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Jalloul W, Moscalu M, Moscalu R, Jalloul D, Grierosu IC, Gutu M, Haba D, Mocanu V, Gutu MM, Stefanescu C. Are MTV and TLG Accurate for Quantifying the Intensity of Brown Adipose Tissue Activation? Biomedicines 2024; 12:151. [PMID: 38255256 PMCID: PMC10813038 DOI: 10.3390/biomedicines12010151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Recent research has suggested that one novel mechanism of action for anti-obesity medications is to stimulate the activation of brown adipose tissue (BAT). 18FDG PET/CT remains the gold standard for defining and quantifying BAT. SUVmax is the most often used quantification tool in clinical practice. However, this parameter does not reflect the entire BAT volume. As a potential method for precisely evaluating BAT, we have utilised metabolic tumour volume (MTV) and total lesion glycolysis (TLG) to answer the question: Are MTV and TLG accurate in quantifying the intensity of BAT activation? After analysing the total number of oncological 18F-FDG PET/CT scans between 2021-2023, we selected patients with active BAT. Based on the BAT SUVmax, the patients were divided into BAT-moderate activation (MA) vs. BAT-high activation (HA). Furthermore, we statistically analysed the accuracy of TLG and MTV in assessing BAT activation intensity. The results showed that both parameters increased their predictive value regarding BAT activation, and presented a significantly high sensitivity and specificity for the correct classification of BAT activation intensity. To conclude, these parameters could be important indicators with increased accuracy for classifying BAT expression, and could bring additional information about the volume of BAT to complement the limitations of the SUVmax.
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Affiliation(s)
- Wael Jalloul
- Department of Biophysics and Medical Physics-Nuclear Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (W.J.); (D.J.); (I.C.G.); (C.S.)
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Roxana Moscalu
- Manchester Academic Health Science Centre, Cell Matrix Biology and Regenerative Medicine, The University of Manchester, Manchester M13 9PT, UK;
| | - Despina Jalloul
- Department of Biophysics and Medical Physics-Nuclear Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (W.J.); (D.J.); (I.C.G.); (C.S.)
| | - Irena Cristina Grierosu
- Department of Biophysics and Medical Physics-Nuclear Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (W.J.); (D.J.); (I.C.G.); (C.S.)
| | - Mihaela Gutu
- County Hospital of Emergency “Saint John the New”, 720224 Suceava, Romania; (M.G.); (M.M.G.)
| | - Danisia Haba
- Department 1 Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Veronica Mocanu
- Department of Morpho-Functional Sciences (Pathophysiology), “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Mihai Marius Gutu
- County Hospital of Emergency “Saint John the New”, 720224 Suceava, Romania; (M.G.); (M.M.G.)
| | - Cipriana Stefanescu
- Department of Biophysics and Medical Physics-Nuclear Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (W.J.); (D.J.); (I.C.G.); (C.S.)
