Respiratory motion and organ movement can lead to considerable distortion artifact and can make image registration a challenge. The pancreas poses an added barrier due to the increasing utilization of metal biliary stents. Metal stents are preferred over plastic stents due to lower occlusion and complication rates . Recently, multiple companies have developed MRI compatible metal stents selleck chemical using a nickel titanium alloy (nitinol). We compared the artifact from a standard stainless steel stent to two nitinol containing stents in a water phantom. The stainless steel stent produced considerable streak artifact which would make the interpretation and determination/quantification of ADC values difficult. Additionally,
it is unknown if stainless steel stents are safe in patients undergoing MRI. The two Selleck GSK269962 nitinol stents we tested are marketed as MRI compatible and produced minimal artifact on diffusion-weighted sequences. This finding allows for the potential inclusion of patients with nitinol containing biliary stents on future studies examining dMRI. There are several limitations to our study including the small number of patients and the endpoints examined. This study was designed as a feasibility study to demonstrate dMRI can be used in patients with pancreatic cancer undergoing chemoradiation. It was not powered to determine if diffusion metrics could be used to predict subsequent survival. Our primary endpoint was pathologic response according
to the grading system developed by Evans et al. . This system has been utilized in prior studies and is shown to correlate with patient outcome  and . Larger studies will be required to determine if dMRI is useful as a prognostic marker for early treatment response stratification of patients with pancreatic
cancer. In conclusion, the use of dMRI in the management of patients with pancreatic cancer has several exciting potential applications. In our study we found a correlation between pretreatment mean ADC values PLEK2 and subsequent tumor response. Larger studies examining the utility of this imaging modality as an early response biomarker in patients with pancreatic cancer are underway at our institution. The authors have no conflicts of interest to report. This study received NIH support from grants U01CA166104 and P01CA087634. ”
“Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal lung disease of unknown etiology that is still lacking of effective therapy. IPF is associated to lung cancer onset with a prevalence that is ranging from 4% to 48% . IPF progression has often been assimilated to that of a neoplastic disease, and several signaling patterns appear to be disrupted in both conditions . For the past decades, comprehensive sequencing programs have led to define cancer as, in essence, a genetic disease . Cancer cells accumulate somatic DNA alterations that are responsible for oncogene activation or tumor suppressor gene silencing.