During the last decade, growing efforts have focused on human papillomavirus (HPV) detection using liquid hybridization, conventional PCR, and real-time PCR-based methods to increase the overall proportion of patients participating in cervical cancer screening procedures. We proposed a new general HPV DNA real-time PCR on the Mx4000 (Stratagene) and LightCycler (Roche Diagnostics) systems usable for both cervical scrape specimens and urine samples. A linear range was obtained from 5 DNA copies to 8 log 10 DNA copies/ml, and intra-and interassay variations were between 1.8 and 4%. Cervical carcinoma and HPV DNA screening was performed in 333 individual women referred for gynecological examination at the university hospitals of Angers and Brest and enrolled in the PapU study. Among cervical specimens (n ‫؍‬ 333), 45% were positive for HPV DNA, with a mean viral load at 5.00 log/ml (؎ 1.73). Among urine samples (n ‫؍‬ 177), 37% were positive with a significant 50-fold-lower mean viral load (3.77 ؎ 1.32 log/ml; P < 0.0001). Kappa agreement for HPV DNA between cervical and urine specimens was excellent (93%). Thus, we developed a highly sensitive and quantitative general HPV DNA real-time PCR method that allows mass screening of patients with HPV infection. The ongoing longitudinal and prospective multicenter PapU study should give us the opportunity to validate this method adapted to HPV DNA screening in urine samples in a larger population.Human papillomaviruses (HPVs) are epitheliotropic viruses associated with benign and malignant lesions of cutaneous and mucosal epithelia. More than 100 different types of HPV have been identified to date, of which 40 have been reported in anogenital infections. In a recent multicenter analysis involving 1,918 women in 11 case-control studies (14), 15 HPV genotypes (HPV types 16,18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) were classified as high risk (HR-HPV) and associated with precancerous lesions of the cervix, 3 were classified as probable HR-HPV (types 26, 53, and 66), and 12 were classified as low risk (LR), i.e., not associated with the development of cervical carcinoma (types 6,11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108). Because of the strong association between HPV infection and cervical cancer, detection of HPV DNA in cervical samples may be an option for identifying women at risk of developing cancer (13). However, cervical sampling is uncomfortable, time-consuming, and requires a degree of skill. Self-collected cervical sampling was not found to be as efficient as sampling done by a physician (19). Therefore, about 40% of the women in France presenting a cervical carcinoma have never been screened. Moreover, it would be easier to use urine specimens as is done with molecular detection of Chlamydia trachomatis (7,21). This would simplify mass screening and survey of HR-HPV female carriers.Efficient HPV culturing remains elusive, and the clinical performance of serological assays is still poor. Thus, diagnosis of HPV infection is based almost...

Nutritional care improves quality of life (QOL) in head and neck cancer patients treated with radiotherapy. The aim of our study was to determine whether intensive nutritional care (INC) would further improve QOL. In addition to a control group based on European and American guidelines, patients included in the INC group received six meetings with a dietitian. QOL was measured after radiotherapy using the EORTC QLQ-C30. We performed a meta-analysis to determine the best nutritional care. In the 87 patients, the QOL scores, weight, energy, and protein intakes were similar between the INC group (n = 43) and the control group (n = 44). The meta-analysis revealed no heterogeneity and significant differences in QOL (three studies) (p = 0.46) or weight changes after radiotherapy (four studies) (p = 0.06). The nutritional care specified in the European and American guidelines is composed of well-defined recommendations, and appears sufficient to maintain QOL without further intervention.

Background: Refining the risk of malignancy in patients presenting with thyroid nodules with indeterminate cytology (IC) is a critical challenge. We investigated the performances of 18 F-fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) to predict malignancy. Methods: Between May 2016 and March 2019, 107 patients presenting with a thyroid nodule ≥15 mm with IC and eligible for surgery were included in this prospective study. Head-and-neck PET/CT acquisitions were performed 20 and 60 minutes after injection of 1.5 MBq/kg of FCH. PET/CT acquisition was scored positive when maximal standardized uptake value in the IC nodule was higher than in the thyroid background. Pathology was the gold standard for diagnosis. Results: At pathology, 19 (18%) nodules were malignant, 87 were benign, and one was a noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Sensitivity, specificity, accuracy, positive-predictive value (PPV), and negative-predictive value (NPV) of FCH PET/CT in detecting cancer or NIFTP were 90%, 50%, 55%, 29%, and 96% at 20 minutes and 85%, 49%, 67%, 28%, and 94% at 60 minutes, respectively. Higher specificity (58% vs. 33%, p = 0.01) was observed in nononcocytic ( n = 72) than in oncocytic IC nodules ( n = 35). The pre-PET/CT probability of cancer or NIFTP in Bethesda III–IV nodules was 11% and the post-PET/CT probability was 19% in PET-positives and 0% in PET-negatives. In retrospective analysis, 42% of surgeries would have been unnecessary after PET/CT and 81% before ( p < 0.001), resulting in a hypothetical 48% reduction (95% confidence interval [32–64]). Conclusions: FCH PET/CT offers high NPV to reliably exclude cancer in PET-negative IC nodules, but suffers from low PPV, particularly in those with oncocytic cytology. identifier: NCT02784223.

Regional myocardial adrenergic (123)I-MIBG imaging SPECT has a potential diagnostic value to identify LBD+.

An efficient method to incorporate the fluorine-18 radionuclide in 2-nitropurine-based nucleosides was developed. The nucleophilic radiofluorination of the labeling precursor with [ 18 F]KF under aminopolyether-mediated conditions (Kryptofix 2.2.2/K 2 CO 3 ) followed by deprotection was straightforward and, after formulation, gave 2-[ 18 F]fluoroadenosine, ready for injection with a radiochemical yield of 45 ( 5%, a radiochemical purity of >98%, and a specific radioactivity up to 148 GBq/μmol. A micropositron emission tomography imaging and biodistribution study on rodents was reported.