Blood-based tumor mutational burden impacts clinical outcomes of immune checkpoint inhibitor treated breast and prostate cancers.

Background: Breast and prostate tumors are known to be less responsive to immune checkpoint inhibitors (ICIs). Tissue-based tumor mutation burden (tTMB) has emerged as a predictive biomarker of response to ICIs, including in these "cold tumors". In clinical practice, when tTMB is not available, blood-based TMB score (bTMB) can be used to consider treatment with ICIs.

Physics-guided self-supervised learning: Demonstration for generalized RF pulse design.

Purpose: To introduce a new method for generalized RF pulse design using physics-guided self-supervised learning (GPS), which uses the Bloch equations as the guiding physics model.

Theory And Methods: The GPS framework consists of a neural network module and a physics module, where the physics module is a Bloch simulator for MRI applications. For RF pulse design, the neural network module maps an input target profile to an RF pulse, which is subsequently loaded into the physics module.

POSE: POSition Encoding for accelerated quantitative MRI.

Quantitative MRI utilizes multiple acquisitions with varying sequence parameters to sufficiently characterize a biophysical model of interest, resulting in undesirable scan times. Here we propose, validate and demonstrate a new general strategy for accelerating MRI using subvoxel shifting as a source of encoding called POSition Encoding (POSE). The POSE framework applies unique subvoxel shifts along the acquisition parameter dimension, thereby creating an extra source of encoding.

Diffusion Modeling with Domain-conditioned Prior Guidance for Accelerated MRI and qMRI Reconstruction.

This study introduces a novel image reconstruction technique based on a diffusion model that is conditioned on the native data domain. Our method is applied to multi-coil MRI and quantitative MRI (qMRI) reconstruction, leveraging the domain-conditioned diffusion model within the frequency and parameter domains. The prior MRI physics are used as embeddings in the diffusion model, enforcing data consistency to guide the training and sampling process, characterizing MRI k-space encoding in MRI reconstruction, and leveraging MR signal modeling for qMRI reconstruction.

Long-Term Outcomes of Endovascular Repair Within and Outside the Instructions for Use in Korean Patients With Abdominal Aortic Aneurysm.

Objective: Endovascular aneurysm repair (EVAR) has been used worldwide to treat abdominal aortic aneurysms (AAAs). Outcomes after EVAR within and outside the instruction for use (IFU) remain controversial. We analyzed long-term outcomes of EVAR within-the-IFU compared with that outside-the-IFU and baseline clinical/anatomical characteristics that influence outcomes of EVAR.

Improving quantitative MRI using self-supervised deep learning with model reinforcement: Demonstration for rapid T1 mapping.

Purpose: This paper proposes a novel self-supervised learning framework that uses model reinforcement, REference-free LAtent map eXtraction with MOdel REinforcement (RELAX-MORE), for accelerated quantitative MRI (qMRI) reconstruction. The proposed method uses an optimization algorithm to unroll an iterative model-based qMRI reconstruction into a deep learning framework, enabling accelerated MR parameter maps that are highly accurate and robust.

Methods: Unlike conventional deep learning methods which require large amounts of training data, RELAX-MORE is a subject-specific method that can be trained on single-subject data through self-supervised learning, making it accessible and practically applicable to many qMRI studies.

Novel therapies for metastatic prostate cancer.

Introduction: Patients with metastatic prostate cancer, especially in the castrate-resistant setting, have a poor prognosis. Many agents have been approved for metastatic prostate cancer, such as androgen receptor pathway inhibitors, taxane-based chemotherapy, radiopharmaceuticals, and immunotherapy. However, prostate cancer remains the leading cause of cancer deaths in nonsmoking men.

Long-term clinical outcomes for patients with uncrossable patent foramen ovale.

Introduction: Patent foramen ovale (PFO) closure is performed in selected patients with cryptogenic stroke to prevent recurrence. The prognosis of patients with uncrossable PFO after failed guidewire or catheter passage during the procedure remains unknown. We compared the long-term prognosis between uncrossable PFO and successful PFO closure in patients with high-grade PFO shunts.

Improved intra-atrial conduction delay after successful ablation for atrial fibrillation by scar homogenization in right atrium.

