Feasibility of whole-body 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography angiography using continuous bed motion in patients with vascular disease: a pilot study.

OBJECTIVE: Positron emission tomography (PET) angiography is a promising PET imaging method for vessel evaluation. With advances in PET technologies, PET angiography of the whole body is now possible using continuous bed motion (CBM) mode. This study aimed to evaluate the image quality for depicting the aorta and main branches and the diagnostic performance of whole-body PET angiography in patients with vascular disease. METHODS: We retrospectively identified 12 consecutive patients who underwent whole-body 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) PET angiography in CBM mode. Whole-body PET angiography was performed between 20 and 45 s after administering [18F]FDG using CBM from the neck to the pelvis. The visibility of whole-body PET angiography was assessed for the 24 segments in three regions per patient using a 4-point grading scale (1, unacceptable; 2, poor; 3, good; 4, excellent), and grades 3 and 4 were considered diagnostic. The diagnostic accuracy of whole-body PET angiography for detecting vascular abnormalities was calculated using contrast-enhanced CT as a reference standard. RESULTS: We evaluated 285 segments from 12 patients, and overall, 170/285 segments (60%) were considered diagnostic throughout the whole body, including 96/117 (82%), 22/72 (31%), and 52/96 (54%) segments in the neck-to-chest region, abdominal region, and pelvic region, respectively. The sensitivity, specificity, and accuracy of whole-body PET angiography for detecting vascular abnormalities were 75.9%, 98.8%, and 96.5%, respectively. CONCLUSIONS: Whole-body PET angiography showed a better image quality for the neck-to-chest and pelvic regions in this setting, although it provided limited information on the vessels in the abdominal region.

Effects of cleaning sports mouthguards with ethylene-vinyl acetate on oral bacteria.

Background: Sports mouthguards, worn in the oral cavity to prevent sports injuries, are constantly exposed to various microorganisms that cause oral infections. Hence, the optimal cleaning methods for sports mouthguards have been thoroughly examined. In this study, we evaluated the efficiency of cleaning effects with a mouthguard cleaner (MC) on microbial biofilm formation in sports mouthguards in vitro and in vivo. Methods: We evaluated the cleaning effects of the discs produced by ethylene-vinyl acetate (EVA) on bacterial biofilms formed by the commensal bacterium Streptococcus oralis, the cariogenic bacterium Streptococcus mutans, and the opportunistic pathogen Staphylococcus aureus in vitro. EVA discs with biofilm were subjected to sterile distilled water (CTRL) and ultrasonic washing (UW), followed by treatment with MC and sodium hypochlorite (NaClO) as positive controls. Thereafter, the viable bacterial cell counts were determined. The bacteria adhering to the sheets before and after the treatment were observed under an electron microscope. The degree of cleanliness and measurement of viable microbial cell counts for total bacteria, Streptococci and Candida, opportunistic fungi, were evaluated on the used experimental sports mouthguards with and without UW and MC treatment in vivo. Results: The number of bacterial cells significantly decreased against all the tested biofilm bacteria upon treatment with MC, compared with CTRL and UW. Electron microscopy analysis revealed the biofilm formation by all bacteria on the EVA discs before cleaning. We observed fewer bacteria on the EVA discs treated with MC than those treated with CTRL and UW. Furthermore, the degree of cleanliness of the used experimental sports mouthguards cleaned using MC was significantly higher than that of the CTRL-treated mouthguards. Moreover, the viable microbial cell counts on the used experimental sports mouthguard were considerably lower than those on the CTRL ones. Conclusion: The cleaning effect of MC against oral bacteria was more effective than that of UW. MC treatment might have a potential future application as a cleaning method for sports mouthguards to protect athletes from oral infection.

Evaluating the effect of high-density measurement mode on patient-specific quality assurance for head and neck cancer with ArcCHECK.

The high-density measurement (HDm) mode of the ArcCHECK device can achieve a twofold resolution enhancement compared to the standard measurement (Sm) mode. The aim of this study was to evaluate the effect of HDm on the gamma passing rate (GPR) for the patient-specific quality assurance (PSQA) in head and neck cancer. We retrospectively evaluated 30 patients who underwent volumetric modulated arc therapy (VMAT) for head and neck cancer. Absolute gamma analysis was performed on Sm and HDm data. We also investigated correlations between the modulation complexity score for VMAT (MCSv) and differences in the GPR between the two measurement modes. The global GPR of Sm and HDm was 81.0% ± 8.4% and 82.6% ± 7.6% for the 2%/2 mm criterion, 94.0% ± 4.1% and 94.9% ± 3.6% for the 3%/2 mm criterion, and 96.6% ± 2.4% and 97.0% ± 2.4% for the 3%/3 mm criterion, respectively. HDm slightly improved GPR (p < 0.01) for the 2%/2 mm criterion. Differences in GPR between Sm and HDm for the 2%/2 mm, 3%/2 mm, and 3%/3 mm criteria were 1.6% ± 3.0%, 0.8% ± 2.0%, and 0.4% ± 1.2%, respectively. No correlation was identified between the MCSv and the difference in GPR between Sm and HDm. Despite an improvement in GPR with HDm, the difference in GPR between Sm and HDm was approximately 2% even when the tighter criteria were used. Moreover, the change in the GPR between Sm and HDm did not depend on plan complexity. Thus, the effect of HDm on GPR is limited for the PSQA in VMAT for head and neck cancer.

