軟質材料と硬質材料を組み合わせた放射線治療補助装置の考案

軟質材料と硬質材料を組み合わせた放射線治療補助装置の考案

Journal of Japanese Academy of Oral and Maxillofacial Rehabilitation Technology

日本口腔顎顔面技工学会会誌


Evaluation of dose constraint for contralateral neck in the unilateral neck volumetric-modulated arc radiotherapy

片側頸部を標的とした強度変調回転照射における線量制約の検討


ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討

ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討


Radiomics analysis of [18F]-fluoro-2-deoxyglucose positron emission tomography for the prediction of cervical lymph node metastasis in tongue squamous cell carcinoma

This study aimed to create a predictive model for cervical lymph node metastasis (CLNM) in patients with tongue squamous cell carcinoma (SCC) based on radiomics features detected by [F]-fluoro-2-deoxyglucose (F-FDG) positron emission tomography (PET). A total of 40 patients with tongue SCC who underwent F-FDG PET imaging during their first medical examination were enrolled. During the follow-up period (mean 28 months), 20 patients had CLNM, including six with late CLNM, whereas the remaining 20 patients did not have CLNM. Radiomics features were extracted from F-FDG PET images of all patients irrespective of metal artifact, and clinicopathological factors were obtained from the medical records. Late CLNM was defined as the CLNM that occurred after major treatment. The least absolute shrinkage and selection operator (LASSO) model was used for radiomics feature selection and sequential data fitting. The receiver operating characteristic curve analysis was used to assess the predictive performance of the F-FDG PET-based model and clinicopathological factors model (CFM) for CLNM. Six radiomics features were selected from LASSO analysis. The average values of the area under the curve (AUC), accuracy, sensitivity, and specificity of radiomics analysis for predicting CLNM from F-FDG PET images were 0.79, 0.68, 0.65, and 0.70, respectively. In contrast, those of the CFM were 0.54, 0.60, 0.60, and 0.60, respectively. The F-FDG PET-based model showed significantly higher AUC than that of the CFM. The F-FDG PET-based model has better potential for diagnosing CLNM and predicting late CLNM in patients with tongue SCC than the CFM.


Evaluation of anatomical references for locating the course of the posterior superior alveolar artery for dental implant surgery

This retrospective cohort study aimed to identify the best anatomical reference for predicting the posterior superior alveolar artery (PSAA) location. Computed tomographic images of 90 maxillary sinuses were evaluated. We studied five references, including the alveolar crest, maxillary sinus floor, zygomatoalveolar crest, hard palate and soft palate, and measured the distances between them and the PSAA. Variations in the distance were evaluated by the standard deviation and coefficient of variation (CV). The zygomatoalveolar crest was an unstable reference, owing to its high standard deviation and CV. The smallest CV was for the distance between the alveolar crest and PSAA, although the distance was smaller in edentulous jaws than dentulous jaws. The distance between the sinus floor and PSAA was larger in male and edentulous patients. The PSAA was detected in 40.0%, 44.4%, 54.4% and 56.7% of the sinus walls at the first and second premolar and the first and second molar positions, respectively. At these tooth positions, the respective heights above the hard palate were 11.2 ± 4.9, 8.2 ± 4.9, 6.2 ± 2.8 and 8.1 ± 2.9 mm. The hard palate was the most stable reference for predicting the location of the PSAA, irrespective of sex, age and dentition.

International Journal of Oral and Maxillofacial Surgery


Effect of dental metal artifact conversion volume on dose distribution in head-and-neck volumetric-modulated arc therapy

