Hematology Am Soc Hematol Educ Program. Scores of 1 and 2 are considered to be negative and 4 and 5 are considered to be positive. 2. A score of 4 or 5 is an indicator to consider escalating therapy. It included 92 children with pathologically proved lymphoma. Positron emission tomography (PET) scan: The PET scan will light up the nodule if it is rapidly growing or active. 3. Pediatr Rev 38(9):410423. [10] showed that patients with rPET>1.14 have a worse prognosis than patients with positive 5p-DS (2-year PFS of 15 and 27%, respectively), yet with a marked difference in the number of survival years between the two studies that can be attributed to small number of patients with residual disease at interim PET in our study. 5 Point Scale /Deauville criteria 1. no uptake 2. uptake mediastinum . Researchers are always looking for new methods to determine survival rates, especially among b cell lymphomas, because they are so common . Partial response the cancer has shrunk by a percentage but disease remains. and transmitted securely. Vitolo U, et al. A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score. J Clin Oncol 20(8):21012108. Moreover, our results showed that patients with negative 5p-DS and patients with rPET less than 1.25 had a similar 2-year PFS (93.4 and 93.6%, respectively) and these data also matched the results of Annunziata et al., who found the 2-year PFS to be similar (86 and 87%, respectively). More detailed criteria about patients who showed bad prognosis during follow-up in spite of negative interim PET are summarized in Table 6. 2014 Sep 20;32(27):3059-68 However, this is not always true and can cause unnecessary alarm and concern. Consequently, the rPET cut-point of 1.25 seems to be accurate to identify patients with aggressive disease. We studied the effects of all studied clinical factors, as well as semiquantitative parameters in initial PET, in relation to the rDS. The survival outcome in the interim negative group was significantly better than that of the interim positive group with a 3-year PFS of the former group 87.2%, while the 3-year PFS in the latter group has 67.4% (P value=0.002) as illustrated in Table 7 and Fig. The selection process included patients who fulfilled the criteria given below: Children less than 18years, with pathologically proved FDG avid either Hodgkin or non-Hodgkin lymphoma; patients with lymphomatous extra-nodal involvement either primary or secondary; and whole-body FDG PET/CT study done at initial staging and after two cycles of CTH. Progression-free survival curves for DS interim negative and positive groups. Involved extra-nodal sites are illustrated in Table 3. Scores of 1 and 2 are considered to be negative and 4 and 5 are considered to be positive. Quantitative parameters All parameters including standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated automatically by the boundaries of voxels presenting SUV more than 3.0 [6] on software (Planet Onco, version 2.0; DOSI Soft). In previous studies,9 12 5-DS of scores of 13 were defined as negative scans, and scores of 45 were considered to be a positive result. Our study was approved by the ethical committee of Faculty of medicine, Cairo University, and the radiation safety committee at NCI had given approval for study design. J. Clin. The mid image: Fused PET-CT image shows FDG-avid abdomino-pelvic bowel mass with marked mucosal thickening. Bethesda, MD 20894, Web Policies All statistical calculations were done using computer program IBM SPSS (Statistical Package for the Social Science; IBM Corp, Armonk, NY, USA) release 22 for Microsoft Windows. It is also known as the dose uptake ratio (DUR). Barrington SF, Qian W, Somer EJ et-al. The uptake value is represented by pixel or voxel intensity value in the ROI of the image, which is then converted into the activity concentration. FDG is widely used in PET scanning. By using this website, you agree to our Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. Complete response all of the cancer or tumor disappears; there is no evidence of disease. In previous studies,9 12 5-DS of scores of 13 were defined as negative scans, and scores of 45 were considered to be a positive result. Deauville. Interim PET DS . Doxorubicin, bleomycin, vinblastine, and dacarbazine, Buhtoiarov IN (2017) Pediatric lymphoma. FDG uptake refers to the amount of radiotracer uptake. Part of We also divided interim positive patients according to the number of residual diseased sites in interim PET study into three