Imaging Core Laboratory Research Articles

Pseudoprogression in cancer immunotherapy: Rates, time course and patient outcomes.

6580Background: Pseudoprogression (PP), tumor growth from treatment effect rather than true disease progression, has been described with immune checkpoint inhibitors. Our study measures rates and time course of PP and associated patient outcomes using RECIST 1.1 and irRC criteria. Methods: Cohort was retrospectively drawn from subjects enrolled in phase I and II trials from March 2008 to July 2015 at two hospitals within one cancer center network. Inclusion required followup with every 4-12 week scheduled torso CT or MRI for > 1 year or until death analyzed using RECIST 1.1 and irRC criteria by the imaging core lab. A single investigator blinded to patient outcome abstracted the core lab database; another blinded to imaging assessment abstracted patient survival from the medical record. Pattern of response during the first year of therapy assessed according to RECIST 1.1 and irRC criteria were categorized as stable (SD), partial response (PR), progressive disease (PD) or pseudoprogression (PP). PP was def...

Thromboaspiration technique as first approach for endovascular treatment of acute ischemic stroke: initial experience at nine Italian stroke centers

Background and purposeAspiration thrombectomy of large vessel occlusions has made a comeback among recanalization techniques thanks to recent advances in catheter technology resulting in faster recanalization and promising clinical results...

The Need for Standardized Methods for Measuring the Aorta: Multimodality Core Lab Experience From the GenTAC Registry

ObjectivesThis study sought to evaluate variability in aortic measurements with multiple imaging modalities in clinical centers by comparing with a standardized measuring protocol implemented in a core laboratory. BackgroundIn patients with aortic disease, imaging of thoracic aorta plays a major role in risk stratifying individuals for life-threatening complications and in determining timing of surgical intervention. However, standardization of the procedures for performance of aortic measurements is lacking. MethodsTo characterize the diversity of methods used in clinical practice, we compared aortic measurements performed by echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) at the 6 GenTAC (National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) clinical centers to those performed at the imaging core laboratory in 965 studies. Each center acquired and analyzed their images according to local protocols. The same images were subsequently analyzed blindly by the core laboratory, on the basis of a standardized protocol for all imaging modalities. Paired measurements from clinical centers and core laboratory were compared by mean of differences and intraclass correlation coefficient (ICC). ResultsFor all segments of the ascending aorta, echocardiography showed a higher ICC (0.84 to 0.93) than CT (0.84) and MRI (0.82 to 0.90), with smaller mean of differences. MRI showed higher ICC for the arch and descending aorta (0.91 and 0.93). In a mixed adjusted model, the different imaging modalities and clinical centers were identified as sources of variability between clinical and core laboratory measurements, whereas age groups or diagnosis at enrollment were not. ConclusionsBy comparing core laboratory with measurements from clinical centers, our study identified important sources of variability in aortic measurements. Furthermore, our findings with regard to CT and MRI suggest a need for imaging societies to work toward the development of unifying acquisition protocols and common measuring methods.

Reproducibility of serial optical coherence tomography measurements for lumen area and plaque components in humans (The CLI-VAR [Centro per la Lotta Contro l'Infarto-variability] II study).

Frequency-domain optical coherence tomography (FD-OCT) is a promising intracoronary imaging technique to study atherosclerosis. Indeed, its unprecedented spatial resolution allows the assessment of fibrous cap thickness, lipid pool and features of plaque vulnerability. Aim of this study was to determine the reproducibility of the in vivo FD-OCT measurements of lumen area and plaque components in serial studies. Twenty-six patients undergoing FD-OCT assessment of intermediate lesion during coronary angiography were included in this study. FD-OCT pullbacks were acquired twice from the same coronary segment at interval of 5 min without additional intervention and analyzed off-line at an independent imaging core laboratory. Lumen diameter (LD), lumen area (LA), fibrous cap (FC) thickness and lipid pool (LP) arc extension measurements were compared in 440 matched frames. Both the per-segment and per-frame analyses showed excellent correlation coefficients for the inter-pullback comparisons for all parameters explored (R > 0.95 and p < 0.001 in all cases). Accordingly, the Bland-Altman estimates of bias showed non-significant differences in the inter-pullback comparisons at all levels. Per-frame analysis showed a slightly variations of LA in 45.8% of cases with changes greater than 2% likely related to different phases of cardiac cycle. Nevertheless, nor FC thickness or circumferential arc of LP were affected by LA changes during serial FD-OCT acquisition. This study showed an excellent reproducibility of lumen and plaque component measurements obtained with FD-OCT in vivo. Thus, this intracoronary imaging technique could be used to assess atherosclerosis progression and describe accurate plaque evolution in repeated serial studies.

