The Diagnostic Value of 18F-FDG PET/CT Bone Marrow Uptake Pattern in Detecting Bone Marrow Involvement in Pediatric Neuroblastoma Patients

Objectives. To explore the diagnostic value of 18F-FDG PET/CT bone marrow uptake pattern (BMUP) in detecting bone marrow involvement (BMI) in pediatric neuroblastoma (NB) patients. Methods. Ninety-eight NB patients were enrolled in BMI analysis. Four patterns of bone marrow uptake were categorized based on pretreatment cF-FDG PET/CT images. Some crucial inspection indexes and 18F-FDG PET/CT metabolic parameters were analyzed. The BMUP was divided into BMUP1, BMUP2, BMUP3, and BMUP4. Paired-like homeobox 2b (PHOX2B) of bone marrow and blood, bone marrow biopsy (BMB) result, and 18F-FDG PET/CT were compared to detect BMI. All patients were followed up for at least six months. Results. BMUP had excellent consistency among different physicians. Kappa coefficients of two residents and two attending physicians and between the resident and attending physician, were 0.857, 0.891, and 0.845, respectively. The optimal cut-off value of SUVmax-Bone/Liver was 2.08 to diagnose BMI for BMUP3 patients, and the area under curve (AUC) was 0.873. AUC of PHOX2B of bone marrow (PHOX2B of BM), PHOX2B of blood, BMB, and 18F-FDG PET/CT were 0.916, 0.811, 0.806, and 0.904, respectively. There was no significant difference between PHOX2B of BM and PET/CT. Positive predictive value, negative predictive value, sensitivity, and specificity in diagnosis of BMI were 92.9%, 92.9%, 97.0%, and 83.9% for PET/CT and 96.7%, 80.6%, 89.6%, and 93.5% for PHOX2B of BM, respectively. Conclusions. BMUP of pretreatment 18F-FDG PET/CT is a simple and practical method, which has a relatively high diagnostic efficiency in detecting BMI and might decrease unnecessary invasive inspections in some pediatric NB patients.

Diagnostic Evaluation of 99mTc-TRODAT-1 SPECT in Parkinsonism

Background Parkinsonism as a group of movement disorders, exhibit similar clinical presentation. Therefore, clinically differentiating these diseases is difficult. We investigated the diagnostic value of 99m Tc-TRODAT-1 SPECT in this setting. Due to the fact that this modality has some limitations in imaging small organs like the sub-regions of basal ganglia, we also evaluated the use of anatomical MR imaging along with functional SPECT imaging in parkinsonism. Methods This follow-up diagnostic test evaluation study was performed with 40 patients with the clinical presentation of parkinsonism, and 10 healthy subjects as controls. After administration of the radiopharmaceutical, SPECT images were acquired, then co-registered on MRI. Uptake values were evaluated in basal ganglia semi-quantitatively. Results In this study, 99mTc-TRODAT-1 SPECT was able to differentiate essential tremor and healthy subjects from progressive supranuclear palsy (PSP) and Parkinson’s disease (PD) with a sensitivity of 76.47% and specificity of 100% at a cut-off of 0.53; however, findings were not significant in differentiation of PD from PSP (p ˃0.05), and the results were similar in SPECT and co-registered MRI/SPECT images. In evaluation of the uptake pattern in basal ganglia, the lateralization of decreased uptake was only seen in PD; and in PSP, the dysfunction was bilateral in all patients. Conclusion 99mTc-TRODAT-1 SPECT is sensitive and specific in diagnosing basal ganglia dysfunction; however, 99mTc-TRODAT-1 SPECT alone or co-registration on MRI are not adequate in differentiation of the etiologies of basal ganglia dysfunction.

