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Sample records for four-dimensional superquadric-based cardiac

  1. Cardiac imaging using 256-detector row four-dimensional CT. Preliminary clinical report

    International Nuclear Information System (INIS)

    Kido, Teruhito; Kurata, Akira; Higashino, Hiroshi

    2007-01-01

    Along with the increase of detector rows on the z-axis and a faster gantry rotation speed, the spatial and temporal resolutions of the multislice computed tomography (CT) have been improved for noninvasive coronary artery imaging. We investigated the feasibility of the second specification prototype 256-detector row four-dimensional CT for assessing coronary artery and cardiac function. The subjects were five patients with coronary artery disease. Contrast medium (40-60 ml) was intravenously administered at the rate of 3-4 ml/s. The patient's whole heart was scanned for 1.5 s to cover at least one cardiac cycle during breathholding without electrocardiographic gating. Parameters used were 0.5 mm slice thickness, 0.5 s/rotation, 120 Kv, and 350 mA, with a half-scan reconstruction algorithm (temporal resolution 250 ms). Twenty-six transaxial datasets were reconstructed at intervals of 50 ms. The assessability of the coronary arteries in American Heart Association (AHA) segments 1, 2, 3, 5, 6, 7, 9, and 11 was visually evaluated, resulting in 29 of 32 (90.9%) segments being assessable. Functional assessment was also performed using animated movies without banding artifacts in all cases. The 256-detector row four-dimensional CT can assess the coronary artery and cardiac function using data during 1.5 s without banding artifacts. (author)

  2. A priori motion models for four-dimensional reconstruction in gated cardiac SPECT

    International Nuclear Information System (INIS)

    Lalush, D.S.; Tsui, B.M.W.; Cui, Lin

    1996-01-01

    We investigate the benefit of incorporating a priori assumptions about cardiac motion in a fully four-dimensional (4D) reconstruction algorithm for gated cardiac SPECT. Previous work has shown that non-motion-specific 4D Gibbs priors enforcing smoothing in time and space can control noise while preserving resolution. In this paper, we evaluate methods for incorporating known heart motion in the Gibbs prior model. The new model is derived by assigning motion vectors to each 4D voxel, defining the movement of that volume of activity into the neighboring time frames. Weights for the Gibbs cliques are computed based on these open-quotes most likelyclose quotes motion vectors. To evaluate, we employ the mathematical cardiac-torso (MCAT) phantom with a new dynamic heart model that simulates the beating and twisting motion of the heart. Sixteen realistically-simulated gated datasets were generated, with noise simulated to emulate a real Tl-201 gated SPECT study. Reconstructions were performed using several different reconstruction algorithms, all modeling nonuniform attenuation and three-dimensional detector response. These include ML-EM with 4D filtering, 4D MAP-EM without prior motion assumption, and 4D MAP-EM with prior motion assumptions. The prior motion assumptions included both the correct motion model and incorrect models. Results show that reconstructions using the 4D prior model can smooth noise and preserve time-domain resolution more effectively than 4D linear filters. We conclude that modeling of motion in 4D reconstruction algorithms can be a powerful tool for smoothing noise and preserving temporal resolution in gated cardiac studies

  3. Extracting cardiac shapes and motion of the chick embryo heart outflow tract from four-dimensional optical coherence tomography images

    Science.gov (United States)

    Yin, Xin; Liu, Aiping; Thornburg, Kent L.; Wang, Ruikang K.; Rugonyi, Sandra

    2012-09-01

    Recent advances in optical coherence tomography (OCT), and the development of image reconstruction algorithms, enabled four-dimensional (4-D) (three-dimensional imaging over time) imaging of the embryonic heart. To further analyze and quantify the dynamics of cardiac beating, segmentation procedures that can extract the shape of the heart and its motion are needed. Most previous studies analyzed cardiac image sequences using manually extracted shapes and measurements. However, this is time consuming and subject to inter-operator variability. Automated or semi-automated analyses of 4-D cardiac OCT images, although very desirable, are also extremely challenging. This work proposes a robust algorithm to semi automatically detect and track cardiac tissue layers from 4-D OCT images of early (tubular) embryonic hearts. Our algorithm uses a two-dimensional (2-D) deformable double-line model (DLM) to detect target cardiac tissues. The detection algorithm uses a maximum-likelihood estimator and was successfully applied to 4-D in vivo OCT images of the heart outflow tract of day three chicken embryos. The extracted shapes captured the dynamics of the chick embryonic heart outflow tract wall, enabling further analysis of cardiac motion.

  4. Improving left ventricular segmentation in four-dimensional flow MRI using intramodality image registration for cardiac blood flow analysis.

    Science.gov (United States)

    Gupta, Vikas; Bustamante, Mariana; Fredriksson, Alexandru; Carlhäll, Carl-Johan; Ebbers, Tino

    2018-01-01

    Assessment of blood flow in the left ventricle using four-dimensional flow MRI requires accurate left ventricle segmentation that is often hampered by the low contrast between blood and the myocardium. The purpose of this work is to improve left-ventricular segmentation in four-dimensional flow MRI for reliable blood flow analysis. The left ventricle segmentations are first obtained using morphological cine-MRI with better in-plane resolution and contrast, and then aligned to four-dimensional flow MRI data. This alignment is, however, not trivial due to inter-slice misalignment errors caused by patient motion and respiratory drift during breath-hold based cine-MRI acquisition. A robust image registration based framework is proposed to mitigate such errors automatically. Data from 20 subjects, including healthy volunteers and patients, was used to evaluate its geometric accuracy and impact on blood flow analysis. High spatial correspondence was observed between manually and automatically aligned segmentations, and the improvements in alignment compared to uncorrected segmentations were significant (P  0.05). Our results demonstrate the efficacy of the proposed approach in improving left-ventricular segmentation in four-dimensional flow MRI, and its potential for reliable blood flow analysis. Magn Reson Med 79:554-560, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  5. The four-dimensional non-uniform rational B-splines-based cardiac-torso phantom and its application in medical imaging research

    International Nuclear Information System (INIS)

    Li Chongguo; Wu Dake; Lang Jinyi

    2008-01-01

    Simulation skill is playing an increasingly important role in medical imaging research. four-dimensional non-uniform rational B-splines-based cardiac-torso (4D NCAT) phantom is new tool for meoical imaging res catch and when combined with accurate models for the imaging process a wealth of realistic imaging data from subjects of various anatomies. Can be provided 4D NCAT phantoms have bend widely used in medical research such as SPECT, PET, CT and so on. 4D NCAT phantoms have also been used in inverse planning system of intensity modulated radiation therapy. (authors)

  6. On four dimensional mirror symmetry

    International Nuclear Information System (INIS)

    Losev, A.; Nekrasov, N.; Shatashvili, S.

    2000-01-01

    A conjecture relating instanton calculus in four dimensional supersymmetric theories and the deformation theory of Lagrangian submanifolds in C 2r invariant under a (subgroup of) Sp(2r,Z) is formulated. This is a four dimensional counterpart of the mirror symmetry of topological strings (relating Gromov-Witten invariants and generalized variations of Hodge structure). (orig.)

  7. Fetal cardiac stroke volume determination by four-dimensional ultrasound with spatio-temporal image correlation compared with two-dimensional and Doppler ultrasonography.

    Science.gov (United States)

    Rizzo, Giuseppe; Capponi, Alessandra; Cavicchioni, Ottavia; Vendola, Marianne; Arduini, Domenico

    2007-12-01

    To assess the agreement of stroke volume (SV) measured with two-dimensional (2D) ultrasonography with Doppler capability (vs) four-dimensional (4D) with spatiotemporal image correlation (STIC) in normal and growth restricted fetuses. 2D Doppler and 4D STIC were used to measure SV of 40 normal fetuses at 20 to 22 and 28 to 32 weeks, and 16 growth-restricted fetuses at 26 to 34 weeks of gestation. Intraclass correlation was used to evaluate the agreement between left and right SV obtained by the two techniques, and proportionate Bland-Altman plots constructed. The time necessary to obtain SV was analyzed. The intraclass correlation coefficient between 2D Doppler and 4D STIC measurements for the left ventricle were 0.977 and 0.980 for the right ventricle. The proportionate limits of agreement between the two methods were 18.7 to 23.9% for the left ventricle and - 20.9 to 21.7% for the right ventricle. The time necessary to measure SV was significantly shorter with 4D STIC (3.1 (vs) 7.9 min p < 0.0001) than with 2D Doppler. There is a good agreement between SV measured either by 2D Doppler or by 4D STIC. The 4D STIC represents a simple and rapid technique to estimate fetal SV and promises to become the method of choice. Copyright (c) 2007 John Wiley & Sons, Ltd.

  8. A Four-Dimensional Approach

    African Journals Online (AJOL)

    ... of East Asian Students in English-speaking Countries: A Four-Dimensional ... country's language greatly shapes all aspects of the student's international education ... Taking this ecological approach will help clearly define the role that home ...

  9. Four Dimensional Trace Space Measurement

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, M.

    2005-02-10

    Future high energy colliders and FELs (Free Electron Lasers) such as the proposed LCLS (Linac Coherent Light Source) at SLAC require high brightness electron beams. In general a high brightness electron beam will contain a large number of electrons that occupy a short longitudinal duration, can be focused to a small transverse area while having small transverse divergences. Therefore the beam must have a high peak current and occupy small areas in transverse phase space and so have small transverse emittances. Additionally the beam should propagate at high energy and have a low energy spread to reduce chromatic effects. The requirements of the LCLS for example are pulses which contain 10{sup 10} electrons in a temporal duration of 10 ps FWHM with projected normalized transverse emittances of 1{pi} mm mrad[1]. Currently the most promising method of producing such a beam is the RF photoinjector. The GTF (Gun Test Facility) at SLAC was constructed to produce and characterize laser and electron beams which fulfill the LCLS requirements. Emittance measurements of the electron beam at the GTF contain evidence of strong coupling between the transverse dimensions of the beam. This thesis explores the effects of this coupling on the determination of the projected emittances of the electron beam. In the presence of such a coupling the projected normalized emittance is no longer a conserved quantity. The conserved quantity is the normalized full four dimensional phase space occupied by the beam. A method to determine the presence and evaluate the strength of the coupling in emittance measurements made in the laboratory is developed. A method to calculate the four dimensional volume the beam occupies in phase space using quantities available in the laboratory environment is also developed. Results of measurements made of the electron beam at the GTF that demonstrate these concepts are presented and discussed.

  10. New four-dimensional symmetry

    International Nuclear Information System (INIS)

    Hsu, J.P.

    1976-01-01

    A new picture of nature is proposed in which there are only two fundamental universal constants anti e (identical with e/c) and dirac constant (identical with dirac constant/c). The theory is developed within the framework of a new four-dimensional symmetry which is constructed on the basis of the Poincare--Einstein principle of relativity for the laws of physics and the Newtonian concept of time. One obtains a new space--light transformation law, a velocity-addition law, and so on. In this symmetry scheme, the speed of light is constant and is completely relative. The new theory is logically self-consistent, and it moreover is in agreement with all previously established experimental facts, such as the ''lifetime dilatation'' of unstable particles, the Michelson--Morley experiment, etc. There is a difference relative to the usual theory, though, in that our theory predicts a new law for the Doppler frequency shift, which can be tested experimentally by measuring the second-order frequency shift

  11. Super integrable four-dimensional autonomous mappings

    International Nuclear Information System (INIS)

    Capel, H W; Sahadevan, R; Rajakumar, S

    2007-01-01

    A systematic investigation of the complete integrability of a fourth-order autonomous difference equation of the type w(n + 4) = w(n)F(w(n + 1), w(n + 2), w(n + 3)) is presented. We identify seven distinct families of four-dimensional mappings which are super integrable and have three (independent) integrals via a duality relation as introduced in a recent paper by Quispel, Capel and Roberts (2005 J. Phys. A: Math. Gen. 38 3965-80). It is observed that these seven families can be related to the four-dimensional symplectic mappings with two integrals including all the four-dimensional periodic reductions of the integrable double-discrete modified Korteweg-deVries and sine-Gordon equations treated in an earlier paper by two of us (Capel and Sahadevan 2001 Physica A 289 86-106)

  12. Extended supersymmetry in four-dimensional Euclidean space

    International Nuclear Information System (INIS)

    McKeon, D.G.C.; Sherry, T.N.

    2000-01-01

    Since the generators of the two SU(2) groups which comprise SO(4) are not Hermitian conjugates of each other, the simplest supersymmetry algebra in four-dimensional Euclidean space more closely resembles the N=2 than the N=1 supersymmetry algebra in four-dimensional Minkowski space. An extended supersymmetry algebra in four-dimensional Euclidean space is considered in this paper; its structure resembles that of N=4 supersymmetry in four-dimensional Minkowski space. The relationship of this algebra to the algebra found by dimensionally reducing the N=1 supersymmetry algebra in ten-dimensional Euclidean space to four-dimensional Euclidean space is examined. The dimensional reduction of N=1 super Yang-Mills theory in ten-dimensional Minkowski space to four-dimensional Euclidean space is also considered

  13. Unmanned Aerial System Four-Dimensional Gunnery Training Device Development

    Science.gov (United States)

    2017-10-01

    Aerial System (UAS) Four-Dimensional Gunnery Training Device: Training Effectiveness Assessment (James & Miller, in press). 31 Technical ...Research Product 2018-05 Unmanned Aerial System Four-Dimensional Gunnery Training Device Development David R. James...for the Department of the Army by Northrop Grumman Corporation. Technical review by Thomas Rhett Graves, Ph.D., U.S. Army Research Institute

  14. Inverse Operation of Four-dimensional Vector Matrix

    OpenAIRE

    H J Bao; A J Sang; H X Chen

    2011-01-01

    This is a new series of study to define and prove multidimensional vector matrix mathematics, which includes four-dimensional vector matrix determinant, four-dimensional vector matrix inverse and related properties. There are innovative concepts of multi-dimensional vector matrix mathematics created by authors with numerous applications in engineering, math, video conferencing, 3D TV, and other fields.

  15. Four-dimensional strings: Phenomenology and model building

    International Nuclear Information System (INIS)

    Quiros, M.

    1989-01-01

    In these lectures we will review some of the last developments in string theories leading to the construction of realistic four-dimensional string models. Special attention will be paid to world-sheet and space-time supersymmetry, modular invariance and model building for supersymmetric and (tachyon-free) nonsupersymmetric ten and four-dimensional models. (orig.)

  16. Oscillator potential for the four-dimensional Hall effect

    International Nuclear Information System (INIS)

    Mardoyan, Levon; Nersessian, Armen

    2005-01-01

    We suggest an exactly solvable model of an oscillator on a four-dimensional sphere interacting with an SU(2) Yang monopole. We show that the properties of the model essentially depend on the monopole charge

  17. Commutative curvature operators over four-dimensional generalized symmetric

    Directory of Open Access Journals (Sweden)

    Ali Haji-Badali

    2014-12-01

    Full Text Available Commutative properties of four-dimensional generalized symmetric pseudo-Riemannian manifolds were considered. Specially, in this paper, we studied Skew-Tsankov and Jacobi-Tsankov conditions in 4-dimensional pseudo-Riemannian generalized symmetric manifolds.

  18. Massive supermultiplets in four-dimensional superstring theory

    International Nuclear Information System (INIS)

    Feng Wanzhe; Lüst, Dieter; Schlotterer, Oliver

    2012-01-01

    We extend the discussion of Feng et al. (2011) on massive Regge excitations on the first mass level of four-dimensional superstring theory. For the lightest massive modes of the open string sector, universal supermultiplets common to all four-dimensional compactifications with N=1,2 and N=4 spacetime supersymmetry are constructed respectively - both their vertex operators and their supersymmetry variations. Massive spinor helicity methods shed light on the interplay between individual polarization states.

  19. The four-dimensional mouse whole-body phantoms and its application in medical imaging research

    International Nuclear Information System (INIS)

    Li Chongguo; Wu Dake

    2012-01-01

    Medical imaging simulation is a powerful tool for characterizing,evaluating,and optimizing medical imaging devices and techniques. A vital aspect of simulation is to have a realistic phantom or model of the subject's anatomy. Four-dimensional mouse whole-body phantoms provide realistic models of the mouse anatomy and physiology for imaging studies. When combined with accurate models for the imaging process,are capable of providing a wealth of realistic imaging data from subjects with various anatomies and motions (cardiac and respiratory) in health and disease. With this ability, the four-dimensional mouse whole-body phantoms have enormous potential to study the effects of anatomical, physiological and physical factors on medical and small animal imaging and to research new instrumentation, image acquisition strategies, image processing, reconstruction methods, image visualization and interpretation techniques. (authors)

  20. Four-dimensional hilbert curves for R-trees

    DEFF Research Database (Denmark)

    Haverkort, Herman; Walderveen, Freek van

    2011-01-01

    Two-dimensional R-trees are a class of spatial index structures in which objects are arranged to enable fast window queries: report all objects that intersect a given query window. One of the most successful methods of arranging the objects in the index structure is based on sorting the objects...... according to the positions of their centers along a two-dimensional Hilbert space-filling curve. Alternatively, one may use the coordinates of the objects' bounding boxes to represent each object by a four-dimensional point, and sort these points along a four-dimensional Hilbert-type curve. In experiments...

  1. Lattice classification of the four-dimensional heterotic strings

    International Nuclear Information System (INIS)

    Balog, J.; Forgacs, P.; Vecsernyes, P.; Horvath, Z.

    1987-06-01

    A lattice slicing procedure is proposed which leads to the classification of all four-dimensional chiral heterotic strings based on Conway and Sloane's 22-dimensional self-dual Euclidean lattices. By reversing this procedure it is possible to construct all these theories. (author)

  2. The scalar curvature problem on the four dimensional half sphere

    CERN Document Server

    Ben-Ayed, M; El-Mehdi, K

    2003-01-01

    In this paper, we consider the problem of prescribing the scalar curvature under minimal boundary conditions on the standard four dimensional half sphere. We provide an Euler-Hopf type criterion for a given function to be a scalar curvature for some metric conformal to the standard one. Our proof involves the study of critical points at infinity of the associated variational problem.

  3. Statistical Entropy of Four-Dimensional Extremal Black Holes

    International Nuclear Information System (INIS)

    Maldacena, J.M.; Strominger, A.

    1996-01-01

    String theory is used to count microstates of four-dimensional extremal black holes in compactifications with N=4 and N=8 supersymmetry. The result agrees for large charges with the Bekenstein-Hawking entropy. copyright 1996 The American Physical Society

  4. Four-dimensional conversion for spiritual leadership development: A ...

    African Journals Online (AJOL)

    The process of a four-dimensional conversion and/or transformation strives in helping the leadership of an organisation, especially such as the church, with practical ways that may lead to the development of an effective leadership by observing the four important aspects of human spirituality as elaborated on in the article.

  5. Variability of four-dimensional computed tomography patient models

    NARCIS (Netherlands)

    Sonke, Jan-Jakob; Lebesque, Joos; van Herk, Marcel

    2008-01-01

    PURPOSE: To quantify the interfractional variability in lung tumor trajectory and mean position during the course of radiation therapy. METHODS AND MATERIALS: Repeat four-dimensional (4D) cone-beam computed tomography (CBCT) scans (median, nine scans/patient) routinely acquired during the course of

  6. Identification of Architectural Functions in A Four-Dimensional Space

    Directory of Open Access Journals (Sweden)

    Firza Utama

    2012-06-01

    Full Text Available This research has explored the possibilities and concept of architectural space in a virtual environment. The virtual environment exists as a different concept, and challenges the constraints of the physical world. One of the possibilities in a virtual environment is that it is able to extend the spatial dimension higher than the physical three-dimension. To take the advantage of this possibility, this research has applied some geometrical four-dimensional (4D methods to define virtual architectural space. The spatial characteristics of 4D space is established by analyzing the four-dimensional structure that can be comprehended by human participant for its spatial quality, and by developing a system to control the fourth axis of movement. Multiple three-dimensional spaces that fluidly change their volume have been defined as one of the possibilities of virtual architecturalspace concept in order to enrich our understanding of virtual spatial experience.

  7. Common time in a four-dimensional symmetry framework

    International Nuclear Information System (INIS)

    Hsu, J.P.; Sherry, T.N.

    1980-01-01

    Following the ideas of Poincare, Reichenbach, and Grunbaum concerning the convention of setting up clock systems, we analyze clock systems and light propagation within the framework of four-dimensional symmetry. It is possible to construct a new four-dimensional symmetry framework incorporating common time: observers in different inertial frames of reference use one and the same clock system, which is located in any one of the frames. Consequently, simultaneity has a meaning independent of position and independent of frame of reference. A further consequence is that the two-way speeds of light alone are isotropic in any frame. By the choice of clock system there will be one frame in which the one-way speed of light is isotropic. This frame can be arbitrarily chosen. The difference between one-way speeds an two-way speeds of light signals is considered in detail

  8. Supergravity duals of supersymmetric four dimensional gauge theories

    Energy Technology Data Exchange (ETDEWEB)

    Bigazzi, F [Abdus Salam International Centre for Theoretical Physics, Trieste (Italy); Cotrone, A L [Centre de Physique Theorique, Ecole Polytechnique, Palaiseau Cedex (France); [INFN, Rome (Italy); Petrini, M [Centre de Physique Theorique, Ecole Polytechnique, Palaiseau (France); Zaffaroni, A [Universita di Milano-Bicocca and INFN, Milan (Italy)

    2002-03-01

    This article contains an overview of some recent attempts of understanding supergravity and string duals of four dimensional gauge theories using the AdS/CFT correspondence. We discuss the general philosophy underlying the various ways to realize Super Yang-Mills theories in terms of systems of branes. We then review some of the existing duals for N=2 and N=1 theories. We also discuss differences and similarities with realistic theories. (author)

  9. Four dimensional sigma model coupled to the metric tensor field

    International Nuclear Information System (INIS)

    Ghika, G.; Visinescu, M.

    1980-02-01

    We discuss the four dimensional nonlinear sigma model with an internal O(n) invariance coupled to the metric tensor field satisfying Einstein equations. We derive a bound on the coupling constant between the sigma field and the metric tensor using the theory of harmonic maps. A special attention is paid to Einstein spaces and some new explicit solutions of the model are constructed. (author)

  10. Spinors and supersymmetry in four-dimensional Euclidean space

    International Nuclear Information System (INIS)

    McKeon, D.G.C.; Sherry, T.N.

    2001-01-01

    Spinors in four-dimensional Euclidean space are treated using the decomposition of the Euclidean space SO(4) symmetry group into SU(2)xSU(2). Both 2- and 4-spinor representations of this SO(4) symmetry group are shown to differ significantly from the corresponding spinor representations of the SO(3, 1) symmetry group in Minkowski space. The simplest self conjugate supersymmetry algebra allowed in four-dimensional Euclidean space is demonstrated to be an N=2 supersymmetry algebra which resembles the N=2 supersymmetry algebra in four-dimensional Minkowski space. The differences between the two supersymmetry algebras gives rise to different representations; in particular an analysis of the Clifford algebra structure shows that the momentum invariant is bounded above by the central charges in 4dE, while in 4dM the central charges bound the momentum invariant from below. Dimensional reduction of the N=1 SUSY algebra in six-dimensional Minkowski space (6dM) to 4dE reproduces our SUSY algebra in 4dE. This dimensional reduction can be used to introduce additional generators into the SUSY algebra in 4dE. Well known interpolating maps are used to relate the N=2 SUSY algebra in 4dE derived in this paper to the N=2 SUSY algebra in 4dM. The nature of the spinors in 4dE allows us to write an axially gauge invariant model which is shown to be both Hermitian and anomaly-free. No equivalent model exists in 4dM. Useful formulae in 4dE are collected together in two appendixes

  11. On 'Common time' in the four-dimensional symmetry framework

    International Nuclear Information System (INIS)

    Gulati, Shobha

    1980-01-01

    Recently Hsu has advanced a 'Four-Dimensional Symmetry Theory' with a 'Common time' for all inertial frames. He believes that such a 'Common time' is physically possible. However, as a consequence of 'Common time', Hsu asserts that the speed of light in some inertial frames is not necessarily invariant and isotropic - a result, quite contrary to Einstein's Principle of the constancy of the velocity of light. In the present paper, taking Hsu's 'Common time' at its face value, the author has demonstrated that his formulation itself leads to physically absurd results. A 'Common time' for all inertial frames is just not possible. (author)

  12. Naked singularities in four-dimensional string backgrounds

    International Nuclear Information System (INIS)

    Mohammedi, N.

    1993-04-01

    It is shown that gauged nonlinear sigma models can be always deformed by terms proportional to the field strength of the gauge fields (nonminimal gauging). These deformations can be interpreted as perturbations, by marginal operators, of conformal coset models. When applied to the SL(2, R)xSU(2)/U(1)xU(1)) WZWN model, a large class of four-dimensional curved spacetime backgrounds are obtained. In particular, a naked singularity may form at a time when the volume of the universe is different from zero. (orig.)

  13. Quantum walk with a four-dimensional coin

    International Nuclear Information System (INIS)

    Hamilton, Craig S; Gabris, Aurel; Jex, Igor; Barnett, Stephen M

    2011-01-01

    We examine the physical implementation of a discrete time quantum walk with a four-dimensional coin. Our quantum walker is a photon moving repeatedly through a time delay loop, with time being our position space. The quantum coin is implemented using the internal states of the photon: the polarization and two of the orbital angular momentum states. We demonstrate how to implement this physically and what components would be needed. We then illustrate some of the results that could be obtained by performing the experiment.

  14. Four-dimensional optical manipulation of colloidal particles

    DEFF Research Database (Denmark)

    Rodrigo, P.J.; Daria, V.R.; Glückstad, J.

    2005-01-01

    We transform a TEM00 laser mode into multiple counterpropagating optical traps to achieve four-dimensional simultaneous manipulation of multiple particles. Efficient synthesis and dynamic control of the counterpropagating-beam traps is carried out via the generalized phase contrast method......, and a spatial polarization-encoding scheme. Our experiments genuinely demonstrate real-time, interactive particle-position control for forming arbitrary volumetric constellations and complex three-dimensional trajectories of multiple particles. This opens up doors for cross-disciplinary cutting-edge research...

  15. Four-dimensional maps of the human somatosensory system.

    Science.gov (United States)

    Avanzini, Pietro; Abdollahi, Rouhollah O; Sartori, Ivana; Caruana, Fausto; Pelliccia, Veronica; Casaceli, Giuseppe; Mai, Roberto; Lo Russo, Giorgio; Rizzolatti, Giacomo; Orban, Guy A

    2016-03-29

    A fine-grained description of the spatiotemporal dynamics of human brain activity is a major goal of neuroscientific research. Limitations in spatial and temporal resolution of available noninvasive recording and imaging techniques have hindered so far the acquisition of precise, comprehensive four-dimensional maps of human neural activity. The present study combines anatomical and functional data from intracerebral recordings of nearly 100 patients, to generate highly resolved four-dimensional maps of human cortical processing of nonpainful somatosensory stimuli. These maps indicate that the human somatosensory system devoted to the hand encompasses a widespread network covering more than 10% of the cortical surface of both hemispheres. This network includes phasic components, centered on primary somatosensory cortex and neighboring motor, premotor, and inferior parietal regions, and tonic components, centered on opercular and insular areas, and involving human parietal rostroventral area and ventral medial-superior-temporal area. The technique described opens new avenues for investigating the neural basis of all levels of cortical processing in humans.

  16. Four-dimensional gravity as an almost-Poisson system

    Science.gov (United States)

    Ita, Eyo Eyo

    2015-04-01

    In this paper, we examine the phase space structure of a noncanonical formulation of four-dimensional gravity referred to as the Instanton representation of Plebanski gravity (IRPG). The typical Hamiltonian (symplectic) approach leads to an obstruction to the definition of a symplectic structure on the full phase space of the IRPG. We circumvent this obstruction, using the Lagrange equations of motion, to find the appropriate generalization of the Poisson bracket. It is shown that the IRPG does not support a Poisson bracket except on the vector constraint surface. Yet there exists a fundamental bilinear operation on its phase space which produces the correct equations of motion and induces the correct transformation properties of the basic fields. This bilinear operation is known as the almost-Poisson bracket, which fails to satisfy the Jacobi identity and in this case also the condition of antisymmetry. We place these results into the overall context of nonsymplectic systems.

  17. Twistors and four-dimensional conformal field theory

    International Nuclear Information System (INIS)

    Singer, M.A.

    1990-01-01

    This is a report (with technical details omitted) on work concerned with generalizations to four dimensions of two-dimensional Conformed Field Theory. Accounts of this and related material are contained elsewhere. The Hilbert space of the four-dimensional theory has a natural interpretation in terms of massless spinor fields on real Minkowski space. From the twistor point of view this follows from the boundary CR-manifold P being precisely the space of light rays in real compactified Minkowski space. All the amplitudes can therefore be regarded as defined on Hilbert spaces built from Lorentzian spinor fields. Thus the twistor picture provides a kind of halfway house between the Lorentzian and Euclidean field theories. (author)

  18. Four-dimensional Printing of Liquid Crystal Elastomers.

    Science.gov (United States)

    Ambulo, Cedric P; Burroughs, Julia J; Boothby, Jennifer M; Kim, Hyun; Shankar, M Ravi; Ware, Taylor H

    2017-10-25

    Three-dimensional structures capable of reversible changes in shape, i.e., four-dimensional-printed structures, may enable new generations of soft robotics, implantable medical devices, and consumer products. Here, thermally responsive liquid crystal elastomers (LCEs) are direct-write printed into 3D structures with a controlled molecular order. Molecular order is locally programmed by controlling the print path used to build the 3D object, and this order controls the stimulus response. Each aligned LCE filament undergoes 40% reversible contraction along the print direction on heating. By printing objects with controlled geometry and stimulus response, magnified shape transformations, for example, volumetric contractions or rapid, repetitive snap-through transitions, are realized.

  19. Raman scattering in air: four-dimensional analysis

    International Nuclear Information System (INIS)

    Lin, Y.; Kessler, T.J.; Lawrence, G.N.

    1994-01-01

    Inertial confinement fusion requires propagation of high-intensity, pulse-shaped IR and UV laser beams through long air paths. Such beams are subject to energy losses and decreased beam quality as a result by stimulated rotational Raman scattering (SRRS). In this paper we describe how quantum fluctuations, stimulated Raman amplification, diffraction propagation, and optical aberrations interact during the propagation of short, high-power laser pulses using a four-dimensional (4-D) model of the optical beams and the medium. The 4-D model has been incorporated into a general optical-propagation computer program that allows the entire optical system to be modeled and that is implemented on high-end personal computers, workstations, and supercomputers. The numerical model is used to illustrate important phenomena in the evolution of the optical beams. In addition, the OMEGA Upgrade laser system is used as a design case to illustrate the various considerations for inertial confinement fusion laser design

  20. Four-Dimensional Data Assimilation Using the Adjoint Method

    Science.gov (United States)

    Bao, Jian-Wen

    The calculus of variations is used to confirm that variational four-dimensional data assimilation (FDDA) using the adjoint method can be implemented when the numerical model equations have a finite number of first-order discontinuous points. These points represent the on/off switches associated with physical processes, for which the Jacobian matrix of the model equation does not exist. Numerical evidence suggests that, in some situations when the adjoint method is used for FDDA, the temperature field retrieved using horizontal wind data is numerically not unique. A physical interpretation of this type of non-uniqueness of the retrieval is proposed in terms of energetics. The adjoint equations of a numerical model can also be used for model-parameter estimation. A general computational procedure is developed to determine the size and distribution of any internal model parameter. The procedure is then applied to a one-dimensional shallow -fluid model in the context of analysis-nudging FDDA: the weighting coefficients used by the Newtonian nudging technique are determined. The sensitivity of these nudging coefficients to the optimal objectives and constraints is investigated. Experiments of FDDA using the adjoint method are conducted using the dry version of the hydrostatic Penn State/NCAR mesoscale model (MM4) and its adjoint. The minimization procedure converges and the initialization experiment is successful. Temperature-retrieval experiments involving an assimilation of the horizontal wind are also carried out using the adjoint of MM4.

  1. Semiautomated four-dimensional computed tomography segmentation using deformable models

    International Nuclear Information System (INIS)

    Ragan, Dustin; Starkschall, George; McNutt, Todd; Kaus, Michael; Guerrero, Thomas; Stevens, Craig W.

    2005-01-01

    The purpose of this work is to demonstrate a proof of feasibility of the application of a commercial prototype deformable model algorithm to the problem of delineation of anatomic structures on four-dimensional (4D) computed tomography (CT) image data sets. We acquired a 4D CT image data set of a patient's thorax that consisted of three-dimensional (3D) image data sets from eight phases in the respiratory cycle. The contours of the right and left lungs, cord, heart, and esophagus were manually delineated on the end inspiration data set. An interactive deformable model algorithm, originally intended for deforming an atlas-based model surface to a 3D CT image data set, was applied in an automated fashion. Triangulations based on the contours generated on each phase were deformed to the CT data set on the succeeding phase to generate the contours on that phase. Deformation was propagated through the eight phases, and the contours obtained on the end inspiration data set were compared with the original manually delineated contours. Structures defined by high-density gradients, such as lungs, cord, and heart, were accurately reproduced, except in regions where other gradient boundaries may have confused the algorithm, such as near bronchi. The algorithm failed to accurately contour the esophagus, a soft-tissue structure completely surrounded by tissue of similar density, without manual interaction. This technique has the potential to facilitate contour delineation in 4D CT image data sets; and future evolution of the software is expected to improve the process

  2. Model-based image reconstruction for four-dimensional PET

    International Nuclear Information System (INIS)

    Li Tianfang; Thorndyke, Brian; Schreibmann, Eduard; Yang Yong; Xing Lei

    2006-01-01

    Positron emission tonography (PET) is useful in diagnosis and radiation treatment planning for a variety of cancers. For patients with cancers in thoracic or upper abdominal region, the respiratory motion produces large distortions in the tumor shape and size, affecting the accuracy in both diagnosis and treatment. Four-dimensional (4D) (gated) PET aims to reduce the motion artifacts and to provide accurate measurement of the tumor volume and the tracer concentration. A major issue in 4D PET is the lack of statistics. Since the collected photons are divided into several frames in the 4D PET scan, the quality of each reconstructed frame degrades as the number of frames increases. The increased noise in each frame heavily degrades the quantitative accuracy of the PET imaging. In this work, we propose a method to enhance the performance of 4D PET by developing a new technique of 4D PET reconstruction with incorporation of an organ motion model derived from 4D-CT images. The method is based on the well-known maximum-likelihood expectation-maximization (ML-EM) algorithm. During the processes of forward- and backward-projection in the ML-EM iterations, all projection data acquired at different phases are combined together to update the emission map with the aid of deformable model, the statistics is therefore greatly improved. The proposed algorithm was first evaluated with computer simulations using a mathematical dynamic phantom. Experiment with a moving physical phantom was then carried out to demonstrate the accuracy of the proposed method and the increase of signal-to-noise ratio over three-dimensional PET. Finally, the 4D PET reconstruction was applied to a patient case

  3. Performance studies of four-dimensional cone beam computed tomography

    International Nuclear Information System (INIS)

    Qi Zhihua; Chen Guanghong

    2011-01-01

    Four-dimensional cone beam computed tomography (4DCBCT) has been proposed to characterize the breathing motion of tumors before radiotherapy treatment. However, when the acquired cone beam projection data are retrospectively gated into several respiratory phases, the available data to reconstruct each phase is under-sampled and thus causes streaking artifacts in the reconstructed images. To solve the under-sampling problem and improve image quality in 4DCBCT, various methods have been developed. This paper presents performance studies of three different 4DCBCT methods based on different reconstruction algorithms. The aims of this paper are to study (1) the relationship between the accuracy of the extracted motion trajectories and the data acquisition time of a 4DCBCT scan and (2) the relationship between the accuracy of the extracted motion trajectories and the number of phase bins used to sort projection data. These aims will be applied to three different 4DCBCT methods: conventional filtered backprojection reconstruction (FBP), FBP with McKinnon-Bates correction (MB) and prior image constrained compressed sensing (PICCS) reconstruction. A hybrid phantom consisting of realistic chest anatomy and a moving elliptical object with known 3D motion trajectories was constructed by superimposing the analytical projection data of the moving object to the simulated projection data from a chest CT volume dataset. CBCT scans with gantry rotation times from 1 to 4 min were simulated, and the generated projection data were sorted into 5, 10 and 20 phase bins before different methods were used to reconstruct 4D images. The motion trajectories of the moving object were extracted using a fast free-form deformable registration algorithm. The root mean square errors (RMSE) of the extracted motion trajectories were evaluated for all simulated cases to quantitatively study the performance. The results demonstrate (1) longer acquisition times result in more accurate motion delineation

  4. Four-dimensional ultrasonography of the fetal heart with spatiotemporal image correlation.

    Science.gov (United States)

    Gonçalves, Luís F; Lee, Wesley; Chaiworapongsa, Tinnakorn; Espinoza, Jimmy; Schoen, Mary Lou; Falkensammer, Peter; Treadwell, Marjorie; Romero, Roberto

    2003-12-01

    This study was undertaken to describe a new technique for the examination of the fetal heart using four-dimensional ultrasonography with spatiotemporal image correlation (STIC). Volume data sets of the fetal heart were acquired with a new cardiac gating technique (STIC), which uses automated transverse and longitudinal sweeps of the anterior chest wall. These volumes were obtained from 69 fetuses: 35 normal, 16 with congenital anomalies not affecting the cardiovascular system, and 18 with cardiac abnormalities. Dynamic multiplanar slicing and surface rendering of cardiac structures were performed. To illustrate the STIC technique, two representative volumes from a normal fetus were compared with volumes obtained from fetuses with the following congenital heart anomalies: atrioventricular septal defect, tricuspid stenosis, tricuspid atresia, and interrupted inferior vena cava with abnormal venous drainage. Volume datasets obtained with a transverse sweep were utilized to demonstrate the cardiac chambers, moderator band, interatrial and interventricular septae, atrioventricular valves, pulmonary veins, and outflow tracts. With the use of a reference dot to navigate the four-chamber view, intracardiac structures could be simultaneously studied in three orthogonal planes. The same volume dataset was used for surface rendering of the atrioventricular valves. The aortic and ductal arches were best visualized when the original plane of acquisition was sagittal. Volumes could be interactively manipulated to simultaneously visualize both outflow tracts, in addition to the aortic and ductal arches. Novel views of specific structures were generated. For example, the location and extent of a ventricular septal defect was imaged in a sagittal view of the interventricular septum. Furthermore, surface-rendered images of the atrioventricular valves were employed to distinguish between normal and pathologic conditions. Representative video clips were posted on the Journal's Web

  5. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization.

    Science.gov (United States)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-06-01

    This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ=1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. A covariant form of the Maxwell's equations in four-dimensional spaces with an arbitrary signature

    International Nuclear Information System (INIS)

    Lukac, I.

    1991-01-01

    The concept of duality in the four-dimensional spaces with the arbitrary constant metric is strictly mathematically formulated. A covariant model for covariant and contravariant bivectors in this space based on three four-dimensional vectors is proposed. 14 refs

  7. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

    International Nuclear Information System (INIS)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-01-01

    Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

  8. Comment on non-renormalization theorem in the four dimensional superstrings

    International Nuclear Information System (INIS)

    Soda, Jiro; Nakazawa, Naohito; Sakai, Kenji; Ojima, Shuichi.

    1987-10-01

    We discuss non-renormalization theorem in the context of the four dimensional superstrings. We explicitly demonstrate that the graviton 3-point one-loop amplitude does not vanish in contrast to the ten dimensional superstring theories. (author)

  9. Four-Dimensional Ultrafast Electron Microscopy: Insights into an Emerging Technique

    KAUST Repository

    Adhikari, Aniruddha; Eliason, Jeffrey K.; Sun, Jingya; Bose, Riya; Flannigan, David J.; Mohammed, Omar F.

    2016-01-01

    Four-dimensional ultrafast electron microscopy (4D-UEM) is a novel analytical technique that aims to fulfill the long-held dream of researchers to investigate materials at extremely short spatial and temporal resolutions by integrating the excellent

  10. Ultra high speed optical transmission using subcarrier-multiplexed four-dimensional LDPC-coded modulation.

    Science.gov (United States)

    Batshon, Hussam G; Djordjevic, Ivan; Schmidt, Ted

    2010-09-13

    We propose a subcarrier-multiplexed four-dimensional LDPC bit-interleaved coded modulation scheme that is capable of achieving beyond 480 Gb/s single-channel transmission rate over optical channels. Subcarrier-multiplexed four-dimensional LDPC coded modulation scheme outperforms the corresponding dual polarization schemes by up to 4.6 dB in OSNR at BER 10(-8).

  11. Four-dimensional Hall mechanics as a particle on CP3

    International Nuclear Information System (INIS)

    Bellucci, Stefano; Casteill, Pierre-Yves; Nersessian, Armen

    2003-01-01

    In order to establish an explicit connection between four-dimensional Hall effect on S 4 and six-dimensional Hall effect on CP 3 , we perform the Hamiltonian reduction of a particle moving on CP 3 in a constant magnetic field to the four-dimensional Hall mechanics (i.e., a-bar particle on S 4 in a SU(2) instanton field). This reduction corresponds to fixing the isospin of the latter system

  12. Hawking radiation from four-dimensional Schwarzschild black holes in M theory

    International Nuclear Information System (INIS)

    Das, S.R.; Mathur, S.D.; Ramadevi, P.

    1999-01-01

    Recently a method has been developed for relating four dimensional Schwarzschild black holes in M theory to near-extremal black holes in string theory with four charges, using suitably defined open-quotes boostsclose quotes and T dualities. We show that this method can be extended to obtain the emission rate of low energy massless scalars for the four dimensional Schwarzschild hole from the microscopic picture of radiation from the near extremal hole. copyright 1999 The American Physical Society

  13. Renormalization of period doubling in symmetric four-dimensional volume-preserving maps

    International Nuclear Information System (INIS)

    Mao, J.; Greene, J.M.

    1987-01-01

    We have determined three maps (truncated at quadratic terms) that are fixed under the renormalization operator of pitchfork period doubling in symmetric four-dimensional volume-preserving maps. Each of these contains the previously known two-dimensional area-preserving map that is fixed under the period-doubling operator. One of these three fixed maps consists of two uncoupled two-dimensional (nonlinear) area-preserving fixed maps. The other two contain also the two-dimensional area-preserving fixed map coupled (in general) with a linear two-dimensional map. The renormalization calculation recovers all numerical results for the pitchfork period doubling in the symmetric four-dimensional volume-preserving maps, reported by Mao and Helleman [Phys. Rev. A 35, 1847 (1987)]. For a large class of nonsymmetric four-dimensional volume-preserving maps, we found that the fixed maps are the same as those for the symmetric maps

  14. A validation study of the Four-Dimensional Symptom Questionnaire (4DSQ) in insurance medicine

    NARCIS (Netherlands)

    Langerak, W.; Langeland, W.; van Balkom, A.J.L.M.; Draisma, S.; Terluin, B.; Draijer, P.J.

    2012-01-01

    Objective: This study aimed to evaluate the criterion validity and the diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) regarding the identification of depressive and anxiety disorders in an insurance medicine setting. Participants: Our sample consisted of 230 individuals who

  15. Bosonisation of four dimensional real fermionic string models and asymmetric orbifolds

    International Nuclear Information System (INIS)

    Bailin, D.; Dunbar, D.C.; Love, A.

    1990-01-01

    Models of four dimensional strings based on internal world-sheet fermions are bosonised and the partition functions are compared with the partition functions of asymmetric Z 2 M orbifold models. Selection rules and couplings are also compared between the two formations. (orig.)

  16. Energy and angular-momentum non-conservation in four-dimensional gauge theories

    International Nuclear Information System (INIS)

    Manohar, A.

    1985-01-01

    We study energy and angular-momentum non-conservation on four-dimensional chiral gauge theories using Landau levels. These effects are physical manifestations of the usual gauge anomaly, and enable us to understand in a semi-classical approximation why anomaly cancellation is required for a consistent field theory. (orig.)

  17. Quantum theory of string in the four-dimensional space-time

    International Nuclear Information System (INIS)

    Pron'ko, G.P.

    1986-01-01

    The Lorentz invariant quantum theory of string is constructed in four-dimensional space-time. Unlike the traditional approach whose result was breaking of Lorentz invariance, our method is based on the usage of other variables for description of string configurations. The method of an auxiliary spectral problem for periodic potentials is the main tool in construction of these new variables

  18. Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration

    NARCIS (Netherlands)

    Dieleman, Edith M. T.; Senan, Suresh; Vincent, Andrew; Lagerwaard, Frank J.; Slotman, Ben J.; van Sörnsen de Koste, John R.

    2007-01-01

    BACKGROUND: Chemo-radiotherapy for thoracic tumors can result in high-grade radiation esophagitis. Treatment planning to reduce esophageal irradiation requires organ motion to be accounted for. In this study, esophageal mobility was assessed using four-dimensional computed tomography (4DCT). METHODS

  19. Registration-based Reconstruction of Four-dimensional Cone Beam Computed Tomography

    DEFF Research Database (Denmark)

    Christoffersen, Christian; Hansen, David Christoffer; Poulsen, Per Rugaard

    2013-01-01

    We present a new method for reconstruction of four-dimensional (4D) cone beam computed tomography from an undersampled set of X-ray projections. The novelty of the proposed method lies in utilizing optical flow based registration to facilitate that each temporal phase is reconstructed from the full...

  20. Spontaneous transition to a stochastic state in a four-dimensional Yang-Mills quantum theory

    International Nuclear Information System (INIS)

    Semikhatov, A.M.

    1983-01-01

    The quantum expectation values in a four-dimensional Yang-Mills theory are represented in each topological sector as expectation values over the diffusion which develops in the ''fourth'' Euclidean time. The Langevin equations of this diffusion are stochastic duality equations in the A 4 = 0 gauge

  1. Adding Four- Dimensional Data Assimilation (a.k.a. grid nudging) to MPAS

    Science.gov (United States)

    Adding four-dimensional data assimilation (a.k.a. grid nudging) to MPAS.The U.S. Environmental Protection Agency is investigating the use of MPAS as the meteorological driver for its next-generation air quality model. To function as such, MPAS needs to operate in a diagnostic mod...

  2. Nonrenormalizable quantum field models in four-dimensional space-time

    International Nuclear Information System (INIS)

    Raczka, R.

    1978-01-01

    The construction of no-cutoff Euclidean Green's functions for nonrenormalizable interactions L/sub I/(phi) = lambda∫ddelta (epsilon): expepsilonphi: in four-dimensional space-time is carried out. It is shown that all axioms for the generating functional of the Euclidean Green's function are satisfied except perhaps SO(4) invariance

  3. Four-dimensional optical coherence tomography imaging of total liquid ventilated rats

    Science.gov (United States)

    Kirsten, Lars; Schnabel, Christian; Gaertner, Maria; Koch, Edmund

    2013-06-01

    Optical coherence tomography (OCT) can be utilized for the spatially and temporally resolved visualization of alveolar tissue and its dynamics in rodent models, which allows the investigation of lung dynamics on the microscopic scale of single alveoli. The findings could provide experimental input data for numerical simulations of lung tissue mechanics and could support the development of protective ventilation strategies. Real four-dimensional OCT imaging permits the acquisition of several OCT stacks within one single ventilation cycle. Thus, the entire four-dimensional information is directly obtained. Compared to conventional virtual four-dimensional OCT imaging, where the image acquisition is extended over many ventilation cycles and is triggered on pressure levels, real four-dimensional OCT is less vulnerable against motion artifacts and non-reproducible movement of the lung tissue over subsequent ventilation cycles, which widely reduces image artifacts. However, OCT imaging of alveolar tissue is affected by refraction and total internal reflection at air-tissue interfaces. Thus, only the first alveolar layer beneath the pleura is visible. To circumvent this effect, total liquid ventilation can be carried out to match the refractive indices of lung tissue and the breathing medium, which improves the visibility of the alveolar structure, the image quality and the penetration depth and provides the real structure of the alveolar tissue. In this study, a combination of four-dimensional OCT imaging with total liquid ventilation allowed the visualization of the alveolar structure in rat lung tissue benefiting from the improved depth range beneath the pleura and from the high spatial and temporal resolution.

  4. T2-weighted four dimensional magnetic resonance imaging with result-driven phase sorting

    International Nuclear Information System (INIS)

    Liu, Yilin; Yin, Fang-Fang; Cai, Jing; Czito, Brian G.; Bashir, Mustafa R.

    2015-01-01

    Purpose: T2-weighted MRI provides excellent tumor-to-tissue contrast for target volume delineation in radiation therapy treatment planning. This study aims at developing a novel T2-weighted retrospective four dimensional magnetic resonance imaging (4D-MRI) phase sorting technique for imaging organ/tumor respiratory motion. Methods: A 2D fast T2-weighted half-Fourier acquisition single-shot turbo spin-echo MR sequence was used for image acquisition of 4D-MRI, with a frame rate of 2–3 frames/s. Respiratory motion was measured using an external breathing monitoring device. A phase sorting method was developed to sort the images by their corresponding respiratory phases. Besides, a result-driven strategy was applied to effectively utilize redundant images in the case when multiple images were allocated to a bin. This strategy, selecting the image with minimal amplitude error, will generate the most representative 4D-MRI. Since we are using a different image acquisition mode for 4D imaging (the sequential image acquisition scheme) with the conventionally used cine or helical image acquisition scheme, the 4D dataset sufficient condition was not obviously and directly predictable. An important challenge of the proposed technique was to determine the number of repeated scans (N_R) required to obtain sufficient phase information at each slice position. To tackle this challenge, the authors first conducted computer simulations using real-time position management respiratory signals of the 29 cancer patients under an IRB-approved retrospective study to derive the relationships between N_R and the following factors: number of slices (N_S), number of 4D-MRI respiratory bins (N_B), and starting phase at image acquisition (P_0). To validate the authors’ technique, 4D-MRI acquisition and reconstruction were simulated on a 4D digital extended cardiac-torso (XCAT) human phantom using simulation derived parameters. Twelve healthy volunteers were involved in an IRB-approved study

  5. Four dimensional magnetic resonance imaging with retrospective k-space reordering: A feasibility study

    International Nuclear Information System (INIS)

    Liu, Yilin; Yin, Fang-Fang; Cai, Jing; Chen, Nan-kuei; Chu, Mei-Lan

    2015-01-01

    Purpose: Current four dimensional magnetic resonance imaging (4D-MRI) techniques lack sufficient temporal/spatial resolution and consistent tumor contrast. To overcome these limitations, this study presents the development and initial evaluation of a new strategy for 4D-MRI which is based on retrospective k-space reordering. Methods: We simulated a k-space reordered 4D-MRI on a 4D digital extended cardiac-torso (XCAT) human phantom. A 2D echo planar imaging MRI sequence [frame rate (F) = 0.448 Hz; image resolution (R) = 256 × 256; number of k-space segments (N KS ) = 4] with sequential image acquisition mode was assumed for the simulation. Image quality of the simulated “4D-MRI” acquired from the XCAT phantom was qualitatively evaluated, and tumor motion trajectories were compared to input signals. In particular, mean absolute amplitude differences (D) and cross correlation coefficients (CC) were calculated. Furthermore, to evaluate the data sufficient condition for the new 4D-MRI technique, a comprehensive simulation study was performed using 30 cancer patients’ respiratory profiles to study the relationships between data completeness (C p ) and a number of impacting factors: the number of repeated scans (N R ), number of slices (N S ), number of respiratory phase bins (N P ), N KS , F, R, and initial respiratory phase at image acquisition (P 0 ). As a proof-of-concept, we implemented the proposed k-space reordering 4D-MRI technique on a T2-weighted fast spin echo MR sequence and tested it on a healthy volunteer. Results: The simulated 4D-MRI acquired from the XCAT phantom matched closely to the original XCAT images. Tumor motion trajectories measured from the simulated 4D-MRI matched well with input signals (D = 0.83 and 0.83 mm, and CC = 0.998 and 0.992 in superior–inferior and anterior–posterior directions, respectively). The relationship between C p and N R was found best represented by an exponential function (C P =100(1−e −0.18N R ), when N S

  6. Four-dimensional cone beam CT reconstruction and enhancement using a temporal nonlocal means method

    Energy Technology Data Exchange (ETDEWEB)

    Jia Xun; Tian Zhen; Lou Yifei; Sonke, Jan-Jakob; Jiang, Steve B. [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92037 (United States); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30318 (United States); Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92037 (United States)

    2012-09-15

    Purpose: Four-dimensional cone beam computed tomography (4D-CBCT) has been developed to provide respiratory phase-resolved volumetric imaging in image guided radiation therapy. Conventionally, it is reconstructed by first sorting the x-ray projections into multiple respiratory phase bins according to a breathing signal extracted either from the projection images or some external surrogates, and then reconstructing a 3D CBCT image in each phase bin independently using FDK algorithm. This method requires adequate number of projections for each phase, which can be achieved using a low gantry rotation or multiple gantry rotations. Inadequate number of projections in each phase bin results in low quality 4D-CBCT images with obvious streaking artifacts. 4D-CBCT images at different breathing phases share a lot of redundant information, because they represent the same anatomy captured at slightly different temporal points. Taking this redundancy along the temporal dimension into account can in principle facilitate the reconstruction in the situation of inadequate number of projection images. In this work, the authors propose two novel 4D-CBCT algorithms: an iterative reconstruction algorithm and an enhancement algorithm, utilizing a temporal nonlocal means (TNLM) method. Methods: The authors define a TNLM energy term for a given set of 4D-CBCT images. Minimization of this term favors those 4D-CBCT images such that any anatomical features at one spatial point at one phase can be found in a nearby spatial point at neighboring phases. 4D-CBCT reconstruction is achieved by minimizing a total energy containing a data fidelity term and the TNLM energy term. As for the image enhancement, 4D-CBCT images generated by the FDK algorithm are enhanced by minimizing the TNLM function while keeping the enhanced images close to the FDK results. A forward-backward splitting algorithm and a Gauss-Jacobi iteration method are employed to solve the problems. The algorithms implementation on

  7. Four-dimensional (4D) flow of the whole heart and great vessels using real-time respiratory self-gating

    DEFF Research Database (Denmark)

    Uribe, Sergio; Beerbaum, Philipp; Sørensen, Thomas Sangild

    2009-01-01

    Four-dimensional (4D) flow imaging has been used to study flow patterns and pathophysiology, usually focused on specific thoracic vessels and cardiac chambers. Whole-heart 4D flow at high measurement accuracy covering the entire thoracic cardiovascular system would be desirable to simplify...... and improve hemodynamic assessment. This has been a challenge because compensation of respiratory motion is difficult to achieve, but it is paramount to limit artifacts and improve accuracy. In this work we propose a self-gating technique for respiratory motion-compensation integrated into a whole-heart 4D...... flow acquisition that overcomes these challenges. Flow components are measured in all three directions for each pixel over the complete cardiac cycle, and 1D volume projections are obtained at certain time intervals for respiratory gating in real time during the acquisition. The technique was tested...

  8. String propagation in an exact four-dimensional black hole background

    International Nuclear Information System (INIS)

    Mahapatra, S.

    1997-01-01

    We study string propagation in an exact, stringy, four-dimensional dyonic black hole background. The exact solutions in terms of elliptic functions describing string configurations in the J=0 limit are obtained by solving the string equations of motion and constraints. By using the covariant formalism, we also investigate the propagation of physical perturbations along the string in the given curved background. copyright 1997 The American Physical Society

  9. Statistical Entropy of Nonextremal Four-Dimensional Black Holes and U-Duality

    International Nuclear Information System (INIS)

    Horowitz, G.T.; Lowe, D.A.; Maldacena, J.M.

    1996-01-01

    We identify the states in string theory which are responsible for the entropy of near-extremal rotating four-dimensional black holes in N=8 supergravity. For black holes far from extremality (with no rotation), the Bekenstein-Hawking entropy is exactly matched by a mysterious duality invariant extension of the formulas derived for near-extremal black holes states. copyright 1996 The American Physical Society

  10. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery.

    Science.gov (United States)

    Pasricha, Neel D; Bhullar, Paramjit K; Shieh, Christine; Carrasco-Zevallos, Oscar M; Keller, Brenton; Izatt, Joseph A; Toth, Cynthia A; Freedman, Sharon F; Kuo, Anthony N

    2017-02-14

    The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes. [J Pediatr Ophthalmol Strabismus. 2017;54:e1-e5.]. Copyright 2017, SLACK Incorporated.

  11. Haunted Kaluza universe with four-dimensional Lorentzian flat, Kerr, and Taub-NUT slices

    International Nuclear Information System (INIS)

    Ivanov, Rossen I.; Prodanov, Emil M.

    2005-01-01

    The duality between the original Kaluza's theory and Klein's subsequent modification is duality between slicing and threading decomposition of the five-dimensional spacetime. The field equations of the original Kaluza's theory lead to the interpretation of the four-dimensional Lorentzian Kerr and Taub-NUT solutions as resulting from static electric and magnetic charges and dipoles in the presence of ghost matter and constant dilaton, which models Newton's constant

  12. Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty.

    Science.gov (United States)

    Yamamoto, Michiro; Murakami, Yukimi; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Hirata, Hitoshi

    2016-04-02

    Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A "two rings" method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. We showed that four-dimensional, preoperative simulation can be generated by

  13. Nonperturbative construction of nonrenormalizable models of quantum field theory in four-dimensional space-time

    International Nuclear Information System (INIS)

    Raczka, R.

