Current Status and Future Direction of Hepatic Radioembolisation Alsultan, A.A.; Braat, A.J.A.T.; Smits, M.L.J. ...
Clinical oncology (Royal College of Radiologists (Great Britain)),
February 2021, 2021-Feb, 2021-02-00, 20210201, Letnik:
33, Številka:
2
Journal Article
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Radioembolisation is a locoregional treatment modality for hepatic malignancies. It consists of several stages that are vital to its success, which include a pre-treatment angiographic simulation ...followed by nuclear medicine imaging, treatment activity choice, treatment procedure and post-treatment imaging. All these stages have seen much advancement over the past decade. Here we aim to provide an overview of the practice of radioembolisation, discuss the limitations of currently applied methods and explore promising developments.
Summary
Background
Localized scleroderma (LoS) is characterized by a phase of disease activity followed by remission. However, disease recurrences occur. Knowledge concerning these recurrences can ...help prompt treatment, thereby preventing disease damage.
Objectives
To investigate the frequency and characteristics of disease recurrences in paediatric‐ and adult‐onset LoS, and to identify patient variables that are associated with a higher risk of disease recurrence.
Methods
Retrospective chart reviews were performed of patients with LoS. Data concerning the frequency and characteristics of the disease recurrences were collected. A multivariate analysis was performed to identify patient variables that were associated with a higher risk of disease recurrence.
Results
In total, 344 patients were included in the analysis, of whom 119 (35%) had paediatric‐onset LoS and 225 (65%) had adult‐onset LoS. Disease recurrence was present in 27% (n = 32) of the paediatric‐onset group and 17% (n = 39) of the adult‐onset group (P = 0·037). Multivariate analysis identified a statistically significant association between disease recurrence and the linear LoS of the limbs subtype, independent of age at disease onset.
Conclusions
Recurrences in LoS occurred in almost one‐quarter of the patients and were most frequent in the linear LoS of the limbs subtype, independent of age at disease onset. These disease recurrences can occur even after many years of quiescent disease. Awareness of the high recurrence rates may help treating physicians to recognize reactivation of the disease, leading to a decreased delay in treatment reinitiation.
What's already known about this topic?
Localized scleroderma is characterized by a phase of disease activity followed by remission. However, disease recurrences occur.
What does this study add?
Recurrences occur in almost one‐quarter of patients and are more frequent in the linear localized scleroderma of the limbs subtype, independent of age at disease onset.
Awareness of high recurrence rates may help treating physicians to recognize reactivation of the disease, leading to a decreased delay in treatment reinitiation.
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•Silver particle sizes were tuned by varying only precursor decomposition parameters.•Detailed study of particle size effects in ethylene epoxidation was performed.•Particles of ...60–70 nm give maximum weight-based activity.•Selectivity depends strongly on conversion.•Selectivity is independent of particle size if measured at constant conversion.
Currently, for the industrial ethylene epoxidation α-alumina supported silver catalysts are the only catalyst of choice. We demonstrate a novel method to produce these catalysts with different silver particle sizes, but without changing other key parameters that may affect the catalytic performance such as support specific surface area or metal precursor. α-Alumina was impregnated with a silver oxalate solution, and was subsequently dried and treated in different gas atmospheres and at different temperatures to tune the silver particle sizes in the range of 20–500 nm. Particles of 20 nm exhibited a lower turnover frequency than particles of 70 nm and larger, which exhibit a constant turnover frequency, in accordance with results in literature. However, the selectivity, when measured at constant conversion, was particle size independent. This is the first time that the effect of the particle size on the selectivity of ethylene epoxidation is reported at constant conversion. This was made possible by a new method of producing supported silver catalysts, which we expect that is also applicable for silver catalysts with other supports and for the preparation of other supported metal catalysts.
