PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences

Positron emission tomography-computed tomography (PET-CT) has gained widespread acceptance as a staging investigation in the diagnostic workup of malignant tumours and may be used to visualize metabolic changes before the evolution of morphological changes. To make histology of PET findings without distinctive structural changes available for treatment decisions, we developed a protocol for multimodal image-guided interventions using an integrated PET-CT machine. We report our first experience in 12 patients admitted for staging and restaging of breast cancer, non-small cell lung cancer, cervical cancer, soft tissue sarcoma, and osteosarcoma. Patients were repositioned according to the findings in PET-CT and intervention was planned based on a subsequent single-bed PET-CT acquisition of the region concerned. The needle was introduced under CT guidance in a step-by-step technique and correct needle position in the centre of the FDG avid lesion was assured by repetition of a single-bed PET-CT acquisition before sampling. The metabolically active part of lesions was accurately targeted in all patients and representative samples were obtained in 92%. No major adverse effects occurred. We conclude that PET-CT guidance for interventions is feasible and may be promising to optimize the diagnostic yield of CT-guided interventions and to make metabolically active lesions without morphological correlate accessible to percutaneous interventions.

Selective sampling during catastrophic disruption: Mapping the location of reaccumulated fragments in the original parent body

In this paper, we simulate numerically the catastrophic disruption of a large asteroid as a result of a collision with a smaller projectile and the subsequent reaccumulation of fragments as a result of their mutual gravitational attractions. We then investigate the original location within the parent body of the small pieces that eventually reaccumulate to form the largest offspring of the disruption as a function of the internal structure of the parent body. We consider four cases that may represent the internal structure of such a body (whose diameter is fixed at 250 km) in various early stages of the Solar System evolution: fully molten, half molten (i.e., a 26 km-deep outer layer of melt containing half of the mass), solid except a thin molten layer (8 km thick) centered at 10 km depth, and fully solid. The solid material has properties of basalt. We then focus on the three largest offspring that have enough reaccumulated pieces to consider. Our results indicate that the particles that eventually reaccumulate to form the largest reaccumulated bodies retain a memory of their original locations in the parent body. Most particles in each reaccumulated body are clustered from the same original region, even if their reaccumulations take place far away. The extent of the original region varies considerably depending on the internal structure of the parent. It seems to shrink with the solidity of the body. The fraction of particles coming from a given depth is computed for the four cases, which can give constraints on the internal structure of parent bodies of some meteorites. As one example, we consider the ureilites, which in some petrogenetic models are inferred to have formed at particular depths within their parent body. (C) 2014 Elsevier Ltd. All rights reserved.