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At least 253 records · Page 14

Endovascular Management of Iatrogenic Native Renal Arterial Pseudoaneurysms

Purpose: Our purpose was to evaluate iatrogenic renal pseudoaneurysms, endovascular treatment, and outcomes. Methods: This retrospective study (2003-2011) reported the technical and clinical outcomes of endovascular therapy for renal pseudoaneurysms in eight patients (mean age, 46 (range 24-68) years). Renal parenchymal loss evaluation was based on digital subtraction angiography and computed tomography. Results: We identified eight iatrogenic renal pseudoaneurysm patients with symptoms of hematuria, pain, and hematoma after renal biopsy (n = 3), surgery (n = 3), percutaneous nephrolithotomy (n = 1), and endoscopic shock-wave lithotripsy (n = 1). In six patients, the pseudoaneurysms were small-sized (<20 mm) and peripherally located and were treated solely with coil embolization (n = 5). In one patient, coil embolization was preceded by embolization with 500-700 micron embospheres to control active bleeding. The remaining two patients had large-sized ({>=}50 mm), centrally located renal pseudoaneurysms treated with thrombin {+-} coils. Technical success with immediate bleeding cessation was achieved in all patients. There were no procedure-related deaths or complications (mean follow-up, 23.5 (range, 1-67) months). Conclusions: Treatment of renal pseudoaneurysms using endovascular approach is a relatively safe and viable option regardless of location (central or peripheral) and size of the lesions with minimal renal parenchymal sacrifice.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting

IntroductionComputed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking.Materials and MethodsRadiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator’s finger skin was measured using thermoluminescent dosimeter rings.ResultsThe mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator’s finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA.ConclusionRadiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Unidirectional wireless power transfer using near-field plates

One of the obstacles preventing wireless power transfer from becoming ubiquitous is their leakage of power: high-amplitude electromagnetic fields that can interfere with other electronic devices, increase health concerns, or hinder power metering. In this paper, we present near-field plates (NFPs) as a novel method to tailor the electromagnetic fields generated by a wireless power transfer system while maintaining high efficiency. NFPs are modulated arrays or surfaces designed to form prescribed near-field patterns. The NFP proposed in this paper consists of an array of loaded loops that are designed to confine the electromagnetic fields of a resonant transmitting loop to the desired direction (receiving loop) while suppressing fields in other directions. The step-by-step design procedure for this device is outlined. Two NFPs are designed and examined in full-wave simulation. Their performance is shown to be in close agreement with the design predictions, thereby verifying the proposed design and operation. A NFP is also fabricated and experimentally shown to form a unidirectional wireless power transfer link with high efficiency.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

SU-E-J-216: A Sequence Independent Approach for Quantification of MR Image Deformations From Brachytherapy Applicators

Purpose: MRI is increasingly used as a single imaging modality for brachytherapy treatment planning. The presence of a brachytherapy applicator may cause distortions in the images, especially at higher field strengths. Our aim is to develop a procedure to quantify these distortions theoretically for any MR-sequence and to verify the estimated deformations for clinical sequences. Methods: Image distortions due to perturbation of the B0-field are proportional to the ratio of the induced frequency shift and the read-out bandwidth of the applied sequence. By reconstructing a frequency-shift map from the phase data from a multi-echo sequence, distortions can be calculated for any MR-sequence. Verification of this method for estimating distortions was performed by acquiring images with opposing read-out directions and consequently opposing distortions. The applicator shift can be determined by rigidly matching these images. Clinically, T2W-TSE-images are used for this purpose. For pre-clinical tests, EPI-sequences with narrow read-out bandwidth (19.5–47.5Hz), consequently large distortions, were added to the set of clinical MRsequences. To quantify deformations of the Utrecht Interstitial CT/MR applicator (Elekta Brachytherapy) on a Philips Ingenia 3T MRI, pre-clinical tests were performed in a phantom with the applicator in water, followed by clinical validation. Results: Deformations observed in the narrow bandwidth EPI-images were well predicted using the frequency-shift, the latter giving an overestimation up to 30%/up to 1 voxel. For clinically applied MR-sequences distortions were well below the voxel size. In patient setup distortions determined from the frequency-shift map were at sub-voxel level (<0.7mm). Using T2W-images larger distortions were found (1–2mm). This discrepancy was caused by patient movement between/during acquisition of the T2W-images with opposing read-out directions. Conclusion: Phantom experiments demonstrated the feasibility of a clinical procedure for quantification of MR-image distortions for any MR-sequence. In a clinical set-up the distortions from a Utrecht interstitial CT/MR applicator are sub-voxel level. This work was partially funded by Elekta Brachytherpy.

