Search results for: ultrasound computed tomography (USCT)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1457

Search results for: ultrasound computed tomography (USCT)

1157 The Role of High-Intensity Focused Ultrasound (HIFU) in the Treatment of Fibroadenomas: A Systematic Review

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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1156 Axillary Evaluation with Targeted Axillary Dissection Using Ultrasound-Visible Clips after Neoadjuvant Chemotherapy for Patients with Node-Positive Breast Cancer

Authors: Naomi Sakamoto, Eisuke Fukuma, Mika Nashimoto, Yoshitomo Koshida

Abstract:

Background: Selective localization of the metastatic lymph node with clip and removal of clipped nodes with sentinel lymph node (SLN), known as targeted axillary dissection (TAD), reduced false-negative rates (FNR) of SLN biopsy (SLNB) after neoadjuvant chemotherapy (NAC). For the patients who achieved nodal pathologic complete response (pCR), accurate staging of axilla by TAD lead to omit axillary lymph node dissection (ALND), decreasing postoperative arm morbidity without a negative effect on overall survival. This study aimed to investigate the ultrasound (US) identification rate and success removal rate of two kinds of ultrasound-visible clips placed in metastatic lymph nodes during TAD procedure. Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. A US-visible clip was placed in the suspicious lymph node under US guidance before neoadjuvant chemotherapy. Before surgery, US examination was performed to evaluate the detection rate of clipped node. During the surgery, the clipped node was removed using several localization techniques, including hook-wire localization, dye-injection, or fluorescence technique, followed by a dual-technique SLNB and resection of palpable nodes if present. For the fluorescence technique, after injection of 0.1-0.2 mL of indocyanine green dye (ICG) into the clipped node, ICG fluorescent imaging was performed using the Photodynamic Eye infrared camera (Hamamatsu Photonics k. k., Shizuoka, Japan). For the dye injection method, 0.1-0.2 mL of pyoktanin blue dye was injected into the clipped node. Results: A total of 29 patients were enrolled. Hydromark™ breast biopsy site markers (Hydromark, T3 shape; Devicor Medical Japan, Tokyo, Japan) was used in 15patients, whereas a UltraCor™ Twirl™ breast marker (Twirl; C.R. Bard, Inc, NJ, USA) was placed in 14 patients. US identified the clipped node marked with the UltraCore Twirl in 100% (14/14) and with the Hydromark in 93.3% (14/15, p = ns). Success removal of clipped node marked with the UltraCore Twirl was achieved in 100% (14/14), whereas the node marked with the Hydromark was removed in 80% (12/15) (p = ns). Conclusions: The ultrasound identification rate differed between the two types of ultrasound-visible clips, which also affected the success removal rate of clipped nodes. Labelling the positive node with a US-highly-visible clip allowed successful TAD.

Keywords: breast cancer, neoadjuvant chemotherapy, targeted axillary dissection, breast tissue marker, clip

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1155 A Robust and Efficient Segmentation Method Applied for Cardiac Left Ventricle with Abnormal Shapes

Authors: Peifei Zhu, Zisheng Li, Yasuki Kakishita, Mayumi Suzuki, Tomoaki Chono

Abstract:

Segmentation of left ventricle (LV) from cardiac ultrasound images provides a quantitative functional analysis of the heart to diagnose disease. Active Shape Model (ASM) is a widely used approach for LV segmentation but suffers from the drawback that initialization of the shape model is not sufficiently close to the target, especially when dealing with abnormal shapes in disease. In this work, a two-step framework is proposed to improve the accuracy and speed of the model-based segmentation. Firstly, a robust and efficient detector based on Hough forest is proposed to localize cardiac feature points, and such points are used to predict the initial fitting of the LV shape model. Secondly, to achieve more accurate and detailed segmentation, ASM is applied to further fit the LV shape model to the cardiac ultrasound image. The performance of the proposed method is evaluated on a dataset of 800 cardiac ultrasound images that are mostly of abnormal shapes. The proposed method is compared to several combinations of ASM and existing initialization methods. The experiment results demonstrate that the accuracy of feature point detection for initialization was improved by 40% compared to the existing methods. Moreover, the proposed method significantly reduces the number of necessary ASM fitting loops, thus speeding up the whole segmentation process. Therefore, the proposed method is able to achieve more accurate and efficient segmentation results and is applicable to unusual shapes of heart with cardiac diseases, such as left atrial enlargement.

