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Abstract Objective To evaluate the impact of a postoperative baseline (PB) MRI on diagnostic confidence and performance in detecting local recurrence (LR) of soft-tissue sarcoma (STS) of the limb. Materials and methods A total of 72 patients (8 with LR, 64 without LR) with primary STS of the limb were included. Routine follow-up MRI (1.5 T) at 6 and approximately 36 months (meanLR: 39.7 months; meanno LR: 34.9 months) after multimodal therapy or at time of LR were assessed by three independent readers using a 5-point Likert scale. Furthermore, the following imaging parameters were evaluated: presence of a mass, signal characteristics at T2- and T1-weighted imaging, contrast enhancement (CE), and in some of the cases signal intensity on the apparent diffusion coefficient (ADC). U-test, McNemar test, and ROC-analysis were applied. Interobserver reliability was calculated using Fleiss kappa statistics. A p value of 0.05 was considered statistically significant. Results The presence of a PB MRI significantly improved diagnostic confidence in detecting LR of STS (p κ: 73.1–83.6; 0.34) followed by T2-hyperintensity (50.8–66.7; 0.08), CE (52.4–62.5; 0.13), and T1-hypointensity (54.7–77.3; 0.23). ADC showed an AUC of 65.6–96.6% and a κ of 0.55. Conclusion The presence of a PB MRI increases diagnostic confidence in detecting LR of STS of the limb.

Floquet engineering offers a compelling approach for designing the time evolution of periodically driven systems. We implement a periodic atom-light coupling to realize Floquet atom optics on the strontium ${}^1\!S_0\,\text{-}\, {}^3\!P_1$ transition. These atom optics reach pulse efficiencies above $99.4\%$ over a wide range of frequency offsets between light and atomic resonance, even under strong driving where this detuning is on the order of the Rabi frequency. Moreover, we use Floquet atom optics to compensate for differential Doppler shifts in large momentum transfer atom interferometers and achieve state-of-the-art momentum separation in excess of $400~\hbar k$. This technique can be applied to any two-level system at arbitrary coupling strength, with broad application in coherent quantum control., Comment: 5 pages, 3 figures, plus supplemental material

Background Radiology reporting of emergency whole-body computed tomography (CT) scans is time-critical and therefore involves a significant risk of pathology under-detection. We hypothesize a relevant number of initially missed secondary thoracic findings that would have been detected by an artificial intelligence (AI) software platform including several pathology-specific AI algorithms. Methods This retrospective proof-of-concept-study consecutively included 105 shock-room whole-body CT scans. Image data was analyzed by platform-bundled AI-algorithms, findings were reviewed by radiology experts and compared with the original radiologist's reports. We focused on secondary thoracic findings, such as cardiomegaly, coronary artery plaques, lung lesions, aortic aneurysms and vertebral fractures. Results We identified a relevant number of initially missed findings, with their quantification based on 105 analyzed CT scans as follows: up to 25 patients (23.8%) with cardiomegaly or borderline heart size, 17 patients (16.2%) with coronary plaques, 34 patients (32.4%) with aortic ectasia, 2 patients (1.9%) with lung lesions classified as "recommended to control" and 13 initially missed vertebral fractures (two with an acute traumatic origin). A high number of false positive or non-relevant AI-based findings remain problematic especially regarding lung lesions and vertebral fractures. Conclusions We consider AI to be a promising approach to reduce the number of missed findings in clinical settings with a necessary time-critical radiological reporting. Nevertheless, algorithm improvement is necessary focusing on a reduction of "false positive" findings and on algorithm features assessing the finding relevance, e.g., fracture age or lung lesion malignancy.

MR-guided high-intensity focused ultrasound (MR-HIFU) is an effective method for treating symptomatic uterine fibroids, especially solitary lesions. The aim of our study was to compare the clinical and morphological outcomes of patients who underwent MR-HIFU due to solitary fibroid (SF) or multiple fibroids (MFs) in a prospective clinical trial. We prospectively included 21 consecutive patients with SF (10) and MF (11) eligible for MR-guided HIFU. The morphological data were assessed using mint Lesion™ for MRI. The clinical data were determined using the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire before and 6 months after treatment. Unpaired and paired Wilcoxon-test and t-tests were applied, and Pearson’s coefficient was used for correlation analysis. A p-value of 0.05 was considered statistically significant. The volume of treated fibroids significantly decreased in both the SF (mean baseline: 118.6 cm3; mean 6-month follow-up: 64.6 cm3) and MF (107.2 cm3; 55.1 cm3) groups. The UFS-QOL showed clinical symptoms significantly improved for patients in both the SF and MF groups regarding concern, activities, energy/mood, and control. The short-term outcome for the treatment of symptomatic fibroids in myomatous uterus by MR-guided HIFU is clinically similar to that of solitary fibroids.

