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Duarte S, Roque A, Saraiva T, Afonso C, Marques BA, Lima CB, Neves D, Lai AC, Costa G, Cipriano A, Geraldes C, Ruzickova L, Carda JP, Gomes M. Interim FDG 18-PET SUV max Variation Adds Prognostic Value to Deauville 5-Point Scale in the Identification of Patients with Ultra-High-Risk Diffuse Large B Cell Lymphoma. Clin Lymphoma Myeloma Leuk 2023; 23:e107-e116. [PMID: 36567213 DOI: 10.1016/j.clml.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Interim response evaluation by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (iPET) in diffuse large B cell lymphoma (DLBCL) could be important to rule out disease progression and has been suggested to be predictive of survival. However, treatment guidance by iPET is not yet recommended for DLBCL in clinical practice. We aimed to compare the predictive value of iPET when utilizing the visual Deauville 5-point scale (DS) and the semiquantitative variation of maximum standardized uptake value (ΔSUVmax). MATERIALS AND METHODS We included 85 patients diagnosed with DLBCL and uniformly treated with standard protocols. iPET with DS of 1-3 and/or ΔSUVmax ≥66% was defined as negative. Univariable and multivariable Cox regression analyses were performed to determine the independent factors affecting progression free survival (PFS) or overall survival (OS) and to estimate PFS and OS. RESULTS iPET positivity, measured by DS or ΔSUVmax, showed predictive value of disease refractoriness, improved by combining DS and ΔSUVmax. After a median follow-up of 50.1 months, iPET was an independent predictor for both PFS and OS when interpreted by DS, but only for PFS by ΔSUVmax. Combined visual and semiquantitative analysis (D4-5 & ΔSUVmax<66%) was an independent predictor of PFS and OS, and allowed to identify an ultra-high-risk subgroup of patients with very dismal outcome, increasing the discriminating capacity for iPET. CONCLUSION Our study suggests that combined DS and ΔSUVmax in iPET assessment predicts refractory disease and distinguishes ultra-high-risk DLBCL patients with a very dismal prognosis, who may benefit from PET-guided therapy adjustment.
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Affiliation(s)
- Sara Duarte
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal.
| | - Adriana Roque
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Tiago Saraiva
- Nuclear Medicine Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Carolina Afonso
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Bárbara Almeida Marques
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Carla Barros Lima
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Dulcelena Neves
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Ana Catarina Lai
- Pathology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Gracinda Costa
- Nuclear Medicine Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Augusta Cipriano
- Pathology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - Catarina Geraldes
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Lenka Ruzickova
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
| | - José Pedro Carda
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marília Gomes
- Clinical Hematology Department, Hospital and University Centre of Coimbra, Coimbra, Portugal
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Salinet J, Molero R, Schlindwein FS, Karel J, Rodrigo M, Rojo-Álvarez JL, Berenfeld O, Climent AM, Zenger B, Vanheusden F, Paredes JGS, MacLeod R, Atienza F, Guillem MS, Cluitmans M, Bonizzi P. Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value. Front Physiol 2021; 12:653013. [PMID: 33995122 PMCID: PMC8120164 DOI: 10.3389/fphys.2021.653013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023] Open
Abstract
Electrocardiographic imaging (ECGI) is a technique to reconstruct non-invasively the electrical activity on the heart surface from body-surface potential recordings and geometric information of the torso and the heart. ECGI has shown scientific and clinical value when used to characterize and treat both atrial and ventricular arrhythmias. Regarding atrial fibrillation (AF), the characterization of the electrical propagation and the underlying substrate favoring AF is inherently more challenging than for ventricular arrhythmias, due to the progressive and heterogeneous nature of the disease and its manifestation, the small volume and wall thickness of the atria, and the relatively large role of microstructural abnormalities in AF. At the same time, ECGI has the advantage over other mapping technologies of allowing a global characterization of atrial electrical activity at every atrial beat and non-invasively. However, since ECGI is time-consuming and costly and the use of electrical mapping to guide AF ablation is still not fully established, the clinical value of ECGI for AF is still under assessment. Nonetheless, AF is known to be the manifestation of a complex interaction between electrical and structural abnormalities and therefore, true electro-anatomical-structural imaging may elucidate important key factors of AF development, progression, and treatment. Therefore, it is paramount to identify which clinical questions could be successfully addressed by ECGI when it comes to AF characterization and treatment, and which questions may be beyond its technical limitations. In this manuscript we review the questions that researchers have tried to address on the use of ECGI for AF characterization and treatment guidance (for example, localization of AF triggers and sustaining mechanisms), and we discuss the technological requirements and validation. We address experimental and clinical results, limitations, and future challenges for fruitful application of ECGI for AF understanding and management. We pay attention to existing techniques and clinical application, to computer models and (animal or human) experiments, to challenges of methodological and clinical validation. The overall objective of the study is to provide a consensus on valuable directions that ECGI research may take to provide future improvements in AF characterization and treatment guidance.