Purpose: During treatment planning for head-and-neck volumetric-modulated arc therapy (VMAT), manual contouring of the metal artifact area of artificial teeth is done, and the area is replaced with water computed tomography (CT) values for dose calculation. This contouring of the metal artifact areas, which is performed manually, is subject to human variability. The purpose of this study is to evaluate and analyze the effect of inter-observer variation on dose distribution.Methods: The subjects were 25 cases of cancer of the oropharynx for which VMAT was performed. Six radiation oncologists (ROs) performed metal artifact contouring for all of the cases. Gross tumor volume, clinical target volume, planning target volume (PTV), and oral cavity were evaluated. The contouring of the six ROs was divided into two groups, small and large groups. A reference RO was determined for each group and the dose distribution was compared with those of the other radiation oncologists by gamma analysis (GA).As an additional experiment, we changed the contouring of each dental metal artifact area, creating enlarged contours (L), reduced contours (S), and undrawn contours (N) based on the contouring by the six ROs and compared these structure-sets.Results: The evaluation of inter-observer variation showed no significant difference between the large and small groups, and the GA pass rate was 100%. Similar results were obtained comparing structure-sets L and S, but in the comparison of structure-sets L and N, there were cases with pass rates below 70%.Conclusions: The results show that the artificial variability of manual artificial tooth metal artifact contouring has little effect on the dose distribution of VMAT. However, it should be noted that the dose distribution may change depending on the contouring method in cases where the overlap between PTV and metal artifact areas is large.

Journal of Applied Clinical Medical Physics


強度変調放射線治療に伴う放射線性顎骨壊死の頻度と危険因子の検討

強度変調放射線治療に伴う放射線性顎骨壊死の頻度と危険因子の検討


Inferior alveolar nerve paresthesia caused by the extrusion of calcium hydroxide-based paste into themandibular canal: A case report.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology


Clinical outcomes and prognostic factors of definitive radiotherapy for esophageal cancer

Purpose To assess the treatment results of definitive radiotherapy for esophageal cancer at Tokushima University Hospital and clarify the prognostic factors. Methods Seventy consecutive patients with esophageal cancer who underwent definitive radiotherapy between May 2004 and March 2012 were included in the present study. Local control rate, overall survival rate, and radiation morbidity were examined and univariate and multivariate analyses were performed to investigate prognostic factors. Results The 5-yearoverall survival rates of stages I, II, III, and IVA were 81%, 71%, 0%, and 9%, respectively. Performance status, clinical stage, and neoadjuvant chemotherapy were significant prognostic factors. A past history of interstitial pneumonia was associated with severe radiation-induced lung injury. Conclusions Patients who underwent definitive chemoradiotherapy for esophageal cancer in stage I/II showed good prognosis. However, treatment results of the patients in stage III/IV were not satisfactory, and those who could not undergo surgery after neoadjuvant chemotherapy had the worst prognosis.J.Med.Invest.66:99-105, February, 2019.

The Journal of Medical Investigation : JMI


Fabrication and Evaluation of Carbonate Apatite-coated Calcium Carbonate Bone Substitutes for Bone Tissue Engineering

Carbonate apatite-coated calcium carbonate (CO Ap/CaCO ) was fabricated through a dissolution-precipitation reaction using CaCO granules as a precursor to accelerate bone replacement based on superior osteoconductivity of the CO Ap shell, along with Ca release from the CaCO core and quicker resorption of the CaCO core. In the present study, CaCO , 10% CO Ap/CaCO , 30% CO Ap/CaCO , and CO Ap granules were fabricated and examined histologically to evaluate their potential as bone substitutes. Larger contents of CaCO in the granules resulted in higher Ca release and promoted cell proliferation of murine preosteoblasts at 6 days compared with CO Ap. Interestingly, in a rabbit femur defect model, 10% CO Ap/CaCO induced significantly higher new bone formation and higher material resorption compared with CO Ap at 8 weeks. Nevertheless, CO Ap showed a superior osteoconductive potential compared with 10% CO Ap/CaCO at 8 weeks. All tested granules were most likely resorbed by cell mediation including multinucleated giant cell functions. Therefore, we conclude that CO Ap/CaCO has a positive potential for bone tissue engineering based on well-controlled calcium release, bone formation, and material resorption.

Journal of Tissue Engineering and Regenerative Medicine


Compositional and histological comparison of carbonate apatite fabricated by dissolutionprecipitation reaction and Bio-Oss®.

Carbonate apatite (COAp) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of COAp (COAp-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that COAp-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of COAp-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. COAp-DP had a larger amount of CO than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with COAp-DP and Bio-Oss®, COAp-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. COAp-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that COAp-DP and Bio-Oss® showed different behavior even though they were both classified as COAp. The CO content in COAp played a more important role than the crystallinity of COAp for replacement to bone and high osteoconductivity.

