The clinical application of PET/CT: a contemporary review

The combination of positron emission tomography (PET) scanners and x-ray computed tomography (CT) scanners into a single PET/CT scanner has resulted in vast improvements in the diagnosis of disease, particularly in the field of oncology. A decade on from the publication of the details of the first PET/CT scanner, we review the technology and applications of the modality. We examine the design aspects of combining two different imaging types into a single scanner, and the artefacts produced such as attenuation correction, motion and CT truncation artefacts. The article also provides a discussion and literature review of the applications of PET/CT to date, covering detection of tumours, radiotherapy treatment planning, patient management, and applications external to the field of oncology

Understanding and developing procedures for video-based assessment in medical education

Introduction Novel uses of video aim to enhance assessment in health-professionals education. Whilst these uses presume equivalence between video and live scoring, some research suggests that poorly understood variations could challenge validity. We aimed to understand examiners’ and students’ interaction with video whilst developing procedures to promote its optimal use. Methods Using design-based research we developed theory and procedures for video use in assessment, iteratively adapting conditions across simulated OSCE stations. We explored examiners’ and students’ perceptions using think-aloud, interviews and focus group. Data were analysed using constructivist grounded-theory methods. Results Video-based assessment produced detachment and reduced volitional control for examiners. Examiners ability to make valid video-based judgements was mediated by the interaction of station content and specifically selected filming parameters. Examiners displayed several judgemental tendencies which helped them manage videos’ limitations but could also bias judgements in some circumstances. Students rarely found carefully-placed cameras intrusive and considered filming acceptable if adequately justified. Discussion Successful use of video-based assessment relies on balancing the need to ensure station-specific information adequacy; avoiding disruptive intrusion; and the degree of justification provided by video’s educational purpose. Video has the potential to enhance assessment validity and students’ learning when an appropriate balance is achieved

Statistical Mechanics of Glass Formation in Molecular Liquids with OTP as an Example

We extend our statistical mechanical theory of the glass transition from examples consisting of point particles to molecular liquids with internal degrees of freedom. As before, the fundamental assertion is that super-cooled liquids are ergodic, although becoming very viscous at lower temperatures, and are therefore describable in principle by statistical mechanics. The theory is based on analyzing the local neighborhoods of each molecule, and a statistical mechanical weight is assigned to every possible local organization. This results in an approximate theory that is in very good agreement with simulations regarding both thermodynamical and dynamical properties

Integration and isolation in the global petrochemical industry: A multi-scalar corporate network analysis

The global petrochemical industry has long been characterized by stable patterns of Western corporate and geographic leadership, but since the early 2000s, the global playing field has changed significantly. China has overtaken the United States and Europe as the world’s largest petrochemical producer, and other emerging economies have emerged as global petrochemical players. Combining insights from scholarship on global corporate elites, world city networks, and relational economic geography, this article examines patterns in the corporate networks of leading petrochemical corporations. The research is based on a multi-scalar corporate network analysis, applying social network analysis to identify board interlocks, joint venture interlocks, and spatial interlocks between corporations. Through analyzing corporate networks across multiple scales, the research reveals patterns of both integration and isolation within the petrochemical industry. Isolation is evident in disconnected regional corporate elite networks, where the established North Atlantic corporate elite is interconnected through board interlocks, while corporate networks in Asia and other emerging economies remain disconnected. However, high levels of integration within the industry are also evident in an interconnected international company system formed through joint venture collaborations, and in overlapping subsidiary networks centered on petrochemical hubs around the world. The article argues that the results demonstrate a combination of resilience and change, or path dependence and contingency, in patterns of corporate power and collaboration. Western company networks still form the social and spatial backbone of the industry, but these have been challenged by emerging strategic centers and isolated elite networks in other parts of the world. This paper contributes to debates on industrial corporate elites, multiple globalizations, and the multipolar global economy

How freshwater biomonitoring tools vary sub‐seasonally reflects temporary river flow regimes

