研究者詳細 - 冨田　晃司

論文 - 冨田　晃司

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皮膚直下のタイプII動静脈奇形に対してポリドカノールフォームを用いて硬化療法を施行した一例

松井裕輔, 宇賀麻由, 平木隆夫, 生口俊浩, 冨田晃司, 馬越紀行, 小牧稔幸, 宗友一晃, 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 ( Suppl. ) 242 - 242 2021年4月

腎凍結療法における低線量CTプロトコルの後方視的検討

小牧稔幸, 松井裕輔, 梶田聡一郎, 馬越紀行, 冨田晃司, 宇賀麻由, 生口俊浩, 櫻井淳, 平木隆夫, 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 ( Suppl. ) 145 - 145 2021年4月

肺動静脈奇形コイル塞栓術の再開通評価におけるTime-resolved MR Angiographyの有用性

宗友一晃, 冨田晃司, 郷原英夫, 平木隆夫, 生口俊浩, 松井裕輔, 宇賀麻由, 梶田聡一朗, 小牧稔幸, 馬越紀行, 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 ( Suppl. ) 166 - 166 2021年4月

胸膜に接する肺結節に対するCT透視ガイド下生検の穿刺経路の比較(CT fluoroscopy-guided biopsy for lung nodules with pleural contact: Comparison with puncture routes)

生口俊浩, 平木隆夫, 松井裕輔, 冨田晃司, 宇賀麻由, 馬越紀行, 梶田聡一郎, 小牧稔幸, 宗友一晃, 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 ( Suppl. ) 149 - 149 2021年4月

当院におけるT3a腎癌に対する経皮的凍結療法成績の検討(Percutaneous cryoablation outcome for clinical T3a renal cell carcinoma at our institution)

宇賀麻由, 大川七子, 宗友一晃, 馬越紀行, 小牧稔幸, 梶田聡一郎, 冨田晃司, 松井裕輔, 櫻井淳, 生口俊浩, 郷原英夫, 平木隆夫, 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 ( Suppl. ) 182 - 182 2021年4月

腎癌凍結療法後の造影CTと単純MRI画像の関係性の検討

馬越紀行, 生口俊浩, 平木隆夫, 松井裕輔, 冨田晃司, 宇賀麻由, 梶田聡一郎, 小牧稔幸, 宗友一晃, 櫻井淳, 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 ( Suppl. ) 181 - 181 2021年4月

Oncologic outcomes and safety of percutaneous cryoablation for biopsy-proven renal cell carcinoma up to 4 cm in diameter: a prospective observational study.

Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Yusuke Matsui, Jun Sakurai, Mayu Uka, Koji Tomita, Toshiyuki Komaki, Yasuyuki Kobayasi, Motoo Araki, Toyohiko Watanabe, Susumu Kanazawa

International journal of clinical oncology 26 ( 3 ) 562 - 568 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Percutaneous cryoablation is widely used for the treatment of renal cell carcinoma. We prospectively evaluated the oncologic outcomes and safety of percutaneous cryoablation for the treatment of tumors ≤ 4 cm in diameter. METHODS: We included patients aged ≥ 20 years, who had histologically proven renal cell carcinoma, tumor diameter ≤ 4 cm, a performance status of ≤ 1, acceptable laboratory parameters, were inoperable or refused to undergo surgery, and had signed a written informed consent. The primary endpoint was the cause-specific survival rate. The secondary endpoints were overall and progression-free survival, and adverse event frequency and grade. All procedures were percutaneously performed under computed tomography fluoroscopy guidance. RESULTS: From October 2013 to October 2015, 33 patients (mean age: 68 ± 14 years; sex: six women, 27 men) were enrolled. The mean tumor diameter was 2.1 ± 0.6 (range 1.0-3.4) cm. The median follow-up period was 60.1 (range 18.4-76.6) months. One patient died of non-renal cell carcinoma-related disease 46 months after percutaneous cryoablation. The cause-specific and overall survival rates were 100% and 96.8% at 3 years, and 100% and 96.8% at 5 years, respectively. There was no local tumor progression or distant metastasis. The incidence of severe urological (urinary fistula and perinephric infection) and non-urological adverse events (increased creatine kinase and skin ulceration) was 6% each. CONCLUSION: Percutaneous cryoablation for renal cell carcinoma ≤ 4 cm in diameter achieved good tumor control with a low complication frequency.

DOI： 10.1007/s10147-020-01825-4

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Needle Tract Ablation in Liver Tissue Using a Cryoprobe Combined with an Electrosurgical Device: Influence of ex vivo and in vivo Animal Models.

