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Chung C, Jeong D, Sohn H, Choi H, Kang YA. Low household income increases the risk of tuberculosis recurrence: a retrospective nationwide cohort study in South Korea. Public Health 2024; 226:228-236. [PMID: 38091811 DOI: 10.1016/j.puhe.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/14/2023] [Accepted: 11/08/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES We assessed the impact of household income on tuberculosis (TB) recurrence and the long-term impact of TB on household income. STUDY DESIGN This was a retrospective nationwide cohort study of patients with drug-susceptible TB (DS-TB) and TB recurrence. METHODS Using the South Korean national TB cohort database, we identified a sub-set cohort of patients with newly diagnosed drug-susceptible TB between 2013 and 2016 and tracked their TB recurrence and longitudinal income data from 2007 to 2018. Income levels were evaluated as 'Medical aid' and quintile categories. To assess risk factors associated with TB recurrence, we used a sub-distribution hazard model, adjusting for the competing risks of death. RESULTS Of 66,690 patients successfully treated with DS-TB, 2095 (3.1 %) experienced recurrence during a median follow-up of 39 months. The incidence of TB recurrence was 982.1/100,000 person-years, with 50.3 % of the recurrences occurring within 1 year of treatment completion. The risk of TB recurrence increased with decreasing income levels, with the highest risk observed in the lowest income group. The effect of income on TB recurrence was prominent in males but not in females. Overall, patients with TB recurrence experienced a linear decline in income levels, compared with those without recurrence. CONCLUSIONS Household income during the initial TB episode was an important risk factor for TB recurrence, particularly in males.
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Affiliation(s)
- C Chung
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - D Jeong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Choi
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Y A Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
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2
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Jeong D, Morse B, Polk SL, Chen DT, Li J, Hodul P, Centeno BA, Costello J, Jiang K, Machado S, El Naqa I, Farah PT, Huynh T, Raghunand N, Mok S, Dam A, Malafa M, Qayyum A, Fleming JB, Permuth JB. Pancreatic Cyst Size Measurement on Magnetic Resonance Imaging Compared to Pathology. Cancers (Basel) 2024; 16:206. [PMID: 38201633 PMCID: PMC10778543 DOI: 10.3390/cancers16010206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND While multiple cyst features are evaluated for stratifying pancreatic intraductal papillary mucinous neoplasms (IPMN), cyst size is an important factor that can influence treatment strategies. When magnetic resonance imaging (MRI) is used to evaluate IPMNs, no universally accepted sequence provides optimal size measurements. T2-weighted coronal/axial have been suggested as primary measurement sequences; however, it remains unknown how well these and maximum all-sequence diameter measurements correlate with pathology size. This study aims to compare agreement and bias between IPMN long-axis measurements on seven commonly obtained MRI sequences with pathologic size measurements. METHODS This retrospective cohort included surgically resected IPMN cases with preoperative MRI exams. Long-axis diameter tumor measurements and the presence of worrisome features and/orhigh-risk stigmata were noted on all seven MRI sequences. MRI size and pathology agreement and MRI inter-observer agreement involved concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC), respectively. The presence of worrisome features and high-risk stigmata were compared to the tumor grade using kappa analysis. The Bland-Altman analysis assessed the systematic bias between MRI-size and pathology. RESULTS In 52 patients (age 68 ± 13 years, 22 males), MRI sequences produced mean long-axis tumor measurements from 2.45-2.65 cm. The maximum MRI lesion size had a strong agreement with pathology (CCC = 0.82 (95% CI: 0.71-0.89)). The maximum IPMN size was typically observed on the axial T1 arterial post-contrast and MRCP coronal series and overestimated size versus pathology with bias +0.34 cm. The radiologist interobserver agreement reached ICCs 0.74 to 0.91 on the MRI sequences. CONCLUSION The maximum MRI IPMN size strongly correlated with but tended to overestimate the length compared to the pathology, potentially related to formalin tissue shrinkage during tissue processing.
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Affiliation(s)
- Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.M.); (J.C.); (A.Q.)
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 3011 Holly Drive, Tampa, FL 33612, USA;
| | - Brian Morse
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.M.); (J.C.); (A.Q.)
| | - Stuart Lane Polk
- College of Medicine, University of South Florida, 12902 USF Magnolia Drive, Tampa, FL 33612, USA;
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (D.-T.C.); (J.L.)
| | - Jiannong Li
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (D.-T.C.); (J.L.)
| | - Pamela Hodul
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
| | - Barbara A. Centeno
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.A.C.); (K.J.)
| | - James Costello
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.M.); (J.C.); (A.Q.)
| | - Kun Jiang
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.A.C.); (K.J.)
| | - Sebastian Machado
- Department of Clinical Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (S.M.); (P.T.F.)
| | - Issam El Naqa
- Department of Machine Learning, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA;
| | - Paola T. Farah
- Department of Clinical Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (S.M.); (P.T.F.)
| | - Tri Huynh
- College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA;
| | - Natarajan Raghunand
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA;
| | - Shaffer Mok
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
| | - Aamir Dam
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
| | - Aliya Qayyum
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (B.M.); (J.C.); (A.Q.)
| | - Jason B. Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
| | - Jennifer B. Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 3011 Holly Drive, Tampa, FL 33612, USA;
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA; (P.H.); (S.M.); (A.D.); (M.M.); (J.B.F.)
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Ose J, Beswick E, Van ST, Viskochil RH, Warby CA, Yap JT, Covington MF, Nguyen AH, Stanford JW, Lin T, Peoples AR, Hardikar S, Li CI, Grady WM, Shibatta D, Toriola AT, Schneider M, Figueiredo JC, Jeong D, Siegel EM, Ulrich CM, Gigic B. Abstract 355: Examination of systemic myokine concentrations with risk of cachexia in non-metastatic colorectal cancer patients - Results from the ColoCare Study. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
BACKGROUND: Cachexia is a multifactorial metabolic syndrome associated with higher risk of mortality. The precise molecular mechanisms and biological pathways involved remain poorly characterized. A specific criterion of cachexia is loss of muscle mass. Myokines affect muscle mass and have profound effects on glucose and lipid metabolism, thus contributing to energy homeostasis and potentially cachexia. Only sparse data for patients with non-metastatic colorectal cancer exist. This study aims to investigate associations of systemic myokine concentrations with onset of cachexia in non-metastatic colorectal cancer patients.
METHODS: Serum samples from n=125 colorectal cancer patients (stage I-III) recruited from the ColoCare Study site at Huntsman Cancer Institute were collected prior to surgery (baseline). Assays were run with the Milliplex Human Myokine Magnetic panel containing beads such as FABP3, Oncostatin M, and FGF21. Patients were defined as cachectic, pre-cachectic, or non-cachectic based on the criteria by Fearon et al. based on sex, BMI, and weight loss over a period of six months. ANOVA were applied to analyze associations of myokines with cachexia at 12 month after surgery, adjusted by age at diagnosis, sex, tumor stage, and tumor site.
RESULTS: At the 12 months follow-up, 11% of patients were diagnosed with cachexia (n=14), 14% of patients with pre-cachexia (n=18), and 74% of patients were defined as non-cachectic. Patients with cachexia were more likely to be diagnosed with rectal cancer (57%) compared to pre-cachectic (17%) or non-cachectic patients (42%; p<0.01). Patients who received neo-adjuvant treatment were more likely to be cachectic compared to pre-cachectic or non-cachectic patients (36% vs 11% vs 26%, respectively, p<0.01). FABP3 at baseline was significantly different across the three groups, e.g., FABP3 was 11.4 pg/ml for cachectic patients, 10.5 pg/ml for pre-cachectic patients, and 10.4 pg/ml for non-cachectic patients (p=0.02). FABP3 was associated with 65% increased risk of cachexia in unadjusted models, e.g., Odds ratio 1.65, 95% Confidence Intervals 1.05-2.61; p=0.03). After additional adjustment for age, sex, tumor site, and tumor stage the result was non-significant (p=0.26). There were no statistically significant differences in FGF21 and Oncostatin M concentrations across cachexia stages. C
ONCLUSIONS: Cachectic patients presented higher FABP3 concentrations (p=0.02) which were associated with increased risk of cachexia, however these results were not significant after adjustment. In this study, cachectic patients were more likely to be diagnosed with rectal cancer. In summary, larger studies are needed to further evaluate FABP3 and other myokines as potential prognostic biomarkers for cachexia and consider differences by tumor site.
Citation Format: Jennifer Ose, Ellen Beswick, Simon Ta Van, Richard H. Viskochil, Christy A. Warby, Jeffrey T. Yap, Matthew F. Covington, Anne H. Nguyen, Jordan W. Stanford, Tengda Lin, Anita R. Peoples, Sheetal Hardikar, Christopher I. Li, William M. Grady, David Shibatta, Adetunji T. Toriola, Martin Schneider, Jane C. Figueiredo, Daniel Jeong, Erin M. Siegel, Cornelia M. Ulrich, Biljana Gigic. Examination of systemic myokine concentrations with risk of cachexia in non-metastatic colorectal cancer patients - Results from the ColoCare Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 355.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tengda Lin
- 1Huntsman Cancer Institute, Salt Lake City, UT
| | | | | | | | | | - David Shibatta
- 5University of Tennessee Health Science Center, Memphis, TN
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4
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Lee DH, Chandrasekhar S, Jain MD, Mhaskar R, Reid K, Lee SB, Corallo S, Hidalgo-Vargas MJ, Kumar A, Chavez J, Shah B, Lazaryan A, Khimani F, Nishihori T, Bachmeier C, Faramand R, Fradley MG, Jeong D, Oliveira GH, Locke FL, Davila ML, Alomar M. Cardiac and inflammatory biomarker differences in adverse cardiac events after chimeric antigen receptor T-Cell therapy: an exploratory study. Cardiooncology 2023; 9:18. [PMID: 37005652 PMCID: PMC10067156 DOI: 10.1186/s40959-023-00170-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Chimeric antigen receptor T- Cell (CAR-T) immunotherapy has been a breakthrough treatment for various hematological malignancies. However, cardiotoxicities such as new-onset heart failure, arrhythmia, acute coronary syndrome and cardiovascular death occur in 10-15% of patients treated with CAR-T. This study aims to investigate the changes in cardiac and inflammatory biomarkers in CAR-T therapy to determine the role of pro-inflammatory cytokines. METHODS In this observational study, ninety consecutive patients treated with CAR-T underwent baseline cardiac investigation with electrocardiogram (ECG), transthoracic echocardiogram (TTE), troponin-I, and B-type natriuretic peptide (BNP). Follow-up ECG, troponin-I and BNP were obtained five days post- CAR-T. In a subset of patients (N = 53), serum inflammatory cytokines interleukin (IL)-2, IL-6, IL-15, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, granulocyte-macrophage colony-stimulating factor (GM-CSF), and angiopoietin 1 & 2 were tested serially, including baseline and daily during hospitalization. Adverse cardiac events were defined as new-onset cardiomyopathy/heart failure, acute coronary syndrome, arrhythmia and cardiovascular death. RESULTS Eleven patients (12%) had adverse cardiac events (one with new-onset cardiomyopathy and ten with new-onset atrial fibrillation). Adverse cardiac events appear to have occurred among patients with advanced age (77 vs. 66 years; p = 0.002), higher baseline creatinine (0.9 vs. 0.7 mg/dL; 0.007) and higher left atrial volume index (23.9 vs. 16.9mL/m2; p = 0.042). Day 5 BNP levels (125 vs. 63pg/mL; p = 0.019), but not troponin-I, were higher in patients with adverse cardiac events, compared to those without. The maximum levels of IL-6 (3855.0 vs. 254.0 pg/mL; p = 0.021), IFN-γ (474.0 vs. 48.8pg/mL; p = 0.006) and IL-15 (70.2 vs. 39.2pg/mL; p = 0.026) were also higher in the adverse cardiac events group. However, cardiac and inflammatory biomarker levels were not associated with cardiac events. Patients who developed cardiac events did not exhibit worse survival compared to patients without cardiac events (Log-rank p = 0.200). CONCLUSION Adverse cardiac events, predominantly atrial fibrillation, occur commonly after CAR-T (12%). The changes in serial inflammatory cytokine after CAR-T in the setting of adverse cardiac events suggests pro-inflammation as a pathophysiology and require further investigation for their role in adverse cardiac events. TWEET BRIEF HANDLE CAR-T related Cardiotoxicity has elevated cardiac and inflammatory biomarkers. #CARTCell #CardioOnc #CardioImmunology.
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Affiliation(s)
- Dae Hyun Lee
- Division of Cardiovascular Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Sanjay Chandrasekhar
- Division of Cardiovascular Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Michael D Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Kayla Reid
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Sae Bom Lee
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Salvatore Corallo
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Melanie J Hidalgo-Vargas
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Abhishek Kumar
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Julio Chavez
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Bijal Shah
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Aleksandr Lazaryan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Farhad Khimani
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Christina Bachmeier
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rawan Faramand
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Michael G Fradley
- Cardio-Oncology Center of Excellence, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel Jeong
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Guilherme H Oliveira
- Division of Cardiovascular Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Frederick L Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Marco L Davila
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Mohammed Alomar
- Division of Cardiovascular Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, CSB 3130, Tampa, Florida, 33612, USA.
