bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Related to Prescription Drug Monitoring Program Queries for Veterans Receiving Long-Term Opioid Therapy
Authors: Andrea Sarah B , Gilbert Tess A , Morasco Benjamin J , Saha Somnath , Carlson Kathleen F
Published: September 2020

Objective

State prescription drug monitoring programs (PDMPs) identify controlled medications dispensed across providers and systems. Department of Veterans Affairs (VA) policy requires electronic health record documentation of PDMP queries at least annually for VA patients receiving controlled medications; however, queries are not uniformly conducted. We examined factors associated with PDMP queries for veterans receiving long-term opioid therapy.

Methods

Veterans with a VA provider who received long-term opioid therapy between August 2015 and August 2016 within a four-state region were identified; 9,879 were due for a PDMP query between August 2016 and February 2017. Likelihood of veterans’ PDMP queries during this follow-up period was modeled as a function of patient, provider, and facility characteristics of interest in mixed-effects modified Poisson models estimating relative risk and 95% confidence intervals. Multivariable models controlled for potential confounders identified through the use of directed acyclic graphs.

Results

PDMP queries were documented for 62.1% of veterans that were due for a PDMP query. Veterans were more likely to be queried if they were Hispanic or if they received methadone, had average daily milligram morphine equivalents >20, or received urine drug screening during the studied period. Veterans were less likely to be queried if they had a rural address, mail order medication, or cancer diagnosis. Likelihood of PDMP queries was also lower for veterans whose opioid-prescribing provider was an oncologist or working in a low-complexity facility.

Conclusions

Adherence to PDMP query policy within the VA varied by patient, clinician, and facility factors. Mechanisms to standardize the conduct of PDMP queries may be needed.
Relevance and Verification
Authors: Blumson Ben
Published: September 2020

A. J. Ayer’s empiricist criterion of meaning was supposed to have sorted all statements into nonsense on the one hand, and tautologies or genuinely factual statements on the other. Unfortunately for Ayer, it follows from classical logic that his criterion is trivial—it classifies all statements as either tautologies or genuinely factual, but none as nonsense. However, in this paper, I argue that Ayer’s criterion of meaning can be defended from classical proofs of its triviality by the adoption of a relevant logic—an idea which is motivated because, according to Ayer, the genuinely factual statements are those which observation is relevant to.
Cost-effectiveness of on-site musculoskeletal ultrasound in an outpatient rheumatology clinic
Authors: Acebes Carlos , Rubio Laura , Román Almudena , Herrero Antonio , Arcos Javier
Published: September 2020

Objective

To evaluate the impact of the routine use of musculoskeletal ultrasound (MSUS) in rheumatology clinics by comparing one clinic with on-site MSUS (REU 1) and four clinics without this resource, which need to refer patients for the MSUS exams (REU 2–5).

Methods

The electronic medical records of all new patients at five rheumatology clinics during a 12-month period were reviewed. The impact of MSUS was analysed by comparing the percentage of direct discharges of patients from the different clinics, as an outcome of effectiveness, and the number and cost of radiology referrals for imaging exams (MSUS and MRI), as an outcome of cost-saving.

Results

The medical records of 4923 patients were included in the study, distributed as follows: REU 1, 1464 (29.7%); REU 2, 1042 (21.2%); REU 3, 1089 (22.1%); REU 4, 579 (11.8%); and REU 5, 749 (15.2%). There were more direct discharges from REU 1 (34.4%) than from REU 2–5 (15.6%) (P<0.001). REU 1 made radiological referrals for X-rays, MRIs or MSUS exams in 773 (52.8%) patients, compared with 2626 (75.9%) patients in REU 2–5 (P<0.001). An estimation of costs for the clinical assessment of 1000 new patients revealed a cost-saving in REU 1 of €21 413 in MSUS and of €877 in MRI exams.

Conclusion

The implementation of on-site MSUS in a new-patient rheumatology clinic is cost-effective, facilitating the direct discharge of patients and reducing the number and cost of radiological referrals for imaging exams.
Nontyphoidal Salmonella Osteomyelitis in an Immunocompetent Adult Without Preceding Symptoms
Authors: Hanssen Jaap L. J. , Anten Sander , Stollenwerck Guido , Kuijpers Laura M. F.
Published: September 2020

A 23-year-old man presented with a painful swelling of his left shin approximately 5 weeks after a very mild trauma. He had not experienced fever, abdominal pain, or diarrhea. Magnetic resonance images were compatible with chronic osteomyelitis. The cultures of the bone biopsy showed growth of Salmonella enterica serovar Enteritidis. Blood cultures remained sterile, there were no signs of a carrier state, and no immune deficiency could be found. After surgical debridement, the patient was treated with ceftriaxone and co-trimoxazole and later ciprofloxacin because of an allergic reaction. Nontyphoidal Salmonella osteomyelitis is rare in immunocompetent adults without a hemoglobinopathy. The treatment consists of surgical debridement and prolonged antibiotics.
The Use of Debates in an Online Nursing Course
Authors: George Tracy P. , Munn Allison C. , Phillips Tiffany A.
Published: September 2020

Background

It is important to foster active participation in online graduate nursing courses through creative teaching strategies, such as virtual synchronous debates.

Method

A free videoconferencing system was used to complete the virtual synchronous debates. Demographic information and survey data were obtained to assess the impact of an online debate on critical thinking and presentation skills.

Results

Seven of the 10 scored survey items had statistically significant differences in preimplementation and postimplementation ranked scores. Five qualitative themes were revealed: predebate anxiety/nervousness, technical issues/online format, learning experience, improved presentation skills, and group work.

