Diagnostics

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11 pages, 2436 KiB

Open AccessArticle

Multi-Slice CT Features Predict Pathological Risk Classification in Gastric Stromal Tumors Larger Than 2 cm: A Retrospective Study

by Sikai Wang, Ping Dai, Guangyan Si, Mengsu Zeng and Mingliang Wang

Diagnostics 2023, 13(20), 3192; https://doi.org/10.3390/diagnostics13203192 - 12 Oct 2023

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Abstract

Background: The Armed Forces Institute of Pathology (AFIP) had higher accuracy and reliability in prognostic assessment and treatment strategies for patients with gastric stromal tumors (GSTs). The AFIP classification is frequently used in clinical applications. But the risk classification is only available for [...] Read more.

Background: The Armed Forces Institute of Pathology (AFIP) had higher accuracy and reliability in prognostic assessment and treatment strategies for patients with gastric stromal tumors (GSTs). The AFIP classification is frequently used in clinical applications. But the risk classification is only available for patients who are previously untreated and received complete resection. We aimed to investigate the feasibility of multi-slice MSCT features of GSTs in predicting AFIP risk classification preoperatively. Methods: The clinical data and MSCT features of 424 patients with solitary GSTs were retrospectively reviewed. According to pathological AFIP risk criteria, 424 GSTs were divided into a low-risk group (n = 282), a moderate-risk group (n = 72), and a high-risk group (n = 70). The clinical data and MSCT features of GSTs were compared among the three groups. Those variables (p < 0.05) in the univariate analysis were included in the multivariate analysis. The nomogram was created using the rms package. Results: We found significant differences in the tumor location, morphology, necrosis, ulceration, growth pattern, feeding artery, vascular-like enhancement, fat-positive signs around GSTs, CT value in the venous phase, CT value increment in the venous phase, longest diameter, and maximum short diameter (all p < 0.05). Two nomogram models were successfully constructed to predict the risk of GSTs. Low- vs. high-risk group: the independent risk factors of high-risk GSTs included the location, ulceration, and longest diameter. The area under the receiver operating characteristic curve (AUC) of the prediction model was 0.911 (95% CI: 0.872–0.951), and the sensitivity and specificity were 80.0% and 89.0%, respectively. Moderate- vs. high-risk group: the morphology, necrosis, and feeding artery were independent risk factors of a high risk of GSTs, with an AUC value of 0.826 (95% CI: 0.759–0.893), and the sensitivity and specificity were 85.7% and 70.8%, respectively. Conclusions: The MSCT features of GSTs and the nomogram model have great practical value in predicting pathological AFIP risk classification between high-risk and non-high-risk groups before surgery. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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12 pages, 2246 KiB

Open AccessArticle

Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Measuring Perfusion in Pancreatic Ductal Adenocarcinoma and Different Tumor Grade: A Preliminary Single Center Study

by Inga Zaborienė, Vestina Strakšytė, Povilas Ignatavičius, Giedrius Barauskas, Rūta Dambrauskienė and Kristina Žvinienė

Diagnostics 2023, 13(3), 521; https://doi.org/10.3390/diagnostics13030521 - 31 Jan 2023

Cited by 2 | Viewed by 1716

Abstract

Background: Dynamic contrast-enhanced magnetic resonance imaging is a noninvasive imaging modality that can supply information regarding the tumor anatomy and physiology. The aim of the study was to analyze DCE-MRI perfusion parameters in normal pancreatic parenchymal tissue and PDAC and to evaluate the [...] Read more.

Background: Dynamic contrast-enhanced magnetic resonance imaging is a noninvasive imaging modality that can supply information regarding the tumor anatomy and physiology. The aim of the study was to analyze DCE-MRI perfusion parameters in normal pancreatic parenchymal tissue and PDAC and to evaluate the efficacy of this diagnostic modality in determining the tumor grade. Methods: A single-center retrospective study was performed. A total of 28 patients with histologically proven PDAC underwent DCE-MRI; the control group enrolled 14 patients with normal pancreatic parenchymal tissue; the radiological findings were compared with histopathological data. The study patients were further grouped according to the differentiation grade (G value): well- and moderately differentiated and poorly differentiated PDAC. Results: The median values of K^trans, k_ep and iAUC were calculated lower in PDAC compared with the normal pancreatic parenchymal tissue (p < 0.05). The mean value of Ve was higher in PDAC, compared with the normal pancreatic tissue (p < 0.05). K^trans, k_ep and iAUC were lower in poorly differentiated PDAC, whereas Ve showed no differences between groups. Conclusions: Ve and iAUC DCE-MRI perfusion parameters are important as independent diagnostic criteria predicting the probability of PDAC; the Ktrans and iAUC DCE-MRI perfusion parameters may serve as effective independent prognosticators preoperatively identifying poorly differentiated PDAC. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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Review

