Japanese Journal of Radiology最新文献

{"title":"Updates on molecular classification and treatment in endometrial cancer.","authors":"Kensuke Sakai, Takuma Yoshimura, Wataru Yamagami","doi":"10.1007/s11604-026-02031-4","DOIUrl":"10.1007/s11604-026-02031-4","url":null,"abstract":"<p><p>Endometrial cancer (EC) is the most common gynecological malignancy in developed countries, with a steadily rising global incidence. The Cancer Genome Atlas (TCGA) study identified four molecular subtypes- POLE (ultramutated), MSI (hypermutated), copy number low, and copy number high-each with distinct prognostic and therapeutic implications. Integration of molecular classification into the WHO 2020 classification and the FIGO 2023 staging system has transformed clinical practice. Although major European ESGO/ESTRO/ESP guidelines now incorporate molecular subtyping into treatment algorithms, the Japanese JSGO 2023 guidelines have not yet formally integrated molecular classification into adjuvant treatment decisions. Notable differences exist between Japanese and Western approaches, particularly regarding the role of adjuvant radiation therapy versus chemotherapy. Recent landmark trials have provided compelling evidence for biomarker-driven treatment based on molecular classification. Furthermore, some immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) are emerging as promising therapeutic options. This review provides an updated overview of the molecular classification of EC, its impact on current guidelines with emphasis on radiation therapy, and the latest therapeutic advances including immunotherapy and ADCs.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1758-1767"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271515","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":"In reply: Moving from maximum uptake to volumetric heterogeneous dose coverage in BNCT.","authors":"Yuki Yoshino, Satoshi Takeno, Teruhito Aihara, Naonori Hu, Yasukazu Kanai, Akinori Sasaki, Mai Nojiri, Keiji Nihei, Koji Ono","doi":"10.1007/s11604-026-02057-8","DOIUrl":"10.1007/s11604-026-02057-8","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1889-1890"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548875","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":"MYC upregulation as candidate predictive biomarker for radioresistance in cervical cancer.","authors":"Kento Tomizawa, Soichiro Sakamoto, Yuhei Miyasaka, Takahiro Oike, Hidenari Hirata, Yuya Yoshimoto, Yasushi Sasaki, Takashi Tokino, Ken Ando, Atsushi Shibata, Tatsuya Ohno","doi":"10.1007/s11604-026-02036-z","DOIUrl":"10.1007/s11604-026-02036-z","url":null,"abstract":"<p><strong>Background: </strong>A subset of uterine cervical cancers recurs locally after definitive radiotherapy, highlighting the need for establishing biomarkers to predict radioresistance for dose optimisation. However, low local recurrence rate constitutes a barrier to research progress. This study aimed at exploring candidate predictive biomarker of radioresistance of uterine cervical cancer by analyzing multiple omics layers using nested case-control approach.</p><p><strong>Methods: </strong>A discovery cohort (n = 8) was created from a series of 192 patients (all with squamous cell carcinoma of the uterine cervix underwent definitive radiotherapy) by 1:1 random case-control matching on pelvic recurrence (PR) for RNA sequencing. A validation cohort (n = 54) was created from the same series by 1:2 propensity score matching on PR for panel-based DNA sequencing and pelvic recurrence-free survival (PRFS) analysis. by using the Kaplan-Meier method and cause-specific proportional hazards models.</p><p><strong>Results: </strong>In the discovery cohort, Gene set enrichment analysis revealed that the genes targeted by MYC were upregulated in patients with PR. In the validation cohort, the prevalence of MYC amplification was significantly greater in patients with PR than in those without (72% vs. 36%, respectively). The 5-year PRFS of patients with MYC amplification was significantly worse than that of those without (47.4% vs. 80.6%, respectively). Multivariate analysis identified MYC amplification as the significant predictor of PR.</p><p><strong>Conclusions: </strong>These data suggest that upregulation of MYC plays a role in radioresistance of uterine cervical cancer, making MYC amplification a potential predictive biomarker for radioresistance.