Nine human malignant gliomas (2 astrocytomas grade III and 7 glioblastomas) were analyzed using comparative genomic hybridization (CGH). In addition to the amplification of the EGFR gene at 7p12 in 4 ...of 9 cases, six new amplification sites were mapped to 1q32, 4q12, 7q21.1, 7q21.2-3, 12p, and 22q12. Nonrandom chromosomal gains and losses were identified with overrepresentation of chromosome 7 and underrepresentation of chromosome 10 as the most frequent events (1 of 2 astrocytomas, 7 of 7 glioblastomas). Gain of a part or the whole chromosome 19 and losses of chromosome bands 9pter-23 and 22q13 were detected each in five cases. Loss of chromosome band 17p13 and gain of chromosome 20 were revealed each in three cases. The validity of the CGH data was confirmed using interphase cytogenetics with YAC clones, chromosome painting in tumor metaphase spreads, and DNA fingerprinting. A comparison of CGH data with the results of chromosome banding analyses indicates that metaphase spreads accessible in primary tumor cell cultures may not represent the clones predominant in the tumor tissue.
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Background: Clinical responses to PD1 blockade have been linked to IFN-γ associated gene expression in the tumor microenvironment. Stereotactic body radiotherapy (SBRT) can stimulate ...innate and adaptive immunity to potentially augment immunotherapy. Anti-PD1 treatment outcomes are improved with lower disease burden and multi-site radiation is an emerging paradigm for eradicating metastatic disease. Methods: We conducted a phase I study for patients with metastatic solid tumors who progressed on standard treatment. The primary aim was to evaluate the safety of pembrolizumab Immunotherapy with Multi-Organ Site Ablative stereotactic body Radiation Therapy (iMOSART). Two to four metastases were chosen for each patient and not all sites of disease were targeted with SBRT. Metastases > 65cc were partially irradiated. Pembrolizumab was initiated within 7 days after the final SBRT treatment. Results: 79 patients were enrolled, three patients did not receive any treatment and three patients only received SBRT. The 73 patients included in the analysis were treated with SBRT and at least 1 cycle of pembrolizumab. 94.5% of patients had two lesions treated with SBRT. Median follow-up for toxicity was 5.5 months (IQR 3.3-8.1). Six patients experienced dose-limiting toxicity (DLT) with no radiation dose reductions. RECIST overall objective response rate was 13.5% in the 68 patients with imaging follow-up. Superior control of irradiated lesions was observed compared to non-irradiated target lesions for the 52 patients with paired data (p = 0·0005) with a mean percent tumor burden change -21·7% (SD 24·3%) for irradiated lesions vs. 1·7% (SD 46·3%) for non-irradiated lesions (p = 0·0008). While abscopal response defined by 30% reduction in any single non-irradiated measurable lesion was present in 26·9% of patients, abscopal response was 13·2% when defined by 30% reduction in aggregate diameter of non-irradiated measurable lesions. Conclusions: iMOSART was well tolerated with acceptable toxicity. Further randomized studies are warranted to investigate the potential clinical benefit of this combination approach. Clinical trial information: NCT02608385.
Abstract
Purpose
Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT).
Methods
In a ...cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT’s level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded. Each RiT performed two punctures. The first puncture was performed with a transaxial or single angulated needle path and the second with a single or double angulated needle path. Puncture deviation and puncture duration were compared between the procedures and were correlated with the self-assessments.
Results
RiTs in both the CT guidance and CACT guidance groups did not differ with respect to radiologic experience (p = 1), angiographic experience (p = 0.415), and number of ultrasound-guided puncture procedures (p = 0.483), CT-guided puncture procedures (p = 0.934), and CACT-guided puncture procedures (p = 0.466). The puncture duration was significantly longer with CT guidance (without navigation tool) than with CACT guidance with navigation software (p < 0.001). There was no significant difference in the puncture duration between the first and second puncture using CT guidance (p = 0.719). However, in the case of CACT, the second puncture was significantly faster (p = 0.006). Puncture deviations were not different between CT-guided and CACT-guided puncture (p = 0.337) and between the first and second puncture of CT-guided and CACT-guided puncture (CT: p = 0.130; CACT: p = 0.391). The self-assessment of manual skills did not correlate with puncture deviation (p = 0.059) and puncture duration (p = 0.158). The self-assessed spatial skills correlated positively with puncture deviation (p = 0.011) but not with puncture duration (p = 0.541).
Conclusion
The RiTs achieved a puncture deviation that was clinically adequate with respect to their level of training and did not differ between CT-guided and CACT-guided puncture. The puncture duration was shorter when using CACT. CACT guidance with navigation software support has a potentially steeper learning curve. Spatial skills might accelerate the learning of image-guided puncture.
