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Purpose To investigate whether whole-liver enhancing tumor burden [ETB] can serve as an imaging biomarker and help predict survival better than World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST (mRECIST), and European Association for the Study of the Liver (EASL) methods in patients with multifocal, bilobar neuroendocrine liver metastases (NELM) after the first transarterial chemoembolization (TACE) procedure. Materials and Methods This HIPAA-compliant, institutional review board-approved retrospective study included 51 patients (mean age, 57.8 years ± 13.2; range, 13.5-85.8 years) with multifocal, bilobar NELM treated with TACE. The largest area (WHO), longest diameter (RECIST), longest enhancing diameter (mRECIST), largest enhancing area (EASL), and largest enhancing volume (ETB) were measured at baseline and after the first TACE on contrast material-enhanced magnetic resonance images. With three-dimensional software, ETB was measured as more than 2 standard deviations the signal intensity of a region of interest in normal liver. Response was assessed with WHO, RECIST, mRECIST, and EASL methods according to their respective criteria. For ETB response, a decrease in enhancement of at least 30%, 50%, and 65% was analyzed by using the Akaike information criterion. Survival analysis included Kaplan-Meier curves and Cox regressions. Results Treatment response occurred in 5.9% (WHO criteria), 2.0% (RECIST), 25.5% (mRECIST), and 23.5% (EASL criteria) of patients. With 30%, 50%, and 65% cutoffs, ETB response was seen in 60.8%, 39.2%, and 21.6% of patients, respectively, and was the only biomarker associated with a survival difference between responders and nonresponders (45.0 months vs 10.0 months, 84.3 months vs 16.7 months, and 85.2 months vs 21.2 months, respectively; P < .01 for all). The 50% cutoff provided the best survival model (hazard ratio [HR]: 0.2; 95% confidence interval [CI]: 0.1, 0.4). At multivariate analysis, ETB response was an independent predictor of survival (HR: 0.2; 95% CI: 0.1, 0.6). Conclusion Volumetric ETB is an early treatment response biomarker and surrogate for survival in patients with multifocal, bilobar NELM after the first TACE procedure. © RSNA, 2016.

It remains controversial whether transarterial chemoembolization (TACE) should be performed in patients with advanced-stage hepatocellular carcinoma (HCC). The present large retrospective cohort study aimed to define the survival outcome following TACE of advanced HCC and to identify the prognostic factors. Five hundred eight patients with Barcelona Clinic Liver Cancer (BCLC) C-stage HCC, Child-Pugh A/B who were treated with TACE between November 1998 and December 2013 were identified. There was no significant difference in overall survival (OS) between patients with Eastern Cooperative Oncology Group (ECOG) 0 and those with ECOG ≥1 (10.5months vs. 11.9months, P = 0.87). The median OS of patients without portal vein tumor thrombosis (PVTT) was longer than that of patients with PVTT (16.9 vs. 6.1months, P 6.5 (high-risk group) (24.1 vs. 7.5months, respectively; P

To compare the diagnostic accuracy of hand-held point-of-care (POC) versus conventional sonography in a general diagnostic setting with the intention to inform medical providers or clinicians on the rational use of POC ultrasound in resource limited settings.Over 3 months in 2010, 47 patients were prospectively enrolled at a single academic center to obtain 54 clinical conventional ultrasound examinations and 54 study-only POC ultrasound examinations. Indications were 48% abdominal, 26% retroperitoneal, and 24% obstetrical. Nine blinded readers (sonographers, residents, and attending radiologists) sequentially assigned diagnoses to POC and then conventional studies, yielding 476 interpreted study pairs. Diagnostic accuracy was obtained by comparing POC and conventional diagnoses to a reference diagnosis established by the unblinded, senior author. Analysis was stratified by study type, body mass index (BMI), diagnostic confidence, and image quality.The mean diagnostic accuracy of conventional sonography was 84% compared with 74% for POC (P.001). This difference was constant regardless of reader, exam type, or BMI. The sensitivity and specificity to detect abnormalities with conventional was 85 and 83%, compared with 75 and 68% for POC. The POC sonography demonstrated greater variability in image quality and diagnostic confidence, and this accounted for lower diagnostic accuracy. When image quality and diagnostic confidence were similar between POC and conventional examinations, there was no difference in accuracy.Point-of-care was nearly as accurate as conventional sonography for basic, focused examinations. Observed differences in accuracy were attributed to greater variation in POC image quality.

