Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) is undertaking a major revision of ICH E6 Good Clinical Practice (GCP) decided to involve external stakeholders in ICH-GCP renovation. Activities such as surveys and public conferences have taken place in the United States, European Union, and Japan. For stakeholder engagement in Japan, a designated research group conducted a survey of academic stakeholders.


</sec><sec>
<title>Methods</title>
A total of 105 academic stakeholders from 18 institutions responded to the survey. The research group developed recommendations reflecting the survey results and the opinions from patients and the public.


</sec><sec>
<title>Results</title>
The survey showed the top four principles needing renovation were (i) informed consent (Chapter 2.9, 12.4% of respondents believed it needed renovation), (ii) systems for quality assurance (Chapter 2.13, 9.5%), (iii) information on an investigational product (Chapter 2.4, 5.7%), and (iv) procedures on clinical trial information (Chapter 2.10, 5.7%). The top three sections identified as needing renovation were: (i) informed consent (Chapter 4.8, 27.6%), (ii) monitoring (Chapter 5.18, 22.9%), and (iii) composition, functions, and operations of the ethics committee (Chapter 3.2, 14.3%). Recommendations included clarification of ICH-GCP’s scope, proportionality in various aspects of clinical trials, diversity and liquidity of ethics committee members, modernization of informed consent procedures, variations in monitoring, and regulatory grade when using real-world data.


</sec><sec>
<title>Conclusion</title>
The recommendations from Japanese investigators and patients have been submitted to the ICH E6 Expert Working Group, which will strengthen the robustness of the GCP renovation.


</sec>

DOI： 10.1007/s43441-021-00350-4

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1007/s43441-021-00350-4/fulltext.html

Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s11604-021-01211-8

researchmap

Other Link： https://link.springer.com/article/10.1007/s11604-021-01211-8/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

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.

DOI： 10.1007/s00270-021-02876-4

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To retrospectively compare the outcomes of radiofrequency (RF) ablation, stereotactic body radiotherapy (SBRT), and sublobar resection (SLR) in patients with stage I non-small-cell lung cancer (NSCLC) at a single center. MATERIALS AND METHODS: Overall, 289 patients (38 RF ablation, 58 SBRT, and 193 SLR) were included. Kaplan-Meier curves were generated, multiple propensity score was estimated using a multinomial logistic regression model, and relationships between treatments and outcomes were assessed using a Cox proportional hazard model. Hazard ratios (HRs) for death from any cause and disease progression or death from any cause were examined by a crude model, an inverse probability of treatment weighting (IPTW) model, and an IPTW model adjusted for missing variables. RESULTS: The 5-year overall and progression-free survival rates were 58.9% and 39.9%, respectively, for RF ablation; 42.0% and 34.9%, respectively, for SBRT; and 85.5% and 75.9%, respectively, for SLR. Significantly longer survival time and lower HR were observed for SLR than other treatments. However, after statistical adjustment, these relationships were not significant except for reduced HR of disease progression or death from any cause of SLR compared to RF ablation in the IPTW model. The median hospital stays for RF ablation, SBRT, and SLR were 6.5, 6, and 16 days, respectively. Adverse events of grade 3 or higher occurred only in 11 SLR cases. CONCLUSIONS: SLR achieved the longest survival. However, after statistical adjustment, there were no significant outcome differences among RF ablation, SBRT, and SLR, except for 1 model. RF ablation or SBRT may be alternative treatments for selected patients with early-stage NSCLC.

DOI： 10.1016/j.jvir.2019.11.035

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

An aspiration-type semi-automatic cutting biopsy needle enables tissue cutting during application of negative pressure, which is expected to contribute to a larger amount of specimen. The aim of the present study was to evaluate this novel needle in a clinical setting. Patients who underwent image-guided percutaneous biopsy for lung or renal masses were enrolled. Cutting biopsy was performed with and without aspiration during each procedure. The specimens were weighed using an electronic scale. The weights were compared between specimens obtained with and without aspiration using a paired t-test. The data from 45 lung and 30 renal biopsy procedures were analyzed. In lung biopsy, the mean±standard deviation weights of specimens obtained with and without aspiration were 2.20±1.05 mg and 2.24±1.08 mg, respectively. In renal biopsy, the mean weights were 6.52±2.18 mg and 6.42±1.62 mg, respectively. The weights were not significantly different between specimens obtained with and without aspiration either in lung (p=0.799) or renal (p=0.789) biopsies. The application of negative pressure with the aspiration-type semi-automatic cutting biopsy needle did not contribute to an increase in the amount of the specimen obtained in lung and renal biopsies.

DOI： 10.18926/AMO/59951

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To prospectively evaluate the efficacy and safety of embolization using hydrogel-coated coils for the treatment of pulmonary arteriovenous malformations (PAVMs). MATERIALS AND METHODS: The outcomes of 21 PAVMs in 19 patients (3 men and 16 women; mean age, 58.8±15.2 [SD] years; age range 14-78 years) treated by venous sac embolization (VSE) with additional feeding artery embolization were prospectively evaluated. For VSE, using one or more 0.018-inch hydrogel-coated coils was mandatory. Recanalization and/or reperfusion were evaluated by pulmonary arteriography 1 year after embolization. RESULTS: The mean feeding artery and venous sac sizes were 4.0mm and 8.5mm, respectively. Embolization was successfully completed in 20/21 PAVMs, yielding a technical success rate of 95%. The feeding artery was also embolized in 17/20 successful PAVMs (85%). A technical failure occurred in one PAVM, where embolization was abandoned because of migration of one bare coil to the left ventricle. The mean numbers of hydrogel-coated coils and bare platinum detachable coils used for VSE were 3.3±2.1 (SD) (range, 1-8) and 4.4±3.9 (SD) (range, 1-17), respectively. The mean percentages of hydrogel-coated coils in number, length, and estimated volume were 42.9%, 33.3%, and 72.7% respectively. One patient with one PAVM was lost to follow-up after 3 months. Neither recanalization nor reperfusion was noted in the remaining 19 PAVMs (success rate, 19/19 [100%]). One grade 4 (coil migration) adverse event occurred, and it was treated without any sequelae. CONCLUSION: VSE using hydrogel-coated coils with additional feeding artery embolization is a safe and effective treatment for PAVM.

