Comparison of MRI, PSMA PET/CT, and Fusion PSMA PET/MRI for Detection of Clinically Significant Prostate Cancer.
MRI、PSMA PET/CT和融合PSMA PET/MRI检测临床显著前列腺癌的比较。
- 作者列表："Arslan A","Karaarslan E","Güner AL","Sağlıcan Y","Tuna MB","Özışık O","Kural AR
PURPOSE:The aim of our study is to compare the efficacy of positron emission tomography (PET) and magnetic resonance imaging (MRI) for detecting intraprostatic lesions in patients with clinically significant prostate cancer who underwent radical prostatectomy; additionally, investigate the benefits of rostate-specific membrane antigen (PSMA) PET-MR software fusion images to the diagnosis. METHODS:Thirty patients, who underwent radical prostatectomy between June 2015 and April 2018, were included in the study. Subjects with gallium PSMA PET-CT and multiparametric prostate MRI performed according to Prostate Imaging Reporting and Data System v2 criteria in our clinic were included in the study. 68Ga-PSMA PET-CT images were fused with MR sequences for analysis. RESULTS:The mean age of cases was 63.2 years (ranged from 45 to 79 years). Index lesions of 29 cases were detected by MRI and 22 of them by PET CT. Both modalities were found to be less sensitive for detection of bilaterality and multifocality (42.85% and 20% for MRI, 28.57% and 20% for PET CT, respectively). There was no statistically significant difference between modalities. It was observed that if a clinically significant tumor focus was not detected by MRI, it was small (6 mm or less) in diameter or had a low Gleason score. CONCLUSIONS:Software fusion PSMA PET-MRI increased the sensitivity of the index lesion identification compared with PSMA PET-CT and also increased the sensitivity of real lesion size identification compared with multiparametric prostate MRI.
目的: 本研究的目的是比较正电子发射断层扫描 (PET) 和磁共振成像 (MRI) 对接受根治性前列腺切除术的临床显著前列腺癌患者前列腺内病变的检测效果; 此外，研究rostate特异性膜抗原 (PSMA) 的益处pet-mr软件融合图像进行诊断。 方法: 本研究纳入了2015年6月至2018年4月期间接受根治性前列腺切除术的30例患者。本研究包括根据我们诊所的前列腺成像报告和数据系统v2标准进行镓PSMA pet-ct和多参数前列腺MRI的受试者。68Ga-PSMA pet-ct图像与MR序列融合用于分析。 结果: 病例平均年龄63.2岁 (45 ~ 79岁)。MRI检出指标性病变29例，PET/CT检出22例。发现两种方式对检测双侧性和多焦性的敏感性较低 (MRI分别为42.85% 和20%，PET CT分别为28.57% 和20%)。两种模式之间没有统计学显著差异。观察到，如果MRI未检测到临床上显著的肿瘤病灶，则其直径较小 (6毫米或更小) 或具有低Gleason评分。 结论: 与PSMA pet-ct相比，软件融合PSMA pet-mri增加了指示病灶识别的灵敏度，并且与多参数前列腺MRI相比，增加了真实病灶大小识别的灵敏度。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.