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    • ". The EASL and the AASLD guidelines recommend MR cholangiography as the first line imaging examination in patients with suspected PSC [34]. However, endoscopic retrograde cholangiography should still be performed when MR cholangiography is doubtful or inconclusive. "
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    ABSTRACT: Inflammatory bowel diseases (IBD) are associated with an increased risk of gastrointestinal cancers and more specifically in sites affected by chronic inflammation. However, patients with IBD have also an increased risk for developing a variety of extra-intestinal cancers. In this regard, hepatobiliary cancers, such as cholangiocarcinoma, are more frequently observed in IBD patients because of a high prevalence of primary sclerosing cholangitis, which is considered as a favoring condition. Extra-intestinal lymphomas, mostly non-Hodgkin lymphomas, and skin cancers are also observed with an increased incidence in IBD patients by comparison with that in patients without IBD. This review provides an update on demographics, risk factors and clinical features of extra-intestinal malignancies, including cholangiocarcinoma, hepatocellular carcinoma and lymphoma, that occur in patients with IBD along with a special emphasis on the multidetector row computed tomography and magnetic resonance imaging features of these uncommon conditions. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
    Diagnostic and interventional imaging 04/2015; DOI:10.1016/j.diii.2015.02.009
    • "PSC is a chronic fibro-inflammation with the formation of biliary strictures, harbouring the potential for malignant transformation. The life-time risk for cholangiocellular adenocarcinoma (CCA) is estimated to be 5–15%, in up to 50% of patients within the first year after presentation of PSC [1] [2] [3] [4]. CCA is believed to develop sequentially from dysplasia to overt carcinoma [5] [6] [7], supporting the rationale for monitoring PSC patients to detect high grade dysplasia (HGD), but how such monitoring should be undertaken is still unclear [8] [9]. "
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    ABSTRACT: Background/Aims Despite high risk of cholangiocellular adenocarcinoma (CCA) it is unclear how surveillance of patients with primary sclerosing cholangitis (PSC) should be performed. Method We evaluated a follow-up algorithm of brush cytology and positron emission tomography/computed tomography with [18F]fluorodeoxyglucose ([18F]FDG-PET/CT), measured as the maximum standardized uptake values normalized to the liver background (SUVmax/liver) at 180 minutes, in PSC patients with dominant bile duct strictures. Results Brush cytology with high grade dysplasia (HGD) was detected in 12/70 patients (17%), yielding diagnostic sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 56%, 89%, 75% and 88%, respectively. Preemptive liver transplantations due to repeated HGD before manifest CCA were performed in six patients. Receiver operating characteristic (ROC) analysis of [18F]FDG uptake showed that a SUVmax/liver quotient of 3.3 was able to discriminate between CCA and non-malignant disease with a sensitivity, specificity, PPV and NPV for CCA of 89%, 92%, 62%, 98%, respectively. A SUVmax/liver >3.3 detected CCA in 8/9 patients whereas a quotient < 2.4 excluded CCA. Combining brush cytology and quantitative [18F]FDG-PET/CT yielded a sensitivity for HGD and/or CCA of 100% and a specificity of 88%. Conclusion Early detection of HGD before manifest CCA is feasible with repeated brush cytology and may allow for preemptive liver transplantation. [18F]FDG-PET/CT has a high sensitivity for manifest CCA and a negative scan indicates a non-malignant state of the disease. Brush cytology and [18F]FDG-PET/CT are complementary in monitoring and managing PSC patients with dominant strictures.
    Journal of Hepatology 12/2014; 61(6). DOI:10.1016/j.jhep.2014.07.032 · 11.34 Impact Factor
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    • "Primary sclerosing cholangitis is a chronic cholestatic liver disease that causes inflammation, fibrosis, scarring, and destruction of the bile ducts at intrahepatic and extrahepatic levels (Cullen and Chapman 2003; Harrison and others 2005). The disease is a progressive immune-mediated disorder that culminates in cirrhosis, hepatic decompensation, and portal hypertension (Chapman and others 2010). About 70% of primary sclerosing cholangitis patients are young and middle-aged men (Mendes and Lindor 2010). "
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    ABSTRACT: Curcumin, the natural yellow-colored active principle, also called turmeric yellow, extracted from the perennial herb Curcuma longa L., has potent biological and pharmacological properties such as antioxidant, anti-inflammatory, antifungal, antibacterial, anti-ischemic, antitumor, and anticancer actions. The molecular mechanism of the hepatoprotective action of curcumin is due to its antioxidant properties and inhibitory activity against nuclear factor (NF)-B that regulates different proinflammatory and profibrotic cytokines. Overall, scientific reports demonstrate that curcumin has high therapeutic ability for treating hepatic disorders. Here is a systematic discussion of the hepatoprotective activity of curcumin and its possible mechanisms of actions.
    Comprehensive Reviews in Food Science and Food Safety 01/2014; 13(1). DOI:10.1111/1541-4337.12047 · 4.18 Impact Factor
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