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2.
RSC Med Chem ; 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39246752

RESUMEN

Cancer patients undergoing chemotherapy are highly susceptible to infections owing to their compromised immune system, which also promotes cancer progression through inflammation. Thus, this study aimed to develop novel chemotherapeutic agents with both anticancer and antimicrobial properties. A series of diarylurea derivatives based on pyridazinone scaffolds were designed, synthesized, and characterized as surrogates for sorafenib. The synthesized compounds were tested for their antimicrobial activity and screened against 60 cancer cell lines at the National Cancer Institute (NCI). Compound 10h exhibited potent antibacterial activity against Staphylococcus aureus (MIC = 16 µg mL-1), whereas compound 8g showed significant antifungal activity against Candida albicans (MIC = 16 µg mL-1). Additionally, ten compounds were further evaluated for VEGFR-2 inhibition, with compound 17a showing the best inhibitory activity. Compounds 8f, 10l, and 17a demonstrated significant anticancer activity against melanoma, NSCLC, prostate cancer, and colon cancer, with growth inhibition percentages (GI%) ranging from 62.21% to 100.14%. Compounds 10l and 17a were selected for five-dose screening, displaying GI50 values of 1.66-100 µM. Compound 10l induced G0-G1 phase cell cycle arrest in the A549/ATCC cell line, increasing the cell population from 85.41% to 90.86%. Gene expression analysis showed that compound 10l upregulated pro-apoptotic genes p53 and Bax and downregulated the anti-apoptotic gene Bcl-2. Molecular docking studies provided insights into the binding modes of the compounds to the VEGFR-2 enzyme. In conclusion, the pyridazinone-based diarylurea derivatives developed in this study show promise as dual-function antimicrobial and anticancer agents, warranting further investigation.

3.
Aesthetic Plast Surg ; 2024 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-39299938

RESUMEN

BACKGROUND: Breast deformity following massive weight loss poses a unique challenge inadequately managed by traditional methods. Patients also have considerable lateral and posterior upper trunk tissue surplus. Multiple studies have used chest wall flaps for auto-augmentation with mastopexy to tackle this problem. However, the outcome measures did not include any objective tools to assess the reliability of these flaps. Hence, in this study sono-mammography and breast anthropometric measurements are used for evaluation of the added volume and long-term sustainability of chest wall perforator flaps. METHODOLOGY: Twenty massive weight loss patients with Pittsburgh Rating Scale score 2-3 underwent mastopexy with autologous augmentation through perforator flaps encompassing lateral chest wall skin. Outcome measures were breast volume, and the presence of fat necrosis on mammography, and direct breast anthropometry. CONCLUSION: All patients showed a consistent increase in volume postoperatively and no fat necrosis in postoperative mammography, reflecting flap reliability over one year of follow-up. All postoperative anthropometric measurements showed improvement in the breast deformities addressed. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

4.
Radiographics ; 44(8): e230216, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-39088361

RESUMEN

Disease spread in the abdomen and pelvis generally occurs in a predictable pattern in relation to anatomic landmarks and fascial planes. Anatomically, the abdominopelvic cavity is subdivided into several smaller spaces or compartments by key ligaments and fascial planes. The abdominal cavity has been traditionally divided into peritoneal, retroperitoneal, and pelvic extraperitoneal spaces. Recently, more clinically relevant classifications have evolved. Many pathologic conditions affect the abdominal cavity, including traumatic, inflammatory, infectious, and neoplastic processes. These abnormalities can extend beyond their sites of origin through various pathways. Identifying the origin of a disease process is the first step in formulating a differential diagnosis and ultimately reaching a final diagnosis. Pathologic conditions differ in terms of pathways of disease spread. For example, simple fluid tracks along fascial planes, respecting anatomic boundaries, while fluid from acute necrotizing pancreatitis can destroy fascial planes, resulting in transfascial spread without regard for anatomic landmarks. Furthermore, neoplastic processes can spread through multiple pathways, with a propensity for spread to noncontiguous sites. When the origin of a disease process is not readily apparent, recognizing the spread pattern can allow the radiologist to work backward and ultimately arrive at the site or source of pathogenesis. As such, a cohesive understanding of the peritoneal anatomy, the typical organ or site of origin for a disease process, and the corresponding pattern of disease spread is critical not only for initial diagnosis but also for establishing a road map for staging, anticipating further disease spread, guiding search patterns and report checklists, determining prognosis, and tailoring appropriate follow-up imaging studies. ©RSNA, 2024 Supplemental material is available for this article.


