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1.
Nat Commun ; 15(1): 4809, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844444

RESUMO

The direct access of olfactory afferents to memory-related cortical systems has inspired theories about the role of the olfactory pathways in the development of cortical neurodegeneration in Alzheimer's disease (AD). In this study, we used baseline olfactory identification measures with longitudinal flortaucipir and PiB PET, diffusion MRI of 89 cognitively normal older adults (73.82 ± 8.44 years; 56% females), and a transcriptomic data atlas to investigate the spatiotemporal spreading and genetic vulnerabilities of AD-related pathology aggregates in the olfactory system. We find that odor identification deficits are predominantly associated with tau accumulation in key areas of the olfactory pathway, with a particularly strong predictive power for longitudinal tau progression. We observe that tau spreads from the medial temporal lobe structures toward the olfactory system, not the reverse. Moreover, we observed a genetic background of odor perception-related genes that might confer vulnerability to tau accumulation along the olfactory system.


Assuntos
Envelhecimento , Doença de Alzheimer , Percepção Olfatória , Tomografia por Emissão de Pósitrons , Proteínas tau , Humanos , Feminino , Proteínas tau/metabolismo , Proteínas tau/genética , Masculino , Idoso , Percepção Olfatória/fisiologia , Envelhecimento/fisiologia , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Idoso de 80 Anos ou mais , Condutos Olfatórios/metabolismo , Condutos Olfatórios/diagnóstico por imagem , Olfato/fisiologia , Encéfalo/metabolismo , Encéfalo/diagnóstico por imagem , Lobo Temporal/metabolismo , Lobo Temporal/diagnóstico por imagem , Pessoa de Meia-Idade
2.
Head Neck ; 46(7): 1637-1659, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38235957

RESUMO

BACKGROUND: The prevalence of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in post-irradiated patients with nasopharyngeal carcinoma (NPC) is unknown. MATERIALS AND METHODS: In a cross-sectional study, 31 NPC and 12 control patients completed questionnaires for GERD/LPR before esophageal manometry and 24-h pH monitoring. The DeMeester score and reflux finding score (RFS) were used to define GERD and LPR, respectively. Risk factors were identified. RESULTS: 51.6% of NPC and 8.3% of control patients, and 77.4% of NPC and 33% of control patients, were GERD-positive and LPR-positive, respectively. The GERD/LPR questionnaire failed to identify either condition in patients with NPC. No parameter differences in esophageal manometry or pneumonia incidence were noted between GERD/LPR-positive and GERD/LPR-negative patients. Post radiotherapy duration, high BMI, lack of chemotherapy, and dysphagia were positive risk factors for GERD/LPR. CONCLUSIONS: A high prevalence of GERD/LPR in patients with post-irradiated NPC exists, but reflux symptoms are inadequate for diagnosis.


Assuntos
Transtornos de Deglutição , Refluxo Gastroesofágico , Refluxo Laringofaríngeo , Manometria , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Humanos , Masculino , Feminino , Refluxo Laringofaríngeo/epidemiologia , Refluxo Laringofaríngeo/etiologia , Pessoa de Meia-Idade , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/complicações , Estudos Transversais , Prevalência , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/epidemiologia , Adulto , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/complicações , Carcinoma Nasofaríngeo/radioterapia , Carcinoma Nasofaríngeo/complicações , Idoso , Inquéritos e Questionários , Carcinoma/radioterapia , Fatores de Risco , Monitoramento do pH Esofágico , Estudos de Casos e Controles
3.
Nat Rev Chem ; 8(2): 136-151, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38273177

RESUMO

Exciton science sits at the intersection of chemical, optical and spin-based implementations of information processing, but using excitons to conduct logical operations remains relatively unexplored. Excitons encoding information could be read optically (photoexcitation-photoemission) or electrically (charge recombination-separation), travel through materials via exciton energy transfer, and interact with one another in stimuli-responsive molecular excitonic devices. Excitonic logic offers the potential to mediate electrical, optical and chemical information. Additionally, high-spin triplet and quintet (multi)excitons offer access to well defined spin states of relevance to magnetic field effects, classical spintronics and spin-based quantum information science. In this Roadmap, we propose a framework for developing excitonic computing based on singlet fission (SF) and triplet-triplet annihilation (TTA). Various molecular components capable of modulating SF/TTA for logical operations are suggested, including molecular photo-switching and multi-colour photoexcitation. We then outline a pathway for constructing excitonic logic devices, considering aspects of circuit assembly, logical operation synchronization, and exciton transport and amplification. Promising future directions and challenges are identified, and the potential for realizing excitonic computing in the near future is discussed.

