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Aim The aim of this study is to present the reliability and efficacy of Exoseal vascular closure device (EVCD) for closure of extrafemoral punctures. Materials and methods All patients who were treated with EVCD following arterial endovascular treatment involving an extrafemoral puncture between April 2013 and January 2014 were examined retrospectively. This study included 11 patients (4 women and 7 men between the ages of 48 and 87 years; average age = 65 years). A total of 13 procedures were performed in 11 patients involving the following access routes: brachial artery (n = 5), popliteal artery (n = 4), and polytetrafluoroethylene graft (n = 4). Results Twelve out of 13 EVCD procedures achieved technical success and procedural success. One minor and one major complications occurred. Both complications were revealed to be pseudoaneurysms, both in the brachial artery. Pseudoaneurysm of the minor complication was treated by Fibrin Sealant (Tisseel) injection guided by ultrasonography and the other pseudoaneurysm was treated by covered stent placement. Conclusions The femoral artery is an essential access route of arterial endovascular procedures; however, in some cases, the extrafemoral arterial route is necessary. In this study, EVCD was found to be useful for closing extrafemoral arterial routes. This study had a limited number of cases and more large-scale studies are needed.

The β-diketone moiety is commonly present in many anticancer drugs, antibiotics, and natural products. We describe a general method for radiolabeling β-diketone-bearing molecules with fluoride-18. Radiolabeling is carried out via (18)F-(19)F isotopic exchange on non-radioactive difluoro-dioxaborinins, which are generated by minimally modifying the β-diketone as a difluoroborate. Radiochemistry is one-step, rapid (< 10 min), high-yielding (> 80%), and proceeds at room temperature to accommodate the half-life of F-18 (t(1/2) = 110 min). High molar activities (7.4 Ci/μmol) were achieved with relatively low starting activities (16.4 mCi). It was found that substituents affect both the solvolytic stability and fluorescence properties of difluoro-dioxaborinins. An F-18 radiolabeled difluoro-dioxaborinin probe that is simultaneously fluorescent showed sufficient stability for in vivo PET/fluorescence imaging in mice, rabbits, and patients. These findings will guide: the design of probes with specific PET/fluorescence properties; the development of new PET/fluorescence dual-modality reporters; and accurate in vivo tracking of β-diketone molecules.

Background Magnetic resonance myelography (MRM) with three-dimensional (3D) T2-weighted (T2W) turbo spin echo (TSE) sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) may be a guide to the etiology of low back pain. Purpose To research the efficiency of a 3D T2W TSE SPACE MRM sequence for visualization of anatomic details of spinal nerve root at the spinal canal and lateral recess levels in the patients with low back pain. Material and Methods Lumbar spinal MRM 3D T2W TSE SPACE was performed in a total of 70 patients (median age 46 years). Patients were imaged while lying in a supine position with straightened legs. According to the degree of facet arthropathy findings, patients were divided into four separate subgroups in our retrospective cross-sectional study. Spinal nerve root angle was measured within the spinal canal and at lateral recess level, and facet joint angle and lumbar lordosis measurements were measured by two radiologists, independently. Results Lumbar level was strongly negatively correlated with facet joint angle (r = −0.95) as well as nerve root angle within the spinal canal (NRASC) (r = –0.857) and at the lateral recess level (NRALR) (r = −0.947). Intracanal decline of the spinal root angle caused by spinal stenosis findings was also observed ( P SC and NRALR, inter-observer correlation was 0.85 and 0.82 for the spinal canal and at lateral recess level, respectively. Conclusion 3D T2W SPACE in NRASC and NRALR provided high resolution images for evaluation. Therefore, this method may be a qualitative guide for the clinician and the surgeon in terms of root anatomy before any intervention.

