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Pancreatic Neoplasms: HELP
Articles by Kosuke Minaga
Based on 13 articles published since 2008
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Between 2008 and 2019, Kosuke Minaga wrote the following 13 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration. 2017

Minaga, Kosuke / Takenaka, Mamoru / Katanuma, Akio / Kitano, Masayuki / Yamashita, Yukitaka / Kamata, Ken / Yamao, Kentaro / Watanabe, Tomohiro / Maguchi, Hiroyuki / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258068.

ABSTRACT: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been widely used for diagnosis of both inflammatory and tumor lesions located in and adjacent to the gastrointestinal tract. EUS-FNA has been considered to be a safe technique with few complications, as shown in recent review articles in which EUS-FNA-related morbidity and mortality rates were reported to be <1%. It should be noted, however, that needle tract seeding, although uncommon, can occur after diagnostic EUS-FNA and that this complication affects the prognosis of patients. Although an accurate value for the frequency of needle tract seeding caused by EUS-FNA has not been reported, the numbers of case reports on needle tract seeding have been rapidly increasing, especially in Japan. These case reports regarding EUS-FNA-related needle tract seeding prompted us to reevaluate the safety of EUS-FNA because this complication may have a significant influence on patients' prognoses. In this review, we summarize the clinical features and outcomes of needle tract seeding after EUS on the basis of the previously reported cases and provide useful information to prevent and reduce this serious complication.

2 Review The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence. 2016

Fusaroli, Pietro / Napoleon, Bertrand / Gincul, Rodica / Lefort, Christine / Palazzo, Laurent / Palazzo, Maxime / Kitano, Masayuki / Minaga, Kosuke / Caletti, Giancarlo / Lisotti, Andrea. ·Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy. · Department of Gastroenterology, Private Hospital Jean Mermoz, Lyon, France. · Trocadero Clinic, Paris, France. · Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. ·Gastrointest Endosc · Pubmed #27311654.

ABSTRACT: BACKGROUND AND AIMS: The use of contrast-harmonic EUS (CH-EUS) in routine clinical practice is increasing rapidly but is not yet standardized. We present the levels of evidence (LEs) found in the literature to put its clinical outcomes in the appropriate perspective. METHODS: We conducted a systematic review of the available English-language articles. The LEs were stratified according to the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS: Overall, 210 articles were included and presented according to different pathologic conditions. For pancreatic solid neoplasms, the pooled sensitivity and specificity in the diagnosis of pancreatic carcinoma were very high (LE 1); quantitative analysis and guidance of FNA were reported as investigational research (LE 2-3). For pancreatic cystic lesions, the identification of neoplastic solid components as hyperenhanced lesions represented a promising application of CH-EUS (LE 2). For lymph nodes, CH-EUS increased the diagnostic yield of B-mode EUS for the detection of malignancy (LE 2). For submucosal tumors, CH-EUS seemed useful for differential diagnosis and risk stratification (LE 2-3). For other applications, differential diagnosis of gallbladder and vascular abnormalities by CH-EUS were reported (LE 2-3). CONCLUSIONS: The LEs of CH-EUS in the literature have evolved from the initial descriptive studies to multicenter and prospective trials, and even meta-analyses. The differential diagnosis between benign and malignant lesions is the main field of application of CH-EUS. With regard to pancreatic solid neoplasms, the concomitant use of both CH-EUS and EUS-FNA may have additive value in increasing the overall accuracy by overcoming the false-negative results associated with each individual technique. Other applications are promising but still investigational.

3 Article Value of additional endoscopic ultrasonography for surveillance after surgical removal of intraductal papillary mucinous neoplasms. 2018

Kamata, Ken / Takenaka, Mamoru / Minaga, Kosuke / Omoto, Shunsuke / Miyata, Takeshi / Yamao, Kentaro / Imai, Hajime / Nakai, Atsushi / Tanaka, Hidekazu / Chiba, Yasutaka / Watanabe, Tomohiro / Sakurai, Toshiharu / Nishida, Naoshi / Chikugo, Takaaki / Matsumoto, Ippei / Takeyama, Yoshifumi / Kitano, Masayuki / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University, Osaka-sayama, Japan. · Clinical Research Center, Kindai University Hospital, Osaka-sayama, Japan. · Department of Pathology, Kindai University, Osaka-sayama, Japan. · Department of Surgery, Faculty of Medicine, Kindai University, Osaka-sayama, Japan. · Second Department of Internal Medicine, Wakayama Medical University, School of Medicine, Wakayama, Japan. ·Dig Endosc · Pubmed #29675938.

