Visualization Of Nodes Research Articles

Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case-Control Study.

The distinction between D3 lymph nodes and actual lymphatic pathways in primary tumors can be difficult during surgery, making it challenging to confirm the completeness of D3 lymph node dissection. Fluorescence lymph node mapping (FLNM) is a promising method for lymph node visualization. This study aimed to assess whether FLNM enhances the effectiveness of D3 lymph node dissection in patients with right-sided colon cancer. Endoscopic submucosal indocyanine green injection were performed on the distal margin of the colon cancer. In an FLNM group, the lymphatic drainage pathway and distribution of D3 lymph nodes were explored. Pathological evaluations were conducted for the fluorescent D3 and non-fluorescent D3 lymph nodes. The FLNM group showed a significantly higher number of harvested lymph nodes in the D3 area. In stage III patients, the proportion of D3 lymph node metastasis was significantly higher in the FLNM group. The harvested D3 lymph node count showed a proportional correlation with a metastatic lymph node count of up to 15. FLNM could be considered a promising new strategy to potentially increase harvested D3 lymph node counts in colon cancer surgery.

Discovery and Feasibility Study of Medical Fluorophore 33 as a Novel Theranostic Agent.

Fluorescent dyes have garnered significant attention as theranostic platforms owing to their inherent characteristics. In this study, we present the discovery of Medical Fluorophore 33 (MF33), a novel and potent theranostic agent with a phenaleno-isoquinolinium salt structure that can serve as a cancer therapeutic strategy. The synthesis of MF33 is readily achievable through a simple Rh(III)-catalyzed reaction. Moreover, MF33 displayed strong fluorescence signals, excellent microsomal stability, and high biocompatibility in vivo. It induces significant apoptosis in cancer cells via the p53/p21/caspase-3 signaling pathway, leading to selective cytotoxicity in various cancer cells. In vivo fluorescence imaging with MF33 enabled the visualization of sentinel lymph nodes in living mice. Notably, repeated intraperitoneal administration of MF33 resulted in antitumor activity in mice with colorectal cancer. Collectively, our findings suggest that phenaleno-isoquinolinium salt-based MF33 is a viable theranostic agent for biomedical imaging and cancer treatment.

Graph Self-Supervised Learning With Application to Brain Networks Analysis.

The less training data and insufficient supervision limit the performance of the deep supervised models for brain disease diagnosis. It is significant to construct a learning framework that can capture more information in limited data and insufficient supervision. To address these issues, we focus on self-supervised learning and aim to generalize the self-supervised learning to the brain networks, which are non-Euclidean graph data. More specifically, we propose an ensemble masked graph self-supervised framework named BrainGSLs, which incorporates 1) a local topological-aware encoder that takes the partially visible nodes as input and learns these latent representations, 2) a node-edge bi-decoder that reconstructs the masked edges by the representations of both the masked and visible nodes, 3) a signal representation learning module for capturing temporal representations from BOLD signals and 4) a classifier used for the classification. We evaluate our model on three real medical clinical applications: diagnosis of Autism Spectrum Disorder (ASD), diagnosis of Bipolar Disorder (BD) and diagnosis of Major Depressive Disorder (MDD). The results suggest that the proposed self-supervised training has led to remarkable improvement and outperforms state-of-the-art methods. Moreover, our method is able to identify the biomarkers associated with the diseases, which is consistent with the previous studies. We also explore the correlation of these three diseases and find the strong association between ASD and BD. To the best of our knowledge, our work is the first attempt of applying the idea of self-supervised learning with masked autoencoder on the brain network analysis.

