Volume Variation Research Articles

Mendelian randomization analyses reveal causal relationship between liver volume and stroke

BackgroundObservational studies have suggested a potential association between abdominal viscera volume and increased risk of stroke. However, the causal relationship remains unclear. This study aims to utilize Mendelian randomization (MR) to explore the genetic causal relationship between them. MethodsWe conducted MR analysis to study the causal effects of five abdominal viscera volumes on stroke. The genetic variations of abdominal viscera volume were obtained from the UK Biobank, and the summary data for stroke and ischemic stroke were acquired from the MEGASTROKE consortium. This study employed inverse variance weighting (IVW), MR Egger, and weighted median methods. IVW served as the primary MR analysis method, supplemented by other sensitivity analyses to validate the robustness of the results. ResultsWe found that liver volume can causally increase the risk of stroke [odds ratio (OR): 1.13, 95 % confidence interval (CI): 1.03-1.25, P = 0.013] and ischemic stroke (OR: 1.14, 95 % CI: 1.03-1.26, P = 0.012). No causal relationships between other abdominal viscera volumes and stroke and ischemic stroke appeared to be present (P > 0.05). Sensitivity analyses confirmed the robustness of the results. ConclusionOur research findings indicate a causal relationship between liver volume and stroke, highlighting the potential role of liver volume in the onset of stroke. However, further basic and clinical research is needed to delve into the specific mechanisms underlying the relationship between liver volume and stroke, and to implement interventions aimed at reducing the impact of liver volume on stroke risk.

Role of electrocardiometry in hemodynamic assessment of children with shock in multisystem inflammatory syndrome following COVID-19: A single-center prospective observational study

Background: The hemodynamic profile in multisystem inflammatory syndrome in children (MIS-C) has not been well described. Therefore, we conducted the study utilizing electrocardiometry (EC) to assess the hemodynamic characteristics in MIS-C patients presenting with shock. Subjects and Methods: This pilot prospective observational study was conducted in the pediatric intensive care unit of a tertiary care hospital. Children between 2 months and 18 years meeting the WHO criteria for MIS-C presenting with shock during second COVID-19 pandemic were included in the study. All patients underwent measurement of hemodynamic profile with EC for the initial 48 h of enrollment. Based on EC assessment at enrolment, the systemic vascular resistance index (SVRi) of 1000–1600 dyn s/cm5/m2 was regarded as normal. The hemodynamic categorization was defined as vasodilatory shock in EC (VDEC) (SVRi <1000 dyn s/[cm5/m2]) and vasoconstrictive shock in EC (VCEC) (SVRi > 1600 dyn s/[cm5/m2]). Results: Thirty-one children met the WHO case definition of MIS-C during the study period. Sixteen children with shock were enrolled and studied. Clinically, 7 (43.75%) children had cold shock, whereas 9 (56.25%) had warm shock. The measured baseline (mean [standard deviation]) hemodynamic variables were cardiac index (CI) of 6 ± 1.41 L/min/m2, stroke volume variation of 23% ±9.6%, SVRi of 954.75 ± 263.35 dyn s/(cm5/m2), and thoracic fluid content of 51.18 ± 17.26 ml. VDEC was the predominant manifestation (87.5%) based on EC. Conclusions: Vasodilatory shock was the predominant phenotype observed in critically ill children with MIS-C with shock by EC assessment.

In segregation influence on properties of InAs quantum dots in dots-in-a-well

We investigated the growth of InAs quantum dots (QDs) in a dots-in-a-well (DWELL) from the perspective of the influence of In segregation from the InGaAs layers in the DWELL. Reflection high-energy electron diffraction (RHEED) measurements during the growth of the lower InGaAs layer indicated that In segregation increased with the In composition of the InGaAs layer. The estimated In segregation values were consistent with the decreases in the critical thickness for the QDs growth and the total volume variations of the grown QDs. These results illustrate that the segregated In from the lower InGaAs layer contributes to the QD growth in the DWELL, and their density increases. Furthermore, RHEED measurements during the growth of the upper InGaAs layer indicated the suppression of the deformation of embedded QDs , which could partially contribute to the longer emission wavelength of the QDs in the DWELL.

