Τετάρτη, 25 Απριλίου 2018

Post mortem CT angiography in fetuses or newborn: very affordable pump and catheter solution

Publication date: Available online 25 April 2018
Source:Journal of Forensic Radiology and Imaging
Author(s): Wolf Schweitzer, Michael Thali, Rosa Maria Martinez, Lars Ebert
This technical note describes a pump and catheter setup that is geared towards performing post mortem computed tomography angiography (PMCTA) examinations in fetal humans. With a voltage controlled very affordable immersion pump and a modified butterfly injection needle, relatively stable linear voltage flow rate relationships can be obtained across flow rates in the range of 30 to 150 ml/min. Flow rates are calculated and compared with actual measurements, whereas practical results suggest a degree of turbulence within the setup used. Practical testing with a fetal pig results in excellent vascular filling. This was subject to considerable partial volume effect, however, so using a micro computed tomography scanner for better quality scans of PMCTA for fetal humans is highly recommended.



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Editorial Board



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Contents



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Important ESTRO dates



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Corrigendum to “PO0994 Integrin antagonistic drugs reveal different effectiveness in 2D monolayer vs. 3D spheroid culture” [Radiother. Onco. 123(Suppl. 1) (2017), S544]

The authors regret that the order of authors in the above mentioned abstract, were published in an incorrect order. The correct listing is shown above.

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Quality of radiotherapy services in post-Soviet countries: An IAEA survey

The quality of radiotherapy services in post-Soviet countries has not yet been studied following a formal methodology. The IAEA conducted a survey using two sets of validated radiation oncology quality indicators (ROIs).

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Impact of Patient Age and Histological Type on Radioactive Iodine Avidity of Recurrent Lesions of Differentiated Thyroid Carcinoma.

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Impact of Patient Age and Histological Type on Radioactive Iodine Avidity of Recurrent Lesions of Differentiated Thyroid Carcinoma.

Clin Nucl Med. 2018 Apr 23;:

Authors: Nakanishi K, Kikumori T, Miyajima N, Takano Y, Noda S, Takeuchi D, Iwano S, Kodera Y

Abstract
BACKGROUND: Age is a prognostic factor for recurrent differentiated thyroid carcinoma (DTC) and may be related to radioactive iodine (RAI) nonavidity. Indications for molecular-targeted drugs (MTDs) are currently limited to RAI-refractory DTC. Demonstrating refractoriness to RAI, mainly indicated by RAI nonavidity, may be a barrier to the introduction of MTDs for elderly patients. The present study was conducted to evaluate the impact of age and histological type on the RAI avidity of recurrent lesions of DTC.
METHODS: Two hundred fifty-eight patients (189 patients with classic papillary thyroid carcinoma [cPTC], 8 patients with follicular variant of papillary thyroid carcinoma, and 61 patients with follicular thyroid carcinoma), who underwent their first RAI whole-body scanning for recurrent DTC at our institution between 2004 and 2013, were retrospectively studied. Radioactive iodine uptake was determined by visible uptake by metastatic lesion(s) in a diagnostic RAI-whole-body scan.
RESULTS: The prevalence of RAI-avid lung metastases in cPTC indicated a significant, inverse correlation with age (<55 years, 36.2%; ≥55 years, 3%; P < 0.001). By contrast, for follicular thyroid carcinoma, the prevalence of RAI avidity was not influenced by age. Similar tendencies were observed for lymph node metastases.
CONCLUSIONS: Radioactive iodine avidity by metastatic lesions of cPTC in elderly patients, especially those older than 55 years, was seldom demonstrated. Adherence to a strategy of restricting MTD administration after confirmation of RAI refractoriness should be revisited for elderly patients. A strategy of omitting RAI treatment should be taken into account when considering age and histological type.

PMID: 29688947 [PubMed - as supplied by publisher]



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THE TRENDS OF HYPERTHYROIDISM TREATMENT IN TAIWAN: A NATIONWIDE POPULATION-BASED STUDY.

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THE TRENDS OF HYPERTHYROIDISM TREATMENT IN TAIWAN: A NATIONWIDE POPULATION-BASED STUDY.

Endocr Pract. 2018 Apr 24;:

Authors: Kornelius E, Yang YS, Huang CN, Wang YH, Lo SC, Lai YR, Chiou JY

Abstract
OBJECTIVE: Over the past three decades, few studies on hyperthyroidism treatment trends have been reported. Therefore, we used a nationwide population-based database to evaluate the current practices and management of hyperthyroidism in Taiwan.
METHODS: This retrospective study included a random selection of 1 million people in Taiwan between 2004 and 2010. Hyperthyroidism patients who received anti-thyroid drugs (ATD), radioactive iodine (RAI), or surgery were identified. We calculated the proportion and treatment trends of those 3 treatment options annually. Poisson regression model was used to determine whether there was a change of trends in hyperthyroidism patients. P < 0.05 was considered statistically significant.
RESULTS: The prevalence of overt hyperthyroidism increased steadily in Taiwan from 2,666 (0.27%) in 2004, to 3,464 (0.37%) in 2010. The incidence of hyperthyroidism (per 1,000 persons) also increased from 0.97 in 2004 to 1.06 in 2010. The major proportion of hyperthyroidism in this study was Graves' disease (95%), followed by toxic nodular goiter (2%), and other causes (3%). ATD is the most commonly used (96-97%) treatment for hyperthyroidism, followed by surgery (2-3%), and RAI (<1%). There was a significant decreasing trend for surgery, which decreased from 2.9% in 2004 to 2% in 2010, especially in female patients (3.3% in 2004 to 2.3% in 2010, p <001) and patients younger than 40 (3.8% in 2004 to 2.9% in 2010, p <001). Meanwhile, the proportion of ATD and RAI remain unchanged. The most common ATD prescription was methimazole (45-50%), followed by propylthiouracil (30-32%) and carbimazole (19-21%).
CONCLUSION: For the period 2004-2010, ATD was the treatment of choice in Taiwan, followed by surgery and RAI.

PMID: 29688762 [PubMed - as supplied by publisher]



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Abdominal manifestations of IgG4-related disease: a pictorial review

Abstract

In the last decade, autoimmune pancreatitis has become recognised as part of a wider spectrum of IgG4-related disease, typically associated with elevated serum IgG4 levels and demonstrating a response to corticosteroid therapy. Radiologically, there is imaging overlap with other benign and neoplastic conditions. This pictorial review discusses the intra-abdominal manifestations of this disease on cross-sectional imaging before and after steroid treatment and the main radiological features which help to distinguish it from other key differentials.

Teaching Points

Autoimmune pancreatitis is part of a spectrum of IgG4-related disease.

Diagnosis is based on raised serum IgG4, clinical, radiological and histopathological findings.

Cross-sectional imaging can demonstrate the typical findings of abdominal IgG4-related disease.

Cross-sectional imaging can be used to monitor response to corticosteroid treatment.



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Brain-injured Survivors of Monochorionic Twin Pregnancies Complicated by Single Intrauterine Death: MR Findings in a Multicenter Study.

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Brain-injured Survivors of Monochorionic Twin Pregnancies Complicated by Single Intrauterine Death: MR Findings in a Multicenter Study.

Radiology. 2018 Apr 24;:

Authors: Conte G, Righini A, Griffiths PD, Rustico M, Lanna M, Mackie FL, Pinelli L, Prefumo F, Persico N, Igra MS, Parazzini C, Doneda C, Fichera A, Ambrosi C, Kilby M, Severino M, Triulzi F, Rossi A, Skipper N

Abstract
Purpose To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in co-twin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD. Results Forty-two surviving MC twins were described. The primary distinction of brain abnormalities was into nonfocal and focal lesions. The nonfocal lesions included periventricular leukomalacia (group 1; two fetuses), generalized encephalomalacia (group 2; nine fetuses), posterior encephalomalacia (group 3; seven fetuses), and bilateral parasagittal and perisylvian injury (group 4; three fetuses). The focal lesions included nonhemorrhagic lesions (group 5; 14 fetuses) and hemorrhagic lesions (group 6; seven fetuses). Focal brain lesions were more likely to be found in the surviving MC pregnancies complicated by twin-twin transfusion syndrome (TTTS) (odds ratio, 2.4; 95% confidence interval: 1.3, 18.5; P = .01) and in fetuses that underwent an obstetric intervention (odds ratio, 2.8; 95% confidence interval: 1.8, 23.6; P = .006). Conclusion Brain injury of the surviving co-twin after SIUD in MC pregnancies is usually of ischemic origin and spares the brainstem and cerebellum. Focal brain lesions are more frequent in pregnancies complicated by TTTS or in those where an intervention has been performed.

PMID: 29688161 [PubMed - as supplied by publisher]



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Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.

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Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study.

Radiology. 2018 Apr 24;:172592

Authors: Zonoobi D, Hareendranathan A, Mostofi E, Mabee M, Pasha S, Cobzas D, Rao P, Dulai SK, Kapur J, Jaremko JL

Abstract
Purpose To validate accuracy of diagnosis of developmental dysplasia of the hip (DDH) from geometric properties of acetabular shape extracted from three-dimensional (3D) ultrasonography (US). Materials and Methods In this retrospective multi-institutional study, 3D US was added to conventional two-dimensional (2D) US of 1728 infants (mean age, 67 days; age range, 3-238 days) evaluated for DDH from January 2013 to December 2016. Clinical diagnosis after more than 6 months follow-up was normal (n = 1347), borderline (Graf IIa, later normalizing spontaneously; n = 140) or dysplastic (Graf IIb or higher, n = 241). Custom software accessible through the institution's research portal automatically calculated indexes including 3D posterior and anterior alpha angle and osculating circle radius from hip surface models generated with less than 1 minute of user input. Logistic regression predicted clinical diagnosis (normal = 0, dysplastic = 1) from 3D indexes (ie, age and sex). Output represented probability of hip dysplasia from 0 to 1 (output: >0.9, dysplastic; 0.11-0.89, borderline; <0.1, normal). Software can be accessed through the research portal. Results Area under the receiver operating characteristic curve was equivalently high for 3D US indexes and 2D US alpha angle (0.996 vs 0.987). Three-dimensional US helped to correctly categorize 97.5% (235 of 241) dysplastic and 99.4% (1339 of 1347) normal hips. No dysplastic hips were categorized as normal. Correct diagnosis was provided at initial 3D US scan in 69.3% (97 of 140) of the studies diagnosed as borderline at initial 2D US scans. Conclusion Automatically calculated 3D indexes of acetabular shape performed equivalently to high-quality 2D US scans at tertiary medical centers to help diagnose DDH. Three-dimensional US reduced the number of borderline studies requiring follow-up imaging by over two-thirds.

