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At least 973 records · Page 54

Microbial community proteomics for characterizing the range of metabolic functions and activities of human gut microbiota

We found that the human gastrointestinal (GI) tract is a complex, dynamic ecosystem that consists of a carefully tuned balance of human host and microbiota membership. The microbiome component is not insignificant, but rather provides important functions that are absolutely critical to many aspects of human health, including nutrient transformation and absorption, drug metabolism, pathogen defense, and immune system development. Microbial community proteomics (sometimes referred to as metaproteomics) provides a powerful approach to measure the range and details of human gut microbiota functions and metabolic activities, revealing information about microbiome development and stability especially with regard to human health vs. disease states. In most cases, both microbial and human proteins are extracted from fecal samples and then measured by the high performance MS-based proteomics technology. We review the field of human gut microbiome community proteomics, with a focus on the experimental and informatics considerations involved in characterizing systems that range from low complexity defined model gut microbiota in gnotobiotic mice, to the simple gut microbiota in the GI tract of newborn infants, and finally to the complex gut microbiota in adults. Moreover, the current state-of-the-art in experimental and bioinformatics capabilities for community proteomics enable a detailed measurement of the gut microbiota, yielding valuable insights into the broad functional profiles of even complex microbiota. Future developments are likely to expand into improved analysis throughput and coverage depth, as well as post-translational modification characterizations.

59 BASIC BIOLOGICAL SCIENCES↗

Circumstances of suicide among individuals with a history of cancer

Abstract Objective Cancer can trigger psychological distress, which may be associated with risk of suicide. We explored precipitating circumstances of suicides among decedents with and without a history of cancer. Methods Coroner or medical examiner and law enforcement narratives of adult suicides were coded from 17 participating states in Centers for Disease Control and Prevention's National Violent Death Reporting System during 2004 to 2013. Bivariate and multivariate analyses examined associations between cancer history and factors that precipitated suicide. Results Of 90 581 suicides, 4182 decedents (4.6%) had a history of cancer. Significantly more decedents with a history of cancer (versus without) were male, non‐Hispanic white, married, veterans, and aged 55 or older ( P < .001). Decedents with a history of cancer were more likely to die of suicide by firearm and less likely to die of suicide by suffocation compared to poisoning. In matched case analyses controlling for demographic and recent circumstances, fewer decedents with a history of cancer had mental health problems, history of suicide attempts, alcohol use problems, intimate partner problems, financial problems, job problems, and recent crisis. Conclusions Findings highlight the potential to identify high‐risk populations for suicide prevention in clinical practice.

Massetti, Greta M.↗

Application of a Physiologically Based Pharmacokinetic Model to Study Theophylline Metabolism and Its Interactions With Ciprofloxacin and Caffeine: Application of a Physiologically Based Pharmacokinetic

Theophylline is a commonly used bronchodilator. However, due to its narrow therapeutic range, moderate elevation of serum concentration can result in adverse drug reactions (ADRs). ADRs occur because of interhuman pharmacokinetic variability and interactions with coprescribed medicines. We developed a physiologically based pharmacokinetic (PBPK) model of theophylline, caffeine, and ciprofloxacin metabolisms to: examine theophylline pharmacokinetic variability, and predict population-level outcomes of drug–drug interactions (DDIs). A simulation-based equation for personalized dosing of theophylline was derived. Simulations of DDI show that calculated personalized doses are safe even after cotreatment with large doses of strong inhibitors. Simulations of adult populations indicate that the elderly are most susceptible to ADRs stemming from theophylline–ciprofloxacin and theophylline–caffeine interactions. Females, especially Asians, due to their smaller average size, are more susceptible to DDI-induced ADRs following typical dosing practices. Our simulations also show that the higher adipose and lower muscle fractions in females significantly alter the pharmacokinetics of theophylline or ciprofloxacin.

