Hilar Cholangiocarcinoma: Staging with Intrabiliary MRI

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Blalock 544, 600 N Wolfe St., Baltimore, MD 21287, USA.
American Journal of Roentgenology (Impact Factor: 2.73). 11/2004; 183(4):1071-4. DOI: 10.2214/ajr.183.4.1831071
Source: PubMed
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    • "Intraluminal MRI may greatly facilitate the development of MRI-guided gene therapy in other organs and systems. For example, recent studies have demonstrated the feasibility of generating intraluminal MRI of non-cardiovascular systems, such as the esophagus [6] and hepatobiliary system [7]. These intraluminal MRI techniques enable us to (a) observe the luminal walls at high-resolution scales; and (b) combine the intraluminally placed MR devices with different existing interventional procedures, including gene therapy. "
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    ABSTRACT: MRI has the ability to generate high-contrast and high-resolution images, to obtain multiple diagnostic evaluations of organ function and morphology, and to provide multiple image planes with no risk of ionizing radiation. Recent efforts have focused on using MR technology to monitor gene delivery, to enhance gene transfection/transduction, and to track gene expression. This review summarizes the current status of MRI-guided gene therapy.
    FEBS Letters 06/2006; 580(12):2958-61. DOI:10.1016/j.febslet.2006.04.027 · 3.17 Impact Factor
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    ABSTRACT: Miniature flexible RF coils for magnetic resonance imaging have been constructed using electroplated conductors and substrates formed in SU-8 epoxy photoresist. The coils are batch fabricated on glass wafers, removed by thermal shock and integrated into a catheter probe designed for endoscopic insertion into the bile duct. 1 H MRI with at least 1 mm resolution is demonstrated in vitro using microfabricated phantoms and liver tissue at 1.5 T.
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    ABSTRACT: Objective: To review the role of diagnostic laparoscopy (DL) for staging of malignant diseases of the liver and biliary tract. Methodology: Critical review of the current literature. Results: Analysis of the utility of DL in hepatobiliary cancers depends on several criteria, particularly in the era of high quality prelaparotomy and pre-DL imaging. Selection criteria for DL, selection criteria for resection, definition of resectability, patterns of intra- and extrahepatic spread, association with underlying liver disease and frequency of indications for palliative laparotomy impact the utility of DL depending on the disease studied. Conclusions: DL has a very limited role for staging patients with colorectal liver metastases as a result of expanding definitions of resectability, multistage approaches to bilateral metastases, and methods to increase resectability such as portal vein embolization and preoperative chemotherapy. For hepatocellular carcinoma, DL can be useful for staging patients with advanced tumours and cirrhosis, and might have an emerging role for the evaluation of transplant candidates with equivocal imaging findings. For biliary cancers, DL is indicated for patients with advanced stage hilar cholangiocarcinoma and gall bladder carcinoma.
    Surgical Practice 08/2005; 9(3):78-89. DOI:10.1111/j.1744-1633.2005.00263.x · 0.17 Impact Factor
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