Detection of internal mammary chain infiltration in breast cancer patients by [18F]FDG PET/MRI. Therapy implications

OBJECTIVE

To evaluate the detection rate and therapeutic implication of the infiltration of the internal mammary chain (IMCI) by [18F]FDG PET/MRI for staging of patients with breast cancer.

METHODS

Prospective study including 41 women with breast cancer (stage ≥ IIB) staged by [18F]FDG PET/MR. Two-phase exam: breast imaging (prone), whole-body (supine). TNM stage assessed by peer consensus with Nuclear Medicine and Radiology specialists. Study of the afferent vessel (AV) to IMC by breast MRI. IMCI was correlated with age, AV-IMC, T stage, breast quadrants, axillary and distant infiltration. Therapeutic re-evaluation by a multidisciplinary committee.

RESULTS

IMCI detection rate of 34% (14/41), with 8/14 patients under 55 years of age. All 14 patients with IMCI showed AV-IMC, 6 of them (43.9%) without VA-axillary. Of 27/41 patients without IMCI, in 13 (48.1%) only AV-axillary was found, in the remaining 14 (51.9%), AV-axillary and AV-IMC was found. In 57% (8/14) tumours were multicentric and 42% (6/14) focal, in inner quadrants in 4/6 (66.7%). In 1/14 patient (7.1%) only IMCI was found, in 9/14 (64.3%) axillary and IMC, in 4/14 patients (28.6%) distant lesions were detected. Committee re-evaluation: no further treatment in 27/41 patients (65.8%), thoracic radiotherapy in 10/41 patients (24.4%), systemic therapy in 4/41 patients (9.7%).

CONCLUSION

Our detection rate of IMCI in breast cancer staging by [18F]FDG PET/MR was 34%. Related factors were age, multicentric tumours, inner quadrants, detection of AV-IMC, NM staging. The evidence of IMCI allowed tailored therapy, with thoracic radiotherapy implementation in 24.4% of patients.

Cross section for inelastic neutron scattering from 193Ir at 6 MeV

Two samples, one of natural iridium and the other of enriched ¹⁹³Ir, were irradiated with a monoenergetic neutron beam of energy 6.0 MeV at the Triangle Universities Nuclear Laboratory. The product of the ¹⁹³Ir [Formula: see text] Ir reaction was determined by means of measuring X-rays following electron conversion of the isomeric state at 80.2 keV in ¹⁹³Ir. The cross section for inelastic neutron scattering is reported disagreeing with the literature data.

Removal of anionic (Acid Yellow 17 and Amaranth) dyes using aminated avocado (Persea americana) seed powder: adsorption/desorption, kinetics, isotherms, thermodynamics, and recycling studies

Aminated avocado seed powder (AASP)-an eco-friendly novel adsorbent has been used for the removal of Acid Yellow 17 (AY 17) and Amaranth (AMR) from an aqueous phase. The AASP (before and after adsorption) was systematically characterized by different analytical techniques such as FT-IR, FESEM, EDX, and N₂ adsorption-desorption analysis. Non-linear form of various kinetic (PFO and PSO) and isotherm (Langmuir and Freundlich) models were used to examine the adsorption behavior of AY 17 and AMR onto AASP. The adsorption of AY 17 and AMR onto AASP was well illustrated by the PSO kinetic model and Langmuir isotherm models. At 303 K, the maximum adsorption capacities (obtained from the Langmuir) of the AASP for AY 17 and AMR was 42.7 and 89.2 mg/g, respectively. The AY 17 and AMR adsorption was strongly pH-dependent with an optimum pH value of 2.0. Activation energy was calculated as 12.3 and 16.3 kJ/mol for AY 17 and AMR respectively, suggesting physical adsorption. The positive values of ΔG^o and ΔH^o indicated that the adsorption process of AY 17 and AMR onto AASP was non-spontaneous and endothermic. The negligible loss of adsorption capacity and excellent regeneration of AASP were observed for the five cycles. Statement of novelty: The present research majorly focused on the synthesis of adsorbent from Avocado seed for the removal of Acid Yellow 17 and Amaranth anionic dyes from aqueous solution. Although the literature is available on direct seed powder as adsorbent, to the best of our knowledge, no chemical modified adsorbent synthesis was not available. Hence, to fill the gap in the literature, we chose the following study that significantly enhanced the adsorption efficiency of the selected anionic dyes.

