研究者詳細 - 冨田　晃司

論文 - 冨田　晃司

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Catecholamine Crisis Due to Cryoinjury of the Adrenal Gland during Renal Cryoablation. 国際誌

Kazuaki Munetomo, Yusuke Matsui, Toshihiro Iguchi, Koji Tomita, Mayu Uka, Hideo Gobara, Takao Hiraki

Journal of vascular and interventional radiology : JVIR 33 ( 3 ) 350 - 352 2022年3月

CT fluoroscopy-guided biopsy of pulmonary lesions contacting the interlobar fissure: An analysis of 72 biopsies. 国際誌

Toshihiro Iguchi, Yusuke Matsui, Koji Tomita, Mayu Uka, Noriyuki Umakoshi, Kazuaki Munetomo, Takao Hiraki

Diagnostic and interventional imaging 103 ( 6 ) 302 - 309 2022年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The purpose of this study was to evaluate retrospectively the safety and diagnostic yield of computed tomography (CT) fluoroscopy-guided biopsy for pulmonary lesions with interlobar fissure contact. MATERIALS AND METHODS: Seventy-two lesions showing interlobar fissure contact (mean size, 15.2 ± 5.3 [SD] mm [range: 5.3-27.0 mm]; mean length of interlobar fissure contact, 8.9 ± 3.6 [SD] mm [range: 2.6-17.5 mm] in 72 patients (33 men, 39 women; mean age, 69.7 ± 10.3 [SD] years; age range: 37-91 years) were evaluated. Multiple variables were assessed to determine the risk factors for diagnostic failure and pneumothorax. Additionally, these variables were compared between these 72 lesions and randomly selected controls (i.e., non-contact lesions). RESULTS: All biopsies were technically successful using the transfissural (n = 14) or conventional routes (the route into the lung lobe with the target) with (n = 35) or without (n = 23) possible risk of needle insertion into the interlobar fissure after penetrating the target lesion. Sixty-eight (94.4%) procedures succeeded diagnostically and four (5.6%) failed. There were 27 grade I pneumothorax (37.5%), one (1.4%) grade II bleeding, and five (6.9%) grade IIIa pneumothorax requiring chest tube placement. Groups with and without pneumothorax did not differ significantly in patient-, lesion-, or procedure-related variables. Diagnostic yields and pneumothorax occurrence showed no significant differences between lesions with interlobar fissure contact and controls. CONCLUSION: CT fluoroscopy-guided biopsy of pulmonary lesions with interlobar fissure contact is a safe procedure with a high diagnostic yield. Furthermore, because of potential complications, the transfissural route should be used only when a safer route is not possible.

DOI： 10.1016/j.diii.2022.01.008

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In Vivo Microwave Ablation of Normal Swine Lung at High-power, Short-duration Settings.

Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Tomohiro Toji, Mayu Uka, Koji Tomita, Toshiyuki Komaki, Noriyuki Umakoshi, Toshiharu Mitsuhashi, Susumu Kanazawa

Acta medica Okayama 76 ( 1 ) 57 - 62 2022年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

To evaluate the volume and heat-sink effects of microwave ablation (MWA) in the ablation zone of the normal swine lung. MWA at 100 W was performed for 1, 2, and 3 min in 7, 5, and 5 lung zones, respectively. We assessed the histopathology in the ablation zones and other outcome measures: namely, length of the longest long and short axes, sphericity, ellipsoid area, and ellipsoid volume. The mean long- and short-axis diameters were 22.0 and 14.1 mm in the 1-min ablation zone, 27.6 and 20.2 mm in the 2-min ablation zone; and 29.2 and 21.2 mm in the 3-min ablation zone, respectively. All measures, except sphericity, were significantly less with 1-min ablation than with either 2- or 3-min ablation. There were no significant differences between the 2- and 3-min ablation zones, but all measures except sphericity were larger with 3-min ablation. Although there were no blood vessels that resulted in a heat-sink effect within the ablation zones, the presence of bronchi nearby in 5 lung ablation zones resulted in reduced ablation size. In high-power, short-duration MWA, the lung ablation volume was affected by ablation time. Some ablations showed that a heat-sink effect by a neighboring bronchus might occur.

