1
|
Wang H, Bai J, Miao P, Wei Y, Chen X, Lan H, Qing Y, Zhao M, Li Y, Tang R, Yang X. The key to intestinal health: a review and perspective on food additives. Front Nutr 2024; 11:1420358. [PMID: 39360286 PMCID: PMC11444971 DOI: 10.3389/fnut.2024.1420358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 09/09/2024] [Indexed: 10/04/2024] Open
Abstract
In this review, we explore the effects of food additives on intestinal health. Food additives, such as preservatives, antioxidants and colorants, are widely used to improve food quality and extend shelf life. However, their effects on intestinal microecology May pose health risks. Starting from the basic functions of food additives and the importance of intestinal microecology, we analyze in detail how additives affect the diversity of intestinal flora, oxidative stress and immune responses. Additionally, we examine the association between food additives and intestinal disorders, including inflammatory bowel disease and irritable bowel syndrome, and how the timing, dosage, and individual differences affect the body's response to additives. We also assess the safety and regulatory policies of food additives and explore the potential of natural additives. Finally, we propose future research directions, emphasizing the refinement of risk assessment methods and the creation of safer, innovative additives.
Collapse
Affiliation(s)
- Haitao Wang
- The School of Clinical Medical Sciences, Southwest Medical University, Luzhou, Sichuan, China
| | - Junyi Bai
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | - Pengyu Miao
- School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, China
| | - Yu Wei
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | | | - Haibo Lan
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | - Yong Qing
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | - Meizhu Zhao
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | - Yanyu Li
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | - Rui Tang
- Chengdu Anorectal Hospital, Chengdu, Sichuan, China
| | | |
Collapse
|
2
|
Dhillon P, Naidu M, Olson MC, VanBuren WM, Sheedy SP, Wells ML, Fidler JL, Heiken JP, Venkatesh SK, Kelm ZS. Diffusely Infiltrative Small Bowel Disease. Radiographics 2024; 44:e230148. [PMID: 39207924 DOI: 10.1148/rg.230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Multiple infiltrative disorders can affect the small bowel, often resulting in diffuse small bowel wall thickening. These infiltrative disorders can manifest owing to various factors such as an influx of immunologic or neoplastic cells or the accumulation of substances within one or more layers of the intestinal wall. Although there can be considerable overlap in the appearances of infiltrative diseases on cross-sectional images, a comprehensive understanding of more specific ancillary imaging features and clinicopathologic correlation can substantially narrow the differential diagnosis. The radiologist can be instrumental in synthesizing the clinical and imaging information and guiding subsequent workup. The authors present a comprehensive review of the infiltrative disorders that commonly involve the small bowel. These disorders are organized on the basis of their pathophysiologic features, with multiple illustrative case examples to enhance understanding of these entities. CT and MRI are currently the most commonly used imaging modalities for evaluating small bowel disorders, and this review is focused on these two modalities. Detailed information regarding the pathologic features, clinical presentation, and imaging findings of these infiltrative disorders is provided to aid radiologists in recognizing and differentiating these conditions. ©RSNA, 2024.
Collapse
Affiliation(s)
- Preet Dhillon
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Madeline Naidu
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Michael C Olson
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Wendaline M VanBuren
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Shannon P Sheedy
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Michael L Wells
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Jeff L Fidler
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Jay P Heiken
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Sudhakar K Venkatesh
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| | - Zachary S Kelm
- From the Department of Radiology (P.D., M.C.O., W.M.V., S.P.S., M.L.W., J.L.F., J.P.H., S.K.V., Z.S.K.), Mayo Clinic (M.N.), 200 First St SW, Rochester, MN 55905
| |
Collapse
|
3
|
Vulasala SS, Virarkar M, Gopireddy D, Waters R, Alkhasawneh A, Awad Z, Maxwell J, Ramani N, Kumar S, Onteddu N, Morani AC. Small Bowel Neuroendocrine Neoplasms-A Review. J Comput Assist Tomogr 2024; 48:563-576. [PMID: 38110305 DOI: 10.1097/rct.0000000000001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
ABSTRACT Neuroendocrine neoplasms (NENs) are rapidly evolving small bowel tumors, and the patients are asymptomatic at the initial stages. Metastases are commonly observed at the time of presentation and diagnosis. This review addresses the small bowel NEN (SB-NEN) and its molecular, histological, and imaging features, which aid diagnosis and therapy guidance. Somatic cell number alterations and epigenetic mutations are studied to be responsible for sporadic and familial SB-NEN. The review also describes the grading of SB-NEN in addition to rare histological findings such as mixed neuroendocrine-non-NENs. Anatomic and nuclear imaging with conventional computed tomography, magnetic resonance imaging, computed tomographic enterography, and positron emission tomography are adopted in clinical practice for diagnosing, staging, and follow-up of NEN. Along with the characteristic imaging features of SB-NEN, the therapeutic aspects of imaging, such as peptide receptor radionuclide therapy, are discussed in this review.
