Current quantification methods of
123
I-FP-CIT SPECT rely on anatomical parcellation of the striatum. We propose here to implement a new method based on MRI segmentation and functional atlas of the ...basal ganglia (MR-ATLAS) that could provide a reliable quantification within the sensorimotor, associative, and limbic territories of the striatum. Patients with Parkinson’s disease (PD), idiopathic rapid eye movement sleep behavioral disorder (iRBD), and healthy controls underwent
123
I-FP-CIT SPECT, MRI, motor, and cognitive assessments. SPECT data were corrected for partial volume effects and registered to a functional atlas of the striatum to allow quantification in every functional region of the striatum (nucleus accumbens, limbic, associative, and sensorimotor parts of the striatum). The MR-ATLAS quantification method is proved to be reliable in every territory of the striatum. In addition, good correlations were found between cognitive dysexecutive tests and the binding within the functional (limbic) territories of the striatum using the MR-ATLAS method, slightly better than correlations found using the anatomical quantification method. This new MR-ATLAS method provides a robust and useful tool for studying the dopaminergic system in PD, particularly with respect to cognitive functions. It may also be relevant to further unravel the relationship between dopaminergic denervation and cognitive or behavioral symptoms.
PURPOSERetrospective description of anatomical sites of relapse based on (18F)-choline PET-CT, (68Ga)-prostatic specific-membrane antigen PET-CT, bone scan, and prostate magnetic resonance imaging ...(MRI) data. MATERIALS AND METHODSFrom two French prospective cohorts, patients treated with exclusive radiotherapy for an intermediate-risk cancer were identified during their follow-ups. They were included if they presented a rising of the prostate-specific antigen (PSA) associated with the realization of an imaging showing the sites of recurrences. RESULTSTwo hundred and sixty-three patients were included. After a median follow-up of 76 months (interquartile range IQR 67-95), 65 patients had biochemical recurrence and positive imaging. The median nadir PSA was 0.6ng/mL and the median PSA at recurrence was 3.4ng/mL. A single lesion was found in 48% of cases, 2 to 4 lesions in 43% of cases and more than 4 lesions in 9% of cases. The sites of relapse identified were prostate (37/65), prostate only (19/65), seminal vesicles (9/65) Pelvic nodes (35/65), extrapelvic nodes (15/65) and bone (13/65). CONCLUSIONSThe majority of relapses presented as a single lesion localized in the pelvis.
A comparative study of electronic transport and Hall measurements of PbBi
2
Te
4
and SnBi
2
Te
4
single crystals are presented here. The phase coherence lengths at different temperatures are ...determined by fitting observed low-field weak antilocalization (WAL) effect with modified Hikami-Larkin-Nagaoka equation. Temperature dependence of phase coherence lengths are described in conjugation with electron–electron (
e–e
) and electron–phonon (
e–p
) interactions. The fitting parameters reveal
e–e
,
e–p
interactions that follow
T
-
1
,
T
-
2.68
power law, respectively, for PbBi
2
Te
4
single crystal, while for SnBi
2
Te
4
single crystal
e-e
and
e-p
interactions obey
T
-
1
and
T
-
2.8
power law, respectively. These indicate the two-dimensional conducting channels are participating in WAL effect. Analysis of the high-field beat-like Shubnikov-de Haas (SdH) oscillations reveals the presence of topological surface states and an elongated band outside the surface states, the non-trivial nature of which is confirmed from the observed
1
2
-shift in Landau levels fan diagram. Estimated lower effective mass from Lifshitz-Kosevich (LK) fit and higher mobility values determined from Dingle analysis confirm the surface origin of the SdH oscillations. Comparison of the effective mass, quantum scattering time, mean free path, mobility, and metallicity parameters for the carriers at the topological surface states determined from the SdH oscillations for both the compounds reflect the topological surface states in PbBi
2
Te
4
are of superior quality over the topological surface states in SnBi
2
Te
4
. This is indeed the case as Pb with higher atomic weight is replaced for Sn in SnBi
2
Te
4
, which provides more spin-orbit coupling in the system.
•This is the first European cost-effectiveness analysis of moderately hypofractionated radiotherapy (H-RT) compared to conventional radiotherapy (C-RT).•Using H-RT as a standard treatment for ...intermediate-risk prostate cancer is cost saving.•The economic evidence supporting the shift towards H-RT in France should stimulate reimbursement policy changes.
To evaluate the cost-effectiveness of moderate Hypofractionated Radiotherapy (H-RT) compared to Conventional Radiotherapy (C-RT) for intermediate-risk prostate caner (PCa).