Atrial fibrosis in the right atrium (RA) presenting as a low-voltage zone might be the mechanism of atrial fibrillation (AF) and intra-atrial conduction delay. The impact of scar homogenization in RA on intra-atrial conduction delay is unknown. We describe a patient with paroxysmal AF and significant intra-atrial conduction delay with repetitive atrial flutter, triggered from the lateral free wall in the RA between the significant low-voltage zone and slow conduction area after pulmonary vein isolation.

Prediction of Resistance to Lu-PSMA Therapy by Assessment of Baseline Circulating Tumor DNA Biomarkers.

Lu-PSMA-617 and Lu-PSMA I&T (collectively termed Lu-PSMA) are currently being used for the treatment of selected metastatic castration-resistant prostate cancer (mCRPC) patients with PSMA PET-positive disease, but biomarkers for these agents remain incompletely understood. Pretreatment circulating tumor DNA (ctDNA) samples were collected from 44 mCRPC patients receiving Lu-PSMA treatment. Prostate-specific antigen responders and nonresponders were assessed relative to the ctDNA findings at baseline.

Safety and Efficacy of Post-Dilation in Percutaneous Coronary Intervention Using Polymer-Free Ultrathin Strut Sirolimus-Probucol Coated Drug-Eluting Stents.

: Polymer-free ultrathin strut sirolimus- and probucol-eluting stents (PF-SES) are recognized as safe and effective in diverse patient populations, although the implications of post-dilation during stent implantation remain underexamined. : In this study, patients implanted with PF-SES at Gachon University Gil Medical Center between December 2014 and February 2018 were evaluated. Major adverse cardiovascular events (MACE), encompassing nonfatal myocardial infarction (MI), nonfatal stroke, and cardiovascular death were identified as primary outcomes, with secondary outcomes including target vessel revascularization (TVR), target lesion revascularization (TLR), and in-stent restenosis (ISR).

Biomarker-Directed Therapy in Black and White Men With Metastatic Castration-Resistant Prostate Cancer.

Importance: Black men have higher incidence and mortality from prostate cancer. Whether precision oncology disparities affect Black men with metastatic castration-resistant prostate cancer (mCRPC) is unknown.

Objective: To compare precision medicine data and outcomes between Black and White men with mCRPC.

Pathogenic/Likely Pathogenic Somatic CDK12 Mutations in Black Men With Prostate Cancer.

Considering recently published data, this letter to the editor highlights the clinical relevance of CDK12 pathogenic or likely pathogenic mutations, noting that Black men have prostate cancers with increased rates of this pathologic alteration. Practitioners should be made aware of recent findings, given that CDK12 mutations are known to be associated with aggressive variants of prostate cancer and that they may confer susceptibility to PD-1 antagonists.

Magnetic Resonance Parameter Mapping using Self-supervised Deep Learning with Model Reinforcement.

This paper proposes a novel self-supervised learning method, RELAX-MORE, for quantitative MRI (qMRI) reconstruction. The proposed method uses an optimization algorithm to unroll a model-based qMRI reconstruction into a deep learning framework, enabling the generation of highly accurate and robust MR parameter maps at imaging acceleration. Unlike conventional deep learning methods requiring a large amount of training data, RELAX-MORE is a subject-specific method that can be trained on single-subject data through self-supervised learning, making it accessible and practically applicable to many qMRI studies.

Targeted Alpha-Particle Therapy: A Review of Current Trials.

Radiopharmaceuticals are rapidly developing as a field, with the successful use of targeted beta emitters in neuroendocrine tumors and prostate cancer serving as catalysts. Targeted alpha emitters are in current development for several potential oncologic indications. Herein, we review the three most prevalently studied conjugated/chelated alpha emitters (actinium, lead, and astatine) and focus on contemporary clinical trials in an effort to more fully appreciate the breadth of the current evaluation.

Longitudinal Monitoring of Circulating Tumor DNA to Assess the Efficacy of Immune Checkpoint Inhibitors in Patients With Advanced Genitourinary Malignancies.

Purpose: Circulating tumor DNA (ctDNA) detection in blood has emerged as a prognostic and predictive biomarker demonstrating improved assessment of treatment response in patients receiving immune checkpoint inhibitors (ICIs). Here, we performed a pilot study to support the role of ctDNA for longitudinal treatment response monitoring in patients with advanced genitourinary (GU) malignancies receiving ICIs.

Materials And Methods: Patients with histologically confirmed advanced GU malignancies were prospectively enrolled.