ESR Essentials: diagnosis of hepatocellular carcinoma—practice recommendations by ESGAR

Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and a leading cause of cancer related death worldwide. Current guidelines for the noninvasive diagnosis of HCC are provided by the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Diseases (AASLD) which endorsed the Liver Imaging Reporting and Data System (LI-RADS) algorithm, the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC), and the Asian-Pacific Association for the Study of the Liver (APASL). These allow the diagnosis of HCC in high-risk patients in the presence of typical imaging features on contrast-enhanced CT, MRI, or contrast-enhanced ultrasound. Size, non-rim arterial phase hyperenhancement, non-peripheral washout, enhancing capsule, and growth are major imaging features and they should be combined for the diagnosis of HCC. This article provides concise and relevant practice recommendations aimed at general radiologist audience, summarizing the best practice and informing on the essential imaging criteria for the diagnosis of HCC, while also discussing the high-risk population criteria, imaging modalities, and imaging features according to the current guidelines

Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient.

OBJECTIVE: To evaluate the use of the Vittel criteria in addition to a clinical examination to determine the need for a whole body scan (WBS) in a severe trauma patient. MATERIALS AND METHODS: Between December 2008 and November 2009, 339 severe trauma patients with at least one Vittel criterion were prospectively evaluated with a WBS. The following data were collected: the Vittel criteria present, circumstances of the accident, traumatic injury on the WBS, and irradiation. The original intent to prescribe a computed tomography (CT) scan (whole body or a targeted region), based solely on clinical signs, was specified. RESULTS: Injuries were diagnosed in 55.75% of the WBS (n=189). The most common Vittel criteria were "global assessment" (n=266), "thrown, run over" (n=116), and "ejected from vehicle" (n=94). The multivariate analysis used the following as independent criteria for predicting severe traumatic injury on the WBS: Glasgow score less than 13, penetrating trauma, and colloid resuscitation greater than 11. Based solely on clinical factors, 164 patients would not have had any scan or (only) a targeted scan. In that case, 15% of the severe injuries would have been missed. CONCLUSION: Using the Vittel criteria to determine the need for a WBS in a severe trauma patient makes it possible to find serious injuries not suspected on the clinical examination, but at the cost of an increased number of normal scans

Non-monotonic field-dependence of the ZFC magnetization peak in some systems of magnetic nanoparticles

We have performed magnetic measurements on a diluted system of gamma-Fe2O3 nanoparticles (~7nm), and on a ferritin sample. In both cases, the ZFC-peak presents a non-monotonic field dependence, as has already been reported in some experiments,and discussed as a possible evidence of resonant tunneling. Within simple assumptions, we derive expressions for the magnetization obtained in the usual ZFC, FC, TRM procedures. We point out that the ZFC-peak position is extremely sensitive to the width of the particle size distribution, and give some numerical estimates of this effect. We propose to combine the FC magnetization with a modified TRM measurement, a procedure which allows a more direct access to the barrier distribution in a field. The typical barrier values which are obtained with this method show a monotonic decrease for increasing fields, as expected from the simple effect of anisotropy barrier lowering, in contrast with the ZFC results. From our measurements on gamma-Fe2O3 particles, we show that the width of the effective barrier distribution is slightly increasing with the field, an effect which is sufficient for causing the observed initial increase of the ZFC-peak temperatures.Comment: LaTeX file 19 pages, 9 postscript figures. To appear in Phys. Rev. B (tentative schedule: Dec.97

Searching for faint companions with VLTI/PIONIER. I. Method and first results

Context. A new four-telescope interferometric instrument called PIONIER has recently been installed at VLTI. It provides improved imaging capabilities together with high precision. Aims. We search for low-mass companions around a few bright stars using different strategies, and determine the dynamic range currently reachable with PIONIER. Methods. Our method is based on the closure phase, which is the most robust interferometric quantity when searching for faint companions. We computed the chi^2 goodness of fit for a series of binary star models at different positions and with various flux ratios. The resulting chi^2 cube was used to identify the best-fit binary model and evaluate its significance, or to determine upper limits on the companion flux in case of non detections. Results. No companion is found around Fomalhaut, tau Cet and Regulus. The median upper limits at 3 sigma on the companion flux ratio are respectively of 2.3e-3 (in 4 h), 3.5e-3 (in 3 h) and 5.4e-3 (in 1.5 h) on the search region extending from 5 to 100 mas. Our observations confirm that the previously detected near-infrared excess emissions around Fomalhaut and tau Cet are not related to a low-mass companion, and instead come from an extended source such as an exozodiacal disk. In the case of del Aqr, in 30 min of observation, we obtain the first direct detection of a previously known companion, at an angular distance of about 40 mas and with a flux ratio of 2.05e-2 \pm 0.16e-2. Due to the limited u,v plane coverage, its position can, however, not be unambiguously determined. Conclusions. After only a few months of operation, PIONIER has already achieved one of the best dynamic ranges world-wide for multi-aperture interferometers. A dynamic range up to about 1:500 is demonstrated, but significant improvements are still required to reach the ultimate goal of directly detecting hot giant extrasolar planets.Comment: 11 pages, 6 figures, accepted for publication in A&

