Updated on 2022/09/16

写真a

 
GOBARA Hideo
 
Organization
Okayama University Hospital Professor
Position
Professor
External link

Degree

  • 医学博士 ( 岡山大学 )

Research Interests

  • Diagnostic Radiology

  • Medical Informatics

  • Interventional Radiology

  • radiofrequency ablation

  • cryoablation

Research Areas

  • Informatics / Life, health and medical informatics

  • Life Science / Radiological sciences

Education

  • Okayama University Graduate School of Medicine    

    1991.4 - 1995.3

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    Country: Japan

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  • Okayama University   医学部  

    1985.4 - 1991.3

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Research History

  • Okayama University Hospital   Division of Medical Informatics   Professor

    2016

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  • Okayama University   放射線部   Associate Professor

    2014 - 2016

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  • Okayama University hospital   放射線部   Lecturer

    2011 - 2014

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  • Okayama University   Department of Radiology   Assistant Professor

    2004 - 2011

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Committee Memberships

  • National Cancer Center, Center for Cancer Control and Information Services   Member of Cancer Registration Subcommittee of Designated cancer hospitals and cancer control  

    2016.4   

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Papers

  • Percutaneous cryoablation combined with prior transcatheter arterial embolization for renal cell carcinomas of 3 cm or larger: a prospective study

    Hideo Gobara, Yusuke Matsui, Mayu Uka, Koji Tomita, Noriyuki Umakoshi, Motoo Araki, Jun Sakurai, Toshihiro Iguchi, Takao Hiraki

    International Journal of Clinical Oncology   2022.8

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

    DOI: 10.1007/s10147-022-02224-7

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    Other Link: https://link.springer.com/article/10.1007/s10147-022-02224-7/fulltext.html

  • Percutaneous cryoablation for clinical T3a renal cell carcinoma (< 7 cm) with segmental vein involvement or perinephric fat invasion based on preoperative evaluation of high-resolution multidetector computed tomography scan

    Mayu Uka, Toshihiro Iguchi, Nanako Okawa, Yusuke Matsui, Koji Tomita, Noriyuki Umakoshi, Kazuaki Munetomo, Hideo Gobara, Motoo Araki, Takao Hiraki

    Japanese Journal of Radiology   2022.6

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

    Abstract

    Purpose

    To retrospectively assess the feasibility, safety, renal function, technique efficacy rate, and survival of patients with clinical T3a renal cell carcinoma (RCC).

    Materials and methods

    Sixteen cryoablation sessions were performed in 14 patients (10 men; mean age, 69.8 ± 10.5 years; range, 49–90 years) with 14 clear cell T3a RCCs (mean, 3.3 ± 0.9 cm; range, 1.9–5.2 cm). One patient was on dialysis. Transcatheter arterial embolization was performed before cryoablation in 15 sessions. The primary endpoint was the technique efficacy rate. The secondary endpoints included feasibility, safety, renal function, and survival.

    Results

    Cryoablation was technically successful in all RCC cases. In two RCCs, cryoablation was performed twice because of local tumor progression. No major adverse events were observed. All patients were alive without metastases, with a median follow-up of 45 months (6−93 months). Complete response was achieved by cryoablation in 11 RCCs (78.6%). The primary and secondary technique efficacy rates were 77.1% and 84.4% at 1 year, 57.9% and 73.9% at 3 years, and 57.9% and 73.9% at 5 years, respectively. One patient underwent dialysis given a total contralateral nephrectomy due to another RCC 1 month after initial cryoablation and a total ipsilateral nephrectomy 46 months after initial cryoablation due to local progression. Except for two dialysis patients, of the 12 patients with a median follow-up of 41 months (6–93 months), none were on dialysis.

    Conclusion

    Cryoablation was safe and effective in T3a RCC, which mainly involved the renal venous branches and may represent an alternative treatment for inoperable patients.

    DOI: 10.1007/s11604-022-01297-8

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    Other Link: https://link.springer.com/article/10.1007/s11604-022-01297-8/fulltext.html

  • Early enlarging cavitation after percutaneous radiofrequency ablation of lung tumors: Incidence, risk factors and outcome. International journal

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

    Diagnostic and interventional imaging   2022.5

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    PURPOSE: The purpose of this study was to retrospectively determine the incidence of early enlarging cavitation after percutaneous radiofrequency ablation (RFA) of lung tumor and identify risk factors associated with their occurrence. PATIENTS AND METHODS: A total of 245 patients (140 men, 105 women; mean age, 62.7 ± 11.8 [SD] years; age range: 31-87 years) with 605 lung tumors who were treated using 401 RFA sessions from April 2010 to March 2020 were included. Of which, 31 patients with 38 early enlarging cavitation and control group (151 patients with 228 tumors) were analyzed. Early enlarging cavitation was defined as cavities with an enlarged size (>3 cm) occurring on ablated lesions within seven days after RFA. Incidence of cavitation, risk and post-procedural factors of occurrence, major adverse events (AEs) that occurred in RFA sessions with cavitation, and course of cavitation were evaluated. AEs were classified using the CIRSE classification system for complications. RESULTS: Thirty-eight cavities (6.3%, 38/605 tumors) in 31 patients occurred in an average of 3.1 ± 1.7 days (range, 1-7 days) after 32 RFA sessions. Distance from pleura ≥ 20 mm, contact with vessel ≥ 3 mm, multitined expandable electrode ≥ 3 cm, and bronchus ≥ 2 mm encompassed in the ablation zone were independent risk factors of occurrence. Fever ≥ 38.5 °C, white blood cell count ≥ 10,000/μl one day after RFA, and steroid therapy were independent post-procedural factors of occurrence. Twenty-four Grade 3 and two Grade 6 AEs occurred. Twenty-nine cavities disappeared within a mean duration of 111.9 ± 64.9 (SD) days (range: 44-274 days) and four remained with a mean follow-up of 279.2 ± 174 (SD) days; five patients were lost to follow-up. CONCLUSIONS: Early enlarging cavitation occurs in 6.3% of lung tumors treated with RFA and are associated with 26 major AEs in 32 sessions. Aforementioned procedural factors and post-procedural inflammation were significant risk factors of occurrence.

    DOI: 10.1016/j.diii.2022.05.004

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  • Correlation between renal ablation zone in contrast-enhanced CT and non-enhanced MRI during the early period following percutaneous cryoablation.

    Noriyuki Umakoshi, Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Koji Tomita, Mayu Uka, Soichiro Kajita, Motoo Araki, Toshiharu Mitsuhashi, Hideo Gobara, Susumu Kanazawa

    Japanese journal of radiology   2022.5

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    PURPOSE: To retrospectively evaluate and correlate the contrast-enhanced computed tomography (CECT) and non-enhanced magnetic resonance imaging (MRI) during the early period following renal cryoablation. MATERIALS AND METHODS: Both dynamic CECT and non-enhanced MRI were performed within 4 days following cryoablation in 34 renal tumors in 33 patients. The renal volumes of the unenhanced regions on dynamic CECT (nephrogenic phase, 4 mm thickness) and the regions with signal intensity changes on non-enhanced MRI (fat-suppressed T2-weighted image, 4 mm thickness) were evaluated. Fusion images of the axial, coronal, and sagittal sections of CECT and MRI images were created from the maximum cross-section of the renal tumor, and the match score of each image was visually evaluated on a 5-point scale. RESULTS: The mean renal volume of the unenhanced regions on CECT and those with signal intensity changes on non-enhanced MRI following cryoablation were 29.5 ± 19.9 cm3 (range, 4.3-97.4 cm3) and 30.7 ± 19.8 cm3 (range, 6.7-94.0 cm3), respectively; the difference between them was -1.17 cm3 (95% confidence interval [CI] -2.74, 0.40, P = 0.139). The Pearson's product-moment correlation coefficient (r = 0.975; 95% CI, 0.951, 0.988; P < 0.0001) showed a strong correlation between the volumes. The average match score between CECT and non-enhanced MRI was as high as 4.5 ± 0.5 points (radiologist 1, 4.3 ± 0.5; radiologist 2, 4.7 ± 0.5). Local tumor control rate was 94.1% (32/34 tumors) and recurrence-free survival rate was 82.0% (95% CI: 64.2%, 91.5%) at 5 years. CONCLUSIONS: The region with signal intensity changes on non-enhanced MRI was strongly correlated with the unenhanced region on CECT during the early period following renal cryoablation.

    DOI: 10.1007/s11604-022-01285-y

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  • Catecholamine crisis due to cryoinjury of adrenal gland during renal cryoablation

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

    Journal of Vascular and Interventional Radiology   2021.12

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    Publishing type:Research paper (scientific journal)   Publisher:Elsevier BV  

    DOI: 10.1016/j.jvir.2021.12.003

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  • Percutaneous needle biopsy under 1.2 Tesla open MRI guidance Reviewed

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

    JAPANESE JOURNAL OF RADIOLOGY   2021.11

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

    DOI: 10.1007/s11604-021-01211-8

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

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

    Interventional Radiology   6 ( 3 )   69 - 74   2021.11

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

    DOI: 10.22575/interventionalradiology.2020-0019

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

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

    JAPANESE JOURNAL OF RADIOLOGY   39 ( 11 )   1103 - 1110   2021.11

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

    DOI: 10.1007/s11604-021-01142-4

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  • Percutaneous Cryoablation of Lower Limb Soft-Tissue Venous Malformations: Preliminary Results of Long-Term Efficacy Reviewed International journal

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

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   44 ( 9 )   1485 - 1490   2021.9

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

    DOI: 10.1007/s00270-021-02876-4

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  • CT-guided biopsy of lung nodules with pleural contact: Comparison of two puncture routes Reviewed International journal

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

    DIAGNOSTIC AND INTERVENTIONAL IMAGING   102 ( 9 )   539 - 544   2021.9

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

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

    DOI: 10.1016/j.diii.2021.05.005

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  • Location of embolization affects patency after coil embolization for pulmonary arteriovenous malformations: importance of time-resolved magnetic resonance angiography for diagnosis of patency Reviewed International journal

    Masashi Shimohira, Hiro Kiyosue, Keigo Osuga, Hideo Gobara, Hiroshi Kondo, Tetsuro Nakazawa, Yusuke Matsui, Kohei Hamamoto, Tomoya Ishiguro, Miyuki Maruno, Koji Sugimoto, Masamichi Koganemaru, Akira Kitagawa, Koichiro Yamakado

    EUROPEAN RADIOLOGY   31 ( 7 )   5409 - 5420   2021.7

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    OBJECTIVES: This study aimed to assess the diagnostic accuracy of computed tomography (CT) and time-resolved magnetic resonance angiography (TR-MRA) for patency after coil embolization of pulmonary arteriovenous malformations (PAVMs) and identify factors affecting patency. METHODS: Data from the records of 205 patients with 378 untreated PAVMs were retrospectively analyzed. Differences in proportional reduction of the sac or draining vein on CT between occluded and patent PAVMs were examined, and receiver operating characteristic analysis was performed to assess the accuracy of CT using digital subtraction angiography (DSA) as the definitive diagnostic modality. The accuracy of TR-MRA was also assessed in comparison to DSA. Potential factors affecting patency, including sex, age, number of PAVMs, location of PAVMs, type of PAVM, and location of embolization, were evaluated. RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CT were 82%, 81%, 77%, 85%, and 82%, respectively, when the reduction rate threshold was set to 55%, which led to the highest diagnostic accuracy. The sensitivity, specificity, PPV, NPV, and accuracy of TR-MRA were 89%, 95%, 89%, 95%, and 93%, respectively. On both univariable and multivariable analyses, embolization of the distal position to the last normal branch of the pulmonary artery was a factor that significantly affected the prevention of patency. CONCLUSIONS: TR-MRA appears to be an appropriate method for follow-up examinations due to its high accuracy for the diagnosis of patency after coil embolization of PAVMs. The location of embolization is a factor affecting patency. KEY POINTS: • Diagnosis of patency after coil embolization for pulmonary arteriovenous malformations (PAVMs) is important because a patent PAVM can lead to neurologic complications. • The diagnostic accuracies of CT with a cutoff value of 55% and TR-MRA were 82% and 93%, respectively. • The positioning of the coils relative to the sac and the last normal branch of the artery was significant for preventing PAVM patency.

    DOI: 10.1007/s00330-020-07669-w

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  • CT evaluation of patent artery after percutaneous cryoablation of renal cell carcinoma. Reviewed International journal

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

    Diagnostic and interventional imaging   2021.6

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

    DOI: 10.1016/j.diii.2021.06.001

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  • Needle artifact characteristics and insertion accuracy using a 1.2 T open MRI scanner: A phantom study Reviewed International journal

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

    DIAGNOSTIC AND INTERVENTIONAL IMAGING   102 ( 6 )   363 - 370   2021.6

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

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

    DOI: 10.1016/j.diii.2020.12.007

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

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

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   26 ( 3 )   562 - 568   2021.3

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    Authorship:Lead author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:SPRINGER JAPAN KK  

    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.

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

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

    ACTA MEDICA OKAYAMA   75 ( 1 )   9 - 14   2021.2

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

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

    DOI: 10.18926/AMO/61428

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

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

    Diagnostic and Interventional Imaging   101 ( 11 )   715 - 720   2020.11

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

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  • Survival Outcomes of Treatment with Radiofrequency Ablation, Stereotactic Body Radiotherapy, or Sublobar Resection for Patients with Clinical Stage I Non-Small-Cell Lung Cancer: A Single-Center Evaluation Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Toshiharu Mitsuhashi, Norihisa Katayama, Kuniaki Katsui, Junichi Soh, Jun Sakurai, Hideo Gobara, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   31 ( 7 )   1044 - 1051   2020.7

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    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.

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  • Histological findings in non-tumoral liver and tumor after chemoembolization with drug-eluting beads Reviewed International journal

    Yusuke Matsui, Hiroyasu Fujiwara, Takao Hiraki, Toshihiro Iguchi, Toshiyuki Komaki, Takehiro Tanaka, Takahito Yagi, Hideo Gobara, Susumu Kanazawa

    MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES   29 ( 4 )   217 - 223   2020.7

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    Purpose: To evaluate the histological findings in both tumor and surrounding non-tumoral liver parenchyma after trans-arterial chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC) in patients who subsequently underwent hepatectomy.Material and methods: This study included six patients with an HCC (size 15-61 mm). DEB-TACE was performed using polyvinyl alcohol-based hydrogel microspheres loaded with epirubicin. Radiological tumor response was evaluated after DEB-TACE and before hepatectomy, according to the Modified Response Evaluation Criteria in Solid Tumors. Surgical specimens were histologically evaluated with hematoxylin and eosin, and elastic Van Gieson's staining.Results: Segmental, sub-segmental, or partial hepatectomy were performed 14-58 days after DEB-TACE. There was no remarkable destructive change and minimal to absent inflammatory cell infiltration in the surrounding non-tumoral liver parenchyma. There was no evidence of biliary tract or arterial wall impairment. Complete and partial histological tumor necrosis were found in three cases, respectively, in agreement with the complete and partial responses seen during the radiological evaluation.Conclusion: Histological examination of resected liver specimens after DEB-TACE showed substantial tumor necrosis without any severe inflammatory or destructive changes in the non-tumoral liver parenchyma.

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  • A Clinical Study Evaluating an Aspiration-type Semi-Automatic Cutting Biopsy Needle (SCIRO-1702) Reviewed

    Yusuke Matsui, Takao Hiraki, Toshihiro Iguchi, Jun Sakurai, Mayu Uka, Yoshihisa Masaoka, Hideo Gobara, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   74 ( 3 )   209 - 214   2020.6

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    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.

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  • Computed tomography fluoroscopy-guided cutting needle biopsy of pulmonary nodules <= 8 mm: A retrospective study including 117 nodules Reviewed International journal

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

    EUROPEAN JOURNAL OF RADIOLOGY   125   108903 - 108903   2020.4

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

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  • Differentiation of Small (<= 4 cm) Renal Masses on Multiphase Contrast-Enhanced CT by Deep Learning Reviewed International journal

    Takashi Tanaka, Yong Huang, Yohei Marukawa, Yuka Tsuboi, Yoshihisa Masaoka, Katsuhide Kojima, Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyuki Yanai, Yasutomo Nasu, Susumu Kanazawa

    AMERICAN JOURNAL OF ROENTGENOLOGY   214 ( 3 )   605 - 612   2020.3

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    OBJECTIVE. This study evaluated the utility of a deep learning method for determining whether a small (≤ 4 cm) solid renal mass was benign or malignant on multiphase contrast-enhanced CT. MATERIALS AND METHODS. This retrospective study included 1807 image sets from 168 pathologically diagnosed small (≤ 4 cm) solid renal masses with four CT phases (unenhanced, corticomedullary, nephrogenic, and excretory) in 159 patients between 2012 and 2016. Masses were classified as malignant (n = 136) or benign (n = 32). The dataset was randomly divided into five subsets: four were used for augmentation and supervised training (48,832 images), and one was used for testing (281 images). The Inception-v3 architecture convolutional neural network (CNN) model was used. The AUC for malignancy and accuracy at optimal cutoff values of output data were evaluated in six different CNN models. Multivariate logistic regression analysis was also performed. RESULTS. Malignant and benign lesions showed no significant difference of size. The AUC value of corticomedullary phase was higher than that of other phases (corticomedullary vs excretory, p = 0.022). The highest accuracy (88%) was achieved in corticomedullary phase images. Multivariate analysis revealed that the CNN model of corticomedullary phase was a significant predictor for malignancy compared with other CNN models, age, sex, and lesion size. CONCLUSION. A deep learning method with a CNN allowed acceptable differentiation of small (≤ 4 cm) solid renal masses in dynamic CT images, especially in the corticomedullary image model.

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  • Embolization using hydrogel-coated coils for pulmonary arteriovenous malformations Reviewed

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

    Diagnostic and Interventional Imaging   101 ( 3 )   129 - 135   2020.3

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    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 4.0 mm and 8.5 mm, 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.

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  • Robotic CT-guided out-of-plane needle insertion: comparison of angle accuracy with manual insertion in phantom and measurement of distance accuracy in animals Reviewed International journal

    Toshiyuki Komaki, Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Jun Sakurai, Ryutaro Matsuura, Takuya Yamaguchi, Takanori Sasaki, Toshiharu Mitsuhashi, Soichiro Okamoto, Mayu Uka, Yusuke Matsui, Toshihiro Iguchi, Hideo Gobara, Susumu Kanazawa

    EUROPEAN RADIOLOGY   30 ( 3 )   1342 - 1349   2020.3

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    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.

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  • Robotic needle insertion during computed tomography fluoroscopy-guided biopsy: prospective first-in-human feasibility trial Reviewed International journal

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

    EUROPEAN RADIOLOGY   30 ( 2 )   927 - 933   2020.2

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    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.

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  • Post-ablation syndrome after percutaneous cryoablation of small renal tumors: A prospective study of incidence, severity, duration, and effect on lifestyle Reviewed International journal

    Takahiro Kawabata, Takao Hiraki, Toshihiro Iguchi, Yusuke Matsui, Mayu Uka, Yoshihisa Masaoka, Toshiyuki Komaki, Jun Sakurai, Hideo Gobara, Motoo Araki, Yasutomo Nasu, Susumu Kanazawa

    EUROPEAN JOURNAL OF RADIOLOGY   122   108750 - 108750   2020.1

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    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.

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

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

    Interventional Radiology   5 ( 3 )   128 - 133   2020

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

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

    Diagnostic and Interventional Imaging   100 ( 11 )   671 - 677   2019.11

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

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

    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   2019.8

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    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.

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  • Cryoablation of renal cell carcinoma for patients with stage 4 or 5 non-dialysis chronic kidney disease Reviewed

    Hideo Gobara, Atsuhiro Nakatsuka, Kanichiro Shimizu, Takashi Yamanaka, Yusuke Matsui, Toshihiro Iguchi, Takao Hiraki, Koichiro Yamakado

    JAPANESE JOURNAL OF RADIOLOGY   37 ( 6 )   481 - 486   2019.6

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    PURPOSE: To evaluate the safety and efficacy of cryoablation for renal cell carcinoma (RCC) in patients with stage 4 or 5 non-dialysis chronic kidney disease (CKD). MATERIALS AND METHODS: This retrospective multicenter study included patients with maximum tumor diameter ≤ 4 cm, estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m2, in whom cryoablation was performed percutaneously with curative intent between July 2011 and May 2016. RESULTS: Of 541 patients who underwent renal tumor cryoablation, 17 (3.1%; 4 women, 13 men; mean age 70.1 ± 10.6 years) with stage 4 or 5 non-dialysis CKD were included in this study. The pre-cryoablation eGFR was 22.5 ± 6.3 ml/min/1.73 m2. The mean tumor diameter was 2.8 ± 0.7 cm. No Grade 3 or higher adverse events occurred post-cryoablation. The eGFR at each time point was significantly lower than that before treatment. One patient required hemodialysis initiation at 21 months post-procedure. None of the patients showed residual RCC at their last follow-up. CONCLUSION: Cryoablation of RCC is safe in patients with stage 4 or 5 non-dialysis CKD and yields treatment results comparable to those in patients without CKD. This treatment could be completed without the early initiation of hemodialysis after the procedure.

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  • Ureteral obstruction by sloughed tumor complicating cryoablation of a renal oncocytoma. Reviewed International journal

    Hiro Okawa, Hideo Gobara, Yusuke Matsui, Toshihiro Iguchi, Takao Hiraki, Susumu Kanazawa

    Radiology case reports   13 ( 6 )   1195 - 1198   2018.12

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    Percutaneous cryoablation for renal tumors may be associated with rare complications such as injury to the ureter. A 65-year-old woman underwent percutaneous cryoablation after a transcatheter arterial embolization using lipiodol and ethanol for left renal oncocytoma. Two months after the percutaneous cryoablation, computed tomography images showed left hydronephrosis caused by high-density debris, which was assumed to be sloughed tumor with lipiodol accumulation in the left ureter. A stent was placed in the left ureter to enhance the drainage of urine and the necrotic cell debris. Three months later, the ureteral stent was removed, and she remained asymptomatic during the follow-up period of 4 months. We should consider the possibility of urinary tract obstruction by sloughed tumor when hydronephrosis occurs after percutaneous cryoablation of a renal tumor.

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  • Radiofrequency ablation versus cryoablation for T1b renal cell carcinoma: a multi-center study Reviewed

    Takaaki Hasegawa, Takashi Yamanaka, Hideo Gobara, Masaya Miyazaki, Haruyuki Takaki, Yozo Sato, Yoshitaka Inaba, Koichiro Yamakado

    JAPANESE JOURNAL OF RADIOLOGY   36 ( 9 )   551 - 558   2018.9

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    PURPOSE: To compare the clinical outcomes between radiofrequency ablation (RFA) and cryoablation for the treatment of clinical T1b (cT1b) renal cell carcinoma (RCC). MATERIALS AND METHODS: The data of 46 patients [(39 men and 7 women, median age; 73 years, range 39-87 years)] were gathered from 3 institutions. RFA and cryoablation were performed on 23 patients each. The median number of ablation needle was 2 (range 1-4) and 4 (range 3-5, p < 0.0001) in RFA and cryoablation, respectively. Technique efficacy defined as coverage of the tumor by ablative zone, adverse events, local tumor progression, and survival were compared between the RFA and cryoablation groups. RESULTS: The primary technique efficacy rate was significantly higher in the cryoablation group (96%, 22/23) than in the RFA group (65%, 15/23, P = 0.02). There was no significant difference in the secondary technique efficacy rate after additional RFA and cryoablation [21/23 (91%) vs. 23/23 (100%); P = 0.24]. The incidence of grade 3 or higher adverse events was similar between the 2 groups (P > 0.99). There was no significant difference between local tumor progression rate after RFA and cryoablation [3/21 (14%) vs. 2/23 (9%); P = 0.66]. The 5-year overall survival rates were comparable between RFA and cryoablation (78 vs. 82%; P =0.82). CONCLUSION: Other than primary technique efficacy, the clinical outcomes between RFA and cryoablation were similar in patients with cT1b RCC.

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  • Robotic Insertion of Various Ablation Needles Under Computed Tomography Guidance: Accuracy in Animal Experiments Reviewed International journal

    Takao Hiraki, Takayuki Matsuno, Tetsushi Kamegawa, Toshiyuki Komaki, Jun Sakurai, Ryutaro Matsuura, Takuya Yamaguchi, Takanori Sasaki, Toshihiro Iguchi, Yusuke Matsui, Hideo Gobara, Susumu Kanazawa

    EUROPEAN JOURNAL OF RADIOLOGY   105   162 - 167   2018.8

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    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.

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  • Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Hiroyasu Fujiwara, Yoshihisa Masaoka, Takashi Tanaka, Takuya Sato, Hideo Gobara, Shinichi Toyooka, Susumu Kanazawa

    EUROPEAN RADIOLOGY   28 ( 5 )   2194 - 2202   2018.5

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    OBJECTIVES: To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. METHODS: In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. RESULTS: Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429-43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631-0.996; p = 0.046). CONCLUSIONS: The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. KEY POINTS: • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.

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  • CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Yusuke Matsui, Hiroyasu Fujiwara, Jun Sakurai, Yoshihisa Masaoka, Hideo Gobara, Susumu Kanazawa

    EUROPEAN RADIOLOGY   28 ( 1 )   283 - 290   2018.1

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    OBJECTIVES: To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. METHODS: 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 ≤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. RESULTS: 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 ≥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 (≤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. CONCLUSION: CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. KEY POINTS: • CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield. • CT fluoroscopy-guided renal tumour biopsy is safe. • Small tumour size (≤1.5 cm) is a risk factor for diagnostic failure.

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  • Robotically Driven CT-guided Needle Insertion: Preliminary Results in Phantom and Animal Experiments Reviewed International journal

    Takao Hiraki, Tetsushi Kamegawa, Takayuki Matsuno, Jun Sakurai, Yasuzo Kirita, Ryutaro Matsuura, Takuya Yamaguchi, Takanori Sasaki, Toshiharu Mitsuhashi, Toshiyuki Komaki, Yoshihisa Masaoka, Yusuke Matsui, Hiroyasu Fujiwara, Toshihiro Iguchi, Hideo Gobara, Susumu Kanazawa

    RADIOLOGY   285 ( 2 )   454 - 461   2017.11

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    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 -0.3 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 μSv, while that during manual insertion was 5.7 μSv on average (P < .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. © RSNA, 2017 Online supplemental material is available for this article.

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  • Clinical Outcomes of Radiofrequency Ablation and Cryoablation for cT1b Renal Cell Carcinoma: Multi-Center Study Reviewed

    Takaaki Hasegawa, Takashi Yamanaka, Hideo Gobara, Masaya Miyazaki, Koichiro Yamakado

    ANNALS OF ONCOLOGY   28   2017.10

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  • Disappearance of Renal Cysts Included in Ice Ball During Cryoablation of Renal-Cell Carcinoma: A Potential Therapy for Symptomatic Renal Cysts? International journal

    Mitsuko Yodoya, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Yoshihisa Masaoka, Jun Sakurai, Toshiharu Mitsuhashi, Hideo Gobara, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   28 ( 6 )   869 - 876   2017.6

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    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 < .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.

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  • Value of percutaneous needle biopsy of small renal tumors in patients referred for cryoablation Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Jun Sakurai, Yusuke Matsui, Motoo Araki, Yasutomo Nasu, Susumu Kanazawa

    MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES   26 ( 2 )   86 - 91   2017.4

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    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.

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  • Radiofrequency ablation of pulmonary metastases from sarcoma: single-center retrospective evaluation of 46 patients Reviewed

    Takuya Sato, Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Jun Sakurai, Yusuke Matsui, Toshiharu Mitsuhashi, Junichi Soh, Shinichi Toyooka, Susumu Kanazawa

    JAPANESE JOURNAL OF RADIOLOGY   35 ( 2 )   61 - 67   2017.2

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    PURPOSE: This retrospective, single-center study evaluated radiofrequency (RF) ablation for pulmonary metastases of sarcoma. MATERIALS AND METHODS: 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. RESULTS: 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 ≥ 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 ≤12 months (P = 0.015) as significant negative prognostic factors. CONCLUSION: RF ablation is safe, offers good local control, and may be a viable treatment option for pulmonary metastasis of sarcoma.

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  • Translumbar Embolization of a Type 2 Endoleak after Endovascular Aneurysm Repair Involving Five Communicating Arteries and the Endoleak Sac: A Case Report Reviewed

    Toshiyuki Komaki, Hiroyasu Fujiwara, Takao Hiraki, Toshihiro Iguchi, Yusuke Matsui, Hideo Gobara, Susumu Kanazawa

    Interventional Radiology   2 ( 3 )   89 - 93   2017

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  • A Case of Solitary Metastasis from a Hepatocellular Carcinoma to the Sacral Bone Successfully Treated with Percutaneous Cryoablation Reviewed

    Noriyuki Umakoshi, Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Jun Sakurai, Yusuke Matsui, Yoshihisa Masaoka, Hiroki Ihara, Toshiaki Wada, Tomonori Seno, Susumu Kanazawa

    Interventional Radiology   2 ( 1 )   14 - 18   2017

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  • Acute Bowel Injury due to Cryoablation for Renal Cell Carcinoma: Correlated Radiologic and Pathologic Findings Reviewed

    Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Takeshi Nagasaka, Hiroyuki Kishimoto, Takehiro Tanaka, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   70 ( 6 )   511 - 514   2016.12

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    An 87-year-old Japanese man underwent percutaneous cryoablation (PCA) therapy for his renal cell tumor. We displaced the colon from the tumor using hydrodissection. Computed tomography (CT) immediately after PCA was indicative of iceball extension to the colon wall, and a discontinuous enhancement of the colon wall was observed. We therefore performed an emergency surgery. On laparotomy, we observed a dark-purple area on the affected area of the colon, and the resected specimen showed focal, deep ulceration on the mucosal surface. Photomicrography revealed mucosal necrosis, submucosal hemorrhage, and necrotic foci in the muscularis propria, corresponding to the discontinuous colon wall enhancement on CT and the deep ulceration and dark-purple area on laparotomy. He recovered from surgery and was discharged without any complications.