4.
Facial Plast Surg Aesthet Med ; 26(1): 15-22, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37256708

RESUMO

Background: An implant (porous polyethylene) is an alternative to rib cartilage for microtia reconstruction but carries a risk of extrusion. Objective: To evaluate the outcome of a hybrid framework of implant with rib cartilage for microtia reconstruction. Methods: Patients who underwent Nagata's technique for microtia reconstruction were reviewed for complications and aesthetic score. In stage 1, a rib cartilage framework or a hybrid framework of implant with rib cartilage was used. In stage 2, the framework was elevated and supported by an implant for projection. Postoperative outcomes were reported for both groups. Results: Forty-four ears of 40 patients underwent surgery. Eleven ears received a rib auricular framework and 33 ears a hybrid auricular framework. The mean postoperative follow-up for the rib and hybrid groups was 76.3 and 43.1 months, respectively. No supporting postauricular implant extruded, whereas stainless-steel wires extruded in seven ears (15.9%). Five (15.2%) hybrid frameworks were removed due to infection or extrusion. Mean operating time was 2 h shorter in the hybrid group. Aesthetic outcomes were similar for both groups. Conclusion: A hybrid framework of rib and implant that requires less harvested cartilage is feasible for microtia reconstruction, but caution should be used due to its higher explantation rate.


Assuntos
Microtia Congênita , Procedimentos de Cirurgia Plástica , Humanos , Microtia Congênita/cirurgia , Polietileno , Porosidade , Cartilagem/transplante , Costelas/cirurgia
5.
Clin Imaging ; 106: 110031, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38128405

RESUMO

Awarded the Radiological Society of North America (RSNA) Gold Medal in 2018, Dr. Deborah Levine's research, journalism, and mentorship have left an indelible mark on the radiology field. Her work in ultrasound led to its use as the standard for monitoring benign adnexal cysts. She helped popularize obstetric magnetic resonance imaging (MRI) through her research on its use in placental accreta and fetal abnormalities, which led to the development of the 'Compendium of Fetal MRI' website. This work in research led naturally to a career in journalism, where she eventually became Senior Deputy Editor of Radiology and founded Radiology Select. Concurrently with her personal achievements, Dr. Levine has dedicated herself to the mentorship of her female trainees. She sought various leadership positions to learn more about and advocate for the promotion and support of female leadership in radiology departments. In many ways, Dr. Levine's career and work have transformed radiology as we know it today for both patients and physicians.


Assuntos
Placenta , Radiologia , Gravidez , Humanos , Feminino , Radiografia , América do Norte , Liberdade
6.
Laryngoscope Investig Otolaryngol ; 8(6): 1532-1546, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38130249

RESUMO

Background: Exercise-based swallowing training (EBST) and transcutaneous neuromuscular electrical stimulation (TNMES) are common modalities used to treat late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). We aimed to investigate and compare the efficacies of EBST and TNMES as proactive treatments administered early after radiotherapy. Methods: Patients with early post-radiotherapy NPC (n = 120) underwent either TNMES or EBST. Flexible endoscopic evaluation of swallowing (FEES), quality of life (QOL), and swallowing function questionnaires were completed before the intervention as well as immediately, 6, and 12 months after the intervention. Outcome measures included the scores for the swallowing function score (SFS), penetration and aspiration scale (PAS), dynamic imaging grade of swallowing toxicity (DIGEST), functional oral intake scale (FOIS), swallowing performance status scale (SPSS), pharyngeal motor impairment (PMI), pharyngeal function impairment (PFI), and functional assessment after cancer therapy-nasopharyngeal (FACT-NP) questionnaire. Results: Three months after radiotherapy, 31 and 34 patients underwent TNMES and EBST, respectively, and completed swallowing assessments at all four assessment timepoints. All patients showed post-radiotherapy impairments in the SFS, PAS, DIGEST, PMI, and PFI. Compared with the EBST group, the TNMES group showed significant improvements in the PFI and PMI scores, with small-to-medium effect sizes. Additionally, compared with the EBST group, the TNMES group demonstrated a trend toward slightly better improvements in the PAS, DIGEST, FOIS, and SPSS scores immediately and 6 months after the intervention. The SFS scores improved from baseline in both groups; however, the TNMES group showed an earlier improvement. Finally, the TNMES group showed better QOL according to the FACT-NP than the EBST group. Conclusion: Proactive TMNES and EBST are safe and feasible modalities for improving swallowing in patients with NPC when administered early after radiotherapy. Although TNMES showed better results than EBST, these results should be interpreted with caution given the study limitations. Level of evidence: 1B.

