We've found that a few Windows machines take our .epubs and, inexplicably, rename the .epub file extension .zip. None of our ebook files should come to you in .zip format. If you're seeing a .zip file, it's an error.
I'm developing a simple epub reader on iPhone but been wondering how to go about loading it. I know reading files such as a PDF is somewhat straightforward because it's one file in itself and can be loaded using UIWebView or CoreGraphics. It's unlike ePub which requires a bit more work to get(parsing xml's ...etc) the contents since it's essentially a ZIP file.
It's The Way You Say It Epub
I wish I knew if I should better choose the pdf or the epub version offered. I have been using Calibre for a while, but occasionally even the Kindle versions sold by Amazon have bugs. Recently I again experienced a problem. The footnotes are not linked, in fact this time did not even appear in the text. I had similar problems before. Would the pdf version, which I can choose just as easily since I have to convert it anyway, be based on the same technology as the pdf version or a completely independent version? Now I follow the link to Wikipedia and check if it gives me an idea. ?
Hi, thanks so much for your instructions. I downloaded Calibre, converted my epub books to mobi then connected my kindle fire. However Calibre is not connecting to my device. I have closed the programme, disconnected the Kindle, but nothing works. Any advice? Thanks so much.
Kaye you must always be aware of the rights you have to any book, epub or otherwise, and the laws are different in each country. You should not be stripping out DRM (digital rights management) but many epub books are free and available to use as you wish.
I self-published a book with Lulu.com in 2008 in order to meet a launch deadline. Last year Lulu performed complimentary epub conversions on the work of all pre-existing authors who did not actively opt out, in order to take maximum advantage of the e-reader explosion. I was anxious to check out my new epub before putting it on sale, but did not have an e-reader. This situation became an emergency when I discovered that, unbeknown to me, those good people at Lulu had put my epub on sale in the States through Barnes and Noble! (I am in the UK.)
So I bought a Kindle for Christmas for my 12-year-old daughter, who had started to devour teen chick lit, with intent to borrow it to check out my epub file. I was gobsmacked when I discovered that the Kindle could not read the file! But with the help of Calibre and your instructions I was able to do the job.
I have just purchased a Pandigital which supports the Amazon Kindle library. I have tried to convert my epub books to mobi, works but my Pandigital still cannot read them. I have tried every way recommended in this forum.Has anyone succeeded with Pandigital?
i can convert a pdf file using calibre to an ebub file but the problem is that when i send it to the device it still turns up as a pdf file. on the computer i can chose to view pdf or epub but on my kindle it only sends the pdf. do you know how i can chose the epub version to send? if so then thankyou! files that are already epub to begin with work fine though.
I started to read only because you suggested that Kindle can be made to read epubs. Only after reading more did I understand that you do not have the information that your title suggests and instead provide the trivial information on how to use Calibre.
Ideally, our free ebook templates would magically match your brand colors. But they probably don't; this is where you get to truly personalize your work. However, because ebooks offer more real estate for color than your logo or website, it's good to consider secondary colors within your brand's color palette. Ebooks are where this color scheme can truly shine.
Now, we don't have a dedicated CTA template slide in the PowerPoint ebook templates ... but it's still simple! You just have to duplicate the Header/Subheader slide and customize the copy or add images as needed. You can also go to Insert >> New Slide and work from there.
The more complex your product is, the more information your customers will need to use it correctly. If your product or service has many use cases or it's hard to set up alone, dedicate a brief ebook to showing people how to make the most out of it.
I have an epub file created in ID containing several tables originally created in MS Word. These show up reasonably well in ADE (truncated vertically but not horizontally) but are an absolute disaster in mobi (all Kindle versions) regardless of the conversion method used. Any ideas?
