MRI of female genital tract congenital anomalies: European Society of Urogenital Radiology (ESUR) guidelines

OBJECTIVE: To develop imaging guidelines for the MR work-up of female genital tract congenital anomalies (FGTCA). METHODS: These guidelines were prepared based on a questionnaire sent to all members of the European Society of Urogenital Radiology (ESUR) Female Pelvic Imaging Working Group (FPI-WG), critical review of the literature and expert consensus decision. RESULTS: The returned questionnaires from 17 different institutions have shown reasonable homogeneity of practice. Recommendations with focus on patient preparation and MR protocol are proposed, as these are key to optimised examinations. Details on MR sequences and planning of uterus-orientated sequences are provided. CONCLUSIONS: The multiplanar capabilities and soft tissue resolution of MRI provide superb characterisation of the wide spectrum of findings in FGTCA. A standardised imaging protocol and method of reporting ensures that the salient features are recognised, contributing to a correct diagnosis and classification of FGTCA, associated anomalies and complications. These imaging guidelines are based on current practice among expert radiologists in the field and incorporate up to date information regarding MR protocols and essentials of recently published classification systems. KEY POINTS: * MRI allows comprehensive evaluation of female genital tract congenital anomalies, in a single examination. * A dedicated MRI protocol comprises uterus-orientated sequences and vaginal and renal evaluation. * Integration of classification systems and structured reporting helps in successful communication of the imaging findings

Outcomes and potential impact of a virtual hands-on training program on MRI staging confidence and performance in rectal cancer

Objectives: To explore the potential impact of a dedicated virtual training course on MRI staging confidence and performance in rectal cancer. // Methods: Forty-two radiologists completed a stepwise virtual training course on rectal cancer MRI staging composed of a pre-course (baseline) test with 7 test cases (5 staging, 2 restaging), a 1-day online workshop, 1 month of individual case readings (n = 70 cases with online feedback), a live online feedback session supervised by two expert faculty members, and a post-course test. The ESGAR structured reporting templates for (re)staging were used throughout the course. Results of the pre-course and post-course test were compared in terms of group interobserver agreement (Krippendorf’s alpha), staging confidence (perceived staging difficulty), and diagnostic accuracy (using an expert reference standard). // Results: Though results were largely not statistically significant, the majority of staging variables showed a mild increase in diagnostic accuracy after the course, ranging between + 2% and + 17%. A similar trend was observed for IOA which improved for nearly all variables when comparing the pre- and post-course. There was a significant decrease in the perceived difficulty level (p = 0.03), indicating an improved diagnostic confidence after completion of the course. // Conclusions: Though exploratory in nature, our study results suggest that use of a dedicated virtual training course and web platform has potential to enhance staging performance, confidence, and interobserver agreement to assess rectal cancer on MRI virtual training and could thus be a good alternative (or addition) to in-person training. // Clinical relevance statement: Rectal cancer MRI reporting quality is highly dependent on radiologists’ expertise, stressing the need for dedicated training/teaching. This study shows promising results for a virtual web-based training program, which could be a good alternative (or addition) to in-person training. // Key Points: • Rectal cancer MRI reporting quality is highly dependent on radiologists’ expertise, stressing the need for dedicated training and teaching. • Using a dedicated virtual training course and web-based platform, encouraging first results were achieved to improve staging accuracy, diagnostic confidence, and interobserver agreement. • These exploratory results suggest that virtual training could thus be a good alternative (or addition) to in-person training

Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR)

Objective The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging staging guidelines for vulvar cancer and to propose standardised MRI protocols and reporting. Methods The guidelines recommended from the ESUR in this article resulted from a questionnaire analysis regarding imaging staging of vulvar cancer that was answered by all members of the Female Pelvic Imaging Working Group. Only the answers with an agreement equal to or more than 80% were considered. Additionally, the literature was reviewed to complement and further support our conclusions. Results The critical review of the literature and consensus obtained among experts allows for recommendations regarding imaging staging guidelines, patient preparation, MRI protocol, and a structured MRI report. Conclusions Standardising image acquisition techniques and MRI interpretation reduces ambiguity and ultimately improves the contribution of radiology to the staging and management of patients with vulvar cancer. Moreover, structured reporting assists with the communication of clinically relevant information to the referring physician

