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https://www.readbyqxmd.com/read/27913839/the-ability-of-emergency-physicians-to-diagnose-and-score-acute-pancreatitis-on-computed-tomography
#1
A Karagöz, E E Ünlüer, O Oyar, F E Topal, F Topal
PURPOSE: The aim of this study is to determine the ability of emergency physicians' (EP) interpreting contrast-enhanced computed tomographies (CECTs) performed in patients diagnosed or suspected acute pancreatitis (AP), using the modified computed tomography severity index (MCTSI) scoring system. METHODS: This study was conducted in Training and Research Hospital's Emergency Department. From January 1, 2013 to April 30, 2016, patients whom performed CECT within 24 h of admission with diagnosis or suspicion of AP were reviewed retrospectively...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27906105/pancreatic-metastases-from-ocular-malignant-melanoma-the-use-of-endoscopic-ultrasound-guided-fine-needle-aspiration-to-establish-a-definitive-cytologic-diagnosis-a-case-report
#2
Diogo Turiani Hourneaux De Moura, Danielle Azevedo Chacon, Ryan Tanigawa, Martin Coronel, Spencer Cheng, Éverson L A Artifon, José Jukemura, Eduardo Guimarães Hourneaux De Moura
BACKGROUND: When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27904249/benign-biliary-strictures
#3
REVIEW
Ashley Altman, Steven M Zangan
Differentiating benign and malignant biliary strictures is a challenging and important clinical scenario. The typical presentation is indolent and involves elevation of liver enzymes, constitutional symptoms, and obstructive jaundice with or without superimposed or recurrent cholangitis. While overall the most common causes of biliary strictures are malignant, including cholangiocarcinoma and pancreatic adenocarcinoma, benign strictures encompass a wide spectrum of etiologies including iatrogenic, autoimmune, infectious, inflammatory, and congenital...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27900729/radical-resection-of-t1-pancreatic-adenocarcinoma-with-a-pseudocyst-of-the-tail-due-to-acute-obstructive-pancreatitis-report-of-a-case
#4
Yuki Fujiwara, Fumitake Suzuki, Masaru Kanehira, Yasuro Futagawa, Tomoyoshi Okamoto, Katsuhiko Yanaga
A 53-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a simple cyst of the pancreatic tail attached to the stomach. A distal main pancreatic duct (MPD) was clearly dilated, but no pancreatic tumor was identified around the stenosis of MPD by CT scan and magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde pancreatography (ERP) revealed stenosis and distal dilation of the MPD located between the body and tail of the pancreas...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27897432/low-skeletal-muscle-radiation-attenuation-and-visceral-adiposity-are-associated-with-overall-survival-and-surgical-site-infections-in-patients-with-pancreatic-cancer
#5
David P J van Dijk, Maikel J A M Bakens, Mariëlle M E Coolsen, Sander S Rensen, Ronald M van Dam, Martijn J L Bours, Matty P Weijenberg, Cornelis H C Dejong, Steven W M Olde Damink
BACKGROUND: Cancer cachexia and skeletal muscle wasting are related to poor survival. In this study, quantitative body composition measurements using computed tomography (CT) were investigated in relation to survival, post-operative complications, and surgical site infections in surgical patients with cancer of the head of the pancreas. METHODS: A prospective cohort of 199 patients with cancer of the head of the pancreas was analysed by CT imaging at the L3 level to determine (i) muscle radiation attenuation (average Hounsfield units of total L3 skeletal muscle); (ii) visceral adipose tissue area; (iii) subcutaneous adipose tissue area; (iv) intermuscular adipose tissue area; and (v) skeletal muscle area...