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  • Fracture of totally implanted central venous access devices: a propensity-score-matched comparison of risks for Groshong silicone versus polyurethane catheters Reviewed International journal

    Soichi Kojima, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Toshiharu Mitsuhashi, Susumu Kanazawa

    JOURNAL OF VASCULAR ACCESS   17 ( 6 )   535 - 541   2016.11

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    PURPOSE: To evaluate retrospectively the fracture risk of totally implanted venous access devices connected to Groshong silicone (SC) versus polyurethane (PU) catheters, inserted via the internal jugular vein. MATERIALS AND METHODS: The study population comprised 384 SC and 221 PU central venous catheters implanted via the internal jugular vein. The presence of catheter fracture was evaluated. Variables possibly related to catheter fracture were evaluated. First, in order to determine the factors associated with fracture, fracture rates were compared with the log-rank test between the two groups divided by each of the variables. Then, in order to adjust for potential confounders, propensity-score matching of the variables was employed in the two catheter groups. Finally, the rates of fracture were compared between the two propensity-score-matched catheter groups. RESULTS: There were 16 cases of catheter fracture, for an overall fracture percentage of 2.6% (16/605). All 16 cases of fracture occurred in the SC catheter group. Smaller patient body mass index (p = 0.039), deeper catheter tip position (p = 0.022), and SC catheters (p = 0.019) were significantly associated with fracture. With the propensity-score-matching method, 180 cases were selected in each catheter group. Comparison of the two propensity-score-matched groups showed that fracture rates for SC catheters remained significantly (p = 0.018) higher than those for PU catheters. CONCLUSIONS: Ports connected to Groshong SC catheters - when implanted via the internal jugular vein - posed a higher risk of fracture than did ports connected to PU catheters.

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  • Phase I/II Multi-Institutional Study of Percutaneous Radiofrequency Ablation for Painful Osteoid Osteoma (JIVROSG-0704) Reviewed International journal

    Masaya Miyazaki, Yasuaki Arai, Akira Myoui, Hideo Gobara, Miyuki Sone, Daniel I. Rosenthal, Yoshito Tsushima, Susumu Kanazawa, Shigeru Ehara, Keigo Endo

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   39 ( 10 )   1464 - 1470   2016.10

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    PURPOSE: This multicenter prospective study was conducted to evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) for painful osteoid osteoma (OO). MATERIALS AND METHODS: Patients with OO (femur: n = 17, tibia: n = 2, humerus: n = 1, rib: n = 1) were enrolled and treated with RFA. In phase I, nine patients were evaluated for safety. In phase II, 12 patients were accrued, and an intent-to-treat analysis was performed on all patients. The primary endpoint was to evaluate the treatment safety. The secondary endpoint was to evaluate the efficacy for pain relief by the visual analogue scale (VAS) at 4 weeks after RFA. Treatment efficacy was classified as significantly effective (SE) when VAS score decreased by ≥5 or score was <2, moderately effective when VAS score decreased by <5-≥2 and score was ≥2, and not effective (NE) when VAS score decreased by <2 or score was increased. Cases where the need for analgesics increased after treatment were also NE. RESULTS: RFA procedures were completed in all patients. Minor adverse effects (AEs) were observed as 4.8-14.3 % in 12 patients, and no major AEs were observed. Mean VAS score was 7.1 before treatment, 1.6 at 1 week, 0.3 at 4 weeks, and 0.2 at 3 months. All procedures were classified as SE. Pain recurrence was not noted in any patient during follow-up (mean: 15.1 months). CONCLUSION: RFA is a safe, highly effective, and fast-acting treatment for painful extraspinal OO. Future studies with a greater number of patients are needed.

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  • Long-Term Survival after Radiofrequency Ablation of Lung Oligometastases from Five Types of Primary Lesions: A Retrospective Evaluation Reviewed International journal

    Kenichi Omae, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Shinichi Toyooka, Takeshi Nagasaka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   27 ( 9 )   1362 - 1370   2016.9

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    PURPOSE: To conduct a retrospective evaluation of long-term survival after radiofrequency (RF) ablation for lung oligometastases from 5 types of primary lesions. MATERIALS AND METHODS: The study population consisted of 123 patients with lung oligometastases from colorectal cancer (CRC), non-small-cell lung cancer, hepatocellular carcinoma, esophageal cancer, and renal-cell carcinoma treated with RF ablation. Lung oligometastases were defined as 1-5 metastases confined to the lung while the primary cancer and other metastases were eradicated. Overall survival (OS) and recurrence-free survival (RFS) were estimated for the overall study population and for patients with each type of primary lesion. The OS and RFS rates were compared with those of the patients with any of the other four primary lesion types. Finally, various variables were analyzed to determine what factors influenced OS and RFS. RESULTS: The median follow-up was 45.7 months, and the 5-year OS and RFS rates for all 123 patients were 62% and 25%, respectively. The OS time for patients with metastases from CRC was significantly longer (P = .042); it was significantly shorter (P = .022) in patients with metastases from esophageal cancer. Longer disease-free interval was significantly (P = .015) associated with better OS. There was no variable significantly associated with OS and RFS on multivariate analyses. CONCLUSIONS: Data from this single-center study appear promising in terms of long-term survival after RF ablation of lung oligometastases from 5 primary lesions.

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  • Single Center Prospective Phase II Trial of CT-guided Radiofrequency Ablation for Pulmonary Metastases from Colorectal Cancer (SCIRO-1401)

    Jun Sakurai, Yusuke Matsui, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Hideo Gobara, Toshiharu Mitsuhashi, Takeshi Nagasaka, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   70 ( 4 )   317 - 321   2016.8

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    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.

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  • Percutaneous radiofrequency ablation for patients with malignant lung tumors: a phase II prospective multicenter study (JIVROSG-0702) Reviewed

    Hideo Gobara, Yasuaki Arai, Takeshi Kobayashi, Koichiro Yamakado, Yoshitaka Inaba, Yoshihisa Kodama, Takuji Yamagami, Miyuki Sone, Hirokazu Watanabe, Yoshihiro Okumura, Takayoshi Shinya, Hiroaki Kurihara, Susumu Kanazawa

    JAPANESE JOURNAL OF RADIOLOGY   34 ( 8 )   556 - 563   2016.8

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    PURPOSE: This prospective multicenter study aimed to evaluate the efficacy and safety of percutaneous radiofrequency (RF) ablation for lung cancer. MATERIALS AND METHODS: From May 2008 to April 2012, 33 patients (26 men, 7 women; mean age 70.5 years) were enrolled. RF ablation was performed using an internally cooled or expandable multitined electrode. The primary endpoint was complete response (CR) determined using (18)F fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) performed 6 months after RF ablation. The secondary endpoint was the incidence and grade of adverse events (AEs) evaluated using the Common Toxicity Criteria for Adverse Events, version 3.0. RESULTS: All patients underwent RF ablation and had efficacy analyses evaluated; however, FDG-PET/CT images before RF ablation were not available for two patients. The CR rate was 68 % (21 of 31 patients). One patient had a grade 5 AE unrelated to RF ablation. Grade ≥3 AEs occurred in 12 % of patients. During the follow-up period (median 37 months; range 1-55 months), five patients developed local tumor progression and nine (29 %) died. Overall survival at 1, 2, and 3 years was 97, 82, and 74 %, respectively. CONCLUSION: Percutaneous RF ablation is a safe, feasible, and effective treatment for small malignant lung tumors.

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  • Safety of Percutaneous Cryoablation in Patients with Painful Bone and Soft Tissue Tumors: A Single Center Prospective Study (SCIRO-1502) Reviewed

    Toshihiro Iguchi, Jun Sakurai, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Yoshihisa Masaoka, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   70 ( 4 )   303 - 306   2016.8

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    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.

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  • A Case of Focal Bone Marrow Reconversion Mimicking Bone Metastasis: The Value of (111)Indium Chloride Reviewed

    Takashi Tanaka, Hideo Gobara, Ryota Inai, Toshihiro Iguchi, Akihiro Tada, Shuhei Sato, Hiroyuki Yanai, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   70 ( 4 )   285 - 289   2016.8

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    We present a case of a 66-year-old man with esophageal carcinoma. 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for evaluating distant metastasis and staging revealed 18F-FDG uptake in the third lumbar vertebra and other vertebrae. Magnetic resonance imaging could not differentiate bone metastases from benign bone lesions. We considered the possibility of bone marrow reconversion. 111Indium chloride (111In-Cl3) scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) revealed erythroid bone marrow components in the bone lesions. The diagnosis of bone marrow reconversion was pathologically confirmed by a bone biopsy of the third lumbar vertebra. The patient underwent esophagectomy and has remained disease-free in the 2 years since. To the best of our knowledge, this is the first report to describe the usefulness of 111In-Cl3 with SPECT/CT for the diagnosis of bone marrow reconversion.

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  • Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting Reviewed International journal

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Takahiro Kawabata, Takatsugu Yamauchi, Takuya Yamaguchi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   39 ( 6 )   894 - 901   2016.6

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    INTRODUCTION: Computed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking. MATERIALS AND METHODS: Radiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator's finger skin was measured using thermoluminescent dosimeter rings. RESULTS: The mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator's finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA. CONCLUSION: Radiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

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  • Phase I/II Study of Radiofrequency Ablation for Malignant Renal Tumors: Japan Interventional Radiology in Oncology Study Group 0701 Reviewed International journal

    Hidefumi Mimura, Yasuaki Arai, Koichiro Yamakado, Miyuki Sone, Yoshito Takeuchi, Tsuneharu Miki, Hideo Gobara, Yusuke Sakuhara, Takanobu Yamamoto, Yozo Sato, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   39 ( 5 )   717 - 723   2016.5

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    PURPOSE: This multicenter phase I/II study evaluated the safety, feasibility, and initial efficacy of radiofrequency ablation (RFA) for small malignant renal tumors. METHODS: Thirty-three patients were enrolled in the study. A single session of RFA was performed in patients with a renal tumor of 1-3 cm in greatest diameter, with the exception of lesions adjacent to the renal hilum. The primary endpoint was the safety of renal RFA, and the secondary endpoints were its feasibility and initial efficacy for local control, as well as the incidence and grade of adverse events. Clinical efficacy was evaluated by CT scans within 1 week and at a further 4 weeks after the procedure using the criteria adapted from the Response Evaluation Criteria in Solid Tumors. RESULTS: The RFA procedure was completed in 100% (95% confidence interval [CI] 89-100%) of all 33 patients. There were no severe adverse events (0% [95% CI 0-11%]). Among the 33 patients, a complete response, partial response, progressive disease, and stable disease were seen in 28 (85%), 0 (0%), one (3%), and one (3%) patient(s), respectively, with a tumor response rate of 85% [95% CI 68-95%]). Three patients (9%), including one ineligible patient (3%), were not evaluable. Out of 30 evaluable patients, a complete response was achieved in 28 (93%). CONCLUSION: The current multicenter trial revealed that RFA is a safe, feasible, and effective treatment for small malignant renal tumors in patients who are not candidates for surgery.

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  • Radiofrequency Ablation of Lung Tumors Using a Multitined Expandable Electrode: Impact of the Electrode Array Diameter on Local Tumor Progression Reviewed International journal

    Hiroki Ihara, Hideo Gobara, Takao Hiraki, Toshiharu Mitsuhashi, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Junichi Soh, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   27 ( 1 )   87 - 95   2016.1

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    PURPOSE: To retrospectively investigate the impact of the electrode array diameter on local tumor progression after lung radiofrequency ablation. MATERIALS AND METHODS: This study included 651 lung tumors treated using multitined expandable electrodes and followed for ≥ 6 months. The mean long-axis tumor diameter was 12 mm ± 7 (range, 2-42 mm). The difference between electrode array diameter and tumor diameter (DAT) was used to investigate the impact of the electrode array diameter. All tumors were classified into 2 groups according to various variables including DAT (≥ 10 mm or < 10 mm). The primary technique efficacy rates were calculated using Kaplan-Meier analysis and compared between the 2 groups of each variable using the log-rank test. In addition, crude and multivariate multilevel survival analyses were performed by sequentially including DAT and the other variables in 5 models. RESULTS: The median DAT for 651 tumors was 12 mm (range, -15 to 24 mm). The technique efficacy rate was significantly lower in the < 10 mm DAT group than in the ≥ 10 mm group (P < .001). In the crude and multivariate multilevel survival analyses, < 10 mm DAT was a significant risk factor for local progression in all models except model 5 (P = .067). In the ≥ 10 mm group, the technique efficacy rates were not significantly different between the 2 ≥ 10 mm DAT subgroups (10 to <15 mm DAT vs ≥ 15 mm DAT). CONCLUSIONS: DAT is an important risk factor for local progression. We recommend an electrode that is ≥ 10 mm larger than the tumor diameter.

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  • CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Shinichiro Miyoshi, Susumu Kanazawa

    EUROPEAN RADIOLOGY   26 ( 1 )   114 - 121   2016.1

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    OBJECTIVES: To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. METHODS: We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. RESULTS: Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P =0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. CONCLUSION: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. KEY POINTS: Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. Complications are usually minor and asymptomatic. A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

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  • Regression of a Pulmonary Arteriovenous Malformation after Acute Interstitial Nephritis Reviewed

    Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Masashi Kitagawa, Nobuhisa Hanayama, Susumu Kanazawa

    INTERNAL MEDICINE   55 ( 11 )   1487 - 1489   2016

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    A 68-year-old woman was scheduled to undergo percutaneous embolization of a pulmonary arteriovenous malformation (PAVM) to prevent a paradoxical embolic event. After contrast-enhanced computed tomography (CT) was performed to carefully evaluate the PAVM, she developed acute interstitial nephritis, which required steroid therapy. Moreover, her D-dimer level increased, which was suggestive of thrombus formation. After nine months, we noted that the affected vessels had markedly decreased in size, and the fistula had almost disappeared on unenhanced CT images. To our knowledge, this is the first case report to describe the regression of a PAVM, detected by CT, after the onset of acute interstitial nephritis.

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  • Percutaneous CT-guided Radiofrequency Ablation for Renal Cell Carcinoma in von Hippel-Lindau Disease: Midterm Results Reviewed

    Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Hiroyasu Fujiwara, Yasutomo Nasu, Susumu Kanazawa

    Interventional Radiology   1 ( 1 )   1 - 6   2016

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  • Transosseous Route for CT Fluoroscopy-Guided Radiofrequency Ablation of Lung Tumors Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hiroaki Ishii, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   26 ( 11 )   1694 - 1698   2015.11

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    PURPOSE: To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. MATERIALS AND METHODS: Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. RESULTS: The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7% at 6 mo, 81.5% at 1 y, and 81.5% at 2 y. CONCLUSIONS: The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.

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  • Fever after lung radiofrequency ablation: Prospective evaluation of its incidence and associated factors Reviewed International journal

    Yoshihisa Masaoka, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Shinichi Toyooka, Junichi Soh, Katsuyuki Kiura, Susumu Kanazawa

    EUROPEAN JOURNAL OF RADIOLOGY   84 ( 11 )   2202 - 2209   2015.11

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    PURPOSE: To prospectively investigate the incidence of post-lung radiofrequency (RF) ablation fever as well as its associated factors, according to the grade of fever. MATERIALS AND METHODS: A total of 56 patients who underwent 67 lung RF sessions were analyzed. Post-ablation fever (≥ 37.0°C) was graded according to the common toxicity criteria of adverse events v. 4.0. Fever ≥ 37.0°C and <38.0°C was defined as grade 0 fever. The 67 RF sessions were divided into two groups according to the presence of post-ablation fever, and the factors associated with fever were determined using univariate and multivariate analyses. Subsequently, the RF sessions accompanied by post-ablation fever were further divided into two groups according to the grade of fever (grade 0 vs. grade ≥ 1), and the factors associated with the grade of fever were determined. RESULTS: Grade 0, 1, and 2 fever accompanied 36 (54%), 11 (16%), and 2 (3%) sessions, respectively. Post-ablation fever was significantly associated with larger ablated parenchymal volume (P=0.001) and development of pulmonary infiltration (P=0.004). Additionally, development of pulmonary infiltration (P=0.048) was also significantly and independently associated with higher grade of fever in the multivariate analysis. CONCLUSIONS: The incidences of grade 0, 1, and 2 post-ablation fever were 54%, 16%, and 3%, respectively. Larger ablated parenchymal volume and development of pulmonary infiltration were found to be associated with the development of post-ablation fever, with the latter being an independent factor associated with higher grade of fever.

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  • Retained Short Hook Wires Used for Preoperative Localization of Small Pulmonary Lesions During Video-Assisted Thoracoscopic Surgery: A Report of 2 Cases Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Seiichiro Sugimoto, Shinichiro Miyoshi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   38 ( 5 )   1376 - 1379   2015.10

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  • Tension Pneumopericardium as a Complication of Preoperative Localization of a Small Pulmonary Metastasis Using a Short Hook Wire and Suture System Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Hiromasa Yamamoto, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   38 ( 5 )   1346 - 1348   2015.10

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  • Simultaneous Multiple Preoperative Localizations of Small Pulmonary Lesions Using a Short Hook Wire and Suture System Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Seiichiro Sugimoto, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   38 ( 4 )   971 - 976   2015.8

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    PURPOSE: The aim of the study was to retrospectively evaluate simultaneous multiple hook wire placement outcomes before video-assisted thoracoscopic surgery (VATS). MATERIALS AND METHODS: Thirty-eight procedures were performed on 35 patients (13 men and 22 women; mean age, 59.9 years) with 80 lung lesions (mean diameter 7.9 mm) who underwent simultaneous multiple hook wire placements for preoperative localizations. The primary endpoints were technical success, complications, procedure duration, and VATS outcome; secondary endpoints included comparisons between technical success rates, complication rates, and procedure durations of the 238 single-placement procedures performed. Complications were also evaluated. RESULTS: In 35 procedures including 74 lesions, multiple hook wire placements were technically successful; in the remaining three procedures, the second target placement was aborted because of massive pneumothorax after the first placement. Although complications occurred in 34 procedures, no grade 3 or above adverse event was observed. The mean procedure duration was 36.4 ± 11.8 min. Three hook wires dislodged during patient transport to the surgical suite. Seventy-four successfully marked lesions were resected. Six lesions without hook wires were successfully resected after detection by palpation with an additional mini-thoracotomy or using subtle pleural changes as a guide. The complication rates and procedure durations of multiple-placement procedures were significantly higher (P = 0.04) and longer (P < 0.001) than those in the single-placement group, respectively, while the technical success rate was not significantly different (P = 0.051). CONCLUSIONS: Simultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.

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  • Retrograde Renal Ablation via the Renal Vein as a New Treatment Option for Renovascular Hypertension Reviewed International journal

    Hiroyasu Fujiwara, Hideo Gobara, Takao Hiraki, Toshihiro Iguchi, Haruhito Adam Uchida, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   26 ( 6 )   807 - 808   2015.6

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  • Radiofrequency Ablation of Lung Metastases from Adenoid Cystic Carcinoma of the Head and Neck: Retrospective Evaluation of Nine Patients Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Shinichi Toyooka, Kazunori Nishizaki, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   26 ( 5 )   703 - 708   2015.5

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    PURPOSE: To retrospectively evaluate the outcomes of radiofrequency (RF) ablation of lung metastases from head and neck adenoid cystic carcinoma (ACC). MATERIALS AND METHODS: Nine patients (two men and seven women; mean age, 61.6 y) with 45 lung metastases (mean diameter, 1.1 cm; range, 0.4-2.7 cm) from head and neck ACC underwent RF ablation in 30 sessions. Primary endpoints were technical success, technique effectiveness, and procedural complications. Secondary endpoints included overall survival (OS). RESULTS: RF ablation was technically successful for all 45 metastases. The median tumor follow-up period was 37.1 months (range, 12.9-128.3 mo). Local progression occurred in six tumors, two of which were treated again and subsequently showed complete response. Major complications (pneumothorax requiring chest tube placement) occurred in five sessions (16.7%). The median patient follow-up period was 61.6 months (range, 20.5-134.5 mo). Two patients died of disease progression at 38.9 and 61.6 months after RF ablation, respectively, whereas the other seven remained alive at the end of the study. OS rates from the initial RF ablation were 100% at 3 years and 83.3% at 5 years (mean survival time, 106.4 mo). OS rates from the treatment of the primary site were 100% at 5 years and 62.5% at 10 years (mean survival time, 210.1 mo). CONCLUSIONS: Radiofrequency ablation is an acceptable and effective local treatment for lung metastases from head and neck ACC. However, further study is needed to evaluate its effect on patient survival.

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  • Percutaneous Radiofrequency Ablation of Lung Cancer Presenting as Ground-Glass Opacity Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Junichi Soh, Shinichi Toyooka, Katsuyuki Kiura, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   38 ( 2 )   409 - 415   2015.4

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    PURPOSE: We retrospectively evaluated the outcomes of lung cancer patients presenting with ground-glass opacity (GGO) who received radiofrequency ablation (RFA). METHODS: Sixteen patients (5 men and 11 women; mean age, 72.6 years) with 17 lung cancer lesions showing GGO (mean long axis diameter, 1.6 cm) underwent a total of 20 percutaneous computed tomography (CT) fluoroscopy-guided RFA sessions, including three repeated sessions for local progression. Lung cancer with GGO was defined as a histologically confirmed malignant pulmonary lesion with a GGO component accounting for >50 % of the lesion on high-resolution CT. Procedure outcomes were evaluated. RESULTS: There were no major complications. Pneumothorax occurred in 15 of 20 treatment sessions: 14 were asymptomatic, and 1 required chest tube placement but resolved satisfactorily within 48 h. Minor pulmonary hemorrhage occurred in two and mild pneumonitis in one. The median tumor follow-up period was 61.5 (range 6.1-96.6) months. The effectiveness rates of the primary and secondary techniques were 100 and 100 % at 1 year, 93.3 and 100 % at 2 years, and 78.3 and 92.3 % at 3 years, respectively. The median patient follow-up period was 65.6 (range 6.1-96.6) months. One patient died owing to recurrent other cancer 11.7 months after RFA, whereas the other 15 remained alive. Overall survival and disease-specific survival rates were 93.3 and 100 % at 1 year and 93.3 and 100 % at 5 years, respectively. CONCLUSIONS: RFA for lung cancer with GGO was safe and effective, and resulted in promising survival rates.

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  • Long-Term Survival following Percutaneous Radiofrequency Ablation of Colorectal Lung Metastases Reviewed International journal

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Takeshi Nagasaka, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   26 ( 3 )   303 - 310   2015.3

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    PURPOSE: To retrospectively evaluate long-term survival outcomes of radiofrequency (RF) ablation of colorectal lung metastases and evaluate factors associated with improved survival. MATERIALS AND METHODS: Eighty-four patients (46 male and 38 female; median age, 65 y) with 172 colorectal lung metastases (median size, 1.2 cm) underwent 113 RF ablation sessions. Thirteen patients had viable extrapulmonary recurrences at the time of RF ablation. The primary endpoint was patient survival. Prognostic factors associated with survival were determined by univariate and multivariate analyses. Secondary endpoints were local tumor progression and adverse events (per National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0). RESULTS: During follow-up (median duration, 37.5 mo), 36 patients (42.9%) died. The estimated overall survival (OS) rates were 95.2%, 65.0%, and 51.6% at 1, 3, and 5 years, respectively (median OS time, 67.0 mo). Multivariate analysis revealed that a carcinoembryonic antigen (CEA) level of at least 5 ng/mL before RF ablation (P = .03) and the presence of viable extrapulmonary recurrences at the time of RF ablation (P = .001) were independent negative prognostic factors. The local tumor progression rate was 14.0% (24 of 172 tumors). Grade 3 adverse events were observed after two sessions (1.8%), and grade 4/5 adverse events were not observed. CONCLUSIONS: RF ablation of colorectal lung metastases provided favorable long-term survival with a low incidence of severe adverse events. Independent prognostic factors were a high CEA level before RF ablation and the presence of viable extrapulmonary recurrences at the time of RF ablation.

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  • Transfissural Route Used for Preoperative Localization of Small Pulmonary Lesions with a Short Hook Wire and Suture System Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Seiichiro Sugimoto, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   38 ( 1 )   222 - 226   2015.2

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    PURPOSE: We retrospectively evaluated the results of the transfissural route for preoperative localization with a short hook wire and suture system for video-assisted thoracoscopic surgery (VATS). METHODS: Eleven patients with 11 tumors underwent CT-guided transfissural placement of a hook wire before VATS. This route was selected for all patients, because the distance between the tumor and interlobar fissure was much shorter than the required distance traversed using the conventional approach. Complications were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0. RESULTS: The hook wire was successfully placed using the transfissural route in all but one case. Of these ten successful placements, two tumors needed a second puncture for optimal placement, because the CT scan showed that the first hook wire was not properly placed in the lung. In one patient, we did not attempt replacement after the first placement was incorrect. In ten successful procedures, the mean distance traversed in the parenchyma of the unaffected lung lobe was 27.9 mm. The distance between the pleura and placed hook wire was significantly shorter than the estimated distance between the pleura and hook wire using the conventional route (mean 16.3 vs. 40.9 mm; P = 0.0002). Grade 1 adverse events occurred (11 pneumothoraxes and 4 pulmonary hemorrhages). No grade 2 or higher adverse event was observed. CONCLUSIONS: The transfissural route used for preoperative localization before VATS is useful for selected patients because this route may allow for more limited lung parenchyma resection.

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

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

    INTERNAL MEDICINE   54 ( 16 )   2001 - 2005   2015

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    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.

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  • Polycythemia Vera Diagnosed after Esophageal Variceal Rupture. Reviewed

    Yoshiyasu Kono, Akinobu Takaki, Hideo Gobara, Ken-Ichi Matsuoka, Masato Nishino, Hiroyuki Okada, Kazuhide Yamamoto

    Internal medicine (Tokyo, Japan)   54 ( 18 )   2395 - 9   2015

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    Polycythemia vera (PV) is a chronic myeloproliferative neoplasm that leads to hyperviscosity and the risk of thrombosis. We encountered the case of a young male Filipino patient diagnosed with PV after the rupture of esophageal varices. The complete blood cell count showed a slight increase in white blood cells. An abdominal computed tomography scan disclosed splenomegaly and occlusion of the portal vein and collateral vessels. A blood examination demonstrated an increase in all three blood cell lines within three months. Based on the presence of severe hypercellularity of the bone marrow and positivity for the JAK2V617F mutation, we finally diagnosed the patient with PV.

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  • Creation of an Artificial Hydromediastinum for Radiofrequency Ablation of Lung Tumor: A Report of Two Cases Reviewed International journal

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

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   25 ( 11 )   1834 - 1837   2014.11

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  • Percutaneous Radiofrequency Ablation for Pulmonary Metastases from Esophageal Cancer: Retrospective Evaluation of 21 Patients Reviewed International journal

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Toshihiro Iguchi, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   25 ( 10 )   1566 - 1572   2014.10

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    PURPOSE: To evaluate retrospectively outcomes after radiofrequency (RF) ablation for pulmonary metastases from esophageal cancer. MATERIALS AND METHODS: This study included 21 consecutive patients who met inclusion criteria (all men; mean age, 66.0 y) and had pulmonary metastases from esophageal cancer. There were 31 tumors (mean size, 1.7 cm) that were treated with 27 planned ablation sessions. At the initial RF ablation sessions, 3 patients had viable extrapulmonary recurrences, and 18 patients had viable recurrences confined to the lung. Primary study endpoints included patient survival and the determination of prognostic factors. Secondary endpoints included local efficacy and safety of the treatment. The log-rank test was used to identify prognostic factors. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0. RESULTS: Median follow-up duration after the initial RF ablation was 22.4 months (range, 6.2-76.1 mo). Estimated overall survival rates were 85.7% at 1 year, 54.8% at 2 years, and 38.4% at 3 years after the initial RF ablation session. The presence of viable extrapulmonary recurrences at the initial RF ablation session was an unfavorable prognostic factor (P < .001). Local tumor progression was observed in 25.8% (8 of 31) of tumors and occurred 2.6-10.0 months (median, 4.8 mo) after RF ablation. Grade 3 adverse events occurred in 7.4% (2 of 27) of sessions, including pleural effusion requiring chest tube placement and pneumoderma requiring surgical intervention. No grade 4 or greater adverse events occurred. CONCLUSIONS: RF ablation is a promising treatment option for patients with pulmonary metastases from esophageal cancer.

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  • Risk Factors for Systemic Air Embolism as a Complication of Percutaneous CT-guided Lung Biopsy: Multicenter Case-control Study Reviewed International journal

    Hiroaki Ishii, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Hidefumi Mimura, Kotaro Yasui, Tetsuya Doke, Takashi Mukai, Hironori Kurokawa, Yoshitomo Ando, Soichiro Hase, Toshihiro Iguchi, Takayuki Yabuki, Kenichi Omae, Nobuhisa Tajiri, Toshiharu Mitsuhashi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   37 ( 5 )   1312 - 1320   2014.10

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    PURPOSE: To determine risk factors for systemic air embolism by percutaneous computed tomography (CT)-guided lung biopsy. METHODS: This case-control study used data from 2216 percutaneous lung biopsy procedures performed over 11 years at 12 institutions in Japan. Systemic air embolism was identified by retrospective review of CT images obtained during and immediately after the procedures. To fulfill our objective, multiple variables were compared between cases and controls with univariate analyses by using Student's t test and Fisher's exact test for numerical and categorical values, respectively. Multivariate logistic regression analysis was then performed using selected variables. RESULTS: Ten cases of systemic air embolism and 2,206 controls were identified. Univariate analyses showed that the lesions in the lower lobe (P = 0.025) and occurrence of parenchymal hemorrhage (P = 0.019) were significant risk factors. Multivariate analysis showed that the use of a larger biopsy needle was a significant risk factor (P = 0.014). CONCLUSION: Parenchymal hemorrhage during the procedure, lesions in the lower lobe, and the use of larger biopsy needles may be risk factors for systemic air embolism by percutaneous CT-guided lung biopsy. Our findings may provide clues toward minimizing the risk of this complication.

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  • Association between reperfusion and shrinkage percentage of the aneurysmal sac after embolization of pulmonary arteriovenous malformation: evaluation based on contrast-enhanced thin-section CT images Reviewed

    Satoko Makimoto, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Toshihiro Iguchi, Yusuke Matsui, Hidefumi Mimura, Susumu Kanazawa

    JAPANESE JOURNAL OF RADIOLOGY   32 ( 5 )   266 - 273   2014.5

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    PURPOSE: To investigate an association between reperfusion and the percentage of shrinkage of the aneurysmal sac after embolization of pulmonary arteriovenous malformation (PAVM) and to determine the cutoff value of the shrinkage percentage for indicating reperfusion. MATERIALS AND METHODS: Twenty-two PAVMs with completely embolized feeding arteries with coils were examined. The percentage of sac shrinkage and the presence of reperfusion were evaluated on computed tomography before and 1, 3, and 12 months after embolization. The percentages of sac shrinkage were compared between the occlusion and reperfusion groups. The receiver-operating characteristic (ROC) curve was generated to determine the diagnostic efficiency of reperfusion of PAVM by using shrinkage percentages. RESULTS: Reperfusion was seen in 14, 13, and 11 lesions at 1, 3, and 12 months, respectively. The mean percentage of sac shrinkage was significantly different between the two groups at 3 and 12 months. The area under the ROC curve was 0.991 at 3 months and 0.934 at 12 months. All 9 lesions with <60% sac shrinkage at 12 months showed reperfusion. CONCLUSION: The percentage of sac shrinkage was closely associated with reperfusion after embolization of PAVMs at 3 and 12 months. A shrinkage percentage of <60% at 12 months indicated reperfusion.