Key Points:
The CT-guided and CACT-guided puncture experience of the RiTs selected as part of the program “Researchers for the Future” of the German Roentgen Society was adequate with respect to the level of training.
Despite the lower collective experience of the RiTs with CACT-guided puncture with navigation software assistance, the learning curve regarding CACT-guided puncture may be faster compared to the CT-guided puncture technique.
If the needle path is complex, CACT guidance with navigation software assistance might have an advantage over CT guidance.
Citation Format
Meine TC, Hinrichs JB, Werncke T et al. Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology. Fortschr Röntgenstr 2022; 194: 272 – 280
Zusammenfassung
Ziel
Vergleich der Punktionsabweichung und -dauer zwischen Computertomografie (CT) – und C-Arm-CT (CACT) -gesteuertem Punktionsverfahren bei Anwendung durch Assistenzärzte in Weiterbildung (AiW).
Material und Methode
In einer Kohorte von 25 AiW, die Teil einer wissenschaftlichen Förderung waren, wurden entweder CT- oder CACT-gesteuerte Punktionen an einem Phantom durchgeführt. Vor Beginn wurden der Weiterbildungsstand, die Erfahrung mit Spielen eines Musikinstruments, mit Videospielen und mit Ballsportarten und die Selbsteinschätzung von manueller Geschicklichkeit und räumlichem Denkvermögen abgefragt. Jede/r AiW führte 2 Punktionen durch, wobei die 1. Punktion mit einem transaxialen bzw. einfach angulierten Nadelpfad und die 2. Punktion mit einem einfach bzw. doppelt angulierten Nadelpfad erfolgte. Punktionsabweichung und -dauer wurden zwischen den Verfahren verglichen und mit den Selbsteinschätzungen korreliert.
Ergebnisse
Die beiden Gruppen der AiW zeigten keine Unterschiede in der Erfahrung in der Radiologie (p = 1), in der Angiografie (p = 0.415) und in der Anzahl bereits durchgeführter Punktionen gesteuert durch Ultraschall (p = 0,483), CT (p = 0,934) und CACT (p = 0,466). In der CT (ohne Navigationssoftware) war die Punktionsdauer signifikant länger als mit der CACT-Bildsteuerung mit Navigationssoftware (p < 0,001). Bei der Punktionsdauer zeigten sich keine signifikanten Unterschiede zwischen der 1. und 2. Punktion im CT (p = 0,719), während die 2. Punktion mit CACT schneller durchgeführt werden konnte (p = 0,006). Die Punktionsabweichung war weder signifikant zwischen CT- und CACT-Bildsteuerung (p = 0,337), noch zwischen der 1. und 2. Punktion der jeweiligen Verfahren (CT: p = 0,130; CACT: p = 0,391). Die Selbsteinschätzung der manuellen Geschicklichkeit korrelierte nicht mit der Punktionsabweichung (p = 0,059) und -dauer (p = 0,158). Das subjektive räumliche Denkvermögen zeigte eine moderate positive Korrelation zur Punktionsabweichung (p = 0,011), aber nicht zur -dauer (p = 0,541).
Schlussfolgerung
Die AiW erreichten eine dem Ausbildungsstand entsprechende, klinisch adäquate Punktionsabweichung unter CT- und CACT-Bildsteuerung. Die CACT-gesteuerten Punktionen mit Unterstützung durch Navigationssoftware wurden schneller durchgeführt, und auch die Lernkurve war mit CACT-Bildsteuerung steiler. Räumliches Denkvermögen kann möglicherweise das Erlernen bildgesteuerter Punktionen beschleunigen.
Kernaussagen:
Die Erfahrung mit Punktionen war in einer Gruppe von AiW, die im Rahmen des Programms der Deutschen Röntgengesellschaft e. V. „Forscher-für-die-Zukunft“ ausgesucht wurden, dem Weiterbildungsstand entsprechend.
Trotz kollektiv geringerer Erfahrung der radiologischen AiW mit der CACT-gesteuerten Punktion mit Navigationssoftwareunterstützung ist die Lernkurve gegenüber der einfachen CT-Punktion möglicherweise steiler.
Bei schwierigen Punktionswegen könnte die CACT-Bildsteuerung mit Softwareunterstützung einen Vorteil in der Durchführung gegenüber der konventionellen CT-Bildsteuerung haben.
