Differentiation between intra-axial metastatic tumor progression and radiation injury following fractionated radiation therapy or stereotactic radiosurgery using MR spectroscopy, perfusion MR imaging or volume progression modeling

Objective

To determine the accuracy of magnetic resonance spectroscopy (MRS), perfusion MR imaging (MRP), or volume modeling in distinguishing tumor progression from radiation injury following radiotherapy for brain metastasis.

Methods

Twenty-six patients with 33 intra-axial metastatic lesions who underwent MRS (n=41) with or without MRP (n=32) after cranial irradiation were retrospectively studied. The final diagnosis was based on histopathology (n=4) or magnetic resonance imaging (MRI) follow-up with clinical correlation (n=29). Cho/Cr (choline/creatinine), Cho/NAA (choline/N-acetylaspartate), Cho/nCho (choline/contralateral normal brain choline) ratios were retrospectively calculated for the multi-voxel MRS. Relative cerebral blood volume (rCBV), relative peak height (rPH) and percentage of signal-intensity recovery (PSR) were also retrospectively derived for the MRPs. Tumor volumes were determined using manual segmentation method and analyzed using different volume progression modeling. Different ratios or models were tested and plotted on the receiver operating characteristic curve (ROC), with their performances quantified as area under the ROC curve (AUC). MRI follow-up time was calculated from the date of initial radiotherapy until the last MRI or the last MRI before surgical diagnosis.

Results

Median MRI follow-up was 16 months (range: 2-33). Thirty percent of lesions (n=10) were determined to be radiation injury; 70% (n=23) were determined to be tumor progression. For the MRS, Cho/nCho had the best performance (AUC of 0.612), and Cho/nCho >1.2 had 33% sensitivity and 100% specificity in predicting tumor progression. For the MRP, rCBV had the best performance (AUC of 0.802), and rCBV >2 had 56% sensitivity and 100% specificity. The best volume model was percent increase (AUC of 0.891); 65% tumor volume increase had 100% sensitivity and 80% specificity.

Conclusion

Cho/nCho of MRS, rCBV of MRP, and percent increase of MRI volume modeling provide the best discrimination of intra-axial metastatic tumor progression from radiation injury for their respective modalities. Cho/nCho and rCBV appear to have high specificities but low sensitivities. In contrast, percent volume increase of 65% can be a highly sensitive and moderately specific predictor for tumor progression after radiotherapy. Future incorporation of 65% volume increase as a pretest selection criterion may compensate for the low sensitivities of MRS and MRP.     

Self-adjointness of unbounded tridiagonal operators and spectra of their finite truncations

This paper addresses two different but related questions regarding an unbounded symmetric tridiagonal operator: its self-adjointness and the approximation of its spectrum by the eigenvalues of its finite truncations. The sufficient conditions given in both cases improve and generalize previously known results. It turns out that, not only self-adjointness helps to study limit points of eigenvalues of truncated operators, but the analysis of such limit points is a key help to prove self-adjointness. Several examples show the advantages of these new results compared with previous ones. Besides, an application to the theory of continued fractions is pointed out.     

Geometry of manifolds with densities

We study the geometry of complete Riemannian manifolds endowed with a weighted measure, where the weight function is of quadratic growth. Assuming the associated Bakry–Émery curvature is bounded from below, we derive a new Laplacian comparison theorem and establish various sharp volume upper and lower bounds. We also obtain some splitting type results by analyzing the Busemann functions. In particular, we show that a complete manifold with nonnegative Bakry–Émery curvature must split off a line if it is not connected at infinity and its weighted volume entropy is of maximal value among linear growth weight functions.     

Dispersion Stability and Particle Characterization by Sedimentation Kinetics in a Centrifugal Field

ABSTRACT

The analysis of sedimentation or flotation (creaming) by detecting the transmission profile over the entire sample height in an analytical centrifuge (using a Stability Analyzer) is described and illustrated for a diverse range of practical dispersions and emulsions. It is also illustrated how to use extrapolated results to estimate dispersion shelf life stability for samples in a gravitational field. Formulation optimization, such as choosing appropriate surfactant levels, is also shown to be a practical application of such methods.     

An Application of Groupoids of Fractions to Inverse Semigroups

We describe an application of category theory to the theory of inverse semigroups: we prove the P-theorem for E-unitary inverse semigroups using groupoids of fractions of their associated division categories.     

A paired queueing system arising in multimedia synchronization

One of the most important and distinguishing features of multimedia applications is the integration of multiple media streams that have to be presented in a synchronized fashion. In this paper, a queueing system with a special service mechanism arising in multimedia synchronization is considered. The system is characterized by arrival of two types of customers (media streams), and servicing of customers (processing of packets) in pairs with one customer from each type for a pair. The exact transient system size probabilities are obtained as the stationary solutions do not exist for this system and these are illustrated numerically. The density function of the first return to the origin for the queueing system is also obtained.     

The Levels-Recursive Algorithm for Vector Valued Interpolants by Triple Branched Continued Fractions

1 Introduction Let Πl,m,n be a set of points in three dimensional space R3, Πl,m,n = {(xi, yj, zk), i = 0, 1, · · · l; j = 0, 1, · · · m; k = 0, 1, · · · n}. Let a d?dimensional vector vi,j,k be given at every point (xi, yj, zk) ∈ Πl,m,n and     

Quadruple systems of the projective special linear group PSL(2,q), q ≡ 1 (mod 4)

We determine the distribution of quadruple systems among the orbits of 4‐element subsets under the action of PSL(2,q) on the projective line when q ≡ 1 (mod 4). © 2003 Wiley Periodicals, Inc. J Combin Designs 11: 339–351, 2003; Published online in Wiley InterScience ( www.interscience.wiley.com ). DOI 10.1002/jcd.10043     

节理岩体中地下洞室超挖计算

讨论了超挖的定义以及不稳定块体体积与超挖的关系 ,总结了计算块体位置和体积的方法可分为随机、确定性和半概率方法三类 ,为今后超挖方面的研究提出了指导方向。重点分析并给出了被三个节理面切割的岩块以及隐含危险岩块的位置计算的确定性方法 ,提出了岩块体积计算简易的近似算法。超挖计算对洞室安全、高效地现场施工具有重要指导意义.     

Rheological models with microstructural constraints

Rheological models of complex fluids with a physically restricted microstructure are analyzed to obtain general classes of dynamical evolution equations for these materials. These classes insure that the appropriate mathematical constraints, associated with each type of physical restriction, are consistently incorporated into the corresponding model development. Describing the microstructure of the complex fluid with a second-rank tensor variable, a general class of dynamical evolution equations is derived for three physically meaningful constraints associated with constancy of the invariants of this microstructural tensor. The physical rationale for each of these constraints is discussed, and a corresponding set of constrained dynamical evolution equations is derived in general terms. Abdellatif Ait-Kadi passed away suddenly during the course of this research. The surviving authors express their gratitude to Abdellatif for our many hours of productive work and companionship.