Conclusion

Through virtual synchronous debates, graduate nursing students can gain a stronger appreciation for ethical issues in health care, learn to succinctly convey their views, and increase their confidence in presenting a professional argument.
Histopathologic Characterization of Bladder Perivascular Epithelioid Cell Neoplasms (PEComa)
Authors: Neumann Neil M. , Haffner Michael C. , Argani Pedram , Kao Chia-Sui , Epstein Jonathan I.
Published: September 2020

Perivascular epithelioid cell neoplasms (PEComas) of the bladder are extremely rare, with ~30 case reports. A subset of PEComas contain TFE3 gene rearrangement, however, the distinct histomorphologic features of these translocation tumors has not been fully explored in bladder PEComas. In our series, 11 cases of bladder PEComas were collected, including 1 internal and 10 consults, with 1 case previously reported. There was a female predominance (9 female, 2 male) with a mean age of 44.2 years (24 to 61 y). In only 1 of the 10 consult cases was PEComa considered in the differential diagnosis. In 10 of 11 cases, prominent epithelioid features were noted, with the final case having focal epithelioid morphology. Mitotic rate was increased in 2 of 11 cases, and 2 of 11 cases had cytological atypia. Two cases were malignant, with invasion into perivesicle tissue in 1 case, and metastases to lungs and brain followed by death in the other case. Immunohistochemically, there was strong, and diffuse staining for cathepsin K in 10/11 cases with the 1 negative case restained on a previously stained slide. HMB-45 was diffusely positive in 8/11 cases, while melan-A was present in only 1/10 cases. Muscle markers were variably expressed with positivity for both smooth muscle actin in 6/10 cases and desmin in 3/10 cases. Keratin AE1/3 was uniformly negative (0/11). In 5/8 cases where TFE3 was rearranged by fluorescence in situ hybridization, the morphology had a predominantly epithelioid, nested architecture. Overall, bladder PEComas are particularly difficult to diagnose given their rarity, are predominantly epithelioid and do not always express melanocytic markers. Diagnosis in the bladder requires a combination of morphologic characterization, exclusion of other diagnostic possibilities, positive Cathepsin K staining, variable melanocytic marker expression, with some cases showing a TFE3 gene rearrangement.
68Ga-DOTATATE PET/MRI for Neuroendocrine Tumors
Authors: Nguyen Nghi C. , Moon Chan-Hong , Muthukrishnan Ashok , Furlan Alessandro
Published: September 2020

Neuroendocrine tumors (NETs) constitute a variety of neoplastic entities and exhibit variable degrees of neuroendocrine differentiation and phenotypes, as well as genetic profiles. 68Ga-DOTATATE PET is a novel imaging technique for NET. Although PET/CT is commonly utilized for oncologic imaging, PET/MRI is particularly suited for NETs, as MRI provides greater soft tissue contrast than CT, allowing for improved detection and characterization of NETs, particularly when liver metastasis is suspected or needs to be ruled out. The current pictorial review aims to illustrate the complementary advantages, as well as pitfalls of 68Ga-DOTATATE PET/MRI in the evaluation of NETs.
Scrotal Sac Metastasis in Adenocarcinoma Prostate
Authors: Tripathy Sarthak , Prakash Sneha , Angamathu Meivel , Kumar Arunav , Shamim Shamim Ahmed
Published: September 2020

Metastasis to the scrotal sac is a very rare phenomenon. We present a case of a 45-year-old man diagnosed with locally advanced acinar adenocarcinoma prostate, post bilateral orchidectomy and radiotherapy treatment, who showed a rising trend of serum PSA levels with discovery of scrotal sac metastasis on serial 68Ga–prostate-specific membrane antigen PET/CT scans.
Incidentally Detected 18F-PSMA Uptake in Glomus Jugulare
Authors: Zade Anand , Trivedi Chintan , Ingule Amol , Jha Smriti , Agrwal Anup
Published: September 2020

PSMA (prostate-specific membrane antigen) PET/CT scan is the imaging modality of choice for staging and restaging of carcinoma prostate. Although initially thought to be a tracer with high specificity for prostatic tissue, with its extensive clinical use, there has been a rise in published literature citing its uptake in nonprostatic conditions. We present a case where false-positive PSMA uptake was noted in glomus jugulare during staging workup for carcinoma prostate.
Rare Case of Testicular Sarcoidosis Detected on FDG PET/CT in a Patient With PUO
Authors: Parida Girish Kumar , Kumar Adarsh , Mitra Sujata , Suman Akchata , Muthu G. Sonai
Published: September 2020

Genitourinary sarcoidosis is an uncommon entity, and testicular sarcoidosis is even rarer. We present a case of 66-year-old man who presented to our hospital as PUO (pyrexia of unknown origin) and later diagnosed as testicular sarcoidosis with the help of FDG PET/CT.
A Case of Localized Malignant Peritoneal Mesothelioma With Lung Cancer Detected by 18F-FDG PET/CT
Authors: Kobayashi Shimizu Shotaro , Okamura Terue , Koyama Koichi , Seura Hirotaka , Nishida Norifumi
Published: September 2020

A 62-year-old woman was referred for cough and lower abdominal pain. 18F-FDG PET/CT showed strong uptake not only in the left lung mass and hilar and mediastinal lymph nodes, but also a huge lower abdominal mass. All lesions were initially thought to be multiple metastases because bronchial biopsy of the lung mass showed poorly differentiated adenocarcinoma. However, the abdominal mass was found to be malignant peritoneal mesothelioma after surgical resection. It was difficult to diagnose this case correctly before resection because localized malignant peritoneal mesothelioma is rare.
Prominent Bone Marrow Metastases Without Concurrent Intra-Chest Metastasis in a Case of Cardiac Angiosarcoma
Authors: Cheng Junjun , Ou Xiaohong
Published: September 2020