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42 pages, 12403 KiB

Open AccessReview

Rare Solid Pancreatic Lesions on Cross-Sectional Imaging

by Ana Veron Sanchez, Nuria Santamaria Guinea, Silvia Cayon Somacarrera, Ilias Bennouna, Martina Pezzullo and Maria Antonietta Bali

Diagnostics 2023, 13(16), 2719; https://doi.org/10.3390/diagnostics13162719 - 21 Aug 2023

Cited by 3 | Viewed by 2610

Abstract

Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, [...] Read more.

Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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39 pages, 41790 KiB

Open AccessReview

Unravelling Peritoneal Carcinomatosis Using Cross-Sectional Imaging Modalities

by Ana Veron Sanchez, Ilias Bennouna, Nicolas Coquelet, Jorge Cabo Bolado, Inmaculada Pinilla Fernandez, Luis A. Mullor Delgado, Martina Pezzullo, Gabriel Liberale, Maria Gomez Galdon and Maria A. Bali

Diagnostics 2023, 13(13), 2253; https://doi.org/10.3390/diagnostics13132253 - 3 Jul 2023

Cited by 4 | Viewed by 4234

Abstract

Peritoneal carcinomatosis (PC) refers to malignant epithelial cells that spread to the peritoneum, principally from abdominal malignancies. Until recently, PC prognosis has been considered ill-fated, with palliative therapies serving as the only treatment option. New locoregional treatments are changing the outcome of PC, [...] Read more.

Peritoneal carcinomatosis (PC) refers to malignant epithelial cells that spread to the peritoneum, principally from abdominal malignancies. Until recently, PC prognosis has been considered ill-fated, with palliative therapies serving as the only treatment option. New locoregional treatments are changing the outcome of PC, and imaging modalities have a critical role in early diagnosis and disease staging, determining treatment decision making strategies. The aim of this review is to provide a practical approach for detecting and characterizing peritoneal deposits in cross-sectional imaging modalities, taking into account their appearances, including the secondary complications, the anatomical characteristics of the peritoneal cavity, together with the differential diagnosis with other benign and malignant peritoneal conditions. Among the cross-sectional imaging modalities, computed tomography (CT) is widely available and fast; however, magnetic resonance (MR) performs better in terms of sensitivity (92% vs. 68%), due to its higher contrast resolution. The appearance of peritoneal deposits on CT and MR mainly depends on the primary tumour histology; in case of unknown primary tumour (3–5% of cases), their behaviour at imaging may provide insights into the tumour origin. The timepoint of tumour evolution, previous or ongoing treatments, and the peritoneal spaces in which they occur also play an important role in determining the appearance of peritoneal deposits. Thus, knowledge of peritoneal anatomy and fluid circulation is essential in the detection and characterisation of peritoneal deposits. Several benign and malignant conditions show similar imaging features that overlap those of PC, making differential diagnosis challenging. Knowledge of peritoneal anatomy and primary tumour histology is crucial, but one must also consider clinical history, laboratory findings, and previous imaging examinations to achieve a correct diagnosis. In conclusion, to correctly diagnose PC in cross-sectional imaging modalities, knowledge of peritoneal anatomy and peritoneal fluid flow characteristics are mandatory. Peritoneal deposit features reflect the primary tumour characteristics, and this specificity may be helpful in its identification when it is unknown. Moreover, several benign and malignant peritoneal conditions may mimic PC, which need to be considered even in oncologic patients. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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13 pages, 11856 KiB

Open AccessReview

The Spectrum of Solitary Benign Splenic Lesions—Imaging Clues for a Noninvasive Diagnosis

by Sofia Gourtsoyianni, Michael Laniado, Luis Ros-Mendoza, Giancarlo Mansueto and Giulia A. Zamboni

Diagnostics 2023, 13(12), 2120; https://doi.org/10.3390/diagnostics13122120 - 20 Jun 2023

Cited by 6 | Viewed by 5945

Abstract

Cross-sectional imaging of the upper abdomen, especially if intravenous contrast has been administered, will most likely reveal any acute or chronic disease harbored in the spleen. Unless imaging is performed with the specific purpose of evaluating the spleen or characterizing a known splenic [...] Read more.

