\u3csup\u3e68\u3c/sup\u3e Ga-Labeled Prostate-specific Membrane Antigen Ligand Positron Emission Tomography/Computed Tomography for Prostate Cancer: A Systematic Review and Meta-analysis

Context: Gallium prostate-specific membrane antigen (PSMA) ligand Ga-HBED-CC-PSMA ( Ga-PSMA) is a promising radiotracer for positron emission tomography (PET)/computed tomography (CT) of prostate cancer. Objective: To conduct a meta-analysis to evaluate detection rate, diagnostic test accuracy, and adverse effects of Ga-PSMA PET/CT or PET/magnetic resonance imaging (MRI) for staging of prostate cancer and for restaging of rising prostate-specific antigen (PSA) after initial treatment. Evidence acquisition: Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, our systematic review searched for articles in PubMed and EMBASE databases from 2012 to July 2016. The reference standard was pathology after biopsy or surgery. The analyses used a random effect model and a hierarchical summary receiver operating characteristic model. Evidence synthesis: Fifteen Ga-PSMA PET/CT studies with 1256 patients met the inclusion criteria. Seven studies of staging PET/CT or PET/MRI detected a regional site of cancer for 203 of 273 patients (74%). Nine studies of restaging PET/CT detected sites of recurrence in 799 of 983 patients (81%) with a 50% detection rate (74 of 147 patients) for restaging PSA of 0.2–0.49 ng/ml and a 53% detection rate (56 of 195 patients) for restaging PSA of 0.50–0.99 ng/ml. Staging Ga-PSMA PET/CT in the studies had higher detection rates of sites in the prostate bed than restaging Ga-PSMA PET/CT (mean 57% vs 14%, p = 0.031, t test). Both staging and restaging Ga-PSMA PET/CT found that a subgroup of the patients had metastatic sites in pelvic lymph nodes or distant organs. Eight studies of staging PET/CT undertook histologic correlations. We performed prostate-segment-based analysis specifically regarding the primary cancer lesion for four of these studies, and patient-based analysis specifically regarding pelvic lymph node metastases for four other studies. The pooled sensitivities for staging in the two groups of studies were 70% and 61%, and the pooled specificities were 84% and 97%. None of the studies reported complications from the PET/CT imaging. Conclusions: Ga-PSMA PET/CT has clinical relevance to detect sites of recurrence for patients with PSA recurrence after radical prostatectomy (RP) with PSA levels less than 1.0 ng/ml. Patient summary: Choline positron emission tomography (PET)/computed tomography (CT) can detect sites of recurrent prostate cancer in an earlier phase of prostate-specific antigen (PSA) recurrence than bone scans and CT scans, but choline PET/CT is rarely positive for patients with restaging PSA levels under 1 ng/ml. A new radiotracer called Ga-PSMA for PET/CT was able to detect sites of recurring cancer in up to 50% of patients who had an early rise in PSA exceeding 0.5 ng/ml after initial radical prostatectomy. The published studies did not report adverse effects of Ga-PSMA PET/CT imaging. The rate of detection of sites in the prostate bed was significantly higher for staging than for restaging positron emission tomography (PET) using a Ga-labeled prostate-specific membrane (PSMA) antigen ligand. Overall, the detection rate did not differ significantly between staging and restaging. The detection rate for restaging Ga-PSMA PET/computed tomography (CT) was 50% for restaging prostate-specific antigen (PSA) of 0.2–0.48 ng/ml, 53% for restaging PSA of 0.50–0.99 ng/ml, and higher for higher restaging PSA levels. Patient-based and lesion-based analysis of staging Ga-PSMA PET/CT had sensitivity of 61–70% and specificity of 84–97%. The studies did not report any adverse effects due to imaging. 68 68 68 68 68 68 68 68 68 68 68 68 68 6

Optimizing psma radioligand therapy for patients with metastatic castration-resistant prostate cancer. A systematic review and meta-analysis

The aim of the review was to evaluate patient and treatment characteristics for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with PSMA radioligand therapy (PRLT) associated with above-average outcome. The systematic review and meta-analysis followed recommendations by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). We searched for publications in PubMed, Embase, and ClinicalTrials.gov up to 31 September 2020. Thirty-six publications and four duplicates reported 2346 patients. Nearly two-thirds of the patients had bone metastases. Median overall survival (OS) was 16 months. Asymptomatic patients and patients with only lymph node metastases lived longer than symptomatic patients and patients with more extensive metastases. Patients treated with an intensified schedule of177Lu PRLT lived longer than those treated with a conventional schedule. Half of the patients obtained a PSA decline ≥ 50% and these patients lived longer than those with less PSA decline. Approximately 10% of the patients developed hematologic toxicity with anemia grade 3 as the most severe adverse effect. Characteristics for patients, cancer, restaging, and PRLT predict above average overall survival following treatment with PRLT

Health mindset is associated with anxiety and depression in patients undergoing treatment for breast cancer

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156141/2/tbj13765_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156141/1/tbj13765.pd

Hiding Relations

The present vogue of ‘managing for development results’ is an expression of a historically dominant mode of thought in international aid – ‘substantialism’ – which sees the world primarily in terms of ‘entities’ such as ‘poverty’, ‘basic needs’, ‘rights’, ‘women’, or ‘results’. Another important mode of thought, ‘relationalism’ – in association more generally with ideas of process and complexity – appears to be absent in the thinking of aid institutions. Drawing on my own experiences of working with the UK Department for International Development (DFID), I illustrate how despite formally subscribing to the institution’s substantialist view of the world, some staff are ‘closet relationists’, behaving according to one mode of thought while officially framing their action in terms of the other, more orthodox mode. In so doing, they may be unwittingly keeping international aid sufficiently viable - by the apparent proof of the efficacy of results-based management - to enable the institution as a whole to maintain its substantialist imaginary

Continuous Interaction with a Virtual Human

Attentive Speaking and Active Listening require that a Virtual Human be capable of simultaneous perception/interpretation and production of communicative behavior. A Virtual Human should be able to signal its attitude and attention while it is listening to its interaction partner, and be able to attend to its interaction partner while it is speaking – and modify its communicative behavior on-the-fly based on what it perceives from its partner. This report presents the results of a four week summer project that was part of eNTERFACE’10. The project resulted in progress on several aspects of continuous interaction such as scheduling and interrupting multimodal behavior, automatic classification of listener responses, generation of response eliciting behavior, and models for appropriate reactions to listener responses. A pilot user study was conducted with ten participants. In addition, the project yielded a number of deliverables that are released for public access