703 research outputs found

    3D printing endobronchial models for surgical training and simulation

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    Lung cancer is the leading cause of cancer-related deaths. Many methods and devices help acquire more accurate clinical and localization information during lung interventions and may impact the death rate for lung cancer. However, there is a learning curve for operating these tools due to the complex structure of the airway. In this study, we first discuss the creation of a lung phantom model from medical images, which is followed by a comparison of 3D printing in terms of quality and consistency. Two tests were conducted to test the performance of the developed phantom, which was designed for training simulations of the target and ablation processes in endochonchial interventions. The target test was conducted through an electromagnetic tracking catheter with navigation software. An ablation catheter with a recently developed thermochromic ablation gel conducted the ablation test. The results of two tests show that the phantom was very useful for target and ablation simulation. In addition, the thermochromic gel allowed doctors to visualize the ablation zone. Many lung interventions may benefit from custom training or accuracy with the proposed low-cost and patient-specific phantom

    Origami lesion-targeting device for CT-guided interventions

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    The objective of this study is to preliminarily evaluate a lesion-targeting device for CT-guided interventions. The device is created by laser cutting the structure from a sheet of medical grade paperboard, 3D printing two radiocontrast agent grids onto the surface and folding the structure into a rectangular prism with a viewing window. An abdominal imaging phantom was used to evaluate the device through CT imaging and the targeting of lesions for needle insertion. The lesion-targeting trials resulted in a mean targeting error of 2.53 mm (SD 0.59 mm, n = 30). The device is rigid enough to adequately support standard biopsy needles, and it attaches to the patient, reducing the risk of tissue laceration by needles held rigidly in place by an external manipulator. Additional advantages include adequate support for the insertion of multiple surgical tools at once for procedures such as composite ablation and the potential to guide off-axial needle insertion. The low-cost and disposability of the device make it well-suited for the minimally invasive image-guided therapy environment

    A Review of Ultrasound-Mediated Checkpoint Inhibitor Immunotherapy.

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    Over the past decade, immunotherapy has emerged as a major modality in cancer medicine. However, despite its unprecedented success, immunotherapy currently benefits only a subgroup of patients, may induce responses of limited duration and is associated with potentially treatment-limiting side effects. In addition, responses to immunotherapeutics are sometimes diminished by the emergence of a complex array of resistance mechanisms. The efficacy of immunotherapy depends on dynamic interactions between tumour cells and the immune landscape in the tumour microenvironment. Ultrasound, especially in conjunction with cavitation-promoting agents such as microbubbles, can assist in the uptake and/or local release of immunotherapeutic agents at specific target sites, thereby increasing treatment efficacy and reducing systemic toxicity. There is also increasing evidence that ultrasound and/or cavitation may themselves directly stimulate a beneficial immune response. In this review, we summarize the latest developments in the use of ultrasound and cavitation agents to promote checkpoint inhibitor immunotherapy

    Assessment of the response of hepatocellular carcinoma to interventional radiology treatments

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    According to Barcelona Clinic Liver Cancer (BCLC) guidelines, interventional radiology procedures are valuable treatment options for many hepatocellular carcinomas (HCCs) that are not amenable to resection or transplantation. Accurate assessment of the efficacy of therapies at earlier stages enables completion of treatment, optimal follow-up and to prevent potentially unnecessary treatments, side effects and costly failure. The goal of this review is to summarize and describe the radiological strategies that have been proposed to predict survival and to stratify HCC responses after interventional radiology therapies. New techniques currently in development are also described

    Commentary: how will interventional oncology navigate the "valleys of death" for new medical devices?

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    Whereas clinical trials of cancer drugs have methodological standards and conventional primary endpoints, these are not necessarily applicable to the clinical development of loco-regional treatments and new medical devices. The current challenge is to generate high-level clinical evidence for loco-regional treatments to define the benefits for patients. In this article, we argue that, to generate convincing evidence of clinical efficacy and safety, the collective coherence of the entire data package is often more important than the primary endpoint of one clinical trial. We also propose that, when a comprehensive clinical data package is not feasible, limited clinical data can be supplemented with other types of evidence. Emerging life science companies often define the "valley of death" after securing initial investment to translate an early medical device concept to a development stage that is attractive to funders. Unfortunately for this industry, there is a second "valley of death" if the focus and goal is only regulatory approval, to the neglect of clinical acceptance and reimbursement. For the emerging specialism of interventional oncology, it is critical to plan a clear line of sight for each new medical device to avoid the valleys of death and to demonstrate the clinical benefit. Increased international guidance to establish realistic yet convincing standards in this area may avoid attrition of potentially beneficial devices and therapeutic procedures in the valleys of death