Asunto(s)
Enfermedades Peritoneales , Peritoneo , Humanos , Peritoneo/diagnóstico por imagen , Peritoneo/patología , Peritoneo/anatomía & histología , Enfermedades Peritoneales/diagnóstico por imagen , Diagnóstico Diferencial
6.
Bioengineering (Basel) ; 11(7)2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-39061717

RESUMEN

Prostate cancer (PC) is a prevalent and potentially fatal form of cancer that affects men globally. However, the existing diagnostic methods, such as biopsies or digital rectal examination (DRE), have limitations in terms of invasiveness, cost, and accuracy. This study proposes a novel machine learning approach for the diagnosis of PC by leveraging clinical biomarkers and personalized questionnaires. In our research, we explore various machine learning methods, including traditional, tree-based, and advanced tabular deep learning methods, to analyze tabular data related to PC. Additionally, we introduce the novel utilization of convolutional neural networks (CNNs) and transfer learning, which have been predominantly applied in image-related tasks, for handling tabular data after being transformed to proper graphical representations via our proposed Tab2Visual modeling framework. Furthermore, we investigate leveraging the prediction accuracy further by constructing ensemble models. An experimental evaluation of our proposed approach demonstrates its effectiveness in achieving superior performance attaining an F1-score of 0.907 and an AUC of 0.911. This offers promising potential for the accurate detection of PC without the reliance on invasive and high-cost procedures.

7.
Arch Oral Biol ; 166: 106048, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39002180

RESUMEN

OBJECTIVE: Loss of ovarian function in menopause is commonly associated with salivary gland dysfunction. The aim is to study the possible therapeutic effect of bone marrow mesenchymal stem cells (BM-MSCs) on the altered structure of the submandibular salivary glands (SMGs) of ovariectomized rats. DESIGN: Twenty-four female, adult, Wistar rats were used and distributed into three groups (8 rats/group). The control group included sham-operated rats. The ovariectomized group consisted of rats with removed ovaries. The third group consisted of ovariectomized rats received injections, via tail, of MSCs extracted from bone marrow of 3-weeks-old rat hind limb (BM-MSC group). Four weeks after BM-MSC transplantation, the bone mineral density (BMD) of the femur was detected. The SMG was dissected and processed for histological, immunohistochemical, and histomorphometric analyses. RESULTS: The ovariectomized rats depicted low BMD in the femur. The SMG acini revealed atrophy. The ductal and acinar cells depicted vacuolization and abnormal nuclear histology. GLUT1 immunostaining was decreased in SMG ducts. The BM-MSC group resumed the normal SMG histology and GLUT1 immunolabelling. CONCLUSIONS: BM-MSC therapy restored the normal SMG structure and GLUT1 immunostaining in the treated ovariectomized rats, suggesting improved glucose transporting function.


Asunto(s)
Densidad Ósea , Transportador de Glucosa de Tipo 1 , Trasplante de Células Madre Mesenquimatosas , Ovariectomía , Ratas Wistar , Glándula Submandibular , Animales , Femenino , Ratas , Trasplante de Células Madre Mesenquimatosas/métodos , Glándula Submandibular/metabolismo , Transportador de Glucosa de Tipo 1/metabolismo , Células Madre Mesenquimatosas/metabolismo , Inmunohistoquímica , Fémur , Células de la Médula Ósea
8.
Bioengineering (Basel) ; 11(6)2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38927865

