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At least 379 records · Page 21

End-hole Versus Microvalve Infusion Catheters in Patients Undergoing Drug-Eluting Microspheres-TACE for Solitary Hepatocellular Carcinoma Tumors: A Retrospective Analysis

Introduction: Pre-transplant locoregional therapy for hepatocellular carcinoma (HCC) during bridge-to-transplant impacts recurrence and survival rates following liver transplantation. Optimizing the effectiveness of transarterial chemoembolization (TACE) in this population is imperative, and microvalve infusion catheters offer a means of such improvement. Methods: All treatment-naive patients with solitary HCC tumors < 6.5 cm who underwent drug-eluting microspheres (DEM) TACE between 04/2015 and 08/2017 were retrospectively reviewed. Eighty-eight included patients underwent DEM-TACE with either standard end-hole catheters (EH) or microvalve infusion catheters (MVI). The EH (n = 70) and MVI (n = 18) cohorts had similar baseline tumor size, laboratory values, and tumor etiologies. Results: Initial objective response rates were significantly higher in MVI vs. EH (100% vs. 76.5%, p = 0.019). There was no difference in adverse events between groups (p = 0.265). MVI patients exhibited lower AST (p = 0.003) and ALT (p = 0.044) at 6 months. Blinded pathological analysis of explanted livers showed greater concentrations of microspheres within the tumor relative to the surrounding tissue in MVI explants (88.7 ± 10.6%) versus the EH explants (55.3 ± 32.7%) (p = 0.002). There was significantly higher percentage tumor necrosis in the MVI group (89.0 ± 2.2%) compared with the EH group (56.1 ± 44.5%) (p = 0.006). Conclusion: In this retrospective study of a single-center cohort, DEM-TACE procedures with MVI were associated with improved tumor response, increased deposition of microspheres within tumor tissue, and higher percentage tumor necrosis at explant relative to those performed using EH catheters.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Standard Lexicons, Coding Systems and Ontologies for Interoperability and Semantic Computation in Imaging

Standard clinical terms, codes, and ontologies promote clarity and interoperability. Within radiology, there is a variety of relevant content resources, tools and technologies. These provide the basis for fundamental imaging workflows such as reporting and billing, and also facilitate a range of applications in quality improvement and research. This article reviews the key characteristics of lexicons, coding systems, and ontologies. A number of standards are described, including International Classification of Diseases-10-Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT), Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT), Logical Observation Identifiers Names and Codes (LOINC), and RadLex. Tools for accessing this material are reviewed, such as the National Center for Biomedical Ontology BioPortal system. Web services are discussed as a mechanism for semantic application development. Several example systems, workflows, and research applications using semantic technology are also surveyed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A procedure for the estimation of the numerical uncertainty of CFD calculations based on grid refinement studies

This paper offers a procedure for the estimation of the numerical uncertainty of any integral or local flow quantity as a result of a fluid flow computation; the procedure requires solutions on systematically refined grids. The error is estimated with power series expansions as a function of the typical cell size. These expansions, of which four types are used, are fitted to the data in the least-squares sense. The selection of the best error estimate is based on the standard deviation of the fits. The error estimate is converted into an uncertainty with a safety factor that depends on the observed order of grid convergence and on the standard deviation of the fit. For well-behaved data sets, i.e. monotonic convergence with the expected observed order of grid convergence and no scatter in the data, the method reduces to the well known Grid Convergence Index. Examples of application of the procedure are included. - Highlights: • Estimation of the numerical uncertainty of any integral or local flow quantity. • Least squares fits to power series expansions to handle noisy data. • Excellent results obtained for manufactured solutions. • Consistent results obtained for practical CFD calculations. • Reduces to the well known Grid Convergence Index for well-behaved data sets.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Direct current injection and thermocapillary flow for purification of aligned arrays of single-walled carbon nanotubes

