330 research outputs found
Image guidance in neurosurgical procedures, the "Visages" point of view.
This paper gives an overview of the evolution of clinical
neuroinformatics in the domain of neurosurgery. It shows how
image guided neurosurgery (IGNS) is evolving according to the integration of new imaging modalities before, during and after the surgical procedure and how this acts as the premise of the Operative Room of the future. These different issues, as addressed by the VisAGeS INRIA/INSERM U746 research team (http://www.irisa.fr/visages), are presented and discussed in order to exhibit the benefits of an integrated work between physicians (radiologists, neurologists and neurosurgeons) and computer scientists to give adequate answers toward a more effective use of
images in IGNS
Multimodal Hippocampal Subfield Grading For Alzheimerâs Disease Classification
Numerous studies have proposed biomarkers based on magnetic resonance imaging (MRI) to detect and predict the risk of evolution toward Alzheimerâs disease (AD). Most of these methods have focused on the hippocampus, which is known to be one of the earliest structures impacted by the disease. To date, patch-based grading approaches provide among the best biomarkers based on the hippocampus. However, this structure is complex and is divided into different subfields, not equally impacted by AD. Former in-vivo imaging studies mainly investigated structural alterations of these subfields using volumetric measurements and microstructural modifications with mean diffusivity measurements. The aim of our work is to improve the current classification performances based on the hippocampus with a new multimodal patch-based framework combining structural and diffusivity MRI. The combination of these two MRI modalities enables the capture of subtle structural and microstructural alterations. Moreover, we propose to study the efficiency of this new framework applied to the hippocampal subfields. To this end, we compare the classification accuracy provided by the different hippocampal subfields using volume, mean diffusivity, and our novel multimodal patch-based grading framework combining structural and diffusion MRI. The experiments conducted in this work show that our new multimodal patch-based method applied to the whole hippocampus provides the most discriminating biomarker for advanced AD detection while our new framework applied into subiculum obtains the best results for AD prediction, improving by two percentage points the accuracy compared to the whole hippocampus
SoLid : Search for Oscillations with Lithium-6 Detector at the SCK-CEN BR2 reactor
Sterile neutrinos have been considered as a possible explanation for the recent reactor and Gallium anomalies arising from reanalysis of reactor flux and calibration data of previous neutrino experiments. A way to test this hypothesis is to look for distortions of the anti-neutrino energy caused by oscillation from active to sterile neutrino at close stand-off (similar to 6-8m) of a compact reactor core. Due to the low rate of anti-neutrino interactions the main challenge in such measurement is to control the high level of gamma rays and neutron background.
The SoLid experiment is a proposal to search for active-to-sterile anti-neutrino oscillation at very short baseline of the SCK center dot CEN BR2 research reactor.
This experiment uses a novel approach to detect anti-neutrino with a highly segmented detector based on Lithium-6. With the combination of high granularity, high neutron-gamma discrimination using 6LiF:ZnS(Ag) and precise localization of the Inverse Beta Decay products, a better experimental sensitivity can be achieved compared to other state-of-the-art technology. This compact system requires minimum passive shielding allowing for very close stand off to the reactor. The experimental set up of the SoLid experiment and the BR2 reactor will be presented. The new principle of neutrino detection and the detector design with expected performance will be described. The expected sensitivity to new oscillations of the SoLid detector as well as the first measurements made with the 8 kg prototype detector deployed at the BR2 reactor in 2013-2014 will be reported
Mixed-Model Noise Removal in 3D MRI via Rotation-and-Scale Invariant Non-Local Means
Mixed noise is a major issue influencing quantitative analysis in different forms of magnetic resonance image (MRI), such as T1 and diffusion image like DWI and DTI. Using different filters sequentially to remove mixed noise will severely deteriorate such medical images. We present a novel algorithm called rotation-and-scale invariant nonlocal means filter (RSNLM) to simultaneously remove mixed noise from different kinds of three-dimensional (3D) MRI images. First, we design a new similarity weights, including rank-ordered absolute difference (ROAD), coming from a trilateral filter (TriF) that is obtained to detect the mixed and high-level noise. Then, we present a shape view to consider the MRI data as a 3D operator, with which the similarity between the patches is calculated with the rigid transformation. The translation, rotation and scale have no influence on the similarity. Finally, the adaptive parameter estimation method of ROAD is illustrated, and the effective proof that validates the proposed algorithm is presented. Experiments using synthetic data with impulse noise, Rician noise, and the real MRI data confirm that the proposed method yields superior performance compared with current state-of-the-art methods
Evolution of the X-ray spectrum in the flare model of Active Galactic Nuclei
Nayakshin & Kazanas (2002) have considered the time-dependent illumination of
an accretion disc in Active Galactic Nuclei, in the lamppost model. We extend
their study to the flare model, which postulates the release of a large X-ray
flux above a small region of the accretion disc. A fundamental difference with
the lamppost model is that the region of the disc below the flare is not
illuminated before the onset of the flare.
