1
|
Xu K, Chen Y, Shen W, Liu F, Wu R, Ni J, Wang L, Chen C, Zhu L, Zhou W, Zhang J, Zuo C, Wang J. Desmoplastic Small Round Cell Tumor: a study of CT, MRI, PET/CT multimodal imaging features and their correlations with pathology. BMC Med Imaging 2024; 24:336. [PMID: 39695980 DOI: 10.1186/s12880-024-01500-4] [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: 08/20/2024] [Accepted: 11/18/2024] [Indexed: 12/20/2024] Open
Abstract
PURPOSE Exploring the computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT Multimodal Imaging Characteristics of Desmoplastic Small Round Cell Tumor (DSRCT) to enhance the diagnostic proficiency of this condition. METHODS A retrospective analysis was performed on clinical data and multimodal imaging manifestations (CT, MRI, FDG-PET/CT) of eight cases of DSRCT. These findings were systematically compared with pathological results to succinctly summarize imaging features and elucidate their associations with both clinical and pathological characteristics. RESULTS All eight cases within this cohort exhibited abdominal-pelvic masses, comprising six solitary masses and two instances of multiple nodules, except for one case located in the left kidney, the remaining cases lacked a clear organ source. On plain images, seven cases exhibited patchy areas of low density within the masses, four cases showed calcification within the masses. Post-contrast imaging displayed mild-to-moderate, uneven enhancement. Larger masses displayed patchy areas without significant enhancement at the center. In the four MRI examinations, T1-weighted images exhibited uneven, low signal intensity, while T2-weighted images demonstrated uneven high signal intensity. Imaging unveiled four cases of liver metastasis, four cases of ascites, seven cases of lymph node metastasis, three cases of diffuse peritoneal thickening, and one case involving left ureter invasion with obstruction. In the FDG-PET/CT examinations of seven cases, multiple abnormal FDG accumulations were observed in the abdominal cavity, retroperitoneum, pelvis, and liver. One postoperative case revealed a new metastatic focus near the colonic hepatic region. The range of maximum standardized uptake values (SUVmax) for all lesions are 6.62-11.15. CONCLUSIONS DSRCT is commonly seen in young men, and the imaging results are mostly multiple lesions with no clear organ source. Other common findings include intratumoral calcification, liver metastasis, ascites, peritoneal metastasis, and retroperitoneal lymph node enlargement. The combined use of CT, MRI and FDG-PET/CT can improve the diagnostic accuracy and treatment evaluation of DSRCT. However, it is imperative to underscore that the definitive diagnosis remains contingent upon pathological examination.
Collapse
Affiliation(s)
- Kaiwei Xu
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
| | - Yi Chen
- Department of Radiology, Ningbo Medical Center of Lihuili Hospital of Ningbo University, 57 Xingning Road, Ningbo, 315040, People's Republic of China
| | - Wenqi Shen
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Ningbo University, 59 Liuting Street, Ningbo, 315010, People's Republic of China
| | - Fan Liu
- Department of Radiology, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361000, People's Republic of China
| | - Ruoyu Wu
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
| | - Jiajing Ni
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Ningbo University, 59 Liuting Street, Ningbo, 315010, People's Republic of China
| | - Linwei Wang
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Ningbo University, 59 Liuting Street, Ningbo, 315010, People's Republic of China
| | - Chunqu Chen
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
| | - Lubin Zhu
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Ningbo University, 59 Liuting Street, Ningbo, 315010, People's Republic of China
| | - Weijian Zhou
- Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Ningbo University, 59 Liuting Street, Ningbo, 315010, People's Republic of China
| | - Jian Zhang
- Shanghai Universal Medical Imaging Diagnostic Center, Building 8, 406 Guilin Road, Xuhui District, Shanghai, 201103, People's Republic of China.
| | - Changjing Zuo
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, 200433, People's Republic of China.
| | - Jianhua Wang
- Department of Radiology, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361000, People's Republic of China.