Keywords: hough forest, active shape model, segmentation, cardiac left ventricle

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1154 Strain Based Failure Criterion for Composite Notched Laminates

Authors: Ibrahim A. Elsayed, Mohamed H. Elalfy, Mostafa M. Abdalla

Abstract:

A strain-based failure criterion for composite notched laminates is introduced where the most critical stress concentration factor for the anisotropic notched laminates could be related to the failure of the corresponding quasi-isotropic laminate and the anisotropy ratio of the laminate. The proposed criterion will simplify the design of composites to meet notched failure requirements by eliminating the need for the detailed specifications of the stacking sequence at the preliminary design stage. The designer will be able to design based on the stiffness of the laminate, then at a later stage, select an appropriate stacking sequence to meet the stiffness requirements. The failure strains for the notched laminates are computed using the material’s Omni-strain envelope. The concept of Omni-strain envelope concerns the region of average strain where the laminate is safe regardless of ply orientation. In this work, we use Hashin’s failure criteria and the strains around the hole are computed using Savin’s analytic solution. A progressive damage analysis study has been conducted where the failure loads for the notched laminates are computed using finite element analysis. The failure strains are computed and used to estimate the concentration factor. It is found that the correlation found using Savin’s analytic solution predicts the same ratio of concentration factors between anisotropic and quasi-isotropic laminates as the more expensive progressive failure analysis.

Keywords: anisotropy ratio, failure criteria, notched laminates, Omni-strain envelope, savin’s solution

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1153 Image Segmentation with Deep Learning of Prostate Cancer Bone Metastases on Computed Tomography

Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

Abstract:

Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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1152 Association of Fetal Abdominal Circumference and Birthweight in Maternal Hyperglycemia

Authors: Silpa Mariyam John, S. Baburaj, Prajit Geevarghese

Abstract:

Diabetes accelerates pregnancy and can cause adverse effects on the fetus. Studies have shown that fetal abdominal circumference measured in ultrasound is an early parameter for the assessment of macrosomia. The objective of the study is to compare the fetal abdominal circumferences between diabetes and non-diabetic mothers. It was a comparative cross-sectional study conducted in a tertiary care hospital in Trivandrum, Kerala, with a sample size calculated as 95 for each group. All mothers taking antenatal care and delivering at the hospital were included after obtaining consent. The mothers and their newborns were divided into 2 groups (diabetic and non-diabetic). Relevant fetal biometry values were collected from medical records, and birth weight was measured by a calibrated electronic weighing machine after birth. The data were entered in MS EXCEL and analyzed. It was found that there is a significant relationship between the fetal abdominal circumference and birthweight in diabetic mothers during the first and third trimesters.

Keywords: newborn, diabetes, abdominal circumference, ultrasound

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1151 Optimization of Extraction Conditions for Phenolic Compounds from Deverra Scoparia Coss and Dur

Authors: Roukia Hammoudi, Chabrouk Farid, Dehak Karima, Mahfoud Hadj Mahammed, Mohamed Didi Ouldelhadj

Abstract:

The objective of this study was to optimise the extraction conditions for phenolic compounds from Deverra scoparia Coss and Dur. Apiaceae plant by ultrasound assisted extraction (UAE). The effects of solvent type (acetone, ethanol and methanol), solvent concentration (%), extraction time (mins) and extraction temperature (°C) on total phenolic content (TPC) were determined. The optimum extraction conditions were found to be acetone concentration of 80%, extraction time of 25 min and extraction temperature of 25°C. Under the optimized conditions, the value for TPC was 9.68 ± 1.05 mg GAE/g of extract. The study of the antioxidant power of these oils was performed by the method of DPPH. The results showed that antioxidant activity of the Deverra scoparia essential oil was more effective as compared to ascorbic acid and trolox.

Keywords: Deverra scoparia, phenolic compounds, ultrasound assisted extraction, total phenolic content, antioxidant activity

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1150 Optimization of Extraction Conditions for Phenolic Compounds from Deverra scoparia Coss. and Dur

Authors: Roukia Hammoudi, Dehak Karima, Chabrouk Farid, Mahfoud Hadj Mahammed, Mohamed Didi Ouldelhadj

Abstract:

The objective of this study was to optimise the extraction conditions for phenolic compounds from Deverra scoparia Coss and Dur. Apiaceae plant by ultrasound assisted extraction (UAE). The effects of solvent type (Acetone, Ethanol and methanol), solvent concentration (%), extraction time (mins) and extraction temperature (°C) on total phenolic content (TPC) were determined. the optimum extraction conditions were found to be acetone concentration of 80%, extraction time of 25 min and extraction temperature of 25°C. Under the optimized conditions, the value for TPC was 9.68 ± 1.05 mg GAE/g of extract. The study of the antioxidant power of these oils was performed by the method of DPPH. The results showed that antioxidant activity of the Deverra scoparia essential oil was more effective as compared to ascorbic acid and trolox.

