Pediatric choledochal cysts: diagnosis and current management.

Choledochal cysts are rare congenital disorders first described by Vater and Ezler in 1723. Their exact etiology remains incompletely understood; however, an anomalous pancreaticobiliary union (APBDU) and subsequent reflux of biliary contents into the biliary tree are thought to play a role. Accordingly, APBDU-associated choledochal cyst patients are significantly more likely to have evidence of hepatitis, cholangitis or pancreatitis and pathologically confirmed inflammation.

Preoperative T Staging of Potentially Resectable Esophageal Cancer: A Comparison between Free-Breathing Radial VIBE and Breath-Hold Cartesian VIBE, with Histopathological Correlation.

Purpose: To compare the T staging of potentially resectable esophageal cancer using free-breathing radial VIBE (r-VIBE) and breath-hold Cartesian VIBE (C-VIBE), with pathologic confirmation of the T stage.

Materials And Methods: Fifty patients with endoscopically proven esophageal cancer and indeterminate T1/T2/T3 stage by CT scan were examined on a 3-T scanner. The MRI protocol included C-VIBE at 150 seconds post-IV contrast, immediately followed by a work-in-progress r-VIBE with identical spatial resolution (1.

Combination epigenetic therapy in metastatic colorectal cancer (mCRC) with subcutaneous 5-azacitidine and entinostat: a phase 2 consortium/stand up 2 cancer study.

Purpose: Therapy with demethylating agent 5-azacitidine and histone deacetylase inhibitor entinostat shows synergistic re-expression of tumor-suppressor genes and growth inhibition in colorectal (CRC) cell lines and in vivo studies.

Experimental Design: We conducted a phase II, multi-institutional study of the combination in metastatic CRC patients. Subcutaneous azacitidine was administered at 40 mg/m2 days 1-5 and 8-10 and entinostat was given 7 mg orally on days 3 and 10.

Proton-density fat fraction measurement: A viable quantitative biomarker for differentiating adrenal adenomas from nonadenomas.

Purpose: This study aims to compare the accuracy of proton-density fat fraction (PDFF) measurements with chemical shift magnetic resonance imaging (CSI) for quantifying the fat content of adrenal nodules and for differentiating adenomas from nonadenomas.

Materials And Methods: Oil-saline phantom measurements was performed to compare the correlation between PDFF and CSI in detecting and quantifying fat content. 43 consecutive patients who had known adrenal nodules were imaged on a 3.

Structural and Functional Correlates of Myocardial T1 Mapping in 321 Patients With Hypertrophic Cardiomyopathy.

Objective: The aim of this study was to evaluate the structural and functional correlates of T1 mapping in 321 patients with hypertrophic cardiomyopathy (HCM).

Methods: Three hundred twenty-one patients with HCM who underwent cardiac magnetic resonance from 2003 to 2013 were retrospectively identified from our institution's HCM registry. Left ventricular volume, function, late gadolinium enhancement (LGE), and Look-Locker T1 time were quantified.

Arterial Phase with CAIPIRINHA-Dixon-TWIST (CDT)-Volume-Interpolated Breath-Hold Examination (VIBE) in Detecting Hepatic Metastases.

Purpose: To evaluate lesion enhancement performance of Multi-Arterial CAIPIRINHA-Dixon-TWIST-Volume-Interpolated Breath-Hold Examination (MA-CDT-VIBE) for the detection of hepatic metastases.

Materials And Methods: Thirty-one patients with suspicious hepatic metastases were enrolled in this retrospective study. Two independent radiologists scored visualization of each lesion on a scale of 1 (poor visualization) to 11 (excellent visualization) on 11 sets of images.

Elucidation of Percutaneously Accessible Lymph Nodes in Swine: A Large Animal Model for Interventional Lymphatic Research.

Purpose: To define percutaneously accessible, anatomically reproducible swine lymph nodes using magnetic resonance imaging, ultrasound, and ethiodized oil (Lipiodol; Guerbet, Bloomington, Indiana) lymphangiography.

Materials And Methods: Five adult female swine (Yorkshire, 50-60 kg) were used. Under general anesthesia, T1-weighted and T2-weighted, coronal and axial images of the entire swine were obtained.

Monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models: Quantitative biomarkers for differentiating renal clear cell carcinoma and minimal fat angiomyolipoma.

Purpose: To determine the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging (DWI) models in differentiating between minimal fat angiomyolipoma (MFAML) and clear cell renal cell carcinoma (ccRCC).

Materials And Methods: One hundred thirty-one patients with pathologically confirmed MFAML (n = 27) or ccRCC (n = 104) underwent multi-b value DWI (0∼1700 s/mm ) imaging at 3.0 Tesla MRI.

Sarcopenia predicts costs among patients undergoing major abdominal operations.

Background: Although sarcopenia has been identified as a predictor of poor, postoperative, clinical outcomes, the financial impact of sarcopenia remains undetermined. We sought to evaluate the relationship between sarcopenia and hospital finances among a cohort of patients undergoing a hepato-pancreatico-biliary or colorectal resection.

Methods: Clinical, financial, and morphometric data were collected for 1,169 patients undergoing operative resection between January 2011 and December 2013 at the Johns Hopkins Hospital.

Current Concepts on Diagnosis and Prognosis of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia.

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an uncommon cardiac disease characterized by progressive right ventricular dysfunction due to fibrofatty replacement of myocytes and risk of sudden cardiac death from malignant arrhythmias. ARVC/D is a disease of the cardiac desmosome, with genetic mutations in genes encoding proteins critical to this structure found in the majority of patients. The diagnosis of ARVC/D is based on fulfilling a combination of clinical, imaging, pathologic, and/or genetic criteria set forth by the 2010 modified Task Force Criteria.

Monitoring outcomes in intrahepatic cholangiocarcinoma patients following hepatic resection.

Intrahepatic cholangiocarcinoma (iCCA) is one of the fatal gastrointestinal cancers with increasing incidence and mortality. Although surgery offers the only potential for cure in iCCA patients, the prognosis is not optimal with low overall survival rate and high disease recurrence. Hence, adjuvant therapy is generally recommended in the management of high-risk patients.

Evaluation of Hepatocellular Carcinoma Tumor Response After Transcatheter Arterial Chemoembolization Using Gadobenate Dimeglumine-Enhanced Liver Magnetic Resonance.

Objective: Use of gadobenate dimeglumine-enhanced liver magnetic resonance (MR) for evaluation of hepatocellular carcinoma tumor response after transcatheter arterial chemoembolization (TACE).

Methods: Forty-five patients with hepatocellular carcinoma were imaged with multiphase gadobenate dimeglumine-enhanced MR examination at baseline and 1-month follow-up after TACE. Nodule size, enhancement, and apparent diffusion coefficient were measured for both examinations by 2 reviewers.

Effects of paroxetine on intravaginal ejaculatory latency time in Egyptian patients with lifelong premature ejaculation as a function of serotonin transporter polymorphism.

Premature ejaculation (PE) is a common ejaculatory complaint. The estimated rates among Turkish men reached 20%, although the severest type of PE (lifelong PE) usually does not exceed 2.3%.

Hypo-Vascular Liver Metastases Treated with Transarterial chemoembolization: Assessment of Early Response by Volumetric Contrast-Enhanced and Diffusion-Weighted Magnetic Resonance Imaging.

Objective: To evaluate the value of anatomic and volumetric functional magnetic resonance imaging (MRI) in early assessment of response to trans-arterial chemoembolization (TACE) in hypovascular liver metastases.

Methods: This retrospective study included 52 metastatic lesions (42 targeted and 10 non-targeted) in 17 patients who underwent MRI before and early after TACE. Two reviewers reported response by anatomic criteria (Response Evaluation Criteria in Solid Tumor [RECIST], modified RECIST [mRECIST], and European Association for the Study of Liver Disease [EASL]) and functional criteria (volumetric apparent diffusion coefficient and contrast enhancement).

Evaluation of Left Ventricular Outflow Tract Obstruction With Four-Dimensional Phase Contrast Magnetic Resonance Imaging in Patients with Hypertrophic Cardiomyopathy-A Pilot Study.