    1979-01-01

    Construction of non-cutoff Euclidean Green's functions for nonrenormalizable interactions Lsub(I)(phi)=lambda∫dσ(epsilon):expepsilonphi: in four-dimensional space-time is presented. It is shown that all axioms for the generating functional of E.G.F. are satisfied except perhaps the SO(4) invariance. It is shown that the singularities of E.G.F. for coinciding points are not worse than those of the free theory. (author)

  14. Higher-order gravity in higher dimensions: geometrical origins of four-dimensional cosmology?

    Energy Technology Data Exchange (ETDEWEB)

    Troisi, Antonio [Universita degli Studi di Salerno, Dipartimento di Fisica ' ' E.R. Caianiello' ' , Salerno (Italy)

    2017-03-15

    Determining the cosmological field equations is still very much debated and led to a wide discussion around different theoretical proposals. A suitable conceptual scheme could be represented by gravity models that naturally generalize Einstein theory like higher-order gravity theories and higher-dimensional ones. Both of these two different approaches allow one to define, at the effective level, Einstein field equations equipped with source-like energy-momentum tensors of geometrical origin. In this paper, the possibility is discussed to develop a five-dimensional fourth-order gravity model whose lower-dimensional reduction could provide an interpretation of cosmological four-dimensional matter-energy components. We describe the basic concepts of the model, the complete field equations formalism and the 5-D to 4-D reduction procedure. Five-dimensional f(R) field equations turn out to be equivalent, on the four-dimensional hypersurfaces orthogonal to the extra coordinate, to an Einstein-like cosmological model with three matter-energy tensors related with higher derivative and higher-dimensional counter-terms. By considering the gravity model with f(R) = f{sub 0}R{sup n} the possibility is investigated to obtain five-dimensional power law solutions. The effective four-dimensional picture and the behaviour of the geometrically induced sources are finally outlined in correspondence to simple cases of such higher-dimensional solutions. (orig.)

  15. Effect of Novel Amplitude/Phase Binning Algorithm on Commercial Four-Dimensional Computed Tomography Quality

    International Nuclear Information System (INIS)

    Olsen, Jeffrey R.; Lu Wei; Hubenschmidt, James P.; Nystrom, Michelle M.; Klahr, Paul; Bradley, Jeffrey D.; Low, Daniel A.; Parikh, Parag J.

    2008-01-01

    Purpose: Respiratory motion is a significant source of anatomic uncertainty in radiotherapy planning and can result in errors of portal size and the subsequent radiation dose. Although four-dimensional computed tomography allows for more accurate analysis of the respiratory cycle, breathing irregularities during data acquisition can cause considerable image distortions. The aim of this study was to examine the effect of respiratory irregularities on four-dimensional computed tomography, and to evaluate a novel image reconstruction algorithm using percentile-based tagging of the respiratory cycle. Methods and Materials: Respiratory-correlated helical computed tomography scans were acquired for 11 consecutive patients. The inspiration and expiration data sets were reconstructed using the default phase-based method, as well as a novel respiration percentile-based method with patient-specific metrics to define the ranges of the reconstruction. The image output was analyzed in a blinded fashion for the phase- and percentile-based reconstructions to determine the prevalence and severity of the image artifacts. Results: The percentile-based algorithm resulted in a significant reduction in artifact severity compared with the phase-based algorithm, although the overall artifact prevalence did not differ between the two algorithms. The magnitude of differences in respiratory tag placement between the phase- and percentile-based algorithms correlated with the presence of image artifacts. Conclusion: The results of our study have indicated that our novel four-dimensional computed tomography reconstruction method could be useful in detecting clinically relevant image distortions that might otherwise go unnoticed and to reduce the image distortion associated with some respiratory irregularities. Additional work is necessary to assess the clinical impact on areas of possible irregular breathing

  16. A four-dimensional variational chemistry data assimilation scheme for Eulerian chemistry transport modeling

    Science.gov (United States)

    Eibern, Hendrik; Schmidt, Hauke

    1999-08-01

    The inverse problem of data assimilation of tropospheric trace gas observations into an Eulerian chemistry transport model has been solved by the four-dimensional variational technique including chemical reactions, transport, and diffusion. The University of Cologne European Air Pollution Dispersion Chemistry Transport Model 2 with the Regional Acid Deposition Model 2 gas phase mechanism is taken as the basis for developing a full four-dimensional variational data assimilation package, on the basis of the adjoint model version, which includes the adjoint operators of horizontal and vertical advection, implicit vertical diffusion, and the adjoint gas phase mechanism. To assess the potential and limitations of the technique without degrading the impact of nonperfect meteorological analyses and statistically not established error covariance estimates, artificial meteorological data and observations are used. The results are presented on the basis of a suite of experiments, where reduced records of artificial "observations" are provided to the assimilation procedure, while other "data" is retained for performance control of the analysis. The paper demonstrates that the four-dimensional variational technique is applicable for a comprehensive chemistry transport model in terms of computational and storage requirements on advanced parallel platforms. It is further shown that observed species can generally be analyzed, even if the "measurements" have unbiased random errors. More challenging experiments are presented, aiming to tax the skill of the method (1) by restricting available observations mostly to surface ozone observations for a limited assimilation interval of 6 hours and (2) by starting with poorly chosen first guess values. In this first such application to a three-dimensional chemistry transport model, success was also achieved in analyzing not only observed but also chemically closely related unobserved constituents.

  17. Acquiring a four-dimensional computed tomography dataset using an external respiratory signal

    International Nuclear Information System (INIS)

    Vedam, S S; Keall, P J; Kini, V R; Mostafavi, H; Shukla, H P; Mohan, R

    2003-01-01

    Four-dimensional (4D) methods strive to achieve highly conformal radiotherapy, particularly for lung and breast tumours, in the presence of respiratory-induced motion of tumours and normal tissues. Four-dimensional radiotherapy accounts for respiratory motion during imaging, planning and radiation delivery, and requires a 4D CT image in which the internal anatomy motion as a function of the respiratory cycle can be quantified. The aims of our research were (a) to develop a method to acquire 4D CT images from a spiral CT scan using an external respiratory signal and (b) to examine the potential utility of 4D CT imaging. A commercially available respiratory motion monitoring system provided an 'external' tracking signal of the patient's breathing. Simultaneous recording of a TTL 'X-Ray ON' signal from the CT scanner indicated the start time of CT image acquisition, thus facilitating time stamping of all subsequent images. An over-sampled spiral CT scan was acquired using a pitch of 0.5 and scanner rotation time of 1.5 s. Each image from such a scan was sorted into an image bin that corresponded with the phase of the respiratory cycle in which the image was acquired. The complete set of such image bins accumulated over a respiratory cycle constitutes a 4D CT dataset. Four-dimensional CT datasets of a mechanical oscillator phantom and a patient undergoing lung radiotherapy were acquired. Motion artefacts were significantly reduced in the images in the 4D CT dataset compared to the three-dimensional (3D) images, for which respiratory motion was not accounted. Accounting for respiratory motion using 4D CT imaging is feasible and yields images with less distortion than 3D images. 4D images also contain respiratory motion information not available in a 3D CT image

  18. Four-dimensional imaging of the initial stage of fast evolving plasmas

    International Nuclear Information System (INIS)

    Zhu Pengfei; Wang Weimin; Zhang Zhongchao; Chen Long; Zheng Jun; Li Runze; Qian Dong; Li Junjie; Wang Xuan; Cao Jianming; Sheng Zhengming; Zhang Jie

    2010-01-01

    Using an ultrafast electron probe capable of four-dimensional diagnosis, the initial stage of fast evolving plasmas produced by a 10 14 W/cm 2 laser irradiation of a metal target was investigated in real time with picosecond time resolution. The associated strong transient electric field was identified to have two components, which either focus or defocus the probe electron beam. The effects of this field on the probe electron beam can be reproduced by a self-expanding charge cloud containing about 5x10 7 suprathermal electrons with the outermost layer expanding at an average speed of 1.2x10 7 m/s.

  19. Non-critical string duals of four-dimensional CFTs with fundamental matter

    International Nuclear Information System (INIS)

    Bigazzi, F.; Casero, R.; Paredes, A.; Cotrone, A.L.

    2006-01-01

    The two-derivative approximation to non-critical strings is used as a qualitative tool to find solutions dual to four dimensional CFTs with matter in the fundamental. Two solutions are discussed: an AdS 5 x S 3 , which is dual to an N=1 SCFT only for a ratio of N f /N c and an AdS 5 which is proposed to be dual to N=0 QCD in the conformal window. All solutions have curvatures of the order of the string scale. (Abstract Copyright [2006], Wiley Periodicals, Inc.)

  20. Post-Newtonian approximation of the maximum four-dimensional Yang-Mills gauge theory

    International Nuclear Information System (INIS)

    Smalley, L.L.

    1982-01-01

    We have calculated the post-Newtonian approximation of the maximum four-dimensional Yang-Mills theory proposed by Hsu. The theory contains torsion; however, torsion is not active at the level of the post-Newtonian approximation of the metric. Depending on the nature of the approximation, we obtain the general-relativistic values for the classical Robertson parameters (γ = β = 1), but deviations for the Nordtvedt effect and violations of post-Newtonian conservation laws. We conclude that in its present form the theory is not a viable theory of gravitation

  1. Bifurcation structures and transient chaos in a four-dimensional Chua model

    Energy Technology Data Exchange (ETDEWEB)

    Hoff, Anderson, E-mail: hoffande@gmail.com; Silva, Denilson T. da; Manchein, Cesar, E-mail: cesar.manchein@udesc.br; Albuquerque, Holokx A., E-mail: holokx.albuquerque@udesc.br

    2014-01-10

    A four-dimensional four-parameter Chua model with cubic nonlinearity is studied applying numerical continuation and numerical solutions methods. Regarding numerical solution methods, its dynamics is characterized on Lyapunov and isoperiodic diagrams and regarding numerical continuation method, the bifurcation curves are obtained. Combining both methods the bifurcation structures of the model were obtained with the possibility to describe the shrimp-shaped domains and their endoskeletons. We study the effect of a parameter that controls the dimension of the system leading the model to present transient chaos with its corresponding basin of attraction being riddled.

  2. Four-dimensional (4D) tracking of high-temperature microparticles

    International Nuclear Information System (INIS)

    Wang, Zhehui; Liu, Q.; Waganaar, W.; Fontanese, J.; James, D.; Munsat, T.

    2016-01-01

    High-speed tracking of hot and molten microparticles in motion provides rich information about burning plasmas in magnetic fusion. An exploding-wire apparatus is used to produce moving high-temperature metallic microparticles and to develop four-dimensional (4D) or time-resolved 3D particle tracking techniques. The pinhole camera model and algorithms developed for computer vision are used for scene calibration and 4D reconstructions. 3D positions and velocities are then derived for different microparticles. Velocity resolution approaches 0.1 m/s by using the local constant velocity approximation.

  3. Quasinormal modes of four-dimensional topological nonlinear charged Lifshitz black holes

    Energy Technology Data Exchange (ETDEWEB)

    Becar, Ramon [Universidad Cato lica de Temuco, Departamento de Ciencias Matematicas y Fisicas, Temuco (Chile); Gonzalez, P.A. [Universidad Diego Portales, Facultad de Ingenieria, Santiago (Chile); Vasquez, Yerko [Universidad de La Serena, Departamento de Fisica, Facultad de Ciencias, La Serena (Chile)

    2016-02-15

    We study scalar perturbations of four- dimensional topological nonlinear charged Lifshitz black holes with spherical and plane transverse sections, and we find numerically the quasinormal modes for scalar fields. Then we study the stability of these black holes under massive and massless scalar field perturbations. We focus our study on the dependence of the dynamical exponent, the nonlinear exponent, the angular momentum, and the mass of the scalar field in the modes. It is found that the modes are overdamped, depending strongly on the dynamical exponent and the angular momentum of the scalar field for a spherical transverse section. In contrast, for plane transverse sections the modes are always overdamped. (orig.)

  4. Finite-temperature symmetry restoration in the four-dimensional Φ4 model with four components

    International Nuclear Information System (INIS)

    Jansen, K.

    1990-01-01

    The finite-temperature symmetry restoration in the four-dimensional φ 4 theory with four components and with an infinite self-coupling is studied by means of Monte Carlo simulations on lattices with time extensions L t =4,5,6 and space extensions 12 3 -28 3 . The numerical calculations are done by means of the Wolff cluster algorithm which is very efficient for simulations near a phase transition. The numerical results are in good agreement with an improved one-loop expansion and with the 1/N-expansion, indicating that in the electroweak theory the symmetry restoration temperature T sr is about 350 GeV. (orig.)

  5. Four-dimensional dose evaluation using deformable image registration in radiotherapy for liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hoon Jung, Sang; Min Yoon, Sang; Ho Park, Sung; Cho, Byungchul; Won Park, Jae; Jung, Jinhong; Park, Jin-hong; Hoon Kim, Jong; Do Ahn, Seung [Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736 (Korea, Republic of)

    2013-01-15

    Purpose: In order to evaluate the dosimetric impact of respiratory motion on the dose delivered to the target volume and critical organs during free-breathing radiotherapy, a four-dimensional dose was evaluated using deformable image registration (DIR). Methods: Four-dimensional computed tomography (4DCT) images were acquired for 11 patients who were treated for liver cancer. Internal target volume-based treatment planning and dose calculation (3D dose) were performed using the end-exhalation phase images. The four-dimensional dose (4D dose) was calculated based on DIR of all phase images from 4DCT to the planned image. Dosimetric parameters from the 4D dose, were calculated and compared with those from the 3D dose. Results: There was no significant change of the dosimetric parameters for gross tumor volume (p > 0.05). The increase D{sub mean} and generalized equivalent uniform dose (gEUD) for liver were by 3.1%{+-} 3.3% (p= 0.003) and 2.8%{+-} 3.3% (p= 0.008), respectively, and for duodenum, they were decreased by 15.7%{+-} 11.2% (p= 0.003) and 15.1%{+-} 11.0% (p= 0.003), respectively. The D{sub max} and gEUD for stomach was decreased by 5.3%{+-} 5.8% (p= 0.003) and 9.7%{+-} 8.7% (p= 0.003), respectively. The D{sub max} and gEUD for right kidney was decreased by 11.2%{+-} 16.2% (p= 0.003) and 14.9%{+-} 16.8% (p= 0.005), respectively. For left kidney, D{sub max} and gEUD were decreased by 11.4%{+-} 11.0% (p= 0.003) and 12.8%{+-} 12.1% (p= 0.005), respectively. The NTCP values for duodenum and stomach were decreased by 8.4%{+-} 5.8% (p= 0.003) and 17.2%{+-} 13.7% (p= 0.003), respectively. Conclusions: The four-dimensional dose with a more realistic dose calculation accounting for respiratory motion revealed no significant difference in target coverage and potentially significant change in the physical and biological dosimetric parameters in normal organs during free-breathing treatment.

  6. An accessible four-dimensional treatment of Maxwell's equations in terms of differential forms

    Science.gov (United States)

    Sá, Lucas

    2017-03-01

    Maxwell’s equations are derived in terms of differential forms in the four-dimensional Minkowski representation, starting from the three-dimensional vector calculus differential version of these equations. Introducing all the mathematical and physical concepts needed (including the tool of differential forms), using only knowledge of elementary vector calculus and the local vector version of Maxwell’s equations, the equations are reduced to a simple and elegant set of two equations for a unified quantity, the electromagnetic field. The treatment should be accessible for students taking a first course on electromagnetism.

  7. Analysis of interfractional variations in pancreatic position based on four-dimensional computed tomography

    International Nuclear Information System (INIS)

    Shiinoki, Takehiro; Itoh, Akio; Shibuya, Keiko; Nakamura, Mitsuhiro; Nakamura, Akira; Matsuo, Yukinori; Sawada, Akira; Mizowaki, Takashi; Hiraoka, Masahiro

    2010-01-01

    The purpose of this study was to assess inter-fractional variations in pancreatic position using four-dimensional computed tomography (4D-CT) and to find the suitable phase of respiration for breath-holding. The variations in respiratory motion range during treatment course and inter-fractional variations in pancreatic positions were not negligible; however, our study suggested that breath-holding at end-exhalation with some coaching techniques might be considerable one of the non-invasive approaches to get higher positional reproducibility of pancreatic tumors. (author)

  8. Four-dimensional Hooke's law can encompass linear elasticity and inertia

    International Nuclear Information System (INIS)

    Antoci, S.; Mihich, L.

    1999-01-01

    The question is examined whether the formally straightforward extension of Hooke's time-honoured stress-strain relation to the four dimensions of special and of general relativity can make physical sense. The four-dimensional Hooke law is found able to account for the inertia of matter; in the flat-space, slow-motion approximation the field equations for the displacement four-vector field ξ i can encompass both linear elasticity and inertia. In this limit one just recovers the equations of motion of the classical theory of elasticity

  9. One-way quantum computation with four-dimensional photonic qudits

    International Nuclear Information System (INIS)

    Joo, Jaewoo; Knight, Peter L.; O'Brien, Jeremy L.; Rudolph, Terry

    2007-01-01

    We consider the possibility of performing linear optical quantum computations making use of extra photonic degrees of freedom. In particular, we focus on the case where we use photons as quadbits, four-dimensional photonic qudits. The basic 2-quadbit cluster state is a hyperentangled state across polarization and two spatial mode degrees of freedom. We examine the nondeterministic methods whereby such states can be created from single photons and/or Bell pairs and then give some mechanisms for performing higher-dimensional fusion gates

  10. Gravitational matter-antimatter asymmetry and four-dimensional Yang-Mills gauge symmetry

    Science.gov (United States)

    Hsu, J. P.

    1981-01-01

    A formulation of gravity based on the maximum four-dimensional Yang-Mills gauge symmetry is studied. The theory predicts that the gravitational force inside matter (fermions) is different from that inside antimatter. This difference could lead to the cosmic separation of matter and antimatter in the evolution of the universe. Moreover, a new gravitational long-range spin-force between two fermions is predicted, in addition to the usual Newtonian force. The geometrical foundation of such a gravitational theory is the Riemann-Cartan geometry, in which there is a torsion. The results of the theory for weak fields are consistent with previous experiments.

  11. A novel four-dimensional analytical approach for analysis of complex samples.

    Science.gov (United States)

    Stephan, Susanne; Jakob, Cornelia; Hippler, Jörg; Schmitz, Oliver J

    2016-05-01

    A two-dimensional LC (2D-LC) method, based on the work of Erni and Frei in 1978, was developed and coupled to an ion mobility-high-resolution mass spectrometer (IM-MS), which enabled the separation of complex samples in four dimensions (2D-LC, ion mobility spectrometry (IMS), and mass spectrometry (MS)). This approach works as a continuous multiheart-cutting LC system, using a long modulation time of 4 min, which allows the complete transfer of most of the first - dimension peaks to the second - dimension column without fractionation, in comparison to comprehensive two-dimensional liquid chromatography. Hence, each compound delivers only one peak in the second dimension, which simplifies the data handling even when ion mobility spectrometry as a third and mass spectrometry as a fourth dimension are introduced. The analysis of a plant extract from Ginkgo biloba shows the separation power of this four-dimensional separation method with a calculated total peak capacity of more than 8700. Furthermore, the advantage of ion mobility for characterizing unknown compounds by their collision cross section (CCS) and accurate mass in a non-target approach is shown for different matrices like plant extracts and coffee. Graphical abstract Principle of the four-dimensional separation.

  12. On the four-dimensional character of micro-physical phenomena

    International Nuclear Information System (INIS)

    Rietdijk, C.W.

    1984-01-01

    It is proved that retroactive effects exist in Nature. This emphasizes the fact that micro-processes constitute integrated wholes so much that it is no longer far-fetched to posit the hypothesis that events, that is, action, rather than objects, constitute the proper stuff of the (four-dimensional) Universe. Mind here, too, that retroactivity implies that the future and future parts of events 'exist already'. Then, distances between (e.g., alternative) events A and B have to be measured by the quantity of 'occurring' or action that is needed in order to transform event A into event B. The action metric so introduced appears to be in a position to solve the nonlocality paradoxes of quantum mechanics such as wave-particle 'duality' and the EPR paradox. In this connection, the Minkowski metric corresponds to a macro scheme which cannot be 'interpolated' to within a micro-process, i.e., to within action quanta, without producing serious metrical distortions. Generally, metric is considered to be a property of events, it having no existence independent of them as a 'pre-existing scheme'. Planck's elementary quantities of action h are seen as real entities in the four-dimensional world, i.e., as the 'atoms of occurring'. By intersecting (dilated) series of them with a now-hyperplane we in an imaginable way get the wave patterns satisfying the relevant wave equation. (Auth.)

  13. Decision-making for supplying energy projects: A four-dimensional model

    International Nuclear Information System (INIS)

    Smith Stegen, Karen; Palovic, Martin

    2014-01-01

    Highlights: • Extant pipeline evaluation models offer insufficient supplier analysis tools. • We offer a four-dimensional decision-making tool to augment extant models. • Model employs four filters to help decision makers eliminate unsuitable suppliers. • Aids in prioritization of best courses of action for overcoming obstacles. • Case study of Nabucco pipeline shows Azerbaijan would have been best supply option. - Abstract: Importing states and regions employ myriad strategies to enhance energy security, from stockpiling to diversification to efficiency programs. As has occurred in recent years, importers can seek diversification by initiating pipeline and liquefied natural gas projects, meaning they may also have to select suppliers. However, most extant pipeline evaluation models erroneously assume suppliers are known and thus neglect supplier selection. We propose a decision-making tool to augment these older models: a systematic and replicable four-dimensional model to help policymakers and managers identify suitable suppliers and prioritize the best courses of action for overcoming obstacles. The first three dimensions—timeframe, supply availability and infrastructure constraints—filter out unsuitable suppliers. The fourth dimension then assesses the political, geopolitical and commercial stability of the remaining candidates. To demonstrate the model in practice, we assess the original Nabucco pipeline proposal, which was designed to transport gas from the Caspian and Middle East regions to Europe

  14. Estimation of four-dimensional dose distribution using electronic portal imaging device in radiation therapy

    International Nuclear Information System (INIS)

    Mizoguchi, Asumi; Arimura, Hidetaka; Shioyama, Yoshiyuki

    2013-01-01

    We are developing a method to evaluate four-dimensional radiation dose distribution in a patient body based upon the animated image of EPID (electronic portal imaging device) which is an image of beam-direction at the irradiation. In the first place, we have obtained the image of the dose which is emitted from patient body at therapy planning using therapy planning CT image and dose evaluation algorism. In the second place, we have estimated the emission dose image at the irradiation using EPID animated image which is obtained at the irradiation. In the third place, we have got an affine transformation matrix including respiratory movement in the body by performing linear registration on the emission dose image at therapy planning to get the one at the irradiation. In the fourth place, we have applied the affine transformation matrix on the therapy planning CT image and estimated the CT image 'at irradiation'. Finally we have evaluated four-dimensional dose distribution by calculating dose distribution in the CT image 'at irradiation' which has been estimated for each frame of the EPID animated-image. This scheme may be useful for evaluating therapy results and risk management. (author)

  15. Four-dimensional conversion for spiritual leadership development: A missiological approach for African churches

    Directory of Open Access Journals (Sweden)

    Kalemba Mwambazambi

    2014-02-01

    Full Text Available The process of a four-dimensional conversion and/or transformation strives in helping the leadership of an organisation, especially such as the church, with practical ways that may lead to the development of an effective leadership by observing the four important aspects of human spirituality as elaborated on in the article. The spiritual, intellectual, moral and socio-political dimensions of the transformation can be catered for so that the complete inner being of humans, as well as their social and political attitudes and behaviours, can equally be transformed to maximum spiritual, personal and socio-political profitability. Mutombo-Mukendi demonstrates that the need for a spiritual leadership that can contribute to an effective transformation of Africa is dire, both for the church and the larger community. The real challenge is how to develop such leadership. This article provides intentional and practical ways that may lead to the development of the needed leadership. Four-dimensional transformation of people can be planned and carried out both in the church arena and in the surrounding communities. Skills development and transfer can also take place when skilled people from the church work with unskilled people from the community.

  16. Four dimensional chaos and intermittency in a mesoscopic model of the electroencephalogram.

    Science.gov (United States)

    Dafilis, Mathew P; Frascoli, Federico; Cadusch, Peter J; Liley, David T J

    2013-06-01

    The occurrence of so-called four dimensional chaos in dynamical systems represented by coupled, nonlinear, ordinary differential equations is rarely reported in the literature. In this paper, we present evidence that Liley's mesoscopic theory of the electroencephalogram (EEG), which has been used to describe brain activity in a variety of clinically relevant contexts, possesses a chaotic attractor with a Kaplan-Yorke dimension significantly larger than three. This accounts for simple, high order chaos for a physiologically admissible parameter set. Whilst the Lyapunov spectrum of the attractor has only one positive exponent, the contracting dimensions are such that the integer part of the Kaplan-Yorke dimension is three, thus giving rise to four dimensional chaos. A one-parameter bifurcation analysis with respect to the parameter corresponding to extracortical input is conducted, with results indicating that the origin of chaos is due to an inverse period doubling cascade. Hence, in the vicinity of the high order, strange attractor, the model is shown to display intermittent behavior, with random alternations between oscillatory and chaotic regimes. This phenomenon represents a possible dynamical justification of some of the typical features of clinically established EEG traces, which can arise in the case of burst suppression in anesthesia and epileptic encephalopathies in early infancy.

  17. Charged rotating black holes in four-dimensional gauged and ungauged supergravities

    International Nuclear Information System (INIS)

    Chong, Z.-W.; Cvetic, M.; Lue, H.; Pope, C.N.

    2005-01-01

    We study four-dimensional non-extremal charged rotating black holes in ungauged and gauged supergravity. In the ungauged case, we obtain rotating black holes with four independent charges, as solutions of N=2 supergravity coupled to three Abelian vector multiplets. This is done by reducing the theory along the time direction to three dimensions, where it has an O(4,4) global symmetry. Applied to the reduction of the uncharged Kerr metric, O(1,1) 4 is a subject of O(4,4) transformations generate new solutions that correspond, after lifting back to four dimensions, to the introduction of four independent electromagnetic charges. In the case where these charges are set pairwise equal, we then generalise the four-dimensional rotating black holes to solutions of gauged N=4 supergravity, with mass, angular momentum and two independent electromagnetic charges. The dilaton and axion fields are non-constant. We also find generalisations of the gauged and ungauged solutions to include the NUT parameter, and for the ungauged solutions, the acceleration parameter too. The solutions in gauged supergravity provide new gravitational backgrounds for a further study of the AdS 4 /CFT 3 correspondence at non-zero temperature

  18. Mass, angular momentum and thermodynamics in four-dimensional Kerr-AdS black holes

    Energy Technology Data Exchange (ETDEWEB)

    Olea, Rodrigo [Departamento de Fisica, Pontificia Universidad Catolica de Chile, Casilla 306, Santiago 22 (Chile)

    2005-06-01

    In this paper, the connection between the Lorentz-covariant counterterms that regularize the four-dimensional AdS gravity action and topological invariants is explored. It is shown that demanding the spacetime to have a negative constant curvature in the asymptotic region permits the explicit construction of such series of boundary terms. The orthonormal frame is adapted to appropriately describe the boundary geometry and, as a result, the boundary term can be expressed as a functional of the boundary metric, extrinsic curvature and intrinsic curvature. This choice also allows to write down the background-independent Noether charges associated to asymptotic symmetries in standard tensorial formalism. The absence of the Gibbons-Hawking term is a consequence of an action principle based on a boundary condition different than Dirichlet on the metric. This argument makes plausible the idea of regarding this approach as an alternative regularization scheme for AdS gravity in all even dimensions, different than the standard counterterms prescription. As an illustration of the finiteness of the charges and the euclidean action in this framework, the conserved quantities and black hole entropy for four-dimensional Kerr-AdS are computed.

  19. Comparison of spirometry and abdominal height as four-dimensional computed tomography metrics in lung

    International Nuclear Information System (INIS)

    Lu Wei; Low, Daniel A.; Parikh, Parag J.; Nystrom, Michelle M.; El Naqa, Issam M.; Wahab, Sasha H.; Handoko, Maureen; Fooshee, David; Bradley, Jeffrey D.

    2005-01-01

    An important consideration in four-dimensional CT scanning is the selection of a breathing metric for sorting the CT data and modeling internal motion. This study compared two noninvasive breathing metrics, spirometry and abdominal height, against internal air content, used as a surrogate for internal motion. Both metrics were shown to be accurate, but the spirometry showed a stronger and more reproducible relationship than the abdominal height in the lung. The abdominal height was known to be affected by sensor placement and patient positioning while the spirometer exhibited signal drift. By combining these two, a normalization of the drift-free metric to tidal volume may be generated and the overall metric precision may be improved

  20. Galactic Cosmic-ray Transport in the Global Heliosphere: A Four-Dimensional Stochastic Model

    Science.gov (United States)

    Florinski, V.

    2009-04-01

    We study galactic cosmic-ray transport in the outer heliosphere and heliosheath using a newly developed transport model based on stochastic integration of the phase-space trajectories of Parker's equation. The model employs backward integration of the diffusion-convection transport equation using Ito calculus and is four-dimensional in space+momentum. We apply the model to the problem of galactic proton transport in the heliosphere during a negative solar minimum. Model results are compared with the Voyager measurements of galactic proton radial gradients and spectra in the heliosheath. We show that the heliosheath is not as efficient in diverting cosmic rays during solar minima as predicted by earlier two-dimensional models.

  1. Quantum theory of spinor field in four-dimensional Riemannian space-time

    International Nuclear Information System (INIS)

    Shavokhina, N.S.

    1996-01-01

    The review deals with the spinor field in the four-dimensional Riemannian space-time. The field beys the Dirac-Fock-Ivanenko equation. Principles of quantization of the spinor field in the Riemannian space-time are formulated which in a particular case of the plane space-time are equivalent to the canonical rules of quantization. The formulated principles are exemplified by the De Sitter space-time. The study of quantum field theory in the De Sitter space-time is interesting because it itself leads to a method of an invariant well for plane space-time. However, the study of the quantum spinor field theory in an arbitrary Riemannian space-time allows one to take into account the influence of the external gravitational field on the quantized spinor field. 60 refs

  2. Euler numbers of four-dimensional rotating black holes with the Euclidean signature

    International Nuclear Information System (INIS)

    Ma Zhengze

    2003-01-01

    For a black hole's spacetime manifold in the Euclidean signature, its metric is positive definite and therefore a Riemannian manifold. It can be regarded as a gravitational instanton and a topological characteristic which is the Euler number to which it is associated. In this paper we derive a formula for the Euler numbers of four-dimensional rotating black holes by the integral of the Euler density on the spacetime manifolds of black holes. Using this formula, we obtain that the Euler numbers of Kerr and Kerr-Newman black holes are 2. We also obtain that the Euler number of the Kerr-Sen metric in the heterotic string theory with one boost angle nonzero is 2, which is in accordance with its topology

  3. Four-dimensional Yang-Mills theory, gauge invariant mass and fluctuating three-branes

    International Nuclear Information System (INIS)

    Niemi, Antti J; Slizovskiy, Sergey

    2010-01-01

    We are interested in a gauge invariant coupling between four-dimensional Yang-Mills field and a three-brane that can fluctuate into higher dimensions. For this we interpret the Yang-Mills theory as a higher dimensional bulk gravity theory with dynamics that is governed by the Einstein action, and with a metric tensor constructed from the gauge field in a manner that displays the original gauge symmetry as an isometry. The brane moves in this higher dimensional spacetime under the influence of its bulk gravity, with dynamics determined by the Nambu action. This introduces the desired interaction between the brane and the gauge field in a way that preserves the original gauge invariance as an isometry of the induced metric. After a prudent change of variables the result can be interpreted as a gauge invariant and massive vector field that propagates in the original spacetime R 4 . The presence of the brane becomes entirely invisible, expect for the mass.

  4. New classes of bi-axially symmetric solutions to four-dimensional Vasiliev higher spin gravity

    Energy Technology Data Exchange (ETDEWEB)

    Sundell, Per; Yin, Yihao [Departamento de Ciencias Físicas, Universidad Andres Bello,Republica 220, Santiago de Chile (Chile)

    2017-01-11

    We present new infinite-dimensional spaces of bi-axially symmetric asymptotically anti-de Sitter solutions to four-dimensional Vasiliev higher spin gravity, obtained by modifications of the Ansatz used in https://arxiv.org/abs/1107.1217, which gave rise to a Type-D solution space. The current Ansatz is based on internal semigroup algebras (without identity) generated by exponentials formed out of the bi-axial symmetry generators. After having switched on the vacuum gauge function, the resulting generalized Weyl tensor is given by a sum of generalized Petrov type-D tensors that are Kerr-like or 2-brane-like in the asymptotic AdS{sub 4} region, and the twistor space connection is smooth in twistor space over finite regions of spacetime. We provide evidence for that the linearized twistor space connection can be brought to Vasiliev gauge.

  5. All the Four-Dimensional Static, Spherically Symmetric Solutions of Abelian Kaluza-Klein Theory

    International Nuclear Information System (INIS)

    Cvetic, M.; Youm, D.

    1995-01-01

    We present the explicit form for all the four-dimensional, static, spherically symmetric solutions in (4+n)-d Abelian Kaluza-Klein theory by performing a subset of SO(2,n) transformations corresponding to four SO(1,1) boosts on the Schwarzschild solution, supplemented by SO(n)/SO(n-2) transformations. The solutions are parametrized by the mass M, Taub-NUT charge a, and n electric rvec Q and n magnetic rvec P charges. Nonextreme black holes (with zero Taub-NUT charge) have either the Reissner-Nordstroem or Schwarzschild global space-time. Supersymmetric extreme black holes have a null or naked singularity, while nonsupersymmetric extreme ones have a global space-time of extreme Reissner-Nordstroem black holes. copyright 1995 The American Physical Society

  6. Structures of larger proteins in solution: Three- and four-dimensional heteronuclear NMR spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Gronenborn, A.M.; Clore, G.M. [National Institutes of Health, Bethesda, MD (United States)

    1994-12-01

    Complete understanding of a protein`s function and mechanism of action can only be achieved with a knowledge of its three-dimensional structure at atomic resolution. At present, there are two methods available for determining such structures. The first method, which has been established for many years, is x-ray diffraction of protein single crystals. The second method has blossomed only in the last 5 years and is based on the application of nuclear magnetic resonance (NMR) spectroscopy to proteins in solution. This review paper describes three- and four-dimensional NMR methods applied to protein structure determination and was adapted from Clore and Gronenborn. The review focuses on the underlying principals and practice of multidimensional NMR and the structural information obtained.

  7. No-go theorems for R symmetries in four-dimensional GUTs

    CERN Document Server

    Fallbacher, Maximilian; Vaudrevange, Patrick K S

    2011-01-01

    We prove that it is impossible to construct a grand unified model, based on a simple gauge group, in four dimensions that leads to the exact MSSM, nor to a singlet extension, and possesses an unbroken R symmetry. This implies that no MSSM model with either a Z_{M>=3}^R or U(1)_R symmetry can be completed by a four-dimensional GUT in the ultraviolet. However, our no-go theorem does not apply to GUT models with extra dimensions. We also show that it is impossible to construct a 4D GUT that leads to the MSSM plus an additional anomaly-free symmetry that forbids the mu term.

  8. Automated four-dimensional Monte Carlo workflow using log files and real-time motion monitoring

    International Nuclear Information System (INIS)

    Sibolt, P; Andersen, C E; Cronholm, R O; Heath, E; Behrens, C F

    2017-01-01

    With emerging techniques for tracking and gating methods in radiotherapy of lung cancer patients, there is an increasing need for efficient four-dimensional Monte Carlo (4DMC) based quality assurance (QA). An automated and flexible workflow for 4DMC QA, based on the 4DdefDOSXYZnrc user code, has been developed in python. The workflow has been tested and verified using an in-house developed dosimetry system comprised of a dynamic thorax phantom constructed for plastic scintillator dosimetry. The workflow is directly compatible with any treatment planning system and can also be triggered by the appearance of linac log files. It has minimum user interaction and, with the use of linac log files, it provides a method for verification of the actually delivered dose in the patient geometry. (paper)

  9. Universal time versus relativistic time in four-dimensional symmetry framework

    International Nuclear Information System (INIS)

    Chiu, C.B.; Hsu, J.P.; Sherry, T.N.

    1976-12-01

    A new four-dimensional symmetry framework with a universal time is investigated which can be realized by a radioactive clock--the measured survival fraction of unstable particles gives the elapsed time. The world picture turns out to be quite different from that in special relativity. The general space-light transformation and the nonuniversal speed of light in this framework are discussed. The difference between the one-way speed and the two-way speed of a light signal is considered in detail. Moreover, the discussion sheds light on the connection between the universality of the light speed and the clock which does not read universal time. The relation with special relativity theory is examined in a few cases

  10. Four-dimensional optoacoustic temperature mapping in laser-induced thermotherapy

    Science.gov (United States)

    Oyaga Landa, Francisco Javier; Deán-Ben, Xosé Luís.; Sroka, Ronald; Razansky, Daniel

    2018-02-01

    Photoablative laser therapy is in common use for selective destruction of malignant masses, vascular and brain abnormalities. Tissue ablation and coagulation are irreversible processes occurring shortly after crossing a certain thermal exposure threshold. As a result, accurate mapping of the temperature field is essential for optimizing the outcome of these clinical interventions. Here we demonstrate four-dimensional optoacoustic temperature mapping of the entire photoablated region. Accuracy of the method is investigated in tissue-mimicking phantom experiments. Deviations of the volumetric optoacoustic temperature readings provided at 40ms intervals remained below 10% for temperature elevations above 3°C, as validated by simultaneous thermocouple measurements. The excellent spatio-temporal resolution of the new temperature monitoring approach aims at improving safety and efficacy of laser-based photothermal procedures.

  11. Power Doppler flow mapping and four-dimensional ultrasound for evaluating tubal patency compared with laparoscopy.

    Science.gov (United States)

    Soliman, Amr A; Shaalan, Waleed; Abdel-Dayem, Tamer; Awad, Elsayed Elbadawy; Elkassar, Yasser; Lüdders, Dörte; Malik, Eduard; Sallam, Hassan N

    2015-12-01

    To study the accuracy of four-dimensional (4D) ultrasound and power Doppler flow mapping in detecting tubal patency in women with sub-/infertility, and compare it with laparoscopy and chromopertubation. A prospective study. The study was performed in the outpatient clinic and infertility unit of a university hospital. The sonographic team and laparoscopic team were blinded to the results of each other. Women aged younger than 43 years seeking medical advice due to primary or secondary infertility and who planned to have a diagnostic laparoscopy performed, were recruited to the study after signing an informed consent. All of the recruited patients had power Doppler flow mapping and 4D hysterosalpingo-sonography by injecting sterile saline into the fallopian tubes 1 day before surgery. Registering Doppler signals, while using power Doppler, both at the tubal ostia and fimbrial end and the ability to demonstrate the course of the tube especially the isthmus and fimbrial end, while using 4D mode, was considered a patent tube. Out of 50 recruited patients, 33 women had bilateral patent tubes and five had unilateral patent tubes as shown by chromopertubation during diagnostic laparoscopy. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for two-dimensional power Doppler hysterosalpingography were 94.4%, 100%, 100%, 89.2%, and 96.2%, respectively and for 4D ultrasound were 70.4%, 100%, 100%, 70.4%, and 82.6%, respectively. Four-dimensional saline hysterosalpingography has acceptable accuracy in detecting tubal patency, but is surpassed by power Doppler saline hysterosalpingography. Power Doppler saline hysterosalpingography could be incorporated into the routine sub-/infertility workup. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Four-Dimensional CT of the Diaphragm in Children: Initial Experience

    Science.gov (United States)

    2018-01-01

    Objective To evaluate the technical feasibility of four-dimensional (4D) CT for the functional evaluation of the pediatric diaphragm. Materials and Methods In 22 consecutive children (median age 3.5 months, age range 3 days–3 years), 4D CT was performed to assess diaphragm motion. Diaphragm abnormalities were qualitatively evaluated and diaphragm motion was quantitatively measured on 4D CT. Lung density changes between peak inspiration and expiration were measured in the basal lung parenchyma. The diaphragm motions and lung density changes measured on 4D CT were compared between various diaphragm conditions. In 11 of the 22 children, chest sonography was available for comparison. Results Four-dimensional CT demonstrated normal diaphragm (n = 8), paralysis (n = 10), eventration (n = 3), and diffusely decreased motion (n = 1). Chest sonography demonstrated normal diaphragm (n = 2), paralysis (n = 6), eventration (n = 2), and right pleural effusion (n = 1). The sonographic findings were concordant with the 4D CT findings in 90.9% (10/11) of the patients. In diaphragm paralysis, the affected diaphragm motion was significantly decreased compared with the contralateral normal diaphragm motion (−1.1 ± 2.2 mm vs. 7.6 ± 3.8 mm, p = 0.005). The normal diaphragms showed significantly greater motion than the paralyzed diaphragms (4.5 ± 2.1 mm vs. −1.1 ± 2.2 mm, p Hounsfield units [HU] vs. 180 ± 71 HU, p = 0.03), while no significant differences were found between the normal diaphragms and the paralyzed diaphragms (136 ± 66 HU vs. 89 ± 73 HU, p = 0.1) or between the normal diaphragms and the contralateral normal diaphragms in paralysis (136 ± 66 HU vs. 180 ± 71 HU, p = 0.1). Conclusion The functional evaluation of the pediatric diaphragm is feasible with 4D CT in select children. PMID:29354007

  13. Four-dimensional reconstruction of cultural heritage sites based on photogrammetry and clustering

    Science.gov (United States)

    Voulodimos, Athanasios; Doulamis, Nikolaos; Fritsch, Dieter; Makantasis, Konstantinos; Doulamis, Anastasios; Klein, Michael

    2017-01-01

    A system designed and developed for the three-dimensional (3-D) reconstruction of cultural heritage (CH) assets is presented. Two basic approaches are presented. The first one, resulting in an "approximate" 3-D model, uses images retrieved in online multimedia collections; it employs a clustering-based technique to perform content-based filtering and eliminate outliers that significantly reduce the performance of 3-D reconstruction frameworks. The second one is based on input image data acquired through terrestrial laser scanning, as well as close range and airborne photogrammetry; it follows a sophisticated multistep strategy, which leads to a "precise" 3-D model. Furthermore, the concept of change history maps is proposed to address the computational limitations involved in four-dimensional (4-D) modeling, i.e., capturing 3-D models of a CH landmark or site at different time instances. The system also comprises a presentation viewer, which manages the display of the multifaceted CH content collected and created. The described methods have been successfully applied and evaluated in challenging real-world scenarios, including the 4-D reconstruction of the historic Market Square of the German city of Calw in the context of the 4-D-CH-World EU project.

  14. Quantum Mechanics and Black Holes in Four-Dimensional String Theory

    CERN Document Server

    Ellis, Jonathan Richard; Nanopoulos, Dimitri V

    1992-01-01

    In previous papers we have shown how strings in a two-dimensional target space reconcile quantum mechanics with general relativity, thanks to an infinite set of conserved quantum numbers, ``W-hair'', associated with topological soliton-like states. In this paper we extend these arguments to four dimensions, by considering explicitly the case of string black holes with radial symmetry. The key infinite-dimensional W-symmetry is associated with the $\\frac{SU(1,1)}{U(1)}$ coset structure of the dilaton-graviton sector that is a model-independent feature of spherically symmetric four-dimensional strings. Arguments are also given that the enormous number of string {\\it discrete (topological)} states account for the maintenance of quantum coherence during the (non-thermal) stringy evaporation process, as well as quenching the large Hawking-Bekenstein entropy associated with the black hole. Defining the latter as the measure of the loss of information for an observer at infinity, who - ignoring the higher string qua...

  15. A four-dimensional virtual hand brain-machine interface using active dimension selection.

    Science.gov (United States)

    Rouse, Adam G

    2016-06-01

    Brain-machine interfaces (BMI) traditionally rely on a fixed, linear transformation from neural signals to an output state-space. In this study, the assumption that a BMI must control a fixed, orthogonal basis set was challenged and a novel active dimension selection (ADS) decoder was explored. ADS utilizes a two stage decoder by using neural signals to both (i) select an active dimension being controlled and (ii) control the velocity along the selected dimension. ADS decoding was tested in a monkey using 16 single units from premotor and primary motor cortex to successfully control a virtual hand avatar to move to eight different postures. Following training with the ADS decoder to control 2, 3, and then 4 dimensions, each emulating a grasp shape of the hand, performance reached 93% correct with a bit rate of 2.4 bits s(-1) for eight targets. Selection of eight targets using ADS control was more efficient, as measured by bit rate, than either full four-dimensional control or computer assisted one-dimensional control. ADS decoding allows a user to quickly and efficiently select different hand postures. This novel decoding scheme represents a potential method to reduce the complexity of high-dimension BMI control of the hand.

  16. Quantification of Artifact Reduction With Real-Time Cine Four-Dimensional Computed Tomography Acquisition Methods

    International Nuclear Information System (INIS)

    Langner, Ulrich W.; Keall, Paul J.

    2010-01-01

    Purpose: To quantify the magnitude and frequency of artifacts in simulated four-dimensional computed tomography (4D CT) images using three real-time acquisition methods- direction-dependent displacement acquisition, simultaneous displacement and phase acquisition, and simultaneous displacement and velocity acquisition- and to compare these methods with commonly used retrospective phase sorting. Methods and Materials: Image acquisition for the four 4D CT methods was simulated with different displacement and velocity tolerances for spheres with radii of 0.5 cm, 1.5 cm, and 2.5 cm, using 58 patient-measured tumors and respiratory motion traces. The magnitude and frequency of artifacts, CT doses, and acquisition times were computed for each method. Results: The mean artifact magnitude was 50% smaller for the three real-time methods than for retrospective phase sorting. The dose was ∼50% lower, but the acquisition time was 20% to 100% longer for the real-time methods than for retrospective phase sorting. Conclusions: Real-time acquisition methods can reduce the frequency and magnitude of artifacts in 4D CT images, as well as the imaging dose, but they increase the image acquisition time. The results suggest that direction-dependent displacement acquisition is the preferred real-time 4D CT acquisition method, because on average, the lowest dose is delivered to the patient and the acquisition time is the shortest for the resulting number and magnitude of artifacts.

  17. N = 1 supersymmetric indices and the four-dimensional A-model

    Science.gov (United States)

    Closset, Cyril; Kim, Heeyeon; Willett, Brian

    2017-08-01

    We compute the supersymmetric partition function of N = 1 supersymmetric gauge theories with an R-symmetry on M_4\\cong M_{g,p}× {S}^1 , a principal elliptic fiber bundle of degree p over a genus- g Riemann surface, Σ g . Equivalently, we compute the generalized supersymmetric index I_{M}{_{g,p}, with the supersymmetric three-manifold M_{g,p} as the spatial slice. The ordinary N = 1 supersymmetric index on the round three-sphere is recovered as a special case. We approach this computation from the point of view of a topological A-model for the abelianized gauge fields on the base Σ g . This A-model — or A-twisted two-dimensional N = (2 , 2) gauge theory — encodes all the information about the generalized indices, which are viewed as expectations values of some canonically-defined surface defects wrapped on T 2 inside Σ g × T 2. Being defined by compactification on the torus, the A-model also enjoys natural modular properties, governed by the four-dimensional 't Hooft anomalies. As an application of our results, we provide new tests of Seiberg duality. We also present a new evaluation formula for the three-sphere index as a sum over two-dimensional vacua.

  18. Diagnosis of fetal syndromes by three- and four-dimensional ultrasound: is there any improvement?

    Science.gov (United States)

    Barišić, Lara Spalldi; Stanojević, Milan; Kurjak, Asim; Porović, Selma; Gaber, Ghalia

    2017-08-28

    With all of our present knowledge, high technology diagnostic equipment, electronic databases and other available supporting resources, detection of fetal syndromes is still a challenge for healthcare providers in prenatal as well as in the postnatal period. Prenatal diagnosis of fetal syndromes is not straightforward, and it is a difficult puzzle that needs to be assembled and solved. Detection of one anomaly should always raise a suspicion of the existence of more anomalies, and can be a trigger to investigate further and raise awareness of possible syndromes. Highly specialized software systems for three- and four-dimensional ultrasound (3D/4D US) enabled detailed depiction of fetal anatomy and assessment of the dynamics of fetal structural and functional development in real time. With recent advances in 3D/4D US technology, antenatal diagnosis of fetal anomalies and syndromes shifted from the 2nd to the 1st trimester of pregnancy. It is questionable what can and should be done after the prenatal diagnosis of fetal syndrome. The 3D and 4D US techniques improved detection accuracy of fetal abnormalities and syndromes from early pregnancy onwards. It is not easy to make prenatal diagnosis of fetal syndromes, so tools which help like online integrated databases are needed to increase diagnostic precision. The aim of this paper is to present the possibilities of different US techniques in the detection of some fetal syndromes prenatally.

  19. N=12 supersymmetric four-dimensional nonlinear σ-models from nonanticommutative superspace

    International Nuclear Information System (INIS)

    Hatanaka, Tomoya; Ketov, Sergei V.; Kobayashi, Yoshishige; Sasaki, Shin

    2005-01-01

    The component structure of a generic N=1/2 supersymmetric nonlinear sigma-model (NLSM) defined in the four-dimensional (Euclidean) nonanticommutative (NAC) superspace is investigated in detail. The most general NLSM is described in terms of arbitrary Kahler potential, and chiral and antichiral superpotentials. The case of a single chiral superfield gives rise to splitting of the NLSM potentials, whereas the case of several chiral superfields results in smearing (or fuzziness) of the NLSM potentials, while both effects are controlled by the auxiliary fields. We eliminate the auxiliary fields by solving their algebraic equations of motion, and demonstrate that the results are dependent upon whether the auxiliary integrations responsible for the fuzziness are performed before or after elimination of the auxiliary fields. There is no ambiguity in the case of splitting, i.e., for a single chiral superfield. Fully explicit results are derived in the case of the N=1/2 supersymmetric NAC-deformed CP n NLSM in four dimensions. Here we find another surprise that our results differ from the N=1/2 supersymmetric CP n NLSM derived by the quotient construction from the N=1/2 supersymmetric NAC-deformed gauge theory. We conclude that an N=1/2 supersymmetric deformation of a generic NLSM from the NAC superspace is not unique

  20. Simulations of four-dimensional simplicial quantum gravity as dynamical triangulation

    International Nuclear Information System (INIS)

    Agishtein, M.E.; Migdal, A.A.

    1992-01-01

    In this paper, Four-Dimensional Simplicial Quantum Gravity is simulated using the dynamical triangulation approach. The authors studied simplicial manifolds of spherical topology and found the critical line for the cosmological constant as a function of the gravitational one, separating the phases of opened and closed Universe. When the bare cosmological constant approaches this line from above, the four-volume grows: the authors reached about 5 x 10 4 simplexes, which proved to be sufficient for the statistical limit of infinite volume. However, for the genuine continuum theory of gravity, the parameters of the lattice model should be further adjusted to reach the second order phase transition point, where the correlation length grows to infinity. The authors varied the gravitational constant, and they found the first order phase transition, similar to the one found in three-dimensional model, except in 4D the fluctuations are rather large at the transition point, so that this is close to the second order phase transition. The average curvature in cutoff units is large and positive in one phase (gravity), and small negative in another (antigravity). The authors studied the fractal geometry of both phases, using the heavy particle propagator to define the geodesic map, as well as with the old approach using the shortest lattice paths

  1. Assessment of turbulent flow effects on the vessel wall using four-dimensional flow MRI.

    Science.gov (United States)

    Ziegler, Magnus; Lantz, Jonas; Ebbers, Tino; Dyverfeldt, Petter

    2017-06-01

    To explore the use of MR-estimated turbulence quantities for the assessment of turbulent flow effects on the vessel wall. Numerical velocity data for two patient-derived models was obtained using computational fluid dynamics (CFD) for two physiological flow rates. The four-dimensional (4D) Flow MRI measurements were simulated at three different spatial resolutions and used to investigate the estimation of turbulent wall shear stress (tWSS) using the intravoxel standard deviation (IVSD) of velocity and turbulent kinetic energy (TKE) estimated near the vessel wall. Accurate estimation of tWSS using the IVSD is limited by the spatial resolution achievable with 4D Flow MRI. TKE, estimated near the wall, has a strong linear relationship to the tWSS (mean R 2  = 0.84). Near-wall TKE estimates from MR simulations have good agreement to CFD-derived ground truth (mean R 2  = 0.90). Maps of near-wall TKE have strong visual correspondence to tWSS. Near-wall estimation of TKE permits assessment of relative maps of tWSS, but direct estimation of tWSS is challenging due to limitations in spatial resolution. Assessment of tWSS and near-wall TKE may open new avenues for analysis of different pathologies. Magn Reson Med 77:2310-2319, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  2. Four-dimensional parameter estimation of plane waves using swarming intelligence

    International Nuclear Information System (INIS)

    Zaman Fawad; Munir Fahad; Khan Zafar Ullah; Qureshi Ijaz Mansoor

    2014-01-01

    This paper proposes an efficient approach for four-dimensional (4D) parameter estimation of plane waves impinging on a 2-L shape array. The 4D parameters include amplitude, frequency and the two-dimensional (2D) direction of arrival, namely, azimuth and elevation angles. The proposed approach is based on memetic computation, in which the global optimizer, particle swarm optimization is hybridized with a rapid local search technique, pattern search. For this purpose, a new multi-objective fitness function is used. This fitness function is the combination of mean square error and the correlation between the normalized desired and estimated vectors. The proposed hybrid scheme is not only compared with individual performances of particle swarm optimization and pattern search, but also with the performance of the hybrid genetic algorithm and that of the traditional approach. A large number of Monte—Carlo simulations are carried out to validate the performance of the proposed scheme. It gives promising results in terms of estimation accuracy, convergence rate, proximity effect and robustness against noise. (interdisciplinary physics and related areas of science and technology)

  3. Four-dimensional microscope- integrated optical coherence tomography to enhance visualization in glaucoma surgeries.

    Science.gov (United States)

    Pasricha, Neel Dave; Bhullar, Paramjit Kaur; Shieh, Christine; Viehland, Christian; Carrasco-Zevallos, Oscar Mijail; Keller, Brenton; Izatt, Joseph Adam; Toth, Cynthia Ann; Challa, Pratap; Kuo, Anthony Nanlin

    2017-01-01

    We report the first use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT) capable of live four-dimensional (4D) (three-dimensional across time) imaging intraoperatively to directly visualize tube shunt placement and trabeculectomy surgeries in two patients with severe open-angle glaucoma and elevated intraocular pressure (IOP) that was not adequately managed by medical intervention or prior surgery. We performed tube shunt placement and trabeculectomy surgery and used SS-MIOCT to visualize and record surgical steps that benefitted from the enhanced visualization. In the case of tube shunt placement, SS-MIOCT successfully visualized the scleral tunneling, tube shunt positioning in the anterior chamber, and tube shunt suturing. For the trabeculectomy, SS-MIOCT successfully visualized the scleral flap creation, sclerotomy, and iridectomy. Postoperatively, both patients did well, with IOPs decreasing to the target goal. We found the benefit of SS-MIOCT was greatest in surgical steps requiring depth-based assessments. This technology has the potential to improve clinical outcomes.

  4. False vacuum decay in quantum mechanics and four dimensional scalar field theory

    Science.gov (United States)

    Bezuglov, Maxim

    2018-04-01

    When the Higgs boson was discovered in 2012 it was realized that electroweak vacuum may suffer a possible metastability on the Planck scale and can eventually decay. To understand this problem it is important to have reliable predictions for the vacuum decay rate within the framework of quantum field theory. For now, it can only be done at one loop level, which is apparently is not enough. The aim of this work is to develop a technique for the calculation of two and higher order radiative corrections to the false vacuum decay rate in the framework of four dimensional scalar quantum field theory and then apply it to the case of the Standard Model. To achieve this goal, we first start from the case of d=1 dimensional QFT i.e. quantum mechanics. We show that for some potentials two and three loop corrections can be very important and must be taken into account. Next, we use quantum mechanical example as a template for the general d=4 dimensional theory. In it we are concentrating on the calculations of bounce solution and corresponding Green function in so called thin wall approximation. The obtained Green function is then used as a main ingredient for the calculation of two loop radiative corrections to the false vacuum decay rate.

  5. Four-Dimensional Ultrafast Electron Microscopy: Insights into an Emerging Technique

    KAUST Repository

    Adhikari, Aniruddha

    2016-12-15

    Four-dimensional ultrafast electron microscopy (4D-UEM) is a novel analytical technique that aims to fulfill the long-held dream of researchers to investigate materials at extremely short spatial and temporal resolutions by integrating the excellent spatial resolution of electron microscopes with the temporal resolution of ultrafast femtosecond laser-based spectroscopy. The ingenious use of pulsed photoelectrons to probe surfaces and volumes of materials enables time-resolved snapshots of the dynamics to be captured in a way hitherto impossible by other conventional techniques. The flexibility of 4D-UEM lies in the fact that it can be used in both the scanning (S-UEM) and transmission (UEM) modes depending upon the type of electron microscope involved. While UEM can be employed to monitor elementary structural changes and phase transitions in samples using real-space mapping, diffraction, electron energy-loss spectroscopy, and tomography, S-UEM is well suited to map ultrafast dynamical events on materials surfaces in space and time. This review provides an overview of the unique features that distinguish these techniques and also illustrates the applications of both S-UEM and UEM to a multitude of problems relevant to materials science and chemistry.

  6. Two-dimensional topological field theories coupled to four-dimensional BF theory

    International Nuclear Information System (INIS)

    Montesinos, Merced; Perez, Alejandro

    2008-01-01

    Four-dimensional BF theory admits a natural coupling to extended sources supported on two-dimensional surfaces or string world sheets. Solutions of the theory are in one to one correspondence with solutions of Einstein equations with distributional matter (cosmic strings). We study new (topological field) theories that can be constructed by adding extra degrees of freedom to the two-dimensional world sheet. We show how two-dimensional Yang-Mills degrees of freedom can be added on the world sheet, producing in this way, an interactive (topological) theory of Yang-Mills fields with BF fields in four dimensions. We also show how a world sheet tetrad can be naturally added. As in the previous case the set of solutions of these theories are contained in the set of solutions of Einstein's equations if one allows distributional matter supported on two-dimensional surfaces. These theories are argued to be exactly quantizable. In the context of quantum gravity, one important motivation to study these models is to explore the possibility of constructing a background-independent quantum field theory where local degrees of freedom at low energies arise from global topological (world sheet) degrees of freedom at the fundamental level

  7. Outcome of four-dimensional stereotactic radiotherapy for centrally located lung tumors

    International Nuclear Information System (INIS)

    Nuyttens, Joost J.; Voort van Zyp, Noelle C. van der; Praag, John; Aluwini, Shafak; Klaveren, Rob J. van; Verhoef, Cornelis; Pattynama, Peter M.; Hoogeman, Mischa S.