(1) Background: Time-consuming SARS-CoV-2 RT-PCR suffers from limited sensitivity in early infection stages whereas fast available chest CT can already raise COVID-19 suspicion. Nevertheless, radiologists&rsquo, performance to differentiate COVID-19, especially from influenza pneumonia, is not sufficiently characterized. (2) Methods: A total of 201 pneumonia CTs were identified and divided into subgroups based on RT-PCR: 78 COVID-19 CTs, 65 influenza CTs and 62 Non-COVID-19-Non-influenza (NCNI) CTs. Three radiology experts (blinded from RT-PCR results) raised pathogen-specific suspicion (separately for COVID-19, influenza, bacterial pneumonia and fungal pneumonia) according to the following reading scores: 0&mdash, not typical/1&mdash, possible/2&mdash, highly suspected. Diagnostic performances were calculated with RT-PCR as a reference standard. Dependencies of radiologists&rsquo, pathogen suspicion scores were characterized by Pearson&rsquo, s Chi2 Test for Independence. (3) Results: Depending on whether the intermediate reading score 1 was considered as positive or negative, radiologists correctly classified 83&ndash, 85% (vs. NCNI)/79&ndash, 82% (vs. influenza) of COVID-19 cases (sensitivity up to 94%). Contrarily, radiologists correctly classified only 52&ndash, 56% (vs. NCNI)/50&ndash, 60% (vs. COVID-19) of influenza cases. The COVID-19 scoring was more specific than the influenza scoring compared with suspected bacterial or fungal infection. (4) Conclusions: High-accuracy COVID-19 detection by CT might expedite patient management even during the upcoming influenza season.

(1) Background: Chest radiography (CXR) is still a key diagnostic component in the emergency department (ED). Correct interpretation is essential since some pathologies require urgent treatment. This study quantifies potential discrepancies in CXR analysis between radiologists and non-radiology physicians in training with ED experience. (2) Methods: Nine differently qualified physicians (three board-certified radiologists [BCR], three radiology residents [RR], and three non-radiology residents involved in ED [NRR]) evaluated a series of 563 posterior-anterior CXR images by quantifying suspicion for four relevant pathologies: pleural effusion, pneumothorax, pneumonia, and pulmonary nodules. Reading results were noted separately for each hemithorax on a Likert scale (0–4; 0: no suspicion of pathology, 4: safe existence of pathology) adding up to a total of 40,536 reported pathology suspicions. Interrater reliability/correlation and Kruskal–Wallis tests were performed for statistical analysis. (3) Results: While interrater reliability was good among radiologists, major discrepancies between radiologists’ and non-radiologists’ reading results could be observed in all pathologies. Highest overall interrater agreement was found for pneumothorax detection and lowest agreement in raising suspicion for malignancy suspicious nodules. Pleural effusion and pneumonia were often suspected with indifferent choices (1–3). In terms of pneumothorax detection, all readers mainly decided for a clear option (0 or 4). Interrater reliability was usually higher when evaluating the right hemithorax (all pathologies except pneumothorax). (4) Conclusions: Quantified CXR interrater reliability analysis displays a general uncertainty and strongly depends on medical training. NRR can benefit from radiology reporting in terms of time efficiency and diagnostic accuracy. CXR evaluation of long-time trained ED specialists has not been tested.

International audience; In contrast to light, matter-wave optics of quantum gases deals with interactions even in free space and for ensembles comprising millions of atoms. We exploit these interactions in a quantum degenerate gas as an adjustable lens for coherent atom optics. By combining an interaction-driven quadrupole-mode excitation of a Bose-Einstein condensate (BEC) with a magnetic lens, we form a time-domain matter-wave lens system. The focus is tuned by the strength of the lensing potential and the oscillatory phase of the quadrupole mode. By placing the focus at infinity, we lower the total internal kinetic energy of a BEC comprising 101(37) thousand atoms in three dimensions to 3/2 kB⋅38+6−7 pK. Our method paves the way for free-fall experiments lasting ten or more seconds as envisioned for tests of fundamental physics and high-precision BEC interferometry, as well as opens up a new kinetic energy regime.

