The effects of cardiac output and pulmonary arterial hypertension on volumetric capnography derived-variables during normoxia and hypoxia

The aim of this study was to test the effect of cardiac output (CO) and pulmonary artery hypertension (PHT) on volumetric capnography (VCap) derived-variables. Nine pigs were mechanically ventilated using fixed ventilatory settings. Two steps of PHT were induced by IV infusion of a thromboxane analogue: PHT25 [mean pulmonary arterial pressure (MPAP) of 25 mmHg] and PHT40 (MPAP of 40 mmHg). CO was increased by 50 % from baseline (COup) with an infusion of dobutamine ≥5 μg kg(-1) min(-1) and decreased by 40 % from baseline (COdown) infusing sodium nitroglycerine ≥30 μg kg(-1) min(-1) plus esmolol 500 μg kg(-1) min(-1). Another state of PHT and COdown was induced by severe hypoxemia (FiO2 0.07). Invasive hemodynamic data and VCap were recorded and compared before and after each step using a mixed random effects model. Compared to baseline, the normalized slope of phase III (SnIII) increased by 32 % in PHT25 and by 22 % in PHT40. SnIII decreased non-significantly by 4 % with COdown. A combination of PHT and COdown associated with severe hypoxemia increased SnIII by 28 % compared to baseline. The elimination of CO2 per breath decreased by 7 % in PHT40 and by 12 % in COdown but increased only slightly with COup. Dead space variables did not change significantly along the protocol. At constant ventilation and body metabolism, pulmonary artery hypertension and decreases in CO had the biggest effects on the SnIII of the volumetric capnogram and on the elimination of CO2.

Volumetric analysis of lung nodules in computed tomography (CT): comparison of two different segmentation algorithm softwares and two different reconstruction filters on automated volume calculation.

BACKGROUND A precise detection of volume change allows for better estimating the biological behavior of the lung nodules. Postprocessing tools with automated detection, segmentation, and volumetric analysis of lung nodules may expedite radiological processes and give additional confidence to the radiologists. PURPOSE To compare two different postprocessing software algorithms (LMS Lung, Median Technologies; LungCARE®, Siemens) in CT volumetric measurement and to analyze the effect of soft (B30) and hard reconstruction filter (B70) on automated volume measurement. MATERIAL AND METHODS Between January 2010 and April 2010, 45 patients with a total of 113 pulmonary nodules were included. The CT exam was performed on a 64-row multidetector CT scanner (Somatom Sensation, Siemens, Erlangen, Germany) with the following parameters: collimation, 24x1.2 mm; pitch, 1.15; voltage, 120 kVp; reference tube current-time, 100 mAs. Automated volumetric measurement of each lung nodule was performed with the two different postprocessing algorithms based on two reconstruction filters (B30 and B70). The average relative volume measurement difference (VME%) and the limits of agreement between two methods were used for comparison. RESULTS At soft reconstruction filters the LMS system produced mean nodule volumes that were 34.1% (P < 0.0001) larger than those by LungCARE® system. The VME% was 42.2% with a limit of agreement between -53.9% and 138.4%.The volume measurement with soft filters (B30) was significantly larger than with hard filters (B70); 11.2% for LMS and 1.6% for LungCARE®, respectively (both with P < 0.05). LMS measured greater volumes with both filters, 13.6% for soft and 3.8% for hard filters, respectively (P < 0.01 and P > 0.05). CONCLUSION There is a substantial inter-software (LMS/LungCARE®) as well as intra-software variability (B30/B70) in lung nodule volume measurement; therefore, it is mandatory to use the same equipment with the same reconstruction filter for the follow-up of lung nodule volume.

