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Biomedical subjects

S Siegelman

Publications and source records attributed to S Siegelman.

16 recordsLinked to original sources

CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment?

OBJECTIVE: The purpose of this study was to determine whether CT can be used to distinguish serous cystadenomas from mucinous cystadenomas or cystadenocarcinomas of the pancreas and play an enhanced role in patient triage and treatment. MATERIALS AND METHODS: A blinded retrospective analysis of CT scans from 50 patients with pathologically proven primary cystic pancreatic neoplasms was performed independently by three radiologists. Using classic CT criteria as reported in the literature, each tumor was categorized as definitely serous, mucinous, or indeterminate. Tumor location, size, presence of calcification, and size of largest cyst were recorded. Data for each reviewer were analyzed independently. Consensus data were then subjected to multivariate logistic regression analysis. RESULTS: The ability of our reviewers to diagnose serous neoplasms ranged from 23% to 41%. Eight mucinous neoplasms were mistaken for serous tumors by two of the three reviewers. When consensus between at least two of the three reviewers was used for diagnosis, 27% of serous neoplasms were correctly diagnosed and all of the mucinous tumors were correctly identified as uncertain or mucinous, yielding the same clinical end point. For multivariate logistic regression analysis, a cyst smaller than 2 cm had a statistically significant association (p = 0.005) with serous tumors, and the presence of peripheral tumoral calcification had a statistically significant association (p = 0.01) with mucinous tumors. CONCLUSION: There is significant variability in the CT appearance of serous and mucinous neoplasms of the pancreas, making CT an insensitive tool for differentiating these tumors. All tumors with peripheral calcifications were identified as mucinous neoplasms.

Adult↗

The pharmaceutical industry.

Pharmaceutical research once focused primarily on curing infectious diseases, many of which have been virtually eliminated. Today, there is growing emphasis on finding ways to prevent, treat, and cure chronic illnesses such as cardiovascular disease and cancer.

Acquired Immunodeficiency Syndrome↗

Flexible transbronchial needle aspiration for staging of bronchogenic carcinoma.

Flexible transbronchial needle aspiration (TBNA) provides access to mediastinal lymph nodes, but its role in staging bronchogenic carcinoma is unknown. To determine the efficacy and safety of this procedure for staging the extent of mediastinal disease, the results of TBNA performed during fiberoptic bronchoscopy in 39 patients without known extrathoracic metastases were reviewed. Flexible TBNA was found to be a safe, effective method for determining the presence or absence of mediastinal metastases from bronchogenic carcinoma. Furthermore, TBNA results compare favorably with roentgenographic staging techniques, with the added advantage of providing cytopathologic information.

Adenocarcinoma↗

The value of ultrasonic imaging and CT scanning in planning the radiotherapy for prostatic carcinoma.

Forty-four consecutive patients with potentially curable carcinoma of the prostate were localized with an Old Delft Simulator with the methods described by Bagshaw. The isocenter and the treatment portal were marked on the skin of the patient. Subsequently, the adequacy of the portal was checked by ultrasonography and/or CT scanning. Of 30 patients who underwent ultrasonography, five patients (17%) were found to have tumor extending beyond the initially simulated treatment portals. Using CT scanning, three of 22 patients were found to have tumor extending beyond the initially simulated portals. As a result, 1-2 cm were added to the initially simulated treatment portals for adequate coverage of the tumor volumes. Eight of our 44 patients underwent both studies and results were similar with ultrasonography and CT scanning. Only patients in the group presenting with clinical stage C disease had modifications of the initially simulated treatment portal. It is recommended that conventional simulation should be done first in order to establish the isocenter and treatment volume, which then should be confirmed by ultrasonography or CT scanning.

Aged↗

Use of isotopic immunoglobulin in therapy.

Antibodies raised in heterologous species against tumor-associated antigens such as ferritin and carcinoembryonic antigen may be utilized in diagnostic scanning and in cancer therapy. The radiolabeled (131I) antibodies have a mean effective half-life of 3 days. The tumor-bearing regions retain activity which was associated with objective evidence of remission in primary hepatic cancers. Major organ toxicity was not apparent in eight of nine patients treated with radioactive antibody. Objective evidence of clinical remission was documented by computer-assisted axial tomography scan remission in sequential studies that determine residual tumor in the same planar cuts. Future possible improvements in radioimmunoglobulin are discussed in light of the clinical findings.

Carcinoembryonic Antigen↗

Bladder involvement in Crohn disease: role of CT in detection and evaluation.

A retrospective review of 275 consecutive patients with symptomatic Crohn disease to determine the frequency and type of bladder involvement yielded 14 cases. All 14 patients had a long standing history of Crohn disease with other positive radiologic features at the time of detection of bladder involvement. Patients were categorized into two groups based on the CT findings: Group I (n = 4) had focal bladder wall thickening adjacent to an extravesical soft tissue mass and/or focal bowel wall thickening; Group II (n = 10) had fistula formation with intravesical air with associated focal bowel wall thickening and/or extravesical soft tissue mass. Bladder involvement in Crohn disease is a progressive pathological process that can result in formation of an enterovesical fistula. The patient may come to radiologic attention at any stage in the course of the disease. Computed tomography is a sensitive and noninvasive method of evaluating the bladder and can be used to identify patients in the prodromal stage who are at risk of developing enterovesical fistulae. Timely intervention may prevent frank perforation into the lumen of the bladder by an inflammatory mass.

Adult↗