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Images from 64 patients undergoing an enhanced abdominal-pelvis scan at portal phase in dual-energy CT mode for the diagnosis of colitis or bowel obstruction were retrospectively analyzed. Acquisitions were performed on a third-generation dual-source CT (DSCT) 100/Sn150 kVp. Mixed images were generated, as well as virtual monoenergetic images (VMIs) at 40/50/60/70 keV. Objective image quality was assessed on VMIs and mixed images by measuring contrast, noise and contrast-to-noise ratio (CNR). Noise, smoothing and overall image quality were subjectively analyzed by two radiologists using Likert scales. For both patient groups, the noise decreased significantly according to the energy level from 40 to 60 keV by -47.2 ± 24.0% for bowel obstruction and -50.4 ± 18.2% for colitis. It was similar between 60 and 70 keV ( p = 0.475 and 0.059, respectively). Noise values were significantly higher in VMIs than in mixed images, except for 70 keV ( p = 0.53 and 0.071, respectively). Similar results were observed for contrast values, with a decrease between 40 and 70 keV of -56.3 ± 7.9% for bowel obstruction -56.2 ± 10.9% for colitis. The maximum CNR value was found at 60 keV compared to other energy levels and mixed images, but there was no significant difference with the other energy levels apart from 70 keV (-9.7 ± 9.8%) for bowel obstruction and 40 keV (-6.6 ± 8.2%) and 70 keV (-5.8 ± 9.2%) for colitis. The VMIs at 60 keV presented higher scores for all criteria for bowel obstruction and colitis, with no significant difference in smoothing score compared to mixed images ( p = 0.119 and p = 0.888, respectively).

