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Background Recently, there has been an increase in the number of reports of needle tract seeding (NTS) of tumor cells after a biopsy as one of the adverse events related to endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). In most of the previously reported cases of NTS in pancreatic cancer, distal pancreatectomy was performed as the initial surgery, following which metachronous metastasis was discovered in the gastric wall, whose localization matched the puncture route of the EUS-FNA. We report a case of early metastasis from pancreatic cancer in the gastric wall, which was postulated to be caused by NTS. Our patient underwent a total pancreatectomy (TP), and the NTS was resected synchronously. Case presentation A 70-year-old woman with a diagnosis of pancreatic head-body-tail cancer presented to our department for surgery. Transgastric EUS-FNA and biopsy established the histological diagnosis in her case. We administered neoadjuvant chemotherapy (NAC) to the patient and performed a TP. Histopathological and immunohistochemical examination subsequently confirmed the diagnosis of pT3N1aM1 pancreatic adenocarcinoma and its gastric metastasis, which was caused by NTS. It is postulated that the tumor cells of NTS had progressed to develop the metastatic lesion in the gastric wall during the NAC period. This was also resected during the initial surgery. The patient developed an early postoperative recurrence in the peritoneum 8 months after the surgery. Conclusion In pancreatic head cancer cases, the puncture route is often included in the resection area of radical surgery, and NTS is seldom considered as a potential clinical problem. However, NTS can progress rapidly and may be associated with early recurrence of malignancy. Therefore, when transgastrointestinal puncture is performed for the diagnosis of pancreatic cancer, the treatment strategy should be established considering the potential development of NTS.

We developed a human-scale single-ring OpenPET (SROP) system, which had an open space allowing us access to the subject during measurement. The SROP system consisted of 160 4-layer depth-of-interaction detectors. The open space with the axial width of 430 mm was achieved with the ring axial width of 214 mm and the ring inner diameter of 660 mm. The detectors were axially shifted to each other so that the detector ring was aligned along a plane horizontally tilted by 45° against the axial direction. The system was developed as a mobile scanner to be used not only in clinical positron emission tomography (PET) rooms but also in charged-particle therapy treatment rooms as well as animal experiment rooms. Almost uniform spatial resolution better than 3 mm throughout the entire field of view (FOV) was realized with an iterative image reconstruction method. Peak absolute sensitivity was 3.1%, and there was a region with sensitivity better than 0.8% for a length of more than 700 mm. An in-beam imaging experiment conducted at the heavy ion medical accelerator in Chiba showed that the system was operable even at the highest beam intensity available for heavy-ion therapy. In addition, we conducted entire-body monkey dynamic imaging utilizing the long region inside the gantry by positioning a monkey along the direction having the longest FOV tilted by 45° against the axial direction. We concluded the developed system has a capability to realize versatile PET applications by utilizing its wide-open space and mobility in addition to high spatial resolution with sufficiently good sensitivity. -9mm]Please consider rephrasing the sentence “We concluded the developed system” for clarity.

Makoto Kobayashi, Eiji Yoshida, Takuro Kyuno, Ryoko Kawagishi, Kei Sato, Tsuyoshi Kono, Takehiro Chiba, Hitoshi Yonezawa, Osamu Funato, Akinori Takagane Department of Surgery, Hakodate Goryoukaku Hospital, Hakodate City, Hokkaido, 040-8611, JapanCorrespondence: Makoto KobayashiDepartment of Surgery, Hakodate Goryoukaku Hospital, 38-3 Goryoukaku-cho, Hakodate City, Hokkaido, 040-8611, JapanTel +81-138-51-2295Fax +81-138-56-2696Email koba86gg@gmail.comPurpose: Faster surgery has been associated with better outcomes. In the present study, we aimed to determine whether surgical duration affected overall survival (OS) in patients undergoing esophagectomy. Additionally, we assessed factors that influence surgical duration.Patients and Methods: This single-center retrospective cohort study included 128 patients who underwent Ivor-Lewis esophagectomy by a single surgeon between 2005 and 2019. The Cox proportional hazard model was used to evaluate the association of OS with the following variables: surgical duration, neo-adjuvant chemotherapy, pathological grade of depth of tumor invasion, lymph node (LN) metastasis, body mass index (BMI), and cervical LN dissection. Additionally, factors associated with prolonged surgical duration were examined by logistic regression analysis.Results: Based on the multivariate analysis, surgical duration was not associated with OS [hazard ratio (HR), 1.065; 95% confidence interval (CI), 0.586– 1.937; P = 0.837]. On the other hand, tumor invasion (HR, 2.901; 95% CI, 1.483– 5.674; P = 0.002) and LN metastasis (HR, 2.338 2.403; 95% CI, 1.237– 4.420 1.257– 4.593; P = 0.009 0.008) significantly influenced OS. The assessment of variables affecting surgical duration showed that BMI had a significant effect on surgical duration (odds ratio, 2.790; 95% CI, 1.254– 6.204, P = 0.012).Conclusion: According to the analysis of patients who underwent the same surgical approach by a single surgeon, surgical duration of esophagectomy for esophageal cancer was significantly influenced by BMI; however, surgical duration had no impact on patient survival.Keywords: esophagectomy, Ivor-Lewis approach, depth of tumor invasion, lymph node metastasis, body mass index, overall survival