Aligned arrays of semiconducting single-walled carbon nanotubes (s-SWNTs) represent ideal configurations for use of this class of material in high performance electronics. Development of means for removing the metallic SWNTs (m-SWNTs) in as-grown arrays represents an essential challenge. Here, we introduce a simple scheme that achieves this type of purification using direct, selective current injection through interdigitated electrodes into the m-SWNTs, to allow their complete removal using processes of thermocapillarity and dry etching. Experiments and numerical simulations establish the fundamental aspects that lead to selectivity in this process, thereby setting design rules for optimization. Single-step purification of arrays that include thousands of SWNTs demonstrates the effectiveness and simplicity of the procedures. The result is a practical route to large-area aligned arrays of purely s-SWNTs with low-cost experimental setups.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses

PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of the patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Communication: A difference density picture for the self-consistent field ansatz

We formulate self-consistent field (SCF) theory in terms of an interaction picture where the working variable is the difference density matrix between the true system and a corresponding superposition of atomic densities. As the difference density matrix directly represents the electronic deformations inherent in chemical bonding, this “difference self-consistent field (dSCF)” picture provides a number of significant conceptual and computational advantages. We show that this allows for a stable and efficient dSCF iterative procedure with wholly single-precision Coulomb and exchange matrix builds. We also show that the dSCF iterative procedure can be performed with aggressive screening of the pair space. These approximations are tested and found to be accurate for systems with up to 1860 atoms and >10 000 basis functions, providing for immediate overall speedups of up to 70% in the heavily optimized TERACHEM SCF implementation.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

DETECTING BARYON ACOUSTIC OSCILLATIONS

Baryon acoustic oscillations (BAOs) are a feature imprinted in the galaxy distribution by acoustic waves traveling in the plasma of the early universe. Their detection at the expected scale in large-scale structures strongly supports current cosmological models with a nearly linear evolution from redshift z Almost-Equal-To 1000 and the existence of dark energy. In addition, BAOs provide a standard ruler for studying cosmic expansion. In this paper, we focus on methods for BAO detection using the correlation function measurement {xi}-hat. For each method, we want to understand the tested hypothesis (the hypothesis H{sub 0} to be rejected) and the underlying assumptions. We first present wavelet methods which are mildly model-dependent and mostly sensitive to the BAO feature. Then we turn to fully model-dependent methods. We present the method used most often based on the {chi}{sup 2} statistic, but we find that it has limitations. In general the assumptions of the {chi}{sup 2} method are not verified, and it only gives a rough estimate of the significance. The estimate can become very wrong when considering more realistic hypotheses, where the covariance matrix of {xi}-hat depends on cosmological parameters. Instead, we propose to use the {Delta}l method based on two modifications: we modify the procedure for computing the significance and make it rigorous, and we modify the statistic to obtain better results in the case of varying covariance matrix. We verify with simulations that correct significances are different from the ones obtained using the classical {chi}{sup 2} procedure. We also test a simple example of varying covariance matrix. In this case we find that our modified statistic outperforms the classical {chi}{sup 2} statistic when both significances are correctly computed. Finally, we find that taking into account variations of the covariance matrix can change both BAO detection levels and cosmological parameter constraints.

79 ASTRONOMY AND ASTROPHYSICS↗

Boundary layer simulator (BLIMPJ) improvement

Improvements were made to advance the current Boundary Layer Integral Matrix Procedure - Version J (BLIMPJ) containing previously modeled simplified calculation methods accounting for surface roughness, relaminarization, and thick boundary layer effects. These improvements have potential applications in the design of the future Orbit Transfer Vehicles (OTV) engines. The coded wall roughness module was validated successfully against measured data from the LeRC 60-15 degree half-angle conical nozzle. The relaminarization model was modified to include wall cooling and roughness based on a set of test data from the same nozzle. The model was compared against typical data sets for validation in different flow regimes. The thrust loss calculation for thick boundary layer effects was computerized where the iterations between TDK and BLIMPJ proceeded automatically until convergence was achieved. An example is given for a typical OTV nozzle with an area ratio 1293.

