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Masakazu Hirakawa Last modified date:2021.06.01

Associate Professor / Radiology 
Kyushu University Hospital


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Homepage
https://kyushu-u.pure.elsevier.com/en/persons/masakazu-hirakawa
 Reseacher Profiling Tool Kyushu University Pure
Phone
0977-21-1609
Fax
0977-27-1605
Academic Degree
DOCTOR OF PHILOSOPHY (Medical Science)
Country of degree conferring institution (Overseas)
Yes
Field of Specialization
Diagnotic abdominal imaging, Interventional Radiology, Radiation protection
Total Priod of education and research career in the foreign country
00years00months
Outline Activities
Research and Education
IVR
Abdominal imaging
Research
Research Interests
  • Radiation protection during Interventional radiology
    keyword : Radiation protection Interventional radiology
    2020.04~2021.03.
  • Radiation protection during Interventional radiology
    keyword : Radiation protection Interventional radiology
    2021.04~2023.03.
  • Assessment of improvement of efficacy transarterial chemoembolization for hepatocellular carcinoma
    Assessment of the radiation dose reduction of patients and physicians during Interventional radiological procedure
    keyword : HCC,TACE,Radiation dose,IVR
    2015.04~2020.03.
  • Analysis of radiosentization controlling microRNA for esophageal carcinoma
    keyword : esophageal carcinoma radiosentization microRNA
    2011.04~2013.05.
  • Research of radiation sensitizer to malignant tumor
    keyword : radiation sensitizer malignant tumor
    2009.04~2011.03.
  • Research of radiation sensitizer to malignant tumor
    keyword : radiation sensitizer to malignant tumor
    2005.04~2009.03.
Academic Activities
Papers
1. Masakazu Hirakawa1)2), Torahiko Yamanouchi2), Satoru Tsuruta3), Akihiro Inoue2), Hidenari Hirata1), Keiji Matsumoto1), Katsumi Sakamoto1), Hironori Sakai3), Koshi Mimori4), Hiroshi Honda5), Midterm Outcomes and Prognostic Factors of Patients Treated Using Microballoon-Occluded Transarterial Chemoembolization with Miriplatin: A Retrospective Study of 37 Cases, Interventional Radiology, 3, 97-109, Interventional Radiology 2018; 3: 97-109, 2018.06, Purpose: This study aimed to retrospectively evaluate the overall survival and prognostic factors of patients
treated using microballoon-occluded transarterial chemoembolization (B-TACE) with miriplatin for hepatocellular
carcinoma (HCC).
Materials and Methods: Thirty-seven patients (23 men and 14 women; mean age, 74.1 years; Barcelona
Clinic Liver Cancer stage A:21, B:10, C:6; first TACE, 17) treated using B-TACE with miriplatin were retrospectively
analyzed. Overall survival and progression-free survival were analyzed using Kaplan-Meier methods,
and a multivariate analysis was performed to identify prognostic factors. Side effects were analyzed on
the basis of the National Cancer Institute’s Common Terminology Criteria for Adverse Events (ver. 4.0).
Results: The 1-, 2-, and 3-year survival rates were 89.2% (95% confidence interval [CI], 74.5-95.9%),
67.3% (95% CI, 50.7-80.4%), and 60.9% (95% CI, 44.1-75.4%), respectively. The median survival time was
3.6 years. The median progression-free survival time was 8 months. Balloon increase (increased tumor stain
under balloon occlusion; hazard ratio, 3.17; 95% CI, 1.135-11.201; P = 0.027) was the only factor significantly
associated with overall survival on the multivariate analysis. No deaths occurred, but grade 2 cholecystitis
requiring conservative treatment developed in 2 patients (4.8%). No adverse events over grade 3 occurred.
Conclusion: B-TACE with miriplatin was associated with comparable tumor control and overall survival
without severe adverse events in patients with HCC. Balloon increase was the only factor significantly associated
with overall survival..
2. Masakazu Hirakawa, Torahiko Yamanouchi, Satoru Tsuruta, Hidenari Hirata, Koushi Mimori, Hiroshi Honda, Comparison of the Local Control Effects of Microballoon-Occluded Transarterial Chemoembolization (TACE) Using Miriplatin and Using Epirubicin for Hepatocellular Carcinoma: A Retrospective Study of 62 Cases, Interventional Radiology, 2, 64-73, 2017.06, Purpose: This study aimed to retrospectively compare the local control and safety of microballoonoccluded
transarterial chemoembolization (B-TACE) using miriplatin (MPT) and of conventional TACE (CTACE)
using epirubicin (EPIR) for hepatocellular carcinoma (HCC).
Materials and Methods: Thirty-nine patients (24 men, 15 women; mean age, 73.4 years) were treated using
B-TACE with MPT (MPT-B-TACE group). As a historical comparison, 23 patients (13 men, 10 women;
mean age, 72.2 years) who were treated using C-TACE with EPIR (EPIR-C-TACE group) were investigated.
The therapeutic effect within 2 weeks after treatment was compared between the groups based on the Response
