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An inverse measurement procedure for the determination of a full set of piezoelectric material parameters using a single sample is presented. The basis for the measurement procedure is a measurement of the frequency-dependent impedance of the sample. To yield sufficient sensitivity of this measurement with respect to all material parameters (mechanical, electrical, and coupling parameters), an optimal electrode configuration for the sample is determined before the inverse measurement procedure is realised using a novel topology optimisation approach. After initial estimates for the material parameters are provided by analytical expressions, a sensitivity-based, staged, local optimisation procedure yields material parameters for the sample by fitting the impedance of a finite element simulation model to the measured electrical impedance. Results for different absorption models as well as for different piezoelectric materials (hard, soft, and lead-free piezoceramics) are included.

Terrestrial laser scanner (TLS) measurements are unavoidably affected by systematic influences due to internal misalignments. The magnitude of the resulting errors can exceed the magnitude of random errors significantly deteriorating the quality of the obtained point clouds. Hence, the task of calibrating TLSs is important for applications with high demands regarding accuracy. In recent years, multiple in-situ self-calibration approaches were derived allowing the successful estimation of up-to-date calibration parameters. These approaches rely either on using manually placed targets or on using man-made geometric objects found in surroundings. Herein, we widen the existing toolbox with an alternative approach for panoramic TLSs, for the cases where such prerequisites cannot be met. We build upon the existing target-based two-face calibration method by substituting targets with precisely localized 2D keypoints, i.e. local features, detected in panoramic intensity images using the Förstner operator. To overcome the detriment of the perspective change on the feature localization accuracy, we estimate the majority of the relevant calibration parameters from a single station. The approach is verified on real data obtained with the Leica ScanStation P20. The obtained results were tested against the affirmed target-based two-face self-calibration. Analysis proved that the estimated calibration parameters are directly comparable both in the terms of parameter precision and correlation. In the end, we employ an effective evaluation procedure for testing the impact of the calibration results on the point cloud quality.

In this paper, we investigate the usage of unmanned aerial vehicles (UAV) to assess the crop geometry with special focus on the crop height extraction. Crop height is classified as a reliable trait in crop phenotyping and recognized as a good indicator for biomass, expected yield, lodging or crop stress. The current industrial standard for crop height measurement is a manual procedure using a ruler, but this method is considered as time consuming, labour intensive and subjective. This study investigates methods for reliable and rapid deriving of the crop height from high spatial, spectral and time resolution UAV data considering the influences of the reference surface and the selected crop height generation method to the final calculation. To do this, we performed UAV missions during two winter wheat growing seasons and generate point clouds from areal images using photogrammetric methods. For the accuracy assessment we compare UAV based crop height with ruler based crop height as current industrial standard and terrestrial laser scanner (TLS) based crop height as a reliable validation method. The high correlation between UAV based and ruler based crop height and especially the correlation with TLS data shows that the UAV based crop height extraction method can provide reliable winter wheat height information in a non-invasive and rapid way. Along with crop height as a single value per area of interest, 3D UAV crop data should provide some additional information like lodging area, which can also be of interest in the plant breeding community.

For some years now, UAVs (unmanned aerial vehicles) are commonly used for different mobile mapping applications, such as in the fields of surveying, mining or archeology. To improve the efficiency of these applications an automation of the flight as well as the processing of the collected data is currently aimed at. One precondition for an automated mapping with UAVs is that the georeferencing is performed directly with cm-accuracies or better. Usually, a cm-accurate direct positioning of UAVs is based on an onboard multi-sensor system, which consists of an RTK-capable (real-time kinematic) GPS (global positioning system) receiver and additional sensors (e.g. inertial sensors). In this case, the absolute positioning accuracy essentially depends on the local GPS measurement conditions. Especially during mobile mapping applications in urban areas, these conditions can be very challenging, due to a satellite shadowing, non-line-of sight receptions, signal diffraction or multipath effects. In this paper, two straightforward and easy to implement strategies will be described and analyzed, which improve the direct positioning accuracies for UAV-based mapping and surveying applications under challenging GPS measurement conditions. Based on a 3D model of the surrounding buildings and vegetation in the area of interest, a GPS geometry map is determined, which can be integrated in the flight planning process, to avoid GPS challenging environments as far as possible. If these challenging environments cannot be avoided, the GPS positioning solution is improved by using obstruction adaptive elevation masks, to mitigate systematic GPS errors in the RTK-GPS positioning. Simulations and results of field tests demonstrate the profit of both strategies.

We analyze the benefit of combining hyperspectral images information with 3D geometry information for the detection of Cercospora leaf spot disease symptoms on sugar beet plants. Besides commonly used one-class Support Vector Machines, we utilize an unsupervised sparse representation-based approach with group sparsity prior. Geometry information is incorporated by representing each sample of interest with an inclination-sorted dictionary, which can be seen as an 1D topographic dictionary. We compare this approach with a sparse representation based approach without geometry information and One-Class Support Vector Machines. One-Class Support Vector Machines are applied to hyperspectral data without geometry information as well as to hyperspectral images with additional pixelwise inclination information. Our results show a gain in accuracy when using geometry information beside spectral information regardless of the used approach. However, both methods have different demands on the data when applied to new test data sets. One-Class Support Vector Machines require full inclination information on test and training data whereas the topographic dictionary approach only need spectral information for reconstruction of test data once the dictionary is build by spectra with inclination.

In recent years, unmanned aerial vehicles (UAVs) have increasingly been used in various application areas, such as in the remote sensing or surveying. For these applications the UAV has to be equipped with a mapping sensor, which is mostly a camera. Furthermore, a georeferencing of the UAV platform and/or the acquired mapping data is required. The most efficient way to realize this georeferencing is the direct georeferencing, which is based on an onboard multi-sensor system. In recent decades, direct georeferencing systems have been researched and used extensively in airborne, ship and land vehicle applications. However, these systems cannot easily be adapted to UAV platforms, which is mainly due to weight and size limitations. In this paper a direct georeferencing system for micro- and mini-sized UAVs is presented, which consists of a dual-frequency geodetic grade OEM GPS board, a low-cost single-frequency GPS chip, a tactical grade IMU and a magnetometer. To allow for cm-level position and sub-degree attitude accuracies, RTK GPS (real-time kinematic) and GPS attitude (GPS compass) determination algorithms are running on this system, as well as a GPS/IMU integration. Beside the direct georeferencing, also the precise time synchronization of the camera, which acts as the main sensor for mobile mapping applications, and the calibration of the lever arm between the camera reference point and the direct georeferencing reference point are explained in this paper. Especially the high accurate time synchronization of the camera is very important, to still allow for high surveying accuracies, when the images are taken during the motion of the UAV. Results of flight tests demonstrate that the developed system, the camera synchronization and the lever arm calibration make directly georeferenced UAV based single point measurements possible, which have cm-level accuracies on the ground.

