-
Magnetic Resonance in Medicine Oct 2021To assess the effects of cardiovascular-induced motion on conventional DWI of the pancreas and to evaluate motion-robust DWI methods in a motion phantom and healthy...
PURPOSE
To assess the effects of cardiovascular-induced motion on conventional DWI of the pancreas and to evaluate motion-robust DWI methods in a motion phantom and healthy volunteers.
METHODS
3T DWI was acquired using standard monopolar and motion-compensated gradient waveforms, including in an anatomically accurate pancreas phantom with controllable compressive motion and healthy volunteers (n = 8, 10). In volunteers, highly controlled single-slice DWI using breath-holding and cardiac gating and whole-pancreas respiratory-triggered DWI were acquired. For each acquisition, the ADC variability across volunteers, as well as ADC differences across parts of the pancreas were evaluated.
RESULTS
In motion phantom scans, conventional DWI led to biased ADC, whereas motion-compensated waveforms produced consistent ADC. In the breath-held, cardiac-triggered study, conventional DWI led to heterogeneous DW signals and highly variable ADC across the pancreas, whereas motion-compensated DWI avoided these artifacts. In the respiratory-triggered study, conventional DWI produced heterogeneous ADC across the pancreas (head: 1756 ± 173 × 10 mm /s; body: 1530 ± 338 × 10 mm /s; tail: 1388 ± 267 × 10 mm /s), with ADCs in the head significantly higher than in the tail (P < .05). Motion-compensated ADC had lower variability across volunteers (head: 1277 ± 102 × 10 mm /s; body: 1204 ± 169 × 10 mm /s; tail: 1235 ± 178 × 10 mm /s), with no significant difference (P ≥ .19) across the pancreas.
CONCLUSION
Cardiovascular motion introduces artifacts and ADC bias in pancreas DWI, which are addressed by motion-robust DWI.
Topics: Artifacts; Diffusion Magnetic Resonance Imaging; Humans; Motion; Pancreas; Reproducibility of Results
PubMed: 34142375
DOI: 10.1002/mrm.28846 -
Journal of Gastrointestinal and Liver... Dec 2022
Topics: Humans; Pancreas, Exocrine; Diabetes Mellitus; Pancreatitis, Chronic; Pancreas; Diabetes Mellitus, Type 1
PubMed: 36535041
DOI: 10.15403/jgld-4744 -
International Journal of Hyperthermia :... 2023Pancreatic cancer is a malignant disease associated with poor survival and nearly 80% present with unresectable tumors. Treatments such as chemotherapy and radiation...
Pancreatic cancer is a malignant disease associated with poor survival and nearly 80% present with unresectable tumors. Treatments such as chemotherapy and radiation therapy have shown overall improved survival benefits, albeit limited. Histotripsy is a noninvasive, non-ionizing, and non-thermal focused ultrasound ablation modality that has shown efficacy in treating hepatic tumors and other malignancies. In this novel study, we investigate histotripsy for noninvasive pancreas ablation in a pig model. In two studies, histotripsy was applied to the healthy pancreas in 11 pigs using a custom 32-element, 500 kHz histotripsy transducer attached to a clinical histotripsy system, with treatments guided by real-time ultrasound imaging. A pilot study was conducted in 3 fasted pigs with histotripsy applied at a pulse repetition frequency (PRF) of 500 Hz. Results showed no pancreas visualization on coaxial ultrasound imaging due to overlying intestinal gas, resulting in off-target injury and no pancreas damage. To minimize gas, a second group of pigs ( = 8) were fed a custard diet containing simethicone and bisacodyl. Pigs were euthanized immediately ( = 4) or survived for 1 week ( = 4) post-treatment. Damage to the pancreas and surrounding tissue was characterized using gross morphology, histological analysis, and CT imaging. Results showed histotripsy bubble clouds were generated inside pancreases that were visually maintained on coaxial ultrasound ( = 4), with 2 pigs exhibiting off-target damage. For chronic animals, results showed the treatments were well-tolerated with no complication signs or changes in blood markers. This study provides initial evidence suggesting histotripsy's potential for noninvasive pancreas ablation and warrants further evaluation in more comprehensive studies.
Topics: Swine; Animals; Feasibility Studies; Pilot Projects; Pancreas; Pancreatic Neoplasms; Ultrasonography, Interventional
PubMed: 37643768
DOI: 10.1080/02656736.2023.2247187 -
African Journal of Paediatric Surgery :... 2022The annular pancreas is a rare congenital disorder of the pancreas first recognized in 1818. It is believed to result from faulty rotation of the ventral pancreatic bud... (Review)
Review
BACKGROUND
The annular pancreas is a rare congenital disorder of the pancreas first recognized in 1818. It is believed to result from faulty rotation of the ventral pancreatic bud in its course around the posterior aspect of the duodenal anlage. The duodenum is encircled and might be obstructed by normal pancreatic tissue. The management of the annular pancreas is still developing and under revision.