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  • Sclerotherapy for venous malformations Reviewed

    H. Mimura, K. Shibamoto, Y. Soda, K. Kojima, Y. Matsui, H. Fujiwara, T. Hiraki, H. Gobara, S. Kanazawa

    Japanese Journal of Clinical Radiology   59 ( 4 )   524 - 532   2014.4

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    Sclerotherapy is a mainstay in the treatment of venous malformations (VMs). Indications for sclerotherapy of VMs include symptoms such as pain, swelling, hemorrhage, or dysfunction of adjacent organs. Ethanol and detergent sclerosants (for example polidocanol and ethanolamine oleate) are amongst the sclerosants used to treat VMs. To increase the volume and effect of detergent sclerosants, they may be mixed with gas to form a foam. The predictors of a good response after sclerotherapy may be small size, a well-defined margin, and good stasis of sclerosant during sclerotherapy.

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  • A Case of Pulmonary Aspergilloma Treated with Radiofrequency Ablation Reviewed International journal

    Takao Hiraki, Hideo Gobara, Katsuya Kato, Hiroyasu Fujiwara, Toshihiro Iguchi, Yusuke Matsui, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   37 ( 2 )   554 - 557   2014.4

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  • Radiofrequency ablation of lung cancer Reviewed

    T. Hiraki, H. Gobara, T. Iguchi, H. Fujiwara, Y. Matsui, S. Kanazawa

    Japanese Journal of Clinical Radiology   59 ( 4 )   511 - 519   2014.4

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    Radiofrequency ablation (RFA) has been accepted as a treatment option for lung cancer. Techniques for lung RFA are similar to those used for percutaneous lung biopsy. The most common complication is pneumothorax. Minor but serious complications include massive hemorrhage, intractable pneumothorax, pulmonary artery pseudoaneurysm, systemic air embolism, pneumonitis, injury of the nearby tissues, and needle-tract seeding. Local efficacy of lung RFA depends on tumor size. Survival data after RFA are promising for patients with early-stage primary lung cancer and metastasis from various primary lesions.

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  • Radiofrequency ablation as treatment for pulmonary metastasis of colorectal cancer Reviewed International journal

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

    WORLD JOURNAL OF GASTROENTEROLOGY   20 ( 4 )   988 - 996   2014.1

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    Radiofrequency ablation (RFA) causes focal coagulation necrosis in tissue. Its first clinical application was reported in 2000, and RFA has since been commonly used in both primary and metastatic lung cancer. The procedure is typically performed using computed tomography guidance, and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy. The most common complication is pneumothorax, which occurs in up to 50% of procedures; chest tube placement for pneumothorax is required in up to 25% of procedures. Other severe complications, such as pleural effusion requiring chest tube placement, infection, and nerve injury, are rare. The local efficacy depends on tumor size, and local progression after RFA is not rare, occurring in 10% or more of patients. The local progression rate is particularly high for tumors > 3 cm. Repeat RFA may be used to treat local progression. Short- to mid-term survival after RFA appears promising and is approximately 85%-95% at 1 year and 45%-55% at 3 years. Long-term survival data are sparse. Better survival may be expected for patients with small metastasis, low carcinoembryonic antigen levels, and/or no extrapulmonary metastasis. The notable advantages of RFA are that it is simple and minimally invasive; preserves pulmonary function; can be repeated; and is applicable regardless of previous treatments. Its most substantial limitation is limited local efficacy. Although surgery is still the method of choice for treatment with curative intent, the ultimate application of RFA may be to replace metastasectomy for small metastases. Randomized trials comparing RFA with surgery are needed.

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  • Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer Reviewed International journal

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

    BIOMED RESEARCH INTERNATIONAL   2014   152087 - 152087   2014

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    This review examines studies of radiofrequency ablation (RFA) of nonsmall cell lung cancer (NSCLC) and discusses the role of RFA in treatment of early-stage NSCLC. RFA is usually performed under local anesthesia with computed tomography guidance. RFA-associated mortality, while being rare, can result from pulmonary events. RFA causes pneumothorax in up to 63% of cases, although pneumothorax requiring chest drainage occurs in less than 15% of procedures. Other severe complications are rare. After RFA of stage I NSCLC, 31-42% of patients show local progression. The 1-, 2-, 3-, and 5-year overall survival rates after RFA of stage I NSCLC were 78% to 100%, 53% to 86%, 36% to 88%, and 25% to 61%, respectively. The median survival time ranged from 29 to 67 months. The 1-, 2-, and 3-year cancer-specific survival rates after RFA of stage I NSCLC were 89% to 100%, 92% to 93%, and 59% to 88%, respectively. RFA has a higher local failure rate than sublobar resection and stereotactic body radiation therapy (SBRT). Therefore, RFA may currently be reserved for early-stage NSCLC patients who are unfit for sublobar resection or SBRT. Various technologies are being developed to improve clinical outcomes of RFA for early-stage NSCLC.

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  • Bleeding into a pulmonary cyst caused by pulmonary radiofrequency ablation. Reviewed International journal

    Ryotaro Kishi, Hidefumi Mimura, Takao Hiraki, Hideo Gobara, Mayu Uka, Shinichi Toyooka, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   24 ( 7 )   1069 - 71   2013.7

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  • Lung Cancer Ablation: Complications Reviewed International journal

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

    SEMINARS IN INTERVENTIONAL RADIOLOGY   30 ( 2 )   169 - 175   2013.6

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    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.

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  • The Maximum Standardized Uptake Value Is More Reliable Than Size Measurement in Early Follow-up to Evaluate Potential Pulmonary Malignancies Following Radiofrequency Ablation Reviewed

    Aierken Alafate, Takayoshi Shinya, Yoshihiro Okumura, Shuhei Sato, Takao Hiraki, Hiroaki Ishii, Hideo Gobara, Katsuya Kato, Toshiyoshi Fujiwara, Shinichiro Miyoshi, Mitsumasa Kaji, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   67 ( 2 )   105 - 112   2013.4

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    We retrospectively evaluated the accumulation of fluorodeoxy glucose (FDG) in pulmonary malignancies without local recurrence during 2-year follow-up on positron emission tomography (PET)/computed tomography (CT) after radiofrequency ablation (RFA). Thirty tumors in 25 patients were studied (10 non-small cell lung cancers;20 pulmonary metastatic tumors). PET/CT was performed before RFA, 3 months after RFA, and 6 months after RFA. We assessed the FDG accumulation with the maximum standardized uptake value (SUVmax) compared with the diameters of the lesions. The SUVmax had a decreasing tendency in the first 6 months and, at 6 months post-ablation, FDG accumulation was less affected by inflammatory changes than at 3 months post-RFA. The diameter of the ablated lesion exceeded that of the initial tumor at 3 months post-RFA and shrank to pre-ablation dimensions by 6 months post-RFA. SUVmax was more reliable than the size measurements by CT in the first 6 months after RFA, and PET/CT at 6 months post-RFA may be more appropriate for the assessment of FDG accumulation than that at 3 months post-RFA.

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  • Management of Lumbar Artery Injury Related to Pedicle Screw Insertion Reviewed

    Yoshihisa Sugimoto, Masato Tanaka, Hideo Gobara, Haruo Misawa, Toshiyuki Kunisada, Toshifumi Ozaki

    ACTA MEDICA OKAYAMA   67 ( 2 )   113 - 116   2013.4

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    We report on 2 patients who experienced injury to one of their lumbar arteries related to pedicle screw misplacement. In this report, the lumbar pedicle screw holes were made laterally with resultant injury to the lumbar artery. During surgery, arterial bleeding was controlled with pressure and gauze; however, the patients experienced vital shock after surgery. Vital shock ensued and they were rescued by catheter embolization. If patients receiving lumbar instrumentation surgery experience severe anemia or vital shock postoperatively, the surgeon should assume lumbar artery injury as a differential diagnosis.

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  • [Preliminary experience of transcatheter hepatic artery embolization using microspheres for polycystic liver disease]. Reviewed

    Hidefumi Mimura, Mayu Uka, Yusuke Matsui, Yuko Soda, Hideo Gobara, Takao Hiraki, Susumu Kanazawa, Miwa Kawanaka, Yoshiyuki Oshiro, Takahito Yagi

    Nihon Jinzo Gakkai shi   55 ( 4 )   559 - 60   2013

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  • Influence of Radiofrequency Ablation of Lung Cancer on Pulmonary Function Reviewed International journal

    Akihiro Tada, Takao Hiraki, Toshihiro Iguchi, Hideo Gobara, Hidefumi Mimura, Shinichi Toyooka, Katsuyuki Kiura, Toshihide Tsuda, Toshiharu Mitsuhashi, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   35 ( 4 )   860 - 867   2012.8

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    PURPOSE: The purpose of this study was to evaluate altered pulmonary function retrospectively after RFA. METHODS: This retrospective study comprised 41 ablation sessions for 39 patients (22 men and 17 women; mean age, 64.8 years). Vital capacity (VC) and forced expiratory volume in 1 s (FEV(1)) at 1 and 3 months after RFA were compared with the baseline (i.e., values before RFA). To evaluate the factors that influenced impaired pulmonary function, univariate analysis was performed by using multiple variables. If two or more variables were indicated as statistically significant by univariate analysis, these variables were subjected to multivariate analysis to identify independent factors. RESULTS: The mean VC and FEV(1) before RFA and 1 and 3 months after RFA were 3.04 and 2.24 l, 2.79 and 2.11 l, and 2.85 and 2.13 l, respectively. The values at 1 and 3 months were significantly lower than the baseline. Severe pleuritis after RFA was identified as the independent factor influencing impaired VC at 1 month (P = 0.003). For impaired FEV(1) at 1 month, only severe pleuritis (P = 0.01) was statistically significant by univariate analysis. At 3 months, severe pleuritis (VC, P = 0.019; FEV(1), P = 0.003) and an ablated parenchymal volume ≥20 cm(3) (VC, P = 0.047; FEV(1), P = 0.038) were independent factors for impaired VC and FEV(1). CONCLUSIONS: Pulmonary function decreased after RFA. RFA-induced severe pleuritis and ablation of a large volume of marginal parenchyma were associated with impaired pulmonary function.

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  • A Case of Delayed Massive Hemothorax Caused by the Rupture of a Pulmonary Artery Pseudoaneurysm after Radiofrequency Ablation of Lung Tumors Reviewed International journal

    Junichi Soh, Shinichi Toyooka, Hideo Gobara, Takao Hiraki, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto, Susumu Kanazawa, Shinichiro Miyoshi

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   42 ( 7 )   646 - 649   2012.7

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    Radiofrequency ablation has been applied as a minimally invasive therapy for the local control of lung tumors, including primary and metastatic neoplasms. Hemorrhagic complications after radiofrequency ablation can usually be treated conservatively, but such complications can be massive and fatal in some cases. In this paper, we report the rare case of delayed massive hemothorax caused by the rupture of a pulmonary artery pseudoaneurysm after lung radiofrequency ablation that was treated using transcatheter coil embolization followed by a left lower lobectomy. A 75-year-old woman underwent radiofrequency ablation for the treatment of a metastatic lung tumor in the left lower lobe arising from a colorectal carcinoma located close to a branch of the pulmonary artery. Thirty-six hours later, hemothorax and hemorrhagic shock occurred as a result of a ruptured pulmonary artery pseudoaneurysm and radiofrequency ablation-induced damage to the interlobular pleura. After transcatheter coil embolization of the pulmonary artery pseudoaneurysm, she recovered from a state of shock and a left lower lobectomy was performed. Histological findings revealed the presence of residual tumor cells in the ablated lung tumor. The postoperative course was uneventful, and no evidence of recurrence of the primary disease was seen at 1 year after the surgery. Although hemothorax secondary to the rupture of a pulmonary artery pseudoaneurysm after lung radiofrequency ablation is a rare complication, it should be recognized as a serious potential complication of lung radiofrequency ablation for a tumor located close to the pulmonary artery branch.

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  • Phrenic Nerve Injury after Radiofrequency Ablation of Lung Tumors: Retrospective Evaluation of the Incidence and Risk Factors Reviewed International journal

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Mayu Uka, Yoshihisa Masaoka, Akihiro Tada, Shinichi Toyooka, Toshiharu Mitsuhashi, Hidefumi Mimura, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   23 ( 6 )   780 - 785   2012.6

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    PURPOSE: To retrospectively investigate the incidence of and risk factors for phrenic nerve injury after radiofrequency (RF) ablation of lung tumors. MATERIALS AND METHODS: The study included 814 RF ablation procedures of lung tumors. To evaluate the development of phrenic nerve injury, chest radiographs obtained before and after the procedure were examined. Phrenic nerve injury was assumed to have developed if the diaphragmatic level was elevated after the procedure. To identify risk factors for phrenic nerve injury, multiple variables were compared between cases of phrenic nerve injury and randomly selected controls by using univariate analyses. Multivariate analysis was then performed to identify independent risk factors. RESULTS: Evaluation of phrenic nerve injury from chest radiographs was possible after 786 procedures. Evidence of phrenic nerve injury developed after 10 cases (1.3%). Univariate analysis revealed that larger tumor size (≥ 20 mm; P = .014), proximity of the phrenic nerve to the tumor (< 10 mm; P < .001), the use of larger electrodes (array diameter or noninsulated tip length ≥ 3 cm; P = .001), and higher maximum power applied during ablation (≥ 100 W; P < .001) were significantly associated with the development of phrenic nerve injury. Multivariate analysis demonstrated that the proximity of the phrenic nerve to the tumor (< 10 mm; P < .001) was a significant independent risk factor. CONCLUSIONS: The incidence of phrenic nerve injury after RF ablation was 1.3%. The proximity of the phrenic nerve to the tumor was an independent risk factor for phrenic nerve injury.

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  • CT fluoroscopy-guided cutting needle biopsy of focal pure ground-glass opacity lung lesions: Diagnostic yield in 83 lesions Reviewed International journal

    Daisaku Inoue, Hideo Gobara, Takao Hiraki, Hidefumi Mimura, Katsuya Kato, Kentaro Shibamoto, Tatsuhiko Iishi, Yusuke Matsui, Shinichi Toyooka, Susumu Kanazawa

    EUROPEAN JOURNAL OF RADIOLOGY   81 ( 2 )   354 - 359   2012.2

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    OBJECTIVE: The objective of our study was to retrospectively determine the diagnostic yield of CT fluoroscopy-guided cutting needle biopsy of focal pure ground-glass opacity lung lesions. MATERIALS AND METHODS: Biopsies were performed using 20-G coaxial cutting needles for 83 focal pure ground-glass opacity lung lesions (mean lesion size, 12.1mm). After excluding the lesions for which biopsy specimens were unobtainable and final diagnoses were undetermined, the diagnostic yield, including sensitivity and specificity for a diagnosis of malignancy and accuracy, was calculated. The lesions were then divided into 2 groups: the diagnostic failure group, comprising lesions with false-negative results and for which a biopsy specimen was unobtainable; and the diagnostic success group, comprising lesions with true-negative results and true-positive results. Various variables were compared between the 2 groups by univariate analysis. RESULTS: Biopsy specimens were obtained from 82 lesions, while specimens could not be obtained from 1 lesion. Final diagnosis was undetermined in 16 lesions. The sensitivity and specificity for a diagnosis of malignancy were 95% (58/61) and 100% (5/5), respectively. Diagnostic accuracy was 95% (63/66). The 4 lesions in diagnostic failure group were smaller, deeper, and more likely to be located in the lower lobe and further, for those lesions, number of specimens obtained was smaller, compared with 63 lesions in diagnostic success group. However, none of the differences were statistically significant. CONCLUSION: CT fluoroscopy-guided cutting needle biopsy provided high diagnostic yield for focal pure ground-glass opacity lung lesions.

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  • Presence of EGFR mutation in pathologically non-malignant specimens from computed tomography-guided lung needle biopsies Reviewed International journal

    Tsuyoshi Ueno, Junichi Soh, Takao Hiraki, Hiroaki Asano, Koichi Ichimura, Kentaro Shibamoto, Hideo Gobara, Susumu Kanazawa, Shinichi Toyooka, Shinichiro Miyoshi

    ONCOLOGY LETTERS   3 ( 2 )   401 - 404   2012.2

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    Activating mutations of the epidermal growth factor receptor (EGFR) gene are characteristic of non-small cell lung cancer (NSCLC). EGFR mutations were previously detected in histologically normal lung tissue around NSCLC tumors. Computed tomography-guided lung needle biopsy (CTNB) is an accurate and useful technique for the diagnosis of lung tumors. However, pathologically non-malignant cases occasionally become apparent following lung tumor resection. In this study, we determined the EGFR mutational status of lung tumors diagnosed as non-malignant in CTNB specimens, but diagnosed as NSCLC following surgical resection. Between 2000 and 2008, 1,109 CTNBs were performed at Okayama University Hospital. Among them, 15 cases were initially diagnosed as non-malignant by CTNB, but diagnosed as NSCLC following surgical resection as a result of a high likelihood of malignancy by clinical findings. Twelve paired DNAs of CTNB and corresponding resected specimens were available to examine the EGFR mutational status using a mutant-enriched PCR assay. EGFR mutations were detected in one out of 12 CTNB specimens and three of the corresponding resected tumors. This case harbored the same EGFR mutation in the CTNB specimen and resected tumor, but not in the distant corresponding non-malignant lung tissue. Our results indicated that the detection of EGFR mutations may therefore aid the diagnosis of NSCLC in pathologically non-malignant CTNB specimens.

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  • Bronchiolitis Obliterans Organizing Pneumonia after Radiofrequency Ablation of Lung Cancer: Report of Three Cases Reviewed International journal

    Takao Hiraki, Hideo Gobara, Katsuya Kato, Shinichi Toyooka, Hidefumi Mimura, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   23 ( 1 )   126 - 130   2012.1

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    The present report describes three cases of a bronchiolitis obliterans organizing pneumonia (BOOP)-like reactive pneumonitis following radiofrequency (RF) ablation for lung cancer. The incidence of BOOP-like reactive pneumonitis after RF ablation at the authors' institution was estimated to be approximately 0.4% (three of 840 sessions). The patients presented with nonspecific symptoms. Computed tomography images showed consolidation or ground-glass opacity in a peripheral-dominant distribution and/or patchy air-space opacities. The disease was nonresponsive to antibiotic therapy but responded favorably to pulse therapy of steroids. BOOP-like reactive pneumonitis should be recognized as a complication following lung RF ablation.

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  • Diaphragmatic hernia after percutaneous radiofrequency ablation of lung tumor. Reviewed International journal

    Takao Hiraki, Hideo Gobara, Yoshihisa Masaoka, Shinichi Toyooka, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   22 ( 12 )   1777 - 8   2011.12

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  • The Usefulness of Pre-Radiofrequency Ablation SUVmax in F-18-FDG PET/CT to Predict the Risk of a Local Recurrence of Malignant Lung Tumors after Lung Radiofrequency Ablation Reviewed

    Sosuke Harada, Shuhei Sato, Etsuji Suzuki, Yoshihiro Okumura, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Susumu Kanazawa, Mitsumasa Kaji, Toshiyoshi Fujiwara

    ACTA MEDICA OKAYAMA   65 ( 6 )   395 - 402   2011.12

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    The aim of the present study was to assess the diagnostic usefulness of Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the prediction of local recurrence of malignant lung tumors by analyzing the pre-radiofrequency ablation (RFA) maximal standardized uptake value (SUV(max)). We performed a historical cohort study of consecutive malignant lung tumors treated by RFA from January 2007 to May 2008 at Okayama University Hospital. We selected only lung tumors examined by PET/CT within 90 days before RFA and divided them (10 primary and 29 metastatic) into 3 groups according to their tertiles of SUV(max). We calculated recurrence odds ratios in the medium group and the high group compared to the low group using multivariate logistic analysis. After we examined the relationship between SUV(max) and recurrence in a crude model, we adjusted for some factors. Tumors with higher SUV(max) showed higher recurrence odds ratios (medium group; 1.84, high group; 4.14, respectively). The tumor size also increased the recurrence odds ratio (2.67); we thought this was mainly due to selection bias because we excluded tumors less than 10mm in diameter. This study demonstrated the pre-RFA SUV(max) in PET/CT may be a prognostic factor for local recurrence of malignant lung tumors.

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  • A case of renal transcatheter arterial embolization with ethanol in autosomal dominant polycystic kidney disease for volume reduction. Reviewed

    Takashi Mukai, Hidefumi Mimura, Hideo Gobara, Mitsuharu Shimizu, Harutaka Niiya, Susumu Kanazawa

    Acta medica Okayama   65 ( 5 )   347 - 51   2011.10

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    We report herein the case of a 76-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) and chronic renal failure resulting in intractable abdominal distension and anorexia. Computed tomography (CT) showed enlarged and cystic kidneys. We performed transcatheter arterial embolization (TAE) for renal arteries with ethanol. Absolute ethanol with iodinated contrast medium or Lipiodol was delivered into both renal arteries. The patient's low-grade fever subsided in 5 days, and no other complication occurred. The sensation of abdominal distension diminished approximately 1 month after embolization. A progressive decrease in kidney size was observed soon after embolization. The percentage of the decrement of kidney size was approximately 50% after 17 months. These results indicate that renal TAE with ethanol is a safe, cost-effective, and minimally invasive technique to reduce kidney size in symptomatic ADPKD patients.

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  • Radiofrequency Ablation of Lung Cancer at Okayama University Hospital: A Review of 10 Years of Experience Reviewed

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shinichi Toyooka, Hiroyasu Fujiwara, Kotaro Yasui, Yoshifumi Sano, Toshihiro Iguchi, Jun Sakurai, Nobuhisa Tajiri, Takashi Mukai, Yusuke Matsui, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   65 ( 5 )   287 - 297   2011.10

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    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.

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  • Percutaneous radiofrequency ablation of clinical stage I non-small cell lung cancer Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Yusuke Matsui, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY   142 ( 1 )   24 - 30   2011.7

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    OBJECTIVE: This study aimed at retrospectively evaluating the outcomes of radiofrequency ablation of clinical stage I non-small cell lung cancer. METHODS: This study was carried out on 50 nonsurgical candidates (29 men and 21 women; mean age, 74.7 years) with clinical stage I (IA, n = 38; IB, n = 12) histologically proven non-small cell lung cancer. A total of 52 tumors were treated with 52 ablation sessions. Radiofrequency ablation was performed percutaneously under computed tomography fluoroscopic guidance. The outcomes of radiofrequency ablation were evaluated, including toxicity, local efficacy, and patient survival. Toxicity was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0. Local efficacy was evaluated by using computed tomography scan with a contrast medium. The overall, cancer-specific, and disease-free survivals were estimated with Kaplan-Meier analysis. RESULTS: Grade 2 and 3 adverse events occurred after 6 (12%) and 3 (6%) of the 52 sessions, respectively. The median follow-up period was 37 months. Local progression was observed in 16 (31%) of the 52 tumors. The median survival time was 67 months. The overall, cancer-specific, and disease-free survivals were 94%, 100%, and 82% at 1 year, 86%, 93%, and 64% at 2 years, and 74%, 80%, and 53% at 3 years, respectively. CONCLUSIONS: Radiofrequency ablation of clinical stage I non-small cell lung cancer was minimally invasive and provided promising patient survival, although the local efficacy needs to be improved.

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  • Percutaneous Radiofrequency Ablation for Pulmonary Metastases from Hepatocellular Carcinoma: Results of a Multicenter Study in Japan Reviewed International journal

    Takao Hiraki, Koichiro Yamakado, Osamu Ikeda, Toshiyuki Matsuoka, Toshio Kaminou, Takuji Yamagami, Hideo Gobara, Hidefumi Mimura, Koichi Kawanaka, Kan Takeda, Yasuyuki Yamashita, Yuichi Inoue, Toshihide Ogawa, Tsunehiko Nishimura, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   22 ( 6 )   741 - 748   2011.6

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    PURPOSE: To retrospectively evaluate technical success, effectiveness, complications, patient survival, and prognostic factors with percutaneous radiofrequency (RF) ablation for pulmonary metastases resulting from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Thirty-two patients from six institutions were included, with a total of 83 pulmonary metastases treated in 65 sessions. RF ablation was always performed percutaneously with computed tomography (CT) guidance. Primary endpoints were technical success and technique effectiveness. Technique effectiveness was evaluated based on sequential follow-up CT images. Secondary study endpoints were complications, patient survival, and determination of prognostic factors. Complications were classified as major or minor. Prognostic factors were determined by analyzing multiple variables with the log-rank test. RESULTS: Technical success rate was 100%. Primary technique effectiveness rates were 92% each at 1, 2, and 3 years. Major and minor complications occurred after 16 (25%) and 23 (35%) of the 65 sessions, respectively. The median follow-up period was 20.5 months. Overall survival rates were 87% at 1 year and 57% each at 2 and 3 years (median and mean survival times, 37.7 mo and 43.2 mo, respectively). Significantly better survival rates were obtained in cases of (i) no viable intrahepatic recurrence (P < .001), (ii) Child-Pugh class A disease (P < .001), (iii) absence of liver cirrhosis (P < .001), (iv) absence of hepatitis C virus infection (P = .006), and (v) α-fetoprotein level of 10 ng/mL or lower (P = .007) at the time of RF ablation. CONCLUSIONS: RF ablation appears effective, with an acceptable safety profile, in selected patients with pulmonary metastases resulting from HCC.

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  • Technique for Creation of Artificial Pneumothorax for Pain Relief during Radiofrequency Ablation of Peripheral Lung Tumors: Report of Seven Cases Reviewed International journal

    Takao Hiraki, Hideo Gobara, Kentaro Shibamoto, Hidefumi Mimura, Yuko Soda, Mayu Uka, Yoshihisa Masaoka, Shinichi Toyooka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   22 ( 4 )   503 - 506   2011.4

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    This report describes seven cases in which a pneumothorax was artificially created for relief from severe pain that occurred during radiofrequency (RF) ablation of peripheral lung tumors. In this procedure, the multitined probe surrounding the lesion was advanced into the chest, displacing the tines and the peripheral tumor away from the parietal pleura and the chest wall and resulting in pain relief in one patient; in the remaining patients, an intravenous catheter was also introduced, followed by the administration of carbon dioxide (CO(2)) into the space between the tumor and the parietal pleura. The pain decreased considerably immediately after this procedure. No complication related to the creation of the artificial pneumothorax was observed. Creation of an artificial pneumothorax is a safe and effective method for pain relief.

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  • Radiofrequency ablation as a novel therapy for pulmonary metastasis from colorectal cancer Reviewed

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Susumu Kanazawa

    Colorectal Cancer: Risk, Diagnosis and Treatments   203 - 208   2011.1

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    Radiofrequency (RF) ablation is a thermal therapy that results in coagulation necrosis. Initially, RF ablation was mainly used for treating hepatocellular carcinoma. Favorable outcomes in the treatment of hepatocellular carcinoma have encouraged the application of this technique to neoplasms in other organs, including the lungs. RF ablation for lung cancer may be carried out percutaneously by using computed tomographic (CT) guidance; the techniques used in this therapy are simple and quite similar to those used in CT-guided lung biopsy. Mortality rate has been reported to be 0.4%. There have been promising survival data after RF ablation: 68% at 2 years, 74% at 3 years, and 75% at 2 years for patients with clinical stage I non-small-cell lung cancer; and 66% at 2 years and 46%-48% at 3 years for patients with metastatic colorectal cancer. Therefore, RF ablation of lung cancer is currently one of the hot topics in interventional radiology. In this commentary, we describe the outcomes of RF ablation as a novel therapy for pulmonary metastasis from colorectal cancer. © 2011 Nova Science Publishers, Inc. All rights reserved.

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  • Role of Computed Tomography Fluoroscopy-Guided Cutting Needle Biopsy of Lung Lesions After Transbronchial Examination Resulting in Negative Diagnosis Reviewed International journal

    Yusuke Matsui, Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Daisaku Inoue, Tatsuhiko Iishi, Shinichi Toyooka, Susumu Kanazawa

    CLINICAL LUNG CANCER   12 ( 1 )   51 - 55   2011.1

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    INTRODUCTION: Computed tomography (CT)-guided lung biopsy is occasionally used for the lesions that were diagnosed as nonmalignant by transbronchial examination despite the fact that other clinical data suggested those as malignant. The purpose of this study is to evaluate the outcomes of CT fluoroscopy-guided cutting needle biopsy of lung lesions after transbronchial examination resulting in negative diagnosis. PATIENTS AND METHODS: We retrospectively evaluated the outcomes of CT fluoroscopy-guided lung biopsy for 351 lesions (mean size, 2.8 cm) that were found to be nonmalignant by transbronchial examination. Diagnostic yield, including sensitivity and specificity for the diagnosis of malignancy, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Various variables were analyzed to determine the factors for diagnostic failure. RESULTS: The biopsy result was nondiagnostic, true-positive, true-negative, false-positive, or false-negative for 2, 262, 70, 0, or 17 lesions, respectively. Thus, the sensitivity, specificity, PPV, NPV, and accuracy of CT fluoroscopy-guided cutting needle biopsy was found to be 93% (262/281), 100% (70/70), 100% (262/262), 80% (70/87), and 94% (332/351), respectively. There was no significant risk factor for diagnostic failure. CONCLUSION: Computed tomography fluoroscopy-guided cutting needle lung biopsy is a useful technique to correct or confirm negative diagnosis by transbronchial examination.

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  • 次世代の外科治療 腎がんに対するCTガイド下経皮的ラジオ波焼灼療法(RFA)の現状と将来

    那須 保友, 小林 泰之, 雑賀 隆史, 公文 裕巳, 郷原 英夫, 金澤 右

    西日本泌尿器科   72 ( 増刊 )   81 - 81   2010.10

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  • Brachial Nerve Injury Caused by Percutaneous Radiofrequency Ablation of Apical Lung Cancer: A Report of Four Cases Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Yoshifumi Sano, Shinichi Toyooka, Kentaro Shibamoto, Ryotaro Kishi, Mayu Uka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   21 ( 7 )   1129 - 1133   2010.7

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    The present report describes four cases of brachial nerve injury caused by percutaneous radiofrequency (RF) ablation of lung cancer. All the tumors were located in the lung apex. The patients developed symptoms indicative of a low brachial plexus injury during RF ablation or as long as 7 days afterward. These symptoms partially receded over time. The indications of RF ablation in patients with apical lung cancer should be carefully determined because of the risk of brachial nerve injury associated with the procedure.

