Imaging characterization of non-hypersecreting adrenal masses. Comparison between MR and radionuclide techniques.

AIM: In patients with non-hypersecreting adrenal masses, tumor characterization is clinically relevant to establish the appropriate treatment planning. The aim of this study was to comparatively characterize such adrenal lesions using MR and radionuclide techniques. METHODS: Thirty patients with non-hypersecreting unilateral adrenal tumors underwent both MR and adrenal scintigraphy. MR was performed using SE T1- (pre- and post-gadolinium DTPA) and T2-weighted images as well as in- and out-phase chemical-shift imaging (CSI). MR qualitative and quantitative (signal intensity ratios) evaluation was performed. Radionuclide studies consisted of iodine-131 nor-cholesterol (n=20), iodine-131 MIBG (n=15) and fluorine-18 FDG PET (n=11) scans. Histology (n=16), biopsy (n=3) or clinical-imaging follow-up (n=11) demomstrated 13 adenomas, 3 cysts, 2 myelolipomas, 4 pheochromocytomas (pheos), 4 carcinomas, 1 sarcoma and 3 metastases. Comparative imaging analysis was focused on adenomas, pheos and malignant tumors. RESULTS: Qualitative MR evaluation showed: signal T2-hyperintensity in 46% of adenomas and in 100% of pheos and malignant tumors, no gadolinium enhancement in 92% of adenomas and definite signal intensity loss on CSI in 100% of such tumor lesions, gadolinium enhancement in 100% of pheos and in 63% of malignancies and no absolute change of signal intensity on CSI in 100% of both pheos and malignancies. Quantitative MR analysis demonstrated: significantly higher signal T2-hyperintensity of pheos compared to adenomas and malignancies as well as significantly higher enhancement after gadolinium in pheos compared to adenomas and malignancies (p<0.03). Radionuclide studies showed significantly increased nor-cholesterol uptake only in adenomas (n=13), significant MIBG accumulation only in pheos (n=4) and FDG activity only in malignant adrenal lesions (n=8). CONCLUSION: MR techniques may provide some presumptive criteria to characterize non-hypersecreting adrenal masses, such as no gadolinium enhancement and definite signal intensity loss on CSI in adenomas or quantitatively measured T2-hyperintensity and gadolinium enhancement in pheos. On the other hand, radionuclide modalities offer more specific findings in this setting since nor-cholesterol and MIBG scans are respectively able to reveal benign tumors such as adenoma and pheochromocytoma, while FDG imaging allows identification of malignant adrenal lesions. Adrenal scintigraphy is recommended in those patients, when MR images are uncertain or inconclusive

On the asymptotic magnitude of subsets of Euclidean space

Magnitude is a canonical invariant of finite metric spaces which has its origins in category theory; it is analogous to cardinality of finite sets. Here, by approximating certain compact subsets of Euclidean space with finite subsets, the magnitudes of line segments, circles and Cantor sets are defined and calculated. It is observed that asymptotically these satisfy the inclusion-exclusion principle, relating them to intrinsic volumes of polyconvex sets.Comment: 23 pages. Version 2: updated to reflect more recent work, in particular, the approximation method is now known to calculate (rather than merely define) the magnitude; also minor alterations such as references adde

The equation of state for two-dimensional hard-sphere gases: Hard-sphere gases as ideal gases with multi-core boundaries

The equation of state for a two-dimensional hard-sphere gas is difficult to calculate by usual methods. In this paper we develop an approach for calculating the equation of state of hard-sphere gases, both for two- and three-dimensional cases. By regarding a hard-sphere gas as an ideal gas confined in a container with a multi-core (excluded sphere) boundary, we treat the hard-sphere interaction in an interacting gas as the boundary effect on an ideal quantum gas; this enables us to treat an interacting gas as an ideal one. We calculate the equation of state for a three-dimensional hard-sphere gas with spin $j$, and compare it with the results obtained by other methods. By this approach the equation of state for a two-dimensional hard-sphere gas can be calculated directly.Comment: 9 pages, 1 figur

Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine

Patients with masticatory muscle pain and migraine typically report that the intensity of pain fluctuates over time and is affected by weather changes. Weather variables, such as ambient temperature and humidity, may vary significantly depending on whether the individual is outdoor or indoor. It is, therefore, important to assess these variables at the individual level using portable monitors, during everyday life. This study aimed to determine and compare the temporal patterns of pain in individuals affected with facial and head pain and to investigate its relation with weather changes. Eleven patients (27·3 ± 7·4 years) with chronic masticatory muscle pain (MP) and twenty (33·1 ± 8·7 years) with migraine headache (MH) were asked to report their current pain level on a visual analogue scale (VAS) every hour over fourteen consecutive days. The VAS scores were collected using portable data-loggers, which were also used to record temperature, atmospheric pressure and relative humidity. VAS scores varied markedly over time in both groups. Pain VAS scores fluctuate less in the MP group than in the MH group, but their mean, minimum and maximum values were higher than those of migraine patients (all P < 0·05). Pain scores <2 cm were more common in the MH than in the MP group (P < 0·001). Perceived intensity of pain was negatively associated with atmospheric pressure in the MP group and positively associated with temperature and atmospheric in the MH group. Our results reveal that patients with masticatory muscle pain and patients with migraine present typical temporal pain patterns that are influenced in a different way by weather changes

Minimally invasive percutaneous treatment for osteoid osteoma of the Spine. A case report

