OBJECTIVE The aim of this study was to analyze the early radiological response of melanoma brain metastases to single high-dose irradiation and to reveal possible correlations between tumor radioresponsiveness and patient clinical outcomes. METHODS The authors performed a retrospective analysis of the medical data for all patients with melanoma brain metastases who had undergone Gamma Knife radiosurgery (GKRS) and follow-up MRI examinations with standard protocols at regular 2- to 3-month intervals. Volumetric measurements of the metastases on pretreatment and initial posttreatment images were performed to assess the rate of early radiological response. Patients were divided into 2 groups according to the rate of response, and overall survival, local control, and the appearance of new metastases in the brain were compared in these groups using the long-rank test. Univariate and multivariate analyses were performed to identify predictors of clinical outcomes. RESULTS After retrospective analysis of 298 melanoma brain metastases in 78 patients, the authors determined that early radiological responses of these metastases to GKRS differ considerably and can be divided into 2 distinct groups. One group of tumors underwent rapid shrinkage after radiosurgery, whereas the other showed minor fluctuations in size (rapid- and slow-response groups, respectively). Median survival for patients with a slow response was 15.2 months compared with 6.3 months for those with a rapid response (p < 0.0001). In the multivariate analysis, improved overall survival was associated with a slow response to radiosurgery (p < 0.0001), stable systemic disease (p = 0.001), and a higher Karnofsky Performance Scale score (p = 0.001). Stratification by Recursive Partitioning Analysis, score index for radiosurgery, and diagnosis-specific Graded Prognostic Assessment classes further confirmed the difference in overall survival for patients with a slow versus rapid radiation response. Local recurrence was observed in 11% of patients with a rapid response and in 6% of patients with a slow response, at a median of more than 8 months after radiosurgery. New brain metastases were diagnosed in 67% of patients with a slow response at a median of 8.6 months after radiosurgery and in 82% of patients with a rapid response at a considerably earlier median time of 2.7 months. In the multivariate analysis, a longer time to the development of new brain metastases was associated with a slow response (p = 0.012), stable systemic disease (p = 0.034), and a single brain metastasis (p = 0.030). CONCLUSIONS Melanoma brain metastases show different early radioresponsiveness to radiosurgery. Rapid shrinkage of brain metastases is associated with poor patient prognosis, which may indicate more aggressive biological behavior of this tumor phenotype.
One hepatobiliary sequence had the highest contrast-to-noise ratio with a value of 41 (vs other sequences range of 3.2-28.1. Lesion measurements on all sequences showed high-interobserver agreement, with hepatobiliary sequences showing some of the highest levels of agreement.Our results support the use of contrast agents with hepatobiliary excretion when imaging neuroendocrine tumors metastatic to liver.
Lower level of albumin, higher level of alpha-fetoprotein, and larger tumor on preoperative imaging were independently associated with MVI AbstractText: This largest Western series to evaluate the utility of preoperative inflammatory markers in patients with HCC found that only PLR was associated with RFS and OS and that albumin ...
Hepatocellular Carcinoma (2), Neoplasms (2), Cirrhosis (1), more mentions
We therefore assessed the prevalence of positive computed tomography (CT) images and lung cancers in PLWHIV AbstractText: The Copenhagen comorbidity in HIV infection (COCOMO) study is an observational, longitudinal cohort study. Single-round LDCT was performed with subsequent clinical follow-up (NCT02382822) AbstractText: Outcomes included histology-proven lung cancer identified by LDCT and positive CT images (noncalcified nodules) in the ...
Oncology (5) Lung Neoplasms (5), HIV Infections (1), more mentions
BACKGROUND/AIMS: The diagnostic efficacy of magnifying blue laser imaging (M-BLI) and M-BLI in bright mode (M-BLI-bright) in the identification of early gastric cancer (EGC) was evaluated for comparison to that of magnifying narrow-band imaging (M-NBI).
METHODS: This prospective, multicenter study evaluated 114 gastric lesions examined using M-BLI, M-BLI-bright, and M-NBI between May 2012 and November 2012; 104 EGCs were evaluated by each modality. The vessel plus surface classification system was used to evaluate the demarcation line (DL), microvascular pattern (MVP), and microsurface pattern (MSP).