PMID: 29688160 [PubMed - as supplied by publisher]



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Radiomics of CT Features May Be Nonreproducible and Redundant: Influence of CT Acquisition Parameters.

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Radiomics of CT Features May Be Nonreproducible and Redundant: Influence of CT Acquisition Parameters.

Radiology. 2018 Apr 24;:172361

Authors: Berenguer R, Pastor-Juan MDR, Canales-Vázquez J, Castro-García M, Villas MV, Legorburo FM, Sabater S

Abstract
Purpose To identify the reproducible and nonredundant radiomics features (RFs) for computed tomography (CT). Materials and Methods Two phantoms were used to test RF reproducibility by using test-retest analysis, by changing the CT acquisition parameters (hereafter, intra-CT analysis), and by comparing five different scanners with the same CT parameters (hereafter, inter-CT analysis). Reproducible RFs were selected by using the concordance correlation coefficient (as a measure of the agreement between variables) and the coefficient of variation (defined as the ratio of the standard deviation to the mean). Redundant features were grouped by using hierarchical cluster analysis. Results A total of 177 RFs including intensity, shape, and texture features were evaluated. The test-retest analysis showed that 91% (161 of 177) of the RFs were reproducible according to concordance correlation coefficient. Reproducibility of intra-CT RFs, based on coefficient of variation, ranged from 89.3% (151 of 177) to 43.1% (76 of 177) where the pitch factor and the reconstruction kernel were modified, respectively. Reproducibility of inter-CT RFs, based on coefficient of variation, also showed large material differences, from 85.3% (151 of 177; wood) to only 15.8% (28 of 177; polyurethane). Ten clusters were identified after the hierarchical cluster analysis and one RF per cluster was chosen as representative. Conclusion Many RFs were redundant and nonreproducible. If all the CT parameters are fixed except field of view, tube voltage, and milliamperage, then the information provided by the analyzed RFs can be summarized in only 10 RFs (each representing a cluster) because of redundancy.

PMID: 29688159 [PubMed - as supplied by publisher]



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Prospective Comparison of the Diagnostic Accuracy of MR Imaging versus CT for Acute Appendicitis.

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Prospective Comparison of the Diagnostic Accuracy of MR Imaging versus CT for Acute Appendicitis.

Radiology. 2018 Apr 24;:171838

Authors: Repplinger MD, Pickhardt PJ, Robbins JB, Kitchin DR, Ziemlewicz TJ, Hetzel SJ, Golden SK, Harringa JB, Reeder SB

Abstract
Purpose To compare the accuracy of magnetic resonance (MR) imaging with that of computed tomography (CT) for the diagnosis of acute appendicitis in emergency department (ED) patients. Materials and Methods This was an institutional review board-approved, prospective, observational study of ED patients at an academic medical center (February 2012 to August 2014). Eligible patients were nonpregnant and 12- year-old or older patients in whom a CT study had been ordered for evaluation for appendicitis. After informed consent was obtained, CT and MR imaging (with non-contrast material-enhanced, diffusion-weighted, and intravenous contrast-enhanced sequences) were performed in tandem, and the images were subsequently retrospectively interpreted in random order by three abdominal radiologists who were blinded to the patients' clinical outcomes. Likelihood of appendicitis was rated on a five-point scale for both CT and MR imaging. A composite reference standard of surgical and histopathologic results and clinical follow-up was used, arbitrated by an expert panel of three investigators. Test characteristics were calculated and reported as point estimates with 95% confidence intervals (CIs). Results Analysis included images of 198 patients (114 women [58%]; mean age, 31.6 years ± 14.2 [range, 12-81 years]; prevalence of appendicitis, 32.3%). The sensitivity and specificity were 96.9% (95% CI: 88.2%, 99.5%) and 81.3% (95% CI: 73.5%, 87.3%) for MR imaging and 98.4% (95% CI: 90.5%, 99.9%) and 89.6% (95% CI: 82.8%, 94.0%) for CT, respectively, when a cutoff point of 3 or higher was used. The positive and negative likelihood ratios were 5.2 (95% CI: 3.7, 7.7) and 0.04 (95% CI: 0, 0.11) for MR imaging and 9.4 (95% CI: 5.9, 16.4) and 0.02 (95% CI: 0.00, 0.06) for CT, respectively. Receiver operating characteristic curve analysis demonstrated that the optimal cutoff point to maximize accuracy was 4 or higher, at which point there was no difference between MR imaging and CT. Conclusion The diagnostic accuracy of MR imaging was similar to that of CT for the diagnosis of acute appendicitis.