Praharaj, S. C.↗

Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-J-150: Development of An End-To-End Chain Test for the First-In-Man MR-Guided Treatments with the MRI Linear Accelerator by Using the Alderson Phantom

The Alderson phantom is a human shaped quality assurance tool that has been used for over 30 years in radiotherapy. The phantom can provide integrated tests of the entire chain of treatment planning and delivery. The purpose of this research was to investigate if this phantom can be used to chain test a treatment on the MRI linear accelerator (MRL) which is currently being developed at the UMC Utrecht, in collaboration with Elekta and Philips. The latter was demonstrated by chain testing the future First-in-Man treatments with this system.An Alderson phantom was used to chain test an entire treatment with the MRL. First, a CT was acquired of the phantom with additional markers that are both visible on MR and CT. A treatment plan for treating bone metastases in the sacrum was made. The phantom was consecutively placed in the MRL. For MRI imaging, an 3D volume was acquired. The initially developed treatment plan was then simulated on the new MRI dataset. For simulation, both the MR and CT data was used by registering them together. Before treatment delivery a MV image was acquired and compared with a DRR that was calculated form the MR/CT registration data. Finally, the treatment was delivered. Figure 1 shows both the T1 weighted MR-image of the phantom and the CT that was registered to the MR image. Figure 2 shows both the calculated and measured MV image that was acquired by the MV panel. Figure 3 shows the dose distribution that was simulated. The total elapsed time for the entire procedure excluding irradiation was 13:35 minutes.The Alderson Phantom yields sufficient MR contrast and can be used for full MR guided radiotherapy treatment chain testing. As a result, we are able to perform an end-to-end chain test of the future First-in-Man treatments.

60 APPLIED LIFE SCIENCES↗

On Quantitative Determination of the Degree of Independence of Qubit Transformation by a Quantum Gate or Channel

A multiqubit channel (quantum gate) is considered. A procedure of calculating the distance from the quantum-gate matrix to the subspace of matrices, which are tensor products of the transformation matrices of qubit subsystems, is proposed. The value of this distance indicates the degree of independence of transformation of these qubit subsystems. The proposed approach is considered as applied to waveguide implementation of quantum bits.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Micro-based fact collection tool user's manual

A procedure designed for use by an analyst to assist in the collection and organization of data gathered during the interview processes associated with system analysis and modeling task is described. The basic concept behind the development of this tool is that during the interview process an analyst is presented with assertions of facts by the domain expert. The analyst also makes observations of the domain. These facts need to be collected and preserved in such a way as to allow them to serve as the basis for a number of decision making processes throughout the system development process. This tool can be thought of as a computerization of the analysts's notebook.

Mayer, Richard↗

Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

Purpose: Our experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described. Methods: Altogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed. Results: The ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred. Conclusions: Application of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Determination of real machine-tool settings and minimization of real surface deviation by computerized inspection

A numerical method is developed for the minimization of deviations of real tooth surfaces from the theoretical ones. The deviations are caused by errors of manufacturing, errors of installment of machine-tool settings and distortion of surfaces by heat-treatment. The deviations are determined by coordinate measurements of gear tooth surfaces. The minimization of deviations is based on the proper correction of initially applied machine-tool settings. The contents of accomplished research project cover the following topics: (1) Descriptions of the principle of coordinate measurements of gear tooth surfaces; (2) Deviation of theoretical tooth surfaces (with examples of surfaces of hypoid gears and references for spiral bevel gears); (3) Determination of the reference point and the grid; (4) Determination of the deviations of real tooth surfaces at the points of the grid; and (5) Determination of required corrections of machine-tool settings for minimization of deviations. The procedure for minimization of deviations is based on numerical solution of an overdetermined system of n linear equations in m unknowns (m much less than n ), where n is the number of points of measurements and m is the number of parameters of applied machine-tool settings to be corrected. The developed approach is illustrated with numerical examples.