ObjectivesTo investigate the influence of region-of-interest (ROI) placement on 3D tumour enhancement [Quantitative European Association for the Study of the Liver (qEASL)] in hepatocellular carcinoma (HCC) patients treated with transcatheter arterial chemoembolization (TACE).MethodsPhase 1: 40 HCC patients had nine ROIs placed by one reader using systematic techniques (3 ipsilateral to the lesion, 3 contralateral to the lesion, and 3 dispersed throughout the liver) and qEASL variance was measured. Intra-class correlations were computed. Phase 2: 15 HCC patients with histosegmentation were selected. Six ROIs were systematically placed by AC (3 ROIs ipsilateral and 3 ROIs contralateral to the lesion). Three ROIs were placed by 2 radiologists. qEASL values were compared to histopathology by Pearson's correlation, linear regression, and median difference.ResultsPhase 1: The dispersed method (abandoned in phase 2) had low consistency and high variance. Phase 2: qEASL correlated strongly with pathology in systematic methods [Pearson's correlation coefficient = 0.886 (ipsilateral) and 0.727 (contralateral)] and in clinical methods (0.625 and 0.879). However, ipsilateral placement matched best with pathology (median difference: 5.4 %; correlation: 0.89; regression CI: [0.904, 0.1409]).ConclusionsqEASL is a robust method with comparable values among tested placements. Ipsilateral placement showed high consistency and better pathological correlation.Key pointsIpsilateral and contralateral ROI placement produces high consistency and low variance. Both ROI placement methods produce qEASL values that correlate well with histopathology. Ipsilateral ROI placement produces best correlation to pathology along with high consistency.

Identification of major contributors to odour annoyance in areas with multiple emission sources is necessary to address and resolve odour disputes. In an effort to develop an appropriate tool for this task, odour samples were collected on-site at a piggery and an abattoir (the major odour sources in the area) and at surrounding off-site areas, then analysed using a commercial non-specific chemical sensor array to develop an odour fingerprint database. The developed odour fingerprint database was analysed using two pattern recognition algorithms including a partial least squares-discriminant analysis (PLS-DA) and a Kohonen self-organising map (KSOM). The KSOM model could identify odour samples sourced from the piggery shed 15, piggery pond 8, piggery pond 9, abattoir, motel and others with mean percentage values of 77.5, 65.0, 90.2, 75.7, 44.8 and 64.6%, respectively.

A commercial non-specific gas sensor array system was evaluated in terms of its capability to monitor the odour abatement performance of a biofiltration system developed for treating emissions from a commercial piggery building. The biofiltration system was a modular system comprising an inlet ducting system, humidifier and closed-bed biofilter. It also included a gravimetric moisture monitoring and water application system for precise control of moisture content of an organic woodchip medium. Principal component analysis (PCA) of the sensor array measurements indicated that the biofilter outlet air was significantly different to both inlet air of the system and post-humidifier air. Data pre-processing techniques including normalising and outlier handling were applied to improve the odour discrimination performance of the non-specific gas sensor array. To develop an odour quantification model using the sensor array responses of the non-specific sensor array, PCA regression, artificial neural network (ANN) and partial least squares (PLS) modelling techniques were applied. The correlation coefficient (r(2)) values of the PCA, ANN, and PLS models were 0.44, 0.62 and 0.79, respectively.

Continuous odour monitoring technologies are necessary to understand the complex odour-generating mechanisms within poultry housing as well as to identify strategies to reduce the impact of odour emissions on local communities. To evaluate electronic nose (EN) technologies for continuously assessing odour concentration in poultry housing, a mobile laboratory containing an electronic nose and an associated sample delivery system was deployed to a commercial poultry farm and tested over a broiler production cycle. The results demonstrated that it was possible to develop a model to allow an electronic nose to provide a semi-continuous measurement of odour concentrations. The electronic nose was also able to demonstrate the influence of shed conditions on odour emissions.