Micro-cracking on the surface of zinc metal improves the cycle performance of aqueous zinc ion batteries

The notorious zinc dendrite is a severe constraint to the practical application of zinc-based batteries, as the metal tips growing vertically in two dimensions on the surface of the electrodes during cycling and loosely packed sharp edges may pierce through the diaphragm, posing a safety hazard. In this study, physical stress extrusion was used to generate micron- or submicron-sized cracks on zinc metal anodes, which significantly increased the specific surface area of the electrodes and mitigated the local current density of the electrodes. Zinc ion fluxes were significantly dispersed, producing a dense Zn2SO4(OH)6-xH2O (ZHS) layer, which differed distinctly from the by-products of the loose upright growth on the surface of Raw Zn (RZn). Additionally, three-dimensional structure of cracked zinc composition allows it to adjust the zinc volume variations during electroplating/stripping, and the abundance of nucleation sites significantly reduces the Zn polarization voltage, resulting in uniform Zn deposition. The average cycle life of the symmetric cell was >400 h at 1 mA cm−2 current density, and nearly 500 cycles at 5 mA cm−2 current density for the asymmetric cell, with an average Coulombic efficiency of 99.3 %. The activation energy substantially declined with the increase in Zn ion flux per unit time (29.615 KJ mol−1 vs. 44.041 KJ mol−1), demonstrating efficient desolvation kinetics. Furthermore, the Crack Zn || V2O5 full cell also exhibits outstanding self-discharge performance, with 85 % capacity retention in a 48 h resting charge/discharge testing, superior to the raw zinc foil anode (78.3 %). Herein, a method of creating microcrack configurations on the surface of zinc anodes using stress extrusion was presented, sparing the current density while optimizing the undesirable growth patterns of ZHS by-products.

A Solid-State Reaction in a Vapor Chamber: Synthesis of Bi2(MoO4)3 Nanorods as High-Capacity Anode for Lithium-Ion Batteries

Conversion- and alloying-type materials have been investigated as alternatives to intercalating graphite anodes of lithium-ion batteries for recent decades. However, the electrochemical pulverization and limitations in large-scale production of metal oxides prohibit them from practical applications. This work provided an ambient solid-state reaction accelerated by water vapor for synthesizing Bi2(MoO4)3 nanorods combined with carbon under mild-condition ball-milling for composite fabrication. The obtained composite performs superior electrochemical performance: a delivered capacity of 802.2 mAh·g−1 after 300 cycles at a specific current of 500 mA·g−1 with a retention of 82.3%. This improvement was ascribed to the better accommodation to volume variation and reinforced physical contact raised by one-dimensional morphology and ball-milling treatment. The complex conversion-intercalation-alloying mechanism of the lithium-ion storage in Bi2(MoO4)3 anode was also clarified using cyclic voltammetry and ex situ X-ray photoelectron spectroscopy results.

Mura‐free G8.5 220ppi inkjet printing technology for OLED and QLED display panels

AbstractThis paper reported on the development of a Mura‐free and high precise printing to realize high‐resolution organic light‐emitting diode and quantum dot light‐emitting diode display panels with a G8.5 glass substrate. To realize Mura‐free printing, we developed the single‐path print line head and the new pixel volume adjustment system with a pixel volume variation of ±0.8%. And to realize high precise printing, we developed the G8.5 table system that compensated for the drop position by changing the jetting time of each nozzle. And verified a drop position accuracy of ±2.1 μm. By combining these technologies, we achieved Mura‐free 220‐ppi printing on the G8.5 table.

