{"id":536,"date":"2020-06-02T20:23:00","date_gmt":"2020-06-02T11:23:00","guid":{"rendered":"https:\/\/idsc-gunma.jp\/congress\/jstm\/?p=536"},"modified":"2022-05-26T20:19:30","modified_gmt":"2022-05-26T11:19:30","slug":"%e9%99%90%e5%b1%80%e6%80%a7%e4%bd%8e%e3%83%aa%e3%82%b9%e3%82%af%e5%89%8d%e7%ab%8b%e8%85%ba%e7%99%8c%e6%b2%bb%e7%99%82%e3%81%ae%e3%81%9f%e3%82%81%e3%81%ae%e3%83%aa%e3%82%a2%e3%83%ab%e3%82%bf%e3%82%a4","status":"publish","type":"post","link":"https:\/\/idsc-gunma.jp\/congress\/jstm\/%e9%99%90%e5%b1%80%e6%80%a7%e4%bd%8e%e3%83%aa%e3%82%b9%e3%82%af%e5%89%8d%e7%ab%8b%e8%85%ba%e7%99%8c%e6%b2%bb%e7%99%82%e3%81%ae%e3%81%9f%e3%82%81%e3%81%ae%e3%83%aa%e3%82%a2%e3%83%ab%e3%82%bf%e3%82%a4\/","title":{"rendered":"\u9650\u5c40\u6027\u4f4e\u30ea\u30b9\u30af\u524d\u7acb\u817a\u764c\u6cbb\u7642\u306e\u305f\u3081\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0MRI\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u304a\u3088\u3073\u7d4c\u5c3f\u9053\u7684\u96c6\u675f\u8d85\u97f3\u6ce2\u6cbb\u7642"},"content":{"rendered":"\n<p>\u4e00\u793e\uff09\u65e5\u672c\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u5b66\u4f1a\u30cb\u30e5\u30fc\u30b9No.112\u3010\u5b66\u8853\u5831\u544a47\u3011<br>\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u306b\u95a2\u3059\u308b\u6700\u8fd1\u306e\u8a71\u984c47<\/p>\n\n\n\n<p><strong>\u9650\u5c40\u6027\u4f4e\u30ea\u30b9\u30af\u524d\u7acb\u817a\u764c\u6cbb\u7642\u306e\u305f\u3081\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0MRI\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u304a\u3088\u3073\u7d4c\u5c3f\u9053\u7684\u96c6\u675f\u8d85\u97f3\u6ce2\u6cbb\u7642<\/strong><\/p>\n\n\n\n<p>\u6cb3\u5408\u61b2\u5eb7, 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therapy<\/strong><strong>\u3067<\/strong>\u306f\uff0c\u60a3\u8005\u306e\u4e88\u5f8c\u306b\u5f71\u97ff\u3059\u308b\u3068\u8003\u3048\u3089\u308c\u308b<strong>\u764c<\/strong>\u75c5\u5de3\u3092\u6cbb\u7642\u3059\u308b\u4e00\u65b9\uff0c\u6b63\u5e38\u7d44\u7e54\u3092\u53ef\u80fd\u306a\u9650\u308a\u6e29\u5b58\u3059\u308b\u3053\u3068\u3067\uff0c\u6cbb\u7642\u3068\u6a5f\u80fd\u6e29\u5b58\u3092\u4e21\u7acb\u3059\u308b\u3053\u3068\u3092\u76ee\u7684\u3068\u3059\u308b\uff0e\u30a2\u30d6\u30ec\u30fc\u30b7\u30e7\u30f3\u3092\u542b\u3081\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u6cbb\u7642\u306f\u4fb5\u8972\u6027\u306e\u4f4e\u3044\u6cbb\u7642\u3068\u3057\u3066\u4f4d\u7f6e\u3065\u3051\u3089\u308c\u3066\u3044\u308b\u304c\uff0c\u8ab2\u984c\u306f\u52a0\u6e29\u90e8\u4f4d\u306e\u6e29\u5ea6\u3092\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0\u306b\u53ef\u8996\u5316\u3067\u304d\u306a\u3044\u3053\u3068\u306b\u3042\u308b\uff0e\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u6cbb\u7642\u306b\u95a2\u3057\u3066\uff0c\u3088\u308a\u9ad8\u6b21\u5143\u306e\u6cbb\u7642\u6cd5\uff0c\u6e29\u5ea6\u30fb\u6cbb\u7642\u90e8\u4f4d\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0\u3067\u306e\u898b\u3048\u308b\u5316\u3068\u5fc5\u8981\u90e8\u4f4d\u306e\u307f\u306e\u30d4\u30f3\u30dd\u30a4\u30f3\u30c8\u6cbb\u7642\u306e\u6d41\u308c\u304c\u52a0\u901f\u3057\u3066\u3044\u308b\uff0e\u3053\u3053\u3067\u306f\u3001\u300c\