Collapse
Affiliation(s)
- Sai Swarupa Vulasala
- From the Department of Radiology, University of Florida College of Medicine, Jacksonville
| | - Mayur Virarkar
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL
| | - Dheeraj Gopireddy
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL
| | - Rebecca Waters
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Ziad Awad
- Surgery, University of Florida College of Medicine, Jacksonville, FL
| | - Jessica Maxwell
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center
| | - Nisha Ramani
- Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, TX
| | - Sindhu Kumar
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL
| | - Nirmal Onteddu
- Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL
| | - Ajaykumar C Morani
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
4
|
Moran S, Abadi A, DiSantis D, Revels J, Rohrmann C, Bhargava P, Mansoori B. Small Bowel Follow-Through in the Age of Cross-sectional Imaging. Radiographics 2024; 44:e230135. [PMID: 38843095 DOI: 10.1148/rg.230135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Affiliation(s)
- Shamus Moran
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - Alireza Abadi
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - David DiSantis
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - Jonathan Revels
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - Charles Rohrmann
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - Puneet Bhargava
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| | - Bahar Mansoori
- From the Division of Abdominal Imaging, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195-7115 (S.M., A.A., C.R., P.B. B.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Jacksonville, Fla (D.D.); and Division of Abdominal Imaging, Department of Radiology, New York University, New York, NY (J.R.)
| |
Collapse
|
5
|
Asare B, Huang C, Melia J, Fishman EK, Gawande R. Cross-sectional imaging of mimics of inflammatory bowel disease: not everything is Crohn's disease or ulcerative colitis. Abdom Radiol (NY) 2024:10.1007/s00261-024-04436-z. [PMID: 38935092 DOI: 10.1007/s00261-024-04436-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
Acute and chronic bowel pathologies can often be mistaken for manifestations of inflammatory bowel disease (IBD), and there are many entities with imaging and clinical features that overlap with IBD, making diagnosis difficult. We describe multiple inflammatory, infectious, neoplastic, and vascular entities with imaging and clinical features that may mimic IBD, and highlight differentiating features to assist in diagnosis.
Collapse
Affiliation(s)
- Belinda Asare
- Department of Radiology, NYU Langone, New York, NY, USA
| | | | - Joanna Melia
- Department of Gastroenterology, Johns Hopkins University, Baltimore, MD, USA
| | - Elliot K Fishman
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Rakhee Gawande
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
- Russell H. Morgan Department of Radiology and Radiological Science, Diagnostic Radiology, Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 3235-A, Baltimore, MD, 21287, USA.
| |
Collapse
|
6
|
Wu S, Yu H, Liu Y, Zhou H, Zhou Y. Small bowel adenocarcinoma of the jejunum detected by double contrast enhanced ultrasound: a case report of a novel ultrasound modality. Front Oncol 2024; 14:1288041. [PMID: 38962263 PMCID: PMC11219900 DOI: 10.3389/fonc.2024.1288041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Background Small Bowel Adenocarcinoma (SBA) is rare, occult and life-threatening malignancy in digestive system. Given low incidence and nonspecific symptoms, SBA is frequently detected in later stages. Double contrast enhanced ultrasound (DCEUS) is an innovative imaging technique applied to visualize the gastrointestinal tract, merging intravenous contrast-enhanced ultrasound with oral contrast-enhanced ultrasound. In this case, DCEUS was utilized and successfully detected an SBA of the jejunum. Case presentation A Chinese woman, aged 64, sought consultation in the gastroenterology department at our hospital, reporting symptoms of abdominal pain. Three months before entering the hospital, she underwent gastroscopy and colonoscopy which suggested chronic gastritis, and she was treated with oral drugs. However, her symptoms were not relieved, and even worsened. To further investigate, DCEUS was performed. The oral contrast agent dilated the luminal space of the upper gastrointestinal tract, resolving the hindrance caused by gas in the gastrointestinal tract and creating an acoustic window for scanning. Through this acoustic window, oral agent contrast-enhanced ultrasound (OA-CEUS) revealed a localized thickening of jejunal intestinal wall measuring 4x3 cm. Following intravenous injection of ultrasound contrast agent, the jejunal lesion exhibited faster enhancement and heterogeneous hyper-enhancement. Finally, the patient underwent jejunal tumor resection. Pathological examination revealed a jejunal adenocarcinoma. Conclusion The timely diagnosis of SBA can be challenging. DCEUS may have the potential to contribute to diagnosis and detailed evaluation of SBA, particularly in cases involving jejunum. Further researches are needed to fully explore the benefits of DCEUS in the standard diagnostic approach for small bowel diseases.