DOI： 10.18926/AMO/63212

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腎腫瘍生検後の出血に対し腎動脈塞栓術を施行した1例

宗友一晃, 生口俊浩, 郷原英夫, 松井裕輔, 冨田晃司, 宇賀麻由, 馬越紀行, 小牧稔幸, 平木隆夫, 金澤右

Japanese Journal of Radiology 40 ( Suppl. ) 44 - 44 2022年2月

CTガイド下生検で診断された腎capillary hemangiomaの1例

白石明日香, 松井裕輔, 宗友一晃, 平木隆夫, 生口俊浩, 冨田晃司, 宇賀麻由, 馬越紀行, 小牧稔幸, 金澤右

Japanese Journal of Radiology 40 ( Suppl. ) 44 - 44 2022年2月

上大静脈症候群に対するコスモテックステント留置の1例

馬越紀行, 冨田晃司, 平木隆夫, 生口俊浩, 松井裕輔, 宇賀麻由, 小牧稔幸, 宗友一晃, 郷原英夫, 金澤右

Japanese Journal of Radiology 40 ( Suppl. ) 45 - 45 2022年2月

胆管チューブステントを経皮的に体外抜去した1例

河村俊一, 馬越紀行, 松井裕輔, 宗友一晃, 小牧稔幸, 宇賀麻由, 冨田晃司, 櫻井淳, 生口俊浩, 郷原英夫, 平木隆夫

Japanese Journal of Radiology 40 ( Suppl. ) 50 - 50 2022年2月

マルチモダリティロードマップを用いて経頸静脈的肝内門脈大循環短期術(TIPS)を行った1例

白石明日香, 冨田晃司, 宗友一晃, 平木隆夫, 生口俊浩, 松井裕輔, 宇賀麻由, 馬越紀行, 小牧稔幸, 金澤右

Japanese Journal of Radiology 40 ( Suppl. ) 50 - 50 2022年2月

骨盤内動静脈奇形に対し経静脈的アプローチにて塞栓術を施行した2例

櫻井淳暢, 宇賀麻由, 松井裕輔, 宗友一晃, 生口俊浩, 小牧稔幸, 馬越紀行, 富田晃司, 櫻井淳, 郷原英夫, 平木隆夫

Japanese Journal of Radiology 40 ( Suppl. ) 51 - 51 2022年2月

Pneumodissection during percutaneous renal cryoablation resulting in massive subcutaneous and mediastinal emphysema. 国際誌

Koji Tomita, Toshihiro Iguchi, Yusuke Matsui, Mayu Uka, Noriyuki Umakoshi, Takao Hiraki

Diagnostic and interventional imaging 103 ( 4 ) 231 - 232 2022年1月

A single-center, single-arm, prospective, open-label trial to evaluate the efficacy and safety of percutaneous sclerotherapy with polidocanol for painful venous malformations (SCIRO-2001): study protocol 査読

Mayu Uka, Jun Sakurai, Yusuke Matsui, Toshihiro Iguchi, Koji Tomita, Noriyuki Umakoshi, Kazuaki Munetomo, Toshiharu Mitsuhashi, Hideo Gobara, Takao Hiraki

Nagoya J. Med. Sci. 84. 746–751, 2022 2021年12月

Percutaneous needle biopsy under 1.2 Tesla open MRI guidance.

Yusuke Matsui, Takao Hiraki, Jun Sakurai, Soichiro Okamoto, Toshihiro Iguchi, Koji Tomita, Mayu Uka, Takatsugu Yamauchi, Hideo Gobara, Susumu Kanazawa

