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endoscopic ultrasound pancreatic cancer

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https://www.readbyqxmd.com/read/29116342/gastroenterology-and-pancreatic-adenocarcinoma-what-the-radiologist-needs-to-know
#1
Abhik Bhattacharya, Namita S Gandhi, Mark E Baker, Prabhleen Chahal
In this article, we review the information that radiologists need to know regarding the endoscopic approach to the diagnosis and management of pancreatic cancer. This includes a review of the indications, techniques, and complications of endoscopic ultrasound. We also review information regarding endoscopic retrograde cholangiopancreatography, including the various biliary drainage techniques and the use of endoscopic palliation for patients with pancreatic cancer.
November 7, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29101607/development-of-a-high-risk-pancreatic-screening-clinic-using-3-0%C3%A2-t-mri
#2
Chad A Barnes, Elizabeth Krzywda, Shannon Lahiff, Dena McDowell, Kathleen K Christians, Paul Knechtges, Parag Tolat, Mark Hohenwalter, Kulwinder Dua, Abdul H Khan, Douglas B Evans, Jennifer Geurts, Susan Tsai
Selective screening for pancreatic cancer (PC) has been proposed. We describe the establishment of a comprehensive multidisciplinary screening program using 3.0 T MRI. Criteria for screening included the presence of PC in: ≥ 2 first degree relatives (FDR), 1 FDR and 1 s degree relative (SDR), ≥ 3 any degree relatives (ADR), or any known hereditary cancer syndrome with increased PC risk. Imaging with 3.0 T MRI was performed routinely and endoscopic ultrasound was used selectively. Screening was completed in 75 patients (pts)...
November 3, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29081794/eus-morphology-is-reliable-in-selecting-patients-with-mucinous-pancreatic-cyst-s-most-likely-to-benefit-from-surgical-resection
#3
Siddharth Javia, Satish Munigala, Sushovan Guha, Banke Agarwal
BACKGROUND AND STUDY AIMS: Endoscopic ultrasound (EUS) surveillance of patients with mucinous pancreatic cysts relies on the assessment of morphologic features suggestive of malignant transformation. These criteria were derived from the evaluation of surgical pathology in patients with pancreatic cysts who underwent surgery. Reliability of these criteria when evaluated by EUS in identifying lesions which require surgery has still not been established. PATIENTS AND METHODS: This retrospective cohort study included seventy-eight patients who underwent surgical resection of pancreatic cysts based on EUS-FNA (fine-needle aspiration) findings suggestive of mucinous pancreatic cysts with concern for malignancy...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29070996/pancreatic-adenocarcinoma-masquerading-as-idiopathic-chronic-pancreatitis-with-delayed-diagnosis
#4
Sunil Badami, Htay Htay Kyi, Sunil Upadhaya, Samer Al Hadidi
Pancreatic cancer carries poor prognosis. Establishing the diagnosis early could help in improving outcome. We are presenting a case of pancreatic cancer with delayed diagnosis. Our 60-year-old patient underwent multiple endoscopic ultrasound-guided biopsies with no evidence of malignancy. He had normal molecular tumor biomarkers. The patient needed 8 months to receive the diagnosis and initiate the treatment. There are no specific guidelines regarding choice of tissue sampling modalities in such cases.
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29065734/comparison-of-22-gauge-standard-fine-needle-versus-core-biopsy-needle-for-endoscopic-ultrasound-guided-sampling-of-suspected-pancreatic-cancer-a-randomized-crossover-trial
#5
Dong Hyo Noh, Kyu Choi, Seonhye Gu, Juhee Cho, Kee-Taek Jang, Young Sik Woo, Kyu Taek Lee, Jong Kyun Lee, Kwang Hyuck Lee
BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is effective for tissue diagnosis of pancreatic mass. To improve diagnostic yield and drawbacks, 22-gauge (G) core biopsy (FNB) needle has been developed. This study aims to compare 22G FNA and FNB needles for EUS-guided sampling of suspected pancreatic cancer. METHODS: This is a randomized controlled crossover trial. A total of 60 patients with suspected unresectable pancreatic cancer referred for EUS-guided sampling were randomly assigned to two groups...