DOI： 10.1016/j.diii.2019.10.008

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To evaluate the accuracy of robotic CT-guided out-of-plane needle insertion in phantom and animal experiments. METHODS: A robotic system (Zerobot), developed at our institution, was used for needle insertion. In the phantom experiment, 12 robotic needle insertions into a phantom at various angles in the XY and YZ planes were performed, and the same insertions were manually performed freehand, as well as guided by a smartphone application (SmartPuncture). Angle errors were compared between the robotic and smartphone-guided manual insertions using Student's t test. In the animal experiment, 6 robotic out-of-plane needle insertions toward targets of 1.0 mm in diameter placed in the kidneys and hip muscles of swine were performed, each with and without adjustment of needle orientation based on reconstructed CT images during insertion. Distance accuracy was calculated as the distance between the needle tip and the target center. RESULTS: In the phantom experiment, the mean angle errors of the robotic, freehand manual, and smartphone-guided manual insertions were 0.4°, 7.0°, and 3.7° in the XY plane and 0.6°, 6.3°, and 0.6° in the YZ plane, respectively. Robotic insertions in the XY plane were significantly (p < 0.001) more accurate than smartphone-guided insertions. In the animal experiment, the overall mean distance accuracy of robotic insertions with and without adjustment of needle orientation was 2.5 mm and 5.0 mm, respectively. CONCLUSION: Robotic CT-guided out-of-plane needle insertions were more accurate than smartphone-guided manual insertions in the phantom and were also accurate in the in vivo procedure, particularly with adjustment during insertion. KEY POINTS: • Out-of-plane needle insertions performed using our robot were more accurate than smartphone-guided manual insertions in the phantom experiment and were also accurate in the in vivo procedure. • In the phantom experiment, the mean angle errors of the robotic and smartphone-guided manual out-of-plane needle insertions were 0.4° and 3.7° in the XY plane (p < 0.001) and 0.6° and 0.6° in the YZ plane (p = 0.65), respectively. • In the animal experiment, the overall mean distance accuracies of the robotic out-of-plane needle insertions with and without adjustments of needle orientation during insertion were 2.5 mm and 5.0 mm, respectively.

DOI： 10.1007/s00330-019-06477-1

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To prospectively investigate the incidence, severity, duration, and effect on lifestyle of post-ablation syndrome (PAS) after percutaneous renal cryoablation. MATERIALS AND METHODS: We enrolled 39 patients (27 male and 12 female; mean age, 62 years) who underwent 40 CT-guided cryoablation sessions for pathologically proven renal cancer (mean size, 20 mm) between December 2015 and December 2017. Four symptoms attributable to PAS, i.e., fever, nausea, vomiting, malaise, and the synergistic effect of these symptoms on lifestyle by 21 days after ablation were evaluated using a questionnaire. Symptoms were graded according to the common toxicity criteria of adverse events. RESULTS: The incidences of fever, nausea, vomiting, and malaise were 100% (40/40), 20% (8/40), 20% (8/40), and 63% (25/40), respectively. Most (78/81, 96%) symptoms had begun by day 2. The highest grade of fever per session was 0 (defined as ≥37.0 °C and <38.0 °C) (n = 24), 1 (n = 15), or 2 (n = 1); that of nausea was 2 (n = 8); that of vomiting was 1 (n = 7) or 3 (n = 1); and that of malaise was 1 (n = 14) or 2 (n = 11). Most (76/81, 94%) symptoms had resolved by day 8. The average values for the maximum scores of interference with general activity and work were 3.6 and 1.1, respectively. CONCLUSION: All symptoms were generally early-onset and self-limiting, with minimal impact on lifestyle and resolution by day 8. The clinical course and impact of PAS should be acknowledged by practitioners who manage patients undergoing renal cryoablation.

DOI： 10.1016/j.ejrad.2019.108750

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Interventional Radiology  

DOI： 10.22575/interventionalradiology.2020-0007

researchmap

Language：English  

DOI： 10.1016/j.diii.2019.06.001

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Since 2012, we have been developing a remote-controlled robotic system (Zerobot®) for needle insertion during computed tomography (CT)-guided interventional procedures, such as ablation, biopsy, and drainage. The system was designed via a collaboration between the medical and engineering departments at Okayama University, including various risk control features. It consists of a robot with 6 degrees of freedom that is manipulated using an operation interface to perform needle insertions under CT-guidance. The procedure includes robot positioning, needle targeting, and needle insertion. Phantom experiments have indicated that robotic insertion is equivalent in accuracy to manual insertion, without physician radiation exposure. Animal experiments have revealed that robotic insertion of biopsy introducer needles and various ablation needles is safe and accurate in vivo. The first in vivo human trial, therefore, began in April 2018. After its completion, a larger clinical study will be conducted for commercialization of the robot. This robotic procedure has many potential advantages over a manual procedure: 1) decreased physician fatigue; 2) stable and accurate needle posture without tremor; 3) procedure automation; 4) less experience required for proficiency in needle insertion skills; 5) decreased variance in technical skills among physicians; and 6) increased likelihood of performing the procedure at remote hospitals (i.e., telemedicine).

DOI： 10.18926/AMO/56370

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ireland Ltd  

Objective: To evaluate the accuracy of robotic insertion of various ablation needles at various locations under computed tomography (CT) guidance in swine. Materials and methods: The robot was used for CT-guided insertion of four ablation needles, namely a single internally cooled radiofrequency ablation (RFA) needle (Cool-tip), a multi-tined expandable RFA needle (LeVeen), a cryoablation needle (IceRod), and an internally cooled microwave ablation needle (Emprint). One author remotely operated the robot with the operation interface in order to orient and insert the needles under CT guidance. Five insertions of each type of ablation needle towards 1.0-mm targets in the liver, kidney, lung, and hip muscle were attempted on the plane of an axial CT image in six swine. Accuracy of needle insertion was evaluated as the three-dimensional length between the target centre and needle tip. The accuracy of needle insertion was compared according to the type of needle used and the location using one-way analysis of variance. Results: The overall mean accuracy of all four needles in all four locations was 2.8 mm. The mean accuracy of insertion of the Cool-tip needle, LeVeen needle, IceRod needle, and Emprint needle was 2.8 mm, 3.1 mm, 2.5 mm, and 2.7 mm, respectively. The mean accuracy of insertion into the liver, kidney, lung, and hip muscle was 2.7 mm, 2.9 mm, 2.9 mm, and 2.5 mm, respectively. There was no significant difference in insertion accuracy among the needles (P =.38) or the locations (P =.53). Conclusion: Robotic insertion of various ablation needles under CT guidance was accurate regardless of type of needle or location in swine.