October 26, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27896518/analysis-of-predictors-of-resection-and-survival-in-locally-advanced-stage-iii-pancreatic-cancer-does-the-nature-of-chemotherapy-regimen-influence-outcomes
#6
Filip Bednar, Mazen S Zenati, Jennifer Steve, Sharon Winters, Lee M Ocuin, Nathan Bahary, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Locally advanced unresectable pancreatic cancer (LAPC) historically portends a poor prognosis. FOLFIRINOX and gemcitabine/nab-paclitaxel have proven effective in the metastatic setting. We sought to evaluate the outcomes of these regimens compared with older regimens in LAPC. METHODS: A retrospective, single institutional review of all consecutive LAPC treated with "new" (FOLFIRINOX and/or gemcitabine/nab-paclitaxel) and "old" (gemcitabine or 5-FU) chemotherapy from 2010 to 2014 was performed...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896509/shape-and-enhancement-characteristics-of-pancreatic-neuroendocrine-tumor-on-preoperative-contrast-enhanced-computed-tomography-may-be-prognostic-indicators
#7
Hirohisa Okabe, Daisuke Hashimoto, Akira Chikamoto, Morikatsu Yoshida, Katsunobu Taki, Kota Arima, Katsunori Imai, Yoshitaka Tamura, Osamu Ikeda, Takatoshi Ishiko, Hideaki Uchiyama, Toru Ikegami, Norifumi Harimoto, Shinji Itoh, Yo-Ichi Yamashita, Tomoharu Yoshizumi, Toru Beppu, Yasuyuki Yamashita, Hideo Baba, Yoshihiko Maehara
BACKGROUND: Prognostic indicators of the malignant potential of pancreatic neuroendocrine tumors (PNET) are limited. We assessed tumor shape and enhancement pattern on contrast-enhanced computed tomography as predictors of malignant potential. METHODS: Sixty cases of PNET patients undergoing curative surgery from 2001 to 2014 were enrolled onto our retrospective study. Preoperative enhanced CTs were assessed, and criteria defined for regularly shaped and enhancing tumors (group 1), and irregularly shaped and/or enhancing tumors (group 2)...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896469/ct-evaluation-after-neoadjuvant-folfirinox-chemotherapy-for-borderline-and-locally-advanced-pancreatic-adenocarcinoma
#8
Mathilde Wagner, Celia Antunes, Daniel Pietrasz, Christophe Cassinotto, Magaly Zappa, Antonio Sa Cunha, Oliver Lucidarme, Jean-Baptiste Bachet
AIM: To assess anatomic changes on computed tomography (CT) after neoadjuvant FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy for secondary resected borderline resectable (BR) and locally advanced (LA) pancreatic adenocarcinoma and their accuracy to predict resectability and pathological response. METHODS: Thirty-six patients with secondary resected BR/LA pancreatic adenocarcinoma after neoadjuvant FOLFIRINOX chemotherapy (± chemoradiotherapy) were retrospectively included...
November 28, 2016: European Radiology
https://www.readbyqxmd.com/read/27895425/folfirinox-in-elderly-patients-with-pancreatic-or-colorectal-cancer-tolerance-and-efficacy
#9
Jean-Florian Guion-Dusserre, Aurélie Bertaut, François Ghiringhelli, Julie Vincent, Valérie Quipourt, Sophie Marilier, Zoé Tharin, Leila Bengrine-Lefevre
AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m(2) intraveinous infusion over 46 h) repeated every 2 wk...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894508/intrapancreatic-accessory-spleen-ipas-a-single-institution-experience-and-review-of-the-literature
#10
Neal Bhutiani, Michael E Egger, Catherine A Doughtie, Elizabeth S Burkardt, Charles R Scoggins, Robert C G Martin, Kelly M McMasters
INTRODUCTION: Accessory spleens located within the pancreatic parenchyma (intrapancreatic accessory spleen, IPAS) pose a unique clinical challenge. In many cases, despite imaging and other diagnostic studies, malignancy cannot be excluded and patients are subjected to pancreatic resection. We review our experience with the presentation, diagnosis, and treatment of patients with IPAS to provide insight into improving pre-operative evaluation of these patients METHODS: A retrospective chart review identified seven patients who underwent surgical resection of an intrapancreatic spleen at University of Louisville Hospital between 2004 and 2015...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27893776/diagnostic-value-and-interreader-agreement-of-the-pancreaticolienal-gap-in-pancreatic-cancer-on-mdct
#11
Khoschy Schawkat, Wolfgang Kühn, Daniel Inderbitzin, Beat Gloor, Johannes T Heverhagen, Val Murray Runge, Andreas Christe
OBJECTIVE: The aim of this retrospective study was to evaluate the diagnostic value and measure interreader agreement of the pancreaticolienal gap (PLG) in the assessment of imaging features of pancreatic carcinoma (PC) on contrast-enhanced multi-detector computed tomography (CE-MDCT). MATERIALS AND METHODS: CE-MDCT studies in the portal venous phase were retrospectively reviewed for 66 patients with PC. The age- and gender-matched control group comprised 103 healthy individuals...
2016: PloS One
https://www.readbyqxmd.com/read/27891549/a-pilot-study-of-the-diagnostic-and-prognostic-values-of-flt-pet-ct-for-pancreatic-cancer-comparison-with-fdg-pet-ct
#12
Masatoyo Nakajo, Yoriko Kajiya, Atsushi Tani, Megumi Jinguji, Masayuki Nakajo, Tohru Nihara, Yoshihiko Fukukura, Takashi Yoshiura
PURPOSE: The purpose of the study was to examine the diagnostic and prognostic values of (18)F-fluorothymidine (FLT)-PET/CT for pancreatic cancer by comparing with (18)F-fluorodeoxyglucose (FDG)-PET/CT. METHODS: Fifteen patients with newly diagnosed pancreatic cancer underwent both FLT and FDG-PET/CT scans before treatment. The sensitivity, specificity, and accuracy in detecting nodal and distant metastases were compared between both scans using McNemar exact or χ (2) test...