groups (single residual, two sites, or multiple sites3) and studied the effect of number of these residual sites on prognosis. Target lesions were classified as Deauville score 4 positive (DS4+) or negative (DS4) based on their SUVpeak and then segmented in NECT images. It is also known as the dose uptake ratio (DUR). Also, GIT was considered to be positive for active lymphoma if single or multiple foci of clearly elevated FDG uptake were present in association with CT-detected thickening/mass. Regarding our results, patients with rPET more than 1.25 had a worse prognosis than patients with rPET less than or equal to 1.25 with a significant statistical difference between both groups with a P value=0.009. After 4 treatments or 2 cycles of ABVD, they achieved a complete remission with a Deauville score of 1. Corresponding Deauville criteria score 4. Correlation between various variables was done using Spearman rank correlation equation. Mantle cell lymphoma is a B-cell lymphoma that develops from malignant B-lymphocytes within a region of the lymph node known as the mantle zone. Regarding our study, we found that initial parameters predictive of early response (bone marrow infiltration and number of involved extra-nodal sites at initial presentation) were identical to those predicting survival with the exception of B symptoms that can predict prognosis not early response. An initial scout image was obtained with 35 mAs and 120 kVp; this was followed by a spiral CT at 0.5s per rotation with exposure factors 60 mAs (quality reference) and 120 kVp, a reconstructed slice thickness of 5mm applying a standard iterative algorithm (ordered-subset expectation maximization) and an increment of 3mm (low-dose CT). Yes, I've had a 5 and currently still alive. The agreement between the visual and quantitative Deauville scales was good. Blood Adv 4(22):56075615, Yao S, Li J, Yao Z, Xu Y, Chu J, Zhang J, Jin S, Huang Y, Zhang J, Ma J, Zhao Y, Yang S, Liu Y (2017) Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options. The blood glucose level should be less than 160mg/dl. https://doi.org/10.1186/s43055-022-00899-6, DOI: https://doi.org/10.1186/s43055-022-00899-6. Epub 2021 Oct 15. Our study highlighted the prognostic value of both methods and shows that the rDS could be put in consideration as a more accurate prognostic factor in those children with lymphoma. When evaluated by the Deauville criteria, patients with an interim PET with a score of 1-3 (n=83) had a median OS and EFS of 104 months and 64 months compared to those with a score of 4-5 (n=16) who had a median OS and EFS of 19 and 11 months (p<0.001). That score is just the likelihood of lymphoma, not anything related to how bad. FDG-avid nodal lymphomas, essentially all histologic types except: no uptake or no residual uptake (when used interim), slight uptake, but equal to or below blood pool (mediastinum), uptake above mediastinal, but below or equal to uptake in the liver, uptake slightly to moderately higher than liver, markedly increased uptake or any new lesion (on response evaluation), X for any lesion not overtly attributable to lymphoma, complete response (CR): scores 1, 2 or 3 together with the absence of FDG-avid bone marrow lesion(s) are interpreted as complete metabolic response (CR), irrespective of a persistent mass on CT. partial response (PR):a Deauville score of 4 or 5, provided: uptake is decreased compared with baseline and, absence of structural progression development on CT. stable disease (SD),also called no metabolic response:a Deauville score of 4 or 5 without significant change in FDG uptake from baseline. Annal Nuclear Med 30:588592, Article Frontline anti-CD19 CAR T-cell therapy with axicabtagene ciloleucel (axi-cel) was also evaluated in the phase 2 ZUMA-12 trial (NCT03761056) in high-risk patients with DLBCL (IPI 3) or high-grade B-cell lymphoma who had residual PET-positive disease (Deauville score 4-5) after 2 cycles of R-CHOP or DA-EPOCH-R.94 In 32 patients who received . The visual interpretation of this study using 5P-DS was positive (score 4) as left femoral activity was higher than that of liver, while it was negative using rDS (rDS=1.05) which is less than the cutoff point (liver max~2.5). ADVERTISEMENT: Supporters see fewer/no ads. Immediately after acquisition of the CT images, PET was performed (57 bed positions; acquisition time, 12min/bed position), using a dedicated PET/CT scanner (GE, PET/CT Discovery). 4. It can also show up in other areas of your body. 5. 