Predictive role of lymphoscintigraphy undergoing lymphovenous anastomosis in patients with lower extremity lymphedema: a preliminary study

Background We investigated whether preoperative lymphoscintigraphy could predict the treatment response of unilateral lymphovenous anastomosis (LVA) in patients with lower extremity lymphedema. Materials and methods A total of 17 patients undergoing lymphoscintigraphy subsequent to LVA was included. As qualitative lymphoscintigraphic indicators, ilioinguinal lymph node uptake, main lymphatic vessel, collateral vessel, and four types of dermal backflow patterns (absent; distal only; proximal only; whole lower limb) were evaluated. Lymph node uptake ratio, extremity uptake ratio, and injection site clearance ratio were obtained as quantitative lymphoscintigraphic indicators at 1 and 2-h after injection. To evaluate therapy response, the volume difference ratio of the whole lower limb at 3 months (early response) and 1 year (late response) was measured. Volume difference ratios (continuous variable and binary variable with a cut-off value of zero) were compared according to the lymphoscintigraphic variables. Results The group with whole lower limb dermal backflow had a greater volume change than the other groups (p = 0.047). The group with dermal backflow in the whole lower limb OR only in the distal part had a higher rate of volume reduction than the group with dermal backflow only in the proximal part OR absent (p = 0.050). The 2-h extremity uptake ratio was the only indicator that positively correlated with early and late volume difference ratio (p = 0.016, p = 0.001). The rate of volume decrease at 1 year was high in patients with high 2-h extremity uptake ratio (p = 0.027). As the amount of dermal backflow increases, the postoperative therapeutic effect increases (p = 0.040). Conclusions Preoperative lymphoscintigraphy is useful to predict both early and late therapy response in patients with lower extremity lymphedema undergoing LVA. Both dermal backflow pattern and extremity uptake ratio may be predictive lymphoscintigraphic indicators.

Clinical utility of quantitative analysis of bone scintigraphy in detecting clinically active joint and high disease activity in patients with rheumatoid arthritis

Background The purpose of this study was to investigate the efficiency of quantitative parameters of bone scintigraphy in detecting clinically active joint and high disease activity in patients with rheumatoid arthritis. Methods We retrospectively enrolled 65 patients with rheumatoid arthritis who underwent bone scintigraphy for diagnostic work-up. Quantitative analysis of bone scintigraphy images was conducted using an in-house software, and joint uptake ratio of 28 joints was measured for the calculation of the disease activity score of 28 joints using erythrocyte sedimentation rate (DAS28-ESR). The relationship between joint uptake ratio and clinical findings and the efficiency of joint uptake ratio in detecting clinically active joint and high disease activity were assessed. Results Clinically active joint (tender and/or swollen joints) showed significantly higher joint uptake ratio than did other non-affected joints (p < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of joint uptake ratio for identifying clinically active joint were 78.7%, 52.0%, 32.9%, and 89.1%, respectively, and those of the summed joint uptake ratio for detecting high disease activity were 92.9%, 66.8%, 43.3%, and 97.1%, respectively; the joint uptake ratio showed high detection ability, especially for active joints of the elbow, wrist, and metacarpo-phalangeal joint areas. The summed joint uptake ratio of 28 joints showed a significantly strong positive correlation with DAS28-ESR (p < 0.001; correlation coefficient, 0.725). Conclusion Quantitative parameters of bone scintigraphy showed high sensitivity and NPV for detecting clinically active joint and high disease activity in patients with rheumatoid arthritis.

Utility of 99mTc-sestamibi Heart/Liver uptake ratio in Screening Non-alcoholic Fatty Liver Disease during Myocardial Perfusion Imaging

