bluuebunny/crossref_metadata_2025 huggingface dataset:
The Imaging Features and Clinical Associations of a Novel Tau PET Tracer—18F-APN1607 in Alzheimer Disease
Authors: Hsu Jung-Lung , Lin Kun-Ju , Hsiao Ing-Tsung , Huang Kuo-Lun , Liu Chi-Hung , Wu Hsiu-Chuan , Weng Yi-Ching , Huang Chu-Yun , Chang Chiung-Chih , Yen Tzu-Chen , Higuchi Makoto , Jang Ming-Kuei , Huang Chin-Chang
Published: September 2020

Purpose of the Report

In vivo tau PET imaging could help clarify the spatial distribution of tau deposition in Alzheimer disease (AD) and aid in the differential diagnosis of tauopathies. To date, there have been no in vivo 18F-APN1607 tau PET studies in patients with AD.

Methods

We applied tau tracer in 12 normal controls (NCs) and 10 patients in the mild to moderate stage of probable AD. Detailed clinical information, cognitive measurements, and disease severity were documented. Regional SUV ratios (SUVRs) from 18F-AV-45 (florbetapir), 18F-APN1607 PET images, and regional gray matter (GM) atrophic ratios were calculated for further analysis.

Results

Quantitative analyses showed significantly elevated SUVRs in the frontal, temporal, parietal, occipital lobes, anterior and posterior cingulate gyri, precuneus, and parahippocampal region (all P’s < 0.01) with medium to large effect sizes (0.44–0.75). The SUVRs from 18F-APN1607 PET imaging showed significant correlations with the Alzheimer’s Disease Assessment Scale (ADAS-cog) scores (all P’s < 0.01) and strong correlation coefficients (R
2 ranged from 0.54 to 0.68), even adjusted for age and sex effects. Finally, the SUVRs from 18F-APN1607 PET imaging of the parahippocampal region showed rapid saturation as the ADAS-cog scores increased, and the SUVRs of the posterior cingulate gyrus and the temporal, frontal, parietal, and occipital regions slowly increased. The combined SUVRs from amyloid, tau PET, and regional GM atrophic ratio showed regional specific patterns as the ADAS-cog scores increased.

Conclusions

Our findings suggest that the 18F-APN1607 tau tracer correlated well with cognitive changes and demonstrated the spatial pattern of amyloid, tau deposition, and GM atrophy in the progression of AD.
Peptide Receptor Radionuclide Therapy as First-Line Systemic Treatment in Advanced Inoperable/Metastatic Neuroendocrine Tumors
Authors: Satapathy Swayamjeet , Mittal Bhagwant Rai , Sood Ashwani , Sood Apurva , Kapoor Rakesh , Gupta Rajesh
Published: September 2020

Purpose

Advanced inoperable/metastatic neuroendocrine tumors (NETs) pose a therapeutic challenge with limited treatment options. Peptide receptor radionuclide therapy (PRRT), being specific in targeting the somatostatin receptors, is a promising and viable option in this setting. In this study, we intended to evaluate the role of PRRT as the first-line systemic therapy in advanced inoperable/metastatic NETs.

Methods

Data of consecutive patients of advanced inoperable/metastatic NETs treated with first-line 177Lu-DOTATATE at our center, from September 2012 to August 2019, were collected and analyzed.

Results

Forty-five patients (median age, 50 years; range, 14–72 years) with treatment-naive advanced NETs received a median cumulative dose of 27 GBq (range, 13.3–41.3 GBq; over 2–7 cycles) 177Lu-DOTATATE and 1250 mg/m2 capecitabine from days 0 to 14 of each PRRT cycle. Three patients were lost to follow-up, 2 had nonmeasurable lesions on CT, and hence, radiological response using Response Evaluation Criteria in Solid Tumors version 1.1 could be assessed in 40 patients. Twelve of 40 patients (30%) showed a partial response, whereas stable disease was observed in 22 of 40 patients (55%). Disease progression was limited to 6 of 40 patients (15%). Treatment-related adverse effects were minimal with grade 3/4 anemia, leukopenia, neutropenia, and hepatotoxicity observed in 2%, 2%, 4%, and 4% of the patients, respectively. Median progression-free survival was 48 months (95% confidence interval, 34.7–61.3 months).

Conclusions

Our results indicate the efficacy and safety of first-line PRRT in advanced NETs. Future randomized trials, comparing PRRT and somatostatin analogs in treatment-naive patients, are required to identify the definite sequence of treatment options for these patients.
A Rare Case of Solitary Pituitary Metastasis From Spitzoid Melanoma Detected by FDG PET/CT
Authors: Annunziata Salvatore , Annovazzi Alessio , Pasqualoni Rosella , Bergomi Serenella , Sciuto Rosa
Published: September 2020

A 33-year-old man had a diagnosis of a spitzoid melanoma by dorsal skin biopsy. During the oncological follow-up, patient underwent whole-body FDG PET/CT for restaging purpose. FDG PET/CT showed a large necrotic mass of the pituitary gland, subsequently confirming a solitary pituitary metastasis from spitzoid melanoma.
PET/CT of COVID-19 as an Organizing Pneumonia
Authors: Alonso Sanchez Jaime , García Prieto Julia , Galiana Morón Alvaro , Pilkington-Woll John Patrick
Published: September 2020