    How Many CMEs Have Flux Ropes? Deciphering the Signatures of Shocks, Flux Ropes, and Prominences in Coronagraph Observations of CMEs

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    We intend to provide a comprehensive answer to the question on whether all Coronal Mass Ejections (CMEs) have flux rope structure. To achieve this, we present a synthesis of the LASCO CME observations over the last sixteen years, assisted by 3D MHD simulations of the breakout model, EUV and coronagraphic observations from STEREO and SDO, and statistics from a revised LASCO CME database. We argue that the bright loop often seen as the CME leading edge is the result of pileup at the boundary of the erupting flux rope irrespective of whether a cavity or, more generally, a 3-part CME can be identified. Based on our previous work on white light shock detection and supported by the MHD simulations, we identify a new type of morphology, the `two-front' morphology. It consists of a faint front followed by diffuse emission and the bright loop-like CME leading edge. We show that the faint front is caused by density compression at a wave (or possibly shock) front driven by the CME. We also present high-detailed multi-wavelength EUV observations that clarify the relative positioning of the prominence at the bottom of a coronal cavity with clear flux rope structure. Finally, we visually check the full LASCO CME database for flux rope structures. In the process, we classify the events into two clear flux rope classes (`3-part', `Loop'), jets and outflows (no clear structure). We find that at least 40% of the observed CMEs have clear flux rope structures. We propose a new definition for flux rope CMEs (FR-CMEs) as a coherent magnetic, twist-carrying coronal structure with angular width of at least 40 deg and able to reach beyond 10 Rsun which erupts on a time scale of a few minutes to several hours. We conclude that flux ropes are a common occurrence in CMEs and pose a challenge for future studies to identify CMEs that are clearly not FR-CMEs.Comment: 26 pages, 9 figs, to be published in Solar Physics Topical Issue "Flux Rope Structure of CMEs

    Solar Flares and Coronal Mass Ejections: A Statistically Determined Flare Flux-CME Mass Correlation

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    In an effort to examine the relationship between flare flux and corresponding CME mass, we temporally and spatially correlate all X-ray flares and CMEs in the LASCO and GOES archives from 1996 to 2006. We cross-reference 6,733 CMEs having well-measured masses against 12,050 X-ray flares having position information as determined from their optical counterparts. For a given flare, we search in time for CMEs which occur 10-80 minutes afterward, and we further require the flare and CME to occur within +/-45 degrees in position angle on the solar disk. There are 826 CME/flare pairs which fit these criteria. Comparing the flare fluxes with CME masses of these paired events, we find CME mass increases with flare flux, following an approximately log-linear, broken relationship: in the limit of lower flare fluxes, log(CME mass)~0.68*log(flare flux), and in the limit of higher flare fluxes, log(CME mass)~0.33*log(flare flux). We show that this broken power-law, and in particular the flatter slope at higher flare fluxes, may be due to an observational bias against CMEs associated with the most energetic flares: halo CMEs. Correcting for this bias yields a single power-law relationship of the form log(CME mass)~0.70*log(flare flux). This function describes the relationship between CME mass and flare flux over at least 3 dex in flare flux, from ~10^-7 to 10^-4 W m^-2.Comment: 28 pages, 16 figures, accepted to Solar Physic

    Structural thermal stability of graphene oxide-doped copper-cobalt oxide coatings as a solar selective surface

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    3d transition metal oxides based thin film coatings such as copper-cobalt oxides exhibit high absorption in the visible region and low emittance in the infra-red to far-infra-red region of the solar spectrum which is favourable for use as potential selective surface materials in photothermal devices. These materials have the potential to minimize heating while increasing absorption in the operative spectrum range and therefore achieve higher solar selectivity. A series of mixed copper-cobalt metal spinel oxides (CuxCoyOz) doped with graphene oxide thin films were deposited on commercial grade aluminium substrates using a sol–gel dip-coating technique at an annealing temperature of 500 °C in air for 1 h. Characterizations of the synthesized films were carried out by high temperature synchrotron radiation X-ray Diffraction (SR-XRD), UV-Vis, Fourier Transform infrared spectroscopy (FTIR) and X-ray photoelectron microscopy (XPS) techniques. High thermal stability of coatings with multiple phases, binary and ternary metal oxides, was defined through SR-XRD study. FTIR analysis shows moderate (<80%) to high (up to 99%) reflectance in the infra-red region while the UV-Vis investigations demonstrate that, in the visible region, solar absorption increases gradually (up to 95%) with the addition of graphene oxide to the CuxCoyOz coatings. With the incorporation of 1.5 wt% of graphene oxide to the copper-cobalt oxide coatings, a high solar selectivity of 29.01 (the ratio of the average solar absorptance in visible and the average thermal emittance in infra-red to far infra-red region; α/ε) was achieved
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