Japanese journal of radiology 40 ( 4 ) 430 - 438 2021年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To evaluate the feasibility of percutaneous needle biopsy using a 1.2 Tesla open magnetic resonance imaging (MRI) system, which has the highest field strength among the currently available open MRI systems. MATERIALS AND METHODS: This single-center prospective study included 10 patients. The primary endpoint was the feasibility of biopsy needle insertion into a target lesion under 1.2 Tesla open MRI guidance. The secondary endpoints included adverse events, device failures, and success of tissue specimen acquisition. Biopsy was performed for targets in various organs using an MRI-compatible coaxial needle system consisting of a 16G introducer needle and 18G semi-automatic biopsy needle. A newly developed body coil with a suitable design for intervention was used for intraprocedural imaging. RESULTS: Biopsy procedures were performed for six musculoskeletal masses, two retroperitoneal masses, one renal mass, and one liver mass. The median diameter of the targets was 4.9 cm (range 2.1-22.8 cm). MRI-guided biopsy needle insertion was feasible in all 10 patients. In total, four grade 1 adverse events (as per Common Terminology Criteria for Adverse Events version 4.0) occurred in three patients. Adequate biopsy specimens for pathological diagnosis were successfully obtained from all 10 patients. CONCLUSION: Percutaneous needle biopsy using a 1.2 Tesla open MRI system was feasible for relatively large targets, especially in the musculoskeletal region.

DOI： 10.1007/s11604-021-01211-8

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良性腫瘍に対する低侵襲治療類骨骨種に対するRFA

冨田晃司, 馬越紀行, 宇賀麻由, 藤原智洋, 松井裕輔, 中田英二, 生口俊浩, 国定俊之, 平木隆夫, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S39 - S39 2021年11月

【泌尿器科領域のIVR】腎癌に対するアブレーション治療

生口俊浩, 平木隆夫, 松井裕輔, 冨田晃司, 宇賀麻由, 郷原英夫, 金澤右

日本インターベンショナルラジオロジー学会雑誌 36 ( 1 ) 2 - 6 2021年9月

記述言語：日本語出版者・発行元：(一社)日本インターベンショナルラジオロジー学会

日本では2011年に小径腎細胞癌に対する凍結療法(CA)が保険収載となり、低侵襲、安全、高い局所制御率を有するアブレーション治療の施行件数は増加傾向にある。アブレーション治療として施行例の多いCAとラジオ波焼灼術(RFA)について、その原理と特徴、適応、治療の流れとアブレーション手技、治療成績と合併症、費用などについて概説した。

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精巣静脈が排血路となった腸間膜静脈瘤に対する塞栓術の1例

馬越紀行, 冨田晃司, 平木隆夫, 生口俊浩, 松井裕輔, 宇賀麻由, 小牧稔幸, 宗友一晃, 櫻井淳, 郷原英夫, 金澤右

日本門脈圧亢進症学会雑誌 27 ( 3 ) 136 - 136 2021年8月

CT evaluation of patent artery after percutaneous cryoablation of renal cell carcinoma. 国際誌

Soichiro Kajita, Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Koji Tomita, Mayu Uka, Takashi Tanaka, Motoo Araki, Hideo Gobara, Susumu Kanazawa

Diagnostic and interventional imaging 102 ( 12 ) 753 - 758 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The purpose of this retrospective study was to determine the incidence of persistent patent artery after percutaneous cryoablation of renal cell carcinoma (RCC) and the relationship between patent arteries one month after cryoablation and early tumor progression. MATERIALS AND METHODS: One hundred and fifty-nine patients (112 men, 47 women; mean age, 63.6±14.6 [SD] years; age range: 21-91 years) who underwent percutaneous cryoablation for 186 RCCs (mean diameter, 1.9±0.6 [SD] cm; range: 0.7-4.0cm) were retrospectively included. After cryoablation, patients underwent contrast-enhanced computed tomography (CT) with ≤2-mm slice thickness within one week from cryoablation, and at one, three, and six months. The time course of patent artery in the ablated renal parenchyma after cryoablation was the primary endpoint. The relationships between patent arteries one month after cryoablation and treatment effectiveness, tumor vascularity, tumor enhancement one month after cryoablation, tumor subtype, and renal function changes were evaluated as secondary endpoints. RESULTS: CT showed patent arteries in the ablated renal parenchyma within one week in 166 RCCs (89.2%), at one month in 54 RCCs (29.0%), at three months in 8 RCCs (4.3%), and at six months in 2 RCCs (1.1%). The presence of patent artery one month after cryoablation was significantly associated with tumor enhancement at the same time point (P=0.015). There was no association between patent arteries one month after cryoablation and treatment effectiveness (P=0.693). CONCLUSION: Patent arteries in the ablated renal parenchyma are commonly observed on CT examination after percutaneous cryoablation of RCC. However, they gradually disappear and do not require specific treatment.

