Concentration of Selected Adipokines and Factors Regulating Carbohydrate Metabolism in Patients with Head and Neck Cancer in Respect to Their Body Mass Index.

Head and neck cancers (HNCs) are a group of tumors not common in European populations. So far, not much is known about the role of obesity, adipokines, glucose metabolism, and inflammation in the pathogenesis of HNC. The aim of the study was to determine the concentrations of ghrelin, omentin-1, adipsin, adiponectin, leptin, resistin, visfatin, glucagon, insulin, C-peptide, glucagon-like peptide-1 (GLP-1), plasminogen activator inhibitor-1 (PAI-1), and gastric inhibitory peptide (GIP) in the blood serum of HNC patients depending on their body mass index (BMI). The study included 46 patients divided into two groups according to their BMI values: the normal BMI group (nBMI) included 23 patients with BMI < 25 kg/m2 and the increased BMI group (iBMI) included patients with BMI ≥ 25 kg/m2. A control group (CG) included 23 healthy people (BMI < 25 kg/m2). Statistically significant differences in the levels of adipsin, ghrelin, glucagon, PAI-1, and visfatin were shown between nBMI and CG. In the case of nBMI and iBMI, statistically significant differences were observed in the concentrations of adiponectin, C-peptide, ghrelin, GLP-1, insulin, leptin, omentin-1, PAI-1, resistin, and visfatin. The obtained results indicate a disruption of endocrine function of adipose tissue and impaired glucose metabolism in HNC. Obesity, which is not a typical risk factor for HNC, may aggravate the negative metabolic changes associated with this type of neoplasm. Ghrelin, visfatin, PAI-1, adipsin, and glucagon might be related to head and neck carcinogenesis. They seem to be promising directions for further research.

Redox State and Lysosomal Activity in Women with Ovarian Cancer with Tumor Recurrence and Multiorgan Metastasis.

The aim of the study is to evaluate oxidant-antioxidant balance as well as lysosomal and anti-protease activities in ovarian cancer since it has been emphasized that the crucial inducing factor of carcinogenesis may be reactive oxygen/nitrogen species or, more precisely, oxidative stress-induced inflammation. The study involved 15 women with ovarian cancer, aged 59.9 ± 7.8 years, and 9 healthy women aged 56.3 ± 4.3 years (controls). The study material was venous blood collected from fasting subjects. In erythrocytes, the activities of superoxide dismutase, glutathione peroxidase, and catalase, as well as concentrations of conjugated dienes (CDs) and thiobarbituric acid reactive substances (TBARS), were investigated. CD, TBARS, and vitamins A and E plasma concentrations were also determined. Moreover, total antioxidant capacity and concentrations of 4-hydroxynonenal adducts and 8-iso-prostaglandin F2α, as well as activities of acid phosphatase, arylsulfatase, cathepsin D, and α1-antitrypsin, were studied in serum. The vitamin E and 8-iso-prostaglandin F2α concentrations as well as arylsulfatase activity were lower in the women with cancer compared to the controls (p = 0.006, p = 0.03, p = 0.001, respectively). In contrast, cathepsin D activity was lower in the controls (p = 0.04). In the peripheral blood of the women with cancer, oxidant-antioxidant and lysosomal disturbances were observed.

18F-fluoro-ethyl-tyrosine (18F-FET) PET/CT as a potential new diagnostic tool in multiple myeloma: a preliminary study.

AIM OF THE STUDY: The aim of this study was to analyse the diagnostic accuracy of "18F-fluoro-ethyl-tyrosine (18F-FET) PET/CT tracer in multiple myeloma. MATERIAL AND METHODS: The analysed group included: patients with newly diagnosed active myeloma (eight patients); in very good partial remission or complete remission (VGPR or CR) after treatment (nine patients); and with active disease after relapse (15 patients). RESULTS: In patients with newly diagnosed myeloma, 64 lesions were found using CT and 83 lesions using 18F-FET. In six patients, the number of lesions using CT and 18F-FET was the same, and two had more lesions with the 18F-FET than with the CT. Patients in VGPR or CR had no FET-positive lesions. Fourteen out of 15 patients with active relapsed myeloma had 47 FET-positive lesions, CT assessment of the same group showed 282 lesions. In one patient with relapse soft tissue mass was found with 18F-FET but not with CT. CONCLUSIONS: 18F-FET can be a promising alternative to 18F-FDG PET/CT for myeloma-related bone disease diagnosis.