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1854-1862"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470677","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":"White matter microstructural abnormalities in children with Tourette syndrome using tract-based spatial statistics analysis.","authors":"Jirui Wang, Xianbin Wang, Wenyan Zhang, Zhongyi Liu, Anyi Zhang, Weiwei Men, Guojun Zhang, Xu Hong, Yonghua Cui, Tianyuan Lei","doi":"10.1007/s11604-026-02024-3","DOIUrl":"10.1007/s11604-026-02024-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate alterations in white matter microstructure in children with Tourette syndrome (TS) and to explore its potential role in pathophysiology.</p><p><strong>Methods: </strong>Diffusion tensor imaging data were collected from 53 children with TS and 91 typically developing controls. White matter integrity was assessed and analyzed using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Correlations with tic severity and quality of life (QOL) were examined, followed by mediation analysis to assess whether motor tic severity mediated the relationship between FA values in the right anterior corona radiata (ACR_R) and QOL.</p><p><strong>Results: </strong>Children with TS exhibited widespread white matter alterations, lower FA in ACR_R and left anterior limb of the internal capsule, lower MD in the inferior fronto-occipital fasciculus, and lower AD in ACR_R, alongside higher MD in the genu of the corpus callosum, higher AD in the inferior fronto-occipital fasciculus, and higher RD in ACR_R. The FA values in ACR_R showed a significant negative correlation with motor tic severity (r = - 0.302, P = 0.031) and a significant negative correlation with physical/activities of daily living (ADL) subscale of QOL (r = - 0.468, P < 0.001). Motor tic severity was positively correlated with physical/ADL subscale of QOL (r = 0.430, P = 0.008). Motor tic severity partially mediated the relationship between FA values in ACR_R and physical/ADL scores (β = - 0.091, 95% CI [- 0.208, - 0.016]).</p><p><strong>Conclusions: </strong>These findings suggest that impaired white matter microstructure may be associated with the pathophysiology of TS, and that future interventions may benefit from simultaneously addressing neural circuit integrity and symptom management.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1818-1828"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163142","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":"Verification of the impact of differences between objective and subjective evaluation methods on the interpretation of artificial intelligence systems generating mammogram reports using vision-language model.","authors":"Chiharu Kai, Hideaki Tamori, Yuta Hirono, Sachi Ishizuka, Satoshi Kondo, Tsunehiro Ohtsuka, Satoshi Kasai","doi":"10.1007/s11604-026-02032-3","DOIUrl":"10.1007/s11604-026-02032-3","url":null,"abstract":"<p><strong>Purpose: </strong>Research on vision-language models (VLMs) in the medical field has recently increased. However, while multifaceted evaluation is necessary to avoid the high risks associated with misdiagnosis, artificial intelligence (AI)-assisted mammogram report generation remains insufficient, with no studies on objective and subjective generation. We aimed to develop an AI system that generates mammogram reports and to verify the impact of differences between objective and subjective evaluation methods on the interpretation of this AI system.</p><p><strong>Materials and methods: </strong>We used a public dataset consisting of mammograms and their reports, preparing question prompts and performing low-rank adaptation tuning on Qwen2.5(7B). We analyzed the Breast Imaging Reporting and Data System (BI-RADS) and findings agreement rate, Recall-Oriented Understudy for Gisting Evaluation (ROUGE), and Bilingual Evaluation Understudy (BLEU) for the objective evaluation. A breast clinician performed score-based evaluations of generated reports as subjective assessments. Finally, we analyzed samples of inconsistent objective and subjective results.