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At least 631 records · Page 35

UAVs for Radiological Monitoring: Determining Ideal Operational Parameters From GEANT4 Simulations - 18025

Owing in no small part to the enormous advances in radiation detector technology (size, sensitivity and spectral-resolution), there has been an increased drive and requirement to accurately map both the spatial extent and magnitude of radiological contamination at the greatest possible spatial resolutions. To undertake this, a range of different methods have been devised and include the use of cars and human, but also planes (and more recently) unmanned aerial vehicles (UAVs). However, critical to the remote sensing using such UAVs in contrast to ground-based sensing, is (i) the selection of the ideal operational parameters to attain the best on-ground resolution in addition to, (ii) understanding the correct normalisation procedures and other influences on results that surveys at these reduced altitudes might present. Resulting from earlier works, through employing combined modelling and experimental data, the optimal height for a UAV survey using the more realistic 'area' radioactive source term (opposed to an infinitely-small 'point-source') is determined to be approximately 5 m - suitably maximizing cross detector counts. At greater altitudes than this, the influence of variations in neighboring topology / topography and nearby structures are observed to be negligible. However, at this and further-reduced altitudes (where optimal count-rates exists), small height-related variations are observed to result, and impact considerably on the complexity of the data normalisation. Whilst not occurring as a tool to entirely replace ground-based surveys, UAV systems are able to perform in challenging or dangerous environments, inadvisable or problematic to send humans. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Sci—Thur PM: Imaging — 06: Canada's National Computed Tomography (CT) Survey

The value of computed tomography (CT) in medical imaging is reflected in its' increased use and availability since the early 1990's; however, given CT's relatively larger exposures (vs. planar x-ray) greater care must be taken to ensure that CT procedures are optimised in terms of providing the smallest dose possible while maintaining sufficient diagnostic image quality. The development of CT Diagnostic Reference Levels (DRLs) supports this process. DRLs have been suggested/supported by international/national bodies since the early 1990's and widely adopted elsewhere, but not on a national basis in Canada. Essentially, CT DRLs provide guidance on what is considered good practice for common CT exams, but require a representative sample of CT examination data to make any recommendations. Canada's National CT Survey project, in collaboration with provincial/territorial authorities, has collected a large national sample of CT practice data for 7 common examinations (with associated clinical indications) of both adult and pediatric patients. Following completion of data entry into a common database, a survey summary report and recommendations will be made on CT DRLs from this data. It is hoped that these can then be used by local regions to promote CT practice optimisation and support any dose reduction initiatives.

60 APPLIED LIFE SCIENCES↗

Percutaneous Radiofrequency Ablation of Lung Cancer Presenting as Ground-Glass Opacity

PurposeWe retrospectively evaluated the outcomes of lung cancer patients presenting with ground-glass opacity (GGO) who received radiofrequency ablation (RFA).MethodsSixteen patients (5 men and 11 women; mean age, 72.6 years) with 17 lung cancer lesions showing GGO (mean long axis diameter, 1.6 cm) underwent a total of 20 percutaneous computed tomography (CT) fluoroscopy-guided RFA sessions, including three repeated sessions for local progression. Lung cancer with GGO was defined as a histologically confirmed malignant pulmonary lesion with a GGO component accounting for >50 % of the lesion on high-resolution CT. Procedure outcomes were evaluated.ResultsThere were no major complications. Pneumothorax occurred in 15 of 20 treatment sessions: 14 were asymptomatic, and 1 required chest tube placement but resolved satisfactorily within 48 h. Minor pulmonary hemorrhage occurred in two and mild pneumonitis in one. The median tumor follow-up period was 61.5 (range 6.1–96.6) months. The effectiveness rates of the primary and secondary techniques were 100 and 100 % at 1 year, 93.3 and 100 % at 2 years, and 78.3 and 92.3 % at 3 years, respectively. The median patient follow-up period was 65.6 (range 6.1–96.6) months. One patient died owing to recurrent other cancer 11.7 months after RFA, whereas the other 15 remained alive. Overall survival and disease-specific survival rates were 93.3 and 100 % at 1 year and 93.3 and 100 % at 5 years, respectively.ConclusionsRFA for lung cancer with GGO was safe and effective, and resulted in promising survival rates.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Long-Term Evaluation of Percutaneous Groin Access for EVAR

