-
Clinical Nuclear Medicine Aug 2024We present a case with systemic amyloidosis secondary to ankylosing spondylitis (AA amyloidosis), whose 99mTc PYP scintigraphy revealed amyloid deposition in the thyroid...
We present a case with systemic amyloidosis secondary to ankylosing spondylitis (AA amyloidosis), whose 99mTc PYP scintigraphy revealed amyloid deposition in the thyroid gland (amyloid goiter). Amyloidosis is characterized by extracellular accumulation of amyloid fibril proteins leading to organ malfunction. Even though AA amyloidosis can be observed in patients with systemic inflammatory diseases, it is a very rare complication in ankylosing spondylitis. SPECT/CT images showed diffuse tracer uptake in enlarged thyroid gland containing fat density areas.
Topics: Humans; Amyloidosis; Spondylitis, Ankylosing; Single Photon Emission Computed Tomography Computed Tomography; Goiter; Male; Technetium Tc 99m Pyrophosphate; Middle Aged
PubMed: 38967510
DOI: 10.1097/RLU.0000000000005280 -
Clinical Nuclear Medicine Aug 2024Currently, monoamine oxidase B is recognized as the primary target of 18F-THK5351, although 18F-THK5351 was initially developed to target neurofibrillary tangles (NFTs)... (Comparative Study)
Comparative Study
Currently, monoamine oxidase B is recognized as the primary target of 18F-THK5351, although 18F-THK5351 was initially developed to target neurofibrillary tangles (NFTs) in Alzheimer disease. When clinically applying 18F-THK5351 PET to visualize ongoing astrogliosis via estimating monoamine oxidase B levels, a crucial concern is how much degree 18F-THK5351 uptake reflects NFTs in in vivo images. To unravel this concern, a head-to-head comparison between 18F-THK5351 and 18F-MK-6240 (estimating NFT) images in the NFT lesion ideally without accompanying astrogliosis is essential. Here, we present such a case suggesting that 18F-THK5351 uptake may not estimate NFTs in in vivo images.
Topics: Neurofibrillary Tangles; Humans; Positron-Emission Tomography; Aminopyridines; Biological Transport; Aged; Male; Female; Alzheimer Disease; Isoquinolines; Quinolines
PubMed: 38967508
DOI: 10.1097/RLU.0000000000005316 -
Clinical Nuclear Medicine Aug 2024We report a case of recurrent nasopharyngeal carcinoma postnasopharyngectomy, presenting with headaches. MRI revealed abnormal signals of the clivus with enhancement,...
We report a case of recurrent nasopharyngeal carcinoma postnasopharyngectomy, presenting with headaches. MRI revealed abnormal signals of the clivus with enhancement, and FDG PET/CT indicated intense uptake in the nasopharynx, clivus, and left neck lymph nodes. Bone SPECT/CT showed bony erosion and uptake in bilateral skull base areas. Biopsy confirmed aspergillosis. Despite the challenges in distinguishing tumor invasion from Aspergillus infection on MRI, bone SPECT/CT, and FDG PET/CT, the short postsurgery period and extensive uptake suggested skull base osteomyelitis.
Topics: Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Diagnosis, Differential; Skull Base; Aspergillosis; Male; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography; Middle Aged; Carcinoma; Magnetic Resonance Imaging; Recurrence
PubMed: 38967507
DOI: 10.1097/RLU.0000000000005317 -
Clinical Nuclear Medicine Aug 2024A 51-year-old woman with a 2-mm-Breslow-thickness melanoma on her arm had 99mTc-nanocolloid lymphoscintigraphy to localize the associated sentinel lymph node. A single...
A 51-year-old woman with a 2-mm-Breslow-thickness melanoma on her arm had 99mTc-nanocolloid lymphoscintigraphy to localize the associated sentinel lymph node. A single axillary node was identified, and histology confirmed a micrometastasis of breast tissue origin. Imaging of the patient's breasts and subsequent biopsy confirmed ipsilateral stage III breast cancer, which was treated with lumpectomy and axillary node clearance. This is the first reported case of an incidental solid cancer diagnosis from a sentinel lymph node biopsy undertaken for a different tumor origin. This illustrates the importance of recognizing overlapping lymphatic distribution of sentinel lymph nodes, which can drain multiple organs.
Topics: Humans; Female; Middle Aged; Breast Neoplasms; Melanoma; Lymphoscintigraphy; Technetium Tc 99m Aggregated Albumin; Skin Neoplasms; Incidental Findings; Arm; Melanoma, Cutaneous Malignant; Sentinel Lymph Node Biopsy
PubMed: 38967506
DOI: 10.1097/RLU.0000000000005312 -
Clinical Nuclear Medicine Aug 2024The aim of this study was to generate deep learning-based regions of interest (ROIs) from equilibrium radionuclide angiography datasets for left ventricular ejection...