Hideo Gobara, Akira Yamamoto, Toshiyuki Komaki, Toshiaki Kitayama, Jun Sakurai, Toshihiro Iguchi, Yusuke Matsui, Mayu Uka, Koji Tomita, Takao Hiraki, Susumu Kanazawa

Acta medica Okayama 75 ( 1 ) 9 - 14 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

To assess the feasibility of needle tract ablation in liver tissue in ex vivo and in vivo animal models using a cryo-probe and electrosurgical device. The experimental device is made by inserting a cryoprobe through an intro-ducer sheath for insulation, with 2-cm of probe tip projecting out. A beagle liver was punctured by the device, and electric current was applied at 30-W with the electrosurgical knife touching the non-insulated device base. The discolored area of cut surface along the device was evaluated in 5 application-time groups (5 , 10 , 15 , 20, or 25 seconds). An ex vivo experiment was performed to determine an ablation algorithm with an appropriate application time by comparison with radiofrequency ablation (RFA) results. Thereafter, an in vivo experiment was performed to verify the algorithm's feasibility. In the ex vivo model, the cut surface demonstrated different amounts of discolored area according to the application time. The total discolored area in the 20-seconds group was similar to that by RFA. In the in vivo model, the liver did not bleed, the total discolored area was similar to that ex vivo, and coagulation necrosis was confirmed by photomicrograph. Needle tract ablation can be per-formed using the experimental device and electrosurgical device.

DOI： 10.18926/AMO/61428

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Computed Tomography-guided Core Needle Biopsy for Renal Tumors: A Review

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

Interventional Radiology 6 ( 3 ) 69 - 74 2021年

Image-guided core biopsy of 2-cm or smaller renal tumors 査読

T. Iguchi, T. Hiraki, Y. Matsui, K. Tomita, M. Uka, T. Tanaka, T. Komaki, T. Toji, H. Gobara, S. Kanazawa

Diagnostic and Interventional Imaging 101 ( 11 ) 715 - 720 2020年11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 evaluate diagnostic yield, risk factors for diagnostic failure, and safety of image-guided core biopsy of renal tumors ≤ 2 cm. Materials and methods: Eighty-four biopsies of 84 renal tumors (mean size, 1.5 ± 0.4 [SD] cm; range, 0.6–2.0 cm) from 84 patients (53 men, 31 women; mean age, 61.7 ± 12.7 [SD] years; age range, 34–87 years) were included. All adverse events (AEs) were evaluated based on the CIRSE classification. The 84 procedures were classified as diagnostic or nondiagnostic. Multiple variables related to the patients, tumors, and procedures were assessed to identify variables associated with diagnostic failure. Results: All 84 biopsies (100%) were technically successful, defined as penetration of the target and acquisition of some specimens. Eighty (80/84; 95.2%) biopsy procedures were diagnostic and four (4/84; 4.8%) procedures were nondiagnostic. Among 80 diagnosed renal tumors, 71/80 (88.8%) tumors were malignant (49 clear cell renal cell carcinomas [RCCs], 14 papillary RCCs, 3 chromophobe RCCs, 3 metastatic renal cancers, 1 lymphoma, and 1 unclassified RCC) and 9/80 (11.2%) lesions were benign (5 angiomyolipomas, 3 oncocytomas, and 1 inflammatory lesion). No significant differences existed in any variables between the two groups. A total of 57 (57/84; 67.9%) procedures resulted in 56 Grade 1, 2 Grade 2, and 1 Grade 3 AEs. Conclusion: Image-guided biopsy of renal tumors ≤ 2 cm is safe and has a high diagnostic yield.

DOI： 10.1016/j.diii.2020.07.002

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肺がん診断と治療の最前線 CTガイド下肺アブレーション

松井裕輔, 平木隆夫, 生口俊浩, 冨田晃司, 宇賀麻由, 金澤右

肺癌 60 ( 6 ) 474 - 474 2020年10月

【泌尿器がんに対するfocal therapyの現状と展望】小径腎がんに対する経皮的ラジオ波焼灼療法の現状と展望

平木隆夫, 宇賀麻由, 冨田晃司, 松井裕輔, 生口俊浩, 金澤右, 荒木元朗, 小林泰之, 渡邉豊彦, 郷原英夫

泌尿器科 12 ( 3 ) 233 - 240 2020年9月

Difference in specimen weights with semi-automatic cutting biopsy needles.

Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Toshiharu Mitsuhashi, Toshiyuki Komaki, Soichiro Okamoto, Shogo Fukuma, Koji Tomita, Mayu Uka, Susumu Kanazawa

Japanese journal of radiology 38 ( 6 ) 579 - 586 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To assess specimen weight difference of six types of semi-automatic cutting biopsy needles. MATERIALS AND METHODS: We compared 18- and 20-gauge needles, one aspiration-type (STARCUT® aspiration-type, TSK Laboratory, Tochigi, Japan) and five non-aspiration-type (MISSION®, BARD, AZ; SuperCore™, Argon Medical Devices, TX; Temno Evolution®, Care Fusion, IL; FINE CORE®, Toray Medical, Tokyo, Japan; Quick-Core®, Cook, IN) needles. Four biopsies were performed with each needle with the longest throw length on an excised bovine liver. The biopsies were repeated with new needles, four times with four different livers. STARCUT® was used both with and without aspiration. RESULTS: Sixteen specimens were obtained with each needle. In needles of gauges, STARCUT® with aspiration provided the heaviest specimen and significantly heavier specimens were obtained with STARCUT® with aspiration (P < 0.05) than five non-aspiration-type needles. The specimen weight differed significantly (P < 0.001) among all 18- and 20-gauge needles. The specimen weights did not differ significantly between aspiration and non-aspiration biopsies with STARCUT® (6.32 vs. 5.97 mg with 18-gauge needle, P = 0.342; 1.95 vs. 1.92 mg with 20-gauge needle, P = 0.886). CONCLUSION: Although STARCUT® with aspiration provided the heaviest specimen, specimen weights were not significantly different between aspiration and non-aspiration biopsies. We assessed the specimen weight difference of six types of semi-automatic cutting biopsy needles. Significantly heavier specimens were obtained with STARCUT® with aspiration than the other needles. The specimen weight differed significantly among all 18- and 20-gauge needles but did not differ significantly between aspiration and non-aspiration biopsies with STARCUT®.

DOI： 10.1007/s11604-020-00935-3

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Computed tomography fluoroscopy-guided cutting needle biopsy of pulmonary nodules ≤8 mm: A retrospective study including 117 nodules. 国際誌

Yanqing Zhao, Yusuke Matsui, Takao Hiraki, Toshihiro Iguchi, Koji Tomita, Mayu Uka, Hideo Gobara, Shinichi Toyooka, Susumu Kanazawa

European journal of radiology 125 108903 - 108903 2020年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To evaluate the diagnostic yield and safety of computed tomography (CT) fluoroscopy-guided cutting needle biopsy (CNB) for pulmonary nodules ≤ 8 mm. METHOD: Data of CT fluoroscopy-guided CNB for pulmonary nodules ≤ 8 mm performed in a single institution were retrospectively analyzed. One hundred and seventeen biopsy procedures for 117 pulmonary nodules (mean size, 7.4 mm) in 114 patients were included in the study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. Univariate analyses were performed to elucidate the risk factors for diagnostic failure (i.e., non-diagnostic, false-positive, or false-negative results). Complications were graded per the Clavien-Dindo Classification. RESULTS: One (0.9 %) non-diagnostic biopsy result was found. The diagnostic accuracy was 95.7 % (112/117). The sensitivity and specificity were 95.8 % (91/95) and 95.5 % (21/22), respectively. PPV and NPV were 98.9 % (91/92) and 87.5 % (21/24), respectively. Univariate analyses showed that nodules in the lower lobes (p = 0.006) and prone biopsy position (p = 0.021) were the significant risk factors for diagnostic failure. The incidence of pneumothorax requiring chest tube placement (Grade IIIa) was 6.8 % (8/117). No Grade IIIb or higher complications were observed. CONCLUSION: CT fluoroscopy-guided CNB for pulmonary nodules ≤ 8 mm showed a high diagnostic yield without severe complications.

DOI： 10.1016/j.ejrad.2020.108903

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Percutaneous Gastrojejunostomy Catheter Placement Using a Slow-Leak Balloon through the Reconstructed Gastric Tube after Esophagectomy. 国際誌

Shinichi Morita, Yasuaki Arai, Shunsuke Sugawara, Miyuki Sone, Koji Tomita, Hiroaki Ishii, Shuji Terai

Journal of vascular and interventional radiology : JVIR 31 ( 3 ) 478 - 481 2020年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Twelve patients who had undergone esophageal reconstruction because of cancer and in whom conventional percutaneous radiologic or endoscopic gastrostomy was considered difficult are reported. These patients underwent placement of a percutaneous gastrojejunostomy catheter through the reconstructed gastric tube using a slow-leak balloon that had been developed for percutaneous transesophageal gastrotubing. Retrospective evaluation showed successful outcomes without severe complications in all patients. Eight (66.6%) were able to resume oral intake, which allowed gastrojejunostomy catheter withdrawal in 3 (25%). This technique is feasible with acceptable clinical outcomes for patients who have undergone gastric tube reconstruction after esophagectomy.