Anomalous Aortic Origin of Coronary Arteries in the Young: Echocardiographic Evaluation With Surgical Correlation

ObjectivesThis study sought to compare findings from institutional echocardiographic reports with imaging core laboratory (ICL) review of corresponding echocardiographic images and operative reports in 159 patients with anomalous aortic origin of a coronary artery (AAOCA). The study also sought to develop a “best practice” protocol for imaging and interpreting images in establishing the diagnosis of AAOCA. BackgroundAAOCA is associated with sudden death in the young. Underlying anatomic risk factors that can cause ischemia-related events include coronary arterial ostial stenosis, intramural course of the proximal coronary within the aortic wall, interarterial course, and potential compression between the great arteries. Consistent protocols for diagnosing and evaluating these features are lacking, potentially precluding the ability to risk stratify patients based on evidence and plan surgical strategy. MethodsFor a prescribed set of anatomic AAOCA features, percentages of missing data in institutional echocardiographic reports were calculated. For each feature, agreement among institutional echocardiographic reports, ICL review of images, and surgical reports was evaluated using the weighted kappa statistic. An echocardiographic imaging protocol was developed heuristically to reduce differences between institutional reports and ICL review. ResultsA total of 13%, 33%, and 62% of echocardiograms were missing images enabling diagnosis of intra-arterial course, proximal intramural course, and high ostial takeoff, respectively. There was poor agreement between institutional reports and ICL review for diagnosis of origin of coronary artery, interarterial course, intramural course, and acute angle takeoff (kappa = 0.74, 0.11, –0.03, 0.13, respectively). Surgical findings were also significantly different from those of reports, and to a lesser extent ICL reviews. The resulting protocol contains technical recommendations for imaging each of these features. ConclusionsPoor agreement between institutional reports and ICL review for AAOCA suggests need for an imaging protocol to permit evidence-based risk stratification and surgical planning. Even then, delineation of echocardiographic details in AAOCA will remain imperfect.

NIMG-18EVALUATING TUMOR PROGRESSION AND IMMUNOLOGIC REACTIONS DURING IMMUNOTHERAPY: NEUROIMAGING OBSERVATIONS FROM A MULTICENTER STUDY OF NIVOLUMAB MONOTHERAPY AND NIVOLUMAB IN COMBINATION WITH IPILIMUMAB IN RECURRENT GLIOBLASTOMA (CHECKMATE-143)

BACKGROUND: Determining disease progression and response in glioblastoma (GBM) is challenging as standard therapies may alter tumor enhancement on MRI and technical factors complicate interpretation of imaging results in multicenter trials. The emergence of investigational immunomodulatory agents for GBM has further challenged investigators to distinguish possible treatment-related immunologic reactions at the tumor site from disease progression using non-invasive imaging techniques. METHODS: Eligible patients had first recurrence of primary GBM, no prior bevacizumab treatment, and KPS ≥70. Patients were randomized to nivolumab 3 mg/kg Q2W (NIVO) or nivolumab 1 mg/kg + ipilimumab 3 mg/kg Q3W followed by nivolumab 3 mg/kg Q2W (NIVO + IPI). Participating institutions underwent imaging standardization; sites were qualified and images were read locally then transmitted to an independent imaging core lab. MRI was obtained at baseline, week 7, week 13, then Q8W. RANO criteria were applied. Select patients (n = 7) underwent advanced and exploratory neuroimaging, including dynamic contrast-enhanced MRI (DCE-MRI) and [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET). RESULTS: Twenty patients were enrolled (NIVO, n = 10; NIVO + IPI, n = 10). Median age: 57 (range 37–73); MGMT: methylated (n = 4), unmethylated (n = 10), and undetermined (n = 6). Investigator-assessed objective responses: partial response (n = 1), stable disease (n = 8), and progression (n = 10). A subset of patients demonstrated biopsy-confirmed immune-related treatment effects, with pathology showing reactive changes and minimal to no tumor. Additional neuroimaging in one of these patients showed hypermetabolism on the FDG-PET scan, while the DCE-MRI results were equivocal, with only mildly increased Ktrans and plasma volume. Standard and advanced neuroimaging results from this preliminary cohort will be reported. CONCLUSIONS: Use of checkpoint inhibitors in GBM may be associated with treatment-related imaging changes that may be difficult to distinguish from disease progression using standard MRI imaging. Additional multi-modality imaging studies, particularly perfusion MRI, may be helpful to address such discordant findings.

