bluuebunny/crossref_metadata_2025_split huggingface dataset:
RMTD-08 RADIATION ABSORBED DOSE TO SPINAL CORD: THERAPY OF LEPTOMENINGEAL METASTASES USING BETA-EMISSION RADIOPHARMACEUTICALS
Authors: Bao Ande , Zhao Xia , Phillips William , Brenner Andrew , Youssef Michael , Kumthekar Priya , Yang Jonathan , Zheng Yiran , Spratt Daniel E , Moore Melissa , Hedrick Marc , LaFrance Norman , Juverdianu Leonardo , Blouw Barbara 
Published: August 2024

Abstract

BACKGROUND
Over 100,000 cancer patients develop leptomeningeal metastases (LM) annually in the US. LM prognosis is poor with limited treatment options. Beta-emission radiopharmaceuticals, for example, 186Re-nanoliposomes (Rhenium (186Re) Obisbemeda, 186RNL), are a promising new therapeutic approach to deliver high doses of ionizing radiation to the disease without significant normal tissue exposure. However, the dose and possible toxicity to the spinal cord may be a concern. Herein, we report radiation dosimetry to understand the radiation absorbed dose to spinal cord for this novel treatment approach.

METHODS
The T2-weighted MRI of the cervical spine from a patient with LM was segmented into volumes of the cerebrospinal fluid (CSF) and spinal cord. The radiation absorbed dose distribution in CSF and spinal cord were calculated using dose voxel kernel and 3D convolution. The beta-emission radionuclides with different beta-energies (177Lu, 131I, 186Re, 188Re, and 90Y) were calculated. The dose distribution in CSF and spinal cord were summarized and evaluated.

RESULTS
It was found that the radiation absorbed doses to spinal cord are associated with the beta-energy of radionuclides. The mean doses to the spinal cord in the calculated volume were 2.75%, 7.25%, 10.89%, 29.69%, and 37.66% of mean doses in CSF for 177Lu, 131I, 186Re, 188Re, and 90Y, respectively. The radionuclides with lower beta-energy can largely spare the spinal cord with significantly lower radiation doses. The radionuclides with higher beta-energy provide larger doses to spinal cord, while the dose to CSF were more heterogeneous.

CONCLUSION
This radiation dosimetry study demonstrates that beta-emission radiopharmaceuticals with lower beta-energies are optimal for the treatment of LM to maximize the therapeutic ratio given the proximity of the spinal cord. This study provides the guidance for the possible doses to be applied for the safe treatment of LM, including the treatment of patients with previous external beam radiation therapy.
SPCM-04 SURGICAL EXCISION OF SPINAL INTRADURAL METASTASES: A 10 YEAR INSTITUTIONAL EXPERIENCE
Authors: Ambati Vardhaan , Patel Arati , Tawil Michael , Krishnan Nishanth , Bernabei John , Zammar Samer , Ames Christopher , Clark Aaron , Chin Cynthia , Alan Nima , Chou Dean , Mummaneni Praveen 
Published: August 2024

Abstract

INTRODUCTION)
Spinal intradural metastases are rare and are usually managed non-operatively given poor prognosis of widespread metastatic disease. Surgical resection is considered in cases of rapid, progressive neurological decline. We describe our single-center, 10-year experience of surgical resection of spinal intradural metastases.

METHODS)
Adults who underwent surgical resection of spinal intradural metastatic (excluding neurogenic) tumors at a single quaternary care institution over 10 years were reviewed. Clinical, surgical, and postoperative outcomes were summarized.

