Classification of hepatobiliary scintigraphy patterns in segmented gallbladder according to anatomical discordance

BACKGROUND Hepatobiliary scintigraphy(HBS)is a useful diagnostic imaging technique that uses radiotracers to evaluate the function of the gallbladder(GB)and biliary system.In segmented GB,some HBS images reveal a discordant GB boundary as compared to anatomical images.AIM To evaluate the characteristics of HBS in segmented GB and determine the clinical relevance according to HBS characteristics.METHODS A total of 268 patients with chronic cholecystitis,gallstones,or biliary colic symptoms who underwent HBS between 2011 and 2020 were enrolled.Segmented GB was defined as segmental luminal narrowing of the GB body on computed tomography(CT)or magnetic resonance(MR)images,and HBS was examined 1 mo before or after CT or MR.Segmented GB was classified into 3 types based on the filling and emptying patterns of the proximal and distal segments according to the characteristics of HBS images,and GB ejection fraction(GBEF)was identified:Type 1 was defined as a normal filling and emptying pattern;Type 2 was defined as an emptying defect on the distal segment;and Type 3 was defined as a filling defect in the distal segment.RESULTS Segmented GB accounted for 63 cases(23.5%),including 36 patients(57.1%)with Type 1,18 patients(28.6%)with Type 2,and 9 patients(14.3%)with Type 3 emptying pattern.Thus,approximately 43%of HBS images showed a discordant pattern as compared to anatomical imaging of segmented GB.Although there were no significant differences in clinical symptoms,rate of cholecystectomy,or pathological findings based on the type,most gallstones occurred in the distal segment.Reported GBEF was 62.50%±24.79%for Type 1,75.89%±17.21%for Type 2,and 88.56%±7.20%for Type 3.Type 1 showed no difference in reported GBEF compared to the non-segmented GB group(62.50%±24.79%vs 67.40%±21.78%).In contrast,the reported GBEF was higher in Types 2 and 3 with defective emptying and filling when compared to Type 1(80.11%±15.70%vs 62.57%±24.79%;P=0.001).CONCLUSION In segmented GB,discordance in the filling patterns detected by HBS and anatomical imaging could lead to misinterpretation of GBEF.For this reason,clinicians should be cautious when interpreting HBS results in patients with segmented GB.

Optimal three-dimensional impact time guidance with seeker’s field-of-view constraint

This paper proposes a new three-dimensional optimal guidance law for impact time control with seeker’s Field-of-View(FOV) constraint to intercept a stationary target. The proposed guidance law is devised in conjunction with the concept of biased Proportional Navigation Guidance(PNG). The guidance law developed leverages a nonlinear function to ensure the boundedness of velocity lead angle to cater to the seeker’s FOV limit. It is proven that the impact time error is nullified in a finite-time under the proposed method. Additionally, the optimality of the biased command is theoretically analyzed. Numerical simulations confirm the superiority of the proposed method and validate the analytic findings.

A unified formulation of optimal guidance-to-collision law for accelerating and decelerating targets

This paper provides a unified formulation of optimal guidance-to-collision law for a target with an arbitrary acceleration or deceleration.The collision course for general target acceleration or deceleration is first determined from the engagement geometry in conjunction with the nonlinear engagement kinematics in the proposed approach.The heading error defined in the collision course is then adopted as a variable to be nullified for accomplishing the intercept condition.The proposed guidance law is derived based on the heading error dynamics and the optimal error dynamics to ensure optimality and finite-time convergence.As illustrative examples,the proposed guidance command for a constant target acceleration and a target deceleration in the form of a quadratic function of speed are provided.Additionally,the time-to-go prediction method is suggested for implementing the proposed method.The characteristics of the proposed guidance command are analytically investigated to provide insight into the proposed method.The key benefits of the proposed method lie in not producing unnecessary guidance commands near a target compared to other methods and ensuring optimality in guidance command even in the nonlinear engagement kinematics.Finally,numerical simulations are performed to validate the proposed method and to show our findings.