Abstract Purpose To study the feasibility of induction chemotherapy added to concomitant cisplatin-based chemoradiotherapy (CRT) in patients with locally advanced head and neck cancer (LAHNC). ...Patients and methods LAHNC patients were treated with 4 courses of docetaxel/cisplatin/5-fluorouracil (TPF) followed by randomization to either cisplatin 100 mg/m2 with conventional radiotherapy (cis100 + RT) or cisplatin 40 mg/m2 weekly with accelerated radiotherapy (cis40 + ART). Primary endpoint was feasibility, defined as receiving ≥90% of the scheduled total radiation dose. Based on power analysis 70 patients were needed. Results 65 patients were enrolled. The data safety monitoring board advised to prematurely terminate the study, because only 22% and 41% (32% in total) of the patients treated with cis100 + RT (n = 27) and cis40 + ART (n = 29) could receive the planned dose cisplatin during CRT, respectively, even though the primary endpoint was reached. Most common grade 3–4 toxicity was febrile neutropenia (18%) during TPF and dehydration (26% vs 14%), dysphagia (26% vs 24%) and mucositis (22% vs 57%) during cis100 + RT and cis40 + ART, respectively. For the patients treated with cis100 + RT and cis40 + ART, two years progression free survival and overall survival were 70% and 78% versus 72% and 79%, respectively. Conclusion After TPF induction chemotherapy, cisplatin-containing CRT is not feasible in LAHNC patients, because the total planned cisplatin dose could only be administered in 32% of the patients due to toxicity. However, all but 2 patients received more than 90% of the planned radiotherapy. Clinical Trials Information: NCT00774319.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition which is underdiagnosed and undertreated in women. For decades, the ADHD field has called for more insight ...into female-specific therapy. Preliminary findings postulate that changes in sex hormones during the menstrual cycle may influence the effectiveness of psychostimulant medication. Yet, pharmacotherapeutic interventions tailored to women with ADHD remain scarce. Previously, our group showed an increase in mood symptoms in the premenstrual week in women with ADHD. Premenstrual worsening of depressive and ADHD symptoms represent a treatment challenge. In our adult ADHD clinic, we noted several women describing exacerbation of their ADHD and depressive symptoms in the premenstrual week and/or insufficient effect of their established dosage of psychostimulant. We responded to the need expressed by these women by increasing their stimulant dosage in the premenstrual week, while monitoring the response and side effects.
This community case study of nine consecutive women being treated for ADHD and co-occurring conditions (including depression and premenstrual dysphoric disorder), reports our local experience of increasing the individually prescribed psychostimulant dosage during the premenstrual period. We methodically monitored the effect of this increased dosage on ADHD symptoms, mood and somatic symptoms for the following 6-24 months.
With premenstrual dose elevation, all nine women experienced improved ADHD and mood symptoms with minimal adverse events. Premenstrual inattention, irritability and energy levels improved, and now resembled the other non-premenstrual weeks more closely. All women decided to continue with the elevated premenstrual pharmacotherapy.
Our preliminary results demonstrate potential benefits of increasing premenstrual psychostimulant dosage in women with ADHD, experiencing premenstrual worsening of ADHD and mood symptoms. The results concur with previous findings of diminished response to amphetamines in the late luteal phase. Increased dosage may help combat premenstrual worsening of cognitive and emotional symptoms in women with ADHD, with significant clinical implications. Better management of premenstrual ADHD and mood symptoms in vulnerable women can improve treatment outcome and meet an unmet need. However, implementation should be individually explored. Further investigation of luteal phase psychostimulant dose adjustment is required for safe, optimal and individualised treatment for women with ADHD.