Zhang, Weiqi/0000-0003-4315-6809; Sayman, Haluk Burcak/0000-0002-0954-5707; Rodriguez, Erik/0000-0001-9143-2535 WOS:000476957100009 PubMed ID: 31120734 Clinical trials involving genome-edited cells are growing in popularity, where CAR-T immunotherapy and CRISPR/Cas9 editing are more recognized strategies. Genetic reporters are needed to localize the molecular events inside these cells in patients. Specifically, a nonimmunogenic genetic reporter is urgently needed as current reporters are immunogenic due to derivation from nonhuman sources. Prostate-specific membrane antigen (PSMA) is potentially nonimmunogenic due to its natural, low-level expression in select tissues (self-MHC display). PSMA overexpression on human prostate adenocarcinoma is also visible with excellent contrast. We exploit these properties in a transduced, two component, Human-Derived, Genetic, Positron-emitting, and Fluorescent (HD-GPF) reporter system. Mechanistically analogous to the luciferase and luciferin reporter, PSMA is genetically encoded into non-PSMA expressing 8505C cells and tracked with ACUPA-Cy3-BF3, a single, systemically injected small molecule that delivers positron emitting fluoride (F-18) and a fluorophore (Cy3) to report on cells expressing PSMA. PSMA-lentivirus transduced tissues become visible by Cy3 fluorescence,[F-18]-positron emission tomography (PET), and gamma-scintillated biodistribution. HD-GPF fluorescence is visible at subcellular resolution, while a reduced PET background is achieved in vivo, due to rapid ACUPA-Cy3-BF3 renal excretion. Co-transduction with luciferase and GFP show specific advantages over popular genetic reporters in advanced murine models including, a "mosaic" model of solid-tumor intratumoral heterogeneity and a survival model for observing postsurgical recurrence. We report an advanced genetic reporter that tracks genetically modified cells in entire animals and with subcellular resolution with PET and fluorescence, respectively. This reporter system is potentially nonimmunogenic and will therefore be useful in human studies. PSMA is a biomarker of prostate adenocarcinoma and ACUPA-Cy3-BF3 potential in radical prostatectomy is demonstrated. National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [EB013904, R01CA178007, P30CA008748]; NATIONAL CANCER INSTITUTEUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [R01CA178007, R01CA217059, R01CA217059, R01CA217059] Funding Source: NIH RePORTER The project was supported by National Institutes of Health Grants EB013904, R01CA178007, and P30CA008748.

Objective To evaluate the association of changes in chest computed tomography (CT) lesion densities with clinical improvement in COVID‐19 patients. Methods This was a cross‐sectional analysis of hospitalised COVID‐19 patients who underwent repeated chest CT. Patients who improved clinically but showed radiological progression were included. Demographic data, presentation complaints and laboratory results were retrieved from the electronic database of the hospital. Lesion density that was measured in Hounsfield units was compred between admission and discharge chest CT scans. Results Forty patients (21 males, mean age 47.4 ± 15.1 years) were included in the analysis. The median white blood cell count and C‐reactive protein significantly decreased, whereas the median lymphocyte count significantly increased at discharge compared with the admission values. The mean density significantly reduced from admission to discharge. Conclusion This is the first study in the literature reporting reduction in chest CT lesion densities correlated with clinical and laboratory improvement in COVID‐19 patients.

BackgroundPreclinical testing of new locoregional therapies for pancreatic cancer has been challenging, due to the lack of a suitable large animal model.PurposeTo develop and characterize a porcine model of pancreatic cancer. Unlike small animals, pigs have similar physiology, drug dosing, and immune response to humans. Locoregional therapy in pigs can be performed using the same size catheters and devices as in humans.MethodsThe Oncopig is a transgenic pig with Cre-inducible TP53R167H and KRASG12D mutations. In 12 Oncopigs, CT-guided core biopsy of the pancreas was performed. The core biopsy was incubated with an adenoviral vector carrying the Cre recombinase gene. The transformed core biopsy was injected back into the pancreas (head, tail, or both). The resulting tumors (n = 19) were characterized on multi-phase contrast-enhanced CT, and on pathology, including immunohistochemistry. Angiographic characterization of the tumors was performed in 3 pigs.ResultsPancreatic tumors developed at 19 out of 22 sites (86%) that were inoculated. Average tumor size was 3.0 cm at 1 week (range: 0.5-5.1 cm). H&E and immunohistochemical stains revealed undifferentiated carcinomas, similar to those of the pancreatobiliary system in humans. Neoplastic cells were accompanied by a major inflammatory component. 1 of 12 pigs only had inflammatory nodules without evidence of neoplasia. On multiphase CT, tumors were hypovascular compared to the normal pancreas. There was no pancreatic duct dilation. In 3 pigs, angiography was performed, and in all 3 cases, the artery supplying the pancreatic tumor could be catheterized using a 2.4 F microcatheter. Selective angiography showed the pancreatic tumor, without extra-pancreatic perfusion.ConclusionPancreatic cancer can be induced in a transgenic pig. Intra-arterial procedures using catheters designed for human interventions were technically feasible in this large animal model.

