨床的意義  [Not invited]
    岡嶋 馨
    第21回京奈臨床画像カンファレンス  2005/03  奈良  第21回京奈臨床画像カンファレンス
     
    リンパ節の画像診断が、外科手術・放射線治療・合併症・予後に及ぼす影響について講演した。
  • 外傷性肝破裂の一例  [Not invited]
    井上 雅智; 村田 賢; 北口 博士; 新﨑 亘; 中山 剛之; 小川 稔; 湯川 真生; 岩﨑 拓也; 山本 敬; 岡嶋 馨; 阿部 泰志; 橋本 幸彦; 近畿大学医学部付属病院研修医; 近畿大学医学部付属病院研修医; 近畿大学医学部付属病院研修医
    第4回中河内消化器病研究会  2005/01  第4回中河内消化器病研究会
  • Energy and field characteristic of displacement the effective point in thimble ionization chamber by parallel setting to the X-ray beam axis  [Not invited]
    南部秀和; 渡辺恵美; 小金谷容子; 岡嶋 馨; 西村 恭昌; 下野哲範
    2004/11
  • MDCTにより作成した３D、MPR画像による肝胆膵疾患術前評価の有用性と限界  [Not invited]
    村田 賢; 湯川 真生; 中山 剛之; 小川 稔; 井上 雅智; 新﨑 亘; 橋本 幸彦; 山本 敬; 岡嶋 馨; 近畿大学医学部付属病院
    第34回日本消化器病学会大会  2004/10  福岡市  第34回日本消化器病学会大会
  • 急性虫垂炎の診療における腹部CT検査の有用性  [Not invited]
    村田 賢; 湯川 真生; 北口 博士; 新﨑 亘; 中山 剛之; 小川 稔; 井上 雅智; 橋本 幸彦; 山本 敬; 岡嶋 馨
    第66回日本臨床外科学会総会  2004/10  盛岡市  第66回日本臨床外科学会総会
  • 画像診断が困難であった原発性肝癌の1例  [Not invited]
    北口 博士; 村田 賢; 新﨑 亘; 中山 剛之; 小川 稔; 湯川 真生; 井上 雅智; 橋本 幸彦; 水野 成人; 小川 力; 岡嶋 馨; 山本 敬
    第３回中河内消化器病研究会  2004/07  八尾市  第３回中河内消化器病研究会
  • 進行膵癌に対するGemcitabineの治療成績  [Not invited]
    村田 賢; 湯川 真生; 中山 剛之; 小川 稔; 井上 雅智; 北口 博士; 新﨑 亘; 山本 敬; 岡嶋 馨; 橋本 幸彦
    第59回日本消化器外科学会定期学術集会  2004/07  鹿児島市  第59回日本消化器外科学会定期学術集会
  • フィルムレスシステムの使用経験  [Not invited]
    岡嶋 馨
    第60回日本放射線技術学会総会  2004/04  横浜  第60回日本放射線技術学会総会
     
    全国に先駆けて運用した、フィルムレスシステムの現実的な問題点と、院内全体での評価についてシンポジストの一人として講演した。
  • 各科からみた全病院フィルムレスシステム－4年の実用経験  [Not invited]
    岡嶋 馨; 長谷川 博一; 西田 千嘉子; 山本 敬; 西村 恭昌
    第63回日本医学放射線学会  2004/04  横浜  第63回日本医学放射線学会
     
    フィルムレスシステムに関して、院内各科に対して行ったアンケート調査と実用の現状を報告した。
  • MDCTにより進展度診断を行った肝門部胆管癌症例  [Not invited]
    村田 賢; 湯川 真生; 中山 剛之; 小川 稔; 井上 雅智; 岡嶋 馨; 太田 善夫; 橋本 幸彦; 山本 敬; 新﨑 亘; 近畿大学医学部付属病院形成外科
    第３２回近畿肝臓外科研究会  2004/02  大阪  第３２回近畿肝臓外科研究会
  • Coronary Artery Calcification in Symptomatic Patients on Non-Gated Multi-Detector CT: Correlation with Thallium Exercise Stress Test  [Not invited]
    西田 千嘉子; 岡嶋 馨; 山本 敬; 長谷川 博一; 工藤 崇; 西村 恭昌
    Radiological Society of North America  2003/12  Radiological Society of North America
  • 頭頚部腫瘍の放射線治療計画における画像診断の有用性  [Not invited]
    岡嶋 馨
    第32回断層映像研究会  2003/11  東京  第32回断層映像研究会
     