Accuracy of dynamic sentinel lymph node biopsy for inguinal lymph node staging in cN0 penile cancer

BackgroundPenile cancer is characterized by an early lymphatic dissemination. In intermediate and high-risk primary tumors without palpable inguinal lymph nodes, there is a 6–30% risk of micro-metastatic disease. Invasive lymph node staging in these patients is performed using dynamic sentinel lymph node biopsy (DSNB). In this study, the role of DSNB in cN0 penile cancer was studied, evaluating features of sentinel lymph node (SN) visualization and outcome parameters. Patients with penile cancer without inguinal lymph node metastases who were referred for DSNB at our center between January 2015 and May 2021 and had a follow-up period of at least 18 months, were retrospectively included. After injection of 85 ± 20 MBq [99mTc]Tc-nanocolloid peritumorally, dynamic, static planar and SPECT/CT imaging was performed. Primary endpoints were sensitivity of the diagnostic procedure, disease-free survival and DSNB-related adverse events. Secondary endpoints were SN detection rate, number of SNs and the number of counts of the most active SN.ResultsSeventy-seven penile DSNB procedures in 75 patients (67 ± 11 years) were included. The detection rate of DSNB was 91% and 96% per procedure and groin, respectively. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were 79%, 100%, 97% and 100%, respectively. More SNs were seen on SPECT/CT than on static planar imaging (1.33 vs. 1.17, p = 0.001). The mean counts per SN on static planar imaging was lower compared to SPECT/CT (1343 vs. 5008; p < 0.0001). There was a positive correlation between the total counts of the SN on the static planar image and the SPECT/CT (r = 0.79, p < 0.0001). Only one out of seventy-five patients (1%) experienced DSNB-related adverse events. After 18 months, 58 patients remained disease free (77%), 13 developed local recurrence (17%), and 4 developed lymphatic or distant metastases (5%).ConclusionDNSB is a safe diagnostic procedure with a good detection rate and in particular high negative predictive value. It can therefore prevent overtreatment of patients with negative inguinal groins on clinical examination and DSNB examination. Finally, DSNB enables an early detection of occult metastases which would not be visualized with standardized imaging modalities.

Pneumatic Compression-Assisted Lymphoscintigraphy for Quantitative Evaluation of Breast Cancer-Related Lymphedema.

Acquired lymphedema of upper extremity is a chronic pathologic status that frequently occurs after breast cancer treatment. Reliable and quantitative evaluation of lymphedema is crucial for successful management of patients. Although lymphoscintigraphy is the primary investigation for the confirmation and evaluation of lymphedema, the specific protocol of stress intervention is not well established. This study aims to introduce intermittent pneumatic compression (IPC) as a part of stress lymphoscintigraphy and compare the effectiveness of conventional stress lymphoscintigraphy (CSL) and pneumatic compression-assisted lymphoscintigraphy (PCAL). Our study was designed as a retrospective analysis of 85 breast cancer patients with lymphedema who underwent lymphoscintigraphy utilizing either IPC device or conventional stress maneuver and received complex decongestive therapy. The flow extent of the lymphatic fluid (FE) was evaluated using a 0- to 4-point scale based on lymphoscintigraphic images. The visualization of lymph nodes was also assessed. The clinical outcomes were evaluated by changes in side-to-side circumferential and volume differences of upper extremities and compared between groups. Of 85 patients, 47 underwent CSL, and 38 underwent PCAL. Participants with relatively preserved flow extent of the lymphatic fluid (FE 3) showed a significant difference in percentage reduction of volume (PRV) between CSL and PCAL groups ( P = 0.036). In the other groups, CSL and PCAL demonstrated comparable differences in PRV without statistical significance. Our study suggests that participants in the PCAL group with relatively preserved lymphatic flow extent (FE 3) had better PRV compared with those in the CSL group. The use of IPC devices in lymphoscintigraphy with the novel stress maneuver can help in the quantitative description of lymphedema status and the selection of an appropriate treatment method.

