Schröder Rj

Radiation Exposure to Patient and Staff in Hepatic Chemoembolization: Risk Estimation of Cancer and Deterministic Effects

The purpose of the study was to determine the risks of radiation-induced cancer and deterministic effects for the patient and staff in transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Sixty-five patients with HCC underwent the first cycle of TACE. Thermoluminescence dosemeters and conversion factors were used to measure surface doses and to calculate organ doses and effective dose. For the patient, the risk of fatal cancer and severe genetic defect was in the magnitude of 10−4 and 10−5, respectively. Five patients showed surface doses over the first lumbar vertebra exceeding 2000 mSv and 45 patients showed doses over the spine or the liver region above 500 mSv. The risk of fatal cancer and severe genetic defect for the radiologist and assistant was in the magnitude of 10−7 to 10−8. They could exceed the threshold for lens opacity in the case of more than 490 and 1613 TACE yearly for a period of many years, respectively. Radiation dose could lead to local transient erythema and/or local depression of hematopoiesis in many patients after TACE. For the radiologist and assistant, risk of fatal cancer and genetic defect and lens opacity might arise when they perform interventions such as TACE intensively.

Evaluation of image quality of the Iso C3D image processor in comparison to computer tomography. Use in the pelvic area

ZusammenfassungDie intraoperative 3D-Bilddatengewinnung mit dem Bildwandler Siremobil Iso-C3D (Fa. Siemens, Erlangen) hat sich bereits in kürzester Zeit seit der klinischen Einführung des Gerätes bei Operationen an der Wirbelsäule und an den Extremitäten bewährt.Als Vorbereitung des klinischen Einsatzes des Siremobil Iso-C3D am Becken wurde in dieser Studie an 8 Humanpräparaten die Bildqualität im Vergleich zum derzeitigen Standard, der Computertomographie, in vier therapierelevanten Beckenregionen und bei eingebrachten Implantaten untersucht. Im Ergebnis scheint die Bildqualität des Siremobil Iso-C3D in allen untersuchten Beckenregionen geeignet für die intra- und postoperative Kontrolle bei bekannter Diagnose am Becken, ohne das eine Abhängigkeit vom BMI des Patienten gefunden wurde. Bei eingebrachten Implantaten war die Bildqualität durch die Metallartefakte zwar eingeschränkt, aber dennoch ausreichend zur Beurteilung der knöchernen Strukturen. Für die Primärdiagnostik ist die Computertomographie aufgrund der besseren Bildqualität deutlich überlegen. Vorteile werden von der intraoperativen 3D-Bilddatengewinnung für die intraoperative Kontrolle der Reposition und der Lage der Implantate im hinteren Beckenring erwartet.AbstractIntraoperative 3-D visualization using the Siremobil Iso C3D (Siemens, Erlangen, Germany) has been approved for use in spine and long bone surgery since its recent clinical launch.In preparation for the clinical use of the Siremobil Iso C3D in pelvic surgery, the aim of this study was to grade the quality of visualization in comparison with the gold standard of computer tomography in four therapy relevant pelvic regions in eight human cadavers, including SI screws to exemplify implants in the dorsal pelvic ring. Besides the influence of the body mass index and the interference of metal artefacts, visualization quality was evaluated in different pelvic regions (sacroiliac joint, acetabulum, femoral neck and anterior pelvic ring) using a score with five subgroups, rating the applicability of Siremobil Iso C3D in pelvic surgery. The grading of image quality in comparable standard projections was performed independently by three surgeons and three radiologists.Visualization quality appeared sufficient for both intraoperative and postoperative control in cases with a known preoperative diagnosis. There was no influence of body mass index found in any of the eight cadavers. Implants positioned in the dorsal pelvic ring reduced visualization quality, but sufficient estimation of bony structures was still possible. For primary diagnostics, computer tomography remains a clearly superior option due to better image quality. For intraoperative control of the reduction and positioning of implants in pelvic surgery, however, the additional intraoperative use of Siremobil Iso C3D is considered to offer clear advantages over current 2-D C-arm visualization tools.

Development of Broadband ISDN Telecommunication Services Using SDL'92, ASN.1 and Automatic Code Generation

We present current research and implementation work in the field of advanced broadband telecommunication services based on ATM using like SDL and ASN.1. Different considerations taken in European research projects like RACE led to the development of a modular approach describing B-ISDN services in a flexible way. Using SDL in combination with ASN.1 just adopted by ITU-T in Z.105 and the possibility to generate C++ code directly from SDL’88 and SDL’92 specification enables to speed up the development process. Changes and modifications in the developing increasingly penetrating telecommunication market can be implemented easily following our approach. We describe the whole way from service methodology and its FDT-based representation towards real platform implementation.

Case 147: Langerhans Cell Histiocytosis of the Femur

History A 12-year-old boy presented with pain in the right thigh that had persisted for 4 days. There was no trauma, and the patients history provided no clues. The proximal thigh was tender on palpation, and there was no swelling or reddening. The patients white blood cell count and other laboratory parameters were unremarkable. Conventional radiography and 3-T magnetic resonance (MR) imaging of the right femur were performed before and after administration of gadoterate meglumine (Dotarem; Guerbet, Paris, France). Open biopsy was performed 5 days after imaging to enable histologic confirmation.