CASE PRESENTATION
Six cases of neonatal intestinal obstruction secondary to the annular pancreas diagnosed, operated on, and involved in our study. Age, gender, maturity, age at referral, birth weight, clinical presentation, imaging findings, associated congenital anomalies, treatment, complications, and hospital stay were all studied. Polyhydramnios is found in 3 cases (50%). Down syndrome was diagnosed in one case. One patient has associated malrotation. Symptoms started earlier within the first 24 hours. Vomiting was bile stained in 4 cases (66.7%). Passing meconium, sometimes frequent, does not exclude the annular pancreas. Most patients show double bubbles sign on plain abdominal X-ray. All six neonates were treated with duodenoduodenostomy with excellent results. Survival was 100% and complications were minimum.
CONCLUSION
The annular pancreas, although rare, is an important cause of neonatal duodenal obstruction. The accurate diagnosis is usually performed during laparotomy. Vomiting may contain bile or not, furthermore, passing meconium does not exclude this condition. The best and the excellent surgical option is diamond duodenoduodenostomy. This case series might be added to the registered cases of the annular pancreas to standardize the method of diagnosis and to define the best management.
Topics: Anastomosis, Surgical; Duodenal Obstruction; Humans; Infant, Newborn; Pancreas; Pancreatic Diseases
PubMed: 35017379
DOI: 10.4103/ajps.AJPS_180_20 -
Diabetes Care Mar 2024This multicenter prospective cohort study compared pancreas volume as assessed by MRI, metabolic scores derived from oral glucose tolerance testing (OGTT), and a...
OBJECTIVE
This multicenter prospective cohort study compared pancreas volume as assessed by MRI, metabolic scores derived from oral glucose tolerance testing (OGTT), and a combination of pancreas volume and metabolic scores for predicting progression to stage 3 type 1 diabetes (T1D) in individuals with multiple diabetes-related autoantibodies.
RESEARCH DESIGN AND METHODS
Pancreas MRI was performed in 65 multiple autoantibody-positive participants enrolled in the Type 1 Diabetes TrialNet Pathway to Prevention study. Prediction of progression to stage 3 T1D was assessed using pancreas volume index (PVI), OGTT-derived Index60 score and Diabetes Prevention Trial-Type 1 Risk Score (DPTRS), and a combination of PVI and DPTRS.
RESULTS
PVI, Index60, and DPTRS were all significantly different at study entry in 11 individuals who subsequently experienced progression to stage 3 T1D compared with 54 participants who did not experience progression (P < 0.005). PVI did not correlate with metabolic testing across individual study participants. PVI declined longitudinally in the 11 individuals diagnosed with stage 3 T1D, whereas Index60 and DPTRS increased. The area under the receiver operating characteristic curve for predicting progression to stage 3 from measurements at study entry was 0.76 for PVI, 0.79 for Index60, 0.79 for DPTRS, and 0.91 for PVI plus DPTRS.
CONCLUSIONS
These findings suggest that measures of pancreas volume and metabolism reflect distinct components of risk for developing stage 3 type 1 diabetes and that a combination of these measures may provide superior prediction than either alone.
Topics: Humans; Diabetes Mellitus, Type 1; Prospective Studies; Pancreas; Risk Factors; Autoantibodies; Magnetic Resonance Imaging
PubMed: 38151474
DOI: 10.2337/dc23-1681 -
Clinical and Experimental Immunology Dec 2019Recent studies in Type 1 Diabetes (T1D) support an emerging model of disease pathogenesis that involves intrinsic β-cell fragility combined with defects in both innate... (Review)
Review
Recent studies in Type 1 Diabetes (T1D) support an emerging model of disease pathogenesis that involves intrinsic β-cell fragility combined with defects in both innate and adaptive immune cell regulation. This combination of defects induces systematic changes leading to organ-level atrophy and dysfunction of both the endocrine and exocrine portions of the pancreas, ultimately culminating in insulin deficiency and β-cell destruction. In this review, we discuss the animal model data and human tissue studies that have informed our current understanding of the cross-talk that occurs between β-cells, the resident stroma, and immune cells that potentiate T1D. Specifically, we will review the cellular and molecular signatures emerging from studies on tissues derived from organ procurement programs, focusing on in situ defects occurring within the T1D islet microenvironment, many of which are not yet detectable by standard peripheral blood biomarkers. In addition to improved access to organ donor tissues, various methodological advances, including immune receptor repertoire sequencing and single-cell molecular profiling, are poised to improve our understanding of antigen-specific autoimmunity during disease development. Collectively, the knowledge gains from these studies at the islet-immune interface are enhancing our understanding of T1D heterogeneity, likely to be an essential component for instructing future efforts to develop targeted interventions to restore immune tolerance and preserve β-cell mass and function.