Training improves the interobserver agreement of the expert positron emission tomography review panel in primary mediastinal B-cell lymphoma: interim analysis in the ongoing International Extranodal Lymphoma Study Group-37 study.

The International Extranodal Lymphoma Study Group (IELSG)-37 is a prospective randomized trial assessing the role of consolidation mediastinal radiotherapy after immunochemotherapy to patients with newly diagnosed primary mediastinal large B-cell lymphoma (PMBCL). It is a positron emission tomography (PET) response-guided study where patients obtaining a complete metabolic response on an end-of-therapy PET-computed tomography (CT) scan evaluated by a central review are randomized to receive radiotherapy or no further treatment. The aims of this study were to measure agreement between reviewers reporting PET-CT scans for this trial and to determine the effect of training upon concordance rates. The review panel comprised 6 experienced nuclear physicians who read PET-CT scans using the 5-point Deauville scale. Interobserver agreement (IOA) was measured at 4 time points: after a blinded review of a "training set" of 20 patients with PMBCL from the previous IELSG-26 study (phase 1); after the first 10 clinical cases enrolled in the IELSG-37 (phase 2); and after 2 further groups of 50 (phase 3) and 40 clinical cases (phase 4). After feedback from the training set and the first 10 cases, a meeting was held to discuss interpretation, and a detailed set of instructions for the review procedure was agreed and acted upon. Between 2012 and 2014, the first 100 patients were reviewed. Using Deauville score 3 as the cutoff for a complete metabolic response, the overall IOA among the reviewers was good (Krippendorff α = 0.72.) The binary concordance between pairs of reviewers (Cohen κ) ranged from 0.60 to 0.78. The IOA, initially moderate, improved progressively from phase 1 to 4 (Krippendorff α from 0.53 to 0.81; Cohen κ from 0.35-0.72 to 0.77-0.87). Our experience indicates that the agreement among "expert" nuclear physicians reporting PMBCL, even using standardized criteria, was only moderate when the study began. However, agreement improved using a harmonization process, which included a training exercise with discussion of points leading to disagreement and compiling practical rules to sit alongside commonly adopted interpretation criteria.

Quantitative anatomy of the primary ossification center of the femoral shaft in human fetuses.

PURPOSE: Early clinical distinction of congenital defects in the femur is extremely important, as it determines the prognosis of the development of the lower limb. This study was performed to quantitatively examine the primary center of ossification in the femoral shaft with respect to its linear, planar, and volumetric parameters. MATERIALS AND METHODS: Using methods of CT, digital-image analysis, and statistics, the size of the primary ossification center of the femoral shaft in 47 spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: With no sex and laterality differences, the best fit growth dynamics for femoral shaft ossification center was modelled by the following functions: y = 5.717 + 0.040 × (age)2 ± 2.905 (R 2 = 0.86) for its length, y = -3.579 + 0.368 × age ± 0.529 (R 2 = 0.88) for its proximal transverse diameter, y = -1.105 + 0.187 × age ± 0.309 (R 2 = 0.84) for its middle transverse diameter, y = -2.321 + 0.323 × age ± 0.558 (R 2 = 0.83) for its distal transverse diameter, y = -50.306 + 0.308 × (age)2 ± 18.289 (R 2 = 0.90) for its projection surface area, and y = -91.458 + 0.390 × (age)3 ± 92.146 (R 2 = 0.88) for its volume. CONCLUSIONS: The size of the femoral shaft ossification center displays neither sex nor laterality differences. The ossification center in the femoral shaft follows quadratic functions with respect to its length and projection surface area, linear functions with respect to its proximal, middle, and distal transverse diameters, and a cubic function with respect to its volume. The obtained morphometric data of the femoral shaft ossification center are considered normative for respective prenatal weeks and may be of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.

