Artificial intelligence in Nuclear Medicine Physics and Imaging.

No one can deny the significant impact of artificial intelligence (AI) on everyday life, especially in the health sector where it has emerged as a crucial and beneficial tool in Nuclear Medicine (NM) and molecular imaging. The objective of this review is to provide a summary of the various applications of AI in single-photon emission computed tomography (SPECT) and positron emission tomography (PET), with or without anatomical information (CT or magnetic resonance imaging (MRI)). This review analyzes subsets of AI, such as machine learning (ML) and Deep Learning (DL), and elaborates on their applications in NM imaging (NMI) physics, including the generation of attenuation maps, estimation of scattered events, depth of interaction (DOI), time of flight (TOF), NM image reconstruction (optimization of the reconstruction algorithm), and low dose imaging.

Predictors of Cyberbystander Intervention Among Adolescents.

The purpose of the current study was to examine the association between personal characteristics and the steps of the bystander intervention model (i.e., notice, interpret as emergency, accept responsibility, know how to intervene, and act) applied to cyberbullying. Examining bystander intervention as discrete steps instead of the single act has advantages for training individuals to intervene when they observe these acts of interpersonal violence. The five-step bystander intervention model has been applied to examine bystander intervention in traditional bullying, sexual assault, and drinking behavior, but not cyberbullying. In this study, we examine how specific personal characteristics (social support, social-emotional wellness, cognitive empathy, and affective empathy) are related to each step of the model. Data on students' perceptions of these characteristics and their engagement in the five-step model were collected from 872 sixth-grade through twelfth-grade students ages 11 to 18 in the southeastern area of the United States. Using multi-group path analysis, associations between the characteristics and steps were examined for boys and girls separately. Results indicated that social support was significantly associated with step 2 (interpreting as an emergency), step 4 (know how to intervene), and step 5 (acting). Affective empathy was significantly associated with the first four steps of the model. Social-emotional wellness was only significantly associated with step 1 and cognitive empathy was not significantly associated with any of the steps. These results suggest that it may be important to emphasize positive relationships, affective empathy, and social support for interventions primarily directed at reducing cyberbullying. Training adolescents to intervene in cyberbullying and also to increase these characteristics is important to consider.

Second line trastuzumab emtansine following horizontal dual blockade in a real-life setting.

Despite relevant medical advancements, metastatic breast cancer remains an uncurable disease. HER2 signaling conditions tumor behavior and treatment strategies of HER2 expressing breast cancer. Cancer treatment guidelines uniformly identify dual blockade with pertuzumab and trastuzumab plus a taxane as best first line and trastuzumab emtansine as preferred second line choice. However, there is no prospectively designed available study focusing on the sequence and outcomes of patients treated with T-DM1 following the triplet. In the following report, data concerning a wide series of patients treated in a real-life setting are presented. Results obtained in terms of response and median progression free survival suggests a significant role for T-DM1 in disease control of metastatic HER2 expressing breast cancer.

Clinical and pathological factors predictive of response to neoadjuvant chemotherapy in breast cancer: A single center experience.

Neoadjuvant chemotherapy (NAC) of breast cancer (BC) improves outcomes, especially in patients with locally advanced and inflammatory cancer. Further insight into clinic-pathological factors influencing outcomes is essential to define the optimal therapeutic strategy for each category of patients and to predict the response to the treatment. In total, 117 patients with BC were treated with NAC with or without trastuzumab between 2010 and 2015. The histologic response to NAC was defined as a pathological complete response (pCR) when there was no evidence of residual invasive tumor in the breast or axillary lymph nodes. Relapse-free survival (RFS) was estimated using the Kaplan-Meier method and compared using log rank analysis. P-value <0.05 was considered statistically significant. The median age of the 117 patients enrolled in the present study was 52 years (age range, 35-85 years). The overall response rate (complete and partial responses) assessed by radiological and pathological evaluation were 76 and 72%, respectively. pCR was achieved in 35 out of 117 patients (~30%). In total, 6 patients (5%) developed progressive disease during chemotherapy. The RFS was 85 months (SE=3; 95% CI 79-91). The median was not reached and the mean follow-up time was 55 months (median 52 months; range 11-100 months). In this time, 20 patients (17%) experienced tumor recurrence. From the univariate analysis, the pathological response was significantly associated with receptor-based subtype, menopausal status and T-stage. From the multivariate analysis by using linear multiple regression and including receptor- menopausal status and T-stage, the model was not significant (P=0.062). However, by using the multiple logistic regression, and including age, pCR was significantly associated with ER+ HER2neg (P=0.006), T2 (P=0.043) and T3 (P=0.018). T-stage, menopausal status and receptor status are significantly associated with the pathological response in patients with inoperable BC treated with NAC.