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Maushart CI, Sun W, Othman A, Ghosh A, Senn JR, Fischer JGW, Madoerin P, Loeliger RC, Benz RM, Takes M, Zech CJ, Chirindel A, Beuschlein F, Reincke M, Wild D, Bieri O, Zamboni N, Wolfrum C, Betz MJ. Effect of high-dose glucocorticoid treatment on human brown adipose tissue activity: a randomised, double-blinded, placebo-controlled cross-over trial in healthy men. EBioMedicine 2023; 96:104771. [PMID: 37659283 PMCID: PMC10483510 DOI: 10.1016/j.ebiom.2023.104771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND Glucocorticoids (GCs) are widely applied anti-inflammatory drugs that are associated with adverse metabolic effects including insulin resistance and weight gain. Previous research indicates that GCs may negatively impact brown adipose tissue (BAT) activity in rodents and humans. METHODS We performed a randomised, double-blinded cross-over trial in 16 healthy men (clinicaltrials.govNCT03269747). Participants received 40 mg of prednisone per day for one week or placebo. After a washout period of four weeks, participants crossed-over to the other treatment arm. Primary endpoint was the increase in resting energy expenditure (EE) in response to a mild-cold stimulus (cold-induced thermogenesis, CIT). Secondary outcomes comprised mean 18F-FDG uptake into supraclavicular BAT (SUVmean) as determined by FDG-PET/CT, volume of the BAT depot as well as fat content determined by MRI. The plasma metabolome and the transcriptome of supraclavicular BAT and of skeletal muscle biopsies after each treatment period were analysed. FINDINGS Sixteen participants were recruited to the trial and completed it successfully per protocol. After prednisone treatment resting EE was higher both during warm and cold conditions. However, CIT was similar, 153 kcal/24 h (95% CI 40-266 kcal/24 h) after placebo and 186 kcal/24 h (95% CI 94-277 kcal/24 h, p = 0.38) after prednisone. SUVmean of BAT after cold exposure was not significantly affected by prednisone (3.36 g/ml, 95% CI 2.69-4.02 g/ml, vs 3.07 g/ml, 95% CI 2.52-3.62 g/ml, p = 0.28). Results of plasma metabolomics and BAT transcriptomics corroborated these findings. RNA sequencing of muscle biopsies revealed higher expression of genes involved in calcium cycling. No serious adverse events were reported and adverse events were evenly distributed between the two treatments. INTERPRETATION Prednisone increased EE in healthy men possibly by altering skeletal muscle calcium cycling. Cold-induced BAT activity was not affected by GC treatment, which indicates that the unfavourable metabolic effects of GCs are independent from thermogenic adipocytes. FUNDING Grants from Swiss National Science Foundation (PZ00P3_167823), Bangerter-Rhyner Foundation and from Nora van der Meeuwen-Häfliger Foundation to MJB. A fellowship-grant from the Swiss National Science Foundation (SNF211053) to WS. Grants from German Research Foundation (project number: 314061271-TRR 205) and Else Kröner-Fresenius (grant support 2012_A103 and 2015_A228) to MR.
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Affiliation(s)
- Claudia Irene Maushart
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Wenfei Sun
- Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland.
| | - Alaa Othman
- Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland.
| | - Adhideb Ghosh
- Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland; Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland.
| | - Jaël Rut Senn
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Jonas Gabriel William Fischer
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Philipp Madoerin
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Rahel Catherina Loeliger
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Robyn Melanie Benz
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland.
| | - Martin Takes
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Christoph Johannes Zech
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Alin Chirindel
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University Zurich (UZH), Zurich, Switzerland; Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
| | - Martin Reincke
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
| | - Damian Wild
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Oliver Bieri
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Nicola Zamboni
- Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland.
| | - Christian Wolfrum
- Institute of Food, Nutrition, and Health, ETH Zurich, Schwerzenbach, Switzerland.
| | - Matthias Johannes Betz
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Basel, Switzerland.
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Ricci M, De Feo MS, Granese GM, Frantellizzi V, Carabellese B, Lubrano E, Cimini A. 18F-FDG PET/CT technology for the assessment of brown adipose tissue: an updated review. Expert Rev Med Devices 2023; 20:1143-1156. [PMID: 37965719 DOI: 10.1080/17434440.2023.2283618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION This review provides an update of 18 F-fluorodeoxyglucose ([18F] FDG) for Brown adipose tissue (BAT) activity quantification, whose role is not completely understood. AREAS COVERED We conducted an unstructured search of the literature for any studies employing the [18F] FDG PET in BAT assessment. We explored BAT quantification both in healthy individuals and in different pathologies, after cold exposure and as a metabolic biomarker. The assessment of possible BAT modulators by using [18F] FDG PET is shown. Further PET tracers and novel developments for BAT assessments are also described. EXPERT OPINION Further PET tracers and imaging modalities are under investigation, but the [18F] FDG PET is currently the method of choice for the evaluation of BAT and further multicentric trials are needed for a better understanding of the BAT physiopathology, also after cold stimuli. The modulation of BAT activity, assessed by [18F] FDG PET imaging, seems a promising tool for the management of conditions such as obesity and type 2 diabetes. Moreover, an interesting possible correlation of BAT activation with prognostic [18F] FDG PET indices in cancer patients should be assessed with further multicentric trials.
