A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT.
Abstract. In the engineering domain, the development of complex products (e.g., cars) necessitates the coordination of thousands of (sub-)processes. One of the biggest challenges for process management systems is to support the modeling, monitoring and maintenance of the many interdependencies between these sub-processes. The resulting process structures are large and can be characterized by a strong relationship with the assembly of the product; i.e., the sub-processes to be coordinated can be related to the dierent product components. So far, sub-process coordination has been mainly accomplished manually, resulting in high eorts and inconsistencies. IT support is required to utilize the information about the product and its structure for deriving, coordinating and maintaining such data-driven process structures. In this paper, we introduce the COREPRO framework for the data-driven modeling of large process structures. The approach reduces modeling eorts signicantly and provides mechanisms for maintaining data-driven process structures.
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Abstract. Car development is based on long running, concurrently executed and highly dependent processes. The coordination and synchronization of these processes has become a complex and error-prone task due to the increasing number of functions and embedded systems in modern cars. These systems realize advanced features by embedded software and enable the distribution of functionality as required, for example, by safety equipment. Different life cycle times of mechanical, software and hardware components as well as different duration of their development processes require efficient coordination. Furthermore, productdriven process structures, dynamic adaptation of these structures, and handling real-world exceptions result in challenging demands for any IT system. In this paper we elaborate fundamental requirements for the IT support of car development processes, taking release management as characteristic example. We show to which extent current product data and process management technology meets these requirements, and discuss which essential limitations still exist. This results in a number of fundamental challenges requiring new paradigms for the product-driven design, enactment and adaptation of processes.
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