鈴木　悠史 （スズキ　ユウシ）

Suzuki, Yushi

写真a

所属（所属キャンパス）

医学部 形成外科学教室 （信濃町）

職名

特任助教（有期）
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  • ライフサイエンス / 形成外科学

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  • Photoacoustic lymphangiography is a possible alternative for lymphedema staging

    Watanabe S., Kajita H., Suzuki Y., Urano M., Otaki M., Sakuma H., Imanishi N., Tsuji T., Jinzaki M., Kishi K.

    Journal of Vascular Surgery: Venous and Lymphatic Disorders （Journal of Vascular Surgery: Venous and Lymphatic Disorders）  10 （ 6 ） 1318 - 1324.e2 2022年11月

    ISSN  2213333X

    　概要を見る

    Objective: Photoacoustic imaging is a new technique that uses the photoacoustic effect. In photoacoustic lymphangiography (PAL), images of the lymphatic vessels can be visualized using light-absorbing contrast agents. In the present study, we investigated the efficacy of PAL for lymphedema staging. Methods: We performed PAL of the lower extremities and examined the clinical implications of using PAL for staging lymphedema by comparing the PAL images with those obtained using lymphoscintigraphy. Of 47 patients with lymphedema who had been outpatients or hospitalized at our institution between May 2018 and September 2020 and had undergone PAL, 15 with 18 limbs who had also undergone lymphoscintigraphy were included in the present study. The lymphoscintigraphy findings were classified using the Maegawa classification. We also investigated whether PAL could clearly visualize the lymphatic vessels and concisely reflect the disease state by counting the number of lymphatic vessels observed using PAL. Results: The PAL findings were categorized into three groups: collecting lymphatic vessels, dermal backflow (DBF), and no lymphatic vessels. The collecting lymphatic vessels group corresponded to types 2 and 3 in the Maegawa classification; DBF corresponded to types 3 and 4, and the no lymphatic vessels group corresponded to type 4. The number of lymphatic vessels visualized using PAL was similar to that with lymphoscintigraphy. As the disease progressed, the number of lymphatic vessels observed decreased, increased DBF was detected, and, eventually, the lymphatic vessels were not visible, corresponding to the general changes observed via lymphoscintigraphy with stage progression. Conclusions: The findings from PAL and lymphoscintigraphy tended to correspond, suggesting that PAL could be useful for lymphedema staging.

  • Application of Photoacoustic Imaging for Lymphedema Treatment

    Suzuki Y., Kajita H., Watanabe S., Okabe K., Sakuma H., Imanishi N., Aiso S., Kishi K.

    Journal of Reconstructive Microsurgery （Journal of Reconstructive Microsurgery）  38 （ 3 ） 254 - 262 2022年03月

    ISSN  0743684X

    　概要を見る

    Background Lymphatic vessels are difficult to identify using existing modalities as because of their small diameter and the transparency of the lymph fluid flowing through them. Methods Here, we introduce photoacoustic lymphangiography (PAL), a new modality widely used for lymphedema treatment, to observe limb lymphatic vessels. The photoacoustic imaging system used in this study can simultaneously visualize lymphatic vessels and veins with a high resolution (0.2 mm) and can also observe their three-dimensional relationship with each other. Results High-resolution images of the lymphatic vessels, detailed structure of the dermal back flow, and the three-dimensional positional relationship between the lymphatic vessels and veins were observed by PAL. Conclusion The clear image provided by PAL could have a major application in pre- and postoperative use during lymphaticovenular anastomosis for lymphedema treatment.

  • Photoacoustic lymphangiography exhibits advantages over near-infrared fluorescence lymphangiography as a diagnostic tool in patients with lymphedema

    Suzuki Y., Kajita H., Oh A., Urano M., Watanabe S., Sakuma H., Imanishi N., Tsuji T., Jinzaki M., Kishi K.

