Annual Report 2020
Department of Radiological Technology
I. Radiological Diagnosis
Tomohiko Aso, Kanyu Ihara, Toshihiro Ishihara, Hirobumi Nagasawa, Chieko Nagashima, Toshimitsu Utsuno, Naoya Ikeno, Yoshiaki Miyazaki, Hiromi Suzuki, Takatsugu Magara, Atsushi Shishido, Makoto Mimatsu, Jun Torii, Yasutake Ishikawa, Minami Maruyama, Akiko Nagoshi, Manabu Kimura, Hiroki Miyazaki, Eiko Taguchi, Yusuke Miyamoto, Mitsuhiro Kon, Yuya Kanai, Tatsuya Horita, Ryo Kawana, Yusuke Wakatsuki, Ikuya Ishii, Yuto Tanaka, Gyoko To, Yuki Yamada, Seiya Mochizuki, Nao Ozaki, Motoi Nagata, Yuhei Shimizu, Shuhei Kamikaji, Seiya Sato, Yuta Miyamae, Akira Yoshida, Masae Fujisawa, Aya Shimoike, Shogo Nakamura, Satoru Kanzawa, Miku Kousaka, Chihiro Muto, Chihiro Kuroki, Midori Nonaka, Syunya Oguri, Ken Shimizu, Satsuki Watanabe, Kazuki Matsubara, Ai Arisue, Takumi Miyairi, Ayame Sugou, Tomoka Harada, Kouki Fukushi, Yutaro Tsukahara, Yusuke Taira
Introduction
This department offers a wide range of radiological modalities, namely, general X-rays, computed tomography (CT), magnetic resonance imaging (MRI), interventional radiology (IR), 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 worldwide.
The Team and What We Do
1. General X-rays
As with last year, we focused on newcomer education.
In addition, through joint research with a company, we verified the efficacy of an alcohol-based silver antibacterial agent in the X-ray room and reported the research results.
In mammography, we selected cases in order of difficulty to enable the qualification of a mammography screening radiological technologist. We also conducted X-ray interpretation training for engineers and newcomers who do not go on to X-ray certification.
2. Computed Tomography (CT)
We use a 320-row area-detector CT system to optimize the imaging dose through deep learning -based reconstruction technology and new dual-energy imaging featuring a rapid kV switching system with tube current modulation. Virtual monochromatic images and iodine maps are also provided for additional information for diagnostic imaging. Through collaborative research with a company, we published studies on new dual-energy CT, ultra-high-resolution CT and deep learning-based reconstruction technology.
3. Magnetic Resonance Imaging (MRI)
We provide high-resolution clinical images thanks to the introduction of a new MRI device. We have reviewed the use of contrast media and work to improve its management.
4. Interventional Radiology (IR)
To provide high-quality team medical care, we share information on cases and the effective use of equipment. With the diversification of procedures, it has become possible to conduct simulations by drawing the intrahepatic bile duct in advance using a 3D workstation. We are also developing new applications through joint research with companies.
5. Fluoroscopy
We are working on human resource development of staff who can perform inspections using fluoroscopy. We also perform COVID-19 compliant inspections (CT and general X-rays).
6. Endoscopy
With the increase in our staff, we are developing our human resources. We presented the results of a collaborative study on 3D mapping conducted until last year. We examined CT scan conditions and the control of fluoroscopy to improve mapping accuracy.
7. Nuclear Medicine (NM)
Ongoing from last year, we are training human resources to respond to the increase in PET/MRI examinations, and we are continuing the phase I RI radionuclide therapy clinical trial. We have started joint research with a company on an automatic RI administration medicine device.
Research activities
1. In collaboration with Nemoto Kyorindo Co., Ltd., we developed a barcode reading system for CT contrast medium syringes and verified the accuracy of the system. In the future, we will standardize the safety of CT contrast agent syringe IC tags.
2. For dose management, in collaboration with FUJIFILM Medical Solutions Co., Ltd., we have developed and commercialized a reading method for Optical Character Recognition (OCR) processing that reads the optical characters from captured images of radiological medical equipment that do not support dose information output.
Education
1. We continuously participate in training sessions hosted by the Ministry of Health, Labor and Welfare and the National Hospital Organization, as well as in workshops of various certification organizations.
2. In addition to participation in in-hospital conferences organized by each department, a radiological technologist conference was held to improve specialized knowledge and skills.
