セッション情報 International Session8(消化器内視鏡学会・消化器病学会合同)

Recent advances in Interventional EUS 《Video》

タイトル 内IS8-11:

Newly Developed Interventional EUS

演者 R. Ashida(Departments of Cancer Survey and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases)
共同演者 T. Ioka(Departments of Cancer Survey and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases), K. Katayama(Departments of Cancer Survey and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases)
抄録 EUS has evolved from EUS imaging to EUS-guided FNA, and now to interventional EUS. Currently, CPN/CGN and drainage/anastomosis are commonly performed in Japan. Here we introduce newly developed interventional EUS.<Fiducial markers placement> Image-guided radiation therapy (IGRT) is dependent on the presence of fiducial markers for target localization and tracking. EUS-guided placement of fiducial markers has been recently reported. The target lesion was identified by linear EUS, a 19/22G needle preloaded with a gold coil fiducial was inserted into the lesion, and the fiducial was deployed under EUS/fluoroscopy guidance.<Tattooing> EUS-guided tattooing is an ideal technique for preoperative marking of lesions to reduce operating time and complication. Indocyanine green was injected on the day before surgery using 22G needle into pancreas parenchyma adjacent to previously diagnosed lesion. During the operation, the tattooed area was easily recognized using ICG fluorescent camera. <Microbubble> Microbubbles (MBs) have recently been revealed to act as therapeutic agents such as HIFU sensitizers or carriers of drug delivery system. However it is difficult to deliver MBs efficiently into pancreatic cancer due to hypovascularity of tumor or high sensitivity of MBs to pressure changes. Therefore, we developed MBs precursors which were prepared as droplets but will change into MBs by ultrasound stimulation. This phase change nano droplets were successfully injected using 22G needle and changed into MBs in either in vitro and ex vivo study.
索引用語 EUS, Interventional