Metal oxide semiconductor (MOS) sensors are a class of chemical sensors that have potential for being a practical core sensor module for an electronic nose system in various environmental monitoring applications. However, the responses of these sensors may be affected by changes in humidity and this must be taken into consideration when developing calibration models. This paper characterises the humidity dependence of a sensor array which consists of 12 MOS sensors. The results were used to develop calibration models using partial least squares (PLS). Effects of humidity on the response of the sensor array and predictive ability of partial least squares are discussed. It is shown that partial least squares can provide proper calibration models to compensate for effects caused by changes in humidity. Special Issue: Selected Paper from the 12th International Symposium on Olfaction and Electronic Noses - ISOEN 2007, International Symposium on Olfaction and Electronic Noses.

To compare the ability of single- vs. multi-lesion assessment on baseline MRI using 1D- and 3D-based measurements to predict overall survival (OS) in patients with hepatocellular carcinoma (HCC) before transarterial chemoembolization (TACE).This retrospective analysis included 122 patients. A quantitative 3D analysis was performed on baseline MRI to calculate enhancing tumour volume (ETV [cm(3)]) and enhancing tumour burden (ETB [%]) (ratio between ETV [cm(3)] and liver volume). Furthermore, enhancing and overall tumour diameters were measured. Patients were stratified into two groups using thresholds derived from the BCLC staging system. Statistical analysis included Kaplan-Meier plots, uni- and multivariate cox proportional hazard ratios (HR) and concordances.All methods achieved good separation of the survival curves (p 0.05). Multivariate analysis showed an HR of 5.2 (95 % CI 3.1-8.8, p 0.001) for ETV [cm(3)] and HR 6.6 (95 % CI 3.7-11.5, p 0.001) for ETB [%] vs. HR 2.6 (95 % CI 1.2-5.6, p = 0.012) for overall diameter and HR 3.0 (95 % CI 1.5-6.3, p = 0.003) for enhancing diameter. Concordances were highest for ETB [%], with no added predictive power for multi-lesion assessment (difference between concordances not significant).3D quantitative assessment is a stronger predictor of survival as compared to diameter-based measurements. Assessing multiple lesions provides no substantial improvement in predicting OS than evaluating the dominant lesion alone.• 3D quantitative tumour assessment on baseline MRI predicts survival in HCC patients. • 3D quantitative tumour assessment predicts survival better than any current radiological method. • Multiple lesion assessment provides no improvement than evaluating the dominant lesion alone. • Measuring enhancing tumour volume in proportion to liver volume reflects tumour burden.

Replicable experimental studies using a novel experimental facility and a machine-based odour quantification technique were conducted to demonstrate the relationship between odour emission rates and pond loading rates. The odour quantification technique consisted of an electronic nose, AromaScan A32S, and an artificial neural network. Odour concentrations determined by olfactometry were used along with the AromaScan responses to train the artificial neural network. The trained network was able to predict the odour emission rates for the test data with a correlation coefficient of 0.98. Time averaged odour emission rates predicted by the machine-based odour quantification technique, were strongly correlated with volatile solids loading rate, demonstrating the increased magnitude of emissions from a heavily loaded effluent pond. However, it was not possible to obtain the same relationship between volatile solids loading rates and odour emission rates from the individual data. It is concluded that taking a limited number of odour samples over a short period is unlikely to provide a representative rate of odour emissions from an effluent pond. A continuous odour monitoring instrument will be required for that more demanding task.

The rate of odour emission depends on meteorological factors, such as wind speed, humidity and temperature, but no wind tunnels control these factors adequately. A novel laboratory wind tunnel was developed that can control airflow rate. The gas recovery efficiency of the tunnel was evaluated and the aerodynamic characteristics were then examined to further assess its performance. Gas recovery efficiencies ranged from 62 to 107% with an average of 81%. The optimal performance of the tunnel (gas recovery efficiency of 89%) occurred at an airflow rate and CO supply rate of 1·68 m 3 min −1 and 10·0 l min −1 , respectively. The vertical and cross-sectional wind speed profiles exhibited a substantial degree of non-uniformity. The airflow was turbulent, although Reynolds numbers were low indicating it to be close to laminar. The non-uniform wind speed profiles and CO concentration profiles illustrate the difficulty in obtaining representative samples from which to calculate emission rates. Further work is required to improve aerodynamic characteristics and hence performance of the tunnel.

