Soft Tissue
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2021 ◽  
Chujie Bai ◽  
Lu Zhang ◽  
Yaohui Wang ◽  
Taiyan Guo ◽  
Xia You ◽  

Abstract Undifferentiated high-grade pleomorphic sarcoma (UPS) is a rare soft tissue sarcoma (STS) of mesenchymal origin, particularly the extremities and retroperitoneum, meanwhile it has been reported in almost all parts of the body. UPS is highly invasive and has a poor prognosis due to its clinical manifestations of painless mass and deep tumor site, which are usually found at an advanced stage. Patients with UPS tend to have a lower 5-year survival rate than patients with other types of STS. Recently, NTRK fusions were detected in many cancer types, such as thyroid cancer, colorectal cancer, non-small cell lung cancer, soft tissue tumors, uterine sarcomas, and melanomas. However, the mutation frequency of NTRK fusion in all cancers is only 0.1-1%. Targeted therapy with NTRK inhibitors, such as Larotrectinib and Entrectinib, leads to a response in most patients with NTRK1/2/3 gene fusion-positive tumors. Herein, we present a 68-years old man diagnosed with stage IIIA (T2N0M0G3) UPS. Next-generation sequencing (NGS) revealed a novel TMTC2-NTRK3 fusion. The NTRK3 positivity was also detected by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). He had a response to Larotrectinib. This report broadens the spectrum of NTRK fusions in UPS and highlights a new target for treatment.

2021 ◽  
Vol 11 ◽  
Colette J. Shen ◽  
Stephanie A. Terezakis

Ongoing rapid advances in molecular diagnostics, precision imaging, and development of targeted therapies have resulted in a constantly evolving landscape for treatment of pediatric cancers. Radiotherapy remains a critical element of the therapeutic toolbox, and its role in the era of precision medicine continues to adapt and undergo re-evaluation. Here, we review emerging strategies for combining radiotherapy with novel targeted systemic therapies (for example, for pediatric gliomas or soft tissue sarcomas), modifying use or intensity of radiotherapy when appropriate via molecular diagnostics that allow better characterization and individualization of each patient’s treatments (for example, de-intensification of radiotherapy in WNT subgroup medulloblastoma), as well as exploring more effective targeted systemic therapies that may allow omission or delay of radiotherapy. Many of these strategies are still under investigation but highlight the importance of continued pre-clinical and clinical studies evaluating the role of radiotherapy in this era of precision oncology.

2021 ◽  
Vol 48 (5) ◽  
pp. 503-510
Brian N. Dang ◽  
Allison C. Hu ◽  
Anthony A. Bertrand ◽  
Candace H. Chan ◽  
Nirbhay S. Jain ◽  

Facial feminization surgery (FFS) incorporates aesthetic and craniofacial surgical principles and techniques to feminize masculine facial features and facilitate gender transitioning. A detailed understanding of the defining male and female facial characteristics is essential for success. In this first part of a two-part series, we discuss key aspects of the general preoperative consultation that should be considered when evaluating the prospective facial feminization patient. Assessment of the forehead, orbits, hairline, eyebrows, eyes, and nose and the associated procedures, including scalp advancement, supraorbital rim reduction, setback of the anterior table of the frontal sinus, rhinoplasty, and soft tissue modifications of the upper and midface are discussed. In the second part of this series, bony manipulation of the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty are discussed. Finally, a review of the literature on patient-reported outcomes in this population following FFS is provided.

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Jeonghwan Shin ◽  
Uk Jang ◽  
Sang Oon Baek ◽  
Jun Yong Lee

A full-thickness skin graft (FTSG) is useful for covering small skin and soft tissue defects. In this paper, we suggest FTSG in consideration of the relaxed skin tension line (RSTL) concept for scar quality improvement since FTSG has disadvantages, including contour irregularities and mismatches of color and texture. We conducted a retrospective chart review of twenty-one patients with skin cancer on the face who underwent wide excision and FTSG by a single surgeon from October 2013 to July 2019. Twenty-one patients with skin cancer on the face were divided into RSTL-matched and RSTL-unmatched groups, and FTSG was performed. Each group was subjected to scar assessment three months after surgery. Observer assessment was performed by five independent observers using the observer component of the patient and observer scar assessment scale (POSAS) and Vancouver scar scale (VSS). Our results indicate that there were significant differences between the RSTL-matched and RSTL-unmatched groups in the VSS and POSAS components. In addition, the RSTL-matched group showed a natural appearance with surrounding tissue in the dynamic animation phase compared to the unmatched group. RSTL-matched FTSG can be an attractive option for face skin and soft tissue defect coverage. (An earlier version of this paper has been presented at the International Conference on PRS Korea 2020.)

