Imaging of malignant neoplasms of the mesenteric small bowel: New trends and perspectives

Soyer, Philippe; Boudiaf, Mourad; Fishman, Elliot K.; Hoeffel, Christine; Dray, Xavier; Manfredi, Riccardo; Marteau, Philippe

doi:10.1016/j.critrevonc.2010.09.010

Cited by 45 publications

(29 citation statements)

References 142 publications

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“…Initial studies comparing DBE and spiral enteroscopy have suggested that the two procedures have similar diagnostic yields [66][67][68] . Further studies CE for detecting small bowel neoplasms [80,81] .…”

Section: Spiral Enteroscopymentioning

confidence: 99%

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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Core tip: This article examines the role of current diagnostic modalities for the investigation of obscure gastrointestinal bleeding (OGIB) and outcomes in patients undergoing these investigations. Capsule endoscopy and double balloon enteroscopy remain the cornerstone of diagnostic and therapeutic management. The diagnostic and therapeutic capabilities of certain modalities are influenced by the nature of bleeding in OGIB. Longterm outcome data in patients with OGIB is limited but is most promising for capsule endoscopy.Santhakumar C, Liu K. Evaluation and outcomes of patients with obscure gastrointestinal bleeding. World J Gastrointest Pathophysiol 2014; 5(4

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Section: Spiral Enteroscopymentioning

confidence: 99%

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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“…3 The diagnosis of small bowel tumor is really challenging even in the modern medicine when novel approaches such as video capsule endoscopy and nuclear magnetic resonance (NMR) are available. [5][6][7][8][9][10][11][12] Here, we report the diagnosis of small bowel cancer with NMR in a patient presenting with intestine sub-occlusion.…”

Section: Introductionmentioning

confidence: 99%

Small bowel cancer diagnosis: role of nuclear magnetic resonance

et al. 2015

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Small intestine tumors are rare, with an incidence of less than 1 case per 100,000/year and accounting for less than 0.5% of all cancers.1 However, in almost 80% of the cases small bowel tumors are malignant.2,3 Adenocarcinomas comprise 35-50% of all tumors, carcinoid tumors 20-40%, lymphomas 15% and the remaining is characterized by sarcomas. 4 Generally, adenocarcinomas are located in the duodenum, while lymphomas and carcinoid tumors are frequently in the ileum. Benign tumors are generally stromal tumor and adenomas. Finally, cancers from other organs may infiltrate peritoneum and small bowel in metastatic diseases. Small bowel tumors did not have a recurrent clinical presentation and could be associated with abdominal pain, unspecific gastrointestinal symptoms or can exhibit symptoms/signs due to the secretion of different hormones. 3 The diagnosis of small bowel tumor is really challenging even in the modern medicine when novel approaches such as video capsule endoscopy and nuclear magnetic resonance (NMR) are available.5-12 Here, we report the diagnosis of small bowel cancer with NMR in a patient presenting with intestine sub-occlusion. Case ReportA male patient was admitted to our division of Internal Medicine because of abdominal pain, weight loss and intestinal sub-occlusion. Both abdomen echography and computed tomography-scan (data not shown) did not reveal any significant pathological signs. Due to the persistence of the symptoms, an abdomen NMR was performed. As shown in Figure 1A and B, NMR revealed that a portion of the small bowel was characterized by the swelling of the bowel wall. A laparoscopic surgical evaluation was performed confirming the presence of small bowel stenosis. This small intestine segment was therefore surgical removed. At the pathological examination, this portion of the bowel revealed an infiltration of the wall by an adenocarcinoma ( Figure 1C). Moreover, infiltration of the peritoneum was also observed ( Figure 1D). Small bowel cancer diagnosis: role of nuclear magnetic resonance ABSTRACTThe diagnosis of small intestine tumors is challenging. Even in the era of modern medicine, standard approaches including echography, computed tomography-scan and conventional endoscopy are unable to reveal small bowel lesions. Video-capsule has substantially improved the evaluation of small bowel; however this procedure cannot be proposed to all patients and in particular to those experiencing intestine sub-occlusion. Nuclear magnetic resonance (NMR) of the abdomen is an additional diagnostic approach that offers high sensitivity in the identification of small bowel lesions. Here, we describe a case of small bowel neoplasia identified with NMR of the abdomen.

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“…The rate of false-negative findings may reach up to 19% for VCE in the detection of small bowel tumours [7,8]. This is because VCE shows the mucosal layer only and may not detect submucosal tumours such as stromal tumours, leiomyosarcomas, Kaposi's sarcoma, and metastases from lung cancer, breast cancer and melanoma [9].…”

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confidence: 99%

“…One undisputed advantage of CT enterography or CT enteroclysis over VCE is the ability to detect extra-enteric abnormalities [9,14]. Some of them (such as the presence of hepatic metastases in the case of malignant small-bowel tumours) may have a major impact on the therapeutic approach [9], whereas others (such as the detection of mesenteric mass with focal calcification and surrounding desmoplastic reaction) may be a clue to a specific diagnosis [14].…”

mentioning

confidence: 99%

“…Some of them (such as the presence of hepatic metastases in the case of malignant small-bowel tumours) may have a major impact on the therapeutic approach [9], whereas others (such as the detection of mesenteric mass with focal calcification and surrounding desmoplastic reaction) may be a clue to a specific diagnosis [14]. In addition, CT enterography may show incidental findings in up to 20% of patients, and a proportion may require additional investigations or alteration of the therapeutic decision [2,15].…”

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confidence: 99%

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Obscure gastrointestinal bleeding: difficulties in comparing CT enterography and video capsule endoscopy

Soyer

2012

Eur Radiol

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A paper reports the results of a retrospective study that was designed to evaluate the potential role of video capsule endoscopy (VCE) in elucidating the cause of bleeding in patients with obscure gastrointestinal bleeding (OGIB) for whom CT enterography was negative. The authors highlight the limitations of dual-phase CT enterography for the detection of flat lesions of the small bowel such as ulcers, angiodysplasias or arteriovenous malformations, and confirm the superiority of VCE for the detection of this category of lesions. This commentary discusses some of the issues raised. Key Points • Video capsule endoscopy surpasses CT enterography in detecting flat small bowel lesions.• Retrospective VCE and CT enterography findings in obscure bleeding need further evaluation.• A fair and unbiased comparison of the two investigations is still needed. [2]. They used CT enterography in patients with OGIB for whom VCE was negative. Using dual phase CT enterography, they did not detect the cause of bleeding in any of the 11 patients with occult OGIB and negative VCE [2].The results of these two studies can be interpreted in two different ways. One way should be to definitely consider that CT enterography has limited or even no value for the evaluation of patients with OGIB and that VCE should be the favoured test for this indication. The alternative way would be to admit that these two techniques are complementary and not competing tests for this elective indication. I must admit that I strongly agree with the second approach for several reasons that I will discuss herein.Because of their study design with inclusion of patients with negative CT enterography, Heo et al. did not address the limitations of VCE [1]. In this regard, none of the patients in

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Imaging of malignant neoplasms of the mesenteric small bowel: New trends and perspectives

Cited by 45 publications

References 142 publications

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Small bowel cancer diagnosis: role of nuclear magnetic resonance

Obscure gastrointestinal bleeding: difficulties in comparing CT enterography and video capsule endoscopy

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