pe

How European security is changing

How European security is changing Expert comment LJefferson 10 January 2022

Although migration, economic, health, tech and climate policy are increasingly thought of in terms of security, different issues are taking place in each of these policy areas.

Since the end of the Cold War, debates about security among both academics and policymakers have shifted away from traditional military or state security towards a broader conception of what security is – including, for example, ideas such as ‘human security’.

More recently, there has been a widespread perception of a ‘return of great power competition’ and even renewed fears about great power war – in other words, a resurgence of traditional security debates that many hoped and believed were a thing of the past. At the same time, and especially since the COVID-19 pandemic began in 2020, the concept of ‘security’ has also been increasingly applied to other areas like economic and health policies.

These complex and parallel developments raise a number of difficult questions. First, does the changing way in which the concept of ‘security’ is used – and in particular the way people now increasingly speak of ‘economic security’ and ‘health security’ – reflect a changing reality or rather simply a changing perception of reality? Second, are these changes in the way we think about security helpful or not? In other words, is the redefinition of security that seems to be taking place leading to good policy responses and making citizens more secure, or is it rather unhelpfully ‘securitizing’ policy areas and possibly undermining democracy in the process?

Part of the reason that these questions are difficult to answer is that there are different developments taking place in different policy areas. This article briefly analyses developments in five policy areas: migration policy, economic and trade policy, health policy, technology policy, and climate policy.

The authors argue there are at least three separate developments taking place, though it is often quite difficult to disentangle them – and more than one development may be taking place in each policy area. The analysis focuses on developments in Europe – defined broadly as including countries such as the UK which are outside the European Union (EU) – which may be different from those taking place elsewhere.

Five policy areas, three trends

In migration policy, the clearest development that is taking place, in particular since the so-called ‘refugee crisis’ of 2015, is the militarization of borders in Europe – in particular, the militarization of the EU’s external border.

The removal of borders within Europe was once seen by some as a step towards a borderless world, but since 2015 the EU seems to have concluded that the internal removal of borders requires a much harder external border than was previously the case.

The removal of borders within Europe was once seen by some as a step towards a borderless world, but since 2015 the EU seems to have concluded that the internal removal of borders requires a much harder external border than was previously the case

In particular, since the ‘refugee crisis’, the EU has massively invested in Frontex, its border agency, which describes itself as ‘Europe’s first uniformed service’ that ‘helps guarantee free movement without internal borders checks that many of us take for granted’. In short, we are seeing an application to migration policy of military tools, including armed border guards.

Something different seems to be taking place in economic policy. For the last three or four decades since the end of the Cold War, economic policy has been dominated by (neo-)liberal assumptions. But these are now increasingly being challenged and a shift may be taking place away from this macroeconomic paradigm.

The reasons for this are complex – in part, a domestic backlash against this paradigm, particularly from the ‘losers’ or ‘left behind’ (in other words those who have suffered from the distributional consequences of the economic and especially trade policies of the last 30-40 years going back to the ‘neoliberal turn’), and in part a sense among analysts and policymakers that a different set of more protectionist policies are required in order to compete with China as a ‘systemic rival’.

These two different drivers of an economic paradigm shift have become even more tightly connected since the COVID-19 pandemic began in 2020. The pandemic led to both an increased demand for a new economic paradigm and a sense of intensified competition with China and, in the EU, to a lesser extent with the United States.

However, because the set of rules governing economic and in particular trade policy was set during the earlier period of (neo-)liberal hegemony, they restricted the ability of states to pursue what were seen as protectionist policies in order to redistribute and created exceptions only for security reasons. This has created a structural pressure on nation states to present economic policies in terms of security.

Here, however, the EU may be an outlier. During the last few decades, the EU has gone even further than the rest of the world has in creating rules around economic policy – at least internally. In particular, the EU’s fiscal rules may prevent its member states from borrowing to invest and its state aid rules may prevent them from experimenting with new kinds of industrial policy.

Therefore, the EU may be structurally constrained from making the kind of paradigm shift in economic policy that many now think is necessary. In particular, despite the rhetoric about a more ‘geopolitical’ EU, it may be limited in the extent to which it can think of economic policy in terms of security – sometimes to the regret of security establishments, as is the case for debates around 5G, for example.

The EU may be structurally constrained from making the kind of paradigm shift in economic policy that many now think is necessary

In health policy, something similar may be happening as in economic policy. During the last three or four decades, health policy has been approached in a rather liberal way. Across Europe, though to different degrees and in different ways, market principles have been introduced into health systems.

In many cases such as the UK, this has involved privatizing what were previously state functions in healthcare. But since the pandemic, there has been a renewed focus on renationalizing or, in the case of the EU, ‘re-regionalizing’ supply chains, in particular for personal protective equipment (PPE) and vaccines, which is presented in terms of ‘health security’. COVID-19 has also reinforced the need to better include pandemic preparedness in national security planning.

A similar trend seems to be taking place in technology policy, which as with health policy is now increasingly viewed in a defensive, protectionist way rather than the liberal way it was previously seen. For example, the production of semiconductors was previously viewed in economic liberal terms – in other words, they should be produced wherever they can be produced most efficiently.

Technology policy, like health policy, is now increasingly viewed in a defensive, protectionist way rather than the liberal way it was previously seen

But analysts and policymakers increasingly see technology as central to the competition between China and the United States – or even more broadly between authoritarian states and democracies. As in health policy, there is an increasing focus on a shared approach among allies and on the ‘resilience’ of supply chains for technology. A similar shift is taking place on the management of data flows and the need to think harder – and maybe, be less naive – about the security impact of our online life.

Finally, in climate policy, something different seems to be taking place. Here, there is neither an attempt to apply military tools (notwithstanding the fact some national European militaries as well as NATO are increasingly interested in climate security, for instance regarding the ability to train and fight in altered weather conditions, notably extreme heat) nor a paradigm shift away from liberalism – although some, especially on the left, do question whether it is possible to prevent catastrophic climate change unless we abandon economic liberalism and much of the debate about green investment is closely connected to debates about an economic paradigm shift.

In climate policy, something different seems to be taking place. Here, there is neither an attempt to apply military tools, nor a paradigm shift away from liberalism

Rather, what is striking is the increasing talk of a ‘climate emergency’ – with its implication of the need to suspend normal democratic decision-making – and of the need to take extraordinary measures to prevent catastrophic climate change. However, for the time being, such rhetoric on climate change is not matched by relevant extraordinary emergency measures.

Across these five policy areas, in other words, there seem to be at least three developments taking place that are reshaping how we think about security in Europe. The difficult question is whether each of these developments is a ‘good’ thing or not, i.e. whether they actually make European citizens more secure in an appropriate way.

In other words, is it a good idea to militarize the EU’s borders, to shift away from the earlier liberal paradigm in economic, health and technology policy and frame the shift in terms of ‘security’, or to invoke an emergency in order to be able to take more drastic measures to prevent climate change?

The limits of securitization theory

One way of thinking about these issues is what academics call ‘securitization’ – the situation when something is identified in rhetoric as an existential threat to some object, specifying a point of no return, that legitimizes the use of extraordinary measures and pushes the issue higher on the political and policy agenda.

The response to COVID-19 can be seen as an example of securitization – the existential threat to human beings but also healthcare systems was used to legitimize lockdowns and social distancing requirements.




pe

Review: Islam's role in shaping Europe

Review: Islam's role in shaping Europe The World Today rsoppelsa.drupal 1 February 2022

Maryyum Mehmood on a work that recasts the role of Muslim minorities

Muslims and the Making of Modern Europe
Emily Greble, Oxford University Press, £26.99

When discussing the historical role of Muslims in Europe, most authors focus on Muslims in the western part of the continent, many of whom arrived as immigrant settlers from Muslim-majority nations. As a result, Muslims are easily identifiable as a foreign ‘other’. 

Emily Greble takes a different trajectory. In Muslims and the Making of Modern Europe, Greble centres her analysis on south-eastern European Muslims who are native to the region and, despite this fact, have still been subject to continuous stigmatization. 

In light of the present-day political tensions and targeted attacks on Muslims in Bosnia, which has seen inter-ethnic and religious hostility at its worst in 30 years, Greble’s nuanced retelling of the region’s social and political landscape has renewed urgency. Her work serves as a refreshing intervention to the literature on various fronts. It subverts stereotypical assumptions promulgated by the ‘Eastern Question’, whereby Muslims are portrayed as a simple ethnic minority living under colonial rule. Instead, Greble shows how they are a marginalized indigenous group that is by no means a monolithic, homogeneous entity. 

By uncovering the history of the region through the lens of Muslims, Greble highlights their capabilities as agents of change. Muslims were not just passive subjects but active citizens whose engagement was vital in the framing of social norms, political, ethical and legislative structures. 

By uncovering the history of the region through the lens of Muslims, Greble highlights their capabilities as agents of change

Greble’s neatly crafted thesis serves as a counterpunch to a decades-long clash-of-civilizations discourse, which pits Muslims of the region as Ottoman outsiders to be scapegoated as and when deemed necessary. 

The author offers a proposition that while secularism was the overarching aim of the new European state-project, the role of religion, especially marginalized or ‘othered’ religious communities cannot be overlooked or relegated to a simple ‘minority’ issue. 

This argument is laid out in three historical parts, beginning with the post-Ottoman transition of power (1878-1921), to the Yugoslav nation-building project (1918-1941) and finally to the political overhaul in a post-Second World War Europe (1941-1949).

Most historical analyses of the region focus on state actions towards Muslim minorities. Greble points out that such an approach is lacking because it is riddled with institutional biases from the very sources and methods used to understand them. 

Instead, the author takes Muslims, their lived realities and agency as her starting point and effectively manages to avoid such pitfalls.

What is most remarkable about this book is Greble’s self-reflective approach to confronting such a sensitive topic with great care.

The reader is shown how Muslims affected change and steered the trajectory of democracies in Europe at key historical junctures

Almost every chapter begins with an insightful and deeply personal historical account from a Muslim from the region which sets the scene for Greble’s assessment of key social, political and legal struggles.

With an enriching methodology, Greble explores the topic through first and second-hand accounts of how Muslims manoeuvred in both the secular realm and within religious spaces, such as madrasas (Islamic seminaries), waqfs (local community funds), muftis and ulemas (religious scholar), and the shariah courts. As a result, the reader is shown how Muslims affected change and steered the trajectory of constitutional democracies in Europe at key historical junctures. 

By taking this lens, Greble does not just offer another retelling of the significance of the 1878 Congress of Berlin, which enabled the demarcation of new territorial boundaries in a post-Ottoman world, but also conveys the story of how Muslims contributed to the emerging narratives around citizenship. 

Crucially, we are exposed to Muslim leadership as more than just a docile, homogenous grouping, but a defining entity that shaped the European citizenship project by refashioning both imperial secular norms, as well as Islamic jurisprudential rulings to suit their unique context, as opposed to a remnant of bygone Ottoman rule. 

A fundamental difference that sets this book apart from other contemporary work on the topic is that the author brings forth multiple intra-faith complexities found within Muslim groups of the region, from revivalist to reformists, and all else in between. The fluctuating relationship between the traditionalist ulema, muftis and qadis (religious scholars, clergy and judges) and the secular state powers is intricately captured across most chapters in this book. 

At times, the ulema would be seen to bandy with the state to acculturate Muslims to the emerging polities of the region. As Greble shows, muftis in 1914 travelled across southern Serbia giving dawah (missionary work) to locals to encourage them to support the Serbian state. Similarly, qadis in Montenegro in 1902 reassured local Muslims that by following the law of the land, they would be guaranteed their ‘shariah rights’, which were loosely defined by the Muslim clergy. 

