Equivalent tumor detection for early and late FAPI-46 PET acquisition.

INTRODUCTION: Positron emission tomography (PET) using small ligands of the fibroblast activation protein (FAP) was recently introduced. However, optimal uptake time has not been defined yet. Here, we systematically compare early (~ 10 min p.i.) and late (~ 60 min p.i.) FAPI-46 imaging in patients with various types of cancer. METHODS: This is a retrospective single-institutional study. Imaging was performed at the Essen University Hospital, Germany. A total of 69 patients who underwent dual time-point imaging for either restaging (n = 52, 75%) or staging (n = 17, 25%) of cancer were included. Patients underwent PET with two acquisitions: early (mean 11 min, SD 4) and late (mean 66 min, SD 9). Mean injected activity was 148 MBq (SD 33). RESULTS: In total, 400 lesions were detected in 69 patients. Two of 400 (0.5%) lesions were only seen in early time-point imaging but not in late time-point imaging. On a per-patient level, there was no significant difference between SUVmax of hottest tumor lesions (Wilcoxon: P = 0.73). Organ uptake demonstrated significant early to late decrease in SUVmean (average ∆SUVmean: - 0.48, - 0.14, - 0.27 for gluteus, liver, and mediastinum, respectively; Wilcoxon: P < 0.001). On a per-lesion basis, a slight increase of SUVmax was observed (average ∆SUVmax: + 0.4, Wilcoxon: P = 0.03). CONCLUSION: In conclusion, early (~ 10 min p.i.) versus late (~ 60 min p.i.) FAPI-46 imaging resulted in equivalent lesion uptake and tumor detection. For improved feasibility and scan volume, we implement early FAPI-46 PET in future clinical and research protocols.

Hematologic markers of distant metastases and poor prognosis in gynecological cancers.

BACKGROUND: Despite the recent progress in the development of anti-cancer drugs, the treatment of metastatic tumors is usually ineffective. The systemic inflammatory response performs key roles in different stages of the carcinogenesis process including metastasis. The high neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were found to be associated with poor survival rates in the majority of solid tumors. However, only a few studies were conducted to further investigate this association in patients with advanced gynecological cancers. METHODS: Clinical data from 264 patients with FIGO stage III and IV gynecological (endometrial, ovarian and cervical) cancers treated at King Hussein Cancer Center (Amman-Jordan) from 2006 to 2012 were retrospectively reviewed. We examined the association between absolute neutrophil count (ANC), absolute monocyte count (AMC), MLR, PLR, and NLR with distant metastases, overall survival and event-free survival in gynecological cancers. For survival analysis, Receiver Operating Characteristic (ROC) curve analysis was operated to determine the optimal cutoff values. RESULTS: Patients with high baseline NLR (≥4.1) had more baseline distant metastases than patients with low baseline NLR (< 4.1), (p-value 0.045). Patients with high baseline AMC (≥560) had more distant metastases in comparison to patients with low baseline AMC (< 560), (p-value 0.040). Furthermore, Patients with high baseline PLR (≥0.3) had more distant metastases in comparison to patients with low baseline PLR (< 0.3), (p-value 0.025). Additionally, patients with high baseline ANC (≥5700) had worse overall survival compared to the patients with low baseline ANC (< 5700), (p-value 0.015). Also, patients with high baseline AMC (≥490) had worse overall survival compared to the patients with low baseline AMC (< 490), (p-value 0.044). CONCLUSION: Different hematologic markers obtained from a cheap test (CBC) could potentially be used to predict the presence of distant metastases thus used as prognostic indices in gynecological cancers.

Assessing knowledge and attitudes of owners or managers of hospitality venues regarding a policy banning indoor smoking.

OBJECTIVES: In response to accumulating evidence on the detrimental health effects of second-hand smoke, governments throughout the world have adopted laws prohibiting indoor smoking in public places. Lebanon has recently enacted a law prohibiting indoor smoking in all of its forms, rendered effective as of 3 September 2012. This study examined the knowledge and attitudes of owners/managers of restaurants, cafes, pubs and nightclubs in Beirut towards the ban, three months before it came into effect. STUDY DESIGN: Self-administered cross-sectional survey. METHODS: Data were derived from a self-administered cross-sectional survey conducted in June 2012. In total, 262 hospitality venues (restaurants, cafes, pubs and nightclubs) were sampled at random to participate. RESULTS: The response rate was 74% (194/262). Overall, 84% of owners/managers reported that they were aware of the ban, yet the average knowledge score was only 3.43/10. A general positive attitude was noted towards customer satisfaction (44.8%), law enforcement (61.1%) and employee protection from second-hand smoke (74%), while 55% of owners/managers were concerned that their revenues would decrease. However, 83.3% expressed their willingness to implement the law. CONCLUSIONS: This quantitative study is the first to examine the knowledge and attitudes of owners/managers of hospitality venues regarding the indoor smoking ban in Lebanon. Civil society and government bodies should use the findings to develop a campaign to address the knowledge and attitudes of owners/managers of hospitality venues to ensure successful enforcement.