| |
Collapse
|
2
|
Chen Q, Zhao B, Chen Y, Yang X, Zhou K. Migrating pseudolipoma of Glisson's capsule: A case report. Radiol Case Rep 2024; 19:5365-5369. [PMID: 39280743 PMCID: PMC11402135 DOI: 10.1016/j.radcr.2024.08.028] [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: 06/03/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 09/18/2024] Open
Abstract
Pseudolipoma of Glisson's capsule is a rare, benign subcapsular liver lesion that typically occurs in older adult men. It comprises degenerated fat tissue that likely originates from detached mesothelial appendages or degenerated liver lipomas. We report the case of a 58-year-old female patient with a gastric malignant tumor after admission. No lesions were found in the liver capsule before surgery. During postoperative reviews from 2015 to 2018, new dense, fatty lesions were found under the liver capsule, and highly unusually, the lesions moved under the liver capsule over time. To the best of our knowledge, only 1 other case has been reported of a pseudolipoma of Glisson's capsule that migrated over time. This supports the hypothesis that migrating mesothelial attachments form Glisson capsule pseudolipomas. This case report aims to review liver capsule anatomy, explain why the liver is particularly susceptible to this phenomenon, and present information to aid the diagnosis of fat-containing hepatic lesions by providing a unique perspective on certain pathologies affecting the liver.
Collapse
Affiliation(s)
- Qiongying Chen
- Department of Radiology, Third People's Hospital of Zigong, Sichuan Province, China
| | - Bo Zhao
- Department of Radiology, Third People's Hospital of Zigong, Sichuan Province, China
| | - Yao Chen
- Department of Radiology, Third People's Hospital of Zigong, Sichuan Province, China
| | - Xing Yang
- Department of Radiology, Third People's Hospital of Zigong, Sichuan Province, China
| | - Ke Zhou
- Department of Radiology, Third People's Hospital of Zigong, Sichuan Province, China
| |
Collapse
|
3
|
Pan Y, Cheng J, Zhu Y, Zhang J, Fan W, Chen X. Immunological nanomaterials to combat cancer metastasis. Chem Soc Rev 2024; 53:6399-6444. [PMID: 38745455 DOI: 10.1039/d2cs00968d] [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: 05/16/2024]
Abstract
Metastasis causes greater than 90% of cancer-associated deaths, presenting huge challenges for detection and efficient treatment of cancer due to its high heterogeneity and widespread dissemination to various organs. Therefore, it is imperative to combat cancer metastasis, which is the key to achieving complete cancer eradication. Immunotherapy as a systemic approach has shown promising potential to combat metastasis. However, current clinical immunotherapies are not effective for all patients or all types of cancer metastases owing to insufficient immune responses. In recent years, immunological nanomaterials with intrinsic immunogenicity or immunomodulatory agents with efficient loading have been shown to enhance immune responses to eliminate metastasis. In this review, we would like to summarize various types of immunological nanomaterials against metastasis. Moreover, this review will summarize a series of immunological nanomaterial-mediated immunotherapy strategies to combat metastasis, including immunogenic cell death, regulation of chemokines and cytokines, improving the immunosuppressive tumour microenvironment, activation of the STING pathway, enhancing cytotoxic natural killer cell activity, enhancing antigen presentation of dendritic cells, and enhancing chimeric antigen receptor T cell therapy. Furthermore, the synergistic anti-metastasis strategies based on the combinational use of immunotherapy and other therapeutic modalities will also be introduced. In addition, the nanomaterial-mediated imaging techniques (e.g., optical imaging, magnetic resonance imaging, computed tomography, photoacoustic imaging, surface-enhanced Raman scattering, radionuclide imaging, etc.) for detecting metastasis and monitoring anti-metastasis efficacy are also summarized. Finally, the current challenges and future prospects of immunological nanomaterial-based anti-metastasis are also elucidated with the intention to accelerate its clinical translation.
Collapse
Affiliation(s)
- Yuanbo Pan
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou, 310009, Zhejiang, China
- Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, 310009, China
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore.
- Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Junjie Cheng
- Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, China
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore.
- Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yang Zhu
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China.
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore.
- Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou, 310009, Zhejiang, China
- Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, 310009, China
| | - Wenpei Fan
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, Center of Advanced Pharmaceuticals and Biomaterials, China Pharmaceutical University, Nanjing, 211198, China.
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore.