November 28, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27891265/a-unique-case-of-pancreatic-mass-due-to-pancreatic-elastofibromatosis
#13
Abhinav Goyal, Deepanshu Jain, Ishfaq Bhat, Shailender Singh
Elastofibroma is a benign tumor of the musculoskeletal system characterized by the abnormal accumulation of elastinophilic fibers. It has been classically described for subscapular region but has been reported in several musculoskeletal sites over the years and rarely even in the GI tract but never in pancreas. We therefore present the case of a 45-year-old female who presented with intermittent abdominal pain. CT of abdomen revealed 1.4 cm pancreatic neck lesion without peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) guided FNA was nondiagnostic...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27891175/multidetector-computer-tomography-in-the-pancreatic-adenocarcinoma-assessment-an-update
#14
REVIEW
Vincenza Granata, Roberta Fusco, Orlando Catalano, Sergio Venanzio Setola, Elisabetta de Lutio di Castelguidone, Mauro Piccirillo, Raffaele Palaia, Roberto Grassi, Francesco Granata, Francesco Izzo, Antonella Petrillo
Ductal adenocarcinoma of the pancreas is one of the most aggressive forms of cancer, with only a minority of cases being resectable at the moment of their diagnosis. The accurate detection and characterization of pancreatic carcinoma is very important for patient management. Multidetector-row computed tomography (MDCT) has become the cross-sectional modality of choice in the diagnosis, staging, treatment planning, and follow-up of patients with pancreatic tumors. However, approximately 11% of ductal adenocarcinomas still remain undetected at MDCT because of the lack of attenuation gradient between the lesion and the adjacent pancreatic parenchyma...
2016: Infectious Agents and Cancer
https://www.readbyqxmd.com/read/27890912/performance-of-laparoscopic-pancreatoduodenectomy-for-solid-pseudopapillary-tumor-of-pancreas
#15
Orlando Jorge M Torres, José Maria A Moraes Junior, Anmara Moura Moraes, Camila Cristina S Torres, Antonio Talvane T Oliveira
BACKGROUND Solid pseudopapillary tumor of the pancreas (Frantz tumor) is a rare, low-grade malignant neoplasm. Laparoscopic pancreatoduodenectomy is a good approach for tumors located in the pancreatic head. We present two successful cases in young women. CASE REPORT A 19-year-old woman was admitted to Department of Digestive Surgery due to epigastric pain, nausea, and vomiting. Computed tomography scan of the abdomen was performed, and a 3.0×2.2 cm solid tumor localized in the head of the pancreas was observed...
November 28, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27890421/contrast-enhanced-mdct-in-patients-with-pancreatic-neuroendocrine-tumours-correlation-with-histological-findings-and-diagnostic-performance-in-differentiation-between-tumour-grades
#16
E Belousova, G Karmazanovsky, A Kriger, D Kalinin, L Mannelli, A Glotov, N Karelskaya, O Paklina, A Kaldarov
AIM: To identify the multidetector computed tomography (MDCT) features of pancreatic neuroendocrine tumours (pNETs), which correlate with tumour histology and enable preoperative grading. MATERIALS AND METHODS: Thirty-nine patients with histologically confirmed pNET who underwent preoperative contrast-enhanced MDCT were included in this study. Nineteen tumours were classified as Grade 1 (G1) and 20 as Grade 2 (G2). Histopathology slides were reviewed to assess the intratumoural microvascular density (MVD) and the amount of tumour stroma...
November 24, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27887016/inferior-vena-caval-filter-strut-perforation-causing-intramural-duodenal-haematoma
#17
Zoheb Berry Williams, Nicole M Organ, Stephen Deane
We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27885893/tumor-vessel-relationships-in-pancreatic-ductal-adenocarcinoma-at-multidetector-ct-different-classification-systems-and-their-influence-on-treatment-planning
#18
Ahmed M Zaky, Christopher L Wolfgang, Matthew J Weiss, Ammar A Javed, Elliot K Fishman, Atif Zaheer
Treatment of pancreatic ductal adenocarcinoma (PDAC) remains a challenge, given its propensity for early systemic spread and growth into the adjacent vital vascular structures. With the advent of newer surgical techniques and chemoradiation therapies, multidetector computed tomography (CT) plays a crucial role in the identification of patients with borderline resectable disease who may benefit from such treatments. Stage III PDAC is divided into two categories-locally advanced, defined by arterial encasement or nonreconstructible portovenous axis involvement; and borderline resectable, defined by limited arterial involvement and/or reconstructible portovenous involvement...
November 25, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#19
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
November 25, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27885864/probabilistic-treatment-planning-for-pancreatic-cancer-treatment-prospective-incorporation-of-respiratory-motion-shows-only-limited-dosimetric-benefit
#20
Eelco Lens, Alexis N T J Kotte, Ajay Patel, Hanne D Heerkens, Matthieu Bal, Geertjan van Tienhoven, Arjan Bel, Astrid van der Horst, Gert J Meijer
BACKGROUND: We introduced a probabilistic treatment planning approach that prospectively incorporates respiratory-induced motion in the treatment plan optimization. The aim of this study was to determine the potential dosimetric benefit by comparing this approach to the use of an internal target volume (ITV). MATERIAL AND METHOD: We retrospectively compared the probabilistic respiratory motion-incorporated (RMI) approach to the ITV approach for 18 pancreatic cancer patients, for seven simulated respiratory amplitudes from 5 to 50 mm in the superior-inferior (SI) direction...
November 25, 2016: Acta Oncologica
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