¹¹C methionine (¹¹C-MET) is increasingly being used in addition to contrast-enhanced MRI to plan for radiotherapy of patients with glioblastomas. This study aimed to assess the recurrence pattern quantitatively. Glioblastoma patients undergoing 11C-MET PET examination before primary radiotherapy from 2018 to 2023 were included in the analysis. A clinical target volume was manually created and fused with MRI-based gross tumor volumes and MET PET-based biological target volume. The recurrence was noted as an area of contrast enhancement on the first MRI scan, which showed progression. The recurrent tumor was identified on the radiological MR images in terms of recurrent tumor volume, and recurrences were classified as central, in-field, marginal, or ex-field tumors. We then compared the MET-PET-defined biological target volume with the MRI-defined recurrent tumor volume regarding spatial overlap (the Dice coefficient) and the Hausdorff distance. Most recurrences occurred locally within the primary tumor area (64.8%). The mean Hausdorff distance was 39.4 mm (SD 32.25), and the mean Dice coefficient was 0.30 (SD 0.22). In patients with glioblastoma, the analysis of the recurrence pattern has been mainly based on FET-PET. Our study confirms that the recurrence pattern after gross tumor volume-based treatment contoured by MET-PET is consistent with the FET-PET-based treatment described in the literature.

Dysregulated T-cell-mediated immune responses are a hallmark of inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). MicroRNAs (miRNAs) regulate various biological processes and play a significant role in the pathophysiology of numerous diseases. In this study, we aim to clarify the relationship between dysregulated immune response and altered miRNA signatures in patients with IBD. Our goal is to identify differentially expressed miRNAs that could potentially serve as diagnostic markers to differentiate between CD and UC. To quantify circulating miRNAs, we employed small RNA sequencing. To describe immune dysregulation, we determined the levels of circulating T-cell-related cytokines and the distribution of T-cell subpopulations in both circulation and in tissue samples. Our analysis revealed that 14 miRNAs exhibited significant expression differences between IBD patients and control subjects. These miRNAs may also implicate pathways associated with colitis-related colorectal carcinogenesis, suggesting their value in early risk assessment. Furthermore, we found that five miRNAs demonstrated a strong ability to discriminate between CD and UC patients. Additionally, levels of IL-22 and IFN-γ were significantly elevated in individuals with IBD. Notably, miRNA levels showed strong correlations with cytokine levels and T-cell subset distribution in both blood and tissue samples, exhibiting disease-specific patterns. In conclusion, we identified differentially expressed miRNAs in IBD patient groups, and a subset of these miRNAs might exhibit diagnostic potential to distinguish between CD and UC. Analyzing miRNAs in the blood of IBD patients may provide valuable insights into the underlying immune dysfunction.

Background: Stereotactic body radiotherapy (SBRT) is an established curative modality for patients with early-stage non-small cell lung cancer (NSCLC) who are not candidates for surgery. In circumstances where neither surgical resection nor tissue sampling can be performed, SBRT may still be administered empirically, with accumulating evidence indicating excellent efficacy and safety. Objective: This single-institution retrospective study aimed to evaluate the clinical outcomes of SBRT for presumed malignant lung lesions, focusing on local control, survival, and treatment-related toxicity, and to compare these findings with published results in histologically confirmed NSCLC. Methods: Between 2018 and 2024, 80 cases with 85 pulmonary lesions received SBRT at the Department of Oncoradiology, University of Debrecen. All patients underwent comprehensive staging with chest CT and PET-CT, and treatment decisions were made by a multidisciplinary tumor board. Eligibility required the absence of other primary malignancies within 5 years. Treatment planning was based on 4D-CT imaging with internal target volume delineation across multiple respiratory phases. SBRT was delivered on linear accelerators in 4–8 fractions, to a total dose of 48–60 Gy, using volumetric-modulated arc therapy and daily image guidance with 4D cone-beam CT. Results: Most patients presented with solitary lesions, while several had synchronous or metachronous multiple lesions (maximum 3 lesions). The median age was 70.1 years, with 60% ECOG performance status 1. Median follow-up was 21 months. One- and two-year local control rates were 89.8% and 94.3%, respectively, with a 51.4% complete response rate at two years. Mean overall survival was 49.6 months. No grade ≥ 3 toxicities were observed. Conclusions: Empirical SBRT is a safe, well-tolerated, and highly effective treatment option in elderly, inoperable patients with presumed malignant lung lesions. Its favorable efficacy supports its broader use as a curative alternative when histological confirmation is not feasible.

