Neuroblastoma is one of the more common pediatric cancers. Although there have undoubtedly been major advances in therapy over recent decades, there is still room for significant improvements in outcome to be made. Neuroblastoma is a disease with a variable outlook, encompassing a spectrum-from patients with disease which may undergo spontaneous regression, through those who may be cured with limited treatment, to others whose disease is refractory even to the most aggressive management strategies. Great progress has been made toward understanding the basic biology of the disease, which allows reliable allocation of individual patients to good, intermediate, or poor prognostic groups and aids selection of appropriate therapeutic approaches. Unfortunately, attempts to improve the outcome of patients with adverse prognostic factors have been less effective.This paper reviews the clinical and biological features of neuroblastoma which determine outcome, and outlines current management policies. Some experimental approaches involving translational research which seek to exploit the unique biology of neuroblastoma are discussed. Although currently unproven, such new treatments are undergoing clinical evaluation and may yet offer new hope for patients with this enigmatic disease.
Background Limited information is available on sex differences in myocardial T1 relaxation times over age ranges. We used cardiac magnetic resonance (CMR) imaging at two field strengths to assess myocardial T1. Methods Healthy adults underwent CMR at 1.5 Tesla (T) (Avanto) and 3.0 T (Verio). T1 maps were acquired in three short axis slices, using an optimised MOLLI investigational prototype sequence (Siemens Healthcare WIP 448). Global mean T1, in milliseconds (ms), was calculated from evaluable regionsof-interest using 16-segment model. Results 84 volunteers (43 male) underwent scans 1.4 ± 1.4 days apart. Because of artefacts related to cardio-respiratory motion and susceptibility effects, 47 (3.9%) segments were excluded at 1.5 T and 81 (6.3%) segments at 3.0 T, with a preponderance occurring at the distal slice.Age-related decrease in T1 was observed in females, whereas male T1 remained reasonably constant ( Figure 1 and Table 1). At 1.5 T, amongst those <40 years T1 was higher for females (961.3 ± 19.3 ms) than males (932.0 ± 22.8 ms, p < 0.001), whereas there was no difference in those ‡60 years (937.2 ± 28.7 vs. 934.3 ± 24.3 ms, respectively, p = 0.807). Results were similar at 3.0 T; female T1 was higher at <40 years (1166.0 ± 41.7 vs. 1139.6 ± 26.1 ms, p = 0.044), but not at ‡60 years (1151.0 ± 39.3 vs. 1124.3 ± 31.6 ms, p = 0.087).Regression analysis shows that at 1.5 T average T1 decreases by 5.13 ms for each additional decade (p = 0.038). An identical trend was observed at 3.0 T, with regression coefficient À0.564 ms/year approaching statistical significance (p = 0.064). Conclusions In healthy adults, sex difference in global myocardial mean T1 relaxation times are observed amongst younger. This pattern is consistent across CMR field strengths. Pre-vs. post-menopausal differences in myocardial structure and function of females may explain these differences and this possibility merits further assessment. Background Extracellular volume (ECV) quantification by cardiovascular magnetic resonance (CMR) measures the extracellular space. Current methodologies require blood haematocrit (Hct) correction, a barrier to easy clinical use. We hypothesised that the relationship between Hct and longitudinal relaxation time of blood (T1 blood ) could be calibrated and used to generate a synthetic ECV without Hct.
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