Infra-patellar fat pad morphology and MRI signal distribution in advanced radiographic knee OA – Data from the OAI

s / Osteoarthritis and Cartilage 23 (2015) A82eA416 A219 349 INFRA-PATELLAR FAT PAD MORPHOLOGY AND MRI SIGNAL DISTRIBUTION IN ADVANCED RADIOGRAPHIC KNEE OA e DATA FROM THE OAI F. Eckstein yz, J. Diepold y, A. Ruhdorfer y, T. Dannhauer yz, W. Wirth yz, A. Guermazi xk. y Paracelsus Med. Univ., Salzburg & Nuremberg, Austria; zChondrometrics GmbH, Ainring, Germany; xBoston Univ. Sch. of Med., Boston, MA, USA; kBoston Imaging Core Lab, Boston, MA, USA Purpose: Recent studies suggest that obesity-related risk of knee OA is not fully explained by mechanical challenge, i.e. increased body weight. Yet, adipokines (e.g. leptin) secreted from fat tissue appear to cause lowgrade inflammation, and to contribute to the release of metallo-proteinases and growth factors, which are known to promote cartilage loss and osteophyte formation. The infra-patellar fat pad (IPFP) is unique in representing intra-articular adipose tissue, and is a source of intraarticular leptin. Only few studies, however, have studied the role of the IPFP in human knee OA. Here we explore whether quantitative imaging measures of IPFP size and MRI signal differ between painful knees with and without advanced radiographic knee OA in the same person, and between OA and healthy reference knees. Methods: The sample was drawn from the Osteoarthritis Initiative (OAI) cohort and fulfilled the following criteria: OARSI medial JSN in one knee, no-JSN in the contra-lateral knee, BMI>25, frequent knee pain in both knees. The 28 participants who displayed OARSI JSN grades 2 or 3 in one (and grade 0 in the other) knee were matched 1:1 with subjects from the OAI healthy reference cohort without knee pain radiographic signs, or risk factors of incident knee OA, based on the same sex and similar body height. A sagittal fat-suppressed IM-weighted TSE sequence was used for segmentation of the entire IPFP (J.D.), volumetric 3D analysis of its morphology and signal, and for semi-quantitative evaluation of MOAKS synovitis scores (A.G.). Paired t-tests were used to compare JSN with contra-lateral non-JSN knees, and with matched reference knees. Results: The 28 JSN participants (21 medial JSN grade 2 and 7 grade 3; 21 women, 7 men) were 165±11 cm tall (age 61±10y; weight 87±14 kg, BMI 32.2±4.4). The matched healthy reference subjects were of similar height (165±10cm), but younger (54±6y) and less heavy (70±13 kg; BMI 26±2.7). No significant differences in IPFP volume, surface areas, or thickness were observed between JSN and no-JSN knees. Compared with healthy reference knees, JSN knees displayed a 10% larger IPFP anterior surface area (p<0.01), but a slightly lower thickness, and no significant difference in IPFP volume (Table 1). JSN knees displayed a significantly greater mean MRI signal intensity (SI) and greater MRI SI heterogeneity (i.e. standard deviation [SD]) than the no-JSN knees; further JSN knees displayed a substantially and significantly greater SD SI than healthy reference knees (Table 1: (b) 1⁄4 p<0.01; (c) 1⁄4 p<0.001)).