ABSTRACT: BACKGROUND AND AIM: This study evaluated the utility of endoscopic ultrasonography (EUS) combined with contrast-enhanced harmonic EUS (CH-EUS) for surveillance of the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). METHODS: This was a single-center, retrospective, descriptive study. A total of 134 consecutive patients who underwent surgical resection for IPMN between April 2009 and March 2015 were evaluated. Rates of recurrence and development of IPMN-concomitant pancreatic ductal adenocarcinoma (PDAC) during follow up were assessed. Clinical findings of patients with recurrence or development of PDAC were also evaluated. RESULTS: Of 134 resected IPMN 56 (41.8%) and 78 (58.2%) were classified as benign and malignant, respectively. Patients were followed up for a median of 29 months, 33 (24.6%) by both contrast-enhanced computed tomography (CE-CT) and EUS, and 101 (75.4%) by computed tomography (CT) alone. Thirteen patients (9.7%) showed tumor recurrence, five with intra-pancreatic recurrence and eight with extra-pancreatic metastases. An enhancing mural nodule within the dilated main pancreatic duct was successfully detected by EUS in one patient, but not by CE-CT. Two patients developed IPMN-concomitant PDAC during follow up. EUS combined with CH-EUS successfully detected small IPMN-concomitant PDAC in two patients, whereas these lesions were not detected by CT. CH-EUS was useful for better visualization of the margins of IPMN-concomitant PDAC in one of these two patients. CONCLUSION: Endoscopic ultrasonography combined with CH-EUS may improve follow up of patients with resected IPMN.

4 Article Outcomes of endoscopic biliary drainage in pancreatic cancer patients with an indwelling gastroduodenal stent: a multicenter cohort study in West Japan. 2018

Yamao, Kentaro / Kitano, Masayuki / Takenaka, Mamoru / Minaga, Kosuke / Sakurai, Toshiharu / Watanabe, Tomohiro / Kayahara, Takahisa / Yoshikawa, Tomoe / Yamashita, Yukitaka / Asada, Masanori / Okabe, Yoshihiro / Hanada, Keiji / Chiba, Yasutaka / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. · Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan; Second Department of Internal Medicine, School of Medicine, Wakayama Medical University, Wakayama, Japan. · Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan. · Department of Gastroenterology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. · Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan. · Department of Gastroenterology, Onomichi General Hospital, Onomichi, Japan. · Division of Biostatistics, Clinical Research Center, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. ·Gastrointest Endosc · Pubmed #29382465.

ABSTRACT: BACKGROUND AND AIMS: Gastroduodenal and biliary obstruction may occur synchronously or asynchronously in advanced pancreatic cancer, and endoscopic double stent placement may be required. EUS-guided biliary drainage (EUS-BD) often is performed after unsuccessful placement of an endoscopic transpapillary stent (ETS), and EUS-BD may be beneficial in double stent placement. This retrospective multicenter cohort study compared the outcomes of ETS placement and EUS-BD in patients with an indwelling gastroduodenal stent (GDS). METHODS: We recorded the clinical outcomes of patients at 5 tertiary-care medical centers who required biliary drainage after GDS placement between March 2009 and March 2014. RESULTS: Thirty-nine patients were included in this study. Patients' mean age was 68.5 years; 23 (59.0%) were men. The GDS overlay the papilla in 23 patients (59.0%). The overall technical success rate was significantly higher with EUS-BD (95.2%) than with ETS placement (56.0%; P < .01). Furthermore, the technical success rate was significantly higher with EUS-BD (93.3%) than with ETS placement (22.2%; P < .01) when the GDS overlies the papilla. The overall clinical success rate of EUS-BD also was significantly higher than for ETS placement (90.5% vs 52.0%, respectively; P = .01), and there was no significant difference in the incidence of adverse events (ETS, 32.0% vs EUS-BD, 42.9%; P = .65). CONCLUSION: Endoscopic double stent placement with EUS-BD is technically and clinically superior to ETS placement in patients with an indwelling GDS. EUS-BD should be considered the first-line treatment option for patients with an indwelling GDS that overlies the papilla. ETS placement remains a reasonable alternative when the papilla is not covered by the GDS.

