Can dynamic imaging, using 18F-FDG PET/CT and CT perfusion differentiate between benign and malignant pulmonary nodules?

BACKGROUND: The aim of the study was to derive and compare metabolic parameters relating to benign and malignant pulmonary nodules using dynamic 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET/CT, and nodule perfusion parameters derived through perfusion computed tomography (CT). PATIENTS AND METHODS: Twenty patients with 21 pulmonary nodules incidentally detected on CT underwent a dynamic 18F-FDG PET/CT and a perfusion CT. The maximum standardized uptake value (SUVmax) was measured on conventional 18F-FDG PET/CT images. The influx constant (Ki ) was calculated from the dynamic 18F-FDG PET/CT data using Patlak model. Arterial flow (AF) using the maximum slope model and blood volume (BV) using the Patlak plot method for each nodule were calculated from the perfusion CT data. All nodules were characterized as malignant or benign based on histopathology or 2 year follow up CT. All parameters were statistically compared between the two groups using the nonparametric Mann-Whitney test. RESULTS: Twelve malignant and 9 benign lung nodules were analysed (median size 20.1 mm, 9-29 mm) in 21 patients (male/female = 11/9; mean age ± SD: 65.3 ± 7.4; age range: 50-76 years). The average SUVmax values ± SD of the benign and malignant nodules were 2.2 ± 1.7 vs. 7.0 ± 4.5, respectively (p = 0.0148). Average Ki values in benign and malignant nodules were 0.0057 ± 0.0071 and 0.0230 ± 0.0155 min-1, respectively (p = 0.0311). Average BV for the benign and malignant nodules were 11.6857 ± 6.7347 and 28.3400 ± 15.9672 ml/100 ml, respectively (p = 0.0250). Average AF for the benign and malignant nodules were 74.4571 ± 89.0321 and 89.200 ± 49.8883 ml/100g/min, respectively (p = 0.1613). CONCLUSIONS: Dynamic 18F-FDG PET/CT and perfusion CT derived blood volume had similar capability to differentiate benign from malignant lung nodules

Remaking Europe: the new manufacturing as an engine for growth. Bruegel Blueprint Series 26 September 2017

Europe needs to know how it can realise the potential for industrial rejuvenation. How well are European firms responding to the new opportunities for growth, and in which global value chains are they developing these new activities? The policy discussion on the future of manufacturing requires an understanding of the changing role of manufacturing in Europe’s growth agenda

The ESR1 (6q25) locus is associated with calcaneal ultrasound parameters and radial volumetric bone mineral density in European men

<p><b>Purpose:</b> Genome-wide association studies (GWAS) have identified 6q25, which incorporates the oestrogen receptor alpha gene (ESR1), as a quantitative trait locus for areal bone mineral density (BMD(a)) of the hip and lumbar spine. The aim of this study was to determine the influence of this locus on other bone health outcomes; calcaneal ultrasound (QUS) parameters, radial peripheral quantitative computed tomography (pQCT) parameters and markers of bone turnover in a population sample of European men.</p> <p><b>Methods:</b> Eight single nucleotide polymorphisms (SNP) in the 6q25 locus were genotyped in men aged 40-79 years from 7 European countries, participating in the European Male Ageing Study (EMAS). The associations between SNPs and measured bone parameters were tested under an additive genetic model adjusting for centre using linear regression.</p> <p><b>Results:</b> 2468 men, mean (SD) aged 59.9 (11.1) years had QUS measurements performed and bone turnover marker levels measured. A subset of 628 men had DXA and pQCT measurements. Multiple independent SNPs showed significant associations with BMD using all three measurement techniques. Most notably, rs1999805 was associated with a 0.10 SD (95%CI 0.05, 0.16; p = 0.0001) lower estimated BMD at the calcaneus, a 0.14 SD (95%CI 0.05, 0.24; p = 0.004) lower total hip BMD(a), a 0.12 SD (95%CI 0.02, 0.23; p = 0.026) lower lumbar spine BMD(a) and a 0.18 SD (95%CI 0.06, 0.29; p = 0.003) lower trabecular BMD at the distal radius for each copy of the minor allele. There was no association with serum levels of bone turnover markers and a single SNP which was associated with cortical density was also associated with cortical BMC and thickness.</p> <p><b>Conclusions:</b> Our data replicate previous associations found between SNPs in the 6q25 locus and BMD(a) at the hip and extend these data to include associations with calcaneal ultrasound parameters and radial volumetric BMD.</p&gt

Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. Methods We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. Results We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4–46.1) had thrombocytopenia; 23.4% (20–26) had thrombocytopenia at ICU admission, and 19.8% (17.6–22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19–2.42). Conclusion Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio

Evaluation of the radiologically indeterminate lung nodules with dynamic positron emission tomography with computed tomography and perfusion parameters

Izhodišče Razvoj novih slikovnih diagnostičnih tehnologij nam omogoča funkcionalno sledenje radiofarmakov in kontrastnih sredstev v pljučnih nodulih. Namen doktorske naloge je bil oceniti vlogo dinamične pozitronske emisijske tomografije in računalniške tomografije z radioizotopom 18-fluordeoksiglukozo (18F-FDG PET/CT) in perfuzijske CT pri karakterizaciji pljučnih nodulov. Bolniki in metode V raziskavo smo vključili 20 zaporednih preiskovancev z naključno odkritim pljučnimi noduli, ki so opravili dinamično 18F-FDG PET/CT preiskavo in perfuzijski CT. V nodulih smo izmerili vrednost ‘standardised uptake value’ (SUVmax), na dinamičnem 18F-FDG PET/CT smo s Patlakovo metodo določili konstanto fosforilacije (Ki). Na perfuzijskem CT smo s Patlakovim modelom izračunali parameter volumen krvi ‘blood volume’ (BV), z metodo maksimalnega naklona smo določili perfuzijski parameter arterijskega pretoka ‘arterial flow’. Nodule smo razdelili v benigno in maligno skupino na osnovi histološke diagnoze ali 2-letnega sledenja s CT. Parametre smo statistično primerjali med skupinama z neparemtričnim Mann-Whitney testom, p<0.05 je veljal kot statistično pomemben. Rezultati Analizirali smo 21 pljučnih nodulov (povprečen premer ± SD: 20,1±7,5 mm9-29 mm) pri 20 bolnikih (11 moških, 9 žensk, povprečna starost 65,3 leta, starostni razpon 50-76 let). Povprečna SUVmax ±SD v benigni skupini je bila 2.2±1.7, v maligni 7.0±4.5, p=0.0148. Ki parameter v benigni skupini je bil 0.0057±0.0071 min-1, v maligni skupini 0.0230±0.0155 min-1, p=0.0311. Povprečen BV med benignimi noduli je bil 11.6857±6.7347 ml/100ml ter 28.3400±15.9672 ml/100ml med malignimi noduli, p=0.0250. Povprečen AF v maligni skupini je bil 74.4571±89.0321 ml/100g/min, v maligni skupini 89.200±49.8883 ml/100g/min, p=0.1613. Zaključki Potrdili smo hipotezo, da je metabolični parameter dinamične 18F-FDG PET/CT različnen v benignih in malignih pljučnih nodulih. Hipotezo, da so parametri perfuzijske CT različni v benignih in malignih pljučnih nodulih, smo delno potrdili in delno zavrgli. Potrdili smo, da je parameter BV perfuzijske CT različen v benignih in malignih pljučnih nodulih. Parameter AF perfuzijske CT ni bil različen v benignih in malignih pljučnih nodulih.Background Advances in imaging technology now enable evaluation of lung nodule perfusion. We aimed to derive metabolic parameters relating to pulmonary nodules using dynamic 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG PET/CT), and nodule perfusion parameters derived through perfusion computed tomography (CT), and to determine whether these factors can differentiate benign from malignant pulmonary nodules. Materials and Methods Twenty patients with 21 pulmonary nodules incidentally detected on CT were recruited to undergo a dynamic 18F-FDG PET/CT and a perfusion CT. For each nodule the maximum standardised uptake value (SUVmax) was measured on conventional 18F-FDG PET/CT images. The net FDG phosphorylation rate or influx constant (Ki) was calculated from the dynamic 18F-FDG PET/CT data sets by using Patlak plot model. Arterial flow (AF) using the maximum slope model and blood volume (BV) using the Patlak plot method for each nodule were calculated from the perfusion CT. All nodules were characterised as malignant or benign based on histopathology or 2 year follow up CT. SUVmax, Ki and perfusion indices were statistically compared between the two groups using the nonparametric Mann-Whitney test. Results Twelve malignant and nine benign pulmonary nodules were analysed (median size 20.1 mm, 9–29 mm) in 21 patients (male/female=11/9mean age±SD: 65.3±7.4age range: 50–76 years). The average SUVmax±SD of the benign and malignant nodules were 2.2±1.7 vs 7.0±4.5, respectively (p=0.0148). The dynamic 18F-FDG PET/CT average Ki values in benign and malignant nodules were 0.0057±0.0071 and 0.0230±0.0155 min-1, respectively (p=0.0311). Average BV parameters for the benign and malignant nodules were 11.6857±6.7347 and 28.3400±15.9672 ml/100ml, respectively (p=0.0250). Average values of AF for the benign and malignant nodules were 74.4571±89.0321 and 89.200±49.8883 ml/100g/min, respectively (p=0.1613). Conclusion Dynamic 18F-FDG PET/CT and perfusion CT can both differentiate benign from malignant lung nodules. Perfusion CT derived BV proved the most accurate parameter at making this differentiation