Pseudoaneurysm of the Sinus of Valsalva

Journal of Cardiac SurgeryVolume 30, Issue 4 p. 368-369 Images in Cardiac Surgery Pseudoaneurysm of the Sinus of Valsalva Antonella Galeone M.D., Ph.D., Corresponding Author Antonella Galeone M.D., Ph.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, France Address for correspondence: Antonella Galeone, M.D., Ph.D., Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, Paris 75013, France. Fax: +33142165639; e-mail: a.galeone@email.itSearch for more papers by this authorEleodoro Barreda M.D., Eleodoro Barreda M.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorDorian Verscheure M.D., Dorian Verscheure M.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorOlivier Barthélémy M.D., Olivier Barthélémy M.D. Department of Cardiology, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorAlban Redheuil M.D., Ph.D., Corresponding Author Alban Redheuil M.D., Ph.D. Department of Cardiovascular Imaging and Interventional Radiology, La Pitiè-Salpêtrière Hospital, Paris, France Institute of Cardiometabolism and Nutrition (ICAN) Imaging Core Lab, Paris, France Sorbonne Universités, Université Pierre et Marie Curie, Paris, France Address for correspondence: Antonella Galeone, M.D., Ph.D., Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, Paris 75013, France. Fax: +33142165639; e-mail: a.galeone@email.itSearch for more papers by this authorPascal Leprince M.D., Ph.D., Pascal Leprince M.D., Ph.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, France Sorbonne Universités, Université Pierre et Marie Curie, Paris, FranceSearch for more papers by this author Antonella Galeone M.D., Ph.D., Corresponding Author Antonella Galeone M.D., Ph.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, France Address for correspondence: Antonella Galeone, M.D., Ph.D., Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, Paris 75013, France. Fax: +33142165639; e-mail: a.galeone@email.itSearch for more papers by this authorEleodoro Barreda M.D., Eleodoro Barreda M.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorDorian Verscheure M.D., Dorian Verscheure M.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorOlivier Barthélémy M.D., Olivier Barthélémy M.D. Department of Cardiology, La Pitiè-Salpêtrière Hospital, Paris, FranceSearch for more papers by this authorAlban Redheuil M.D., Ph.D., Corresponding Author Alban Redheuil M.D., Ph.D. Department of Cardiovascular Imaging and Interventional Radiology, La Pitiè-Salpêtrière Hospital, Paris, France Institute of Cardiometabolism and Nutrition (ICAN) Imaging Core Lab, Paris, France Sorbonne Universités, Université Pierre et Marie Curie, Paris, France Address for correspondence: Antonella Galeone, M.D., Ph.D., Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, 47-83, boulevard de l'Hôpital, Paris 75013, France. Fax: +33142165639; e-mail: a.galeone@email.itSearch for more papers by this authorPascal Leprince M.D., Ph.D., Pascal Leprince M.D., Ph.D. Department of Thoracic and Cardiovascular Surgery, La Pitiè-Salpêtrière Hospital, Paris, France Sorbonne Universités, Université Pierre et Marie Curie, Paris, FranceSearch for more papers by this author First published: 09 January 2015 https://doi.org/10.1111/jocs.12496Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume30, Issue4April 2015Pages 368-369 RelatedInformation

The imaging core lab perspective on glioblastoma imaging and response assessment in clinical trials.

Multicenter clinical trials that include medical images as a key component of response assessment often involve an imaging service provider (a core laboratory or contract research organization) to collect images and often to provide independent assessments of treatment response. The brief discussion and recommendations provided here are not intended as a rigorous academic analysis but reflect the practical experience accumulated at one such institution, which has conducted the image collection and review for numerous glioblastoma trials, in every phase of drug development, encompassing over 4000 patients scanned at over 900 sites.

Central endoscopy reads in inflammatory bowel disease clinical trials: The role of the imaging core lab.

Clinical trials in inflammatory bowel disease (IBD) are evolving at a rapid pace by employing central reading for endoscopic mucosal assessment in a field that was, historically, largely based on assessments by local physicians. This transition from local to central reading carries with it numerous technical, operational, and scientific challenges, many of which can be resolved by imaging core laboratories (ICLs), a concept that has a longer history in clinical trials in a number of diseases outside the realm of gastroenterology. For IBD trials, ICLs have the dual goals of providing objective, consistent assessments of endoscopic findings using central-reading paradigms whilst providing important expertise with regard to operational issues and regulatory expectations. This review focuses on current approaches to using ICLs for central endoscopic reading in IBD trials.

THU0195 Semiquantitatively Assessed Bone Marrow Lesions, Cartilage Damage, Meniscal Damage and Extrusion PREDICT Quantitatively Measured Cartilage Thickness Loss in the Same Femorotibial Compartment: the Most Study

BackgroundStudies have shown associations of structural progression of knee OA with several MRI-assessed pathologic features such as bone marrow lesions (BMLs) cartilage damage and meniscal lesions1,2. However previous studies commonly...

OP0124 Mri-Based Long Term Predicition of Incident Radiographic Osteoarthritis

BackgroundPre-radiographic structural damage is likely to increase the risk of incident radiographic osteoarthritis (ROA). It is not known, however, which specific structural changes predict incident ROA over the long-term.ObjectivesThe aim...