Journal of Materials Science. Materials in Medicine


徳島県における口腔がん検診の現状

徳島県における口腔がん検診の現状

日本歯科人間ドック学会誌

日本歯科人間ドック学会誌


Effectiveness of Newly Developed Water-Equivalent Mouthpiece during External Beam Radiotherapy for Oral Cancer


Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images.

Palatine tonsilloliths incidentally detected on diagnostic imaging should be differentiated from pathologic calcifications to enable correct diagnosis and treatment. The aim of this study is to clarify the prevalence and imaging characteristics of palatine tonsilloliths on panoramic radiographs. We retrospectively reviewed 2244 individuals who underwent pairs of consecutive panoramic radiography and computed tomography (CT) of the head and neck region. The imaging characteristics of palatine tonsilloliths on panoramic radiography were compared with the findings from CT, which was considered the gold standard. Tonsilloliths were detected in 300 (13.4 %) and 914 (40.7 %) of the 2244 individuals on panoramic radiographs and CT, respectively. On panoramic radiographs, tonsilloliths were superimposed over the ramus of the mandible at the level coincident with and inferior to the soft palate in 176 (7.8 %) and 90 (4.0 %) individuals, respectively. Tonsilloliths were also superimposed over the surrounding soft tissue inferior to the body of the mandible, postero-inferior to the angle of the mandible, and posterior to the ramus of the mandible in 33 (1.5 %), 26 (1.2 %), and 28 (1.3 %) individuals, respectively. A significant correlation was observed between the detectability on panoramic radiographs and the size (Spearman r = 1.000) and number (Spearman r = 0.991) of tonsilloliths, as revealed by CT images. The present results suggest that tonsilloliths are commonly detected on panoramic radiographs. Furthermore, they can be superimposed on both the mandible and the surrounding soft tissue. Clinicians should include tonsilloliths among the differential diagnoses when calcified bodies are detected on panoramic radiographs.


A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull

A case of tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate (CPPD) crystal deposition disease) in the temporomandibular joint (TMJ), extending to the base of the skull, is reported. A 38-year-old man was referred to the hospital with mild pain in the right chin and tip of the tongue. Panoramic radiography showed a large calcified mass around the right TMJ. Computed tomography imaging revealed a large, granular, calcified mass surrounding the right condylar head and extending to the base of the skull. The mass was clinically and radiographically suspected to be a pseudogout lesion. A biopsy specimen was collected under general anaesthesia to confirm the diagnosis. On histology, the mass was found to contain deposits of numerous rod-shaped and rhomboid crystals, which suggested tophaceous pseudogout. The deposits were identified as CPPD crystal deposition, based on analysis by X-ray diffraction and Fourier transform infrared spectroscopy. These two crystallography methods were useful in confirming the diagnosis of CPPD crystal deposition disease in the TMJ.

International Journal of Oral and Maxillofacial Surgery


Neuroendocrine tumor in the mandible: a case report with imaging and histopathologic findings

Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are mostly observed in the gastrointestinal tract, pancreas, and lungs. NETs in the oral and maxillofacial region are extremely rare. We report a case of a 59-year-old woman with an NET in the mandible. The patient did not show any symptoms except for remarkable swelling and bleeding. The lesion appeared as a radiolucent honeycomb abnormality with bone destruction on panoramic radiography. The histopathologic diagnosis following a biopsy was NET. Contrast-enhanced computed tomography (CT), (18)F-fluorodeoxyglucose positron emission computed tomography ((18)F-FDG PET/CT), and adrenal scintigraphy-labeled meta-iodobenylguanidine were the modalities added to identify the primary site. Multiple lesions were confirmed in the gastrointestinal tract. Endoscopy was performed to identify the lesions, and several lesions were observed protruding from the mucous membranes. However, the endoscopy specimens did not yield an accurate diagnosis because adequate samples were not acquired. Blood and urine tests revealed no functional activity caused by the tumors. Although the origin was not histopathologically confirmed with endoscopy, this patient was situationally diagnosed with nonfunctional NET originating from the duodenum, as demonstrated by the metastases in the mandible.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology


Prevalence and Imaging Characteristics of Palatine Tonsilloloths Detected by CT in 2,873 Consecutive Patients


Changes of tumor and normal structures of the neck during radiation therapy for head and neck cancer requires adaptive strategy.

