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Magnetic resonance imaging radiomics to predict high-risk intraductal papillary mucinous neoplasms of the pancreasSchilsky, Juliana Brooke 17 June 2019 (has links)
BACKGROUND: Pancreatic cancer is one of the most lethal cancers. Despite enhanced understanding of the disease, the 5-year survival rate remains 8% due to the late stage of diagnosis and a lack of effective treatment options. Early detection of precancerous lesions, such as intraductal papillary mucinous neoplasms (IPMNs), is a strategy to prevent pancreas cancer related death. Standard qualitative imaging assessment cannot reliably distinguish between benign and malignant branch duct intraductal papillary mucinous neoplasms (BD-IPMNs). A more consistent risk prediction method is needed to inform clinical decision making such that patients with benign cysts may be spared from unnecessary surgical resection.
OBJECTIVE: To assess whether a BD-IPMN malignancy risk prediction model which demonstrated strong potential on preoperative computed tomography (CT) images would show similar results on magnetic resonance imaging (MRI).
METHODS: 19 pathologically proven BD-IPMN patients with preoperative contrast-enhanced CT and MRI and were included in the study. Five radiomics features were extracted from the portal-venous phase CT and MR images of the largest cyst. Associations between radiomics features extracted from CT and MR were assessed using Pearson correlations.
RESULTS: Of the five radiomics features, average-weighted eccentricity (AWE) was most strongly correlated between imaging modalities in all patients (n=19, r=0.46, 95% CI=0.001-0.75, p=0.05), low-risk patients (r=0.63, 95% CI=0.09-0.88, p=0.028), and patients with a solid component or mural nodule (r=0.66, 95% CI=-0.32-0.96, p=0.15). However, when two outliers within the dataset were removed from analysis, AWE no longer correlated between MR and CT. None of the other radiomics features displayed significant correlations between the modalities.
CONCLUSIONS: The CT-based risk prediction model cannot be applied to MR data suggesting that a new model should be created from MRI data alone. / 2021-06-17T00:00:00Z
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Quantificação da intensidade de sinal nas ponderações T1 e T2 em ressonância magnética na diferenciação das neoplasias císticas pancreáticas serosas e mucinosas / Signal intensity quantification on T1 and T2-weighted magnetic resonance imaging in the differentiation of serous and mucinous pancreatic cystic neoplasmsRicci, Vitor Vita 02 June 2017 (has links)
INTRODUÇÃO: O diagnóstico diferencial entre cistadenomas serosos (CAS) e neoplasias císticas mucinosas (NCM) é essencial, pois os CAS são benignos e o tratamento em geral é conservador, ao passo que as NCM são pré-malignas (ou malignas) e devem ser ressecadas. A sobreposição de características de imagem não é incomum, portanto métodos auxiliares não-invasivos podem ser úteis na diferenciação entre elas. OBJETIVOS: Apresentar casuística de CAS e NCM estudados por ressonância magnética aplicando critérios diagnósticos morfológicos tradicionais e avaliar a quantificação da intensidade de sinal (IS) nas ponderações T1 e T2 (ambas com supressão de gordura) e do coeficiente de difusão aparente (ADC) na diferenciação entre estes tipos de lesões císticas pancreáticas (LCP). MATERIAIS E MÉTODOS: As LCP foram avaliadas quanto à loculação, paredes e presença ou não de cicatriz central, septos grosseiros e componentes sólidos. Foram feitas, ainda, avaliações qualitativa e quantitativa da IS nas ponderações T1 e T2, comparando as LCP com o parênquima pancreático (PP), bem como avaliação quantitativa do ADC. RESULTADOS: Dois radiologistas estudaram 9 CAS e 8 NCM de forma independente, sendo observada correlação perfeita entre eles quanto às avaliações morfológica e qualitativa da IS. Não houve diferença significativa entre os grupos de CAS e NCM na comparação das variáveis quantitativas da IS nas ponderações T1 