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Article ; Online: What is the optimum post treatment surveillance imaging protocol for low grade appendiceal mucinous neoplasms and pseudomyxoma peritoneii?

Dempsey, Philip J / Power, Jack W / Yates, Andrew H / Martín-Román, Lorena / Aird, John J / Mulsow, Jürgen / Fenlon, Helen M / Cronin, Carmel G

The British journal of radiology

2024

Abstract: Appendiceal mucinous neoplasms are rare and can be associated with the development of disseminated peritoneal disease known as pseudomyxoma peritonei (PMP). Mucinous tumours identified on appendicectomy are therefore followed up to assess for recurrence ... ...

Abstract	Appendiceal mucinous neoplasms are rare and can be associated with the development of disseminated peritoneal disease known as pseudomyxoma peritonei (PMP). Mucinous tumours identified on appendicectomy are therefore followed up to assess for recurrence and the development of PMP. In additional, individuals who initially present with PMP who are treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) are followed up to assess for recurrence. However, despite the concerted efforts of multiple expert groups, the optimal imaging follow-up protocol is yet to be established. The purpose of this paper is to review the available evidence for imaging surveillance in these populations to identify the optimum post-resection imaging follow-up protocol.
Language	English
Publishing date	2024-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1093/bjr/tqae102
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Article ; Online: Pararenal malignant melanotic nerve sheath tumour: a rare tumour in an unfamiliar location.

Buckley, Bryan / Delaney, Francis / Aird, John J / Bolster, Ferdia

BMJ case reports

2022 Volume 15, Issue 8

MeSH term(s)	Brain Neoplasms ; Humans ; Nerve Sheath Neoplasms/diagnostic imaging ; Nerve Sheath Neoplasms/surgery
Language	English
Publishing date	2022-08-12
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-252107
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Article ; Online: Correlation between PSOGI pathological classification and survival outcomes of patients with pseudomyxoma peritonei treated using cytoreductive surgery and HIPEC

Martín-Román Lorena / Hannan Enda / Faraz Khan Mohammad / Müller Anna Sophia / Shields Conor / Aird John / Moran Brendan / Mulsow Jurgen

Pleura and Peritoneum, Vol 8, Iss 2, Pp 65-

national referral centre experience and literature review

2023 Volume 74

Abstract: The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive surgery (CRS) ...

Abstract	The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) from a national referral centre and to correlate the PSOGI classification with survival.
Keywords	acellular mucin ; appendiceal mucinous neoplasms ; appendiceal mucinous neoplasms with signet ring cells ; cytoreductive surgery and hyperthermic intraperitoneal chemotherapy ; grading pathology and classification ; pseudomyxoma peritonei ; Medicine ; R ; Specialties of internal medicine ; RC581-951
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: King Edward's Hospital Fund for London.

Smith, Hugh C / Aird, John

The Hospital

2018 Volume 36, Issue 921, Page(s) 145–146

Language	English
Publishing date	2018-06-07
Publishing country	England
Document type	Journal Article
ISSN	0267-6478
ISSN	0267-6478
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Article ; Online: Correlation between PSOGI pathological classification and survival outcomes of patients with pseudomyxoma peritonei treated using cytoreductive surgery and HIPEC: national referral centre experience and literature review.

Martín-Román, Lorena / Hannan, Enda / Faraz Khan, Mohammad / Müller, Anna Sophia / Shields, Conor / Aird, John / Moran, Brendan / Mulsow, Jurgen

Pleura and peritoneum

2023 Volume 8, Issue 2, Page(s) 65–74

Abstract: Objectives: The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive ... ...