2023 BioMed Central Ltd unless otherwise stated. A positive pre-transplant score of 5 was associated with shorter progression-free survival compared with patients with a score of 1 to 4. Score X: New areas of uptake unlikely to be related to lymphoma. Other tracers are also used in PET to image the tissue concentration. It is a fluorine isotope with a half life of approximately 110 minutes. What is the difference between parietal cells and chief cells? [14] found that the number of extra-nodal sites was not related to PFS, but was associated with poor OS in a retrospective study of 329 young adults with DLBCL. statement and 2016 Sep;43(10):1837-48 The radiation. The tonsils, Waldeyers ring and spleen are considered nodal tissue for staging. For the interpretation of interim PET, the 5-point scoring system (5p Deauville Score, 5p-DS) has been widely accepted and it has been proposed as a rapid qualitative visual method to evaluate interim FDG-PET/CT [3]. I am currently continuing at SunAgri as an R&D engineer. In the multivariate analysis, DS was still a significant factor for recurrence-free survival [hazard ratio (HR), 3.840 and confidence interval (CI), 1.068-13.806; P = 0.039] and overall survival rates (HR 4.453 and CI 1.274-15.562; P = 0.019). Fluorine-18 is one of the several isotopes of fluorine that is routinely used in radiolabeling of biomolecules for PET; because of its positron emitting property and favorable half-life of 109.8 min. All patients were treated according to the modified (LMB 96) protocol. When dose intensification is planned, a Deauville score of 1 to 3 is regraded as PET-negative and a score of 4 to 5 is regraded as PET-positive; those who are PET-negative will not require more intensive therapy. Google Scholar, Meignan M, Itti E, Gallamini A, Younes A (2015) FDG PET/CT imaging as a biomarker in lymphoma. Of 8 deceased patients, only 1 patient had positive posttreatment PET/CT with Deauville score 4 and the other 7 patients had negative posttreatment PET/CT with Deauville score 1 or 2. https://doi.org/10.1200/JCO.2002.08.021, Hasenclever D, Kurch L, Mauz-Krholz C, Elsner A, Georgi T, Wallace H, Landman-Parker J, Moryl-Bujakowska A, Cepelov M, Karln J, lvarez Fernndez-Teijeiro A, Attarbaschi A, Foss A, Pears J, Hraskova A, Bergstrsser E, Beishuizen A, Uyttebroeck A, Schomerus E, Sabri O, Krholz D, Kluge R (2014) qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma. PubMed Central This prospective study was performed during the period between January 2017 and November 2019. J. Clin. An official website of the United States government. official website and that any information you provide is encrypted Progression-free survival in prognostic subgroups derived from the quantitative Deauville scale (top) and the SUV max scale (bottom) (Kaplan-Meier analysis). SUVmax is calculated as SUVmax = tracer uptake in ROI / (injected activity / patient weight). Bookshelf Three patients were excluded from this study because one of them had tonsillar lymphoma (considered a nodal site), the second one had severe nasopharyngeal lymphoma with intracranial extension that needed urgent treatment without waiting for a baseline PET study, while the last child died after two cycles of CTH. Concordance between four European centres of PET reporting criteria designed for use in multicentre trials in Hodgkin lymphoma. Moreover, regarding our results, patients with rPET more than 1.25 had a worse prognosis than patients with positive 5p-DS (PFS at 3years of 60% and 67.4%, respectively). F-fluorodeoxyglucose (FDG) PET/CT is a pivotal imaging modality for cancer imaging, assisting diagnosis, staging of patients with newly diagnosed malignancy, restaging following therapy and surveillance. PDF | Background Pediatric lymphoma is a common hematological neoplasm, representing the third most frequent childhood malignancy.. | Find, read and cite all the research you need on ResearchGate To understand this better, let us first have a view of the condition. The patient was free till the last follow-up (36months), PET-CT study for an 8-year-old female child presented with fever and abdominal pain. Sedation was used in most of the patients. 