Classical novae are thermonuclear explosions in stellar binary systems, and important sources of 26 Al and 22 Na. While γ rays from the decay of the former radioisotope have been observed throughout the Galaxy, 22 Na remains untraceable. Its half-life (2.6 yr) would allow the observation of its 1.275 MeV γ-ray line from a cosmic source. However, the prediction of such an observation requires good knowledge of its nucleosynthesis. The 22 Na(p, γ) 23 Mg reaction remains the only source of large uncertainty about the amount of 22 Na ejected. Its rate is dominated by a single resonance on the short-lived state at 7785.0(7) keV in 23 Mg. Here, we propose a combined analysis of particle-particle correlations and velocity-difference profiles to measure femtosecond nuclear lifetimes. The application of this method to the study of the 23 Mg states, places strong limits on the amount of 22 Na produced in novae and constrains its detectability with future space-borne observatories., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Purpose: The purpose of this study was to evaluate whether concomitant left gastric vein embolization (LGVE) during transjugular intrahepatic portosystemic shunt (TIPS) for acute variceal hemorrhage could reduce the risk of bleeding recurrence., Material and Method: A national multicenter observational study was conducted in 14 centers between January 2019 and December 2020. All cirrhotic patients who underwent TIPS placement for acute variceal bleeding were included. During TIPS procedure, size of left gastric vein (LGV), performance of LGVE, material used for LGVE and portosystemic pressure gradient (PPG) before and after TIPS placement were collected. A propensity score for the occurrence of LGVE was calculated to assess effect of LGVE on rebleeding recurrence at six weeks and one year., Results: A total of 356 patients were included (mean age 57.3 ± 10.8 [standard deviation] years; 283/356 [79%] men). Median follow-up was 11.2 months [interquartile range: 1.2, 13.3]. The main indication for TIPS was pre-emptive TIPS (162/356; 46%), rebleeding despite secondary prophylaxis (105/356; 29%), and salvage TIPS (89/356; 25%). Overall, 128/356 (36%) patients underwent LGVE during TIPS procedure. At six weeks and one year, rebleeding-free survival did not differ significantly between patients who underwent LGVE and those who did not (6/128 [5%] vs. 15/228 [7%] at six weeks, and 11/128 [5%] vs. 22/228 [7%] at one year, P = 0.622 and P = 0.889 respectively). A total of 55 pairs of patients were retained after propensity score matching. In patients without LGVE, the rebleeding rate was not different from those with LGVE (3/55 [5%] vs. 4/55 [7%], P > 0.99, and 5/55 [9%] vs. 6/55[11%], P > 0.99, at six weeks and one year respectively). Multivariable analysis identified PPG after TIPS placement as the only predictor of bleeding recurrence (hazard ratio = 1.09; 95% confidence interval: 1.02-1.18; P = 0.012)., Conclusion: In this multicenter national real-life study, we did not observe any benefit of concomitant LGVE during TIPS placement for acute variceal bleeding on bleeding recurrence rate., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: Several studies have suggested a strong relationship between the number of peripherally inserted central catheter (PICC) lumens and the risk of complications. The purpose of this study is to evaluate the impact of the intervention of a clinical pharmacist (CP) on the number of lumens of PICC inserted and assess PICC-related complications., Method: This prospective monocentric study included all consecutive patients from 5 different units who underwent PICC insertions from September 2017 to March 2018. In the intervention group, the CP validated the pertinence of each PICC request according to the patients' records, choice of device (single or double lumen), and incompatibilities between treatments. The control group consisted of patients who underwent PICC insertions without a CP intervention. Complications were prospectively recorded up to PICC removal. Multivariate analyses adjusted for sex, age, and PICC line duration were performed., Results: In the intervention group, 207 PICCs were inserted, 81.2% (n = 168) were single-lumen devices and 18.8% (n = 39) were double-lumen devices. In the control group (n = 77), the use of single-lumen PICCs was significantly lower (n = 48, 62.3%; P = 0.002). After intervention, the overall complication incidence rate decreased from 4.42 to 3.23 per 1000 catheter days ( P = 0.082). Considering the overall population, 216 single-lumen PICCs were inserted with significantly fewer complications than double-lumens (respectively n = 16, 16/216 = 7.4%, versus n = 15, 15/68 = 22.1%, P = 0.002). The adjusted odds ratio of double-lumen PICC was 3.83 (95% confidence interval, 1.46-10.07; P = 0.007)., Conclusions: Our study showed the intervention of a CP in the PICC insertion process could increase the use of single-lumen PICCs and tended to reduce associated complications., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: This study aimed to retrospectively analyze dosimetric indicators recorded since 2012 for thoracic, abdominal or pelvic embolizations to evaluate the contribution of new tools and technologies in dose reduction. Methods: Dosimetric indicators (dose area product (DAP) and air kerma (AK)) from 1449 embolizations were retrospectively reviewed from August 2012 to March 2022. A total of 1089 embolizations were performed in an older fixed C-Arm system (A1), 222 in a newer fixed C-Arm system (A2) and 138 in a 4DCT system (A3). The embolization procedures were gathered to compare A1, A2 and A3. Results: DAP were significantly lower with A2 compared to A1 for all procedures (median −50% ± 5%, p < 0.05), except for uterine elective embolizations and gonadal vein embolization. The DAP values were significantly lower with A3 than with A1 (p < 0.001). CT scan was used for guidance in 90% of embolization procedures. Conclusions: The last C-Arm technology allowed a median reduction of 50% of the X-ray dose. The implementation of a CT scan inside the IR room allowed for more precise 3D-guidance with no increase of the dose delivered.

Severe impairment of social functioning is the core feature of schizophrenia that persists despite treatment, and contributes to chronic functional disability. Abnormal non-verbal behaviors have been reported during interpersonal interactions but the temporal coordination of co-speech gestures with language abilities have been poorly studied to date in this pathology. Using the dynamical systems framework, the goal of the current study was to investigate whether gestures and speech synchrony is impaired in schizophrenia, exploring a new approach to report communicational skill disorders. Performing the first continuous kinematic-acoustic analysis in individuals with schizophrenia, we examined gesture-speech synchrony in solo spontaneous speech and in sensorimotor synchronization task. The experimental group consisted of twenty-eight participants with a diagnosis of schizophrenia and the control group consisted of twenty-four healthy participants age-gender-education matched. The results showed that spontaneous gesture-speech synchrony was preserved while intentional finger tapping-speech synchrony was impaired. In sensorimotor synchronization task, the schizophrenia group displayed greater asynchronies between finger tapping and syllable uttering and lower stability of coordination patterns. These findings suggest a specific deficit in time delay of information circulation and processing, especially in explicit functions. Thus, investigating intrapersonal coordination in schizophrenia may constitute a promising window into brain/behavior dynamic relationship., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The reduced transition probabilities for the 4&#95;{1}^{+}→2&#95;{1}^{+} and 2&#95;{1}^{+}→0&#95;{1}^{+} transitions in ^{92}Mo and ^{94}Ru and for the 4&#95;{1}^{+}→2&#95;{1}^{+} and 6&#95;{1}^{+}→4&#95;{1}^{+} transitions in ^{90}Zr have been determined in this experiment making use of a multinucleon transfer reaction. These results have been interpreted on the basis of realistic shell-model calculations in the f&#95;{5/2}, p&#95;{3/2}, p&#95;{1/2}, and g&#95;{9/2} proton valence space. Only the combination of extensive lifetime information and large scale shell-model calculations allowed the extent of the seniority conservation in the N=50 g&#95;{9/2} orbital to be understood. The conclusion is that seniority is largely conserved in the first πg&#95;{9/2} orbital.

