研究者詳細 - 冨田　晃司

論文 - 冨田　晃司

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MRI-guided percutaneous needle biopsy with 1.2T open MRI: study protocol for a prospective feasibility study (SCIRO-1701).

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

Nagoya journal of medical science 81 ( 3 ) 463 - 468 2019年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

There has been growing interest in magnetic resonance imaging (MRI)-guided interventional procedures such as percutaneous needle biopsy. Although open MRI is preferable for MRI-guided procedures in terms of patient accessibility, its inferior imaging capability due to lower field strength is a substantial limitation. In this situation, the high-field (1.2T) open MRI has recently become available. This novel MRI system is expected to provide excellent image quality as well as good patient accessibility, potentially contributing to safe and accurate device manipulation. This trial is designed to investigate the feasibility of MRI-guided percutaneous needle biopsy with this system. Patients with lesions needing percutaneous needle biopsy for pathological diagnosis are included. The enrollment of ten patients is intended. The primary endpoint of this study is the feasibility of biopsy needle insertion under real-time MR-fluoroscopy guidance based on the presence of the notch of the biopsy needle within the target lesion. The secondary endpoints are adverse events, device failures, and success of specimen acquisition. Once the feasibility of MRI-guided biopsy with 1.2T open MRI is validated by this study, it may potentially encourage widespread use of MRI-guidance for biopsy procedures. Furthermore, it may lead to development of the other MRI-guided interventional procedures using this MRI system.

DOI： 10.18999/nagjms.81.3.463

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CT透視ガイド下腎凍結療法における患者被曝の検討

松井裕輔, 平木隆夫, 生口俊浩, 冨田晃司, 宇賀麻由, 趙彦清, 山口卓也, 山内崇嗣, 市川大樹, 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 34 ( Suppl. ) 243 - 243 2019年5月

Simultaneous biopsy and radiofrequency ablation of T1a renal cell carcinoma 査読

T. Iguchi, T. Hiraki, K. Tomita, H. Gobara, H. Fujiwara, J. Sakurai, Y. Matsui, S. Kanazawa

DIAGNOSTIC AND INTERVENTIONAL IMAGING 97 ( 11 ) 1159 - 1164 2016年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：ELSEVIER MASSON

Objective: The goal of this study was to retrospectively evaluate the outcome, including feasibility, safety, diagnostic yield, and factors affecting the success of computed tomography fluoroscopy-guided biopsy when performed during the same procedure than radiofrequency ablation (RFA) in renal tumors strongly suspected of being T1a renal cell carcinoma (RCC).
Materials and methods: Nineteen patients (13 men, 6 women; mean age, 66.7 years) with a total of 19 suspected renal tumors (mean diameter, 1.8 cm) underwent computed tomography fluoroscopy-guided biopsy during (n = 6) or immediately after (n = 13) RFA. All patients were strongly suspected of having RCC on the basis of patient's medical histories and/or the results of imaging investigations. All procedures were divided into diagnostic and non-diagnostic biopsies. Various variables were compared between the 2 groups using univariate analysis.
Results: In all tumors, biopsy procedures were technically feasible. No major complications were observed, except for 8 minor post-procedural bleedings. All but one tumor was completely ablated. Local recurrence in the ablation zone as well as tumor seeding in retroperitoneal fat occurred in 1 patient 8.5 months after the procedure and were successfully treated with further percutaneous cryoablation. Thirteen tumors were diagnosed as RCC, whereas 6 were ultimately found to contain normal renal tissue (n = 5) or connective tissue (n = 1). Univariate analysis revealed that none of the variables were significantly different between the diagnostic and non-diagnostic biopsies.
Conclusion: The performance of renal tumor biopsy and RFA in the same session is feasible and safe. Although pre-treatment pathological diagnosis would be generally desirable, simultaneous biopsy with RFA can be an option for the patients who are not amenable to pre-treatment biopsy. (C) 2016 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

DOI： 10.1016/j.diii.2016.05.001

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Angio-CT-Assisted Balloon Dissection: Protection of the Adjacent Intestine during Cryoablation for Patients with Renal Cancer. 国際誌

Miyuki Sone, Yasuaki Arai, Shunsuke Sugawara, Koji Tomita, Keishi Fujiwara, Hiroaki Ishii, Shinichi Morita

Journal of vascular and interventional radiology : JVIR 27 ( 9 ) 1414 - 1419 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

The present study describes the technical feasibility of a combined-modality angiography/computed tomography (angio-CT)-assisted balloon dissection technique for bowel protection during renal cryoablation in six procedures in five patients. A retrospective review was performed to evaluate balloon dissection using the angio-CT system. Mean bowel-to-tumor distances before and after balloon dissection were 0.9 mm (range, 0-3 mm) and 13.0 mm (range, 11-17 mm), respectively. No bowel injury was observed during the mean follow-up period of 19 months (range, 7-44 mo). Our preliminary experience suggests that balloon dissection using the angio-CT system for bowel protection during renal cryoablation may be feasible and effective.

