The aim of this meta-analysis was to estimate the clinical use value of
C-FMZ and
F-FDG in PET for the localization of epileptogenic zone and to provide evidence for practitioners' clinical decision-making.
We searched PubMed and Embase in a time frame from inception to May 31, 2020. Studies utilizing FMZ or FDG-PET or FDG-PET/MRI used in patients with epilepsy, with EEG or surgical outcomes as the gold standard and corresponding outcomes such as concordance rates of PET or PET/MRI scan compared with reference standard, absolute numbers of participants with true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) results in FDG or FMZ PET. Pooled concordance rates, overall sensitivity, and specificity of
C-FMZ-PET and
F-FDG-PET were calculated.
In total, 44 studies met the inclusion criteria. The pooled concordance rates of FDG-PET, FMZ-PET, and FDG-PET/MRI coregistration compared with reference standard were 0.67 (95% CI 0.60-0.73), 0.75 (95% CI 0.57-0.93), and 0.93 (95% CI 0.89-0.97), respectively. The concordance rate of
F-FDG-PET in patients with temporal lobe epilepsy (TLE) was 0.79 (0.63; 0.92). The overall sensitivity and specificity of
F-FDG-PET were 0.66 (95% CI 0.58-0.73) and 0.71 (95% CI 0.63-0.78), respectively.
C-FMZ-PET displayed an overall sensitivity of 0.62 (95% CI 0.49-0.73) and specificity of 0.73 (95% CI 0.59-0.84).
Both
C-FMZ PET and
F-FDG PET are the choice of modalities for the localization of epileptogenic zone, especially when coregistered with MRI.
•
C-FMZ-PET may be more helpful than
F-FDG-PET in the localization of epilepsy foci. • Coregistration of FDG-PET and MRI is recommended in the localization of epileptogenic zone.
• 11C-FMZ-PET may be more helpful than 18F-FDG-PET in the localization of epilepsy foci. • Coregistration of FDG-PET and MRI is recommended in the localization of epileptogenic zone.
To estimate human fetal brain MRI tissue properties including apparent T
(T
) and apparent proton density (PD
) by using a rapid multi-contrast acquisition protocol called STrategically Acquired Gradient Echo (STAGE) imaging.
STAGE data were collected using two flip angles (15° and 60°, with a TR = 600 ms) for 30 pregnant women at 1.5 T (15 healthy controls gestational age (GA) range 19 + 1/7 weeks to 34 + 5/7 weeks; 11 abnormal subjects with ventriculomegaly GA range 21 + 5/7 weeks to 31 + 5/7 weeks; 4 subjects with other abnormalities). Both T
and PD
maps of the fetal brain were calculated from the STAGE data. A region-of-interest-based approach was used to measure T
and PD
in the subplate/intermediate zone (SP/IZ), cortical plate (CP), and cerebrospinal fluid (CSF) in the fetal brain.
The ratios of T
/T
and PD
/PD
were larger than unity while T
/T
and PD
/PD
were both less than unity.
STAGE imaging provides a potential practical approach to estimate multi-parametric properties of the human fetal brain.
• STAGE is feasible in measuring fetal brain tissue properties. • Water content in cortical plate and subplate/intermediate zone approaches that of cerebrospinal fluid in early gestational ages.
• STAGE is feasible in measuring fetal brain tissue properties. • Water content in cortical plate and subplate/intermediate zone approaches that of cerebrospinal fluid in early gestational ages.
The 9th International Forum for Liver Magnetic Resonance Imaging (MRI) was held in Singapore in September 2019, bringing together radiologists and allied specialists to discuss the latest developments in and formulate consensus statements for liver MRI, including the applications of gadoxetic acid-enhanced imaging.
As at previous Liver Forums, the meeting was held over 2 days. Presentations by the faculty on days 1 and 2 and breakout group discussions on day 1 were followed by delegate voting on consensus statements presented on day 2. Presentations and discussions centered on two main meeting themes relating to the use of gadoxetic acid-enhanced MRI in primary liver cancer and metastatic liver disease.
Gadoxetic acid-enhanced MRI offers the ability to monitor response to systemic therapy and to assist in pre-surgical/pre-interventional planning in liver metastases. In hepatocellular carcinoma, gadoxetic acid-enhanced MRI provides precise staging information for accurate treatment decision-making and fof liver and biliary function is under active investigation.