Abstract: A transarterial left hepatic artery radioembolization involving 90Y microspheres was performed on a cirrhotic man with hypermetabolic 18F-FDG segment III hepatocellular carcinoma. During the 18F-FDG PET/CT follow-up, the disappearance of the hypermetabolic lesion was initially observed. Then, a focal segment III hypermetabolism reappeared mimicking a recurrence before disappearing without any treatment. Finally, the hepatic MRI demonstrated that the transitory segment III hypermetabolism matched a thrombus of the dilated recanalized umbilical vein., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The purpose of this study was to compare peak skin dose (PSD) and dose map calculated by Dose-Tracking-System® (DTS) software and measured with radiochromic films in patients undergoing abdominopelvic embolization., Material and Methods: The PSD measured by radiochromic films (PSD Film ) or calculated by DTS software (PSD DTS ) were compared in patients who underwent abdominopelvic embolization between September 2020 and April 2021. Concordance between PSD Film and PSD DTS was computed using the Lin's concordance correlation coefficient and the clinical concordance using Bland Altman analysis. PSD values were compared using the paired Mann-Whitney-Wilcoxon test., Results: A total of 40 patients were included. There were 32 men and 8 women with a mean age of 73.0 ± 14.6 (SD) years (age range: 30-92 years). Median PSD Film was 756 mGy (IQR: 390; 1094) and median PSD DTS was 768 mGy (IQR: 421; 1076), resulting in a median difference of -5% (IQR: -10%; 0%) between PSD Film and PSD DTS (P = 0.024). The concordance correlation between PSD Film and PSD DTS was substantial in patients (0.986; 95% CI: 0.977-0.992). Bland Altman analysis showed that PSD DTS was underestimated compared to PSD Film by -36 mGy (95% CI: -68--4). Visually similar dose maps were found with DTS and radiochromic films., Conclusion: Real-time DTS software allows computing PSD with high accuracy and generating adequate dose map. PSD DTS was slightly underestimated compared to PSD Film requiring the use of a correction factor for the PSD DTS to avoid lack of follow-up for some patients., Competing Interests: Declaration of competing interest The authors have no relevant conflicts of interest to declare., (Copyright © 2022 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Primary Objective: Recently, selective internal radiation therapy using yttrium-90 (Y90) glass microspheres (TheraSphere™) was approved for reimbursement by health authorities in France. The PROACTIF study aims to gather data on effectiveness, patient quality of life, and safety with use of Y90 glass microspheres in real-world clinical settings in France., Inclusion Criteria: Patient with a diagnosis of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCC), and/or metastatic colorectal cancer (mCRC) who was treated with a dose of Y90 glass microspheres that has been reimbursed in France and who do not oppose use of their personal medical data., Exclusion Criteria: If data collection is opposed, treatment is reimbursed but not administered, or treatment is administered but not reimbursed., Outcome Measures: Primary outcome measures include overall survival from time of Y90 glass microsphere treatment and quality of life, as assessed using the Functional Assessment of Cancer Therapy- Hepatobiliary questionnaire., Estimated Number of Patients to Be Included: This is an open study and there is no set number of patients; 115 have already been enrolled., Planned Subgroup Analyses: Analyses will be stratified by disease state (HCC, iCC, or mCRC). Subgroups to be analyzed include age group, unilobar/bilobar disease at baseline, Eastern Cooperative Oncology Group (ECOG) status at baseline, liver tumor burden at baseline, target lesion size, and standard versus multi-compartment personalized dosimetry treatment., Planned Recruitment and Observation Period: Recruitment includes patients who are prescribed and treated with a commercial vial of Y90 glass microspheres between 01 January 2019 and 31 December 2024., Trial Registration: ClinicalTrials.gov Identifier: NCT04069468., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)

