{"title":"Regional disparities in pediatric radiotherapy utilization in Japan: analysis of a nationwide database.","authors":"Takahiro Aoyama, Yutaro Koide, Tomoki Kitagawa, Ryoma Tomoda, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira","doi":"10.1007/s11604-026-01996-6","DOIUrl":"https://doi.org/10.1007/s11604-026-01996-6","url":null,"abstract":"<p><strong>Background: </strong>Pediatric radiotherapy (RT) plays a key role in childhood cancer care, yet regional disparities in its utilization and delivery persist. We aimed to quantify prefecture-level disparities in pediatric RT utilization and examine associations with workforce and facility factors.</p><p><strong>Procedure: </strong>Using the Ministry of Health, Labour and Welfare National Database Open Data, we extracted counts of pediatric RT add-on claims (fractions) for fiscal year 2023. Utilization was calculated as claims per 100,000 children (< 15 years). Explanatory variables were the number of board-certified pediatricians and the presence of a designated pediatric cancer hub hospital in each prefecture. We conducted Pearson/Spearman correlation analyses and Welch's t-test, reporting Cohen's d. Supplementary analyses summarized prefecture-level distributions and 5-year trends (2019-2023).</p><p><strong>Results: </strong>The national mean utilization was 58.7 fractions per 100,000 children (range, 0.0-161.0), with marked inter-prefectural variability. Pediatrician numbers strongly correlated with claim counts (r = 0.94, p < 0.001) but not with claims per 100,000 children (r = 0.18, p = 0.22). Prefectures with a pediatric cancer hub hospital had significantly higher utilization than those without (80.9 vs. 50.2 per 100,000; p = 0.046), with Cohen's d = 0.66. In a multi-year view, several prefectures (e.g., Mie, Miyagi, Tokyo) repeatedly maintained higher utilization.</p><p><strong>Conclusions: </strong>This study examined prefecture-level disparities in pediatric radiotherapy across Japan. The number of board-certified pediatricians was associated with crude treatment counts but not with population-normalized rates, whereas prefectures with a designated pediatric cancer hub hospital showed significantly higher rates. These findings can inform policy making and healthcare resource allocation, particularly efforts to strengthen hub hospitals and cross-prefectural referral networks.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of conventional transarterial chemoembolization for hepatocellular carcinoma using a glass membrane emulsification device: comparison with a three-way stopcock.","authors":"Yusuke Ono, Yasushi Kimura, Yu Masuda, Hiroki Satomura, Kosuke Tomotake, Yuji Koretsune, Hiroki Yano, Daisuke Katayama, Kaishu Tanaka, Hiroki Higashihara, Noriyuki Tomiyama","doi":"10.1007/s11604-026-01995-7","DOIUrl":"https://doi.org/10.1007/s11604-026-01995-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy and safety of conventional transarterial chemoembolization (cTACE) using a glass membrane emulsification device (GMD) versus a three-way stopcock (3WS) in treatment-naïve target lesions of hepatocellular carcinoma (HCC).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 54 patients (73 target lesions) treated with GMD-cTACE and 39 patients (55 target lesions) treated with 3WS-cTACE. The emulsion consisted of 5 mL of Lipiodol and 2.5 mL of an iodinated nonionic contrast medium (iomeprol 300 mg I/mL) containing 50 mg of epirubicin. The primary endpoints were the direct treatment effect on target lesions, assessed by RECICL (2015). Recurrence-free survival (RFS), safety and modified albumin-bilirubin (mALBI) grade changes were evaluated as secondary endpoints.