Litvin, Faydor L.↗

Transcatheter Arterial Embolization with a Mixture of Absolute Ethanol and Iodized Oil for Poorly Visualized Endophytic Renal Masses Prior to CT-Guided Percutaneous Cryoablation

PurposeTo retrospectively evaluate the feasibility of transcatheter arterial embolization (TAE) using a mixture of absolute ethanol and iodized oil to improve localization of endophytic renal masses on unenhanced computed tomography (CT) prior to CT-guided percutaneous cryoablation (PCA).Materials and MethodsOur institutional review board approved this retrospective study. From September 2011 to June 2015, 17 patients (mean age, 66.8 years) with stage T1a endophytic renal masses (mean diameter, 26.5 mm) underwent TAE using a mixture of absolute ethanol and iodized oil to improve visualization of small and endophytic renal masses on unenhanced CT prior to CT-guided PCA. TAE was considered successful that accumulated iodized oil depicted whole of the tumor edge on CT. PCA was considered successful when the iceball covered the entire tumor with over a 5 mm margin. Oncological and renal functional outcomes and complications were also evaluated.ResultsTAE was successfully performed in 16 of 17 endophytic tumors. The 16 tumors were performed under CT-guided PCA with their distinct visualization of localization and safe ablated margin. During the mean follow-up period of 15.4 ± 5.1 months, one patient developed local recurrence. Estimated glomerular filtration rate declined by 8 % with statistical significance (P = 0.01). There was no procedure-related significant complication.ConclusionTAE using a mixture of absolute ethanol and iodized oil to improve visualization of endophytic renal masses facilitated tumor localization on unenhanced CT, permitting depiction of the tumor edge as well as a safe margin for ablation during CT-guided PCA, with an acceptable decline in renal function.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Computer simulation of magnetization-controlled shunt reactors for calculating electromagnetic transients in power systems

A computer procedure for simulating magnetization-controlled dc shunt reactors is described, which enables the electromagnetic transients in electric power systems to be calculated. It is shown that, by taking technically simple measures in the control system, one can obtain high-speed reactors sufficient for many purposes, and dispense with the use of high-power devices for compensating higher harmonic components.

24 POWER TRANSMISSION AND DISTRIBUTION↗

CT-Guided Superior Vena Cava Puncture: A Solution to Re-Establishing Access in Haemodialysis-Related Central Venous Occlusion Refractory to Conventional Endovascular Techniques

PurposeThe purpose of this technical note is to demonstrate the novel use of CT-guided superior vena cava (SVC) puncture and subsequent tunnelled haemodialysis (HD) line placement in end-stage renal failure (ESRF) patients with central venous obstruction refractory to conventional percutaneous venoplasty (PTV) and wire transgression, thereby allowing resumption of HD.MethodsThree successive ESRF patients underwent CT-guided SVC puncture with subsequent tract recanalisation. Ultrasound-guided puncture of the right internal jugular vein was performed, the needle advanced to the patent SVC under CT guidance, with subsequent insertion of a stabilisation guidewire. Following appropriate tract angioplasty, twin-tunnelled HD catheters were inserted and HD resumed.ResultsNo immediate complications were identified. There was resumption of HD in all three patients with a 100 % success rate. One patient’s HD catheter remained in use for 2 years post-procedure, and another remains functional 1 year to the present day. One patient died 2 weeks after the procedure due to pancreatitis-related abdominal sepsis unrelated to the Tesio lines.ConclusionCT-guided SVC puncture and tunnelled HD line insertion in HD-related central venous occlusion (CVO) refractory to conventional recanalisation options can be performed safely, requires no extra equipment and lies within the skill set and resources of most interventional radiology departments involved in the management of HD patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Stable explicit coupling of the Yee scheme with a linear current model in fluctuating magnetized plasmas

This work analyzes the stability of the Yee scheme for non-stationary Maxwell's equations coupled with a linear current model with density fluctuations. We show that the usual procedure may yield unstable scheme for physical situations that correspond to strongly magnetized plasmas in X-mode (TE) polarization. We propose to use first order clustered discretization of the vectorial product that gives back a stable coupling. We validate the schemes on some test cases representative of direct numerical simulations of X-mode in a magnetic fusion plasma including turbulence.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