DOI： 10.1016/j.jvir.2016.02.028

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Evaluation of Lung Radiofrequency Ablation With Dual-Energy Computed Tomography: Analysis of Tumor Composition and Lung Perfusion

Koji Tomita, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Toshihiro Iguchi, Yusuke Matsui, Susumu Kanazawa

JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 40 ( 5 ) 752 - 756 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS

Objective The aim of this study was to evaluate radiofrequency ablation (RFA) of lung tumors with dual-energy computed tomography while focusing on tumor composition and lung perfusion.Methods The 36 tumors in 25 patients were included. Dual-energy computed tomography was performed before RFA and at 2 days and 1, 3, and 6 months thereafter. The effective atomic number (Z(eff)) of the tumors before RFA was compared with the Z(eff) at each follow-up using the paired t test. Lung perfusion was evaluated by iodine map images. When decreased perfusion was suspected after RFA, lung perfusion scintigraphy was performed.Results The mean Z(eff) of the tumors significantly (P < 0.001) decreased at each follow-up, compared with that before RFA. Lung perfusion in the parenchyma peripheral to the tumors appeared to decrease at 2 days in 9 tumors, which was confirmed by scintigraphy in 7 tumors.Conclusions Dual-energy computed tomography was useful by providing additional information on tumor composition and lung perfusion.

DOI： 10.1097/RCT.0000000000000422

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Hepatic Intracystic Organizing Hematoma Mimicking Biliary Cystadenocarcinoma in a Patient with Polycystic Liver Disease.

Takashi Tanaka, Hideo Gobara, Koji Tomita, Takao Hiraki, Takehiro Tanaka, Susumu Kanazawa

Internal medicine (Tokyo, Japan) 54 ( 16 ) 2001 - 5 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

Hepatic intracystic hemorrhage is a rare complication of polycystic liver diseases, such as autosomal dominant polycystic kidney disease (ADPKD). A hepatic cyst with mural nodules and septation may suggest the presence of a cystic malignancy, such as biliary cystadenocarcinoma. We herein report a case of hepatic intracystic hematoma with a mural nodule mimicking biliary cystadenocarcinoma in a patient with ADPKD. Hepatic intracystic hemorrhage with a mural nodule is a very rare occurrence. A fat-saturated T1-weighted magnetic resonance image may be useful for making an accurate diagnosis of intracystic hematoma.

DOI： 10.2169/internalmedicine.54.4218

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Lung cancer ablation: complications. 国際誌

Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Hiroaki Ishii, Koji Tomita, Mayu Uka, Satoko Makimoto, Susumu Kanazawa

Seminars in interventional radiology 30 ( 2 ) 169 - 75 2013年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Although radiofrequency ablation for lung cancer is generally safe (with a mortality rate <1%), it may cause various complications. Common complications include pneumothorax, pleural effusion, and parenchymal hemorrhage. Although most complications can be treated conservatively or with minimal therapy, physicians should be aware of rare but serious complications. Potentially fatal complications include massive hemorrhage, intractable pneumothorax due to bronchopleural fistula, pulmonary artery pseudoaneurysm, systemic air embolism, and pneumonitis. Other serious complications include injury to the nearby tissues (e.g., brachial nerve plexus, phrenic nerve, diaphragm, and chest wall), needle tract seeding, lung abscess, empyema, and skin burn. Although cavitation of the ablation zone is usually insignificant clinically, such a cavity occasionally ruptures, leading to pneumothorax and bleeding. Cavities may also serve as a scaffold for fungal colonization. Precautions to minimize risk should be taken whenever possible. Nevertheless, serious complications may occur, and thus physicians should be aware of the appropriate treatments for these complications. This article reviews complications associated with lung cancer ablation.

DOI： 10.1055/s-0033-1342958

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