Evaluation Criteria in Cancer of the Liver (RECICL), and time to local recurrence was compared
based on the Kaplan-Meier method and log-rank tests. The side effects were compared based on the Common
Terminology Criteria for Adverse Events (ver. 4.0).
Results: No significant differences were noted in patients’ characteristics between the groups. The overall
incidence of postembolization syndrome was significantly lower in the MPT-B-TACE group than in the
EPIR-C-TACE group (p<0.05), but two cases in the MPT-B-TACE group developed grade 2 cholecystitis.
Based on the RECICL, the objective response rate, including TE4 and TE3, within 2 weeks after treatment
was significantly higher in the MPT-B-TACE group (89.7%) than in the EPIR-C-TACE group (78.3%). Overall,
local recurrence was significantly less frequent in the MPT-B-TACE group than in the EPIR-C-TACE
group (p=0.02).
Conclusion: MPT-B-TACE was associated with a higher objective response rate and lower local recurrence
rate than EPIR-C-TACE without a significant increase in adverse effects..
3. Hirata H, Sugimachi K, Komatsu H, Ueda M, Masuda T, Uchi R, Sakimura S, Nambara S, Saito T, Shinden Y, Iguchi T, Eguchi H, Ito S, Terashima K, Sakamoto K, Hirakawa M, Honda H, Mimori K., Decreased Expression of Fructose-1,6-bisphosphatase Associates with Glucose Metabolism and Tumor Progression in Hepatocellular Carcinoma., Cancer Res, 76, 11, 3265-3276, 2016.06, Fructose-1,6-bisphosphatase (FBP1), the rate-limiting enzyme in gluconeogenesis, is reduced in expression in certain cancers where it has been hypothesized to act as a tumor suppressor, including in hepatocellular carcinoma (HCC). Here, we report functional evidence supporting this hypothesis, providing a preclinical rationale to develop FBP1 as a therapeutic target for HCC treatment. Three independent cohorts totaling 594 cases of HCC were analyzed to address clinical significance. Lower FBP1 expression associated with advanced tumor stage, poor overall survival, and higher tumor recurrence rates. In HCC cell lines, where endogenous FBP1 expression is low, engineering its ectopic overexpression inhibited tumor growth and intracellular glucose uptake by reducing aerobic glycolysis. In patient specimens, promoter methylation and copy-number loss of FBP1 were independently associated with decreased FBP1 expression. Similarly, FBP1 downregulation in HCC cell lines was also associated with copy-number loss. HCC specimens exhibiting low expression of FBP1 had a highly malignant phenotype, including large tumor size, poor differentiation, impaired gluconeogenesis, and enhanced aerobic glycolysis. The effects of FBP1 expression on prognosis and glucose metabolism were confirmed by gene set enrichment analysis. Overall, our findings established that FBP1 downregulation in HCC contributed to tumor progression and poor prognosis by altering glucose metabolism, and they rationalize further study of FBP1 as a prognostic biomarker and therapeutic target in HCC patients. .
4. Kohno K, Wang KY, Takahashi M, Kurita T, Yoshida Y, Hirakawa M, Harada Y, Kuma A, Izumi H, Matsumoto S, Mitochondrial Transcription Factor A and Mitochondrial Genome as Molecular Targets for Cisplatin-Based Cancer Chemotherapy., Int J Mol Sci., 16, 8, 19836-19850, 2015.08, Mitochondria are important cellular organelles that function as control centers of the energy supply for highly proliferative cancer cells and regulate apoptosis after cancer chemotherapy. Cisplatin is one of the most important chemotherapeutic agents and a key drug in therapeutic regimens for a broad range of solid tumors. Cisplatin may directly interact with mitochondria, which can induce apoptosis. The direct interactions between cisplatin and mitochondria may account for our understanding of the clinical activity of cisplatin and development of resistance. However, the basis for the roles of mitochondria under treatment with chemotherapy is poorly understood. In this review, we present novel aspects regarding the unique characteristics of the mitochondrial genome in relation to the use of platinum-based chemotherapy and describe our recent work demonstrating the importance of the mitochondrial transcription factor A (mtTFA) expression in cancer cells..
5. Hirata H, Sugimachi K, Takahashi Y,3, Ueda M, Sakimura S, Uchi R, Kurashige J, Takano Y, Nanbara S, Komatsu H, Saito T, Shinden Y, Iguchi T, Eguchi H, Atsumi K, Sakamoto K, Doi T, Hirakawa M, Honda H, Mimori K., Downregulation of PRRX1 Confers Cancer Stem Cell-Like Properties and Predicts Poor Prognosis in Hepatocellular Carcinoma., Ann Surg Oncol., 3, S1, 402-409, 2015.12, BACKGROUND:
Downregulation of paired related homeobox 1 (PRRX1) is associated with the acquisition of cancer stem cell (CSC)-like properties and poor prognosis in cancers. The purpose of this study is to clarify the role of PRRX1 expression in predicting prognosis and mediating CSC-like properties in hepatocellular carcinoma (HCC).