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0\u3067\u898b\u3048\u308b\u5316\u300d\u3068\u300c\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5\u300d\u3092\u57fa\u672c\u3068\u3057\u305f\u9650\u5c40\u6027\u524d\u7acb\u817a\u764c\u306b\u5bfe\u3059\u308b\u65b0\u3057\u3044\u69d8\u5f0f\u306e\u7570\u306a\u308b\u4e8c\u3064\u306e\u6cbb\u7642\u6cd5\u306b\u95a2\u3059\u308b\u8ad6\u6587\u3092\u7d39\u4ecb\u3059\u308b\uff0e\u4e00\u3064\u306f\u9650\u5c40\u6027\u524d\u7acb\u817a\u764c\u306eFocal therapy\u3092\u76ee\u7684\u3068\u3057\u305f\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5<sup>1, 2)<\/sup>\uff0c\u3082\u3046\u4e00\u3064\u306f\uff0c\u9650\u5c40\u6027\u524d\u7acb\u817a\u764c\u306e\u6cbb\u7642\u3068\u3057\u3066\uff0c\u764c\u75c5\u5de3\u3068\u6b63\u5e38\u7d44\u7e54\u3059\u3079\u3066\u3092\u542b\u3080\u524d\u7acb\u817a\u5168\u4f53\u3092\u713c\u707c\u3059\u308b\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u5c3f\u9053\u7684\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5(MRI-guided&nbsp;<strong>T<\/strong>ransurethral&nbsp;<strong>UL<\/strong>tra<strong>S<\/strong>ound&nbsp;<strong>A<\/strong>blation\uff0c\u4ee5\u4e0bTULSA)<sup>3)<\/sup><strong>\u3067\u3042\u308b<\/strong>\uff0e<\/p>\n\n\n\n<p><strong>\u3010<\/strong>\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5\u3000Magnetic resonance-guided high frequency focused ultrasound (MRgFUS)<strong>\u3011<\/strong><\/p>\n\n\n\n<p>\u524d\u7acb\u817a\u764c\u306e<strong>Focal therapy<\/strong>\u306e\u305f\u3081\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0MRI\u30ac\u30a4\u30c9\u4e0b\u96c6\u675f\u8d85\u97f3\u6ce2\u6cbb\u7642<sup>\u2606<\/sup>\u306f\uff0c\u7b2c\u2160\u76f8\u8a66\u9a13\u3068\u3057\u3066\u5b9f\u65bd\u3055\u308c\uff0c2015\u5e74\u306b\u5831\u544a\u3055\u308c\u305f<sup>1)<\/sup>\uff0e4\u540d\u306ePSA 10ng\/mL\u4ee5\u4e0b\uff0c\u816b\u760d\u5206\u985ecT2a(\u524d\u7acb\u817a\u306b\u9650\u5c40\u3059\u308b\u816b\u760d\u3067\u7247\u8449\u306e1\/2\u4ee5\u5185\u306e\u9032\u5c55)\uff0c\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a2<sup>\u2606<\/sup>6(3+3)\u306e\u60a3\u8005\u3067\uff0cmpMRI<sup>\u2606<\/sup>\u3068\u7d4c\u76f4\u8178\u7684\u751f\u691c\u304c\u884c\u308f\u308c\u305f\uff0e\u305d\u306e\u5f8c, MRI\u30ac\u30a4\u30c9\u4e0b\uff0c\u6e29\u5ea6\u6e2c\u5b9a\u3068\u713c\u707c\u304c\u5b9f\u65bd\u3055\u308c\u305f\uff0e6\u304b\u6708\u5f8c\u306b\u6709\u5bb3\u4e8b\u8c61\uff0cQOL\u306b\u95a2\u3057\u3066\u8abf\u67fb\u3057, \u816b\u760d\u5b66\u7684\u691c\u67fb\u306b\u3064\u3044\u3066\u306fmpMRI\u3068\u7d4c\u76f4\u8178\u7684\u751f\u691c\u3092\u884c\u3063\u305f\uff0e4\u540d\u306b\u3064\u3044\u30666\u304b\u6240\u304c\u6cbb\u7642\u3055\u308c\u305f\u304c\uff0c\u8853\u5f8c\u5408\u4f75\u75c7\u306f\u898f\u6e96\uff08Clavien-Dindo\u5206\u985e\uff09I\u4ee5\u4e0b\u3067\u3042\u3063\u305f\uff0eMRI\u753b\u50cf\u4e0a4\u540d\u3068\u3082\u6b63\u5e38\u3067\uff0c3\u540d\u3067\u306f\u6cbb\u7642\u90e8\u4f4d\u306e\u75c5\u5909\u306f\u6d88\u5931\u3057\uff0c\u6cbb\u7642\u3057\u305f5\u304b\u6240\u3067\u306f\u5b8c\u5168\u713c\u707c\u304c\u3067\u304d\u305f\uff0e\u5168\u3066\u306e\u60a3\u8005\u306f\u6cbb\u7642\u90e8\u4f4d\u4ee5\u5916\u306b\u5c11\u306a\u304f\u3068\u30821\u304b\u6240\u306e\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a26\u306e\u30b3\u30a2\u75c5\u5909\u3092\u8a8d\u3081\u305f\uff0e\u4eca\u4e00\u3064\u306e<strong>Focal