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Chakiryan NH, Kim Y, Berglund A, Chang A, Kimmel GJ, Hajiran A, Nguyen J, Moran-Segura C, Saeed-Vafa D, Katende EN, Lopez-Blanco N, Chahoud J, Rappold P, Spiess PE, Fournier M, Jeong D, Wang L, Teer JK, Dhillon J, Kuo F, Hakimi AA, Altrock PM, Mulé JJ, Manley BJ. Geospatial characterization of immune cell distributions and dynamics across the microenvironment in clear cell renal cell carcinoma. J Immunother Cancer 2023; 11:jitc-2022-006195. [PMID: 37185232 PMCID: PMC10151991 DOI: 10.1136/jitc-2022-006195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION In clear cell renal cell carcinoma (ccRCC), tumor-associated macrophage (TAM) induction of CD8+T cells into a terminally exhausted state has been implicated as a major mechanism of immunotherapy resistance, but a deeper biological understanding is necessary. METHODS Primary ccRCC tumor samples were obtained from 97 patients between 2004 and 2018. Multiplex immunofluorescence using lymphoid and myeloid markers was performed in seven regions of interest per patient across three predefined zones, and geospatial analysis was performed using Ripley's K analysis, a methodology adapted from ecology. RESULTS Clustering of CD163+M2 like TAMs into the stromal compartment at the tumor-stroma interface was associated with worse clinical stage (tumor/CD163+nK(75): stage I/II: 4.4 (IQR -0.5 to 5.1); stage III: 1.4 (IQR -0.3 to 3.5); stage IV: 0.6 (IQR -2.1 to 2.1); p=0.04 between stage I/II and stage IV), and worse overall survival (OS) and cancer-specific survival (CSS) (tumor/CD163+nK(75): median OS-hi=149 months, lo=86 months, false-discovery rate (FDR)-adj. Cox p<0.001; median CSS-hi=174 months, lo=85 months; FDR-adj. Cox p<0.001). An RNA-seq differential gene expression score was developed using this geospatial metric, and was externally validated in multiple independent cohorts of patients with ccRCC including: TCGA KIRC, and the IMmotion151, IMmotion150, and JAVELIN Renal 101 clinical trials. In addition, this CD163+ geospatial pattern was found to be associated with a higher TIM-3+ proportion of CD8+T cells, indicative of terminal exhaustion (tumor-core: 0.07 (IQR 0.04-0.14) vs 0.40 (IQR 0.15-0.66), p=0.05). CONCLUSIONS Geospatial clustering of CD163+M2 like TAMs into the stromal compartment at the tumor-stromal interface was associated with poor clinical outcomes and CD8+T cell terminal exhaustion.
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Affiliation(s)
- Nicholas H Chakiryan
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Translational Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA
| | - Youngchul Kim
- Biostatistics and Bioinformatics, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Anders Berglund
- Biostatistics and Bioinformatics, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Andrew Chang
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Gregory J Kimmel
- Integrated Mathematical Oncology Department, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Ali Hajiran
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jonathan Nguyen
- Department of Pathology, H Lee Moffitt Cancer Center, Tampa, Florida, USA
| | | | | | - Esther N Katende
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Neale Lopez-Blanco
- Department of Pathology, H Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Jad Chahoud
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Phillip Rappold
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Michelle Fournier
- Tissue Core, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Daniel Jeong
- Department of Radiology, H Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Liang Wang
- Department of Tumor Biology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jamie K Teer
- Biostatistics and Bioinformatics, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jasreman Dhillon
- Department of Pathology, H Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Fengshen Kuo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Abraham Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Philipp M Altrock
- Department of Evolutionary Theory, Max Planck Institute for Evolutionary Biology, Ploen, Germany
| | - James J Mulé
- Department of Immunology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Radiation Oncology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Cutaneous Oncology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Brandon J Manley
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Integrated Mathematical Oncology Department, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Markovitz M, Jiang K, Kim D, Rose T, Permuth JB, Jeong D. Pancreatic colloid adenocarcinoma arising from intraductal papillary mucinous neoplasm: Radiologic-pathologic correlation with cinematic rendering. Acta Radiol Open 2023; 12:20584601231157046. [PMID: 36817179 PMCID: PMC9932949 DOI: 10.1177/20584601231157046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023] Open
Abstract
Intraductal papillary mucinous neoplasms (IPMN) of the pancreas have the potential for malignant progression into adenocarcinoma. Colloid or mucinous non-cystic carcinoma of the pancreas is an uncommon variant neoplasm that can arise within an intestinal type IPMN and have a relatively improved prognosis but may mimic the more lethal tubular or ductal adenocarcinoma. Colloid carcinoma is an infiltrating ductal epithelial neoplasm containing primarily extracellular stromal mucin pools and scant amount of centrally floating neoplastic cells. While several reports have evaluated the unique pathologic and immunohistochemical profile of colloid carcinomas, there has been limited radiologic-pathologic correlation in the literature. We report a case of an 83-year-old female who presented for evaluation of slowly progressive abdominal pain and was found to have colloid carcinoma arising from an IPMN. This is one of the first reports to correlate the multimodality radiology including cinematic rendering (CR) and histopathology features associated with this tumor. An enhanced understanding of the correlation between imaging appearance and specific histopathologic findings may aid in the early recognition and treatment of this rare neoplasm. Emphasis is placed on CR as this may help guide surgical management.
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Affiliation(s)
- Michael Markovitz
- Department of Radiology,
University
of South Florida, Tampa, FL, USA
| | - Kun Jiang
- Department of Anatomic Pathology,
H. Lee
Moffitt Cancer Center & Research
Institute, Tampa, FL, USA
| | - Daniel Kim
- University of South Florida College of
Medicine, Tampa, FL, USA
| | - Trevor Rose
- Department of Diagnostic and
Interventional Radiology, H. Lee Moffitt Cancer Center & Research
Institute, Tampa, FL, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal
Oncology, H. Lee
Moffitt Cancer Center & Research
Institute, Tampa, FL, USA,Department of Cancer Epidemiology,
H. Lee
Moffitt Cancer Center & Research
Institute, Tampa, FL, USA
| | - Daniel Jeong
- Department of Diagnostic and
Interventional Radiology, H. Lee Moffitt Cancer Center & Research
Institute, Tampa, FL, USA,Department of Cancer Epidemiology,
H. Lee
Moffitt Cancer Center & Research
Institute, Tampa, FL, USA,Daniel Jeong, Department of Diagnostic
Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center &
Research Institute, 12902 Magnolia Dr, Tampa, FL 33612, USA.
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7
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Sarcar B, Fang B, Izumi V, O Nunez Lopez Y, Tassielli A, Pratley R, Jeong D, Permuth JB, Koomen JM, Fleming JB, Stewart PA. A comparative Proteomics Analysis Identified Differentially Expressed Proteins in Pancreatic Cancer-Associated Stellate Cell Small Extracellular Vesicles. Mol Cell Proteomics 2022; 21:100438. [PMID: 36332889 PMCID: PMC9792568 DOI: 10.1016/j.mcpro.2022.100438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
Human pancreatic stellate cells (HPSCs) are an essential stromal component and mediators of pancreatic ductal adenocarcinoma (PDAC) progression. Small extracellular vesicles (sEVs) are membrane-enclosed nanoparticles involved in cell-to-cell communications and are released from stromal cells within PDAC. A detailed comparison of sEVs from normal pancreatic stellate cells (HPaStec) and from PDAC-associated stellate cells (HPSCs) remains a gap in our current knowledge regarding stellate cells and PDAC. We hypothesized there would be differences in sEVs secretion and protein expression that might contribute to PDAC biology. To test this hypothesis, we isolated sEVs using ultracentrifugation followed by characterization by electron microscopy and Nanoparticle Tracking Analysis. We report here our initial observations. First, HPSC cells derived from PDAC tumors secrete a higher volume of sEVs when compared to normal pancreatic stellate cells (HPaStec). Although our data revealed that both normal and tumor-derived sEVs demonstrated no significant biological effect on cancer cells, we observed efficient uptake of sEVs by both normal and cancer epithelial cells. Additionally, intact membrane-associated proteins on sEVs were essential for efficient uptake. We then compared sEV proteins isolated from HPSCs and HPaStecs cells using liquid chromatography-tandem mass spectrometry. Most of the 1481 protein groups identified were shared with the exosome database, ExoCarta. Eighty-seven protein groups were differentially expressed (selected by 2-fold difference and adjusted p value ≤0.05) between HPSC and HPaStec sEVs. Of note, HPSC sEVs contained dramatically more CSE1L (chromosome segregation 1-like protein), a described marker of poor prognosis in patients with pancreatic cancer. Based on our results, we have demonstrated unique populations of sEVs originating from stromal cells with PDAC and suggest that these are significant to cancer biology. Further studies should be undertaken to gain a deeper understanding that could drive novel therapy.
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Affiliation(s)
- Bhaswati Sarcar
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Bin Fang
- Proteomics and Metabolomics Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Victoria Izumi
- Proteomics and Metabolomics Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Alexandra Tassielli
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Richard Pratley
- Translational Research Institute, Advent Health, Orlando, Florida, USA
| | - Daniel Jeong
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - John M Koomen
- Proteomics and Metabolomics Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jason B Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
| | - Paul A Stewart
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
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8
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Lee DH, Jain M, Lazaryan A, Locke FL, Jeong D, Alomar M. Case of Myocarditis After Chimeric Antigen Receptor T Cells With Intracardiac Lymphoma. JACC Case Rep 2022; 8:101634. [PMID: 36860560 PMCID: PMC9969540 DOI: 10.1016/j.jaccas.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022]
Abstract
Chimeric antigen receptor T cells (CAR-T) therapy is a novel therapeutic approach that modifies T cells to attack cancer cells, including lymphoma. We present a case of large B cell lymphoma with intracardiac involvement treated with CAR-T in a patient who later experienced myocarditis after CAR-T therapy. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Dae Hyun Lee
- Division of Cardiovascular Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA,Department of Cardio-Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Michael Jain
- Department of Bone and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Aleksandr Lazaryan
- Department of Bone and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Frederick L. Locke
- Department of Bone and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Daniel Jeong
- Department of Radiology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Mohammed Alomar
- Division of Cardiovascular Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA,Department of Cardio-Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA,Address for correspondence: Dr. Mohammed Alomar, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, STC 5th floor Cardiology, Tampa, Florida 33602, USA. @mealomar
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9
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Swanson W, Beard C, Hou A, Hornik C, Jeong D. PARENT-REPORTED OUTCOMES DESIGN IN A DIGITAL EARLY ALLERGEN FEEDING STUDY WITH ECZEMATOUS AND NON-ECZEMATOUS INFANTS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Liu I, Jiang L, Samuelsson E, Marco Salas S, Hack O, Jeong D, Shaw M, Englinger B, LaBelle J, Ernst K, Palova H, Pokorna P, Sterba J, Slaby O, Geyeregger R, Jones D, Koschmann C, Svedlund J, Resnick A, Diaz A, Haberler C, Czech T, Slavc I, Cotter J, Ligon K, Alexandrescu S, Yung W, Arrillaga-Romany I, Suva M, Beck A, Gojo J, Monje M, Nilsson M, Filbin M. JS04.6.A The landscape of tumor cell states and spatial organization in H3-K27M mutant diffuse midline glioma across age and location. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Histone 3 lysine27-to-methionine mutations (H3-K27M) frequently occur in childhood diffuse midline gliomas (DMGs) of the pons, thalamus and spinal cord, presumed to be driven by the specific spatiotemporal context of these midline locations during postnatal development. While most common in the pons and at mid-childhood ages, the same oncohistone mutation is recurrently detected in adult DMGs and throughout different midline regions. The potential heterogeneity of tumors at different ages and in different anatomical locations of the midline are vastly understudied.
Material and Methods
Through dissecting the transcriptomic, epigenomic and spatial architectures of a comprehensive cohort of patient H3-K27M DMGs - spanning the age range from 2-68 years and locations from spinal cord to thalamus - at single cell resolution, we delineate how age- and location-dependent contexts shape glioma cell-intrinsic and -extrinsic features in light of the shared driver mutation.
Results
We identify that oligodendrocyte precursor (OPC)-like cells constitute the stem-like compartment in H3-K27M DMGs across all clinico-anatomical groups, however, depending on location, display varying levels of maturity resembling less differentiated pre-OPCs or more mature OPCs further differentiated along the oligodendroglial lineage. We further demonstrate increased mesenchymal cell states in adult tumors, which we link to age-related differences in glioma-associated immune cell compartments. We for the first time resolve the spatial organization of H3-K27M DMG cell types in intact patient tissues, identifying a local niche of the oligodendroglial lineage.
Conclusion
Our study provides a powerful resource for rational modeling and therapeutic frameworks taking into account determinants of age and location in this lethal glioma group.