Why go through all this (which really really hard and did not work) when this website converts your epub to mobi in under a minute and for free.I donated it was that fast and easy. =5WPFYLAD
I am a long-time user of the VarioUltra which does not have a method for skipping blank lines. I am also a long-time user of Epub files.What I've done is written a SED script to make text files read nicely on the VarioUltra. If you are on the VarioUltra list you can reply to me directly or search its archives for my script.As a Mac user, you can easily use Sed or any other Unix/Linux tools on the mac. I am not a mac user, so you will probably need to surf around for help using the command line in terminal on the mac. But mastering command line tools is the best way to clean up text to read on a Braille display or even if you like reading text with Alex on your Mac.Also know that an epub is merely a zipped file. If you unzip it you will find it contains HTML which can be opened in browsers, like Chrome. This way you can read it on your Mac with Firefox say and the Braille display connected -- since I'm a Windows user, perhaps another Mac user will chime in here now I've got you started down the right road!
A recent study found that patients\u2019 decisions about whether or not to seek treatment for actinic keratosis are significantly influenced by the words used to describe the skin disorder, in particular its risk for transforming into skin cancer.1 \\n\\nA total of 539 participants completed an online survey that included 5 questions to determine if the way actinic keratosis is framed could influence the participant\u2019s intention to receive treatment. The results revealed that when it was described solely as a precancerous condition, a high proportion of participants would opt to treat actinic keratosis; whereas, when it was described as a condition where a majority of the lesions might not turn into skin cancer and some of the lesions could resolve without getting treatment, a low proportion of participants would treat it. These findings indicate that patients\u2019 decisions about whether to treat actinic keratosis are significantly influenced by the way information about the disease is presented, especially with reference to malignant transformation.1 \\n\\nOne of the authors of the study, Joslyn S. Kirby, MD, MS, MEd, of the Department of Dermatology at Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, said, \u201cIn my own practice, I've developed consistent ways of describing conditions or treatments. My goal was to strike a balance between clarity and honesty while avoiding information overload. Yet, I felt my use of the word \u2018pre-cancer\u2019 to describe actinic keratoses wasn't inclusive of the more indolent behavior reported. It\u2019s quick and easy for me to use the word, but because of this study, I've changed how I counsel patients about actinic keratoses and other aspects of care \u2013 I recognize that the way I deliver a message will influence them, so I try to give a balanced view \u2013 the positive and the negative. It takes longer to explain, just seconds really, but I think it's worth it.\u201d\\n\\nSteven R. Feldman, MD, PhD, of the department of dermatology at Wake Forest University School of Medicine, Winston-Salem, North Carolina, said, \u201cWhat is remarkable about this study is that it raises a general issue of tremendous importance to patient care: that how we frame issues has dramatic effects on how patients interpret those issues. Humans assess things very subjectively. That\u2019s the way our minds work. How we present something to a patient will certainly affect his or her willingness to agree and adhere to treatment. If we tell patients, \u2018Actinic keratoses can turn into cancers,\u2019 they would be very likely to accept treatment, while if we say, \u201899 out of 100 of these actinic keratoses are likely not to turn into anything bad,\u2019 they would be much less likely to want to treat. Both of these statements are accurate and in no way in conflict, but they would be perceived very differently by patients.