Choline PET and PET/CT in Primary Diagnosis and Staging of Prostate Cancer

PET and PET/CT using [11C]- and [18F]-labelled choline derivates is increasingly being used for imaging of primary and recurrent prostate cancer. While PET and PET/CT with [11C]- and [18F]-labelled choline derivates in patients suffering from biochemical recurrence of prostate cancer has been examined in many studies that demonstrate an increasing importance, its role in the primary staging of prostate cancer is still a matter of debate

Pretreatment 18F-FAZA PET Predicts Success of Hypoxia-Directed Radiochemotherapy Using Tirapazamine

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The new Athens center on data processing from the neutron monitor network in real time

International audienceThe ground-based neutron monitors (NMs) record galactic and solar relativistic cosmic rays which can play a useful key role in space weather forecasting, as a result of their interaction with interplanetary disturbances. The Earth's-based neutron monitor network has been used in order to produce a real-time prediction of space weather phenomena. Therefore, the Athens Neutron Monitor Data Processing Center (ANMODAP) takes advantage of this unique multi-directional device to solve problems concerning the diagnosis and forecasting of space weather. At this moment there has been a multi-sided use of neutron monitors. On the one hand, a preliminary alert for ground level enhancements (GLEs) may be provided due to relativistic solar particles and can be registered around 20 to 30 min before the arrival of the main part of lower energy particles responsible for radiation hazard. To make a more reliable prognosis of these events, real time data from channels of lower energy particles and X-ray intensity from the GOES satellite are involved in the analysis. The other possibility is to search in real time for predictors of geomagnetic storms when they occur simultaneously with Forbush effects, using hourly, on-line accessible neutron monitor data from the worldwide network and applying a special method of processing. This chance of prognosis is only being elaborated and considered here as one of the possible uses of the Neutron Monitor Network for forecasting the arrival of interplanetary disturbance to the Earth. The achievements, the processes and the future results, are discussed in this work

Categorical versus continuous circulating tumor cell enumeration as early surrogate marker for therapy response and prognosis during docetaxel therapy in metastatic prostate cancer patients

Background: Circulating tumor cell (CTCs) counts might serve as early surrogate marker for treatment efficacy in metastatic castration-resistant prostate cancer (mCRPC) patients. We prospectively assessed categorical and continuous CTC-counts for their utility in early prediction of radiographic response, progression-free (PFS) and overall survival (OS) in mCRPC patients treated with docetaxel. Methods: CTC-counts were assessed in 122 serial samples, as continuous or categorical (= 5 CTCs) variables, at baseline (q0) and after 1 (q1),4 (q4) and 10 (q10) cycles of docetaxel (3-weekly, 75 mg/m2) in 33 mCRPC patients. Treatment response (TR) was defined as non-progressive (non-PD) and progressive disease (PD),by morphologic RECIST or clinical criteria at q4 and q10. Binary logistic and Cox proportional hazards regression analyses were used as statistical methods. Results: Categorical CTC-count status predicted PD at q4 already after one cycle (q1) and after 4 cycles (q4) of chemotherapy with an odds ratio (OR) of 14.9 (p = 0.02) and 18.0 (p = 0.01). Continuous CTC-values predicted PD only at q4 (OR 1.04, p = 0.048). Regarding PFS, categorical CTC-counts at q1 were independent prognostic markers with a hazard ratio (HR) of 3.85 (95 % CI 1.1-13.8, p = 0.04) whereas early continuous CTC-values at q1 failed significance (HR 1.02, 95 % CI 0.99-1.05, p = 0.14). For OS early categorical and continuous CTC-counts were independent prognostic markers at q1 with a HR of 3.0 (95 % CI 1.6-15.7, p = 0.007) and 1.02 (95 % CI 1.0-1.040, p = 0.04). Conclusions: Categorical CTC-count status is an early independent predictor for TR, PFS and OS only 3 weeks following treatment initiation with docetaxel whereas continuous CTC-counts were an inconsistent surrogate marker in mCRPC patients. For clinical practice, categorical CTC-counts may provide complementary information towards individualized treatment strategies with early prediction of treatment efficacy and optimized sequential treatment

Stimulation der TSH-Sekretion durch TRF-Belastung bei hypothalamischen und hypophysären Krankheitsbildern