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Affiliation(s)
- I Liu
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - L Jiang
- Dana-Farber Cancer Institute , Boston, MA , United States
| | | | | | - O Hack
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - D Jeong
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - M Shaw
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - B Englinger
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - J LaBelle
- Dana-Farber Cancer Institute , Boston, MA , United States
| | | | - H Palova
- Masaryk University , Brno , Czech Republic
| | - P Pokorna
- Masaryk University , Brno , Czech Republic
| | - J Sterba
- Masaryk University , Brno , Czech Republic
| | - O Slaby
- Masaryk University , Brno , Czech Republic
| | | | | | - C Koschmann
- University of Michigan , Ann Arbor, MI , United States
| | - J Svedlund
- Stockholm University , Stockholm , Sweden
| | - A Resnick
- Children's Hospital of Philadelphia , Philadelphia, PA , United States
| | - A Diaz
- UCSF , San Francisco, CA , United States
| | - C Haberler
- Medical University of Vienna , Vienna , Austria
| | - T Czech
- Medical University of Vienna , Vienna , Austria
| | - I Slavc
- Medical University of Vienna , Vienna , Austria
| | - J Cotter
- University of Southern California , Los Angeles, CA , United States
| | - K Ligon
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - S Alexandrescu
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - W Yung
- MD Anderson Cancer Center , Houston, TX , United States
| | | | - M Suva
- MGH , Boston, MA , United States
| | | | - J Gojo
- Medical University of Vienna , Vienna , Austria
| | - M Monje
- Stanford University , Stanford, CA , United States
| | - M Nilsson
- Stockholm University , Stockholm , Sweden
| | - M Filbin
- Dana-Farber Cancer Institute , Boston, MA , United States
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11
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Kim H, Jeong D, Jung Y. 518 Role Of TLR4 In chronic relapsing itch induced by subcutaneous capsaicin injection in neonatal rats. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Colin-Leitzinger C, Jeong D, Abdalah M, Cannioto R, Chern JY, Davis E, Gillies R, McGettigan M, Perez-Morales J, Raghunand N, Sinha S, Stringfield O, Tirbene R, Schabath M, Peres LC. Abstract 5886: Pre-treatment adiposity measured by computed tomography and survival of women with high-grade serous ovarian cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The association of body mass index (BMI) with survival of women with ovarian cancer remains unclear due to mixed epidemiological evidence. This may be due, in part, to the fact that BMI is an imperfect measure of body fat as BMI does not distinguish weight from lean muscle versus adipose tissue. Here, we investigated the association of adiposity measured by computed tomography (CT) with survival among the most common histotype of ovarian cancer, high-grade serous ovarian cancer (HGSOC). The present study included 383 women diagnosed with HGSOC from 2008 to 2019 who were evaluated at H. Lee Moffitt Cancer Center and Research Institute and had pre-treatment computed tomography scans available for analysis. The sliceOmatic v5.0 rev13 (Tomovision, Magog, Canada) medical image analysis software and accompanying ABACS module for segmentation was used to quantify subcutaneous (SAT), visceral (VAT), and intermuscular adipose tissue (IMAT) from the third lumbar (L3) axial slice including the transverse processes. We used Cox proportional hazard regression to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for the association of each measure of adiposity with overall survival (OS) and recurrence-free survival (RFS) while adjusting for age at diagnosis, stage, race and ethnicity, and first-line treatment. The degree of ascites was included in the VAT models as ascites fluid density can mask VAT. We also assessed these associations within first-line treatment groups (upfront chemotherapy [n=147], upfront surgery [n=236]). In the overall study population, we observed a positive but not statistically significant association with OS and RFS for the highest vs. lowest tertile of IMAT (HR= 1.18, 95% CI=0.83, 1.67 and HR=1.16, 95% CI=0.85, 1.58, respectively). Among women who received upfront surgery, the highest tertile of IMAT was associated with a 57% increased risk of recurrence compared to the lowest tertile (HR=1.57, 95% CI=1.04, 2.37), while the association between IMAT and OS was similar to the findings in the overall population (HR=1.14, 95% CI=0.73, 1.78). No association was observed between IMAT and OS or RFS among women who received upfront chemotherapy. No associations with OS or RFS were observed for SAT or VAT overall or within first-line treatment groups. In summary, we observed inferior RFS among HGSOC patients with higher IMAT. These findings suggest that IMAT measured from standard-of-care imaging may represent a biomarker of recurrence among HGSOC patients, and incorporating lifestyle and behavioral changes (e.g., diet, exercise) to decrease IMAT may be warranted for this patient population.
Citation Format: Christelle Colin-Leitzinger, Daniel Jeong, Mahmoud Abdalah, Rikki Cannioto, Jing-Yi Chern, Evan Davis, Robert Gillies, Melissa McGettigan, Jaileene Perez-Morales, Natarajan Raghunand, Sweta Sinha, Olya Stringfield, Rajwantee Tirbene, Matthew Schabath, Lauren C. Peres. Pre-treatment adiposity measured by computed tomography and survival of women with high-grade serous ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5886.
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Affiliation(s)
| | - Daniel Jeong
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mahmoud Abdalah
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Jing-Yi Chern
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Evan Davis
- 2Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Robert Gillies
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | | | - Sweta Sinha
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | | | - Lauren C. Peres
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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13
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Park MA, Krishna SG, Genilo-Delgado MC, Gumpper-Fedus K, Conwell DL, Hart PA, Dillhoff ME, Gomez MF, Basinski TL, Dam AN, Klapman JB, Fleming JB, Malafa M, Mohammadi A, Centeno BA, Jiang K, Jeong D, Chen DT, Xie M, Tan AC, Fridley BL, Teer JK, Cruz-Monserrate Z, Permuth JB. Abstract 2522: Pathway and immune profile analysis of cyst-derived versus PanIN-derived pancreatic ductal adenocarcinomas. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Pancreatic cystic lesions (PCL) are common and a subset of mucinous cysts will transform into pancreatic ductal adenocarcinoma (PDAC). However, predicting which of these mucinous PCL may progress to PDAC and warrant surgery remains a clinical challenge. Moreover, identifying those clinically emergent mucinous PCL for which a surveillance approach is best is a dire clinical need. Therefore, we aimed to identify molecular signatures that distinguished between PDAC with and without clinical evidence of a PCL to identify novel biomarkers.
Methods: We leveraged data from the Oncology Research Information Exchange Network (ORIEN) multi-institute sequencing project and analyzed 66 PDAC cases recruited to ORIEN from The Ohio State University Wexner Medical Center and Moffitt Cancer Center for which tumor whole transcriptome sequencing datasets were generated. We separated the cases based on whether a tumor had originated from a cystic lesion (n=16) or presumably through the pancreatic intraepithelial neoplasia (PanIN) pathway (n=50). We then performed differential expression and pathway analysis using both Gene-Set Enrichment Analysis (GSEA) and Pathway Analysis with Down-weighted Genes (PADOG) algorithms. Based on the emerging importance of the immune landscape in PDAC development, we also analyzed immune profiles using a novel tool, Tumor-immune Microenvironment Deconvolution Web-portal for Bulk Transcriptomics (TIMEx).
Results: When grouped by tumor origin, cyst-derived PDAC gene expression sets are enriched in immune signaling pathways, specifically NOTCH signaling (p=0.04), and demonstrate significant downregulation in amino acid metabolism, mitochondrial import and Gsα signaling pathways. Furthermore, GSEA based on TIMEx signatures indicated that multiple immune cell-specific profiles had significant enrichment scores in either the cyst-derived (for example, plasma cell: normalized enrichment score=-1.53; p=0.007) or non-cyst-derived (for example, neutrophil: normalized enrichment score=2.24; p=0.0001) PDAC cohorts.
Conclusions: Our data suggest that cyst-derived and non-cyst-derived PDACs differ by immune profile, enhanced NOTCH pathway usage and in the metabolic processing of multiple amino acids. These initial findings support future studies to assess the accuracy of risk stratifying PCLs based on their amino acid, metabolic, or immune profiles, and exploration into mechanisms to explain these findings.
Citation Format: Margaret A. Park, Somashekar G. Krishna, Maria C. Genilo-Delgado, Kristyn Gumpper-Fedus, Darwin L. Conwell, Phil A. Hart, Mary E. Dillhoff, Maria F. Gomez, Toni L. Basinski, Aamir N. Dam, Jason B. Klapman, Jason B. Fleming, Mokenge Malafa, Amir Mohammadi, Barbara A. Centeno, Kun Jiang, Daniel Jeong, Dung-Tsa Chen, Mengyu Xie, Aik Choon Tan, Brooke L. Fridley, Jamie K. Teer, Zobeida Cruz-Monserrate, Jennifer B. Permuth. Pathway and immune profile analysis of cyst-derived versus PanIN-derived pancreatic ductal adenocarcinomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2522.
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14
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Ose J, Yap JT, Jeong D, Van ST, Covington MF, Gigic B, Nattenmueller J, Haaland B, Lin T, Hardikar S, Himbert C, Peoples AR, Ashworth A, Boehm J, Schrotz-King P, Figueiredo JC, Toriola AT, Siegel EM, Li CI, Ulrich AB, Schneider M, Kauczor HU, Shibata D, Ulrich CM. Abstract 3221: Differences in body composition among rectal cancer patients with neo-adjuvant treatment-related toxicity: Results from the ColoCare Study. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND Neo-adjuvant chemoradiation is standard of care for patients diagnosed with stage II and III rectal cancer. This treatment can cause significant toxicities and may require treatment modifications. Obesity and low muscle mass (=sarcopenia) may portend increased toxicity to chemotherapy and/or radiation and may further affect mortality in rectal patients. The present study investigates associations of pre-treatment body composition parameters with toxicity in prospectively followed rectal cancer patients.
METHODS This initial analysis includes data from n=320 stage II and III rectal cancer patients from four study sites of the ColoCare Study. All patients underwent neo-adjuvant treatment. Pre-treatment CT scans were semi-automatically segmented at spinal level L3 vertebrae using SliceOmatic + ABACS software v5.0 rev13 to quantify: subcutaneous and visceral fat area (SFA/VFA, cm2) and skeletal muscle area (SMA, cm2). Information on toxicities was abstracted from medical charts and categorized into gastrointestinal, cardiovascular, and other system-specific toxicities. Median values were calculated for continuous variables (e.g., age at diagnosis, VFA, SFA, and SMA) and compared among patients who did versus did not experience toxicities. Frequencies and percentages were calculated for categorical variables.
RESULTS Among n=320 rectal cancer patients, n=48 (15%) patients experienced at least one toxicity that required treatment modification (defined as dose reduction or discontinuation of therapy). Patients who experienced toxicities were older (58 years vs 56 years), more likely to be male (63% vs 59%), and more likely to be diagnosed with stage III cancer (92% vs 69%) compared to patients who did not experience toxicities. Patients who had higher VFA (166 cm2 vs 148 cm2), lower SFA (197 cm2 vs 208 cm2), and lower SMA (144 cm2 vs 147 cm2) were more likely to experience toxicities compared to patients with lower VFA, higher SFA, or higher SMA.
CONCLUSIONS Body composition parameters may differ between rectal cancer patients who experience toxicities versus those who do not. Multivariate logistic regression and Cox proportional hazard analyses are underway to investigate in more detail the associations of body composition parameters (VFA, SFA, SMA), sarcopenia, and sarcopenic obesity with toxicity and survival in rectal cancer patients.
Citation Format: Jennifer Ose, Jeffrey T. Yap, Daniel Jeong, Simon Ta Van, Matthew F. Covington, Biljana Gigic, Johanna Nattenmueller, Benjamin Haaland, Tengda Lin, Sheetal Hardikar, Caroline Himbert, Anita R. Peoples, Anjelica Ashworth, Juergen Boehm, Petra Schrotz-King, Jane C. Figueiredo, Adetunji T. Toriola, Erin M. Siegel, Christopher I. Li, Alexis B. Ulrich, Martin Schneider, Hans-Ulrich Kauczor, David Shibata, Cornelia M. Ulrich. Differences in body composition among rectal cancer patients with neo-adjuvant treatment-related toxicity: Results from the ColoCare Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3221.
