[Level IV inferior vena cava tumor thrombus : A rare diagnosis in patients with renal cell carcinoma]. / Level-IV-Cavathrombus : Eine seltene Diagnose bei Patienten mit Nierenzellkarzinom.

Renal cell carcinoma in combination with a supradiaphragmatic tumor thrombus is a rare tumor entity. Radical surgery including nephrectomy and thrombectomy is still considered standard treatment. The extent of the tumor thrombus should be preoperatively evaluated by MRI and TEE. An interdisciplinary team is important for surgery planning and realization. Despite the known risks of an operation, a longer overall survival is achieved.

[Significance of PSMA imaging in prostate cancer]. / Stellenwert der PSMA-Liganden-Bildgebung beim Prostatakarzinom.

BACKGROUND: Prostate cancer (PCa) is one of the most common malignancies of men in developed countries. To improve clinical diagnostics of PCa, 68Ga-PSMA-11 was recently introduced as a new PET tracer. 68Ga-PSMA-11 is able to specifically bind to the prostate-specific membrane antigen (PSMA), which is upregulated on the surface of prostate cancer cells in most patients. OBJECTIVES: To analyse the current significance of 68Ga-PSMA-11 PET imaging in prostate cancer in relation to staging of men with initial diagnosis, biochemical recurrence and metastatic disease. MATERIALS AND METHODS: Retrospective analysis of current literature (PubMed search) regarding 68Ga-PSMA-11 PET diagnostics in primary staging, in biochemical recurrence and in metastasized disease. RESULTS: Compared to conventional imaging, 68Ga-PSMA-11 PET/CT reaches a higher sensitivity with an excellent specificity in the clinical diagnosis of primary staging as well as staging for recurrence and advanced, metastasized disease. In biochemical recurrence, 68Ga-PSMA-11 PET/CT shows significantly higher detection rates in comparison to choline PET/CT, especially in patients with low PSA values. In the clinical diagnosis of recurrent disease, therapy concepts were changed in more than a quarter of the patients due to the use of 68Ga-PSMA-11 PET/CT. The significance of staging with 68Ga-PSMA-11 PET/CT in advanced metastasized patients remains uncertain. CONCLUSIONS: Due to the excellent results of 68Ga-PSMA-11 PET imaging, even in patients with slightly elevated PSA levels, it will continue to play an important role in clinical diagnostics of prostate cancer and, thus, its clinical utilization will become more widely spread.

Improved detection of anterior fibromuscular stroma and transition zone prostate cancer using biparametric and multiparametric MRI with MRI-targeted biopsy and MRI-US fusion guidance.

BACKGROUND: The objective of this study was to analyze the potential of prostate magnetic resonance imaging (MRI) and MRI/transrectal ultrasound-fusion biopsies to detect and to characterize significant prostate cancer (sPC) in the anterior fibromuscular stroma (AFMS) and in the transition zone (TZ) of the prostate and to assess the accuracy of multiparametric MRI (mpMRI) and biparametric MRI (bpMRI) (T2w and diffusion-weighted imaging (DWI)). METHODS: Seven hundred and fifty-five consecutive patients underwent prebiopsy 3 T mpMRI and transperineal biopsy between October 2012 and September 2014. MRI images were analyzed using PIRADS (Prostate Imaging-Reporting and Data System). All patients had systematic biopsies (SBs, median n=24) as reference test and targeted biopsies (TBs) with rigid software registration in case of MRI-suspicious lesions. Detection rates of SBs and TBs were assessed for all PC and sPC patients defined by Gleason score (GS)⩾3+4 and GS⩾4+3. For PC, which were not concordantly detected by TBs and SBs, prostatectomy specimens were assessed. We further compared bpMRI with mpMRI. RESULTS: One hundred and ninety-one patients harbored 194 lesions in AFMS and TZ on mpMRI. Patient-based analysis detected no difference in the detection of all PC for SBs vs TBs in the overall cohort, but in the repeat-biopsy population TBs performed significantly better compared with SBs (P=0.004 for GS⩾3+4 and P=0.022 for GS⩾4+3, respectively). Nine GS⩾4+3 sPCs were overlooked by SBs, whereas TBs missed two sPC in men undergoing primary biopsy. The combination of SBs and TBs provided optimal local staging. Non-inferiority analysis showed no relevant difference of bpMRI to mpMRI in sPC detection. CONCLUSIONS: MRI-targeted biopsies detected significantly more anteriorly located sPC compared with SBs in the repeat-biopsy setting. The more cost-efficient bpMRI was statistically not inferior to mpMRI in sPC detection in TZ/AFMS.

Association of pro-melanin concentrating hormone genotype with beef carcass quality and yield.