RESULTS: M-BLI, M-BLI-bright, and M-NBI revealed a DL for 96.1, 98.1, and 98.1% and irregular MVP for 95.1, 95.1, and 96.2% of lesions, respectively, with no significant difference. Irregular MSP was observed by M-BLI, M-BLI-bright, and M-NBI in 97.1, 90.4, and 78.8% of lesions, respectively, with significant differences (p < 0.001). The proportion of moderately differentiated adenocarcinoma with irregular MSP on M-BLI and absent MSP on M-NBI was significantly higher than that with irregular MSP on M-BLI and M-NBI (35.0 and 9.9%, respectively; p = 0.002).
CONCLUSION: M-BLI and M-BLI-bright provided excellent visualization of microstructures and microvessels similar to M-NBI. Irregular MSP in a moderately differentiated adenocarcinoma might be frequently visualized using M-BLI and M-BLI-bright compared with using M-NBI.
Oncology (3) Stomach Neoplasms (3), Adenocarcinoma (2), more mentions
OBJECTIVE: To analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study.
DESIGN: A total of 1077 participants (521 men, mean age 55.8±12.8 years) of 2333 participants from the population-based Study of Health in Pomerania (SHIP) underwent magnetic resonance cholangiopancreaticography (MRCP) at baseline (2008-2012). MRCP was analysed for pancreatic cysts with a diameter ≥2 mm. 676/1077 subjects received a 5-year follow-up (2014-2016). The prevalence and incidence of pancreatic cysts (weighted for study participation) were assessed in association to age, gender and suspected epidemiological risk factors. Mortality follow-up was performed in 2015 for all SHIP participants (mean follow-up period 5.9 years, range 3.2-7.5 years).
RESULTS: At baseline pancreatic cysts had a weighted prevalence of 49.1%, with an average number of 3.9 (95% CI 3.2 to 4.5) cysts per subject in the subgroup harbouring cysts. Cyst size ranged from 2 to 29 mm. Prevalence (p<0.001), number (p=0.001) and maximum size (p<0.001) increased significantly with age. The 5-year follow-up revealed a weighted incidence of 12.9% newly detected pancreatic cysts. 57.1% of the subjects initially harbouring pancreatic cysts showed an increase in number and/or maximum cyst size. Of all subjects undergoing MRCP, no participant died of pancreatic diseases within mortality follow-up.
CONCLUSION: The prevalence of pancreatic cysts in the general population is unexpectedly high, and their number and size increase with age. Overall, no pancreatic cancer was observed in this collective during a 5-year follow-up. Nevertheless, prospective follow-up imaging showed minimal progress in more than 50%. Only about 6% of cysts and 2.5% of the study group initially presented with cysts of more than 1 cm and thus might be clinically meaningful.
PURPOSE: To describe anatomic sites of recurrence among prostate cancer patients with biochemical recurrence following radical prostatectomy (RP) and postoperative radiotherapy (RT) and/or androgen deprivation therapy (ADT) using (11)C-Choline PET/CT and multiparametric-MRI.
MATERIALS AND METHODS: RP patients evaluated with (11)C-Choline PET/CT and multiparametric-MRI following RT and/or ADT were evaluated for patterns of recurrence and clinicopathologic features. Recurrent sites were described as either local-only (seminal vesicle bed/prostate fossa, vesicourethral anastomosis and bladder neck) or distant metastatic disease. Features associated with identification of any distant metastatic disease were evaluated using multivariable logistic regression.
RESULTS: A total of 550 patients were identified. Treatment included 108 with ADT, 201 with RT, and 241 with both. Median PSA at evaluation was 3.9, 3.6, and 2.8 ng/mL for patients treated with ADT, RT, or a combination, respectively. 77 patients (14%) recurred locally, 411 (75%) recurred with distant metastasis only, and 62 (11%) recurred with both local and distant metastatic disease. On multivariable analysis, treatment with radiotherapy (OR 7.18; 95%CI 2.92-17.65; p<0.01) and radiotherapy and hormonal therapy (OR 9.23; 95%CI 3.90-21.87; p<0.01) were associated with an increased odds of distant failure at evaluation.
CONCLUSIONS: The combination of (11)C-choline PET/CT and multiparametric-MRI successfully identified patterns of recurrence following postoperative RT, ADT, or both, at median PSA less than 4. Half of this cohort had local only recurrence and/or low disease burden limited to pelvic lymph nodes and may benefit from additional local therapy. This data and analysis may facilitate the evaluation of such patients with biochemically recurrent prostate cancer.
... a significant association between location and adherence to follow-up (χ(2) = 22.75, p < 0.001) with patients using the mobile unit less likely to return for additional imaging (cancer center = 2.65%, mobile unit = 17.03%) AbstractText: Significant differences were found among patients visiting the cancer center versus the mobile mammography van.