    Journal of Vascular Surgery: Venous and Lymphatic Disorders （Journal of Vascular Surgery: Venous and Lymphatic Disorders）  10 （ 2 ） 454 - 462.e1 2022年03月

    ISSN  2213333X

    　概要を見る

    Objective: Photoacoustic imaging is a new technique that can evaluate the vascular system using photoacoustic effects. The present study compared the ability of the new photoacoustic lymphangiography (PAL) method and more standard near-infrared fluorescence (NIRF) to image the lymphatic system in patients with secondary lymphedema after gynecological cancer surgery. Methods: Patients with secondary lymphedema in the lower extremities after gynecologic cancer surgery, who were assessed using PAL between May 2018 and January 2019, were recruited. NIRF was performed first using 5.0 mg/mL of indocyanine green injected using a 0.2-cc 30-gauge needle. Correlations between NIRF and PAL findings on patient images were subsequently examined. Results: Seventeen patients with secondary lymphedema were enrolled. The mean age of the patients was 61 ± 11 years. The imaging sites were the medial lower leg in 15 patients, the posterior lower leg in 9 patients, the lateral lower leg in 7 patients, the medial knee in 4 patients, and other areas in 3 patients. A total of 38 pictures were obtained. Five distinct lymphatic patterns were observed over the entire sample using PAL: straight, winding, spiderweb, nebulous, and black-out pattern. Eighteen of the 24 limbs (75%) that exhibited a linear pattern in NIRF exhibited a straight pattern in PAL, and 19 of the 20 limbs (95%) that exhibited a splash pattern in NIRF exhibited a winding or spiderweb pattern in PAL. Eight limbs exhibiting diffuse patterns without linear or splash patterns with NIRF were all nebulous or black-out patterns in PAL. This suggests that more severe lymphatic degeneration was associated with poorer visualization in PAL. Conclusions: NIRF plays an important role in lymphedema treatment. In the present study, various PAL patterns were compared with those observed using NIRF. PAL provided clearer images including transectional views, which were not available using NIRF, and may promote further understanding of the changes in the lymphatic structure and function in patients with secondary lymphedema.

  • Surgical applications of lymphatic vessel visualization using photoacoustic imaging and augmented reality

    Suzuki Y., Kajita H., Watanabe S., Otaki M., Okabe K., Sakuma H., Takatsume Y., Imanishi N., Aiso S., Kishi K.

    Journal of Clinical Medicine （Journal of Clinical Medicine）  11 （ 1 ）  2022年01月

    　概要を見る

    Lymphaticovenular anastomosis (LVA) is a widely performed surgical procedure for the treatment of lymphedema. For good LVA outcomes, identifying lymphatic vessels and venules is crucial. Photoacoustic lymphangiography (PAL) is a new technology for visualizing lymphatic vessels. It can depict lymphatic vessels at high resolution; therefore, this study focused on how to apply PAL for lymphatic surgery. To visualize lymphatic vessels, indocyanine green was injected as a color agent. PAI-05 was used as the photoacoustic imaging device. Lymphatic vessels and veins were visualized at 797-and 835-nm wavelengths. First, it was confirmed whether the branching of the vasculature as depicted by the PAL was consistent with the actual branching of the vasculature as confirmed intraoperatively. Second, to use PAL images for surgical planning, preoperative photoacoustic images were superimposed onto the patient limb through augmented reality (AR) glasses (MOVERIO Smart Glass BT-30E). Lymphatics and venule markings drawn using AR glasses were consistent with the actual intraoperative images obtained during LVA. To anastomose multiple lymphatic vessels, a site with abundant venous branching was selected as the incision site; and selecting the incision site became easier. The anatomical morphology obtained by PAL matched the surgical field. AR-based marking could be very useful in future LVA.

  • Use of photoacoustic imaging to determine the effects of aging on lower extremity lymphatic vessel function

    Suzuki Y., Kajita H., Oh A., Takemaru M., Sakuma H., Tsuji T., Imanishi N., Aiso S., Kishi K.