Bodily expression of felt emotion has been documented in the literature. However, it is often associated with high motor variability between individuals. This study aimed to identify individual motor signature (IMS) of emotions. IMS is a new method of motion analysis and visualization able to capture the subtle differences in the way each of us moves, seen as a kinematic fingerprint. We hypothesized that the individual motor signature would be different depending on the induced emotional state and that an emotional motor signature of joy and sadness common to all participants would emerge. For that purpose, we elicited these emotions (joy, sadness, and a neutral control emotion) in 26 individuals using an autobiographical memory paradigm, before they performed a motor improvization task (e.g., the mirror game). We extracted the individual motor signature under each emotional condition. Participants completed a self-report emotion before and after each trial. Comparing the similarity indexes of intra- and inter-emotional condition signatures, we confirmed our hypothesis and showed the existence of a specific motor signature for joy and sadness, allowing us to introduce the notion of emotional individual motor signature (EIMS). Our study indicates that EIMS can reinforce emotion discrimination and constitutes the first step in modeling emotional behavior during individual task performances or social interactions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Lozano-Goupil, Bardy and Marin.)

Objectives: To validate the performance of an automatic tool to estimate a patient's peak skin dose (PSD) and a skin dose map from data collected by a radiation dose management system (RDMS) during interventional procedures., Methods: In total, 288 eligible consecutive patients undergoing abdominopelvic embolisation or planned coronary angioplasty using radiochromic films were screened between June 2018 and March 2019. For 98 included patients, PSD was measured using radiochromic films (PSD Film ) and computed by RDMS (PSD RDMS ) using one flat and two anthropomorphic phantoms. Statistical concordance between PSD Film and PSD RDMS was computed with Lin's concordance correlation coefficient and clinical concordance with the Bland and Altman graphic; values were compared using the paired Mann-Whitney-Wilcoxon test., Results: In total, 190/288 patients were excluded and 98 patients were analysed (69 men, mean age 66 ± 14 years). The PSD Film median (1st; 3rd quartile) was 0.59 Gy (0.40; 1.08). PSD RDMS was 0.62 Gy (0.43; 1.22) for the flat phantom and 0.62 Gy (0.42; 1.19) for anthropomorphic phantoms. The concordance between PSD Film and PSD RDMS was good for both phantoms (flat: 0.94 [0.91; 0.95]; anthropomorphic 0.94 [0.91; 0.96]). Compared with the values of PSD Film , the values of PSD RDMS were significantly increased by 5% (- 4%; 16%) for flat phantom (p = 0.001) and 7% (- 6%; 22%) for anthropomorphic phantoms (p = 0.002) for vascular procedures and 9% (- 4%; 26%, p = 0.01) and 6% (- 4%; 23%, p = 0.02) for cardiac procedures, respectively. Dose map representations matched for most patients. The gaps identified were due to table displacement during fluoroscopy events and the use of a wedge filter., Conclusions: The RDMS skin dose map tool allowed the computation of the PSD and skin dose distribution for all patients with fewer constraints than radiochromic films. However, the computed PSD was overestimated, increasing the number of patients requiring follow-up., Key Points: • A good concordance correlation was identified between the peak skin dose (PSD) values measured with radiochromic films and estimated with the radiation dose management system (RDMS) skin dose map tool. • Differences were related to table displacement during fluoroscopy events and the use of a wedge filter, which are not accounted in the Digital Imaging and Communications in Medicine Radiation Dose Structured Reports. • For all procedures, the estimated PSDs were significantly higher than the measured PSDs by 5% (- 4%; 18%) for flat phantom (p < 0.001) and 6% (- 5%; 22%) for anthropomorphic phantoms (p < 0.001).

