Radiomics to better characterize small renal masses

Purpose: Radiomics is a specific field of medical research that uses programmable recognition tools to extract objective information from standard images to combine with clinical data, with the aim of improving diagnostic, prognostic, and predictive accuracy beyond standard visual interpretation. We performed a narrative review of radiomic applications that may support improved characterization of small renal masses (SRM). The main focus of the review was to identify and discuss methods which may accurately differentiate benign from malignant renal masses, specifically between renal cell carcinoma (RCC) subtypes and from angiomyolipoma without visible fat (fat-poor AML) and oncocytoma. Furthermore, prediction of grade, sarcomatoid features, and gene mutations would be of importance in terms of potential clinical utility in prognostic stratification and selecting personalised patient management strategies. / Methods: A detailed search of original articles was performed using the PubMed–MEDLINE database until 20 September 2020 to identify the English literature relevant to radiomics applications in renal tumour assessment. In total, 42 articles were included in the analysis in 3 main categories related to SRM: prediction of benign versus malignant SRM, subtypes, and nuclear grade, and other features of aggressiveness. / Conclusion: Overall, studies reported the superiority of radiomics over expert radiological assessment, but were mainly of retrospective design and therefore of low-quality evidence. However, it is clear that radiomics is an attractive modality that has the potential to improve the non-invasive diagnostic accuracy of SRM imaging and prediction of its natural behaviour. Further prospective validation studies of radiomics are needed to augment management algorithms of SRM

Cytoreductive nephrectomy in the current treatment algorithm

The two recent prospective randomized trials CARMENA and SURTIME have changed the therapy paradigm of metastatic renal cell carcinoma. The CARMENA trial was conducted to investigate whether cytoreductive nephrectomy (CN) is required in the targeted therapy area, whereas SURTIME studied whether deferred CN in combination with sunitinib can be used to identify patients with inherent targeted therapy resistance. In the current review, we provide a comprehensive discussion of two randomized studies and the current evidence with up-do-date algorithms for treating primary metastatic clear-cell renal cell carcinoma in the era of targeted therapy and immune-checkpoint inhibition

Scalar-tensor cosmologies: fixed points of the Jordan frame scalar field

We study the evolution of homogeneous and isotropic, flat cosmological models within the general scalar-tensor theory of gravity with arbitrary coupling function and potential. After introducing the limit of general relativity we describe the details of the phase space geometry. Using the methods of dynamical systems for the decoupled equation of the Jordan frame scalar field we find the fixed points of flows in two cases: potential domination and matter domination. We present the conditions on the mathematical form of the coupling function and potential which determine the nature of the fixed points (attractor or other). There are two types of fixed points, both are characterized by cosmological evolution mimicking general relativity, but only one of the types is compatible with the Solar System PPN constraints. The phase space structure should also carry over to the Einstein frame as long as the transformation between the frames is regular which however is not the case for the latter (PPN compatible) fixed point.Comment: 21 pages, 4 figures, some comments and references adde

Fiducial Reference Measurements for Satellite Ocean Colour (FRM4SOC)

Earth observation data can help us understand and address some of the grand challenges and threats facing us today as a species and as a planet, for example climate change and its impacts and sustainable use of the Earth’s resources. However, in order to have confidence in earth observation data, measurements made at the surface of the Earth, with the intention of providing verification or validation of satellite-mounted sensor measurements, should be trustworthy and at least of the same high quality as those taken with the satellite sensors themselves. Metrology tells us that in order to be trustworthy, measurements should include an unbroken chain of SI-traceable calibrations and comparisons and full uncertainty budgets for each of the in situ sensors. Until now, this has not been the case for most satellite validation measurements. Therefore, within this context, the European Space Agency (ESA) funded a series of Fiducial Reference Measurements (FRM) projects targeting the validation of satellite data products of the atmosphere, land, and ocean, and setting the framework, standards, and protocols for future satellite validation efforts. The FRM4SOC project was structured to provide this support for evaluating and improving the state of the art in ocean colour radiometry (OCR) and satellite ocean colour validation through a series of comparisons under the auspices of the Committee on Earth Observation Satellites (CEOS). This followed the recommendations from the International Ocean Colour Coordinating Group’s white paper and supports the CEOS ocean colour virtual constellation. The main objective was to establish and maintain SI traceable ground-based FRM for satellite ocean colour and thus make a fundamental contribution to the European system for monitoring the Earth (Copernicus). This paper outlines the FRM4SOC project structure, objectives and methodology and highlights the main results and achievements of the project: (1) An international SI-traceable comparison of irradiance and radiance sources used for OCR calibration that set measurement, calibration and uncertainty estimation protocols and indicated good agreement between the participating calibration laboratories from around the world; (2) An international SI-traceable laboratory and outdoor comparison of radiometers used for satellite ocean colour validation that set OCR calibration and comparison protocols; (3) A major review and update to the protocols for taking irradiance and radiance field measurements for satellite ocean colour validation, with particular focus on aspects of data acquisition and processing that must be considered in the estimation of measurement uncertainty and guidelines for good practice; (4) A technical comparison of the main radiometers used globally for satellite ocean colour validation bringing radiometer manufacturers together around the same table for the first time to discuss instrument characterisation and its documentation, as needed for measurement uncertainty estimation; (5) Two major international side-by-side field intercomparisons of multiple ocean colour radiometers, one on the Atlantic Meridional Transect (AMT) oceanographic cruise, and the other on the Acqua Alta oceanographic tower in the Gulf of Venice; (6) Impact and promotion of FRM within the ocean colour community, including a scientific road map for the FRM-based future of satellite ocean colour validation and vicarious calibration (based on the findings of the FRM4SOC project, the consensus from two major international FRM4SOC workshops and previous literature, including the IOCCG white paper on in situ ocean colour radiometry)

