Development of innovative techniques of endoscopic ultrasound for early diagnosis of pancreatic cancer and its prognostic improvement

• Project/Area Number: 16K09410
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Wakayama Medical University
• Principal Investigator: KITANO Masayuki 和歌山県立医科大学, 医学部, 教授 (50314571)
• Co-Investigator(Kenkyū-buntansha): 西尾 和人 近畿大学, 医学部, 教授 (10208134) ; 工藤 正俊 近畿大学, 医学部, 教授 (10298953)
• 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: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 超音波内視鏡 / 膵癌 / 胆管ドレナージ / 造影ハーモニック法

Outline of Final Research Achievements

We conducted a meta-analysis for usefulness of contrast-enhanced harmonic endoscopic ultrasonography (EUS), which revealed pooled sensitivity and specificity were 93% and 80%, respectively, without a significant publication bias. We developed a new device specific for EUS-guided biliary drainage. Preclinical study and prospective trial showed EUS-guided biliary drainage with the new device is useful and safe for biliary drainage in patients with malignant obstructive jaundice after failed ERCP. Multicenter studies revealed various techniques of EUS-guided biliary drainage including rendezvous technique, choledochoduodenostomy, hepatocogastrosotomy and antegrade stenting are useful and safe in patients with malignant obstructive jaundice after failed ERCP.

Academic Significance and Societal Importance of the Research Achievements

膵癌は他の消化器疾患と比較すると、早期診断が難しいが、造影ハーモニックEUSによる診断精度が高いことが判明したため、今後本検査を用いることにより、膵癌の早期発見・予後向上につながることが期待される。また、多施設共同研究によりEUS下胆管ドレナージ術の有用性・安全性を実証したこと、EUS下胆管ドレナージ術の特化したデバイスの開発により、安全かつ有効に胆管ドレナージ術が行えるようになったことより、ERCP不成功の悪性胆管閉塞に対する本治療の重要性が高まり、膵癌に伴う閉塞性黄疸患者の治療成績・予後が改善することが期待される。