An 85-year-old woman with history of melanoma is referred for a follow-up 18F-FDG PET/CT. 18F-FDG PET/CT scan showed bilateral and peripheral ground-glass opacities in upper and lower pulmonary lobes surrounded by consolidations of crescent shape with increased FDG uptake, findings compatible with organizing pneumonia. Following further inquiry, the patient reported low-grade fever, sore throat, and fatigue for the past 6 days. Because of the ongoing COVID-19 pandemic, the patient was tested for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which resulted positive.
Extramedullary Myeloma of the Uterus on 18F-FDG PET/CT
Authors: Causa Andrieu Pamela Ines , Das Jeeban Paul , Woo Sungmin , Ryan Reddy , Akin Oguz , Ulaner Gary A.
Published: September 2020

Involvement of the uterus by myeloma is an extremely rare manifestation of extramedullary multiple myeloma (MM), denoting a poor prognosis. Extramedullary MM occurs in 7% to 18% of newly diagnosed patients with MM, and 6% to 20% of patients can develop it later. We present a case of extramedullary MM of the uterus suspected on 18F-FDG PET/CT as a site of disease recurrence in a 47-year-old woman previously in remission. Further evaluation with pelvic MRI identified an infiltrative process involving the uterus, and subsequent tissue sampling confirmed malignant plasma cell infiltration of the uterus. This case highlights a rare site of myeloma recurrence, which can be detected by 18F-FDG PET/CT.
Sequential Duo–Peptide Receptor Radionuclide Therapy With Indigenous 90Y-DOTATATE and 177Lu-DOTATATE in Large-Volume Neuroendocrine Tumors
Authors: Parghane Rahul V. , Mitra Arpit , Upadhye Trupti , Rakshit Sutapa , Banerjee Sharmila , Basu Sandip
Published: September 2020

The efficacy of 177Lu-DOTATATE in large neuroendocrine tumors (NETs) is reduced because of the lower energy (Eβmax 0.497 MeV) and shorter range of 177Lu. The pure β-emitter 90Y with its longer β range is more effective in larger tumors. This should be balanced with the greater risk of 90Y-DOTATATE–related nephrotoxicity. Sequential duo–peptide receptor radionuclide therapy may result in a better response with minimal adverse effects in large-volume heterogeneous NETs. A 56-year-old man with large rectal NET liver metastases, treated with 90Y-DOTATATE and 177Lu-DOTATATE and sequential duo–peptide receptor radionuclide therapy, presented with post-90Y-DOTATATE bremsstrahlung and PET/CT in comparison with 68Ga-DOTATATE PET/CT and 177Lu-DOTATATE scans.
Pearls and Pitfalls of Quantitative Software Analysis of Dopamine Transporter SPECT
Authors: Mushtaq Raza , Kay Matthew D. , Steinmeyer Laura , Warhadpande Devdutta , Kuo Phillip H.
Published: September 2020

Dopamine transporter SPECT with 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-ioflupane) aids in the diagnosis of parkinsonian syndrome by demonstrating loss of striatal dopamine transporters, proportional to nigrostriatal dopaminergic neuronal loss. Quantitative software analysis (QSA) is a helpful adjunct to visual interpretation. An atlas of pearls and pitfalls of QSA is presented. Examples include correction for head tilt/orientation, scaling artifacts, and detection of balanced loss of activity. Additional examples are provided where QSA can potentially fail such as patient variation and vascular disease.
Incidental Finding of an Ovarian Carcinoid on 11C-Methionine PET/CT
Authors: Maccora Daria , Caldarella Carmelo , Leombroni Martina , De Stefano Valerio , Leccisotti Lucia
Published: September 2020

A 68-year-old woman with a history of multiple myeloma on regular hematological follow-up and with no previous relevant gynecological diseases was found to have an incidental focal uptake by the right ovary at 11C-methionine PET/CT (C-MET). Transvaginal ultrasound was then performed showing a 2-cm solid right ovarian mass with irregular borders and moderate vascularization at color Doppler examination. Therefore, the patient underwent bilateral salpingectomy, and the final histological results revealed a rare presentation of mature teratoma with insular carcinoid tumor arising from the right ovary.
Gallbladder Visualization in Peptide Receptor Radionuclide Therapy With 177Lu-DOTATATE
Authors: Diekmann Johanna , Werner Rudolf A. , Ross Tobias L. , Derlin Thorsten
Published: September 2020

Gallbladder visualization represents a rare incidental finding when using somatostatin receptor–targeted SPECT radiopharmaceuticals such as 111In-octreotide. We present the case of a 30-year-old man with pseudomyogenic hemangioendothelioma who underwent 68Ga-DOTATATE PET/CT for restaging of metastatic disease and subsequent treatment with peptide receptor radionuclide therapy with 177Lu-DOTATATE. Posttherapeutic SPECT/CT, but not pretherapeutic or posttherapeutic PET/CT, showed gallbladder visualization, evidencing 177Lu-DOTATATE excretion into the bile. This case highlights that biliary 177Lu-DOTATATE excretion may represent a rare mimicker of hepatic metastases and emphasizes the role SPECT/CT for precise anatomical correlation to avoid misinterpretation.
Squamous Cell Carcinoma of Thymus Presenting as Constrictive Pericarditis Diagnosed With 18F-FDG PET/CT
Authors: Kousik Vankadari , Milap Milap , Bollam Rajesh , Prasad Rama Krishna , Krishna Gopi
Published: September 2020

Constrictive pericarditis refers to focal or global thickening of pericardium causing impedance to diastolic filling and increased systemic venous pressure. We discuss a case of thymic carcinoma presenting as constrictive pericarditis. A 70-year-old man experiencing shortness of breath underwent Doppler echocardiography for further evaluation. Echocardiography was suggestive of thickened nodular pericardium with minimal pericardial effusion, and Doppler features were suggestive of constrictive pericarditis. 18F-FDG PET/CT done to exclude malignancy reveals locally advanced thymic carcinoma spreading along the pericardial sheath with metabolically active rib metastases.
Rosai-Dorfman Disease of the Right Atrium Revealed by FDG PET/CT
Authors: Hou Guozhu , Pan Qingqing , Cui Ruixue , Li Fang , Cheng Wuying
Published: September 2020

Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic disorder, which is rare and typically occurs in lymph nodes. However, one third of the cases manifest as extranodal disease. The cardiac involvement of this disease is extremely rare. We reported here the FDG PET/CT findings of a pathologically confirmed Rosai-Dorfman disease occurring in the right atrium in a 60-year-old man.
68Ga–Prostate-Specific Membrane Antigen-11–Avid Cardiac Metastases in a Patient With Adenoid Cystic Carcinoma, A Rare Presentation of a Rare Cancer
Authors: Uijen Maike José Maria , van Boxtel Wim , van Herpen Carla Marie Louise , Gotthardt Martin , Nagarajah James
Published: September 2020

Adenoid cystic carcinoma is a rare cancer that arises from secretory glands. Metastases are mainly seen in the lungs and bones. Cardiac metastases are extremely rare; only 1 case has previously been described. In this patient, cardiac metastases were suspected based on CT imaging. Tumor imaging by 68Ga–prostate-specific membrane antigen (PSMA)-11 PET is mainly used in prostate cancer patients but is also of interest in adenoid cystic carcinoma patients because of high PSMA-ligand uptake in salivary glands. 68Ga-PSMA-11 PET imaging supported the suspicion of cardiac metastases, because the cardiac lesions showed similar tracer uptake compared with other metastases.
Nivolumab-Induced Periaortitis Demonstrated by FDG PET/CT
Authors: Hotta Masatoshi , Naka Go , Minamimoto Ryogo , Takeda Yuichiro , Hojo Masayuki
Published: September 2020

A 66-year-old man with a history of non–small cell lung cancer treated with nivolumab underwent contrast-enhanced CT and FDG PET/CT. No recurrence was demonstrated; however, soft-tissue thickening that showed delayed contrast enhancement and FDG uptake was detected around an abdominal aortic aneurysm. After discontinuation of nivolumab, the periaortic lesion disappeared within 2 months, indicating nivolumab-induced periaortitis. Immune checkpoint inhibitors such as nivolumab can cause vasculitis and periaortitis, a potentially fatal condition, as immune-related adverse events. The underlying aortic aneurysm may have contributed to genesis of periaortitis. FDG PET/CT can be useful for detecting periaortitis and excluding other forms of vasculitis.
Incidental Detection of Malignant Melanoma Brain Recurrence on 68Ga–Prostate-Specific Membrane Antigen PET/CT
Authors: Hod Nir , Lantsberg Sophie , Benkovich Elya , Kazap Dina Ezroh , Preiskel Mark , Levin Daniel
Published: September 2020

A 76-year-old man with a prior medical history of resected malignant melanoma of the skull underwent 68Ga–prostate-specific membrane antigen (PSMA) PET/CT due to rising tumor markers of a known prostate carcinoma. Unexpected high 68Ga-PSMA brain uptake was encountered around the surgical cavity in the skull with initially no specific structural changes on anatomical imaging. Successive CT and MRI eventually revealed local melanoma brain recurrence at this site. This interesting case demonstrates the diagnostic potential of 68Ga-PSMA PET/CT imaging for detection of malignant melanoma brain recurrence.
One-by-One Comparison of Lymph Nodes Between 18F-FDG Uptake and Pathological Diagnosis in Esophageal Cancer
Authors: Yoshimura Shuntaro , Takahashi Miwako , Aikou Susumu , Okumura Yasuhiro , Jinbo Keiichi , Onoyama Haruna , Urabe Masayuki , Kawasaki Koichiro , Yagi Koichi , Nishida Masato , Mori Kazuhiko , Yamashita Hiroharu , Nomura Sachiyo , Koyama Keitaro , Momose Toshimitsu , Abe Hiroyuki , Ushiku Tetsuo , Fukayama Masashi , Seto Yasuyuki
Published: September 2020

Purpose

Esophagectomy with extended lymph node (LN) dissection is a standard treatment for resectable esophageal cancer to prevent recurrence, but severe, potentially life-threatening postoperative complications are still important issues. Accurate diagnosis of LN metastases would enable the decision to dissect or leave the LNs in regions with high risk of complications. Advancements in intraoperative gamma probe and radioactivity detectors have made intraoperative navigation surgery possible using a radiotracer as a marker. 18F-FDG is one such candidate markers, and the diagnostic power of FDG through counting the radioactivity close to each LN should be elucidated.

Materials and Methods

In 20 patients, 1073 LNs including 38 metastatic LNs were prospectively investigated. Preoperative FDG PET was performed on the same day before esophagectomy and visually surveyed in each LN station to identify abnormal uptake. The FDG radioactivity of each individual dissected LN was measured by a well-type counter, and the pathological diagnosis was compared with LN radioactivity on a one-by-one basis and with the preoperative FDG PET findings for each LN station.

Results

Lymph node station-based analysis showed a sensitivity and specificity of 28.6% and 96.7%, respectively. One-by-one LN-based analysis using a cutoff value obtained from the receiver operating characteristic curve showed a sensitivity and specificity of 94.7% and 78.7%, respectively, demonstrating higher accuracy compared with the use of LN weight or the shortest diameter.

