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Introduction: Biology-guided radiotherapy (BgRT) is a novel radiation delivery approach utilizing fluorodeoxyglucose (FDG) activity on positron emission tomography (PET) imaging performed in real-time to track and direct RT. Our institution recently acquired the RefleXion X1 BgRT system and sought to assess the feasibility of targeting metastatic sites in various organs, including the liver. However, in order for BgRT to function appropriate, adequate contrast in FDG activity between the tumor and the background tissue, referred to as the normalized SUV (NSUV), is necessary for optimal functioning of BgRT. Methods: We reviewed the charts of 50 lung adenocarcinoma patients with liver metastases. The following variables were collected: SUVmax and SUVmean for each liver metastasis, SUVmean and SUVmax at 5 and 10 mm radially from the lesion, and NSUV at 5 mm and 10 mm (SUVmax of the liver metastasis divided by SUV mean at 5 mm at 10 mm respectively). Results: 82 measurable liver metastases were included in the final analysis. The average SUVbackground of liver was 2.26 (95% confidence interval [CI] 2.17–2.35); average SUVmean for liver metastases was 5.31 (95% CI 4.87–5.75), and average SUVmax of liver metastases was 9.19 (95% CI 7.59–10.78). The average SUVmean at 5 mm and 10 mm radially from each lesion were 3.08 (95% CI 3.00-2.16) and 2.60 (95% CI 2.52–2.68), respectively. The mean NSUV at 5 mm and 10 mm were 3.13 (95% CI 2.53–3.73) and 3.69 (95% CI 3.00-4.41) respectively. Furthermore, 90% of lesions had NSUV greater than 1.45 at 5 mm and greater than 1.77 at 10 mm. Conclusions: This is the first study to comprehensively characterize FDG contrast between the liver tumor and background, referred to as NSUV. Due to the high background SUV normally found in the liver, this work will be valuable for guiding optimization of BgRT for treating liver metastases in the future using the RefleXion® X1 and potentially other similar BgRT platforms. [ABSTRACT FROM AUTHOR]

A new aryltetralin lignan, bupleroid A (1), along with ten known analogues (2–11) were isolated from Bupleurum marginatum. The structures of these isolates were determined by 1D and 2D NMR, HRESIMS, and ECD data analysis. In addition, the DPPH radical scavenging capacities of all compounds were evaluated. Compound 6 exhibited good DPPH radical scavenging activity at a concentration of 50 μM. [ABSTRACT FROM AUTHOR]

Erratum: "Evaluation of repeatability and reproducibility of radiomic features produced by the fan-beam kV-CT on a novel ring gantry-based PET/CT linear accelerator" https://10.1002/mp.16399 In Ketcherside et al., 1 the COI disclosure statement missed disclosing three authors who are from commercial companies, thus the COI disclosure statement is corrected. CONFLICT OF INTEREST STATEMENT David Leung, Andrew Sundquist, and Calvin Huntzinger are employed by Reflexion Medical. [Extracted from the article]

Management of oligometastatic non-small cell lung cancer (OM-NSCLC) has changed considerably in recent years, as these patients were found to have better survival with systemic therapy followed by consolidative radiation. Stereotactic body radiotherapy (SBRT), characterized by high doses of radiation delivered in a limited number of fractions, has been shown to have improved local control compared to conventionally fractionated radiation in early-stage lung cancer, but its use in large tumors, ultra-central tumors, or mediastinal nodal regions is limited due to concerns of toxicity to nearby serial mediastinal structures. Recent improvements in image guidance and fast replanning allow adaptive radiotherapy to be used to personalize treatment to the patient's daily anatomy and ensure accurate dose delivery to the tumor while minimizing dose and toxicity to normal. Adaptive SBRT can expand its use into ultra-central tumors that otherwise may not be amenable to SBRT or enable alternative fractionation schedules such as personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) with one-month intervals between fractions. In this case, we report a patient initially presenting with bulky OM-NSCLC of the left lung and mediastinum with an isolated left femur metastasis who was referred for consolidative radiotherapy after systemic therapy. We demonstrate how CT-guided online adaptive radiotherapy to the lung and mediastinum can be used despite the long time interval between treatments. In addition, adaptive plans lead to a substantial decrease in the heart dose, with moderate decreases in other organs compared to non-adaptive plans. This case demonstrates the feasibility of using adaptive radiotherapy for PULSAR of ultra-central OM-NSCLC., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Eustace et al.)