Value of spectral detector computed tomography for assessment of pancreatic lesions

This study examined whether a novel, detector-based spectral CT scanner (SDCT) may improve subjective assessment of different types of pancreatic lesions and if various quantitative maps may improve lesion contrast and differentiation.Materials and methods61 consecutive patients who underwent clinical, contrast-agent enhanced, abdominal SDCT scans and showed pancreatic lesions of different origins were included. Subjective image analysis was performed by two readers who assessed image quality, lesion conspicuity and diagnostic confidence on 5-point Likert scales for conventional polyenergetic reconstructions (polyE), virtual monoenergetic images (monoE), virtual non-contrast images, iodine density, iodine overlay, and Z effective (Zeff) maps. Two readers acquired quantitative values from these maps ROI-based from which contrast-to-noise and lesion-to-parenchyma ratios were calculated.ResultsMonoE images at low keV levels yielded highest Likert scores regarding lesion conspicuity and reader confidence; iodine overlays facilitated lesion delineation. Inter-observer agreement ranged between substantial and excellent (kappa values 0.73-0.81). Contrast-to-noise-ratios for low keV monoE images were significantly higher, compared to polyE images (e.g. monoE 40 keV p 
Source: European Journal of Radiology - Category: Radiology Source Type: research

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CONCLUSION: In individuals with metastatic PDAC who have mutations involved in DNA repair, Olaparib may provide clinical benefit. BRCA mutations affecting RAD51 binding domains translated to improved median OS. QTA of individual tumors may allow for additional information that predicts outcomes to treatment with PARP inhibitors. IMPLICATIONS FOR PRACTICE: Pursuing germline and somatic DNA sequencing in individuals with pancreatic ductal adenocarcinoma may yield abnormalities in DNA repair pathways. These individuals may receive benefit with poly (ADP-ribose) polymerase (PARP) inhibition. Radiomics and deep sequencing ...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
CONCLUSIONAwareness of the entity and use of ancillary techniques in making the pre-operative diagnosis could have saved the patient from an extensive surgical procedure.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
jalmar van Santvoort Bas Groot Koerkamp Olivier R. Busch I. Quintus Molenaar Casper H. van Eijck Marc G. Besselink the Dutch Pancreatic Cancer Group and International Collaborative Group on Locally Advanced Pancreatic Cancer Locally advanced pancreatic cancer (LAPC) has several definitions but essentially is a nonmetastasized pancreatic cancer, in which upfront resection is considered not beneficial due to extensive vascular involvement and consequent high chance of a nonradical resection. The introduction of FOLFIRINOX chemotherapy and gemcitabine-nab-paclitaxel (gem-nab) has had major implications for th...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
The objective of this study was to evaluate the role and limit of iodine maps by dual-energy computed tomography (CT) single scan for pancreatic cancer. Methods Thirty patients with suspected solitary pancreatic cancer were enrolled in this study and underwent CT perfusion and iodine maps. The parameters of pancreatic cancer and normal pancreatic tissue were calculated. Pearson correlation and paired t test were used for evaluating 2 techniques. Results Iodine concentration had a moderate positive correlation with blood flow or blood volume (P
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Abdominal Imaging Source Type: research
A 75-year-old morbidly obese man presented with increasing diameter of a known abdominal aortic aneurysm (AAA) and right common iliac artery aneurysm. He was diagnosed with these aneurysms at the age of 69  years while undergoing computed tomography for evaluation of pancreatic cancer. At the time of diagnosis, the AAA diameter was 3.9 cm. His past medical history was significant for hypertension and hyperlipidemia. He was observed with serial aortoiliac duplex ultrasound scans. By November 2018 (6  years after the original diagnosis), the AAA diameter increased to 6.3 cm and the right common iliac arte...
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Vascular images Source Type: research
A 79-year-old man was admitted with asymptomatic elevation of liver enzymes and tumor markers. Abdominal contrast-enhanced computed tomography demonstrated swelling of the pancreatic head, and additional blood test showed raised IgG4 levels. Histological examination by endoscopic ultrasonography (EUS)-guided fine needle aspiration for pancreatic head mass revealed storiform fibrosis and IgG4-positive plasma cell infiltration. We diagnosed this case as type 1 autoimmune pancreatitis (AIP). In addition, there was a cystic lesion in the pancreatic body apart from the pancreatic head mass. A mural nodule in the multilocular cy...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
ConclusionThe yield of staging laparoscopy for occult intrahepatic or peritoneal metastases in patients with locally advanced pancreatic cancer was 19%. Staging laparoscopy is recomended for patients with LAPC for accurate staging to determine optimal treatment.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
The recent development of quinoline-based PET tracers that act as fibroblast-activation-protein inhibitors (FAPIs) demonstrated promising preclinical and clinical results. FAP is overexpressed by cancer-associated fibroblasts of several tumor entities. Here, we quantify the tumor uptake on 68Ga-FAPI PET/CT of various primary and metastatic tumors to identify the most promising indications for future application. Methods: 68Ga-FAPI PET/CT scans were requested by various referring physicians according to individual clinical indications that were considered insufficiently covered by 18F-FDG PET/CT or other imaging modalities....
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Source Type: research
CONCLUSION: Patients with associated invasive carcinoma from pancreatic ITPN may have presented a trend toward larger tumor size and dilated pancreatic duct with pancreatoliths, but the difference was not statistically significant. Further studies with a larger number of patients are needed to provide better insight into these findings. Pancreatic ITPN can show various atypical imaging findings as well as typical intraductal solid tumor on multimodality imaging. The presence of lesion multiplicity and synchronous or metachronous biliary cancer can be helpful for assisting with the diagnosis of pancreatic ITPN. PMID: 3...
Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology - Category: Radiology Authors: Tags: Diagn Interv Radiol Source Type: research
CONCLUSION: When mapping of local relapses was evaluated according to the CTVRTOG, the CJ site was identified as a high-risk area of local recurrence but was insufficiently covered within the CTVRTOG. These findings may help construct a target volume for postoperative radiotherapy in DEHC. ADVANCES IN KNOWLEDGE: Mapping local recurrences can aid in defining appropriate target volume for postoperative radiotherapy in DEHC. PMID: 31145644 [PubMed - as supplied by publisher]
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
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