The treatment period over which radiation therapy is administered extends over several weeks. Since tumor shrinkage in response to radiation therapy and weight loss due to radiation-induced mucositis may impact on the dose distribution in both target and organ at risk in patients with head and neck cancer, the anatomical changes of tumor and neck volumes during this period should be taken into consideration. We investigated the anatomical changes that occurred in the target and normal structure of the neck during radiation therapy for pharyngeal cancer, and evaluated the necessity of an adaptive strategy. Ten patients with pharyngeal cancer who underwent radical chemoradiation therapy using 3-dimensional conformal radiation therapy RT (66-70 Gy in 33-35 fractions) between April 2009 and September 2010 were enrolled in the study. Patients underwent CT scans every week during their course of treatment. We analyzed the CT data in the radiation treatment planning system and measured changes of tumor, organ at risk, and neck volume. Gross tumor volume (GTV) was rapidly reduced by 28% of the original volume on average in the first 3 weeks. The right and left submandibular glands volume decreased to 70% and 63% of their initial volumes on average, respectively. The volume of the neck in the radiation fields decreased to 89% of its initial volume on average by the sixth week mainly caused by body weight loss due to acute radiation morbidity. Considerable anatomical change in the radiation filed that will affect dose distribution of the target and organ at risk was observed during radiation therapy for head and neck cancer.

The Journal of Medical Investigation : JMI


Shielding Effect of a Customized Intraoral Mold Including Lead Material in High-dose-rate 192-Ir Brachytherapy for Oral Cavity Cancer.

A high-dose-rate (HDR) 192-Ir brachytherapy using a customized intraoral mold is effective for superficial oral cavity cancer, and the surrounding normal tissue is kept away from the radioactive source with gauze pads and/or mouth piece for reducing the dose on the normal tissues. In the Tokushima university hospital, the mold has a lead shield which utilizes the space prepared with sufficient border-molding by a specific dental technique using modeling compound. In HDR 192-Ir brachytherapy using a lead shielded customized intraoral mold, there are no reports measuring the absorbed dose. The purpose of the present study is to measure the absorbed dose and discuss the optimum thickness of lead in HDR 192-Ir brachytherapy using a customized intraoral mold with lead shield using a 1 cm thickness mimic mold. The thickness of lead in the mold could be changed by varying the arrangement of 0.1 cm thickness sheet of the acrylic resin plate and lead. The measured doses at the lateral surface of the mold with thermo-luminescence dosimeter were reduced to 1.12, 0.79, 0.57, 0.41, 0.31, 0.24 and 0.19 Gy and the ratios to the prescription dose were reduced to 56, 40, 29, 21, 16, 12 and 10 percent as lead thickness increased from 0 to 0.6 cm in 0.1 cm increments, respectively. A 0.3 cm thickness lead was considered to be required for a 1 cm thickness mold, and it was necessary to thicken the lead as much as possible with the constraint of limited space in the oral cavity, especially at the fornix vestibule.


High-dose-rate brachytherapy for patients with maxillary gingival carcinoma using a novel customized intraoral mold technique.

OBJECTIVE: The purpose of this study was to introduce a novel customized intraoral mold treatment for maxillary gingival carcinoma (UGC). STUDY DESIGN: Two patients with UGC were treated as salvage therapy using this technique. The mold was designed to keep normal soft tissues adjacent to the tumor away from the radioactive source as much as possible, and it was shielded by lead. The radiation dose on the buccal mucosa and tongue was measured at the inner and outer surfaces of the intraoral mold before starting high-dose-rate brachytherapy by the remote afterloading system, and was reduced to almost one tenth. RESULTS: The patient had no recurrence and no severe adverse effects on the normal soft tissue adjacent to the tumor until the end of the follow-up period. CONCLUSION: High-dose-rate brachytherapy using the novel customized intraoral mold might be a treatment option of not only salvage therapy, but definitive therapy of UGC.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics


Effective bladder preservation strategy with low-dose radiation therapy and concurrent intraarterial chemotherapy for muscle-invasive bladder cancer.

