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Prone versus Supine FDG PET/CT in the Staging of Breast Cancer. Diagnostics (Basel) 2023; 13:diagnostics13030367. [PMID: 36766472 PMCID: PMC9914486 DOI: 10.3390/diagnostics13030367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 01/21/2023] Open
Abstract
Supine [18F]Fluorodeoxyglucose (FDG) positron emission technology/computed tomography (PET/CT) is a commonly used modality for the initial staging of breast cancer, and several previous studies have shown superior sensitivity and specificity of prone FDG PET/CT in comparison to its supine counterpart. This retrospective study included 25 females with breast cancer referred for staging. They underwent supine FDG PET/CT followed by prone FDG PET/CT. The outcomes were: number of primary breast lesions, anatomical site of FDG-avid lymph nodes (LNs), and number and type of bone lesions, with SUVmax of all corresponding parameters. Performance was superior in prone acquisition compared to supine acquisition, with the respective results: 29 vs. 22 breast tumor lesions detected, 62 vs. 27 FDG-avid axillary LNs detected, sensitivity of 68% vs. 57%, specificity of 64% vs. 53%. The detection rate of axillary LNs in the prone position was significantly higher (p = 0.001). SUVmax for breast tumor lesions (p = 0.000) and number of detected axillary LNs (p = 0.002) were significantly higher in prone acquisition. Five patients were upstaged after experts read the prone acquisition. Prone FDG PET/CT acquisition is a promising technique in detecting primary breast lesions and metastatic LNs possibly missed in supine acquisition, which may lead to change in patient staging and management.
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Xue C, Tang FH, Lai CWK, Grimm LJ, Lo JY. Multimodal Patient-Specific Registration for Breast Imaging Using Biomechanical Modeling with Reference to AI Evaluation of Breast Tumor Change. Life (Basel) 2021; 11:life11080747. [PMID: 34440490 PMCID: PMC8401473 DOI: 10.3390/life11080747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The strategy to combat the problem associated with large deformations in the breast due to the difference in the medical imaging of patient posture plays a vital role in multimodal medical image registration with artificial intelligence (AI) initiatives. How to build a breast biomechanical model simulating the large-scale deformation of soft tissue remains a challenge but is highly desirable. Methods: This study proposed a hybrid individual-specific registration model of the breast combining finite element analysis, property optimization, and affine transformation to register breast images. During the registration process, the mechanical properties of the breast tissues were individually assigned using an optimization process, which allowed the model to become patient specific. Evaluation and results: The proposed method has been extensively tested on two datasets collected from two independent institutions, one from America and another from Hong Kong. Conclusions: Our method can accurately predict the deformation of breasts from the supine to prone position for both the Hong Kong and American samples, with a small target registration error of lesions.
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Affiliation(s)
- Cheng Xue
- School of Medical and Health Sciences, Tung Wah College, Hong Kong, China;
| | - Fuk-Hay Tang
- School of Medical and Health Sciences, Tung Wah College, Hong Kong, China;
- Correspondence:
| | - Christopher W. K. Lai
- Health and Social Sciences, Singapore Institute of Technology, Singapore 138683, Singapore;
| | - Lars J. Grimm
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA; (L.J.G.); (J.Y.L.)
| | - Joseph Y. Lo
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA; (L.J.G.); (J.Y.L.)
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Urbano N, Scimeca M, Bonfiglio R, Bonanno E, Schillaci O. New advance in breast cancer pathology and imaging. Future Oncol 2019; 15:2707-2722. [DOI: 10.2217/fon-2019-0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The improvement of knowledge concerning the pathology of breast cancer could provide the rationale for the development of new imaging diagnostic protocols. Indeed, as for the microcalcifications, new histopathological markers can be used as target for in vivo early detection of breast cancer lesions by using molecular imaging techniques such as positron emission tomography. Specifically, the mutual contribution of these medical specialties can ‘nourish’ the dream of a personalized medicine that takes into account the intrinsic variability of breast cancer. In this review, we report the main discoveries concerning breast cancer pathology highlighting the possible cooperation between the departments of anatomic pathology and imaging diagnostics.