Primary cardiac angiosarcoma is rare and often advances by dissemination. Lungs are the most common metastatic sites, especially when the tumor originates in the right side of the heart. Bone metastases from cardiac angiosarcoma very rarely occur without concurrent pulmonary metastases. We report a case of cardiac angiosarcoma having prominent bone metastases without concurrent pulmonary lesions, as demonstrated by FDG PET/CT scan.
68Ga-DOTATATE and 18F-FDG PET/CT for the Management of Esthesioneuroblastoma of the Sphenoclival Region
Authors: Dadgar Habibollah , Norouzbeigi Nasim , Ahmadzadehfar Hojjat , Assadi Majid
Published: September 2020

We present a 48-year-old woman with an olfactory neuroblastoma who was referred for accurate staging using PET/CT. The 68Ga-DOTATATE PET/CT showed a 51 × 32-mm mass with an SUVmax of 7.59 in the sphenoidal sinuses, whereas radiotracer uptake on 18F-FDG PET/CT was similar to that of brain tissue. 68Ga-DOTATATE PET/CT might be especially useful in regions with difficult tumor visualization resulting from high background, such as brain tissue. The results of this case may suggest that somatostatin receptor imaging in patients with esthesioneuroblastoma may facilitate the potential application of radiotheranostic agents for the treatment of this aggressive subtype of tumors.
Incidental Finding of COVID-19 Lung Infection in 18F-FDG PET/CT
Authors: Habouzit Vincent , Sanchez Alicia , Dehbi Sabrina , Prevot Nathalie , Bonnefoy Pierre-Benoît
Published: September 2020

We report the case of an asymptomatic (no fever, no cough, no dyspnea) 80-year-old woman who had an 18F-FDG PET/CT scan for initial staging of Lieberkühnian adenocarcinoma located on anal canal. Chest analysis incidentally revealed bilateral diffuse patchy ground-glass opacity with mild increasing 18F-FDG uptake, consistent with incidental COVID-19 infection finding during the March 2020 pandemic. The infection was confirmed by reverse transcription–polymerase chain reaction. It led us to improve patient flow and to undertake broader measures to avoid patient clinical issues and potential disease spreading.
18F-FDG PET/MRI of Rhinosporidiosis of the Upper Airways
Authors: Cazzador Diego , Cecchin Diego , Colangeli Roberta , Crimì Filippo , Emanuelli Enzo
Published: September 2020

A 41-year-old man from South Asia presented with a several months’ history of unilateral nasal obstruction and bleeding. At nasal endoscopy, two strawberry-like, friable, polypoid masses in the upper airways were detected. The patient’s clinical trait was compatible with an infectious disease. 18F-FDG PET/MRI was performed to evaluate the disease extension. Two lesions occupying the nasal cavity and the nasopharynx, slightly hyperintense in T2-weighted sequences, with intense radiopharmaceutical uptake were evidenced. Endoscopic resection was performed with histopathologic diagnosis of rhinosporidiosis, a chronic granulomatous disease caused by Rhinosporidium seeberi. Although rare, rhinosporidiosis should be considered in the differential diagnoses of sinonasal hypermetabolic lesions.
18F-FDG PET/CT Metabolic Behavior of COVID-19 Pneumonia
Authors: Albano Domenico , Camoni Luca , Rinaldi Roberto , Bertagna Francesco , Giubbini Raffaele
Published: September 2020

Between March 26 and April 6, among 80 patients who underwent 18F-FDG PET/CT in our department (Brescia, Italy), 4 showed the presence of an interstitial pneumonia suspected for COVID-19 with reverse transcriptase polymerase chain reaction confirmation. All patients except one had bilateral ground-glass opacities and/or lung consolidations in at least 2 pulmonary lobes. Inferior lobes and basal segments were the most frequent site of disease. All lung lesions had an increased FDG uptake corresponding to the interstitial pneumonia, and in one case, mediastinal nodal involvement was registered.
COVID-19
Authors: Sinha Partha , Sinha Shyamashree , Schlehr Evemarie , Schlehr James M.
Published: September 2020

A 73-year-old man with chronic obstructive pulmonary disease and no known malignancies was evaluated for back pain. MR examination showed lumbar spine compression fractures, and an 18F-FDG PET/CT scan was requested to assess for skeletal metastatic disease and potential detection of a primary neoplasm. The PET/CT examination revealed scattered FDG-avid pulmonary opacities with upper lobe preponderance highly suspicious for COVID-19. Real-time polymerase chain reaction testing of nasopharyngeal swabs confirmed the diagnosis.
Isolated Lymph Node Amyloidosis
Authors: Tripathy Sarthak , Bharadwaj Mangu , Prakash Sneha , Pramanik Raja , Mittal Abhenil , Shamim Shamim Ahmed
Published: September 2020

Amyloidosis is a disorder resulting from the deposition of fibrillary protein in the extracellular tissue and can be classified into primary, secondary, familial, and senile types. Isolated lymph node amyloidosis without any other organ involvement is very rarely seen in clinical parlance, and diagnosis remains very challenging owing to nonspecific imaging findings. We present a case of 50-year-old man with lymphadenopathy, which was later confirmed to be amyloidosis on biopsy and serum-free light chain assay with efficacious use of 18F-FDG PET/CT for response assessment to bortezomib, cyclophosphamide, and dexamethasone.
The Correlation of Salivary Gland Uptake Between 18F-FP-CIT PET/CT and Salivary Scan
Authors: Kang Seo Young , Yun Ji Young , Kim Hye Ok , Moon Byung Seok , Yoon Hai-Jeon , Kim Bom Sahn
Published: September 2020

An 85-year-old woman visited our hospital with repetitive diarrhea, nausea, and anorexia, as well as aggressive behavior. The neurologist decided to perform dopamine transporter imaging (18F-FP-CIT PET/CT) for accurate diagnosis, taking into account the potential adverse effects of l-dopa that the patient had been taking for a long time. The uptake of dopamine transporter in the bilateral basal ganglia was well preserved, but reduced uptake in the left parotid gland was incidentally detected. A subsequent salivary scan showed reduced uptake in the left parotid gland with the same pattern as that on 18F-FP-CIT PET/CT.
18F-THK5351 PET Can Identify Lesions of Acute Traumatic Brain Injury
Authors: Takami Yasukage , Yamamoto Yuka , Norikane Takashi , Mitamura Katsuya , Hatakeyama Tetsuhiro , Nishiyama Yoshihiro
Published: September 2020