    頭頚部腫瘍において、近年の画像診断の発達が放射線治療の高精度化に寄与している点を講演した。
  • 唾液腺障害と線量との相関－ＤＶＨによる検討  [Not invited]
    岡嶋 馨; 南部 秀和; 中松 清志; 金森 修一; 西村 恭昌
    日本放射線腫瘍学会第16回学術大会  2003/11  東京  日本放射線腫瘍学会第16回学術大会
     
    放射線治療後の唾液腺障害には、30Gy 程度の低い線量が照射された体積が影響する。
  • Ａ ｃａｓｅ ｏｆ Ａｃｔｉｎｉｃ Ｋｅｒａｔｏｓｉｓ ｓｕｃｃｅｓｓｆｕｌｌｙ ｔｒｅａｔｅｄ ｗｉｔｈ ｅｌｅｃｔｒｏｎ ｔｈｅｒａｐｙ  [Not invited]
    熊本 貴之; 山田 秀和; 杉原 和子; 岡嶋 馨
    皮膚科学会大阪地方会  2003/07  大阪  皮膚科学会大阪地方会
     
    85歳男性。左側頭部の？痒を伴う紅斑出現。生検したところ日光角化症と診断。高齢、既往歴、合併症等を考え、電子線療法を選択した。治療後、腫瘍は消失し、現在も再発を認めていない。
  • 多発結節性肝病変を呈したnodular regenerative hyperplasia  [Not invited]
    米倉 竹夫; 小角 卓也; 大割 貢; 前川 貴伸; 岡嶋 馨; 山本 敬; 西田 千嘉子; 小林 庸次
    第39回 日本小児放射線学会  2003/06  東京  第39回 日本小児放射線学会
  • MDCTによる冠状断を用いた、喉頭癌に対する放射線治療計画：従来法とのＣＴＶ認識の相違  [Not invited]
    岡嶋 馨; 西田 千嘉子; 長谷川 博一; 山本 敬; 西村 恭昌
    横浜  2003/04  横浜
     
    MDCTの出現後、ＣＴによる治療計画は任意の断面で可能となった。その問題点と利点をCTV認識の相違から検討した。
  • 繰り返す発熱と肝機能障害を契機に発見された多発結節性肝病変：病気は何？  [Not invited]
    米倉 竹夫; 小角 卓也; 大割 貢; 前川 貴伸; 岡嶋 馨; 山本 敬; 西田 千嘉子
    第49回小児外科わからん会  2003/03  大阪  第49回小児外科わからん会
  • 胆嚢腫瘤性病変について  [Not invited]
    長谷川 博一; 岡嶋 馨; 西田 千嘉子; 山本 敬
    第273回 日本医学放射線学会関西地方会  2003/03  大阪  第273回 日本医学放射線学会関西地方会
     
    胆嚢腫瘤性病変を良性と悪性、隆起性と浸潤性に分類し、それぞれCT造影所見を中心に検討した。
  • フィルムレスシステムの現状と課題  [Not invited]
    岡嶋 馨
    第9回医用マルチメディア研究会  2003/02  大阪  第9回医用マルチメディア研究会
     
    3年以上実用運用してきた、オンライン画像システムについて、その利点と問題点とを講演した。
  • 放射線治療におけるインフォームドコンセントと同意書－院内各科との比較  [Not invited]
    岡嶋 馨; 南部 秀和; 金森 修一; 中松 清志; 西村 恭昌
    日本放射線腫瘍学会第15回学術大会  2002/11  東京  日本放射線腫瘍学会第15回学術大会
     
