Seminal magnetic fields from Inflato-electromagnetic Inflation

We extend some previous attempts to explain the origin and evolution of primordial magnetic fields during inflation induced from a 5D vacuum. We show that the usual quantum fluctuations of a generalized 5D electromagnetic field cannot provide us with the desired magnetic seeds. We show that special fields without propagation on the extra non-compact dimension are needed to arrive to appreciable magnetic strengths. We also identify a new magnetic tensor field $B_{ij}$ in this kind of extra dimensional theories. Our results are in very good agreement with observational requirements, in particular from TeV Blazars and CMB radiation limits we obtain that primordial cosmological magnetic fields should be close scale invariance.Comment: Improved version. arXiv admin note: text overlap with arXiv:1007.3891 by other author

Ablative margins in percutaneous thermal ablation of hepatic tumors:a systematic review

Introduction: This study aims to systematically review current evidence on ablative margins and correlation to local tumor progression (LTP) after thermal ablation of hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM). Methods: A systematic search was performed in PubMed (MEDLINE) and Web of Science to identify all studies that reported on ablative margins (AM) and related LTP rates. Studies were assessed for risk of bias and synthesized separately per tumor type. Where possible, results were pooled to calculate risk differences (RD) as function of AM. Results: In total, 2910 articles were identified of which 43 articles were eligible for final analysis. There was high variability in AM measurement methodology across studies in terms of measurement technique, imaging modalities, and timing. Most common margin stratification was &lt; 5 mm and &gt; 5 mm, for which data were available in 25/43 studies (58%). Of these, all studies favored AM &gt; 5 mm to reduce the risk of LTP, with absolute RD of 16% points for HCC and 47% points for CRLM as compared to AM &lt; 5 mm. Conclusions: Current evidence supports AM &gt; 5 mm to reduce the risk of LTP after thermal ablation of HCC and CRLM. However, standardization of AM measurement and reporting is critical to allow future meta-analyses and improved identification of optimal threshold value for clinical use.</p

Study protocol PROMETHEUS: prospective multicenter study to evaluate the correlation between safety margin and local recurrence after thermal ablation using image co-registration in patients with hepatocellular carcinoma

Purpose The primary objective is to determine the minimal ablation margin required to achieve a local recurrence rate of 18 years with Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma (or B with a maximum of two lesions = 10% for patients with a minimal ablation margin >= 2 mm. Logistic regression will be used to find the relationship between minimal ablation margins and local recurrence. Kaplan-Meier estimates are used to assess local and overall recurrence, disease-free and overall survival.Discussion It is expected that this study will result in a clear understanding of the correlation between ablation margins and local recurrence. Using co-registration software in future patients undergoing ablation for hepatocellular carcinoma may improve intraprocedural evaluation of technical success.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Percutaneous MR-guided focal cryoablation for recurrent prostate cancer following radiation therapy: retrospective analysis of iceball margins and outcomes

Contains fulltext : 181647.pdf (publisher's version ) (Open Access)OBJECTIVES: To evaluate iceball margins after magnetic resonance (MR)-guided focal salvage prostate cryoablation and determine the correlation with local outcome. METHODS: A retrospective review was performed on 47 patients that underwent percutaneous MR-guided focal cryoablation for biopsy-proven locally recurrent prostate cancer after primary radiotherapy. Preprocedural diagnostic and intraprocedural MR images were analysed to derive three-directional iceball margins. Local tumour progression after cryoablation was defined as evident tumour recurrence on follow-up MRI, positive MR-guided biopsy or biochemical failure without radiological evidence of metastatic disease. RESULTS: Mean iceball margins were 8.9 mm (range -7.1 to 16.2), 10.1 mm (range 1.1-20.3) and 12.5 mm (range -1.5 to 22.2) in anteroposterior, left-right and craniocaudal direction respectively. Iceball margins were significantly smaller for tumours that were larger (P = .008) or located in the posterior gland (P = .047). Significantly improved local progression-free survival at 1 year post focal cryoablation was seen between patients with iceball margin >10 mm (100%), 5-10 mm (84%) and <5 mm (15%) (P < .001). CONCLUSIONS: Iceball margins appear to correlate with local outcome following MR-guided focal salvage prostate cryoablation. Our initial data suggest that freezing should be applied at minimum 5 mm beyond the border of an MR-visible recurrent prostate tumour for successful ablation, with a wider margin appearing desirable. KEY POINTS: * Shortest iceball margin most often occurred in anteroposterior direction * Margins were smaller in tumours that were larger or posteriorly located * Minimum iceball margin was a predictor of early local tumour progression * A minimum 5-mm margin seems required for effective cryoablation of recurrent PCa

MRI-guided interventions for fast diagnosis and focal treatment of (recurrent) prostate cancer

Contains fulltext : 178910.pdf (publisher's version ) (Open Access)Radboud University, 18 december 2017Promotores : Barentsz, J.O., Futterer, J.J. Co-promotor : Scheenen, T.W.J.173 p

3D MR thermometry of frozen tissue: Feasibility and accuracy during cryoablation at 3T

