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Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias
Multiple myeloma (MM) is an incurable plasma cell malignancy of the bone marrow. MM has 3 components: diffuse marrow infiltration, focal bone lesions, and soft-tissue (extramedullary) disease. The hallmark biomarker in blood or urine is a monoclonal immunoglobulin, the monoclonal protein. Waldenstrom macroglobulinemia is a similar disease with secretion of IgM. Staging is classically performed with the 1975 Durie-Salmon system, which includes conventional radiographs. Recently updated, the Durie-Salmon Plus staging system includes CT, MRI, and (18)F-FDG PET/CT. The hallmark radiographic lesion of symptomatic MM is a well-demarcated, focal osteolytic bone lesion. The number of focal bone lesions correlates inversely with outcome. Extramedullary disease is typically an aggressive, poorly differentiated form of MM that confers inferior outcome, with median survival of less than 1 y if present at diagnosis. Achievement of a complete response on (18)F-FDG PET before stem-cell transplantation correlates with a superior outcome.
Journal Article
John Cena : world wrestling champ
The life of the Massachusetts-born champion pro wrestler who has gone on to act in several movies.
Book
Evaluation of Dynamic 18F-FDG-PET Imaging for the Detection of Acute Post-Surgical Bone Infection
Diagnosing bone infection in its acute early stage is of utmost clinical importance as the failure to do so results in a therapeutically recalcitrant chronic infection that can only be resolved with extensive surgical intervention, the end result often being a structurally unstable defect requiring reconstructive procedures. [(18)F]-FDG-PET has been extensively investigated for this purpose, but the results have been mixed in that, while highly sensitive, its specificity with respect to distinguishing between acute infection and sterile inflammatory processes, including normal recuperative post-surgical healing, is limited. This study investigated the possibility that alternative means of acquiring and analyzing FDG-PET data could be used to overcome this lack of specificity without an unacceptable loss of sensitivity. This was done in the context of an experimental rabbit model of post-surgical osteomyelitis with the objective of distinguishing between acute infection and sterile post-surgical inflammation. Imaging was done 7 and 14 days after surgery with continuous data acquisition for a 90-minute period after administration of tracer. Results were evaluated based on both single and dual time point data analysis. The results suggest that the diagnostic utility of FDG-PET is likely limited to well-defined clinical circumstances. We conclude that, in the complicated clinical context of acute post-surgical or post-traumatic infection, the diagnostic utility accuracy of FDG-PET is severely limited based on its focus on the increased glucose utilization that is generally characteristic of inflammatory processes.
Journal Article
The SNM Practice Guideline for Somatostatin Receptor Scintigraphy 2.0
VOICE Credit: This activity has been approved for 1.0 VOICE (Category A) credit. For CE credit, participants can access this activity on page 325 or on the SNM Web site (http://www.snm.org/ce_online) through December 31, 2013. You must answer 80% or the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit.
Journal Article
White lines II : Sunny : a white lines novel
\"On the surface, it appears that Sunny has got it all-looks, money, a beautiful home, a healthy daughter, and friends who love her. But Sunny has a secret--something she hasn't even told her best friend. The truth is Sunny is unhappy. She still misses her beloved Dorian, and worries that no other man will ever captivate her the way he did. She dated some very powerful and successful men since Dorian's death. But will she ever find love again? It's not long before Sunny is chasing those white lines again. And, when the truth finally explodes, will Sunny be able to put her life back together again?\"-- Provided by publisher.
Book
Volumetric MRI and MRS provide sensitive measures of Alzheimer's disease neuropathology in inducible Tau transgenic mice (rTg4510)
The purpose of this study was to determine if in vivo high resolution 3D MRI and localized 1H MR spectroscopy (MRS) can detect brain findings resembling Alzheimer's disease in a transgenic mouse model of Tau pathology. Seven double transgenic rTg4510 female mice and 7 age-matched wild-type (wt) female mice were evaluated at 5months of age. To confirm the usefulness and consistency of in vivo MRI/S, we also scanned the brains of 14 male mice (7 rTg4510 and 7 age-matched wt) at 8months of age. Mean hippocampal and cerebral cortex volumes in the female rTg4510 mice were 26.7% and 20.6% smaller than that in the wt controls (p<0.0001), respectively. Mean hippocampal and cerebral cortex volumes in the male rTg4510 mice were 18.4% and 16.9% smaller than that in the wt controls (p<0.00005), respectively. The mean volumes of the cerebellum were not statistically different between the rTg4510 and the wt groups. MRS assessment revealed that the myo-inositol to total creatine ratios (mIns/tCr), a measure of gliosis, were significantly higher in the hippocampus of rTg4510 mice relative to wt mice (p=0.03 for the females; p=0.005 for the males). Immunohistochemistry and histology in the same animals verified previously published data showing elevation of hyperphosphorylated Tau, glial activation and cortical and hippocampal neuronal loss. This study demonstrates that in vivo MRI/S can be a non-invasive biomarker to assess brain atrophy and related biochemical changes in the rTg4510 mouse model.
► Application of in vivo MRI/S to tauopathy mouse model- rTg4510. ► High resolution 3D MRI can sensitively assess brain atrophy of rTg4510 mice. ► Myo-inositol can be a sensitive biomarker for glial activation. ► The MRI/S findings were verified by histology and immunohistochemistry.
Journal Article
Culinary arts : a practical career guide
\"Culinary Arts, which includes interviews with professionals in the field, covers five main areas of this field that have proven to be stable, lucrative, and growing professions: Chefs; Pop-up and traditional restaurant owners; Caterers; Media and art-related careers; Bakers\"-- Provided by publisher.
Book
Pueblo Indians and Spanish Colonial Authority in Eighteenth-Century New Mexico
Pueblo people reacted to Spanish colonialism in many different ways. While some resisted change and struggled to keep to their long-standing traditions, others reworked old practices or even adopted Spanish ones.Pueblo Indians and Spanish Colonial Authority in Eighteenth-Century New Mexicoexamines the multiple approaches Pueblo individuals and villages adopted to mitigate and manage the demands that Spanish colonial authorities made upon them. In doing so, author Tracy L. Brown counters the prevailing argument that Pueblo individuals and communities' only response to Spanish colonialism was to compartmentalize-and thus freeze in time and space-their traditions behind a cultural \"iron curtain.\"Brown addresses an understudied period of Pueblo Indian/Spanish colonial history of New Mexico with a work that paints a portrait of pre-contact times through the colonial period with a special emphasis on the eighteenth century. The Pueblo communities that the Spaniards encountered were divided by language, religion,and political and kinship organization. Brown highlights the changes to, but also the maintenance of, social practices and beliefs in the economic, political, spiritual and familial and intimate realms of life that resulted from Pueblo attempts to negotiate Spanish colonial power.The author combines an analysis of eighteenth century Spanish documentation with archaeological findings concerning Pueblo beliefs and practices that spans the pre-contact period to the eighteenth century in the Southwest. Brown presents a nonlinear view of Pueblo life that examines politics, economics, ritual, and personal relationships. The book paints a portrait of the Pueblo peoples and their complex responses to Spanish colonialism by making sense of little-researched archival documents and archaeological findings that cast light on the daily life of Pueblo peoples.
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