Purpose Non-alcoholic fatty liver disease (NAFLD) is the most common chronic hepatic disease worldwide with functional impairment of the mitochondria occurring from early stages. Technetium-99m methoxy-isobutyl-isonitrile (99mTc-MIBI) is a lipophilic agent trapped in the mitochondria. This study aims to evaluate the utility of 99mTc-MIBI heart/liver uptake ratio in screening for NAFLD during myocardial perfusion imaging (MPI). Methods 70eligible patients underwent a two-day rest/stress 99mTc-MIBI scan with a 2-minute planar image acquired in rest phase, at 30, 60 and 120 minutes post radiotracer administration. Heart/liver uptake ratio was calculated by placing identical regions of interest on the heart and liver dome. All patients underwent liver ultrasound and were allocated into groups A, having NAFLD, and B, healthy individuals without NAFLD. Results Mean count per pixel heart/liver ratios gradually increased over time in either groups; nonetheless the values were significantly higher in group A, regardless of acquisition timing; with the P-value equal to 0.007, 0.014 and 0.010 at 30, 60 and 120 minutes, respectively. Conclusions Determining 99mTc-MIBI heart/liver uptake ratio during rest phase in patients undergoing MPI may be a useful, non-invasive screening method for NAFLD; with no additional cost, radiation burden or adverse effects in these patients.

Predictive role of lymphoscintigraphy undergoing lymphovenous anastomosis in patients with lower extremity lymphedema

Background We investigated whether preoperative lymphoscintigraphy could predict the treatment response of unilateral lymphovenous anastomosis (LVA) in patients with lower extremity lymphedema. Materials and methods A total of 17 patients undergoing lymphoscintigraphy subsequent to LVA was included. As qualitative lymphoscintigraphic indicators, ilioinguinal lymph node uptake, main lymphatic vessel, collateral vessel, and dermal backflow pattern were evaluated. Lymph node uptake ratio, extremity uptake ratio, and injection site clearance ratio were obtained as quantitative lymphoscintigraphic indicators at 1 and 2-h after injection. To evaluate therapy response, the volume difference ratio of the whole leg at 3 months (early response) and 1 year (late response) was measured. Results The group with whole leg dermal backflow had a greater volume change than the other groups (p=0.047). The group with dermal backflow in the whole leg OR only in the distal part had a higher rate of volume reduction than the group with dermal backflow only in the proximal part OR absent (p=0.050). The 2-h extremity uptake ratio was the only indicator that positively correlated with early and late volume difference ratio (p=0.016, p=0.001). The rate of volume decrease at 1 year was high in patients with high 2-h extremity uptake ratio (p=0.027). As the amount of dermal backflow increases, the postoperative therapeutic effect increases (p=0.040). Conclusions Preoperative lymphoscintigraphy is useful to predict both early and late therapy response in patients with lower extremity lymphedema undergoing LVA. Both dermal backflow pattern and extremity uptake ratio may be predictive lymphoscintigraphic indicators.

Torrefaction and Pelleting of Wheat and Barley Straw for Biofuel and Energy Applications

Microwave (MW)-assisted torrefaction and pelleting could enhance biomass fuel properties and energy applications. Plastic wastes are considered as a replacement source binder in pellets to minimize their effect on the environment as pollutants. High-density polyethylene (HDPE), an extractable plastic from recycling waste, was investigated as a binder for torrefied wheat and barley straw pellets. Fuel pellet characteristics, such as durability, density, tensile strength, and water absorption, were used to evaluate the pellets produced from a single pelleting test. The results showed that the addition of HDPE as a binder significantly increased the pellet quality in terms of density (686.12–982.93 kg/m3), tensile strength (3.68 and 4.53 MPa) for wheat and barley straw, and reduced ash content of the pellet from 10.34 to 4.59% for barley straw pellet and 10.66 to 3.88% for wheat straw pellets. The higher heating value (HHV) increased with increasing biochar mix and HDPE binder blend. The highest HHV value observed for barley straw was 28.34 MJ/kg, while wheat straw was 29.78 MJ/kg. The study further indicated that MW torrefaction of biomass-biochar mix with HDPE binder reduced the moisture adsorption of wheat and barley straw pellets, which can significantly improve their storage capability in humid locations. The moisture uptake ratio for MW-torrefied barley straw pellets was 0.10–0.25 and wheat straw pellets 0.11–0.25 against a moisture uptake ratio of 1.0 for untreated biomass. MW torrefaction of wheat and barley straw with biochar and HDPE binder addition during pelleting is a promising technique to improve biomass fuel pellet properties.