Abstract	Objectives: The Peritoneal Surface Oncology Group International (PSOGI) consensus subdivided pseudomyxoma peritonei (PMP) into four groups according to histopathological features. The aim of this paper is to report survival outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) from a national referral centre and to correlate the PSOGI classification with survival. Methods: A retrospective study of a prospectively maintained database was performed. Consecutive patients treated with CRS + HIPEC for PMP of appendiceal origin were included (September-2013 to December-2021). Pathological features of the peritoneal disease were used to classify patients into the four groups proposed by PSOGI. Survival analysis was performed to evaluate the correlation of pathology on overall survival (OS) and disease-free survival (DFS). Results: Overall, 104 patients were identified; 29.6 % were reclassified as acellular mucin (AM), 43.9 % as low-grade mucinous carcinoma peritonei (LGMCP), 22.4 % as high-grade MCP (HGMCP) and 4.1 % as HGMCP with signet ring cells (HGMCP-SRC). Median PCI and rate of optimal cytoreduction were 19 and 82.7 %, respectively. Median OS and DFS were not reached, 5-year OS and DFS were 88.6(SD 0.04) % and 61.6(SD 0.06) %, respectively. Log-Rank test revealed significant differences in terms of OS and DFS across the different histological subgroups (p<0.001 in both cases). However, histology did not retain its significance in the multivariate analysis for OS or DFS (p=0.932 and p=0.872, respectively). Conclusions: Survival outcomes after CRS + HIPEC for PMP are excellent. The PSOGI pathological classification correlates with OS and DFS, but differences were not significant at multivariate analysis when adjusted for other prognostic factors.
Language	English
Publishing date	2023-05-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2861909-2
ISSN	2364-768X ; 2364-7671
ISSN (online)	2364-768X
ISSN	2364-7671
DOI	10.1515/pp-2023-0001
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Article ; Online: Acute colonic pseudo-obstruction post-cesarean section is not a benign entity: A case series and review of the literature.

Reynolds, Ian S / McDermott, Edward / Liddy, Richard / Aird, John J / Flood, Karen / McCormack, Orla / Geoghegan, Tony / Brannigan, Ann E

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023 Volume 165, Issue 1, Page(s) 59–66

Abstract: Acute colonic pseudo-obstruction (ACPO) is an infrequent occurrence after cesarean section. Anecdotal evidence suggests that the clinical course of ACPO in the obstetric setting is different to that seen in non-pregnant adult patients with ACPO secondary ...

Abstract	Acute colonic pseudo-obstruction (ACPO) is an infrequent occurrence after cesarean section. Anecdotal evidence suggests that the clinical course of ACPO in the obstetric setting is different to that seen in non-pregnant adult patients with ACPO secondary to alternative causes, such as systemic illnesses, the use of certain medications, and after non-abdominal surgery. The risk of progression to ischemia and perforation, as well as the need for emergency surgery, appears to be higher after cesarean section. Here we describe the clinical course of ACPO in four patients after cesarean section from our institution, followed by a review of the literature and a discussion of the important issues surrounding this condition in the postpartum time period. The findings from our cohort of patients and the reports from the medical literature support a hands-on combined approach from a group of specialists including obstetricians, surgeons, radiologists, and enterostomal therapists. Immediate imaging followed by regular observation is mandatory for any patient being managed conservatively. Early use of endoscopic decompression should be considered for patients who are not resolving with a conservative approach. Clinical signs of peritonism or radiological signs of ischemia or perforation in patients with ACPO mandate immediate surgical intervention. Appropriate postoperative care is necessary to deal with the complex physiological and psychological consequences of emergency surgery and potential stoma formation so soon after cesarean section.
MeSH term(s)	Adult ; Humans ; Pregnancy ; Female ; Colonic Pseudo-Obstruction/diagnosis ; Colonic Pseudo-Obstruction/etiology ; Colonic Pseudo-Obstruction/therapy ; Cesarean Section/adverse effects ; Decompression, Surgical/adverse effects ; Lumbar Vertebrae/surgery ; Ischemia/complications ; Ischemia/surgery ; Disease Progression
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.15086
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Zs.A 355: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Geotemporal Fluorophore Biodistribution Mapping of Colorectal Cancer: Micro and Macroscopic Insights.

Hardy, Niall P / Mulligan, Niall / Dalli, Jeffrey / Epperlein, Jonathan P / Neary, Peter M / Robertson, William / Liddy, Richard / Thorpe, Stephen D / Aird, John J / Cahill, Ronan A

Current oncology (Toronto, Ont.)