Generative and discriminative training of Boltzmann machine through quantum annealing

A hybrid quantum-classical method for learning Boltzmann machines (BM) for a generative and discriminative task is presented. BM are undirected graphs with a network of visible and hidden nodes where the former is used as the reading site. In contrast, the latter is used to manipulate visible states’ probability. In Generative BM, the samples of visible data imitate the probability distribution of a given data set. In contrast, the visible sites of discriminative BM are treated as Input/Output (I/O) reading sites where the conditional probability of output state is optimized for a given set of input states. The cost function for learning BM is defined as a weighted sum of Kullback-Leibler (KL) divergence and Negative conditional Log-likelihood (NCLL), adjusted using a hyper-parameter. Here, the KL Divergence is the cost for generative learning, and NCLL is the cost for discriminative learning. A Stochastic Newton-Raphson optimization scheme is presented. The gradients and the Hessians are approximated using direct samples of BM obtained through quantum annealing. Quantum annealers are hardware representing the physics of the Ising model that operates on low but finite temperatures. This temperature affects the probability distribution of the BM; however, its value is unknown. Previous efforts have focused on estimating this unknown temperature through regression of theoretical Boltzmann energies of sampled states with the probability of states sampled by the actual hardware. These approaches assume that the control parameter change does not affect the system temperature; however, this is usually untrue. Instead of using energies, the probability distribution of samples is employed to estimate the optimal parameter set, ensuring that the optimal set can be obtained from a single set of samples. The KL divergence and NCLL are optimized for the system temperature, and the result is used to rescale the control parameter set. The performance of this approach, as tested against the theoretically expected distributions, shows promising results for Boltzmann training on quantum annealers.

Comparison of surgical resection of Axillary Lymph Nodes in Dogs with Mammary Gland Tumors with or without sentinel lymph node visualization with patent blue dye.

Dogs' axillary lymph node (ALN) is often difficult to locate before surgical resection. The anatomical location of ALN often discourages Veterinarians from surgical lymphadenectomy. Considering the limited literature available, the actual incidence of metastases and the prognostic relevance are poorly understood. A non-randomized, prospective clinical study was conducted with female dogs (n = 41) with mammary gland tumor (MGT) in the thoracic or cranial abdominal mammary glands. The study investigated the risks of ALN metastasis based on tumors clinical findings, tumor size, histopathological diagnosis and grade. The main aim of this study was to compare ALN resection with or without patent blue 2.5% (PB) dye injection for sentinel lymph node visualization. A total of 46 mastectomies were performed and five animals underwent two mastectomies. In the first group, 17 patients underwent a mastectomy and lymphadenectomy without PB injection (G1). In contrast, in the second group, 24 patients also received PB injections for sentinel lymph node mapping (G2). The ALN was identified in 38/46 cases (82%). The ALN was identified and excised in only 58% of surgeries in G1(19/46), while in group 2, the lymph node was identified in 92% of the cases and resected in 100% of the cases. The use of PB improves ALN's identification and reduces the surgical resection time in dogs with MGT. Surgical time differed between the two groups, as it was significantly shorter in the PB injection group compared to group 1 (80 vs. 45 min) (p < 0.0001). The overall frequency of ALN metastasis was 32%. Macroscopic abnormalities in the lymph nodes, tumor size (>3 cm), and diagnosis of anaplastic carcinoma or grade II/III mammary gland tumors were associated with a higher probability of ALN metastasis. Metastases in the ALNs are more common, in dogs presenting with tumors larger than 3 cm and diagnosed with aggressive histological subtypes. The ALNs should be removed for correct staging, prognostic evaluation, and decision for adjuvant therapy.

Preclinical evaluation of a novel EGFR&c-Met bispecific near infrared probe for visualization of esophageal cancer and metastatic lymph nodes.