Background: Percutaneous endovascular aneurysm repair (PEVAR) has been shown to have high success rates, shorter operating times and length of stay compared to open access. However, there exists a lack of long-term follow-up data on these patients, and questions remain regarding longer-term outcomes. This study aims to assess the long-term complications and evolution of accessed vessels post-PEVAR. Methods: Sixty-one cases of bilateral PEVAR (122 groins) with > 36 months follow-up were analysed. Vessel diameter, calcification, dissection, lymphocele, pseudoaneurysm and thrombus formation were reviewed at 30th day and at the most recent follow-up CT. Notes were reviewed for groin infections, haematomas and nerve injury. Complications were considered ‘major’ if they required intervention or treatment. Results: Mean follow-up time from procedure to most recent scan was 49.9 months. There were no major short- or long-term complications. The early complication rate was 9.8%, with six pseudoaneurysms, four dissections, one thrombus, one nerve injury and no lymphoceles, haematomas or groin infections. The long-term complication rate was 0.8%, with only one pseudoaneurysm. The remainder of early complications resolved naturally without intervention. Accessed vessel showed significantly (P ≤ 0.05) increased diameter and calcification between 30th day and last follow-up scan. Conclusion: This study provides the largest clinical cohort and the longest mean follow-up time reported in the literature and demonstrates the long-term safety of PEVAR. PEVAR has a very low long-term complication rate, without any major complications in our cohort. The accessed common femoral arteries do not show stenosis or thrombosis. Minor short-term complications appear to gradually resolve without intervention. Larger multi-centre studies are recommended.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Acoustic radiation force on a rigid elliptical cylinder in plane (quasi)standing waves

The acoustic radiation force on a 2D elliptical (non-circular) cylinder centered on the axis of wave propagation of plane quasi-standing and standing waves is derived, based on the partial-wave series expansion (PWSE) method in cylindrical coordinates. A non-dimensional acoustic radiation force function, which is the radiation force per unit length, per characteristic energy density and per unit cross-sectional surface of the ellipse, is defined in terms of the scattering coefficients that are determined by applying the Neumann boundary condition for an immovable surface. A system of linear equations involving a single numerical integration procedure is solved by matrix inversion. Numerical simulations showing the transition from the quasi-standing to the (equi-amplitude) standing wave behaviour are performed with particular emphasis on the aspect ratio a/b, where a and b are the ellipse semi-axes, as well as the dimensionless size parameter kb (where k is the wavenumber), without the restriction to a particular range of frequencies. It is found that at high kb values > 1, the radiation force per length with broadside incidence is larger, whereas the opposite situation occurs in the long-wavelength limit (i.e., kb < 1). The results are particularly relevant in acoustic levitation of elliptical cylinders, the acoustic stabilization of liquid columns in a host medium, acousto-fluidics devices, and other particle dynamics applications to name a few. Moreover, the formalism presented here may be effectively applied to compute the acoustic radiation force on other 2D surfaces of arbitrary shape such as super-ellipses, Chebyshev cylindrical particles, or other non-circular geometries.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Does Drug-Eluting Bead TACE Enhance the Local Effect of IRE? Imaging and Histopathological Evaluation in a Porcine Model