Research Products

• [Journal Article] A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device (2019)
  • Author(s): Van Riet PA, Larghi A, Attili F, Rindi G, Nguyen NQ, Ruszkiewicz A, Kitano M, Chikugo T, Aslanian H, Farrell J, Robert M, Adeniran A, Van Der Merwe S, Roskams T, Chang K, Lin F, Lee JG, Arcidiacono PG, Petrone M, Doglioni C, Iglesias-Garcia J, Abdulkader I, et al.
  • Journal Title: Gastrointestinal Endoscopy Volume: 89 Issue: 2 Pages: 329-339
  • DOI: 10.1016/j.gie.2018.10.026
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Prospective multicenter study of primary EUS-guided choledochoduodenostomy using a covered metal stent (2019)
  • Author(s): Nakai Y, Isayama H, Kawakami H, Ishiwatari H, Kitano M, Ito Y, Yasuda I, Kato H, Matsubara S, Irisawa A, Itoi T
  • Journal Title: Endoscopic Ultrasound Volume: 8 Issue: 2 Pages: 111-111
  • DOI: 10.4103/eus.eus_17_18
  • Peer Reviewed
• [Journal Article] Radical treatment for walled‐off necrosis: Transmural nasocyst continuous irrigation (2019)
  • Author(s): Tamura T, Itonaga M, Tanioka K, Kawaji Y, Nuta J, Hatamaru K, Yamashita Y, Yoshida T, Ida Y, Maekita T, Iguchi M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 3 Pages: 307-315
  • DOI: 10.1111/den.13319
  • NAID: 130007833308
  • Peer Reviewed
• [Journal Article] Value of contrast‐enhanced harmonic endoscopic ultrasonography with enhancement pattern for diagnosis of pancreatic cancer: A meta‐analysis (2019)
  • Author(s): Yamashita Y, Shimokawa T, Napoléon B, Fusaroli P, Gincul R, Kudo M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 2 Pages: 125-133
  • DOI: 10.1111/den.13290
  • Peer Reviewed / Open Access
• [Journal Article] International study of endoscopic management of distal malignant biliary obstruction combined with duodenal obstruction (2018)
  • Author(s): Hamada T, Nakai Y, Lau JY, Moon JH, Hayashi T, Yasuda I, Hu B, Seo DW, Kawakami H, Kuwatani M, Katanuma A, Kitano M, Ryozawa S, Hanada K, Iwashita T, Ito Y, Yagioka H, Togawa O, Maetani I, Isayama H
  • Journal Title: Scandinavian Journal of Gastroenterology Volume: 53 Issue: 1 Pages: 46-55
  • DOI: 10.1080/00365521.2017.1382567
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Multicenter prospective evaluation study of endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting (with video). (2018)
  • Author(s): Ogura T, Kitano M, Takenaka M, Okuda A, Minaga K, Yamao K, Yamashita Y, Hatamaru K, Noguchi C, Gotoh Y, Kuroda T, Yokota T, Nishikiori H, Sagami R, Higuchi K, Chiba Y.
  • Journal Title: Dig Endosc Volume: 30 Issue: 2 Pages: 252-259
  • DOI: 10.1111/den.12976
  • Peer Reviewed
• [Journal Article] Long-term outcomes of EUS-guided choledochoduodenostomy using a lumen-apposing metal stent for malignant distal biliary obstruction: a prospective multicenter study (2018)
  • Author(s): Tsuchiya T, Teoh AYB, Itoi T, Yamao K, Hara K, Nakai Y, Isayama H, Kitano M
  • Journal Title: Gastrointestinal Endoscopy Volume: 87 Issue: 4 Pages: 1138-1146
  • DOI: 10.1016/j.gie.2017.08.017
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Outcomes of endoscopic biliary drainage in pancreatic cancer patients with an indwelling gastroduodenal stent: a multicenter cohort study in West Japan. (2018)
  • Author(s): Yamao K, Kitano M, Takenaka M, Minaga K, Sakurai T, Watanabe T, Kayahara T, Yoshikawa T, Yamashita Y, Asada M, Okabe Y, Hanada K, Chiba Y, Kudo M.
  • Journal Title: Gastrointest Endosc Volume: 88 Issue: 1 Pages: 66-75
  • DOI: 10.1016/j.gie.2018.01.021
  • Peer Reviewed / Open Access
• [Journal Article] Clinical efficacy and safety of endoscopic ultrasound‐guided gallbladder drainage replacement of percutaneous drainage: A multicenter retrospective study (2018)
  • Author(s): Minaga K, Yamashita Y, Ogura T, Takenaka M, Shimokawa Y, Hisa T, Itonaga M, Kato H, Nishikiori H, Okuda A, Matsumoto H, Uenoyama Y, Watanabe T, Chiba Y, Higuchi K, Kudo M, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 2 Pages: 180-187
  • DOI: 10.1111/den.13242
  • Peer Reviewed