Quantitative anatomy of the growing clavicle in the human fetus: CT, digital image analysis, and statistical study.

PURPOSES: Knowledge of dimensions of fetal long bones is useful in both the assessment of fetal growth and early detection of inherited defects. Measurements of the fetal clavicle may facilitate detection of numerous defects, e.g., cleidocranial dysplasia, Holt-Oram syndrome, Goltz syndrome, and Melnick-Needles syndrome. METHODS: Using the methods of CT, digital image analysis, and statistics, the size of the growing clavicle in 42 spontaneously aborted human fetuses (21 males and 21 females) at ages of 18-30 weeks was studied. RESULTS: Without any male-female and right-left significant differences, the best fit growth models for the growing clavicle with relation to age in weeks were as follows: y = -54.439 + 24.673 × ln(age) ± 0.237 (R 2 = 0.86) for length, y = -12.042 + 4.906 × ln(age) ± 0.362 (R 2 = 0.82) for width of acromial end, y = -4.210 + 2.028 × ln(age) ± 0.177 (R 2 = 0.77) for width of central part, y = -4.687 + 2.364 × ln(age) ± 0.242 (R 2 = 0.70) for width of sternal end, y = -51.078 + 4.174 × ln(age) ± 6.943 (R 2 = 0.82) for cross-sectional area, and y = -766.948 + 281.774 × ln(age) ± 19.610 (R 2 = 0.84) for volume. CONCLUSIONS: With no sex and laterality differences, the clavicle grows logarithmically with respect to its length, width, and volume, and linearly with respect to its projection surface area. The obtained morphometric data of the growing clavicle are considered normative for their respective weeks of gestation and may be of relevance in the diagnosis of congenital defects.

Ossification center of the humeral shaft in the human fetus: a CT, digital, and statistical study.

PURPOSE: The knowledge of the development of the humeral shaft ossification center may be useful both in determining the fetal stage and maturity and for detecting congenital disorders, as well. This study was performed to quantitatively examine the humeral shaft ossification center with respect to its linear, planar, and volumetric parameters. MATERIALS AND METHOD: Using methods of CT, digital image analysis, and statistics, the size of the humeral shaft ossification center in 48 spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: With no sex differences, the best-fit growth dynamics for the humeral shaft ossification center was modeled by the following functions: y = -78.568 + 34.114 × ln (age) ± 2.160 for its length, y = -12.733 + 5.654 × ln(age) ± 0.515 for its proximal transverse diameter, y = -4.750 + 2.609 × ln (age) ± 0.294 for its middle transverse diameter, y = -10.037 + 4.648 × ln (age) ± 0.560 for its distal transverse diameter, y = -146.601 + 11.237 × age ± 19.907 for its projection surface area, and y = 121.159 + 0.001 × (age)4 ± 102.944 for its volume. CONCLUSIONS: With no sex differences, the ossification center of the humeral shaft grows logarithmically with respect to its length and transverse diameters, linearly with respect to its projection surface area, and fourth-degree polynomially with respect to its volume. The obtained morphometric data of the humeral shaft ossification center are considered normative for respective prenatal weeks and may be of relevance in both the estimation of fetal ages and the ultrasonic diagnostics of congenital defects.

A one-step automated synthesis of the dopamine transporter ligand [(18)F]FECNT from the chlorinated precursor.