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
- Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Institute of Molecular and Cell Biology, Agency for Science, Technology, and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore, 138673, Singapore
- Theranostics Center of Excellence (TCE), Yong Loo Lin School of Medicine, National University of Singapore, 11 Biopolis Way, Helios, Singapore 138667, Singapore
| |
Collapse
|
4
|
Li J, Zhang J, Wang F, Ma J, Cui S, Ye Z. CT-Based Radiomics for the Preoperative Prediction of Occult Peritoneal Metastasis in Epithelial Ovarian Cancers. Acad Radiol 2024; 31:1918-1930. [PMID: 38072725 DOI: 10.1016/j.acra.2023.11.032] [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] [Received: 08/14/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 05/12/2024]
Abstract
RATIONALE AND OBJECTIVES The objective of this study was to develop a comprehensive combined model for predicting occult peritoneal metastasis (OPM) in epithelial ovarian cancers (EOCs) using radiomics features derived from computed tomography (CT) and clinical-radiological predictors. MATERIALS AND METHODS A total of 224 patients with EOCs were randomly divided into training dataset (N = 156) and test dataset (N = 86). Five clinical factors and seven radiological features were collected. The radiomics features were extracted from CT images of each patient. Multivariate logistic regression was employed to construct clinical and radiological models. The correlation analysis and least absolute shrinkage and selection operator algorithm were used to select radiomics features and build radiomics model. The important clinical, radiological factors, and radiomics features were integrated into a combined model by multivariate logistic regression. Receiver operating characteristics curve with area under the curve (AUC) were used to evaluate and compare predictive performance. RESULTS Carbohydrate antigen 125 (CA-125) and human epididymal protein 4 (HE-4) were independent clinical predictors. Laterality, thickened septa and margin were independent radiological predictors. In the training dataset, the AUCs for the clinical, radiological and radiomics models in evaluating OPM were 0.759, 0.819, and 0.830, respectively. In the test dataset, the AUCs for these models were 0.846, 0.835, and 0.779, respectively. The combined model outperformed other models in both the training and the test datasets with AUCs of 0.901 and 0.912, respectively. Decision curve analysis indicated that the combined model yielded a higher net benefit compared to the other models. CONCLUSION The combined model, integrating radiomics features with clinical and radiological predictors exhibited improved accuracy in predicting OPM in EOCs.
Collapse
Affiliation(s)
- Jiaojiao Li
- Department of Radiology, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China (J.L., S.C.); Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China (J.L., J.Z., F.W., J.M., Z.Y.)
| | - Jianing Zhang
- Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China (J.L., J.Z., F.W., J.M., Z.Y.)
| | - Fang Wang
- Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China (J.L., J.Z., F.W., J.M., Z.Y.)
| | - Juanwei Ma
- Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China (J.L., J.Z., F.W., J.M., Z.Y.)
| | - Shujun Cui
- Department of Radiology, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China (J.L., S.C.)
| | - Zhaoxiang Ye
- Department of Radiology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China (J.L., J.Z., F.W., J.M., Z.Y.).
| |
Collapse
|
5
|
Ionescu S, Marincas M, Madge OL, Dicu-Andreescu IG, Chitoran E, Rotaru V, Cirimbei C, Gherghe M, Ene A, Rosca R, Radu M, Simion L. Ovarian Causes of Pseudomyxoma Peritonei (PMP)-A Literature Review. Cancers (Basel) 2024; 16:1446. [PMID: 38672528 PMCID: PMC11047873 DOI: 10.3390/cancers16081446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare, progressive, slowly growing, inadequately understood neoplasm with a 5-year progression-free survival rate of as low as 48%. It is characterized by varying degrees of malignancy and the production of mucinous and gelatinous structures. Typically, the development of pseudomyxoma peritonei is associated with the rupture of appendiceal mucinous tumors and other gastrointestinal or ovarian mucinous tumors. The goal of our literature review was to identify various aspects that characterize the ovarian causes of pseudomyxoma peritonei. MATERIALS AND METHODS The authors performed an extensive literature search between 1 February 2024 and 2 March 2024 on the following databases: Pubmed, Scopus, Oxford Journals, and Reaxys, and the findings were summarized into seven main clinical and paraclinical situations. RESULTS According to our research, the main instances in which pseudomyxoma peritonei can be triggered by an ovarian cause are the following: (1) mucinous cystadenoma; (2) mucinous ovarian cancer; (3) colon cancer with ovarian metastasis; (4) malignant transformation of an ovarian primary mature cystic teratoma; (5) appendiceal mucocele with peritoneal dissemination mimicking an ovarian tumor with peritoneal carcinomatosis; (6) mucinous borderline tumor developing inside an ovarian teratoma; and (7) the association between a mucinous bilateral ovarian cancer and a colonic tumor. CONCLUSIONS In our study, we aimed to provide a comprehensive overview of the ovarian causes of pseudomyxoma peritonei, including its epidemiology, imagery characteristics, symptoms, current treatment, and promising future therapies, in the hopes of finding feasible solutions, as a lack of understanding of this mucus-secreting malignant disease increases the risk of delayed diagnosis or uncontrolled deterioration.