Distinguishing between primary central nervous system lymphoma and glioblastoma using [18F]fluoromisonidazole and [18F]FDG PET.

OBJECTIVE: The purpose of this study was to assess the diagnostic value of [18F]fluoromisonidazole (FMISO) and 2-deoxy-2-[18F]fluoro-D-glucose (FDG) PET to discriminate primary central nervous system lymphoma (PCNSL) from glioblastoma. METHODS: FMISO and FDG PET/CT scans before therapy obtained in 13 patients with PCNSL and in 62 patients with glioblastoma were retrospectively reviewed. PET results were evaluated by visual and semiquantitative analysis. For semiquantitative analysis, the maximum standardized uptake value (SUV) for tumor (T) and the mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. The performance in discriminating PCNSL and glioblastoma was evaluated using a receiver-operating characteristics analysis. Area-under-the-curve (AUC) values for the discrimination were calculated. RESULTS: On visual analysis, 54% of PCNSL and 89% of glioblastoma showed positive on FMISO PET. All patients with PCNSL and glioblastoma were FDG positive. FMISO T/N ratio in PCNSL (mean ± SD = 1.80 ± 0.59) was significantly lower than that in glioblastoma (mean ± SD = 2.75 ± 0.84) (P < 0.001). FDG T/N ratio in PCNSL (mean ± SD = 3.01 ± 1.11) was significantly higher than that in glioblastoma (mean ± SD = 1.77 ± 0.79) (P < 0.001). For discrimination of patients with PCNSL from glioblastoma, the AUC values for the FMISO T/N ratio, FDG T/N ratio and combination of the two parameters were 0.833, 0.825 and 0.900, respectively. CONCLUSION: FMISO PET is as helpful for differentiating PCNSL from glioblastoma as FDG PET.

[Investigation of the Administration Accuracy of an Auto Infusion Device in 18F-FDG PET].

PURPOSE: The administration accuracy of the automated infusion device for the positron emission radiopharmaceutical affects to calculation of the standardized uptake value (SUV) in 18F-fluorodeoxyglucose (18F-FDG) PET examination. The purpose of this study was to investigate the administration error in the clinical use of an automated infusion device for quantitative management in PET examination. METHODS: We assumed clinical use of the automated infusion device and investigated two types of administration errors. First, for investigating the administration error over time in a day (errorday), a total of 13 infusion works were performed every 30 minutes. Second, for investigating the long period administration error (errorperiod), the infusion work was performed once before clinical use of an automated infusion device. The dispensed radioactivity was set to 150 MBq. The administration error was calculated using output values from the automated infusion device and measured values from the dose calibrator. RESULTS: The administration errorday was 0.9±1.3%, and the maximum error was 2.7%. The administration errorperiod was 1.1±2.0%, and the maximum error was 5.9%. CONCLUSION: We investigated the administration error of the automated infusion device. We confirmed the approximately 1% administration error and high-accuracy injection in an automated-device method.

Effect of quantitative values on shortened acquisition duration in brain tumor 11C-methionine PET/CT.

BACKGROUND: The amount of signal decreases when the acquisition duration is shortened. However, it is not clear how this affects the quantitative values. This study aims to clarify the effect of acquisition time shortening in brain tumor PET/CT using 11C-methionine on the quantitative values. METHOD: This study was a retrospective analysis of 30 patients who underwent clinical 11C-methionine PET/CT examination. PET images were acquired in list mode for 10 min. PET images of acquisition duration from 1 to 10 min with 1-min step were reconstructed. We examined the effect on the quantitative values of acquisition duration. We placed a volume of interest to include the entire tumor and regions of interest in the shape of a large crescent in the contralateral hemisphere in 5 contiguous axial slices as normal tissue. Quantitative values examined were maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, SUVmean), metabolic tumor volume (MTV), and maximum tumor to normal tissue ratio (TNRmax), with each duration compared to that with 10 min. RESULTS: SUVmax, MTV, and TNRmax showed the highest values due to the effects of statistical noise when the acquisition time was 1 min. These values were stable when the acquisition duration was > 6 min. SUVpeak and SUVmean showed mostly consistent values regardless of duration. CONCLUSIONS: SUVmax, MTV, and TNRmax are affected by acquisition time. If the acquisition duration was > 6 min, the fluctuation could be suppressed within 5% in these quantitative values. However, SUVpeak was suggested to be a robust index regardless of the acquisition duration.

