Purpose 2-[F-18]FDG PET/CT is of utmost importance for radiation treatment (RT) planning and response monitoring in lung cancer patients, in both non-small and small cell lung cancer (NSCLC and... Show morePurpose 2-[F-18]FDG PET/CT is of utmost importance for radiation treatment (RT) planning and response monitoring in lung cancer patients, in both non-small and small cell lung cancer (NSCLC and SCLC). This topic has been addressed in guidelines composed by experts within the field of radiation oncology. However, up to present, there is no procedural guideline on this subject, with involvement of the nuclear medicine societies. Methods A literature review was performed, followed by a discussion between a multidisciplinary team of experts in the different fields involved in the RT planning of lung cancer, in order to guide clinical management. The project was led by experts of the two nuclear medicine societies (EANM and SNMMI) and radiation oncology (ESTRO). Results and conclusion This guideline results from a joint and dynamic collaboration between the relevant disciplines for this topic. It provides a worldwide, state of the art, and multidisciplinary guide to 2-[F-18]FDG PET/CT RT planning in NSCLC and SCLC. These practical recommendations describe applicable updates for existing clinical practices, highlight potential flaws, and provide solutions to overcome these as well. Finally, the recent developments considered for future application are also reviewed. Show less
Scheepens, K.M.J.; Marsidi, N.; Genders, R.E.; Horeman-Franse, T. 2022
After surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function. An incision placed in the wrong direction causes unnecessary skin tension... Show moreAfter surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function. An incision placed in the wrong direction causes unnecessary skin tension on the wound, resulting in increased collagen disposition and potentially hypertrophic scars. Currently, skin tension lines are used for incision planning. However, these lines are not universal and are a static representation of the skin tension that is in fact under influence of muscle action. By designing a new skin force measurement device the authors intend to make research on dynamic skin characteristics possible and to objectify incision planning and excision closure planning. The device applies a known compressive force to the skin in standardized directions and measures the displacement of the skin. This allows users to measure the skin reaction force in response to compression and to determine the optimal incision line or best wound closure direction. The device has an accuracy of 96% and a sensitivity of < 0.01 mm. It is compact, works non-invasively and standardizes measurement directions and is therefore an improvement over previously designed skin tensiometers. Show less
Elmahdy, M.S.; Beljaards, L.; Yousefi, S.; Sokooti, H.; Verbeek, F.; Heide, U.A. van der; Staring, M. 2021
Medical image registration and segmentation are two of the most frequent tasks in medical image analysis. As these tasks are complementary and correlated, it would be beneficial to apply them... Show moreMedical image registration and segmentation are two of the most frequent tasks in medical image analysis. As these tasks are complementary and correlated, it would be beneficial to apply them simultaneously in a joint manner. In this paper, we formulate registration and segmentation as a joint problem via a Multi-Task Learning (MTL) setting, allowing these tasks to leverage their strengths and mitigate their weaknesses through the sharing of beneficial information. We propose to merge these tasks not only on the loss level, but on the architectural level as well. We studied this approach in the context of adaptive image-guided radiotherapy for prostate cancer, where planning and follow-up CT images as well as their corresponding contours are available for training. At testing time the contours of the follow-up scans are not available, which is a common scenario in adaptive radiotherapy. The study involves two datasets from different manufacturers and institutes. The first dataset was divided into training (12 patients) and validation (6 patients), and was used to optimize and validate the methodology, while the second dataset (14 patients) was used as an independent test set. We carried out an extensive quantitative comparison between the quality of the automatically generated contours from different network architectures as well as loss weighting methods. Moreover, we evaluated the quality of the generated deformation vector field (DVF). We show that MTL algorithms outperform their Single-Task Learning (STL) counterparts and achieve better generalization on the independent test set. The best algorithm achieved a mean surface distance of 1.06 +/- 0.3 mm, 1.27 +/- 0.4 mm, 0.91 +/- 0.4 mm, and 1.76 +/- 0.8 mm on the validation set for the prostate, seminal vesicles, bladder, and rectum, respectively. The high accuracy of the proposed method combined with the fast inference speed, makes it a promising method for automatic re-contouring of follow-up scans for adaptive radiotherapy, potentially reducing treatment related complications and therefore improving patients quality-of-life after treatment. The source code is available at https://github.com/moelmahdy/JRS-MTL. Show less
Between 1960 and 1983 the Dutch economist Dr. Albert Winsemius (1910-1996) was the most influential economic adviser to the government of Singapore and one of the leading architects of Singapore’s... Show moreBetween 1960 and 1983 the Dutch economist Dr. Albert Winsemius (1910-1996) was the most influential economic adviser to the government of Singapore and one of the leading architects of Singapore’s highly successful development model. Winsemius' beliefs and recommendations chimed with the views of Singapore’s first-generation postcolonial political leaders and quickly grew in popular appeal once they started yielding impressive economic results. Winsemius’ uncompromising hostility to communism, and at the same time his sympathy toward moderate trade unionism, were of particular importance here.This research identifies strategies and policies that contributed to Singapore's development, and that can be traced to Albert Winsemius as a historical principal. It concludes that in essence, many of these successful strategies and policies were based on Winsemius’ experiences in his earlier life and career: the economic reconstruction in the Netherlands in the years after World War Two, in which he played a key role, his empathy toward the United States and the American way of life, his contacts with other right-wing governments, and his involvement during the Cold War in the production of arms. Show less
Since 1979, the hydrology of the Waza-Logone floodplain in semi-arid Cameroon has been affected by the construction upstream of a dam and embankment, reducing the flooding intensity in an area of... Show moreSince 1979, the hydrology of the Waza-Logone floodplain in semi-arid Cameroon has been affected by the construction upstream of a dam and embankment, reducing the flooding intensity in an area of 1500 km2, including Waza National Park. Subsequently, annual grasses invaded productive perennial grasslands, reducing the carrying capacity of the area for livestock, fisheries and wildlife. In 1994, after local consultations, a watercourse blocked by the embankment along the Logone river was re-opened, rehabilitating an area of 600 km2 of desiccated floodplain. Monitoring showed a gradual recovery of perennial grasslands, virtually completed in 2003, albeit with a species composition somewhat different from the 1970s. Numbers of most waterbirds increased two-fold, especially when their colonies benefited from local communities’ protection, whereas colonies of piscivorous birds were frequently destroyed. Floodplain antelopes showed an initial increase that has not persisted, probably because of increasing competition with livestock which densities increased three-fold due to the arrival of new pastoral groups and prolonged stay of herds traditionally frequenting the area. These developments indicate a problem in the sharing of the reflooding benefits between wildlife and people that rapidly respond to new opportunities, calling for intensified management planning to anticipate this unexpected success. A dialogue was institutionalised between protected area authorities and local communities. Effective conservation called for a stronger and lasting involvement of protected area personnel in planning and community conservation. Developed training courses showed good potential to upgrade knowledge and skills of present personnel. In addition, institutional changes are needed to assure the necessary increase in numbers of park personnel and their rotation, not only in and amongst national parks but with training institutes as well. The success of floodplain rehabilitation ultimately depends on long-term ecological and socio-economic monitoring, with individuals and institutions capable to translate upcoming insights into practice. Show less
