Development of breast cancer preserving surgery support system by ultrasound system using image fusion technology

• Project/Area Number: 16K10297
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Aichi Medical University
• Principal Investigator: Ando Takahito 愛知医科大学, 医学部, 助教 (40634134)
• Co-Investigator(Kenkyū-buntansha): 中野 正吾 愛知医科大学, 医学部, 教授 (20351108) ; 藤井 公人 愛知医科大学, 医学部, 准教授 (00524331) ; 高阪 絢子 愛知医科大学, 医学部, 助教 (50440748) ; 石口 恒男 愛知医科大学, 医学部, 教授 (70115525) ; 塩見 有佳子 (毛利有佳子) 愛知医科大学, 医学部, 助教 (90465576)
• Research Collaborator: MOURI Yukako ; GOTOU Manami
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000); Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2016: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
• Keywords: 乳房部分切除術 / RVS / 切除断端 / 再手術率 / 安全性 / non mass enhancement / breast cancer / surgical outcome / surgical margin / conserving surgery / 超音波fusion技術 / 乳癌 / non-mass enhancement / 乳腺部分切除術 / 乳癌広がり診断 / Breast cancer / MRI / リアルタイムバーチャルソノグラフィ / 乳房温存手術 / 手術支援システム

Outline of Final Research Achievements

Between 2011 and 2015, we enrolled 12 consecutive patients who had lesions with Non-mass enhancement that exceeded the US hypoechoic area, in which it was particularly difficult to evaluate the tumor margin. During preoperative planning, RVS was used to delineate the enhancing area on the breast surface after　additional breast supine MRI was performed. And then, BCS was performed. We analyzed both the surgical margin positivity rate and the reoperation rate. After RVS-guided marking was performed on the surface of the affected breast, lumpectomy and quadrantectomy were conducted in 7 and 5 patients, respectively. The surgical margins were negative in 10 (83%) patients. Two patients with positive margins showed DCIS of 1 duct each, at 2.4 mm and 3.2 mm from the resection margin, respectively. None of the patients required additional resection.
We papered the above results and were accepted by Ultrasound in Medicine & Biology.

Academic Significance and Societal Importance of the Research Achievements

乳癌の広がり評価において断端の評価が難しく，乳房部分切除術が安全に提供できない可能性のある症例を経験することがある。本研究ではRVSを用い，複数画像モダリティを１画面でリアルタイムに評価することで，正確な乳癌の広がりを評価することが可能となった。このことより，従来は乳房部分切除術の安全な実施は困難とされていた症例においても，安全性の高い部分切除術の提供が可能となった。