5 Article Impact of avascular areas, as measured by contrast-enhanced harmonic EUS, on the accuracy of FNA for pancreatic adenocarcinoma. 2018

Kamata, Ken / Takenaka, Mamoru / Omoto, Shunsuke / Miyata, Takeshi / Minaga, Kosuke / Yamao, Kentaro / Imai, Hajime / Sakurai, Toshiharu / Nishida, Naoshi / Chikugo, Takaaki / Chiba, Yasutaka / Matsumoto, Ippei / Takeyama, Yoshifumi / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan. · Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Japan. · Clinical Research Center, Kindai University Hospital, Osaka-sayama, Japan. · Department of Surgery, Kindai University Faculty of Medicine, Osaka-sayama, Japan. ·Gastrointest Endosc · Pubmed #28619244.

ABSTRACT: BACKGROUND AND AIMS: EUS-guided FNA (EUS-FNA) is used for the diagnosis of pancreatic adenocarcinoma, but sometimes the method results in a false negative. Occasionally, an avascular area may be observed within the pancreatic adenocarcinoma tumor during contrast-enhanced harmonic EUS (CH-EUS). The aim of this study was to evaluate whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was affected by the presence of avascularity on CH-EUS. METHODS: Two hundred ninety-two patients with pancreatic adenocarcinoma who presented at Kindai University Hospital for EUS-FNA and CH-EUS between June 2009 and August 2013 were retrospectively evaluated. This was a single-center retrospective analysis of prospectively collected data held in a registry. The overall sensitivity of EUS-FNA for the diagnosis of pancreatic adenocarcinoma was calculated. The sensitivities of cytology, histology, and the combination of cytology and histology were also evaluated. These variables were individually evaluated according to the presence or absence of an avascular area on CH-EUS to assess whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was related to the presence of an avascular area within the tumors. RESULTS: The overall sensitivity of EUS-FNA was 90.8% (265/292). The sensitivities of EUS-FNA for lesions with and without an avascular area were 72.9% (35/48) and 94.3% (230/244), respectively, with the difference being statistically significant (P < .001). CONCLUSIONS: EUS-FNA has lower sensitivity for pancreatic adenocarcinoma with avascular areas on CH-EUS.

6 Article Association between the Risk Factors for Pancreatic Ductal Adenocarcinoma and Those for Malignant Intraductal Papillary Mucinous Neoplasm. 2017

Kamata, Ken / Takenaka, Mamoru / Nakai, Atsushi / Omoto, Shunsuke / Miyata, Takeshi / Minaga, Kosuke / Matsuda, Tomohiro / Yamao, Kentaro / Imai, Hajime / Chiba, Yasutaka / Sakurai, Toshiharu / Watanabe, Tomohiro / Nishida, Naoshi / Chikugo, Takaaki / Matsumoto, Ippei / Takeyama, Yoshifumi / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258117.

ABSTRACT: BACKGROUND AND AIMS: Risk factors for pancreatic ductal adenocarcinoma (PDAC) include diabetes mellitus, chronic pancreatitis, obesity, a family history of pancreatic cancer, and a history of smoking or alcohol consumption. The aim of this study was to evaluate the association between risk factors for PDAC and malignant intraductal papillary mucinous neoplasm (IPMN). METHODS: The study included 134 consecutive patients with IPMN who underwent surgical resection at Kindai University Hospital between April 2009 and March 2015. Data on the presence or absence of mural nodules (MNs) and risk factors for PDAC were evaluated. Multivariable logistic regression analysis was performed with malignant IPMN as the outcome variable and MNs and risk factors for PDAC as explanatory variables. RESULTS: The odds ratio of malignant IPMN to MNs was 3.88 (95% confidence interval [CI] 1.53-9.84; p = 0.004), whereas that of malignant IPMN to smoking history was 1.66 (95% CI 0.74-3.71; p = 0.22). When the presence of MNs was considered as a predictive factor for malignancy, the sensitivity and specificity were 88.5 and 32.1%, respectively, whereas when the presence of both smoking history and MNs was considered, the specificity improved to 73.2%, with a decrease in sensitivity to 42.3%. CONCLUSIONS: The presence of both a smoking history and MNs was a valuable predictive factor for malignant IPMN with high specificity. A smoking history should be considered before surgical resection in addition to the presence of MNs.

7 Article EUS-Guided Pancreatic Duct Drainage for Repeat Pancreatitis in a Patient with Pancreatic Cancer. 2017

Kamata, Ken / Takenaka, Mamoru / Minaga, Kosuke / Sakurai, Toshiharu / Watanabe, Tomohiro / Nishida, Naoshi / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258100.