therapy<\/strong><strong>\u3092\u76ee\u6307\u3057\u305f\u524d\u5411\u304d<\/strong>\u7b2c\u2160\u76f8\u8a66\u9a13<strong>\u306b\u306f<\/strong>\uff0c<strong>8<\/strong><strong>\u540d\u306e\u4f4e\u30fb\u4e2d\u30ea\u30b9\u30af\u60a3\u8005\uff08<\/strong>PSA \u2264 10 ng\/ml\uff0c \u2264 cT2a, \u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a2 \u2264 7 (4 + 3)\uff09<strong>\u304c\u53c2\u52a0\u3057\u305f<\/strong><strong><sup>2)<\/sup><\/strong>\uff0e<strong>10<\/strong><strong>\u7b87\u6240<\/strong><strong>(<\/strong>\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a26\u304c6\u304b\u6240\u30017\u304c4\u304b\u6240)<strong>\u304c\u6cbb\u7642\u5bfe\u8c61\u3067\u3042\u3063\u305f<\/strong>\uff0e<strong>\u524d\u7acb\u817a\u5bb9\u7a4d<\/strong>25-50 cc; \u5e73\u5747 MRI \u6642\u9593\uff0c248 min\/\u4eba; \u5e73\u5747\u8d85\u97f3\u6ce2\u7167\u5c04\u6642\u959365\u5206\u3067\u3042\u3063\u305f\uff0e\u5e73\u5747\u306e\u6a19\u7684\u5bb9\u7a4d2.7 cc\uff0c\u6cbb\u7642\u5f8c\u306e\u5e73\u5747\u975e\u9084\u6d41\u5bb9\u7a4d\u306f4.3 cc.\u3067\u3042\u3063\u305f\uff0e6\u540d\u306e\u60a3\u8005\u30676\u304b\u6708\u5f8c\u306eQOL\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u3068\u540c\u69d8\u3067\u3042\u3063\u305f\uff0e\u307e\u305f\uff0c\u5168\u3066\u306b\u304a\u3044\u3066MRI\u691c\u67fb\u3067\u306f\u764c\u306f\u78ba\u8a8d\u3067\u304d\u306a\u304b\u3063\u305f. 4\u60a3\u8005 \u304a\u3088\u3073 6\u75c5\u5909\u306f\u751f\u691c\u3067\u3082\u9670\u6027\u3067\u3042\u3063\u305f\uff0e2-mm \u306e \u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a28 \u75c5\u5909\u3092\u6709\u3059\u308b\u60a3\u8005\u306f\u6458\u51fa\u624b\u8853\u304c\u884c\u308f\u308c\uff0c\u75c5\u7406\u691c\u67fb\u3067\u9670\u6027\u3067\u3042\u3063\u305f\uff0e\u4f4e\u5bb9\u7a4d(5-15%)\u306e\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a26 \u6b8b\u5b58\u75c5\u5909\u3092\u6709\u3059\u308b\u60a3\u8005\u306f\u5f37\u5316\u76e3\u8996\u7642\u6cd5\u3068\u3057\u305f\uff0e\u5e73\u5747PSA\u5024\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e5.06 \u304b\u30896\u304b\u6708\u5f8c3.4 ng\/ml \u306b\u4f4e\u4e0b\u3057\u305f\uff0e\u4ee5\u4e0a\u3088\u308a\uff0c\u77ed\u671f\u9593\u306e\u89b3\u5bdf\u3067\u306f\u3042\u308b\u304c\uff0cMRgFUS\u306e\u6709\u7528\u6027\u304c\u793a\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n<p>\u3010\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u5c3f\u9053\u7684\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5(MRI-guided Transurethral ULtraSound Ablation:TULSA\u3011<\/p>\n\n\n\n<p>\u524d\u8ff0\u306e\u6cbb\u7642\u6cd5(MRgFUS)\u3067\u306f\u8d85\u97f3\u6ce2\u767a\u751f\u88c5\u7f6e\u3067\u3042\u308b\u30a2\u30d7\u30ea\u30b1\u30fc\u30bf\u30fc\u306f\u76f4\u8178\u633f\u5165\u578b\u3067\u524d\u7acb\u817a\u5916\u90e8\u304b\u3089\u75c5\u5de3\u3092\u8d85\u97f3\u6ce2\u713c\u707c\u3059\u308b\u304c\uff0cTULSA\u306f\u65b0\u3057\u3044\u65b9\u6cd5\u3067\uff0c\u30a2\u30d7\u30ea\u30b1\u30fc\u30bf\u30fc\u306f\u7d4c\u5c3f\u9053\u578b\u3067