Research Products

• [Journal Article] Pre-Operative Planning Using Real-Time Virtual Sonography, an MRI/Ultrasound Image Fusion Technique, for Breast-Conserving Surgery in Patients with Non-Mass Enhancement on Breast MRI: A Preliminary Study. (2018)
  • Author(s): Ando T, Ito Y, Ido M, Osawa M, Kousaka J, Mouri Y, Fujii K, Nakano S, Kimura J, Ishiguchi T, Watanebe R, Imai T, Fukutomi T.
  • Journal Title: Ultrasound Med Biol. Volume: in press Issue: 7 Pages: 1364-1370
  • DOI: 10.1016/j.ultrasmedbio.2018.03.001
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Second-look US Using Real-time Virtual Sonography, a Coordinated Breast US and MRI System with Electromagnetic Tracking Technology: A Pilot Study. (2017)
  • Author(s): Watanabe R, Ando T, Osawa M, Ido M, Kousaka J, Mouri Y, Fujii K, Nakano S, Kimura J, Ishiguchi T, Yoshida M, Imai T, Fukutomi T.
  • Journal Title: Ultrasound Med Biol. Volume: 43 Issue: 10 Pages: 2362-2371
  • DOI: 10.1016/j.ultrasmedbio.2017.04.024
  • Peer Reviewed / Open Access
• [Journal Article] 乳房MRI-detected lesion検出における超音波fusion技術の臨床応用と将来展望 (2017)
  • Author(s): 中野 正吾, 藤井 公人, 高阪 絢子, 毛利 有佳子, 安藤 孝人, 大澤 真奈美, 井戸 美来, 伊藤 由季絵, 石口 恒男, 渡辺 理恵
  • Journal Title: INNERVISION Volume: 32 Pages: 27-30
• [Journal Article] Second-look US using real-time virtual sonography, a coordinated breast US and MRI system with electromagnetic tracking technology: A pilot study (2017)
  • Author(s): Watanabe R, Ando T, et al.
  • Journal Title: Ultrasound Med Biol Volume: 印刷中
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Targeted sonography using an image fusion technique for evaluation of incidentally detected breast lesions on chest CT: a pilot study. (2015)
  • Author(s): Kousaka J, Nakano S, Ando T, et al.
  • Journal Title: Breast cancer (in press) Volume: 0 Issue: 2 Pages: 0-00
  • DOI: 10.1007/s12282-014-0574-7
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Presentation] 乳房MRI non mass病変に対しUS/MRI fusionモダリティ（RVS）を術前マーキングに用いた乳房部分切除術断端陽性率減少への取り組み (2019)
  • Author(s): 安藤孝人 伊藤由季絵 井戸美来 大澤真奈美 毛利有佳子 高阪絢子 藤井公人 中野正吾
  • Organizer: 第119回日本外科学会総会
• [Presentation] Preoperative planning using an MRI-US fusion imaging system for breast-conserving surgery in patients with non-mass-like enhancement on breast MRI (2018)
  • Author(s): T. Ando, S. Nakano, M. Osawa, Y. Shiomi, J. Kousaka, K .Fujii, T. Imai, T. Ishiguchi, O. Arai
  • Organizer: 38th European CanCer Organisation
  • Int'l Joint Research
• [Presentation] 乳房MRI非腫瘤性病変に対するReal Virtual Sonographyを用いた乳房部分切除術断端陽性率減少への取り組み (2018)
  • Author(s): 安藤孝人 伊藤由季絵 井戸美来 大澤真奈美 毛利有佳子 高阪絢子 藤井公人 中野正吾
  • Organizer: 第80回日本臨床外科学会総会
• [Presentation] 乳房MRI における非腫瘤性病変へのRVSを用いた乳房部分切除術断端陽性率減少の取り組み (2018)
  • Author(s): 安藤孝人 伊藤由季絵 井戸美来 大澤真奈美 毛利有佳子 高阪絢子 藤井公人 中野正吾
  • Organizer: 第26回日本乳癌学会総会
• [Presentation] 乳房MRInon-mass enhancementの乳房温存手術切除範囲決定における超音波fusion技術の応用 (2018)
  • Author(s): 中野 正吾, 藤井 公人, 高阪 絢子, 毛利 有佳子, 安藤 孝人, 井戸 美来, 大澤 真奈美, 伊藤 由季絵, 石口 恒男
  • Organizer: 乳腺甲状腺超音波医学
• [Presentation] Impact of MRI and ultrasound image-fusion guided biopsy for MRI-detected breast lesions (2018)
  • Author(s): S. Nakano, K. Fujii, J. Kousaka, Y. Mouri, T. Ando, M. Ido, Goto, Y. Ito, T. Ishiguchi
  • Organizer: European congress of Radiology (ECR)
  • Int'l Joint Research
• [Presentation] Real-time virtual sonography, a coordinated sonography and MRI/CT system, for localization of parathyroid gland in patients with hyperparathyroidism. A Pilot study (2018)
  • Author(s): S. Nakano, K. Fujii, J. Kousaka, Y. Mouri, T. Ando, M. Ido, Goto, Y. Ito, T.
  • Organizer: 16th Congress of the Asian Association of Endocrine Surgeons,
  • Int'l Joint Research
• [Presentation] 乳房MRIの非腫瘍性病変へのRVSを用いた断端評価における検討 (2017)
  • Author(s): 安藤 孝人, 伊藤 由季絵, 井戸 美来, 大澤 真奈美, 毛利 有佳子, 高阪 絢子, 藤井 公人, 中野 正吾
  • Organizer: 日本臨床外科学会
• [Presentation] 乳房MRI non-mass病変に対し、RVSを用いた術前マーキングの断端陽性率における検討 (2017)
  • Author(s): 安藤 孝人, 伊藤 由季絵, 井戸 美来, 大澤 真奈美, 石田 陽祐, 毛利 有佳子, 高阪 絢子, 藤井 公人, 中野 正吾
  • Organizer: 日本乳癌学会総会 25回
• [Presentation] 術前化学療法後cCR症例に対する乳房温存手術切除範囲決定における超音波fusion技術の有用性 (2017)
  • Author(s): 中野 正吾, 藤井 公人, 高阪 絢子, 毛利 有佳子, 安藤 孝人, 大澤 真奈美, 井戸 美来
  • Organizer: 日本外科学会定期学術集会 117回
• [Presentation] Impact of image fusion technique for the localization of the achieved clinically complete response (cCR) lesions on breast conserving surgery after neoadjuvant chemotherapy. (2017)
  • Author(s): Nakano S, Ando T, et al.
  • Organizer: European Congress of Radiology
  • Place of Presentation: Vienna
  • Int'l Joint Research
• [Presentation] Impact of ultrasound image fusion technique for breast conserving surgery in patients who achieve a cCR after neoadjuvant chemotherapy. (2017)
  • Author(s): 中野 正吾, 安藤孝人ら
  • Organizer: 日本外科学会
  • Place of Presentation: 横浜
• [Presentation] Breast ultrasound surveillance with image fusion technique in a short-interval follow-up for BI-RADS category 3 mass lesions (2016)
  • Author(s): Nakano S, Ando T, et al.
  • Organizer: San Antonio Breast Cancer Symposium
  • Place of Presentation: San Antonio
  • Int'l Joint Research