Kazunori Kubota

Publications (12)16.88 Total impact

• Article: [A Long-Surviving Case of HER2-Positive Breast Cancer with Brain Metastasis Treated by Multidisciplinary Therapy].

  Hitoshi Sugimoto, Tsuyoshi Nakagawa, Takanobu Sato, Makoto Nagahara, Toshiyuki Ishiba, Mai Kasahara, Hiroshi Kawachi, Kazunori Kubota, Kenichi Sugihara
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  ABSTRACT: We present a case of a 55-year-old woman who visited our hospital aware of a lump in her right breast. We diagnosed it as bilateral breast cancer [Rt: ABCDE, T3N1M0, ER (-), PgR (-), HER2: 3+, Stage IIIA; Lt: C, T2N0M0, ER (-), PgR (-), HER2: 1+, Stage IIA]. She underwent NAC with EC followed by docetaxel. After cPR, an operation (Rt Bt+Ax, Lt Bp+Ax) was performed. Liver metastases were identified 9 months after the operation, and she was administered weekly paclitaxel+trastuzumab for 12 courses. After cPR, the treatment was changed to trastuzumab only. Because a cerebellar metastasis appeared in postoperative month 19, she underwent an operation using a gamma-knife. Because a new cerebellar metastasis appeared in postoperative month 26, she underwent another gamma-knife operation. Furthermore, liver metastases were diagnosed as PD, and treatment was changed to vinorelbine and trastuzumab. Because third new cerebellar metastasis appeared in postoperative month 45, she underwent another gamma-knife operation. Lung metastases were identified 59 months after the operation, and the therapy was changed to lapatinib and capecitabine. There was no subsequent growth of metastatic tumors, and good control was obtained.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2071-3.
• Article: FDG PET/CT of a benign ovarian Brenner tumor.

  Akira Toriihara, Yoshimi Taniguchi, Mariko Negi, Kazunori Kubota, Tomoko Makino, Hitoshi Shibuya
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  ABSTRACT: We present a case of an ovarian benign Brenner tumor identified in an 85-year-old woman. During an observation period of over 1 year, the tumor increased in size and showed newly appeared solid component. Magnetic resonance imaging was typical of a Brenner tumor; fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings revealed mild FDG uptake and calcification in the solid component. These findings of PET/CT are often found in ovarian mucinous carcinomas. Our case suggests that magnetic resonance imaging is superior to FDG PET/CT for the differential diagnosis of ovarian Brenner tumors from other malignant tumors.
  Clinical imaging 09/2012; 36(5):650-3. · 0.73 Impact Factor
• Article: Evaluation of sequential FDG-PET/CT for monitoring bone metastasis of breast cancer during therapy: correlation between morphological and metabolic changes with tumor markers.

  Takashi Katayama, Kazunori Kubota, Youichi Machida, Akira Toriihara, Hitoshi Shibuya
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  ABSTRACT: PURPOSE: The purpose of this study was to clarify the significance of positron emission tomography (PET) and computed tomography (CT) findings for evaluating the bone metastasis of breast cancer during therapy. PATIENTS AND METHODS: Forty-seven patients with bone metastases from breast cancer who underwent sequential FDG-PET/CT studies during therapy were enrolled. A total of 771 lesions were identified. The changes in the PET and CT findings were compared with the tumor marker levels in each patient by calculating the weighted kappa value. The correlation between the PET and CT findings was examined for each lesion by an adjusted Chi-square test. RESULTS: The change in the tumor marker levels was substantially correlated with the PET findings and moderately correlated with the CT findings (weighted kappa = 0.780 and 0.585 for quadratic weighting, respectively). An increase in FDG uptake was correlated with lytic changes on the CT images (62/65, 95.4 %, p < 0.05). Sclerotic changes suggested improvement, but sclerosis and progression occurred at the same time in some lesions. CONCLUSION: Changes of FDG uptake are useful for evaluating individual bone metastases in cases of breast cancer during therapy. Lytic change on CT images suggests progression of bone metastasis. The lysis-progression/sclerosis-improvement pattern was observed in the majority of subjects, but a sclerosis-progression pattern was also observed. The hybrid pattern of increase of FDG uptake on PET/lytic change on CT is most accurate to show progression of bone metastases. Assessments of these processes during therapy are necessary for the precise evaluation of bone metastases.
  Annals of Nuclear Medicine 04/2012; · 1.50 Impact Factor
• Article: Utility of F-18 FDG PET/CT in screening for paraneoplastic neurological syndromes.

