埼玉医科大学雑誌 第35巻 第1号別頁 (2008年12月) T23-T30頁 ◇論文(図表を含む全文)は,PDFファイルとなっています.

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Thesis
肝細胞癌に対するラジオ波焼灼療法 ―段階的焼灼法および必要最小限展開法の開発―

今村 雅俊
埼玉医科大学 内科学消化器・肝臓内科部門
(指導:持田 智 教授)

医学博士 乙第1062号 平成19年9月21日 (埼玉医科大学)


Radiofrequency Ablation for Hepatocellular Carcinoma - Invention of “the stepwise deployment ablation method” and “the array deployment with minimum requirement diameter method”-
Masatoshi Imamura (Division of Gastroenterology & Hepatology, Internal Medicine, Saitama Medical University,Moroyama, Iruma-gun, Saitama 350 - 0495, Japan )

 The applicant utilizes the expandable arrays technology for this RFA therapy, and invented the two methods of RFA therapies. The first one is “the stepwise deployment ablation method”, which coagulates the center of the tumor first by half deployment, then coagulates entire tumor by full deployment. The other one is “the array deployment with minimum requirement diameter method”, which coagulate the minimum tumor lesion by deploying the arrays with minimally required.
To prove the efficacy of those methods, the applicant conducted the basic research of the process of coagulation in dead cow liver. It was found that the stepwise deployment method enables to create necrotic lesion shorter time than the ablation by the manufacturers recommended ablation algorithm. On the other hand, this method is also clarified that all practical HCC tumor treatment cases are surely able to achieve “roll-off”, the measurement sign of the complete necrosis. In addition, it was clarified that the array deployment with minimum requirement diameter method is minimum invasive ablation procedure, because it does not coagulate the lesions of “non-tumor part” around the ablation target tumor when the tumor size is less than 1.5cm in diameter.
Moreover, these methods enabled to be applied in the tumors such as large-scale HCC or the tumors located right under the diaphragm, which tumors were not in the RFA treatment criteria for the reason of the safety.
Therefore, the RFA treatment therapy by utilizing “the stepwise deployment ablation method” and “the array deployment with minimum requirement diameter method” can be considered as safe and effective therapy for liver malignant tumors.
Keywords: RFA, HCC, The stepwise deployment ablation method, The array deployment with minimum requirement diameter method


(C) 2008 The Medical Society of Saitama Medical University