PURPOSE: The aim of this study was to evaluate retrospectively the toxicity and response, bladder preservation, and survival of patients with muscle-invasive bladder cancer treated with multimodality therapy consisting of low-dose radiation therapy (RT) and concurrent intraarterial chemotherapy (IACT). METHODS AND MATERIALS:. Between November 1999 and July 2005, a total of 27 consecutive, previously untreated patients with muscle-invasive bladder cancer underwent transurethral bladder tumor resection followed by concurrent low-dose RT and IACT. Patients who achieved a complete response (CR) were followed up closely without further therapy, and patients who did not achieve a CR underwent further treatment. RESULTS: Complete response was achieved in 22 of 27 patients (81%). Of these 22 patients, 7 developed recurrences, and 3 died of their disease. In five patients who did not achieve CR, one died from bone metastases. The 3-year overall survival rate was 81%, with a median follow-up time of 27 months; and 22 of 27 patients (81%) with a preserved bladder were tumor-free at the last follow-up. Three patients (11%) developed grade 3 acute hematological toxicity. CONCLUSION: Multimodality therapy consisting of low-dose RT and concurrent IACT for muscle-invasive bladder cancer can achieve survival rates similar to those in patients treated with radical cystectomy, with successful bladder preservation and minimal adverse effects.


Can Kampo Therapy prolong the life of cancer patients?

Our policy regarding the performance of radiotherapy to squamous cell carcinoma of the uterine cervix has not changed since 1969. We have already reported the treatment results which were as good as those from other institutions. Since 1978, Kampo therapy was first introduced in the treatment of cancer patients in dealing with problems such as the side effects of radiotherapy and chemotherapy and various types of general malaise. We analyzed our treatment results in order to re-evaluate the chemo-radiotherapy in combination with Kampo. Survival rates for 5, 10 and 15 years, respectively, were 90.9%, 71.6% and 71.6% for Stage IB, 78.9%, 61.8% and 41.8% for Stage II, 62.3%, 49.1% and 41.2% for Stage III and 53.1%, 36.5% and 16.7% for Stage IV. The Kampo significantly extended the survival of patients with uterine cervical cancer. We intend to perform further research with more patients to explore how this therapy contributes to the prolonging of patients survival.


Radiation therapy for cervical cancer in the elderly

To evaluate the long-term results of radical radiation therapy (RT) for cervical cancer in elderly patients. We reviewed the clinical records of 727 patients with cervical cancer who underwent radical RT at the Tokushima University Hospital and compared the treatment results of three age groups: </=64 years (younger group [YG], 337 patients), 65-74 years (young-old group [YOG], 258 patients), and >/=75 years (older group [OG], 132 patients). At the last follow-up, 155 YG (46%), 77 YOG (30%), and 48 OG patients (36%) had died of cervical cancer; the median follow-up periods were 82, 87, and 68 months, respectively. The 5-/10-year disease-specific survival rates were 60%/52% in YG, 76%/68% in YOG, and 66%/57% in OG. Differences between OG and the other groups were not significant. The 5-/10-year disease-specific survival rate of YOG was significantly superior to that of YG (p<0.001). Clinical stage was the only significant prognostic variable (p<0.001). Late radiation morbidity of grades 2-4 in the bladder and/or rectum occurred in 22% of YG, 31% of YOG, and 8% of OG patients. RT was well tolerated in elderly patients, and age was not a significant prognostic factor. In the management of cervical cancer, advanced age is not a contraindication to radical RT.


Significance of Abdominal CT Examination for the Screening of Distant Metastasis of the Orofacial Malignancies

口腔顎顔面悪性腫瘍の遠隔転移評価における躯幹部CT検査の位置づけ

Abdominal CT examinations for the scouting of distant metastasis (DM) of orofacial malignant tumors were retrospectively evaluated, for the purpose of establishing the standard way of examination. Out of 159 patients with oral malignancies, 247 abdominal CT examinations were performed for the purpose of scouting DM. During the examination, intravenous contrast enhancement (CE) was performed in 166 examinations. DM were detected in 13 patients (8.2%). DM were found in 6 at administration, and 8 were late DM. Nine DM were detected out of 166 (5.4%) examinations with CE, and 5 were detected out of 81 (6.2%) examinations without CE. In detecting the DM, no improvement was found by CE. DM attacked lungs in 13, mediastinum in 3, liver in 2, paraaortic lymph nodes in 1, chest wall in 1, and vertebra in 1. Only 2 patients with DM were free from cervical metastasis, and the remainder was combined with cervical metastasis, regardless the status of the primary sites. Conclusions: Abdominal CT was useful for detecting DM. Intravenous CE was not necessary for scouting the DM. Patients with cervical metastasis had a high potential for developing DM.


