INTRODUCTION: The gold standard for serum neurofilament light chain (sNfL) determination is the single molecule array (SIMOA), the use of which is limited by availability and cost. The VEUS method is a fully automated, user-friendly diagnostic system requiring no sample preparation, with high reported sensitivity, multiplexing capability, and rapid diagnostics. The aim of this study was to compare the SIMOA and VEUS methods for determining sNfL levels in patients with multiple sclerosis (MS). METHODOLOGY: A single-centre cross-sectional study was conducted at the MS Centre of University Hospital Ostrava. Patients were enrolled in the study from January 18 to January 31, 2024. Inclusion criteria were: 1) diagnosis of MS according to the revised 2017 McDonald criteria, 2) age ≥18 years, and 3) signed informed consent. The NF-light V2 diagnostic kit (SIMOA, Quanterix) and the Singleplex Neurology assay kit (VEUDx, EZDiatech) were used to determine sNfL concentrations. The two methods were compared by use of Spearman correlation, Passing-Bablok regression, and Bland-Altman analysis. RESULTS: A total of 49 patients were included in the study, of whom 39 (79.6 %) were female. The median sNfL concentration was 7.73 (IQR 5.80-9.93) ng/L determined by SIMOA and 1.31 (IQR 1.18-1.65) ng/L by VEUS. We did not find a correlation between SIMOA and VEUS (rs = 0.025, p = 0.866). Passing-Bablok regression demonstrated a systematic and proportional difference between the two methods. A significant disagreement between them was also confirmed by the Bland-Altman plots. On average, sNfL values measured by SIMOA were 3.56 ng/L (95 % CI 0.78 to 6.34) higher than those measured by VEUS. CONCLUSION: Our investigation uncovered noteworthy disparities between the SIMOA and VEUS techniques in determining sNfL levels. Specifically, the VEUS technique systematically produces lower estimates of sNFL levels. This substantial variance emphasizes the importance of carefully evaluating assay methods when quantifying sNfL.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- neurofilamentové proteiny * krev MeSH
- průřezové studie MeSH
- roztroušená skleróza * krev diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND AND OBJECTIVES: Nonconvulsive status epilepticus (NCSE) manifests as a change in mental status without a coma (NCSE proper) or comatose NCSE. Hypocretin-1/orexin-A (H/O) is involved in alertness and sleep maintenance. Sleep impairment and excessive daytime sleepiness (EDS) have a negative impact on cognitive functions and activities of daily living (ADL). METHODS: Patients meeting the NCSE criteria underwent cerebrospinal fluid and brain magnetic resonance imaging examinations, polysomnographies (PSG), multiple latency sleep tests (MSLT), and completed Epworth Sleepiness Scale (ESS). Montreal Cognitive Assessment was used to evaluate cognitive functions, and the Barthel Index was used to assess ADL in the acute phase (V1) and three months follow-up (V2). RESULTS: From May 2020 to May 2023, we enrolled 15 patients, eight (53.3 %) women, with a median age of 69 (14) years. The median H/O CSF concentration was 250 (63.6) pg/ml; however, only three CSF samples (20 %) decreased below the borderline concentration of 200 pg/ml. Fourteen out of 15 patients (93.3 %) completed the PSG study. The median of wakefulness after sleep onset was 167 (173.5) min, sleep efficiency (SE) was 62.9 (63) %, sleep latency (SL) was 6 (32) min, REM sleep was 2.85 (7.2) %, and REM first episode latency was 210.5 (196.5) minutes. The medians of the stages N1 NREM were 4.65 (15) %, N2 NREM 68.4 (29.9) %, and N3 NREM 21.8 (35.5) %. MSLT mean latency was 7.7 (12.6) minutes. A significant negative correlation exists between H/O CSF concentrations and the stage N1 NREM (rs = -0.612, p = 0.02), and the proportion of cumulative sleep time with oxygen saturation below 90 % in total sleep time (TST) t90 (rs = -0.57, p = 0.03). MSLT had significant negative correlation with TST (rs = -0.5369, p = 0.0478), with SE (rs = -0.5897, p = 0.0265), with apnea-hypopnea index (rs = -0.7631, p = 0.0002) and with deoxygenation index (rs = -0.8009, p = 0.0006). A positive correlation exists between MSLT and SL (rs = 0.6284, p = 0.0161) and between ESS and t90 (rs = 0.9014, p = 0.0004). The correlation between H/O CSF concentrations and EDS, cognitive performance, and ADL was not proved. CONCLUSIONS: Patients after NCSE exhibited sleep impairment and excessive daytime sleepiness. Hypocretin-1/orexin-A concentrations decreased only in 20 % of these cases.
- MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- orexiny * mozkomíšní mok MeSH
- polysomnografie * MeSH
- poruchy nadměrné spavosti * mozkomíšní mok MeSH
- průřezové studie MeSH
- senioři MeSH
- spánek fyziologie MeSH
- status epilepticus * mozkomíšní mok MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Aim of this paper is to evaluate short and long-term changes in T2 relaxation times after radiotherapy in patients with low and intermediate risk localized prostate cancer. A total of 24 patients were selected for this retrospective study. Each participant underwent 1.5T magnetic resonance imaging on seven separate occasions: initially after the implantation of gold fiducials, the required step for Cyberknife therapy guidance, followed by MRI scans two weeks post-therapy and monthly thereafter. As part of each MRI scan, the prostate region was manually delineated, and the T2 relaxation times were calculated for quantitative analysis. The T2 relaxation times between individual follow-ups were analyzed using Repeated Measures Analysis of Variance that revealed a significant difference across all measurements (F (6, 120) = 0.611, p << 0.001). A Bonferroni post hoc test revealed significant differences in median T2 values between the baseline and subsequent measurements, particularly between pre-therapy (M0) and two weeks post-therapy (M1), as well as during the monthly interval checks (M2 - M6). Some cases showed a delayed decrease in relaxation times, indicating the prolonged effects of therapy. The changes in T2 values during the course of radiotherapy can help in monitoring radiotherapy response in unconfirmed patients, quantifying the scarring process, and recognizing the therapy failure.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Roztroušená skleróza (RS) je chronické autoimunitní onemocnění s prvky neurodegenerace, které často vede kromě jiných symptomů také ke kognitivnímu deficitu. Pokles kognitivních funkcí má v rámci jednotlivých forem RS různou prevalenci, přičemž častěji se vyskytuje u progresivních variant, vždy však snižuje kvalitu života pacienta. Kognici je nutno u pacientů s RS v rámci běžného sledování vyšetřovat a adekvátně léčit i koincidující nemoci, často deprese nebo úzkostné poruchy, které mohou kognitivní schopnosti pacienta dále narušovat.
Multiple sclerosis (MS) is an immune-based neurodegenerative disease that often leads to cognitive deficit in addition to other symptoms. The decline in cognitive functions has a various prevalence in the respective forms of MS, whereas it occurs more often in progressive variants, however, it always reduces the patient's quality of life. Cognition in patients with MS should be examined as a part of the routine follow-up and coincident diseases, such as depression or anxiety, which can further impair the patient's cognitive abilities, should be also addressed adequately.
Úvod: Léčebný management karcinomu rekta je založen na multidisciplinárním přístupu; indikace neoadjuvantní léčby vychází z popisu lokální pokročilosti karcinomu na magnetické rezonanci (MR). I když je přesnost MR v hodnocení hloubky invaze karcinomu uspokojivá, spolehlivost MR při hodnocení uzlinového postižení je velmi diskutabilní. Metody: Prospektivní, unicentrická, kohortová studie byla zaměřena na stanovení spolehlivosti předoperačního MR v hodnocení mezorektálních LU. Nález na MR byl detailně srovnáván s histopatologickým hodnocením resekovaných preparátů rekta. Výsledky: Do studie bylo zařazeno 40 pacientů s karcinomem rekta, kteří podstoupili primární resekci rekta s totální mezorektální excizí. T-stadium karcinomu bylo pomocí MR správně určeno u 22 ze 40 studijních pacientů (55,0 %). Overstaging T-stadia karcinomu rekta byl zjištěn u 14 (35,0 %), understaging u 4 (10,0 %) studijních pacientů. Celkem 50 uzlin bylo na MR dle Horvatových kritérií považováno za suspektní/maligní, histopatologické vyšetření potvrdilo malignitu pouze ve 13 z těchto 50 uzlin (26,0 %). 18 našich pacientů mělo dle předoperačního MR suspektní/pozitivní LU a bylo klasifikováno jako cN+. MR diagnóza maligní lymfadenopatie byla přitom správná pouze u 33,3 % z těchto pacientů. Závěr: MR vykazuje velmi nízkou přesnost v hodnocení uzlinového postižení u pacientů s karcinomem rekta. Při selekci pacientů pro neoadjuvantní léčbu by proto měl být kladen důraz pouze na MR hodnocení hloubky invaze karcinomu (T-stadium a vztah nádoru k fascia recti propria).