RESUMEN

Prostate cancer is a significant health concern with high mortality rates and substantial economic impact. Early detection plays a crucial role in improving patient outcomes. This study introduces a non-invasive computer-aided diagnosis (CAD) system that leverages intravoxel incoherent motion (IVIM) parameters for the detection and diagnosis of prostate cancer (PCa). IVIM imaging enables the differentiation of water molecule diffusion within capillaries and outside vessels, offering valuable insights into tumor characteristics. The proposed approach utilizes a two-step segmentation approach through the use of three U-Net architectures for extracting tumor-containing regions of interest (ROIs) from the segmented images. The performance of the CAD system is thoroughly evaluated, considering the optimal classifier and IVIM parameters for differentiation and comparing the diagnostic value of IVIM parameters with the commonly used apparent diffusion coefficient (ADC). The results demonstrate that the combination of central zone (CZ) and peripheral zone (PZ) features with the Random Forest Classifier (RFC) yields the best performance. The CAD system achieves an accuracy of 84.08% and a balanced accuracy of 82.60%. This combination showcases high sensitivity (93.24%) and reasonable specificity (71.96%), along with good precision (81.48%) and F1 score (86.96%). These findings highlight the effectiveness of the proposed CAD system in accurately segmenting and diagnosing PCa. This study represents a significant advancement in non-invasive methods for early detection and diagnosis of PCa, showcasing the potential of IVIM parameters in combination with machine learning techniques. This developed solution has the potential to revolutionize PCa diagnosis, leading to improved patient outcomes and reduced healthcare costs.

9.
Diagn Interv Radiol ; 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38874163

RESUMEN

In patients with cancer, spontaneous renal bleeding can stem from a range of underlying factors, necessitating precise diagnostic tools for effective patient management. Benign and malignant renal tumors are among the primary culprits, with angiomyolipomas and renal cell carcinomas being the most common among them. Vascular anomalies, infections, ureteral obstructions, and coagulation disorders can also contribute to renal-related bleeding. Cross-sectional imaging techniques, particularly ultrasound and computed tomography (CT), play pivotal roles in the initial detection of renal bleeding. Magnetic resonance imaging and CT are preferred for follow-up evaluations and aid in detecting underlying enhancing masses. IV contrast-enhanced ultrasound can provide additional information for active bleeding detection and differentiation. This review article explores specific disorders associated with or resembling spontaneous acute renal bleeding in patients with renal tumors; it focuses on the significance of advanced imaging techniques in accurately identifying and characterizing renal bleeding in these individuals. It also provides insights into the clinical presentations, imaging findings, and treatment options for various causes of renal bleeding, aiming to enhance the understanding, diagnosis, and management of the issue.

10.
Arch Oral Biol ; 165: 106010, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38795432

RESUMEN

OBJECTIVE: To decipher the role of locally injected bone marrow mesenchymal stem cells (BM-MSCs) in the tongue of hypothyroid rats. DESIGN: A total 24 male Wister rats were utilized and allocated into 3 groups (n = 8). As for the control group, rats received distilled water via oral gavage. In the hypothyroid group, rats administered carbimazole 5 mg/ 250 g/ day for 6 successive weeks, for hypothyroidism induction. The BM-MSC treated hypothyroid group (BM-MSC group); hypothyroid rats received local injection of 0.5 million BM-MSCs in tongue. Six weeks after BM-MSC injection, tongue samples were processed for Hematoxylin and eosin (H and E) staining, Ki67-immunohistochemistry and histomorphometric analysis. RESULTS: The hypothyroid group revealed degenerative alterations in the lingual papillae, and apparent thinning of the inferior lingual epithelium compared to their controls. Tongues of the BM-MSC group depicted restoration of the normal tongue histology. The Ki67 immunoreaction was apparently decreased in the lingual epithelium of hypothyroid group compared to their controls, however the BM-MSC group regained Ki67 immunostaining. CONCLUSION: Our data suggest that administration of BM-MSCs rescued the degenerative changes in the lingual mucosa and one of the possible underlying mechanisms could be the restoration of cellular proliferation in the lingual epithelium.