  Akiyuki Matsuhisa, Akira Toriihara, Kazunori Kubota, Tomoko Makino, Hidehiro Mizusawa, Hitoshi Shibuya
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  ABSTRACT: The aim of this study was to assess the utility of positron emission tomography/computed tomography (PET/CT) for the investigation of patients with suspected paraneoplastic neurologic syndrome (PNS). We reviewed the whole-body fluorodeoxyglucose (FDG) PET/CT studies (ordered by the neurology department) performed at our hospital between December 2005 and November 2010; 27 cases (16 men, 11 women; mean age, 65 years) who were suspected of having PNS were selected. Of the 27 patients, 6 (22%) had an abnormal FDG uptake. Of these 6 patients, 5 (19%) were histologically confirmed as having a malignancy. Of the 27 patients, 7 were tested for the presence of well-characterized paraneoplastic antibodies (anti-Hu, anti-Ri, anti-Yo); 1 had anti-Hu, but the patient did not have an abnormal FDG uptake or malignancy. PET/CT may be a useful screening tool for patients with clinically suspected PNS who do not exhibit well-characterized paraneoplastic antibodies. Therefore, we recommended that PET/CT should be performed for patients with clinically suspicious PNS regardless of the presence of well-characterized paraneoplastic antibodies.
  Clinical nuclear medicine 01/2012; 37(1):39-43. · 3.92 Impact Factor
• Article: [A case of scalp metastases from breast cancer successfully treated with letrozole].

  Takashi Kuwayama, Takanobu Sato, Tsuyoshi Nakagawa, Hitoshi Sugimoto, Toshiyuki Ishiba, Kazunori Kubota, Kenichi Sugihara
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  ABSTRACT: A 62-years-old woman visited a dermatology clinic for hard mass at her scalp. Clinicallly, the mass was hard and alopecic. The diameter was 3 cm. A skin biopsy was done and histpathological examination showed adenocarcinoma. Immunehistchemically, estrogen receptor was positive. It was suspected that breast cancer could be metastasized to the scalp, but mammography, ultrasound, and positron emission tomography showed no particular metastases in her breast and other organs. Magnetic resonance imaging showed enhanced lesions in her birateral breast. Needle biopsy was done and pathological findings showed bilateral breast carcinoma and metastases to the scalp. So we started endocrine therapy using letrozole, the mass was shrunk to 1 cm after 6-month. It is rare that breast cancer was metastasized to the scalp. But Conner et al. reported that 84% of metastatic scalp carcinoma was from the breast, so we should examine the breast more carefully.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2183-5.
• Article: [A case of stage IV breast cancer with bone metastases that responded well for long-term to hormonal therapy].

  Goshi Oda, Tsuyoshi Nakagawa, Takanobu Sato, Takashi Kuwayama, Kohei Yamamoto, Hiroshi Kawachi, Kazunori Kubota, Kenichi Sugihara
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  ABSTRACT: A case was a 48 years old woman. She was aware of a lump in her left breast and visited our hospital. We diagnosed it as an invasive ductal carcinoma. Immunostaining for both ER and PgR was strongly positive. CT of the initial consultation showed multiple bone metastases (thoracic vertebrae, lumbar vertebrae, and iliac bone). After AC followed by docetaxel and tamoxifen, LH-RH analogue was started. We used anastrozole after menopause. The bisphosphonate has been used from the beginning of the treatment. After the chemotherapy, the clinical response of primary tumor was judged as partial response. For six years, the size of primary tumor has not been changed, and PET-CT has not showed another metastasis. Anastrozole was superior to tamoxifen with respect to TTP (median values of 10.7 and 6.4 months for anastrozole and tamoxifen, respectively) in postmenopausal women with ER and/or PgR receptor positive tumors. Our study indicated that many patients responding to hormonal therapy appear to have been increasing from now on.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2753-5.
• Article: [A case of inflammatory breast cancer responding to anastrozole].