Zitierweise
Meine TC, Hinrichs JB, Werncke T et al. Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology. Fortschr Röntgenstr 2022; 194: 272 – 280
Zusammenfassung
Die Planung und Implantation eines individuellen Beckenteilersatzes stellt hohe Anforderungen sowohl an den Operateur als auch an das gesamte Team (Ingenieur, Assistenten, ...Operationsteam). Durch die sorgfältige präoperative Planung sowie die stringente intraoperative Durchführung stellt der individuelle Beckenteilersatz ein aufwendiges, aber zuverlässig anwendbares Verfahren zur Defektrekonstruktion auch hochkomplexer azetabulärer Knochendefekte dar, auch nach multiplen Voroperationen.
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Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background: Despite progress in diagnosis and therapy, the prognosis of patients with glioblastoma remains poor. Recently
it has been found that the antibacterial agent taurolidine has a direct and ...selective antineoplastic effect on brain tumor
cells by the induction of programmed cell death. This paper reports on intravenous taurolidine treatment in two patients with
a progressive glioblastoma despite conventional therapy. Patients and Methods: Two male patients with histopathologically
diagnosed glioblastoma were included. The tumors were progressive despite conventional therapy. Intravenous taurolidine treatment
was initiated. Results: The neurological condition and quality of life improved in both patients such that they could be discharged
for further outpatient treatment. Follow-up demonstrated partial remission of the tumor in both patients. However, both patients
died about 4 months following the start of taurolidine treatment, from pneumonia and acute thrombembolism, respectively. Conclusion:
Both patients achieved a transient, marked improvement in quality of life and partial tumor remission. There was a clear response
to the taurolidine treatment.
Auf der Suche nach lebenswerten urbanen Räumen: Wie werden Sehnsuchtsstädte medial konstruiert und kommuniziert? Wie eignen Menschen sich ihren Lebensraum im Alltag an? Welche Sehnsüchte stehen ...hinter technologischen und planerischen Zukunftskonzepten?
Die interdisziplinären Beiträge des Bandes thematisieren diese Fragen aus den Blickwinkeln der Kulturwissenschaften, der Soziologie sowie der Stadtplanung und der Ingenieurswissenschaften.
Data Quality Monitoring (DQM) is a crucial task in large particle physics
experiments, since detector malfunctioning can compromise the data. DQM is
currently performed by human shifters, which is ...costly and results in limited
accuracy. In this work, we provide a proof-of-concept for applying
human-in-the-loop Reinforcement Learning (RL) to automate the DQM process while
adapting to operating conditions that change over time. We implement a
prototype based on the Proximal Policy Optimization (PPO) algorithm and
validate it on a simplified synthetic dataset. We demonstrate how a multi-agent
system can be trained for continuous automated monitoring during data
collection, with human intervention actively requested only when relevant. We
show that random, unbiased noise in human classification can be reduced,
leading to an improved accuracy over the baseline. Additionally, we propose
data augmentation techniques to deal with scarce data and to accelerate the
learning process. Finally, we discuss further steps needed to implement the
approach in the real world, including protocols for periodic control of the
algorithm's outputs.
The present project, which involved seven industrial or academic partners (Ascometal, Bosch, CNRS, CSIC-CENIM, GERDAU I+D EUROPA, Ruhr Universität Bochum, Technische Universität Kaiserslautern AWP), ...was concerned with understanding the ductility and the fatigue properties of 'carbide-free' low temperature bainite as obtained through isothermal transformation at 220-250 °C. The tensile and fatigue properties of six different materials were investigated, with different heat-treatment conditions. Efforts to understand tensile ductility focussed on retained austenite stability and were successful in relating tensile ductility with retained austenite mechanical stability. It is shown that poor stability leads to brittle behaviour (rupture before UTS), and that the onset of fracture in these conditions may be related to the fraction of martensite formed. Once sufficient stability was achieved, tensile elongation improved constantly with retained austenite stability. From a microstructural point of view, it is shown that poor stability is associated with a higher fraction of blocky retained austenite and/or a lesser carbon enrichment of these features. For at least one of the materials, fatigue performances were shown to be 10-20% superior to the reference material 100Cr6 (heat-treated to a UTS of 2300 MPa). Detailed investigation of fatigue specimens suggested that the critical microstructural feature governing fatigue strength was the block size. Finally, modelling helped explain the supersaturation of bainitic ferrite, and explore the potential role of Si in that respect. It was shown that higher carbon solubility in bainitic ferrite could be expected if the latter retained its tetragonality. Estimation of the different interface strengths were carried out, and the influence of alloying elements such as Si and C on the latter was estimated. It was shown that in the presence of C, differences in strength between the different interfaces tended to level out. Finally, the results suggest that addition of Si and C, as they increase reduce the tendency for mechanical destabilisation of austenite, which is consistent with many of the experimental results obtained.
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