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Carlos Fernandezdel Castillo - One of the best experts on this subject based on the ideXlab platform.
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serous cystadenoma of the Pancreas Tumor growth rates and recommendations for treatment
Annals of Surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Carlos Fernandezdel CastilloAbstract:OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the Pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the Pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the Pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and Tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and Tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean Tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors or =4 cm (22% vs. 72%, P or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large Tumors. Whereas expectant management is reasonable in small asymptomatic Tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.
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Serous cystadenoma of the Pancreas: Tumor growth rates and recommendations for treatment
Annals of surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Andrew L. Warshaw, Carlos Fernandezdel CastilloAbstract:Cystic neoplasms of the Pancreas are increasingly diagnosed in the modern era. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified.1–4 For decades, it has been clear that correctly differentiating between a cystic neoplasm and a pseudocyst is vital to avoid incorrect treatment.5 More recently, as the divergent natural histories and malignant potentials of different cystic neoplasms have been elucidated, differentiating between mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), serous cystadenomas, and other less common Tumors has become increasingly important.6–9 As opposed to pancreatic pseudocysts, serous and mucinous cystic Tumors have an epithelial lining. The epithelium of IPMNs and MCNs is made up of columnar mucin-producing epithelium. However, MCNs, which occur almost exclusively in women, are devoid of communication with the ductal system and are supported by ovarian-type stroma, whereas IPMNs arise in the main pancreatic duct or its major branches. In contrast, serous cystic Tumors are lined by an inconspicuous single layer of either cuboidal or flattened cells. The cytoplasm of the cells is either clear or eosinophilic and the nuclei are usually centrally located, small, and hyperchromatic. Mitoses are conspicuously absent. Most serous cystadenomas are microcystic, forming an honeycomb-like appearance, but macrocystic variants have been described.10–12 The overwhelming majority of these Tumors are benign, with only a handful of case reports of serous cystadenocarcinomas.13–18 Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater malignant potential. Some authors have recommended resection for all cystic neoplasms of the Pancreas,14,15,19 whereas others (including our group) advocate a more selective approach.4,20 Our study had three specific aims: to describe a large single-center experience with serous cystadenoma of the Pancreas, including presenting signs and symptoms and methods of diagnosis; to analyze serial radiography in available patients to determine the rate of growth; and to make recommendations for the accurate diagnosis and optimal treatment of patients with this neoplasm.
Jennifer F Tseng - One of the best experts on this subject based on the ideXlab platform.
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serous cystadenoma of the Pancreas Tumor growth rates and recommendations for treatment
Annals of Surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Carlos Fernandezdel CastilloAbstract:OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the Pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the Pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the Pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and Tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and Tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean Tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors or =4 cm (22% vs. 72%, P or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large Tumors. Whereas expectant management is reasonable in small asymptomatic Tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.
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Serous cystadenoma of the Pancreas: Tumor growth rates and recommendations for treatment
Annals of surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Andrew L. Warshaw, Carlos Fernandezdel CastilloAbstract:Cystic neoplasms of the Pancreas are increasingly diagnosed in the modern era. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified.1–4 For decades, it has been clear that correctly differentiating between a cystic neoplasm and a pseudocyst is vital to avoid incorrect treatment.5 More recently, as the divergent natural histories and malignant potentials of different cystic neoplasms have been elucidated, differentiating between mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), serous cystadenomas, and other less common Tumors has become increasingly important.6–9 As opposed to pancreatic pseudocysts, serous and mucinous cystic Tumors have an epithelial lining. The epithelium of IPMNs and MCNs is made up of columnar mucin-producing epithelium. However, MCNs, which occur almost exclusively in women, are devoid of communication with the ductal system and are supported by ovarian-type stroma, whereas IPMNs arise in the main pancreatic duct or its major branches. In contrast, serous cystic Tumors are lined by an inconspicuous single layer of either cuboidal or flattened cells. The cytoplasm of the cells is either clear or eosinophilic and the nuclei are usually centrally located, small, and hyperchromatic. Mitoses are conspicuously absent. Most serous cystadenomas are microcystic, forming an honeycomb-like appearance, but macrocystic variants have been described.10–12 The overwhelming majority of these Tumors are benign, with only a handful of case reports of serous cystadenocarcinomas.13–18 Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater malignant potential. Some authors have recommended resection for all cystic neoplasms of the Pancreas,14,15,19 whereas others (including our group) advocate a more selective approach.4,20 Our study had three specific aims: to describe a large single-center experience with serous cystadenoma of the Pancreas, including presenting signs and symptoms and methods of diagnosis; to analyze serial radiography in available patients to determine the rate of growth; and to make recommendations for the accurate diagnosis and optimal treatment of patients with this neoplasm.
Brian W. Pogue - One of the best experts on this subject based on the ideXlab platform.
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Pancreas Tumor interstitial pressure catheter measurement
Proceedings of SPIE, 2016Co-Authors: Michael D. Nieskoski, B. Stuart Trembly, Kayla Marra, Jason R. Gunn, Brian W. PogueAbstract:This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma Tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma Tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma Tumor was measured using a probe-based experimental dosimeter.