Asunto(s)
Carbimazol , Hipotiroidismo , Ratas Wistar , Lengua , Animales , Hipotiroidismo/inducido químicamente , Hipotiroidismo/patología , Masculino , Ratas , Lengua/patología , Trasplante de Células Madre Mesenquimatosas/métodos , Antitiroideos/farmacología , Inmunohistoquímica , Antígeno Ki-67/metabolismo , Células Madre Mesenquimatosas/efectos de los fármacos , Modelos Animales de Enfermedad
11.
Trop Anim Health Prod ; 56(3): 122, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38607593

RESUMEN

The present study aimed to use poor quality roughages, such as rice and faba bean straw, treated with or without urea, and their impacts on digestibility, rumen fermentation, some blood parameters, and growth performance of lambs. Twenty crossbred male lambs (1/4 Finland ×¾ Ossimi, 25±1.13kg live body weight) were chosen and divided into four groups. All lambs were fed rations of concentrated feed mixture at 2% of live weight with the following roughages ad libitum: URS (control group, untreated rice straw), TRS (urea-treated rice straw), FBS (faba bean straw), and TRS+FBS (mixture of TRS and FBS, 1:1). Nutrient digestibility and feeding values improved (P<0.05) with TRS+FBS lambs versus FBS, TRS and URS lambs. The highest numerical values of ruminal total volatile fatty acid (VFA) concentration in TRS lambs were recorded 23.9 ml.eq/dl followed by TRS+FBS, URS and FBS. Regarding to the ruminal parameters, there were no differences (P>0.05) among evaluated groups except for NH3-N, the highest concentration (P<0.05) was recorded in TRS lambs at 3 h post-feeding. Lambs of TRS, FBS and TRS+FBS showed faster growth (P<0.05) than those of the control (i.e., URS). Intakes of dry matter, total digestible nutrients, and digestible crude protein were numerically increased for TRS, FBS, and TRS+FBS. Feed conversion, as kg dry matter/kg gain, was improved for TRS, FBS, and TRS+FBS lambs versus URS. Daily gain of lambs increased (P<0.05) with lambs of TRS, FBS, and TRS+FBS but URS lambs showed a decrease (P<0.05) in daily gain. Feed conversion as kg dry matter intake/kg gain was improved (P<0.05) by feeding on TRS, FBS and TRS+FBS rations versus URS. The TRS+FBS lambs tended to have the highest economic efficiency versus URS, TRS and FBS lambs. It was concluded that urea-treated rice straw could be used as sole roughage or mixed with faba bean straw (1:1) in growing lambs' ration to improve their performance and economic efficiency without adversely affecting their health.The present study aimed to use poor quality roughages, such as rice and faba bean straw, treated with or without urea, and their impacts on digestibility, rumen fermentation, some blood parameters, and growth performance of lambs. Twenty crossbred male lambs (1/4 Finland ×¾ Ossimi, 25±1.13kg live body weight) were chosen and divided into four groups. All lambs were fed rations of concentrated feed mixture at 2% of live weight with the following roughages ad libitum: URS (control group, untreated rice straw), TRS (urea-treated rice straw), FBS (faba bean straw), and TRS+FBS (mixture of TRS and FBS, 1:1). Nutrient digestibility and feeding values improved (P<0.05) with TRS+FBS lambs versus FBS, TRS and URS lambs. The highest numerical values of ruminal total volatile fatty acid (VFA) concentration in TRS lambs were recorded 23.9 ml.eq/dl followed by TRS+FBS, URS and FBS. Regarding to the ruminal parameters, there were no differences (P>0.05) among evaluated groups except for NH3-N, the highest concentration (P<0.05) was recorded in TRS lambs at 3 h post-feeding. Lambs of TRS, FBS and TRS+FBS showed faster growth (P<0.05) than those of the control (i.e., URS). Intakes of dry matter, total digestible nutrients, and digestible crude protein were numerically increased for TRS, FBS, and TRS+FBS. Feed conversion, as kg dry matter/kg gain, was improved for TRS, FBS, and TRS+FBS lambs versus URS. Daily gain of lambs increased (P<0.05) with lambs of TRS, FBS, and TRS+FBS but URS lambs showed a decrease (P<0.05) in daily gain. Feed conversion as kg dry matter intake/kg gain was improved (P<0.05) by feeding on TRS, FBS and TRS+FBS rations versus URS. The TRS+FBS lambs tended to have the highest economic efficiency versus URS, TRS and FBS lambs. It was concluded that urea-treated rice straw could be used as sole roughage or mixed with faba bean straw (1:1) in growing lambs' ration to improve their performance and economic efficiency without adversely affecting their health.