Prognostic significance of bone marrow and spleen 18F-FDG uptake in patients with colorectal cancer

Serum inflammatory markers are used in the prognostication of colorectal cancer (CRC); however, the corresponding role of positron emission tomography (PET)-derived inflammatory markers remains unclear. This study aimed to investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) uptake in the bone marrow and spleen of patients with CRC and evaluate the relationship between FDG uptake estimates in these organs and serum inflammatory markers. In total, 411 patients who underwent preoperative FDG PET/computed tomography (CT) within 1 month of surgery were enrolled. The mean standardized uptake values of the bone marrow and spleen were normalized to the value of the liver, thereby generating bone marrow-to-liver uptake ratio (BLR) and spleen-to-liver uptake ratio (SLR) estimates. The value of BLR and SLR in predicting overall survival (OS) was assessed using the Cox proportional hazards model. The correlation between BLR or SLR and neutrophil-to-lymphocyte ratio (NLR) was evaluated. The predictive accuracy of BLR alone and in combination with SLR was compared using the integrated area under the receiver operating characteristic curves (iAUC). In the univariate analysis, BLR (> 1.06) and SLR (> 0.93) were significant predictors of OS. In the multivariate analysis, BLR was an independent predictor of OS (hazard ratio = 5.279; p < 0.001). Both BLR and SLR were correlated with NLR (p < 0.001). A combination of BLR and SLR was better than BLR alone at CRC prognostication (iAUC, 0.561 vs. 0.542). FDG uptake estimates in the bone marrow and spleen may be useful imaging-derived biomarkers of systemic inflammation, supporting CRC prognostication.

Commercial Kevlar derived activated carbons for CO2 and C2H4 sorption

The carbonaceous precursor was obtained via pyrolysis of commercial aramid polymer (Kevlar). Additionally the precursor was activated at 1000°C in CO2 atmosphere for different times. Obtained materials were characterised by BET; XPS; SEM and optical microscopy. The sorption capacities were determined by temperature swing adsorption performed in TGA apparatus for CO2 and C2H4 gases. The obtained materials exhibit high difference in sorption of these gases i.e. 1.5 and 2.8 mmol/g @30°C respectively and high SSA ~1600 m2/g what can be applied in separation applications. The highest uptakes were 1.8 and 3.1 mmol/g @30°C respectively. It was found that the presence of oxygen and nitrogen functional groups enhances C2H4/CO2 uptake ratio.

Multi-Atlas MRI-Based Striatum Segmentation for 123I-FP-CIT SPECT (DAT-SPECT) Compared With the Bolt Method and SPECT-Atlas-Based Segmentation Method Toward the Accurate Diagnosis of Parkinson's Disease/Syndrome

Aims: This study aimed to analyze the performance of multi-atlas MRI-based parcellation for 123I-FP-CIT SPECT (DAT-SPECT) in healthy volunteers. The proposed method was compared with the SPECT-atlas-based and Bolt methods. 18F-FE-PE2I-PET (DAT-PET) was used as a reference.Methods: Thirty healthy subjects underwent DAT-SPECT, DAT-PET, and 3D-T1WI-MRI. We calculated the striatum uptake ratio (SUR/SBR), caudate uptake ratio (CUR), and putamen uptake ratio (PUR) for DAT-SPECT using the multi-atlas MRI-based method, SPECT-atlas-based method, and Bolt method. In the multi-atlas MRI-based method, the cerebellum, occipital cortex, and whole-brain were used as reference regions. The correlation of age with DAT-SPECT activity and the correlations of SUR/SBR, CUR, and PUR between DAT-SPECT and DAT-PET were calculated by each of the three methods.Results: The correlation between age and SUR/SBR for DAT-SPECT based on the multi-atlas MRI-based method was comparable to that based on the SPECT-atlas-based method (r = −0.441 to −0.496 vs. −0.488). The highest correlation between DAT-SPECT and DAT-PET was observed using the multi-atlas MRI-based method with the occipital lobe defined as the reference region compared with the SPECT-atlas-based and Bolt methods (SUR, CUR, and PUR: 0.687, 0.723, and 0.676 vs. 0.698, 0.660, and 0.616 vs. 0.655).Conclusion: Multi-atlas MRI-based parcellation with the occipital lobe defined as the reference region was at least comparable to the clinical methods.