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Affiliation(s)
- Maria Ricci
- Nuclear Medicine Unit, Cardarelli Hospital, Campobasso, Italy
| | - Maria Silvia De Feo
- Department of Radiological Sciences Oncology and Anatomo-Pathology, Sapienza University of Rome, Rome, Italy
| | - Giorgia Maria Granese
- Department of Radiological Sciences Oncology and Anatomo-Pathology, Sapienza University of Rome, Rome, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences Oncology and Anatomo-Pathology, Sapienza University of Rome, Rome, Italy
| | | | - Ennio Lubrano
- Dipartimento di Medicina e Scienze della Salute, Università degli Studi del Molise, Italy
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Andrea Cimini
- Nuclear Medicine Unit, St. Salvatore Hospital, L'Aquila, Italy
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Owaki Y, Minamishima K, Nakajima K. Optimization of pediatric FDG-PET/CT examinations based on physical indicators using the SiPM-PET/CT system. Nucl Med Commun 2022. [PMID: 35045549 DOI: 10.1097/MNM.0000000000001527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the appropriate Silicon photomultiplier -PET/CT acquisition and image reconstruction conditions for each age group. METHODS The original phantom was developed to reflect the thickness and width of the torso in each age group (neonates, 1-year-olds, 5-year-olds, 10-year-olds, 15-year-olds, and adults). The ratio of hot spheres to background radioactivity was 4:1, and the radioactivity concentration was adjusted according to the Japanese consensus guidelines for appropriate implementation of pediatric nuclear medicine examinations. We evaluated the root mean square error (RMSE) as an assessment/function of the standardized uptake value of each hot sphere, the background variability (N10 mm), the % contrast of the hot sphere (QH, 10 mm/N10 mm), and the noise equivalent counts to determine the optimal reconstruction parameters and the appropriate acquisition time. RESULTS The minimum RMSE was obtained by setting the half-width of the Gaussian filter to 0-2 mm for iteration 1 or 2 and to 2-4 mm for iteration 3 or more. The acquisition times that satisfied the image quality equivalent to 120 s acquisitions in the adult phantoms were 30 s in the neonatal and 1-year-old phantoms, 60 s in the 5- and 10-year-old phantoms, and 75 s in the 15-year-old phantoms. CONCLUSION This study demonstrated that good PET images could be obtained with short acquisition times when the examination is performed under appropriate reconstruction conditions.
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Niu N, Xing H, Wang X, Ding J, Hao Z, Ren C, Ba J, Zheng L, Fu C, Zhao H, Huo L. Comparative [ 18F]FDG and [ 18F]DPA714 PET imaging and time-dependent changes of brown adipose tissue in tumour-bearing mice. Adipocyte 2020; 9:542-549. [PMID: 32902340 PMCID: PMC7714432 DOI: 10.1080/21623945.2020.1814546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Brown adipose tissue (BAT) is important in monitoring energy homeostasis and cancer cachexia. Different from white adipose tissue, BAT is characterized by the presence of a large number of mitochondria in adipocytes. Translocator protein 18 kDa (TSPO), a critical transporter, is expressed in the outer membrane of mitochondria. We speculated that [18F]DPA714, a specific TSPO tracer, may monitor BAT activity in tumor-bearing mice in vivo. We first analyzed the radioactive uptake of positron emission tomography (PET) tracers in BAT of CT26 xenograft mice with 18F-fluorodeoxyglucose ([18F]FDG) and [18F]DPA714. We also studied the BAT uptake of [18F]DPA714 in CT26, A549 and LLC tumor models. The dynamic distribution of [18F]FDG is quite variable among animals, even in mice of the same tumor model (%ID/g-mean: mean ± SDM, 8.61 ± 8.90, n = 16). Contrarily, [18F]DPA714 produced high-quality and stable BAT imaging in different tumor models and different animals of the same model. Interestingly, %ID/g-mean of [18F]DPA714 in BAT was significantly higher on day 26 than that on day 7 in CT26 xenograft model. Taken together, these results strongly indicate the potential feasibility of [18F]DPA714 PET imaging in investigating BAT and energy metabolism during tumor progression in preclinical and clinical study.