N-Hydroxymethyl-N-methylformamide (HMMF) and N-methylformamide (NMF) in urine samples from workers exposed to N,N-dimethylformamide (DMF) cannot be distinguished by a gas chromatographic method because HMMF is converted to NMF at the injection port of gas chromatography (GC). Total NMF (HMMF+NMF) has been measured instead. Also, the determination of N-acetyl-S-(N-methylcarbamoyl)cystein (AMCC), which is supposed to be related to the toxicity of DMF, needs multiple treatments to convert to a volatile compound before GC analysis. There is no previous report of a simultaneous determination of three major metabolites of DMF in urine. The aim of this study is to develop a simple and selective method for the determination of DMF metabolite in urine. By using a liquid chromatography-tandem mass spectrometry, we can directly distinguish these three major metabolites of DMF in a single run. The diluted urine samples were analyzed on Capcell Pak MF SG80 column with the mobile phase of methanol in 2mM formic acid (10:90, v/v). The analytes were detected by an electrospray ionization tandem mass spectrometry in the multiple-reaction-monitoring mode. The standard curves were linear (r>0.999) over the concentration ranges of 0.004-8 microg/mL. The precision and accuracy of quality control samples for inter-batch (n=6) analyses were in the range of 1.3-9.8% and 94.7-116.8, respectively. The sum of each HMMF and NMF concentration determined by LC-MS/MS method shows high correlation (r=0.9927 with the slope of 1.0415, p

An Artificial Neural Network (ANN) and an electronic nose, AromaScan, were used to predict the piggery odour concentrations emanating from an effluent pond and to develop a confident, rapid, and cost-effective technique for odour measurement. Odour samples from five different piggery effluent ponds were analysed using the AromaScan and dynamic dilution olfactometry. The resulting sensor data were used to train the artificial neural network to correlate the responses to the odour concentrations measured by olfactometry. Effectiveness was evaluated through simulation with various pre-processing techniques and network architectures. The simulation results have shown that a two-layer back-propagation neural network, which has a tan-sigmoid transfer function in the hidden layer and a linear transfer function in the output layer, could be trained to predict piggery odour concentrations with high value of the correlation coefficient R of 0·984 under the best network performance. The results from the application of scaling and principal component analysis suggest that these techniques are necessary not only to avoid the failure of the network caused by saturation but also to enhance performance. An early stopping technique was shown to provide benefits to the network performance in terms of a decrease in computation time and overfitting. It was found that the optimal number of hidden neurons for the network was 20. Odour concentration of unknown samples were able to be predicted with significant accuracy.

Background & aimsThere is debate over the best way to stage hepatocellular carcinoma (HCC). We attempted to validate the prognostic and clinical utility of the recently developed Hong Kong Liver Cancer (HKLC) staging system, a hepatitis B-based model, and compared data with that from the Barcelona Clinic Liver Cancer (BCLC) staging system in a North American population that underwent intra-arterial therapy (IAT).MethodsWe performed a retrospective analysis of data from 1009 patients with HCC who underwent IAT from 2000 through 2014. Most patients had hepatitis C or unresectable tumors; all patients underwent IAT, with or without resection, transplantation, and/or systemic chemotherapy. We calculated HCC stage for each patient using 5-stage HKLC (HKLC-5) and 9-stage HKLC (HKLC-9) system classifications, and the BCLC system. Survival information was collected up until the end of 2014 at which point living or unconfirmed patients were censored. We compared performance of the BCLC, HKLC-5, and HKLC-9 systems in predicting patient outcomes using Kaplan-Meier estimates, calibration plots, C statistic, Akaike information criterion, and the likelihood ratio test.ResultsMedian overall survival time, calculated from first IAT until date of death or censorship, for the entire cohort (all stages) was 9.8 months. The BCLC and HKLC staging systems predicted patient survival times with significance (P < .001). HKLC-5 and HKLC-9 each demonstrated good calibration. The HKLC-5 system outperformed the BCLC system in predicting patient survival times (HKLC C= 0.71, Akaike information criterion= 6242; BCLC C= 0.64, Akaike information criterion= 6320), reducing error in predicting survival time (HKLC reduced error by 14%, BCLC reduced error by 12%), and homogeneity (HKLC chi-square= 201, P < .001; BCLC chi-square= 119, P < .001) and monotonicity (HKLC linear trend chi-square= 193, P < .001; BCLC linear trend chi-square= 111, P < .001). Small proportions of patients with HCC of stages IV or V, according to the HKLC system, survived for 6 months and 4 months, respectively.ConclusionsIn a retrospective analysis of patients who underwent IAT for unresectable HCC, we found the HKLC-5 staging system to have the best combination of performances in survival separation, calibration, and discrimination; it consistently outperformed the BCLC system in predicting survival times of patients. The HKLC system identified patients with HCC of stages IV and V who are unlikely to benefit from IAT.