2021 ◽  
Vol 14 (9) ◽  
pp. 927
Agustos Cetin Ozbey ◽  
David Combarel ◽  
Vianney Poinsignon ◽  
Christine Lovera ◽  
Esma Saada ◽  

Pazopanib is a potent multi-targeted kinase inhibitor approved for the treatment of advanced renal cell carcinoma and soft tissue sarcoma. The pharmacokinetics of pazopanib is characterized by a significant inter- and intra-patient variability and a target through plasma concentration of 20.5 mg·L−1. However, routine monitoring of trough plasma concentrations at fixed hours is difficult in daily practice. Herein, we aimed to characterize the pharmacokinetic (PK) profile of pazopanib and to identify a target area under the curve (AUC) more easily extrapolated from blood samples obtained at various timings after drug intake. A population pharmacokinetic (popPK) model was constructed to analyze pazopanib PK and to estimate the pazopanib clearance of a patient regardless of the time of sampling. Data from the therapeutic drug monitoring (TDM) of patients with cancer at Institute Gustave Roussy and a clinical study (phase I/II) that evaluates the tolerance to pazopanib were used. From the individual clearance, it is then possible to obtain the patient’s AUC. A target AUC for maximum efficacy and minimum side effects of 750 mg·h·L−1 was determined. The comparison of the estimated AUC with the target AUC would enable us to determine whether plasma exposure is adequate or whether it would be necessary to propose therapeutic adjustments.

2021 ◽  
Sorapong Aootaphao ◽  
Saowapak Thongvigitmanee ◽  
Puttisak Puttawibul ◽  
Pairash Thajchayapong

Abstract Background: Iterative reconstruction for cone-beam computed tomography (CBCT) has been applied to improve image quality and reduce radiation dose. In a case where an object is larger than a flat panel detector, most CBCT images contain truncated data or incomplete projections, which degrade image quality. In this work, we propose the truncation effect reduction for fast iterative reconstruction in CBCT imaging inside the field of view (FOV).Methods: The volume matrix size of FOV and the height of projection images were extrapolated to a suitable size. These extended projections were reconstructed by fast iterative reconstruction. Moreover, a smoothing parameter for noise regularization in iterative reconstruction was also modified to reduce the accumulated error while processing. The proposed work was evaluated by image quality measurements and compared with the conventional filtered back projection (FBP) method. To validate the proposed method, we used a head phantom for evaluation and tested on real human head data. Results: In the experimental results, the reconstructed images from the head phantom can be enhanced apparently. In addition, fast iteration reconstruction can be run continuously while remaining the consistent mean-percentage-error (MPE) value with a large number of iterations. The CNR of the soft-tissue images was improved by the increased contrast and the decreased noise. Visualization of low contrast in the ventricle and soft-tissue images can be observed much clearer compared to those from FBP using the same effective radiation dose of 5 mGy. Conclusions: Our proposed work has satisfactory performance to reduce the truncation effect, especially inside the FOV with better image quality for soft-tissue imaging. The convergence of fast iterative reconstruction tends to be stable for many iterations.

ESMO Open ◽  
2021 ◽  
Vol 6 (5) ◽  
pp. 100258
E. Younger ◽  
R.L. Jones ◽  
D. den Hollander ◽  
V.L.M.N. Soomers ◽  
I.M.E. Desar ◽  

2021 ◽  
pp. 20210268
Sohaib Shujaat ◽  
Michael M. Bornstein ◽  
Jeffery B. Price ◽  
Reinhilde Jacobs

The digital workflow process follows different steps for all dental specialties. However, the main ingredient for the diagnosis, treatment planning and follow-up workflow recipes is the imaging chain. The steps in the imaging chain usually include all or at least some of the following modalities: cone-beam computed tomographic data acquisition, segmentation of the cone-beam computed tomography image, intraoral scanning, facial three-dimensional soft tissue capture and superimposition of all the images for the creation of a virtual augmented model. As a relevant clinical problem, the accumulation of error at each step of the chain might negatively influence the final outcome. For an efficient digital workflow, it is important to be aware of the existing challenges within the imaging chain. Furthermore, artificial intelligence-based strategies need to be integrated in the future to make the workflow more simplified, accurate and efficient.

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