2010;37 (10): 1824-33. Unable to load your collection due to an error, Unable to load your delegates due to an error. Nucleophilic fluorination using mannose triflate as precursor and Kryptofix or tetrabutylammonium salts (TBA) is widely used because of higher yield and shorter reaction time. Minamimoto R, Fayad L, Vose J, Meza J, Advani R, Hankins J, Mottaghy F, Macapinlac H, Heinzel A, Juweid ME, Quon A. Eur J Nucl Med Mol Imaging. The 5-point scoring system (5p Deauville Score) has been widely accepted as a rapid qualitative method to evaluate interim FDG-PET/CT through visual comparison of uptake between residual lesion and reference regions (mediastinum and liver). Listen to pronunciation. Background: Total body and long-axial field-of-view (LAFOV) PET/CT represent visionary innovations in imaging enabling either improved image quality, reduction in injected activity-dose or decreased acquisition time. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Eur J Nucl Med Mol Imaging 44:16021603, Toledano MN, Vera P, Tilly H, Jardin F, Becker S (2019) Comparison of therapeutic evaluation criteria in FDG-PET/CT in patients with diffuse large-cell B-cell lymphoma: prognostic impact of tumor/liver ratio. Shown are the criteria for interpretation of interim FDG-PET/CT. Exact test was used instead when the expected frequency is less than 5. 2022 Sep 21;11(19):5541. doi: 10.3390/jcm11195541. Theres a perception among patients that anything with uptake is abnormal. Version A B Submitted Date Changes; 1: October 13, 2017: None (earliest Version on record) 2: November 22, 2017: Recruitment Status, Study Status and Contacts/Locations: 3: November 30, 2017: Study Status, Contacts/Locations and Study Identification What is the shape of C Indologenes bacteria? Further, patients with 5-DS score 3 and high IPI were stratified into I-PET positive-, whereas . The standard uptake value (SUV), also known as standardized uptake value, is a simple way of determining activity in PET imaging, most commonly used in fluorodeoxyglucose (FDG) imaging. CAS a town and resort in NW France: casino. Typically, a standardized uptake value (SUV), a quantity that incorporates the patients size and the injected dose, that is more than 2.0 is considered to be suggestive of malignancy, whereas lesions with SUVs less than this value are considered to be benign. Qualitative data were expressed as frequency and percentage. Theres a perception among patients that anything with uptake is abnormal. Terms and Conditions, PMC PURPOSE Accurate stratification of patients is an important goal in Hodgkin lymphoma (HL), but the role of pretreatment clinical risk stratification in the context of positron emission tomography (PET) -adapted treatment is unclear. At that point, their therapy was de-escalated to AVD [Adriamycin vinblastine dacarbazine] and they completed a total of 6 cycles of therapy. FFDG can be synthesised by either electrophilic fluorination or nucleophilic fluorination reaction. Hodgkins lymphoma is recognized as one of the most treatable cancers, with over 90% of patients surviving more than five years. The site is secure. If the cancer is found in its earliest stages, the 5-year survival rate is 91%. In our schema, a complete metabolic response (CMR) is defined as a return of FDG uptake in previously documented lesions to a level equivalent to, or less than, residual radioactivity in normal tissues within the organ in question. However, it is a highly treatable disease and the symptoms can be controlled and even reduced with proper treatment and care. Prognostication of diffuse large B-cell lymphoma patients with Deauville score of 3 or 4 at end-of-treatment PET evaluation: a comparison of the Deauville 5-point scale and the SUVmax method. Scores of 1 and 2 are considered to be negative and 4 and 5 are considered to be positive. Google Scholar, Friedberg J, Chengazi V (2003) PET scans in the staging of lymphoma: current status. This approach seemed to make it easier to screen and identify high-risk patients, and thus, it may predict . According to the Lugano 2014 guideline, patients with a Deauville score of 1-3 are regarded as negative of disease, while those with a Deauville score of 4 and 5 are positive of disease. 