This created a paradox for the states: the role of nation-building and liberalizing orthodox religious communities was given to conservative clerics who, in turn, were gatekeepers setting the boundaries and thus interpreted and applied Islam to preserve their position of power. The consequences were twofold. As Greble suggests, ‘instead of becoming more tied to secular structures of state and society – through centralized law, conscription, political representation – Muslims in formerly Ottoman lands were becoming more deeply bound to Islam’. 

Simultaneously, the rhetoric used further embedded Muslims firmly as a minority. 

Ironically in contrast, it was the liberal reformist thinkers who, sometimes, stood in opposition to the state regimes. Such internal divisions within Muslim spaces became more overtly discernible under communist rule, wherein members of the same Muslim community fought in different camps. 

The author offers a complex perspective not only of Balkan Muslims and their lived experiences, but also, their impact upon wider society and the states themselves

For instance, the author notes how some were aligned with the communist regime, while others were fighting with the allied forces and many were still backing revivalist Islamic groups. In light of this, what is perhaps most intriguing is how the communist takeover in 1945 managed to tear down any seemingly progressive movement that benefited the region’s Muslims. And it brought them back to square one, with the scrapping of shariah law and the removal of a mufti-led judiciary. Such crackdowns caused greater frenzy among the region’s Muslims and led to resistance movements in the form of activism and insurgencies. 

Ultimately, the author offers a complex perspective not only of Balkan Muslims and their lived experiences, but also, the implications of this upon wider society and the states themselves.

Greble’s remapping of the historical underpinnings of the tale of Muslims and the Making of Modern Europe is not just a clear example of how Muslims are not a foreign entity to the region, but a call to overturn the entrenched Great Replacement theory which uses this foreign ‘othering’ to further prejudice and calls for the ousting of Muslims and other minorities from Europe, a land which has forever been their home.
 




pe

Ukraine response reveals Europe’s security is changing

Ukraine response reveals Europe’s security is changing Expert comment NCapeling 8 February 2022

Recent events regarding Ukraine show an active UK responding quickly while EU powers deliberate. But pulling ahead of the pack is not the same as leadership.

Britain’s relationship with Ukraine appears to be thriving, with Ukrainian defence journalist Illia Ponomarenko recently tweeting the ‘British are just unstoppable these days’ and that the UK finds itself ‘on the right side of history’ while one Ukrainian wine bar has started offering free drinks to British nationals.

Ponomarenko’s remarks and the wine bar offer – certainly one post-Brexit benefit of having a British passport – are down to the UK decision to send anti-tank weapons to support Ukraine’s forces against a potential Russian attack.

The UK’s quick response was praised by Ponomarenko as being ‘wise enough not to be lured into going the easiest way, which is always the fastest lane straight to hell’ and strikes a clear contrast with that of Germany, whose typically moderated approach to geopolitical tensions went down badly in Kyiv.

The chief of Germany’s navy was forced to resign after saying Russian president Vladimir Putin ‘deserved respect’ and that Ukraine will never win back annexed Crimea. The German government also sought an energy exception to proposed US sanctions, so that gas can continue to flow into Europe.

The question for leaders in Paris, Berlin, and Brussels is how to deal with an active Britain committed to Europe but under no obligation to work within EU processes

France’s response was somewhat stronger but rather confusing as Emmanuel Macron initially called for European Union (EU) member states to ‘conduct their own dialogue’ with Russia, seemingly as an alternative to supporting the US-led NATO response.

Risks of a ‘bullying’ Russia

Although positioning himself as the convener of a transatlantic response to the Ukraine crisis brings welcome respite for UK prime minister Boris Johnson from his domestic ‘partygate’ fiasco, he is also reported as saying some world leaders ‘may not appreciate the deteriorating picture on the Ukrainian border, or fully comprehend the risks posed by a bullying Russia’.

One particular image sums up the difference in approach between the UK and the EU, as a flight path shows a British RAF plane flying around Germany before taking a detour over Denmark on route to Ukraine.

Given that Germany later blocked the export of NATO ally Estonia’s weapons to Ukraine, this image gives ‘Global Britain’ advocates a strong symbol of apparent British reliability and resourcefulness in the face of supposed European deliberation and disunity.

But although the UK’s response to the Ukraine crisis has rightly been credited as swift and substantial, it also reveals deeper developments in the current European security landscape as EU countries had worried Britain might choose to become absent post-Brexit.

Losing one of its two main military powers would certainly have been a blow to Europe, particularly as Russia’s threat has grown in recent years, so there will be relief that the Ukraine crisis shows Britain is undoubtedly committed to the region. Now the question for leaders in Paris, Berlin, and Brussels is how to deal with an active Britain committed to Europe but under no obligation to work within EU processes.

The UK already has an interesting network of bilateral and mini-lateral relationships with European allies. Its Joint Expeditionary Force brings together ten European countries – including Scandinavian and Baltic states – and is well-placed to support NATO activities while also remaining flexible and independent. In the past year, the UK worked with Norway in the Arctic region, provided military engineers support to Poland, and worked directly with France and Germany through the E3 grouping – once again bypassing EU institutions.

The UK also brings a unique diplomatic, technology, and intelligence-sharing relationship with the US which is unavoidably important in dealing with the threat from Russia. As the US sees European security through a NATO lens – rather than an EU one – this makes Britain a leading player as one of the few countries meeting its NATO spending commitments.

UK must do more to win trust

But despite such creative partnerships transcending the constraints of Brexit, the UK must do more to win the trust of the EU’s biggest players France and Germany to be a permanent power in the region. And relations with France have deteriorated following disputes over fishing, a lack of cooperation on migrants, and the AUKUS defence technology agreement between the UK, US, and Australia.

When it comes to Germany, the UK must not use the Ukraine crisis as an opportunity for geopolitical point-scoring. There are good historical reasons for Germany’s cautious approach to military engagement, even if these do constrain the country’s response to this challenge.

In dealing with Russia, some members of Germany’s ruling SPD sincerely believe their party’s less confrontational posture was central to de-escalating conflict during the Cold War. And although some historians may dispute that belief, it is still a distinct and more noble motivation for ‘dovishness’ than pure economic self-interest.

Despite such creative partnerships transcending the constraints of Brexit, the UK must do more to win the trust of the EU’s biggest players France and Germany to be a permanent power in the region

Cooperation always requires some compromise on all sides. Germany must accept some level of economic risk if sanctions against Russia are to be meaningful and France has to accept the necessity of the UK and US’s involvement and that the most effective dialogue is unlikely to be achieved through EU institutions.

Meanwhile, the UK must accept some role for the two biggest EU players, particularly as the Normandy Format which includes Russia, Ukraine, France, and Germany has proved productive in the past. And the UK needs to clamp down on its own economic ties with Russia.




pe

Limited expectations as Scholz heads to Kyiv and Moscow

Limited expectations as Scholz heads to Kyiv and Moscow Expert comment NCapeling 14 February 2022

After heavy criticism for an initially timid response, the approach of Germany’s new government to the Ukraine crisis is improving as its position on Russia evolves.

Olaf Scholz is a famously quiet and cautious communicator and, as concerns mounted in Washington and London about the possibility of a Russian invasion of Ukraine, the new German chancellor remained silent.

This time his silence reflected the fact that his government was unprepared for its first major foreign policy test, with marked divisions between the SPD and the Greens on how to manage a rapidly deteriorating relationship with Russia.

When he did speak, Scholz caused dismay in several NATO capitals by defending the controversial Nord Stream 2 pipeline. He called it ‘a purely private economic project’ even though the company building the pipeline is a subsidiary of Russia’s state-owned Gazprom.

Scholz has prepared the ground carefully for his visits to Kyiv and Moscow, extensively coordinating with NATO allies, such as France and Poland – as part of the Weimar Triangle – and the three Baltic states

The absence of crisis management from Berlin was a stark reminder of the gap left by Angela Merkel. Her knowledge of Russia and Ukraine, and her personal experience of dealing with Vladimir Putin, were key assets in 2014 in developing a unified western response to Russia’s annexation of Crimea and its destabilization of south-eastern Ukraine.

Germany has coordinated with its allies

Scholz has prepared the ground carefully for his visits to Kyiv and Moscow, extensively coordinating with NATO allies, such as France and Poland – as part of the Weimar Triangle – and the three Baltic states. His inaugural visit to Washington helped align positions on US-EU efforts to develop an economic deterrent against further Russian intervention in Ukraine.

Scholz has also repeated Merkel’s language from 2014 to signal to Moscow that Germany and its partners are ‘united and determined’ to stand their ground. And he has spoken of Germany’s continuing double strategy of ‘clear announcements’ to Moscow of the price it would pay for further aggression accompanied by a readiness to use all possible channels of dialogue to preserve peace.

The continuation of Germany’s established policy will not surprise Moscow. But under the surface Germany’s discourse on Russia is evolving as the political class internalizes the fact that the current Russian leadership is openly threatening to use military force to impose its will on Ukraine and re-configure Europe’s security arrangements.

Despite deep concerns about Germany’s dependence on Russian gas – more than half of the gas it consumes comes from Russia – there is broad acceptance that Nord Stream 2 cannot go ahead if Russia invades Ukraine. But typically, Scholz has not yet said as much publicly, limiting himself to stating ‘all options are on the table.’

Despite its mantra that there is no alternative to the Minsk Agreements, Berlin now admits these currently offer no prospect of resolving the war in Donbas

Robert Habeck, Germany’s vice-chancellor as well as economic affairs and climate action minister, says the ‘geopolitical situation’ requires Germany to diversify its gas supplies and infrastructure for importing gas. For years, a strong pro-Russian gas lobby has dominated the thinking of the Economics Ministry and one consequence is the complete absence of facilities to import liquefied natural gas.

The German debate on Russia is shifting

A public debate has also started about weapons deliveries to Ukraine, even though this runs counter to deeply embedded pacifist tendencies in German society. Some MPs, former diplomats, and experts have begun to make the case for Germany to supply weapons to Ukraine so it can exercise its right to self-defence and deter military attack.

Christoph Heusgen, a former long-standing foreign policy adviser in the Federal Chancellery, says Berlin’s decision not to deliver arms to Ukraine to avoid endangering the Minsk peace process requires revision now Moscow has abandoned the path of negotiation.

Despite its mantra that there is no alternative to the Minsk Agreements, Berlin now admits these currently offer no prospect of resolving the war in Donbas because Russia is not prepared to implement them properly.

Other taboos are also being broken inside Germany. Heavyweight left-of-centre Die Zeit published the first results of its investigation into the SPD’s links with Russia and their place in Russia’s channels of influence in Germany. And even the SPD’s Sigmar Gabriel, an outspoken champion of Nord Stream 2 during his time as a government minister, has raised the question of Germany terminating energy imports from Russia if there is a drastic deterioration of the security situation.




pe

Ukraine exposes Europe’s double standards for refugees

Ukraine exposes Europe’s double standards for refugees Expert comment NCapeling 30 March 2022

As European governments provide swift protection assurances to those fleeing Ukraine, non-European asylum-seekers continue to face violence at the EU’s borders.

One month after Russia’s invasion of Ukraine, the European Union (EU) already faces its largest refugee crisis since World War Two, with more than ten million people having fled their homes – 6.5 million displaced within Ukraine and 3.9 million escaping to neighbouring countries.

Acting quickly and decisively, European governments have opened borders and European citizens have opened their homes in an unprecedented showing of solidarity towards refugees. But, with all eyes on Ukraine, the Greek coastguard continues to illegally push back asylum-seekers crossing from Turkey while Spanish police forcefully repel those who dare to jump the fence in Melilla.