Facile construction of Cu2-xSe@C nanobelts as anode for superior sodium-ion storage

Transition metal selenides are considered promising electrochemical energy storage materials due to their excellent rate properties and high capacity based on multi-step conversion reactions. However, its practical applications are hampered by poor conductivity and large volume variation for Na+ storage, which resulting fast capacity decay. Herein, a facile metal-organic framework (MOF) derived method is explored to embed Cu2-xSe@C particles into a carbon nanobelts matrix. Such carbon encapsulated nanobelts' structural moderate integral electronic conductivity and maintained the structure from collapsing during Na+ insertion/extraction. Furthermore, the porous structure of these nanobelts endows enough void space to mitigate volume stress and provide more diffusion channels for Na+/electrons transporting. Due to the unique structure, these Cu2-xSe@C nanobelts achieved ultra-stable cycling performance (170.7 mAh/g at 1.0 A/g after 1000 cycles) and superior rate capability (94.6 mAh/g at 8 A/g) for sodium-ion batteries. The kinetic analysis reveals that these Cu2-xSe@C nanobelts with considerable pesoudecapactive contribution benefit the rapid sodiation/desodiation. This rational design strategy broadens an avenue for the development of metal selenide materials for energy storage devices.

Soil Stabilization Using Agricultural Waste (Wheat Husk, Rice Husk and Sugarcane Straw)

Abstract: For civil engineers, the safe disposal of both hazardous and non-hazardous waste is a challenge. This is because just a few states can securely deposit agricultural trash. This study includes studies on the safe disposal of agricultural wastes such as wheat husk (WH), rice husk (RH), and sugarcane straw (SCS). In this study, attempts were undertaken to improve soil quality by employing WH, RH, and SCS. The primary goal of ground improvement is to increase shear strength and reduce soil compressibility.The investigation was done utilizing the expansive soil by taking variable volumes, which are then mixed with the different stabilized material for Atterberg limit tests and California bearing ratio (CBR) test. These tests are tested and proven using the standard tests IS 2720, and it is ultimately decided that the test results improve the geotechnical qualities of the soil.

Calculate The Thermal Efficiency Of a Distilled Water Evaporator Using Clean Water as Raw Material

Increasing the efficiency of equipment is very necessary to avoid wasting energy. It is known that fossil fuel energy continues to increase and runs out quickly, so alternative energy is needed that can be used continuously and does not run out quickly when used because this energy is easy to obtain and comes from nature. The aim of this research is to create a design for this equipment that can be applied in laboratories, pharmacies, hospitals, etc. The methods used in this design are structural plans and functional plans. In the process of heating the air in the evaporator with varying volumes, namely 1 liter, 2 liters, 2.5 liters, 3 liters and 3.5 liters, you can see a large amount of steam with a short heating process. The results of the research show that it can be seen that the electrical thermal efficiency shows that the smaller the value of the feed water volume, the greater the electrical thermal efficiency (inversely proportional). This shows that one indication is that the performance of the aquadest evaporator saves electrical energy in the heating and evaporation process of optimal water because the less feed, the faster the heating process, and the greater the amount of steam produced in one hour of operation and it can be seen that the energy consumption is spent on a volume of 3.5 liters because the heating time is long compared to other variations in feed water volume so the energy consumption is large

Analysis of Anaerobic Digestion Installation Testing for Tofu Liquid Waste Utilization into Biogas with the Addition of Cow Manure Variations

The purpose of this study is to convert tofu wastewater into biogas using an anaerobic digester with varying cow dung mixtures (10%, 15%, and 20%). The study method entails creating digesters including independent, dependent, and controlled variables. Variations in pH, temperature, biogas pressure, and biogas volume were detected throughout the course of a 15-day fermentation. The data show that in the 10% fluctuation, the greatest pH was on day 7 (7), whereas the highest temperature was 32°C on days 6 and 7. Biogas pressure emerged on day 6 (89.2 cmHg), resulting in a volume of 90 liters by day 15. In the 15% variation, the highest pH (7.2) occurred on day 8, with the highest temperature (34°C) on days 9 and 10. Biogas pressure began on day 5 (89.9 cmHg), with a biogas volume of 95 liters on day 15. The 20% variance resulted in the highest pH (7.4) on day 8 and the highest temperature of 35°C from days 9-11. Biogas pressure began on day 5 (90.7 cmHg), resulting in a biogas volume of 100 liters on day 15. This study sheds light on how to manage tofu waste into biogas with varying degrees of effectiveness and efficiency.