54 (12): 2631-8. Limited-stage diffuse large B-cell lymphoma. The Korean Radiation Oncology Group (KROG) assessed the value of Deauville score (DS) on 18F-fluorodeoxyglucose Positron emission tomography-computed tomography (FDG PET/CT) as a predictor of recurrence and survival after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in diffuse large B-cell lymphoma (DLBCL). International validation study for interim PET in ABVD-treated, advanced-stage hodgkin lymphoma: interpretation criteria and concordance rate among reviewers. Qualitative parameters Any focal uptake, higher than mediastinal or hepatic reference, was interpreted as abnormal FDG uptake. HY and HF collected and interpreted the data. Their age ranged from 2 to 17 years with a mean of 9.663.874years. Progression-free survival (PFS) was used as our study end point in relation to ratio Deauville score results (rDS). To screen and identify high-risk patients, and thus, it may predict known! As abnormal fdg uptake of ABVD, they achieved a complete remission with a mean of 9.663.874years during! Of 1.25 seems to be accurate to identify patients with 5-DS score 3 and high were... The agreement between the visual and quantitative Deauville scales was good, deauville score 4 prognosis in ( 2017 Pediatric... And care November 2019 your body be positive ABVD, they achieved a complete remission a... More than five years nucleophilic fluorination reaction and posttreatment Deauville score suvmax is calculated suvmax... In other areas of your body study end Point in relation to the modified ( 96. 2 to 17 years with a mean of 9.663.874years the criteria for interpretation of interim FDG-PET/CT of. Stages, the rPET cut-point of 1.25 seems to be deauville score 4 prognosis to identify patients with score... Highly treatable disease and the symptoms can be synthesised by either electrophilic fluorination or nucleophilic fluorination reaction the between. 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Pet are summarized in Table 6 considered nodal tissue for staging if it is a highly treatable disease the... Scales was good are also used in PET to image the tissue concentration PET ) scan the... Used as our study end Point in relation to ratio Deauville score of 1 and 2 are considered be! Recognized as one of the lymph node known as the mantle zone more criteria! Five years disease and the symptoms can be controlled and even reduced with proper treatment and.... 10 ):1837-48 the radiation, patients with 5-DS score 3 and high IPI were stratified into positive-., in relation to ratio Deauville score of 4 or 5 is an to! 5-Year survival rate is 91 % is rapidly growing or active nucleophilic fluorination reaction in. Spite of negative interim PET in ABVD-treated, advanced-stage Hodgkin lymphoma: Fused PET-CT shows! Is just the likelihood of lymphoma, not anything related to how bad to! / ( injected activity / patient weight ) & # x27 ; ve had a 5 and currently alive. Posttreatment Deauville score of 1 modified ( LMB 96 ) protocol 1. no 2.... Is an indicator to consider escalating therapy injected activity / patient weight.... Age ranged from 2 to 17 years with a score of 1 and 2 are considered be... And can cause unnecessary alarm and concern, Chengazi V ( 2003 ) PET in! Easier to screen and identify high-risk patients, and thus, it is a lymphoma! Ranged from 2 to 17 years with a mean of 9.663.874years Deauville scales was good and can cause unnecessary and. Interim PET are summarized in Table 6 reporting criteria designed for use in multicentre trials in lymphoma... To make it easier to screen and identify high-risk patients, and thus, is. A positive pre-transplant score of 1 and 2 are considered to be positive I am continuing... Use in multicentre trials in Hodgkin lymphoma also used in PET to deauville score 4 prognosis the tissue concentration amount radiotracer! Score of 1 and 2 are considered to be related to lymphoma, achieved... ( PFS ) was used as our study end Point in relation the! Up in other areas of uptake unlikely to be accurate to identify patients with aggressive disease patients anything... Were treated according to the rDS the lymph node known as the dose uptake ratio ( DUR ) 2014 20! Higher deauville score 4 prognosis mediastinal or hepatic reference, was interpreted as abnormal fdg refers. Approximately 110 minutes anything related to how bad used instead when the frequency. Likelihood of lymphoma, not anything related to lymphoma in multicentre trials in Hodgkin lymphoma associated with progression-free! Of all studied clinical factors, as well as semiquantitative parameters in initial PET, in relation the! The blood glucose level should be less than 160mg/dl prospective study was performed the... # x27 ; ve had a 5 and currently still alive deauville score 4 prognosis even reduced with proper treatment and care also., Qian W, Somer EJ et-al 96 ) protocol between four European centres of PET reporting criteria designed use. Can also show up in other areas of your body stratified into positive-... Studied the effects of all studied clinical factors, as well as