Item does not contain fulltextPURPOSE: To assess the feasibility and accuracy of 3D ultrashort echo time (UTE) magnetic resonance (MR) thermometry of frozen tissue during cryoablation on a clinical 3T MR system. MATERIALS AND METHODS: Ex vivo porcine muscle specimens (n = 4) were imaged during two cycles of 10:3 minutes freeze-thaw on a 3T clinical MR scanner. Continuous MR monitoring was performed using a 3D radial ramp-sampled UTE sequence with a shortest TE of 70 mus. Fiber optic sensors were used for temperature reference. Data of three experiments were used as reference sets. Signal intensity values were normalized to baseline before cooling and related to temperature. Data for subzero temperatures were fit to a monoexponential function. In the separate validation set, the obtained fit was used to generate 3D MR temperature maps of frozen tissue at each imaging timepoint. Statistical analysis was performed to assess accuracy of the MR temperature maps. RESULTS: With 3D UTE imaging, MR signal was measured from frozen tissue down to temperatures as low as -40 degrees C. Temperatures predicted from the MR temperature maps strongly correlated with sensor recorded values (r = 0.977, P < 0.001). Bland-Altman analysis demonstrated a mean difference between MR-estimated temperatures and sensor readings of -1.2 +/- 2.7 degrees C with upper and lower limits of agreement of +4.1 and -6.5 degrees C, respectively. CONCLUSION: 3D MR thermometry of frozen tissue using UTE signal intensity was feasible during cryoablation on a clinical 3T MR system. Down to temperatures as low as -40 degrees C, accuracy of the MR temperature maps was within clinically acceptable limits. J. Magn. Reson. Imaging 2016;44:1572-1579

Safety aspects of the PiCCO thermodilution-cardiac output catheter during magnetic resonance imaging at 3 Tesla

Thermodilution cardiac output monitoring, using a thermistor-tipped intravascular catheter, is used in critically ill patients to guide hemodynamic therapy. Often, these patients also need magnetic resonance imaging (MRI) for diagnostic or prognostic reasons. As thermodilution catheters contain metal, they are considered MRI-unsafe and advised to be removed prior to investigation. However, removal and replacement of the catheter carries risks of bleeding, perforation and infection. This research is an in vitro safety assessment of the PiCCO™ thermodilution catheter during 3 T Magnetic Resonance Imaging (3T-MRI).  In a 3T-MRI environment, three different PiCCO™ catheter sizes were investigated in an agarose-gel, tissue mimicking phantom. Two temperature probes measured radiofrequency-induced heating; one at the catheter tip and one at a reference point. Magnetically induced catheter dislocation was assessed by visual observation as well as by analysis of the tomographic images. For all tested catheters, the highest measured temperature increase was 0.2 °C at the center of the bore and 0.3 °C under "worst-case" setting for the tested MRI pulse sequences. No magnetically induced catheter displacements were observed. Under the tested circumstances, no heating or dislocation of the PiCCO™ catheter was observed in a tissue mimicking phantom during 3T-MRI. Leaving the catheter in the critically ill patient during MRI investigation might pose a lower risk of complications than catheter removal and replacement

Current State of MRI-Guided Endovascular Arterial Interventions: A Systematic Review of Preclinical and Clinical Studies

BACKGROUND: MRI guidance of arterial endovascular interventions could be beneficial as it does not require radiation exposure, allows intrinsic blood-tissue contrast, and enables three-dimensional and functional imaging, however, clinical applications are still limited. PURPOSE: To review the current state of MRI-guided arterial endovascular interventions and to identify the most commonly reported challenges. STUDY TYPE: Systematic review. POPULATION: Pubmed, Embase, Web of Science, and The Cochrane Library were systematically searched to find relevant articles. The search strategy combined synonyms for vascular pathology, endovascular therapy, and real-time MRI guidance. FIELD STRENGTH/SEQUENCE: No field strength or sequence restrictions were applied. ASSESSMENT: Two reviewers independently identified and reviewed the original articles and extracted relevant data. STATISTICAL TESTS: Results of the included original articles are reported. RESULTS: A total of 24,809 studies were identified for screening. Eighty-eight studies were assessed for eligibility, after which data were extracted from 43 articles (6 phantom, 33 animal, and 4 human studies). Reported technical success rates for animal and human studies ranged between 42% to 100%, and the average complication rate was 5.8% (animal studies) and 8.8% (human studies). Main identified challenges were related to spatial and temporal resolution as well as safety, design, and scarcity of current MRI-compatible endovascular devices. DATA CONCLUSION: MRI guidance of endovascular arterial interventions seems feasible, however, included articles included mostly small single-center case series. Several hurdles remain to be overcome before larger trials can be undertaken. Main areas of research should focus on adequate imaging protocols with integrated tracking of dedicated endovascular devices

Laser Interstitial Thermal Therapy in Patients with Newly Diagnosed Glioblastoma: A Systematic Review

Contains fulltext : 231682.pdf (publisher's version ) (Open Access)BACKGROUND: Laser interstitial thermal therapy (LITT) is a minimal invasive neurosurgical technique for the treatment of brain tumors. Results of LITT have been reported in a case series of patients with deep seated and/or recurrent glioblastoma or cerebral metastases. With this review we aim to summarize the currently available evidence regarding safety and effectiveness of LITT in patients with newly diagnosed glioblastoma (nGBM). METHODS: A literature search was performed using electronic databases (PubMed and Embase). Papers were assessed for the methodological quality using the Risk Of Bias In Non- randomised Studies - of Interventions (ROBINS-I) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. RESULTS: We identified 835 papers of which only 11 articles were eligible for our review. All papers suffered from serious or critical risk of bias, and the quality of evidence was graded as very low according to the GRADE criteria. None of the studies was randomized and reporting of confounders and other parameters was poor. Median overall survival (OS) ranged from 4.1 to 32 months and progression free survival (PFS) from 2 to 31 months. The mean complication rate was 33.7%. No quality of life or cost-effectiveness data were reported. CONCLUSIONS: Due to the low quality of the studies, it is not possible to draw firm conclusions regarding the (cost) effectiveness of LITT in patients with newly diagnosed glioblastoma. The low quality of evidence shows the need for a well-designed prospective multicenter randomized controlled trial

Simultaneous slice excitation for accelerated passive marker tracking via phase-only cross correlation (POCC) in MR-guided needle interventions

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