Feasibility of in vivo 15N MRS detection of hyperpolarized 15N labeled choline in rats.

The increase of total choline in tumors has become an important biomarker in cancer diagnosis. Choline and choline metabolites can be measured in vivo and in vitro using multinuclear MRS. Recent in vivo(13)C MRS studies using labeled substrates enhanced via dynamic nuclear polarization demonstrated the tremendous potential of hyperpolarization for real-time metabolic studies. The present study demonstrates the feasibility of detecting hyperpolarized (15)N labeled choline in vivo in a rat head at 9.4 T. We furthermore report the in vitro (172 +/- 16 s) and in vivo (126 +/- 15 s) longitudinal relaxation times. We conclude that with appropriate infusion protocols it is feasible to detect hyperpolarized (15)N labeled choline in live animals.

Whole-body 3D T1-weighted MR imaging in patients with prostate cancer: feasibility and evaluation in screening for metastatic disease.

PURPOSE: To develop and assess the diagnostic performance of a three-dimensional (3D) whole-body T1-weighted magnetic resonance (MR) imaging pulse sequence at 3.0 T for bone and node staging in patients with prostate cancer. MATERIALS AND METHODS This prospective study was approved by the institutional ethics committee; informed consent was obtained from all patients. Thirty patients with prostate cancer at high risk for metastases underwent whole-body 3D T1-weighted imaging in addition to the routine MR imaging protocol for node and/or bone metastasis screening, which included coronal two-dimensional (2D) whole-body T1-weighted MR imaging, sagittal proton-density fat-saturated (PDFS) imaging of the spine, and whole-body diffusion-weighted MR imaging. Two observers read the 2D and 3D images separately in a blinded manner for bone and node screening. Images were read in random order. The consensus review of MR images and the findings at prospective clinical and MR imaging follow-up at 6 months were used as the standard of reference. The interobserver agreement and diagnostic performance of each sequence were assessed on per-patient and per-lesion bases. RESULTS: The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were significantly higher with whole-body 3D T1-weighted imaging than with whole-body 2D T1-weighted imaging regardless of the reference region (bone or fat) and lesion location (bone or node) (P < .003 for all). For node metastasis, diagnostic performance (area under the receiver operating characteristic curve) was higher for whole-body 3D T1-weighted imaging (per-patient analysis; observer 1: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P = .006 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging; observer 2: P = .006 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P = .006 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging), as was sensitivity (per-lesion analysis; observer 1: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P < .001 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging; observer 2: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P < .001 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging). CONCLUSION: Whole-body MR imaging is feasible with a 3D T1-weighted sequence and provides better SNR and CNR compared with 2D sequences, with a diagnostic performance that is as good or better for the detection of bone metastases and better for the detection of lymph node metastases.

Feasibility of radiotherapy or chemoradiotherapy after taxane-based induction chemotherapy for nonoperated locally advanced head and neck squamous cell carcinomas.

To assess the use of radiotherapy (RT) or concurrent chemoradiotherapy (CRT) following taxane-based induction chemotherapy (T-ICT) in locally advanced head and neck squamous cell carcinoma (LAHNSCC) and to evaluate the tolerability of CRT after T-ICT. From 01/2006 to 08/2012, 173 LAHNSCC patients treated as a curative intent by T-ICT, followed by definitive RT/CRT were included in this analysis. There was an 86% objective response (OR) after ICT among 154 evaluable patients. Forty-four patients received less than three cycles (25%) and 20 received only one cycle of T-ICT. The 3-year actuarial overall survival (OS) was 49% and there was no OS difference according to the type of ICT (regimen or number of cycle) or the addition of concurrent CT (cisplatin, carboplatin, or cetuximab) to RT. In multivariate analysis (MVA), clinically involved lymph node (cN+), age more than 60 years, the absence of OR after ICT, and performance status of at least 1 predicted for a decreased OS, with hazard ratios (HR) of 2.8, 2.2, 2.1, and 2, respectively. The 3-year actuarial locoregional control (LRC) and distant control (DC) rates were 52 and 73%, respectively. In MVA, the absence of OR after ICT (HR: 3.2), cN+ (HR: 3), and age more than 60 years (HR: 1.7) were prognostic for a lower LRC whereas cN+ (HR: 4.2) and carboplatin-based T-ICT (HR: 2.9) were prognostic for a lower DC. The number of cycles (≤ 2) received during ICT was borderline significant for DC in the MVA (P=0.08). Among patients receiving less than or equal to three cycles of ICT, higher outcomes were observed in patients who received cisplatin-based T-ICT (vs. carboplatin-based T-ICT) or subsequent CRT (vs. RT). T-ICT in our experience, followed by RT or CRT, raises several questions on the role and type of induction, and the efficacy of CRT over RT. The role of RT or CRT following induction, although feasible in these advanced patients, awaits answers from randomized trials.

