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  1. Article: Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Challenging Diagnosis.

    Triantopoulou, Charikleia / Gourtsoyianni, Sofia / Karakaxas, Dimitriοs / Delis, Spiros

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 12

    Abstract: Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from ... ...

    Abstract Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from slight dysplasia to invasive carcinoma. In addition, different aspects of tumor progression may be seen in the same lesion. Three types are recognized, the branch duct variant, the main duct variant, which shows a much higher prevalence for malignancy, and the mixed-type variant, which combines branch and main duct characteristics. Advances in cross-sectional imaging have led to an increased rate of IPMN detection. The main imaging characteristic of IPMN is the dilatation of the pancreatic duct without the presence of an obstructing lesion. The diagnosis of a branch duct IPMN is based on the proof of its communication with the main pancreatic duct on MRI-MRCP examination. Early identification by imaging of the so-called worrisome features or predictors for malignancy is an important and challenging task. In this review, we will present recent imaging advances in the diagnosis and characterization of different types of IPMNs, as well as imaging tools available for early recognition of worrisome features for malignancy. A critical appraisal of current IPMN management guidelines from both a radiologist's and surgeon's perspective will be made. Special mention is made of complications that might arise during the course of IPMNs as well as concomitant pancreatic neoplasms including pancreatic adenocarcinoma and pancreatic endocrine neoplasms. Finally, recent research on prognostic and predictive biomarkers including radiomics will be discussed.
    Language English
    Publishing date 2023-06-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13122015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Intraductal Papillary Mucinous Neoplasm of the Pancreas

    Charikleia Triantopoulou / Sofia Gourtsoyianni / Dimitriοs Karakaxas / Spiros Delis

    Diagnostics, Vol 13, Iss 2015, p

    A Challenging Diagnosis

    2023  Volume 2015

    Abstract: Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from ... ...

    Abstract Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from slight dysplasia to invasive carcinoma. In addition, different aspects of tumor progression may be seen in the same lesion. Three types are recognized, the branch duct variant, the main duct variant, which shows a much higher prevalence for malignancy, and the mixed-type variant, which combines branch and main duct characteristics. Advances in cross-sectional imaging have led to an increased rate of IPMN detection. The main imaging characteristic of IPMN is the dilatation of the pancreatic duct without the presence of an obstructing lesion. The diagnosis of a branch duct IPMN is based on the proof of its communication with the main pancreatic duct on MRI-MRCP examination. Early identification by imaging of the so-called worrisome features or predictors for malignancy is an important and challenging task. In this review, we will present recent imaging advances in the diagnosis and characterization of different types of IPMNs, as well as imaging tools available for early recognition of worrisome features for malignancy. A critical appraisal of current IPMN management guidelines from both a radiologist’s and surgeon’s perspective will be made. Special mention is made of complications that might arise during the course of IPMNs as well as concomitant pancreatic neoplasms including pancreatic adenocarcinoma and pancreatic endocrine neoplasms. Finally, recent research on prognostic and predictive biomarkers including radiomics will be discussed.
    Keywords intraductal papillary mucinous tumor ; pancreas ; CT ; MRI ; PETA ; EUS ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Development and implementation of a quality control protocol for B-mode ultrasound equipment.

    Tsapaki, Virginia / Tsalafoutas, Ioannis A / Triantopoulou, Sotiria S / Triantopoulou, Charikleia

    Journal of ultrasound

    2021  Volume 25, Issue 2, Page(s) 155–165

    Abstract: Purpose: Quality assurance (QA) of ultrasound (US) equipment is currently required in only a few countries around the world. In Greece, no national or other norms exist for regulating the use of US equipment. However, to obtain accreditation for the ... ...

    Abstract Purpose: Quality assurance (QA) of ultrasound (US) equipment is currently required in only a few countries around the world. In Greece, no national or other norms exist for regulating the use of US equipment. However, to obtain accreditation for the radiology department of a Greek hospital, the establishment and implementation of a quality control (QC) protocol and a QA programme for US equipment was required.
    Materials and methods: A literature review regarding US QC/QA procedures was performed. The information collected was used as a guide to create a QC/QA protocol and to obtain an appropriate US QC phantom. Drafting and testing of the initial protocol lasted 6 months. Its final version was implemented for 18 months in two US systems and five US transducers.
    Results: The QC tests included in the protocol evaluate mechanical and electrical safety, image display, uniformity, penetration depth, distance accuracy, greyscale display, anechoic object imaging, geometric distortion, and axial/lateral resolution. The only QC test that failed was the test for uniformity since intense non-uniformities were observed that led to the replacement of two linear transducers.
    Conclusion: US imaging is considered safe and, where appropriate, is preferred over imaging modalities that use ionizing radiation. However, the lack of QC/QA implies that US image quality is not routinely monitored. Therefore, the possibility of malfunctions that may go undetected and lead to wrong diagnosis cannot be excluded. A QC/QΑ programme can contribute to the elimination of such errors and ensure that performance is maintained over time.
    MeSH term(s) Humans ; Phantoms, Imaging ; Quality Control ; Review Literature as Topic ; Transducers ; Ultrasonography
    Language English
    Publishing date 2021-04-08
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2365426-0
    ISSN 1876-7931 ; 1971-3495
    ISSN (online) 1876-7931
    ISSN 1971-3495
    DOI 10.1007/s40477-021-00579-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Pericolic or paracolic? The right word in the right place for acute diverticulitis.