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  • Pneumopericardium as a Complication of CT-guided Lung Biopsy Reviewed International journal

    Takao Hiraki, Ryota Inai, Hidefumi Mimura, Hideo Gobara, Kentaro Shibamoto, Ryotaro Kishi, Mayu Uka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   21 ( 7 )   1136 - 1138   2010.7

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  • Pulmonary Artery Pseudoaneurysm Related to Radiofrequency Ablation of Lung Tumor Reviewed International journal

    Jun Sakurai, Hidefumi Mimura, Hideo Gobara, Takao Hiraki, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   33 ( 2 )   413 - 416   2010.4

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    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.

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  • Does tumor type affect local control by radiofrequency ablation in the lungs? Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Yoshifumi Sano, Toshihide Tsuda, Toshihiro Iguchi, Hiroyasu Fujiwara, Ryotaro Kishi, Yusuke Matsui, Susumu Kanazawa

    EUROPEAN JOURNAL OF RADIOLOGY   74 ( 1 )   136 - 141   2010.4

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    OBJECTIVE: : To retrospectively evaluate the effect of tumor type on local control by radiofrequency ablation in the lungs. MATERIALS AND METHODS: : This study included 252 lung tumors (mean size, 13.5mm) in 105 patients (73 men and 32 women; mean age, 66.6 years) who underwent radiofrequency ablation with a multitined expandable electrode. Those tumors comprised five tumor types: primary lung cancer (n=35) and pulmonary metastases from colorectal cancer (n=117), lung cancer (n=23), renal cell carcinoma (n=49), and hepatocellular carcinoma (n=28). Local control was evaluated with contrast-enhanced computed tomography. The overall local control rates were estimated as well as those for each tumor type using the Kaplan-Meier analysis. Local control rates for a given tumor type were compared with those for the four other types. Then, multivariate multilevel analysis was performed using the variables of tumor type, tumor size, contact with a vessel or bronchus, and procedure period. RESULTS: : The overall local control rates were 97%, 86%, 81%, and 76% at 6, 12, 18, and 24 months, respectively. Local control rates varied among the tumor types, and metastatic colorectal cancer showed significantly (P=.023) higher local control rates than those of the four other types. However, multivariate analysis indicated that the relative risk of local progression for a given tumor type was comparable to the risks for the four other types. CONCLUSION: : Tumor type per se did not significantly influence local control.

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  • Incidence of and Risk Factors for Pneumothorax and Chest Tube Placement After CT Fluoroscopy-Guided Percutaneous Lung Biopsy: Retrospective Analysis of the Procedures Conducted Over a 9-Year Period Reviewed International journal

    Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Kentaro Shibamoto, Daisaku Inoue, Yusuke Matsui, Susumu Kanazawa

    AMERICAN JOURNAL OF ROENTGENOLOGY   194 ( 3 )   809 - 814   2010.3

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    OBJECTIVE: The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy. MATERIALS AND METHODS: We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis. RESULTS: The overall incidence of pneumothorax was 42.3% (464/1,098). Chest tube placement was required for 11.9% (55/464) of pneumothoraces (5.0% [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p < 0.001), greater lesion depth (p < 0.001), and a needle trajectory angle of < 45 degrees (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p < 0.001) and greater lesion depth (p < 0.001). CONCLUSION: Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.

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  • Radiofrequency Ablation of Small Lung Metastases by a Single Application of a 2-cm Expandable Electrode: Determination of Favorable Responders Reviewed International journal

    Jun Sakurai, Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Hiroyasu Fujiwara, Nobuhisa Tajiri, Yoshifumi Sano, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   21 ( 2 )   231 - 236   2010.2

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    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 (<or=1 cm) lung metastases not in contact with a bronchus.

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  • Percutaneous Computed Tomography-Guided Lung Biopsy and Pleural Dissemination An Assessment by Intraoperative Pleural Lavage Cytology Reviewed International journal

    Yoshifumi Sano, Hiroshi Date, Shinichi Toyooka, Takahiro Oto, Masaomi Yamane, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Susumu Kanazawa

    CANCER   115 ( 23 )   5526 - 5533   2009.12

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    BACKGROUND: Percutaneous computed tomography (CT)-guided needle biopsy remains one of the most important diagnostic tools in the management of lung nodules; however, it carries a risk of intrapleural dissemination of cancer cells. METHODS: CT-guided lung biopsy was performed before surgery in 171 (34.8%) of 491 patients. A coaxial biopsy system was used that comprised a 19-gauge introducer needle and a 20-gauge core biopsy needle. A total of 412 (83.9%) of the 491 patients underwent intraoperative pleural lavage cytology just after thoracotomy. Intraoperative pleural lavage cytology was performed immediately after opening the thorax, after the pleural cavity was gently washed with 50 mL of saline. RESULTS: No patients had implantation of cancer cells in the chest wall after a median follow-up of 20.2 months. Intraoperative pleural lavage cytology results were positive for 5 (2.9%) of the 171 patients who underwent CT-guided biopsy before surgery, in contrast to 13 (5.4%) of the 241 patients who did not undergo biopsy before surgery. The difference between the biopsy and nonbiopsy groups was not statistically significant. When the analysis was limited to patients with stage IA disease, intraoperative pleural lavage cytology results were positive for 1 (0.8%) of the 128 patients who underwent CT-guided biopsy, in contrast to 3 (2.7%) of the 110 patients who did not undergo biopsy. This difference was also not statistically significant. CONCLUSIONS: No significant association was observed between percutaneous CT-guided lung biopsy and intraoperative pleural lavage cytology results, even in patients with stage IA disease. Percutaneous CT-guided lung biopsy with a coaxial needle does not seem to cause pleural dissemination.

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  • Sclerotherapy for Peribiliary Cysts Accompanied by Biliary Stenosis Reviewed International journal

    Hiroyasu Fujiwara, Hideo Gobara, Hidefumi Mimura, Takao Hiraki, Toshihiro Iguchi, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   20 ( 12 )   1644 - 1645   2009.12

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  • CT Fluoroscopy-Guided Biopsy of 1,000 Pulmonary Lesions Performed With 20-Gauge Coaxial Cutting Needles: Diagnostic Yield and Risk Factors for Diagnostic Failure Reviewed International journal

    Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Jun Sakurai, Yusuke Matsui, Daisaku Inoue, Shinichi Toyooka, Yoshifumi Sano, Susumu Kanazawa

    CHEST   136 ( 6 )   1612 - 1617   2009.12

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    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 <or= 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 <or= 1.0 cm (OR, 3.85; p = 0.016) and >or= 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 <or= 1.0 cm or >or= 3.1 cm significantly increased the rate of diagnostic failure.

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  • Aspergilloma in a Cavity Formed after Percutaneous Radiofrequency Ablation for Lung Cancer Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Yoshifumi Sano, Nagio Takigawa, Takehiro Tanaka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   20 ( 11 )   1499 - 1500   2009.11

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  • Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief Reviewed International journal

    Hidefumi Mimura, Hiroyasu Fujiwara, Takao Hiraki, Hideo Gobara, Takashi Mukai, Tsuyoshi Hyodo, Toshihiro Iguchi, Kotaro Yasui, Yoshihiro Kimata, Susumu Kanazawa

    EUROPEAN RADIOLOGY   19 ( 10 )   2474 - 2480   2009.10

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    The aim of this study was to retrospectively evaluate the safety and efficacy of polidocanol sclerotherapy in pain relief for painful venous malformations (VMs). Thirty-one patients with painful VMs underwent polidocanol sclerotherapy. Pain intensity was assessed with an 11-point verbal numerical rating scale. Sclerotherapy was technically successful in 58 (98.3%) of 59 sessions. Twenty-six (89.7%) out of 29 patients experienced an improvement in pain after sclerotherapy at follow-up, a mean of 46 months after treatment. The mean pain score improved from 6.6 + or - 2.5 before treatment to 2.4 + or - 2.9 after treatment (P <.001). The factors that significantly influenced the therapeutic effect were size of lesion (P = .008), margin of lesion (P = .006), and stasis of sclerosant (P = .032). Adverse events included hypotension and bradycardia during the procedure. No major complication occurred. Polidocanol sclerotherapy is safe and most efficacious in providing pain relief for patients with small VMs (equal to or less than 10 cm in diameter), VMs with a well-defined margin, and VMs with good stasis of sclerosant during sclerotherapy.

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  • Percutaneous radiofrequency ablation for unresectable pulmonary metastases from renal cell carcinoma. Reviewed International journal

    Norihito Soga, Koichiro Yamakado, Hideo Gohara, Haruyuki Takaki, Takao Hiraki, Tomomi Yamada, Kiminobu Arima, Kan Takeda, Susumu Kanazawa, Yoshiki Sugimura

    BJU international   104 ( 6 )   790 - 4   2009.9

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    OBJECTIVE: To evaluate the clinical utility of lung radiofrequency ablation (RFA) in patients with unresectable pulmonary metastasis from renal cell carcinoma (RCC). PATIENTS AND METHODS: We retrospectively examined 39 patients with unresectable metastases from RCC who were treated with lung RFA. Patients with six or fewer lung metastases measuring < or =6 cm that were confined in the lung, had all lung tumours ablated (curative ablation). Patients with extrapulmonary lesions, seven or more lung tumours, or large tumours of >6 cm, had mass reduction (palliative ablation). The primary endpoints was the overall survival, secondary endpoints were safety, local tumour progression rate, and recurrence-free survival in the curative ablation group. RESULTS: There were significant differences in the overall survival rates between the curative and palliative groups at 1 year (100% vs 90%), 3 years (100% vs 52%) and 5 years (100% vs 52%) (P < 0.05). The maximum lung tumour diameter was also a significant prognostic factor. There was local tumour progression in 13 patients (33%) during the mean follow-up of 25 months. The recurrence-free survival rates were 92% at 1 year, 23% at 3 years and 23% at 5 years in the curative ablation group. Pneumothorax requiring chest tube placement (six of 89, 7%) and pneumonia (one of 89, 1%) were major complications. CONCLUSION: Lung RFA is a safe and effective treatment for prolonging survival in patients with unresectable RCC lung metastases.

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  • Clinical outcomes of short hook wire and suture marking system in thoracoscopic resection for pulmonary nodules Reviewed International journal

    Kentaroh Miyoshi, Shinichi Toyooka, Hideo Gobara, Takahiro Oto, Hidefumi Mimura, Yoshifumi Sano, Susumu Kanazawa, Hiroshi Date

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   36 ( 2 )   378 - 382   2009.8

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    OBJECTIVE: The short hook wire and suture marking system is a device for localization of small pulmonary nodules in thoracoscopic resection. We and other authors have shown the feasibility of the marking procedure. In this study, we reviewed our recent experience to examine the problems for resecting procedure using the device and determine if the system negatively impacts the survival rates for lung cancers. METHODS: Between November 1996 and March 2007, a total of 125 pulmonary nodular lesions in 108 patients were intended for thoracoscopic resection after localization with computed tomography-guided short hook wire and suture placement. We reviewed the major problems during surgery among all cases and prognosis in 64 patients with primary lung cancer. RESULTS: One hundred and seventeen lesions (93.6%) were successfully resected by initial resection with no major complication. However, we experienced missing events, the major problem during surgery, which was defined as temporarily missing lesions or hook wires. Eight missing events (6.4%) consisting of five unresected lesions and three remaining hook wires occurred after initial wedge resection. All the missing lesions and one remaining hook wire were recovered by additional resection. No specific factors of lesions, including location, diameter, distance from the pleural surface, and opacification were related to incidence of the 'missing event'. Five-year survival of patients with stage IA lung cancer was 90.0% with no local recurrence. CONCLUSIONS: Our localization method assured a consistent quality of resection regardless of the lesion characteristics and a reasonable prognosis for patients with primary lung cancer. The short hook wire and suture system provides acceptable utility in thoracoscopic surgery.

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  • Long-term Survival after Radiofrequency Ablation for Pulmonary Metastasis from Hepatocellular Carcinoma: Report of Two Cases Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Takahito Yagi, Yoshifumi Sano, Noriaki Tanaka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   20 ( 8 )   1106 - 1107   2009.8

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  • Pulmonary Edema as a Complication of Transcatheter Embolization of Renal Angiomyolipoma in a Patient with Pulmonary Lymphangioleiomyomatosis Due to Tuberous Sclerosis Complex Reviewed International journal

    Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Hiroyasu Fujiwara, Toshihiro Iguchi, Jun Sakurai, Seiichiro Norikane, Katsuya Kato, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   20 ( 6 )   819 - 823   2009.6

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    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.

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  • Infusion of Hypertonic Saline into the Lung Parenchyma during Radiofrequency Ablation of the Lungs with Multitined Expandable Electrodes: Results Using a Porcine Model Reviewed

    Tatsuhiko Iishi, Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Taichi Kurose, Hiroyasu Fujiwara, Jun Sakurai, Hiroyuki Yanai, Tadashi Yoshino, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   63 ( 3 )   137 - 144   2009.6

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    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, 1,421mm3) than group 2 (mean, 858 mm3, p=0.039) and had a tendency toward larger necrosis volume than group 1 (mean, 878 mm3, 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.

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  • Central retinal and posterior ciliary artery occlusion after intralesional injection of sclerosant to glabellar subcutaneous hemangioma. Reviewed International journal

    Toshihiko Matsuo, Hiroyasu Fujiwara, Hideo Gobara, Hidefumi Mimura, Susumu Kanazawa

    Cardiovascular and interventional radiology   32 ( 2 )   341 - 6   2009.3

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    The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

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  • Percutaneous Coil Embolization Using the Direct Puncture Technique for a Subclavian Artery Pseudoaneurysm After Inadvertent Puncture Reviewed International journal

    Hidefumi Mimura, Hideo Gobara, Takao Hiraki, Hiroyasu Fujiwara, Jun Sakurai, Kenji Sugiu, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   32 ( 2 )   371 - 373   2009.3

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  • Two Cases of Needle-Tract Seeding after Percutaneous Radiofrequency Ablation for Lung Cancer Reviewed International journal

    Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Yoshifumi Sano, Hiroyasu Fujiwara, Toshihiro Iguchi, Jun Sakurai, Ryotaro Kishi, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   20 ( 3 )   415 - 418   2009.3

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    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.

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  • エンドユロロジー・腹腔鏡領域 腎癌に対するCTガイド下経皮的ラジオ波焼灼療法

    小林 泰之, 郷原 英夫, 枝村 康平, 小武家 誠, 上杉 達也, 雑賀 隆史, 那須 保友, 金澤 右, 公文 裕巳

    日本泌尿器科学会雑誌   100 ( 2 )   77 - 77   2009.2

  • Percutaneous radiofrequency ablation of lung cancer Reviewed International journal

    Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Yoshifumi Sano, Susumu Kanazawa

    LANCET ONCOLOGY   9 ( 7 )   604 - 605   2008.7

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  • Detection of EGFR gene mutations using the wash fluid of CT-guided biopsy needle in NSCLC patients Reviewed International journal

    Hiroki Otani, Shinichi Toyooka, Junichi Soh, Hiromasa Yamamoto, Hiroshi Suehisa, Naruyuki Kobayashi, Hideo Gobara, Hidefumi Mimura, Katsuyuki Kiura, Yoshifumi Sano, Susumu Kanazawa, Hiroshi Date

    JOURNAL OF THORACIC ONCOLOGY   3 ( 5 )   472 - 476   2008.5

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    INTRODUCTION: In this study, we examined whether epidermal growth factor receptor (EGFR) mutations were detectable using a polymerase chain reaction-based assay and wash fluid of computed tomography (CT)-guided lung biopsy needles. METHODS: DNA was extracted from wash fluid of CT-guided biopsy needles of 53 lung tumors (as diagnosed according to the results of the CT-guided biopsies). EGFR mutations, specifically exon19 deletions and exon21 L858R mutations, were examined using a mutant-enriched polymerase chain reaction assay. We also examined the presence of EGFR mutations in 26 surgically resected tumor specimens and compared the results with those obtained for the corresponding wash fluid samples. RESULTS: The amount of DNA obtained for the wash fluid of the CT-guided biopsy needles ranged from 35 to 2360 ng. There were no significant differences in the amount of extracted DNA according to the tumor characteristics, including tumor size and the percentage of ground glass opacity. Thirty-four of the 53 lung tumor samples were histologically diagnosed as non-small cell lung cancer (NSCLC). Exon19 deletions and exon21 L858R mutations in EGFR were detected in 4 (12%) and 13 (38%) of 34 NSCLC cases, respectively. No EGFR mutations were found in the non-NSCLC cases. The EGFR mutation status in the wash fluid samples was consistent with those obtained for all 26 corresponding surgical specimens. CONCLUSION: Our results indicate that EGFR mutations can be detected using wash fluid of CT-guided biopsy needles. In this manner, the DNA genotype can be determined even in extremely small clinical specimens using highly sensitive assays.

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  • Repeat radiofrequency ablation for local progression of lung tumors: Does it have a role in local tumor control? Reviewed International journal

    Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Yoshifumi Sano, Hiroyasu Fujiwara, Hiroshi Date, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   19 ( 5 )   706 - 711   2008.5

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    PURPOSE: To retrospectively evaluate the role of repeat radiofrequency (RF) ablation for local progression of lung tumors in local tumor control. MATERIALS AND METHODS: From June 2001 to February 2007, the authors treated 797 lung tumors (primary lung cancer, n=66; metastatic lung neoplasm, n=731; mean tumor size, 1.7 cm) in 295 patients with RF ablation. After RF ablation, patients were followed-up with contrast-enhanced chest computed tomography at 1, 3, 6, 9, and 12 months and thereafter at 6-month intervals. Local progression was observed in 117 of the 797 lung tumors. Fifty repeat RF ablation sessions were performed for 56 tumors (primary lung cancer, n=9; metastatic lung neoplasm, n=47; mean tumor size, 2.7 cm) in 46 patients (33 men, 13 women; mean age, 59.6 years). Repeat RF ablation was not performed for the remaining 61 locally progressing tumors because it was not presumed to provide survival benefit. For all 797 tumors, the overall primary and secondary technique effectiveness rates (TERs) after the first RF ablation were compared with each other. To determine the risk factors for local control with repeat RF ablation, multiple variables were analyzed. Next, local control with repeat RF ablation was evaluated for tumors with and tumors without risk factors. RESULTS: The overall secondary TERs were significantly higher than the overall primary TERs (P<.00001). Tumor size of at least 2 cm at the first RF ablation (P=.045) and contact with bronchi (P=.045) or vessels (P=.048) were risk factors for local control with repeat RF ablation. The secondary TERs after the first RF ablation were 94% at 1 year, 68% at 2 years, and 55% at 3 years for tumors without risk factors and 60% at 1 year and 40% at 2 years for tumors with at least one risk factor. Among the 50 repeat RF ablation sessions, pneumothorax occurred in 13 sessions (26%), one of which necessitated chest tube placement; pleural effusion occurred in nine sessions (18%), all of which resolved spontaneously. Thermal injury of the brachial plexus occurred after one session. CONCLUSIONS: Repeat RF ablation improved the overall local control outcomes. In particular, it offered an opportunity to salvage tumors that had no risk factors but nevertheless progressed locally after the first RF ablation. Conversely, tumors with risk factors were not controlled sufficiently even after repeating the procedure.

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  • Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor Reviewed

    Fumiyo Higaki, Yoshihiro Okumura, Shuhei Sato, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shiro Akaki, Toshihide Tsuda, Susumu Kanazawa

    ANNALS OF NUCLEAR MEDICINE   22 ( 3 )   157 - 163   2008.4

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    OBJECTIVE: The aim of this study was to clarify the most appropriate follow-up initiation time point for positron emission tomography (PET)/computed tomography (CT) following radio frequency ablation (RFA) of lung tumors, and the cutoff values of maximum standard uptake value (SUV(max)) to evaluate local tumor progression. METHODS: We enrolled 15 patients (8 men, median age 62 years) with 60 tumors, who were treated with RFA of lung tumors and underwent fluorodeoxyglucose (FDG)-PET/CT following RFA. Local tumor progression was assessed by periodic chest CT images prior to and following intravenous administration of a contrast medium. The SUV(max) of three periods, namely, 0-3 months, 3-6 months, and 6-9 months after RFA, was evaluated. The appropriate time point for follow-up initiation and the cutoff value of SUV(max) were determined using receiver-operating characteristic (ROC) analysis. RESULTS: The median follow-up period was 357 days. Of 60 tumors, 10 showed local progression. The area under the ROC curve (Az) for the 6-9 months (P = 0.044) was the largest and almost equal to that of the 3-6 months (P = 0.024). Az for the 0-3 months was the smallest and statistically insignificant (P = 0.705). The cutoff value of 1.5 of SUV(max) at 3-9 months after RFA showed 77.8% sensitivity and 85.7-90.5% specificity. CONCLUSIONS: The appropriate follow-up initiation time point is at least 3 months following RFA. Thus, SUV(max) is a useful and reliable predictive indicator.

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  • A novel strategy for treatment of metastatic pulmonary tumors: Radiofrequency ablation in conjunction with surgery Reviewed International journal

    Yoshifumi Sano, Susumu Kanazawa, Hidefumi Mimura, Hideo Gobara, Takao Hiraki, Hiroyasu Fujiwara, Masaomi Yamane, Shinichi Toyooka, Takahiro Oto, Hiroshi Date

    JOURNAL OF THORACIC ONCOLOGY   3 ( 3 )   283 - 288   2008.3

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    INTRODUCTION: Local treatment that includes surgical resection of metastatic pulmonary tumors is controversial because of the biologic features and invasiveness of these tumors. We report our experience with a premeditated treatment involving combined computed tomography-guided radiofrequency ablation and surgical resection in three patients with metastatic pulmonary tumors. METHODS: Three patients underwent radiofrequency ablation in conjunction with surgical resection. The first was a 67-year-old man with pulmonary metastases of bronchial adenoid cystic carcinoma. We performed partial resection of five tumors in the right lung and ablated a tumor in the left lung. The second was a 66-year-old man with pulmonary metastases of renal cell carcinoma. He underwent radiofrequency ablation for three tumors in the right upper and middle lobes, and right lower lobectomy for tumors in that lobe. The third was a 55-year-old man with pulmonary metastases of high-grade sarcoma of the right thigh. We performed partial resection of five tumors in the left lung and ablated a tumor in the right lung. RESULTS: Two patients had metastatic lesions on both sides of the lung; we performed surgical resection on one side and radiofrequency ablation contralaterally to avoid bilateral thoracotomy. The third patient underwent surgical resection and radiofrequency ablation to avoid highly invasive right pneumonectomy. All patients survived for more than 1(1/2) years after combination therapy. CONCLUSIONS: Premeditated treatment involving a combination of radiofrequency ablation and surgical resection can be a useful option in patients with metastatic pulmonary tumors, improving curability and avoiding highly invasive procedures.

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  • Radiofrequency ablation of functioning lung metastases from parathyroid carcinoma Reviewed International journal

    Toshihiro Iguchi, Kotaro Yasui, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shuhei Sato, Hiroyasu Fujiwara, Ai Yano, Hiroyoshi Doihara, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   19 ( 3 )   462 - 464   2008.3

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  • Assessment of mean transit time in the engrafted lung with Xe-133 lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients Reviewed

    Takayoshi Shinya, Shuhei Sato, Katsuya Kato, Hideo Gobara, Shiro Akaki, Hiroshi Date, Susumu Kanazawa

    ANNALS OF NUCLEAR MEDICINE   22 ( 1 )   31 - 39   2008.1

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    OBJECTIVE: Staging of bronchiolitis obliterans syndrome (BOS) following lung transplantation is based on declines in forced expiratory volume in 1 s (FEV(1)). The aim of this study was to evaluate the usefulness of (133)Xe ventilation scintigraphy in the early detection of BOS following living-donor lobar lung transplantation (LDLLT), to compare (133)Xe washout imaging with computed tomography (CT) findings for early detection of BOS following LDLLT, and to evaluate (133)Xe washout imaging by quantitative analyses. METHODS: Subjects comprised 30 double-lung recipients and 1 single-lung recipient, who had undergone LDLLT at our institution and survived more than 1 year. Clinically diagnosed BOS developed in six recipients. Declines in graft function were evaluated using a combination of three methods, namely, dynamic spirometry, high-resolution CT (HRCT), and (133)Xe ventilation scintigraphy. Findings for all transplanted lungs were compared between CT and (133)Xe washout imaging. (133)Xe washout imaging was assessed using mean transit time (MTT) of bi-and unilateral lungs. Correlations between MTT of bilateral lungs and FEV(1)% were evaluated. Differences in MTT between BOS and non-BOS lungs, and between non-BOS and donor lungs were also evaluated on unilateral lungs. Appropriate cut-off values of MTT of unilateral lungs were set for the diagnosis of BOS. RESULTS: In all six BOS cases, prolonged-washout images of engrafted lungs revealed early-phase BOS with declines from baseline FEV(1), whereas only one BOS case could be detected using early CT findings of BO (bronchodilatation, decrease in number and size of pulmonary vessels, thickening of septal lines, and volume reduction). A significant correlation was identified between MTT and FEV(1)% (r = -0.346, P < 0.0001). MTT of unilateral lungs was significantly longer in BOS lungs than in non-BOS lungs (P < 0.0001). The cut-off MTT of unilateral lungs for the diagnosis of BOS was set at 64.77 s. CONCLUSIONS: Our data show that (133)Xe washout imaging offers excellent potential for early detection of BOS compared with early CT findings. Using (133)Xe washout imaging and MTT with radioactive tracer offers a noninvasive indication of selective ventilatory function in engrafted lungs following LDLLT. MTT appears useful for identifying BOS following LDLLT and allows quantitative evaluation of graft function in unilateral lungs.

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  • Percutaneous radiofrequency ablation for clinical stage I non-small cell lung cancer: Results in 20 nonsurgical candidates Reviewed International journal

    Takao Hiraki, Hideo Gobara, Tatsuhiko Iishi, Yoshifumi Sano, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Jun Sakurai, Hiroshi Date, Hidefumi Mimura, Susumu Kanazawa

    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY   134 ( 5 )   1306 - 1312   2007.11

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    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.

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  • Percutaneous radiofrequency ablation for pulmonary metastases from colorectal cancer: Midterm results in 27 patients Reviewed International journal

    Takao Hiraki, Hideo Gobara, Tatsuhiko Iishi, Yoshifumi Sano, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Jun Sakurai, Hiroshi Date, Hidefumi Mimura, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   18 ( 10 )   1264 - 1269   2007.10

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    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 major 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 extrapulmonary 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.

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  • Nonfatal systemic air embolism complicating percutaneous CT-guided transthoracic needle biopsy - Four cases from a single institution Reviewed International journal

    Takao Hiraki, Hiroyasu Fujiwara, Jun Sakurai, Toshihiro Iguchi, Hideo Gobara, Nobuhisa Tajirl, Hidefumi Mimura, Susumu Kanazawa

    CHEST   132 ( 2 )   684 - 690   2007.8

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    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.

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  • Percutaneous radiofrequency ablation of lung tumors close to the heart or aorta: Evaluation of safety and effectiveness Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Hiroyasu Fujiwara, Nobuhisa Tajiri, Jun Sakurai, Kotaro Yasui, Hiroshi Date, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   18 ( 6 )   733 - 740   2007.6

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    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 < .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.

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  • Radiofrequency ablation followed by radiation therapy for large primary lung tumors Reviewed

    Takashi Mukai, Hidefumi Mimura, Hideo Gobara, Mitsuhiro Takemoto, Kengo Himei, Takao Hiraki, Soichiro Hase, Hiroyasu Fujiwara, Toshihiro Iguchi, Nobuhisa Tajiri, Jun Sakurai, Kotaro Yasui, Yoshifumi Sano, Hiroshi Date, Susumu Kanazawa

    ACTA MEDICA OKAYAMA   61 ( 3 )   177 - 180   2007.6

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    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.

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  • Feasibility of percutaneous radiofrequency ablation for intrathoracic malignancies - A large single-center experience Reviewed International journal

    Yoshifumi Sano, Susumu Kanazawa, Hideo Gobara, Takashi Mukai, Takao Hiraki, Soichiro Hase, Shinichi Toyooka, Motoi Aoe, Hiroshi Date

    CANCER   109 ( 7 )   1397 - 1405   2007.4

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    BACKGROUND: Radiofrequency ablation (RFA) has become an accepted alternative for treating intrathoracic malignancies; however, the incidence and characteristics of peri- and postprocedural complications are not well described. The purpose of the study was to assess the safety and technical feasibility of percutaneous RFA in unresectable intrathoracic malignancies. METHODS: Percutaneous RFA was performed in patients with intrathoracic malignancies between June 2001 and December 2004. In total, 366 tumors were treated in 137 patients in 211 sessions. All patients were nonsurgical candidates or had refused surgery. Three hundred and thirty-six lesions were subjected to RFA for the treatment of metastases and 30 lesions for primary lung carcinoma. RESULTS: Although no procedural mortality occurred, 2 patients died during the course of the study because of intractable pneumothorax and massive hemoptysis (0.9%). The overall major complication rate was 17.1% (pneumothoraces requiring tube drainage in 25, pleuritis in 6, pleural effusion requiring tube drainage in 4, lung abscess in 1, and intrapulmonary hemorrhage with hemothorax in 1). Minor complications included pneumothoraces not requiring tube drainage in 108 sessions, pleural effusion without drainage in 34, hemosputum in 9, nausea and/or vomiting in 3, subcutaneous emphysema in 3, cough in 2, skin burn in 2, atelectasis in 1, and subileus in 1. High fever and/or chest pain were seen in 33.8% and 39.3% of patients, respectively. CONCLUSIONS: With over 200 procedures, RFA appears to be a safe and minimally invasive option with negligible mortality and little morbidity in selected patients with unresectable intrathoracic malignancies.