OBJECTIVES Chest radiographs (CXRs) are commonly performed in emergency units (EUs), but the interpretation requires radiology experience. We developed an artificial intelligence (AI) system (precommercial) that aims to mimic board-certified radiologists' (BCRs') performance and can therefore support non-radiology residents (NRRs) in clinical settings lacking 24/7 radiology coverage. We validated by quantifying the clinical value of our AI system for radiology residents (RRs) and EU-experienced NRRs in a clinically representative EU setting. MATERIALS AND METHODS A total of 563 EU CXRs were retrospectively assessed by 3 BCRs, 3 RRs, and 3 EU-experienced NRRs. Suspected pathologies (pleural effusion, pneumothorax, consolidations suspicious for pneumonia, lung lesions) were reported on a 5-step confidence scale (sum of 20,268 reported pathology suspicions [563 images × 9 readers × 4 pathologies]) separately by every involved reader. Board-certified radiologists' confidence scores were converted into 4 binary reference standards (RFSs) of different sensitivities. The RRs' and NRRs' performances were statistically compared with our AI system (trained on nonpublic data from different clinical sites) based on receiver operating characteristics (ROCs) and operating point metrics approximated to the maximum sum of sensitivity and specificity (Youden statistics). RESULTS The NRRs lose diagnostic accuracy to RRs with increasingly sensitive BCRs' RFSs for all considered pathologies. Based on our external validation data set, the AI system/NRRs' consensus mimicked the most sensitive BCRs' RFSs with areas under ROC of 0.940/0.837 (pneumothorax), 0.953/0.823 (pleural effusion), and 0.883/0.747 (lung lesions), which were comparable to experienced RRs and significantly overcomes EU-experienced NRRs' diagnostic performance. For consolidation detection, the AI system performed on the NRRs' consensus level (and overcomes each individual NRR) with an area under ROC of 0.847 referenced to the BCRs' most sensitive RFS. CONCLUSIONS Our AI system matched RRs' performance, meanwhile significantly outperformed NRRs' diagnostic accuracy for most of considered CXR pathologies (pneumothorax, pleural effusion, and lung lesions) and therefore might serve as clinical decision support for NRRs.

MAGIS-100 is a next-generation quantum sensor under construction at Fermilab that aims to explore fundamental physics with atom interferometry over a 100-meter baseline. This novel detector will search for ultralight dark matter, test quantum mechanics in new regimes, and serve as a technology pathfinder for future gravitational wave detectors in a previously unexplored frequency band. It combines techniques demonstrated in state-of-the-art 10-meter-scale atom interferometers with the latest technological advances of the world's best atomic clocks. MAGIS-100 will provide a development platform for a future kilometer-scale detector that would be sufficiently sensitive to detect gravitational waves from known sources. Here we present the science case for the MAGIS concept, review the operating principles of the detector, describe the instrument design, and study the detector systematics., Comment: 65 pages, 18 figures

We report the first realization of large momentum transfer (LMT) clock atom interferometry. Using single-photon interactions on the strontium ${}^1S_0 - {}^3P_1$ transition, we demonstrate Mach-Zehnder interferometers with state-of-the-art momentum separation of up to $141\,\hbar k$ and gradiometers of up to $81\,\hbar k$. Moreover, we circumvent excited state decay limitations and extend the gradiometer duration to 50 times the excited state lifetime. Because of the broad velocity acceptance of the interferometry pulses, all experiments are performed with laser-cooled atoms at a temperature of $3\,\mu \text{K}$. This work has applications in high-precision inertial sensing and paves the way for LMT-enhanced clock atom interferometry on even narrower transitions, a key ingredient in proposals for gravitational wave detection and dark matter searches., Comment: 6 pages, 4 figures