Beef cattle from 3 independent studies conducted in the Texas Panhandle (Exp. 1: n = 3,906 and Exp. 2: n = 4,000) and southern Idaho (Exp. 3; n = 542) were used to investigate the association of pro-melanin concentrating hormone (PMCH) genotype with beef carcass quality and yield attributes. Tissue samples were collected from each animal to determine which PMCH allele they expressed (Trial 1: AA, 62.60%; AT, 32.05%; and TT, 5.35%; Trial 2: AA, 64.33%; AT, 31.07%; and TT, 4.60%; Trial 3: AA, 65.87%; AT, 29.34%; and TT, 4.80%). Twenty-four hours after harvest, carcass attributes were evaluated for all carcasses and longissimus dorsi steak samples were allocated from a subset of carcasses in Exp. 2 (n = 352; AA, 49.43%; AT, 28.98%; and TT, 21.59%) and each carcass in Exp. 3. Warner-Bratzler shear force measurements were determined for each steak after aging for 7, 14, or 21 d postmortem. Carcasses from Exp. 1 and 2 expressing the AA genotype had greater (P < 0.01) 12th rib subcutaneous (s.c.) fat depth and marbling scores, concurrent with smaller (P < 0.01) LM area than carcasses of AT and TT genotypes. Subsequently, carcasses expressing the AA genotype were represented by a greater (P < 0.02) proportion achieving Prime and Premium Choice quality grades, and a lesser (P < 0.01) proportion grading Select or Standard. In all trials, carcasses of the AA genotype had greater (P < 0.04) calculated yield grades than carcasses of the TT genotype. Carcass composition was associated with PMCH genotype evident by calculated empty body fat differences (P < 0.04) between AA and TT cattle in Exp. 1 and 3, and differences (P < 0.01) among all 3 genotypes in Trial 2. Shear force data on 7-d postmortem aging tended (P = 0.06) to favor cattle of the AA genotype in Exp. 2. However, additional aging to 14 or 21 d minimized any tenderness differences. These data illustrate the potential relationship that may exist among PMCH genotypes and indicators of carcass composition.

Zilpaterol improves feeding performance and fabrication yield of concentrate-finished cull cows.

The objective of this study was to quantify the effects of zilpaterol hydrochloride (ZH) on feeding performance and fabrication yield of concentrate-finished cull cows. Three hundred twenty commercial cull cows (2 to 10 yr old) were obtained from ranches in Missouri and South Dakota and assigned to 1 of 2 treatments: 1) a control diet containing no ZH and 2) a diet that contained ZH. Cows were fed for 75, 88, or 110 d, and all received the control ration until ZH treatments were initiated. Twenty-four days before slaughter, ZH feeding began for the designated treatment pens; cows were fed ZH [8.33 mg/kg (100% DM basis)] for 20 d with a 4-d withdrawal period before slaughter. No differences (P>0.05) were detected between the 2 treatment groups for initial BW or DMI. Final BW (640.5 vs. 619.1 kg), ADG for the last 24 d (2.75 vs. 2.17 kg), and G:F for the last 24 d (0.160 vs. 0.126) were greater (P<0.01) in cows fed ZH than the control cows. No differences (P > 0.05) were found for lean or skeletal maturity score, fat thickness, LM area, HCW, or calculated yield grade among the 2 treatment groups. Feeding ZH increased (P<0.01) HCW (390.1 vs. 369.2 kg), dressed carcass yield (61.01 vs. 59.45%), and LM area (93.3 vs. 86.5 cm(2)) and decreased (P<0.01) marbling score (Slight(63) vs. Slight(86)) compared with control cows. Cows fed ZH had greater (P<0.05) primal weights for chuck (mock) tender (2.63 vs. 2.28 kg), lip-on rib eye roll (13.54 vs. 12.56 kg), top sirloin butt (12.74 vs. 11.82 kg), top (inside) round (14.58 vs. 12.89 kg), and peeled knuckle (12.87 vs. 11.51 kg) while yielding a decreased percentage of mechanical knife trimmings (1.15 vs. 1.35%; P<0.01) and more top (inside) rounds (3.71 vs. 3.46%; P=0.02) than the control cows. No differences (P>0.07) were found for the remaining fabrication yield attributes. The ZH-treated cows had greater (P<0.05) fabrication dollar values for chuck (mock) tender (8.82 vs. 7.66 $/carcass), lip-on rib eye roll (64.20 vs. 59.56 $/carcass), strip loin (0 × 1; 49.13 vs. 44.75 $/carcass), top sirloin butt (35.60 vs. 33.01 $/carcass), bottom round (flat; 44.23 vs. 39.23 $/carcass), top (inside) round (60.30 vs. 53.33 $/carcass), knuckle (peeled; 44.26 vs. 39.57 $/carcass), and total salable yield (879.50 vs. 803.70 $/carcass) than control cows. These results suggest the feeding of ZH to concentrate-finished cull cows enhances production efficiencies and can add new value to the cull cow market.