Ultra-low-dose dual-source CT coronary angiography with high pitch: diagnostic yield of a volumetric planning scan and effects on dose reduction and imaging strategy

OBJECTIVE To evaluate the role of an ultra-low-dose dual-source CT coronary angiography (CTCA) scan with high pitch for delimiting the range of the subsequent standard CTCA scan. METHODS 30 patients with an indication for CTCA were prospectively examined using a two-scan dual-source CTCA protocol (2.0 × 64.0 × 0.6 mm; pitch, 3.4; rotation time of 280 ms; 100 kV): Scan 1 was acquired with one-fifth of the tube current suggested by the automatic exposure control software [CareDose 4D™ (Siemens Healthcare, Erlangen, Germany) using 100 kV and 370 mAs as a reference] with the scan length from the tracheal bifurcation to the diaphragmatic border. Scan 2 was acquired with standard tube current extending with reduced scan length based on Scan 1. Nine central coronary artery segments were analysed qualitatively on both scans. RESULTS Scan 2 (105.1 ± 10.1 mm) was significantly shorter than Scan 1 (127.0 ± 8.7 mm). Image quality scores were significantly better for Scan 2. However, in 5 of 6 (83%) patients with stenotic coronary artery disease, a stenosis was already detected in Scan 1 and in 13 of 24 (54%) patients with non-stenotic coronary arteries, a stenosis was already excluded by Scan 1. Using Scan 2 as reference, the positive- and negative-predictive value of Scan 1 was 83% (5 of 6 patients) and 100% (13 of 13 patients), respectively. CONCLUSION An ultra-low-dose CTCA planning scan enables a reliable scan length reduction of the following standard CTCA scan and allows for correct diagnosis in a substantial proportion of patients. ADVANCES IN KNOWLEDGE Further dose reductions are possible owing to a change in the individual patient's imaging strategy as a prior ultra-low-dose CTCA scan may already rule out the presence of a stenosis or may lead to a direct transferal to an invasive catheter procedure.

Volumetric Modulated Arc Therapy Evaluation with the Radiological Physics Center Head and Neck Phantom

Validation of treatment plan quality and dose calculation accuracy is essential for new radiotherapy techniques, including volumetric modulated arc therapy (VMAT). VMAT delivers intensity modulated radiotherapy treatments while simultaneously rotating the gantry, adding an additional level of complexity to both the dose calculation and delivery of VMAT treatments compared to static gantry IMRT. The purpose of this project was to compare two VMAT systems, Elekta VMAT and Varian RapidArc, to the current standard of care, IMRT, in terms of both treatment plan quality and dosimetric delivery accuracy using the Radiological Physics Center (RPC) head and neck (H&N) phantom. Clinically relevant treatment plans were created for the phantom using typical prescription and dose constraints for Elekta VMAT (planned with Pinnacle3 Smart Arc) and RapidArc and IMRT (both planned with Eclipse). The treatment plans were evaluated to determine if they were clinically comparable using several dosimetric criteria, including ability to meet dose objectives, hot spots, conformity index, and homogeneity index. The planned treatments were delivered to the phantom and absolute doses and relative dose distributions were measured with thermoluminescent dosimeters (TLDs) and radiochromic film, respectively. The measured and calculated doses of each treatment were compared to determine if they were clinically acceptable based upon RPC criteria of ±7% dose difference and 4 mm distance-to-agreement. Gamma analysis was used to assess dosimetric accuracy, as well. All treatment plans were able to meet the dosimetric objectives set by the RPC and had similar hot spots in the normal tissue. The Elekta VMAT plan was more homogenous but less conformal than the RapidArc and IMRT plans. When comparing the measured and calculated doses, all plans met the RPC ±7%/4 mm criteria. The percent of points passing the gamma analysis for each treatment delivery was acceptable. Treatment plan quality of the Elekta VMAT, RapidArc and IMRT treatments were comparable for consistent dose prescriptions and constraints. Additionally, the dosimetric accuracy of the Elekta VMAT and RapidArc treatments was verified to be within acceptable tolerances.