7.
Radiother Oncol ; 188: 109774, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37394103

RESUMO

PURPOSE: With the increased use of focal radiation dose escalation for primary prostate cancer (PCa), accurate delineation of gross tumor volume (GTV) in prostate-specific membrane antigen PET (PSMA-PET) becomes crucial. Manual approaches are time-consuming and observer dependent. The purpose of this study was to create a deep learning model for the accurate delineation of the intraprostatic GTV in PSMA-PET. METHODS: A 3D U-Net was trained on 128 different 18F-PSMA-1007 PET images from three different institutions. Testing was done on 52 patients including one independent internal cohort (Freiburg: n = 19) and three independent external cohorts (Dresden: n = 14 18F-PSMA-1007, Boston: Massachusetts General Hospital (MGH): n = 9 18F-DCFPyL-PSMA and Dana-Farber Cancer Institute (DFCI): n = 10 68Ga-PSMA-11). Expert contours were generated in consensus using a validated technique. CNN predictions were compared to expert contours using Dice similarity coefficient (DSC). Co-registered whole-mount histology was used for the internal testing cohort to assess sensitivity/specificity. RESULTS: Median DSCs were Freiburg: 0.82 (IQR: 0.73-0.88), Dresden: 0.71 (IQR: 0.53-0.75), MGH: 0.80 (IQR: 0.64-0.83) and DFCI: 0.80 (IQR: 0.67-0.84), respectively. Median sensitivity for CNN and expert contours were 0.88 (IQR: 0.68-0.97) and 0.85 (IQR: 0.75-0.88) (p = 0.40), respectively. GTV volumes did not differ significantly (p > 0.1 for all comparisons). Median specificity of 0.83 (IQR: 0.57-0.97) and 0.88 (IQR: 0.69-0.98) were observed for CNN and expert contours (p = 0.014), respectively. CNN prediction took 3.81 seconds on average per patient. CONCLUSION: The CNN was trained and tested on internal and external datasets as well as histopathology reference, achieving a fast GTV segmentation for three PSMA-PET tracers with high diagnostic accuracy comparable to manual experts.


Assuntos
Aprendizado Profundo , Neoplasias da Próstata , Masculino , Humanos , Carga Tumoral , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/patologia
8.
J Am Chem Soc ; 145(28): 15275-15283, 2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37417583

RESUMO

The quintet triplet-pair state may be generated upon singlet fission and is a critical intermediate that dictates the fate of excitons, which can be exploited for photovoltaics, information technologies, and biomedical imaging. In this report, we demonstrate that continuous-wave and pulsed electron spin resonance techniques such as phase-inverted echo-amplitude detected nutation (PEANUT), which have emerged as the primary tool for identifying the spin pathways in singlet fission, probe fundamentally different triplet-pair species. We directly observe that the generation rate of high-spin triplet pairs is dependent on the molecular orientation with respect to the static magnetic field. Moreover, we demonstrate that this observation can prevent incorrect analysis of continuous-wave electron spin resonance (cw-ESR) measurements and provide insight into the design of materials to target specific pathways that optimize exciton properties for specific applications.