Topics: Animals; Autoimmunity; Diabetes Mellitus, Type 1; Humans; Immune Tolerance; Insulin; Insulin-Secreting Cells; Islets of Langerhans; Pancreas
PubMed: 31309537
DOI: 10.1111/cei.13349 -
International Journal of Medical... 2021Acute pancreatitis (AP) is a leading cause of gastrointestinal-related hospital admissions with significant morbidity and mortality. Although the underlying... (Review)
Review
Acute pancreatitis (AP) is a leading cause of gastrointestinal-related hospital admissions with significant morbidity and mortality. Although the underlying pathophysiology of AP is rather complex, which greatly limits the treatment options, more and more studies have revealed that infiltrating immune cells play a critical role in the pathogenesis of AP and determine disease severity. Thus, immunomodulatory therapy targeting immune cells and related inflammatory mediators is expected to be a novel treatment modality for AP which may improve the prognosis of patients. Cells of the innate immune system, including macrophages, neutrophils, dendritic cells, and mast cells, represent the majority of infiltrating cells during AP. In this review, an overview of different populations of innate immune cells and their role during AP will be discussed, with a special focus on neutrophils and macrophages.
Topics: Animals; Dendritic Cells; Disease Models, Animal; Humans; Immunity, Innate; Immunotherapy; Macrophages; Mast Cells; Neutrophils; Pancreas; Pancreatitis
PubMed: 33390823
DOI: 10.7150/ijms.51618 -
Function (Oxford, England) 2023George Palade's pioneering electron microscopical studies of the pancreatic acinar cell revealed the intracellular secretory pathway from the rough endoplasmic reticulum... (Review)
Review
George Palade's pioneering electron microscopical studies of the pancreatic acinar cell revealed the intracellular secretory pathway from the rough endoplasmic reticulum at the base of the cell to the zymogen granules in the apical region. Palade also described for the first time the final stage of exocytotic enzyme secretion into the acinar lumen. The contemporary studies of the mechanism by which secretion is acutely controlled, and how the pancreas is destroyed in the disease acute pancreatitis, rely on monitoring molecular events in the various identified pancreatic cell types in the living pancreas. These studies have been carried out with the help of high-resolution fluorescence recordings, often in conjunction with patch clamp current measurements. In such studies we have gained much detailed information about the regulatory events in the exocrine pancreas in health as well as disease, and new therapeutic opportunities have been revealed.
Topics: Humans; Pancreas, Exocrine; Pancreatitis; Acute Disease; Pancreas; Acinar Cells
PubMed: 36606242
DOI: 10.1093/function/zqac061 -
Transplant International : Official... Jul 2021Utilization of pancreases for transplantation remains inferior to that of other organs. Herein, we analysed UK pancreas discards to identify the reasons for the low... (Review)
Review
Utilization of pancreases for transplantation remains inferior to that of other organs. Herein, we analysed UK pancreas discards to identify the reasons for the low utilization rates. Data on all pancreases offered first for solid organ transplantation between 1st January 2005 and 31st December 2015 were extracted from the UK Transplant Registry. The number of organs discarded, reasons and the time point of discard were analysed. A centre specific comparison was also undertaken. 7367 pancreases were offered first for solid organ transplantation. 35% were donors after circulatory death (DCD). 3668 (49.7%) organs were not retrieved. Of the 3699 pancreases retrieved, 38% were initially accepted but subsequently discarded. 2145 (29%) grafts offered were transplanted as simultaneous pancreas-kidney or solitary pancreas. 1177 (55%) were transplanted on the first offer whilst the remaining 968 were transplanted after a median of three offers. 52% DBD pancreases were accepted and transplanted on the first offer compared with 68% DCD grafts. There were significant differences in discard rates between centres (30-80% for DBD and 3-78% for DCD, P < 0.001). A significant number of solid pancreases are discarded. Better graft assessment at retrieval could minimize unnecessary organ travel and discards. Closer links with islet programmes may allow for better utilization of discarded grafts.
Topics: Graft Survival; Humans; Organ Transplantation; Pancreas; Pancreas Transplantation; Tissue Donors; Tissue and Organ Procurement; United Kingdom
PubMed: 33794037
DOI: 10.1111/tri.13876 -
Cell Stem Cell Jun 2021In this issue of Cell Stem Cell, Huang et al. (2021) and Breunig et al. (2021) developed human stem-cell-derived organoid culture systems to recapitulate pancreatic...
In this issue of Cell Stem Cell, Huang et al. (2021) and Breunig et al. (2021) developed human stem-cell-derived organoid culture systems to recapitulate pancreatic acinar and ductal lineages. This provides opportunities to study cellular plasticity and transformation in pancreatic cancer initiation and progression.
Topics: Acinar Cells; Humans; Organoids; Pancreas; Pancreas, Exocrine; Pancreatic Ducts; Pancreatic Neoplasms; Pluripotent Stem Cells
PubMed: 34087158
DOI: 10.1016/j.stem.2021.05.006