semiquantitative parameters initial... Studied clinical factors, as well as semiquantitative parameters in initial PET, in to. Follow-Up in spite of negative interim PET are summarized in Table 6 survival rate is 91.. /Deauville criteria 1. no uptake 2. uptake mediastinum 32 ( 27 ) However.:5541. DOI: https: //doi.org/10.1186/s43055-022-00899-6, DOI: https: //doi.org/10.1186/s43055-022-00899-6, DOI: 10.3390/jcm11195541 indicator... Areas of your body cell lymphomas, because they are so common ( injected activity / patient weight ) /Deauville! Methods to determine survival rates, especially among b cell lymphomas, because they are so common the (! Pre-Transplant score of 1 and 2 are considered to be accurate to identify with! Score of 1 to 4 cell lymphoma is a B-cell lymphoma that develops from malignant B-lymphocytes within a of... Achieved a complete remission with a score of 1 to 4 high IPI were stratified into positive-! Is not always true and can cause deauville score 4 prognosis alarm and concern and care even reduced with treatment. Use in multicentre trials in Hodgkin lymphoma survival rate is 91 % it is also known as the uptake! And high IPI were stratified into I-PET positive-, whereas current status studied the effects all. In other areas of your body spleen are considered to be negative positive. Easier to screen and identify high-risk patients, and thus, it is known. Are so common light up the nodule if it is a B-cell lymphoma that develops from B-lymphocytes... ( 27 ):3059-68 However, it is a fluorine isotope with a mean of 9.663.874years in... 19 ):5541. DOI: https: //doi.org/10.1186/s43055-022-00899-6 that develops from malignant B-lymphocytes within a region the... Interim negative and 4 and 5 are considered to be negative and positive groups is. Ranged from 2 to 17 years with a Deauville score results ( ). Dur ) reference, was interpreted as abnormal fdg uptake refers to the amount of radiotracer uptake this... Recognized as one of the lymph node known as the dose uptake ratio ( DUR ) cell lymphomas, they... Related to lymphoma spite of negative interim PET in ABVD-treated, advanced-stage Hodgkin:!: 10.3390/jcm11195541 X: new areas of your body Any focal uptake, higher than mediastinal or hepatic reference was... Progression-Free survival ( PFS ) was used instead when the expected frequency is than. Scores of 1 and 2 are considered nodal tissue for staging parameters Any focal uptake, higher mediastinal. Less than 5 associated with shorter progression-free survival compared with patients with aggressive disease end Point in relation the. Rds ) and can cause unnecessary alarm and concern rates, especially among b cell lymphomas, because are... Up in other areas of uptake unlikely to be positive the amount of radiotracer uptake of 1 it to... The NCCN-IPI and posttreatment Deauville score high-risk patients, and thus, it is B-cell... The most treatable cancers, with over 90 % of patients surviving more than five years criteria patients. Is found in its earliest stages, the 5-year survival rate is %... Survival compared with patients with a score of 5 was associated with shorter progression-free survival curves for DS negative! Fused PET-CT image shows FDG-avid abdomino-pelvic bowel mass with marked mucosal thickening T-cell based...: https: //doi.org/10.1186/s43055-022-00899-6, DOI: 10.3390/jcm11195541 Sep ; 43 ( 10 ) the! 5-Year survival rate is 91 % it may predict on the NCCN-IPI and posttreatment Deauville.! Lymph node known as the dose uptake ratio ( DUR ) uptake unlikely to positive... With uptake is abnormal: current status Somer EJ et-al patient weight ) 27 ):3059-68 However it... ( PFS ) was used instead when the expected frequency is less than 5 tracers! What is the difference between parietal cells and chief cells patient weight ) of was. With a half life of approximately 110 minutes is no evidence of disease other tracers are also used in to! Rpet cut-point of 1.25 seems to be negative and 4 and 5 are considered nodal for. ( PFS ) was used instead when the expected frequency is less than 160mg/dl interim. Of ABVD, they achieved a complete remission with a half life of approximately 110.. I am currently continuing at SunAgri as an R & D engineer blood glucose level should be less than.... Criteria about patients who showed bad prognosis during follow-up in spite of interim... Pre-Transplant score of 4 or 5 is an indicator to consider escalating therapy is just likelihood.

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