ABSTRACT: Endoscopic ultrasound-guided pancreatic drainage (EUS-PD) was performed in a patient with unresectable pancreatic cancer who developed pancreatitis. In this case, EUS-PD was useful as salvage therapy for pancreatitis as the transpapillary approach was difficult.

8 Article A Case of Pancreatic Carcinoma in situ Diagnosed by Repeated Pancreatic Juice Cytology. 2017

Miyata, Takeshi / Takenaka, Mamoru / Omoto, Shunsuke / Kamata, Ken / Minaga, Kosuke / Yamao, Kentaro / Imai, Hajime / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258095.

ABSTRACT: Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage (ENPD) has a high diagnostic yield and might be useful for the diagnosis of early-stage pancreatic cancer. A 67-year-old man presented with a pancreatic cyst occasionally detectable in the body of the pancreas by ultrasonography (US). No obvious pancreatic tumor was detected by US, computed tomography (CT), magnetic resonance cholangiopancreatography, and endoscopic ultrasound (EUS) (although the latter did reveal a weak, low echoic area). Endoscopic retrograde pancreatography showed irregular narrowing of the main pancreatic duct (MPD) at the pancreatic body. Pancreatic juice cytology was also performed, but did not give evidence of a malignancy. Therefore, the patient was followed up. CT and EUS performed after 3 months showed the same findings as did endoscopic retrograde pancreatography; however, the results of repeated pancreatic juice cytology performed via ENPD tube revealed a suspected malignancy on 2 of 6 occasions. Therefore, we performed a central pancreatectomy. Histopathological examination of a resected specimen revealed carcinoma in situ in the narrow MPD at the body of the pancreas. In the current case, repeated pancreatic juice cytology via ENPD was effective. A weak low echoic area around the MPD stricture on EUS might be related to the inflammatory change accompanying carcinoma in situ of the pancreas.

9 Article Detection of High-Grade Pancreatic Intraepithelial Neoplasia without Morphological Changes of the Main Pancreatic Duct over a Long Period: Importance for Close Follow-Up for Confirmation. 2017

Yamao, Kentaro / Takenaka, Mamoru / Nakai, Atsushi / Omoto, Shunske / Kamata, Ken / Minaga, Kosuke / Miyata, Takeshi / Imai, Hajime / Sakurai, Toshiharu / Watanabe, Tomohiro / Nishida, Naoshi / Matsumoto, Ippei / Takeyama, Yosihumi / Chikugo, Takaaki / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258080.

ABSTRACT: Pancreatic intraepithelial neoplasia (PanIN) is a microscopic papillary noninvasive lesion arising from the pancreatic ductal epithelium. However, the natural history and time to progression of high-grade PanIN remain unclear. Herein, we report 2 cases of high-grade PanIN without morphological changes of the main pancreatic duct (MPD) over relatively long periods. In the first case, a 63-year-old man was identified with MPD dilation. Magnetic resonance cholangiopancreatography showed localized stenosis in the pancreatic body with distal MPD dilation. Endoscopic retrograde pancreatography (ERP) was attempted because of possible high-grade PanIN but was unsuccessful. At 15-month follow-up, there was no change in the form of the MPD in various images. However, ERP was re-performed because of possible high-grade PanIN, and cytology showed adenocarcinoma. Postoperative pathology indicated diffuse lesions corresponding to high-grade PanINs in the MPD stenosis and surrounding branches. Final diagnosis was high-grade PanIN. In the second case, a 77-year-old man was identified with MPD dilation. Magnetic resonance cholangiography showed localized stenosis in the MPD of the pancreatic head with distal MPD dilation. He was diagnosed with MPD stenosis caused by chronic pancreatitis, and further examination was not recommended. At 25 months, the patient was referred to our hospital because of a mild change in MPD dilation. ERP showed localized irregular stenosis in the MPD, and cytology showed suspected adenocarcinoma. Postoperative pathology indicated a localized lesion with high-grade PanIN in the branch duct around the MPD stenosis. Final diagnosis was high-grade PanIN. In conclusion, we report 2 cases of high-grade PanIN without morphological changes of the MPD over relatively long periods. Even if a definite diagnosis is not obtained at initial examination, a strict follow-up observational study should be performed. Re-examination, including ERP, should also be considered in cases with risk factors of pancreatic cancer, even if there is no change in MPD form.