Conclusions

The FDG uptake by each LN is a potentially useful marker for navigation surgery in esophageal cancer and has higher accuracy than LN weight or diameter.
Giant Cell Tumor With Atypical Imaging Implying Osteosarcoma
Authors: Ariga Akane , Kanda Hiroaki , Ando Yoshiaki , Gokita Tabu
Published: September 2020

Giant cell tumor (GCT) of bone is benign and typically shows osteolytic changes on x-ray, whereas osteosarcoma is malignant and generally shows osteolytic and osteoblastic mixed images. We experienced a rare case of GCT with atypical radiological findings. The tumor found in the right knee of a 15-year-old girl comprised a wide range of osteoblastic and osteolytic lesion in medial femur. Technetium uptake, however, was detected only in osteoblastic part, and immunohistochemical staining of biopsy showed diffusely positive for antihistone G34W and almost negative for Ki-67. These results strongly suggest the tumor was GCT.
Diffuse Increased 68Ga-DOTATATE But Unimpressive 18F-FDG Osseous Activity in a Patient With Rapid-Progressing Synchronous Multifocal Osteosarcoma
Authors: Qin Chunxia , Shao Fuqiang , Lan Xiaoli
Published: September 2020

Osteosarcoma is usually 18F-FDG–avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased 68Ga-DOTATATE uptake in the osseous lesions, whereas the 18F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features.
Pancreatic Schwannoma on FDG PET/CT
Authors: Wang Xuezhu , Lv Jingqiao , Fu Chao , Chang Xiaoyan , Huo Li
Published: September 2020

A 55-year-old woman underwent FDG PET/CT to evaluate a pancreatic mass. The images showed elevated FDG activity in the uncinated process of the pancreas, suggestive of malignancy. However, pathological examination from the resected lesion demonstrated pancreatic schwannoma.
68Ga-FAPI PET/CT in Assessment of Leptomeningeal Metastases in a Patient With Lung Adenocarcinoma
Authors: Hao Bing , Wu Jingxun , Pang Yizhen , Sun Long , Chen Haojun
Published: September 2020

We presented a case of 64-year-old woman with pathologically diagnosed lung adenocarcinoma. Brain metastases were highly suspected due to the appearance of neurological symptoms. However, no abnormal finding in the brain was observed on 18F-FDG PET/CT. Contrast-enhanced MRI showed the presence of leptomeningeal metastases but with a negative cerebrospinal fluid analysis. For this reason, the patient underwent 68Ga-FAPI PET/CT, later fused with MRI scans that showed intense uptake of 68Ga-FAPI in leptomeningeal regions correspondent to the sites of gadolinium enhancement. This case highlights that 68Ga-FAPI would be promising for the identification of leptomeningeal involvement in patients with malignant disease.
3P’s of Wermer/MEN1 Syndrome on 68Ga-DOTANOC PET/CT Scan
Authors: Tripathy Sarthak , Prakash Sneha , Arun Raj Sreedharan Thankarajan , Kumar Arunav , Shamim Shamim Ahmed
Published: September 2020

Wermer/MEN1 syndrome is composed of the triad of pancreatic, pituitary, and parathyroid (3P’s) tumors. We describe the 68Ga-DOTANOC PET/CT findings of a 43-year-old man, which revealed the classic 3P’s of MEN1 syndrome with somatostatin receptor expression. The patient further underwent surgery for parathyroid lesions, which were suggestive of adenomas.
Abdominal Metastases of Intracranial Germ Cell Tumor Via Ventriculoperitoneal Shunt Detected by 18F-FDG PET/CT
Authors: Yang Qiao , Zhu Wenjia , Huo Li
Published: September 2020

Extraneural metastases of primary brain tumors are rare. Here, we provided a case of a 19-year-old man presenting with 2 intra-abdominal masses, who had a history of intracranial germ cell tumors and a ventriculoperitoneal shunt implanted in order to alleviate obstructive hydrocephalus. The intra-abdominal lesions showed intense FDG uptake and were confirmed to be germ cell tumors by postoperative histopathology. 18F-FDG PET scan could be useful in monitoring metastases of intracranial germ cell tumors via ventriculoperitoneal shunt.
Images of COVID-19 Infection Cases in Asymptomatic or Paucisymptomatic Patients With Neoplastic Diseases on 18F-FDG PET/CT
Authors: Grellier Jean-François , Lussato David , Guernou Mohamed , Queneau Mathieu , Bonardel Gérald
Published: September 2020

We describe the results of 18F-FDG PET/CT of 3 patients referred to our institution during the single day of Monday, March 23, 2020, for an initial assessment of cancer extension or for the therapeutic evaluation of chemotherapy of neoplastic pathology, with no obvious infectious or respiratory symptoms at the time of examination. A retrospective review of the recent clinical history of patients in association with the typical pulmonary images on CT scan suggested the diagnosis of COVID-19. The characteristic aspects of COVID-19 infection should be recognized on 18F-FDG PET/CT, even if patients are asymptomatic or minimally symptomatic.
Quality and Safety in Healthcare, Part LXXXI
Authors: Harolds Jay A. , Miller Laura B.
Published: September 2020

When the “Standards for Establishing and Sustaining Healthy Work Environments” set forth by the American Association of Critical-Care Nurses are met in a health care system, there is enhanced safety and quality care for the patient, better job satisfaction, and less turnover by the staff. The American Association of Critical-Care Nurses started the Beacon Award for Excellence not only to recognize those who have such high standards but also to encourage units who already have achieved this distinction or are applying for it to do better.
FDG PET/CT of Hepatoid Adenocarcinoma of the Gallbladder
Authors: Ji Xia , Dong Hui , Dong Aisheng
Published: September 2020

