Multi-parametric Magnetic Resonance Imaging (MRI) in Prostate Cancer

Prostate cancer is extremely prevalent, with shifting patient demographics leading to an increasing number of men balancing treatment efficacy with associated side-effects. Non-invasive characterization of disease – useful for guiding biopsy, to monitor disease progression during active surveillance, or for treatment planning of focal therapies – could have a significant impact on patient management. Through its excellent anatomic imaging capabilities and its ability to characterize physiologic properties, magnetic resonance imaging (MRI) has the potential to fulfill clinical goals; however, further improvements are necessary to maximize accuracy and impact. Thus, this thesis presents: 1) the development of a multi-parametric model to combine parameters derived from measurement of T2 relaxation, diffusion weighted imaging, and dynamic contrast-enhanced MRI to improve the discrimination between normal and malignant peripheral zone tissue; 2) determination of the impact that the presence of normal tissue within regions of tumour has on the measurement of apparent diffusion coefficient (ADC) and T2 relaxation in the peripheral zone; and 3) relationships between MRI measurement and underlying prostate tissue composition. A common patient cohort was used for all studies, with prostate cancer patients having in vivo MRI prior to prostatectomy followed by whole-mount histologic sectioning of the surgical specimens, facilitating the use of pathology as a gold-standard for all analyses. In the first study, the optimal multi-parametric model combines ADC, T2, and volume transfer constant (Ktrans) to yield the probability of malignancy for each voxel. Performance of the model is better than each single parameter, but not significantly so compared to ADC. The second study demonstrates that there is no difference in ADC and T2 between tumours containing significant portions of normal tissue and the surrounding normal tissue itself, indicating that full characterization of prostate cancer with MRI may be limited. Finally, by determining relationships between MRI parameters and tissue characteristics, the third study suggests mechanisms driving MR image appearance in the prostate, including the visualization of cancer. Taken together, this thesis presents potential improvements to prostate cancer imaging, and provides further insight into the interplay between the underlying histology and MRI.Ph

The Business of Social Media: A Qualitative Analysis on How and Why Businesses and Brands Use Social Media Marketing for Strategic Consumer Communication

Social media has infiltrated our lives and have changed the ways we communicate with one another. We like to share our lives online and connect through different social media platforms. Just like us, companies and brands are implementing social media into their marketing strategies in order to become more relatable, market their products more effectively, and be where their consumers are. This study provides an analysis on social media marketing in the business and marketing sphere, and how and why they are implementing certain platforms for their companies. From expert interviews and textual analysis, this study examines how and why social media is being used from a business standpoint. The results showed that social media has enhanced traditional marketing efforts, humanized companies, and made them more transparent and relatable to consumers, which could lead to better consumer relationships and possible increased business. Keywords: social media marketing, marketing, brand-consumer interaction, strategic marketing communicatio

A comparative analysis: International variation in PET-CT service provision in oncology- A n International Cancer Benchmarking Partnership study

Abstract Objective To explore differences in position emission tomography-computed tomography (PET-CT) service provision internationally to further understand the impact variation may have upon cancer services. To identify areas of further exploration for researchers and policymakers to optimize PET-CT services and improve the quality of cancer services. Design Comparative analysis using data based on pre-defined PET-CT service metrics from PET-CT stakeholders across seven countries. This was further informed via document analysis of clinical indication guidance and expert consensus through round-table discussions of relevant PET-CT stakeholders. Descriptive comparative analyses were produced on use, capacity and indication guidance for PET-CT services between jurisdictions. Setting PET-CT services across 21 jurisdictions in seven countries (Australia, Denmark, Canada, Ireland, New Zealand, Norway and the UK). Participants None. Intervention(s) None. Main Outcome Measure(s) None. Results PET-CT service provision has grown over the period 2006–2017, but scale of increase in capacity and demand is variable. Clinical indication guidance varied across countries, particularly for small-cell lung cancer staging and the specific acknowledgement of gastric cancer within oesophagogastric cancers. There is limited and inconsistent data capture, coding, accessibility and availability of PET-CT activity across countries studied. Conclusions Variation in PET-CT scanner quantity, acquisition over time and guidance upon use exists internationally. There is a lack of routinely captured and accessible PET-CT data across the International Cancer Benchmarking Partnership countries due to inconsistent data definitions, data linkage issues, uncertain coverage of data and lack of specific coding. This is a barrier in improving the quality of PET-CT services globally. There needs to be greater, richer data capture of diagnostic and staging tools to facilitate learning of best practice and optimize cancer services