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Affiliation(s)
- Nicoletta Urbano
- Nuclear Medicine, Policlinico ‘Tor Vergata,’ viale Oxford, 81, Rome, 00133, Italy
| | - Manuel Scimeca
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS San Raffaele, Via di Val Cannuta 247, 00166, Rome, Italy
- Fondazione Umberto Veronesi (FUV), Piazza Velasca 5, 20122 Milano (Mi), Italy
| | - Rita Bonfiglio
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
| | - Elena Bonanno
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- Neuromed Group, ‘Diagnostica Medica’ & ‘Villa dei Platani', Via Errico Carmelo, 2, 83100 Avellino AV, Italy
| | - Orazio Schillaci
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Manapragada PP. Molecular Imaging in Management of Breast Cancer. Semin Roentgenol 2018; 53:301-310. [PMID: 30449348 DOI: 10.1053/j.ro.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sasada S, Masumoto N, Goda N, Kajitani K, Emi A, Kadoya T, Okada M. Dedicated breast PET for detecting residual disease after neoadjuvant chemotherapy in operable breast cancer: A prospective cohort study. Eur J Surg Oncol 2018; 44:444-448. [DOI: 10.1016/j.ejso.2018.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/10/2017] [Accepted: 01/07/2018] [Indexed: 11/15/2022] Open
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Potential Clinical Applications of 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Mammography in Breast Cancer. Nucl Med Mol Imaging 2016; 51:217-226. [PMID: 28878847 DOI: 10.1007/s13139-016-0446-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 07/19/2016] [Accepted: 07/29/2016] [Indexed: 01/30/2023] Open
Abstract
The whole-body positron emission tomography (PET)/magnetic resonance (MR) scan is a cutting edge technology providing comprehensive structural information from MR imaging and functional features from PET in a single session. Recent research findings and clinical experience have shown that 18F-fluorodeoxyglucose (FDG) whole-body PET/MR imaging has a diagnostic performance comparable with or superior to that of PET/CT in the field of oncology, including for breast cancer. In particular, FDG PET/MR mammography in the prone position with the breast hanging in a pendant manner can provide more comprehensive information about the metabolism, anatomy, and functional features of a breast lesion than a whole-body PET/MR scan. This article reports on current state-of-the-art PET/MR mammography in patients with breast cancer and the prospects for potential application in the future.
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Variations in (18)F-FDG uptake in breast cancer depending on PET/CT acquisition position. Clin Radiol 2015; 71:86-91. [PMID: 26646369 DOI: 10.1016/j.crad.2015.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/18/2015] [Accepted: 10/28/2015] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the variability of quantitative 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) combined with computed tomography (CT) parameters depending on acquisition position in a dual-position protocol for breast cancers. MATERIALS AND METHODS For initial staging work-up, whole-body PET/CT was first acquired in a supine position, and then followed by a regional breast scan in a prone position. The maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were measured on both acquisition positions. MTV50 and TLG50 were calculated with a threshold set to be 50% of SUVmax, and MTV2.5 and TLG2.5 with a fixed SUV threshold of 2.5. RESULTS The median SUVmax of breast cancers measured on the supine scans was 4.88, and 4.49 on the prone images (p<0.05). MTV and TLG also yielded significantly lower values from supine images. Regarding the tendency for the acquisition position to yield different results, a significant disagreement was observed between SUVmax and MTV50 and between SUVmax and TLG50 (kappa = -0156 and -0.001, respectively), while MTV2.5 and TLG2.5 showed a fair to moderate agreement with SUVmax (kappa = 0.311 and 0.416, respectively). CONCLUSIONS SUVmax, MTV, and TLG yielded lower values when acquired in the prone position compared to in the supine position. This observation could be due to the partial volume effect. When using 50% of SUVmax as a threshold, there was a significant discordance between SUVmax and volumetric parameters. Thus, acquisition position may affect quantitative PET/CT parameters and the clinical implications.