TU‐C‐9A‐01: IROC Organization and Clinical Trial Credentialing

As a response to recommendations from a report from the Institute of Medicine, NCI is reorganizing it clinical trial groups into a National Clinical Trial Network (NCTN) that consists of four adult groups (Alliance, ECOGACRIN, NRG, and SWOG) and one children’s group (COG). NRG will house CIRO, a center to promote innovative radiation therapy research and intergroup collaboration in radiation. The quality assurance groups that support clinical trials have also been restructured. ITC, OSU Imaging corelab, Philadelphia Imaging core‐lab, QARC, RPC, and RTOGQA have joined together to create the Imaging and Radiation Oncology Core (IROC) Group. IROC’s mission is to provide integrated radiation oncology and diagnostic imaging quality control programs in support of the NCI’s NCTN thereby assuring high quality data for clinical trials designed to improve the clinical outcomes for cancer patients worldwide. This will be accomplished through five core services: site qualification, trial design support, credentialing, data management, case review. These changes are important for physicist participating in NCI clinical trials to understand. We will describe in detail the IROC’s activities and five core services so that as a user, the medical physicist can learn how to efficiently utilize this group. We will describe common pitfalls encountered in credentialing for current protocols and present methods to avoid them. These may include the which benchmarks are required for NSABP B‐51/RTOG 1304 and how to plan them as well as tips for phantom planning. We will explain how to submit patient and phantom cases in the TRIAD system used by IROC.Learning Objectives: To understand the basic organization of IROC, its mission and five core services To learn how to use TRIAD for patient and phantom data submission To learn how to avoid common pitfalls in credentialing for current trials

18F-FDG PET/CT for Early Prediction of Response to Neoadjuvant Lapatinib, Trastuzumab, and Their Combination in HER2-Positive Breast Cancer: Results from Neo-ALTTO

Molecular imaging receives increased attention for selecting patients who will benefit from targeted anticancer therapies. Neo-ALTTO (Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) enrolled 455 women with invasive human epidermal growth factor receptor 2 (HER2)-positive breast cancer and compared rates of pathologic complete response (pCR) to neoadjuvant lapatinib, trastuzumab, and their combination. Each anti-HER2 therapy was given alone for 6 wk, followed by 12 wk of the same therapy plus weekly paclitaxel. The early metabolic effects of the anti-HER2 therapies on the primary tumors and their predictive values for pCR were assessed in a subset of patients. Eighty-six patients underwent (18)F-FDG PET/CT at baseline and weeks 2 and 6 of anti-HER2 treatment. An imaging core laboratory provided central validation, and 2 independent reviewers, masked to assigned treatment arm and clinical outcomes, performed consensus (18)F-FDG PET/CT readings. Maximum standardized uptake value (SUVmax) reductions from baseline were used to measure metabolic response. Seventy-seven of the 86 enrolled patients presented an evaluable baseline (18)F-FDG PET/CT scan; of these, 68 and 66 were evaluable at weeks 2 and 6, respectively. Metabolic responses in the primary tumors were evident after 2 wk of targeted therapy and correlated highly with metabolic responses at week 6 (R(2) = 0.81). pCRs were associated with greater SUVmax reductions at both time points. Mean SUVmax reductions for pCR and non-pCR, respectively, were 54.3% versus 32.8% at week 2 (P = 0.02) and 61.5% versus 34.1% at week 6 (P = 0.02). (18)F-FDG PET/CT metabolic response rates at weeks 2 and 6 were 71.6% and 60%, respectively using European Organization for Research and Treatment of Cancer criteria; pCR rates were twice as high for (18)F-FDG PET/CT responders than nonresponders (week 2: 42% vs. 21%, P = 0.12; week 6: 44% vs. 19%, P = 0.05). Early metabolic assessment using (18)F-FDG PET/CT can identify patients with an increased likelihood of pCR after neoadjuvant trastuzumab, lapatinib, or their combination when given with chemotherapy.

