Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes; that individuals who enter screening programmes should be provided with information on the benefits and harms of screening, and smoking cessation should be offered to all current smokers; that management of detected solid nodules should use semi-automatically measured volume and volume-doubling time; that national quality assurance boards should be set up to oversee technical standards; that a lung nodule management pathway should be established and incorporated into clinical practice with a tailored screening approach; that non-calcified baseline lung nodules greater than 300 mm, and new lung nodules greater than 200 mm, should be managed in multidisciplinary teams according to this EU position statement recommendations to ensure that patients receive the most appropriate treatment; and planning for implementation of low-dose CT screening should start throughout Europe as soon as possible. European countries need to set a timeline for implementing lung cancer screening.

In 2011, the U.S. National Lung Cancer Screening Trial (NLST) reported a 20% reduction of lung cancer mortality after regular screening by low‐dose computed tomography (LDCT), as compared to X‐ray screening. The introduction of lung cancer screening programs in Europe awaits confirmation of these first findings from European trials that started in parallel with the NLST. The German Lung cancer Screening Intervention (LUSI) is a randomized trial among 4,052 long‐term smokers, 50–69 years of age, recruited from the general population, comparing five annual rounds of LDCT screening (screening arm; n = 2,029 participants) with a control arm (n = 2,023) followed by annual postal questionnaire inquiries. Data on lung cancer incidence and mortality and vital status were collected from hospitals or office‐based physicians, cancer registries, population registers and health offices. Over an average observation time of 8.8 years after randomization, the hazard ratio for lung cancer mortality was 0.74 (95% CI: 0.46–1.19; p = 0.21) among men and women combined. Modeling by sex, however showed a statistically significant reduction in lung cancer mortality among women (HR = 0.31 [95% CI: 0.10–0.96], p = 0.04), but not among men (HR = 0.94 [95% CI: 0.54–1.61], p = 0.81) screened by LDCT (pheterogeneity = 0.09). Findings from LUSI are in line with those from other trials, including NLST, that suggest a stronger reduction of lung cancer mortality after LDCT screening among women as compared to men. This heterogeneity could be the result of different relative counts of lung tumor subtypes occurring in men and women.

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The purpose of this study was to quantify microcirculation and microvasculature in breast lesions by pharmacokinetic analysis of Gd-DTPA-enhanced MRI series. Strongly T 1 -weighted MR images were acquired in 18 patients with breast lesions using a saturation-recovery-TurboFLASH sequence. Concentrationtime courses were determined for blood, pectoral muscle, and breast masses and subsequently analyzed by a two-compartment model to estimate plasma flow and the capillary transfer coefficient per unit of plasma volume (F/V P , K PS /V P ) as well as fractional volumes of the plasma and interstitial space (f P , f I ). Breast cancer represents the most common malignancy in females, constituting a major health problem, particularly in developed countries. Conventional X-ray mammography, supplemented by sonography, has been proven to be the primary modality for breast imaging. However, despite the important role played by X-ray mammography as a diagnostic and screening tool, it suffers especially from a limited specificity and thus leads to unnecessary breast biopsies. Therefore, new noninvasive imaging strategies are required for discriminating between benign and malignant breast masses in women with equivocal findings in conventional breast imaging or women with breast implants, previous therapy, or predisposing mutations of tumor suppressor genes. Besides positron emission tomography (PET), dynamic contrast-enhanced MRI is the most promising approach providing information on tumor pathophysiology for improved diagnosis and management of breast lesions.As summarized in recent review articles on dynamic MR mammography (1-3), the kinetics of signal variation in breast lesions after injection of a paramagnetic contrast medium (CM) represents an important criterion for the detection and differentiation of suspicious breast masses. According to the analysis presented by Kuhl et al. (4), a persisting (accumulating) enhancement pattern or a washout phenomenon over a period of time of about 5-6 min after the initial perfusion phase is a strong indicator for benign and malignant lesions, respectively.Although the histopathological basis of the different enhancement patterns in breast masses is not yet fully understood, it is well known that angiogenesis, i.e., the formation of new vessels, is an important aspect (5,6). Microvessels in solid tumors exhibit a series of severe structural and functional abnormalities: They are often dilated, tortuous, elongated, and saccular and show an incomplete or even missing endothelial lining and an interrupted basement membrane. Moreover, there is an anarchic vascular organization of microvessels accompanied by significant arterio-venous shunt flow (6).To gain further insight into contrast enhancement in breast lesions and its histopathological basis, it is necessary to study tumor microvasculature and microcirculation in more detail in vivo. To this end, various MR studies were performed to quantify different aspects of contrast enhancement using either simple compartment models or princip...

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We recommend use of wb-MRI for risk stratification of patients with asymptomatic multiple myeloma.

Super-resolution imaging methods promote tissue characterization beyond the spatial resolution limits of the devices and bridge the gap between histopathological analysis and non-invasive imaging. Here, we introduce motion model ultrasound localization microscopy (mULM) as an easily applicable and robust new tool to morphologically and functionally characterize fine vascular networks in tumors at super-resolution. In tumor-bearing mice and for the first time in patients, we demonstrate that within less than 1 min scan time mULM can be realized using conventional preclinical and clinical ultrasound devices. In this context, next to highly detailed images of tumor microvascularization and the reliable quantification of relative blood volume and perfusion, mULM provides multiple new functional and morphological parameters that discriminate tumors with different vascular phenotypes. Furthermore, our initial patient data indicate that mULM can be applied in a clinical ultrasound setting opening avenues for the multiparametric characterization of tumors and the assessment of therapy response.

Many lizards are able to undergo scar-free wound healing and regeneration following loss of the tail. In most instances, lizard tail loss is facilitated by autotomy, an evolved mechanism that permits the tail to be self-detached at pre-existing fracture planes. However, it has also been reported that the tail can regenerate following surgical amputation outside the fracture plane. In this study, we used the leopard gecko, Eublepharis macularius, to investigate and compare wound healing and regeneration following autotomy at a fracture plane and amputation outside the fracture plane. Both forms of tail loss undergo a nearly identical sequence of events leading to scar-free wound healing and regeneration. Early wound healing is characterized by transient myofibroblasts and the formation of a highly proliferative wound epithelium immunoreactive for the wound keratin marker WE6. The new tail forms from what is commonly referred to as a blastema, a mass of proliferating mesenchymallike cells. Blastema cells express the protease matrix metalloproteinase-9. Apoptosis (demonstrated by activated caspase 3 immunostaining) is largely restricted to isolated cells of the original and regenerating tail tissues, although cell death also occurs within dermal structures at the original-regenerated tissue interface and among clusters of newly formed myocytes. Furthermore, the autotomized tail is unique in demonstrating apoptosis among cells adjacent to the fracture planes. Unlike mammals, transforming growth factor-b3 is not involved in wound healing. We demonstrate that scar-free wound healing and regeneration are intrinsic properties of the tail, unrelated to the location or mode of tail detachment. Anat Rec, 295:1575Rec, 295: -1595Rec, 295: , 2012. V C 2012 Wiley-Periodicals, Inc.