Gas content, composition of gas hydrate and volumetric gas/water ratios of ODP and DSDP sites

Gas hydrate samples were recovered from four sites (Sites 994, 995, 996, and 997) along the crest of the Blake Ridge during Ocean Drilling Program (ODP) Leg 164. At Site 996, an area of active gas venting, pockmarks, and chemosynthetic communities, vein-like gas hydrate was recovered from less than 1 meter below seafloor (mbsf) and intermittently through the maximum cored depth of 63 mbsf. In contrast, massive gas hydrate, probably fault filling and/or stratigraphically controlled, was recovered from depths of 260 mbsf at Site 994, and from 331 mbsf at Site 997. Downhole-logging data, along with geochemical and core temperature profiles, indicate that gas hydrate at Sites 994, 995, and 997 occurs from about 180 to 450 mbsf and is dispersed in sediment as 5- to 30-m-thick zones of up to about 15% bulk volume gas hydrate. Selected gas hydrate samples were placed in a sealed chamber and allowed to dissociate. Evolved gas to water volumetric ratios measured on seven samples from Site 996 ranged from 20 to 143 mL gas/mL water to 154 mL gas/mL water in one sample from Site 994, and to 139 mL gas/mL water in one sample from Site 997, which can be compared to the theoretical maximum gas to water ratio of 216. These ratios are minimum gas/water ratios for gas hydrate because of partial dissociation during core recovery and potential contamination with pore waters. Nonetheless, the maximum measured volumetric ratio indicates that at least 71% of the cages in this gas hydrate were filled with gas molecules. When corrections for pore-water contamination are made, these volumetric ratios range from 29 to 204, suggesting that cages in some natural gas hydrate are nearly filled. Methane comprises the bulk of the evolved gas from all sites (98.4%-99.9% methane and 0%-1.5% CO2). Site 996 hydrate contained little CO2 (0%-0.56%). Ethane concentrations differed significantly from Site 996, where they ranged from 720 to 1010 parts per million by volume (ppmv), to Sites 994 and 997, which contained much less ethane (up to 86 ppmv). Up to 19 ppmv propane and other higher homologues were noted; however, these gases are likely contaminants derived from sediment in some hydrate samples. CO2 concentrations are less in gas hydrate than in the surrounding sediment, likely an artifact of core depressurization, which released CO2 derived from dissolved organic carbon (DIC) into sediment. The isotopic composition of methane from gas hydrate ranges from d13C of -62.5 per mil to -70.7 per mil and dD of -175 per mil to -200 per mil and is identical to the isotopic composition of methane from surrounding sediment. Methane of this isotopic composition is mainly microbial in origin and likely produced by bacterial reduction of bicarbonate. The hydrocarbon gases here are likely the products of early microbial diagenesis. The isotopic composition of CO2 from gas hydrate ranges from d13C of -5.7 per mil to -6.9 per mil, about 15 per mil lighter than CO2 derived from nearby sediment.

Implementation of the Heated Pulsed Theory using actively heated fiber optics: measurements of soil volumetric water content and soil volumetric heat capacity