Purpose: To compare the evaluation of malignant focal liver lesions (FLLs) using a semi-automated RECIST tool with a standard and an ultra-low dose (ULD) computed tomography (CT) protocol., Materials and Methods: Thirty-four patients with malignant FLLs underwent two abdominal-pelvic CT examinations one using a standard protocol and one using an ULD protocol. There were 23 men and 11 women with a mean age 64.3±14.4 (SD) years (range: 22-91 years). Dosimetric indicators were recorded, and effective dose was calculated for both examinations. Mean malignant FLL attenuation, image noise and contrast-to-noise-ratio (CNR) were compared. The largest malignant FLL per patient was evaluated using the semi-automated RECIST tool to determine longest axis length, longest orthogonal axis length, volume and World Health Organisation area., Results: Dosimetric values were significantly reduced by -56% with ULD compared to standard protocol. No differences in mean malignant FLL attenuation values were found between the two protocols. Image noise was significantly increased for all locations (P<0.05) with ULD compared to standard protocol, and CNR was significantly reduced (P<0.05). On the 34 malignant FLLs analyzed, six semi-automated shapes non-concordant with radiologist's visual impression were highlighted with the software, including one FLL (1/34; 3%) with standard CT acquisition only, three FLLs (3/34; 9%) with ULD CT acquisition only and two FLLs (2/34; 6%) with both CT acquisitions. After manual editing, the concordance of the values of the studied criteria between both acquisitions was good and no significant difference was reported., Conclusion: Semi-automated RECIST tool demonstrates good performances using ULD CT protocol. It could be used in routine clinical practice with a ULD protocol for follow-up studies in patients with known malignant FLL., (Copyright © 2020 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

The low-lying energy spectrum of the extremely neutron-deficient self-conjugate (N=Z) nuclide &#95;{44}^{88}Ru&#95;{44} has been measured using the combination of the Advanced Gamma Tracking Array (AGATA) spectrometer, the NEDA and Neutron Wall neutron detector arrays, and the DIAMANT charged particle detector array. Excited states in ^{88}Ru were populated via the ^{54}Fe(^{36}Ar,2nγ)^{88}Ru^{*} fusion-evaporation reaction at the Grand Accélérateur National d'Ions Lourds (GANIL) accelerator complex. The observed γ-ray cascade is assigned to ^{88}Ru using clean prompt γ-γ-2-neutron coincidences in anticoincidence with the detection of charged particles, confirming and extending the previously assigned sequence of low-lying excited states. It is consistent with a moderately deformed rotating system exhibiting a band crossing at a rotational frequency that is significantly higher than standard theoretical predictions with isovector pairing, as well as observations in neighboring N>Z nuclides. The direct observation of such a "delayed" rotational alignment in a deformed N=Z nucleus is in agreement with theoretical predictions related to the presence of strong isoscalar neutron-proton pair correlations.

This study aimed to define the core components of Family Navigation for autism spectrum disorder, a promising intervention to reduce disparities in care for this population. Teams from four trials of Family Navigation for autism spectrum disorder completed the Template for Intervention Description and Replication checklist to outline intervention components. Through intervention component analysis and qualitative synthesis, we identified 11 core components across three domains: Training and Supervision, Navigator Tools, and Navigator Activities. We discuss the importance of identifying these core components and implications for future research and practice.

