The role of dynamic magnetic resonance imaging in exclusion of inguinal hernia in patients suffering from indefinitive groin pain.

RATIONALE AND OBJECTIVES: The objective of this study was to analyze the role of dynamic magnetic resonance imaging (MRI) in patients who suffered from groin pain and whose physical examination and ultrasound returned inconclusive/indefinite results, as well as in patients receiving an ongoing assessment for a previous herniotomy. MATERIAL AND METHODS: For this study, 25 patients 14 women and 11 men were selected with a mean age of 41.6 years, including clinical complaints, such as groin pain and or a previous herniotomies. These patients underwent dynamic MRI. Reports were created by a radiology resident and a radiology consultant. Clinical and ultrasound documentation were compared to with imaging results from the MRI. RESULTS: The results of the dynamic MRI were negative for 23 patients (92%) and positive for two patients (8%). One patient suffered from an indirect hernia and one from a femoral hernia. A repeated hernia was an excluding for the preoperated patients with pain and ongoing assessment. CONCLUSIONS: Dynamic MRI shows substantially higher diagnostic performance in exclusion of inguinal hernia, when compared to a physical examination and ultrasound. The examination can also be used in assessments to analyze the operation's results.

Computed Tomography Radiomics to Differentiate Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma.

AIMS: Intrahepatic cholangiocarcinoma (iCCA) and hepatocellular carcinoma (HCC) differ in prognosis and treatment. We aimed to non-invasively differentiate iCCA and HCC by means of radiomics extracted from contrast-enhanced standard-of-care computed tomography (CT). MATERIALS AND METHODS: In total, 94 patients (male, n = 68, mean age 63.3 ± 12.4 years) with histologically confirmed iCCA (n = 47) or HCC (n = 47) who underwent contrast-enhanced abdominal CT between August 2014 and November 2021 were retrospectively included. The enhancing tumour border was manually segmented in a clinically feasible way by defining three three-dimensional volumes of interest per tumour. Radiomics features were extracted. Intraclass correlation analysis and Pearson metrics were used to stratify robust and non-redundant features with further feature reduction by LASSO (least absolute shrinkage and selection operator). Independent training and testing datasets were used to build four different machine learning models. Performance metrics and feature importance values were computed to increase the models' interpretability. RESULTS: The patient population was split into 65 patients for training (iCCA, n = 32) and 29 patients for testing (iCCA, n = 15). A final combined feature set of three radiomics features and the clinical features age and sex revealed a top test model performance of receiver operating characteristic (ROC) area under the curve (AUC) = 0.82 (95% confidence interval =0.66-0.98; train ROC AUC = 0.82) using a logistic regression classifier. The model was well calibrated, and the Youden J Index suggested an optimal cut-off of 0.501 to discriminate between iCCA and HCC with a sensitivity of 0.733 and a specificity of 0.857. CONCLUSIONS: Radiomics-based imaging biomarkers can potentially help to non-invasively discriminate between iCCA and HCC.

CD74 regulates complexity of tumor cell HLA class II peptidome in brain metastasis and is a positive prognostic marker for patient survival.

Despite multidisciplinary local and systemic therapeutic approaches, the prognosis for most patients with brain metastases is still dismal. The role of adaptive and innate anti-tumor response including the Human Leukocyte Antigen (HLA) machinery of antigen presentation is still unclear. We present data on the HLA class II-chaperone molecule CD74 in brain metastases and its impact on the HLA peptidome complexity.We analyzed CD74 and HLA class II expression on tumor cells in a subset of 236 human brain metastases, primary tumors and peripheral metastases of different entities in association with clinical data including overall survival. Additionally, we assessed whole DNA methylome profiles including CD74 promoter methylation and differential methylation in 21 brain metastases. We analyzed the effects of a siRNA mediated CD74 knockdown on HLA-expression and HLA peptidome composition in a brain metastatic melanoma cell line.We observed that CD74 expression on tumor cells is a strong positive prognostic marker in brain metastasis patients and positively associated with tumor-infiltrating T-lymphocytes (TILs). Whole DNA methylome analysis suggested that CD74 tumor cell expression might be regulated epigenetically via CD74 promoter methylation. CD74high and TILhigh tumors displayed a differential DNA methylation pattern with highest enrichment scores for antigen processing and presentation. Furthermore, CD74 knockdown in vitro lead to a reduction of HLA class II peptidome complexity, while HLA class I peptidome remained unaffected.In summary, our results demonstrate that a functional HLA class II processing machinery in brain metastatic tumor cells, reflected by a high expression of CD74 and a complex tumor cell HLA peptidome, seems to be crucial for better patient prognosis.

Radiolabeled thymidine: a sensitive tracer for early tumor response and recurrence after irradiation.

