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Pancreatic Neoplasms: HELP
Articles by Karen B. Bleich
Based on 2 articles published since 2010
(Why 2 articles?)
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Between 2010 and 2020, Karen Bleich wrote the following 2 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Pancreaticoduodenectomy with venous resection and reconstruction: current surgical techniques and associated postoperative imaging findings. 2018

Javed, Ammar A / Bleich, Karen / Bagante, Fabio / He, Jin / Weiss, Matthew J / Wolfgang, Christopher L / Fishman, Elliot K. ·Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, USA. · Department of Radiology, The Johns Hopkins Hospital, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, USA. · Department of Surgery, Chirurgia Generale e Epatobiliare, G.B. Rossi University Hospital, University of Verona, Verona, Italy. · Department of Radiology, The Johns Hopkins Hospital, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, USA. efishman@jhmi.edu. ·Abdom Radiol (NY) · Pubmed #28828527.

ABSTRACT: PURPOSE: Introduction of effective neoadjuvant therapy for pancreas cancer has resulted in complex and aggressive operations involving vasculature resection. This results in complicated postoperative CT appearance of vasculature, which in addition to high rate of recurrence makes interpretation of imaging difficult. The aim of this study was to identify patterns of postoperative appearance of portal vein-superior mesenteric vein complex (PV-SMV). METHODS: A retrospective study was conducted on patients undergoing pancreaticoduodenectomy with PV-SMV resection and reconstruction (PVR) between 2004 and 2014. Clinicopathological data were collected from a prospectively maintained database. Postoperative CT scans were reviewed to identify patterns of venous and perivenous features. RESULTS: The mean age, of 70 patients included in the study, was 63.0 ± 12.2 years and 37 (52.9%) were males. The median time between surgery and postoperative scan was 10 days (IQR 7-25). Tangential resection with PVR via primary closure or use of a patch was performed in 37 (52.9%) patients while the rest underwent segmental resection with PVR via end-to-end anastomosis or use of a graft. Postoperative patterns of PV-SMV included concentric narrowing (N = 40, 57.1%), eccentric narrowing (N = 19, 27.1%) or partial venous thrombosis (N = 7, 10.0%). Perivenous features included perivenous fluid collection and induration (N = 57, 81.4%) and mass-like soft tissue thickening (N = 13, 18.6%). Long-term follow-up was available on 44 (62.9%) patients of which 28 (63.6%) demonstrated no recurrence of disease. CONCLUSION: This is a novel study that identifies and categorizes postoperative features of PV-SMV after PVR. These features overlap with those of disease recurrence and their better understanding can results in an accurate interpretation of postoperative imaging.

2 Article Intrapancreatic accessory spleen: possibilities of computed tomography in differentiation from nonfunctioning pancreatic neuroendocrine tumor. 2014

Coquia, Stephanie F / Kawamoto, Satomi / Zaheer, Atif / Bleich, Karen B / Blackford, Amanda L / Hruban, Ralph H / Fishman, Elliot K. ·From the *Department of Radiology, †Division of Biostatistics and Bioinformatics, Sidney Kimmel Cancer Center, and ‡Department of Pathology, the Sol Goldman Pancreatic Center Research Center, Johns Hopkins Hospital, Baltimore, MD. ·J Comput Assist Tomogr · Pubmed #24979264.

ABSTRACT: OBJECTIVE: The aim of this study was to evaluate the ability of computed tomography (CT) in differentiating between intrapancreatic accessory spleen (IPAS) from pancreatic neuroendocrine tumor (PanNET). METHODS: Eight IPASs and 12 PanNETs in the pancreatic tail were retrospectively evaluated by 2 radiologists. Readers assigned a diagnosis to each examination and evaluated for the presence or absence of 9 CT findings that may aid in the diagnosis. RESULTS: Reader 1 had a sensitivity of 0.83 and a specificity of 1; reader 2 had a sensitivity of 0.78 and a specificity of 0.86. Three of the 9 CT findings were found to be statistically significant in IPASs: the lesion present along the pancreatic dorsal surface, the lesion demonstrating the same enhancement as the spleen on venous phase, and heterogeneous enhancement during arterial phase. CONCLUSIONS: CT can be used to differentiate between IPAS and PanNET with good specificity and sensitivity. The IPAS mirrors the spleen's enhancement and is usually located along the dorsal surface of the pancreas.