effects of weight and injected dose in the liver’s Signal-to-Noise Ratio in patients submitted to PET/CT scans

The quality of the image of 18F-FDG PET/CT scans in overweight patients is commonly degraded. This study evaluates, retrospectively, the relation between SNR, weight and dose injected in 65 patients, with a range of weights from 35 to 120 kg, with scans performed using the Biograph mCT using a standardized protocol in the Nuclear Medicine Department at Radboud University Medical Centre in Nijmegen, The Netherlands. Five ROI’s were made in the liver, assumed to be an organ of homogenous metabolism, at the same location, in five consecutive slices of the PET/CT scans to obtain the mean uptake (signal) values and its standard deviation (noise). The ratio of both gave us the Signal-to- Noise Ratio in the liver. With the help of a spreadsheet, weight, height, SNR and Body Mass Index were calculated and graphs were designed in order to obtain the relation between these factors. The graphs showed that SNR decreases as the body weight and/or BMI increased and also showed that, even though the dose injected increased, the SNR also decreased. This is due to the fact that heavier patients receive higher dose and, as reported, heavier patients have less SNR. These findings suggest that the quality of the images, measured by SNR, that were acquired in heavier patients are worst than thinner patients, even though higher FDG doses are given. With all this taken in consideration, it was necessary to make a new formula to calculate a new dose to give to patients and having a good and constant SNR in every patient. Through mathematic calculations, it was possible to reach to two new equations (power and exponential), which would lead to a SNR from a scan made with a specific reference weight (86 kg was the considered one) which was independent of body mass. The study implies that with these new formulas, patients heavier than the reference weight will receive higher doses and lighter patients will receive less doses. With the median being 86 kg, the new dose and new SNR was calculated and concluded that the quality of the image remains almost constant as the weight increases and the quantity of the necessary FDG remains almost the same, without increasing the costs for the total amount of FDG used in all these patients.

Aplicação do EMAR 66 a Sistemas de Aeronaves Não Tripuladas

Este trabalho de investigação tem como objetivo aferir quais as tarefas e valências específicas necessárias para a manutenção permanente de UAS, em contraste com os requisitos preconizados nos regulamentos de aeronavegabilidade permanente de aeronaves militares. A aeronavegabilidade consiste na avaliação e certificação de uma aeronave voar de acordo com os padrões de segurança estabelecidos. Esta é dividida em aeronavegabilidade continuada, que avalia a condição de uma aeronave após a sua construção, e a aeronavegabilidade permanente, que estabelece as ações de manutenção necessárias para manter os níveis de aeronavegabilidade pretendidos durante a sua operação. Para assegurar que os UAS atingem os padrões aeronáutica atuais, é importante perceber como os regulamentos podem ser adaptados para responder à sua especificidade. Para aferir quais as tarefas e valências de manutenção específicas para UAS, é desenvolvido um modelo qualitativo e indutivo fazendo uso da análise de literatura e dados recolhidos através de entrevistas estruturadas a pessoal de manutenção de UAS. As dimensões consideradas seguem o modelo SHELL preconizado pela ICAO para a análise de fatores humanos em sistemas aeronáuticos. A partir do modelo gerado, é sintetizado um conjunto de conteúdos curriculares como proposta para adequação a UAS dos conteúdos requeridos no EMAR 66. Abstract: This research work has the objective of assessing which specific tasks and skills are necessary for the continuous maintenance of UAS, in contrast with the requirements recommended in the rules and regulations for continuous airworthiness of militar aircrafts. Airworthiness consists on the evaluation and certification of the capability of an aircraft to fly in compliance with the established safety standards. It is divided in initial airworthiness, which evaluates the condition of na aircraft after its construction, and the continuous airworthiness, which establishes what are the necessary maintenance actions in order to keep the desired airworthiness levels during operation. In order to assure that UAS meet the current aeronautics standards, it is paramount to understand how the rules and regulations can be adapted to cope with its specific features. In order to understand which are the specific maintenance tasks and skills specific for UAS, it is developed a qualitative and inductive model taking into consideration a literature analysis and structured interviews to UAS maintenance personnel. The dimensions considered follow the SHELL model recommended by ICAO for the analysis of human factors in aviation. From the developed model, it is synthesized a set of learning topics that serves as a proposal for extending the basic skills required by the EMAR 66.