greeting

The Department of Radiology is in charge of the diagnostic imaging center (general radiography, CT / MR), endoscopy center, RI / radiotherapy center (nuclear medicine / linac / cyberknife), and IVR center (angiography). In each department, we work in cooperation with department staff including Registered Nurse Radiological Technologist is becoming more and more important in the ever-advancing medical care.
Under these circumstances, we will fulfill our responsibilities based on the department's philosophy and code of conduct.

Radiology Department Chief Hidekazu Tanaka

Radiation Department Philosophy

1. We will practice team medical care in cooperation with other occupations.
2. We provide high-quality images with high diagnostic value and advanced radiotherapy.
3. We will endeavor to use radiation equipment safely and reduce the exposure dose.

Radiation Department Code of Conduct

1. Try to give a kind and easy-to-understand explanation.
2. We strive for medical safety and prevent accidents.
3. Participate in academic societies, study sessions, and seminars to acquire the latest knowledge and skills.
4. We support all 24-hour radiological examinations (excluding RI and radiation therapy).
5. We will carry out the inspection even if it is not reserved on the day.
6. We will strive to reduce the waiting time for patient examinations, the waiting time for multiple radiological examinations, and the waiting time for image data (CD, film) output.
7. We will also actively accept requested inspections through the Regional Cooperation Office.
8. any will continue to study with the goal of acquiring various certifications and entering conference presentations.

Diagnostic Imaging Center

We perform general radiography, contrast examination, bone mineral density examination, X-ray CT, and MRI.

General shooting

General radiography is a general term for X-ray radiography that does not use contrast media, such as radiography of the head, spine, chest, mammary glands, abdomen, limbs, and Surgery Inflammation, pain, bone deformities / fractures, gas status, presence of stones, etc. will be photographed.

Chest

abdomen

head

Pantomo (panorama)

Contrast examination

IVP (Excretory Renal Meng Urethrography) Examination

A contrast medium is injected intravenously and the image is taken over time. You can see the morphology of kidney function, kidney, and bladder. The examination time is about 30 minutes, and there are dietary restrictions.

Lower limb vein examination

Side image

Front image

Stomach / esophagus / duodenal examination

Large intestine examination (enema examination)

Endoscopic retrograde cholangiopancreatography

This is an examination in which a catheter is inserted into the duodenal papilla using an endoscope to perform contrast. Observe the bile duct, bile duct, and pancreatic duct.

Stomach examination

Large intestine examination

Biliary pancreatography

Mammography

Mammography device

It is an excellent test for detecting breast cancer.
Because the breast is a soft tissue, it cannot be taken clearly with a normal X-ray machine. Therefore, by using an X-ray machine dedicated to the breast, it is possible to capture "small calcifications" and "lumps" that lead to the detection of breast cancer.

In addition, as a detailed examination of "lumps", a biopsy (a needle is pierced and a "lump" is aspirated to examine cells) is performed with a mammotome device.

​A female technician is in charge of photography and mammothome examination. The shooting time is 20 to 30 minutes, and the mammothome biopsy is about 1 to 2 hours.

Breast image

Changing room

Quantitative bone mineral test (bone density test)

Two types of X-rays are irradiated, and the bone density is calculated based on the X-ray transmission intensity. It is effective in diagnosing osteoporosis, which is common in women. The examination time is about 10 minutes, and the lumbar spine and femur are examined.

CT (Computed Tomography) inspection

The human body is irradiated with X-rays from a 360 ° direction, and the absorption difference of the transmitted X-rays is processed by a computer to create a sliced image of an organ or a three-dimensional image. At our hospital, 320-row and 64-row multi-slice CT are in operation, and it is possible to image a wide range with thin slices in a short time. The time required for a CT examination varies depending on the area to be imaged and the use of contrast media, but it is about 5 to 20 minutes. Although it is a reservation system, we also perform non-reservation examinations at the discretion of the doctor.

To cooperate with patients

CT laboratory (320-row multi-CT)

• If metal is attached to the part to be photographed, it may interfere with the image. You will be asked to change into an inspection garment if necessary.
• If you are pregnant or may become pregnant, please let us know.
  (Basically, inspection is not possible.)

Contrast Enhanced CT (Contrast Enhanced CT)

Depending on the purpose of the test, iodine contrast medium is injected through a vein in the arm for testing. Contrast media have the effect of spreading to blood vessels and organs in the body and allowing you to see their morphology in more detail.