Objectives: We conducted an in vivo trial on swine to compare the ablation volumes of irreversible electroporation (IRE) followed by drug-eluting beads transarterial chemoembolization (DEB-TACE) versus IRE only. Materials and Methods: Nine swine underwent CT-guided IRE in one liver lobe and IRE immediately followed by DEB-TACE in a different liver lobe. For DEB-TACE, 100–300 µm beads (DC-Beads{sup ®}) were loaded with 50 mg doxorubicin. For IRE, the NanoKnife{sup ®} was used employing two electrodes according to the vendor’s protocol. Imaging follow-up was performed including CT-based lesion volume assessment using contrast-enhanced CT (venous phase) on days 1, 3, and 7 after the procedure. Three animals were killed for histopathological analysis after each follow-up. Results: Ablation volumes in CT in the IRE + DEB-TACE group were 15.4 ± 10.5 ml on day 1, 8.7 ± 5.6 ml on day 3, and 1.6 ± 0.7 ml on day 7. In the IRE group, the corresponding values were 5.2 ± 5.2 ml on day 1, 1.0 ± 1.2 ml on day 3, and 0.1 ± 0.1 ml on day 7. On day 1 and day 3, ablation volumes of IRE + TACE group were significantly larger than in the IRE group (p < 0.05). 96% of beads were depicted in or around ablative lesions. 69% of these beads were found in the surrounding hemorrhagic infiltration and 31% within the ablative lesion itself. Conclusions: Combination of IRE immediately followed by DEB-TACE resulted in larger ablation volumes compared to IRE alone, suggesting that local efficacy of IRE can be enhanced by post-IRE DEB-TACE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation

Purpose: The purpose of this study was to determine the effects of atlas selection based on different morphometric parameters, on the accuracy of automatic brachial plexus (BP) segmentation for radiation therapy planning. The segmentation accuracy was measured by comparing all of the generated automatic segmentations with anatomically validated gold standard atlases developed using cadavers. Methods and Materials: Twelve cadaver computed tomography (CT) atlases (3 males, 9 females; mean age: 73 years) were included in the study. One atlas was selected to serve as a patient, and the other 11 atlases were registered separately onto this “patient” using deformable image registration. This procedure was repeated for every atlas as a patient. Next, the Dice and Jaccard similarity indices and inclusion index were calculated for every registered BP with the original gold standard BP. In parallel, differences in several morphometric parameters that may influence the BP segmentation accuracy were measured for the different atlases. Specific brachial plexus-related CT-visible bony points were used to define the morphometric parameters. Subsequently, correlations between the similarity indices and morphometric parameters were calculated. Results: A clear negative correlation between difference in protraction-retraction distance and the similarity indices was observed (mean Pearson correlation coefficient = −0.546). All of the other investigated Pearson correlation coefficients were weak. Conclusions: Differences in the shoulder protraction-retraction position between the atlas and the patient during planning CT influence the BP autosegmentation accuracy. A greater difference in the protraction-retraction distance between the atlas and the patient reduces the accuracy of the BP automatic segmentation result.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms

PurposeTo assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).Materials and MethodsSeventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.ResultsSeventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53 %). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88 %). Technical success rate of TAE was 100 %. TAE was performed using metallic coils in all patients (100 %), in association with gelatin sponge in 5/17 patients (29 %). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94 %). In 1/17 patient (6 %), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12 %, respectively. Morbidity consisted in coil migration in 1/17 patient (6 %) and transient serum liver enzyme elevation in 1/17 patient (6 %).ConclusionTAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94 %. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Comparative Analysis of Intra-arterial Cone-Beam Versus Conventional Computed Tomography During Hepatic Arteriography for Transarterial Chemoembolization Planning

Purpose: To compare the imaging characteristics of intra-arterial cone-beam computed tomography during hepatic arteriography (CBCTHA) versus intra-arterial computed tomography during hepatic arteriography (CTHA) for intraprocedural transarterial chemoembolization (TACE) planning. Materials and Methods: This single-institution retrospective study included 144 patients (96 men, mean age 67.9 years; 48 women, mean age 62.3 years) who underwent 181 TACE sessions between January 2015 and July 2017. Intraprocedural CBCTHA (111 procedures) or CTHA (70 procedures) was performed for TACE planning. Reformatted maximum intensity projection CBCTHA and CTHA images were reviewed by two radiologists and classified using an ordinal scoring system (for tumor identification, tumor feeder vessel identification, and streaking artifact) and a binary scoring system (for the presence of breathing motion artifact and field of view encompassing the entire liver). Data were analyzed using an F test and a z-score test. Results: There were no significant differences in demographic and tumor characteristics between the CBCTHA and CTHA patient cohorts. CTHA was superior to CBCTHA for tumor identification (P < .0001), tumor feeder vessel identification (P < .05), streaking artifact (P < .0001), and field of view encompassing the entire liver (P < .0001). There was a trend toward a lower frequency of breathing motion artifact with CTHA than with CBCTHA (1.4% vs. 10%; P = .057). Conclusion: CTHA provides improved clinical relevant imaging information compared to CBCTHA for intraprocedural TACE planning. Level of Evidence: Level III, retrospective comparative study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Procedure design of F and B operation and its impact on the risk of a nuclear power plant - 168