To improve positron emission tomography (PET) image quality, depth-of-interaction (DOI) information and time-of-flight (TOF) information are key technologies. In this work, we developed the DOI-TOF detector based on our original single-ended readout scheme with the continuous layered gadolinium fine aluminum garnet (GFAG) array. The size of each GFAG crystal is $1.45\times 1.45\times 20$ mm3. The multipixel photon counter (MPPC) used as a photo sensor has a surface area of $3.0\times 3.0$ mm2. One pair of crystals coupled with a partial optical window is arranged across two MPPCs. Boundaries without the partial optical window are covered with optical reflectors. Each pair is coupled with paired MPPCs of different patterns. Crystal identification is obtained from paired MPPCs of different patterns and output rates. By limiting the spread of scintillation light, the proposed DOI detector based on the local centroid calculation was expected to improve crystal response, including the edge. For performance comparison, we prepared three discrete layers of the GFAG array with the same total thickness. For the continuous layer, the DOI resolution, the energy resolution and the timing resolution of the pair of detectors are 4.7 mm, 14%, and 402 ps, respectively. Their respective values are 29%, 20%, and 33% better than those with the three discrete layers.

A synthetic route to ecteinascidin 743 has been established via an intramolecular cascade Heck reaction to construct the diazabicyclo[3.3.1]nonane skeleton while controlling the two contiguous stereogenic centers. The strategically formed five-membered ring was oxidatively cleaved to generate a dialdehyde intermediate, from which the B ring of ecteinascidin 743 was constructed.

Background In pancreatic cancer surgery, accurate identification and resection of intrapancreatic residual tumors are quite difficult. We have developed a novel open-typed PET system (called 'OpenPET'), which enables high-resolution PET-guided surgery in real time, and demonstrated that OpenPET-guided surgery with intraperitoneally administered 64Cu-labeled anti-epidermal growth factor receptor antibody cetuximab is useful to detect and resect primary pancreatic cancer. Here, we investigated applicability of OpenPET-guided surgery for unexpected residual intrapancreatic tumors and examined its survival benefit over conventional surgery. Methods A mouse model with large (>1 cm) resectable pancreatic cancer of xPA-1-DC cells expressing red fluorescent protein was used. OpenPET-guided surgery was conducted 24 h after intraperitoneal administration of 64Cu-labeled cetuximab (7.4 MBq/mouse). For comparison, similar surgical procedures were conducted, and conventional tumor resection was attempted using only the naked eye (control). Survival rate after OpenPET-guided surgery was compared to that after control operations. Results Intraoperative OpenPET guidance enabled detection and resection of small residual tumors. Ten residual tumor specimens (3-10 mm in diameter) were intraoperatively isolated with OpenPET guidance (n = 7 mice). All isolated specimens showed tumor RFP signals. No resection of tumor tissue was performed in control group because the tumor could not be clearly detected with the naked eye alone. Mice after OpenPET-guided surgery showed significantly longer survival rates than those in control group. Conclusions OpenPET-guided surgery with 64Cu-labeled-cetuximab enabled intraoperative identification and resection of intrapancreatic small residual tumors. This technology could be useful to prevent tumor residuals during surgery and improve pancreatic cancer survival.

Background To confirm the performance of the first hemispherical positron emission tomography (PET) for the brain (Vrain) that we developed to visualise the small nuclei in the deep brain area, we compared 18F-fluorodeoxyglucose (FDG) brain images with whole-body PET images. Methods Ten healthy male volunteers (aged 22–45 years) underwent a representative clinical whole-body PET, followed by Vrain each for 10 min. These two scans were initiated 30 min and 45 min after FDG injection (4.1 ± 0.5 MBq/kg), respectively. First, we visually identified the small nuclei and then compared their standardised uptake values (SUVs) with the participants’ age. Next, the SUVs of each brain region, which were determined by applying a volume-of-interest template for anatomically normalised PET images, were compared between the brain images with the Vrain and those with the whole-body PET images. Results Small nuclei, such as the inferior colliculus, red nucleus, and substantia nigra, were more clearly visualised in Vrain than in whole-body PET. The anterior nucleus and dorsomedial nucleus in the thalamus and raphe nucleus in the brainstem were identified in Vrain but not in whole-body PET. The SUVs of the inferior colliculus and dentate gyrus in the cerebellum positively correlated with age (Spearman’s correlation coefficient r = 0.811, p = 0.004; r = 0.738, p = 0.015, respectively). The SUVs of Vrain were slightly higher in the mesial temporal and medial parietal lobes than those in whole-body PET. Conclusions This was the first time that the raphe nuclei, anterior nuclei, and dorsomedial nuclei were successfully visualised using the first hemispherical brain PET. Trial registration Japan Registry of Clinical Trials, jRCTs032210086, Registered 13 May 2021, https://jrct.niph.go.jp/latest-detail/jRCTs032210086.

