2022 Fiscal Year Final Research Report

Elucidation of undetermined pathological mechanism and quantification of the diseases that demonstrate more relevant symptoms in the standing position than in the supine position by using upright CT

Research Project

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Project/Area Number	20K08056
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 52040:Radiological sciences-related
Research Institution	Keio University
Principal Investigator	Yamada Yoshitake 慶應義塾大学, 医学部(信濃町), 講師 (60383791)
Co-Investigator(Kenkyū-buntansha)	山田稔慶應義塾大学, 医学部(信濃町), 特任准教授 (60365434) 橋本正弘慶應義塾大学, 医学部(信濃町), 特任助教 (20528393) 鈴木達也慶應義塾大学, 医学部(信濃町), 助教 (70627166) 成田啓一慶應義塾大学, 医学部(信濃町), 助教 (80627167) 陣崎雅弘慶應義塾大学, 医学部(信濃町), 教授 (80216259)
Project Period (FY)	2020-04-01 – 2023-03-31
Keywords	CT / 立位 / 座位 / 画像 / 解明 / 病態 / computed tomography / 臥位
Outline of Final Research Achievements	Using a new diagnostic modality, upright CT, we have shown that the anatomical structures of the whole body, including the head and neck, trunk, upper and lower limbs, are considerably different between the supine and standing positions in healthy volunteers. In addition, in diseases such as chronic obstructive pulmonary disease, scoliosis, knee osteoarthritis, and post-operative neurosurgery, in which symptoms differ between the supine and upright positions, we found that the morphology of the lesions or peri-lesion structures changed considerably between the supine and upright positions, and quantified the lesions or peri-lesion structures in the upright position. Furthermore, we found that various anatomical parameters in the upright CT correlated better with pulmonary function test results, cardiac catheterization results, and clinical findings than in the supine CT.
Free Research Field	放射線科学
Academic Significance and Societal Importance of the Research Achievements	現在の通常のCTは臥位で撮影するため、ヒトの日常生活の状態(立位/座位)を3次元的に画像化できていなかった。新たな診断機器である立位CTを用いた本研究成果は、特に臥位と立位で症状の異なる疾患において、その病態メカニズムのさらなる解明につながり、患者さんにも大きな恩恵をもたらす可能性がある。また、立位/座位での病変/病変周囲構造の定量化ができたため、立位CTを用いた新たな診断法の確立につながる可能性がある。そして、感染症パンデミック時などの肺機能検査が施行できない状況下や心臓カテーテル検査が施行できない状況下において、立位CTはある程度それら検査の代替法となり得る可能性が示唆された。