2024 Volume 31, Issue 2, Page(s) 849–861

Abstract: Fluorescence-guided oncology promises to improve both the detection and treatment of malignancy. We sought to investigate the temporal distribution of indocyanine green (ICG), an exogenous fluorophore in human colorectal cancer. This analysis aims to ... ...

Abstract	Fluorescence-guided oncology promises to improve both the detection and treatment of malignancy. We sought to investigate the temporal distribution of indocyanine green (ICG), an exogenous fluorophore in human colorectal cancer. This analysis aims to enhance our understanding of ICG's effectiveness in current tumour detection and inform potential future diagnostic and therapeutic enhancements. Methods: Fifty consenting patients undergoing treatment for suspected/confirmed colorectal neoplasia provided near infrared (NIR) video and imagery of transanally recorded and ex vivo resected rectal lesions following intravenous ICG administration (0.25 mg/kg), with a subgroup providing tissue samples for microscopic (including near infrared) analysis. Computer vision techniques detailed macroscopic 'early' (<15 min post ICG administration) and 'late' (>2 h) tissue fluorescence appearances from surgical imagery with digital NIR scanning (Licor, Lincoln, NE, USA) and from microscopic analysis (Nikon, Tokyo, Japan) undertaken by a consultant pathologist detailing tissue-level fluorescence distribution over the same time. Results: Significant intra-tumoural fluorescence heterogeneity was seen 'early' in malignant versus benign lesions. In all 'early' samples, fluorescence was predominantly within the tissue stroma, with uptake within plasma cells, blood vessels and lymphatics, but not within malignant or healthy glands. At 'late' stage observation, fluorescence was visualised non-uniformly within the intracellular cytoplasm of malignant tissue but not retained in benign glands. Fluorescence also accumulated within any present peritumoural inflammatory tissue. Conclusion: This study demonstrates the time course diffusion patterns of ICG through both benign and malignant tumours in vivo in human patients at both macroscopic and microscopic levels, demonstrating important cellular drivers and features of geolocalisation and how they differ longitudinally after exposure to ICG.
MeSH term(s)	Humans ; Tissue Distribution ; Indocyanine Green ; Colorectal Neoplasms/surgery
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2024-02-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol31020063
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Article: Rectal neuroendocrine tumours and the role of emerging endoscopic techniques.

Keating, Eoin / Bennett, Gayle / Murray, Michelle A / Ryan, Sinead / Aird, John / O'Connor, Donal B / O'Toole, Dermot / Lahiff, Conor

World journal of gastrointestinal endoscopy

2022 Volume 15, Issue 5, Page(s) 368–375

Abstract: Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening. Patient outcomes with early diagnosis are excellent. However endoscopic recognition of ... ...

Abstract	Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening. Patient outcomes with early diagnosis are excellent. However endoscopic recognition of this lesion is variable and misdiagnosis can result in suboptimal endoscopic resection with subsequent uncertainty in relation to optimal long-term management. Endoscopic techniques have shown particular utility in managing this under-recognized neuroendocrine tumour.
Language	English
Publishing date	2022-06-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2573698-X
ISSN	1948-5190
ISSN	1948-5190
DOI	10.4253/wjge.v15.i5.368
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Article ; Online: Real-time administration of indocyanine green in combination with computer vision and artificial intelligence for the identification and delineation of colorectal liver metastases.

Hardy, Niall P / Epperlein, Jonathan P / Dalli, Jeffrey / Robertson, William / Liddy, Richard / Aird, John J / Mulligan, Niall / Neary, Peter M / McEntee, Gerard P / Conneely, John B / Cahill, Ronan A

Surgery open science

2023 Volume 12, Page(s) 48–54

Abstract: Introduction: Fluorescence guided surgery for the identification of colorectal liver metastases (CRLM) can be better with low specificity and antecedent dosing impracticalities limiting indocyanine green (ICG) usefulness currently. We investigated the ... ...