Acceptability of the Transitional Wearable Companion "+me" in Typical Children: A Pilot Study.

This work presents the results of the first experimentation of +me-the first prototype of Transitional Wearable Companion-run on 15 typically developed (TD) children with ages between 8 and 34 months. +me is an interactive device that looks like a teddy bear that can be worn around the neck, has touch sensors, can emit appealing lights and sounds, and has input-output contingencies that can be regulated with a tablet via Bluetooth. The participants were engaged in social play activities involving both the device and an adult experimenter. +me was designed with the objective of exploiting its intrinsic allure as an attractive toy to stimulate social interactions (e.g., eye contact, turn taking, imitation, social smiles), an aspect potentially helpful in the therapy of Autism Spectrum Disorders (ASD) and other Pervasive Developmental Disorders (PDD). The main purpose of this preliminary study is to evaluate the general acceptability of the toy by TD children, observing the elicited behaviors in preparation for future experiments involving children with ASD and other PDD. First observations, based on video recording and scoring, show that +me stimulates good social engagement in TD children, especially when their age is higher than 24 months.

Safety and efficacy evaluation of albumin-bound paclitaxel.

INTRODUCTION: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is a novel solvent-free formulation of paclitaxel, which was developed to avoid toxicities associated with Cremophor EL® vehicle used in solvent-based paclitaxel. It is approved as monotherapy for treatment of metastatic breast cancer (MBC) in Europe and the US; in combination therapy for non-small-cell lung cancer (NSCLC) and for first-line treatment of advanced pancreatic cancer (PC) only in the US. The European Medicines Agency has recently released only a positive opinion for use of nab-paclitaxel in PC. AREAS COVERED: This review reports the clinical findings and the safety data of nab-paclitaxel for MBC, NSCLC and PC. EXPERT OPINION: In MBC, nab-paclitaxel has demonstrated a good safety and an efficacy profile compared with other taxanes, but no strong data on overall survival are available. Considering the role of markers or predictive factors for nab-paclitaxel effectiveness in the metastatic setting would be useful. In PC, nab-paclitaxel and gemcitabine represent a new therapeutic choice with significant improvement in survival. In a Phase III study with NSCLC patients, nab-paclitaxel showed better results in a subgroup of patients with squamous histology, for whom results with conventional therapies are still poor and improved therapeutic options are needed.

Radiation doses in common X-ray examinations carried out in two dedicated paediatric hospitals.

In this study, the entrance surface dose (ESD) and the respective effective dose (E) were determined for paediatric patients undergoing various common radiological examinations in two dedicated paediatric hospitals. Measurements of ESD were carried out in 289 examinations using thermoluminescent dosemeters. The patients were categorised according to their age and the mean ESD and E values were determined for each examination and age category. These ESD values were compared with the existing diagnostic reference levels (DRLs). In both hospitals there were cases where the DRLs were exceeded but in one of them this was rather the general rule, since additionally to the routine use of grid and low tube potential settings, occasional use of fluoroscopy for positioning check was also observed. While the remedial actions required to appropriately reduce the doses were clearly identified, this cannot be achieved without the cooperation of medical physicists with operators and radiologists.