\u201d\\n\\nIt is very important to be aware of the ways clinicians\u2019 specific words and framing of discussions can affect patients\u2019 perceptions and treatment inclinations, especially for a disease such as actinic keratosis, where it may not make sense to treat it every time, but then again, at other times, treatment could be important. It is the most common skin disease in adults, with an estimated prevalence of almost 40 million in the year 2004 in the United States alone. While it can progress to invasive squamous cell carcinoma, the progression rate was estimated to be only about 0.1% to 0.6% lesions per year.1,2 In addition, lesions may spontaneously regress, but regressed lesions may also recur.2 Therefore, there are many different factors that would have to be considered when deciding whether to treat actinic keratosis. In Dr. Feldman\u2019s opinion, \u201cIf it were a mild lesion that wasn\u2019t symptomatic, I would likely just keep the sun off it and see if it would go away on its own. If I were 99 years old and likely to die of heart disease at any moment, I surely would not undergo any painful treatment for an actinic keratosis. But if I had had multiple skin cancers in the past and was in good health otherwise, I would want it treated.\u201d\\n\\nRather than viewing choice framing as an added or unnecessary burden to clinical practice, Dr. Feldman considers it to be \u201ca powerful tool\u201d when communicating with patients. He explained, \u201cWhen we educate patients, we cannot present the information in an unframed way. The information we present will be framed in some way, and we certainly want to do it in a way that we think will optimize patients\u2019 well-being.\u201d\\n\\nEven though this study is about choice framing actinic keratosis for patients, Dr. Feldman sees it as an opportunity to take a closer look at what motivates clinicians as well. \u201cIt seems likely that being paid to use destructive treatments for actinic keratosis may affect how we view such treatments relative to topical treatment and how we view whether actinic keratoses even need treatment at all. It is hard to recognize our own biases. Hopefully seeing how framing affects patients so dramatically will make us consider our own biases more clearly,\u201d he said. \",\"notes\":[\"Actinic keratosis is a common skin disease that may progress to invasive squamous cell carcinoma.\\n\",\"A recent study revealed that the way actinic keratosis is framed significantly influences patients\u2019 intention to receive treatment.\\n\",\"It is important for clinicians to be mindful of the words they use when discussing actinic keratosis with patients and to present both positive and negative information fairly.\"],\"byline\":\"By Cheryl Zigrand\\rReviewed by Roger S. Ho, MD, MS, MPH, FAAD, Assistant Professor of Dermatology, New York University School of Medicine, New York, NY\",\"meta_data\":\"description\":\"A recent study revealed that the words used to describe actinic keratosis significantly influence patients\u2019 intention to receive treatment.\",\"title\":\"What You Say & How You Say It Affects Patients\u2019 Decisions About Actinic Keratosis\",\"keywords\":\"\",\"synopsis\":\"A recent study revealed that the words used to describe actinic keratosis significantly influence patients\u2019 intention to receive treatment.\",\"section_id\":202,\"section_name\":\"Other Skin Cancers\",\"active\":1,\"published\":1,\"images\":[\"image_id\":1,\"url\":\"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/cs-Treatment-Decisions-Actinic-Keratosis-RM-65065.jpg\",\"caption\":\"\"],\"references\":[\"display_text\":\"Berry K, Butt M, Kirby JS. Influence of information framing on patient decisions to treat actinic keratosis. JAMA Dermatol. 2017 Jan 18. Doi: 10.1001\/jamadermatol.2016.5245. [Epub ahead of print] \",\"url\":\"http:\/\/jamanetwork.com\/journals\/jamadermatology\/article-abstract\/2597894\",\"id\":1,\"display_text\":\"Siegel JA, Korgavkar K, Weinstock MA. Current perspective on actinic keratosis: a review. Br J Dermatol. 2016 Aug 8. Doi: 10.1111\/bjd.14852. [Epub ahead of print]\",\"url\":\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27500794\",\"id\":2],\"ad_zone\":\"\",\"rewrite_url\":\"you-say-you-say-affects-patients-decisions-actinic-keratosis\",\"main_image_url\":\"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/cs-Treatment-Decisions-Actinic-Keratosis-RM-65065.jpg\"}","publish_date":"2018-06-20 00:00:00","published":"1","active":"1","dc":"0000-00-00 00:00:00","dlm":"2018-06-20 00:00:00","rewrite_url":"\/resource-centers\/contemporary-approaches-non-melanoma-skin-cancer\/you-say-you-say-affects-patients-decisions-actinic-keratosis\/2046","main_image_url":"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/cs-Treatment-Decisions-Actinic-Keratosis-RM-65065.jpg","brightcove_video_id":null,"ign_video_id":null,"case_id":null,"sailthru":"actinic keratosis,actinic