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  • Intractable pneumothorax due to bronchopleural fistula after radiofrequency ablation of lung tumors Reviewed International journal

    Jun Sakurai, Takao Hiraki, Takashi Mukai, Hidefumi Mimura, Kotaro Yasui, Hideo Gobara, Soichiro Hase, Hiroyasu Fujiwara, Toshihiro Iguchi, Nobuhisa Tajiri, Motoi Aoe, Yoshifumi Sano, Hiroshi Date, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   18 ( 1 )   141 - 145   2007.1

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    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

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  • Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Reviewed International journal

    Takao Hiraki, Jun Sakurai, Toshihide Tsuda, Hideo Gobara, Yoshifumi Sano, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Hiroshi Date, Susumu Kanazawa

    Cancer   107 ( 12 )   2873 - 80   2006.12

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    BACKGROUND: The purpose of the study was to retrospectively evaluate the risk factors for local progression after percutaneous radiofrequency (RF) 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 tumor size (hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.47-2.65; P < .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.

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  • Radiofrequency ablation of normal lungs after pulmonary artery embolization with use of degradable starch microspheres: Results in a porcine model Reviewed International journal

    Takao Hiraki, Hideo Gobara, Jun Sakurai, Hidefumi Mimura, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Hiroyuki Yanai, Tadashi Yoshino, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   17 ( 12 )   1991 - 1998   2006.12

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    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 cm3, 2.1+/-0.4 cm3, 2.1+/-1.0 cm3, and 1.9+/-0.6 cm3 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

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  • Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: Incidence and risk factors Reviewed International journal

    Takao Hiraki, Nobuhisa Tajiri, Hidefumi Mimura, Kotaro Yasui, Hideo Gobara, Takashi Mukai, Soichiro Hase, Hiroyasu Fujiwara, Toshihiro Iguchi, Yoshifumi Sano, Nobuyoshi Shimizu, Susumu Kanazawa

    RADIOLOGY   241 ( 1 )   275 - 283   2006.10

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    PURPOSE: To retrospectively evaluate the incidence of and risk factors for pneumothorax, pleural effusion, and chest tube placement for pneumothorax after radiofrequency (RF) ablation of lung tumors. MATERIALS AND METHODS: Institutional review board approval was obtained, with waiver of informed consent. This retrospective study comprised 224 ablation sessions for 392 tumors in 142 patients (92 men, 50 women; mean age, 64.0 years). Multiple variables were analyzed by using the Student t test or the Mann-Whitney U test for numerical values and by using the chi(2) test or the Fisher exact test for categorical values in order to assess risk factors for pneumothorax, pleural effusion, and chest tube placement for pneumothorax. RESULTS: The incidence of pneumothorax, pleural effusion, and chest tube placement for pneumothorax was 52% (117 of 224 sessions), 19% (42 of 224 sessions), and 21% (24 of 117 sessions), respectively. For pneumothorax, risk factors included male sex (P = .030), no history of pulmonary surgery (P < .001), a greater number of tumors ablated (P < .001), involvement of the middle or lower lobe (P = .008), and increased length of the aerated lung traversed by the electrode (P = .014). For pleural effusion, risk factors included the use of a cluster electrode (P = .008), decreased distance to the nearest pleura (P = .040), and decreased length of the aerated lung traversed by the electrode (P = .019). For chest tube placement for pneumothorax, risk factors included no history of pulmonary surgery (P = .002), the use of a cluster electrode (P < .001), and involvement of the upper lobe (P < .001). CONCLUSION: Pneumothorax and pleural effusion can occur after RF ablation in patients with lung tumors, and chest tube placement for pneumothorax is sometimes required.

    DOI: 10.1148/radiol.2411051087

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  • Percutaneous radiofrequency ablation combined with previous bronchial arterial chemoembolization and followed by radiation therapy for pulmonary metastasis from hepatocellular carcinoma Reviewed International journal

    Takao Hiraki, Hideo Gobara, Mitsuhiro Takemoto, Hidefumi Mimura, Takashi Mukai, Kengo Himei, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Takahito Yagi, Noriaki Tanaka, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   17 ( 7 )   1189 - 1193   2006.7

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    A 56-year-old man had a lung metastasis from hepatocellular carcinoma 4.7 cm x 3.4 cm in size located directly adjacent to the pulmonary hilar vessels. The tumor was treated with radiofrequency ablation combined with earlier bronchial arterial chemoembolization and subsequent radiation therapy. A complete remission of the tumor has been observed for 6 months since completion of therapy. Considering that complete treatment of such an intermediate-sized tumor adjacent to the large vessels is usually difficult with radiofrequency ablation alone, this result suggests a possible role for combined therapy for pulmonary neoplasms.

    DOI: 10.1097/01.RVI.0000228370.09886.66

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  • Erratum: Sloughing of intraductal tumor thrombus of hepatocellular carcinoma after transcatheter chemoembolization causing obstructive jaundice and acute pancreatitis (Journal of Vascular and Interventional Radiology (2006) 17 (583-585)) Reviewed

    Takao Hiraki, Jun Sakurai, Hideo Gobara, Hirofumi Kawamoto, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Yasushi Shiratori, Susumu Kanazawa

    Journal of Vascular and Interventional Radiology   17 ( 7 )   1207   2006.7

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    DOI: 10.1016/S1051-0443(07)60861-6

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  • Effects of radiofrequency ablation on individual renal function: assessment by technetium-99m mercaptoacetyltriglycine renal scintigraphy. Reviewed

    Takashi Mukai, Shuhei Sato, Toshihiro Iguchi, Hidefumi Mimura, Kotaro Yasui, Hideo Gobara, Takashi Saika, Yasutomo Nasu, Hiromi Kumon, Susumu Kanazawa

    Acta medica Okayama   60 ( 2 )   85 - 91   2006.4

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    We quantitatively evaluated total and individual renal function by technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) renal scintigraphy before and after radiofrequency ablation (RFA) of renal tumors. Eleven patients who underwent Tc-99m MAG3 renal scintigraphy 1 week before and after RFA were evaluated (7 men and 4 women; age range: 23-83 years; mean age: 60.6 years). Five patients had solitary kidneys, and five had normally or minimally functioning contralateral kidneys. One patient had a renal cell carcinoma in the contralateral kidney. One patient with a solitary kidney underwent RFA a second time for a residual tumor. In patients with a solitary kidney, MAG3 clearance decreased after 5 of 6 RFAs, and in patients with a normally functioning contralateral kidney, MAG3 clearance decreased after 4 of 5 RFAs, but no significant differences were observed between before and after treatments. In addition to the total MAG3 clearance, the split MAG3 clearance was evaluated in patients with a normally functioning contralateral kidney. MAG3 clearance decreased in 4 of 5 treated kidneys, while it adversely increased in the contralateral kidneys after 4 of 5 RFAs. No significant differences, however, were observed between before and after treatments. The results of our study revealed no significant differences in sCr, BUN, CCr, or MAG3 clearance between pre- and post-RFA values. These results support data regarding the functional impact and safety of renal RFA in published reports. We evaluated total and individual renal function quantitatively using Tc-99m MAG3 renal scintigraphy before and after treatment. This scintigraphy was very useful in assessing the effects of RFA on renal function.

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  • Sloughing of intraductal tumor thrombus of hepatocellular carcinoma after transcatheter chemoembolization causing obstructive jaundice and acute pancreatitis. Reviewed International journal

    Takao Hiraki, Jun Sakurai, Hideo Gobara, Hirofumi Kawamoto, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Yasushi Shiratori, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   17 ( 3 )   583 - 5   2006.3

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  • Re: transsternal approach for computed tomography-guided percutaneous radiofrequency ablation of a solitary lung metastasis. Reviewed International journal

    Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Takashi Mukai, Soichiro Hase, Hiroyasu Fujiwara, Nobuhisa Tajiri, Susumu Kanazawa

    Journal of vascular and interventional radiology : JVIR   17 ( 1 )   184 - 5   2006.1

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  • Radiofrequency ablation of metastatic mediastinal lymph nodes during cooling and temperature monitoring of the tracheal mucosa to prevent thermal tracheal damage: initial experience. Reviewed International journal

    Takao Hiraki, Kotaro Yasui, Hidefumi Mimura, Hideo Gobara, Takashi Mukai, Soichiro Hase, Hiroyasu Fujiwara, Nobuhisa Tajiri, Yoshio Naomoto, Tomoki Yamatsuji, Yasuhiro Shirakawa, Shinya Asami, Hideki Nakatsuka, Motohiko Hanazaki, Kiyoshi Morita, Noriaki Tanaka, Susumu Kanazawa

    Radiology   237 ( 3 )   1068 - 74   2005.12

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    Institutional review board approval and patient informed consent were obtained. Radiofrequency ablation in a total of 10 sessions was performed for each mediastinal lymph node metastasis from esophageal cancer that had a mean largest diameter of 2.2 cm +/- 0.6 (standard deviation) in seven male patients (mean age, 59 years). During ablation, cooling and temperature of the tracheal mucosa were monitored in the proper position in eight of the 10 sessions; in the other two sessions, monitoring was not done because of tracheal stenosis (perforation resulted). Three of the four lymph nodes that were 2.0 cm or smaller in largest diameter showed no evidence of local progression for at least 1 year since ablation; all three of the nodes greater than 2.0 cm in largest diameter progressed within 6 months. The 1-year survival rate was 60%; the median survival time was 13 months. Radiofrequency ablation may be effective for local control of small metastatic mediastinal lymph nodes, and cooling and temperature monitoring of the tracheal mucosa in the proper position may prevent thermal tracheal damage.

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  • 腎癌に対するCTガイド下経皮的ラジオ波治療(Radiofrequency Ablation) 15例の臨床的検討

    小林 知子, 眞鍋 大輔, 江原 伸, 生口 俊浩, 郷原 英夫, 賀来 春紀, 雑賀 隆史, 那須 保友, 公文 裕巳

    日本癌治療学会誌   40 ( 2 )   621 - 621   2005.9

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  • A case of cortical bone metastasis Reviewed

    Nobuhisa Tajiri, H. Gobara, K. Kato, S. Akaki, S. Hase, S. Kanazawa

    Japanese Journal of Clinical Radiology   50 ( 12 )   1706 - 1710   2005

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    We report a 56-year-old man with solitary bone tumor of the right femur. The tumor was predominantly located at the cortex, and extended into soft tissue, but did not infiltrate the bone marrow. The diagnosis of bone metastasis of rectal carcinoma was made by percutaneous biopsy. Although solitary cortical bone metastasis may appear close to primary bone tumor, cortical bone metastasis can be also possible.

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  • A case of multiple retroperitoneal ganglioneuromas Reviewed

    Takao Hiraki, H. Mimura, H. Gobara, T. Mukai, S. Hase, H. Fujiwara, S. Kanazawa, H. Yanai

    Japanese Journal of Clinical Radiology   50 ( 3 )   425 - 429   2005

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    We report a case of a 31-year-old man with multiple ganglioneuromas in the retroperitoneum. Unenhanced abdominal CT images showed a large tumor with punctate calcification and a small tumor in the right retroperitoneum, both of which had homogeneous low attenuation. Dynamic CT images showed that both had minimal enhancement at the early phase. MRI images demonstrated the large one with heterogenous high signal intensity on T2-weighted images and inhomogenous gradual enhancement on dynamic images and the small one with homogenous low signal intensity on T2-weighted images and hypervascularity on dynamic images. Histopathological study confirmed that both were compatible with ganglioneuroma, consisting of ganglion cells, Schwann cells, nerve fibers, collagen and myxoid stroma. There was abundant myxoid stroma and less cellular component in the central part of the large one. On the other hand, the small one consisted mainly of cell component and collagen, possessing scarce myxoid stroma.

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  • A case of gallbladder carcinoma presenting multicystic appearance Reviewed

    Nobuhisa Tajiri, H. Gobara, T. Sato, Y. Ando, M. Takahashi, N. Yokoyama, S. Kanazawa, Y. Hiraki

    Japanese Journal of Clinical Radiology   49 ( 3 )   434 - 438   2004

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    We report a case of multicystic gallbladder carcinoma in a 47 years old male, who had no abdominal discomfort and showed no abnormal laboratory test except for mild elevation of leukocyte and C reactive protein. On computed tomography and magnetic resonance imaging. the gallbladder wall was multicystically thickened and its cavity was narrow. The mucosal line was not disrupted. On gross appearance, there were multiple cysts containing mucus in thickened gallbladder wall. The tumor was pathologically diagnosed as the gallbladder carcinoma with two histological types including mucinous cystadenocarcinoma and tubular adenocarcinoma.

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  • Two cases of cat-scratch disease Reviewed

    Yoshitomo Ando, H. Gobara, T. Sato, S. Hase, H. Fujiwara, H. Mimura, S. Kanazawa, Y. Hiraki

    Japanese Journal of Clinical Radiology   47 ( 11 )   1608 - 1611   2002

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    We present two cases of cat-scratch disease. Case 1: A 44-year-old woman was presented at our hospital with chief complaint of the right epitrochlear masses. MR imaging showed epitrochlear lymphadenopathy, appearing as heterogeneous masses with surrounding edema. Case 2: A 8-year-old boy was presented at our hospital because of fever and bilateral cervical lymphadenopathy. CT demonstrated soft tissue masses with mixed density and central low attenuation. Diagnosis of both cases was confirmed by the detection of IgG antibodies to Bartonella henselae with an indirect fluorescence antibody method.

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  • Advanced gastric cancer with tumor thrombi extending into left gastric vein and portal vein: A case report Reviewed

    Souichirou Hase, H. Gobara, T. Sato, Y. Ando, H. Ino, H. Fujiwara, H. Mimura, Y. Hiraki

    Japanese Journal of Clinical Radiology   47 ( 4 )   578 - 581   2002

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    We experienced a case of advanced gastric cancer with tumor thrombi extending into left gastric vein and portal vein. CT demonstrates the tumor thrombi that show nodular and tubular structures along the left gastric artery continuous to the portal vein. On preoperative CT evaluation of gastric cancer, further attention should be paid to differentiate portal venous thrombi from lymph nodal metastases.

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  • MR imaging of lumber epidural spinal infection Reviewed

    H. Gobara, H. Fujiwara, S. Hase, H. Kodama, Y. Hiraki

    Japanese Journal of Clinical Radiology   46 ( 7 )   793 - 799   2001

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    Five patients with spinal epidural abscess were evaluated with MR imaging. The lesions were best visualized on T1 weighted images with gadopentetate dimeglumine. In all five cases, peripheral enhancement surrounded a central focus of low signal intensity, representing necrotic abscess. In three cases, initial MR imaging showed normal appearance or only hyperintensity of the intervertebral disk. But a epidural abscess could be demonstrated clearly in each patient on follow-up MRI. Therefore, repetitive examinations may be warranted if there is suspicion of intraspinal infection on clinical grounds, even if the initial MRI scans show no abnormality.

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  • A case of abdominal tuberculous lymphadenitis limited in the hepatoduodenal ligament Reviewed

    H. Fujiwara, S. Hase, H. Gohara, Y. Mitogawa, M. Kobayashi, S. Hiraki

    Japanese Journal of Clinical Radiology   45 ( 10 )   1175 - 1179   2000

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    We experienced a rare case of abdominal tuberculous lymphadenitis limited in the hepatoduodenal ligament. Abdominal US examination showed low-echoic lymphnodes. With CT and MRI enlarged lymph nodes showed peripheral rim enhancement and non-enhanced center, which is characteristic but not pathognomonic finding in tuberculous lymphadenitis. As the lesions were difficult to distinguish from metastatic malignancy and malignant lymphoma, laparoscopic-guided biopsy was performed. When enlarged abdominal lymphnodes are observed, especially with thick and irregular peripheral rim enhancement, we should consider tuberculous lymphadenitis as a possible differential diagnosis.

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Books

  • 先端医療NAVIGATORⅡ

    日本医学出版  2014 

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  • 先端医療NAVIGATORⅡ

    日本医学出版  2014 

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  • 平成17年度 科学研究費補助金(基盤研究(C))実績報告書

    2005 

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  • 画像診断を考える -よりよい診断のために-

    秀潤社  2003 

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MISC

  • 【現場視点からセキュリティ対策を検証する】強固かつ柔軟な安全対策の要諦 病院情報システムの端末管理とセキュリティ対策 HIS更新時に講じた対応を中心に

    郷原 英夫

    新医療   47 ( 11 )   30 - 33   2020.11

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    Language:Japanese   Publisher:(株)エムイー振興協会  

    岡山大学病院では、病院情報システムの更新に伴い、端末管理にはトレーサビリティソリューションの導入を、セキュリティ対策としてファイアウォールの変更と安全性対策を講じたファイル交換システムの導入などを行ったので、その概要を紹介する。(著者抄録)

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  • Fumarate Hydratase(FH)-deficient RCCの1例

    田中 高志, 大野 凌, 田邊 新, 大川 広, 小河 七子, 槇本 怜子, 稲井 良太, 正岡 佳久, 新家 崇義, 郷原 英夫, 金澤 右, 柳井 広之

    Japanese Journal of Radiology   38 ( Suppl. )   57 - 57   2020.2

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  • Current status and future perspective of percutaneous radiofrequency ablation for small renal cell carcinoma.

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

    月刊泌尿器科   12 ( 3 )   2020

  • 骨盤うっ血症候群に対し塞栓術を施行した2例

    宗友一晃, 冨田晃司, 郷原英夫, 平木隆夫, 生口俊浩, 松井裕輔, 宇賀麻由, 梶田聡一郎, 小牧稔幸, 岡本聡一郎, 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(Web)   34 ( 4 )   2020

  • 小児生体肝移植後の難治性肝静脈狭窄に対して肝静脈ステントを留置した1例

    北山貴裕, 宇賀麻由, 宗友一晃, 岡本聡一郎, 小牧稔幸, 梶田聡一郎, 冨田晃司, 松井裕輔, 藤原寛康, 生口俊浩, 平木隆夫, 郷原英夫, 金澤右

    日本インターベンショナルラジオロジー学会雑誌(Web)   34 ( 4 )   2020

  • 動脈塞栓術が有効であった上腕骨外側上顆炎の2例

    冨田晃司, 宗友一晃, 岡本聡一郎, 小牧稔幸, 梶田聡一郎, 宇賀麻由, 松井裕輔, 櫻井淳, 生口俊浩, 平木隆夫, 郷原英夫, 金澤右

    日本インターベンショナルラジオロジー学会雑誌(Web)   34 ( 4 )   2020

  • 肝切除後の難治性胆汁漏に対して胆管ablationが有効であった1例

    大野凌, 宇賀麻由, 岡本聡一郎, 小牧稔幸, 梶田聡一郎, 冨田晃司, 松井裕輔, 生口俊浩, 平木隆夫, 郷原英夫, 金澤右

    日本インターベンショナルラジオロジー学会雑誌(Web)   34 ( 4 )   2020

  • 画像診断レポーティングシステム上からの病理所見閲覧機能の実装

    郷原英夫, 松井祐輔, 生口俊浩, 平木隆夫, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   56th   2020

  • 腎生検・凍結療法後に腫瘍播種を生じ再凍結療法を施行した1例

    岡本 聡一郎, 松井 裕輔, 平木 隆夫, 郷原 英夫, 生口 俊浩, 藤原 寛康, 櫻井 淳, 宇賀 麻由, 正岡 佳久, 金澤 右

    Japanese Journal of Radiology   37 ( Suppl. )   56 - 56   2019.2

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  • 腎動静脈奇形に対して流出静脈からのアプローチで良好に塞栓できた1例

    小牧 稔幸, 宇賀 麻由, 平木 隆夫, 大川 広, 岡本 聡一郎, 正岡 佳久, 松井 裕輔, 藤原 寛康, 櫻井 淳, 郷原 英夫, 金澤 右

    Japanese Journal of Radiology   37 ( Suppl. )   51 - 51   2019.2

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  • 肝動注リザーバーカテーテルが抜去不能となった1例

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

    IVR   33 ( 4 )   2019

  • A case of renal arteriovenous malformation incidentally detected during embolization of renal angiomyolipoma

    63 ( 8 )   933 - 936   2018.8

  • DWHを用いたCT実施件数の把握と待ち時間の改善

    郷原英夫, 黄勇, 赤木憲明, 佐藤修平, 平木隆夫, 生口俊浩, 藤原寛康, 櫻井淳, 児島克英, 多田明博, 松井裕輔, 正岡佳久, 金澤右

    Japanese Journal of Radiology   36 ( Supplement )   44   2018.2

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    J-GLOBAL

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  • EVAR後のType Iaエンドリークに対して,経カテーテル的コイル塞栓術を施行した1例

    馬越紀行, 平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 正岡佳久, 梶田聡一郎, 浅野雄大, 小牧稔幸, 渡邊謙太, 久住研人, 杉山聡一, 横田智紗子, 郷原英夫, 金澤右

    Japanese Journal of Radiology   36 ( Supplement )   2018

  • 総合病院と地域(画像診断):遠隔読影を用いた地域連携-岡山大学における運用から

    郷原英夫, 生口俊浩, 平木隆夫, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   54th   2018

  • 血管内平滑筋腫症に対し動脈塞栓術を施行した1例

    横田智紗子, 正岡佳久, 郷原英夫, 平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 梶田聡一郎, 小牧稔幸, 馬越紀行, 金澤右

    Japanese Journal of Radiology   36 ( Supplement )   2018

  • VATSマーカー留置時に緊張性心嚢気腫を生じた1例

    小牧 稔幸, 生口 俊浩, 郷原 英夫, 平木 隆夫, 藤原 寛康, 川端 隆寛, 沼 哲也, 梶田 聡一郎, 馬越 紀行, 金澤 右

    IVR: Interventional Radiology   32 ( 3 )   241 - 242   2017.10

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  • 悪性下大静脈症候群に対してNiti-S大腸用ステントを留置し、水分管理に難渋した1例

    小牧 稔幸, 郷原 英夫, 平木 隆夫, 生口 俊浩, 藤原 寛康, 櫻井 淳, 松井 裕輔, 正岡 佳久, 金澤 右

    IVR: Interventional Radiology   32 ( 3 )   248 - 248   2017.10

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  • IVRにおける仮想透視画像の有用性

    正岡 佳久, 平木 隆夫, 郷原 英夫, 生口 俊浩, 藤原 寛康, 松井 裕輔, 梶田 聡一郎, 浅野 雄大, 馬越 紀行, 小牧 稔幸, 金澤 右

    IVR: Interventional Radiology   32 ( 3 )   251 - 251   2017.10

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  • Pyloric/Duodenal stent placement for malignant inferior vena cava syndrome : a case report

    62 ( 5 )   725 - 728   2017.5

  • 腎洞側に突出する腎癌に対する凍結療法の検討

    梶田 聡一郎, 生口 俊浩, 川端 隆寛, 沼 真吾, 沼 哲也, 小牧 稔幸, 馬越 紀行, 藤原 寛康, 平木 隆夫, 郷原 英夫, 金澤 右

    Japanese Journal of Radiology   35 ( Suppl. )   75 - 75   2017.2

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  • 肝移植後にトリコアキシシャルシステムを使用してPSEを施行した2例

    藤原 寛康, 郷原 英夫, 平木 隆夫, 生口 俊浩, 川端 隆寛, 馬越 紀行, 梶田 聡一郎, 沼 哲也, 小牧 稔幸, 金澤 右

    Japanese Journal of Radiology   35 ( Suppl. )   66 - 66   2017.2

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  • FGF-23産生腫瘍の局在同定に全身静脈サンプリングが有用であった1例

    小牧 稔幸, 平木 隆夫, 生口 俊浩, 藤原 寛康, 稲井 良太, 郷原 英夫, 金澤 右, 櫻井 淳, 稲垣 兼一

    Japanese Journal of Radiology   35 ( Suppl. )   67 - 67   2017.2

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  • Renal Cryoablation

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

    The Official Journal of the Japanese Society of Interventional Radiology   32 ( 2 )   148 - 152   2017

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    DOI: 10.11407/ivr.32.148

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  • 特集 知っておきたい泌尿器画像診断ー新たな動向も含めてー腎癌の治療におけるアブレーションの現状ー凍結治療を中心にー

    平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 金澤 右, 荒木元朗, 和田耕一郎, 郷原英夫

    画像診断   37 ( 14 )   1452 - 1460   2017

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    DOI: 10.15105/GZ.0000000183

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  • 遠隔読影の可能性-岡山大学における運用から-

    郷原英夫, 平木隆夫, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   53rd   2017

  • 岡山大学病院における超高精細CT運用に向けての取り組み

    多田明博, 郷原英夫, 平木隆夫, 生口俊浩, 新家崇義, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   53rd   2017

  • Lymphography for filarial chyluria : a case report

    61 ( 9 )   1169 - 1172   2016.9

  • 前腕静脈奇形に対して凍結療法を施行した1例

    藤原 寛康, 郷原 英夫, 平木 隆夫, 生口 俊浩, 櫻井 淳, 馬越 紀行, 梶田 聡一郎, 小牧 稔幸, 金澤 右

    IVR: Interventional Radiology   31 ( Suppl. )   147 - 147   2016.4

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  • DEB-TACE後のHCC及び正常肝実質に生じる病理学的変化に対する検討

    小牧 稔幸, 藤原 寛康, 郷原 英夫, 平木 隆夫, 生口 俊浩, 櫻井 淳, 川端 隆寛, 梶田 聡一郎, 沼 哲也, 馬越 紀行, 田中 健大, 柳井 広之, 岡田 裕之, 八木 孝仁, 金澤 右

    IVR: Interventional Radiology   31 ( Suppl. )   155 - 155   2016.4

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  • 腎洞側に突出する腎癌に対するCT透視下凍結療法の検討(CT fluoroscopy-guided cryoablation for central type renal cell carcinoma)

    梶田 聡一郎, 生口 俊浩, 郷原 英夫, 平木 隆夫, 藤原 寛康, 川端 隆寛, 沼 真吾, 沼 哲也, 小牧 稔幸, 馬越 紀行, 金澤 右

    IVR: Interventional Radiology   31 ( Suppl. )   220 - 220   2016.4

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  • ハイドロコイルを用いた動脈瘤塞栓の経験

    和田敏明, 平木隆夫, 郷原英夫, 藤原寛康, 生口俊浩, 松井裕輔, 金澤右

    Japanese Journal of Radiology   34 ( Supplement )   2016

  • 腎癌の凍結治療:どこまで治療できるか

    郷原英夫, 平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 正岡佳久, 櫻井淳, 金澤右

    泌尿器画像診断・治療技術研究会プログラム・抄録   4th   2016

  • 腎癌に対する腎凍結療法 初期経験の報告

    淀谷 光子, 平木 隆夫, 内海 暢子, 坂本 拓己, 和田 敏明, 兒島 聡一, 小河 七子, 槇本 怜子, 小林 由季, 生口 俊浩, 藤原 寛康, 郷原 英夫, 金澤 右

    Japanese Journal of Radiology   33 ( Suppl. )   87 - 87   2015.2

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  • 肺癌のIVR前の画像診断

    生口俊浩, 郷原英夫, 平木隆夫, 藤原寛康, 金澤 右

    臨床画像   2015

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  • レポート端末から電子カルテ端末への患者IDの受け渡しシステムの導入

    郷原英夫, 加藤勝也, 平木隆夫, 生口俊浩, 藤原寛康, 多田明博, 佐藤修平, 金澤 右

    映像情報Medical   2015

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  • Hydrodissectionと腎癌に対する凍結治療

    メディックス   2015

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  • 腎癌の診断とIVR治療

    画像診断   2015

  • タブレット端末を用いた夜間,休日読影

    郷原英夫, 藤原寛康, 生口俊浩, 平木隆夫, 児島克秀, 多田明宏, 乗金精一郎, 櫻井潤, 佐藤修平, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   51st   2015

  • 肺RFAにおける電極針展開径が局所制御に及ぼす影響についての検討

    井原弘貴, 郷原英夫, 松井裕輔, 生口俊浩, 藤原寛康, 平木隆夫, 金澤右

    IVR   30 ( 1 )   2015

  • 腎癌のcryoablation

    郷原英夫, 平木隆夫, 生口俊浩, 藤原寛康, 金澤右

    泌尿器画像診断・治療技術研究会プログラム・抄録   3rd   2015

  • 肺アスペルギローマにラジオ波焼灼療法が有用であった1例

    淀谷光子, 平木隆夫, 郷原英夫, 加藤勝也, 藤原寛康, 生口俊浩, 松井裕輔, 金澤右

    Japanese Journal of Radiology   33 ( Supplement )   2015

  • 骨軟部腫瘍に対する凍結治療 (特集 凍結治療最前線)

    郷原 英夫, 平木 隆夫, 生口 俊浩

    映像情報medical   46 ( 11 )   930 - 933,900   2014.10

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    Other Link: http://search.jamas.or.jp/link/ui/2015012869

  • 肺腺癌の胸膜浸潤診断におけるF-18 FDG-PETおよびCT所見との対比

    田中 高志, 新家 崇義, 佐藤 修平, 稲井 良太, 井田 健太郎, 郷原 英夫, 加地 充昌, 金澤 右

    核医学   51 ( 3 )   288 - 288   2014.9

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  • タリウムシンチグラフィを用いた良悪性骨病変の鑑別能に関する検討

    稲井 良太, 新家 崇義, 佐藤 修平, 田中 高志, 井田 健太郎, 郷原 英夫, 金澤 右

    核医学   51 ( 3 )   324 - 324   2014.9

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  • Radiofrequency ablation of lung cancer

    59 ( 4 )   511 - 519   2014.4

  • MRIとSPECT/CTが診断に有用であったpure struma ovariiの1例

    槇本 怜子, 新家 崇義, 佐藤 修平, 田中 高志, 小河 七子, 佐野 由佳, 井田 健太郎, 加藤 勝也, 郷原 英夫, 金澤 右, 上者 郁夫, 柳井 広之, 関 典子, 平松 祐司

    Japanese Journal of Radiology   32 ( Suppl. )   60 - 60   2014.2

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  • イレウスにて発症した心嚢内ヘルニアの1例

    粉川 怜子, 郷原 英夫, 新家 崇義, 井田 健太郎, 加藤 勝也, 佐藤 修平, 田邊 俊介, 野間 和広, 櫻間 教文

    Japanese Journal of Radiology   32 ( Suppl. )   50 - 50   2014.2

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  • 静脈奇形の硬化療法

    三村秀文, 芝本健太郎, 宗田由子, 児島克英, 松井裕輔, 藤原寛康, 平木隆夫, 郷原英夫, 金澤 右

    臨床放射線   2014

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  • 岡山大学病院IVRセンターにおける電子情報環境

    郷原英夫, 平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 金澤 右

    映像情報Medical   2014

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  • 腎凍結療法の実際

    藤原寛康, 平木隆夫, 郷原英夫, 生口俊浩, 松井裕輔, 金澤 右

    Rad Fan   2014

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  • 軟部動静脈奇形の塞栓術

    三村秀文, 芝本健太郎, 宗田由子, 児島克英, 松井裕輔, 藤原寛康, 平木隆夫, 郷原英夫, 金澤 右

    臨床画像   2014

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  • 小腸出血に対し緊急でバルーン閉塞下逆行性経静脈的塞栓術を施行した1例

    淀谷光子, 冨田晃司, 石井裕朗, 小河七子, 粉川怜子, 宇賀麻由, 藤原寛康, 平木隆夫, 郷原英夫, 金澤右

    Japanese Journal of Radiology   32 ( Supplement )   2014

  • 肩甲骨経由でのCTガイド下針穿刺の検討

    小河七子, 宇賀麻由, 石井裕朗, 平木隆夫, 淀谷光子, 冨田晃司, 藤原寛康, 郷原英夫, 金澤右

    Japanese Journal of Radiology   32 ( Supplement )   2014

  • 肝嚢胞性腫瘍との鑑別を要した肝嚢胞内出血の1例

    田中高志, 郷原英夫, 冨田晃司, 宇賀麻由, 石井裕朗, 新家崇義, 藤原寛康, 井田健太郎, 平木隆夫, 加藤勝也, 佐藤修平, 金澤右

    Japanese Journal of Radiology   32 ( Supplement )   2014

  • A Case of Renovascular Hypertension Complicated with Ulcerative Colitis in a 40-year-old male

    Tanaka Keiko, Hiraoka Sakiko, Terasaka Ritsuko, Sugiyama Hitoshi, Wada Jun, Adam Uchida Haruhito, Hiramatsu Sumie, Tenta Masafumi, Inoue Akiko, Okuyama Yuka, Umebayashi Ryoko, Gobara Hideo, Oozawa Susumu

    The Journal of Japanese College of Angiology   54 ( 10 )   167 - 172   2014

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    Renovascular hypertension (RVH) is caused from various diseases. Here, we report a case of RVH complicated with ulcerative colitis in a 40-year-old male. The contrast enhanced CT scan and angiography revealed right renal artery occlusion and developed collateral arteries. It also revealed the stenosis of left renal segmental artery and hepatic artery, obstruction of the beginning of both internal iliac arteries, and partial constriction of the abdominal aorta. FDG-PET demonstrated no uptake of FDG in large vessels. Skin and colon biopsies showed no evidence of any vasculitis. Thus, this case was very difficult to diagnose what caused RVH.