Keywords: Deverra scoparia, phenolic compounds, ultrasound assisted extraction, total phenolic content, antioxidant activity

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1149 Physicochemical Properties of Pea Protein Isolate (PPI)-Starch and Soy Protein Isolate (SPI)-Starch Nanocomplexes Treated by Ultrasound at Different pH Values

Authors: Gulcin Yildiz, Hao Feng

Abstract:

Soybean proteins are the most widely used and researched proteins in the food industry. Due to soy allergies among consumers, however, alternative legume proteins having similar functional properties have been studied in recent years. These alternative proteins are also expected to have a price advantage over soy proteins. One such protein that has shown good potential for food applications is pea protein. Besides the favorable functional properties of pea protein, it also contains fewer anti-nutritional substances than soy protein. However, a comparison of the physicochemical properties of pea protein isolate (PPI)-starch nanocomplexes and soy protein isolate (SPI)-starch nanocomplexes treated by ultrasound has not been well documented. This study was undertaken to investigate the effects of ultrasound treatment on the physicochemical properties of PPI-starch and SPI-starch nanocomplexes. Pea protein isolate (85% pea protein) provided by Roquette (Geneva, IL, USA) and soy protein isolate (SPI, Pro-Fam® 955) obtained from the Archer Daniels Midland Company were adjusted to different pH levels (2-12) and treated with 5 minutes of ultrasonication (100% amplitude) to form complexes with starch. The soluble protein content was determined by the Bradford method using BSA as the standard. The turbidity of the samples was measured using a spectrophotometer (Lambda 1050 UV/VIS/NIR Spectrometer, PerkinElmer, Waltham, MA, USA). The volume-weighted mean diameters (D4, 3) of the soluble proteins were determined by dynamic light scattering (DLS). The emulsifying properties of the proteins were evaluated by the emulsion stability index (ESI) and emulsion activity index (EAI). Both the soy and pea protein isolates showed a U-shaped solubility curve as a function of pH, with a high solubility above the isoelectric point and a low one below it. Increasing the pH from 2 to 12 resulted in increased solubility for both the SPI and PPI-starch complexes. The pea nanocomplexes showed greater solubility than the soy ones. The SPI-starch nanocomplexes showed better emulsifying properties determined by the emulsion stability index (ESI) and emulsion activity index (EAI) due to SPI’s high solubility and high protein content. The PPI had similar or better emulsifying properties at certain pH values than the SPI. The ultrasound treatment significantly decreased the particle sizes of both kinds of nanocomplex. For all pH levels with both proteins, the droplet sizes were found to be lower than 300 nm. The present study clearly demonstrated that applying ultrasonication under different pH conditions significantly improved the solubility and emulsify¬ing properties of the SPI and PPI. The PPI exhibited better solubility and emulsifying properties than the SPI at certain pH levels

Keywords: emulsifying properties, pea protein isolate, soy protein isolate, ultrasonication

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1148 Investigation of TEC Using YOUTHSAT RaBIT Payload Data for Low Latitude Regions

Authors: Perumalla Naveen Kumar

Abstract:

Global Positioning System (GPS) is used for civilian and military user positioning applications. The accuracy of GPS is degrading mainly because of ionospheric error. It is very important to analyze the effects of ionosphere on the performance of satellite systems especially in the low latitude regions. These variations depend on the Total Electron Content (TEC) in the ionosphere. To investigate the variations in the atmosphere, a mini satellite known as YOUTHSAT is launched by India. This is the outcome of the collaboration between India and USSR. One of the YOUTHSAT Indian payload is RaBIT (Radio Beacon for Ionospheric Tomography). In this paper, YOUTHSAT RaBIT payload data for the three typical days of 2011 are considered. The analysis is carried out for four Indian stations. The variations of Slant TEC, elevation angle and azimuth angles are analyzed with respect to local time. The obtained results are encouraging.

Keywords: Global Positioning System (GPS), Total Electron Content (TEC), YOUTHSAT, Radio Beacon for Ionospheric Tomography (RaBIT)

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1147 Ultrasound-Assisted Extraction of Carotenoids from Tangerine Peel Using Ostrich Oil as a Green Solvent and Optimization of the Process by Response Surface Methodology

Authors: Fariba Tadayon, Nika Gharahgolooyan, Ateke Tadayon, Mostafa Jafarian

Abstract:

Carotenoid pigments are a various group of lipophilic compounds that generate the yellow to red colors of many plants, foods and flowers. A well-known type of carotenoids which is pro-vitamin A is β-carotene. Due to the color of citrus fruit’s peel, the peel can be a good source of different carotenoids. Ostrich oil is one of the most valuable foundations in many branches of industry, medicine, cosmetics and nutrition. The animal-based ostrich oil could be considered as an alternative and green solvent. Following this study, wastes of citrus peel will recycle by a simple method and extracted carotenoids can increase properties of ostrich oil. In this work, a simple and efficient method for extraction of carotenoids from tangerine peel was designed. Ultrasound-assisted extraction (UAE) showed significant effect on the extraction rate by increasing the mass transfer rate. Ostrich oil can be used as a green solvent in many studies to eliminate petroleum-based solvents. Since tangerine peel is a complex source of different carotenoids separation and determination was performed by high-performance liquid chromatography (HPLC). In addition, the ability of ostrich oil and sunflower oil in carotenoid extraction from tangerine peel and carrot was compared. The highest yield of β-carotene extracted from tangerine peel using sunflower oil and ostrich oil were 75.741 and 88.110 (mg/L), respectively. Optimization of the process was achieved by response surface methodology (RSM) and the optimal extraction conditions were tangerine peel powder particle size of 0.180 mm, ultrasonic intensity of 19 W/cm2 and sonication time of 30 minutes.

Keywords: β-carotene, carotenoids, citrus peel, ostrich oil, response surface methodology, ultrasound-assisted extraction

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1146 Defects Analysis, Components Distribution, and Properties Simulation in the Fuel Cells and Batteries by 2D and 3D Characterization Techniques

Authors: Amir Peyman Soleymani, Jasna Jankovic

Abstract:

The augmented demand of the clean and renewable energy has necessitated the fuel cell and battery industries to produce more efficient devices at the lower prices, which can be achieved through the improvement of the electrode. Microstructural characterization, as one of the main materials development tools, plays a pivotal role in the production of better clean energy devices. In this study, methods for characterization and studying of the defects and components distribution were performed on the polymer electrolyte membrane fuel cell (PEMFC) and Li-ion battery (LIB) electrodes in 2D and 3D. The particles distribution, porosity, mechanical defects, and component distribution were studied by Scanning Electron Microscope (SEM), SEM-Focused Ion Beam (SEM-FIB), and Scanning Transmission Electron Microscope equipped with Energy Dispersive Spectroscopy (STEM-EDS). The 3D results obtained from X-ray Computed Tomography (XCT) revealed the pathways for electron and ion conductivity and defects progression maps. Computer-aided methods (Avizo) were employed to simulate the properties and performance of the microstructure in the electrodes. The suggestions were provided to improve the performance of PEMFCs and LIBs by adjusting the microstructure and the distribution of the components in the electrodes.

Keywords: PEM fuel cells, Li-ion batteries, 2D and 3D imaging, materials characterizations

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1145 Grid Pattern Recognition and Suppression in Computed Radiographic Images

Authors: Igor Belykh

Abstract:

Anti-scatter grids used in radiographic imaging for the contrast enhancement leave specific artifacts. Those artifacts may be visible or may cause Moiré effect when a digital image is resized on a diagnostic monitor. In this paper, we propose an automated grid artifacts detection and suppression algorithm which is still an actual problem. Grid artifacts detection is based on statistical approach in spatial domain. Grid artifacts suppression is based on Kaiser bandstop filter transfer function design and application avoiding ringing artifacts. Experimental results are discussed and concluded with description of advantages over existing approaches.

Keywords: grid, computed radiography, pattern recognition, image processing, filtering

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1144 Understanding ASPECTS of Stroke: Interrater Reliability between Emergency Medicine Physician and Radiologist in a Rural Setup

Authors: Vineel Inampudi, Arjun Prakash, Joseph Vinod

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Aims and Objectives: To evaluate the interrater reliability in grading ASPECTS score, between emergency medicine physician at first contact and radiologist among patients with acute ischemic stroke. Materials and Methods: We conducted a retrospective analysis of 86 acute ischemic stroke cases referred to the Department of Radiodiagnosis during November 2014 to January 2016. The imaging (plain CT scan) was performed using GE Bright Speed Elite 16 Slice CT Scanner. ASPECTS score was calculated separately by an emergency medicine physician and radiologist. Interrater reliability for total and dichotomized ASPECTS (≥ 6 and < 6) scores were assessed using statistical analysis (ICC and Cohen ĸ coefficients) on SPSS software (v17.0). Results: Interrater agreement for total and dichotomized ASPECTS was substantial (ICC 0.79 and Cohen ĸ 0.68) between the emergency physician and radiologist. Mean difference in ASPECTS between the two readers was only 0.15 with standard deviation of 1.58. No proportionality bias was detected. Bland Altman plot was constructed to demonstrate the distribution of ASPECT differences between the two readers. Conclusion: Substantial interrater agreement was noted in grading ASPECTS between emergency medicine physician at first contact and radiologist thereby confirming its robustness even in a rural setting.

