Characterisation of a high resolution small field of view portable gamma camera

A handheld, high-resolution small field of view (SFOV) pinhole gamma camera has been characterised using a new set of protocols adapted from standards previously developed for large field of view (LFOV) systems. Parameters investigated include intrinsic and extrinsic spatial resolution, spatial linearity, uniformity, sensitivity, count rate capability and energy resolution. Camera characteristics are compared to some clinical LFOV gamma cameras and also to other SFOV cameras in development.     

Image processing algorithms to facilitate and enhance sentinel node detection using a hand-held gamma ray camera in surgical breast cancer staging

We have developed a miniature scintillation camera to be used in surgical cancer staging. The availability of such a compact hand-held gamma camera may in certain cases improve localization of the sentinel lymph node and reduce the duration of a surgical breast cancer staging procedure. We have investigated image processing algorithms applied to planar images that may improve node detection capabilities for breast cancer staging. We have also studied contrast enhancement methods that may be able to identify nodes that would otherwise be missed. Exposure duration for a given camera position can be adaptively shortened or increased by using an optical flow algorithm to estimate camera motion with respect to the current frame. By determining if the camera is in motion or not, the exposure time may be increased to allow more image counts to accumulate at a given camera position. Adaptive exposure time may improve the ease of use of the hand-held camera, and allow regions of interest to be imaged more effectively. We feel that these image processing techniques can improve the utility of a hand-held gamma ray imager for sentinel lymph node detection during breast cancer staging.     

Detecting infiltrating lobular carcinoma using scintimammographic breast specific gamma imaging

This study evaluated the effectiveness of scintimammography performed with gamma cameras optimized for breast imaging in the detection of infiltrating lobular carcinoma. This new procedure, Breast Specific Gamma Imaging (BSGI), was conducted on 105 patient presenting with 113 breast lesions. Studies were conducted at two medical centers using three prototype cameras [14, 16]. Biopsy and pathology reports were obtained for all cases and, of the 34 detected carcinomas, 6 were determined to be infiltrating lobular type without mixed component other than lobular carcinoma in situ. Of the 6 lesions, 4 were smaller than 1 cm, the smallest moasuring 3 mm at biopsy. BSGI detected all 6 of the lobular carcinomas and correctly identified the secondary lesion in the only multifocal case. The BSGI foci sizes matched the lesion size at biopsy to within +/-5.5 mm, with about an equal number of cases ovar and under estimated. Conclusion: BSGI provides an effective tool for the detection of lobular carcinoma and in the determination of lesion size and multifocality.     

Evaluation of a dual-panel PET camera design to breast cancer imaging

We are developing a novel, portable dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging. With a sensitive area of ∼ 150 cm², this camera is based on arrays of lutetium oxyorthosilicate (LSO) crystals (1×1×3 mm³) coupled to 11×11-mm² position-sensitive avalanche photodiodes (PSAPD). GATE open source software was used to perform Monte Carlo simulations to optimize the parameters for the camera design. The noise equivalent counting (NEC) rate, together with the true, scatter, and random counting rates were simulated at different time and energy windows. Focal plane tomography (FPT) was used for visualizing the tumors at different depths between the two detector panels. Attenuation and uniformity corrections were applied to images.     

Establishment of bovine chromosome region specific high resolution maps using microdissection

An alternative approach for the direct analysis of chromosome regions corresponding to economical traits on the basis of chromosome microdissection is described. Large fragment clones isolated with primer pairs designed from chromosome fragment-specific DNA sequences were localized by FISH to the scraped chromosome region of interest. The chromosome fragment-specific clones are a useful tool for the generation of region specific high density marker and gene maps and represent the source material for the development of a DNA contig including the economical trait.     