In tropical eastern Africa, vegetation distribution is largely controlled by regional hydrology, which has varied over the past 20 000 years. Therefore, accurate reconstructions of past vegetation and hydrological changes are crucial for a better understanding of climate variability in the tropical southeastern African region. We present high-resolution pollen records from a marine sediment core recovered offshore of the Rufiji River delta. Our data document significant shifts in pollen assemblages during the last deglaciation, identifying, through changes in both upland and lowland vegetation, specific responses of plant communities to atmospheric (precipitation) and coastal (coastal dynamics and sea-level changes) alterations. Specifically, arid conditions reflected by a maximum pollen representation of dry and open vegetation occurred during the Northern Hemisphere cold Heinrich event 1 (H1), suggesting that the expansion of drier upland vegetation was synchronous with cold Northern Hemisphere conditions. This arid period is followed by an interval in which forest and humid woodlands expanded, indicating a hydrologic shift towards more humid conditions. Droughts during H1 and the shift to humid conditions around 14.8 kyr BP in the uplands are consistent with latitudinal shifts of the intertropical convergence zone (ITCZ) driven by high-latitude Northern Hemisphere climatic fluctuations. Additionally, our results show that the lowland vegetation, consisting of well-developed salt marshes and mangroves in a successional pattern typical for vegetation occurring in intertidal habitats, has responded mainly to local coastal dynamics related to marine inundation frequencies and soil salinity in the Rufiji Delta as well as to the local moisture availability. Lowland vegetation shows a substantial expansion of mangrove trees after ~ 14.8 kyr BP, suggesting an increased moisture availability and river runoff in the coastal area. The results of this study highlight the decoupled climatic and environmental processes to which the vegetation in the uplands and the Rufiji Delta has responded during the last deglaciation.

In many unmanned aerial vehicle (UAV) applications a direct georeferencing is required. The reason can be that the UAV flies autonomous and must be navigated precisely, or that the UAV performs a remote sensing operation, where the position of the camera has to be known at the moment of the recording. In our application, a project called Mapping on Demand, we are motivated by both of these reasons. The goal of this project is to develop a lightweight autonomously flying UAV that is able to identify and measure inaccessible three-dimensional objects by use of visual information. Due to payload and space limitations, precise position and attitude determination of micro- and mini-sized UAVs is very challenging. The limitations do not only affect the onboard computing capacity, but they are also noticeable when choosing the georeferencing sensors. In this article, we will present a new developed onboard direct georeferencing system which is real-time capable, applicable for lightweight UAVs and provides very precise results (position accuracy σ < 5 cm and attitude accuracy σ < 0.5 deg). In this system GPS, inertial sensors, magnetic field sensors, a barometer as well as stereo video cameras are used as georeferencing sensors. We will describe the hardware development and will go into details of the implemented software. In this context especially the RTK-GPS software and the concept of the attitude determination by use of inertial sensors, magnetic field sensors as well as an onboard GPS baseline will be highlighted. Finally, results of first field tests as well as an outlook on further developments will conclude this contribution.

Purpose: This executive summary of a German national guideline aims to provide the most relevant evidence-based recommendations on the diagnosis and treatment of nosocomial pneumonia., Methods: The guideline made use of a systematic assessment and decision process using evidence to decision framework (GRADE). Recommendations were consented by an interdisciplinary panel. Evidence analysis and interpretation was supported by the German innovation fund providing extensive literature searches and (meta-) analyses by an independent methodologist. For this executive summary, selected key recommendations are presented including the quality of evidence and rationale for the level of recommendation., Results: The original guideline contains 26 recommendations for the diagnosis and treatment of adults with nosocomial pneumonia, thirteen of which are based on systematic review and/or meta-analysis, while the other 13 represent consensus expert opinion. For this key summary, we present 11 most relevant for everyday clinical practice key recommendations with evidence overview and rationale, of which two are expert consensus and 9 evidence-based (4 strong, 5 weak and 2 open recommendations). For the management of nosocomial pneumonia patients should be divided in those with and without risk factors for multidrug-resistant pathogens and/or Pseudomonas aeruginosa. Bacterial multiplex-polymerase chain reaction (PCR) should not be used routinely. Bronchoscopic diagnosis is not considered superior to´non-bronchoscopic sampling in terms of main outcomes. Only patients with septic shock and the presence of an additional risk factor for multidrug-resistant pathogens (MDRP) should receive empiric combination therapy. In clinically stabilized patients, antibiotic therapy should be de-escalated and focused. In critically ill patients, prolonged application of suitable beta-lactam antibiotics should be preferred. Therapy duration is suggested for 7-8 days. Procalcitonin (PCT) based algorithm might be used to shorten the duration of antibiotic treatment. Patients on the intensive care unit (ICU) are at risk for invasive pulmonary aspergillosis (IPA). Diagnostics for Aspergillus should be performed with an antigen test from bronchial lavage fluid., Conclusion: The current guideline focuses on German epidemiology and standards of care. It should be a guide for the current treatment and management of nosocomial pneumonia in Germany., Competing Interests: Declarations. Conflict of interest: JR received research support from Bundesministerium für Bildung und Forschung (BMBF), Bundesministerium für Gesundheit (BMG) Infectopharm; lecture fees from AstraZeneca, GSK, Chiesi, Esanum, Novartis, ThermoFisher, Berlin-Chemie, MSD, Boehringer, Pfizer, Shionogi; Consultant fees from Shionogi, GSK, Advanz, Gilead, MSD BG received lecture fees from Biotest, Gilead, Infectopharm, MIP, MSD, Pfizer and Shionogi; consultant fees from MSD, Pfizer, Gilead und Mundipharma. SG received speaker fees from Becton Dickinson, bioMérieux and Bio-Rad. SH received research support from Bundesministerium für Bildung und Forschung (BMBF); lecture fees from Pfizer, MSD, Infectopharm, Philips, Advanz, Beckman Coulter, Thermofisher, Shionogi, Tillots; Consultant fees from Advanz, Shionogi, Pfizer CPH received personal fees from Schering-Plough; grants and personal fees from Pfizer, Boehringer Ingelheim, Siemens; personal fees from Basilea, Novartis, Roche, Astellas, Gilead, MSD, Lilly, Intermune, Fresenius, Essex, AstraZeneca, Bracco, MEDA Pharma, Chiesi, Covidien, Pierre Fabre, Grifols, Bayer; and grants from MeVis, German Center for Lung Research. SK received research support from Cytosorbents and Daiichi Sankyo; lecture fees from ADVITOS, Biotest, Daiichi Sankyo, Fresenius Medical Care, Gilead, Mitsubishi Tanabe Pharma, MSD, Pfizer, Shionogi and Zoll; consultant fees from ADVITOS, Fresenius, Gilead, MSD and Pfizer. MK received research support from Pfizer; lecture fees from Astra-Zeneca, Berlin-Chemie, Böhringer-Ingelheim, Gilead, GSK, Insmed, Pfizer; consultant fees from AstraZeneca, Sanofi, GSK, Insmed MP received lecture fees from Siemens Healthineers, Roche, Janssen-Cilag, Diasorin; consultant fees from Sanofi, GR received support for research from BMBF, GSK, and honoraria from AstraZeneca, Boehringer, Bayer, Berlin-Chemie, Grifols, Insmed, MSD, Novartis, Pfizer, GSK, Roche. H.J.F. Salzer received honoraria for lectures or consulting fees from Insmed, GlaxoSmithKline, AstraZeneca, Advanz Pharma, MSD and Chiesi, MAW reports personal fees from MSD, Gilead, Pfizer, Shionogi, Mundipharma, Eumedica, Coulter, Biotest, Sedana, SOBI, and Böhringer; and patent EPA17198330 “Delta- Like Ligand 1 for diagnosing severe infections”. TW received support for research from DFG, BMBF, GSK, and honoraria for lectures/ad board from AstraZeneca, GSK, Jansen, Moderna, MSD, Pfizer, Sanofi-Aventis. TW provides unpaid advice to Leopoldina, EMA, CDC and is honorary Chairman of the Board of Trustees of CAPNETZ Foundation, MWP received support for research from DFG, BMBF, EKFS, Manchot Foundation, Sonnenfeld Foundation, Aptarion, Biotest, Pantherna, Vaxxilon, and honoraria from Aptarion, AstraZeneca, Biotest, Chiesi, Gilead, Insmed, Pantherna, Vaxxilon. All other authors declare no competing interests., (© 2024. The Author(s).)