    2012-01-01

    Purpose: To assess local control, overall survival, and toxicity of four-dimensional, risk-adapted stereotactic body radiotherapy (SBRT) delivered while tracking respiratory motion in patients with primary and metastatic lung cancer located in the central chest. Methods: Fifty-eight central lesions of 56 patients (39 with primary, 17 with metastatic tumors) were treated. Fifteen tumors located near the esophagus were treated with 6 fractions of 8 Gy. Other tumors were treated according to the following dose escalation scheme: 5 fractions of 9 Gy (n = 6), then 5 fractions of 10 Gy (n = 15), and finally 5 fractions of 12 Gy (n = 22). Results: Dose constraints for critical structures were generally achieved; in 21 patients the coverage of the PTV was reduced below 95% to protect adjacent organs at risk. At a median follow-up of 23 months, the actuarial 2-years local tumor control was 85% for tumors treated with a BED >100 Gy compared to 60% for tumors treated with a BED ⩽100 Gy. No grade 4 or 5 toxicity was observed. Acute grade 1–2 esophagitis was observed in 11% of patients. Conclusion: SBRT of central lung lesions can be safely delivered, with promising early tumor control in patients many of whom have severe comorbid conditions.

  8. Evaluating four-dimensional time-lapse electrical resistivity tomography for monitoring DNAPL source zone remediation.

    Science.gov (United States)

    Power, Christopher; Gerhard, Jason I; Karaoulis, Marios; Tsourlos, Panagiotis; Giannopoulos, Antonios

    2014-07-01

    Practical, non-invasive tools do not currently exist for mapping the remediation of dense non-aqueous phase liquids (DNAPLs). Electrical resistivity tomography (ERT) exhibits significant potential but has not yet become a practitioner's tool due to challenges in interpreting the survey results at real sites. This study explores the effectiveness of recently developed four-dimensional (4D, i.e., 3D space plus time) time-lapse surface ERT to monitor DNAPL source zone remediation. A laboratory experiment demonstrated the approach for mapping a changing NAPL distribution over time. A recently developed DNAPL-ERT numerical model was then employed to independently simulate the experiment, providing confidence that the DNAPL-ERT model is a reliable tool for simulating real systems. The numerical model was then used to evaluate the potential for this approach at the field scale. Four DNAPL source zones, exhibiting a range of complexity, were initially simulated, followed by modeled time-lapse ERT monitoring of complete DNAPL remediation by enhanced dissolution. 4D ERT inversion provided estimates of the regions of the source zone experiencing mass reduction with time. Results show that 4D time-lapse ERT has significant potential to map both the outline and the center of mass of the evolving treated portion of the source zone to within a few meters in each direction. In addition, the technique can provide a reasonable, albeit conservative, estimate of the DNAPL volume remediated with time: 25% underestimation in the upper 2m and up to 50% underestimation at late time between 2 and 4m depth. The technique is less reliable for identifying cleanup of DNAPL stringers outside the main DNAPL body. Overall, this study demonstrates that 4D time-lapse ERT has potential for mapping where and how quickly DNAPL mass changes in real time during site remediation. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Determination of Respiratory Motion for Distal Esophagus Cancer Using Four-Dimensional Computed Tomography

    International Nuclear Information System (INIS)

    Yaremko, Brian P.; Guerrero, Thomas M.; McAleer, Mary F.; Bucci, M. Kara; Noyola-Martinez, Josue M.S.; Nguyen, Linda T. C.; Balter, Peter A.; Guerra, Rudy; Komaki, Ritsuko; Liao Zhongxing

    2008-01-01

    Purpose: To investigate the motion characteristics of distal esophagus cancer primary tumors using four-dimensional computed tomography (4D CT). Methods and Materials: Thirty-one consecutive patients treated for esophagus cancer who received respiratory-gated 4D CT imaging for treatment planning were selected. Deformable image registration was used to map the full expiratory motion gross tumor volume (GTV) to the full-inspiratory CT image, allowing quantitative assessment of each voxel's displacement. These displacements were correlated with patient tumor and respiratory characteristics. Results: The mean (SE) tidal volume was 608 (73) mL. The mean GTV volume was 64.3 (10.7) mL on expiration and 64.1 (10.7) mL on inspiration (no significant difference). The mean tumor motion in the x-direction was 0.13 (0.006) cm (average of absolute values), in the y-direction 0.23 (0.01) cm (anteriorly), and in the z-direction 0.71 (0.02) cm (inferiorly). Tumor motion correlated with tidal volume. Comparison of tumor motion above vs. below the diaphragm was significant for the average net displacement (p = 0.014), motion below the diaphragm was greater than above. From the cumulative distribution 95% of the tumors moved less than 0.80 cm radially and 1.75 cm inferiorly. Conclusions: Primary esophagus tumor motion was evaluated with 4D CT. According to the results of this study, when 4D CT is not available, a radial margin of 0.8 cm and axial margin of ±1.8 cm would provide tumor motion coverage for 95% of the cases in our study population

  10. Stable de Sitter vacua in four-dimensional supergravity originating from five dimensions

    International Nuclear Information System (INIS)

    Oegetbil, O.

    2008-01-01

    The five-dimensional stable de Sitter ground states in N=2 supergravity obtained by gauging SO(1,1) symmetry of the real symmetric scalar manifold (in particular, a generic Jordan family manifold of the vector multiplets) simultaneously with a subgroup R s of the R-symmetry group descend to four-dimensional de Sitter ground states under certain conditions. First, the holomorphic section in four dimensions has to be chosen carefully by using the symplectic freedom in four dimensions; second, a group contraction is necessary to bring the potential into a desired form. Under these conditions, stable de Sitter vacua can be obtained in dimensionally reduced theories (from 5D to 4D) if the semidirect product of SO(1,1) with R (1,1) together with a simultaneous R s is gauged. We review the stable de Sitter vacua in four dimensions found in earlier literature for N=2 Yang-Mills Einstein supergravity with the SO(2,1)xR s gauge group in a symplectic basis that comes naturally after dimensional reduction. Although this particular gauge group does not descend directly from five dimensions, we show that its contraction does. Hence, two different theories overlap in certain limits. Examples of stable de Sitter vacua are given for the cases: (i) R s =U(1) R , (ii) R s =SU(2) R , and (iii) N=2 Yang-Mills/Einstein supergravity theory coupled to a universal hypermultiplet. We conclude with a discussion regarding the extension of our results to supergravity theories with more general homogeneous scalar manifolds.

  11. Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration

    International Nuclear Information System (INIS)

    Dieleman, Edith; Senan, Suresh; Vincent, Andrew; Lagerwaard, Frank J.; Slotman, Ben J.; Soernsen de Koste, John R. van

    2007-01-01

    Background: Chemo-radiotherapy for thoracic tumors can result in high-grade radiation esophagitis. Treatment planning to reduce esophageal irradiation requires organ motion to be accounted for. In this study, esophageal mobility was assessed using four-dimensional computed tomography (4DCT). Methods and Materials: Thoracic 4DCT scans were acquired on a 16-slice CT scanner in 29 patients. The outer esophageal wall was contoured in two extreme phases of respiration in 9 patients with nonesophageal malignancies. The displacement of the center of contour was measured at 2-cm intervals. In 20 additional patients with Stage I lung cancer, the esophagus was contoured in all 10 phases of each 4DCT at five defined anatomic levels. Both approaches were then applied to 4DCT scans of 4 patients who each had two repeat scans performed. A linear mixed effects model was constructed with fixed effects: measurement direction, measurement type, and measurement location along the cranio-caudal axis. Results: Measurement location and direction were significant descriptive parameters (Wald F-tests, p < 0.001), and the interaction term between the two was significant (p = 0.02). Medio-lateral mobility exceeded dorso-ventral mobility in the lower half of the esophagus but was of a similar magnitude in the upper half. Margins that would have incorporated all movement in medio-lateral and dorso-ventral directions were 5 mm proximally, 7 mm and 6 mm respectively in the mid-esophagus, and 9 mm and 8 mm respectively in the distal esophagus. Conclusions: The distal esophagus shows more mobility. Margins for mobility that can encompass all movement were derived for use in treatment planning, particularly for stereotactic radiotherapy

  12. Conceptual formulation on four-dimensional inverse planning for intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Lee, Louis; Ma Yunzhi; Xing Lei; Ye Yinyu

    2009-01-01

    Four-dimensional computed tomography (4DCT) offers an extra dimension of 'time' on the three-dimensional patient model with which we can incorporate target motion in radiation treatment (RT) planning and delivery in various ways such as in the concept of internal target volume, in gated treatment or in target tracking. However, for all these methodologies, different phases are essentially considered as non-interconnected independent phases for the purpose of optimization, in other words, the 'time' dimension has yet to be incorporated explicitly in the optimization algorithm and fully exploited. In this note, we have formulated a new 4D inverse planning technique that treats all the phases in the 4DCT as one single entity in the optimization. The optimization is formulated as a quadratic problem for disciplined convex programming that enables the problem to be analyzed and solved efficiently. In the proof-of-principle examples illustrated, we show that the temporal information of the spatial relation of the target and organs at risk could be 'exchanged' amongst different phases so that an appropriate weighting of dose deposition could be allocated to each phase, thus enabling a treatment with a tight target margin and a full duty cycle otherwise not achievable by either of the aforementioned methodologies. Yet there are practical issues to be solved in the 4D RT planning and delivery. The 4D concept in the optimization we have formulated here does provide insight on how the 'time' dimension can be exploited in the 4D optimization process. (note)

  13. Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography

    International Nuclear Information System (INIS)

    Pai Panandiker, Atmaram S.; Sharma, Shelly; Naik, Mihir H.; Wu, Shengjie; Hua, Chiaho; Beltran, Chris; Krasin, Matthew J.; Merchant, Thomas E.

    2012-01-01

    Objectives: Abdominal intensity-modulated radiation therapy and proton therapy require quantification of target and organ motion to optimize localization and treatment. Although addressed in adults, there is no available literature on this issue in pediatric patients. We assessed physiologic renal motion in pediatric patients. Methods and Materials: Twenty free-breathing pediatric patients at a median age of 8 years (range, 2–18 years) with intra-abdominal tumors underwent computed tomography simulation and four-dimensional computed tomography acquisition (slice thickness, 3 mm). Kidneys and diaphragms were contoured during eight phases of respiration to estimate center-of-mass motion. We quantified center of kidney mass mobility vectors in three dimensions: anteroposterior (AP), mediolateral (ML), and superoinferior (SI). Results: Kidney motion decreases linearly with decreasing age and height. The 95% confidence interval for the averaged minima and maxima of renal motion in children younger than 9 years was 5–9 mm in the ML direction, 4–11 mm in the AP direction, and 12–25 mm in the SI dimension for both kidneys. In children older than 9 years, the same confidence interval reveals a widening range of motion that was 5–16 mm in the ML direction, 6–17 mm in the AP direction, and 21–52 mm in the SI direction. Although not statistically significant, renal motion correlated with diaphragm motion in older patients. The correlation between diaphragm motion and body mass index was borderline (r = 0.52, p = 0.0816) in younger patients. Conclusions: Renal motion is age and height dependent. Measuring diaphragmatic motion alone does not reliably quantify pediatric renal motion. Renal motion in young children ranges from 5 to 25 mm in orientation-specific directions. The vectors of motion range from 5 to 52 mm in older children. These preliminary data represent novel analyses of pediatric intra-abdominal organ motion.

  14. Four-dimensional cone beam CT with adaptive gantry rotation and adaptive data sampling

    International Nuclear Information System (INIS)

    Lu Jun; Guerrero, Thomas M.; Munro, Peter; Jeung, Andrew; Chi, P.-C. M.; Balter, Peter; Zhu, X. Ronald; Mohan, Radhe; Pan Tinsu

    2007-01-01

    We have developed a new four-dimensional cone beam CT (4D-CBCT) on a Varian image-guided radiation therapy system, which has radiation therapy treatment and cone beam CT imaging capabilities. We adapted the speed of gantry rotation time of the CBCT to the average breath cycle of the patient to maintain the same level of image quality and adjusted the data sampling frequency to keep a similar level of radiation exposure to the patient. Our design utilized the real-time positioning and monitoring system to record the respiratory signal of the patient during the acquisition of the CBCT data. We used the full-fan bowtie filter during data acquisition, acquired the projection data over 200 deg of gantry rotation, and reconstructed the images with a half-scan cone beam reconstruction. The scan time for a 200-deg gantry rotation per patient ranged from 3.3 to 6.6 min for the average breath cycle of 3-6 s. The radiation dose of the 4D-CBCT was about 1-2 times the radiation dose of the 4D-CT on a multislice CT scanner. We evaluated the 4D-CBCT in scanning, data processing and image quality with phantom studies. We demonstrated the clinical applicability of the 4D-CBCT and compared the 4D-CBCT and the 4D-CT scans in four patient studies. The contrast-to-noise ratio of the 4D-CT was 2.8-3.5 times of the contrast-to-noise ratio of the 4D-CBCT in the four patient studies

  15. Four-Dimensional (4D) Printing: Applying Soft Adaptive Materials to Additive Manufacturing

    Science.gov (United States)

    Li, Zibiao; Loh, Xian Jun

    Four-dimensional (4D) printing is an up-and-coming technology for the creation of dynamic devices which have shape changing capabilities or on-demand capabilities over time. Through the printing of adaptive 3D structures, the concept of 4D printing can be realized. Modern manufacturing primarily utilizes direct assembly techniques, limiting the possibility of error correction or instant modification of a structure. Self-building, programmable physical materials are interesting for the automatic and remote construction of structures. Adaptive materials are programmable physical or biological materials which possess shape changing properties or can be made to have simple logic responses. There is immense potential in having disorganized fragments form an ordered construct through physical interactions. However, these are currently limited to only self-assembly at the smallest scale, typically at the nanoscale. The answer to customizable macro-structures is in additive manufacturing, or 3D printing. 3D printing is a 30 years old technology which is beginning to be widely used by consumers. However, the main gripes about this technology are that it is too inefficient, inaccessible, and slow. Cost is also a significant factor in the adoption of this technology. 3D printing has the potential to transform and disrupt the manufacturing landscape as well as our lives. 4D printing seeks to use multi-functional materials in 3D printing so that the printed structure has multiple response capabilities and able to self-assemble on the macroscale. In this paper, we will analyze the early promise of this technology as well as to highlight potential challenges that adopters could face. The primary focus will be to have a look at the application of materials to 3D printing and to show how these materials can be tailored to create responsive customized 4D structures.

  16. Muon borehole detector development for use in four-dimensional tomographic density monitoring

    Science.gov (United States)

    Flygare, Joshua

    The increase of CO2 concentrations in the atmosphere and the correlated temperature rise has initiated research into methods of carbon sequestration. One promising possibility is to store CO2 in subsurface reservoirs of porous rock. After injection, the monitoring of the injected CO2 is of paramount importance because the CO2 plume, if escaped, poses health and environmental risks. Traditionally, seismic reflection methods are the chosen method of determining changes in the reservoir density due to CO2 injection, but this is expensive and not continuous. A potential and promising alternative is to use cosmic muon tomography to determine density changes in the reservoir over a period of time. The work I have completed was the development of a muon detector that will be capable of being deployed in boreholes and perform long-term tomography of the reservoir of interest. The detector has the required dimensions, an angular resolution of approximately 2 degrees, and is robust enough to survive the caustic nature of the fluids in boreholes, as well as temperature and pressure fluctuations. The detector design is based on polystyrene scintillating rods arrayed in alternating layers. The layers, as arranged, can provide four-dimensional (4D) tomographic data to detect small changes in density at depths up to approximately 2 kilometers. Geant4, a Monte Carlo simulation code, was used to develop and optimize the detector design. Additionally, I developed a method of determining the muon flux at depth, including CO2 saturation changes in subsurface reservoirs. Preliminary experiments were performed at Pacific Northwest National Laboratory. This thesis will show the simulations I performed to determine the angular resolution and background discrimination required of the detector, the experiments to determine light transport through the polystyrene scintillating rods and fibers, and the method developed to predict muon flux changes at depth expected after injection.

  17. Novel Assessment of Renal Motion in Children as Measured via Four-Dimensional Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Pai Panandiker, Atmaram S., E-mail: atmaram.pai-panandiker@stjude.org [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States); Sharma, Shelly; Naik, Mihir H. [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States); Wu, Shengjie [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, TN (United States); Hua, Chiaho; Beltran, Chris; Krasin, Matthew J.; Merchant, Thomas E. [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2012-04-01

    Objectives: Abdominal intensity-modulated radiation therapy and proton therapy require quantification of target and organ motion to optimize localization and treatment. Although addressed in adults, there is no available literature on this issue in pediatric patients. We assessed physiologic renal motion in pediatric patients. Methods and Materials: Twenty free-breathing pediatric patients at a median age of 8 years (range, 2-18 years) with intra-abdominal tumors underwent computed tomography simulation and four-dimensional computed tomography acquisition (slice thickness, 3 mm). Kidneys and diaphragms were contoured during eight phases of respiration to estimate center-of-mass motion. We quantified center of kidney mass mobility vectors in three dimensions: anteroposterior (AP), mediolateral (ML), and superoinferior (SI). Results: Kidney motion decreases linearly with decreasing age and height. The 95% confidence interval for the averaged minima and maxima of renal motion in children younger than 9 years was 5-9 mm in the ML direction, 4-11 mm in the AP direction, and 12-25 mm in the SI dimension for both kidneys. In children older than 9 years, the same confidence interval reveals a widening range of motion that was 5-16 mm in the ML direction, 6-17 mm in the AP direction, and 21-52 mm in the SI direction. Although not statistically significant, renal motion correlated with diaphragm motion in older patients. The correlation between diaphragm motion and body mass index was borderline (r = 0.52, p = 0.0816) in younger patients. Conclusions: Renal motion is age and height dependent. Measuring diaphragmatic motion alone does not reliably quantify pediatric renal motion. Renal motion in young children ranges from 5 to 25 mm in orientation-specific directions. The vectors of motion range from 5 to 52 mm in older children. These preliminary data represent novel analyses of pediatric intra-abdominal organ motion.

  18. Definition of internal target volume and domestric study for hepatocellular carcinoma using four-dimensional CT

    International Nuclear Information System (INIS)

    Xi Mian; Liu Mengzhong; Deng Xiaowu; Zhang Li; Huang Xiaoyan; Cai Ling

    2009-01-01

    Objective: To define individualized internal target volume (ITV) for hepatocellular carcinoma using four-dimensional (4D) CT, and to compare the differences in target volume definition and dose distribution among 3D, 4D and respiratory-gated plans. Methods: 4DCT scanning was obtained for 12 patients with hepatocellular. Gross tumor volume (GTV), clinical target volume (CTV) and normal tissues were contoured on all 10 respiratory phases of 4DCT images. The 3D, 4D and gated treatment plans were prepared for each patient using three different planning target volumes (PTVs): 1) PTV 3D was derived from a single CTV plus conventional margins; 2) PTV 4D was derived from ITV 4D , which encompassed all 10 CTVs plus setup margins (SMs); 3) PT Gating was derived from ITV Gating , which encompassed 3 CTVs within gating-window at end-expiration plus SMs. The PTV volume and dose distribution were compared among different plans. Results: The PTV3D was the largest in all 12 patients, but still missed partial target volume in 5 patients when comparing with PTV4D. Both the 4D plans and the gated plans spared more normal tissues than the 3D plans, especially the liver. Without increasing normal tissue dose, the 4D plans allowed for increasing the calculated dose from (50.8 ± 2.0) Gy (3D plans) to (54.7 ± 3.3) Gy, and the gated plans could further increase the dose to (58.0 ± 3.9) Gy. Conclusions: The 4DCT-based plans can ensure optimal target coverage with less irradiation of normal tissues and allow dose escalation when compared with 3D plans. Respiratory gated radiotherapy can further reduce the target volumes to spare more surrounding tissues, especially for patients with large extent of respiratory mobility. (authors)

  19. Defining internal target volume (ITV) for hepatocellular carcinoma using four-dimensional CT

    International Nuclear Information System (INIS)

    X, Mian; Liu Mengzhong; Deng Xiaowu; Zhang Li; Huang Xiaoyan; Liu Hui; Li Qiaoqiao; Hu Yonghong; Cai Ling; Cui Nianji

    2007-01-01

    Background and purpose: To define individualized internal target volume (ITV) for hepatocellular carcinoma using four-dimensional computed tomography (4DCT). Materials and methods: Gross tumor volumes (GTVs) and clinical target volumes (CTVs) were contoured on all 10 respiratory phases of 4DCT scans in 10 patients with hepatocellular carcinoma. The 3D and 4D treatment plans were performed for each patient using two different planning target volumes (PTVs): (1) PTV 3D was derived from a single CTV plus conventional margins; (2) PTV 4D was derived from ITV 4D , which encompassed all 10 CTVs plus setup margins (SMs). The volumes of PTVs and dose distribution were compared between the two plans. Results: The average PTV volume of the 4D plans (328.4 ± 152.2 cm 3 ) was less than 3D plans (407.0 ± 165.6 cm 3 ). The 4D plans spared more surrounding normal tissues than 3D plans, especially normal liver. Compared with 3D plans, the mean dose to normal liver (MDTNL) decreased from 22.7 to 20.3 Gy. Without increasing the normal tissue complication probability (NTCP), the 4D plans allowed for increasing the calculated dose from 50.4 ± 1.3 to 54.2 ± 2.6 Gy, an average increase of 7.5% (range 4.0-16.0%). Conclusions: The conventional 3D plans can result in geometric miss and include excess normal tissues. The 4DCT-based plans can reduce the target volumes to spare more normal tissues and allow dose escalation compared with 3D plans

  20. Prenatal diagnosis of congenital heart disease using four-dimensional spatio-temporal image correlation (STIC) telemedicine via an Internet link: a pilot study.

    Science.gov (United States)

    Viñals, F; Mandujano, L; Vargas, G; Giuliano, A

    2005-01-01

    To assess whether the spatio-temporal image correlation (STIC) acquisition technique can be taught to a general obstetrician by e-mail; whether STIC volume datasets can be transmitted over the Internet; and whether STIC volume datasets analyzed offline at a remote setting can be used to confirm or exclude major cardiac defects (TELE-STIC). This was a prospective study involving 50 pregnant women with gestational ages ranging between 20 and 36 weeks. These patients were selected by two general obstetricians (operators) working in geographically remote areas of Chile. Although both obstetricians were users of equipment capable of four-dimensional (4D) ultrasound with STIC, they lacked skill in the performance of fetal cardiac examination. A dedicated web disk was created to upload the acquired volume datasets using an Internet broadband connection. Offline analysis was performed by a single investigator experienced in fetal echocardiography (the administrator). A telemedicine link via the Internet was possible in all cases. Seventy-seven volume datasets were sent to the web server. A complete cardiac examination according to set criteria was achieved by the administrator in 86% of the cases scanned by one operator and 95% of the cases scanned by the other operator. Three patients had cardiac defects confirmed postnatally, two fetuses had extracardiac anomalies and one fetus had a suspected cardiac defect unconfirmed by second-opinion TELE-STIC. There were two isolated major congenital heart defects. Both patients were given advice by e-mail and teleconference using a web camera about the likely outcome and benefits of scheduling in utero transport to a tertiary care center. STIC volumes can be obtained by operators inexperienced in fetal echocardiography, transmitted via the Internet, and their analysis enables recognition of most of the structures and views necessary to assess fetal cardiac anatomy. The preliminary use of TELE-STIC allowed us to demonstrate that

  1. A method for the reconstruction of four-dimensional synchronized CT scans acquired during free breathing

    International Nuclear Information System (INIS)

    Low, Daniel A.; Nystrom, Michelle; Kalinin, Eugene; Parikh, Parag; Dempsey, James F.; Bradley, Jeffrey D.; Mutic, Sasa; Wahab, Sasha H.; Islam, Tareque; Christensen, Gary; Politte, David G.; Whiting, Bruce R.

    2003-01-01

    Breathing motion is a significant source of error in radiotherapy treatment planning for the thorax and upper abdomen. Accounting for breathing motion has a profound effect on the size of conformal radiation portals employed in these sites. Breathing motion also causes artifacts and distortions in treatment planning computed tomography (CT) scans acquired during free breathing and also causes a breakdown of the assumption of the superposition of radiation portals in intensity-modulated radiation therapy, possibly leading to significant dose delivery errors. Proposed voluntary and involuntary breath-hold techniques have the potential for reducing or eliminating the effects of breathing motion, however, they are limited in practice, by the fact that many lung cancer patients cannot tolerate holding their breath. We present an alternative solution to accounting for breathing motion in radiotherapy treatment planning, where multislice CT scans are collected simultaneously with digital spirometry over many free breathing cycles to create a four-dimensional (4-D) image set, where tidal lung volume is the additional dimension. An analysis of this 4-D data leads to methods for digital-spirometry, based elimination or accounting of breathing motion artifacts in radiotherapy treatment planning for free breathing patients. The 4-D image set is generated by sorting free-breathing multislice CT scans according to user-defined tidal-volume bins. A multislice CT scanner is operated in the cine mode, acquiring 15 scans per couch position, while the patient undergoes simultaneous digital-spirometry measurements. The spirometry is used to retrospectively sort the CT scans by their correlated tidal lung volume within the patient's normal breathing cycle. This method has been prototyped using data from three lung cancer patients. The actual tidal lung volumes agreed with the specified bin volumes within standard deviations ranging between 22 and 33 cm 3 . An analysis of sagittal and

  2. Four dimensional digital tomosynthesis using on-board imager for the verification of respiratory motion.

    Directory of Open Access Journals (Sweden)

    Justin C Park

    Full Text Available PURPOSE: To evaluate respiratory motion of a patient by generating four-dimensional digital tomosynthesis (4D DTS, extracting respiratory signal from patients' on-board projection data, and ensuring the feasibility of 4D DTS as a localization tool for the targets which have respiratory movement. METHODS AND MATERIALS: Four patients with lung and liver cancer were included to verify the feasibility of 4D-DTS with an on-board imager. CBCT acquisition (650-670 projections was used to reconstruct 4D DTS images and the breath signal of the patients was generated by extracting the motion of diaphragm during data acquisition. Based on the extracted signal, the projection data was divided into four phases: peak-exhale phase, mid-inhale phase, peak-inhale phase, and mid-exhale phase. The binned projection data was then used to generate 4D DTS, where the total scan angle was assigned as ±22.5° from rotation center, centered on 0° and 180° for coronal "half-fan" 4D DTS, and 90° and 270° for sagittal "half-fan" 4D DTS. The result was then compared with 4D CBCT which we have also generated with the same phase distribution. RESULTS: The motion of the diaphragm was evident from the 4D DTS results for peak-exhale, mid-inhale, peak-inhale and mid-exhale phase assignment which was absent in 3D DTS. Compared to the result of 4D CBCT, the view aliasing effect due to arbitrary angle reconstruction was less severe. In addition, the severity of metal artifacts, the image distortion due to presence of metal, was less than that of the 4D CBCT results. CONCLUSION: We have implemented on-board 4D DTS on patients data to visualize the movement of anatomy due to respiratory motion. The results indicate that 4D-DTS could be a promising alternative to 4D CBCT for acquiring the respiratory motion of internal organs just prior to radiotherapy treatment.

  3. A novel four-dimensional radiotherapy planning strategy from a tumor-tracking beam's eye view

    Science.gov (United States)

    Li, Guang; Cohen, Patrice; Xie, Huchen; Low, Daniel; Li, Diana; Rimner, Andreas

    2012-11-01

    To investigate the feasibility of four-dimensional radiotherapy (4DRT) planning from a tumor-tracking beam's eye view (ttBEV) with reliable gross tumor volume (GTV) delineation, realistic normal tissue representation, high planning accuracy and low clinical workload, we propose and validate a novel 4D conformal planning strategy based on a synthesized 3.5D computed tomographic (3.5DCT) image with a motion-compensated tumor. To recreate patient anatomy from a ttBEV in the moving tumor coordinate system for 4DRT planning (or 4D planning), the centers of delineated GTVs in all phase CT images of 4DCT were aligned, and then the aligned CTs were averaged to produce a new 3.5DCT image. This GTV-motion-compensated CT contains a motionless target (with motion artifacts minimized) and motion-blurred normal tissues (with a realistic temporal density average). Semi-automatic threshold-based segmentation of the tumor, lung and body was applied, while manual delineation was used for other organs at risk (OARs). To validate this 3.5DCT-based 4D planning strategy, five patients with peripheral lung lesions of small size (tumor and a minor beam aperture and weighting adjustment to maintain plan conformality. The dose-volume histogram (DVH) of the 4DCT plan was created with two methods: one is an integrated DVH (iDVH4D), which is defined as the temporal average of all 3D-phase-plan DVHs, and the other (DVH4D) is based on the dose distribution in a reference phase CT image by dose warping from all phase plans using the displacement vector field (DVF) from a free-form deformable image registration (DIR). The DVH3.5D (for the 3.5DCT plan) was compared with both iDVH4D and DVH4D. To quantify the DVH difference between the 3.5DCT plan and the 4DCT plan, two methods were used: relative difference (%) of the areas underneath the DVH curves and the volumes receiving more than 20% (V20) and 50% (V50) of prescribed dose of these 4D plans. The volume of the delineated GTV from different phase

  4. Four-dimensional optical multiband-OFDM for beyond 1.4 Tb/s serial optical transmission.

    Science.gov (United States)

    Djordjevic, Ivan; Batshon, Hussam G; Xu, Lei; Wang, Ting

    2011-01-17

    We propose a four-dimensional (4D) coded multiband-OFDM scheme suitable for beyond 1.4 Tb/s serial optical transport. The proposed scheme organizes the N-dimensional (ND) signal constellation points in the form of signal matrix; employs 2D-inverse FFT and 2D-FFT to perform modulation and demodulation, respectively; and exploits both orthogonal polarizations. This scheme can fully exploit advantages of OFDM to deal with chromatic dispersion, PMD and PDL effects; and multidimensional signal constellations to improve OSNR sensitivity of conventional optical OFDM. The improvement of 4D-OFDM over corresponding polarization-multiplexed QAM (with the same number of constellation points) ranges from 1.79 dB for 16 signal constellation point-four-dimensional-OFDM (16-4D-OFDM) up to 4.53 dB for 128-4D-OFDM.

  5. Monte Carlo Study of Four-Dimensional Self-avoiding Walks of up to One Billion Steps

    Science.gov (United States)

    Clisby, Nathan

    2018-04-01

    We study self-avoiding walks on the four-dimensional hypercubic lattice via Monte Carlo simulations of walks with up to one billion steps. We study the expected logarithmic corrections to scaling, and find convincing evidence in support the scaling form predicted by the renormalization group, with an estimate for the power of the logarithmic factor of 0.2516(14), which is consistent with the predicted value of 1/4. We also characterize the behaviour of the pivot algorithm for sampling four dimensional self-avoiding walks, and conjecture that the probability of a pivot move being successful for an N-step walk is O([ log N ]^{-1/4}).

  6. On the entropy of four-dimensional near-extremal N = 2 black holes with R2-terms

    International Nuclear Information System (INIS)

    Gruss, Eyal; Oz, Yaron

    2007-01-01

    We consider the entropy of four-dimensional near-extremal N = 2 black holes. The Bekenstein-Hawking entropy formula has the structure of the extremal black holes entropy with a shift of the charges depending on the non-extremality parameter and the moduli at infinity. We construct a class of near-extremal horizon solutions with R 2 -terms, and show that the generalized Wald entropy formula exhibits the same property

  7. A Novel Four-Dimensional Energy-Saving and Emission-Reduction System and Its Linear Feedback Control

    Directory of Open Access Journals (Sweden)

    Minggang Wang

    2012-01-01

    Full Text Available This paper reports a new four-dimensional energy-saving and emission-reduction chaotic system. The system is obtained in accordance with the complicated relationship between energy saving and emission reduction, carbon emission, economic growth, and new energy development. The dynamics behavior of the system will be analyzed by means of Lyapunov exponents and equilibrium points. Linear feedback control methods are used to suppress chaos to unstable equilibrium. Numerical simulations are presented to show these results.

  8. Role of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation in detecting fetal pulmonary veins.

    Science.gov (United States)

    Sun, Xue; Zhang, Ying; Fan, Miao; Wang, Yu; Wang, Meilian; Siddiqui, Faiza Amber; Sun, Wei; Sun, Feifei; Zhang, Dongyu; Lei, Wenjia; Hu, Guyue

    2017-06-01

    Prenatal diagnosis of fetal total anomalous pulmonary vein connection (TAPVC) remains challenging for most screening sonographers. The purpose of this study was to evaluate the use of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation (4D-HDFI) in identifying pulmonary veins in normal and TAPVC fetuses. We retrospectively reviewed and performed 4D-HDFI in 204 normal and 12 fetuses with confirmed diagnosis of TAPVC. Cardiac volumes were available for postanalysis to obtain 4D-rendered images of the pulmonary veins. For the normal fetuses, two other traditional modalities including color Doppler and HDFI were used to detect the number of pulmonary veins and comparisons were made between each of these traditional methods and 4D-HDFI. For conventional echocardiography, HDFI modality was superior to color Doppler in detecting more pulmonary veins in normal fetuses throughout the gestational period. 4D-HDFI was the best method during the second trimester of pregnancy in identifying normal fetal pulmonary veins. 4D-HDFI images vividly depicted the figure, course, and drainage of pulmonary veins in both normal and TAPVC fetuses. HDFI and the advanced 4D-HDFI technique could facilitate identification of the anatomical features of pulmonary veins in both normal and TAPVC fetuses; 4D-HDFI therefore provides additional and more precise information than conventional echocardiography techniques. © 2017, Wiley Periodicals, Inc.

  9. Four-dimensional anti-de Sitter toroidal black holes from a three-dimensional perspective: Full complexity

    International Nuclear Information System (INIS)

    Zanchin, Vilson T.; Kleber, Antares; Lemos, Jose P.S.

    2002-01-01

    The dimensional reduction of black hole solutions in four-dimensional (4D) general relativity is performed and new 3D black hole solutions are obtained. Considering a 4D spacetime with one spacelike Killing vector, it is possible to split the Einstein-Hilbert-Maxwell action with a cosmological term in terms of 3D quantities. Definitions of quasilocal mass and charges in 3D spacetimes are reviewed. The analysis is then particularized to the toroidal charged rotating anti-de Sitter black hole. The reinterpretation of the fields and charges in terms of a three-dimensional point of view is given in each case, and the causal structure analyzed

  10. Hemodynamic measurement using four-dimensional phase-contrast MRI: Quantification of hemodynamic parameters and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Ho Jin; Lee, Sang Joon [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang (Korea, Republic of); Kim, Guk Bae; Kweon, Ji Hoon; Kim, Young Hak; Lee, Deok Hee; Yang, Dong Hyun; KIm, Nam Kug [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.

  11. Hemodynamic Measurement Using Four-Dimensional Phase-Contrast MRI: Quantification of Hemodynamic Parameters and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Hojin [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Kim, Guk Bae [Asan Institute of Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Kweon, Jihoon [Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Lee, Sang Joon [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Kim, Young-Hak [Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Lee, Deok Hee; Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Kim, Namkug [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of)

    2016-11-01

    Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.

  12. An accessible four-dimensional treatment of Maxwell's equations in terms of differential forms

    International Nuclear Information System (INIS)

    Sá, Lucas

    2017-01-01

    Maxwell’s equations are derived in terms of differential forms in the four-dimensional Minkowski representation, starting from the three-dimensional vector calculus differential version of these equations. Introducing all the mathematical and physical concepts needed (including the tool of differential forms), using only knowledge of elementary vector calculus and the local vector version of Maxwell’s equations, the equations are reduced to a simple and elegant set of two equations for a unified quantity, the electromagnetic field. The treatment should be accessible for students taking a first course on electromagnetism. (paper)

  13. Motion of particles on a four-dimensional asymptotically AdS black hole with scalar hair

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, P.A.; Olivares, Marco [Universidad Diego Portales, Facultad de Ingenieria, Santiago (Chile); Vasquez, Yerko [Universidad de La Serena, Departamento de Fisica, Facultad de Ciencias, La Serena (Chile)

    2015-10-15

    Motivated by black hole solutions with matter fields outside their horizon, we study the effect of these matter fields on the motion of massless and massive particles. We consider as background a four-dimensional asymptotically AdS black hole with scalar hair. The geodesics are studied numerically and we discuss the differences in the motion of particles between the four-dimensional asymptotically AdS black holes with scalar hair and their no-hair limit, that is, Schwarzschild AdS black holes. Mainly, we found that there are bounded orbits like planetary orbits in this background. However, the periods associated to circular orbits are modified by the presence of the scalar hair. Besides, we found that some classical tests such as perihelion precession, deflection of light, and gravitational time delay have the standard value of general relativity plus a correction term coming from the cosmological constant and the scalar hair. Finally, we found a specific value of the parameter associated to the scalar hair, in order to explain the discrepancy between the theory and the observations, for the perihelion precession of Mercury and light deflection. (orig.)

  14. Quality Assurance Challenges for Motion-Adaptive Radiation Therapy: Gating, Breath Holding, and Four-Dimensional Computed Tomography

    International Nuclear Information System (INIS)

    Jiang, Steve B.; Wolfgang, John; Mageras, Gig S.

    2008-01-01

    Compared with conventional three-dimensional (3D) conformal radiation therapy and intensity-modulated radiation therapy treatments, quality assurance (QA) for motion-adaptive radiation therapy involves various challenges because of the added temporal dimension. Here we discuss those challenges for three specific techniques related to motion-adaptive therapy: namely respiratory gating, breath holding, and four-dimensional computed tomography. Similar to the introduction of any other new technologies in clinical practice, typical QA measures should be taken for these techniques also, including initial testing of equipment and clinical procedures, as well as frequent QA examinations during the early stage of implementation. Here, rather than covering every QA aspect in depth, we focus on some major QA challenges. The biggest QA challenge for gating and breath holding is how to ensure treatment accuracy when internal target position is predicted using external surrogates. Recommended QA measures for each component of treatment, including simulation, planning, patient positioning, and treatment delivery and verification, are discussed. For four-dimensional computed tomography, some major QA challenges have also been discussed

  15. Sensitivity of the model error parameter specification in weak-constraint four-dimensional variational data assimilation

    Science.gov (United States)

    Shaw, Jeremy A.; Daescu, Dacian N.

    2017-08-01

    This article presents the mathematical framework to evaluate the sensitivity of a forecast error aspect to the input parameters of a weak-constraint four-dimensional variational data assimilation system (w4D-Var DAS), extending the established theory from strong-constraint 4D-Var. Emphasis is placed on the derivation of the equations for evaluating the forecast sensitivity to parameters in the DAS representation of the model error statistics, including bias, standard deviation, and correlation structure. A novel adjoint-based procedure for adaptive tuning of the specified model error covariance matrix is introduced. Results from numerical convergence tests establish the validity of the model error sensitivity equations. Preliminary experiments providing a proof-of-concept are performed using the Lorenz multi-scale model to illustrate the theoretical concepts and potential benefits for practical applications.

  16. The Topological Structure of the SU(2) Chern–Simons Topological Current in the Four-Dimensional Quantum Hall Effect

    International Nuclear Information System (INIS)

    Xiu-Ming, Zhang; Yi-Shi, Duan

    2010-01-01

    In the light of the decomposition of the SU(2) gauge potential for I = 1/2, we obtain the SU(2) Chern-Simons current over S 4 , i.e. the vortex current in the effective field for the four-dimensional quantum Hall effect. Similar to the vortex excitations in the two-dimensional quantum Hall effect (2D FQH) which are generated from the zero points of the complex scalar field, in the 4D FQH, we show that the SU(2) Chern–Simons vortices are generated from the zero points of the two-component wave functions Ψ, and their topological charges are quantized in terms of the Hopf indices and Brouwer degrees of φ-mapping under the condition that the zero points of field Ψ are regular points. (condensed matter: electronicstructure, electrical, magnetic, and opticalproperties)

  17. Energy analysis of four dimensional extended hyperbolic Scarf I plus three dimensional separable trigonometric noncentral potentials using SUSY QM approach

    International Nuclear Information System (INIS)

    Suparmi, A.; Cari, C.; Deta, U. A.; Handhika, J.

    2016-01-01

    The non-relativistic energies and wave functions of extended hyperbolic Scarf I plus separable non-central shape invariant potential in four dimensions are investigated using Supersymmetric Quantum Mechanics (SUSY QM) Approach. The three dimensional separable non-central shape invariant angular potential consists of trigonometric Scarf II, Manning Rosen and Poschl-Teller potentials. The four dimensional Schrodinger equation with separable shape invariant non-central potential is reduced into four one dimensional Schrodinger equations through variable separation method. By using SUSY QM, the non-relativistic energies and radial wave functions are obtained from radial Schrodinger equation, the orbital quantum numbers and angular wave functions are obtained from angular Schrodinger equations. The extended potential means there is perturbation terms in potential and cause the decrease in energy spectra of Scarf I potential. (paper)

  18. The study of two, three and four dimensional nonlinear dynamics of nuclear fission reactors and effective parameters on its behaviour

    International Nuclear Information System (INIS)

    Tajik, M.; Ghasemizad, A.

    2008-01-01

    In this research, new physical fission reactor parameters which have very sensitive effects on the qualitative behavior of a reactor, are introduced. Therefore, the two, the nonlinear dynamics of two, three and four dimensional, considering almost the effective parameters are formulated for describing nuclear fission reactor systems. Using both analytical and numerical methods, the stability and instability of the given dynamical equations and the conditions of stability are studied in these systems. We have shown that the two parameters of the mean energy residence time in fuel and coolant and also their ratios have the most qualitative effects on the dynamical behaviour of a typical nuclear fission reactor. Increasing or decreasing of these parameters from a captain limit can lead to stability or un stability in a given system

  19. Four-dimensional symmetry from a broad viewpoint. II Invariant distribution of quantized field oscillators and questions on infinities

    Science.gov (United States)

    Hsu, J. P.

    1983-01-01

    The foundation of the quantum field theory is changed by introducing a new universal probability principle into field operators: one single inherent and invariant probability distribution P(/k/) is postulated for boson and fermion field oscillators. This can be accomplished only when one treats the four-dimensional symmetry from a broad viewpoint. Special relativity is too restrictive to allow such a universal probability principle. A radical length, R, appears in physics through the probability distribution P(/k/). The force between two point particles vanishes when their relative distance tends to zero. This appears to be a general property for all forces and resembles the property of asymptotic freedom. The usual infinities in vacuum fluctuations and in local interactions, however complicated they may be, are all removed from quantum field theories. In appendix A a simple finite and unitary theory of unified electroweak interactions is discussed without assuming Higgs scalar bosons.

  20. Boson-fermion mass splittings in four-dimensional heterotic string models with anomalous U(1) gauge groups

    International Nuclear Information System (INIS)

    Yamaguchi, Masahiro; Yamamoto, Hisashi; Onogi, Tetsuya

    1989-01-01

    In four-dimensional heterotic string models with anomalous U(1) gauge groups, space-time supersymmetry (SUSY) breaks down spontaneously at one loop. In this paper, the Ward-Takahashi identity of broken SUSY in one-loop two-point amplitudes is investigated in all generalities. The boson-fermion mass splitting of any supersymmetric pair in an arbitrary model is proportional to the product of the D-term expectation value (the sum of (chirality)x(U(1) charge) of massless fermions in the model) and the U(1) charge of the external particle. In order to give a better understanding of the results, we present some examples of the mass splittings in a simple Z 3 orbifold model. (orig.)

  1. Use of Respiratory-Correlated Four-Dimensional Computed Tomography to Determine Acceptable Treatment Margins for Locally Advanced Pancreatic Adenocarcinoma

    International Nuclear Information System (INIS)

    Goldstein, Seth D.; Ford, Eric C.; Duhon, Mario; McNutt, Todd; Wong, John; Herman, Joseph M.

    2010-01-01

    Purpose: Respiratory-induced excursions of locally advanced pancreatic adenocarcinoma could affect dose delivery. This study quantified tumor motion and evaluated standard treatment margins. Methods and Materials: Respiratory-correlated four-dimensional computed tomography images were obtained on 30 patients with locally advanced pancreatic adenocarcinoma; 15 of whom underwent repeat scanning before cone-down treatment. Treatment planning software was used to contour the gross tumor volume (GTV), bilateral kidneys, and biliary stent. Excursions were calculated according to the centroid of the contoured volumes. Results: The mean ± standard deviation GTV excursion in the superoinferior (SI) direction was 0.55 ± 0.23 cm; an expansion of 1.0 cm adequately accounted for the GTV motion in 97% of locally advanced pancreatic adenocarcinoma patients. Motion GTVs were generated and resulted in a 25% average volume increase compared with the static GTV. Of the 30 patients, 17 had biliary stents. The mean SI stent excursion was 0.84 ± 0.32 cm, significantly greater than the GTV motion. The xiphoid process moved an average of 0.35 ± 0.12 cm, significantly less than the GTV. The mean SI motion of the left and right kidneys was 0.65 ± 0.27 cm and 0.77 ± 0.30 cm, respectively. At repeat scanning, no significant changes were seen in the mean GTV size (p = .8) or excursion (p = .3). Conclusion: These data suggest that an asymmetric expansion of 1.0, 0.7, and 0.6 cm along the respective SI, anteroposterior, and medial-lateral directions is recommended if a respiratory-correlated four-dimensional computed tomography scan is not available to evaluate the tumor motion during treatment planning. Surrogates of tumor motion, such as biliary stents or external markers, should be used with caution.

  2. Four-dimensional CT-based evaluation of volumetric modulated arc therapy for abdominal lymph node metastasis from hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Zhang Li; Xi Mian; Deng Xiaowu; Li Qiaoqiao; Huang Xiaoyan; Liu Mengzhong

    2012-01-01

    This study aimed to identify the potential benefits and limitations of a new volumetric modulated arc therapy (VMAT) planning system in Monaco, compared with conventional intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Four-dimensional CT scans of 13 patients with abdominal lymph node metastasis from hepatocellular carcinoma were selected. Internal target volume was defined as the combined volume of clinical target volumes (CTVs) in the multiple four-dimensional computed tomography (4DCT) phases. Dose prescription was set to 45 Gy for the planning target volume (PTV) in daily 3.0-Gy fractions. The PTV dose coverage, organs at risk (OAR) doses, delivery parameters and treatment accuracy were assessed. Compared with 3DCRT, both VMAT and IMRT provided a systematic improvement in PTV coverage and homogeneity. Planning objectives were not fulfilled for the right kidney, in which the 3DCRT plans exceeded the dose constraints in two patients. Equivalent target coverage and sparing of OARs were achieved with VMAT compared with IMRT. The number of MU/fraction was 462±68 (3DCRT), 564±105 (IMRT) and 601±134 (VMAT), respectively. Effective treatment times were as follows: 1.8±0.2 min (3DCRT), 6.1±1.5 min (IMRT) and 4.8±1.0 min (VMAT). This study suggests that the VMAT plans generated in Monaco improved delivery efficiency for equivalent dosimetric quality to IMRT, and were superior to 3DCRT in target coverage and sparing of most OARs. However, the superiority of VMAT over IMRT in delivery efficiency is limited. (author)

  3. Investigation of four-dimensional computed tomography-based pulmonary ventilation imaging in patients with emphysematous lung regions

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Tokihiro; Loo, Billy W Jr; Keall, Paul J [Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Dr, Stanford, CA 94305-5847 (United States); Kabus, Sven; Lorenz, Cristian; Von Berg, Jens; Blaffert, Thomas [Department of Digital Imaging, Philips Research Europe, Roentgenstrasse 24-26, D-22335 Hamburg (Germany); Klinder, Tobias, E-mail: Tokihiro@stanford.edu [Clinical Informatics, Interventional, and Translational Solutions, Philips Research North America, Briarcliff Manor, NY 10510 (United States)

    2011-04-07

    A pulmonary ventilation imaging technique based on four-dimensional (4D) computed tomography (CT) has advantages over existing techniques. However, physiologically accurate 4D-CT ventilation imaging has not been achieved in patients. The purpose of this study was to evaluate 4D-CT ventilation imaging by correlating ventilation with emphysema. Emphysematous lung regions are less ventilated and can be used as surrogates for low ventilation. We tested the hypothesis: 4D-CT ventilation in emphysematous lung regions is significantly lower than in non-emphysematous regions. Four-dimensional CT ventilation images were created for 12 patients with emphysematous lung regions as observed on CT, using a total of four combinations of two deformable image registration (DIR) algorithms: surface-based (DIR{sup sur}) and volumetric (DIR{sup vol}), and two metrics: Hounsfield unit (HU) change (V{sub HU}) and Jacobian determinant of deformation (V{sub Jac}), yielding four ventilation image sets per patient. Emphysematous lung regions were detected by density masking. We tested our hypothesis using the one-tailed t-test. Visually, different DIR algorithms and metrics yielded spatially variant 4D-CT ventilation images. The mean ventilation values in emphysematous lung regions were consistently lower than in non-emphysematous regions for all the combinations of DIR algorithms and metrics. V{sub HU} resulted in statistically significant differences for both DIR{sup sur} (0.14 {+-} 0.14 versus 0.29 {+-} 0.16, p = 0.01) and DIR{sup vol} (0.13 {+-} 0.13 versus 0.27 {+-} 0.15, p < 0.01). However, V{sub Jac} resulted in non-significant differences for both DIR{sup sur} (0.15 {+-} 0.07 versus 0.17 {+-} 0.08, p = 0.20) and DIR{sup vol} (0.17 {+-} 0.08 versus 0.19 {+-} 0.09, p = 0.30). This study demonstrated the strong correlation between the HU-based 4D-CT ventilation and emphysema, which indicates the potential for HU-based 4D-CT ventilation imaging to achieve high physiologic accuracy. A

  4. Four-dimensional volume-of-interest reconstruction for cone-beam computed tomography-guided radiation therapy.

    Science.gov (United States)

    Ahmad, Moiz; Balter, Peter; Pan, Tinsu

    2011-10-01

    Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstruction and the McKinnon-Bates (MB) reconstruction algorithms. Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction shows a motion blur of 13 mm

  5. Curvature invariant characterization of event horizons of four-dimensional black holes conformal to stationary black holes

    Science.gov (United States)

    McNutt, David D.

    2017-11-01

    We introduce three approaches to generate curvature invariants that transform covariantly under a conformal transformation of a four-dimensional spacetime. For any black hole conformally related to a stationary black hole, we show how a set of conformally covariant invariants can be combined to produce a conformally covariant invariant that detects the event horizon of the conformally related black hole. As an application we consider the rotating dynamical black holes conformally related to the Kerr-Newman-Unti-Tamburino-(anti)-de Sitter spacetimes and construct an invariant that detects the conformal Killing horizon along with a second invariant that detects the conformal stationary limit surface. In addition, we present necessary conditions for a dynamical black hole to be conformally related to a stationary black hole and apply these conditions to the ingoing Kerr-Vaidya and Vaidya black hole solutions to determine if they are conformally related to stationary black holes for particular choices of the mass function. While two of the three approaches cannot be generalized to higher dimensions, we discuss the existence of a conformally covariant invariant that will detect the event horizon for any higher dimensional black hole conformally related to a stationary black hole which admits at least two conformally covariant invariants, including all vacuum spacetimes.

  6. Comparison of Volumes between Four-Dimensional Computed Tomography and Cone-Beam Computed Tomography Images using Dynamic Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Eun; Won, Hui Su; Hong, Joo Wan; Chang, Nam Jun; Jung, Woo Hyun; Choi, Byeong Don [Dept. of Radiation Oncology, Seoul National University Bundang Hospital, Sungnam (Korea, Republic of)

    2016-12-15

    The aim of this study was to compare the differences between the volumes acquired with four-dimensional computed tomography (4DCT)images with a reconstruction image-filtering algorithm and cone-beam computed tomography (CBCT) images with dynamic phantom. The 4DCT images were obtained from the computerized imaging reference systems (CIRS) phantom using a computed tomography (CT) simulator. We analyzed the volumes for maximum intensity projection (MIP), minimum intensity projection (MinIP) and average intensity projection (AVG) of the images obtained with the 4DCT scanner against those acquired from CBCT images with CT ranger tools. Difference in volume for node of 1, 2 and 3 cm between CBCT and 4DCT was 0.54⁓2.33, 5.16⁓8.06, 9.03⁓20.11 ml in MIP, respectively, 0.00⁓1.48, 0.00⁓8.47, 1.42⁓24.85 ml in MinIP, respectively and 0.00⁓1.17, 0.00⁓2.19, 0.04⁓3.35 ml in AVG, respectively. After a comparative analysis of the volumes for each nodal size, it was apparent that the CBCT images were similar to the AVG images acquired using 4DCT.

  7. Gross tumor volume dependency on phase sorting methods of four-dimensional computed tomography images for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Yong; Lim, Sang Wook; Ma, Sun Young; Yu, Je Sang [Dept. of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

    2017-09-15

    To see the gross tumor volume (GTV) dependency according to the phase selection and reconstruction methods, we measured and analyzed the changes of tumor volume and motion at each phase in 20 cases with lung cancer patients who underwent image-guided radiotherapy. We retrospectively analyzed four-dimensional computed tomography (4D-CT) images in 20 cases of 19 patients who underwent image-guided radiotherapy. The 4D-CT images were reconstructed by the maximum intensity projection (MIP) and the minimum intensity projection (Min-IP) method after sorting phase as 40%–60%, 30%–70%, and 0%–90%. We analyzed the relationship between the range of motion and the change of GTV according to the reconstruction method. The motion ranges of GTVs are statistically significant only for the tumor motion in craniocaudal direction. The discrepancies of GTV volume and motion between MIP and Min-IP increased rapidly as the wider ranges of duty cycles are selected. As narrow as possible duty cycle such as 40%–60% and MIP reconstruction was suitable for lung cancer if the respiration was stable. Selecting the reconstruction methods and duty cycle is important for small size and for large motion range tumors.

  8. Differences in abdominal organ movement between supine and prone positions measured using four-dimensional computed tomography

    International Nuclear Information System (INIS)

    Kim, Young Seok; Park, Sung Ho; Ahn, Seung Do; Lee, Jeong Eun; Choi, Eun Kyung; Lee, Sang-wook; Shin, Seong Soo; Yoon, Sang Min; Kim, Jong Hoon

    2007-01-01

    Background and purpose: To analyze the differences in intrafractional organ movement throughout the breathing cycles between the supine and prone positions using four-dimensional computed tomography (4D CT). Materials and methods: We performed 4D CT on nine volunteers in the supine and prone positions, with each examinee asked to breathe normally during scanning. The movement of abdominal organs in the cranio-caudal (CC), anterior-posterior (AP) and right-left (RL) directions was quantified by contouring on each phase between inspiration and expiration. Results: The mean intrafractional motions of the hepatic dome, lower tip, pancreatic head and tail, both kidneys, spleen, and celiac axis in the supine/prone position were 17.3/13.0, 14.4/11.0, 12.8/8.9, 13.0/10.0, 14.3/12.1, 12.3/12.6, 11.7/12.6 and 2.2/1.8 mm, respectively. Intrafractional movements of the liver dome and pancreatic head were reduced significantly in the prone position. The CC directional excursions were major determinants of the 3D displacements of the abdominal organs. Alteration from the supine to the prone position did not change the amount of intrafractional movements of kidneys, spleen, and celiac axis. Conclusion: There was a significant reduction in the movements of the liver and pancreas during the prone position, especially in the CC direction, suggesting possible advantage of radiotherapy to these organs in this position

  9. Evaluation of four-dimensional nonbinary LDPC-coded modulation for next-generation long-haul optical transport networks.

    Science.gov (United States)

    Zhang, Yequn; Arabaci, Murat; Djordjevic, Ivan B

    2012-04-09

    Leveraging the advanced coherent optical communication technologies, this paper explores the feasibility of using four-dimensional (4D) nonbinary LDPC-coded modulation (4D-NB-LDPC-CM) schemes for long-haul transmission in future optical transport networks. In contrast to our previous works on 4D-NB-LDPC-CM which considered amplified spontaneous emission (ASE) noise as the dominant impairment, this paper undertakes transmission in a more realistic optical fiber transmission environment, taking into account impairments due to dispersion effects, nonlinear phase noise, Kerr nonlinearities, and stimulated Raman scattering in addition to ASE noise. We first reveal the advantages of using 4D modulation formats in LDPC-coded modulation instead of conventional two-dimensional (2D) modulation formats used with polarization-division multiplexing (PDM). Then we demonstrate that 4D LDPC-coded modulation schemes with nonbinary LDPC component codes significantly outperform not only their conventional PDM-2D counterparts but also the corresponding 4D bit-interleaved LDPC-coded modulation (4D-BI-LDPC-CM) schemes, which employ binary LDPC codes as component codes. We also show that the transmission reach improvement offered by the 4D-NB-LDPC-CM over 4D-BI-LDPC-CM increases as the underlying constellation size and hence the spectral efficiency of transmission increases. Our results suggest that 4D-NB-LDPC-CM can be an excellent candidate for long-haul transmission in next-generation optical networks.

  10. Tailoring four-dimensional cone-beam CT acquisition settings for fiducial marker-based image guidance in radiation therapy.