Evaluating appropriateness of treatment for Crohn's disease : feasibility of an explicit approach

Résumé Dans la maladie de Crohn, le clinicien ne dispose pas toujours d'études prospectives randomisées ou autres preuves solides sur lesquelles appuyer sa décision thérapeutique. Pour pallier ce manque, la méthode RAND, qui combine une revue détaillée de la littérature et une synthèse méthodique de l'opinion d'experts, a été utilisée pour développer des critères détaillés d'adéquation de traitements pour les différentes présentations cliniques de la maladie de Crohn. La présente étude a eu pour but d'examiner la faisabilité d'une utilisation rétrospective de ces critères dans une cohorte de patients souffrant de maladie de Crohn. Les dossiers médicaux des patients ayant consulté leur spécialiste au moins une fois dans les 6 mois précédents ont été revus à la recherche des éléments établis par les experts. Pour les dossiers contenant tous les éléments nécessaires, l'adéquation des divers traitements a été évaluée. Les dossiers médicaux de 260 patients suivis par 22 gastro-entérologues ont été examinés. 116 patients ont été exclus pour absence de consultation dans les 6 mois précédents. 136 patients (53%) représentant 148 consultations ont été retenus. Dans plus de 90% des cas, les éléments nécessaires à l'évaluation de l'adéquation du traitement étaient disponibles, cette proportion variant quelque peu selon la catégorie de la maladie. En appliquant les critères lorsque les éléments nécessaires étaient présents dans le dossier médical, 18% des indications aux traitements étaient appropriées, 29% inappropriées et pour 38% l'indication était incertaine. Pour 15% des cas, la situation clinique rencontrée n'avait pas été explicitement évaluée par les experts. Les informations nécessaires à l'évaluation des indications aux divers traitements de la maladie de Crohn sont disponibles dans la très grande majorité des dossiers médicaux, permettant ainsi l'évaluation de l'adéquation des traitements. Cette étude ouvre la voie à l'utilisation prospective de ces critères.

Retrospective feasibility study of simultaneous integrated boost in cervical cancer using Tomotherapy: the impact of organ motion and tumor regression.

BACKGROUND: Whole pelvis intensity modulated radiotherapy (IMRT) is increasingly being used to treat cervical cancer aiming to reduce side effects. Encouraged by this, some groups have proposed the use of simultaneous integrated boost (SIB) to target the tumor, either to get a higher tumoricidal effect or to replace brachytherapy. Nevertheless, physiological organ movement and rapid tumor regression throughout treatment might substantially reduce any benefit of this approach. PURPOSE: To evaluate the clinical target volume - simultaneous integrated boost (CTV-SIB) regression and motion during chemo-radiotherapy (CRT) for cervical cancer, and to monitor treatment progress dosimetrically and volumetrically to ensure treatment goals are met. METHODS AND MATERIALS: Ten patients treated with standard doses of CRT and brachytherapy were retrospectively re-planned using a helical Tomotherapy - SIB technique for the hypothetical scenario of this feasibility study. Target and organs at risk (OAR) were contoured on deformable fused planning-computed tomography and megavoltage computed tomography images. The CTV-SIB volume regression was determined. The center of mass (CM) was used to evaluate the degree of motion. The Dice's similarity coefficient (DSC) was used to assess the spatial overlap of CTV-SIBs between scans. A cumulative dose-volume histogram modeled estimated delivered doses. RESULTS: The CTV-SIB relative reduction was between 31 and 70%. The mean maximum CM change was 12.5, 9, and 3 mm in the superior-inferior, antero-posterior, and right-left dimensions, respectively. The CTV-SIB-DSC approached 1 in the first week of treatment, indicating almost perfect overlap. CTV-SIB-DSC regressed linearly during therapy, and by the end of treatment was 0.5, indicating 50% discordance. Two patients received less than 95% of the prescribed dose. Much higher doses to the OAR were observed. A multiple regression analysis showed a significant interaction between CTV-SIB reduction and OAR dose increase. CONCLUSIONS: The CTV-SIB had important regression and motion during CRT, receiving lower therapeutic doses than expected. The OAR had unpredictable shifts and received higher doses. The use of SIB without frequent adaptation of the treatment plan exposes cervical cancer patients to an unpredictable risk of under-dosing the target and/or overdosing adjacent critical structures. In that scenario, brachytherapy continues to be the gold standard approach.