A 67-year-old woman sustained a mild traumatic brain injury (TBI) in a traffic accident and had an initial Glasgow Coma Scale score of 13. She underwent 18F-THK5351 PET 18 days after TBI. Fused 18F-THK5351 PET/MRI showed that the location of 18F-THK5351 accumulations corresponded anatomically to intraparenchymal lesions of acute TBI on MRI. 18F-THK5351 reportedly binds to monoamine oxidase B highly expressed in astrocytes. Furthermore, TBI induces reactive astrogliosis or blood-brain barrier breakdown included in primary brain injury. Therefore, 18F-THK5351 uptake may represent primary brain injury in acute TBI lesions.
Feasibility of 177Lu Therapy Monitoring Using Fast Whole-Body SPECT Recordings Provided by a High-Speed 360° CZT Camera
Authors: Chevalier Elodie , Boursier Caroline , Claudin Marine , Marie Pierre-Yves , Imbert Laetitia
Published: September 2020

The whole-body absolute quantification of 177Lu-DOTATATE therapy was achieved using a high-speed 360° CZT SPECT/CT system. Twelve high-resolution swelling detectors may be positioned close to patients, providing a high-count sensitivity that is particularly advantageous for the low-count rate conditions of 177Lu imaging. After initially validating 177Lu quantification on phantom, serial whole-body SPECT/CT acquisitions of only 20 minutes were obtained for a 70-year-old woman treated by 177Lu-DOTATATE injections for a metastatic recurrence of a pancreatic neuroendocrine tumor. The progressive decrease in tumor uptake between the consecutive 177Lu-DOTATATE injections could be quantified, and thereby the corresponding dosimetry changes could be estimated.
Typical Acute Traumatic Fracture Healing in an 83-Year-Old Man Undergoing 223Ra Treatment for Prostatic Cancer Bone Metastases
Authors: Minekawa Thaís , Lima Mariana , Moraes André , Santos Allan , Etchebehere Elba
Published: September 2020

We report the case of a fracture healing after 223Ra in an 83-year-old wheelchair-bound man with prostate castration-resistant adenocarcinoma treated due to uncontrollable pain from widespread bone metastases. The patient fractured both right tibia and fibula 15 days prior to the first 223Ra cycle. After the first cycle, there was complete remission of his metastatic bone pain; after the second cycle, he began walking with support, which helped improve fracture healing; and after the third cycle, he presented complete mobility. Posttreatment images showed consolidated fractures. By improving metastatic bone pain with 223Ra, consolidation of the insufficiency fracture was possible.
Expression of CXCR4 Receptors in Refractory Atypical Mediastinal Carcinoid
Authors: Krishnaraju Venkata Subramanian , Satapathy Swayamjeet , Sood Ashwani , Das Chandan Krushna , Chatterjee Debajyoti , Shukla Jaya , Mittal Bhagwant Rai
Published: September 2020

Primary neuroendocrine tumor of the mediastinum is a relatively rare entity. In metastatic/inoperable disease, therapeutic options are limited to cytotoxic chemotherapy in poorly differentiated tumors and peptide receptor radionuclide therapy in case of well-differentiated tumors. We present the case of a 52-year-old man with mediastinal atypical carcinoid (grade II) neuroendocrine tumor showing mild somatostatin receptor expression and intense FDG avidity with progressive disease on chemotherapy. Chemokine receptor targeted PET/CT with CXCR4 (68Ga-CXCR4) showed tracer avidity in tumor sites higher than the physiological sites, which may pave the way for CXCR4-targeted radionuclide therapy in this subgroup of patients.
Long-term Trace of Radiation Pneumonitis With 18F-Fluoroestradiol
Authors: Morel Agnès , Maucherat Bruno , Chiavassa Sophie , Kraeber-Bodéré Françoise , Rousseau Caroline
Published: September 2020

Radiation pneumonitis (RP) can be an adverse complication of radiotherapy and usually occurs as an acute reaction from 6 to 12 weeks after radiotherapy. FDG PET is described as an early and adequate barometer for RP diagnosis. Only 1 case of fluoroestradiol uptake contemporary of metabolic FDG changes attributed to RP is reported. We report a case of a breast cancer patient with asymptomatic RP, who at 1 year later, at sequelar stage on CT, showed long-term memory of RP by 18F-fluoroestradiol PET imaging with nonmetabolic FDG PET.
Extensive Extramedullary Hematopoiesis in Thalassemia
Authors: Usmani Sharjeel , Ahmed Najeeb , Muzaffar Samreen , Al Kandari Fareeda
Published: September 2020

We report the case of a 45-year-old man with thalassemia major referred for a bone scan as a workup for generalized bone pain. 99mTc-MDP SPECT CT showed multiple elongated soft tissue masses along the inner aspects of ribs and along both sides of dorsal spine with calcification and mild tracer uptake. There was also a large lobulated presacral soft tissue mass displacing the bladder and involving the adjacent pelvic bone. Biopsy of mildly avid tracer uptake in pelvic soft tissue mass was extramedullary hematopoiesis confirmed by biopsy.
Lung Scintigraphy Imaging Features in a Young Patient With COVID-19
Authors: Goetz Christian , Fassbender Thomas F. , Meyer Philipp T.
Published: September 2020