METHODS:
The association between PRRX1 expression and overall survival (OS) of patients with HCC was analyzed in three independent datasets: 62 resected primary cases, 242 cases from GSE14520, and 162 cases from The Cancer Genome Atlas (TCGA). A cell line expressing PRRX1 (HuH7) was established for the functional analyses. The ability to form spheres, the expression levels of the hepatic CSC surface markers (CD13, CD133, and EpCAM), in vitro chemosensitivity to 5-fluorouracil (FU), and radiosensitivity were evaluated.

RESULTS:
Univariate and multivariate analyses showed that the 5-year OS of the low PRRX1 expression group was significantly poorer than that of the high PRRX1 expression group (P = 0.024 and P = 0.045, respectively). Consistent with this, the low PRRX1 expression group in GSE14520 and TCGA datasets showed significantly shorter OS (P = 0.027 and P = 0.010, respectively). Gene set enrichment analysis on GSE14520 and TCGA datasets indicated that downregulation of PRRX1 was correlated with the stemness signature. The number of spheres and the expression levels of CSC markers were significantly decreased when PRRX1 was expressed. Moreover, PRRX1 impaired resistance to 5-FU and radiation.

CONCLUSIONS:
Downregulation of PRRX1 expression contributes to the poor prognosis of patients with HCC through acquisition of CSC-like properties..
6. Wataru todoroki, Masakazu Hirakawa, Eiki nagao, Hiroyasu soeda, Satoru Tsuruta, Hiroshi Honda, Transarterial chemoembolization for hepatocellular carcinoma using a new double-lumen microballoon catheter with a side hole., J Vasc Interv Radiol, 25, 9, 1485-1486, 2014.09.
7. Masakazu Hirakawa, Akihiro Nishie, Asayama Yoshiki, Fujita Nobuhiro, Kousei Ishigami, Tatsuro Tajiri, tomoaki taguchi, Hiroshi Honda, Efficacy of preoperative transcatheter arterial chemoembolization combined with systemic chemotherapy for treatment of unresectable hepatoblastoma in children., Jpn J Radiol., 32, 9, 529-536, 2014.09, PURPOSE:
The purpose of this study was to evaluate, retrospectively, the clinical efficacy of preoperative transcatheter arterial chemoembolization (TACE) combined with systemic chemotherapy for unresectable hepatoblastoma.
MATERIALS AND METHODS:
Five boys and three girls (mean age 15.2 months) were treated with preoperative TACE combined with systemic chemotherapy for unresectable hepatoblastomas. Mean tumor diameter and mean alfa-fetoprotein (AFP) level were 11.8 cm and 549,386 ng/mL, respectively. Pretreatment, the extent of disease (PRETEXT) was: II, 1; III, 6; IV, 1. For all patients, preoperative systemic chemotherapy was administered before TACE. At each TACE, carboplatin and adriamycin mixed with iodized oil were infused into the feeding arteries. Tumor response and prognosis after treatment were evaluated.
RESULTS:
TACE resulted in few Grade 1 adverse effects (AEs), without G3 or more AEs, according to CTACAE 3.0. Mean tumor shrinkage was 60.9 %, and the mean AFP decrease from initial levels was 94.8 %. In all cases TACE combined with systemic chemotherapy enabled subsequent safe and complete surgical resection. After a mean follow-up of 59 months, tumor-free survival was 75 %.
CONCLUSION:
Preoperative TACE combined with systemic chemotherapy was effective in inducing surgical resectability of unresectable hepatoblastoma..
8. Kazushige Atsumi, Katsumasa Nakamura, Koichiro Abe, Masakazu Hirakawa, Ohga Saiji, Shingo Baba, 磯田 拓郎, Hiroshi Honda, Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer.

, J Radiat Res., 54, 8, 890-898, 2013.09.
9. Hirakawa Masakazu, Eiki Nagao, Hiroyasu Soeda, Satoru Tsuruta, Hironori Sakai, Honda Hiroshi, Transcatheter arterial embolization for chest wall metastasis of hepatocellular carcinoma., World J Radiology, 28, 5(2), 45-48, 2013.02, Hemothorax due to rupture of metastatic hepatocellular carcinoma (HCC) is a very rare complication with high mortality because of uncontrollable hemorrhage. A 71-year-old man treated by transcatheter arterial embolization for HCC with massive bleeding from chest wall metastasis is reported. Enhanced computed tomography and selective intercostal angiogram showed a hypervascular mass in the right chest wall and extravasation of contrast agent. After successful transcatheter arterial embolization with gelatin sponge particles and metallic coils, the patient recovered from shock without major complication. To our knowledge, a successfully treated case of hemothorax due to rupture of metastatic HCC has not previously been described..
10. Hirakawa Masakazu, Nishie Akihiro, Yoshiki Asayama, Ishigami Kousei, Ushijima Yasuhiro, Nobuhiro Fujita, Honda Hiroshi, Clinical outcomes of symptomatic arterioportal fistulas after transcatheter arterial embolization., World J Radiology, 28, 5(2), 33-44, 2013.02, AIM:

To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs).

METHODS:

Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n = 5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n = 1) underwent TAE for symptoms related to severe APFs [refractory ascites (n = 4), hemorrhoidal hemorrhage (n = 1), and hepatic encephalopathy (n = 1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo).

RESULTS:

In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n = 4) and both MCs and n-butyl cyanoacrylate (n = 2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients.

CONCLUSION:

Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs.
.
11. Hirakawa M, Kobayashi N, Ishiyama M, Fuwa S, Saida Y, Honda H, Numaguchi Y. , Radiological findings as favorable predictors of pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty: a retrospective study of 156 cases.


, Jpn J Radiol. 2012 Feb 28. , 2012.02, Abstract

PURPOSE:

We evaluated the relationships between pre-procedural radiological findings and short-term pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty (PVP).

MATERIALS AND METHODS:

A retrospective review of pre-procedural radiological images of 156 patients with painful osteoporotic compression fracture was performed. Pain was measured with a visual analogue scale (VAS). Complete pain relief was defined as a VAS pain score of 0 or 1 at 3 months after PVP. Statistical analyses were conducted to evaluate the relationship between the pre-procedural imaging factors and pain relief using Pearson's chi-squared test. Multivariate logistic regression analysis was also performed.

RESULTS:

Complete pain relief was obtained in 45.5% of patients. An intravertebral cleft larger than half the height of the fractured vertebral body (FVB) was a significant key factor in the complete pain relief group after 3 months. Further, ≥40% of the spinal canal occupied by bony fragments of the FVB was related to incomplete pain relief.

CONCLUSION:

A large intravertebral cleft was a favorable short-term outcome predictor in patients with osteoporotic compression fractures after PVP, while severe protrusion of the FVB causing lumbar spinal canal stenosis was not a favorable short-term outcome predictor of complete pain relief..
12. Masakazu Hirakawa, Kengo Yoshimitsu, Hiroyuki Irie, Tsuyoshi Tajima, Akihiro Nishie, Yoshiki Asayayama, Kousei Ishigami, Daisuke Kakihara, Akinobu Taketomi, Shin-ichi Aishima and Hiroshi Honda , Performance of radiological methods in diagnosing hepatocellular carcinoma preoperatively in a recipient of living related liver transplantation: comparison with step section histopathology
, Jpn J Radiol, 29, 2, 129-37, 2011.02.
13. Nishie A, Tajima T, Asayama Y, Ishigami K, Hirakawa M, Nakayama T, Ushijima Y, Kakihara D, Okamoto D, Yoshiura T, Masumoto K, Taguchi T, Tsukimori K, Tokunaga S, Irie H, Yoshimitsu K, Honda H., MR prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia using right lung signal intensity: comparison with that using right lung volume., J Magn Reson Imaging, 30 , 1, 112-20., 2009.07.
14. Hirakawa M, Tajima T, Yoshimitsu K, Irie H, Ishigami K, Yahata H, Wake N, Honda H., Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes., AJR Am J Roentgenol. 2009 Jun, 192 , 6, 1601-7., 2009.06.
15. Hirakawa M, Karashima Y, Watanabe M, Kimura C, Ito Y, Oike M., Protein kinase A inhibits lysophosphatidic acid-induced migration of airway smooth muscle cells.
, J Pharmacol Exp Ther. 2007 Jun;321(3):1102-8. Epub 2007 Mar 8. , 2007.06.
16. Hirakawa M, Oike M, Watanabe M, Karashima Y, Ito Y., Pivotal role of integrin alpha5beta1 in hypotonic stress-induced responses of human endothelium.
, FASEB J. 2006 Oct;20(12):1992-9. , 2006.10.
17. Hirakawa M, Oike M, Masuda K, Ito Y., Tumor cell apoptosis by irradiation-induced nitric oxide production in vascular endothelium, Cancer Res. 2002 Mar 1;62(5):1450-7. , 62, 5, 1450-1457, 2002.05.
Presentations
1. M Hirakawa, Y Kikuchi , A Inoue , S Tsuruta, H Sakai, K Mimori, Comparison of microballoon-occluded TACE versus DEB-TACE for the treatment of patients with large and intermediate-stage HCCs, CIRSE 2019, 2019.09, OBJECTIVE:
Recently, microballoon-occluded transarterial chemoembolization (B-TACE) was developed in Japan, B-TACE induce dense lipidol accumulation in targeted hepatocellular carcinomas (HCCs) nodules. However, to the best of our knowledge, no comparison study has yet analyzed outcomes after B-TACE and TACE with drug-eluting-bead (DEB-TACE) in patients with HCC. The purpose of this study is to evaluate the efficacy and safety associated with B-TACE versus DEB-TACE for large (maximal diameter > 5 cm) and intermediate-stage HCCs.
MATERIALS AND METHODS:
This retrospective study involved naïve 35 patients with large and intermediate-stage HCCs who underwent B-TACE (n = 18) or DEB-TACE (n = 17) between April 2013 and May 2016. The decision between B-TACE and DEB-TACE was based on patient choice. Local control of largest tumor 3months after TACE, overall survival (OS) and adverse events (AEs) were compared between the two groups.
RESULTS:
The median duration of follow-up was 19 months (range, 8-48 months). Objective response rate analyzed with modified Response Evaluation Criteria in Solid Tumors (RECIST) was 38.9% after B-TACE and 52.9% after DEB-TACE (P = 0.039). No significant differences could be detected between the B-TACE and DEB-TACE groups with regard to median OS analyzed with the Kaplan-Meier method (28 versus 30 months, respectively; p=0.08). The 1-, 2-, and 3-year OS rates were 72.2, 62.4, and 42.8%, respectively, for the B-TACE and 82.4, 50.2, and 31.4%, respectively, for the DEB-TACE group. Hepatic dysfunction of grade 3 related DEB-TACE occurred in one patient and rate of AEs after DEB-TACE tended to be higher than B-TACE.
CONTCLUSION:
For the treatment of patients with large and intermediate-stage HCCs, DEB-TACE provided better tumor responses in comparison with B-TACE, which in turn DEB-TACE did not seem to improve survival in comparison with B-TACE.
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2. Masakazu Hirakawa, Radiation protection on patient and physician during Vascular Interventional Radiology for body disease
, The 78th Annual Meeting of the Japan Radiological Society, 2019.04, As minimally invasive procedures in vascular Interventional Radiology (IR) are increasingly adopted and becoming more complex, many IR procedures can result in clinically significant radiation doses to patients and to the physicians and paramedical staff in room. The radiation protection of both patients and medical stuffs is of particular concern. Radiation-induced cataracts secondary to occupational exposure represent a recently recognized entity. In 2011, the International Commission on Radiological Protection (ICRP) recommended reduction the occupational exposure dose limit for the eye lens to 20 mSv/y. However, NRA (Nuclear Regulation Authority, Japan) does not respond to these newly introduced criteria. The NRA considers the action to respond to new criteria for lens of eyes applicable to occupational exposure as introduced in the IAEA safety standard. Recent study reported that occupational eye doses from IR procedures have the potential to exceed the new ICRP equivalent dose limit, particularly if no eye lens protective equipment is always used. Therefore, radiologists are supposed to play a pivotal role for the radiation dose reduction during IR procedures. In this symposium, I would like to emphasize the importance of patients’ dose reduction trial and reliable measurement of operators’ eye dose by using DOSIRIS [direct monitoring of eye lens dose in terms of Hp(3)]under lead glass during IR procedures through my clinical experience and previous studies..
3. Masakazu Hirakawa, Y Asayama, K Ishigami, Y Ushijima, A Nishie, H Honda , Significant Importance of Novel Direct Eye Dosimeter and Protective Lead Devices for Complying with ICRP Recommended Limit for the Eye Lens in Transarterial Chemoembolization for HCC, Radiological Society of North America's 104th Scientific Assembly and Annual Meeting, 2018.11, Objective This study aimed to evaluate the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS, 3mm dose equivalent, Hp(3)) during transarterial chemoembolization (TACE) for HCC and to investigate possible number of TACE procedures/y within current dose limit of 20 mSv/y.