Porphyran-capped silver nanoparticles as a promising antibacterial agent and electrode modifier for 5-fluorouracil electroanalysis

In the present work, the green synthesis of silver nanoparticles (AgNPs) using the sulfated polysaccharide porphyran (PFR) as capping agent and d-glucose as reducing agent is described. PFR was extracted from red seaweed and characterized by employing ¹³C NMR and determination of total sugar, protein, and sulfate contents. The obtained AgNPs-PFR were characterized by using UV-VIS spectroscopy, zeta potential determination, FESEM, and TEM, which demonstrated that PFR was effective at capping the AgNPs, yielding stable suspensions. The AgNPs-PFR presented good antimicrobial properties against Gram-positive and Gram-negative bacterial strains (Staphylococcus aureus and Escherichia coli, respectively). The AgNPs-PFR were also employed as the modifier of carbon paste electrodes, which were efficiently applied as electrochemical sensors for the determination of 5-fluorouracil (5-FU), an important anticancer drug, through square wave voltammetry (SWV). The AgNPs-PFR improved the electrochemical properties of the electrodes, and enhanced their electroanalytical performance. The developed sensing device presented detection and quantification limits equal to 10.7 and 35.8 μmol L-1, respectively, towards 5-FU determination. The proposed electrochemical sensor successfully quantified 5-FU in a real pharmaceutical formulation, confirming its potential as a new promising analytical detection tool for 5-FU quality control purposes.

Pyrrole-2,5-dione analogs as a promising antioxidant agents: microwave-assisted synthesis, bio-evaluation, SAR analysis and DFT studies/interpretation

A new series of pyrrole analogs were developed via the microwave irradiation synthesis. Consequently, got a high yield of the products. As pyrroles are familiar for showing various biological properties, all obtained compounds were screened for their antioxidant properties, most of the compounds showing significant activity. In fact, the motifs 5e, 5g, 5h and 5m showed outstanding antioxidant properties. Further, to enlighten the biologically energetic behavior underlying the antioxidant activity, compounds DFT studies were performed. Noteworthy results have been attained and the structure activity relationship (SAR) was discussed with the support of this results. It was found that highly biological active compounds exhibited a low HOMO-LUMO energy gap (Eg) and the high Eg value compounds show very low/negligible or inactive antioxidant activities. In other cases, compounds containing high HOMO energy levels also provide high antioxidant activity. The thought-provoking point of our results is that theoretical descriptors of the HOMO-LUMO energy gap and the highest occupied molecular orbital energy are important descriptors in the bioorganic research to support the biological experiments.

Novel pyranopyrazole derivatives comprising a benzoxazole core as antimicrobial inhibitors: Design, synthesis, microbial resistance and machine aided results

From a medical point of view lot of existing antibiotics became unusable because microbial gained strong antibiotic resistance. The combination of two compounds in one core may lead to kill such type of pathogens. Herein, we developed pyranopyrazole derivatives comprising benzoxazole moiety by green approach strategy and studied their antimicrobial performance on four bacteria and two fungi. As a result, most of the compounds delivered reliable toxicity to kill the pathogens. In those,6aexhibited considerable activity against the microbial pathogens. Moreover,compounds 6d, 6l,and6nshowed prominent antibacterial activity. In addition, molecular docking studies of docked compounds revealed the strong bonding interaction with DNA-Gyrase and were docked into the intercalation location of DNA of the DNA-gyrase complex. The molecule bounded to the DNA stabilized by the H bonds, hydrophobic interactions, and π-π interaction. In addition, the linked 5-chlorobenazoxazole structure stabilized by the DT-8 and DG2009 of the F chain with pi-pi interactions. From the computer-aided results, it was observed that compound6a demonstrated maximum docking score -10.0 kcal/mole towards DNA-gyrase. Overall, this investigation suggested that these biologically active compounds can be utilized as leads for preclinical studies with the goal of developing newer antimicrobial drugs.

Standardization of acquisition protocols using PET/CT with 18F-Choline in prostate cancer

AIM

To standardize acquisition protocols for ¹⁸F-Choline PET/CT to prevent from urine interference, to determine the best time point for the whole-body study, and to assess whether "dual point" acquisition allows for differentiating malignant vs. benign lesions.

