Paths to justice in the Netherlands: looking for signs of social exclusion

In 2003 Genn's Paths to Justice study for the UK was replicated in the Netherlands. A survey was held among 3.500 citizens into their experiences with problems for which there might be a legal solution.The data were collected by internet questionnaires, which were addressed to a random sample of an internet panel. In this paper we present some major findings on: (1) the incidence of justiciable problems within the population; (2) the kind of strategies people choose to solve their problems; (3) the outcome of different strategies for resolving justiciable problems; (4) the public's perceptions of the legal system. More specifically, we study differences with respect to age, marital status, educational level, income level and social class, in order to shed some light on the role and scope of social exclusion. Our results suggest that access to justice in the Netherlands is not so much restricted by the supply of legal advice and the organisation of the legal system, as well as by insufficient social-psychological capabilities of the citizens concerned.Legal procedure, legal system, social exclusion

Paths to justice in the Netherlands: looking for signs of social exclusion

In 2003 Genn's Paths to Justice study for the UK was replicated in the Netherlands. A survey was held among 3.500 citizens into their experiences with problems for which there might be a legal solution.The data were collected by internet questionnaires, which were addressed to a random sample of an internet panel. In this paper we present some major findings on: (1) the incidence of justiciable problems within the population; (2) the kind of strategies people choose to solve their problems; (3) the outcome of different strategies for resolving justiciable problems; (4) the public's perceptions of the legal system. More specifically, we study differences with respect to age, marital status, educational level, income level and social class, in order to shed some light on the role and scope of social exclusion. Our results suggest that access to justice in the Netherlands is not so much restricted by the supply of legal advice and the organisation of the legal system, as well as by insufficient social-psychological capabilities of the citizens concerned

Paths to Justice in the Netherlands

FDR Het institutionele en rechtsstatelijke kader van de rechtspleging - ou

Paths to justice in the Netherlands: looking for signs of social exclusion

In 2003 Genn's Paths to Justice study for the UK was replicated in the Netherlands. A survey was held among 3.500 citizens into their experiences with problems for which there might be a legal solution.The data were collected by internet questionnaires, which were addressed to a random sample of an internet panel. In this paper we present some major findings on: (1) the incidence of justiciable problems within the population; (2) the kind of strategies people choose to solve their problems; (3) the outcome of different strategies for resolving justiciable problems; (4) the public's perceptions of the legal system. More specifically, we study differences with respect to age, marital status, educational level, income level and social class, in order to shed some light on the role and scope of social exclusion. Our results suggest that access to justice in the Netherlands is not so much restricted by the supply of legal advice and the organisation of the legal system, as well as by insufficient social-psychological capabilities of the citizens concerned

Over meten en samenloop van juridische problemen in de delta

FDR Het institutionele en rechtsstatelijke kader van de rechtspleging - ou

Metal artifact reduction in 68^{68}Ga-PSMA-11 PET/MRI for prostate cancer patients with hip joint replacement using multiacquisition variable-resonance image combination

BACKGROUND PET/MRI has a high potential in oncology imaging, especially for tumor indications where high soft tissue contrast is crucial such as genitourinary tumors. One of the challenges for PET/MRI acquisition is handling of metal implants. In addition to conventional methods, more innovative techniques have been developed to reduce artifacts caused by those implants such as the selective multiacquisition variable-image combination (MAVRIC-SL). The aim of this study is to perform a quantitative and qualitative assessment of metal artifact reduction in $^{68}$Ga-PSMA-11 PET/MRI for prostate cancer patients with hip joint replacement using a selective MAVRIC-SL sequence for the whole pelvis. METHODS We retrospectively analyzed data of 20 men with 37 metal hip implants diagnosed with PCA, staged or restaged by $^{68}$Ga-PSMA-11 PET/MRI from June 2016 to December 2017. Each signal cancellation per side or metal implant was analyzed on the reference sequence LAVA-FLEX, as well as T1-weighted fast spin echo (T1w-FSE) sequence and MAVRIC-SL. Two independent reviewers reported on a four-point scale whether abnormal pelvic $^{68}$Ga-PSMA-11 uptake could be assigned to an anatomical structure in the tested sequences. RESULTS The smallest averaged signal void was observed on MAVRIC-SL sequences with a mean artifact size of 26.17 cm$^{2}$ (range 12.63 to 42.93 cm$^{2}$, p < 0.001). The best image quality regarding anatomical assignment of pathological PSMA uptakes in the pelvis by two independent readers was noted for MAVRIC-SL sequences, followed by T1w-FSE with excellent interreader agreement. CONCLUSIONS MAVRIC-SL sequence allows better image quality in the surrounding of hip implants by reducing MR signal voids and increasing so the accuracy of anatomical assignment of pathological $^{68}$Ga-PSMA-11 uptake in the pelvis over LAVA-FLEX and T1w-FSE sequences

Reproducibility of Standardized Uptake Values Including Volume Metrics Between TOF-PET-MR and TOF-PET-CT.