Collapse
Affiliation(s)
- Sinziana Ionescu
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Marian Marincas
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Octavia Luciana Madge
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
- Faculty of Letters, University of Bucharest, 030018 Bucharest, Romania
| | - Irinel Gabriel Dicu-Andreescu
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Elena Chitoran
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Vlad Rotaru
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Ciprian Cirimbei
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| | - Mirela Gherghe
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- The Clinical Nuclear Medicine Laboratory, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Adina Ene
- Pathology Department, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.E.); (M.R.)
| | - Robert Rosca
- Pathology Department, Bucharest Emergency University Hospital, 050098 Bucharest, Romania;
| | - Madalina Radu
- Pathology Department, Oncological Institute “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.E.); (M.R.)
| | - Laurentiu Simion
- Surgery Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.I.); (E.C.); (V.R.); (C.C.); (L.S.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania; (O.L.M.); (I.G.D.-A.)
| |
Collapse
|
6
|
Wahba R, Schmidt T, Buchner D, Wagner T, Bruns CJ. [Surgical treatment of pseudomyxoma peritonei-Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:840-844. [PMID: 37578542 DOI: 10.1007/s00104-023-01937-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Pseudomyxoma peritonei syndrome (PMP) is an orphan disease. Surgery is the fundament of treatment. METHOD Short review summarizing the state of the art treatment. RESULTS Cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) form the foundations of treatment for PMP. The peritoneal cancer index should be preoperatively determined based on imaging and/or laparoscopy, intraoperatively validated and both should be documented. An extraperitoneal surgical preparation technique leads to effective en bloc resection of the peritoneum and the affected abdominal area. The HIPEC technique should be performed with mitomycin C for 60-90 min. Complete CRS (CC = 0, CC = 1) and the histological subtype are relevant for the prognosis. Structured educational programs and mentoring can optimize the learning curve. The aftercare should be performed at the surgical center. After follow-up imaging at 3 months after CRS, in the first 2 years a control should be carried out every 6 months. Thereafter, the intervals can be extended to 1 year. CONCLUSION Standardized surgical treatment and HIPEC, optimized specific surgical training and structured follow-up at the center lead to an excellent long-term prognosis for patients with PMP.
Collapse
Affiliation(s)
- Roger Wahba
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
| | - Thomas Schmidt
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Denise Buchner
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Tristan Wagner
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| | - Christiane J Bruns
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland
| |
Collapse
|
7
|
Triumbari EKA, Rufini V, Mingels C, Rominger A, Alavi A, Fanfani F, Badawi RD, Nardo L. Long Axial Field-of-View PET/CT Could Answer Unmet Needs in Gynecological Cancers. Cancers (Basel) 2023; 15:2407. [PMID: 37173874 PMCID: PMC10177015 DOI: 10.3390/cancers15092407] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Gynecological malignancies currently affect about 3.5 million women all over the world. Imaging of uterine, cervical, vaginal, ovarian, and vulvar cancer still presents several unmet needs when using conventional modalities such as ultrasound, computed tomography (CT), magnetic resonance, and standard positron emission tomography (PET)/CT. Some of the current diagnostic limitations are represented by differential diagnosis between inflammatory and cancerous findings, detection of peritoneal carcinomatosis and metastases <1 cm, detection of cancer-associated vascular complications, effective assessment of post-therapy changes, as well as bone metabolism and osteoporosis assessment. As a result of recent advances in PET/CT instrumentation, new systems now offer a long-axial field-of-view (LAFOV) to image between 106 cm and 194 cm (i.e., total-body PET) of the patient's body simultaneously and feature higher physical sensitivity and spatial resolution compared to standard PET/CT systems. LAFOV PET could overcome the forementioned limitations of conventional imaging and provide valuable global disease assessment, allowing for improved patient-tailored care. This article provides a comprehensive overview of these and other potential applications of LAFOV PET/CT imaging for patients with gynecological malignancies.