Keywords: ASPECTS, computed tomography, MCA territory, stroke

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1143 Quantification of Soft Tissue Artefacts Using Motion Capture Data and Ultrasound Depth Measurements

Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

Abstract:

The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

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1142 Measurement and Analysis of Radiation Doses to Radiosensitive Organs from CT Examination of the Cervical Spine Using Radiochromic Films and Monte Carlo Simulation Based Software

Authors: Khaled Soliman, Abdullah Alrushoud, Abdulrahman Alkhalifah, Raed Albathi, Salman Altymiat

Abstract:

Radiation dose received by patients undergoing Computed Tomography (CT) examination of the cervical spine was evaluated using Gafchromic XR-QA2 films and CT-EXPO software (ver. 2.3), in order to document our clinical dose values and to compare our results with other benchmarks reported in the current literature. Radiochromic films were recently used as practical dosimetry tool that provides dose profile information not available using the standard ionisation chamber routinely used in CT dosimetry. We have developed an in-house program to use the films in order to calculate the Entrance Dose Length Product (EDLP) in (mGy.cm) and to relate the EDLP to various organ doses calculated using the CT-EXPO software. We also calculated conversion factor in (mSv/mGy.cm) relating the EDLP to the effective dose (ED) from the examination using CT-EXPO software. Variability among different types of CT scanners and dose modulation methods are reported from at least three major CT brands available at our medical institution. Our work describes the dosimetry method and results are reported. The method can be used as in-vivo dosimetry method. But this work only reports results obtained from adult female anthropomorphic Phantom studies.

Keywords: CT dosimetry, gafchromic films, XR-QA2, CT-Expo software

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1141 Effects of Heat Treatment on the Elastic Constants of Cedar Wood

Authors: Tugba Yilmaz Aydin, Ergun Guntekin, Murat Aydin

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Effects of heat treatment on the elastic constants of cedar wood (Cedrus libani) were investigated. Specimens were exposed to heat under atmospheric pressure at four different temperatures (120, 150, 180, 210 °C) and three different time levels (2, 5, 8 hours). Three Young’s modulus (EL, ER, ET) and six Poisson ratios (μLR, μLT, μRL, μRT, μTL, μTR) were determined from compression test using bi-axial extensometer at constant moisture content (12 %). Three shear modulus were determined using ultrasound. Six shear wave velocities propagating along the principal axes of anisotropy were measured using EPOCH 650 ultrasonic flaw detector with 1 MHz transverse transducers. The properties of the samples tested were significantly affected by heat treatment by different degree. As a result, softer treatments yielded some amount of increase in Young modulus and shear modulus values, but increase of time and temperature resulted in significant decrease for both values. Poisson ratios seemed insensitive to heat treatment.

Keywords: cedar wood, elastic constants, heat treatment, ultrasound

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1140 An Ultrasonic Approach to Investigate the Effect of Aeration on Rheological Properties of Soft Biological Materials with Bubbles Embedded

Authors: Hussein M. Elmehdi

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In this paper, we present the results of our recent experiments done to examine the effect of air bubbles, which were introduced to bio-samples during preparation, on the rheological properties of soft biological materials. To effectively achieve this, we three samples each prepared with differently. Our soft biological systems comprised of three types of flour dough systems made from different flour varieties with variable protein concentrations. The samples were investigated using ultrasonic waves operated at low frequency in transmission mode. The sample investigated included dough made from bread flour, wheat flour and all-purpose flour. During mixing, the main ingredient of the samples (the flour) was transformed into cohesive dough comprised of the continuous dough matrix and air pebbles. The rheological properties of such materials determine the quality of the end cereal product. Two ultrasonic parameters, the longitudinal velocity and attenuation coefficient were found to be very sensitive to properties such as the size of the occluded bubbles, and hence have great potential of providing quantitative evaluation of the properties of such materials. The results showed that the magnitudes of the ultrasonic velocity and attenuation coefficient peaked at optimum mixing times; the latter of which is taken as an indication of the end of the mixing process. There was an agreement between the results obtained by conventional rheology and ultrasound measurements, thus showing the potential of the use of ultrasound as an on-line quality control technique for dough-based products. The results of this work are explained with respect to the molecular changes occurring in the dough system as the mixing process proceeds; particular emphasis is placed on the presence of free water and bound water.