RESULTS)
Twelve patients (5 female) with mean age 58.3 (range 32.5-77.6) years underwent resection of spinal intradural metastases (5 intramedullary, 7 extramedullary). Cases included metastatic adenocarcinoma (2 breast, 1 parotid, 1 uterine), melanoma (3), renal cell carcinoma (2), follicular thyroid carcinoma (1), adenoid cystic carcinoma (1), and prostate cancer (1). Tumors were located at thoracolumbar junction (6), cervicothoracic junction (3), lumbar (2), and cervical spine (1). Patients presented with mean 9.4 weeks (range 1-day to 1-year) of symptoms. At presentation, 9 were found to have leptomeningeal disease; 6 had brain metastases. All patients underwent laminectomy (median 3; range 2-5 levels). Gross total resection of symptom-causing tumors was achieved in 5 of 12 patients. Postoperatively, 11 patients demonstrated stable/improving neurological exams from preoperative baseline. Ninety-day readmission rate was 50%, and two patients required reoperation for pseudomeningocele. Eleven patients were treated with neoadjuvant/adjuvant therapy (TKIs, hormonal, immunotherapy). Six underwent radiation therapy. Mean follow-up was 1.2 years, at which point, 3 patients died (mean survival 2-years, range 1month-4.9years). Mean cohort Karnofsky Performance Scale (KPS) improved from 44% preoperatively (range 30-70%) to 53% (range 0% [deceased]-90%); mean KPS improves to 64% if deceased patients are excluded.

CONCLUSION)
This represents one of the largest series of surgically treated intradural nonneurogenic metastases. Even in patients with widespread metastatic burden, intradural tumor resection in patients with neurological decline may improve postoperative function and survival.
QSPC-06 TIME-SERIES SINGLE-CELL ANALYSES REVEAL INCESSANT REWIRING OF MICROGLIA AFTER OF CRANIAL IRRADIATION
Authors: Osman Ahmed , Romero Alejandro Lastra , Preka Efthalia , Pizzirusso Giusy , Arroyo-Garcia Luis Enrique , Zisiadis Georgios Alkis , Oliva-Vilarnau Nuria , Seitz Thea , Zhou Kai , Isla Arturo Gonzalez , Sun Ying , Zhu Changlian , Rodrigues Carlos , Fisahn André , Fragkopoulou Adamantia , Lauschke Volker , Betsholtz Christer , Blomgren Klas 
Published: August 2024

Abstract
Cranial irradiation (IR) is one of the pillars of treatment of brain tumors and metastases, but it causes progressive neurocognitive impairments in cancer survivors. Neuroinflammation is believed to contribute to this, but its dynamics and consequences on brain function remain poorly understood. Here, we performed longitudinal molecular and cellular profiling of the irradiated mouse hippocampus, a key brain structure for cognitive tasks, using single cell transcriptomics and computational analyses, proteomics and histology, covering multiple time points, from 6 hours to 1 year after IR. We found that IR induced biphasic inflammatory waves, and microglia were the key orchestrating cells. The first wave occurred within the first 24 hours after IR, triggered by the death of neural progenitors in the dentate gyrus. The second, delayed wave occurred 2 weeks after IR, coupling interferon signaling to mitotic progression, and a subsequent induction of temporally regulated subtypes. Trajectory analysis uncovered that this subset of microglia drives microglial mitotic progression, cell death, or a senescent-like phenotype predominantly observed 6 weeks after IR. At this timepoint, the levels of cytokines known to have negative effects on cognition, like tumor necrosis factor and interleukin-6, were increased, coinciding with neuronal asynchrony of the hippocampal circuitry. We also found that IR caused progressive microglial loss and that they fail to repopulate the empty territories by self-renewal, leading to infiltration of peripheral macrophages to repopulate the hippocampus and differentiate into microglia-like cells by 6 months after IR. After 1 year, microglial alterations were largely related to neuronal and synaptic plasticity, and again coinciding with neuronal asynchrony. Thus, the inflammation profile in the hippocampus after IR is dynamic, and therapies targeting inflammation should be tailored accordingly.
SRGD-03 PRESENTATION AND POST-OPERATIVE OUTCOMES IN DIVERSE PATIENTS RECEIVING LASER ABLATION FOR CENTRAL NERVOUS SYSTEM METASTASES
Authors: Haskell-Mendoza Aden , Gonzalez Ariel , Reason Ellery , Jackson Joshua , Seas Andreas , Zaidi Saif , Mohan Aditya , Lerner Emily , Srinivasan Ethan , Bradbury Claire , Herndon James , Goodwin C Rory , Fecci Peter 
Published: August 2024

Abstract

OBJECTIVE
Laser interstitial thermal therapy (LITT) is a minimally invasive option for the management of intracranial pathologies, including radiographically progressive tumors following stereotactic radiosurgery. Although LITT has been increasingly accepted in recent years, little is known regarding presentation and outcomes of patients with diverse backgrounds, particularly for centers specializing in central nervous system (CNS) metastases.