Blood flow through the cavities of the heart and great vessels is pulsatile and is subject to time and multidirectional variations. To date, the recording of blood flow in multiple directions and phases has been limited. 4D-flow MRI offers advantages for the recording, visualization and analysis of blood flow. The status quo of the method was summarized through analysis with the PubMed database using the keywords "4D-flow MRI, phase-contrast magnetic resonance imaging, MR flow imaging/visualization, MR flow quantification, 3 D cine (time-resolved) phase-contrast CMR, three-directional velocity-encoding MRI". This review summarizes the current status of the technical development of 4D-flow MRI, discusses its advantages and disadvantages and describes clinical applications. Finally, the most important principles and parameters are explained to give the reader relevant information about clinical indications, postprocessing methods and limitations of the method. · 4D-Fluss-MRT. · 3-dimensionale zeitaufgelöste Phasenkontrast-MRT. · Flussanalyse-MRT (Wall-Shear-Stress/Druckgradienten-Messung/Vortex-Fluss/turbulente kinetische Energie/Flussgeschwindigkeit/Flussrate).· Sträter A, Huber A, Rudolph J et al. 4D-Flow MRI: Technique and Applications. Fortschr Röntgenstr 2018; 190: 1025 - 1035. Der Blutfluss durch das Herz und die großen Gefäße erfolgt pulsatil und unterliegt zeitlichen wie auch multidirektionalen Schwankungen. Bisher ist die Erfassung des Blutflusses in alle Richtungen und Phasen deutlich limitiert. Die MRT-gestützte 4D-Flussmessung ist eine fortschrittliche Methode zur Erfassung, Darstellung und Analyse von Flussverhältnissen in den Gefäßen. Basierend auf einer Literaturrecherche in der PubMed-Datenbank mit den Begriffen „4D-Flow-MRI, Phase-contrast magnetic-resonance-imaging, MR-flow-imaging/-visualization, MR-Flow-quantification, 3D-cine (time-resolved) phase-contrast CMR, three-directional velocity-encoding MR“ wurde der aktuelle Stand der Methode in dieser Übersichtsarbeit zusammengefasst. Diese Übersichtsarbeit fasst den aktuellen Stand der technischen Entwicklung der 4D-Flussmessung zusammen, diskutiert ihre Vor- und Nachteile und zeigt Anwendungsmöglichkeiten auf. Schließlich werden die wichtigsten Prinzipien und Parameter erklärt, sodass der Leser über die Anwendung der Methode, die möglichen klinischen Indikationen, die Auswertung verschiedener Parameter durch Post-processing-Methoden und die Limitationen des Verfahrens relevante Informationen erhält. · 4D-Fluss-MRT. · 3-dimensionale zeitaufgelöste Phasenkontrast-MRT. · Flussanalyse-MRT (Wall-Shear-Stress/Druckgradienten-Messung/Vortex-Fluss/turbulente kinetische Energie/Flussgeschwindigkeit/Flussrate).· Sträter A, Huber A, Rudolph J et al. 4D-Flow MRI: Technique and Applications. Fortschr Röntgenstr 2018; 190: 1025 – 1035.

Atom interferometers have a multitude of proposed applications in space including precise measurements of the Earth's gravitational field, in navigation & ranging, and in fundamental physics such as tests of the weak equivalence principle (WEP) and gravitational wave detection. While atom interferometers are realized routinely in ground-based laboratories, current efforts aim at the development of a space compatible design optimized with respect to dimensions, weight, power consumption, mechanical robustness and radiation hardness. In this paper, we present a design of a high-sensitivity differential dual species $^{85}$Rb/$^{87}$Rb atom interferometer for space, including physics package, laser system, electronics and software. The physics package comprises the atom source consisting of dispensers and a 2D magneto-optical trap (MOT), the science chamber with a 3D-MOT, a magnetic trap based on an atom chip and an optical dipole trap (ODT) used for Bose-Einstein condensate (BEC) creation and interferometry, the detection unit, the vacuum system for $10^{-11}$ mbar ultra-high vacuum generation, and the high-suppression factor magnetic shielding as well as the thermal control system. The laser system is based on a hybrid approach using fiber-based telecom components and high-power laser diode technology and includes all laser sources for 2D-MOT, 3D-MOT, ODT, interferometry and detection. Manipulation and switching of the laser beams is carried out on an optical bench using Zerodur bonding technology. The instrument consists of 9 units with an overall mass of 221 kg, an average power consumption of 608 W (819 W peak), and a volume of 470 liters which would well fit on a satellite to be launched with a Soyuz rocket, as system studies have shown., 30 pages, 23 figures, accepted for publication in Experimental Astronomy

Quantum sensors based on coherent matter-waves are precise measurement devices whose ultimate accuracy is achieved with Bose-Einstein condensates (BEC) in extended free fall. This is ideally realized in microgravity environments such as drop towers, ballistic rockets and space platforms. However, the transition from lab-based BEC machines to robust and mobile sources with comparable performance is a challenging endeavor. Here we report on the realization of a miniaturized setup, generating a flux of $4 \times 10^5$ quantum degenerate $^{87}$Rb atoms every 1.6$\,$s. Ensembles of $1 \times 10^5$ atoms can be produced at a 1$\,$Hz rate. This is achieved by loading a cold atomic beam directly into a multi-layer atom chip that is designed for efficient transfer from laser-cooled to magnetically trapped clouds. The attained flux of degenerate atoms is on par with current lab-based BEC experiments while offering significantly higher repetition rates. Additionally, the flux is approaching those of current interferometers employing Raman-type velocity selection of laser-cooled atoms. The compact and robust design allows for mobile operation in a variety of demanding environments and paves the way for transportable high-precision quantum sensors., 22 pages, 6 figures