Outline Research Education Lectures & Courses Clinical Services & Other Works Clinical Performances

Staffs

Title Name Researcher information
Professor TATEISHI Ukihide
Associate Professor YAMADA Ichiro
Assistant Professor MORI Mio
Project Professor SAIDA Yukihisa
Graduate Student WATANABE Ryousuke
Graduate Student ADACHI Takuya
Graduate Student Takehiro Tamura
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Outline

While diagnostic radiology and nuclear medicine demand high-level capabilities and therefore extensive training to acquire those capabilities, keeping a watch on developments in medical knowledge and maintaining those skills is also an issue for these disciplines. Similarly, it is also necessary to maintain knowledge, skills and capabilities in ethics, not only radiology knowledge and skills, in order to respond to changes in medical practices as well as the social and political environment.Contributing to the community is a basic responsibility of diagnostic radiology so it remains the university’s mission to unflinchingly fulfill its responsibility to provide high-level, advanced medical care, working toward resolution of community problems through education, research and medical activities, as well as to develop the diagnostic radiology professionals who will bear the responsibility for providing community medical care, and to develop professionals who have a global outlook and can flourish in this age of globalization. More than ever, advancing the fundamental medical concepts of “patient-oriented medical care” and “thorough medical safety management” are core principles in the field of diagnostic radiology and nuclear medicine, so continuing to maintain capabilities from this perspective is essential in daily practice.
Under the new radiologist system, it is possible to obtain a qualification by completing two years of post-graduate clinical training, followed by three years of general training at a training facility approved by the Japan Radiological Society, then sitting the radiologist examination (sixth year after graduation). After passing that examination, it is then possible to obtain a qualification in either radiotherapy or diagnostic radiology by completing a further two years of specialist training and sitting either the radiotherapist or the diagnostic radiologist examination (eighth year after graduation).
Diagnostic radiology and nuclear medicine was divided off the specialist field responsible for diagnostic radiology in July 2013. However, because the radiologist examination covers both treatment and diagnosis, the plan for the three years of general training is to provide it without dividing students into treatment or diagnosis streams. In compliance with the specialist training curriculum guidelines set out by the Japan Radiological Society, students generally complete about one year of training in the university, then about two years of training in an external affiliated hospital. There are currently 15 external affiliated hospitals approved by JRS as training hospitals. When commencing specialist training, students are allocated to their specialist fields. After the two years of specialist training, all students decide whether to aim to become a radiotherapist or a diagnostic radiologist. Almost all then set out to obtain a further degree by enrolling in either a post-graduate school or adult graduate school. In addition, many also obtain certification as a senior (first class) radiation protection supervisor.
In recent times, diagnostic radiology has been experiencing an increasing load in terms of image processing, the number of image readings, and server storage, owing to improvements in instrument performance. As hybrid imaging such as PET/CT, SPECT/CT, PET/MRI become more prevalent, the diversification of diagnostic methods is accelerating. This trend is expected to continue, so there is a need for work on adequate personnel responses, including infrastructure improvement. And because the combined use of functional images to monitor metabolism and blood flow from morphologic images alone will be fundamental, it is essential that the university goes on enhancing education for radiologists so that they acquire the capabilities to extract and analyze clinically useful information from the complex data gathered.
Remote diagnostic imaging is a good example of this. In regard to its responsibility to contribute to the community, there have been changes in the way diagnostic radiology today has been active in society. The community gives special privileges to the diagnosing doctor, including the exclusive or primary responsibility to provide specified medical services. The university must unwaveringly fulfill its mission as such by providing advanced medical care through medical practice, as well as developing the doctors who will provide healthcare to communities. Although it could not be claimed that the environment surrounding diagnostic radiology in community healthcare has fully matured, as specialists, it is necessary to contribute to the development of local communities and to exercise the privileges granted as specialists: we should carry out our responsibilities while firmly holding to this approach.
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Research

