Annual Report 2018
Department of Radiological Technology
I. Radiological Diagnosis
Tomohiko Aso, Kanyu Ihara, Toshihiro Ishihara, Shingo Kawaguchi, Takahiro Miyoshi, Chieko Nagashima, Jun Takita, Hirobumi Nagasawa, Toshimitsu Utsuno, Naoya Ikeno, Takatsugu Magara, Hiromi Suzuki, Jun Torii, Yasutake Ishikawa, Noriko Nishikawa, Akiko Nagoshi, Junko Sonehara, Kenta Hiroi, Masae Fujisawa, Manabu Kimura, Eiko Taguchi, Yusuke Miyamoto, Yoshihiro Mizumachi, Hiroki Miyazaki, Atsushi Aoki, Gyoko To, Yusuke Wakatsuki, Yuji Jibiki, Aika Ozaki, Tatsuya Horita, Yuya Kanai, Nao Ozaki, Yuto Tanaka, Wataru Ouchi, Shuhei Kamikaji, Ryo Kawana, Yuhei Shimizu, Seiya Sato, Seiya Mochizuki, Yuta Miyamae, Satoru Kanzawa, Chihiro Muto, Miku Kousaka, Midori Nonaka, Shinnosuke Ishikawa, Shiho Seto, Masahiro Mizuki, Syunya Oguri
Introduction
This department has a wide range of radiological modalities, namely, interventional radiology (IR), general X-rays, computed tomography (CT), magnetic resonance imaging (MRI), mammography, and nuclear medicine (NM). Serving as a teaching hospital, we put considerable effort into education. We accept students, visitors, and trainees from around the world. We also attend academic congresses around the world.
The Team and What We Do
1. General X-ray
We revised the Examination photography manual and the education manual to unify the teaching methods. By participating in conferences about mammary gland-related procedures and orthopedic procedures, we strengthened cooperation with many work fields and provided appropriate images. In addition, with the introduction of the radiation dose management system using an image examination system, we announced the results of verification of operation methods.
2. Computed Tomography (CT)
We offer clinical images superior in spatial resolution using ultra-high-resolution CT. We have collaborated with numerous companies and showcased the clinical use of the new reconstruction method which applies deep learning technology. We collaborated with doctors to present research presentations in Japan and abroad, and we are investigating image quality improvement and clinical usefulness.
3. Magnetic Resonance Imaging (MRI)
In order to increase the number of examination cases and shorten the waiting time for patients, we improved working conditions by introducing a flex system. We chose a more detailed contrast media that matched each patient's weight and kidney function. We also conducted phantom research and development for 3T MRI. Furthermore, regarding PET MRI, we examined and constructed a business system for smooth operation considering division linkage.
4. Interventional Radiology (IR)
With the increase in the number of cases and the diversification of procedures, we have strengthened human resources development and education, in addition to introducing the late shift system as a form of work improvement. In collaboration with a company, we are advancing research in accuracy improvement and usefulness of the automated tumor-feeder detection system.
5. Fluoroscopy
In recent years, esophageal contrast studies are increasing. Therefore, we are working on human resource development of staff who can respond to inspections.
In addition, we also made an academic announcement on the theme of CT colonography (CTC) and tomosynthesis.
6. Endoscopy
We have cultivated human resources so that we can cope with the diversification of inspections. We are continuing collaborative research on 3D mapping using C-arm X-ray fluoroscopy and conducted research presentations for improving mapping functions. In addition, we presented at the European Congress of Radiology (ECR) and Japan Radiological Society (JRS).
7. Nuclear Medicine (NM)
We have cultivated human resources so that we can cope with the increase of PET-MRI examinations. Following on from last year, we continued joint research on introducing a sterile isolator for PET formulation.
Research activities
1) We studied and developed a performance evaluation phantom based on the JIS standard for 3tesla MRI equipment using liquid paraffin, and solved the uniformity degradation due to RF magnetic field reflection. (Joint research with Kyoto Kagaku Co.)
2) We developed a sterile isolator with a PET drug dispensing function and evaluated its performance, and reported the results at the Japanese Nuclear Medicine Society. (Joint research with Sumitomo Heavy Industries, Ltd.)
3) We have improved the accuracy of the mapping function of 3D mapping using a fluoroscope. (Joint research with Hitachi, Ltd.)
4) We have developed a spatial strain measurement phantom to evaluate radiation therapy planning using PET / MRI. (Joint research with GE Healthcare Japan.)
Education
1) The network-type self-evaluation system was used, and the results of the counting were used to improve the efficiency of balanced education and departmental rotation as a radiological technologist.
2) We continuously participated in training sessions hosted by the Ministry of Health, Labour and Welfare and the National Hospital Organization, etc., and workshops of various certification organizations.