METHODS

One hundred consecutive patients with prostate cancer were prospectively studied. Immediately after ¹⁸F-Choline injection, a pelvis study was acquired, and a whole-body was subsequently obtained 1 and 2 hours p.i. Mean SUVmax was obtained in regions and for every sequential imaging. Mean analysis (χ²) and SUV percentage change (2/1 hours; 1 hours/0 min) were obtained. Metabolic pattern dynamics were assessed: accumulative vs. clearance. Patient follow-up after therapy and directed classification whenever ethically possible were performed.

RESULTS

Fifty-three prostate foci, without disturbing urinary activity was ever found on early images. Accumulative pattern in 42, with percentage increase was: 0 min/1 hour: +16.7% (χ²0.94); 1/2 hours: +10,0% (χ² 0.83). Clearance pattern in 11, with percentage decrease: 0 min/1 hour: -21.4% (χ²0.91): -7.7% (χ²0.85), corresponding in 7 to initial staging and in 4 post-radiotherapy biochemical recurrence. Every infradiaphragmatic uptake (n: 24) showed accumulative pattern, with percentage increase of +9.1% (χ²0.97), all of them depicted on early imaging. As for 12 supradiaphragmantic uptake, 8 of them showed clearance pattern with percentage decrease: -13.0% (χ²0.95). Accumulative pattern showed in 4 of them with percentage increase +13.0% (χ² 0.96), thus being assessed as invasive/malignant. Every bone uptake (n: 18) showed accumulative pattern, with percentage increase: +17.1% (χ²0.95), all of them depicted on 1 hour imaging.

CONCLUSIONS

As for prostate assessment is concerned, dual point at 0 min/1 hour proved to be the best procedure. As for supradiaphragmatic lymph-nodes detection, dual point with 1/2 hours performed best. As for infradiaphragmatic and bone involvement, as well as for inconclusive findings, the 2 hour imaging increased our diagnostic confidence.

Assessment of the extension of pressure ulcers into soft tissue and osteomyelitis diagnosis using 18F-FDG PET/CT

The precise assessment of pressure ulcer extension in patients with neurological diseases has crucial therapeutic implications, especially in the early detection of fistula to interior structures and osteomyelitis. Two case reports are presented on patients with a similar ischial ulcer, in whom an ¹⁸F-FDG PET/CT study enabled a precise assessment of infectious complications in underlying tissues. These cases support the implementation of ¹⁸F-FDG PET/CT as a first-line technique in their management.

18F-FDG PET/CT in follow-up evaluation in pediatric patients with Langerhans histiocytosis

PURPOSE

We evaluated the impact of ¹⁸F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH).

METHOD

During 2007-2013, 13 ¹⁸F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques.

RESULTS

PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of ¹⁸F-FDG bone uptake at 17 and 19 months.

CONCLUSION

In our preliminar study, ¹⁸F-FDG PET is a useful imaging procedure, along with other diagnostic tools, for identification of active lesions.

18F-FDG PET/CT in the Staging and Management of Breast Cancer: Value in Disease Outcome and Planning Therapy

In hormone receptor-positive locally advanced breast cancer, endocrine therapy becomes an integral part of the therapeutic strategy. There are now significant numbers of available hormonal directed compounds, including selective aromatase and mTOR inhibitors, which allow an important therapeutic advance in these patients. Sequential F-FDG PET/CT studies provided essential information regarding response to different treatments, including targeted therapies, and adverse therapeutic effects that helped to better define the right moment to implement each therapeutic approach.

The value of 11C-methionine PET in the early differentiation between tumour recurrence and radionecrosis in patients treated for a high-grade glioma and indeterminate MRI

OBJECTIVE

To evaluate the contribution of ¹¹C-Methionine PET in the early differentiation between tumour recurrence and radionecrosis in patients treated for a high grade glioma.

METHOD

The study included 30 patients with glioma (III/IV grade) treated with surgery/radiotherapy/chemotherapy (5-8 months) and with an indeterminate MRI. All patients underwent a ¹¹C-Methione PET (within 15 days of MRI) and studies were visually analysed (intensity and morphology of uptake), quantified (SUV max/SUV mean background), and coregistered to MRI (3D-Flair). Patient management was decided by the neuro-oncology committee to clinical and imaging follow-up, second-line treatment, or surgery.