Collapse
Affiliation(s)
| | | | | | | | - Yang Zhou
- Department of Medical Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| |
Collapse
|
7
|
Silva F, Bustamante M, Latorre G, Flandez J, Montero I, Dukes E, Gandara V, Robles C, Uribe J, Iglesias A, Bellolio F, Molina ME, Migueles R, Urrejola G, Larach T, Besser N, Sharp A, Agüero C, Riquelme A, Vargas JI, Candia R, Monrroy H, De Simone F, Espino A. Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:491-499. [PMID: 38331316 DOI: 10.1016/j.gastrohep.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America. AIM To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs. METHODS Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile. RESULTS A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n=38), gastrointestinal stromal tumors (GIST) (21.8%, n=19), lymphoma (17.2%, n=15) and adenocarcinoma (AC) (11.5%, n=10). GIST was more frequent in duodenum (50%; n=12) and NET in the ileum (65.8%; n=25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC (p=0.035), as well as gastrointestinal bleeding in GIST (p=0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5-year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1-99.2), 82.2% (95%CI: 57.6-93.3), 40.0% (95%CI: 16.5-82.8) and 25.9% (95%CI: 4.5-55.7%), respectively. NET (HR 6.1; 95%CI: 2.1-17.2) and GIST (HR 24.4; 95%CI: 3.0-19.8) were independently associated with higher survival compared to AC, adjusted for age and sex. CONCLUSIONS Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes.
Collapse
Affiliation(s)
- Felipe Silva
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Miguel Bustamante
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Latorre
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - Jorge Flandez
- Institute of Medicine, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - Isabella Montero
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eitan Dukes
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Gandara
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Robles
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Uribe
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Iglesias
- Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Bellolio
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Elena Molina
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Migueles
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Urrejola
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomás Larach
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolas Besser
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Allan Sharp
- Universidad Católica-Christus Health, Santiago, Chile; Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Agüero
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - Arnoldo Riquelme
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - José Ignacio Vargas
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - Roberto Candia
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - Hugo Monrroy
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile
| | - Federico De Simone
- Department of Digestive Endoscopy, Médica Uruguaya, Clínica CEVEN, Montevideo, Uruguay
| | - Alberto Espino
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Universidad Católica-Christus Health, Santiago, Chile.
| |
Collapse
|
8
|
Li L, Zhang S, Fu G. Trending of small bowel adenocarcinoma research from 2000 to 2022: A bibliometric analysis. Medicine (Baltimore) 2024; 103:e37795. [PMID: 38608051 PMCID: PMC11018234 DOI: 10.1097/md.0000000000037795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
Small bowel adenocarcinoma (SBA) is a rare tumor entity with a relatively poor prognosis. Diagnosis and management of SBA are still challenging despite recent advancement of diagnostic methods and publication of guidelines. This study aimed to analyze and visualize the trending of SBA research in the past 22 years in the 21st century through bibliometric analysis. Our study collected 1270 publication records of SBA from 2000 Jan 1st to 2022 December 31 from Web of Science and used VOSviewer and CiteSpace to analyze countries, institutions, journals, authors, references and keywords to present the latest trends in SBA research. The USA was the most productive country in terms of the total number of publications (n = 418). The Mayo Clinic (n = 22) and University of Texas MD Cancer Center (n = 22) were the institutions with top publications. The "World Journal Of Gastroenterology" (n = 30) had the largest publications. Overman Michael J (n = 17) was the most active and prolific author. The "small bowel adenocarcinoma" was the most frequent keyword. Our bibliometric analysis provides a comprehensive overview of the trends and gaps in the research of SBA. Despite the challenges faced, researchers from USA, Japan and China have made significant contributions to the field of SBA research, and further research is necessary to develop evidence-based guidelines, and advance the understanding and management of SBA.
Collapse
Affiliation(s)
- Li Li
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, China
| | - Shao Zhang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, China
| | - Guang Fu
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, China
| |
Collapse
|
9
|
Wang L, Zhang H, Wang D, Shen Q, Huang L, Liu T. Clinical features of intussusception in children secondary to small bowel tumours: a retrospective study of 31 cases. BMC Pediatr 2024; 24:227. [PMID: 38561715 PMCID: PMC10983748 DOI: 10.1186/s12887-024-04717-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Summarizing the clinical features of children with intussusception secondary to small bowel tumours and enhancing awareness of the disease. METHODS Retrospective summary of children with intussusception admitted to our emergency department from January 2016 to January 2022, who underwent surgery and were diagnosed with small bowel tumours. Summarize the types of tumours, clinical presentation, treatment, and prognosis. RESULTS Thirty-one patients were included in our study, 24 males and 7 females, with an age of onset ranging from 1 m to 11y 5 m. Post-operative pathology revealed 4 types of small intestinal tumour, 17 lymphomas, 10 adenomas, 4 inflammatory myofibroblastomas and 1 lipoma. The majority of tumours in the small bowel occur in the ileum (83.9%, 26/31). Abdominal pain, vomiting and bloody stools were the most common clinical signs. Operative findings indicated that the small bowel (54.8%, 17/31) and ileocolic gut were the main sites of intussusception. Two types of procedure were applied: segmental bowel resection (28 cases) and wedge resection of mass in bowel wall (3 cases). All patients recovered well postoperatively, with no surgical complications observed. However, the primary diseases leading to intussusception showed slight differences in long-term prognosis due to variations in tumor types. CONCLUSIONS Lymphoma is the most common cause of intussusception in pediatric patients with small bowel tumours, followed by adenoma. Small bowel tumours in children tend to occur in the ileum. Therefore, the treatment of SBT patients not only requires surgeons to address symptoms through surgery and obtain tissue samples but also relies heavily on the expertise of pathologists for accurate diagnosis. This has a significant impact on the overall prognosis of these patients.