Keywords: ultrasound, soft biological materials, velocity, attenuation

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1139 TomoTherapy® System Repositioning Accuracy According to Treatment Localization

Authors: Veronica Sorgato, Jeremy Belhassen, Philippe Chartier, Roddy Sihanath, Nicolas Docquiere, Jean-Yves Giraud

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We analyzed the image-guided radiotherapy method used by the TomoTherapy® System (Accuray Corp.) for patient repositioning in clinical routine. The TomoTherapy® System computes X, Y, Z and roll displacements to match the reference CT, on which the dosimetry has been performed, with the pre-treatment MV CT. The accuracy of the repositioning method has been studied according to the treatment localization. For this, a database of 18774 treatment sessions, performed during 2 consecutive years (2016-2017 period) has been used. The database includes the X, Y, Z and roll displacements proposed by TomoTherapy® System as well as the manual correction of these proposals applied by the radiation therapist. This manual correction aims to further improve the repositioning based on the clinical situation and depends on the structures surrounding the target tumor tissue. The statistical analysis performed on the database aims to define repositioning limits to be used as security and guiding tool for the manual adjustment implemented by the radiation therapist. This tool will participate not only to notify potential repositioning errors but also to further improve patient positioning for optimal treatment.

Keywords: accuracy, IGRT MVCT, image-guided radiotherapy megavoltage computed tomography, statistical analysis, tomotherapy, localization

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1138 A Generative Pretrained Transformer-Based Question-Answer Chatbot and Phantom-Less Quantitative Computed Tomography Bone Mineral Density Measurement System for Osteoporosis

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

Abstract:

Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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1137 Perceptual and Ultrasound Articulatory Training Effects on English L2 Vowels Production by Italian Learners

Authors: I. Sonia d’Apolito, Bianca Sisinni, Mirko Grimaldi, Barbara Gili Fivela

Abstract:

The American English contrast /ɑ-ʌ/ (cop-cup) is difficult to be produced by Italian learners since they realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively, due to differences in phonetic-phonological systems and also in grapheme-to-phoneme conversion rules. In this paper, we try to answer the following research questions: Can a short training improve the production of English /ɑ-ʌ/ by Italian learners? Is a perceptual training better than an articulatory (ultrasound - US) training? Thus, we compare a perceptual training with an US articulatory one to observe: 1) the effects of short trainings on L2-/ɑ-ʌ/ productions; 2) if the US articulatory training improves the pronunciation better than the perceptual training. In this pilot study, 9 Salento-Italian monolingual adults participated: 3 subjects performed a 1-hour perceptual training (ES-P); 3 subjects performed a 1-hour US training (ES-US); and 3 control subjects did not receive any training (CS). Verbal instructions about the phonetic properties of L2-/ɑ-ʌ/ and L1-/ɔ-a/ and their differences (representation on F1-F2 plane) were provided during both trainings. After these instructions, the ES-P group performed an identification training based on the High Variability Phonetic Training procedure, while the ES-US group performed the articulatory training, by means of US video of tongue gestures in L2-/ɑ-ʌ/ production and dynamic view of their own tongue movements and position using a probe under their chin. The acoustic data were analyzed and the first three formants were calculated. Independent t-tests were run to compare: 1) /ɑ-ʌ/ in pre- vs. post-test respectively; /ɑ-ʌ/ in pre- and post-test vs. L1-/a-ɔ/ respectively. Results show that in the pre-test all speakers realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively. Contrary to CS and ES-P groups, the ES-US group in the post-test differentiates the L2 vowels from those produced in the pre-test as well as from the L1 vowels, although only one ES-US subject produces both L2 vowels accurately. The articulatory training seems more effective than the perceptual one since it favors the production of vowels in the correct direction of L2 vowels and differently from the similar L1 vowels.

Keywords: L2 vowel production, perceptual training, articulatory training, ultrasound

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1136 Ultrasonic Treatment of Baker’s Yeast Effluent

Authors: Emine Yılmaz, Serap Fındık

Abstract:

Baker’s yeast industry uses molasses as a raw material. Molasses is end product of sugar industry. Wastewater from molasses processing presents large amount of coloured substances that give dark brown color and high organic load to the effluents. The main coloured compounds are known as melanoidins. Melanoidins are product of Maillard reaction between amino acid and carbonyl groups in molasses. Dark colour prevents sunlight penetration and reduces photosynthetic activity and dissolved oxygen level of surface waters. Various methods like biological processes (aerobic and anaerobic), ozonation, wet air oxidation, coagulation/flocculation are used to treatment of baker’s yeast effluent. Before effluent is discharged adequate treatment is imperative. In addition to this, increasingly stringent environmental regulations are forcing distilleries to improve existing treatment and also to find alternative methods of effluent management or combination of treatment methods. Sonochemical oxidation is one of the alternative methods. Sonochemical oxidation employs ultrasound resulting in cavitation phenomena. In this study, decolorization of baker’s yeast effluent was investigated by using ultrasound. Baker’s yeast effluent was supplied from a factory which is located in the north of Turkey. An ultrasonic homogenizator used for this study. Its operating frequency is 20 kHz. TiO2-ZnO catalyst has been used as sonocatalyst. The effects of molar proportion of TiO2-ZnO, calcination temperature and time, catalyst amount were investigated on the decolorization of baker’s yeast effluent. The results showed that prepared composite TiO2-ZnO with 4:1 molar proportion treated at 700°C for 90 min provides better result. Initial decolorization rate at 15 min is 3% without catalyst, 14,5% with catalyst treated at 700°C for 90 min respectively.

Keywords: baker’s yeast effluent, decolorization, sonocatalyst, ultrasound

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1135 Epigastric Pain in Emergency Room: Median Arcuate Ligament Syndrome

Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

Abstract:

Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

Procedia PDF Downloads 241
1134 128-Multidetector CT for Assessment of Optimal Depth of Electrode Array Insertion in Cochlear Implant Operations

Authors: Amina Sultan, Mohamed Ghonim, Eman Oweida, Aya Abdelaziz

Abstract:

Objective: To assess the diagnostic reliability of multi-detector CT in pre and post-operative evaluation of cochlear implant candidates. Material and Methods: The study includes 40 patients (18 males and 22 females); mean age 5.6 years. They were classified into two groups: Group A (20 patients): cochlear implant device was Nucleus-22 and Group B (20 patients): the device was MED-EL. Cochlear length (CL) and cochlear height (CH) were measured pre-operatively by 128-multidetector CT. Electrode length (EL) and insertion depth angle (α) were measured post-operatively by MDCT. Results: For Group A mean CL was 9.1 mm ± 0.4 SD; mean CH was 4.1 ± 0.3 SD; mean EL was 18 ± 2.7 SD; mean α angle was 299.05 ± 37 SD. Significant statistical correlation (P < 0.05) was found between preoperative CL and post-operative EL (r²=0.6); as well as EL and α angle (r²=0.7). Group B's mean CL was 9.1 mm ± 0.3 SD; mean CH was 4.1 ± 0.4 SD; mean EL was 27 ± 2.1 SD; mean α angle was 287.6 ± 41.7 SD. Significant statistical correlation was found between CL and EL (r²= 0.6) and α angle (r²=0.5). Also, a strong correlation was found between EL and α angle (r²=0.8). Significant statistical difference was detected between the two devices as regards to the electrode length. Conclusion: Multidetector CT is a reliable tool for preoperative planning and post-operative evaluation of the outcomes of cochlear implant operations. Cochlear length is a valuable prognostic parameter for prediction of the depth of electrode array insertion which can influence criteria of device selection.

Keywords: angle of insertion (α angle), cochlear implant (CI), cochlear length (CL), Multidetector Computed Tomography (MDCT)

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1133 Extraction of Nutraceutical Bioactive Compounds from the Native Algae Using Solvents with a Deep Natural Eutectic Point and Ultrasonic-assisted Extraction

Authors: Seyedeh Bahar Hashemi, Alireza Rahimi, Mehdi Arjmand

Abstract:

Food is the source of energy and growth through the breakdown of its vital components and plays a vital role in human health and nutrition. Many natural compounds found in plant and animal materials play a special role in biological systems and the origin of many such compounds directly or indirectly is algae. Algae is an enormous source of polysaccharides and have gained much interest in human flourishing. In this study, algae biomass extraction is conducted using deep eutectic-based solvents (NADES) and Ultrasound-assisted extraction (UAE). The aim of this research is to extract bioactive compounds including total carotenoid, antioxidant activity, and polyphenolic contents. For this purpose, the influence of three important extraction parameters namely, biomass-to-solvent ratio, temperature, and time are studied with respect to their impact on the recovery of carotenoids, and phenolics, and on the extracts’ antioxidant activity. Here we employ the Response Surface Methodology for the process optimization. The influence of the independent parameters on each dependent is determined through Analysis of Variance. Our results show that Ultrasound-assisted extraction (UAE) for 50 min is the best extraction condition, and proline:lactic acid (1:1) and choline chloride:urea (1:2) extracts show the highest total phenolic contents (50.00 ± 0.70 mgGAE/gdw) and antioxidant activity [60.00 ± 1.70 mgTE/gdw, 70.00 ± 0.90 mgTE/gdw in 2.2-diphenyl-1-picrylhydrazyl (DPPH), and 2.2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS)]. Our results confirm that the combination of UAE and NADES provides an excellent alternative to organic solvents for sustainable and green extraction and has huge potential for use in industrial applications involving the extraction of bioactive compounds from algae. This study is among the first attempts to optimize the effects of ultrasonic-assisted extraction, ultrasonic devices, and deep natural eutectic point and investigate their application in bioactive compounds extraction from algae. We also study the future perspective of ultrasound technology which helps to understand the complex mechanism of ultrasonic-assisted extraction and further guide its application in algae.

