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Usefulness of dual-energy CT scanning at 80 kVp for identifying hilar and mediastinal structures: evaluation of contrast enhancement of the pulmonary vessels and lymph nodes.

Usefulness of dual-energy CT scanning at 80 kVp for identifying hilar and mediastinal structures: evaluation of contrast enhancement of the pulmonary vessels and lymph nodes.

Jpn J Radiol. 2011 Dec 3;

Authors: Imafuji A, Hara M, Sasaki S, Arakawa T, Ozawa Y, Shibamoto Y

Abstract
PURPOSE: We examined whether the 80-kVp CT images scanned at 100 s after contrast material injection using a dual-source scanner could be substituted for the conventional 120-kVp images obtained at an earlier timing of 30 s. MATERIALS AND METHODS: Seventy-eight patients with suspected lung cancer were examined with a 120-kVp mode at 30 s after contrast material injection (early phase) and a dual-energy (80 and 140 kVp) mode at 100 s (late phase). CT numbers of the pulmonary artery (PA), pulmonary vein (PV) and hilar zone lymph nodes (LN) were measured. Contrast between the PA/PV and LN was visually evaluated using a 5-point scale. Beam-hardening artifacts were also visually assessed. RESULTS: The mean difference in attenuation between the PA/PV and LN on the early phase 120-kVp, late phase 80-kVp and late phase weighted-average 120-kVp images was 171.3/160.8, 100.5/106.8 and 67.5/67.5, respectively (p < 0.001). The mean contrast score of these three images for the hilar/mediastinal LN was 4.5/4.7, 3.4/3.8 and 2.9/3.3, respectively (all p < 0.05). The mean artifact score of the three images was 2.6, 4.0 and 4.0, respectively; on most early phase images, the beam-hardening artifacts influenced the diagnosis (p < 0.001). CONCLUSION: The late phase 80-kVp images showing few artifacts may be an alternative to early phase 120-kVp images.

PMID: 22139758 [PubMed - as supplied by publisher]

Predictive Mathematical Models of Cancer Signalling Pathways.

Predictive Mathematical Models of Cancer Signalling Pathways.

J Intern Med. 2011 Dec 5;

Authors: Bachmann J, Raue A, Schilling M, Becker V, Timmer J, Klingmüller U

Abstract
Complex intracellular signalling networks integrate extracellular signals and convert them into cellular responses. In cancer cells, the tightly regulated and fine-tuned dynamics of information processing in signalling networks is altered leading to uncontrolled cell proliferation, survival and migration. Systems biology combines mathematical modelling with comprehensive, quantitative, time-resolved data and is most advanced in addressing dynamic properties of intracellular signalling networks. Here, we introduce different modelling approaches and their application to medical systems biology, focusing on the identifiability of parameters in ordinary differential equation models and their importance in network modelling to predict cellular decisions. Two related examples are given, which include processing of ligand-encoded information and dual feedback regulation in erythropoietin (Epo) receptor signalling. Finally, we review the current understanding of how systems biology could foster the development of new treatment strategies in the context of lung cancer and anaemia.

PMID: 22142263 [PubMed - as supplied by publisher]

Screening for lung cancer: Is this the way forward?

Screening for lung cancer: Is this the way forward?

Respirology. 2011 Dec 5;

Authors: Spiro SG, Navani N

Abstract
Whilst low-dose CT scans have been shown to detect greater numbers of early lung cancers than conventional CXR, the first randomized trial of CT versus CXR screening, in more than 50,000 subjects, has shown a 20% reduction in mortality with CT. There are several other randomized trials in progress. CT scanning may be a useful technique for identifying lung cancer at an earlier stage, and may reduce mortality. However, before it can be used on a wider scale, issues such as over-diagnosis bias, cost-effectiveness, false positive findings of multiple non-calcified nodules, and the willingness of the relevant population to accept CT scanning, need to be evaluated. There is still very little information on the cost per life-year saved as a result of CT scanning, as the data to date is very imprecise. There is no evidence that screening programs influence smoking rates, despite the inclusion of cessation programs in many trials. Furthermore, if CT screening is adopted, much work is needed to persuade individuals at high-risk, mostly current or former heavy smokers with some airflow obstruction, to participate in a screening program.

PMID: 22142440 [PubMed - as supplied by publisher]

Immunotherapy of Lung Adenocarcinoma Patient with Peptide-Pulsed Dendritic Cells: a Case Report.

Immunotherapy with ex vivo generated dendritic cells (DCs) is reported to be of low toxicity and of diverse effectiveness in cancer treatment. The synthetic antigens are frequently used for immunotherapy especially for patients with stable disease after prior treatment.

We described the effect of peptide-loaded DCs-based immunotherapy on patient with recurrent surgically resected adenocarcinoma with bronchoalveolar feature with co-existing of Takayasu arteritis and chronic hepatitis B.

In January 2010, 61-year-old patient received subcutaneously four bi-weekly vaccinations of DCs loaded with MUC1 and MAGE-3 epitopes. Additionally, he received three bi-weekly booster vaccinations after 7 months from the first course of immunotherapy. Delayed-type hypersensitivity test was positive only for MAGE-3 antigen. The evidence expansion of MAGE-3-specific CD8(+) cells after first vaccination and after third vaccination during boosters injections was observed (from 0.08% before vaccination to 0.5% after first vaccination; from 0.05% before booster vaccination to 0.24% after third injection). Computed tomography scans performed after first course and after booster course of vaccination until April 2011 did not shown any presence of lung tumour or metastases.

Based on clinical factors (no completed wedge-resection and recurrent character of cancer) as well as on the presence of the tumour-antigen-specific immunological response, we could speculated that immunotherapy prolonged disease free-survival in our patient. Over 16 months from first vaccination, the patient remains without symptoms of cancer.

Cancer before age 40 in France.

Cancer is a rare pathology before the age of 40: a total of 14,000 new cases have been diagnosed in patients under age 40 in 2005, 1,700 under age 15 and 12,500 in the age-group of 15 to 39, this represents 4% of the cancers diagnosed in 2005.

The number of deaths is small: in 2008, 2,235 patients died before age 40 in France, 246 under age 15 and 1,989 between age 15 and 39; this corresponds to 1% of the cancer deaths in 2008.

The incidence increased between 1980 and 2005, both in the population aged 0 to 14 and in the population aged 15 to 39. Overall, cancer mortality has been decreasing for more than 25 years. The only increase in mortality is observed for brain tumours in children. The overall incidence increase is mostly due to the extension of screening coverage and to improvements in diagnostic procedures. The decrease observed for cervix cancer and lung cancer in men demonstrates the efficacy of screening and of tobacco smoking prevention. The mortality decrease is explained both by improved treatments and by the decreased incidence of some types of cancer.

The increasing brain tumours mortality in children is worrying.

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