Book Review

Reviewing William Butler Eldridge, Narcotics and the Law: A Critique of the American Experiment in Drug Control, American Bar Foundation, 196

Book Review

Reviewing William Butler Eldridge, Narcotics and the Law: A Critique of the American Experiment in Drug Control, American Bar Foundation, 196

Solicitation by and for Attorneys

The young attorney often may have time on his hands. He may be tempted to increase his following by advertising or by soliciting clients, but rules of the bar and statutes against solicitation prevent this. There are, of course, some forms of advertising open to all lawyers. National directories and law lists, such as the Martin dale-Hubbell Law Directory, theoretically published only for lawyers, not only advertise the attorney and his firm, but also list the names of any clients whom he wishes to give as representative of his practice and his specialties

Consideration of the Affirmation and Appeal, with Appreciation for the Work of Norman J. Threinen

This Panel was convened on October 25, 2022, as part of the Webinar Series “For the Sake of the Gospel” hosted by the Remembering Today for the Church of Tomorrow Project in partnership with Martin Luther University College and Lutheran Theological Seminary. The intention was to address the Affirmation and Appeal of 1970, to reflect upon the contributions of Norman J. Threinen, and to respond to CHAT questions from Webinar participants

Remembering Canadians in Global Missions and World Service

“Remembering Canadians in Global Missions and World Service” is included in this issue of Consensus as it was part of the Call for Papers by the Remembering Today for the Church of Tomorrow Project. Additional details can be found at https://canadianlutheranhistory.ca/global-service

Hyperpolarized 13C-pyruvate MRI detects real-time metabolic flux in prostate cancer metastases to bone and liver: a clinical feasibility study.

BackgroundHyperpolarized (HP) 13C-pyruvate MRI is a stable-isotope molecular imaging modality that provides real-time assessment of the rate of metabolism through glycolytic pathways in human prostate cancer. Heretofore this imaging modality has been successfully utilized in prostate cancer only in localized disease. This pilot clinical study investigated the feasibility and imaging performance of HP 13C-pyruvate MR metabolic imaging in prostate cancer patients with metastases to the bone and/or viscera.MethodsSix patients who had metastatic castration-resistant prostate cancer were recruited. Carbon-13 MR examination were conducted on a clinical 3T MRI following injection of 250 mM hyperpolarized 13C-pyruvate, where pyruvate-to-lactate conversion rate (kPL) was calculated. Paired metastatic tumor biopsy was performed with histopathological and RNA-seq analyses.ResultsWe observed a high rate of glycolytic metabolism in prostate cancer metastases, with a mean kPL value of 0.020 ± 0.006 (s-1) and 0.026 ± 0.000 (s-1) in bone (N = 4) and liver (N = 2) metastases, respectively. Overall, high kPL showed concordance with biopsy-confirmed high-grade prostate cancer including neuroendocrine differentiation in one case. Interval decrease of kPL from 0.026 at baseline to 0.015 (s-1) was observed in a liver metastasis 2 months after the initiation of taxane plus platinum chemotherapy. RNA-seq found higher levels of the lactate dehydrogenase isoform A (Ldha,15.7 ± 0.7) expression relative to the dominant isoform of pyruvate dehydrogenase (Pdha1, 12.8 ± 0.9).ConclusionsHP 13C-pyruvate MRI can detect real-time glycolytic metabolism within prostate cancer metastases, and can measure changes in quantitative kPL values following treatment response at early time points. This first feasibility study supports future clinical studies of HP 13C-pyruvate MRI in the setting of advanced prostate cancer

A metabolite specific 3D stack-of-spirals bSSFP sequence for improved bicarbonate imaging in hyperpolarized [1-13C]Pyruvate MRI

13C-bicarbonate is a crucial measure of pyruvate oxidation and TCA cycle flux, but is challenging to measure due to its relatively low concentration and thus will greatly benefit from improved signal-to-noise ratio (SNR). To address this, we developed and investigated the feasibility of a 3D stack-of-spirals metabolite-specific balanced steady-state free precession (MS-bSSFP) sequence for improving the SNR and spatial resolution of dynamic 13C-bicarbonate imaging in hyperpolarized [1-13C]pyruvate studies. The bicarbonate MS-bSSFP sequence was evaluated by simulations, phantoms studies, preclinical studies on five rats, brain studies on two healthy volunteers and renal study on one renal cell carcinoma patient. The simulations and phantom results showed that the bicarbonate-specific pulse had minimal perturbation of other metabolites (<1%). In the animal studies, the MS-bSSFP sequence provided an approximately 2.6-3 × improvement in 13C-bicarbonate SNR compared to a metabolite-specific gradient echo (MS-GRE) sequence without altering the bicarbonate or pyruvate kinetics, and the shorter spiral readout in the MS-bSSFP approach reduced blurring. Using the SNR ratio between MS-bSSFP and MS-GRE, the T2 values of bicarbonate and lactate in the rat kidneys were estimated as 0.5 s and 1.1 s, respectively. The in-vivo feasibility of bicarbonate MS-bSSFP sequence was demonstrated in two human brain studies and one renal study. These studies demonstrate the potential of the sequence for in-vivo applications, laying the foundation for future studies to observe this relatively low concentration metabolite with high-quality images and improve measurements of pyruvate oxidation

Calibrationless Multi-coil Magnetic Resonance Imaging with Compressed Sensing

We present a method for combining the data retrieved by multiple coils of a Magnetic Resonance Imaging (MRI) system with the a priori assumption of compressed sensing to reconstruct a single image. The final image is the result of an optimization problem that only includes constraints based on fundamental physics (Maxwell's equations and the Biot-Savart law) and accepted phenomena (e.g. sparsity in the Wavelet domain). The problem is solved using an alternating minimization approach: two convex optimization problems are alternately solved, one with the Fast Iterative Shrinkage Threshold Algorithm (FISTA) and the other with the Primal-Dual Hybrid Gradient (PDHG) method. We show results on simulated data as well as data of the knee, brain, and ankle. In all cases studied, results from the new algorithm show higher quality and increased detail when compared to conventional reconstruction algorithms