PMID: 29688158 [PubMed - as supplied by publisher]



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Three-dimensional US in Infants with Developmental Dysplasia of the Hip: Ready for Prime Time.

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Three-dimensional US in Infants with Developmental Dysplasia of the Hip: Ready for Prime Time.

Radiology. 2018 Apr 24;:180141

Authors: Jaramillo D

PMID: 29688157 [PubMed - as supplied by publisher]



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Radiation Segmentectomy for Hepatocellular Carcinoma: Ready for Prime Time?

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Radiation Segmentectomy for Hepatocellular Carcinoma: Ready for Prime Time?

Radiology. 2018 Apr 24;:180163

Authors: Sofocleous CT, Boas FE

PMID: 29688156 [PubMed - as supplied by publisher]



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Radiation Segmentectomy: Potential Curative Therapy for Early Hepatocellular Carcinoma.

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Radiation Segmentectomy: Potential Curative Therapy for Early Hepatocellular Carcinoma.

Radiology. 2018 Apr 24;:171768

Authors: Lewandowski RJ, Gabr A, Abouchaleh N, Ali R, Al Asadi A, Mora RA, Kulik L, Ganger D, Desai K, Thornburg B, Mouli S, Hickey R, Caicedo JC, Abecassis M, Riaz A, Salem R

Abstract
Purpose To report long-term outcomes of radiation segmentectomy (RS) for early hepatocellular carcinoma (HCC). The authors hypothesized that outcomes are comparable to curative treatments for patients with solitary HCC less than or equal to 5 cm and preserved liver function. Materials and Methods This retrospective study included 70 patients (median age, 71 years; range, 22-96 years) with solitary HCC less than or equal to 5 cm not amenable to percutaneous ablation who underwent RS (dose of >190 Gy) between 2003 and 2016. Patients who underwent subsequent curative liver transplantation were excluded to eliminate this confounding variable affecting survival. Radiologic response of time to progression and median overall survival were estimated by using the Kaplan-Meier method per the guidelines of the European Association for the Study of the Liver (EASL) and the World Health Organization (WHO). Results Seventy patients were treated with RS over 14 years. Sixty-three patients (90%) showed response by using EASL criteria, of which 41 (59%) showed complete response. Fifty patients (71%) achieved response by using WHO criteria, of which 11 (16%) achieved complete response. Response rates at 6 months were 86% and 49% by using EASL and WHO criteria, respectively. Median time to progression was 2.4 years (95% confidence interval: 2.1, 5.7), with 72% of patients having no target lesion progression at 5 years. Median overall survival was 6.7 years (95% confidence interval: 3.1, 6.7); survival probability at 1, 3, and 5 years was 98%, 66%, and 57%, respectively. Overall survival probability at 1, 3, and 5 years was 100%, 82%, and 75%, respectively, in patients with baseline tumor size less than or equal to 3 cm (n = 45) and was significantly longer than in patients with tumors greater than 3 cm (P = .026). Conclusion RS provides response rates, tumor control, and survival outcomes comparable to curative-intent treatments for selected patients with early-stage HCC who have preserved liver function. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29688155 [PubMed - as supplied by publisher]



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Use of Myocardial T1 Mapping at 3.0 T to Differentiate Anderson-Fabry Disease from Hypertrophic Cardiomyopathy.

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Use of Myocardial T1 Mapping at 3.0 T to Differentiate Anderson-Fabry Disease from Hypertrophic Cardiomyopathy.

Radiology. 2018 Apr 24;:172613

Authors: Karur GR, Robison S, Iwanochko RM, Morel CF, Crean AM, Thavendiranathan P, Nguyen ET, Mathur S, Wasim S, Hanneman K

Abstract
Purpose To compare left ventricular (LV) and right ventricular (RV) 3.0-T cardiac magnetic resonance (MR) imaging T1 values in Anderson-Fabry disease (AFD) and hypertrophic cardiomyopathy (HCM) and evaluate the diagnostic value of native T1 values beyond age, sex, and conventional imaging features. Materials and Methods For this prospective study, 30 patients with gene-positive AFD (37% male; mean age ± standard deviation, 45.0 years ± 14.1) and 30 patients with HCM (57% male; mean age, 49.3 years ± 13.5) were prospectively recruited between June 2016 and September 2017 to undergo cardiac MR imaging T1 mapping with a modified Look-Locker inversion recovery (MOLLI) acquisition scheme at 3.0 T (repetition time msec/echo time msec, 280/1.12; section thickness, 8 mm). LV and RV T1 values were evaluated. Statistical analysis included independent samples t test, receiver operating characteristic curve analysis, multivariable logistic regression, and likelihood ratio test. Results Septal LV, global LV, and RV native T1 values were significantly lower in AFD compared with those in HCM (1161 msec ± 47 vs 1296 msec ± 55, respectively [P < .001]; 1192 msec ± 52 vs 1268 msec ± 55 [P < .001]; and 1221 msec ± 54 vs 1271 msec ± 37 [P = .001], respectively). A septal LV native T1 cutoff point of 1220 msec or lower distinguished AFD from HCM with sensitivity of 97%, specificity of 93%, and accuracy of 95%. Septal LV native T1 values differentiated AFD from HCM after adjustment for age, sex, and conventional imaging features (odds ratio, 0.94; 95% confidence interval: 0.91, 0.98; P = < .001). In a nested logistic regression model with age, sex, and conventional imaging features, model fit was significantly improved by the addition of septal LV native T1 values (χ2 [df = 1] = 33.4; P < .001). Conclusion Cardiac MR imaging native T1 values at 3.0 T are significantly lower in patients with AFD compared with those with HCM and provide independent and incremental diagnostic value beyond age, sex, and conventional imaging features. © RSNA, 2018.