PURPOSE
The aim of this study was to generate deep learning-based regions of interest (ROIs) from equilibrium radionuclide angiography datasets for left ventricular ejection fraction (LVEF) measurement.
PATIENTS AND METHODS
Manually drawn ROIs (mROIs) on end-systolic and end-diastolic images were extracted from reports in a Picture Archiving and Communications System. To reduce observer variability, preprocessed ROIs (pROIs) were delineated using a 41% threshold of the maximal pixel counts of the extracted mROIs and were labeled as ground-truth. Background ROIs were automatically created using an algorithm to identify areas with minimum counts within specified probability areas around the end-systolic ROI. A 2-dimensional U-Net convolutional neural network architecture was trained to generate deep learning-based ROIs (dlROIs) from pROIs. The model's performance was evaluated using Lin's concordance correlation coefficient (CCC). Bland-Altman plots were used to assess bias and 95% limits of agreement.
RESULTS
A total of 41,462 scans (19,309 patients) were included. Strong concordance was found between LVEF measurements from dlROIs and pROIs (CCC = 85.6%; 95% confidence interval, 85.4%-85.9%), and between LVEF measurements from dlROIs and mROIs (CCC = 86.1%; 95% confidence interval, 85.8%-86.3%). In the Bland-Altman analysis, the mean differences and 95% limits of agreement of the LVEF measurements were -0.6% and -6.6% to 5.3%, respectively, for dlROIs and pROIs, and -0.4% and -6.3% to 5.4% for dlROIs and mROIs, respectively. In 37,537 scans (91%), the absolute LVEF difference between dlROIs and mROIs was <5%.
CONCLUSIONS
Our 2-dimensional U-Net convolutional neural network architecture showed excellent performance in generating LV ROIs from equilibrium radionuclide angiography scans. It may enhance the convenience and reproducibility of LVEF measurements.
Topics: Humans; Neural Networks, Computer; Automation; Angiocardiography; Male; Image Processing, Computer-Assisted; Female; Middle Aged; Stroke Volume; Aged; Gated Blood-Pool Imaging; Deep Learning
PubMed: 38967505
DOI: 10.1097/RLU.0000000000005275 -
Multimedia Manual of Cardiothoracic... Jul 2024In this case report, we describe the surgical treatment of a right coronary sinus aneurysm. A 69-year-old male patient was screened because of palpitations. He was...
In this case report, we describe the surgical treatment of a right coronary sinus aneurysm. A 69-year-old male patient was screened because of palpitations. He was finally diagnosed with an aneurysm of the sinus of Valsalva of the right coronary cusp. According to current aortic guidelines, surgical reconstruction was proposed. The patient underwent a cardiac operation through a median sternotomy under routine cardiopulmonary bypass. After aortic cross-clamping, the aorta was opened and the connection between the aorta and the aneurysm was clearly visualized, underneath the ostium of the right coronary artery. After excision of the right coronary button and the remaining right coronary sinus wall, this sinus was reconstructed with a Dacron graft, with subsequent coronary reimplantation. The postoperative course was uneventful. The patient was discharged on postoperative day 7. A complete sinus reconstruction was preferred over local patching of the defect because of the proximity of the aneurysm sac to the right coronary artery and the fragile, thin aortic tissue just underneath the coronary ostium.
Topics: Humans; Male; Aged; Coronary Sinus; Sinus of Valsalva; Coronary Aneurysm; Blood Vessel Prosthesis Implantation; Treatment Outcome; Cardiopulmonary Bypass
PubMed: 38967498
DOI: 10.1510/mmcts.2024.034 -
Cancer Medicine Jul 2024The purpose of this study was to evaluate the efficacy and safety of fruquintinib-based therapy as a salvage therapy for patients with advanced or metastatic sarcoma,...
BACKGROUND
The purpose of this study was to evaluate the efficacy and safety of fruquintinib-based therapy as a salvage therapy for patients with advanced or metastatic sarcoma, including soft tissue sarcoma (STS) and bone sarcoma.
METHODS
Patients with advanced or metastatic sarcoma were divided into two groups. One group received fruquintinib monotherapy, while the other received fruquintinib combined therapy. Safety and efficacy of fruquintinib-based therapy were recorded and reviewed retrospectively, including progression-free survival (PFS), overall response rate (ORR), and adverse events (AEs).