A feed and bleed (F and B) operation is an operator's emergency task to remove core heat from a reactor coolant system by bleeding coolant from the pressurizer, and feeding makeup water through safety injection systems under the loss of all feedwater condition. Even though the F and B operation is an important task having a significant impact on the risk of a nuclear power plant, there is a high uncertainty regarding its modeling and analysis in a PSA. This paper introduces a study on the design of an operational strategy for an F and B operation and its impact on the risk of a nuclear power plant in Korea. An intensive support analysis was conducted to understand the plant behavior and revise the success criteria for the HRA of the F and B operation. A human performance analysis on the emergency tasks was also conducted using a training simulator to generate the operator's performance time for the F and B operation. We revised the PSA model and updated the risk of the reference plant, which shows that the risk of the revised model is much higher than that of the existing model. (authors)

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Composite vibrational spectroscopy of the group 12 difluorides: ZnF{sub 2}, CdF{sub 2}, and HgF{sub 2}

The vibrational spectra of group 12 difluorides, MF{sub 2} (M = Zn, Cd, Hg), were investigated via coupled cluster singles, doubles, and perturbative triples, CCSD(T), including core correlation, with a series of correlation consistent basis sets ranging in size from triple-zeta through quintuple-zeta quality, which were then extrapolated to the complete basis set (CBS) limit using a variety of extrapolation procedures. The explicitly correlated coupled cluster method, CCSD(T)-F12b, was employed as well. Although exhibiting quite different convergence behavior, the F12b method yielded the CBS limit estimates closely matching more computationally expensive conventional CBS extrapolations. The convergence with respect to basis set size was examined for the contributions entering into composite vibrational spectroscopy, including those from higher-order correlation accounted for through the CCSDT(Q) level of theory, second-order spin-orbit coupling effects assessed within four-component and two-component relativistic formalisms, and vibrational anharmonicity evaluated via a perturbative treatment. Overall, the composite results are in excellent agreement with available experimental values, except for the CdF{sub 2} bond-stretching frequencies compared to spectral assignments proposed in a matrix isolation infrared and Raman study of cadmium difluoride vapor species [Loewenschuss et al., J. Chem. Phys. 50, 2502 (1969); Givan and Loewenschuss, J. Chem. Phys. 72, 3809 (1980)]. These assignments are called into question in the light of the composite results.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

THE EFFECTS OF PATCHY REIONIZATION ON SATELLITE GALAXIES OF THE MILKY WAY

We combine the high-resolution Aquarius simulations with three-dimensional models of reionization based on the initial density field of the Aquarius parent simulation, Millennium-II, to study the impact of patchy reionization on the faint satellite population of Milky Way halos. Because the Aquarius suite consists of zoom-in simulations of halos in the Millennium-II volume, we follow the formation of substructure and the growth of reionization bubbles due to the larger environment simultaneously, and thereby determine the reionization redshifts of satellite candidates. We do this for four different reionization models and also compare results to instantaneous reionization. Using a simple procedure for selecting satellites and assigning luminosities in the simulations, we compare the resulting satellite populations. We find that the overall number of satellites depends sensitively on the reionization model, with a factor of 3-4 variation between the four models for a given host halo, although the difference is entirely in the population of faint satellites (M{sub V} > -10). In addition, we find that for a given reionization model the total number of satellites differs by 10%-20% between the patchy and homogeneous scenarios, provided that the redshift is chosen appropriately for the instantaneous case. However, the halo-halo scatter from the six Aquarius halos is large, up to a factor of 2-3, and so is comparable to the difference between reionization scenarios. In order to use the population of faint dwarf galaxies around the Milky Way as a probe of the local reionization history, it is necessary to first better understand the general distribution of substructure around Milky Way-mass halos.