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Affiliation(s)
- Na Niu
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Haiqun Xing
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xuezhu Wang
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jie Ding
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Zhixin Hao
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Chao Ren
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jiantao Ba
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Lianfang Zheng
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Chao Fu
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Haiyan Zhao
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Li Huo
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
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Fischer JGW, Maushart CI, Becker AS, Müller J, Madoerin P, Chirindel A, Wild D, Ter Voert EEGW, Bieri O, Burger I, Betz MJ. Comparison of [ 18F]FDG PET/CT with magnetic resonance imaging for the assessment of human brown adipose tissue activity. EJNMMI Res 2020; 10:85. [PMID: 32699996 PMCID: PMC7376767 DOI: 10.1186/s13550-020-00665-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/25/2020] [Indexed: 12/26/2022] Open
Abstract
Background Brown adipose tissue (BAT) is a thermogenic tissue which can generate heat in response to mild cold exposure. As it constitutes a promising target in the fight against obesity, we need reliable techniques to quantify its activity in response to therapeutic interventions. The current standard for the quantification of BAT activity is [18F]FDG PET/CT. Various sequences in magnetic resonance imaging (MRI), including those measuring its relative fat content (fat fraction), have been proposed and evaluated in small proof-of-principle studies, showing diverging results. Here, we systematically compare the predictive value of adipose tissue fat fraction measured by MRI to the results of [18F]FDG PET/CT. Methods We analyzed the diagnostic reliability of MRI measured fat fraction (FF) for the estimation of human BAT activity in two cohorts of healthy volunteers participating in two prospective clinical trials (NCT03189511, NCT03269747). In both cohorts, BAT activity was stimulated by mild cold exposure. In cohort 1, we performed [18F]FDG PET/MRI; in cohort 2, we used [18F]FDG PET/CT followed by MRI. Fat fraction was determined by 2-point Dixon and 6-point Dixon measurement, respectively. Fat fraction values were compared to SUVmean in the corresponding tissue depot by simple linear regression. Results In total, 33 male participants with a mean age of 23.9 years and a mean BMI of 22.8 kg/m2 were recruited. In 32 participants, active BAT was visible. On an intra-individual level, FF was significantly lower in high-SUV areas compared to low-SUV areas (cohort 1: p < 0.0001 and cohort 2: p = 0.0002). The FF of the supraclavicular adipose tissue depot was inversely related to its metabolic activity (SUVmean) in both cohorts (cohort 1: R2 = 0.18, p = 0.09 and cohort 2: R2 = 0.42, p = 0.009). Conclusion MRI FF explains only about 40% of the variation in BAT glucose uptake. Thus, it can currently not be used to substitute [18F] FDG PET-based imaging for quantification of BAT activity. Trial registration ClinicalTrials.gov. NCT03189511, registered on June 17, 2017, actual study start date was on May 31, 2017, retrospectively registered. NCT03269747, registered on September 01, 2017.
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Affiliation(s)
- Jonas Gabriel William Fischer
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland, and University of Basel, Basel, Switzerland
| | - Claudia Irene Maushart
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland, and University of Basel, Basel, Switzerland
| | - Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Julian Müller
- Department of Nuclear Medicine, University Hospital Zürich, Rämistrasse 100, Zürich, 8091, Switzerland
| | - Philipp Madoerin
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
| | - Alin Chirindel
- Division of Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Damian Wild
- Division of Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Edwin E G W Ter Voert
- Department of Nuclear Medicine, University Hospital Zürich, Rämistrasse 100, Zürich, 8091, Switzerland
| | - Oliver Bieri
- Department of Radiology, University Hospital of Basel and University of Basel, Basel, Switzerland
| | - Irene Burger
- Department of Nuclear Medicine, University Hospital Zürich, Rämistrasse 100, Zürich, 8091, Switzerland
| | - Matthias Johannes Betz
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland, and University of Basel, Basel, Switzerland.
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