Collapse
Affiliation(s)
- Li Wang
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Hanwen Zhang
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Dayong Wang
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Qiulong Shen
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Liuming Huang
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Beijing, 100045, PR China.
| | - Tingting Liu
- Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Beijing, 100045, PR China.
| |
Collapse
|
10
|
Shin SY, Shen TC, Wank SA, Summers RM. Fully-automated detection of small bowel carcinoid tumors in CT scans using deep learning. Med Phys 2023; 50:7865-7878. [PMID: 36988164 PMCID: PMC10539477 DOI: 10.1002/mp.16391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/20/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Small bowel carcinoid tumor is a rare neoplasm and increasing in incidence. Patients with small bowel carcinoid tumors often experience long delays in diagnosis due to the vague symptoms, slow growth of tumors, and lack of clinician awareness. Computed tomography (CT) is the most common imaging study for diagnosis of small bowel carcinoid tumor. It is often used with positron emission tomography (PET) to capture anatomical and functional aspects of carcinoid tumors and thus to increase the sensitivity. PURPOSE We compared three different kinds of methods for the automatic detection of small bowel carcinoid tumors on CT scans, which is the first to the best of our knowledge. METHODS Thirty-three preoperative CT scans of 33 unique patients with surgically-proven carcinoid tumors within the small bowel were collected. Ground-truth segmentation of tumors was drawn on CT scans by referring to available 18 F-DOPA PET scans and the corresponding radiology report. These scans were split into the trainval set (n = 24) and the test positive set (n= 9). Additionally, 22 CT scans of 22 unique patients who had no evidence of the tumor were collected to comprise the test negative set. We compared three different kinds of detection methods, which are detection network, patch-based classification, and segmentation-based methods. We also investigated the usefulness of small bowel segmentation for reduction of false positives (FPs) for each method. Free-response receiver operating characteristic (FROC) curves and receiver operating characteristic (ROC) curves were used for lesion- and patient-level evaluations, respectively. Statistical analyses comparing the FROC and ROC curves were also performed. RESULTS The detection network method performed the best among the compared methods. For lesion-level detection, the detection network method, without the small bowel segmentation-based filtering, achieved sensitivity values of (60.8%, 81.1%, 82.4%, 86.5%) at per-scan FP rates of (1, 2, 4 ,8), respectively. The use of the small bowel segmentation did not improve the performance (p = 0.742 $p=0.742$ ). For patient-level detection, again the detection network method, but with the small bowel segmentation-based filtering, achieved the highest AUC of 0.86 with a sensitivity of 78% and specificity of 82% at the Youden point. CONCLUSIONS The carcinoid tumors in this patient population were very small and potentially difficult to diagnose. The presented method showed reasonable sensitivity at small numbers of FPs for lesion-level detection. It also achieved a promising AUC for patient-level detection. The method may have clinical application in patients with this rare and difficult to detect disease.
Collapse
Affiliation(s)
- Seung Yeon Shin
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Thomas C Shen
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen A Wank
- Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ronald M Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
11
|
Shin SY, Shen TC, Summers RM. Improving segmentation and detection of lesions in CT scans using intensity distribution supervision. Comput Med Imaging Graph 2023; 108:102259. [PMID: 37348281 PMCID: PMC10527342 DOI: 10.1016/j.compmedimag.2023.102259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
We propose a method to incorporate the intensity information of a target lesion on CT scans in training segmentation and detection networks. We first build an intensity-based lesion probability (ILP) function from an intensity histogram of the target lesion. It is used to compute the probability of being the lesion for each voxel based on its intensity. Finally, the computed ILP map of each input CT scan is provided as additional supervision for network training, which aims to inform the network about possible lesion locations in terms of intensity values at no additional labeling cost. The method was applied to improve the segmentation of three different lesion types, namely, small bowel carcinoid tumor, kidney tumor, and lung nodule. The effectiveness of the proposed method on a detection task was also investigated. We observed improvements of 41.3% → 47.8%, 74.2% → 76.0%, and 26.4% → 32.7% in segmenting small bowel carcinoid tumor, kidney tumor, and lung nodule, respectively, in terms of per case Dice scores. An improvement of 64.6% → 75.5% was achieved in detecting kidney tumors in terms of average precision. The results of different usages of the ILP map and the effect of varied amount of training data are also presented.
Collapse
Affiliation(s)
- Seung Yeon Shin
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, 20892, MD, USA.
| | - Thomas C Shen
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, 20892, MD, USA
| | - Ronald M Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, 20892, MD, USA
| |
Collapse
|
12
|
Maccioni F, Busato L, Valenti A, Cardaccio S, Longhi A, Catalano C. Magnetic Resonance Imaging of the Gastrointestinal Tract: Current Role, Recent Advancements and Future Prospectives. Diagnostics (Basel) 2023; 13:2410. [PMID: 37510154 PMCID: PMC10378103 DOI: 10.3390/diagnostics13142410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed with the more advanced imaging techniques allows accurate assessment of many bowel diseases, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and disease monitoring under treatment. Several MRI parameters are currently considered activity biomarkers for inflammation and neoplastic disease. Furthermore, in younger patients with acute or chronic GI disease, MRI can be safely used for short-term follow-up studies in many critical clinical situations because it is radiation-free. MRI assessment of functional gastro-esophageal and small bowel disorders is still in its infancy but very promising, while it is well established and widely used for dynamic assessment of anorectal and pelvic floor dysfunction; MRI motility biomarkers have also been described. There are still some limitations to GI MRI related to high cost and limited accessibility. However, technical advances are expected, such as faster sequences, more specific intestinal contrast agents, AI analysis of MRI data, and possibly increased accessibility to GI MRI studies. Clinical interest in the evaluation of bowel disease using MRI is already very high, but is expected to increase significantly in the coming years.
