CT ventilation imaging derived from breath hold CT exhibits good regional accuracy with Galligas PET

Publication date: Available online 28 December 2017
Source:Radiotherapy and Oncology
Author(s): Enid M. Eslick, John Kipritidis, Denis Gradinscak, Mark J. Stevens, Dale L. Bailey, Benjamin Harris, Jeremy T. Booth, Paul J. Keall
Background and purposeCT ventilation imaging (CTVI) derived from four dimensional CT (4DCT) has shown only moderate spatial accuracy in humans due to 4DCT image artefacts. Here we assess the accuracy of an improved CTVI using high quality exhale/inhale breath-hold CT (BHCT).Materials and methodsEighteen lung cancer patients underwent exhale/inhale BHCT, 4DCT and Galligas PET ventilation scans in a single imaging session. For each BHCT and 4DCT scan, we performed deformable image registration (DIR) between the inhale and exhale phase images to quantify ventilation using three published metrics: (i) breathing induced lung density change, CTVIDIR-HU (ii) breathing induced volume change CTVIDIR-Jac and (iii) the regional air-tissue product, CTVIHU Spatial accuracy was reported as the voxel-wise Spearman correlation r between CTVI and Galligas PET.ResultsFor BHCT-based CTVIs (N = 16), the CTVIDIR-HU, CTVIDIR-Jac and CTVIHU methods yielded mean (range) r values of 0.67 (0.52–0.87), 0.57 (0.18–0.77) and 0.49 (0.14–0.75) respectively. By comparison the 4DCT-based CTVIs (n = 14) had values of 0.32 (−0.04 to 0.51), 0.16 (−0.31 to 44) and 0.49 (0.20–0.77) respectively.ConclusionsHigh quality CT imaging is a key requirement for accurate CT ventilation imaging. The use of exhale/inhale BHCT can improve the accuracy of CTVI for human subjects.



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Murphy’s law and Murphy eyes

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Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage

Summary

Background

Skin laxity and wrinkling on the neck and décolletage reveal age as reliably as the face.

Objective

To evaluate the combined use of microfocused ultrasound with visualization (MFU-V; Ultherapy^®) and diluted calcium hydroxylapatite (CaHA; Radiesse^®) for treating the neck and décolletage.

Methods

Subjects with moderate-to-severe lines on the neck and/or décolletage were retrospectively enrolled. MFU-V was applied using 7 and 10 MHz transducers followed by subdermal injection of CaHA diluted 1:1 with lidocaine solution. Photographs at baseline and 90 days were assessed by two independent, blinded evaluators using three scales: Merz Aesthetics décolleté wrinkles, Fabi-Bolton chest wrinkle, and Allergan transverse neck lines scales.

Results

A total of 47 subjects were treated as follows: 29 (neck only), five (décolletage only), and 13 (both areas). Mean neckline score improved from 2.6 (moderate-to-severe lines) at baseline to 1.3 (mild lines) 90 days after treatment (P < .001). Mean décolletage scores improved from 2.6 and 3.3 (moderate-to-severe wrinkles) on the Merz Aesthetics and Fabi-Bolton scales, respectively, to 1.1 and 1.8 (mild wrinkles), respectively, after treatment (both P < .001). Both procedures were well tolerated with high subject satisfaction.

Conclusions

Combining MFU-V with 1:1 diluted CaHA is effective for improving the appearance of neck and décolletage lines and wrinkles.

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"Malays J Pathol"[jour]; +19 new citations

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Clinical Complications and Their Management

Publication date: Available online 28 December 2017
Source:Hematology/Oncology Clinics of North America
Author(s): Alessia Marcon, Irene Motta, Ali Taher, Maria Domenica Cappellini

Teaser

The hallmarks of thalassemias are ineffective erythropoiesis and peripheral hemolysis leading to a cascade of events responsible for several clinical complications. This pathophysiologic mechanism can be partially controlled by blood transfusions or by correction of the severity of ineffective erythropoiesis. Thalassemias include a spectrum of phenotypes. Two main groups can be clinically distinguished: transfusion-dependent (TDT) and non–transfusion-dependent (NTDT) thalassemia. Both conditions are characterized by several clinical complications along life; some are shared, whereas some have higher prevalence in one group over the other. The authors present the most common clinical complications in TDT and NTDT and their management.


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The Role of Human Papillomavirus Vaccines in Cervical Cancer: Prevention and Treatment

Publication date: Available online 28 December 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Giorgio Bogani, Umberto Leone Roberti Maggiore, Mauro Signorelli, Fabio Martinelli, Antonino Ditto, Ilaria Sabatucci, Lavinia Mosca, Domenica Lorusso, Francesco Raspagliesi
Human papillomavirus (HPV) is the most common sexually transmitted disease, worldwide. Primary prevention thorough vaccination si able to reduce the burden of HPV-related lesions. Ten years ago the Food and drug Administration (FDA) approved the first vaccine against HPV. In the last decades, growing data on safety and effectiveness have been collected. In the present review we report the current knowledge on vaccine against HPV, highlighting the current value and prospective regarding the widespread diffusion of HPV vaccines. The role of emerging therapeutic vaccines is reviewed.



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Progressive delayed hemidystonia following clinically mild traumatic brain injury

A 16-year-old boy presented with progressive left hemidystonia over 3 years. The possibilities of symptomatic hemidystonia due to focal lesions such as infarct (vasculitis), tumours, tuberculoma, arteriovenous malformations or heredodegenerative disorders such as Wilson disease were considered. Imaging showed a peculiar scar involving right basifrontal region extending upto anterior, centromedian and dorsomedial nuclei of thalamus due to blowout fracture of roof of orbit. This scar was responsible for progressive left hemidystonia. On probing the history, it was revealed that patient had sustained a mild traumatic brain injury (mTBI) 3 years ago. Burke-Fahn-Marsden dystonia severity rating scale showed improvement from 19 to 6 after treatment with tablet trihexyphenidyl 16 mg and clonazepam 1 mg. A linear scar reaching upto thalamus due to blowout fracture of roof of orbit following clinically mTBI is unique. Delayed, progressive hemidystonia has been reported following severe head injury, however is less common following clinically mTBI.

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