cheilitis,eruption of skin,disorder of skin,mass of body structure","adRefreshRate":"60000"}; window.MPT.decodedJSON = "title":"What You Say & How You Say It Affects Patients\u2019 Decisions About Actinic Keratosis","publish_date":"2018-06-20 00:00:00","description":"A recent study revealed that the words used to describe actinic keratosis significantly influence patients\u2019 intention to receive treatment.","content_id":"2046","content":"A recent study found that patients\u2019 decisions about whether or not to seek treatment for actinic keratosis are significantly influenced by the words used to describe the skin disorder, in particular its risk for transforming into skin cancer.1 \n\nA total of 539 participants completed an online survey that included 5 questions to determine if the way actinic keratosis is framed could influence the participant\u2019s intention to receive treatment. The results revealed that when it was described solely as a precancerous condition, a high proportion of participants would opt to treat actinic keratosis; whereas, when it was described as a condition where a majority of the lesions might not turn into skin cancer and some of the lesions could resolve without getting treatment, a low proportion of participants would treat it. These findings indicate that patients\u2019 decisions about whether to treat actinic keratosis are significantly influenced by the way information about the disease is presented, especially with reference to malignant transformation.1 \n\nOne of the authors of the study, Joslyn S. Kirby, MD, MS, MEd, of the Department of Dermatology at Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, said, \u201cIn my own practice, I've developed consistent ways of describing conditions or treatments. My goal was to strike a balance between clarity and honesty while avoiding information overload. Yet, I felt my use of the word \u2018pre-cancer\u2019 to describe actinic keratoses wasn't inclusive of the more indolent behavior reported. It\u2019s quick and easy for me to use the word, but because of this study, I've changed how I counsel patients about actinic keratoses and other aspects of care \u2013 I recognize that the way I deliver a message will influence them, so I try to give a balanced view \u2013 the positive and the negative. It takes longer to explain, just seconds really, but I think it's worth it.\u201d\n\nSteven R. Feldman, MD, PhD, of the department of dermatology at Wake Forest University School of Medicine, Winston-Salem, North Carolina, said, \u201cWhat is remarkable about this study is that it raises a general issue of tremendous importance to patient care: that how we frame issues has dramatic effects on how patients interpret those issues. Humans assess things very subjectively. That\u2019s the way our minds work. How we present something to a patient will certainly affect his or her willingness to agree and adhere to treatment. If we tell patients, \u2018Actinic keratoses can turn into cancers,\u2019 they would be very likely to accept treatment, while if we say, \u201899 out of 100 of these actinic keratoses are likely not to turn into anything bad,\u2019 they would be much less likely to want to treat. Both of these statements are accurate and in no way in conflict, but they would be perceived very differently by patients.\u201d\n\nIt is very important to be aware of the ways clinicians\u2019 specific words and framing of discussions can affect patients\u2019 perceptions and treatment inclinations, especially for a disease such as actinic keratosis, where it may not make sense to treat it every time, but then again, at other times, treatment could be important. It is the most common skin disease in adults, with an estimated prevalence of almost 40 million in the year 2004 in the United States alone. While it can progress to invasive squamous cell carcinoma, the progression rate was estimated to be only about 0.1% to 0.6% lesions per year.1,2 In addition, lesions may spontaneously regress, but regressed lesions may also recur.2 Therefore, there are many different factors that would have to be considered when deciding whether to treat actinic keratosis. In Dr. Feldman\u2019s opinion, \u201cIf it were a mild lesion that wasn\u2019t symptomatic, I would likely just keep the sun off it and see if it would go away on its own. If I were 99 years old and likely to die of heart disease at any moment, I surely would not undergo any painful treatment for an actinic keratosis. But if I had had multiple skin cancers in the past and was in good health otherwise, I would want it treated.