RESULTS

There were 23 ¹¹C-Methionine PET studies visually positive. Morphology of uptake was focal in 15, diffuse in 4, and ring-shaped in 4. Three out of the focal uptake cases underwent resection (Histopathology +). Sixteen underwent second-line therapy (11 responded; 5 progressed). The 4 cases with ring-shaped uptake were followed-up, and progression was found in 2 (true-positive), and disease-free in 2 (follow-up of 6 and 7 months, respectively) (false-positive). Seven out of ¹¹C-Methionine studies PET were visually negative, and all of them were disease-free (follow-up of 3-12 months). SUV lesion/background was 2.79±1.35 in tumour recurrence, and 1.53±0.39 in radionecrosis (P<.05). Taking into account a SUV lesion/background threshold of 2.35, the sensitivity and specificity values were 90.5% and 100%, respectively.

CONCLUSION

Visual analysis, quantitative and PET/MRI coregistration of ¹¹C-Methionine PET showed their complementary role in patients with indeterminate MRI results, thus allowing early differentiation between tumour recurrence and radionecrosis, and helping in the individual therapy approach.

Synthesis, antimicrobial activity and advances in structure-activity relationships (SARs) of novel tri-substituted thiazole derivatives

Trisubstituted thiazoles were synthesized and studied for their antimicrobial activity and supported by theoretical calculations. In addition, MIC, MBC and MFC were also tested. Moreover, the present study was analyzed to scrutinize comprehensive structure-activity relationships. In fact, LUMO orbital energy and orbital orientation was reliable to explain their antibacterial and antifungal assay. Amongst the tested compounds, tri-methyl-substituted thiazole compound showed higher antimicrobial activity and low MIC value due to highest LUMO energy.

Peritoneal Cancer Index by (18)F-FDG PET/TC pre and post-hyperthermic intraperitoneal chemotherapy. Report of a case

Radical cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy increases survival in patients with end-stage peritoneal carcinomatosis, and who are under palliative therapy. The Peritoneal Cancer Index enables the tumor burden to be quantified during surgery, as well as treatment planning and patient prognosis. It is obtained by combining the tumor spread in 13 abdominal and pelvic regions with the largest tumor size. Fluorodeoxyglucose positron emission tomography/computed tomography is the technique of choice for those patients selected to undergo radical cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy, due to its higher detection rate of carcinomatosis, and since it allows extra-peritoneal disease staging. The simplified Peritoneal Cancer Index (9 regions defined by 2 transverse and 2 sagittal planes) obtained by fluorodeoxyglucose positron emission tomography/computed tomography allows correlation with the surgical procedure, therefore its standardization is advisable.

11C-Choline PET/CT in the primary diagnosis of prostate cancer: impact on treatment planning

AIM

Aim of the present study was to evaluate the usefulness of 11C-choline PET/CT for detecting lymphatic or haematogenous spread and for planning radiotherapy in patients with medium-to-high risk prostate cancer.

METHODS

We have included 61 consecutive patients recently diagnosed with cancer prostate by biopsy. All patients were classified as medium-to-high risk: Gleason: 7-9; PSA: 6.3-30.4 ng/mL; stage T2c (N.=20) or stage T3 (N.=41). Image acquisition began 5 min after intravenous injection of 11C-choline (656+119 MBq), starting at the pelvis and continuing craniocaudally. Images were interpreted visually to evaluate uptake by the prostate gland. Lymph nodes with 11C-choline uptake were considered invaded, regardless of their size. Bone lesions were considered positive when they showed greater focal uptake than the surrounding bone. In patients with evidence of lymph-node invasion or bone metastases (15 patients), disease was classified as locoregional, oligometastatic, or multimetastatic.

RESULTS

All patients had prostate gland uptake (20 focal, 8 bifocal, and 33 multifocal). Extraprostatic disease was present in 15 patients (24.6%), as follows: 9 (60%) in a single location: in an infradiaphragmatic lymph node (N.=6), in a supradiaphragmatic lymph node (N.=1), and in bone (M1) (N.=2). Six (40%) as multifocal invasion: with both infra- and supradiaphragmatic lymph node involvement (N.=2); with infradiaphragmatic lymph node involvement and M1 bone metastases (N.=3); and infra- and supradiaphragmatic lymph node involvement plus M1 bone metastases (N.=1). Disease was classified as locoregional (N.=6), oligometastatic (N.=5), and multimetastatic (N.=4). The 11 (73.3%) patients with locoregional and oligometastatic disease were selected to undergo intensity-modulated radiation therapy with dose escalation based on the PET findings.

