Gastrointestinal Stromal Tumour : RadioPath Correlation

Discussing the Radiology and Pathological aspects of GIST in a integrated medical teaching video

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Increased infiltration of CD11c+/CD123+ dendritic cell subsets and upregulation of TLR/IFN-α signaling participate in pathogenesis of oral lichen planus

Publication date: Available online 18 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yufeng Wang, Shu Shang, Qianqian Sun, Junjun Chen, Guanhuan Du, Hong Nie, Xiaozhe Han, Guoyao Tang
ObjectiveInvestigation of dendritic cell (DC) subsets and expression patterns of Toll-like receptors (TLRs) was conducted to understand the pathogenesis in oral lichen planus (OLP).Study DesignBlood, OLP lesion and control samples were collected. Four DC subsets (CD11c⁺CD123^-myeloid DC-mDC1, CD141⁺myeloid DC-mDC2, CD11c^-CD123⁺plasmacytoid DC-pDC and CD1a⁺CD207⁺Langerhans cells-LC) were investigated via flow cytometry (FCM) and immunohistochemical (IHC) staining. Expression patterns of TLRs and their downstream molecules were analyzed via qRT-PCR and IHC in situ.ResultsThirty-two samples were collected (9 controls and 23 OLP patients). FCM results showed the percentages of LC, mDC1, mDC2 and pDC in situ were 0.0119±0.0251%, 0.0064±0.0134%, 0.0005±0.0011%, and 0.0022±0.0019% in control mucosa, respectively. The mDC1 (0.0300±0.0276%) and pDC (0.0204±0.0186%) subsets were significantly increased in OLP lesions (p<0.01). No marked differences were evident, when comparing all four DC subsets from blood, between control and OLP groups. Significant upregulation of TLR7, TLR8 and TLR9 were disclosed in OLP (p<0.01), along with their downstream interferon-α(IFN-α) signaling molecules(IRF7 and IFN-α, p<0.01).ConclusionOur findings of increased infiltration of pDC and mDC1, along with upregulation of TLR/IFN-α signaling, provide valuable information for further understanding the immunity in OLP.



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An actionable test using loss of heterozygosity in identifying high-risk oral premalignant lesions

Publication date: Available online 18 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Kelly Y.P. Liu, X.J. David Lu, Yi-Shing L. Cheng, Hagen Klieb, Samson Ng, Kelly McNeil, Aly Karsan, Catherine F. Poh
Objectives.To develop an actionable test using fluorescent-labeled primers with capillary gel electrophoresis (FCE) to assess loss of heterozygosity (LOH) of histologically similar low-grade lesions (LGLs) to identify high-risk lesions for oral cancer progression.Study Design.To determine the cut-offs of LOH, the FCE results of 52 surgical margin samples were used to compare to the existing LOH results from the previously validated ³²P-GE approach. Using the developed FCE workflow, an independent set of 102 LGLs with known progression status was used to determine the LOH molecular risk (MR) patterns and associated risk of progression.Results.Using 65% cut-off LOH-FCE, the agreement of LOH-³²P-GE showed an average of 82.3% (76.8-87.8). Comparing to non-progressors (n=61), anatomical site, and MR patterns (LOH at 9p21, 3p14, or 17p13) were independent risk factors. High-risk profile of tongue and MR3 (LOH at 9p21 and/or 3p14, and 17p13) was significantly associated with progression (HR, 6.7; 95% CI, 2.6-17.6) with specificity of 98.4% at identifying progressors.Conclusions.We have developed an objective, fast, environmental-safe, and cost-effective test using LOH to stratify the risk of LGLs. With further validation, it can be used in the clinical settings to provide clinicians additional information guiding the management of these lesions.



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Detection of Intra-Articular Screw Penetration of Proximal Humerus Fractures

Publication date: Available online 18 December 2017
Source:Academic Radiology
Author(s): Xiaoyang Jia, Yanxi Chen, Minfei Qiang, Kun Zhang, Haobo Li, Yuchen Jiang, Yijie Zhang
Rationale and ObjectiveScrew penetration is the common complication of proximal humerus fractures treated with locking plates. This study compared postoperative plain radiography to computed tomography (CT) for their abilities in determining screw penetration, and was to evaluate whether advanced imaging modalities (two-dimensional [2D] CT; three-dimensional [3D] CT) could increase surgeons' level of confidence regarding their diagnoses.Materials and MethodsTwo observers reviewed radiological images of 134 patients who sustained proximal humerus fractures treated with locking plates. The observers were asked to answer two questions: (1) Is there screw penetrating into glenohumeral joint for this patient (Yes/No)? and (2) On a scale from 0 to 10, how confident are you about this diagnosis: (0–10) (0 = not at all confident; 10 = very confident)? Three evaluations were performed: (1) plain radiography alone, (2) radiography and 2D CT 4 weeks later, and (3) radiography in combination with 2D and 3D CT after that. This process was then repeated for intraobserver analysis.ResultsCT obtained almost perfect interobserver and intraobserver agreement (0.818–0.961), which was higher than radiography (0.377–0.655). For incidence of screw penetration, the significant difference was found between radiographs and CT images (P < .0125), but not between 2D and 3D CT images (P > .05). For confidence of diagnosis, the differences between imaging modalities were significant (all P < .001).ConclusionsWe suggest that postoperative CT scans (especially 3D CT images) should be used to evaluate the intra-articular screw penetration of proximal humerus fractures, especially when surgeons have not enough confidence in determining screw penetration using radiography alone.



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ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges

Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations.

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Prospect of robotic assistance for fully automated brachytherapy seed placement into skull base: Experimental validation in phantom and cadaver

To investigate the feasibility and accuracy of robot-assisted brachytherapy for skull base tumours.

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ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges

Publication date: Available online 18 December 2017
Source:Radiotherapy and Oncology
Author(s): Frank Verhaegen, Ludwig Dubois, Stefano Gianolini, Mark A. Hill, Christian P. Karger, Kirsten Lauber, Kevin M. Prise, David Sarrut, Daniela Thorwarth, Christian Vanhove, Boris Vojnovic, Robert Weersink, Jan J. Wilkens, Dietmar Georg
Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations. This report discusses the combination of precision irradiation systems, small animal imaging (CT, MRI, PET, SPECT, bioluminescence) systems, image registration, treatment planning, and data processing. It also provides guidelines for reporting on studies.



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