\u3042\u308b\uff0e\u3064\u307e\u308a\uff0c\u524d\u7acb\u817a\u90e8\u5c3f\u9053\u306b\u30a2\u30d7\u30ea\u30b1\u30fc\u30bf\u30fc\u3092\u8a2d\u7f6e\u3057\uff0c\u524d\u7acb\u817a\u5185\u90e8\u304b\u3089\u8d85\u97f3\u6ce2\u713c\u707c\u3092\u884c\u3046\u3082\u306e\u3067\u3042\u308b\uff0e\u307e\u305f\uff0c\u75c5\u5de3\u306e\u307f\u3092\u713c\u707c\u3059\u308b\u306e\u3067\u306f\u306a\u304f\uff0c\u6b63\u5e38\u7d44\u7e54\u3092\u542b\u3081\u3066\u524d\u7acb\u817a\u5168\u4f53\u3092\u713c\u707c\u3059\u308b\uff0e\u3053\u306e\u8ad6\u6587\u3067\u306fTULSA\u306b\u95a2\u3059\u308b\u7b2c\u2160\u76f8\u8a66\u9a13(14\u540d)\u306e\u5358\u4e00\u30bb\u30f3\u30bf\u30fc\u30b3\u30db\u30fc\u30c8\u306e\u5831\u544a\uff0c\u305d\u3057\u3066\uff0c\u305d\u308c\u3092\u5143\u306b\u524d\u7acb\u817a\u7d44\u7e54\u306eMRI\u30ac\u30a4\u30c9\u4e0b\u5f8c\u306e\u5b89\u5168\u6027\uff0c\u6a5f\u80fd\u8a55\u4fa1\u304a\u3088\u3073PSA\u306b\u95a2\u3057\u3066\u5f37\u5316\u6cbb\u7642\u306e\u52b9\u679c\u3092\u8a55\u4fa1\u3057\u305f\u81e8\u5e8a\u8a66\u9a13 (TACT: TULSA-PRO Ablation Clinical Trial)(15\u540d)\u306e\u5831\u544a\u304c\u3055\u308c\u3066\u3044\u308b<sup>3)<\/sup>\uff0e\u7b2c\u2160\u76f8\u8a66\u9a13\u304a\u3088\u3073TACT\u8a66\u9a13\u3067\u306f\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304a\u3088\u30736\u304b\u6708\u8ffd\u8de1\u30c7\u30fc\u30bf\u304c\u96c6\u3081\u3089\u308c\u305f\uff0e\u4e2d\u592e\u8a66\u9a13\u3067\u306f\u5f37\u5316\u6cbb\u7642\u6307\u6a19(\u6e29\u5ea6\u4e0a\u6607\uff0c\u713c\u707c\u7bc4\u56f2\u306e\u7a7a\u9593\u7684\u62e1\u5927)\u3092\u7528\u3044\u305f\uff0e\u4e21\u7814\u7a76\u306e\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u9593\u306e\u6709\u5bb3\u4e8b\u8c61\uff0c\u5c3f\u610f\uff0c\u6392\u5c3f\uff0c\u52c3\u8d77\u6a5f\u80fd\u306e\u6bd4\u8f03\u306b\u95a2\u3057\u3066\u533b\u5e2b\u306e\u7d4c\u9a13\u306e\u5f71\u97ff\u3092\u6700\u5c0f\u5316\u3057\u305f\uff0e\u7b2cI\u76f8\u304a\u3088\u3073TACT\u60a3\u8005(\u5e74\u9f62\u306e\u4e2d\u592e\u5024\u306f71\u6b73\u306867\u6b73)\uff0c\u524d\u7acb\u817a\u5bb9\u7a4d\u306f41.0\u304a\u3088\u307344.5 ml\u3067PSA\u306f\u3068\u3082\u306b6.7 ng\/ml\u3067\u3042\u3063\u305f. \u7b2cI\u76f8\u306e\u516814\u540d\u306f\u4f4e\u30ea\u30b9\u30af\u764c\u3067TACT\u306e\u5834\u5408\u3067\u306f15\u540d\u4e2d7\u540d\u306f\u4e2d\u30ea\u30b9\u30af\u7fa4\u3067\u3042\u3063\u305f\uff0e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u3068 IIEF (International Index of Erectile Function), IPSS (International Prostate Symptom Score)\uff0c\u751f\u6d3b\u306e\u8cea, \u5c3f\u30d1\u30c3\u30c9\u4f7f\u7528\u306f\u4e21\u7fa4\u3067\u540c\u69d8\u3067\u3042\u3063\u305f. PSA\u5024\u306e\u5909\u5316\u306b\u3064\u3044\u3066\u306f\uff0c6\u30f6\u6708\u5f8c\u3067\u7b2c\u2160\u76f8\u8a66\u9a13\u3067\u306f0.7(0.2-0.8)\uff0cTACT\u8a66\u9a13\u3067\u306f0.5(0.2-1.2) ng\/ml\u307e\u3067\u4e0b\u964d\u3057\u305f. 