To cooperate with patients

Coronary CT (cardiac CT)

• Since contrast media have side effects, please read the "Contrast Agent Manual and Consent Form" in advance. If you do not have data on renal function (serum creatinine level), please collect blood in advance. In that case, please wait until the result is obtained. Please note.
• Please do not eat for 3 hours before the test (water and tea are fine).

CPR image (showing coronary arteries)

Angio View image

Head CT

Perform when bleeding, infarction, trauma, etc. are suspected.

Intracranial image

Skull image

Chest CT

This is done when mediastinal disease of the lung field is suspected.

Mediastinal image

Lung field image

CT angiography (angiography) image

This is done when there is a suspicion of running blood vessels or a disease. Create a stereoscopic image of the artery using a contrast medium. By making a stereoscopic image, it is possible to observe from any direction.

Head and neck vascular CT

Lower limb blood vessel CT

 

MRI (Magnetic Resonance Imaging) examination

A human body is placed in a device that generates a strong magnetic field, and information such as water, fat, and blood flow in the body is imaged by the resonance action of the magnetic field and electromagnetic waves. It takes about 30 minutes to inspect because images in various directions are taken out. In addition, a contrast medium may be used if necessary.

Precautions

MRI device (1.5 Tesla)

• There will be a noise during the inspection.
• People who are not good at narrow spaces may not be able to inspect.

To cooperate with patients

• Metals (hearing aids, hairpins, glasses, watches, etc.) are not allowed.
• If you are using a pacemaker, please let us know.

Brain MRI

It is performed when intracerebral lesions such as cerebral infarction, subarachnoid hemorrhage, brain tumor, and bone fracture are suspected.

T2WI

T1WI

DWI

 

Abdominal MRCP (Magnetic Resonance Cholangio Pancreatograhy)

This test is performed when a lesion such as a gallstone is suspected. Draw the bile duct, bile duct, and pancreas (pancreas).

 

Contrast-enhanced MRI CE MRI (Contrast Enhanced MRI)

It can be visualized in detail by using a contrast medium.

 

MRA (MR Angio)

MRA is a test that images the blood dynamics in blood vessels. It is also possible to create a stereoscopic image that shows the state of blood vessels. It is used to diagnose vascular disorders such as aneurysms. A contrast medium is used for areas with a wide range of examination, such as the normal neck, abdomen, and lower limbs, where there is movement such as breathing. In addition, MRA examination technology (TOF method) has been established for cerebrovascular disease, etc., and if limited, examination can be performed without using a contrast medium.

Cerebrovascular MRA (without contrast medium)

Cervical contrast MRA

IVR Center

IVR Center (interventional radiology)

Cardiac catheterization (cardiac catheterization)
Cardiac catheterization is a test in which a catheter is inserted into a heart chamber or blood vessel under fluoroscopy, and a contrast medium is used to detect the condition of the heart or abnormalities in blood vessels.

Heart catheter image

Cerebrovascular examination
Cerebrovascular examinations are mainly taken in two directions, front and side, and then a 3D image is created by rotation photography and observed from any angle. This is a test to check for aneurysms and bleeding.

Cerebrovascular front image

Side image

Image of head bone removed (DSA image)

About team medical care

Due to recent advances in medical technology, the work required of medical professionals is wide-ranging and at the same time requires specialization. Today, the role of radiologists in hospitals must be aware that they are part of a team in providing technology and provide patient-centered services. In addition, it is necessary to perform duties with sincerity and sincerity for staff of other occupations.

Hospitals consist of doctors and Registered Nurse, Pharmacist, Biomedical Laboratory Scientist, physiotherapists, Occupational Therapist, Clinical Engineer, nutritionists, radiologists, and other comedics, each of whom has an increasing role. Comedics have different basic knowledge and skills, but each requires a high degree of specialization. We must work together on medical services in the course of medical care that respects the development of new technologies and treatment methods and the QOL (Quality of life) of patients.

In addition, we are actively promoting cooperation between medical examinations (cooperation between hospitals and clinics or clinics) as stated in the hospital's philosophy of "creating better regional medical care for local people." It is possible to share expensive medical equipment such as CT / MRI / RI examinations, mammography, and bone mineral quantification examinations. Under these circumstances, the Department of Radiology will continue to practice team medical care in a broad sense so that we can provide safe and high-quality medical care centered on local patients.