Shining Light on the Sunshine Act

Shining Light on the Sunshine Act

One-year outcomes from an international study of the Ovation Abdominal Stent Graft System for endovascular aneurysm repair

This study evaluated 1-year safety and effectiveness outcomes of the United States regulatory trial for the Ovation Abdominal Stent Graft System (TriVascular Inc, Santa Rosa, Calif) for endovascular repair of abdominal aortic aneurysms (AAAs). This prospective, multicenter, single-arm trial was conducted at 36 sites in the United States, Germany, and Chile to evaluate the safety and effectiveness of the Ovation stent graft. From November 2009 to May 2011, 161 patients (88% males; mean age, 73 ± 8 years) with AAAs (mean diameter, 54 ± 9 mm) were treated with the Ovation stent graft. The main body is a modular two-docking limb device with a 14F outer diameter delivery system, active suprarenal fixation, and polymer-filled proximal rings that accommodate the aortic neck for seal. Main inclusion criteria included proximal aortic neck length ≥ 7 mm, inner neck diameter between 16 and 30 mm, distal iliac landing zones length ≥ 10 mm, and diameter between 8 and 20 mm. Patients were treated under a common protocol, including clinical and imaging follow-up at discharge, 30 days, 6 months, and annually through 5 years. A Clinical Events Committee adjudicated adverse events, an independent imaging core laboratory analyzed imaging, and a Data Safety and Monitoring Board provided study oversight. Complete 1-year follow-up data were available for this report. The Ovation stent graft was implanted successfully in 161 patients (100%), including 69 (42.9%) by percutaneous access. General anesthesia was used in 106 patients (65.8%). Technical success was 100%, and mean procedure time was 110 minutes. Median procedural blood loss was 150 mL, and median hospital stay was 1 day. The 30-day major adverse event rate was 2.5%. At 1 year, AAA-related and all-cause mortality were 0.6% and 2.5%, respectively. Major adverse event and serious adverse event rates through 1 year were 6.2% and 38.5%, respectively. The 1-year treatment success rate was 99.3%. The imaging core laboratory reported no stent graft migration or type I, III, or IV endoleaks. At 1 year, type II endoleaks were identified in 34% of patients, and AAA enlargement was identified in one patient (0.7%). No AAA rupture or conversion to open surgery was reported. AAA-related secondary procedures were performed in 10 patients (6.2%) for 12 findings, including endoleak (six), aortic main body stenosis (three), and iliac limb stenosis or occlusion (three). The 1-year results of the Ovation Abdominal Stent Graft System demonstrate excellent safety and effectiveness in treatment of patients with AAAs, particularly in patients with challenging anatomic characteristics, including short aortic necks and narrow iliac arteries. Longer-term follow-up is needed.

ADP-ribosylation of Translation Elongation Factor 2 by Diphtheria Toxin in Yeast Inhibits Translation and Cell Separation

Eukaryotic translation elongation factor 2 (eEF2) facilitates the movement of the peptidyl tRNA-mRNA complex from the A site of the ribosome to the P site during protein synthesis. ADP-ribosylation (ADP(R)) of eEF2 by bacterial toxins on a unique diphthamide residue inhibits its translocation activity, but the mechanism is unclear. We have employed a hormone-inducible diphtheria toxin (DT) expression system in Saccharomyces cerevisiae which allows for the rapid induction of ADP(R)-eEF2 to examine the effects of DT in vivo. ADP(R) of eEF2 resulted in a decrease in total protein synthesis consistent with a defect in translation elongation. Association of eEF2 with polyribosomes, however, was unchanged upon expression of DT. Upon prolonged exposure to DT, cells with an abnormal morphology and increased DNA content accumulated. This observation was specific to DT expression and was not observed when translation elongation was inhibited by other methods. Examination of these cells by electron microscopy indicated a defect in cell separation following mitosis. These results suggest that expression of proteins late in the cell cycle is particularly sensitive to inhibition by ADP(R)-eEF2.

O-001 Pre-Treatment Imaging is Critical in Identifying Stroke Patients with Small and Medium Infarcts Who are Likely to Benefit from IA Therapy

Introduction/PurposeThe Penumbra START Trial is a multicentre, prospective, single-arm trial with a primary aim of determining whether core infarct size on pre-treatment neuroimaging predicts clinical response to intra-arterial acute stroke...

OP0270 The association of delayed gadolinium-enhanced MRI of cartilage (DGEMRIC) and cartilage morphometry in a sample of middle-aged women: A 2-year follow-up MRI study

BackgroundDelayed gadolinium-enhanced MRI of cartilage (dGEMRIC) may detect early cartilage pathology as it allows assessment of matrix proteoglycan content. It is not known whether changes in dGEMRIC indices are associated...

SAT0322 Presence of large bone marrow lesions (BMLS) and worsening of BMLS in the medial TIBIO-femoral joint increase risk for knee replacement – data from the osteoarthritis initiative

BackgroundTotal knee joint replacement (TKR) is a cost-effective procedure with good long-term outcomes. However, there is no clear consensus on indications for TKR. Subchondral bone marrow lesions (BMLs), have been...