3. In cooperation with the Nursing Department, we conducted risk prediction training for the purpose of medical safety.
4. We gave a lecture on the cancer radiotherapy nursing course at the Cancer Control Information Center Cancer Nursing Specialist Training.
5. We are continuously engaged in human resource exchanges between the University of Tokyo Hospital and Kyoto University Hospital.
6. We accept many visits, clinical training sessions from domestic radiological technologist schools and countries around the world.
Future Prospects
1. To prevent infection with COVID-19, etc., we are conducting verification research on the antibacterial effect of alcohol-based silver antibacterial agent, and the result will be published in medical journals.
2. We will develop a new dose management system for sharing optimal dose information with patients and will compare it with the current system.
3. We will develop a dose management system for obtaining injection information on nuclear medicine drugs online from an automatic injection device. We will then conduct verification studies on optimizing medical exposure protection and improving work efficiency.
II. Radiological Oncology
Tomohiko Aso, Shouichi Katsuta, Tomonori Goka, Ako Aikawa, Toshimitsu Sofue, Miyuki Murata, Minoru Hamada, Yoshihiro Shibata, Tatsuya Sakasai, Keita Kaga, Yuuki Miura, Rie Ishikawa, Yuuya Hisaki, Daisuke Fujiyama, Mitsuhiro Kon, Junichi Kuwahara, Yuuhei Shimizu, Seiya Satou, Masae Fujisawa, Miku Kousaka, Hironori Murakami, Chihiro Kuroki, Kazuki Takasou, Yuuki Tsunoda, Yuuya Arai, Hiroko Sugaya
Introduction
This section is equipped with four Linear Accelerators (LINAC) and CyberKnife and MRIdian systems, which support Intensity Modulated Radiation Therapy (IMRT), Stereotactic Radiation Therapy (SRT) and Image-guided Radiation therapy (IGRT). An Image-Guided Brachytherapy system is also employed.
The Team and What We Do
1) We updated one of the LINACs to the latest model, which includes the highly precise positioning support system (ExacTrac). By aligning compatible machines, we aimed to strengthen our radiotherapy facility against breakdowns.
2) We updated one MDCT with 16DAS to one with 80DAS and a large-bore suite for radiotherapy planning. In this update, we reconsidered the imaging protocols to achieve a reduction in metal artifacts and a reduction in patient radiation exposure.
3) The MRI-guided adaptive radiotherapy system (MRIdian) was used on 88 patients. Online adaptive treatment, the highest-level radiation therapy technique, was performed 161 times on our patients, including those undergoing in-hospital clinical trials.
4) 52 total body irradiation (TBI) procedures for bone marrow transplantations were performed.
5) To prevent COVID-19, we reinforced the infection precautions and managed the business continuity plan.
6) For the application of sensing systems, we conducted joint development with Computer System Technology Co., Ltd.
Research activities
In regard to the MRIdian system, we have developed a video display system to manage the patients' respiratory movements.
Clinical trials
1) We participated in a clinical study on brachytherapy using alpha particle-emitting radioisotopes below the lower limit of the regulations. The clinical trial was performed on 2 patients.
2) We participated in a boron neutron capture therapy (BNCT) clinical study. The clinical trial was performed on 2 patients.
Education
1) We conducted staff rotations among the modalities according to our educational programs.
2) One technologist worked as a concurrent staff member at the Section of Radiation Safety and Quality Assurance to learn radiation therapy planning and quality control.
3) We reviewed and improved our workflow through comprehensive training on radiotherapy processes.
Future Prospects
1) For the BNCT system, we will promote our collaboration to complete the clinical trials and achieve early clinical implementation.
2) For the MRIdian system, we will establish an efficient quality control system and education system, and will contribute to disseminating safe treatment practices.
3) The MRIdian system should change its radiation source from 60-cobalt to a LINAC system to achieve more advanced features.
4) To provide stable treatment conditions, we plan to replace the LINAC employed over the past 10 years with a new system supporting higher precision and adaptive radiation therapy.
5) We will collaborate in the clinical trials performed in the Department of Radiation Oncology.
List of papers published in 2020
Journal
1. Miyazaki Y, Tabata N, Kubo Y, Shinozaki K. Utility of Tissue Classification in Invasive Ductal Carcinoma using Dynamic Magnetic Resonance Imaging of the Mammary Gland. J Clin Imaging Sci, 11:4, 2021