RESULTS
Between August 2021 and December 2022, 38 sarcoma patients were retrospectively included. A total of 14 patients received fruquintinib alone (including 6 STS and 8 bone sarcoma), while 24 were treated with fruquintinib combined therapy (including 2 STS and 22 bone sarcoma). The median follow-up was 10.2 months (95% CI, 6.4-11.5). For the entire population, the median PFS was 8.0 months (95% CI, 5.5-13.0). The ORR was 13.1%, while the disease control rate (DCR) was 86.8%. The univariate analysis showed that radiotherapy history (HR, 4.56; 95% CI, 1.70-12.24; p = 0.003), bone sarcoma (HR, 0.34; 95% CI, 0.14-0.87; p = 0.024), and treatment method of fruquintinib (HR, 0.36; 95% CI, 0.15-0.85; p = 0.021) were significantly associated with PFS. The multivariate analysis showed that patients without radiotherapy history were associated with a better PFS (HR, 3.71; 95% CI: 1.31-10.55; p = 0.014) than patients with radiotherapy history. Patients in combination group reported pneumothorax (8.3%), leukopenia (33.3%), thrombocytopenia (12.5%), diarrhea (4.2%), and anemia (4.2%) as the most frequent grade 3 or higher treatment-emergent AEs (TEAEs), while there was no severe TEAEs occurred in the monotherapy group.
CONCLUSIONS
Fruquintinib-based therapy displayed an optimal tumor control and an acceptable safety profile in patients with advanced or metastatic sarcoma.
Topics: Humans; Female; Sarcoma; Male; Middle Aged; Adult; Retrospective Studies; Quinazolines; Aged; Benzofurans; Bone Neoplasms; Young Adult; Salvage Therapy; Antineoplastic Combined Chemotherapy Protocols; Progression-Free Survival; Adolescent; Treatment Outcome
PubMed: 38967496
DOI: 10.1002/cam4.7438 -
The American Journal of Bioethics : AJOB Jul 2024Efforts to revise the Uniform Determination of Death Act in order to align law with medical practice have failed. Medical practice must now align with the law. People...
Efforts to revise the Uniform Determination of Death Act in order to align law with medical practice have failed. Medical practice must now align with the law. People who are not dead under the law that defines death should not be declared dead. There is no compelling reason to continue the practice of declaring legally living persons to be dead.
PubMed: 38967488
DOI: 10.1080/15265161.2024.2371129 -
Applied Neuropsychology. Adult Jul 2024This study examined the role of caregivers' perception of cognitive impairment in burden of family caregivers in Alzheimer's disease (AD). We hypothesized that the...
OBJECTIVES
This study examined the role of caregivers' perception of cognitive impairment in burden of family caregivers in Alzheimer's disease (AD). We hypothesized that the evaluation of cognitive impairment by family caregivers plays a pivotal role in burden.
METHODS
The study included 110 dyads (person with AD and their caregiver) recruited from a Memory Unit in France. The cognitive impairment and depressive symptoms of person with AD were evaluated by a geriatrician using the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15). Caregivers provided self-reports on the perception of cognitive impairment (IQCODE) of the care recipient, the caregiving burden (ZBI), depressive symptoms (GDS-15), and self-esteem (RSE). Descriptive analyses, comparison of different caregiver burden groups, and multinomial logistic regression analyses to understand correlates of caregiver burden were conducted with SPSS, version 20.
RESULTS
The findings show that the caregivers are on average 60 years old and the majority are women. They care for persons with AD, who are on average 82 years old and most of whom are women. Our results show that the duration of caregiving, depression of the caregiver, and caregivers' perception of cognitive impairment contribute significantly to burden of caregiver.
DISCUSSION
This study shows that it is necessary to adopt the caregiver-centered approach to support the dyad. The role of the caregivers' perception of cognitive impairment in AD should be developed when supporting caregivers in suffering.
PubMed: 38967486
DOI: 10.1080/23279095.2024.2367102 -
ACS Biomaterials Science & Engineering Jul 2024Drug resistance is arguably one of the biggest challenges facing cancer research today. Understanding the underlying mechanisms of drug resistance in tumor progression... (Review)
Review
Drug resistance is arguably one of the biggest challenges facing cancer research today. Understanding the underlying mechanisms of drug resistance in tumor progression and metastasis are essential in developing better treatment modalities. Given the matrix stiffness affecting the mechanotransduction capabilities of cancer cells, characterization of the related signal transduction pathways can provide a better understanding for developing novel therapeutic strategies. In this review, we aimed to summarize the recent advancements in tumor matrix biology in parallel to therapeutic approaches targeting matrix stiffness and its consequences in cellular processes in tumor progression and metastasis. The cellular processes governed by signal transduction pathways and their aberrant activation may result in activating the epithelial-to-mesenchymal transition, cancer stemness, and autophagy, which can be attributed to drug resistance. Developing therapeutic strategies to target these cellular processes in cancer biology will offer novel therapeutic approaches to tailor better personalized treatment modalities for clinical studies.
PubMed: 38967485
DOI: 10.1021/acsbiomaterials.4c00445