Glioma Grading: The Role of Combined Perfusion MR Imaging and Single-Voxel MR Spectroscopy Compared to Conventional MR Imaging

Abstract Body: Purpose To assess the contribution of combined perfusion MR imaging (MRI) and single-voxel MR spectroscopy (MRS) in grading primary gliomas compared with conventional MRI. Materials & Methods Thirty-two patients with primary cerebral glioma underwent conventional MRI, dynamic contrast-enhanced T2*-weighted perfusion MRI and single-voxel proton MRS. Gliomas were graded as low or high based on conventional MRI. The rCBV measurements were obtained from regions of maximum perfusion normalized between tumor and healthy tissue. Metabolite ratios ( [Cho]/[Cr], [Cho]/[NAA], [NAA]/[Cr]) were measured with TE: 34 ms. Tumor grade determined with the three methods then was compared with that from histopathologic grading. Logistic regression and ROC analyses were performed to determine which parameters best increased diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) Results Statistically significant differences were found for rCBV tumor/normal tissue ratio, and NAA/Cr ratio in tumor and Cho/Cr ratio in tumor between low- and high-grade tumors. The best performing single parameter for glioma grading was normalized rCBV value. Combined rCBV tumor/normal tissue ratio and NAA/Cr tumor ratio increased overall accuracy in glioma grading. Receiver operating characteristic curves demonstrated a rCBV tumor/normal tissue ratio of >1.16 and NAA/Cr tumor ratio of <0.44 has the higher probability for a neoplasm to be a high-grade glioma. Conclusion The rCBV measurements and metabolite ratios both individually and in combination can increase the accuracy when compared with conventional MRI alone in determining glioma grade. The best performing parameter was found to be the rCBV measurements. Threshold values can provide a means for guiding treatment and predicting postoperative patient outcome

Imaging of hepatocellular carcinoma recurrence after liver transplantation

Liver transplantation (LT) provides the highest survival benefit to patients with unresectable hepatocellular carcinoma (HCC). The Milan criteria have been developed for the selection of LT candidates with the goal of improving survival and maintaining an acceptable risk of HCC recurrence. Despite this, recurrence of HCC after LT occurs in up to 20% of cases and represents a major concern due to the poor prognosis of these patients. Furthermore, several extended criteria for the selection of LT candidates have been proposed to account for the growing demand for organs and the resultant increase in the risk of HCC recurrence. Radiologists should be aware that HCC can recur after LT with multiple organ involvement. Knowledge of the location and radiologic appearance of recurrent HCC is necessary to ensure the choice of the most appropriate therapy. This paper aims to comprehensively summarize the spectrum of HCC recurrence after LT and to examine and discuss the imaging features of these lesions. CRITICAL RELEVANCE STATEMENT: This paper aims to share a review of imaging findings of HCC recurrence after LT and to make radiologists familiar with the spectrum of this disease

Biocompatible cellulose nanocrystal-based Trojan horse enables targeted delivery of nano-Au radiosensitizers to triple negative breast cancer cells

: A hybrid cellulose-based programmable nanoplatform for applications in precision radiation oncology is described. Here, sugar heads work as tumor targeting moieties and steer the precise delivery of radiosensitizers, i.e. gold nanoparticles (AuNPs) into triple negative breast cancer (TNBC) cells. This "Trojan horse" approach promotes a specific and massive accumulation of radiosensitizers in TNBC cells, thus avoiding the fast turnover of small-sized AuNPs and the need for high doses of AuNPs for treatment. Application of X-rays resulted in a significant increase of the therapeutic effect while delivering the same dose, showing the possibility to use roughly half dose of X-rays to obtain the same radiotoxicity effect. These data suggest that this hybrid nanoplatform acts as a promising tool for applications in enhancing cancer radiotherapy effects with lower doses of X-rays

Efficacy and safety of growth hormone treatment in children with short stature: the Italian cohort of the GeNeSIS clinical study

Purpose: We examined auxological changes in growth hormone (GH)-treated children in Italy using data from the Italian cohort of the multinational observational Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS) of pediatric patients requiring GH treatment. Methods: We studied 711 children (median baseline age 9.6&nbsp;years). Diagnosis associated with short stature was as determined by the investigator. Height standard deviation score (SDS) was evaluated yearly until final or near-final height (n&nbsp;=&nbsp;78). Adverse events were assessed in all GH-treated patients. Results: The diagnosis resulting in GH treatment was GH deficiency (GHD) in 85.5&nbsp;% of patients, followed by Turner syndrome (TS 6.6&nbsp;%). Median starting GH dose was higher in patients with TS (0.30&nbsp;mg/kg/week) than patients with GHD (0.23&nbsp;mg/kg/week). Median (interquartile range) GH treatment duration was 2.6 (0.6\u20133.7) years. Mean (95&nbsp;% confidence interval) final height SDS gain was 2.00 (1.27\u20132.73) for patients with organic GHD (n&nbsp;=&nbsp;18) and 1.19 (0.97\u20131.40) for patients with idiopathic GHD (n&nbsp;=&nbsp;41), but lower for patients with TS, 0.37 ( 120.03 to 0.77, n&nbsp;=&nbsp;13). Final height SDS was&nbsp;&gt; 122 for 94&nbsp;% of organic GHD, 88&nbsp;% of idiopathic GHD and 62&nbsp;% of TS patients. Mean age at GH start was lower for organic GHD patients, and treatment duration was longer than for other groups, resulting in greater mean final height gain. GH-related adverse events occurred mainly in patients diagnosed with idiopathic GHD. Conclusions: Data from the Italian cohort of GeNeSIS showed auxological changes and safety of GH therapy consistent with results from international surveillance databases

The degradation of modern oil paintings: a multianalytical study of ageing phenomena

Modern oil paints, industrially produced since the early 19th century, show degradation phenomena which are different than the ones observed for traditional oil paints. Yellowing, surface cracking and efflorescences of metal soaps are some of the most common problems to face in oil paintings. The analysis of the composition of the original and degraded paint is fundamental to project conservation and restoration procedures. Fresh and cured commercial oil paints have been studied in reverse-phase high-performance liquid chromatography coupled to electrospray ionization quadrupole time-of-flight mass spectrometry (RP-HPLC-ESI-q-ToF) and a chromatographic method has been developed to investigate the composition of the paint, in terms of fatty acids and glycerides, in a single chromatographic run. In order to improve the separation and resolution of fatty acids in HPLC-ESI-q-ToF, a derivatization procedure has been studied, in which the carboxylic moiety of fatty acids is transformed into a hydrazide group by the reaction with 2-hydrazinoquinoline. Derivatized fatty acids signals show improved resolution. The developed method was employed to study the degree of hydrolysis and oxidation of oil paint reconstructions. Fresh commercial oil paints have been investigated via thermogravimetric analyses (oxygen uptake curves, TGAs) in order to study the capability of uptaking oxygen and the curing process of the paints. The influence of several treatments and additives, as well as that of different pigments dispersed in the same binding medium, has been investigated. The influence of environmental moisture on the ageing process and on the hydrolysis degree of two sets of oil paint reconstructions has been investigated. One set of paint reconstructions was prepared in 2006 and naturally aged for ten years; another set of paint reconstructions was made in 2016 and cured for a few days before artificial ageing. The two sets of paint layers have been aged for 12 weeks in high and low relative humidity conditions at high temperature. The fatty acids and glycerides composition of the oil paints during ageing has been monitored by electrospray ionization quadrupole time-of-flight mass spectrometry (ESI-q-ToF)