This study aimed to establish a near infrared fluorescent (NIRF) probe based on an EGFR&c-Met bispecific antibody for visualization of esophageal cancer (EC) and metastatic lymph nodes (mLNs). EGFR and c-Met expression were assessed by immunohistochemistry. EGFR&c-Met bispecific antibody EMB01 was labeled with IRDye800cw. The binding of EMB01-IR800 was assessed by enzyme linked immunosorbent assay, flow cytometry, and immunofluorescence. Subcutaneous tumors, orthotopic tumors, and patient-derived xenograft (PDX) were established for in vivo fluorescent imaging. PDX models using lymph nodes with or without metastasis were constructed to assess the performance of EMB01-IR800 in differential diagnosis of lymph nodes. The prevalence of overexpressing EGFR or c-Met was significantly higher than single marker either in EC or corresponding mLNs. The bispecific probe EMB01-IR800 was successfully synthesized, with strong binding affinity. EMB01-IR800 showed strong cellular binding to both Kyse30 (EGFR overexpressing) and OE33 (c-Met overexpressing) cells. In vivo fluorescent imaging showed prominent EMB01-IR800 uptake in either Kyse30 or OE33 subcutaneous tumors. Likewise, EMB01-IR800 exhibited superior tumor enrichment in both thoracic orthotopic esophageal squamous cell carcinoma and abdominal orthotopic esophageal adenocarcinoma models. Moreover, EMB01-IR800 produced significantly higher fluorescence in patient-derived mLNs than in benign lymph nodes. This study demonstrated the complementary overexpression of EGFR and c-Met in EC. Compared to single-target probes, the EGFR&c-Met bispecific NIRF probe can efficiently depict heterogeneous esophageal tumors and mLNs, which greatly increased the sensitivity of tumor and mLN identification.

Clinical application of indocyanine green fluorescence imaging navigation for pediatric renal cancer.

Indocyanine Green (ICG) fluorescence imaging has been widely used in the surgical treatment of adult renal cancers, but its application in pediatric renal cancers has rarely been reported. This study aims to summarize the experience of ICG fluorescence imaging in pediatric renal cancers and explores its safety and feasibility. The clinical features, surgical information, ICG administration regimen, near infrared radiography data in vivo and ex vivo and pathological results of children with renal cancers using ICG navigation were analyzed and summarized. There were 7 cases of renal cancer, including 4 cases of Wilms tumor (WT), 1 case of malignant rhabdoid tumor of the kidney (MRTK) and 2 cases of renal cell carcinoma (RCC). By intraoperative intravenous injection of ICG from 2.5 to 5 mg (0.05-0.67 mg/kg), the tumors were visualized in 6 cases in vivo or ex vivo, and the tumor visualization failed in 1 case due to renal artery embolization before operation. By injecting 5 mg ICG into the normal renal tissue during the operation, 3 patients achieved fluorescent localization of sentinel lymph nodes. No ICG-related adverse reactions were found in any of the patients during or after operation. ICG fluorescence imaging is safe and feasible for renal cancers in children. Intraoperative administration can achieve tumor and sentinel lymph node visualization which will facilitate the development of nephron sparing surgery (NSS). However, the technique is affected by ICG dose, anatomical conditions around the tumor, and renal blood flow. A proper dose of ICG and the complete removal of perirenal fat are helpful for the fluorescence imaging of the tumor. It has potential in the operation of renal cancer in children.