Impact of high energy resolution detectors on the performance of a PET system dedicated to breast cancer imaging

We are developing a high resolution, high sensitivity PET camera dedicated to breast cancer imaging. We are studying two novel detector technologies for this imaging system: a scintillation detector comprising layers of small lutetium oxyorthosilicate (LSO) crystals coupled to new position sensitive avalanche photodiodes (PSAPDs), and a pure semiconductor detector comprising cadmium zinc telluride (CZT) crystal slabs with thin anode and cathode strips deposited in orthogonal directions on either side of each slab. Both detectors achieve 1 mm spatial resolution with 3–5 mm directly measured photon interaction depth resolution, which promotes uniform reconstructed spatial resolution throughout a compact, breast-size field of view. Both detector types also achieve outstanding energy resolution (<3% and <12%, respectively for LSO-PSAPD and CZT at 511 keV). This paper studies the effects that this excellent energy resolution has on the expected system performance. Results indicate the importance that high energy resolution and narrow energy window settings have in reducing background random as well as scatter coincidences without compromising statistical quality of the dedicated breast PET data. Simulations predict that using either detector type the excellent performance and novel arrangement of these detectors proposed for the system facilitate ∼20% instrument sensitivity at the system center and a peak noise-equivalent count rate of >4 kcps for 200 microCi in a simulated breast phantom.     

Active,specific immunotherapy of stage III breast cancer

Summary Active specific immunization with autologous irradiated tumor cells (AITC) admixed with BCG was attempted in 49 stage III breast cancer patients whose median follow-up at present is 3 years. As a first immunizing procedure 41 patients received repeated intradermal inoculations and 8 had a single endolymphatic instillation (ELI). Skin response (SR) to AITC alone was induced after two to nine weekly immunizations. Eight of 41 patients with negative or weak responses were effectively reimmunized by ELI, as indicated by conversion and invigoration of SR. Following immunization, radiotherapy to breast and axilla was administered. Thereafter, fortnightly 5-FU and monthly boosters of AITC-BCG mixture were given for 2 years. Strength of response to AITC induced by active immunization was found to relate to subsequent disease recurrence, with 15% relapsing among the good responders and 53% among the weak and non-responders. Positive SR to AITC — once elicited — was steadily maintained in the majority of patients; its decline was associated with manifest disease recurrence. Conversion to AITC positivity in vivo following specific immunization was not detectable by the LMI assay. Lymphocyte stimulation (MLTI) by AITC in vitro was found in only 9 of 26 tested patients with positive in vivo SR to AITC. Cutaneous response to AITC appears to be the only parameter of antitumor response showing clinical correlation, while specific in vitro correlates of cell-mediated immunity were found unsuitable for monitoring patients undergoing specific immunotherapy. While in vivo PPD response was mainly unchanged or enhanced, in vitro lymphocyte stimulation by PPD and PHA showed a distinct decline at the time of relapse. The cumulative proportion of relapse among the immunotherapy patients at 3 years was 32% with mortality of 12% (13 relapsed, 5 died), both being significantly lower than reported results in stage III breast cancer without immunotherapy. It is concluded that specific immunization with AITC is feasible in most breast cancer patients with loco-regionally advanced disease and that this intervention is conducive to favorable modification of the course of their disease.     

Sentinel node biopsy in breast cancer using infrared laser system first experience with PDE camera

Background

Sentinel node biopsy (SNB) is a gold standard in staging of early breast cancer. Nowadays, routine mapping of lymphatic tract is based on two tracers: human albumin with radioactive technetium, with or without blue dye. Recent years have seen a search for new tracers to examine sentinel node as well as lymphatic network. One of them is indocyanine green (ICG) visible in infrared light.

Aim

The aim of this study is to evaluate clinical usage of ICG in comparison with standard tracer, i.e. nanocoll, in SNB of breast cancer patients.

Materials and methods

In the 1st Department of Surgical Oncology and General Surgery, Greater Poland Cancer Centre, Poznań, 13 female breast cancer patients have benn operated since September 2010. All these patients had sentinel node biopsy with nanocoll (human albumin with radioactive technetium), and with indocyanine green. The feasibility of this new method was assessed in comparison with the standard nanocoll.

Results

A lymphatic network between the place of injection of ICG and sentinel node was seen in infrared light. An area where a sentinel node was possibly located was confirmed by gamma probe. Sensitivity of this method was 100%.

Conclusion

SNB using ICG is a new, promising diagnostics technique. This procedure is not without drawbacks; nevertheless it opens new horizons in lymphatic network diagnostics.     