CONCLUSION

Our results suggest that 11C-choline PET/CT is a useful one-stop diagnostic procedure for evaluating patients with medium/high risk prostate cancer scheduled for radical treatment. 11C-choline PET/CT can reliably rule out lymph node involvement and remote metastases, allowing to select candidates for radiotherapy and to plan their treatment.

[Diagnostic performance of bone scintigraphy and (11)C-Choline PET/CT in the detection of bone metastases in patients with biochemical recurrence of prostate cancer]

AIM

To compare bone scan (BS) with (11)C-Choline PET/CT for the detection of bone metastases in patients with biochemical recurrence of prostate cancer (PC).

MATERIAL AND METHODS

A total of 169 patients with biochemical recurrence of PC(PSA:2.4-58 ng/ml) who were referred for both exams (0-15 days-in-between) were included. Lesion-detection-rate per patients and lesions were analyzed for both BS and (11)C-Choline PET/CT. Metastasis diagnosis was reached by: biopsy, CT/(18)F-Fluoride PET/MRI confirmation, or evidence of progression in subsequent imaging procedures.

RESULTS

A total of 91 lesions were found to be active in BS and/or (11)C-choline PET/CT (40 patients), with 78 of which were metastatic. BS detected 38 blastic, 2 lytic and 10 non-CT-evident lesions. (11)C-Choline PET/CT detected 41 blastic, 4 lytic and 29 non-CT-evident lesions. BS and (11)C-Choline PET/CT sensitivities were 65.4% and 96.1%; specificities ere 38.5 and 92.3% (χ(2) 8.27, p<0.04). Both imaging techniques were negative in 118 patients. Tracer avid lesions were found in 51 patients: with 30/51 being BS and (11)C-Choline PET/CT concordant; in 21/51 patients had discordant lesions (kappa 0.712, p=0.00). Lesions were absolutely discordant in 10/19 patients,: 5 FN BS, 2 FP BS (degenerative changes; dysplasia), 1 FN (11)C-Choline PET/CT (blastic), 1 FP (11)C-Choline PET/CT (degenerative), 1 out of field-of-view lesion with (11)C-Choline PET/CT (tibia alone). (11)C-Choline PET/CT showed extraosseous involvement in 26/51 patients with bone metastases: 9 local recurrences, 5 infra-diaphragmatic-lymph-nodes, 2 supra-diaphragmatic, 5 local and infra-diaphragmatic, 4 infra- and supra-diaphragmatic, 1 supra-diaphragmatic and lung metastases.

CONCLUSION

(11)C-Choline PET/CT yielded better sensitivity and specificity than BS for the detection of bone involvement in patients with biochemical recurrence of PC and allowed extraosseous restaging, with an impact in the clinical management of these patients.

Partner associations across sympatric broad-headed bug species and their environmentally acquired bacterial symbionts

Many organisms have intimate associations with beneficial microbes acquired from the environment. These host-symbiont associations can be specific and stable, but they are prone to lower partner specificity and more partner-switching than vertically transmitted mutualisms. To investigate partner specificity in an environmentally acquired insect symbiosis, we used 16S rRNA gene and multilocus sequencing to survey the bacterial population in the bacteria-harbouring organ (crypts) of 49 individuals across four sympatric broad-headed bug species (Alydus calcaratus, A. conspersus, A. tomentosus and Megalotomus quinquespinosus). Similar to other insect-bacteria associations, Burkholderia spp. were the most common residents of the crypts in all four insect species (77.2% of recovered sequences). Burkholderia presence was associated with prolonged survival to adulthood in A. tomentosus, suggesting a beneficial role of these specialized associations. Burkholderia were also found in environmental reservoirs in the insects' habitat, which may facilitate acquisition by insects by increasing Burkholderia-insect encounters. Symbiont establishment could also be facilitated by resistance to insect defences; zone of inhibition assays demonstrated that Burkholderia and other bacteria isolated from crypts are resistant to insect defences that limit growth of Escherichia coli. Alternatively, the insects' defences may not efficiently kill a broad range of bacteria. Although the symbiosis is targeted to Burkholderia, the insects' crypts housed other bacteria, including non-Burkholderiaceae species. There is no significant effect of host insect species on Burkholderia distribution, suggesting a lack of strong partner specificity at finer scales. The presence of frequent partner-switching between sympatric insects and their symbionts likely prevents tight co-evolutionary dynamics.