Background: Renal cell carcinoma is one of the most aggressive urogenital malignancies, with an increasing number of cases worldwide. The majority of cases are diagnosed at an advanced stage, as this form of growth is typically silent. An accurate evaluation of the extent of the disease is crucial for selecting the most appropriate treatment approach. Nuclear medicine imaging is increasingly being applied in oncological diagnostics, prompting ongoing research into renal cell carcinoma markers that could serve as a foundation for theranostic approaches in this disease. Positron emission tomography/computed tomography imaging with prostate-specific membrane antigen (PSMA) ligands has already demonstrated successful utility in diagnosis of other cancers, including prostate cancer and gliomas. Emerging evidence of high sensitivity and specificity in detecting renal cell carcinoma lesions provides a suitable foundation for its application in both the diagnosis and subsequent management of this malignancy. Methods: This systematic review synthesizes the current scientific evidence on the molecular imaging of renal cell carcinoma using PSMA ligands, emphasizing the potential future applications of this imaging marker in theranostic approaches. Results and Conclusions: Based on a systematic review of the literature, it appears that PET/CT with PSMA ligands has the potential to surpass traditional imaging techniques in diagnostic accuracy while also providing valuable prognostic information.

Cerebral amyloid angiopathy (CAA) is one form of disease of the small vessels of the brain and can cause frequent cerebral hemorrhages as well as other types of stroke. The aim of the study was to analyze the static and dynamic balance of the body and changes in the tension of selected muscles of the cervical spine in patients with CAA after stroke, depending on visual control or its absence, compared to healthy volunteers. Eight stroke patients and eight healthy subjects were examined. The functional Unterberger test and the Biodex SD platform were used to test the dynamic equilibrium, on which the static equilibrium was also assessed. Muscle tension was tested with the Luna EMG device. In static tests, the LC muscle (longus colli) was significantly more active with and without visual control (p = 0.016; p = 0.002), and in dynamic tests, significantly higher results for MOS (p = 0.046) were noted. The comparison of the groups led to the conclusion that the more functional deficits, the more difficult it is to keep balance, also with eye control.

Deep medullary veins (DMVs) play important roles within the cerebrovascular network related to brain drainage and clearance. Although they have been previously correlated with brain volume, it is unknown whether their count is specifically correlated with subcortical or cortical volume changes. This study aims to better understand the relationship between DMVs, subcortical (lateral ventricle to intracranial volume ratio (ICV)) and cortical atrophy (cortical thickness) to identify whether DMVs can be a predictor of volume changes in these regions. We performed a retrospective analysis of 332 cognitively healthy subjects previously followed between 2010 and 2019. Imaging and patient charts were analyzed for baseline demographic and clinical characteristics. Patients underwent a standardized cognitive interview and received a magnetic resonance imaging scan to assess DMVs, cortical thickness, lateral ventricle and global gray matter (GM) volumes, white matter lesions (WMLs) and microbleeds. Among 332 patients (62% female, median age 70), lateral ventricle/ICV was significantly related to DMV count (p<0.001). Similarly, sex stratified analyses confirmed that a larger lateral ventricle/ICV ratio, but not cortical thickness or global GM volumes, was associated with fewer DMVs. In the entire group, subcortical atrophy remained a significant predictor of DMVs even after accounting for baseline characteristics, WMLs, microbleeds and total gray matter volume. In a large cohort of cognitively unaffected people, subcortical, but not cortical, atrophy was significantly correlated with venous health as measured by DMVs. Reduced DMVs are a strong predictor of ventricular enlargement.

MRI generated forces are the source of potential complications in patients with cardiac implantable electronic devices (CIED). The technological progress, and growing clinical evidence concerning the operation of the contemporary MR non-conditional CIEDs during MRI, have started to significantly change our every-day clinical practice. Nevertheless, a lot of patients who could have an MRI performed safely, still have been refused the examination. In many clinical situations, an MRI examination in a patient with a CIED is reasonable, and is linked to a negligible risk of complications if performed under strict precautions. The MagnaSave Registry that evaluated the influence of nonthoracic MRI on the function of MR non-conditional CIEDs, and numerous studies involving thoracic and non-thoracic MRIs in patients with legacy CIEDs, have confirmed the feasibility and safety of such examinations. In this article, practical tips aimed towards improving the safety of MRI in MR conditional and non-conditional CIED patients are largely based on the very recently released (2017) HRS expert consensus statement. Clinical data emphasize the necessity of making the MRI more accessible to CIED patients, also in the case of MR non-conditional systems or when the thorax MR imaging is clinically reasonable. This goal should be achieved by increasing the number of centers complying with respective recommendations and applying protocols that would guarantee the highest safety level. Further studies are warranted to assess safety issues related to the main current contraindication to MRI, i.e., the presence of abandoned leads.

Wprowadzenie i cel: Cerebrolizyna jest preparatem o wielomodalnym działaniu cerebroprotekcyjnym, mogącym wpływać na działanie bariery krew–mózg, jednostki nerwowo-naczyniowej, oraz procesy plastyczności po uszkodzeniu ośrodkowego układu nerwowego. Celem pracy jest syntetyczna prezentacja i krytyczna ocena nowych danych klinicznych (opublikowanych po 2020 roku) dotyczących zastosowania cerebrolizyny w ostrej fazie udaru niedokrwiennego, w tym jako terapii skojarzonej z reperfuzją, oraz w neurointensywnej opiece u pacjentów z pourazowym uszkodzeniem mózgu. Materiał i metody: Przeprowadzono przegląd narracyjny randomizowanych badań klinicznych, metaanaliz oraz badań prospektywnych i obserwacyjnych, uwzględniając analizę NIHSS (National Institutes of Health Stroke Scale), zmodyfikowaną skalę Rankina (mRS), transformację krwotoczną (HT), w tym objawową (sHT), a także bezpieczeństwo i wykonalność leczenia. Wyniki: Badania nad terapią łączoną cerebrolizyną z dożylną trombolizą z użyciem tkankowego aktywatora plazminogenu (CEREHETIS, CERE-LYSE) wykazały redukcję sHT po trombolizie i szybszą poprawę ocenianą w skali NIHSS, przy braku różnic w 90-dniowym mRS. W rejestrze C-REGS2 u chorych z umiarkowaną ostrą fazą udaru niedokrwiennego cerebrolizyna wiązała się z korzystnym przesunięciem rozkładu mRS i lepszymi wynikami funkcji poznawczych. Trzy badania obserwacyjne po trombektomii, w tym jedno z 12-miesięczną obserwacją (CEREBROLYSIN-WIM Study) sugerują większą szansę uzyskania niezależności funkcjonalnej i redukcję HT/sHT, jednak brak randomizacji ogranicza możliwość wyciągania wniosków przyczynowych. W pourazowym uszkodzeniu mózgu projekt CAPTAIN (185 chorych) wykazał korzystny wpływ na globalny wielowymiarowy punkt końcowy oceniany w 90. dobie, przy porównywalnym bezpieczeństwie. Metaanalizy wskazują na poprawę wyników w skali Glasgow, bez redukcji śmiertelności, przy istotnej heterogenności danych. Wnioski: Istnieją obiecujące przesłanki dotyczące roli cerebrolizyny jako terapii wspomagającej reperfuzję/rehabilitację w ostrej fazie udaru niedokrwiennego oraz jako interwencji wspomagającej w pourazowym uszkodzeniu mózgu. Potrzebne są jednak wieloośrodkowe randomizowane badania kliniczne z precyzyjną selekcją pacjentów oraz optymalizacją czasu, dawki i długości leczenia.