23 research outputs found

    Is there a role for diagnostic scans in the management of intermediate-risk thyroid cancer?

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    Radioiodine (RAI) is selectively recommended for intermediate-risk differentiated thyroid carcinomas (DTC). The information gleaned from pretherapy stimulated thyroglobulin levels (sTg) and diagnostic 131I whole-body scans (DxWBS) to guide therapy remains controversial. The present study aimed at evaluating the impact of preablation sTg and DxWBS in the management of intermediate-risk DTC. A retrospective analysis of 301 intermediate-risk DTC patients submitted to total thyroidectomy and RAI therapy was performed. Pretherapy sTg and DxWBS and post-therapy WBS (RxWBS) findings were analyzed and compared to outcomes. Fifty-two patients (17.3%) had metastases diagnosed by DxWBS and/or RxWBS. The DxWBS identified 10.6% of patients with functioning metastases, including unexpected distant metastases. If combined with SPECT-CT, DxWBS detected RAI-avid metastases more frequently, particularly lymph node metastases (13.1% vs 4.2% planar WBS, P = 0.015). The DxWBS findings modified patient management in 8.3%. A pretherapy sTg <1 ng/mL was associated with a low false-negative rate for the presence of metastases (5.2%), and its performance in excluding metastasis was improved by a negative DxWBS (2.7% of patients with both negative exams had metastases in RxWBS). A sTg <1 ng/mL predicted statistically significant lower rates of recurrent/persistent disease and biochemical/structural incomplete responses. In conclusion, preablation sTg and DxWBS contribute to the detection of unknown or persistent metastatic disease in intermediate-risk DTC patients. A sTg <1 ng/mL in combination with a negative DxWBS is highly suggestive of the absence of remaining malignant disease, and one may consider deferring RAI ablation if both exams are negative. A stunning effect is rarely observed and it does not impair proper treatment of metastases

    Epiretinal Membrane and Cystoid Macular Edema after Retinal Detachment Repair with Small-Gauge Pars Plana Vitrectomy

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    To evaluate the incidence rates of cystoid macular edema (CME) and epiretinal membrane (ERM) formation after uncomplicated primary 23-G and 25-G retinal detachment (RD) repair and to identify risk factors associated with postoperative CME and ERM formation. This was a consecutive interventional case series of 587 eyes that underwent one RD repair with 23-G or 25-G pars plana vitrectomy (PPV) with scleral buckling. Epiretinal membrane and CME were confirmed by optical coherence tomography (OCT) and fluorescein angiography (FA). A total of 587 eyes with a mean follow-up of 404 days had incidence rates of 35.1% for ERM and 15.2% for CME. The incidence of ERM after combined PPV and scleral buckling (48.4%) (n = 61) was greater (p<0.0001) compared to that after PPV alone (31.2%) (n = 144). Epiretinal membrane and CME develop frequently after small-gauge RD repair. Pars plana vitrectomy combined with scleral buckling is associated with a higher incidence of ERM. Patients might benefit from increased use of OCT and FA to help rule out CME/ERM

    Prospects for Îł\gamma-ray observations of the Perseus galaxy cluster with the Cherenkov Telescope Array

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    International audienceGalaxy clusters are expected to be dark matter (DM) reservoirs and storage rooms for the cosmic-ray protons (CRp) that accumulate along the cluster's formation history. Accordingly, they are excellent targets to search for signals of DM annihilation and decay at gamma-ray energies and are predicted to be sources of large-scale gamma-ray emission due to hadronic interactions in the intracluster medium. We estimate the sensitivity of the Cherenkov Telescope Array (CTA) to detect diffuse gamma-ray emission from the Perseus galaxy cluster. We perform a detailed spatial and spectral modelling of the expected signal for the DM and the CRp components. For each, we compute the expected CTA sensitivity. The observing strategy of Perseus is also discussed. In the absence of a diffuse signal (non-detection), CTA should constrain the CRp to thermal energy ratio within the radius R500R_{500} down to about X5001027X_{500}10^{27}s for DM masses above 1 TeV. These constraints will provide unprecedented sensitivity to the physics of both CRp acceleration and transport at cluster scale and to TeV DM particle models, especially in the decay scenario

    Prospects for Îł\gamma-ray observations of the Perseus galaxy cluster with the Cherenkov Telescope Array

    No full text
    Galaxy clusters are expected to be dark matter (DM) reservoirs and storage rooms for the cosmic-ray protons (CRp) that accumulate along the cluster's formation history. Accordingly, they are excellent targets to search for signals of DM annihilation and decay at gamma-ray energies and are predicted to be sources of large-scale gamma-ray emission due to hadronic interactions in the intracluster medium. We estimate the sensitivity of the Cherenkov Telescope Array (CTA) to detect diffuse gamma-ray emission from the Perseus galaxy cluster. We perform a detailed spatial and spectral modelling of the expected signal for the DM and the CRp components. For each, we compute the expected CTA sensitivity. The observing strategy of Perseus is also discussed. In the absence of a diffuse signal (non-detection), CTA should constrain the CRp to thermal energy ratio within the radius R500R_{500} down to about X5001027X_{500}10^{27}s for DM masses above 1 TeV. These constraints will provide unprecedented sensitivity to the physics of both CRp acceleration and transport at cluster scale and to TeV DM particle models, especially in the decay scenario

    Galactic transient sources with the Cherenkov Telescope Array

    No full text
    International audienceA wide variety of Galactic sources show transient emission at soft and hard X-ray energies: low-mass and high-mass X-ray binaries containing compact objects (e.g., novae, microquasars, transitional millisecond pulsars, supergiant fast X-ray transients), isolated neutron stars exhibiting extreme variability as magnetars as well as pulsar wind nebulae. Although most of them can show emission up to MeV and/or GeV energies, many have not yet been detected in the TeV domain by Imaging Atmospheric Cherenkov Telescopes. In this paper, we explore the feasibility of detecting new Galactic transients with the Cherenkov Telescope Array (CTA) and the prospects for studying them with Target of Opportunity observations. We show that CTA will likely detect new sources in the TeV regime, such as the massive microquasars in the Cygnus region, low-mass X-ray binaries with low-viewing angle, flaring emission from the Crab pulsar-wind nebula or other novae explosions, among others. We also discuss the multi-wavelength synergies with other instruments and large astronomical facilities

    Prospects for Îł\gamma-ray observations of the Perseus galaxy cluster with the Cherenkov Telescope Array

    No full text
    International audienceGalaxy clusters are expected to be dark matter (DM) reservoirs and storage rooms for the cosmic-ray protons (CRp) that accumulate along the cluster's formation history. Accordingly, they are excellent targets to search for signals of DM annihilation and decay at gamma-ray energies and are predicted to be sources of large-scale gamma-ray emission due to hadronic interactions in the intracluster medium. We estimate the sensitivity of the Cherenkov Telescope Array (CTA) to detect diffuse gamma-ray emission from the Perseus galaxy cluster. We perform a detailed spatial and spectral modelling of the expected signal for the DM and the CRp components. For each, we compute the expected CTA sensitivity. The observing strategy of Perseus is also discussed. In the absence of a diffuse signal (non-detection), CTA should constrain the CRp to thermal energy ratio within the radius R500R_{500} down to about X5001027X_{500}10^{27}s for DM masses above 1 TeV. These constraints will provide unprecedented sensitivity to the physics of both CRp acceleration and transport at cluster scale and to TeV DM particle models, especially in the decay scenario
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