</p><p><strong>Results: </strong>TE4 rates were 86.3% in the GMD group and 76.4% in the 3WS group (P = 0.15). The combined TE4 + TE3 rates were 93.2% versus 83.6%, respectively (P = 0.09). The median RFS of target lesions was 1,047 days in the GMD group and 362 days in the 3WS group. RFS of target lesions tended to be longer with GMD (log-rank P = 0.058), with 1-year RFS estimates of 0.740 (GMD) and 0.470 (3WS). Restricted mean survival time (RMST) up to 365 days favored GMD (difference, 40.2 days; 95% CI, - 0.8 to 81.1; P = 0.054). Changes in hepatic reserve were not significantly different between groups.</p><p><strong>Conclusion: </strong>GMD-cTACE showed numerically longer RFS of target lesions than 3WS-cTACE, with no significant between-group difference in hepatic function deterioration. Standardizing emulsion quality with GMD may improve the durability of local control in cTACE; larger prospective studies are warranted.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Head and neck manifestations of IgG4-related disease: current understanding.","authors":"Kenichi Takano","doi":"10.1007/s11604-025-01934-y","DOIUrl":"10.1007/s11604-025-01934-y","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"856-865"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging findings of intra-articular tumor/tumor-like lesions based on pathologic correlation.","authors":"Jun Tsukamoto, Akitaka Fujisaki, Koichiro Futatsuya, Yuki Koreeda, Kazuhiro Kajio, Sayaka Inoue, Yoshiko Hayashida, Akinori Sakai, Masanori Hisaoka, Yoshinao Oda, Takatoshi Aoki","doi":"10.1007/s11604-025-01928-w","DOIUrl":"10.1007/s11604-025-01928-w","url":null,"abstract":"<p><p>Proper treatment of intra-articular tumor/tumor-like lesions (tenosynovial giant cell tumor, synovial chondromatosis, synovial hemangioma / intra-articular venous malformations, lipoma arborescens, etc.) depends on an accurate diagnosis. This review highlights the imaging findings of intra-articular tumor/tumor-like lesions and the other synovial diseases (gout, amyloid arthropathy, rheumatoid arthritis, ganglion, and postoperative intra-articular tumor) to determine whether they could help in establishing the correct diagnosis. Many synovial proliferative diseases have specific imaging characteristics and an awareness of these characteristics along with their pathological and anatomical features can allow for an accurate diagnosis. Even though a wide spectrum of diseases may involve the synovium, careful MRI assessment used in conjunction with clinical information can lead to a substantial narrowing of the differential diagnosis.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"866-881"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"FDG uptake in upper abdominal lymph node as a distinctive pattern in sarcoidosis.","authors":"Ryogo Minamimoto, Yumi Abe, Ryota Morimoto, Rintato Ito, Naotoshi Fujita, Toyoaki Murohara, Katsuhiko Kato, Shinji Naganawa","doi":"10.1007/s11604-025-01935-x","DOIUrl":"10.1007/s11604-025-01935-x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the distribution patterns of sarcoidosis involvement on FDG-PET/CT in patients with known or suspected cardiac sarcoidosis (CS), with a particular focus on upper abdominal lymph nodes (LN) (periportal LN [PLN], anterior pancreaticoduodenal LN [APDLN], and posterior pancreaticoduodenal LN [PPDLN]) and the association of them with other lesions and myocardium.</p><p><strong>Methods: </strong>We identified 861 FDG-PET/CT scans performed between July 2016 and August 2024 in patients with known or suspected CS, and included 178 cases for analysis of FDG uptake patterns suggestive of sarcoid involvement. FDG-positive LNs or regions were classified as sarcoidosis-related based on treatment response, characteristic uptake patterns, or histological confirmation. The occurrence ratio of FDG-positive lymph nodes or regions was also assessed in relation to myocardial FDG uptake patterns.