DOI： 10.1016/j.ejrad.2018.06.006

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Retinal prosthesis or artificial retina is a promising modality of treatment for outer retinal degeneration, caused by primary and secondary loss of photoreceptor cells, in hereditary retinal dystrophy and age-related macular degeneration, respectively. Okayama University-type retinal prosthesis (OUReP) is a photoelectric dye-coupled polyethylene film which generates electric potential in response to light and stimulates nearby neurons. The dyecoupled films were implanted by vitreous surgery in the subretinal space of monkey eyes with macular degeneration which had been induced by cobalt chloride injection from the scleral side. A pilot 1-month observation study involved 6 monkeys and a pivotal 6-month observation study involved 8 monkeys. Of 8 monkeys in 6-month group, 3 monkeys underwent dye-coupled film removal at 5 months and were observed further for 1 month. The amplitude of visual evoked potential which had been reduced by macular degeneration did recover at 1 month after film implantation and maintained the level at 6 months. Optical coherence tomography showed no retinal detachment, and full-field electroretinograms maintained a-wave and b-wave amplitudes, indicative of no retinal toxicity. Pathological examinations after 6-month implantation showed structural integrity of the inner retinal layer in close apposition to dye-coupled films. The implanted films which were removed by vitrectomy 5 months later showed light-evoked surface electric potentials by scanning Kelvin probe measurement. The photoelectric dye-coupled film (OUReP), which serves as a light-receiver and a displacement current generator in the subretinal space of the eye, has a potential for recovering vision in diseases with photoreceptor cell loss, such as retinitis pigmentosa and age-related macular degeneration.

DOI： 10.1111/aor.13120

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Masson SAS  

Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men
mean [± standard deviation] age, 53.8 ± 20.0 years
range, 14–88 years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Results: Seventy-one biopsies (71 masses
mean size, 67.5 ± 27.3 mm
range 8.6–128.2 mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4% overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2%) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3%) masses
the 63 masses diagnosed successfully included thymic carcinoma (n = 17), lung cancer (n = 14), thymoma (n = 12), malignant lymphoma (n = 11), germ cell tumor (n = 3), and others (n = 6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P = 0.039). Conclusion: CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield
however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis.

DOI： 10.1016/j.diii.2017.10.007

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy.
Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ae&lt;currency&gt;4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure.
After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ae&lt;yen&gt;IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (ae&lt;currency&gt;1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure.
CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (ae&lt;currency&gt;1.5 cm) is a significant risk factor for diagnostic failure.
aEuro cent CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield.
aEuro cent CT fluoroscopy-guided renal tumour biopsy is safe.
aEuro cent Small tumour size (ae&lt;currency&gt;1.5 cm) is a risk factor for diagnostic failure.

DOI： 10.1007/s00330-017-4969-7

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：RADIOLOGICAL SOC NORTH AMERICA  

Purpose: To evaluate the accuracy of the remote-controlled robotic computed tomography (CT)-guided needle insertion in phantom and animal experiments.
Materials and Methods: In a phantom experiment, 18 robotic and manual insertions each were performed with 19-gauge needles by using CT fluoroscopic guidance for the evaluation of the equivalence of accuracy of insertion between the two groups with a 1.0-mm margin. Needle insertion time, CT fluoroscopy time, and radiation exposure were compared by using the Student t test. The animal experiments were approved by the institutional animal care and use committee. In the animal experiment, five robotic insertions each were attempted toward targets in the liver, kidneys, lungs, and hip muscle of three swine by using 19-gauge or 17-gauge needles and by using conventional CT guidance. The feasibility, safety, and accuracy of robotic insertion were evaluated.
Results: The mean accuracies of robotic and manual insertion in phantoms were 1.6 and 1.4 mm, respectively. The 95% confidence interval of the mean difference was 20.3 to 0.6 mm. There were no significant differences in needle insertion time, CT fluoroscopy time, or radiation exposure to the phantom between the two methods. Effective dose to the physician during robotic insertion was always 0 mSv, while that during manual insertion was 5.7 mSv on average (P&lt;.001). Robotic insertion was feasible in the animals, with an overall mean accuracy of 3.2 mm and three minor procedure-related complications.
Conclusion: Robotic insertion exhibited equivalent accuracy as manual insertion in phantoms, without radiation exposure to the physician. It was also found to be accurate in an in vivo procedure in animals. (C) RSNA, 2017

DOI： 10.1148/radiol.2017162856

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER MASSON  

Purpose: To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm.
Materials and methods: A total of 26 patients (15 men, 11 women; mean age, 61.5 years +/- 13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance &lt; 10 mm) were included. Mean tumor diameter was 11.0 mm +/- 5.3 (SD) (range, 2-23 mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade &gt;= 3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0, were compared between patients with lung tumors near the diaphragm and a control group of patients with more distally located lung tumors (i.e., distance &gt;= 10 mm).
Results: RFA was technically feasible for all tumors near the diaphragm. Four grade 3 adverse events (1 pneumothorax requiring pleurodesis and 3 phrenic nerve injuries) were observed. No grade &gt;= 4 adverse events were reported. The median follow-up period for tumors near the diaphragm was 18.3 months. Local progression was observed 3.3 months after RFA in 1 tumor. The technique efficacy rates were 96.2% at 1 year and 96.2% at 2 years and were not different, from those observed in control subjects (186 tumors; P = 0.839). Shoulder pain (P &lt; 0.001) and grade 1 pleural effusion (P &lt; 0.001) were more frequently observed in patients with lung tumor near the diaphragm. The rates of grade &gt;= 3 adverse events did not significantly differ between tumors near the diaphragm (4/26 sessions) and the controls (7/133 sessions) (P = 0.083).
Conclusion: RFA is a feasible and effective therapeutic option for lung tumors located near the diaphragm. However, it conveys a higher rate of shoulder pain and asymptomatic pleural effusion by comparison with more distant lung tumors. (C) 2017 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

DOI： 10.1016/j.diii.2017.01.008

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To retrospectively evaluate the effect of cryoablation of renal-cell carcinoma on nearby renal cysts with the goal to investigate the potential for an alternative therapy to treat symptomatic renal cysts.
Materials and Methods: The study population comprised 46 cysts (mean size, 12 mm; range, 5-43 mm) that were within or near the ice ball during cryoablation in 22 patients. Size change of each cyst was evaluated via enhanced CT or MR imaging before and 1, 3, 6, and 12 months after cryoablation. Forty-one cysts were also followed after 12 months. Variables including positional relationship between the cyst and the ice ball were evaluated via linear regression analysis using generalized estimating equation models to determine which factors affected cyst shrinkage rate at 12 months.
Results: Fifteen, 12, and 19 cysts were completely included in, partially included in, or excluded from the ice ball, respectively. The overall shrinkage rate was 62%, and 57% of cysts (26 of 46) had disappeared at 12 months. Only the relationship between the cyst and the ice ball was significantly (P &lt; .001) associated with cyst shrinkage rate. Cyst disappearance rates at 12 months were 100% (15 of 15), 67% (8 of 12), and 16% (3 of 19) for cysts completely included, partially included, and excluded from the ice ball, respectively: Among the 22 cysts that disappeared at 12 months and continued to be followed, none recurred after 12 months.
Conclusions: All renal cysts that were completely included in the ice ball disappeared after cryoablation, demonstrating the potential utility of cryoablation as an alternative therapy for symptomatic renal cysts.