A 31-year-old man developed diarrhea, fatigue, and intermittent fever for 2 weeks. The past few days he had experienced increasing dyspnea and dry cough. Ambulatory reverse transcriptase–polymerase chain reaction testing was positive for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Because of elevated d-dimer (1.5 mg/L), a lung scintigraphy (V/Q scan) was performed as SPECT/CT. Ventilation SPECT showed reduced ventilation with central nuclide deposition, whereas perfusion SPECT was inconspicuous, excluding pulmonary embolism. However, the low-dose CT revealed bilateral ground-glass opacities as previously described in COVID-19. This case highlights the procedure and findings of V/Q scanning (without embolism) in COVID-19.
Incidental Finding on 11C-Choline-PET/CT of Hepatocellular Carcinoma Recurrence in a Prostate Cancer Patient With Negative Abdominal CT Scan
Authors: Guglielmo Priscilla , Pisu Nicola , Sanna Silvia , Pung Bi Llie Joy , Boero Michele
Published: September 2020

A 76-year-old man, who experienced prostate cancer biochemical relapse after 12 years from radical prostatectomy, underwent abdominal CT scan for restaging purposes, negative for metastases, and then 11C-choline PET/CT. The only finding was an area of focal uptake of radiotracer between the intestinal loops and the abdominal wall; after resection, the lesion demonstrated to be a metastasis from hepatocellular carcinoma (HCC), for which the patient had undergone liver resection 2 years earlier. This case proves that abnormal foci of 11C-choline uptake in the peritoneum in HCC patients have to be kept in mind as possible sites of HCC-metastases.
18F-Fluciclovine Uptake in Acute Appendicitis
Authors: Ahn Grace S. , Barsky Andrew R. , Galperin-Aizenberg Maya , Vapiwala Neha , Pantel Austin R.
Published: September 2020

An 85-year-old man with biochemical recurrence of prostate cancer after prostatectomy was imaged with 18F-fluciclovine PET/CT. Images incidentally revealed 18F-fluciclovine uptake in a dilated appendix with associated fat stranding, suggestive of acute appendicitis. The patient was then questioned about abdominal symptoms, and he reported severe right lower quadrant pain. He then underwent laparoscopic appendectomy with pathology confirming acute appendicitis.
Dual-Phase 99mTc-MIBI SPECT/CT in the Characterization of Enhancing Solid Renal Tumors
Authors: Zhu Hongjing , Yang Bo , Dong Aisheng , Ye Huamao , Cheng Chao , Pan Guixia , Zuo Changjing
Published: September 2020

Purpose

The aim of this study was to investigate the value of dual-phase 99mTc-MIBI SPECT/CT in the differential diagnosis between benign and malignant enhancing solid renal tumors.

Patients and Methods

Totally, 180 patients were imaged with dual-phase 99mTc-MIBI SPECT/CT, which was performed 30 minutes and 90 minutes after 99mTc-MIBI administration. Among them, 147 patients with 148 histologically proved solid renal tumors met the selection criteria and were included for the final analysis. Relative quantification was performed by measuring the radioactive uptake ratio of tumor to the normal renal parenchymal background for both early and delayed images.

Results

Benign renal tumors (4 renal oncocytomas and 8 lipid-poor angiomyolipomas) demonstrated a significantly higher early relative uptake value (ERUV) and delayed relative uptake value (DRUV) than malignant renal tumors (n = 136; both P < 0.0001). The ERUV cutoff value of 0.53 helped to differentiate benign from malignant renal tumors, with sensitivity of 100%, specificity of 94.8%, and accuracy of 95.3% for the diagnosis of benign renal tumors. The DRUV cutoff value of 0.50 helped to differentiate benign from malignant renal tumors, with sensitivity of 100%, specificity of 96.3%, and accuracy of 96.6% for the diagnosis of benign renal tumors. There was no statistically significant difference between the efficacy of ERUV and DRUV in the differential diagnosis between benign and malignant renal tumors (P = 0.5). The efficacies of ERUV and DRUV were all significantly higher than the retention index (both P < 0.0001).

Conclusions

Both early and delayed phase 99mTc-MIBI SPECT/CT are helpful for distinguishing benign renal oncocytoma and lipid-poor angiomyolipoma from malignant renal tumors, and the delayed phase imaging tends to show higher diagnostic accuracy.
18F-Florbetapir PET in Primary Cerebral Amyloidoma
Authors: Soffers Frederik , Ceyssens Sarah , Buffet Wendi , de Surgeloose Didier , Crols Roeland
Published: September 2020

Amyloid deposition can lead to Alzheimer disease and cerebral amyloid angiopathy. Rarely, it presents as a solitary focal deposition, primary cerebral amyloidoma, which can be misinterpreted as a neoplasm because of the “tumor-like” appearances. We present the case of a 54-year-old woman where MRI revealed a T2-hyperintense mass periventricular in the white matter with moderate contrast enhancement. Pathological investigation revealed AL (lambda) amyloidoma. 18F-florbetapir PET/CT was used to support the diagnosis and in follow-up. This case highlights that 18F-florbetapir PET/CT might play a role in the diagnostic workup of patients suggestive of cerebral amyloidoma, especially in cases where biopsy is not feasible.
Incidental Detection of Elastofibroma Dorsi With 68Ga-FAPI-46 and 18F-FDG PET/CT in a Patient With Esophageal Cancer
Authors: Hayrapetian Artineh , Girgis Mark D. , Yanagawa Jane , French Samuel W. , Schelbert Heinrich R. , Auerbach Martin S. , Czernin Johannes , Calais Jeremie
Published: September 2020

A 71-year-old man underwent 18F-FDG and 68Ga-FAPI-46 PET/CT for initial staging prior to surgery of a squamous cell carcinoma of the lower esophagus under the prospective study NCT04147494. Both scans showed increased uptake in the mid and distal esophagus without evidence of metastatic disease. A soft tissue right infrascapular mass with mild 18F-FDG and moderate 68Ga-FAPI-46 uptake was incidentally found. The patient underwent robotic-assisted Ivor-Lewis esophagectomy and excision of the right infrascapular mass. Histopathology of the right chest wall mass confirmed the diagnosis of elastofibroma.
Quality and Safety in Healthcare, Part LXXVI
Authors: Harolds Jay A. , Miller Laura B.
Published: September 2020