Primary hepatoid adenocarcinoma of the gallbladder is rare. A 67-year-old woman presented with right upper quadrant abdominal pain with elevated α-fetoprotein level. Abdominal ultrasound and MRI showed a tumor in the gallbladder with normal liver. FDG PET/CT showed increased FDG uptake of the gallbladder tumor with retroperitoneal lymph node metastasis. Cholecystectomy was performed. Primary hepatoid adenocarcinoma of the gallbladder was confirmed by histopathology.
Clinical Evaluation of 18F-PI-2620 as a Potent PET Radiotracer Imaging Tau Protein in Alzheimer Disease and Other Neurodegenerative Diseases Compared With 18F-THK-5351
Authors: Oh Minyoung , Oh Seung Jun , Lee Sang Ju , Oh Jungsu S. , Roh Jee Hoon , Chung Sun Ju , Lee Jae-Hong , Lee Chong Sik , Kim Jae Seung
Published: September 2020

Purpose

PET is a useful tool for detecting the presence and extent of brain tau accumulation. However, most first-generation tau PET tracers are limited for high off-target binding and detection of tau in non-Alzheimer disease (AD). This study evaluated potential clinical applications of 18F-PI-2620 as a novel PET tracer with a high binding affinity for tau deposition in AD and non-AD tauopathies.

Methods

Twenty-six participants diagnosed with either mild cognitive impairment, probable AD, frontotemporal dementia, or parkinsonism, as well as healthy controls underwent a 60- to 90-minute brain PET scan after 7 mci (259 MBq) injection of 18F-PI-2620. Some participants had previous PET scans using 18F-THK-5351 or 18F-FP-CIT for dopamine transporter imaging.

Results

All participants showed no increase in off-target binding in basal ganglia on 18F-PI-2620 PET images, as noted for first-generation tau tracers. Aβ+ mild cognitive impairment or AD patients showed diverse cortical 18F-PI-2620 uptake in frontotemporoparietal cortex that correlated with Mini-Mental Status Examination (ρ = −0.692, P = 0.013). Aβ+ Parkinson disease with dementia and (Aβ unknown) primary progressive aphasia patients also showed increased 18F-PI-2620 uptakes in the frontotemporoparietal cortex. Patients with parkinsonism showed increased uptakes in the pallidum compared with Aβ− healthy controls (left: 1.41 ± 0.14 vs 1.04 ± 0.13, P = 0.014; right: 1.18 ± 0.16 vs 0.95 ± 0.07, P = 0.014).

Conclusions

18F-PI-2620 PET might be a sensitive tool to detect cortical tau deposits in patients with Aβ+ AD and Aβ+ non-AD tauopathies. Furthermore, this study showed that “off-target” binding in the basal ganglia does not affect 18F-PI-2620.
Extensive Tumor Thrombosis of Portal Venous System Demonstrated on 68Ga-DOTATATE and 68Ga-NODAGA-LM3 PET/CT in a Patient With Well-Differentiated Neuroendocrine Tumor
Authors: Zhu Wenjia , Cheng Yuejuan , Ding Ning , Huo Li
Published: September 2020

We present a case with a pancreatic neuroendocrine tumor and extensive tumor thrombosis in portal venous system. The tumor was first identified on contrast-enhanced CT and later confirmed using 68Ga-DOTATATE and 68Ga-NODAGA-LM3 PET/CT. Both tracers demonstrated similar pattern with higher tumor affinity and tumor-to-background ratio using 68Ga-NODAGA-LM3.
68Ga-DOTATATE and 18F-FDG in Castleman Disease
Authors: Verçosa Alinne Fernanda Amaral , Flamini Maria Eduarda Duarte de Mello , Loureiro Luiz Victor Maia , Flamini Rodrigo de Carvalho
Published: September 2020

A 35-year-old woman with rectal neuroendocrine tumor, Ki-67 proliferation index less than 2%, and a mediastinal mass on CT postoperatively was referred for restaging with PET/CT 68Ga-DOTATATE. The examination showed uptake on the pelvic lymph node and mediastinal mass. Because of differences in lesions’ SUVs and clinical presentation, the hypothesis of lymphoma for the mediastinal mass was raised, and 18F-FDG PET/CT was performed, which showed glycolytic hypermetabolism in the mediastinal mass and absence of hypermetabolism in pelvic lymph nodes. Transthoracic biopsy of the mass revealed atypical large-cell lymphoid proliferation, and immunohistochemistry study was compatible with Castleman disease.
111In-Oxine-WBC SPECT/CT of Lumbosacral Facet Joint Septic Arthritis
Authors: Zamora Edgar , Valdivia Ana Y. , Kumar Arun , Chun Kwang J.
Published: September 2020

Spinal facet joint septic arthritis is a rare pathology associated with pyogenic organisms. It may present in older adults with back pain, fever, and positive bacterial blood cultures. However, clinical presentation may be equivocal, and diagnosis relies on anatomic imaging for differentiation from other pathologies. Magnetic resonance is considered the imaging modality of choice and has been found superior to CT; however, it is unable to differentiate facet joint septic arthritis from other inflammatory arthropathies. We present a case of lumbosacral facet joint septic arthritis as seen on 111In-oxine-WBC scintigraphy and SPECT/CT.
The Use of Peptide Receptor Radionuclide Therapy in Patients With Neuroendocrine Tumor Cardiac Metastases
Authors: Yu Irene S. , Funk Gayle , Lin Eugene , Kennecke Hagen F.
Published: September 2020

Cardiac metastases are an infrequent site of metastasis in neuroendocrine tumors, and the treatment implications in the era of peptide receptor radionuclide therapy (PRRT) are unclear. Potential safety concerns exist regarding cardiac integrity and function in response to PRRT. We describe our institutional experience with 4 patients with well-differentiated, midgut neuroendocrine tumors with cardiac involvement detected on 68Ga-DOTATATE PET/CT scans who were treated with PRRT.
Complete Right-to-Left Shunt in Lung Perfusion Scintigraphy
Authors: Gühne Falk , Drescher Robert , Ndum Ferdinand , Seifert Philipp , Freesmeyer Martin
Published: September 2020