    Science.gov (United States)

    Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C C M; Bel, Arjan; Alderliesten, Tanja

    2018-04-01

    Use of four-dimensional cone-beam CT (4D-CBCT) and fiducial markers for image guidance during radiation therapy (RT) of mobile tumors is challenging due to the trade-off among image quality, imaging dose, and scanning time. This study aimed to investigate different 4D-CBCT acquisition settings for good visibility of fiducial markers in 4D-CBCT. Using these 4D-CBCTs, the feasibility of marker-based 4D registration for RT setup verification and manual respiration-induced motion quantification was investigated. For this, we applied a dynamic phantom with three different breathing motion amplitudes and included two patients with implanted markers. Irrespective of the motion amplitude, for a medium field of view (FOV), marker visibility was improved by reducing the imaging dose per projection and increasing the number of projection images; however, the scanning time was 4 to 8 min. For a small FOV, the total imaging dose and the scanning time were reduced (62.5% of the dose using a medium FOV, 2.5 min) without losing marker visibility. However, the body contour could be missing for a small FOV, which is not preferred in RT. The marker-based 4D setup verification was feasible for both the phantom and patient data. Moreover, manual marker motion quantification can achieve a high accuracy with a mean error of [Formula: see text].

  11. Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery.

    Science.gov (United States)

    Carrasco-Zevallos, Oscar M; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Seider, Michael I; Izatt, Joseph A; Toth, Cynthia A

    2016-07-01

    Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions.

  12. Inflow hemodynamics evaluated by using four-dimensional flow magnetic resonance imaging and the size ratio of unruptured cerebral aneurysms

    International Nuclear Information System (INIS)

    Futami, Kazuya; Nambu, Iku; Kitabayashi, Tomohiro; Sano, Hiroki; Misaki, Kouichi; Uchiyama, Naoyuki; Nakada, Mitsutoshi

    2017-01-01

    Prediction of the rupture risk is critical for the identification of unruptured cerebral aneurysms (UCAs) eligible for invasive treatments. The size ratio (SR) is a strong morphological predictor for rupture. We investigated the relationship between the inflow hemodynamics evaluated on four-dimensional (4D) flow magnetic resonance (MR) imaging and the SR to identify specific characteristics related to UCA rupture. We evaluated the inflow jet patterns and inflow hemodynamic parameters of 70 UCAs on 4D flow MR imaging and compared them among 23 aneurysms with an SR ≥2.1 and 47 aneurysms with an SR ≤2.0. Based on the shape of inflow streamline bundles with a velocity ≥75% of the maximum flow velocity in the parent artery, the inflow jet patterns were classified as concentrated (C), diffuse (D), neck-limited (N), and unvisualized (U). The incidence of patterns C and N was significantly higher in aneurysms with an SR ≥2.1. The rate of pattern U was significantly higher in aneurysms with an SR ≤2.0. The maximum inflow rate and the inflow rate ratio were significantly higher in aneurysms with an SR ≥2.1. The SR affected the inflow jet pattern, the maximum inflow rate, and the inflow rate ratio of UCAs. In conjunction with the SR, inflow hemodynamic analysis using 4D flow MR imaging may contribute to the risk stratification for aneurysmal rupture. (orig.)

  13. Inflow hemodynamics evaluated by using four-dimensional flow magnetic resonance imaging and the size ratio of unruptured cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Futami, Kazuya [Matto-Ishikawa Central Hospital, Department of Neurosurgery, Hakusan, Ishikawa (Japan); Nambu, Iku; Kitabayashi, Tomohiro; Sano, Hiroki; Misaki, Kouichi; Uchiyama, Naoyuki; Nakada, Mitsutoshi [Kanazawa University School of Medicine, Department of Neurosurgery, Kanazawa, Ishikawa (Japan)

    2017-04-15

    Prediction of the rupture risk is critical for the identification of unruptured cerebral aneurysms (UCAs) eligible for invasive treatments. The size ratio (SR) is a strong morphological predictor for rupture. We investigated the relationship between the inflow hemodynamics evaluated on four-dimensional (4D) flow magnetic resonance (MR) imaging and the SR to identify specific characteristics related to UCA rupture. We evaluated the inflow jet patterns and inflow hemodynamic parameters of 70 UCAs on 4D flow MR imaging and compared them among 23 aneurysms with an SR ≥2.1 and 47 aneurysms with an SR ≤2.0. Based on the shape of inflow streamline bundles with a velocity ≥75% of the maximum flow velocity in the parent artery, the inflow jet patterns were classified as concentrated (C), diffuse (D), neck-limited (N), and unvisualized (U). The incidence of patterns C and N was significantly higher in aneurysms with an SR ≥2.1. The rate of pattern U was significantly higher in aneurysms with an SR ≤2.0. The maximum inflow rate and the inflow rate ratio were significantly higher in aneurysms with an SR ≥2.1. The SR affected the inflow jet pattern, the maximum inflow rate, and the inflow rate ratio of UCAs. In conjunction with the SR, inflow hemodynamic analysis using 4D flow MR imaging may contribute to the risk stratification for aneurysmal rupture. (orig.)

  14. Four-dimensional variational data assimilation for inverse modelling of atmospheric methane emissions: method and comparison with synthesis inversion

    Directory of Open Access Journals (Sweden)

    J. F. Meirink

    2008-11-01

    Full Text Available A four-dimensional variational (4D-Var data assimilation system for inverse modelling of atmospheric methane emissions is presented. The system is based on the TM5 atmospheric transport model. It can be used for assimilating large volumes of measurements, in particular satellite observations and quasi-continuous in-situ observations, and at the same time it enables the optimization of a large number of model parameters, specifically grid-scale emission rates. Furthermore, the variational method allows to estimate uncertainties in posterior emissions. Here, the system is applied to optimize monthly methane emissions over a 1-year time window on the basis of surface observations from the NOAA-ESRL network. The results are rigorously compared with an analogous inversion by Bergamaschi et al. (2007, which was based on the traditional synthesis approach. The posterior emissions as well as their uncertainties obtained in both inversions show a high degree of consistency. At the same time we illustrate the advantage of 4D-Var in reducing aggregation errors by optimizing emissions at the grid scale of the transport model. The full potential of the assimilation system is exploited in Meirink et al. (2008, who use satellite observations of column-averaged methane mixing ratios to optimize emissions at high spatial resolution, taking advantage of the zooming capability of the TM5 model.

  15. Four-dimensional echocardiography area strain combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis.

    Science.gov (United States)

    Deng, Yan; Peng, Long; Liu, Yuan-Yuan; Yin, Li-Xue; Li, Chun-Mei; Wang, Yi; Rao, Li

    2017-09-01

    The aim of this prospective study was to assess the diagnosis value of four-dimensional echocardiography area strain (AS) combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis. Based on treadmill exercise load status, two-dimensional conventional echocardiography and four-dimensional echocardiography area strain were performed on patients suspected coronary artery disease before coronary angiogram. Thirty patients (case group) with mild left anterior descending coronary artery stenosis (stenosis Four-dimensional echocardiography area strain combined with exercise stress echocardiography could sensitively find left ventricular regional systolic function abnormality in patients with mild single vessel coronary artery stenosis, and locate stenosis coronary artery accordingly. © 2017, Wiley Periodicals, Inc.

  16. Efficient approach for determining four-dimensional computed tomography-based internal target volume in stereotactic radiotherapy of lung cancer

    International Nuclear Information System (INIS)

    Yeo, Seung Gu; Kim, Eun Seog

    2013-01-01

    This study aimed to investigate efficient approaches for determining internal target volume (ITV) from four-dimensional computed tomography (4D CT) images used in stereotactic body radiotherapy (SBRT) for patients with early-stage non-small cell lung cancer (NSCLC). 4D CT images were analyzed for 15 patients who received SBRT for stage I NSCLC. Three different ITVs were determined as follows: combining clinical target volume (CTV) from all 10 respiratory phases (ITV 10Phases ); combining CTV from four respiratory phases, including two extreme phases (0% and 50%) plus two intermediate phases (20% and 70%) (ITV 4Phases ); and combining CTV from two extreme phases (ITV 2Phases ). The matching index (MI) of ITV 4Phases and ITV 2Phases was defined as the ratio of ITV 4Phases and ITV 2Phases , respectively, to the ITV 10Phases . The tumor motion index (TMI) was defined as the ratio of ITV 10Phases to CTV mean , which was the mean of 10 CTVs delineated on 10 respiratory phases. The ITVs were significantly different in the order of ITV 10Phases , ITV 4Phases , and ITV 2Phases (all p 4Phases was significantly higher than that of ITV 2Phases (p 4Phases was inversely related to TMI (r = -0.569, p = 0.034). In a subgroup with low TMI (n = 7), ITV 4Phases was not statistically different from ITV 10Phases (p = 0.192) and its MI was significantly higher than that of ITV 2Phases (p = 0.016). The ITV 4Phases may be an efficient approach alternative to optimal ITV 10Phases in SBRT for early-stage NSCLC with less tumor motion.

  17. A correlation study on position and volume variation of primary lung cancer during respiration by four-dimensional CT

    International Nuclear Information System (INIS)

    Zhang Yingjie; Li Jianbin; Tian Shiyu; Li Fengxiang; Fan Tingyong; Shao Qian; Xu Min; Lu Jie

    2011-01-01

    Objective: To investigate the correlation of position movement of primary tumor with interested organs and skin markers, and to investigate the correlation of volume variation of primary tumors and lungs during different respiration phases for patients with lung cancer at free breath condition scanned by four-dimensional CT (4DCT) simulation. Methods: 16 patients with lung cancer were scanned at free breath condition by simulation 4DCT which connected to a respiration-monitoring system. A coordinate system was created based on image of T 5 phase,gross tumor volume (GTV) and normal tissue structures of 10 phases were contoured. The three dimensional position variation of them were measured and their correlation were analyzed, and the same for the volume variation of GTV and lungs of 10 respiratory phases. Results: Movement range of lung cancer in different lobe differed extinct: 0.8 - 5.0 mm in upper lobe, 5.7 -5.9 mm in middle lobe and 10.2 - 13.7 mm in lower lobe, respectively. Movement range of lung cancer in three dimensional direction was different: z-axis 4.3 mm ± 4.3 mm > y-axis 2.2 mm ± 1.0 mm > x-axis 1.7 mm ± 1.5 mm (χ 2 =16.22, P =0.000), respectively. There was no statistical significant correlation for movement vector of GTV and interested structures (r =-0.50 - -0.01, P =0.058 - -0.961), nor for volume variation of tumor and lung (r =0.23, P =0.520). Conclusions: Based on 4DCT, statistically significant differences of GTV centroid movement are observed at different pulmonary lobes and in three dimensional directions. So individual 4DCT measurement is necessary for definition of internal target volume margin for lung cancer. (authors)

  18. Quantification of Mediastinal and Hilar Lymph Node Movement Using Four-Dimensional Computed Tomography Scan: Implications for Radiation Treatment Planning

    International Nuclear Information System (INIS)

    Sher, David J.; Wolfgang, John A.; Niemierko, Andrzej; Choi, Noah C.

    2007-01-01

    Purpose: To quantitatively describe mediastinal and hilar lymph node movement in patients with lymph node-positive lung cancer. Methods and Materials: Twenty-four patients with lung cancer who underwent four-dimensional computed tomography scanning at Massachusetts General Hospital were included in the study. The maximum extent of superior motion of the superior border was measured, as well as the maximum inferior movement of the inferior border. The average of these two values is defined as the peak-to-peak movement. This process was repeated for mediolateral (ML) and anterior-posterior (AP) movement. Linear regression was used to determine lymph node characteristics associated with peak-to-peak movement. Various uniform expansions were investigated to determine the expansion margins necessary to ensure complete internal target volume (ITV) coverage. Results: The mean peak-to-peak displacements of paratracheal lymph nodes were 4 mm (craniocaudal [CC]), 2 mm (ML), and 2 mm (AP). For subcarinal lymph nodes, the mean peak-to-peak movements were 6 mm (CC), 4 mm (ML), and 2 mm (AP). The mean peak-to-peak displacements of hilar lymph nodes were 7 mm (CC), 1 mm (ML), and 4 mm (AP). On multivariate analysis, lymph node station and lymph node size were significantly related to peak-to-peak movement. Expansions of 8 mm for paratracheal nodes and 13 mm for subcarinal and hilar nodes would have been necessary to cover the ITV of 95% of these nodal masses. Conclusions: Subcarinal and hilar lymph nodes may move substantially throughout the respiratory cycle. In the absence of patient-specific information on nodal motion, expansions of at least 8 mm, 13 mm, and 13 mm should be considered to cover the ITV of paratracheal, subcarinal, and hilar lymph nodes, respectively

  19. A four-dimensional motion field atlas of the tongue from tagged and cine magnetic resonance imaging

    Science.gov (United States)

    Xing, Fangxu; Prince, Jerry L.; Stone, Maureen; Wedeen, Van J.; El Fakhri, Georges; Woo, Jonghye

    2017-02-01

    Representation of human tongue motion using three-dimensional vector fields over time can be used to better understand tongue function during speech, swallowing, and other lingual behaviors. To characterize the inter-subject variability of the tongue's shape and motion of a population carrying out one of these functions it is desirable to build a statistical model of the four-dimensional (4D) tongue. In this paper, we propose a method to construct a spatio-temporal atlas of tongue motion using magnetic resonance (MR) images acquired from fourteen healthy human subjects. First, cine MR images revealing the anatomical features of the tongue are used to construct a 4D intensity image atlas. Second, tagged MR images acquired to capture internal motion are used to compute a dense motion field at each time frame using a phase-based motion tracking method. Third, motion fields from each subject are pulled back to the cine atlas space using the deformation fields computed during the cine atlas construction. Finally, a spatio-temporal motion field atlas is created to show a sequence of mean motion fields and their inter-subject variation. The quality of the atlas was evaluated by deforming cine images in the atlas space. Comparison between deformed and original cine images showed high correspondence. The proposed method provides a quantitative representation to observe the commonality and variability of the tongue motion field for the first time, and shows potential in evaluation of common properties such as strains and other tensors based on motion fields.

  20. Estimation of emission adjustments from the application of four-dimensional data assimilation to photochemical air quality modeling

    International Nuclear Information System (INIS)

    Mendoza-Dominguez, A.; Russell, A.G.

    2001-01-01

    Four-dimensional data assimilation applied to photochemical air quality modeling is used to suggest adjustments to the emissions inventory of the Atlanta, Georgia metropolitan area. In this approach, a three-dimensional air quality model, coupled with direct sensitivity analysis, develops spatially and temporally varying concentration and sensitivity fields that account for chemical and physical processing, and receptor analysis is used to adjust source strengths. Proposed changes to domain-wide NO x , volatile organic compounds (VOCs) and CO emissions from anthropogenic sources and for VOC emissions from biogenic sources were estimated, as well as modifications to sources based on their spatial location (urban vs. rural areas). In general, domain-wide anthropogenic VOC emissions were increased approximately two times their base case level to best match observations, domain-wide anthropogenic NO x and biogenic VOC emissions (BEIS2 estimates) remained close to their base case value and domain-wide CO emissions were decreased. Adjustments for anthropogenic NO x emissions increased their level of uncertainty when adjustments were computed for mobile and area sources (or urban and rural sources) separately, due in part to the poor spatial resolution of the observation field of nitrogen-containing species. Estimated changes to CO emissions also suffer from poor spatial resolution of the measurements. Results suggest that rural anthropogenic VOC emissions appear to be severely underpredicted. The FDDA approach was also used to investigate the speciation profiles of VOC emissions, and results warrant revision of these profiles. In general, the results obtained here are consistent with what are viewed as the current deficiencies in emissions inventories as derived by other top-down techniques, such as tunnel studies and analysis of ambient measurements. (Author)

  1. Quantification of respiration-induced esophageal tumor motion using fiducial markers and four-dimensional computed tomography.

    Science.gov (United States)

    Jin, Peng; Hulshof, Maarten C C M; de Jong, Rianne; van Hooft, Jeanin E; Bel, Arjan; Alderliesten, Tanja

    2016-03-01

    Respiration-induced tumor motion is an important geometrical uncertainty in esophageal cancer radiation therapy. The aim of this study was to quantify this motion using fiducial markers and four-dimensional computed tomography (4DCT). Twenty esophageal cancer patients underwent endoscopy-guided marker implantation in the tumor volume and 4DCT acquisition. The 4DCT data were sorted into 10 breathing phases and the end-of-inhalation phase was selected as reference. We quantified for each visible marker (n=60) the motion in each phase and derived the peak-to-peak motion magnitude throughout the breathing cycle. The motion was quantified and analyzed for four different regions and in three orthogonal directions. The median(interquartile range) of the peak-to-peak magnitudes of the respiration-induced marker motion (left-right/anterior-posterior/cranial-caudal) was 1.5(0.5)/1.6(0.5)/2.9(1.4) mm for the proximal esophagus (n=6), 1.5(1.4)/1.4(1.3)/3.7(2.6) mm for the middle esophagus (n=12), 2.6(1.3)/3.3(1.8)/5.4(2.9) mm for the distal esophagus (n=25), and 3.7(2.1)/5.3(1.8)/8.2(3.1) mm for the proximal stomach (n=17). The variations in the results between the three directions, four regions, and patients suggest the need of individualized region-dependent anisotropic internal margins. Therefore, we recommend using markers with 4DCT to patient-specifically adapt the internal target volume (ITV). Without 4DCT, 3DCTs at the end-of-inhalation and end-of-exhalation phases could be alternatively applied for ITV individualization. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Correlation of primary middle and distal esophageal cancers motion with surrounding tissues using four-dimensional computed tomography.

    Science.gov (United States)

    Wang, Wei; Li, Jianbin; Zhang, Yingjie; Shao, Qian; Xu, Min; Guo, Bing; Shang, Dongping

    2016-01-01

    To investigate the correlation of gross tumor volume (GTV) motion with the structure of interest (SOI) motion and volume variation for middle and distal esophageal cancers using four-dimensional computed tomography (4DCT). Thirty-three patients with middle or distal esophageal carcinoma underwent 4DCT simulation scan during free breathing. All image sets were registered with 0% phase, and the GTV, apex of diaphragm, lung, and heart were delineated on each phase of the 4DCT data. The position of GTV and SOI was identified in all 4DCT phases, and the volume of lung and heart was also achieved. The phase relationship between the GTV and SOI was estimated through Pearson's correlation test. The mean peak-to-peak displacement of all primary tumors in the lateral (LR), anteroposterior (AP), and superoinferior (SI) directions was 0.13 cm, 0.20 cm, and 0.30 cm, respectively. The SI peak-to-peak motion of the GTV was defined as the greatest magnitude of motion. The displacement of GTV correlated well with heart in three dimensions and significantly associated with bilateral lung in LR and SI directions. A significant correlation was found between the GTV and apex of the diaphragm in SI direction (r left=0.918 and r right=0.928). A significant inverse correlation was found between GTV motion and varying lung volume, but the correlation was not significant with heart (r LR=-0.530, r AP=-0.531, and r SI=-0.588) during respiratory cycle. For middle and distal esophageal cancers, GTV should expand asymmetric internal margins. The primary tumor motion has quite good correlation with diaphragm, heart, and lung.

  3. TH-E-17A-05: Optimizing Four Dimensional Cone Beam Computed Tomography Projection Allocation to Respiratory Bins

    International Nuclear Information System (INIS)

    OBrien, R; Shieh, C; Kipritidis, J; Keall, P

    2014-01-01

    Purpose: Four dimensional cone beam computed tomography (4DCBCT) is an emerging image guidance strategy but it can suffer from poor image quality. To avoid repeating scans it is beneficial to make the best use of the imaging data obtained. For conventional 4DCBCT the location and size of respiratory bins is fixed and projections are allocated to the respiratory bin within which it falls. Strictly adhering to this rule is unnecessary and can compromise image quality. In this study we optimize the size and location of respiratory bins and allow projections to be sourced from adjacent phases of the respiratory cycle. Methods: A mathematical optimization framework using mixed integer quadratic programming has been developed that determines when to source projections from adjacent respiratory bins and optimizes the size and location of the bins. The method, which we will call projection sharing, runs in under 2 seconds of CPU time. Five 4DCBCT datasets of stage III-IV lung cancer patients were used to test the algorithm. The standard deviation of the angular separation between projections (SD-A) and the standard deviation in the volume of the reconstructed fiducial gold coil (SD-V) were used as proxies to measure streaking artefacts and motion blur respectively. Results: The SD-A using displacement binning and projection sharing was 30%–50% smaller than conventional phase based binning and 59%–76% smaller than conventional displacement binning indicating more uniformly spaced projections and fewer streaking artefacts. The SD-V was 20–90% smaller when using projection sharing than using conventional phase based binning suggesting more uniform marker segmentation and less motion blur. Conclusion: Image quality was visibly and significantly improved with projection sharing. Projection sharing does not require any modifications to existing hardware and offers a more robust replacement to phase based binning, or, an option if phase based reconstruction is not of a

  4. Dynamic measurement of the optical properties of bovine enamel demineralization models using four-dimensional optical coherence tomography

    Science.gov (United States)

    Aden, Abdirahman; Anthony, Arthi; Brigi, Carel; Merchant, Muhammad Sabih; Siraj, Huda; Tomlins, Peter H.

    2017-07-01

    Dental enamel mineral loss is multifactorial and is consequently explored using a variety of in vitro models. Important factors include the presence of acidic pH and its specific ionic composition, which can both influence lesion characteristics. Optical coherence tomography (OCT) has been demonstrated as a promising tool for studying dental enamel demineralization. However, OCT-based characterization and comparison of demineralization model dynamics are challenging without a consistent experimental environment. Therefore, an automated four-dimensional OCT system was integrated with a multispecimen flow cell to measure and compare the optical properties of subsurface enamel demineralization in different models. This configuration was entirely automated, thus mitigating any need to disturb the specimens and ensuring spatial registration of OCT image volumes at multiple time points. Twelve bovine enamel disks were divided equally among three model groups. The model demineralization solutions were citric acid (pH 3.8), acetic acid (pH 4.0), and acetic acid with added calcium and phosphate (pH 4.4). Bovine specimens were exposed to the solution continuously for 48 h. Three-dimensional OCT data were obtained automatically from each specimen at a minimum of 1-h intervals from the same location within each specimen. Lesion dynamics were measured in terms of the depth below the surface to which the lesion extended and the attenuation coefficient. The net loss of surface enamel was also measured for comparison. Similarities between the dynamics of each model were observed, although there were also distinct characteristic differences. Notably, the attenuation coefficients showed a systematic offset and temporal shift with respect to the different models. Furthermore, the lesion depth curves displayed a discontinuous increase several hours after the initial acid challenge. This work demonstrated the capability of OCT to distinguish between different enamel demineralization

  5. Dissipation of the tilting degree of freedom in heavy-ion-induced fission from four-dimensional Langevin dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Nadtochy, P.N. [Omsk State Technical University, Omsk (Russian Federation); Ryabov, E.G.; Cheredov, A.V.; Adeev, G.D. [Omsk State University, Omsk (Russian Federation)

    2016-10-15

    A stochastic approach based on four-dimensional Langevin fission dynamics is applied to the calculation of a wide set of experimental observables of excited compound nuclei from {sup 199}Pb to {sup 248}Cf formed in reactions induced by heavy ions. In the model under investigation, the tilting degree of freedom (K coordinate) representing the projection of the total angular momentum onto the symmetry axis of the nucleus is taken into account in addition to three collective shape coordinates introduced on the basis of {c,h,α} parametrization. The evolution of the K coordinate is described by means of the Langevin equation in the overdamped regime. The friction tensor for the shape collective coordinates is calculated under the assumption of the modified version of the one-body dissipation mechanism, where the reduction coefficient k{sub s} of the contribution from the ''wall'' formula is introduced. The calculations are performed both for the constant values of the coefficient k{sub s} and for the coordinate-dependent reduction coefficient k{sub s}(q) which is found on the basis of the ''chaos-weighted wall formula''. Different possibilities of the deformation-dependent dissipation coefficient (γ{sub K}) for the K coordinate are investigated. The presented results demonstrate that an impact of the k{sub s} and γ{sub K} parameters on the calculated observable fission characteristics can be selectively probed. It was found that it is possible to describe the experimental data consistently with the deformation-dependent γ{sub K}(q) coefficient for shapes featuring a neck, which predicts quite small values of γ{sub K} = 0.0077 (MeV zs){sup -1/2} and constant γ{sub K} = 0.1 -0.4 (MeV zs){sup -1/2} for compact shapes featuring no neck. (orig.)

  6. Airflow and air quality simulations over the western mountainous region with a four-dimensional data assimilation technique

    Science.gov (United States)

    Yamada, Tetsuji; Kao, Chih-Yue; Bunker, Susan

    We apply a three-dimensional meteorological model with a four-dimensional data assimilation (4-DDA) technique to simulate diurnal variations of wind, temperature, water vapor, and turbulence in a region extending from the west coast to east of the Rockies and from northern Mexico to Wyoming. The wind data taken during the 1985 SCENES ( Subregional Cooperative Electric Utility, Dept. of Defense, National Park Service, and Environmental Protection Agency Study on Visibility) field experiments are successfully assimilated into the model through the 4-DDA technique by 'nudging' the modeled winds toward the observed winds. The modeled winds and turbulence fields are then used in a Lagrangian random-particle statistical model to investigate how pollutants from potential sources are transported and diffused. Finally, we calculate the ground concentrations through a kernel density estimator. Two scenarios in different weather patterns are investigated with simulation periods up to 6 days. One is associated with the evolution of a surface cold front and the other under a high-pressure stagnant condition. In the frontal case, the impact of air-mass movement on the ground concentrations of pollutants released from the Los Angeles area is well depicted by the model. Also, the pollutants produced from Los Angeles can be transported to the Grand Canyon area within 24 h. However, if we use only the data that were obtained from the regular NWS rawinsonde network, whose temporal and spatial resolutions are coarser than those of the special network, the plume goes north-northeast and never reaches the Grand Canyon area. In the stagnant case, the pollutants meander around the source area and can have significant impact on local air quality.

  7. Dosimetric variation due to CT inter-slice spacing in four-dimensional carbon beam lung therapy

    International Nuclear Information System (INIS)

    Kumagai, Motoki; Mori, Shinichiro; Kandatsu, Susumu; Baba, Masayuki; Sharp, Gregory C; Asakura, Hiroshi; Endo, Masahiro

    2009-01-01

    When CT data with thick slice thickness are used in treatment planning, geometrical uncertainty may induce dosimetric errors. We evaluated carbon ion dose variations due to different CT slice thicknesses using a four-dimensional (4D) carbon ion beam dose calculation, and compared results between ungated and gated respiratory strategies. Seven lung patients were scanned in 4D mode with a 0.5 mm slice thickness using a 256-multi-slice CT scanner. CT images were averaged with various numbers of images to simulate reconstructed images with various slice thicknesses (0.5-5.0 mm). Two scenarios were studied (respiratory-ungated and -gated strategies). Range compensators were designed for each of the CT volumes with coarse inter-slice spacing to cover the internal target volume (ITV), as defined from 4DCT. Carbon ion dose distribution was computed for each resulting ITV on the 0.5 mm slice 4DCT data. The accumulated dose distribution was then calculated using deformable registration for 4D dose assessment. The magnitude of over- and under-dosage was found to be larger with the use of range compensators designed with a coarser inter-slice spacing than those obtained with a 0.5 mm slice thickness. Although no under-dosage was observed within the clinical target volume (CTV) region, D95 remained at over 97% of the prescribed dose for the ungated strategy and 95% for the gated strategy for all slice thicknesses. An inter-slice spacing of less than 3 mm may be able to minimize dose variation between the ungated and gated strategies. Although volumes with increased inter-slice spacing may reduce geometrical accuracy at a certain respiratory phase, this does not significantly affect delivery of the accumulated dose to the target during the treatment course.

  8. Mid-ventilation CT scan construction from four-dimensional respiration-correlated CT scans for radiotherapy planning of lung cancer patients

    NARCIS (Netherlands)

    Wolthaus, Jochem W. H.; Schneider, Christoph; Sonke, Jan-Jakob; van Herk, Marcel; Belderbos, José S. A.; Rossi, Maddalena M. G.; Lebesque, Joos V.; Damen, Eugène M. F.

    2006-01-01

    PURPOSE: Four-dimensional (4D) respiration-correlated imaging techniques can be used to obtain (respiration) artifact-free computed tomography (CT) images of the thorax. Current radiotherapy planning systems, however, do not accommodate 4D-CT data. The purpose of this study was to develop a simple,

  9. Real-Space Imaging of Carrier Dynamics of Materials Surfaces by Second-Generation Four-Dimensional Scanning Ultrafast Electron Microscopy

    KAUST Repository

    Sun, Jingya; Melnikov, Vasily; Khan, Jafar Iqbal; Mohammed, Omar F.

    2015-01-01

    , we establish a second generation of four-dimensional scanning ultrafast electron microscopy (4D S-UEM) and demonstrate the ability to record time-resolved images (snapshots) of material surfaces with 650 fs and ∼5 nm temporal and spatial resolutions

  10. To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? A psychometric study

    NARCIS (Netherlands)

    Terluin, B.; Oosterbaan, D.B.; Brouwers, E.P.; Straten, A. van; Ven, P.M. van de; Langerak, W.; Marwijk, H.W.J. van

    2014-01-01

    BACKGROUND: Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety

  11. To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care?

    NARCIS (Netherlands)

    Terluin, B.; Oosterbaan, D.B.; Brouwers, E.P.; van Straten, A.; van de Ven, P.M.; Langerak, W.; van Marwijk, H.W.

    2014-01-01

    Background: Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety

  12. The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

    NARCIS (Netherlands)

    Terluin, B.; van Marwijk, H.W.J.; Ader, H.J.; de Vet, H.C.W.; Penninx, B.W.J.H.; Hermens, M.L.M.; van Boeijen, C.A.; van Balkom, A.J.L.M.; van der Klink, J.J.L.; Stalman, W.A.B.

    2006-01-01

    Background: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity.

  13. The Four-Dimensional Symptom Questionnaire (4DSQ) in the general population: scale structure, reliability, measurement invariance and normative data : A cross-sectional survey

    NARCIS (Netherlands)

    Terluin, B.; Smits, N.; Brouwers, E.P.M.; De Vet, H.C.W.

    2016-01-01

    Background The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire measuring distress, depression, anxiety and somatization with separate scales. The 4DSQ has extensively been validated in clinical samples, especially from primary care settings. Information about measurement

  14. The Four-Dimensional Symptom Questionnaire (4DSQ) in the general population : scale structure, reliability, measurement invariance and normative data: a cross-sectional survey

    NARCIS (Netherlands)

    Terluin, B.; Smits, N.; Brouwers, E.P.M.; de Vet, H.C.W.

    2016-01-01

    Background: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire measuring distress, depression, anxiety and somatization with separate scales. The 4DSQ has extensively been validated in clinical samples, especially from primary care settings. Information about

  15. To what extent does the anxiety scale of the Four Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? : A psychometric study

    NARCIS (Netherlands)

    Terluin, B.; Oosterbaan, D.B.; Brouwers, E.P.M.; van Straten, A.H.M.; van de Ven, P.; Langerak, W.; van Marwijk, H.W.J.

    2014-01-01

    Background Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety

  16. Planning Study Comparison of Real-Time Target Tracking and Four-Dimensional Inverse Planning for Managing Patient Respiratory Motion

    International Nuclear Information System (INIS)

    Zhang Peng; Hugo, Geoffrey D.; Yan Di

    2008-01-01

    Purpose: Real-time target tracking (RT-TT) and four-dimensional inverse planning (4D-IP) are two potential methods to manage respiratory target motion. In this study, we evaluated each method using the cumulative dose-volume criteria in lung cancer radiotherapy. Methods and Materials: Respiration-correlated computed tomography scans were acquired for 4 patients. Deformable image registration was applied to generate a displacement mapping for each phase image of the respiration-correlated computed tomography images. First, the dose distribution for the organs of interest obtained from an idealized RT-TT technique was evaluated, assuming perfect knowledge of organ motion and beam tracking. Inverse planning was performed on each phase image separately. The treatment dose to the organs of interest was then accumulated from the optimized plans. Second, 4D-IP was performed using the probability density function of respiratory motion. The beam arrangement, prescription dose, and objectives were consistent in both planning methods. The dose-volume and equivalent uniform dose in the target volume, lung, heart, and spinal cord were used for the evaluation. Results: The cumulative dose in the target was similar for both techniques. The equivalent uniform dose of the lung, heart, and spinal cord was 4.6 ± 2.2, 11 ± 4.4, and 11 ± 6.6 Gy for RT-TT with a 0-mm target margin, 5.2 ± 3.1, 12 ± 5.9, and 12 ± 7.8 Gy for RT-TT with a 2-mm target margin, and 5.3 ± 2.3, 11.9 ± 5.0, and 12 ± 5.6 Gy for 4D-IP, respectively. Conclusion: The results of our study have shown that 4D-IP can achieve plans similar to those achieved by RT-TT. Considering clinical implementation, 4D-IP could be a more reliable and practical method to manage patient respiration-induced motion

  17. Motion-map constrained image reconstruction (MCIR): Application to four-dimensional cone-beam computed tomography

    International Nuclear Information System (INIS)

    Park, Justin C.; Kim, Jin Sung; Park, Sung Ho; Liu, Zhaowei; Song, Bongyong; Song, William Y.

    2013-01-01

    Purpose: Utilization of respiratory correlated four-dimensional cone-beam computed tomography (4DCBCT) has enabled verification of internal target motion and volume immediately prior to treatment. However, with current standard CBCT scan, 4DCBCT poses challenge for reconstruction due to the fact that multiple phase binning leads to insufficient number of projection data to reconstruct and thus cause streaking artifacts. The purpose of this study is to develop a novel 4DCBCT reconstruction algorithm framework called motion-map constrained image reconstruction (MCIR), that allows reconstruction of high quality and high phase resolution 4DCBCT images with no more than the imaging dose as well as projections used in a standard free breathing 3DCBCT (FB-3DCBCT) scan.Methods: The unknown 4DCBCT volume at each phase was mathematically modeled as a combination of FB-3DCBCT and phase-specific update vector which has an associated motion-map matrix. The motion-map matrix, which is the key innovation of the MCIR algorithm, was defined as the matrix that distinguishes voxels that are moving from stationary ones. This 4DCBCT model was then reconstructed with compressed sensing (CS) reconstruction framework such that the voxels with high motion would be aggressively updated by the phase-wise sorted projections and the voxels with less motion would be minimally updated to preserve the FB-3DCBCT. To evaluate the performance of our proposed MCIR algorithm, we evaluated both numerical phantoms and a lung cancer patient. The results were then compared with the (1) clinical FB-3DCBCT reconstructed using the FDK, (2) 4DCBCT reconstructed using the FDK, and (3) 4DCBCT reconstructed using the well-known prior image constrained compressed sensing (PICCS).Results: Examination of the MCIR algorithm showed that high phase-resolved 4DCBCT with sets of up to 20 phases using a typical FB-3DCBCT scan could be reconstructed without compromising the image quality. Moreover, in comparison with

  18. An analysis of respiratory induced kidney motion on four-dimensional computed tomography and its implications for stereotactic kidney radiotherapy

    International Nuclear Information System (INIS)

    Siva, Shankar; Pham, Daniel; Gill, Suki; Bressel, Mathias; Dang, Kim; Devereux, Thomas; Kron, Tomas; Foroudi, Farshad

    2013-01-01

    Stereotactic ablative body radiotherapy (SABR) is an emerging treatment modality for primary renal cell carcinoma. To account for respiratory-induced target motion, an internal target volume (ITV) concept is often used in treatment planning of SABR. The purpose of this study is to assess patterns of kidney motion and investigate potential surrogates of kidney displacement with the view of ITV verification during treatment. Datasets from 71 consecutive patients with free breathing four-dimensional computed tomography (4DCT) planning scans were included in this study. The displacement of the left and right hemi-diaphragm, liver dome and abdominal wall were measured and tested for correlation with the displacement of the both kidneys and patient breathing frequency. Nine patients were excluded due to severe banding artifact. Of 62 evaluable patients, the median age was 68 years, with 41 male patients and 21 female patients. The mean (range) of the maximum, minimum and average breathing frequency throughout the 4DCTs were 20.1 (11–38), 15.1 (9–24) and 17.3 (9–27.5) breaths per minute, respectively. The mean (interquartile range) displacement of the left and right kidneys was 0.74 cm (0.45-0.98 cm) and 0.75 cm (0.49-0.97) respectively. The amplitude of liver-dome motion was correlated with right kidney displacement (r=0.52, p<0.001), but not with left kidney displacement (p=0.796). There was a statistically significant correlation between the magnitude of right kidney displacement and that of abdominal displacement (r=0.36, p=0.004), but not the left kidney (r=0.24, p=0.056). Hemi-diaphragm displacements were correlated with kidney displacements respectively, with a weaker correlation for the left kidney/left diaphragm (r=0.45, [95% CI 0.22 to 0.63], p=<0.001) than for the right kidney/right diaphragm (r=0.57, [95% CI 0.37 to 0.72], p=<0.001). For the majority of patients, maximal left and right kidney displacement is subcentimeter in magnitude. The magnitude of

  19. Correlation of primary middle and distal esophageal cancers motion with surrounding tissues using four-dimensional computed tomography

    Directory of Open Access Journals (Sweden)

    Wang W

    2016-06-01

    Full Text Available Wei Wang,1 Jianbin Li,1 Yingjie Zhang,1 Qian Shao,1 Min Xu,1 Bing Guo,1 Dongping Shang2 1Department of Radiation Oncology, 2Department of Big Bore CT Room, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China Purpose: To investigate the correlation of gross tumor volume (GTV motion with the structure of interest (SOI motion and volume variation for middle and distal esophageal cancers using four-dimensional computed tomography (4DCT.Patients and methods: Thirty-three patients with middle or distal esophageal carcinoma underwent 4DCT simulation scan during free breathing. All image sets were registered with 0% phase, and the GTV, apex of diaphragm, lung, and heart were delineated on each phase of the 4DCT data. The position of GTV and SOI was identified in all 4DCT phases, and the volume of lung and heart was also achieved. The phase relationship between the GTV and SOI was estimated through Pearson’s correlation test.Results: The mean peak-to-peak displacement of all primary tumors in the lateral (LR, anteroposterior (AP, and superoinferior (SI directions was 0.13 cm, 0.20 cm, and 0.30 cm, respectively. The SI peak-to-peak motion of the GTV was defined as the greatest magnitude of motion. The displacement of GTV correlated well with heart in three dimensions and significantly associated with bilateral lung in LR and SI directions. A significant correlation was found between the GTV and apex of the diaphragm in SI direction (rleft=0.918 and rright=0.928. A significant inverse correlation was found between GTV motion and varying lung volume, but the correlation was not significant with heart (rLR=–0.530, rAP=–0.531, and rSI=–0.588 during respiratory cycle.Conclusion: For middle and distal esophageal cancers, GTV should expand asymmetric internal margins. The primary tumor motion has quite good correlation with diaphragm, heart, and lung. Keywords

  20. Improving thoracic four-dimensional cone-beam CT reconstruction with anatomical-adaptive image regularization (AAIR)

    International Nuclear Information System (INIS)

    Shieh, Chun-Chien; Kipritidis, John; O'Brien, Ricky T; Cooper, Benjamin J; Keall, Paul J; Kuncic, Zdenka

    2015-01-01

    Total-variation (TV) minimization reconstructions can significantly reduce noise and streaks in thoracic four-dimensional cone-beam computed tomography (4D CBCT) images compared to the Feldkamp–Davis–Kress (FDK) algorithm currently used in practice. TV minimization reconstructions are, however, prone to over-smoothing anatomical details and are also computationally inefficient. The aim of this study is to demonstrate a proof of concept that these disadvantages can be overcome by incorporating the general knowledge of the thoracic anatomy via anatomy segmentation into the reconstruction. The proposed method, referred as the anatomical-adaptive image regularization (AAIR) method, utilizes the adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS) framework, but introduces an additional anatomy segmentation step in every iteration. The anatomy segmentation information is implemented in the reconstruction using a heuristic approach to adaptively suppress over-smoothing at anatomical structures of interest. The performance of AAIR depends on parameters describing the weighting of the anatomy segmentation prior and segmentation threshold values. A sensitivity study revealed that the reconstruction outcome is not sensitive to these parameters as long as they are chosen within a suitable range. AAIR was validated using a digital phantom and a patient scan and was compared to FDK, ASD-POCS and the prior image constrained compressed sensing (PICCS) method. For the phantom case, AAIR reconstruction was quantitatively shown to be the most accurate as indicated by the mean absolute difference and the structural similarity index. For the patient case, AAIR resulted in the highest signal-to-noise ratio (i.e. the lowest level of noise and streaking) and the highest contrast-to-noise ratios for the tumor and the bony anatomy (i.e. the best visibility of anatomical details). Overall, AAIR was much less prone to over-smoothing anatomical details compared to ASD-POCS and

  1. Motion-map constrained image reconstruction (MCIR): Application to four-dimensional cone-beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Justin C. [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92093 and Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, California 92093 (United States); Kim, Jin Sung [Department of Radiation Oncology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of); Park, Sung Ho [Department of Medical Physics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 138-736 (Korea, Republic of); Liu, Zhaowei [Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, California 92093 (United States); Song, Bongyong; Song, William Y. [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92093 (United States)

    2013-12-15

    Purpose: Utilization of respiratory correlated four-dimensional cone-beam computed tomography (4DCBCT) has enabled verification of internal target motion and volume immediately prior to treatment. However, with current standard CBCT scan, 4DCBCT poses challenge for reconstruction due to the fact that multiple phase binning leads to insufficient number of projection data to reconstruct and thus cause streaking artifacts. The purpose of this study is to develop a novel 4DCBCT reconstruction algorithm framework called motion-map constrained image reconstruction (MCIR), that allows reconstruction of high quality and high phase resolution 4DCBCT images with no more than the imaging dose as well as projections used in a standard free breathing 3DCBCT (FB-3DCBCT) scan.Methods: The unknown 4DCBCT volume at each phase was mathematically modeled as a combination of FB-3DCBCT and phase-specific update vector which has an associated motion-map matrix. The motion-map matrix, which is the key innovation of the MCIR algorithm, was defined as the matrix that distinguishes voxels that are moving from stationary ones. This 4DCBCT model was then reconstructed with compressed sensing (CS) reconstruction framework such that the voxels with high motion would be aggressively updated by the phase-wise sorted projections and the voxels with less motion would be minimally updated to preserve the FB-3DCBCT. To evaluate the performance of our proposed MCIR algorithm, we evaluated both numerical phantoms and a lung cancer patient. The results were then compared with the (1) clinical FB-3DCBCT reconstructed using the FDK, (2) 4DCBCT reconstructed using the FDK, and (3) 4DCBCT reconstructed using the well-known prior image constrained compressed sensing (PICCS).Results: Examination of the MCIR algorithm showed that high phase-resolved 4DCBCT with sets of up to 20 phases using a typical FB-3DCBCT scan could be reconstructed without compromising the image quality. Moreover, in comparison with

  2. Quality assurance device for four-dimensional IMRT or SBRT and respiratory gating using patient-specific intrafraction motion kernels.

    Science.gov (United States)

    Nelms, Benjamin E; Ehler, Eric; Bragg, Henry; Tomé, Wolfgang A

    2007-09-17

    Emerging technologies such as four-dimensional computed tomography (4D CT) and implanted beacons are expected to allow clinicians to accurately model intrafraction motion and to quantitatively estimate internal target volumes (ITVs) for radiation therapy involving moving targets. In the case of intensity-modulated (IMRT) and stereotactic body radiation therapy (SBRT) delivery, clinicians must consider the interplay between the temporal nature of the modulation and the target motion within the ITV. A need exists for a 4D IMRT/SBRT quality assurance (QA) device that can incorporate and analyze customized intrafraction motion as it relates to dose delivery and respiratory gating. We built a 4D IMRT/SBRT prototype device and entered (X, Y, Z)(T) coordinates representing a motion kernel into a software application that 1. transformed the kernel into beam-specific two-dimensional (2D) motion "projections," 2. previewed the motion in real time, and 3. drove a recision X-Y motorized device that had, atop it, a mounted planar IMRT QA measurement device. The detectors that intersected the target in the beam's-eye-view of any single phase of the breathing cycle (a small subset of all the detectors) were defined as "target detectors" to be analyzed for dose uniformity between multiple fractions. Data regarding the use of this device to quantify dose variation fraction-to-fraction resulting from target motion (for several delivery modalities and with and without gating) have been recently published. A combined software and hardware solution for patient-customized 4D IMRT/SBRT QA is an effective tool for assessing IMRT delivery under conditions of intrafraction motion. The 4D IMRT QA device accurately reproduced the projected motion kernels for all beam's-eye-view motion kernels. This device has been proved to, effectively quantify the degradation in dose uniformity resulting from a moving target within a static planning target volume, and, integrate with a commercial

  3. Four-dimensional distribution of the 2010 Eyjafjallajökull volcanic cloud over Europe observed by EARLINET

    Directory of Open Access Journals (Sweden)

    G. Pappalardo

    2013-04-01

    Full Text Available The eruption of the Icelandic volcano Eyjafjallajökull in April–May 2010 represents a "natural experiment" to study the impact of volcanic emissions on a continental scale. For the first time, quantitative data about the presence, altitude, and layering of the volcanic cloud, in conjunction with optical information, are available for most parts of Europe derived from the observations by the European Aerosol Research Lidar NETwork (EARLINET. Based on multi-wavelength Raman lidar systems, EARLINET is the only instrument worldwide that is able to provide dense time series of high-quality optical data to be used for aerosol typing and for the retrieval of particle microphysical properties as a function of altitude. In this work we show the four-dimensional (4-D distribution of the Eyjafjallajökull volcanic cloud in the troposphere over Europe as observed by EARLINET during the entire volcanic event (15 April–26 May 2010. All optical properties directly measured (backscatter, extinction, and particle linear depolarization ratio are stored in the EARLINET database available at http://www.earlinet.org. A specific relational database providing the volcanic mask over Europe, realized ad hoc for this specific event, has been developed and is available on request at http://www.earlinet.org. During the first days after the eruption, volcanic particles were detected over Central Europe within a wide range of altitudes, from the upper troposphere down to the local planetary boundary layer (PBL. After 19 April 2010, volcanic particles were detected over southern and south-eastern Europe. During the first half of May (5–15 May, material emitted by the Eyjafjallajökull volcano was detected over Spain and Portugal and then over the Mediterranean and the Balkans. The last observations of the event were recorded until 25 May in Central Europe and in the Eastern Mediterranean area. The 4-D distribution of volcanic aerosol layering and optical properties on

  4. Effect of tumor volume on the enhancement pattern of parathyroid adenoma on parathyroid four-dimensional CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Dongguk University Ilsan Hospital, Department of Radiology, Goyang-si (Korea, Republic of); Yun, Tae Jin; Kim, Ji-hoon; Kang, Koung Mi; Choi, Seung Hong; Sohn, Chul-Ho [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Lee, Kyu Eun; Kim, Su-jin [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Won, Jae-Kyung [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of)

    2016-05-15

    The purpose of this study is to assess the effect of tumor volume on the enhancement pattern of parathyroid adenoma (PTA) on four-dimensional computed tomography (4D-CT). We analyzed the enhancement patterns of PTA on four-phase 4D-CT in 44 patients. Dependency of the changes of Hounsfield unit values (ΔHU) on the tumor volumes and clinical characteristics was evaluated using linear regression analyses. In addition, an unpaired t test was used to compare ΔHU of PTAs between PTA volume ≥1 cm{sup 3} and <1 cm{sup 3}, thyroid gland, and lymph node. PTA volume based on CT was the strongest factor on the ΔHU{sub Pre} {sub to} {sub Arterial} and ΔHU{sub Arterial} {sub to} {sub Venous} and ΔHU{sub Arterial} {sub to} {sub Delayed} (R {sup 2} = 0.34, 0.25, and 0.32, respectively, P < 0.001 for both). PTA ≥1 cm {sup 3} had statistically significant greater enhancement between the unenhanced phase and the arterial phase than PTA <1 cm {sup 3} (mean values ± standard deviations (SDs) of ΔHU{sub Pre} {sub to} {sub Arterial}, 102.7 ± 33.7 and 57.5 ± 28.8, respectively, P < 0.001). PTA ≥1 cm {sup 3} showed an early washout pattern on the venous phase, whereas PTA <1 cm {sup 3} showed a progressive enhancement pattern on the venous phase (mean values ± SDs of ΔHU{sub Arterial} {sub to} {sub Venous}, -13.2 ± 31.6 and 14.4 ± 32.7, respectively; P = 0.009). The enhancement pattern of PTA on 4D-CT is variable with respect to PTA volume based on CT. Therefore, the enhancement pattern of PTA on 4D-CT requires careful interpretation concerning the tumor volume, especially in cases of PTA <1 cm {sup 3}. (orig.)

  5. Quantitation of the reconstruction quality of a four-dimensional computed tomography process for lung cancer patients

    International Nuclear Information System (INIS)

    Lu Wei; Parikh, Parag J.; El Naqa, Issam M.; Nystrom, Michelle M.; Hubenschmidt, James P.; Wahab, Sasha H.; Mutic, Sasa; Singh, Anurag K.; Christensen, Gary E.; Bradley, Jeffrey D.; Low, Daniel A.

    2005-01-01

    We have developed a four-dimensional computed tomography (4D CT) technique for mapping breathing motion in radiotherapy treatment planning. A multislice CT scanner (1.5 mm slices) operated in cine mode was used to acquire 12 contiguous slices in each couch position for 15 consecutive scans (0.5 s rotation, 0.25 s between scans) while the patient underwent simultaneous quantitative spirometry measurements to provide a sorting metric. The spirometry-sorted scans were used to reconstruct a 4D data set. A critical factor for 4D CT is quantifying the reconstructed data set quality which we measure by correlating the metric used relative to internal-object motion. For this study, the internal air content within the lung was used as a surrogate for internal motion measurements. Thresholding and image morphological operations were applied to delineate the air-containing tissues (lungs, trachea) from each CT slice. The Hounsfield values were converted to the internal air content (V). The relationship between the air content and spirometer-measured tidal volume (ν) was found to be quite linear throughout the lungs and was used to estimate the overall accuracy and precision of tidal volume-sorted 4D CT. Inspection of the CT-scan air content as a function of tidal volume showed excellent correlations (typically r>0.99) throughout the lung volume. Because of the discovered linear relationship, the ratio of internal air content to tidal volume was indicative of the fraction of air change in each couch position. Theoretically, due to air density differences within the lung and in room, the sum of these ratios would equal 1.11. For 12 patients, the mean value was 1.08±0.06, indicating the high quality of spirometry-based image sorting. The residual of a first-order fit between ν and V was used to estimate the process precision. For all patients, the precision was better than 8%, with a mean value of 5.1%±1.9%. This quantitative analysis highlights the value of using spirometry

  6. Reliability of pelvic floor measurements on three- and four-dimensional ultrasound during and after first pregnancy: implications for training.

    Science.gov (United States)

    van Veelen, G A; Schweitzer, K J; van der Vaart, C H

    2013-11-01

    To evaluate the reliability of measurements of the levator hiatus and levator-urethra gap (LUG) using three/four-dimensional (3D/4D) transperineal ultrasound in women during their first pregnancy and 6 months postpartum, and to assess the learning process for these measurements. An inexperienced observer was taught to perform measurements of the levator hiatus and LUG by an experienced observer. After training, 3D/4D ultrasound volume datasets of 40 women in the first trimester were analyzed by these two observers. Another training session then took place and both observers repeated the analyses of the same volume datasets. Finally, analyses of 40 volume datasets of the women 6 months postpartum were performed by both observers. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) with 95% CIs. For levator hiatal measurements, in the women during their first pregnancy the interobserver reliability was substantial to almost perfect after both the first and second training session (ICC, 0.62-0.83 and 0.71-0.89, respectively, for anteroposterior diameter, transverse diameter and area at rest, on contraction and on Valsalva) and the intraobserver reliability was substantial to almost perfect for both observers. For these measurements performed once the women had delivered, interobserver reliability was moderate to almost perfect. For LUG measurements performed during pregnancy, interobserver reliability was slight to moderate after the first training session (ICC, 0.14-0.54), but improved after the second training session (ICC, 0.38-0.71), and intraobserver reliability was moderate to substantial for the experienced observer and slight to moderate for the inexperienced observer. For these measurements performed when the women had delivered, interobserver reliability was fair to moderate. The levator hiatus and LUG can be measured reliably using 3D/4D ultrasound in primigravid and primiparous women. The technique to measure

  7. Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging

    International Nuclear Information System (INIS)

    Kipritidis, John; Keall, Paul J.; Hugo, Geoffrey; Weiss, Elisabeth; Williamson, Jeffrey

    2015-01-01

    Purpose: Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), a novel technique for functional lung imaging. Methods: The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4–6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. Results: The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r - Inter =0.52±0

  8. Four-dimensional dose reconstruction through in vivo phase matching of cine images of electronic portal imaging device.

    Science.gov (United States)

    Yoon, Jihyung; Jung, Jae Won; Kim, Jong Oh; Yi, Byong Yong; Yeo, Inhwan

    2016-07-01

    A method is proposed to reconstruct a four-dimensional (4D) dose distribution using phase matching of measured cine images to precalculated images of electronic portal imaging device (EPID). (1) A phantom, designed to simulate a tumor in lung (a polystyrene block with a 3 cm diameter embedded in cork), was placed on a sinusoidally moving platform with an amplitude of 1 cm and a period of 4 s. Ten-phase 4D computed tomography (CT) images of the phantom were acquired. A planning target volume (PTV) was created by adding a margin of 1 cm around the internal target volume of the tumor. (2) Three beams were designed, which included a static beam, a theoretical dynamic beam, and a planning-optimized dynamic beam (PODB). While the theoretical beam was made by manually programming a simplistic sliding leaf motion, the planning-optimized beam was obtained from treatment planning. From the three beams, three-dimensional (3D) doses on the phantom were calculated; 4D dose was calculated by means of the ten phase images (integrated over phases afterward); serving as "reference" images, phase-specific EPID dose images under the lung phantom were also calculated for each of the ten phases. (3) Cine EPID images were acquired while the beams were irradiated to the moving phantom. (4) Each cine image was phase-matched to a phase-specific CT image at which common irradiation occurred by intercomparing the cine image with the reference images. (5) Each cine image was used to reconstruct dose in the phase-matched CT image, and the reconstructed doses were summed over all phases. (6) The summation was compared with forwardly calculated 4D and 3D dose distributions. Accounting for realistic situations, intratreatment breathing irregularity was simulated by assuming an amplitude of 0.5 cm for the phantom during a portion of breathing trace in which the phase matching could not be performed. Intertreatment breathing irregularity between the time of treatment and the time of planning CT was

  9. Measuring interfraction and intrafraction lung function changes during radiation therapy using four-dimensional cone beam CT ventilation imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kipritidis, John, E-mail: john.kipritidis@sydney.edu.au; Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney NSW 2006 (Australia); Hugo, Geoffrey; Weiss, Elisabeth; Williamson, Jeffrey [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

    2015-03-15

    Purpose: Adaptive ventilation guided radiation therapy could minimize the irradiation of healthy lung based on repeat lung ventilation imaging (VI) during treatment. However the efficacy of adaptive ventilation guidance requires that interfraction (e.g., week-to-week), ventilation changes are not washed out by intrafraction (e.g., pre- and postfraction) changes, for example, due to patient breathing variability. The authors hypothesize that patients undergoing lung cancer radiation therapy exhibit larger interfraction ventilation changes compared to intrafraction function changes. To test this, the authors perform the first comparison of interfraction and intrafraction lung VI pairs using four-dimensional cone beam CT ventilation imaging (4D-CBCT VI), a novel technique for functional lung imaging. Methods: The authors analyzed a total of 215 4D-CBCT scans acquired for 19 locally advanced non-small cell lung cancer (LA-NSCLC) patients over 4–6 weeks of radiation therapy. This set of 215 scans was sorted into 56 interfraction pairs (including first day scans and each of treatment weeks 2, 4, and 6) and 78 intrafraction pairs (including pre/postfraction scans on the same-day), with some scans appearing in both sets. VIs were obtained from the Jacobian determinant of the transform between the 4D-CBCT end-exhale and end-inhale images after deformable image registration. All VIs were deformably registered to their corresponding planning CT and normalized to account for differences in breathing effort, thus facilitating image comparison in terms of (i) voxelwise Spearman correlations, (ii) mean image differences, and (iii) gamma pass rates for all interfraction and intrafraction VI pairs. For the side of the lung ipsilateral to the tumor, we applied two-sided t-tests to determine whether interfraction VI pairs were more different than intrafraction VI pairs. Results: The (mean ± standard deviation) Spearman correlation for interfraction VI pairs was r{sup -}{sub Inter

  10. Comparison of planning target volumes based on three-dimensional and four-dimensional CT imaging of thoracic esophageal cancer

    Directory of Open Access Journals (Sweden)

    Wang W

    2016-08-01

    Full Text Available Wei Wang, Jianbin Li, Yingjie Zhang, Qian Shao, Min Xu, Tingyong Fan, Jinzhi Wang Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Shandong, People’s Republic of China Background and purpose: To investigate the definition of planning target volumes (PTVs based on four-dimensional computed tomography (4DCT compared with conventional PTV definition and PTV definition using asymmetrical margins for thoracic primary esophageal cancer. Materials and methods: Forty-three patients with esophageal cancer underwent 3DCT and 4DCT simulation scans during free breathing. The motions of primary tumors located in the proximal (group A, middle (group B, and distal (group C thoracic esophagus were obtained from the 4DCT scans. PTV3D was defined on 3DCT using the tumor motion measured based on 4DCT, PTV conventional (PTVconv was defined on 3DCT by adding a 1.0 cm margin to the clinical target volume, and PTV4D was defined as the union of the target volumes contoured on the ten phases of the 4DCT images. The centroid positions, volumetric differences, and dice similarity coefficients were evaluated for all PTVs. Results: The median centroid shifts between PTV3D and PTV4D and between PTVconv and PTV4D in all three dimensions were <0.3 cm for the three groups. The median size ratios of PTV4D to PTV3D were 0.80, 0.88, and 0.71, and PTV4D to PTVconv were 0.67, 0.73, and 0.76 (χ2=–3.18, –2.98, and –3.06; P=0.001, 0.003, and 0.002 for groups A, B, and C, respectively. The dice similarity coefficients were 0.87, 0.90, and 0.81 between PTV4D and PTV3D and 0.80, 0.84, and 0.83 between PTV4D and PTVconv (χ2=–3.18, –2.98, and –3.06; P=0.001, 0.003, and 0.002 for groups A, B, and C, respectively. The difference between the degree of inclusion of PTV4D in PTV3D and that of PTV4D in PTVconv was <2% for all groups. Compared with PTVconv, the amount of irradiated normal tissue

  11. Four-dimensional dose reconstruction through in vivo phase matching of cine images of electronic portal imaging device

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jihyung; Jung, Jae Won, E-mail: jungj@ecu.edu [Department of Physics, East Carolina University, Greenville, North Carolina 27858 (United States); Kim, Jong Oh [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania 15232 (United States); Yi, Byong Yong [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201 (United States); Yeo, Inhwan [Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California 92354 (United States)

    2016-07-15

    Purpose: A method is proposed to reconstruct a four-dimensional (4D) dose distribution using phase matching of measured cine images to precalculated images of electronic portal imaging device (EPID). Methods: (1) A phantom, designed to simulate a tumor in lung (a polystyrene block with a 3 cm diameter embedded in cork), was placed on a sinusoidally moving platform with an amplitude of 1 cm and a period of 4 s. Ten-phase 4D computed tomography (CT) images of the phantom were acquired. A planning target volume (PTV) was created by adding a margin of 1 cm around the internal target volume of the tumor. (2) Three beams were designed, which included a static beam, a theoretical dynamic beam, and a planning-optimized dynamic beam (PODB). While the theoretical beam was made by manually programming a simplistic sliding leaf motion, the planning-optimized beam was obtained from treatment planning. From the three beams, three-dimensional (3D) doses on the phantom were calculated; 4D dose was calculated by means of the ten phase images (integrated over phases afterward); serving as “reference” images, phase-specific EPID dose images under the lung phantom were also calculated for each of the ten phases. (3) Cine EPID images were acquired while the beams were irradiated to the moving phantom. (4) Each cine image was phase-matched to a phase-specific CT image at which common irradiation occurred by intercomparing the cine image with the reference images. (5) Each cine image was used to reconstruct dose in the phase-matched CT image, and the reconstructed doses were summed over all phases. (6) The summation was compared with forwardly calculated 4D and 3D dose distributions. Accounting for realistic situations, intratreatment breathing irregularity was simulated by assuming an amplitude of 0.5 cm for the phantom during a portion of breathing trace in which the phase matching could not be performed. Intertreatment breathing irregularity between the time of treatment and the

  12. Quantum corrections to ward identities of chronological AVV- and AAA-current correlators for nondegenerate many-fermion systems in the four-dimensional world

    International Nuclear Information System (INIS)

    Kucheryavij, V.Yi.