Collapse
Affiliation(s)
- Francesca Maccioni
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Ludovica Busato
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Alessandra Valenti
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Sara Cardaccio
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Alessandro Longhi
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| |
Collapse
|
13
|
Xu J, Yao Z, Liao G, OuYang X, Mao S, Cao J, Lai B. Prediction of distant metastasis and specific survival prediction of small intestine cancer patients with metastasis: A population-based study. Cancer Med 2023; 12:15037-15053. [PMID: 37255376 PMCID: PMC10417179 DOI: 10.1002/cam4.6166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Small intestine cancer (SIC) is difficult to diagnose early and presents a poor prognosis due to distant metastasis. This study aimed to develop nomograms for diagnosing and assessing the prognosis of SIC with distant metastasis. METHODS Patients diagnosed with SIC between 2010 and 2015 were included from the Surveillance, Epidemiology and End Results database. Univariate and multifactor analysis determined independent risk factors for distant metastasis and prognostic factors for overall and cancer-specific survival. We then constructed the corresponding three nomograms and assessed the diagnostic accuracy of the nomograms by net reclassification improvement, receiver operating characteristic curves and calibration curves, assessed the clinical utility by decision curve analysis. RESULTS The cohort consisted of 6697 patients, of whom 1299 had distant metastasis at diagnosis. Tstage, Nstage, age, tumor size, grade, and histological type were independent risk factors for distant metastasis. Age, histological type, T stage, N stage, grade, tumor size, whether receiving surgery, number of lymph nodes removed, and the presence of bone or lung metastases were predictors of both overall survival and cancer-specific survival. The nomograms showed excellent accuracy in predicting distant metastasis and prognosis. CONCLUSION Nomograms were developed and validated for SIC patients with distant metastasis, aiding physicians in making rational and personalized clinical decisions.
Collapse
Affiliation(s)
- Jinyi Xu
- Nanchang UniversityNanchangChina
| | | | - Guoliang Liao
- Department of General SurgeryLongnan people's HospitalLongnanChina
| | - Xi OuYang
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Shengxun Mao
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Jiaqing Cao
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Bin Lai
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| |
Collapse
|
14
|
Vlachou E, Koffas A, Toumpanakis C, Keuchel M. Updates in the diagnosis and management of small-bowel tumors. Best Pract Res Clin Gastroenterol 2023; 64-65:101860. [PMID: 37652650 DOI: 10.1016/j.bpg.2023.101860] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023]
Abstract
Small-bowel tumors represent a rare entity comprising 0.6% of all new cancer cases in the US, and only 3% of all gastrointestinal neoplasms. They are a heterogenous group of neoplasms comprising of about forty different histological subtypes with the most common being adenocarcinoma, neuroendocrine tumors, stromal tumors and lymphomas. Their incidence has been reportedly increasing over recent years, partly owing to the advances and developments in the diagnostic modalities. Small-bowel capsule endoscopy, device assisted enteroscopy and dedicated small-bowel cross-sectional imaging are complimentary tools, supplementing each other in the diagnostic process. Therapeutic management of small-bowel tumors largely depends on the histological type and staging at diagnosis. The aim of the present review article is to discuss relevant advances in the diagnosis and management of small-bowel tumors.
Collapse
Affiliation(s)
- Erasmia Vlachou
- Evgenidion Clinic Agia Trias SA, Papadiamantopoulou 20, Athens, 11528, Greece.
| | - Apostolos Koffas
- Gastrointestinal and Liver Services, Royal London Hospital, Barts Health NHS Trust, Whitechapel Rd, London, E1 1FR, UK.
| | - Christos Toumpanakis
- Centre for Gastroenterology, Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, Pond St, London, NW3 2QG, UK.
| | - Martin Keuchel
- Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Glindersweg 80, 21029, Hamburg, Germany.
| |
Collapse
|
15
|
Bansal A, Baheti AD, Goyal A, Chandramohan A, Eapen A, Gupta P, Sen S, Ankathi SK, Agarwal A, Saklani A, Mittal R, Parshad R, Sharma R. Imaging Recommendations for Diagnosis, Staging, and Management of Small Bowel and Colorectal Malignancies. Indian J Med Paediatr Oncol 2023. [DOI: 10.1055/s-0042-1759713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
AbstractSmall bowel malignancies are rare, though colorectal cancers are common. This article reviews the current imaging recommendations for small bowel and colorectal malignancies. Contrast-enhanced computed tomography (CT) is the imaging modality of choice for diagnosis/staging/response evaluation/follow-up of the small bowel and colonic tumors. Magnetic resonance imaging of the pelvis with high-resolution T2-weighted images in sagittal, oblique axial, and coronal planes is the imaging modality of choice for staging/response evaluation of anorectal tumors. CT colonography may be utilized as a tumor screening modality, alternative to colonoscopy.
