Conventional MRI-Derived Biomarkers of Adult-Type Diffuse Glioma Molecular Subtypes: A Comprehensive Review

The introduction of molecular criteria into the classification of diffuse gliomas has added interesting practical implications to glioma management. This has created a new clinical need for correlating imaging characteristics with glioma genotypes, also known as radiogenomics or imaging genomics. Although many studies have primarily focused on the use of advanced magnetic resonance imaging (MRI) techniques for radiogenomics purposes, conventional MRI sequences remain the reference point in the study and characterization of brain tumors. A summary of the conventional imaging features of glioma molecular subtypes should be useful as a tool for daily diagnostic brain tumor management. Hence, this article aims to summarize the conventional MRI features of glioma molecular subtypes in light of the recent literature

L'identificazione delle Diagnosi Infermieristiche* "Non Adesione (00079)" e "Inefficace Autogestione della Salute (00078)": Studio pilota

Scopo. Rilevare su un campione di studenti infermieri di II e III anno dati riguardanti le competenze nell'identificazione delle Diagnosi Infermieristiche Inefficace autogestione della salute (00078) e Non adesione (00079) e determinare le differenze e le similitudini fra le due diagnosi rilevate dagli studenti, quali elementi vengono presi in considerazione per identificarle, le possibili cause di un'errata identificazione. Metodo: Intervista semistrutturata con analisi di un caso clinico Risultati: Sono state riscontrate conoscenze carenti rispetto ad entrambe le diagnosi e gli studenti stessi hanno dichiarato difficoltí  nella loro comprensione ed identificazione; la maggior parte degli studenti intervistati tende a confondere le due diagnosi proprio perché non ne riconosce le diversití . Nonostante ciò, la maggior parte di essi ha correttamente identificato la diagnosi in riferimento al caso clinico proposto, motivando in modo appropriato le scelte effettuate. Conclusioni: Lo studio evidenzia la necessití  di sviluppare le competenze degli studenti in riferimento all'identificazione delle 2 diagnosi. Le condizioni della persona che esse descrivono non sono chiaramente distinguibili quindi gli obiettivi assistenziali e gli interventi per il loro trattamento possono essere definiti in modo inappropriato e inefficace per la salute. Le azioni di miglioramento andranno rivolte alle possibili cause di una diagnosi differenziale difficoltosa e dovranno riguardare l'ambito della formazione attraverso metodi e strumenti utilizzati dai docenti nella relazione di apprendimento(per modificare conoscenze, atteggiamenti e convinzioni, percezione di autoefficacia) ma anche i contesti assistenziali (applicazione delle competenze cognitive acquisite sulle diagnosi infermieristiche durante il tirocinio clinico).Parole Chiave: non adesione, inefficace autogestione della salute, studenti, diagnosi infermieristicheIdentification of Nursing Diagnosis "Non compliance (00079)" and "Ineffective Self-Health Management (00078)": Pilot studyObjectives: Survey on a sample of second and third years nursing students, data concerning skills in identifying nursing diagnosis "Ineffective Self-Health management (00078)" and "Non compliance (00079)". The main objectives were to determine differences and similarities between the two diagnosis detected by students, to recognize which elements taken into account to identify them and to determine possible causes of misidentification. Method: Semi structured interview with analisys of a clinical case. Results: Lacking knowledge was found regarding both diagnosis. Students stated to have some difficulties to understand and identify diagnosis; most of the them interviewed tend to confuse these two diagnosis precisely because they do not discern the differences. Despite that, most of them succeded in identifying the correct diagnosis in reference to the proposed clinical case, and were able to justify properly the choices made. Conclusion: The study highlights the need to develop students' skills for the identification of the two diagnoses. There is a overall confusion in describing patient's health conditions, this leads to an innapropriate identification of nursing goals and interventions and to an not efficient delivery of care. Improving actions should be addressed to the causes of a difficult differential identification. Educator therefore should be focus on learning development in order to change knowledge, attitudes and beliefs, perception of self-efficacy, but also in clinical practice in order to improve cognitive skills on nursing diagnosis.Keywords: non compliance, ineffective self health management, students, nursing diagnosi

The Wandering Mesenteric Lymph Node: Delayed 68Ga-DOTANOC PET/CT Imaging to Overcome a Potential Pitfall

A patient multiple endocrine neoplasia type 1 presenting with radiological suspicion of pancreatic neuroendocrine tumor relapse after surgical and somatostatin analog treatment underwent restaging Ga-DOTANOC PET/CT. Standard and delayed images detected an area of focal intense uptake moving from the left para-aortic to the paracaval region. The lesion was identified at previous imaging in different abdominal locations (eg, adjacent to the duodenal wall at presurgical PET and in the aortocaval region at restaging contrast-enhanced CT). Dual time-point Ga-DOTANOC PET/CT was crucial to accurately diagnose the wandering mesenteric lymph node, a potential interpretation pitfall especially when found far from the initial positio