    Kechagias, Aristotelis / Palomäki, Ari / Dervenis, Christos / Triantopoulou, Charikleia

    European radiology

    2018  Volume 29, Issue 8, Page(s) 4377–4378

    Abstract: Key point: • The term "pericolic" is wrongly used to describe an abscess adjacent to the colon in patients with acute diverticulitis. We explain why the proper term is the word "paracolic." ...

    Abstract Key point: • The term "pericolic" is wrongly used to describe an abscess adjacent to the colon in patients with acute diverticulitis. We explain why the proper term is the word "paracolic."
    MeSH term(s) Abscess/pathology ; Acute Disease ; Colonic Diseases/pathology ; Diverticulitis, Colonic/pathology ; Humans ; Terminology as Topic
    Language English
    Publishing date 2018-12-03
    Publishing country Germany
    Document type Letter
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-018-5827-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Massive Scrotal Hematoma due to Ruptured Anastomotic Pseudoaneurysm in a Patient with Aortobifemoral Bypass Surgery: CTA Evaluation.

    Smarda, Magdalini / Fagkrezos, Dimitrios / Dodos, Ilias / Potouridis, Anastasios / Staramos, Dimitrios / Triantopoulou, Charikleia / Maniatis, Petros

    Case reports in vascular medicine

    2019  Volume 2019, Page(s) 9013697

    Abstract: A 74-year-old male patient was presented with scrotal swelling and a pulsatile mass of the left femoro-inguinal region. His medical history included hypertension, coronary artery disease, respiratory failure, and an aortobifemoral bypass surgery ... ...

    Abstract A 74-year-old male patient was presented with scrotal swelling and a pulsatile mass of the left femoro-inguinal region. His medical history included hypertension, coronary artery disease, respiratory failure, and an aortobifemoral bypass surgery performed 7 years ago. Ultrasound evaluation revealed a massive scrotal hematoma. Computed tomography angiography (CTA) was conducted, confirming the aortobifemoral graft existence and revealing bilateral anastomotic pseudoaneurysms with the left one being ruptured, resulting in extension of the hematoma to the left femoro-inguinal region and the scrotum. An emergency surgery was performed, where proximal control of the left limb of the synthetic graft as well as distal control of the iliac vessels were accomplished. After the control of the hemorrhage, an iliofemoral bypass with a Polytetrafluoroethylene (PTFE) 6 mm synthetic graft was placed. Unfortunately, the patient passed away during the first postoperative day due to myocardial infarction.
    Language English
    Publishing date 2019-11-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2629916-1
    ISSN 2090-6994 ; 2090-6986
    ISSN (online) 2090-6994
    ISSN 2090-6986
    DOI 10.1155/2019/9013697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation.

    Triantopoulou, Charikleia / Papaparaskeva, Kleo / Agalianos, Christos / Dervenis, Christos

    European journal of radiology open

    2016  Volume 3, Page(s) 49–59

    Abstract: The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for ... ...

    Abstract The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts). The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3-4 mm). This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure-consistency (areas of necrosis-hemorrhage-fibrosis-inflammation), the degree of vessels' infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors' consistency and way of extension helps to improve radiologists' diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.
    Language English
    Publishing date 2016-03-11
    Publishing country England
    Document type Journal Article
    ISSN 2352-0477
    ISSN 2352-0477
    DOI 10.1016/j.ejro.2016.02.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    Charikleia Triantopoulou / Kleo Papaparaskeva / Christos Agalianos / Christos Dervenis

    European Journal of Radiology Open, Vol 3, Iss C, Pp 49-

    2016  Volume 59

    Abstract: The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for ... ...