Quality improvement (QI) projects are an integral part of today's radiology practice, helping identify opportunities for improving outcomes by refining work processes. QI projects are typically driven by outcome measures, but the data can be difficult to interpret: The numbers tend to fluctuate even before a process is altered, and after a QI intervention takes place, it may be even more difficult to determine the cause of such vacillations. Control chart analysis helps the QI project team identify variations that should be targeted for intervention and avoid tampering in processes in which variation is random or harmless. Statistical control charts make it possible to distinguish among random variation or noise in the data, outlying tendencies that should be targeted for future intervention, and changes that signify the success of previous intervention. The data on control charts are plotted over time and integrated with various graphic devices that represent statistical reasoning (eg, control limits) to allow visualization of the intensity and overall effect-negative or positive-of variability. Even when variability has no substantial negative effect, appropriate intervention based on the results of control chart analysis can help increase the efficiency of a process by optimizing the central tendency of the outcome measure. Different types of control charts may be used to analyze the same outcome dataset: For example, paired charts of individual values (x) and the moving range (mR) allow robust and reliable analyses of most types of data from radiology QI projects. Many spreadsheet programs and templates are available for use in creating x-mR charts and other types of control charts.

Continued population growth, expansion of poultry production and urban encroachment has resulted in increased odour complaints from local residents. Odour management has typically been based on buffer distances, however poultry expansion now requires accurate and reliable odour monitoring data for setting-up new broiler sheds and enlarging existing farms. Current olfactory and chemical based methods do not provide effective real-time monitoring, particularly for detecting unknown compounds. Senso-instrumental systems such as eNOSE offer potential odour monitoring opportunities, however current non-specific sensor array configurations are inappropriate for detecting the major contributing odorants to odour annoyance. GC-MS/O analysis of poultry shed emissions was used to identify the major contributing volatile organic compounds in terms of odour impact and chemical abundance. These compounds can now be used to develop sensor array configurations that detect odorous compounds associated with poultry shed emissions.

In Australia, factors such as local planning processes, urban encroachment into rural areas and intensification of the poultry industry have increased the potential for odour and dust nuisance. At present, accurate estimates of odour emissions from mechanically ventilated poultry housing systems do not exist for Australian conditions. This has made the poultry industry vulnerable to unsubstantiated criticism. Recently, the Australian poultry industry have made a significant investment in research to obtain accurate estimates of odour, dust and volatile chemical emission rates from typical poultry housing systems. This paper describes the measurement of odour emissions from tunnel ventilated poultry housing systems in different climatic zones in Queensland and Victoria, Australia (humid sub-tropical and Mediterranean respectively) during two seasons (summer and winter). Samples were collected at defined intervals over typical batch production cycles to define the odour emission profiles. These samples were analysed using dynamic olfactometry according to the Australian Standard 4323.3 to derive the odour concentration values. Ventilation rates were measured concurrently, allowing the calculation of odour emission rates. Odour concentration and emission rates were assessed in terms of ventilation rate, ambient and shed air temperature and relative humidity and litter moisture status. Odour emission rates varied with bird age. Seasonal differences in odour emission rate were also observed.