Keywords: natural deep eutectic solvents, ultrasound-assisted extraction, algae, antioxidant activity, phenolic compounds, carotenoids

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1132 A Study of Common Carotid Artery Behavior from B-Mode Ultrasound Image for Different Gender and BMI Categories

Authors: Nabilah Ibrahim, Khaliza Musa

Abstract:

The increment thickness of intima-media thickness (IMT) which involves the changes of diameter of the carotid artery is one of the early symptoms of the atherosclerosis lesion. The manual measurement of arterial diameter is time consuming and lack of reproducibility. Thus, this study reports the automatic approach to find the arterial diameter behavior for different gender, and body mass index (BMI) categories, focus on tracked region. BMI category is divided into underweight, normal, and overweight categories. Canny edge detection is employed to the B-mode image to extract the important information to be deal as the carotid wall boundary. The result shows the significant difference of arterial diameter between male and female groups which is 2.5% difference. In addition, the significant result of differences of arterial diameter for BMI category is the decreasing of arterial diameter proportional to the BMI.

Keywords: B-mode Ultrasound Image, carotid artery diameter, canny edge detection, body mass index

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1131 Ultrasonographic Manifestation of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka

Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosairo, M. H. M. N. Herath, D. M. R. D. Mirihella

Abstract:

Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia, preterm neonates

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1130 The Role of Intraluminal Endoscopy in the Diagnosis and Treatment of Fluid Collections in Patients With Acute Pancreatitis

Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov

Abstract:

Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.

Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage

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1129 Pneumoperitoneum Creation Assisted with Optical Coherence Tomography and Automatic Identification

Authors: Eric Yi-Hsiu Huang, Meng-Chun Kao, Wen-Chuan Kuo

Abstract:

For every laparoscopic surgery, a safe pneumoperitoneumcreation (gaining access to the peritoneal cavity) is the first and essential step. However, closed pneumoperitoneum is usually obtained by blind insertion of a Veress needle into the peritoneal cavity, which may carry potential risks suchas bowel and vascular injury.Until now, there remains no definite measure to visually confirm the position of the needle tip inside the peritoneal cavity. Therefore, this study established an image-guided Veress needle method by combining a fiber probe with optical coherence tomography (OCT). An algorithm was also proposed for determining the exact location of the needle tip through the acquisition of OCT images. Our method not only generates a series of “live” two-dimensional (2D) images during the needle puncture toward the peritoneal cavity but also can eliminate operator variation in image judgment, thus improving peritoneal access safety. This study was approved by the Ethics Committee of Taipei Veterans General Hospital (Taipei VGH IACUC 2020-144). A total of 2400 in vivo OCT images, independent of each other, were acquired from experiments of forty peritoneal punctures on two piglets. Characteristic OCT image patterns could be observed during the puncturing process. The ROC curve demonstrates the discrimination capability of these quantitative image features of the classifier, showing the accuracy of the classifier for determining the inside vs. outside of the peritoneal was 98% (AUC=0.98). In summary, the present study demonstrates the ability of the combination of our proposed automatic identification method and OCT imaging for automatically and objectively identifying the location of the needle tip. OCT images translate the blind closed technique of peritoneal access into a visualized procedure, thus improving peritoneal access safety.

Keywords: pneumoperitoneum, optical coherence tomography, automatic identification, veress needle

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1128 Preliminary Results on a Maximum Mean Discrepancy Approach for Seizure Detection

Authors: Boumediene Hamzi, Turky N. AlOtaiby, Saleh AlShebeili, Arwa AlAnqary

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We introduce a data-driven method for seizure detection drawing on recent progress in Machine Learning. The method is based on embedding probability measures in a high (or infinite) dimensional reproducing kernel Hilbert space (RKHS) where the Maximum Mean Discrepancy (MMD) is computed. The MMD is metric between probability measures that are computed as the difference between the means of probability measures after being embedded in an RKHS. Working in RKHS provides a convenient, general functional-analytical framework for theoretical understanding of data. We apply this approach to the problem of seizure detection.

Keywords: kernel methods, maximum mean discrepancy, seizure detection, machine learning

Procedia PDF Downloads 216