DOI： 10.1016/j.jvir.2017.02.027

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

This retrospective, single-center study evaluated radiofrequency (RF) ablation for pulmonary metastases of sarcoma.
Forty-six patients with sarcoma (144 pulmonary metastases) underwent 88 RF ablation sessions. Data regarding local tumor progression, efficacy, procedural adverse events (AEs; National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0), overall survival (OS), and OS-associated prognostic factors were retrospectively evaluated using univariate analyses.
Local progression occurred in 22 of 144 tumors (15.3%). Primary and secondary efficacy rates were 83.5 and 90.0% at 1 year and 76.3 and 81.4% at 2 years, respectively. Seventy-three grade 1 AEs, 33 grade 2 AEs, and no grade &gt;= 3 AEs were observed. Twenty-eight patients (60.9%) remained alive and 18 died, yielding 1-, 2-, and 3-year OS rates of 80.6, 70.1, and 47.1% (median survival time, 31.7 months). Univariate analysis revealed extrapulmonary metastasis (P = 0.005), noncurative RF ablation (P = 0.009), and a post-RF ablation disease-free interval of &lt;= 12 months (P = 0.015) as significant negative prognostic factors.
RF ablation is safe, offers good local control, and may be a viable treatment option for pulmonary metastasis of sarcoma.

DOI： 10.1007/s11604-016-0601-z

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS LTD  

Purpose: To retrospectively evaluate the safety and diagnostic yield of needle biopsy of small renal tumors, and the clinical consequences of performing needle biopsy in patients referred for percutaneous cryoablation before their treatment.
Material and methods: Biopsy was performed for 120 tumors (mean diameter, 2.2 cm) in 119 patients. All procedures were divided into diagnostic and non-diagnostic biopsies. Various variables were compared between the two groups. All cryoablation procedures were divided into two groups: procedures with or without simultaneous biopsy. The rates of benign or non-diagnostic tumors in each group were compared.
Results: After performing 120 initial and eight repeat biopsies, Grade 1 bleedings occurred in 44 cases. Six tumors were non-diagnostic and 114 were pathologically diagnosed. There were no significant variables between the diagnostic and non-diagnostic biopsies. Unnecessary cryoablation was avoided in nine benign lesions by performing biopsy in advance. Cryoablation performed simultaneously with biopsy included significantly more benign or non-diagnostic tumors than cryoablation performed after biopsy (15.2% vs. 1.4%; p =.01).
Conclusions: Percutaneous biopsy of small renal tumors referred for cryoablation was a safe procedure with high diagnostic yield. The confirmation of pathological diagnosis prior to cryoablation is necessary because patients with benign tumors can avoid unnecessary treatment.

DOI： 10.1080/13645706.2016.1249889

Web of Science

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Interventional Radiology  

DOI： 10.22575/interventionalradiology.2017-0010

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Interventional Radiology  

DOI： 10.22575/interventionalradiology.2.1_14

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：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

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OKAYAMA UNIV MED SCHOOL  

This single center prospective study is being conducted to evaluate the safety of the cryoablation for patients with pathologically diagnosed painful bone and soft tissue tumors. Enrollment of 10 patients is planned over the 3-year recruitment period. Patients have related local pain after receiving medications or external radiation therapies will be included in this study. Cryoablation will be percutaneously performed under imaging guidance, and a temperature sensor will be used during treatment as necessary. The primary endpoint is prevalence of severe adverse events within 4 weeks after therapy. The secondary endpoint is effectiveness 4 weeks after the procedure.

DOI： 10.18926/AMO/54509

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OKAYAMA UNIV MED SCHOOL  

The present single center prospective phase II clinical trial is designed to evaluate the efficacy and safety of percutaneous radiofrequency (RF) ablation for colorectal lung metastases. Patients who have colorectal lung metastases without extrapulmonary metastases are included in this study. The primary endpoint is 3-year overall survival (OS) after RF ablation. The secondary endpoints are the prevalence of adverse events within 4 weeks, local tumor progression rate, 1- and 5-year OS, cause-specific survival, and relapse-free survival. The recruitment of patients commenced in July 2014, and the enrolment of 45 patients is intended over the 3 years of study period.

DOI： 10.18926/AMO/54512

Web of Science

PubMed

researchmap

Language：English   Publisher：OKAYAMA UNIV MED SCHOOL  

The application of radiofrequency ablation for the treatment of lung cancer by our group at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences began in June 2001, and in the present report, we review our 10-year experience with this treatment modality at Okayama University Hospital. The local efficacy of radiofrequency ablation for the treatment of lung cancer depends on tumor size and the type of electrode used, but not on tumor type. An important factor for the prevention of local failure may be the acquisition of an adequate ablative margin. The combination of embolization and radiation therapy enhances the local efficacy. Local failure may be salvaged by repeating the radiofrequency ablation, particularly in small tumors. Survival rates after radiofrequency ablation are quite promising for patients with clinical stage I non-small cell lung cancer and pulmonary metastasis from colorectal cancer, hepatocellular carcinoma, and renal cell carcinoma. The complications caused by radiofrequency ablation can be treated conservatively in the majority of cases. However, attention should be paid to rare but serious complications. This review shows that radiofrequency ablation is a promising treatment for patients with lung cancer.

DOI： 10.18926/AMO/47010

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

We describe a case of pulmonary artery (PA) pseudoaneurysm related to radiofrequency ablation (RFA) of lung tumor. We performed RFA for a pulmonary epithelioid hemangioendothelioma directly adjacent to a branch of the PA. Seventeen days later, the patient complained of hemoptysis. A chest CT image revealed PA pseudoaneurysm. Transcatheter coil embolization was performed 59 days after RFA. Although PA pseudoaneurysm is rare, with an incidence of 0.2% (1/538 sessions) at our institution, it should be recognized as a risk when treating lung tumors adjacent to a branch of the PA.

DOI： 10.1007/s00270-009-9565-z

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To determine which lung metastases are most likely to be treated effectively with a single radiofrequency (RF) application (defined as two separate applications of RF energy at a single electrode position) with a multitined expandable electrode with arrays 2 cm in diameter.
MATERIALS AND METHODS: The authors retrospectively evaluated 88 lung metastases (mean long-axis diameter, 0.9 cm) in 36 patients (20 men and 16 women; mean age, 57 years) treated with a single RF application with a multitined expandable electrode with arrays 2 cm in diameter. Based on follow-up computed tomographic examinations, the technique effectiveness rates were estimated with Kaplan-Meier analysis. Multiple variables were analyzed with the log-rank test to determine risk factors for local progression. Then, the technique effectiveness rates were again estimated when considering only metastases without risk factors and compared with those of other tumors.
RESULTS: The median follow-up period was 13.2 months (range, 6.0-24.7 months). Tumor size greater than 1.0 cm (P = .033) and contact with the bronchus with an inner diameter of at least 2 mm (P = .047) were the significant risk factors for local progression. The technique effectiveness rates for metastases 1.0 cm or smaller that were not in contact with the bronchus (n = 59) were 96% at 1 year and at 2 years; those rates were significantly (P = .010) higher than those in other tumors (n = 29).
CONCLUSIONS: A single RF application with a multitined expandable electrode with arrays 2 cm in diameter is most likely to suffice in small (&lt;= 1 cm) lung metastases not in contact with a bronchus.