Water jet vacuum cooling system for improving the quality of multiflora honey from bee (Apis dorsata Fabricus) in Indonesia

Honey has great benefits to humans, both as medicine and food. It contains glucose, fructose and water in addition to small quantities of proteins, minerals, organic acids, and vitamins. Vacuum cooling is a rapid cooling technique based on the principle of evaporation, which lowers the boiling point of water based on the vacuum pressure inside a cooler room. A prototype vacuum-cooling jet water system was used to process the honey. Raw honey obtained from the forests of Riau was used in the present study. This study aimed to determine the effect of jet water vacuum cooling with variations in volume (V/V), capacity (12.5%, 25%, and 50%) on the quality of honey (Apis dorsata Fabricus) to accelerate the cooling process and preserve product quality. The cooling mechanical analysis parameters reviewed included the processing time and the lowest maximum pressure. The parameters of the quality of honey observed included moisture content, viscosity, density and total dissolved solids. As a result, the vacuum cooling process can suppress damage to the quality of honey owing to the heating process. At the cooling time and lowest maximum pressure value, the mechanical aspects of the water jet system vacuum cooling process showed the maximum results. The water contents of 12.5% (V/V), 25% (V/V) and 50% (V/V) filling were 13.69%, 12.89%, and 14.25%, respectively. The viscosities at 12.5% (V/V), 25% (V/V) and 50% (V/V) filling were 2.604 Pa.s, 2.355 Pa.s, and 1.644 Pa.s, respectively. Density with 12.5% (V/V), 25% (V/V) and 50% (V/V) filling were 1.52 g/cm3, 1.53 g/cm3 and 1.50 g/cm3, respectively. Total dissolved solid values of honey with 12.5 % (V/V), 25 % (V/V), and 50 % (V/V) fillings were 78.16%, 78.16% and 77.66%, respectively. Water jet vacuum cooling with a 25% chamber volume capacity accelerates honey with the best total dissolved solids, density and moisture content. Vacuum cooling can be used to improve product quality, shorten handling time, extend product shelf life and improve security. Key words: honey, pressure, vacuum cooling, density, moisture content, viscosity

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature.

The management of hepatoblastoma (HB) becomes challenging when the tumor remains in close proximity to the major liver vasculature (PMV) even after a full course of neoadjuvant chemotherapy (NAC). In such cases, extreme liver resection can be considered a potential option. To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC. We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023. We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC. Sixty-seven children diagnosed with HB underwent surgical resection. The age at diagnosis was 21.4 ± 18.8 months, and 40 boys and 27 girls were included. Fifty-nine (88.1%) patients had a single tumor, 39 (58.2%) of which was located in the right lobe of the liver. A total of 47 patients (70.1%) had PRE-TEXT III or IV. Thirty-nine patients (58.2%) underwent delayed resection. After a full course of NAC, 16 patients still had close PMV (within 1 cm in two patients, touching in 11 patients, compressing in four patients, and showing tumor thrombus in three patients). There were 6 patients of tumors in the middle lobe of the liver, and four of those patients exhibited liver anatomy variations. These 16 children underwent extreme liver resection after comprehensive preoperative evaluation. Intraoperative procedures were performed according to the preoperative plan, and the operations were successfully performed. Currently, the 3-year event-free survival of 67 children with HB is 88%. Among the 16 children who underwent extreme liver resection, three experienced recurrence, and one died due to multiple metastases. Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible. This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis. Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB, particularly for assessing vascular involvement, remnant liver volume and anatomical variations.

Surface N Sites Mediate the Formation of Li Metal Cluster@N-Enriched Hierarchically Porous Carbon for Ultrahigh-Capacity Lithium Storage.

Graphite is the popular anode material of current lithium-ion batteries (LIBs). However, its low specific capacity and poor lithium intercalation potential hinder its use for high-power and large-scale energy storage. To meet the demand for energy storage, novel anode materials with high capacity, fast chargeable capability, and long cycle life are of great interest. Herein, we demonstrate an advanced nitrogen-enriched hierarchical porous carbon serving as a lithiophilic anode material for ultrahigh capacity and long-life LIBs. NHPC-700 (under optimal synthetic conditions), featuring a high surface area, rich N-doping, high porosity, and partially graphitized nanosheet structures, is successfully fabricated from a Schiff-base copolymer via a template-incipient wetness impregnation method. NHPC-700 exhibits an ultrahigh reversible lithium storage capacity of 2796 mA h g-1 at 0.1 A g-1 while still maintaining a high capacity of 526 mA h g-1 at 10 A g-1 after 1000 cycles. Theoretical and experimental studies reveal that this remarkable Li storage performance can be attributed to the large number of N lithiophilic sites on the inner surface of the small mesoporous pores. These sites guide Li metal nucleation in the initial period and control well the volume variation during charge/discharge cycles, thus exhibiting excellent cycle stability and great potential for practical application.