</p><p><strong>Results: </strong>FDG uptake was observed most frequently in hilar and mediastinal LNs (79% and 76%, respectively). Upper abdominal LN uptake was observed in 49.4% of patients, most commonly in the PLN (31.5%), APDLN (38.2%), and PPDLN (37.1%). Heatmap analyses revealed strong co-occurrence between thoracic and upper abdominal LNs, suggesting a lymphatic dissemination pattern. Peripheral LNs such as axillary, subclavian, and inguinal/pelvic stations demonstrated low uptake and minimal co-occurrence.</p><p><strong>Conclusions: </strong>FDG-PET/CT provides valuable insight into the structured lymphatic dissemination of sarcoidosis. Frequent FDG uptake in upper abdominal lymph nodes, particularly when accompanied by thoracic involvement, represents a characteristic finding in sarcoidosis. Recognition of this pattern can improve diagnostic accuracy and help differentiate sarcoidosis from other systemic diseases. This study assessed lymph node involvement on FDG-PET/CT in patients with suspected or known cardiac sarcoidosis, revealing distinct dissemination patterns into the upper abdomen. These findings enhance understanding of disease pathophysiology and may improve diagnostic evaluation.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"916-925"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic performance of digital markings on head computed tomography for evaluating intracranial hypertension in neonates and infants.","authors":"Akira Yogi, Tomohide Yoshida, Naoya Imanaga, Amiko Kayo, Erina Iha, Gyo Iida, Nanae Tsuchiya, Yukari Tomori, Akihiro Nishie","doi":"10.1007/s11604-025-01927-x","DOIUrl":"10.1007/s11604-025-01927-x","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"895-904"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Japanese clinical practice guidelines for vascular tumors, vascular malformations, lymphatic malformations, and lymphangiomatosis 2022.","authors":"Yoshiaki Kinoshita, Kosuke Ishikawa, Sadanori Akita, Katsuyoshi Koh, Satoru Sasaki, Masatoshi Jinnin, Hidefumi Mimura, Keigo Osuga, Michio Ozeki, Michiko Nagahama, Akihiro Fujino, Yoko Aoki, Akiko Asai, Noriko Aramaki-Hattori, Ryohei Ishiura, Masanori Inoue, Yuki Iwashina, Takafumi Ohshiro, Keiko Ogawa, Mine Ozaki, Junko Ochi, Shiro Onozawa, Motoi Kato, Takahide Kaneko, Tamihiro Kawakami, Akira Kitagawa, Masakazu Kurita, Yoshihiro Kuwano, Taro Kono, Shien Seike, Shinsuke Takagi, Nobuyuki Takakura, Takao Tachibana, Shuichi Tanoue, Kumiko Chuman, Hiroki Nakaoka, Yasuhiro Nakamura, Fumio Nagai, Yasunari Niimi, Shunsuke Nosaka, Taiki Nozaki, Tadashi Nomura, Kazuki Hashimoto, Ayato Hayashi, Satoshi Hirakawa, Takeshi Hirabayashi, Taizo Furukawa, Hiroshi Furukawa, Yumiko Hori, Takanobu Maekawa, Kentaro Matsuoka, Hideki Mori, Eiichi Morii, Akira Morimoto, Yuta Moriwaki, Shunsuke Yuzuriha, Naoaki Rikihisa, Munezumi Fujita, Yasuyuki Yamahana, Kyoichi Deie, Asami Tozawa, Daisuke Hasegawa, Akira Higashiyama, Daisuke Maeda, Sachiko Asayama, Yuhki Arai, Yohei Iwata, Mayu Uka, Hidehito Usui, Mizuki Uchiyama, Saori Endo, Hideki Endo, Rintaro Ono, Naoya Oshima, Toshihiro Otsuka, Kuniaki Ohara, Shinji Kagami, Tomo Kakihara, Mototoshi Kato, Hiroki Kanamori, Masafumi Kamata, Ami Kawaguchi, Akiko Kishi, Hiroshi Kitagawa, Kiyokazu Kim, Tamotsu Kobayashi, Takeshi Saito, Yusuke Shikano, Shuichi Shimada, Keisuke Suzuki, Masataka Takahashi, Shohei Takami, Reiko Takeda, Aya Tanaka, Kaishu Tanaka, Satoru Tamura, Masashi Tamura, Kanako Danno, Kenji Tsuboi, Yuta Nakajima, Ryo Nakatani, Miho Noguchi, Akifumi Nozawa, Naoki Hashizume, Masashi Hayakawa, Daichi Hayashi, Takaya Fukumoto, Mamoru Honda, Norifumi Matsuda, Hayato Maruguchi, Naoki Murakami, Kiichiro Yaguchi, Shiho