M&M The measurements of eye doses [Hp(3)]were carried out for 3 Interventional radiologists (IR) (IR1 operator with lead glass and ceiling mounted lead glass screen, IR2 operator without lead glass and with ceiling mounted lead glass screen, IR3 operator without lead glass and ceiling mounted lead glass screen) performing 132 TACE procedures using DOSIRIS. For protective lead devices, wraparound type lead glass eye wear (0.07mmPb) and ceiling mounted lead glass screen are used. To measure the occupational eye dose, DOSIRIS was stuck just lateral to the left eye under lead glass and without lead glass. We calculated the eye dose per TACE procedures and possible number of TACE procedures/ y within current dose limit of 20 mSv/y for each operators.
Result The mean fluoroscopy time, air kerma and dose area product/TACE were 38.2min, 1.45Gy and 200587mGy・cm2, respectively. The eye dose per TACE procedure for 1,2, and 3 operator were 34.8, 72.2, and 240μSv, respectively. The eye dose of IR1 with protective lead devices was significantly lower than IR without protective lead devices (IR3). Possible number of TACE procedures /y within ICRP recommended dose limit of 20 mSv/y for 1, 2, and 3 operator were 574, 277, and 83, respectively.
Conclusion The eye dose limit of 20mSv/y may be exceeded in IR operators who do not use protective lead glasses and ceiling mounted lead glass screen. For complying with ICRP recommendation, protective lead devices and correct evaluation of the eye dose using direct eye dosimeter (Hp(3)) under protective lead glasses might be needed.
.
4. Current status and prospect of B-TACE for hepatocellular carcinoma.
5. Masakazu Hirakawa, T Yamanouchi, A Inoue, S Tsuruta, H Sakai, K Mimori, H Honda , Let’s start Balanced-TACE, JSIR, ISIR 2018, 2018.05.
6. Masakazu Hirakawa, Y Torahiko, S Tsuruta, A Inoue, H Sakai, K Mimori, H Honda , Evaluation of the occupational eye doses estimated using direct eye dosimeter during TACE for HCC
, JSIR, ISIR 2018, 2018.05, Objective This study aimed to evaluate the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS, 3-mm dose equivalent, Hp(3)) during transarterial chemoembolization (TACE) for HCC and to investigate possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1. M&M The eye doses [Hp(3)] of 3 Interventional radiology(IR) operators (1 operator with lead glass and ceiling mounted lead glass screen, 2 operator without lead glass and with ceiling mounted lead glass screen, 3 operator without lead glass and ceiling mounted lead glass screen) were recorded using DOSIRIS. 96 TACE procedures were included in this study. For eye protective equipment, wraparound type lead glass eye wear (0.07mmPb) are used. To measure the occupational eye dose, DOSIRIS was stuck just lateral to the left eye under lead glass and without lead glass. We calculated the eye dose per TACE procedures and possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1for each operators. Result The mean fluoroscopy time, air kerma and dose area product were 38.1 min, 1.62 Gy and 183.2 Gy cm2, respectively. The eye dose per TACE procedure for 1,2, and 3 operator were 35.9μSv, 76.2μSv, and 236.4μSv, respectively. Possible number of TACE procedures y-1 for 1, 2, and 3 operator were 557, 262, and 85, respectively. Conclusion The eye dose limit of 20mSv y-1 may be exceeded in IR operators who do not use protective lead glasses and ceiling mounted lead glass screen. Correct evaluation of the eye dose (Hp(3)) using direct eye dosimeter might be needed..
7. Masakazu Hirakawa, Y Torahiko, H Wakiyama, K Matsumoto, K Sakamoto, S Tsuruta, A Inoue, H Sakai, K Mimori, H Honda , Comparison of occupational eye radiation dose estimated on novel direct eye dosimeter and film badge in transarterial chemoembolization for hepatocellular carcinoma
, 第77回日本医学放射線学会総会, 2018.04, Objective This study aimed to compare the occupational eye doses estimated using novel direct eye dosimeter (DOSIRIS) and film badge during transarterial chemoembolization (TACE) and to investigate possible number of TACE procedures y-1. M&M Thirty six HCC cases (17 men, 19 women; mean age, 76.4 years) treated with TACE over a 6-month period were included in this study. For eye protective equipment, wraparound type lead glass eye wear (0.07mmPb) are used. The personal film badge dosimeter (Hp(0.07)) stuck on the left side of the cap and DOSIRIS (Hp(3)) was stuck just lateral to the left eye under lead glass to measure the occupational eye dose. We calculated the cumulative 6-month eye dose and realistic eye dose per TACE procedures. RESULTS The mean fluoroscopy time, air kerma and dose area product were 40.9 min, 2.09 Gy and 129.8 Gy cm2, respectively. The cumulative 6-month eye dose and eye dose per procedure on DOSIRIS was 1.4 mSv and 38. 9μSv, respectively. Legal cumulative 6-month eye dose and eye dose per procedure estimated on film badge was 2.4 mSv and 66.7μSv, respectively. Possible number of TACE procedures y-1 within current dose limit of 20 mSv y-1 estimated on DOSIRIS and film badge was 514 and 300, respectively.CONCLUSION The new eye dose limit of 20mSv y-1 may be exceeded in interventional radiological physicians who do not wear protective lead glasses. Correct evaluation of the eye dose (Hp(3)) using novel direct eye dosimeter might be needed..
8. Masakazu Hirakawa, Y Asayama, K Ishigami, Y Ushijima, A Nishie, H Honda , Assessment of the occupational radiation dose to eye lens of interventional physicians during transarterial chemoembolization for hepatocellular carcinoma
, 103rd RSNA Scientific Assembly and Annual Meeting, 2017.11, PURPOSE
This study aimed to estimate lens doses using film badge and electronic pocket dosimeter and to investigate correlations between occupational lens doses and patient doses during transarterial chemoembolization (TACE) for hepatocellular carcinoma.

