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Predictive value of multi-detector computed tomography for accurate diagnosis of serous cystadenoma:Radiologic-pathologic correlation

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World Journal of Gastroenterology 2009年第22期15卷 2739-2747页

作者： Anjuli A Shah Nisha I Sainani Avinash Kambadakone Ramesh Zarine K Shah Vikram Deshpande Peter F Hahn Dushyant V Sahani Department of radiology Division of Abdominal Imaging and Interventional RadiologyWhite Bldg.270Massachusetts General Hospital Department of Pathology Massachusetts General Hospital

AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.

关键词： Pancreas Serous cystadenoma Multidetector computed tomography Central scar Lobulations Microcystic

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Treatment of SMA type 1 infants using a single-dose AAV9-mediated gene therapy via intrathecal injection of GC101: An open-label, single-arm study

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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 9页

作者： Ma Xiuwei Zhuang Lu Ma Wenhao Li Jun Wang Xiaodong Li Zhongqiu Jiang Xinyang Wang Yongxia Du Ying Zhang Yingqian He Fang Zhu Zhiming Du Shaopeng Xu Juan Gu Ruijie Zhang Yanping Zhang Shan Li Ting Yang Xiao Zhang Sheng Zhu Lina Li Qiuping Dong Xiaoyan Wu Xiaobing Feng Zhichun Department of Neurodevelopment Faculty of Pediatrics The Seventh Medical Center of Chinese PLA General Hospital Beijing China National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology Beijing China Research and Development division Genecradle Therapeutics Inc. Beijing China Medical division Genecradle Therapeutics Inc. Beijing China Department of Pharmacy Medical Supplies Center of Chinese PLA General Hospital Beijing China Beijing Key Laboratory of pediatric Organ Failure Beijing China

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Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation

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World Journal of Gastroenterology 2017年第20期23卷 3690-3701页

作者： Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli division of Hepatobiliary and Transplant Surgery Department of Experimental and Clinical MedicinePolytechnic University of Marche division of general and pediatric radiology Department of Radiological SciencesPolytechnic University of Marche division of Interventional radiology Department of Radiological SciencesPolytechnic University of Marche division of Pathology Department of PathologyPolytechnic University of Marche division of radiology Department of RadiologyMemorial Sloan Kettering Cancer Center

To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological *** to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before

关键词： Liver transplantation Recurrence-free survival Hepatocellular carcinoma Radiological response Locoregional therapies Inflammatory markers Selection criteria

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New approaches for precise response evaluation in hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第12期20卷 3059-3068页

作者： Koichi Hayano Jorge M Fuentes-Orrego Dushyant V Sahani division of Abdominal Imaging and Intervention Department of RadiologyMassachusetts General Hospital

With the increasing clinical use of cytostatic and novel biologic targeted agents,conventional morphologic tumor burden assessments,including World Health Organization criteria and Response Evaluation Criteria in Solid Tumors,are confronting limitations because of their difficulties in distinguishing viable tumor from necrotic or fibrotic ***,the investigation for reliable quantitative biomarkers of therapeutic response such as metabolic imaging or functional imaging has been *** this review,we will discuss the conventional and new approaches to assess tumor *** targeted therapy or locoregional therapies can induce biological changes much earlier than morphological changes,these functional tumor burden analyses are very ***,some of them have not gone thorough all steps for standardization and ***,these new techniques and criteria will play an important role in the cancer management,and provide each patient more tailored therapy.

关键词： Hepatocellular carcinoma World Health Organization criteria Response Evaluation Criteria in Solid Tumors European Association for the Study of Liver Computed tomography perfusion Dynamic contrast-enhanced-magnetic resonance imaging Diffusion-weighted imaging Positron emission tomography

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Assessment of bone turnover and bone quality in type 2 diabetic bone disease： current concepts and future directions

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Bone Research 2016年第1期4卷 1-9页

作者： Mishaela R Rubin Janina M Patsch Metabolic Bone Disease Unit Department of Medicine Columbia University College of P&S New York USA division of general radiology and pediatric radiology Department of Biomedical Imaging and Image-Guided Therapy Medical University of Vienna Vienna Austria

Substantial evidence exists that in addition to the well-known complications of diabetes, increased fracture risk is an important morbidity. This risk is probably due to altered bone properties in diabetes. Circulating biochemical markers of bone turnover have been found to be decreased in type 2 diabetes （T2D） and may be predictive of fractures independently of bone mineral density （BMD）. Serum sclerostin levels have been found to be increased in T2D and appear to be predictive of fracture risk independent of BMD. Bone imaging technologies, including trabecular bone score （TBS） and quantitative CT testing have revealed differences in diabetic bone as compared to non-diabetic individuals. Specifically, high resolution peripheral quantitative CT （HRpQCT） imaging has demonstrated increased cortical porosity in diabetic postmenopausal women. Other factors such as bone marrow fat saturation and advanced glycation endproduct （AGE） accumulation might also relate to bone cell function and fracture risk in diabetes. These data have increased our understanding of how T2D adversely impacts both bone metabolism and fracture risk.

