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T L Tio

Publications and source records attributed to T L Tio.

At least 37 records · Page 2Linked to original sources
PubMed1994

Assessment of tumor infiltration depth in rectal cancer with transrectal sonography: caution is necessary.

PURPOSE: To assess the depth of infiltration of rectal cancer with transrectal ultrasound (US) (TRUS) and analyze interpretation errors. MATERIALS AND METHODS: Fifty-five consecutive patients with rectal cancer who underwent TRUS were prospectively studied. The effect of different patient inclusion criteria and US criteria was evaluated retrospectively. RESULTS: Extensive overstaging of T2 tumors, partially caused by inflammatory (desmoplastic) reaction or retraction of the muscularis propria, resulted in a specificity of only 24% for detection of perirectal infiltration. Sensitivity was 97%, and accuracy was 64%. Considerable variation in staging accuracy was observed when different patient selection criteria were used. Variation of US criteria improved differentiation between T2 and T3 tumors only slightly. CONCLUSION: The effect of different US criteria on differentiation of T2 and T3 tumors is limited. Spontaneous or iatrogenic inflammation is a major limiting factor. The accuracy of TRUS in staging rectal cancer is affected by patient inclusion criteria.

Aged↗
PubMed1993

Endosonography and cytology in diagnosing and staging pancreatic body and tail carcinoma. Preliminary results of endosonographic guided puncture.

Endosonography was performed in diagnosing and staging pancreatic body and tail carcinoma in two patients. In the first case endoscopy, abdominal ultrasound, and computed tomography were nondiagnostic in diagnosing the origin of submucosal gastric abnormalities. Endosonography diagnosed a pancreatic tail carcinoma with submucosal gastric involvement, and this was confirmed by endosonographic-guided cytology. Fundus varices due to segmented splenic vein involvement were found. Surgery was not recommended due to the advanced disease. In the second case pancreatic body carcinoma was diagnosed by ERCP and computed tomography. Transcutaneous ultrasonographic-guided cytological puncture confirmed the diagnosis. Endosonography revealed additional information of segmental portal hypertension with fundic varices due to splenic vein involvement. Autopsy confirmed the endosonographic diagnosis.

Aged↗
PubMed1993

Endosonography in the clinical staging of Klatskin tumor.

Endosonography was performed preoperatively in 46 patients with carcinoma of the common hepatic duct and its bifurcation. The results of endosonography were correlated with findings during surgery and pathological examination of the resected specimen and classified according to the new (1987) TNM classification. Overall accuracy in assessing the depth of tumor infiltration was 86.0%. Endosonography was accurate in predicting the presence of lymph nodes but not accurate in defining non-metastatic changes of lymph nodes. Staging of distant metastases was not accurate due to the low penetration depth of ultrasound.

Adenoma, Bile Duct↗
PubMed1992

Endosonography in diagnosing and staging duodenal villous adenoma.

Endosonography was carried out in a patient with an extensive juxtapapillary tumour. Radiology and endoscopy were unable to distinguish a villous adenoma from an invasive carcinoma. Endosonography revealed a mucosal hypoechoic tumour without penetration into the submucosa and muscularis propria. The common bile duct, pancreatic duct, and pancreas were normal. Lymph node abnormalities were not found. Based on the endosonography findings, local surgical tumour resection was undertaken instead of a Whipple procedure. The histology of the resected specimen confirmed the endosonography diagnosis.

Adenoma↗
PubMed1992

Colorectal villous adenoma: transrectal US in screening for invasive malignancy.

Exclusion of focal infiltrating malignancy in colorectal villous adenoma is a prerequisite when nonsurgical treatment is considered. In a study of 81 patients with endoscopically identified colorectal villous adenoma screened for malignancy with transrectal ultrasonography (US), 15 patients were excluded because of incomplete follow-up. Twelve carcinomas were present, confirmed with either histopathologic examination after surgical resection (n = 9) or biopsies during laser treatment (n = 3). Nine of them were detected with transrectal US on the basis of disruption of the anatomic wall layers (sensitivity, 75%). In 46 of the 54 adenomas transrectal US helped confirm the benign nature of the lesion (specificity, 85%). Seven of the eight false-positive cases happened to be previously treated with surgery or coagulation. Treatment-associated inflammatory changes in the wall layers seemed responsible for this misinterpretation. Because of the high predictive value for a negative result (benign adenoma, 94%), transrectal US is recommended for the evaluation of villous adenomas to detect malignancy, especially when nonsurgical treatment is considered. Transrectal US should be performed before diagnostic polypectomy.