A prospective randomized clinical trial including 222 patients from six French cancer centers was conducted as an ancillary study of the international PROstate Fractionated Irradiation Trial (PROFIT). We carried-out a cost-effectiveness analysis (CEA) from the payer’s perspective, with a time horizon of 48 months.
Patients assigned to the H-RT arm received 6000 cGy in 20 fractions over 4 weeks, or 7800 cGy in 39 fractions over 7 to 8 weeks in the C-RT arm. Patients completed quality of life (QoL) questionnaire: Expanded Prostate Cancer Index Composite (EPIC) at baseline, 24 and 48 months, which were mapped to obtain a EuroQol five-dimensional questionnaire (EQ-5D) equivalent to generate Quality Adjusted Life Years (QALY).
We assessed differences in QALYs and costs between the two arms with Generalized Linear Models (GLMs). Costs, estimated in euro (€) 2020, were combined with QALYs to estimate the Incremental Cost-effectiveness ratio (ICER) with non-parametric bootstrap.
Total costs per patien were lower in the H-RT arm compared to the C-RT arm €3,062 (95 % CI: 2,368 to 3,754) versus €4,285 (95 % CI: 3,355 to 5,215), (p < 0.05). QALY were marginally higher in the H-RT arm, however this difference was not significant: 0.044 (95 % CI: − 0.016 to 0.099).
Treating localized prostate cancer with moderate H-RT could reduce national health insurance spending. Adopting such a treatment with an updated reimbursement tariff would result in improving resource allocation in RT management.
PET/MRI with
F-FDG has demonstrated the advantages of simultaneous PET and MR imaging in head and neck cancer imaging, MRI allowing excellent soft-tissue contrast, while PET provides metabolic ...information. The aim of this study was to evaluate the added value of gadolinium contrast-enhanced sequences in the tumor delineation of head and neck cancers on
F-FDG-PET/MR imaging.
Consecutive patients who underwent simultaneous head and neck
F-FDG-PET/MR imaging staging or restaging followed by surgery were retrospectively included. Local tumor invasion and lymph node extension were assessed in 45 head and neck anatomic regions using
F-FDG-PET/MR imaging by 2 rater groups (each one including a radiologist and a nuclear medicine physician). Two reading sessions were performed, one without contrast-enhanced sequences (using only T1WI, T2WI, and PET images) and a second with additional T1WI postcontrast sequences. The results were compared with the detailed histopathologic analysis, used as reference standard. The κ concordance coefficient between the reading sessions and sensitivity and specificity for each region were calculated.
Thirty patients were included. There was excellent agreement between the contrast-free and postgadolinium reading sessions in delineating precise tumor extension in the 45 anatomic regions studied (Cohen κ = 0.96, 95% CI = 0.94-0.97,
< .001). The diagnostic accuracy did not differ between contrast-free and postgadolinium reading sessions, being 0.97 for both groups and both reading sessions. For the 2 rater groups, there was good sensitivity for both contrast-free (0.83 and 0.85) and postgadolinium reading sessions (0.88 and 0.90, respectively). Moreover, there was excellent specificity (0.98) for both groups and reading sessions.
Gadolinium chelate contrast administration showed no added value for accurate characterization of head and neck primary tumor extension and could possibly be avoided in the PET/MR imaging head and neck workflow.
Description rétrospective des sites anatomiques de rechute à partir des données de tomographie par émission de positons (TEP-tomodensitométrie) à la (18F)-choline (TEP-choline), TEP-TDM au ...(68Ga)-prostatic specific-membrane antigen (TEP-PSMA), scintigraphie osseuse et imagerie par résonance magnétique (IRM) prostatique.
À partir de deux cohortes prospectives françaises, des patients traités par irradiation exclusive pour un cancer de risque intermédiaire ont été identifiés. Ils étaient inclus s’il y avait une élévation du prostate-specific antigen (PSA) associée à la réalisation d’une imagerie mettant en évidence les sites de récidives.
Deux cent soixante-trois patients ont été inclus. Après un suivi médian de 77 mois (écart interquartile EI 68–96), une récidive biochimique avec une imagerie positive est survenue chez 65 patients. Le nadir du PSA médian était de 0,6ng/mL et le PSA médian à la rechute de 3,4ng/mL. Une lésion unique a été retrouvée dans 48 % des cas, deux à quatre lésions dans 43 % des cas et plus de quatre lésions dans 9 % des cas. Les sites de rechutes identifiés étaient la prostate (37/65), dont seule (19/65), les vésicules séminales (9/65) Les ganglions pelviens (35/65), les ganglions extra-pelviens (15/65) et les os (13/65).
La majorité des rechutes survenant dans les suites d’une radiothérapie prostatique exclusive pour cancer de prostate de risque intermédiaire sont uniques et localisées dans le pelvis, ce qui pourrait permettre d’envisager un traitement locorégional de rattrapage.