Collapse
Affiliation(s)
- Abhinav Bansal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Akshay D Baheti
- Department of Radiodiagnosis, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ankur Goyal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anuradha Chandramohan
- Department of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pankaj Gupta
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Saugata Sen
- Department of Radiology and Imaging Sciences, Tata Medical Center, Kolkata, West Bengal, India
| | - Suman K Ankathi
- Department of Radiodiagnosis, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Archi Agarwal
- Department of Nuclear Medicine, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Avanish Saklani
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rohin Mittal
- Department of Colorectal Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rajinder Parshad
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
16
|
Shetty AS, Bhattacharya A, Konstantinoff K, Wilson-Flewelling S, Ballard DH, Hoegger MJ, Itani M, Mellnick VM, Rajput MZ, Zulfiqar M, Balfe D. Fundamentals of Small Bowel Imaging: What Radiology Residents Should Know. Radiographics 2023; 43:e220094. [PMID: 36633972 DOI: 10.1148/rg.220094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Anup S Shetty
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Anup Bhattacharya
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Katerina Konstantinoff
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Scott Wilson-Flewelling
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - David H Ballard
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Mark J Hoegger
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Malak Itani
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Vincent M Mellnick
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Mohamed Z Rajput
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Maria Zulfiqar
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Dennis Balfe
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| |
Collapse
|
17
|
Imaging congenital anomalies of the ileum in adults:a pictorial review. Abdom Radiol (NY) 2023; 48:502-509. [PMID: 36401130 DOI: 10.1007/s00261-022-03739-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
The ileal loops are anatomical location for the majority of congenital anomalies affecting the gastrointestinal tract. These include Meckel's diverticulum, ileal duplication, dysgenesis, atresia, mucosal diaphragm, and malposition of the ileum. Symptomatic lesions that often present with abdominal pain, intestinal obstruction or bleeding are usually diagnosed and treated during infancy and childhood. However, many of these congenital conditions may remain clinically silent and detected incidentally in adults undergoing radiological evaluation for unrelated medical reasons. This article presents the spectrum of the congenital ileal anomalies and their distinct features on small bowel examination and CT of the abdomen.
Collapse
|
18
|
Shin SY, Shen TC, Wank SA, Summers RM. Improving Small Lesion Segmentation in CT Scans using Intensity Distribution Supervision: Application to Small Bowel Carcinoid Tumor. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12465:124651S. [PMID: 37124052 PMCID: PMC10139734 DOI: 10.1117/12.2651979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Finding small lesions is very challenging due to lack of noticeable features, severe class imbalance, as well as the size itself. One approach to improve small lesion segmentation is to reduce the region of interest and inspect it at a higher sensitivity rather than performing it for the entire region. It is usually implemented as sequential or joint segmentation of organ and lesion, which requires additional supervision on organ segmentation. Instead, we propose to utilize an intensity distribution of a target lesion at no additional labeling cost to effectively separate regions where the lesions are possibly located from the background. It is incorporated into network training as an auxiliary task. We applied the proposed method to segmentation of small bowel carcinoid tumors in CT scans. We observed improvements for all metrics (33.5% → 38.2%, 41.3% → 47.8%, 30.0% → 35.9% for the global, per case, and per tumor Dice scores, respectively.) compared to the baseline method, which proves the validity of our idea. Our method can be one option for explicitly incorporating intensity distribution information of a target in network training.
Collapse
Affiliation(s)
- Seung Yeon Shin
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Thomas C. Shen
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Stephen A. Wank
- Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ronald M. Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
19
|
Behers BJ, Behers BM, Perez RC, Grewal K, Cyriac J, Makar J, Novak RW. Rare Presentation of Small Bowel Obstruction Secondary to Intestinal Leiomyoma in a Patient with Crohn's Disease. Case Rep Surg 2023; 2023:8008712. [PMID: 36936354 PMCID: PMC10023226 DOI: 10.1155/2023/8008712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/01/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Small bowel obstructions (SBOs) are surgical emergencies that can occur with mechanical blockage of the intestinal lumen. These blockages are most commonly caused by adhesions or hernias, but can also result from intestinal neoplasms. This case report documents the rare occurrence of SBO due to a submucosal leiomyoma. This case was complicated by the patient's longstanding history of Crohn's disease, which has a considerable overlap in symptomatology with SBOs. This may have resulted in a delay in the patient's diagnosis. Leiomyomas should always be considered as a potential, albeit rare, cause of SBO.