\u201d\n\nRather than viewing choice framing as an added or unnecessary burden to clinical practice, Dr. Feldman considers it to be \u201ca powerful tool\u201d when communicating with patients. He explained, \u201cWhen we educate patients, we cannot present the information in an unframed way. The information we present will be framed in some way, and we certainly want to do it in a way that we think will optimize patients\u2019 well-being.\u201d\n\nEven though this study is about choice framing actinic keratosis for patients, Dr. Feldman sees it as an opportunity to take a closer look at what motivates clinicians as well. \u201cIt seems likely that being paid to use destructive treatments for actinic keratosis may affect how we view such treatments relative to topical treatment and how we view whether actinic keratoses even need treatment at all. It is hard to recognize our own biases. Hopefully seeing how framing affects patients so dramatically will make us consider our own biases more clearly,\u201d he said. ","notes":["Actinic keratosis is a common skin disease that may progress to invasive squamous cell carcinoma.\n","A recent study revealed that the way actinic keratosis is framed significantly influences patients\u2019 intention to receive treatment.\n","It is important for clinicians to be mindful of the words they use when discussing actinic keratosis with patients and to present both positive and negative information fairly."],"byline":"By Cheryl Zigrand\rReviewed by Roger S. 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But we need to know more about who will, or will not, respond adequately.","full_json":"\"title\":\"Metastatic cSCC: PD-L1 Expression\",\"publish_date\":\"2020-09-15 00:00:00\",\"description\":\"Anti-PD1 immunotherapy improves outcomes for patients with metastatic cutaneous squamous cell carcinoma (cSCC). But we need to know more about who will, or will not, respond adequately.\",\"content_id\":\"2978\",\"content\":\"The incidence of cutaneous squamous cell carcinoma (cSCC) has been increasing in the U.S. Rates of detection are higher among older adults and those who have been exposed to the sun longer, and mortality rates across the southern and central U.S. are close to those of melanoma.1 As many as 12,500 patients with cSCC develop nodal metastases annually in the U.S. and, with limited treatment options, almost 9000 die of the disease.1,2\\nIn recent years, however, anti-PD1 (programmed death receptor 1) immunotherapy has improved outcomes for patients with metastatic cSCC, but the relationship between PD-L1 expression and CD8+ cytotoxic T cells in metastatic cSCC is still emerging. A new study published in Head & Neck aims to further elucidate this relationship.2\\n\u201cAnti-PD1 treatment is having a major impact on this disease [metastatic cSCC], and there\u2019s a potential for a larger impact in the future,\u201d says study co-author Kevin Emerick, MD, of the Department of Otolaryngology\u2014Head and Neck Surgery at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, in Boston. \u201cUnderstanding PD-L1 expression and how it can be used as part of a biomarker profile is critical. Our study is another important step in creating that profile.\u201d\\nHow the study was constructed\\nFor patients with metastatic SCC, higher levels of CD8+ cytotoxic T cells is associated with improved prognosis. PD1 suppresses the response of CD8+ T cells, and it follows that anti-PD1 immunotherapy may potentiate the antitumor effects of CD8+ T cells.\\nDr. Emerick and his colleagues looked at PD-L1 expression and CD8+ infiltrates in metastatic lymph nodes, using archived tissue from patients with metastatic cSCC treated at Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital between 2008 and 2013.2 Complete clinical data, including age, gender, primary tumor features, metastasis location and number, treatment (surgery with or without adjuvant radiotherapy, chemoradiotherapy, or none), and current disease and survival status, also were obtained for each patient.2\\nImmunohistochemical staining with primary antibodies against PD-L1 was used to determine PD-L1 expression. A cutoff value of \u226510% for high versus low PD-L1 expression was used because approximately half of included samples fell on each side: 13 were 4 mm.2\\nThe retrospective study examined medical records from patients with cSCC who were treated between January 2010 and December 