DOI： 10.1016/j.diii.2021.06.001

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Percutaneous Cryoablation of Lower Limb Soft-Tissue Venous Malformations: Preliminary Results of Long-Term Efficacy. 国際誌

Hiroyasu Fujiwara, Takao Hiraki, Yusuke Matsui, Mayu Uka, Koji Tomita, Toshihiro Iguchi, Jun Sakurai, Takao Soshi, Hideo Gobara, Susumu Kanazawa

Cardiovascular and interventional radiology 44 ( 9 ) 1485 - 1490 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To retrospectively evaluate long-term efficacy of percutaneous cryoablation for lower limb soft-tissue venous malformations. MATERIALS AND METHODS: Nine patients (mean age, 36.6 years) with lower limb soft-tissue venous malformations were included. Cryoablation was performed percutaneously using an argon-based system. Adverse events (AE) using the Common Terminology Criteria for AEs version 4.0 were evaluated. The visual analog scale (VAS) scores and lesion volumes measured on magnetic resonance imaging were also evaluated at 12 months and 5-6 years. RESULTS: Technical success (i.e., complete coverage of the lesion by an iceball) was achieved in eight of the nine patients. All patients developed a total of 14 grade 1 or 2 adverse events. The mean (± standard deviation) VAS score was 6.0 (± 1.7) before therapy, whereas it was 0.14 (± 0.27) at 12 months and 0.97 (± 1.3) at 5-6 years (58-78 months). Complete pain relief was obtained in 6 and 5 patients at 12 months and 5-6 years, respectively. The median lesion volume was 2.49 mL before therapy, whereas it was 0.26 mL at 12 months and 0.35 mL at 5-6 years. CONCLUSION: Percutaneous cryoablation of lower limb soft-tissue venous malformations achieved considerable pain relief and lesion shrinkage for 5-6 years in this small preliminary study. LEVEL OF EVIDENCE: Level 4, Case Series.

DOI： 10.1007/s00270-021-02876-4

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CT-guided biopsy of lung nodules with pleural contact: Comparison of two puncture routes. 国際誌

Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Koji Tomita, Mayu Uka, Takashi Tanaka, Kazuaki Munetomo, Hideo Gobara, Susumu Kanazawa

Diagnostic and interventional imaging 102 ( 9 ) 539 - 544 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The purpose of this study was to retrospectively compare two puncture routes (transpleural vs. transpulmonary) for computed tomography (CT) fluoroscopy-guided cutting needle biopsy of lung nodules with pleural contact. PATIENTS AND METHODS: A total of 102 patients (72 men; mean age, 71.1±9.5 [SD] years) were included and 102 biopsies of 102 lung nodules (mean size, 16.7±5.9 [SD] mm; range, 6.0-29.4mm; mean length of pleural contact, 10.1±4.2 [SD] mm; range, 2.8-19.6mm) were analyzed. All procedures were classified as biopsies via the direct transpleural route or the transpulmonary route. The patient-, lesion-, and biopsy-related variables, diagnostic yields, and incidence of complications were compared between the two routes. RESULTS: Biopsy was performed via the direct transpleural route (n=59; 57.8%) and transpulmonary route (n=43; 42.2%). In the transpulmonary route group, the mean distance of the intrapulmonary pathway was 17.7±9.4 [SD] mm (range: 4.1-47.6mm; P<0.001) and the introducer needle trajectory angle of<45° was significantly observed (8.5% [5/59] vs. 60.5% [26/43]; P<0.001). There was no significant difference in diagnostic accuracy between the direct transpleural and transpulmonary routes (93.2% [55/59] vs. 90.7% [39/43]; P=0.718). The frequencies of all complications (64.4% [38/59] vs. 97.7% [42/43]; P<0.001), pneumothorax (33.9% [20/59] vs. 65.1% [28/43]; P=0.003), pneumothorax with chest tube placement (3.4% [2/59] vs. 18.6% [8/43]; P=0.016), and pulmonary hemorrhage (47.5% [28/59] vs. 76.7% [33/43]; P=0.004) were significantly lower in the direct transpleural group. CONCLUSION: Direct transpleural route is recommended for CT fluoroscopy-guided biopsy of lung nodules with pleural contact because it is safer and yields similar diagnostic accuracy than transpulmonary route.