Lung scintigraphy was performed to rule out pulmonary embolism in a 37-year-old woman suffering from dyspnea and hypoxemia after routine diagnostics failed to find the underlying disease. Perfusion scans did not show tracer uptake within the lungs despite ventilation scans being unremarkable. Instead, the result suggested a complete right-to-left shunt, which was a conundrum. With the assistance of CT an uncommon congenital vessel aberration turned out to be the cause of this exceptional scintigraphy finding, as well as the yet unexplained hypoxemia.
FDG PET/CT Findings of Extrarenal Wilms Tumor Originating From the Spinal Cord
Authors: Filizoglu Nuh , Oksuzoglu Kevser , Bozkurt Suheyla , Ozguven Salih , Erdil Tanju Yusuf
Published: September 2020

Extrarenal Wilms tumor (ERWT) is an extremely rare neoplasm of childhood. It occurs predominantly in retroperitoneum and pelvic or inguinal region without involvement of the kidneys. Although the importance of FDG PET/CT in Wilms tumor is well known, its use in ERWT is limited. Herein, we present FDG PET/CT findings of a 3-year-old girl with a lumbar mass, which was later diagnosed with ERWT.
Atrial Metastasis From Sarcomatoid Renal Cell Carcinoma
Authors: Filippi Luca , Iannarelli Angelo , Ambrogi Cesare , Bagni Oreste
Published: September 2020

We describe the case of a 54-year-old woman, previously submitted to nephrectomy for sarcomatoid renal cell carcinoma and treated with antibiotics because of central venous catheter infection. An 18F-FDG PET/CT scan was obtained that demonstrated bone and lymph node metastases and also disclosed an irregular area of highly increased uptake (SUVmax 19.4) in the right atrium. Clinical data did not suggest a relapsed infection. A contrast-enhanced CT examination of the heart enabled the diagnosis of intra-atrial metastasis. Furthermore, integration between PET and cardiac 3-dimensional volume rendering proved useful for defining the anatomical relationships between atrial metastasis and large vessels.
Visceral Metastases as Predictors of Response and Survival Outcomes in Patients of Castration-Resistant Prostate Cancer Treated With 177Lu-Labeled Prostate-Specific Membrane Antigen Radioligand Therapy
Authors: Satapathy Swayamjeet , Mittal Bhagwant Rai , Sood Ashwani
Published: September 2020

Background

The presence of visceral metastases is associated with poor prognosis in patients of metastatic castration-resistant prostate cancer (mCRPC) treated with hormonal therapy and chemotherapy. However, studies evaluating its impact on treatment outcomes with 177Lu-labeled prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) are currently limited and show inconsistent results. This systematic review was conducted to precisely evaluate the impact of visceral metastases on biochemical response and survival outcomes in patients of mCRPC treated with 177Lu-PSMA RLT.

Methods

This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Searches in PubMed, Scopus, and EMBASE were made using relevant keywords, and articles up to May 2020 were included. Univariate and multivariate odds ratios and hazard ratios (HRs) were extracted from the individual articles, and pooled estimates were generated using meta-analysis.

Results

Twelve articles comprising 1504 patients were included in this review. Presence of visceral metastases not only predicted low biochemical response rate (pooled univariate odds ratio: 0.38, 95% confidence interval [CI], 0.22–0.66) but was also a significant prognosticator of worse progression-free survival (pooled univariate HR, 1.85; 95% CI, 1.39–2.46; and pooled multivariate HR, 1.48; 95% CI, 1.15–1.92) and overall survival (pooled univariate HR, 1.77; 95% CI, 1.29–2.44; and pooled multivariate HR, 2.22; 95% CI, 1.82–2.70). There was no evidence of publication bias.

Conclusions

Presence of visceral metastases was associated with poor response and survival outcomes in patients of mCRPC treated with 177Lu-PSMA RLT. The results are clinically significant for pretreatment risk stratification of such patients and to guide optimal treatment strategies.
Golf-Related Craniofacial Injuries in Adults: A NEISS Database Study
Authors: Brennan Matthew J. , Fish Sarah , Cohn Jason E. , Othman Sammy , Stucker Fred J. , Bundrick Paige
Published: September 2020

Introduction:

Despite its popularity, there have been no reports outlining adult craniofacial trauma in the setting of golf injuries. Our main objective was to identify and describe trends in head and neck injuries incurred while participating in golf including injury type, anatomic location, and patient disposition.

Methods:

A retrospective cohort analysis of the National Electronic Injury Surveillance System (NEISS) was conducted from 2009–2018. Population characteristics of golf-related injuries were recorded, including, age, sex, and race distributions. Distribution of injury anatomic location, injury type, distribution of fracture location, patient disposition was further analyzed. A one way ANOVA was utilized to obtain the mean ages for all injuries and compare them for any statistical difference. To identify statistical significance, a Fisher exact test with a Monte Carlo simulation was performed.

Results:

A total of 509 golf-related injuries (national estimate 24,425 cases) were recorded over the study period. Lacerations were the most common injury overall (54.2%), while contusions and abrasions were the next most common injuries (27.3%). The most common fracture subtype observed was midface (40.43%), followed by nasal bone (27.66%), mandible (12.77%), skull (12.77%), and cervical spine (6.38%). The highest proportion of patients admitted for further treatment were individuals >70 years of age. Fractures had the highest rate of admission (29.8%).