The aim of this study is to examine the precision of semi-automatic, conventional and automatic volumetry tools for pulmonary nodules in chest CT with phantom N1 LUNGMAN. The phantom is a life-size anatomical chest model with pulmonary nodules representing solid and subsolid metastases. Gross tumor volumes (GTV i s) were contoured using various approaches: manually (0); as a means of semi-automated, conventional contouring with (I) adaptive-brush function; (II) flood-fill function; and (III) image-thresholding function. Furthermore, a deep-learning algorithm for automatic contouring was applied (IV). An intermodality comparison of the above-mentioned strategies for contouring GTV i s was performed. For the mean GTV ref (standard deviation (SD)), the interquartile range (IQR)) was 0.68 mL (0.33; 0.34-1.1). GTV segmentation was distributed as follows: (I) 0.61 mL (0.27; 0.36-0.92); (II) 0.41 mL (0.28; 0.23-0.63); (III) 0.65 mL (0.35; 0.32-0.90); and (IV) 0.61 mL (0.29; 0.33-0.95). GTV ref was found to be significantly correlated with GTV i s (I) p < 0.001, r = 0.989 (III) p = 0.001, r = 0.916, and (IV) p < 0.001, r = 0.986, but not with (II) p = 0.091, r = 0.595. The Sørensen-Dice indices for the semi-automatic tools were 0.74 (I), 0.57 (II) and 0.71 (III). For the semi-automatic, conventional segmentation tools evaluated, the adaptive-brush function (I) performed closest to the reference standard (0). The automatic deep learning tool (IV) showed high performance for auto-segmentation and was close to the reference standard. For high precision radiation therapy, visual control, and, where necessary, manual correction, are mandatory for all evaluated tools.

Background: Massive hemoptysis is a rare but potentially life-threatening condition of patients with cystic fibrosis (CF) and advanced pulmonary disease. Hypertrophied bronchial arteries are understood to cause massive hemoptysis when rupturing. Risk factors to predict massive hemoptysis are scarce and bronchial artery diameters are not part of any scoring system in follow-up of patients with CF. Aim of this study was to correlate bronchial artery diameter with massive hemoptysis in CF., Methods: Bronchial artery and non-bronchial systemic artery diameters were measured in contrast enhanced computed tomography (CT) scans in patients with massive hemoptysis and compared to patients with end-stage CF and no history of hemoptysis. Demographic and clinical data and side of bronchial artery/non-bronchial systemic artery hypertrophy and coil embolization were documented., Results: In this retrospective multicenter study 33 patients with massive hemoptysis were included for bronchial artery/non-bronchial systemic artery diameter measurements, (13 female, 20 male, median age 30 years (18-55)). Bronchial artery diameters were significantly larger in the case group than in the control group with median 4 mm (2.2-8.2 mm), and median 3 mm (1-7 mm), respectively (p = 0.002). Sensitivity of bronchial arteries ≥ 3.5 mm to be associated with hemoptysis was 0.76 and specificity 0.71 with ROC creating an area under the curve of 0.719. If non-bronchial systemic arteries were present, they were considered culprit and embolized in 92% of cases., Conclusion: Bronchial arteries ≥ 3.5 mm and presence of hypertrophied non-bronchial systemic arteries correlate with massive hemoptysis in patients with CF and might serve as risk predictor for massive hemoptysis. Therefore, in patients with advanced CF we propose CT scans to be carried out as CT angiography to search for bronchial arteries ≥ 3.5 mm and for hypertrophied non-bronchial systemic arteries as possible risk factors for massive hemoptysis., (© 2022. The Author(s).)

Regeneration of articular cartilage remains challenging. The aim of this study was to increase the stability of pure bioactive glass (BG) scaffolds by means of solvent phase polymer infiltration and to maintain cell adherence on the glass struts. Therefore, BG scaffolds either pure or enhanced with three different amounts of poly(D-L-lactide-co-glycolide) (PLGA) were characterized in detail. Scaffolds were seeded with primary porcine articular chondrocytes (pACs) and human mesenchymal stem cells (hMSCs) in a dynamic long-term culture (35 days). Light microscopy evaluations showed that PLGA was detectable in every region of the scaffold. Porosity was greater than 70%. The biomechanical stability was increased by polymer infiltration. PLGA infiltration did not result in a decrease in viability of both cell types, but increased DNA and sulfated glycosaminoglycan (sGAG) contents of hMSCs-colonized scaffolds. Successful chondrogenesis of hMSC-colonized scaffolds was demonstrated by immunocytochemical staining of collagen type II, cartilage proteoglycans and the transcription factor SOX9. PLGA-infiltrated scaffolds showed a higher relative expression of cartilage related genes not only of pAC-, but also of hMSC-colonized scaffolds in comparison to the pure BG. Based on the novel data, our recommendation is BG scaffolds with single infiltrated PLGA for cartilage tissue engineering.

Deforestation is a major threat to terrestrial tropical ecosystems, particularly in Southeast Asia where human activities have dramatic consequences for the survival of many species. However, responses of species to anthropogenic impact are highly variable. In order to establish effective conservation strategies, it is critical to determine a species' ability to persist in degraded habitats. Here, we used camera trapping data to provide the first insights into the temporal and spatial distribution of southern pig-tailed macaques ( Macaca nemestrina , listed as 'Vulnerable' by the IUCN) across intact and degraded forest habitats in Peninsular Malaysia, with a particular focus on the effects of clear-cutting and selective logging on macaque occupancy. Specifically, we found a 10% decline in macaque site occupancy in the highly degraded Pasoh Forest Reserve from 2013 to 2017. This may be strongly linked to the macaques' sensitivity to intensive disturbance through clear-cutting, which significantly increased the probability that M. nemestrina became locally extinct at a previously occupied site. However, we found no clear relationship between moderate disturbance, i.e ., selective logging, and the macaques' local extinction probability or site occupancy in the Pasoh Forest Reserve and Belum-Temengor Forest Complex. Further, an identical age and sex structure of macaques in selectively logged and completely undisturbed habitat types within the Belum-Temengor Forest Complex indicated that the macaques did not show increased mortality or declining birth rates when exposed to selective logging. Overall, this suggests that low to moderately disturbed forests may still constitute valuable habitats that support viable populations of M. nemestrina , and thus need to be protected against further degradation. Our results emphasize the significance of population monitoring through camera trapping for understanding the ability of threatened species to cope with anthropogenic disturbance. This can inform species management plans and facilitate the development of effective conservation measures to protect biodiversity., Competing Interests: Anja Widdig is an Academic Editor for PeerJ., (© 2021 Holzner et al.)