October 24, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29063873/future-role-of-endoscopic-ultrasound-in-personalized-management-of-pancreatic-cancer
#6
REVIEW
Marie Ooi, An Phan, Nam Q Nguyen
Pancreatic ductal adenocarcinoma (PDAC) is aggressive and lethal with the majority of cases presenting with advanced unresectable disease due to delayed diagnosis. Despite improvement in surgery, chemotherapies, and intensive care medicine, the outcome of PDAC remains poor, which may relate to the tumor biology. Recent data suggest that PDAC is a "systemic cancer" with complex molecular or genomics derangement with marked heterogeneity. The ability to characterize the PDAC better by detailed evaluation of tissue biomarkers or genomics allows for improved prediction of prognosis and stratification of treatment, a concept known as "personalized cancer therapy...
September 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29057146/light-scattering-spectroscopy-identifies-the-malignant-potential-of-pancreatic-cysts-during-endoscopy
#7
Lei Zhang, Douglas K Pleskow, Vladimir Turzhitsky, Eric U Yee, Tyler M Berzin, Mandeep Sawhney, Shweta Shinagare, Edward Vitkin, Yuri Zakharov, Umar Khan, Fen Wang, Jeffrey D Goldsmith, Saveli Goldberg, Ram Chuttani, Irving Itzkan, Le Qiu, Lev T Perelman
Pancreatic cancers are usually detected at an advanced stage and have poor prognosis. About one fifth of these arise from pancreatic cystic lesions. Yet not all lesions are precancerous, and imaging tools lack adequate accuracy for distinguishing precancerous from benign cysts. Therefore, decisions on surgical resection usually rely on endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Unfortunately, cyst fluid often contains few cells, and fluid chemical analysis lacks accuracy, resulting in dire consequences, including unnecessary pancreatic surgery for benign cysts and the development of cancer...
2017: Nature biomedical engineering
https://www.readbyqxmd.com/read/29051395/role-of-computer-tomography-and-endoscopic-ultrasonography-in-assessing-portal-and-superior-mesenteric-vessels-invasion-in-cephalo-pancreatic-adenocarcinoma
#8
Raluca Bodea, Andrada Seicean, Tudor Vasile, Tudor Calinici, Irina Ciuca, Nadim Al Hajjar, Cornel Iancu, Constantin Iordache
AIM: The aim of this study is to evaluate the information given by contrast-enhanced computer tomography (CECT) and ultrasound endoscopy (EUS) regarding vascular involvement of cephalo-pancreatic cancer, data compared with intraoperative findings. MATERIAL AND METHODS: We choose to analyze the most often interested vessels by tumor development, such as superior mesenteric artery (SMA), superior mesenteric vein (SMV) and portal vein (PV). The patients included in the study (n=425) had a cephalo-pancreatic tumor diagnosed in our Institute and a positive histology for pancreatic adenocarcinoma...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29045075/immunocytochemistry-for-sox-11-and-tfe3-as-diagnostic-markers-for-solid-pseudopapillary-neoplasms-of-the-pancreas-in-fna-biopsies
#9
Wen-Chi Foo, Grant Harrison, Xuefeng Zhang
BACKGROUND: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare malignant tumors that can be sampled via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Although diagnosing SPNs can be straightforward in cases with a classic morphology and a typical immunoprofile, challenges can occur with morphologic variants or limited specimens. Recently, 2 immunohistochemical stains, SRY-related high-mobility group box 11 (SOX-11) and transcription factor E3 (TFE3), have been demonstrated to be highly sensitive and specific for SPNs in pancreatic resection specimens...
November 2017: Cancer
https://www.readbyqxmd.com/read/29043580/a-comprehensive-assessment-of-accurate-lymph-node-staging-and-preoperative-detection-in-resected-pancreatic-cancer
#10
Toshiro Masuda, Amanda M Dann, Irmina A Elliott, Hideo Baba, Stephen Kim, Alireza Sedarat, V Raman Muthusamy, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
BACKGROUND: The current (seventh edition) American Joint Commission on Cancer (AJCC) Staging System for pancreatic ductal adenocarcinoma (PDAC) dichotomizes pathologic lymph node (LN) involvement into absence (pN0) or presence (pN1) of disease. The recently announced eighth edition also includes stratification on the number of positive nodes. Furthermore, LNs detected on preoperative imaging (CT, MRI, or endoscopic ultrasound-EUS) are considered to be pathologically involved in other gastrointestinal cancers...