10 Article Characterization of Pancreatic Tumors with Quantitative Perfusion Analysis in Contrast-Enhanced Harmonic Endoscopic Ultrasonography. 2017

Omoto, Shunsuke / Takenaka, Mamoru / Kitano, Masayuki / Miyata, Takeshi / Kamata, Ken / Minaga, Kosuke / Arizumi, Tadaaki / Yamao, Kentaro / Imai, Hajime / Sakamoto, Hiroki / Harwani, Yogesh / Sakurai, Toshiharu / Watanabe, Tomohiro / Nishida, Naoshi / Takeyama, Yoshifumi / Chiba, Yasutaka / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. ·Oncology · Pubmed #29258065.

ABSTRACT: OBJECTIVES: This study evaluated whether quantitative perfusion analysis with contrast-enhanced harmonic (CH) endoscopic ultrasonography (EUS) characterizes pancreatic tumors, and compared the hemodynamic parameters used to diagnose pancreatic carcinoma. METHODS: CH-EUS data from pancreatic tumors of 76 patients were retrospectively analyzed. Time-intensity curves (TIC) were generated to depict changes in signal intensity over time, and 6 parameters were assessed: baseline intensity, peak intensity, time to peak, intensity gain, intensity at 60 s (I60), and reduction rate. These parameters were compared between pancreatic carcinomas (n = 41), inflammatory pseudotumors (n = 14), pancreatic neuroendocrine tumors (n = 14), and other tumors (n = 7). All 6 TIC parameters and subjective analysis for diagnosing pancreatic carcinoma were compared. RESULTS: Values of peak intensity and I60 were significantly lower and time to peak was significantly longer in the groups with pancreatic carcinomas than in the other 3 tumor groups (p < 0.05). Reduction rate was significantly higher in pancreatic carcinomas than in pancreatic neuroendocrine tumors (p < 0.05). Areas under the receiver-operating characteristic curves for the diagnosis of pancreatic carcinoma using subjective analysis, baseline intensity, peak intensity, intensity gain, I60, time to peak, and reduction rate, were 0.817, 0.664, 0.810, 0.751, 0.845, 0.777, and 0.725, respectively. I60 was the most accurate parameter for differentiating pancreatic carcinomas from the other groups, giving values of sensitivity/specificity of 92.7/68.6% when optimal cutoffs were chosen. CONCLUSIONS: In pancreatic carcinomas, TIC patterns were markedly different from the other tumor types, with I60 being the most accurate diagnostic parameter. Quantitative perfusion analysis is useful for differentiating pancreatic carcinomas from other pancreatic tumors.

11 Article Stent migration during EUS-guided hepaticogastrostomy in a patient with massive ascites: Troubleshooting using additional EUS-guided antegrade stenting. 2017

Kamata, Ken / Takenaka, Mamoru / Minaga, Kosuke / Omoto, Shunsuke / Miyata, Takeshi / Yamao, Kentaro / Imai, Hajime / Kudo, Masatoshi. ·Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka, Japan. · Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osaka, Japan. Electronic address: mamoxyo45@gmail.com. ·Arab J Gastroenterol · Pubmed #28622882.

ABSTRACT: EUS-guided hepaticogastrostomy (EUS-HGS) is useful for treating obstructive jaundice. However, stent migration may sometimes occur both during and after the procedure. This report describes a patient with pancreatic cancer and massive ascites who underwent EUS-HGS combined with EUS-guided antegrade stenting (EUS-AS), with additional EUS-AS playing a role in troubleshooting for stent migration during EUS-HGS.

12 Article Needle-Tract Seeding on the Proximal Gastric Wall After EUS-Guided Fine-Needle Aspiration of a Pancreatic Mass. 2016

Minaga, Kosuke / Kitano, Masayuki / Enoki, Eisuke / Kashida, Hiroshi / Kudo, Masatoshi. ·Kinki University Faculty of Medicine, Osaka-Sayama, Japan. ·Am J Gastroenterol · Pubmed #27808133.

ABSTRACT: -- No abstract --

13 Article Surgically resected needle tract seeding following endoscopic ultrasound-guided fine-needle aspiration in pancreatic cancer. 2015

Minaga, Kosuke / Kitano, Masayuki / Yamashita, Yukitaka. ·Department of Gastroenterology and Hepatology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan. · Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama 589-8511, Japan. ·J Hepatobiliary Pancreat Sci · Pubmed #26084566.

ABSTRACT: -- No abstract --