  Takanobu Sato, Tsuyoshi Nakagawa, Takashi Kuwayama, Kazunori Kubota, Shiho Suzuki, Kenichi Sugihara
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  ABSTRACT: A case is 61 years old woman. In February 2008, she was aware of swelling, skin redness and edema in her left breast and visited our hospital. We diagnosed it as inflammatory breast cancer with positive hormone receptor (ER+, PgR+) and unexpression of HER2 (HercepTest 1 +). We started preoperative chemotherapy with weekly paclitaxel followed by FEC100, but we canceled chemotherapy because she developed cerebral infarction when we administered paclitaxel twice. Then, hormonotherapy using anastrozole (Arimidex) was therefore attempted. Three months later, treatment with anastrozole alone reduced the swelling, skin redness and edema in her left breast. After eight months of administration, the breast swelling, skin redness and edema were completely disappeared. MRI revealed the disappearance of the enhanced area. Then mastectomy with auxiliary dissection was performed.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2477-9.
• Article: PET/CT evaluation of the physiologic accumulation of 18F-FDG within the gallbladder vesicle.

  Yuji Murata, Hiroshige Watanabe, Kazunori Kubota, Kazuma Toda, Shin Nakamura, Kiyoshi Okouchi, Hitoshi Shibuya
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  ABSTRACT: The aim of this study was to investigate physiological fluorine 18-labeled fluourodeoxyglucose accumulation in the gallbladder (GB) during clinical positron emission tomography (PET) examinations. Three patient groups were included. In Group 1, nine patients with higher fluourodeoxyglucose (FDG) accumulation in the GB than in the liver were examined, followed up and finally diagnosed. In Group 2, the correlations between FDG GB accumulation and various parameters in 286 patients were investigated. In Group 3, changes in FDG GB accumulation between early and delayed PET scans were analyzed in 12 patients. In Group 1, all nine patients who exhibited a high FDG GB accumulation had no evidence of GB disease. In Group 2, FDG GB accumulation was significantly correlated with the injection-scan time interval and inversely correlated with the GB size index. Group 3 showed a significant increase in FDG accumulation in the GB on delayed PET scans, compared with that seen on early scans. In clinical PET studies, FDG accumulation within the GB is infrequently observed but may be due to FDG excretion into the bile. Recognition of this phenomenon may be important to avoid misdiagnosing physiological GB FDG accumulation as indicating a pathologic status and preventing unnecessary examinations.
  Nuclear Medicine and Biology 12/2007; 34(8):961-6. · 3.02 Impact Factor
• Article: Growth rate of locally recurrent hepatocellular carcinoma after transcatheter arterial chemoembolization: comparing the growth rate of locally recurrent tumor with that of primary hepatocellular carcinoma.

  Mikio Tezuka, Keiji Hayashi, Kazunori Kubota, Sachiko Sekine, Yoichi Okada, Hiroyasu Ina, Tetsuya Irie
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  ABSTRACT: We compared the growth rate of locally recurrent hepatocellular carcinoma (HCC) with that of primary HCC. After the first treatment by transcatheter arterial chemoembolization (TACE), 60 locally recurrent HCC nodules were reviewed. The tumor volume doubling time (DT) of locally recurrent HCC was significantly shorter than that of primary HCC. The 95% lower threshold value was 17.7 days. The 6-, 12-, and 36-month recurrence-free rates of the tumors having DTs more than 70 days after the second TACE (77.7%, 53.8%, and 40.4%) were significantly higher than those of the tumors having DTs less than 70 days (26.7%, 26.7%, and 17.8%). Locally recurrent HCCs cannot double in diameter in less than 53 days. In the case that an equivocal lesion smaller than the section collimation depicted during a contrast-enhanced computed tomography (CECT) screening cannot be ruled out as local recurrence, the next CECT screening should be performed 2 months later.
  Digestive Diseases and Sciences 04/2007; 52(3):783-8. · 2.12 Impact Factor
• Article: Magnetic resonance imaging of the metal clip in a breast: safety and its availability as a negative marker.