PMID: 29688154 [PubMed - as supplied by publisher]



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Medium or Large Hepatocellular Carcinoma: Sorafenib Combined with Transarterial Chemoembolization and Radiofrequency Ablation.

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Medium or Large Hepatocellular Carcinoma: Sorafenib Combined with Transarterial Chemoembolization and Radiofrequency Ablation.

Radiology. 2018 Apr 24;:172028

Authors: Zhu K, Huang J, Lai L, Huang W, Cai M, Zhou J, Guo Y, Chen J

Abstract
Purpose To determine the safety and efficacy of sorafenib combined with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) (hereafter, S-TACE-RFA) in patients with medium or large (range, 3.1-7.0 cm in diameter) hepatocellular carcinoma (HCC). Materials and Methods This retrospective study evaluated the medical records of consecutive patients with medium or large HCC who underwent S-TACE-RFA or combined TACE and RFA (hereafter, TACE-RFA) from January 2010 to December 2014. Sorafenib was started 3-5 days after TACE, and RFA was performed 1-2 weeks after TACE. Treatment complications, recurrence-free survival (RFS), and overall survival (OS) in patients who underwent S-TACE-RFA were compared with those in patients who underwent TACE-RFA. Results Of the 174 patients who underwent S-TACE-RFA or TACE-RFA, 106 who met the eligibility criteria were included in this study. Among them, 40 underwent S-TACE-RFA and 66 underwent TACE-RFA. The patients who underwent S-TACE-RFA had longer RFS (median, 24.0 vs 10.0 months; P = .04) and better OS (median, 63.0 vs 36.0 months, P = .048) than those who underwent TACE-RFA. S-TACE-RFA and α-fetoprotein level were independent prognostic factors for survival in uni- and multivariable analyses. The rate of complications in patients who underwent S-TACE-RFA was similar to that in patients who underwent TACE-RFA (22.5% vs 18.2%, P = .59). Conclusion S-TACE-RFA resulted in longer RFS and better OS than did TACE-RFA in patients with medium or large HCC. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29688153 [PubMed - as supplied by publisher]



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Freiburg Neuropathology Case Conference



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Improvement of region of interest extraction and scanning method of computer-aided diagnosis system for osteoporosis using panoramic radiographs

Abstract

Objectives

Patients undergoing osteoporosis treatment benefit greatly from early detection. We previously developed a computer-aided diagnosis (CAD) system to identify osteoporosis using panoramic radiographs. However, the region of interest (ROI) was relatively small, and the method to select suitable ROIs was labor-intensive. This study aimed to expand the ROI and perform semi-automatized extraction of ROIs. The diagnostic performance and operating time were also assessed.

Methods

We used panoramic radiographs and skeletal bone mineral density data of 200 postmenopausal women. Using the reference point that we defined by averaging 100 panoramic images as the lower mandibular border under the mental foramen, a 400 × 100-pixel ROI was automatically extracted and divided into four 100 × 100-pixel blocks. Valid blocks were analyzed using program 1, which examined each block separately, and program 2, which divided the blocks into smaller segments and performed scans/analyses across blocks. Diagnostic performance was evaluated using another set of 100 panoramic images.

Results

Most ROIs (97.0%) were correctly extracted. The operation time decreased to 51.4% for program 1 and to 69.3% for program 2. The sensitivity, specificity, and accuracy for identifying osteoporosis were 84.0, 68.0, and 72.0% for program 1 and 92.0, 62.7, and 70.0% for program 2, respectively. Compared with the previous conventional system, program 2 recorded a slightly higher sensitivity, although it occasionally also elicited false positives.

Conclusions

Patients at risk for osteoporosis can be identified more rapidly using this new CAD system, which may contribute to earlier detection and intervention and improved medical care.



