Clinical value of 18F-PSMA-1007 PET/MRI in primary staging of patients with intermediate- to high-risk prostate cancer

OBJECTIVE

To assess the utility of 18F-PSMA-1007 PET/MRI in initial staging of intermediate- to high-risk prostate cancer (HRPCa).

METHODS

A total of 46 patients with pathologically verified intermediate and/or HRPCa who underwent 18F-PSMA-1007 PET/MRI with dedicated pelvic high-resolution multiparametric MRI (mpMRI) were included.

RESULTS

PET/MRI showed 100% sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy in detecting seminal vesicle (SV) and rectal invasion, versus 87.5%, 100%, 100% 93.8%, 95.7% and 50%, 100%,100%, 95.5%, and 95.7% for mpMRI respectively. However, PET/MRI had poor SN (40% and 0%) but high SP (94.4% and 100%) in detection of UB and neurovascular bundle (NV) invasion compared to 100% SN and SP for mpMRI. PET/MRI demonstrated stronger TNM staging agreement with the gold standard than mpMRI-WBMRI. It demonstrated concordance with T, N, and M stages in 40, 41, and 36 patients (k 0.84, 0.60, and 0.68, respectively) versus 29, 33, and 31 patients (k 0.54, 0.22, and 0.50) with accurate over all staging of 38/46 patients versus 30/46 patients (K 0.52 versus 0.22).

CONCLUSION

18F-PSMA-1007 PET/MRI is a promising imaging modality with high diagnostic accuracy in staging intermediate- and HRPCa; it improves local tumour evaluation and provides precise TNM staging.

ADVANCES IN KNOWLEDGE

18F-PSMA-1007 PET/MRI could have high diagnostic accuracy as shown in the current study for staging HRPCa patients that is crucial for treatment selection. We think that our study will contribute to the body of knowledge and improve the literature surrounding the clinical uses of integrated 18F-PSMA-1007 PET/MRI.

Avoiding medical emergencies

Medical emergencies can occur at any time in any location. This article and associated presentation at the forthcoming British Dental Conference Exhibition provide key advice on avoiding medical emergencies in dental practice; including advice on risk assessing all patients, understanding the importance of a checklist, and using a National Early Warning Score (NEWS).

Entanglement of two impurities through electron scattering

We study how two magnetic impurities embedded in a solid can be entangled by an injected electron scattering between them and by subsequent measurement of the electron's state. We start by investigating an ideal case where only the electronic spin interacts successively through the same unitary operation with the spins of the two impurities. We find conditions for the impurity spins to be maximally entangled with a significant success probability. We then consider a more realistic description which includes both the forward and backscattering amplitudes. In this scenario, we obtain the entanglement between the impurities as a function of the interaction strength of the electron-impurity coupling. We find that our scheme allows us to entangle the impurities maximally with a significant probability.

Entanglement concentration using quantum statistics

We propose an entanglement concentration scheme which uses only the effects of quantum statistics of indistinguishable particles. This establishes the fact that useful quantum information processing can be accomplished by quantum statistics alone. Because of the basis independence of statistical effects, our protocol requires less knowledge of the initial state than most entanglement concentration schemes. Moreover, no explicit controlled operation is required at any stage.

Bilateral origin of the internal thoracic artery from the third part of the subclavian artery: a case report

The routine use of the internal thoracic artery (ITA) as a conduit in coronary artery bypass grafting surgery has highlighted the need to appreciate this vessel's anatomic variations. The usual origin of this vessel is from the first part of the subclavian artery, occasionally from the second and rarely from the third. Henriques-Pino and Prates described a unilateral origin from the third part on the left and Vorster et al on the right. Our cadaveric case report presents an unusual bilateral origin of the ITA arising from the third part of the subclavian artery in a 25-year-old Black South African female. The ITA arose from the ventral aspect, 7.3 cm on the right side and 8.5 cm on the left side from the origin of the subclavian artery, and inclined acutely inferiorly and medially, anterior to the distal attachment of the scalenus anterior m., followed the inner border of the first rib for a short distance and, thereafter, continued its usual course in the thorax. This appears to be the first case report presenting a bilateral origin of the ITA from the third part of the subclavian artery.

Breast cancer in Arabic women

A case-control study of breast cancer was conducted in Cairo, Egypt and in Kuwait. This is the first such report from Arabic countries and the most significant finding is the animal incidence rate of 7.67 per 100,000 in Kuwaiti women, which ranks amongst the lowest thus far reported in the world. Factors which contribute to this low rate are a short period of active menstruation, low family history, first childbirth at very early age and most likely significant dietary factors. More than 45% of Egyptian women give birth to a child before the age of 20, with 56.5% of controls and 42.3% of patients (p less than 0.01). Many patients already have extensive disease at time of diagnosis as a result of considerable delay. However, this delay did not result in a high incidence of inflammatory breast carcinoma, such as has been reported in Tunisia.