Collapse
Affiliation(s)
| | - Brett M. Behers
- 2University of South Florida College of Medicine, Tampa, FL, USA
| | - Ryan C. Perez
- 1Florida State University College of Medicine, Tallahassee, FL, USA
| | - Kabir Grewal
- 1Florida State University College of Medicine, Tallahassee, FL, USA
| | - Joe Cyriac
- 1Florida State University College of Medicine, Tallahassee, FL, USA
| | - Joanne Makar
- 1Florida State University College of Medicine, Tallahassee, FL, USA
| | | |
Collapse
|
20
|
Khanna L, Vargas D, Menias C‘C, Katabathina V. Oncologic Emergencies in the Chest, Abdomen, and Pelvis. Radiol Clin North Am 2023; 61:91-110. [DOI: 10.1016/j.rcl.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
21
|
Lee JS, Park SH, Choi SJ. Radiologic Review of Small Bowel Malignancies and Their Mimicking Lesions. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:110-126. [PMID: 36818705 PMCID: PMC9935952 DOI: 10.3348/jksr.2021.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/22/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
Because of their small size, small bowel malignancies are often easily missed when radiologists read CT images, which can lead to errors in the normal small bowel due to their similar enhancement to the small bowel or non-specific enhancement. In addition, small bowel malignancies are sometimes mistaken for masses of other origins, such as the uterus, rectum, or omentum. In this article, we describe various small-bowel malignancies, their mimicking lesions and the typical and atypical features on CT imaging along with their clinical manifestations.
Collapse
Affiliation(s)
- Jong Soo Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seung Joon Choi
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| |
Collapse
|
22
|
Pungwe P, Peng FB, Hair C. Unusual Diagnosis of Multiple Small Bowel Masses. Gastroenterology 2022; 164:e9-e12. [PMID: 36372220 DOI: 10.1053/j.gastro.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Prisca Pungwe
- Department of Medicine, Baylor College of Medicine, Houston, Texas.
| | - Frederick B Peng
- Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas
| | - Clark Hair
- Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| |
Collapse
|
23
|
Jang Y, Park DH, Kong JS. [Isolated Small Bowel Metastasis of Endometrial Carcinoma with Resultant Jejunojejunal Intussusception: A Case Report]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:1380-1384. [PMID: 36545417 PMCID: PMC9748457 DOI: 10.3348/jksr.2021.0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/26/2022] [Accepted: 05/28/2022] [Indexed: 12/24/2022]
Abstract
Endometrial carcinoma is a common gynecologic malignancy; however, metastasis to the small bowel is rare. Metastatic endometrial carcinoma usually occurs through local extension rather than distant metastasis. Isolated small bowel metastasis is extremely rare; further, intussusception with resultant intestinal obstruction is not common. We report the imaging findings of a patient with isolated small bowel metastasis of endometrial carcinoma with resultant jejunojejunal intussusception.
Collapse
|
24
|
Mendes Serrao E, Joslin E, McMorran V, Hough C, Palmer C, McDonald S, Cargill E, Shaw AS, O'Carrigan B, Parkinson CA, Corrie PG, Sadler TJ. The forgotten appearance of metastatic melanoma in the small bowel. Cancer Imaging 2022; 22:27. [PMID: 35701818 PMCID: PMC9195247 DOI: 10.1186/s40644-022-00463-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Melanoma is the most aggressive form of skin cancer, with a tendency to metastasise to any organ of the human body. While the most common body organs affected include liver, lungs, brain and soft tissues, spread to the gastrointestinal tract is not uncommon. In the bowel, it can present with a multitude of imaging appearances, more rarely as an aneurysmal dilatation. This appearance is classically associated with lymphoma, but it has more rarely been associated with other forms of malignancy. CASE PRESENTATION We report a case series of three patients with aneurysmal dilatation in the small bowel (SB) confirmed to be due to metastatic melanoma (MM). All patients had non-specific symptoms; most times being attributed initially to causes other than melanoma. On CT the identified aneurysmal SB dilatations were diagnosed as presumed lymphoma in all cases. In two cases, the aneurysmal dilatation was the first presentation of metastatic disease and in two of the cases more than one site of the gastrointestinal tract was concomitantly involved. All patients underwent surgical resection with histological confirmation of MM. CONCLUSIONS Recognition of unusual SB presentation of MM, such as aneurysmal SB dilatation, is important to expedite diagnosis, provide appropriate treatment, and consequently improve quality of life and likely survival of these patients. As the most common cancer to metastasise to the SB and as a known imaging mimicker, MM should remain in any radiologist's differential diagnosis for SB lesions with aneurysmal dilatation.