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Imaging features of benign mass lesions in the nasal cavity and paranasal sinuses according to the 2017 WHO classification

Abstract

The World Health Organization (WHO) 2017 classification of head and neck tumors has been just published and has reorganized tumors of the nasal cavity and paranasal sinuses. In this classification, three new entities (seromucinous hamartoma, NUT carcinoma, and biphenotypic sinonasal sarcoma) were included, while the total number of tumors has been reduced by excluding tumors if they did not occur exclusively or predominantly in this region. Among these entities, benign tumors were classified as sinonasal papillomas, respiratory epithelial lesions, salivary gland tumors, benign soft tissue tumors, or other tumors. In contrast, inflammatory diseases often show tumor-like appearances. The imaging features of these benign tumors and tumor-like inflammatory diseases often resemble malignant tumors, and some benign lesions should be given attention in the follow-up period and before surgery to avoid recurrence, malignant transformation, or massive bleeding. Understanding the CT and MR imaging features of various benign mass lesions is clinically important for appropriate therapy. The purpose of this article is to describe the clinical characteristics and imaging features of each of clinically important nasal and paranasal benign mass lesions, as classified according to the WHO 2017 classification of head and neck tumors, along with some inflammatory diseases.



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Performance of an Automated Versus a Manual Whole-Body Magnetic Resonance Imaging Workflow

Objectives The aim of this study was to evaluate the performance of an automated workflow for whole-body magnetic resonance imaging (WB-MRI), which reduces user interaction compared with the manual WB-MRI workflow. Materials and Methods This prospective study was approved by the local ethics committee. Twenty patients underwent WB-MRI for myopathy evaluation on a 3 T MRI scanner. Ten patients (7 women; age, 52 ± 13 years; body weight, 69.9 ± 13.3 kg; height, 173 ± 9.3 cm; body mass index, 23.2 ± 3.0) were examined with a prototypical automated WB-MRI workflow, which automatically segments the whole body, and 10 patients (6 women; age, 35.9 ± 12.4 years; body weight, 72 ± 21 kg; height, 169.2 ± 10.4 cm; body mass index, 24.9 ± 5.6) with a manual scan. Overall image quality (IQ; 5-point scale: 5, excellent; 1, poor) and coverage of the study volume were assessed by 2 readers for each sequence (coronal T2-weighted turbo inversion recovery magnitude [TIRM] and axial contrast-enhanced T1-weighted [ce-T1w] gradient dual-echo sequence). Interreader agreement was evaluated with intraclass correlation coefficients. Examination time, number of user interactions, and MR technicians' acceptance rating (1, highest; 10, lowest) was compared between both groups. Results Total examination time was significantly shorter for automated WB-MRI workflow versus manual WB-MRI workflow (30.0 ± 4.2 vs 41.5 ± 3.4 minutes, P

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Application of induced pluripotency in cancer studies

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Publication date: May–June 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 3
Author(s): Patrycja Czerwińska, Sylwia Mazurek, Maciej Wiznerowicz
As soon as induced pluripotent stem cells (iPSCs) reprogramming of somatic cells were developed, the discovery attracted the attention of scientists, offering new perspectives for personalized medicine and providing a powerful platform for drug testing. The technology was almost immediately applied to cancer studies. As presented in this review, direct reprogramming of cancer cells with enforced expression of pluripotency factors have several basic purposes, all of which aim to explain the complex nature of cancer development and progression, therapy-resistance and relapse, and ultimately lead to the development of novel anti-cancer therapies. Here, we briefly present recent advances in reprogramming methodologies as well as commonalities between cell reprogramming and carcinogenesis and discuss recent outcomes from the implementation of induced pluripotency into cancer research.



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Performance of an Automated Versus a Manual Whole-Body Magnetic Resonance Imaging Workflow

Objectives The aim of this study was to evaluate the performance of an automated workflow for whole-body magnetic resonance imaging (WB-MRI), which reduces user interaction compared with the manual WB-MRI workflow. Materials and Methods This prospective study was approved by the local ethics committee. Twenty patients underwent WB-MRI for myopathy evaluation on a 3 T MRI scanner. Ten patients (7 women; age, 52 ± 13 years; body weight, 69.9 ± 13.3 kg; height, 173 ± 9.3 cm; body mass index, 23.2 ± 3.0) were examined with a prototypical automated WB-MRI workflow, which automatically segments the whole body, and 10 patients (6 women; age, 35.9 ± 12.4 years; body weight, 72 ± 21 kg; height, 169.2 ± 10.4 cm; body mass index, 24.9 ± 5.6) with a manual scan. Overall image quality (IQ; 5-point scale: 5, excellent; 1, poor) and coverage of the study volume were assessed by 2 readers for each sequence (coronal T2-weighted turbo inversion recovery magnitude [TIRM] and axial contrast-enhanced T1-weighted [ce-T1w] gradient dual-echo sequence). Interreader agreement was evaluated with intraclass correlation coefficients. Examination time, number of user interactions, and MR technicians' acceptance rating (1, highest; 10, lowest) was compared between both groups. Results Total examination time was significantly shorter for automated WB-MRI workflow versus manual WB-MRI workflow (30.0 ± 4.2 vs 41.5 ± 3.4 minutes, P

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Preparation of MnO2 coated fibers for gamma spectrometric measurements - A comparison of four practical approaches