What kind of heat loss requirements NZEB and deep renovation sets for building envelope?

In most of countries the energy performance of buildings is defined as (primary) energy use of whole buildingâ s (heating, cooling, ventilation, DHW, lighting, HVAC auxiliary, appliances), not as specific requirements for building envelope. For construction companies of production of modular renovation panels it in necessary to know heat loss properties of building envelope (U, W/(m2â K); ï , W/(mâ K); ï £, W/K; q50, m3/(hâ m2)). In this study it is analyzed what kind of heat loss requirements exists for building envelope to meet on annual basis to following targets: nZEB i.e. national nearly zero energy definition; deep energy renovation with 80 % reduction of primary energy; ZEB i.e. net Zero Energy Building = the annual primary energy use = 0 kWh/(m² a). Indoor climate and energy calculations were made based on national energy calculation methodologies in six countries: Denmark, Estonia, Latvia, Czech Republic, Portugal, and Netherlands. Requirements for heat loss of building envelope vary depending on requirements on indoor climate and energy performance in specific country, outdoor climate, availability of renewable energy, and building typology. The thermal transmittance of the modular wall panels for nZEB was â 5% from pre renovation thermal transmittance in Latvia, â 10% in Estonia and up to 50% in Portugal. For roof the decrease of thermal transmittance was smaller mainly due to smaller thermal transmittance before renovation. Results show the difficulties to reach ZEB with multi-story apartment buildings in cold climate. There are not enough places to install renewables for energy production on site.The study has been conducted in the projects H2020 MoreConnect, TK146 the Estonian Centre of Excellence in Zero Energy and Resource Efficient Smart Buildings and Districts, ZEBE, IUT1−15 Nearly-zero energy solutions and their implementation on deep renovation of buildings

Management of Sporadic Renal Angiomyolipomas: A Systematic Review of Available Evidence to Guide Recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel

CONTEXT: Little is known about the natural history of sporadic angiomyolipomas (AMLs); there is uncertainty regarding the indications of treatment and treatment options. OBJECTIVE: To evaluate the indications, effectiveness, harms, and follow-up of different management modalities for sporadic AML to provide guidance for clinical practice. EVIDENCE ACQUISITION: A systematic review of the literature was undertaken, incorporating Medline, Embase, and the Cochrane Library (from 1 January 1990 to 30 June 2017), in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. No restriction on study design was imposed. Patients with sporadic AML were included. The main interventions included active surveillance, surgery (nephron-sparing surgery and radical nephrectomy), selective arterial embolisation, and percutaneous or laparoscopic thermal ablations (radiofrequency, microwaves, or cryoablation). The outcomes included indications for active treatment, AML growth rate, AML recurrence rate, risk of bleeding, post-treatment renal function, adverse events of treatments, and modalities of follow-up. Risk of bias assessment was performed using standard Cochrane methods. EVIDENCE SYNTHESIS: Among 2704 articles identified, 43 were eligible for inclusion (zero randomised controlled trials, nine nonrandomised comparative retrospective studies, and 34 single-arm case series). Most studies were retrospective and uncontrolled, and had a moderate to high risk of bias. CONCLUSIONS: In active surveillance series, spontaneous bleeding was reported in 2% of patients and active treatment was undertaken in 5%. Active surveillance is the most chosen option in 48% of the cases, followed by surgery in 31% and selective arterial embolisation in 17% of the cases. Selective arterial embolisation appeared to reduce AML volume but required secondary treatment in 30% of the cases. Surgery (particularly nephron-sparing surgery) was the most effective treatment in terms of recurrence and need for secondary procedures. Thermal ablation was an infrequent option. The association between AML size and the risk of bleeding remained unclear; as such the traditional 4-cm cut-off should not per se trigger active treatment. In spite of the limitations and uncertainties relating to the evidence base, the findings may be used to guide and inform clinical practice, until more robust data emerge. PATIENT SUMMARY: Sporadic angiomyolipoma (AML) is a benign tumour of the kidney consisting of a mixture of blood vessels, fat, and muscle. Large tumours may have a risk of spontaneous bleeding. However, the size beyond which these tumours need to be treated remains unclear. Most small AMLs can be monitored without any active treatment. For those who need treatment, options include surgical removal of the tumour or stopping its blood supply (selective embolisation). Surgery has a lower recurrence rate and lower need for a repeat surgical procedure