Objective. For PET imaging systems, a smaller detector ring enables less intrinsic spatial resolution loss due to the photon non-collinearity effect as well as better balance between production cost and sensitivity, and a hemispherical detector arrangement is more appropriate for brain imaging than a conventional cylindrical arrangement. Therefore, we have developed a brain-dedicated PET system with a hemispherical detector arrangement, which has been commercialized in Japan under the product name of VRAINTM. In this study, we evaluated imaging performance of VRAIN. Approach. The VRAIN used 54 detectors to form the main hemispherical unit and an additional half-ring behind the neck. Each detector was composed of a 12 × 12 array of lutetium fine silicate crystals (4.1 × 4.1 × 10 mm3) and a 12 × 12 array of silicon photomultipliers (4 × 4 mm2 active area) with the one-to-one coupling. We evaluated the physical performance of VRAIN according to the NEMA NU 2–2018 standards. Some measurements were modified so as to fit the hemispherical geometry. In addition, we performed 18F-FDG imaging in a healthy volunteer. Main results. In the phantom study, the VRAIN showed high resolution for separating 2.2 mm rods, 229 ps TOF resolution and 19% scatter fraction. With the TOF gain for a 20 cm diameter object (an assumed head diameter), the peak noise-equivalent count rate was 144 kcps at 9.8 kBq ml−1 and the sensitivity was 25 kcps MBq−1. Overall, the VRAIN provided excellent image quality in phantom and human studies. In the human FDG images, small brain nuclei and gray matter structures were clearly visualized with high contrast and low noise. Significance. We demonstrated the excellent imaging performance of VRAIN, which supported the advantages of the hemispherical detector arrangement.

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of infection in hospitalized patients and can be prevalent in humans and various animal species. In European countries, MRSA isolates belonging to clonal complex 398 have been detected at high rates in pigs. However, the prevalence of MRSA in pigs and farm environments in Japan remains unclear. MRSA isolates were obtained from pigs in slaughterhouses, diseased pigs on farms, imported breeding pigs, and farm dust. We conducted whole-genome sequencing (WGS) and analyzed the molecular epidemiological relationship between these MRSA isolates using core genome multilocus sequence typing (cgMLST). The prevalence rates of MRSA among pigs in slaughterhouses, diseased pigs on farms, imported breeding pigs, and farm dust were 5.2 %, 3.4 %, 28.8 %, and 0.06 %, respectively. ST 398 isolates that classified as ST398/t034 were isolated from pigs from all sources. The results of cgMLST showed that ST398/t034 isolates originating from domestic pigs clustered into the same cluster as the isolates from imported breeding pigs. However, some clusters only included isolates of domestic pig origin. Most MRSA isolates in this study carried resistance genes for aminoglycosides, β-lactams, macrolides, tetracyclines, and zinc. None of the MRSA isolates in this study harbored Panton-Valentine leukocidin toxin genes. Molecular epidemiological analysis suggested a relationship between isolates from slaughter pigs and imported breeding pigs and the presence of MRSA isolates of domestic origin. However, more data are needed for elucidation of the origin of these MRSA variants in the pig industry in Japan.

In this article, we developed the novel single-end readout depth-of-interaction (DOI) detector with quadrisected crystals comparable in size to a single photo sensor. The proposed DOI detector consists of 784 gadolinium aluminum gallium garnet (GAGG) crystals, which are arranged in four layers of $14\times14$ arrays coupled with an $8\times8$ multipixel photon counter (MPPC) array. The size of each GAGG crystal is $1.45\times 1.45\times4.5$ mm3. Also, each MPPC has a surface area of $3.0\times3.0$ mm2. One pair of four-layered crystals coupled with a partial optical window is arranged across two MPPCs. Boundaries without the partial optical window are covered with optical reflectors. Light sharing is done between a pair of four-layered crystals optically coupled at one end. Each pair is coupled with paired silicon photomultipliers of different patterns. Crystal identification from each pair is obtained from the output rate of two MPPCs. From 511-keV uniform irradiation, responses of all crystal elements in the four layers can be separated clearly on a 2-D position histogram after applying the Anger calculation. Also, DOI information can be mapped to each cluster on curved lines. The energy resolution for all crystals is 9.1% after event reduction of intercrystal scatter.

Noninvasive quantification of myocardial blood flow with PET is a vital tool for detecting and monitoring of coronary artery disease. However, current standard cylindrical PET scanners are not optimized for cardiac imaging because they are designed mainly for whole-body imaging. In this study, we proposed two compact geometries, the elliptical geometry and the D-shape geometry, for cardiac-dedicated PET systems. We then evaluated their performance compared with a whole-body-size cylindrical geometry by using the Geant4 Monte Carlo simulation toolkit. In the simulation, an elliptical water phantom was scanned for 10-sec, and we calculated the sensitivity and the noise-equivalent count rate (NECR). Subsequently, a digital chest phantom was scanned for 30-sec and the coincidence data were reconstructed by in-house image reconstruction software. We evaluated the image noise in the liver region and the contrast recoveries in the heart region. Even with the limited number of detectors, the proposed compact geometries showed higher sensitivity than the whole-body geometry. The D-shape geometry achieved 47% higher NECR and 44% lower image noise compared with the whole-body cylindrical geometry. However, the contrasts in the hot area obtained by the proposed compact geometries were not as good as that obtained by the whole-body cylindrical geometry. There was no considerable difference in image quality between the elliptical geometry and the D-shape geometry. In conclusion, the compact geometries we have proposed are promising designs for a high-sensitivity and low-cost cardiac-dedicated PET system. A further study using a defect phantom model is required to evaluate the contrast of cold areas.