9.
Clin Cancer Res ; 29(17): 3457-3470, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37289199

RESUMO

PURPOSE: Oncogene-driven macropinocytosis fuels nutrient scavenging in some cancer types, yet whether this occurs in thyroid cancers with prominent MAPK-ERK and PI3K pathway mutations remains unclear. We hypothesized that understanding links between thyroid cancer signaling and macropinocytosis might uncover new therapeutic strategies. EXPERIMENTAL DESIGN: Macropinocytosis was assessed across cells derived from papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), non-malignant follicular thyroid, and aggressive anaplastic thyroid cancer (ATC), by imaging fluorescent dextran and serum albumin. The impacts of ectopic BRAFV600E and mutant RAS, genetic PTEN silencing, and inhibitors targeting RET, BRAF, and MEK kinases were quantified. BrafV600E p53-/- ATC tumors in immunocompetent mice were used to measure efficacy of an albumin-drug conjugate comprising microtubule-destabilizing monomethyl auristatin E (MMAE) linked to serum albumin via a cathepsin-cleavable peptide (Alb-vc-MMAE). RESULTS: FTC and ATC cells showed greater macropinocytosis than non-malignant and PTC cells. ATC tumors accumulated albumin at 8.8% injected dose per gram tissue. Alb-vc-MMAE, but not MMAE alone, reduced tumor size by >90% (P < 0.01). ATC macropinocytosis depended on MAPK/ERK activity and nutrient signaling, and increased by up to 230% with metformin, phenformin, or inhibition of IGF1Ri in monoculture but not in vivo. Macrophages also accumulated albumin and express the cognate IGF1R ligand, IGF1, which reduced ATC responsiveness to IGF1Ri. CONCLUSIONS: These findings identify regulated oncogene-driven macropinocytosis in thyroid cancers and demonstrate the potential of designing albumin-bound drugs to efficiently treat them.


Assuntos
Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Camundongos , Animais , Fosfatidilinositol 3-Quinases/genética , Mutação , Proteínas Proto-Oncogênicas B-raf , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/metabolismo , Carcinoma Anaplásico da Tireoide/tratamento farmacológico , Carcinoma Anaplásico da Tireoide/genética , Oncogenes , Câncer Papilífero da Tireoide/genética , Albumina Sérica/genética , Albumina Sérica/uso terapêutico
10.
AJR Am J Roentgenol ; 221(5): 575-581, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37195791

RESUMO

Paid family and medical leave (FML) has significant benefits to organizations, including improvements in employee recruitment and retention, workplace culture, and employee morale and productivity, and is supported by evidence for overall cost savings. Furthermore, paid FML related to childbirth has significant benefits to individuals and families, including but not limited to improved maternal and infant health outcomes and improved breastfeeding initiation and duration. In the case of nonchildbearing parental leave, paid FML is associated with more equitable long-term division of household labor and childcare. Paid FML is increasingly being recognized as an important issue in medicine, as evidenced by the recent passage of policies by national societies and governing bodies, including the American Board of Medical Specialties, American Board of Radiology, Accreditation Council for Graduate Medical Education (ACGME), American College of Radiology, and American Medical Association. Implementation of paid FML requires adherence to federal, state, and local laws as well as institutional requirements. Specific requirements pertain to trainees from national governing bodies, such as the ACGME and medical specialty boards. Flexibility, work coverage, culture, and finances are additional considerations for ensuring an optimal paid FML policy that accounts for concerns of all impacted individuals.

11.
Clin Imaging ; 99: 10-18, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37043868

RESUMO

COVID-19 is a multisystemic disease, and hence its potential manifestations on nuclear medicine imaging can extend beyond the lung. Therefore, it is important for the nuclear medicine physician to recognize these manifestations in the clinic. While FDG-PET/CT is not indicated routinely in COVID-19 evaluation, its unique capability to provide a functional and anatomical assessment of the entire body means that it can be a powerful tool to monitor acute, subacute, and long-term effects of COVID-19. Single-photon scintigraphy is routinely used to assess conditions such as pulmonary embolism, cardiac ischemia, and thyroiditis, and COVID-19 may present in these studies. The most common nuclear imaging finding of COVID-19 vaccination to date is hypermetabolic axillary lymphadenopathy. This may pose important diagnostic and management dilemmas in oncologic patients, particularly those with malignancies where the axilla constitutes a lymphatic drainage area. This article aims to summarize the relevant literature published since the beginning of the pandemic on the intersection between COVID-19 and nuclear medicine.


