The Experts below are selected from a list of 105 Experts worldwide ranked by ideXlab platform
Ramin Khorasani - One of the best experts on this subject based on the ideXlab platform.
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Focal Cystic Pancreatic Lesion Follow-up Recommendations After Publication of ACR White Paper on Managing Incidental Findings
Journal of the American College of Radiology : JACR, 2017Co-Authors: Mark D. Bobbin, V. Anik Sahni, Atul B. Shinagare, Ramin KhorasaniAbstract:Abstract Purpose To describe the variation in radiologists' follow-up recommendations for focal Cystic Pancreatic Lesions (FCPL) after publication of the 2010 ACR incidental findings White Paper and determine adherence to guidance of the ACR Incidental Findings Committee. Methods Institutional Review Board approval was obtained for this retrospective, HIPAA-compliant observational study. Patients with FCPL were identified from abdominal CT and MRI reports generated in 2013 using natural language processing software. Patient-, Lesion-, and radiologist-specific variables were recorded. Primary outcome was whether a follow-up recommendation was made, and if it included a specific study or intervention and recommended time for follow-up. χ 2 and logistic regression models were used to identify predictors and controlled for recommendation. These data were compared with 2009 data obtained before the White Paper's publication. Secondary outcome was adherence to the ACR's guidance. Results During calendar year 2013, 1,377 reports describing FCPLs were identified in 1,038 patients. After excluding examinations from low-volume readers (n = 80), radiologists recommended follow-up imaging in 13.5% (175/1,297) of cases, a decrease from 2009 when it was recommended in 23.7% (221/933) of cases ( P Conclusions Despite published guidance recommendations and reported awareness of them, fewer than half of follow-up recommendations for FCPL are consistent with the guidance and considerable variability persists among radiologists.
Michael G Sarr - One of the best experts on this subject based on the ideXlab platform.
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Primary Pancreatic Cystic neoplasms revisited: part II. Mucinous Cystic neoplasms.
Surgical oncology, 2011Co-Authors: George H Sakorafas, Vasileios Smyrniotis, Kaye M Reid-lombardo, Michael G SarrAbstract:Mucinous Cystic neoplasms (MCNs) of the pancreas represent one of the most common primary Pancreatic Cystic neoplasms, accounting for approximately half of these cases. MCNs are observed almost exclusively in women, and most commonly are located in the body/tail of the pancreas. In contrast to SCNs, MCNs have malignant potential. Proliferative changes (hyperplasia with or without atypia, borderline changes, non-invasive or carcinomas in-situ, and invasive carcinomas) can often be observed within the same neoplasm. Several risk factors for the presence of underlying malignancy within an MCN have recently been recognized. Cross-sectional imaging is of key importance for the diagnostic evaluation of patients with a Cystic Pancreatic Lesion. Cyst fluid examination (cytology, biochemical/genetic analysis) is possible by using fine needle aspiration of the MCN, usually under endoscopic guidance, and may provide useful information for the differential diagnosis. Since MCNs have malignant potential, surgical resection is the treatment of choice.
Kevin Mcgrath - One of the best experts on this subject based on the ideXlab platform.
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endoscopic ultrasound guided fine needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas a multicenter experience
Endoscopy, 2007Co-Authors: Niraj Jani, John M Dewitt, M A Eloubeidi, Shyam Varadarajulu, V Appalaneni, Brenda J Hoffman, William R Brugge, Kenneth K W Lee, Ayesha N Khalid, Kevin McgrathAbstract:BACKGROUND AND STUDY AIMS: Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other Pancreatic tumors, especially Pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultrasound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. PATIENTS AND METHODS: Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. RESULTS: A total of 28 patients were identified (four men [14 %], 24 women [86 %], mean age +/- standard deviation [SD] 35 +/- 10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50 % of cases. The mean tumor size +/- SD was 42 +/- 19.5 mm and the majority were located in the Pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86 %; the tumors were solid in 14 patients (50 %), mixed solid and Cystic in 11 patients (39 %), and Cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %). CONCLUSIONS: A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/Cystic Pancreatic Lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75 % in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.
Randall W Burt - One of the best experts on this subject based on the ideXlab platform.
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abdominal desmoid in familial adenomatous polyposis presenting as a Pancreatic Cystic Lesion
Familial Cancer, 2005Co-Authors: Lana N Pho, Cheryl M Coffin, Randall W BurtAbstract:A 17-year-old male with familial adenomatous polyposis (FAP) presented with chest pain and significant weight loss. An abdominal CT scan detected a Cystic Pancreatic Lesion of unknown etiology. The patient therefore underwent surgical resection of the distal pancreas, which included the Lesion, because of the known association of Pancreatic cancer with FAP. Histopathological examination of the resected specimen showed a benign Pancreatic cyst and fibrous plaque with desmoid fibromatosis adherent to the surface of the pancreas, serosa of the stomach, and colon. The fibrous plaque was histologically identical to the fibrous mesenteric plaque known to occur in FAP and associated mesenteric fibromatosis. We present pathologic evidence that the Pancreatic cyst formation was induced by FAP-associated desmoid invasion. Desmoid growth should be considered in the differential diagnosis of a Pancreatic Cystic mass Lesion in patients with FAP or its Gardner syndrome variant. This case report provides the first pathologic evidence for benign epithelial cyst formation in the pancreas caused by fibromatosis invasion of that organ as a part of FAP.
V. Anik Sahni - One of the best experts on this subject based on the ideXlab platform.
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Focal Cystic Pancreatic Lesion Follow-up Recommendations After Publication of ACR White Paper on Managing Incidental Findings
Journal of the American College of Radiology : JACR, 2017Co-Authors: Mark D. Bobbin, V. Anik Sahni, Atul B. Shinagare, Ramin KhorasaniAbstract:Abstract Purpose To describe the variation in radiologists' follow-up recommendations for focal Cystic Pancreatic Lesions (FCPL) after publication of the 2010 ACR incidental findings White Paper and determine adherence to guidance of the ACR Incidental Findings Committee. Methods Institutional Review Board approval was obtained for this retrospective, HIPAA-compliant observational study. Patients with FCPL were identified from abdominal CT and MRI reports generated in 2013 using natural language processing software. Patient-, Lesion-, and radiologist-specific variables were recorded. Primary outcome was whether a follow-up recommendation was made, and if it included a specific study or intervention and recommended time for follow-up. χ 2 and logistic regression models were used to identify predictors and controlled for recommendation. These data were compared with 2009 data obtained before the White Paper's publication. Secondary outcome was adherence to the ACR's guidance. Results During calendar year 2013, 1,377 reports describing FCPLs were identified in 1,038 patients. After excluding examinations from low-volume readers (n = 80), radiologists recommended follow-up imaging in 13.5% (175/1,297) of cases, a decrease from 2009 when it was recommended in 23.7% (221/933) of cases ( P Conclusions Despite published guidance recommendations and reported awareness of them, fewer than half of follow-up recommendations for FCPL are consistent with the guidance and considerable variability persists among radiologists.
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Diffusion-weighted MRI of focal Cystic Pancreatic Lesions at 3.0-Tesla: preliminary results
Abdominal imaging, 2011Co-Authors: Jeffrey C. Mottola, V. Anik Sahni, Sukru Mehmet Erturk, Richard Swanson, Peter A. Banks, Koenraad J. MorteleAbstract:Purpose To determine the utility of 3.0-Tesla diffusion-weighted (DW) magnetic resonance imaging (MRI) for focal Cystic Pancreatic Lesion (FCPL) characterization.