    Abstract The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts). The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm). This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation), the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors’ consistency and way of extension helps to improve radiologists’ diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.
    Keywords Pancreas ; Neoplasms ; MDCT ; MRI ; Histopathology ; Specimen ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Secondary extramedullary plasmacytoma of sigmoid colon in a patient with multiple myeloma: a case report.

    Fagkrezos, Dimitris / Manes, Konstantinos / Paraskeva, Konstantina / Lenos, Michalis / Triantopoulou, Charikleia / Apessou, Dimitra / Maniatis, Petros

    Journal of medical case reports

    2018  Volume 12, Issue 1, Page(s) 379

    Abstract: Background: Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another ... ...

    Abstract Background: Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases.
    Case presentation: A 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon.
    Conclusions: Plasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity.
    MeSH term(s) Abdominal Pain ; Aged ; Colectomy ; Colon, Sigmoid/pathology ; Diverticulitis/pathology ; Diverticulitis/surgery ; Female ; Humans ; Intestinal Perforation/surgery ; Multiple Myeloma/drug therapy ; Multiple Myeloma/pathology ; Plasmacytoma/pathology ; Plasmacytoma/surgery ; Pneumoperitoneum/diagnostic imaging ; Pneumoperitoneum/pathology ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2018-12-25
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2269805-X
    ISSN 1752-1947 ; 1752-1947
    ISSN (online) 1752-1947
    ISSN 1752-1947
    DOI 10.1186/s13256-018-1888-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Secondary extramedullary plasmacytoma of sigmoid colon in a patient with multiple myeloma

    Dimitris Fagkrezos / Konstantinos Manes / Konstantina Paraskeva / Michalis Lenos / Charikleia Triantopoulou / Dimitra Apessou / Petros Maniatis

    Journal of Medical Case Reports, Vol 12, Iss 1, Pp 1-

    a case report

    2018  Volume 7

    Abstract: Abstract Background Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to ... ...

    Abstract Abstract Background Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases. Case presentation A 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon. Conclusions Plasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity.
    Keywords Secondary extramedullary plasmacytoma ; Sigmoid colon ; Oncology ; Multiple myeloma ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2018-12-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: An anatomic anal sphincter-saving procedure for rectal cancers located at anorectal junction.

    Mariolis-Sapsakos, Theodoros / Psathas, Giannos / Nikolouzakis, Taxiarchis Konstantinos / Laschos, Konstantinos / Triantopoulou, Charikleia / Bonatsos, Gerasimos / Tsiaoussis, John

    World journal of surgical oncology

    2019  Volume 17, Issue 1, Page(s) 131

    Abstract: Background: This study aims to present the feasibility of the open approach of hemilevator excision (HLE) as a promising alternative of the laparoscopic and/or robotic ones for the treatment of low rectal cancer extending to the ipsilateral puborectalis ...

    Abstract Background: This study aims to present the feasibility of the open approach of hemilevator excision (HLE) as a promising alternative of the laparoscopic and/or robotic ones for the treatment of low rectal cancer extending to the ipsilateral puborectalis muscle.
    Methods: A 60-year-old male patient with a high-grade differentiated rectal adenocarcinoma at the right side of the lower rectum invading puborectalis muscle. The proposed operation consists of a combination of extralevator abdomino-perineal excision (ELAPE), intersphicteric resection (ISR), and low anterior resection (LAR) since it resects the ipsilateral to tumor levator ani muscle (LAM) from its attachment at the internal obturator fascia and the deep part of ipsilateral external anal sphincter (EAS), while the distal part of dissection is completed in the intersphincteric space taking out the internal anal sphincter (IAS). At the contralateral side of the tumor, the dissection plane follows the classic route of LAR.
    Results: Pathology proved the oncologic adequacy of resection. MRI at the fourth postoperative week showed clearly the right aspect of anorectal junction free of tumor. Anorectal manometry revealed a fair anorectal function which is in accordance with the findings of clinical assessment of patient after restoring large bowel continuity (post-op Wexner score, 7).
    Conclusion: This is the first case of the open HLE that seems to be a good alternative compared to ELAPE or conventional APR, as it offers oncologic adequacy and a fair anorectal function.
    MeSH term(s) Anal Canal/surgery ; Humans ; Laparoscopy/methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Perineum/surgery ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Rectum/pathology ; Robotic Surgical Procedures/methods
    Language English
    Publishing date 2019-08-02
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2118383-1
    ISSN 1477-7819 ; 1477-7819
    ISSN (online) 1477-7819
    ISSN 1477-7819
    DOI 10.1186/s12957-019-1672-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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