Assuntos
COVID-19 , Medicina Nuclear , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Vacinas contra COVID-19 , Fluordesoxiglucose F18 , Cintilografia , Tomografia por Emissão de Pósitrons , Dedos do Pé
13.
Asia Ocean J Nucl Med Biol ; 11(1): 89-92, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36619186

RESUMO

Neurolymphomatosis is an uncommon manifestation of lymphoma, often presenting with painful polyneuropathy or polyradiculopathy and concomitant distal extremity weakness. Differentiation from other etiologies resulting in similar neuropathic symptoms such as compressive or inflammatory pathologies can be difficult and often results in delayed diagnosis. Here we describe a case of neurolymphomatosis affecting a 64-year-old man with a history of diffuse large B-cell lymphoma (DLBCL) in remission presenting with a right-sided foot drop following a gunshot wound. MRI at that time demonstrated thickening and enhancement of the cauda equina nerve roots. Over the course of the subsequent eight months, he developed left lower extremity sensory symptoms, left-sided foot drop and signs of upper motor neuron involvement, including left facial weakness, dysphonia, and dysphagia. 18F-FDG PET/CT revealed intensely avid left lumbosacral nerve roots, bilateral lower extremity and left upper extremity neurovascular bundles. Left sural nerve biopsies showed infiltration of DLBCL and confirmed neurolymphomatosis. We highlight the role of 18F-FDG PET/CT, with histological verification, for the diagnosis of an extended course of neurolymphomatosis occurring in the absence of typical painful neuropathy but with cranial and peripheral neuropathies.

14.
Acad Radiol ; 30(4): 755-762, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36058816

RESUMO

RATIONALE AND OBJECTIVES: To understand the current state of radiology residents' exposure to nuclear medicine and molecular imaging (NM/MI), determine key factors that may attract more trainees into the field, and identify differentiating aspects between those specializing in NM/MI and those who are not. MATERIALS AND METHODS: An anonymous web-based survey was sent to contacts at all diagnostic radiology residency programs in the United States for dissemination to their residents, collecting information about trainees' NM/MI exposure during residency and factors that may attract them to NM/MI. RESULTS: A total of 198 trainees responded to the survey, 34 of whom plan on pursuing a career in NM/MI. Most trainees reported early exposure to NM/MI during residency; most (97.4%) reported ample exposure to general NM/MI and oncologic studies. Less than 3% of trainees reported adequate exposure to therapies, neurological applications, molecular imaging/research advances, and physics. Respondents reported a need for better quality education (38.9%) and exposure to mentors (28.8%) as ways to attract trainees to NM/MI. Routinely encountered clinical pathology was the most interesting for those specializing in NM/MI (29.4%), whereas lifestyle was the most attractive aspect of NM/MI for those not pursuing a career in the field (27.4%). NM/MI-associated research was the least attractive for those specializing in NM/MI (35.3%), while job market concerns was the least attractive aspect for those not specializing in NM/MI (37.2%). Trainees planning to specialize in NM/MI reported higher satisfaction with their orientation to NM/MI during their first clinical rotation compared to those who do not plan to specialize in the field (3.03/5.00 and 2.67/5.00, respectively, p = 0.04). CONCLUSION: This survey highlights several factors that training programs and national societies can target to improve interest in NM/MI among radiology residents. We found that optimized education initiatives, including improved orientation to the field, increased mentoring, and career opportunities are essential levers for recruiting radiology trainees into the NM/MI workforce.