Purpose: The purpose of this study was to evaluate a cooperation program in order to compare incidence of complications after peripherally inserted central catheter (PICC) placement between radiologists and technicians., Materials and Methods: PICC placement technique was standardized with ultrasound-guided puncture and fluoroscopic guidance. Numbers of PICC delegated to technicians, and PICC placement difficulties, were prospectively recorded for the whole study population whereas complications such as PICC infection, deep venous thrombosis and catheter occlusion were prospectively recorded until PICC removal for a subgroup of patients included during one month., Results: A total of 722 patients had PICC placement. There were 382 men and 340 women with a mean age of 66.8±15.8 (SD) years (range: 18-94years); of these, 442/722 patients (61.22%) were included in the cooperation program with 433/722 patients (59.97%) who effectively had PICC placement by technicians and 289/722 (40.03%) by radiologists. Technicians needed radiologists' help for 23/442 patients (5.20%) including 6 failed PICC placement subsequently performed by radiologists. Twenty complications (20/77; 26%) were recorded in the subgroup of 77 patients studied for complications. No differences in complications rate were found between the 33 patients who underwent PICC placement by radiologists (6/33; 18%) and the 44 patients who underwent PICC placement by technicians (14/44; 32%) (P=0.296). Complications included 8 PICC-related infections (8/77; 10.4%), 3 deep venous thromboses (3/77; 3.9%) and 9 catheter occlusions (9/77; 11.7%)., Conclusion: PICC placement led by technicians is feasible and safe without statistical difference in terms of complications compared to PICC placement made by radiologists., (Copyright © 2019 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Objective: To assess the interactive Skin Dose Map® tool (SDM Tool ) integrated to the radiation dose management system (RDMS) DoseWatch® with Gafchromic® films for implementation in routine practice., Methods: A retrospective dose estimation software SDM Tool was used to calculate Peak Skin Dose (PSD) and display the patient skin dose distribution. PSD was calculated with a triangle mesh of 0.055 cm 2 resolution on ICRP 110 male anthropomorphic phantom and with a square ROI of 1 cm 2 on flat phantom. The tool uses Radiation Dose Structured Reports (RDSR) data to model exposure events and calculate the PSD per event. The PSD and the skin dose distribution estimated with SDM Tool were evaluated in comparison with Gafchromic® films positioned under the PMMA phantom (20 cm) for 13 configurations. Measurements were performed on a Philips system. Statistical analysis were carried out to compare PSD Film and PSD SDM ., Results: Average differences between PSD Film and PSD SDM were 6% ± 6% (range from -3% to 22%) for flat phantom and 5% ± 7% (range from -3% to 25%) for ICRP phantom. Concordance was good between the measured PSD Film and the estimated PSD SDM with Lin's coefficient estimation and 95% Confidence Interval of 0.979 [0.875; 0.984] for flat phantom and 0.977 [0.877; 0.985] for ICRP phantom. Dose map representations are concordant for 11 of the 13 tests on PMMA phantom. Disparities arose from the limitations of the RSDR format: table displacement during fluoroscopy events and the use of wedge filter., Conclusion: The results found in this experimental evaluation show that the SDM Tool is a suitable alternative to Gafchromic® film to calculate PSD., (Copyright © 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

There is growing interest in Family Navigation as an approach to improving access to care for children with autism spectrum disorder, yet little data exist on the implementation of Family Navigation. The aim of this study was to identify potential failures in implementing Family Navigation for children with autism spectrum disorder, using a failure modes and effects analysis. This mixed-methods study was set within a randomized controlled trial testing the effectiveness of Family Navigation in reducing the time from screening to diagnosis and treatment for autism spectrum disorder across three states. Using standard failure modes and effects analysis methodology, experts in Family Navigation for autism spectrum disorder (n = 9) rated potential failures in implementation on a 10-point scale in three categories: likelihood of the failure occurring, likelihood of not detecting the failure, and severity of failure. Ratings were then used to create a risk priority number for each failure. The failure modes and effects analysis detected five areas for potential "high priority" failures in implementation: (1) setting up community-based services, (2) initial family meeting, (3) training, (4) fidelity monitoring, and (5) attending testing appointments. Reasons for failure included families not receptive, scheduling, and insufficient training time. The process with the highest risk profile was "setting up community-based services." Failure in "attending testing appointment" was rated as the most severe potential failure. A number of potential failures in Family Navigation implementation-along with strategies for mitigation-were identified. These data can guide those working to implement Family Navigation for children with autism spectrum disorder.