Adenoma↗
PubMed1992

Endosonography in staging early carcinoma of the ampulla of vater.

A 52-year-old man with a pedunculated ampullary carcinoma was referred for endosonography. Endoscopic retrograde cholangiopancreatography was unsuccessful because of pedunculation of the papilla. Endosonography revealed a superficial hypoechoic tumor limited to the mucosa, which was compatible with a T1 carcinoma according to the new (1987) Union Internationale Contre le Cancer TNM classification of the polypoid tumor. No lymph node metastases were found, the staging being T1N0. Local tumor resection was performed. Lymph node metastases were not found at surgery. Histology of the resected specimen confirmed the findings at endosonography. Follow-up endoscopy and endosonography 18 months after surgery showed no evidence of tumor recurrence or lymphadenopathy.

Adenocarcinoma↗
PubMed1991

Endosonography of groove pancreatitis.

Groove pancreatitis is a rare form of chronic pancreatitis. Distinction between pancreatitis and pancreatic carcinoma is often difficult. Two cases of groove pancreatitis diagnosed by endosonography are described. A hypoechoic pattern between the duodenal wall and pancreas was clearly imaged in both patients. Narrowing of the second part of the duodenum and evidence of bile duct obstruction were also found. The endosonographic diagnosis was confirmed either by surgery or follow-up examination.

Chronic Disease↗
PubMed1991

Colorectal carcinoma: preoperative TNM classification with endosonography.

Transcolorectal endosonography (TES) with use of both a nonoptic instrument and an echocolonoscope was performed in 91 patients with colorectal carcinomas (61 rectal and 30 colonic). Correlation of results at TES with results of histologic analysis of resected specimens according to the 1987 TNM classification demonstrated that TES allowed accurate staging of all tumors except T2 carcinomas, which were often accompanied by peritumoral inflammation or abscesses. Overall, the accuracy of staging rectal and colonic carcinomas with TES was 81% and 93%, respectively; overstaging occurred in 13% and understaging in 2%. For regional lymph nodes, the accuracy of staging with TES was 70%, the sensitivity was 94%, and the specificity was 55%. Correlations between findings at TES and the Dukes classification were as follows: for rectal carcinoma, 48% for class A, 50% for class B, and 96% for class C; for colonic carcinoma, 67% for class A, 46% for class B, and 91% for class C. Overall accuracy was 67%. With the addition of abdominal computed tomographic or ultrasonographic examinations to evaluate distant metastases, TES should become an important imaging technique for clinical TNM staging of colorectal carcinomas.

Adult↗
PubMed1991

Transrectal US in the diagnosis of localized colitis cystica profunda.

Colitis cystica profunda (CCP) mimicks rectal carcinoma, which makes distinguishing this benign lesion from the more common rectal neoplasm clinically and pathologically difficult. When transrectal ultrasound (US) was used in this case, three features of CCP were seen. There were multiple lesions, which did not penetrate beyond the submucosa. A large cystic component was seen, with a layer of uniform thickness in two of the three lesions. Non-solid contents and a lack of infiltration can be visualized at transrectal US, which helps diagnose CCP.

Colitis↗
PubMed1991

Esophageal ultrasonography.

Esophageal ultrasonography (EUS) is the most sophisticated noninvasive technique for characterizing esophageal mucosal detail. Many pathologic states can be defined more accurately with the use of EUS, resulting in better patient-management decisions. Technical and practical aspects of EUS are discussed in this article.

Esophageal Neoplasms↗
PubMed1991

Endosonographic TNM staging of extrahepatic bile duct cancer: comparison with pathological staging.

