scholarly journals The Evolving Role of Pathology in New Developments, Classification, Terminology, and Diagnosis of Pancreatobiliary Neoplasms

2017 ◽  
Vol 141 (3) ◽  
pp. 366-380 ◽  
Author(s):  
Michelle D. Reid ◽  
Melinda M. Lewis ◽  
Field F. Willingham ◽  
N. Volkan Adsay
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pancreatic Cysts ◽  
Routine Practice ◽  
Resonance Imaging ◽  
Cystic Neoplasms ◽  
Ki 67 ◽  
Mucinous Neoplasms ◽  
Serous Cystic Neoplasms ◽  
Intraepithelial Neoplasms

Pancreatobiliary tract lesions are increasingly being discovered because of more sensitive imaging modalities. Magnetic resonance imaging has identified incidental pancreatic cysts in 13.5% of patients of progressively increasing age. Pancreatobiliary tissue is more accessible through endoscopic ultrasound and magnetic resonance imaging–guided biopsy procedures, and is now an integral part of pathologists' routine practice. Accordingly, several new tumor categories have been recently recognized, including intraductal tubulopapillary neoplasm, a new addition to tumoral intraepithelial neoplasms. Other entities have been reclassified, including the recent transition to 2-tiered grading of preinvasive neoplasms, as well as new perspectives on the distinctive biologic behavior of oncocytic intraductal papillary mucinous neoplasms (IPMNs) compared with other IPMN subtypes. This has led to proposals for revised staging of virtually every segment of the pancreatobiliary tree, with theranostic markers becoming an integral part of workup. Ki-67 is now an integral part of the classification of neuroendocrine tumors, with new definitions of “high-grade neuroendocrine carcinoma.” Although bile duct brushings have opened new avenues for diagnosis, their sensitivity remains low and often requires concomitant fluorescent in situ hybridization to better define ambiguous cases. Various molecular pathways have been elucidated for pancreatic cysts, including KRAS for ductal neoplasia, GNAS for intestinal IPMNs, RNF3 for mucinous cysts, and VHL for serous cystic neoplasms, all key players in diagnostic workup. Integration of these updates into our understanding of pancreatobiliary disease requires active engagement of pathologists for appropriate specimen triage, judicious interpretation of results, and incorporation into reporting and staging. They also provide exciting opportunities for targeted therapy.

scholarly journals Prevalence of pancreatic cystic neoplasms on imaging exams: association with signs of malignancy risk

2018 ◽  
Vol 51 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Aline Falqueto ◽  
Gustavo Lemos Pelandré ◽  
Mariânges Zadrozny Gouvêa da Costa ◽  
Marcelo Souto Nacif ◽  
Edson Marchiori
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Pancreatic Cysts ◽  
Resonance Imaging ◽  
Cystic Neoplasms ◽  
Cross Sectional ◽  
Malignancy Risk ◽  
Pancreatic Cystic Neoplasms

Abstract Objective: To analyze the prevalence of cystic lesions of the pancreas on imaging exams and their association with signs of malignancy risk. Materials and methods: This was an observational cross-sectional study, in which we evaluated 924 sequential computed tomography and magnetic resonance imaging scans of the abdomen. For all of the patients included in the study, we reviewed the demographic data available in the medical records and evaluated the images. Results: Cysts were observed in 4.5% of patients, the prevalence of cysts being highest (7.6%) in patients over 60 years of age. Lesions were detected at higher rates on magnetic resonance imaging and in patients with pancreatic symptoms (6.1% and 42.9%, respectively). Signs of malignancy risk were observed in 26.3% of the patients, more frequently in those who were male and over 60 years of age. Conclusion: The prevalence of pancreatic cysts was 4.5%. Signs of malignancy risk were observed in 26.3% of the cystic neoplasms identified.

scholarly journals Dilated Virchow–Robin Spaces Mimicking a Brainstem Arteriovenous Malformation

2017 ◽  
Vol 08 (02) ◽  
pp. 291-293 ◽  
Author(s):  
Thomas J. Buell ◽  
Arjun Ramesh ◽  
Dale Ding ◽  
Daniel M. S. Raper ◽  
Ching-Jen Chen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Pulse Sequences ◽  
Resonance Imaging ◽  
Unique Case ◽  
Cystic Neoplasms ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

ABSTRACTVirchow–Robin spaces (VRS) are ubiquitous and commonly observed as the resolution of magnetic resonance imaging (MRI) continues to improve. The function of VRS and the etiology of their dilation is still a subject of research. Diagnosing dilated VRS (dVRS) can be challenging because they may appear similar to other pathologies such as cystic neoplasms, infectious cysts, and even arteriovenous malformations (AVMs) on certain MRI pulse sequences. We reported a unique case of brainstem dVRS mimicking an AVM. Furthermore, the extensive pontine involvement of our patient’s lesion is rarely described in neurosurgical literature. Understanding the imaging characteristics of dVRS is critical to accurately diagnose these lesions and avoid unnecessary tests and procedures.

