Restoration of linear disturbances from oil-and-gas exploration in boreal landscapes: How can network models help?

In western Canada, decades of oil-and-gas exploration have fragmented boreal landscapes with a dense network of linear forest disturbances (seismic lines). These seismic lines are implicated in the decline in wildlife populations that are adapted to function in unfragmented forest landscapes. In particular, anthropogenic disturbances have led to a decline of woodland caribou populations due to increasing predator access to core caribou habitat. Restoration of seismic lines aims to reduce the landscape fragmentation and stop the decline of caribou populations. However, planning restoration in complex landscapes can be challenging because it must account for a multitude of diverse aspects. To assist with restoration planning, we present a spatial network optimization approach that selects restoration locations in a fragmented landscape while addressing key environmental and logistical constraints. We applied the model to develop restoration scenarios in the Redrock-Prairie Creek caribou range in northwestern Alberta, Canada, which includes a combination of caribou habitat and active oil-and-gas and timber extraction areas. Our study applies network optimization at two distinct scales to address both the broad-scale restoration policy planning and project-level constraints at the level of individual forest sites. We first delineated a contiguous set of coarse-scale regions where restoration is most cost-effective and used this solution to solve a fine-scale network optimization model that addresses environmental and logistical planning constraints at the level of forest patches. Our two-tiered approach helps address the challenges of fine-scale spatial optimization of restoration activities. An additional coarse-scale optimization step finds a feasible starting solution for the fine-scale restoration problem, which serves to reduce the time to find an optimal solution. The added coarse-scale spatial constraints also make the fine-scale restoration solution align with the coarse-scale landscape features, which helps address the broad-scale restoration policies. The approach is generalizable and applicable to assist restoration planning in other regions fragmented by oil-and-gas activities.

Early repeated 18F-FDG PET scans during neoadjuvant chemoradiation fail to predict histopathologic response or survival benefit in adenocarcinoma of the esophagus.

UNLABELLED: This study evaluated the role of (18)F-FDG PET as an early predictor of histopathologic response to neoadjuvant chemoradiotherapy and overall survival in patients with adenocarcinoma of the esophagus undergoing multimodal therapy. METHODS: Thirty-seven patients with locally advanced adenocarcinoma of the esophagus underwent pretreatment and an intratreatment (18)F-FDG PET scan in the second week of a 6-wk regimen of neoadjuvant chemoradiotherapy. Histopathologic response and overall survival were correlated with percentage change in (18)F-FDG uptake (%Δmaximum standardized uptake value [%ΔSUVmax]). RESULTS: In 16 patients (43%), treatment induced a histopathologic response (<10% viable tumor cells), which was associated with a significant (P < 0.05) survival benefit. The optimal reduction in (18)F-FDG uptake, which separated histopathologic responders and nonresponders, was a -26.4% ΔSUVmax (receiver-operating-characteristic curve analysis). At this separation, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (area under the receiver operating characteristic curve) were 62.5%, 71.4%, 62.5%, 71.4%, and 67.4%, respectively, for intratreatment (18)F-FDG PET scans. Kaplan-Meier survival analysis of (18)F-FDG PET responders (>26.4% reduction in SUVmax), compared with (18)F-FDG PET nonresponders (<26.4% reduction in SUVmax), revealed no survival benefit for responders (P = 0.6812). CONCLUSION: The %ΔSUVmax during the second week of induction chemoradiation did not correlate either with histopathologic response or with survival. Our results show that, in contrast to published reports on neoadjuvant chemotherapy, combined chemoradiotherapy in patients with adenocarcinoma of the esophagus lowers the predictive accuracy of early repeated (18)F-FDG PET in identifying histopathologic responders and those with chances for increased survival below clinically applicable levels.

Radionuclide impurities in proton-irradiated [18O]H2O for the production of 18F-: activities and distribution in the [18F]FDG synthesis process.