1\u30f6\u6708\u6642\u306e\u5c3f\u30d1\u30c3\u30c9\u4f7f\u7528\uff0c3\u304b\u6708\u6642\u306e\u751f\u6d3b\u306e\u8cea\u306f\u7b2c\u2160\u76f8\u8a66\u9a13\u60a3\u8005\u304c\u512a\u308c\u305f\uff0e6\u304b\u6708\u3067\u306f\u6a5f\u80fd\u306e\u8a55\u4fa1\u3042\u308b\u3044\u306f\u6709\u5bb3\u4e8b\u8c61\u306b\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\uff0eTULSA\u306f\u7b2cI\u76f8\u8a66\u9a13\u3067\u53d7\u5bb9\u53ef\u80fd\u306a\u81e8\u5e8a\u7684\u5b89\u5168\u6027\u304c\u8a3c\u660e\u3055\u308c\u305f\uff0eTACT\u4e2d\u592e\u8a66\u884c\u306b\u304a\u3051\u308b\u5f37\u5316\u6cbb\u7642\u6307\u6a19\u306f6\u304b\u6708\u6642\u306e\u6a5f\u80fd\u8a55\u4fa1\u7d50\u679c\u3084\u6709\u5bb3\u4e8b\u8c61\u306b\u5f71\u97ff\u3092\u53ca\u307c\u3059\u3053\u3068\u306a\u304f\uff0c\u713c\u707c\u7bc4\u56f2\u3092\u524d\u7acb\u817a\u7d44\u7e54\u306e90\uff05\uff5e98\uff05\u306b\u4e0a\u3052\u308b\u3053\u3068\u304c\u3067\u304d\u305f\uff0e\u9577\u671f\u8ffd\u8de1\u8abf\u67fb\u308412\u304b\u6708\u3067\u306e\u751f\u691c\u306f\u816b\u760d\u5b66\u4e0a\u306e\u5b89\u5168\u6027\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306b\u5fc5\u8981\u3068\u3055\u308c\u308b\uff0e<\/p>\n\n\n\n<p>MRgFUS\u306f\u81e8\u5e8a\u7684\u306b\u610f\u7fa9\u306e\u3042\u308b\u764c(significant cancer)\u3092\u6cbb\u7642\u3059\u308bFocal therapy\u3092\u76ee\u7684\u3068\u3057\u3066\u3044\u308b\uff0e\u305d\u306e\u7d50\u679c\uff0c\u6cbb\u7642\u5f8c\u306ePSA\u306e\u8457\u3057\u3044\u4e0b\u964d\u306f\u8a8d\u3081\u306a\u3044\uff0eTULSA\u306f\u524d\u7acb\u817a\u5168\u4f53\u3092\u713c\u707c\u3059\u308b\u65b9\u6cd5\u3067\uff0c\u6982\u5ff5\u3068\u3057\u3066\u306f\u6839\u6cbb\u7684\u5f37\u5ea6\u5909\u8abf\u578b\u653e\u5c04\u7dda\u6cbb\u7642(IMRT)\u306b\u4f3c\u3066\u3044\u308b\uff0e\u305d\u306e\u7d50\u679c\uff0c\u6cbb\u7642\u5f8c\u306ePSA\u3082\u5c0f\u6570\u70b9\u4ee5\u4e0b\u306b\u4e0b\u964d\u3059\u308b\uff0e\u9650\u5c40\u6027\u306b\u9650\u3089\u305a\u524d\u7acb\u817a\u764c\u306e\u6cbb\u7642\u5f8c\u306e\u4e88\u5f8c\u306b\u306fPSA\u4e0b\u964d\u7387\u304c\u95a2\u4fc2\u3059\u308b\u3068\u8a00\u308f\u308c\u3066\u3044\u308b\u306e\u3067\uff0c\u6cbb\u7642\u5f8c\u306e\u4e88\u5f8c\u3092\u8003\u3048\u308b\u3068MRgFUS\u3088\u308aTULSA\u306e\u65b9\u304c\u6709\u7528\u306a\u306e\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u3057\u304b\u3057\uff0c\u3069\u3061\u3089\u306e\u65b9\u6cd5\u3082\u9577\u671f\u4e88\u5f8c\u306b\u3064\u3044\u3066\u306f\u3053\u308c\u304b\u3089\u8a55\u4fa1\u3055\u308c\u308b\u3053\u3068\u306b\u306a\u308b\uff0e<\/p>\n\n\n\n<p>MRgFUS\u3082TULSA\u3082\u9650\u5c40\u6027\u524d\u7acb\u817a\u764c\u306b\u5bfe\u3059\u308b\uff0c\u8d85\u97f3\u6ce2\u713c\u707c\u3092\u7528\u3044\u305f\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u6cbb\u7642\u3067\u300c\u898b\u3048\u308b\u304b\u5316\u300d\u3092\u5b9f\u73fe\u3057\u305f\u6cbb\u7642\u6cd5\u3067\u3042\u308b\uff0e\u3057\u304b\u3057\uff0cMRgFUS\u306fFocal therapy\u3092\u76ee\u6307\u3057\uff0cTULSA\u306fIMRT\u306e\u3054\u3068\u304f\u524d\u7acb\u817a\u5168\u4f53\u306e\u713c\u707c\u3092\u76ee\u7684\u3068\u3057\u305f\u6982\u5ff5\u304c\u7570\u306a\u308b\u6cbb\u7642\u6cd5\u3067\u3042\u308b\uff0e\u305d\u306e\u305f\u3081\u512a\u52a3\u306f\u5358\u7d14\u306b\u306f\u6bd4\u8f03\u3067\u304d\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u308b\uff0e\u6839\u6cbb\u7684\u524d\u7acb\u817a\u764c\u306e\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u306f\uff0cIMRT\u3084\u30ed\u30dc\u30c3\u30c8\u652f\u63f4\u524d\u7acb\u817a\u5168\u6458\u8853(Robotic