The valve uptake index: a new measure in [18F]FDG PET/CT for the diagnosis of prosthetic valve endocarditis

Background Diagnosis of PVE by PET/CTA is based on visual and quantitative evaluation of morpho-metabolic features. The FDG uptake pattern is a main diagnostic criterion, but can be visually unclear and susceptible to subjectivity. The valve uptake index (VUI) is a new measure designed to provide a more objective indication of the distribution of metabolic activity. Purpose To validate the diagnostic accuracy of the valve uptake index (VUI) (SUVmax-SUVmean)/SUVmax, in patients with suspicion of prosthetic valve endocarditis (PVE). To establish a cut-off value that allows diagnosis of infection. Finally, to determine the incremental value of adding the VUI to the classic parameters for the diagnostis of PVE by PET/CT. Methods Retrospective analysis of 122 patients, with a conclusive diagnosis of definite or rejected PVE and who had undergone a cardiac PET/CTA scan. We measured the VUI and recorded the SUVmax, SUVratio, uptake pattern and the presence of endocarditis-related anatomic lesions. The diagnostic accuracy of these parameters was calculated. Results The VUI values were 0.54±0.1 vs. 0.36±0.08 in the definite PVE group vs. the rejected group, respectively (mean±SD; p<0.001). A cut-off value of VUI>0.45 showed a sensitivity, specificity and diagnostic accuracy for PVE of 85%, 90.3% and 87.4%, and significantly increased diagnostic ability for confirming endocarditis when combined with the standard diagnostic criteria. Conclusions The VUI had good diagnostic accuracy for PVE. The diagnostic power of currently used morphometabolic parametersis significantly increased by the addition of the VUI. Integration of the VUI in the diagnostic algorithm may clarify doubtful cases, and improve the diagnostic yield of PET/CTA. FUNDunding Acknowledgement Type of funding sources: None.

Diagnostic Performance of Three-Phase Bone Scintigraphy and Digital Infrared Thermography Imaging for Chronic Post-Traumatic Complex Regional Pain Syndrome

This study aimed to evaluate the diagnostic performance of three-phase bone scintigraphy (TPBS) and digital infrared thermography imaging (DITI) in the chronic post-traumatic CRPS and propose new imaging diagnostic criteria that combine the two tests. We retrospectively enrolled 44 patients with suspected symptoms of CRPS from various injuries during obligatory military service. We analyzed the following findings: (1) uptake pattern on TPBS, (2) uptake ratios of affected and unaffected sides in each phase of TPBS, (3) difference in body skin temperature on DITI. New criteria combining the above findings were also evaluated. Eighteen patients were finally defined as CRPS according to the Budapest criteria. Uptake pattern and uptake ratio in blood pool phase on the TPBS were significantly different between CRPS and non-CRPS groups (both p < 0.05). The DITI could not discriminate significantly between the groups (p = 0.334). The diagnostic criteria considering both the pattern analysis and quantitative analysis in TPBS exhibited the highest positive likelihood ratio. On the other hand, the diagnostic criteria combining DITI and TPBS showed the lowest negative likelihood ratio value. TPBS can be useful in diagnosing chronic post-traumatic CRPS. Moreover, we can suggest that different diagnostic criteria be applied depending on the purpose.

Foliar Water Uptake in the Needles of Pinus Torreyana

In semi-arid climate systems that encounter low clouds or fog, many plants have adapted to capture atmospheric moisture on the foliar surface. The natural habitat of Pinus torreyana, the Torrey pine, is restricted to two locales in coastal Southern California that experience substantial fog and low clouds during the dry months of a Mediterranean climate. In this study, droplet contact angles were used to assess surface wettability, and droplet uptake was used to measure the foliar water uptake rate along a needle. We demonstrated that there are only remnants of epicuticular wax on the needle. The results showed that the needle surface of P. torreyana, including under the base sheath, is hydrophilic and capable of direct water uptake. There are small spatial gradients in the uptake pattern, but the variability is high and the statistical significance is not strong. However, the decrease in uptake at higher contact angles can be described by an ordinary linear regression (r2 = 0.45, p = 4 x 10-8). On average, the foliar uptake of the adaxial surface of a one-year-old needle is 2.88 ± 0.60 x 10-2 mg cm–2s–1. In comparison, the uptake rates by the adaxial surfaces of four local broadleaf plants are between 0.05 and 0.6 of that of P. torreyana.