Biological Evaluation of [18F]AlF-NOTA-NSC-GLU as a Positron Emission Tomography Tracer for Hepatocellular Carcinoma

Purpose: N-(2-[18F]fluoropropionyl)-L-glutamate ([18F]FPGLU) for hepatocellular carcinoma (HCC) imaging has been performed in our previous studies, but its radiosynthesis method and stability in vivo need to be improved. Hence, we evaluated the synthesis and biological properties of a simple [18F]-labeled glutamate analog, [18F]AlF-1,4,7-triazacyclononane-1,4,7-triacetic-acid-2-S-(4-isothiocyanatobenzyl)-l-glutamate ([18F]AlF-NOTA-NSC-GLU), for HCC imaging.Procedures: [18F]AlF-NOTA-NSC-GLU was synthesized via a one-step reaction sequence from NOTA-NSC-GLU. In order to investigate the imaging value of [18F]AlF-NOTA-NSC-GLU in HCC, we conducted positron emission tomography/computed tomography (PET/CT) imaging and competitive binding of [18F]AlF-NOTA-NSC-GLU in human Hep3B tumor-bearing mice. The transport mechanism of [18F]AlF-NOTA-NSC-GLU was determined by competitive inhibition and protein incorporation experiments in vitro.Results: [18F]AlF-NOTA-NSC-GLU was prepared with an overall radiochemical yield of 29.3 ± 5.6% (n = 10) without decay correction within 20 min. In vitro competitive inhibition experiments demonstrated that the Na+-dependent systems XAG-, B0+, ASC, and minor XC- were involved in the uptake of [18F]AlF-NOTA-NSC-GLU, with the Na+-dependent system XAG- possibly playing a more dominant role. Protein incorporation studies of the Hep3B human hepatoma cell line showed almost no protein incorporation. Micro-PET/CT imaging with [18F]AlF-NOTA-NSC-GLU showed good tumor-to-background contrast in Hep3B human hepatoma-bearing mouse models. After [18F]AlF-NOTA-NSC-GLU injection, the tumor-to-liver uptake ratio of [18F]AlF-NOTA-NSC-GLU was 2.06 ± 0.17 at 30 min post-injection. In vivo competitive binding experiments showed that the tumor-to-liver uptake ratio decreased with the addition of inhibitors to block the XAG system.Conclusions: We have successfully synthesized [18F]AlF-NOTA-NSC-GLU as a novel PET tracer with good radiochemical yield and high radiochemical purity. Our findings indicate that [18F]AlF-NOTA-NSC-GLU may be a potential candidate for HCC imaging. Also, a further biological evaluation is underway.

Magnesium may be a key nutrient mechanism related to Fusarium wilt resistance: a new banana cultivar (Zhongjiao No. 9)

Zhongjiao No. 9 (Musa spp.), a new Fusarium wilt-resistant banana cultivar, has shown considerable promise in the field. However, the growth, nutrient budgets, and key nutrient mechanisms related to Fusarium wilt resistance have not been explicitly examined. Here, the plant growth, yield, fruit quality, and nutrient budgets of Zhongjiao No. 9 were investigated. The results showed that Zhongjiao No. 9 has a large biomass with a high yield (54.65 t ha−1). The concentrations of N, P, K, Ca, Mg, Mn, B, and Mo were mainly high in the leaves and bunches of mother plants as well as in the leaves and pseudostems of daughter plants, while Cu and Fe were enriched in the roots of both mother plants and daughter plants. Linear discriminant analysis revealed that K, Ca, and Fe were important for plant growth in both the mother plants and daughter plants; S, Zn, and Mn were important for the mother plants, and N, P, and B for were important for the daughter plants. The nutrient uptake ratio of N:P:K:Ca:Mg:S was 1:0.13:3.86:0.68:0.40:0.07. Compared with local cultivars, there was a higher Mg concentration in pseudostems and a higher Mg uptake ratio were observed in Zhongjiao No. 9. Together, our results provide insight into the importance of Mg accumulation in relation to Fusarium wilt resistance, and we provide information on nutrient demands and fertilization application.