• [Journal Article] Value of additional endoscopic ultrasonography for surveillance after surgical removal of intraductal papillary mucinous neoplasms. (2018)
  • Author(s): Kamata K, Takenaka M, Minaga K, Omoto S, Miyata T, Yamao K, Imai H, Nakai A, Tanaka H, Chiba Y, Watanabe T, Sakurai T, Nishida N, Chikugo T, Matsumoto I, Takeyama Y, Kitano M, Kudo M.
  • Journal Title: Dig Endosc Volume: 印刷中 Issue: 5 Pages: 659-666
  • DOI: 10.1111/den.13176
  • NAID: 130007635776
  • Peer Reviewed / Open Access
• [Journal Article] Endoscopic ultrasound‐guided choledochoduodenostomy using a thin stent delivery system in patients with unresectable malignant distal biliary obstruction: A prospective multicenter study (2018)
  • Author(s): Itonaga M, Kitano M, Hatamaru K, Tamura T, Nuta J, Kawaji Y, Takenaka M, Minaga K, Kudo M, Ogura T, Higuchi K, Chiba Y
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 3 Pages: 291-298
  • DOI: 10.1111/den.13300
  • Peer Reviewed
• [Journal Article] Recent advances in endoscopic ultrasound-guided biliary drainage (2018)
  • Author(s): Minaga K, Kitano M
  • Journal Title: Digestive Endoscopy Volume: 30 Issue: 1 Pages: 38-47
  • DOI: 10.1111/den.12910
  • Peer Reviewed
• [Journal Article] Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis (2018)
  • Author(s): Minaga K, Takenaka M, Kamata K, Yoshikawa T, Nakai A, Omoto S, Miyata T, Yamao K, Imai H, Sakamoto H, Kitano M, Kudo M
  • Journal Title: Cancers Volume: 10 Issue: 2 Pages: 50-50
  • DOI: 10.3390/cancers10020050
  • Peer Reviewed / Open Access
• [Journal Article] Endoscopic ultrasound-guided biliary drainage using a newly designed metal stent with a thin delivery system: a preclinical study in phantom and porcine models. (2018)
  • Author(s): Minaga K, Kitano M, Itonaga M, Imai H, Miyata T, Yamao K, Tamura T, Nuta J, Warigaya K, Kudo M.
  • Journal Title: J Med Ultrason Volume: 印刷中 Issue: 3 Pages: 391-397
  • DOI: 10.1007/s10396-017-0850-1
  • Peer Reviewed
• [Journal Article] Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders. (2018)
  • Author(s): Shiomi H, Yamao K, Hoki N, Hisa T, Ogura T, Minaga K, Masuda A, Matsumoto K, Kato H, Kamada H, Goto D, Imai H, Takenaka M, Noguchi C, Nishikiori H, Chiba Y, Kutsumi H, Kitano M.
  • Journal Title: Dig Dis Sci Volume: 63 Issue: 3 Pages: 787-796
  • DOI: 10.1007/s10620-018-4908-8
  • Peer Reviewed
• [Journal Article] Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions (2017)
  • Author(s): Kamata Ken、Takenaka Mamoru、Kitano Masayuki、Omoto Shunsuke、Miyata Takeshi、Minaga Kosuke、Yamao Kentaro、Imai Hajime、Sakurai Tosiharu、Nishida Naoshi、Kashida Hiroshi、Chikugo Takaaki、Chiba Yasutaka、Nakai Takuya、Takeyama Yoshifumi、Lisotti Andrea、Fusaroli Pietro、Kudo Masatoshi
  • Journal Title: Digestive Endoscopy Volume: 30 Issue: 1 Pages: 98-106
  • DOI: 10.1111/den.12900
  • NAID: 130007485238
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Clinical significance of Akt2 in advanced pancreatic cancer treated with erlotinib. (2017)
  • Author(s): Banno E, Togashi Y, de Velasco MA, Mizukami T, Nakamura Y, Terashima M, Sakai K, Fujita Y, Kamata K, Kitano M, Kudo M, Nishio K
  • Journal Title: Int J Oncol Volume: 50 Issue: 6 Pages: 2049-2058
  • DOI: 10.3892/ijo.2017.3961
  • Peer Reviewed
• [Journal Article] Contrast-enhanced endoscopic ultrasonography for diagnosis of pancreatobiliary diseases (2017)
  • Author(s): 山下泰伸、北野雅之、糸永昌弘
  • Journal Title: Nippon Shokakibyo Gakkai Zasshi Volume: 114 Issue: 8 Pages: 1407-1414
  • DOI: 10.11405/nisshoshi.114.1407
  • NAID: 130005906886
  • ISSN: 0446-6586, 1349-7693
  • Peer Reviewed
• [Journal Article] New Imaging Techniques for Endoscopic Ultrasonography: Contrast-Enhanced Endoscopic Ultrasonography. (2017)
  • Author(s): Kitano M, Yamashita Y
  • Journal Title: Gastrointest Endosc Clin N Am Volume: 27 Issue: 4 Pages: 569-583
  • DOI: 10.1016/j.giec.2017.06.002
  • Peer Reviewed
• [Journal Article] Characterization of Pancreatic Tumors with Quantitative Perfusion Analysis in Contrast-Enhanced Harmonic Endoscopic Ultrasonography. (2017)
  • Author(s): Omoto S, Takenaka M, Kitano M, Miyata T, Kamata K, Minaga K, Arizumi T, Yamao K, Imai H, Sakamoto H, Harwani Y, Sakurai T, Watanabe T, Nishida N, Takeyama Y, Chiba Y, Kudo M.