e T2, bem como da razão ISLCP/ISPP e dos valores de ADC. CONCLUSÃO: Quanto à morfologia, a classificação do aspecto cístico (microcística, macrocística ou unilocular) foi a variável que apresentou a maior associação com os grupos, sendo, portanto, importante na definição diagnóstica. A quantificação da IS nas ponderações T1 e T2, assim como a medida do ADC das LCP, não permitiram a diferenciação das neoplasias císticas pancreáticas serosas e mucinosas. / INTRODUCTION: Differential diagnosis between serous cystadenomas (SCA) and mucinous cystic neoplasms (MCN) is essential, since SCA is benign and treatment is generally conservative, whereas MCN is premalignant (or malignant) and should be resected. The overlapping of imaging features is not uncommon, so non-invasive aids may be useful in differentiating between them. OBJECTIVES: To present a SCA and MCN caseload using magnetic resonance imaging traditional morphological diagnostic criteria and to evaluate the quantification of signal intensity (SI) in T1 and T2 weights (both with fat suppression) and the apparent diffusion coefficient (ADC) in differentiation between these types of pancreatic cystic lesions (PCL). MATERIALS AND METHODS: PCL were evaluated for loculation, walls and presence of central scar, coarse septa and solid components. Qualitative and quantitative SI assessments were also performed in T1 and T2 weights, comparing PCL with pancreatic parenchyma (PP), as well as ADC quantitative evaluation. RESULTS: Two radiologists studied 9 SCA and 8 MCN independently, with a perfect correlation between morphological and qualitative IS scores. There was no significant difference between the SCA and MCN groups when comparing the quantitative IS variables in the T1 and T2 weights, as well as the SIPCL/SIPP ratio and the ADC values. CONCLUSION: As to morphology, the classification of the cystic aspect (microcystic, macrocystic or unilocular) was the variable that presented the greatest association with the groups, being therefore important in the diagnostic definition. The quantification of SI in the T1 and T2 weights, as well as the ADC measurement of the PCL, did not allow the differentiation of serous and mucinous pancreatic cystic neoplasms.
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Quantificação da intensidade de sinal nas ponderações T1 e T2 em ressonância magnética na diferenciação das neoplasias císticas pancreáticas serosas e mucinosas / Signal intensity quantification on T1 and T2-weighted magnetic resonance imaging in the differentiation of serous and mucinous pancreatic cystic neoplasmsVitor Vita Ricci 02 June 2017 (has links)
INTRODUÇÃO: O diagnóstico diferencial entre cistadenomas serosos (CAS) e neoplasias císticas mucinosas (NCM) é essencial, pois os CAS são benignos e o tratamento em geral é conservador, ao passo que as NCM são pré-malignas (ou malignas) e devem ser ressecadas. A sobreposição de características de imagem não é incomum, portanto métodos auxiliares não-invasivos podem ser úteis na diferenciação entre elas. OBJETIVOS: Apresentar casuística de CAS e NCM estudados por ressonância magnética aplicando critérios diagnósticos morfológicos tradicionais e avaliar a quantificação da intensidade de sinal (IS) nas ponderações T1 e T2 (ambas com supressão de gordura) e do coeficiente de difusão aparente (ADC) na diferenciação entre estes tipos de lesões císticas pancreáticas (LCP). MATERIAIS E MÉTODOS: As LCP foram avaliadas quanto à loculação, paredes e presença ou não de cicatriz central, septos grosseiros e componentes sólidos. Foram feitas, ainda, avaliações qualitativa e quantitativa da IS nas ponderações T1 e T2, comparando as LCP com o parênquima pancreático (PP), bem como avaliação quantitativa do ADC. RESULTADOS: Dois radiologistas estudaram 9 CAS e 8 NCM de forma independente, sendo observada correlação perfeita entre eles quanto às avaliações morfológica e qualitativa da IS. Não houve diferença significativa entre os grupos de CAS e NCM na comparação das variáveis quantitativas da