59 BASIC BIOLOGICAL SCIENCES↗

Effects of Supplementation in Upper Yakima River Chinook Salmon

Abstract To promote recovery of natural salmonid populations, managers are utilizing hatchery supplementation programs to increase abundance of spawners on the spawning grounds. However, studies have provided evidence that captive breeding can result in domestication, demonstrated by lower fitness of hatchery‐origin compared with natural‐origin fish. Supplementation programs, therefore, typically use natural‐origin broodstock in an effort to minimize long‐term negative fitness impacts. Here we evaluated the upper Yakima River spring supplementation program for Chinook Salmon Oncorhynchus tshawytscha , which has broodstock comprised exclusively of unmarked fish presumed to be of natural‐origin. Using 5 years of spawner data, we tested for effects of hatchery breeding and rearing on total adult returns and their individual reproductive success when spawning naturally. Our study revealed that supplementation increased overall abundance of fish spawning naturally on the spawning grounds. However, on average, compared with natural‐origin spawners, hatchery‐origin fish had reduced reproductive success, which also translated to reduced reproductive success in three out of five return years for natural‐origin fish that spawned with hatchery‐origin fish. As expected, body length and return timing were also significant predictors of reproductive success. However, more generations of data are needed to establish the extent to which reduced reproductive success is passed on to naturally produced progeny.

Koch, Ilana J.↗

Investigating the Relationship between Need for Cognition and Skill in Ethical Hackers

As technology gets more complex and increasingly connected, there is an increasing concern with cyber security. There is also a growing demand for cyber security professionals. Unfortunately there currently are not enough skilled professionals to meet that demand. In order to prepare the next generation of cyber security professionals to meet this demand, we need to understand what characteristics make skilled cyber security professionals. For this work, we focus on professionals who take an offensive approach to cyber security, so called ethical hackers. These hackers utilize many of the same skills that the adversaries that we defend against would use, with the goal of identifying vulnerabilities and address them before they are exploited by adversaries. A commonly held belief among ethical hackers is that hackers must possess exceptional curiosity and problem solving skills in order to be successful. Curiosity is has been studied extensively in psychology, but there is no consensus on what it is and how to measure it. Further, many existing inventories for assessing curiosity are targeted at measuring curiosity in children. Although there isn’t an accepted standard to assess curiosity in adults, a related construct, called Need for Cognition (may capture what is meant when people speak of curiosity. The Need for Cognition scale also captures the tendency toward preferring complex problems (which correlates with good problem solving skills), which may provide insight into what make skilled hackers. In addition to the Need for Cognition, we used a structured interview to assess hacker skill. Hackers rated their own skill on a scale from one to ten on a predefined list of hacker skills. They were then asked to rate a peer who they felt was most skilled in each of the skills. They were asked to rate two peers for each skill, one that they worked with directly and one person that was the most skilled in the field (these could be known by reputation only). The hypothesis is that hackers have a higher than average (i.e., compared to non-hackers) Need for cognition and that Need for Cognition will be positively correlated with self-reported and peer reported skill. We interviewed 20 cyber security researchers who specialize in offensive approaches. Based on the responses to the hacker skill inventory, we generated a self-reported skill score for each participant. We also developed a peer-rating for each participant based on the number of times each individual that was interviewed was named as the most skilled in a particular area. The results indicate that the sample of ethical hackers has a high Need for Cognition and that Need for cognition was related to both self-reported skill and peer-reported skill. The results are discussed in the context of training and recruitment of cyber security professionals.

99 GENERAL AND MISCELLANEOUS↗

Assessment of potential impact of magnetic fields from a subsea high-voltage DC power cable on migrating green sturgeon, Acipenser medirostris

Abstract Empirical evidence suggests that marine animals perceive and orient to local distortions in the earth’s natural magnetic field. Magnetic fields (MFs) generated by electrified underwater cables may produce similar local distortions in the earth’s main field. Concern exists that these distortions may impact migration movements of MF-sensitive animals. The Trans Bay Cable (TBC) is a ± 200-kV, 400-megawatt, 85-km high-voltage direct current transmission line buried through San Francisco Bay (37° 56′ 8.81″ N, 122° 27′ 0.19″ W). Detections of adult green sturgeon implanted with acoustic transmitters were used from six cross-bay receiver arrays from 2006 to 2015 to investigate how inbound and outbound migration movements through lower portions of their route to/from upstream breeding grounds are related to the TBC’s energization status (off/on) and other local environmental variables. Here, we assess how these variables impacted transit success, misdirection from the migration route, transit times, and migration path locations within stretches between the Bay’s mouth and the start of the Sacramento River. Overall, there was varied evidence for any effect on migration behavior associated with cable status (off/on). A higher percentage of inbound fish successfully transited after the cable was energized, but this effect was nonsignificant in models including temperature. Outbound fish took longer to transit after cable energization. Inbound and outbound migration path locations were not significantly influenced by cable energization, but results suggest a potential subtle relationship between energization and both inbound and outbound paths. Overall, additional migration-based studies are needed to investigate the impact of anthropogenic cables on marine species.