Moisture Sources for the Explosive Cyclogenesis of Extratropical Cyclone Miguel (2019) through a Lagrangian Approach

In this study, the moisture sources for the explosive cyclogenesis Miguel that occurred during 4–9 June 2019 in the North Atlantic were investigated. To determine the moisture sources, the Lagrangian FLEXPART particle dispersion model was used. The moisture uptake pattern revealed the western North Atlantic Ocean extending to north-western North America, the south-eastern coast of Greenland, and the central North Atlantic Ocean around 45° N and 50°–20° W as the main moisture sources for Miguel explosive cyclogenesis. Furthermore, the moisture uptake from these regions was higher than the climatology. During the intensification of Miguel, the moisture contribution from oceanic sources was higher than terrestrial sources. Although the total amount of atmospheric moisture achieved during the explosive intensification was similar to that absorbed the 24 h prior, they changed in intensity geographically, being more intense the local support over central and northern North Atlantic basin.

Comparison of amino acid radiotracers L-[methyl-11 C]methionine and О-2-[18F]fluoroethyl-L-tyrosine for PET/CT imaging of cerebral gliomas

Introduction. The radiotracer L-[methyl-11C]methionine (Met) has long been considered the tracer of choice in CNS tumors diagnosis using positron emission tomography, combined with computed tomography (PET/CT). However, there are more and more logistic arguments for the introduction of fluorinated amino acids into diagnostics, in particular, O-2-[18F]fluoroethyl-L-tyrosine (FET), for which our institute has developed its own method of radiochemical synthesis. The aim of the study was to compare amino acid radiotracers L-[methyl-11C]methionine (Met) and O-2-[18F]fluoroethyl-L-tyrosine (FET) in the imaging of cerebral gliomasusing PET/CT. Materials and methods. PET/CT studies using Met and FET were performed in 36 patients (15 men and 21 women) aged 28 to 73 years with suspected intracerebral tumor before surgery of biopsy. Pathohistologicalstudy verified gliomas(n-31) or other tumors (n=3), inflammatory process (n=2). The analysis of results included visual comparison of images, calculation of the tumor-to-brainratio (TBR) and metabolic tumor volume for Met and PET. Results. Visual and quantitative analysis of the scans revealed that tumor uptake pattern of FET was similar to those of Met. No significant differences were found in the TBR of both radiotracers in tumors of different grades of malignancy. A strong significant correlation (r=0,9) was revealed between the TBR of Met and FET in gliomas. There were no significant differences between tumor metabolic volumes when using the same cutoff values for both radiotracers. The ROC analysis established the same diagnostic value of Met and FET in differentiating low and high grade gliomas (area under curve 0,884 and 0,881, respectively). Conclusion. Amino acid radiotracers provide comparable diagnostic information in preoperative imaging of gliomas using PET/CT, which makes it possible to recommend FET as an adequate alternative to Met for PET centers without on-site cyclotron.

Interactive effects of rice bran compost and chemical fertilizers on macronutrients, oil and protein content in sunflower (Helianthus annuus L.)