Cross-sectional imaging of the upper abdomen, especially if intravenous contrast has been administered, will most likely reveal any acute or chronic disease harbored in the spleen. Unless imaging is performed with the specific purpose of evaluating the spleen or characterizing a known splenic lesion, incidentally discovered splenic lesions pose a small challenge. Solitary benign splenic lesions include cysts, hemangiomas, sclerosing angiomatous nodular transformation (SANT), hamartomas, and abscesses, among others. Sarcoidosis and tuberculosis, although predominantly diffuse micronodular disease processes, may also present as a solitary splenic mass lesion. In addition, infarction and rupture, both traumatic and spontaneous, may take place in the spleen. This review aims to describe the imaging features of the most common benign focal splenic lesions, with emphasis on the imaging findings as these are encountered on routine cross-sectional imaging from a multicenter pool of cases that, coupled with clinical information, can allow a definite diagnosis. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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20 pages, 3148 KiB

Open AccessReview

Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Challenging Diagnosis

by Charikleia Triantopoulou, Sofia Gourtsoyianni, Dimitriοs Karakaxas and Spiros Delis

Diagnostics 2023, 13(12), 2015; https://doi.org/10.3390/diagnostics13122015 - 9 Jun 2023

Cited by 1 | Viewed by 5671

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. [...] Read more.

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. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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13 pages, 2704 KiB

Open AccessReview

Principles and Applications of Dual-Layer Spectral CT in Gastrointestinal Imaging

by Paolo Niccolò Franco, Chiara Maria Spasiano, Cesare Maino, Elena De Ponti, Maria Ragusi, Teresa Giandola, Simone Terrani, Marta Peroni, Rocco Corso and Davide Ippolito

Diagnostics 2023, 13(10), 1740; https://doi.org/10.3390/diagnostics13101740 - 15 May 2023

Cited by 8 | Viewed by 2378

Abstract

The advance in technology allows for the development of different CT scanners in the field of dual-energy computed tomography (DECT). In particular, a recently developed detector-based technology can collect data from different energy levels, thanks to its layers. The use of this system [...] Read more.

The advance in technology allows for the development of different CT scanners in the field of dual-energy computed tomography (DECT). In particular, a recently developed detector-based technology can collect data from different energy levels, thanks to its layers. The use of this system is suited for material decomposition with perfect spatial and temporal registration. Thanks to post-processing techniques, these scanners can generate conventional, material decomposition (including virtual non-contrast (VNC), iodine maps, Z-effective imaging, and uric acid pair images) and virtual monoenergetic images (VMIs). In recent years, different studies have been published regarding the use of DECT in clinical practice. On these bases, considering that different papers have been published using the DECT technology, a review regarding its clinical application can be useful. We focused on the usefulness of DECT technology in gastrointestinal imaging, where DECT plays an important role. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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30 pages, 14035 KiB

Open AccessReview

Spectral CT: Current Liver Applications

by Ana P. Borges, Célia Antunes and Filipe Caseiro-Alves

Diagnostics 2023, 13(10), 1673; https://doi.org/10.3390/diagnostics13101673 - 9 May 2023

Cited by 2 | Viewed by 4927

Abstract

Using two different energy levels, dual-energy computed tomography (DECT) allows for material differentiation, improves image quality and iodine conspicuity, and allows researchers the opportunity to determine iodine contrast and radiation dose reduction. Several commercialized platforms with different acquisition techniques are constantly being improved. [...] Read more.