Magnet recognition has value that benefits patients; nurses, physicians, and other providers; the healthcare organization; and the community. This includes not only better job satisfaction, more empowerment, and less turnover for nurses, but also better outcomes for patients, more research and evidence-based practice, a superior reputation for the organization, and an easier time recruiting for the organization.
FDG PET/CT Findings in Biliary Papillomatosis
Authors: Tu Zhuolong , Yang Yingnan , Ruan Jing , Tu Jinfu
Published: September 2020

Biliary papillomatosis is a rare disease with high malignant potential. A 64-year-old woman underwent FDG PET/CT, which showed an intense FDG uptake in the location of an aggregated biliary papillomatosis with high-grade intraepithelial neoplasia/carcinoma in situ but did not show FDG uptake in the sporadic, small biliary papilloma. FDG PET/CT may be an effective method to identify the components of the malignant transformation of biliary papillomatosis.
Detection of Residual Tumor With 68Ga-Pentixafor PET/CT in a Patient With Waldenström Macroglobulinemia and Concurrent John Cunningham Virus–Related Progressive Multifocal Leukoencephalopathy
Authors: Pan Qingqing , Luo Yaping , Qian Min
Published: September 2020

A 75-year-old man diagnosed with Waldenström macroglobulinemia (WM) complained of neurological symptoms. Baseline 18F-FDG PET/CT showed diffusely increased radioactivity in the bone marrow and decreased FDG uptake in the right cerebellum. After rituximab-containing immunochemotherapy, the patient had clinically partial response of WM, but the cerebellar lesion was enlarged. Repeated 18F-FDG PET/CT was similar to the baseline. 68Ga-pentixafor PET/CT detected residual tumor of WM in occipital bone and cervical lymph nodes, but there was no uptake in the cerebellar lesion. Finally, John Cunningham virus–related progressive multifocal leukoencephalopathy was confirmed.
PET/CT Integrated With CT Colonography in Preoperative Obstructive Colorectal Cancer by Incomplete Optical Colonoscopy
Authors: Sánchez-Izquierdo Nuria , Pagès Mario , Mayoral Maria , Rubello Domenico , Colletti Patrick M. , Campos Francisco , Romero Inmaculada , Casanueva Sebastián , Fritsch Andrea , Fuster David
Published: September 2020

Aim

The aim of this study was to evaluate if integrating whole-body PET/CT with CT colonography (PET/CTC) improves the preoperative diagnosis of obstructive colorectal cancer (CRC).

Methods

We prospectively included 47 consecutive patients (18 women and 29 men; mean age, 71 ± 14 years) suspected of having CRC by optical colonoscopy, which was not completed due to obstructive masses. To perform PET/CTC, a small caliber Foley catheter was inserted to distend the colon with CO2 insufflations. Polyps measuring 10 mm or larger were considered as high risk of malignancy. All findings were histologically confirmed.

Results

Colorectal cancer was localized in the sigmoid (n = 21), rectum (n = 7), rectosigmoid junction (n = 5), ascending (n = 7), descending (n = 5), and transverse (n = 2) colon. All tumors showed FDG uptake (mean ± SD SUVmax, 20.02 ± 9.9) including one synchronic tumor (SUVmax, 10.46). Forty-seven polyps were histologically confirmed as smaller than 10 mm (n = 35) and 10 mm or larger (n = 12). All 12 polyps 10 mm or larger showed FDG uptake (SUVmax range, 3.08–19.5), but only one smaller than 10 mm could be identified by PET. Pathological lymph nodes were diagnosed in 17/47 cases after surgical removal with a sensitivity and specificity for CTC and PET/CTC of 71% and 97% and 59% and 100%, respectively. Liver metastases were confirmed in 9 patients and in 4/9 along with lung metastases (n = 2) or implants (n = 2), showing a sensitivity and specificity for CTC of 89% and 100% and both 100% for PET/CTC.

Conclusions

PET/CTC is a reliable technique for staging CRC and diagnosing synchronous tumors. In this series, PET/CTC was not able to identify small polyps but showed potential use for ruling out 10 mm or larger polyps at high risk of malignancy.
Intense 99mTc-MDP Uptake in the Abdominal Soft Tissue Secondary to Subcutaneous Insulin Injection
Authors: Fu Wenhui , Zeng Chengrun , Xu Tingting , Zhang Xinyi , Chen Yue
Published: September 2020

A 65-year-old woman with known breast cancer presented with lower back pain over 1 month. Multiple sclerotic foci of increased tracer uptake in the bones were noted on the 99mTc-MDP bone scintigraphy and SPECT/CT images, suggesting osteoblastic metastasis. Unexpectedly, symmetric 99mTc-MDP activity was visualized in the soft tissue near the umbilical area, corresponding to the sites of insulin injection.
A Case of Primary Sinonasal Yolk Sac Tumor
Authors: Wang Peipei , Hou Guozhu , Li Fang , Cheng Xin
Published: September 2020

Yolk sac tumor (YST) is a rare and highly malignant germ cell tumor that is extremely rare in the nasal region. Herein, we present a case of biopsy-proven nasal YST admixed with transitional cell carcinoma in a 58-year-old woman. Complementary 18F-FDG PET/CT revealed the only FDG-avid mass in the right nasal cavity. This case indicates that YST could occur in the nasal region primarily, and 18F-FDG PET/CT is a useful tool to distinguish between primary and metastatic lesions.
18F-Fluciclovine Uptake in a Ureterocele
Authors: Bitar Ryan , Szklaruk Janio , Martiniova Lucia , Zurita Amado J. , Chery Lisly J. , Ravizzini Gregory
Published: September 2020