The role of ICG-fuorescence imaging in abdominal surgical oncology

The purpose of the study was to summarize and analyze the available data on modern methods of additional imaging using indocyanine green (ICG) used in abdominal surgical oncology.Material and Methods. The search and analysis of publications over the last 7–10 years was carried out using RSCI (Russian Science Citation Index), E-library, PubMed, Scopus, MedLine, Elsevier, Web of Science, ScienceDirect systems. The following keywords were used for the search: “ICG-fluorescent navigation”, “ICG-fluorescence”, “gastric cancer”, “colorectal cancer”, “indocyanine green”.Results. The role of ICG-fluorescent navigation in abdominal oncology, in particular, in surgery for cancer of the stomach, colon and rectum, identification of peritoneal carcinomatosis and liver metastases, as well as in biliary surgery and cholangiography, was shown. Intraoperative visualization of sentinel lymph nodes and mapping of lymph nodes in patients with gastric and colorectal cancers were described. In addition, the information on the diagnostic value of vascular imaging in colorectal surgery, detection of the boundaries of hepatocellular carcinoma and surrounding tissues, as well as real-time liver metastases using indocyanine green, was provided. Special attention was paid to ICG-mediated cholecystectomy and cholangiography. ICG fluorescence imaging in colorectal and gastric cancer surgery makes it possible to individualize the surgical approach and provide functional surgery associated with the performance of a sufficient and prophylactically excessive volume of surgical intervention more effectively. Conclusion. The presented data confirm the relevance of the search for a vector of improving the imaging methods used in abdominal surgical oncology, which requires even more even more multicenter prospective cohort studies to determine the best ways of improving the technique.

REAL TIME VISUALIZATION OF MEDIASTINAL LYMPH NODES WHILE DOING ENDOBRONCHIALULTRASOUND GUIDED TRANS BRONCHIAL NEEDLE ASPIRATION (EBUS-TBNA) USING CONVEX PROBE GIVES BETTER DIAGNOSTIC YIELD THAN CONVENTIONAL TBNA AND MEDIASTINOSCOPY:

Introduction:Real time visualisation of mediastinal lymph nodes makes it easy to Hit &amp; Run with convex probe while doing Endobronchial Ultrasound guided Trans Bronchial Needle Aspiration (CP-EBUS-TBNA) whichgives better safety profile, diagnostic yield and is gradually replacingConventional Trans Bronchial Needle Aspiration( C-TBNA) and Mediastinoscopy. We analysed retrospectively the diagnostic yield of EBUS-TBNA done at Asian Institute of Medical Sciences, a tertiary hospital at Faridabad in Haryana. Materials and Methods: We pulled in the dataof EBUS-TBNA done on patients with Mediastinal lymphadenopathy short axis nodal diameter &gt;0.5 cm, on computed tomography of thorax from Nov 2016 to May 2019. The procedures were done under conscious sedation by multiple operators who had done 20 EBUS-TBNA independently. A sample that was positive for AFB smears/malignant cells or granuloma was considered to be diagnostic. Results: The study included 250 patients (156 males) with mean age 49.6 years. EBUS-TBNA detected 427enlarged mediastinal nodes with average diameter of 14.45±8.56 mm. A total of 376 lesions were sampled of which subcarinal lymph node was the most common station (86.4%) followed by Pre &amp; Paratracheal (11.6 %). Average of 1.5 lymph nodes was sampled per patient with 3 passes per lymph node. The procedure had a diagnostic yield of 86 %. Majority of the patients were diagnosed with Granulomatous pathology (44.8 %): Sarcoidosis (24 %)followed by Tuberculosis (20 %). Malignancy was diagnosed in 12 % of patients of which non small cell cancer constituted the major diagnosis(50%). No complication was observed. Conclusion: EBUS- TBNA is very safe procedure with consistent good diagnostic yieldwith multiple operators beyond learning curves than for C- TBNA which require extensive training and expertise of the operator besides size and location of the lesion, though the availability due tohigher costs limits its usage.

Hybrid photoacoustic and fast super-resolution ultrasound imaging

The combination of photoacoustic (PA) imaging and ultrasound localization microscopy (ULM) with microbubbles has great potential in various fields such as oncology, neuroscience, nephrology, and immunology. Here we developed an interleaved PA/fast ULM imaging technique that enables super-resolution vascular and physiological imaging in less than 2 seconds per frame in vivo. By using sparsity-constrained (SC) optimization, we accelerated the frame rate of ULM up to 37 times with synthetic data and 28 times with in vivo data. This allows for the development of a 3D dual imaging sequence with a commonly used linear array imaging system, without the need for complicated motion correction. Using the dual imaging scheme, we demonstrated two in vivo scenarios challenging to image with either technique alone: the visualization of a dye-labeled mouse lymph node showing nearby microvasculature, and a mouse kidney microangiography with tissue oxygenation. This technique offers a powerful tool for mapping tissue physiological conditions and tracking the contrast agent biodistribution non-invasively.