Purpose Early management is crucial for acute intestinal blood flow disorders; however, no published study has identified criteria for the time limit for blood flow resumption. This study specifically examines the time factors for avoiding intestinal resection. Methods The subjects of this retrospective cohort study were 125 consecutive patients who underwent emergency surgery for a confirmed diagnosis of intestinal strangulation (n = 86), incarceration (n = 27), or volvulus (n = 12), between January 2015 and March 2021. Intestinal resection was performed when intestinal irreversible changes had occurred even after ischemia was relieved surgically. We analyzed the relationship between the time from computed tomography (CT) imaging to the start of surgery (C-S time) and intestinal resection using the Kaplan–Meier method and calculated the estimated intestinal rescue rate. Patient background factors affecting intestinal resection were also examined. Results The time limit for achieving 80% intestinal rescue rate was 200 min in C-S time, and when this exceeded 300 min, the intestinal rescue rate dropped to less than 50%. Multivariate analysis identified the APACHE II score as a significant influencing factor. Conclusion A rapid transition from early diagnosis to early surgery is critical for patients with acute abdomen originating from intestinal blood flow disorders. The times from presentation at the hospital to surgery should be reduced further, especially for severe cases.

Coincidence timing resolution (CTR) is an important parameter in clinical positron emission tomography (PET) scanners to increase the signal-to-noise ratio of PET images by using time-of-flight (TOF) information. Lutetium (Lu) based scintillators are often used for TOF-PET systems. However, the self-radiation of Lu-based scintillators may influence the image quality for ultra-low activity PET imaging. Recently, a gadolinium fine aluminum gallate (Ce:GFAG) scintillation crystal that features a fast decay time (∼55 ns) and no self-radiation was developed. The present study aimed at optimizing the GFAG crystal surface treatment to enhance both CTR and energy resolution (ER). The TOF-PET detector consisted of a GFAG crystal (3.0 × 3.0 × 20 mm3) and a SiPM with an effective area of 3.0 × 3.0 mm2. The timing and energy signals were extracted using a high-frequency SiPM readout circuit and then were digitized using a CAMAC DAQ system. The CTR and ER were evaluated with nine different crystal surface treatments such as partial saw-cut and chemical polishing and the 1-side saw-cut was the best choice among the treatments. The respective CTR and ER of 202 ± 2 ps and 9.5 ± 0.1% were obtained with the 1-side saw-cut; the other 5-side mechanically polished GFAG crystals had respective values which were 18 ps (9.0%) and 1.3% better than those of the all-side mechanically polished GFAG crystal. The chemically polished GFAG crystals also offered enhanced CTR and ER of about 17 ps (8.2%) and 2.1%, respectively, over the mechanically polished GFAG crystals.

The quality and uniformity of positron emission tomography (PET) images can be improved significantly using a PET scanner, which has both time-of-flight (TOF) and depth-of-interaction (DOI) capabilities. We have already developed a DOI dual-end detector using segmented crystal bars by applying a subsurface laser engraving (SSLE) technique, and the DOI was determined by the ratio of the detected light between two readouts using the Anger calculation. In this study, we investigated the influence of the number of DOI segments on the performance of DOI identification and the coincidence timing performance of the detector. The detector consisted of a single lutetium fine silicate (LFS) crystal bar (3 × 3 × 20 mm3) with various numbers of DOI segments that were made by applying the SSLE technique and Hamamatsu silicon photomultiplier (SiPM) modules. The maximum number of DOI segments was six, and the SiPM module included one hundred forty-four 4 mm × 4 mm SiPM readouts. The coincidence resolving time (CRT) of each DOI segment was obtained from the side irradiation of the dual-end detector. All DOI segments of the detector with 2, 3, 4, 5 or 6 DOI segments were clearly identified, and average energy resolutions of 9.8 ± 0.5% and 12.5 ± 1.4% were obtained at the 511 keV photo peak for the detectors with 2 DOI and 6 DOI segments, respectively. The minimum and maximum estimated CRT of 180 ± 6 ps and 236 ± 6 ps were obtained for the detectors with 2 DOI and 6 DOI segments, respectively. Insignificant differences were observed between the CRT values of different segments of one detector. Greater CRT values were obtained for detectors with larger DOIs. The results of this study prove that there is a high potential for segmented crystal bars using the SSLE technique as a good candidate for PET scanners with TOF and DOI capabilities, which can significantly improve the quality of PET images.

Previously, we had developed a four-layered depth-of-interaction (DOI) PET detector based on the light sharing method. Reflectors , which were inserted in every two lines of crystal segments and shifted differently for each layer, projected 3D crystal positions onto a 2D position histogram without any overlapping after applying the Anger-type calculation. The best crystal separation we ever obtained was for the four-layered 32 × 32 array of LYSO crystals sized at 1.45 × 1.45 × 5 mm3. However, assembling small crystals tended to cost a lot, and fine tuning of the front-end circuit was required to get fine crystal identification. In this paper, therefore, we proposed a more practical four-layered DOI detector. Its key concept was that the crystals in the top layer, which have the highest detection efficiency, are the biggest contributors to the PET spatial resolution. We applied two new ideas: (1) using quarter size crystals only for the first (top) layer and (2) inserting a thin light guide between the first and the second layers of the crystal array. In the developed prototype detector, we used 24 × 24 LYSO crystals of quarter size (1.4 × 1.4 × 5.0 mm3) in the first layer and the other layers were 12 × 12 arrays of crystals of 2.8 × 2.8 × 5.0 mm3. For better crystal identification of small crystals in the first layer, we optimized the optical condition between crystals by using an optical adhesive and air. Also, the thin light guide of 0.5 mm thickness was inserted between the first and the second layers for improvement of crystal identification of the first layer. With the appropriate insertion of the light guide, all crystals of the first layer were identified as well as the crystals in the other layers. Our developed four-layered DOI detector showed good potential for high spatial resolution without a large increase in the number of crystals.