RI / Radiation Therapy Center

RI (Radio Isotope) test: Nuclear medicine test

① Bone scintigraphy examination
Radiopharmaceuticals that collect in the bones are administered into the body and pictures of the bones of the whole body are taken. The test will start about 3 hours after the injection. The inspection time is about 30 to 40 minutes. This test mainly checks for the presence or absence of bone metastases in the cancer.
Bone metastases appear black on the photo, but some are lacking in shape. In addition, fractures and degenerative diseases of the spine also appear black.

② Cerebral blood flow scintigraphy test
Radiopharmaceuticals (there are two types) that are taken into brain tissue from blood vessels in the brain are administered into the body to examine the blood flow status in the brain. The test will start at the same time as the injection. The inspection time is about 30 to 40 minutes. This test mainly diagnoses cerebrovascular accidents and Alzheimer's dementia.

The obtained data is analyzed by a computer to create an image as shown in the above figure. The upper left figure is a cross-sectional view of the brain, and the blood flow state is expressed in an easy-to-understand manner by displaying the cerebral blood flow distribution in color. And the figure on the upper right is called the image statistical analysis method, and by comparing it with the normal brain, you can visually see only the place where the blood flow is reduced. This image statistical analysis method is used as an auxiliary role for doctors to make a diagnosis.

③ Myocardial blood flow scintigraphy test
Radiopharmaceuticals taken into the heart muscle from the blood vessels of the heart are administered into the body to examine the blood flow status of the heart muscle. This test involves two tests, one at rest and one at load. In the load test, either exercise load using a bicycle or drug load using a drug is performed. The inspection time is about 2 hours. This test looks at the diagnosis of ischemic myocardium, the decision of cardiac catheterization, and the recovery of blood flow after the treatment.


The obtained data is analyzed by a computer, and the heart is sliced as shown in the upper left figure to create an image as shown in the upper right figure. By displaying the blood flow distribution of the myocardium in color, the blood flow state is expressed in an easy-to-understand manner.

Radiation therapy

Linac device
The energy of our linac device can generate a total of 8 beams of 6, 10 MV for X-rays and 5, 6, 8, 10, 12, and 14 MeV for electron beams. Energy is selected and performed by considering the size and location of the disease. In addition, since a part called a multi-leaf collimator is attached, it is possible to irradiate the beam to a shape that matches the shape and size of the tumor, so it is possible to minimize the exposure dose to normal tissue. ..
The actual flow of radiation therapy is first examined by a radiation therapist, then a CT for treatment planning is taken and the CT data is used to plan the irradiation plan. On the first day of radiation therapy, a confirmation photo called "linacgraphy" is taken, so the total time required is about 20 to 40 minutes. Once this is confirmed, mark it with an ink called skin ink. From the second day onward, the body position will be adjusted according to the mark on the first day and treatment will be performed, so the time required will be about 10 to 20 minutes. In addition, a confirmation photo may be taken again to confirm that the irradiation position has not shifted on the way.
In addition, we will provide regular medical examinations, so if you have any questions or concerns regarding radiation therapy, please feel free to ask.

Brachytherapy
Intra-tissue irradiation performed at this hospital is a method of implanting an isotope called iodine 125 in the prostate. Iodo 125 is a nuclide that emits low-energy photons with a half-life of 59.4 days and a low energy photon of 27.4 to 35.5 keV. Is possible.
Also, since it is permanently embedded, there is no need to take it out. The procedure takes about 3 hours and is usually hospitalized for 2 days and 1 night.
Side effects include frequent stools and defecation pain, bleeding, frequent urination and micturition pain, radiation dermatitis and diarrhea. After the end of radiation therapy, the side effects diminish over time. Check with your doctor in advance about side effects. No matter how much the symptoms of prostate cancer improve, it is not always the best choice if it causes severe side effects. Also, if you have any side effects and are having a hard time, please do not overdo it and consult your doctor.

Cyberknife device

1. What is Cyberknife?
Cyberknife treatment is an epoch-making treatment method that combines a high-precision robot arm with an X-ray irradiation device. During treatment, even slight movements of the patient are detected three-dimensionally, and the deviation is immediately corrected, and the robot accurately aims at the lesion from multiple directions. It is possible to concentrate radiation only on the lesion and minimize the effect on surrounding normal tissues.

