scholarly journals Quantification of Tc-99m macroaggregated albumin liver perfusion as a predictor of tumor response to intra-arterial therapy with yttrium 90 spheres

2021 ◽  
Vol 5 ◽  
pp. 20
Author(s):  
Isis Gayed ◽  
Neroj Tripathee ◽  
Harleen Kaur ◽  
Alan Cohen
Keyword(s):  
Tumor Response ◽  
Geometric Mean ◽  
Lesion Size ◽  
Emission Computed Tomography ◽  
Average Dose ◽  
Tumor Lesion ◽  
Liver Cancers ◽  
Significant Difference ◽  
Planar Images ◽  
Yttrium 90

Objectives: It remains unclear whether quantifying the pre-therapy tumor Technetium 99m macro aggregated albumin (Tc 99m MAA) localization can accurately predict the response to Yttrium 90 (Y-90) spheres therapy. Present studies are limited and with contradictory results. The aim of this study is to determine if quantification of Tc-99m MAA in hepatic tumor lesion(s) on pretherapy planning nuclear scan can predict the degree of tumor response after radioembolization using Y-90 Spheres. Material and Methods: We retrospectively included patients with primary liver cancers or metastases who were treated with SirSpheres or TheraSpheres. All patients had a Tc-99m MAA scan with an average dose of 5.0mCi injected aseptically in either the right, left, or common hepatic artery. The patients were subsequently transferred for imaging using planar and single-photon emission computed tomography (SPECT) of the abdomen and planar images of the chest. We calculated geometric mean of radiotracer counts in the largest lesion in the lobe to be treated by placing same size region of interest (ROI) around the largest lesion on the anterior and posterior planar images. Subsequently, an irregular ROI around the liver or lobe to be treated were drawn to calculate the geometric mean of counts in the liver. The percent tracer accumulation in the largest lesion was calculated by dividing the geometric mean of counts in the largest lesion by the geometric mean of counts in the liver or lobe and multiplying by 100%. The size of this largest lesion was obtained on the most recent CT or magnetic resonance imaging (MRI) in cm in 2 directions prior to treatment with Y-90 Spheres. The extent of the response to Y-90 Spheres therapy was re-evaluated with 3 months follow-up MRI or CT by measuring the decrease in the largest lesion size. Comparison of the percent Tc-99 MAA count accumulation in the largest lesion on the pre-therapy scan with the reduction in size using anatomic imaging was performed. Results: A total of 30 patients were included (16 hepatocellular carcinoma, eight colorectal, three breast, one neuroendocrine, one cholangiocarcinoma, and one cervical metastases). There were 14 patients in stable disease or progressive disease group (SD/PD gp) and 16 patients in partial response or complete response group (PR/CR gp). The median lesion size was 3.5 cm in the PD/SD gp versus 2.8 cm in the PR/CR gp (P = 0.31). Additionally, the median delivered Y90 Spheres treatment dose was 51.3 mCi in the PD/SD versus 43.2 mCi in the PR/CR gp (P = 0.22). The percent median largest lesion to liver concentration was 21.9% in the PR/CR gp versus 23.3% in the PR/CR gp (P = 0.74). There was no significant difference in percent Tc-99m MAA distribution in the largest liver lesion between the SD/PD gp and the PR/CR gp. Conclusion: The degree of Tc-99m MAA localization in the largest tumor lesion in the liver compared to the remainder of the liver as quantified from planar images does not predict the response to Y-90 spheres therapy.

scholarly journals A critical analysis of the prostate magnetic resonance imaging lesion diameter threshold for advanced pathology features

2021 ◽  
Author(s):  
Yavuz Onur Danacioglu ◽  
Rustu Turkay ◽  
Omer Yildiz ◽  
Salih Polat ◽  
Yusuf Arıkan ◽  
...  
Keyword(s):  
Surgical Margin ◽  
Lesion Size ◽  
Fusion Biopsy ◽  
Independent Predictive Factor ◽  
T Stage ◽  
Tumor Lesion ◽  
Significant Difference ◽  
Group A ◽  
Clinically Significant ◽  
Group B