    放射線治療を開始する場合には全例で同意書に署名していただいている。その署名した書類の有無や形式を、院内の各科と比較検討した。
  • 集学的治療が奏効したStageIV後腹膜悪性腫瘍の2例  [Not invited]
    大割 貢; 米倉 竹夫; 廣岡 慎治; 小角 卓也; 太田 善夫; 岡嶋 馨
    第38回日本小児外科学会近畿地方会  2002/08  大阪  第38回日本小児外科学会近畿地方会
  • 集学的治療が奏効したStageIV後腹膜悪性腫瘍の2例  [Not invited]
    大割 貢; 米倉 竹夫; 廣岡 慎治; 小角 卓也; 吉林 宗夫; 箕輪 秀樹; 内田 優美子; 恵比須 礼子; 太田 善夫; 岡嶋 馨
    第79回日本小児科学会奈良地方会  2002/07  奈良  第79回日本小児科学会奈良地方会
  • 放射線科におけるリスクマネージメント  [Not invited]
    岡嶋 馨
    三重県放射線技師会平成14年度春季講習会  2002/06  津  三重県放射線技師会平成14年度春季講習会
     
    近年のリスクマネージメントの考え方を、放射線診療の実際に即して講演した。
  • 胎児MRIの検討  [Not invited]
    綿井良輔; 西村 恭昌; 下野 太郎; 足利 竜一朗; 井上正昭; 山本敬; 西田千嘉子; 岡嶋馨; 米倉竹夫
    第61回日本医学放射線学会学術発表会  2002/04  神戸  第61回日本医学放射線学会学術発表会
     
    超音波検査で異常と診断された胎児22例に対し、MRIを施行した。MRIで診断可能であった症例は、水腎症、リンパ管腫、先天性横隔膜ヘルニア、子宮中隔、中枢神経疾患であった。診断が困難であった症例は、消化器疾患の一部および臍帯過捻転であった。しかし、食道閉塞症のGross A型では、羊水過多、口腔から上部食道の液体貯留および胃内容液の消失を確認することが診断の手掛かりになった。
  • 非同期ＭＤＣＴによる冠動脈石灰化スクリーニングの意義：Ｔｌ心筋シンチグラフィーとの相関  [Not invited]
    西田 千嘉子; 岡嶋 馨; 山本 敬; 工藤 崇; 西村 恭昌
    2002/04
  • 機能温存放射線治療の現況  [Not invited]
    岡嶋 馨
    平成13年度奈良県医師会放射線部会  2002/04  橿原  平成13年度奈良県医師会放射線部会
     
    乳癌・膀胱癌・前立腺癌を例に、近年の放射線治療が機能温存に貢献している点を講演した。
  • 放射線治療と画像診断 －Multidetector Row CT と放射線治療  [Not invited]
    岡嶋 馨
    第１５回日本医学放射線学会・専門医師会冬季セミナー  2002/02  大阪  第１５回日本医学放射線学会・専門医師会冬季セミナー
     
    Multidetector Row CT の画像が、放射線治療に及ぼす効果について講演した。
  • 集学的治療が奏効したStage4副腎皮質癌の1例  [Not invited]
    廣岡 慎治; 米倉 竹夫; 小角 卓也; 吉林 宗夫; 箕輪 秀樹; 恵比須 礼子; 岡嶋 馨; 太田 善夫
    第17回日本小児がん学会総会  2001/12  東京  第17回日本小児がん学会総会
  • Image quality of the digittaly reconstructed radiographs (DRRs): Improvement by isotropic voxel obtained by a multi-detector row CT and clinical application  [Not invited]
    南部 秀和; 岡嶋 馨; 西村 恭昌
    43th Annual Meeting of the American Society for Therpeutic Radiology and Oncology  2001/11  サンフランシスコ  43th Annual Meeting of the American Society for Therpeutic Radiology and Oncology
     
    放射線治療用の照合画像 (DRR) を、MDCT の高分解能を生かして臨床応用した。
  • 全病院フィルムレスシステムの運用－放射線治療における効果  [Not invited]
    岡嶋 馨; 南部 秀和; 鈴木 実; 金森 修一; 中松 清志; 西村 恭昌
    日本放射線腫瘍学会第14回学術大会  2001/11  大阪  日本放射線腫瘍学会第14回学術大会
     