METHODS
All patients receiving their index LITT for brain metastasis at a single center from 2015 – 2023 were retrospectively reviewed. Patient demographics and geospatial data was used to compare differences in receipt of LITT by race/ethnicity, survival outcomes, and clinical trial enrollment.

RESULTS
From 2015-2023, 137 patients presented for LITT to 146 intracranial lesions. One hundred and six patients (77.3%) were non-Hispanic White (NHW), 25 (18.2%) were Black or African American, 5 (3.6%) were Asian American/Pacific Islander, and 1 (0.7%) was Hispanic or Latino (Hispanic or non-White, HNW). Among HNW patients, women more frequently received LITT (P = 0.022), with skin cancers being a more frequent indication among NHW patients (P = 0.019). NHW patients traveled a median of 62.0 (6.2 – 1045.9) miles to receive LITT vs 25.9 (1.31 – 238.3) miles for HNW patients (p = 0.001). In multivariate analyses, post-LITT overall survival was predicted by pre-LITT KPS (P = 0.0007) and recurrent tumor on biopsy (P = 0.0002), while probability of clinical trial enrollment was lower among those of female sex (P = 0.049), HNW race/ethnicity (P = 0.041), or external referral status (P = 0.035).

CONCLUSION
Patient sex, systemic disease histology, and distance from a treating center may differentially influence presentation for LITT according to underlying racial/ethnic identity. However, patients successfully treated in multidisciplinary CNS metastasis centers experience excellent post-procedural outcomes. Such centers should enact measures to ensure equitable clinical trial enrollment.
TRSC-05 TUMOR REACTIVE T CELLS FROM THE CEREBROSPINAL FLUID IN MELANOMA LEPTOMENINGEAL DISEASE
Authors: Pina Yolanda , Carter Michael , Hall Maclean , Rodriguez Madeline , Beatty Matthew , Forsyth Peter , Pilon-Thomas Shari 
Published: August 2024

Abstract

BACKGROUND
Leptomeningeal disease (LMD) is a devastating complication from cancer, with a median survival of 6-8 weeks. The incidence of LMD is highest in melanoma (5-25%) carrying the worst prognosis. Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) showed complete and durable responses in patients with advanced metastatic melanoma. CSF-derived T cell populations in LMD shift to more exhausted phenotypes compared to extracranial and brain metastases. Adoptive T cell transfer can be a novel therapeutic approach to treat melanoma LMD (M-LMD). Our goal is to optimize CSF-derived tumor reactive T cell expansion in M-LMD and assess their anti-tumoral response.

METHODS
Cells from CSF from M-LMD patients (n=6) were plated following established TIL culture protocols to determine optimal expansion conditions i.e.: 1) 6000 IU/mL IL-2, 2) IL-2+OKT3, 3) IL-2+anti-4-1BB agonistic antibody, 4) IL-2+IL-7+IL-15+IL-21, 5) IL-2+anti-CD3/CD28 human dynabeads, & 6) IL-2+anti-CD3/CD28/CD137 human dynabeads. After 4 weeks, T cells were propagated via REP and phenotyped. T cells were co-cultured with HLA-matched melanoma cell lines and IFN-y levels evaluated. TCR beta seq was done at different times point of expansion and peripheral T cells.

RESULTS
After initial culture in IL-2, 61.9% of samples showed increased cell yield with an average 101.68-fold expansion (range 2.35-1054). PreREP T cells were predominantly CD4+ (45.7%). REP was 100% success rate (mean 187.47-fold expansion). Post-REP flow cytometry revealed similar results. M-LMD T cells were highly functional, producing substantial levels of IFN-y in response to HLA-matched cells. Anti-CD3/CD28 produced a larger expansion of T cells with higher levels of IFN-y. TCR beta sequencing results are pending.