METHOD AND MATERIALS
Fifty eight HCC cases (31 men, 27 women; mean age, 74.4 years, mean BMI, 25.5) treated with TACE (Lipiodol-TACE: 53, DEB-TACE: 5) were included in this study. The DSA machine was equipped with a 16-inch flat-panel detector. For eye lens protective equipment, the ceiling-mounted lead screen and wraparound type lead glass eyewear (0.07mmPb, calculation-based correction factor: 0.5) are used. The both film badge dosimeter (radiophotoluminescence glass dosimeter (RGDs), Hp(10 and 0.07)) and electronic pocket dosimeter(Silicon semiconductor detector, Hp(10)) were stuck on the left side of the cap to measure the maximum eye dose. Eye lens dose were estimated from measured radiation dose on both dosimeters. Additionally, dose area product (DAP), air kerma(AK) and fluoroscopy time of each TACE procedures were recorded from DSA machine.

RESULTS
The mean fluoroscopy time, AK and DAP were 38.1 min, 1.21Gy and 297.7 Gy cm2, respectively. The unprotected eye lens dose per procedure measured on film badge tended to be higher than that of pocket dosimeter (65.5μSv vs. 26.4μSv), respectively. The protected eye lens dose per procedure on film badge tended to be higher than that of pocket dosimeter (32.75μSv vs. 13.2μSv), respectively. Estimated eye dose per unit DAP on pocket dosimeter and film badge was 0.89μSvGy-1cm-2 and 2.21μSvGy-1cm-2, respectively.The current dose limit of 20 mSv /year can be reached for 305 and 610 TACE procedures /y for the operator without and with lead glass eyewear, respectively.

CONCLUSION
The current dose limit of 20 mSv /year can be reached for a few hundreds of TACE procedures /y without lead glass eyewear. Occupational eye doses from interventional radiology procedures have the potential to exceed the new ICRP equivalent dose limit, particularly if no eye lens protective equipment is always used.
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9. Masakazu Hirakawa, Kotaro Terashima, Katsumi Sakamoto, Satoru Tsuruta, Hironori Sakai, Koshi Mimori, Hiroshi Honda, A Significant and simple trial of radiation dose reduction during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma, 2017 European congress Radiology, 2017.03, OBJECTIVE This study aimed to evaluate patient radiation dose reduction, during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma (HCC) while maintaining treatment effect (TE), adverse events(AE) and the image quality (IQ), using a new our clinical trial of radiation dose reduction. MATERIALS AND METHODS Ninety HCC cases treated with DEB-TACE were included in this study. Forty five patients (30 men, 15 women; mean age, 71.6 years) were treated under normal mode(the normal group), and 45 patients (28 men, 17 women; mean age, 70.8 years) were treated under radiation reduction mode using reduction filter (0.4mmCu+1.0mmAl), half frame rate and reduction of detector dose rate (the reduction group). Dose area product (DAP), air kerma (AK) and radiation time of each digital fluoroscopy (DF) were compared between the two groups. IQ of digital subtraction angiography (DSA) and digital angiography (DA) during infusion of DEB was assessed by two blinded and independent readers on a four-rank scale. RESULTS There were no significant differences in patient's characteristics and tumor burden between the groups. The overall adverse events relating DEB-TACE did not significantly differ between the groups. Fluoroscopy time were equivalent between the groups. Compared to the normal group, in the reduction group, AK and DAP could be significantly reduced by 65.4% (2.63 Gy vs. 1.72 Gy, p<0.05) and 69.2% (48300 mGy cm2 vs. 33400 mGy cm2, p<0.05), respectively. TE, AEs and IQ were rated comparable between the groups. CONCLUSION: Our simple trial of radiation dose reduction during DEB-TACE for HCC could reduce to almost 65% level recorded in the normal mode without negative impact on treatment effect, image quality and severe adverse events. IR doctors should review default setting of own angiography system and DEB-TACE procedure. .
10. Masakazu Hirakawa, Kousei Ishigami, Yasuhiro Ushijima, Akihiro Nishie, Hiroshi Honda, A clinical trial of radiation dose reduction during transarterial chemoembolization(TACE) with drug-eluting bead(DEB) for hepatocellular carcinoma
, The 102nd Scientific Assembly & Annual Meeting Radiological Society of North America, 2016.12, OBJECTIVE This study aimed to evaluate patient radiation dose reduction, during transarterial chemoembolization (TACE) with drug-eluting bead (DEB) for hepatocellular carcinoma (HCC) while maintaining treatment effect (TE), adverse events(AE) and the image quality (IQ), using a new our clinical trial of radiation dose reduction. MATERIALS AND METHODS Eighty five HCC cases treated with DEB-TACE were included in this study. Forty five patients (30 men, 15 women; mean age, 71.6 years) were treated under normal mode(the normal group), and 40 patients (25 men, 15 women; mean age, 69.6 years) were treated under radiation reduction mode using reduction filter, lower frame rate and etc (the reduction group). Dose area product (DAP), air kerma (AK) and radiation time of each digital fluoroscopy (DF) were compared between the two groups. IQ of digital subtraction angiography (DSA) and digital angiography (DA) during infusion of DEB was assessed by two blinded and independent readers on a four-rank scale. RESULTS There were no significant differences in patient's characteristics and tumor burden between the groups. The overall adverse events relating DEB-TACE did not significantly differ between the groups. Fluoroscopy time were equivalent between the groups. Compared to the normal group, in the reduction group, AK and DAP could be significantly reduced by 64.2% (2.63 Gy vs. 1.64 Gy, p<0.05) and 67.4% (483 Gy cm2 vs. 328 Gy cm2, p<0.05), respectively. TE, AEs and IQ were rated comparable between the groups. CONCLUSION In our clinical trial of radiation dose reduction, radiation dose could be reduced significantly without negative impact on treatment effect, image quality and severe adverse events..
11. Masakazu Hirakawa, Keishi Sugimachi, Koshi Mimori, Hiroshi Honda, Beyond “Simple” B-TACE: Combined Conventional and B-TACE Can Be Superior to Simple B-TACE?, JSIR, ISIR & APCIO 2015 , 2015.05.
12. Masakazu Hirakawa, Keishi Sugimachi, Koshi Mimori, Hiroshi Honda, Microballoon-occluded transarterial chemoembolization (B-TACE) using Miriplatin for HCCCan B-TACE enhance the local control ?, JSIR, ISIR & APCIO 2015, 2015.05.
13. Masakazu Hirakawa, Noriaki Wada, Hidenari Hirata, Kotaro Terashima, Katsumi Sakamoto, Kimitaka Miyajima, Satoru Tsuruta, Hironori Sakai, Koshi Mimori, Hiroshi Honda, A clinical trial of radiation dose reduction during transarterial chemoembolization(TACE) with drug-eluting bead(DEB) for hepatocellular carcinoma
, 第75回日本医学放射線学会総会, 2016.04.
14. Initial Result of TACE with Epirubicin loaded drug-eluting beads for hypervascular liver tumor
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15. Masakazu Hirakawa, Kimitaka Miyajima, Keishi Sugimachi, Satoru Tsuruta, hironori Sakai, Koshi Mimori, Hiroshi Honda, Significant efficacy of new microballoon-occluded transarterial chemoembolization with miriplatin for hepatocellular carcinoma
: a retrospective comparison of conventional TACE with epirubicin
, 100th annual meeting Radiological Society of North America, 2014.11, Objective: This study aimed to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) with miriplatin (MPT) and those of TACE with epirubicin (EPIR) for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: Sixty-five HCC cases were treated with TACE using EPIR or MPT. Forty patients (25 men, 15 women; mean age, 73.4 years) were treated using B-TACE with MPT (the MPT-B-TACE group), and 25 patients (15 men, 10 women; mean age, 72.2 years) were treated using TACE with EPIR (the EPIR-TACE group). The local control rates (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to local recurrence (Kaplan-Meier and log-rank tests), and adverse events (AEs) were evaluated. Statistical analyses were conducted to evaluate the relationship between the patient’s characteristics and local recurrence after MPT-B-TACE using Pearson's Chi-squared test. Multivariate logistic regression analysis was also performed.