The painful contrast exposes the double standards in the EU’s approach to refugees. With Europe’s grim history of restrictive asylum policies, it is wishful thinking that the warm welcome to Ukrainians will extend to all asylum-seekers. The EU solidarity to displaced Ukrainians illustrates the deeply politicized – and often discriminatory – nature of providing refugee protection.

The waves of women and children leaving Ukraine prompted a surge of humanitarian action but they are also a chilling reality check of Europe’s double standards

However, the hope is this turning point in European history can at least set an important precedent for treating refugees more humanely. Undoubtedly, EU solidarity towards people fleeing the horrors of Putin’s war is critically important and the initial response is positive in its efforts to meet immense humanitarian needs.

Solidarity with Ukrainians

The EU activation of the Temporary Protection Directive (TPD) is a significant step towards a more humane protection regime and fairer responsibility-sharing among member states. Without the need for the examination of individual applications, those fleeing Ukraine can access harmonized rights across the EU for three years – including residence, housing, medical assistance, and access to the labour market and education.

The TPD is also a move away from the strict ‘Dublin’ rules which put the pressure of hosting refugees onto the countries of ‘first arrival’. Ironically, the fiercest opponents of intra-EU solidarity, such as Poland and Hungary, are the ones benefiting from this change now but, in the case of Ukraine, geographical proximity and shared histories must be considered when analysing Europe’s response.

Eastern European and Baltic countries share a post-Soviet history and fear of Russian aggression, and Ukrainians already enjoyed 90 days of visa-free travel in the EU – with a large diaspora, many have established networks across Europe. But even considering these distinctive connections with Ukrainian displacement, the initial response still shows that European countries have both the political will and the capacity to host refugees.

Unlike the usual – often media-fuelled – narratives of refugee ‘invasions’ into Europe, the waves of women and children leaving Ukraine prompted a surge of humanitarian action but they are also a chilling reality check of Europe’s double standards.

The EU has used agreements with countries such as Turkey and Libya to prevent arrivals and outsource asylum responsibilities, while border violence, detention, and lengthy asylum procedures await the few asylum seekers who manage to enter Europe from the Middle East, Asia, and Africa.

These ‘fortress Europe’ legacies have even undercut the humanitarian response in Ukraine, with reports of incidents of discrimination towards people of colour at the EU borders being condemned by the United Nations (UN) and the African Union (AU), the media facing allegations of racist reporting, and comments from Bulgarian PM Kiril Petkov providing a stark reminder of the islamophobia, racism, and history of colonization which still pervades European asylum policies.

The unity shown over Ukraine can help reshape and refocus political efforts towards increased responsibility-sharing among EU member states – the perennial ‘hot potato’ of the EU asylum system

Foreign policy also influences how EU leaders treat the right to asylum, as the geopolitics of Europe’s efforts to create a united front against Russian aggression is an undercurrent to the prompt European response to Ukrainians. But only a few months ago, non-European asylum-seekers trapped in freezing forests at the Poland-Belarus border were used as political pawns by Belarusian leader Aliaksandr Lukashenka and then dehumanised as a ‘hybrid attack’ by EU leaders.

A turning point for asylum in Europe?

Despite entrenched discriminatory precedents, it is worth looking ahead at this moment of reckoning. Although policy changes remain far off, the unity shown over Ukraine can help reshape and refocus political efforts towards increased responsibility-sharing among EU member states – the perennial ‘hot potato’ of the EU asylum system.




pe

Africa and Europe: Cooperation on digital transitions and new technologies

Africa and Europe: Cooperation on digital transitions and new technologies 26 May 2022 — 8:00AM TO 12:30PM Anonymous (not verified) 12 May 2022 Online

The 11th Africa Day International Conference takes place under the auspices of the president of the Republic of Slovenia, HE Mr Borut Pahor, and within the framework of the Bled Strategic Forum.

Slovenia’s annual high-level Africa event seeks to improve policy outcomes for citizens in Europe and Africa as a result of a mutual understanding and strengthened cooperation between the two regions.

The event is co-hosted by the Ministry of Foreign Affairs of the Republic of Slovenia, the Chatham House Africa Programme and the European Commission.

Expert discussions at this year’s edition will examine collaborative links between Africa and Europe in promoting responsible innovation and governance of emerging technologies, as well as the role of technology in shaping creative and cultural economies.

The conference will be broadcast live on this website, on the Slovenian Ministry of Foreign Affairs website and on the Africa Programme Facebook page.




pe

Russia's war: How will it shape the region's future?

Russia's war: How will it shape the region's future? 1 December 2022 — 9:00AM TO 6:00PM Anonymous (not verified) 17 August 2022 Chatham House and Online

This conference takes a deep-dive into the implications of the war for the wider region.

You will receive an email in advance of the conference with further details on accessing the event.

The video on this page is of the opening session only. To view all the session videos, please visit the conference playlist on YouTube.

How will Russia’s war shape the region’s future?

Russia’s latest invasion of Ukraine is on such a scale that it will have a seismic effect on all the countries that once formed the Soviet empire. Vladimir Putin’s decisions have accelerated trends across the region leading to unintended consequences.

Now it is more crucial than ever – not only for those concerned with the region’s economic and democratic development, but for all those with a stake in the future security of Europe.

For some states, this will mean a faster break from the legacy of the USSR and from Russia’s ‘Geopathological embrace‘ while, for others, maybe even a fresh start at democracy and good governance.

In isolated cases, the war will conceivably hasten assimilation with Russia. But the two principal combatants, Ukraine and Russia, will diverge even further. Ukraine, though fighting for its survival now, will at least get the opportunity to ‘build back better’ if it achieves some form of victory.

Whatever the course of the war, however, Russia’s aspirations to be a global power again are doomed as it is gradually deglobalized from Western structures.

This conference analyses:

  • How Russia’s war will affect the broader regional economy and whether this will hasten Vladimir Putin’s exit
  • What to hope for, what to fear and the key trends that will dominate the region going forward.
  • Unique expertise in an independent forum on what’s at stake for Europe. 




pe

Central and Eastern Europe become hawkish on China

Central and Eastern Europe become hawkish on China Expert comment LJefferson 16 September 2022

The recent withdrawal of the Baltic countries from the ‘17+1’ format displays changing perceptions of China due to its ambiguity towards the war in Ukraine.

While the Russian invasion of Ukraine only confirmed Central and Eastern Europe’s views of Russia, it is also affecting their relations with China. Although the relationship was already complicated due to unfulfilled Chinese economic promises to CEE countries and growing indications of efforts to influence their domestic politics, China’s support for Russia is pushing Central and Eastern Europeans even further away.

This shift was highlighted, and formalized, recently by several countries in the region leaving the ‘17+1’ format, through which China cooperates with a group of countries from the region. The shifting attitudes towards China will also influence the relationship between the European Union as a whole and China.

A Trojan Horse that never was

When the format was launched in 2012 between 16 CEE countries at the time and China, the countries jumping on board expected a wave of Chinese investment and an opportunity to diversify mostly west-bound trade.

These hopes never fully materialized as Chinese foreign direct investment (FDI) in CEE has been generally lower compared to the rest of Europe and China never became an important export destination for any of the countries. The growing disillusionment and concern about Chinese security threats has led to some of the countries speaking up about the perceived perils of closer cooperation.

The first to withdraw from what had become ‘17+1’ by 2021 was Lithuania, which also took an interest in strengthening ties with Taiwan and allowed it to open a Taiwanese representative office in Vilnius. This triggered a breakdown in the bilateral relations with China. As a retaliatory response, China blocked Lithuanian imports and imports from other EU states containing inputs from Lithuania, leading the EU to launch an official dispute at the WTO.

War in Ukraine

Since the invasion started, CEE countries have been dealing with large numbers of Ukrainian refugees, organizing shipments of military equipment to Ukraine, and at the same time worrying whether they could be next on Russia’s list.

However, the concerns and security environment that these countries face seems to be almost entirely disregarded by China. On the sidelines of the 2022 Winter Olympics in Beijing, Xi and Putin signed the joint communiqué in which China backed Moscow’s demands to reverse NATO borders to the pre-1997 situation, completely disregarding CEE’s security interests.

Since the invasion started, CEE countries have been dealing with large numbers of Ukrainian refugees, organizing shipments of military equipment to Ukraine, and at the same time worrying whether they could be next on Russia’s list.

China’s implicit support for Russia after the invasion has sowed deep mistrust of its respect for the sovereignty of other nations. The Chinese diplomatic apparatus clearly noticed this changing mood among CEE governments and sent a special envoy to eight capitals in April-May tasked with ‘eliminating misunderstandings regarding Russia-Ukraine conflict’.

However, the trip was not particularly successful. The delegation failed to secure high-level meetings, with the most prominent case being the Polish minister of foreign affairs declining to meet Huo Yuzhen, the Chinese Special Councilor for CEEC cooperation. Given that Andrzej Duda, President of Poland, was the only head of an EU state who attended the Beijing Olympics opening ceremony just before the Russian invasion in February, the change in attitudes is clear.

Following the envoy’s visit to the Czech Republic, the Czech parliament’s foreign affairs committee unanimously approved a resolution calling for the country to quit the ‘16+1’ format and the government is expected to act upon it in the near future. Meanwhile, Latvia and Estonia recently jointly announced that they would no longer be participating in the cooperation framework, turning it into ‘14+1’.




pe

Russian imperial mindset must change for real victory

Russian imperial mindset must change for real victory Expert comment NCapeling 8 December 2022

The attitude of Russia’s elite – and wider population – to the states which used to constitute the USSR needs to change in order to solve the Russia challenge.

Although the reverberations of Russia’s invasion of Ukraine clearly stretch around the globe, the strongest shocks are – and will continue to be – felt by those countries Moscow used to directly rule.

These countries struggle to shrug off a Soviet legacy as, to varying degrees – linguistically, technologically, culturally, and politically – they bear psychological and physical scars of Russia’s colonial past and its present mentality.

It does not help that these countries lack an appropriate collective descriptor. Over the years there has been ‘Newly Independent States’ – hardly appropriate after 31 years – the now-defunct ‘Commonwealth of Independent States’, the ‘post-Soviet space’ and ‘Former Soviet Union’ which both reference the past, and simply ‘Eurasia’ which is hardly appropriate for either Ukraine or Turkmenistan.

Some of these former ‘colonies’ are as badly governed and as sinister – albeit not as lethal beyond their borders – as Russia itself. Others, most notably the Baltic states, are modern, liberal, affluent societies, but Moscow’s shadow still looms.

There is a strong mindset in most of Russia’s citizens that, because that it used to rule these other countries, it either still has privileged rights over them or they are not real countries at all – but instead historical aberrations to be extinguished.

What is past is gone

As historian Timothy Snyder has noted, whatever the wrongs of Putin’s ‘history-based’ assertions about the ‘return of historic lands’, all historical claims are bunkum anyway. If the past brings validity, almost no land border on earth would be beyond dispute. It is agreements which count, and Russia signed away the other successor states in 1991.

There is a strong mindset in most of Russia’s citizens that, because that it used to rule these other countries, it either still has privileged rights over them or they are not real countries at all

The Russia and Eurasia programme at Chatham House has, for the last 31 years, always taken as a starting position that these countries are as sovereign as any other. This of course this means they can choose to be in Russia’s embrace if they wish. But none do because Russia is insufficiently attractive. Some have better relationships with Moscow than others – mainly the more autocratic ones – but no former slave goes back to their master willingly.

At the recent Chatham House conference Russia’s war: How will it shape the region’s future? (note the avoidance of a specific descriptor), the overwhelming consensus was that Russia must lose, that Ukraine must be reconstructed and planning for that must start now, and that the regional economy is convulsing.