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Michael Schubert, Martin Oberreich, Jan Scholten
The analysis of natural radium-in-water activity concentrations is for two reasons of general interest: (1) radium in natural waters may pose a problem with regard to radiation protection and (2) radium isotopes in natural waters can be used as environmental tracers in hydrological studies. A state-of-the-art method for radium extraction from (generally large) water sample volumes is radium adsorption onto MnO2 coated acrylic fibers. In our study we comparatively evaluated four methodical approaches for post-extraction preparation of the fiber to allow gamma spectrometric measurements. The methods included (1) straightforward measurement of the loose fiber, (2) compressing the fiber after mixing it with an adhesive, (3) combustion of the fiber and embedding the ash in candlewax, and (4) leaching of the fiber and embedding the resulting precipitate in candlewax. The aim of the study was to compare the advantages and disadvantages of the four preparation approaches with respect to their individual practicability. Even though the methodical fiber preparation approaches have been suggested in the literature before (as cited in this paper), results of their direct practical comparison have not been presented yet. Our study revealed that balancing practical sample preparation effort against data reproducibility suggests a measurement of the compressed fiber applying an adhesive to be the preferable approach.



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Geochemical signature of NORM waste in Brazilian oil and gas industry

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): G.T. De-Paula-Costa, I.C. Guerrante, J. Costa-de-Moura, F.C. Amorim
The Brazilian Nuclear Energy Agency (CNEN) is responsible for any radioactive waste storage and disposal in the country. The storage of radioactive waste is carried out in the facilities under CNEN regulation and its disposal is operated, managed and controlled by the CNEN. Oil NORM (Naturally Occurring Radioactive Materials) in this article refers to waste coming from oil exploitation. Oil NORM has called much attention during the last decades, mostly because it is not possible to determine its primary source due to the actual absence of a regulatory control mechanism. There is no efficient regulatory tool which allows determining the origin of such NORM wastes even among those facilities under regulatory control. This fact may encourage non-authorized radioactive material transportation, smuggling and terrorism. The aim of this project is to provide a geochemical signature for oil NORM waste using its naturally occurring isotopic composition to identify its origin. The here proposed method is the modeling of radioisotopes normally present in oil pipe contamination such as 228Ac, 214Bi and 214Pb analyzed by gamma spectrometry. The specific activities of elements from different decay series are plotted in a scatter diagram. This method was successfully tested with gamma spectrometry analyses of oil sludge NORM samples from four different sources obtained from Petrobras reports for the Campos Basin/Brazil.



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Comparison of experimental and calculated shielding factors for modular buildings in a radioactive fallout scenario

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Yvonne Hinrichsen, Robert Finck, Karl Östlund, Christopher Rääf, Kasper Grann Andersson
Experimentally and theoretically determined shielding factors for a common light construction dwelling type were obtained and compared. Sources of the gamma-emitting radionuclides 60Co and 137Cs were positioned around and on top of a modular building to represent homogeneous fallout. The modular building used was a standard prefabricated structure obtained from a commercial manufacturer. Four reference positions for the gamma radiation detectors were used inside the building. Theoretical dose rate calculations were performed using the Monte Carlo code MCNP6, and additional calculations were performed that compared the shielding factor for 137Cs and 134Cs. This work demonstrated the applicability of using MCNP6 for theoretical calculations of radioactive fallout scenarios. Furthermore, the work showed that the shielding effect for modular buildings is almost the same for 134Cs as for 137Cs.



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‘Omic’ technologies as a helpful tool in radioecological research

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Polina Yu. Volkova, Stanislav A. Geras'kin
This article presents a brief review of the modern 'omic' technologies, namely genomics, epigenomics, transcriptomics, proteomics, and metabolomics, as well as the examples of their possible use in radioecology. For each technology, a short description of advances, limitations, and instrumental applications is given. In addition, the review contains examples of successful use of 'omic' technologies in the assessment of biological effects of pollutants in the field conditions.



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A survey of uranium levels in urine and hair of people living in a coal mining area in Yili, Xinjiang, China

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Rehemanjiang Wufuer, Wenjuan Song, Daoyong Zhang, Xiangliang Pan, Geoffrey Michael Gadd
Recent reports have drawn attention to the uranium contamination arising from coal mining activities in the Yili region of Xinjiang, China due to the mixed distribution of uranium and coal mines, and some of the coal mines being associated with a high uranium content. In this study, we have collected water samples, solid samples such as soil, mud, coal, and coal ash, and hair and urine samples from local populations in order to evaluate the uranium level in this environment and its implications for humans in this high uranium coal mining area. Our results showed that uranium concentrations were 8.71–10.91 μg L−1 in underground water, whereas lower levels of uranium occurred in river water. Among the solid samples, coal ash contained fairly high concentrations of uranium (33.1 μg g−1) due to enrichment from coal burning. In addition, uranium levels in the other solid samples were around 2.8 μg g−1 (the Earth's average background value). Uranium concentrations in hair and urine samples were 22.2–634.5 ng g−1 (mean: 156.2 ng g−1) and 8.44–761.6 ng L−1 (mean: 202.6 ng L−1), respectively, which are significantly higher than reference values reported for unexposed subjects in other areas. Therefore, these results indicate that people living in this coal mining area have been subjected to uranium exposure for long periods of time.