关键词： bone Assessment of bone turnover and bone quality in type 2 diabetic bone disease type

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International consensus guidelines on robotic pancreatic surgery in 2023

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 89-104页

作者： Rong Liu Mohammed Abu Hilal Marc G.Besselink Thilo Hackert Chinnusamy Palanivelu Yupei Zhao Jin He Ugo Boggi Jin-Young Jang Fabrizio Panaro Brian K.P.Goh Mikhail Efanov Yuichi Nagakawa Hong-Jin Kim Xiaoyu Yin Zhiming Zhao Yi-Ming Shyr Shridhar Iyer Eli Kakiashvili Ho-Seong Han Jae Hoon Lee Roland Croner Marco Vito Marino Arun Prasad Wei Wang Songqing He Kehu Yang Qu Liu Zizheng Wang Mengyang Li Shuai Xu Kongyuan Wei Zhaoda Deng Yuze Jia Tess M.E.van Ramshorst Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of Surgery Poliambulanza Foundation HospitalBresciaItaly Department of Surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Amsterdam UMC location University of AmsterdamDepartment of SurgeryAmsterdamThe Netherlands Cancer Center Amsterdam AmsterdamThe Netherlands Department of general Visceral and Thoracic SurgeryUniversity Hospital Hamburg-EppendorfHamburgGermany Department of Minimal Invasive Hernia Surgery GEM Hospital and Research CentreChennaiTamil NaduIndia Department of general Surgery Peking Union Medical College Hospital BeijingBeijingChina Department of Surgery Johns Hopkins University School of MedicineBaltimoreMDUSA division of general and Transplant Surgery University of PisaPisaItaly Department of Surgery Seoul National University HospitalSeoul National University College of MedicineSeoulKorea Department of Surgery/division of HBP Surgery&Transplantation University of MontpellierMontpellierFrance Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Department of Gastrointestinal and pediatric Surgery Tokyo Medical UniversityShinjukuTokyoJapan Department of Surgery Yeungnam University College of MedicineDaeguKorea Department of Pancreato-Biliary Surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina 18 division of Hepatobiliary Pancreatic Surgery and Liver TransplantationNational University HospitalSingaporeSingapore Department of Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-siKorea division of Hepato-Biliary and Pancreatic Surgery Department of SurgeryAsan Medical Cente

Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the ***,evidence-based guidelines regarding its application,safety,and efficacy are still *** harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of ***:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the *** online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved *** the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus ***:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the ***:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social *** randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.

关键词： Robotic surgery guidelines pancreatectomy pancreaticoduodenectomy distal pancreatectomy(DP)

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Autoimmune pancreatitis in the context of IgG4-related disease:Review of imaging findings

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World Journal of Gastroenterology 2014年第41期20卷 15177-15189页

作者： Leslie K Lee Dushyant V Sahani division of Abdominal Imaging and Intervention Department of RadiologyMassachusetts General HospitalHarvard Medical School

Current understanding of autoimmune pancreatitis (AIP) recognizes a histopathological subtype of the disease to fall within the spectrum of IgG4-related disease. Along with clinical, laboratory, and histopathological data, imaging plays an important role in the diagnosis and management of AIP, and more broadly, within the spectrum of IgG4-related disease. In addition to the defined role of imaging in consensus diagnostic protocols, an array of imaging modalities can provide complementary data to address specific clinical concerns. These include contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging for pancreatic parenchymal lesion localization and characterization, endoscopic retrograde and magnetic resonance cholangiopancreatography (ERCP and MRCP) to assess for duct involvement, and more recently, positron emission tomography (PET) imaging to assess for extra-pancreatic sites of involvement. While the imaging appearance of AIP varies widely, certain imaging features are more likely to represent AIP than alternate diagnoses, such as pancreatic cancer. While nonspecific, imaging findings which favor a diagnosis of AIP rather than pancreatic cancer include: delayed enhancement of affected pancreas, mild dilatation of the main pancreatic duct over a long segment, the “capsule” and “penetrating duct” signs, and responsiveness to corticosteroid therapy. Systemic, extra-pancreatic sites of involvement are also often seen in AIP and IgG4-related disease, and typically respond to corticosteroid therapy. Imaging by CT, MR, and PET also play a role in the diagnosis and monitoring after treatment of involved sites.

关键词： Autoimmune pancreatitis IgG4-related disease Pancreatic cancer Imaging Computed tomography Magnetic resonance Positron emission tomography Review

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Intrahepatic cholestasis without jaundice

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Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 103-105页

作者： Thomas Namdar Andreas Raffel Stefan Andreas Topp Jan Schulte am Esch Günther Fürst Wolfram Trudo Knoefel Claus Ferdinand Eisenberger Department of general Visceral and Pediatric Surgery Heinrich-Heine University Institute of Diagnostic radiology Heinrich-Heine University

BACKGROUND:Cholangiocarcinoma(CC),the most common biliary tract malignancy,is frequently seen in advanced unresectable stages and is typically localized *** diagnosis is unusual because of nonspecific *** jaundice is usually the first sign of tumor. METHOD:We present a patient with a CC(Klatskin tumor) with a complete biliary drainage by an aberrant bile duct without jaundice. RESULTS:A 67-year-old woman presented with persisting elevation of liver *** tests showed a Klatskin tumor typeⅡ.A curative right hepatic trisegmentectomy was performed after liver volume augmentation by preoperative vein embolization. CONCLUSIONS:A direct drainage of the right posterior bile duct into the common bile duct as an aberrant hepatic duct is a rare variation and is present in less than 5%of the *** case of persistently perturbed liver function tests,an aberrant bile duct can cover up severe intrahepatic cholestasis and even obscure the diagnosis of a Klatskin *** to now it has not been described in the literature.

