The prognostic value of semi-quantitative i-123 mibg scintigraphy at diagnosis in high risk neuroblastoma: validation of the siopen score method

Purpose: SIOPEN scoring of 123I mIBG imaging has been shown to predict response to induction chemotherapy and outcome at diagnosis in children with HRN.Method: Patterns of skeletal 123I mIBG uptake were assigned numerical scores (Mscore) ranging from 0 (no metastasis) to 72 (diffuse metastases) within 12 body areas as described previously. 271 anonymised, paired image data sets acquired at diagnosis and on completion of Rapid COJEC induction chemotherapy were reviewed, constituting a representative sample of 1602 children treated prospectively within the HR-NBL1/SIOPEN trial. Pre-and post-treatment Mscores were compared with bone marrow cytology (BM) and 3 year event free survival (EFS).Results: Results 224/271 patients showed skeletal MIBG-uptake at diagnosis and were evaluable forMIBG-response. Complete response (CR) on MIBG to Rapid COJEC induction was achieved by 66%, 34% and 15% of patients who had pre-treatment Mscores of <18 (n¼65, 29%), 18-44 (n¼95,42%) and Y ´ 45 (n¼64, 28.5%) respectively (chi squared test p<.0001). Mscore at diagnosis and on completion of Rapid COJEC correlated strongly with BM involvement (p<0.0001). The correlation of pre score with post scores and response was highly significant (p<0.001). Most importantly, the 3 year EFS in 47 children with Mscore 0 at diagnosis was 0.68 (A ` 0.07), by comparison with 0.42 (A` 0.06), 0.35 (A` 0.05) and 0.25 (A` 0.06) for patients in pre-treatment score groups <18, 18-44 and Y ´ 45, respectively (p<0.001). AnMscore threshold ofY ´ 45 at diagnosis was associated with significantly worse outcome by comparison with all other Mscore groups (p¼0.029). The 3 year EFS of 0.53 (A` 0.07) of patients in metastatic CR (mIBG and BM) after Rapid Cojec (33%) is clearly superior to patients not achieving metastatic CR (0.24 (A ` 0.04), p¼0.005).Conclusion: SIOPEN scoring of 123I mIBG imaging has been shown to predict response to induction chemotherapy and outcome at diagnosis in children with HRN.

[(18)F]FDG-PET Standard Uptake Value as a Metabolic Predictor of Bone Marrow Response to Radiation: Impact on Acute and Late Hematological Toxicity in Cervical Cancer Patients Treated With Chemoradiation Therapy.

PURPOSE: To quantify the relationship between bone marrow (BM) response to radiation and radiation dose by using (18)F-labeled fluorodeoxyglucose positron emission tomography [(18)F]FDG-PET standard uptake values (SUV) and to correlate these findings with hematological toxicity (HT) in cervical cancer (CC) patients treated with chemoradiation therapy (CRT). METHODS AND MATERIALS: Seventeen women with a diagnosis of CC were treated with standard doses of CRT. All patients underwent pre- and post-therapy [(18)F]FDG-PET/computed tomography (CT). Hemograms were obtained before and during treatment and 3 months after treatment and at last follow-up. Pelvic bone was autosegmented as total bone marrow (BMTOT). Active bone marrow (BMACT) was contoured based on SUV greater than the mean SUV of BMTOT. The volumes (V) of each region receiving 10, 20, 30, and 40 Gy (V10, V20, V30, and V40, respectively) were calculated. Metabolic volume histograms and voxel SUV map response graphs were created. Relative changes in SUV before and after therapy were calculated by separating SUV voxels into radiation therapy dose ranges of 5 Gy. The relationships among SUV decrease, radiation dose, and HT were investigated using multiple regression models. RESULTS: Mean relative pre-post-therapy SUV reductions in BMTOT and BMACT were 27% and 38%, respectively. BMACT volume was significantly reduced after treatment (from 651.5 to 231.6 cm(3), respectively; P<.0001). BMACT V30 was significantly correlated with a reduction in BMACT SUV (R(2), 0.14; P<.001). The reduction in BMACT SUV significantly correlated with reduction in white blood cells (WBCs) at 3 months post-treatment (R(2), 0.27; P=.04) and at last follow-up (R(2), 0.25; P=.04). Different dosimetric parameters of BMTOT and BMACT correlated with long-term hematological outcome. CONCLUSIONS: The volumes of BMTOT and BMACT that are exposed to even relatively low doses of radiation are associated with a decrease in WBC counts following CRT. The loss in proliferative BM SUV uptake translates into low WBC nadirs after treatment. These results suggest the potential of intensity modulated radiation therapy to spare BMTOT to reduce long-term hematological toxicity.