CONCLUSIONS
Therapies for LMD patients are desperately needed. Results demonstrate successful expansion of T cells ex vivo from CSF in M-LMD. Results raise potential to use autologous CSF-derived T cells as therapeutic strategy for patients with LMD.
Radiation protection adherence and associated factors among radiology personnel
Authors: Fathabadi Amirhossein , Oloomi Shabnam 
Published: August 2024

Abstract
The aim of the study was to investigate radiation protection adherence among radiology personnel and associated factors. In light of the increasing integration of ionizing radiation in medical diagnostics and treatment—specifically in areas such as computed tomography, fluoroscopy, and therapeutic radiology—it is vital for radiology personnel to consistently uphold rigorous radiation protection standards. This cross-sectional study employed a self-administered questionnaire to collect demographic data and assess various aspects of radiation protection adherence among radiology personnel. The gathered data were entered into SPSS 16 for statistical analysis. Among the 119 participants, 72 (60.5%) worked in the radiology department, and 88 (77.9%) were married. Significant associations were observed between adherence levels and marital status, age groups, years of experience, and department type. Study findings showed a significant association between several demographic factors and radiation protection adherence. Furthermore, our results highlight the value of implementing radiation protection courses to enhance adherence among personnel.
A Qualitative Analysis of Workers Perceptions on the Role of Management in Promoting Health Behavior, Informed by the COM-B Model
Authors: Gradidge Philippe Jean-Luc , Alsop Tahlia , Palmeira António , Gordon Neil F. , Gomersall Sjaan 
Published: August 2024

Background
The primary objective of this study was to explore the viewpoints held by employees at a pharmaceutical manufacturing workplace in a middle-income country regarding management's role in promoting health behaviors in the workplace.

Methods
This study used transcripts of focus group discussion from an original study that investigated employee perceptions of factors associated with healthy behaviors among South African pharmaceutical manufacturing factory workers.

Results
Participants felt that workplace managers could improve capability through health promotion strategies, supportive leadership, and promoting a culture of health. They could provide opportunity through employee engagement programs and resources, and physical activity opportunities were specifically identified.

Conclusions
This study demonstrates that managers in a middle-income country have the potential to contribute to workplace health in a range of ways that include addressing capability, opportunity, and motivation of their workers.
Effect of Deep Learning Image Reconstruction Algorithms on Radiomic Features of Pulmonary Nodules in Ultra-Low-Dose CT
Authors: Zheng Zhijuan , Liang Yuying , Wu Zhehao , Han Qijia , Ai Zhu , Ma Kun , Xiang Zhiming 
Published: August 2024

Objective
The purpose of this study is to explore the impact of deep learning image reconstruction (DLIR) algorithm on the quantification of radiomic features in ultra-low-dose computed tomography (ULD-CT) compared with adaptive statistical iterative reconstruction-Veo (ASIR-V).

Methods
One hundred eighty-three patients with pulmonary nodules underwent standard-dose computed tomography (SDCT) (4.30 ± 0.36 mSv) and ULD-CT (UL-A, 0.57 ± 0.09 mSv or UL-B, 0.33 ± 0.04 mSv). SDCT was the reference standard using (ASIR-V) at 50% strength (50%ASIR-V). ULD-CT was reconstructed with 50%ASIR-V, DLIR at medium and high strength (DLIR-M, DLIR-H). Radiomics analysis extracted 102 features, and the intraclass correlation coefficient (ICC) quantified reproducibility between ULD-CT and SDCT reconstructed by 50%ASIR-V, DLIR-M, and DLIR-H for each feature.