Asisted Radical Prostatectomy: RARP)\u304c\u3059\u3067\u306b\u78ba\u7acb\u3055\u308c\u3066\u3044\u308b\uff0eMRgFUS\uff0cTULSA\u306e\u610f\u7fa9\u306f\uff0c\u60a3\u8005\u3054\u3068\u306bIMRT, RARP\u3092\u542b\u3081\u3066\u30e1\u30ea\u30c3\u30c8\uff0c\u30c7\u30e1\u30ea\u30c3\u30c8\u3092\u7dcf\u5408\u7684\u306b\u5224\u65ad\u3057\u3066\u9078\u629e\u3055\u308c\u3066\u3044\u304f\u3082\u306e\u3068\u8003\u3048\u3089\u308c\u308b\uff0e<\/p>\n\n\n\n<p><strong>\u53c2\u8003\u6587\u732e<\/strong><\/p>\n\n\n\n<p><strong>1)\u3000<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=date&amp;term=Ghai+S&amp;cauthor_id=26204305\">Ghai<\/a>&nbsp;S.,&nbsp;<em>et al<\/em>. Real-time MRI-guided focused ultrasound for focal therapy of locally confined low-risk prostate cancer: Feasibility and preliminary outcomes. AJR Am J Roentgenol 205: W177-184, 2015.<\/strong><\/p>\n\n\n\n<p>2)\u3000<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Ghai%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=29696431\">Ghai S<\/a>.,&nbsp;<em>et al<\/em>. Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy in prostate cancer &#8211; phase 1 trial.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29696431\">Eur Radiol<\/a>&nbsp;28: 4281-4287, 2018.<\/p>\n\n\n\n<p>3)\u3000Hatiboglu G.,&nbsp;<em>et al<\/em>.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31062122\">Magnetic resonance imaging-guided transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: single-center evaluation of 6-month treatment safety and functional outcomes of intensified treatment parameters.<\/a>&nbsp;World J Urol 38:343-350. 2020.<\/p>\n\n\n\n<p><strong>\u7528\u8a9e\u8aac\u660e<\/strong><\/p>\n\n\n\n<p><sup>\u2606<\/sup><strong>\u96c6\u675f\u8d85\u97f3\u6ce2\u6cbb\u7642<\/strong>\uff1a Focused ultrasound(FUS)\u3042\u308b\u3044\u306fHigh Intensity Focused ultrasound(HIFU)\u3068\u79f0\u3055\u308c\u308b\u7d4c\u76f4\u8178\u7684\u8d85\u97f3\u6ce2\u6cbb\u7642\u88c5\u7f6e\u3067\u306f, \u524d\u7acb\u817a\u80a5\u5927\u3092\u6cbb\u7642\u5bfe\u8c61\u3068\u3057\u305f\u304c\uff0c\u6700\u8fd1\u306f\u524d\u7acb\u817a\u764c\u6cbb\u7642\u88c5\u7f6e\u3068\u3057\u3066\u767a\u5c55\u3057\u3066\u3044\u308b\uff0eSonablate<sup>R<\/sup>&nbsp;HIFU, Sonacare Medical, Charlotte, NC, USA\u304c\u6b74\u53f2\u306f\u3042\u308b\u304c\u753b\u50cf\u8a3a\u65ad\u306b\u306f\u8d85\u97f3\u6ce2\u3092\u4f7f\u7528\u3057\u3066\u3044\u308b\uff0e\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u5c3f\u9053\u7684\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5(MRI-guided&nbsp;<strong>T<\/strong>ransurethral&nbsp;<strong>UL<\/strong>tra<strong>S<\/strong>ound&nbsp;<strong>A<\/strong>blation\uff0c\u4ee5\u4e0bTULSA)\u7528\u6a5f\u5668\u3068\u3057\u3066\uff0cTULSA-PRO (Profound Medical Inc, Toronto, Canada)\uff0c\u78c1\u6c17\u5171\u9cf4\u753b\u50cf\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u7684\u8d85\u97f3\u6ce2\u713c\u707c\u7642\u6cd5\u7528\u6a5f\u5668(MRgFUS)\u3068\u3057\u3066 Exablate Prostate (Insightec Ltd. Tirat Carmel, Israel)\u304c\u5e02\u5834\u306b\u3067\u3066\u3044\u308b\uff0e<\/p>\n\n\n\n<p><sup>\u2606<\/sup><strong>\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a2\uff1a<\/strong><strong>\u30b0\u30ea\u30bd\u30f3<\/strong>\u5206\u985e\u3068\u306f\uff0c\u524d\u7acb\u817a\u764c\u306e\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u5206\u985e\u3068\u3057\u3066\uff0c1966\u5e74\u306b\u7c73\u56fd\u306eDonald F<strong>.