Diagnostic specialists must keep up with the latest research in their fields, applying medical research findings to clinical practice, and making use of continuing education, continuing professional development programs, medical journals, society activities and the internet to maintain their skills. Along with the importance of maintaining awareness of how to interpret and apply research findings to the patient, it is also necessary to go on formulating broad education programs from a specialist perspective, in order to stay well informed about the fundamentals of research methods and to practice appropriate medicine. By managing the faculty effectively, it will go on clarifying radiological perspectives designed to effect inter-disciplinary research activities, taking a whole-university outlook that crosses over the limits of individual departments or graduate schools. The faculty ensures the education and research activities at graduate schools are reflected in the departments while also energetically tackling strategies to secure external funding and strengthen industry collaborations, with the aim of further improving research results. The faculty continues to actively advance international cooperative networks with the Radiological Society of North America (RSNA), the European Congress of Radiology (ECR), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), etc. from the standpoint of diagnostic radiology and nuclear medicine, and continues to advance research based on a thorough awareness of the impacts emerging in the field and the potentialities developing in related practical application fields.
Diagnostic radiology provides diagnoses by extracting information about the morphology of organs and tissues, three-dimensional structures. It is important in terms of learning to systematically organize that information for comparison of imaging study analyses with the reference pathological tissue. Within that, using CT or MRI for tissue characterization that reflects the macro-pathology is important for identifying diseases.
Diagnostic radiology is a discipline in which it is possible to zero in on understanding of a pathological condition by collecting and analyzing blood flow and metabolic data over time. The faculty is continuing research into a minimally invasive method of extracting in vivo blood flow data to enable the use of in vivo dynamic analysis as a biomarker with formulation of dynamic scan protocols that obtain images over time with bolus contrast injection before high-resolution, multi-slice CT or high magnetic field MRI. Texture analysis and AI imaging are applied to both of anatomic and functional imaging modalities. We investigate from first order (kurtosis) to high order (NGLCM、NGTDM、GLSZM). The faculty is also formulating scan protocols that obtain images over time with 3D PET/CT, as a minimally invasive technique of extracting in vivo metabolic data. Known tracers include 18F-FDG (glucose metabolism), 11C-choline (lipid metabolism), 11C-acetate (lipid metabolism), 18F-FAZA (hypoxia), 18F-FACBC (amino acid metabolism), 62/64Cu-ATSM (redox), 18F-FLT (DNA synthesis), 18F-NaF (bone metabolism), 68Ga-DOTATATE (somatostatin receptor), and 18F-Fluorobetapir (Amyloid), 18F-Flutemetamol (Amyloid). The usefulness of multiple tracers in the discipline of oncology has been observed in numerous carcinomas. 177Lu-DOTATATE PRRT started as the first domestic Phase I study. Given the need for examination with standardized imaging and assessment techniques, by conducting a multi-center joint study using PET/CT, the faculty is working to realize and to formulate methodologies for standardization to facilitate participation in global clinical trials in Japan.
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Education

In order to meet the expectations of both the patient and diagnostic radiologist, it is important to know the values, especially empathy, capabilities, and autonomy that lie at the core of medical care, and to continue to independently demonstrate them. Diagnostic radiology demands high-level capabilities, so extensive training is required to acquire those capabilities, while keeping a watch on developments in medical knowledge and maintaining those capabilities is also an issue for the discipline. Similarly, it is also necessary to maintain knowledge, skills and capabilities in ethics, not only radiology knowledge and skills, in order to respond to changes in medical practices as well as the social and political environment.Education in the department aims to develop professionals equipped with the capabilities to resolve a range of problems and the attitude to identify and research topics themselves, by developing three subject groups, problem presentation, technical skill acquisition, and collaboration with the profession, and by formulating and implementing specialist education based on those groups, from the radiological perspective. Education in the postgraduate school aims to develop professionals who can resolve the problems faced by humanity from a global viewpoint, implementing research into leading-edge topics within a framework for research guidance under numerous teachers in addition to the acquisition of specialist knowledge, delivering education that develops inventive and practical research capabilities, from the radiological perspective. An essential aspect of postgraduate school education is the ongoing maintenance of capabilities from that perspective.
Under the new radiology specialist system, it is possible to obtain a qualification by completing two years of post-graduate clinical training, followed by three years of general training at a training facility approved by the Japan Radiological Society, then sitting the radiology specialist examination (sixth year after graduation). After passing that examination, it is possible to obtain a qualification in either radiotherapy or diagnostic radiology by completing a further two years of specialist training and sitting either the radiotherapist or the diagnostic radiologist examination (eighth year after graduation).
In July 2013, radiation oncology was divided into diagnostic radiology and nuclear medicine responsible for diagnostic radiology and radiotherapeutic oncology, in turn responsible for radiotherapy. However, because the radiologist examination covers both treatment and diagnosis, the plan for the three years of general training is to provide the training without dividing students into treatment or diagnosis streams. In compliance with the specialist training curriculum guidelines set out by the Japan Radiological Society, students generally complete about one year of training in the university, then about two years of training in an external affiliated hospital. There are currently 11 external affiliated hospitals (five in Tokyo and six in the Kanto region) approved by the Society as training hospitals. When students commence specialist training, they will be allocated to their specialist fields. After the two years of specialist training, all students decide whether to aim to become a radiotherapist or a diagnostic radiologist. Almost all students then set out to obtain a further degree by enrolling in either a post-graduate school or adult graduate school. From the standpoint of managing sealed and unsealed sources in nuclear medicine, many students also obtain certification as a senior (first class) radiation protection supervisor before engaging in clinical and research work.
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Lectures & Courses