Purpose To investigate the reproducibility of tracer uptake measurements, including volume metrics, such as metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) obtained by TOF-PET-CT and TOF-PET-MR. Materials and Methods Eighty consecutive patients with different oncologic diagnoses underwent TOF-PET-CT (Discovery 690; GE Healthcare) and TOF-PET-MR (SIGNA PET-MR; GE Healthcare) on the same day with single dose-18F-FDG injection. The scan order, PET-CT following or followed by PET-MR, was randomly assigned. A spherical volume of interest (VOI) of 30 mm was placed on the liver in accordance with the PERCIST criteria. For liver, the maximum and mean standard uptake value for body weight (SUV) and lean body mass (SUL) were obtained. For tumor delineation, VOI with a threshold of 40 and 50% of SUVmax was used (VOI40 and VOI50). The SUVmax, SUVmean, SUVpeak, MTV and TLG were calculated. The measurements were compared between the two scanners. Results In total, 80 tumor lesions from 35 patients were evaluated. There was no statistical difference observed in liver regions, whereas in tumor lesions, SUVmax, SUV mean, and SUVpeak of PET-MR were significantly underestimated (p < 0.001) in both VOI40 and VOI50. Among volume metrics, there was no statistical difference observed except TLG on VOI50 (p = 0.03). Correlation between PET-CT and PET-MR of each metrics were calculated. There was a moderate correlation of the liver SUV and SUL metrics (r = 0.63-0.78). In tumor lesions, SUVmax and SUVmean had a stronger correlation with underestimation in PET-MR on VOI 40 (SUVmax and SUVmean; r = 0.92 and 0.91 with slope = 0.71 and 0.72, respectively). In the evaluation of MTV and TLG, the stronger correlations were observed both on VOI40 (MTV and TLG; r = 0.75 and 0.92) and VOI50 (MTV and TLG; r = 0.88 and 0.95) between PET-CT and PET-MR. Conclusion PET metrics on TOF-PET-MR showed a good correlation with that of TOF-PET-CT. SUVmax and SUVpeak of tumor lesions were underestimated by 16% on PET-MRI. MTV with % threshold can be regarded as identical volumetric markers for both TOF-PET-CT and TOF-PET-MR

PET/MR outperforms PET/CT in suspected occult tumors

BACKGROUND To compare the diagnostic accuracy of PET/MR and PET/CT in patients with suspected occult primary tumors. METHODS This prospective study was approved by the institutional review board. Sequential PET/CT-MR was performed in 43 patients (22 male subjects; median age, 58 years; range, 20-86 years) referred for suspected occult primary tumors. Patients were assessed with PET/CT and PET/MR for the presence of a primary tumor, lymph node metastases, and distant metastases. Wilcoxon signed-rank test was performed to compare the diagnostic accuracy of PET/CT and PET/MR. RESULT According to the standard of reference, a primary lesion was found in 14 patients. In 16 patients, the primary lesion remained occult. In the remaining 13 patients, lesions proved to be benign. PET/MR was superior to PET/CT for primary tumor detection (sensitivity/specificity, 0.85/0.97 vs 0.69/0.73; P = 0.020) and comparable to PET/CT for the detection of lymph node metastases (sensitivity/specificity, 0.93/1.00 vs 0.93/0.93; P = 0.157) and distant metastases (sensitivity/specificity, 1.00/0.97 vs 0.82/1.00; P = 0.564). PET/CT tended to misclassify physiologic FDG uptake as malignancy compared with PET/MR (8 patients vs 1 patient). CONCLUSIONS PET/MR outperforms PET/CT in the workup of suspected occult malignancies. PET/MR may replace PET/CT to improve clinical workflow

Response Monitoring with [18F]FLT PET and Diffusion-Weighted MRI After Cytotoxic 5-FU Treatment in an Experimental Rat Model for Colorectal Liver Metastases.

PURPOSE: The aim of the study was to investigate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) and 3'-dexoy-3'-[(¹⁸)F]fluorothymidine ([(¹⁸)F]FLT) positron emission tomography (PET) as early biomarkers of treatment response of 5-fluorouracil (5-FU) in a syngeneic rat model of colorectal cancer liver metastases. PROCEDURES: Wag/Rij rats with intrahepatic syngeneic CC531 tumors were treated with 5-FU (15, 30, or 60 mg/kg in weekly intervals). Before treatment and at days 1, 3, 7, and 14 after treatment rats underwent DW-MRI and [(¹⁸)F]FLT PET. Tumors were analyzed immunohistochemically for Ki67, TK1, and ENT1 expression. RESULTS: 5-FU inhibited the growth of CC531 tumors in a dose-dependent manner. Immunohistochemical analysis did not show significant changes in Ki67, TK1, and ENT1 expression. However, [(¹⁸)F]FLT SUV_mean and SUV_max were significantly increased at days 4 and 7 after treatment with 5-FU (60 mg/kg) and returned to baseline at day 14 (SUV_max at days -1, 4, 7, and 14 was 1.1 ± 0.1, 2.3 ± 0.5, 2.3 ± 0.6, and 1.5 ± 0.4, respectively). No changes in [(¹⁸)F]FLT uptake were observed in the nontreated animals. Furthermore, the apparent diffusion coefficient (ADCmean) did not change in 5-FU-treated rats compared to untreated rats. CONCLUSION: This study suggests that 5-FU treatment induces a flare in [(¹⁸)F]FLT uptake of responsive CC531 tumors in the liver, while the ADC_mean did not change significantly. Future studies in larger groups are warranted to further investigate whether [(¹⁸)F]FLT PET can discriminate between disease progression and treatment response.The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking (www.imi.europa.eu) under grant agreement number 115151, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in kind contribution