    現在運用しているオンライン画像システムが放射線治療において効果が高いことを報告した。
  • Image quality of the Digitally reconstructed radiographs(DRRs): Improvement by isotoropic voxel obtained by Multi-detector row CT and the clinical application  [Not invited]
    南部秀和; 岡嶋 馨; 西村 恭昌
    2001/11
  • Stress Analysis of Temporomandibular Joint applied Masticatory Force by Finite Element Method  [Not invited]
    松本 俊郎; 宮村紘司; 加藤 暢宏; 岡嶋 馨; 宮脇正一; 川上哲司; 馬場
    第 14 回計算力学講演会 （札幌）  2001/11  第 14 回計算力学講演会 （札幌）
     
    下顎骨が咀嚼を行っている場合の顎関節の応力を関節円板の位置を考慮に入れて FEM により解析を行い考察した。
  • Multidetector-row CT を用いたＤＲＲの画質の改良  [Not invited]
    岡嶋 馨; 西田 千嘉子; 山本 敬; 西村 恭昌
    第60回日本医学放射線学会学術発表会  2001/04  神戸  第60回日本医学放射線学会学術発表会
     
    多列検出器型ＣＴにより、頭尾方向の空間解像度は向上した。これを放射線治療画像に応用した。
  • 両側性閉鎖孔ヘルニアの１例  [Not invited]
    西田 千嘉子; 岡嶋 馨; 山本 敬; 中山 剛之; 湯川 真生; 井上 雅智; 石川 原; 西村 恭昌
    日本医学放射線学会関西地方会  2000/12  大阪  日本医学放射線学会関西地方会
  • Concurrent Chemotherapy and Radiotherapy for Nasopharyngeal Carcinoma  [Not invited]
    溝脇尚志; 岡嶋 馨; 西村 恭昌; 永田 靖; 光森通英; 平岡真寛
    86th Scientific Assembly of Radiological Society of North America  2000/11  シカゴ  86th Scientific Assembly of Radiological Society of North America
     
    化学療法の併用により、上咽頭癌の局所制御率は有意に向上した。
  • 肺扁平上皮癌に対する化学放射線療法の効果判定：画像所見と組織学的効果との比較検討  [Not invited]
    岡嶋 馨; 西村 恭昌; 中松 清志; 藤原一央; 鈴木 実
    日本放射線腫瘍学会第１３回学術大会  2000/11  新潟  日本放射線腫瘍学会第１３回学術大会
     
    肺扁平上皮癌に対する化学放射線治療の効果を、ＣＴによる臨床的判定と切除された組織での判定とで比較検討した。
  • CT evaluation of tumor response after concurrent chemoradiotherapy for squamous cell lung cancer: Correlation of CT findings with histopathologic tumor viability.  [Not invited]
    岡嶋 馨; 西村 恭昌; 西脇滉一; 川上 明; 岡本英一
    86th Annual Metting of Radiological Society of North America  2000/11  シカゴ  86th Annual Metting of Radiological Society of North America
     
    25例の肺扁平上皮癌症例に対し、化学放射線療法にひきつづき外科的切除を行った。そのＣＴ所見の変化と病理組織学的治療効果とを比較検討した。ＣＴでの腫瘍の縮小率と病理像での効果との相関は強くなかった。
  • Improvement in quality of DRR by isotrophic voxel  [Not invited]
    南部秀和; 林田里依; 岡嶋馨
    2000/11
  • 近畿大学における新放射線治療システム  [Not invited]
    西村 恭昌; 奥村雅彦; 岡嶋馨; 新谷直也; 早雲里絵; 橋場久幸; 澄田貢; 村野喜彦; 鈴木実
    第10回京都放射線腫瘍研究会  2000/09  京都  第10回京都放射線腫瘍研究会
     
    平成12年度に近畿大学医学部附属病院に導入された新放射線治療システムの概要について報告した
  • 近大奈良病院におけるフィルムレスシステムの現状  [Not invited]
    岡嶋 馨
    厚生省近畿放射線技師会学術講習会  2000/06  大阪  厚生省近畿放射線技師会学術講習会
     