A few test models show that the spectrum which follows immediately the
increase in continuum flux should display the characteristics of a highly
illuminated but dense gas, i.e. very intense X-ray emission lines and
ionization edges in the soft X-ray range. The behaviour of the iron line is
different in the case of a "moderate" and a ``strong'' flare: for a moderate
flare, the spectrum displays a neutral component of the Fe K line at
6.4 keV, gradually leading to more highly ionized lines. For a strong flare,
the lines are already emitted by FeXXV (around 6.7 keV) after the onset, and
have an equivalent width of several hundreds of eV. We find that the observed
correlations between , , and the X-ray flux, are well accounted by a
combination of flares having not achieved pressure equilibrium, strongly
suggesting that the observed spectrum is dominated by regions in non-pressure
equilibrium, typical of the onset of the flares. Finally a flare being confined
to a small region of the disc, the spectral lines should be narrow (except for
a weak Compton broadening), Doppler shifted, and moving.Comment: 14 pages, 13 figures, accepted in A & A, english corrected versio
Evaluation of the benefits, harms and costâeffectiveness of potential alternatives to iFOBT testing for colorectal cancer screening in Australia
The Australian National Bowel Cancer Screening Program (NBCSP) will fully rollâout 2âyearly screening using the immunochemical Faecal Occult Blood Testing (iFOBT) in people aged 50 to 74 years by 2020. In this study, we aimed to estimate the comparative health benefits, harms, and costâeffectiveness of screening with iFOBT, versus other potential alternative or adjunctive technologies. A comprehensive validated microsimulation model, Policy1âBowel, was used to simulate a total of 13 screening approaches involving use of iFOBT, colonoscopy, sigmoidoscopy, computed tomographic colonography (CTC), faecal DNA (fDNA) and plasma DNA (pDNA), in people aged 50 to 74 years. All strategies were evaluated in three scenarios: (i) perfect adherence, (ii) high (but imperfect) adherence, and (iii) low adherence. When assuming perfect adherence, the most effective strategies involved using iFOBT (annually, or biennially with/without adjunct sigmoidoscopy either at 50, or at 54, 64 and 74 years for individuals with negative iFOBT), or colonoscopy (10âyearly, or onceâoff at 50 years combined with biennial iFOBT). Colorectal cancer incidence (mortality) reductions for these strategies were 51â67(74â80)% in comparison with no screening; 2âyearly iFOBT screening (i.e. the NBCSP) would be associated with reductions of 51(74)%. Only 2âyearly iFOBT screening was found to be costâeffective in all scenarios in context of an indicative willingnessâtoâpay threshold of A2,984/LYSâA$5,981/LYS (depending on adherence). The fully rolledâout NBCSP is highly costâeffective, and is also one of the most effective approaches for bowel cancer screening in Australia
Towards a comprehensive evaluation of ultrasound speckle reduction
Over the last three decades, several despeckling filters have been developed to reduce the speckle noise inherently present in ultrasound images without losing the diagnostic information. In this paper, a new intensity and feature preservation evaluation metric for full speckle reduction evaluation is proposed based contrast and feature similarities. A comparison of the despeckling methods is done, using quality metrics and visual interpretation of images profiles to evaluate their performance and show the benefits each one can contribute to noise reduction and feature preservation. To test the methods, noise-free images and simulated B-mode ultrasound images are used. This way, the despeckling techniques can be compared using numeric metrics, taking the noise-free image as a reference. In this study, a total of seventeen different speckle reduction algorithms have been documented based on adaptive filtering, diffusion filtering and wavelet filtering, with sixteen qualitative metrics estimation.info:eu-repo/semantics/publishedVersio