’ FEATURED ABSTRACT Hong Kong liver cancer staging outperforms Barcelona clinic liver cancer staging as a prognostic classification system in patients treated with intra-arterial therapy: a North American study J. Sohn, R. Duran, H. Lee, S. Sahu, R. E. Schernthaner, L. Zhao, M. Lin, F. N. Fleckenstein, Y. Zhao, J.H. Geschwind; Interventional Radiology, Johns Hopkins Hospital, Baltimore, MD; U/S Imaging and Interventions (UII), Philips Research North America, Barcliff Manor, NY

TPS503 Background: In transarterial chemoembolization (TACE) for primary and metastatic liver malignancies ethiodized oil (Lipiodol) serves 3 roles: vehicle to deliver high concentration of the chemotherapeutic agent to the tumor, embolic agent to the tumor feeding artery and a contrast agent. The latter allows for intraprocedural visualization during drug delivery. Because of increased retention in liver tumors, Lipiodol can be visualized post-TACE for several weeks to months. Controversial preclinical and clinical data have been published about the role of Lipiodol as an imaging biomarker for treatment success after TACE. Here we investigate whether increased tumor Lipiodol deposition correlates with tumor response and survival using multimodality imaging and radiological/pathological correlation. Methods: This is a prospective phase 2, single center, IRB-approved study. Inclusion criteria include adult patients (Child-Pugh class of A or B and ECOG performance status of 0-2) with unresectable HCC with liver predominant disease or hepatic metastases from any solid tumor. Dynamic contrast-enhanced (DCE) MRI and CT of the liver and PET-CT were obtained before TACE. 24 hours after TACE, a noncontrast CT of the liver was obtained to quantify Lipiodol retention in the targeted tumor. Follow-up imaging consisting of DCE-MRI, CT and PET–CT were also performed approximately 1, 3 and 6 months after the last TACE. Follow up imaging will continue every 2-3 months for up to 4 years. Percent deposition of Lipiodol in the targeted tumor was assessed using 3D quantitative analysis on the 24hr post-TACE CT. Tumor response using RECIST, EASL, modified RECIST, tumor volume (volumetric RECIST), and volumetric tumor enhancement (quantitative EASL) were performed on the DCE-MRI, CT, and PET-CT, and correlated with Lipiodol deposition. Spearman rank correlation coefficient and Pearson’s product-moment correlation were used. The Kaplan-Meier method with the log-rank test was used to assess whether Lipiodol is a biomarker of survival. 12/30 patients with HCC and 12/30 patients with hepatic metastases have been enrolled (#NCT01877187). Clinical trial information: NCT01877187.

Odour emission rates were measured from nine tunnel-ventilated broiler farms in south-eastern Queensland, Australia. At one farm, odour emission rates were measured over two sequential batches approximately weekly, while at the remaining farms, odour emission rates were measured just before the first pickup (around Day 35 of the batch) when bird liveweight was greatest and peak odour emission rates were expected. Odour samples were analysed using dynamic olfactometry (to AS/NZS 4323.3:2001), and an artificial olfaction system was used to continuously monitor odour emission rates at one farm. Odour emission rates ranged from 330 to 2960 ou/s per 1000 birds and from 0.19 to 2.12 ou/s.kg, with a significant amount of variability observed throughout the batch and throughout each sampling day. While the wide range in odour emission rates was primarily due to changes in bird liveweight and ventilation requirements, other factors were also involved. The artificial olfaction system proved useful for quantifying the range and variability of odour emission rates, especially when olfactometry analysis was impractical.

PURPOSE Liver metastases from renal cell carcinoma (RCC) are not uncommon in the course of disease. However, data about tumor response to intraarterial therapy (IAT) are scarce. This study assessed whether changes of enhancing tumor volume using quantitative European Association for the Study of the Liver (qEASL) on magnetic resonance imaging (MRI) and computed tomography (CT) can evaluate tumor response and predict overall survival (OS) early after therapy. METHODS AND MATERIALS Fourteen patients with liver metastatic RCC treated with IAT (transarterial chemoembolization: n= 9 and yttrium-90: n= 5) were retrospectively included. All patients underwent contrast-enhanced imaging (MRI: n= 10 and CT: n= 4) 3 to 4 weeks pre- and posttreatment. Response to treatment was evaluated on the arterial phase using Response Evaluation Criteria in Solid Tumors (RECIST), World Health Organization, modified RECIST, EASL, tumor volume, and qEASL. Paired t test was used to compare measurements pre- and post-IAT. Patients were stratified into responders (≥65% decrease in qEASL) and nonresponders (