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Gastrointestinal (GI) sygdom er en af de hyppigste årsager til, at hunde præsenteres hos dyrlægen. Biomarkører, der er i stand til at hjælpe med diagnosticering og prognosticering af GI-ætiologier, er nødvendige. To nye biomarkører, myeloperoxidase (MPO) og cellefrit DNA (cfDNA), er blevet undersøgt humant og viser forandringer som respons på inflammation. Begge biomarkører bliver rutinemæssigt målt på hæmatologisystemet ADVIA 2120 som myeloperoxidase index (MPXI) og nukleinsyreholdige enheder (NACU). Stabiliteten af MPXI i hundeblod er dog ikke veldokumenteret. Formålet var at undersøge det diagnostiske og prognostiske potentiale af de nye biomarkører, MPXI og NACU, hos hunde med akut GI-sygdom sammenlignet med kronisk GI-sygdom og kontrolhunde. Derudover blev et panel af udvalgte cirkulatoriske inflammatoriske biomarkører og ratioer (C-reaktivt protein (CRP), fibrinogen, neutrofil-lymfocyt ratio (NLR), monocyt-lymfocyt ratio (MLR) og CRP/albumin ratio (CRP/ALB)) vurderet og evalueret som biomarkører hos hunde med akut GI-sygdom. Dette studie kombinerede et laboratorievariabilitetsstudie med et klinisk retrospektivt og prospektivt observerende case control studie udført på Universitetshospitalet for Familiedyr (UHCA) og Veterinært Diagnostisk Laboratorium (KU VetLab). Sytten hunde blev inkluderet i variabilitetsstudiet (neutrofile indenfor normalreference (n = 11), neutrofili (n = 5) og neutropeni (n = 1)), hvor stabiliteten af MPXI i EDTA-stabiliseret hundeblod blev testet på fem forskellige tidspunkter. En intra- og inter-assay variationskoefficient (CV) blev beregnet og viste, at CV var acceptabelt i op til 72 timer. Syvogtredive hunde blev inkluderet i det kliniske studie og opdelt i tre grupper: Akut GI (n = 16), kronisk GI (n = 9) og kontrolhunde (n = 12). Ingen signifikante forskelle i MPXI og NACU blev fundet. En sammenligning af de udvalgte inflammatoriske biomarkørniveauer mellem den akutte GI-gruppe og den kroniske GI-gruppe kunne identificere, Gastrointestinal (GI) disease is one of the most common presenting complaints for dogs in veterinary practice. Biomarkers capable of aiding in the diagnosis and prognosis of GI etiologies are needed. Recent human studies investigating the two novel biomarkers myeloperoxidase (MPO) and cell-free DNA (cfDNA), have indicated that they change in response to inflammation. Both biomarkers are routinely measured on the hematology analyzer ADVIA 2120 as myeloperoxidase index (MPXI) and nucleic acid-containing units (NACU). However, the stability of MPXI in canine blood is not well-documented. The objective was to investigate the diagnostic and prognostic potential of the novel biomarkers MPXI and NACU in dogs with acute GI disease compared to chronic GI disease and control dogs. Additionally, a panel of selected circulatory inflammatory biomarkers and ratios (C-reactive protein (CRP), fibrinogen, neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and CRP/albumin ratio (CRP/ALB)) were assessed and evaluated as biomarkers for acute GI disease. This study combined a laboratory variability study with a clinical retrospective and prospective observational case control study performed on EDTA-stabilized canine blood at the University Hospital for Companion Animals (UHCA), and Veterinary Diagnostic Laboratory (KU VetLab). Seventeen dogs were included in the variability study (normal neutrophil range (n = 11), neutrophilia (n = 5), and neutropenia (n = 1)), where the stability of MPXI in EDTA-stabilized canine blood was tested at five time points. An intra- and inter-assay coefficient of variation (CV) were calculated and showed that the CV was acceptable for up to 72 hours. Thirty-seven dogs were included in the clinical study and divided into three groups: Acute GI (n = 16), chronic GI (n = 9), and control dogs (n = 12). No significant differences in MPXI and NACU were found. Comparing the selected inflammatory biomarker levels in the acute GI group and