Predictive and prognostic value of 18F-DOPA PET/CT in patients affected by recurrent medullary carcinoma of the thyroid

Medullary thyroid carcinoma (MTC) is a malignancy accounting for about 5-8% of thyroid cancers. Serum calcitonin and carcinoembryonic antigen (CEA) levels are widely used to monitor disease progression. However, prognostic factors able to predict outcomes are highly desirable. We, therefore, aimed to assess the prognostic role of F-18-DOPA PET/CT in patients with recurrent MTC.60 patients (mean age 64 +/- 13 years, range 44-82) with recurrent MTC were eligible from a multicenter database. All patients underwent a restaging F-18-DOPA PET/CT, performed at least 6 months after surgery. CEA/calcitonin levels, local recurrences, nodal involvement and metastases at PET/CT were recorded. SUVmax, SUVmean (also normalized to mediastinal uptake) and metabolic tumor volume were automatically calculated for each lesion, by placing a volume of interest around the lesion with 40% of peak activity as threshold for the automatic contouring. The patients were clinically and radiologically followed up for 21 +/- 11 months. Rate of progression-free survival (PFS), disease-specific survival (DSS) and incremental prognostic value of F-18-DOPA PET/CT over conventional imaging modalities were assessed by Kaplan-Meier curves and Log-Rank test. Cox regression univariate and multivariate analyses were performed for assessing predictors of prognosis.F-18-DOPA PET/CT showed abnormal findings in 27 patients (45%) and resulted unremarkable in 33 (55%). PFS was significantly longer in patients with an unremarkable PET/CT scan (p = 0.018). Similarly, an unremarkable PET/CT study was associated with a significantly longer DSS (p = 0.04). F-18-DOPA PET/CT added prognostic value over other imaging modalities both for PFS and for DSS (p < 0.001 and p = 0.012, respectively). Neither semiquantitative PET parameters nor clinical or laboratory data were predictive of a worse PFS and DSS in patients with recurrent MTC.F-18-DOPA PET/CT scan has an important prognostic value in predicting disease progression and mortality rate

Correction to: Predictive and prognostic value of 18F-DOPA PET/CT in patients affected by recurrent medullary carcinoma of the thyroid (Annals of Nuclear Medicine, (2018), 32, 1, (7-15), 10.1007/s12149-017-1213-0)

The following affiliation should be added to the authors Agostino Chiaravalloti and Orazio Schillaci

Prognostic and diagnostic value of [18F]FDG-PET/CT in restaging patients with small cell lung carcinoma: an Italian multicenter study

BACKGROUND: The presence of residual disease after initial treatment in small cell lung cancer (SCLC) influences prognosis and impacts patient management. To date, few data exist on the value of fluorine-18-fluorodeoxyglucose ([F]FDG)-PET/computed tomography (CT) in SCLC at restaging. Therefore, in restaging patients with SCLC, we aimed to (a) evaluate the prognostic value yielded by [F]FDG-PET/CT and (b) assess the diagnostic agreement between [F]FDG-PET/CT and contrast-enhanced computed tomography (ceCT). PATIENTS AND METHODS: From a multicenter database, we evaluated 164 patients with SCLC who underwent [F]FDG-PET/CT for restaging purposes. PET scans were evaluated visually to identify the presence of recurrence. For each patient, the maximum and the mean standardized uptake value (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis were calculated, taking into account the lesion with the highest [F]FDG uptake (namely, the index lesion) in the local recurrences, lymph node involvement, and distant metastasis categories. Kaplan-Meier curves were computed to assess the effects of [F]FDG-PET/CT findings on overall survival (OS) and progression-free survival. Furthermore, the agreement between PET/CT and ceCT in detecting metastases was evaluated in 119 patients on a patient-based analysis (Cohen's \u3ba; P < 0.05). RESULTS: The presence of metastatic lesions at [F]FDG-PET/CT was associated with a significantly shorter OS (P = 0.039) and progression-free survival (P < 0.001). Higher SUVmax showed a trend toward a shorter OS (P = 0.065). The K-agreement between ceCT and PET/CT in recurrent SCLC was 0.37 (P < 0.001). PET/CT and ceCT showed the same number of lesions in 52 (43.7%) patients, whereas PET/CT detected additional lesions in 35 (29.4%) patients. CONCLUSION: Detection of metastatic lesions at restaging by [F]FDG-PET/CT can predict a higher rate of progression and negatively influence OS in patients with SCLC. [F]FDG-PET/CT and ceCT seem to be complementary imaging modalities in patients with metastatic SCLC