关键词： Klatskin tumor hyperbilirubinemia cholangiocarcinoma

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Unusual gastric tumors and tumor-like lesions: Radiological with pathological correlation and literature review

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World Journal of Gastroenterology 2017年第14期23卷 2493-2504页

作者： Yuan-Mao Lin Nai-Chi Chiu Anna Fen-Yao Li Chien-An Liu Yi-Hong Chou Yi-You Chiou division of Gastrointestinal radiology Department of RadiologyTaipei Veterans General Hospital Faculty of Medicine School of MedicineNational Yang-Ming University Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital

Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography(MDCT), with water as a negative oral contrast agent and intravenous contrast medium, can provide critical information for the diagnosis of gastric diseases. In addition, MDCT can evaluate the involvement of the gastric wall and extragastric extent of the disease, as compared with gastroenteroscopy and double-contrast upper gastrointestinal study. Regarding lesion location and size, enhancing and growth patterns, presence of calcification or fat, and involvement of the gastric wall and adjacent structures, CT may provide useful information. In this review article, we review the relevant literature and discuss the CT features and the histopathologic findings of different types of gastric lesions. The lesions are divided into benign(glomus tumors, schwannomas, leiomyomas, and lipomas), malignant(gastrointestinal stromal tumors, mucinous carcinomas, lymphomas, and carcinoid tumors), and tumor-like lesions(ectopic pancreas and bezoar). Familiarity with imaging appearances and pathologic findings can help physicians make an accurate diagnosis.

关键词： Multidetector computed tomography stomach neoplasm adenocarcinoma carcinoid lymphoma lipoma glomus tumor heterotopic pancreas schwannoma gastrointestinal submucosal tumor leiomyoma bezoar

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Fetal lung growth predicts the risk for early-life respiratory infections and childhood asthma

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World Journal of pediatrics 2024年第5期20卷 481-495页

作者： Dimitra E.Zazara Olympia Giannou Steven Schepanski Mirja Pagenkemper Anastasios D.Giannou Maike Pincus Ioannis Belios Stefan Bonn Ania C.Muntau Kurt Hecher Anke Diemert Petra Clara Arck division for Experimental Feto-Maternal Medicine Department of Obstetrics and Fetal MedicineUniversity Medical Center Hamburg-Eppendorf(UKE)Martinistraße 5220251HamburgGermany University Children’s Hospital UKEHamburgGermany Computer Engineering and Informatics Department Polytechnic SchoolUniversity of PatrasPatrasGreece Institute of Developmental Neurophysiology Center for Molecular Neurobiology Hamburg(ZMNH)UKEHamburgGermany Department of Obstetrics and Fetal Medicine UKEHamburgGermany Department of general Visceral and Thoracic SurgeryUKEHamburgGermany Section of Molecular Immunology and Gastroenterology Ⅰ.Department of MedicineUKEHamburgGermany pediatrics and pediatric Pneumology Practice BerlinGermany Institute of Medical Systems Biology ZMNHUKEHamburgGermany Hamburg Center for Translational Immunology UKEHamburgGermany

Background Early-life respiratory infections and asthma are major health burdens during *** predicting an increased risk for early-life respiratory diseases are ***,we identified the predictive value of ultrasound-monitored fetal lung growth for the risk of early-life respiratory infections and *** Fetal lung size was serially assessed at standardized time points by transabdominal ultrasound in pregnant women participating in a pregnancy *** between fetal lung growth and respiratory infections in infancy or early-onset asthma at five years were ***-learning models relying on extreme gradient boosting regressor or classifier algorithms were developed to predict respiratory infection or asthma risk based on fetal lung *** model development and validation,study participants were randomly divided into a training and a testing group,respectively,by the employed *** Enhanced fetal lung growth throughout pregnancy predicted a lower early-life respiratory infection *** sex was associated with a higher risk for respiratory infections in *** lung growth could also predict the risk of asthma at five years of *** designed three machine-learning models to predict the risk and number of infections in infancy as well as the risk of early-onset *** models’R2 values were 0.92,0.90 and 0.93,respectively,underscoring a high accuracy and agreement between the actual and predicted *** variables included known risk factors and novel predictors,such as ultrasound-monitored fetal lung *** Sonographic monitoring of fetal lung growth allows to predict the risk for early-life respiratory infections and asthma.

关键词： Asthma Child risk Early-life respiratory infections Prenatal lung development Sexual dimorphism

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