PET/CT with the tracer 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) has improved diagnostic imaging in cancer and is routinely used for diagnosing, staging and treatment planning in lung cancer patients. However, pitfalls of [18F]FDG-PET/CT limit the use in specific settings. Additionally, lung cancer is still the leading cause of cancer associated death and has high risk of recurrence after curative treatment. These circumstances have led to the continuous search for more sensitive and specific PET tracers to optimize lung cancer diagnosis, staging, treatment planning and evaluation. The objective of this review is to present and discuss current knowledge and perspectives of new PET tracers for use in lung cancer. A literature search was performed on PubMed and clinicaltrials.gov, limited to the past decade, excluding case reports, preclinical studies and studies on established tracers such as [18F]FDG and DOTATE. The most relevant papers from the search were evaluated. Several tracers have been developed targeting specific tumor characteristics and hallmarks of cancer. A small number of tracers have been studied extensively and evaluated head-to-head with [18F]FDG-PET/CT, whereas others need further investigation and validation in larger clinical trials. At this moment, none of the tracers can replace [18F]FDG-PET/CT. However, they might serve as supplementary imaging methods to provide more knowledge about biological tumor characteristics and visualize intra- and inter-tumoral heterogeneity.

BACKGROUND: Conjunctivitis and several other ocular surface diseases (OSDs) have been linked to atopic dermatitis (AD) and its treatment.OBJECTIVES: To examine the association between AD, conjunctivitis and other OSDs.METHODS: A systematic review and meta-analysis was performed. Two authors independently searched EMBASE, PubMed, SCOPUS and Web of Science, performed title/abstract and full-text review and data abstraction. Pooled random-effects prevalence and odds ratios (OR) with 95% confidence intervals (CI) were estimated.RESULTS: The search yielded 5,719 non-duplicate articles, 134 were included in the quantitative analysis. AD was associated with conjunctivitis compared to reference individuals (OR 2.78, 95% CI 2.33-3.32); the prevalence of conjunctivitis in AD patients and reference individuals being 31.7% (95% CI 27.7-35.9) and 13.3% (95% CI 11.0-15.7), respectively. Keratoconus (OR 3.71, 95% CI 1.99-6.94) and ocular herpes simplex (OR 3.65, 95% CI 2.04-6.51) were also associated with AD.LIMITATIONS: Disease definitions differed and often relied on self-reports. Few studies provided data concerning AD phenotype or OSDs other than conjunctivitis.CONCLUSIONS: Conjunctivitis is the most common ocular comorbidity in AD. Signs and symptoms of conjunctivitis and other OSDs in AD may be underreported, making proactive inquiry and examination by physicians treating AD patients important.

Radiation-induced changes may cause a non-malignant high 2-deoxy-2-[18F]fluoro-d-glucose (FDG)-uptake. The 3'-deoxy-3'-[18F]fluorothymidine (FLT)-PET/CT performs better in the differential diagnosis of inflammatory changes and lung lesions with a higher specificity than FDG-PET/CT. We investigated the association between post-radiotherapy FDG-PET-parameters, FLT-PET-parameters, and outcome. Sixty-one patients suspected for having a relapse after definitive radiotherapy for lung cancer were included. All the patients had FDG-PET/CT and FLT-PET/CT. FDG-PET- and FLT-PET-parameters were collected from within the irradiated high-dose volume (HDV) and from recurrent pulmonary lesions. For associations between PET-parameters and relapse status, respectively, the overall survival was analyzed. Thirty patients had a relapse, of these, 16 patients had a relapse within the HDV. FDG-SUVmax and FLT-SUVmax were higher in relapsed HDVs compared with non-relapsed HDVs (median FDG-SUVmax: 12.8 vs. 4.2; p < 0.001; median FLT-SUVmax 3.9 vs. 2.2; p < 0.001). A relapse within HDV had higher FDG-SUVpeak (median FDG-SUVpeak: 7.1 vs. 3.5; p = 0.014) and was larger (median metabolic tumor volume (MTV50%): 2.5 vs. 0.7; 0.014) than the relapsed lesions outside of HDV. The proliferative tumor volume (PTV50%) was prognostic for the overall survival (hazard ratio: 1.07 pr cm3 [1.01-1.13]; p = 0.014) in the univariate analysis, but not in the multivariate analysis. FDG-SUVmax and FLT-SUVmax may be helpful tools for differentiating the relapse from radiation-induced changes, however, they should not be used definitively for relapse detection.