UNLABELLED: This study evaluated the sensitivity of a radiolabeled thymidine tracer for assessment of early tumor response and recurrence after irradiation. METHODS: SW707 human colon carcinoma implanted into nude mice was irradiated with 6 or 20 Gy. Tumor volume was determined for an interval of 14 d. At 4, 8 and 24 h and at 2, 3, 7, 10 and 14 d after irradiation, [14C]thymidine uptake into the tumor was determined with a liquid scintillation counter and the intratumoral distribution of [14C]thymidine was visualized and evaluated semiquantitatively by autoradiography using a phosphor imager. RESULTS: In both groups, tumor volume decreased until day 7 after irradiation; afterward, regrowth occurred in only the group that had received 6 Gy. A decrease in thymidine uptake was found as early as 8 h after irradiation. On day 3 after irradiation, thymidine uptake increased again in the 6-Gy group, before the increase in tumor volume, but remained unchanged in the 20-Gy group. Also on day 3, multiple foci of thymidine uptake suggesting proliferation preceding tumor recurrence were seen on autoradiographs from the 6-Gy group but not from the 20-Gy group. Histological findings correlated with the results of autoradiography. CONCLUSION: The results show that radiolabeled thymidine is a sensitive tracer for assessment of early tumor response and recurrence after irradiation. The rapid decrease in uptake, however, does not allow any prediction about tumor recurrence.

Cytotoxic effect of immunoconjugate composed of glucose-oxidase coupled to an anti-ganglioside (GD2) antibody on spheroids.

As a new treatment protocol for neuroblastoma, the chimeric (human/mouse) antiganglioside GD2 antibody chl4.18 is being clinically tested. To improve the therapeutic effect of the antibody alone, we are currently investigating the cytotoxicity of glucose-oxidase coupled to the antibody chl4.18 on spheroids of the neuroblastoma cell line SK-N-LO. The cytotoxic effect of glucose-oxidase is achieved by the production of hydrogenperoxide (H2O2) and probably by the following reaction of H2O2 with iron to form hydrogen radicals (OH.). The cytotoxicity of glucose-oxidase was measured by two viability tests (MTT and WST 1). After a 4 hour treatment of the spheroids with the immunoconjugate, a reduction of viability to 50% (MTT-test) and 25% (WST 1-test), respectively, was obtained. The difference between the results of these two tests, might be explained by the different measurement protocols.

Biodistribution of 99mTc-glutathione in mice with osteosarcoma: effect of gamma irradiation on tumour uptake.

The aim of this study was to determine the efficacy of 99mTc-glutathione (GSH) in scintigraphic demonstration of osteosarcoma tumour in mice and the effect of gamma irradiation of tumour on tumour uptake of 99mTc-GSH. The biodistribution of 99mTc-GSH was studied in 30 Balb C mice 3 weeks after isotransplanting osteosarcoma OTS-64 in their thighs. The mice were injected with 400 microCi of 99mTc-GSH in 0.1 ml through the tail vein. They were equally divided into two groups. In the second group the tumours were subjected to gamma irradiation for 10 min (20 Gy). The mice in both groups were killed at 1, 3 and 6 h. Scintigrams were obtained at each time point. The organs, tumours, some muscle and some blood were removed, weighed and assayed for radioactivity. Tumour, liver and muscle sections were also obtained for gross autoradiographic studies. The tumours were well visualized on scintigrams. The tumour uptake values as a function of time after injection were 3.27+/-0.80, 1.53+/-0.69, and 1.51+/-0.55 for the control and 5.18+/-1.28, 0.399+/-0.120, and 1.67+/-1.05%/g for the irradiated groups at 1, 3 and 6 h, respectively. The tumor-to-muscle concentration ratios were 34.03+/-12.2, 21.4+/-11.3 and 18.7+/-11.4 for the control and 18.8+/-7.2, 3.63+/-1.9, and 24.1+/-9.0 for the irradiated groups, respectively. The gross autoradiographic images of tumour sections indicated focal sites of increased uptake within tumour tissue, indicating the presence of necrotic areas. In conclusion, 99mTc-GSH accumulated in osteosarcoma and resulted in high tumour-to-other tissue concentration ratios in mice. The increase in uptake values after tumour irradiation might be a result of increased demand of tumour cells for GSH attributable to its well-known biological function as a reducing agent in addition to increased blood flow and capillary permeability in malignant tissues.

Cathode ray tube quality control and acceptance testing program: initial results for clinical PACS displays.

The use of picture archiving and communication systems (PACS) and primary soft-copy interpretation in radiology is growing rapidly. The authors present a cathode ray tube (CRT) acceptance test and quality control (QC) program developed over a 5-year period on the basis of experience with multiple PACS and CRT vendors. The CRT QC procedures address monitor cleanliness and setup, qualitative image quality, and quantitative luminance and color measurements. Required materials include a photometer with luminance and color probes and 100%-video, flat-field window and test images from the Society of Motion Picture Test Engineers (SMPTE). Luminance was found to change over time for all gray-scale CRTs examined, which necessitated quarterly recalibration. The phosphor color of these monitors was also found to change, but changes were consistent and slow enough to warrant only annual measurements. Color measurements were found to be especially useful at initial setup and for CRT replacement. Use of this program allowed standardization of absolute luminance of individual CRTs, matching of phosphor color for multimonitor workstations, and systematic tracking of image artifacts. Implementation of a QC program is strongly recommended owing to the dynamic nature of CRT displays.