Impact of data transfer between treatment planning systems on dosimetric parameters

PurposeIn radiotherapy it is often necessary to transfer a patient’s DICOM (Digital Imaging and COmmunications in Medicine) dataset from one system to another for re-treatment, plan-summation or registration purposes. The aim of the study is to evaluate effects of dataset transfer between treatment planning systems. Materials and methodsTwenty-five patients treated in a 0.35T MR-Linac (MRidian, ViewRay) for locally-advanced pancreatic cancer were enrolled. For each patient, a nominal dose distribution was optimized on the planning MRI. Each plan was daily re-optimized if needed to match the anatomy and exported from MRIdian-TPS (ViewRay Inc.) to Eclipse-TPS (Siemens-Varian). A comparison between the two TPSs was performed considering the PTV and OARs volumes (cc), as well as dose coverages and clinical constraints. ResultsFrom the twenty-five enrolled patients, 139 plans were included in the data comparison. The median values of percentage PTV volume variation are 10.8 % for each fraction, while percentage differences of PTV coverage have a mean value of −1.4 %. The median values of the percentage OARs volume variation are 16.0 %, 7.0 %, 10.4 % and 8.5 % for duodenum, stomach, small and large bowel, respectively. The percentage variations of the dose constraints are 41.0 %, 52.7 % and 49.8 % for duodenum, stomach and small bowel, respectively. ConclusionsThis study has demonstrated a non-negligible variation in size and dosimetric parameters when datasets are transferred between TPSs. Such variations should be clinically considered. Investigations are focused on DICOM structure algorithm employed by the TPSs during the transfer to understand the cause of such variations.

Retrospective application of a validated algorithm for estimation of adrenal gland volume after computed tomography on 46 dogs undergoing adrenalectomy.

Canine adrenal gland volume can be predicted based on body weight and computed tomography (CT) measurements using a validated algorithm. Use of this algorithm to detect adrenal pathology, including hyperplasia, hypoplasia and neoplasia, in clinical cases has not been described. The objective of this study was to illustrate application of the algorithm by estimating subject-specific adrenal gland volume in a historical cohort of dogs with known adrenal disease. Forty-six dogs that underwent CT and subsequent adrenalectomy were included. Clinical records and CT images from dogs that underwent adrenalectomy and histologic examination of the excised adrenal gland(s) were reviewed. Normal adrenal gland volumes for each dog were estimated using the algorithm, and compared with measured volumes of the affected glands. Linear measurement of the largest lesion diameter was also recorded. Fifty-eight adrenal glands were removed from 46 dogs, with pathology confirmed in all glands. Pathology included 28 adenomas, 13 carcinomas, 11 pheochromocytomas and 6 other benign pathologies. The volume of all removed adrenal glands was measured to be larger than the expected normal volume estimated by the algorithm, ranging from 1.1 to 212.9 times larger than estimated. Adrenal glands with malignant and benign pathology showed variable volumes with overlapping ranges recorded. Assessment of the dimensions of any focal lesion against a cut-off of 20 mm failed to discriminate malignancy. This study illustrates and supports the application of a validated volumetric algorithm for estimation of subject-specific adrenal gland volume to identify the presence of pathology and as a tool to assist clinical decision-making.

Hydrogen bonds and elastic anisotropy of nitrile molecular crystals: an investigation from first-principles

ABSTRACT Atomistic calculations based on semi-classical dispersion-corrected density functional theory were performed to investigate bonding and elastic properties of low temperature polymorphs of three nitrile molecular crystals. For that purpose, the DFT-PBE-D3ijk method, which account for both pair and three-body interactions, was applied. The analysis of Hirshfeld surfaces demonstrated that the (C-N…H) hydrogen bonds are the strongest and the dominant ones in the three nitrile molecular crystals. The latter were found to share a common structural feature, consisting of an antiparallel orientation of the terminal nitrile groups at their constituent molecules. Our prediction of the elastic properties demonstrated that malonitrile has the highest Young modulus and succinonitrile has the lower one. The three nitrile crystals are expected to have similar resistance to volume variation while succinonitrle is predicted to exhibit the lowest resistance to shape change. Otherwise, succinonitrile was found to be ductile while malononitrile and acetonitrile were shown to be brittle. Elasticity anisotropy analysis demonstrated that the directions of maximum Young’s modulus are always nearly parallel to the direction of alignment of strong (C-H…N) hydrogen bonds in the three nitrile crystals. The present analyses are relevant for understanding the structure and the properties of more complex high temperature phases.

Continuous and bilevel positive airway pressure may improve radiotherapy delivery in patients with intra-thoracic tumors

BackgroundMinimizing tumor motion in radiotherapy for intra-thoracic tumors reduces side-effects by limiting radiation exposure to healthy tissue. Continuous or Bilevel Positive Airway Pressure (CPAP/BiPAP) could achieve this, since it could increase lung inflation and decrease tidal volume variability. We aim to identify the better CPAP/BiPAP setting for minimizing tumor motion. MethodsIn 10 patients (5 with lung cancer, 5 with other intra-thoracic tumors), CPAP/BiPAP was tested with the following settings for 10 min each: CPAP 5, 10 and 15 cmH2O and BiPAP 14/10 cmH2O with a lower (7 breaths/min) and higher back-up respiratory rate (BURR initially 1 breath/min above the spontaneous breathing frequency, with the option to adjust if the patient continued to initiate breaths). Electrical impedance tomography was used to analyse end-expiratory lung impedance (EELI) as an estimate of end-expiratory lung volume and tidal impedance variation (TIV) as an estimate of tidal volume. ResultsNine out of ten patients tolerated all settings; one patient could not sustain CPAP-15. A significant difference in EELI was observed between settings (χ2 22.960, p < 0.001), with most increase during CPAP-15 (median (IQR) 1.03 (1.00 – 1.06), normalized to the EELI during spontaneous breathing). No significant differences in TIV and breathing variability were found between settings. ConclusionsThis study shows that the application of different settings of CPAP/BiPAP in patients with intra-thoracic tumors is feasible and tolerable. BiPAP with a higher BURR may offer the greatest potential for mitigating tumor motion among the applied settings, although further research investigating tumor motion should be conducted.

Integrating Microseismic Monitoring for Predicting Water Inrush Hazards in Coal Mines

The essence of roof water inrush in coal mines fundamentally stems from the development of water-bearing fracture zones, facilitating the intrusion of overlying aquifers and thereby leading to water hazard incidents. Monitoring rock-fracturing conditions through the analysis of microseismic data can, to a certain extent, facilitate the prediction and early warning of water hazards. The water inflow volume stands as the most characteristic type of data in mine water inrush accidents. Hence, we investigated the feasibility of predicting water inrush events through anomalies in microseismic data from the perspective of water inflow volume variations. The data collected from the microseismic monitoring system at the 208 working face were utilized to compute localization information and source parameters. Based on the hydrogeological conditions of the working face, the energy screening range and its calculation grid characteristics were determined, followed by the generation of kernel density cloud maps at different depths. By observing these microseismic kernel density cloud maps, probabilities of roof water-conducting channel formation and potential locations were inferred. Subsequently, based on the positions of these roof water-conducting channels on the planar domain, the extension depth and expansion direction of the water-conducting channels were determined. Utilizing microseismic monitoring data, a quantitative assessment of water inrush risk was conducted, thereby establishing a linkage between microseismic data and water (inrush) data, which are two indirectly related datasets. The height of microseismic events was directly proportional to the trend of water inflow in the working face. In contrast, the occurrence of water inflow events and microseismic events exhibited a specific lag effect, with microseismic events occurring prior to water inrush events. Abnormalities in microseismic monitoring data partially reflect changes in water-conducting channel patterns. When connected with coal seam damage zones, water inrush hazards may occur. Therefore, abnormalities in microseismic monitoring data can be regarded as one of the precursor signals indicating potential floor water inrushes in coal seams.

