Enfortumab vedotin as a salvage option as 5th line therapy for metastatic urothelial bladder cancer.

A 67-year-old female patient with a muscle-invasive, non-metastatic urothelial bladder cancer (UC) (pT2 G3 cN0 cM0) developed metachronous metastases within 6 months after radical cystectomy with ileal conduit urinary diversion. After a good primary response to platinum-based chemotherapy, treatment was switched to the immune checkpoint inhibitor (ICI) pembrolizumab due to progressive disease. Subsequently the patient underwent selective internal radiotherapy (SIRT) of the liver and received vinflunine as well as a re-challenge with pembrolizumab.

First Line Medical Treatment of Metastatic Renal Cell Carcinoma: A Podcast on Choosing Wisely and Managing Safely.

During the last 15 years, tremendous efforts have been made toward medical treatment of metastatic renal cell carcinoma (mRCC). Checkpoint inhibitors (CPI) and tyrosine kinase inhibitors (TKI) dominate the therapeutic armamentarium, as a combination of either CPIs or CPI/TKI, while the value of TKI monotherapy is decreasing. With increasing efficiency, however, toxicity also increases.

A Podcast Discussion on the Current Treatment Landscape for Renal Cell Carcinoma.

During the last 15 years, tremendous efforts have been made in the medical treatment of metastatic renal cell carcinoma (mRCC). Immune-oncological (IO) combinations are the current standard of care in the first-line setting of mRCC. Here, the current phase 3 trials CM214 (nivolumab/ipilimumab vs.

Anti-EGFR-Based Therapy in Recurrent or Metastatic HNSCC - What Difference Does it Make?

Patients with R/M HNSCC treated with palliative first-line therapy at Hannover Medical School between October 2005 and December 2016 have been included to show changes in survival following broad utilization of cetuximab. Treatment periods were defined from 10/2005 to 12/2008 (Period A) and 01/2009 to 12/2016. Overall survival did not improve over time.

Improving survival in metastatic renal cell carcinoma (mRCC) patients: do elderly patients benefit from expanded targeted therapeutic options?

Introduction: Treatment advances in metastatic renal cell carcinoma (mRCC) have improved overall survival (OS) in mRCC patients over the last two decades. This single center retrospective analysis assesses if the purported survival benefits are also applicable in elderly mRCC patients.

Methods: 401 patients with mRCC treated at Hannover Medical School from 01/2003-05/2016 were identified and evaluated by chart review.

Impact of sarcopenia in advanced and metastatic soft tissue sarcoma.

Introduction: Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Patient counseling on treatment aggressiveness is pivotal to avoid over- or undertreatment. Recently, evaluation of body composition markers like the skeletal muscle index (SMI) became focus of interest in a variety of cancers.

[Oncologic aspects in treatment of pathologic fractures].

Background: Pathological fractures are not only incisive events for tumor patients often with the need of surgical treatment but also often represent a relevant challenge in the overall concept of oncological treatment.

Objective: The aim of this article is to illustrate the necessity of a pre-interventional interdisciplinary consideration of disease-specific and patient-specific characteristics.

Material And Methods: A literature search and evaluation of existing guidelines were carried out including the keywords "bone metastases" and "pathological fractures" with respect to the oncological and radiotherapeutic treatment.

Feasibility and Robustness of 3T Magnetic Resonance Angiography Using Modified Dixon Fat Suppression in Patients With Known or Suspected Peripheral Artery Disease.

Contrast-enhanced magnetic resonance angiography (CE-MRA) is a well-established non-invasive imaging technique for the assessment of peripheral artery disease (PAD). A subtractionless method using modified Dixon (mDixon) fat suppression showed superior image quality at 1.5T over the common subtraction method, using a three-positions stepping table approach with a single dose of contrast agent.

Hepatic toxicity during regorafenib treatment in patients with metastatic gastrointestinal stromal tumors.

Regorafenib is a multi-target tyrosine kinase inhibitor that has been approved for the treatment of metastatic colorectal cancer, advanced hepatocellular carcinoma, and metastatic gastrointestinal stromal tumors (GIST). Severe hepatobiliary toxicity has been reported in patients with colorectal cancer treated with regorafenib, but not in those with GIST. Therefore, the aim of the present study was to investigate the incidence and clinical course of regorafenib-associated hepatic toxicity (HT) in patients with GIST in a real-world setting.

