Tu1344 VALUE OF CONTRAST-ENHANCED HARMONIC EUS WITH ENHANCEMENT PATTERN FOR DIAGNOSIS OF PANCREATIC CANCER: A META-ANALYSIS

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

Download Full-text

Meta-analysis and systematic review of contrast-enhanced ultrasound in evaluating the treatment response after locoregional therapy of hepatocellular carcinoma

Abdominal Radiology ◽

10.1007/s00261-021-03248-9 ◽

2021 ◽

Author(s):

Yang Hai ◽

Esika Savsani ◽

Weelic Chong ◽

John Eisenbrey ◽

Andrej Lyshchik

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Treatment Response ◽

Meta Analysis ◽

Locoregional Therapy ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

Download Full-text

Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

Diagnostics ◽

10.3390/diagnostics11050776 ◽

2021 ◽

Vol 11 (5) ◽

pp. 776

Author(s):

Robert Psar ◽

Ondrej Urban ◽

Marie Cerna ◽

Tomas Rohan ◽

Martin Hill

Keyword(s):

Computed Tomography ◽

Pancreatic Cancer ◽

Pancreatic Duct ◽

Fine Needle Aspiration ◽

Pancreatic Head ◽

Needle Aspiration ◽

Characteristic Analysis ◽

Fine Needle ◽

Contrast Enhanced ◽

Secondary Signs

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.

Download Full-text

Evaluation of Peritoneal Deposits in Undiagnosed Ascites by Advanced Endoscopic Ultrasound Imaging Techniques

Journal of Digestive Endoscopy ◽

10.1055/s-0040-1715284 ◽

2021 ◽

Vol 12 (01) ◽

pp. 049-050

Author(s):

Surinder Singh Rana ◽

Ravi Sharma ◽

Rajesh Gupta

Keyword(s):

Ascitic Fluid ◽

Endoscopic Ultrasound ◽

Imaging Techniques ◽

Needle Aspiration ◽

Enhancement Pattern ◽

Etiological Diagnosis ◽

Fine Needle ◽

Contrast Enhanced ◽

Biochemical Evaluation ◽

Repeat Sampling

AbstractEtiology of ascites can be usually determined with ascitic fluid cytological and biochemical evaluation. Occasionally, the cause of ascites cannot be determined despite repeated ascitic fluid evaluations. These patients with undiagnosed ascites usually undergo diagnostic laparotomy/laparoscopy for etiological diagnosis. Endoscopic ultrasound (EUS) can help in resolving the diagnostic conundrum of undiagnosed ascites by visualizing as well as sampling peritoneal and omental deposits/thickening. However, rarely fine-needle aspiration from deposits may be falsely negative and patient may need repeat sampling. Newer EUS imaging techniques such as elastography and contrast-enhanced harmonic EUS by providing additive information on stiffness and enhancement pattern of the lesion can help in differential diagnosis.

Download Full-text

A multilayered post-GWAS assessment on genetic susceptibility to pancreatic cancer

Genome Medicine ◽

10.1186/s13073-020-00816-4 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Evangelina López de Maturana ◽

◽

Juan Antonio Rodríguez ◽

Lola Alonso ◽

Oscar Lao ◽

...

Keyword(s):

Pancreatic Cancer ◽

Functional Analysis ◽

Genetic Susceptibility ◽

In Silico ◽

Complex Disease ◽

Meta Analysis ◽

Low Frequency ◽

Acinar Cells ◽

Pancreatic Acinar Cells ◽

Phenotypic Variance

Abstract Background Pancreatic cancer (PC) is a complex disease in which both non-genetic and genetic factors interplay. To date, 40 GWAS hits have been associated with PC risk in individuals of European descent, explaining 4.1% of the phenotypic variance. Methods We complemented a new conventional PC GWAS (1D) with genome spatial autocorrelation analysis (2D) permitting to prioritize low frequency variants not detected by GWAS. These were further expanded via Hi-C map (3D) interactions to gain additional insight into the inherited basis of PC. In silico functional analysis of public genomic information allowed prioritization of potentially relevant candidate variants. Results We identified several new variants located in genes for which there is experimental evidence of their implication in the biology and function of pancreatic acinar cells. Among them is a novel independent variant in NR5A2 (rs3790840) with a meta-analysis p value = 5.91E−06 in 1D approach and a Local Moran’s Index (LMI) = 7.76 in 2D approach. We also identified a multi-hit region in CASC8—a lncRNA associated with pancreatic carcinogenesis—with a lowest p value = 6.91E−05. Importantly, two new PC loci were identified both by 2D and 3D approaches: SIAH3 (LMI = 18.24), CTRB2/BCAR1 (LMI = 6.03), in addition to a chromatin interacting region in XBP1—a major regulator of the ER stress and unfolded protein responses in acinar cells—identified by 3D; all of them with a strong in silico functional support. Conclusions This multi-step strategy, combined with an in-depth in silico functional analysis, offers a comprehensive approach to advance the study of PC genetic susceptibility and could be applied to other diseases.

Download Full-text