Existe una creciente necesidad de hacer el mejor uso del agua para regadío. Una alternativa eficiente consiste en la monitorización del contenido volumétrico de agua (θ), utilizando sensores de humedad. A pesar de existir una gran diversidad de sensores y tecnologías disponibles, actualmente ninguna de ellas permite obtener medidas distribuidas en perfiles verticales de un metro y en escalas laterales de 0.1-1,000 m. En este sentido, es necesario buscar tecnologías alternativas que sirvan de puente entre las medidas puntuales y las escalas intermedias. Esta tesis doctoral se basa en el uso de Fibra Óptica (FO) con sistema de medida de temperatura distribuida (DTS), una tecnología alternativa de reciente creación que ha levantado gran expectación en las últimas dos décadas. Específicamente utilizamos el método de fibra calentada, en inglés Actively Heated Fiber Optic (AHFO), en la cual los cables de Fibra Óptica se utilizan como sondas de calor mediante la aplicación de corriente eléctrica a través de la camisa de acero inoxidable, o de un conductor eléctrico simétricamente posicionado, envuelto, alrededor del haz de fibra óptica. El uso de fibra calentada se basa en la utilización de la teoría de los pulsos de calor, en inglés Heated Pulsed Theory (HPP), por la cual el conductor se aproxima a una fuente de calor lineal e infinitesimal que introduce calor en el suelo. Mediante el análisis del tiempo de ocurrencia y magnitud de la respuesta térmica ante un pulso de calor, es posible estimar algunas propiedades específicas del suelo, tales como el contenido de humedad, calor específico (C) y conductividad térmica. Estos parámetros pueden ser estimados utilizando un sensor de temperatura adyacente a la sonda de calor [método simple, en inglés single heated pulsed probes (SHPP)], ó a una distancia radial r [método doble, en inglés dual heated pulsed probes (DHPP)]. Esta tesis doctoral pretende probar la idoneidad de los sistemas de fibra óptica calentada para la aplicación de la teoría clásica de sondas calentadas. Para ello, se desarrollarán dos sistemas FO-DTS. El primero se sitúa en un campo agrícola de La Nava de Arévalo (Ávila, España), en el cual se aplica la teoría SHPP para estimar θ. El segundo sistema se desarrolla en laboratorio y emplea la teoría DHPP para medir tanto θ como C. La teoría SHPP puede ser implementada con fibra óptica calentada para obtener medidas distribuidas de θ, mediante la utilización de sistemas FO-DTS y el uso de curvas de calibración específicas para cada suelo. Sin embargo, la mayoría de aplicaciones AHFO se han desarrollado exclusivamente en laboratorio utilizando medios porosos homogéneos. En esta tesis se utiliza el programa Hydrus 2D/3D para definir tales curvas de calibración. El modelo propuesto es validado en un segmento de cable enterrado en una instalación de fibra óptica y es capaz de predecir la respuesta térmica del suelo en puntos concretos de la instalación una vez que las propiedades físicas y térmicas de éste son definidas. La exactitud de la metodología para predecir θ frente a medidas puntuales tomadas con sensores de humedad comerciales fue de 0.001 a 0.022 m3 m-3 La implementación de la teoría DHPP con AHFO para medir C y θ suponen una oportunidad sin precedentes para aplicaciones medioambientales. En esta tesis se emplean diferentes combinaciones de cables y fuentes emisoras de calor, que se colocan en paralelo y utilizan un rango variado de espaciamientos, todo ello en el laboratorio. La amplitud de la señal y el tiempo de llegada se han observado como funciones del calor específico del suelo. Medidas de C, utilizando esta metodología y ante un rango variado de contenidos de humedad, sugirieron la idoneidad del método, aunque también se observaron importantes errores en contenidos bajos de humedad de hasta un 22%. La mejora del método requerirá otros modelos más precisos que tengan en cuenta el diámetro del cable, así como la posible influencia térmica del mismo. ABSTRACT There is an increasing need to make the most efficient use of water for irrigation. A good approach to make irrigation as efficient as possible is to monitor soil water content (θ) using soil moisture sensors. Although, there is a broad range of different sensors and technologies, currently, none of them can practically and accurately provide vertical and lateral moisture profiles spanning 0-1 m depth and 0.1-1,000 m lateral scales. In this regard, further research to fulfill the intermediate scale and to bridge single-point measurement with the broaden scales is still needed. This dissertation is based on the use of Fiber Optics with Distributed Temperature Sensing (FO-DTS), a novel approach which has been receiving growing interest in the last two decades. Specifically, we employ the so called Actively Heated Fiber Optic (AHFO) method, in which FO cables are employed as heat probe conductors by applying electricity to the stainless steel armoring jacket or an added conductor symmetrically positioned (wrapped) about the FO cable. AHFO is based on the classic Heated Pulsed Theory (HPP) which usually employs a heat probe conductor that approximates to an infinite line heat source which injects heat into the soil. Observation of the timing and magnitude of the thermal response to the energy input provide enough information to derive certain specific soil thermal characteristics such as the soil heat capacity, soil thermal conductivity or soil water content. These parameters can be estimated by capturing the soil thermal response (using a thermal sensor) adjacent to the heat source (the heating and the thermal sources are mounted together in the so called single heated pulsed probe (SHPP)), or separated at a certain distance, r (dual heated pulsed method (DHPP) This dissertation aims to test the feasibility of heated fiber optics to implement the HPP theory. Specifically, we focus on measuring soil water content (θ) and soil heat capacity (C) by employing two types of FO-DTS systems. The first one is located in an agricultural field in La Nava de Arévalo (Ávila, Spain) and employ the SHPP theory to estimate θ. The second one is developed in the laboratory using the procedures described in the DHPP theory, and focuses on estimating both C and θ. The SHPP theory can be implemented with actively heated fiber optics (AHFO) to obtain distributed measurements of soil water content (θ) by using reported soil thermal responses in Distributed Temperature Sensing (DTS) and with a soil-specific calibration relationship. However, most reported AHFO applications have been calibrated under laboratory homogeneous soil conditions, while inexpensive efficient calibration procedures useful in heterogeneous soils are lacking. In this PhD thesis, we employ the Hydrus 2D/3D code to define these soil-specific calibration curves. The model is then validated at a selected FO transect of the DTS installation. The model was able to predict the soil thermal response at specific locations of the fiber optic cable once the surrounding soil hydraulic and thermal properties were known. Results using electromagnetic moisture sensors at the same specific locations demonstrate the feasibility of the model to detect θ within an accuracy of 0.001 to 0.022 m3 m-3. Implementation of the Dual Heated Pulsed Probe (DPHP) theory for measurement of volumetric heat capacity (C) and water content (θ) with Distributed Temperature Sensing (DTS) heated fiber optic (FO) systems presents an unprecedented opportunity for environmental monitoring. We test the method using different combinations of FO cables and heat sources at a range of spacings in a laboratory setting. The amplitude and phase-shift in the heat signal with distance was found to be a function of the soil volumetric heat capacity (referred, here, to as Cs). Estimations of Cs at a range of θ suggest feasibility via responsiveness to the changes in θ (we observed a linear relationship in all FO combinations), though observed bias with decreasing soil water contents (up to 22%) was also reported. Optimization will require further models to account for the finite radius and thermal influence of the FO cables, employed here as “needle probes”. Also, consideration of the range of soil conditions and cable spacing and jacket configurations, suggested here to be valuable subjects of further study and development.