    放射線部フィルムレスシステムの現状を報告した。
  • 院内 total PACS の臨床応用  [Not invited]
    岡嶋 馨; 西田 千嘉子; 山本 敬; 西村 恭昌; 石井克尚; 岩井
    第59回日本医学放射線学会  2000/04  横浜  第59回日本医学放射線学会
     
    近畿大学奈良病院において、1999年10月より稼動した全病院オンライン画像システムについて報告した。

MISC

Research Grants & Projects

  • 日本学術振興会：科学研究費助成事業
    Date (from‐to) : 1997 -1997 
    Author : 永田 靖; 岡嶋 馨; 平岡 真寛
     
    1。精度確認用ファントムによるMR画像「ゆがみ」の定量化:まずMR画像のゆがみの精度の確認用に自作した格子上のファントムを用いて、永久磁石型MR装置で撮像したMR画像に生じる画像の「ゆがみ」を定量化した。その結果、MR画像の「ゆがみ」は撮像中心から離れるほど明瞭であったが、撮像中心から100mm以内の撮像範囲ならば、格子点座標の実測値と実際の位置のずれは2mm以内にとどまっていた。このことより、放射線治療計画においても、この範囲内での通常スキャンでの画像を使用するならばMR画像の治療計画への臨床応用が可能であると考えた。 また、MR画像の「ゆがみ」の経時的な再現性を検討した。その結果、半年間の経過を経ても、MR画像の「ゆがみ」値に再現性は高く、同じ「ゆがみ」値が確認された。このことより、今後に恒久的にMR位置座標を修正するために、「ゆがみ」補正ソフトウエアを開発することの意義は高いと考えられた。 2。放射線治療計画システム内での転送実験:現在までに、CTシミュレータ、MRシミュレータ、三次元治療計画装置間の画像転送ネットワークをDigital Communications in Medicine(DICOM-3)プロトコールを用いることによって完了した。具体的には、リングを患者頭部に固定した状態で撮影したCT画像とMR画像を、それぞれ治療計画装置に転送する。それらの画像を重ね合わせて三次元治療計画を行った後に、定位放射線照射を実施することが可能になった。現在までにMR画像の重ね合わせの3例の臨床応用を実現している。
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 1996 -1997 
    Author : NAGATA Yasushi; MITSUMORI Michihide; OKAJIMA Kaoru; HIRAOKA Masahiro
     
    In 1996, a new helical CT scanner was added to our CT simulator system. This CT scanner facilitates not only rapid CT scanning by the conventional parallel scanning method but also helical and continuous scanning. However, the accuracy of the reconstructed helical CT image for radiotherapy treatment planning (RTP) is not established. The usefulness and limitations of reconstructed helical CT images were demonstrated using an acryl phantom. A conical phantom measuring 100-mm in diameter was specially constructed using acryl. For identification of marginal distortion in the reconstructed CT image, the conical phantom was scanned using 5 mm and 10 mm collimation with 5 or 10mm/sec table speed for 1 sec/rotation with scanning parameters of 120 kVp and 50 mA.Image reconstruction was performed with both the 180-degree compensation algorithm (SHI algorithm) and the 360-degree compensation algorithm (SFI algorithm). The CT window and level was fixed at 200 Hounsfield units (HU), and 120 HU,respectively. A column phantom was also used for measuring the gradient in the CT number at the marginal surface of different materials. In the study of a conical phantom, the distorsion (D) was measured as a difference netween a larger radius (R) and a smaller radius (r) scanned at the level of 100 mm in radius. In the study of a column phantom, the CT number of each CT slice was measured at every 1 mm intervals. As a result, the reconstructed shape of the margin was competely round when the conical phantom was scanned by the routine conventional CT method. However, distortion appeared when it was reconstructed from helical CT scans. The maximal distortion at a eadius of 100 mm was 2 mm when the phantom was scanned at 5 mm or 10 mm collimation thickness and 10 mm/sec table speed and reconstructed with the SHI algorithm. However, the distortion was below the limits of detection when the phantom was scanned at 5 mm or 10 mm collimation thickness and 5 mm/sec table speed and reconstructed with the SFI algorithm. The gradient of the change in the CT number was larger at the boundary between the acryl and air than at the boundary between the acryl and water. The gradient was also larger at the 5 mm thickness than 10 mm thickness, and at 5 mm/sec table speed than at 10 mm/sec table speed. In conclusion, helical CT parameters should be set up very cautiously for radiotherapy treatment planning because they are subject to image distortion and CT number changes. On the other hand, a network was developed netween the CT simulator and a treatment planning machine. The three-dimensional treatment planning can be possible for clinical application. The clinical significance of the helical CT simulator will be evaluated.
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 1995 -1997 
    Author : HIRAOKA Masahiro; KOKUBO Masaki; OKAJIMA Kaoru; MITSUMORI Michihide; NAGATA Yasushi
     