Enhanced analysis of human breast cancer proteomes using micro-scale solution isoelectrofocusing combined with high resolution 1-D and 2-D gels

Current methods for quantitatively comparing proteomes (protein profiling) have inadequate resolution and dynamic range for complex proteomes such as those from mammalian cells or tissues. More extensive profiling of complex proteomes would be obtained if the proteomes could be reproducibly divided into a moderate number of well-separated pools. But the utility of any prefractionation is dependent upon the resolution obtained because extensive cross contamination of many proteins among different pools would make quantitative comparisons impractical. The current study used a recently developed microscale solution isoelectrofocusing (musol-IEF) method to separate human breast cancer cell extracts into seven well-resolved pools. High resolution fractionation could be achieved in a series of small volume tandem chambers separated by thin acrylamide partitions containing covalently bound immobilines that establish discrete pH zones to separate proteins based upon their pIs. In contrast to analytical 2-D gels, this prefractionation method was capable of separating very large proteins (up to about 500 kDa) that could be subsequently profiled and quantitated using large-pore 1-D SDS gels. The pH 4.5-6.5 region was divided into four 0.5 pH unit ranges because this region had the greatest number of proteins. By using very narrow pH range fractions, sample amounts applied to narrow pH range 2-D gels could be increased to detect lower abundance proteins. Although 1.0 pH range 2-D gels were used in these experiments, further protein resolution should be feasible by using 2-D gels with pH ranges that are only slightly wider than the pH ranges of the musol-IEF fractions. By combining musol-IEF prefractionation with subsequent large pore 1-D SDS-PAGE (>100 kDa) and narrow range 2-D gels (<100 kDa), large proteins can be reliably quantitated, many more proteins can be resolved, and lower abundance proteins can be detected.     

Promising techniques for breast cancer detection,diagnosis, and staging using non-ionizing radiation imaging techniques

Traditional imaging for the diagnosis and staging of breast cancer has relied on the tissue morphology of cancers in the background of normal patterns of fibroglandular breast tissue. X-ray mammography and ultrasound have been the primary modalities for the diagnosis and the work-up of breast cancer. New modalities have been validated including magnetic resonance imaging (MRI) and positron emission tomography (PET). New pulse sequences in MRI combined with contrast enhancement kinetic perfusion curves have greatly enhanced detection of mammographically occult cancers. New modalities on the horizon include optical imaging, exploiting again the differential perfusion properties of cancers in a background of normal glandular tissue. Even more specificity can be ach eved with the addition of ductal or intravenous introduction of optical probes specific to tumor associated antigens such as the HER-2/neu receptor in aggressive breast cancers. Quantum dots and other fluorescent dyes coupled to peptides or other probes will greatly enhance our ability to detect cancers earlier and without ionizing radiation.     

Optical diagnosis of laryngeal cancer using high wavenumber Raman spectroscopy

We report the implementation of the transnasal image-guided high wavenumber (HW) Raman spectroscopy to differentiate tumor from normal laryngeal tissue at endoscopy. A rapid-acquisition Raman spectroscopy system coupled with a miniaturized fiber-optic Raman probe was utilized to realize real-time HW Raman (2800-3020 cm(-1)) measurements in the larynx. A total of 94 HW Raman spectra (22 normal sites, 72 tumor sites) were acquired from 39 patients who underwent laryngoscopic screening. Significant differences in Raman intensities of prominent Raman bands at 2845, 2880 and 2920 cm(-1) (CH(2) stretching of lipids), and 2940 cm(-1) (CH(3) stretching of proteins) were observed between normal and cancer laryngeal tissue. The diagnostic algorithms based on principal components analysis (PCA) and linear discriminant analysis (LDA) together with the leave-one subject-out, cross-validation method on HW Raman spectra yielded a diagnostic sensitivity of 90.3% (65/72) and specificity of 90.9% (20/22) for laryngeal cancer identification. This study demonstrates that HW Raman spectroscopy has the potential for the noninvasive, real-time diagnosis and detection of laryngeal cancer at the molecular level.     