Conclusions:

A better understanding of golf injuries can allow for rapid detection and appropriate treatment when encountered. This knowledge can also help to develop safety precautions by potentially reforming rules and regulations as well as protective equipment.
Needs Assessment for Lower Urinary Tract Injury Curriculum for FPMRS Fellowships
Authors: Mueller Margaret G. , Corton Marlene , Kenton Kimberly
Published: September 2020

Objective

The aim of this study was to determine the level and types of training Accreditation Council for Graduate Medical Education–accredited programs use for female pelvic medicine and reconstructive surgery (FPMRS) fellows’ education on lower urinary tract injuries (LUTIs).

Methods

Two surveys were developed to assess the need for LUTI curriculum from both program director (PD) and fellow vantages through a multistage process, including review by knowledgeable colleagues, cognitive interviews, and pilot testing. Surveys were distributed in an electronic link via e-mail to graduating fellows and program directors from each of the 58 Accreditation Council for Graduate Medical Education–accredited FPMRS programs.

Results

Thirty-four graduating FPMRS fellows (71%) and 39 FPMRS PDs (67%) completed the survey. Both PDs and fellows responded that both the evaluation and management of LUTI were necessary to FPMRS training. The majority of PDs use a combination of didactics and hands-on learning in the operating room (60% and 71%). Only 40% and 30% incorporate simulation into the curriculum to address LUTI. Graduating fellows report low numbers of procedures to evaluate and manage LUTI. Specifically, only 15% of fellows graduate with greater than 2 ureteral reimplantations and 44% graduate with no minimally invasive abdominal vesicovaginal fistula repairs. The majority of graduating fellows reported feeling prepared to evaluate for LUTI, but nearly one third do not feel ready to independently manage LUTI upon graduation.

Conclusions

FPMRS PDs and fellows agree that the evaluation and management of LUTI are important; however, most programs use only didactics and hands-on learning in the operating room with extremely low case volumes, leading to decreased proficiency.
A unifying theory for two-dimensional spatial redistribution kernels with applications in population spread modelling
Authors: Koch Dean C. , Lewis Mark A. , Lele Subhash R.
Published: September 2020

When building models to explain the dispersal patterns of organisms, ecologists often use an isotropic redistribution kernel to represent the distribution of movement distances based on phenomenological observations or biological considerations of the underlying physical movement mechanism. The Gaussian, two-dimensional (2D) Laplace and Bessel kernels are common choices for 2D space. All three are special (or limiting) cases of a kernel family, the Whittle–Matérn–Yasuda (WMY), first derived by Yasuda from an assumption of 2D Fickian diffusion with gamma-distributed settling times. We provide a novel derivation of this kernel family, using the simpler assumption of constant settling hazard, by means of a non-Fickian 2D diffusion equation representing movements through heterogeneous 2D media having a fractal structure. Our derivation reveals connections among a number of established redistribution kernels, unifying them under a single, flexible modelling framework. We demonstrate improvements in predictive performance in an established model for the spread of the mountain pine beetle upon replacing the Gaussian kernel by the Whittle–Matérn–Yasuda, and report similar results for a novel approximation, the product-Whittle–Matérn–Yasuda, that substantially speeds computations in applications to large datasets.
Rapid indirect solar responses observed in the lower atmosphere
Authors: Harrison R. Giles , Lockwood Michael
Published: September 2020

Establishing clear evidence of solar-induced lower atmosphere effects is hampered by the small 11-year solar cycle responses, typically swamped by meteorological variability. Strong 27-day cyclic changes are exploited here instead. During the 2007/8 minimum in solar activity, regular 27-day lighthouse-like sweeps of energetic particles crossed the heliosphere and Earth, followed by a burst of solar ultraviolet radiation. Averaging the atmospheric responses at UK sites reveals immediate cooling in the troposphere after the peak energetic particle flux, followed by warming in the stratosphere. Regionally, this is accompanied by zonal wind changes, and temperature changes beneath cloud at the same time. Of two possible rapid distinct routes of solar influence—photochemical (through ozone) and atmospheric electrical (through low level clouds)—the ozone route does not provide a phase-locked response but the electrical route is supported by observed phase-locked thickening of low level clouds. These findings have potential value to weather forecasting.
Social rank modulates how environmental quality influences cooperation and conflict within animal societies
Authors: Liu Mark , Chen Bo-Fei , Rubenstein Dustin R. , Shen Sheng-Feng
Published: September 2020

Although dominance hierarchies occur in most societies, our understanding of how these power structures influence individual investment in cooperative and competitive behaviours remains elusive. Both conflict and cooperation in animal societies are often environmentally regulated, yet how individuals alter their cooperative and competitive investments as environmental quality changes remain unclear. Using game theoretic modelling, we predict that individuals of all ranks will invest more in cooperation and less in social conflict in harsh environments than individuals of the same ranks in benign environments. Counterintuitively, low-ranking subordinates should increase their investment in cooperation proportionally more than high-ranking dominants, suggesting that subordinates contribute relatively more when facing environmental challenges. We then test and confirm these predictions experimentally using the Asian burying beetleNicrophorus nepalensis. Ultimately, we demonstrate how social rank modulates the relationships between environmental quality and cooperative and competitive behaviours, a topic crucial for understanding the evolution of complex societies.
Predictive Modelling of COVID-19 New Cases in Algeria using An Extreme Learning Machines (ELM)
Authors: Djeddou Messaoud , Hameed Ibrahim A. , Nejatian Abolfazl , Loukam Imed
Published: September 2020

In this research, an extreme learning machine (ELM) is proposed to predict the new COVID-19 cases in Algeria. In the present study, public health database from Algeria health ministry has been used to train and test the ELM models.

