Neoplasms
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Neoplasms
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New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Read more
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External radioactive markers for PET data-driven respiratory gating in positron emission tomography.
Journal: European journal of nuclear medicine and molecular imaging
August/19/2013
Description

OBJECTIVE

Respiratory gating is an established approach to overcoming respiration-induced image artefacts in PET. Of special interest in this respect are raw PET data-driven gating methods which do not require additional hardware to acquire respiratory signals during the scan. However, these methods rely heavily on the quality of the acquired PET data (statistical properties, data contrast, etc.). We therefore combined external radioactive markers with data-driven respiratory gating in PET/CT. The feasibility and accuracy of this approach was studied for [(18)F]FDG PET/CT imaging in patients with malignant liver and lung lesions.

METHODS

PET data from 30 patients with abdominal or thoracic [(18)F]FDG-positive lesions (primary tumours or metastases) were included in this prospective study. The patients underwent a 10-min list-mode PET scan with a single bed position following a standard clinical whole-body [(18)F]FDG PET/CT scan. During this scan, one to three radioactive point sources (either (22)Na or (18)F, 50-100 kBq) in a dedicated holder were attached the patient's abdomen. The list mode data acquired were retrospectively analysed for respiratory signals using established data-driven gating approaches and additionally by tracking the motion of the point sources in sinogram space. Gated reconstructions were examined qualitatively, in terms of the amount of respiratory displacement and in respect of changes in local image intensity in the gated images.

RESULTS

The presence of the external markers did not affect whole-body PET/CT image quality. Tracking of the markers led to characteristic respiratory curves in all patients. Applying these curves for gated reconstructions resulted in images in which motion was well resolved. Quantitatively, the performance of the external marker-based approach was similar to that of the best intrinsic data-driven methods. Overall, the gain in measured tumour uptake from the nongated to the gated images indicating successful removal of respiratory motion was correlated with the magnitude of the respiratory displacement of the respective tumour lesion, but not with lesion size.

CONCLUSIONS

Respiratory information can be assessed from list-mode PET/CT through PET data-derived tracking of external radioactive markers. This information can be successfully applied to respiratory gating to reduce motion-related image blurring. In contrast to other previously described PET data-driven approaches, the external marker approach is independent of tumour uptake and thereby applicable even in patients with poor uptake and small tumours.

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Four-dimensional targeting error analysis in image-guided radiotherapy.
Journal: Physics in medicine and biology
January/14/2010
Description

Image-guided therapy (IGT) involves acquisition and processing of biomedical images to actively guide medical interventions. The proliferation of IGT technologies has been particularly significant in image-guided radiotherapy (IGRT), as a way to increase the tumor targeting accuracy. When IGRT is applied to moving tumors, image guidance becomes challenging, as motion leads to increased uncertainty. Different strategies may be applied to mitigate the effects of motion: each technique is related to a different technological effort and complexity in treatment planning and delivery. The objective comparison of different motion mitigation strategies can be achieved by quantifying the residual uncertainties in tumor targeting, to be detected by means of IGRT technologies. Such quantification requires an extension of targeting error theory to a 4D space, where the 3D tumor trajectory as a function of time measured (4D Targeting Error, 4DTE). Accurate 4DTE analysis can be represented by a motion probability density function, describing the statistical fluctuations of tumor trajectory. We illustrate the application of 4DTE analysis through examples, including weekly variations in tumor trajectory as detected by 4DCT, respiratory gating via external surrogates and real-time tumor tracking.

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Cell survival and apoptosis-related molecules in cancer cells in effusions: a comprehensive review.
Journal: Diagnostic cytopathology
September/22/2009
Description

Spreading of cancer cells to effusions is a manifestation of advanced disease, for which the chances of achieving cure using conventional treatment are low. This emphasizes both the importance of improving early detection and the need for developing targeted therapy modes. Such approaches should be based on characterization of the antiapoptotic, survival and drug resistance mechanisms of the metastatic cells in addition to analysis of the primary tumor. This review presents current knowledge regarding the expression and clinical role of cell survival and apoptosis-related molecules in nonhematological cancers in effusions. Differences in the anatomic site-related expression and clinical role of these proteins are additionally discussed. The data presented highlight the complexity of the multiple molecular pathways that mediate tumor cell survival within the serosal cavities.

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Pubmed
Developing an initial physical function item bank from existing sources.
Journal: Journal of applied measurement
July/6/2003
Description

The objective of this article is to illustrate incremental item banking using health-related quality of life data collected from two samples of patients receiving cancer treatment. The kinds of decisions one faces in establishing an item bank for computerized adaptive testing are also illustrated. Pre-calibration procedures include: identifying common items across databases; creating a new database with data from each pool; reverse-scoring "negative" items; identifying rating scales used in items; identifying pivot points in each rating scale; pivot anchoring items at comparable rating scale categories; and identifying items in each instrument that measure the construct of interest. A series of calibrations were conducted in which a small proportion of new items were added to the common core and misfitting items were identified and deleted until an initial item bank has been developed.

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Dental care of the pediatric cancer patient.
Journal: Pediatric dentistry
May/3/2004
Description

Although the rate for childhood cancer has remained relatively stable for the past 2 decades, there have been drastic declines in mortality due to early diagnosis and improvements in therapy. Now over 75% of children diagnosed with cancer survive more than 5 years. The pediatric dental professional plays an important role in the prevention, stabilization, and treatment of oral and dental problems that can compromise the child's health and quality of life before, during, and after the cancer treatment. This manuscript discusses recommendations for the dental care of the pediatric oncology patient.

