Objective To compare the sensitivity and positive predictive value (PPV) of pinhole dual-phase Tc-99m sestamibi vs combined Tc-99m sestamibi and Tc-99m pertechnetate scintigraphy in patients with hyperparathyroidism where single-photon emission computed tomography (SPECT)/CT is unavailable. Methods All patients with biochemically proven hyperparathyroidism who underwent both pinhole Tc-99m sestamibi and Tc-99m pertechnetate scintigraphy between January 2012 and December 2017 with surgery performed within 3 months of imaging were analyzed. Tc-99m sestamibi images alone and combined with Tc-99m pertechnetate images were interpreted by two nuclear medicine physicians. The sensitivity and PPV of the two imaging approaches were determined based on the surgical findings. Results Of the 38 patients included, surgery revealed 33 single parathyroid adenomas (PA), one double adenoma and four parathyroid hyperplasia (PH). On a per-patient basis, the sensitivity and PPV for detection of PA or PH were 76% and 100%, respectively, with Tc-99m sestamibi alone vs 84% and 100% using the combined approach. For PA, the sensitivity and PPV were 82% and 100%, respectively, with Tc-99m sestamibi alone vs. 91% and 100% with the combined approach. PH was identified in only one of four patients with Tc-99m sestamibi alone or in combination. There were no significant differences in sensitivity (P = 0.08) and PPV (P > 0.99) between Tc-99m sestamibi alone and Tc-99m sestamibi with Tc-99m pertechnetate. Conclusion Pinhole dual-phase Tc-99m sestamibi alone has high accuracy in the detection of PA. The routine addition of Tc-99m pertechnetate to Tc-99m sestamibi does not result in significant improvement in the detection of PA or PH and should be reserved for equivocal cases.
e24036 Background: In the US, it is projected that more than 22 million people will be living with cancer by 2030. As survivorship increases, there is a need for simple, convenient tools to quantify patient quality of life and encourage healthy behaviors. To fill this gap, a new psychometric tool named the SMILE Scale was created. The SMILE Scale is a brief self-administered questionnaire assessing the frequency of behaviors intended to improve wellness in five domains: Sleep, physical activity (Move), stress management (Inhale and Exhale), social interactions (Love and connect), and nutrition (Eat to nourish). In this study, we aimed to determine the feasibility of collecting daily self-reported SMILE Scale data and weekly quality of life data, via electronic surveys in patients with cancer. We also aimed to measure the association between SMILE Scale responses and validated health-related quality of life (HRQOL) tools (PROMIS-29+2 and SymTrak-8) as a pilot test of the hypothesis that increased wellness behaviors may impact quality of life. Methods: We surveyed 100 patients with cancer at the IU Simon Comprehensive Cancer Center. Participants were asked to complete daily SMILE Scale assessments over a two-week period, as well as weekly PROMIS-29+2 and SymTrak-8 surveys. The primary endpoint was the SMILE Scale completion rate. Secondary endpoints in this single-arm pilot study included correlations between SMILE Scale results and the other HRQOL tools. Results: Daily completion rate of the SMILE Scale ranged from 57% to 65% of participants over a 14-day period. Among the 61% of participants who completed SMILE on day 1, 87% completed SMILE on 10 of 14 days. Further, 77% completed SMILE at least 1 of the 14 days. By end of study, participants who self-reported more wellness behaviors (i.e., higher daily SMILE scores) demonstrated significantly higher PROMIS physical health (p = .003), higher PROMIS mental health (p = .008), and lower (better) SymTrak total symptom burden (p = .006). Further, among those who completed at least 1 of 14 daily SMILE assessments, quality of life significantly improved over the two-week period for PROMIS mental health (p = .018) and SymTrak total symptom burden (p = .014). Conclusions: The SMILE Scale completion rate on any given day did not satisfy our pre-planned ≥70% threshold for feasibility; however, the rate for completing SMILE at least once during the 14 days (77%) met this threshold. There is growing recognition that interventions with modest uptake may benefit interested patients. The SMILE completion rate across 14 days among those who completed at least one day indicates benefit for providing a daily or on-demand option for those interested. Further, significant correlative results between SMILE scores and secondary QOL endpoints suggest a potential benefit for delivering SMILE in clinical practice and warrants testing the SMILE Scale’s causal impact in a future randomized trial.
Figure 1. a. Early filling of dilated mesenteric veins (bottom arrow) with adjacent bowel wall edema due to venous congestion (top arrow) b & c. inferior mesenteric artery (arrows) adjacent to illdefined area of contrast (dashed arrow) thought to represent arterio-venous fistula d. view from sigmoidoscopy showing ischemic colitis in the sigmoid colon.
e23010 Background: Gender inequalities in medicine are ongoing challenges facing health care providers in different fields. Gender bias in medicine is gaining more attention, raising the awareness of this important topic. Per ASCO 2022 snapshot, females represent 35.8% of total oncologists in the United States. This study aims to spot the light on female representation in ASCO abstracts authors and presidents, adding to the continuous efforts aiming to achieve gender equity in the oncology practice. Methods: Data from the ASCO database and conference materials was gathered for analysis in the different categories. These categories included presidents of ASCO since it was founded in 1964 through 2022, and first authors in abstracts accepted over the past 5 years (2018-2022). Statistical analyses on first authors data were conducted, and a P-value of < 0.001 was deemed to be statistically significant. Results: In the 58-year period (1964-2022), ASCO had 49 men (85%) and 9 women (15%) serve as presidents. 7 out of 9 total female presidents were elected in the last 20 years. In the 5 year period (2018-2022), there was a significant increase in the percentage of abstracts accepted for a female author. 37.1% of the presenters in 2018 were females, compared to 41.4% in 2022, with statistically significant results (P value < 0.001), detailed percentages are shown in tables. Conclusions: Gender gap in the field of oncology goes beyond pay differences to include leadership positions and research authorship. But as shown by our analysis, there has been an increase in representation of females in ASCO abstracts authorship and leadership over the past years. Nonetheless, further work is needed to identify factors contributing to lower representation of women in oncology, and suggested solutions. [Table: see text][Table: see text]
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