    1994-01-01

    The explicit form of nontrivial quantum corrections to Ward identities for AVV- and AAA-current correlators in the four-dimensional world for nondegenerate many-fermion systems of general type is obtained. The characteristics of all nontrivial quantum corrections for nondegenerate two-flavour fermion systems are classified and described. In particular, the well-known results follow from ours for the trivial quantum corrections (anomalies) in the case of the degenerate spectrum of fermion masses

  13. Four-dimensional data coupled to alternating weighted residue constraint quadrilinear decomposition model applied to environmental analysis: Determination of polycyclic aromatic hydrocarbons

    Science.gov (United States)

    Liu, Tingting; Zhang, Ling; Wang, Shutao; Cui, Yaoyao; Wang, Yutian; Liu, Lingfei; Yang, Zhe

    2018-03-01

    Qualitative and quantitative analysis of polycyclic aromatic hydrocarbons (PAHs) was carried out by three-dimensional fluorescence spectroscopy combining with Alternating Weighted Residue Constraint Quadrilinear Decomposition (AWRCQLD). The experimental subjects were acenaphthene (ANA) and naphthalene (NAP). Firstly, in order to solve the redundant information of the three-dimensional fluorescence spectral data, the wavelet transform was used to compress data in preprocessing. Then, the four-dimensional data was constructed by using the excitation-emission fluorescence spectra of different concentration PAHs. The sample data was obtained from three solvents that are methanol, ethanol and Ultra-pure water. The four-dimensional spectral data was analyzed by AWRCQLD, then the recovery rate of PAHs was obtained from the three solvents and compared respectively. On one hand, the results showed that PAHs can be measured more accurately by the high-order data, and the recovery rate was higher. On the other hand, the results presented that AWRCQLD can better reflect the superiority of four-dimensional algorithm than the second-order calibration and other third-order calibration algorithms. The recovery rate of ANA was 96.5% 103.3% and the root mean square error of prediction was 0.04 μgL- 1. The recovery rate of NAP was 96.7% 115.7% and the root mean square error of prediction was 0.06 μgL- 1.

  14. Cardiac cone-beam CT

    International Nuclear Information System (INIS)

    Manzke, Robert

    2005-01-01

    This doctoral thesis addresses imaging of the heart with retrospectively gated helical cone-beam computed tomography (CT). A thorough review of the CT reconstruction literature is presented in combination with a historic overview of cardiac CT imaging and a brief introduction to other cardiac imaging modalities. The thesis includes a comprehensive chapter about the theory of CT reconstruction, familiarizing the reader with the problem of cone-beam reconstruction. The anatomic and dynamic properties of the heart are outlined and techniques to derive the gating information are reviewed. With the extended cardiac reconstruction (ECR) framework, a new approach is presented for the heart-rate-adaptive gated helical cardiac cone-beam CT reconstruction. Reconstruction assessment criteria such as the temporal resolution, the homogeneity in terms of the cardiac phase, and the smoothness at cycle-to-cycle transitions are developed. Several reconstruction optimization approaches are described: An approach for the heart-rate-adaptive optimization of the temporal resolution is presented. Streak artifacts at cycle-to-cycle transitions can be minimized by using an improved cardiac weighting scheme. The optimal quiescent cardiac phase for the reconstruction can be determined automatically with the motion map technique. Results for all optimization procedures applied to ECR are presented and discussed based on patient and phantom data. The ECR algorithm is analyzed for larger detector arrays of future cone-beam systems throughout an extensive simulation study based on a four-dimensional cardiac CT phantom. The results of the scientific work are summarized and an outlook proposing future directions is given. The presented thesis is available for public download at www.cardiac-ct.net

  15. Comparison of Rigid and Adaptive Methods of Propagating Gross Tumor Volume Through Respiratory Phases of Four-Dimensional Computed Tomography Image Data Set

    International Nuclear Information System (INIS)

    Ezhil, Muthuveni; Choi, Bum; Starkschall, George; Bucci, M. Kara; Vedam, Sastry; Balter, Peter

    2008-01-01

    Purpose: To compare three different methods of propagating the gross tumor volume (GTV) through the respiratory phases that constitute a four-dimensional computed tomography image data set. Methods and Materials: Four-dimensional computed tomography data sets of 20 patients who had undergone definitive hypofractionated radiotherapy to the lung were acquired. The GTV regions of interest (ROIs) were manually delineated on each phase of the four-dimensional computed tomography data set. The ROI from the end-expiration phase was propagated to the remaining nine phases of respiration using the following three techniques: (1) rigid-image registration using in-house software, (2) rigid image registration using research software from a commercial radiotherapy planning system vendor, and (3) rigid-image registration followed by deformable adaptation originally intended for organ-at-risk delineation using the same software. The internal GTVs generated from the various propagation methods were compared with the manual internal GTV using the normalized Dice similarity coefficient (DSC) index. Results: The normalized DSC index of 1.01 ± 0.06 (SD) for rigid propagation using the in-house software program was identical to the normalized DSC index of 1.01 ± 0.06 for rigid propagation achieved with the vendor's research software. Adaptive propagation yielded poorer results, with a normalized DSC index of 0.89 ± 0.10 (paired t test, p <0.001). Conclusion: Propagation of the GTV ROIs through the respiratory phases using rigid- body registration is an acceptable method within a 1-mm margin of uncertainty. The adaptive organ-at-risk propagation method was not applicable to propagating GTV ROIs, resulting in an unacceptable reduction of the volume and distortion of the ROIs

  16. Investigation of pancreas tumour movements and of their potential markers by four-dimensional scanography: implication for image-guided radiotherapy

    International Nuclear Information System (INIS)

    Huguet, F.; Yorke, E.; Davidson, M.; Zhang, Z.; Jackson, A.; Mageras, G.; Wu, A.; Goodman, K.

    2011-01-01

    The authors report the study which aimed at quantifying pancreas tumour movements induced by breathing by using four-dimensional scanography, and at assessing the reliability of biliary prosthesis, of intra-tumor fiducials, and of an external maker as position markers of the gross tumour volume (GTV). The authors analyzed scanography images acquired during the simulation of 22 patients treated for locally advanced pancreas cancer by intensity-modulated conformational irradiation with respiratory gating. Average movements in different directions have measured. Respiratory gating limits the GTV movement amplitude by 40 to 60 per cent. GTV movements are in good correlation with that of biliary prostheses and intra-tumor fiducials. Short communication

  17. The end point of the first-order phase transition of the SU(2) gauge-Higgs model on a four-dimensional isotropic lattice

    International Nuclear Information System (INIS)

    Aoki, Y.; Csikor, F.; Fodor, Z.; Ukawa, A.

    1999-01-01

    We report results of a study of the end point of the electroweak phase transition of the SU(2) gauge-Higgs model defined on a four-dimensional isotropic lattice with N t = 2. Finite-size scaling study of Lee-Yang zeros yields λ c = 0.00116(16) for the end point. Combined with a zero-temperature measurement of Higgs and W boson masses, this leads to M H,c = 68.2 ± 6.6 GeV for the critical Higgs boson mass. An independent analysis of Binder cumulant gives a consistent value λ c = 0.00102(3) for the end point

  18. Study of fission dynamics of the excited nuclei produced in fusion reactions in the framework of the four-dimensional Langevin equations

    Energy Technology Data Exchange (ETDEWEB)

    Eslamizadeh, H. [Persian Gulf University, Department of Physics, Bushehr (Iran, Islamic Republic of)

    2014-12-01

    The dynamics of fission of excited nuclei has been studied by solving four-dimensional Langevin equations with dissipation generated through the chaos-weighted wall and window friction formula. The projection of the total spin of the compound nucleus to the symmetry axis, K, was considered as the fourth dimension in Langevin dynamical calculations. The average pre-scission neutron multiplicities, mean kinetic energy of fission fragments and the variances of the mass and kinetic energy have been calculated in a wide range of fissile parameter for compound nuclei {sup 162}Yb, {sup 172}Yb, {sup 215}Fr, {sup 224}Th, {sup 248}Cf, {sup 260}Rf and results compared with the experimental data. Calculations were performed with a constant dissipation coefficient of K, {sub γK} (MeV zs){sup -1/2}, and with a non-constant dissipation coefficient. Comparison of the theoretical results for the average pre-scission neutron multiplicities, mean kinetic energy of fission fragments and the variances of the mass and kinetic energy with the experimental data showed that the results of four-dimensional Langevin equations with a non-constant dissipation coefficient are in better agreement with the experimental data. Furthermore, the difference between the results of two models for compound nuclei with low fissile parameter is low whereas, for heavy compound nuclei, is high. (orig.)

  19. Unified treatment of complete orthonormal sets for wave functions, and Slater orbitals of particles with arbitrary spin in coordinate, momentum and four-dimensional spaces

    International Nuclear Information System (INIS)

    Guseinov, I.I.

    2007-01-01

    The new analytical relations of complete orthonormal sets for the tensor wave functions and the tensor Slater orbitals of particles with arbitrary spin in coordinate, momentum and four-dimensional spaces are derived using the properties of tensor spherical harmonics and complete orthonormal scalar basis sets of ψ α -exponential type orbitals, φ α -momentum space orbitals and z α -hyperspherical harmonics introduced by the author for particles with spin s=0, where the α=1,0,-1,-2,.... All of the tensor wave functions obtained are complete without the inclusion of the continuum and, therefore, their group of transformations is the four-dimensional rotation group O(4). The analytical formulas in coordinate space are also derived for the overlap integrals over tensor Slater orbitals with the same screening constant. We notice that the new idea presented in this work is the combination of tensor spherical harmonics of rank s with complete orthonormal scalar sets for radial parts of ψ α -, φ α - and z α -orbitals, where s=1/2,1,3/2,2,...

  20. Nonlinear spatio-temporal filtering of dynamic PET data using a four-dimensional Gaussian filter and expectation-maximization deconvolution

    International Nuclear Information System (INIS)

    Floberg, J M; Holden, J E

    2013-01-01

    We introduce a method for denoising dynamic PET data, spatio-temporal expectation-maximization (STEM) filtering, that combines four-dimensional Gaussian filtering with EM deconvolution. The initial Gaussian filter suppresses noise at a broad range of spatial and temporal frequencies and EM deconvolution quickly restores the frequencies most important to the signal. We aim to demonstrate that STEM filtering can improve variance in both individual time frames and in parametric images without introducing significant bias. We evaluate STEM filtering with a dynamic phantom study, and with simulated and human dynamic PET studies of a tracer with reversible binding behaviour, [C-11]raclopride, and a tracer with irreversible binding behaviour, [F-18]FDOPA. STEM filtering is compared to a number of established three and four-dimensional denoising methods. STEM filtering provides substantial improvements in variance in both individual time frames and in parametric images generated with a number of kinetic analysis techniques while introducing little bias. STEM filtering does bias early frames, but this does not affect quantitative parameter estimates. STEM filtering is shown to be superior to the other simple denoising methods studied. STEM filtering is a simple and effective denoising method that could be valuable for a wide range of dynamic PET applications. (paper)

  1. Gauge constructs and immersions of four-dimensional spacetimes in (4 + k)-dimensional flat spaces: algebraic evaluation of gravity fields

    International Nuclear Information System (INIS)

    Edelen, Dominic G B

    2003-01-01

    Local action of the fundamental group SO(a, 4 + k - a) is used to show that any solution of an algebraically closed differential system, that is generated from matrix Lie algebra valued 1-forms on a four-dimensional parameter space, will generate families of immersions of four-dimensional spacetimes R 4 in flat (4 + k)-dimensional spaces M 4+k with compatible signature. The algorithm is shown to work with local action of SO(a, 4 + k - a) replaced by local action of GL(4 + k). Immersions generated by local action of the Poincare group on the target spacetime are also obtained. Evaluations of the line elements, immersion loci and connection and curvature forms of these immersions are algebraic. Families of immersions that depend on one or more arbitrary functions are calculated for 1 ≤ k ≤ 4. Appropriate sections of graphs of the conformal factor for two and three interacting line singularities immersed in M 6 are given in appendix A. The local immersion theorem given in appendix B shows that all local solutions of the immersion problem are obtained by use of this method and an algebraic extension in exceptional cases

  2. Map-based model of the cardiac action potential

    International Nuclear Information System (INIS)

    Pavlov, Evgeny A.; Osipov, Grigory V.; Chan, C.K.; Suykens, Johan A.K.

    2011-01-01

    A simple computationally efficient model which is capable of replicating the basic features of cardiac cell action potential is proposed. The model is a four-dimensional map and demonstrates good correspondence with real cardiac cells. Various regimes of cardiac activity, which can be reproduced by the proposed model, are shown. Bifurcation mechanisms of these regimes transitions are explained using phase space analysis. The dynamics of 1D and 2D lattices of coupled maps which model the behavior of electrically connected cells is discussed in the context of synchronization theory. -- Highlights: → Recent experimental-data based models are complicated for analysis and simulation. → The simplified map-based model of the cardiac cell is constructed. → The model is capable for replication of different types of cardiac activity. → The spatio-temporal dynamics of ensembles of coupled maps are investigated. → Received data are analyzed in context of biophysical processes in the myocardium.

  3. Map-based model of the cardiac action potential

    Energy Technology Data Exchange (ETDEWEB)

    Pavlov, Evgeny A., E-mail: genie.pavlov@gmail.com [Department of Computational Mathematics and Cybernetics, Nizhny Novgorod State University, 23, Gagarin Avenue, 603950 Nizhny Novgorod (Russian Federation); Osipov, Grigory V. [Department of Computational Mathematics and Cybernetics, Nizhny Novgorod State University, 23, Gagarin Avenue, 603950 Nizhny Novgorod (Russian Federation); Chan, C.K. [Institute of Physics, Academia Sinica, 128 Sec. 2, Academia Road, Nankang, Taipei 115, Taiwan (China); Suykens, Johan A.K. [K.U. Leuven, ESAT-SCD/SISTA, Kasteelpark Arenberg 10, B-3001 Leuven (Heverlee) (Belgium)

    2011-07-25

    A simple computationally efficient model which is capable of replicating the basic features of cardiac cell action potential is proposed. The model is a four-dimensional map and demonstrates good correspondence with real cardiac cells. Various regimes of cardiac activity, which can be reproduced by the proposed model, are shown. Bifurcation mechanisms of these regimes transitions are explained using phase space analysis. The dynamics of 1D and 2D lattices of coupled maps which model the behavior of electrically connected cells is discussed in the context of synchronization theory. -- Highlights: → Recent experimental-data based models are complicated for analysis and simulation. → The simplified map-based model of the cardiac cell is constructed. → The model is capable for replication of different types of cardiac activity. → The spatio-temporal dynamics of ensembles of coupled maps are investigated. → Received data are analyzed in context of biophysical processes in the myocardium.

  4. Solitons in four dimensional gravity

    International Nuclear Information System (INIS)

    Matos, T.

    1990-01-01

    An alternative method to solve the Chiral equations with SL (2,R) symmetry is developed. One gets the N-soliton solution using the Neugebauer Ansatz. For N = 1 one obtains the Backlund transformation of the Chiral equations. From the application of this transformation for the flat seed solution one finds the Kerr-NUT solution. This method can be applied to generate solutions of the n-dimensional Einstein equations (Author)

  5. Four-Dimensional Golden Search

    Energy Technology Data Exchange (ETDEWEB)

    Fenimore, Edward E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-02-25

    The Golden search technique is a method to search a multiple-dimension space to find the minimum. It basically subdivides the possible ranges of parameters until it brackets, to within an arbitrarily small distance, the minimum. It has the advantages that (1) the function to be minimized can be non-linear, (2) it does not require derivatives of the function, (3) the convergence criterion does not depend on the magnitude of the function. Thus, if the function is a goodness of fit parameter such as chi-square, the convergence does not depend on the noise being correctly estimated or the function correctly following the chi-square statistic. And, (4) the convergence criterion does not depend on the shape of the function. Thus, long shallow surfaces can be searched without the problem of premature convergence. As with many methods, the Golden search technique can be confused by surfaces with multiple minima.

  6. Four-dimensional superstring models

    International Nuclear Information System (INIS)

    Lykken, J.D.

    1997-01-01

    These five lectures give an elementary introduction to perturbative superstring theory, superstring phenomenology, and the fermionic construction of perturbative string models. These lectures assume no prior knowledge of string theory. (author) string theory. (author)

  7. Cardiac rehabilitation

    Science.gov (United States)

    ... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...

  8. A four dimensional separation method based on continuous heart-cutting gas chromatography with ion mobility and high resolution mass spectrometry.

    Science.gov (United States)

    Lipok, Christian; Hippler, Jörg; Schmitz, Oliver J

    2018-02-09

    A two-dimensional GC (2D-GC) method was developed and coupled to an ion mobility-high resolution mass spectrometer, which enables the separation of complex samples in four dimensions (2D-GC, ion mobilility spectrometry and mass spectrometry). This approach works as a continuous multiheart-cutting GC-system (GC+GC), using a long modulation time of 20s, which allows the complete transfer of most of the first dimension peaks to the second dimension column without fractionation, in comparison to comprehensive two-dimensional gas chromatography (GCxGC). Hence, each compound delivers only one peak in the second dimension, which simplifies the data handling even when ion mobility spectrometry as a third and mass spectrometry as a fourth dimension are introduced. The analysis of a plant extract from Calendula officinales shows the separation power of this four dimensional separation method. The introduction of ion mobility spectrometry provides an additional separation dimension and allows to determine collision cross sections (CCS) of the analytes as a further physicochemical constant supporting the identification. A CCS database with more than 800 standard substances including drug-like compounds and pesticides was used for CCS data base search in this work. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Speed and amplitude of lung tumor motion precisely detected in four-dimensional setup and in real-time tumor-tracking radiotherapy

    International Nuclear Information System (INIS)

    Shirato, Hiroki; Suzuki, Keishiro; Sharp, Gregory C.; Fujita, Katsuhisa R.T.; Onimaru, Rikiya; Fujino, Masaharu; Kato, Norio; Osaka, Yasuhiro; Kinoshita, Rumiko; Taguchi, Hiroshi; Onodera, Shunsuke; Miyasaka, Kazuo

    2006-01-01

    Background: To reduce the uncertainty of registration for lung tumors, we have developed a four-dimensional (4D) setup system using a real-time tumor-tracking radiotherapy system. Methods and Materials: During treatment planning and daily setup in the treatment room, the trajectory of the internal fiducial marker was recorded for 1 to 2 min at the rate of 30 times per second by the real-time tumor-tracking radiotherapy system. To maximize gating efficiency, the patient's position on the treatment couch was adjusted using the 4D setup system with fine on-line remote control of the treatment couch. Results: The trajectory of the marker detected in the 4D setup system was well visualized and used for daily setup. Various degrees of interfractional and intrafractional changes in the absolute amplitude and speed of the internal marker were detected. Readjustments were necessary during each treatment session, prompted by baseline shifting of the tumor position. Conclusion: The 4D setup system was shown to be useful for reducing the uncertainty of tumor motion and for increasing the efficiency of gated irradiation. Considering the interfractional and intrafractional changes in speed and amplitude detected in this study, intercepting radiotherapy is the safe and cost-effective method for 4D radiotherapy using real-time tracking technology

  10. Dimensional Reduction of N=1, E_8 SYM over SU(3)/U(1) x U(1) x Z_3 and its four-dimensional effective action

    CERN Document Server

    Irges, Nikos; Zoupanos, George

    2011-01-01

    We present an extension of the Standard Model inspired by the E_8 x E_8 Heterotic String. In order that a reasonable effective Lagrangian is presented we neglect everything else other than the ten-dimensional N=1 supersymmetric Yang-Mills sector associated with one of the gauge factors and certain couplings necessary for anomaly cancellation. We consider a compactified space-time M_4 x B_0 / Z_3, where B_0 is the nearly-Kaehler manifold SU(3)/U(1) x U(1) and Z_3 is a freely acting discrete group on B_0. Then we reduce dimensionally the E_8 on this manifold and we employ the Wilson flux mechanism leading in four dimensions to an SU(3)^3 gauge theory with the spectrum of a N=1 supersymmetric theory. We compute the effective four-dimensional Lagrangian and demonstrate that an extension of the Standard Model is obtained with interesting features including a conserved baryon number and fixed tree level Yukawa couplings and scalar potential. The spectrum contains new states such as right handed neutrinos and heavy ...

  11. Four-dimensional real-time sonographically guided cauterization of the umbilical cord in a case of twin-twin transfusion syndrome.

    Science.gov (United States)

    Timor-Tritsch, Ilan E; Rebarber, Andrei; MacKenzie, Andrew; Caglione, Christopher F; Young, Bruce K

    2003-07-01

    In the past decade, three-dimensional (3D) sonographic technology has matured from a static imaging modality to near-real-time imaging. One of the more notable improvements in this technology has been the speed with which the imaged volume is acquired and displayed. This has enabled the birth of the near-real-time or four-dimensional (4D) sonographic concept. Using the 4D feature of the current 3D sonography machines allows us to follow moving structures, such as fetal motion, in almost real time. Shortly after the emergence of 3D and 4D technology as a clinical imaging tool, its use in guiding needles into structures was explored by other investigators. We present a case in which we used the 4D feature of our sonographic equipment to follow the course and motion of an instrument inserted into the uterus to occlude the umbilical cord of a fetus in a case of twin-twin transfusion syndrome.

  12. Four-dimensional CT angiography (4D-CTA) in the evaluation of juvenile nasopharyngeal angiofibromas: comparison with digital subtraction angiography (DSA) and surgical findings.

    Science.gov (United States)

    Xiao, Zebin; Zheng, Yingyan; Li, Jian; Chen, Dehua; Liu, Fang; Cao, Dairong

    2017-12-01

    To explore the value of four-dimensional CT angiography (4D-CTA) in the preoperative evaluation of juvenile nasopharyngeal angiofibromas (JNAs) using 320-row volume CT. 4D-CTA and DSA data of 18 patients with histopathologically proven JNAs were retrospectively reviewed. The location, extent, feeding vessels and stage of JNAs were assessed by two radiologists independently and blindly. The agreements between both reviewers and between 4D-CTA and surgical findings for assessing the above indicators were analysed, respectively. The radiation dose and the number of feeding arteries between 4D-CTA and digital subtraction angiography (DSA) were also compared. 4D-CTA showed high diagnostic consistency with surgical pathology for JNAs with consistent rates of 96.2 and 100% in both reviewers, respectively. The effective dose of 4D-CTA was significantly less than that of DSA (p 0.05). 4D-CTA can provide a reliable preoperative diagnosis and assessment of JNAs, which is useful for determining the surgical strategy and management of this condition.

  13. Modulated Structures of Homologous Compounds In MO 3(ZnO) m( M=In, Ga; m=Integer) Described by Four-Dimensional Superspace Group

    Science.gov (United States)

    Li, Chunfei; Bando, Yoshio; Nakamura, Masaki; Onoda, Mitsuko; Kimizuka, Noboru

    1998-09-01

    The modulated structures appearing in the homologous compounds InMO3(ZnO)m(M=In, Ga;m=integer) were observed by using a high-resoultion transmission electron microscope and are described based on a four-dimensional superspace group. The electron diffraction patterns for compounds withmlarger than 6 reveal extra spots, indicating the formation of a modulated structure. The subcell structures form=odd and even numbers are assigned to be either monoclinic or orthorhombic, respectively. On the other hand, extra spots can be indexed by one-dimensional modulated structure. The possible space groups for the subcell structure areCm,C2, andC2/mform=odd numbers, while those form=even numbers areCcm21andCcmm, respectively. Then, corresponding possible superspace groups are assigned to bePC2s,PCmoverline1, andPC2/msoverline1for oddmnumbers andPCcm211overline1overline1andPCcmm1overline11for evenmnumbers. Based on the superspace group determination, a structure model for a one-dimensional modulated structure is proposed.

  14. Real-Space Imaging of Carrier Dynamics of Materials Surfaces by Second-Generation Four-Dimensional Scanning Ultrafast Electron Microscopy

    KAUST Repository

    Sun, Jingya

    2015-09-14

    In the fields of photocatalysis and photovoltaics, ultrafast dynamical processes, including carrier trapping and recombination on material surfaces, are among the key factors that determine the overall energy conversion efficiency. A precise knowledge of these dynamical events on the nanometer (nm) and femtosecond (fs) scales was not accessible until recently. The only way to access such fundamental processes fully is to map the surface dynamics selectively in real space and time. In this study, we establish a second generation of four-dimensional scanning ultrafast electron microscopy (4D S-UEM) and demonstrate the ability to record time-resolved images (snapshots) of material surfaces with 650 fs and ∼5 nm temporal and spatial resolutions, respectively. In this method, the surface of a specimen is excited by a clocking optical pulse and imaged using a pulsed primary electron beam as a probe pulse, generating secondary electrons (SEs), which are emitted from the surface of the specimen in a manner that is sensitive to the local electron/hole density. This method provides direct and controllable information regarding surface dynamics. We clearly demonstrate how the surface morphology, grains, defects, and nanostructured features can significantly impact the overall dynamical processes on the surface of photoactive-materials. In addition, the ability to access two regimes of dynamical probing in a single experiment and the energy loss of SEs in semiconductor-nanoscale materials will also be discussed.

  15. Reliability of fetal cardiac volumetry using spatiotemporal image correlation: assessment of in-vivo and in-vitro measurements

    NARCIS (Netherlands)

    Uittenbogaard, L.B.; Haak, M.C.; Tromp, C.H.N.; Terwee, C.B.; van Vugt, J.M.G.

    2010-01-01

    Objective To assess the reliability of measurement of fetal cardiac ventricular volume, stroke volume, and ejection fraction with four-dimensional ultrasound using spatiotemporal image correlation (STIC). Methods Volume datasets were collected from two sources: 24 from fetuses over a range of

  16. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    International Nuclear Information System (INIS)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di; Ionascu, Dan

    2012-01-01

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non–small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non–small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T L N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T L N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 ± 0.7 cm and 0.8 ± 0.3 cm, respectively, for B and T L N. Primary and involved LN expansions were 0.7 ± 0.5 cm and 1.1 ± 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T L N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  17. Assessing Respiration-Induced Tumor Motion and Internal Target Volume Using Four-Dimensional Computed Tomography for Radiotherapy of Lung Cancer

    International Nuclear Information System (INIS)

    Liu, H. Helen; Balter, Peter; Tutt, Teresa; Choi, Bum; Zhang, Joy; Wang, Catherine; Chi, Melinda; Luo Dershan; Pan Tinsu; Hunjan, Sandeep; Starkschall, George; Rosen, Isaac; Prado, Karl; Liao Zhongxing; Chang, Joe; Komaki, Ritsuko; Cox, James D.; Mohan, Radhe; Dong Lei

    2007-01-01

    Purpose: To assess three-dimensional tumor motion caused by respiration and internal target volume (ITV) for radiotherapy of lung cancer. Methods and Materials: Respiration-induced tumor motion was analyzed for 166 tumors from 152 lung cancer patients, 57.2% of whom had Stage III or IV non-small-cell lung cancer. All patients underwent four-dimensional computed tomography (4DCT) during normal breathing before treatment. The expiratory phase of 4DCT images was used as the reference set to delineate gross tumor volume (GTV). Gross tumor volumes on other respiratory phases and resulting ITVs were determined using rigid-body registration of 4DCT images. The association of GTV motion with various clinical and anatomic factors was analyzed statistically. Results: The proportions of tumors that moved >0.5 cm along the superior-inferior (SI), lateral, and anterior-posterior (AP) axes during normal breathing were 39.2%, 1.8%, and 5.4%, respectively. For 95% of the tumors, the magnitude of motion was less than 1.34 cm, 0.40 cm, and 0.59 cm along the SI, lateral, and AP directions. The principal component of tumor motion was in the SI direction, with only 10.8% of tumors moving >1.0 cm. The tumor motion was found to be associated with diaphragm motion, the SI tumor location in the lung, size of the GTV, and disease T stage. Conclusions: Lung tumor motion is primarily driven by diaphragm motion. The motion of locally advanced lung tumors is unlikely to exceed 1.0 cm during quiet normal breathing except for small lesions located in the lower half of the lung

  18. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ionascu, Dan, E-mail: Dan.ionascu@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-03-15

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T{sub L}N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T{sub L}N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 {+-} 0.7 cm and 0.8 {+-} 0.3 cm, respectively, for B and T{sub L}N. Primary and involved LN expansions were 0.7 {+-} 0.5 cm and 1.1 {+-} 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T{sub L}N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  19. Four-dimensional measurement of the displacement of internal fiducial and skin markers during 320-multislice computed tomography scanning of breast cancer.

    Science.gov (United States)

    Yamashita, Hideomi; Okuma, Kae; Tada, Keiichiro; Shiraishi, Kenshiro; Takahashi, Wataru; Shibata-Mobayashi, Shino; Sakumi, Akira; Saotome, Naoya; Haga, Akihiro; Onoe, Tsuyoshi; Ino, Kenji; Akahane, Masaaki; Ohtomo, Kuni; Nakagawa, Keiichi

    2012-10-01

    To study the three-dimensional movement of internal tumor bed fiducial and breast skin markers, using 320-multislice computed tomography (CT); and to analyze intrafractional errors for breast cancer patients undergoing breast irradiation. This study examined 280 markers on the skin of the breast (200 markers) and on the primary tumor bed (80 markers) of 20 patients treated by external-beam photon radiotherapy. Motion assessment was analyzed in 41 respiratory phases during 20 s of cine CT in the radiotherapy position. To assess intrafractional errors resulting from respiratory motion, four-dimensional CT scans were acquired for 20 patients. Motion in the anterior-posterior (A/P) and superior-inferior (S/I) directions showed a strong correlation (|r| > 0.7) with the respiratory curve for most markers (79% and 70%, respectively). The average marker displacements between maximum and minimum value during 20 s for the 200 breast skin metal markers were 1.1 ± 0.3 mm, 2.1 ± 0.6 mm, and 1.6 ± 0.4 mm in the left-right, A/P, and S/I directions, respectively. For the 80 tumor bed clips, displacements were 0.9 ± 0.2 mm in left-right, 1.7 ± 0.5 mm in A/P, and 1.1 ± 0.3 mm in S/I. There was no significant difference in the motion between breast quadrant regions or between the primary site and the other regions. Motion in primary breast tumors was evaluated with 320-multislice CT. Very little change was detected during individual radiation treatment fractions. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Comparison of Intensity-Modulated Radiotherapy Planning Based on Manual and Automatically Generated Contours Using Deformable Image Registration in Four-Dimensional Computed Tomography of Lung Cancer Patients

    International Nuclear Information System (INIS)

    Weiss, Elisabeth; Wijesooriya, Krishni; Ramakrishnan, Viswanathan; Keall, Paul J.

    2008-01-01

    Purpose: To evaluate the implications of differences between contours drawn manually and contours generated automatically by deformable image registration for four-dimensional (4D) treatment planning. Methods and Materials: In 12 lung cancer patients intensity-modulated radiotherapy (IMRT) planning was performed for both manual contours and automatically generated ('auto') contours in mid and peak expiration of 4D computed tomography scans, with the manual contours in peak inspiration serving as the reference for the displacement vector fields. Manual and auto plans were analyzed with respect to their coverage of the manual contours, which were assumed to represent the anatomically correct volumes. Results: Auto contours were on average larger than manual contours by up to 9%. Objective scores, D 2% and D 98% of the planning target volume, homogeneity and conformity indices, and coverage of normal tissue structures (lungs, heart, esophagus, spinal cord) at defined dose levels were not significantly different between plans (p = 0.22-0.94). Differences were statistically insignificant for the generalized equivalent uniform dose of the planning target volume (p = 0.19-0.94) and normal tissue complication probabilities for lung and esophagus (p = 0.13-0.47). Dosimetric differences >2% or >1 Gy were more frequent in patients with auto/manual volume differences ≥10% (p = 0.04). Conclusions: The applied deformable image registration algorithm produces clinically plausible auto contours in the majority of structures. At this stage clinical supervision of the auto contouring process is required, and manual interventions may become necessary. Before routine use, further investigations are required, particularly to reduce imaging artifacts

  1. Interfractional variability of respiration-induced esophageal tumor motion quantified using fiducial markers and four-dimensional cone-beam computed tomography.

    Science.gov (United States)

    Jin, Peng; Hulshof, Maarten C C M; van Wieringen, Niek; Bel, Arjan; Alderliesten, Tanja

    2017-07-01

    To investigate the interfractional variability of respiration-induced esophageal tumor motion using fiducial markers and four-dimensional cone-beam computed tomography (4D-CBCT) and assess if a 4D-CT is sufficient for predicting the motion during the treatment. Twenty-four patients with 63 markers visible in the retrospectively reconstructed 4D-CBCTs were included. For each marker, we calculated the amplitude and trajectory of the respiration-induced motion. Possible time trends of the amplitude over the treatment course and the interfractional variability of amplitudes and trajectory shapes were assessed. Further, the amplitudes measured in the 4D-CT were compared to those in the 4D-CBCTs. The amplitude was largest in the cranial-caudal direction of the distal esophagus (mean: 7.1mm) and proximal stomach (mean: 7.8mm). No time trend was observed in the amplitude over the treatment course. The interfractional variability of amplitudes and trajectory shapes was limited (mean: ≤1.4mm). Moreover, small and insignificant deviation was found between the amplitudes quantified in the 4D-CT and in the 4D-CBCT (mean absolute difference: ≤1.0mm). The limited interfractional variability of amplitudes and trajectory shapes and small amplitude difference between 4D-CT-based and 4D-CBCT-based measurements imply that a single 4D-CT would be sufficient for predicting the respiration-induced esophageal tumor motion during the treatment course. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. SU-G-TeP1-06: Fast GPU Framework for Four-Dimensional Monte Carlo in Adaptive Intensity Modulated Proton Therapy (IMPT) for Mobile Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Botas, P [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Heidelberg University, Heidelberg (Germany); Grassberger, C; Sharp, G; Paganetti, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Qin, N; Jia, X; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: To demonstrate the feasibility of fast Monte Carlo (MC) treatment planning and verification using four-dimensional CT (4DCT) for adaptive IMPT for lung cancer patients. Methods: A validated GPU MC code, gPMC, has been linked to the patient database at our institution and employed to compute the dose-influence matrices (Dij) on the planning CT (pCT). The pCT is an average of the respiratory motion of the patient. The Dijs and patient structures were fed to the optimizer to calculate a treatment plan. To validate the plan against motion, a 4D dose distribution averaged over the possible starting phases is calculated using the 4DCT and a model of the time structure of the delivered spot map. The dose is accumulated using vector maps created by a GPU-accelerated deformable image registration program (DIR) from each phase of the 4DCT to the reference phase using the B-spline method. Calculation of the Dij matrices and the DIR are performed on a cluster, with each field and vector map calculated in parallel. Results: The Dij production takes ∼3.5s per beamlet for 10e6 protons, depending on the energy and the CT size. Generating a plan with 4D simulation of 1000 spots in 4 fields takes approximately 1h. To test the framework, IMPT plans for 10 lung cancer patients were generated for validation. Differences between the planned and the delivered dose of 19% in dose to some organs at risk and 1.4/21.1% in target mean dose/homogeneity with respect to the plan were observed, suggesting potential for improvement if adaptation is considered. Conclusion: A fast MC treatment planning framework has been developed that allows reliable plan design and verification for mobile targets and adaptation of treatment plans. This will significantly impact treatments for lung tumors, as 4D-MC dose calculations can now become part of planning strategies.

  3. The Prognostic Value of a Four-Dimensional CT Angiography-Based Collateral Grading Scale for Reperfusion Therapy in Acute Ischemic Stroke Patients.

    Science.gov (United States)

    Zhang, Sheng; Chen, Weili; Tang, Huan; Han, Quan; Yan, Shenqiang; Zhang, Xiaocheng; Chen, Qingmeng; Parsons, Mark; Wang, Shaoshi; Lou, Min

    2016-01-01

    Leptomeningeal collaterals, which affects tissue fate, are still challenging to assess. Four-dimensional CT angiography (4D CTA) originated from CT perfusion (CTP) provides the possibility of non-invasive and time-resolved assessment of leptomeningeal collateral flow. We sought to develop a comprehensive rating system to integrate the speed and extent of collateral flow on 4D CTA, and investigate its prognostic value for reperfusion therapy in acute ischemic stroke (AIS) patients. We retrospectively studied 80 patients with M1 ± internal carotid artery (ICA) occlusion who had baseline CTP before intravenous thrombolysis. The velocity and extent of collaterals were evaluated by regional leptomeningeal collateral score on peak phase (rLMC-P) and temporally fused intensity projections (tMIP) (rLMC-M) on 4D CTA, respectively. The cutoffs of rLMC-P and rLMC-M score for predicting good outcome (mRS score ≤ 2) were integrated to develop the collateral grading scale (CGS) (rating from 0-2). The CGS score was correlated with 3-months mRS score (non-recanalizers: ρ = -0.495, p = 0.01; recanalizers: ρ = -0.671, p < 0.001). Patients with intermediate or good collaterals (CGS score of 1 and 2) who recanalized were more likely to have good outcome than those without recanalization (p = 0.038, p = 0.018), while there was no significant difference in outcome in patients with poor collaterals (CGS score of 0) stratified by recanalization (p = 0.227). Identification of collaterals based on CGS may help to select good responders to reperfusion therapy in patients with large artery occlusion.

  4. The English version of the four-dimensional symptom questionnaire (4DSQ) measures the same as the original Dutch questionnaire: a validation study.

    Science.gov (United States)

    Terluin, Berend; Smits, Niels; Miedema, Baukje

    2014-12-01

    Translations of questionnaires need to be carefully validated to assure that the translation measures the same construct(s) as the original questionnaire. The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-report questionnaire measuring distress, depression, anxiety and somatization. To evaluate the equivalence of the English version of the 4DSQ. 4DSQ data of English and Dutch speaking general practice attendees were analysed and compared. The English speaking group consisted of 205 attendees, aged 18-64 years, in general practice, in Canada whereas the Dutch group consisted of 302 general practice attendees in the Netherlands. Differential item functioning (DIF) analysis was conducted using the Mantel-Haenszel method and ordinal logistic regression. Differential test functioning (DTF; i.e., the scale impact of DIF) was evaluated using linear regression analysis. DIF was detected in 2/16 distress items, 2/6 depression items, 2/12 anxiety items, and 1/16 somatization items. With respect to mean scale scores, the impact of DIF on the scale level was negligible for all scales. On the anxiety scale DIF caused the English speaking patients with moderate to severe anxiety to score about one point lower than Dutch patients with the same anxiety level. The English 4DSQ measures the same constructs like the original Dutch 4DSQ. The distress, depression and somatization scales can employ the same cut-off points as the corresponding Dutch scales. However, cut-off points of the English 4DSQ anxiety scale should be lowered by one point to retain the same meaning as the Dutch anxiety cut-off points.

  5. Mid-Ventilation Concept for Mobile Pulmonary Tumors: Internal Tumor Trajectory Versus Selective Reconstruction of Four-Dimensional Computed Tomography Frames Based on External Breathing Motion

    International Nuclear Information System (INIS)

    Guckenberger, Matthias; Wilbert, Juergen; Krieger, Thomas; Richter, Anne; Baier, Kurt; Flentje, Michael

    2009-01-01

    Purpose: To evaluate the accuracy of direct reconstruction of mid-ventilation and peak-phase four-dimensional (4D) computed tomography (CT) frames based on the external breathing signal. Methods and Materials: For 11 patients with 15 pulmonary targets, a respiration-correlated CT study (4D CT) was acquired for treatment planning. After retrospective time-based sorting of raw projection data and reconstruction of eight CT frames equally distributed over the breathing cycle, mean tumor position (P mean ), mid-ventilation frame, and breathing motion were evaluated based on the internal tumor trajectory. Analysis of the external breathing signal (pressure sensor around abdomen) with amplitude-based sorting of projections was performed for direct reconstruction of the mid-ventilation frame and frames at peak phases of the breathing cycle. Results: On the basis of the eight 4D CT frames equally spaced in time, tumor motion was largest in the craniocaudal direction, with 12 ± 7 mm on average. Tumor motion between the two frames reconstructed at peak phases was not different in the craniocaudal and anterior-posterior directions but was systematically smaller in the left-right direction by 1 mm on average. The 3-dimensional distance between P mean and the tumor position in the mid-ventilation frame based on the internal tumor trajectory was 1.2 ± 1 mm. Reconstruction of the mid-ventilation frame at the mean amplitude position of the external breathing signal resulted in tumor positions 2.0 ± 1.1 mm distant from P mean . Breathing-induced motion artifacts in mid-ventilation frames caused negligible changes in tumor volume and shape. Conclusions: Direct reconstruction of the mid-ventilation frame and frames at peak phases based on the external breathing signal was reliable. This makes the reconstruction of only three 4D CT frames sufficient for application of the mid-ventilation technique in clinical practice.

  6. SU-F-J-133: Adaptive Radiation Therapy with a Four-Dimensional Dose Calculation Algorithm That Optimizes Dose Distribution Considering Breathing Motion

    Energy Technology Data Exchange (ETDEWEB)

    Ali, I; Algan, O; Ahmad, S [University of Oklahoma Health Sciences, Oklahoma City, OK (United States); Alsbou, N [University of Central Oklahoma, Edmond, OK (United States)

    2016-06-15

    Purpose: To model patient motion and produce four-dimensional (4D) optimized dose distributions that consider motion-artifacts in the dose calculation during the treatment planning process. Methods: An algorithm for dose calculation is developed where patient motion is considered in dose calculation at the stage of the treatment planning. First, optimal dose distributions are calculated for the stationary target volume where the dose distributions are optimized considering intensity-modulated radiation therapy (IMRT). Second, a convolution-kernel is produced from the best-fitting curve which matches the motion trajectory of the patient. Third, the motion kernel is deconvolved with the initial dose distribution optimized for the stationary target to produce a dose distribution that is optimized in four-dimensions. This algorithm is tested with measured doses using a mobile phantom that moves with controlled motion patterns. Results: A motion-optimized dose distribution is obtained from the initial dose distribution of the stationary target by deconvolution with the motion-kernel of the mobile target. This motion-optimized dose distribution is equivalent to that optimized for the stationary target using IMRT. The motion-optimized and measured dose distributions are tested with the gamma index with a passing rate of >95% considering 3% dose-difference and 3mm distance-to-agreement. If the dose delivery per beam takes place over several respiratory cycles, then the spread-out of the dose distributions is only dependent on the motion amplitude and not affected by motion frequency and phase. This algorithm is limited to motion amplitudes that are smaller than the length of the target along the direction of motion. Conclusion: An algorithm is developed to optimize dose in 4D. Besides IMRT that provides optimal dose coverage for a stationary target, it extends dose optimization to 4D considering target motion. This algorithm provides alternative to motion management

  7. Correlations of third-trimester hiatal biometry obtained using four-dimensional translabial ultrasonography with the delivery route in nulliparous pregnant women

    Directory of Open Access Journals (Sweden)

    Teerayut Temtanakitpaisan

    2016-01-01

    Full Text Available Purpose: The goal of this study was to evaluate normal hiatal dimensions in the third trimester in nulliparous Thai pregnant women and to establish which biometric factors were associated with various pregnancy outcomes. Methods: Fifty-seven consecutive nulliparous pregnant Thai women in their third trimester were recruited on a voluntary basis from April to October 2014. All subjects underwent four-dimensional (4D translabial ultrasonography. Hiatal biometric parameters were measured at rest, while performing a Valsalva maneuver, and during contraction. Information about the patients’ eventual deliveries was obtained from their medical records. Results: The mean values of the patients’ age, body mass index, and gestational age at the time of examination were 27.4±5.47 years, 26.7±3.48 kg/m2, and 36.6±1.49 weeks, respectively. No subjects had vaginal lumps or experienced prolapse greater than stage 1 of the Pelvic Organ Prolapse Quantification system. Ultrasonography showed that the mean values of the hiatal area at rest, while performing a Valsalva maneuver, and during contraction were 13.10±2.92 cm2, 17.50±4.81 cm2, and 9.69±2.09 cm2, respectively. The hiatal area at rest, the axial measurement at rest, and the axial measurement while performing a Valsalva maneuver were significantly associated with the route of delivery (P=0.02, P=0.04, and P=0.03, respectively. Conclusion: The route of delivery was associated with hiatal biometric values measured using 4D translabial ultrasonography, based on the results of nulliparous Thai women in the third trimester.

  8. Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

    Science.gov (United States)

    Löbel, Ulrike; Forkert, Nils Daniel; Schmitt, Peter; Dohrmann, Thorsten; Schroeder, Maria; Magnus, Tim; Kluge, Stefan; Weiler-Normann, Christina; Bi, Xiaoming; Fiehler, Jens; Sedlacik, Jan

    2016-01-01

    Conventional magnetic resonance imaging (MRI) of patients with hemolytic uremic syndrome (HUS) and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI) revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF) and aimed to identify a plausible cause. Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years) were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved) magnetic resonance angiography (4D MRA) assessed cerebral hemodynamics by global time-to-peak (TTP), as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2. SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4). Hemoglobin at the time of MRI (n = 35) was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4); hematocrit (n = 33) was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2). Creatinine was abnormally high in 30 of 36 patients (83%) (range, 0.8 to 9.7; mean, 3.7 ± 2.2). SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015), hematocrit (r = 0.65, P effect of blood transfusions in patients with HUS and neurological symptoms.

  9. Four dimensional data assimilation (FDDA) impacts on WRF performance in simulating inversion layer structure and distributions of CMAQ-simulated winter ozone concentrations in Uintah Basin

    Science.gov (United States)

    Tran, Trang; Tran, Huy; Mansfield, Marc; Lyman, Seth; Crosman, Erik

    2018-03-01

    Four-dimensional data assimilation (FDDA) was applied in WRF-CMAQ model sensitivity tests to study the impact of observational and analysis nudging on model performance in simulating inversion layers and O3 concentration distributions within the Uintah Basin, Utah, U.S.A. in winter 2013. Observational nudging substantially improved WRF model performance in simulating surface wind fields, correcting a 10 °C warm surface temperature bias, correcting overestimation of the planetary boundary layer height (PBLH) and correcting underestimation of inversion strengths produced by regular WRF model physics without nudging. However, the combined effects of poor performance of WRF meteorological model physical parameterization schemes in simulating low clouds, and warm and moist biases in the temperature and moisture initialization and subsequent simulation fields, likely amplified the overestimation of warm clouds during inversion days when observational nudging was applied, impacting the resulting O3 photochemical formation in the chemistry model. To reduce the impact of a moist bias in the simulations on warm cloud formation, nudging with the analysis water mixing ratio above the planetary boundary layer (PBL) was applied. However, due to poor analysis vertical temperature profiles, applying analysis nudging also increased the errors in the modeled inversion layer vertical structure compared to observational nudging. Combining both observational and analysis nudging methods resulted in unrealistically extreme stratified stability that trapped pollutants at the lowest elevations at the center of the Uintah Basin and yielded the worst WRF performance in simulating inversion layer structure among the four sensitivity tests. The results of this study illustrate the importance of carefully considering the representativeness and quality of the observational and model analysis data sets when applying nudging techniques within stable PBLs, and the need to evaluate model results

  10. Dosimetric Advantages of Four-Dimensional Adaptive Image-Guided Radiotherapy for Lung Tumors Using Online Cone-Beam Computed Tomography

    International Nuclear Information System (INIS)

    Harsolia, Asif; Hugo, Geoffrey D.; Kestin, Larry L.; Grills, Inga S.; Yan Di

    2008-01-01

    Purpose: This study compares multiple planning techniques designed to improve accuracy while allowing reduced planning target volume (PTV) margins though image-guided radiotherapy (IGRT) with four-dimensional (4D) cone-beam computed tomography (CBCT). Methods and Materials: Free-breathing planning and 4D-CBCT scans were obtained in 8 patients with lung tumors. Four plans were generated for each patient: 3D-conformal, 4D-union, 4D-offline adaptive with a single correction (offline ART), and 4D-online adaptive with daily correction (online ART). For the 4D-union plan, the union of gross tumor volumes from all phases of the 4D-CBCT was created with a 5-mm expansion applied for setup uncertainty. For offline and online ART, the gross tumor volume was delineated at the mean position of tumor motion from the 4D-CBCT. The PTV margins were calculated from the random components of tumor motion and setup uncertainty. Results: Adaptive IGRT techniques provided better PTV coverage with less irradiated normal tissues. Compared with 3D plans, mean relative decreases in PTV volumes were 15%, 39%, and 44% using 4D-union, offline ART, and online ART planning techniques, respectively. This resulted in mean lung volume receiving ≥ 20Gy (V20) relative decreases of 21%, 23%, and 31% and mean lung dose relative decreases of 16%, 26%, and 31% for the 4D-union, 4D-offline ART, and 4D-online ART, respectively. Conclusions: Adaptive IGRT using CBCT is feasible for the treatment of patients with lung tumors and significantly decreases PTV volume and dose to normal tissues, allowing for the possibility of dose escalation. All analyzed 4D planning strategies resulted in improvements over 3D plans, with 4D-online ART appearing optimal

  11. Comparison of three approaches to delineate internal gross tumor volume based on four-dimensional CT simulation images of non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Li Fengxiang; Li Jianbin; Zhang Yingjie; Shang Dongping; Liu Tonghai; Tian Shiyu; Xu Min; Ma Changsheng

    2011-01-01

    Objective: To compare positional and volumetric differences of internal gross tumor volume (IGTV) delineated separately by three approaches based on four-dimensional CT (4DCT) for the primary tumor of non-small cell lung cancer (NLCLC). Methods: Twenty-one patients with NLCLC underwent big bore 4DCT simulation scan of the thorax. IGTVs of the primary tumor of NSCLC were delineated using three approaches as followed: (1) the gross tumor volume (GTV) on each of the ten the respiratory phases of the 4DCT image set were delineated and the ten GTV were fused to produce IGTV 10 ; (2) the GTV delineated separately based on 0% and 50% phase were fused to produce IGTV EI+EE ; (3) the visible tumor on the MIP images were delineated to produce IGTV MIP . The position of the target center, the volume of target, the degree of inclusion (DI) and the matching index (MI) were compared reciprocally between IGTV 10 , IGTV EI+EE and IGTV MIP . Results: Average differences between the position of the center of IGTVs on direction of x, y and z axes were less than 1 mm, with no statistically significant difference. The volume of IGTV 10 was larger than that of IGTV EI+EE , the difference was statistically significant (t=2.37, P=0.028); the volume of IGTV 10 was larger than that of IGTV MIP , but the difference was not statistically significant (t=1.95, P=0.065). The ratio of IGTV EI+EE with IGTV 10 , IGTV MIP with IGTV 10 were 0.85±0.08 and 0.92±0.11, respectively. DI of IGTV EI+EE in IGTV 10 , IGTV MIP in IGTV 10 were 84.78% ± 8. 95% and 88.47% ±9.04%. MI between IGTV 10 and IGTV EI+EE , IGTV 10 and IGTV MIP were 0.85 ±0.09, 0.86±0.09, respectively. Conclusions: The center displacement of the IGTVs delineated separately by the three different techniques based on 4DCT images are not obvious; IGTV EI+EE and IGTV MIP can not replace IGTV 10 , however, IGTV MIP is more close to IGTV 10 comparing to IGTV EI+EE . The ratio of GTV EI+EE with IGTV 10 is correlated to the tumor motion

  12. SU-F-207-13: Comparison of Four Dimensional Computed Tomography (4D CT) Versus Breath Hold Images to Determine Pulmonary Nodule Elasticity

    Energy Technology Data Exchange (ETDEWEB)

    Negahdar, M; Loo, B; Maxim, P [Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: Elasticity may distinguish malignant from benign pulmonary nodules. To compare determining of malignant pulmonary nodule (MPN) elasticity from four dimensional computed tomography (4D CT) images versus inhale/exhale breath-hold CT images. Methods: We analyzed phase 00 and 50 of 4D CT and deep inhale and natural exhale of breath-hold CT images of 30 MPN treated with stereotactic ablative radiotherapy (SABR). The radius of the smallest MPN was 0.3 cm while the biggest one was 2.1 cm. An intensity based deformable image registration (DIR) workflow was applied to the 4D CT and breath-hold images to determine the volumes of the MPNs and a 1 cm ring of surrounding lung tissue (ring) in each state. Next, an elasticity parameter was derived by calculating the ratio of the volume changes of MPN (exhale:inhale or phase50:phase00) to that of a 1 cm ring of lung tissue surrounding the MPN. The proposed formulation of elasticity enables us to compare volume changes of two different MPN in two different locations of lung. Results: The calculated volume ratio of MPNs from 4D CT (phase50:phase00) and breath-hold images (exhale:inhale) was 1.00±0.23 and 0.95±0.11, respectively. It shows the stiffness of MPN and comparably bigger volume changes of MPN in breath-hold images because of the deeper degree of inhalation. The calculated elasticity of MPNs from 4D CT and breath-hold images was 1.12±0.22 and 1.23±0.26, respectively. For five patients who have had two MPN in their lung, calculated elasticity of tumor A and tumor B follows same trend in both 4D CT and breath-hold images. Conclusion: We showed that 4D CT and breath-hold images are comparable in the ability to calculate the elasticity of MPN. This study has been supported by Department of Defense LCRP 2011 #W81XWH-12-1-0286.

  13. Development of an ultrasmall C-band linear accelerator guide for a four-dimensional image-guided radiotherapy system with a gimbaled x-ray head.

    Science.gov (United States)

    Kamino, Yuichiro; Miura, Sadao; Kokubo, Masaki; Yamashita, Ichiro; Hirai, Etsuro; Hiraoka, Masahiro; Ishikawa, Junzo

    2007-05-01

    We are developing a four-dimensional image-guided radiotherapy system with a gimbaled x-ray head. It is capable of pursuing irradiation and delivering irradiation precisely with the help of an agile moving x-ray head on the gimbals. Requirements for the accelerator guide were established, system design was developed, and detailed design was conducted. An accelerator guide was manufactured and basic beam performance and leakage radiation from the accelerator guide were evaluated at a low pulse repetition rate. The accelerator guide including the electron gun is 38 cm long and weighs about 10 kg. The length of the accelerating structure is 24.4 cm. The accelerating structure is a standing wave type and is composed of the axial-coupled injector section and the side-coupled acceleration cavity section. The injector section is composed of one prebuncher cavity, one buncher cavity, one side-coupled half cavity, and two axial coupling cavities. The acceleration cavity section is composed of eight side-coupled nose reentrant cavities and eight coupling cavities. The electron gun is a diode-type gun with a cerium hexaboride (CeB6) direct heating cathode. The accelerator guide can be operated without any magnetic focusing device. Output beam current was 75 mA with a transmission efficiency of 58%, and the average energy was 5.24 MeV. Beam energy was distributed from 4.95 to 5.6 MeV. The beam profile, measured 88 mm from the beam output hole on the axis of the accelerator guide, was 0.7 mm X 0.9 mm full width at half maximum (FWHM) width. The beam loading line was 5.925 (MeV)-Ib (mA) X 0.00808 (MeV/mA), where Ib is output beam current. The maximum radiation leakage of the accelerator guide at 100 cm from the axis of the accelerator guide was calculated as 0.33 cGy/min at the rated x-ray output of 500 cGy/min from the measured value. This leakage requires no radiation shielding for the accelerator guide itself per IEC 60601-2-1.