October 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29042120/pilot-study-on-the-impact-of-f18-labeled-thymidine-pet-ct-on-gross-tumor-volume-identification-and-definition-for-pancreatic-cancer
#11
Jennifer L Pretz, Michael A Blake, Joseph H Killoran, Harvey J Mamon, Jennifer Y Wo, Andrew X Zhu, Theodore S Hong
PURPOSE: Accurate target definition for radiation therapy planning in localized pancreatic cancer is critical, particularly when using strategies that omit elective coverage. Standard imaging modalities such as computed tomography (CT), magnetic resonance imaging, and endoscopic ultrasound have limited concordance with pathologic evaluation. Biologic imaging with [F18]-fluorodeoxyglucose (FDG)-positron emission tomography (PET) can also be difficult to interpret because increased activity is indicative of increased glucose metabolism, rather than cellular proliferation...
September 18, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29029521/contrast-enhanced-endoscopic-ultrasound-for-differential-diagnosis-of-pancreatic-cancer-an-updated-meta-analysis
#12
Xing-Kang He, Yue Ding, Lei-Min Sun
AIM: We aim to assess the diagnostic value of contrast-enhanced endoscopic ultrasound (CE-EUS) for pancreatic cancer and inflammatory lesions by pooling current evidence. MATERIALS AND METHODS: A systematical search of PubMed, Web of Science and the Cochrane Library was performed from inception to January 2016. Two authors independently screened and extracted detailed data from included studies. A random effect model was adopted to estimate the pooled sensitivity, specificity in order to determine the diagnostic ablitity of CE-EUS...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28991562/imaging-and-screening-of-pancreatic-cancer
#13
REVIEW
Kristine S Burk, Grace C Lo, Michael S Gee, Dushyant V Sahani
Given the low disease prevalence of both exocrine and endocrine cancers in the general population, screening is not recommended. However, in as many as 25% of cases there is a precursor lesion or an identifiable genetic predisposition. For these patients at increased risk, screening with imaging is recommended. Multidetector computed tomography, MR imaging or magnetic resonance cholangiopancreatography, and endoscopic ultrasound examination can be used as screening modalities. Recent advances in dual energy CT and total body MR imaging have increased the suitability of these noninvasive modalities as first-line imaging screening options...
November 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28979722/pancreatic-adenosquamous-carcinoma-and-intraductal-papillary-mucinous-neoplasm-in-a-cdkn2a-germline-mutation-carrier
#14
Fernando Martínez de Juan, María Reolid Escribano, Carmen Martínez Lapiedra, Fernanda Maia de Alcantara, María Caballero Soto, Ana Calatrava Fons, Isidro Machado
A 69-year-old woman from a kindred with familial atypical multiple mole melanoma and carrier of a germline mutation in CDKN2A, presented with abdominal pain caused by a solid-cystic pancreatic mass. The patient had an abdominal computed tomography three years before in which there was no evidence of pancreatic lesion. The endoscopic ultrasound guided fine needle aspiration showed adenocarcinoma with squamous component. After surgical resection the final diagnosis was adenosquamous pancreatic carcinoma (ASPC) arising in an intraductal papillar mucinous neoplasm (IPMN)...