Assuntos
Internato e Residência , Medicina Nuclear , Humanos , Estados Unidos , Radiografia , Inquéritos e Questionários , Cintilografia , Escolha da Profissão
15.
Dig Dis Sci ; 68(2): 541-553, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35995883

RESUMO

BACKGROUND/AIMS: Gastric emptying scintigraphy is commonly performed to assess for dysmotility. A standardized meal with associated threshold criteria was established in 2000 to enable robust interpretation. However, no guidance is available to interpret results when patients do not ingest the entire meal. The purpose of this study is to determine the continued appropriateness of the threshold criteria in contemporary clinical practice and its relevance for partially ingested meals. METHODS: This retrospective study analyzed patients (n = 1365 total) who underwent solid-phase gastric emptying scintigraphy at an academic medical center. Patients were stratified based on their completion of the standard meal. Patients were further stratified into normal and delayed gastric emptying cohorts based on the current criteria. Percent gastric retention values at 1, 2, 3, and 4 h were compared. RESULTS: Median (95% upper reference) normal gastric retention values for the complete standard meal were 64% (87%) at 1 h, 25% (60%) at 2 h, 13% (54%) at 3 h and 4% (9%) at 4 h. Consumption of at least 50% of the standard meal yielded similar retention; 53% (86%) at 1 h, 19% (58%) at 2 h, 6% (29%) at 3 h and 3% (10%) at 4 h. There was no significant age- or gender-specific differences using the current criteria, and no differences were observed based on diabetic status. Retention values matched well with the current criteria and validated with data-driven clustering. CONCLUSION: Adult normative standards for gastric emptying scintigraphy are appropriate for differentiating normal and delayed populations and can be applied to partial meals with at least 50% completion.


Assuntos
Esvaziamento Gástrico , Refeições , Humanos , Adulto , Estudos Retrospectivos , Cintilografia , Ingestão de Alimentos
16.
Sci Adv ; 8(17): eabl6339, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35486732

RESUMO

BRAF-targeted kinase inhibitors (KIs) are used to treat malignancies including BRAF-mutant non-small cell lung cancer, colorectal cancer, anaplastic thyroid cancer, and, most prominently, melanoma. However, KI selection criteria in patients remain unclear, as are pharmacokinetic/pharmacodynamic (PK/PD) mechanisms that may limit context-dependent efficacy and differentiate related drugs. To address this issue, we imaged mouse models of BRAF-mutant cancers, fluorescent KI tracers, and unlabeled drug to calibrate in silico spatial PK/PD models. Results indicated that drug lipophilicity, plasma clearance, faster target dissociation, and, in particular, high albumin binding could limit dabrafenib action in visceral metastases compared to other KIs. This correlated with retrospective clinical observations. Computational modeling identified a timed strategy for combining dabrafenib and encorafenib to better sustain BRAF inhibition, which showed enhanced efficacy in mice. This study thus offers principles of spatial drug action that may help guide drug development, KI selection, and combination.

17.
Curr Opin Chem Biol ; 67: 102117, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35219177

RESUMO

Cancer immunotherapies typically aim to stimulate the accumulation and activity of cytotoxic T-cells or pro-inflammatory antigen-presenting cells, reduce immunosuppressive myeloid cells or regulatory T-cells, or elicit some combination of effects thereof. Notwithstanding the encouraging results, immunotherapies such as PD-1/PD-L1-targeted immune checkpoint blockade act heterogeneously across individual patients. It remains challenging to predict and monitor individual responses, especially across multiple sites of metastasis or sites of potential toxicity. To address this need, in vivo imaging of both adaptive and innate immune cell populations has emerged as a tool to quantify spatial leukocyte accumulation in tumors non-invasively. Here we review recent progress in the translational development of probes for in vivo leukocyte imaging, focusing on complementary perspectives provided by imaging of T-cells, phagocytic macrophages, and their responses to therapy.


Assuntos
Neoplasias , Microambiente Tumoral , Células Apresentadoras de Antígenos , Humanos , Imunoterapia/métodos , Neoplasias/diagnóstico por imagem , Linfócitos T
18.
Laryngoscope Investig Otolaryngol ; 7(1): 170-179, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35155795