2015 at a single center, the University Medical Centre Rostock, in Germany. Their analysis included data for 99 patients with a total of 142 cases of facial cSCC, of which 100 cases were primary tumors and 42 cases were secondary tumors. Most primary tumors were found on the cheeks (28.2%), followed by the forehead (21.1%), scalp (16.2%), and outer ear (13.4%), with fewer than 10% each occurring on the nose, outer lip, or around the eyes. All included cases were treated using standard surgical excision, with local recurrence defined as occurring within a radius of 10 mm around the index location of the primary tumor, and follow-up histopathological assessment of the margins.2\\nChi square tests were used to compare binary data for \u22652 unpaired samples, Pearson correlation was used to assess linear relationships between continuous variable pairs, and Spearman\u2019s rank correlation coefficient was used to calculate 2 constant sample characteristics (\u00b11 indicating likely and \u00b10 indicating unlikely). P values 6 cm in horizontal extension). There were no stage T4 tumors at diagnosis. While mean maximum horizontal diameters ranged from 8.9 mm with stage T1 tumors to 51.4 mm with stage T3 tumors, no correlation existed between this measurement and risk of local recurrence in the analysis. Similarly, neither mean maximum vertical diameter nor tumor histological grading correlated with the development of local recurrence.2\\nTo analyze the effect of microscopic clear margins, 4 groups based on margin intervals were used for both horizontal and vertical margins: 0-2 mm, 2.1-4 mm, 4.1-6 mm, and >6 mm. Possibly because of the low event rate, no significant association was observed between margin size and local recurrence; however, the researchers suggest that a horizontal or vertical margin \u201c>4.1 mm was found to be a negative cut-off value, showing no occurrence of local recurrence\u201d.2\\nSCC is the second most common form of skin cancer in the United States after basal cell carcinoma (together known as keratinocyte carcinomas), and thought to make up approximately 20% of skin cancers.1,2 Although prognosis is generally good after excision or treatment, these tumors can be associated with tissue destruction and disfiguring scars and may invade bone or other tissues.1 Rates of metastatic progression are low (generally \u22646%) with recommended surgical excision and margin evaluation. However even with the recommended Mohs microscopic surgical approach, which allows margin control intraoperatively, disease recurrence are still seen.1 The potential for further disfigurement and metastasis to other tissues makes prevention of recurrence an important treatment goal; in fact, recurrent disease is associated with a higher risk for metastasis than primary tumors.1\\nThe current study identified a microscopic clear margin diameter of \u22644 mm as a potential risk factor for locally recurrent disease after surgery for facial cSCC. In their report, the researchers acknowledge that the retrospective nature of their study, as well as the small number of patients from a single center, limit the extent to which the finding can be generalized and must be considered descriptive. However, they write, \u201cNonetheless, to our knowledge, this study is the first to identify microscopic clear margin diameter as an independent risk factor for local recurrence.\u201d2\",\"notes\":[\"SCC is the second most common form of skin cancer in the United States.\",\"Even with preferred Mohs microscopic surgery, which allows margin control intraoperatively, disease recurrence is a possibility.\",\"A retrospective analysis found that a microscopic clear margin diameter of \u22644 mm is a potential risk factor for locally recurrent disease after surgery for facial cSCC.\"],\"byline\":\"By Leslie Burgess\\rReviewed by Michael Leapman, MD\",\"meta_data\":\"description\":\"A retrospective analysis at a single center in Germany found that a microscopic clear margin diameter of \u22644 mm is a potential risk factor for locally recurrent disease after surgery for facial cSCC.\",\"title\":\"Cutaneous SCC: Surgical Margins and Recurrence\",\"keywords\":\"cutaneous squamous cell carcinoma; surgical margins; recurrence; face\",\"synopsis\":\"A retrospective analysis at a single center in Germany found that a microscopic clear margin diameter of \u22644 mm is a potential risk factor for locally recurrent disease after surgery for facial cSCC.