Introduction: Multidisciplinary management of patients with rectal cancer presents a gold standard of care; neoadjuvant therapy indications are based on magnetic resonance imaging (MRI) description of the local stage of the carcinoma. Although the accuracy of MRI-based assessment of cancer depth of invasion is satisfactory, its accuracy in the assessment of mesorectal lymphadenopathy is very questionable. Methods: This was a prospective, single-centre, cohort study focused on the accuracy of preoperative MRI in the assessment of mesorectal lymph nodes (LN). MRI findings of each patient were compared with detailed histopathological examination of rectal specimens. Results: Forty patients with rectal cancer, undergoing rectal resection with total mesorectal excision were enrolled in the study. MRI assessment of the T-stage was correct in 22 of the 40 study patients (55.0%). T-stage overstaging was noted in 14 (35.0%), and understaging in 4 (10.0%) study patients. According to preoperative MRI (using Horvat’s criteria), there were 50 suspicious/malignant lymph nodes. Only 13 of these 50 LNs (26.0%) were proved malignant on histopathology examination. In total, our study group included 18 patients with suspicious/positive LNs (according to preoperative MRI) who were classified as cN+. MRI diagnosis of malignant lymphadenopathy was correct in only 33.3% of these patients. Conclusion: MRI shows very low accuracy in the evaluation of mesorectal lymph nodes in patients with rectal cancer. Therefore neoadjuvant therapy should be offered particularly with respect to MRI description of the depth of carcinoma invasion (T-stage and relationship to fascia propria of the rectum).
- MeSH
- autoimunitní nemoci nervového systému * diagnóza terapie MeSH
- imunoglobuliny aplikace a dávkování farmakologie terapeutické užití MeSH
- kognitivní dysfunkce MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- neurozobrazování metody MeSH
- předškolní dítě MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE: Magnetic resonance imaging (MRI) is a fundamental diagnostic modality for the evaluation of primary rectal cancer, but MRI assessment of nodal involvement remains a confounding factor. METHOD: This prospective cohort study was conducted to investigate the accuracy of preoperative MRI in the assessment of nodal status by comparing histopathology reports to MRI findings on a node-by-node basis in 69 patients with rectal cancer. RESULTS: Primary surgery was performed in 40 (58.0%) patients; 29 (42.0%) study patients underwent neoadjuvant chemoradiotherapy (CRT). Histopathological examination revealed T1 tumour in 8 (11.6%) patients, T2 tumour in 30 (43.5%), and T3 tumour in 25 (36.2%). In total, 897 lymph nodes (LNs) have been harvested (13.1 ± 5.4 LNs per specimen). There were 77 MRI-suspicious LNs, 21 (27.3%) of which were histologically proven malignant. The sensitivity of MRI for assessing nodal involvement was 51.2% and specificity 93.4%. Of the 28 patients with MRI-suspicious LNs the diagnosis was correct in 42.8%. The MRI accuracy was 33.3% in "primary surgery" subgroup (n = 18, malignant LNs found in 6 patients). Diagnosis of MRI-negative LNs was correct in 90.2% of study patients; malignant nodes were found in 9.8% of patients initially classified as cN0. CONCLUSIONS: MRI prediction of nodal status in patients with rectal cancer has very low accuracy. Decisions regarding neoadjuvant CRT should not be based on MRI assessment of nodal status, but on the MRI evaluation of tumour depth invasion (T stage and relationship between the tumour and mesorectal fascia).
- MeSH
- lidé MeSH
- lymfatické metastázy diagnostické zobrazování patologie MeSH
- lymfatické uzliny diagnostické zobrazování patologie MeSH
- magnetická rezonanční tomografie metody MeSH
- nádory rekta * diagnostické zobrazování chirurgie patologie MeSH
- prospektivní studie MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Přehledové sdělení se věnuje standardizovanému protokolu zobrazení nádorů mozku dětského věku dle doporučení European Society for Paediatric Oncology (SIOPE) ke zvýšení efektivity prvovyšetření takto nemocných dětí i pro možnost komparace následujících MR. Protokol je sestaven s ohledem na rozdíly v hardwarovém i softwarovém vybavení pracovišť a je rozčleněn do základní (povinné) části a rozšiřujících sekvencí, které už jsou prováděny ve specializovaných centrech. Sdělení představuje základní použití sekvencí dle síly přístroje MR, zdůrazňuje možnosti využití nových technik. V pokročilé části protokolu uvádí základní princip i možnosti implementace.
The overview report is devoted to the standardized protocol for intracranial imaging of the childhood brain tumors according to the European Society for Pediatric Oncology (SIOPE) recommendations to increase the effectiveness of the initial examination of such sick children, as well as for the possibility of comparing subsequent MRI. The protocol takes into account the differences in the hardware and software equipment of workplaces. It is divided into basic (mandatory) parts and extension sequences, which are already carried out in specialized centres. The communication presents the essential use of sequences according to the power of the MRI device and emphasizes the possibilities of using new techniques. The advanced part of the protocol offers the basic principle and implementation options.
- Klíčová slova
- standardní protokol zobrazení, pokročilý protokol zobrazení,
- MeSH
- dítě MeSH
- klinické protokoly MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody normy MeSH
- nádory mozku * diagnostické zobrazování MeSH
- zobrazování difuzních tenzorů metody normy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