DOI： 10.1016/j.jvir.2009.09.028

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JPN SOC MAGNETIC RESONANCE IN MEDICINE  

Chronic expanding hematoma is rare and occasionally misdiagnosed as malignant neoplasm. We describe a case in the female pelvis and correlate findings from pathology and magnetic resonance imaging. On diffusion-weighted images (DWI), our patient's hematoma showed 2 different signal intensities, which corresponded to pathological features of fresh and altered blood components. DWI can distinguish between such pathological features of a chronic expanding hematoma.

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER COLL CHEST PHYSICIANS  

Background: Although conventional CT scan-guided needle biopsy is an established diagnostic method for pulmonary lesions, few large studies have been conducted on the diagnostic outcomes of CT fluoroscopy-guided lung biopsy. We have conducted a retrospective analysis to evaluate the diagnostic outcomes of 1,000 CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles.
Methods: We determined the diagnostic yield of CT fluoroscopy-guided lung biopsies performed with 20-gauge coaxial cutting needles for 1,000 lesions in 901 patients. Independent risk factors for diagnostic failure (ie, nondiagnostic, false-positive, and false-negative results) were determined with multivariate logistic regression analysis.
Results: The biopsy results were nondiagnostic in 0.6% of the lesions (6 of 1,000 lesions). The sensitivity and specificity for the diagnosis of malignancy was 94.2% (741 of 787 lesions) and 99.1% (211 of 213 lesions), respectively; diagnostic accuracy was 95.2% (952 of 1,000 lesions). For lesions measuring &lt;= 1.0 cm, the diagnostic accuracy was 92.7% (140 of 151 lesions). The significant independent risk factors for diagnostic failure were as follows: the acquisition of two or fewer specimens (odds ratio [OR], 2.43; p = 0.007), lesions in the lower lobe (OR, 2.50; p = 0.003), malignant lesions (OR, 7.16; p = 0.007), and lesions measuring &lt;= 1.0 cm (OR, 3.85; p = 0.016) and &gt;= 3.1 cm (OR, 4.32; p = 0.007).
Conclusions: CT fluoroscopy-guided lung biopsy performed with 20-gauge coaxial cutting needles resulted in a high diagnostic yield, even in the case of small lesions. Factors such as the acquisition of two or fewer specimens, lesions in the lower lobe, malignant lesions, and lesions measuring &lt;= 1.0 cm or &gt;= 3.1 cm significantly increased the rate of diagnostic failure. (CHEST 2009; 136:1612-1617)

DOI： 10.1378/chest.09-0370

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Tuberous sclerosis complex (TSC) is an autosomal-dominant disorder characterized by seizures, mental retardation, and various hamartomatous lesions including renal angiomyolipoma (AML) and pulmonary lymphangioleiomyomatosis. A 22-year-old woman with TSC presented with multiple renal AMLs exceeding 4 cm in diameter. She underwent two transcatheter embolization procedures with a mixture of ethanol and iodized oil. She complained of dyspnea and minor hemoptysis 4 and 6 hours after the procedure. Findings on chest radiographs and computed tomographic images were indicative of pulmonary edema. The patient was treated with conservative therapy. The possible causes of the pulmonary edema are discussed in the text.

DOI： 10.1016/j.jvir.2009.02.019

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OKAYAMA UNIV MED SCHOOL  

The present study was performed to clarify the effect of hypertonic saline infusion into the lung parenchyma on radiofrequency ablation (RFA) of the lungs. A total of 20 ablation zones were created in 3 pigs. The ablation zones were divided into 3 groups. Group 1 (n = 6) consisted of ablation zones created by applying smaller radiofrequency (RF) power without saline infusion; group 2 (n = 5) zones were created by applying greater RF power without saline infusion; and group 3 (n = 9) zones were created by applying greater RF power with saline infusion. The techniques of saline infusion included administration of hypertonic saline 1 ml before RFA, followed by continuous administration at a rate of 1 ml/min during the first 2 min after the initiation of RFA. The ablation parameters and coagulation necrosis volumes were compared among the groups. Group 3 had a tendency toward smaller mean impedance than group 1 (p = 0.059) and group 2 (p = 0.053). Group 3 showed significantly longer RF application time than group 2 (p = 0.004) and significantly greater maximum RF power than group 1 (p = 0.001) and group 2 (p = 0.004). Group 3 showed significantly larger coagulation necrosis volume (mean, 1,421 mm(3)) than group 2 (mean, 858 mm(3), p = 0.039) and had a tendency toward larger necrosis volume than group 1 (mean, 878 mm(3), p = 0.077). Although this small study had limited statistical power, hypertonic saline infusion during RFA appeared to enlarge coagulation necrosis of the lung parenchyma.

DOI： 10.18926/AMO/31848

Web of Science

PubMed

researchmap

Language：English   Publisher：SPRINGER  

DOI： 10.1007/s00270-008-9436-z

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

The authors describe two cases of needle-tract seeding after percutaneous radiofrequency (RF) ablation for lung cancer. Needle biopsy was performed immediately before RF ablation in one case. In both cases, RF ablation was performed with a single internally cooled electrode, which was removed without cauterizing the electrode tract. The seeding nodule appeared 4 or 7 months after RF ablation and was then completely treated with a repeat RF ablation.

DOI： 10.1016/j.jvir.2008.12.411

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

The purpose of this study was to investigate the relationship between pleural temperature and pneumothorax or pleural effusion after radiofrequency (RF) ablation of lung tumors. The pleural temperature was measured immediately outside the lung surface nearest to the tumor with a fiber-type thermocouple during 25 ablation procedures for 34 tumors in 22 patients. The procedures were divided into two groups depending on the highest pleural temperature: P-group I and P-group II, with highest pleural temperatures of &lt; 40 degrees C and &gt;= 40 degrees C, respectively. The incidence of pneumothorax or pleural effusion was compared between the groups. Multiple variables were compared between the groups to determine the factors that affect the pleural temperature. The overall incidence of pneumothorax and pleural effusion was 56% (14/25) and 20% (5/25), respectively. Temperature data in five ablation procedures were excluded from the analyses because these were affected by the pneumothorax. P-group I and P-group II comprised 10 procedures and 10 procedures, respectively. The incidence of pleural effusion was significantly higher in P-group II (4/10) than in P-group I (0/10) (p = 0.043). However, the incidence of pneumothorax did not differ significantly (p = 0.50) between P-group I (4/10) and P-group II (5/10). Factors significantly affecting the pleural temperature were distance between the electrode and the pleura (p &lt; 0.001) and length of the lung parenchyma between the electrode and the pleura (p &lt; 0.001). We conclude that higher pleural temperature appeared to be associated with the occurrence of pleural effusion and not with that of pneumothorax.

