Intra-arterial PRRT with Lu-177 DOTATATE in Liver-dominant Metastatic Neuroendocrine Tumors: Early Assessment of Efficacy and Toxicity.

Purpose: We proposed to administer Lu-177-DOTATATE in intra-arterial (IA) mode for higher first-pass localization to somatostatin receptors, higher residence time in liver metastases, and more radiation to tumor. This study aimed at assessing early hematological, renal and hepatotoxicity; and objective response to IA peptide receptor radionuclide therapy (PRRT). Materials and Methods: Fourteen patients (4 females and 10 males) were prospectively assessed. 5/14 patients underwent 2 cycles, whereas 3/14 underwent 3 cycles, and 6/14 received 1 cycle of IA PRRT. 200 mCi of Lu-177-DOTATATE was administered in 15-20 min by IA route under angiographic guidance. Patients were asked to follow-up at 4 and 8 weeks with hematological, liver, and renal functional parameters, and Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT) after 8 weeks. Response was assessed using RECIST 1.1 and EORTC PET criteria. Results: Safety: 2/14 patients had high total and direct bilirubin, which reverted to normal after IA PRRT. Three patients had low albumin, which improved after 1 cycle. Nine patients showed no worsening of liver function. Two patients showed Grade 1 hematotoxicity which reverted to normal. Five patients showed high creatinine, but preserved glomerular filtration rate and EC clearance. On follow-up at 8 weeks, serum creatinine reverted to normal. Efficacy: In five patients who underwent 2 cycles of IA PRRT, 3 showed partial response (PR) on RECIST 1.1 and partial metabolic response (PMR) on EORTC criteria, whereas 2 showed stable disease (SD). In patients who underwent 3 cycles, 1 showed SD, whereas other patient showed PMR on DOTANOC PET/CT, with PR in size. Among the remaining seven patients, 5 showed PMR, whereas the other 2 showed SD. Thus 9/14 patients showed PR, whereas 5 showed SD on metabolic and size criteria. Conclusions: IA PRRT is a safe and efficacious approach for the treatment of liver dominant metastatic neuroendocrine tumors.

Edible coatings and films for shelf-life extension of fruit and vegetables.

The execution of the edible coatings and films for food preservation; vegetables, fruits, meat, and dry fruits has been ladened in history. The study of literature portrays enough pieces of evidence dating back from centuries of coatings or films being utilized for the conservation of numerous fruits and vegetables to stretch their average shelf-life. The mechanism that remains operative in extending the shelf-life of fruits and vegetables beyond the normal shelf-life is the controlled entry and exit of moisture and gases. The non- biodegradable packaging which is also non-sustainable can be substituted with compostable and edible coatings and films made up of natural biopolymers. Therefore, keeping in mind the environment and consumer safety, a score of research has been going on from former decades for the development of edible coatings and films with efficient shelf life-extending qualities. The films composed of proteins exhibit a good mechanical strength while the polysaccharide composed films and coatings show efficient gas blocking qualities, however, both lack moisture shielding attributes. These shortcomings can be fixed by combining them with lipids and or some appropriate hydrocolloids. The edible coatings and films have been integrated with various food products; however, they haven't been completely successful in substitution of the total fraction of their non-edible counterparts. The implementation of edible coatings and films have shown to serve an immense value in extending the shelf-life of fruits and vegetables along with being a sustainable and eco-friendly approach for food packaging.

Metabolic tumor parameters complement clinicopathological factors in prognosticating advanced stage Hodgkin Lymphoma.

Objectives: Advanced Hodgkin Lymphoma has a higher probability of relapse and recurrence. Classical clinicopathological parameters including the International Prognostic Score (IPS) have not been reliable in predicting prognosis or tailoring treatment. Since FDG PET/CT is the standard of care in staging Hodgkin Lymphoma, this study attempted to evaluate the clinical utility of baseline metabolic tumor parameters in a cohort of advanced Hodgkin lymphoma (stage III and IV). Methods: Histology-proven advanced Hodgkin Patients presenting to our institute between 2012-2016 and treated with chemo-radiotherapy (ABVD / AEVD) were followed up till 2019. Quantitative PET/CT and clinicopathological parameters were used to estimate the Event Free Survival (EFS) in 100 patients. Kaplan-Meier method with log-rank test was used to compare the survival times of prognostic factors. Results: At a median follow-up of 48.83 months (IQR:33.31-63.05 months), the five-year-EFS was 81%. Of the 100 patients, 16 had relapsed (16%) and none died at the last follow-up. On Univariate analysis, among non-PET parameters bulky disease (P=0.03) and B-symptoms (P=0.04) were significant while among PET/CT parameters SUVmax (p=0.001), SUVmean (P=0.002), WBMTV2.5 (P<0.001), WBMTV41% (P<0.001), WBTLG2.5 (P<0.001) and WBTLG41% (P <0.001) predicted poorer EFS. 5-year EFS for patients with low WBMTV2.5 [<1038.3 cm3] was 89% and 35% for patients with high WBMTV2.5 [≥1038.3 cm3] (p <0.001). In a multivariate model, only WBMTV2.5 (P=0.03) independently predicted poorer EFS. Conclusion: PET-based metabolic parameter (WBMTV2.5) was able to prognosticate and complement the classical clinical prognostic factors in advanced Hodgkin Lymphoma. This parameter could have a surrogate value for prognosticating advanced Hodgkin lymphoma. Better prognostication at baseline translates to tailored or risk-modified treatment and hence higher survival.

Investigation of the Internal Structure of Hardened 3D-Printed Concrete by X-CT Scanning and Its Influence on the Mechanical Performance.