Angiofil-mediated visualization of the vascular system by microcomputed tomography: a feasibility study.

Visualization of the vascular systems of organs or of small animals is important for an assessment of basic physiological conditions, especially in studies that involve genetically manipulated mice. For a detailed morphological analysis of the vascular tree, it is necessary to demonstrate the system in its entirety. In this study, we present a new lipophilic contrast agent, Angiofil, for performing postmortem microangiography by using microcomputed tomography. The new contrast agent was tested in 10 wild-type mice. Imaging of the vascular system revealed vessels down to the caliber of capillaries, and the digital three-dimensional data obtained from the scans allowed for virtual cutting, amplification, and scaling without destroying the sample. By use of computer software, parameters such as vessel length and caliber could be quantified and remapped by color coding onto the surface of the vascular system. The liquid Angiofil is easy to handle and highly radio-opaque. Because of its lipophilic abilities, it is retained intravascularly, hence it facilitates virtual vessel segmentation, and yields an enduring signal which is advantageous during repetitive investigations, or if samples need to be transported from the site of preparation to the place of actual analysis, respectively. These characteristics make Angiofil a promising novel contrast agent; when combined with microcomputed tomography, it has the potential to turn into a powerful method for rapid vascular phenotyping.

Executive Summary, Feasibility Report on Proposed Amtrak Service Quad Cities-Chicago, January 7, 2008

Since the introduction of expanded levels of intrastate service on October 30, 2006, Amtrak trains in Illinois have produced impressive gains in both ridership and ticket revenue. This success and continuing stakeholder support has given rise to a formal request from the Illinois Department of Transportation (“Ill. DOT”) to Amtrak to develop a feasibility study regarding possible service consisting of a morning and an evening train in each direction between Chicago and the Quad Cities. The area between Chicago and the Quad Cities includes many rapidly growing communities. From Chicago toward the West and South, many towns and cities have experienced double digit growth increases in population since the year 2000. Southern DuPage, Cook and Will counties have seen especially strong growth, pressuring highway infrastructure, utilities, and schools. Community development and highway congestion are readily apparent when traveling the nearly 3 hour, 175 mile route between Chicago and the Quad Cities. As information, there are only three weekday round trip bus frequencies available between Chicago and the Quad Cities. The Quad City International Airport offers a total of 10 daily scheduled round trip flights to Chicago's O'Hare International Airport via two separate carriers flying regional jets. The Quad Cities (Davenport, Moline, Rock Island, and Bettendorf) are located along the Mississippi River. Nearly 60% of its visitors are from the Chicago area. With dozens of miles of scenic riverfront, river boating, casinos, and thousands of acres of expansive public spaces, the Quad Cities area is a major draw from both Iowa and Illinois. The huge Rock Island Arsenal, one of the largest military arsenals in the country and located along the river, is transitioning to become the headquarters of the United States First Army. As will be discussed later in the report, there is only one logical rail route through the Quad Cities themselves. The Iowa Interstate Railroad operates through the Quad Cities along the river and heads west through Iowa. The Quad Cities are considering at least three potential locations for an Amtrak station. A study now underway supported by several local stakeholders will recommend a site which will then be considered, given available local and other financial support. If Amtrak service were to terminate in the Quad Cities, an overnight storage track of sufficient length along with ample parking and certain other requirements covered elsewhere in the report would be required.