• Gadoxetic acid-enhanced MRI is the preferred imaging method for pre-surgical or pre-interventional planning for liver metastases after systemic therapy. • Gadoxetic acid-enhanced MRI provides accurate staging of HCC before and after treatment with locoregional/biologic therapies. • Abbreviated protocols for gadoxetic acid-enhanced MRI offer potential time and cost savings, but more evidence is necessary. The use of gadoxetic acid-enhanced MRI for the assessment of liver and biliary function is under active investigation.Live attenuated vaccines are contraindicated for patients on immunosuppressive agents or biological agent, except for live attenuated varicella vaccine, although previous reports showed their effectiveness and safety. This study is the nationwide cross-sectional research about the current utilization of live attenuated vaccines for patients on immunosuppressive agents or biological agents in Japan. We sent questionnaires to pediatric centers and examined whether each institution offered live attenuated vaccines to patients with immunosuppressive agents or biological agents (institutional research). We also examined adverse events associated with live attenuated vaccines between 2013 and 2017 (patient research). In the institutional research, 46 out of 334 institutions (13.8%) administered live attenuated vaccines to patients receiving immunosuppressive agents. In contrast, only six out of 270 institutions (2.2%) administered live attenuated vaccines to patients receiving biological agents. However, 66.3% of pn from the vaccine strains. • Viral infections, such as measles and varicella, cause serious complications in children receiving IS. • Several previous reports showed that LAV is relatively effective and safe for patients receiving IS. What is new • In Japan, the demand for LAV in patients receiving IS was high, and most physicians hoped they should be immunized. • Vaccine-associated infection is rarely observed in patients with IS after LAV administration. • Immunization with LAV appeared safe in patients receiving IS.
University Hospital Medical Information Network (UMIN).
UMIN000029176.Date of registration 2017/09/19.
UMIN000029176.Date of registration 2017/09/19.
Although immune-checkpoint inhibitors have become a new therapeutic option for recurrent/metastatic non-small cell lung cancers (R/M-NSCLC), its clinical benefit in the real-world is still unclear.
We investigated 1181 Korean patients with programmed death-1 ligand 1 (PD-L1)-positive [tumor proportion score (TPS) ≥ 10% by the SP263 assay or ≥ 50% by the 22C3 assay] R/M-NSCLC treated with pembrolizumab or nivolumab after failure of platinum-based chemotherapy.
The median age was 67years, 13% of patients had ECOG-PS ≥ 2, and 27% were never-smokers. Adenocarcinoma was predominant (61%) and 18.1% harbored an EGFR activating mutation or ALK rearrangement. Pembrolizumab and nivolumab were administered to 51.3% and 48.7, respectively, and 42% received them beyond the third-line chemotherapy. Objective response rate (ORR) was 28.6%. Pembrolizumab group showed numerically higher ORR (30.7%) than the nivolumab group (26.4%), but it was comparable with that of the nivolumab group having PD-L1 TPS ≥ 50% (32.4%). Medently predict better treatment outcomes, while EGFR mutation negatively affected OS.Patterns of β-diversity can provide insight into forces shaping community assembly. We analyzed species-rich insect assemblages in two reserve fragments that had once been part of one contiguous Mediterranean coastal pine forest. Local environments are still similar across both fragments, but their landscape context differs strongly, with one surrounded by intense agricultural land, while the other neighbors the urbanized area of Ravenna. Using 23,870 light-trap records of 392 moth species, and multiple local and landscape metrics, we compared the relative importance of habitat- versus landscape-scale environmental factors for shaping small-scale variation in differentiation and proportional insect β-diversity across 30 sites per reserve. Moth assemblage composition differed substantially between fragments, most likely due to ecological drift and landscape-scale variation. For proportional β-diversity, especially local forest structure was important. At well-developed forest sites, additive homogenization could be observed, whereas the lack of typical forest species at dry, dense, and younger forest sites increased species turnover (subtractive heterogenization). For differentiation β-diversity, local and landscape-scale factors were equally important in both reserves. At the landscape-scale (500 m radius around light-trapping sites) the proximity to urban areas and the fraction of human-altered land were most important. At the habitat scale, gradients in soil humidity, nutrient levels and forest structure mattered most, whereas plant diversity had very little explanatory power. Overall, landscape-scale anthropogenic alterations had major effects on moth communities inside the two conservation areas. Yet, even for these parts of one formerly contiguous forest trajectories in community change were remarkably idiosyncratic.
New-onset seizures after cranioplasty (NOSAC) are reported to be a frequent complication of cranioplasty (CP) after decompressive hemicraniectomy (DHC). There are considerable differences in the incidence of NOSAC and contradictory data about presumed risk factors in the literature. learn more We suggest NOSAC to be a consequence of patients' initial condition which led to DHC, rather than a complication of subsequent CP. We conducted a retrospective analysis to verify our hypothesis.
The medical records of all patients ≥ 18years who underwent CP between 2002 and 2017 at our institution were evaluated including incidence of seizures, time of seizure onset, and presumed risk factors. Indication for DHC, type of implant used, timing of CP, patient age, presence of a ventriculoperitoneal shunt (VP shunt), and postoperative complications were compared between patients with and without NOSAC.
A total of 302 patients underwent CP between 2002 and 2017, 276of whom were included in the outcome analysis and the incidence of NOSAC was 23.2%. Although time between DHC and CP differed significantly between DHC indication groups, time between DHC and seizure onset did not differ, suggesting the occurrence of seizures to be independent of the procedure of CP. Time of follow-up was the only factor associated with the occurrence of NOSAC.
New-onset seizures may be a consequence of the initial condition leading to DHC rather than of CP itself. Time of follow-up seems to play a major role in detection of new-onset seizures.
New-onset seizures may be a consequence of the initial condition leading to DHC rather than of CP itself. Time of follow-up seems to play a major role in detection of new-onset seizures.learn more
Top comments (0)