Wyman, Megan T. (ORCID:0000000256844603)↗

Evaluation of biliary anatomy in the caudate lobe using drip infusion cholangiography-computed tomography

Purpose: This study aimed to retrospectively evaluate the caudate branches (CBs), which are bile ducts originating from the caudate lobe (CL), using drip infusion cholangiography with computed tomography (DIC-CT). Methods: The confluence patterns of CBs were evaluated in 185 adult patients undergoing DIC-CT. The following bile duct features were evaluated: (a) number of depicted CBs; (b) identification of the caudate portion from which the CBs were derived; (c) identification of the confluence site of a CB; and (d) whether there was a difference in the confluence site of the CBs depending on the position of the right posterior hepatic duct (RPHD) and the portal vein (PV). Results: DIC-CT enabled detection of a total of 640 bile ducts from the CL in 185 patients, and the total number of CBs from the Spiegel lobe (SP), the paracaval portion, and the caudate process (CP) were 347 (54.2%), 112 (17.5%), and 181 (28.2%), respectively. In the SP, over 60% of CBs joined the left hepatic duct system (LHDS). The positional relationship between the RPHD and the PV was divided into a supra-portal course (n = 168) and an infra-portal course (n = 17). The number of CBs joining the LHDS was significantly different between a supra-portal course and an infra-portal course (p = 0.0484). Conclusion: CBs were depicted by DIC-CT in 98.9% of the subjects, and a detailed evaluation was possible. The number of CBs joining the LHDS was associated with the position of the RPHD and the PV.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

MR elastography of liver at 3 Tesla: comparison of gradient-recalled echo (GRE) and spin-echo (SE) echo-planar imaging (EPI) sequences and agreement across stiffness measurements

Purpose: To compare 2D gradient-recalled echo (GRE) and 2D spin-echo (SE) echo-planar imaging (EPI) MR elastography (MRE) for measurement of hepatic stiffness in adult patients with known or suspected liver disease at 3 Tesla. Materials and methods: Three hundred and eighty-seven consecutive patients underwent MRE of the liver at 3 Tesla with 2D-GRE and 2D-SE-EPI sequences. ‘Mean liver stiffness (LS)’ calculated by averaging 3 ROIs in the right lobe, ‘Maximum LS’ calculated by an ROI in the right lobe; and ‘Freehand LS’ calculated by an ROI in the entire liver were measured by two independent readers. Inter-observer and inter-class variability in stiffness measurements were assessed. Stiffness values were correlated with degree of liver fibrosis (METAVIR scores) in 97 patients who underwent biopsy. The diagnostic performance was compared by a receiver-operating characteristic analysis. Results: The technical failure rate was 2.8% for 2D-SE-EPI (11/387) and 4.1% for 2D-GRE (16/387, 9 had R{sub 2}* > 80 s{sup −1} indicating iron overload). There is high reproducibility for both GRE and SE-EPI variants (ICC = 0.84–0.94 for both GRE and SE-EPI MRE). The highest sensitivity, specificity, and accuracy of differentiating mild fibrosis (F0–F2) from advanced fibrosis (F3–F4) are 0.84 (GRE Freehand measurement), 0.92 (GRE Maximum stiffness measurement), and 0.88 (GRE Freehand measurement), respectively. Conclusions: High intra-class correlation and intra-reader correlation are seen on measured hepatic stiffness for both 2D-GRE and 2D-SE-EPI MRE. 2D-SE-EPI has lower failure rate. Diagnostic performance of both sequences is equivalent, with highest sensitivity for 2D-GRE Freehand stiffness measurement, and highest specificity 2D-GRE Maximum stiffness measurement.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A comparison of segmented abdominopelvic fluid volumes with conventional CT signs of abdominal compartment syndrome in a trauma population