Abstract	Introduction: Fluorescence guided surgery for the identification of colorectal liver metastases (CRLM) can be better with low specificity and antecedent dosing impracticalities limiting indocyanine green (ICG) usefulness currently. We investigated the application of artificial intelligence methods (AIM) to demonstrate and characterise CLRMs based on dynamic signalling immediately following intraoperative ICG administration. Methods: Twenty-five patients with liver surface lesions (24 CRLM and 1 benign cyst) undergoing open/laparoscopic/robotic procedures were studied. ICG (0.05 mg/kg) was administered with near-infrared recording of fluorescence perfusion. User-selected region-of-interest (ROI) perfusion profiles were generated, milestones relating to ICG inflow/outflow extracted and used to train a machine learning (ML) classifier. 2D heatmaps were constructed in a subset using AIM to depict whole screen imaging based on dynamic tissue-ICG interaction. Fluorescence appearances were also assessed microscopically (using H&E and fresh-frozen preparations) to provide tissue-level explainability of such methods. Results: The ML algorithm correctly classified 97.2 % of CRLM ROIs (n = 132) and all benign lesion ROIs (n = 6) within 90-s of ICG administration following initial mathematical curve analysis identifying ICG inflow/outflow differentials between healthy liver and CRLMs. Time-fluorescence plots extracted for each pixel in 10 lesions enabled creation of 2D characterising heatmaps using flow parameters and through unsupervised ML. Microscopy confirmed statistically less CLRM fluorescence vs adjacent liver (mean ± std deviation signal/area 2.46 ± 9.56 vs 507.43 ± 160.82 respectively p < 0.001) with H&E diminishing ICG signal (n = 4). Conclusion: ML accurately identifies CRLMs from surrounding liver tissue enabling representative 2D mapping of such lesions from their fluorescence perfusion patterns using AIM. This may assist in reducing positive margin rates at metastatectomy and in identifying unexpected/occult malignancies.
Language	English
Publishing date	2023-03-02
Publishing country	United States
Document type	Journal Article
ISSN	2589-8450
ISSN (online)	2589-8450
DOI	10.1016/j.sopen.2023.03.004
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Article ; Online: Rates and outcomes of testing for lynch syndrome in a national colorectal cancer screening programme.

Cudmore, Jane / Kumar, Lakshman / O'Moráin, Neil / Cullen, Garrett / Horgan, Gareth / Aird, John / Sheahan, Kieran / Winter, Desmond C / Kennelly, Rory / Leyden, Jan

Cancer epidemiology

2023 Volume 82, Page(s) 102314

Abstract: Background: Lynch Syndrome (LS), the most common cause of hereditary colorectal cancer (CRC), is characterised by pathogenic variants in mismatch repair (MMR) genes. Universal testing of all CRCs for LS can increase detection. Rates and outcomes of ... ...

Abstract	Background: Lynch Syndrome (LS), the most common cause of hereditary colorectal cancer (CRC), is characterised by pathogenic variants in mismatch repair (MMR) genes. Universal testing of all CRCs for LS can increase detection. Rates and outcomes of testing in Ireland's national CRC screening programme have not been examined previously. Methods: CRCs diagnosed at two screening sites between 2015 and 2020 were identified. Patient records were used to determine if CRCs had been tested for MMR deficiency and if detected, what downstream testing to rule out LS or genetic testing to confirm LS was undertaken. Results: Over five years, 206 CRCs were diagnosed. Testing for LS was carried out for 100% of CRCs at site A and 69% of CRCs at site B. Of CRCs tested for LS, 14 (8%) were MMR deficient. After downstream testing for BRAF mutation or hypermethylation of MLH1, three CRCs were identified as potentially LS-related. Of these two individuals declined genetic testing and one was lost to follow-up. Conclusions: By 2020 both sites had implemented universal testing of all CRCs for LS. A small number of individuals were identified as being eligible for genetic testing for LS, however those offered declined testing and one individual was lost to follow up. This highlights the importance of universal testing and the need for referral pathways to ensure all appropriate individuals are referred onwards to genetic services.
MeSH term(s)	Humans ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; Early Detection of Cancer ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/genetics ; Neoplastic Syndromes, Hereditary/genetics ; Genetic Testing ; DNA Mismatch Repair/genetics
Language	English
Publishing date	2023-01-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2508729-0
ISSN	1877-783X ; 1877-7821
ISSN (online)	1877-783X
ISSN	1877-7821
DOI	10.1016/j.canep.2022.102314
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