This work presents an iterative method for the estimation of the absolute dose distribution in patients undergoing carbon ion therapy, via analysis of the distribution of positron annihilations resulting from the decay of positron-emitting fragments created in the target volume. The proposed method relies on the decomposition of the total positron-annihilation distributions into profiles of the three principal positron-emitting fragment species - 11C, 10C and 15O. A library of basis functions is constructed by simulating a range of monoenergetic 12C ion irradiations of a homogeneous polymethyl methacrylate phantom and measuring the resulting one-dimensional positron-emitting fragment profiles and dose distributions. To estimate the dose delivered during an arbitrary polyenergetic irradiation, a linear combination of factors from the fragment profile library is iteratively fitted to the decomposed positron annihilation profile acquired during the irradiation, and the resulting weights combined with the corresponding monoenergetic dose profiles to estimate the total dose distribution. A total variation regularisation term is incorporated into the fitting process to suppress high-frequency noise. The method was evaluated with 14 different polyenergetic 12C dose profiles in a polymethyl methacrylate target: one which produces a flat biological dose, 10 with randomised energy weighting factors, and three with distinct dose maxima or minima within the spread-out Bragg peak region. The proposed method is able to calculate the dose profile with mean relative errors of 0.8%, 1.0% and 1.6% from the 11C, 10C, 15O fragment profiles, respectively, and estimate the position of the distal edge of the SOBP to within an average of 0.7 mm, 1.9 mm and 1.2 mm of its true location.

The goal of whole gamma imaging (WGI) is to utilize all detectable gamma rays from radioactive decays for imaging. By inserting a scatterer ring into a PET ring, the WGI detects not only 511 keV annihilation photons of positron emitters but also single gamma rays with various energies as Compton events. The Compton events include one photon of a pair of the annihilation photons in that the other photon is not detected, as well as a single gamma-ray photon emitted from a non-pure positron emitter. To realize the WGI concept, it is necessary to develop an image reconstruction method combining the two different types of events. In this study, therefore, we developed a hybrid image reconstruction algorithm which utilized PET and Compton events efficiently in each iteration based on the list-mode ordered subset expectation maximization framework. For each sub-iteration of the proposed algorithm, a weighted sum of update images individually calculated for PET and Compton events was used as an update image. To demonstrate the effectiveness, we used our WGI prototype to measure a contrast phantom filled with a 89Zr solution of 9.4 MBq having a hot to background ratio of 4:1. We extracted 511 keV PET events and 909 keV Compton events by setting different energy windows in software-based coincidence detection. Reconstructed images obtained using both PET and Compton events were compared with those using PET events only and those using Compton events only. The contrast recovery against background variability for each iteration was used as a figure of merit. The results showed the image reconstructed using both PET and Compton events had better image contrast compared with other images.

Compton imaging or Compton camera imaging has been studied well, but its advantages in nuclear medicine and molecular imaging have not been demonstrated yet. Therefore, the aim of this work was to compare Compton imaging with positron emission tomography (PET) by using the same imaging platform of whole gamma imaging (WGI). WGI is a concept that combines PET with Compton imaging by inserting a scatterer ring into a PET ring. This concept utilizes diverse types of gamma rays for 3D tomographic imaging. In this paper, we remodeled our previous WGI prototype for small animal imaging, and we developed an image reconstruction method based on a list-mode ordered subset expectation maximization algorithm incorporating detector response function modeling, random correction and normalization (sensitivity correction) for either PET and Compton imaging. To the best of our knowledge, this is the world’s first realization of a full-ring Compton imaging system. We selected 89Zr as an imaging target because a 89Zr nuclide emits a 909 keV single-gamma ray as well as a positron, and we can directly compare Compton imaging of 909 keV photons with PET, a well-established modality. We measured a cylindrical phantom and a small rod phantom filled with 89Zr solutions of 10.3 MBq and 10.2 MBq activity, respectively, for 1 h each. The uniform radioactivity distribution of the cylindrical phantom was reconstructed with normalization in both PET and Compton imaging. Coefficients of variation for region-of-interest values were 4.2% for Compton imaging and 3.3% for PET; the difference might be explained by the difference in the detected count number. The small rod phantom experiment showed that the WGI Compton imaging had spatial resolution better than 3.0 mm at the peripheral region although the center region had lower resolution. PET resolved 2.2 mm rods clearly at any location. We measured a mouse for 1 h, 1 d after injection of 9.8 MBq 89Zr oxalate. The 89Zr assimilated in the mouse bony structures was clearly depicted, and Compton imaging results agreed well with PET images, especially for the region inside the scatterer ring. In conclusion, we demonstrated the performance of WGI using the developed Compton image reconstruction method. We realized Compton imaging with a quality approaching that of PET, which is supporting a future expectation that Compton imaging outperforms PET.

Persistent memory (PMEM) is an emerging byte-addressable memory device that sits on a memory bus like conventional DRAM. A first PMEM product, Intel® Optane™ DC Persistent Memory (DCPM), has a larger capacity and lower cost per gigabyte than DRAM, although its performance is lower than that of DRAM. Therefore, hybrid memory systems that combine DRAM and DCPM for main memory are recommended to take advantage of both of them. However, our previous work revealed significant unfairness between two processes co-running on a real hybrid memory system; the performance of a process accessing DRAM is significantly degraded by another performing frequent writes to DCPM, but not vice versa. In this work, we propose FairHym that is a dynamic frequency scaling technique to improve the inter-process fairness on hybrid memory systems. It decreases the operating frequencies of CPU cores that run a process performing frequent DCPM writes in order to throttle its access frequency and prevent DRAM accesses from being blocked. We implement FairHym as a user-level runtime system and evaluate it with 36 two-process workloads on a real server. The evaluation results show that FairHym improves a fairness metric from 0.66 to 0.86 on average, compared to the default setting that maximizes the frequencies of all cores.

