RESUMEN
BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) can change management in a large fraction of patients with biochemically recurrent prostate cancer (BCR). PURPOSE: To investigate the added value of PET to MRI and CT for this patient group, and to explore whether the choice of the PET paired modality (PET/MRI vs. PET/CT) impacts detection rates and clinical management. STUDY TYPE: Retrospective. SUBJECTS: 41 patients with BCR (median age [range]: 68 [55-78]). FIELD STRENGTH/SEQUENCE: 3T, including T1-weighted gradient echo (GRE), T2-weighted turbo spin echo (TSE) and dynamic contrast-enhanced GRE sequences, diffusion-weighted echo-planar imaging, and a T1-weighted TSE spine sequence. In addition to MRI, [18F]PSMA-1007 PET and low-dose CT were acquired on the same day. ASSESSMENT: Images were reported using a five-point Likert scale by two teams each consisting of a radiologist and a nuclear medicine physician. The radiologist performed a reading using CT and MRI data and a joint reading between radiologist and nuclear medicine physician was performed using MRI, CT, and PET from either PET/MRI or PET/CT. Findings were presented to an oncologist to create intended treatment plans. Intrareader and interreader agreement analysis was performed. STATISTICAL TESTS: McNemar test, Cohen's κ, and intraclass correlation coefficients. A P-value <0.05 was considered significant. RESULTS: 7 patients had positive findings on MRI and CT, 22 patients on joint reading with PET/CT, and 18 patients joint reading with PET/MRI. For overall positivity, interreader agreement was poor for MR and CT (κ = 0.36) and almost perfect with addition of PET (PET/CT κ = 0.85, PET/MRI κ = 0.85). The addition of PET from PET/CT and PET/MRI changed intended treatment in 20 and 18 patients, respectively. Between joint readings, intended treatment was different for eight patients. DATA CONCLUSION: The addition of [18F]PSMA-1007 PET/MRI or PET/CT to MRI and CT may increase detection rates, could reduce interreader variability, and may change intended treatment in half of patients with BCR. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 3.
RESUMEN
Radical formation in single crystals of L-asparagine monohydrate following X-irradiation at 6 K has been investigated at 6 K and at elevated temperatures using various electron magnetic resonance (EMR) techniques such as electron paramagnetic resonance (EPR), electron nuclear double resonance (ENDOR), and ENDOR-induced EPR (EIE) spectroscopy. Molecular structures of the three free radicals stable at 6 K were assessed by detailed analysis of the experimental data and density functional theory (DFT) calculations in a periodic approach. Radical LI is assumed to result from one-electron reduction at the amide functional group in the asparagine side chain followed by protonation at the amide carbonyl oxygen by proton transfer from a neighboring molecule across a hydrogen bond. Radical LII is assigned to a one-electron reduction of the carboxyl group in the amino acid backbone, followed by proton transfer across a hydrogen bond between a carboxylic oxygen and a neighboring asparagine molecule. Radical LIII is suggested to be formed by a net CO2 abstraction from an initial one-electron oxidized amino acid backbone. For the DFT modeling of LIII at 6 K, it was chosen to include the CO2 group stably embedded in the crystalline lattice. The assignments made are discussed in relation to previous work on L-asparagine. The relevance of these results to possible charge transfer processes in protein:DNA complexes is discussed.