IS nas ponderações T1 e T2, bem como da razão ISLCP/ISPP e dos valores de ADC. CONCLUSÃO: Quanto à morfologia, a classificação do aspecto cístico (microcística, macrocística ou unilocular) foi a variável que apresentou a maior associação com os grupos, sendo, portanto, importante na definição diagnóstica. A quantificação da IS nas ponderações T1 e T2, assim como a medida do ADC das LCP, não permitiram a diferenciação das neoplasias císticas pancreáticas serosas e mucinosas. / INTRODUCTION: Differential diagnosis between serous cystadenomas (SCA) and mucinous cystic neoplasms (MCN) is essential, since SCA is benign and treatment is generally conservative, whereas MCN is premalignant (or malignant) and should be resected. The overlapping of imaging features is not uncommon, so non-invasive aids may be useful in differentiating between them. OBJECTIVES: To present a SCA and MCN caseload using magnetic resonance imaging traditional morphological diagnostic criteria and to evaluate the quantification of signal intensity (SI) in T1 and T2 weights (both with fat suppression) and the apparent diffusion coefficient (ADC) in differentiation between these types of pancreatic cystic lesions (PCL). MATERIALS AND METHODS: PCL were evaluated for loculation, walls and presence of central scar, coarse septa and solid components. Qualitative and quantitative SI assessments were also performed in T1 and T2 weights, comparing PCL with pancreatic parenchyma (PP), as well as ADC quantitative evaluation. RESULTS: Two radiologists studied 9 SCA and 8 MCN independently, with a perfect correlation between morphological and qualitative IS scores. There was no significant difference between the SCA and MCN groups when comparing the quantitative IS variables in the T1 and T2 weights, as well as the SIPCL/SIPP ratio and the ADC values. CONCLUSION: As to morphology, the classification of the cystic aspect (microcystic, macrocystic or unilocular) was the variable that presented the greatest association with the groups, being therefore important in the diagnostic definition. The quantification of SI in the T1 and T2 weights, as well as the ADC measurement of the PCL, did not allow the differentiation of serous and mucinous pancreatic cystic neoplasms.
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Carcinomas mucinosos no ovário : caracterização macroscópica, histológica e imunoistoquímica para o diferencial entre tumores primários e metastáticos / Mucinous carcinomas in the ovary : macroscopic, histologic and immunohistochemical characterization for the differential diagnosis of primary or metastatic tumorsPinto, Paola Bertolotti Cardoso, 1976- 12 February 2013 (has links)
Orientadores: Liliana Aparecida Lucci De Angelo Andrade, Sophie Francoise Mauricette Derchain / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T12:06:20Z (GMT). No. of bitstreams: 1
Pinto_PaolaBertolottiCardoso_D.pdf: 22982855 bytes, checksum: ca4a4e679f0037c1494bf2866a333968 (MD5)
Previous issue date: 2013 / Resumo: Os carcinomas mucinosos do ovário são raros e representam apenas 3% dos carcinomas. Frente a este diagnóstico, é preciso descartar a possibilidade de metástase para o ovário, principalmente de neoplasia primária do trato gastrointestinal. Apesar da avaliação morfológica, macro e microscópica, e das reações imunoistoquímicas contribuírem para o diagnóstico diferencial, existem casos de difícil diferenciação. Um algoritmo para separar os carcinomas mucinosos primários dos metastáticos no ovário foi proposto na literatura e determina que são metastáticos os tumores bilaterais ou unilaterais menores que 13cm, classificando as neoplasias com uma acurácia de quase 90%. Objetivos: comparar os aspectos macro e microscópicos aliados à avaliação imunoistoquímica para a diferenciação entre tumores mucinosos primários e metastáticos no ovário, avaliando a acurácia do algoritmo nos casos, os dados clínicos e sua evolução. Métodos: Todos os tumores mucinosos envolvendo o ovário, dos arquivos do Laboratório de Anatomia Patológica da UNICAMP no período de 1994 a 2009 foram levantados. Feita revisão dos prontuários com descrição dos dados clínicos, evolução das pacientes, revisão de lâminas para avaliação de dados histopatológicos e seleção dos blocos de parafina para a construção de micro-arranjo de tecidos, onde foram realizadas as reações imunoistoquímicas para: CK7, CK20, ?