Paleoclimate reconstructions have enhanced our understanding of how past climates have shaped present-day biodiversity. We hypothesize that the geographic extent of Pleistocene forest refugia and suitable habitat fluctuated significantly in time during the late Quaternary for chimpanzees (Pan troglodytes). Using bioclimatic variables representing monthly temperature and precipitation estimates, past human population density data, and an extensive database of georeferenced presence points, we built a model of changing habitat suitability for chimpanzees at fine spatio-temporal scales dating back to the Last Interglacial (120,000 BP). Our models cover a spatial resolution of 0.0467° (approximately 5.19 km 2 grid cells) and a temporal resolution of between 1000 and 4000 years. Using our model, we mapped habitat stability over time using three approaches, comparing our modeled stability estimates to existing knowledge of Afrotropical refugia, as well as contemporary patterns of major keystone tropical food resources used by chimpanzees, figs (Moraceae), and palms (Arecacae). Results show habitat stability congruent with known glacial refugia across Africa, suggesting their extents may have been underestimated for chimpanzees, with potentially up to approximately 60,000 km 2 of previously unrecognized glacial refugia. The refugia we highlight coincide with higher species richness for figs and palms. Our results provide spatio-temporally explicit insights into the role of refugia across the chimpanzee range, forming the empirical foundation for developing and testing hypotheses about behavioral, ecological, and genetic diversity with additional data. This methodology can be applied to other species and geographic areas when sufficient data are available., (© 2021 The Authors. American Journal of Primatology published by Wiley Periodicals LLC.)

Cardiac and liver computed tomography (CT) perfusion has not been routinely implemented in the clinic and requires high radiation doses. The purpose of this study is to examine the radiation exposure and technical settings for cardiac and liver CT perfusion scans at different CT scanners. Two cardiac and three liver CT perfusion protocols were examined with the N1 LUNGMAN phantom at three multi-slice CT scanners: a single-source (I) and second- (II) and third-generation (III) dual-source CT scanners. Radiation doses were reported for the CT dose index (CTDI vol ) and dose-length product (DLP) and a standardised DLP (DLP 10cm ) for cardiac and liver perfusion. The effective dose (ED 10cm ) for a standardised scan length of 10 cm was estimated using conversion factors based on the International Commission on Radiological Protection (ICRP) 110 phantoms and tissue-weighting factors from ICRP 103. The proposed total lifetime attributable risk of developing cancer was determined as a function of organ, age and sex for adults. Radiation exposure for CTDI vol , DLP/DLP 10 cm and ED 10 cm during CT perfusion was distributed as follows: for cardiac perfusion (II) 144 mGy, 1036 mGy·cm/1440 mGy·cm and 39 mSv, and (III) 28 mGy, 295 mGy·cm/279 mGy·cm and 8 mSv; for liver perfusion (I) 225 mGy, 3360 mGy·cm/2249 mGy·cm and 54 mSv, (II) 94 mGy, 1451 mGy·cm/937 mGy·cm and 22 mSv, and (III) 74 mGy, 1096 mGy·cm/739 mGy·cm and 18 mSv. The third-generation dual-source CT scanner applied the lowest doses. Proposed total lifetime attributable risk increased with decreasing age. Even though CT perfusion is a high-dose examination, we observed that new-generation CT scanners could achieve lower doses. There is a strong impact of organ, age and sex on lifetime attributable risk. Further investigations of the feasibility of these perfusion scans are required for clinical implementation., (© 2021 Society for Radiological Protection. Published on behalf of SRP by IOP Publishing Limited. All rights reserved.)

The aim of this phantom study is to examine radiation doses of dual- and single-energy computed tomography (DECT and SECT) in the chest and upper abdomen for three different multi-slice CT scanners. A total of 34 CT protocols were examined with the phantom N1 LUNGMAN. Four different CT examination types of different anatomic regions were performed both in single- and dual-energy technique: chest, aorta, pulmonary arteries for suspected pulmonary embolism and liver. Radiation doses were examined for the CT dose index CTDIvol and dose-length product (DLP). Radiation doses of DECT were significantly higher than doses for SECT. In terms of CTDIvol, radiation doses were 1.1-3.2 times higher, and in terms of DLP, these were 1.1-3.8 times higher for DECT compared with SECT. The third-generation dual-source CT applied the lowest dose in 7 of 15 different examination types of different anatomic regions., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Stable isotope analysis is an increasingly used molecular tool to reconstruct the diet and ecology of elusive primates such as unhabituated chimpanzees. The consumption of C4 plant feeding termites by chimpanzees may partly explain the relatively high carbon isotope values reported for some chimpanzee communities. However, the modest availability of termite isotope data as well as the diversity and cryptic ecology of termites potentially consumed by chimpanzees obscures our ability to assess the plausibility of these termites as a C4 resource. Here we report the carbon and nitrogen isotope values from 79 Macrotermes termite samples from six savanna woodland chimpanzee research sites across equatorial Africa. Using mixing models, we estimated the proportion of Macrotermes C4 plant consumption across savanna woodland sites. Additionally, we tested for isotopic differences between termite colonies in different vegetation types and between the social castes within the same colony in a subset of 47 samples from 12 mounds. We found that Macrotermes carbon isotope values were indistinguishable from those of C3 plants. Only 5 to 15% of Macrotermes diets were comprised of C4 plants across sites, suggesting that they cannot be considered a C4 food resource substantially influencing the isotope signatures of consumers. In the Macrotermes subsample, vegetation type and caste were significantly correlated with termite carbon values, but not with nitrogen isotope values. Large Macrotermes soldiers, preferentially consumed by chimpanzees, had comparably low carbon isotope values relative to other termite castes. We conclude that Macrotermes consumption is unlikely to result in high carbon isotope values in either extant chimpanzees or fossil hominins., Competing Interests: The authors have declared that no competing interests exist.

This information provided by the Thoracic Imaging Section of the German Radiological Society is intended to give physicians recommendations on the use of thoracic imaging procedures in the context of the current COVID-19 pandemic. It represents the consensus of the authors based on the previous scientific knowledge and is intended to provide guidance for unified, structured CT reporting if COVID-19 pneumonia is suspected. The recommendations presented correspond to state of knowledge at the time of print and will be updated according to the results of ongoing and future scientific studies. KEY POINTS:: · COVID-19. · chest imaging. · German Radiological Society. CITATION FORMAT: · Vogel-Claussen J, Ley-Zaporozhan J, Agarwal P et al. Recommendations of the Thoracic Imaging Section of the German Radiological Society for clinical application of chest imaging and structured CT reporting in the COVID-19 pandemic. Fortschr Röntgenstr 2020; DOI: 10.1055/a-1174-8378., Competing Interests: The authors declare that they have no conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a major cause of morbidity and death in IPF. However, sensitive predictive factors of AE-IPF have not been well-investigated. To investigate whether high-resolution computed tomographic (HRCT) abnormalities predict AE-IPF in independent ethnic cohorts, this study included 121 patients with IPF (54 German and 67 Japanese; mean age, 68.5 ± 7.6 years). Two radiologists independently visually assessed the presence and extent of lung abnormalities in each patient. Twenty-two (18.2%) patients experienced AE-IPF during the follow-up. The incidence of AE-IPF was significantly higher in the Japanese patients ( n = 18, 26.9%) than in the German patients ( n = 4, 7.3%, p < 0.01). In the Kaplan-Meier analysis, patients with a larger extent of ground glass opacity (GGO), fibrosis, and traction bronchiectasis experienced an earlier onset of AE-IPF ( p = 0.0033, 0.0088, and 0.049, respectively). In the multivariate analysis, a larger extent of GGO and fibrosis on HRCT were independent predictors of AE-IPF ( p = 0.026 and 0.037, respectively). Additionally, Japanese ethnicity was independently associated with the incidence of AE-IPF after adjustment for HRCT findings ( p = 0.0074). In conclusion, a larger extent of GGO and fibrosis on HRCT and Japanese ethnicity appear to be risk factors for AE-IPF.

