¹²³I-meta-iodobenzylguanidine single-photon emission computerized tomography/computerized tomography scintigraphy in the management of neuroblastoma

Neuroblastoma is the most common pediatric extracranial solid tumor. High-risk neuroblastoma is the most frequent presentation with an overall survival of approximately 50%. ¹²³I-meta-iodobenzylguanidine (¹²³I-mIBG) scintigraphy in the assessment of the primary tumor and its metastases at diagnosis and after chemotherapy is a cornerstone imaging modality. In particular, the bulk of skeletal metastatic disease evaluated with ¹²³I-mIBG at diagnosis and the following chemotherapy has a prognostic value. Currently, single-photon emission computerized tomography/computerised tomography (SPECT/CT) is considered a fundamental part of ¹²³I-mIBG scintigraphy. ¹²³I-mIBG SPECT/CT is a highly specific and sensitive imaging biomarker and it has been the basis of all existing neuroblastoma trials requiring molecular imaging. The introduction of SPECT/CT has shown not only the heterogeneity of the mIBG uptake within the primary tumor but also the presence of completely mIBG nonavid metastatic lesions with mIBG-avid primary neuroblastomas. It is currently possible to semi-quantitatively assess tracer uptake with standardized uptake value, which allows a more precise evaluation of the tracer avidity and can help monitor chemotherapy response. The patchy mIBG uptake has consequences from a theranostic perspective and may partly explain the failure of some neuroblastomas to respond to ¹³¹I-mIBG molecular radiotherapy. Various positron emission tomography tracers, targeting different aspects of neuroblastoma cell biology, are being tested as possible alternatives to ¹²³I-mIBG

Thymomas: a review.

Thymomas are neoplasma of thymic epithelial cells. They may be benign or malignant and may associate with locai ìnvasiveness and paraneoplastic diseases. Myasthenia gravis is often associated with thymomas, bui this is not thè rule. Several classifications have been proposed: some of them follow thè histopathological findings (Rosai and Levine, Snover, Marino and Muller- Hermelink classification), other emphasizes thè clinic-pathological stage (Masaoka, Verley and Hollmann stadiation). One third of thymomas is asymptomatic. Diagnosis is made often by plain X-ray and confirmed by Computed Tomography or fine needle biopsy. Surgery is effective in 100% of noninvasive cases and in 58% of invasive ones. Radio and chemotherapy are recommended only in advanced or inoperable stages

Studying bone mineral density in young people: The complexity of choosing a pQCT reference database

BACKGROUND: Many chronic illnesses affect bone health, and commonly lead to mineralization abnormalities in young people. As cortical and trabecular bone may be differentially affected in certain diseases, an imaging technique that allows for detailed study of the bone structure is required. Peripheral quantitative computed tomography (pQCT) overcomes the limitations of dual energy X-ray absorptiometry (DXA) and is perhaps more widely available for use in research than bone biopsy. However, in contrast to DXA, where there are large reference datasets, this is not the case for pQCT. METHODS: Fifty-five children and young adults aged 7 to 30 years had the non-dominant tibia scanned at the 3% & 4% sites for trabecular bone mineral density and the 38% site for cortical bone mineral density and bone mineral content. Image acquisition and analysis was undertaken according to the protocols of two of the largest reference datasets for tibial pQCT. The Z-scores generated were compared to examine the differences between protocols and the differences from the expected median of zero in a healthy population. RESULTS: The trabecular bone mineral density Z-scores generated by the two protocols were similar. The same was true for cortical mineral content Z-scores at the 38% site. Cortical bone mineral density was significantly different between protocols and likely affected by differences in the ethnicity of our cohort compared to the reference datasets. Only one reference dataset extended from childhood to young adulthood. Only trabecular bone mineral density, periosteal and endosteal circumference Z-scores from one methodology were not significantly biased when tested for deviation of the median from zero. CONCLUSIONS: pQCT is a useful tool for studying trabecular and cortical compartments separately but, there are variations in pQCT scanning protocols, analysis methodology, and a paucity of reference data. Reference datasets may not be generalizable to local study populations, even when analysed using identical analysis protocols

The 4 K outer cryostat for the CUORE experiment: construction and quality control

The external shell of the CUORE cryostat is a large cryogen-free system designed to host the dilution refrigerator and the bolometers of the CUORE experiment in a low radioactivity environment. The three vessels that form the outer shell were produced and delivered to the Gran Sasso underground Laboratories in July 2012. In this paper, we describe the production techniques and the validation tests done at the production site in 2012.Comment: 11 pages, 13 figures; to appear in NIM

Comparison Between Diffusion-Weighted MRI and I-123-mIBG Uptake in Primary High-Risk Neuroblastoma