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Affiliation(s)
- João Salinet
- Biomedical Engineering, Centre for Engineering, Modelling and Applied Social Sciences (CECS), Federal University of ABC, São Bernardo do Campo, Brazil
| | - Rubén Molero
- ITACA Institute, Universitat Politècnica de València, València, Spain
| | - Fernando S. Schlindwein
- School of Engineering, University of Leicester, United Kingdom and National Institute for Health Research, Leicester Cardiovascular Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Joël Karel
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands
| | - Miguel Rodrigo
- Electronic Engineering Department, Universitat de València, València, Spain
| | - José Luis Rojo-Álvarez
- Department of Signal Theory and Communications and Telematic Systems and Computation, University Rey Juan Carlos, Madrid, Spain
| | - Omer Berenfeld
- Center for Arrhythmia Research, University of Michigan, Ann Arbor, MI, United States
| | - Andreu M. Climent
- ITACA Institute, Universitat Politècnica de València, València, Spain
| | - Brian Zenger
- Biomedical Engineering Department, Scientific Computing and Imaging Institute (SCI), and Cardiovascular Research and Training Institute (CVRTI), The University of Utah, Salt Lake City, UT, United States
| | - Frederique Vanheusden
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Jimena Gabriela Siles Paredes
- Biomedical Engineering, Centre for Engineering, Modelling and Applied Social Sciences (CECS), Federal University of ABC, São Bernardo do Campo, Brazil
| | - Rob MacLeod
- Biomedical Engineering Department, Scientific Computing and Imaging Institute (SCI), and Cardiovascular Research and Training Institute (CVRTI), The University of Utah, Salt Lake City, UT, United States
| | - Felipe Atienza
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, and Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - María S. Guillem
- ITACA Institute, Universitat Politècnica de València, València, Spain
| | - Matthijs Cluitmans
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Pietro Bonizzi
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands
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Williams KM, Wilson PT, Silva-Palacios F, Kebbe J, LaBeaud AD, Agudelo H, Sidonio RF, Stowell SR, Josephson CD, Tarini BA, Holter Chakrabarty JL, Agwu AL. COVID-19 Cliff Notes: A COVID-19 Multidisciplinary Care Compendium. Transplant Cell Ther 2021; 27:474.e1-474.e3. [PMID: 33686384 PMCID: PMC7927582 DOI: 10.1016/j.jtct.2021.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/28/2021] [Indexed: 12/15/2022]
Abstract
As we pass the nearly 9 month mark of the coronavirus virus disease 2019 (COVID-19) pandemic in the United States, we sought to compile a brief multi-disciplinary compendium of COVID-19 information learned to date. COVID-19 is an active viral pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that confers high morbidity and mortality. COVID-19 has been associated with: pulmonary compromise and acute respiratory distress syndrome, thrombotic events, inflammation and cytokine, and post-infectious syndromes. Mitigation of these complications and expeditious therapy are a global urgency; this is brief summary of current data and management approaches synthesized from publications, experience, cross-disciplinary expertise (Figure 1).
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Affiliation(s)
- Kirsten M Williams
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
| | - P T Wilson
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Columbia University Medical Center, New York, New York
| | - F Silva-Palacios
- Vascular Medicine, Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - J Kebbe
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - A D LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California
| | - Higuita Agudelo
- Section of Infectious Diseases, Department of Medicine, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - R F Sidonio
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - S R Stowell
- Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia
| | - C D Josephson
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia; Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia
| | - B A Tarini
- Children's Research Institute, Children's National Hospital, Department of Pediatrics, George Washington University, Washington, DC
| | - J L Holter Chakrabarty
- Department of Medicine, Division of Hematology/Oncology/Marrow Transplantation and Cell Therapy, University of Oklahoma, Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - A L Agwu
- Department of Pediatrics and Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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