A 60-year-old man with prostate adenocarcinoma status post radical prostatectomy and bilateral pelvic lymph node dissection referred for restaging 18F-fluciclovine PET/CT due to rising serum prostate-specific antigen levels (1.1 ng/mL at that time of imaging). PET/CT images were obtained from the proximal thighs to the vertex of the skull approximately 3 to 5 minutes after the IV administration of 347.8 MBq (9.4 mCi) of 18F-fluciclovine. PET/CT imaging demonstrated a focus of abnormally increased 18F-fluciclovine uptake at the right ureterovesical junction. Subsequent MRI of the pelvis revealed that this focus corresponded to a benign ureterocele.
Incidental Detection of Pancreatic Arteriovenous Malformation by 99mTc-RBC SPECT/CT
Authors: Yang Xu , Wang Wei , Kan Ying , Yang Jigang
Published: September 2020

A patient with multiple episodes of gastrointestinal bleeding underwent99mTc-labeled red blood cell scintigraphy to detect the source of bleeding, which showed a focally increased activity in the upper midabdomen. SPECT/CT demonstrated that the activity was located in the pancreatic head. Angiography confirmed the diagnosis of pancreatic arteriovenous malformation. After transarterial embolization therapy, the patient no longer had bleeding episode. Based on the present case, pancreatic arteriovenous malformation should be included as differential diagnosis during99mTc–red blood cell scintigraphy.
Postablative 131I SPECT/CT Is Much More Sensitive Than Cervical Ultrasonography for the Detection of Thyroid Remnants in Patients After Total Thyroidectomy for Differentiated Thyroid Cancer
Authors: Bulzacka Iwona , Makarewicz Jacek
Published: September 2020

Purpose

Evaluation of utility of cervical ultrasound (US) for detection of thyroid remnants (ThR) in patients after thyroidectomy for differentiated thyroid cancer.

Methods

Included were 154 consecutive patients (17–89 years, 123 female and 31 male patients), without known cancer residues or cervical lymph nodes metastases, admitted for ThR ablation with 131I, 14 to 20 weeks after surgery. Neck uptake of 131I (Tup) and thyroglobulin were determined, and location and volume of ThR detected by cervical US were recorded. On days 3 to 4 after ablation (1.7–4.6GBq, 46–124.3 mCi 131I), neck SPECT/CT was performed, and 131I uptake foci were assigned to one of the regions as described below. The anterior neck was divided into 2 compartments: superior and inferior to lower margin of thyroid cartilage, and each compartment was subdivided into middle and lateral regions (in SPECT/CT, posterolateral and anterolateral regions were also marked out). 131I uptake sites and ThR detected by US, if congruent with SPECT/CT, were counted and analyzed.

Results

In total, 341 131I uptake foci were found in 150 patients (97.4%) by SPECT/CT and 213 corresponding ThR in 118 patients (76.6%) by US. Ultrasound detected 30% to 46% of 131I uptake foci in superior lateral regions, 49% in pyramidal lobe/thyroglossal duct area (both P < 0.05), 74% to 77% in inferior lateral regions, and 22% in isthmus (both P > 0.05). Correlation between ThR volume and Tup was strong (r = 0.79), and that between ThR volume and thyroglobulin was weak (r = 0.24).

Conclusions

Ultrasound is less sensitive than 131I posttherapy scans for ThR detection in patients after thyroidectomy, especially for remnants located above the lower margin of thyroid cartilage.
High Glucose Metabolism in the Right Ventricular Myocardium Due to Extrinsic Pulmonary Stenosis by Mediastinal Lymphoma
Authors: Parida Girish Kumar , Mitra Sujata , Suman Akchata , Muthu Gopal Sonai
Published: September 2020

Acquired pulmonary stenosis in adults is rare and is usually caused by extrinsic compression from a mediastinal tumor. We present a case of anterior mediastinal Hodgkin lymphoma, who presented with cough and hemoptysis. Compression of the bilateral pulmonary arteries by the mediastinal mass was demonstrated by transthoracic echocardiography and CT pulmonary angiography. FDG PET/CT showed diffusely increased FDG uptake in right ventricular myocardium in addition to lymphomatous involvement of the lymph nodes and spleen.
18F-FDG PET/CT Helps Differentiate Peripheral Nerve Myeloid Sarcoma From a Presumed Benign Nerve Sheath Tumor
Authors: Das Jeeban P. , Riedl Christopher C. , Ulaner Gary A.
Published: September 2020

A 21-year-old man with NF1 (neurofibromatosis type 1) mutation and in remission from acute myeloid leukemia presented with a painless mass in the left upper limb. MRI showed a soft-tissue mass involving the ulnar nerve presumed to be a nerve sheath tumor. 18F-FDG PET/CT was performed demonstrating high FDG avidity in the mass, prompting a biopsy. Histopathology and immunohistochemistry of the biopsy sample demonstrated myeloid sarcoma of the ulnar nerve. This case highlights the role of 18F-FDG PET/CT in raising the suspicion of malignancy in otherwise presumably benign lesions of the nerve.
Observation of sublimation of ice using terahertz spectroscopy
Authors: Matsumura Keisuke , Kawase Kodo , Takeya Kei
Published: September 2020

Although many studies have investigated the phase change of water, few have focused on the sublimation of ice. This study revealed that ice sublimation can be observed using terahertz (THz) spectroscopy. From measurements in the range of 210–270 K, the sublimation was observed over the entire temperature range and the rate of sublimation was increased proportionally with temperature. Particularly on a time scale of a few hundred minutes, the sublimation progresses visibly above 250 K. Above a certain temperature, the absorption coefficient increased during sublimation. These findings suggest that an interesting phenomenon may occur in the phase change of water at sub-zero temperatures, indicating that THz spectroscopy would be useful for measuring water and ice.
Prevalence of post-traumatic symptomatology and anxiety among residential nursing and care home workers following the first COVID-19 outbreak in Northern Italy
Authors: Riello Marianna , Purgato Marianna , Bove Chiara , MacTaggart David , Rusconi Elena
Published: September 2020