An Investigation of Accidental Aspiration and Swallowing during the Dental Treatment at Tokushima University Hospital

徳島大学病院歯科診療部門における誤飲・誤嚥の実態調査

When an accident of aspiration or swallowing occurs during dental treatment, the patient would fall into severe clinical condition such as pneumonia, peritonitis, sepsis, and even death, unless a dentist immediately judges the patient's situation. As most dental material is radiopaque, radiography of a chest or an abdomen allows to see the accidental materials. From 1995 to 2002, 35 radiographic examinations were performed after the accidents at Tokushima University Dental Hospirtal. Mean of accidents was 4.4 cases a year. The incidence was 0.004% in the cumulative numbers of dental examinations. The location of accidental material on the radiography was clearly observed in 18 among 35 cases. Radiography of multiple times was performed 13 in 18 cases in order to confirm the excretion. In 5 cases, accidental materials were not confirmed to excrete. Furthermore, there were many cases in which clinical records about accidents were not described. Present findings indicate that it is necessary to detect precisely the location of accidental materials and that radiographic detection is very important.


Early Exposure in the Department of Oral and Maxillofacial Radiology --- -Analysis of Self-evaluation by Students-

歯科放射線科における早期体験実習 --- -学生自身による自己評価の分析-

The Journal of Japanese Dental Education Association

日本歯科医学教育学会雑誌


Pelvic bone complications following radiation therapy of gynecologic malignancies: clinical evaluation of radiation-induced pelvic insufficiency fractures

To investigate the incidence, clinical and imaging finding of insufficiency fractures (IF) of the female pelvis following radiation therapy. We reviewed the radiation oncology records of 158 patients with gynecologic malignancies who underwent external beam radiation therapy of the whole pelvis between April 1993 and March 2004. All patients underwent computed tomography (CT) scan every 6 months in follow-up after radiation therapy and magnetic resonance imaging (MRI) and radionuclide bone scan were added when the patients complained of a pelvic pain. Eighteen of 158 patients (11.4%) developed IF in the irradiated field with a median interval of 6 months (range 3-51) from the completion of external beam radiation therapy. The cumulative incidence of symptomatic IF at 5 years calculated with Kaplan-Meyer methods was 13%. Median age of the patients who developed IF was 70 years (range 48-88), and all of them were postmenopausal. IF occurred in the sacloiliac joints, upper limb of pubic bone, acetabulum, sacral body and 5th lumbar vertebra. Twelve of 18 patients had multiple lesions and 8 had symmetric longitudinal fracture lines parallel to the sacroiliac joints. Avoidance of weight bearing by bed rest and analgesics provided good pain relief in all patients, although symptoms lasted from 3 to 20 months. Radiation-induced pelvic IF following radiation therapy for gynecologic malignancies were frequently observed in the postmenopausal patients within 1 year after external beam radiation therapy. Symmetric fractures of the both sacroiliac joints were the characteristic pattern of pelvic IF. Knowledge of characteristic imaging pattern of IF is essential in order to rule out the bone metastasis. Therapy recommendations are conservative with analgesics.


Chemoradiation Therapy for Cervical Cancer:Toxicity of Concurrent Weekly Cisplatio