Purpose: To compare the utility of abdominopelvic fluid volume measurements with established computed tomography signs for refractory post-traumatic abdominal compartment syndrome. Methods: This retrospective observational cohort study included 64 consecutive adult trauma patients with preoperative CT and diagnosis of refractory abdominal compartment syndrome requiring decompressive laparotomy at a level I trauma referral center between 2004 and 2014. We hypothesized that abdominal fluid volume measurements would be more predictive of the need for early laparotomy than previously described conventional CT signs of refractory ACS. Abdominopelvic fluid volumes were determined quantitatively using semi-automated segmentation software. The following conventional imaging parameters were recorded: abdominal anteroposterior:transverse ratio (round belly sign); infrahepatic vena cava diameter; distal abdominal aortic diameter; largest single small bowel wall diameter; hydronephrosis, inguinal herniation; and mesenteric and body wall edema. For outcome analysis, patients were stratified into two groups: those who underwent early (< 24 h) and late (≥ 24 h) decompressive laparotomy following CT. Correlation analysis, comparison of means, and multivariate logistic regression were performed. Results: Abdominal fluid volumes (p = 0.001) and anteroposterior:transverse ratio (p = 0.009) were increased and inferior vena cava diameter (p = 0.009) was decreased in the early decompressive laparotomy group. Multivariate analysis including conventional CT variables, fluid volumes, and laboratory values revealed abdominal fluid volumes (p = 0.012; Δ in log odds of 1.002/mL) as the only independent predictor of early decompressive laparotomy. Conclusions: Segmented abdominopelvic free fluid volumes had greater predictive utility for decision to perform early decompressive laparotomy than previously described ACS-related CT signs in trauma patients who developed refractory abdominal compartment syndrome.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Multimodality imaging of the male urethra: trauma, infection, neoplasm, and common surgical repairs

Objective: The aim of this article is to describe the indications and proper technique for RUG and MRI, their respective image findings in various disease states, and the common surgical techniques and imaging strategies employed for stricture correction. Results: Because of its length and passage through numerous anatomic structures, the adult male urethra can undergo a wide array of acquired maladies, including traumatic injury, infection, and neoplasm. For the urologist, imaging plays a crucial role in the diagnosis of these conditions, as well as complications such as stricture and fistula formation. While retrograde urethrography (RUG) and voiding cystourethrography (VCUG) have traditionally been the cornerstone of urethral imaging, MRI has become a useful adjunct particularly for the staging of suspected urethral neoplasm, visualization of complex posterior urethral fistulas, and problem solving for indeterminate findings at RUG. Conclusions: Familiarity with common urethral pathology, as well as its appearance on conventional urethrography and MRI, is crucial for the radiologist in order to guide the treating urologist in patient management.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Differentiation of pancreatic head ductal adenocarcinoma from inflammatory pancreatic pseudomass by MR cholangio-pancreatography: utility of the duct-interrupted, corona, and attraction signs

Purpose: To determine sensitivity and specificity of the “duct-interrupted,” “corona,” and “attraction” signs on MR cholangio-pancreatography (MRCP) in distinguishing pancreatic head ductal adenocarcinoma (PDAC) from inflammatory pancreatic pseudomass (IPP). Materials and methods: This study included 53 adults (33 men and 20 women, mean age, 55 years; range, 17–87 years) with a pancreatic head mass who underwent MRCP. Three blinded radiologists independently reviewed each MRCP exam and three signs were assessed: (1) the “duct-interrupted” sign, deemed positive for PDAC if the duct within the mass demonstrated complete interruption with upstream dilation; (2) the “corona” sign, considered positive for PDAC if dilated side-branches were located exclusively outside the mass; and (3) the “attraction” sign, deemed positive for IPP if the dilated common bile duct showed attraction and angulation towards the mass. Sensitivity, specificity, and positive and negative predictive values of the signs were calculated, as well as interobserver agreement. Results: Out of 53 masses, 17 (32%) were PDAC and 36 (68%) were IPP. Sensitivity, specificity, and positive and negative predictive values of the “duct-interrupted” sign to differentiate between PDAC from IPP for the three readers were 29–53%, 89–95%, 56–82% and 73–81%, respectively (κ = 0.41); for the “corona” sign, they were 29–53%, 81–100%, 56–100%, and 75–78%, respectively (κ = 0.4), and for the “attraction” sign, they were 20–25%, 71–82%, 64–75%, and 31–34%, respectively (κ = 0.54). Conclusion: The “duct-interrupted” and “corona” MRCP signs have high specificity for diagnosing PDAC, while the “attraction” sign has good specificity for identifying IPP.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Determination of the Nonlethal Margin Inside the Visible 'Ice-Ball' During Percutaneous Cryoablation of Renal Tissue