Characterizing temporary river ecosystem responses to flow regimes is vital for conserving their biodiversity and the services they provide to society. However, freshwater biomonitoring tools rarely reflect community responses to hydrological variations or flow cessation events, and those available have not been widely tested within temporary rivers. This study examines two invertebrate biomonitoring tools characterizing community responses to different flow‐related properties: the “Drought Effect of Habitat Loss on Invertebrates” (DEHLI) and “Lotic‐invertebrate Index for Flow Evaluation” (LIFE), which, respectively reflect community responses to habitat and hydraulic properties associated with changing flow conditions. Sub‐seasonal (monthly) variations of LIFE and DEHLI were explored within two groundwater‐fed intermittent rivers, one dries sporadically (a flashy, karstic hydrology—River Lathkill) and the other dries seasonally (a highly buffered flow regime—South Winterbourne). Biomonitoring tools were highly sensitive to channel drying and also responded to reduced discharges in permanently flowing reaches. Biomonitoring tools captured ecological recovery patterns in the Lathkill following a supra‐seasonal drought. Some unexpected results were observed in the South Winterbourne where LIFE and DEHLI indicated relatively high‐flow conditions despite low discharges occurring during some summer months. This probably reflected macrophyte encroachment, which benefitted certain invertebrates (e.g., marginal‐dwelling taxa) and highlights the importance of considering instream habitat conditions when interpreting flow regime influences on biomonitoring tools. Although LIFE and DEHLI were positively correlated, the latter responded more clearly to drying events, highlighting that communities respond strongly to the disconnection of instream habitats as flows recede. The results highlighted short‐term ecological responses to hydrological variations and the value in adopting sub‐seasonal sampling strategies within temporary rivers. Findings from this study indicate the importance of establishing flow response guilds which group taxa that respond comparably to flow cessation events. Such information could be adopted within biomonitoring practices to better characterize temporary river ecosystem responses to hydrological variations

Long-term two-dimensional pixel stability of EPIDs used for regular linear accelerator quality assurance

The long-term stability of three clinical electronic portal imaging devices (EPIDs) was studied to determine if longer times between calibrations can be justified. This would make alternatives to flood-field calibration of EPIDs clinically feasible, allowing for more effective use of EPIDs for dosimetry. Images were acquired monthly for each EPID as part of regular clinical quality assurance over a time period of approximately 3 years. The images were analysed to determine (1) the long-term stability of the EPID positioning system, (2) the dose response of the central pixels and (3) the long term stability of each pixel in the imager. The position of the EPID was found to be very repeatable with variations less than 0.3 pixels (0.27 mm) for all imagers (1 standard deviation). The central axis dose response was found to reliably track ion chamber measurements to better than 0.5%. The mean variation in pixel response (1 standard deviation), averaged over all pixels in the EPID, was found to be at most 0.6% for the three EPIDs studied over the entire period. More than 99% of pixels in each EPID showed less than 1% variation. Since the EPID response was found to be very stable over long periods of time, an annual calibration should be sufficient in most cases. More complex dosimetric calibrations should be clinically feasible

Monte Carlo-based adaptive EPID dose kernel accounting for different field size responses of imagers

The aim of this study is to present an efficient method to generate imager-specific Monte Carlo (MC)-based dose kernels for amorphous silicon-based electronic portal image device dose prediction and determine the effective backscattering thicknesses for such imagers. EPID field size-dependent responses were measured for five matched Varian accelerators from three institutions with 6 MV beams at the source to detector distance (SDD) of 105 cm. For two imagers, measurements were made with and without the imager mounted on the robotic supporting arm. Monoenergetic energy deposition kernels with 0–2.5 cm of water backscattering thicknesses were simultaneously computed by MC to a high precision. For each imager, the backscattering thickness required to match measured field size responses was determined. The monoenergetic kernel method was validated by comparing measured and predicted field size responses at 150 cm SDD, 10×10 cm2 multileaf collimator (MLC) sliding window fields created with 5, 10, 20, and 50 mm gaps, and a head-and-neck (H&N) intensity modulated radiation therapy (IMRT) patient field. Field size responses for the five different imagers deviated by up to 1.3%. When imagers were removed from the robotic arms, response deviations were reduced to 0.2%. All imager field size responses were captured by using between 1.0 and 1.6 cm backscatter. The predicted field size responses by the imager-specific kernels matched measurements for all involved imagers with the maximal deviation of 0.34%. The maximal deviation between the predicted and measured field size responses at 150 cm SDD is 0.39%. The maximal deviation between the predicted and measured MLC sliding window fields is 0.39%. For the patient field, gamma analysis yielded that 99.0% of the pixels have γ<1 by the 2%, 2 mm criteria with a 3% dose threshold. Tunable imager-specific kernels can be generated rapidly and accurately in a single MC simulation. The resultant kernels are imager position independent and are able to predict fields with varied incident energy spectra and a H&N IMRT patient field. The proposed adaptive EPID dose kernel method provides the necessary infrastructure to build reliable and accurate portal dosimetry systems

The clinical application of PET/CT: A contemporary review

The combination of positron emission tomography (PET) scanners and x-ray computed tomography (CT) scanners into a single PET/CT scanner has resulted in significant improvements in the diagnosis and staging of disease, particularly in the field of oncology. A decade on from the publication of the details of the first PET/CT scanner, we review the technology and applications of the modality. We examine the design aspects of combining two different imaging types into a single scanner, and the artefacts produced such as attenuation correction, motion and CT truncation artefacts. The article also provides a discussion and literature review of the applications of PET/CT to date, covering detection of tumours, radiotherapy treatment planning, patient management, and applications external to the field of oncology