    DOI: 10.7133/jca.14-00031

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  • 経皮経肝的に塞栓を施行した肝仮性動脈瘤の1例

    宇賀麻由, 藤原寛康, 小河七子, 粉川玲子, 淀谷光子, 冨田晃司, 石井裕朗, 平木隆夫, 郷原英夫, 金澤右

    Japanese Journal of Radiology   32 ( Supplement )   2014

  • Strangulated intrapericardial hernia of the small bowel following pericardial-peritoneal window : a case report

    58 ( 12 )   1785 - 1788   2013.11

  • F-18 FDG PET/CTが診断に有用であったRosai-Dorfman病の2例

    新家 崇義, 佐藤 修平, 井田 健太郎, 郷原 英夫, 加地 充昌, 金澤 右

    核医学   50 ( 3 )   S232 - S232   2013.9

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  • Application of RFA for the treatment of oligometastasis and oligo-recurrence

    58 ( 8 )   1069 - 1075   2013.8

  • Ⅹ 肺癌の治療戦略 インターベンショナルラジオロジーによる治療 肺癌のラジオ波焼灼療法

    金澤 右, 郷原英夫, 平木隆夫

    日本臨牀 最新肺癌学ー基礎と臨床の最新研究動向ー   2013

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  • Ablationの現状と未来 6.不可逆電気穿孔法

    藤原寛康, 平木隆夫, 石井裕朗, 郷原英夫, 金澤 右

    IVR会誌   2013

  • Ablationの現状と未来 4.肺癌に対するラジオ波焼灼療法

    平木隆夫, 郷原英夫, 藤原寛康, 金澤 右

    IVR会誌   2013

  • Polidocanol Sclerotherapy for Venous Malformations

    Mimura Hidefumi, Matsui Yusuke, Soda Yuko, Michishita Norishige, Fujiwara Hiroyasu, Hiraki Takao, Gobara Hideo, Kanazawa Susumu

    The Official Journal of the Japanese Society of Interventional Radiology   28 ( 1 )   87 - 91   2013

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    DOI: 10.11407/ivr.28.87

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  • 岡山大学病院でのCTガイドの現況とMRIガイドの今後

    郷原英夫

    新医療   2013

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  • アブレーション:腎癌 -凍結療法を中心に-

    郷原英夫, 平木隆夫, 藤原寛康, 生口俊浩, 松井裕輔, 金澤 右

    臨床画像   2013

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  • Lung cancer ablation: Complications International journal

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

    Seminars in Interventional Radiology   30 ( 2 )   169 - 175   2013

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    Although radiofrequency ablation for lung cancer is generally safe (with a mortality rate &lt
    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. © 2013 by Thieme Medical Publishers, Inc.

    DOI: 10.1055/s-0033-1342958

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  • [Preliminary experience of transcatheter hepatic artery embolization using microspheres for polycystic liver disease].

    Hidefumi Mimura, Mayu Uka, Yusuke Matsui, Yuko Soda, Hideo Gobara, Takao Hiraki, Susumu Kanazawa, Miwa Kawanaka, Yoshiyuki Oshiro, Takahito Yagi

    Nihon Jinzo Gakkai shi   55 ( 4 )   559 - 60   2013

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  • 埋込型中心静脈カテーテルの断裂を来した2例

    上原健敬, 武田健, 兒島聡一, 長谷井嬢, 郷原英夫, 国定俊之, 尾崎敏文

    中国・四国整形外科学会雑誌   25 ( 3 )   2013

  • 多発結節性脂肪肝の1例

    冨田晃司, 平木隆夫, 郷原英夫, 石井裕朗, 金澤右

    Japanese Journal of Radiology   31 ( Supplement 1 )   2013

  • 岡山大学病院IVRセンターの電子情報環境

    郷原英夫, 平木隆夫, 生口俊浩, 藤原寛康, 松井裕輔, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   49th   2013

  • 肺動静脈瘻の塞栓術後のaneurysmal sacの縮小率と再灌流の検討

    槇本怜子, 平木隆夫, 淀谷光子, 宇賀麻由, 冨田晃司, 石井裕朗, 藤原寛康, 郷原英夫, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   72nd   2013

  • 非小細胞肺癌におけるF-18 FDG PET/CTの有用性 転移性リンパ節と胸膜浸潤の診断に関して

    新家 崇義, 佐藤 修平, アラファト・アルキン, 井田 健太郎, 郷原 英夫, 加地 充昌, 金澤 右

    核医学   49 ( 3 )   S200 - S200   2012.8

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  • 軟骨性腫瘍の良悪性鑑別におけるTc-99m DMSA(V)シンチグラフィの有用性に関する検討

    Alafate Aierken, 新家 崇義, 佐藤 修平, 井田 健太郎, 郷原 英夫, 金澤 右

    核医学   49 ( 3 )   S205 - S205   2012.8

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  • Phrenic Nerve Injury after Radiofrequency Ablation of Lung Tumors: Retrospective Evaluation of the Incidence and Risk Factors International journal

    Yusuke Matsui, Takao Hiraki, Hideo Gobara, Mayu Uka, Yoshihisa Masaoka, Akihiro Tada, Shinichi Toyooka, Toshiharu Mitsuhashi, Hidefumi Mimura, Susumu Kanazawa

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   23 ( 6 )   780 - 785   2012.6

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    Purpose: To retrospectively investigate the incidence of and risk factors for phrenic nerve injury after radiofrequency (RF) ablation of lung tumors.
    Materials and Methods: The study included 814 RF ablation procedures of lung tumors. To evaluate the development of phrenic nerve injury, chest radiographs obtained before and after the procedure were examined. Phrenic nerve injury was assumed to have developed if the diaphragmatic level was elevated after the procedure. To identify risk factors for phrenic nerve injury, multiple variables were compared between cases of phrenic nerve injury and randomly selected controls by using univariate analyses. Multivariate analysis was then performed to identify independent risk factors.
    Results: Evaluation of phrenic nerve injury from chest radiographs was possible after 786 procedures. Evidence of phrenic nerve injury developed after 10 cases (1.3%). Univariate analysis revealed that larger tumor size &gt;= 20 mm; P = .014), proximity of the phrenic nerve to the tumor (&lt; 10 mm; P &lt; .001), the use of larger electrodes (array diameter or noninsulated tip length &gt;= 3 cm; P = .001), and higher maximum power applied during ablation (&gt;= 100 W; P &lt; .001) were significantly associated with the development of phrenic nerve injury. Multivariate analysis demonstrated that the proximity of the phrenic nerve to the tumor (&lt; 10 mm; P &lt; .001) was a significant independent risk factor.
    Conclusions: The incidence of phrenic nerve injury after RF ablation was 1.3%. The proximity of the phrenic nerve to the tumor was an independent risk factor for phrenic nerve injury.

    DOI: 10.1016/j.jvir.2012.02.014

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  • Myxoinflammatory fibroblastic sarcomaの1例

    新家 崇義, 多田 明博, 原田 聡介, 稲井 良太, 郷原 英夫, 加藤 勝也, 清 哲朗, 奥村 能啓, 佐藤 修平, 金澤 右, 越宗 靖二郎, 長谷川 健二朗, 田中 健大

    Japanese Journal of Radiology   30 ( Suppl.I )   67 - 67   2012.2

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  • ISSVA分類とその臨床的意義.

    三村秀文, 松井裕輔, 藤原寛康, 平木隆夫, 郷原英夫, 宗田由子, 道下宣成, 木股敬裕, 金澤 右

    画像診断   32 ( 10 )   974 - 985   2012

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  • 肺ラジオ波焼灼療法後のF-18FDG集積に関する検討

    アラファト アルキン, 奥村能啓, 新家崇義, 平木隆夫, 郷原英夫, 加藤勝也, 佐藤修平, 藤原俊義, 三好新一郎, 金澤右

    日本医学放射線学会総会抄録集   71st   2012

  • 肺生検後に生じた心嚢気腫の1例

    稲井良太, 平木隆夫, 芝本健太郎, 郷原英夫, 三村秀文, 金澤右

    Japanese Journal of Radiology   30 ( Supplement 1 )   2012

  • 肺RFA後に呼吸停止をきたした1例

    岸亮太郎, 三村秀文, 芝本健太郎, 平木隆夫, 郷原英夫, 金澤右, 豊岡伸一

    Japanese Journal of Radiology   30 ( Supplement 1 )   2012

  • 腎細胞癌に対し腹腔鏡下ラジオ波焼灼術を施行した2例

    石川 勉, 小林 泰之, 神原 大樹, 岸本 涼, 和田 耕一郎, 杉本 盛人, 江原 伸, 郷原 英夫, 藤原 寛康, 渡辺 豊彦, 雑賀 隆史, 那須 保友, 公文 裕巳

    西日本泌尿器科   73 ( 増刊 )   140 - 140   2011.10

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  • RADIOFREQUENCY ABLATION OF RENAL CELL CARCINOMA UNDER CT GUID ANCE : PRESENT AND FUTURE STATUS

    NASU YASUTOMO, KOBAYASHI YASUYUKI, UEMATSU KATSUTOSHI, SAIKA TAKASHI, KUMON HIROMI, GOHARA HIDEO, MIMURA HIDEFUMI, KANAZAWA SUSUMU

    The Nishinihon journal of urology   73 ( 5 )   223 - 227   2011.5

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  • ラジオ波焼灼療法後に遅発性血気胸を発症した大腸癌肺転移の1例

    宗淳一, 豊岡伸一, 郷原英夫, 大谷真二, 杉本誠一郎, 山根正修, 大藤剛宏, 三好新一郎

    日本呼吸器外科学会雑誌   25 ( 3(Web) )   P45-07 (WEB ONLY)   2011.4

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  • 腎RFA 適応と合併症

    三村秀文, 郷原英夫, 平木隆夫, 藤原寛康, 芝本健太郎, 金澤 右

    Jpn J Intervent Radiol   26 ( 4 )   708 - 411   2011

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  • 非小細胞肺癌の治療後変化

    奥村能啓, 新家崇義, 宗田由子, 生口俊浩, 小林 満, 檜垣文代, 平木隆夫, 郷原英夫, 加藤勝也, 佐藤修平, 加地充昌, 金澤 右

    臨床画像   27 ( 12 )   1446 - 1455   2011

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  • 当院における生体肝移植後肝静脈拡張術

    芝本健太郎, 山本岳玄, 井原弘貴, 宇賀麻由, 正岡佳久, 宗田由子, 原田聡介, 平木隆夫, 郷原英夫, 三村秀文, 金澤右

    IVR   26 ( 1 )   2011

  • 肺RFA後に横隔膜ヘルニアを生じた1例

    正岡佳久, 山本岳玄, 井原弘貴, 宇賀麻由, 宗田由子, 芝本健太郎, 平木隆夫, 郷原英夫, 加藤勝也, 三村秀文, 金澤右

    IVR   26 ( 1 )   2011

  • 肺ラジオ波焼灼療法後の高度炎症反応発生のリスクファクター

    郷原英夫, 平木隆夫, 芝本健太郎, 三村秀文, 宗田由子, 原田聡介, 宇賀麻由, 正岡佳久, 井原弘貴, 金澤右

    日本医学放射線学会総会抄録集   70th   2011

  • 腎原発のmixed small cell and urothelial cell carcinomaの1例

    正岡佳久, 芝本健太郎, 平木隆夫, 郷原英夫, 加藤勝也, 奥村能啓, 佐藤修平, 三村秀文, 金澤右, 佐々木克己, 雑賀隆史, 公文裕巳, 柳井広之

    Japanese Journal of Radiology   29 ( Supplement 1 )   2011

  • 肺癌に対するラジオ波焼灼術が呼吸機能に及ぼす影響の検討

    多田明博, 平木隆夫, 生口俊浩, 郷原英夫, 三村秀文, 金澤右

    IVR   26 ( Supplement )   2011

  • 多発HCC病変に対し,ミリプラチン使用TACEを行い重篤な副作用おこした1例

    宗田由子, 芝本健太郎, 山本岳玄, 井原弘貴, 宇賀麻由, 正岡佳久, 原田聡介, 平木隆夫, 郷原英夫, 三村秀文, 金澤右

    IVR   26 ( 1 )   2011

  • Embozene embolization後の平滑筋肉腫肝転移1切除例

    宇賀麻由, 三村秀文, 山本岳玄, 井原弘貴, 正岡佳久, 宗田由子, 原田聡介, 芝本健太郎, 平木隆夫, 郷原英夫, 金澤右, 内海方嗣, 松田浩明, 八木孝仁, 田中健大

    IVR   26 ( 1 )   2011

  • Embozeneによる動脈塞栓術が著効した仙骨巨細胞腫の1例

    郷原英夫, 三村秀文, 平木隆夫, 芝本健太郎, 宗田由子, 原田聡介, 宇賀麻由, 正岡佳久, 井原弘貴, 山本岳玄, 金澤右, 岸亮太郎, 高橋正秀

    IVR   26 ( 1 )   2011

  • Feature article: Challenges to intractable diseases: advanced therapies for intractable diseases: Interventional radiology for vascular anomalies

    三村秀文, 藤原寛康, 平木隆夫, 郷原英夫, 芝本健太郎, 木股敬裕, 尾崎敏文, 佐々木了, 金澤右

    Journal of Okayama Medical Association   122 ( 1 )   55 - 59   2010.4

  • RFAの実際.

    金澤 右, 郷原英夫

    臨床画像   26巻 ( 2号 )   183 - 191   2010

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  • 血管腫・血管奇形に対するinterventional radiology

    三村秀文, 藤原寛康, 平木隆夫, 郷原英夫, 芝本健太郎, 木股 敬裕, 尾﨑 敏文, 佐々木 了, 金澤 右

    岡山医学会雑誌   122巻 ( 1号 )   55 - 59   2010

  • ラジオ波焼灼術とスクリュー固定により低侵襲治療できた大腿骨頸部osteoblastomaの1例

    郷原英夫, 丸中三菜子, 平木隆夫, 芝本健太郎, 岸亮太郎, 三村秀文, 金澤右

    IVR   25 ( 1 )   2010

  • 脈絡膜黒色腫の病期,再発診断におけるFDG-PET/CTの初期経験

    荻野裕香, 奥村能啓, 佐藤修平, 新家崇義, 原田聡介, 檜垣文代, 宗田由子, 山本岳玄, 加藤勝也, 郷原英夫, 平木隆夫, 三村秀文, 加地充昌, 松尾俊彦, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   46th   2010

  • 肺ラジオ波焼灼療法後のFDG-PET/CTでの評価-3ケ月後と6ケ月後の比較-

    アラファト アルキン, 奥村能啓, 原田聡介, 郷原英夫, 平木隆夫, 加藤勝也, 佐藤修平, 三村秀文, 佐野由文, 藤原俊義, 加地充昌, 金澤右

    核医学   47 ( 4 )   2010

  • 腎RFAにてRCCを治療し糖尿病が改善した1例

    岸亮太郎, 郷原英夫, 芝本健太郎, 平木隆夫, 三村秀文, 金澤右

    IVR   25 ( 1 )   2010

  • 肝細胞癌肺転移に対するラジオ波焼灼療法:日本における多施設共同研究の結果

    平木隆夫, 山門享一郎, 池田理, 松岡利幸, 神納敏夫, 山上卓士, 郷原英夫, 金澤右

    日本医学放射線学会総会抄録集   69th   2010

  • Budd-Chiari症候群に対してPTAを施行した1例

    芝本健太郎, 三村秀文, 稲井良太, 宇賀麻由, 正岡佳久, 岸亮太郎, 宗田由子, 多田明博, 平木隆夫, 郷原英夫, 金澤右, 井石龍比古

    IVR   25 ( 1 )   2010

  • 胆嚢転移を呈した腎癌の2例

    稲井良太, 郷原英夫, 平木隆夫, 加藤勝也, 佐藤修平, 金澤右, 篠浦先, 貞森裕, 八木孝仁

    Japanese Journal of Radiology   28 ( Supplement 1 )   2010

  • 肺RFA後にtumor seedimgを生じた2例

    岸亮太郎, 平木隆夫, 芝本健太郎, 郷原英夫, 三村秀文, 金澤右

    Japanese Journal of Radiology   28 ( Supplement 1 )   2010

  • HIV陽性者に発症し,HARRT療法後に消退したMALTomaの1例

    岡村淳, 加藤勝也, 井上大作, 平木隆夫, 郷原英夫, 清哲郎, 佐藤修平, 金澤右, 市村浩一, 吉野正

    Japanese Journal of Radiology   28 ( Supplement 1 )   2010

  • 肺ラジオ波焼灼術後のpneumatocele形成

    郷原英夫, 平木隆夫, 芝本健太郎, 岸亮太郎, 宗田由子, 原田聡介, 宇賀麻由, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   69th   2010

  • 肺RFA後に生じた空洞にアスペルギローマを生じた1例

    正岡佳久, 平木隆夫, 郷原英夫, 芝本健太郎, 多田明博, 岸亮太郎, 宇賀麻由, 宗田由子, 三村秀文, 金澤右

    IVR   25 ( 1 )   2010

  • 挙上空腸静脈瘤出血に対して経回腸静脈NBCA塞栓術を施行した2例

    三村秀文, 郷原英夫, 宇賀麻由, 稲井良太, 正岡佳久, 岸亮太郎, 宗田由子, 多田明博, 芝本健太郎, 平木隆夫, 金澤右, 吉田龍一, 貞森裕, 八木孝仁, 神崎洋光, 石田悦嗣, 河本博文, 山本和秀

    IVR   25 ( 1 )   2010

  • 腎細胞癌に伴う肺転移巣に対するRadiofrequency ablationの効果

    曽我 倫久人, 山門 亨一郎, 郷原 英夫, 高木 治行, 平木 隆夫, 有馬 公伸, 竹田 寛, 金澤 右, 杉村 芳樹

    腎癌研究会会報   ( 37 )   11 - 13   2009.9

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    腎癌原発の切除不能肺転移病変に、経皮的にradiofrequency ablation(RFA)を行った。対象は39例で、肺転移部位個数が6個以下、かつ最大径6cm未満のCurative群15例(C群)、肺転移部位個数が7個以上、もしくは最大径6cm以上のPalliative群24例(P群)に分けた。Over all survivalは、1年はC群:100%、P群:90.3%、5年はC群:100%、P群:52.4%で、C群において有意に高かった。RFAを行った病変のlocal progression rateは、C群:2例(13%)、P群:11例(46%)で、risk factorは最大腫瘍径:3cm以上であった。C群におけるrecurrence-free rateは、1年:92.3%、5年:23.2%であった。合併症は、majorなものはC群:15%、P群:5%、minorなものはC群:8%、P群:5%で、2群間に有意差はなかった。経皮的RFAは、腎癌肺転移巣に対する局所治療として有益で、肺病変が6個以下、最大径3cm以下、肺転移以外に転移病巣が確認されていない症例には良い適応だと思われた。

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  • 肺腫瘍に対するRFAの現況と最前線 (特集 IVRの新しい波)

    郷原 英夫, 平木 隆夫, 三村 秀文

    映像情報medical   41 ( 6 )   594 - 596   2009.6

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  • CTガイド下肺生検に合併した空気塞栓症の4例

    松井裕輔, 平木隆夫, 櫻井淳, 藤原寛康, 黒瀬太一, 郷原英夫, 三村秀文, 金澤右

    Radiat Med   27 ( Supplement 1 )   79   2009.4

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  • CT上pure GGOを呈した卵巣癌肺転移の1例

    松井裕輔, 郷原英夫, 加藤勝也, 櫻井淳, 田尻展久, 藤原寛康, 黒瀬太一, 三村秀文, 金澤右

    Radiat Med   27 ( Supplement 1 )   65   2009.4

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  • 腎細胞癌に伴う肺転移巣に対するRadiofrequency ablationの効果

    曽我倫久人, 山門亨一郎, 郷原英夫, 高木治行, 平木隆夫, 有馬公伸, 竹田寛, 金澤右, 杉村芳樹

    日本泌尿器科学会雑誌   100 ( 2 )   135   2009.2

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  • 肺RFA3,6ケ月後におけるFDG-PET/CTでの半定量評価の前向き検討

    奥村能啓, アラファトアウキン, 原田聡介, 郷原英夫, 平木隆夫, 加藤勝也, 佐藤修平, 三村秀文, 佐野由文, 藤原俊義, 加地充昌, 金澤右

    肺癌   49 ( 5 )   2009

  • JUP1-2 腎癌に対するCTガイド下経皮的ラジオ波焼灼療法(JUAアップデートセッション パネルディスカッション1「エンドユロロジー・腹腔鏡領域」,第97回日本泌尿器科学会総会)

    小林 泰之, 郷原 英夫, 枝村 康平, 小武家 誠, 上杉 達也, 雑賀 隆史, 那須 保友, 金澤 右, 公文 裕巳

    日本泌尿器科学会雑誌   100 ( 2 )   2009

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  • 産科緊急止血のIVR 3.産科出血の動脈塞栓術による緊急止血-ゼラチンスポンジ,コイル-

    芝本健太郎, 三村秀文, 平木隆夫, 郷原英夫, 金澤右

    IVR   24 ( 2 )   2009

  • 大腿骨頭置換術による外腸骨静脈損傷をIVRで治療した1例

    冨田晃司, 三村秀文, 平木隆夫, 郷原英夫, 宇賀麻由, 丸中三菜子, 松井裕輔, 原田聡介, 岸亮太郎, 井上大作, 芝本健太郎, 金澤右

    IVR   24 ( 4 )   2009

  • 結節性硬化症に伴う腎血管筋脂肪腫に対してエタノールによる腎動脈塞栓術後に肺水腫を来した1例

    岸亮太郎, 平木隆夫, 芝本健太郎, 郷原英夫, 三村秀文, 金澤右

    IVR   24 ( 4 )   2009

  • 動脈塞栓術を施行した外傷性持続勃起症の1例

    芝本健太郎, 三村秀文, 岸亮太郎, 原田聡介, 松井裕輔, 丸中三菜子, 井上大作, 平木隆夫, 郷原英夫, 金澤右, 石井和史

    IVR   24 ( 4 )   2009

  • 肺ラジオ波焼灼術後の肺病変に対するステロイド投与併用群についての検討

    宇賀麻由, 加藤勝也, 郷原英夫, 児島克英, 三村秀文, 金澤右

    日本呼吸器学会雑誌   47   2009

  • IVR Today 2009 IVRの可能性と限界-見えない壁を越えて I IVRの最新動向:限界への挑戦 1.Vascular IVR 4)血管腫・血管奇形のIVR 静脈奇形の最新治療-フォーム硬化療法

    三村秀文, 藤原寛康, 郷原英夫, 平木隆夫, 芝本健太郎, 金澤右

    Innervision   24 ( 12 )   2009

  • 経皮的ドレナージ~横隔膜下膿瘍,膵周囲液体貯留・腫瘍,その他の腹腔内・後腹膜腫瘍~

    三村秀文, 郷原英夫, 平木隆夫, 芝本健太郎, 井上大作, 金澤右

    IVR   24 ( 1 )   2009

  • 肺RFA3ケ月,6ケ月後のFDG PET-CTでの集積における半定量的評価の前向き検討

    奥村能啓, 郷原英夫, 井上大作, 平木隆夫, 三村秀文, 佐藤修平, 佐野由文, 藤原俊義, 加地充昌, 金澤右

    日本医学放射線学会総会抄録集   68th   2009

  • 肺癌RFA3,6カ月後のPET/CTの集積程度の検討

    奥村能啓, 郷原英夫, 井上大作, 平木隆夫, 三村秀文, 金澤右, 佐野由文, 藤原俊義, 加地充昌

    IVR   24 ( 4 )   2009

  • RFA前のPET/CTにおけるSUVとRFA後の腫瘍再発との関連性について

    原田聡介, 奥村能啓, 郷原英夫, 平木隆夫, 加藤勝也, 佐藤修平, 三村秀文, 丸中三菜子, 佐野由文, 藤原俊義, 加地充昌, 金澤右

    肺癌   49 ( 5 )   2009

  • RFA前のFDG-PETにおけるSUVmaxとRFA後の腫瘍再発に関連はあるか

    原田聡介, 奥村能啓, 佐藤修平, 丸中三菜子, 郷原英夫, 平木隆夫, 新家崇義, 檜垣文代, 加地充昌, 金澤右

    核医学   46 ( 3 )   2009

  • 肺ラジオ波焼灼療法における再発危険因子の検討-主として技術的要因について-

    郷原英夫, 平木隆夫, 井上大作, 松井祐輔, 丸中三菜子, 岸亮太郎, 宇賀麻由, 芝本健太郎, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   68th   2009

  • 肺RFAによる呼吸機能への早期影響の検討

    生口俊浩, 平木隆夫, 郷原英夫, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   68th   2009

  • 肺ラジオ波焼灼療法による局所制御は腫瘍の種類に影響されるか?

    平木隆夫, 郷原英夫, 三村秀文, 芝本健太郎, 岸亮太郎, 松井裕輔, 宇賀麻由, 芝本健太郎, 冨田晃司, 金澤右

    日本医学放射線学会総会抄録集   68th   2009

  • 肺RFA後局所再発の評価における造影CTの有用性

    丸中三菜子, 郷原英夫, 芝本健太郎, 平木隆夫, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   68th   2009

  • 腎ラジオ波焼灼療法時の消化管熱損傷予防対策

    井石龍比古, 平木隆夫, 井上大作, 櫻井淳, 藤原寛康, 黒瀬太一, 郷原英夫, 三村秀文, 金澤右, 田尻展久, 生口俊浩

    Radiation Medicine   27 ( Supplement 1 )   2009

  • Diagnosis and interventional radiology of vascular anaomalies

    三村秀文, 藤原寛康, 郷原英夫, 平木隆夫, 芝本健太郎, 井上大作, 金澤右

    関節外科   28 ( 6 )   2009

  • 前腕部グロームス腫瘍の1例

    丸中三菜子, 藤原寛康, 櫻井淳, 平木隆夫, 黒瀬太一, 郷原英夫, 三村秀文, 金澤右

    Radiation Medicine   27 ( Supplement 1 )   2009

  • 20Gコアキシャル生検針を用いたCT透視下肺生検:1000病変での診断成績

    平木隆夫, 三村秀文, 郷原英夫, 芝本健太郎, 宇賀麻由, 岸亮太郎

    肺癌   49 ( 5 )   2009

  • Radiofrequency Ablation for Lung Cancer

    GOBARA Hideo, KANAZAWA Susumu

    Haigan   48 ( 6 )   759 - 764   2008.10

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    Primary lung cancer is a worldwide problem, but many patients are non-surgical candidates due to comorbidities. Percutaneous radiofrequency (RF) ablation is a newly developed therapeutic option for unresectable lung cancer. Several authors have reported preliminary and midterm results of this therapy, including its usefulness and minimal invasiveness. However, its technique is not well established. RF ablation for lung cancer has been performed at Okayama University since June 2001 after we obtained approval from our institutional review board. A total of 312 patients with 853 tumors have been treated as of the end of April 2007. Primary and secondary technique effectiveness rate at 3 years is 58% and 66%, respectively. Survival after this therapy seems promising, especially for those patients with unresectable stage-I non small cell lung cancer (NSCLC), with intrapulmonary recurrence after resection of primary NSCLC, and with pulmonary metastases from colorectal cancer. In this paper, we describe the indications, ablation planning, techniques, results, complications, and prospects for the future of this therapy, based on our 6-year experience.<br>

    DOI: 10.2482/haigan.48.759

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  • CTガイド下肺生検に合併した空気塞栓症の4例

    松井裕輔, 平木隆夫, 櫻井淳, 藤原寛康, 黒瀬太一, 郷原英夫, 三村秀文, 金澤右

    日本医学放射線学会総会抄録集   67th   S252   2008.2

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  • PET/CTによる肺癌RFA後の再発診断の至適時期の検討

    奥村能啓, 郷原英夫, 井上大作, 平木隆夫, 三村秀文, 佐藤修平, 加藤勝也, 加地充昌, 佐野由文, 藤原俊義, 金澤右

    肺癌   48 ( 5 )   2008

  • PP-449 腎癌に対するCTガイド下経皮的ラジオ波焼灼療法(Radiofrequency Ablation) : 5年間の治療成績(腎腫瘍/手術(腹腔鏡をのぞく),一般演題ポスター,第96回日本泌尿器科学会総会)

    小林 知子, 金澤 右, 公文 裕巳, 田尻 展久, 谷本 竜太, 小武家 誠, 上杉 達也, 郷原 英夫, 賀来 春紀, 雑賀 隆史, 那須 保友

    日本泌尿器科学会雑誌   99 ( 2 )   490 - 490   2008

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    DOI: 10.5980/jpnjurol.99.490_1

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  • 大腿骨頭置換術による外腸骨静脈損傷をIVRで治療した一例

    冨田晃司, 三村秀文, 平木隆夫, 郷原英夫, 宇賀麻由, 丸中三菜子, 松井裕輔, 原田聡介, 岸亮太郎, 井上大作, 芝本健太郎, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   44th   2008

  • 縦隔腫瘍の形態を呈して診断に苦慮した結核症の1例

    児島克英, 加藤勝也, 冨田晃司, 井上大作, 郷原英夫, 奥村能啓, 佐藤修平, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   44th   2008

  • Evaluation of Images of Radiofrequency Ablation of Malignant Renal Tumor

    生口俊浩, 平木隆夫, 郷原英夫, 三村秀文, 金澤右

    断層映像研究会雑誌   35 ( 3 )   2008

  • 類骨骨腫に対する経皮的 CT ガイド下ラジオ波焼灼術 (RFA) の治療経験.