Osteoid osteomas are benign but painful bone-forming tumors usually involving long bones, with localization at the spine in 10-20% of the cases. The most common symptom is back pain responding to nonsteroidal anti-inflammatory drugs, but in some cases, also radicular pain can be present. For years, surgical excision has been considered the best choice of treatment for cases with unresponsive pain and has been practiced with a high percentage of success but also a high rate of fusion with instrumentation. In the last years, percutaneous radiofrequency ablation has been proposed as a new mini-invasive technique for the treatment of osteoid osteomas

Beyond genus statistics: a unifying approach to the morphology of cosmic structure

The genus statistics of isodensity contours has become a well-established tool in cosmology. In this Letter we place the genus in the wider framework of a complete family of morphological descriptors. These are known as the Minkowski functionals, and we here apply them for the first time to isodensity contours of a continuous random field. By taking two equivalent approaches, one through differential geometry, the other through integral geometry, we derive two complementary formulae suitable for numerically calculating the Minkowski functionals. As an example we apply them to simulated Gaussian random fields and compare the outcome to the analytically known results, demonstrating that both are indeed well suited for numerical evaluation. The code used for calculating all Minkowski functionals is available from the authors.Comment: 8 pages plus 1 figure; uses aaspp4.sty and flushrt.sty. Matches version accepted for publication in Ap. J. Let

Integral geometry of complex space forms

We show how Alesker's theory of valuations on manifolds gives rise to an algebraic picture of the integral geometry of any Riemannian isotropic space. We then apply this method to give a thorough account of the integral geometry of the complex space forms, i.e. complex projective space, complex hyperbolic space and complex euclidean space. In particular, we compute the family of kinematic formulas for invariant valuations and invariant curvature measures in these spaces. In addition to new and more efficient framings of the tube formulas of Gray and the kinematic formulas of Shifrin, this approach yields a new formula expressing the volumes of the tubes about a totally real submanifold in terms of its intrinsic Riemannian structure. We also show by direct calculation that the Lipschitz-Killing valuations stabilize the subspace of invariant angular curvature measures, suggesting the possibility that a similar phenomenon holds for all Riemannian manifolds. We conclude with a number of open questions and conjectures.Comment: 68 pages; minor change

Emergence of Secondary Motifs in Tube-Like Polymers in a Solvent

We study the effects of two kinds of interactions in tube-like polymers and demonstrate that they result in the formation of secondary motifs. The first has an entropic origin and is a measure of the effective space available to the solvent. The second arises from solvophobic interactions of the solvent with the polymers and leads to an energy proportional to the contact surface between the tube and solvent particles. The solvent molecules are modeled as hard spheres and the two interactions are considered separately with the solvent density affecting their relative strength. In addition to analytical calculations, we present the results of numerical simulations in order to understand the role played by the finite length of short polymers and the discrete versus continuum descriptions of the system in determining the preferred conformation.Comment: 5 pages, 2 figures, 1 table. Accepted by Phys. Rev.

Oncogenic driver mutations predict outcome in a cohort of head and neck squamous cell carcinoma (HNSCC) patients within a clinical trial

234 diagnostic formalin-fixed paraffin-embedded (FFPE) blocks from homogeneously treated patients with locally advanced head and neck squamous cell carcinoma (HNSCC) within a multicentre phase III clinical trial were characterised. The mutational spectrum was examined by next generation sequencing in the 26 most frequent oncogenic drivers in cancer and correlated with treatment response and survival. Human papillomavirus (HPV) status was measured by p16INK4a immunohistochemistry in oropharyngeal tumours. Clinicopathological features and response to treatment were measured and compared with the sequencing results. The results indicated TP53 as the most mutated gene in locally advanced HNSCC. HPV-positive oropharyngeal tumours were less mutated than HPV-negative tumours in TP53 (p < 0.01). Mutational and HPV status influences patient survival, being mutated or HPV-negative tumours associated with poor overall survival (p < 0.05). No association was found between mutations and clinicopathological features. This study confirmed and expanded previously published genomic characterization data in HNSCC. Survival analysis showed that non-mutated HNSCC tumours associated with better prognosis and lack of mutations can be identified as an important biomarker in HNSCC. Frequent alterations in PI3K pathway in HPV-positive HNSCC could define a promising pathway for pharmacological intervention in this group of tumours

The Convex Geometry of Linear Inverse Problems

In applications throughout science and engineering one is often faced with the challenge of solving an ill-posed inverse problem, where the number of available measurements is smaller than the dimension of the model to be estimated. However in many practical situations of interest, models are constrained structurally so that they only have a few degrees of freedom relative to their ambient dimension. This paper provides a general framework to convert notions of simplicity into convex penalty functions, resulting in convex optimization solutions to linear, underdetermined inverse problems. The class of simple models considered are those formed as the sum of a few atoms from some (possibly infinite) elementary atomic set; examples include well-studied cases such as sparse vectors and low-rank matrices, as well as several others including sums of a few permutations matrices, low-rank tensors, orthogonal matrices, and atomic measures. The convex programming formulation is based on minimizing the norm induced by the convex hull of the atomic set; this norm is referred to as the atomic norm. The facial structure of the atomic norm ball carries a number of favorable properties that are useful for recovering simple models, and an analysis of the underlying convex geometry provides sharp estimates of the number of generic measurements required for exact and robust recovery of models from partial information. These estimates are based on computing the Gaussian widths of tangent cones to the atomic norm ball. When the atomic set has algebraic structure the resulting optimization problems can be solved or approximated via semidefinite programming. The quality of these approximations affects the number of measurements required for recovery. Thus this work extends the catalog of simple models that can be recovered from limited linear information via tractable convex programming