Results
Among 102 radiomic features, the percentages of reproducibility of 50%ASIR-V, DLIR-M, and DLIR-H were 48.04% (49/102), 49.02% (50/102), and 52.94% (54/102), respectively. Shape and first order features demonstrated high reproducibility across different reconstruction algorithms and radiation doses, with mean ICC values exceeding 0.75. In texture features, DLIR-M and DLIR-H showed improved mean ICC values for pure ground glass nodules (pGGNs) from 0.69 ± 0.23 to 0.75 ± 0.18 and 0.81 ± 0.12, respectively, compared with 50%ASIR-V. Similarly, the mean ICC values for solid nodules (SNs) increased from 0.60 ± 0.19 to 0.66 ± 0.14 and 0.69 ± 0.13, respectively. Additionally, the mean ICC values of texture features for pGGNs and SNs in both ULD-CT groups decreased with reduced radiation dose.

Conclusions
DLIR can improve the reproducibility of radiomic features at ultra-low doses compared with ASIR-V. In addition, pGGNs showed better reproducibility at ultra-low doses than SNs.
Impact on Image Quality and Diagnostic Performance of Dual-Layer Detector Spectral CT for Pulmonary Subsolid Nodules: Comparison With Hybrid and Model-Based Iterative Reconstruction
Authors: Ding Li , Li Xiaomei , Lin Jie , Deng Shuting , Chen Mingwang , Deng Weiwei , Xu Yikai , Chen Zhao , Yan Chenggong 
Published: August 2024

Objective
To evaluate the image quality and diagnostic performance of pulmonary subsolid nodules on conventional iterative algorithms, virtual monoenergetic images (VMIs), and electron density mapping (EDM) using a dual-layer detector spectral CT (DLSCT).

Methods
This retrospective study recruited 270 patients who underwent DLSCT scan for lung nodule screening or follow-up. All CT examinations with subsolid nodules (pure ground-glass nodules [GGNs] or part-solid nodules) were reconstructed with hybrid and model-based iterative reconstruction, VMI at 40, 70, 100, and 130 keV levels, and EDM. The CT number, objective image noise, signal-to-noise ratio, contrast-to-noise ratio, diameter, and volume of subsolid nodules were measured for quantitative analysis. The overall image quality, image noise, visualization of nodules, artifact, and sharpness were subjectively rated by 2 thoracic radiologists on a 5-point scale (1 = unacceptable, 5 = excellent) in consensus. The objective image quality measurements, diameter, and volume were compared among the 7 groups with a repeated 1-way analysis of variance. The subjective scores were compared with Kruskal-Wallis test.

Results
A total of 198 subsolid nodules, including 179 pure GGNs, and 19 part-solid nodules were identified. Based on the objective analysis, EDM had the highest signal-to-noise ratio (164.71 ± 133.60; P < 0.001) and contrast-to-noise ratio (227.97 ± 161.96; P < 0.001) among all image sets. Furthermore, EDM had a superior mean subjective rating score (4.80 ± 0.42) for visualization of GGNs compared to other reconstructed images (all P < 0.001), although the model-based iterative reconstruction had superior subjective scores of overall image quality. For pure GGNs, the measured diameter and volume did not significantly differ among different reconstructions (both P > 0.05).

Conclusions
EDM derived from DLSCT enabled improved image quality and lesion conspicuity for the evaluation of lung subsolid nodules compared to conventional iterative reconstruction algorithms and VMIs.
Usefulness of Picture Archiving and Communication System–Based Quantitative Ultrasound Measurements in Evaluation of Allograft Dysfunction in Patients With Liver Transplantation
Authors: Erdem Toslak Iclal , Joyce Cara , Yacoub Joseph H. 
Published: August 2024

Objective
The aim of this study was to assess the usefulness of picture archiving and communication system (PACS)–based quantitative grayscale ultrasonography (US) measurements in detecting allograft dysfunction in posttransplant patients.

Methods
In this retrospective study, 116 patients with liver transplantation who underwent biopsy for allograft evaluation were recruited from the database. All participants had US images prior to procedure. Normal, acute cellular rejection (ACR), recurrent hepatitis (Hep), or combined (ACR/Hep) groups were generated based on pathology results. Region of interests were drawn for liver and rectus abdominus muscle to perform quantitative US analysis. The liver/muscle mean ratio (L/M) and heterogeneity index (HI; liver standard deviation/liver mean) were obtained. The ratios of groups were compared, and receiver-operating-characteristic analysis was performed.