  14. SU-E-J-110: Dosimetric Analysis of Respiratory Motion Based On Four-Dimensional Dose Accumulation in Liver Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, S; Kim, D; Kim, T; Kim, K; Cho, M; Shin, D; Suh, T [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States); Park, S [Uijeongbu St.Mary’s Hospital, GyeongGi-Do (Korea, Republic of)

    2015-06-15

    Purpose: Respiratory motion in thoracic and abdominal region could lead to significant underdosing of target and increased dose to healthy tissues. The aim of this study is to evaluate the dosimetric effect of respiratory motion in conventional 3D dose by comparing 4D deformable dose in liver stereotactic body radiotherapy (SBRT). Methods: Five patients who had previously treated liver SBRT were included in this study. Four-dimensional computed tomography (4DCT) images with 10 phases for all patients were acquired on multi-slice CT scanner (Siemens, Somatom definition). Conventional 3D planning was performed using the average intensity projection (AIP) images. 4D dose accumulation was calculated by summation of dose distribution for all phase images of 4DCT using deformable image registration (DIR) . The target volume and normal organs dose were evaluated with the 4D dose and compared with those from 3D dose. And also, Index of achievement (IOA) which assesses the consistency between planned dose and prescription dose was used to compare target dose distribution between 3D and 4D dose. Results: Although the 3D dose calculation considered the moving target coverage, significant differences of various dosimetric parameters between 4D and 3D dose were observed in normal organs and PTV. The conventional 3D dose overestimated dose to PTV, however, there was no significant difference for GTV. The average difference of IOA which become ‘1’ in an ideal case was 3.2% in PTV. The average difference of liver and duodenum was 5% and 16% respectively. Conclusion: 4D dose accumulation which can provide dosimetric effect of respiratory motion has a possibility to predict the more accurate delivered dose to target and normal organs and improve treatment accuracy. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the

  15. TU-F-17A-09: Four-Dimensional Cone Beam CT Ventilation Imaging Can Detect Interfraction Lung Function Variations for Locally Advanced Lung Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kipritidis, J; Keall, P [Radiation Physics Laboratory, University of Sydney, Sydney NSW 2006 Australia (Australia); Hugo, G; Weiss, E; Williamson, J [Department of Radiation Oncology, Virginia Commonwealth University, Richmond VA (United States)

    2014-06-15

    Purpose: Four-dimensional cone beam CT ventilation imaging (4D-CBCT VI) is a novel functional lung imaging modality requiring validation. We hypothesize that 4D-CBCT VI satisfies a necessary condition for validity: that intrafraction variations (e.g. due to poor 4D-CBCT image quality) are substantially different to interfraction variations (e.g. due to changes in underlying function). We perform the first comparison of intrafraction (pre/post fraction) and interfraction (week-to-week) 4D-CBCT VIs for locally advanced non small cell lung cancer (LA NSCLC) patients undergoing radiation therapy. Methods: A total of 215 4D-CBCT scans were acquired for 19 LA NSCLC patients over 4-6 weeks of radiation therapy, including 75 pairs of pre-/post-fraction scans on the same day. 4D-CBCT VIs were obtained by applying state-of-the-art, B-spline deformable image registration to obtain the Jacobian determinant of deformation between the end-exhale and end-inhale phases. All VIs were deformably registered to the corresponding first day scan, normalized between the 10th and 90th percentile values and cropped to the ipsilateral lung only. Intrafraction variations were assessed by computing the mean and standard deviation of voxel-wise differences between all same-day pairs of pre-/post-fraction VIs. Interfraction differences were computed between first-day VIs and treatment weeks 2, 4 and 6 for all 19 patients. We tested the hypothesis by comparing cumulative distribution functions (CDFs) of intrafraction and interfraction ventilation differences using two-sided Kolmogorov-Smirnov goodness-of-fit tests. Results: The (mean ± std. dev.) of intrafraction differences was (−0.007 ± 0.079). Interfraction differences for weeks 2, 4 and 6 were (−0.035 ± 0.103), (−0.006 ± 0.094) and (−0.019 ± 0.127) respectively. For week 2, the changes in CDFs for intrafraction and interfraction differences approached statistical significance (p=0.099). Conclusion: We have shown that 4D-CBCT VI

  16. O the Development and Use of Four-Dimensional Data Assimilation in Limited-Area Mesoscale Models Used for Meteorological Analysis.

    Science.gov (United States)

    Stauffer, David R.

    1990-01-01

    The application of dynamic relationships to the analysis problem for the atmosphere is extended to use a full-physics limited-area mesoscale model as the dynamic constraint. A four-dimensional data assimilation (FDDA) scheme based on Newtonian relaxation or "nudging" is developed and evaluated in the Penn State/National Center for Atmospheric Research (PSU/NCAR) mesoscale model, which is used here as a dynamic-analysis tool. The thesis is to determine what assimilation strategies and what meterological fields (mass, wind or both) have the greatest positive impact on the 72-h numerical simulations (dynamic analyses) of two mid-latitude, real-data cases. The basic FDDA methodology is tested in a 10-layer version of the model with a bulk-aerodynamic (single-layer) representation of the planetary boundary layer (PBL), and refined in a 15-layer version of the model by considering the effects of data assimilation within a multi-layer PBL scheme. As designed, the model solution can be relaxed toward either gridded analyses ("analysis nudging"), or toward the actual observations ("obs nudging"). The data used for assimilation include standard 12-hourly rawinsonde data, and also 3-hourly mesoalpha-scale surface data which are applied within the model's multi-layer PBL. Continuous assimilation of standard-resolution rawinsonde data into the 10-layer model successfully reduced large-scale amplitude and phase errors while the model realistically simulated mesoscale structures poorly defined or absent in the rawinsonde analyses and in the model simulations without FDDA. Nudging the model fields directly toward the rawinsonde observations generally produced results comparable to nudging toward gridded analyses. This obs -nudging technique is especially attractive for the assimilation of high-frequency, asynoptic data. Assimilation of 3-hourly surface wind and moisture data into the 15-layer FDDA system was most effective for improving the simulated precipitation fields because a

  17. New Visualization Techniques to Analyze Ultra-High Resolution Four-dimensional Surface Deformation Imagery Collected With Ground-based Tripod LiDAR

    Science.gov (United States)

    Kreylos, O.; Bawden, G. W.; Kellogg, L. H.

    2005-12-01

    We are developing a visualization application to display and interact with very large (tens of millions of points) four-dimensional point position datasets in an immersive environment such that point groups from repeated Tripod LiDAR (Light Detection And Ranging) surveys can be selected, measured, and analyzed for land surface change using 3D~interactions. Ground-based tripod or terrestrial LiDAR (T-LiDAR) can remotely collect ultra-high resolution (centimeter to subcentimeter) and accurate (± 4 mm) digital imagery of the scanned target, and at scanning rates of 2,000 (x, y, z, i) (3D~position~+ intensity) points per second over 7~million points can be collected for a given target in an hour. We developed a multiresolution point set data representation based on octrees to display large T-LiDAR point cloud datasets at the frame rates required for immersive display (between 60 Hz and 120 Hz). Data inside an observer's region of interest is shown in full detail, whereas data outside the field of view or far away from the observer is shown at reduced resolution to provide context. Using 3D input devices at the University of California Davis KeckCAVES, users can navigate large point sets, accurately select related point groups in two or more point sets by sweeping regions of space, and guide the software in deriving positional information from point groups to compute their displacements between surveys. We used this new software application in the KeckCAVES to analyze 4D T-LiDAR imagery from the June~1, 2005 Blue Bird Canyon landslide in Laguna Beach, southern California. Over 50~million (x, y, z, i) data points were collected between 10 and 21~days after the landslide to evaluate T-LiDAR as a natural hazards response tool. The visualization of the T-LiDAR scans within the immediate landslide showed minor readjustments in the weeks following the primarily landslide with no observable continued motion on the primary landslide. Recovery and demolition efforts across the

  18. Real-time respiration monitoring using the radiotherapy treatment beam and four-dimensional computed tomography (4DCT)-a conceptual study

    International Nuclear Information System (INIS)

    Lu Weiguo; Ruchala, Kenneth J; Chen, Ming-Li; Chen, Quan; Olivera, Gustavo H

    2006-01-01

    Real-time knowledge of intra-fraction motion, such as respiration, is essential for four-dimensional (4D) radiotherapy. Surrogate-based and internal-fiducial-based methods may suffer from one or many drawbacks such as false correlation, being invasive, delivering extra patient radiation, and requiring complicated hardware and software development and implementation. In this paper we develop a simple non-surrogate, non-invasive method to monitor respiratory motion during radiotherapy treatments in real time. This method directly utilizes the treatment beam and thus imposes no additional radiation to the patient. The method requires a pre-treatment 4DCT and a real-time detector system. The method combines off-line processes with on-line processes. The off-line processes include 4DCT imaging and pre-calculating detector signals at each phase of the 4DCT based on the planned fluence map and the detector response function. The on-line processes include measuring detector signal from the treatment beam, and correlating the measured detector signal with the pre-calculated signals. The respiration phase is determined as the position of peak correlation. We tested our method with extensive simulations based on a TomoTherapy machine and a 4DCT of a lung cancer patient. Three types of simulations were implemented to mimic the clinical situations. Each type of simulation used three different TomoTherapy delivery sinograms, each with 800 to 1000 projections, as input fluences. Three arbitrary breathing patterns were simulated and two dose levels, 2 Gy/fraction and 2 cGy/fraction, were used for simulations to study the robustness of this method against detector quantum noise. The algorithm was used to determine the breathing phases and this result was compared with the simulated breathing patterns. For the 2 Gy/fraction simulations, the respiration phases were accurately determined within one phase error in real time for most projections of the treatment, except for a few

  19. Electromechanical vortex filaments during cardiac fibrillation

    Science.gov (United States)

    Christoph, J.; Chebbok, M.; Richter, C.; Schröder-Schetelig, J.; Bittihn, P.; Stein, S.; Uzelac, I.; Fenton, F. H.; Hasenfuß, G.; Gilmour, R. F., Jr.; Luther, S.

    2018-03-01

    The self-organized dynamics of vortex-like rotating waves, which are also known as scroll waves, are the basis of the formation of complex spatiotemporal patterns in many excitable chemical and biological systems. In the heart, filament-like phase singularities that are associated with three-dimensional scroll waves are considered to be the organizing centres of life-threatening cardiac arrhythmias. The mechanisms that underlie the onset, maintenance and control of electromechanical turbulence in the heart are inherently three-dimensional phenomena. However, it has not previously been possible to visualize the three-dimensional spatiotemporal dynamics of scroll waves inside cardiac tissues. Here we show that three-dimensional mechanical scroll waves and filament-like phase singularities can be observed deep inside the contracting heart wall using high-resolution four-dimensional ultrasound-based strain imaging. We found that mechanical phase singularities co-exist with electrical phase singularities during cardiac fibrillation. We investigated the dynamics of electrical and mechanical phase singularities by simultaneously measuring the membrane potential, intracellular calcium concentration and mechanical contractions of the heart. We show that cardiac fibrillation can be characterized using the three-dimensional spatiotemporal dynamics of mechanical phase singularities, which arise inside the fibrillating contracting ventricular wall. We demonstrate that electrical and mechanical phase singularities show complex interactions and we characterize their dynamics in terms of trajectories, topological charge and lifetime. We anticipate that our findings will provide novel perspectives for non-invasive diagnostic imaging and therapeutic applications.

  20. Cardiac arrest

    Science.gov (United States)

    ... magnesium. These minerals help your heart's electrical system work. Abnormally high or low levels can cause cardiac arrest. Severe physical stress. Anything that causes a severe stress on your ...

  1. Cardiac Ochronosis

    Science.gov (United States)

    Erek, Ersin; Casselman, Filip P.A.; Vanermen, Hugo

    2004-01-01

    We report the case of 67-year-old woman who underwent aortic valve replacement and mitral valve repair due to ochronotic valvular disease (alkaptonuria), which was diagnosed incidentally during cardiac surgery. PMID:15745303

  2. Cardiac catheterization

    Science.gov (United States)

    ... tests. However, it is very safe when done by an experienced team. The risks include: Cardiac tamponade Heart attack Injury to a coronary artery Irregular heartbeat Low blood pressure Reaction to the contrast dye Stroke Possible complications ...

  3. A correlation study on the displacement of the whole breast target after breast-conserving surgery based on four-dimensional computed tomography

    International Nuclear Information System (INIS)

    Wang Wei; Li Jianbin; Wang Suzhen; Zhang Yingjie; Li Fengxiang; Xu Min; Shang Dongping

    2011-01-01

    Objective: To investigate the correlations of the whole breast displacement in different respiratory cycle during free breathing (FB) following breast-conserving surgery to the displacement of selected skin marker, nipple, and selected surgical clip based on four-dimensional computed tomography (4D-CT). Methods: Thirteen breast cancer patients who had undergone breast-conserving surgery received whole breast intensity-modulated radiotherapy (IMRT). Respiration-synchronized 4D-CT image data were gathered during FB and were exported to the Varian Eclipse treatment planning system, and the whole breast target, nipple, superior clip,and metal marker on the skin at the anterior body midline were delineated on the CT images of ten phases of the respiratory cycle by the same radiotherapist based on the same delineating criteria. The displacement distances of the delineated target in the mediolateral (x), anteroposterior (y), and superoinferior (z) axles were achieved,and the correlations of the whole breast target displacement to the displacement of the clip, nipple, and skin marker were analyzed. The ipsilateral lung was delineated on the CT images of every phase of the respiratory cycle, and the changes in ipsilateral lung volume were analyzed during the respiratory cycle relative to the displacement of the breast. Results: The maximal displacement distances of the whole breast target in the x, y, and z axles during FB were 0.71, 0.76 and 1.29 mm, respectively (F=5.755, P<0.05). There was no relationship between the three-dimensional (3D) displacement of the whole breast and the volume of the whole breast (r=-0.264, P<0.05), and there was no relationship between the displacement of the whole breast and the volume change of the ipsilateral lung (r=0.346, P<0.05). There was no significant difference among the mean target displacement distances in 3 axles,and among 2 selected successive end-inspiration (EI) phases and 3 selected successive end-expiration (EE) phases. There

  4. The effect of irregular breathing patterns on internal target volumes in four-dimensional CT and cone-beam CT images in the context of stereotactic lung radiotherapy

    International Nuclear Information System (INIS)

    Clements, N.; Kron, T.; Roxby, P.; Franich, R.; Dunn, L.; Aarons, Y.; Chesson, B.; Siva, S.; Duplan, D.; Ball, D.

    2013-01-01

    Purpose: Stereotactic lung radiotherapy is complicated by tumor motion from patient respiration. Four-dimensional CT (4DCT) imaging is a motion compensation method used in treatment planning to generate a maximum intensity projection (MIP) internal target volume (ITV). Image guided radiotherapy during treatment may involve acquiring a volumetric cone-beam CT (CBCT) image and visually aligning the tumor to the planning 4DCT MIP ITV contour. Moving targets imaged with CBCT can appear blurred and currently there are no studies reporting on the effect that irregular breathing patterns have on CBCT volumes and their alignment to 4DCT MIP ITV contours. The objective of this work was therefore to image a phantom moving with irregular breathing patterns to determine whether any configurations resulted in errors in volume contouring or alignment. Methods: A Perspex thorax phantom was used to simulate a patient. Three wooden “lung” inserts with embedded Perspex “lesions” were moved up to 4 cm with computer-generated motion patterns, and up to 1 cm with patient-specific breathing patterns. The phantom was imaged on 4DCT and CBCT with the same acquisition settings used for stereotactic lung patients in the clinic and the volumes on all phantom images were contoured. This project assessed the volumes for qualitative and quantitative changes including volume, length of the volume, and errors in alignment between CBCT volumes and 4DCT MIP ITV contours. Results: When motion was introduced 4DCT and CBCT volumes were reduced by up to 20% and 30% and shortened by up to 7 and 11 mm, respectively, indicating that volume was being under-represented at the extremes of motion. Banding artifacts were present in 4DCT MIP images, while CBCT volumes were largely reduced in contrast. When variable amplitudes from patient traces were used and CBCT ITVs were compared to 4DCT MIP ITVs there was a distinct trend in reduced ITV with increasing amplitude that was not seen when compared to

  5. The effect of irregular breathing patterns on internal target volumes in four-dimensional CT and cone-beam CT images in the context of stereotactic lung radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Clements, N. [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne 3002, Australia and Department of Applied Sciences, RMIT University, Melbourne 3001 (Australia); Kron, T.; Roxby, P. [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne 3002 (Australia); Franich, R.; Dunn, L. [Department of Applied Sciences, RMIT University, Melbourne 3001 (Australia); Aarons, Y.; Chesson, B. [Department of Radiation Therapy, Peter MacCallum Cancer Centre, East Melbourne 3002 (Australia); Siva, S.; Duplan, D.; Ball, D. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne 3002 (Australia)

    2013-02-15

    Purpose: Stereotactic lung radiotherapy is complicated by tumor motion from patient respiration. Four-dimensional CT (4DCT) imaging is a motion compensation method used in treatment planning to generate a maximum intensity projection (MIP) internal target volume (ITV). Image guided radiotherapy during treatment may involve acquiring a volumetric cone-beam CT (CBCT) image and visually aligning the tumor to the planning 4DCT MIP ITV contour. Moving targets imaged with CBCT can appear blurred and currently there are no studies reporting on the effect that irregular breathing patterns have on CBCT volumes and their alignment to 4DCT MIP ITV contours. The objective of this work was therefore to image a phantom moving with irregular breathing patterns to determine whether any configurations resulted in errors in volume contouring or alignment. Methods: A Perspex thorax phantom was used to simulate a patient. Three wooden 'lung' inserts with embedded Perspex 'lesions' were moved up to 4 cm with computer-generated motion patterns, and up to 1 cm with patient-specific breathing patterns. The phantom was imaged on 4DCT and CBCT with the same acquisition settings used for stereotactic lung patients in the clinic and the volumes on all phantom images were contoured. This project assessed the volumes for qualitative and quantitative changes including volume, length of the volume, and errors in alignment between CBCT volumes and 4DCT MIP ITV contours. Results: When motion was introduced 4DCT and CBCT volumes were reduced by up to 20% and 30% and shortened by up to 7 and 11 mm, respectively, indicating that volume was being under-represented at the extremes of motion. Banding artifacts were present in 4DCT MIP images, while CBCT volumes were largely reduced in contrast. When variable amplitudes from patient traces were used and CBCT ITVs were compared to 4DCT MIP ITVs there was a distinct trend in reduced ITV with increasing amplitude that was not seen when

  6. SU-F-303-13: Initial Evaluation of Four Dimensional Diffusion- Weighted MRI (4D-DWI) and Its Effect On Apparent Diffusion Coefficient (ADC) Measurement

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Y [Duke University Medical Physics Program (United States); Yin, F; Czito, B; Bashir, M; Palta, M; Cai, J [Duke University Medical Center, Durham, NC (United States); Zhong, X; Dale, B [Siemens Healthcare, Durham, NC (United States)

    2015-06-15

    Purpose: Diffusion-weighted imaging(DWI) has been shown to have superior tumor-to-tissue contrast for cancer detection.This study aims at developing and evaluating a four dimensional DWI(4D-DWI) technique using retrospective sorting method for imaging respiratory motion for radiotherapy planning,and evaluate its effect on Apparent Diffusion Coefficient(ADC) measurement. Materials/Methods: Image acquisition was performed by repeatedly imaging a volume of interest using a multi-slice single-shot 2D-DWI sequence in the axial planes and cine MRI(served as reference) using FIESTA sequence.Each 2D-DWI image were acquired in xyz-diffusion-directions with a high b-value(b=500s/mm2).The respiratory motion was simultaneously recorded using bellows.Retrospective sorting was applied in each direction to reconstruct 4D-DWI.The technique was evaluated using a computer simulated 4D-digital human phantom(XCAT),a motion phantom and a healthy volunteer under an IRB-approved study.Motion trajectories of regions-of-interests(ROI) were extracted from 4D-DWI and compared with reference.The mean motion trajectory amplitude differences(D) between the two was calculated.To quantitatively analyze the motion artifacts,XCAT were controlled to simulate regular motion and the motions of 10 liver cancer patients.4D-DWI,free-breathing DWI(FB- DWI) were reconstructed.Tumor volume difference(VD) of each phase of 4D-DWI and FB-DWI from the input static tumor were calculated.Furthermore, ADC was measured for each phase of 4D-DWI and FB-DWI data,and mean tumor ADC values(M-ADC) were calculated.Mean M-ADC over all 4D-DWI phases was compared with M-ADC calculated from FB-DWI. Results: 4D-DWI of XCAT,the motion phantom and the healthy volunteer demonstrated the respiratory motion clearly.ROI D values were 1.9mm,1.7mm and 2.0mm,respectively.For motion artifacts analysis,XCAT 4D-DWI images show much less motion artifacts compare to FB-DWI.Mean VD for 4D-WDI and FB-DWI were 8.5±1.4% and 108±15

  7. Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

    Directory of Open Access Journals (Sweden)

    Ulrike Löbel

    Full Text Available Conventional magnetic resonance imaging (MRI of patients with hemolytic uremic syndrome (HUS and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF and aimed to identify a plausible cause.Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved magnetic resonance angiography (4D MRA assessed cerebral hemodynamics by global time-to-peak (TTP, as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2.SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4. Hemoglobin at the time of MRI (n = 35 was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4; hematocrit (n = 33 was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2. Creatinine was abnormally high in 30 of 36 patients (83% (range, 0.8 to 9.7; mean, 3.7 ± 2.2. SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015, hematocrit (r = 0.65, P < 0.001, and TTP (r = 0.35, P = 0.036. No correlation of SWI with blood pressure, heart rate, end-tidal CO2, creatinine, and urea level was observed. Findings suggest that the loss of venous contrast is related to an increase in CBF secondary to severe anemia related to HUS. SWI contrast of patients with pathological conventional MRI findings was significantly lower compared to patients with normal MRI (mean SWI score, 1

  8. Nuclear cardiac

    International Nuclear Information System (INIS)

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques

  9. Four-dimensional MAP-RBI-EM image reconstruction method with a 4D motion prior for 4D gated myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taek-Soo; Tsui, Benjamin M.W. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Radiology; Gullberg, Grant T. [Lawrence Berkeley National Laboratory, Berkeley, CA (United States)

    2011-07-01

    We evaluated and proposed here a 4D maximum a posteriori rescaled-block iterative (MAP-RBI)-EM image reconstruction method with a motion prior to improve the accuracy of 4D gated myocardial perfusion (GMP) SPECT images. We hypothesized that a 4D motion prior which resembles the global motion of the true 4D motion of the heart will improve the accuracy of the reconstructed images with regional myocardial motion defect. Normal heart model in the 4D XCAT (eXtended CArdiac-Torso) phantom is used as the prior in the 4D MAP-RBI-EM algorithm where a Gaussian-shaped distribution is used as the derivative of potential function (DPF) that determines the smoothing strength and range of the prior in the algorithm. The mean and width of the DPF equal to the expected difference between the reconstructed image and the motion prior, and smoothing range, respectively. To evaluate the algorithm, we used simulated projection data from a typical clinical {sup 99m}Tc Sestamibi GMP SPECT study using the 4D XCAT phantom. The noise-free projection data were generated using an analytical projector that included the effects of attenuation, collimator-detector response and scatter (ADS) and Poisson noise was added to generated noisy projection data. The projection datasets were reconstructed using the modified 4D MAP-RBI-EM with various iterations, prior weights, and sigma values as well as with ADS correction. The results showed that the 4D reconstructed image estimates looked more like the motion prior with sharper edges as the weight of prior increased. It also demonstrated that edge preservation of the myocardium in the GMP SPECT images could be controlled by a proper motion prior. The Gaussian-shaped DPF allowed stronger and weaker smoothing force for smaller and larger difference of neighboring voxel values, respectively, depending on its parameter values. We concluded the 4D MAP-RBI-EM algorithm with the general motion prior can be used to provide 4D GMP SPECT images with improved

  10. Cardiac CT

    International Nuclear Information System (INIS)

    Dewey, Marc

    2011-01-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  11. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  12. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  13. [Cardiac cachexia].

    Science.gov (United States)

    Miján, Alberto; Martín, Elvira; de Mateo, Beatriz

    2006-05-01

    Chronic heart failure (CHF), especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular) mass and adipose and bone tissue osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  14. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    Fiandra, O.; Espasandin, W.; Fiandra, H.

    1984-01-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  15. Prenatal Diagnosis of Fetal Interrupted Aortic Arch Type A by Two-Dimensional Echocardiography and Four-Dimensional Echocardiography with B-Flow Imaging and Spatiotemporal Image Correlation.

    Science.gov (United States)

    Zhang, Dongyu; Zhang, Ying; Ren, Weidong; Sun, Feifei; Guo, Yajun; Sun, Wei; Wang, Yu; Huang, Liping; Cai, Ailu

    2016-01-01

    Fetal interrupted aortic arch (IAA) is a rare cardiac anomaly and its prenatal diagnosis is challenging. The purpose of our report is to evaluate the use of two-dimensional echocardiography (2DE) and 4D echocardiography with B-flow imaging and spatiotemporal image correlation (4D BF-STIC) in detecting IAA type A (IAA-A). Twenty-three cases of confirmed IAA-A identified by fetal echocardiography were involved in the study. The fetal echocardiography image data were reviewed to analyze the ratio of right ventricle to left ventricle (RV/LV) diameter, the ratio of main pulmonary artery to ascending aorta (MPA/AAO) diameter, and the correlation of RV/LV diameter ratio and size of ventricular septal defect (VSD). 4D BF-STIC was performed in 21 fetuses using the sagittal view (4D BF-STIC-sagittal) and the four-chamber view (4D BF-STIC-4CV) as initial planes of view. An additional 183 normal fetuses were also included in our study. RV/LV and MPA/AAO ratios were calculated and compared with that of IAA-A fetuses. Fetal 2DE, 4D BF-STIC-sagittal, and 4D BF-STIC-4CV were used to visualize the aortic arch and its associated neck vessels. Six subgroups were evaluated according to gestational age. Fetal 2DE, 4D BF-STIC-sagittal, and 4D BF-STIC-4CV made the correct prenatal diagnosis of IAA-A in 19/23 (82.6%), 14/21 (66.7%), and 19/21 (90.5%) of patients, respectively. A significantly enlarged MPA combined with symmetric ventricles was found in the IAA-A fetuses, while the size of the VSD was negatively correlated with RV/LV ratio. 4D BF-STIC-sagittal and 4D BF-STIC-4CV were better than traditional 2D ultrasound in detecting the aortic arch and neck vessels between 17 and 28 gestational weeks and 29 to 40 gestational weeks in normal fetuses. It is demonstrated that IAA-A could be diagnosed by traditional fetal echocardiography, while 4D technique could better display the anatomic structure and the spatial relationships of the great arteries. Use of volume reconstruction may

  16. Research on the Countermeasures for High-end Talent Development in the New Material Industry from the Perspective of Four-dimensional Subject-With Hunan Province as an Example

    Science.gov (United States)

    Wen, Qiong

    2018-03-01

    In the context of the increasingly severe international economic situation, the new material industry is as one of the seven strategic emerging industries, and its development has become a major strategic decision of China that should be insisted at present and in the future. The implementation of this strategic decision cannot be achieved without talents. Based on the actual situation of Hunan Province, this paper points out the four major problems in high-end talent development of Hunan Province, namely, immaturity of industry development, unreasonable talent structure, imperfect training mechanism and unscientific incentive measures, and purposes the countermeasures in the perspective of four-dimensional subject involving government, enterprises, schools and students.

  17. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  18. Cardiac pacemaker

    International Nuclear Information System (INIS)

    Kolenik, S.A.

    1976-01-01

    The construction of a cardiac pacemaker is described which is characterized by particularly small dimensions, small weight and long life duration. The weight is under 100g, the specific weight under 1.7. Mass inertia forces which occur through acceleration and retardation processes, thus remain below the threshold values, above which one would have to reckon with considerable damaging of the surrounding body tissue. The maintaining of small size and slight weight is achieved by using an oscillator on COSMOS basis, where by considerably lower energy consumption, amongst others the lifetimes of the batteries used - a lithium anode with thionyl chloride electrolyte - is extended to over 5 years. The reliability can be increased by the use of 2 or more batteries. The designed dimension are 20x60x60 mm 3 . (ORU/LH) [de

  19. Cardiac ventriculography

    International Nuclear Information System (INIS)

    Hillis, L.D.; Grossman, W.

    1986-01-01

    Cardiac ventriculography has been used extensively to define the anatomy of the ventricles and related structures in patients with congenital, valvular, coronary, and cardiomyopathic heart disease. Specifically, left ventriculography may provide valuable information about global and segmental left ventricular function, mitral valvular incompetence, and the presence, location, and severity of a number of other abnormalities, including ventricular septal defect and hypertrophic cardiomyopathy. As a result, it should be a routine part of catheterization in patients being evaluated for coronary artery disease, aortic or mitral valvular disease, unexplained left ventricular failure, or congenital heart disease. Similarly, right ventriculography may provide information about global and segmental right ventricular function and can be especially helpful in patients with congenital heart disease

  20. Magnetic properties of four dimensional fermions

    Science.gov (United States)

    Bergman, Oren; Lifschytz, Gilad; Lippert, Matthew

    2013-12-01

    We investigate the Sakai-Sugimoto model at nonzero baryon chemical potential in a background magnetic field in the chiral symmetric phase. We find that a new form of baryonic matter shows up, and we investigate its properties. We find a generated axial current, a reduction in the amount of charge participating in dissipative interactions and a metamagnetic like phase transition at low temperature.

  1. EIT image reconstruction with four dimensional regularization.

    Science.gov (United States)

    Dai, Tao; Soleimani, Manuchehr; Adler, Andy

    2008-09-01

    Electrical impedance tomography (EIT) reconstructs internal impedance images of the body from electrical measurements on body surface. The temporal resolution of EIT data can be very high, although the spatial resolution of the images is relatively low. Most EIT reconstruction algorithms calculate images from data frames independently, although data are actually highly correlated especially in high speed EIT systems. This paper proposes a 4-D EIT image reconstruction for functional EIT. The new approach is developed to directly use prior models of the temporal correlations among images and 3-D spatial correlations among image elements. A fast algorithm is also developed to reconstruct the regularized images. Image reconstruction is posed in terms of an augmented image and measurement vector which are concatenated from a specific number of previous and future frames. The reconstruction is then based on an augmented regularization matrix which reflects the a priori constraints on temporal and 3-D spatial correlations of image elements. A temporal factor reflecting the relative strength of the image correlation is objectively calculated from measurement data. Results show that image reconstruction models which account for inter-element correlations, in both space and time, show improved resolution and noise performance, in comparison to simpler image models.

  2. A Four-Dimensional Product Innovativeness Typology

    DEFF Research Database (Denmark)

    Rosenø, Axel

    2005-01-01

    ) typology with four newproduct types; Leonard-Barton's (1995) five product types; and Veryzer's (1998a)four types in a two-by-two matrix.Interestingly, these two meta-perspectives on product innovativeness (i.e. 1. new tothe market and/or new to the company and 2. technological and/or marketnewness...... discontinuous newproduct projects (Song & Montoya-Weiss 1998; Atuahene-Gima 1995; Veryzer 1998a;Lynn et al. 1996; O'Connor 1998; Rice et al. 1998). By looking at both these types ofnew product development projects, empirical observations are likely to be morerealistic than those of studies that do...... the dichotomous view and, thereby, lend themselves to a more finegrainedstudy of innovation management practices for different types of newproduct projects.In fact, various innovativeness typologies exist that include more than two producttypes. Notably, the typology by Booz, Allen & Hamilton (1982)2 introduces...

  3. Cardiac regeneration therapy: connections to cardiac physiology.

    Science.gov (United States)

    Takehara, Naofumi; Matsubara, Hiroaki

    2011-12-01

    Without heart transplantation, a large number of patients with failing hearts worldwide face poor outcomes. By means of cardiomyocyte regeneration, cardiac regeneration therapy is emerging with great promise as a means for restoring loss of cardiac function. However, the limited success of clinical trials using bone marrow-derived cells and myoblasts with heterogeneous constituents, transplanted at a wide range of cell doses, has led to disagreement on the efficacy of cell therapy. It is therefore essential to reevaluate the evidence for the efficacy of cell-based cardiac regeneration therapy, focusing on targets, materials, and methodologies. Meanwhile, the revolutionary innovation of cardiac regeneration therapy is sorely needed to help the millions of people who suffer heart failure from acquired loss of cardiomyocytes. Cardiac regeneration has been used only in limited species or as a developing process in the rodent heart; now, the possibility of cardiomyocyte turnover in the human heart is being revisited. In the pursuit of this concept, the use of cardiac stem/progenitor stem cells in the cardiac niche must be focused to usher in a second era of cardiac regeneration therapy for the severely injured heart. In addition, tissue engineering and cellular reprogramming will advance the next era of treatment that will enable current cell-based therapy to progress to "real" cardiac regeneration therapy. Although many barriers remain, the prevention of refractory heart failure through cardiac regeneration is now becoming a realistic possibility.

  4. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    Gulati, Gurpreet S; Kothari, Shyam S

    2011-01-01

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  5. Comparison of primary tumour volumes delineated on four-dimensional computed tomography maximum intensity projection and 18F-fluorodeoxyglucose positron emission tomography computed tomography images of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Duan, Yili; Li, Jianbin; Zhang, Yingjie; Wang, Wei; Fan, Tingyong; Shao, Qian; Xu, Min; Guo, Yanluan; Sun, Xiaorong; Shang, Dongping

    2015-01-01

    The study aims to compare the positional and volumetric differences of tumour volumes based on the maximum intensity projection (MIP) of four-dimensional CT (4DCT) and 18 F-fluorodexyglucose ( 18 F-FDG) positron emission tomography CT (PET/CT) images for the primary tumour of non-small cell lung cancer (NSCLC). Ten patients with NSCLC underwent 4DCT and 18 F-FDG PET/CT scans of the thorax on the same day. Internal gross target volumes (IGTVs) of the primary tumours were contoured on the MIP images of 4DCT to generate IGTV MIP . Gross target volumes (GTVs) based on PET (GTV PET ) were determined with nine different threshold methods using the auto-contouring function. The differences in the volume, position, matching index (MI) and degree of inclusion (DI) of the GTV PET and IGTV MIP were investigated. In volume terms, GTV PET2.0 and GTV PET20% approximated closely to IGTV MIP with mean volume ratio of 0.93 ± 0.45 and 1.06 ± 0.43, respectively. The best MI was between IGTV MIP and GTV PET20% (0.45 ± 0.23). The best DI of IGTV MIP in GTV PET was IGTV MIP in GTV PET20% (0.61 ± 0.26). In 3D PET images, the GTVPET contoured by standardised uptake value (SUV) 2.0 or 20% of maximal SUV (SUV max ) approximate closely to the IGTV MIP in target size, while the spatial mismatch is apparent between them. Therefore, neither of them could replace IGTV MIP in spatial position and form. The advent of 4D PET/CT may improve the accuracy of contouring the perimeter for moving targets.

  6. MO-DE-207A-08: Four-Dimensional Cone-Beam CT Iterative Reconstruction with Time-Ordered Chain Graph Model for Non-Periodic Organ Motion and Deformation

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, M; Haga, A; Hanaoka, S; Nakagawa, K [The University of Tokyo Hospital, Bunkyo-ku, Tokyo (Japan); Kotoku, J [Teikyo University, Itabashi-ku, Tokyo (Japan); Magome, T [Komazawa University, Setagaya-ku, Tokyo (Japan); Masutani, Y [Hiroshima-City University, Hiroshima, Hiroshima (Japan)

    2016-06-15

    Purpose: The purpose of this study is to propose a new concept of four-dimensional (4D) cone-beam CT (CBCT) reconstruction for non-periodic organ motion using the Time-ordered Chain Graph Model (TCGM), and to compare the reconstructed results with the previously proposed methods, the total variation-based compressed sensing (TVCS) and prior-image constrained compressed sensing (PICCS). Methods: CBCT reconstruction method introduced in this study consisted of maximum a posteriori (MAP) iterative reconstruction combined with a regularization term derived from a concept of TCGM, which includes a constraint coming from the images of neighbouring time-phases. The time-ordered image series were concurrently reconstructed in the MAP iterative reconstruction framework. Angular range of projections for each time-phase was 90 degrees for TCGM and PICCS, and 200 degrees for TVCS. Two kinds of projection data, an elliptic-cylindrical digital phantom data and two clinical patients’ data, were used for reconstruction. The digital phantom contained an air sphere moving 3 cm along longitudinal axis, and temporal resolution of each method was evaluated by measuring the penumbral width of reconstructed moving air sphere. The clinical feasibility of non-periodic time-ordered 4D CBCT reconstruction was also examined using projection data of prostate cancer patients. Results: The results of reconstructed digital phantom shows that the penumbral widths of TCGM yielded the narrowest result; PICCS and TCGM were 10.6% and 17.4% narrower than that of TVCS, respectively. This suggests that the TCGM has the better temporal resolution than the others. Patients’ CBCT projection data were also reconstructed and all three reconstructed results showed motion of rectal gas and stool. The result of TCGM provided visually clearer and less blurring images. Conclusion: The present study demonstrates that the new concept for 4D CBCT reconstruction, TCGM, combined with MAP iterative reconstruction

  7. Quantification of the kV X-ray imaging dose during real-time tumor tracking and from three- and four-dimensional cone-beam computed tomography in lung cancer patients using a Monte Carlo simulation.

    Science.gov (United States)

    Nakamura, Mitsuhiro; Ishihara, Yoshitomo; Matsuo, Yukinori; Iizuka, Yusuke; Ueki, Nami; Iramina, Hiraku; Hirashima, Hideaki; Mizowaki, Takashi

    2018-03-01

    Knowledge of the imaging doses delivered to patients and accurate dosimetry of the radiation to organs from various imaging procedures is becoming increasingly important for clinicians. The purposes of this study were to calculate imaging doses delivered to the organs of lung cancer patients during real-time tumor tracking (RTTT) with three-dimensional (3D), and four-dimensional (4D) cone-beam computed tomography (CBCT), using Monte Carlo techniques to simulate kV X-ray dose distributions delivered using the Vero4DRT. Imaging doses from RTTT, 3D-CBCT and 4D-CBCT were calculated with the planning CT images for nine lung cancer patients who underwent stereotactic body radiotherapy (SBRT) with RTTT. With RTTT, imaging doses from correlation modeling and from monitoring of imaging during beam delivery were calculated. With CBCT, doses from 3D-CBCT and 4D-CBCT were also simulated. The doses covering 2-cc volumes (D2cc) in correlation modeling were up to 9.3 cGy for soft tissues and 48.4 cGy for bone. The values from correlation modeling and monitoring were up to 11.0 cGy for soft tissues and 59.8 cGy for bone. Imaging doses in correlation modeling were larger with RTTT. On a single 4D-CBCT, the skin and bone D2cc values were in the ranges of 7.4-10.5 cGy and 33.5-58.1 cGy, respectively. The D2cc from 4D-CBCT was approximately double that from 3D-CBCT. Clinicians should Figure that the imaging dose increases the cumulative doses to organs.

  8. Cardiac gated ventilation

    International Nuclear Information System (INIS)

    Hanson, C.W. III; Hoffman, E.A.

    1995-01-01

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart

  9. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  10. Geometrical differences in target volumes based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography and four-dimensional computed tomography maximum intensity projection images of primary thoracic esophageal cancer.

    Science.gov (United States)

    Guo, Y; Li, J; Wang, W; Zhang, Y; Wang, J; Duan, Y; Shang, D; Fu, Z

    2014-01-01

    The objective of the study was to compare geometrical differences of target volumes based on four-dimensional computed tomography (4DCT) maximum intensity projection (MIP) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images of primary thoracic esophageal cancer for radiation treatment. Twenty-one patients with thoracic esophageal cancer sequentially underwent contrast-enhanced three-dimensional computed tomography (3DCT), 4DCT, and 18F-FDG PET/CT thoracic simulation scans during normal free breathing. The internal gross target volume defined as IGTVMIP was obtained by contouring on MIP images. The gross target volumes based on PET/CT images (GTVPET ) were determined with nine different standardized uptake value (SUV) thresholds and manual contouring: SUV≥2.0, 2.5, 3.0, 3.5 (SUVn); ≥20%, 25%, 30%, 35%, 40% of the maximum (percentages of SUVmax, SUVn%). The differences in volume ratio (VR), conformity index (CI), and degree of inclusion (DI) between IGTVMIP and GTVPET were investigated. The mean centroid distance between GTVPET and IGTVMIP ranged from 4.98 mm to 6.53 mm. The VR ranged from 0.37 to 1.34, being significantly (P<0.05) closest to 1 at SUV2.5 (0.94), SUV20% (1.07), or manual contouring (1.10). The mean CI ranged from 0.34 to 0.58, being significantly closest to 1 (P<0.05) at SUV2.0 (0.55), SUV2.5 (0.56), SUV20% (0.56), SUV25% (0.53), or manual contouring (0.58). The mean DI of GTVPET in IGTVMIP ranged from 0.61 to 0.91, and the mean DI of IGTVMIP in GTVPET ranged from 0.34 to 0.86. The SUV threshold setting of SUV2.5, SUV20% or manual contouring yields the best tumor VR and CI with internal-gross target volume contoured on MIP of 4DCT dataset, but 3DPET/CT and 4DCT MIP could not replace each other for motion encompassing target volume delineation for radiation treatment. © 2014 International Society for Diseases of the Esophagus.

  11. SU-G-JeP4-06: Evaluation of Interfractional and Intrafractional Tumor Motion in Stereotactic Liver Radiotherapy, Based On Four-Dimensional Cone-Beam Computed Tomography Using Fiducial Markers

    International Nuclear Information System (INIS)

    Shimohigashi, Y; Araki, F; Toya, R; Maruyama, M; Nakaguchi, Y

    2016-01-01

    Purpose: The purpose of this study was to evaluate the interfractional and intrafractional motion of liver tumors in stereotactic body radiation therapy (SBRT), based on four-dimensional cone-beam computed tomography using fiducial markers. (4D-CBCT). Methods: Seven patients with liver tumors were treated by SBRT with abdominal compression (AC) in five fractions with image guidance based on 4D-CBCT. The 4D-CBCT studies were performed to determine the individualized internal margin for the planning simulation. The interfractional and intrafractional changes of liver tumor motion for all patients was measured, based on the planning simulation 4D-CBCT, pre-SBRT 4D-CBCT, and post-SBRT 4D-CBCT. The interfractional motion change was calculated from the difference in liver tumor amplitude on pre-SBRT 4D-CBCT relative to that of the planning simulation 4D-CBCT for each fraction. The intrafractional motion change was calculated from the difference between the liver tumor amplitudes of the pre- and post-SBRT 4D-CBCT for each fraction. Significant interfractional and intrafractional changes in liver tumor motion were defined as a change ≥3 mm. Statistical analysis was performed using the Pearson correlation. Results: The values of the mean amplitude of liver tumor, as indicated by planning simulation 4D-CBCT, were 1.6 ± 0.8 mm, 1.6 ± 0.9 mm, and 4.9 ± 2.2 mm in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions, respectively. Pearson correlation coefficients between the liver tumor amplitudes, based on planning simulation 4D-CBCT, and pre-SBRT 4D-CBCT during fraction treatment in the LR, AP, and SI directions were 0.6, 0.7, and 0.8, respectively. Interfractional and intrafractional motion changes of ≥3 mm occurred in 23% and 3% of treatment fractions, respectively. Conclusion: The interfractional and intrafractional changes of liver tumor motion were small in most patients who received liver SBRT with AC. In addition, planning

  12. SU-G-JeP4-06: Evaluation of Interfractional and Intrafractional Tumor Motion in Stereotactic Liver Radiotherapy, Based On Four-Dimensional Cone-Beam Computed Tomography Using Fiducial Markers

    Energy Technology Data Exchange (ETDEWEB)

    Shimohigashi, Y [Department of Radiological Technology, Kumamoto University Hospital, Department of Graduate School of Health Sciences, Kumamoto University (Japan); Araki, F [Department of Health Sciences, Kumamoto University (Japan); Toya, R [Department of Radiation Oncology, Kumamoto University Hospital (Japan); Department of Human Oncology, University of Wisconsin School of Medicine and Public Health (United States); Maruyama, M; Nakaguchi, Y [Department of Radiological Technology, Kumamoto University Hospital (Japan)

    2016-06-15

    Purpose: The purpose of this study was to evaluate the interfractional and intrafractional motion of liver tumors in stereotactic body radiation therapy (SBRT), based on four-dimensional cone-beam computed tomography using fiducial markers. (4D-CBCT). Methods: Seven patients with liver tumors were treated by SBRT with abdominal compression (AC) in five fractions with image guidance based on 4D-CBCT. The 4D-CBCT studies were performed to determine the individualized internal margin for the planning simulation. The interfractional and intrafractional changes of liver tumor motion for all patients was measured, based on the planning simulation 4D-CBCT, pre-SBRT 4D-CBCT, and post-SBRT 4D-CBCT. The interfractional motion change was calculated from the difference in liver tumor amplitude on pre-SBRT 4D-CBCT relative to that of the planning simulation 4D-CBCT for each fraction. The intrafractional motion change was calculated from the difference between the liver tumor amplitudes of the pre- and post-SBRT 4D-CBCT for each fraction. Significant interfractional and intrafractional changes in liver tumor motion were defined as a change ≥3 mm. Statistical analysis was performed using the Pearson correlation. Results: The values of the mean amplitude of liver tumor, as indicated by planning simulation 4D-CBCT, were 1.6 ± 0.8 mm, 1.6 ± 0.9 mm, and 4.9 ± 2.2 mm in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions, respectively. Pearson correlation coefficients between the liver tumor amplitudes, based on planning simulation 4D-CBCT, and pre-SBRT 4D-CBCT during fraction treatment in the LR, AP, and SI directions were 0.6, 0.7, and 0.8, respectively. Interfractional and intrafractional motion changes of ≥3 mm occurred in 23% and 3% of treatment fractions, respectively. Conclusion: The interfractional and intrafractional changes of liver tumor motion were small in most patients who received liver SBRT with AC. In addition, planning

  13. Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ and the Hospital Anxiety and Depression Scale (HADS

    Directory of Open Access Journals (Sweden)

    Verhaak Peter FM

    2009-08-01

    Full Text Available Abstract Background Depressive and anxiety disorders often go unrecognized in distressed primary care patients, despite the overtly psychosocial nature of their demand for help. This is especially problematic in more severe disorders needing specific treatment (e.g. antidepressant pharmacotherapy or specialized cognitive behavioural therapy. The use of a screening tool to detect (more severe depressive and anxiety disorders may be useful not to overlook such disorders. We examined the accuracy with which the Four-Dimensional Symptom Questionnaire (4DSQ and the Hospital Anxiety and Depression Scale (HADS are able to detect (more severe depressive and anxiety disorders in distressed patients, and which cut-off points should be used. Methods Seventy general practitioners (GPs included 295 patients on sick leave due to psychological problems. They excluded patients with recognized depressive or anxiety disorders. Patients completed the 4DSQ and HADS. Standardized diagnoses of DSM-IV defined depressive and anxiety disorders were established with the Composite International Diagnostic Interview (CIDI. Receiver Operating Characteristic (ROC analyses were performed to obtain sensitivity and specificity values for a range of scores, and area under the curve (AUC values as a measure of diagnostic accuracy. Results With respect to the detection of any depressive or anxiety disorder (180 patients, 61%, the 4DSQ and HADS scales yielded comparable results with AUC values between 0.745 and 0.815. Also with respect to the detection of moderate or severe depressive disorder, the 4DSQ and HADS depression scales performed comparably (AUC 0.780 and 0.739, p 0.165. With respect to the detection of panic disorder, agoraphobia and social phobia, the 4DSQ anxiety scale performed significantly better than the HADS anxiety scale (AUC 0.852 versus 0.757, p 0.001. The recommended cut-off points of both HADS scales appeared to be too low while those of the 4DSQ anxiety

  14. Preoperative assessment of pleural adhesion by Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) with Adaptive Iterative Dose Reduction using Three-Dimensional processing (AIDR-3D).

    Science.gov (United States)

    Hashimoto, Masayuki; Nagatani, Yukihiro; Oshio, Yasuhiko; Nitta, Norihisa; Yamashiro, Tsuneo; Tsukagoshi, Shinsuke; Ushio, Noritoshi; Mayumi, Masayuki; Kimoto, Tatsuya; Igarashi, Tomoyuki; Yoshigoe, Makoto; Iwai, Kyohei; Tanaka, Koki; Sato, Shigetaka; Sonoda, Akinaga; Otani, Hideji; Murata, Kiyoshi; Hanaoka, Jun

    2018-01-01

    To assess the feasibility of Four-Dimensional Ultra-Low-Dose Computed Tomography (4D-ULDCT) for distinguishing pleural aspects with localized pleural adhesion (LPA) from those without. Twenty-seven patients underwent 4D-ULDCT during a single respiration with a 16cm-coverage of the body axis. The presence and severity of LPA was confirmed by their intraoperative thoracoscopic findings. A point on the pleura and a corresponding point on the outer edge of the costal bone were placed in identical axial planes at end-inspiration. The distance of the two points (PCD), traced by automatic tracking functions respectively, was calculated at each respiratory phase. The maximal and average change amounts in PCD (PCD MCA and PCD ACA ) were compared among 110 measurement points (MPs) without LPA, 16MPs with mild LPA and 10MPs with severe LPA in upper lung field cranial to the bronchial bifurcation (ULF), and 150MPs without LPA, 17MPs with mild LPA and 9MPs with severe LPA in lower lung field caudal to the bronchial bifurcation (LLF) using the Mann-Whitney U test. In the LLF, PCD ACA as well as PCD MCA demonstrated a significant difference among non-LPA, mild LPA and severe LPA (18.1±9.2, 12.3±6.2 and 5.0±3.3mm) (p<0.05). Also in the ULF, PCD ACA showed a significant difference among three conditions (9.2±5.5, 5.7±2.8 and 2.2±0.4mm, respectively) (p<0.05), whereas PCD MCA for mild LPA was similar to that for non-LPA (12.3±5.9 and 17.5±11.0mm). Four D-ULDCT could be a useful non-invasive preoperative assessment modality for the detection of the presence or severity of LPA. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS).

    Science.gov (United States)

    Terluin, Berend; Brouwers, Evelien P M; van Marwijk, Harm W J; Verhaak, Peter F M; van der Horst, Henriëtte E

    2009-08-23

    Depressive and anxiety disorders often go unrecognized in distressed primary care patients, despite the overtly psychosocial nature of their demand for help. This is especially problematic in more severe disorders needing specific treatment (e.g. antidepressant pharmacotherapy or specialized cognitive behavioural therapy). The use of a screening tool to detect (more severe) depressive and anxiety disorders may be useful not to overlook such disorders. We examined the accuracy with which the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS) are able to detect (more severe) depressive and anxiety disorders in distressed patients, and which cut-off points should be used. Seventy general practitioners (GPs) included 295 patients on sick leave due to psychological problems. They excluded patients with recognized depressive or anxiety disorders. Patients completed the 4DSQ and HADS. Standardized diagnoses of DSM-IV defined depressive and anxiety disorders were established with the Composite International Diagnostic Interview (CIDI). Receiver Operating Characteristic (ROC) analyses were performed to obtain sensitivity and specificity values for a range of scores, and area under the curve (AUC) values as a measure of diagnostic accuracy. With respect to the detection of any depressive or anxiety disorder (180 patients, 61%), the 4DSQ and HADS scales yielded comparable results with AUC values between 0.745 and 0.815. Also with respect to the detection of moderate or severe depressive disorder, the 4DSQ and HADS depression scales performed comparably (AUC 0.780 and 0.739, p 0.165). With respect to the detection of panic disorder, agoraphobia and social phobia, the 4DSQ anxiety scale performed significantly better than the HADS anxiety scale (AUC 0.852 versus 0.757, p 0.001). The recommended cut-off points of both HADS scales appeared to be too low while those of the 4DSQ anxiety scale appeared to be too high. In general

  16. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  17. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  18. Cardiac Catheterization (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español Cardiac Catheterization KidsHealth / For Kids / Cardiac Catheterization What's in this article? What Is ...

  19. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  20. CARDIAC LYMPHOMA IN DOG

    Directory of Open Access Journals (Sweden)

    G. D. Cruz

    2016-11-01

    Full Text Available Lymphoma is a lymphoid tumor that originates in hematopoietic organs such as lymph node, spleen or liver. In dogs, the overall prevalence of cardiac tumors was estimated to be only 0.19% based on the results of the survey of a large database, and lymphomas accounts for approximately 2% of all cardiac tumors. In general, the involvement of the myocardium is rarely described in canine lymphoma. Currently, there is no evidence of a viral association with primary cardiac lymphoma in dogs, but other types of immunosuppression may contribute to abnormal events, such as involvement primary cardiac. The aim of this study was to analyze a case of sudden death of a bitch, SRD, aged 10, who had the final diagnosis of cardiac lymphoma.

  1. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  2. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  3. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  4. Dual energy cardiac CT.

    Science.gov (United States)

    Carrascosa, Patricia; Deviggiano, Alejandro; Rodriguez-Granillo, Gastón

    2017-06-01

    Conventional single energy CT suffers from technical limitations related to the polychromatic nature of X-rays. Dual energy cardiac CT (DECT) shows promise to attenuate and even overcome some of these limitations, and might broaden the scope of patients eligible for cardiac CT towards the inclusion of higher risk patients. This might be achieved as a result of both safety (contrast reduction) and physiopathological (myocardial perfusion and characterization) issues. In this article, we will review the main clinical cardiac applications of DECT, that can be summarized in two core aspects: coronary artery evaluation, and myocardial evaluation.

  5. Cardiac Catheterization (For Parents)

    Science.gov (United States)

    ... cases, the doctor might call for a cardiac magnetic resonance imaging (MRI) scan or a CAT scan . ... first couple of days. This means no heavy lifting (more than 10 pounds) and no sports. After ...

  6. Cardiac Catheterization (For Teens)

    Science.gov (United States)

    ... doctor may also call for a cardiac MRI (magnetic resonance imaging) scan or a CT (computerized tomography) ... first couple of days. This means no heavy lifting (nothing over 10 pounds) and no sports. After ...

  7. Autonomic cardiac innervation

    Science.gov (United States)

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory

  8. Cardiac imaging in adults

    International Nuclear Information System (INIS)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority

  9. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  10. Cardiac biomarkers in Neonatology

    OpenAIRE

    Vijlbrief, D.C.

    2015-01-01

    In this thesis, the role for cardiac biomarkers in neonatology was investigated. Several clinically relevant results were reported. In term and preterm infants, hypoxia and subsequent adaptation play an important role in cardiac biomarker elevation. The elevated natriuretic peptides are indicative of abnormal function; elevated troponins are suggestive for cardiomyocyte damage. This methodology makes these biomarkers of additional value in the treatment of newborn infants, separate or as a co...

  11. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  12. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  13. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    Directory of Open Access Journals (Sweden)

    Olivia Chen

    2015-01-01

    Full Text Available Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

  14. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  15. Isolated Cardiac Hydatid Cyst

    International Nuclear Information System (INIS)

    Shakil, U.; Rehman, A. U.; Shahid, R.

    2015-01-01

    Hydatid cyst disease is common in our part of the world. Cardiac hydatid cyst is its rare manifestation. We report this case of 48-year male having isolated cardiac hydatid cyst, incidentally found on computed tomography. This patient presented in medical OPD of Combined Military Hospital, Lahore with one month history of mild retrosternal discomfort. His general physical and systemic examinations as well as ECG were unremarkable. Chest X-ray showed an enlarged cardiac shadow with mildly irregular left heart border. Contrast enhanced CT scan of the chest showed a large well defined multiloculated non-enhancing cystic lesion with multiple daughter cysts involving wall of left ventricle and overlying pericardium. Serology for echinococcus confirmed the diagnosis of hydatid cyst. Patient was offered the surgical treatment but he opted for medical treatment only. Albendezol was prescribed. His follow-up echocardiography after one month showed no significant decrease in size of the cyst. (author)

  16. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  17. Quantitative cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, M.; Dueber, C.; Wolff, P.; Erbel, R.; Hoffmann, T.

    1985-06-01

    The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The enddiastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

  18. Cardiac output measurement

    Directory of Open Access Journals (Sweden)

    Andreja Möller Petrun

    2014-02-01

    Full Text Available In recent years, developments in the measuring of cardiac output and other haemodynamic variables are focused on the so-called minimally invasive methods. The aim of these methods is to simplify the management of high-risk and haemodynamically unstable patients. Due to the need of invasive approach and the possibility of serious complications the use of pulmonary artery catheter has decreased. This article describes the methods for measuring cardiac output, which are based on volume measurement (Fick method, indicator dilution method, pulse wave analysis, Doppler effect, and electrical bioimpedance.

