Purpose We sought to investigate the performance of radiomics analysis on baseline 18F-FDG PET/CT for predicting response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL). Material and methods Forty-five patients who received first-line rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy for DLBCL were included in the study. Radiomics features and standard uptake value (SUV)-based measurements were extracted from baseline PET images for a total of 147 lesions. The selection of the most relevant features was made using the recursive feature elimination algorithm. A machine-learning model was trained using the logistic regression classifier with cross-validation to predict treatment response. The independent predictors of incomplete response were evaluated with multivariable regression analysis. Results A total of 14 textural features were selected by the recursive elimination algorithm, achieving a feature-to-lesion ratio of 1:10. The accuracy and area under the receiver operating characteristic curve of the model for predicting incomplete response were 0.87 and 0.81, respectively. Multivariable analysis revealed that SUVmax and gray level co-occurrence matrix dissimilarity were independent predictors of lesions with incomplete response to first-line R-CHOP chemotherapy. Conclusion Increased textural heterogeneity in baseline PET images was found to be associated with incomplete response in DLBCL.
Despite dissimilarities between hand and foot, acral skin drainage to interval SLNs is high enough to obligate a thorough interval SLN exploration in acral primaries.
The pathogenesis of reflex sympathetic dystrophy (RSD) is not completely understood. However, an excessive regional inflammation, sensitization of primary somatosensory afferents, and sensitization of spinal neurons are considered to have a role in the pathogenesis of RSD. The underlying pathophysiology relating the clinical picture may help to determine the pharmacotherapeutic approach for an individual patient. Scintigraphy using radiolabelled human polyclonal non-specific immunoglobulin (HIG) has been recognized as a useful tool for the localization of inflammatory disorders. Thirty-six consecutive RSD patients associated with hemiplegia were included in this study. All the patients in this study had three phases bone scan and Tc-99m HIG scintigraphy. On admission, of 36 patients with positive bone scan, 30 had positive Tc-99m HIG scan. All the patients were symptomatic at the time of bone scanning. On the contrary, 24 out of 36 patients subsequently became asymptomatic at an 8-month re-evaluation period. Tc-99m HIG scintigraphy is a non-invasive complementary method for the determination of ongoing inflammatory reactions which also aids the clinicians to predict the response to anti-inflammatory therapy at the very early phase of RSD associated with hemiplegia. This preliminary study may be a source of inspiration for further studies with larger series and longer follow-up .
Objectives:The aim of our retrospective study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) to three phase bone scintigraphy/SPECT for the assessment of osteomyelitis (OM) and patient’s management.Methods:Eighty-five patients who were suspected as having OM were included in this study. Tc-99m MDP three phase bone scintigraphy and SPECT/CT were performed to the region of suspected OM. SPECT/CT findings were compared with the findings of planar images/SPECT. Both planar bone scan/SPECT and SPECT/CT findings were divided into two groups: With OM and without OM. In all patients, scintigraphic diagnosis was confirmed by clinical follow up, laboratory findings, microscopic-bacteriological examinations, radiological, surgical, and pathological findings.Results:SPECT/CT changed the diagnosis and treatment planning in 14/85 (16.5%) patients. SPECT/CT was significantly superior to planar scan/SPECT imaging for determining OM (kappa value was 0.626 for planar scan/SPECT, 0.929 for SPECT/CT). SPECT/CT was statistically more successful in detection of chronic OM, and useful in differentiating chronic OM from acute OM (kappa value was 0.541 for planar scan/SPECT, 0.944 for SPECT/CT).Conclusion:SPECT/CT increases accuracy of the diagnosis in the evaluation of OM when it is compared to three phase bone scintigraphy/SPECT. SPECT/CT can change the diagnosis and management of the patients.
Effects of the electromagnetic fields on living bodies, bones in particular, are among the relevant issues of contemporary life. In this study, we report the influences of 50 Hz and 0 Hz (static) electric fields (EF), on intact rat bones, as evaluated by dual energy X-ray absorbtion (DEXA) measurements on bone content and density when these animals (n = 27) are continuously exposed in utero and neonatally to EFs (10 kV/m) 14 days before and 14 days after their birth, for 28 days in total. Differences between 50 Hz EF and static EF groups are found to be significant (95% confidence level) for total bone mineral content (BMC), TBMC (P = .002). Differences between 50 Hz and control groups are found to be significant for total bone mineral density (BMD), TBMD (P = .002), lumbar BMC, LBMC (P = .023), and TBMC (P = .001). Differences between static EF and control groups are found to be significant for femoral BMD, FBMD (P = .009), TBMD (P = .002), LBMC (P = .001), and TBMC (P = .001). Note that TBMC parameters are jointly significant for all differences between the three groups of test animals. These results have shown that both static and 50 Hz EFs influence the early development of rat bones. However, the influence of static EFs is more pronounced than that of the 50 Hz field.
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