LHC Impedance Model: Experience with High Intensity Operation in the LHC

The CERN Large Hadron Collider (LHC) is now in luminosity production mode and has been pushing its performance in the past months by increasing the proton beam brightness, the collision energy and the machine availability. As a consequence, collective effects have started to become more and more visible and have effectively slowed down the performance increase of the machine. Among these collective effects, the interaction of brighter LHC bunches with the longitudinal and transverse impedance of the machine has been observed to generate beam induced heating, as well as longitudinal and transverse instabilities since 2010. This contribution reviews the current LHC impedance model obtained from theory, simulations and bench measurements as well as a selection of measured effects with the LHC beam

Update on Beam Induced RF Heating in the LHC

Since June 2011 the rapid increase of the luminosity performance of the LHC has come at the expense of both increased temperature and pressure of specific, near-beam, LHC equipment. In some cases, this beam induced heating has caused delays while equipment cool-down, beam dumps and even degradation of some devices. This contribution gathers the observations of beam induced heating, attributed to longitudinal beam coupling impedance, their current level of understanding and possible actions planned to be implemented during the 1st LHC Long Shutdown (LS1) in 2013-2014

ELABORATION ET CARACTERISATION DE COUCHES MINCES PYROELECTRIQUES DE LiTaO3 PAR PULVERISATION CATHODIQUE RF MAGNETRON POUR DES APPLICATIONS DETECTEURS IR

This thesis relates differents steps for manufacturing IR pyroelectric detector with LiTaO3 thin films. The first chapter treats pyroelectric effect in IR detectors. LiTaO3 cristal's chemical and physical properties are shown in second chapter. The characterisation tools and technicals of deposition used to realise the study system (top electrode / pyroelectric film / back electrode) are presented in the third chapter. The fourth and the fifh chapters respectively present the material study of ruthenium oxide thin films deposited by RF sputtering which are used as back contact and the material study of the pyroelectric LiTaO3 thin films elaborated by RF magnetron sputtering. The top electrode is deposited by thermal evaporation of Al or by RF sputtering for NiCr contacts. In the sixth chapter, dielectric characterisations showed that Ru film presence at interface between RuO2 film and substrate decreases the dielectrics loses. These characterisations also showed the influence of LiTaO3 growth conditions on their dielectric properties. These results are in agreement with measurements of pyroelectric coefficients presented in the seventh chapter. In addition, this chapter examines the effect of parasite charges on the pyroelectric current. In part, the effect is attributed to interface between LiTaO3 and back electrode. For Li enriched target, the thin films can present pyroelectric coefficient equal to 55 µC/cm2K ( LiTaO3 bulk crystal is 180 µC/cm2K). The last chapter is devoted to IR pyroelectric detector realisation (micro usining, associated electronic) and current reponsivityCette thèse décrit les différentes étapes nécessaires à la réalisation d'un détecteur IR pyroélectrique en couches minces de LiTaO3, depuis l'étude matériau aux procédés de la microélectronique. Le premier chapitre reprend le principe de l'effet pyroélectrique dans les détecteurs IR. Les propriétés physiques et chimiques du cristal de LiTaO3 sont données dans le second chapitre. Le troisième chapitre fait l'inventaire des outils et des techniques de dépôts utilisés pour réaliser l'empilement de base du détecteur IR (contact avant/ couche pyroélectrique / contact arrière). Les chapitres suivants sont consacrés aux résultats expérimentaux. Le quatrième et le cinquième chapitres présentent respectivement l'étude matériau des couches minces de dioxyde de ruthénium qui servent de contact arrière et l'étude matériau des couches minces pyroélectriques de LiTaO3. La pulvérisation cathodique RF et la pulvérisation cathodique RF magnétron sont les deux méthodes de dépôt utilisées. L'électrode supérieure est déposée par évaporation thermique pour les plots d'aluminium ou par pulvérisation cathodique RF pour les pistes en NiCr. Les caractérisations diélectriques présentées dans le sixième chapitre ont montré que la présence d'une couche d'accroche de Ru à l'interface substrat électrode enterrée diminue de moitié les pertes dans le diélectrique. Ces caractérisations ont également permis de mettre en évidence l'influence des conditions de dépôt des couches de LiTaO3 sur leurs propriétés diélectriques. Ces tendances sont confortées par les résultats obtenus par des mesures du coefficient pyroélectrique présentées dans le septième chapitre. Ce chapitre met en avant le rôle du contact arrière quant à la présence de charges parasites pouvant se superposer à l'effet pyroélectrique permanent. Pour une cible enrichie en Li, les couches peuvent présenter des coefficients pyroélectriques de 55 µC/cm2K (180 µC/cm2K pour le cristal massif de LiTaO3). Le dernier chapitre est consacré à la réalisation du détecteur pyroélectrique IR (micro-usinage, électronique associée) et à sa réponse en courant