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The digital PET/CT scanner with digital photon-counting technique promises a shorter scan time, improved small-lesion detectability, and reduced radiation dose for the PET and CT portions of the exam while improving image quality. Methods: In this single-institution retrospective review study, 84 participants who had undergone PET/CT on both analog and digital scanners were analyzed. The aim was to evaluate the impact of image field of view (FOV) and body mass index (BMI) on the digital compared with the analog PET/CT scanners. The participants were categorized into different groups based on their BMI. Total scan times, 18F-FDG doses, and dose-length products (DLP) were collected and compared. Image quality was also assessed by certified nuclear medicine physicians and graded on a scale from 1 to 5. Results: In the skull-to-mid-thigh FOVs, the digital scanner had a scan time shorter by 37% (P < 0.001), a 18F-FDG dose lower by 16% (P < 0.001), but only an 8% reduction in DLP (P = 0.2). In the head-to-toe FOV cases, the digital scanner showed reductions in scan time (33%; P < 0.001), 18F-FDG dose (13%; P < 0.001), and DLP (19%; P < 0.001). When BMI was accounted for, the digital scanner had a scan time shorter by 33% (P < 0.001), as well as a reduced DLP (P < 0.001) and 18F-FDG dose (P < 0.001), with the most prominent changes being in the overweight and obese participants. Image quality was also improved by the digital scanner, with a score of 4.5, versus 4.0 for the analog scanner. Conclusion: The digital scanner has a shorter scan time and lower DLP, requires a lower 18F-FDG dose, and provides improved image quality when compared with the analog scanner. The most impactful difference in scan time, DLP, and 18F-FDG dose were observed in obese and overweight participants. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis Determine the accuracy of bone marrow cytologic evaluations in detecting occult cancellous invasion by squamous cell carcinomas (SCCa) beyond the original margins of bone resection that would have gone undetected without the use of intraoperative bone-marrow margin analysis. Study Design Retrospective single institution cohort study. Methods Retrospective chart review of imaging, clinical, pathological, and follow-up data of 51 patients who underwent mandibular resections with intraoperative bone-marrow cytologic evaluation. The accuracy of bone marrow cytologic evaluations to predict final bone margins was calculated. Five-year survival rates were determined. Results The accuracy of bone marrow cytologic evaluations in detecting occult cancellous invasion by SCCa beyond the original margins of bone resection was 100%. Twelve percent (6/51) were found to have positive bone margins on cytology and were re-resected to obtain clear margins. Patients with a prior history of radiation had a significantly higher incidence of initially positive bone-marrow margins ( P = 0.03). The patients with initially positive bone-margins did not have a significantly different prognosis than the patients with initially negative bone-marrow margins. Conclusion 1) The consistent use of intraoperative bone-marrow cytologic evaluation, when applicable, will improve the ability to obtain clear bone margins. 2) Patients with a history of prior radiation therapy have a significantly higher risk of having occult cancellous invasion of SCCa beyond the original margins of bone resection. 3) The prognosis of patients with initially positive bone-marrow margins is not significantly different than patients with initially negative bone-marrow margins. Level of Evidence 4. Laryngoscope, 125:E173-E179, 2015 [ABSTRACT FROM AUTHOR]

Objective: To find the survival rate of patients ≥ 80 years old who undergo salvage surgery for squamous cell carcinoma of the larynx., Study Design: National data registry analysis., Setting: Seventeen population-based registries comprising the National Cancer Institute's Surveillance, Epidemiology, and End Results database., Subjects and Methods: Overall, cancer-specific, and relative survival rates were calculated from 1418 patients, stratified into 3 age cohorts, who underwent surgery following radiation therapy for treatment of laryngeal cancer., Results: The 1-year overall survival of patients ≥ 80 years old (n = 57) was 76.1%. The cancer-specific survival at 1 year was 86.4%. These survival rates were significantly less than those of patients <65 years old (n = 869), who had a 1-year overall survival of 88.1% (P = .006) and cancer-specific survival of 90.5% (P = .029). Patients aged between 65 and 79 years old (n = 492) displayed 1-year overall survival of 80.7% (P = .426) and cancer-specific survival of 85.1% (P = .711), which were not significantly different from the ≥ 80 year cohort. When comparing relative survival at 5 years, the ≥ 80-year-old cohort's survival trended the highest (≥ 80 years, 62.8%; 65-79 years, 51.3%; 20-64 years, 56.2%)., Conclusion: While patients ≥ 80 years old have a less favorable prognosis than patients <65 years old, the survival rates of patients ≥ 80 years old are not significantly different from the 65- to 79-year-old cohort. After controlling for non-cancer-related death, patients ≥ 80 years old appear to have similar 5-year survival outcomes compared with other patients.