The use of [(18)F]labelled nortropane derivative 2ß-carbomethoxy-3ß-(4-chlorophenyl)-8-(2-fluoroethyl)-nortropane (FECNT) as a dopamine transporter ligand for PET imaging is dependent on efficient radiosynthesis method. Herein, the automated synthesis of [(18)F]FECNT from its chlorinated precursor in commercially available SynChrom [(18)F] R&D module has been developed. The synthesis unit was readily configured for the one-step synthesis from corresponding chlorinated precursor. The radiolabeling process involved a classical [(18)F]fluoride nucleophilic substitution performed at 110 °C for 12 min and finally HPLC and SPE purification. Crude [(18)F]FECNT was obtained with a radiolabeling yield of 59 ± 12% (n = 5). The average uncorrected amount of [(18)F]FECNT in the final formulated dose was 2.0 ± 0.5 GBq (32 ± 7% overall decay-corrected yields) obtained with radiochemical purity over 99% and specific activity of 55 GBq/µmol. The total duration of the procedure was 80-90 min. An automated radiosynthesis of [(18)F]FECNT with high radiochemical purity may provide a simple and robust method of radiopharmaceutical preparation for routine clinical applications.

Morphometric study of the neural ossification centers of the atlas and axis in the human fetus.

PURPOSES: The knowledge of the developing cervical spine and its individual vertebrae, including their neural processes may be useful in the diagnostics of congenital vertebral malformations. This study was performed to quantitatively examine the neural ossification centers of the atlas and axis with respect to their linear, planar and volumetric parameters. METHODS: Using the methods of CT, digital-image analysis and statistics, the size of neural ossification centers in the atlas and axis in 55 spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: Without any male-female and right-left significant differences, the best fit growth dynamics for the neural ossification centers of the atlas and axis were, respectively, modelled by the following functions: for length: y = -13.461 + 6.140 × ln(age) ± 0.570 and y = -15.683 + 6.882 × ln(age) ± 0.503, for width: y = -4.006 + 1.930 × ln(age) ± 0.178 and y = -3.054 + 1.648 × ln(age) ± 0.178, for cross-sectional area: y = -7.362 + 0.780 × age ± 1.700 and y = -9.930 + 0.869 × age ± 1.911, and for volume: y = -6.417 + 0.836 × age ± 1.924 and y = -11.592 + 1.087 × age ± 2.509. CONCLUSIONS: The size of neural ossification centers of the atlas and axis shows neither sexual nor bilateral differences. The neural ossification centers of the atlas and axis grow logarithmically in both length and width and linearly in both cross-sectional area and volume. The numerical data relating to the size of neural ossification centers of the atlas and axis derived from the CT and digital-image analysis are considered specific-age reference values of potential relevance in both the ultrasound monitoring and the early detection of spinal abnormalities relating to the neural processes of the first two cervical vertebrae in the fetus.

Morphometric study of the two fused primary ossification centers of the clavicle in the human fetus.

PURPOSES: A satisfactory understanding of the clavicle development may be contributing to both the diagnosis of its congenital defects and prevention of perinatal damage to the shoulder girdle. This study was carried out to examine the transverse and sagittal diameters, cross-sectional area and volume of the two fused primary ossification centers of the clavicle. METHODS: Using the methods of CT, digital-image analysis and statistics, the size for two fused primary ossification centers of the clavicle in 42 spontaneously aborted human fetuses at ages of 18-30 weeks was studied. RESULTS: Without any male-female and right-left significant differences, the best fit growth models for two fused primary ossification centers of the clavicle were as follows: y = -31.373 + 15.243 × ln(age) ± 1.424 (R (2) = 0.74) for transverse diameter, y = -7.945 + 3.225 × ln(age) ± 0.262 (R (2) = 0.78), y = -4.503 + 2.007 × ln(age) ± 0.218 (R (2) = 0.68), and y = -4.860 + 2.117 × ln(age) ± 0.200 (R (2) = 0.73) for sagittal diameters of the lateral, middle and medial ends respectively, y = -31.390 + 2.432 × age ± 4.599 (R (2) = 0.78) for cross-sectional area, and y = 28.161 + 0.00017 × (age)(4) ± 15.357 (R (2) = 0.83) for volume. CONCLUSIONS: With no sex and laterality differences, the fused primary ossification centers of the clavicle grow logarithmically in both transverse and sagittal diameters, linearly in cross-sectional area, and fourth-degree polynomially in volume. Our normative quantitative findings may be conducive in monitoring normal fetal growth and screening for inherited faults and anomalies of the clavicle in European human fetuses.