Feasibility Study of Strengthening Existing Single Span Steel Beam Concrete Deck Bridges, June 1961

Iowa has the same problem that confronts most states in the United States: many bridges constructed more than 20 years ago either have deteriorated to the point that they are inadequate for original design loads or have been rendered inadequate by changes in design/maintenance standards or design loads. Inadequate bridges require either strengthening or posting for reduced loads. A sizeable number of single span, composite concrete deck - steel I beam bridges in Iowa currently cannot be rated to carry today's design loads. Various methods for strengthening the unsafe bridges have been proposed and some methods have been tried. No method appears to be as economical and promising as strengthening by post-tensioning of the steel beams. At the time this research study was begun, the feasibility of posttensioning existing composite bridges was unknown. As one would expect, the design of a bridge-strengthening scheme utilizing post-tensioning is quite complex. The design involves composite construction stressed in an abnormal manner (possible tension in the deck slab), consideration of different sizes of exterior and interior beams, cover-plated beams already designed for maximum moment at midspan and at plate cut-off points, complex live load distribution, and distribution of post-tensioningforces and moments among the bridge beams. Although information is available on many of these topics, there is miminal information on several of them and no information available on the total design problem. This study, therefore, is an effort to gather some of the missing information, primarily through testing a half-size bridge model and thus determining the feasibility of strengthening composite bridges by post-tensioning. Based on the results of this study, the authors anticipate that a second phase of the study will be undertaken and directed toward strengthening of one or more prototype bridges in Iowa.

Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study.

OBJECTIVE: To evaluate the feasibility and effects of non-invasive pressure support ventilation (NIV) on the breathing pattern in infants developing respiratory failure after extubation. DESIGN: Prospective pilot clinical study; each patient served as their own control. SETTING: A nine-bed paediatric intensive care unit of a tertiary university hospital. PATIENTS: Six patients (median age 5 months, range 0.5-7 months; median weight 4.2 kg, range 3.8-5.1 kg) who developed respiratory failure after extubation. INTERVENTIONS: After a period of spontaneous breathing (SB), children who developed respiratory failure were treated with NIV. MEASUREMENTS AND RESULTS: Measurements included clinical dyspnoea score (DS), blood gases and oesophageal pressure recordings, which were analysed for respiratory rate (RR), oesophageal inspiratory pressure swing (dPes) and oesophageal pressure-time product (PTPes). All data were collected during both periods (SB and NIV). When comparing NIV with SB, DS was reduced by 44% (P < 0.001), RR by 32% (P < 0.001), dPes by 45% (P < 0.01) and PTPes by 57% (P < 0.001). A non-significant trend for decrease in PaCO(2) was observed. CONCLUSION: In these infants, non-invasive pressure support ventilation with turbine flow generator induced a reduction of breathing frequency, dPes and PTPes, indicating reduced load of the inspiratory muscles. NIV can be used with some benefits in infants with respiratory failure after extubation.

Cedar-Iowa River Rail Transit Project Feasibility Study, November 9, 2006

Five Seasons Transportation & Parking (FSTP) and the Johnson County Council of Governments (JCCOG) are interested in evaluating the feasibility of prospective passenger rail service(s) that would operate over existing trackage of the Cedar Rapids and Iowa City Railway Company (CRANDIC), seen below left, and/or the Iowa Interstate Railroad System (IAIS), seen below right, connecting Cedar Rapids, Iowa City and the Amana Colonies. To perform the study, FSTP and JCCOG selected R.L. Banks & Associates, Inc. (RLBA) as Prime Contractors, HNTB Corporation (HNTB) and Snyder & Associates, Inc. (Snyder) as Subcontractors, hereafter Consultant Team. Both railroads participated in the study and contributed time and resources, as did many local government and civic organizations. The purpose of the study is to determine whether it is feasible to establish regularly scheduled passenger rail service and/or special event excursion rail service, in conjunction with the Five Seasons Transit system, Iowa City Transit, East Central Iowa Transit, Coralville Transit and the University of Iowa CAMBUS.