Impact of rotational errors of whole pelvis on the dose of prostate-based image-guided radiotherapy to pelvic lymph nodes and small bowel in high-risk prostate cancer.

BACKGROUND: The target volume increases when the prostate and pelvic lymph nodes (PLNs) are combined, and the fiducial markers (FMs) are placed at the edge of the irradiation field. Thus, the position of FMs may be changed by the rotational errors (REs) of "whole pelvis". The aim of this study was to examine the impact of REs of "whole pelvis" on the dose of FMs-based image-guided radiotherapy to the PLNs and the small bowel in prostate cancer including the PLNs. MATERIALS AND METHODS: We retrospectively evaluated 10 patients who underwent prostate cancer radiotherapy involving the PLNs. The position of FMs was calculated from the radiographs obtained before and after the 6D correction of pelvic REs. We simulated the delivery dose considering the daily pelvic REs and calculated the difference from the planned dose in the D98% of the PLN clinical target volume and the D2cc, and V45Gy of the small bowel. RESULT: The position of FMs strongly correlated with the pelvic REs in the pitch direction (r = 0.7788). However, the mean delivered doses to PLNs for 10 patients were not significantly different from the planned doses (p = 0.625). Although the D2cc and V45Gy of the small bowel strongly correlated with the pitch rotation of the pelvis, there was no significant difference between the delivered and planned doses (p = 0.922 and p = 0.232, respectively). CONCLUSION: The dosimetric effect of pelvic REs on the dose to PLNs and the small bowel was negligible during the treatment course.

Accuracy of target delineation by positron emission tomography-based auto-segmentation methods after deformable image registration: A phantom study.

PURPOSE: Diagnostic positron emission tomography and computed tomography (PET/CT) images can be fused to the planning CT images by a deformable image registration (DIR). The aim of this study was to evaluate the standardized uptake value (SUV) and target delineation on deformed PET images. METHODS: We used a cylindrical phantom and removable inserts of four spheres (16-38 mm in diameter) and three ellipsoids with a volume equal to the 38-mm-diameter sphere (S38) in each. S38 was filled with 18F-fluorodeoxyglucose activity, and then PET/CT images were acquired. The contours of S38 were generated using original PET images by PET auto-segmentation (PET-AS) methods of (1) SUV2.5, (2) 40% of maximum SUV (SUV40%max), and (3) gradient-based (GB), and were deformed to the other inserts by DIR. We compared the volumes and the SUVmax with the generated contours using the deformed PET images. RESULTS: The SUVmax was slightly decreased by DIR; the mean absolute difference was -0.10 ± 0.04. For SUV2.5 and SUV40%max, the differences in S38 volumes between the original and deformed PET images were less than 5%, regardless of deformation type. For the GB, the contoured volumes obtained from deformed PET images were larger than those of the original PET images for the deformation type of ellipsoids. When the S38 was deformed to the 16-mm-diameter sphere, the maximum volume difference was -22.8%. CONCLUSIONS: Although SUV fluctuations by DIR were negligible, the target delineation on deformed PET images by the GB should be carefully considered owing to the distortion of intensity profiles.

A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

Most anesthetics have an immuno-suppressive effect on cellular and neurohumoral immunity, and research shows that total intravenous anesthesia (TIVA) with propofol has a greater immuno-protective effect than inhalational anesthesia in human medicine. However, in veterinary clinics, these effects remain ambiguous. To clarify the details, we focused on propofol and isoflurane, investigating clinical blood hematology and immunological profiles drawn from healthy dogs under and after two anesthesia techniques. Twelve healthy adult beagles were included in this study, randomly assigned to the propofol anesthesia group (group P: n=6) or the isoflurane anesthesia group (group I: n=6). In both groups, the number of lymphocytes in peripheral blood decreased after 2 hr of anesthesia (2 hr), but group P showed significantly less decrease than group I. For T-lymphocyte subsets examined by flowcytometry, the ratio of CD3+, CD4+ and CD8+ lymphocytes in the peripheral blood mononuclear cell (PBMC) of group P at 2 hr also exhibited a high level compared to group I. Moreover, for mRNA expression of cytokines measured by real-time PCR, the IL2 (pro-inflammatory cytokine) of group P showed no decrease like group I. The IL10 (anti-inflammatory cytokine) of group P also showed no increase like group I, while both cytokines maintained nearly the same level until 2 hr. These results suggest that, compared to propofol, isoflurane had more strongly immuno-suppression caused by anesthesia, and propofol itself might have some immuno-protective effects. Thus, TIVA with propofol might benefit immunological support in the perioperative period of dogs.