Digital image analysis of ossification centers in the axial dens and body in the human fetus.

PURPOSES: The detailed understanding of the anatomy and timing of ossification centers is indispensable in both determining the fetal stage and maturity and for detecting congenital disorders. This study was performed to quantitatively examine the odontoid and body ossification centers in the axis with respect to their linear, planar and volumetric parameters. METHODS: Using the methods of CT, digital image analysis and statistics, the size of the odontoid and body ossification centers in the axis in 55 spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: With no sex difference, the best fit growth dynamics for odontoid and body ossification centers of the axis were, respectively, as follows: for transverse diameter y = -10.752 + 4.276 × ln(age) ± 0.335 and y = -10.578 + 4.265 × ln(age) ± 0.338, for sagittal diameter y = -4.329 + 2.010 × ln(age) ± 0.182 and y = -3.934 + 1.930 × ln(age) ± 0.182, for cross-sectional area y = -7.102 + 0.520 × age ± 0.724 and y = -7.002 + 0.521 × age ± 0.726, and for volume y = -37.021 + 14.014 × ln(age) ± 1.091 and y = -37.425 + 14.197 × ln(age) ± 1.109. CONCLUSIONS: With no sex differences, the odontoid and body ossification centers of the axis grow logarithmically in transverse and sagittal diameters, and in volume, while proportionately in cross-sectional area. Our specific-age reference data for the odontoid and body ossification centers of the axis may be relevant for determining the fetal stage and maturity and for in utero three-dimensional sonographic detecting segmentation anomalies of the axis.

Primary mediastinal B-cell lymphoma - metabolic and anatomical features in 18FDG-PET/CT and response to therapy.

AIM OF THE STUDY: Determining the role of PET/CT imaging in the evaluation of treatment efficacy in primary mediastinal B-cell lymphoma (PMBCL). MATERIAL AND METHODS: Retrospective analysis of seven PMBCL patients, treated at the University Hospital in Krakow, with interim PET/CT after the third course of chemo-immunotherapy.The analysis was based on the calculation of exact tumour volume and metabolic activity, compared with initial values (directly after diagnosis). RESULTS: Patients (five females, two males, average age 26.2 years, range 18-40 years), in clinical stage IIBX at diagnosis, were treated with eight cycles of R-CHOP-14 regimen, with radiotherapy consolidation (7/7) and central nervous system prophylaxis (6/7). The observed decrease in tumour volume between the initial staging and the interim PET ranged 72-89%. The mean ΔSUVmax reduction between initial (when available) and interim PET was 87% (range 84-89%). In 3/7 cases in the interim PET/CT, the uptake of the tumour was higher than the liver (Deauville Criteria score 4-5), and in 4/7 it was lower than the liver but higher than mediastinal blood pool structures (score 3 according to Deauville Criteria). After a median follow-up of 58 months - OS and EFS is 100%. CONCLUSIONS: The excellent clinical outcome in the study group corresponds with very good metabolic and volumetric response in the interim PET. The ΔSUVmax seems to be easier in implementation and has a more significant impact than other measurements.

The influence of Sm-153 therapy on bone marrow function.

AIM OF THE STUDY: Studies about possible risks connected with ß-emitterradiotherapy concentrate mainly on potential myelotoxicity. Results of previously published analysis based on white blood cells (WBC) and platelet (PLT) counts - before and after radionuclide treatment - are quite varied. The aim of our study was to present the greatest possible impact of Samarium-153 on bone marrow function in clinical practice. MATERIAL AND METHODS: The study included the blood test results of 175 patients with bone metastases treated with Sm-153 in the years 2012-2014. We compared levels of WBC, PLT, red blood cells (RBC), and haemoglobin (HGB) from two blood tests - one performed directly before the therapy and the other 2-6 weeks after isotope injection. RESULTS AND CONCLUSIONS: The study showed decreased mean level of WBC in a control test performed after therapy in comparison to output results at about 27.1%. In our study 1.1% of patients developed the third-grade toxicity in CTCAE (Common Terminology Criteria for Adverse Events). Mean decrease of PLT was about 18%. Three patients (1.7% of all) result qualified as third-grade toxicity in a control test, one as fourth-grade. Analysis of RBC level showed 5.7% reduction of output values. The same calculation was seen for HGB - 5.1%. The greatest but acceptable decrease in haematological parameters was observed in WBC and PLT. Analysis of changes in WBC and PLT level showed them to be similar or smaller than was proven in previously published studies.

