Cryoablation for myoma uteri under reflux flow of hot saline solution into the intrauterine cavity

• Project/Area Number: 16K10352
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Kochi University
• Principal Investigator: YAMAGAMI TAKUJI 高知大学, 教育研究部医療学系臨床医学部門, 教授 (10257537)
• Co-Investigator(Kenkyū-buntansha): 吉松 梨香 高知大学, 教育研究部医療学系臨床医学部門, 助教 (10607592) ; 岡本 芳晴 鳥取大学, 農学部, 教授 (50194410)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2016: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
• Keywords: 凍結療法 / 子宮筋腫 / インターベンショナルラジオロジー

Outline of Final Research Achievements

Uterine temperature during cryoablation tended to be higher in cases perforemd under reflux flow of hot saline solution into the intrauterine cavity. Damage to the uterine was same or more serious in cases without reflux flow compared with cases with reflux flow. In the area temperature was higher than -30℃　damage to the mormal tissue was more mild. On the other hand, in the area temperature was lower than -30℃　damage to the mormal tissue was stronger.
From this study, when cryoablation for uterine myoma is performed, it might be suggested that reflux flow of hot saline solution is useful to prevent damage to the normal tissues.

Academic Significance and Societal Importance of the Research Achievements

腎癌に対する凍結療法は、平成24年3月に保険適用となって以来、急速に広まりつつある。一方、子宮筋腫に対しても、本治療法は新しい低侵襲性治療として期待が高まっている。特に治療の際の痛みが非常に少ないという大きな利点がある。しかし、新しい治療法であるため、どのような凍結療法プログラムを組むことが、子宮筋腫に対して最も治療効果が高くなるか明らかではない。また、子宮内膜や卵巣への影響など未知の問題も多い。本研究で、子宮腔内に加温水を還流しつつ凍結療法を行うことにより、病変のみを凍結し正常子宮内膜をより温存することができる可能性が示唆された点が意義深い。

Research Products

• [Journal Article] Protection from injury of organs adjacent to a renal tumor during percutaneous cryoablation (2019)
  • Author(s): Yamagami T, Yoshimatsu R, Kajiwara K, Yamanishi T, Minamiguchi H, Karashima T, Inoue K.
  • Journal Title: Int J Urol. Volume: 26 Issue: 8 Pages: 785-790
  • DOI: 10.1111/iju.14013
  • Peer Reviewed / Open Access
• [Journal Article] Time-Dependent Effects of Cryoablation for Renal Tumor on Overall and Split Renal Function (2019)
  • Author(s): Yoshimatsu R, Yamagami T, Nishimori M, Ogi K, Murata Y, Iwasa H, Kajiwara K, Yamanishi T, Minamiguchi H, Karashima T, Inoue K
  • Journal Title: J Vasc Interv Radiol Volume: 30 Issue: 3 Pages: 460-465
  • DOI: 10.1016/j.jvir.2018.10.017
  • Peer Reviewed
• [Journal Article] Prediction of the ablated area prior to radiofrequency ablation for liver tumor under CT guidance (2018)
  • Author(s): Yoshimatsu R, Doi A, Yamanishi T, Nishimori M, Ogi K, Kajiwara K. Tamura T, Minamiguchi H, Yamagami T.
  • Journal Title: Minim Invasive Ther Allied Technol Volume: 27 Issue: 1 Pages: 22-26
  • DOI: 10.1080/13645706.2017.1407799
  • Peer Reviewed / Open Access
• [Journal Article] Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma (2016)
  • Author(s): Yoshimatsu R, Yamagami T, Ishikawa M, Kajiwara K, Aikata H, Chayama K, Awai K
  • Journal Title: Cardiovasc Intervent Radiol Volume: ３９ Issue: 6 Pages: 865-874
  • DOI: 10.1007/s00270-015-1279-9
  • Peer Reviewed / Open Access
• [Journal Article] Therapeutic response to a novel enzyme-targeting radiosensitization treatment (Kochi Oxydol-Radiation Therapy for Unresedctable carcinomas) in patients with recurrent breast cancer (2016)
  • Author(s): Aoyama N, Ogawa Y, Yasuoka M, Takahashi M, Iwasa H, Miyatake K, Yamanishi T, Hamada N, Tamura T, Nishioka A, Yamagami T
  • Journal Title: Oncology Letters Volume: 11 Issue: 1 Pages: 1-6
  • DOI: 10.3892/ol.2016.4589
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Presentation] Time-Dependent Effects of Cryoablation for Renal Tumor on Overall and Split Renal Function (2019)
  • Author(s): Yoshimatsu R, Yamagami T, Nishimori M, Ogi K, Murata Y, Iwasa H, Kajiwara K, Yamanishi T, Minamiguchi H, Karashima T, Inoue K
  • Organizer: 第48回日本IVR学会総会
  • Invited
• [Presentation] 異なる位置で交差する２本の凍結針により形成されるice ballの検討 (2019)
  • Author(s): 山下政矩、三浦寛司、廣田達哉、浅井俊輔、山端康之、辻悠佑、山田恵、高松洋、福永鷹信、山上卓士
  • Organizer: 第48回日本IVR学会総会
• [Presentation] Usefulness of transarterial infusion of iodized oil and gelatin particles for marking before CT-guided percutaneous cryoablation of renal cell carcinoma (2019)
  • Author(s): Kajiwara K, Yoshimatsu R, Nishimori M, Yamanishi T, Mianmiguchi H, Karashima T, Inoue K, Awai K, Yamagami T
  • Organizer: CIRSE 2019
• [Presentation] Prediction of the ablated area prior to radiofrequency ablation for hepatocellular carcinoma under CT fluoroscopic guidance (2018)
  • Author(s): Yamagami T, Yoshimatsu R, Doi A, Yamanishi T, Kajiwara K, Minamiguchi H
  • Organizer: SMIT2018-IBEC2018 Joint Conferecne 2018
  • Int'l Joint Research / Invited