A female septuagenarian had poorly controlled diabetes mellitus for more than 20 years. She had persistent pyuria, but did not seek further examination. In 2019, she was transported to our hospital by ambulance for sudden abdominal pain. Physical examination showed a sign of panperitonitis with sepsis. Computed tomography showed ascites and intraperitoneal free air. In addition, there was also a defect in the bladder wall, suggesting bladder rupture. Blood tests showed a marked increase in serum creatinine in addition to increased inflammatory reactants. Because perforation of gastrointestinal tract could not be excluded, an emergency laparotomy was performed. An intraperitoneal perforation of the posterior wall of the bladder was revealed, though there was no intestinal damage. The bladder wall was repaired and cystostomy was performed followed by irrigation and drainage of the abdominal cavity. After the operation, her abdominal symptom resolved and her general status improved. We speculated that voiding disturbance due to neurogenic bladder associated with diabetes mellitus and chronic infection caused the spontaneous bladder rupture. Most cases of spontaneous bladder rupture are associated with a history of pelvic surgery or irradiation, which suggests that this case is extremely rare. In patients with repeated urinary tract infection and underlying disease affecting bladder function, evaluation and appropriate management of bladder dysfunction should be performed ; otherwise, spontaneous bladder rupture may occur.

We investigated the adsorption of lipoteichoic acid (LTA) on titanium surfaces by using the quartz crystal microbalance (QCM) method, and confirmed the influence of mucin (MUC) pre-adsorption on LTA adsorption. Two injection methods were evaluated. Namely, Method A: single-step injection of LTA solution to the Ti sensor, and Method B: MUC solution was injected to the Ti sensor followed by LTA injection on the MUC pre-adsorbed surface. QCM measurement revealed that the adsorbed amount of LTA by Method A was low and constant regardless of the increase in LTA concentration. In contrast, the adsorption amount of LTA in Method B increased according with increasing concentration of LTA and was significantly higher than that of Method A. The hydrophobic surface after MUC pre-adsorption was presumed to contribute to the enhancement of LTA adsorption. Our results revealed that MUC pre-adsorption to Ti is necessary for LTA adsorption in living tissue.

Datacenter networks are constructed of high speed networks, such as 40Gbps Ethernet, and quite severe communication quality, low latency and high throughput, is required from applications. RDMA (Remote Direct Memory Access) is now a hot topic in datacenter networking because it can operate high speed data transmission without TCP/IP protocol overhead. DCQCN (Datacenter Quantized Congestion Notification) has been proposed as congestion control for RDMA over Ethernet. In this paper, we reveal with our preliminary evaluation for DCQCN that 1) byte counter behavior causes fairness issues, 2) parameter setting of small timer for time counter and large byte counter makes time counter a dominant factor in rate increase algorithm, and 3) time counter behavior which is independent of transmission rate resolves fairness issues. And we also show that DCQCN has a technical problem of delaying transition timing to Hyper-Active Increase phase due to large byte counter setting, which causes slow convergence to the desirable transmission rate. We propose a new setting for byte counter in DCQCN so that its interval of counter increment is independent of transmission rate. This algorithm, named Adaptive Byte Counter DCQCN (ABCDCQCN), enables shorter interval of byte counter increment and can resolve both fairness issue and fast convergence of transmission rate.

Brain PET, which has led research in molecular imaging and diagnosis of brain cancer, epilepsy and neurodegenerative disorders, is being spotlighted again to promote earlier diagnosis of dementia with the advent of amyloid and tau tracers. To meet this demand, in this paper, we developed a brain-dedicated PET imaging device with a hemispherical detector arrangement, which provides comparable sensitivity with fewer detectors than conventional cylindrical geometries. The introduction of the time-of-flight (TOF) measurement capability was a key point for the development to get a gain in the image signal-to-noise ratio. Currently, whole-body PET scanners with around 200-400 ps coincidence resolving time (CRT) are commercially available. In order to obtain the same TOF gain which can be obtained with 400 ps CRT for a 30 cm diameter object, 267 ps CRT will be required for a 20 cm diameter object such as the human head. In this work, therefore, we aimed at developing a TOF brain-dedicated PET prototype with the hemisphere detector arrangement and the CRT faster than 267 ps. The detector was composed of a 12 × 12 lutetium fine silicate (LFS) array coupled with a 12 × 12 multi-pixel photon counter (MPPC) array. Each LFS crystal with a size of 4.14 × 4.14 × 10 mm3 was individually coupled to a separate MPPC. Singles list-mode data from each detector were stored, and coincidences were identified using a coincidence-detection software algorithm. The CRT of 245 ps was finally achieved as the system average after a fine timing correction. For image reconstruction, we implemented the list-mode TOF-OSEM. For a small rod phantom, rods of 3 mm diameter were clearly separated. Also, images of the 3D Hoffman brain phantom, which demonstrated clear contrast between gray and white matter, supported the effect of TOF information.