Herpesviruses are thought to have evolved in very close association with their hosts. This is notably the case for cytomegaloviruses (CMVs; genus Cytomegalovirus ) infecting primates, which exhibit a strong signal of co-divergence with their hosts. Some herpesviruses are however known to have crossed species barriers. Based on a limited sampling of CMV diversity in the hominine (African great ape and human) lineage, we hypothesized that chimpanzees and gorillas might have mutually exchanged CMVs in the past. Here, we performed a comprehensive molecular screening of all 9 African great ape species/subspecies, using 675 fecal samples collected from wild animals. We identified CMVs in eight species/subspecies, notably generating the first CMV sequences from bonobos. We used this extended dataset to test competing hypotheses with various degrees of co-divergence/number of host switches while simultaneously estimating the dates of these events in a Bayesian framework. The model best supported by the data involved the transmission of a gorilla CMV to the panine (chimpanzee and bonobo) lineage and the transmission of a panine CMV to the gorilla lineage prior to the divergence of chimpanzees and bonobos, more than 800,000 years ago. Panine CMVs then co-diverged with their hosts. These results add to a growing body of evidence suggesting that viruses with a double-stranded DNA genome (including other herpesviruses, adenoviruses, and papillomaviruses) often jumped between hominine lineages over the last few million years.

Background: The histologic presence of aggressive local growth of pulmonary metastases is associated with an increased risk for local intrapulmonary recurrence after enucleation or wedge resection. Patient tailored resection planning is possible when morphologic pattern of aggressive growth could be identified based on preoperative CT scans., Methods: Radiomorphology and microscopic growth characteristics from 232 pulmonary metastases from 87 patients were prospectively compared for the presence or absence of aggressive patterns of local intrapulmonary dissemination., Results: Microscopic aggressive local growth was found: pleural involvement (18.5%), lymphatic invasion (6.9%), vascular invasion (7.3%), interstitial growth (38.4%), micro satellite nodules (24.5%), spread through air spaces (STAS) (13.4%), and a smooth, slightly blurred or irregular surface in 34.1%, 43.1% and 22.8%. The radiologic margin demarcation was smooth in 37.1%, blurred in 27.6% or irregular in 35.3% and spiculae were present in 26.3% of the lesions. The microscopic and radiologic description of the metastasis surface correlated well [correlation coefficient (CC) =0.75, P<0.001]. A smooth surface on CT scan corresponded with a smooth microscopic surface in 72/86 (83.7%) of the lesions. The radiomorphologic feature of an irregular or cloudy surface was highly associated with the presence of at least one aggressive pattern of local dissemination (P<0.001). The presence of spiculae on CT scan was well associated with the presence of aggressive local spread (P<0.001) and the microscopic features corresponding with spiculae were interstitial growth, STAS and L1., Conclusions: Radiomorphologic characteristics of lung metastases correspond well with the microscopic appearance of the resected lesion. Therefore it seems possible to adjust safety margins based on the radiologic appearance of the metastasis., Competing Interests: Conflicts of Interest: Parts of the data have been presented at the National Thoracic Surgeons Congress in Germany 2017.

Carrion scavenging is a well-studied phenomenon, but virtually nothing is known about scavenging on plant material, especially on remnants of cracked nuts. Just like meat, the insides of hard-shelled nuts are high in energetic value, and both foods are difficult to acquire. In the Taï forest, chimpanzees (Pan troglodytes) and red river hogs (Potamochoerus porcus) crack nuts by using tools or strong jaws, respectively. In this study, previously collected non-invasive camera trap data were used to investigate scavenging by sooty mangabeys (Cercocebus atys), two species of Guinea fowl (Agelestres meleagrides; Guttera verreauxi), and squirrels (Scrunidae spp.) on the nut remnants cracked by chimpanzees and red river hogs. We investigated how scavengers located nut remnants, by analyzing their visiting behavior in relation to known nut-cracking events. Furthermore, since mangabeys are infrequently preyed upon by chimpanzees, we investigated whether they perceive an increase in predation risk when approaching nut remnants. In total, 190 nut-cracking events were observed in four different areas of Taï National Park, Ivory Coast. We could confirm that mangabeys scavenged on the nuts cracked by chimpanzees and hogs and that this enabled them to access food source that would not be accessible otherwise. We furthermore found that mangabeys, but not the other species, were more likely to visit nut-cracking sites after nut-cracking activities than before, and discuss the potential strategies that the monkeys could have used to locate nut remnants. In addition, mangabeys showed elevated levels of vigilance at the chimpanzee nut-cracking sites compared with other foraging sites, suggesting that they perceived elevated danger at these sites. Scavenging on remnants of cracked nuts is a hitherto understudied type of foraging behavior that could be widespread in nature and increases the complexity of community ecology in tropical rainforests., (© 2018 The Authors. American Journal of Primatology Published by Wiley Periodicals, Inc.)

A recent global analysis of GenBank DNA sequences from amphibians and mammals indicated consistent poleward decrease of intraspecific genetic diversity in both classes. We highlight that this result was biased by not accounting for distance decay of similarity and reanalyse the datasets, revealing distinct latitudinal gradients in mammals and amphibians., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: Chromosomal rearrangements involving ROS1 define a rare entity of lung adenocarcinomas with exquisite sensitivity to molecularly targeted therapy. We report clinical outcomes and genomic findings of patients with ROS1-positive lung cancer who were prospectively identified within a multiplex biomarker profiling program at the West German Cancer Center., Methods: Standardized immunohistochemical (IHC) analysis, fluorescence in situ hybridization (FISH), and hotspot mutation analyses were performed in 1345 patients with advanced cancer, including 805 patients with metastatic lung adenocarcinoma. Clinical and epidemiological data were retrieved from the institutional database., Results: ROS1 positivity by IHC analysis was detected in 25 patients with lung cancer (4.8% of lung adenocarcinomas), including 13 patients (2.5%) with ROS1 FISH positivity with a cutoff of at least 15% of events. Of the ROS1 IHC analysis-positive cases, 36% presented with concomitant oncogenic driver mutations involving EGFR (six cases, five of which were clinically validated by response to EGFR-targeting agents), KRAS (two cases), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA), and BRAF. Three cases initially classified as ROS1 FISH-negative passed the threshold of 15% positive events when repeat biopsies were analyzed at progression. The median overall survival of the ROS1-positive patients (104 months) was significantly superior to that of the 261 patients with EGFR/anaplastic lymphoma kinase/ROS1-negative lung adenocarcinoma (24.4 months, p = 0.044). Interestingly, the overall survival of the 13 ROS1-positive patients with lung cancer from initiation of pemetrexed-based chemotherapy was significantly prolonged when compared with that of 169 pemetrexed-treated patients with EGFR/anaplastic lymphoma kinase/ROS1-negative adenocarcinoma (p = 0.01)., Conclusions: ROS1-positive metastatic lung adenocarcinomas frequently harbor concomitant oncogenic driver mutations. Levels of ROS1 FISH-positive events are variable over time. This heterogeneity provides additional therapeutic options if discovered by multiplex biomarker testing and repeat biopsies., (Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Our closest living relatives, chimpanzees and bonobos, have a complex demographic history. We analyzed the high-coverage whole genomes of 75 wild-born chimpanzees and bonobos from 10 countries in Africa. We found that chimpanzee population substructure makes genetic information a good predictor of geographic origin at country and regional scales. Multiple lines of evidence suggest that gene flow occurred from bonobos into the ancestors of central and eastern chimpanzees between 200,000 and 550,000 years ago, probably with subsequent spread into Nigeria-Cameroon chimpanzees. Together with another, possibly more recent contact (after 200,000 years ago), bonobos contributed less than 1% to the central chimpanzee genomes. Admixture thus appears to have been widespread during hominid evolution., (Copyright © 2016, American Association for the Advancement of Science.)