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The association between mental distress and the use of alternative medicine among cancer patients in North Norway.
Journal: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
October/22/2003
Description

OBJECTIVE

To study the association between mental distress and the use of alternative medicine (AM) among cancer patients.

METHODS

A longitudinal questionnaire-based study was carried out at the Department of Oncology, University Hospital of Tromsø, Norway, during the period 1990-1991. The level of mental distress in 158 patients aged less than 75 years was assessed 4 months after first admission to the cancer ward. The patients answered five questions about mental distress selected from the General Health Questionnaire (GHQ). The questions were scored continuously according to the Likert scoring procedure. The level of mental distress was also ranked from 1 (little or no mental distress) to 3 (high mental distress).

RESULTS

A total of 53 of the 158 patients reported use of AM at inclusion of the study or during the 4 months of follow-up. Among patients with low mental distress, 21% were users of AM, 36% of patients with medium distress and 48% in patients with high level of mental distress (p-value for linear trend = 0.02). Adjusted for all known relevant variables, patients with medium level of mental distress had 1.9 times higher prevalence of use of AM than patients with low level of mental distress, patients with high mental distress had a 2.9 times higher prevalence (p = 0.15 and 0.07, respectively). Analyzed as a continuous variable (Likert score between 5 and 20), mental distress was associated with use of AM (p = 0.007).

CONCLUSIONS

These findings suggest that seeking alternative treatment is more common among mentally distressed cancer patients.

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Is the measurement of thymidylate synthase to determine suitability for treatment with 5-fluoropyrimidines ready for prime time?
Journal: Clinical cancer research : an official journal of the American Association for Cancer Research
January/19/2004
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Selection of human antibody fragments directed against tumor T-cell epitopes for adoptive T-cell therapy.
Journal: Cytometry. Part A : the journal of the International Society for Analytical Cytology
December/8/2008
Description

Adoptive transfer of antigen-specific T-cells has shown therapeutic successes in the treatment of tumors in patients with metastatic melanoma. Tumor antigen-specific T-lymphocytes, however, occur only at low frequencies in a small proportion of patients. This low T-lymphocyte frequency together with the difficulties associated with in vitro generation of T-lymphocytes specific for cancers other than melanoma hampers adoptive T cell therapy. To make adoptive T-cell therapy more uniformly applicable, strategies were developed at transferring tumor-specificity to primary human T-lymphocytes via antibody (Ig) or T-cell receptor (TCR) molecules. We exploited the selection power of phage display that allows for the testing of tens of billions of individual clones with a high-throughput selection of Fabs with peptide/MHC complex binding capacity. Following in vitro selection, human "TCR-like" Fab fragments have been functionally expressed on human T-lymphocytes, resulting in MHC-restricted, tumor-specific lysis and cytokine production. Currently, we have extended our selections to a panel of class I and II MHC-restricted MAGE and other tumor-specific epitopes, and would like to propose that phage display represents a technology able to expand T-cell therapy to numerous tumor types.

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Sensitive and selective tumor imaging with novel and highly activatable fluorescence probes.
Journal: Analytical sciences : the international journal of the Japan Society for Analytical Chemistry
April/27/2008
Description

Selective and sensitive tumor imaging in vivo is one of the most requested methodologies in medical sciences. Although several imaging modalities have been developed including positron emission tomography (PET) and magnetic resonance (MR) imaging for the detection of tumors, none of these modalities can activate the signals upon being accumulated or uptaken to tumor sites. Among these modalities, only optical fluorescence imaging has a marked advantage, that is, their signals can be dramatically increased upon detecting some biological features. In this short review, I will introduce some recent strategies for activatable optical fluorescence imaging of tumors, and discuss their advantages over other modalities.

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Evaluating patient distress from cancer-related fatigue: an instrument development study.
Journal: Oncology nursing forum
February/21/2001
Description

OBJECTIVE

To develop a clinically useful and psychometrically sound tool for the measurement of the distress from fatigue in patients with cancer.

METHODS

Instrument development of a numeric rating scale to assess cancer-related fatigue (CRF) distress.

METHODS

A comprehensive cancer center and a Veterans Administration hospital.

METHODS

The interview sample consisted of 17 adults with cancer experiencing CRF. The sample for instrument testing consisted of 221 adults with cancer. Twenty-nine different types of cancers were among the diagnoses. Seventy-eight percent of the participants were receiving some form of cancer treatment. The mean age was 60.

METHODS

The Cancer-Related Fatigue Distress Scale (CRFDS) was developed from 23 in-depth audiotaped interviews with patients experiencing CRF. Krippendorff's content analysis procedures were used for interview analysis. Twenty-three items were generated. Five cancer survivors assessed content validity. Factor analysis was used to assess construct validity, and coefficient alpha was used to estimate the reliability of the CRFDS.

RESULTS

Factor analysis resulted in all items loading on one factor, indicating a single scale. The coefficient alpha was 0.98 after the elimination of three items.

CONCLUSIONS

The CRFDS has strong content validity, high reliability, and very good construct validity.

CONCLUSIONS

The CRFDS is a clinically useful and psychometrically sound tool for the measurement of CRF distress. This tool is clinically useful because of its brevity (20 items), clear instructions that required no training to use, and a readability score at the third-grade level.

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