    国定 俊之, 森本 裕樹, 尾﨑 敏文, 丸中三菜子, 郷原 英夫, 金澤 右

    中部整災誌   51 ( 5 )   911 - 912   2008

  • WS6-1 画像所見によりアスベスト新法の救済認定対象となる肺癌症例の検討(ワークショップ アスベスト関連肺癌,第48回日本肺癌学会総会号)

    加藤 勝也, 田尻 展久, 藤原 寛康, 郷原 英夫, 佐藤 修平, 木浦 勝行, 伊達 洋至, 金澤 右

    肺癌   47 ( 5 )   459 - 459   2007.10

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  • CT上pure GGOを呈した卵巣癌肺転移の1例

    松井裕輔, 郷原英夫, 加藤勝也, 櫻井淳, 田尻展久, 藤原寛康, 黒瀬太一, 三村秀文, 金澤右

    日本医学放射線学会秋季臨床大会抄録集   43rd   S508   2007.9

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  • 各種悪性腫瘍に対するラジオ波焼灼療法 (特集 最先端のIVR)

    金澤 右, 三村 秀文, 郷原 英夫

    映像情報medical   39 ( 6 )   544 - 550,528   2007.6

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    Other Link: http://search.jamas.or.jp/link/ui/2008016477

  • 原発性肺癌のN因子,M因子におけるFDG-PET/CTの診断能について

    奥村能啓, 佐藤修平, 新家崇義, 檜垣文代, 平木隆夫, 郷原英夫, 赤木史郎, 金澤右

    核医学   44 ( 3 )   2007

  • Focal GGO病変に対するCTガイド下肺生検についての検討

    井上大作, 郷原英夫, 三村秀文, 加藤勝也, 平木隆夫, 藤原寛康, 田尻展久, 金澤右, 藤原俊義, 佐野由文, 伊達洋至

    肺癌   47 ( 5 )   2007

  • Segmental Arterial Mediolysis(SAM)が疑われた1例

    長谷聡一郎, 田尻展久, 藤原寛康, 平木隆夫, 田頭周一, 向井敬, 郷原英夫, 三村秀文, 金澤右, 滝正樹, 岩垣博巳, 田中紀章

    Radiation Medicine   25   2007

  • P-82 原発性肺癌の病期診断におけるF-18 FDG PET/CTの診断能について(FDG-PET2, 第47回日本肺癌学会総会)

    奥村 能啓, 檜垣 文代, 佐藤 修平, 平木 隆夫, 向井 敬, 郷原 英夫, 金澤 右

    肺癌   46 ( 5 )   546 - 546   2006.11

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  • 軟部腫瘍のTIシンチグラフィ 疑陽性例の検討

    赤木 史郎, 新家 崇義, 郷原 英夫, 佐藤 修平, 黒田 昌宏, 金澤 右

    核医学   43 ( 3 )   244 - 244   2006.10

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  • 健診で発見された肺犬糸状虫症の1例 本邦報告117例の集計

    櫻井 淳, 郷原英夫, 田尻展久, 安藤由智, 丸山修一郎, 横山伸二, 大林千穂, 金澤 右

    臨床放射線   2006

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  • 肺腫瘍のRFA

    安井光太郎, 金澤 右, 郷原英夫, 向井 敬, 平木隆夫, 長谷聡一郎, 藤原寛康, 戸上 泉, 井上信浩, 守都常晴, 長谷川 明

    臨床放射線   2006

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  • 気管冷却下に施行した縦隔リンパ節転移に対するラジオ波焼灼療法

    平木隆夫, 安井光太郎, 三村秀文, 郷原英夫, 向井 敬, 長谷聡一郎, 藤原寛康, 田尻展久, 猶本良夫, 山辻知樹, 白川靖博, 浅海信也, 中塚秀輝, 花崎元彦, 森田 潔, 田中紀章, 金澤 右

    岡山医学会雑誌   118 ( 2 )   105 - 108   2006

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    ラジオ波焼灼療法は、時に、隣接構造物に熱損傷を与える。それを防ぐために気管粘膜の温度モニタリングと冷却を行いながら、食道癌術後の縦隔リンパ節転移に対してラジオ波焼灼療法を施行した。食道癌術後の縦隔リンパ節転移7例を対象とした。リンパ節転移の大きさが2cm以下の4例中3例では、1回もしくは2回の治療により、リンパ節は完全焼灼され、局所再発を認めていない。リンパ節が2cmを超える3例は全て6ヵ月以内に再発した。合併症は、経肺的に電極針を刺入した4セッションのうち2セッションで気胸が生じたが、いずれも無治療で改善した。ホルネル症候群が2例にみられた。気管狭窄のため気管内チューブのカフを腫瘍レベルまで挿入することが出来ず、そのため適切な位置での気管冷却、温度モニタリングが出来なかった2例では、いずれも気管膜様部で穿孔が生じた。

    DOI: 10.4044/joma1947.118.2_105

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  • 肺癌に対するラジオ波焼灼療法-当院での経験をもとに-

    郷原英夫, 向井 敬, 三村秀文, 平木隆夫, 佐野由文, 伊達洋至, 金澤 右

    IVR会誌   2006

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  • 肺腫瘍のCTガイド下RFAによる治療

    安井光太郎, 金澤 右, 郷原英夫, 向井 敬, 平木隆夫, 長谷聡一郎, 藤原寛康, 田尻展久, 戸上 泉, 井上信浩, 守都常晴, 長谷川 明

    臨床放射線   2006

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  • 腫瘍 ablation 総論

    金澤 右, 郷原英夫, 向井 敬, 平木隆夫, 田尻展久, 櫻井 淳

    臨床放射線   51,11,194-205.   2006

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  • 私の考えるレジデンシープログラム

    郷原英夫, 金澤 右

    臨床画像   22,6,1771-1775.   2006

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  • 心臓・大動脈に近接する肺腫瘍に対するラジオ凝固療法の検討

    生口俊浩, 郷原英夫, 平木隆夫, 向井敬, 田尻展久, 佐野由文, 青江基, 伊達洋至, 勝井邦彰, 金澤右

    肺癌   46 ( 5 )   2006

  • 肺腫瘍の良悪性診断におけるF-18FDG PET/CTとMRI(DWIBS,T2WI)の比較

    奥村能啓, 檜垣文代, 佐藤修平, 平木隆夫, 向井敬, 郷原英夫, 金澤右

    肺癌   46 ( 5 )   2006

  • DSMを用いたTAEが著効した子宮肉腫多発転移の1例

    田尻展久, 郷原英夫, 平木隆夫, 向井敬, 長谷聡一郎, 藤原寛康, 生口俊浩, 櫻井淳, 金澤右

    Radiology Frontier   9 ( 2 )   2006

  • RFA後の肺結節性病変におけるFDG-PET/CTの診断能について

    檜垣文代, 奥村能啓, 佐藤修平, 郷原英夫, 向井敬, 平木隆夫, 金澤右

    肺癌   46 ( 5 )   2006

  • 食道癌縦隔再発に対するラジオ波焼灼術

    浅海信也, 猶本良夫, 桜間一史, 羽井佐実, 花崎元彦, 多賀直行, 中塚秀輝, 郷原英夫, 三村秀文

    岡山医学会雑誌   116 ( 3 )   318   2005.1

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  • 皮質骨転移の1例

    田尻展久, 郷原英夫, 加藤勝也, 赤木史郎, 長谷聡一郎, 金澤 右

    臨床放射線   2005

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  • 胸部悪性腫瘍に対するラジオ波(RFA)およびマイクロ波(MCT)治療

    佐野由文, 伊達洋至, 向井 敬, 郷原英夫, 金澤 右

    外科治療   2005

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  • 肺悪性腫瘍のラジオ波治療

    金澤 右, 三村秀文, 郷原英夫, 向井 敬, 平木隆夫, 長谷聡一郎, 藤原寛康, 田尻展久, 佐野由文, 清水信義, 藤原俊義, 田中紀章

    成人病と生活習慣病   2005

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  • 多発性後腹膜神経節細胞腫(ganglioneuroma)の1例

    平木隆夫, 三村秀文, 柳井広之, 郷原英夫, 向井 敬, 長谷聡一郎, 藤原寛康, 金澤 右

    臨床放射線   2005

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  • RFA・PEI

    郷原英夫, 金澤 右

    臨床画像   2005

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  • 肺高血圧症を合併した肺動静脈ろうに対して塞栓術を施行した1例

    向井敬, 郷原英夫, 平木隆夫, 長谷聡一郎, 藤原寛康, 生口俊浩, 田尻展久, 金沢右

    IVR   20 ( 4 )   2005

  • 人工喉頭留置のための気管食道ろう造設術

    藤原寛康, 郷原英夫, 三村秀文, 向井敬, 田頭周一, 平木隆夫, 田尻展久, 金沢右

    日本医学放射線学会学術集会抄録集   64th   2005

  • 胸部悪性腫ように対するラジオ波焼灼療法後のCTによる経過観察-特に造影CTについて-

    向井敬, 三村秀文, 加藤勝也, 郷原英夫, 平木隆夫, 長谷聡一郎, 藤原寛康, 田尻展久, 安井光太郎

    日本医学放射線学会学術集会抄録集   64th   2005

  • 肺腫ように対する経皮的ラジオ波焼灼療法(RFA)の中期治療成績

    長谷聡一郎, 郷原英夫, 三村秀文, 向井敬, 平木隆夫, 藤原寛康, 生口俊浩, 田尻展久, 桜井淳, 金沢右, 安井光太郎

    IVR   20 ( 4 )   2005

  • 腎癌に対するCTガイド下経皮的ラジオ波治療(Radiofrequency Ablation)-15例の臨床的検討

    小林知子, 真鍋大輔, 江原伸, 生口俊浩, 郷原英夫, 賀来春紀, 雑賀隆史, 那須保友, 公文裕巳

    日本癌治療学会誌   40 ( 2 )   2005

  • 肺悪性腫瘍のラジオ波治療.

    金澤 右, 向井 敬, 三村秀文, 田頭周一, 藤原寛康, 平木隆夫, 郷原英夫, 佐野由文, 伊達洋至, 藤原俊義, 清水信義, 横山正尚, 安井光太郎, 生口俊浩, 兵頭 剛

    映像情報Medical   2004

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  • 多房性嚢胞性腫瘤を示した胆嚢癌の1例.

    田尻展久, 郷原英夫, 佐藤卓也, 安藤由智, 高橋三奈, 横山伸二, 金澤 右, 平木祥夫

    臨床放射線   2004

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  • 陰嚢AVMの1例

    藤原寛康, 三村秀文, 田尻展久, 原武史, 平木隆夫, 田頭周一, 向井敬, 郷原英夫, 光嶋勲

    IVR   19 ( 3 )   2004

  • 浸潤性発育を示し悪性腫瘍と鑑別困難であった腎血管腫の1例

    郷原英夫, 安藤由智, 佐藤卓也, 田尻展久, 長谷聡一郎, 村田 匡, 野田雅敏, 金澤 右 平木祥夫

    腹部画像診断アトラス〔IIIV〕   2003

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  • 卵巣疾患の鑑別診断

    郷原英夫, 安藤由智, 田尻展久, 佐藤卓也, 平木祥夫

    画像診断   23巻 3号 245-253   2003

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  • エストロゲン産生を認めた転移性卵巣腫瘍の1例

    安藤由智, 郷原英夫, 佐藤卓也, 田尻展久, 長谷聡一郎, 金澤 右 平木祥夫

    腹部画像診断アトラス〔IIIV〕   2003

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  • 猫ひっかき病の2例

    安藤由智, 郷原英夫, 佐藤卓也, 長谷聡一郎, 藤原寛康, 三村秀文, 金澤 右 平木祥夫

    臨床放射線   2002

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  • 特異な形態を呈し蛋白漏出性胃腸症をきたした早期胃癌の1例

    郷原英夫, 佐藤卓也, 長谷聡一郎, 安藤由智, 伊野英男, 大谷 順, 藤原寛康, 金澤 右 平木祥夫

    腹部画像診断アトラス〔IIV〕   2002

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  • 原発巣から連続性に門脈内腫瘍栓をきたした胃癌の1例

    長谷聡一郎, 郷原英夫, 佐藤卓也, 安藤由智, 伊野英男, 藤原寛康, 三村秀文, 平木祥夫

    臨床放射線   2002

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  • 膵管狭細型慢性膵炎の1例

    長谷聡一郎, 郷原英夫, 藤原寛康, 水戸川芳巳, 三村秀文, 金澤 右 平木祥夫

    腹部画像診断アトラス〔IV〕   2001

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  • 腰椎硬膜外膿瘍のMRI

    郷原英夫, 藤原寛康, 長谷聡一郎, 児玉浩昭, 平木祥夫

    臨床放射線   2001

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  • 肝十二指腸間膜に限局した腹部リンパ節結核の1例

    藤原寛康, 長谷聡一郎, 郷原英夫, 水戸川芳已, 小村まき, 平木祥夫

    臨床放射線   2000

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  • 直腸癌に合併したBiliary Hamartomasの1例

    郷原英夫, 長谷聡一郎, 塩出 壮, 水戸川芳已, 三村秀文, 平木隆夫, 平木祥夫

    腹部画像診断アトラス〔V〕   2000

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  • 直腸癌に合併したBiliary Hamartomaの1例

    郷原英夫, 長谷聡一郎, 塩出壮, 水戸川芳巳, 三村秀文, 平木隆夫, 平木祥夫

    日獨医報   44 ( 4 )   1999

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Presentations

  • CT透視ガイド下腎腫瘍生検の検討

    第3回 日本泌尿器癌局所療法研究会  2017 

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  • 病院情報のシステムのITセキュリティリスク

    福山医療センター オープンカンファレンス  2017 

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  • 高度腎機能障害患者に発生した腎がんに対する凍結治療:多施設による後向き研究

    第3回 日本泌尿器癌局所療法研究会  2017 

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  • PD後に生じたCHA仮性動脈瘤出血に対してバイアバーンを用いて治療した1例

    第23回 日本血管内治療学会総会  2017 

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  • 著名な門脈圧亢進を来したArterioportal Fistulaに対して塞栓術を施行した1例

    第128回 日本医学放射線学会中国・四国地方会  2017 

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  • 先天性門脈欠損症の1例

    第128回 日本医学放射線学会中国・四国地方会  2017 

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  • 腎血管筋脂肪腫の治療中に腎動静脈奇形が発見された1例

    第128回 日本医学放射線学会中国・四国地方会  2017 

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  • PD後に生じたCHA仮性動脈瘤出血に対してバイアバーンを用いて治療した1例

    第31回 中国四国IVR研究会  2017 

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  • 遠隔読影の可能性 -岡山大学における運用から-

    第53回 日本医学放射線学会秋季臨床大会 -第30回 電子情報研究会学術集会-  2017 

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  • 腎癌に対する凍結治療 Up to date

    第53回 日本医学放射線学会秋季臨床大会  2017 

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  • 高度腎機能障害患者に発生した腎がんに対する凍結治療:多施設による後向き研究

    第18回 RFA・凍結療法研究会  2017 

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  • 腎生検・凍結療法後に腫瘍播種を生じ再凍結療法を施行した1例

    第129回 日本医学放射線学会中国・四国地方会  2017 

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  • 膵癌肝転移破裂に対しTAE施行した1例

    第31回 中国四国IVR研究会  2017 

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  • TIPS後にステント破損を認めた1例

    第31回 中国四国IVR研究会  2017 

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  • 腎動静脈奇形に対して流出静脈からのアプローチで良好に塞栓できた1例

    第129回 日本医学放射線学会中国・四国地方会  2017 

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  • 腎生検後に遅発性出血を来した1例

    第129回 日本医学放射線学会中国・四国地方会  2017 

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  • 小腎腫瘍に対するCT透視ガイド下生検の安全性、診断能、失敗因子の検討

    第45回 日本IVR学会総会  2016 

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  • 腎洞側に突出する腎癌に対するCT透視下凍結療法の検討

    第45回 日本IVR学会総会  2016 

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  • 腎癌凍結療法による腎嚢胞の縮小について

    第45回 日本IVR学会総会  2016 

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  • DEB-TACE後のHCC及び正常肝実質に生じる病理学的変化に対する検討

    第45回 日本IVR学会総会  2016 

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  • Balloon displacementが必要であった腎癌凍結治療の1例

    第126回 日本医学放射線学会中国・四国地方会  2016 

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  • 腹壁から逆行性にアプローチした小腸静脈瘤の1例

    第126回 日本医学放射線学会中国・四国地方会  2016 

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  • DWHを用いたCT予約枠改善の試み

    第126回 日本医学放射線学会中国・四国地方会  2016 

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  • Niti-S大腸ステントが有用だった悪性下大静脈症候群の1例

    第126回 日本医学放射線学会中国・四国地方会  2016 

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  • ラジオ波、凍結治療後の画像診断:各臓器における画像スペクトラム

    第52回 日本医学放射線学会秋季臨床大会  2016 

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  • 横隔膜近傍の肺腫瘍に対するRFAの検討

    第17回 RFA・凍結療法研究会  2016 

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  • 電子カルテにおける画像検査の同意書の現状と問題点

    第29回 電子情報研究会学術集会  2016 

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  • IVRにおける仮想透視画像の有用性

    第30回 中国四国IVR研究会  2016 

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  • 入院後に突然出血した腎腫瘍の1例

    第30回 中国四国IVR研究会  2016 

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  • 悪性下大静脈症候群に対してNiti-S大腸用ステントを留置し、水分管理に難渋した1例

    第30回 中国四国IVR研究会  2016 

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  • 腎癌の凍結治療:どこまで治療できるか

    第4回 JSURT  2016 

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  • EVAR後のType Ⅰaエンドリークに対して、経カテーテル的コイル塞栓術を施行した1例

    第127回 日本医学放射線学会中国・四国地方会  2016 

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  • EVAR後のtype2 endoleak に対して直接穿刺で流入・流出路を塞栓した1例

    第127回 日本医学放射線学会中国・四国地方会  2016 

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  • 血管内平滑筋腫症に対し動脈塞栓術を施行した1例

    第127回 日本医学放射線学会中国・四国地方会  2016 

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  • Beyond Kidney: Imaging for Systemic Diseases Affecting the Kidney. Where the Kidney Meets the Others?

    RSNA 102h scientific assembly & annual meeting 2016  2016 

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  • 凍結治療予定の小径腎腫瘍への腎生検の評価

    第2回 日本泌尿器癌局所療法研究会  2016 

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  • 前立腺癌治療

    第2回 日本泌尿器癌局所療法研究会  2016 

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  • 前腕静脈奇形に対して凍結療法を施行した1例

    第45回 日本IVR学会総会  2016 

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  • VHL患者の腎癌に対するラジオ波焼灼療法

    第75回 日本医学放射線学会総会  2016 

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  • FGF-23産生腫瘍の局在同定に全身静脈サンプリングが有用であった1例

    第125回 日本医学放射線学会中国・四国地方会  2015 

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  • Retrograde renal ablation via the renal vein as a new treatment option for renovascular hypertension.

    第44回日本IVR学会総会  2015 

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  • 肺腫瘍に対するラジオ波焼灼療法:本邦における前向き多施設共同研究(JIVROSG-0702)

    第74回 日本医学放射線学会総会  2015 

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  • Radiofrequeny electric current energy delivery to cryoprobe tract:influence on ablation result in ex vivo liver model

    第44回日本IVR学会総会  2015 

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  • Radiofrequency ablation of lung metastases from head and neck adenoid cystic carcinoma

    第44回日本IVR学会総会  2015 

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  • Electrode tract embolization to decrease a risk of pneumothorax accompanied with lung radiofrequency ablation

    第44回日本IVR学会総会  2015 

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  • フィラリア性乳び尿に対するリンパ管造影の1例

    第124回日本医学放射線学会中国・四国地方会  2015 

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  • 肺AVMに対するコイル塞栓術後に脳梗塞を生じた1例

    第124回日本医学放射線学会中国・四国地方会  2015 

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  • 腎がんに対してRFAと同時に生検を施行した症例の検討

    第124回日本医学放射線学会中国・四国地方会  2015 

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  • 凍結治療とMRI

    Advanced CT・MR 2015  2015 

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  • 当院における副鼻腔癌に対する動注化学療法の治療成績

    第29回 中国四国IVR研究会  2015 

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  • 腎凍結療法後に後腹膜膿瘍を生じた一例

    第29回 中国四国IVR研究会  2015 

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  • 転移性骨腫瘍との鑑別に苦慮したradiation-induced sarcomaの1例

    第124回日本医学放射線学会中国・四国地方会  2015 

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  • リンパ管造影にて乳びの漏出が軽快した傍椎体部リンパ腫の1例

    第124回日本医学放射線学会中国・四国地方会  2015 

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  • VATSマーカー留置時に緊張性心襄気腫を生じた1例

    第29回 中国四国IVR研究会  2015 

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  • 腎癌のcryoablation

    第3回 JSURT 泌尿器画像診断・治療技術研究会  2015 

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  • 腹腔動脈合併尾側膵切除術(DP-CAR)術前の血流改変にVacular plugを使用した1例

    第29回 中国四国IVR研究会  2015 

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  • 腎RFAと同一のセッションで腎生検を施行した症例の検討

    第16回 RFA・凍結療法研究会  2015 

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  • 腎疾患に対するIVR

    第44回 断層映像研究会  2015 

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  • タブレット端末を用いた夜間,休日読影

    第28回 電子情報研究会学術集会  2015 

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  • Cryoablation of vascular malformations: a phase I clinical trial.

    第30回欧州心臓血管IVR会議  2015 

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  • センチネルリンパ節を対側腋窩または対側乳房に認めた乳癌の3例

    第55回 日本核医学会学術総会  2015 

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  • A case of solitary sacral bone metastasis from hepatocellular carcinoma successfully treated with percutanesou cryoablation.

    第2回 Asian Conference on Tumor Ablation  2015 

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  • CT guided percutaneous cryoablation for renal cell carcinoma: Experience in 114 biopsy-proven cases.

    第2回 Asian Conference on Tumor Ablation  2015 

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  • 腎凍結療法による腎嚢胞への影響について

    第16回 RFA・凍結療法研究会  2015 

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  • 膵全摘術後に生じた腹腔動脈仮性瘤に対してグラフトマスターを使用した1例

    第125回 日本医学放射線学会中国・四国地方会  2015 

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  • 肝移植後にトリニアキシシャルシステムを使用してPSEを施行した2例

    第125回 日本医学放射線学会中国・四国地方会  2015 

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  • Imaging Characteristics of Tumors and Tumor-like Lesions of the Foot: common, Less common, Rare disease.

    Radiological Society of North America 2015  2015 

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  • 凍結治療の基本と実際

    熊本画像診断研究会  2015 

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  • 腎洞側に突出する腎癌に対する凍結療法の検討

    第125回 日本医学放射線学会中国・四国地方会  2015 

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  • 電子カルテシステムにおけるCT/MRIの造影剤の同意書の検討

    第32回中国四国医療情報学研究会  2014 

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  • Results of preoperative localizations of 200 small pulmonary lesions with a short hook wire and suture system

    The 15th Asian Oceanian Congress of Radiology (AOCR2014)  2014 

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  • 電子カルテシステムにおけるCT/MRIの造影剤の同意書の検討

    第32回中国四国医療情報学研究会  2014 

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  • 類骨骨種と鑑別が必要であった大腿骨頚部線維性骨異形成の1例

    第25回日本骨軟部放射線研究会  2014 

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  • 類骨骨種と鑑別が必要であった大腿骨頚部線維性骨異形成の1例

    第25回日本骨軟部放射線研究会  2014 

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  • 肺がんに対する画像ガイド下アブレーション治療

    第73回 日本医学放射線学会総会  2014 

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  • A case of hepatic intracystic oraganizing hematoma mimicking billary cystadenocarcinoma in a polycystic liver diaease patient

    The 15th Asian Oceanian Congress of Radiology (AOCR2014)  2014 

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  • Cryoablation of renal cell carcinoma .

    第41回日本低温医学会総会  2014 

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  • Stage G4以上の慢性腎臓病患者に合併した腎癌に対する凍結治療

    第28回 中国四国IVR研究会  2014 

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  • 肺ラジオ波療法における穿刺経路塞栓の経験

    第28回 中国四国IVR研究会  2014 

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  • 肺RFAにおける電極針展開径が局所制御に及ぼす影響についての検討

    第28回 中国四国IVR研究会  2014 

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  • Amplatzer Vascular plugの初期使用経験

    第123回 日本医学放射線学会中国四国地方  2014 

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  • IVCフィルター抜去困難例に対して改良型wire-loop techniqueにて回収しえた1例

    第123回 日本医学放射線学会中国四国地方  2014 

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  • 非小細胞肺癌の治療後合併症および変化におけるCT,FDG-PETの像について

    第73回 日本医学放射線学会総会  2014 

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  • IVRの最前線:凍結療法とIVRセンター

    第73回 日本医学放射線学会総会  2014 

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  • 腎凍結治療後のMRI所見

    第73回 日本医学放射線学会総会  2014 

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  • 腎癌凍結療法後のCT画像

    第73回 日本医学放射線学会総会  2014 

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  • 食道癌の肺転移に対する経皮的ラジオ波凝固療法の検討

    第73回 日本医学放射線学会総会  2014 

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  • すりガラス肺がんに対する経皮的ラジオ波焼灼療法

    第73回 日本医学放射線学会総会  2014 

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  • マルチスライスCT 透視装置を用いたCT ガイド下肺ラジオ波焼灼術における術者被曝の検討

    第43回 日本IVR学会総会  2014 

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  • 肺アスペルギローマにラジオ波焼灼療法が有用であった1例

    第43回 日本IVR学会総会  2014 

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  • 腎癌凍結療法後のCT 画像 ~ 主に腫瘍の造影効果について~

    第43回 日本IVR学会総会  2014 

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  • 経葉間ルートで行った術前VATS マーカー留置の検討

    第43回 日本IVR学会総会  2014 

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  • Morbidity&Mortality

    第43回 日本IVR学会  2014 

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  • 内頸静脈穿刺にて留置したCV ポートカテーテル破損のリスク因子に対する検討

    第43回 日本IVR学会総会  2014 

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  • 当院における異所性静脈瘤に対するIVR の検討

    第43回 日本IVR学会総会  2014 

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  • 切除可能な大腸癌肺転移に対する経皮的ラジオ波凝固療法:第2相臨床試験(SURF study):症例登録完了報告

    第15回RFA・凍結療法研究会  2014 

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  • Stage G4以上の慢性腎臓病に合併した腎癌に対する凍結治療

    第15回RFA・凍結療法研究会  2014 

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  • 食道静脈瘤破裂を契機に発見された真性多血症の1例

    第28回日本腹部放射線学会  2014 

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  • 若年成人発症の腎low-grade fibromyxoid sarcomaの1例

    第28回日本腹部放射線学会  2014 

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  • レポート端末から電子カルテ端末への患者IDの受け渡しシステムの導入

    第27回電子情報研究会学術集会  2014 

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  • 肺ラジオ波焼灼療法後の高度炎症:前向き試験における頻度と危険因子の検討

    第42回 日本IVR学会総会  2013 

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  • 嚢胞硬化術によって肝容積減少を図ったADPCKの4例

    第120回 日本医学放射線学会中国・四国地方会  2013 

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  • 腎癌に対する腎凍結療法:初期経験の報告

    第120回 日本医学放射線学会中国・四国地方会  2013 

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  • PpPD術後に生じた総肝動脈仮性瘤に対してグラフトマスターを用いて治療した一例

    第120回 日本医学放射線学会中国・四国地方会  2013 

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  • 各種がんに対するIVR治療

    岡山大学病院IVRセンター市民公開講座  2013 

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  • F-18 FDG PET/CTが診断に有用であったRosai-Dorfman病の一例

    第26回 臨床核医学研究会  2013 

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  • 両側巨大副腎myelolipomaの1例

    第27回 日本腹部放射線研究会  2013 

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  • 前立腺肉腫の2例

    第27回 日本腹部放射線研究会  2013 

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  • 胸部異常陰影の1例

    第34回岡山胸部画像病理カンファレンス  2013 

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  • 肺癌の孤立性胸壁転移に対して凍結療法を施行した1例

    第14回 RFA研究会  2013 

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  • 腎癌に対する腎凍結療法:初期経験の報告

    第14回 RFA研究会  2013 

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  • T1b腎がんに対する凍結療法

    第121回 日本医学放射線学会 中国・四国地方会  2013 

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  • 肺アスペルギローマにラジオ波焼灼療法が有用であった1例

    第121回 日本医学放射線学会 中国・四国地方会  2013 

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  • F-18FDG PET/CTが診断に有用であったRosai-Dorfman病の2例

    第53回日本核医学会学術総会  2013 

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  • 当院におけるクライオサージェリー現況と展望

    第51回 広島IVR研究会  2013 

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  • 肝癌の孤立性仙骨転移に対して凍結治療を行った1例

    第121回 日本医学放射線学会 中国・四国地方会  2013 

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  • 肺動静脈瘻の塞栓術後のaneurysmal sacの縮小率と再灌流の検討

    第72回 日本医学放射線学会総会  2013 

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  • 肺ラジオ波焼灼療法後の高度炎症:前向き試験における頻度と危険因子の検討

    第72回 日本医学放射線学会総会  2013 

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  • VHL関連腎癌に対するCTガイド下ラジオ波焼灼療法