The input parameters for the predictive models include Cumulative Confirmed COVID-19 Cases (CCCC), Calculated COVID-19 New Cases (CCNC), and Index Day (ID).

The predictive accuracy of the seven models has been assessed via several statistical parameters. The results showed that the proposed ELM model achieved an adequate level of prediction accuracy with smallest errors (MSE= 0.16, RMSE=0.4114, and MAE= 0.2912), and highest performance’s (NSE = 0.9999, IO = 0.9988, R2 = 0.9999). Hence, the ELM model could be utilized as a reliable and accurate modeling approach for predicting the new COVIS-19 cases in Algeria.

The proposed ELM model, it can be used as a decision support tool to manage public health medical efforts and facilities against the COVID-19 pandemic crisis.
Tethering-facilitated DNA ‘opening’ and complementary roles of β-hairpin motifs in the Rad4/XPC DNA damage sensor protein
Authors: Paul Debamita , Mu Hong , Tavakoli Amirrasoul , Dai Qing , Chen Xuejing , Chakraborty Sagnik , He Chuan , Ansari Anjum , Broyde Suse , Min Jung-Hyun
Published: September 2020

XPC/Rad4 initiates eukaryotic nucleotide excision repair on structurally diverse helix-destabilizing/distorting DNA lesions by selectively ‘opening’ these sites while rapidly diffusing along undamaged DNA. Previous structural studies showed that Rad4, when tethered to DNA, could also open undamaged DNA, suggesting a ‘kinetic gating’ mechanism whereby lesion discrimination relied on efficient opening versus diffusion. However, solution studies in support of such a mechanism were lacking and how ‘opening’ is brought about remained unclear. Here, we present crystal structures and fluorescence-based conformational analyses on tethered complexes, showing that Rad4 can indeed ‘open’ undamaged DNA in solution and that such ‘opening’ can largely occur without one or the other of the β-hairpin motifs in the BHD2 or BHD3 domains. Notably, the Rad4-bound ‘open’ DNA adopts multiple conformations in solution notwithstanding the DNA’s original structure or the β-hairpins. Molecular dynamics simulations reveal compensatory roles of the β-hairpins, which may render robustness in dealing with and opening diverse lesions. Our study showcases how fluorescence-based studies can be used to obtain information complementary to ensemble structural studies. The tethering-facilitated DNA ‘opening’ of undamaged sites and the dynamic nature of ‘open’ DNA may shed light on how the protein functions within and beyond NER in cells.
Probabilistic mapping of human functional brain networks identifies regions of high group consensus
Authors: Dworetsky Ally , Seitzman Benjamin A. , Adeyemo Babatunde , Neta Maital , Coalson Rebecca S. , Petersen Steven E. , Gratton Caterina
Published: September 2020

Many recent developments surrounding the functional network organization of the human brain have focused on data that have been averaged across groups of individuals. While such group-level approaches have shed considerable light on the brain’s large-scale distributed systems, they conceal individual differences in network organization, which recent work has demonstrated to be common and widespread. This individual variability produces noise in group analyses, which may average together regions that are part of different functional systems across participants, limiting interpretability. However, cost and feasibility constraints may limit the possibility for individual-level mapping within studies. Here our goal was to leverage information about individual-level brain organization to probabilistically map common functional systems and identify locations of high inter-subject consensus for use in future group analyses. We probabilistically mapped 14 functional networks in multiple datasets with relatively high amounts of data. All networks show “core” (high-probability) regions, but differ from one another in the extent of their higher-variability components. These patterns replicate well across four datasets with different participants and scanning parameters. We produced a set of high-probability regions of interest (ROIs) from these probabilistic maps; these and the probabilistic maps are made publicly available, together with a tool for querying the network membership probabilities associated with any given cortical location. These quantitative estimates and public tools may allow researchers to apply information about inter-subject consensus to their own fMRI studies, improving inferences about systems and their functional specializations.
A framework for mutational signature analysis based on DNA shape parameters
Authors: Karolak Aleksandra , Levatić Jurica , Supek Fran
Published: September 2020

The mutation risk of a DNA locus depends on its oligonucleotide context. In turn, mutability of oligonucleotides varies across individuals, due to exposure to mutagenic agents or due to variable efficiency and/or accuracy of DNA repair. Such variability is captured by mutational signatures, a mathematical construct obtained by a deconvolution of mutation frequency spectra across individuals. There is a need to enhance methods for inferring mutational signatures to make better use of sparse mutation data (e.g., resulting from exome sequencing of cancers), to facilitate insight into underlying biological mechanisms, and to provide more accurate mutation rate baselines for inferring positive and negative selection. We propose a conceptualization of mutational signatures that represents oligonucleotidesviadescriptors of DNA conformation: base pair, base pair step, and minor groove width parameters. We demonstrate how such DNA structural parameters can accurately predict mutation occurrence due to DNA repair failures or due to exposure to diverse mutagens such as radiation, chemical exposure, and the APOBEC cytosine deaminase enzymes. Furthermore, the mutation frequency of DNA oligomers classed by structural features can accurately capture systematic variability in mutagenesis of >1,000 tumors originating from diverse human tissues. A nonnegative matrix factorization was applied to mutation spectra stratified by DNA structural features, thereby extracting novel mutational signatures. Moreover, many of the known trinucleotide signatures were associated with an additional spectrum in the DNA structural descriptor space, which may aid interpretation and provide mechanistic insight. Overall, we suggest that the power of DNA sequence motif-based mutational signature analysis can be enhanced by drawing on DNA shape features.