Can Dual Energy CT using Iodine Mapping Predict the Nuclear Grade of Clear Cell Type of Renal Cell Carcinoma

INTRODUCTION : Renal cell carcinoma, most common malignancy of kidney is predominantly disease of elderly. With a steady rise in global incidence of RCC number of incidentally detected disease and small, localised diseases are also increasing. Other than tumour stage, nuclear grade is considered an independent prognostic factor of RCC. Recently introduced dual energy CT which uses two different peak energies enables us to reconstruct virtual non contrast images, virtual monochromatic images and two material (commonly iodine and water) decomposition and quantification. AIMS : The aim of the study is to see whether iodine concentration in the clear cell renal cell carcinoma (RCC), obtained using iodine mapping in dual energy CT (DECT) can predict the nuclear grade of clear cell type of renal cell carcinoma. OBJECTIVES : 1 To correlate iodine concentration in clear cell type of RCC can predict the nuclear grade of RCC. 2 To identify cut off values of iodine concentration which can best identify the nuclear grade of RCC. MATERIALS & METHODS : It was a prospective study conducted during the time period of September 2014 to July 2016. Institutional review board approved the study. All patients with suspected or known renal mass referred for pre-operative CT abdomen was recruited for the study who underwent dual energy CT in arterial and venous phase in GE Discovery 750 HD CT machine. This is a single source fast kV switching dual energy CT machine. Water suppressed iodine density images are obtained to draw ROI in three different levels in RCC in both arterial and venous phases to get maximum, minimum and mean iodine concentration. ROIs are also drawn in aorta and normal kidney in arterial and venous phases. Post operatively histological types and nuclear grades were noted. Finally, patients with clear cell type of RCC are included for analysis. RESULTS & ANALYSIS : Total 95 lesions were analysed in 95 different patients. For three patients with multiple RCCs larger lesion was considered for analysis. Predominantly cystic lesions did not correlate well with nuclear grade. Solid tumours show good correlation with nuclear grades. The mean iodine concentration in the venous phase showed maximum correlation to predict nuclear grade. Mean venous phase iodine concentration of 16.74 mg/cc or less was found to predict higher grades of RCC (grade 3 and 4) with 65% sensitivity and 81% specificity. Other factors which also show significant correlation with nuclear grades are minimum venous phase iodine concentration, ratio of minimum venous phase iodine concentration to mean iodine concentration in kidney and ratio of minimum iodine concentration in arterial phase to arterial phase mean kidney iodine concentration. CONCLUSION : The mean iodine concentration in the venous phase can predict nuclear grade with moderate accuracy for solid tumours. For predominantly cystic RCCs iodine concentration did not correlate with the nuclear grade

Loneliness and Internet Addiction: A Correlative Analysis in the Context of Online Education among Young Adults

Due to pandemic online education has become the only accessible process to address diverse community in education system. It also compels students to use internet with unprescribed manner which leads to several usage of it at levels that can be called as internet addiction. On the other hand online education has excluded the social interaction process to virtual platforms with changing manner and characteristics. Due to this one can find himself/herself isolated and on the other hand who is reluctant of participation can find he/she secure. Thus with different dimensions of loneliness and a growing amount of internet addiction, the present study aims to find the primary relation between these two variables

Layered double hydroxide: Inorganic organic conjugate nanocarrier for methotrexate

Layered double hydroxide (LDH)-methotrexate (MTX) nanohybrids were successfully synthesized using ex situ and in situ processes. X-ray diffraction patterns of the synthesized nanopowders revealed that intercalated MTX molecules were stabilized in tilted longitudinal conformation into the hydroxide interlayer space. Two separate hydroxyl peaks were found in the FTIR spectra of LDH-MTX nanopowders suggesting successful intercalation of the MIX molecule into LDH matrix. The synthesized powders were further characterized using transmission electron microscopy (TEM) and selected area electron diffraction (SAED) pattern. HRTEM images showed an increase in interlayer spacing in hydrothermally crystallized LDH-MTX nanohybrids as compared to pristine LDH. The study showed that depending on the synthesis route used to synthesize LDH-MTX nanohybrid, its particle size as well as morphology can be varied at nano scale. (C) 2011 Elsevier Ltd. All rights reserved

Effect of Process Variations on Anticancerous Drug Intercalation in Ceramic Based Delivery System

Two methods have been attempted to intercalate an anionic anticancerous drug methotrexate (MTX) into Mg-Al layered double hydroxide (LDH): a) anion exchange method (sample A') and b) in situ coprecipitation method followed by a soft hydrothermal treatment (sample A `') to form a biohybrid material. Both the materials obtained were characterized by powdered sample X-ray diffraction (XRD), Fourier transform infrared spectra (FT-IR), thermogravimetric-differential thermal analysis (TG-DTA), particle size distribution (PSD) analysis and field emission scanning electron microscopy (FE-SEM). High performance liquid chromatography (HPLC) was used to determine the integrity of the MTX and to quantify the drug loading in the materials. HPLC data of sample A' confirms the integrity of the MTX moiety in the interlayer space of Mg-Al-LDH which has been further verified by XRD and FTIR spectroscopy and drug loading in the hybrid system was found to be 20.22 mg.g(-1). However, the HPLC data of sample A `' supports that under soft hydrothermal condition decomposition of MTX is operating and the major decomposition product was identified as N(10)-methyl folic acid that remains adsorbed on Mg-Al-LDH surface, primarily, as indicated by the TG-DTA study