Purpose: To investigate the relationship between lesion size determined using mpMRI and histopathological findings of specimens obtained after mpMRI fusion biopsy and radical prostatectomy. Material and Methods: We retrospectively analyzed 590 patients with PCa who underwent an MRI fusion biopsy between 2017-2019. We measured the diameter of suspicious tumor lesions on diffusion-weighted mpMRI and stratified the cohort into two groups. Group A included patients with a suspicious tumor lesion equal and smaller than 10 mm and Group B included those with a suspicious tumor lesion larger than 10 mm. RP was performed in 53 patients. The patients in Groups A and B were compared according to their pathological findings obtained with fusion biopsy and RP. Results: After applying the inclusion and exclusion criteria, Group A consisted of 144 patients and Group B comprised 146. In Group B, PI-RADS score determined in mpMRI was higher than Group A, and there was a statistically significant difference between the two groups in terms of clinical T-stage. The PCa detection rate and the number of positive cores were statistically significantly higher in Group B than in Group A. In addition, there was a statistically significant difference between the two groups in relation to the biopsy, the ISUP grades and the presence of clinically significant PCa. In Group B, pathological T-stage and extraprostatic extension (EPE) and surgical margin (SM) positivity were found to be higher among the patients who underwent RP. In the multivariate analysis, the mpMRI lesion size being >10 mm was found to be an independent predictive factor for SM and EPE positivity. Conclusion: The radiologists and clinicians should be awared of the possibility of presence of features that may affect local staging, such as EPE positivity, in the presence of lesions larger than 10 mm in which prostate cancer is detected.

Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

No Difference in Outcomes Following Osteochondral Allograft with Fresh Precut Cores Compared to Hemi-Condylar Allografts

Cartilage ◽  
2021 ◽  
pp. 194760352110219
Author(s):  
Danielle H. Markus ◽  
Anna M. Blaeser ◽  
Eoghan T. Hurley ◽  
Brian J. Mannino ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Lesion Size ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Objective The purpose of the current study is to evaluate the clinical and radiographic outcomes at early to midterm follow-up between fresh precut cores versus hemi-condylar osteochondral allograft (OCAs) in the treatment of symptomatic osteochondral lesions. Design A retrospective review of patients who underwent an OCA was performed. Patient matching between those with OCA harvested from an allograft condyle/patella or a fresh precut allograft core was performed to generate 2 comparable groups. The cartilage at the graft site was assessed with use of a modified Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system and patient-reported outcomes were collected. Results Overall, 52 total patients who underwent OCA with either fresh precut OCA cores ( n = 26) and hemi-condylar OCA ( n = 26) were pair matched at a mean follow-up of 34.0 months (range 12 months to 99 months). The mean ages were 31.5 ± 10.7 for fresh precut cores and 30.9 ± 9.8 for hemi-condylar ( P = 0.673). Males accounted for 36.4% of the overall cohort, and the mean lesion size for fresh precut OCA core was 19.6 mm2 compared to 21.2 mm2 for whole condyle ( P = 0.178). There was no significant difference in patient-reported outcomes including Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and Tegner ( P > 0.5 for each), or in MOCART score (69.2 vs. 68.3, P = 0.93). Conclusions This study found that there was no difference in patient-reported clinical outcomes or MOCART scores following OCA implantation using fresh precut OCA cores or size matched condylar grafts at early to midterm follow-up.

scholarly journals Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

2022 ◽  
Vol 14 (1) ◽  
pp. 43-55
Author(s):  
Cristina Micali ◽  
Ylenia Russotto ◽  
Grazia Caci ◽  
Manuela Ceccarelli ◽  
Andrea Marino ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cancer Staging ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Liver Cancers ◽  
Significant Difference ◽  
Cancer Specific Mortality ◽  
Living With Hiv ◽  
Hiv Negative

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

scholarly journals Detection Rate and Clinical Impact of PET/CT with 18F-FACBC in Patients with Biochemical Recurrence of Prostate Cancer: A Retrospective Bicentric Study

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 177
Author(s):  
Luca Filippi ◽  
Oreste Bagni ◽  
Carmelo Crisafulli ◽  
Ivan Cerio ◽  
Gabriele Brunotti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Management ◽  
Biochemical Recurrence ◽  
Detection Rate ◽  
Major Change ◽  
Emission Computed Tomography ◽  
Prostate Bed ◽  
Pet Ct ◽  
Significant Difference ◽  
Clinical Records