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Affiliation(s)
| | | | - Daniel Jeong
- 2H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | | | | | | | - Tengda Lin
- 1Huntsman Cancer Institute, Salt Lake City, UT
| | | | | | | | | | | | | | | | | | - Erin M. Siegel
- 2H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
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15
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Permuth JB, Mesa T, Williams SL, Cardentey Y, Zhang D, Pawlak EA, Li J, Cameron ME, Ali KN, Jeong D, Yoder SJ, Chen DT, Trevino JG, Merchant N, Malafa M. A pilot study to troubleshoot quality control metrics when assessing circulating miRNA expression data reproducibility across study sites. Cancer Biomark 2022; 33:467-478. [PMID: 35491771 PMCID: PMC9428925 DOI: 10.3233/cbm-210255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Given the growing interest in using microRNAs (miRNAs) as biomarkers of early disease, establishment of robust protocols and platforms for miRNA quantification in biological fluids is critical. OBJECTIVE: The goal of this multi-center pilot study was to evaluate the reproducibility of NanoString nCounter™ technology when analyzing the abundance of miRNAs in plasma and cystic fluid from patients with pancreatic lesions. METHODS: Using sample triplicates analyzed across three study sites, we assessed potential sources of variability (RNA isolation, sample processing/ligation, hybridization, and lot-to-lot variability) that may contribute to suboptimal reproducibility of miRNA abundance when using nCounter™, and evaluated expression of positive and negative controls, housekeeping genes, spike-in genes, and miRNAs. RESULTS: Positive controls showed a high correlation across samples from each site (median correlation coefficient, r> 0.9). Most negative control probes had expression levels below background. Housekeeping and spike-in genes each showed a similar distribution of expression and comparable pairwise correlation coefficients of replicate samples across sites. A total of 804 miRNAs showed a similar distribution of pairwise correlation coefficients between replicate samples (p= 0.93). After normalization and selecting miRNAs with expression levels above zero in 80% of samples, 55 miRNAs were identified; heatmap and principal component analysis revealed similar expression patterns and clustering in replicate samples. CONCLUSIONS: Findings from this pilot investigation suggest the nCounter platform can yield reproducible results across study sites. This study underscores the importance of implementing quality control procedures when designing multi-center evaluations of miRNA abundance.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Tania Mesa
- Molecular Genomics Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sion L. Williams
- Oncogenomics Shared Resource, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Yoslayma Cardentey
- Oncogenomics Shared Resource, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Dongyu Zhang
- Department of Cancer Epidemiology, University of Florida, Gainesville, FL, USA
| | | | - Jiannong Li
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Miles E. Cameron
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Karla N. Ali
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Tampa, FL, USA
| | - Sean J. Yoder
- Molecular Genomics Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jose G. Trevino
- Department of Surgery, University of Florida, Gainesville, FL, USA
- Department of Surgery, Division of Surgical Oncology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Nipun Merchant
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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16
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Adu P, Binka M, Mahmood B, Jeong D, Buller-Tylor T, Damascene MJ, Iyaniwura S, Ringa N, Velasquez H, Wong S, Yu A, Bartlett S, Wilton J, Irvine M, Otterstatter M, Janjua N. Quantifying Contact Patterns: Development and Characteristics of the British Columbia COVID-19 Population Mixing Patterns Survey. Int J Infect Dis 2022. [PMCID: PMC8884815 DOI: 10.1016/j.ijid.2021.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Several non-pharmaceutical interventions such as physical distancing, self-isolation, a stay-at-home order, hand washing, and schools and businesses closures were implemented in British Columbia (BC) following the first lab-tested case of COVID-19 on January 26, 2020. These interventions were aimed at minimizing in-person contacts that could potentially lead to new COVID-19 infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. We describe the BC-Mix survey design and the demographic characteristics of respondents. Methods & Materials The ongoing repeated online survey was launched in September 2020. Participants are recruited through a variety of social media platforms including Instagram, Facebook, YouTube, and community group mailing lists. A follow up survey is sent to participants two to four weeks after completing the first iteration. Survey responses are weighted to BC's population by age, sex, geography, and ethnicity to obtain generalizable estimates. A survey completion rate of at least 33% AND a valid response for the sex questionnaire item AND a valid response for age questionnaire item were required for inclusion in weighting and further analysis. Additional indices such as material and social deprivation index, and residential instability are generated using census and location data. Results As of June 14, 2021, over 58,000 residents of BC had participated in the survey of which 31,007 survey responses were eligible for analysis. Of the eligible participants, about 60% provided consent for monthly follow up and about 26% provided their personal health numbers for linkage with other healthcare utilization databases. Approximately 51% were females 39% were 55 years or older, 63% identified as white or not a visible minority and 48% had at least a university degree. Conclusion The pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represented a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey continues to inform provincial COVID-19-related control measures.
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17
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Ehab J, Powers B, Kim R, Haider M, Utuama O, Chin A, Denbo J, Kis B, Frakes J, Jeong D, Lauwers G, Vadaparampil S, Fleming JB, Anaya DA. ASO Visual Abstract: Integrating a Disease-Focused Tumor Board as a Delivery-of-Care Model to Expedite Treatment Initiation for Patients with Liver Malignancies. Ann Surg Oncol 2021. [PMID: 34716839 DOI: 10.1245/s10434-021-10952-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jasmina Ehab
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Benjamin Powers
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Richard Kim
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mintallah Haider
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ovie Utuama
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Alicia Chin
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jason Denbo
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Bela Kis
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jessica Frakes
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gregory Lauwers
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jason B Fleming
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel A Anaya
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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18
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Ehab J, Powers B, Kim R, Haider M, Utuama O, Chin A, Denbo J, Kis B, Frakes J, Jeong D, Lauwers G, Vadaparampil S, Fleming JB, Anaya DA. Integrating a Disease-Focused Tumor Board as a Delivery-of-Care Model to Expedite Treatment Initiation for Patients With Liver Malignancies. Ann Surg Oncol 2021; 29:2371-2380. [PMID: 34671878 DOI: 10.1245/s10434-021-10909-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/18/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patients with hepatobiliary malignancies are especially vulnerable to treatment delays. This study sought to evaluate the impact of implementing a new delivery-of-care model centered around a hepatobiliary multidisciplinary tumor board (HB-MTB) and integrated with an optimized patient workflow process to expedite treatment initiation. METHODS A hybrid type 2 study (effectiveness-implementation) was performed. Implementation measures were examined prospectively using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) approach during 5 years after the HB-MTB program deployment (2015-2020). The primary outcome was effectiveness, measured as time to treatment initiation (TTI) using a before and after design (1 year each). The patients were grouped into before (BP) and after (AP) categories based on date of HB-MTB program implementation. Multivariable Cox and linear regression analyses were performed to examine and compare time to treatment initiation between groups. RESULTS The HB-MTB program enrolled 2457 patients (reach). The RE-AIM measures were favorable and improved over time (P < 0.01 for all). The median TTI was lower for the AP group than for the BP group (17 vs 24 days; P < 0.01). In the multivariable Cox and linear regressions, treatment in the AP group was associated with a faster TTI (hazard ratio, 1.75; 95 % confidence interval, 1.31-2.35; p < 0.01), and a mean of 13 days faster treatment initiation than the BP group (P < 0.01). CONCLUSIONS Implementation of an HB-MTB program integrated with an optimized patient workflow was successful and led to faster treatment initiation. This delivery-of-care model can serve as a blueprint to expedite treatment of patients with cancer.
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Affiliation(s)
- Jasmina Ehab
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Benjamin Powers
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Richard Kim
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Mintallah Haider
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Ovie Utuama
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Alicia Chin
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Jason Denbo
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Bela Kis
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.,Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jessica Frakes
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.,Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.,Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gregory Lauwers
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.,Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jason B Fleming
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Daniel A Anaya
- Section of Hepatobiliary Tumors, Department of Gastrointestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA. .,Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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19
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Wahl K, Ennis M, Jeong D, Knight K, Renner R, Munro S, Dunn S, Guilbert E, Norman WV. POSTER ABSTRACTS. Contraception 2021. [PMCID: PMC8421027 DOI: 10.1016/j.contraception.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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20
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Permuth JB, Vyas S, Li J, Chen DT, Jeong D, Choi JW. Comparison of Radiomic Features in a Diverse Cohort of Patients With Pancreatic Ductal Adenocarcinomas. Front Oncol 2021; 11:712950. [PMID: 34367997 PMCID: PMC8339963 DOI: 10.3389/fonc.2021.712950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background Significant racial disparities in pancreatic cancer incidence and mortality rates exist, with the highest rates in African Americans compared to Non-Hispanic Whites and Hispanic/Latinx populations. Computer-derived quantitative imaging or “radiomic” features may serve as non-invasive surrogates for underlying biological factors and heterogeneity that characterize pancreatic tumors from African Americans, yet studies are lacking in this area. The objective of this pilot study was to determine if the radiomic tumor profile extracted from pretreatment computed tomography (CT) images differs between African Americans, Non-Hispanic Whites, and Hispanic/Latinx with pancreatic cancer. Methods We evaluated a retrospective cohort of 71 pancreatic cancer cases (23 African American, 33 Non-Hispanic White, and 15 Hispanic/Latinx) who underwent pretreatment CT imaging at Moffitt Cancer Center and Research Institute. Whole lesion semi-automated segmentation was performed on each slice of the lesion on all pretreatment venous phase CT exams using Healthmyne Software (Healthmyne, Madison, WI, USA) to generate a volume of interest. To reduce feature dimensionality, 135 highly relevant non-texture and texture features were extracted from each segmented lesion and analyzed for each volume of interest. Results Thirty features were identified and significantly associated with race/ethnicity based on Kruskal-Wallis test. Ten of the radiomic features were highly associated with race/ethnicity independent of tumor grade, including sphericity, volumetric mean Hounsfield units (HU), minimum HU, coefficient of variation HU, four gray level texture features, and two wavelet texture features. A radiomic signature summarized by the first principal component partially differentiated African American from non-African American tumors (area underneath the curve = 0.80). Poorer survival among African Americans compared to Non-African Americans was observed for tumors with lower volumetric mean CT [HR: 3.90 (95% CI:1.19–12.78), p=0.024], lower GLCM Avg Column Mean [HR:4.75 (95% CI: 1.44,15.37), p=0.010], and higher GLCM Cluster Tendency [HR:3.36 (95% CI: 1.06–10.68), p=0.040], and associations persisted in volumetric mean CT and GLCM Avg Column after adjustment for key clinicopathologic factors. Conclusions This pilot study identified several textural radiomics features associated with poor overall survival among African Americans with PDAC, independent of other prognostic factors such as grade. Our findings suggest that CT radiomic features may serve as surrogates for underlying biological factors and add value in predicting clinical outcomes when integrated with other parameters in ongoing and future studies of cancer health disparities.
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Affiliation(s)
- Jennifer B Permuth
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Shraddha Vyas
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Jiannong Li
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Daniel Jeong
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Jung W Choi
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
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21
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Parikh P, Rose T, Jeong D, Lam CA, Afiat TP, Rosa M, Araujo C. Diffuse intrasinusoidal hepatic metastasis from breast cancer: Multimodality imaging with pathology correlation. Radiol Case Rep 2021; 16:1005-1009. [PMID: 33680266 PMCID: PMC7917459 DOI: 10.1016/j.radcr.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 01/03/2023] Open
Abstract
Metastatic disease to the liver is a known and common site of breast cancer spread, classically presenting as either hypovascular or hypervascular masses. Rarely, hepatic metastatic disease may have an atypical diffuse and intrasinusoidal pattern of involvement, which may be radiographically occult or extremely challenging to diagnose even with multiphase contrast enhanced techniques. We report a case of a 28-year-old female with stage III invasive ductal carcinoma of the breast, who recently discontinued treatment due to pregnancy, presenting with progressive signs and symptoms of rapidly decompensating liver failure due to sinusoidal obstruction. Multimodality imaging was performed without evidence for focal hepatic metastatic disease; however, intrahepatic vein (IVC) compression was noted. Hepatic sinusoidal tumor infiltration was confirmed by liver biopsy. After palliative chemotherapy the disease became less infiltrative and more conspicuous on imaging, revealing itself as hepatic metastases, with decreased compression of the intrahepatic IVC and resolution of signs and symptoms of sinusoidal obstruction syndrome.
