Evidence map›Paper›PMID 28444494›Full record

Trial reportSurgical endoscopy2017

Imaging of pancreatic cystic lesions with confocal laser endomicroscopy: an ex vivo pilot study.

Abdurrahman Kadayifci, Mustafa Atar, Michelle Yang, Carlos Fernandez-Del Castillo, Mari Mino-Kenudson, William R Brugge

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Abdurrahman KadayifciDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. kadayifci@hotmail.com.ORCID 0000-0002-5200-4164
Mustafa AtarDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Michelle YangDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Carlos Fernandez-Del CastilloDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Mari Mino-KenudsonDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
William R BruggeDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE.

methodsPatients who underwent surgery of a PCL were enrolled. During surgery, intravenous fluorescein (2.5 ml of 10%) was injected just prior to the ligation of blood vessels supplying the pancreas. The freshly excised specimens were transected along the long axis to fully expose the luminal surface. A Gastroflex-UHD CLE probe (pCLE) was used manually to acquire images directly from the surface of cyst wall. The specimen subsequently underwent cross-sectional histology. All recorded data were analyzed by two investigators for predefined and original image findings of PCLs.

resultsTen cases were recruited into the study. All patients underwent surgery because of a mucinous cyst with worrisome features or a symptomatic PCL. Imaging was successful in all patients and differently shaped papillary projections (PP) were visualized in eight patients. Pathological examination of those patients confirmed 6 cases with Intraductal Papillary Mucinous Neoplasm (IPMN) and 2 cases with Mucinous Cystic Neoplasm (MCN). In two patients with serous cystadenoma, typical vascular network was visualized in one patient, and microcystic structures in the other. Three of the IPMNs were malignant. The loss of papillary margin integrity and significant fragmentation together with irregularity was detected in malignant IPMNs by CLE.

conclusionsPancreatic cyst epithelial wall can be visualized successfully by pCLE in ex vivo surgical specimens. Different papillary projections have been seen in all cases of IPMNs and MCNs. CLE has potential for identifying IPMN subtypes and for grading dysplasia.

Indexed as

AdultAgedAged, 80 and overCarcinoma, Pancreatic DuctalCystadenoma, SerousDiagnosis, DifferentialEndoscopyFemaleHumansMaleMicroscopy, ConfocalMiddle AgedPancreatic CystPancreatic NeoplasmsPilot ProjectsProspective StudiesConfocal laser endomicroscopyIntraductal papillary mucinous neoplasmMucinous cystic neoplasmPancreas cystSerous cystadenoma

Identifiers

PMID28444494

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.