DOI： 10.1007/s00270-007-9283-3

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

A 66-year-old man underwent CT-guided drainage catheter placement within a pelvic abscess with a diameter of 46 mm. We performed the drainage by a transsacral approach because it was considered the safest and most feasible approach. An 8G bone marrow biopsy needle was used to penetrate the sacrum to create a path for subsequent drainage catheter insertion. After withdrawal of the biopsy needle, a 6 Fr catheter was advanced into the abscess cavity through the path using the Seldinger technique. Except for bearable pain, no procedure -related complications occurred. Twenty-nine days after the placement, the catheter was withdrawn safely and the abscess cavity had shrunk remarkably.

DOI： 10.1007/s00270-007-9036-3

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

Objective: Our objective was to evaluate the outcomes of radiofrequency ablation for nonsurgical candidates with clinical stage I non-small cell lung cancer.
Methods: This study was carried out on 20 nonsurgical candidates ( 11 men and 9 women; mean age, 75.6 years) with clinical stage I ( IA, n = 14; IB, n = 6) non-small cell lung cancer. All patients were deemed nonsurgical candidates because of poor pulmonary function ( n = 7), poor cardiac function ( n = 3), poor performance status ( n = 4), or refusal to undergo surgery ( n = 6). The mean long-axis tumor diameter was 2.4 cm. Twenty patients underwent 23 percutaneous ablation sessions, including 3 repeat sessions for the treatment of local progression. The outcomes of radiofrequency ablation were retrospectively evaluated.
Results: Procedural complications included pneumothorax ( n = 13 [ 57%]) and pleural effusion ( n = 4 [ 17%]). One case of pneumothorax required chest tube placement. The median follow-up period was 21.8 months. Local progression was observed in 7 ( 35%) patients a median of 9.0 months after the first session. The local control rates were 72% at 1 year, 63% at 2 years, and 63% at 3 years. The mean survival time was 42 months. The overall survivals and cancer-specific survivals were 90% and 100% at 1 year, 84% and 93% at 2 years, and 74% and 83% at 3 years, respectively.
Conclusions: Treating clinical stage I non-small cell lung cancer with one or more radiofrequency ablation sessions provided promising outcomes in terms of survival, although the rate of local progression was relatively high. A prospective study with a larger population and longer follow-up is warranted.

DOI： 10.1016/j.jtcvs.2007.07.013

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To retrospectively evaluate the midterm outcomes (eg, safety, local efficacy, and survival) after radiofrequency (RF) ablation for pulmonary metastases from colorectal cancer.
MATERIALS AND METHODS: Twenty-seven patients (19 men and eight women; mean age, 61.6 years) with 49 pulmonary metastases (mean long axis diameter, 1.5 cm) from colorectal cancer underwent 41 percutaneous computed tomography (CT)-guided RF ablation sessions. Follow-up examinations were performed with CT by using contrast medium administration in all patients; positron emission tomography was performed in five patients. The safety of the procedure, local tumor control, and patient survival were evaluated. Multiple variables were analyzed to determine prognostic factors.
RESULTS: Pneumothorax occurred after 20 of the 41 sessions (49%), three of which necessitated chest tube placement. A small pleural effusion was found after six of the 41 sessions (15%). No maj or hemorrhagic event was observed. None of the patients died due to the procedure. The median follow-up period was 20.1 months (range, 11.2-47.7 months). The primary and secondary technique effectiveness rates were 72% and 85%, respectively, at 1 year, 56% and 62% at 2 years, and 56% and 62% at 3 years. The overall survival rates after RF ablation were 96% at 1 year, 54% at 2 years, and 48% at 3 years. The presence of extrapulmortary metastasis was determined to be a prognostic factor (P =.001).
CONCLUSIONS: The midterm outcomes of percutaneous RF ablation for colorectal pulmonary metastases appear promising. The presence of extrapulmonary metastasis had an adverse effect on survival after RF ablation.

DOI： 10.1016/j.jvir.2007.06.027

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER COLL CHEST PHYSICIANS  

Background: Systemic air embolism is recognized as a potentially fatal but extremely rare complication following percutaneous transthoracic needle biopsy. However, its incidence might be underestimated by missing systemic air in patients without cardiac or cerebral symptoms. Methods: This study was based on four cases (one man and three women; age range, 54 to 75 years) of systemic air embolism complicating CT scan-guided transthoracic needle biopsy, which were encountered among 1,010 procedures performed at our institution from April 1999 to December 2006. The target lesion was a lung tumor in three patients, and a mediastinal tumor in one patient. The procedure was performed percutaneously under CT scan-fluoroscopic guidance by using a coaxial biopsy needle system. Results: In all four patients, a specimen was successfully obtained from the lesions. During or immediately after the procedure, all patients experienced paroxysms of coughing. In three patients without cardiac or cerebral symptoms, the presence of systemic air was confirmed on postprocedural CT scan images; it was resolved without causing morbidity after the immediate therapy. The presence of systemic air was missed in one initially asymptomatic patient, resulting in a subsequent neurologic deficit. Conclusions: Systemic air embolism following CT scan-guided. transthoracic needle biopsy was encountered more frequently than would be expected. The considerable attention we gave to this complication enabled us to recognize it in patients without cardiac or cerebral symptoms. No sequelae were observed in the three patients in whom systemic air embolism was detected, and the therapy was initiated immediately, whereas missing systemic air led to cerebral embolism in one patient in our four cases.

DOI： 10.1378/chest.06-3030

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

We performed percutaneously radiofrequency (RF) ablation of 5 renal cell carcinomas (mean diameter 26 +/- 15 mm) with computed-tomography (CT) fluoroscopic guidance using the transhepatic route. The RF electrode was successfully advanced into all tumors. RF ablation caused one minor complication (small asymptomatic perirenal hematoma); no major complications occurred. The follow-up contrast-enhanced CT images showed no local tumor progression of any tumors in a median period of 10 months (range 3-14 months). In conclusion, it seems that this transhepatic approach is safe and can be an alternative method for electrode insertion during RF ablation of selected renal tumors.