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Affiliation(s)
- Puja Parikh
- University of South Florida, Department of Radiology, 2 Tampa General Circle, STC 7028, Tampa, FL 33606, USA,Corresponding author.
| | - Trevor Rose
- H. Lee Moffitt Cancer Center and Research Institute, Department of Diagnostic and Interventional Radiology, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Daniel Jeong
- H. Lee Moffitt Cancer Center and Research Institute, Department of Diagnostic and Interventional Radiology, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Cesar A. Lam
- H. Lee Moffitt Cancer Center and Research Institute, Department of Diagnostic and Interventional Radiology, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Thanh-Phuong Afiat
- H. Lee Moffitt Cancer Center and Research Institute, Department of Internal Hospital Medicine, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Marilin Rosa
- H. Lee Moffitt Cancer Center and Research Institute, Department of Pathology, Breast Pathology, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Cyrillo Araujo
- H. Lee Moffitt Cancer Center and Research Institute, Department of Diagnostic and Interventional Radiology, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
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22
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Permuth JB, Dezsi KB, Vyas S, Ali KN, Basinski TL, Utuama OA, Denbo JW, Klapman J, Dam A, Carballido E, Kim DW, Pimiento JM, Powers BD, Otto AK, Choi JW, Chen DT, Teer JK, Beato F, Ward A, Cortizas EM, Whisner SY, Williams IE, Riner AN, Tardif K, Velanovich V, Karachristos A, Douglas WG, Legaspi A, Allan BJ, Meredith K, Molina-Vega MA, Bao P, St. Julien J, Huguet KL, Green L, Odedina FT, Kumar NB, Simmons VN, George TJ, Vadaparampil ST, Hodul PJ, Arnoletti JP, Awad ZT, Bose D, Jiang K, Centeno BA, Gwede CK, Malafa M, Judge SM, Judge AR, Jeong D, Bloomston M, Merchant NB, Fleming JB, Trevino JG. The Florida Pancreas Collaborative Next-Generation Biobank: Infrastructure to Reduce Disparities and Improve Survival for a Diverse Cohort of Patients with Pancreatic Cancer. Cancers (Basel) 2021; 13:809. [PMID: 33671939 PMCID: PMC7919015 DOI: 10.3390/cancers13040809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Well-annotated, high-quality biorepositories provide a valuable platform to support translational research. However, most biorepositories have poor representation of minority groups, limiting the ability to address health disparities. Methods: We describe the establishment of the Florida Pancreas Collaborative (FPC), the first state-wide prospective cohort study and biorepository designed to address the higher burden of pancreatic cancer (PaCa) in African Americans (AA) compared to Non-Hispanic Whites (NHW) and Hispanic/Latinx (H/L). We provide an overview of stakeholders; study eligibility and design; recruitment strategies; standard operating procedures to collect, process, store, and transfer biospecimens, medical images, and data; our cloud-based data management platform; and progress regarding recruitment and biobanking. Results: The FPC consists of multidisciplinary teams from fifteen Florida medical institutions. From March 2019 through August 2020, 350 patients were assessed for eligibility, 323 met inclusion/exclusion criteria, and 305 (94%) enrolled, including 228 NHW, 30 AA, and 47 H/L, with 94%, 100%, and 94% participation rates, respectively. A high percentage of participants have donated blood (87%), pancreatic tumor tissue (41%), computed tomography scans (76%), and questionnaires (62%). Conclusions: This biorepository addresses a critical gap in PaCa research and has potential to advance translational studies intended to minimize disparities and reduce PaCa-related morbidity and mortality.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Kaleena B. Dezsi
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Shraddha Vyas
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Karla N. Ali
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Toni L. Basinski
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Ovie A. Utuama
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Jason W. Denbo
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jason Klapman
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Aamir Dam
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Estrella Carballido
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Dae Won Kim
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose M. Pimiento
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Benjamin D. Powers
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Amy K. Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33612, USA;
| | - Jung W. Choi
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Jamie K. Teer
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Francisca Beato
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Alina Ward
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Elena M. Cortizas
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | | | - Iverson E. Williams
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Andrea N. Riner
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Kenneth Tardif
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Vic Velanovich
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Andreas Karachristos
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Wade G. Douglas
- Division of Surgery, Tallahassee Memorial Healthcare, Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, FL 32308, USA;
| | - Adrian Legaspi
- Center for Advanced Surgical Oncology at Palmetto General Hospital, Tenet Healthcare Palmetto General, Hialeah, FL 33016, USA;
| | - Bassan J. Allan
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Kenneth Meredith
- Department of Gastrointestinal Oncology, Brian Jellison Cancer Institute, Sarasota Memorial Hospital, Sarasota, FL 34239, USA;
| | | | - Philip Bao
- Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA;
| | - Jamii St. Julien
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Kevin L. Huguet
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Lee Green
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Folakemi T. Odedina
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL 32610, USA;
| | - Nagi B. Kumar
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Thomas J. George
- Division of Oncology, Department of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Susan T. Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Pamela J. Hodul
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - J. Pablo Arnoletti
- Center for Surgical Oncology, Advent Health Orlando, Orlando, FL 32804, USA;
| | - Ziad T. Awad
- Surgery, University of Florida-Jacksonville, Jacksonville, FL 32209, USA;
| | - Debashish Bose
- Surgical Oncology, University of Florida-Orlando, Orlando, FL 32806, USA;
| | - Kun Jiang
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Barbara A. Centeno
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Clement K. Gwede
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Sarah M. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Andrew R. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Mark Bloomston
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Nipun B. Merchant
- Department of Surgical Oncology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Jason B. Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose G. Trevino
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23219, USA
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Beato F, Reverón D, Dezsi KB, Ortiz A, Johnson JO, Chen DT, Ali K, Yoder SJ, Jeong D, Malafa M, Hodul P, Jiang K, Centeno BA, Abdalah MA, Balasi JA, Tassielli AF, Sarcar B, Teer JK, DeNicola GM, Permuth JB, Fleming JB. Establishing a living biobank of patient-derived organoids of intraductal papillary mucinous neoplasms of the pancreas. J Transl Med 2021; 101:204-217. [PMID: 33037322 PMCID: PMC7855435 DOI: 10.1038/s41374-020-00494-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer (PaCa) is the third leading cause of cancer-related deaths in the United States. There is an unmet need to develop strategies to detect PaCa at an early, operable stage and prevent its progression. Intraductal papillary mucinous neoplasms (IPMNs) are cystic PaCa precursors that comprise nearly 50% of pancreatic cysts detected incidentally via cross-sectional imaging. Since IPMNs can progress from low- and moderate-grade dysplasia to high-grade dysplasia and invasion, the study of these lesions offers a prime opportunity to develop early detection and prevention strategies. Organoids are an ideal preclinical platform to study IPMNs, and the objective of the current investigation was to establish a living biobank of patient-derived organoids (PDO) from IPMNs. IPMN tumors and adjacent normal pancreatic tissues were successfully harvested from 15 patients with IPMNs undergoing pancreatic surgical resection at Moffitt Cancer Center & Research Institute (Tampa, FL) between May of 2017 and March of 2019. Organoid cultures were also generated from cryopreserved tissues. Organoid count and size were determined over time by both Image-Pro Premier 3D Version 9.1 digital platform and Matlab application of a Circular Hough Transform algorithm, and histologic and genomic characterization of a subset of the organoids was performed using immunohistochemistry and targeted sequencing, respectively. The success rates for organoid generation from IPMN tumor and adjacent normal pancreatic tissues were 81% and 87%, respectively. IPMN organoids derived from different epithelial subtypes showed different morphologies in vitro, and organoids recapitulated histologic and genomic characteristics of the parental IPMN tumor. In summary, this preclinical model has the potential to provide new opportunities to unveil mechanisms of IPMN progression to invasion and to shed insight into novel biomarkers for early detection and targets for chemoprevention.
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Affiliation(s)
- Francisca Beato
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Kaleena B Dezsi
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Antonio Ortiz
- Analytical Microscopy Core Facility, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Joseph O Johnson
- Analytical Microscopy Core Facility, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Karla Ali
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sean J Yoder
- Molecular Genomics Core Facility, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Department of Diagnostic Imaging, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Pamela Hodul
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kun Jiang
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Barbara A Centeno
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mahmoud A Abdalah
- Imaging Response Assessment Team Core Facility, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jodi A Balasi
- Tissue Core Histology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Alexandra F Tassielli
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Bhaswati Sarcar
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jamie K Teer
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gina M DeNicola
- Department of Cancer Physiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jason B Fleming
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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24
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Polk SL, Choi JW, McGettigan MJ, Rose T, Ahmed A, Kim J, Jiang K, Balagurunathan Y, Qi J, Farah PT, Rathi A, Permuth JB, Jeong D. Multiphase computed tomography radiomics of pancreatic intraductal papillary mucinous neoplasms to predict malignancy. World J Gastroenterol 2020; 26:3458-3471. [PMID: 32655269 PMCID: PMC7327792 DOI: 10.3748/wjg.v26.i24.3458] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/09/2020] [Accepted: 06/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intraductal papillary mucinous neoplasms (IPMNs) are non-invasive pancreatic precursor lesions that can potentially develop into invasive pancreatic ductal adenocarcinoma. Currently, the International Consensus Guidelines (ICG) for IPMNs provides the basis for evaluating suspected IPMNs on computed tomography (CT) imaging. Despite using the ICG, it remains challenging to accurately predict whether IPMNs harbor high grade or invasive disease which would warrant surgical resection. A supplementary quantitative radiological tool, radiomics, may improve diagnostic accuracy of radiological evaluation of IPMNs. We hypothesized that using CT whole lesion radiomics features in conjunction with the ICG could improve the diagnostic accuracy of predicting IPMN histology.
AIM To evaluate whole lesion CT radiomic analysis of IPMNs for predicting malignant histology compared to International Consensus Guidelines.
METHODS Fifty-one subjects who had pancreatic surgical resection at our institution with histology demonstrating IPMN and available preoperative CT imaging were included in this retrospective cohort. Whole lesion semi-automated segmentation was performed on each preoperative CT using Healthmyne software (Healthmyne, Madison, WI). Thirty-nine relevant radiomic features were extracted from each lesion on each available contrast phase. Univariate analysis of the 39 radiomics features was performed for each contrast phase and values were compared between malignant and benign IPMN groups using logistic regression. Conventional quantitative and qualitative CT measurements were also compared between groups, via χ2 (categorical) and Mann Whitney U (continuous) variables.
RESULTS Twenty-nine subjects (15 males, age 71 ± 9 years) with high grade or invasive tumor histology comprised the "malignant" cohort, while 22 subjects (11 males, age 70 ± 7 years) with low grade tumor histology were included in the "benign" cohort. Radiomic analysis showed 18/39 precontrast, 19/39 arterial phase, and 21/39 venous phase features differentiated malignant from benign IPMNs (P < 0.05). Multivariate analysis including only ICG criteria yielded two significant variables: thickened and enhancing cyst wall and enhancing mural nodule < 5 mm with an AUC (95%CI) of 0.817 (0.709-0.926). Multivariable post contrast radiomics achieved an AUC (95%CI) of 0.87 (0.767-0.974) for a model including arterial phase radiomics features and 0.834 (0.716-0.953) for a model including venous phase radiomics features. Combined multivariable model including conventional variables and arterial phase radiomics features achieved an AUC (95%CI) of 0.93 (0.85-1.0) with a 5-fold cross validation AUC of 0.90.
CONCLUSION Multi-phase CT radiomics evaluation could play a role in improving predictive capability in diagnosing malignancy in IPMNs. Future larger studies may help determine the clinical significance of our findings.
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Affiliation(s)
- Stuart L Polk
- University of South Florida College of Medicine, Tampa, FL 33612, United States
| | - Jung W Choi
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Melissa J McGettigan
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Trevor Rose
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Abraham Ahmed
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Jongphil Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Kun Jiang
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Yoganand Balagurunathan
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Jin Qi
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Paola T Farah
- Department of Clinical Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Alisha Rathi
- Department of Radiology, University of Florida, Gainesville, FL 32610, United States
| | - Jennifer B Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Daniel Jeong
- Department of Diagnostic and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
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Underwood P, Cameron M, Daly AC, Barnett T, Gwede C, Magliocco A, Centeno B, Chen DT, Choi J, Jeong D, Gillies R, Malafa M, Judge A, Merchant N, Permuth J, Trevino J. Abstract C091: Racial disparities in pancreatic cancer pancreatic cancer patients in Florida and an investigation into a possible role of cancer cachexia. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp18-c091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Five-year survival for pancreatic cancer remains low at 8%. While pancreatic cancer health disparities exist among different racial groups, these disparities have not been well investigated in the State of Florida. We aimed to investigate these disparities and hypothesized that cancer cachexia may play a role.
Methods: A retrospective review of data from the Florida Cancer Data System and Florida Agency for Healthcare administration was performed to assess for PC disparities between racial groups in the State of Florida. A cohort of patients at a single center was analyzed for differences in cachexia indicators such as psoas muscle index (PSI) and albumin at presentation.
Results: African Americans (AA) had significantly higher mean age-adjusted PC incidence (12.5/100,000) and mortality rates (10.97/100,000) than NHW (incidence=11.2/100,000; mortality=10.3/100,000) and Hispanics (incidence=9.6/100,000; mortality=8.7/100,000). Of the 67 counties in the State of Florida, 43 (64.2%) observed higher PC incidence rates in AA than NHW and Hispanics. AA are often diagnosed with PC at a younger age than NHW. AA and Hispanics are more likely to be insured by Medicaid compared to NHW (16% and 14% vs 7%, respectively) and less likely to undergo surgical treatment for their condition (31% vs. 37%). AA present with significantly lower serum albumin levels (3.2 vs. 3.7 g/dL). Serum albumin levels < 3.5 correlated with significantly lower survival. When compared to healthy controls presenting for cholecystectomy, AA patients present with a more significant reduction in psoas muscle index compared to Caucasians.
Conclusion: African-Americans with PC have higher incidence rates and mortality than their NHW and Hispanics counterparts. AA are also younger at age of diagnosis, more likely to be insured by Medicaid, and less likely to undergo potential curative surgical treatment for PC. We demonstrated that AA had significantly lower albumin levels and that this correlated with worse survival. AA also present with a significantly greater reduction in psoas muscle index when compared to healthy controls. Further investigation into potential reasons for this disparity in cancer cachexia is warranted.