We present the results of our first year of quasar search in the ongoing ESO public Kilo-Degree Survey (KiDS) and VISTA Kilo-Degree Infrared Galaxy (VIKING) surveys. These surveys are among the ...deeper wide-field surveys that can be used to uncover large numbers of z ~ 6 quasars. This allows us to probe a more common population of z ~ 6 quasars that is fainter than the well-studied quasars from the main Sloan Digital Sky Survey. From this first set of combined survey catalogues covering ~250 deg... we selected point sources down to Z = 22 that had a very red i - Z (i - Z > 2.2) colour. After follow-up imaging and spectroscopy, we discovered four new quasars in the redshift range 5.8 < z < 6.0. The absolute magnitudes at a rest-frame wavelength of 1450 ... are between -26.6 < M... < -24.4, confirming that we can find quasars fainter than M*, which at z = 6 has been estimated to be between M* = -25.1 and M* = -27.6. The discovery of four quasars in 250 deg... of survey data is consistent with predictions based on the z ... 6 quasar luminosity function. We discuss various ways to push the candidate selection to fainter magnitudes and we expect to find about 30 new quasars down to an absolute magnitude of M... = -24. Studying this homogeneously selected faint quasar population will be important to gain insight into the onset of the co-evolution of the black holes and their stellar hosts. (ProQuest: ... denotes formulae/symbols omitted.)
•Detector artefact correction enables true reflectivity measurements in LEEM.•Sub-pixel accurate image registration of LEEM images achieved.•Principal Component Analysis applicable to dimension ...reduction of spectra.•Rich color visualization of 90% of spatial spectrum information in two images.•Data clustering used to automatically distinguish stacking domains in samples.
For many complex materials systems, low-energy electron microscopy (LEEM) offers detailed insights into morphology and crystallography by naturally combining real-space and reciprocal-space information. Its unique strength, however, is that all measurements can easily be performed energy-dependently. Consequently, one should treat LEEM measurements as multi-dimensional, spectroscopic datasets rather than as images to fully harvest this potential. Here we describe a measurement and data analysis approach to obtain such quantitative spectroscopic LEEM datasets with high lateral resolution. The employed detector correction and adjustment techniques enable measurement of true reflectivity values over four orders of magnitudes of intensity. Moreover, we show a drift correction algorithm, tailored for LEEM datasets with inverting contrast, that yields sub-pixel accuracy without special computational demands. Finally, we apply dimension reduction techniques to summarize the key spectroscopic features of datasets with hundreds of images into two single images that can easily be presented and interpreted intuitively. We use cluster analysis to automatically identify different materials within the field of view and to calculate average spectra per material. We demonstrate these methods by analyzing bright-field and dark-field datasets of few-layer graphene grown on silicon carbide and provide a high-performance Python implementation.
Background
With the introduction of prostate specific membrane antigen (PSMA) PET/CT, the detection rate of prostate cancer metastases has improved significantly, both for primary staging and for ...biochemical recurrence. EANM/SNMMI guidelines recommend a 60 min time interval between 68GaGa‐PSMA administration and acquisition.
Purpose
This study evaluates the possibility of a shorter time interval by investigating the dynamic change in image quality measures.
Method
We retrospectively analyzed 10 consecutive prostate cancer patients who underwent a dynamic whole body 68GaGa‐PSMA‐11 PET/CT of 75 min from skull vertex to mid‐thigh using Siemens FlowMotion. PET images were acquired directly after injection of 1.5 MBq/kg 68GaGa‐PSMA‐11. Image quality measures included lesion maximum standardized uptake value corrected for lean body mass (SULmax), tumor‐to‐background ratio (TBR), and contrast‐to‐noise ratio (CNR). Quantitative analysis of image quality in dynamic PET was performed using PMOD (version 4.2). Regions of interest (ROIs), drawn included different types of prostate lesions (primary tumor, lymph nodes, and bone metastasis), organ tissue (liver, spleen, lacrimal gland, submandibular gland, parotid gland, urinary bladder, kidneys blood pool ascending aorta, left ventricle), bone tissue (4th lumbar vertebral body L4) and muscle tissue (gluteus maximus). To further investigate image quality four 10 min multi‐frame reconstructions with clinical parameters were made at different post‐injection times (15, 30, 45, and 60 min). A nuclear medicine physician performed a blinded lesion detectability evaluation on these multi‐frame reconstructions for different prostate cancer lesions.