[The importance of imaging techniques in the modern treatment of multiple myeloma]. / Znaczenie technik obrazowych w nowoczesnym leczeniu szpiczaka plazmocytowego.

The main symptom of multiple myeloma (MM) are pathological changes in bone. Imaging techniques are useful in determining the proper stage of the disease, follow-up after treatment and, as highlighted in recent times, in predicting prognosis and prediction. In the near future, radiographic examination of the whole body can be replaced by more sensitive techniques, such as low-dose computed tomography (CT) of the whole body. Magnetic resonance imaging (MRI) is a standard in the evaluation of bone marrow infiltration of the spine, allowing the prediction of the risk of vertebral fractures. Positron emission tomography (PET) coupled with CT (PET/CT) provides relevant information on the extent of lesions throughout the body, including soft tissues and is the best tool to distinguish active from inactive disease after treatment. Diagnostic imaging technique of PETIMR has the potential for precisely diagnosing in this condition. Prospective use of new imaging techniques in clinical practice in the near future will help to optimize the therapeutic management in individual cases of MM.

A Biopsy-Controlled Prospective Study of Contrast-Enhancing Diffuse Glioma Infiltration Based on FET-PET and FLAIR.

Accurately defining glioma infiltration is crucial for optimizing radiotherapy and surgery, but glioma infiltration is heterogeneous and MRI imperfectly defines the tumor extent. Currently, it is impossible to determine the tumor infiltration gradient within a FLAIR signal. O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET often reveals high-grade glioma infiltration beyond contrast-enhancing areas on MRI. Here, we studied FET uptake dynamics in tumor and normal brain structures by dual-timepoint (10 min and 40-60 min post-injection) acquisition to optimize analysis protocols for defining glioma infiltration. Over 300 serial stereotactic biopsies from 23 patients (mean age 47, 12 female/11 male) of diffuse contrast-enhancing gliomas were taken from areas inside and outside contrast enhancement or outside the FET hotspot but inside FLAIR. The final diagnosis was G4 in 11, grade 3 in 10, and grade 2 in 2 patients. The target-to-background (TBRs) ratios and standardized uptake values (SUVs) were calculated in areas used for biopsy planning and in background structures. The optimal method and threshold values were determined to find a preferred strategy for defining glioma infiltration. Standard thresholding (1.6× uptake in the contralateral brain) in standard acquisition PET images differentiated a tumor of any grade from astrogliosis, although the uptake in astrogliosis and grade 2 glioma was similar. Analyzing an optimal strategy for infiltration volume definition astrogliosis could be accurately differentiated from tumor samples using a choroid plexus as a background. Early acquisition improved the AUC in many cases, especially within FLAIR, from 56% to 90% sensitivity and 41% to 61% specificity (standard TBR 1.6 vs. early TBR plexus). The current FET-PET evaluation protocols for contrast-enhancing gliomas are limited, especially at the tumor border where grade 2 tumor and astrogliosis have similar uptake, but using choroid plexus uptake in early acquisitions as a background, we can precisely define a tumor within FLAIR that was outside of the scope of current FET-PET protocols.

Cross-sectional study of the ossification center of the C1-S5 vertebral bodies.

