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Purpose: Recently introduced hybrid 2-[18 F]-fluoro-2-deoxy-D-glucose (18 F-FDG) Positron Emission Tomography (PET) combined with Magnetic Resonance Imaging (MRI) may aid in proper diagnosis and staging of perihilar cholangiocarcinoma (pCCA). The aim of this study is to assess the effect of 18 F-FDG PET/MRI on diagnosis and clinical decision making in the pre-operative work up of pCCA. Methods: In this single-centre pilot study patients with presumed resectable pCCA underwent state-of-the-art 18 F-FDG hybrid PET/MRI using digital silicone photomultiplier detectors integrated within a 3-Tesla bore. Data were collected on several baseline and imaging characteristics. The primary outcome measure was the added diagnostic information and the effect on clinical decision making. Secondary aim was to correlate quantitative PET signal intensity to patient- and tumour characteristics. High and low SUVmax subgroups related to the mean value were made. Significance of lesion- and patient characteristics with the high and low SUVmax subgroups, as well as TLR and TBR, was evaluated with Fisher’s exact test or Mann-Whitney-U test. Results: In total 14 patients were included (mean age 62.4 years, 64% male). Final diagnosis was pCCA in 10 patients (71.4%), follicular lymphoma in one patient (7.1%) and benign disease in the remaining three patients. FDG-PET/MRI added valuable diagnostic information in six (43%) patients and affected clinical decision making in two of these patients (14%) by increasing confidence for malignancy which lead to the decision for surgery on short term. High SUVmax values were seen in half of cases with pCCA and half of cases with non-cancerous lesions. In addition, high SUVmax values were directly associated with primary sclerosing cholangitis when present (p= 0.03). Conclusion: Simultaneous 18 F-FDG-PET/MRI added diagnostic information in six of fourteen patients and influenced clinical decision making in two patients (14%) with presumed resectable pCCA.

BACKGROUND:: Non-prostatic bed recurrence of prostate cancer (PCa) is usually treated with androgen deprivation therapy (ADT). We analyzed the impact of salvage extended lymph node dissection (sLND) on cancer control in patients with rising PSA and lymph node (LN) metastases. METHODS:: Between 2009 and 2016 we performed sLND in 87 patients with biochemical recurrence (BCR) and positive LNs on 18FEC and 68Ga-PSMA positron emission tomography/X-ray computer tomography (PET/CT) after primary treatment (PT) of PCa. Intra- and postoperative complications according to Clavien-Dindo were assessed and the rates of biochemical response (BR), BCR-free and clinical recurrence (CR)-free survival, as well as time to initiation of systemic treatment were evaluated. RESULTS:: Mean age of patients and mean PSA at sLND was 66.7 years (46–80 years) and 2.63 ng ml−1(1.27–3.75 ng ml−1), respectively. With 87.4% radical prostatectomy (RP) was the most common PT. In all, 57.9% of patients additionally underwent adjuvant/salvage radiation therapy (RT) and 18.4% received ADT before sLND. Complete BR (cBR) was diagnosed in 27.5% of patients and incomplete BR in 40.6%. In total, 62.2% of patients remained without ADT at follow-up. With a median follow-up of 21 months (1–75 months), the cancer-specific mortality rate was 3.7%. The 3-year BCR-free, systemic therapy-free and CR-free survival rates for patients with cBR were 69.3%, 77.0% and 75%, respectively. CONCLUSIONS:: sLND can be performed without significant complications and achieves an immediate BR, thus allowing a significant postponement of systemic therapy in selected patients with BCR and nodal recurrence of PCa. Therefore, sLND following 68Ga-PSMA PET/CT should be considered as part of a multimodal diagnostic and treatment concept for selective patients.

The iodine isotope I-131 has been used in nuclear medicine for several decades to treat both benign and malignant thyroid diseases. The therapy is effective and safe and insensitive to variations in the activity dosage of I-131. Individualization of therapy in order to limit the administered activity to the lowest amount necessary to successfully treat diseased thyrocytes while minimizing exposure to healthy organs requires performing dosimetry through measurement of the individual iodine kinetics. This review discusses the concepts of dosimetry used for patients with thyroid disorders and compiles information on the present evidence for superiority of individualization of therapy by dosimetric assessments. Two main concepts of individualized treatment are used for patients with differentiated thyroid carcinoma: (a) the assessment of the specific absorbed dose to the blood as a substitute for the red marrow dose in order to target at a specific blood dose from therapy and (b) the administration of the I-131 activity determined by lesion dosimetry to be necessary to achieve a fixed absorbed dose to the tumour which is known to be effective in most of the cases. The first concept is mainly used to safely administer the highest tolerable activity, thus enhancing the absorbed dose to the tumour. Increasing evidence exists that patients with advanced disease benefit from this dose optimization. The second concept becomes increasingly feasible with the improvements in dosimetry introduced by advanced imaging techniques like I-124 PET/CT, but bears the inherent risk of under-dosing the patient. Studies reporting response in tumours are not consistent regarding the absorbed dose necessary to certainly eliminate the lesion. In the treatment of benign thyroid diseases, most studies comparing regimes with calculated and estimated activity dosage did not find improved rates of cure and side effects in patients with measured kinetics. A few studies with advanced dosimetric concepts found good dose–response relations. Individualization of radioiodine therapy in the treatment of thyroid disorders still is not used to its full potential. Recently developed imaging techniques like SPECT/CT and PET/CT, enabling 3-dimensional measurement of dose distributions, allow considerable improvements in dosimetry. Prospective randomized trials with appropriate and controlled dosimetry are necessary to provide conclusive information on the value of individualized treatment planning and to identify the major confounding variables responsible for treatment failure.