DOI： 10.1007/s00270-007-9037-2

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: The authors retrospectively evaluated the safety and effectiveness of percutaneous radiofrequency ablation of lung tumors close to the heart or aorta.
MATERIALS AND METHODS: Forty-two tumors (mean diameter, 25 mm +/- 16; range, 5-73 mm) located less than 10 mm. from the heart or aorta were treated with radiofrequency ablation in 47 sessions. Lung tumors were classified into two groups according to their distance from the heart or aorta: group A (n = 27) comprised tumors at a distance of 1-9 mm; group B (n = 15) comprised contiguous tumors (distance, 0 mm). The safety and technique effectiveness of the procedure, defined as no evidence of local tumor progression, were evaluated.
RESULTS: Radiofrequency ablation was feasible for all the 42 tumors. Procedural complications included asymptomatic pleural effusion (n = 5), small pneumothorax (n = 11), pneumothorax that necessitated chest tube placement (n = 4), and lung abscess (n = 1). No complications related to the specific tumor location, such as the accidental insertion of the electrode into the heart or aorta, pericardial effusion, arrhythmia, or cardiac infarction, occurred. The overall primary technique effectiveness rate was 75.8%, 45.9%, and 45.9% at 6, 12, and 24 months, respectively. This rate in group A (94.7%, 69.3%, and 69.3% at 6, 12, and 24 months, respectively) was significantly (P &lt; .001) higher than that in group B (42.9% and 8.6% at 6 and 12 months, respectively).
CONCLUSIONS: Radiofrequency ablation of lung tumors close to the heart or aorta was safely performed. The local control of tumors contiguous to the heart or aorta was considerably lower compared with the tumors that were close but not contiguous to these structures.

DOI： 10.1016/j.jvir.2007.02.024

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OKAYAMA UNIV MED SCHOOL  

We report the clinical experience of radiofrequency ablation followed by radiation therapy for large primary lung tumors. Two patients with large primary lung tumors were treated with combined radiofrequency ablation and radiation therapy, and good local control was observed. Combined radiofrequency ablation and radiation therapy that involves minimally invasive techniques appears to be promising for the treatment of large lung tumors.

DOI： 10.18926/AMO/32906

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

We describe two cases of intractable pneumothorax that were attributed to a bronchopleural fistula (BPF) after radiofrequency ablation of lung tumors. In both cases, radiofrequency ablation induced necrosis of the lung tissue between the pleural space and the bronchus. The bronchopleural fistula formed after sloughing of the necrotic tissue. Management of the bronchopleural fistula was quite challenging, requiring frequent treatments, including pleurodesis, endobronchial management, and/or surgical repair. In one of the patients, air leakage persisted despite these efforts, and the patient died of acute pneumonia 52 days after the procedure. Although it is rare, with an incidence of 0.6% (2/334) at our institution, intractable pneumothorax due to bronchopleural fistula should be recognized as a risk associated with radiofrequency ablation of lung tumors.

DOI： 10.1016/j.jvir.2006.10.011

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JOHN WILEY & SONS INC  

BACKGROUND. The purpose of the study was to retrospectively evaluate the risk factors for local progression after percutaneous radiofrequency (AF) ablation of lung tumors.
METHODS. The study included 128 patients (77 men, 51 women; mean age, 61.3 years) with 342 tumors (25 primary and 317 metastatic lung neoplasms; mean long-axis diameter, 1.7 cm) treated with RF ablation. The overall primary, and secondary technique effectiveness rates were estimated using Kaplan-Meier analysis. Multiple variables were analyzed using the log-rank test, followed by multivariate multilevel analysis to determine independent risk factors for local progression. The primary and secondary technique effectiveness rates were again estimated when considering only tumors without independent risk factors.
RESULTS. The median follow-up period was 12 months (range, 6-47 months). The overall primary and secondary technique effectiveness rates were 72% and 84% at 1 year, 60% and 71% at 2 years, and 58% and 66% at 3 years, respectively. Larger turner size (hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.47-2.65; P &lt;.00001) and the use of an internally cooled electrode (HR, 2.32; 95% CI, 1.10-4.90; P=.027) were assessed as independent risk factors for local progression. The primary and secondary technique effectiveness rates when considering tumors smaller than 2 cm and treated with a multitined expandable electrode were 89% and 89% at 1 year and 66% and 78% at 2 years, respectively.
CONCLUSIONS. Larger tumor size and the use of an internally cooled electrode were independent risk factors for local progression after RF ablation of lung tumors.

DOI： 10.1002/cncr.22333

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

PURPOSE: The present study was performed to evaluate the effect of pulmonary artery embolization on radiofrequency (RF) ablation of normal porcine lungs.
MATERIALS AND METHODS: RF ablation zones (n = 34) were created in the normal lungs of five domestic pigs (five zones in each of the first two pigs and eight zones in each of the remaining three pigs) with an expandable multitined electrode with use of bilateral thoracotomy. RF ablation was performed without pulmonary artery embolization (group 1, n = 8), immediately after embolization (group 2, n = 11),15 minutes after embolization (group 3, n = 7), and 30 minutes after embolization (group 4, n = 8) with degradable starch microspheres. Among them, 12 ablation zones were excluded from this study because they were considerably limited by the presence of the pleura or large bronchi. The remaining 22 zones were included (n = 7, n = 5, n = 4, and n = 6 in groups 1, 2, 3, and 4, respectively). Coagulation necrosis volumes in the ablation zones were measured and compared among the groups.
RESULTS: Coagulation necrosis volumes were 0.9 +/- 0.5 cm(3), 2.1 +/- 0.4 cm(3), 2.1 +/- 1.0 cm(3), and 1.9 +/- 0.6 cm(3) in groups 1, 2, 3, and 4, respectively. Groups 2-4 showed significantly larger coagulation volumes than group 1 (P = .012, P = .023, and P = .010 in groups 2, 3, and 4, respectively).
CONCLUSION: Pulmonary artery embolization contributed to larger volumes of coagulation necrosis after RF ablation of normal lungs.

DOI： 10.1097/01.RVI.0000251152.12254.AC

Web of Science

PubMed

researchmap

Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/01.RVI.0000200055.74822.ED

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：(株)北隆館  

CTガイド下に行うIVRには、がんの治療であるアブレーションや生検、ドレナージなど様々な手技がある。針を穿刺するのみで実施可能であるため低侵襲であり、超高齢化社会におけるがん医療として需要が高まっている。我々は、2012年からCTガイド下IVR用の針穿刺ロボット(Zerobot)を開発している。様々な非臨床試験によりロボットの安全性と性能を評価した後、2018年にはFirst-in-Humanの臨床試験を特定臨床研究として実施した。今後は治験を実施し、ロボットの薬事承認すなわち製品化を目指す予定である。(著者抄録)

J-GLOBAL

researchmap

Language：Japanese   Publisher：The Japanese Society of Interventional Radiology  

Computed tomography (CT) fluoroscopy-guided interventions such as ablation and biopsy are performed by inserting a specific needle into the lesion under CT fluoroscopy-guidance While those have various advantages including less invasive procedure, short procedure time, and low cost, a major concern to physicians is intraprocedural radiation exposure. In order to address this concern, we hypothesized that a remotely controllable robot could free physicians from radiation exposure. Since 2012, therefore, we have developed such a robot (Zerobot^&reg;), the tasks of which are to hold, target, and insert a needle under CT-guidance by a physician's remotely manipulating a controller. The robot is floor-mounted and specially designed for a sliding-gantry CT scanner for CT-guided interventions. Phantom experiments showed that robotic needle insertion was equivalent in accuracy without exposing the physician to radiation, in comparison to manual insertion. Animal experiments showed that it was feasible, safe, and accurate in an in vivo procedure. In this article, we provide an overview of the robot, including future perspectives.