Simultaneous, Multi-Channel, Near-Infrared Fluorescence Visualization of Mesenteric Lymph Nodes Using Indocyanine Green and Methylene Blue: A Demonstration in a Porcine Model.

Near-infrared fluorescence (NIRF) image-guided surgery is a useful tool that can help reduce perioperative complications and improve tissue recognition. Indocyanine green (ICG) dye is the most frequently used in clinical studies. ICG NIRF imaging has been used for lymph node identification. However, there are still many challenges in lymph node identification by ICG. There is increasing evidence that methylene blue (MB), another clinically applicable fluorescent dye, can also be useful in the intraoperative fluorescence-guided identification of structures and tissues. We hypothesized that MB NIRF imaging could be used for lymph node identification. The aim of this study was to evaluate the feasibility of intraoperative lymph node fluorescence detection using intravenously (IV) administered MB and compare it to ICG via a camera that has two dedicated near-infrared (NIR) channels. Three pigs were used in this study. ICG (0.2 mg/kg) was administered via a peripheral venous catheter followed by immediate administration of MB (0.25 mg/kg). NIRF images were acquired as video recordings at different time points (every 10 min) over an hour using the QUEST SPECTRUM® 3 system (Quest Medical Imaging, Middenmeer, The Netherlands), which has two dedicated NIR channels for simultaneous intraoperative fluorescence guidance. The 800 nm channel was used to capture ICG fluorescence and the 700 nm channel was used for MB. The target (lymph nodes and small bowel) and the background (vessels-free field of the mesentery) were highlighted as the regions of interest (ROIs), and corresponding fluorescence intensities (FI) from these ROIs were measured. The target-to-background ratio (TBR) was then computed as the mean FI of the target minus the mean FI of the background divided by the mean FI of the background. In all included animals, a clear identification of lymph nodes was achieved at all time points. The mean TBR of ICG in lymph nodes and small bowel was 4.57 ± 1.00 and 4.37 ± 1.70, respectively for the overall experimental time. Regarding MB, the mean TBR in lymph nodes and small bowel was 4.60 ± 0.92 and 3.27 ± 0.62, respectively. The Mann-Whitney U test of the lymph node TBR/small bowel TBR showed that the TBR ratio of MB was statistically significantly higher than ICG. The fluorescence optical imaging technology used allows for double-wavelength assessment. This feasibility study proves that lymph nodes can be discriminated using two different fluorophores (MB and ICG) with different wavelengths. The results suggest that MB has a promising potential to be used to detect lymphatic tissue during image-guided surgery. Further preclinical trials are needed before clinical translation.

Lymphoscintigraphic alterations in lower limbs in women with lipedema in comparison to women with overweight/obesity.