Citation Format: Patrick Underwood, Miles Cameron, Ashley Clark Daly, Tracey Barnett, Clement Gwede, Anthony Magliocco, Barbara Centeno, Dung-Tsa Chen, Jung Choi, Daniel Jeong, Robert Gillies, Mokenge Malafa, Andrew Judge, Nipun Merchant, Jennifer Permuth, Jose Trevino. Racial disparities in pancreatic cancer pancreatic cancer patients in Florida and an investigation into a possible role of cancer cachexia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C091.
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Jeong D, Choi KY. Biodegradation of Tetracycline Antibiotic by Laccase Biocatalyst Immobilized on Chitosan-Tripolyphosphate Beads. APPL BIOCHEM MICRO+ 2020. [DOI: 10.1134/s0003683820030047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Huynh T, Ali K, Vyas S, Dezsi K, Strickland D, Basinski T, Chen DT, Jiang K, Centeno B, Malafa M, Klapman JB, Hodul PJ, Jeong D, Permuth JB. Comparison of imaging modalities for measuring the diameter of intraductal papillary mucinous neoplasms of the pancreas. Pancreatology 2020; 20:448-453. [PMID: 32113936 PMCID: PMC7346718 DOI: 10.1016/j.pan.2020.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/05/2020] [Accepted: 02/18/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Intraductal papillary mucinous neoplasms (IPMNs) are pre-malignant pancreatic cysts detected by imaging. Cyst size is one of many features evaluated on computed tomography (CT), magnetic resonance imaging (MRI), or endoscopic ultrasonography (EUS) to help guide IPMN management. Our objective was to determine which imaging modality best predicts pathological cyst size. METHODS We analyzed records for 57 IPMN cases surgically treated at Moffitt Cancer Center from 2008 to 2016 for whom pre-operative CT, MRI, and EUS IPMN cyst size and post-operative pathological cyst size values were available. Long axis cyst diameter measurements were compared to each other and corresponding pathological cyst measurements using within-subjects ANOVA, Bland-Altman analysis, and linear regression. Consensus measurements were also performed on CT and MRI images. RESULTS Cyst size measured via CT and MRI overestimated pathological size by 0.33 cm and 0.27 cm, respectively, whereas EUS underestimated pathological size by 0.05 cm and had the narrowest 95% limit of agreement (LOA). Among pathologically-confirmed cysts <3 cm, MRI overestimated pathological size by 0.30 cm (P = 0.049) and had the widest LOA, followed by EUS and CT. Among cysts ≥3 cm, EUS underestimated pathological size by 0.35 cm (P = 0.059) and MRI and CT overestimated pathological size by 0.23 cm and 0.51 cm, respectively. CONCLUSIONS In this small retrospective study, EUS cyst size measurements correlated best with pathologic specimens compared to CT and MRI, especially for cysts < 3 cm. Larger prospective studies are needed to determine which imaging modalities are best to risk-stratify IPMNs and guide surgical versus. Non-surgical management.
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Affiliation(s)
- Tri Huynh
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Karla Ali
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Shraddha Vyas
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kaleena Dezsi
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Destiny Strickland
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Toni Basinski
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Kun Jiang
- Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Barbara Centeno
- Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jason B Klapman
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Pamela J Hodul
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Daniel Jeong
- Department of Diagnostic Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jennifer B Permuth
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA.
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Howard C, Saraswat D, McLeod G, Yeung A, Jeong D, Lam J. Canada's Prosthetic Coverage: a Review of Provincial Prosthetic Policy. Can Prosthet Orthot J 2020; 2:33489. [PMID: 37614768 PMCID: PMC10443461 DOI: 10.33137/cpoj.v2i2.33489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Abstract
The Canadian healthcare system serves as an example of equity and federal service to citizens across the world. However, it is not without its challenges. Prosthetic coverage across Canada is highly variable and largely unable to provide equal coverage for Canadian persons living with amputation. Many persons with limb loss are forced to rely upon personal resources, fundraising, or the charity of non-governmental organizations in order to meet this basic healthcare need. This disparity in the Canadian healthcare system is unusual and largely undescribed in the literature. We thus explore the nature of Canadian healthcare prosthetic coverage across Canada, investigating the variability in coverage, presence of prosthetic coverage policies, clarity of policy, eligibility criteria, and interval of prosthetic replacement. Our findings highlight potential areas for improvement within current Canadian healthcare policy.
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Affiliation(s)
- C.W. Howard
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D.K. Saraswat
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - G McLeod
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - A Yeung
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - D Jeong
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - J Lam
- Faculty of Medicine, McGill University, Montreal, Québec, Canada
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29
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Lee DH, Armanious M, Huang J, Jeong D, Druta M, Fradley MG. Case of pembrolizumab-induced myocarditis presenting as torsades de pointes with safe re-challenge. J Oncol Pharm Pract 2020; 26:1544-1548. [DOI: 10.1177/1078155220904152] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction Pembrolizumab is an immune checkpoint inhibitor targeting the programmed death receptor with clinical effect on multiple malignancies including sarcoma. Associated cardio-toxicities include myocarditis, cardiomyopathy, heart failure, and arrhythmias. Although in most cases of immune checkpoint inhibitor cardiotoxicity the offending agent is discontinued, we report a case of successful and safe re-challenge with a checkpoint inhibitor in a patient with mild myocarditis. Case report We describe a 37-year-old female with alveolar soft part sarcoma, metastatic to the lungs on cycle 13 of pembrolizumab who presented with dyspnea, cough, and vague chest discomfort. Telemetry showed bigeminal bradycardia that transitioned to self-terminating torsades de pointes. Cardiac MRI showed subtle patchy T2 signal increase within the left ventricular septum without late gadolinium uptake, suggesting mild focal myocarditis. Management and outcome: The patient was started on a steroid taper without additional arrhythmias. We have re-challenged the patient who safely tolerated re-challenge with pembrolizumab despite an episode of torsades de pointes and documented myocarditis. She continues to receive pembrolizumab at seven months after the initial event without further cardiovascular events. Discussion To the best of our knowledge, this is the first reported case of successful re-challenge of pembrolizumab after an episode of myocarditis. In patients with mild myocarditis and no evidence of left ventricular dysfunction, re-challenge may be a viable option. However, close monitoring for the development of heart failure, cardiomyopathy, or serious arrhythmias is necessary to ensure patient safety.
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Affiliation(s)
- Dae Hyun Lee
- Department of Cardiovascular Sciences, University of South Florida, Morsani College of Medicine and Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Merna Armanious
- Department of Cardiovascular Sciences, University of South Florida, Morsani College of Medicine and Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jessica Huang
- Department of Cardiovascular Sciences, University of South Florida, Morsani College of Medicine and Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mihaela Druta
- Department of Sarcoma, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Michael G Fradley
- Department of Cardiovascular Sciences, University of South Florida, Morsani College of Medicine and Cardio-Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Thomas KL, Jeong D, Montilla-Soler J, Feuerlein S. The role of diagnostic imaging in the primary testicular cancer: initial staging, response assessment and surveillance. Transl Androl Urol 2020; 9:S3-S13. [PMID: 32055480 DOI: 10.21037/tau.2019.07.01] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Testicular cancers are a group of uncommon malignancies that account for less than 1% of new cancer cases per year in the United States and globally. The disease typically affects men between the ages of 20-44, and the overwhelming majority of tumors are germ cell in origin. Most cases of testicular cancer are organ confined at diagnosis and have a good overall prognosis. Testicular cancers are staged by the tumor, node, metastasis, serum markers (TNMS) classification set forth by the American Joint Commission on Cancer staging. Diagnostic imaging plays a crucial role in initial staging, specifically in assessing the primary tumor prior to orchiectomy and evaluating for regional and/or distant metastasis. Multimodality imaging is used for initial staging, with ultrasound and computed tomography (CT) most commonly utilized. Diagnostic imaging is also important in evaluating response in patients who initially present with metastatic disease as well as in patients who are undergoing surveillance. Typically, CT is used for response assessment and surveillance, with magnetic resonance imaging (MRI) and positron emission tomography (PET) serving as adjunct modalities. This article reviews the role of various diagnostic imaging modalities and how they are employed in the diagnosis, staging, response assessment and surveillance of primary testicular cancer.
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Affiliation(s)
- Kerry L Thomas
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jaime Montilla-Soler
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sebastian Feuerlein
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Reverón D, Beato F, DeNicola G, Ortiz A, Centeno B, Jiang K, Jeong D, Malafa M, Hodul P, Deszi K, Permuth J, Fleming J. Abstract C46: Establishing a living biobank of patient-derived organoids of intraductal papillary mucinous neoplasms. Cancer Res 2019. [DOI: 10.1158/1538-7445.panca19-c46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Pancreatic cancer is the third leading cause of cancer-related deaths in the United States. There is an unmet need to develop strategies to detect pancreatic cancer at an early, operable stage and prevent its progression. Intraductal papillary mucinous neoplasms (IPMNs) are cystic pancreatic cancer precursors that comprise nearly 50% of pancreatic cysts detected incidentally via computed tomography (CT) scans. Since IPMNs can progress from low- and moderate-grade dysplasia and invasion, the study of these lesions offers a prime opportunity to develop early detection and prevention strategies. Organoids are an ideal preclinical platform to study IPMNs, and the objective of the current investigation was to establish the first living biobank of IPMN tumor organoids. IPMN tumors and adjacent normal pancreatic tissues were harvested from 15 patients undergoing pancreatic surgical resection at Moffitt Cancer Center & Research Institute (Tampa, FL) between 2017 and 2019. Following immunohistopathologic analysis of primary tissues, organoid cultures were generated, expanded, and cryopreserved. Furthermore, organoid cultures were generated from cryopreserved tissues as well. Count and size of the organoids over time was determined via the Image-Pro Premier 3D Version digital platform. Genomic characterization of the organoids was performed through DNA fingerprinting, and a subset of cases were sequenced. The success rates of organoid generation from IPMN tumor and adjacent normal pancreatic tissues were 81% and 87%, respectively. IPMN organoids derived from different IPMN subtypes tissues showed different morphologies in vitro, with the low- and moderate-grade pancreatobiliary subtypes showing the highest proliferation rates. This model has potential to provide new opportunities to unveil mechanisms of IPMN progression to invasion and to shed insight into novel biomarkers for detection and targets for chemoprevention.
Citation Format: Dayana Reverón, Francisca Beato, Gina DeNicola, Antonio Ortiz, Barbara Centeno, Kun Jiang, Daniel Jeong, Mokenge Malafa, Pamela Hodul, Kaleena Deszi, Jennifer Permuth, Jason Fleming. Establishing a living biobank of patient-derived organoids of intraductal papillary mucinous neoplasms [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr C46.
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Pejic M, Shifman M, Rose T, Jeong D. Chronic Anthracycline-related Myocarditis Presenting as Diffuse Myocardial Calcification. J Clin Imaging Sci 2019; 9:47. [PMID: 31819824 PMCID: PMC6884985 DOI: 10.25259/jcis_113_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/02/2019] [Indexed: 12/02/2022] Open
Abstract
In the setting of cardio-oncology, evaluation for myocarditis is a growing indication for cardiovascular magnetic resonance (CMR). Treatment-related side effects of cancer therapies comprise the majority of myocarditis cases in cardio-oncology, and these are often secondary to anthracyclines and even the newer class of immune checkpoint inhibitors. Cardiotoxicity from cancer therapy represents an increasingly recognized etiology of myocarditis and when detected, warrants prompt management changes. The conventional CMR evaluation for myocarditis includes modules for the left ventricular structure and function, early gadolinium enhancement, and late gadolinium enhancement. Newer CMR sequences including native T1 mapping and extracellular volume fraction offer improvement in diagnostic accuracy from conventional CMR methods. We present a case of subacute/ chronic myocarditis related to anthracycline therapy 4 months prior that was diagnosed only after incidental diffuse myocardial calcifications on pre-treatment computed tomography raised suspicion.
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Affiliation(s)
- Marijan Pejic
- Department of Radiology, University of South Florida, Tampa, Florida, USA
| | - Monica Shifman
- Department of Medicine, Ross University, Miramar, Florida, USA
| | - Trevor Rose
- Department of Radiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Daniel Jeong
- Department of Radiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Jeong D, Gladish G, Chitiboi T, Fradley MG, Gage KL, Schiebler ML. MRI in cardio-oncology: A review of cardiac complications in oncologic care. J Magn Reson Imaging 2019; 50:1349-1366. [PMID: 31448472 DOI: 10.1002/jmri.26895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/17/2019] [Indexed: 12/23/2022] Open
Abstract
From detailed characterization of cardiac abnormalities to the assessment of cancer treatment-related cardiac dysfunction, cardiac MRI is playing a growing role in the evaluation of cardiac pathology in oncology patients. Current guidelines are now incorporating the use of MRI for the comprehensive multidisciplinary approach to cancer management, and innovative applications of MRI in research are expanding its potential to provide a powerful noninvasive tool in the arsenal against cancer. This review focuses on the application of cardiac MRI to diagnose and manage cardiovascular complications related to cancer and its treatment. Following an introduction to current cardiac MRI methods and principles, this review is divided into two sections: functional cardiovascular analysis and anatomical or tissue characterization related to cancer and cancer therapeutics. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:1349-1366.