Retrospective description of anatomical sites of relapse based on (18F)-choline PET-CT, (68Ga)-prostatic specific-membrane antigen PET-CT, bone scan, and prostate magnetic resonance imaging (MRI) data.
From two French prospective cohorts, patients treated with exclusive radiotherapy for an intermediate-risk cancer were identified during their follow-ups. They were included if they presented a rising of the prostate-specific antigen (PSA) associated with the realization of an imaging showing the sites of recurrences.
Two hundred and sixty-three patients were included. After a median follow-up of 76 months (interquartile range IQR 67–95), 65 patients had biochemical recurrence and positive imaging. The median nadir PSA was 0.6ng/mL and the median PSA at recurrence was 3.4ng/mL. A single lesion was found in 48% of cases, 2 to 4 lesions in 43% of cases and more than 4 lesions in 9% of cases. The sites of relapse identified were prostate (37/65), prostate only (19/65), seminal vesicles (9/65) Pelvic nodes (35/65), extrapelvic nodes (15/65) and bone (13/65).
The majority of relapses presented as a single lesion localized in the pelvis.
BACKGROUND AND PURPOSEPET/MRI with 18F-FDG has demonstrated the advantages of simultaneous PET and MR imaging in head and neck cancer imaging, MRI allowing excellent soft-tissue contrast, while PET ...provides metabolic information. The aim of this study was to evaluate the added value of gadolinium contrast-enhanced sequences in the tumor delineation of head and neck cancers on 18F-FDG-PET/MR imaging. MATERIALS AND METHODSConsecutive patients who underwent simultaneous head and neck 18F-FDG-PET/MR imaging staging or restaging followed by surgery were retrospectively included. Local tumor invasion and lymph node extension were assessed in 45 head and neck anatomic regions using 18F-FDG-PET/MR imaging by 2 rater groups (each one including a radiologist and a nuclear medicine physician). Two reading sessions were performed, one without contrast-enhanced sequences (using only T1WI, T2WI, and PET images) and a second with additional T1WI postcontrast sequences. The results were compared with the detailed histopathologic analysis, used as reference standard. The κ concordance coefficient between the reading sessions and sensitivity and specificity for each region were calculated. RESULTSThirty patients were included. There was excellent agreement between the contrast-free and postgadolinium reading sessions in delineating precise tumor extension in the 45 anatomic regions studied (Cohen κ = 0.96, 95% CI = 0.94-0.97, P < .001). The diagnostic accuracy did not differ between contrast-free and postgadolinium reading sessions, being 0.97 for both groups and both reading sessions. For the 2 rater groups, there was good sensitivity for both contrast-free (0.83 and 0.85) and postgadolinium reading sessions (0.88 and 0.90, respectively). Moreover, there was excellent specificity (0.98) for both groups and reading sessions. CONCLUSIONSGadolinium chelate contrast administration showed no added value for accurate characterization of head and neck primary tumor extension and could possibly be avoided in the PET/MR imaging head and neck workflow.
Clinical research is an essential activity in cancer care. Both for patients, who can gain access to innovative therapies, and for practitioners, who can maintain their skills and stay at the ...forefront of new treatment approaches. First developed in university hospitals, clinical research is now established in general hospitals and private health institutions. The number of patient inclusions in clinical trials has doubled over the last ten years, thus reflecting the dynamism of it. Strengths and weaknesses, opportunities and threats concerning clinical research, and more specifically clinical research in general hospitals, are exposed in this article.
Hurricane Harvey made landfall in Texas August 25, 2017, bringing massive rains and flooding that impacted soils in a residential neighborhood in East Houston. Trace elements, organochlorine ...pesticides, polycyclic aromatic hydrocarbons (PAHs), polybrominated diphenyl ether fire retardants (PBDEs) and polychlorinated biphenyls (PCBs) were determined in 24 soil samples. The highest concentrations found in soils were total PAHs, which ranged from 1,310 μg/kg to 85,700 μg/kg with a mean of 12,600 μg/kg. Analysis of specific PAH ratios indicate the source of the PAHs were dominated by pyrogenic rather than petrogenic sources. Chlordanes were detectable in the area where the likely local source is for ant control. The trace metal concentrations were below any environmental health concern concentrations but As, Cd, Hg, Pb, Se, Ag, Zn were enriched over the crustal abundance. While Hurricane Harvey was responsible for the redistribution of many contaminants, the large volume of rain and floodwater likely transported contaminants from the land areas and into the Houston Ship Channel and Galveston Bay. The findings from this study will serve as baseline data for determining the mobilization of contaminants caused by natural disasters.
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