The current COVID-19 pandemic has been officially linked to the deaths of hundreds of thousands of people across the globe in just a few months. It is particularly lethal for the elderly in general, as well as for populations residing in long-term stay facilities. By this time, those working and caring for high-risk populations have been exposed to very intense and sudden levels of physical and psychological strain. The situation has taken a particularly tragic turn in residential nursing and care homes (NCH), which were hit hard by the pandemic. In residential NCH, neither residents nor workers tend to have immediate access to the same expertise, medication and equipment as in hospitals, which exacerbates an already tense situation. Among the mental health conditions related to exposure to potentially traumatic events, post-traumatic stress disorder and anxiety are the most prevalent and scientifically recognized. In this survey-based epidemiological study, we test the prevalence of anxiety and post-traumatic symptomatology in residential nursing and care home workers—a group of individuals that has been largely neglected but who nonetheless plays a very important and sensitive role in our society. We do this by focusing on the North of Italy, the most affected region during the first COVID-19 outbreak in Italy. Using a single-stage cluster design, our study returns an estimate for the prevalence of moderate-to-severe anxiety and/or post-traumatic symptomatology of 43% (s.e. = 3.09; 95% CI [37–49]), with an 18% (s.e. = 1.83; 95% CI [14–22]) prevalence of comorbidity among workers of Northern Italian NCH between 15 June and 25 July 2020 (i.e. 12–52 days after the end of national lockdown). Women and workers who had recently been in contact with COVID-19-positive patients/colleagues are more likely to report moderate-to-severe symptoms, with odds ratios of 2.2 and 1.7, respectively.
A magnetically retrievable air and moisture stable gold and palladium nanocatalyst for efficient C−C coupling reactions
Authors: Goonesinghe Chatura , Shaik Mohamed , Ratnaweera Rivi , Nalin De Silva K. M. , De Silva Rohini M.
Published: September 2020

In this study, we report the synthesis of a highly stable, magnetically retrievable gold and palladium nanocatalyst (AuPd@AMNPs), highly active in Suzuki cross-coupling and related homocoupling reactions. The active catalytic component in this system is palladium, which can only be stabilized in the presence of gold nanoparticles. There is no significant loss of activity even after prolonged storage exposed air and moisture. The versatile nature AuPd@AMNPs is demonstrated through the selective catalysis of the homocoupling of phenylboronic acid under low concentrations of O
2
and the oxidation of phenylboronic acid to phenol under high O
2
concentrations. AuPd@AMNPs also demonstrated Ullmann-type homocoupling of 4-iodotolene with excellent yields. The magnetically retrieved catalyst could be re-used up to six times in Suzuki–Miyaura cross-coupling with consistently high activity and with a minimal loss of the noble metal species. Through these reactions we show that the gold-stabilized AuPd@AMNPs can be used as stable and recyclable palladium reservoir for multiple palladium-catalysed reactions.
Factors influencing taxonomic unevenness in scientific research: a mixed-methods case study of non-human primate genomic sequence data generation
Authors: Hernandez Margarita , Shenk Mary K. , Perry George H.
Published: September 2020

Scholars have noted major disparities in the extent of scientific research conducted among taxonomic groups. Such trends may cascade if future scientists gravitate towards study species with more data and resources already available. As new technologies emerge, do research studies employing these technologies continue these disparities? Here, using non-human primates as a case study, we identified disparities in massively parallel genomic sequencing data and conducted interviews with scientists who produced these data to learn their motivations when selecting study species. We tested whether variables including publication history and conservation status were significantly correlated with publicly available sequence data in the NCBI Sequence Read Archive (SRA). Of the 179.6 terabases (Tb) of sequence data in SRA for 519 non-human primate species, 135 Tb (approx. 75%) were from only five species: rhesus macaques, olive baboons, green monkeys, chimpanzees and crab-eating macaques. The strongest predictors of the amount of genomic data were the total number of non-medical publications (linear regression;
r
2
= 0.37;
p
= 6.15 × 10
−12
) and number of medical publications (
r
2
= 0.27;
p
= 9.27 × 10
−9
). In a generalized linear model, the number of non-medical publications (
p
= 0.00064) and closer phylogenetic distance to humans (
p
= 0.024) were the most predictive of the amount of genomic sequence data. We interviewed 33 authors of genomic data-producing publications and analysed their responses using grounded theory. Consistent with our quantitative results, authors mentioned their choice of species was motivated by sample accessibility, prior published work and relevance to human medicine. Our mixed-methods approach helped identify and contextualize some of the driving factors behind species-uneven patterns of scientific research, which can now be considered by funding agencies, scientific societies and research teams aiming to align their broader goals with future data generation efforts.
Using COVID-19 deaths as a surrogate to measure the progression of the pandemics
Authors: Hernandez-Suarez Carlos , Murillo-Zamora Efren
Published: September 2020

The IFR (Infection Fatality Risk) is one of the most important parameters of an infectious disease. If properly estimated, the observed number of deaths divided by the IFR can be used to estimate the current number of infections and, if immunity is permanent, we can estimate the fraction of susceptible which can be used to plan reopening of activities and vaccine deployment, when these become available. Here we suggest how to use the observed deaths by COVID-19 in an arbitrary population as a surrogate for the progression of the epidemic with the purpose of decision making. We compare several estimates of IFR for SARS-CoV-2 with our estimate that uses the number of additional deaths in households in a database population of 159,150 laboratory-confirmed (RT-qPCR) COVID-19 by SARS-COV-2 in Mexico. The main result is that if the number of deaths in a region is close to 2 per thousand individuals, the fraction of remaining susceptible may be too small for the vaccine to make a difference in the total number of infected.