60 APPLIED LIFE SCIENCES↗

Modeling quasi-lattice with octagonal symmetry

We prove the possibility to use the method of modeling of a quasi-lattice with octagonal symmetry similar to that proposed earlier for the decagonal quasicrystal. The method is based on the multiplication of the groups of basis sites according to specified rules. This model is shown to be equivalent to the method of the periodic lattice projection, but is simpler because it considers merely two-dimensional site groups. The application of the proposed modeling procedure to the reciprocal lattice of octagonal quasicrystals shows a fairly good matching with the electron diffraction pattern. Similarly to the decagonal quasicrystals, the possibility of three-index labeling of the diffraction reflections is exhibited in this case. Moreover, the ascertained ratio of indices provides information on the intensity of diffraction reflections.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Development of Treatment Process for Radioactive Wastewater Generated from Molybdenum-99 Study - 16415

Molybdenum-99 (Mo-99) high acidic waste solution was securely stored at INER for numerous years. Until 2004, the procedures of waste solution draw-out and pressure-release were accompanied, along with construction of treatment facilities. In 2009, after simulated solution and small volume Mo-99 waste solution tests, the treatment procedure was determined. Then batch-scale treatment facilities were set up. The waste solution was preserved using the instrument, along with modification of some facilities simultaneously. Ultimately all of 12 tanks of Mo-99 inorganic waste solution stored in Building 014 were finished on July, 2012. And residential 5 tanks of those solution served in Building 015B were also completed on September, 2014. A practicable process has been developed for treating radioactive waste generated from Mo-99 study, and it can effectively remove radionuclides from a nitric acid solution. At first, after the waste was sucked from the bucket, the pH value was adjusted to about 10.0 through acid-alkali neutralization. Then, an adsorbent of natural zeolite powder was added to adsorb nuclides, and two adsorption columns filled with Cs-treat and Sr-treat adsorbents were used for removing nuclear species of Cs-137 and Sr-90. In this step, the nuclear species of Cs-137 and Sr-90 contained in the liquid waste are significantly reduced to a degree for manual operation allowable. Then, nitrate ion and mercury ion were removed through another procedure. As a result, the operations were safer and more efficient than other conventional methods. Additionally, the hazard of accidental leakage caused by corrosion of the bucket after long period of storage can be effectively prevented and potential pollution threats are also eliminated. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Development of a core coolant flow distribution calculation code for HTGRs - 18484

In order to ensure the thermal integrity of fuel in high temperature gas-cooled reactors (HTGRs), it is necessary that the maximum fuel temperature in the normal operation is to be lower than the thermal design target. In the core thermal-hydraulic design of block-type HTGRs, the maximum fuel temperature should be evaluated considering data such as thermal power, core geometry, power and neutron fluence distributions, and core coolant flow distribution. The core coolant flow distribution calculation code used in the design stage of High Temperature engineering Test Reactor (HTTR) presupposes to run on UNIX systems, and its operation and execution procedure are complicated and not user-friendly. Therefore, a new core coolant flow distribution calculation code with a user-friendly system such as simple and easy operations and execution procedures has been developed. In this paper, the outline of the new code is described and the simulation result of an out-of-pile test with one fuel column are shown as the first step of the code validation. The simulation results provide good agreement with the test one. (authors)

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

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↗

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↗

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↗

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↗