The department delivers education based on the university’s fundamental policy aimed at realization of its mission: to contribute to the development of society, with a specific mission to bear the responsibility for the basic functions of education, research and medical care. As a department at the core of medical care, it develops professionals who can engage in practice across different fields, taking the approach that the standards of behavior demonstrated by diagnostic radiologists in clinical practice have far more impact than the formal curriculum in ethics.
The department develops professionals who can continue to work to resolve the issues faced by the university hospital, professionals who know the values, especially empathy, capabilities, and autonomy that lie at the core of medical care to meet the expectations of both the patient and student, can independently demonstrate them, and can flourish while maintaining a global outlook. Education in the department aims to develop professionals equipped with the capabilities to resolve a range of problems and the attitude to identify and research topics themselves, by developing three subject groups, problem presentation, technical skill acquisition, and collaboration with the profession, and by formulating and implementing specialist education based on those groups, from the radiological perspective. Education in the postgraduate school aims to develop professionals who can resolve the problems faced by humanity from a global perspective, implementing research into leading-edge topics within a framework for research guidance under numerous teachers in addition to the acquisition of specialist knowledge, delivering education that develops inventive and practical research capabilities, from the radiological perspective.
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Clinical Services & Other Works

#BDiagnostic Radiology#BR
・CT: A total of three CT scanners are involved in diagnostic radiology: two in the radiology department (64-slice MDCT) and one in the ER center (16-slice MDCT). Not only has the number of examinations using MDCT increased, but it has been possible to obtain improved diagnostic performance by reading MPR (multi-planar reconstruction) images and 1-mm thick images.
・MRI: A total of four MRI scanners are involved in diagnostic radiology: two 1.5-tesla scanners and two 3-tesla scanners. This has allowed for an increase in examinations.
・Ultrasound: The main examinations carried out by diagnostic radiologists are breast and abdominal examinations.
・Angiography and Interventional Radiology (IVR): In the vascular area: TACE for hepatic carcinoma, PTA and stent placement for occlusive arterial disease, intraarterial injection for pelvic tumor, and emergency hemostasis for ER center patients. In the non-vascular area: mainly CT-guided chest biopsy, breast mass biopsy and lymph node biopsy.
・Breast: The department is responsible for breast diagnostic radiology and collaborates with the breast surgery department in team medical care. The department endeavors to diagnose breast cancer at an early stage, provide accurate pre-surgery diagnoses, and formulate treatment plans by providing high-quality diagnostic radiology services combining mammography reading, ultrasound examination, as well as MRI and FDG-PET/CT, in addition to providing image-guided biopsy and surgical marking.
・Conferences: The department holds inter-disciplinary conferences with all departments on a daily basis. The department holds its internal conference every Friday and participates in externally conducted conferences, as appropriate. The department also takes a lead role in organizing conferences aimed at external attendees (Shoheizaka Radiology: twice a year), and the three-university joint conferences (three times a year).
#BNuclear Medicine#BR
・Since the department began operating its second PET/CT scanner in November 2006, it has been conducting 17 PET examinations per day, mainly for malignant tumor, as well as eight to 10 general radioisotope examinations per day, mainly brain and myocardial SPECT. PET/CT for radiation planning and C-11 acetate PET/CT F-18 FLT PET/CT for malignancies were introduced in 2016.
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Clinical Performances

Being a core diagnosis and treatment department, diagnostic radiology and nuclear medicine is a department that engages in inter-disciplinary clinical practice forming strong partnerships to meet the needs of its internal client departments and works to resolve issues faced by the university hospital, bearing its responsibility to unswervingly fulfill its mission from a global perspective. Diagnostic radiology and nuclear medicine is equipped with the capabilities to process large volumes of imaging information, it develops problem presentation, technical skill acquisition, and collaboration with all departments, and possesses the characteristics to go on conscientiously tackling new modalities, probes and contrasts as well as clinical trials.
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