    1.In 1995, we started place metal clips along the resection margin during breast conserving surgery. In CT-Simulation (CT-S), these metal clips were identified on the CT image and the boost irradiation field was automatically generated around the clips. This method enabled more accurate set-up of the boost irradiation field than conventional method. However, the size of the boost radiation field thus generated was approximately 50% larger than those based on conventional method. To address this issue, We started to correlate the pathological information with individual clip. 2.In a series of 20 patients, we compared the 3-D dose distribution between the plans created with CT-S and those created conventionally with surface anatomical markers. For posterolateral margin of the tangential beam, if mid-axillary line was used or posterior axillary line was used with head rotation of the gantry, significant part of the breast tissue escaped from the radiation field. The technique using posterior axillary line as a reference with head rotation of the gantry resulted in the comparable coverage of the breast tissue., CT-S was, however, superior in that it generated more individualized plan for each patient. 3.In a series of 24 patients, we compared the 3-D dose distribution between the two plans with same dimensions but different radiation source (60Co-gamma ray and 6 MV photon). In patients with large breast (400 cm3) or long separation, which was defined as the distance between the anteromedial and posterolateral margin at the isocenter plane, homogeneity of the dose distribution was significantly worse if 60Co-gamma ray was used. These results provided a guideline for an appropriate selection of radiatio
  • 日本学術振興会：科学研究費助成事業
    Date (from‐to) : 1995 -1995 
    Author : 岡嶋 馨
     
    1.核磁気共鳴(MR)画像の歪みを精査するために、アクリル製の格子状ファントムを新規に設計・製作した。本ファントムは、内部に各種液を注入可能で、MRIの水平、矢状および冠状の各断面とCT画像の歪みの評価が可能である。 2.上記ファントムを使用し、本院放射線治療部のMR装置(MRP-20EX)の画像の歪みを検証した。複数のパルスシークエンス(スピンエコー法、T1、T2強調画像)を使用して撮影した、水平、矢状および冠状の各7断面の歪みを、各格子位置のずれを測定することにより定量化し、静磁場中心からの距離と歪みの大きさを明らかにした。その結果、静磁場中心より半径100mmの範囲内では、画像の歪みはほぼ2mm以内で、放射線治療計画への使用が十分に可能であることが明らかとなった。 また、同ファントムをCTで撮影し、CT画像の歪みがないことを確認した。 3.臨床応用に向け、MR装置の撮影台の形状を放射線治療台と同様の平板状に加工改造し、従来のMR装置では実現不可能であった治療体位での撮影を可能とした。また、臨床研究として、骨腫瘍患者14例を対象に、X線シミュレータによる放射線治療計画を、照射野情報を示す皮膚マーカー装着下で撮影したMR画像情報をもとに修正・確認してその有用性を明らかにし、MRシミュレータ実用化の可能性を確認した。 4.CT・MR画像の治療計画装置へのオンラインでの転送プログラムおよびCT・MR画像の両方を使用可能な治療計画プログラムを開発中である。 5.現在、以下の研究を予定している。 (1)Rdiosurgery用固定具対応の新コイルの開発。 (2)MRシミュレータとして使用可能とするために、レーザーポインターの移動式への換装。 (3)MR画像の歪み補正用コンピュータプログラムの開発。
  • 放射線治療計画に関する研究
  • Study on Treatment Planning in Radiotherapy

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