    Journal of Vascular Surgery: Venous and Lymphatic Disorders （Journal of Vascular Surgery: Venous and Lymphatic Disorders）  10 （ 1 ） 125 - 130 2022年01月

    ISSN  2213333X

    　概要を見る

    Objective: Aging is one of the causes of primary lymphedema. However, the effects of aging on the lymphatic system are still not completely understood. We investigated the effects of aging on the lymphatic vessels in the lower extremities of healthy volunteers using photoacoustic imaging. Methods: Healthy volunteers who underwent photoacoustic lymphangiography between March 2018 and January 2019 were enrolled. To visualize lymphatics, indocyanine green (ICG, 5.0 mg/mL) was injected subcutaneously into the first and fourth web spaces of the foot and under the lateral malleolus. Subsequently, near-infrared fluorescence lymphography was performed to confirm good ICG flow, and photoacoustic lymphangiography was performed on the medial side of the lower leg. Ti sapphire laser irradiation at 797 and 835 nm, the optimal wavelengths for visualizing ICG and blood, was applied. The number of lymphatic vessels shown at areas 10 cm (L10) and 20 cm (L20) cranially from the internal malleolus was counted. Results: Nineteen healthy volunteers (4 males and 15 females) were enrolled in the study. Their mean age was 42.9 ± 12.8 years. One volunteer was bilaterally imaged; 15 left lower limbs and 5 right lower limbs were imaged. The number of lymphatic vessels visualized increased with age. There were strong positive correlations between age and L10 (R = 0.729, P <.001) and between age and L20 (R = 0.570, P =.009). Conclusions: Photoacoustic imaging indicates that the number of lymphatic vessels increases with age. Lymphatic stasis resulted in visualization of not only normal drainage pathways but also nonfunctional lymphatic pathways.

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  • Comparison of Patency Rates of Lymphaticovenous Anastomoses at Different Sites for Lower Extremity Lymphedema

    鈴木 悠史,佐久間恒、山崎俊

    The 4th Congress of Asian Pacific Federation of Societies for Reconstructive Microsurgery, 

    2018年05月
    , 

    口頭発表（一般）

  • Comparison of Patency Rates of Two Lymphaticovenous Anastomosis Methods and Obstruction Risk Factor Analysis in Secondary Upper Extremity Lymphedema

    鈴木 悠史,佐久間恒、山崎俊

    The 4th Congress of Asian Pacific Federation of Societies for Reconstructive Microsurgery, 

    2018年05月
    , 

    口頭発表（一般）

  • 下肢リンパ浮腫に対するリンパ管静脈吻合術の吻合部位における開存率の評価

    鈴木 悠史,佐久間恒、山崎俊

    第61回日本形成外科学会総会・学術集会, 

    2018年04月
    , 

    口頭発表（一般）

  • 上肢続発性リンパ浮腫に対するリンパ管静脈吻合術の吻合方式における開存率の評価

    鈴木 悠史,佐久間恒、山崎俊

    第44回日本マイクロサージャリー学会学術集会, 

    2017年12月
    , 

    口頭発表（一般）

  • 有茎深下腹壁動脈穿通枝皮弁によるリンパ流路再建の経験

    鈴木 悠史、佐久間恒、山崎俊、伊原淳

    第60回日本形成外科学会総会・学術集会, 

    2017年04月
    , 

    ポスター発表

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競争的研究費の研究課題 【 表示 ／ 非表示 】

  • ヒト集合リンパ管の三次元的形態視覚化によるリンパ浮腫メカニズムの解明

    2024年04月
    -
    2027年03月

    鈴木 悠史, 基盤研究(C), 補助金,  研究代表者

  • 伸縮性エレクトロニクスを用いた革新的超低侵襲リンパ浮腫診断装置

    2022年04月
    -
    2024年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 鈴木 悠史, 若手研究, 補助金,  研究代表者

  • Supermicrosurgical Parabiosisによる革新的若返り戦略

    2020年04月
    -
    2022年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 鈴木 悠史, 若手研究, 補助金,  研究代表者

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