Feasibility Study on Proposed Amtrak service from Chicago, to Iowa City, Iowa via Quad Cities, December 5, 2007

Soon after the Illinois Department of Transportation (“Ill. DOT”) requested Amtrak to conduct a feasibility study on proposed Amtrak service between Chicago and the Illinois Quad Cities, the Iowa Department of Transportation (“Iowa DOT”) asked that the study be extended to Iowa City and later to Des Moines. This report examines the feasibility of extending service to Iowa City. The completed report for the proposed Chicago – Quad Cities’ service was delivered to Ill. DOT in early January 2008. It assumes a stand-alone train operation strictly within the State of Illinois and makes no reference to extending the service into the State of Iowa. Therefore, there is no discussion about potential cost sharing allocations for capital improvements or operating losses between the two states which will become a matter of future negotiations between the two jurisdictions. That being said, this report on extending the service to Iowa City is simply an addendum to the Quad Cities report and covers such topics as additional capital infrastructure improvements that would be required in Iowa, impacts on operating expenses, revised ridership and revenue projections, and the like. With one minor exception, the recommended level of capital improvements within Illinois will still be required if the service to Iowa City is initiated. It is thus important for the readers of this report to refer to the Illinois study for detailed information on that state’s portion of the route alternatives.

Feasibility Study for Detection and Quantification of Corrosion in Bridge Barrier Rails, RB11-012, 2013

"Technical challenges exist with infrastructure that can be addressed by nondestructive evaluation (NDE) methods, such as detecting corrosion damage to reinforcing steel that anchor concrete bridge railings to bridge road decks. Moisture and chloride ions reach the anchors along the cold joint between the rails and deck, causing corrosion that weakens the anchors and ultimately the barriers. The Center for Nondestructive Evaluation at Iowa State University has experience in development of measurement techniques and new sensors using a variety of interrogating energies. This research evaluated feasibility of three technologies — x-ray radiation, ground-penetrating radar (GPR), and magnetic flux leakage (MFL) — for detection and quantification of corrosion of embedded reinforcing steel. Controlled samples containing pristine reinforcing steel with and without epoxy and reinforcing steel with 25 percent and 50 percent section reduction were embedded in concrete at 2.5 in. deep for laboratory evaluation. Two of the techniques, GPR and MFL, were used in a limited field test on the Iowa Highway 210 Bridge over Interstate 35 in Story County. The methods provide useful and complementary information. GPR provides a rapid approach to identify reinforcing steel that has anomalous responses. MFL provides similar detection responses but could be optimized to provide more quantitative correlation to actual condition. Full implementation could use either GPR or MFL methods to identify areas of concern, followed by radiography to give a visual image of the actual condition, providing the final guidance for maintenance actions." The full 103 page report and the 2 page Tech Transfer Summary are included in this link.

Combined radioimmunotherapy and radiotherapy of liver metastases from colorectal cancer: a feasibility study.

BACKGROUND: A combination of radioimmunotherapy (RIT) and radiotherapy (RT) should allow one to increase the dose of radiation targeting a particular tumour without the concomitant increase of toxic side effects. This might be obtained if the dose limiting side effect of each individual radiation therapy concerned different organs. METHODS: Six patients with limited liver metastatic disease from colorectal cancer were treated with 6.9 GBq (range 4.7 to 8.4 GBq) 131I-labelled anti-CEA MAb F(ab')2 fragments combined with 20 Gy RT to the liver. Both treatments were given in close association, according to timing schedules evaluated in animals that gave the best results. RESULTS: Reversible bone marrow and liver toxicity was observed in 6 and 5 patients, respectively. Three patients who first received 20 Gy RT to the liver, showed a significant platelet drop upon completion of RT. Repeat computerized tomography (CT) after 2 months showed a minor response in 1 patient and stable disease in 3 patients. CONCLUSION: The study shows potential ways of combining RIT and RT, suggesting that this combination is feasible for the treatment of liver metastases.