Purpose To develop and characterize a porcine model of liver cancer that could be used to test new locoregional therapies. Materials and Methods Liver tumors were induced in 18 Oncopigs (transgenic pigs with Cre-inducible TP53R167H and KRASG12D mutations) by using an adenoviral vector encoding the Cre-recombinase gene. The resulting 60 tumors were characterized on multiphase contrast-enhanced CT, angiography, perfusion, micro-CT, and necropsy. Transarterial embolization was performed using 40–120 μm (4 pigs) or 100–300 μm (4 pigs) Embosphere microspheres. Response to embolization was evaluated on imaging. Complications were determined based on daily clinical evaluation, laboratory results, imaging, and necropsy. Results Liver tumors developed at 60/70 (86%) inoculated sites. Mean tumor size was 2.1 cm (range, 0.3–4 cm) at 1 week. Microscopically, all animals developed poorly differentiated to undifferentiated carcinomas accompanied by a major inflammatory component, which resembled undifferentiated carcinomas of the human pancreatobiliary tract. Cytokeratin and vimentin expression confirmed epithelioid and mesenchymal differentiation, respectively. Lymph node, lung, and peritoneal metastases were seen in some cases. On multiphase CT, all tumors had a hypovascular center, and 17/60 (28%) had a hypervascular rim. After transarterial embolization, noncontrast CT showed retained contrast medium in the tumors. Follow-up contrast-enhanced scan showed reduced size of tumors after embolization using either 40–120 μm or 100–300 μm Embosphere microspheres, while untreated tumors showed continued growth. Conclusions Liver tumors can be induced in a transgenic pig and can be successfully treated using bland embolization.