Introduction: Lipedema is a bilateral enlargement of the legs due to abnormal depositions of subcutaneous fat. Recent studies using lymphoscintigraphy documented that lipedema associates with lymphatic alterations. It is still not known, whether non-lipedema obesity also leads to similar lymphoscintigraphic changes within lower legs. Clinically, both, lipedema and obesity may progress to secondary lymphedema. The aim of the study was to evaluate lymphoscintigraphy of lower limbs in women with lipedema in comparison to overweight/obese women. Methods: 51 women (in the mean age of 43.3 ± 13.56) with the diagnosis of lipedema and 31 women (in the mean age of 44.7 ± 13.48) with overweight/obesity were enrolled into the study. Women in both study groups had no clinical signs of lymphedema. The groups were matched by mean volume of their legs, calculated using the formula for a truncated cone. Lymphoscintigraphy was evaluated in every women qualitatively. Body composition parameters were assessed using bioelectric impedance analysis (BIA). Results: Lymphoscintigraphic alterations within lower extremities were similar in both, lipedema and overweight/obese groups and were present in majority of women in both study groups. The most common lymphoscintigraphic alteration in both groups were additional lymphatic vessels (in the lipedema group observed in 76.5% of patients and in the overweight/obesity group - in 93.5%). Visualization of popliteal lymph nodes and dermal backflow were observed respectively in 33% and in 5.9% in the group with lipedema and in 45.2% and in 9.7% in the overweight/obesity group. There were significant relationships between severity of lymphoscintigraphic alterations and weight, lean body mass (LBM), total body water (TBW), volume of both legs and thigh circumference in the lipedema group. Such relationships were absent in the overweight/obesity group. Discussion: Our study indicates that lymphatic alterations are present before development to clinically visible secondary lymphedema in both conditions, lipedema and overweight/obesity. In majority of women from both study groups they indicate rather an overload of the lymphatic system than insufficiency. Lymphoscintigraphic alterations are similar in both groups, therefore, lymphoscintigraphy is not a diagnostic tool that might distinguish lipedema from overweight/obesity.

ICG fluorescence imaging for the evaluation of lymph nodes in bladder cancer

Radical cystectomy is the gold standard treatment for aggressive bladder cancer. Pelvic lymphadenectomy is an important step. This procedure is crucial for the cancer staging, determination of further treatment strategy, and optimization of surgical outcomes. Currently, the sentinel lymph node concept is being actively developed, which allows to reduce the required extent of pelvic lymph node dissection. Decrease in number of removed pelvic lymph node improves surgical safety of the patient. Indocyanine green near-infrared fluorescence is the main approach to the intraoperative visualization of sentinel lymph nodes. The prospects of this diagnostic technique application in radical cystectomy performed for bladder cancer determine the vector of future scientific research in this area.

Agronomic traits of white oat treated with the growth regulator trinexapac-ethyl

The growth and yield performance of white oat cultivars may vary in response to doses of trinexapac-ethyl (TE) growth regulator. The objective of the work was to evaluate the lodging and productive performance of white oat cultivars under different doses of trinexapac-ethyl growth regulator. The experiments were carried out in a randomized complete block design with four replications, in a 4 x 2 factorial scheme, with four doses of trinexapac-ethyl (0, 50, 100 and 150 g ha-1) applied in the phenological stage between the 1st visible stalk node and the 2nd perceptible node in two white oat cultivars (URS Altiva and URS Corona). The following were evaluated: plant height, panicle length, panicles per m2, spikelets per panicle, grains per spikelet, number of grains per panicle, thousand grain weight, plant lodging and grain yield. The application of trinexapac-ethyl at doses 100 and 150 g ha-1 reduces plant height and panicle components: length, number of spikelets and grains per panicle of the two cultivars. TE doses above 100 g ha-1 provide a significant reduction in lodging with an increase in the number of panicles per m2 and in grain yield for the two white oat cultivars.