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Affiliation(s)
- Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Gregory Gladish
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Teodora Chitiboi
- Medical Imaging Technologies, Siemens Healthineers, Princeton, New Jersey, USA
| | - Michael G Fradley
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center & Research Institute and University of South Florida Division of Cardiovascular Medicine, Tampa, Florida, USA
| | - Kenneth L Gage
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Mark L Schiebler
- Department of Radiology, University of Wisconsin Madison, Madison, Wisconsin, USA
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Evens A, Cyriac G, Jeong D, Araujo C, Gage K, Rose T. A Pictorial Essay of Immunotherapy: Complications that Internists Will See, Whether They Like it or Not. Am J Med 2019; 132:808-815. [PMID: 30849381 DOI: 10.1016/j.amjmed.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/01/2019] [Accepted: 02/15/2019] [Indexed: 12/13/2022]
Abstract
Immunotherapy agents for treatment of cancer have been investigated for decades, but effective agents have only recently been identified and are increasingly being used in multiple cancer types. There is growing recognition of adverse side effects in multiple organ systems mediated by dysregulation of the immune system, which can be exacerbated by comorbidities often found in cancer patients such as chronic lung disease, diabetes, and hypertension. As a result, internists and other nononcology clinicians are routinely encountering immunotherapy patients who present with a remarkably wide range of symptoms. Here, we present the radiographic manifestations of common side effects from immunotherapy agents. An accurate diagnosis is critical in these often-complex clinical settings in which the consequences of the underlying cancer and other comorbidities must be distinguished from the variable manifestations of treatment toxicity.
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Affiliation(s)
| | | | - Daniel Jeong
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Cyrillo Araujo
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Kenneth Gage
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Trevor Rose
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
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Johnson EM, Gage KL, Feuerlein S, Jeong D. Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques. J Vis Exp 2019. [PMID: 31259905 DOI: 10.3791/58808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
We present the conventional cardiac magnetic resonance (CMR) protocol for evaluating a suspected thrombus and highlight emerging techniques. The appearance of a mass on certain magnetic resonance (MR) sequences can help differentiate a thrombus from competing diagnoses such as a tumor. T1 and T2 signal characteristics of a thrombus are related to the evolution of hemoglobin properties. A thrombus typically does not enhance following contrast administration, which also helps differentiation from a tumor. We also highlight the emerging role of T1 mapping in the evaluation of a thrombus, which can add another level of support in diagnosis. Prior to any CMR exam, patient screening and interviews are critical to ensure safety and to optimize patient comfort. Effective communication during the exam between the technologist and the patient promotes proper breath holding technique and higher quality images. Volumetric post processing and structured reporting are helpful to ensure that the radiologist answers the ordering services' question and communicates these results effectively. Optimal pre-MR safety evaluation, CMR exam execution, and post exam processing and reporting allow for delivery of high quality radiological service in the evaluation of a suspected cardiac thrombus.
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Affiliation(s)
| | - Kenneth L Gage
- Department of Diagnostic Imaging, H. Lee Moffitt Cancer Center and Research Institute
| | - Sebastian Feuerlein
- Department of Diagnostic Imaging, H. Lee Moffitt Cancer Center and Research Institute
| | - Daniel Jeong
- Department of Diagnostic Imaging, H. Lee Moffitt Cancer Center and Research Institute;
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Permuth JB, Clark Daly A, Jeong D, Choi JW, Cameron ME, Chen D, Teer JK, Barnett TE, Li J, Powers BD, Kumar NB, George TJ, Ali KN, Huynh T, Vyas S, Gwede CK, Simmons VN, Hodul PJ, Carballido EM, Judge AR, Fleming JB, Merchant N, Trevino JG. Racial and ethnic disparities in a state-wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities. Cancer Med 2019; 8:3314-3324. [PMID: 31074202 PMCID: PMC6558500 DOI: 10.1002/cam4.2180] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 12/18/2022] Open
Abstract
Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle-wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and mortality rates may be highest among Black Floridians and the secondary hypothesis that biological correlates of cancer cachexia may underlie disparities. PC incidence and mortality rates were estimated by race/ethnicity, gender, and county using publicly available state-wide cancer registry data that included approximately 2700 Black, 25 200 Non-Hispanic White (NHW), and 3300 Hispanic/Latino (H/L) Floridians diagnosed between 2004 and 2014. Blacks within Florida experienced a significantly (P < 0.05) higher incidence (12.5/100 000) and mortality (10.97/100 000) compared to NHW (incidence = 11.2/100 000; mortality = 10.3/100 000) and H/L (incidence = 9.6/100 000; mortality = 8.7/100 000), especially in rural counties. To investigate radiologic and blood-based correlates of cachexia, we leveraged data from a subset of patients evaluated at two geographically distinct Florida Cancer Centers. In Blacks compared to NHW matched on stage, markers of PC-induced cachexia were more frequent and included greater decreases in core musculature compared to corresponding healthy control patients (25.0% vs 10.1% lower), greater decreases in psoas musculature over time (10.5% vs 4.8% loss), lower baseline serum albumin levels (3.8 vs 4.0 gm/dL), and higher platelet counts (332.8 vs 268.7 k/UL). Together, these findings suggest for the first time that PC and cachexia may affect Blacks disproportionately. Given its nearly universal contribution to illness and PC-related deaths, the early diagnosis and treatment of cachexia may represent an avenue to improve health equity, quality of life, and survival.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | - Ashley Clark Daly
- Division of Behavioral HealthIdaho Department of Health and WelfareBoiseIdaho
| | - Daniel Jeong
- Department of Diagnostic RadiologyMoffitt Cancer CenterTampaFlorida
| | - Jung W. Choi
- Department of Cancer Imaging & MetabolismMoffitt Cancer CenterTampaFlorida
| | - Miles E. Cameron
- Department of Surgery, Division of General SurgeryUniversity of Florida Health Sciences CenterGainesvilleFlorida
| | - Dung‐Tsa Chen
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Jamie K. Teer
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Tracey E. Barnett
- School of Public HealthUniversity of North Texas Health Science CenterFort WorthTexas
| | - Jiannong Li
- Department of Biostatistics and BioinformaticsMoffitt Cancer CenterTampaFlorida
| | - Benjamin D. Powers
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | | | - Thomas J. George
- Department of MedicineUniversity of Florida Health Sciences CenterGainesvilleFlorida
| | - Karla N. Ali
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Tri Huynh
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Shraddha Vyas
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFlorida
| | - Clement K. Gwede
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFlorida
| | - Vani N. Simmons
- Department of Health Outcomes and BehaviorMoffitt Cancer CenterTampaFlorida
| | - Pamela J. Hodul
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | | | - Andrew R. Judge
- Department of Physical TherapyUniversity of FloridaGainesvilleFlorida
| | - Jason B. Fleming
- Department of Gastrointestinal OncologyMoffitt Cancer CenterTampaFlorida
| | - Nipun Merchant
- Department of Surgical Oncology, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiamiFlorida
| | - Jose G. Trevino
- Department of Surgery, Division of General SurgeryUniversity of Florida Health Sciences CenterGainesvilleFlorida
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Abstract
Oncologic imaging is an important facet of abdominal imaging that radiologists encounter nearly every day. Many oncology clinical trials utilize response evaluation criteria in solid tumors (RECIST) version 1.1 which divides tumor sites into target and non-target lesions. Although RECIST v1.1 provides clear instructions regarding the use of imaging in clinical trials, errors in response assessment still occur using these criteria. This is especially true of response assessment with regards to non-target lesions which involve rules which are less well-defined and somewhat subjective. This pictorial essay will review RECIST v1.1 guidelines and common non-target lesion errors which can occur at baseline and follow-up response assessment.
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Affiliation(s)
- Brian Morse
- Department of Diagnostic Imaging, Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL, 33612, USA.
| | - Daniel Jeong
- Department of Diagnostic Imaging, Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL, 33612, USA
| | - Gary Ihnat
- Department of Radiology, University of South Florida, 2 Tampa General Circle, STC 7028, Tampa, FL, 33606, USA
| | - Alvin C Silva
- Department of Radiology, Mayo Clinic Hospital, 13400 E. Shea Blvd., Scottsdale, AZ, 85259, USA
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Jeong D, Aralis H, Bruhn KW, Cotliar J, Craft N, DeLuca IJ, Hamidi R, Nguyen K, Patel VA, Sofen H, Tan BH, David CV. A reliability study using Network Oriented Research Assistant (NORA ® ) examining the use of digital photographs in the assessment of psoriasis. Br J Dermatol 2019; 181:214-215. [PMID: 30703265 DOI: 10.1111/bjd.17702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D Jeong
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
| | - H Aralis
- University of California Los Angeles, Department of Biostatistics, Los Angeles, CA, 90095, U.S.A
| | - K W Bruhn
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
| | - J Cotliar
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A.,Harbor-UCLA Medical Center, Division of Dermatology, Torrance, CA, 90502, U.S.A
| | - N Craft
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
| | - I J DeLuca
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A.,George Washington University, School of Medicine and Health Sciences, Department of Dermatology, Washington, DC, 20052, U.S.A
| | - R Hamidi
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
| | - K Nguyen
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
| | - V A Patel
- George Washington University, School of Medicine and Health Sciences, Department of Dermatology, Washington, DC, 20052, U.S.A
| | - H Sofen
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A.,David Geffen School of Medicine at UCLA, Division of Dermatology, Los Angeles, CA, 90095, U.S.A.,Dermatology Research Associates, Los Angeles, CA, 90045, U.S.A
| | - B H Tan
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A.,Harbor-UCLA Medical Center, Division of Dermatology, Torrance, CA, 90502, U.S.A
| | - C V David
- Science 37, Inc., Los Angeles, CA, 90094, U.S.A
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Luu C, Thapa R, Rose T, Woo K, Jeong D, Thomas K, Chen DT, Friedman M, Malafa MP, Hodul PJ. Identification of nonalcoholic fatty liver disease following pancreatectomy for noninvasive intraductal papillary mucinous neoplasm. Int J Surg 2018; 58:46-49. [PMID: 30218781 DOI: 10.1016/j.ijsu.2018.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 06/27/2018] [Accepted: 09/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) following pancreatectomy is a potential cause of long term morbidity in patients undergoing pancreatic resection with curative intent. Prior studies have reported an incidence of NAFLD up to 30% following pancreatectomy but the investigated cohorts were typically a mix of benign and malignant disease. Here we examined the incidence of NAFLD in a homogenous cohort of patients following pancreatectomy for benign intraductal papillary mucinous neoplasm (IPMN). METHODS A retrospective review of patients who underwent pancreatic resection for IPMN from 2000 to 2016 was performed. Post pancreatectomy CT/MRI scans were obtained as standard surveillance. We investigated changes in the liver parenchymal density on post surgical imaging to estimate the frequency with which NAFLD occurred. Radiographic criteria for NAFLD included Hounsfield units less than 40 on CT or liver:spleen ratio <0.9 on CT or MRI. Fischer's exact test, Kruskal-Wallis test, and logistic regression were performed. RESULTS Our study cohort included 109 patients who underwent pancreatectomy for nonmalignant intraductal papillary mucinous neoplasm with no evidence of NAFLD preoperatively and at least 6 months follow-up. Mean follow-up was 52 months (range 8-130/months). The incidence of postoperative NAFLD was 17/109 (15.6%). Most cases occurred within 12 months of pancreatectomy. On multivariate analysis, proximal pancreatectomy (pancreaticoduodenectomy) and development of atrophy of the pancreas remnant were significant risk factors for development of hepatic steatosis (p < 0.05). CONCLUSION Patients undergoing pancreatectomy for benign disease have a significant risk of developing NAFLD but the frequency is lower than previously reported in cohorts that included individuals with malignant disease. Highest risk was observed in individuals who underwent pancreaticoduodenectomy or developed pancreatic atrophy. Further investigations to define the mechanisms that promote steatosis and interventions to prevent subsequent morbidity from NAFLD are warranted.
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Affiliation(s)
- Carrie Luu
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Ram Thapa
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Trevor Rose
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Katherine Woo
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Kerry Thomas
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Mark Friedman
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Mokenge P Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA
| | - Pamela J Hodul
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA.
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Jeong D, Hakam A, Abuel-Haija M, Chon HS. Ovarian microcystic stromal tumor: Radiologic-pathologic correlation. Gynecol Oncol Rep 2018; 25:11-14. [PMID: 30014019 PMCID: PMC6019857 DOI: 10.1016/j.gore.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/06/2018] [Accepted: 05/07/2018] [Indexed: 11/22/2022] Open
Abstract
Ovarian microcystic stromal tumor (MST) is characterized by microcysts, solid cellular regions with lobulated growth, and collagenous or fibrous stroma forming hyaline plaques. While several reports have evaluated the unique pathologic and immunohistochemical profile of these tumors, there has been limited description of the radiologic findings of ovarian microcystic stromal tumor in the literature. We present a case of a 66 year old female who presented for evaluation of a new cystic pelvic mass found to have ovarian microcystic stromal tumor. To our knowledge, this is one of the first reports to evaluate the radiologic features associated with this tumor. An enhanced understanding of the correlation between imaging appearance and specific histopathologic findings may aid in the early recognition of this rare neoplasm.