September 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28970734/how-to-treat-intestinal-obstruction-due-to-malignant-recurrence-after-whipple-s-resection-for-pancreatic-head-cancer-description-of-2-new-endoscopic-techniques
#15
Christina Mouradides, Alaa Taha, Ivan Borbath, Pierre H Deprez, Tom G Moreels
The prognosis of pancreatic cancer remains poor, even after initial surgical therapy. Local recurrence after Whipple's pancreatico-duodenectomy may lead to intestinal obstruction at the level of the afferent limb or the alimentary limb. Endoscopic insertion of a self-expandable metal stent (SEMS) into the intestinal malignant stricture is the preferred method of choice for palliation. We describe two new endoscopic techniques to treat a malignant intestinal obstruction with the insertion of a SEMS into the afferent limb and the alimentary limb...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28956176/bilateral-vs-unilateral-endoscopic-ultrasound-guided-celiac-plexus-neurolysis-for-abdominal-pain-management-in-patients-with-pancreatic-malignancy-a-systematic-review-and-meta-analysis
#16
REVIEW
Fan Lu, Jifu Dong, Yuming Tang, He Huang, Hui Liu, Li Song, Kexian Zhang
CONTEXT: Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) by bilateral or unilateral approach is widely used in palliative abdominal pain management in pancreatic cancer patients, but the analgesic effect and relative risks of the two different puncture routes remain controversial. OBJECTIVES: The aim of this systematic review was to evaluate the analgesic efficacy and safety of bilateral EUS-CPN compared with unilateral EUS-CPN. METHODS: An electronic database search was performed for randomized controlled trials comparing bilateral and unilateral approaches of EUS-CPN using the Pubmed, Cochrane Library, Web of Science, Google Scholar, and CNKI databases...
September 27, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28947138/speeding-towards-individualized-treatment-for-pancreatic-cancer-by-taking-an-alternative-road
#17
Juan Iovanna, Nelson Dusetti
Accumulation of genetic mutations drives the development of pancreatic ductal adenocarcinoma (PDAC). Contrary to what it is expected, however, genetic analyses, no matter how precise or detailed, do not allow the identification of patient groups with different clinical outcomes or the selection of specific treatments. In fact, clinical outcome and sensitivity to treatments are associated with a given phenotype and are therefore associated at a transcriptomic level. In practical terms, therefore, the most appropriate readout for phenotypically stratifying PDACs should be transcriptomic and not genetic analysis...
September 22, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28943075/a-novel-absorbable-radiopaque-hydrogel-spacer-to-separate-the-head-of-the-pancreas-and-duodenum-in-radiation-therapy-for-pancreatic-cancer
#18
Avani D Rao, Ziwei Feng, Eun Ji Shin, Jin He, Kevin M Waters, Stephanie Coquia, Robert DeJong, Lauren M Rosati, Lin Su, Dengwang Li, Juan Jackson, Stephen Clark, Jeffrey Schultz, Danielle Hutchings, Seong-Hun Kim, Ralph H Hruban, Theodore L DeWeese, John Wong, Amol Narang, Joseph M Herman, Kai Ding
PURPOSE: We assessed the feasibility and theoretical dosimetric advantages of an injectable hydrogel to increase the space between the head of the pancreas (HOP) and duodenum in a human cadaveric model. METHODS AND MATERIALS: Using 3 human cadaveric specimens, an absorbable radiopaque hydrogel was injected between the HOP and duodenum by way of open laparotomy in 1 case and endoscopic ultrasound (EUS) guidance in 2 cases. The cadavers were subsequently imaged using computed tomography and dissected for histologic confirmation of hydrogel placement...
August 14, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28928103/pancreatic-metastasis-from-non-small-cell-lung-cancer-diagnosed-using-endoscopic-ultrasound-guided-fine-needle-aspiration-biopsy-a-case-report
#19
Nobuyasu Kurihara, Hajime Saito, Hiroshi Nanjo, Hayato Konno, Yoshihiro Minamiya
A 56-year-old man presented with a chest computed tomography (CT) finding of a right upper lobe nodule, which was diagnosed using brush cytology as adenocarcinoma stage IB (cT2aN0M0). Repeat CT scan for preoperative evaluation revealed a small, slightly hypodense spot in the pancreatic body, which was diagnosed as pancreatic metastasis from lung cancer using endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). Because of the presence of distant metastasis, surgical resection was deferred and chemotherapy was chosen instead...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28879469/pancreatic-cancer-screening
#20
REVIEW
Koushik K Das, Dayna Early
PURPOSE OF REVIEW: This review describes the rationale for pancreatic cancer screening, outlines groups that are at elevated risk for pancreatic cancer, and summarizes the relative risk in each setting. We also review the methods available for performing pancreatic cancer screening and the recommended screening intervals. RECENT FINDINGS: Several genetic mutations have been identified that increase the risk for pancreatic cancer. Most are rare, however, and at-risk individuals are most often those with a strong family history of pancreatic cancer (with multiple family members affected) but no identifiable genetic mutation...
December 2017: Current Treatment Options in Gastroenterology
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