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Pancreas Tumor model in rabbit imaged by perfusion CT scans
Optical Methods for Tumor Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XXII, 2013Co-Authors: Jason R. Gunn, Kenneth M. Tichauer, Karen L Moodie, Susan Kane, Jack Hoopes, Errol E. Stewart, Jennifer Hadway, Ting-yim Lee, Stephen P. Pereira, Brian W. PogueAbstract:The goal of this work was to develop and validate a Pancreas Tumor animal model to investigate the relationship between photodynamic therapy (PDT) effectiveness and photosensitizer drug delivery. More specifically, this work lays the foundation for investigating the utility of dynamic contrast enhanced blood perfusion imaging to be used to inform subsequent PDT. A VX2 carcinoma rabbit cell line was grown in the tail of the Pancreas of three New Zealand White rabbits and approximately 3-4 weeks after implantation the rabbits were imaged on a CT scanner using a contrast enhanced perfusion protocol, providing parametric maps of blood flow, blood volume, mean transit time, and vascular permeability surface area product.
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Quantifying receptor density in vivo using a dual-probe approach with fluorescence molecular imaging
Proceedings of SPIE--the International Society for Optical Engineering, 2011Co-Authors: Kenneth M. Tichauer, Kimberley S. Samkoe, Julia A. O'hara, Kristian J. Sexton, Scott C. Davis, Brian W. PogueAbstract:Molecular imaging technologies are advancing rapidly and optical techniques in particular are set to play a large role in preclinical pharmaceutical testing. These approaches, however, are generally unable to quantify the level of expression of imaging probe reporters. In this study a novel method of quantification is presented using dual-probe fluorescence imaging, where an endothelial growth factor receptor (EGFR) fluorescent probe was paired with a non-targeted probe before being injected, and tracer kinetic compartmental modeling was used to determine EGFR expression in a region of interest from the uptake curves of the two drugs in that region. The approach was tested out in a simulation experiment and then applied in an in vivo study in one mouse to investigate EGFR expression in various tissue types (Pancreas, Pancreas Tumor, and leg). The binding potentials (a unitless correlate of target availability) of EGFR expression in the various tissue types were 8.57, 25.64, and 0.11 for the Pancreas, Pancreas Tumor, respectively. For the Pancreas and leg, these results correlate well with expected levels of EGFR expression, with the Pancreas demonstrating a much higher expression than the skin and also as expected, the Tumor expressed much more EGFR than either healthy tissue.
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imaging targeted agent binding in vivo with two probes
Journal of Biomedical Optics, 2010Co-Authors: Brian W. Pogue, Kimberley S. Samkoe, Shannon K Hextrum, Julia A Ohara, Michael Jermyn, Subhadra Srinivasan, Tayyaba HasanAbstract:An approach to quantitatively image targeted-agent binding rate in vivo is demonstrated with dual-probe injection of both targeted and nontargeted fluorescent dyes. Images of a binding rate constant are created that reveal lower than expected uptake of epidermal growth factor in an orthotopic xenograft Pancreas Tumor (2.3×10−5 s−1), as compared to the normal Pancreas (3.4×10−5 s−1). This approach allows noninvasive assessment of Tumor receptor targeting in vivo to determine the expected contrast, spatial localization, and efficacy in therapeutic agent delivery.
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Specific binding of molecularly targeted agents to Pancreas Tumors and impact on observed optical contrast
Imaging Manipulation and Analysis of Biomolecules Cells and Tissues VIII, 2010Co-Authors: Kimberley S. Samkoe, Julia A. O'hara, Shannon K Hextrum, Tayyaba Hasan, Omar Pardesi, Brian W. PogueAbstract:In optical imaging it is thought that optimum Tumor contrast can be achieved with the use of small-labeled molecular tracers that have high affinity to their targets and fast clearance rates from the blood stream and healthy tissues. An example of this is fluorescently tagged EGF to monitor the molecular activity of Tumors, such as pancreatic cancer. Extensive fluorescence contrast analysis for fluorescence molecular tomography has been performed on the AsPC-1 Pancreas Tumor, grown orthotopically in mice; yet, the binding dynamics of the EGF-fluorescent agent in vivo is not completely known. The bulk pancreatic Tumor displays 3:1 contrast relative to the normal Pancreas at long times after injection; however, even higher levels of fluorescence in the liver, kidney and intestine suggest that molecular specificity for the Tumor may be low. Mice were administered a fluorescently labeled EGF agent and were sacrificed at various time points post-injection. To analyze the amount of specific binding at each time point frozen tissue samples were fluorescently imaged, washed with saline to remove the interstitially distributed contrast agent, and then imaged again. This technique demonstrated that approximately ~10% of the molecular target was firmly bound to the cell, while 90% was mobile or unbound. This low binding ratio suggests that the contrast observed is from inherent properties of the Tumor (i.e. enhanced permeability and retention effect) and not from specific bound contrast as previously anticipated. The use of EGF contrast agents in MRI-guided fluorescence tomography and the impact of low binding specificity are discussed.