Current Status and New Developments in Breast Cancer Diagnosis and Detection

2013 ◽  
Vol 09 (01) ◽  
pp. 21 ◽  
Author(s):  
Demitrios Tzias ◽  
Elizabeth AM O’Flynn ◽  
Steven D Allen ◽  
A Robin M Wilson ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Imaging ◽  
Imaging Techniques ◽  
Current Status ◽  
Routine Practice ◽  
Resonance Imaging ◽  
High Frequency Ultrasound ◽  
X Ray

Despite extensive research into new ways of imaging the breast x-ray mammography and breast ultrasound, supplemented where necessary by magnetic resonance imaging, remain the techniques used for the vast majority of breast imaging for screening and the assessment of symptomatic breast problems. Recent advances in these technologies mean that these three techniques are highly effective for both detecting disease and for confirming normality. X-ray based imaging of the breast has been around now for 100 years but it is only in the last 10 years or so that digital technology developments have allowed for major advances in the efficacy of this technique. Digital breast tomosynthesis is currently the most promising technology as it has the potential to both improve detection of breast cancer and greatly reduce the numbers of false positive events. Technological advances in grey scale high frequency ultrasound imaging mean that it is now universally used in both symptomatic diagnosis and breast screening. Newer ultrasound techniques such as 3D imaging, Doppler analyses and elastography add some additional value but so far none of these has achieved their hoped for additional potential. Magnetic resonance imaging is currently the most sensitive imaging technique for the detection and characterisation of breast disease, but its cost remains a barrier to its more widespread use. Nuclear medicine techniques have a role is special circumstances but are yet to show that they should be used in routine practice. There are a large number of potential alternative new imaging techniques for the breast, but, as yet, none of these have shown any significant benefits over the current techniques. Dedicated breast computed tomography has perhaps the best promise but clinically effective breast imaging at present remains in the application and refinement of recent developments in digital mammography, ultrasound and magnetic resonance imaging.

scholarly journals Diffusion-Weighted Magnetic Resonance Imaging in Distinguishing Between Mucin-Producing and Serous Pancreatic Cysts

2016 ◽  
Vol 40 (4) ◽  
pp. 505-512 ◽  
Author(s):  
Chiara Pozzessere ◽  
Sandra Luz Castaños Gutiérrez ◽  
Celia Pamela Corona-Villalobos ◽  
Lorenzo Righi ◽  
Chunmiao Xu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pancreatic Cysts ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

Incidental Pancreatic Cysts Found by Magnetic Resonance Imaging and Their Relationship With Pancreatic Cancer

Pancreas ◽  
2012 ◽  
Vol 41 (8) ◽  
pp. 1241-1246 ◽  
Author(s):  
Saburo Matsubara ◽  
Minoru Tada ◽  
Masaaki Akahane ◽  
Hiroshi Yagioka ◽  
Hirofumi Kogure ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pancreatic Cancer ◽  
Magnetic Resonance ◽  
Pancreatic Cysts ◽  
Resonance Imaging ◽  
Incidental Pancreatic Cysts

scholarly journals Assessment of Isocitrate Dehydrogenase 1 Genotype and Cell Proliferation in Gliomas Using Multiple Diffusion Magnetic Resonance Imaging

2021 ◽  
Vol 15 ◽  
Author(s):  
Yan Xie ◽  
Shihui Li ◽  
Nanxi Shen ◽  
Tongjia Gan ◽  
Shun Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cell Proliferation ◽  
Diffusion Coefficient ◽  
Magnetic Resonance ◽  
Isocitrate Dehydrogenase ◽  
Diffusion Magnetic Resonance Imaging ◽  
Wild Type ◽  
Resonance Imaging ◽  
Isocitrate Dehydrogenase 1 ◽  
Ki 67

Objectives: To compare the efficacy of parameters from multiple diffusion magnetic resonance imaging (dMRI) for prediction of isocitrate dehydrogenase 1 (IDH1) genotype and assessment of cell proliferation in gliomas.Methods: Ninety-one patients with glioma underwent diffusion weighted imaging (DWI), multi-b-value DWI, and diffusion kurtosis imaging (DKI)/neurite orientation dispersion and density imaging (NODDI) on 3.0T MRI. Each parameter was compared between IDH1-mutant and IDH1 wild-type groups by Mann–Whitney U test in lower-grade gliomas (LrGGs) and glioblastomas (GBMs), respectively. Further, performance of each parameter was compared for glioma grading under the same IDH1 genotype. Spearman correlation coefficient between Ki-67 labeling index (LI) and each parameter was calculated.Results: The diagnostic performance was better achieved with apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D∗), perfusion fraction (f), distributed diffusion coefficient (DDC), heterogeneity index (α), mean diffusivity (MD), mean kurtosis (MK), and intracellular volume fraction (ICVF) for distinguishing IDH1 genotypes in LrGGs, with statistically insignificant AUC values from 0.750 to 0.817. In GBMs, no difference between the two groups was found. For IDH1-mutant group, all parameters, except for fractional anisotropy (FA) and D∗, significantly discriminated LrGGs from GBMs (P < 0.05). However, for IDH1 wild-type group, only ADC statistically discriminated the two (P = 0.048). In addition, MK has maximal correlation coefficient (r = 0.567, P < 0.001) with Ki-67 LI.Conclusion: dMRI-derived parameters are promising biomarkers for predicting IDH1 genotype in LrGGs, and MK has shown great potential in assessing glioma cell proliferation.

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