In heavy-ion therapy, the stopping position of primary ions in tumours needs to be monitored for effective treatment and to prevent overdose exposure to normal tissues. Positron-emitting ion beams, such as

Finding the valuable data among huge amount of data is too laborious due to the human limitation on perception capability. Reversely, pushed data about a service must miss the point without understanding user's demand. So, our base idea is to collect profiles of users and providers, and to match the user's demand with the providers' service. In this paper, we propose a communication framework for agents to find friend-agents and to share events in place of the client. Concretely we propose two-stage protocols, that is, profile sharing and event sharing. Thereby, only significant events can be shared in real time since friend-agents already have logical linkage. We verify that the latency to convey the valuable event to the receiver can be reduced. Finally, we discuss the structure of the profile data, and shows that required load for word matching can be saved by the hierarchical structure.

Persistent memory (PM) is an emerging memory device that has a larger capacity and lower cost per gigabyte than conventional DRAM. Intel has released a first PM product called Optane™ DC Persistent Memory, but its performance is several times lower than that of DRAM. Therefore, it will be used in combination with DRAM to configure hybrid memory systems that can obtain both the high performance of DRAM and large capacity of PM.In this paper, we evaluate and analyze the performance interference between various types of processes that are concurrently executed on a real server platform having a hybrid memory system. Through the evaluation with a synthetic benchmark, we show that the interference on the hybrid memory system is significantly different from that on a conventional DRAM-only memory system.

Recently, silicon photomultipliers (SiPMs) have become established as photo-sensors for PET scanners. Commercially available SiPM arrays are typically about 3–4 cm in size. In order to develop larger detectors with an Anger calculation, multiple SiPM arrays need to be combined. This configuration requires the use of a light guide and has inactive areas between SiPM arrays. If not addressed, crystal identification degrades not only for peripheral crystals but also for crystals to bridge the gap between the SiPM arrays. On the other hand, we have developed the crosshair light-sharing (CLS) PET detector, which is based on a single-ended readout scheme with roughly quadrisected crystals comparable in size to a SiPM, with depth-of-interaction (DOI) capability. The CLS PET detector based on the local centroid calculation was expected to mitigate the edge effect similar to what the one-to-one coupling detector is able to do. In this work, we developed the axially long CLS PET detector with two multipixel photon counter (MPPC) arrays. The proposed long CLS PET detector consisted of 30 × 14 gadolinium fine aluminum garnet (GFAG) arrays coupled to two 8 × 8 MPPC arrays without the light guide. From 511-keV uniform irradiation, responses of all crystal elements could be separated clearly on a 2D position histogram after applying the Anger calculation. Pulse heights of additional crystals to bridge the gap were 18% lower than those of crystals at the center of the MPPC array, but similar to that of the peripheral crystals based on non-uniformity of the MPPC array. On the other hand, energy resolutions of additional crystals to bridge the gap were almost the same to those of other crystals. The long CLS PET detector promises improvement of the packing fraction while keeping performance.

The depth-of-interaction detector which can identify gamma-ray detection position along the depth direction is essential for a PET scanner to reduce parallax error. The X’tal cube we have developed is composed of a scintillation crystal block segmented into cubes. Six arrays of multipixel photon counters (MPPCs) cover six surfaces of the crystal block. We developed the new X’tal cube consisting of 0.77 mm cubic segments. A (13.1 mm)3 LYSO crystal block had 3-D segmentation in a ${17 \times 17 \times 17}$ array fabricated by the laser engraving technique. $ {4 \times 4}$ MPPC arrays with a size of (13 mm)2 were used. Active area of each MPPC was (3.0 mm)2. To evaluate segment identification performance, we irradiated with gamma-rays from a 22Na source and obtained a 3-D position histogram made by the 3-D Anger-type calculation with all MPPC signals. The histogram showed 17 segments in a row can be identified clearly. Further, to measure its intrinsic spatial resolution with incident angles of 0° and 45°, gamma-rays in a fan-beam were irradiated and scanned onto the X’tal cube. Spatial resolutions of 0.74 ± 0.10 mm and 0.89 ± 0.10 mm were obtained by both scan experiments, respectively.

We have been working on the development of a PET insert for existing magnetic resonance imaging (MRI) systems for simultaneous PET/MR imaging, which integrates radiofrequency (RF)-shielded PET detector modules with an RF head coil. In order to avoid interferences between the PET detector circuits and the different MRI-generated electromagnetic fields, PET detector circuits were installed inside eight Cu-shielded fiber-reinforced plastic boxes, and these eight shielded PET modules were integrated in between the eight elements of a 270-mm-diameter and 280-mm-axial-length cylindrical birdcage RF coil, which was designed to be used with a 3-T clinical MRI system. The diameter of the PET scintillators with a 12-mm axial field-of-view became 255mm, which was very close to the imaging region. In this study, we have investigated the effects of this PET/RF-coil integrated system on the performance of MRI, which include the evaluation of static field (Bo) inhomogeneity, RF field (B1) distribution, local specific absorption rate (SAR) distribution, average SAR, and signal-to-noise ratio (SNR). For the central 170-mm-diameter and 80-mm-axial-length of a homogenous cylindrical phantom (with the total diameter of 200mm and axial-length of 100mm), an increase of about a maximum of 3μT in the Bo inhomogeneity was found, both in the central and 40-mm off-centered transverse planes, and a 5 percentage point increase of B1 field inhomogeneity was observed in the central transverse plane (from 84% without PET to 79% with PET), while B1 homogeneity along the coronal plane was almost unchanged (77%) following the integration of PET with the RF head coil. The average SAR and maximum local SAR were increased by 1.21 and 1.62 times, respectively. However, the SNR study for both spin-echo and gradient-echo sequences showed a reduction of about 70% and 60%, respectively, because of the shielded PET modules. The overall results prove the feasibility of this integrated PET/RF-coil system for using with the existing MRI system.