Objective. The study was designed to determine the distance between the visible 'ice-ball' and the lethal temperature isotherm for normal renal tissue during cryoablation. Methods. The Animal Care Committee approved the study. Nine adult swine were used: three to determine the optimum tissue stain and six to test the hypotheses. They were anesthetized and the left renal artery was catheterized under fluoroscopy. Under MR guidance, the kidney was ablated and (at end of a complete ablation) the nonfrozen renal tissue (surrounding the 'ice-ball') was stained via renal artery catheter. Kidneys were explanted and sent for slide preparation and examination. From each slide, we measured the maximum, minimum, and an in-between distance from the stained to the lethal tissue boundaries (margin). We examined each slide for evidence of 'heat pump' effect. Results. A total of 126 measurements of the margin (visible 'ice-ball'-lethal margin) were made. These measurements were obtained from 29 slides prepared from the 6 test animals. Mean width was 0.75 {+-} 0.44 mm (maximum 1.15 {+-} 0.51 mm). It was found to increase adjacent to large blood vessels. No 'heat pump' effect was noted within the lethal zone. Data are limited to normal swine renal tissue. Conclusions. Considering the effects of the 'heat pump' phenomenon for normal renal tissue, the margin was measured to be 1.15 {+-} 0.51 mm. To approximate the efficacy of the 'gold standard' (partial nephrectomy, {approx}98 %), a minimum margin of 3 mm is recommended (3 Multiplication-Sign SD). Given these assumptions and extrapolating for renal cancer, which reportedly is more cryoresistant with a lethal temperature of -40 Degree-Sign C, the recommended margin is 6 mm.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Long-term Outcomes of Percutaneous Venoplasty and Gianturco Stent Placement to Treat Obstruction of the Inferior Vena Cava Complicating Liver Transplantation

Purpose: Evaluation of long-term outcomes of venoplasty and Gianturco stents to treat inferior vena cava (IVC) obstruction after liver transplantation. Methods: We retrospectively analyzed records from 33 consecutive adult patients referred with the intent to treat suspected IVC obstruction after liver transplantation. Treatment was performed for occlusion or stenosis with a gradient exceeding 3 mmHg. The primary treatment was venoplasty and, if refractory, Gianturco stent placement. Recurrence prompted repeat venoplasty or stent placement. Results: Of the 33 patients, 25 (aged 46.9 ± 12.2 years) required treatment at a mean of 2.3 years (14 days to 20.3 years) after transplantation. For technically successful cases, primary treatment was venoplasty alone (14) or with stent placement (10). Technical success was 96 % (24 of 25) reflecting failure to cross one occlusion. Clinical success was 88 % (22 of 25) reflecting the technical failure and two that died of unrelated complications within 5 weeks. Cumulative primary patencies were 57.1 % at 6 months (n = 21) and 51.4 % at 1 (n = 10), 3 (n = 7), 5 (n = 6), and 7 (n = 5) years. Cumulative primary assisted patency was 95.2 % at 6 months (n = 21) and at 1 (n = 15), 3 (n = 9), 5 (n = 8), and 7 (n = 8) years. The 17 patients stented for refractory (n = 10) or recurrent (n = 7) stenosis had cumulative primary and primary assisted patencies of 86.0 and 100 %, respectively, from 6 months (n = 14) to 7 years (n = 3). No major complications occurred; one fractured stent was observed after 11.6 years. Conclusion: For IVC obstruction following liver transplantation, excellent long-term outcomes can be achieved by venoplasty and Gianturco stent placement.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Temporary Arterial Embolization of Liver Parenchyma with Degradable Starch Microspheres (EmboCept{sup ®}S) in a Swine Model