But another key view was that, in Russia, rent seeking and buying loyalty are likely to lead to the separation of the Russian people and the regime, especially as the population ages and young men being sent to die at the front. Putin may still be popular in some places in Russia, but not in others – although popularity can rise and fall fast in Russia. However, few at the conference foresaw the disintegration of Russia any time soon.

With continued skill, determination, and more weaponry, Ukraine may well vanquish Russia on the battlefield, and this remains a necessary pre-requisite for European security. But even a Ukraine victory will not erase malign intent.

Getting Russians to look upon their neighbours as equals requires widescale self-reassessment in a post-Putin Russia

The Russian imperial itch is so deeply embedded, it must be excised not just from Russian capability but from the intention and mindset of elites and in the popular imagination. That is hard to achieve when so many believe in it as fervently as a religion – even the Russian Orthodox Church invokes a messianism in Russia’s imperial ‘rights’.

The wider region is suffering

Getting Russians to look upon their neighbours as equals requires widescale self-reassessment in a post-Putin Russia. But, for now, the wider region will surely be looking to simply neuter Russia’s destructive capacities.




pe

How Russia’s war affects politics in southeast Europe

How Russia’s war affects politics in southeast Europe 4 April 2023 — 11:00AM TO 12:00PM Anonymous (not verified) 24 March 2023 Online

This event will discuss how the war on Ukraine has affected southeastern Europe.

This event will discuss how the war on Ukraine has affected southeastern Europe. How have the governments and publics responded to the war?

The panel will discuss Russia’s goals and leverage in the region, including the impact of its disinformation campaigns. Are the governments reassessing their foreign policy options?

The granting of EU candidate status to Ukraine and Moldova has brought attention to the stalled accession process in the Western Balkans. What lessons from the Western Balkans can be applied in Ukraine and Moldova? Have new linkages emerged between the two regions?




pe

Review: Rediscovering Milan Kundera’s European tragedy

Review: Rediscovering Milan Kundera’s European tragedy The World Today mhiggins.drupal 28 March 2023

The Czech writer’s 40-year-old essay on the roots of Russia’s empire-building, ‘A Kidnapped West’, reads all too presciently, writes Stefan Auer.

A Kidnapped West: The Tragedy of Central Europe
Milan Kundera, Faber, £10

‘In November 1956, the director of the Hungarian News Agency, shortly before his office was flattened by artillery fire, sent a telex to the entire world with a desperate message announcing that the Russian attack against Budapest had begun. The dispatch ended with these words: “We are going to die for Hungary and for Europe.”’ Thus, Milan Kundera began his 1983 essay for the French journal Le Débat, reflecting on the 1956 Hungarian Uprising.

A seminal essay

The Czech author might well have written a near-identical passage about the fraught hours immediately after Russia’s invasion of Ukraine in 2022. In the event, Russian tanks failed to occupy Kyiv, unlike Budapest in 1956. Nevertheless, Faber has chosen this moment, 40 years later, to republish Kundera’s seminal essay on Europe and Russian aggression in its original translation for the New York Review of Books by Edmund White. How salient are its observations today?

Thanks to the Cold War, the countries of Central Europe were denied their true destiny, Kundera thought, in the democratic West

The essay’s original French title, ‘Un Occident kidnappé ou la tragédie de l’Europe centrale’ (The Kidnapped West, or the Tragedy of Central Europe), described the fate of Hungary, Czechoslovakia in 1968 and, to an extent, Poland in 1980-81 at the hands of the Soviet Union. Owing to the Cold War division of Europe, the countries of Central Europe were denied their true destiny, Kundera thought, to be an integral part of the liberal, democratic West. Kundera himself fled Czechoslovakia for France in 1975.

The author of The Unbearable Lightness of Being might no longer be as well-known as he was at the height of his fame in the 1980s, but his novels and essays still deserve attention. So, it is pleasing to see Kundera’s masterpiece republished, even as it is awful to witness the enduring relevance of the questions it raises.

What did the Hungarian journalist mean when he declared his willingness to die for Europe, Kundera asked? That ‘Russians, in attacking Hungary, were attacking Europe itself. He was ready to die so that Hungary might remain Hungary and European’. The journalist did indeed die in the uprising.

It is a line that President Volodymyr Zelenskyy and his supporters abroad have echoed time and again: that Ukrainian soldiers are not just dying for their country, they are dying for Europe at large.

Kundera’s suspicion of Russia has been validated. His frustration about the indifference of the West less so

The ‘tragedy’ in Kundera’s essay was that the West didn’t care. ‘Europe hasn’t noticed the disappearance of its cultural home,’ Kundera wrote, ‘because Europe no longer perceives its unity as a cultural unity.’

In other words, as the cultural sphere in Central Europe continued to defy the political restrictions imposed by the Soviet empire, it embodied the western values of freedom and democracy more than the West itself did. The extent to which this analysis remains relevant today will prove decisive for Europe’s future.

As timely as ever

Kundera’s essay is as timely as ever but in ways that both vindicate and challenge his key arguments. His suspicion of Russia has been validated. His frustration about the indifference of the West less so. But the true tragedy of Ukraine would be if the West has not changed sufficiently. So far, the West appears to be doing enough to enable Ukraine to defend itself, but not enough to defeat the aggressor.

[A small nation] is one whose very existence can be put in question at any moment; a small nation can disappear and it knows it

Milan Kundera

Faber has made an excellent decision in combining The Tragedy of Central Europe with a lesser-known text by Kundera: his 1967 speech to the Czech Writers’ Congress given the year before the ill-fated Prague Spring. In it, Kundera addressed what was to become a lifelong preoccupation: the fate of small nations. ‘For Czechs’, Kundera wrote, ‘nothing has ever constituted an indisputable possession – neither their language nor their belonging to Europe.’

Rather than reflecting the size of its territory or population, a small nation ‘is one whose very existence can be put in question at any moment; a small nation can disappear, and it knows it.’ In this way Ukraine, Europe’s largest country, apart from Russia, is fighting to avoid the fate of Kundera’s ‘small nation’.

Historically, the ‘small’ nations of Central Europe were threatened by both Germany and Russia. But after the Second World War, the threat was from the Soviet Union, which for Kundera was indistinguishable from Russia (tacitly including Ukraine). In its expansiveness, Russia was the opposite of Central Europe. While the latter was based on the principle of ‘the greatest variety within the smallest space’, the former represented ‘the smallest variety within the greatest space’.

Kundera was criticized for observations that smack of civilizational racism, yet his bleak view of Russia remains prescient

In this sense, authoritarian communism was the fulfilment of Russian history, Kundera argued, writing that ‘Russian communism vigorously reawakened Russia’s old anti-western obsessions and turned it brutally against Europe’. Vladimir Putin’s Russia appears to build on these same pernicious impulses.

Kundera was widely criticized for observations in his essay that smack of civilizational racism (including by me) describing Russians as fundamentally different from us: ‘Russia knows another (greater) dimension of disaster, another image of space (a space so immense that entire nations are swallowed up in it), another sense of time (slow and patient), another way of laughing, living, and dying’.




pe

Independent Thinking: Sweden, Finland, and NATO

Independent Thinking: Sweden, Finland, and NATO Audio NCapeling 31 March 2023

Episode 21 of our weekly podcast examines the latest developments relating to Sweden and Finland’s proposed accession to NATO.

The Hungarian parliament has finally ratified Finland’s membership to the NATO alliance, two weeks after President Erdogan in Turkey gave his seal of approval following a meeting with the Finnish president.

Sweden however remains trapped in limbo, with both Turkey and Hungary delaying Stockholm’s membership and Erdogan in particular asking for more concessions.

The panel discusses why Turkey and Hungary took issue with Sweden and Finland, what the strategic situation in the Baltic looks like now with only Finland joining NATO, and the challenges facing Sweden amid its fraught ties with President Erdogan.

We also look ahead to Turkey’s presidential election in May as recent opinion polls point to a neck-and-neck race, with some polls even showing President Erdogan falling behind the opposition. The panel examines what the sentiment is like in Turkey ahead of the election, and how the world would respond if there was a change in power in Ankara for the first time in 20 years.

Joining Bronwen Maddox on the podcast this week is Henri Vanhanen, research fellow with the Finnish Institute of International Affairs, and Galip Dalay, associate fellow with our Middle East and North Africa programme.

About Independent Thinking

A weekly podcast hosted by Chatham House director Bronwen Maddox, in conversation with leading policymakers, journalists, and Chatham House experts providing insight on the latest international issues.




pe

Africa and Europe: Climate security for the future

Africa and Europe: Climate security for the future 20 April 2023 TO 21 April 2023 — 7:30AM TO 12:00PM Anonymous (not verified) 31 March 2023 Slovenia and Online

The 12th Africa Day International Conference hosted in Slovenia offers a platform for interregional exchange and policy cooperation between African and European countries on climate security.

The 12th Africa Day International Conference offers a platform for inter-regional exchange and cooperation to further contribute to progress on climate security.

The 12th Africa Day International Conference is hosted by the Ministry of Foreign and European Affairs of the Republic of Slovenia, in collaboration with the European Commission and the Chatham House Africa Programme. This high-level annual event seeks to improve policy outcomes for citizens in Europe and Africa on the basis of mutual understanding and cooperation between the two regions, while strengthening bilateral relations between Slovenia and African countries.

Climate change poses one of the most serious threats to global security. No individual country or region can face it alone; strong regional and international partnerships are crucial. Analysing risk and taking action can help towards achieving a number of SDGs and a more secure and sustainable future. Addressing climate security is essential for the well-being and future stability of nations and societies around the world, and for the global community as a whole.

This conference will offer a platform for interregional exchange and cooperation on the topic of climate security policy. It will bring together decision-makers and experts from Europe, Africa and across the globe to identify the key challenges and policy priorities in addressing climate security.

The conference will be broadcast live on the Slovenian Ministry of Foreign Affairs webpage, and on the Africa Programme Facebook page.




pe

[68Ga]Ga-PSMA-11 PET/CT-Positive Hepatic Inflammatory Pseudotumor: Possible PSMA-Avid Pitfall in Nuclear Imaging




pe

Ultrashort Oncologic Whole-Body [18F]FDG Patlak Imaging Using LAFOV PET

Methods to shorten [18F]FDG Patlak PET imaging procedures ranging from 65–90 to 20–30 min after injection, using a population-averaged input function (PIF) scaled to patient-specific image-derived input function (IDIF) values, were recently evaluated. The aim of the present study was to explore the feasibility of ultrashort 10-min [18F]FDG Patlak imaging at 55–65 min after injection using a PIF combined with direct Patlak reconstructions to provide reliable quantitative accuracy of lung tumor uptake, compared with a full-duration 65-min acquisition using an IDIF. Methods: Patients underwent a 65-min dynamic PET acquisition on a long-axial-field-of-view (LAFOV) Biograph Vision Quadra PET/CT scanner. Subsequently, direct Patlak reconstructions and image-based (with reconstructed dynamic images) Patlak analyses were performed using both the IDIF (time to relative kinetic equilibrium between blood and tissue concentration (t*) = 30 min) and a scaled PIF at 30–60 min after injection. Next, direct Patlak reconstructions were performed on the system console using only the last 10 min of the acquisition, that is, from 55 to 65 min after injection, and a scaled PIF using maximum crystal ring difference settings of both 85 and 322. Tumor lesion and healthy-tissue uptake was quantified and compared between the differently obtained parametric images to assess quantitative accuracy. Results: Good agreement was obtained between direct- and image-based Patlak analyses using the IDIF (t* = 30 min) and scaled PIF at 30–60 min after injection, performed using the different approaches, with no more than 8.8% deviation in tumor influx rate value (Ki) (mean difference ranging from –0.0022 to 0.0018 mL/[min x g]). When direct Patlak reconstruction was performed on the system console, excellent agreement was found between the use of a scaled PIF at 30–60 min after injection versus 55–65 min after injection, with 2.4% deviation in tumor Ki (median difference, –0.0018 mL/[min x g]; range, –0.0047 to 0.0036 mL/[min x g]). For different maximum crystal ring difference settings using the scan time interval of 55–65 min after injection, only a 0.5% difference (median difference, 0.0000 mL/[min x g]; range, –0.0004 to 0.0013 mL/[min x g]) in tumor Ki was found. Conclusion: Ultrashort whole-body [18F]FDG Patlak imaging is feasible on an LAFOV Biograph Vision Quadra PET/CT system without loss of quantitative accuracy to assess lung tumor uptake compared with a full-duration 65-min acquisition. The ultrashort 10-min direct Patlak reconstruction with PIF allows for its implementation in clinical practice.