Asunto(s)
Oryza , Vicia faba , Masculino , Ovinos , Animales , Oveja Doméstica , Nutrientes , Fibras de la Dieta , Urea , Ácidos Grasos Volátiles , Peso Corporal
12.
J Hepatocell Carcinoma ; 11: 595-606, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38525156

RESUMEN

Background and Aims: Limited methods exist to accurately characterize the risk of malignant progression of liver lesions. Enhancement pattern mapping (EPM) measures voxel-based root mean square deviation (RMSD) of parenchyma and the contrast-to-noise (CNR) ratio enhances in malignant lesions. This study investigates the utilization of EPM to differentiate between HCC versus cirrhotic parenchyma with and without benign lesions. Methods: Patients with cirrhosis undergoing MRI surveillance were studied prospectively. Cases (n=48) were defined as patients with LI-RADS 3 and 4 lesions who developed HCC during surveillance. Controls (n=99) were patients with and without LI-RADS 3 and 4 lesions who did not develop HCC. Manual and automated EPM signals of liver parenchyma between cases and controls were quantitatively validated on an independent patient set using cross validation with manual methods avoiding parenchyma with artifacts or blood vessels. Results: With manual EPM, RMSD of 0.37 was identified as a cutoff for distinguishing lesions that progress to HCC from background parenchyma with and without lesions on pre-diagnostic scans (median time interval 6.8 months) with an area under the curve (AUC) of 0.83 (CI: 0.73-0.94) and a sensitivity, specificity, and accuracy of 0.65, 0.97, and 0.89, respectively. At the time of diagnostic scans, a sensitivity, specificity, and accuracy of 0.79, 0.93, and 0.88 were achieved with manual EPM with an AUC of 0.89 (CI: 0.82-0.96). EPM RMSD signals of background parenchyma that did not progress to HCC in cases and controls were similar (case EPM: 0.22 ± 0.08, control EPM: 0.22 ± 0.09, p=0.8). Automated EPM produced similar quantitative results and performance. Conclusion: With manual EPM, a cutoff of 0.37 identifies quantifiable differences between HCC cases and controls approximately six months prior to diagnosis of HCC with an accuracy of 89%.


Current surveillance and diagnostic methods in hepatocellular carcinoma are suboptimal. Enhancement pattern mapping is an imaging technique that quantifies lesion signals and may be useful in diagnostic and surveillance methods. Enhancement pattern mapping describes quantifiable differences between malignant and benign liver tissue on contrast-enhanced MRI. It amplifies lesion signal and distinguishes malignancy in a surveillance population. The novel imaging technique was investigated at single institution and analyzed lesions compared to cirrhotic parenchyma. Future efforts will include further risk stratification across LI-RADS group categories. The results provide evidence that enhancement pattern mapping uses available imaging data to distinguish hepatocellular carcinoma from non-cancerous parenchyma with and without benign lesions on scans six months prior to diagnosis with standard MRI. The technique introduces a prospective modality to improve diagnostic accuracy and early detection with the goal of improving clinical outcomes.

13.
Radiat Prot Dosimetry ; 200(4): 417-422, 2024 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-38195763

RESUMEN

This case report investigates the radiation dose received by a paediatric patient with a ventricular assist device who underwent four non-contrast brain computed tomography (CT) scans, two brain perfusion CT scans and two head angiographic CT scans. The total estimated absorbed dose to the lens of the eye is above the 500 mGy radiation-induced cataract threshold. It is recommended that this patient and those with similar imaging histories have routine follow-up with an ophthalmologist. It is also recommended that radiation dose tracking and an electronic medical alert program be implemented to allow the identification of patients who may exceed tissue reaction thresholds.