Dysregulated microRNAs (miRNAs) have been implicated in the pathogenesis and progression of rectal adenocarcinoma. In this study, we aimed to identify miRNA alterations associated with the efficacy of neoadjuvant chemoradiotherapy in rectal cancer patients. High-throughput small RNA sequencing was performed to assess salivary miRNA expression profiles in 31 participants (11 rectal adenocarcinoma patients and 20 healthy volunteers). Paired saliva samples were collected from patients before and after chemoradiation. Tumor regression was classified according to the modified Ryan scheme into responders (tumor regression grade [TRG] 1–2, n = 10) and nonresponders (TRG3, n = 1). Bioinformatic integration of small non-coding RNA data revealed 37 miRNAs with distinct expression differences between patients and healthy controls. Furthermore, seven miRNAs showed significant alterations in response to radiotherapy. Among these, five candidates (hsa-miR-378a-3p, hsa-miR-203a-3p, hsa-miR-200a-5p, hsa-miR-361-5p, and hsa-miR-107) were successfully validated by RT-qPCR, displaying significantly increased salivary expression levels post-radiation compared with the pre-radiation samples (p < 0.05). Notably, hsa-miR-203a-3p, hsa-miR-200a-5p, and hsa-miR-361-5p demonstrated excellent discriminatory power for tumor regression grade (AUC > 0.7). Our findings support the involvement of specific salivary miRNAs in rectal adenocarcinoma tumor regression and highlight their potential as non-invasive biomarkers to evaluate treatment response following neoadjuvant chemoradiotherapy.

Összefoglaló. Háttér: A rheopheresis egy szelektív, extracorporalis, kettős kaszkádfiltrációs eljárás, mely előzetes plazmaszeparációt követően egy speciális filter segítségével kivonja a vérplazmából a hiperviszkozitásért felelős komponenseket, úgymint alacsony sűrűségű lipoprotein, lipoprotein(a), triglicerid, koleszterin, fibrinogén, α2-makroglobulin, Von Willebrand-faktor, immunglobulin-M. Módszer és Betegek: Klinikánkon az elmúlt 5 évben MONET filter alkalmazásával összesen 80 kezelést végeztünk hiperviszkozitással összefüggő, időskori száraz maculadegeneratióban, diabeteses alsó végtagi fekélyben, illetve neuropathiában. Eredmények: A dolgozatban beszámolunk kedvező klinikai tapasztalatainkról, a viszkozitás, a klinikai tünetek és az elektroneurográfiai paraméterek tükrében. Orv Hetil. 2021; 162(10): 375–382. Summary. Background: Rheopheresis is a selective, extracorporeal, double cascade filtration method. After a previous plasma separation, with the help of a special filter it extracts compounds from blood plasma which are responsible for hyperviscosity such as low-density lipoprotein, lipoprotein(a), triglyceride, cholesterine, fibrinogen, α2-macroglobulin, Von Willebrand factor, immunoglobulin M. Method and Patients: In the past 5 years, with the application of MONET filter we performed 80 therapies to treat age-related macula degeneration, diabetic foot ulcers and neuropathy which are complicated with hyperviscosity. Results: The review describes our benefical clinical experiences in consideration of viscosity, clinical symptoms and electroneurography parameters. Orv Hetil. 2021; 162(10): 375–382.

Aims: Rheopheresis is an extracorporeal haematotherapy that improves haemorheological status by filtering proteins that enhance blood viscosity. It also has anti-inflammatory effects by removing inflammatory cytokines. Our study aims to examine the effects of rheopheresis on the endothelial status in diabetic lower extremity ulceration. Methods: In vitro experiments were performed in a HUVEC model to mimic hyperglycaemic stress. We determined the changes in gene expression levels of IL-6, IL-8, TNF-alpha, endothelin convertase enzyme, ET-1, and NO synthase, as well as the ROS and intracellular GSH levels upon hyperglycaemia. In in vivo studies, two rheopheresis procedures were performed on seven patients with diabetic lower extremity ulceration with hyperviscosity, and we measured the changes in plasma concentrations of ET-1, TXB2, SOD enzyme activity, and extracellular components of the glutathione pool depending on treatments. Results: Our results showed that hyperglycaemia increases endothelial expression of inflammatory cytokines, ET-1, and endothelin convertase enzyme, while NO synthase was decreased. As a result of rheopheresis, we observed decreased ET-1 and TXB2 concentrations in the plasma and beneficial changes in the parameters of the glutathione pool. Conclusion: To summarize our results, hyperglycaemia-induced oxidative stress and endothelial inflammation can be moderated by rheopheresis in diabetic lower extremity ulceration with hyperviscosity.