Our aim was to assess the detection rate (DR) of positron emission computed tomography (PET/CT) with anti-1-amino-3-[18F]-flurocyclobutane-1-carboxylic acid (18F-FACBC) in patients with biochemical recurrence (BCR) from prostate cancer (PC). As a secondary endpoint, we evaluated 18F-FACBC PET/CT’s impact on patients management. Clinical records of 81 patients submitted to 18F-FACBC PET/CT due to PC BCR in two Italian Nuclear Medicine Units were retrospectively assessed. DR was gauged in the whole cohort and stratifying patients by discrete intervals of PSA levels. PET/CT’s impact on clinical management was scored as (1) major if it entailed an intermodality change (e.g., from systemic to loco-regional therapy); (2) minor if it led to an intramodality change (e.g., modified radiotherapy field). PET/CT’s DR resulted in 76.9% in the whole cohort, with a positive predictive value of 96.7%. Stratified by PSA quartile intervals, PET/CT’s DR was 66.7%, 71.4%, 78.9% and 90% for PSA 0.2–0.57 ng/mL, 0.58–0.99 ng/mL, 1–1.5 ng/mL and >1.5 ng/mL without significant difference among groups (p = 0.81). The most common sites of relapse were prostate bed and pelvic lymph nodes (59.3%). PET/CT impacted on clinical management in 33/81 cases (40.7%), leading to a major change in 30 subjects (90.9%). 18F-FACBC PET/CT localized recurrence in patients with BCR, with meaningful DR also at low PSA levels and significantly impacted on clinical management.

scholarly journals Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

2020 ◽  
Vol 58 (4) ◽  
pp. 421-430 ◽  
Author(s):  
Seungman Cha ◽  
Sung-Tae Hong ◽  
Jin-Su Lee ◽  
Hoo Gn Jeong ◽  
In-Sun Kwon ◽  
...  
Keyword(s):  
Primary Schools ◽  
Schistosoma Haematobium ◽  
Geometric Mean ◽  
Infection Intensity ◽  
Baseline Survey ◽  
Relative Reduction ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
White Nile

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

Vasoactive Intestinal Polypeptide Evokes Only a Minimal Headache in Healthy Volunteers

Cephalalgia ◽  
2006 ◽  
Vol 26 (8) ◽  
pp. 992-1003 ◽  
Author(s):  
JM Hansen ◽  
J Sitarz ◽  
S Birk ◽  
AM Rahmann ◽  
PS Oturai ◽  
...  
Keyword(s):  
Vasoactive Intestinal Polypeptide ◽  
Healthy Subjects ◽  
Rating Scale ◽  
Superficial Temporal Artery ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Mean Flow ◽  
Arterial Blood ◽  
Significant Difference ◽  
Intestinal Polypeptide

The role of the parasympathetic nervous system in the pathogenesis of migraine is disputed. The headache-eliciting effect of the parasympathetic neurotransmitter, vasoactive intestinal polypeptide (VIP), and its effect on cerebral arteries and brain haemodynamics has not been systematically studied in man. We hypothesized that infusion of VIP might induce headache in healthy subjects and cause changes in cerebral haemodynamics. VIP (8 pmol/kg per min) or placebo (0.9± saline) was infused for 25 min into 12 healthy young volunteers in a crossover, double-blind design. Headache was scored on a verbal rating scale from 0 to 10, regional cerebral blood flow (rCBF) was measured with single-photon emission computed tomography and 133Xe inhalation and mean flow velocity in the middle cerebral artery (VmeanMCA) was measured with transcranial Doppler ultrasonography. The headache was very mild with a maximum score of 2 and described as a pressing or throbbing sensation. Five participants developed headache during VIP and one during placebo. During the infusion, a significant drop in VmeanMCA was seen for VIP compared with placebo ( P < 0.001), but the effect quickly waned and no difference was found when comparing the time between 30 and 120 min. In addition, no significant difference in the diameter of the MCA could be found during the infusion. No significant differences in rCBF ( P = 0.10) were found between VIP and placebo. A marked dilation of the superficial temporal artery was seen ( P = 0.04) after VIP in the first 30 min but no difference was found when comparing the time between 30 and 120 min. We found no difference in mean arterial blood pressure between VIP and placebo days but the heart rate increased significantly on a VIP day compared with a placebo day (AUC0–30min, P < 0.001). Plasma VIP was significantly higher on a VIP day compared with placebo (AUC0–80min, P < 0.001). These results show that VIP causes a decrease in VmeanMCA without affecting rCBF. In spite of a marked vasodilator effect in the extracranial vessels and increased plasma VIP, healthy subjects developed only a very mild headache.