PURPOSE: Knowledge on the normative growth of the spine is relevant in the prenatal detection of its abnormalities. This study describes the size of the ossification center of C1-S5 vertebral bodies. MATERIALS AND METHODS: Using CT, digital-image analysis, and statistics, the size of the ossification center of C1-S5 vertebral bodies in 55 spontaneously aborted human fetuses aged 17-30 weeks was examined. RESULTS: No sex significant differences were found. The body ossification centers were found within the entire presacral spine and in 85.5 % of S1, in 76.4 % of S2, in 67.3 % of S3, in 40.0 % of S4, and in 14.5 % of S5. All the values for the atlas were sharply smaller than for the axis. The mean transverse diameter of the body ossification center gradually increased from the axis to T12 vertebra, so as to stabilize through L1-L3 vertebrae, and finally was intensively decreasing to S5 vertebra. There was a gradual increase in sagittal diameter of the body ossification center from the axis to T5 vertebra and its stabilization for T6-T9 vertebrae. Afterward, an alternate progression was observed: a decrease in values for T10-T12 vertebrae, an increase in values for L1-L2 vertebrae, and finally a decrease in values for L3-S5 vertebrae. The values of cross-sectional area of ossification centers were gradually increasing from the axis to L2 vertebra and then started decreasing to S5 vertebra. The following cross-sectional areas were approximately equivalent to each other: for L5 and T3-T5, and for S4 and C1. The volumetric growth of the body ossification center gradually increased from the axis to L3 vertebra and then sharply decreased from L4 to S5. CONCLUSIONS: No male-female differences are found in the size of the body ossification centers of the spine. The growth dynamics for morphometric parameters of the body ossification centers of the spine follow similarly with gestational age.

Evaluation of FLT-PET/CT usefulness in diagnosis and qualification for surgical treatment of gastric cancer.

AIM OF THE STUDY: Evaluation of FLT/PET/ CT usefulness in diagnosis and qualification for surgical treatment of gastric cancer. MATERIAL AND METHODS: The FLT/PET/CT test was carried out in a group of 50 gastric cancer patients. Based on the test result, a decision followed about the therapeutic procedure to be applied. A comparison was made with regards to the consistency of the cancer growth advancement degree evaluation in the initial preoperative FLT/PET/CT test against the evaluation of postoperative degree of cancer advancement in histopathology. RESULTS: In the group of 50 diagnosed patients a surgical treatment was used for 37 patients. 21 resections were performed out of which 19 operations were radical In the group of 16 non-resective operations 2 post-laparotomic patients were selected for inductive treatment. In the group of 13 patients who did not undergo any surgery, 10 were directed to palliative care and 3 for inductive treatment. In the group of 50 patients, the applied FLT-PET/CT test confirmed presence of primary tumor in 49 patients. The presence of increased uptake of FLT in the local lymph nodes during the preoperative FLT-PET/CT test was confirmed in 22 cases. In 14 patients with FLT-PET/Ct N(+) with the M(-) feature resection surgery was performed. The increased uptake of FLT in localizing metastases (nodal and non-nodal) FLT-PET/CT (M+) was detected in 22 patients. The presence of nodal metastases in the postoperative histopathology examination (hpN+) was detected in 14 cases. In these cases preoperative FLT-PET/CT test proved the N(+) feature in 11 patients. The result FLT-PET/CT N(-) was truly negative in 2 patients, and false negative in 1 patient. In the group of 7 operated hpN(-) patients, in 3 patients a preoperative result FLT-PET/ CT N(+) (false positive result) was obtained. The consistency (positive) of nodal metastases identification in FLT-PET/CT as compared to post-surgical histopathology examination scored 11/15, which equals 73.3%. In the group of patients in whom resection surgery was performed, 4 false negative results were obtained [hp(N+), FLT-PET/CT (N-)] and 3 false positive results [hp(N-), FLT-PET/CT N(+)]. CONCLUSIONS: The initial test results indicate that FLT-PET/CT is an effective method in evaluating the primary tumor and the regional lymph nodes and is useful and beneficial in the diagnosis and further treatment evaluation of gastric cancer. FLT-PET/CT examination facilitates making proper therapeutic decisions - it allows the number of unnecessary laparotomies to be lowered.

Measurement of primary tumor volume by PET-CT to evaluate risk of mediastinal nodal involvement in NSCLC patients with clinically negative N2 lymph nodes.