-catenina, WT-1, CDX-2, Dpc-4, CA125, RE e RP. Resultados: Dos 76 casos selecionados, 35 eram carcinomas mucinosos primários do ovário, 33 eram metastáticos e em 8 casos o primário não foi definido, sendo excluídos da análise estatística. A sobrevida média foi maior nos primários (65X35 meses; p<0.0001). A acurácia do algoritmo foi de 82,1%. A maioria dos metastáticos originou-se do cólon ou reto (54%). Dos primários, 85% eram unilaterais >13 cm e dos metastáticos, 61% eram bilaterais e 18% unilaterais <13cm. Entre as características histológicas, êmbolos carcinomatosos e a ausência de gradiente morfológico foram mais observados nos metastáticos. Na análise bivariada dos marcadores apenas CK7, CK20 e CDX2 mostraram diferenças significantes entre os grupos, entretanto houve muita sobreposição de resultados. Após análise multivariada foram selecionados: gradiente histológico e CK7 para formação de um novo algoritmo que definiu, com acurácia de 91%, que um tumor é metastático quando apresenta qualquer um dos aspectos: bilateral; unilateral e <13 cm; ausência de gradiente histológico; ou gradiente histológico presente com falta de expressão do CK7. Conclusão: tanto o algoritmo, como as reações imunoistoquímicas e os aspectos morfológicos são úteis no diagnóstico diferencial entre primário e metastático, porém não há nenhum dado discriminatório e, em alguns casos, somente a análise com equipe multidisciplinar pode definir o primário, reconhecendo as peculiaridades deste diagnóstico desafiador / Abstract: Primary ovarian mucinous carcinomas are uncommon and the most important differential is metastatic adenocarcinoma, mainly from gastrointestinal origin. Besides immunohistochemical profile, an algorithm determines, with a high accuracy, that unilateral and >13cm tumors are primary carcinomas and all the others, metastasis. Objective: to describe clinical and histopathological aspects of mucinous carcinomas, assessing the algorithm accuracy and immunohistochemical markers contributory to diagnosis. Methods: 76 mucinous carcinomas from our files (1994-2009) were revised; immunohistochemical reactions for CK7, CK20, Ca125, hormonal receptors (ER, PR), WT1, SMAD4, ?-catenin, CDX2 were performed by TMA. Results: 35 were ovarian primary tumors (group 1), 33 were metastasis (group 2). In eight cases the primary was not identified and these were excluded from statistic analysis. Most of the metastasis were from colorectal cancer (54%). Mean survival differed between the groups (65X35 months; p<0.0001). Agreement with the algorithm was 82.1%. In group 1, 85% were unilateral >13cm; in group 2, 61% were bilateral and 18% unilateral tumors <13cm. Different from group 1, common features in group 2 were vascular invasion and tumors without histological gradient. Bivariate analysis pointed out CK7, CK20 and CDX2 as main markers to distinguish both groups, but overlapping of the results was observed. After multivariate analysis, 2 aspects were selected: histological gradient and CK7; a new algorithm was designed and established with an accuracy of 91%, that a mucinous carcinoma is metastatic to the ovary when it shows one of the aspects: bilateral, or unilateral and <13cm, or without histological gradient, or presence of histological gradient but CK7 is negative. Conclusion: Algorithm and immunohistochemistry are useful, but there is no gold-standard marker. In some cases, only multidisciplinary evaluation can achieve reliable anatomo-clinical diagnosis, in this challenging situation / Doutorado / Anatomia Patologica / Doutora em Ciências Médicas