  19. Investigation of pancreas tumour movements and of their potential markers by four-dimensional scanography: implication for image-guided radiotherapy; etude des mouvements des tumeurs du pancreas et de leurs marqueurs potentiels par scanographie quadridimensionnelle: implication pour la radiotherapie guidee par l'image

    Energy Technology Data Exchange (ETDEWEB)

    Huguet, F. [Hopital Tenon, Paris (France); Yorke, E.; Davidson, M.; Zhang, Z.; Jackson, A.; Mageras, G.; Wu, A.; Goodman, K. [Memorial Sloan-Kettering Cancer Center, New York (United States)

    2011-10-15

    The authors report the study which aimed at quantifying pancreas tumour movements induced by breathing by using four-dimensional scanography, and at assessing the reliability of biliary prosthesis, of intra-tumor fiducials, and of an external maker as position markers of the gross tumour volume (GTV). The authors analyzed scanography images acquired during the simulation of 22 patients treated for locally advanced pancreas cancer by intensity-modulated conformational irradiation with respiratory gating. Average movements in different directions have measured. Respiratory gating limits the GTV movement amplitude by 40 to 60 per cent. GTV movements are in good correlation with that of biliary prostheses and intra-tumor fiducials. Short communication

  20. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    flow) or require intervention (surgical or catheter) within the first ... Cardiac. History. Risk factors, e.g. meconium-stained liquor, prematurity, ... 'snowman' sign for supracardiac total anomalous pulmonary venous drainage (TAPVD), cardiomegaly with plethora for ... central cyanosis and on auscultation you hear no murmurs.

  1. Comparative cardiac imaging

    International Nuclear Information System (INIS)

    Brundage, B.H.

    1990-01-01

    This book is designed to compare all major cardiac imaging techniques. All major imaging techniques - including conventional angiography, digital angiography, echocardiography and Doppler imaging, conventional radioisotope techniques, computed tomography, and magnetic resonance imaging - are covered in this text as they apply to the major cardiovascular disorders. There is brief coverage of positron emission tomography and an extensive presentation of ultrafast computed tomography

  2. Advanced Cardiac Life Support.

    Science.gov (United States)

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  3. Cardiac Pacemakers; Marcapasos Cardiacos

    Energy Technology Data Exchange (ETDEWEB)

    Fiandra, O [Universidad de la Republica, Facultad de Maedicina, Departamento de Cardiologia, Montevideo(Uruguay); Espasandin, W [Universidad de la Republica, Facultad de Medicina, Departamento de Cirugia Cardiaca, Montevideo (Uruguay); Fiandra, H [Instituto Nacional de Cirugia Cardiaca, Departamento de Hemodinamia y Marcapasos, Montevideo (Uruguay); and others

    1984-07-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control.

  4. Nonexercise cardiac stress testing

    International Nuclear Information System (INIS)

    Vacek, J.L.; Baldwin, T.

    1989-01-01

    Many patients who require evaluation for coronary artery disease are unable to undergo exercise stress testing because of physiologic or psychological limitations. Drs Vacek and Baldwin describe three alternative methods for assessment of cardiac function in these patients, all of which have high levels of diagnostic sensitivity and specificity. 23 references

  5. Cardiac magnetic resonance imaging

    African Journals Online (AJOL)

    2011-03-06

    Mar 6, 2011 ... Cardiac magnetic resonance imaging. Cardiovascular magnetic resonance imaging is becoming a routine diagnostic technique. BRUCE s sPOTTiswOOdE, PhD. MRC/UCT Medical Imaging Research Unit, University of Cape Town, and Division of Radiology, Stellenbosch University. Bruce Spottiswoode ...

  6. Maternal cardiac metabolism in pregnancy

    Science.gov (United States)

    Liu, Laura X.; Arany, Zolt

    2014-01-01

    Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

  7. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  8. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt

    2012-01-01

    in recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social...

  9. Ictal Cardiac Ryhthym Abnormalities.

    Science.gov (United States)

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy.

  10. Fetal cardiac assessment

    International Nuclear Information System (INIS)

    Greene, K.R.

    1983-01-01

    The better understanding of fetal cardiovascular physiology coupled with improved technology for non-invasive study of the fetus now enable much more detailed assessment of fetal cardiac status than by heart rate alone. Even the latter, relatively simple, measurement contains much more information than was previously realized. It is also increasingly clear that no single measurement will provide the answer to all clinical dilemmas either on cardiac function or the welfare of the fetus as a whole. There are obvious clinical advantages in measuring several variables from one signal and the measurement of heart rate, heart rate variation and waveform from the ECG in labour is a potentially useful combination. Systolic time intervals or flow measurements could easily be added or used separately by combining real-time and Doppler ultrasound probes

  11. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  12. Cardiac nuclear medicine

    International Nuclear Information System (INIS)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma

  13. Cardiac function studies

    International Nuclear Information System (INIS)

    Horn, H.J.

    1986-01-01

    A total of 27 patients were subjected tointramyocardial sequential scintiscanning (first pass) using 99m-Tc human serum albumin. A refined method is described that is suitable to analyse clinically relevant parameters like blood volume, cardiac output, ejection fraction, stroke volume, enddiastolic and endsystolic volumes as well as pulmonal transition time and uses a complete camaracomputer system adapted to the requirements of a routine procedure. Unless there is special hardware available, the method does not yet appear mature enough to be put into general practice. Its importance recently appeared in a new light due to the advent of particularly shortlived isotopes. For the time being, however, ECG-triggered equilibrium studies are to be preferred for cardiac function tests. (TRV) [de

  14. CSI cardiac prevent 2015

    OpenAIRE

    S Ramakrishnan; Manisha Kaushik

    2015-01-01

    The CSI Cardiac Prevent 2015 was held at Hotel Taj Palace, New Delhi, on September 25-27, 2015. The major challenge was to create interest among cardiologists and physicians on preventive cardiology, a neglected area. The theme of the conference was "Innovations in Heart Disease Prevention.′′ This conference included "CSI at WHF Roadmap Workshop, Inauguration Ceremony, scientific program, plenary sessions, Nursing/Dietician track, Industry Exhibition, Social Events," Great India blood pressur...

  15. Multifractality in Cardiac Dynamics

    Science.gov (United States)

    Ivanov, Plamen Ch.; Rosenblum, Misha; Stanley, H. Eugene; Havlin, Shlomo; Goldberger, Ary

    1997-03-01

    Wavelet decomposition is used to analyze the fractal scaling properties of heart beat time series. The singularity spectrum D(h) of the variations in the beat-to-beat intervals is obtained from the wavelet transform modulus maxima which contain information on the hierarchical distribution of the singularities in the signal. Multifractal behavior is observed for healthy cardiac dynamics while pathologies are associated with loss of support in the singularity spectrum.

  16. Integrative Cardiac Health Project

    Science.gov (United States)

    2014-10-01

    primary cardiac arrest. Circulation. 1998;97(2):155Y160. 8. Sesso HD, Lee IM, Gaziano JM, Rexrode KM, Glynn RJ, Buring JE. Maternal and paternal ...to signal transduction, inflammation, and host–pathogen interactions .27 Whole blood RNA isolation systems such as PAXgene accurately capture in vivo...the effect of healthy behaviors on leukocyte function and leukocyte–endothelium interactions that are important for cardiovascular health

  17. Molecular nuclear cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Soo; Paeng, Jin Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-04-01

    Molecular nuclear cardiac imaging has included Tc-99m Annexin imaging to visualize myocardial apoptosis, but is now usually associated with gene therapy and cell-based therapy. Cardiac gene therapy was not successful so far but cardiac reporter gene imaging was made possible using HSV-TK (herpes simplex virus thymidine kinase) and F-18 FHBG (fluoro-hydroxymethylbutyl guanine) or I-124 FIAU (fluoro-deoxyiodo-arabino-furanosyluracil). Gene delivery was performed by needle injection with or without catheter guidance. TK expression did not last longer than 2 weeks in myocardium. Cell-based therapy of ischemic heart or failing heart looks promising, but biodistribution and differentiation of transplanted cells are not known. Reporter genes can be transfected to the stem/progenitor cells and cells containing these genes can be transplanted to the recipients using catheter-based purging or injection. Repeated imaging should be available and if promoter are varied to let express reporter transgenes, cellular (trans)differentiation can be studied. NIS (sodium iodide symporter) or D2R receptor genes are promising in this aspect.

  18. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  19. Cardiac Cachexia Syndrome

    Directory of Open Access Journals (Sweden)

    Teresa Raposo André

    2017-10-01

    Full Text Available Heart failure is a chronic, progressive, and incurable disease. Cardiac cachexia is a strong predictor of poor prognosis, regardless of other important variables. This review intends to gather evidence to enable recognition of cardiac cachexia, identification of early stages of muscle waste and sarcopenia, and improve identification of patients with terminal heart failure in need of palliative care, whose symptoms are no longer controlled by usual medical measures. The pathophysiology is complex and multifactorial. There are many treatment options to prevent or revert muscle waste and sarcopenia; although, these strategies are less effective in advanced stages of cardiac cachexia. In these final stages, symptomatic palliation plays an important role, focussing on the patient’s comfort and avoiding the ‘acute model’ treatment of aggressive, disproportionate, and inefficient care. In order to provide adequate care and attempt to prevent this syndrome, thus reducing its impact on healthcare, there should be improved communication between general practitioners, internal medicine physicians, cardiologists, and palliative care specialists since heart failure has an unforeseeable course and is associated with an increasing number of deaths and different levels of suffering.

  20. Cardiac tissue engineering

    Directory of Open Access Journals (Sweden)

    MILICA RADISIC

    2005-03-01

    Full Text Available We hypothesized that clinically sized (1-5 mm thick,compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3 can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of perfluorocarbons, or with electrical stimulation (continuous application of biphasic pulses, 2 ms, 5 V, 1 Hz. Tissue constructs cultured without perfusion or electrical stimulation served as controls. Medium perfusion and addition of perfluorocarbons resulted in compact, thick constructs containing physiologic density of viable, electromechanically coupled cells, in contrast to control constructs which had only a ~100 mm thick peripheral region with functionally connected cells. Electrical stimulation of cultured constructs resulted in markedly improved contractile properties, increased amounts of cardiac proteins, and remarkably well developed ultrastructure (similar to that of native heart as compared to non-stimulated controls. We discuss here the state of the art of cardiac tissue engineering, in light of the biomimetic approach that reproduces in vitro some of the conditions present during normal tissue development.

  1. Molecular nuclear cardiac imaging

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Paeng, Jin Chul

    2004-01-01

    Molecular nuclear cardiac imaging has included Tc-99m Annexin imaging to visualize myocardial apoptosis, but is now usually associated with gene therapy and cell-based therapy. Cardiac gene therapy was not successful so far but cardiac reporter gene imaging was made possible using HSV-TK (herpes simplex virus thymidine kinase) and F-18 FHBG (fluoro-hydroxymethylbutyl guanine) or I-124 FIAU (fluoro-deoxyiodo-arabino-furanosyluracil). Gene delivery was performed by needle injection with or without catheter guidance. TK expression did not last longer than 2 weeks in myocardium. Cell-based therapy of ischemic heart or failing heart looks promising, but biodistribution and differentiation of transplanted cells are not known. Reporter genes can be transfected to the stem/progenitor cells and cells containing these genes can be transplanted to the recipients using catheter-based purging or injection. Repeated imaging should be available and if promoter are varied to let express reporter transgenes, cellular (trans)differentiation can be studied. NIS (sodium iodide symporter) or D2R receptor genes are promising in this aspect

  2. Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

    Science.gov (United States)

    Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

    2012-01-01

    Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

  3. Standardization of the first-trimester fetal cardiac examination using spatiotemporal image correlation with tomographic ultrasound and color Doppler imaging.

    Science.gov (United States)

    Turan, S; Turan, O M; Ty-Torredes, K; Harman, C R; Baschat, A A

    2009-06-01

    The challenges of the first-trimester examination of the fetal heart may in part be overcome by technical advances in three-dimensional (3D) ultrasound techniques. Our aim was to standardize the first-trimester 3D imaging approach to the cardiac examination to provide the most consistent and accurate display of anatomy. Low-risk women with normal findings on first-trimester screening at 11 to 13 + 6 weeks had cardiac ultrasound using the following sequence: (1) identification of the four-chamber view; (2) four-dimensional (4D) volume acquisition with spatiotemporal image correlation (STIC) and color Doppler imaging (angle = 20 degrees, sweep 10 s); (3) offline, tomographic ultrasound imaging (TUI) analysis with standardized starting plane (four-chamber view), slice number and thickness; (4) assessment of fetal cardiac anatomy (four-chamber view, cardiac axis, size and symmetry, atrioventricular valves, great arteries and descending aorta) with and without color Doppler. 107 consecutive women (age, 16-42 years, body mass index 17.2-50.2 kg/m(2)) were studied. A minimum of three 3D volumes were obtained for each patient, transabdominally in 91.6%. Fetal motion artifact required acquisition of more than three volumes in 20%. The median time for TUI offline analysis was 100 (range, 60-240) s. Individual anatomic landmarks were identified in 89.7-99.1%. Visualization of all structures in one panel was observed in 91 patients (85%). Starting from a simple two-dimensional cardiac landmark-the four-chamber view-the standardized STIC-TUI technique enables detailed segmental cardiac evaluation of the normal fetal heart in the first trimester. (c) 2009 ISUOG.

  4. Fully automated intrinsic respiratory and cardiac gating for small animal CT

    Energy Technology Data Exchange (ETDEWEB)

    Kuntz, J; Baeuerle, T; Semmler, W; Bartling, S H [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Dinkel, J [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Zwick, S [Department of Diagnostic Radiology, Medical Physics, Freiburg University (Germany); Grasruck, M [Siemens Healthcare, Forchheim (Germany); Kiessling, F [Chair of Experimental Molecular Imaging, RWTH-Aachen University, Medical Faculty, Aachen (Germany); Gupta, R [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)], E-mail: j.kuntz@dkfz.de

    2010-04-07

    A fully automated, intrinsic gating algorithm for small animal cone-beam CT is described and evaluated. A parameter representing the organ motion, derived from the raw projection images, is used for both cardiac and respiratory gating. The proposed algorithm makes it possible to reconstruct motion-corrected still images as well as to generate four-dimensional (4D) datasets representing the cardiac and pulmonary anatomy of free-breathing animals without the use of electrocardiogram (ECG) or respiratory sensors. Variation analysis of projections from several rotations is used to place a region of interest (ROI) on the diaphragm. The ROI is cranially extended to include the heart. The centre of mass (COM) variation within this ROI, the filtered frequency response and the local maxima are used to derive a binary motion-gating parameter for phase-sensitive gated reconstruction. This algorithm was implemented on a flat-panel-based cone-beam CT scanner and evaluated using a moving phantom and animal scans (seven rats and eight mice). Volumes were determined using a semiautomatic segmentation. In all cases robust gating signals could be obtained. The maximum volume error in phantom studies was less than 6%. By utilizing extrinsic gating via externally placed cardiac and respiratory sensors, the functional parameters (e.g. cardiac ejection fraction) and image quality were equivalent to this current gold standard. This algorithm obviates the necessity of both gating hardware and user interaction. The simplicity of the proposed algorithm enables adoption in a wide range of small animal cone-beam CT scanners.

  5. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  6. Exercise-related cardiac arrest in cardiac rehabilitation - The ...

    African Journals Online (AJOL)

    Prescribed physical activity plays a major role in the rehabilitation of patients with coronary artery disease, and as with any other form of treatment its benefits must be weighed against its possible risks. This study attempted to establish the safety of cardiac rehabilitation as a medical intervention at the Johannesburg Cardiac ...

  7. Single ventricle cardiac defect

    International Nuclear Information System (INIS)

    Eren, B.; Turkmen, N.; Fedakar, R.; Cetin, V.

    2010-01-01

    Single ventricle heart is defined as a rare cardiac abnormality with a single ventricle chamber involving diverse functional and physiological defects. Our case is of a ten month-old baby boy who died shortly after admission to the hospital due to vomiting and diarrhoea. Autopsy findings revealed cyanosis of finger nails and ears. Internal examination revealed; large heart, weighing 60 grams, single ventricle, without a septum and upper membranous part. Single ventricle is a rare pathology, hence, this paper aims to discuss this case from a medico-legal point of view. (author)

  8. CSI cardiac prevent 2015

    Directory of Open Access Journals (Sweden)

    S Ramakrishnan

    2015-01-01

    Full Text Available The CSI Cardiac Prevent 2015 was held at Hotel Taj Palace, New Delhi, on September 25-27, 2015. The major challenge was to create interest among cardiologists and physicians on preventive cardiology, a neglected area. The theme of the conference was "Innovations in Heart Disease Prevention.′′ This conference included "CSI at WHF Roadmap Workshop, Inauguration Ceremony, scientific program, plenary sessions, Nursing/Dietician track, Industry Exhibition, Social Events," Great India blood pressure Survey, and CSI Smart Heart App. A total of 848 delegates/faculties attended this conference against a total of 1140 people registered for the meeting.

  9. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation......) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  10. Cardiac Arrest: MedlinePlus Health Topic

    Science.gov (United States)

    ... Handouts Cardiac arrest (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cardiac Arrest updates ... this? GO MEDICAL ENCYCLOPEDIA Cardiac arrest Related Health Topics Arrhythmia CPR Pacemakers and Implantable Defibrillators National Institutes ...

  11. Transmission of supersymmetry breaking from a four-dimensional boundary

    International Nuclear Information System (INIS)

    Mirabelli, E.A.; Peskin, M.E.

    1998-01-01

    In the strong-coupling limit of the heterotic string theory constructed by Horava and Witten, an 11-dimensional supergravity theory is coupled to matter multiplets confined to 10-dimensional mirror planes. This structure suggests that realistic unification models are obtained, after compactification of 6 dimensions, as theories of 5-dimensional supergravity in an interval, coupling to matter fields on 4-dimensional walls. Supersymmetry breaking may be communicated from one boundary to another by the 5-dimensional fields. In this paper, we study a toy model of this communication in which 5-dimensional super-Yang-Mills theory in the bulk couples to chiral multiplets on the walls. Using the auxiliary fields of the Yang-Mills multiplet, we find a simple algorithm for coupling the bulk and boundary fields. We demonstrate two different mechanisms for generating soft supersymmetry breaking terms in the boundary theory. We also compute the Casimir energy generated by supersymmetry breaking. copyright 1998 The American Physical Society

  12. Holographic superconductor in a deformed four-dimensional STU model

    Energy Technology Data Exchange (ETDEWEB)

    Pourhassan, B.; Bagheri-Mohagheghi, M.M. [Damghan University, School of Physics, Damghan (Iran, Islamic Republic of)

    2017-11-15

    In this paper, we consider a deformed STU model in four dimensions including both electric and magnetic charges. Using the AdS/CFT correspondence, we study holographic superconductors and obtain transport properties like electrical and thermal conductivities. We obtain transport properties in terms of the magnetic charge of the black hole and interpret it as the magnetic monopole of dual field theory. We find that the presence of the magnetic charge is necessary to have maximum conductivities, and the existence of a magnetic monopole with a critical charge (137 e) to reach the maximum superconductivity is important. Also, we show that the thermal conductivity increases with increasing of the magnetic charge. It may be concluded that the origin of superconductivity is the magnetic monopole. (orig.)

  13. A Lifshitz black hole in four dimensional R2 gravity

    International Nuclear Information System (INIS)

    Cai Ronggen; Liu Yan; Sun Yawen

    2009-01-01

    We consider a higher derivative gravity theory in four dimensions with a negative cosmological constant and show that vacuum solutions of both Lifshitz type and Schroedinger type with arbitrary dynamical exponent z exist in this system. Then we find an analytic black hole solution which asymptotes to the vacuum Lifshitz solution with z = 3/2 at a specific value of the coupling constant. We analyze the thermodynamic behavior of this black hole and find that the black hole has zero entropy while non-zero temperature, which is very similar to the case of BTZ black holes in new massive gravity at a specific coupling. In addition, we find that the three dimensional Lifshitz black hole recently found by E. Ayon-Beato et al. has a negative entropy and mass when the Newton constant is taken to be positive.

  14. Four-dimensional optical manipulation of colloidal particles

    DEFF Research Database (Denmark)

    Rodrigo, Peter John; Daria, Vincent Ricardo Mancao; Glückstad, Jesper

    2010-01-01

    years ago. Bringing together many landmark papers on the field, Optical Tweezers: Methods and Applications covers the techniques and uses of optical tweezers. Each section is introduced by a brief commentary, setting the papers into their historical and contemporary contexts. The first two sections...... of the best in the field, this compendium presents important historical and current developments of optical tweezers in a range of scientific areas, from the manipulation of bacteria to the treatment of DNA....

  15. Four-dimensional boson field theory. II. Existence

    International Nuclear Information System (INIS)

    Baker, G.A. Jr.

    1986-01-01

    The existence of the continuum, quantum field theory found by Baker and Johnson [G. A. Baker, Jr. and J. D. Johnson, J. Phys. A 18, L261 (1985)] to be nontrivial is proved rigorously. It is proved to satisfy all usual requirements of such a field theory, except rotational invariance. Currently known information is consistent with rotational invariance however. Most of the usual properties of other known Euclidean boson quantum field theories hold here, in a somewhat weakened form. Summability of the sufficiently strongly ultraviolet cutoff bare coupling constant perturbation series is proved as well as a nonzero radius of convergence for high-temperature expansions of the corresponding continuous-spin Ising model. The description of the theory by these two series methods is shown to be equivalent. The field theory is probably not asymptotically free

  16. Four-dimensional CP2 model on a lattice

    International Nuclear Information System (INIS)

    Bitar, K.M.; Raja, R.

    1983-01-01

    We investigate the phenomenon of dynamical generation of gauge interactions from CP/sup N/-1 models in four dimensions. We do this for the CP 2 model on a lattice. The phase diagram of a model that interpolates between CP 2 and U(1) gauge theory on a lattice is first mapped out. The potential between static charges in various regions of this diagram is also measured. Contrary to hopes based on the large-N behavior of similar models in two dimensions and on our phase diagram, we find that the potentials generated by CP 2 do not bear any resemblance to those of U(1). They are rather similar to the Higgs phase of an Abelian gauge theory in both phases displayed by CP 2

  17. New four-dimensional integrals by Mellin-Barnes transform

    International Nuclear Information System (INIS)

    Allendes, Pedro; Guerrero, Natanael; Kondrashuk, Igor; Notte Cuello, Eduardo A.

    2010-01-01

    This paper is devoted to the calculation of a special class of integrals by Mellin-Barnes transform. It contains double integrals in the position space in d=4-2ε dimensions, where ε is parameter of dimensional regularization. These integrals contribute to the effective action of the N=4 supersymmetric Yang-Mills theory. The integrand is a fraction in which the numerator is the logarithm of the ratio of space-time intervals, and the denominator is the product of powers of space-time intervals. According to the method developed in the previous papers, in order to make use of the uniqueness technique for one of two integrations, we shift exponents in powers in the denominator of integrands by some multiples of ε. As the next step, the second integration in the position space is done by Mellin-Barnes transform. For normalizing procedure, we reproduce first the known result obtained earlier by Gegenbauer polynomial technique. Then, we make another shift of exponents in powers in the denominator to create the logarithm in the numerator as the derivative with respect to the shift parameter δ. We show that the technique of work with the contour of the integral modified in this way by using Mellin-Barnes transform repeats the technique of work with the contour of the integral without such a modification. In particular, all the operations with a shift of contour of integration over complex variables of twofold Mellin-Barnes transform are the same as before the δ modification of indices, and even the poles of residues coincide. This confirms the observation made in the previous papers that in the position space all the Green's function of N=4 supersymmetric Yang-Mills theory can be expressed in terms of Usyukina-Davydychev functions.

  18. Gradient formula for the four-dimensional hyperspherical harmonics

    International Nuclear Information System (INIS)

    Santos, M.B.

    1975-01-01

    The gradient formula for the hyperspherical harmonics in 4 dimensions is derived, a result which is here obtainned in two distinct ways: either by differentiation of a closed expression for the hyperspherical harmonics or by making use of the Wigner-Eckart theorem for the R 4 group. The result is useful for physical applications in view of the significance of the R 4 group in several physical problems [pt

  19. Determining intrafractional prostate motion using four dimensional ultrasound system

    DEFF Research Database (Denmark)

    Baker, Mariwan; Behrens, Claus F.

    2016-01-01

    , LR, and AP directions, respectively. The mean of the maximal intrafractional Euclidean distance (3D vector) was 0.9 +/- 0.6 mm. For 12 % of the fractions the maximal 3D vector displacements were larger than 2.0 mm. At only two fractions (4 %) displacements larger than 3. 0 mm were observed...

  20. Curvature properties of four-dimensional Walker metrics

    International Nuclear Information System (INIS)

    Chaichi, M; Garcia-Rio, E; Matsushita, Y

    2005-01-01

    A Walker n-manifold is a semi-Riemannian manifold, which admits a field of parallel null r-planes, r ≤ n/2. In the present paper we study curvature properties of a Walker 4-manifold (M, g) which admits a field of parallel null 2-planes. The metric g is necessarily of neutral signature (+ + - -). Such a Walker 4-manifold is the lowest dimensional example not of Lorentz type. There are three functions of coordinates which define a Walker metric. Some recent work shows that a Walker 4-manifold of restricted type whose metric is characterized by two functions exhibits a large variety of symplectic structures, Hermitian structures, Kaehler structures, etc. For such a restricted Walker 4-manifold, we shall study mainly curvature properties, e.g., conditions for a Walker metric to be Einstein, Osserman, or locally conformally flat, etc. One of our main results is the exact solutions to the Einstein equations for a restricted Walker 4-manifold

  1. M Theory, G2-manifolds and four dimensional physics

    International Nuclear Information System (INIS)

    Acharya, B.S.

    2003-01-01

    M theory on a manifold of G 2 -holonomy is a natural framework for obtaining vacua with four large spacetime dimensions and N = 1 supersymmetry. In order to obtain, within this framework, the standard features of particle physics, namely non-Abelian gauge groups and chiral fermions, we consider G 2 -manifolds with certain kinds of singularities at which these features reside. The aim of these lectures is to describe in detail how the above picture emerges. Along the way we will see how interesting aspects of strongly coupled gauge theories, such as confinement, receive relatively simple explanations within the context of M theory. (author)

  2. How the flip target behaves in four-dimensional space

    International Nuclear Information System (INIS)

    Antillon, A.; Kats, J.

    1985-01-01

    We use available coupling theory for understanding how a flip target in a 4-dimensional phase space reduces a gaussian beam of particles. Experimental evidence at the AGS can be qualitatively explained by this theory

  3. Renormalization theory in four dimensional scalar fields. Pt. 2

    International Nuclear Information System (INIS)

    Gallavotti, G.; Rome Univ.; Nicolo, F.; Universita 'La Sapienza', Rome

    1985-01-01

    We interpret the results of the preceding paper (1985) in terms of partial resummations of the perturbative series for the effective interaction. As an application we sketch how our resummation method leads to a simple summation rule leading to a convergent expansion for the Schwinger functions of the planar PHI 4 4 -theory. (orig./HSI)

  4. Vacuum degeneracy in four-dimensional string theories

    International Nuclear Information System (INIS)

    Nilles, H.P.

    1988-01-01

    I present results obtained in collaboration with A. Font, L. Ibanez and F. Quevedo using a method that links explicit string constructions with the techniques of supergravity field theories. We make use of the fact that the supersymmetric vacua of the field theory limit of d=4 N=1 superstring theories are all degenerate. Given a particular string theory we can then test for new 'nearby' string theories by an examination of flat directions in the scalar potential of the underlying field theory. As input from string theory we need the knowledge of the Yukawa couplings (i.e., the superpotential) for any number of fields. In the language of conformal field theory, this amounts to a search for exactly marginal operators and the classification of multicritical points. (orig./HSI)

  5. Four-dimensional Ashkin-Teller gauge theory

    International Nuclear Information System (INIS)

    Alcaraz, F.C.; Jacobs, L.

    1983-01-01

    The authors construct and analyze a lattice field theory of two Z 2 gauge fields which interact in a minimal gauge-invariant fashion. Although the theory presented here, a generalization of the two-dimensional Ashkin-Teller spin system, has no formal continuum limit, it is found that it has an electrodynamicslike phase similar to that observed in general Z/sub N/ theories for N> or =4. This model is probably the simplest generalization of the conventional Z 2 pure gauge theory which has a massless phase separated from the strong- and weak-coupling regions by lines of second-order phase transitions

  6. The construction of ``realistic'' four-dimensional strings through orbifolds

    Science.gov (United States)

    Font, A.; Ibáñez, L. E.; Quevedo, F.; Sierra, A.

    1990-02-01

    We discuss the construction of "realistic" lower rank 4-dimensional strings, through symmetric orbifolds with background fields. We present Z 3 three-generation SU(3) × SU(2) × U(1) models as well as models incorporating a left-right SU(2) L × SU(2) R × U(1) B-L symmetry in which proton stability is automatically guaranteed. Conformal field theory selection rules are used to find the flat directions to all orders which lead to these low-rank models and to study the relevant Yukawa couplings. A hierarchical structure of quark-lepton masses appears naturally in some models. We also present a detailed study of the structure of the Z 3 × Z 3 orbifold including the generalized GSO projection, the effect of discrete torsion and the conformal field theory Yukawa coupling selection rules. All these points are illustrated with a three-generation Z 3 × Z 3 model. We have made an effort to write a self-contained presentation in order to make this material available to non-string experts interested in the phenomenological aspects of this theory.

  7. The construction of 'realistic' four-dimensional strings through orbifolds

    International Nuclear Information System (INIS)

    Font, A.; Quevedo, F.; Sierra, A.

    1990-01-01

    We discuss the construction of 'realistic' lower rank 4-dimensional strings, through symmetric orbifolds with background fields. We present Z 3 three-generation SU(3)xSU(2)xU(1) models as well as models incorporating a left-right SU(2) L xSU(2) R xU(1) B-L symmetry in which proton stability is automatically guaranteed. Conformal field theory selection rules are used to find the flat directions to all orders which lead to these low-rank models and to study the relevant Yukawa couplings. A hierarchical structure of quark-lepton masses appears naturally in some models. We also present a detailed study of the structure of the Z 3 xZ 3 orbifold including the generalized GSO projection, the effect of discrete torsion and the conformal field theory Yukawa coupling selection rules. All these points are illustrated with a three-generation Z 3 xZ 3 model. We have made an effort to write a self-contained presentation in order to make this material available to non-string experts interested in the phenomenological aspects of this theory. (orig.)

  8. Four-dimensional image display for associated particle imaging

    International Nuclear Information System (INIS)

    Headley, G.; Beyerle, A.; Durkee, R.; Hurley, P.; Tunnell, L.

    1994-01-01

    Associated particle imaging (API) is a three-dimensional neutron gamma imaging technique which provides both spatial and spectral information about an unknown. A local area network consisting of a UNIX fileserver and multiple DOS workstations has been chosen to perform the data acquisition and display functions. The data are acquired with a CAMAC system, stored in list mode, and sorted on the fileserver for display on the DOS workstations. Three of the display PCs, interacting with the fileserver, provide coordinated views as the operator ''slices'' the image. The operator has a choice of: a one-dimensional shadowgram from any side, two-dimensional shadowgrams from any side; a three-dimensional view (either perspective projection or stereoscopic). A common color scheme is used to carry energy information into the spatial images. ((orig.))

  9. Brane dynamics and four-dimensional quantum field theory

    International Nuclear Information System (INIS)

    Lambert, N.D.; West, P.C.

    1999-01-01

    We review the relation between the classical dynamics of the M-fivebrane and the quantum low energy effective action for N = 2 Yang-Mills theories. We also discuss some outstanding issues in this correspondence. (author)

  10. Feasibility of four-dimensional conformal planning for robotic radiosurgery

    International Nuclear Information System (INIS)

    Schlaefer, A.; Fisseler, J.; Dieterich, S.; Shiomi, H.; Cleary, K.; Schweikard, A.

    2005-01-01

    Organ motion can have a severe impact on the dose delivered by radiation therapy, and different procedures have been developed to address its effects. Conventional techniques include breath hold methods and gating. A different approach is the compensation for target motion by moving the treatment beams synchronously. Practical results have been reported for robot based radiosurgery, where a linear accelerator mounted on a robotic arm delivers the dose. However, not all organs move in the same way, which results in a relative motion of the beams with respect to the body and the tissues in the proximity of the tumor. This relative motion can severely effect the dose delivered to critical structures. We propose a method to incorporate motion in the treatment planning for robotic radiosurgery to avoid potential overdosing of organs surrounding the target. The method takes into account the motion of all considered volumes, which is discretized for dose calculations. Similarly, the beam motion is taken into account and the aggregated dose coefficient over all discrete steps is used for planning. We simulated the treatment of a moving target with three different planning methods. First, we computed beam weights based on a 3D planning situation and simulated treatment with organ motion and the beams moving synchronously to the target. Second, beam weights were computed by the 4D planning method incorporating the organ and beam motion and treatment was simulated for beams moving synchronously to the target. Third, the beam weights were determined by the 4D planning method with the beams fixed during planning and simulation. For comparison we also give results for the 3D treatment plan if there was no organ motion and when the plan is delivered by fixed beams in the presence of organ motion. The results indicate that the new 4D method is preferable and can further improve the overall conformality of motion compensated robotic radiosurgery

  11. Four-dimensional conversion for spiritual leadership development: A ...

    African Journals Online (AJOL)

    2014-04-14

    Apr 14, 2014 ... being of humans, as well as their social and political attitudes and behaviours, can equally .... be Christians capable of living as dignified citizens of the ..... community leaders, parents or any other people of influence ..... Mostert, B., 2007, The Power of intercession, Carpe Diem Media, Vanderbijlpark.

  12. Cardiac sarcoplasmic reticulum

    International Nuclear Information System (INIS)

    Jacobson, M.S.; Ambudkar, I.S.; Young, E.P.; Naseem, S.M.; Heald, F.P.; Shamoo, A.E.

    1985-01-01

    The effect on the cardiac sarcoplasmic reticulum of an atherogenic (1% cholesterol) diet fed during the neonatal vs the juvenile period of life was studied in Yorkshire swine. Male piglets were randomly assigned at birth to 1 of 4 groups: group I (control), group II (lactation feeding), group III (juvenile period feeding) and group IV (lactation and juvenile feeding). All animals were killed at 55 weeks of age and cardiac sarcoplasmic reticulum (SR) isolated for assay of calcium uptake, Ca 2+ -Mg 2+ ATPase activity, and lipid analysis by thin-layer chromatography and gas chromatography. The amount of cholesterol/mg SR protein and the cholesterol/phospholipid ratio were higher in the animals fed during lactation (groups II and IV) and lower in those fed only during the juvenile period (group III). Phospholipid fatty acid patterns as measured by gas chromatography were unaltered in any group. Calcium uptake was markedly diminished in all experimental conditions: group II 47%, group III 65% and group IV 96%. Compared to the observed changes in calcium transport, the ATP hydrolytic activity was relatively less affected. Only in group IV a significant decrease (41%) was seen. Groups II and III show no change in ATP hydrolytic activity. The decrease in calcium uptake and altered cholesterol/phospholipid ratio without effect on ATP hydrolytic activity is consistent with an uncoupling of calcium transport related to the atherogenic diet in early life. (author)

  13. Cardiac chamber scintiscanning

    International Nuclear Information System (INIS)

    Goretzki, G.

    1981-01-01

    The two methods of cardiac chamber scintiscanning, i.e. 'first pass' and 'ECG-triggered' examinations, are explained and compared. Two tables indicate the most significant radiation doses of the applied radio tracers, i.e. 99m-Tc-pertechnetate and 99m-Tc-HSA, to which a patient is exposed. These averaged values are calculated from various data given in specialised literature. On the basis of data given in literature, an effective half-life of approximately 5 hours in the intravascular space was calculated for the erythrocytes labelled with technetium 99m. On this basis, the radiation doses for the patients due to 99m-Tc-labelled erythrocytes are estimated. The advantages and disadvantages of the two methods applied for cardiac chamber scintiscanning are put into contrast and compared with the advantages and disadvantages of the quantitative X-ray cardiography of the left heart. The still existing problems connected with the assessment of ECG-triggered images are discussed in detail. The author performed investigations of his own, which concerned the above-mentioned problems. (orig./MG) [de

  14. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  15. Lentiginosis, Deafness and Cardiac Abnormalities*

    African Journals Online (AJOL)

    1973-01-06

    Jan 6, 1973 ... His height. mass. intelligence and genitalia were normal. The aSSOCiatIOn between deafness and disturbance of cardiac conduction and between pigmented skin lesions and cardiac abnormalities, has been well described. Should. ~I patient present with multiple lentigines and/or familial sensineural ...

  16. Health Instruction Packages: Cardiac Anatomy.

    Science.gov (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  17. Neuromuscular diseases after cardiac transplantation

    NARCIS (Netherlands)

    Mateen, Farrah J.; van de Beek, Diederik; Kremers, Walter K.; Daly, Richard C.; Edwards, Brooks S.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2009-01-01

    BACKGROUND: Cardiac transplantation is a therapeutic option in end-stage heart failure. Peripheral nervous system (PNS) disease is known to occur in cardiac transplant recipients but has not been fully characterized. METHODS: This retrospective cohort review reports the PNS-related concerns of 313

  18. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  19. Cardiac changes in anorexia nervosa.

    Science.gov (United States)

    Spaulding-Barclay, Michael A; Stern, Jessica; Mehler, Philip S

    2016-04-01

    Introduction Anorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed. A comprehensive literature review on cardiac changes in anorexia nervosa was carried out. There are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs. Cardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

  20. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...... peptides has only been elucidated during the last decade. The cellular synthesis including amino acid modifications and proteolytic cleavages has proven considerably more complex than initially perceived. Consequently, the elimination phase of the peptide products in circulation is not yet well....... An inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  1. Living cardiac patch: the elixir for cardiac regeneration.

    Science.gov (United States)

    Lakshmanan, Rajesh; Krishnan, Uma Maheswari; Sethuraman, Swaminathan

    2012-12-01

    A thorough understanding of the cellular and muscle fiber orientation in left ventricular cardiac tissue is of paramount importance for the generation of artificial cardiac patches to treat the ischemic myocardium. The major challenge faced during cardiac patch engineering is to choose a perfect combination of three entities; cells, scaffolds and signaling molecules comprising the tissue engineering triad for repair and regeneration. This review provides an overview of various scaffold materials, their mechanical properties and fabrication methods utilized in cardiac patch engineering. Stem cell therapies in clinical trials and the commercially available cardiac patch materials were summarized in an attempt to provide a recent perspective in the treatment of heart failure. Various tissue engineering strategies employed thus far to construct viable thick cardiac patches is schematically illustrated. Though many strategies have been proposed for fabrication of various cardiac scaffold materials, the stage and severity of the disease condition demands the incorporation of additional cues in a suitable scaffold material. The scaffold may be nanofibrous patch, hydrogel or custom designed films. Integration of stem cells and biomolecular cues along with the scaffold may provide the right microenvironment for the repair of unhealthy left ventricular tissue as well as promote its regeneration.

  2. Cardiac and vascular malformations

    International Nuclear Information System (INIS)

    Ley, S.; Ley-Zaporozhan, J.

    2015-01-01

    Malformations of the heart and great vessels show a high degree of variation. There are numerous variants and defects with only few clinical manifestations and are only detected by chance, such as a persistent left superior vena cava or a partial anomalous pulmonary venous connection. Other cardiovascular malformations are manifested directly after birth and need prompt mostly surgical interventions. At this point in time echocardiography is the diagnostic modality of choice for morphological and functional characterization of malformations. Additional imaging using computed tomography (CT) or magnetic resonance imaging (MRI) is only required in a minority of cases. If so, the small anatomical structures, the physiological tachycardia and tachypnea are a challenge for imaging modalities and strategies. This review article presents the most frequent vascular, cardiac and complex cardiovascular malformations independent of the first line diagnostic imaging modality. (orig.) [de

  3. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  4. Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2017-01-01

    Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how...... pharmacotherapy may contribute to the overall burden of SCD in the general population. Methods This was a nationwide study that included all deaths that occurred between 2000 and 2009 and between 2007 and 2009 in people age 1 to 35 years and 36 to 49 years, respectively. Two physicians identified all SCDs through...... review of death certificates. Autopsy reports were collected. Pharmacotherapy prescribed within 90 days before SCD was identified in the Danish Registry of Medicinal Product Statistics. Results We identified 1,363 SCDs; median age was 38 years (interquartile range: 29 to 45 years), and 72% (n = 975) were men...

  5. Cardiac Rehabilitation Series: Canada

    Science.gov (United States)

    Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander

    2015-01-01

    Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018

  6. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate...... that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure...

  7. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both...... supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia......, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society...

  8. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  9. Cardiac function in acute hypothyroidism

    International Nuclear Information System (INIS)

    Donaghue, K.; Hales, I.; Allwright, S.; Cooper, R.; Edwards, A.; Grant, S.; Morrow, A.; Wilmshurst, E.; Royal North Shore Hospital, Sydney

    1985-01-01

    It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total tyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidisms, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P<0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effussion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function. (orig.)

  10. Trends in Cardiac Pacemaker Batteries

    Directory of Open Access Journals (Sweden)

    Venkateswara Sarma Mallela

    2004-10-01

    Full Text Available Batteries used in Implantable cardiac pacemakers-present unique challenges to their developers and manufacturers in terms of high levels of safety and reliability. In addition, the batteries must have longevity to avoid frequent replacements. Technological advances in leads/electrodes have reduced energy requirements by two orders of magnitude. Micro-electronics advances sharply reduce internal current drain concurrently decreasing size and increasing functionality, reliability, and longevity. It is reported that about 600,000 pacemakers are implanted each year worldwide and the total number of people with various types of implanted pacemaker has already crossed 3 million. A cardiac pacemaker uses half of its battery power for cardiac stimulation and the other half for housekeeping tasks such as monitoring and data logging. The first implanted cardiac pacemaker used nickel-cadmium rechargeable battery, later on zinc-mercury battery was developed and used which lasted for over 2 years. Lithium iodine battery invented and used by Wilson Greatbatch and his team in 1972 made the real impact to implantable cardiac pacemakers. This battery lasts for about 10 years and even today is the power source for many manufacturers of cardiac pacemakers. This paper briefly reviews various developments of battery technologies since the inception of cardiac pacemaker and presents the alternative to lithium iodine battery for the near future.

  11. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  12. Acupuncture therapy related cardiac injury.

    Science.gov (United States)

    Li, Xue-feng; Wang, Xian

    2013-12-01

    Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

  13. The Johannesburg cardiac rehabilitation programme

    African Journals Online (AJOL)

    1991-02-16

    Feb 16, 1991 ... sion 72,9% of patients were smokers, 26,3% had hypertension and 34,3% had ... Cardiac rehabilitation, including supervised exercise therapy, has become a .... sions on risk factor modification, diet, aspects of heart disease,.

  14. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  15. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  16. Optimal Technique in Cardiac Anesthesia Recovery

    OpenAIRE

    Svircevic, V.

    2014-01-01

    The aim of this thesis is to evaluate fast-track cardiac anesthesia techniques and investigate their impact on postoperative mortality, morbidity and quality of life. The following topics will be discussed in the thesis. (1.) Is fast track cardiac anesthesia a safe technique for cardiac surgery? (2.) Does thoracic epidural anesthesia have an effect on mortality and morbidity after cardiac surgery? (3.) Does thoracic epidural anesthesia have an effect on quality of life after cardiac surgery? ...

  17. Cardiac effects of noncardiac neoplasms

    International Nuclear Information System (INIS)

    Schoen, F.J.; Berger, B.M.; Guerina, N.G.

    1984-01-01

    Clinically significant cardiovascular abnormalities may occur as secondary manifestations of noncardiac neoplasms. The principal cardiac effects of noncardiac tumors include the direct results of metastases to the heart or lungs, the indirect effects of circulating tumor products (causing nonbacterial thrombotic endocarditis, myeloma-associated amyloidosis, pheochromocytoma-associated cardiac hypertrophy and myofibrillar degeneration, and carcinoid heart disease), and the undesired cardiotoxicities of chemotherapy and radiotherapy. 89 references

  18. Imaging in cardiac mass lesions

    International Nuclear Information System (INIS)

    Mundinger, A.; Gruber, H.P.; Dinkel, E.; Geibel, A.; Beck, A.; Wimmer, B.; Schlosser, V.

    1992-01-01

    In 26 patients with cardiac mass lesions confirmed by surgery, diagnostic imaging was performed preoperatively by means of two-dimensional echocardiography (26 patients), angiography (12 patients), correlative computed tomography (CT, 8 patients), and magnetic resonance imaging (MRI, 3 patients). Two-dimensional echocardiography correctly identified the cardiac masses in all patients. Angiography missed two of 12 cardiac masses; CT missed one of eight. MRI identified three of three cardiac masses. Although the sensitivity of two-dimensional echocardiography was high (100%), all methods lacked specificity. None of the methods allowed differentiation between myxoma (n=13) and thrombus (n=7). Malignancy of the lesions was successfully predicted by noninvasive imaging methods in all six patients. However, CT and MRI provided additional information concerning cardiac mural infiltration, pericardial involvement, and extracardiac tumor extension, and should be integrated within a preoperative imaging strategy. Thus two-dimensional echocardiography is the method of choice for primary assessment of patients with suspected cardiac masses. Further preoperative imaging by CT or MRI can be limited to patients with malignancies suspected on the grounds of pericardial effusion or other clinical results. (author)

  19. Cardiac imaging. A multimodality approach

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, Manfred [Johannes Gutenberg University Hospital, Mainz (Germany); Erbel, Raimund [University Hospital Essen (Germany). Dept. of Cardiology; Kreitner, Karl-Friedrich [Johannes Gutenberg University Hospital, Mainz (Germany). Clinic and Polyclinic for Diagnostic and Interventional Radiology; Barkhausen, Joerg (eds.) [University Hospital Schleswig-Holstein, Luebeck (Germany). Dept. of Radiology and Nuclear Medicine

    2009-07-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  20. Cardiac imaging. A multimodality approach

    International Nuclear Information System (INIS)

    Thelen, Manfred; Erbel, Raimund; Kreitner, Karl-Friedrich; Barkhausen, Joerg

    2009-01-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  1. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  2. Recurrent late cardiac tamponade following cardiac surgery : a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Background - Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. Case report - We present a case of recurrent cardiac tamponade following valve surgery. At first presentation,

  3. Recurrent late cardiac tamponade following cardiac surgery: a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. We present a case of recurrent cardiac tamponade following valve surgery. At first presentation, diagnosis was delayed because of

  4. Cardiac function and cognition in older community-dwelling cardiac patients

    NARCIS (Netherlands)

    Eggermont, Laura H.P.; Aly, Mohamed F.A.; Vuijk, Pieter J.; de Boer, Karin; Kamp, Otto; van Rossum, Albert C.; Scherder, Erik J.A.

    2017-01-01

    Background: Cognitive deficits have been reported in older cardiac patients. An underlying mechanism for these findings may be reduced cardiac function. The relationship between cardiac function as represented by different echocardiographic measures and different cognitive function domains in older

  5. Halogenated anaesthetics and cardiac protection in cardiac and non-cardiac anaesthesia

    Directory of Open Access Journals (Sweden)

    Landoni Giovanni

    2009-01-01

    Full Text Available Volatile anaesthetic agents have direct protective properties against ischemic myocardial damage. The implementation of these properties during clinical anaesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. A recent meta-analysis showed that desflurane and sevoflurane reduce postoperative mortality and incidence of myocardial infarction following cardiac surgery, with significant advantages in terms of postoperative cardiac troponin release, need for inotrope support, time on mechanical ventilation, intensive care unit and overall hospital stay. Multicentre, randomised clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalisation following coronary artery bypass graft surgery either with and without cardiopulmonary bypass. The American College of Cardiology/American Heart Association Guidelines recommend volatile anaesthetic agents during non-cardiac surgery for the maintenance of general anaesthesia in patients at risk for myocardial infarction. Nonetheless, e vidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanisms of cardiac protection by volatile agents.

  6. Cardiac rehabilitation costs.

    Science.gov (United States)

    Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

    2017-10-01

    Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  8. Five-dimensional motion compensation for respiratory and cardiac motion with cone-beam CT of the thorax region

    Science.gov (United States)

    Sauppe, Sebastian; Hahn, Andreas; Brehm, Marcus; Paysan, Pascal; Seghers, Dieter; Kachelrieß, Marc

    2016-03-01

    We propose an adapted method of our previously published five-dimensional (5D) motion compensation (MoCo) algorithm1, developed for micro-CT imaging of small animals, to provide for the first time motion artifact-free 5D cone-beam CT (CBCT) images from a conventional flat detector-based CBCT scan of clinical patients. Image quality of retrospectively respiratory- and cardiac-gated volumes from flat detector CBCT scans is deteriorated by severe sparse projection artifacts. These artifacts further complicate motion estimation, as it is required for MoCo image reconstruction. For high quality 5D CBCT images at the same x-ray dose and the same number of projections as todays 3D CBCT we developed a double MoCo approach based on motion vector fields (MVFs) for respiratory and cardiac motion. In a first step our already published four-dimensional (4D) artifact-specific cyclic motion-compensation (acMoCo) approach is applied to compensate for the respiratory patient motion. With this information a cyclic phase-gated deformable heart registration algorithm is applied to the respiratory motion-compensated 4D CBCT data, thus resulting in cardiac MVFs. We apply these MVFs on double-gated images and thereby respiratory and cardiac motion-compensated 5D CBCT images are obtained. Our 5D MoCo approach processing patient data acquired with the TrueBeam 4D CBCT system (Varian Medical Systems). Our double MoCo approach turned out to be very efficient and removed nearly all streak artifacts due to making use of 100% of the projection data for each reconstructed frame. The 5D MoCo patient data show fine details and no motion blurring, even in regions close to the heart where motion is fastest.

  9. Animal models of cardiac cachexia.

    Science.gov (United States)

    Molinari, Francesca; Malara, Natalia; Mollace, Vincenzo; Rosano, Giuseppe; Ferraro, Elisabetta

    2016-09-15

    Cachexia is the loss of body weight associated with several chronic diseases including chronic heart failure (CHF). The cachectic condition is mainly due to loss of skeletal muscle mass and adipose tissue depletion. The majority of experimental in vivo studies on cachexia rely on animal models of cancer cachexia while a reliable and appropriate model for cardiac cachexia has not yet been established. A critical issue in generating a cardiac cachexia model is that genetic modifications or pharmacological treatments impairing the heart functionality and used to obtain the heart failure model might likely impair the skeletal muscle, this also being a striated muscle and sharing with the myocardium several molecular and physiological mechanisms. On the other hand, often, the induction of heart damage in the several existing models of heart failure does not necessarily lead to skeletal muscle loss and cachexia. Here we describe the main features of cardiac cachexia and illustrate some animal models proposed for cardiac cachexia studies; they include the genetic calsequestrin and Dahl salt-sensitive models, the monocrotaline model and the surgical models obtained by left anterior descending (LAD) ligation, transverse aortic constriction (TAC) and ascending aortic banding. The availability of a specific animal model for cardiac cachexia is a crucial issue since, besides the common aspects of cachexia in the different syndromes, each disease has some peculiarities in its etiology and pathophysiology leading to cachexia. Such peculiarities need to be unraveled in order to find new targets for effective therapies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Perioperative Rosuvastatin in Cardiac Surgery.

    Science.gov (United States)

    Zheng, Zhe; Jayaram, Raja; Jiang, Lixin; Emberson, Jonathan; Zhao, Yan; Li, Qi; Du, Juan; Guarguagli, Silvia; Hill, Michael; Chen, Zhengming; Collins, Rory; Casadei, Barbara

    2016-05-05

    Complications after cardiac surgery are common and lead to substantial increases in morbidity and mortality. Meta-analyses of small randomized trials have suggested that perioperative statin therapy can prevent some of these complications. We randomly assigned 1922 patients in sinus rhythm who were scheduled for elective cardiac surgery to receive perioperative rosuvastatin (at a dose of 20 mg daily) or placebo. The primary outcomes were postoperative atrial fibrillation within 5 days after surgery, as assessed by Holter electrocardiographic monitoring, and myocardial injury within 120 hours after surgery, as assessed by serial measurements of the cardiac troponin I concentration. Secondary outcomes included major in-hospital adverse events, duration of stay in the hospital and intensive care unit, left ventricular and renal function, and blood biomarkers. The concentrations of low-density lipoprotein cholesterol and C-reactive protein after surgery were lower in patients assigned to rosuvastatin than in those assigned to placebo (PSTICS ClinicalTrials.gov number, NCT01573143.).

  11. Comparing Methods for Cardiac Output

    DEFF Research Database (Denmark)

    Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F

    2018-01-01

    of the left ventricular outflow tract. METHODS: The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed...... tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation......, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias...

  12. Cerebral Oximetry in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    A. N. Shepelyuk

    2012-01-01

    Full Text Available Based on the data of numerous current references, the review describes different neuromonitoring methods during cardiac surgery under extracorporeal circulation. It shows that it is important and necessary to make neuromonitoring for the early diagnosis and prevention of neurological complications after cardiac surgery. Particular attention is given to cerebral oximetry; the possibilities and advantages of this technique are described. Correction of cerebral oximetric values is shown to improve survival rates and to reduce the incidence of postoperative complications. Lack of cerebral oximetry monitoring denudes a clinician of important information and possibilities to optimize patient status and to prevent potentially menacing complications, which allows one to conclude that it is necessary to use cerebral oximetry procedures within neu-romonitoring in cardiac surgery. Key words: extracorporeal circulation, cerebral oximetry, neurological dysfunction, cerebral oxygenation.

  13. Investigating Cardiac MRI Based Right Ventricular Contractility As A Novel Non-Invasive Metric of Pulmonary Arterial Pressure

    Science.gov (United States)

    Menon, Prahlad G; Adhypak, Srilakshmi M; Williams, Ronald B; Doyle, Mark; Biederman, Robert WW

    2014-01-01

    BACKGROUND We test the hypothesis that cardiac magnetic resonance (CMR) imaging-based indices of four-dimensional (4D) (three dimensions (3D) + time) right ventricle (RV) function have predictive values in ascertaining invasive pulmonary arterial systolic pressure (PASP) measurements from right heart catheterization (RHC) in patients with pulmonary arterial hypertension (PAH). METHODS We studied five patients with idiopathic PAH and two age and sex-matched controls for RV function using a novel contractility index (CI) for amplitude and phase to peak contraction established from analysis of regional shape variation in the RV endocardium over 20 cardiac phases, segmented from CMR images in multiple orientations. RESULTS The amplitude of RV contractility correlated inversely with RV ejection fraction (RVEF; R2 = 0.64, P = 0.03) and PASP (R2 = 0.71, P = 0.02). Phase of peak RV contractility also correlated inversely to RVEF (R2 = 0.499, P = 0.12) and PASP (R2 = 0.66, P = 0.04). CONCLUSIONS RV contractility analyzed from CMR offers promising non-invasive metrics for classification of PAH, which are congruent with invasive pressure measurements. PMID:25624777

  14. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  15. Hybrid options for treating cardiac disease.

    Science.gov (United States)

    Umakanthan, Ramanan; Leacche, Marzia; Zhao, David X; Gallion, Anna H; Mishra, Prabodh C; Byrne, John G

    2011-01-01

    The options for treating heart disease have greatly expanded during the course of the last 2 1/2 decades with the advent of hybrid technology. The hybrid option for treating cardiac disease implies using the technology of both interventional cardiology and cardiac surgery to treat cardiac disease. This rapidly developing technology has given rise to new and creative techniques to treat cardiac disease involving coronary artery disease, coronary artery disease and cardiac valve disease, and atrial fibrillation. It has also led to the establishment of new procedural suites called hybrid operating rooms that facilitate the integration of technologies of interventional cardiology catheterization laboratories with those of cardiac surgery operating rooms. The development of hybrid options for treating cardiac disease has also greatly augmented teamwork and collaboration between interventional cardiologists and cardiac surgeons. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Sudden Cardiac Arrest (SCA) Risk Assessment

    Science.gov (United States)

    ... HRS Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... people of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

  17. Human technology after cardiac epigenesis. Artificial heart versus cardiac transplantation.

    Science.gov (United States)

    Losman, J G

    1977-09-24

    Cardiovascular disease is the chief cause of death in technologically advanced countries and accounts for more than 50% of all deaths in the USA. For a patient with end-stage cardiac failure the only treatment presently available is organ replacement, either by transplantation or by the use of a mechanical heart. Transplantation has demonstrated its value: survival of more than 8 years and restoration of a normal quality of life to patients who were in end-stage cardiac decompensation. However, the prospect of routine clinical application of an artificial heart remains distant. The development of a totally implantable artificial heart still presents a series of challenging engineering problems with regard to strict constraints of size, weight, blood-material compatibility, adaptability of output to demand, efficiency and reliability of the power supply, and safety if nuclear fuel is used. The totally artificial heart is presently not an alternative to the cardiac allograft, but could provide short-term support for patients awaiting cardiac transplantation.

  18. Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants

    Science.gov (United States)

    Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James

    2015-01-01

    Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

  19. Discovery and progress of direct cardiac reprogramming.

    Science.gov (United States)

    Kojima, Hidenori; Ieda, Masaki

    2017-06-01

    Cardiac disease remains a major cause of death worldwide. Direct cardiac reprogramming has emerged as a promising approach for cardiac regenerative therapy. After the discovery of MyoD, a master regulator for skeletal muscle, other single cardiac reprogramming factors (master regulators) have been sought. Discovery of cardiac reprogramming factors was inspired by the finding that multiple, but not single, transcription factors were needed to generate induced pluripotent stem cells (iPSCs) from fibroblasts. We first reported a combination of cardiac-specific transcription factors, Gata4, Mef2c, and Tbx5 (GMT), that could convert mouse fibroblasts into cardiomyocyte-like cells, which were designated as induced cardiomyocyte-like cells (iCMs). Following our first report of cardiac reprogramming, many researchers, including ourselves, demonstrated an improvement in cardiac reprogramming efficiency, in vivo direct cardiac reprogramming for heart regeneration, and cardiac reprogramming in human cells. However, cardiac reprogramming in human cells and adult fibroblasts remains inefficient, and further efforts are needed. We believe that future research elucidating epigenetic barriers and molecular mechanisms of direct cardiac reprogramming will improve the reprogramming efficiency, and that this new technology has great potential for clinical applications.

