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Trends in Radiology-Related Medical Lawsuits Identified by a Legal Database Search

Open Journal of Radiology 2018年第2期8卷 65-73页

作者： Yuki Yamashiro Hiromichi Kuwabara ryohei kuwatsuru Department of Radiology Juntendo University Tokyo Japan Department of Hospital Administration Juntendo University Tokyo Japan

Background: The number of medical lawsuits has been increasing in Japan. This research aimed to clarify trends in radiology-related cases based on a database search of lawsuits and to consider how to avoid the problems that lead to these kinds of lawsuits. Decrease of radiology-related medical lawsuits makes radiologists work more comfortable. Materials and Methods: The Japanese court case search system “***”, a comprehensive database that includes 29,000 laws and 210,000 precedents, was used to search for relevant lawsuits. The primary (α) keyword was related to radiology. A search was conducted as “α” × “medical” × “compensation for damages” for the period from 1 January 1965 through 30 September 2013. Basic information on 3383 extracted lawsuits was examined. Of these, 35 cases directly related to radiologists were selected, and the judgments or outcomes were investigated. All cases were classified by modality (type of treatment), whether damages were awarded in each modality, and whether the litigation issues were related to procedure, informed consent (IC), diagnosis, or interpretation. Court judgments were analyzed to determine whether a causal relationship was established and how that affected the outcome. Results: The number of lawsuits gradually increased in the 1980s and 1990s and then began to decrease slightly in the 2000s. Interventional radiology (IVR) had the greatest number of cases and greatest number where compensation was awarded. No characteristic trends were identified with regard to litigation issues. There was a tendency to reject cases where no causal relationship was recognized and the treatment was considered appropriate. Conclusion: Mistakes in IVR procedures, lesions overlooked during image interpretation, and misdiagnoses were the main causes of litigation. In IVR, it is important to improve techniques and establish improved communication and trust with patients before and after therapy. In addition to developing methods to preven

关键词： Lawsuits Radiologist Interventional Radiology (IVR) Image Interpretation Misdiagnosis

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Influence of Previous Abdominal and Pelvic Surgeries on Uterine Artery Embolization

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Open Journal of Radiology 2023年第4期13卷 246-255页

作者： Yu Hasegawa Juliana Yumi Ishisaki Hitomi Kato Yoshiki kuwatsuru Rie Ozaki Mari Kitade ryohei kuwatsuru Department of Radiology Graduate School of Medicine Juntendo University Tokyo Japan Department of Radiology School of Medicine Juntendo University Tokyo Japan Department of Obstetrics and Gynecology School of Medicine Juntendo University Tokyo Japan Department of Obstetrics and Gynecology Graduate School of Medicine Juntendo University Tokyo Japan

Objective: To assess the influence of previous abdominal and pelvic surgeries on uterine artery embolization (UAE). We hypothesize that the formation of postoperative adhesions can impose technical difficulties for UAE, resulting in longer fluoroscopy time and less reduction of uterus and largest tumor volumes after the procedure. Methods: We retrospectively reviewed the medical records of 122 consecutive patients who underwent uterine artery embolization for the treatment of uterine fibroids in our department. Patients were divided into two groups according to the presence or absence of previous abdominal or pelvic surgery. Fluoroscopy time, change in symptoms, and volume variation of uterus and largest tumor were compared between groups. Results: Forty-seven patients underwent abdominopelvic surgery before UAE (Group 1) and 75 did not (Group 2). Median (IQR) fluoroscopy time was 22 minutes (IQR: 18 - 26.4) for Group 1, and 23.3 minutes (IQR: 19.05 - 28.25) for Group 2. No difference was found between the groups (P = 0.17). Regarding the results after UAE, neither the change in symptoms (P = 0.30) nor the volume variation for uterus (P = 0.41) and largest fibroid (P = 0.18) showed significant difference. Conclusions: In this study, previous abdominopelvic surgeries had no significant influence on fluoroscopy time, and overall outcomes of uterine artery embolization.

关键词： Female Uterine Artery Embolization Leiomyoma Uterus Fluoroscopy

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More Peripheral Visualization of Hepatic Arteries by Using Respiratory-Triggered 3D True Steady-State Free-Precession Projection Magnetic Resonance Angiographic Sequences with Time-Spatial Labeling Inversion Pulse

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Open Journal of Radiology 2014年第4期4卷 314-321页

作者： Daisuke Tsuge ryohei kuwatsuru Tatsuro Inoue Yuki Yamashiro Kazuhiro Suzuki Akihiko Shiraishi Department of Radiology Faculty of Medicine Juntendo University Tokyo Japan