As we know, 3DPC is printed layer by layer compared with mold-casting conventional concrete. Pore structure and layer-to-layer interface are two main aspects of the internal structure for 3DPC, which decide 3DPC's mechanical performance. The layer-to-layer interface caused by printing is specific to 3DPC. The emphasis of this study lies in the layer-to-layer interfaces of 3DPC. The first aim of this study is to quantify the characteristics of the layer-to-layer interface and therefore characterize different aspects of the interfaces. The second aim of this study is to explore how the internal structure of printed concrete influences the mechanical performance of 3DPC. This research set out to design a series of experimental comparisons between 3DPC and casted concrete with the same compositions. Mechanical tests, i.e., compressive stress, ultrasonic Pulse Velocity test, flexural tension, and tension splitting, as well as the Ultrasonic Pulse Velocity test, were performed to check the mechanical performance of 3DPC. Contrary to what has often been expected, the mechanical test results showed the printed concrete has a quality not worse than casted concrete with the same recipe. Meanwhile, the X-ray computed tomography (X-CT) is used to characterize the internal structure, pore shapes, and interfaces of 3DPC. First, the investigation revealed that the lower total porosity and fewer big voids could be the fundamental causes meaning 3DPC has a better mechanical performance than casted concrete. Second, the statistics based on aspect ratio show that the distribution curves follow similar trends, regardless of the printed or casted concrete. Third, this study quantified the depth of the different interfaces for 3DPC. The results suggest that the porosity in an interface varies in a range. The author's pioneer work has contributed to our present understanding of the interfaces of 3DPC.

Rare Case of Neuroendocrine Tumor of Common Bile Duct Identified With Somatostatin Receptor But Not With Glucose Transporter Imaging.

ABSTRACT: Neuroendocrine tumors (NETs) are heterogeneous group of tumors arising from enterochromaffin cells. Neuroendocrine tumors are most commonly found in bowel and pancreatic tissue. Because of paucity of enterochromaffin cells in biliary tract, NETs of bile duct are very rare. Most of the neoplasms in the extrahepatic bile duct are adenocarcinomas; only 0.2% to 0.3% of NETs arise from the bile duct. Cases reported in the literature of biliary carcinoid are diagnosed postoperatively on histopathologic evaluation. We hereby demonstrate a rare presentation of CBD NET identified preoperatively on somatostatin receptor but not on glucose transporter imaging, confirmed by histopathology and immunohistochemistry to be grade 2 NET (Ki-67, 20%).

Congenital Melanocytic Nevi Syndrome With Leptomeningeal Melanoma.

ABSTRACT: The incidence of congenital melanocytic nevi (CMNs) is 1% to 6% for small- to intermediate-size nevi to 1 in 500,000 for giant size nevi. Large and satellite CMNs are known to be associated with neurocutaneous melanosis and central nervous system malformations such as Dandy-Walker malformation, defects of the vertebra-skull, and intraspinal lipomas. We hereby present a case of CMN syndrome in an 18-year-old girl with leptomeningeal melanoma, evaluated with MRI, adequately staged, and screened with FDG PET.

Prognostic value of imaging-based parameters in patients with intermediate-stage hepatocellular carcinoma undergoing transarterial radioembolization.

OBJECTIVE: Patients with inoperable multilobar hepatocellular carcinoma (HCC) Barcelona Clinic Liver Cancer (BCLC) stage B, who have failed other liver-directed treatment options, are ideal candidates for transarterial radioembolization (TARE) with Yttrium-90 (Y-90)-labeled glass spheres. There is limited data regarding variables that impact the prognosis and outcome in these patients. 99mTc-MAA scan for lung shunt fraction (LSF) and 18F-FDG PET/CT are performed during initial workup. We, therefore, decided to assess the prognostic impact of LSF and metabolic parameters, such as maximum SUVmax, MTV and TLG in patients undergoing TARE for HCC. METHODS: We retrospectively analyzed 64 patients of HCC, between January 2010 and December 2016, deemed suitable for TARE. Pre-TARE LSF was computed on 99mTc MAA scan, and SUVmax, MTV and TLG on fluoro-deoxyglucose positron emission tomography/computed tomography were measured using automated software by 3D region of interest. LSF and PET parameters were stratified using optimal cut-offs derived from receiver operating curve analysis. Survival curves for the groups were estimated using the Kaplan-Meier method and were compared using log-rank test. RESULTS: Overall survival (OS) was 15 months. In univariate analysis, high LSF (greater than 7.19), MTV and TLG were statistically significant and were associated with poor OS. In multivariate analysis, TLG (P value 0.044), MTV (P value 0.290) and LSF (P value 0.010) were independent predictors of outcome, after adjustment for significant univariate variables. However, SUVmax was not statistically significant for OS. CONCLUSIONS: LSF, MTV and TLG are significant independent prognostic indicators of outcome in patients undergoing TARE for HCC.

Application of Glass Transition in Food Processing.

The phenomenon of glass transition has been employed to food products to study their stability. It can be applied as an integrated approach along with water activity and physical and chemical changes in food in processing and storage to determine the food stability. Also associated with the changes during agglomeration crystallization, caking, sticking, collapse, oxidation reactions, nonenzymatic browning, and microbial stability of food system. Various techniques such as Differential Scanning Calorimetry, Nuclear Magnetic Resonance, etc. have been developed to determine the glass transition temperature (Tg) of food system. Also, various theories have been applied to explain the concept of Tg and its relation to changes in food system. This review summarizes the understanding of concept of glass transition, its measurement, and application in food technology.