Many studies have suggested a prognostic value of one or several positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC). However, studies are often small, and there is a considerable interstudy disagreement about which PET parameters have a prognostic value. The objective of this study was to perform a review and meta-analysis to identify the most promising PET parameter for prognostication. PubMed®, Cochrane, and Embase® were searched for papers addressing the prognostic value of any PET parameter at any treatment phase with any endpoint in patients with SCLC. Pooled hazard ratios (HRs) were calculated by a random effects model for the prognostic value of the baseline maximum standardized uptake value (SUVmax ) and metabolic tumor volume (MTV). The qualitative analysis included 38 studies, of these, 19 studies were included in the meta-analyses. The pooled results showed that high baseline MTV was prognostic for overall survival (OS) (HR: 2.83 (95% confidence interval [CI]: 2.00–4.01) and progression-free survival (PFS) (HR: 3.11 (95% CI: 1.99–4.90)). The prognostic value of SUVmax was less pronounced (OS: HR: 1.50 (95% CI: 1.17–1.91); PFS: HR: 1.24 (95% CI: 0.94–1.63)). Baseline MTV is a strong prognosticator for OS and PFS in patients with SCLC. MTV has a prognostic value superior to those of other PET parameters, but whether MTV is superior to other prognosticators of tumor burden needs further investigation.

Many studies have suggested a prognostic value of one or several positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC). However, studies are often small, and there is a considerable interstudy disagreement about which PET parameters have a prognostic value. The objective of this study was to perform a review and meta-analysis to identify the most promising PET parameter for prognostication. PubMed®, Cochrane, and Embase® were searched for papers addressing the prognostic value of any PET parameter at any treatment phase with any endpoint in patients with SCLC. Pooled hazard ratios (HRs) were calculated by a random effects model for the prognostic value of the baseline maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV). The qualitative analysis included 38 studies, of these, 19 studies were included in the meta-analyses. The pooled results showed that high baseline MTV was prognostic for overall survival (OS) (HR: 2.83 (95% confidence interval [CI]: 2.00-4.01) and progression-free survival (PFS) (HR: 3.11 (95% CI: 1.99-4.90)). The prognostic value of SUVmax was less pronounced (OS: HR: 1.50 (95% CI: 1.17-1.91); PFS: HR: 1.24 (95% CI: 0.94-1.63)). Baseline MTV is a strong prognosticator for OS and PFS in patients with SCLC. MTV has a prognostic value superior to those of other PET parameters, but whether MTV is superior to other prognosticators of tumor burden needs further investigation.

