Development of intraoperative diagnosis and navigation method of cancer, nerve, and urinary tract using a new fluorescence imaging

2019 Fiscal Year Final Research Report

• Project/Area Number: 18K16344
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: The University of Tokyo
• Principal Investigator: Kawaguchi Yoshikuni 東京大学, 医学部附属病院, 助教 (00597726)
• Project Period (FY): 2018-04-01 – 2020-03-31
• Keywords: 蛍光イメージング / 手術 / 癌の蛍光 / 神経の蛍光 / 尿管の蛍光 / 検体の蛍光観察 / 術中ナビゲーション / 術中診断

Outline of Final Research Achievements

(1) Fluorescence imaging of pancreas tumor, nerve, and urinal tract. We developed a new fluorescence imaging system and conducted an IRB-approved clinical trial in human. We conformed the safety of the new technique and visualized pancreatic neuroendocrine tumor and vessels as fluorescence. Fluorescence of urine was visualized. However, we did not confirm fluorescence of urinal tract and nerve because surgery of urinal tract and never was limited. We’re conducting an experiment using rat models.
(2) Micro fluorescence imaging of cancer. We conducted another IRB-approved clinical trial using a confocal laser endomicroscopy. In more than 90% of surgical specimens, cancerous tissues were differentiated from non-cancerous tissues using this technique. For bile duct cancer, the sensitivity for identifying malignancy was about 60% and the specificity was 80%. We’re conducting a research about AI diagnosis.

Free Research Field

肝胆膵外科

Academic Significance and Societal Importance of the Research Achievements

手術後の短期・長期成績を向上させるため手術損傷の回避は必須である。近年普及しつつあるインドシアニングリーンを用いた蛍光イメージングは胆道排泄のため膵腫瘍、尿管、神経の蛍光観察は不可能であった。それらを描出できる新しい蛍光イメージングは尿管や神経の損傷に起因する合併症を予防し手術時間の短縮、安全性の向上に寄与する可能性がある。癌の手術において術中癌診断は病理医による迅速診断が唯一の方法であった。癌のミクロ蛍光イメージングと術野観察、手術検体観察は術中癌診断にかかる時間を短縮し病理医の負担を軽減する可能性があり、診断精度が確立した際の手術時間の短縮、医療経済の改善がもたらされる可能性がある。