  • Journal Title: Oncology Volume: 93 Suppl 1 Issue: Suppl. 1 Pages: 55-60
  • DOI: 10.1159/000481231
  • Peer Reviewed
• [Journal Article] Utility of Endoscopic Ultrasound-Guided Hepaticogastrostomy with Antegrade Stenting for Malignant Biliary Obstruction after Failed Endoscopic Retrograde Cholangiopancreatography. (2017)
  • Author(s): Imai H, Takenaka M, Omoto S, Kamata K, Miyata T, Minaga K, Yamao K, Sakurai T, Nishida N, Watanabe T, Kitano M, Kudo M.
  • Journal Title: Oncology Volume: 93 Suppl 1 Issue: Suppl. 1 Pages: 69-75
  • DOI: 10.1159/000481233
  • Peer Reviewed
• [Journal Article] Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration. (2017)
  • Author(s): Minaga K, Takenaka M, Katanum A, Kitano M, Yamashita Y, Kamata K, Yamao K, Watanabe T, Maguchi H, Kudo M.
  • Journal Title: Oncology Volume: 93 Suppl 1 Issue: Suppl. 1 Pages: 107-112
  • DOI: 10.1159/000481235
  • Peer Reviewed
• [Journal Article] Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention. (2017)
  • Author(s): Minaga K, Takenaka M, Kitano M, Chiba Y, Imai H, Yamao K, Kamata K, Miyata T, Omoto S, Sakurai T, Watanabe T, Nishida N, Kudo M.
  • Journal Title: Surg Endosc Volume: 印刷中 Issue: 11 Pages: 4764-4772
  • DOI: 10.1007/s00464-017-5553-6
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis: Long-term outcomes after removal of a self-expandable metal stent. (2017)
  • Author(s): Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Kudo M.
  • Journal Title: World J Gastroenterol. Volume: 23 Issue: 4 Pages: 661-667
  • DOI: 10.3748/wjg.v23.i4.661
  • Peer Reviewed
• [Journal Article] Endoscopic ultrasonography-guided choledochoduodenostomy using a newly designed laser-cut metal stent: Feasibility study in a porcine model. (2017)
  • Author(s): Minaga K, Kitano M, Gon C, Yamao K, Imai H, Miyata T, Kamata K, Omoto S, Takenaka M, Kudo M.
  • Journal Title: Digestive Endosc Volume: 29 Issue: 2 Pages: 211-217
  • DOI: 10.1111/den.12741
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Histologic diagnosis of pancreatic masses using 25-gauge endoscopic ultrasound needles with and without a core trap: a multicenter randomized trial. (2016)
  • Author(s): Kamata K, Kitano M, Yasukawa S, Kudo M, Chiba Y, Ogura T, Higuchi K, Fukutake N, Ashida R, Yamasaki T, Nebiki H, Hirose S, Hoki N, Asada M, Yazumi S, Takaoka M, Okazaki K, Matsuda F, Okabe Y, Yanagisawa A.
  • Journal Title: Endoscopy Volume: 48 Issue: 07 Pages: 632-638
  • DOI: 10.1055/s-0042-106294
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Evaluation of anti-migration properties of biliary covered self-expandable metal stents. (2016)
  • Author(s): Minaga K, Kitano M, Imai H, Harwani Y, Yamao K, Kamata K, Miyata T, Omoto S, Kadosaka K, Sakurai T, Nishida N, Kudo M.
  • Journal Title: World J Gastroenterol Volume: 22 Issue: 30 Pages: 6917-24
  • DOI: 10.3748/wjg.v22.i30.6917
  • Peer Reviewed / Open Access
• [Journal Article] Predictors of pain response in patients undergoing endoscopic ultrasound-guided neurolysis for abdominal pain caused by pancreatic cancer. (2016)
  • Author(s): Minaga K, Kitano M, Sakamoto H, Miyata T, Imai H, Yamao K, Kamata K, Omoto S, Kadosaka K, Sakurai T, Nishida N, Chiba Y, Kudo M.
  • Journal Title: Therap Adv Gastroenterol Volume: 9 Issue: 4 Pages: 483-494
  • DOI: 10.1177/1756283x16644248
  • Peer Reviewed / Acknowledgement Compliant
• [Presentation] Guide of Tissue Acquisition (2018)
  • Author(s): Kitano M
  • Organizer: AFSUMB 2018
  • Int'l Joint Research / Invited
• [Presentation] Interventional EUS for pancreatic cancer (2018)
  • Author(s): Kitano M
  • Organizer: IASGO 2018
  • Int'l Joint Research / Invited
• [Presentation] EUS-FNAによる確定診断法の位置づけ，膵臓 現行膵癌超音波診断基準の見直し (2018)
  • Author(s): 北野雅之，糸永昌弘，幡丸景一，山下泰伸，田村崇，奴田絢也，川路祐輝
  • Organizer: 日本超音波医学会第91回学術集会
• [Book] Innovation of Diagnosis and Treatment for Pancreatic Cancer (2017)
  • Author(s): Kitano M, Takenaka M, Minaga K, Miyata T, Kamata K
  • Total Pages: 252
  • Publisher: Springer
  • ISBN: 9789811024856