Intramuscular fat content is a major determinant of meat quality in pigs. Previously, polymorphisms in the adipocyte and heart fatty acid-binding protein genes, A-FABPand H-FABP, have been significantly associated with genetic variation of intramuscular fat content in a Duroc pig population. Further support for the role of H-FABP but not for A-FABP was found in a Meishan crossbred population. However, the effect of closely linked genes could not be excluded in these analyses. To validate the role of A-FABP and H-FABP in intramuscular fat accretion, 153 pigs of a crossbred genotype were evaluated for the A-FABP and H-FABP polymorphisms, mRNA, and protein expression levels of both FABP genes and intramuscular fat content in the longissimus lumborum muscle. For H-FABP, statistical analyses showed significant differences in mRNA but not protein expression levels between H-FABP HaeIII PCR-RFLP genotype classes. Between these genotype classes, significant differences in intramuscular fat content were found within barrows but not in gilts. Moreover, H-FABP mRNA but not protein expression levels were significantly related to intramuscular fat content. For A-FABP genotype classes, no significant differences in mRNA and protein expression levels were found. However, a significant difference in intramuscular fat content was found within barrows but not in gilts. In addition, a significant relationship between A-FABP mRNA but not protein expression levels and intramuscular fat content was found. In conclusion, variation of intramuscular fat content could not be explained by differences in A-FABP and H-FABP mRNA and protein expression levels. However, this may be due to limitations of the assays used and(or) the inappropriateness of the time of sampling. Finally, results suggest that A-FABP and H-FABP expression are translationally rather than transcriptionally regulated.

Livestock meat production capacity is related to muscle fiber numbers and growth. Muscle fibers develop during early embryonic development from proliferating and differentiating myoblasts. Post-natal muscle growth requires satellite cell proliferation and differentiation. Myoblast and satellite cell proliferation and differentiation is regulated by the genes of the MyoD gene family (myogenin, myf-5, myf-6, and MyoD1). Our aim was to study the mRNA expression of these genes in postnatal muscle tissue in relation to porcine selection for growth rate or leanness. Five boars from a line selected for fast growth (F-line) and five boars from a line selected against backfat thickness (L-line) were slaughtered, and biopsies were taken from 12 muscles. Between-line effects, within-line effects in relation to the performance of the pigs, and muscle-specific effects were studied. Comparing the F-line with the L-line revealed significantly greater myogenin, myf-5, and MyoD1 mRNA expression in some muscles of the F-line. The expression of myf-6 showed a tendency for the opposite effect in some muscles. Muscles were ordered by their muscle-specific growth rate (b-value). Within-line evaluation of the data revealed a systematic muscle effect for the myf-6 expression level in the F-line because higher b-values correlated with increased myf-6 expression level. Backfat thickness was negatively related to myogenin expression in the F-line. A relationship was found between myogenin:MyoD1 mRNA expression ratio and meat color/muscle fiber type composition in the L-line. Furthermore, the myogenin:MyoD1 ratio was greater in muscles from F-line boars than in muscles from L-line boars, which relates to the difference between the lines in muscle fiber type. We conclude that the mRNA levels of the MyoD genes in porcine muscle tissue at slaughter showed different relationships to selection for growth rate when evaluated between selection lines and within selection lines.

Lean weight is related to muscle fiber number. Muscle fiber formation (myogenesis) occurs only during embryonic development when it is under the control of the MyoD gene family consisting of myogenin, MyoD1, myf-5, and myf-6. Myogeninhas a central position within the MyoDgene family because myogenin expression abrogates myoblast proliferation potential and regulates the differentiation of single nucleated myoblasts into multinucleated myofibers. Thus, myogenin genotype could be related to variation in the number of muscle fibers formed, leading to variation in muscle mass and, thus, lean weight. A polymorphism at the porcine myogeninlocus was associated with birth weight, growth rate, lean weight at 200 d, and backfat thickness. Yorkshire pigs from two commercial lines were genotyped, and crosses between heterozygous pigs and heterozygous and homozygous pigs were made. Resulting litters were genotyped, and phenotypic data were collected. Significant differences were found between the two homozygous myogeningenotypes for birth weight, growth rate, and lean weight, but not for backfat thickness. Variation at the myogenin locus explained 4% of the total phenotypic variation in birth weight, growth rate, and carcass weight, and 5.8% of the total variation in lean weight. We conclude that myogenin genotype influences porcine growth rate and muscle mass.

In order to find genetic markers to improve the meat quality of pigs by breeding we studied the relationship between variation in the heart fatty acid-binding protein (H-FABP)gene (FABP3) and intramuscular fat (IMF) content. To estimate the effect of H-FABP, pigs from two Duroc populations were selectively mated in such a way that at least two genotypes were present in each litter. In total, data from 983 pigs and pedigree information from three preceding generations were analyzed. Offspring were tested for IMF content as well as backfat thickness (BFT), BW, and drip loss of the meat (DRIP). All pigs were assigned to H-FABP RFLP genotype classes either by the assessed genotype (75%) or based on a probability score determined according to genotypic information of their relatives (25%). Contrasts were detected between homozygous H-FABP RFLP genotype classes for IMF content (.4%, P< .05), BFT (.6 mm, P< .01), and BW (2.4 kg, P< .10). No significant contrasts were detected for DRIP. Results for IMF content, BFT, and BW were confirmed when only genotyped animals were analyzed. Variation in BFT partially explained the effect on IMF content. Although other closely linked genes on porcine chromosome 6 might be responsible for the observed effect, interference of the halothane gene was excluded because all parental animals were noncarriers. In conclusion, H-FABP RFLP can be used as markers to select for increased IMF content and growth in breeding programs.