Reduced regional cerebral blood flow measured by 99mTc-HMPAO SPECT in microgravity simulated by 5-day dry immersion

2021 ◽  
Author(s):  
Laurent Guillon ◽  
Marc Kermorgant ◽  
Thomas Charvolin ◽  
Fabrice Bonneville ◽  
Marie-Pierre Bareille ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Peak Level ◽  
Emission Computed Tomography ◽  
Regional Cerebral Blood ◽  
Caudate Nuclei ◽  
Dry Immersion ◽  
Hmpao Spect ◽  
Significant Difference

Abstract Purpose Neuro-ophthalmological changes defined as spaceflight-associated neuro-ocular syndrome have been reported after long duration space flights. The pathophysiology of this syndrome remains unclear, with the possible involvement of elevated intracranial pressure. Changes in blood flow in the brain, evaluated indirectly by Doppler, have been reported in flight. However, the effects of microgravity on regional cerebral blood flow (rCBF) are not known. We therefore investigated changes in rCBF in a 5-day dry immersion (DI) model. Moreover, we tested thigh cuffs as a countermeasure to prevent potential microgravity-induced modifications in rCBF.Methods 18 healthy male participants underwent 5-day DI with or without a thigh cuffs countermeasure. They were randomly allocated to a control (n = 9) or cuffs (n = 9) group. rCBF was measured 4 days before DI (Pre-DI) and at the end of the fifth day of DI (Post-DI), using single-photon emission computed tomography (SPECT) with radiopharmaceutical 99mTc-hexamethyl propylene amine oxime (HMPAO). SPECT images were processed using statistical parametric mapping (SPM12) software.Results At DI5, we observed a significant decrease in rCBF in 32 cortical and subcortical patterns, with greater hypoperfusion in the occipital region (occipital peak level: z = 4.51, puncorr < 0.001) and basal ganglia (putamen peak level: z = 4.71, puncorr < 0.001; caudate nuclei peak level: z = 3.80, puncorr < 0.001). No significant difference was found between the control and cuffs groups on variations in rCBF at DI5.Conclusion 5-day DI induces a relative decrease in rCBF in cortical and subcortical regions. Nevertheless, the consequences of this decrease for brain function and mechanisms need further investigation.

scholarly journals Retrospective accuracy analysis of MRI based lesion size measurement in neuroblastic tumors: which sequence should we choose?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sebastian Gassenmaier ◽  
Ilias Tsiflikas ◽  
Simon Maennlin ◽  
Cristian Urla ◽  
Steven W. Warmann ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Size ◽  
Three Dimensional ◽  
Lesion Size ◽  
Three Dimensions ◽  
Neuroblastic Tumor ◽  
Significant Difference ◽  
Dimensional Measurements ◽  
Neuroblastic Tumors ◽  
Mri Measurements

Abstract Background MR imaging of neuroblastic tumors is widely used for assessing the effect of chemotherapy on tumor size. However, there are some concerns that MRI might falsely estimate lesion diameters due to calcification and fibrosis. Therefore, the aim of our study was to compare neuroblastic tumor size based on MRI measurements to histopathology measurements of the resected specimens as standard of reference. Methods Inclusion criteria were diagnosis of a neuroblastic tumor, MR imaging within 100 days to surgery and gross total resection without fragmentation of the tumor between 2008 and 2019. Lesion diameters were measured by two radiologists according to RECIST 1.1 in axial plane in T2w turbo spin echo (TSE), diffusion-weighted imaging (DWI), and in T1w pre- and postcontrast sequences. Furthermore, the largest lesion size in three-dimensions was noted. The largest diameter of histopathology measurements of each specimen was used for comparison with MRI. Results Thirty-seven patients (mean age: 5 ± 4 years) with 38 lesions (neuroblastoma: n = 17; ganglioneuroblastoma: n = 11; ganglioneuroma: n = 10) were included in this retrospective study. There was excellent intra-class correlation coefficient between both readers for all sequences (> 0.9) Tumor dimensions of reader 1 based on axial MRI measurements were significantly smaller with the following median differences (cm): T1w precontrast − 1.4 (interquartile range (IQR): 1.8), T1w postcontrast − 1.0 (IQR: 1.9), T2w TSE: -1.0 (IQR: 1.6), and DWI -1.3 (IQR: 2.2) (p < 0.001 for all sequences). However, the evaluation revealed no significant differences between the three-dimensional measurements and histopathology measurements of the resected specimens regardless of the applied MRI sequence. Conclusions Axial MRI based lesion size measurements are significantly smaller than histopathological measurements. However, there was no significant difference between three-dimensional measurements and histopathology measurements of the resected specimens. T2w TSE and T1w postcontrast images provided the lowest deviation and might consequently be preferred for measurements.

Sign in / Sign up

Export Citation Format

Share Document