pe

Improving 18F-FDG PET Quantification Through a Spatial Normalization Method

Quantification of 18F-FDG PET images is useful for accurate diagnosis and evaluation of various brain diseases, including brain tumors, epilepsy, dementia, and Parkinson disease. However, accurate quantification of 18F-FDG PET images requires matched 3-dimensional T1 MRI scans of the same individuals to provide detailed information on brain anatomy. In this paper, we propose a transfer learning approach to adapt a pretrained deep neural network model from amyloid PET to spatially normalize 18F-FDG PET images without the need for 3-dimensional MRI. Methods: The proposed method is based on a deep learning model for automatic spatial normalization of 18F-FDG brain PET images, which was developed by fine-tuning a pretrained model for amyloid PET using only 103 18F-FDG PET and MR images. After training, the algorithm was tested on 65 internal and 78 external test sets. All T1 MR images with a 1-mm isotropic voxel size were processed with FreeSurfer software to provide cortical segmentation maps used to extract a ground-truth regional SUV ratio using cerebellar gray matter as a reference region. These values were compared with those from spatial normalization-based quantification methods using the proposed method and statistical parametric mapping software. Results: The proposed method showed superior spatial normalization compared with statistical parametric mapping, as evidenced by increased normalized mutual information and better size and shape matching in PET images. Quantitative evaluation revealed a consistently higher SUV ratio correlation and intraclass correlation coefficients for the proposed method across various brain regions in both internal and external datasets. The remarkably good correlation and intraclass correlation coefficient values of the proposed method for the external dataset are noteworthy, considering the dataset’s different ethnic distribution and the use of different PET scanners and image reconstruction algorithms. Conclusion: This study successfully applied transfer learning to a deep neural network for 18F-FDG PET spatial normalization, demonstrating its resource efficiency and improved performance. This highlights the efficacy of transfer learning, which requires a smaller number of datasets than does the original network training, thus increasing the potential for broader use of deep learning–based brain PET spatial normalization techniques for various clinical and research radiotracers.




pe

C-X-C Motif Chemokine Receptor 4-Directed Scintigraphy Using [99mTc]Tc-Pentixatec in Primary Aldosteronism: A Proof-of-Concept Study

C-X-C motif chemokine receptor 4 (CXCR4)–directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [99mTc]Tc-pentixatec in patients with PA. Methods: Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [99mTc]Tc-pentixatec. Adrenal CXCR4 expression was analyzed by calculating lesion-to-contralateral ratios (LCRs). Imaging results were correlated to clinical information. Histopathology and clinical follow-up served as the standard of reference. Results: Three subjects showed lateralization of adrenal tracer accumulation, with a mean maximum lesion-to-contralateral ratio of 1.65 (range, 1.52–1.70), which correlated with morphologic findings on CT. One individual underwent adrenalectomy and presented with complete biochemical and clinical remission at follow-up. Histopathologic workup confirmed unilateral aldosterone-producing adenoma. Conclusion: [99mTc]Tc-pentixatec scintigraphy with SPECT in patients with PA is feasible and might offer a valuable alternative to CXCR4-directed imaging with [68Ga]Ga-pentixafor PET.




pe

Molecular Imaging of p53 in Mouse Models of Cancer Using a Radiolabeled Antibody TAT Conjugate with SPECT

Mutations of p53 protein occur in over half of all cancers, with profound effects on tumor biology. We present the first—to our knowledge—method for noninvasive visualization of p53 in tumor tissue in vivo, using SPECT, in 3 different models of cancer. Methods: Anti-p53 monoclonal antibodies were conjugated to the cell-penetrating transactivator of transcription (TAT) peptide and a metal ion chelator and then radiolabeled with 111In to allow SPECT imaging. 111In-anti-p53-TAT conjugates were retained longer in cells overexpressing p53-specific than non–p53-specific 111In-mIgG (mouse IgG from murine plasma)-TAT controls, but not in null p53 cells. Results: In vivo SPECT imaging showed enhanced uptake of 111In-anti-p53-TAT, versus 111In-mIgG-TAT, in high-expression p53R175H and medium-expression wild-type p53 but not in null p53 tumor xenografts. The results were confirmed in mice bearing genetically engineered KPC mouse–derived pancreatic ductal adenocarcinoma tumors. Imaging with 111In-anti-p53-TAT was possible in KPC mice bearing spontaneous p53R172H pancreatic ductal adenocarcinoma tumors. Conclusion: We demonstrate the feasibility of noninvasive in vivo molecular imaging of p53 in tumor tissue using a radiolabeled TAT-modified monoclonal antibody.




pe

Preclinical Evaluation of 177Lu-OncoFAP-23, a Multivalent FAP-Targeted Radiopharmaceutical Therapeutic for Solid Tumors

Fibroblast activation protein (FAP) is abundantly expressed in the stroma of most human solid tumors. Clinical-stage radiolabeled FAP ligands are increasingly used as tools for the detection of various cancer lesions. To unleash the full therapeutic potential of FAP-targeting agents, ligands need to remain at the tumor site for several days after administration. We recently described the discovery of OncoFAP, a high-affinity small organic ligand of FAP with a rapid accumulation in tumors and low uptake in healthy tissues in cancer patients. Trimerization of OncoFAP provided a derivative (named TriOncoFAP, or OncoFAP-23) with improved FAP affinity. In this work, we evaluated the tissue biodistribution profile and the therapeutic performance of OncoFAP-23 in tumor-bearing mice. Methods: OncoFAP-23 was radiolabeled with the theranostic radionuclide 177Lu. Preclinical experiments were conducted on mice bearing SK-RC-52.hFAP (BALB/c nude mice) or CT-26.hFAP (BALB/c mice) tumors. 177Lu-OncoFAP and 177Lu-FAP-2286 were included in the biodistribution study as controls. Toxicologic evaluation was performed on Wistar rats and CD1 mice by injecting high doses of OncoFAP-23 or its cold-labeled counterpart, respectively. Results: 177Lu-OncoFAP-23 emerged for its best-in-class biodistribution profile, high and prolonged tumor uptake (i.e., ~16 percentage injected dose/g at 96 h), and low accumulation in healthy organs, which correlates well with its potent single-agent anticancer activity at low levels of administered radioactivity. Combination treatment with the tumor-targeted interleukin 2 (L19-IL2, a clinical-stage immunocytokine) further expands the therapeutic window of 177Lu-OncoFAP-23 by potentiating its in vivo antitumor activity. Proteomics studies revealed a potent tumor-directed immune response on treatment with the combination. OncoFAP-23 and natLu-OncoFAP-23 exhibited a favorable toxicologic profile, without showing any side effects or signs of toxicity. Conclusion: OncoFAP-23 presents enhanced tumor uptake and tumor retention and low accumulation in healthy organs, findings that correspond to a strongly improved in vivo antitumor efficacy. The data presented in this work support the clinical development of 177Lu-OncoFAP-23 for the treatment of FAP-positive solid tumors.




pe

Dual Somatostatin Receptor/18F-FDG PET/CT Imaging in Patients with Well-Differentiated, Grade 2 and 3 Gastroenteropancreatic Neuroendocrine Tumors

Our purpose was to prospectively assess the distribution of NETPET scores in well-differentiated (WD) grade 2 and 3 gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) and to determine the impact of the NETPET score on clinical management. Methods: This single-arm, institutional ethics review board–approved prospective study included 40 patients with histologically proven WD GEP NETs. 68Ga-DOTATATE PET and 18F-FDG PET were performed within 21 d of each other. NETPET scores were evaluated qualitatively by 2 reviewers, with up to 10 marker lesions selected for each patient. The quantitative parameters that were evaluated included marker lesion SUVmax for each tracer; 18F-FDG/68Ga-DOTATATE SUVmax ratios; functional tumor volume (FTV) and metabolic tumor volume (MTV) on 68Ga-DOTATATE and 18F-FDG PET, respectively; and FTV/MTV ratios. The treatment plan before and after 18F-FDG PET was recorded. Results: There were 22 men and 18 women (mean age, 60.8 y) with grade 2 (n = 24) or grade 3 (n = 16) tumors and a mean Ki-67 index of 16.1%. NETPET scores of P0, P1, P2A, P2B, P3B, P4B, and P5 were documented in 2 (5%), 5 (12.5%), 5 (12.5%) 20 (50%), 2 (5%), 4 (10%), and 2 (5%) patients, respectively. No association was found between the SUVmax of target lesions on 68Ga-DOTATATE and the SUVmax of target lesions on 18F-FDG PET (P = 0.505). 18F-FDG/68Ga-DOTATATE SUVmax ratios were significantly lower for patients with low (P1–P2) primary NETPET scores than for those with high (P3–P5) primary NETPET scores (mean ± SD, 0.20 ± 0.13 and 1.68 ± 1.44, respectively; P < 0.001). MTV on 18F-FDG PET was significantly lower for low primary NETPET scores than for high ones (mean ± SD, 464 ± 601 cm3 and 66 ± 114 cm3, respectively; P = 0.005). A change in the type of management was observed in 42.5% of patients after 18F-FDG PET, with the most common being a change from systemic therapy to peptide receptor radionuclide therapy and from debulking surgery to systemic therapy. Conclusion: There was a heterogeneous distribution of NETPET scores in patients with WD grade 2 and 3 GEP NETs, with more than 1 in 5 patients having a high NETPET score and a frequent change in management after 18F-FDG PET. Quantitative parameters including 18F-FDG/68Ga-DOTATATE SUVmax ratios in target lesions and FTV/MTV ratios can discriminate between patients with high and low NETPET scores.




pe

Quantitative SPECT/CT Metrics in Early Prediction of [177Lu]Lu-DOTATATE Treatment Response in Gastroenteropancreatic Neuroendocrine Tumor Patients