Asunto(s)
Catarata , Cristalino , Humanos , Niño , Dosis de Radiación , Tomografía Computarizada por Rayos X/métodos , Catarata/diagnóstico por imagen , Catarata/etiología , Cabeza , Cristalino/diagnóstico por imagen
15.
Radiographics ; 44(1): e230061, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38060424

RESUMEN

Pancreatic surgery is considered one of the most technically challenging surgical procedures, despite the evolution of modern techniques. Neoplasms remain the most common indication for pancreatic surgery, although inflammatory conditions may also prompt surgical evaluation. The choice of surgical procedure depends on the type and location of the pathologic finding because different parts of the pancreas have separate vascular supplies that may be shared by adjacent organs. The surgical approach could be conventional or minimally invasive (laparoscopic, endoscopic, or robotic assisted). Because of the anatomic complexity of the pancreatic bed, perioperative complications may be frequently encountered and commonly involve the pancreatic-biliary, vascular, lymphatic, or bowel systems, irrespective of the surgical technique used. Imaging plays an important role in the assessment of suspected postoperative complications, with CT considered the primary imaging modality, while MRI, digital subtraction angiography, and molecular imaging are considered ancillary diagnostic tools. Accurate diagnosis of postoperative complications requires a solid understanding of pancreatic anatomy, surgical indications, normal postoperative appearance, and expected postsurgical changes. The practicing radiologist should be familiar with the most common perioperative complications, such as anastomotic leak, abscess, and hemorrhage, and be able to differentiate these entities from normal anticipated postoperative changes such as seroma, edema and fat stranding at the surgical site, and perivascular soft-tissue thickening. In addition to evaluation of the primary operative fossa, imaging plays a fundamental role in assessment of the adjacent organ systems secondarily affected after pancreatic surgery, such as vascular, biliary, and enteric complications. Published under a CC BY 4.0 license. Test Your Knowledge questions are available in the supplemental material. See the invited commentary by Winslow in this issue.


Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Laparoscopía , Neoplasias Pancreáticas , Humanos , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/cirugía , Laparoscopía/métodos , Páncreas/diagnóstico por imagen , Páncreas/cirugía , Diagnóstico por Imagen , Neoplasias Pancreáticas/patología
16.
Curr Urol ; 17(3): 213-218, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37448619

RESUMEN

Background: The lack of overall experience and reporting on angiographic findings in previously published studies of renal arterial embolization (RAE) compelled us to report our overall experience on a series of patients. Materials and methods: A retrospective study was performed analyzing data of patients enrolled for RAE between 2010 and 2019. History, physical examination, and laboratory data were reviewed for all patients. Abdominal ultrasound was the initial imaging study, and all patients underwent subsequent computed tomography or magnetic resonance imaging. The outcome of RAE was determined based on radiographic and clinical findings. Results: Data from 202 patients were analyzed, with a mean age of 45 ± 15 years, and 71.3% of patients were male. Iatrogenic injury was the most common indication for RAE (54%), followed by renal tumors, trauma, and spontaneous, in 27.7%, 10.4%, and 8.4% of patients, respectively. Renal angiography revealing pseudoaneurysm alone or with other pathology in the lower pole of the kidney was the most common finding (40.6%), whereas no lesions were identified on angiography in 32 patients (15.8%), after which RAE was subsequently aborted. Renal arterial embolization was successful in 158 of 170 patients (92.9%) after 1 or more trials (maximum of 4). Microcoil alone or with other embolic materials was the most commonly used material for embolization (85%). Conclusions: Iatrogenic injury was the most common indication for RAE. Pseudoaneurysm alone or with other lesions was the most common lesion on renal angiography; however, angiography showed a negative result in 16% of patients, even those with symptoms. When lesions are present on angiography, the overall success of repeated trials of RAE reached 92.9%.

17.
J Med Imaging Radiat Oncol ; 67(6): 625-633, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37343160

RESUMEN

In recent years, there has been an increased awareness and understanding of the varying gender identities within our society. Consequently, there has also been a need for healthcare providers to be cognizant of the unique needs of a gender-diverse population. Determining the pregnancy status of transgender, gender-diverse and non-binary patients in medical imaging settings has been poorly handled, and there is a lack of standardisation in the Australian and Aotearoa New Zealand setting. The potential risk of exposing a gender-diverse pregnant patient to ionising radiation increases the need for guidance to ensure potentially pregnant persons are not missed during screening questionnaires. This review article explores various approaches to pregnancy status determination for gender-diverse patients, recognising the complexities involved and emphasising the need for future work to establish a widely accepted solution.