3) In addition to participating in in-hospital conferences organized by each department, a radiological technologist conference was held to improve specialized knowledge and improve skills.
4) We are continuously engaged in human resource exchanges with The University of Tokyo Hospital and Kyoto University Hospital.
5) We accept many visits from and undertake training and clinical training for domestic radiological technologist schools and countries around the world.
6) We actively participated in many academic conferences around the world.
7) We regularly hold incident analysis within the department to prevent medical accidents and strive for medical safety.
Future prospects
1) We will examine patient exposure management items with a view to the future from the practical data of patient exposure management information networks such as Radiation Dose Structured Report (RDSR).
2) Optimization of high-resolution monitors required for image display on ultra-high-resolution CT (joint research with EIZO Corporation), examination of image display methods using contrast enhancement using the latest image processing technology, new 3D image development of analysis program (joint research with AMIN Co., Ltd.) and practical application of texture analysis.
3) Continue to enhance joint research and cooperate in medical device development.
II. Radiological Oncology
Yoshihisa Abe, Tooru Kato, Ako Aikawa, Toshimitsu Sofue, Miyuki Murata, Yosihiro Shibata, Minoru Hamada, Tatsuya Sakasai, Akira Yoshida, Junichi Kuwahara, Yuichi Yokoyama, Yuuki Miura, Rie Ishikawa, Ryo Kawana, Daisuke Fujiyama, Nao Ozaki, Yuuya Hisaki, Hironori Murakami, Chihiro Kuroki, Shuto Amanuma, Keishi Tanaka
Introduction
The Department of Radiation (Oncology) is equipped with four Linear Accelerators (LINAC) and CyberKnife and MRIdian systems, which support Intensity Modulated Radiation Therapy (IMRT), Stereotactic Radiation Therapy (SRT) and Image-guided Radiation therapy (IGRT). An Image Guided Brachytherpy system is also utilized.
The Team and What We Do
1) We updated one linear accelerator to the latest model that includes the highly precise positioning support system (ExacTrac), and planned more improvements of the highly precise irradiation system.
2) MRI-guided adaptive radiotherapy system (MRIdian) was used for nine patients on average per month. Online adaptive treatment, the highest-level radiation therapy technique, was carried out 270 times on all patients including ones for in-hospital clinical trials.
3) 63 total body irradiation (TBI) procedures for bone marrow transplantations and two total skin electron beam therapy (TSEBT) procedures were performed.
4) The CyberKnife system was used a lot, including for Stereotactic Body Radiation Therapy (SBRT) with a Synchrony Respiratory Tracking System. We started ablation treatment for cardiac (CyberHeart) with this system for the first time in Japan, and carried it out on three patients.
5) Collaborative research on quality control and construction of treatment workflow in the MRIdian adaptive radiotherapy system was performed.
6) Joint development began to establish a new security system to protect specified radioactive materials used at hospitals.
Research activities
1) A hospital-based Boron Neutron Capture Therapy (BNCT) system with an accelerator was evaluated for safety by measuring dose distributions outside the clinical field. We cooperated with the irradiation management and the biological safety testing.
2) In regard to the MRIdian system, we produced verification results of dose measurement methods in the magnetic field, development of quality control phantoms, inspection of intrafractional organ motion and performance evaluation of the image fusion software.
Education
1) Our department educates the staff effectively according to our educational programs and systematic rotation among modalities.
2) Our department accepted many visitors and trainees from all around Japan.
3) Our department accepted many students learning Radiological Science in Japanese universities and Yuanpei University in Taiwan.
4) "Comprehensive training about the radiation therapy process" has been repeated, reviewed, and improved.
Future prospects
1) In the BNCT system, we work together to complete the clinical trials and achieve early clinical use.
2) In the MRIdian system, we aim at establishing a quality control method and standard workflow, and contribute to dissemination of safe radiation therapy.
3) The MRIdian system should change its radiation source from 60-cobalts to the Linac system to aim for more efficient operation.
4) In order to respond to social needs, our department must plan to replace systems considering features such as high precision or adaptive radiation therapy. It is necessary to replace two LINACs used for more than 10 years.
5) We will cooperate with the clinical trials performed in the department of radiation oncology.
List of papers published in 2018
Journal
1. Okamoto H, Nishioka S, Iijima K, Nakamura S, Sakasai T, Miura Y, Takemori M, Nakayama H, Morishita Y, Shimizu M, Abe Y, Igaki H, Nakayama Y, Itami J. Monte Carlo modeling of a 60Co MRI-guided radiotherapy system on Geant4 and experimental verification of dose calculation under a magnetic field of 035 T. J Radiat Res, 60:116-123, 2019