Exploring the Cost Effectiveness of a Whole-Genome Sequencing-Based Biomarker for Treatment Selection in Patients with Advanced Lung Cancer Ineligible for Targeted Therapy
Objective: We aimed to perform an early cost-effectiveness analysis of using a whole-genome sequencing-based tumor mutation burden (WGS-TMB), instead of programmed death-ligand 1 (PD-L1), for immunotherapy treatment selection in patients with non-squamous advanced/metastatic non-small cell lung cancer ineligible for targeted therapy, from a Dutch healthcare perspective. Methods: A decision-model simulating individual patients with metastatic non-small cell lung cancer was used to evaluate diagnostic strategies to select first-line immunotherapy only or the immunotherapy plus chemotherapy combination. Treatment was selected using PD-L1 [A, current practice], WGS-TMB [B], and both PD-L1 and WGS-TMB [C]. Strategies D, E, and F take into account a patientâs disease burden, in addition to PD-L1, WGS-TMB, and both PD-L1 and WGS-TMB, respectively. Disease burden was defined as a fast-growing tumor, a high number of metastases, and/or weight loss. A threshold of 10 mutations per mega-base was used to classify patients into TMB-high and TMB-low groups. Outcomes were discounted quality-adjusted life-years (QALYs) and healthcare costs measured from the start of first-line treatment to death. Healthcare costs includes drug acquisition, follow-up costs, and molecular diagnostic tests (i.e., standard diagnostic techniques and/or WGS for strategies involving TMB). Results were reported using the net monetary benefit at a willingness-to-pay threshold of âŹ80,000/QALY. Additional scenario and threshold analyses were performed. Results: Strategy B had the lowest QALYs (1.84) and lowest healthcare costs (âŹ120,800). The highest QALYs and healthcare costs were 2.00 and âŹ140,400 in strategy F. In the base-case analysis, strategy A was cost effective with the highest net monetary benefit (âŹ27,300), followed by strategy B (âŹ26,700). Strategy B was cost effective when the cost of WGS testing was decreased by at least 24% or when immunotherapy results in an additional 0.5 year of life gained or more for TMB high compared with TMB low. Strategies C and F, which combined TMB and PD-L1 had the highest net monetary benefit (â„ âŹ76,900) when the cost of WGS testing, immunotherapy, and chemotherapy acquisition were simultaneously reduced by at least 47%, 39%, and 43%, respectively. Furthermore, strategy C resulted in the highest net monetary benefit (â„ âŹ39,900) in a scenario where patients with both PD-L1 low and TMB low were treated with chemotherapy instead of immunotherapy plus chemotherapy. Conclusions: The use of WGS-TMB is not cost effective compared to PD-L1 for immunotherapy treatment selection in non-squamous metastatic non-small cell lung cancer in the Netherlands. WGS-TMB could become cost effective provided there is a reduction in the cost of WGS testing or there is an increase in the predictive value of WGS-TMB for immunotherapy effectiveness. Alternatively, a combination strategy of PD-L1 testing with WGS-TMB would be cost effective if used to support the choice to withhold immunotherapy in patients with a low expected benefit of immunotherapy.</p
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