79 ASTRONOMY AND ASTROPHYSICS↗

EXPLORING MAGNETIC FIELD STRUCTURE IN STAR-FORMING CORES WITH POLARIZATION OF THERMAL DUST EMISSION

The configuration and evolution of the magnetic field in star-forming cores are investigated in order to directly compare simulations and observations. We prepare four different initial clouds having different magnetic field strengths and rotation rates, in which magnetic field lines are aligned/misaligned with the rotation axis. First, we calculate the evolution of such clouds from the prestellar stage until long after protostar formation. Then, we calculate the polarization of thermal dust emission expected from the simulation data. We create polarization maps with arbitrary viewing angles and compare them with observations. Using this procedure, we confirmed that the polarization distribution projected on the celestial plane strongly depends on the viewing angle of the cloud. Thus, by comparing the observations with the polarization map predicted by the simulations, we can roughly determine the angle between the direction of the global magnetic field and the line of sight. The configuration of the polarization vectors also depends on the viewing angle. We find that an hourglass configuration of magnetic field lines is not always realized in a collapsing cloud when the global magnetic field is misaligned with the cloud rotation axis. Depending on the viewing angle, an S-shaped configuration of the magnetic field (or the polarization vectors) appears early in the protostellar accretion phase. This indicates that not only the magnetic field but also the cloud rotation affects the dynamical evolution of such a cloud. In addition, by comparing the simulated polarization with actual observations, we can estimate properties of the host cloud such as the evolutionary stage, magnetic field strength, and rotation rate.

79 ASTRONOMY AND ASTROPHYSICS↗

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

ObjectiveThis study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage.MethodsA review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient’s clinical notes.ResultsA total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32–0.95).ConclusionsPatients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Brought to Light. I. Quantification of Disk Substructure in Dwarf Early-type Galaxies

Dwarf early-type galaxies (ETGs) display a rich diversity in their photometric, structural, and dynamical properties. In this work, we address their structural complexity by studying with deep imaging a sample of nine dwarf ETGs from the Virgo galaxy cluster, characterized by having faint disk features such as bars and spiral arms, that lie mostly hidden within the bright diffuse light of the galaxies. We present a new, robust method that aims to identify and extract the disk substructure embedded in these dwarf ETGs. The method consists in an iterative procedure that gradually separates a galaxy image into two components: the bright, dominant, diffuse component, and the much fainter, underlying disk component. By applying it to the dwarf ETG sample, we quantify their disk substructure and find that its relative contribution to the total galaxy light ranges between 2.2% and 6.4% within two effective radii. We test the reliability of the method, and prove that it is accurate in recovering the disk substructure we introduce in mock galaxy images, even at low disk-to-total light fractions of a few percent. As a potential application of the method, we perform a Fourier analysis on the extracted disk substructures and measure the orientation, length, and strength of the bars, as well as the pitch angle and strength of the spiral arms. We also briefly discuss a scenario based on the numerical simulations presented in our companion paper, Brought to Light II: Smith et al., in which we investigate the origins of the substructure in such dwarf systems.

79 ASTRONOMY AND ASTROPHYSICS↗

Percutaneous Irreversible Electroporation (IRE) of Hepatic Malignancy: A Bi-institutional Analysis of Safety and Outcomes