Superoxide dismutase activity as a measure of hepatic oxidative stress in cattle following ethionine administration.

The goal of this study was to assess if oxidative stress, as measured by alterations in the concentrations of antioxidant enzymes in the liver and erythrocytes of cattle, could be induced following dl-ethionine administration. Whole blood, serum and liver biopsy samples were collected 0, 4, 7 and 10 days after intra-peritoneal ethionine administration to five cows. The activities of the antioxidant enzymes copper zinc superoxide dismutase (Cu, Zn SOD) and catalase were assessed in the liver biopsies which were also examined histopathologically. Significant increases in hepatic Cu, Zn SOD concentrations (P<0.01) were noted on days 7 and 10 post-treatment. Hepatic catalase activity decreased significantly (P<0.01) on days 4, 7 and 10 post-treatment and erythrocyte Cu, Zn SOD activity was significantly increased on day 10. Serum biochemical analysis revealed a significant increase (P<0.01) in non-esterified fatty acid concentrations on day 4 and significant decreases in total cholesterol and phospholipid levels on days 4 (P<0.05), 7 (P<0.01) and 10 (P<0.01). In this model system, dl-ethionine administration was effective in inducing oxidative stress particularly reflected in the liver.

Total glutathione and glutathione reductase in bovine erythrocytes and liver biopsy.

The goal of the present study was to measure the total glutathione level and glutathione reductase activity in bovine erythrocytes and liver biopsy. Five cows were injected intraperitoneally with DL-ethionine (12.5 mg/kg B.W.), and two control cows were injected with normal saline (0.9% NaCl). Ultrasonography guided liver biopsy, and blood samples were collected at 0, 4, 7 and 10 days after injection. The hepatic total glutathione level was significantly increased on Days 7 (p<0.05) and 10 (p<0.01), and hepatic glutathione reductase activity was significantly increased on Days 4 (p<0.05), 7 (p<0.01) and 10 (p<0.01). There were insignificant changes in the erythrocytic total glutathione level. The present study demonstrated that liver biopsy is a valuable tool for detecting oxidative stress and for diagnosing hepatic dysfunction in cattle from the viewpoint of the status of glutathione and glutathione reductase.

Inclusion complex formation between alpha-cyclodextrin and biodegradable aliphatic polyesters.

Inclusion complexes (ICs) between alpha-cyclodextrin (alpha-CD) and three kinds of biodegradable aliphatic polyesters with different sequence lengths of the monomeric repeating units poly(3-hydroxypropionate) [P(3HP)], poly(4-hydroxybutyrate) [P(4HB)] and poly(epsilon-caprolactone)(PCL) were prepared by mixing a solution of alpha-CD with that of the polymer, followed by stirring. The ICs were obtained as insoluble precipitates and characterized by FT-IR, WAXD and DSC. All measurements showed that the polymer chains of all three kinds of polyester were included into the alpha-CD cavity and formed ICs with different stoichiometries. WAXD patterns and thermal analysis indicated that these ICs possessed a channel structure and the crystallization of the polyester chains was suppressed upon inclusion into the alpha-CD cavity.

Immunohistochemical detection of P-glycoprotein (PGP) and multidrug resistance-associated protein (MRP) in canine cutaneous mast cell tumors.

Fifty-four canine cutaneous mast cell tumors were evaluated immunohistochemically for the expression of P-glycoprotein (PGP) and multidrug-resistance-associated protein (MRP). All tumors examined were graded according to the histological malignancy. ranging from grade I to III. The expression of PGP was confirmed in 15% (8/54) of whole, 33% (5/15) of grade I, 10% (3/31) of grade II, and 0% (0/8) of grade III tumors. The expression of MRP was found in 18% (10/54) of whole, 26% (4/15) of grade I, 19% (6/31) of grade II, and 0% (0/8) of grade III tumors. The cases positive to at least one of these 2 multidrug markers were 26%, 47%, 23% and 0% of whole and grade I to III tumors, respectively. These results indicate that at least 26% of canine cutaneous mast cell tumors express PGP and/or MRP and that these tumors may be resistant to several anti-cancer drugs.

Novel quinazoline ring synthesis by cycloaddition of N-arylketenimines with N,N-disubstituted cyanamides.

The reaction of N-aryl-substituted ketenimines with N,N-disubstituted cyanamides or (MeS)2C=N-CN under high pressure afforded 4-(N,N-disubstituted amino) or 4-(MeS)2C=N-substituted quinazoline derivatives, respectively. These products were formed by [4+2] cycloaddition between the aza-diene moieties of the N-arylsubstituted ketenimines and cyano groups. A 4-(unsubstituted amino)quinazoline derivative was synthesized by hydrolysis of the latter product.