68Ga-PSMA-PET/CT-directed IGRT/SBRT for oligometastases of recurrent prostate cancer after initial surgery.

Background: We evaluated efficacy and toxicity of 68Ga-PSMA-Positron Emission Tomography/Computed Tomography (PET/CT)-directed stereotactic body radiotherapy and image-guided radiotherapy (SBRT/IGRT) for oligometastases of prostate cancer recurrences after previous surgery.Methods: Nineteen patients were analyzed within a prospective PET-registry study (064/2013BO1) and retrospectively analyzed (807/2017BO2) fulfilling the following inclusion criteria: biochemical recurrence after radical prostatectomy, ≤five 68Ga-PSMA-PET/CT positive lesions. Biochemical control was evaluated with EORTC (European Organization for Research and Treatment of Cancer)- and Phenix-definitions. Toxicity was scored according to CTCAE-criteria v. 4.03.Results: A total of 38 oligometastases (19 patients, 2 with re-treatment) were treated with SBRT/IGRT from October 2014 to July 2017. 68Ga-PSMA-PET/CT-positive lesions were detected on average 39 months (5-139) after prostatectomy (pT2b-3b pN0-1 cM0). Mean PSA (Prostate-specific antigen)-level at time of imaging reached 2.2 ng/mL (range 0.2-10.1). PET/CT-positive lesions were treated with different fractionation schedules reaching biological equivalent doses (BED) of 116.7-230.0 Gy. Concomitant androgen deprivation therapy (ADT) was given in seven patients. After a median follow-up of 17 months (4-42) all patients were alive. Estimated 1-year PSA- control (n = 19) reached 80.8% (Phenix) and 67.5% (EORTC). A PSA-decline (≥50%) was detected in 16/19 patients after radiotherapy. Higher graded G3+-acute toxicity did not occur. Temporary late G3-proctitis was detected in one patient.Conclusions: Reaching of nadir ≤0.1 or 0.2 ng/mL was associated by improved DMFS (distant metastases free survival) and could serve as a surrogate endpoint for RT of oligometastases after initial prostatectomy. Short term effects of 68Ga-PSMA-PET/CT-based ablative radiotherapy for oligometastases demonstrated an acceptable toxicity profile and favorable biochemical response.

Fluorescence and Cerenkov luminescence imaging. Applications in small animal research.

This review addresses small animal optical imaging (OI) applications in diverse fields of basic research. In the past, OI has proven to be cost- and time-effective, allows real-time imaging as well as high-throughput analysis and does not imply the usage of ionizing radiation (with the exception of Cerenkov imaging applications). Therefore, this technique is widely spread - not only geographically, but also among very different fields of basic research - and is represented by a large body of publications. Originally used in oncology research, OI is nowadays emerging in further areas like inflammation and infectious disease as well as neurology. Besides fluorescent probe-based contrast, the feasibility of Cerenkov luminescence imaging (CLI) has been recently shown in small animals and thus represents a new route for future applications. Thus, this review will focus on examples for OI applications in inflammation, infectious disease, cell tracking as well as neurology, and provides an overview over CLI.

[Fractures of the trapezium. Mechanisms. Anatomo-pathology and therapeutic indications]. / Les fractures du trapèze. Mécanisme. Anatomo-pathologie et indications thérapeutiques.

Fractures of the trapezium are rare and often unrecognized lesions; their diagnosis can only be made by radiographs with specific projections that clearly separate the outline of the trapezium from the radial side of the carpal bony complex. Starting from a series of 88 cases collected from the world literature, 34 of which had been examined by the authors, a study was made of the different mechanisms of these fractures, their main fracture lines and displacements and the current indications for treatment. The physio-pathology of fractures of the trapezium was investigated by personal experiments conducted in the laboratory on 26 wrists and showed 3 main mechanisms: a fall on the hand with the wrist extended and radially deviated (Manon) and direct commissural trauma combined with various degrees of shearing described by Monsche. The fracture line is, in most cases, a vertical one and the lateral fragment which is connected to the first metacarpal is often subluxated proximally and radially. The treatment of these fractures can be conservative with immobilization in plaster either as the fracture lies or after reduction, or by continuous traction after reduction, or it can be operative. Direct internal fixation, completed, if necessary, by a stabilization of the thumb column using one of the various implants available today for the fixation of small fragments, should particularly be used for displaced and unstable fractures. Partial removal of the trapezium should be reserved for small fracture fragments that do not affect the joint surface or affect it very little. Proper treatment of this rare fracture is a key condition for the future function of the thumb column.