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Affiliation(s)
- Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ardeshir Hakam
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mohammad Abuel-Haija
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hye Sook Chon
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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41
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Jeong D, Raghunand N, Hernando D, Poch M, Jeong K, Eck B, Dhillon J. Quantification of sarcomatoid differentiation in renal cell carcinoma on magnetic resonance imaging. Quant Imaging Med Surg 2018; 8:373-382. [PMID: 29928602 DOI: 10.21037/qims.2018.04.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background Sarcomatoid differentiation in renal cell carcinoma (sRCC) is histologically characterized by anaplastic changes of renal cell carcinoma (RCC) subtypes, which has been associated with a poor prognosis. sRCC is managed more aggressively than RCC without sarcomatoid components, so pre-operative detection of sarcomatoid differentiation would significantly affect surgical management. The purpose of this study is to compare the quantification of sarcomatoid features in RCCs on pre-operative magnetic resonance imaging (MRI) to standard histological examination. Methods Patients who had nephrectomy at our institution between 2000 and 2015 with pathology proven RCC and pre-operative contrast enhanced MRI abdominal scans were retrospectively reviewed. A custom MATLAB routine calculated the portion of each manually segmented whole tumor with MRI signal suggestive of sarcomatoid involvement based on prior research (MRI%SARC). The primary endpoint compared MRI%SARC to percent sarcomatoid involvement estimated by histological examination (HIST%SARC) using Pearson correlation and Bland Altman analysis. Results A total of 17 patients with sRCC (10 males, age 60.3±11.1 years) and 17 consecutive control patients with clear cell RCC (ccRCC) without sarcomatoid components (10 males, age 64.5±7.6 years) were evaluated. Pearson correlation analysis revealed a strong association between MRI%SARC and HIST%SARC (r=0.782, P<0.001). Bland-Altman analysis demonstrated proportional bias, with a mean bias of 19.29 [95% confidence interval (CI): 9.79-28.79] and with 95% limits of agreement of -16.93 (95% CI: -33.38 to -0.48) to 55.51 (95% CI: 39.06-71.96), suggesting MRI%SARC underestimated values compared to HIST%SARC by 19%. Conclusions Multiparametric pre-operative MRI analysis to quantify sarcomatoid features in RCC correlates with standard histological examination but underestimates percent sarcomatoid involvement.
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Affiliation(s)
- Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Natarajan Raghunand
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin-Madison. Madison, WI, USA
| | - Michael Poch
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Katherine Jeong
- Department of Internal Hospital Medicine, H. Lee. Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brendan Eck
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Jasreman Dhillon
- Department of Anatomical Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Affiliation(s)
- Kenneth L. Gage
- Diagnostic Imaging and Interventional Radiology Program,
University of South Florida College of Medicine, Tampa, Florida
| | - Kerry Thomas
- Diagnostic Imaging and Interventional Radiology Program,
University of South Florida College of Medicine, Tampa, Florida
| | - Daniel Jeong
- Diagnostic Imaging and Interventional Radiology Program,
University of South Florida College of Medicine, Tampa, Florida
| | - Dexter G. Stallworth
- Diagnostic Imaging and Interventional Radiology Program,
University of South Florida College of Medicine, Tampa, Florida
| | - John A. Arrington
- H. Lee Moffitt Cancer Center & Research Institute, and the Departments of Oncologic Sciences, University of South Florida College of Medicine, Tampa, Florida
- Radiology, University of South Florida College of Medicine,
Tampa, Florida
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Abstract
BACKGROUND Cardiac magnetic resonance imaging (MRI) is emerging as an important diagnostic modality in the management of cardiovascular-related dysfunction in oncological diseases. Advances in imaging techniques have enhanced the detection and evaluation of cardiac masses; meanwhile, innovative applications have created a growing role for cardiac MRI for the management of cardiotoxicity caused by cancer therapies. METHODS An overview is provided of the clinical indications and technical considerations of cardiac MRI. Its role in the evaluation of cardiac masses and cardiac function is reviewed, and novel sequences are discussed that are giving rise to future directions in cardio-oncology research. A review of the literature was also performed, focusing on cardiac MRI findings associated with cardiac dysfunction related to cancer treatment. RESULTS Cardiac MRI can be used to differentiate benign and malignant primary cardiac tumors, metastatic disease, and pseudotumors with high spatial and temporal resolution. Cardiac MRI can also be used to detect the early and long-term effects of cardiotoxicity related to cancer therapy. This is accomplished through a multiparametric approach that uses conventional bright blood, dark blood, and postcontrast sequences while also considering the applicability of newer T1 and T2 mapping sequences and other emerging techniques. CONCLUSIONS Cardio-oncology programs have an expanding presence in the multidisciplinary approach of cancer care. Consequently, knowledge of cardiac MRI and its potential applications is critical to the success of contemporary cancer diagnostics and cancer management.
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Affiliation(s)
- Daniel Jeong
- Department of Radiology, Moffitt Cancer Center, Tampa, FL.
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Archila LD, Chow IT, McGinty JW, Renand A, Jeong D, Robinson D, Farrington ML, Kwok WW. Ana o 1 and Ana o 2 cashew allergens share cross-reactive CD4(+) T cell epitopes with other tree nuts. Clin Exp Allergy 2017; 46:871-83. [PMID: 27129138 DOI: 10.1111/cea.12746] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 02/12/2016] [Accepted: 02/18/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergies to cashew are increasing in prevalence, with clinical symptoms ranging from oral pruritus to fatal anaphylactic reaction. Yet, cashew-specific T cell epitopes and T cell cross-reactivity amongst cashew and other tree nut allergens in humans remain uncharacterized. OBJECTIVES In this study, we characterized cashew-specific T cell responses in cashew-allergic subjects and examined cross-reactivity of these cashew-specific cells towards other tree nut allergens. METHODS CD154 up-regulation assay was used to determine immunodominance hierarchy among cashew major allergens at the T cell level. The phenotype, magnitude and functionality of cashew-specific T cells were determined by utilizing ex vivo staining with MHC class II tetramers. Dual tetramer staining and proliferation experiments were used to determine cross-reactivity to other tree nuts. RESULTS CD4(+) T cell responses were directed towards cashew allergens Ana o 1 and Ana o 2. Multiple Ana o 1 and Ana o 2 T cell epitopes were then identified. These epitopes elicited either TH 2 or TH 2/TH 17 responses in allergic subjects, which were either cashew unique epitope or cross-reactive epitopes. For clones that recognized the cross-reactive epitope, T cell clones responded robustly to cashew, hazelnut and/or pistachio but not to walnut. CONCLUSIONS Phylogenetically diverse tree nut allergens can activate cashew-reactive T cells and elicit a TH 2-type response at an epitope-specific level. CLINICAL RELEVANCE Lack of cross-reactivity between walnut and cashew suggests that cashew peptide immunotherapy approach may not be most effective for walnut.
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Affiliation(s)
- L D Archila
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - I-T Chow
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - J W McGinty
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - A Renand
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - D Jeong
- Virginia Mason Medical center, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
| | - D Robinson
- Virginia Mason Medical center, Seattle, WA, USA
| | | | - W W Kwok
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
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Koh Y, Jeong D. P2.02-060 Prognostic Significance of EDIL3 Expression and Correlation with Mesenchymal Phenotype and Microvessel Density in Lung Adenocarcinoma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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46
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Jeong D, Bui M, Peterson D, Montilla-Soler J, Gage KL. FDG avid breast cancer bone metastases silent on CT and scintigraphy: a case report with radiologic-pathologic correlation. Acta Radiol Open 2017; 6:2058460117734243. [PMID: 29051834 PMCID: PMC5638166 DOI: 10.1177/2058460117734243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 09/07/2017] [Indexed: 01/29/2023] Open
Abstract
Bone is the one of the most common distant metastatic sites in breast cancer. Routine initial breast cancer staging evaluation typically includes computed tomography (CT) and skeletal scintigraphy while 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is reserved for clinically high-risk cases. Since FDG PET-CT is not routinely performed during staging or surveillance evaluations, it is important for radiologists and clinicians to appreciate the limitations of bone metastasis detection on CT and scintigraphy. We present a case of bony metastases of invasive ductal carcinoma of the breast which were not detected on diagnostic CT or skeletal scintigraphy but were metabolically active on FDG PET-CT and evident on magnetic resonance. We provide a review of the literature and radiologic–pathologic correlation to explain the discordant imaging findings.
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Affiliation(s)
- Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Marilyn Bui
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Cell Biology and Pathology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Daniel Peterson
- Department of Cell Biology and Pathology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Jaime Montilla-Soler
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth L Gage
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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Kim K, Jeong D, Jung E, Lee J, Kim C, Yoon T. LB988 Inhibition of collagen production by ICG-001, a small molecule inhibitor for Wnt/β-catenin signaling, in skin fibroblasts. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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48
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Mirkin KA, Luke FE, Gangi A, Pimiento JM, Jeong D, Hollenbeak CS, Wong J. Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis. J Gastrointest Oncol 2017; 8:589-595. [PMID: 28736646 DOI: 10.21037/jgo.2017.03.02] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study's objective was to evaluate the change in sarcopenia score following neoadjuvant chemotherapy (NAC) and to correlate both sarcopenia and change in score with perioperative outcomes in patients with advanced resected gastric cancer. METHODS Multi-institutional analysis of patients with gastric cancer who underwent NAC and resection from 2000-2015 was performed. Demographic and perioperative data were included. Sarcopenia score was defined as CT measurement of total psoas muscle at L3, stratified by height (m). Sarcopenia was defined as a score <385 mm2/m2 in women and <545 mm2/m2 in men. RESULTS Of 36 patients, 19% were sarcopenic prior to NAC. Following NAC, 31% were sarcopenic, with 14% developing sarcopenia during NAC. One patient (3%) became non-sarcopenic. There were no significant differences in patient, disease, or surgery characteristics between patients who were sarcopenic vs. not. Patients with sarcopenia were more likely to have post-operative complications (P=0.05). There was no significant difference in hospital stay (P=0.7402) or survival (P=0.2317). CONCLUSIONS A significant number of patients with gastric cancer become sarcopenic during NAC. Although patients with sarcopenia were nearly twice as likely to develop post-operative complications, this did not appear to impact length of stay (LOS) or survival.
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Affiliation(s)
- Katelin A Mirkin
- Department of Surgery, Division of General Surgery Specialties and Surgical Oncology, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Franklyn E Luke
- Department of Radiology, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Alexandra Gangi
- Department of Surgery, Moffitt Cancer Center, Tampa, FL, USA
| | - Jose M Pimiento
- Department of Surgery, Moffitt Cancer Center, Tampa, FL, USA
| | - Daniel Jeong
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Christopher S Hollenbeak
- Department of Surgery and Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Joyce Wong
- Department of Surgery, Division of General Surgery Specialties and Surgical Oncology, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
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LEE S, Choi J, Lee Y, Jeong D. 0428 DEPRESSION IS ASSOCIATED WITH DECREASED SLEEP QUALITY RATHER THAN RESPIRATORY DISTURBANCE OR HYPOXIA DURING SLEEP IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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50
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Cho S, Chang MH, Yun SH, Kang HG, Chung H, Song KM, Koo D, Chung D, Jeong D, Lee MK, Lim JY, Kim DJ. R&D Activities on the Tritium Storage and Delivery System in Korea. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a12602] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Cho
- National Fusion Research Institute, 52 Eoeun-dong, Yuseong-gu, Daejeon, 305-333, Korea
| | - M. H. Chang
- National Fusion Research Institute, 52 Eoeun-dong, Yuseong-gu, Daejeon, 305-333, Korea
| | - S. H. Yun
- National Fusion Research Institute, 52 Eoeun-dong, Yuseong-gu, Daejeon, 305-333, Korea
| | - H.-G. Kang
- National Fusion Research Institute, 52 Eoeun-dong, Yuseong-gu, Daejeon, 305-333, Korea
| | - H. Chung
- Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong, Daejeon, 305-353, Korea
| | - K. M. Song
- KEPCO Research Institute, 103-16 Munji-Dong, Yuseong-gu, Daejeon, 305-380, Korea
| | - D. Koo
- Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong, Daejeon, 305-353, Korea
| | - D. Chung
- Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong, Daejeon, 305-353, Korea
| | - D. Jeong
- Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong, Daejeon, 305-353, Korea
| | - M. K. Lee
- National Fusion Research Institute, 52 Eoeun-dong, Yuseong-gu, Daejeon, 305-333, Korea
| | - J. Y. Lim
- Korea Research Institute of Standards and Science, 267 Gajeong-ro, Yuseong-gu, Daejeon 305-340, Korea
| | - D. J. Kim
- KOCEN Consulting and Services, Inc, 5442-1 Sangdaewon-dong, Seongnam-si, Gyeonggi 462-729, Korea
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