VSI: the VLTI spectro-imager

The VLTI Spectro Imager (VSI) was proposed as a second-generation instrument of the Very Large Telescope Interferometer providing the ESO community with spectrally-resolved, near-infrared images at angular resolutions down to 1.1 milliarcsecond and spectral resolutions up to R=12000. Targets as faint as K=13 will be imaged without requiring a brighter nearby reference object. The unique combination of high-dynamic-range imaging at high angular resolution and high spectral resolution enables a scientific program which serves a broad user community and at the same time provides the opportunity for breakthroughs in many areas of astrophysic including: probing the initial conditions for planet formation in the AU-scale environments of young stars; imaging convective cells and other phenomena on the surfaces of stars; mapping the chemical and physical environments of evolved stars, stellar remnants, and stellar winds; and disentangling the central regions of active galactic nuclei and supermassive black holes. VSI will provide these new capabilities using technologies which have been extensively tested in the past and VSI requires little in terms of new infrastructure on the VLTI. At the same time, VSI will be able to make maximum use of new infrastructure as it becomes available; for example, by combining 4, 6 and eventually 8 telescopes, enabling rapid imaging through the measurement of up to 28 visibilities in every wavelength channel within a few minutes. The current studies are focused on a 4-telescope version with an upgrade to a 6-telescope one. The instrument contains its own fringe tracker and tip-tilt control in order to reduce the constraints on the VLTI infrastructure and maximize the scientific return.Comment: 12 pages, to be published in Proc. SPIE conference 7013 "Optical and Infrared Interferometry", Schoeller, Danchi, and Delplancke, F. (eds.). See also http://vsi.obs.ujf-grenoble.f

Milli-arcsecond astrophysics with VSI, the VLTI spectro-imager in the ELT era

Nowadays, compact sources like surfaces of nearby stars, circumstellar environments of stars from early stages to the most evolved ones and surroundings of active galactic nuclei can be investigated at milli-arcsecond scales only with the VLT in its interferometric mode. We propose a spectro-imager, named VSI (VLTI spectro-imager), which is capable to probe these sources both over spatial and spectral scales in the near-infrared domain. This instrument will provide information complementary to what is obtained at the same time with ALMA at different wavelengths and the extreme large telescopes.Comment: 8 pages. To be published in the proceedings of the ESO workshop "Science with the VLT in the ELT Era", held in Garching (Germany) on 8-12 October 2007, A. Moorwood edito

First AMBER/VLTI observations of hot massive stars

AMBER is the first near infrared focal instrument of the VLTI. It combines three telescopes and produces spectrally resolved interferometric measures. This paper discusses some preliminary results of the first scientific observations of AMBER with three Unit Telescopes at medium (1500) and high (12000) spectral resolution. We derive a first set of constraints on the structure of the circumstellar material around the Wolf Rayet Gamma2 Velorum and the LBV Eta Carinae

First direct detection of an exoplanet by optical interferometry; Astrometry and K-band spectroscopy of HR8799 e

To date, infrared interferometry at best achieved contrast ratios of a few times $10^{-4}$ on bright targets. GRAVITY, with its dual-field mode, is now capable of high contrast observations, enabling the direct observation of exoplanets. We demonstrate the technique on HR8799, a young planetary system composed of four known giant exoplanets. We used the GRAVITY fringe tracker to lock the fringes on the central star, and integrated off-axis on the HR8799e planet situated at 390 mas from the star. Data reduction included post-processing to remove the flux leaking from the central star and to extract the coherent flux of the planet. The inferred K band spectrum of the planet has a spectral resolution of 500. We also derive the astrometric position of the planet relative to the star with a precision on the order of 100$\,\mu$as. The GRAVITY astrometric measurement disfavors perfectly coplanar stable orbital solutions. A small adjustment of a few degrees to the orbital inclination of HR 8799 e can resolve the tension, implying that the orbits are close to, but not strictly coplanar. The spectrum, with a signal-to-noise ratio of $\approx 5$ per spectral channel, is compatible with a late-type L brown dwarf. Using Exo-REM synthetic spectra, we derive a temperature of $1150\pm50$\,K and a surface gravity of $10^{4.3\pm0.3}\,$cm/s$^{2}$. This corresponds to a radius of $1.17^{+0.13}_{-0.11}\,R_{\rm Jup}$ and a mass of $10^{+7}_{-4}\,M_{\rm Jup}$, which is an independent confirmation of mass estimates from evolutionary models. Our results demonstrate the power of interferometry for the direct detection and spectroscopic study of exoplanets at close angular separations from their stars.Comment: published in A&