Flexible Inkjet-Printed Triple Cation Perovskite X-ray Detectors.

Flexible direct conversion X-ray detectors enable a variety of novel applications in medicine, industry, and science. Hybrid organic-inorganic perovskite semiconductors containing elements of high atomic number combine an efficient X-ray absorption with excellent charge transport properties. Due to their additional cost-effective and low-temperature processability, perovskite semiconductors represent promising candidates to be used as active materials in flexible X-ray detectors.

Rapid deconvolution of low-resolution time-of-flight data using Bayesian inference.

The deconvolution of low-resolution time-of-flight data has numerous advantages, including the ability to extract additional information from the experimental data. We augment the well-known Lucy-Richardson deconvolution algorithm using various Bayesian prior distributions and show that a prior of second-differences of the signal outperforms the standard Lucy-Richardson algorithm, accelerating the rate of convergence by more than a factor of four, while preserving the peak amplitude ratios of a similar fraction of the total peaks. A novel stopping criterion and boosting mechanism are implemented to ensure that these methods converge to a similar final entropy and local minima are avoided.

Renal cell carcinoma in kidney transplant recipients: descriptive analysis and overview of a major German transplant center.

Elevated risk of malignancy-related death after renal transplantation is reported and renal malignancy was ranked as the third most frequent site of malignancy-related death. However, there is a lack of data characterizing renal cell carcinoma associated with end-stage renal disease and kidney transplantation. We retrospectively identified 5250 patients who underwent kidney transplantation at the Hannover Medical School since 1970.

A novel and rapid approach to estimate patient-specific distortions based on mDIXON MRI.

While MRI-only radiation treatment planning (RTP) is becoming more widespread, a robust clinical solution for patient-specific distortion corrections is not available. This work explores B mapping based on mDIXON imaging, often performed for MR-only RTP, as an alternative to separate dual-acquisition gradient-recalled echo imaging, with the overarching goal of developing an efficient and robust approach for patient-specific distortion correction. Initial benchmarking was conducted by scanning a phantom and generating B field maps with two approaches: (1) conventional B mapping and (2) experimental mDIXON imaging.

Sarcoid-Like Lesions Mimicking Pulmonary Metastasis: A Case Series and Review of the Literature.

Background: The association of sarcoid-like lesions and malignancy is well described. Nonetheless, pulmonary lesions in malignant disease are typically presumed metastatic, and do not routinely receive histological validation. Here, we report on pulmonary sarcoid-like lesions identified in patients with a primary malignancy where pulmonary metastatic disease was suspected.

Coated and Printed Perovskites for Photovoltaic Applications.

Hybrid organic-inorganic metal halide perovskite semiconductors provide opportunities and challenges for the fabrication of low-cost thin-film photovoltaic devices. The opportunities are clear: the power conversion efficiency (PCE) of small-area perovskite photovoltaics has surpassed many established thin-film technologies. However, the large-scale solution-based deposition of perovskite layers introduces challenges.

Differentiating supraclavicular from gluteal adipose tissue based on simultaneous PDFF and T * mapping using a 20-echo gradient-echo acquisition.

Background: Adipose tissue (AT) can be classified into white and brown/beige subtypes. Chemical shift encoding-based water-fat MRI-techniques allowing simultaneous mapping of proton density fat fraction (PDFF) and T * result in a lower PDFF and a shorter T * in brown compared with white AT. However, AT T * values vary widely in the literature and are primarily based on 6-echo data.

Automated assessment of paraspinal muscle fat composition based on the segmentation of chemical shift encoding-based water/fat-separated images.

Proton-density fat fraction (PDFF) of the paraspinal muscles, derived from chemical shift encoding-based water-fat magnetic resonance imaging, has emerged as an important surrogate biomarker in individuals with intervertebral disc disease, osteoporosis, sarcopenia and neuromuscular disorders. However, quantification of paraspinal muscle PDFF is currently limited in clinical routine due to the required time-consuming manual segmentation procedure. The present study aimed to develop an automatic segmentation algorithm of the lumbar paraspinal muscles based on water-fat sequences and compare the performance of this algorithm to ground truth data based on manual segmentation.