2. Comparison with Gamma Knife
a.) Fixing method
Surgery uses screws to fix the skull under local anesthesia. With Cyberknife, you simply cover it with a simple mesh-like fixture called a shell.
b.) Treatment target site
Gamma knife can only treat the inside of the skull, but Cyberknife can treat the head and neck and trunk.

3. Features of Cyberknife
a.) Compatible with various shapes and parts
The robot arm with 6 joints can irradiate from up to 1200 directions, and can handle complicated tumor shapes with an accuracy of mm or less.
b.) Automatic tracking system
During treatment, a low-energy X-ray source and a flat-mounted detector capture high-resolution images. At the same time, it is also monitored by a respiratory detector, and even if the patient moves, including those caused by breathing, the position of the tumor is automatically corrected and tracked. If it moves significantly, the irradiation will be stopped automatically, the position will be confirmed again, and the treatment will be resumed.
c.) Dose distribution
Cyberknife selects tissues that you do not want to irradiate in advance and uses a recursive treatment plan (inverse planning) that determines the irradiation direction and dose, so you can obtain an ideal dose distribution for tumors and normal tissues. You can do things. Treatment planning is done in the reverse process of conventional radiation therapy.

4. Number of treatments
It has little effect on the normal tissue around the lesion and can be irradiated with a large dose only to the lesion. Therefore, the time required for one irradiation is longer than that of conventional radiation therapy, but the period of radiation therapy is shorter, and it is possible to reduce the impact on the patient's daily life. The number of treatments is one to several times, but the number of irradiations is appropriately determined according to the type and size of the lesion.

5. Cases to be treated
Indications are one of the following:
・ Primary brain tumor (diameter 3 cm or less)
・ Metastatic brain tumor (3 cm or less in diameter, 3 or less, and general condition can withstand this treatment)
・ Localized head and neck tumor (size that can set the irradiation range of this treatment)
・ Cerebral arteriovenous malformation
・ Local recurrence after whole-brain irradiation (diameter 3 cm or less)

Introduced 80-row CTAquilion PRIME
From December 2013, Toshiba's 80-row CT Aquilion PRIME started operation in the Radiation Therapy Planning Office.
In current radiation therapy, CT is taken for treatment planning in all cases. The position and range of the tumor are identified based on the CT image, and the irradiation range and irradiation amount are determined. With Aquilion PRIME, 80-row helical scan enables imaging in a short time, which shortens the patient's breath holding and enables clear images. In addition, since it is equipped with the latest image processing function, it is possible to diagnose and plan with smooth and less blurred images.
The entrance to the CT has also become wider, making it possible to take pictures using the fixtures used for radiation therapy, and the device has less oppressive feeling.
With Aquilion PRIME, it has become possible to continuously photograph an area of 4 cm, and the movement of the tumor can be visually observed. Pinpoint treatment using Cyberknife introduced in our hospital requires irradiation that accurately grasps the movement of the tumor and enhances concentration, but pinpoint treatment is possible more than ever. Therefore, effective treatment is possible with few side effects.

For medical personnel

About any

·PhD

1 Ph.D., Graduate School of Medical Health Sciences, Kanazawa University

·National qualification

10 first-class radiation handling chiefs

Two first-class working environment measurers

・Certified by the Japan Breast Cancer Screening Quality Control Center for screening mammography

8 certified mammography technicians

・ Certified by the Japan Radiological Engineers Association

1 radiation equipment manager

2 radiation managers

5 clinical advisors

3 X-ray CT certified engineers

Two Radiological Technologist support procedures such as images

1 Ai certified Radiological Technologist

・ Certified by the Radiation Therapy Quality Control Organization

2 radiation therapy quality managers

・ Medical Physicist Certification Organization

2 Medical Physicist

・ Japan Nuclear Medicine Specialist Certification Organization

4 nuclear medicine specialists

・ Japan Emergency Photography Engineer Certification Organization

6 certified emergency photography technicians

・ Japan Radiation Therapy Specialist Certification Organization

1 radiotherapy specialist

・ Japan Angiography / Intervention Radiological Technologist Certification Organization

One Radiological Technologist specializing in angiography and intervention

・ Japan Magnetic Resonance Specialist Certification Organization

1 magnetic resonance technician

・ Lung cancer CT screening certification mechanism

Lung cancer CT screening certified technicians 3

・ Japan Osteoporosis Society

1 osteoporosis manager

(As of December​ ​2021)

To students

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