</p><p><strong>Results: </strong>The BI-RADS agreement rate was 58.1%. Findings were accurately included in generated reports at 76.7% for mass and 81.4% for calcification. ROUGE-L F1 and overall BLEU were 0.672 and 0.542, respectively. Although ROUGE-L F1 or overall BLEU was above average, two samples received low scores in the generated report evaluation; these were considered over- and under-estimation.</p><p><strong>Conclusion: </strong>We developed an AI model that generates mammogram reports. In assessing this model, we found that multifaceted objective and subjective medical VLM evaluations are necessary for determining over- and under-estimation.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1791-1801"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549084","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":"Diagnostic performance of commercial AI systems versus participating radiologists for pulmonary nodule detection in routine clinical practice.","authors":"Hiroaki Watanabe, Hiroyuki Morisaka, Kaori Aoyagi, Ryota Tozuka, Tihan Wumu, Takanori Ii, Kasane Sakamoto, Tomomi Yato, Shintaro Ichikawa","doi":"10.1007/s11604-026-02029-y","DOIUrl":"10.1007/s11604-026-02029-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of two commercial artificial intelligence (AI) systems versus that of radiologists on routine clinical chest computed tomography (CT) and to identify the imaging characteristics that limit AI performance.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the 5-mm-slice chest CT of 102 patients (353 nodules or masses). The detection performance of two board-certified radiologists and two commercial AI systems was compared against an expert-established reference standard. Sensitivity, false positives (FPs) per scan, and positive predictive value (PPV) were evaluated. Logistic regression identified factors influencing detection.</p><p><strong>Results: </strong>The radiologists demonstrated higher sensitivity (90.4-94.3%) than the AI systems (80.2-89.2%) and significantly fewer FPs per scan (1.61-3.56 vs. 5.28-7.97; p < 0.001), resulting in superior PPVs. Multivariate analysis revealed divergent limitations: radiologists were challenged by intrinsic features (e.g., ground-glass nodules [GGNs]), whereas AI performance was degraded by case-level complexity (multiple nodules), specific locations (central), and atypical morphologies (large masses).</p><p><strong>Conclusion: </strong>In this study, the participating radiologists outperformed the commercial AI systems in routine clinical settings. Both exhibited distinct weakness profiles. Current AI systems are best suited as complementary tools rather than autonomous readers, provided FPs are managed effectively.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1779-1790"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271502","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":"A novel robot for CT-guided bone needle insertion with a rotational drilling and force-feedback speed control mechanism: preliminary evaluation in swine.","authors":"Yusuke Matsui, Takao Hiraki, Yuta Kimura, Takanori Sasaki, Ryutaro Matsuura, Koji Tomita, Noriyuki Umakoshi, Soichiro Okamoto, Kazuaki Munetomo, Fumiyo Higaki, Jun Sakurai, Toshihiro Iguchi, Atsushi Nakazawa, Kiyoshi Matsumiya, Takayuki Matsuno, Tetsushi Kamegawa","doi":"10.1007/s11604-026-02030-5","DOIUrl":"10.1007/s11604-026-02030-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility and accuracy of computed tomography (CT)-guided needle insertion into swine bones by using a novel robotic system capable of rotational drilling.</p><p><strong>Materials and methods: </strong>This was an animal experiment using three swine. A remote-controlled robot equipped with a rotational drilling and force-feedback insertion speed control mechanism was developed for bone needle insertion. Using the robot, CT-guided insertion of a 10-gauge bone access needle was attempted in the lumbar vertebrae, ilia, and femora six times each. Needle insertion accuracy was evaluated using the angle error, which is defined as the difference between the predetermined and post-insertion needle angles on axial and sagittal CT images. The time required for needle insertion was measured. The angle error and time required for needle insertion were compared among the bones using the Kruskal-Wallis test. Adverse events were also evaluated.