Collapse
Affiliation(s)
- Elizabeth Katherine Anna Triumbari
- Nuclear Medicine Unit, G-STeP Radiopharmacy Research Core Facility, Department of Radiology, Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Vittoria Rufini
- Nuclear Medicine Unit, Department of Radiology, Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
- Section of Nuclear Medicine, Department of Radiological Sciences, Radiotherapy and Haematology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Francesco Fanfani
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Section of Obstetrics and Gynaecology, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Ramsey D. Badawi
- Department of Radiology, University of California Davis, Sacramento, CA 95819, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA 95819, USA
| |
Collapse
|
8
|
Zorzetto G, Coppola A, Molinelli V, Angeretti MG, Casarin J, Fontana F, Piacentino F, Carcano G, Ghezzi F, Venturini M. Spectral CT in peritoneal carcinomatosis from ovarian cancer: a tool for differential diagnosis of small nodules? Eur Radiol Exp 2022; 6:45. [PMID: 36245001 PMCID: PMC9573836 DOI: 10.1186/s41747-022-00302-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/04/2022] [Indexed: 01/17/2023] Open
Abstract
The detection of peritoneal carcinomatosis in patients with ovarian cancer is crucial to establish the correct therapeutic planning (debulking surgery versus neoadjuvant chemotherapy). Often, however, the nodules of peritoneal carcinomatosis are very small in size or have a reticular appearance that can mimic the fat stranding that is typical of acute inflammation conditions. Our hypothesis is that the use of dual-layer spectral computed tomography with its applications, such as virtual monoenergetic imaging and Z-effective imaging, might improve the detection and the characterisation of peritoneal nodules, increasing sensitivity and diagnostic accuracy, as recently described for other oncological diseases.
Collapse
|
9
|
Maghrebi H, Yakoubi C, Beji H, Letaief F, Megdich S, Makni A, Boukriba S, Frikha W, Ayadi M, Kacem M. Intra-abdominal cystic lymphangioma in adults: A case series of 32 patients and literature review. Ann Med Surg (Lond) 2022; 81:104460. [PMID: 36147158 PMCID: PMC9486738 DOI: 10.1016/j.amsu.2022.104460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/14/2022] [Accepted: 08/14/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Cystic lymphangioma (CL) is a benign tumor originating from the lymph vessels. Lymphangiomas in the abdominal cavity are extremely rare, particularly in adults. This article was designed to study the epidemiological, diagnostic difficulties, and therapeutic principles of intra-abdominal cystic lymphangioma (ACL) in adults. Material and methods We conducted a single-center, retrospective study of 32 adult patients with ACL admitted to surgical department “A” in “La Rabta Hospital” in Tunis, from January 1998 through December 2020. The demographic, clinical, biological, radiological characteristics, histopathologic, and therapeutic data were collected, as well as the surgical intervention used and the postoperative immediate and late complications. Results Thirty-two adult patients with ACL were recruited, including 20 females and 12 males. The median age at treatment was 47 (range 14–80) years. The most prevalent sites were the retroperitoneum (25%), the mesentery (21.9%), and the paracolic gutters (n = 18. 7%). Twenty patients underwent open surgery (62.5%), whereas 12 cases (37.5%) had laparoscopic surgery. Twenty-eight patients received total cystectomy (87%). Three recurrences were observed during follow-up (9.4%). Conclusion The clinical features of CL in adults remain unclear. The diagnosis is only confirmed by histopathological examination after complete surgical resection. The laparoscopic approach is considered safe and feasible. Lymphangiomas in the abdominal cavity are extremely rare, particularly in adults. Cystic lymphangioma is a benign tumor originating from the lymph vessels. The clinical presentation is various. Whenever possible, laparoscopic resection should be the treatment of choice. To prevent a recurrence, complete excision is the best option.
Collapse
|