DOI： 10.1016/j.diii.2021.05.005

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Needle artifact characteristics and insertion accuracy using a 1.2T open MRI scanner: A phantom study. 国際誌

Soichiro Okamoto, Yusuke Matsui, Takao Hiraki, Toshihiro Iguchi, Toshiyuki Komaki, Takatsugu Yamauchi, Mayu Uka, Koji Tomita, Jun Sakurai, Hideo Gobara, Susumu Kanazawa

Diagnostic and interventional imaging 102 ( 6 ) 363 - 370 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To evaluate the characteristics of needle artifacts and the accuracy of needle insertion using a 1.2 Tesla open magnetic resonance imaging (MRI) system in a phantom. MATERIALS AND METHODS: First, the apparent width of the needle on the MRI and the needle tip position error of 16- and 18-gauge MRI-compatible introducer needles and a 17-gauge cryoneedle were examined with different needle angles (0°, 30°, 45°, 60°, and 90°) to the main magnetic field (B0), sequence types (balanced steady-state acquisition with rewound gradient echo [BASG] and T2-weighted fast spin echo [FSE] sequence), and frequency encoding directions. Second, the accuracy of needle insertion was evaluated after 10 MRI fluoroscopy-guided insertions in a phantom. RESULTS: The apparent needle widths was larger when the angle of the needle axis relative to B0 was larger. The needles appeared larger on BASG than on T2-weighted FSE images, with the largest apparent widths of 16-, 17-, and 18-gauge needles of 14.3, 11.6, and 11.0mm, respectively. The apparent needle tip position was always more distal than the actual position on BASG images, with the largest longitudinal error of 4.0mm. Meanwhile, the 16- and 18-gauge needle tips appeared more proximal on T2-weighted FSE images with right-to-left frequency encoding direction. The mean accuracy of MRI fluoroscopy-guided needle insertion was 3.1mm. CONCLUSION: These experiments clarify the characteristics of needle artifacts in a 1.2 Tesla open MRI. With this system, the MRI fluoroscopy-guided needle insertion demonstrated an acceptable accuracy for clinical use.

DOI： 10.1016/j.diii.2020.12.007

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Contrast examination of central venous access port implanted through internal jugular vein for evaluation of suspected complications.

Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Koji Tomita, Mayu Uka, Noriyuki Umakoshi, Soichiro Kajita, Toshiyuki Komaki, Hideo Gobara, Susumu Kanazawa

Japanese journal of radiology 39 ( 11 ) 1103 - 1110 2021年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: We summarized the findings, diagnosis, and outcomes of cases for which contrast examination of central venous access ports (CV-ports) were attempted to detect complications. MATERIALS AND METHODS: Fifty-seven contrast examinations were attempted for 45 patients with 46 CV-ports (median, 162 days after implantation). Contrast examination was performed due to three suspicion catheter fractures or 54 CV-port dysfunctions (combinations of an absence of blood reflux on aspiration and 9 sufficient, 21 insufficient, or 24 impossible drip infusions). RESULTS: Contrast examination was successfully performed in 52 cases and revealed 45 normal findings, 5 pericatheter fibrin sheath formations, and 2 partial catheter fractures. In 23 of 45 cases with normal findings, the resistance to injection was initially mild or moderate but resolved after the CV-port was flushed slowly with heparinized saline solution. Subsequent contrast examination demonstrated normal findings. All fibrin sheath formations disappeared after thrombolytic therapy. Five cases could not undergo contrast examination due to high resistance. After contrast examination, nine of 46 CV-ports were removed or exchanged, while the use of the remaining 37 continued. CONCLUSION: Contrast examination of CV-port allowed the assessment of suspected complications and early treatment.

DOI： 10.1007/s11604-021-01142-4

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