Nihon Shoukaki Gan Kenshin Gakkai zasshi
Online ISSN : 2185-1190
Print ISSN : 1880-7666
ISSN-L : 1880-7666
Volume 56, Issue 4
Displaying 1-6 of 6 articles from this issue
Prefatory Note
Original article
  • Katsuaki KATO, Takashi CHIBA, Takenobu SHIMADA, Daisuke SHIBUYA
    2018 Volume 56 Issue 4 Pages 479-489
    Published: 2018
    Released on J-STAGE: July 19, 2018
    JOURNAL FREE ACCESS
    According to “Categorized Criteria for X-Ray Image Reading of the Population-Based Gastric Cancer Screening,” which has been published by the Japanese Society of Gastrointestinal Cancer Screening, the radiographic findings in the examinees who require close examination are classified into Category (C)-3a, C-3b, C-4, and C-5, depending on the probability of existence of a lesion and the strength of suspicion for malignancy. Of the 10365 examinees who required close examination among 181224 participants in the radiographic screening program in 2015 (rate of close examination required: 5.7%), the frequencies of C-3a, C-3b, C-4, and C-5 were 16.2%, 81.5%, 2.0%, and 0.4%, respectively. Thus, C-3b was most frequent category for which close examination was required. In total, 334 cases of gastric cancer were detected by screening in 2015 (detection rate: 0.18%). The positive predictive values (PPV) of C-3a, C-3b, C-4, and C-5 were 1.5%, 2.7%, 35.4%, and 71.8%, respectively. The PPV of the categorized criteria significantly increased from C-3a to C-5. The lesions of gastric cancer classified as C-3a, C-4, and C-5 were well-expressed in the X-ray images. Among them, the C-3a cases were mainly cases of intraepithelial cancer, but C-4 cases showed increased frequency of submucosal cancers, and the majority of C-5 cases were those of advanced cancers. The C-3b cases also comprised many intraepithelial or submucosal cancers, but most of them were pointed out by uncertain findings due to inadequate imaging or by findings unrelated to the lesions in the X-ray images. Thus, the categorized criteria are considered as useful indices for objective evaluation of the diagnostic process during X-ray image reading, but further discussion on its operation and usage is required.
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  • Satoshi NOZU
    2018 Volume 56 Issue 4 Pages 490-497
    Published: 2018
    Released on J-STAGE: July 19, 2018
    JOURNAL FREE ACCESS
    OBJECTIVES: In general, computed tomography (CT) colonography is interpreted using a combination of 2D images with multiplanar reformats and 3D endoluminal reconstruction (virtual endoscopic images). This study evaluated the use of the virtual dissection technique as the standard reading method in CT colonography as an alternative to virtual endoscopic images for screening of colorectal neoplasms.
    METHODS: Forty-six colorectal neoplasms in 15 patients diagnosed using preoperative CT colonography and optical colonoscopy were included in this study, and three readers evaluated virtual dissection images acquired using three different workstations (Virtual Place: AZE; Ziostation: Ziosoft; SYNAPSE VINCENT: Fujifilm Medical). To compare the virtual dissection images with optical colonoscopic images, each neoplasm was scored on a 5-point Likert scale ranging from 1 (lowest score: neoplasm was not detected) to 5 (highest score: neoplasm was easily detected and resembled the lesion observed in the optical image.
    RESULTS: The mean scores of the three workstations were 2.70±1.01, 2.78±0.93, and 2.28±1.00; the score of one workstation was significantly lower compared with those of the other two workstations. The mean numbers of lesions with a score >3 were 27.3, 29.0, and 19.0; the mean for one workstation was significantly lower than those for the other two workstations.
    In some cases, one workstation falsely identified a true polyp in the stool tagged with contrast material as stool; however, the other two workstations identified it correctly.
    CONCLUSION: Tumor shape and electronic cleansing effects differ between different workstations because of the differences in the reformat algorithm employed. These results suggest that polyp detectability of the virtual dissection technique varies depending on the workstation used. Therefore, we conclude that the virtual dissection technique is not suitable for use as a standard reading method for the interpretation of CT colonography.
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  • Ken TAKABAYASHI, Koichi NAGATA, Takaaki YASUDA, Michiaki HIRAYAMA, Shu ...
    2018 Volume 56 Issue 4 Pages 498-507
    Published: 2018
    Released on J-STAGE: July 19, 2018
    JOURNAL FREE ACCESS
    We have reported adverse events associated with computed tomography (CT) colonography in a Japanese national survey (Eur Radiol 2017; 27: 4970-4978.). Our aim in this study is to review bowel preparation methods for CT colonography practice in Japan. These data have not been published in the previous paper. Any cathartic or laxative preparation was used for bowel cleansing in 92% (398/431) of the sites, and low-dose bowel preparation method was performed for 19% (82/431) of the sites. Fecal tagging with an oral contrast medium was used at 65% (282/431) of the sites. Dietary restrictions on the day before the examination were implemented for 84% (364/431) of the sites, and specially designed test meals were used for 79% (339/431) of the sites. Bowel preparation was started on the day before the examination at 60% (258/431) of the sites. This national survey was useful for reviewing bowel preparation methods used for CT colonography practice in Japan. It is important to establish recommendations for CT colonography standards, which are intended to guide and support clinical practice by promoting improvement of the quality of CT colonography technique and patient experience.
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  • Ryuzo SEKIGUCHI, Akira KUWAJIMA, Taiichi KANDA, Nobuo ITAGAKI
    2018 Volume 56 Issue 4 Pages 508-517
    Published: 2018
    Released on J-STAGE: July 19, 2018
    JOURNAL FREE ACCESS
    Factors affecting the visualization of the pancreas were examined in 42,789 subjects who underwent abdominal ultrasound examination. It was shown that the subjects’ age, male sex, and obesity were background factors that resulted in poor visualization of the pancreas (p<0.0001). The quality of pancreatic visualization became worse with aging in both males and females, and males showed poorer visualization of the pancreas in all age groups compared with females. The visualization of the pancreas in all Body Mass Index (BMI) subgroups was better for females than for males. The higher was the BMI, the poorer was the visualization of the pancreases in both males and females, and in the case of the BMI being over 25, there were only a few cases in which the pancreas visualization degree was good in both males and females, which was only 1.3%. There was no correlation between the number of years of experience of 18 examiners, the existence of an examiner qualification, and the visualization of the pancreas. However, the examiner’s visualization ability with one year of experience was lower than that of an examiner with more than three years of experience. One year of experience was insufficient to visualize the pancreas completely, and it seemed that experience of three years or more was necessary.
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