Our objective is to explore quantitative imaging markers for early prediction of treatment response in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) undergoing [177Lu]Lu-DOTATATE therapy. By doing so, we aim to enable timely switching to more effective therapies in order to prevent time-resource waste and minimize toxicities. Methods: Patients diagnosed with unresectable or metastatic, progressive, well-differentiated, receptor-positive GEP-NETs who received 4 sessions of [177Lu]Lu-DOTATATE were retrospectively selected. Using SPECT/CT images taken at the end of treatment sessions, we counted all visible tumors and measured their largest diameters to calculate the tumor burden score (TBS). Up to 4 target lesions were selected and semiautomatically segmented. Target lesion peak counts and spleen peak counts were measured, and normalized peak counts were calculated. Changes in TBS (TBS) and changes in normalized peak count (nPC) throughout treatment sessions in relation to the first treatment session were calculated. Treatment responses were evaluated using third-month CT and were binarized as progressive disease (PD) or non-PD. Results: Twenty-seven patients were included (7 PD, 20 non-PD). Significant differences were observed in TBSsecond-first, TBSthird-first, and TBSfourth-first (where second-first, third-first, and fourth-first denote scan number between the second and first, third and first, and fourth and first [177Lu]Lu-DOTATATE treatment cycles), respectively) between the PD and non-PD groups (median, 0.043 vs. –0.049, 0.08 vs. –0.116, and 0.109 vs. –0.123 [P = 0.023, P = 0.002, and P < 0.001], respectively). nPCsecond-first showed significant group differences (mean, –0.107 vs. –0.282; P = 0.033); nPCthird-first and nPCfourth-first did not reach statistical significance (mean, –0.122 vs. –0.312 and –0.183 vs. –0.405 [P = 0.117 and 0.067], respectively). At the optimal threshold, TBSfourth-first exhibited an area under the curve (AUC) of 0.957, achieving 100% sensitivity and 80% specificity. TBSsecond-first and TBSthird-first reached AUCs of 0.793 and 0.893, sensitivities of 71.4%, and specificities of 85% and 95%, respectively. nPCsecond-first, nPCthird-first, and nPCfourth-first showed AUCs of 0.764, 0.693, and 0.679; sensitivities of 71.4%, 71.4%, and 100%; and specificities of 75%, 70%, and 35%, respectively. Conclusion: TBS and nPC can predict [177Lu]Lu-DOTATATE response by the second treatment session.




pe

Composite Prediction Score to Interpret Bone Focal Uptake in Hormone-Sensitive Prostate Cancer Patients Imaged with [18F]PSMA-1007 PET/CT

Unspecific bone uptake (UBU) related to [18F]PSMA-1007 PET/CT imaging represents a clinical challenge. We aimed to assess whether a combination of clinical, biochemical, and imaging parameters could predict skeletal metastases in patients with [18F]PSMA-1007 bone focal uptake, aiding in result interpretation. Methods: We retrospectively analyzed [18F]PSMA-1007 PET/CT performed in hormone-sensitive prostate cancer (PCa) patients at 3 tertiary-level cancer centers. A fourth center was involved in performing an external validation. For each, a volume of interest was drawn using a threshold method to extract SUVmax, SUVmean, PSMA tumor volume, and total lesion PSMA. The same volume of interest was applied to CT images to calculate the mean Hounsfield units (HUmean) and maximum Hounsfield units. Clinical and laboratory data were collected from electronic medical records. A composite reference standard, including follow-up histopathology, biochemistry, and imaging data, was used to distinguish between PCa bone metastases and UBU. PET readers with less (n = 2) or more (n = 2) experience, masked to the reference standard, were asked to visually rate a subset of focal bone uptake (n = 178) as PCa metastases or not. Results: In total, 448 bone [18F]PSMA-1007 focal uptake specimens were identified in 267 PCa patients. Of the 448 uptake samples, 188 (41.9%) corresponded to PCa metastases. Ongoing androgen deprivation therapy at PET/CT (P < 0.001) with determination of SUVmax (P < 0.001) and HUmean (P < 0.001) independently predicted bone metastases. A composite prediction score, the bone uptake metastatic probability (BUMP) score, achieving an area under the receiver-operating-characteristic curve (AUC) of 0.87, was validated through a 10-fold internal and external validation (n = 89 bone uptake, 51% metastatic; AUC, 0.92). The BUMP score’s AUC was significantly higher than that of HUmean (AUC, 0.62) and remained high among lesions with HUmean in the first tertile (AUC, 0.80). A decision-curve analysis showed a higher net benefit with the score. Compared with the visual assessment, the BUMP score provided added value in terms of specificity in less-experienced PET readers (88% vs. 54%, P < 0.001). Conclusion: The BUMP score accurately distinguished UBU from bone metastases in PCa patients with [18F]PSMA-1007 focal bone uptake at PET imaging, offering additional value compared with the simple assessment of the osteoblastic CT correlate. Its use could help clinicians interpret imaging results, particularly those with less experience, potentially reducing the risk of patient overstaging.




pe

Clinical Factors That Influence Repeat 68Ga-PSMA-11 PET/CT Scan Positivity in Patients with Recurrent Prostate Cancer Under Observation After a Negative 68Ga-PSMA-11 PET/CT Scan: A Single-Center Retrospective Study

This analysis aimed to identify clinical factors associated with positivity on repeat 68Ga-PSMA-11 PET/CT after a negative scan in patients with recurrent prostate cancer (PCa) under observation. Methods: This single-center, retrospective analysis included patients who underwent at least 2 68Ga-PSMA-11 PET/CT scans (PET1 and PET2) at UCLA between October 2016 and June 2021 for recurrent PCa with negative PET1 and no PCa-related treatments between the 2 scans. Using Prostate Cancer Molecular Imaging Standardized Evaluation criteria to define negative and positive scans, the final cohort was divided into PET2-negative (PET2-Neg) and PET2-positive (PET2-Pos). The same PET1 was used twice in the more than 2 PET cases with inclusion criteria fulfilled. Patient characteristics and clinical parameters were compared between the 2 cohorts using Mann–Whitney U test and Fisher exact test. Areas under the curve (AUCs) of the receiver operating characteristic and the Youden index were computed to determine the discrimination ability of statistically significant factors and specific cut points that maximized sensitivity and specificity, respectively. Results: The final analysis included 83 sets of 2 PET/CT scans from 70 patients. Thirty-nine of 83 (47%) sets were PET2-Neg, and 44 of 83 (53%) sets were PET2-Pos. Prostate-specific antigen (PSA) increased from PET1 to PET2 for all 83 (100%) sets of scans. Median PSA at PET1 was 0.4 ng/mL (interquartile range, 0.2–1.0) and at PET2 was 1.6 ng/mL (interquartile range, 0.9–3.8). We found higher serum PSA at PET2 (median, 1.8 vs. 1.1 ng/mL; P = 0.015), absolute PSA difference (median, 1.4 vs. 0.7 ng/mL; P = 0.006), percentage of PSA change (median, +270.4% vs. +150.0%: P = 0.031), and median PSA velocity (0.044 vs. 0.017 ng/mL/wk, P = 0.002) and shorter PSA doubling time (DT; median, 5.1 vs. 8.3 mo; P = 0.006) in the PET2-Pos cohort than in the PET2-Neg cohort. Receiver operating characteristic curves showed cutoffs for PSA at PET2 of 4.80 ng/mL (sensitivity, 34%; specificity, 92%; AUC, 0.66), absolute PSA difference of 0.95 ng/mL (sensitivity, 62%; specificity, 71%; AUC, 0.68), percentage of PSA change of a positive 289.50% (sensitivity, 48%; specificity, 82%; AUC, 0.64), PSA velocity of 0.033 ng/mL/wk (sensitivity, 57%; specificity, 80%; AUC, 0.70), and PSA DT of 7.91 mo (sensitivity, 71%; specificity, 62%; AUC, 0.67). Conclusion: Patients with recurrent PCa under observation after a negative 68Ga-PSMA-11 PET/CT scan with markedly elevated serum PSA levels and shorter PSA DT are more likely to have positive findings on repeat 68Ga-PSMA-11 PET/CT.




pe

Optimizing the Therapeutic Index of sdAb-Based Radiopharmaceuticals Using Pretargeting

Single-domain antibodies (sdAbs) demonstrate favorable pharmacokinetic profiles for molecular imaging applications. However, their renal excretion and retention are obstacles for applications in targeted radionuclide therapy (TRT). Methods: Using a click-chemistry–based pretargeting approach, we aimed to reduce kidney retention of a fibroblast activation protein α (FAP)–targeted sdAb, 4AH29, for 177Lu-TRT. Key pretargeting parameters (sdAb-injected mass and lag time) were optimized in healthy mice and U87MG (FAP+) xenografts. A TRT study in a pancreatic ductal adenocarcinoma (PDAC) patient-derived xenograft (PDX) model was performed as a pilot study for sdAb-based pretargeting applications. Results: Modification of 4AH29 with trans-cyclooctene (TCO) moieties did not modify the sdAb pharmacokinetic profile. A 200-µg injected mass of 4AH29-TCO and an 8-h lag time for the injection of [177Lu]Lu-DOTA-PEG7-tetrazine resulted in the highest kidney therapeutic index (2.0 ± 0.4), which was 5-fold higher than that of [177Lu]Lu-DOTA-4AH29 (0.4 ± 0.1). FAP expression in the tumor microenvironment was validated in a PDAC PDX model with both immunohistochemistry and PET/CT imaging. Mice treated with the pretargeting high-activity approach (4AH29-TCO + [177Lu]Lu-DOTA-PEG7-tetrazine; 3 x 88 MBq, 1 injection per week for 3 wk) demonstrated prolonged survival compared with the vehicle control and conventionally treated ([177Lu]Lu-DOTA-4AH29; 3 x 37 MBq, 1 injection per week for 3 wk) mice. Mesangial expansion was reported in 7 of 10 mice in the conventional cohort, suggesting treatment-related kidney morphologic changes, but was not observed in the pretargeting cohort. Conclusion: This study validates pretargeting to mitigate sdAbs’ kidney retention with no observation of morphologic changes on therapy regimen at early time points. Clinical translation of click-chemistry–based pre-TRT is warranted on the basis of its ability to alleviate toxicities related to biovectors’ intrinsic pharmacokinetic profiles. The absence of representative animal models with extensive stroma and high FAP expression on cancer-associated fibroblasts led to a low mean tumor-absorbed dose even with high injected activity and consequently to modest survival benefit in this PDAC PDX.




pe

Evaluating the Utility of 18F-FDG PET/CT in Cancer of Unknown Primary

Cancer of unknown primary (CUP) represents a heterogeneous group of metastatic tumors for which standardized diagnostic work-up fails to identify the primary site. We aimed to describe the Peter MacCallum Cancer Centre experience with 18F-FDG PET/CT in extracervical CUP with respect to detection of a primary site and its impact on management. A secondary aim was to compare overall survival (OS) in patients with and without a detected primary site. Methods: CUP patients treated between 2014 and 2020 were identified from medical oncology clinics and 18F-FDG PET/CT records. Information collated from electronic medical records included the suspected primary site and treatment details before and after 18F-FDG PET/CT. Clinicopathologic details and genomic analysis were used to determine the clinically suspected primary site and compared against 2 independent masked reads of 18F-FDG PET/CT images by nuclear medicine specialists to determine sensitivity, specificity, accuracy, and the rate of detection of the primary site. Results: We identified 147 patients, 65% of whom had undergone molecular profiling. The median age at diagnosis was 61 y (range, 20–84 y), and the median follow-up time was 74 mo (range, 26–83 mo). Eighty-two percent were classified as having an unfavorable CUP subtype as per international guidelines.18F-FDG PET/CT demonstrated a primary site detection rate of 41%, resulted in a change in management in 22%, and identified previously occult disease sites in 37%. Median OS was 16.8 mo for all patients and 104.7 and 12.1 mo for favorable and unfavorable CUP subtypes, respectively (P < 0.0001). Median OS in CUP patients when using 18F-FDG PET/CT, clinicopathologic, and genomic information was 19.8 and 8.5 mo when a primary site was detected and not detected, respectively (P = 0.016). Multivariable analysis of survival adjusted for age and sex remained significant for identification of a potential primary site (P < 0.001), a favorable CUP (P < 0.001), and an Eastern Cooperative Oncology Group status of 1 or less (P < 0.001). Conclusion: 18F-FDG PET/CT plays a complementary role in CUP diagnostic work-up and was able to determine the likely primary site in 41% of cases. OS is improved with primary site identification, demonstrating the value of access to diagnostic 18F-FDG PET/CT for CUP patients.