Purpose: To evaluate respiratory-triggered three-dimensional (3D) true steady-state free-precession (SSFP) projection magnetic resonance angiographic sequences with time-spatial labeling inversion pulse (Time-SLIP) for visualizing the hepatic arteries and to optimize the image acquisition protocol. Materials and Methods: A 1.5-T clinical magnetic resonance imager was used to perform abdominal magnetic resonance angiography (MRA) in 25 consecutive patients before transcatheter arterial chemoembolization or surgery. We compared two selective space-labeling inversion pulse (tag pulse) patterns (Patterns I and II, oblique and parallel tag pulses, respectively). Two experienced radiologists evaluated the number of hepatic arterial branches visible on the acquired MRA images, and the results were referenced with those on images from intra-arterial digital subtraction angiography. Results: Images were acquired from all patients. The two radiologists clearly visualized branches of the left and right hepatic arteries. More peripheral hepatic arterial branches were identified in MRA images captured by using tag pulse Pattern I than in those acquired by using Pattern II (P P > 0.05). Conclusion: Non-contrast-enhanced Time-SLIP hepatic MRA with true SSFP allowed selective visualization of peripheral hepatic vessels.

关键词： Hepatic Artery Non-Contrast Magnetic Resonance Angiography Time-Spatial Labeling Inversion Pulse True SSFP Angiography

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Infiltrating angiolipoma of the thoracic wall: A case report

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Open Journal of Clinical Diagnostics 2013年第2期3卷 19-22页

作者： Ayako Hamano Kazuhiro Suzuki Tsuyoshi Saito ryohei kuwatsuru Shiaki Oh Kenji Suzuki Department of General Thoracic Surgery Faculty of Medicine Juntendo University Tokyo Japan Department of Human Pathology Faculty of Medicine Juntendo University Tokyo Japan Department of Radiology Faculty of Medicine Juntendo University Tokyo Japan

We describe a case of infiltrating angiolipoma of the thoracic wall, which is an extremely unusual site for this tumor. Infiltrative angiolipoma is a rare benign soft tissue tumor that commonly affects the extremities and the trunk. This is the first report of infiltrative angiolipoma that affects this site. Magnetic resonance imaging (MRI) revealed a high intensity signal on T2-weighted images and contrast enhanced images showed moderate enhancement effect that mimicked tumors of neurogenic or vascular origin. Angiolipoma should be included in a differential diagnosis of the thoracic wall tumor with T2 high intensity signal and contrast enhancement that is not typical shape and signal for neurogenic tumor or hemangioma.

关键词： Infiltrating Angiolipoma Chest Wall Tumor Computed Tomography Magnetic Resonance Imaging

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Quantitative CT Indexes and CT Visual Score in Interstitial Lung Abnormality as Indicators of Concurrent Lung Cancer

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Open Journal of Radiology 2019年第2期9卷 105-114页

作者： Akihiro Hotta Kazuhiro Suzuki Mariko Fukui Katsutoshi Ando Kenji Suzuki ryohei kuwatsuru Kazuya Takamochi Departments of Radiology Faculty of Medicine Juntendo University Tokyo Japan Departments of Thoracic Surgery Faculty of Medicine Juntendo University Tokyo Japan Departments of Respiratory Medicine Faculty of Medicine Juntendo University Tokyo Japan

Background: The associations between the severity of interstitial lung disease and the stage and histologic type of concurrent lung cancer remain unknown. Purpose: To evaluate whether the severity of interstitial lung abnormality (ILA), as indicated by quantitative computed tomographic (CT) indexes and CT visual score, was correlated with the stage and histological type of concurrent lung cancer. Materials and Methods: Twenty-eight patients with surgically diagnosed lung cancer and ILA on CT were enrolled in this retrospective study. The subjects were allocated to one of three groups by histological type: adenocarcinoma group (13 subjects);squamous cell carcinoma group (10 subjects);and the other histological diagnosis group (5 subjects). Two independent observers evaluated the CT findings to determine the CT visual score, and the kurtosis and skewness of CT-based density histograms were determined. The relationships between severity of ILA and the pathological stage and histological type of concurrent lung cancer were evaluated. Results: There were no significant differences in the CT visual scores and quantitative indexes among the three groups. CT visual score was significantly negatively correlated with pathological stage (r = −0.43, P = 0.025). Conclusion: Patients can have only mild ILA on visual scoring but advanced lung cancer. Therefore, the frequency of follow-up examination should not be based on the severity of ILA on CT.

关键词： CT Visual Score Interstitial Lung Disease Lung Cancer Quantitative CT Index

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A Validation Study of the Deep-Learning-Based Prostate Imaging Reporting and Data System Scoring Algorithm

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Open Journal of Radiology 2022年第3期12卷 59-67页

作者： Ryusuke Irie Maki Amano Kazusa Sugeno Shingo Okada Ali Kamen Bin Lou Heinrich von Busch Robert Grimm Dorin Comaniciu Toshiaki Akashi ryohei kuwatsuru Shigeo Horie Kanako K. Kumamaru Shigeki Aoki Department of Radiology Juntendo University School of Medicine Tokyo Japan Department of Radiology Juntendo University Shizuoka Hospital Shizuoka Japan Digital Technology and Innovation Division Siemens Healthineers Princeton USA Digital Health Siemens Healthcare GmbH Erlangen Germany MR Application Predevelopment Siemens Healthcare GmbH Erlangen Germany Department of Urology Juntendo University School of Medicine Tokyo Japan

