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endoscopic ultrasound pancreatic cancer

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https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#1
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
https://www.readbyqxmd.com/read/28511234/indications-results-and-clinical-impact-of-endoscopic-ultrasound-eus-guided-sampling-in-gastroenterology-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline-updated-january-2017
#2
Jean-Marc Dumonceau, Pierre H Deprez, Christian Jenssen, Julio Iglesias-Garcia, Alberto Larghi, Geoffroy Vanbiervliet, Guruprasad P Aithal, Paolo G Arcidiacono, Pedro Bastos, Silvia Carrara, László Czakó, Gloria Fernández-Esparrach, Paul Fockens, Àngels Ginès, Roald F Havre, Cesare Hassan, Peter Vilmann, Jeanin E van Hooft, Marcin Polkowski
For pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In the case of negative or inconclusive results and a high degree of suspicion of malignant disease, ESGE suggests re-evaluating the pathology slides, repeating EUS-guided sampling, or surgery.Weak recommendation, low quality evidence...
May 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/28502930/branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-involving-type-1-localized-autoimmune-pancreatitis-with-normal-serum-igg4-levels-successfully-diagnosed-by-endoscopic-ultrasound-guided-fine-needle-aspiration-and-treated-without-pancreatic
#3
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Hiroaki Kusunose, Toshitaka Sakai, Toji Murabayashi, Sho Hasegawa, Fumisato Kozakai, Jun Horaguchi, Takashi Sawai
We herein report a 68-year-old man with branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMNs) involving type 1 localized autoimmune pancreatitis (AIP) with normal serum IgG4 levels. Although he was referred to our medical center due to suspicion of pancreatic cancer concomitant with BD-IPMNs, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) revealed a mass suspected of being pancreatic cancer to be type 1 AIP. Steroid administration notably reduced the mass. Although the clinical diagnosis of pancreatic masses in patients with IPMN can be occasionally challenging, performing a pathological examination by EUS-FNA may prevent unnecessary pancreatic surgery in cases of possible AIP...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28489536/dual-frequency-piezoelectric-endoscopic-transducer-for-imaging-vascular-invasion-in-pancreatic-cancer
#4
Brooks D Lindsey, Jinwook Kim, Paul A Dayton, Xiaoning Jiang
Cancers of the pancreas have the poorest prognosis among all cancers, as many tumors are not detected until surgery is no longer a viable option. Surgical viability is typically determined via endoscopic ultrasound imaging. However, many patients who may be eligible for resection are not offered surgery due to diagnostic challenges in determining vascular or lymphatic invasion. In this article, we describe the development of a dual-frequency piezoelectric transducer for rotational endoscopic imaging designed to transmit at 4 MHz and receive at 20 MHz in order to image microbubble-specific superharmonic signals...
May 8, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28465092/biliary-plastic-stent-does-not-influence-the-accuracy-of-endoscopic-ultrasound-guided-sampling-of-pancreatic-head-masses-performed-with-core-biopsy-needles
#5
Filippo Antonini, Lorenzo Fuccio, Sara Giorgini, Carlo Fabbri, Leonardo Frazzoni, Marina Scarpelli, Giampiero Macarri
OBJECTIVE: While the presence of biliary stent significantly decreases the accuracy of endoscopic ultrasound (EUS) for pancreatic head cancer staging, its impact on the EUS-guided sampling accuracy is still debated. Furthermore, data on EUS-fine needle biopsy (EUS-FNB) using core biopsy needles in patients with pancreatic mass and biliary stent are lacking. The aim of this study was to evaluate the influence of biliary stent on the adequacy and accuracy of EUS-FNB in patients with pancreatic head mass...
April 15, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28450086/kras-mutation-testing-on-all-non-malignant-diagnosis-of-pancreatic-endoscopic-ultrasound-guided-fine-needle-aspiration-biopsies-improves-diagnostic-accuracy
#6
Elena Trisolini, Elia Armellini, Alessia Paganotti, Claudia Veggiani, Cristina Bozzola, Milo Frattini, Corinna Pizio, Giuseppe Mancuso, Silvano Andorno, Renzo Boldorini
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the procedure of choice for the cytologic diagnosis of pancreatic masses. The specificity of EUS-FNA approaches 100%, but the sensitivity is still low, and the high rate of indeterminate (atypical and suspicious) and false-negative results needs improvement. KRAS gene is frequently mutated in pancreatic ductal adenocarcinoma (PDAC) (up to 90%), and mutation analysis of KRAS has been proposed as diagnostic biomarker of PDAC. In most laboratories, KRAS mutation testing is performed by Sanger sequencing or real time-quantitative polymerase chain reaction (RT-qPCR), but these methods may give false-negative results in routine samples, mainly due to low cellularity...
