Pleural FDG Uptake More Than a Decade after Talc Pleurodesis

Talc pleurodesis induces a strong local inflammatory reaction which can be detected by PET scan for years after the procedure. When patients undergo PET scanning in the workup of a suspected malignancy later in life, pleural FDG uptake may unnecessarily lead to an additional invasive diagnostic workup. We present two cases of positive pleural PET findings more than 10 years after talc pleurodesis, where we adopted a watchful waiting approach. Positive pleural PET findings as a result of prior talc pleurodesis should always be included in the differential diagnosis of pleural abnormalities

Anaphylactic Reaction to Tc-99m Macrosalb

A 49-year-old woman developed an anaphylactic reaction to Tc-99m macrosalb used for pulmonary scintigraphy. The patient received an intravenous injection of Tc-99m macrosalb 120 MBq, containing macroaggregates of human albumin 0.14 mg. Within 1 min she developed itching all over her body, an itching throat and dyspnoea. This was followed by urticaria and facial oedema. She was diagnosed with an anaphylactic shock. The patient received clemastine and prednisone, and fully recovered after release from the hospital. According to the Naranjo assessment algorithm, the relationship between the allergic reaction and the administration of Tc-99m macrosalb should be considered as 'probable'

¹⁸F-Sodium fluoride PET-CT visualizes disease activity in chronic nonbacterial osteitis in adults

Chronic nonbacterial osteitis (CNO) is a rare disease spectrum, which lacks biomarkers for disease activity. Sodium fluoride-18 positron emission tomography/computed tomography ([18F]NaF-PET/CT) is a sensitive imaging tool for bone diseases and yields quantitative data on bone turnover. We evaluated the capacities of [18F]NaF-PET/CT to provide structural and functional assessment in adult CNO. A coss-sectional study was performed including 43 adult patients with CNO and 16 controls (patients referred for suspected, but not diagnosed with CNO) who underwent [18F]NaF-PET/CT at our expert clinic. Structural features were compared between patients and controls, and maximal standardized uptake values (SUVmax [g/mL]) were calculated for bone lesions, soft tissue/joint lesions, and reference bone. SUVmax was correlated with clinical disease activity in patients. Structural assessment revealed manubrial and costal sclerosis/hyperostosis and calcification of the costoclavicular ligament as typical features associated with CNO. SUVmax of CNO lesions was higher compared with in-patient reference bone (mean paired difference: 11.4; 95% CI: 9.4–13.5; p &lt; .001) and controls (mean difference: 12.4; 95%CI: 9.1–15.8; p &lt; .001). The highest SUVmax values were found in soft tissue and joint areas such as the costoclavicular ligament and manubriosternal joint, and these correlated with erythrocyte sedimentation rate in patients (correlation coefficient: 0.546; p &lt; .002). Our data suggest that [18F]NaF-PET/CT is a promising imaging tool for adult CNO, allowing for detailed structural evaluation of its typical bone, soft-tissue, and joint features. At the same time, [18F]NaF-PET/CT yields quantitative bone remodeling data that represent the pathologically increased bone turnover and the process of new bone formation. Further studies should investigate the application of quantified [18F]NaF uptake as a novel biomarker for disease activity in CNO, and its utility to steer clinical decision making.</p

Youth economic agency and exclusion in fragile settings : Field evidence from South Sudan and Burundi

This report reflectsthe findings of the research project: Youth economic exclusion and violence in Burundi and South Sudan: Improving economic opportunity interventions for young people in fragile settings, a joint project of Wageningen University and five Dutch NGOs: CARE, Save the Children, ZOA, OxfamNovib, and SPARK, funded through the Applied Research Fund of the Knowledge Network Security and Rule of Law, and carried out between May-December 2016

Biomanipulation with quagga mussels (Dreissena rostriformis bugensis) to control harmful algal blooms in eutrophic urban ponds

Many urban ponds in The Netherlands and other countries suffer from eutrophication, resulting in harmful algal blooms which are often dominated by cyanobacteria. A sufficient reduction of nutrients, as prerequisite to mitigate cyanobacterial blooms in urban ponds, is not always feasible. Water managers are in need for applicable alternatives to mitigate these cyanobacterial blooms. The quagga mussel (Dreissena rostriformis bugensis) is a rapidly expanding bivalve species in many standing waters and rivers in The Netherlands. Because quagga mussels feed on algae, they could become a useful tool in controlling harmful algal blooms in urban ponds if provided with the appropriate substrate. We tested the hypothesis that quagga mussels can reduce phytoplankton biomass and induce a clear water state in a shallow hypertrophic urban pond. We executed an in situ enclosure experiment using eight enclosures (750 L) in an urban pond: four enclosures contained quagga mussels (0.3 g ww L-1), and four control enclosures were set up without mussels. We used artificial substrate for the breeding of mussels and the transfer from the breeding location to the experimental site. In contrast to the controls, the enclosures with mussels showed significantly lower concentrations of total chlorophyll-a (2.4 μg L-1 in mussel enclosures versus 84.1 μg L-1 in controls), cyanobacterial chlorophyll-a (1.0 μg L-1 versus 7.3 μg L-1) and total phosphorus (0.08 mg L-1 versus 0.17 mg L-1), and had higher transparency (>0.80 m in mussel enclosures versus 0.57 m in controls) and higher soluble reactive phosphorus concentration (0.03 mg L-1 versus -1). No effect of the mussels on microcystin concentrations was shown. The results show that quagga mussels are able to reduce the phytoplankton biomass in a hypertrophic urban pond, including cyanobacteria and induce a clear water state. We conclude that quagga mussels can be a promising tool in controlling algal blooms in urban ponds, in particular when a sufficient reduction of nutrients is not feasible. A preferred next step in the scaling up of the method is the determination of long-term effectiveness and side-effects in a controlled application in an urban pond. Because the quagga mussel is an invasive alien species, new introductions should be considered carefully and water purification using quagga mussels is preferably applied in water systems where the species is already present

PET in Benign Bone Marrow Disorders

This review aims to describe the current status of benign bone marrow (BM) imaging using PET. BM imaging is important as the BM is not only involved in poiesis of different vital cell lines and. can be affected by primary BM disorders, but it is also frequently affected by several extramedullary diseases. Indications for the use of PET in benign BM disorders are the detection of extramedullary hematopoiesis, evaluation of patients with a discrepancy between BM histology and clinical status, visualizing BM infarctions, location of the optimal site for BM biopsy, diagnosing and staging of other hematological BM disorders, evaluation of radiotherapy effect on BM, and evaluation of BM transplantation. The 3'-F-18-fluoro-3'-deoxy-L-thymidine (FLT) and 2-F-18-2-deoxy-D-glucose (FDG) are the current main PET tracers to image BM physiology and pathology. FLT is a DNA synthesis-related tracer that can be used effectively in primary BM disorders in both diagnosis and monitoring treatment response, for example, in aplastic anemia. In secondary benign BM disorders, FDG-PET reveals that the prevalence of BM involvement in several benign diseases is more common than thought before. Novel PET tracers, such as the proliferation marker 4DST and hypoxia markers FAZA, MISO, and ATSM, are promising to visualize (benign) BM pathology more specifically. PET/MRI using innovative MRI sequences is promising to improve BM imaging in the near future. Additional trials are recommended to evaluate possible clinical applications of these newer tracers and new applications of PET/MRI in daily practice. This should be followed by updated guidelines on the use of PET in benign BM diseases