Endosonography was performed preoperatively in 33 patients with common bile duct carcinoma and in 43 patients with carcinoma of the common hepatic duct and its bifurcation. The results were correlated with the histology of resected specimens according to the new (1987) TNM (tumor, node, metastasis) classification. Endosonography was accurate in the evaluation of the depth of tumor infiltration. Overall accuracy for common bile duct carcinoma and common hepatic duct carcinoma was 82.8% and 85%, respectively. Endosonography was helpful in diagnosing regional lymph node metastases but not accurate in diagnosing nonmetastatic lymph nodes. With common bile duct carcinoma, the incidence of lymph node metastasis increased with progressive depth of tumor infiltration. No such correlation was found in common hepatic duct carcinomas. In the staging of distant metastasis, this technique was limited by the low-penetration depth of ultrasonography. Thus, additional transcutaneous ultrasonography or computed tomography was necessary for complete staging. The routine use of the biopsy channel for endosonographically guided aspiration puncture will further enhance the diagnostic value of endosonography in the future.

Bile Duct Neoplasms↗
PubMed1990

Preoperative TNM classification of proximal extrahepatic bile duct carcinoma by endosonography.

ES was performed preoperatively in 39 patients with a proximal bile duct carcinoma. The results were correlated with the histologic findings of resected specimens or intraoperative excision according to the new (1987) TNM classification. ES was accurate in assessing the depth of tumor infiltration. The overall accuracy of ES was 83.8%. Overstaging of T2 carcinoma occurred in three of ten patients (30%) and understaging of T3 carcinoma occurred in 3 of 27 patients (11%). ES was helpful in diagnosing lymph node metastasis (accuracy, 92.9%) but not accurate in defining nonmetastatic lymph nodes (accuracy, 18.8%). Difficulties occurred in distinguishing inflammatory lymph nodes and micrometastatic lymph node involvement. ES was not accurate in diagnosing hepatic metastases and peritoneal dissemination because of the limited penetration depth of ultrasound. The incidence of lymph node metastasis of advanced stage carcinoma was approximately 40%. Technical improvements, such as reduction of the diameter of the echoprobe, easy handling of ES-guided cytologic puncture, and the routine use of a catheter echoprobe during ERCP will further enhance the accuracy of ES.

Adenoma, Bile Duct↗
PubMed1990

Ampullopancreatic carcinoma: preoperative TNM classification with endosonography.

Endosonography (ES) was used for the preoperative TNM (1987) staging of tumors in 43 patients with pancreatic cancer and 24 patients with ampullary carcinomas. These results were correlated with the histologic findings of resected specimens. Early-stage tumors could be distinguished from advanced stages of cancer with ES. Detailed images of ductular and parenchymal abnormalities allowed distinction between pancreatic and ampullary carcinomas based on anatomic location. The overall accuracy of ES in the assessment of tumor classification in pancreatic and ampullary carcinoma was 92% and 88%, respectively. In diagnosing regional lymph nodes in pancreatic and ampullary tumors the accuracy of ES was 74% and 54%, respectively. For diagnosing metastatic lymph nodes in pancreatic and ampullary carcinoma the accuracy of ES was 91% and 80%, respectively. The prevalence of lymph node metastases in T1 pancreatic cancers and T1 ampullary carcinomas was 40% and 0%, respectively. Discrimination between inflammation and metastases was difficult with ES. ES was not accurate in assessing distant metastases because of the limited penetration depth of ultrasound.

Adult↗
PubMed1990

Preoperative TNM classification of esophageal carcinoma by endosonography.

Endosonography was performed preoperatively in 111 patients with an esophageal carcinoma. The results were correlated with the histology of resected specimens employing the new (1987) TNM classification. Endosonography was accurate in assessing the depth of tumor infiltration (overall accuracy: 89%). Early carcinomas could be distinguished from advanced cancer. Extensive stenosis preventing the passage of the instrument was a limiting factor prior to the availability of a small-caliber catheter echoprobe (25% of cases). Endosonography was helpful for diagnosing lymph node metastasis, but was less accurate in defining non-metastatic enlarged lymph nodes (accuracy: 81%, sensitivity 95% and specificity 50%). The incidence of lymph node metastasis increased with the progression of tumor infiltration. Endosonography was also less accurate for diagnosing liver metastases and peritoneal dissemination because of the low depth of penetration of ultrasound. Technical improvements such as a reduction in the diameter of the instrument will further enhance the accuracy of endosonography. Moreover, ES-guided cytology may become helpful for confirming the ES diagnosis of lymph node metastasis.

Adult↗