Determination of toxaphene specific congeners in fish liver oil and feedingstuff using gas chromatography coupled to high resolution mass spectrometry

A new method for the determination of nine toxaphene specific congeners in fish liver oil and feedingstuff has been developed. The samples were extracted using pressurized liquid extraction followed by a purification on silica and florisil columns. Identification and quantification were conducted using GC-(EI)-HRMS, and comparison with MS/MS detection was performed, using electron ionization and negative chemical ionization. Limits of detection were ranged from 0.01 to 0.22 microg kg(-1) (12% moisture) as required for feed samples. The calibration curves showed a good linearity for all congeners (R(2)>0.99). Repeatability was below 9% for all the congeners and recoveries were in-between 73 and 86%. This analytical method was applied to the quantification of thirteen real samples collected within national monitoring plans for further risk assessment.     

Activity estimation and biokinetic analysis of 99mTc-DMSA in renal infant patients using a gamma camera

Biokinetic data from the administration of radiopharmaceuticals is essential in nuclear medicine dosimetry. It has particular significance in children, as their metabolism is very different from adults. Biokinetic models for paediatric patients could therefore need to be adapted to better reflect their absorption, retention and excretion functions, when compared to adults. Obtaining quality in vivo infant or paediatric biokinetic data is then essential to improve the available reference models, which in turn can lead to the optimization of paediatric procedures and protocols in clinical practice.This study analyses the biokinetic behaviour of ^99mTc-dimercaptosuccinic acid (DMSA), in 8 infants aged 4 months to 2 years old, through an imaging study using a gamma camera, and compares the obtained values with those obtained with the reference ICRP biokinetic model. The in vivo data was treated using an adapted methodology from the MIRD 16 pamphlet. Activity curves for the liver, the kidney and the whole body, were built, and new effective absorption, retention and excretion half-lives were estimated, and compared with the reference biokinetic parameters of ICRP 128. The obtained residence time in the kidneys of 2.56 h, has a deviation of 30.8% to the ICRP 128 value of 3.70 h. The obtained maximum uptake in the kidneys was of 0.22/A₀, which compares to the value of 0.31/A₀ for ICRP.The obtained biokinetic parameters were used to estimate the absorbed dose. The obtained dose values are smaller than the reference ICRP 128 ones by 32.1% in the kidneys, and 18.4% in the liver.     

Patterns out of cases using kohonen maps in breast cancer diagnosis

DESMAI is a framework for helping experts in breast cancer diagnosis. It allows experts to explore digital mammographic image databases according to a certain topology criteria when they need to decide whether a sample is benign or malignant. In this way, they are provided with complementary information to enhance their interpretations and predictions. The core of the application is a SOMCBR system, which is variant of a Case-Based Reasoning system featured by organizing the case memory using a Self-Organizing Map. The article presents a strategy for improving the SOMCBR reliability thanks to the relations between cases and clusters. The approach is successfully applied in DESMAI for estimating, if it is possible, the class of the recovered mammographies.     

Distance dependent centroid to centroid force fields using high resolution decoys

Simplified force fields play an important role in protein structure prediction and de novo protein design by requiring less computational effort than detailed atomistic potentials. A side chain centroid based, distance dependent pairwise interaction potential has been developed. A linear programming based formulation was used in which non-native "decoy" conformers are forced to take a higher energy compared with the corresponding native structure. This model was trained on an enhanced and diverse protein set. High quality decoy structures were generated for approximately 1400 nonhomologous proteins using torsion angle dynamics along with restricted variations of the hydrophobic cores of the native structure. The resulting decoy set was used to train the model yielding two different side chain centroid based force fields that differ in the way distance dependence has been used to calculate energy parameters. These force fields were tested on an independent set of 148 test proteins with 500 decoy structures for each protein. The side chain centroid force fields were successful in correctly identifying approximately 86% native structures. The Z-scores produced by the proposed centroid-centroid distance dependent force fields improved compared with other distance dependent C(alpha)-C(alpha) or side chain based force fields.     