Diagnosing relapse after radiotherapy for lung cancer is challenging. The specificity of both CT and 2-deoxy-2-[18F]fluoro-D-glucose (FDG)-PET/CT is low due to radiation-induced changes. 3'-deoxy-3'-[18F]fluorothymidine (FLT)-PET has previously demonstrated higher specificity for malignancy than FDG-PET. We investigated the value of FLT-PET/CT for diagnosing relapse in irradiated lung cancer. Methods: Patients suspected for relapse of lung cancer after definitive radiotherapy (conventional fractionated radiotherapy (cRT) or stereotactic radiotherapy (SBRT)) were included. Sensitivity and specificity were analysed within the irradiated high-dose volume (HDV) and patient-based. Marginal differences and inter-observer agreement were assessed. Results: Sixty-three patients who had received radiotherapy in 70 HDVs (34 cRT; 36 SBRT) were included. The specificity of FLT-PET/CT was higher than FDG-PET/CT (HDV: 96% [87-100] vs. 71% [57-83]; P = 0.0039; patient-based (90 % [73-98] vs. 55% [36-74]; P = 0.0020)). The difference between specificity of FLT-PET/CT and FDG-PET/CT was higher after cRT compared with SBRT. Sensitivity of FLT-PET/CT was lower than FDG-PET/CT (HDV: 69% [41-89] vs. 94% [70-100]; P = 0.1250; patient-based: 70% [51-84] vs. 94% [80-99]; P = 0.0078). Adding FLT-PET/CT when FDG-PET/CT was positive or inconclusive improved diagnostic value compared with FDG-PET/CT only. In cRT-HDVs, the probability of malignancy increased from 67% for FDG-PET/CT alone to 100% when both PETs were positive. Conclusion: FLT-PET/CT adds diagnostic value to FDG-PET/CT in patients with suspected relapse. The diagnostic impact of FLT-PET/CT was highest after cRT. We suggest adding FLT-PET/CT when FDG-PET/CT is inconclusive or positive within the previously irradiated volume to improve diagnostic value in patients where histological confirmation is not easily obtained.

Background: Small cell lung cancer (SCLC) is an aggressive cancer often presenting in an advanced stage and prognosis is poor. Early response evaluation may have impact on the treatment strategy. Aim: We evaluated 18F-fluorothymidine-(FLT)-PET/diffusion-weighted-(DW)-MRI early after treatment start to describe biological changes during therapy, the potential of early response evaluation, and the added value of FLT-PET/DW-MRI. Methods: Patients with SCLC referred for standard chemotherapy were eligible. FLT-PET/DW-MRI of the chest and brain was acquired within 14 days after treatment start. FLT-PET/DW-MRI was compared with pretreatment FDG-PET/CT. Standardized uptake value (SUV), apparent diffusion coefficient (ADC), and functional tumor volumes were measured. FDG-SUVpeak, FLT-SUVpeak, and ADCmedian; spatial distribution of aggressive areas; and voxel-by-voxel analyses were evaluated to compare the biological information derived from the three functional imaging modalities. FDG-SUVpeak, FLT-SUVpeak, and ADCmedian were also analyzed for ability to predict final treatment response. Results: Twelve patients with SCLC completed FLT-PET/MRI 1–9 days after treatment start. In nine patients, pretreatment FDG-PET/CT was available for comparison. A total of 16 T-sites and 12 N-sites were identified. No brain metastases were detected. FDG-SUVpeak was 2.0–22.7 in T-sites and 5.5–17.3 in N-sites. FLT-SUVpeak was 0.6–11.5 in T-sites and 1.2–2.4 in N-sites. ADCmedian was 0.76–1.74 × 10− 3 mm2/s in T-sites and 0.88–2.09 × 10−3 mm2/s in N-sites. FLT-SUVpeak correlated with FDG-SUVpeak, and voxel-by-voxel correlation was positive, though the hottest regions were dissimilarly distributed in FLT-PET compared to FDG-PET. FLT-SUVpeak was not correlated with ADCmedian, and voxel-by-voxel ana

FDG-PET/CT is a well documented and widespread used imaging modality for the diagnosis and staging of patient with lung cancer. FDG-PET/CT is increasingly used for the assessment of treatment effects during and after chemotherapy. However, PET is not an accepted surrogate end-point for assessment of response rate in clinical trials. The aim of this review is to present current evidence on the use of PET in response evaluation of patients with lung cancer and to introduce the pearls and pitfalls of the PET-technology relating to response assessment. Based on this and relating to validation criteria, including stable technology, standardization, reproducibility and broad availability, the review discusses why, despite numerous studies on response assessment indicating a possible role for FDG-PET/CT, PET still has no place in guidelines relating to response evaluation in lung cancer.