DOI： 10.11407/ivr.33.19

CiNii Article

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02793&link_issn=&doc_id=20180611410003&doc_link_id=10.11407%2Fivr.33.19&url=https%3A%2F%2Fdoi.org%2F10.11407%2Fivr.33.19&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Language：Japanese   Publisher：(株)インナービジョン  

CT画像を見ながら病変に針を刺入して行うIVR(以下、CTガイド下IVR)には、肝、腎など腹部領域のがんの治療が可能なアブレーション(ラジオ波治療、凍結治療など)がある。CT画像上で病変に最短距離でアプローチできるため短時間に行うことができ、かつ針の穿刺のみで治療を行うことができるため低侵襲であり、患者の高齢化も相まってニーズが高まっている。CT透視は、術者が任意の部位を任意の時にCT撮影することができ、撮影したCT画像をリアルタイムに表示するシステムであり、CTガイド下IVRのイメージングガイディングツールとしてきわめて有用である。本稿では、CT透視を用いた腹部領域のIVRと技術革新に伴う将来展望について概説する。(著者抄録)

researchmap

Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

researchmap

Language：Japanese   Publisher：金原出版(株)  

57歳女。下肢腫瘍および歩行困難を主訴とした。切除不能な肝内胆管癌(cT3N0M0 stage III)の診断で化学療法を開始したが、18ヵ月後より下肢の腫脹と疼痛を自覚し、造影CTで胆管癌病変による下大静脈の高度狭窄を認めた。悪性下大静脈症候群の診断で放射線治療や薬物治療を行うも治療抵抗性であり、肝機能、心機能の評価も踏まえた上で、症状緩和を目的とした下大静脈ステント留置術の適応と判断した。消化管用ステントを用いて下大静脈ステント留置術を行ったところ、明らかな合併症を認めることなく下大静脈の狭窄と狭窄部の血流は改善し、側副路の描出減弱と静脈圧の圧較差減少が得られた。消化管用ステントはメッシュが細かく、屈曲に対して柔軟性があり、ステント移動は生じにくいと考えられた。本症例ではステント移動は認めず、良好な治療効果を得られた。

DOI： 10.18888/J01565.2017260620

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01565&link_issn=&doc_id=20170523160013&doc_link_id=10.18888%2FJ01565.2017260620&url=https%3A%2F%2Fdoi.org%2F10.18888%2FJ01565.2017260620&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese  

A Nepalese male in his thirties complained of chyluria. As the filarial body was detected in his blood smears, he was diagnosed as filarial chyluria. Lymphography demonstrated substantial leakage of iodized oil into the left renal pelvis, indicating fistula formation between retroperitoneal lymphatic tract and the renal pelvis. Chyluria was temporarily solved three days after the lymphography, followed by relapse. Given this result, the substantial leakage of iodized oil may possibly be a sign to indicate less therapeutic effectiveness of lymphography.

DOI： 10.18888/J01565.2017017045

Scopus

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.15106/J00349.2014298148

CiNii Article

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：Japan Surgical Association  

We report a case of portal vein stenosis due to pancreatic cancer that was successfully treated with intravenous stent implantation. The patient was a 49-year-old woman who had undergone a pancreatoduodenectomy with the modified Child's method for pancreatic carcinoma and was re-admitted due to melena and severe anemia 20 months after the operation. CT findings revealed that recurrence of pancreatic cancer had narrowed the portal vein and had caused hepatopetal collaterals adjacent to the choledochojejunostomy. Additionally, gastrointestinal endoscopy revealed an exposed vessel at the mucosa of the jejunum, close to the choledochojejunostomy. Bleeding from the varices increased and a hepatopetal collateral was considered to be the cause of the melena ; therefore, an intravenous stent was surgically placed at the site of stenosis of the portal vein. Subsequently performed portography revealed that the collaterals disappeared after the stent replacement and that no further episodes of gastrointestinal hemorrhage had occurred.

DOI： 10.3919/jjsa.74.806

CiNii Article

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.4326/jjcvs.42.114

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.4326/jjcvs.42.132

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.4326/jjcvs.42.23

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.12-00047

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.13-00015

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.22.7

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.22.657

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.4326/jjcvs.41.107

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.20.659

CiNii Article

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.5980/jpnjurol.101.490_3

CiNii Article

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

DOI： 10.11401/jsvs.19.757

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

researchmap

researchmap

Event date： 2021.3.30

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2021.3.5

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2021.2.10

Language：Japanese   Presentation type：Poster presentation  

Country：Japan  

Event date： 2021.1.16

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.12.21

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.12.9

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.11.14 - 2020.11.15

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.10.17

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.10.10

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2020.9.18 - 2020.9.19

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2020.8.25 - 2020.8.27

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2019.9

Language：Japanese   Presentation type：Poster presentation  

Country：Japan  

Event date： 2019.7.1

Language：English   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2018.10

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2018.9

Language：Japanese   Presentation type：Poster presentation  

Country：Japan  

Event date： 2018.6

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Country：Japan  

Event date： 2017.12

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2016

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2016

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2015

Language：English   Presentation type：Oral presentation (invited, special)  

Country：United States  

Event date： 2015

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Oral presentation (keynote)  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2015

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2014

Language：English   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2014

Language：Japanese   Presentation type：Oral presentation (keynote)  

Country：Japan  

Event date： 2014

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2014

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2013

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2007

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Country：Japan  

Event date： 2020.3

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2018.3

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2017

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2016

Language：English   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2016

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2016

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2012

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2012

Language：English   Presentation type：Poster presentation  

Country：Japan  

Event date： 2012

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2010

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2009

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2008.4

Language：English   Presentation type：Poster presentation  

Country：Japan  

Event date： 2008

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2008

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2007

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2007

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2007

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2007

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2006.11

Language：English   Presentation type：Oral presentation (general)  

Country：United States  

Event date： 2006

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2006

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2005

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2003

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2003

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2002

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan