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Brain metastases are major complications of common cancers. Tumor type and proneness to the CNS are thought to define the number and size of brain metastases. It is not known if intrinsic vascular factors can also have an effect. Restricted perfusion due to cerebral small vessel disease is frequent in elderly patients and causes white matter lesions (WML). The aim of this analysis was to evaluate a possible negative effect of WML and patient age on the number and size of brain metastases (BM) of different tumor entities. Pre-therapeutic 3 T brain magnetic resonance imaging (MRI) of 200 patients with BM were analyzed. Location, size and number of BM (NoM) were determined. T2 hyperintensive WML were scored according to Fazekas-Score (grade I–III). Patients with WML grade 1 (NoM: 5.59; p = 0.009) and grade 2 (NoM: 3.68; p = 0.002) had significantly less BM than patients without WML (NoM: 6.99). This effect was present in subgroups of different tumors: NSCLC (p = 0.05), other tumors than NSCLC (p = 0.048). Age (≤65 or >65 years) was positively correlated with the degree of WML but not with number (pNoM = 0.832) or mean diameter (pmDM = 0.662) of brain metastases. While patient age did not appear to be relevant, increasing WML were associated with lower number of brain metastases in different tumor types.

•Vascular white matter lesions (WML) reduce brain metastases (BM) in patients with lung cancer.•If presence of WML negatively affects number of BM in melanoma is unknown.•Degree of WML was higher in BM negative patients with melanoma.•Vascular risk factors were more frequent in BM negative patients.•WML appear to reduce BM in different tumor types. Brain metastasis (BM) is a major complication of different cancers. There is increasing evidence for influence of vascular factors on BM in patients with non-small cell lung cancer (NSCLC). It is not known if the same is true for other tumors that might rely on different forms of vasculogenesis. The objective of this retrospective study was to evaluate a possible negative association of vascular white matter lesions and vascular risk factors (vasRF) with brain metastases in patients with melanoma. 3D-brain magnetic resonance imaging (MRI) of 30 patients with BM from malignant melanoma and screening MRI of 31 BM negative patients were analysed. Number of metastases was calculated and T2 hyperintensive white matter lesions (WML) were classified according to Fazekas-Score (grade I-III) per patient and compared between BM+ and BM− patients. Patients without BM showed more pronounced WML (median = WML 1, mean = 1.3; SD = 1.04,) than patients with BM (median = WML 0, mean = 0.6; SD = 0.8, p = 0.017). With respect to vascular risk factors, BM were more likely (px2 = 0.019) in patients without vasRF. WML and possibly vasRF may reduce the risk of BM in different malignant tumors including melanoma. Presence of WML in patients with BM could potentially influence treatment choice regarding local or whole brain treatment after further multicentric prospective validation.

Objectives To implement a novel voxel-based technique to identify statistically significant local cartilage deformation and analyze in-vivo topographic knee cartilage deformation patterns using a voxel-based thickness map approach for high-flexion postures. Methods Sagittal 3T 3D-T1w-FLASH-WE-sequences of 10 healthy knees were acquired before and immediately after loading (kneeling/squatting/heel sitting/knee bends). After cartilage segmentation, 3D-reconstruction and 3D-registration, colour-coded deformation maps were generated by voxel-based subtraction of loaded from unloaded datasets to visualize cartilage thickness changes in all knee compartments. Results Compression areas were found bifocal at the peripheral medial/caudolateral patella, both posterior femoral condyles and both anterior/central tibiae. Local cartilage thickening were found adjacent to the compression areas. Significant local strain ranged from +13 to -15 %. Changes were most pronounced after squatting, least after knee bends. Shape and location of deformation areas varied slightly with the loading paradigm, but followed a similar pattern consistent between different individuals. Conclusions Voxel-based deformation maps identify individual in-vivo load-specific and posture-associated strain distribution in the articular cartilage. The data facilitate understanding individual knee loading properties and contribute to improve biomechanical 3 models. They lay a base to investigate the relationship between cartilage degeneration patterns in common osteoarthritis and areas at risk of cartilage wear due to mechanical loading in work-related activities. Key points • 3D MRI helps differentiate true knee-cartilage deformation from random measurement error • 3D MRI maps depict in vivo topographic distribution of cartilage deformation after loading • 3D MRI maps depict in vivo intensity of cartilage deformation after loading • Locating cartilage contact areas might aid differentiating common and work-related osteoarthritis

Reintroductions are one means of managing species distributions, but the feasibility of such efforts is uncertain. Here we consider reintroduction for threatened bull trout (Salvelinus confluentus) that currently occupy a small fraction of historically occupied habitats in the upper Klamath River basin owing to climate warming and human modifications of ecosystems. We engaged stakeholders across multiple organizations to co-produce a decision support model that estimated the potential of reintroduction to establish new populations and persistence of donor populations. Stakeholders identified recipient and donor populations, strategy (e.g., artificial propagation, translocation), number of individuals, and life stage of bull trout. The most optimal decision for reintroduction was artificial propagation of 10,000 fry into Annie Creek. This strategy may have negative consequences on donor populations, with the exception of Sun Creek, which was resilient to simulated removal of bull trout. Donor populations and recipient streams identified as most feasible were generally consistent across all of these scenarios. During model development, however, an unexpected and intense wildfire affected half of the streams considered and may have dramatically impacted donor populations. With models in hand from the initial feasibility assessment, we adapted them to further evaluate the potential of supplementation following this massive disturbance. Overall, results of this study indicate the value of developing co-produced tools that can be rapidly adapted to evaluate the consequences of whole-system transformations in near-real-time assessments.

Supratentorial white matter is an important part of the brain and a major site of detrimental effects after whole brain radiotherapy (WBRT). It is not known if prevalence of metastases in white matter justifies standard inclusion of white matter in whole brain treatment. In this retrospective analysis we examined the frequency of metastasis in supratentorial deep cerebral white matter with cerebral magnetic resonance imaging (MRI). Deep white matter (DWM) was defined as white matter in corpus callosum with forceps anterior and posterior and centrum semiovale. Lesions extending from grey matter, gyrus or ventricles into white matter were not classified as DWM metastases. Brain MRI of 198 patients from two centres were analyzed. In total 1330 metastases were counted and only 4.6 % were located in DWM. Metastases in DWM were small (median diameter 6 mm). Only 1/41 patients (2 %) with a singular metastasis had a DWM metastasis, 2/35 patients (6 %) with 2 metastases had a DWM metastasis, 14/79 patients (18 %) with 3–9 metastases and 12/43 patients (28 %) with >9 metastases had a single or more DWM metastases (p = 0.003). There appeared to be tumor related differences with renal cell carcinoma showing significantly more DWM metastasis (6/17, 35 %), than NSCLC (11/85, 13 %, p = 0.024), breast cancer (1/20, 5 %, p = 0.019) or colorectal cancer (0/10, 0 %, p = 0.033). Overall, relevant preservation of DWM from metastases, especially in oligometastatic disease, was shown. This implies that DWM in patients with only few brain metastases is unnecessarily damaged by conventional WBRT.

The signal crayfish (Pacifastacus leniusculus) was introduced to Crater Lake in 1915 and now threatens the local extinction of an endemic salamander, the Mazama newt (Taricha granulosa mazamae). More than a century after their introduction, crayfish have expanded in distribution to occupy nearly 80% of the lakeshore. Although newts remain in uninvaded areas, they are almost entirely absent in crayfish occupied areas. Abundance of benthic macroinvertebrates was dramatically reduced in locations with crayfish compared with areas of the lake where crayfish were absent. Isotopic signatures of newt and crayfish tissue confirm overlap in the diets of the two species and demonstrate their similar position in the Crater Lake food web. Mesocosm experiments conducted with newts and crayfish revealed that crayfish prey directly on newts, displace newts from cover, and generally alter newt behavior. Combined, this evidence suggests that further crayfish expansion likely will cause additional declines in newt abundance and distribution, and could lead to extinction of the unique population of newts in Crater Lake.

The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAs(eff.); 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population.