&nbsp;<\/strong><strong>Gleason<\/strong>\u304c\u6700\u521d\u306b\u63d0\u5531\u3057\u305f\u968e\u5c64\u5316\u306e\u65b9\u6cd5\u3067\u3042\u308b\uff0e\u524d\u7acb\u817a\u764c\u306f\u540c\u3058\u524d\u7acb\u817a\u306e\u306a\u304b\u306b\u60aa\u6027\u5ea6\u306e\u7570\u306a\u308b\u764c\u304c\u767a\u751f\u3059\u308b\uff0e\u305d\u3053\u3067\uff0c<a href=\"https:\/\/www.zenritsusengan.sanofi.co.jp\/glossary.html#sa3\">\u751f\u691c<\/a>\u3067\u63a1\u53d6\u3057\u305f\u764c\u7d30\u80de\u306e\u7d44\u7e54\u69cb\u9020\u3092\u8abf\u3079\uff0c\u6700\u3082\u9762\u7a4d\u306e\u5927\u304d\u3044\u7d44\u7e54\u578b\u30682\u756a\u76ee\u306b\u5927\u304d\u3044\u7d44\u7e54\u578b\u306e\u30b0\u30ec\u30fc\u30c9(5\u6bb5\u968e\u8a55\u4fa1)\u3092\u8db3\u3057\u3066\uff0c\u60aa\u6027\u5ea6\u306e\u5224\u5b9a\u306b\u7528\u3044\u308b\uff0e\u3053\u308c\u304c\u30b0\u30ea\u30bd\u30f3\u30fb\u30b9\u30b3\u30a2\u3068\u547c\u3070\u308c\u308b\u3082\u306e\u3067\uff0c\u30b0\u30ec\u30fc\u30c93\u3068\u30b0\u30ec\u30fc\u30c94\u306e\u7d44\u7e54\u304c\u3042\u308c\u3070\uff0c\u30b9\u30b3\u30a2\u306f\u300c3\uff0b4=7\u300d\u306b\u306a\u308b\uff0e\u5373\u3061\uff0c\u60aa\u6027\u5ea6\u304c\u6700\u3082\u4f4e\u3044\u5834\u5408\u30b9\u30b3\u30a22\u3068\u306a\u308a\uff0c\u6700\u3082\u9ad8\u3044\u5834\u5408\u30b9\u30b3\u30a210\u3067, 9\u6bb5\u968e\u306e\u5206\u985e\u3068\u306a\u308b\uff0e\u524d\u7acb\u817a\u764c\u306e\u91cd\u75c7\u5ea6\u3067\u3042\u308b\u30ea\u30b9\u30af\u5206\u985e\u306f\u816b\u760d\u30de\u30fc\u30ab\u30fc\u3067\u3042\u308bPSA\u5024\u3068\u300c\u30b0\u30ea\u30bd\u30f3\u30b9\u30b3\u30a2\u300d\uff0c\u300c\u75c5\u671f\u5206\u985e\uff08TNM\u5206\u985e\uff09\u300d\u306e\u4e09\u3064\u3092\u7d44\u307f\u5408\u308f\u305b\u3066\u5224\u65ad\u3055\u308c\u308b\uff0e<\/p>\n\n\n\n<p><sup>\u2606<\/sup><strong>mpMRI(<\/strong><strong>\u30de\u30eb\u30c1\u30d1\u30e9\u30e1\u30c8\u30ea\u30c3\u30af<\/strong><strong>MRI<\/strong><strong>\uff0c<\/strong><strong>multiparametric MRI)<\/strong>\uff1a\u901a\u5e38\u306e\u78c1\u6c17\u5171\u9cf4\u8a3a\u65ad\u306eT2\u5f37\u8abf\u50cf\u306b\uff0c2\u7a2e\u985e\u4ee5\u4e0a\u306e\u753b\u50cf\uff08\u9020\u5f71\u5264\u3092\u4f7f\u7528\u3057\u305f\u30c0\u30a4\u30ca\u30df\u30c3\u30af\u753b\u50cf\u3084\u62e1\u6563\u5f37\u8abf\u50cf\u306a\u3069\uff09\u3092\u7d44\u307f\u5408\u308f\u305b\u308b\u8a3a\u65ad\u6cd5\uff0e\u524d\u7acb\u817a\u764c\u3092\u7591\u3046\u90e8\u4f4d\uff0c\u764c\u306e\u5468\u56f2\u3078\u306e\u6d78\u6f64\uff0c\u30ea\u30f3\u30d1\u7bc0\u8ee2\u79fb\u306e\u6709\u7121\u3092\u3088\u308a\u78ba\u5b9f\u306b\u8a3a\u65ad\u3067\u304d\u308b\uff0eT2\u5f37\u8abf\u753b\u50cf\uff1aT2 weighted image(T2WI)\uff0e\u8102\u80aa\u7d44\u7e54\u3060\u3051\u3067\u306a\u304f\uff0c\u6c34\u3084\u6db2\u6027\u6210\u5206\u30fb\u56a2\u80de\u3082\u767d\u304f\u898b\u3048\u816b\u760d\u306f\u3084\u3084\u767d\u304f\u898b\u3048\u308b\uff0e\u62e1\u6563\u5f37\u8abf\u753b\u50cf\uff1adiffusion weighted image (DWI)\uff0e\u7d44\u7e54\u5185\u306e\u6c34\u5206\u5b50\u306e\u52d5\u304d\u3067\u3042\u308b\u62e1\u6563\u904b\u52d5\u3092\u753b\u50cf\u5316\u3059\u308b\u6a5f\u80fd\u7684\u753b\u50cf\u8a3a\u65ad\u6cd5\uff0eDCE-MRI\uff1adynamic contrast-enhanced magnetic resonance imaging \u816b\u760d\u64ae\u50cf\u4e2d\u306b\u9023\u7d9a\u7684\u306b\u9020\u5f71\u5264\u3092\u6295\u4e0e\u3057\u5f97\u3089\u308c\u308b\u6a5f\u80fd\u753b\u50cf\u306e\u4e00\u3064\uff0e\u816b\u760d\u5185\u4fe1\u53f7\u5f37\u5ea6\u5909\u5316\u306f\u8840\u6d41\u306b\u3088\u308b\u9020\u5f71\u5264\u79fb\u884c\u91cf\u306b\u76f8\u5f53\u3057\uff0c\u8840\u6d41\u91cf\uff0c\u8840\u7ba1\u8868\u9762\u7a4d\u3084\u900f\u904e\u6027\uff0c\u8840\u7ba1\u5916\u7d30\u80de\u5916\u306e\u4f53\u7a4d\u304c\u95a2\u4e0e\u3059\u308b\uff0e\u816b\u760d\u753b\u50cf\u5f37\u5ea6\u306e\u5909\u5316\u3092\u89e3\u6790\u3059\u308b\u3053\u3068\u3067\u9020\u5f71\u5264\u306e\u79fb\u884c\u306b\u4fc2\u308b\u6307\u6a19\u304c\u5f97\u3089\u308c\u308b\uff0e mpMRI\u3092\u7528\u3044\u305f\u8a3a\u65ad\u306bProstate Imaging and Reporting and Data System (PI-RADS version 2.1)\u304c\u63d0\u5531\u3055\u308c\uff0c\u4e0a\u8a18\u306eT2WI\uff0cDWI, DCE\u306e\u7d44\u307f\u5408\u308f\u305b\u306b\u3088\u308a, PI-RADS 1\u2013\u764c\u306e\u3042\u308b\u53ef\u80fd\u6027\u306f\u3068\u3066\u3082\u4f4e\u3044\uff0cPI-RADS 2 \u2013\u4f4e\u3044\uff0cPI-RADS 3 \u2013\u3069\u3061\u3089\u3068\u3082\u8a00\u3048\u306a\u3044\uff0cPI-RADS 4 \u2013\u9ad8\u3044\uff0cPI-RADS 5 \u2013\u3068\u3066\u3082\u9ad8\u3044, \u306e5\u6bb5\u968e\u306b\u8a3a\u65ad\u3067\u304d\u308b\uff0e<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u4e00\u793e\uff09\u65e5\u672c\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u5b66\u4f1a\u30cb\u30e5\u30fc\u30b9No.112\u3010\u5b66\u8853\u5831\u544a47\u3011\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u306b\u95a2\u3059\u308b\u6700\u8fd1\u306e\u8a71\u984c47 \u9650\u5c40\u6027\u4f4e\u30ea\u30b9\u30af\u524d\u7acb\u817a\u764c\u6cbb\u7642\u306e\u305f\u3081\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0MRI\u30ac\u30a4\u30c9\u4e0b\u7d4c\u76f4\u8178\u304a\u3088\u3073\u7d4c\u5c3f\u9053\u7684\u96c6\u675f\u8d85\u97f3\u6ce2\u6cbb\u7642 \u6cb3\u5408\u61b2\u5eb7, \u8fd1\u85e4\u3000 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"vkexunit_cta_each_option":"","footnotes":""},"categories":[5],"tags":[],"class_list":["post-536","post","type-post","status-publish","format-standard","hentry","category-report"],"_links":{"self":[{"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/posts\/536","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/comments?post=536"}],"version-history":[{"count":1,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/posts\/536\/revisions"}],"predecessor-version":[{"id":537,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/posts\/536\/revisions\/537"}],"wp:attachment":[{"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/media?parent=536"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/categories?post=536"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idsc-gunma.jp\/congress\/jstm\/wp-json\/wp\/v2\/tags?post=536"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}