DOI： 10.1016/j.jvir.2019.09.009

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Robotic needle insertion during computed tomography fluoroscopy-guided biopsy: prospective first-in-human feasibility trial. 国際誌

Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Jun Sakurai, Toshiyuki Komaki, Takuya Yamaguchi, Koji Tomita, Mayu Uka, Yusuke Matsui, Toshihiro Iguchi, Hideo Gobara, Susumu Kanazawa

European radiology 30 ( 2 ) 927 - 933 2020年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: This was a prospective, first-in-human trial to evaluate the feasibility and safety of insertion of biopsy introducer needles with our robot during CT fluoroscopy-guided biopsy in humans. MATERIALS AND METHODS: Eligible patients were adults with a lesion ≥ 10 mm in an extremity or the trunk requiring pathological diagnosis with CT fluoroscopy-guided biopsy. Patients in whom at-risk structures were located within 10 mm of the scheduled needle tract were excluded. Ten patients (4 females and 6 males; mean [range] age, 72 [52-87] years) with lesions (mean [range] maximum diameter, 28 [14-52] mm) in the kidney (n = 4), lung (n = 3), mediastinum (n = 1), adrenal gland (n = 1), and muscle (n = 1) were enrolled. The biopsy procedure involved robotic insertion of a biopsy introducer needle followed by manual acquisition of specimens using a biopsy needle. The patients were followed up for 14 days. Feasibility was defined as the distance of ≤ 10 mm between needle tip after insertion and the nearest lesion edge on the CT fluoroscopic images. The safety of robotic insertion was evaluated on the basis of machine-related troubles and adverse events according to the Clavien-Dindo classification. RESULTS: Robotic insertion of the introducer needle was feasible in all patients, enabling pathological diagnosis. There was no machine-related trouble. A total of 11 adverse events occurred in 8 patients, including 10 grade I events and 1 grade IIIa event. CONCLUSION: Insertion of biopsy introducer needles with our robot was feasible at several locations in the human body. KEY POINTS: • Insertion of biopsy introducer needles with our robot during CT fluoroscopy-guided biopsy was feasible at several locations in the human body.

DOI： 10.1007/s00330-019-06409-z

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Radiofrequency Ablation for Stage I Non-Small Cell Lung Cancer: An Updated Review of Literature from the Last Decade

Yusuke Matsui, Toshihiro Iguchi, Koji Tomita, Mayu Uka, Jun Sakurai, Hideo Gobara, Susumu Kanazawa

Interventional Radiology 5 ( 2 ) 43 - 49 2020年

Recurring Local Tumor Progression After Cryoablation of Renal Cell Carcinoma

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

Interventional Radiology 5 ( 2 ) 77 - 81 2020年

Computed Tomography Fluoroscopy-guided Core Needle Biopsy of Abdominal Para-aortic Lesions: A Retrospective Evaluation of the Diagnostic Yield and Safety

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

Interventional Radiology 5 ( 3 ) 128 - 133 2020年

Percutaneous thermal ablation for renal cell carcinoma in patients with Birt–Hogg–Dubé syndrome

Y. Matsui, T. Hiraki, H. Gobara, T. Iguchi, K. Tomita, M. Uka, M. Araki, Y. Nasu, M. Furuya, S. Kanazawa

Diagnostic and Interventional Imaging 100 ( 11 ) 671 - 677 2019年11月

掲載種別：研究論文（学術雑誌）

Purpose: The purpose of this study was to analyze the outcome of patients with Birt–Hogg–Dubé (BHD) syndrome who underwent percutaneous thermal ablation of renal cell carcinoma (RCC). Materials and methods: Six patients with genetically proven BHD syndrome who underwent one or more sessions of percutaneous thermal ablation for the treatment of RCC were included. There were 4 men and 2 women, with a mean age of 57.3 ± 7.5 [SD] years (range: 44–67 years). A total of 29 RCCs (1–16 tumors per patient) were treated during 20 thermal ablation sessions (7 with radiofrequency ablation and 13 with cryoablation). Outcomes of thermal ablation therapy were assessed, including technical success, adverse events, local tumor progression, development of metastases, survival after thermal ablation, and changes in renal function. Results: Technical success was achieved in all ablation sessions (success rate, 100%). No grade 4 or 5 adverse events were observed. All patients were alive with no distant metastasis during a median follow-up period of 54 months (range: 6–173 months). No local tumor progression was found. The mean decrease in estimated glomerular filtration rate during follow-up was 10.7 mL/min/1.73 m2. No patients required dialysis or renal transplantation. Conclusion: Radiofrequency ablation and cryoablation show promising results for the treatment of RCCs associated with BHD syndrome. Percutaneous thermal ablation may be a useful treatment option for this rare hereditary condition.

DOI： 10.1016/j.diii.2019.06.009

<冨田 晃司>

論文 - 冨田 晃司

<冨田　晃司>

論文 - 冨田　晃司