Masae Komiyama

Publications (2)2.2 Total impact

• Article: Radiofrequency ablation of hepatocellular carcinoma: The feasibility of magnetic resonance imaging with gadolinium ethoxybenzyl diethylene triamine pentaacetic acid for evaluating the ablative margin

  Hironao Okubo, Shigehiro Kokubu, Masae Komiyama, Hisafumi Yamagata, Akira Uchiyama, Akihisa Miyazaki, Sumio Watanabe
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  ABSTRACT: Aim:  The aim of this study was to evaluate the feasibility of gadolinium ethoxybenzyl diethylene triamine pentaacetic acid (Gd-EOB-DTPA) in magnetic resonance imaging (MRI) to assess the ablative margin of radiofrequency (RF) ablation to hepatocellular carcinoma (HCC).Methods:  RF ablation was performed in the livers of six pigs after the i.v. administration of Gd-EOB-DTPA 20 min before ablation. Three pigs were killed 2 h after administration (group A), and the other pigs were killed 7 days after ablation (group B). Thereafter, correlation between pathological findings and MRI was investigated. Moreover, the Gd concentrations were examined in ablated and non-ablated regions. An initial clinical evaluation was conducted for 28 HCC nodules. Percutaneous RF ablation was performed 20 min after administration, and T1-weighted images were taken 2, 24 and 72 h post-treatment.Results:  On T1-weighted images of the porcine liver, the RF ablated lesions showed hyperintense regions with hypointense rims, which histopathologically corresponded to sinusoidal congestion. The Gd concentrations in ablated regions in group A were significantly higher than those in non-ablated regions, while the concentrations in both regions in group B fell to nearly undetectable levels. In 27 of the 28 HCC nodules, the treated area consisted of a hypointense region, indicative of the tumor, and a surrounding hyperintense rim 2 h after ablation. Subsequently, a thin hypointense region was observed in the outermost layer 24 and 72 h after ablation.Conclusion:  Administration of Gd-EOB-DTPA in conjunction with RF ablation of HCC may be feasible for the assessment of an accurate ablative margin.
  Hepatology Research 09/2010; 40(10):1034 - 1041. · 2.20 Impact Factor
• Article: A novel endoscopic ablation of gastric antral vascular ectasia.

  Masae Komiyama, Kuangi Fu, Takashi Morimoto, Hironori Konuma, Toshifumi Yamagata, Yuko Izumi, Akihisa Miyazaki, Sumio Watanabe
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  ABSTRACT: An 80-year-old woman was admitted to our hospital because of tarry stool with iron deficiency anemia. Her past history included autoimmune hepatitis. Esophagogastroduodenal endoscopy was performed to investigate the bleeding source and revealed multiple linear gastric vascular malformations in the antrum and cardia, compatible with Gastric antral vascular ectasia (GAVE). Endoscopic ablation was carried out with the tip of the hot biopsy forceps without opening at soft coagulation mode of 80W. The patient tolerated the procedure well and there were no complications associated with endoscopic therapies. After two sessions of endoscopic ablation her anemia improved to around 10 g/dL, an increase of 3.6 g/dL. Various endoscopic treatments have been described to manage GAVE. The most popular is argon plasma coagulation (APC), although APC is associated with over-distension induced by the argon plasma gas. To avoid over-distension and to reduce the abdominal discomfort/pain of this patient, we have used hot biopsy forceps instead of APC. Our case suggests that this procedure is effective, easy and convenient, as no special equipment or skill is necessary.
  World journal of gastrointestinal endoscopy. 08/2010; 2(8):298-300.