Results
Six primary prostate tumors in seven patients with prostate in situ, 13 lymph node metastases in six patients and up to 12 bone metastases in three patients were found. The different prostate lesion types (lymph nodes metastases, bone metastases, and primary prostate tumor) all show an increase in average SULmax, TBR, and CNR over time during the scan. The normalized average SULmax, TBR, and CNR of the combined prostate lesions at 15, 30, and 45 min post‐injection scans were all significant p < 0.05 lower from the 60 min post‐injection 68GaGa‐PSMA‐11 PET/CT (9.5 ± 4.5, 12.7 ± 6.2, and 41.8 ± 24.5, respectively). At patient level, the reader concluded the same regarding the presence/absence of primary prostate cancer recurrence, lymph node metastases, and/or bone metastases on all <60 min post‐injection 68GaGa‐PSMA‐11 PET/CT's in comparison to the reference scan (60 min post‐injection). At lesion level, all bone metastases seen on the reference scan were also seen on all <60 min post‐injection 68GaGa‐PSMA‐11 PET/CT's but there were some lymph nodes (n = 2) metastases missed on the 15, 30, and 45 min post‐injection scans. One lymph node metastasis on both the 15 and 30 min post‐injection 68GaGa‐PSMA‐11 PET/CT's was missed and one lymph node metastasis was missed, only on the 45 min post‐injection 68GaGa‐PSMA‐11 PET/CT.
Conclusion
Shorter post‐injection times (15, 30, and 45 min) compared to the recommended post‐injection time of 60 min are not optimal. However, the impact of a shorter time interval of 45 min instead of 60 min between 68GaGa‐PSMA‐11 administration and the start of PET/CT acquisition on both image quality (SULmax, TBR, and CNR) and lesion detection, while significant, is small.
We present a machine-learning photometric redshift (ML photo- z ) analysis of the Kilo-Degree Survey Data Release 3 (KiDS DR3), using two neural-network based techniques: ANNz2 and MLPQNA. Despite ...limited coverage of spectroscopic training sets, these ML codes provide photo- z s of quality comparable to, if not better than, those from the Bayesian Photometric Redshift (BPZ) code, at least up to z phot ≲ 0.9 and r ≲ 23.5. At the bright end of r ≲ 20, where very complete spectroscopic data overlapping with KiDS are available, the performance of the ML photo- z s clearly surpasses that of BPZ, currently the primary photo- z method for KiDS. Using the Galaxy And Mass Assembly (GAMA) spectroscopic survey as calibration, we furthermore study how photo- z s improve for bright sources when photometric parameters additional to magnitudes are included in the photo- z derivation, as well as when VIKING and WISE infrared (IR) bands are added. While the fiducial four-band ugri setup gives a photo- z bias 〈 δz /(1 + z )〉 = −2 × 10 −4 and scatter σ δz/(1+z) < 0.022 at mean 〈 z 〉 = 0.23, combining magnitudes, colours, and galaxy sizes reduces the scatter by ~7% and the bias by an order of magnitude. Once the ugri and IR magnitudes are joined into 12-band photometry spanning up to 12 μ m, the scatter decreases by more than 10% over the fiducial case. Finally, using the 12 bands together with optical colours and linear sizes gives 〈 δz /(1 + z )〉 < 4 × 10 −5 and σ δz /(1+ z ) < 0.019. This paper also serves as a reference for two public photo- z catalogues accompanying KiDS DR3, both obtained using the ANNz2 code. The first one, of general purpose, includes all the 39 million KiDS sources with four-band ugri measurements in DR3. The second dataset, optimised for low-redshift studies such as galaxy-galaxy lensing, is limited to r ≲ 20, and provides photo- z s of much better quality than in the full-depth case thanks to incorporating optical magnitudes, colours, and sizes in the GAMA-calibrated photo- z derivation.
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