Using two different energy levels, dual-energy computed tomography (DECT) allows for material differentiation, improves image quality and iodine conspicuity, and allows researchers the opportunity to determine iodine contrast and radiation dose reduction. Several commercialized platforms with different acquisition techniques are constantly being improved. Furthermore, DECT clinical applications and advantages are continually being reported in a wide range of diseases. We aimed to review the current applications of and challenges in using DECT in the treatment of liver diseases. The greater contrast provided by low-energy reconstructed images and the capability of iodine quantification have been mostly valuable for lesion detection and characterization, accurate staging, treatment response assessment, and thrombi characterization. Material decomposition techniques allow for the non-invasive quantification of fat/iron deposition and fibrosis. Reduced image quality with larger body sizes, cross-vendor and scanner variability, and long reconstruction time are among the limitations of DECT. Promising techniques for improving image quality with lower radiation dose include the deep learning imaging reconstruction method and novel spectral photon-counting computed tomography. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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17 pages, 1576 KiB

Open AccessReview

Imaging Diagnosis of Hepatocellular Carcinoma: A State-of-the-Art Review

by Gianvito Candita, Sara Rossi, Karolina Cwiklinska, Salvatore Claudio Fanni, Dania Cioni, Riccardo Lencioni and Emanuele Neri

Diagnostics 2023, 13(4), 625; https://doi.org/10.3390/diagnostics13040625 - 8 Feb 2023

Cited by 12 | Viewed by 5707

Abstract

Hepatocellular carcinoma (HCC) remains not only a cause of a considerable part of oncologic mortality, but also a diagnostic and therapeutic challenge for healthcare systems worldwide. Early detection of the disease and consequential adequate therapy are imperative to increase patients’ quality of life [...] Read more.

Hepatocellular carcinoma (HCC) remains not only a cause of a considerable part of oncologic mortality, but also a diagnostic and therapeutic challenge for healthcare systems worldwide. Early detection of the disease and consequential adequate therapy are imperative to increase patients’ quality of life and survival. Imaging plays, therefore, a crucial role in the surveillance of patients at risk, the detection and diagnosis of HCC nodules, as well as in the follow-up post-treatment. The unique imaging characteristics of HCC lesions, deriving mainly from the assessment of their vascularity on contrast-enhanced computed tomography (CT), magnetic resonance (MR) or contrast-enhanced ultrasound (CEUS), allow for a more accurate, noninvasive diagnosis and staging. The role of imaging in the management of HCC has further expanded beyond the plain confirmation of a suspected diagnosis due to the introduction of ultrasound and hepatobiliary MRI contrast agents, which allow for the detection of hepatocarcinogenesis even at an early stage. Moreover, the recent technological advancements in artificial intelligence (AI) in radiology contribute an important tool for the diagnostic prediction, prognosis and evaluation of treatment response in the clinical course of the disease. This review presents current imaging modalities and their central role in the management of patients at risk and with HCC. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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20 pages, 4035 KiB

Open AccessReview

Immunotherapy Assessment: A New Paradigm for Radiologists

by Vincenza Granata, Roberta Fusco, Sergio Venanzio Setola, Igino Simonetti, Carmine Picone, Ester Simeone, Lucia Festino, Vito Vanella, Maria Grazia Vitale, Agnese Montanino, Alessandro Morabito, Francesco Izzo, Paolo Antonio Ascierto and Antonella Petrillo

Diagnostics 2023, 13(2), 302; https://doi.org/10.3390/diagnostics13020302 - 13 Jan 2023

Cited by 2 | Viewed by 3024

Abstract

Immunotherapy denotes an exemplar change in an oncological setting. Despite the effective application of these treatments across a broad range of tumors, only a minority of patients have beneficial effects. The efficacy of immunotherapy is affected by several factors, including human immunity, which [...] Read more.

Immunotherapy denotes an exemplar change in an oncological setting. Despite the effective application of these treatments across a broad range of tumors, only a minority of patients have beneficial effects. The efficacy of immunotherapy is affected by several factors, including human immunity, which is strongly correlated to genetic features, such as intra-tumor heterogeneity. Classic imaging assessment, based on computed tomography (CT) or magnetic resonance imaging (MRI), which is useful for conventional treatments, has a limited role in immunotherapy. The reason is due to different patterns of response and/or progression during this kind of treatment which differs from those seen during other treatments, such as the possibility to assess the wide spectrum of immunotherapy-correlated toxic effects (ir-AEs) as soon as possible. In addition, considering the unusual response patterns, the limits of conventional response criteria and the necessity of using related immune-response criteria are clear. Radiomics analysis is a recent field of great interest in a radiological setting and recently it has grown the idea that we could identify patients who will be fit for this treatment or who will develop ir-AEs. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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Other

