PurposeChronic hand and wrist pain is a common clinical issue for orthopaedic surgeons and rheumatologists. The purpose of this study was 1. To analyze the interobserver agreement of SPECT/CT, MRI, CT, bone scan and plain radiographs in patients with non-specific pain of the hand and wrist, and 2. to assess the diagnostic accuracy of these imaging methods in this selected patient population.Materials and MethodsThirty-two consecutive patients with non-specific pain of the hand or wrist were evaluated retrospectively. All patients had been imaged by plain radiographs, planar early-phase imaging (bone scan), late-phase imaging (SPECT/CT including bone scan and CT), and MRI. Two experienced and two inexperienced readers analyzed the images with a standardized read-out protocol. Reading criteria were lesion detection and localisation, type and etiology of the underlying pathology. Diagnostic accuracy and interobserver agreement were determined for all readers and imaging modalities. ResultsThe most accurate modality for experienced readers was SPECT/CT (accuracy 77%), followed by MRI (56%). The best performing, though little accurate modality for inexperienced readers was also SPECT/CT (44%), followed by MRI and bone scan (38% each). The interobserver agreement of experienced readers was generally high in SPECT/CT concerning lesion detection (kappa 0.93, MRI 0.72), localisation (kappa 0.91, MRI 0.75) and etiology (kappa 0.85, MRI 0.74), while MRI yielded better results on typification of lesions (kappa 0.75, SPECT/CT 0.69). There was poor agreement between experienced and inexperienced readers in SPECT/CT and MRI. ConclusionsSPECT/CT proved to be the most helpful imaging modality in patients with non-specific wrist pain. The method was found reliable, providing high interobserver agreement, being outperformed by MRI only concerning the typification of lesions. We believe it is beneficial to integrate SPECT/CT into the diagnostic imaging algorithm of chronic wrist pain.

BackgroundAccurate lymph node staging is essential for adequate prognostication and therapy planning in patients with non-small cell lung cancer (NSCLC). FDG-PET/CT is a sensitive tool for the detection of metastases, including non-palpable supraclavicular lymph node (SCLN) metastases. Histological proof of metastatic spread and mutation analysis is crucial for optimal staging and therapy. The aim of this study was to investigate the value of ultrasound-guided fine needle aspiration cytology (FNAC) and core biopsy (CB) of FDG active, non-palpable SCLN’s in patients with suspicion for lung cancer.MethodsTwelve consecutive patients with suspected lung cancer and FDG-positive SCLN underwent FNAC (n = 11) and/or CB (n = 10) and were included and evaluated retrospectively in this study. Cytologic and/or histologic evaluation was performed to confirm initially suspected diagnosis (lung cancer), to confirm N3 stage, and to screen for driver mutations in lung adenocarcinoma.ResultsFNAC alone showed diagnostic success in 11/11 cases (100%), CB alone in 9/10 patients (90%), and the combination of both procedures was successful in 12/12 cases (100%). Lymph node metastases from NSCLC (7 adenocarcinoma, 2 squamous cell carcinoma) could be confirmed in 9 patients. Other diagnoses were small cell lung cancer (SCLC), breast cancer and sarcoidosis. There was enough material for immunhistochemistry in all patients. For molecular testing, material from this lymph node biopsies and lung biopsy was used. In two patients with adenocarcinoma of the lung driver mutations were detected (EGFR Exon 19 deletion and ALK rearrangement) out of the lymph node metastasis.ConclusionsUS-guided combined FNAC and CB of FDG positive supraclavicular lymph nodes in patients with suspected lung cancer is a safe and effective procedure to confirm N3-stage and to obtain representative material for molecular testing.

Current developments in the aerospace industry point towards more frequent interplanetary travel in the future. However, the main focus of developments is on launcher technology, yet the descent of interplanetary probes is of high importance for the success of future missions. Additionally, to the present landing approaches using either a powered descent requiring fuel or a combination of different parachutes, a third method is investigated in this project. The chosen approach is called autorotation and is commonly used in helicopters. When a helicopter suffers a loss of power, it can still land and even choose its landing site without the utilization of an engine. Similar to parachutes, the presented technology can be applied to various atmospheric conditions by modification of rotor and control parameters. Moreover, a rotor in autorotation can provide directional control and thus the choice of a landing site, which is not feasible using a parachute. All these factors make autorotation an interesting option as an entry descent and landing (EDL) technology for interplanetary missions. Our project, Daedalus 2 implements the autorotation landing strategy as part of the REXUS student project campaign under DLR / ESA / SNSA supervision. Since 2018 we are developing the SpaceSeed Mk.2, a technology demonstrator that incorporates a rotor and all necessary technological means to perform an autorotation EDL maneuver from an apogee of 80 km. The mission concept is laid out within the presented paper. This includes the main challenges like miniaturization of the SpaceSeed v2 due to the size constraints of the REXUS rocket or the used sensors for height and position determination. The importance of a technology demonstrator tested on a sounding rocket to prove the feasibility of our presented system is laid out in our publication. Furthermore, the custom development of electrical, mechanical and software sub systems is discussed. Additionally, the planned mission profile will be explained, including flight phases and different activities conducted by the SpaceSeeds during flight. Moreover, the main differences and improvements to Daedalus 1 are being discussed

The Daedalus 2 mission aboard REXUS 29 is a technology demonstrator for an alternative descent mechanism for very high altitude drops based on auto-rotation. It consists of two probes that are ejected from a sounding rocket at an altitude of about 80 km and decelerate to a soft landing using only a passive rotor with pitch control. This type of autonomous, scientific experiment poses great challenges upon the electronics subsystem, which include mechanical stress, power system reliability, sensor redundancy, subsystem communication, and development procedures.Based on the data gathered in Daedalus 1 [1] multiple new approaches were developed to fulfill these requirements, such as redundant communication links, mechanical decoupling of PCBs and fault-tolerant power source selection.