BackgroundThis study aimed to evaluate the embolic properties, time to reperfusion, and histologic changes in temporary embolization of liver tissue with degradable starch microspheres (DSM) in a swine model.MethodsIn four adult minipigs, DSMs were injected into the right or left hepatic artery on the lobar level until complete stasis of the blood flow was detectable angiographically. The time required to complete angiographically determined reperfusion was noted. The animals were killed 3 h after complete reperfusion, and samples were taken from the liver. Histologic examinations of the embolized liver parenchyma and untreated tissue were performed.ResultsHepatic arterial embolization using DSMs was technically successful in all cases, with complete blood flow stasis shown by control angiography. A single vial of DSMs (450 mg/7.5 ml) was sufficient to embolize a whole liver lobe in all cases. Angiography showed complete reconstitution of hepatic arterial perfusion after a mean time to reperfusion of 32 ± 6.1 min (range, 26–39 min). Hematoxylin and eosin staining showed no histologically detectable differences between untreated tissue and parenchyma embolized with DSMs except for mild sinusoidal congestion in one case. Indirect in situ DNA nick end labeling staining (TUNEL) showed only single positive hepatocytes, indicating apoptosis.ConclusionTemporary embolization of the hepatic artery using DSMs is feasible with complete reperfusion after 30 min in pigs. Even after complete arterial blood flow stasis, no extensive tissue damage to the embolized liver parenchyma was observed at histologic examinations in this short-term study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evaluation of Liver Stiffness After Radioembolization by Real-Time ShearWave™ Elastography: Preliminary Study

PurposeTo evaluate the effect of ShearWave™ elastography (SWE) for the assessment of liver fibrosis after radioembolization (RE) in patients with liver malignancies.Materials and MethodsWe prospectively examined the effects of SWE before and after RE in 17 adult patients, from June 2012 to September 2013. All patients underwent SWE within 1 month before and 3 months (96.3 ± 22.9 days) after RE. Measurements were taken in segments III, IV, V, and VI (lateral/medial left lobe and anterior/posterior right lobe, respectively). Liver stiffness was studied in the 39 treated segments.ResultsThe mean stiffness of liver tissue according to the pre-RE SWE measurements was not different from the post-RE SWE measurements in the segments that did not undergo RE. Conversely, segments treated with RE were significantly stiffer according to the post-RE SWE measurements (mean SWE 17.4 kPa) than according to the baseline measurements (7.0 kPa) (p < 0.001). Patients with hepatocellular carcinoma and preexisting infection with hepatitis B and C viruses had higher pre-embolization stiffness, and the post-embolization stiffness of the treated segments in these patients was higher than that in the remainder of the study population.ConclusionThese data suggest that SWE measurements of liver stiffness increase as early as the third month after RE. SWE could be used as a noninvasive complementary imaging method for preliminary assessment of liver fibrosis before and after RE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Comparison of Patient Skin Dose Evaluated Using Radiochromic Film and Dose Calculation Software

PurposeTo compare, in an interventional radiology setting, peak skin doses (PSDs) delivered as calculated using a dedicated software tool and as measured using radiochromic film. To assess the utility of this dose calculation software tool in routine clinical practice.Materials and MethodsFirst, radiochromic films were positioned on the examination table in the back of an adult anthropomorphic phantom to measure PSD, and X-ray examinations were simulated. Then, films were again positioned in the patient’s back for 59 thoracic or abdominopelvic endovascular interventions. The results obtained with the radiochromic films were taken as a reference and were statistically compared with those of the software.ResultsWith measured PSDs ranging from 100 to 7000 mGy, the median software–film difference was 8.5%. Lin’s concordance coefficient was 0.98 [0.97; 0.99] (p < 0.001), meaning that concordance was excellent between the two methods. For the films where PSD exceeded 1000 mGy, the median difference in the measured value was 8.7% [− 1.3; 21.1], with a maximum discrepancy of 34%. Lin’s concordance coefficient was 0.98 [0.96; 1] (p < 0.001), meaning that concordance was excellent between the two methods.ConclusionComparison between radiochromic films and the software tool showed that the software is a suitable tool for a simple and reliable estimation of PSD. The software seems to be a good alternative to films, whose use remains complex.

62 RADIOLOGY AND NUCLEAR MEDICINE↗