Asunto(s)
Personas Transgénero , Femenino , Humanos , Embarazo , Identidad de Género , Australia , Diagnóstico por Imagen , Nueva Zelanda
18.
J Pediatr Urol ; 19(5): 559.e1-559.e7, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37302924

RESUMEN

BACKGROUND: Children undergoing investigation and management for complex upper tract urolithiasis often require multimodal imaging. The significance of related radiation exposure in stone care pathways has received little attention in the published literature. STUDY DESIGN: Medical records of paediatric patients undergoing percutaneous nephrolithotomy were retrospectively analysed to ascertain the modalities used and determine extent of radiation exposure occurring during each care pathway. Radiation dose simulation and calculation was performed a priori. The cumulative effective dose (mSv) and cumulative organ dose (mGy) for radiosensitive organs was calculated. RESULTS: A total of 140 imaging studies were included from the care pathways of 15 children with complex upper tract urolithiasis. Median follow-up was 9.6 years (range: 6.7-16.8 years). The average number of imaging studies with ionising radiation per patient was nine, with a cumulative effective dose of 18.3 mSv across all modalities. The most common modalities were: mobile fluoroscopy (43%), x-ray (24%), and computed tomography (18%). The cumulative effective dose per study type was greatest for CT (4.09 mSv), followed by fixed and mobile fluoroscopy (2.79 mSv and 1.82 mSv, respectively). CONCLUSION: There is high general awareness of radiation exposure involved in CT scanning with resultant caution in employing this modality in paediatric patients. However, the significant radiation exposure relating to fluoroscopy (whether fixed or mobile) is less well documented in children. We recommend implementing steps to minimise radiation exposure by optimisation and avoidance of certain modalities where possible. Paediatrics urologists must employ strategies to minimise radiation exposure in children with urolithiasis, given the significant exposures encountered.


Asunto(s)
Nefrolitotomía Percutánea , Exposición a la Radiación , Urolitiasis , Humanos , Niño , Estudios Retrospectivos , Dosis de Radiación , Urolitiasis/diagnóstico por imagen , Urolitiasis/cirugía
19.
Nucl Med Commun ; 44(7): 663-670, 2023 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-37158225

RESUMEN

OBJECTIVES: Somatostatin receptor (SSTR) PET imaging is utilized with increasing frequency in the clinical management of neuroendocrine tumors. Incidental PET-avid CNS lesions are commonly noted and presumed to be meningiomas. However, SSTR PET lacks specificity for meningioma identification. This study aimed to clarify the role of SSTR-based imaging in the classification of incidental CNS lesions based on current clinical practice. METHODS: Patients who underwent both Ga-68-DOTATATE PET and brain MRI and had an incidental CNS lesion identified with a radiographic prediction of meningioma via one (discordant prediction) or both (concordant prediction) imaging modalities were retrospectively analyzed. Imaging indication, semiquantitative measures, and clinical history were recorded. RESULTS: Among 48 patients with a CNS lesion identified on both imaging modalities, most scans were performed for a history of neuroendocrine tumor (64.6%). Cases with concordant lesion-type prediction of meningioma between imaging modalities ( N = 24) displayed a significantly higher SUV max (median 7.9 vs. 4.0; P = 0.008) and Krenning score (median 3.0 vs. 2.0; P = 0.005) on Ga-68-DOTATATE PET compared with cases with a discordant prediction of meningioma ( N = 24). In cases with lower SUV max values, Ga-68-DOTATATE was more likely to discordantly predict meningioma without agreement by the corresponding MRI. Prior cranial radiation or use of somatostatin mimetics did not affect quantitative radiographic measures, and MRI-based tumor size was similar across groups. CONCLUSION: Lesions with increased avidity may be more confidently predicted as meningioma in Ga-68-DOTATATE PET scans, whereas there is more discrepancy in prediction among low SUV cases.


Asunto(s)
Neoplasias Meníngeas , Meningioma , Tumores Neuroendocrinos , Compuestos Organometálicos , Humanos , Meningioma/diagnóstico por imagen , Receptores de Somatostatina , Radioisótopos de Galio , Estudios Retrospectivos , Tomografía de Emisión de Positrones/métodos , Biomarcadores , Neoplasias Meníngeas/diagnóstico por imagen , Sistema Nervioso Central/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tumores Neuroendocrinos/diagnóstico por imagen , Tumores Neuroendocrinos/patología
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