Results
There was a significant difference between normal (n = 16) and each of other groups (ACR, 39; Hep, 36; combined, 25) for L/M and HI (P < 0.05). No significant difference was detected between ACR, Hep, and combined groups. The areas under the curve for L/M and HI were 0.755 (moderate) and 0.817 (good), respectively. To differentiate abnormal (ACR, Hep, and combined) from normal allografts sensitivity, specificity, PPV, and NPV were 50.0%, 87.5%, 96.2%, and 21.9% for cut point of L/M ≥1 and 84.0%, 68.8%, 94.4%, and 40.7% for cut point of HI ≥0.2 with odds ratios of 7.52 (for L/M ≥1) and 13.10 (for HI ≥0.2), respectively (P < 0.01).

Conclusions
L/M has moderate and HI has good discrimination of normal from abnormal allograft in liver transplant patients. PACS-based quantitative US measurements is an objective, easy to use, noninvasive auxiliary tool to discriminate hepatic allograft dysfunction.
The Feasibility of a Model-Based Iterative Reconstruction Technique Tuned for the Myocardium on Myocardial Computed Tomography Late Enhancement
Authors: Toritani Hidetaka , Yoshida Kazuki , Hosokawa Takaaki , Tanabe Yuki , Yamamoto Yuta , Nishiyama Hikaru , Kido Tomoyuki , Kawaguchi Naoto , Matsuda Megumi , Nakano Shota , Miyazaki Shigehiro , Uetani Teruyoshi , Inaba Shinji , Yamaguchi Osamu , Kido Teruhito 
Published: August 2024

Objectives
This study evaluated the feasibility of a model-based iterative reconstruction technique (MBIR) tuned for the myocardium on myocardial computed tomography late enhancement (CT-LE).

Methods
Twenty-eight patients who underwent myocardial CT-LE and late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) within 1 year were retrospectively enrolled. Myocardial CT-LE was performed using a 320-row CT with low tube voltage (80 kVp). Myocardial CT-LE images were scanned 7 min after CT angiography (CTA) without additional contrast medium. All myocardial CT-LE images were reconstructed with hybrid iterative reconstruction (HIR), conventional MBIR (MBIR_cardiac), and new MBIR tuned for the myocardium (MBIR_myo). Qualitative (5-grade scale) scores and quantitative parameters (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) were assessed as image quality. The sensitivity, specificity, and accuracy of myocardial CT-LE were evaluated at the segment level using an American Heart Association (AHA) 16-segment model, with LGE-MRI as a reference standard. These results were compared among the different CT image reconstructions.

Results
In 28 patients with 448 segments, 160 segments were diagnosed with positive by LGE-MRI. In the qualitative assessment of myocardial CT-LE, the mean image quality scores were 2.9 ± 1.2 for HIR, 3.0 ± 1.1 for MBIR_cardiac, and 4.0 ± 1.0 for MBIR_myo. MBIR_myo showed a significantly higher score than HIR (P < 0.001) and MBIR_cardiac (P = 0.018). In the quantitative image quality assessment of myocardial CT-LE, the median image SNR was 10.3 (9.1–11.1) for HIR, 10.8 (9.8–12.1) for MBIR_cardiac, and 16.8 (15.7–18.4) for MBIR_myo. The median image CNR was 3.7 (3.0–4.6) for HIR, 3.8 (3.2–5.1) for MBIR_cardiac, and 6.4 (5.0–7.7) for MBIR_myo. MBIR_myo significantly improved the SNR and CNR of CT-LE compared to HIR and MBIR_cardiac (P < 0.001). The sensitivity, specificity, and accuracy for the detection of myocardial CT-LE were 70%, 92%, and 84% for HIR; 71%, 92%, and 85% for MBIR_cardiac; and 84%, 92%, and 89% for MBIR_myo, respectively. MBIR_myo showed significantly higher image quality, sensitivity, and accuracy than the others (P < 0.05).

Conclusions
MBIR tuned for myocardium improved image quality and diagnostic performance for myocardial CT-LE assessment.