Tc-99m-MAA SPECT-derived tumor-to-normal liver ratios for partition model dosimetry in selective internal radiation therapy (SIRT)

Aim: When planning SIRT using 90Y microspheres, the partition model is used to refine the activity calculated by the body surface area (BSA) method to potentially improve the safety and efficacy of treatment. For this partition model dosimetry, accurate determination of mean tumor-to-normal liver ratio (TNR) is critical since it directly impacts absorbed dose estimates. This work aimed at developing and assessing a reliable methodology for the calculation of 99mTc-MAA SPECT/CT-derived TNR ratios based on phantom studies. Materials and methods: IQ NEMA (6 hot spheres) and Kyoto liver phantoms with different hot/background activity concentration ratios were imaged on a SPECT/CT (GE Infinia Hawkeye 4). For each reconstruction with the IQ phantom, TNR quantification was assessed in terms of relative recovery coefficients (RC) and image noise was evaluated in terms of coefficient of variation (COV) in the filled background. RCs were compared using OSEM with Hann, Butterworth and Gaussian filters, as well as FBP reconstruction algorithms. Regarding OSEM, RCs were assessed by varying different parameters independently, such as the number of iterations (i) and subsets (s) and the cut-off frequency of the filter (fc). The influence of the attenuation and diffusion corrections was also investigated. Furthermore, both 2D-ROIs and 3D-VOIs contouring were compared. For this purpose, dedicated Matlab© routines were developed in-house for automatic 2D-ROI/3D-VOI determination to reduce intra-user and intra-slice variability. Best reconstruction parameters and RCs obtained with the IQ phantom were used to recover corrected TNR in case of the Kyoto phantom for arbitrary hot-lesion size. In addition, we computed TNR volume histograms to better assess uptake heterogeneityResults: The highest RCs were obtained with OSEM (i=2, s=10) coupled with the Butterworth filter (fc=0.8). Indeed, we observed a global 20% RC improvement over other OSEM settings and a 50% increase as compared to the best FBP reconstruction. In any case, both attenuation and diffusion corrections must be applied, thus improving RC while preserving good image noise (COV<10%). Both 2D-ROI and 3D-VOI analysis lead to similar results. Nevertheless, we recommend using 3D-VOI since tumor uptake regions are intrinsically 3D. RC-corrected TNR values lie within 17% around the true value, substantially improving the evaluation of small volume (<15 mL) regions. Conclusions: This study reports the multi-parameter optimization of 99mTc MAA SPECT/CT images reconstruction in planning 90Y dosimetry for SIRT. In phantoms, accurate quantification of TNR was obtained using OSEM coupled with Butterworth and RC correction.

Linear relation between deuteron matter radius and the scattering length

We explain the empirical linear relations between the triplet scattering length, or the asymptotic normalization constant, and the deuteron matter radius using the effective range expansion in a manner similar to a recent paper by Bhaduri et al. We emphasize the corrections due to the finite force range and to shape dependence. The discrepancy between the experimental values and the empirical line shows the need for a larger value of the wound extension, a parameter which we introduce here. Short-distance nonlocality of the n-p interaction is a plausible explanation for the discrepancy.

MADAP, a flexible clustering tool for the interpretation of one-dimensional genome annotation data.

A recurring task in the analysis of mass genome annotation data from high-throughput technologies is the identification of peaks or clusters in a noisy signal profile. Examples of such applications are the definition of promoters on the basis of transcription start site profiles, the mapping of transcription factor binding sites based on ChIP-chip data and the identification of quantitative trait loci (QTL) from whole genome SNP profiles. Input to such an analysis is a set of genome coordinates associated with counts or intensities. The output consists of a discrete number of peaks with respective volumes, extensions and center positions. We have developed for this purpose a flexible one-dimensional clustering tool, called MADAP, which we make available as a web server and as standalone program. A set of parameters enables the user to customize the procedure to a specific problem. The web server, which returns results in textual and graphical form, is useful for small to medium-scale applications, as well as for evaluation and parameter tuning in view of large-scale applications, requiring a local installation. The program written in C++ can be freely downloaded from ftp://ftp.epd.unil.ch/pub/software/unix/madap. The MADAP web server can be accessed at http://www.isrec.isb-sib.ch/madap/.

Dépistage des cancers en pratique clinique: une place privilégiée pour le partage de la décision. [Cancer screening in clinical practice: the value of shared decision-making]

Shared decision-making approach to uncertain clinical situations such as cancer screening seems more appropriate than ever. Shared decision making can be defined as an interactive process where physician and patient share all the stages of the decision making process. For patients who wish to be implicated in the management of their health conditions, physicians might express difficulty to do so. Use of patient decision aids appears to improve such process of shared decision making. L'incertitude quant à l'efficacité de certains dépistages de cancers et du traitement en cas de test positif rend l'application du partage de la décision particulièrement appropriée. Le concept du partage de la décision peut être défini comme un processus interactif où le médecin et le patient partagent les étapes du processus de décision. Face aux patients qui désirent être impliqués dans les décisions concernant leur santé, les médecins peinent parfois à le faire. Or, l'utilisation d'outils d'aide à la décision est un moyen efficace de favoriser ce partage de l'information et, si souhaité par le patient, de la décision.