AIM: The study aimed to determine a prognostic value of primary tumor volume measured on the basis of integrated positron emission tomography-computerized tomography (PET-CT) in terms of mediastinal nodal metastases (N2) prediction in non-small-cell lung cancer (NSCLC) patients with PET-CT N2 negative lymph nodes. METHODS: The records of 70 potentially operable NSCLC patients treated with surgical resection were analyzed. All patients underwent diagnostic, preoperative PET-CT, which was the basis for tumor volume calculations as well as the evaluation of N2 nodes status. The logistic regression analysis was employed to determine correlation between mediastinal nodal involvement and volume of primary tumor (izoSUV2.5 volume), that is the volume of primary tumor inside SUV 2.5 line, tumor histology, location (peripheral vs. central), hilar node status. RESULTS: A statistically significant correlation between mediastinal node involvement and izoSUV2.5 volume, tumor histology, locations peripheral vs. central and hilar node status was found. The risk of mediastinal lymph node metastasis is 24% for tumor volume of 100 cm(3) and increases up to 40% for tumor volume of 360 cm(3). An increase of tumor volume by 1 cm(3) increases the risk of lymph node disease by 0.3%. Tumor histology adenocarcinoma vs. squamous cell carcinoma increases the risk of mediastinal lymph node involvement by 195%, location central vs. peripheral by 68% and hilar node involvement by 166%. CONCLUSIONS: The study demonstrates that izoSUV2.5 volume of primary tumor may be considered as a prognostic factor in NSCLC patients, since it strongly correlates with mediastinal lymph node pathological status. This correlation is modified by primary tumor location, histology and hilar node involvement.

Combining amino acid PET and MRI imaging increases accuracy to define malignant areas in adult glioma.

Accurate determination of the extent and grade of adult-type diffuse gliomas is critical to patient management. In clinical practice, contrast-enhancing areas of diffuse gliomas in magnetic resonance imaging (MRI) sequences are usually used to target biopsy, surgery, and radiation therapy, but there can be discrepancies between these areas and the actual tumor extent. Here we show that adding 18F-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) to MRI sequences accurately locates the most malignant areas of contrast-enhancing gliomas, potentially impacting subsequent management and outcomes. We present a prospective analysis of over 300 serial biopsy specimens from 23 patients with contrast-enhancing adult-type diffuse gliomas using a hybrid PET-MRI scanner to compare T2-weighted and contrast-enhancing MRI images with FET-PET. In all cases, we observe and confirm high FET uptake in early PET acquisitions (5-15 min after 18F-FET administration) outside areas of contrast enhancement on MRI, indicative of high-grade glioma. In 30% cases, inclusion of FET-positive sites changes the biopsy result to a higher tumor grade.

Can we rely on PET in the follow-up of advanced seminoma patients?

The management of residuals after completion of chemotherapy in advanced seminoma is controversial. It has been proposed that fluorodeoxyglucose-positron emission tomography (FDG-PET) can be used as a follow-up. In this study we investigated FDG-PET as a follow-up tool in advanced seminoma patients treated previously with chemotherapy or radiotherapy. Thirty-seven patients assigned to an advanced seminoma group based on CT and/or FDG-PET/CT and then treated with chemotherapy were included in the study. All these patients underwent FDG-PET/CT examination as a part of the follow-up scheme. Patients underwent retroperitoneal lymph node dissection (RPLND), radiotherapy, or were followed clinically by CT and/or PET/CT every 6 months. In 8 cases FDG-PET was positive: 5 of them underwent RPLND and 3 radiotherapy. Two patients with negative FDG-PET but positive CT also underwent RPLND. The remaining patients with negative FDG-PET results were followed up. FDG-PET/CT was false positive in one case >3 cm and one <3 cm, in 6 cases >3 cm it was true negative. While FDG-PET can find a viable tumor, there also is an important question of false positive results. It was clinically proven that a negative FDG-PET was correlated with stable disease, but we were unable to examine specimens in these cases.