RESULTS: There were no significant differences in patient’s characteristics between the groups. The overall AE incidence did not significantly differ between the groups. According to the mRECIST, the objective response rate including complete and partial responses, in the MPT-B-TACE group (92%) was significantly higher than that in the EPIR-TACE group (76%). Overall, local recurrences in the MPT-B-TACE group were significantly lower than in the EPIR-TACE group (p < 0.05). Excluding multiple HCC cases, the local recurrence rate in the MP T-B-TACE group was significantly lower than in the EPIR-TACE group (p < 0.05).
Local recurrence after MPT-B-TACE was recognized in the 35% patients in the follow-up periods. Tumor size larger than 2cm and tumor number more than three HCCs were significant key factors in the local recurrence after MPT-B-TACE.
CONCLUSION
MPT-B-TACE was associated with a higher objective response rate and lower local recurrence rate than EPIR-TACE, and both showed similar adverse effects. Tumor size larger than 2cm and tumor number more than three HCCs were risk factors of the local recurrence after MPT-B-TACE.
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16. Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Kimitaka Miyajima, Asayama Yoshiki, Akihiro Nishie, Hiroshi Honda, Local control effects of microballoon-occluded transarterial chemoembolization using miriplatin
for hepatocellular carcinoma : a retrospective comparison of TACE using epirubicin
, The 11th Asia Pacific Congress of Cardiovascular and Interventional Radiology , 2014.05, Objective: The aim of this study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).MATERIALS AND METHODS: 55 HCC cases were treated with TACE using EPIR or MPT. 30 patients (MPT-B-TACE group: 20 men, 10 women; mean age 74.4years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan-Meier and log-rank test) and adverse events (AEs)were evaluated. RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child-Pugh class, and tumor size among each group. The rate of tumor multiplicity for the EPI-TACE group tended to be higher than those for the MPT-B-TACE group. Overall incidence of AEs was not significantly different between each group. According to the mRECIST criteria, the objective response rate, including complete response and partial response, in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p =0.0065). Excluding multiple HCC cases, also, the local recurrence in the MP T-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.0015).CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin..
17. Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization (TACE) with miriplatin and TACE with epirubicin for hepatocellular carcinoma
, The 73rd Annual Meeting of the Japan Radiological Society, 2014.04, OBJECTIVE
This study aimed to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) with miriplatin (MPT) and those of TACE with epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Fifty-five HCC cases were treated with TACE using EPIR or MPT. Thirty patients (20 men, 10 women; mean age, 74.4 years) were treated using B-TACE with MPT (the MPT-B-TACE group), and 25 patients (15 men, 10 women; mean age, 72.2 years) were treated using TACE with EPIR (the EPIR-TACE group). The local control rates (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failures (Kaplan-Meier and log-rank tests), and adverse events (AEs) were evaluated.
RESULTS
There were no significant differences in gender, age, chronic liver disease etiology, Child-Pugh class, and tumor size between the groups. The tumor multiplicity rate of the EPIR-TACE group was higher than that of the MPT-B-TACE group. The overall AE incidence did not significantly differ between the groups. According to the mRECIST, the objective response rate including complete and partial responses, in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%). Overall, local recurrences in the MPT-B-TACE group were significantly lower than in the EPIR-TACE group (p < 0.05). Excluding multiple HCC cases, the local recurrence rate in the MP T-B-TACE group was significantly lower than in the EPIR-TACE group (p < 0.05).
CONCLUSION
MPT-B-TACE was associated with a higher objective response rate and lower local recurrence rate than EPIR-TACE, and both showed similar adverse effects.
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18. Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Wataru Todoroki, Kimitaka Miyajima, Yoshiki Asayama, Akihiro Nishie, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization using miriplatin and TACE using epirubicin for hepatocellular carcinoma: a retrospective study of 50cases
, The Society of Interventional Radiology will hold its 39th Annual Scientific Meeting , 2014.03, PURPOSE: The aim of this retrospective study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Between January 2012 and 2013, 50 HCC cases were treated with TACE using EPIR or MPT. 25 patients (MPT-B-TACE group: 18 men, 7 women; mean age 74.8 ±1.8 years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2 ±1.7 years) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan–Meier and log–rank test) and adverse events (AEs) were evaluated (CTACAE 3.0).
RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child–Pugh class, and tumor size among the two groups. The rate of tumor multiplicity for the EPI-TACE group tended to be higher than those for the MPT-B-TACE group.
No serious adverse events were observed in either group. Overall incidence adverse events was not significantly different between the MPT-B-TACE group (64%) and the EPIR-TACE group (68%, p=0.575). According to the mRECIST criteria, the objective response rate, including complete response (CR) and partial response (PR), in the MPT-B-TACE group (90%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p=0.0065). Excluding multiple HCC cases, also, the local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.0015).
CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin.
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19. Masakazu Hirakawa, Katsumi Sakamoto, Kazushige Atsumi, Asayama Yoshiki, Akihiro Nishie, Hiroshi Honda, Comparison of the local control effects of microballoon-occluded transarterial chemoembolization using miriplatin and TACE using epirubicin for hepatocellular carcinoma, 26th EUROPEAN CONGRESS OF RADIOLOGY, 2014.03, PURPOSE: The aim of this retrospective study is to compare the local control effects of microballoon-occluded transarterial chemoembolization (B-TACE) using miriplatin (MPT) and that of TACE using epirubicin (EPIR) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Between January 2012 and January 2013, 39 HCC cases were treated with TACE using EPIR or MPT. 14 patients (MPT-B-TACE group: 9 men, 5 women; mean age 70.4 ±2.0 years) were treated with B-TACE using MPT, and 25 patients (EPIR-TACE group: 15 men, 10 women; mean age 72.2 ±1.7 years) were treated with TACE using EPIR. The local control rate (modified Response Evaluation Criteria in Solid Tumors [mRECIST]), time to treatment failure (Kaplan–Meier and log–rank test) and adverse events (AEs) were evaluated (CTACAE 3.0).
RESULTS: There were no significant differences in gender, age, etiology of chronic liver disease, Child–Pugh class, and tumor size among the two groups. The rate of Tumor multiplicity and selective TACE procedure for the EPI-TACE group was significantly higher than those for the MPT-B-TACE group (P<0.05).
No serious adverse events were observed in either group. Overall incidence adverse events was not significantly different between the MPT-B-TACE group (50%) and the EPIR-TACE group (49%, p=0.575). According to the mRECIST criteria, the objective response rate, including complete response (CR) and partial response (PR), in the MPT-B-TACE group (92.9%) was significantly higher than that in the EPIR-TACE group (76%, p=0.02). Overall local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE (p=0.05). Excluding multiple HCC cases, also, the local recurrence in the MPT-B-TACE group was significantly lower than in the EPIR-TACE group (p=0.04).
CONCLUSION: B-TACE using miriplatin was associated with an increased objective response rate, low local recurrence rate and comparable adverse effects compared to TACE using epirubicin.
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20. A case of renal angiomyolipoma treated by Microballoon-occluded transarterial embolization .
21. Balloon-occluded Transarterial Chemoembolization with Miriplatin for Hepatocellular Carcinoma: Preliminary Clinical Experience.
22. Analysis of the Response and Prognostic Factors after Cisplatin-based Transcatheter Arterial Chemoembolization along with systemic chemotherapy with Gemcitabine in the palliative Treatment of Unresectable intrahepatic Cholangiocarcinoma .
23. 平川 雅和, 坂本 勝美, 渥美 和重, 西江 昭弘, 浅山 良樹, 本田 浩, Analysis of the response and prognostic factors after cisplatin-based transcatheter arterial chemoembolization along with systemic chemotherapy with gemcitabine in the palliative treatment of unresectable intrahepatic cholangiocarcinoma
, European congress of Radiology , 2013.03, PURPOSE: To evaluate the effectiveness of cisplatin-based transcatheter arterial chemoembolization (TACE) along with systemic chemotherapy with gemcitabine in the palliative treatment of unresectable intrahepatic cholangiocarcinoma (ICC), and to identify factors affecting clinical outcome.