pe

Predicting Pathologic Complete Response in Locally Advanced Rectal Cancer with [68Ga]Ga-FAPI-04 PET, [18F]FDG PET, and Contrast-Enhanced MRI: Lesion-to-Lesion Comparison with Pathology

Neoadjuvant therapy in patients with locally advanced rectal cancer (LARC) has achieved good pathologic complete response (pCR) rates, potentially eliminating the need for surgical intervention. This study investigated preoperative methods for predicting pCR after neoadjuvant short-course radiotherapy (SCRT) combined with immunochemotherapy. Methods: Treatment-naïve patients with histologically confirmed LARC were enrolled from February 2023 to July 2023. Before surgery, the patients received neoadjuvant SCRT followed by 2 cycles of capecitabine and oxaliplatin plus camrelizumab. 68Ga-labeled fibroblast activation protein inhibitor ([68Ga]Ga-FAPI-04) PET/MRI, [18F]FDG PET/CT, and contrast-enhanced MRI were performed before treatment initiation and before surgery in each patient. PET and MRI features and the size and number of lesions were also collected from each scan. Each parameter’s sensitivity, specificity, and diagnostic cutoff were derived via receiver-operating-characteristic curve analysis. Results: Twenty eligible patients (13 men, 7 women; mean age, 60.2 y) were enrolled and completed the entire trial, and all patients had proficient mismatch repair or microsatellite-stable LARC. A postoperative pCR was achieved in 9 patients (45.0%). In the visual evaluation, both [68Ga]Ga-FAPI-04 PET/MRI and [18F]FDG PET/CT were limited to forecasting pCR. Contrast-enhanced MRI had a low sensitivity of 55.56% to predict pCR. In the quantitative evaluation, [68Ga]Ga-FAPI-04 change in SULpeak percentage, where SULpeak is SUVpeak standardized by lean body mass, had the largest area under the curve (0.929) with high specificity (sensitivity, 77.78%; specificity, 100.0%; cutoff, 63.92%). Conclusion: [68Ga]Ga-FAPI-04 PET/MRI is a promising imaging modality for predicting pCR after SCRT combined with immunochemotherapy. The SULpeak decrease exceeding 63.92% may provide valuable guidance in selecting patients who can forgo surgery after neoadjuvant therapy.




pe

Whole-Body HER2 Heterogeneity Identified on HER2 PET in HER2-Negative, -Low, and -Positive Metastatic Breast Cancer

Understanding which patients with human epidermal growth factor receptor 2 (HER2)–negative or –low metastatic breast cancer (MBC) benefit from HER2-targeted strategies is urgently needed. We assessed the whole-body heterogeneity of HER2 expression on 89Zr-trastuzumab PET (HER2 PET) and the diagnostic performance of HER2 PET in a large series of patients, including HER2-negative and -low MBC. Methods: In the IMPACT-MBC study, patients with newly diagnosed and nonrapidly progressive MBC of all subtypes were included. Metastasis HER2 status was determined by immunohistochemistry and in situ hybridization.89Zr-trastuzumab uptake was quantified as SUVmax and SUVmean. HER2 immunohistochemistry was related to the quantitative 89Zr-trastuzumab uptake of all metastases and corresponding biopsied metastasis, uptake heterogeneity, and qualitative scan evaluation. A prediction algorithm for HER2 immunohistochemistry positivity based on uptake was developed. Results: In 200 patients, 89Zr-trastuzumab uptake was quantified in 5,163 metastases, including 186 biopsied metastases. With increasing HER2 immunohistochemistry status, uptake was higher (geometric mean SUVmax of 7.0, 7.6, 7.3, and 17.4 for a HER2 immunohistochemistry score of 0, 1, 2, or 3+, respectively; P < 0.001). High uptake exceeding 14.6 (90th percentile) was observed in one third of patients with a HER2-negative or -low metastasis biopsy. The algorithm performed best when lesion site and size were incorporated (area under the curve, 0.86; 95% CI, 0.79–0.93). Conclusion: HER2 PET had good diagnostic performance in MBC, showing considerable whole-body HER2 heterogeneity and uptake above background in HER2-negative and -low MBC. This provides novel insights into HER2-negative and -low MBC compared with standard HER2 immunohistochemistry on a single biopsy.




pe

Diagnostic Accuracy of [18F]FDG PET/MRI in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Metaanalysis

This study evaluates the diagnostic utility of PET/MRI for primary, locoregional, and nodal head and neck squamous cell carcinoma (HNSCC) through systematic review and metaanalysis. Methods: A systematic search was conducted using PubMed and Scopus to identify studies on the diagnostic accuracy of PET/MRI for HNSCC. The search included specific terms and excluded nonhybrid PET/MRI studies, and those with a sample size of fewer than 10 patients were excluded. Results: In total, 15 studies encompassing 638 patients were found addressing the diagnostic test accuracy for PET/MRI within the chosen subject domain. Squamous cell carcinoma of the nasopharynx was the most observed HNSCC subtype (n = 198). The metaanalysis included 12 studies, with pooled sensitivity and specificity values of 93% and 95% per patient for primary disease evaluation, 93% and 96% for locoregional evaluation, and 89% and 98% per lesion for nodal disease detection, respectively. An examination of a subset of studies comparing PET/MRI against PET/CT or MRI alone for evaluating nodal and locoregional HNSCC found that PET/MRI may offer slightly higher accuracy than other modalities. However, this difference was not statistically significant. Conclusion: PET/MRI has excellent potential for identifying primary, locoregional, and nodal HNSCC.




pe

Development of 18F-Fluoromisonidazole Hypoxia PET/CT Diagnostic Interpretation Criteria and Validation of Interreader Reliability, Reproducibility, and Performance

Tumor hypoxia, an integral biomarker to guide radiotherapy, can be imaged with 18F-fluoromisonidazole (18F-FMISO) hypoxia PET. One major obstacle to its broader application is the lack of standardized interpretation criteria. We sought to develop and validate practical interpretation criteria and a dedicated training protocol for nuclear medicine physicians to interpret 18F-FMISO hypoxia PET. Methods: We randomly selected 123 patients with human papillomavirus–positive oropharyngeal cancer enrolled in a phase II trial who underwent 123 18F-FDG PET/CT and 134 18F-FMISO PET/CT scans. Four independent nuclear medicine physicians with no 18F-FMISO experience read the scans. Interpretation by a fifth nuclear medicine physician with over 2 decades of 18F-FMISO experience was the reference standard. Performance was evaluated after initial instruction and subsequent dedicated training. Scans were considered positive for hypoxia by visual assessment if 18F-FMISO uptake was greater than floor-of-mouth uptake. Additionally, SUVmax was determined to evaluate whether quantitative assessment using tumor-to-background ratios could be helpful to define hypoxia positivity. Results: Visual assessment produced a mean sensitivity and specificity of 77.3% and 80.9%, with fair interreader agreement ( = 0.34), after initial instruction. After dedicated training, mean sensitivity and specificity improved to 97.6% and 86.9%, with almost perfect agreement ( = 0.86). Quantitative assessment with an estimated best SUVmax ratio threshold of more than 1.2 to define hypoxia positivity produced a mean sensitivity and specificity of 56.8% and 95.9%, respectively, with substantial interreader agreement ( = 0.66), after initial instruction. After dedicated training, mean sensitivity improved to 89.6% whereas mean specificity remained high at 95.3%, with near-perfect interreader agreement ( = 0.86). Conclusion: Nuclear medicine physicians without 18F-FMISO hypoxia PET reading experience demonstrate much improved interreader agreement with dedicated training using specific interpretation criteria.




pe

Association Between CA 15-3 and 18F-FDG PET/CT Findings in Recurrent Breast Cancer Patients at a Tertiary Referral Hospital in Kenya

The tumor marker cancer antigen 15-3 (CA 15-3) is that most commonly used to monitor metastatic breast cancer during active therapy and surveillance for disease recurrence after treatment. The association of CA 15-3 and 18F-FDG PET/CT findings can be considered complementary, since any significant rise may indicate the presence of disease and imaging is able to map the tumor sites. Although current guidelines do not recommend the routine performance of CA 15-3 in asymptomatic patients being followed up after definitive breast cancer treatment, most oncologists perform serial assessment of the tumor markers as part of routine follow-up of patients. The aim of this study was to evaluate the correlation between CA 15-3 levels and 18F-FDG PET/CT scan findings in patients with recurrent breast cancer. Methods: This was a cross-sectional study with data collected retrospectively. Patients being evaluated for breast cancer recurrence with 18F-FDG PET/CT imaging and CA 15-3 level were included. Evaluation of the association between CA 15-3 levels and 18F-FDG PET/CT scan findings was then done. Results: In total, 154 cases were included in this study; 62 patients had recurrence (positive) on the 18F-FDG PET/CT scans, whereas 92 patients had normal (negative) findings on follow-up 18F-FDG PET/CT scans. There was an association between CA 15-3 levels and the presence or absence of recurrence on 18F-FDG PET/CT scans, with 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on 18F-FDG PET/CT and 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on 18F-FDG PET/CT as well as a correlation with the burden of metastases. Most patients with disease recurrence on 18F-FDG PET/CT, however, had normal CA 15-3 levels. Conclusion: Higher CA 15-3 levels correlate with breast cancer recurrence on 18F-FDG PET/CT as well as with burden of metastasis. Notably, CA 15-3 levels within the reference range do not exclude breast cancer disease recurrence since more than half of patients with recurrence had normal CA 15-3 levels. 18F-FDG PET/CT should therefore be considered in patients with suspected breast cancer recurrence but normal CA 15-3 levels.




pe

1,090 Publications and 5 Years Later: Is FAP-Targeted Theranostics Really Happening?




pe

Nuclear Imaging of Bispecific Antibodies on the Rise

Bispecific antibodies (bsAbs) are engineered to target 2 different epitopes simultaneously. About 75% of the 16 clinically approved bsAbs have entered the clinic internationally since 2022. Hence, research on biomedical imaging of various radiolabeled bsAb scaffolds may serve to improve patient selection for bsAb therapy. Here, we provide a comprehensive overview of recent advances in radiolabeled bsAbs for imaging via PET or SPECT. We compare direct targeting and pretargeting approaches in preclinical and clinical studies in oncologic research. Furthermore, we show preclinical applications of imaging bsAbs in neurodegenerative diseases. Finally, we offer perspectives on the future directions of imaging bsAbs based on their challenges and opportunities.




pe

EU-Turkey Customs Union: Prospects for Modernization and Lessons for Brexit

EU-Turkey Customs Union: Prospects for Modernization and Lessons for Brexit 12 December 2018 — 12:30PM TO 1:30PM Anonymous (not verified) 26 November 2018 Chatham House | 10 St James's Square | London | SW1Y 4LE

Turkey and the EU have been in a customs union since 1995. Both sides recognize that the current agreement is in need of modernization and have agreed to open negotiations to expand its scope to include services, public procurement, agriculture and other elements that would help bring it into the 21st century.

At the same time, the UK Parliament is debating whether to approve the agreement on the UK’s withdrawal from the EU. It includes a backstop which – if triggered – would keep the UK and the EU in a single customs territory which would limit the disruption of withdrawal but hamper Britain’s ability to pursue an independent trade policy. The political declaration proposes building on this customs arrangement as the basis for the future relationship.

In this context, the speaker will discuss the current EU-Turkey customs union arrangement and its shortcomings, examine the prospects for its modernization and share his insights on the lessons for the UK’s future trading relationship with the EU.

The event will launch the briefing paper ‘EU-Turkey Customs Union: Prospects for Modernization and Lessons for Brexit’.