To retrospectively evaluate the toxicity of concurrent weekly cisplatin and radiation therapy (RT) for locally advanced cervical cancer. Between April 2001 and December 2004, 21 consecutive previously untreated patients with locally advanced cervical cancer were treated with concurrent chemoradiation therapy (CCRT) at the Tokushima University Hospital. Clinical stages were II: 5, III: 15, IVA: 1. External beam radiation therapy (EBRT) was delivered with 10 MV X-rays, 2 Gy fraction per day; total dose to the whole pelvis was 50 Gy. Iridium-192 high-dose-rate (HDR) intracavitary radiation therapy was performed with 10-30 Gy (median, 24 Gy) targeted at point A. Concurrent chemotherapy consisted of cisplatin, administered weekly at a dose of 40 mg/m2 for patients who were younger than 65 years and 30 mg/m2 for those 65 years or over. A maximum single dose of cisplatin, up to 70 mg/body, was administered in 5 cycles during EBRT. A total of 86 cycles of cisplatin were administered to the 21 patients, with a median of 4 cycles (range, 2-5). Severe hematological toxicity occurred in 18 patients (86%), including grade 3 in 17 patients (81%) and grade 4 in one patient (4.8%). Moderate or severe gastrointestinal toxicity occurred in 11 patients (52%), including grade 2 in 10 patients (48%) and grade 3 in one patient (4.8%). The grades of hematological toxicity were significantly greater in the 40 mg/m2 group than in the 30 mg/m2 group. All of the patients who were administered 40 mg/m2 of cisplatin developed grade 3 or greater hematological toxicity, including one patient with grade 4 toxicity. In the 30 mg/m2 group, 3 of 10 patients developed less than grade 3 toxicity, and all patients completed radiation therapy without interruption. The incidence of severe acute hematological toxicity was significantly higher in this study than in previously reported randomized controlled trials (RCTs), especially in the group of 40 mg/m2 cisplatin. A dose of 30 mg/m2 of cisplatin was considered to be feasible in weekly cisplatin and radiation therapy.


Postgraduate Clinical Training at the Department of Oral and Maxillofacial Radiology, University Dental Hospital, The University of Tokushima --- The Questionnaire Survey to the Junior Residents

本学歯学部附属病院歯科放射線科における卒後臨床研修 --- 研修医に対するアンケート調査

日本歯科医学教育学会雑誌


A Questionnaire Survey of Undergraduate Oral Radiology Education to Graduates

卒業生に対する歯科放射線学の卒前教育に関するアンケート調査

The Journal of Dental Education Association

日本歯科医学教育学会雑誌


新構想徳島大学医学部歯学部附属病院におけるHIS,RIS,PACS-モダリティ連携と歯科放射線科


Panoramic Radiography of the Temporomandibular Joint Part 5 --- A Study on Image Layer of Lateral Panoramic Temporomandibular Joint Projection

パノラマX線撮影装置を利用した顎関節撮影法 第五報 --- 顎関節側面パノラマ4分割撮影法における断層域の検討


Panoramic Radiography of theTemporomandibular Joint Part 4 --- Detectability of outline of the Temporomandibular Joint in Lateral Panoramic Temporomandibular Joint Projection

パノラマX線撮影装置を利用した顎関節撮影法 第四報 --- 顎関節側面パノラマ4分割撮影法における骨外形の出現度


パノラマX線写真による歯数の観察 --- 加齢と歯の喪失

パノラマX線写真による歯数の観察 --- 加齢と歯の喪失


The Position of the Condyle and the Disc in Temporomandibular Joint Dysfanction --- Comparison between Tomography and Magnetic Resonance Imaging

顎関節症患者の下顎頭位と円板位置 --- X線断層写真とMR画像の比較


Adenoid Cystic Carcinoma of the Maxilla with Perineural Invasion into the Cranium. Report of a Case

頭蓋内へのPerineural invasion を伴なった上顎部腺様嚢胞癌の一例


Panoramic Rdiography of Temporomandibular joint. Part1: Measurements of the Intercondylar distance

パノラマX線撮影装置を利用した顎関節撮影法 第一報 下顎頭間距離について

To obtain a clear image of the temporomandibular joint (TMJ) on a rotational panoramic radiograph, the mandibular condyle should be in the image layer of panoramic equipment. The intercondylar distance in Japanese subjects was measured to identify the position of TMJ relative to the image layer. Submento-vertex radiographs from 848 patients suspected of having temporomandibular disorders (669 females; between 8 and 82 years, 179 males; between 9 and 79 years) were studied. The distance between the center points on long axes of the bilateral condyles was measured as an intercondylar distance. The measurement value was corrected by a magnification factor calculated from the inter-earplug distance on a radiograph and actual distance. The intercondylar distance showed normal distribution, and its mean value was found to be constant in the subjects with 20 years old or older, 101.1±4.7mm in femaless and 106.1±5.3mm in males. To derive a clear image of TMJ from the rotational panoramic radiography, the effective image layer distance between left and right TMJs should be adjustable to several values, for example, 101 and 106mm.


Construction of Database about Report of Radiographic Examination of Temporomandibular Joint

顎関節X線検査報告書のデータベース化