  20. Cardiac anatomy and physiology: a review.

    Science.gov (United States)

    Gavaghan, M

    1998-04-01

    This article reviews the normal anatomy and physiology of the heart. Understanding the normal anatomic and physiologic relationships described in this article will help perioperative nurses care for patients who are undergoing cardiac procedures. Such knowledge also assists nurses in educating patients about cardiac procedures and about activities that can prevent, reverse, or improve cardiac illness.

  1. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization

  2. Technique for producing cardiac radionuclide motion images

    International Nuclear Information System (INIS)

    Reese, I.C.; Mishkin, F.S.

    1975-01-01

    Sequential frames of different portions of the cardiac cycle are gated into a minicomputer by using an EKG signal recorded onto digital tape simultaneously with imaging information. Serial display of these frames on the computer oscilloscope or projection of 35-mm half frames of these images provides a cardiac motion image with information content adequate for qualitatively assessing cardiac motion. (U.S.)

  3. Optimal Technique in Cardiac Anesthesia Recovery

    NARCIS (Netherlands)

    Svircevic, V.

    2014-01-01

    The aim of this thesis is to evaluate fast-track cardiac anesthesia techniques and investigate their impact on postoperative mortality, morbidity and quality of life. The following topics will be discussed in the thesis. (1.) Is fast track cardiac anesthesia a safe technique for cardiac surgery?

  4. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  5. Reninoma presenting as cardiac syncope

    Science.gov (United States)

    Tak, Shahid I; Wani, Mohd Lateef; Khan, Khursheed A; Alai, Mohd Sultan; Shera, Altaf Hussain; Ahangar, Abdul G; Khan, Yasir Bashir; Nayeem-ul-Hassan; Irshad, Ifat

    2011-01-01

    Reninoma, a renin-secreting tumor of the juxta-glomerular cells of the kidney, is a rare but surgically treatable cause of secondary hypertension in children. We report a case of reninoma presenting as cardiac syncope with long QTc on electrocardiogram due to hypokalemia. PMID:21677812

  6. Approach to cardiac resyncronization therapy

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Dagres, Nikolaos; Svendsen, Jesper Hastrup

    2012-01-01

    fibrillation and standard criteria for CRT. In 24% of the centres, biventricular pacemaker (CRT-P) is implanted in all situations, unless there is an indication for secondary prevention of sudden cardiac death, while 10% always choose to implant a biventricular defibrillator (CRT-D). There are no clear...

  7. The cardiac patient in Ramadan.

    Science.gov (United States)

    Chamsi-Pasha, Majed; Chamsi-Pasha, Hassan

    2016-01-01

    Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting.

  8. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart

  9. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...

  10. Response to cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Schiffer, Angélique A; Widdershoven, Jos W

    2009-01-01

    Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10-40% of patients do not respond to this treatment and are labeled as nonresponders...

  11. Guide to prosthetic cardiac valves

    International Nuclear Information System (INIS)

    Morse, D.; Steiner, R.M.; Fernandez, J.

    1985-01-01

    This book contains 10 chapters. Some of the chapter titles are: The development of artificial heart valves: Introduction and historical perspective; The radiology of prosthetic heart valves; The evaluation of patients for prosthetic valve implantation; Pathology of cardiac valve replacement; and Bioengineering of mechanical and biological heart valve substitutes

  12. Automatic referral to cardiac rehabilitation.

    Science.gov (United States)

    Fischer, Jane P

    2008-01-01

    The pervasive negative impact of cardiovascular disease in the United States is well documented. Although advances have been made, the campaign to reduce the occurrence, progression, and mortality continues. Determining evidence-based data is only half the battle. Implementing new and updated clinical guidelines into daily practice is a challenging task. Cardiac rehabilitation is an example of a proven intervention whose benefit is hindered through erratic implementation. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA) have responded to this problem by publishing the AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services. This new national guideline recommends automatic referral to cardiac rehabilitation for every eligible patient (performance measure A-1). This article offers guidance for the initiation of an automatic referral system, including individualizing your protocol with regard to electronic or paper-based order entry structures.

  13. Can cardiac surgery cause hypopituitarism?

    Science.gov (United States)

    Francis, Flverly; Burger, Ines; Poll, Eva Maria; Reineke, Andrea; Strasburger, Christian J; Dohmen, Guido; Gilsbach, Joachim M; Kreitschmann-Andermahr, Ilonka

    2012-03-01

    Apoplexy of pituitary adenomas with subsequent hypopituitarism is a rare but well recognized complication following cardiac surgery. The nature of cardiac on-pump surgery provides a risk of damage to the pituitary because the vascular supply of the pituitary is not included in the cerebral autoregulation. Thus, pituitary tissue may exhibit an increased susceptibility to hypoperfusion, ischemia or intraoperative embolism. After on-pump procedures, patients often present with physical and psychosocial impairments which resemble symptoms of hypopituitarism. Therefore, we analyzed whether on-pump cardiac surgery may cause pituitary dysfunction also in the absence of pre-existing pituitary disease. Twenty-five patients were examined 3-12 months after on-pump cardiac surgery. Basal hormone levels for all four anterior pituitary hormone axes were measured and a short synacthen test and a growth hormone releasing hormone plus arginine (GHRH-ARG)-test were performed. Quality of life (QoL), depression, subjective distress for a specific life event, sleep quality and fatigue were assessed by means of self-rating questionnaires. Hormonal alterations were only slight and no signs of anterior hypopituitarism were found except for an insufficient growth hormone rise in two overweight patients in the GHRH-ARG-test. Psychosocial impairment was pronounced, including symptoms of moderate to severe depression in 9, reduced mental QoL in 8, dysfunctional coping in 6 and pronounced sleep disturbances in 16 patients. Hormone levels did not correlate with psychosocial impairment. On-pump cardiac surgery did not cause relevant hypopituitarism in our sample of patients and does not serve to explain the psychosocial symptoms of these patients.

  14. Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Lynge, Thomas Hadberg; Risgaard, Bjarke; Jabbari, Reza

    2016-01-01

    AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years...... in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431...... autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought...

  15. Boosters and barriers for direct cardiac reprogramming.

    Science.gov (United States)

    Talkhabi, Mahmood; Zonooz, Elmira Rezaei; Baharvand, Hossein

    2017-06-01

    Heart disease is currently the most significant cause of morbidity and mortality worldwide, which accounts for approximately 33% of all deaths. Recently, a promising and alchemy-like strategy has been developed called direct cardiac reprogramming, which directly converts somatic cells such as fibroblasts to cardiac lineage cells such as cardiomyocytes (CMs), termed induced CMs or iCMs. The first in vitro cardiac reprogramming study, mediated by cardiac transcription factors (TFs)-Gata4, Tbx5 and Mef2C-, was not enough efficient to produce an adequate number of fully reprogrammed, functional iCMs. As a result, numerous combinations of cardiac TFs exist for direct cardiac reprogramming of mouse and human fibroblasts. However, the efficiency of direct cardiac reprogramming remains low. Recently, a number of cellular and molecular mechanisms have been identified to increase the efficiency of direct cardiac reprogramming and the quality of iCMs. For example, microgrooved substrate, cardiogenic growth factors [VEGF, FGF, BMP4 and Activin A], and an appropriate stoichiometry of TFs boost the direct cardiac reprogramming. On the other hand, serum, TGFβ signaling, activators of epithelial to mesenchymal transition, and some epigenetic factors (Bmi1 and Ezh2) are barriers for direct cardiac reprogramming. Manipulating these mechanisms by the application of boosters and removing barriers can increase the efficiency of direct cardiac reprogramming and possibly make iCMs reliable for cell-based therapy or other potential applications. In this review, we summarize the latest trends in cardiac TF- or miRNA-based direct cardiac reprogramming and comprehensively discuses all molecular and cellular boosters and barriers affecting direct cardiac reprogramming. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Cardiac blood pool emission tomography

    International Nuclear Information System (INIS)

    Itti, R.; Philippe, L.; Lorgeron, J.M.; Charbonnier, B.; Raynaud, P.; Brochier, M.

    1983-01-01

    After blood pool labeling using technetium-99m, a series of cardiac pictures is acquired during the rotation of a gamma-camera about the patient. Computer processing leads to reconstruction of various tomographic slices from the original planar projection. Electrocardiographic gating selects the different phases of the cardiac cycle. Individual slices through the left ventricular region are added in order to provide ''thick'' slices on which global and regional parameters of the left ventricular function can be determined. Due to the proportionality existing between count rates and labeled blood volumes, any geometrical model can be avoided. The delineation of regions of interest for count integration is made easier due to the absence of superimposition of structures; no correction for background is necessary. Tomography thus appears to be more consistent and more accurate than the classical methods using planar projections. In addition, right ventricular morphological and kinetic studies can be performed in the same conditions as for the left ventricle [fr

  17. Respiratory gating in cardiac PET

    DEFF Research Database (Denmark)

    Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

    2017-01-01

    BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS: Forty-eight patients were randomized to adenosine or dipyridamole cardiac...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4...

  18. The Danish Cardiac Rehabilitation Database

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne

    2016-01-01

    hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. CONCLUSION: The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD......AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated...... with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date...

  19. Sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Fábio Camilo Pellegrino dos Santos

    2012-11-01

    Full Text Available ABSTRACT The most accepted definition of sudden cardiac death nowadays is an unexplained death occurred suddenly within one hour of symptom onset. If it was not witnessed, individuals need to had been observed for at least 24 hours before the event and should be discarded the possibility of non cardiac causes of sudden death, pulmonary embolism or extensive malignancy. The term athlete refers to individuals of any age who participate in collective or individual regular physical activity, as well as physical training program for regular competitions. The sudden death of a young athlete, whether amateur or professional, especially during competitions, is always dramatic, with strong negative social impact and in the media. The fact that sports are recommended as a formula for longevity and quality of life makes these events a cause for concern in sports and society in general.

  20. Gene Therapy in Cardiac Arrhythmias

    OpenAIRE

    Praveen, S.V; Francis, Johnson; Venugopal, K

    2006-01-01

    Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV...

  1. Cardiac surgery in the parturient.

    Science.gov (United States)

    Chandrasekhar, Shobana; Cook, Christopher R; Collard, Charles D

    2009-03-01

    Heart disease is the primary cause of nonobstetric mortality in pregnancy, occurring in 1%-3% of pregnancies and accounting for 10%-15% of maternal deaths. Congenital heart disease has become more prevalent in women of childbearing age, representing an increasing percentage (up to 75%) of heart disease in pregnancy. Untreated maternal heart disease also places the fetus at risk. Independent predictors of neonatal complications include a maternal New York Heart Association heart failure classification >2, anticoagulation use during pregnancy, smoking, multiple gestation, and left heart obstruction. Because cardiac surgical morbidity and mortality in the parturient is higher than nonpregnant patients, most parturients with cardiac disease are first managed medically, with cardiac surgery being reserved when medical management fails. Risk factors for maternal mortality during cardiac surgery include the use of vasoactive drugs, age, type of surgery, reoperation, and maternal functional class. Risk factors for fetal mortality include maternal age >35 yr, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic time. Nonetheless, acceptable maternal and fetal perioperative mortality rates may be achieved through such measures as early preoperative detection of maternal cardiovascular decompensation, use of fetal monitoring, delivery of a viable fetus before the operation and scheduling surgery on an elective basis during the second trimester. Additionally, fetal morbidity may be reduced during cardiopulmonary bypass by optimizing maternal oxygen-carrying capacity and uterine blood flow. Current maternal bypass recommendations include: 1) maintaining the pump flow rate >2.5 L x min(-1) x m(-2) and perfusion pressure >70 mm Hg; 2) maintaining the hematocrit > 28%; 3) using normothermic perfusion when feasible; 4) using pulsatile flow; and 5) using alpha-stat pH management.

  2. Cardiac rehabilitation: a comprehensive review

    OpenAIRE

    Lear, Scott A; Ignaszewski, Andrew

    2001-01-01

    Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...

  3. The paediatrician and cardiac auscultation

    OpenAIRE

    Roy, Douglas L

    2003-01-01

    The cardiac auscultation (CA) skills of paediatric residents and office-based paediatricians have recently been shown to be suboptimal. CA is known to have a high degree of specificity and sensitivity, and is inexpensive. New teaching aids and availability of surrogate patient heart sounds and murmurs now allow most physicians to acquire CA skills. These teaching aids should be available in all medical schools and in all postgraduate paediatric training programs. While the relationship betwee...

  4. Clinical application of cardiac SPECT

    International Nuclear Information System (INIS)

    Nishimura, Shigeyuki

    1999-01-01

    Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to 201 Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with 201 Tl. Quantitative assessment of 99m Tc MIBI uptake reflect the degree of viability. 123 I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by 123 I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. 23 I-BMIPP (ρ-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, 99m Tc perfusion agents, 123 I-MIBG and 23 I-BMIPP and in associated clinical application to the various cardiac diseases

  5. Pregnancy as a cardiac stress model

    Science.gov (United States)

    Chung, Eunhee; Leinwand, Leslie A.

    2014-01-01

    Cardiac hypertrophy occurs during pregnancy as a consequence of both volume overload and hormonal changes. Both pregnancy- and exercise-induced cardiac hypertrophy are generally thought to be similar and physiological. Despite the fact that there are shared transcriptional responses in both forms of cardiac adaptation, pregnancy results in a distinct signature of gene expression in the heart. In some cases, however, pregnancy can induce adverse cardiac events in previously healthy women without any known cardiovascular disease. Peripartum cardiomyopathy is the leading cause of non-obstetric mortality during pregnancy. To understand how pregnancy can cause heart disease, it is first important to understand cardiac adaptation during normal pregnancy. This review provides an overview of the cardiac consequences of pregnancy, including haemodynamic, functional, structural, and morphological adaptations, as well as molecular phenotypes. In addition, this review describes the signalling pathways responsible for pregnancy-induced cardiac hypertrophy and angiogenesis. We also compare and contrast cardiac adaptation in response to disease, exercise, and pregnancy. The comparisons of these settings of cardiac hypertrophy provide insight into pregnancy-associated cardiac adaptation. PMID:24448313

  6. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  7. Cardiac tamponade: contrast reflux as an indicator of cardiac chamber equalization

    Directory of Open Access Journals (Sweden)

    Nauta Foeke Jacob

    2012-05-01

    Full Text Available Abstract Background Traumatic hemopericardium remains a rare entity; it does however commonly cause cardiac tamponade which remains a major cause of death in traumatic blunt cardiac injury. Objectives We present a case of blunt chest trauma complicated by cardiac tamponade causing cardiac chamber equalization revealed by reflux of contrast. Case report A 29-year-old unidentified male suffered blunt chest trauma in a motor vehicle collision. Computed tomography (CT demonstrated a periaortic hematoma and hemopericardium. Significant contrast reflux was seen in the inferior vena cava and hepatic veins suggesting a change in cardiac chamber pressures. After intensive treatment including cardiac massage this patient expired of cardiac arrest. Conclusion Reflux of contrast on CT imaging can be an indicator of traumatic cardiac tamponade.

  8. Cardiac integrins the ties that bind.

    Science.gov (United States)

    Simpson, D G; Reaves, T A; Shih, D T; Burgess, W; Borg, T K; Terracio, L

    1998-01-01

    An elaborate series of morphogenetic events must be precisely coordinated during development to promote the formation of the elaborate three-dimensional structure of the normal heart. In this study we focus on discussing how interconnections between the cardiac myocyte and its surrounding environment regulate cardiac form and function. In vitro experiments from our laboratories provide direct evidence that cardiac cell shape is regulated by a dynamic interaction between constituents of the extracellular matrix (ECM) and by specific members of the integrin family of matrix receptors. Our data indicates that phenotypic information is stored in the tertiary structure and chemical identity of the ECM. This information appears to be actively communicated and transduced by the α1β1 integrin molecule into an intracellular signal that regulates cardiac cell shape and myofibrillar organization. In this study we have assessed the phenotypic consequences of suppressing the expression and accumulation of the α1 integrin molecule in aligned cultures of cardiac myocytes. In related experiments we have examined how the overexpression of α2 and α5 integrin, integrins normally not present or present at very low copy number on the cell surface of neonatal cardiac myocytes, affect cardiac protein metabolism. We also consider how biochemical signals and the mechanical signals mediated by the integrins may converge on common intracellular signaling pathways in the heart. Experiments with the whole embryo culture system indicate that angiotensin II, a peptide that carries information concerning cardiac load, plays a role in controling cardiac looping and the proliferation of myofibrils during development.

  9. Digital subtraction angiography in cardiac diseases

    International Nuclear Information System (INIS)

    Choi, Deuk Lin; Kim, Ki Jeong

    1986-01-01

    DSA was done in 133 examinations of 128 patients during 2 years consist of 9 examination of IV DSA and 124 examination of selective cardiac DSA after cardiac catheterization. Open heart surgery was performed in 90 patients and 12 patients showed discrepancy between pre-and post operative diagnosis, showing a total 86.7% of diagnostic accuracy with DSA. We experienced the significant reduction in dose of contrast media, 30-40% of dose of conventional cardiac angiography. It is concluded that DSA is useful in the evaluation of septal defects, valvular disease and other congenital heart disease. DSA is an accurate simple and safe method in evaluating of cardiac diseases.

  10. [Thromboelastography and its use in cardiac surgery].

    Science.gov (United States)

    Ak, Koray; Atalan, Nazan; Tekeli, Atike; Işbir, Selim; Civelek, Ali; Emekli, Nesrin; Arsan, Sinan

    2008-04-01

    Thromboelastography is an alternative method to conventional coagulation tests for the general evaluation of hemostatic system. Cardiac surgery with cardiopulmonary bypass is accomplished by complex alterations of hemostasis, including acquired dysfunction of platelets, consumption coagulopathy and increased fibrinolysis. Despite major advances in blood conservation methods and perioperative care of the patients, transfusion rates in cardiac surgery remain high. Thromboelastography has an ability to assess almost all components of haemostatic system globally. Currently, thromboelastography is used with standard coagulation tests to decrease the microvascular bleeding and homologous blood transfusion in cardiac surgery with cardiopulmonary bypass. In this review, we aimed to discuss thromboelastography technology and its usage in cardiac surgery.

  11. Radiation exposure of children during cardiac catheterisation

    International Nuclear Information System (INIS)

    Popp, W.

    1979-01-01

    It is well known that in adults, cardiac catheterisation involves the highest possible radiation exposure for a single examination. The paper now investigates the radiation exposure in paediatric cardiac cathetrisations. Dosimeters attached to the children during the examination were used as well as phantom measurements under the conditions of cardiac catheterisation. With the aid of the phantom, also the total energy absorption during an examination procedure was determined. This value was estimated to be 80 mJ. In spite of the high individual exposure, the contribution to the population exposure is low due to the small number of cardiac catheterisations. (orig.) 891 AJ/orig. 892 MKO [de

  12. Accelerated recovery after cardiac operations.

    Science.gov (United States)

    Kaplan, Mehmet; Kut, Mustafa Sinan; Yurtseven, Nurgul; Cimen, Serdar; Demirtas, Mahmut Murat

    2002-01-01

    The accelerated-recovery approach, involving early extubation, early mobility, decreased duration of intensive care unit stay, and decreased duration of hospitalization has recently become a controversial issue in cardiac surgery. We investigated timing of extubation, length of intensive care unit stay, and duration of hospitalization in 225 consecutive cardiac surgery patients. Of the 225 patients, 139 were male and 86 were female; average age was 49.73 +/- 16.95 years. Coronary artery bypass grafting was performed in 127 patients; 65 patients underwent aortic and/or mitral or pulmonary valvular operations; 5 patients underwent valvular plus coronary artery operations; and in 28 patients surgical interventions for congenital anomalies were carried out. The accelerated-recovery approach could be applied in 169 of the 225 cases (75.11%). Accelerated-recovery patients were extubated after an average of 3.97 +/- 1.59 hours, and the average duration of stay in the intensive care unit was 20.93 +/- 2.44 hours for these patients. Patients were discharged if they met all of the following criteria: hemodynamic stability, cooperativeness, ability to initiate walking exercises within wards, lack of pathology in laboratory investigations, and psychological readiness for discharge. Mean duration of hospitalization for accelerated-recovery patients was 4.24 +/- 0.75 days. Two patients (1.18%) who were extubated within the first 6 hours required reintubation. Four patients (2.36%) who were sent to the wards returned to intensive care unit due to various reasons and 6 (3.55%) of the discharged patients were rehospitalized. Approaches for decreasing duration of intubation, intensive care unit stay and hospitalization may be applied in elective and uncomplicated cardiac surgical interventions with short duration of aortic cross-clamping and cardiopulmonary bypass, without risking patients. Frequencies of reintubation, return to intensive care unit, and rehospitalization are quite

  13. Imaging features of cardiac myxoma

    International Nuclear Information System (INIS)

    Yang Youyou; Zheng Lili; Li Xiangmin; Zhou Xuhui; Kuang Jianyi; Zhang Wenzhao

    2007-01-01

    Objective: To study the imaging features of cardiac myxoma and their diagnostic values. Methods: Twenty-two patrents with cardiac myxoma were reviewed retrospectively for the clinical, pathologic, and radiologic findings. Posteroanterior and lateral chest radiographs, American Imatron C-150 XP Electron Beam CT examination, and Germany Siemens 1.5T Magnetom Vision MR scan were performed on every patient. Results: (1) Radiographs of 17 patients with left atrial myxoma showed evidence of mitral valve obstruction in 14(82.3%), radiographs of 5 patients with right atrial myxoma demonstrated right atrium enlargement in 3(60%) respectively. (2) CT scans of 22 myxomas demonstrated 18 (81.8%) lesions were hypoattenuated and 4 (19.1%) were isoattenuated relative to the myocardium. Calcification or ossification was seen in 3 patients. All myxomas apart from massive one were found attaching to the atrial septum. Movie mode could dis- play the movement of myxoma across the atrioventicular valves. (3) MRI studies of 22 myxomas showed 19 (86.3%) heterogeneous signal intensity and 3 (13.7%) homogeneous. They exhibited slight high or homogeneous signal intensity with both T 1 - and T 2 -weighted sequences, and low signal intensity with cine gradient recalled echo sequences. Point of attachment was visible in 21 (95.4%) cases. Conclusion: The typical radiograph sign of cardiac myxomas is mitral valve obstruction, CT and MR can demonstrate intracavitary lobular masses attacthing to artrial spetum. The latter two kinds of examinations not only provide accurate assessment of the size, location, and attachment point of these lesions, but also have important qualitative diagnostic advantage. (authors)

  14. Wernicke's encephalopathy after cardiac surgery.

    Science.gov (United States)

    Nishimura, Yoshiyuki

    2018-05-01

    A 76-year-old woman who had been on hemodialysis for 3 years developed ischemic mitral valve insufficiency, tricuspid insufficiency, and chronic atrial fibrillation, and underwent cardiac surgery. On the 4th postoperative day, she experienced a sudden disturbance of consciousness, aphasia, and limb ataxia. Brain computed tomography and magnetic resonance imaging showed no abnormalities. Wernicke's encephalopathy was suspected and the patient was given vitamin B1, whereupon her symptoms gradually improved. On the 42nd postoperative day, she was free of neurological symptoms and discharged.

  15. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  16. Cardiac disorders with psychosomatic background

    Directory of Open Access Journals (Sweden)

    Ada Bielejewska

    2017-12-01

    Full Text Available Psychosomatic disorders can be described as psychosocial-derived organic disorders. The influence of depression, sleep disorders, quality of life, addictions, work environment, family situation, and stress on atrial fibrillation, palpitations, syncope, chest pain, coronary heart disease, and heart failure has been analysed in this paper. The correlation between psychosomatic disorders and the cardiovascular system has been shown. It allows us to conclude that an attending physician, while taking medical history of cardiac patients, should take into consideration factors that may have a negative impact on their mental health, which can be risk factors in the development or aggravation of an already present cardiovascular disease.

  17. The cardiac sonography workforce in New Zealand

    Science.gov (United States)

    White, Steve; Poppe, Katrina; Whalley, Gillian

    2015-01-01

    Abstract Introduction: The aim of this paper is to investigate the cardiac sonography workforce characteristics and registration requirements in New Zealand (NZ), with a comparison to similar workforces internationally. Methods: The Survey of Clinical Echocardiography in New Zealand 2 (SCANZ2) audit was performed in December 2010. All of NZ's public‐funded District Health Board (DHB) centers providing echocardiography services responded to questions relating to staff, equipment, procedure types and patient statistics. The Medical Radiation Technologists Board (MRTB), Clinical Physiologists Registration Board (CPRB) and Australian Sonographers Association Registry (ASAR) websites were reviewed in March 2012 for registered sonographers with a cardiac scope of practice. The cardiac sonography workforces in Australia, the UK, the USA and Canada were investigated for comparison. Results: There are 84 cardiac sonographers (60.3 full‐time equivalent) working in DHBs: 71% from a cardiac technical background; 40% have post‐graduate qualifications; a further 17% are undertaking post‐graduate qualifications; and 59 cardiac sonographers have registration with professional bodies in NZ and/or Australia. Cardiac sonographers in NZ do not undergo compulsory registration, but other sonographers in NZ have compulsory registration with the MRTB. Sonographers are predominantly not licensed internationally. Discussion: Disparity exists between registration of cardiac and non‐cardiac sonographers in NZ. Many cardiac sonographers have voluntary registration but few are registered with the MRTB. Reasons for this include professional alignment, educational qualifications and representation. International trends show increased pressure from governments and professional bodies to regulate sonographers. Conclusion: This study provides a snapshot of the cardiac sonography workforce in NZ for the first time. PMID:28191178

  18. Assessment of cardiac sympathetic nerve integrity with positron emission tomography

    International Nuclear Information System (INIS)

    Raffel, David M.; Wieland, Donald M.

    2001-01-01

    The autonomic nervous system plays a critical role in the regulation of cardiac function. Abnormalities of cardiac innervation have been implicated in the pathophysiology of many heart diseases, including sudden cardiac death and congestive heart failure. In an effort to provide clinicians with the ability to regionally map cardiac innervation, several radiotracers for imaging cardiac sympathetic neurons have been developed. This paper reviews the development of neuronal imaging agents and discusses their emerging role in the noninvasive assessment of cardiac sympathetic innervation

  19. Performance benchmarking in cardiac imaging

    International Nuclear Information System (INIS)

    Schick, D.; Thiele, D.

    2004-01-01

    Full text: Diagnostic and interventional procedures performed in a cardiac catheter laboratory while demanding high image quality may also result in high patient radiation dose depending on the length or complexity of the procedure. Clinicians using the X-ray equipment require confidence that the system is operating optimally to ensure maximum benefit to the patient with minimum risk. 17 cardiac catheterisation laboratories have been surveyed using a phantom based on the NEMA XR 21 -2000 standard. The testing protocol measures spatial resolution, low contrast detectability, patient dose rate, dynamic range and motion blur for modes of operation and simulated patient sizes applicable to a diagnostic left heart catheter study. The combined results of the assessed laboratories are presented. The latest generation systems with flat-panel detectors exhibit better spatial resolution than older systems with image intensifiers. Phantom measurements show up to a 6 fold variation in dose rate across the range of systems assessed for a given patient size. As expected, some correlation between patient dose rate and the low contrast detectability score is evident. The extent of temporal filtering and pulse width is reflected in the motion blur score. The dynamic range measurements are found to be a less sensitive measure in evaluating system performance. Examination of patient dose results in the context of low contrast detectability score indicates that dose reduction could be achieved without compromising diagnosis on some systems. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  20. Cardiac cachexia: hic et nunc

    Science.gov (United States)

    Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram

    2016-01-01

    Abstract Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

  1. Blood conservation in cardiac surgery.

    Science.gov (United States)

    Blaudszun, G; Butchart, A; Klein, A A

    2017-09-21

    This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia. The management of haematological abnormalities, most frequently functional iron deficiency, is a matter for debate. However, iron supplementation therapy is increasingly commonly administered. Intra-operatively, antifibrinolytics should be routinely used, whereas the cardiopulmonary bypass strategy should be adapted to minimise haemodilution secondary to circuit priming. There is less evidence to recommend minimally invasive surgery. Cell salvage and point-of-care tests should also be a part of the routine care. Post-operatively, any unnecessary iatrogenic blood loss should be avoided. © 2017 British Blood Transfusion Society.

  2. Sudden Cardiac Death in Children. Part 2

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-03-01

    Full Text Available This article deals with the dysplastic changes in musculo-valve structures of the heart, arrhythmias and conduction disorders, associated with a risk of sudden cardiac death. The diagnostic criteria for sudden cardiac death, the events of cardio-pulmonary resuscitation, prevention of life-threatening conditions in children are provided.

  3. Motivational factors of adherence to cardiac rehabilitation.

    Science.gov (United States)

    Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

    2012-05-01

    Main suggested theories about patients' adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients' adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients' participation and compliance to cardiac rehabilitation by recognizing and understanding the nature of patients' experiences. The participants were selected among the patients with cardiac diseases who were referred to cardiac rehabilitation in Isfahan Cardiovascular Research Center, Iran. The purposive sampling method was used and data saturation achieved after 8 semi-structured interviews. The three main concepts obtained from this study are "beliefs", "supporters" and "group cohesion". In cardiac rehabilitation programs, emphasis on motivational factors affects the patient's adherence. It is suggested that in cardiac rehabilitation programs more attention should be paid to patients' beliefs, the role of patients' supporters and the role of group-based rehabilitation.

  4. Interdisciplinary preoperative patient education in cardiac surgery.

    NARCIS (Netherlands)

    Weert, J. van; Dulmen, S. van; Bar, P.; Venus, E.

    2003-01-01

    Patient education in cardiac surgery is complicated by the fact that cardiac surgery patients meet a lot of different health care providers. Little is known about education processes in terms of interdisciplinary tuning. In this study, complete series of consecutive preoperative consultations of 51

  5. Symptomatic myocardial bridging or cardiac Whipple's Diseas

    OpenAIRE

    Cabral,Virgínia L. Ribeiro; Knecht,Daniella; Pego,Regina Célia; Silva,Nuno C. Figueiredo

    2003-01-01

    This report concerns a patient with articular and cardiac manifestations of Whipple's disease. The disease was diagnosed only when gastrointestinal symptoms had appeared, because all cardiac symptoms were attributed exclusively to myocardial bridging. After 18 months of treatment with trimethoprim-sulfamethoxazole, the patient is fully asymptomatic with a normal echocardiogram.

  6. Automated Segmentation of Cardiac Magnetic Resonance Images

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Nilsson, Jens Chr.; Grønning, Bjørn A.

    2001-01-01

    Magnetic resonance imaging (MRI) has been shown to be an accurate and precise technique to assess cardiac volumes and function in a non-invasive manner and is generally considered to be the current gold-standard for cardiac imaging [1]. Measurement of ventricular volumes, muscle mass and function...

  7. Sudden Cardiac Death in Children. Part 1

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-02-01

    Full Text Available This article presents the prevalence, terminology, classification of sudden cardiac death. A description of congenital structural heart diseases associated with a risk of sudden cardiac death is given. The issues of etiology and pathogenesis of life-threatening conditions are described in detail.

  8. Athletes at Risk for Sudden Cardiac Death

    Science.gov (United States)

    Subasic, Kim

    2010-01-01

    High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…

  9. Conditional shape models for cardiac motion estimation

    DEFF Research Database (Denmark)

    Metz, Coert; Baka, Nora; Kirisli, Hortense

    2010-01-01

    We propose a conditional statistical shape model to predict patient specific cardiac motion from the 3D end-diastolic CTA scan. The model is built from 4D CTA sequences by combining atlas based segmentation and 4D registration. Cardiac motion estimation is, for example, relevant in the dynamic...

  10. Cardiac MRI of the athlete's heart

    NARCIS (Netherlands)

    Prakken, N.H.J.

    2010-01-01

    The increase in pre-participation cardiovascular screening using the Lausanne protocol will ultimately lead to an increased use of cardiac MRI and MDCT in the cardiovascular work-up of athletes. The role of cardiac MRI is well established in the evaluation of cardiomyopathies, myocarditis, aortic

  11. Fetal Primary Cardiac Tumors During Perinatal Period

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2017-06-01

    Full Text Available Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.

  12. Acute cardiac failure in neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  13. Symptomatic myocardial bridging or cardiac Whipple's Diseas

    Directory of Open Access Journals (Sweden)

    Cabral Virgínia L. Ribeiro

    2003-01-01

    Full Text Available This report concerns a patient with articular and cardiac manifestations of Whipple's disease. The disease was diagnosed only when gastrointestinal symptoms had appeared, because all cardiac symptoms were attributed exclusively to myocardial bridging. After 18 months of treatment with trimethoprim-sulfamethoxazole, the patient is fully asymptomatic with a normal echocardiogram.

  14. Stem cell sources for cardiac regeneration

    NARCIS (Netherlands)

    Roccio, M.; Goumans, M. J.; Sluijter, J. P. G.; Doevendans, P. A.

    Cell-based cardiac repair has the ambitious aim to replace the malfunctioning cardiac muscle developed after myocardial infarction, with new contractile cardiomyocytes and vessels. Different stem cell populations have been intensively studied in the last decade as a potential source of new

  15. Cardiac fluid dynamics meets deformation imaging.

    Science.gov (United States)

    Dal Ferro, Matteo; Stolfo, Davide; De Paris, Valerio; Lesizza, Pierluigi; Korcova, Renata; Collia, Dario; Tonti, Giovanni; Sinagra, Gianfranco; Pedrizzetti, Gianni

    2018-02-20

    Cardiac function is about creating and sustaining blood in motion. This is achieved through a proper sequence of myocardial deformation whose final goal is that of creating flow. Deformation imaging provided valuable contributions to understanding cardiac mechanics; more recently, several studies evidenced the existence of an intimate relationship between cardiac function and intra-ventricular fluid dynamics. This paper summarizes the recent advances in cardiac flow evaluations, highlighting its relationship with heart wall mechanics assessed through the newest techniques of deformation imaging and finally providing an opinion of the most promising clinical perspectives of this emerging field. It will be shown how fluid dynamics can integrate volumetric and deformation assessments to provide a further level of knowledge of cardiac mechanics.

  16. Mitochondrial oxidative stress and cardiac ageing.

    Science.gov (United States)

    Martín-Fernández, Beatriz; Gredilla, Ricardo

    According with different international organizations, cardiovascular diseases are becoming the first cause of death in western countries. Although exposure to different risk factors, particularly those related to lifestyle, contribute to the etiopathogenesis of cardiac disorders, the increase in average lifespan and aging are considered major determinants of cardiac diseases events. Mitochondria and oxidative stress have been pointed out as relevant factors both in heart aging and in the development of cardiac diseases such as heart failure, cardiac hypertrophy and diabetic cardiomyopathy. During aging, cellular processes related with mitochondrial function, such as bioenergetics, apoptosis and inflammation are altered leading to cardiac dysfunction. Increasing our knowledge about the mitochondrial mechanisms related with the aging process, will provide new strategies in order to improve this process, particularly the cardiovascular ones. Copyright © 2017 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. FET-biosensor for cardiac troponin biomarker

    Directory of Open Access Journals (Sweden)

    Md Arshad Mohd Khairuddin

    2017-01-01

    Full Text Available Acute myocardial infarction or myocardial infarction (MI is a major health problem, due to diminished flow of blood to the heart, leads to higher rates of mortality and morbidity. The most specific markers for cardiac injury are cardiac troponin I (cTnI and cardiac troponin T (cTnT which have been considered as ‘gold standard’. Due to higher specificity, determination of the level of cardiac troponins became a predominant indicator for MI. Currently, field-effect transistor (FET-based biosensors have been main interest to be implemented in portable sensors with the ultimate application in point-of-care testing (POCT. In this paper, we review on the FET-based biosensor based on its principle of operation, integration with nanomaterial, surface functionalization as well as immobilization, and the introduction of additional gate (for ambipolar conduction on the device architecture for the detection of cardiac troponin I (cTnI biomarker.

  18. Proteostasis in cardiac health and disease.

    Science.gov (United States)

    Henning, Robert H; Brundel, Bianca J J M

    2017-11-01

    The incidence and prevalence of cardiac diseases, which are the main cause of death worldwide, are likely to increase because of population ageing. Prevailing theories about the mechanisms of ageing feature the gradual derailment of cellular protein homeostasis (proteostasis) and loss of protein quality control as central factors. In the heart, loss of protein patency, owing to flaws in genetically-determined design or because of environmentally-induced 'wear and tear', can overwhelm protein quality control, thereby triggering derailment of proteostasis and contributing to cardiac ageing. Failure of protein quality control involves impairment of chaperones, ubiquitin-proteosomal systems, autophagy, and loss of sarcomeric and cytoskeletal proteins, all of which relate to induction of cardiomyocyte senescence. Targeting protein quality control to maintain cardiac proteostasis offers a novel therapeutic strategy to promote cardiac health and combat cardiac disease. Currently marketed drugs are available to explore this concept in the clinical setting.

  19. Association between dental caries and out-of-hospital cardiac arrests of cardiac origin in Japan.

    Science.gov (United States)

    Suematsu, Yasunori; Miura, Shin-Ichiro; Zhang, Bo; Uehara, Yoshinari; Ogawa, Masahiro; Yonemoto, Naohiro; Nonogi, Hiroshi; Nagao, Ken; Kimura, Takeshi; Saku, Keijiro

    2016-04-01

    Oral infection contributes to atherosclerosis and coronary heart disease. We hypothesized that dental caries may be associated with out-of-hospital cardiac arrests (OHCA) of cardiac origin, but not non-cardiac origin. We compared the age-adjusted incidence of OHCA (785,591 cases of OHCA: 55.4% of cardiac origin and 44.6% of non-cardiac origin) to the age-adjusted prevalence of dental caries between 2005 and 2011 in the 47 prefectures of Japan. In both the total population and males over 65 years, the number of cases of dental caries was significantly associated with the number of OHCA of total and cardiac origin from 2005 to 2011, but not those of non-cardiac origin. In the total population, the age-adjusted prevalence of dental caries was not significantly associated with the age-adjusted incidence of OHCA (total OHCA: r correlation coefficient=0.22, p=0.14; OHCA of cardiac origin: r=0.25, p=0.09; OHCA of non-cardiac origin: r=-0.002, p=0.99). Among male patients over 65 years, the age-adjusted prevalence of dental caries was significantly associated with OHCA of total and cardiac origin, but not non-cardiac origin (total OHCA: r=0.47, p<0.001; OHCA of cardiac origin: r=0.37, p=0.01; OHCA of non-cardiac origin: r=0.28, p=0.054). While oral hygiene is important in all age groups, it may be particularly associated with OHCAs of cardiac origin in males over 65 years. Copyright © 2015. Published by Elsevier Ltd.

  20. Myocardial ischaemia and the cardiac nervous system.

    Science.gov (United States)

    Armour, J A

    1999-01-01

    The intrinsic cardiac nervous system has been classically considered to contain only parasympathetic efferent postganglionic neurones which receive inputs from medullary parasympathetic efferent preganglionic neurones. In such a view, intrinsic cardiac ganglia act as simple relay stations of parasympathetic efferent neuronal input to the heart, the major autonomic control of the heart purported to reside solely in the brainstem and spinal cord. Data collected over the past two decades indicate that processing occurs within the mammalian intrinsic cardiac nervous system which involves afferent neurones, local circuit neurones (interconnecting neurones) as well as both sympathetic and parasympathetic efferent postganglionic neurones. As such, intrinsic cardiac ganglionic interactions represent the organ component of the hierarchy of intrathoracic nested feedback control loops which provide rapid and appropriate reflex coordination of efferent autonomic neuronal outflow to the heart. In such a concept, the intrinsic cardiac nervous system acts as a distributive processor, integrating parasympathetic and sympathetic efferent centrifugal information to the heart in addition to centripetal information arising from cardiac sensory neurites. A number of neurochemicals have been shown to influence the interneuronal interactions which occur within the intrathoracic cardiac nervous system. For instance, pharmacological interventions that modify beta-adrenergic or angiotensin II receptors affect cardiomyocyte function not only directly, but indirectly by influencing the capacity of intrathoracic neurones to regulate cardiomyocytes. Thus, current pharmacological management of heart disease may influence cardiomyocyte function directly as well as indirectly secondary to modifying the cardiac nervous system. This review presents a brief summary of developing concepts about the role of the cardiac nervous system in regulating the normal heart. In addition, it provides some

  1. Major Cardiac Events After Non-cardiac Surgery.

    Science.gov (United States)

    Sousa, Gabriela; Lopes, Ana; Reis, Pedro; Carvalho, Vasco; Santos, Alice; Abelha, Fernando José

    2016-08-01

    Postoperative cardiovascular complications might be difficult to assess and are known to be associated with longer hospital stay and increased costs as well as higher morbidity and mortality rates. The aim of this study was to evaluate the predictors for major cardiac events (MCE) after non-cardiac surgery. The study included 4398 patients who were admitted to the Surgical Intensive Care Unit between January 1, 2006 and July 19, 2013. Acute physiology and chronic health evaluation II score and simplified acute physiology score (SAPS II) were calculated, and all variables entered as parameters were evaluated independently. Multivariate logistic regression analysis was performed to assess the independent factors for MCE. A total of 107 people experienced MCE. The independent predictors for postoperative MCE were higher fraction of inspired oxygen (FiO2) (odds ratio [OR] 38.97; 95 % confidence interval [CI] 10.81-140.36), history of ischemic heart disease (OR 3.38; 95 % CI 2.12-5.39), history of congestive heart disease (OR 2.39; 95 % CI 1.49-3.85), history of insulin therapy for diabetes (OR 2.93; 95 % CI 1.66-5.19), and increased SAPS II (OR 1.03; 95 % CI 1.01-1.05). Having a MCE was associated with a longer length of stay in the surgical intensive care unit (OR 1.01, 95 % CI 1.00-1.01). FiO2, ischemic heart disease, congestive heart disease, insulin therapy for diabetes, SAPS II, and length of stay in the surgical intensive care unit were independent predictors for MCE.

  2. Crisis management during anaesthesia: cardiac arrest.

    Science.gov (United States)

    Runciman, W B; Morris, R W; Watterson, L M; Williamson, J A; Paix, A D

    2005-06-01

    Cardiac arrest attributable to anaesthesia occurs at the rate of between 0.5 and 1 case per 10 000 cases, tends to have a different profile to that of cardiac arrest occurring elsewhere, and has an in-hospital mortality of 20%. However, as individual practitioners encounter cardiac arrest rarely, the rapidity with which the diagnosis is made and the consistency of appropriate management varies considerably. To examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a sub-algorithm for cardiac arrest, in the management of cardiac arrest occurring in association with anaesthesia. The potential performance of this structured approach for each the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. There were 129 reports of cardiac arrest associated with anaesthesia among the first 4000 AIMS incident reports. Identified aetiological factors were grouped into five categories: (1) anaesthetic technique (11 cases with this category alone; 32 with this and one or more of the other categories, representing 25% of all 129 cardiac arrests); (2) drug related (16; 32, 25%); (3) associated with surgical procedure (9; 29, 22%); (4) associated with pre-existing medical or surgical disease (30; 82, 64%); (5) unknown (8; 14, 11%). The "real life" presentation and management of cardiac arrest in association with anaesthesia differs substantially from that detailed in general published guidelines. Cardiac rhythms at the time were sinus bradycardia (23%); asystole (22%); tachycardia/ventricular tachycardia/ventricular fibrillation (14%); and normal (7%), with a further third unknown. Details of treatment were recorded in 110 reports; modalities employed included cardiac compression (72%); adrenaline (61%); 100% oxygen (58%); atropine (38%); intravenous fluids (25%), and electrical defibrillation (17%). There

  3. Cardiac Function Remains Impaired Despite Reversible Cardiac Remodeling after Acute Experimental Viral Myocarditis

    Directory of Open Access Journals (Sweden)

    Peter Moritz Becher

    2017-01-01

    Full Text Available Background. Infection with Coxsackievirus B3 induces myocarditis. We aimed to compare the acute and chronic phases of viral myocarditis to identify the immediate effects of cardiac inflammation as well as the long-term effects after resolved inflammation on cardiac fibrosis and consequently on cardiac function. Material and Methods. We infected C57BL/6J mice with Coxsackievirus B3 and determined the hemodynamic function 7 as well as 28 days after infection. Subsequently, we analyzed viral burden and viral replication in the cardiac tissue as well as the expression of cytokines and matrix proteins. Furthermore, cardiac fibroblasts were infected with virus to investigate if viral infection alone induces profibrotic signaling. Results. Severe cardiac inflammation was determined and cardiac fibrosis was consistently colocalized with inflammation during the acute phase of myocarditis. Declined cardiac inflammation but no significantly improved hemodynamic function was observed 28 days after infection. Interestingly, cardiac fibrosis declined to basal levels as well. Both cardiac inflammation and fibrosis were reversible, whereas the hemodynamic function remains impaired after healed viral myocarditis in C57BL/6J mice.

  4. Regulation of cardiac remodeling by cardiac Na/K-ATPase isoforms

    Directory of Open Access Journals (Sweden)

    Lijun Catherine Liu

    2016-09-01

    Full Text Available Cardiac remodeling occurs after cardiac pressure/volume overload or myocardial injury during the development of heart failure and is a determinant of heart failure. Preventing or reversing remodeling is a goal of heart failure therapy. Human cardiomyocyte Na+/K+-ATPase has multiple α isoforms (1-3. The expression of the α subunit of the Na+/K+-ATPase is often altered in hypertrophic and failing hearts. The mechanisms are unclear. There are limited data from human cardiomyocytes. Abundant evidences from rodents show that Na+/K+-ATPase regulates cardiac contractility, cell signaling, hypertrophy and fibrosis. The α1 isoform of the Na+/K+-ATPase is the ubiquitous isoform and possesses both pumping and signaling functions. The α2 isoform of the Na+/K+-ATPase regulates intracellular Ca2+ signaling, contractility and pathological hypertrophy. The α3 isoform of the Na+/K+-ATPase may also be a target for cardiac hypertrophy. Restoration of cardiac Na+/K+-ATPase expression may be an effective approach for prevention of cardiac remodeling. In this article, we will overview: (1 the distribution and function of isoform specific Na+/K+-ATPase in the cardiomyocytes. (2 the role of cardiac Na+/K+-ATPase in the regulation of cell signaling, contractility, cardiac hypertrophy and fibrosis in vitro and in vivo. Selective targeting of cardiac Na+/K+-ATPase isoform may offer a new target for the prevention of cardiac remodeling.

  5. Diagnosis of traumatic cardiac contusion

    International Nuclear Information System (INIS)

    Waxman, K.; Soliman, M.H.; Braunstein, P.; Formosa, P.; Cohen, A.J.; Matsuura, P.; Mason, G.R.

    1986-01-01

    Cardiac contusion following blunt chest trauma remains a diagnostic problem because of a lack of sensitive diagnostic tests. This study evaluated thallous chloride Tl 201 single-photon-emission computed tomography in a series of 48 patients following blunt chest trauma. Of the 48 patients, 23 had normal scans. None of these patients proved to have serious arrhythmias during three days of continuous monitoring. Of 25 patients with abnormal or ambiguous studies, five (20%) developed serious arrhythmias requiring therapy. Single-photon-emission computed tomography scanning thus was sensitive in indicating that group of patients at risk of serious arrhythmias, and may therefore prove to be a useful screening test to determine the need for hospitalization and arrhythmia monitoring following blunt chest trauma

  6. Gene Therapy in Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Praveen S.V

    2006-04-01

    Full Text Available Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV node mimicking beta blockade can be therapeutic in the management of atrial fibrillation. G protein overexpression to modify the AV node also is experimental. Modification and expression of potassium channel genes altering the delayed rectifier potassium currents may permit better management of congenital long QT syndromes. Arrhythmias in a failing heart are due to abnormal calcium cycling. Potential targets for genetic modulation include the sarcoplasmic reticulum calcium pump, calsequestrin and sodium calcium exchanger.Lastly the ethical concerns need to be addressed.

  7. Descartes, Cardiac Heat, and Alchemy.

    Science.gov (United States)

    Heitsch, Dorothea

    2016-11-01

    René Descartes (1596-1650) insisted on a heat and light theory to explain cardiac movement, and used concepts such as distillation of the vital spirits, fermentation in the digestive process, and fermentation in the circulation of the blood. I argue that his theory of the body as a heat-exchange system was based on alchemical and natural philosophical notions of fire and light expounded by precursors and contemporaries who included Jean D'Espagnet, Jean Fernel, Jan Baptist van Helmont, and Andreas Libavius. Descartes endeavoured to mechanise their approaches, creating a theory in which fire and heat, a legacy from thermal explanations of physiology, were transformed into alchemical fire, and then into mechanistic or physicalist heat.

  8. Psychosocial aspects in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Pogosova, Nana; Saner, Hugo; Pedersen, Susanne S.

    2015-01-01

    A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...... of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system...

  9. Psychosocial aspects in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Pogosova, N. V.; Saner, H.; Pedersen, S. S.

    2015-01-01

    A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health- related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...... of life (HRQoL) and prognosis in patients with establishedCHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system...

  10. Assessing quality in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Samer A.M. Nashef

    2005-07-01

    Full Text Available There is a the strong temporal, if not causal, link between the intervention and the outcome in cardiac surgery and therefore a link becomes established between operative mortality and the measurement of surgical performance. In Britain the law stipulates that data collected by any public body or using public funds must be made freely available. Tools and mechanisms we devise and develop are likely to form the models on which the quality of care is assessed in other surgical and perhaps medical specialties. Measuring professional performance should be done by the profession. To measure risk there are a number of scores as crude mortality is not enough. A very important benefit of assessing the risk of death is to use this knowledge in the determination of the indication to operate. The second benefit is in the assessment of the quality of care as risk prediction gives a standard against performance of hospitals and surgeons. Peer review and “naming and shaming” are two mechanisms to monitor quality. There are two potentially damaging outcomes from the publication of results in a league-table form: the first is the damage to the hospital; the second is to refuse to operate on high-risk patients. There is a real need for quality monitoring in medicine in general and in cardiac surgery in particular. Good quality surgical work requires robust knowledge of three crucial variables: activity, risk prediction and performance. In Europe, the three major specialist societies have agreed to establish the European Cardiovascular and Thoracic Surgery Institute of Accreditation (ECTSIA. Performance monitoring is soon to become imperative. If we surgeons are not on board, we shall have no control on its final destination, and the consequences may be equally damaging to us and to our patients.

  11. The Danish Cardiac Rehabilitation Database.

    Science.gov (United States)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole

    2016-01-01

    The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients.

  12. Quantification of heart, pericardium, and left ventricular myocardium movements during the cardiac cycle for thoracic tumor radiotherapy

    Directory of Open Access Journals (Sweden)

    Tong Y

    2018-01-01

    Full Text Available Ying Tong,1,2 Yong Yin,1 Jie Lu,1 Tonghai Liu,1 Jinhu Chen,1 Pinjing Cheng,2 Guanzhong Gong1 1Department of Radiation Physics, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, 2School of Nuclear Science and Technology, University of South China, Hengyang, People’s Republic of China Purpose: The purpose of this study was to quantify variations in the heart, pericardium, and left ventricular myocardium (LVM caused by cardiac movement using the breath-hold technique. Patients and methods: In this study, the electrocardiography-gated four-dimensional computed tomography (CT images of 22 patients were analyzed, which were sorted into 20 phases (0–95% according to the cardiac cycle. The heart, pericardium, and LVM were contoured on each phase of the CT images. The positions, volume, dice similarity coefficient (DSC in reference to 0% phase, and morphological parameters (max 3D diameter, roundness, spherical disproportion, sphericity, and surface area in different phases of the heart, pericardium, and LVM were analyzed, which were presented as mean ± standard deviation. Results: The mean values of displacements along the X, Y, and Z axes respectively were as follows: 1.2 mm, 0.6 mm, and 0.6 mm for the heart; 0.5 mm, 0.4 mm, and 0.8 mm for the pericardium; and 1.0 mm, 4.1 mm, and 1.9 mm for the LVM. The maximum variations in volume and DSC respectively were 16.49%±3.85% and 10.08%±2.14% for the heart, 12.62%±3.94% and 5.20%±1.54% for the pericardium, and 24.23%±11.35% and 184.33%±128.61% for the LVM. The differences in the morphological parameters between the maximum and minimum DSC phases for the heart and pericardium were not significantly different (p>0.05 but were significantly different for the LVM (p<0.05. Conclusion: The volumetric and morphological variations of the heart were similar to those of pericardium, and all were significantly smaller than those of the LVM. This inconsistency in the volumetric and

  13. Mathematical Models of Cardiac Pacemaking Function

    Science.gov (United States)

    Li, Pan; Lines, Glenn T.; Maleckar, Mary M.; Tveito, Aslak

    2013-10-01

    Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  14. Mathematical Models of Cardiac Pacemaking Function

    Directory of Open Access Journals (Sweden)

    Pan eLi

    2013-10-01

    Full Text Available Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  15. Cardiac and pericardial calcifications on chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ferguson, E.C., E-mail: ecferguson@hotmail.co [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States); Berkowitz, E.A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States)

    2010-09-15

    Many types of cardiac and pericardial calcifications identified on chest radiographs can be recognized and distinguished based on characteristic locations and appearances. The purpose of this review is to emphasize the importance of detecting cardiac and pericardial calcifications on chest radiographs, and to illustrate and describe the various types of calcifications that may be encountered and how they may be differentiated from one another. Each type of cardiac and pericardial calcification is discussed, its location and appearance described, and its significance explained. Recognizing and understanding these calcifications is important as they are often encountered in daily practice and play an important role in patient care.

  16. A case of multiple cardiac calcified amorphous tumours

    Directory of Open Access Journals (Sweden)

    Amrit Chowdhary

    2017-05-01

    Full Text Available Cardiac calcified amorphous tumours of the heart are rare non-neoplastic cardiac masses that can present like a malignant mass or an intra-cardiac thrombus. We report an extremely unusual case of a 73 year old man who presented to hospital with dyspnoea and subsequent investigations revealed multiple cardiac CATs.

  17. Cardiac tumours: non invasive detection and assessment by gated cardiac blood pool radionuclide imaging

    International Nuclear Information System (INIS)

    Pitcher, D.; Wainwright, R.; Brennand-Roper, D.; Deverall, P.; Sowton, E.; Maisey, M.

    1980-01-01

    Four patients with cardiac tumours were investigated by gated cardiac blood pool radionuclide imaging and echocardiography. Contrast angiocardiography was performed in three of the cases. Two left atrial tumours were detected by all three techniques. In one of these cases echocardiography alone showed additional mitral valve stenosis, but isotope imaging indicated tumour size more accurately. A large septal mass was detected by all three methods. In this patient echocardiography showed evidence of left ventricular outflow obstruction, confirmed at cardiac catheterisation, but gated isotope imaging provided a more detailed assessment of the abnormal cardiac anatomy. In the fourth case gated isotope imaging detected a large right ventricular tumour which had not been identified by echocardiography. Gated cardiac blood pool isotope imaging is a complementary technique to echocardiography for the non-invasive detection and assessment of cardiac tumours. (author)

  18. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

  19. [Experimental therapy of cardiac remodeling with quercetin-containing drugs].

    Science.gov (United States)

    Kuzmenko, M A; Pavlyuchenko, V B; Tumanovskaya, L V; Dosenko, V E; Moybenko, A A

    2013-01-01

    It was shown that continuous beta-adrenergic hyperstimulation resulted in cardiac function disturbances and fibrosis of cardiac tissue. Treatment with quercetin-containing drugs, particularly, water-soluble corvitin and tableted quertin exerted favourable effect on cardiac hemodynamics, normalized systolic and diastolic function in cardiac remodeling, induced by sustained beta-adrenergic stimulation. It was estimated that conducted experimental therapy limited cardiac fibrosis area almost three-fold, that could be associated with first and foremost improved cardiac distensibility, characteristics of diastolic and also pump function in cardiac remodeling.

  20. Epidemiology and Outcomes After In-Hospital Cardiac Arrest After Pediatric Cardiac Surgery

    Science.gov (United States)

    Gupta, Punkaj; Jacobs, Jeffrey P.; Pasquali, Sara K.; Hill, Kevin D.; Gaynor, J. William; O’Brien, Sean M.; He, Max; Sheng, Shubin; Schexnayder, Stephen M.; Berg, Robert A.; Nadkarni, Vinay M.; Imamura, Michiaki; Jacobs, Marshall L.

    2014-01-01

    Background Multicenter data regarding cardiac arrest in children undergoing heart operations are limited. We describe epidemiology and outcomes associated with postoperative cardiac arrest in a large multiinstitutional cohort. Methods Patients younger than 18 years in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2007 through 2012) were included. Patient factors, operative characteristics, and outcomes were described for patients with and without postoperative cardiac arrest. Multivariable models were used to evaluate the association of center volume with cardiac arrest rate and mortality after cardiac arrest, adjusting for patient and procedural factors. Results Of 70,270 patients (97 centers), 1,843 (2.6%) had postoperative cardiac arrest. Younger age, lower weight, and presence of preoperative morbidities (all p < 0.0001) were associated with cardiac arrest. Arrest rate increased with procedural complexity across common benchmark operations, ranging from 0.7% (ventricular septal defect repair) to 12.7% (Norwood operation). Cardiac arrest was associated with significant mortality risk across procedures, ranging from 15.4% to 62.3% (all p < 0.0001). In multivariable analysis, arrest rate was not associated with center volume (odds ratio, 1.06; 95% confidence interval, 0.71 to 1.57 in low- versus high-volume centers). However, mortality after cardiac arrest was higher in low-volume centers (odds ratio, 2.00; 95% confidence interval, 1.52 to 2.63). This association was present for both high- and low-complexity operations. Conclusions Cardiac arrest carries a significant mortality risk across the stratum of procedural complexity. Although arrest rates are not associated with center volume, lower-volume centers have increased mortality after cardiac arrest. Further study of mechanisms to prevent cardiac arrest and to reduce mortality in those with an arrest is warranted. PMID:25443018