    第72回 日本医学放射線学会総会  2013 

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  • 良性胆管狭窄に対するチューブステント留置の長期成績

    第72回 日本医学放射線学会総会  2013 

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  • 腎癌に対する凍結療法::初期経験の報告

    第72回 日本医学放射線学会総会  2013 

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  • 類骨骨腫に対するラジオ波治療後のMRI 像の検討- 焼灼域の評価における有用性

    第42回 日本IVR学会総会  2013 

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  • 腎癌の凍結療法-IVRセンター開設のご案内とともに-

    第62回 岡山画像診断センター病診連携勉強会  2013 

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  • 経肩甲骨的に肺ラジオ波焼灼療法を施行した8例の検討

    第42回 日本IVR学会総会  2013 

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  • 腎癌に対する凍結療法:初期経験の報告

    第42回 日本IVR学会総会  2013 

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  • 腎凍結療法後の神経障害によると思われる疼痛

    第42回 日本IVR学会総会  2013 

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  • 当院で経験した内頚静脈穿刺にて留置したシリコン性CV カテーテル破損14 例の検討

    第42回 日本IVR学会総会  2013 

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  • 肝嚢胞性病変の1例

    第115回 肝胆膵研究会  2013 

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  • 喀血を契機に発見された多発気管支動脈瘤に対して塞栓術を施行した一例

    第42回 日本IVR学会総会  2013 

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  • Dual energy CT を用いた肺RFA のCT 画像評価:肺血流及び腫瘍成分の変化について

    第42回 日本IVR学会総会  2013 

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  • 腎腫瘍に対するラジオ波焼灼療法後の画像所見:典型例と非典型例

    第71回 日本医学放射線学会総会  2012 

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  • Diagnostic lmaging and Radiofrequency Ablation of Renal ce11 Carcinoma

    The Myanmar Health Research congress (2011)  2012 

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  • Diagnostic lmaging and Radiofrequency Ablation of Renal ce11 Carcinoma

    The Myanmar Health Research congress (2011)  2012 

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  • Risk factors for systemic air embolism complicating percutaneous CT-guided lung biopsy: Multicenter casecontrol study in Japan

    APCCVIR 2012 JSIR & ISIR  2012 

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  • Predictors of renal function after percutaneous radiofrequency ablation of renal tumor

    APCCVIR 2012 JSIR & ISIR  2012 

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  • Association between sac shrinkage and recanalization after transcatheter coil embolization of pulmonary arteriovenous malformation

    APCCVIR 2012 JSIR & ISIR  2012 

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  • 肺ラジオ波焼灼療法後のF-18 FDG集積に関する検討

    第71回 日本医学放射線学会総会  2012 

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  • 小腸出血に対し緊急でバルーン閉塞下逆行性経静脈的塞栓術を施行した1例

    第118回 日本医学放射線学会中国・四国地方会  2012 

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  • 経皮経肝的に塞栓を施行した肝仮性動脈瘤の1例

    第118回 日本医学放射線学会中国・四国地方会  2012 

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  • イレウスにて発症した心嚢内ヘルニアの一例

    第118回 日本医学放射線学会中国・四国地方会  2012 

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  • 子宮漿膜下に巨大腫瘤を形成した低悪性度子宮内膜間質肉腫の1例

    第26回 日本腹部放射線研究会  2012 

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  • Desmoplastic small round cell tumorの1例

    第26回 日本腹部放射線研究会  2012 

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  • 軟骨性腫瘍におけるTc-99m DMSA(Ⅴ)シンチグラフィの有用性の検討

    第47回 日本核医学会中国・四国地方会  2012 

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  • 肩甲骨経由でCTガイド下穿刺を施行した6例

    第118回 日本医学放射線学会中国・四国地方会  2012 

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  • 非小細胞肺癌におけるF-18 FDG PET/CTの有用性-転移性リンパ節と胸膜浸潤の診断に関して-

    第52回 日本核医学会学術集会  2012 

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  • Bigplane angio装置を使用したTIPSの2例

    第26回 日本IVR学会中国四国地方会  2012 

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  • 腎癌に対する経皮的ラジオ波焼却療法後に穿刺経路播種をきたした1例

    第26回 日本IVR学会中国四国地方会  2012 

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  • 腎RFA直後の腎生検の有用性について

    第26回 日本IVR学会中国四国地方会  2012 

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  • Risk Factors for Systemic Air Embolism as a Complication of Percutaneous CT-guided Lung Biopsy: Multicentre Case-Control Study in Japan

    RSNA 98th scientific assembly & annual meeting 2012  2012 

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  • 軟骨性腫瘍の良悪性鑑別におけるTc-99mDMSA(V)シンチグラフィの有用性に関する検討

    第52回 日本核医学会学術集会  2012 

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  • Triaxial systemを使用して塞栓したtype II endoleakの1例

    第119回 日本医学放射線学会中国・四国地方会  2012 

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  • 肝嚢胞性腫瘍との鑑別を要した肝嚢胞内出血の1例

    第119回 日本医学放射線学会中国・四国地方会  2012 

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  • 肺RFA後の再発診断にDual energy CTによる成分分析が有用であった一例

    第119回 日本医学放射線学会中国・四国地方会  2012 

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  • 腎凍結療法による神経障害と思われる疼痛をきたした10例

    第119回 日本医学放射線学会中国・四国地方会  2012 

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  • MRIとSPECT-CTが診断に有用であったpure struma ovariiの一例

    第119回 日本医学放射線学会中国・四国地方会  2012 

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  • "What happens?" Imaging spectrum after radiofrequency ablation of renal cell carcinoma: typical and atypical presentation

    Cardiovascular and Interventional Radiological Society of Europe 2011(CIRSE)  2011 

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  • 肺ラジオ波焼灼療法後の高度炎症反応発生のリスクファクター

    第70回 日本医学放射線学会総会  2011 

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  • change in renal function after percutaneous radiofrequency ablation of renal tumor:Analyses of risk factors

    2011 SIR Annual Scientific Meeting  2011 

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  • EmbozeneTMによる動脈塞栓術が著効した仙骨巨細胞腫の1例

    第22回 骨軟部放射線研究会  2011 

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  • 臨床病期Ⅰ期非小細胞肺癌に対する経皮的ラジオ波焼灼療法:50例での成績

    第70回 日本医学放射線学会総会  2011 

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  • 悪性肺腫瘍に対する経皮的ラジオ波凝固療法についての第Ⅰ/Ⅱ相および第Ⅱ相臨床試験

    第40回 日本IVR学会総会  2011 

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  • 軟部腫瘍の良悪性鑑別におけるTl-201腫瘍シンチグラフィの有用性

    第70回 日本医学放射線学会総会  2011 

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  • 膵転移を来たした肝solitary fi brous tumor

    第25回 日本腹部放射線研究会  2011 

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  • 軟部腫瘍の良悪性鑑別におけるTl-201シンチグラフィの有用性

    第46回 日本核医学会中国・四国地方会  2011 

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  • 多発結節性脂肪肝の1例

    第116回 日本医学放射線学会中国・四国地方会  2011 

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  • 肺RFA.治療の現況と画像評価法.

    第40回 日本IVR学会総会  2011 

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  • 同時性バルーン閉鎖下塞栓術(DBOE)にて止血しえた十二指腸静脈瘤破裂の一例

    第117回 日本医学放射線学会中国・四国地方会  2011 

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  • 肝動注リザーバー留置時の血流改変により肝梗塞を来した2例

    第117回 日本医学放射線学会中国・四国地方会  2011 

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  • 肺RFAによる横隔神経麻痺の検討

    第12回 RFA談話会  2011 

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  • 肝RFA後に広範な肉芽組織を形成した1例

    第115回 日本医学放射線学会中国・四国地方会  2010 

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  • 腎RFAにてRCCを治療し糖尿病が改善した1例

    第29回 日本画像医学会  2010 

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  • 肺ラジオ波焼灼術後のpneumatocele形成

    第69回 日本医学放射線学会総会  2010 

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  • 類骨骨腫に対するラジオ波焼灼療法・当院における初期経験

    第69回 日本医学放射線学会総会  2010 

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  • Percutaneous CT-guided radiofrequency ablation for renal cell carcinoma in von Hippel-Lindau disease

    European Congress of Radiology (ECR) 2010  2010 

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  • Pneumatocele formation after radiofrequency ablation of lung tumor

    European Congress of Radiology (ECR) 2010  2010 

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  • 肝細胞癌肺転移に対するラジオ波焼灼療法:多施設共同研究の結果

    第39回 日本IVR学会総会  2010 

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  • 類骨骨腫に対するラジオ波焼灼療法

    第39回 日本IVR学会総会  2010 

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  • 緩和医療とIVR~疼痛緩和について~

    第39回 日本IVR学会総会  2010 

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  • 肝細胞癌肺転移に対するラジオ波焼灼療法:日本における多施設共同研究の結果

    第69回 日本医学放射線学会総会  2010 

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  • CTガイド下のIVRの実際

    第39回 日本IVR学会総会  2010 

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  • 腎RFA時の隣接臓器への熱損傷予防策についての検討

    第39回 日本IVR学会総会  2010 

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  • 当院における肺腫瘍に対する人口気胸下RFAの検討

    第39回 日本IVR学会総会  2010 

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  • 芝刈り中、突然の後頚部痛・四肢麻痺をきたした特発性脊髄硬膜外血腫の1例

    第114回 日本医学放射線学会中国・四国地方会  2010 

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  • FDG集積を示した上行結腸由来の神経鞘腫

    第24回 腹部放射線研究会  2010 

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  • 膵粘液性嚢胞性腫瘍から発生した退形成性膵癌の1例

    第24回 腹部放射線研究会  2010 

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  • 腎原発の骨外性ユーイング肉腫の1例

    第24回 腹部放射線研究会  2010 

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  • 肺ラジオ波焼灼療法後のFDG-PET/CTの評価 -3ヶ月後と6ヶ月後の比較-

    第114回 日本医学放射線学会中国・四国地方会  2010 

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  • 肺生検後に生じた心嚢気腫の一例

    第114回 日本医学放射線学会中国・四国地方会  2010 

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  • 肺RFA後に呼吸停止をきたした1例

    第114回 日本医学放射線学会中国・四国地方会  2010 

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  • FDG集積を示した横行結腸由来の神経鞘腫

    PETサマーセミナー2010 in 岡山  2010 

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  • PET-CTが有用であった膵粘液性嚢胞性腫瘍から発生した退形成性膵癌の1例

    PETサマーセミナー2010 in 岡山  2010 

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  • 肺ラジオ波焼灼療法後のFDG-PET/CTでの評価―3ヶ月後と6ヶ月後の評価―

    PETサマーセミナー2010 in 岡山  2010 

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  • 18F-FDGの高集積を認めた低分化型肝細胞癌の1例

    PETサマーセミナー2010 in 岡山  2010 

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  • EmbozeneTM による動脈塞栓術が著効した仙骨巨細胞腫の1例

    第24回 日本IVR学会中国四国地方会  2010 

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  • EmbozeneTM embolization 後の平滑筋肉腫肝転移1切除例

    第24回 日本IVR学会中国四国地方会  2010 

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  • 肝動注リザーバ留置後に形成した腹腔動脈瘤に対しコイル塞栓術を施行した1例

    第24回 日本IVR学会中国四国地方会  2010 

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  • 多発HCC病変に対しミリプラチンを使用し重篤な副作用をおこした1例

    第24回 日本IVR学会中国四国地方会  2010 

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  • 当院における生体肝移植後肝静脈拡張術

    第24回 日本IVR学会中国四国地方会  2010 

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  • 肺RFA後に横隔膜ヘルニアを生じた1例

    第24回 日本IVR学会中国四国地方会  2010 

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  • 多施設調査の結果速報

    第11回 RFA談話会  2010 

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  • Myxoinflammatory fibroblastic sarcomaの1例

    第115回 日本医学放射線学会中国・四国地方会  2010 

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  • Risk Factors for Severe Inflammatory Reaction after Percutaneous Radiofrequency Ablation of Lung Tumor.

    RSNA 96nd scientific assembly & annual meeting 2010  2010 

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  • 良性嚢胞性骨腫瘍の画像診断―FEGNOMASHICは正しいか―

    第46回 日本医学放射線学会秋季臨床大会  2010 

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  • 腎RFA後に腎盂内血腫をきたした一例

    第11回 RFA談話会  2010 

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  • 縦隔腫瘍の形態を呈して診断に苦慮した結核症の1例

    第22回 胸部放射線研究会  2008 

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  • 生体肝移植後腹膜PTLD(Posttransplantation Lymphoprolifrerative Disorders)の一例

    第22回腹部放射線研究会  2008 

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  • Thermal nerve injury after percutaneous radiofrecuensy ablation for lung tumor

    SIR 2008 annual meeting  2008 

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  • Percutaneous CT-guided transthoracic needle biopsy of lung lesions with focul pure glound-glass opacity

    SIR 2008 annual meeting  2008 

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  • 肺RFA後のtumor seeding

    第110回日本医学放射線学会中国・四国地方会  2008 

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  • HIV陽性者に発症し、自然消褪した肺MAL Tomaの一例

    第110回日本医学放射線学会中国・四国地方会  2008 

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  • 縦隔腫瘤の一例

    第25回 岡山胸部画像病理カンファレンス  2008 

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  • 肺癌RFA後の再発におけるPET/CTの診断時期の検討

    第22回 日本IVR学会中国四国地方会  2008 

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  • 結節生硬化症に伴う腎血管筋脂肪腫に対してエタノールによる腎動脈塞栓術後に肺水腫うぃお来した一例

    第22回 日本IVR学会中国四国地方会  2008 

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  • 動脈塞栓術を施行した外傷性持続勃起症の一例

    第22回 日本IVR学会中国四国地方会  2008 

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  • 大腿骨頭置換術による外腸骨静脈損傷をIVRで治療した一例

    第22回 日本IVR学会中国四国地方会  2008 

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  • 末梢早期肺癌に対するラジオ波焼灼療法

    第49回 日本肺癌学会総会  2008 

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  • 大腿骨頭置換術による外腸骨静脈損傷をIVRで治療した一例

    第18回 救急放射線研究会  2008 

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  • 肺野に広範な間質性病変を主体としたびまん性陰影を認め、肺腺癌と好酸球性肺炎を合併し、多臓器病変を伴ったlgG4関連疾患の1例

    第22回 胸部放射線研究会  2008 

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  • 胆嚢転移を呈した腎癌の2例

    第111回 日本医学放射線学会中国・四国地方会  2008 

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  • PET/CTによる肺癌RFA後の再発診断の至適時期の検討

    第49回 日本肺癌学会総会  2008 

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  • CT imaging findings after radiofrequency ablation for lung tumors; Morphological features of the tumors with and without local progression

    RSNA 93rd scientific assembly & annual meeting 2007  2007 

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  • Percutaneous CT-guided radiofrequency ablation for metastatic lung tumor from hepatocellular carcinoma

    2007 SIR annual Scientific Meeting  2007 

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  • Postablation Syndrome after Radiofrequency Ablation for Lung Tumors: Incidence and Risk Factors of Fever.

    2007 SIR annual Scientific Meeting  2007 

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  • Desmoid-type fibromatosesに対するT1-201シンチグラフィの検討

    第66回 日本医学放射線学会学術集会  2007 

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  • 肺腫瘍に対する肺ラジオ波焼灼術後のPostablation syndromeについて

    第66回 日本医学放射線学会学術集会  2007 

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  • 2cm展開針を用いた肺ラジオ波焼灼術:1部位焼灼における局所制御率および再発危険因子の検討

    第66回 日本医学放射線学会学術集会  2007 

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  • 術後肺癌の肺内再発に対するラジオ波焼灼療法の治療成績の検討

    第66回 日本医学放射線学会学術集会  2007 

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  • 肝静脈再建を行った右葉graft生体移植後のCT

    第66回 日本医学放射線学会学術集会  2007 

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  • 経肝的に施行したRCCに対するRFAの検討

    第66回 日本医学放射線学会学術集会  2007 

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  • 肺腫瘍に対するラジオ波焼灼療法(RFA)後に神経損傷を来した2例

    第36回 日本IVR学会総会  2007 

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  • 肺腫瘍に対するRFA

    第36回 日本IVR学会総会  2007 

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  • 腎腫瘍に対するラジオ波焼灼療法-岡山大学における中期成績-

    第36回 日本IVR学会総会  2007 

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  • Focal GGO病変に対するCTガイド下肺生検についての検討

    第36回 日本IVR学会総会  2007 

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  • 十二指腸静脈瘤に対してIVRが有効であった3例

    第36回 日本IVR学会総会  2007 

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  • 肺腫瘍のラジオ波焼灼療法後の局所再発における危険因子の検討:342個の腫瘍による評価

    第36回 日本IVR学会総会  2007 

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  • VHL患者に対するCTガイド下腎RFA

    第36回 日本IVR学会総会  2007 

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  • 類骨骨腫に対してRFAを施行した3例

    第8回 RFA談話会  2007 

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  • CT上 pure GGO を呈した卵巣癌肺転移の一例

    第108回 日本医学放射線学会中国・四国地方会  2007 

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  • 非典型的な画像を示し膵頭部腫瘍と鑑別が困難であったparagangliomaの一例

    第21回 腹部放射線研究会  2007 

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  • 骨盤内肉腫様の所見を呈し、診断困難であった巨大血栓化静脈瘤の一例

    第21回 腹部放射線研究会  2007 

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  • 類骨骨腫に対してRFAを施行した3例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • 生食注入下での肺RFA:ブタ正常肺での実験

    第21回 日本IVR学会中国・四国地方会  2007 

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  • NOMIの4例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • 肺ラジオ波焼灼療法後に肺仮性動脈瘤を認めた一例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • Peribiliary cyst による胆管狭窄に対して嚢胞硬化術が有用であった1例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • 肝性脳症に対し脾静脈塞栓術が奏功した一例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • 多発性嚢胞腎に対して無水エタノールを用いて腎動脈塞栓術を施行した1例

    第21回 日本IVR学会中国・四国地方会  2007 

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  • RFA後の肺結節性病変におけるFDG-PET/CTの診断能について

    第47回 日本肺癌学会総会  2006 

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  • DSMを用いた肺動脈塞栓後の肺ラジオ波焼灼療法:ブタの正常肺を用いての検討

    第47回 日本肺癌学会総会  2006 

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  • 心臓・大動脈に近接する肺腫瘍に対するラジオ波凝固療法の検討

    第47回 日本肺癌学会総会  2006 

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  • Pneumothorax, pleural effusion, and chest tube placement after radeiofrequency ablation of lung tumors: incidence and risk factors

    RSNA 92nd scientific assembly & annual meeting 2006  2006 

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  • CT-guided radiofrequency ablation for Stage I lung cancer; two center study

    2006 SIR 31st Annual Scientific Meeting  2006 

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  • 原発性肺癌に対する肺ラジオ波焼灼療法(RFA)の中期治療成績-2施設共同研究-

    第65回 日本医学放射線学会学術集会  2006 

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  • 肺ラジオ波焼灼療法における胸膜温度測定

    第65回 日本医学放射線学会学術集会  2006 

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  • 多施設共同による腎癌肺転移に対する経皮的ラジオ波凝固療法の検討

    第65回 日本医学放射線学会学術集会  2006 

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  • 生体部分肝移植における術前脾動脈塞栓術の有用性の検討

    第35回 日本IVR学会総会  2006 

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  • 肺ラジオ波焼灼療法後に発生した胸膜炎症例の検討

    第35回 日本IVR学会総会  2006 

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  • 肺腫瘍に対する経皮的ラジオ波焼灼療法の中期治療成績

    第65回 日本医学放射線学会学術集会  2006 

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  • 静脈奇形に対する硬化療法

    第65回 日本医学放射線学会学術集会  2006 

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  • 肺ラジオ波焼灼療術における胸膜温度測定

    第35回 日本IVR学会総会  2006 

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  • 胸部悪性腫瘍の経皮的ラジオ波治療:局所制御率の中期成績

    第35回 日本IVR学会総会  2006 

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  • 心臓・大動脈に近い肺腫瘍に対するラジオ波焼灼術の検討

    第35回 日本IVR学会総会  2006 

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  • 肝細胞癌肺転移に対するラジオ波焼灼療法

    第35回 日本IVR学会総会  2006 

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  • 生体肝移植後合併症に対し側副血行路塞栓術等、複合的にIVRを施行した1例

    第106回 日本医学放射線学会中国・四国地方会  2006 

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  • DSMによる肺動脈塞栓後の肺ラジオ波焼灼療法:ブタの正常肺を用いた検討

    第35回 日本IVR学会総会  2006 

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  • 頚動脈的エタノール注入にて良好な治療経過を得た手掌動静脈奇形の1例

    第35回 日本IVR学会総会  2006 

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  • 肺RFAにおける予防的抗生物質使用の臨床的意義

    第7回 肺RFA談話会  2006 

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  • 肺RFA治療後評価におけるFDG-PET検査の至適時期についての検討

    第19回 臨床核医学研究会  2006 

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  • 軟部腫瘍のT1シンチグラフィ -疑陽性例の検討-

    第41回 日本核医学会中国・四国地方会  2006 

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  • 経胸骨的に施行した腎癌肺転移に対するラジオ波凝固療法の1例

    第106回 日本医学放射線学会中国・四国地方会  2006 

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  • 肝細胞癌肺転移に対して気管支動脈塞栓術、ラジオ波焼灼療法、放射線治療を組み合わせて治療した一例

    第20回 日本血管造影・IVR学会中国四国地方会  2006 

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  • 肺ラジオ波治療後に生じた血胸に対して動脈塞栓術を施行した1例

    第20回 日本血管造影・IVR学会中国四国地方会  2006 

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  • 肺RFA治療後評価におけるFDG-PET検査の至適時期についての検討

    第7回 肺RFA談話会  2006 

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  • 肺結節性病変の良悪性鑑別におけるFDG PET/CT, DWIBS, T2WIの診断能の比較について

    第46回 日本核医学会学術総会  2006 

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  • 各種癌に対するIVR治療

    岡山大学附属病院市民公開講座 切らずに治す癌・心臓病・脳卒中-岡大病院の最先端IVR治療-  2006 

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  • 治療に難渋した腎AVMの1例

    第20回 日本血管造影・IVR学会中国四国地方会  2006 

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  • 肺RFAにおける予防的抗生物質使用の臨床的意義

    第20回 日本血管造影・IVR学会中国四国地方会  2006 

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  • Temperature measurement of the pleura during radiofrequency ablation of lung tumors

    RSNA 92nd scientific assembly & annual meeting 2006  2006 

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  • Percutaneous CT-guided radiofrequency ablation for recurrent lung cancer after pulmonary resection

    RSNA 92nd scientific assembly & annual meeting 2006  2006 

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  • RFA後の肺結節性病変におけるFDG-PETの診断能について

    第46回 日本核医学会学術総会  2006 

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  • 軟部腫瘍のTIシンチグラフィ -疑腸性例の検討-

    第46回 日本核医学会学術総会  2006 

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  • PTO及びBRTOにて止血し得た十二指腸静脈瘤破裂の1例

    第107回 日本医学放射線学会中国・四国地方会  2006 

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  • 上腸間膜動脈塞栓症に血栓溶解療法が奏功した1例

    第107回 日本医学放射線学会中国・四国地方会  2006 

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  • 原発性肺癌の病期診断におけるF-18 FDG PET/CTの診断能について

    第47回 日本肺癌学会総会  2006 

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  • 肝細胞癌肺転移に対するラジオ波焼灼療法 (RFA)

    第47回 日本肺癌学会総会  2006 

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  • 肺悪性腫瘍のラジオ波治療

    第47回 日本肺癌学会総会  2006 

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  • 肺癌術後再発に対するラジオ波焼灼療法

    第47回 日本肺癌学会総会  2006 

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  • 肺腫瘍の良悪性診断における F-18 FDG PET/CT と MRI (DWIBS, T2WI) の比較

    第47回 日本肺癌学会総会  2006 

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  • 原発性肺癌に対してラジオ波焼灼療法と放射線療法を併用した2例

    第46回 日本肺癌学会総会  2005 

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  • CT-Guided Microwave Ablation for Treatment of Thoracic Tumors

    RSNA 2005  2005 

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  • ラジオ波焼灼療法に伴う気胸および胸水の頻度とその危険因子の検討

    肺ラジオ波焼灼術における胸膜温度測定  2005 

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  • 肺ラジオ波焼灼術における胸膜温度測定

    第46回 日本肺癌学会総会  2005 

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  • 多血性腫瘍であるHCC、RCCからの肺転移に対するラジオ波焼灼療法

    第46回 日本肺癌学会総会  2005 

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  • Sclerotherapy using polidocanol for venous malformations

    RSNA 91st scientific assembly & annual meeting 2005  2005 

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  • Pulmonary tumors treated with percutaneous radiofrequency ablation: evaluation with follow up CT

    RSNA 91st scientific assembly & annual meeting 2005  2005 

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  • 肺ラジオ波焼灼療法後の空洞形成の検討

    第19回日本血管造影・IVR学会中国四国地方会  2005 

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  • 人工喉頭留置のための気管食道瘻造設術

    第64回 日本医学放射線学会総会  2005 

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  • 胸部悪性腫瘍に対するラジオ波焼灼療法後のCTによる経過観察-特に造影CTについて-

    第64回 日本医学放射線学会総会  2005 

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  • 多血性腫瘍からの肺転移に対するラジオ波焼灼療法

    第104回 日本医学放射線学会中国四国地方会  2005 

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  • 転移性肺腫瘍に対するマイクロ波凝固療法の初期経験

    第104回 日本医学放射線学会中国・四国地方会  2005 

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  • Percutaneous transhepatic choledochojejunostomy using fine puncture needle for the treatment of complete biliary obstruction

    第34回 日本血管造影Intervertional Radiology学会総会  2005 

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  • スフェレックスによる塞栓術が著効した子宮肉腫多発転移の1例

    第19回日本血管造影・IVR学会中国四国地方会  2005 

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  • 肺腫瘍に対する経皮的ラジオ波焼灼療法の治療成績-midterm result-

    第19回日本血管造影・IVR学会中国四国地方会  2005 

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  • 肺高血圧症を合併した肺動静脈瘻に対して塞栓術を施行した一例

    第19回 日本血管造影・IVR学会中国四国地方会  2005 

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  • 十二指腸静脈瘤に対して予防的にPTOを施行した1例

    第104回 日本医学放射線学会中国四国地方会  2005 

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  • 原発性肺癌に対する経皮的ラジオ波焼灼療法-2施設による中期成績-

    第46回 日本肺癌学会総会  2005 

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  • DSMを用いたTAEが著効した子宮肉腫多発転移の1例

    第3回DSMシンポジウム  2005 

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  • 肝膿瘍を契機として発症した肝静脈血栓症の2例

    第102回 日本医学放射線学会中国・四国地方会  2004 

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  • インフルエンザ肺炎のCT所見

    第63回 日本医学放射線学会総会  2004 

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  • 鎖骨下動脈仮性動脈瘤に対し直接穿刺による塞栓術を施行した1例

    第18回 日本血管造影・IVR学会中国四国地方会  2004 

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  • 退形成性膵癌の1例

    第100回日本医学放射線学会・中国四国地方会  2003 

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  • 乳頭状の充実成分により、悪性卵巣腫瘍と鑑別が必要であった骨盤腹膜炎の2例

    第17回 腹部放射線研究会  2003 

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  • 健診で発見された肺犬糸状虫症の1例

    第101回日本医学放射線学会・中国四国地方会  2003 

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  • 輸入脚症候群に対しステント留置した1例

    第17回日本血管造影・IVR学会・中国四国地方会  2003 

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  • 多房性嚢胞性腫瘤を呈した胆嚢癌の1例

    第99回日本医学放射線学会中国四国地方会  2002 

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  • 脱落膜化した異所性内膜が充実部分を呈した内膜症性嚢胞の1例 -画像と病理の対比-

    第21回 日本画像医学会  2002 

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  • HCCに対するTAE、RFA併用療法の初期経験

    第16回日本血管造影・IVR学会中国四国地方会  2002 

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  • 虫垂と両側卵巣に粘液性腫瘍を認めた腹膜偽粘液腫の1例

    第98回日本医学放射線学会中国四国地方会  2002 

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  • エストロゲン産生を認めた転移性卵巣腫瘍の1例

    第16回 腹部放射線研究会  2002 

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  • 画像上浸潤性発育を示し悪性腫瘍と鑑別困難であった腎血管腫の1例

    第16回 腹部放射線研究会  2002 

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  • T1WI冠状断における前十字靭帯内部の線状高信号の臨床的意義

    第38回日本医学放射線学会秋季臨床大会  2002 

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  • USガイド下に窮刺吸引を施行し膝窩動脈外膜嚢腫の1例

    第15回 日本血管造影Intervertional Radiology学会中国四国地方会  2001 

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  • リザーバー治療中総肝動脈に巨大な仮性動脈瘤を形成した胃癌肝転移の1例

    リザーバー研究会  2001 

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  • 妊娠に合併した骨盤内腫瘍の1例

    第22回 岡山画像診断懇話会  2001 

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  • 特異な形態を呈し蛋白漏出性胃腸症をきたした早期胃癌の1例

    第15回 腹部放射線研究会  2001 

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  • ミノマイシンを用いた肝嚢胞硬化療法

    第15回日本血管造影・IVR学会中国四国地方会  2001 

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  • T1強調冠状断における前十字靭帯の線状高信号の臨床的意義

    日本医学放射線学会中国四国地方会  2001 

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  • ネコひっかき病の2例

    第97回日本医学放射線学会中国四国地方会  2001 

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  • 虫垂周囲膿瘍術後の遺残虫垂結石による再発性膿瘍にCT下ドレナージを施行した1例

    日本血管造影・IVR学会中国四国地方会  2000 

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  • Aggressive osteoblastomaの1例

    第94回日本医学放射線学会中国四国地方会  2000 

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  • 腰椎硬膜外膿瘍の5例

    第94回日本医学放射線学会中国四国地方会  2000 

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  • 膵管狭細型慢性膵炎の1例

    第14回腹部放射線研究会  2000 

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  • 異所性に膵管癌が併存したintraductal papillary musinous tumor of the pancreasの1例

    第14回 腹部放射線研究会  2000 

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  • 卵巣Yolk sac tumorの1例

    第95回日本医学放射線学会中国四国地方会  2000 

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  • 骨軟骨病変と鑑別を要した膝関節正常変異の1例

    第95回日本医学放射線学会中国四国地方会  2000 

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Awards

  • Best Reviewer Award

    2017   Acta Medica Okayama  

    GOBARA Hideo

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