The changing rotation period of 3200 Phaethon

International audience3200 Phaethon is one of the largest potentially hazardous asteroids. It is also the first asteroid to be discovered in spacecraft images, the parent body of the Geminid meteor stream, and the target of JAXA's upcoming DESTINY+ mission. We have developed a physical model of Phaethon's shape and rotation state, using radar data from Arecibo and Goldstone in 2007 and 2017, stellar occultations from 2019 through 2021, and lightcurves from many apparitions (from 1989 through 2021). Phaethon has a volume-equivalent diameter of about 5.3 kilometers. It is approximately spheroidal with an equatorial ridge, resembling the shapes of 101955 Bennu and 162173 Ryugu. The earliest available lightcurve of Phaethon is from 1989 October 9 (published in Wisniewski et al. 1997). Hanuš et al. (2016) noticed that their shape model's rotation phase differed from that 1989 observation by about 20 minutes. They noted that this may be from Phaethon's rotation period changing due to activity, but they could not say whether this was real or just a timing error in that one lightcurve, since the next lightcurves are from 1994. A model with a constant rotation period provided a good fit to all of the data from 1994 through 2020. However, this model could not adequately fit the lightcurves that were acquired from four different observatories in 2021. There was a difference of about 15 minutes between the predicted and observed rotation phases — clearly greater than what the observations' uncertainties could permit. We initially considered that Phaethon's rotation period may have changed before the 2021 observations, perhaps due to activity when it was near perihelion in December 2020. However, we found that a constant rotational acceleration provides a good fit to all of the data from 1989 through 2021, clearly accounting for the discrepancies seen in 1989 and 2021 while also slightly improving the model's agreement with the data during other apparitions. We find that Phaethon's sidereal rotation period in December 2017 was 3.603944 hours. Its spin rate is increasing at a rate of 2.1×10-6 deg/day2, which corresponds to its rotation period decreasing by about 4 milliseconds per year

The changing rotation period of 3200 Phaethon

International audience3200 Phaethon is one of the largest potentially hazardous asteroids. It is also the first asteroid to be discovered in spacecraft images, the parent body of the Geminid meteor stream, and the target of JAXA's upcoming DESTINY+ mission. We have developed a physical model of Phaethon's shape and rotation state, using radar data from Arecibo and Goldstone in 2007 and 2017, stellar occultations from 2019 through 2021, and lightcurves from many apparitions (from 1989 through 2021). Phaethon has a volume-equivalent diameter of about 5.3 kilometers. It is approximately spheroidal with an equatorial ridge, resembling the shapes of 101955 Bennu and 162173 Ryugu. The earliest available lightcurve of Phaethon is from 1989 October 9 (published in Wisniewski et al. 1997). Hanuš et al. (2016) noticed that their shape model's rotation phase differed from that 1989 observation by about 20 minutes. They noted that this may be from Phaethon's rotation period changing due to activity, but they could not say whether this was real or just a timing error in that one lightcurve, since the next lightcurves are from 1994. A model with a constant rotation period provided a good fit to all of the data from 1994 through 2020. However, this model could not adequately fit the lightcurves that were acquired from four different observatories in 2021. There was a difference of about 15 minutes between the predicted and observed rotation phases — clearly greater than what the observations' uncertainties could permit. We initially considered that Phaethon's rotation period may have changed before the 2021 observations, perhaps due to activity when it was near perihelion in December 2020. However, we found that a constant rotational acceleration provides a good fit to all of the data from 1989 through 2021, clearly accounting for the discrepancies seen in 1989 and 2021 while also slightly improving the model's agreement with the data during other apparitions. We find that Phaethon's sidereal rotation period in December 2017 was 3.603944 hours. Its spin rate is increasing at a rate of 2.1×10-6 deg/day2, which corresponds to its rotation period decreasing by about 4 milliseconds per year