The use of a low-literacy version of the Medicaid sterilization consent form to assess sterilization-related knowledge in Spanish-speaking women: results from a randomized controlled trial.

Objective: To learn whether a version of the Medicaid Sterilization Consent Form (SCF) adapted for populations of low-literacy can help Spanish-speaking women better understand the process and consequences of tubal sterilization.

Study Design: We randomly assigned Spanish-speaking women, ages 21-45 years, to review either a "standard" or "low-literacy" version of the Medicaid SCF. We assessed sterilization-related knowledge using items from the Postpartum Tubal Sterilization Knowledge questionnaire, using as the primary outcome correct identification of least four or more knowledge items and as secondary outcome participants' preferred version of the SCF.

Improving chemical shift encoding-based water-fat separation based on a detailed consideration of magnetic field contributions.

Purpose: To improve the robustness of existing chemical shift encoding‐based water–fat separation methods by incorporating a priori information of the magnetic field distortions in complex‐based water–fat separation.

Methods: Four major field contributions are considered: inhomogeneities of the scanner magnet, the shim field, an object‐based field map estimate, and a residual field. The former two are completely determined by spherical harmonic expansion coefficients directly available from the magnetic resonance (MR) scanner.

No Evidence for Extensions to the Standard Cosmological Model.

We compute the Bayesian evidence for models considered in the main analysis of Planck cosmic microwave background data. By utilizing carefully defined nearest-neighbor distances in parameter space, we reuse the Monte Carlo Markov chains already produced for parameter inference to compute Bayes factors B for many different model-data set combinations. The standard 6-parameter flat cold dark matter model with a cosmological constant (ΛCDM) is favored over all other models considered, with curvature being mildly favored only when cosmic microwave background lensing is not included.

Association of proton density fat fraction in adipose tissue with imaging-based and anthropometric obesity markers in adults.

Background/objectives: The purpose of this study was to examine the relationship of the proton density fat fraction (PDFF), measured by magnetic resonance imaging (MRI), of supraclavicular and gluteal adipose tissue with subcutaneous and visceral adipose tissue (SAT and VAT) volumes, liver fat fraction and anthropometric obesity markers. The supraclavicular fossa was selected as a typical location where brown adipocytes may be present in humans and the gluteal region was selected as a typical location enclosing primarily white adipocytes.

Subjects/methods: In this cross-sectional study, 61 adults (44 women, median age 29.

Predictive Factors for Second-Line Therapy in Metastatic Renal Cell Carcinoma: A Retrospective Analysis.

Currently, about 50% of patients with metastatic renal cell carcinoma (mRCC) receive a second-line therapy. Therefore, the choice at each subsequent treatment line remains an important issue. In this retrospective study, we sought to identify pretreatment clinical parameters that could predict the likelihood of a patient receiving a second-line therapy.

Measurement of vertebral bone marrow proton density fat fraction in children using quantitative water-fat MRI.

Objectives: To investigate the feasibility of employing a 3D time-interleaved multi-echo gradient-echo (TIMGRE) sequence to measure the proton density fat fraction (PDFF) in the vertebral bone marrow (VBM) of children and to examine cross-sectional changes with age and intra-individual variations from the lumbar to the cervical region in the first two decades of life.

Materials And Methods: Quantitative water-fat imaging of the spine was performed in 93 patients (49 girls; 44 boys; age median 4.5 years; range 0.

ADC Quantification of the Vertebral Bone Marrow Water Component: Removing the Confounding Effect of Residual Fat.

Purpose: To remove the confounding effect of unsuppressed fat on the imaging-based apparent diffusion coefficient (ADC) of the vertebral bone marrow water component when using spectrally selective fat suppression and to compare and validate the proposed quantification strategy against diffusion-weighted magnetic resonance spectroscopy (DW-MRS).

Methods: Twelve subjects underwent diffusion-weighted imaging (DWI) and DW-MRS of the vertebral bone marrow. A theoretical model was developed to take into account and correct the effects of residual fat on ADC, incorporating additional measurements for proton density fat fraction (PDFF) and water T (T ).