Purpose: The Prostate Imaging Reporting and Data System (PI-RADS) was introduced to standardize prostate cancer diagnosis by MRI. However, the inter-reader agreement by PI-RADS scoring is not always high. The purpose of this study was to validate a deep-learning-based diagnostic algorithm of PI-RADS. Methods: We applied a Siemens Healthineers Prostate Artificial Intelligence (AI) prototype (work in progress) for fully automated prostate lesion detection, classification and reporting. More than 2000 bi-parametric MRI studies along with the PI-RADS reports were included as training, validation, and test data. This prospective validation study includes 101 consecutive patients suspected of prostate cancer, and 100 patients were included in the analysis. All subjects underwent a noncontrast-enhanced bi-parametric MRI including T2-weighted and diffusion-weighted imaging. Two board-certified radiologists independently scored the PI-RADS, and if there were disagreements;another radiologist confirmed the diagnosis. We compared the AI results with the interpretation results by the radiologists. Results: The sensitivity of our AI model for PI-RADS ≥ 4 was 0.76, and the specificity was 0.76. For the cases with PI-RADS ≥ 3, the sensitivity was 0.69, and the specificity was 0.76. In the lesion-based analysis, AI detection rates of PI-RADS 3, 4, 5 lesions in the peripheral zone were 43%, 63%, and 100%, respectively. In the transition zone, AI detection rates of PI-RADS 3, 4, 5 were 30%, 54%, and 100%, respectively. Conclusion: Our deep-learning-based algorithm has been validated and shown to help score PI-RADS.

关键词： Deep Learning Artificial Intelligence Prostate Cancer PI-RADS

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Influence of Previous Abdominal and Pelvic Surgeries on Uterine Artery Embolization

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Open Journal of Radiology（放射学期刊） 2023年第4期

作者： Yu Hasegawa Juliana Yumi Ishisaki Hitomi Kato Yoshiki kuwatsuru Rie Ozaki Mari Kitade ryohei kuwatsuru

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A Validation Study of the Deep-Learning-Based Prostate Imaging Reporting and Data System Scoring Algorithm

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Open Journal of Radiology（放射学期刊） 2022年第3期

作者： ryusuke irie maki amano kazusa sugeno shingo okada ali kamen bin lou heinrich von busch robert grimm dorin comaniciu toshiaki akashi ryohei kuwatsuru shigeo horie kanako k. kumamaru shigeki aoki

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咬合重建——科学还是艺术?

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实用口腔医学杂志 2015年第1期31卷 116-122页

作者： K.KOYANO Y.TSUKIYAMA R.kuwatsuru 许毅飞亓坤日本福冈九州大学口腔医学院修复科种植修复组第四军医大学口腔医院.军事口腔医学国家重点实验室

本文综述包括咬合重建中下颌位置、平面、咬合引导、咬合接触、面弓转移、可调式架用法、咬合支持等内容,以明确这些内容是否确实存在客观证据。我们于2011-03在Medline/Pub Med中搜索了超过400篇摘要,选择了其中50篇原文,同时也采... 详细信息

本文综述包括咬合重建中下颌位置、平面、咬合引导、咬合接触、面弓转移、可调式架用法、咬合支持等内容,以明确这些内容是否确实存在客观证据。我们于2011-03在Medline/Pub Med中搜索了超过400篇摘要,选择了其中50篇原文,同时也采用了手工检索。结果表明,许多关于口颌功能与某些特定咬合之间关系的文献,设计不周,研究质量较差,因此其研究结果有很大的不确定性。从改善口颌功能的角度来讲,没有证据支持哪一种类型的咬合优于其他咬合类型,或者哪一种复杂治疗方法的疗效优于那些简单治疗方法。咬合重建需要精确、可重复、简单而快捷的步骤来减少不必要的操作失误和(或)后期补偿性调。因此,尽管那些特殊的治疗尚缺乏相应的科学依据,但有必要让全科牙医掌握一些基本技能,并在继续教育项目中,有目的地提高专科医师的相关知识水平和技能,以便更好地诊治那些复杂病例。

关键词：咬合重建临床依据技术技能

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Gd-EOB-DTPA增强MR成像肝胆期肝脏强化程度的生化和临床预测方法和时间点分析:一项多中心的研究

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国际医学放射学杂志 2017年第1期 85-85页

作者： M.Okada T.Murakami R.kuwatsuru Y.Nakamura H.Isoda S.Goshima 黄黎香 Department of Radiology Kinki University Faculty of Medicine

摘要目的明确钆塞酸二钠(Gd-EOB-DTPA)增强MR成像中与肝脏强化程度随着时间变化相关的生物化学因素,并预测不同临床条件中肝胆期的最佳时间点。材料与方法

关键词：强化程度 DTPA 肝脏时间点生化 MR 肝胆

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