Aortic pathologies benefit from imaging innovation and interventional radiology developments in order to improve patient management. At the early phase, vital risk should be considered. Whole body CT scan evaluate the complete aorta and its branches to assess the pathology and to choose the best approach between surgery or interventional radiology (fenestration, stentgraft, peripheral stenting). Algorithms, based on the understanding of the complications mechanisms and evolutive risk, modified the management specifically for aortic dissection. At chronic phase, GPs and angiologists should follow their patients in order to detect aortic complications and to treat cardiovascular risk factors. MRA is well indicated if possible., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Purpose: The purpose of this study was to evaluate and compare the diagnostic accuracy of ultra-low dose (ULD) computed tomography (CT) with that of standard dose (STD) CT in the detection and characterization of focal liver lesions in neoplastic patients., Materials and Methods: A total of 177 neoplastic patients who underwent two abdominopelvic CT examinations (one with STD and one with ULD protocol) for suspected focal liver lesions were included. There were 103 men and 74 women with a mean age of 64.6±14.4 (SD) (range: 19-93 years). Raw data images were reconstructed with iterative reconstruction. Dose length product (DLP) and effective dose for both protocols were compared. Images were independently evaluated by two radiologists for image-quality, diagnostic quality, and confidence level., Results: DLP for STD and ULD were respectively 215.4±92.0 (SD) mGy·cm (range: 76-599mGy·cm) and 90.7±37.2 (SD) mGy·cm (range: 32-254mGy·cm). Effective dose for STD and ULD CT were 3.2±1.4 (SD) mSv (range: 1.1-9.0mSv) and 1.4±0.6 (SD) mSv (range: 0.5 to 3.8mSv). A significant 58% dose reduction was found between the two protocols (P<0.05). Noise, signal-to-noise ratio and contrast-to-noise ratio were higher with the ULD protocol compared to the STD protocol. No differences in subjective image quality were found between the two protocols. STD CT revealed focal liver lesions in 80 patients and ULD CT in 70 patients (P<0.05). ULD protocol resulted in a sensitivity of 83.8% and a specificity of 96.9% for the diagnosis of focal liver lesions although it was not able to characterize them properly (Se 62.5%)., Conclusion: STD CT helps detect and characterize focal liver lesions. ULD CT offers good performance to detect focal liver lesions but with lower performances for lesion characterization., (Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Purpose: To assess the value of the routine use of radiochromic films in abdominopelvic embolization procedures to improve patient follow-up., Methods: A total of 55 patients who underwent transcatheter abdominopelvic embolization were prospectively included. Six types of procedures were evaluated including hepatic chemoembolization (HCE), gonadal veins embolization (GVE), uterine elective embolization (UEE), uterine urgent embolization (UUE), abdominal elective embolization (AEE), and abdominal urgent embolization (AUE). Dosimetric indicators (DIs) such as air-kerma (AK) and kerma-area-product (KAP) were collected and peak skin dose (PSD) was measured with radiochromic films. Correlations between PSD and DIs were searched for., Results: The mean (±standard deviation [SD]) PSD for the various procedures were: 1033±502 mGy for HCE; 476±271 mGy for GVE; 460±171 mGy for UEE; 531±263 mGy for UUE; 708±896 mGy for AEE; 683±392 mGy for AUE. Strong correlations were observed between PSD and DIs (r=0.974 for AK and r=0.925 for KAP). PSD was>2Gy in one procedure and all procedures (7/132) procedures resulted in AK>2Gy, mostly for HCE and AEE., Conclusion: Dosimetry using radiochromic film is only appropriate for HCE, AEE and AUE, whereas dose-mapping systems present a more suitable solution for all embolizations including those with AK that occasionally exceed 2Gy., (Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

A 27-year-old woman underwent a first vaginal delivery at our institution. She returned four days after delivery, presenting with abdominal pain and an unexplained drop in her hemoglobin value, without external bleeding. The initial computed tomography abdominal scan revealed an isolated diffuse hemoperitoneum. A laparoscopy did not find the cause of bleeding. A second computed tomography scan, performed 15 days later, revealed hemoperitoneum associated with a false aneurysm of the right uterine artery. Treatment consisted of embolization of the uterine arteries, with clinical success. False aneurysms are a rare cause of intra-abdominal non-exteriorized bleeding in late post-partum hemorrhage., (© 2015 Japan Society of Obstetrics and Gynecology.)

The case of a woman with anomalous origin of the circumflex coronary artery that communicates with the left ventricle via a fistula, revealed by typical angina, is described and the several pathomechanisms involved are discussed.

Pseudo-aneurysms of uterine arteries are rare causes of post-partum hemorrhage. We report two cases of rupture, revealed in one case by a hemoperitoneum and in a second case by a retroperitoneal hematoma. The treatment consisted of embolization of uterine arteries with immediate clinical success, to avoid surgery., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

The main issue with chronic coronary artery occlusion relates to optimal treatment and cross sectional imaging is a valuable source of information. Cardiac MR imaging can identify candidates to revascularization by demonstrating viable myocardium. Coronary CTA allows evaluation of the entire coronary system and detection of factors predicting the success of revascularization, either percutaneous (angioplasty) or surgical.