Objectives: Preoperative imaging of vascular invasion is important for surgical resection of pancreatic ductal adenocarcinoma (PDAC). However, whether MRI and CT share the same evaluation criteria remains unclear. This study aimed to compare the diagnostic accuracy of high-resolution MRI (HR-MRI), conventional MRI (non-HR-MRI) and CT for PDAC vascular invasion.
Methods: Pathologically proven PDAC with preoperative HR-MRI (79 cases, 58 with CT) and non-HR-MRI (77 cases, 59 with CT) were retrospectively collected. Vascular invasion was confirmed surgically or pathologically. The degree of tumour-vascular contact, vessel narrowing and contour irregularity were reviewed respectively. Diagnostic criteria 1 (C1) was the presence of all three characteristics, and criteria 2 (C2) was the presence of any one of them. The diagnostic efficacies of different examination methods and criteria were evaluated and compared.
Results: HR-MRI showed satisfactory performance in assessing vascular invasion (AUC: 0.87-0.92), especially better sensitivity (0.79-0.86 vs. 0.40-0.79) than that with non-HR-MRI and CT. HR-MRI was superior to non-HR-MRI. C2 was superior to C1 on CT evaluation (0.85 vs. 0.79, P = 0.03). C1 was superior to C2 in the venous assessment using HR-MRI (0.90 vs. 0.87, P = 0.04) and in the arterial assessment using non-HR-MRI (0.69 vs. 0.68, P = 0.04). The combination of C1-assessed HR-MRI and C2-assessed CT was significantly better than that of CT alone (0.96 vs. 0.86, P = 0.04).
Conclusions: HR-MRI more accurately assessed PDAC vascular invasion than conventional MRI and may contribute to operative decision-making. C1 was more applicable to MRI scans, and C2 to CT scans. The combination of C1-assessed HR-MRI and C2-assessed CT outperformed CT alone and showed the best efficacy in preoperative examination of PDAC.
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http://dx.doi.org/10.1186/s12885-023-11451-8 | DOI Listing |
Port J Card Thorac Vasc Surg
January 2025
Thoracic Surgery Department, Pulido Valente Hospital, CHULN, Lisbon, Portugal.
Introduction: Complete radical resection is crucial for successfully treating thymic carcinomas. However, when the invasion of the great vessels or the heart in Masaoka III and IV stages occurs, the management poses more challenges. The R0 resection often requires neoadjuvant treatment.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Division of Cardiovascular Surgery, Temple University Hospital, Philadelphia, Pennsylvania. USA.
Infective endocarditis carries a high risk of morbidity and mortality with recurrent infections and non-compliance. In the case of right-sided endocarditis, the indications for intervention are less clear. The Angiovac procedure provides a treatment for right-sided endocarditis that is a less-invasive and ideal for a complicated patient population.
View Article and Find Full Text PDFBMC Pulm Med
January 2025
Department of Pulmonary and Critical Care Medicine, School of Medicine, Zhongshan Hospital of Xiamen University, Xiamen University, Xiamen, Fujian, China.
Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly used for diagnosing mediastinal lymphadenopathy. Despite a low complication rate, severe hemorrhage can occur which is reported in this literature, particularly in hypervascular conditions like Castleman disease.
Methods: A 54-year-old male with idiopathic multicentric Castleman disease underwent EBUS-TBNA for mediastinal lymph node sampling.
Sci Rep
January 2025
Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
Optical techniques, such as functional near-infrared spectroscopy (fNIRS), contain high potential for the development of non-invasive wearable systems for evaluating cerebral vascular condition in aging, due to their portability and ability to monitor real-time changes in cerebral hemodynamics. In this study, thirty-six healthy adults were measured by single channel fNIRS to explore differences between two age groups using machine learning (ML). The subjects, measured during functional magnetic resonance imaging (fMRI) at Oulu University Hospital, were divided into young (age ≤ 32) and elderly (age ≥ 57) groups.
View Article and Find Full Text PDFBr J Cancer
January 2025
Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits a high frequency of neural invasion (NI). Schwann cells (SCs) have been shown to be reprogrammed to facilitate cancer cell migration and invasion into nerves. Since extracellular vesicles (EVs) affect the tumour microenvironment and promote metastasis, the present study analysed the involvement of EVs from pancreatic cancer cells and their microenvironment in altering SC phenotype as part of the early events in the process of NI.
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