Identification of specific reachable molecular targets in human breast cancer using a versatile ex vivo proteomic method

Targeting of tumoral tissues is one of the most promising approaches to improve both the efficacy and safety of anticancer treatments. The identification of valid targets, including proteins specifically and abundantly expressed in cancer lesions, is of utmost importance. Despite state-of-the-art technologies, the discovery of cancer-associated target proteins still faces the limitation, in human tissues, of antigen accessibility to suitable high-affinity ligands such as human mAb bound to bioactive molecules. Terminal perfusion of tumor-bearing mice or ex vivo perfusion of human cancer-bearing organs with a reactive biotin ester solution has successfully led to the identification of novel accessible biomarkers. This methodology is however restricted to perfusable organs, and excludes most of the tissues of interest to targeted therapies, e.g. primary breast cancer and metastases. Herein, we report on the development of a new chemical proteomic method that bypasses the perfusion step and thus offers the potential to identify accessible molecular targets in virtually all types of animal and human tissues. We have validated our new procedure by identifying biomarkers selectively expressed in human breast carcinoma. Overall, this powerful technology may lay the ground not only for custom-made therapies in cancer, but also for the development of therapies that need to be selectively delivered in a specific tissue.     

Oxidized alkyl phospholipids are specific, high affinity peroxisome proliferator-activated receptor gamma ligands and agonists

Synthetic high affinity peroxisome proliferator-activated receptor (PPAR) agonists are known, but biologic ligands are of low affinity. Oxidized low density lipoprotein (oxLDL) is inflammatory and signals through PPARs. We showed, by phospholipase A(1) digestion, that PPARgamma agonists in oxLDL arise from the small pool of alkyl phosphatidylcholines in LDL. We identified an abundant oxidatively fragmented alkyl phospholipid in oxLDL, hexadecyl azelaoyl phosphatidylcholine (azPC), as a high affinity ligand and agonist for PPARgamma. [(3)H]azPC bound recombinant PPARgamma with an affinity (K(d)((app)) approximately 40 nm) that was equivalent to rosiglitazone (BRL49653), and competition with rosiglitazone showed that binding occurred in the ligand-binding pocket. azPC induced PPRE reporter gene expression, as did rosiglitazone, with a half-maximal effect at 100 nm. Overexpression of PPARalpha or PPARgamma revealed that azPC was a specific PPARgamma agonist. The scavenger receptor CD36 is encoded by a PPRE-responsive gene, and azPC enhanced expression of CD36 in primary human monocytes. We found that anti-CD36 inhibited azPC uptake, and it inhibited PPRE reporter induction. Results with a small molecule phospholipid flippase mimetic suggest azPC acts intracellularly and that cellular azPC accumulation was efficient. Thus, certain alkyl phospholipid oxidation products in oxLDL are specific, high affinity extracellular ligands and agonists for PPARgamma that induce PPAR-responsive genes.     

Computer-aided diagnosis of breast cancer using cytological images: A systematic review

Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist’s level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date.     

Surveying a supercoil domain by using the gamma delta resolution system in Salmonella typhimurium.

A genetic system was developed to investigate the supercoil structure of bacterial chromosomes. New res-carrying transposons were derived from MudI1734 (MudJr1 and MudJr2) and Tn10 (Tn10dGn). The MudJr1 and MudJr2 elements each have a res site in opposite orientation so that when paired with a Tn10dGn element in the same chromosome, one MudJr res site will be ordered as a direct repeat. Deletion formation was studied in a nonessential region (approximately 100 kb) that extends from the his operon through the cob operon. Strains with a MudJr insertion in the cobT gene at the 5' end of the cob operon plus a Tn10dGn insertion positioned either clockwise or counterclockwise from cobT were exposed to a burst of RES protein. Following a pulse of resolvase expression, deletion formation was monitored by scoring the loss of the Lac+ phenotype or by loss of tetracycline resistance. In exponentially growing populations, deletion products appeared quickly in some cells (in 10 min) but also occurred more than an hour after RES induction. The frequency of deletion (y) diminished with increasing distance (x) between res sites. Results from 15 deletion intervals fit the exponential equation y = 120 . 10(-0.02x). We found that res sites can be plectonemically interwound over long distances ( > 100 kb) and that barriers to supercoil diffusion are placed stochastically within the 43- to 45-min region of the chromosome.