YURDAISIK, ISIL/0000-0001-8316-1229 Objective Today, a biopsy is the gold standard in the diagnosis of non-alcoholic fatty liver. However, a biopsy is an invasive technique, limited to the sample taken, and it may lead to misdiagnosis. Therefore, novel noninvasive options are needed. The objective of this study was to investigate the accuracy of magnetic resonance (MR) Dixon sequence and elastography using magnetic resonance spectroscopy (MRS) as a reference in the quantification of hepatic steatosis. Methods A total of 60 patients were included in the study. All patients underwent magnetic resonance imaging (MRI), MRS, and elastography in order to quantify hepatosteatosis. MRI and MRS imaging studies were performed using MR Dixon and high-speed T2-corrected multiple-echo 1H-MRS sequence (HISTO) sequences, respectively, in order to calculate proton density fat fraction (PDFF) values. Results The mean MRI-PDFF value with the MRS region of interest (ROI) was found as 9.4% +/- 12.1%. The mean MRS-PDFF was found as 8.9% +/- 11.3%. No statistically significant difference was found between MRS-PDFF and MRI-PDFF values measured in ROI (p < 0.005). The correlation between MRS-PDFF and MRI-PDFF was examined with Spearman's correlation analysis. Accordingly, there was an excellent correlation between MRS and MRI values measured in ROI (r = 0.8, p < 0.001). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated as 96%, 100%, 89.5%, and 92.6%, respectively, for MRI-PDFF in predicting hepatic steatosis for the same ROI localization with MRS. The optimum cut-off value of MRS-PDFF in predicting hepatic steatosis was found as 5.3% using the same ROI localization with MRS. Conclusion The results of this study indicated an excellent correlation between MRI-PDFF and MRS-PDFF. The multi-echo Dixon MRI technique seems a promising alternative method in the detection of non-alcoholic fatty liver disease. Amaç: Beyin ölümü, beyin sapı dahil olmak üzere beynin bütün fonksiyonlarının tam ve geri dönüşsüz bir şekilde kaybı olarak tanımlanmaktadır. Beyin ölümü tanısında kullanılan üç esas bulgu koma, beyin sapı reflekslerinin yokluğu ve apnedir. Organ nakli bekleyen hastaların sayısındaki artış ile birlikte beyin ölümü tanısı daha da önemli bir hal almıştır. Bu çalışmada bilgisayarlı tomografi anjiyografinin (BTA) beyin ölümü tanısındaki etkinliğinin belirlenmesi amaçlanmıştır. Hastalar ve Yöntem: Ekim 2015 ile Haziran 2018 arasında hastanemizin yoğun bakım ünitesinde yatan toplam 21 hastanın beyin ölümünün gerçekleştiği klinik olarak bildirilmiştir. Bu hastalardan birine manyetik rezonans anjiyografi (MRA) uygulandığı için çalışma dışı bırakılmıştır. Geriye kalan ve BTA sonuçları mevcut olan toplam 20 hastanın bulguları retrospektif olarak yeniden değerlendirilmiştir. Hastaların yaşları 25 - 75 arasında değişmekte olup, ortalama yaş 45±1 yıldır. BTA değerlendirmeleri 64 dedektör sıralı, döngü başına 128 kesit alan ve 384 kesite kadar yükseltilebilen bir cihaz ile yapılmıştır. 100 ml kontrast madde, çift başlı bir otomatik pompa ile 350-375 mg/ml olacak şekilde 3.5-4 cc/sn hızında verilmiştir. Kontrast madde vermeye başladıktan sonra ilgili bölge (ROI) eşik değer olan 90-100 HU’ya ulaşınca aksiyel planda 15-20 sn aralığında tarama yapılmıştır. BTA bulguları 10 puanlı skala üzerinden değerlendirilmiştir. Bulgular: Çalışmaya alınan ve BTA uygulanan 20 hastanın ölüm nedenleri olarak sekiz hastada intrakranial hemoraji, dört hastada iskemik serebrovasküler olay (SVO), üç hastada kraniotomi sonrası hemoraji, iki hastada kardiyak arrest, bir hastada travma sonrası kontüzyo serebri ve iki hastada metabolik nedenler olarak bildirilmiştir. Toplam 20 hastada ACA, PCA, MCA distal ve ICA supraklinoid dallarında kontrast dolumu “0” iken, 8 hastada ise MCA proksimal dallarında kontrast dolumu saptanmıştır. İki hastada tek taraflı ACA proksimalinde şüpheli bir kontrast dolumu belirlenmiştir. Intrakraniyal dalların her birindeki opasifikasyon kaybına 1 puan verilmiştir. Buna göre 20 hastanın tümü toplam 10 puan almıştır. Sonuç: Organ nakilleri için yasalarla gerekliliği belirlenmiş beyin ölümü tanısı için BTA’nın etkin ve geçerli bir doğrulayıcı yöntem olduğunu düşünmekteyiz NCI NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [P30 CA008748] WOS:000515814500008 32231898

[18/19F]-4, an anionic GCPII/PSMA inhibitor for image-guided intervention in prostate cancer, is described. [19F]-4 is radiolabeled with a radiochemical yield that is ≥27% and a molar activity of 190 ± 50 mCi/μmol in a

Adoptive cell transfer of targeted chimeric antigen receptor (CAR) T cells has emerged as a highly promising cancer therapy. The pharmacodynamic action or CAR T cells is closely related to their pharmacokinetic profile; because of this as well as the risk of non-specific action, it is important to monitor their biodistribution and fate following infusion. To this end, we developed a dual-modal PET/near infrared fluorescent (NIRF) nanoparticle-based imaging agent for non-genomic labeling of human CAR T cells. Since the PET/NIRF nanoparticles did not affect cell viability or cytotoxic functionality and enabled long-term whole-body CAR T cell tracking using PET and NIRF in an ovarian peritoneal carcinomatosis model, this platform is a viable imaging technology to be applied in other cancer models.