Sunitinib treatment leads to improvement in progression-free survival in patients with advanced pancreatic neuroendocrine tumours (pNETs). However, limited data exist regarding the effectiveness, safety and tolerability in clinical practice. We present the results of the first detailed pNET cohort analysis since sunitinib was approved. Patients with advanced, differentiated pNET treated with sunitinib were retrospectively analysed. All patients had progressive disease before start of sunitinib treatment. Twenty-one patients, with a median age of 64 years (range 28-78), were included in this study. Nineteen patients could be analysed for treatment effectiveness. Twelve (57%) patients exhibited either a partial response (1 patient) or stable disease (11 patients) according to the RECIST criteria. The median progression-free survival was 7.0 months (95% CI 3.0-12.0); the probability of being event-free at 6 months was 52.6% (95% CI 28.4-72.1). Potential influencing factors as Ki-67 index, age or duration of disease did not show significant correlations with the response to sunitinib therapy. Considering the differences in patients' characteristics, sunitinib in daily practice showed effectiveness parameters similar to the phase III trial., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To evaluate the influence of Gadolinium contrast agent on image segmentation in magnetic resonance (MR)-based attenuation correction (AC) with four-segment dual-echo time Dixon-sequences in whole-body [18F]-fluorodeoxyglucose positron emission tomography (PET)/MR imaging, and to analyze the consecutive effect on standardized uptake value (SUV)., Materials and Methods: Hybrid imaging with an integrated PET/MR system was performed in 30 oncological patients. AC was based on MR imaging with a Dixon sequence with subsequent automated image segmentation. AC maps (µmaps) were acquired and reconstructed prior to (µmap-gd) and after (µmap+gd) Gd-contrast agent application. For quantification purposes, the SUV of organs and tumors based on both µmaps were compared., Results: Tissue classification based on µmap-gd was correct in 29/30 patients; based on µmap+gd, the brain was falsely classified as fat in 12/30 patients with significant underestimation of SUV. In all cancerous lesions, tissue segmentation was correct. All concordant µmaps-gd/+gd resulted in no significant difference in SUV., Conclusion: In PET/MR, Gd-contrast agent potentially influences fat/water separation in Dixon-sequences of the head with above-average false tissue segmentation and an associated underestimation of SUV. Thus, MR-based AC should be acquired prior to Gd-contrast agent application. Additionally, integrating the MR-based AC maps into the reading-routine in PET/MR is recommended to avoid interpretation errors in cases where tissue segmentation fails.

Objectives: Frozen elephant trunk (FET) can be used for continuous downstream aorta treatment in acute aortic dissection (AAD) and chronic aortic dissection (CAD). The study reports the changes in the lumen volumes along the downstream aorta towards remodelling., Methods: In 70 patients (22 CAD, 48 AAD), pre-, postoperative and at least the 1-year follow-up aortic imaging was available. Volume changes of aortic lumen (AL) and true lumen (TL) between examinations along the stent graft aortic segment (A), downstream to coeliac trunk (B) and distally to bifurcation (C) were used for quantification. TL increase >10% with stable AL or AL decrease >10% with stable TL were classified as positive, changes within a 10% threshold as stable, and all other changes as negative remodelling., Results: In AAD, positive or stable remodelling occurred in A (90%), B (65%), C (58%) within 1 year, thereafter in 26 patients (follow-up: 47 ± 21 months) in A (92%), B (65%), C (62%). Negative remodelling in ≥2 segments was found in 5/26 (19%) patients. In CAD, positive or stable remodelling occurred in A (100%), B (86%), C (77%) within 1 year, thereafter in 16 patients (follow-up: 46 ± 20 months) in A (75%), B (44%), C (38%). Negative remodelling in ≥2 segments was found in 7/16 (43%) patients, 5 underwent reintervention, and stabilized thereafter., Conclusions: FET facilitates positive remodelling in AAD and CAD down to stent graft level. Distally, 20% AAD and 40% CAD patients remain at risk for secondary reintervention, and can be identified by negative remodelling in ≥2 segments in the follow-up examinations., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

We report on a 57-year-old female liver transplanted patient who underwent endovascular aneurysm repair because of an infrarenal abdominal aortic aneurysm. Two months later, she developed an infection, and positron emission tomography computed tomography detected a paraprosthetic abscess. Explantation of the endoprosthesis and aortic reconstruction with a Y-shaped silver graft was made. The patient was discharged on the 12th postoperative day and shows up regularly in our outpatients department in a good clinical condition. After meticulous research of the current literature, this is the first published case of the successful management of an infected endovascular aortic stent in a liver transplanted patient., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: It is now debated whether the screening of heavy smokers for lung cancer with low dose computed tomography (low dose CT) might lower their mortality due to lung cancer. We use data from the National Lung Screening Trial (NLST) in the USA to predict the likely effects of such screening in Germany., Methods: The number of heavy smokers aged 55-74 in Germany was extrapolated from survey data obtained by the Robert Koch Institute. Published data from the NLST were then used to estimate the likely effects of low dose CT screening of heavy smokers in Germany., Results: If low dose CT screening were performed on 50% of the heavy smokers in Germany aged 55-74, an estimated 1 329 506 persons would undergo such screening. If the screening were repeated annually, then, over three years, 916 918 screening CTs would reveal suspect lesions, and the diagnosis of lung cancer would be confirmed thereafter in 32 826 persons. At least one positive test result in three years would be obtained in 39.1% of the participants (519 837 persons). 4155 deaths from lung cancer would be prevented over 6.5 years, and the number of persons aged 55-74 who die of lung cancer in Germany would fall by 2.6%. 12 449 persons would have at least one complication, and 1074 persons would die in the 60 days following screening., Conclusion: The screening of heavy smokers for lung cancer can lower their risk of dying of lung cancer by 20% in relative terms, corresponding to an absolute risk reduction of 0.3 percentage points. These figures can provide the background for a critical discussion of the putative utility of this type of screening in Germany.