Radiofrequency Ablation of Parathyroid Adenoma: Results of a Retrospective Analysis of 60 Patients.

To present the effectiveness and safety of radiofrequency ablation (RFA) in parathyroid adenoma (PTA). In this retrospective study, 60 patients with a single PTA were evaluated for changes in biochemical and ultrasonographic features up to 6months after RFA of the lesion. Adenomas were ablated with an alternative technique so called "Nik jet dissection" which incorporates full hydrodissection and polar artery coagulation. Complications as well as the variations in biochemical data and nodule volumes were analyzed between baseline measurements and at each follow-up interval data (first day, 1, 3, and 6months after ablation) were analyzed. A significant reduction in serum intact parathyroid hormone and calcium levels was observed 6 months after ablation, with a mean difference of - 83.4 ± 104.1pg/mL, p < 0.001, and - 0.29 ± 0.22mmol/L, p < 0.001, respectively. Serum phosphorus levels increased significantly with a mean difference of 0.09 ± 0.19mmol/L, p = 0.040 at the end of the follow up. We observed a significant volume reduction rate of parathyroid adenomas with 89 ± 20.8 percent, p < 0.001. Also, 51% of adenomas disappeared at the end of the follow up. In this study, two cases of hematoma and one case of transient hoarseness (grade 1 of the CIRSE classification) were encountered. Our study showed that RFA with the alternative technique, called "Nik jet dissection" is a safe and effective modality in management of PTA. Therefore, we suggest expanding the indications for RFA in PTA management, especially when surgery is not feasible. Level 3, Local non-random sample.

Absorbed Dose-Response Relationship in Patients with Gastroenteropancreatic Neuroendocrine Tumors Treated with [177Lu]Lu-DOTATATE: One Step Closer to Personalized Medicine.

[177Lu]Lu-DOTATATE has been approved for progressive and inoperable gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that overexpress somatostatin receptors. The absorbed doses by limiting organs and tumors can be quantified by serial postinfusion scintigraphy measurements of the γ-emissions from 177Lu. The objective of this work was to explore how postinfusion [177Lu]Lu-DOTATATE dosimetry could influence clinical management by predicting treatment efficacy (tumor shrinkage and survival) and toxicity. Methods: Patients with GEP-NETs treated with [177Lu]Lu-DOTATATE between 2016 and 2022 and who underwent dosimetry were included. Absorbed doses were calculated for healthy organs (liver, kidneys, bone marrow, and spleen) and tumors using PLANET Dose and the local energy deposition method based on serial posttreatment SPECT/CT. Up to 5 lesions per site were selected and measured on images collected at baseline and 3 mo after treatment end (measurement masked to the somatostatin receptor imaging uptake). For toxicity assessment, laboratory parameters were regularly monitored. Clinical data, including time to death or progression, were collected from the patients' health records. Correlations between absorbed doses by organs and toxicity and between absorbed doses by lesions and tumor volume variation were studied using regression models. Results: In total, 35 dosimetric studies were performed in patients with mostly grade 2 (77%) tumors and metastases in liver (89%), lymph nodes (77%), and bone (34%), and 146 lesions were analyzed: 1-9 lesions per patient, mostly liver metastases (65%) and lymph nodes (25%). The median total absorbed dose by tumors was 94.4 Gy. The absorbed doses by tumors significantly decreased between cycles. The absorbed dose by tumors was significantly associated with tumor volume variation (P < 0.001) 3 mo after treatment end, and it was a significant prognostic factor for survival. Toxicity analysis showed a correlation between the decrease of hematologic parameters such as lymphocytes or platelet concentrations and the absorbed doses by the spleen or bone marrow. The mean absorbed dose by the kidneys was not correlated with nephrotoxicity during the studied period. Conclusion: In patients treated with [177Lu]Lu-DOTATATE for GEP-NETs, tumor and healthy organ dosimetry can predict survival and toxicities, thus influencing clinical management.