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GATA6-positive lung adenocarcinomas are associated with invasive mucinous adenocarcinoma morphology, hepatocyte nuclear factor 4α expression, and KRAS mutations / GATA6陽性肺腺癌は浸潤性粘液性腺癌と関連し、肝細胞核因子4α発現とKRAS変異とも相関するNakajima, Naoki 23 March 2020 (has links)
京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22332号 / 医博第4573号 / 新制||医||1041(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 平井 豊博, 教授 滝田 順子, 教授 松田 道行 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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Promoter-level transcriptome identifies stemness associated with relatively high proliferation in pancreatic cancer cells / 高度増殖性を示す膵臓癌細胞が持つ幹細胞特性のトランスクリプトーム解析による同定Chen, Ru 23 September 2020 (has links)
付記する学位プログラム名: 充実した健康長寿社会を築く総合医療開発リーダー育成プログラム / 京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第22747号 / 医科博第116号 / 新制||医科||8(附属図書館) / 京都大学大学院医学研究科医科学専攻 / (主査)教授 長船 健二, 教授 武藤 学, 教授 小川 誠司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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Druggable Oncogene Fusions in Invasive Mucinous Lung Adenocarcinoma / 浸潤性粘液肺腺がんの遺伝子異常Nakaoku, Takashi 23 March 2016 (has links)
リポジトリの登録にあたっては、Peer reviewされた最終版のみ可能であり、その際には下記の出版社のウェブサイトのアドレスを記載することが求められる。当該論文は2014年6月の出版であり、12ヶ月を経過していることから、公開には差し支えはない。http://clincancerres.aacrjournals.org/content/20/12/3087.full / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19617号 / 医博第4124号 / 新制||医||1015(附属図書館) / 32653 / 京都大学大学院医学研究科医学専攻 / (主査)教授 小川 誠司, 教授 野田 亮, 教授 伊達 洋至 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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ARID1A Maintains Differentiation of Pancreatic Ductal Cells and Inhibits Development of Pancreatic Ductal Adenocarcinoma in Mice / ARID1Aはマウスにおいて膵管細胞の分化を維持し、膵がんの発生を抑制するKimura, Yoshito 26 November 2018 (has links)
京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21420号 / 医博第4410号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 羽賀 博典, 教授 武田 俊一, 教授 坂井 義治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent PregnancySchreck, Arielle M., Mikdachi, Hana F. 03 January 2019 (has links)
Mucinous cystadenomas of the ovary are benign epithelial neoplasms that can grow rapidly during pregnancy. They may cause ovarian torsion, virilization, inferior vena cava syndrome, and even preterm labor and fetal growth restriction. Various theories exist regarding the pathogenesis of these tumors. One hypothesis suggests that they may arise from teratomas. Our case report describes synchronous mucinous cystadenomas and ovarian teratomas, as well as metachronous mucinous cystadenomas in patients with a history of ovarian teratoma. There has been no report of metachronous ipsilateral teratoma after previous mucinous cystadenoma. We present a 22-year-old female with a history of bilateral ovarian tumors in a prior pregnancy noted to have a recurrent ovarian mass on her left ovary at the time of cesarean section of a subsequent pregnancy. She had two prior cystectomies for metachronous mucinous cystadenomas of her left ovary, and a right salpingo-oophorectomy for the ovarian torsion in her previous pregnancy. On her current pregnancy, she developed a mature cystic teratoma of the remaining left ovary. The rapid growth and recurrence rate of these tumors highlights the importance of close surveillance of ovarian masses during pregnancy, even those that seem benign. In this case, a history of unilateral salpingo-oophorectomy with multiple contralateral cystectomies did not appear to affect her fertility. Her future ovarian reserve is unknown, pointing to the need for adequate pre-operative counseling in similar cases of ovarian masses in pregnancy.
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Clinicopathological features of cytokeratin 5-positive pulmonary adenocarcinoma / サイトケラチン5 陽性肺腺癌の臨床病理学的特徴Terada, Kazuhiro 25 March 2024 (has links)
京都大学 / 新制・課程博士 / 博士(医学) / 甲第25158号 / 医博第5044号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 平井 豊博, 教授 小川 誠司, 教授 後藤 慎平 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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