Objective: This study aimed to validate 4-dimensional phase contrast (4D PC) cine magnetic resonance imaging (MRI) as a means of evaluating left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy (HCM).

Methods: In this institutional review board-approved prospective study, 23 patients with suspected HCM from October 2012 to September 2013 underwent 4D PC MRI. Postprocessed 4D PC pathline cine data were reviewed by 2 blinded reviewers to determine presence or absence of LVOT obstruction.

Neuroendocrine tumor liver metastases treated with yttrium-90 radioembolization.

Objective: Yttrium-90 (Y-90) radioembolization is an emerging treatment option for unresectable neuroendocrine liver metastases (NELM). However, the data regarding this treatment are currently limited. This study evaluates the efficacy and tolerability of Y-90 radioembolization and identifies prognostic factors for radiographic response and survival.

A novel approach for selecting combination clinical markers of pathology applied to a large retrospective cohort of surgically resected pancreatic cysts.

Objective: Our objective was to develop an approach for selecting combinatorial markers of pathology from diverse clinical data types. We demonstrate this approach on the problem of pancreatic cyst classification.

Materials And Methods: We analyzed 1026 patients with surgically resected pancreatic cysts, comprising 584 intraductal papillary mucinous neoplasms, 332 serous cystadenomas, 78 mucinous cystic neoplasms, and 42 solid-pseudopapillary neoplasms.

Hepatocellular carcinoma: From diagnosis to treatment.

Primary liver cancer is the sixth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. While surgical resection and transplantation are the cornerstone of therapy in early-stage hepatocellular carcinoma, locoregional therapy and sorafenib are beneficial in those with more advanced disease or those who are not surgical candidates.

Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children.

Background: Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored.

Objectives: To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children.

Improved Detection of Recurrent Hepatocellular Carcinomas in Arterial Phase With CAIPIRINHA-Dixon-TWIST-Volumetric Interpolated Breath-Hold Examination.

Purpose: The aim of this study was to assess the detection rate of recurrent hepatocellular carcinoma (HCC) in arterial phase using multiarterial CAIPIRINHA-Dixon-TWIST-VIBE (MA-CDT-VIBE).

Materials And Methods: Fifty-eight patients with possible recurrence of HCC were retrospectively included in this cohort. Patients were scanned with a prototype dynamic contrast-enhanced breath-hold CDT-VIBE sequence, which included 6 arterial subphases with a temporal resolution of 2.

Impact of Perioperative Phosphorus and Glucose Levels on Liver Regeneration and Long-term Outcomes after Major Liver Resection.

Introduction: The impact of phosphorus as well as glycemic alterations on liver regeneration has not been directly examined. We sought to determine the impact of phosphorus and glucose on liver regeneration after major hepatectomy.

Methods: Early and late liver regeneration index was defined as the relative increase of liver volume (RLV) within 2[(RLV2m-RLVp)/RLVp] and 7 months[(RLV7m-RLVp)/RLVp] following surgery.

Multisite, multivendor validation of the accuracy and reproducibility of proton-density fat-fraction quantification at 1.5T and 3T using a fat-water phantom.

Purpose: To evaluate the accuracy and reproducibility of quantitative chemical shift-encoded (CSE) MRI to quantify proton-density fat-fraction (PDFF) in a fat-water phantom across sites, vendors, field strengths, and protocols.

Methods: Six sites (Philips, Siemens, and GE Healthcare) participated in this study. A phantom containing multiple vials with various oil/water suspensions (PDFF:0%-100%) was built, shipped to each site, and scanned at 1.

Liver regeneration after major liver hepatectomy: Impact of body mass index.

Background: Obese patients may present with metabolic abnormalities that impact liver regeneration. We sought to assess the impact of body mass index (BMI) on liver volume regeneration index (RI) and kinetic growth rate (KGR) among patients undergoing liver resection.

Methods: The study included 102 patients undergoing major hepatectomy (≥3 segments) between July 2004 and April 2015 and stratified the patients by preoperative BMI, number of segments resected, and postoperative remnant liver volume (RLVp) to total liver volume ratio.