April 24, 2017: Pathology
https://www.readbyqxmd.com/read/28415140/imaging-modalities-for-characterising-focal-pancreatic-lesions
#7
REVIEW
Lawrence Mj Best, Vishal Rawji, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Increasing numbers of incidental pancreatic lesions are being detected each year. Accurate characterisation of pancreatic lesions into benign, precancerous, and cancer masses is crucial in deciding whether to use treatment or surveillance. Distinguishing benign lesions from precancerous and cancerous lesions can prevent patients from undergoing unnecessary major surgery. Despite the importance of accurately classifying pancreatic lesions, there is no clear algorithm for management of focal pancreatic lesions...
April 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28378082/diagnostic-performance-of-endoscopic-ultrasound-for-detection-of-pancreatic-malignancy-following-an-indeterminate-multidetector-ct-scan-a-systemic-review-and-meta-analysis
#8
Somashekar G Krishna, Bhavana B Rao, Emmanuel Ugbarugba, Zarine K Shah, Alecia Blaszczak, Alice Hinton, Darwin L Conwell, Phil A Hart
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis in part due to delayed diagnosis. Even with advances in cross-sectional imaging, small pancreatic malignancies can be missed. We sought to determine the performance of endoscopic ultrasound (EUS) in those without an obvious mass on multi-detector CT scan (MDCT), but with clinical suspicion for pancreatic malignancy. METHODS: Multiple databases were systematically searched to identify studies that assessed the diagnostic performance of EUS after negative or inconclusive pancreatic protocol MDCT for detection of pancreatic malignancy when clinically suspected...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28343174/mirna-analysis-in-pancreatic-cancer-the-dartmouth-experience
#9
REVIEW
Francine B de Abreu, Xiaoying Liu, Gregory J Tsongalis
Pancreatic cancer is considered one of the most lethal cancers being the fourth leading cause of cancer deaths in adults in the United States because of the lack of early signs and symptoms and the lack of early detection. Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type among pancreatic cancers, representing 80%-90% of all solid tumors of the pancreas. The majority of PDAC develops from three precursor lesions: pancreatic intraepithelial neoplasia, intraductual papillary mucinous neoplasm and mucinous cystic neoplasm...
May 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28338114/molecular-analysis-of-vascular-endothelial-growth-factor-vegf-receptors-in-eus-guided-samples-obtained-from-patients-with-pancreatic-adenocarcinoma
#10
Madalin Ionut Costache, Sevastita Iordache, Cornelia Alexandra Costache, Ene Dragos, Alexandru Dragos, Adrian Saftoiu
BACKGROUND AND AIMS: Vascular endothelial growth factor (VEGF) and its receptors (VEGF-R1 and VEGF-R2) are the most important angiogenesis stimulating factors in pancreatic cancer. This study aims to assess VEGF-R1 and VEGF-R2 gene expression in EUS-FNA samples and identify prognostic markers in pancreatic adenocarcinoma. METHODS: This was a retrospective study of prospectively collected data of 88 consecutive patients, with clinical and imaging suspicion of pancreatic neoplasms, based on samples obtained through endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28321355/a-rare-presentation-of-sarcoidosis-as-a-pancreatic-head-mass
#11
Shruti Mony, Pradnya D Patil, Rebekah English, Ananya Das, Daniel A Culver, Tanmay S Panchabhai
Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28317015/evaluation-of-the-2015-aga-guidelines-on-pancreatic-cystic-neoplasms-in-a-large-surgically-confirmed-multicenter-cohort
#12
Phillip S Ge, V Raman Muthusamy, Srinivas Gaddam, Diana-Marie Jaiyeola, Stephen Kim, Alireza Sedarat, Timothy R Donahue, Lindsay Hosford, Robert H Wilson, David P Grande, Rajesh N Keswani, Vladimir M Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Srinadh Komanduri, Sachin Wani, Rabindra R Watson
Background and study aims The American Gastroenterological Association (AGA) recently published guidelines for the management of asymptomatic pancreatic cystic neoplasms (PCNs). We aimed to evaluate the diagnostic characteristics of the AGA guidelines in appropriately recommending surgery for malignant PCNs. Patients and methods A retrospective multicenter study was performed of patients who underwent endoscopic ultrasound (EUS) for evaluation of PCNs who ultimately underwent surgical resection from 2004 - 2014...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28250896/endoscopy-guided-ablation-of-pancreatic-lesions-technical-possibilities-and-clinical-outlook
#13
REVIEW
Marianna Signoretti, Roberto Valente, Alessandro Repici, Gianfranco Delle Fave, Gabriele Capurso, Silvia Carrara
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28238191/two-cases-of-resectable-pancreatic-cancer-diagnosed-by-open-surgical-biopsy-after-endoscopic-ultrasound-fine-needle-aspiration-failed-to-yield-diagnosis-case-reports
#14
Reishi Toshiyama, Takehiro Noda, Hidetoshi Eguchi, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Yutaka Takeda, Masahiro Tanemura, Eiichi Morii, Koji Umeshita, Masaki Mori, Yuichiro Doki
BACKGROUND: Tumor biopsy for histological diagnosis is required preoperatively and before initiating chemotherapy or radiation therapy for patients with pancreatic cancer (Cancer of the Pancreas: Clinical Practice Guidelines, European Society for Medical Oncology). Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is widely applied to obtain tissue samples for histological examination. However, in some cases, EUS-FNA cannot be performed safely or tissue samples are insufficient to establish a definitive diagnosis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28229252/pain-in-patients-with-pancreatic-cancer-prevalence-mechanisms-management-and-future-developments
#15
REVIEW
Andreas I Koulouris, Paul Banim, Andrew R Hart
Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence...