Unlabelled: Therapeutic decisions in non-small cell lung cancer (NSCLC) patients depend on the tumor stage. PET/CT with (18)F-FDG is widely accepted as the diagnostic standard of care. The purpose of this study was to compare a dedicated pulmonary (18)F-FDG PET/MR imaging protocol with (18)F-FDG PET/CT for primary and locoregional lymph node staging in NSCLC patients using histopathology as the reference., Methods: Twenty-two patients (12 men, 10 women; mean age ± SD, 65.1 ± 9.1 y) with histopathologically confirmed NSCLC underwent (18)F-FDG PET/CT, followed by (18)F-FDG PET/MR imaging, including a dedicated pulmonary MR imaging protocol. T and N staging according to the seventh edition of the American Joint Committee on Cancer staging manual was performed by 2 readers in separate sessions for (18)F-FDG PET/CT and PET/MR imaging, respectively. Results from histopathology were used as the standard of reference. The mean and maximum standardized uptake value (SUV(mean) and SUV(max), respectively) and maximum diameter of the primary tumor was measured and compared in (18)F-FDG PET/CT and PET/MR imaging., Results: PET/MR imaging and (18)F-FDG PET/CT agreed on T stages in 16 of 16 of patients (100%). All patients were correctly staged by (18)F-FDG PET/CT and PET/MR (100%), compared with histopathology. There was no statistically significant difference between (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging for lymph node metastases detection (P = 0.48). For definition of thoracic N stages, PET/MR imaging and (18)F-FDG PET/CT were concordant in 20 of 22 patients (91%). PET/MR imaging determined the N stage correctly in 20 of 22 patients (91%). (18)F-FDG PET/CT determined the N stage correctly in 18 of 22 patients (82%). The mean differences for SUV(mean) and SUV(max) of NSCLC in (18)F-FDG PET/MR imaging and (18)F-FDG PET/CT were 0.21 and -5.06. These differences were not statistically significant (P > 0.05). The SUV(mean) and SUV(max) measurements derived from (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging exhibited a high correlation (R = 0.74 and 0.86, respectively; P < 0.0001). Size measurements showed an excellent correlation between (18)F-FDG PET/MR imaging and (18)F-FDG PET/CT (R = 0.99; P < 0.0001). The lower and upper limits of agreement between (18)F-FDG PET/CT and (18)F-FDG PET/MR imaging using Bland-Altman analysis were -2.34 to 3.89 for SUV(mean), -7.42 to 4.40 for SUV(max), and -0.59 to 0.83 for the tumor size, respectively., Conclusion: (18)F-FDG PET/MR imaging using a dedicated pulmonary MR imaging protocol, compared with (18)F-FDG PET/CT, does not provide advantages in thoracic staging in NSCLC patients.

Purpose: To compare the apparent diffusion coefficient (ADC) in non-small cell lung cancer lesions with standardized uptake values (SUV) derived from combined 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (FDG-PET/MRI) and those derived from FDG-PET/CT., Materials and Methods: In 18 consecutive patients with histologically proven NSCLC (17 men, 1 woman; mean age, 61 ± 12 years), whole-body FDG-PET/MRI was performed after whole-body FDG-PET/CT. Regions of interest (ROI) encompassing the entire primary tumor were drawn into FDG-PET/CT and FDG-PET/MR images to determine the maximum and mean standardized uptake value (SUVmax; SUVmean) and into ADC parameter maps to assess mean ADC values. Pearson's correlation coefficients were calculated to compare SUV and ADC values., Results: The SUVmax of NSCLC was 12.3 ± 4.8 [mean ±SD], and the SUVmean was 7.2 ± 2.8 as assessed by FDG-PET/MRI. The SUVmax and SUVmean derived from FDG-PET/CT and FDG-PET/MRI correlated well (R = 0.93; p < 0.001 and R = 0.92; p < 0.001, respectively). The ADCmean of the pulmonary tumors was 187.9 ± 88.8 × 10-5 mm²/s [mean ± SD]. The ADCmean exhibited a significant inverse correlation with the SUVmax (R = -0.72; p < 0.001) as well as with the SUVmean assessed by FDG-PET/MRI (R = -0.71; p < 0.001)., Conclusion: This simultaneous PET/MRI study corroborates the assumed significant inverse correlation between increased metabolic activity on FDG-PET and restricted diffusion on DWI in NSCLC.Citation Format:, (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Positron emission tomography/magnetic resonance imaging (PET/MRI) requires efficient scan protocols for whole-body cancer staging. The aim of this study was to evaluate if the application of diffusion-weighted MR imaging (DWI) results in a diagnostic benefit for lesion detection in oncologic patients if added to a whole-body [18F]-fluorodesoxyglucose ([18F]-FDG) PET/MRI protocol., Methods: 25 consecutive oncologic patients (16 men, 9 women; age 57 ± 12 years) prospectively underwent whole-body [18F]-FDG-PET/MRI including DWI on a hybrid PET/MRI scanner. A team of two readers assessed [18F]-FDG PET/MRI without DWI for primary tumors and metastases. In a second session, now considering DWI, readers reassessed [18F]-FDG PET/MRI accordingly. Additionally, the lesion-to-background contrast on [18F]-FDG PET and DWI was rated qualitatively (0, invisible; 1, low; 2, intermediate; 3, high). Wilcoxon's signed-rank test was performed to test for differences in the lesion-to-background contrast., Results: 49 lesions were detected in 16 patients (5 primaries, 44 metastases). All 49 lesions were concordantly detected by [18F]-FDG PET/MRI alone and [18F]-FDG PET/MRI with DWI. The lesion-to-background contrast on DWI compared to [18F]-FDG PET was rated lower in 22 (44.9%) of 49 detected lesions resulting in a significantly higher lesion-to-background contrast on [18F]-FDG PET compared to DWI (P=0.001)., Conclusions: DWI as part of whole-body [18F]-FDG PET/MRI does not benefit lesion detection. Given the necessity to optimize imaging protocols with regard to patient comfort and efficacy, DWI has to be questioned as a standard tool for whole-body staging in oncologic PET/MRI., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Objectives: Shorter distances from coronary ostia to the calcified aortic valve may result in occlusion with potential infarction during transcatheter aortic valve implantation. We hypothesized that preoperative CT-scan measurements might predict coronary occlusion., Methods: Distances from the coronary ostia to the calcified aortic valve were measured during open heart aortic valve replacement in 60 consecutive patients. Distances were compared to preoperative CT-scan measurements evaluating distance of the coronary ostia as well (n = 15)., Results: The distances of the lower lip of the left and the right coronary artery ostia measured from the aortic annulus were 14.7 ± 3.9 mm and 13.4 ± 4.0 mm, respectively. The left, right and noncoronary cusp heights were 13.9 ± 2.5 mm, 12.8 ± 3.0 mm and 13.3 ± 3.1 mm, respectively. Coronary ostia topography indicated variations from the middle to the noncoronary commissure in 40% for the left and 63% for the right coronary ostium. CT-scan based measurements resulted in a distance of 12.8 ± 3.5 mm for the left and 13.9 ± 4.0 mm for the right coronary ostium, compared to 14.2 ± 4.2 mm and 13.5 ± 4.3 mm measured intraoperatively. A mild correlation between both measurements could be observed (r = 0.374, P = 0.188, left and r = 0.46, P = 0.09, n = 15)., Conclusions: CT-scan-based measurements differed from the intraoperative measurements, however preoperative CT-scan evaluation may be a useful tool to identify patients with short distance of coronaries.

Large-scale monitoring schemes are essential in assessing global mammalian biodiversity, and in this framework, leeches have recently been promoted as an indirect source of DNA from terrestrial mammal species. Carrion feeding flies are ubiquitous and can be expected to feed on many vertebrate carcasses. Hence, we tested whether fly-derived DNA analysis may also serve as a novel tool for mammalian diversity surveys. We screened DNA extracted from 201 carrion flies collected in tropical habitats of Côte d'Ivoire and Madagascar for mammal DNA using multiple PCR systems and retrieved DNA sequences from a diverse set of species (22 in Côte d'Ivoire, four in Madagascar) exploiting distinct forest strata and displaying a broad range of body sizes. Deep sequencing of amplicons generated from pools of flies performed equally well as individual sequencing approaches. We conclude that the analysis of fly-derived DNA can be implemented in a very rapid and cost-effective manner and will give a relatively unbiased picture of local mammal diversity. Carrion flies therefore represent an extraordinary and thus far unexploited resource of mammal DNA, which will probably prove useful for future inventories of wild mammal communities., (© 2013 Blackwell Publishing Ltd.)