External communication with SDL Systems

The formal description technique SDL is used for the documentation and verification of complex distributed communication systems. SDL tools are able to transform a specification automatically to a prototype implementation or even to a software product. The generated program is not isolated in a real system environment. However, the communication aspect with a system environment is not standardized. Hence, there are only tool specific solutions. With the standardization of interface description techniques, e.g. ASN.1 and IDL and even the combination of SDL with these techniques, the external communication aspect of SDL should be investigated. Scenarios with different start points are discussed, some of them are applied within an industrial software project.

Contrast-enhanced high resolutionmagnetic resonance imaging of skin tumours

Abstract Purpose: To evaluate the use of Gd-DTPA in imaging epithelial skin tumours and tumour-like lesions, 45 benign and 18 malignant skin tumours were prospectively examined by high resolution magnetic resonance imaging (MRI) at 1.5 T using a 2.5 cm surface coil. Methods: For tumour assessment, transverse plain and contrast-enhanced scans (0.1 nunol kg −1 Gd-DTPA) were performed (TR 500 ms, TE 25 ms, three acquisitions, 256 × 256 matrix, FOV 2.5 cm). Results: Contrast enhancement (CE) was quantitatively determined as the percentage enhancement of signal intensity. Histological findings were correlated using a Wilcoxon test ( P Conclusions: Malignant tumours could not be differentiated from benign lesions by contrast enhancement. MRI using Gd-DTPA does not differentiate skin tumour types.

Using SDL in a Stateless Environment

Telecommunication services are often implemented to maintain their state in persistent storage. The application logic program then has no state variables of its own; it is seeded with a state depending on call context. Superficially, this contradicts the notion of extended state machines as they are defined by SDL-processes, where the state is part of the state machine. This paper presents an approach to separate state from program logic that is transparent to the SDL designer. This approach has been implemented in the SITE SDL runtime system in co-operation with Siemens, Berlin.

Hochauflösende Kernspintomographie bei traumatischen Veränderungen an Fingergelenken

ZusammenfassungZiel der vorliegenden prospektiven Untersuchung war es, die Wertigkeit der hochauflösenden Kernspintomographie mittels einer speziellen Oberflächenspule in der Beurteilung von traumatischen Veränderungen der Fingergelenke zu evaluieren. Ferner sollte die Praktikabilität der Methode in der klinischen Routine überprüft werden.Es wurden 20 Patienten im Alter zwischen 13 und 50 Jahren (im Mittel 28 Jahre) an einem 1,5-T-Ganzkörpertomographen (Magnetom SP 63, Firma Siemens, Erlangen) untersucht. Als Spule wurde ein Prototyp einer hochauflösenden Oberflächenspule mit einem Durchmesser von 2,5 cm benutzt. T1- und T2-gewichtete Sequenzen mit einer maximalen Auflbsung in der Bildebene von 0,195 x 0,098 mm wurden zur Beurteilung von Knochen, Gelenkknorpel und -kapsel, der Sehnen und des Weichteilgewebes akquiriert.Kernspintomographisch fand sich bei 19 Patienten ein pathologischer Befund. Bei all diesen Patienten konnte ein Gelenkerguß nachgewiesen werden. Knöcherne Absprengungen, die anhand konventioneller Röntgenaufnahmen diagnostiziert wurden, zeigten sich kernspintomographisch als dislozierte signalreiche Strukturen. Gelenkknorpelkontusionen stellten sich hyperintens dar. Zur Beurteilung der Kollateralbānder eignete sich vor allem die koronare Schichtebene, da in dieser die Kollateralbdnder per continuitatem darstellbar sind. Sehneneinblutungen wiesen eine Signalerhöhung in T1- und T2-Wichtung auf. Ödeme der Weichteile und Bandstrukturen imponierten in T2-gewichteten Aufnahmen als signalreiche Strukturveränderungen. Aufgrund der hohen anatomischen Detailerkennbarkeit eignet sich die hochauflbsende Kernspintomographie als ergänzendes diagnostisches Verfahren zur nichtinvasiven Diagnostik von traumatischen Knorpel- und Bandläsionen. Unter Berücksichtigung des Zeitaufwandes handelt es sich dabei um eine im klinischen Alltag praktikable Methode.AbstractAim of this study was the evaluation of a prototype of a new high-resolution MRI coil for the detection of finger trauma. The practicability of this new coil for the assessment of traumatic lesions of the finger joints and the diagnostic value of this new method in clinical practice was assessed.Twenty patients between 13 and 50 years of age (mean 28 years) were examined with a 1.5-T whole-body-imager Magnetom SP 63 scanner (Siemens, Erlangen, Germany). A prototype of a high-resolution MRI coil with a diameter of 2.5 cm was used. T1- and T2-weighted images with an in plane resolution of 0.I95 x 0.098 mm were acquired. Bone structures, joint cartilage and capsule, ligaments, tendons and soft tissue alterations were assessed. All 19 patients with pathological changes at the finger joints had a joint effusion. With MR imaging, fractures were detected in almost all patients, compared with the X-ray examinations. Cartilage contusion showed high signal intensity. The collateral ligaments could best be assessed in the transversal, and ligament ruptures in the coronal plane. Hemorrhage in the tendon showed an increased signal intensity in T1- and T2-weighted, edema only in T2-weighted images.Especially traumatic lesions of cartilage and of ligaments can be sufficiently assessed by the high-resolution MRI due to its high anatomic resolution compared to common methods like X-ray. High-resolution MRI is practicable in clinical routine.