</p><p><strong>Results: </strong>Robotic bone needle insertion was successful in all attempts. The median axial and sagittal angle errors were 0.21 and 0.21° for the lumbar vertebrae, 0.32 and 0.13° for the ilia, and 0.65 and 0.25° for the femora, respectively. Axial angle errors were significantly different among the bone types (p = 0.038). The time required for needle insertion was 23.6, 21.3, and 59.7 s for the lumbar vertebrae, ilia, and femora, respectively. Time was significantly different among bone types (p = 0.017). No adverse events were observed.</p><p><strong>Conclusion: </strong>CT-guided bone needle insertion using a robot equipped with a rotational drilling and force-feedback insertion speed control mechanism was feasible and accurate in swine.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1836-1844"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251525","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":"Rethinking DTI-ALPS: from a glymphatic surrogate to a biomarker of brain health.","authors":"Kohsuke Kudo, Yukio Miki","doi":"10.1007/s11604-026-02050-1","DOIUrl":"10.1007/s11604-026-02050-1","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1705-1706"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411899","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":"Development and performance of a vascular inflammation index for spontaneous isolated superior mesenteric artery dissection based on automated radial spatial PVAT analysis.","authors":"Chong Meng, Chen Wu, Xiaolong Wang, Zhen Wang, Yang Wu, Bo Sun, Shang Jin, Tao Ding, Aiyun Sun, Kai Xu, Yankai Meng","doi":"10.1007/s11604-026-02027-0","DOIUrl":"10.1007/s11604-026-02027-0","url":null,"abstract":"<p><strong>Purpose: </strong>Spontaneous isolated superior mesenteric artery dissection (SISMAD) is traditionally diagnosed via CT angiography (CTA) structural features, but localized biological inflammation remains poorly characterized. We aimed to characterize the radial spatial gradient of perivascular adipose tissue (PVAT) in SISMAD and evaluate a composite Vascular Inflammation Index (VII) as an auxiliary indicator of local inflammatory activity.</p><p><strong>Materials and methods: </strong>In this retrospective study (2016-2025), 55 patients with SISMAD and 110 symptomatic controls were evaluated. PVAT volume, mean attenuation, and standard deviation (SD) were quantified across cumulative radial shells (0-1 to 0-5 mm) from the SMA wall. A composite VII, integrating volume burden, expansion kinetics, and tissue texture, was developed. Multivariable logistic regression and bootstrap analysis (1000 iterations) assessed independent predictors and incremental diagnostic value.</p><p><strong>Results: </strong>Participants (mean age, 50.4 years ± 15.9) included SISMAD patients who had higher white blood cell counts than controls (10.7 ± 5.2 vs. 8.7 ± 4.0 × 10⁹/L; P = 0.017). PVAT volume was significantly higher in SISMAD (0-5 mm: 10.1 mm³ ± 5.1 vs. 6.8 mm³ ± 4.0; P < 0.001). SISMAD patients exhibited aggressive radial expansion (expansion ratio: 12.5 vs. 8.6; P = 0.032) and lower 3-mm heterogeneity (22.8 vs. 24.1 HU; P = 0.046), suggesting an edema-induced homogenization effect. The VII achieved an AUC of 0.800 (95% CI 0.723, 0.878) for the identification of SISMAD-associated periarterial involvement and was the independent predictor of SISMAD (OR, 3.23; P < 0.001). Adding VII to the clinical model (Age, Gender, BMI, and WBC) significantly improved performance (AUC, 0.892 vs. 0.857; P = 0.038; increment, 0.035). A seven-day inflammatory plateau was identified post-onset.</p><p><strong>Conclusion: </strong>Automated radial spatial profiling of PVAT reveals a distinct volumetric and kinetic inflammatory signature in SISMAD. The integrated VII provides a quantitative biological assessment that complements structural CTA diagnosis.</p>","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1768-1778"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217546","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":"Moving beyond SUV_max: volumetric and heterogeneous dose evaluation in ¹⁸F-BPA PET-guided BNCT.","authors":"Yuan-Hao Liu","doi":"10.1007/s11604-026-02047-w","DOIUrl":"10.1007/s11604-026-02047-w","url":null,"abstract":"","PeriodicalId":14691,"journal":{"name":"Japanese Journal of Radiology","volume":" ","pages":"1886-1888"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360958","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}