Collapse
Affiliation(s)
- Eva Mendes Serrao
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. .,Department of Radiology, University of Cambridge, Box 218, Cambridge, CB2 0QQ, UK.
| | - Emily Joslin
- Department of Pathology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Victoria McMorran
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Caroline Hough
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Cheryl Palmer
- Department of Oncology, Hinchingbrooke Hospital, Huntingdon, UK
| | - Sarah McDonald
- Department of Pathology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emma Cargill
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ashley S Shaw
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Brent O'Carrigan
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Christine A Parkinson
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Pippa G Corrie
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Timothy J Sadler
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
25
|
Shinya T. Malignant Small Bowel Neoplasms:a review of post-contrast multiphasic multidetector computed tomography. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:19-24. [PMID: 35466141 DOI: 10.2152/jmi.69.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Small bowel neoplasms are rare and account for 3-6% of all gastrointestinal neoplasms. For the diagnosis of small bowel neoplasms, differentiating normal bowel tissue from tumor is critical and depends on imaging modality and scanning techniques. The detection and characterization of small bowel neoplasms have recently improved with the advance of computed tomography (CT) technology. Post-contrast multiphasic CT is an aid to detection and recognition of the vascular nature of small bowel neoplasms. Understanding the typical post-contrast multiphasic CT features of small bowel neoplasms is important because of overlapping features and the necessity of evaluating associated complications and metastases to lymph node and other organs. However, accurate classification of pathologies is still challenging in clinical practice. Texture analysis can quantify complex mathematical patterns within the gray-level distribution of the pixels and voxels of digital images, and texture analysis of the post-contrast multidetector CT data of various tumors has been attracting attention in recent years. The aim of this article is to provide a comprehensive guide to the relevant imaging features for different types of malignant small bowel neoplasms. J. Med. Invest. 69 : 19-24, February, 2022.
Collapse
Affiliation(s)
- Takayoshi Shinya
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences. 3-18-15, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
| |
Collapse
|
26
|
Gelsomino F, Balsano R, De Lorenzo S, Garajová I. Small Bowel Adenocarcinoma: From Molecular Insights to Clinical Management. Curr Oncol 2022; 29:1223-1236. [PMID: 35200603 PMCID: PMC8870676 DOI: 10.3390/curroncol29020104] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 12/03/2022] Open
Abstract
Small bowel adenocarcinoma (SBA) is a rare malignancy, with a rising incidence in recent decades, and accounts for roughly 40% of all cancers of the small bowel. The majority of SBAs arise in the duodenum and are associated with a dismal prognosis. Surgery remains the mainstay of treatment for localized disease, while systemic treatments parallel those used in colorectal cancer (CRC), both in the adjuvant and palliative setting. In fact, owing to the lack of prospective data supporting its optimal management, SBA has historically been treated in the same way as CRC. However, recent genetic and molecular data suggest a distinct profile from other gastrointestinal malignancies and support a more nuanced approach to its management. Herein, we briefly review the state-of-the-art in the clinical management of early-stage and advanced disease and recent discoveries of potentially actionable genetic alterations or pathways along with the most promising ongoing clinical trials, which will hopefully revolutionize the treatment landscape of this orphan disease in the foreseeable future.
Collapse
Affiliation(s)
- Fabio Gelsomino
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, 41124 Modena, Italy
| | - Rita Balsano
- Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy; (R.B.); (I.G.)
| | | | - Ingrid Garajová
- Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy; (R.B.); (I.G.)
| |
Collapse
|
27
|
Azimi-Ghomi O, Kahane G. Ileal Tubulo-Villous Adenoma Causing Small Bowel Obstruction in a Virgin Abdomen. Cureus 2021; 13:e17421. [PMID: 34589331 PMCID: PMC8460552 DOI: 10.7759/cureus.17421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 12/29/2022] Open
Abstract
Small bowel obstructions (SBO) are a common surgical problem accounting for up half of all emergency laparotomies in the United States. SBO in the virgin abdomen (SBO-VA) presents surgeons with a unique predicament as historical teaching has mandated operative exploration in these situations due to their association with more sinister etiologies. More recent research has demonstrated that this may not be the case, with adhesive disease comprising the majority of SBO-VA. Small bowel neoplasms however comprise a considerable portion of SBO-VA. Small bowel tumors comprise around 0.5%-2% of all gastrointestinal tumors, with adenomas being the most common type of benign small bowel tumor. These lesions are most commonly encountered in the duodenum, typically involving the peri-ampullary region, Their incidence decreases with descent down the gastrointestinal tract, and are least commonly found in the ileum. Ileal adenomas have been increasingly described in the literature with the rise of advanced imaging and endoscopic capabilities. The vast majority of these lesions remain asymptomatic; however, they have been reported to undergo malignant transformation resulting in obstruction and intussusception. Small bowel obstruction due to ileal adenomas in the absence of malignancy is exceedingly rare, with only one previously reported case in the literature. We describe a case of an SBO-VA secondary to ileal stricture caused by a tubulo-villous adenoma. We then discuss the topics of SBO and SBO-VA, specifically regarding their etiology and historical and modern management, with a particular focus on the diagnosis and management of small bowel neoplasms, specifically small bowel adenomas.
Collapse
Affiliation(s)
| | - Gerardo Kahane
- General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| |
Collapse
|
28
|
Israrahmed A, Verma V, Ahmad S, Yadav RR. Ileal duplication cyst with giant polypoidal gastric heterotropia. BMJ Case Rep 2021; 14:e245333. [PMID: 34493562 PMCID: PMC8424841 DOI: 10.1136/bcr-2021-245333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/04/2022] Open
Abstract
Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.
Collapse
Affiliation(s)
- Amrin Israrahmed
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Vikrant Verma
- Pathology, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sarfraz Ahmad
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Rajanikant R Yadav
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|