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18 pages, 25869 KiB

Open AccessInteresting Images

The Many Hidden Faces of Gallbladder Carcinoma on CT and MRI Imaging—From A to Z

by Damaris Neculoiu, Lavinia Claudia Neculoiu, Ramona Mihaela Popa and Rosana Mihaela Manea

Diagnostics 2024, 14(5), 475; https://doi.org/10.3390/diagnostics14050475 - 22 Feb 2024

Cited by 1 | Viewed by 3530

Abstract

Gallbladder carcinoma represents the most aggressive biliary tract cancer and the sixth most common gastrointestinal malignancy. The diagnosis is a challenging clinical task due to its clinical presentation, which is often non-specific, mimicking a heterogeneous group of diseases, as well as benign processes [...] Read more.

Gallbladder carcinoma represents the most aggressive biliary tract cancer and the sixth most common gastrointestinal malignancy. The diagnosis is a challenging clinical task due to its clinical presentation, which is often non-specific, mimicking a heterogeneous group of diseases, as well as benign processes such as complicated cholecystitis, xanthogranulomatous cholecystitis, adenomyomatosis, porcelain gallbladder or metastasis to the gallbladder (most frequently derived from melanoma, renal cell carcinoma). Risk factors include gallstones, carcinogen exposure, porcelain gallbladder, typhoid carrier state, gallbladder polyps and abnormal pancreaticobiliary ductal junction. Typical imaging features on CT or MRI reveal three major patterns: asymmetric focal or diffuse wall-thickening of the gallbladder, a solid mass that replaces the gallbladder and invades the adjacent organs or as an intraluminal enhancement mass arising predominantly from the gallbladder fundus. The tumor can spread to the liver, the adjacent internal organs and lymph nodes. Depending on the disease stage, surgical resection is the curative treatment option in early stages and adjuvant combination chemotherapy at advanced stages. The purpose of this scientific paper is to fully illustrate and evaluate, through multimodality imaging findings (CT and MRI), different presentations and imaging scenarios of gallbladder cancer in six patients and thoroughly analyze the risk factors, patterns of spread and differential diagnosis regarding each particular case. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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5 pages, 6356 KiB

Open AccessInteresting Images

An Isolated Intestinal Juvenile Polyp Diagnosed by Abdominal Ultrasonography and Resected by Double-Balloon Endoscopy: A Case Report and Literature Review

by Masumi Nagata, Keisuke Jimbo, Nobuyasu Arai, Kosuke Kashiwagi, Kaori Tokushima, Mitsuyoshi Suzuki, Takahiro Kudo and Toshiaki Shimizu

Diagnostics 2023, 13(3), 494; https://doi.org/10.3390/diagnostics13030494 - 29 Jan 2023

Viewed by 1464

Abstract

Juvenile polyps, typically localized in the rectum and sigmoid colon, are a common cause of pediatric bloody stool. An isolated small intestinal juvenile polyp is uncommon and generally difficult to diagnose. The first case of an isolated juvenile polyp diagnosed by abdominal ultrasonography [...] Read more.

Juvenile polyps, typically localized in the rectum and sigmoid colon, are a common cause of pediatric bloody stool. An isolated small intestinal juvenile polyp is uncommon and generally difficult to diagnose. The first case of an isolated juvenile polyp diagnosed by abdominal ultrasonography before acute abdomen had developed and resected by double-balloon endoscopy is presented along with a review of previous reports including this case. A two-year-old Japanese boy was referred to our institute for further evaluation of anemia persisting from one year of age. Laboratory findings showed mild iron deficiency anemia and elevated fecal human hemoglobin (Hb) and fecal calprotectin values. Upper and lower endoscopic findings showed no abnormalities. Because the abdominal ultrasonography performed one year later demonstrated a 15 mm jejunal polyp, combined with a similar finding on small intestinal capsule endoscopy, this was diagnosed as an isolated lesion. The lesion was resected by cautery with double-balloon endoscopy and diagnosed as a juvenile polyp pathologically. All clinical symptoms disappeared, and all laboratory data improved after treatment, without recurrence for more than one year after the procedure. Abdominal ultrasonographic screening and the fecal calprotectin value led to the diagnosis and non-surgical invasive treatment of an isolated small intestinal juvenile polyp. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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