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Canevari C, Gallivanone F, Zuber V, Marassi A, Losio C, Gianolli L, Gilardi MC, Castiglioni I. Prone 18F-FDG PET/CT changes diagnostic and surgical intervention in a breast cancer patient: some considerations about PET/CT imaging acquisition protocol. Clin Imaging 2015; 39:506-9. [DOI: 10.1016/j.clinimag.2014.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 11/03/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
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Vercher-Conejero JL, Pelegrí-Martinez L, Lopez-Aznar D, Cózar-Santiago MDP. Positron Emission Tomography in Breast Cancer. Diagnostics (Basel) 2015; 5:61-83. [PMID: 26854143 PMCID: PMC4665546 DOI: 10.3390/diagnostics5010061] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 12/26/2022] Open
Abstract
Gradually, FDG-PET/CT has been strengthening within the diagnostic algorithms of oncological diseases. In many of these, PET/CT has shown to be useful at different stages of the disease: diagnosis, staging or re-staging, treatment response assessment, and recurrence. Some of the advantages of this imaging modality versus CT, MRI, bone scan, mammography, or ultrasound, are based on its great diagnostic capacity since, according to the radiopharmaceutical used, it reflects metabolic changes that often occur before morphological changes and therefore allows us to stage at diagnosis. Moreover, another advantage of this technique is that it allows us to evaluate the whole body so it can be very useful for the detection of distant disease. With regard to breast cancer, FDG-PET/CT has proven to be important when recurrence is suspected or in the evaluation of treatment response. The technological advancement of PET equipment through the development of new detectors and equipment designed specifically for breast imaging, and the development of more specific radiopharmaceuticals for the study of the different biological processes of breast cancer, will allow progress not only in making the diagnosis of the disease at an early stage but also in enabling personalized therapy for patients with breast cancer.
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Affiliation(s)
- Jose Luis Vercher-Conejero
- Clinical Area of Medical Imaging, Department of Nuclear Medicine, GIBI230, Polytechnic and University Hospital La Fe, Valencia 46026, Spain.
| | - Laura Pelegrí-Martinez
- Diagnostic Imaging, Sant Joan Despí Moisès Broggi Hospital, Sant Joan Despí, Barcelona 08970, Spain.
| | - Diego Lopez-Aznar
- Department of Nuclear Medicine, Provincial Hospital Consortium, Castellón de la Plana 12002, Spain.
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Bitencourt AGV, Lima ENP, Chojniak R, Marques EF, de Souza JA, Graziano L, Andrade WP, Osório CABDT. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas. Radiol Bras 2015; 47:67-73. [PMID: 25741051 PMCID: PMC4337160 DOI: 10.1590/s0100-39842014000200006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 12/12/2013] [Indexed: 01/09/2023] Open
Abstract
Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose
(18F-FDG) positron emission tomography/computed tomography (PET/CT)
performed with a specific protocol for assessment of breasts with
histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with
biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT
examination in prone position, with a specific protocol for assessment of breasts.
PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum
diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm). Invasive ductal
carcinoma was the most common histological type (n = 47; 79.7%).
At PET/CT, 53 (89.8%) of the lesions demonstrated anomalous concentrations of
18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5). A
statistically significant association was observed between higher values of
maximum SUV and histological type, histological grade, molecular subtype, tumor
diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated
good sensitivity and was associated with relevant histological/immunohistochemical
factors related to aggressiveness and prognosis of breast carcinomas.
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Affiliation(s)
| | | | - Rubens Chojniak
- PhD, MD, Director, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Elvira Ferreira Marques
- Physician Responsible for the Unit of Breast Imaging at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Juliana Alves de Souza
- Titular Physicians, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Luciana Graziano
- Titular Physicians, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wesley Pereira Andrade
- Master, Titular Physician, Department of Mastology, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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Bitencourt AG, Lima EN, Chojniak R, Marques EF, Souza JA, Andrade WP, Guimarães MD. Can 18F-FDG PET improve the evaluation of suspicious breast lesions on MRI? Eur J Radiol 2014; 83:1381-6. [DOI: 10.1016/j.ejrad.2014.05.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/07/2014] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
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Imamura Y, Azuma K, Kurata S, Hattori S, Sasada T, Kinoshita T, Okamoto M, Kawayama T, Kaida H, Ishibashi M, Aizawa H. Prognostic value of SUVmax measurements obtained by FDG-PET in patients with non-small cell lung cancer receiving chemotherapy. Lung Cancer 2011; 71:49-54. [DOI: 10.1016/j.lungcan.2010.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 03/21/2010] [Accepted: 04/01/2010] [Indexed: 11/28/2022]
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Vidal-Sicart S, Aukema T, Vogel W, Hoefnagel C, Valdés-Olmos R. Valor añadido de la técnica en decúbito prono para el estudio con tomografía por emisión de positrones-tomografía computarizada en las pacientes con cáncer de mama. ACTA ACUST UNITED AC 2010; 29:230-5. [DOI: 10.1016/j.remn.2010.05.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 05/07/2010] [Accepted: 05/10/2010] [Indexed: 10/19/2022]
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Modern breast cancer detection: a technological review. Int J Biomed Imaging 2009; 2009:902326. [PMID: 20069109 PMCID: PMC2804038 DOI: 10.1155/2009/902326] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 09/15/2009] [Indexed: 12/29/2022] Open
Abstract
Breast cancer is a serious threat worldwide and is the number two killer of women in the United States. The key to successful management is screening and early detection. What follows is a description of the state of the art in screening and detection for breast cancer as well as a discussion of new and emerging technologies. This paper aims to serve as a starting point for those who are not acquainted with this growing field.