Objectives: The purpose of this study was to test whether the acquisition of positron emission tomography (PET) does interfere with simultaneous diffusion weighted imaging (DWI) in an integrated whole-body PET/MRI system., Material and Methods: Fourteen consecutive oncological patients (9 men, 5 women; age 54 ± 13 years ([mean ± standard deviation]) scheduled for routine [(18)F]-FDG PET/CT were prospectively enrolled. For DWI, an echo planar imaging (EPI) sequence (b=0-500-1000 s/mm(2)) was acquired twice on an integrated whole-body 3T PET/MRI system in each patient; first with simultaneous PET acquisition and a second time with the PET component switched off. The apparent diffusion coefficient (ADC) and the signal-to-noise ratio at b=1000 s/mm(2) (SNR) of the myocardium, paraspinal muscle, liver, spleen, renal cortex and tumor tissue (if present) were measured. In addition, the coefficient of variation (CV) of ADC values was calculated. Student's t-test for paired samples was performed to test for differences of the mean ADC, ADC CV and SNR between DWI with and without simultaneous PET acquisition., Results: There were no significant differences of the ADC [(mean ± standard deviation)] between the DWI acquisitions with and without simultaneous PET acquisition for the myocardium (2572 ± 441 × 10(-6)mm(2)/s and 2586 ± 376 × 10(-6)mm(2)/s, respectively) (P=0.817), paraspinal muscle (1279 ± 254 × 10(-6)mm(2)/s vs. 1219 ± 181 × 10(-6)mm(2)/s) (P=0.318), liver (1245 ± 158 × 10(-6)mm(2)/s vs. 1254 ± 171 × 10(-6)mm(2)/s) (P=0.848), spleen (980 ± 122 × 10(-6)mm(2)/s vs. 1000 ± 187 × 10(-6)mm(2)/s) (P=0.676) and renal cortex (1951 ± 226 × 10(-6)mm(2)/s vs. 1930 ± 273 × 10(-6)mm(2)/s) (P=0.730). Mean ADC of lymph node metastases (n=6) did not differ between with PET acquisition (853 ± 174 × 10(-6)mm(2)/s) and without simultaneous PET (865 ± 170 × 10(-6)mm(2)/s) (P=0.675). There were no significant differences between the CV of ADC values or the SNR values measured in DWI datasets that were acquired with or without simultaneous PET for any evaluated organ site., Conclusion: The simultaneous acquisition of DWI and PET on an integrated PET/MRI system does not impact ADC quantification of normal and tumor tissue and does not alter SNR. This knowledge provides a basis for the use of simultaneous multiparametric PET/MRI comprising DWI in diagnostic imaging and quantitative tumor therapy monitoring using repeated ADC measurements., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Objectives: We studied in a multicenter setting the accuracy and reproducibility of 3-dimensional echocardiography (3DE)-derived measurements of left atrial volume (LAV) using new, dedicated volumetric software, side by side with 2-dimensional echocardiography (2DE), using cardiac magnetic resonance (CMR) imaging as a reference., Background: Increased LAV is associated with adverse cardiovascular outcomes. Although LAV measurements are routinely performed using 2DE, this methodology is limited because it is view dependent and relies on geometric assumptions regarding left atrial shape. Real-time 3DE is free of these limitations and accordingly is an attractive alternative for the evaluation of LAV. However, few studies have validated 3DE-derived LAV measurements against an accepted independent reference standard, such as CMR imaging., Methods: We studied 92 patients with a wide range of LAV who underwent CMR (1.5-T) and echocardiographic imaging on the same day. Images were analyzed to obtain maximal and minimal LAV: CMR images using standard commercial tools, 2DE images using a biplane area-length technique, and 3DE images using Tomtec LA Function software. Intertechnique comparisons included linear regression and Bland-Altman analyses. Reproducibility of all 3 techniques was assessed by calculating the percentage of absolute differences in blinded repeated measurements. Kappa statistics were used to compare 2DE and 3DE classification of normal/enlarged against the CMR reference., Results: 3DE-derived LAV values showed higher correlation with CMR than 2DE measurements (r = 0.93 vs. r = 0.74 for maximal LAV; r = 0.88 vs. r = 0.82 for minimal LAV). Although 2DE underestimated maximal LAV by 31 ± 25 ml and minimal LAV by 16 ± 32 ml, 3DE resulted in a minimal bias of -1 ± 14 ml for maximal LAV and 0 ± 21 ml for minimal LAV. Interobserver and intraobserver variability of 2DE and 3DE measurements of maximal LAV were similar (7% to 12%) and approximately 2 times higher than CMR (4% to 5%). 3DE classified enlarged atria more accurately than 2DE (kappa: 0.88 vs. 0.71)., Conclusions: Compared with CMR reference, 3DE-derived LAV measurements are more accurate than 2DE-based analysis, resulting in fewer patients with undetected atrial enlargement., (Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: This study sought to compare cardiac magnetic resonance imaging (CMR) with dual source computed tomography (DSCT) for analysis of aortic root dimensions prior to transcatheter aortic valve implantation (TAVI). In addition, the potential impact of CMR and DSCT measurements on TAVI strategy defined by 2D-transesophageal echocardiography (TEE) was evaluated., Methods: Aortic root dimensions were measured using CMR and DSCT in 58 patients referred for evaluation of TAVI. The TAVI strategy (choice of prosthesis size and decision to implant) was based on 2D-TEE annulus measurements., Results: CMR and DSCT aortic root measurements showed an overall good correlation (r=0.86, p<0.001 for coronal aortic annulus diameters). There was also a good correlation between TEE and CMR as well as between TEE and DSCT for measurement of sagittal aortic annulus diameters (r=0.69, p<0.001). However, annulus diameters assessed by TEE (22.1±2.3mm) were significantly smaller than coronal aortic annulus diameters assessed by CMR (23.4±1.8mm, p<0.001) or DSCT (23.6±1.8, p<0.001). Regarding TAVI strategy, the agreement between TEE and sagittal CMR (kappa=0.89) as well as sagittal DSCT measurements (kappa=0.87) was statistically perfect. However, decision based on coronal CMR- or MSCT measurements would have modified TAVI strategy as compared to a TEE based choice in a significant number of patients (22% to 24%)., Conclusion: In patients referred for TAVI, CMR measurements of aortic root dimensions show a good correlation with DSCT measurements and thus CMR may be an alternative 3D-imaging modality. Aortic annulus measurements using TEE, CMR and DSCT were close but not identical and the method used has important potential implications on TAVI strategy., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background: Segmental resection in stage I non-small cell lung cancer (NSCLC) has been well described and is considered to have similar survival rates as lobectomy but with increased rates of local tumour recurrence due to inadequate parenchymal margins. In consequence, today segmentectomy is only performed when the tumour is smaller than 2 cm., Methods: Three-dimensional reconstructions from 11 thin-slice CT scans of bronchopulmonary segments were generated, and virtual spherical tumours were placed over the segments, respecting all segmental borders. As a next step, virtual parenchymal safety margins of 2 cm and 3 cm were subtracted and the size of the remaining tumour calculated., Results: The maximum tumour diameters with a 30-mm parenchymal safety margin ranged from 26.1 mm in right-sided segments 7 + 8 to 59.8 mm in the left apical segments 1-3., Conclusions: Using a three-dimensional reconstruction of lung CT scans, we demonstrated that segmentectomy or resection of segmental groups should be feasible with adequate margins, even for larger tumours in selected cases., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)