Proton- and neutron-induced activation products in the components of a high-pressure [(18)O]H(2)O target vessel used for the production of (18)F(-) in a medical cyclotron have been identified using high resolution gamma spectrometry. The activities leached from the target vessel into the [(18)O]H(2)O during irradiation, and the distribution of the identified radionuclide impurities in the various cartridges and solutions used in the [(18)F]FDG synthesis process have been measured and are discussed from the perspective of waste disposal. The results indicate that, at the energies and beam currents employed, only a few, relatively short-lived radionuclides are present in the irradiated [(18)O]H(2)O, and that the activities involved (<10 kBq in each case) are well below typical exemption limits. Activities of beta-emitting (3)H in irradiated [(18)O]H(2)O, produced via the (18)O(p,(3)H)(16)O reaction, have also been determined using liquid scintillation spectrometry. Measured activity concentrations, in the range 150-180 kBq g(-1), are consistent with those reported by other workers. Analyses of the synthesised [(18)F]FDG confirm the radiochemical purity of the product, both for (3)H and for gamma-emitting radionuclides in the energy range 25-1650 keV.

FDG PET in preoperative assessment of colorectal liver metastases combining "evidence-based practice" and "technology assessment" methods to develop departmental imaging protocols: should FDG PET be routinely used in the preoperative assessment of patients with colorectal liver metastases?

In today's environment of progressively evolving and expensive imaging modalities, radiologists are asked to justify the use of resources to patients, referring physicians, hospital management, and third party payers. With this aim, the radiologist may use "top-down" or "bottom-up" "evidence-based practice" (EBP) techniques. "Top-down" suggests that the practitioner should wait until a higher authority, external to their practice, generates a solution to practice dilemmas (e.g., National Institute for Health and Clinical Excellence [NICE] guidelines). "Bottom-up" however, is based on the theory that the ordinary practitioner is best served by a decentralized approach to problem solving that is internal to their practice. The technology assessment framework modeled by Mackenzie and Dixon comprehensively assesses the effects of imaging using levels of efficacy including diagnostic performance, diagnostic impact, and therapeutic impact, impact on health and cost effectiveness. In this article, we describe how issues regarding new imaging modalities in ordinary radiology practice can be addressed by using stepwise "bottom-up" EBP techniques combined with the technology assessment framework. We also detail how EBP techniques form an integral part of practice-based learning among radiology residents as part of noninterpretive residency training. The following clinical scenario is used: your hospital's chief hepatobiliary surgeon writes to your department regarding the lack of access to 18-fluoro-2-deoxy-D-glucose positron emission tomography in the preoperative assessment of patients with colorectal cancer liver metastases under consideration for hepatic resection. How would you approach this problem? Here is how we would do it.

Evaluation of the impact of addition of PET to CT and MR scanning in the staging of patients with head and neck carcinomas.

The addition of whole body positron emission tomography (PET) to the investigation of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC) was assessed over a 6-month period. Staging investigations included laryngoscopy, oesophagoscopy, CXR, CT and MRI. In addition, all patients had an extended-field (whole body) FDG-PET scan and were restaged. Standardised Uptake Values (SUV) were used to measure FDG uptake. SUV levels above 5 were considered indicative of the presence of tumour, values below 3 indicative of benign aetiology and values equal to and between 3 and 5 were considered equivocal. Forty-eight consecutive patients with biopsy proven HNSCC were included for study. Three patients presenting with neck disease had unknown primary tumours. Of the remaining 45 patients, CT scan correctly identified 40 of the primary tumours (89%). MRI and PET both identified 41 primary tumours (91%). Thirty-two patients underwent neck dissection. Of these patients 12 had pathologically N0 necks and 20 had positive nodal disease. CT scan and MRI each correctly staged pN0 necks in 10 of 12 patients (83%) whereas PET alone had a lower true negative rate of 8 out of 12 patients (67%). PET correctly staged the N+ necks in 14/20 patients (70%) versus 12/20 (60%) for MRI, and 8/20 (40%) for CT alone. All four patients who were judged to have distant metastases by PET had these metastases deemed negative by other investigation. None of the three imaging modalities was able to identify the tumour site in the three patients with unknown primaries. In conclusion, although PET has got a higher sensitivity in detecting nodal disease, it has only slightly improved the classification of N+ necks. The findings of this study cast doubt on the merit of routine addition of PET to the current investigative protocols for HNSCC patients.