April 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28208932/spontaneous-rupture-of-the-main-pancreatic-duct-synchronous-with-a-multi-focal-microscopic-pancreatic-adenocarcinoma-a-case-report
#16
Shirly Shohat, Katerina Shulman, Boris Kessel, Oren Gal, Abdel Rauf Zeina
Pancreatic cancer is one of the most lethal types of malignant tumours, commonly diagnosed at an advanced stage. The only curative treatment for this fatal disease is surgery and early diagnosis is the key to a better outcome and prognosis. In this case report we present a 57-year-old woman presenting to the emergency room with abdominal pain and weight loss. Computer Tomography (CT) imaging showed a rupture of the main pancreatic duct and a peri-pancreatic fluid collection with no evidence of a pancreatic mass...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28198009/endoscopic-ultrasound-guided-fine-needle-aspirate-derived-preclinical-pancreatic-cancer-models-reveal-panitumumab-sensitivity-in-kras-wild-type-tumors
#17
William Berry, Elizabeth Algar, Beena Kumar, Christopher Desmond, Michael Swan, Brendan J Jenkins, Daniel Croagh
Pancreatic cancer (PC) is largely refractory to existing therapies used in unselected patient trials, thus emphasizing the pressing need for new approaches for patient selection in personalized medicine. KRAS mutations occur in 90% of PC patients and confer resistance to epidermal growth factor receptor (EGFR) inhibitors (e.g., panitumumab), suggesting that KRAS wild-type PC patients may benefit from targeted panitumumab therapy. Here, we use tumor tissue procured by endoscopic ultrasound-guided fine-needle aspirate (EUS-FNA) to compare the in vivo sensitivity in patient-derived xenografts (PDXs) of KRAS wild-type and mutant PC tumors to panitumumab, and to profile the molecular signature of these tumors in patients with metastatic or localized disease...
May 15, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28184053/gastrointestinal-diseases-and-their-oro-dental-manifestations-part-4-peutz-jeghers-syndrome
#18
S E Korsse, M E van Leerdam, E Dekker
Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant inherited disorder, caused by germline mutations in the LKB1 tumour suppressor gene. It is clinically characterised by distinct perioral mucocutaneous pigmentations, gastrointestinal polyposis and an increased cancer risk in adult life. Hamartomatous polyps can develop already in the first decade of life and may cause various complications, including abdominal pain, bleeding, anaemia, and acute intestinal obstruction. Furthermore, patients have an increased risk for developing cancer, both in the gastrointestinal tract as in other organs...
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28171697/endoscopic-ultrasonography-guided-tumor-ablation
#19
REVIEW
Sundeep Lakhtakia, Dong-Wan Seo
Real-time guidance of needle advancement has transformed endoscopic ultrasound (EUS) from a diagnostic to an interventional procedure. EUS-guided fine-needle puncture has application in various interventional procedures (drainage of pseudocyst, biliary intervention, and injection of drugs). Celiac plexus or ganglion neurolysis for pain control is the major current EUS-guided fine-needle injection procedure. Feasibility and safety to accurately position needle devices and/or inject under real-time EUS imaging with precise delivery of interventional agent have expanded the use of EUS to ablate tumors...
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28160344/endoscopic-ultrasound-guided-celiac-plexus-block-and-neurolysis
#20
REVIEW
Ichiro Yasuda, Hsiu-Po Wang
Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is widely used for reducing pain originating from upper abdominal organs. It is mainly indicated to treat pancreatic cancer pain, but also to relieve pain as a result of chronic pancreatitis. Real-time guidance and color Doppler imaging by EUS made the procedure easier and safer, resulting in greater pain relief. Currently, two techniques are used for EUS-CPN. The classic approach, known as the central technique, involves injection of a neurolytic agent at the base of the celiac axis...
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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