  Kazunori Kubota, Naoya Gomi, Toshihiko Wakita, Hitoshi Shibuya, Masaki Kakimoto, Takayuki Osanai
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  ABSTRACT: This study assesses magnetic resonance (MR) safety of the stainless-steel clip inserted after stereotactic-guided directional vacuum-assisted biopsy (DVAB) of the breast, and evaluates its imaging value. We used a sausage as a substitute breast and inserted the clip into it. The MR images of the substitute were scanned using a breast coil, and it was then dissected. After the substitute experimentation, MR scanning of the breast was performed using a dynamic contrast enhanced technique, in which a clip was placed after DVAB for suspicion of ductal carcinoma was seen as grouped amorphous calcifications on mammography. On every magnetic resonance image of the substitute, the clip was seen as a spotty signal void, with no surrounding artifact. There was no movement and no evidence of increased clip temperature on dissected of the substitute, confirming the safety of breast MR with a clip in place. There was no patient complaint of feeling heat or pain during the MRI examination and there were only biopsy scars on the surgically excised breast specimen material. On the breast MR images, a spreading region of the tumor adjoining the position of the signal void was identified as an early enhancing lesion. The safety and reliability of breast MR examination using a mammotome clip was demonstrated by both the mock examination and the breast examination. It is possible to localize of tumor spread regions based on the marker position using the clip as a negative signal marker.
  Breast Cancer 02/2004; 11(1):55-9. · 1.36 Impact Factor
• Article: Growth rate of primary single hepatocellular carcinoma: determining optimal screening interval with contrast enhanced computed tomography.

  Kazunori Kubota, Hiroyasu Ina, Yoichi Okada, Tetsuya Irie
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  ABSTRACT: To determine the optimal screening interval for detecting small (< 20 mm) hepatocellular carcinoma (HCC) in a high-risk group using multiphase contrast-enhanced computed tomography (CECT), we evaluated the growth rate of primary single HCC. Forty-nine primary single HCC cases were reviewed. CECT screening was performed more than two times preceding to the diagnosis in 29 cases, and HCC nodule was identified at least two times in 22 cases. The initial nodule sizes ranged between 3 and 30 mm. Doubling time of tumor volume ranged from 34.8 to 496.4 days, with a geometric mean of 93.5 days, and a 95% lower threshold value of 27.1 days. It means that HCC will not double in diameter within 3 months. Therefore CECT screening at intervals of 3 months will detect new nodules at 10-20 mm in size and CECT screening at intervals of longer than 3 months will detect new nodules but they might be larger than 20 mm in size.
  Digestive Diseases and Sciences 04/2003; 48(3):581-6. · 2.12 Impact Factor
• Article: Computed tomography-guided transarterial chemoembolization as the initial therapy for hepatocellular carcinoma: experience of 75 cases in a single institute.

  Yoichi Okada, Hiroyasu Ina, Kazunori Kubota, Yoshiro Himeno, Toshihiko Wakita, Isamu Ohashi, Naoya Gomi, Tetsuo Yoshida, Sunao Mae, Tetsuya Irie
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  ABSTRACT: We present the survival rates of 75 nonruptured hepatocellular carcinoma cases initially treated with computed tomography-guided transarterial chemoembolization in a single institute. The 1-, 3-, and 5-year survival rates were 93.9%, 74.7%, and 47.4% in 50 Child's A cases; 75.0%, 43.6%, and 6.8% in 20 Child's B cases; and 60.0%, 40.0%, 0.0% in 5 Child's C cases, respectively. The 1-, 3-, and 5-year survival rates of the 38 estimated resectable hepatocellular carcinoma cases (Child's A, tumors limited in a single lobe) were 94.7%, 82.0%, and 44.6%, respectively. The 1-, 3-, and 5-year survival rates of the 41 cases with estimated indication for percutaneous ethanol injection therapy (tumors less than 3 cm in diameter and three or fewer in number) were 96.8%, 84.6%, and 55.5% in 31 Child's A cases; and 90.0%, 46.7%, and 0% in 10 Child's B cases, respectively. In conclusion, computed tomography-guided transarterial chemoembolization is an excellent primary therapy for hepatocellular carcinoma.
  Digestive Diseases and Sciences 04/2003; 48(3):587-93. · 2.12 Impact Factor