Aim: Irreversible electroporation (IRE) is a non-thermal ablative option in patients unsuitable for standard thermal ablation, due to its potential to preserve collagenous structures (vessels and ducts) and a reduced susceptibility to heat sink effects. In this series from two large tertiary referral hepatobiliary centres, we aim to assess the safety/outcomes of hepatic IRE. Materials and Methods: Bi-institutional retrospective, longitudinal follow-up series of IRE for primary hepatic malignancy; [hepatocellular carcinoma (n = 20), cholangiocarcinoma (n = 3)] and secondary metastatic disease; colorectal (n = 28), neuroendocrine (n = 1), pancreatic (n = 1), breast (n = 1), gastrointestinal stromal tumour (GIST, n = 1) and malignant thymoma (n = 1). Outcome measures included procedural safety/effectiveness, time to progression and time to death. Results: Between 2013 and 2017, 52 patients underwent percutaneous IRE of 59 liver tumours in 53 sessions. All tumours were deemed unsuitable for thermal ablation. Cases were performed using ultrasound (US) or computed tomography (CT) guidance. A complete ablation was achieved in n = 44, (75%) of cases with an overall complication rate of 17% (n = 9). Of the complete ablation group, median time to progression was 8 months. At 12 months, 44% were progression-free (95% CI 30–66%). The data suggest that larger lesion size (> 2 cm) is associated with shorter time to progression and there is highly significant difference with faster time to progression in mCRC compared with HCC. Median survival time was 38 months. Conclusion: This bi-institutional review is the largest UK series of IRE and suggests this ablative technology can be a useful tool, but appears to mainly induce local tumour control rather than cure with HCC having better outcomes than mCRC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Implementation of a hybrid particle code with a PIC description in r–z and a gridless description in ϕ into OSIRIS

For many plasma physics problems, three-dimensional and kinetic effects are very important. However, such simulations are very computationally intensive. Fortunately, there is a class of problems for which there is nearly azimuthal symmetry and the dominant three-dimensional physics is captured by the inclusion of only a few azimuthal harmonics. Recently, it was proposed [1] to model one such problem, laser wakefield acceleration, by expanding the fields and currents in azimuthal harmonics and truncating the expansion. The complex amplitudes of the fundamental and first harmonic for the fields were solved on an r–z grid and a procedure for calculating the complex current amplitudes for each particle based on its motion in Cartesian geometry was presented using a Marder's correction to maintain the validity of Gauss's law. In this paper, we describe an implementation of this algorithm into OSIRIS using a rigorous charge conserving current deposition method to maintain the validity of Gauss's law. We show that this algorithm is a hybrid method which uses a particles-in-cell description in r–z and a gridless description in ϕ. We include the ability to keep an arbitrary number of harmonics and higher order particle shapes. Examples for laser wakefield acceleration, plasma wakefield acceleration, and beam loading are also presented and directions for future work are discussed.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

Perforation of the IVC: Rule Rather Than Exception After Longer Indwelling Times for the Guenther Tulip and Celect Retrievable Filters

Purpose: This study was designed to assess the incidence, magnitude, and impact upon retrievability of vena caval perforation by Guenther Tulip and Celect conical inferior vena cava (IVC) filters on computed tomographic (CT) imaging. Methods: Guenther Tulip and Celect IVC filters placed between July 2007 and May 2009 were identified from medical records. Of 272 IVC filters placed, 50 (23 Guenther Tulip, 46%; 27 Celect, 54%) were retrospectively assessed on follow-up abdominal CT scans performed for reasons unrelated to the filter. Computed tomography scans were examined for evidence of filter perforation through the vena caval wall, tilt, or pericaval tissue injury. Procedure records were reviewed to determine whether IVC filter retrieval was attempted and successful. Results: Perforation of at least one filter component through the IVC was observed in 43 of 50 (86%) filters on CT scans obtained between 1 and 880 days after filter placement. All filters imaged after 71 days showed some degree of vena caval perforation, often as a progressive process. Filter tilt was seen in 20 of 50 (40%) filters, and all tilted filters also demonstrated vena caval perforation. Transjugular removal was attempted in 12 of 50 (24%) filters and was successful in 11 of 12 (92%). Conclusions: Longer indwelling times usually result in vena caval perforation by retrievable Guenther Tulip and Celect IVC filters. Although infrequently reported in the literature, clinical sequelae from IVC filter components breaching the vena cava can be significant. We advocate filter retrieval as early as clinically indicated and increased attention to the appearance of IVC filters on all follow-up imaging studies.

62 RADIOLOGY AND NUCLEAR MEDICINE↗