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Jung SY, Kim SK, Nam BH, Min SY, Lee SJ, Park C, Kwon Y, Kim EA, Ko KL, Park IH, Lee KS, Shin KH, Lee S, Kim SW, Kang HS, Ro J. Prognostic Impact of [18F] FDG-PET in Operable Breast Cancer Treated with Neoadjuvant Chemotherapy. Ann Surg Oncol 2009; 17:247-53. [DOI: 10.1245/s10434-009-0710-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Accepted: 08/20/2009] [Indexed: 11/18/2022]
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Prasanphanich AF, Retzloff L, Lane SR, Nanda PK, Sieckman GL, Rold TL, Ma L, Figueroa SD, Sublett SV, Hoffman TJ, Smith CJ. In vitro and in vivo analysis of [(64)Cu-NO2A-8-Aoc-BBN(7-14)NH(2)]: a site-directed radiopharmaceutical for positron-emission tomography imaging of T-47D human breast cancer tumors. Nucl Med Biol 2009; 36:171-81. [PMID: 19217529 DOI: 10.1016/j.nucmedbio.2008.11.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Revised: 11/04/2008] [Accepted: 11/11/2008] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Human breast cancer, from which the T-47D cell line was derived, is known to overexpress the gastrin-releasing peptide receptor (GRPR) in some cases. Bombesin (BBN), an agonist for the GRPR, has been appended with a radionuclide capable of positron-emission tomography (PET) imaging and therapy. (64)Cu-NO2A-8-Aoc-BBN(7-14)NH(2) (NO2A=1,4,7-triazacyclononane-1,4-diacetate) has produced high-quality microPET images of GRPR-positive breast cancer xenografted tumors in mice. METHODS The imaging probe was synthesized by solid-phase peptide synthesis followed by manual conjugation of the 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA) bifunctional chelator and radiolabeling in aqueous solution. The radiolabeled conjugate was subjected to in vitro and in vivo studies to determine its specificity for the GRPR and its pharmacokinetic profile. A T-47D tumor-bearing mouse was imaged with microPET/CT and microMRI imaging. RESULTS The (64)Cu-NO2A-8-Aoc-BBN(7-14)NH(2) targeting vector was determined to specifically localize in GRPR-positive tissue. Accumulation was observed in the tumor in sufficient quantities to allow for identification of tumors in microPET imaging procedures. For example, uptake and retention in T-47D xenografts at 1, 4 and 24 h were determined to be 2.27+/-0.08, 1.35+/-0.14 and 0.28+/-0.07 % ID/g, respectively. CONCLUSIONS The (64)Cu-NO2A-8-Aoc-BBN(7-14)NH(2) produced high-quality microPET images. The pharmacokinetic profile justifies investigation of this bioconjugate as a potentially useful diagnostic/therapeutic agent. Additionally, the bioconjugate would serve as a good starting point for modification and optimization of similar agents to maximize tumor uptake and minimize nontarget accumulation.
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Affiliation(s)
- Adam F Prasanphanich
- Department of Radiology, University of Missouri School of Medicine, Columbia, MO 65211, USA
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