\",\"section_id\":\"165\",\"section_name\":\"cSCC\",\"active\":1,\"published\":0,\"images\":[\"image_id\":1,\"url\":\"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/Early skin can SqCC-2 (1).jpg\",\"caption\":\"\"],\"references\":[\"display_text\":\"National Comprehensive Cancer Centers Clinical Practice Guidelines in Oncology. Squamous cell skin cancer. Version 1.2020. Published October 2, 2019. Accessed April 27, 2020.\",\"url\":\"https:\/\/www.nccn.org\/\",\"id\":1,\"display_text\":\"Thiem DGE, Scharr K, Pabst AM, Saka B, K\u00e4mmerer PW. Facial cutaneous squamous cell carcinoma\u2014microscopic safety margins and their impact on developing local recurrences. J Craniomaxillofac Surg. 2020;48:49-55. doi:10.1016\/j.jcms.2019.11.022\",\"url\":\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31810842\/\",\"id\":2],\"ad_zone\":\"\",\"rewrite_url\":\"cutaneous-scc-surgical-margins-and-recurrence\",\"main_image_url\":\"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/Early skin can SqCC-2 (1).jpg\",\"display_assoc_logo\":false,\"association_logo_caption\":\"\"","publish_date":"2020-08-28 00:00:00","main_image_url":"\/\/clf1.medpagetoday.com\/assets\/images\/resource-center\/Early skin can SqCC-2 (1).jpg","brightcove_video_id":null,"ign_video_id":null,"rewrite_url":"\/resource-centers\/contemporary-approaches-non-melanoma-skin-cancer\/cutaneous-scc-surgical-margins-and-recurrence\/2957","t_cms_section_id":"165","content_type":"1","name":"Article",{"id":"2928","t_cms_content_type_id":"1","title":"Staging Cutaneous SCC: An Approach with 18F-FDG-PET","description":"For clinicians assessing patients with cutaneous squamous cell carcinoma, CT and MRI have been the gold standard for staging. But a newer modality, fluorine-18-fluorodeoxyglucose\u2013positron emission tomography, may be more sensitive.","full_json":"{\"title\":\"Staging Cutaneous SCC: An Approach with 18F-FDG-PET\",\"publish_date\":\"2020-07-29 00:00:00\",\"description\":\"For clinicians assessing patients with cutaneous squamous cell carcinoma, CT and MRI have been the gold standard for staging. But a newer modality, fluorine-18-fluorodeoxyglucose\u2013positron emission tomography, may be more sensitive.\",\"content_id\":\"2928\",\"content\":\"Each year, approximately 1 million cases of cutaneous squamous cell carcinoma (cSCC) are reported in the U.S., a figure that\u2019s believed to be an underestimate. The incidence of cSCC is increasing worldwide; in Europe, the number of cases is expected to double by 2030. While cSCC is usually manageable, local invasion and metastasis can occur, dramatically impacting survival. Approximately 4% of patients develop lymph node metastases; the overall mortality rate is 2%.1\\nComputed tomography (CT) and magnetic resonance imaging (MRI) are the modalities most frequently used for disease staging. However, a new study recently published in Nuclear Medicine Communications suggests fluorine-18-fluorodeoxyglucose\u2013positron emission tomography (18F-FDG-PET) may be an important tool for initial staging, with high sensitivity and the potential to prompt modification of treatment selection.2\\nDetecting nodes and lesions in a small cohort\\nMahajan and colleagues performed a retrospective analysis of patients with biopsy-proven cSCC who underwent a 18F-FDG scan upon diagnosis at Memorial Sloan Kettering Cancer Center in New York, N.Y., between 2000 and 2016.2 A total of 23 consecutive patients, ranging in age from 54 to 101 years old (median 76 years), underwent 18F-FDG at initial staging and were included in the analysis. Staging was determined based on the American Joint Committee on Cancer 7th edition criteria. (Of note is that only a small minority of patients were offered the PET imaging, possibly introducing selection bias.)\\n\u201cAll patients (n=23) had positive 18F-FDG scans,\u201d the authors wrote, \u201cwith 18F-FDG-avid primary lesions. Ten patients had 18F-FDG-positive disease only in the primary site and 13 patients had 18F-FDG-avid additional sites including locoregional node(s) (nine patients), skin lesion (one patient), both skin lesion and regional node (one patient), both bone lesion and regional node (one patient), and lung nodule (one patient).\u201d2 In total, 51 lesions were seen on all scans, including 24 primary sites and 27 secondary sites.\\nSecondary sites detected included nodes (21), skin lesions (4), lung (1), and bones (1), with a mean size of 0.9 cm (range 0.4 cm to 2.5 cm); 17 of the 21 detected nodes were 2ff7e9595c
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