Gregory Y Lauwers - One of the best experts on this subject based on the ideXlab platform.
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serous cystadenoma of the Pancreas Tumor growth rates and recommendations for treatment
Annals of Surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Carlos Fernandezdel CastilloAbstract:OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the Pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the Pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the Pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and Tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and Tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean Tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors or =4 cm (22% vs. 72%, P or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large Tumors. Whereas expectant management is reasonable in small asymptomatic Tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.
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Serous cystadenoma of the Pancreas: Tumor growth rates and recommendations for treatment
Annals of surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Andrew L. Warshaw, Carlos Fernandezdel CastilloAbstract:Cystic neoplasms of the Pancreas are increasingly diagnosed in the modern era. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified.1–4 For decades, it has been clear that correctly differentiating between a cystic neoplasm and a pseudocyst is vital to avoid incorrect treatment.5 More recently, as the divergent natural histories and malignant potentials of different cystic neoplasms have been elucidated, differentiating between mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), serous cystadenomas, and other less common Tumors has become increasingly important.6–9 As opposed to pancreatic pseudocysts, serous and mucinous cystic Tumors have an epithelial lining. The epithelium of IPMNs and MCNs is made up of columnar mucin-producing epithelium. However, MCNs, which occur almost exclusively in women, are devoid of communication with the ductal system and are supported by ovarian-type stroma, whereas IPMNs arise in the main pancreatic duct or its major branches. In contrast, serous cystic Tumors are lined by an inconspicuous single layer of either cuboidal or flattened cells. The cytoplasm of the cells is either clear or eosinophilic and the nuclei are usually centrally located, small, and hyperchromatic. Mitoses are conspicuously absent. Most serous cystadenomas are microcystic, forming an honeycomb-like appearance, but macrocystic variants have been described.10–12 The overwhelming majority of these Tumors are benign, with only a handful of case reports of serous cystadenocarcinomas.13–18 Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater malignant potential. Some authors have recommended resection for all cystic neoplasms of the Pancreas,14,15,19 whereas others (including our group) advocate a more selective approach.4,20 Our study had three specific aims: to describe a large single-center experience with serous cystadenoma of the Pancreas, including presenting signs and symptoms and methods of diagnosis; to analyze serial radiography in available patients to determine the rate of growth; and to make recommendations for the accurate diagnosis and optimal treatment of patients with this neoplasm.
Dushyant V Sahani - One of the best experts on this subject based on the ideXlab platform.
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serous cystadenoma of the Pancreas Tumor growth rates and recommendations for treatment
Annals of Surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Carlos Fernandezdel CastilloAbstract:OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the Pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the Pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the Pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and Tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and Tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean Tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors or =4 cm (22% vs. 72%, P or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large Tumors. Whereas expectant management is reasonable in small asymptomatic Tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.
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Serous cystadenoma of the Pancreas: Tumor growth rates and recommendations for treatment
Annals of surgery, 2005Co-Authors: Jennifer F Tseng, David W. Rattner, Dushyant V Sahani, Gregory Y Lauwers, Andrew L. Warshaw, Carlos Fernandezdel CastilloAbstract:Cystic neoplasms of the Pancreas are increasingly diagnosed in the modern era. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified.1–4 For decades, it has been clear that correctly differentiating between a cystic neoplasm and a pseudocyst is vital to avoid incorrect treatment.5 More recently, as the divergent natural histories and malignant potentials of different cystic neoplasms have been elucidated, differentiating between mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), serous cystadenomas, and other less common Tumors has become increasingly important.6–9 As opposed to pancreatic pseudocysts, serous and mucinous cystic Tumors have an epithelial lining. The epithelium of IPMNs and MCNs is made up of columnar mucin-producing epithelium. However, MCNs, which occur almost exclusively in women, are devoid of communication with the ductal system and are supported by ovarian-type stroma, whereas IPMNs arise in the main pancreatic duct or its major branches. In contrast, serous cystic Tumors are lined by an inconspicuous single layer of either cuboidal or flattened cells. The cytoplasm of the cells is either clear or eosinophilic and the nuclei are usually centrally located, small, and hyperchromatic. Mitoses are conspicuously absent. Most serous cystadenomas are microcystic, forming an honeycomb-like appearance, but macrocystic variants have been described.10–12 The overwhelming majority of these Tumors are benign, with only a handful of case reports of serous cystadenocarcinomas.13–18 Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater malignant potential. Some authors have recommended resection for all cystic neoplasms of the Pancreas,14,15,19 whereas others (including our group) advocate a more selective approach.4,20 Our study had three specific aims: to describe a large single-center experience with serous cystadenoma of the Pancreas, including presenting signs and symptoms and methods of diagnosis; to analyze serial radiography in available patients to determine the rate of growth; and to make recommendations for the accurate diagnosis and optimal treatment of patients with this neoplasm.