The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination

PurposeUnilateral axillary lymphadenopathy is known to occur after coronavirus disease (COVID-19) vaccination. Post-vaccination lymphadenopathy may mimic the metastatic lymph nodes in breast cancer, and it is challenging to distinguish between them. This study investigated whether the localization of axillary lymphadenopathy on magnetic resonance imaging (MRI) could be used to distinguish reactive lymphadenopathy after COVID-19 vaccines from metastatic nodes.Materials and methodsWe retrospectively examined preoperative MRI images of 684 axillae in 342 patients who underwent breast cancer surgery from June to October 2021. Lymphadenopathy was defined as cortical thickening or short axis ≥ 5 mm. The axilla was divided into ventral and dorsal parts on the axial plane using a perpendicular line extending from the most anterior margin of the muscle group, including the deltoid, latissimus dorsi, or teres major muscles, relative to a line along the lateral chest wall. We recorded the presence or absence of axillary lymphadenopathy in each area and the number of visible lymph nodes.ResultsOf 80 axillae, 41 and 39 were included in the vaccine and metastasis groups, respectively. The median time from the last vaccination to MRI was 19 days in the vaccine group. The number of visible axillary lymph nodes was significantly higher in the vaccine group (median, 15 nodes) than in the metastasis group (7 nodes) (P < 0.001). Dorsal lymphadenopathy was observed in 16 (39.0%) and two (5.1%) axillae in the vaccine and metastasis groups, respectively (P < 0.001). If the presence of both ventral and dorsal lymphadenopathy is considered indicative of vaccine-induced reaction, this finding has a sensitivity of 34.1%, specificity of 97.4%, and positive and negative predictive values of 93.3％ and 58.5%, respectively.ConclusionThe presence of deep axillary lymphadenopathy may be an important factor for distinguishing post-vaccination lymphadenopathy from metastasis. The number of axillary lymph nodes may also help.

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience.

This study aimed to investigate the feasibility of using indocyanine green (ICG) near-infrared (NIR) imaging during lymphadenectomy for oesophageal cancer. Eighty-seven patients with primary oesophageal cancer were enrolled in this study. All the enrolled patients received an endoscopic injection of ICG between 40 min and 23 h before surgery. Nodal dissection during surgery was performed under fluorescence imaging visualisation, with the NIR signal shown in purple. ICG+ or ICG- nodes were recorded station by station and were microscopically evaluated. Endoscopic peritumoral ICG injection was successfully performed in all patients. Major post-surgery complications included wound infection, pleural effusion, dysphonia, pneumonia and anastomotic fistula. No patients experienced ICG-related adverse events. A total of 2,584 lymph nodes were removed, and the mean number of lymph nodes for each patient was 29.70 ± 9.24. Most of the removed nodes (97.83%) were ICG+, and 3.32% of the ICG+ nodes were metastatic. No metastatic nodes were ICG- or belonged to an ICG- lymph node station. The time from ICG injection to surgery did not affect the number of harvested lymph nodes. The use of ICG-NIR imaging during oesophageal cancer surgery can enhance the visualisation of lymph nodes during surgery. It is a feasible, safe and helpful technique for lymphadenectomy.

Doses and application times of trinexapac-ethyl on the industrial quality of white oat grains

The application of trinexapac-ethyl in white oats, in addition to controlling lodging, can modify the architecture of the plant, which can favor good growth and development and the production of well-formed, large and heavy grains, characteristics that are valued by the food industry oat processing. However, the responses of the white oat genotypes regarding the effect of doses and times of application of the growth reducer can be variable. The objective of this work was to evaluate the effect of different doses and application times of the growth regulator trinexapac-ethyl on the industrial quality of white oat grains. The experiment was carried out with the cultivar IPR Artemis, under a randomized block design with four replications, in a 4 x 3 factorial scheme, corresponding to four doses of trinexapac-ethyl (0, 50, 100 and 150 g ha-1) and three application times (E1: plants with the 1st noticeable node; E2: between the 1st visible node and the 2nd noticeable node and E3: plants with the 2nd visible node and 3rd noticeable node). The weight of one thousand grains, hectoliter weight, percentage of grains with thickness greater than two millimeters, husking index and industrial grain yield were evaluated. The application of trinexapac-ethyl regardless of the stages at doses of 0 and 50 g ha-1 does not interfere with the industrial quality of grains, but at doses of 100 and 150 g ha-1, at times E2 and E3, there is a reduction in industrial quality of grains (weight of a thousand grains, hectoliter weight, percentage of grains thicker than two millimeters, hulling and industrial grain yield) of the cultivar IPR Artemis.

Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey

BackgroundUnderstanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. MethodsIn this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. ResultsConsensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. ConclusionAlthough considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.