Background: High-risk neuroblastoma (HR-NB) has a variable response to preoperative chemotherapy. It is not possible to differentiate viable vs. nonviable residual tumor before surgery. Purpose: To explore the association between apparent diffusion coefficient (ADC) values from diffusion-weighted magnetic resonance imaging (DW-MRI), 123I-meta-iodobenzyl-guanidine (123I-mIBG) uptake, and histology before and after chemotherapy. Study Type: Retrospective. Subjects: Forty patients with HR-NB. Field Strength/Sequence: 1.5T axial DW-MRI (b = 0,1000 s/mm2 ) and T2-weighted sequences. 123I-mIBG scintigraphy planar imaging (all patients), with additional 123I-mIBG single-photon emission computed tomography / computerized tomography (SPECT/CT) imaging (15 patients). Assessment: ADC maps and 123I-mIBG SPECT/CT images were coregistered to the T2-weighted images. 123I-mIBG uptake was normalized with a tumor-to-liver count ratio (TLCR). Regions of interest (ROIs) for primary tumor volume and different intratumor subregions were drawn. The lower quartile ADC value (ADC25prc) was used over the entire tumor volume and the overall level of 123I-mIBG uptake was graded into avidity groups. Statistical Tests: Analysis of variance (ANOVA) and linear regression were used to compare ADC and MIBG values before and after treatment. Threshold values to classify tumors as viable/necrotic were obtained using ROC analysis of ADC and TLCR values. Results: No significant difference in whole-tumor ADC25prc values were found between different 123I-mIBG avidity groups pre- (P = 0.31) or postchemotherapy (P = 0.35). In the “intratumor” analysis, 5/15 patients (prechemotherapy) and 0/14 patients (postchemotherapy) showed a significant correlation between ADC and TLCR values (P < 0.05). Increased tumor shrinkage was associated with lower pretreatment tumor ADC25prc values (P < 0.001); no association was found with pretreatment 123I-mIBG avidity (P = 0.17). Completely nonviable tumors had significantly lower postchemotherapy ADC25prc values than tumors with >10% viable tumor (P < 0.05). Both pre- and posttreatment TLCR values were significantly higher in patients with >50% viable tumor than those with 10–50% viable tumor (P < 0.05). Data Conclusion: 123I-mIBG avidity and ADC values are complementary noninvasive biomarkers of therapeutic response in HR-NB. Level of Evidence: 4. Technical Efficacy Stage: 3

Importance of Magnetic Resonance Imaging With Diffusion-weighted Imaging in Guiding Biopsy of Nodular Ganglioneuroblastoma: A Case Report

BACKGROUND: Nodular ganglioneuroblastoma is a rare peripheral neuroblastic tumor of variable prognosis. Accurate diagnosis, staging, and risk categorization can be particularly challenging in patients with nodular ganglioneuroblastoma due to the inherent heterogeneity of these lesions. CASE PRESENTATION: We illustrate the use of diffusion-weighted magnetic resonance imaging to identify tumor nodules and guide tumor biopsy in an almost 5-year-old boy with a large abdominal tumor. CONCLUSIONS: Diffusion-weighted magnetic resonance imaging was successful in detecting and guiding biopsy of a poorly differentiated neuroblastoma nodule within the context of a well-differentiated ganglioneuroma, allowing the diagnosis and characterization of a ganglioneuroblastoma nodular, thus influencing the child's prognosis and treatment

Large area Si low-temperature light detectors with Neganov-Luke effect

Next generation calorimetric experiments for the search of rare events rely on the detection of tiny amounts of light (of the order of 20 optical photons) to discriminate and reduce background sources and improve sensitivity. Calorimetric detectors are the simplest solution for photon detection at cryogenic (mK) temperatures. The development of silicon based light detectors with enhanced performance thanks to the use of the Neganov-Luke effect is described. The aim of this research line is the production of high performance detectors with industrial-grade reproducibility and reliability.Comment: 4 pages, 2 figure

The CUORE Cryostat: A 1-Ton Scale Setup for Bolometric Detectors

The cryogenic underground observatory for rare events (CUORE) is a 1-ton scale bolometric experiment whose detector consists of an array of 988 TeO2 crystals arranged in a cylindrical compact structure of 19 towers. This will be the largest bolometric mass ever operated. The experiment will work at a temperature around or below 10 mK. CUORE cryostat consists of a cryogen-free system based on pulse tubes and a custom high power dilution refrigerator, designed to match these specifications. The cryostat has been commissioned in 2014 at the Gran Sasso National Laboratories and reached a record temperature of 6 mK on a cubic meter scale. In this paper, we present results of CUORE commissioning runs. Details on the thermal characteristics and cryogenic performances of the system will be also given.Comment: 7 pages, 2 figures, LTD16 conference proceedin

Searches for axioelectric effect of solar axions with BGO-scintillator and BGO-bolometer detectors

A search for axioelectric absorption of 5.5 MeV solar axions produced in the $p + d \rightarrow {^3\rm{He}}+\gamma~(5.5~ \rm{MeV})$ reaction has been performed with a BGO detectors. A model-independent limit on the product of axion-nucleon $g_{AN}^3$ and axion-electron $g_{Ae}$ coupling constants has been obtained: $| g_{Ae}\times g_{AN}^3|< 1.9\times 10^{-10}$ for 90\% C.L..Comment: 5 pages, 3 figures, Proceedings of the 10th Patras Workshop on Axions, WIMPs and WISP 29 June - 4 July 2014, CERN, Geneva, Switzerlan