Yasue, Hiroki Yoshihara, Rika Yoshimatsu, Kiyohito Yamamoto, Shinji Wada","doi":"10.1007/s11604-025-01932-0","DOIUrl":"10.1007/s11604-025-01932-0","url":null,"abstract":"<p><p>The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of December 2020 was searched in PubMed, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution Service (Minds) technique. A total of 38 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, pathological diagnosis deciding the diagnosis, and causal genes of vascular anomalies. Thus, the Japanese Clinical Practice Guidelines for Vascular Tumors, Vascular Malformations, Lymphatic Malformations, and Lymphangiomatosis 2022 have been prepared as the evidence-based guidelines for the management of vascular anomalies.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"745-855"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Time-dependent diffusion-weighted imaging assessment of tumor grading and isocitrate dehydrogenase genotypes in adult-type diffuse gliomas.","authors":"Kiyohisa Kamimura, Tsubasa Nakano, Masanori Nakajo, Junki Kamizono, Tomohito Hasegawa, Daiki Tobo, Akie Mukai, Yoshiki Kamimura, Fumitaka Ejima, Hiroaki Nagano, Koji Takumi, Masatoyo Nakajo, Nayuta Higa, Hajime Yonezawa, Ryosuke Hanaya, Mari Kirishima, Akihide Tanimoto, Hirokazu Otsuka, Daisuke Hirahara, Hiroshi Imai, Thorsten Feiweier, Takashi Yoshiura","doi":"10.1007/s11604-025-01936-w","DOIUrl":"10.1007/s11604-025-01936-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the usefulness of time-dependent diffusion magnetic resonance imaging (MRI) parameters compared with the conventional apparent diffusion coefficient (ADC) in distinguishing tumor grade and isocitrate dehydrogenase (IDH) genotypes of adult-type diffuse gliomas.</p><p><strong>Methods: </strong>This retrospective study included 102 patients with adult-type diffuse gliomas. ADC maps obtained using diffusion-weighted imaging at short (7.1 ms) and long (44.5 ms) diffusion times (ADC7.1ms and ADC44.5ms) and maps of ADC changes (cADC) and relative ADC changes (rcADC) between the two diffusion times were generated. The mean, 5th, and 95th percentile values of each parameter were compared between low-grade (LGGs) and high-grade gliomas (HGGs) and between IDH-mutant and IDH-wildtype gliomas. The discriminative performance was assessed using receiver operating characteristic (ROC) analysis, and correlation with Ki-67 labeling index (Ki-67LI) was assessed using Spearman's rank correlation. Multivariable logistic regression analyses were conducted to predict HGGs and IDH-wildtype gliomas.</p><p><strong>Results: </strong>In HGGs, the mean and 5th percentile values of ADC44.5ms and ADC7.1ms were significantly lower, whereas cADC and rcADC indices were significantly higher than those in LGGs. Performance of the mean rcADC (area under the ROC curve: 0.925; 95% confidence interval: 0.855-0.967) was significantly better than any index of conventional ADCs for tumor grade classification. The mean rcADC demonstrated the strongest correlation with Ki-67LI (ρ = 0.542, p < 0.0001). Moreover, the 95th percentile of rcADC was an independent predictor of IDH-wildtype gliomas after adjustment for age and sex, was useful for distinguishing IDH-wildtype from IDH-mutant gliomas CONCLUSIONS: The mean rcADC showed the strongest correlation with the Ki-67 LI and achieved better diagnostic performance than conventional PGSE-based ADC for differentiating LGGs from HGGs. In multivariable analyses, the mean and 95th percentile of rcADC were identified as independent predictors of HGGs and IDH-wildtype gliomas, respectively.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"882-894"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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