RESUMO

OBJECTIVE: To demonstrate that oro-pharyngo-esophageal radionuclide scintigraphy (OPERS) not only detects tracheobronchial aspiration after swallowing, but also quantifies the amount of aspiration and subsequent clearance. METHODS: Data collected between 2014 and 2019 were reviewed for aspiration pneumonia at 12 and 24-months after OPERS. The predictive value for aspiration pneumonia on flexible endoscopic evaluation of swallowing (FEES), videofluoroscopic swallowing study (VFSS), and OPERS, and the overall survival of patients with or without aspiration were determined. RESULTS: Thirty-seven patients treated with radiotherapy for nasopharyngeal carcinoma (NPC) were reviewed. The incidence of aspiration detected on FEES, VFSS, and OPERS was 78.4%, 66.7%, and 44.4%, respectively. Using VFSS as a gold standard, the sensitivity and specificity of OPERS for aspiration was 73.7% and 100%. The positive and negative predictive values for aspiration were 100% and 66.7%, respectively, with an overall accuracy of 82.8%. A history of aspiration pneumonia was one factor associated with a higher chance of subsequent aspiration pneumonia within 12 months (odds ratio: 15.5, 95% CI 1.67-145.8, p < .05) and 24 months (odds ratio: 23.8, 95% CI 3.69-152.89, p < .01) of the swallowing assessment. Aspiration detected by OPERS was a significant risk factor for future aspiration pneumonia at 12 and 24 months respectively. Significantly, better survival was associated with an absence of aspiration on OPERS only, but not on FEES or VFSS. CONCLUSION: OPERS predicts the safety of swallowing, the incidence of subsequent aspiration pneumonia, and the survival prognosis in post-irradiated NPC dysphagia patients. LEVEL OF EVIDENCE: 3.

19.
J Nucl Med ; 63(3): 468-475, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34301782

RESUMO

Attenuation correction remains a challenge in pelvic PET/MRI. In addition to the segmentation/model-based approaches, deep learning methods have shown promise in synthesizing accurate pelvic attenuation maps (µ-maps). However, these methods often misclassify air pockets in the digestive tract, potentially introducing bias in the reconstructed PET images. The aims of this work were to develop deep learning-based methods to automatically segment air pockets and generate pseudo-CT images from CAIPIRINHA-accelerated MR Dixon images. Methods: A convolutional neural network (CNN) was trained to segment air pockets using 3-dimensional CAIPIRINHA-accelerated MR Dixon datasets from 35 subjects and was evaluated against semiautomated segmentations. A separate CNN was trained to synthesize pseudo-CT µ-maps from the Dixon images. Its accuracy was evaluated by comparing the deep learning-, model-, and CT-based µ-maps using data from 30 of the subjects. Finally, the impact of different µ-maps and air pocket segmentation methods on the PET quantification was investigated. Results: Air pockets segmented using the CNN agreed well with semiautomated segmentations, with a mean Dice similarity coefficient of 0.75. The volumetric similarity score between 2 segmentations was 0.85 ± 0.14. The mean absolute relative changes with respect to the CT-based µ-maps were 2.6% and 5.1% in the whole pelvis for the deep learning-based and model-based µ-maps, respectively. The average relative change between PET images reconstructed with deep learning-based and CT-based µ-maps was 2.6%. Conclusion: We developed a deep learning-based method to automatically segment air pockets from CAIPIRINHA-accelerated Dixon images, with accuracy comparable to that of semiautomatic segmentations. The µ-maps synthesized using a deep learning-based method from CAIPIRINHA-accelerated Dixon images were more accurate than those generated with the model-based approach available on integrated PET/MRI scanners.


Assuntos
Aprendizado Profundo , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Pelve/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X
20.
Methods Mol Biol ; 2424: 295-315, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34918302

RESUMO

Ovarian cancer (OVCA) is frequently detected at late stages of disease, often with dissemination throughout the peritoneal cavity surface, abdomen, and ascites fluid. Tumor signaling via mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K) pathways can promote OVCA progression and depend on local microenvironmental cues. To better study OVCA in situ within native tissue contexts, here we describe confocal microscopy techniques to image mouse models of intraperitoneal disease at a single-cell resolution. As a proof of principle demonstration, examples are highlighted for simultaneously imaging tumor vascularization, infiltrating and often immunosuppressive immune cells (tumor-associated macrophages), and OVCA kinase activity.


Assuntos
Neoplasias Ovarianas , Animais , Carcinoma Epitelial do Ovário , Linhagem Celular Tumoral , Feminino , Camundongos , Neoplasias Ovarianas/diagnóstico por imagem , Fosfatidilinositol 3-Quinases , Transdução de Sinais
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