A field experiment was conducted at the research farm of Charfasson Govt. College, Bhola, Bangladesh in rabi season in 2015-2016 to evaluate the impact of conjunctive use of chemical fertilizers with rice bran on concentration, uptake and seed quality of sunflower cv. BARI-2 (Keroni-2). The experiment was laid out in the randomized complete block design (RCBD) having sixteen treatments with three replications. The size of the plots were 3 m x 2 m. Treatments were T1 Control (- RB and -NPK), T2: 2.5 t RB ha-1, T3: 5.0 t RB ha-1,T4: 7.5 t RB ha-1, T5: N40P30K50 kg ha-1,T6: N80P60K100 kg ha-1, T7: N120P90K150 kg ha-1, T8: 2.5 t RB ha-1 + N40P30K50 kg ha-1, T9: 2.5 t RB ha-1 + N80P60K100 kg ha-1, T10: 2.5 t RB ha-1 + N120P90K150 kg ha-1, T11: 5.0 t RB ha-1 + N40P30K50 kg ha-1, T12: 5.0 t RB ha-1 + N80P60K100 kg ha-1, T13: 5.0 t RB ha-1 + N120P90K150 kg ha-1, T14: 7.5 t RB ha-1 + N40P30K50 kg ha-1, T15: 7.5 t RB ha-1 + N80P60K100 kg ha-1, T16: 7.5 t RB ha-1 + N120P90K150 kg ha-1. Results showed that the concentration, uptake and quality of seeds (oil and protein) of the crop increased with increasing rate of the amendments significantly (P<0.05) over the control and the variation between the treatments were also significant irrespective of the sources of amendments in most of the cases. Generally, combination of the treatments showed better performance than their individual application. Maximum values of NPKS concentration (%) in different organs of sunflower were 1.22, 0.35, 1.90, 0.18 for stem; 1.17, 0.35, 2.41, 0.16 for root; 3.98, 0.43, 4.28, 0.24 for leaf, 1.04, 0.65, 3.00, 0.22 for petiole; 2.16, 0.58, 2.21, 0.26 for inflorescence and 5.24, 0.83, 1.60, 0.47 for seed measured in treatments 5.0 t RB ha-1 + N120P90K150 kg ha-1 and 7.5 t RB ha-1 + N120P90K150 kg ha-1 in most of the cases. However, their uptake pattern also followed the same trend as in concentration and the highest values were found in those treatments in most of the cases. Significantly (P<0.05%) the highest content of oil (51.1%) in seed was measured in the treatment 5.0 t RB ha-1 + N120P90K150 kg ha-1 and protein (33.9%) was found in the treatment 5.0 t RB ha-1 +N80P60K100 kg ha-1. Their lowest values were found in control for oil and in 2.5 t RB ha-1 for protein, which was lower than control treatment. The overall findings of this study indicated that rice bran in combination with chemical fertilizers could be applied to achieve better concentration and uptake in different organs, oil and protein content in seeds of sunflower. Int. J. Agril. Res. Innov. Tech. 10(2): 91-99, December 2020

Characterization of 18-fluorodeoxyglucose uptake pattern in infective endocarditis after transcatheter aortic valve implantation

Funding Acknowledgements Type of funding sources: None. Background 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18-FDG-PET/CT) has been included in the modified Duke criteria to improve the diagnosis of prosthetic valvular endocarditis. However, accuracy of 18-FDG-PET/CT have only been validated in patients with a surgical prosthesis and limited data exist for infective endocarditis related to transcatheter aortic valve implantation (IE-TAVI). Methods The study prospectively included 45 patients who underwent 18-FDG-PET/CT after TAVI. The population was divided in two groups. The control group included 31 consecutive patients who perfomed a 18-FDG-PET/CT at one after TAVI implantation. The endocarditis group included 14 consecutive patients admitted for IE-TAVI suspicion. The final diagnosis of IE-TAVI was established by the Endocarditis-Team after 3-month follow-up. Results In the control group, 77% (n = 24/31) of patients did not present 18-FDG uptake at one month. 18-FDG uptake was more observed in patients with a conduction abnormality after TAVI (71% [n = 5/7] vs. 17% [n = 4/24], p = 0.01). In the endocarditis group, 18-FDG-PET/CT was positive in all definite-IE (n = 7) and one with rejected-IE (n = 7). Interestingly, the latter patient presented conduction abdormality after TAVI. The SUVmax and the SUV ratio were similar in definite-IE and positive control examinations. In contrast, all uptakes in definite-IE were focal with small spots of uptake (&lt;25% of the aortic valve circumference) whereas 18-FDG uptake was large and unique (&gt;50% of the aortic valve circumference) in control and rejected-IE. Conclusion Positive 18-FDG-PET/CT examination is uncommon one month after TAVI procedure and the 18-FDG uptake pattern can be easily differentiated from definite-IE. These results indicate that 18-FDG-PET/CT may be used before the 3 months after TAVI procedure to accurately identify IE-TAVI. Abstract Figure.