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The 2014 Integrated Field Exercise of the Comprehensive Nuclear-Test-Ban Treaty revisited: The case for data fusion

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Jonathan L. Burnett, Harry S. Miley, Theodore W. Bowyer, Ian M. Cameron
The International Monitoring System of the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) uses a global network of radionuclide monitoring stations to detect evidence of a nuclear explosion. The two radionuclide technologies employed—particulate and noble gas (radioxenon) detection—have applications for data fusion to improve detection of a nuclear explosion. Using the hypothetical 0.5 kT nuclear explosive test scenario of the CTBTO 2014 Integrated Field Exercise, the intrinsic relationship between particulate and noble gas signatures has been examined. This study shows that, depending upon the time of the radioxenon release, the particulate progeny can produce the more detectable signature. Thus, as both particulate and noble gas signatures are inherently coupled, the authors recommend that the sample categorization schemes should be linked.



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Submarine groundwater discharge and chemical behavior of tracers in Laizhou Bay, China

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Yan Zhang, Hailong Li, Xuejing Wang, Chaoyue Wang, Kai Xiao, Wenjing Qu
Naturally occurring radon (222Rn) and radium isotopes are widely used to trace water mixing and submarine groundwater discharge (SGD) in the coastal zones. However, their activities in groundwater are variable both spatially and temporally. Here, time series sampling of 222Rn and radium was conducted to investigate their behavior in intertidal groundwater of Laizhou Bay, China. The result shows that groundwater redox conditions have an important impact on the behavior of tracers. The activities of tracers will decrease under oxidizing conditions and increase under reducing conditions. Radon and radium mass balance models were used to evaluate the flushing time and SGD based on spatial surveys in Laizhou Bay. The flushing time is estimated to be 32.9–55.3 d with coupled models, which agrees well with the result of tidal prism model. The trace-derived SGD in the whole bay ranges from 6.1 × 108 to 9.0 × 108 m3/d and the re-circulated seawater (RSGD) ranges from 5.5 × 108 to 8.5 × 108 m3/d. The average SGD and RSGD fluxes are 22.8 and 21.1 times greater than the Yellow River discharge in April 2014, respectively. The study provides a better understanding of the dynamics of coastal groundwater and behavior of tracers in a well-studied bay system.



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Evaluation of background radiation dose contributions in the United Arab Emirates

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Braden Goddard, Emmanuel Bosc, Sarra Al Hasani, Cody Lloyd
The natural background radiation consists of three main components; cosmic, terrestrial, and skyshine. Although there are currently methods available to measure the total dose rate from background radiation, no established methods exist that allow for the measurement of each component the background radiation. This analysis consists of a unique methodology in which the dose rate contribution from each component of the natural background radiation is measured and calculated. This project evaluates the natural background dose rate in the Abu Dhabi City region from all three of these components using the developed methodology. Evaluating and understanding the different components of background radiation provides a baseline allowing for the detection, and possibly attribution, of elevated radiation levels. Measurements using a high-pressure ion chamber with different shielding configurations and two offshore measurements provided dose rate information that were attributed to the different components of the background radiation. Additional spectral information was obtained using an HPGe detector to verify and quantify the presence of terrestrial radionuclides. By evaluating the dose rates of the different shielding configurations the comic, terrestrial, and skyshine contribution in the Abu Dhabi City region were determined to be 33.0 ± 1.7, 15.7 ± 2.5, and 2.4 ± 2.1 nSv/h, respectively.



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Characterizing regional-scale temporal evolution of air dose rates after the Fukushima Daiichi Nuclear Power Plant accident

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Haruko M. Wainwright, Akiyuki Seki, Satoshi Mikami, Kimiaki Saito
In this study, we quantify the temporal changes of air dose rates in the regional scale around the Fukushima Dai-ichi Nuclear Power Plant in Japan, and predict the spatial distribution of air dose rates in the future. We first apply the Bayesian geostatistical method developed by Wainwright et al. (2017) to integrate multiscale datasets including ground-based walk and car surveys, and airborne surveys, all of which have different scales, resolutions, spatial coverage, and accuracy. This method is based on geostatistics to represent spatial heterogeneous structures, and also on Bayesian hierarchical models to integrate multiscale, multi-type datasets in a consistent manner. We apply this method to the datasets from three years: 2014 to 2016. The temporal changes among the three integrated maps enables us to characterize the spatiotemporal dynamics of radiation air dose rates. The data-driven ecological decay model is then coupled with the integrated map to predict future dose rates. Results show that the air dose rates are decreasing consistently across the region. While slower in the forested region, the decrease is particularly significant in the town area. The decontamination has contributed to significant reduction of air dose rates. By 2026, the air dose rates will continue to decrease, and the area above 3.8 μSv/h will be almost fully contained within the non-residential forested zone.



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Method for source localization proposed and applied to the October 2017 case of atmospheric dispersion of Ru-106

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Jens Havskov Sørensen
An efficient numerical method for the temporal and spatial localization of an unknown point source of an atmospheric tracer is proposed. The method, which is based on inverse modelling techniques, employs available data from a network of ground-level stations on the condition that the measurements represent the plume geographically and temporally. The method, which employs a level-of-agreement approach, is applied to the October 2017 air concentration measurements of Ru-106 in Europe.



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