MATERIALS AND METHODS: The present study was approved by the institutional review board, and written informed consent was obtained from all patients.
Between 2007 and 2011, 13 patients (5 men, 8 women; mean age 70.4 ±2.0 years) with unresectable ICC underwent cisplatin-based TACE alongside systemic chemotherapy with gemcitabine. Mean tumor size was 9.8 ± 0.7 cm (range, 6.7–15 cm).The adverse effects (AEs), survival rate and prognostic factors of patient survival were evaluated.
RESULTS: The mean TACE sessions and cycles of systemic chemotherapy were 3.5 (range: 1-7) and 6.2 (range: 4 -11), respectively. Combined TACE and systemic chemotherapy were followed by few Grade 3 hematological AEs, without G4 AEs, according to CTACAE 3.0. No deaths and no acute liver failure occurred after TACE. According to the RECIST criteria, 23% (3/13) of patients achieved partial response and 46% (6/13) stabilization of disease. The Kaplan- Meier survival analysis showed that the median overall survival and median progression-free survival were 14 [95%CI: 9-16] and 8 [95%CI: 4-9] months, respectively. Results from multivariable Cox regression analyses confirmed that tumor number (hazard ratio [HR], 8.33; P = .004) and Child-Pugh class (HR, 5.34; P = .02) were the independent factors associated with patient survival duration.

CONCLUSION: Cisplatin-based TACE along with systemic chemotherapy with gemcitabine is a safe and effective treatment for patients with unresectable ICC. Multiple tumors and Child-Pugh class B were poor prognostic factors for determining the patient survival period after treatment for unresectable ICC.
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24. Efficacy of Cisplatin-based Transcatheter Arterial Chemoembolization along with systemic chemotherapy with Gemcitabine in the Treatment of Unresectable intrahepatic Cholangiocarcinoma .
25. Efficacy of Preoperative Transcatheter Arterial Chemoembolization Along With Systemic Chemotherapy in the Treatment of Unresectable Hepatoblastoma in Children.
26. Efficacy of Preoperative Transcatheter Arterial Chemoembolization Along With Systemic Chemotherapy in the Treatment of Unresectable Hepatoblastoma in Children.
Membership in Academic Society
  • Japanese Society of Magnetic Resonance in Medicine
  • Japanease Society of Implantable Port Assisted Treatment
  • Japanese Society of Interventional Radiology
  • Japan Radiological Society(JRS)
Awards
  • Interventional Radiology 2018 Best Paper Award
    Midterm Outcomes and Prognostic Factors of Patients Treated Using Microballoon-Occluded Transarterial Chemoembolization with Miriplatin: A Retrospective Study of 37 Cases
  • Comparison of the local control effects of microballoon-occluded transarterial chemoembolization (TACE) with miriplatin and TACE with epirubicin for hepatocellular carcinoma
  • Performance of radiological methods in diagnosing hepatocellular carcinoma preoperatively in a recipient of living related liver transplantation: comparison with step section histopathology.
Educational
Educational Activities
Training of radiology for clinical residents and fellows
Other Educational Activities
  • 2020.05.
  • 2013.05.