Worldwide demand has increased for the development of a computed tomography (CT) classification system that supplements the ILO classification of radiographs for pneumoconioses. The authors aimed to show preliminary reliability test results for selected referent films for the CT classification system developed through an international effort by researchers from seven countries. Reading trials by eight physicians who have considerable experience in pneumoconioses using a total of 114 lung zones consisting of 6 lung zones of 19 CT films of dust-exposed workers were performed to assess reliability of the classification system by weighted kappa. The results were also utilized for selecting reference films. A good agreement was observed for both first and second reading trials for rounded opacities (weighted kappa=0.76, 0.74, first and second trial results, respectively), irregular opacities (0.60, 0.48), emphysema (0.56, 0.70) and honeycombing (0.72, 0.79). Ground glass opacities, on the other hand, showed moderate agreement (0.43, 0.38). Intra-reader agreements among eight readers were shown in the same table as the mean and standard deviation of weighted kappa statistics. The inter-reader agreement for pleural thickening was not as good as for parenchymal lesions. The CT classification development may pioneer noble and sensitive medical screening for dust-exposed workers in selected settings. This system may be applied to radiographic borderline cases of profusion 0/1 and 1/0 by the ILO classification, in a setting that assures the occupational safety and health of workers exposed to some newly developed chemical compounds.

Asbestfasern können zu einer Lungenfibrose, zu Verdickungen der Pleura und zu Malignomen führen. Diese pathologischen Veränderungen sind fakultativ und abhängig von der Asbestart, der Dauer der Exposition und von individuellen Faktoren. Asbest fand bis 1993 in Deutschland breiten Einsatz. Weltweit besteht noch kein Verbot. Mehrheitlich sind asbestbedingte Erkrankungen Folgen beruflicher Expositionen. Bis zu ihrem Auftreten liegen lange Latenzzeiten bis über 40 Jahre, sodass das Maximum noch nicht erreicht ist. Asbestverursachte Berufserkrankungen am Thorax sind die Asbestose und asbestverursachte benigne Pleuraerkrankungen sowie das maligne Pleuramesotheliom. Bronchialkarzinome können asbestverursacht sein. Zur Beweisführung wird von der Radiologie der Nachweis von Brückenbefunden gefordert. Die Erfassung radiologischer Befunde in Thoraxübersicht und HRCT erfordern hohe Bildgüte und standardisierte Untersuchung. Die internationale ILO-Klassifikation und semiquantitative HRCT-Auswertung sind standardisierte Befundungen. Darauf basieren die Meldekriterien für die gesetzliche Anzeigepflicht.

Die hochauflösende Computertomographie (HRCT, „high resolution CT“) ist ein unerlässlicher Bestandteil der Diagnostik von Staublungenerkrankungen und anderen Inhalationsschäden. Konsensfähige Vereinbarungen über eine standardisierte Untersuchungstechnik und einheitliche Befundung existierten bislang aber nicht.Von der Arbeitsgemeinschaft „Diagnostische Radiologie bei arbeits- und umweltbedingten Erkrankungen“ der Deutschen Röntgengesellschaft (DRG) wurde ein CT-Beurteilungsbogen eingesetzt, der auf Erfahrungen aus gutachtlichen Stellungnahmen, arbeitsmedizinischen nachgehenden Untersuchungen und Fortbildungskursen basiert und im Rahmen einer Multicenterstudie eingesetzt wurde. Ein weiter entwickeltes Schema einer internationalen Arbeitsgruppe (P.A. Gevenois, Belgien; K.G. Hering, T. Kraus, S. Tuengerthal, Deutschland; L. Kivisaari, T. Vehmas, Finnland; M. Letourneux, Frankreich; M.D. Crane, Großbritannien; H. Arikawa, Y. Kusaka, N. Suganuma, Japan; J. Parker, USA) wurde international getestet. Es soll dazu dienen, die computertomographische Befundung der arbeits- und umweltbedingten Lungen- und Pleuraveränderungen zu standardisieren und international Vergleiche zu ermöglichen. Mit Hilfe von CT/HRCT-Referenzfilmen konnte diese reproduzierbare Vergleichbarkeit erreicht werden.Das Klassifizierungsschema hat einen rein deskriptiven Charakter, sodass alle Aspekte arbeits- und umweltbedingter Folgeerscheinungen an Parenchym und Pleura erfasst werden können. Obwohl einige der deskriptiven Bezeichnungen mit pneumokoniotischen Befunden verknüpft sind, wie z. B. rundliche Herde mit der Silikose oder interlobuläre septale und intralobuläre nichtseptale Linien sowie „honeycombing“ mit der Asbestose, finden sich zahlreiche überlappende Bildmuster, die differenzialdiagnostisch zu diskutieren sind.