Heated fiber optic distributed temperature sensing for measuring soil volumetric heat capacity and water content: A dual probe heat-pulse approach

The first feasibility study of using dual-probe heated fiber optics with distributed temperature sensing to measure soil volumetric heat capacity and soil water content is presented. Although results using different combinations of cables demonstrate feasibility, further work is needed to gain accuracy, including a model to account for the finite dimension and the thermal influence of the probes. Implementation of the dual-probe heat-pulse (DPHP) approach for measurement of volumetric heat capacity (C) and water content (θ) with distributed temperature sensing heated fiber optic (FO) systems presents an unprecedented opportunity for environmental monitoring (e.g., simultaneous measurement at thousands of points). We applied uniform heat pulses along a FO cable and monitored the thermal response at adjacent cables. We tested the DPHP method in the laboratory using multiple FO cables at a range of spacings. The amplitude and phase shift in the heat signal with distance was found to be a function of the soil volumetric heat capacity. Estimations of C at a range of moisture contents (θ = 0.09– 0.34 m3 m−3) suggest the feasibility of measurement via responsiveness to the changes in θ, although we observed error with decreasing soil water contents (up to 26% at θ = 0.09 m3 m−3). Optimization will require further models to account for the finite radius and thermal influence of the FO cables. Although the results indicate that the method shows great promise, further study is needed to quantify the effects of soil type, cable spacing, and jacket configurations on accuracy.