1. Die Antworten der Serum-TSH-Spiegel (Thyreoidea-stimulierendes Hormon) auf TRF-Injektion (Thyrotropin Releasing Factor) bei 8 Normalpersonen und 37 z. T. zweimal untersuchten Patienten mit hypophysärer oder hypothalamischer Erkrankung werden mitgeteilt. 2. Hypophysektomierte Patienten mit intrasellären Tumoren (N=12) zeigten keine oder nur subnormale Anstiege der TSH-Spiegel. 3. Von 9 präoperativ untersuchten Patienten mit intrasellärem HVL-Adenom hatten 3 eine sekundäre Hypothyreose. Diese 3 reagierten dennoch mit einem normalen Anstieg der TSH-Spiegel. Dieser Befund schränkt die diagnostische Wertigkeit der TRF-Belastung zur Differenzierung hypophysärer und hypothalamischer sekundärer Hypothyreosen ein. Die 6 euthyreoten Patienten dieser Gruppe zeigten erwartungsgemäß einen normalen TSH-Anstieg. 4. Bei den Patienten mit sekundärer Hypothyreose bei suprasellärem Tumor oder hypothalamischer Erkrankung (N=7) fand sich mit einer Ausnahme ein normaler oder ein erhöhter TSH-Anstieg. Die Bedeutung des Ausschlusses einer primären Hypothyreose wurde dargestellt, da diese Erkrankung ebenfalls durch erhöhte TSH-Anstiege bei TRF-Belastung charakterisiert ist. 5. Je ein Patient aus der Gruppe der aktiven (N=7) und der behandelten (N=6) Akromegalie zeigten einen nicht auf eine primäre Hypothyreose zurückführbaren erhöhen TSH-Anstieg, dessen Rolle für das gehäufte Auftreten einer Struma bei Akromegalie zu diskutieren ist.1. The response of the serum TSH levels after i.v. administration of 500 µg TRF have been determined in normal controls (n=8) and in 37 patients with pituitary tumour or hypothalamic disease. 2. Following hypophysectomy in patients with intrasellar tumours (n=12), the increment in TSH levels after TRF was absent or diminished. 3. Secondary hypothyroidism was found pre-operatively in 3 of 9 patients with intrasellar pituitary adenoma. In these 3 patients, however, a normal TSH response to TRF was found. This result diminishes the diagnostic value of the TRF test regarding the distinction of pituitary and hypothalamic secondary hypothyroidism. A normal TSH response was found, as expected, in the 6 euthyroid patients of this group. 4. The TSH response was found to be normal or elevated in all but one of 7 patients with secondary hypothyroidism due to suprasellar tumour or hypothalamic disease. Primary hypothyroidism is also characterized by an increased TSH response and has to be excluded. 5. Among the patients with active (n=7) or treated (n=6) acromegaly, increased TSH response was found twice, i.e. in one patient of each of the two groups. In both patients, primary hypothyroidism could be excluded. The relevance of this increased TSH response for goitrogenesis in acromegaly is discussed

Applications and usage of the real-time Neutron Monitor Database

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Prognostic Value of [18F]-Fluoro-Deoxy-Glucose PET/CT, S100 or MIA for Assessment of Cancer-Associated Mortality in Patients with High Risk Melanoma

PURPOSE: To assess the prognostic value of FDG PET/CT compared to the tumor markers S100B and melanoma inhibitory activity (MIA) in patients with high risk melanoma. METHODS: Retrospective study in 125 consecutive patients with high risk melanoma that underwent FDG PET/CT for re-staging. Diagnostic accuracy and prognostic value was determined for FDG PET/CT as well as for S100B and MIA. As standard of reference, cytological, histological, PET/CT or MRI follow-up findings as well as clinical follow-up were used. RESULTS: Of 125 patients, FDG PET/CT was positive in 62 patients. 37 (29.6%) patients had elevated S100B (>100 pg/ml) and 24 (20.2%) had elevated MIA (>10 pg/ml) values. Overall specificities for FDG PET/CT, S100B and MIA were 96.8% (95% CI, 89.1% to 99.1%), 85.7% (75.0% to 92.3%), and 95.2% (86.9% to 98.4%), corresponding sensitivities were 96.8% (89.0% to 99.1%), 45.2% (33.4% to 55.5%), and 36.1% (25.2% to 48.6%), respectively. The negative predictive values (NPV) for PET/CT, S100B, and MIA were 96.8% (89.1% to 99.1%), 61.4% (50.9% to 70.9%), and 60.6% (50.8% to 69.7%). The positive predictive values (PPV) were 96.7% (89.0% to 99.1%), 75.7% (59.9% to 86.6%), and 88.0% (70.0% to 95.8%). Patients with elevated S100B- or MIA values or PET/CT positive findings showed a significantly (p<0.001 each, univariate Cox regression models) higher risk of melanoma associated death which was increased 4.2-, 6.5- or 17.2-fold, respectively. CONCLUSION: PET/CT has a higher prognostic power in the assessment of cancer-associated mortality in melanoma patients compared with S100 and MIA