Field Intercomparison of Radiometer Measurements for Ocean Colour Validation

A field intercomparison was conducted at the Acqua Alta Oceanographic Tower (AAOT) in the northern Adriatic Sea, from 9 to 19 July 2018 to assess differences in the accuracy of in- and above-water radiometer measurements used for the validation of ocean colour products. Ten measurement systems were compared. Prior to the intercomparison, the absolute radiometric calibration of all sensors was carried out using the same standards and methods at the same reference laboratory. Measurements were performed under clear sky conditions, relatively low sun zenith angles, moderately low sea state and on the same deployment platform and frame (except in-water systems). The weighted average of five above-water measurements was used as baseline reference for comparisons. For downwelling irradiance (), there was generally good agreement between sensors with differences of <6% for most of the sensors over the spectral range 400 nm–665 nm. One sensor exhibited a systematic bias, of up to 11%, due to poor cosine response. For sky radiance () the spectrally averaged difference between optical systems was <2.5% with a root mean square error (RMS) <0.01 mWm−2 nm−1 sr−1. For total above-water upwelling radiance (), the difference was <3.5% with an RMS <0.009 mWm−2 nm−1 sr−1. For remote-sensing reflectance (), the differences between above-water TriOS RAMSES were <3.5% and <2.5% at 443 and 560 nm, respectively, and were <7.5% for some systems at 665 nm. Seabird HyperSAS sensors were on average within 3.5% at 443 nm, 1% at 560 nm, and 3% at 665 nm. The differences between the weighted mean of the above-water and in-water systems was <15.8% across visible bands. A sensitivity analysis showed that accounted for the largest fraction of the variance in , which suggests that minimizing the errors arising from this measurement is the most important variable in reducing the inter-group differences in . The differences may also be due, in part, to using five of the above-water systems as a reference. To avoid this, in situ normalized water-leaving radiance () was therefore compared to AERONET-OC SeaPRiSM as an alternative reference measurement. For the TriOS-RAMSES and Seabird-Hyperspectral Surface Acquisition System (HyperSAS) sensors the differences were similar across the visible spectra with 4.7% and 4.9%, respectively. The difference between SeaPRiSM and two in-water systems at blue, green and red bands was 11.8%. This was partly due to temporal and spatial differences in sampling between the in-water and above-water systems and possibly due to uncertainties in instrument self-shading for one of the in-water measurements

Laboratory Intercomparison of Radiometers Used for Satellite Validation in the 400–900 nm Range

An intercomparison of radiance and irradiance ocean color radiometers (The Second Laboratory Comparison Exercise—LCE-2) was organized within the frame of the European Space Agency funded project Fiducial Reference Measurements for Satellite Ocean Color (FRM4SOC) May 8–13, 2017 at Tartu Observatory, Estonia. LCE-2 consisted of three sub-tasks: 1) SI-traceable radiometric calibration of all the participating radiance and irradiance radiometers at the Tartu Observatory just before the comparisons; 2) Indoor intercomparison using stable radiance and irradiance sources in controlled environment; and 3) Outdoor intercomparison of natural radiation sources over terrestrial water surface. The aim of the experiment was to provide one link in the chain of traceability from field measurements of water reflectance to the uniform SI-traceable calibration, and after calibration to verify whether different instruments measuring the same object provide results consistent within the expected uncertainty limits. This paper describes the activities and results of the first two phases of LCE-2: the SI-traceable radiometric calibration and indoor intercomparison, the results of outdoor experiment are presented in a related paper of the same journal issue. The indoor experiment of the LCE-2 has proven that uniform calibration just before the use of radiometers is highly effective. Distinct radiometers from different manufacturers operated by different scientists can yield quite close radiance and irradiance results (standard deviation s < 1%) under defined conditions. This holds when measuring stable lamp-based targets under stationary laboratory conditions with all the radiometers uniformly calibrated against the same standards just prior to the experiment. In addition, some unification of measurement and data processing must be settled. Uncertainty of radiance and irradiance measurement under these conditions largely consists of the sensor’s calibration uncertainty and of the spread of results obtained by individual sensors measuring the same object