Attendance at this event is by invitation only.




pe

Europe

Europe

Research on Europe focuses on defence, economics, climate change, energy and security - both inside and outside the EU - and the implications of Brexit.

nfaulds-adams… 20 January 2020

Our work on Europe explores issues such as Brexit, UK and EU foreign policy, and the challenges facing the EU and its member states in the fields of energy, climate change, security and migration.

Key projects include the Chatham House-YouGov Survey, the Tribes of Europe, the refugee crisis, the politics and economics of Turkey, and the UK and European energy and climate policies.


Analysis is also produced examining the rise of populism, extremism, and the future of democracy and European diplomacy.




pe

Turkey's Foreign Policy: The Perspective of the Main Opposition Party

Turkey's Foreign Policy: The Perspective of the Main Opposition Party 5 November 2020 — 12:00PM TO 1:00PM Anonymous (not verified) 14 October 2020 Online

The Republican People’s Party (CHP), the main Turkish opposition party, is becoming a serious contender for a leading role in the country’s politics.

This is an online only event.

CHP’s mayoral candidates defeated the Justice and Development Party (AKP) incumbents in the 2019 local elections in Ankara and Istanbul, which held both cities for a quarter of a century. Its ascendency in Turkish politics is improving prospects for a CHP-led government after the next general election in 2023.

In this webinar, the speaker will share CHP’s stance on the country’s foreign policy towards key regional allies in Europe, as well as its take on relations with Russia, the US and Turkey’s position and role in the Middle East. Finally, the speaker will share how CHP’s external policy might differ from the ruling AKP. 




pe

Turkey's foreign policy: The perspective of the İYİ Parti

Turkey's foreign policy: The perspective of the İYİ Parti 25 January 2021 — 12:00PM TO 1:00PM Anonymous (not verified) 14 January 2021 Online

The centre-right İYİ Parti, the second largest opposition party in Turkey, is attracting voters from the governing alliance between the Justice and Development Party (AKP) and the pro-Turkish National Movement Party (MHP).

Please complete your registration on Zoom:

The İYİ Parti, which was set up in 2017, formed the Nation Alliance (Millet İttifakı) with the left-of-centre Republican People’s Party (CHP) and the pro-Islam Felicity Party (Saadet Partisi) in the 2018 parliamentary elections winning 43 seats in the Grand National Assembly.

In the 2019 municipal elections, the İYİ Parti’s alliance alliance with the CHP played an important role in enabling the latter’s candidates to become the mayors of Istanbul and Ankara after a quarter-century dominance by the ruling Justice and Development Party (AKP).

Its popularity has been rising steadily, according to recent polls. In this webinar, the speaker will outline the party’s viewpoint on the country’s foreign policy towards the European Union, as well as its perspectives on relations with Russia, the US, Iran and the Arab world. Finally, he will share the ways in which the İYİ Parti’s approach to external policy might differ from the ruling AKP.




pe

U.S., South Korea agree to greater cooperation on civil nuclear energy

Earlier this month, the United States and the Republic of Korea reached an agreement on greater cooperation on civil nuclear energy projects, the U.S. Department of Energy said this week.




pe

23andMe to cut 40% of workforce, end therapeutics program

Genetic-testing lab 23andMe plans to cut its workforce by 40% and end its therapeutics program in an effort to cut costs, the company announced Monday.




pe

Shell wins appeal against landmark court-ordered emissions reductions in The Hague

Oil giant Shell emerged victorious Tuesday from a Dutch court where it was appealing a ruling ordering it to slash its global carbon emissions by 45% by the end of the decade in line with the Paris climate agreement.




pe

2025 Luis J. Alvarez and Admiral Grace M. Hopper Postdoc Fellowship in Computing Sciences

2025 Luis J. Alvarez and Admiral Grace M. Hopper Postdoc Fellowship in Computing Sciences - 102564 Division: AC-Computing Luis J. Alvarez Postdoctoral Fellowship and Admiral Grace M. Hopper Postdoctoral Fellowship in Computing Sciences The Computing Sciences Area (https://cs.lbl.gov/) at Lawrence Berkeley National Laboratory (https://www.lbl.gov) is now accepting applications for two distinguished postdoctoral fellowships in Computing Sciences: • Luis W. Alvarez Postdoctoral Fellowship, and • Admiral Grace M. Hopper Postdoctoral Fellowship. Researchers in computer science, mathematics, data science, or any computational science discipline who have received their Ph.D. no earlier than January 1, 2022 but no later than September 30, 2025 are encouraged to apply. Only one (1) application is needed and it will be considered for both postdoctoral fellowships. The successful candidates will participate in research activities in computer science, mathematics, data science, or any computational science discipline of interest to the Computing Sciences Area and Berkeley Lab. Alvarez Fellows apply advances in computer science, mathematics, computational science, data science, machine learning or AI to computational modeling, simulations, and advanced data analytics for scientific discovery in materials science, biology, astronomy, environmental science, energy, particle physics, genomics, and other scientific domains. Hopper Fellows concentrate on the development and optimization of scientific and engineering applications leveraging high-speed network capability provided by the Energy Sciences Network or run on next-generation high performance computing and data systems hosted by the National Energy Research Scientific Computing Center at Berkeley Lab. Since its founding in 2002, Berkeley Lab’s Luis W. Alvarez Postdoctoral Fellowship (go.lbl.gov/alvarez) has cultivated exceptional early career scientists who have gone on to make outstanding contributions to computer science, mathematics, data science, and computational sciences. The Admiral Grace Hopper Postdoctoral Fellowship (go.lbl.gov/hopper) was first awarded in 2015 with the goal of enabling early career scientists to make outstanding contributions in computer science and high performance computing (HPC) research. About Computing Sciences at Berkeley Lab: Whether running extreme-scale simulations on a supercomputer or applying machine-learning or data analysis to massive datasets, scientists today rely on advances in and integration across applied mathematics, computer science, and computational science, as well as large-scale computing and networking facilities, to increase our understanding of ourselves, our planet, and our universe. Berkeley Labs Computing Sciences Area researches, develops, and deploys new tools and technologies to meet these needs and to advance research in our core capabilities of applied mathematics, computer science, data science, and computational science. In addition to fundamental advances in our core capabilities, we impact such areas as astrophysics and cosmology, accelerator physics, chemical science and materials science, combustion, fusion energy, nuclear physics, biology, climate change, and HPC systems and network technology. Research areas in Computing Sciences include but are not limited to: • Developing scientific applications and software technologies for extreme-scale and energy-efficient • Developing mathematical modeling for complex scientific problems • Designing algorithms to improve the performance of scientific applications • Researching digital and post-digital computer architectures for science • Developing and advancing extreme-scale scientific data management, analysis, and visualization • Developing and advancing next-generation machine learning, AI, and data science approaches for science • Advancing quantum computing and networking technologies, software, algorithms and applications • Evaluating or developing new and promising HPC systems and networking technologies • Researching methods to control and manage next-generation networks • Managing scientific data and workflows in distributed environments Qualifications: • Requires a Ph.D. in computer science, mathematics, computational science, or related discipline. • Candidates must have no more than 3 years of Postdoctoral Researcher or similar experience. • Expertise with advanced algorithms, software techniques, HPC systems and/or networking in a related research field. • Demonstrated creativity and the ability to perform independent research. • Demonstrated excellence in a related research field. • Ability to develop new cross-disciplinary partnerships that use advanced computational and/or mathematical techniques to produce unique lab capabilities. • Excellent communication skills with the ability to facilitate communications and collaborations with internal and external stakeholders. Additional Desired Qualifications: • Knowledge of advanced computing and high-performance computing. Application Process: 1. As part of your application process, you must upload and submit the following materials with your online application. 1. Cover letter 2. CV, with publication list included 3. Research Statement (no more than five (5) pages in length when printed using standard letter-size (8.5 inch x 11 inch) paper with 1-inch margins (top, bottom, left, and right) and a font size not smaller than 11 point; figures and references cited, if included, must fit within the five-page limit) 4. Contact information (name, affiliation, and email address) of at least three (3) individuals who will be able to provide letters of reference. 2. Application deadline: October 31, 2024. * It is highly advisable that you have all the required application materials and information ready and available prior to completing and submitting your application. Your application will not be considered complete if any of the above information is missing. Tentative Application Timeline: The Computing Sciences Fellowship Selection Committee is made up of a diverse representation of scientists and engineers across Berkeley Lab’s Computing Sciences Area who will conduct a thorough review of all applications received. • Application deadline: October 31, 2024 • Review and Selection: October 2024 - December 2024 • Decisions made: January/February 2025 Want to learn more about working at Berkeley Lab? Please visit: careers.lbl.gov How To Apply Apply directly online at http://50.73.55.13/counter.php?id=290341 and follow the on-line instructions to complete the application process. Berkeley Lab is committed to inclusion, diversity, equity and accessibility and strives to continue building community with these shared values and commitments. Berkeley Lab is an Equal Opportunity and Affirmative Action Employer. We heartily welcome applications from women, minorities, veterans, and all who would contribute to the Labs mission of leading scientific discovery, inclusion, and professionalism. In support of our diverse global community, all qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. Equal Opportunity and IDEA Information Links: Know your rights, click here (http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm) for the supplement: Equal Employment Opportunity is the Law and the Pay Transparency Nondiscrimination Provision (https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf) under 41 CFR 60-1.4.




pe

Supermicro Introduces JBOF Storage Platform Powered by NVIDIA BlueField-3 for Scalable AI and HPC

SAN JOSE, Calif., Oct. 16, 2024 — Supermicro, Inc. is launching a new optimized storage system for high performance AI training, inference and HPC workloads. This JBOF (Just a Bunch […]

The post Supermicro Introduces JBOF Storage Platform Powered by NVIDIA BlueField-3 for Scalable AI and HPC appeared first on HPCwire.




pe

Microchip Expands 64-Bit Portfolio with High-Performance PIC64HX Microprocessors for Edge Computing

CHANDLER, Ariz., Oct. 23, 2024 — The global edge computing market is expected to grow by more than 30 percent in the next five years, serving mission-critical applications in the […]

The post Microchip Expands 64-Bit Portfolio with High-Performance PIC64HX Microprocessors for Edge Computing appeared first on HPCwire.





pe

SDSC Leads Expansion of Open Storage Network to More Campus Computing Sites

Oct. 24, 2024 — The San Diego Supercomputer Center (SDSC), part of the School of Computing, Information and Data Sciences at UC San Diego, has been leading the Open Storage Network (OSN) program for years, and along […]

The post SDSC Leads Expansion of Open Storage Network to More Campus Computing Sites appeared first on HPCwire.




pe

American woman killed in Budapest allegedly by man she met on vacation

An American woman who was traveling in Hungary was killed in Budapest last week allegedly by a man she met on vacation.




pe

Dutch police hope to solve cold-case murder of sex worker using hologram

A hologram of a sex worker who was murdered in Amsterdam more than a decade ago could help solve the cold case, investigators hope.




pe

At least 56 people, including 20 children, killed in Israeli airstrikes in Lebanon and Gaza

Dozens of people were killed in Israeli military strikes on northern Lebanon and the Gaza strip, including as many as 20 children, authorities said.




pe

Shell wins appeal against landmark court-ordered emissions reductions in The Hague

Oil giant Shell emerged victorious Tuesday from a Dutch court where it was appealing a ruling ordering it to slash its global carbon emissions by 45% by the end of the decade in line with the Paris climate agreement.





pe

ISC Opens Nominations for 2025 Jack Dongarra Early Career Award in HPC

Oct. 16, 2024 — The ISC High Performance Jack Dongarra Early Career Award and Lecture Series is an annual event that honors the remarkable contributions of Professor Jack Dongarra to […]

The post ISC Opens Nominations for 2025 Jack Dongarra Early Career Award in HPC appeared first on HPCwire.