We have developed a four-layer depth of interaction (DOI) detector with single-side photon readout, in which segmented crystals with the patterned reflector insertion are separately identified by the Anger-type calculation. Optical conditions between segmented crystals, where there is no reflector, affect crystal identification ability. Our objective of this work was to improve crystal identification performance of the four-layer DOI detector that uses crystals segmented with a recently developed laser processing technique to include laser processed boundaries (LPBs). The detector consisted of 2 × 2 × 4 mm 3 LYSO crystals and a 4 × 4 array multianode photomultiplier tube (PMT) with 4.5 mm anode pitch. The 2D position map of the detector was calculated by the Anger calculation method. At first, influence of optical condition on crystal identification was evaluated for a one-layer detector consisting of a 2 × 2 crystal array with three different optical conditions between the crystals: crystals stuck together using room temperature vulcanized (RTV) rubber, crystals with air coupling and segmented crystals with LPBs. The crystal array with LPBs gave the shortest distance between crystal responses in the 2D position map compared with the crystal array coupled with RTV rubber or air due to the great amount of cross-talk between segmented crystals with LPBs. These results were used to find optical conditions offering the optimum distance between crystal responses in the 2D position map for the four-layer DOI detector. Crystal identification performance for the four-layer DOI detector consisting of an 8 × 8 array of crystals segmented with LPBs was examined and it was not acceptable for the crystals in the first layer. The crystal identification was improved for the first layer by changing the optical conditions between all 2 × 2 crystal arrays of the first layer to RTV coupling. More improvement was observed by combining different optical conditions between all crystals of the first layer and some crystals of the second and the third layers of the segmented array.

One of the challenging applications of PET is implementing it for in-beam PET, which is an in situ monitoring method for charged particle therapy. For this purpose, we previously proposed the world's first open-type geometries which we named OpenPET. For in-beam PET, careful designing and testing of detectors are important because secondary particles generated in a target degrade detector performance in the OpenPET geometries. As well, we have developed small prototypes and identified their promising potential for in-beam PET and succeeded in visualizing a 3D distribution of beam stopping positrons inside a phantom. In this work, we developed a whole-body dual ring OpenPET (WBDROP) with a singles-based data acquisition (DAQ) system. This scanner design has two separated rings. Each ring has two detector rings of 40 detector blocks, and each detector block consists of a 4-layered depth-of-interaction (DOI) detector. The ring diameter is 660 mm, and the distance between separated rings, which can be controlled, is 94 mm. Each DOI detector consists of 1024 GSOZ crystals which are arranged in four layers of 16 × 16 arrays, coupled to a 64-ch flat panel position sensitive photomultiplier tube. In order to increase scalability and maintain the possibility for future development of complicated coincidence algorithms to reject background signals, our designed DAQ system has no coincidence circuit and uses only singles list-mode DAQ circuits. The DAQ system makes a judgment on coincidence based on software, where the singles list-mode data include 6-bit energy markers and 500-ps tags for timing information. The system sensitivity measured from a 22Na point source was 4.4%. The average spatial resolutions were calculated as about 3.5 mm FWHM. For the singles count rate, the dead time at 250 MBq was about 8%. The singles-based DAQ system had significant performance in singles list-mode data acquisition. For in-beam PET, imaging performance of the WBDROP was confirmed through phantom experiments. Phantom study results with 11C and 10C beam irradiations of about 3 Gy showed that the beam stopping position in the target could be measured with a precision of better than 2 mm. The WBDROP promises high performance for not only conventional PET studies but also in-beam PET measurements.

High sensitivity and high spatial resolution dedicated brain PET scanners are in high demand for early diagnosis of neurodegenerative diseases and studies of brain functions. To meet the demand, we have proposed the helmet-chin PET geometry which has a helmet detector and a chin detector. Our first prototype scanner used 54 4-layer depth-of-interaction (DOI) detectors. The helmet detector of the scanner had three detector rings with different radii arranged on a surface of a hemisphere (with a radius of 126.5 mm) and a top cover detector. Therefore, in this study, for our next development, we propose a spherical arrangement, in which the central axis of each detector points toward the center of the hemisphere, and we optimize the size of the detector crystal block to be arranged on the helmet detector. We simulate the spherical arrangement with the optimized crystal block size and compare its imaging performance with the multi-ring arrangement, which has a similar detector arrangement to that of our first prototype. We conduct Monte Carlo simulation to model the scanners having the 4-layer DOI detectors which consist of LYSO crystals. A dead space of 2 mm is assumed on each side of the crystal blocks such as for wrapping. The size of the crystal block is varied from 4×4 mm2 to 54×54 mm2 while fixing the thickness of the crystal block to 20 mm. We find that the crystal block sized at 42×42 mm2 has the highest sensitivity for a hemispherical phantom. The comparison of the two arrangements with the optimized crystal blocks show that, for the same number of crystal blocks, the spherical arrangement has 17% higher sensitivity for the hemispherical phantom than the multi-ring arrangement. We conclude that the helmet-chin PET with the spherical arrangement constructed from the crystal block sized at 42×42×20 mm3 has better imaging performance especially at the upper part of the brain compared to the multi-ring arrangement while keeping similar spatial resolution throughout the FOV.