Beaufils ranges to assess the cotton nutrient status in the southern region of Mato Grosso

The relationships between nutrient contents and indices of the Diagnosis and Recommendation Integrated System (DRIS) are a useful basis to determine appropriate ranges for the interpretation of leaf nutrient contents. The purpose of this study was to establish Beaufils ranges from statistical models of the relationship between foliar concentrations and DRIS indices, generated by two systems of DRIS norms - the F value and natural logarithm transformation - and assess the nutritional status of cotton plants, based on these Beaufils ranges. Yield data from plots (average acreage 100 ha) and foliar concentrations of macro and micronutrients of cotton (Gossypium hirsutum r. latifolium) plants, in the growing season 2004/2005, were stored in a database. The criterion to define the reference population consisted of plots with above-average yields + 0.5 standard deviation (over 4,575 kg ha-1 seed cotton yield). The best-fitting statistical model of the relationship between foliar nutrient concentrations and DRIS indices was linear, with R² > 0.8090, p < 0.01, except for N, with R² = 0.5987, p < 0.01. The two criteria were effective to diagnose the plant nutritional status. The diagnoses were not random, but based on the effectiveness of the chi-square-tested method. The agreement between the methods to assess the nutritional status was 92.59-100 %, except for S, with 74.07 % agreement.

Precision determination of r(0)Lambda((MS)over-bar) from the QCD static energy

We use the recently obtained theoretical expression for the complete QCD static energy at next-to-next-to-next-to leading-logarithmic accuracy to determine r(0)Lambda((MS) over bar) by comparison with available lattice data, where r(0) is the lattice scale and Lambda((MS) over bar) is the QCD scale. We obtain r(0)Lambda((MS) over bar) = 0.622(-0.015)(+0.019) for the zero-flavor case. The procedure we describe can be directly used to obtain r(0)Lambda((MS) over bar) in the unquenched case, when unquenched lattice data for the static energy at short distances becomes available. Using the value of the strong coupling alpha(s) as an input, the unquenched result would provide a determination of the lattice scale r(0).

Recommendation of soil fertility levels for willow in the southern highlands of Santa Catarina

The species Salix x rubens is being grown on the Southern Plateau of Santa Catarina since the 1940s, but so far the soil fertility requirements of the crop have not been assessed. This study is the first to evaluate the production profile of willow plantations in this region, based on the modified method of Summer & Farina (1986), for the recommendation of fertility levels for willow. By this method, based on the law of Minimum and of Maximum for willow production for the conditions on the Southern Plateau of Santa Catarina, the following ranges could be recommended: pH: 5.0-6.5; P: 12-89 mg dm-3; Mg: 3.2-7.5 mg; Zn: 5.0-8.3 mg dm-3; Cu: 0.8-4.6 mg dm-3; and Mn; 20-164 mg dm-3. The Ca/Mg ratio should be between 1.2 and 2.9. For K and Ca only the lower (sufficiency level), but not the upper threshold (excess) was established, with respectively 114 mg dm-3 and 5.3 cmol c dm-3. It was also possible to determine the upper threshold for Al and the Al/Ca ratio, i.e., 1.7 cmol c dm-3 and 0.28, respectively. For maximum yields, the clay in the soil surface layer should be below 320 g dm-3.

Noise Induced Fronts

A simple model is introduced that exhibits a noise-induced front propagation and where the noise enters multiplicatively. The invasion of the unstable state is studied, both theoretically and numerically. A good agreement is obtained for the mean value of the order parameter and the mean front velocity using the analytical predictions of the linear marginal stability analysis.

Vortices in atomic Bose-Einstein condensates in the large-gas-parameter region

In this work we compare the results of the Gross-Pitaevskii and modified Gross-Pitaevskii equations with ab initio variational Monte Carlo calculations for Bose-Einstein condensates of atoms in axially symmetric traps. We examine both the ground state and excited states having a vortex line along the z axis at high values of the gas parameter and demonstrate an excellent agreement between the modified Gross-Pitaevskii and ab initio Monte Carlo methods, both for the ground and vortex states.

Modelization of surface diffusion of a molecular dimer

A simple model for a dimer molecular diffusion on a crystalline surface, as a function of temperature, is presented. The dimer is formed by two particles coupled by a quadratic potential. The dimer diffusion is modeled by an overdamped Langevin equation in the presence of a two-dimensional periodic potential. Numerical simulation¿s results exhibit some dynamical properties observed, for example, in Si2 diffusion on a silicon [100] surface. They can be used to predict the value of the effective friction parameter. Comparison between our model and experimental measurements is presented.