Sample records for patients expanding image

  1. Angiographic imaging evaluation of patient-specific bifurcation-aneurysm phantom treatment with pre-shaped, self-expanding, flow-diverting stents: feasibility study

    PubMed Central

    Ionita, Ciprian N; Suri, Himanshu; Nataranjian, Sabareesh; Siddiqui, Adnan; Levy, Elad; Hopkins, Nelson L; Bednarek, Daniel R; Rudin, Stephen

    2011-01-01

    Aneurysm treatment using flow diversion could become the treatment of choice in the near future. While such side-wall aneurysm treatments have been studied in many publications and even implemented in selected clinical cases, bifurcation aneurysm treatment using flow diversion has not been addressed in detail. Using angiographic imaging, we evaluated treatment of such cases with several stent designs using patient-specific aneurysm phantoms. The aim is to find a way under fluoroscopic image guidance to place a low-porosity material across the aneurysm orifice while keeping the vessel blockage minimal. Three pre-shaped self-expanding stent designs were developed: the first design uses a middle-flap wing stent, the second uses a two-tapered-wing-ended stent, and the third is a slight modification of the first design in which the middle-flap is anchored tightly against the aneurysm using a standard stent. Treatment effects on flow were evaluated using high-speed angiography (30 fps) and compared with the untreated aneurysm. Contrast inflow was reduced in all the cases: 25% for Type 1, 63% for type 2 and 88% for Type 3. The first and the second stent design allowed some but substantially-reduced flow inside the aneurysm neck as indicated by the time-density curves. The third stent design eliminated almost all flow directed at the aneurysm dome, and only partial filling was observed. In the same time Type 1 and 3 delayed the inflow in the branches up to 100% compared to the untreated phantom. The results are quite promising and warrant future study. PMID:21760699

  2. Multiple paths extraction in images using a constrained expanded trellis.

    PubMed

    Sun, Changming; Appleton, Ben

    2005-12-01

    Single shortest path extraction algorithms have been used in a number of areas such as network flow and image analysis. In image analysis, shortest path techniques can be used for object boundary detection, crack detection, or stereo disparity estimation. Sometimes one needs to find multiple paths as opposed to a single path in a network or an image where the paths must satisfy certain constraints. In this paper, we propose a new algorithm to extract multiple paths simultaneously within an image using a constrained expanded trellis (CET) for feature extraction and object segmentation. We also give a number of application examples for our multiple paths extraction algorithm. PMID:16355660

  3. Expanding Perspectives for Comprehending Visual Images in Multimodal Texts

    ERIC Educational Resources Information Center

    Serafini, Frank

    2011-01-01

    The texts that adolescents encounter today are often multimodal, meaning they incorporate a variety of modes, including visual images, hypertext, and graphic design elements along with written text. Expanding the perspectives readers use to make sense of the multimodal texts is an important aspect of comprehension instruction. Moving beyond the…

  4. Expanding patient involvement in care. Effects on patient outcomes

    Microsoft Academic Search

    Sheldon Greenfield; Sherrie H. Kaplan; Ware John E. Jr

    1985-01-01

    An intervention was developed to increase patient involvement in care. Using a treatment algorithm as a guide, patients were helped to read their medical record and coached to ask questions and negotiate medical decisions with their physicians during a 20-minute session before their regularly scheduled visit. In a randomized controlled trial we compared this intervention with a standard educational session

  5. Nanoscale imaging reveals laterally expanding antimicrobial pores in lipid bilayers

    PubMed Central

    Rakowska, Paulina D.; Jiang, Haibo; Ray, Santanu; Pyne, Alice; Lamarre, Baptiste; Carr, Matthew; Judge, Peter J.; Ravi, Jascindra; M. Gerling, Ulla I.; Koksch, Beate; Martyna, Glenn J.; Hoogenboom, Bart W.; Watts, Anthony; Crain, Jason; Grovenor, Chris R. M.; Ryadnov, Maxim G.

    2013-01-01

    Antimicrobial peptides are postulated to disrupt microbial phospholipid membranes. The prevailing molecular model is based on the formation of stable or transient pores although the direct observation of the fundamental processes is lacking. By combining rational peptide design with topographical (atomic force microscopy) and chemical (nanoscale secondary ion mass spectrometry) imaging on the same samples, we show that pores formed by antimicrobial peptides in supported lipid bilayers are not necessarily limited to a particular diameter, nor they are transient, but can expand laterally at the nano-to-micrometer scale to the point of complete membrane disintegration. The results offer a mechanistic basis for membrane poration as a generic physicochemical process of cooperative and continuous peptide recruitment in the available phospholipid matrix. PMID:23671080

  6. The patient behind the image

    Microsoft Academic Search

    Barry L. Zaret

    2001-01-01

    Nuclear cardiologists, by the very nature of their practice, are often several steps removed from the patient, the patient’s family, and often the patient’s physician. As laboratory specialists, we obtain a set of high-quality images; from these images, we infer relevant diagnostic and prognostic information; from this information, on the basis of prior correlative studies involving large patient populations, inferences

  7. Reconfigurable Mesh Algorithms For Image Shrinking, Expanding, Clustering, And Template Matching*

    E-print Network

    Sahni, Sartaj K.

    Reconfigurable Mesh Algorithms For Image Shrinking, Expanding, Clustering, And Template Matching reconfigurable mesh algorithms are developed for the following image processing prob- lems: shrinking, expanding, clustering, and template matching. Our NÃ?N reconfigurable mesh algorithm for the q-step shrinking

  8. As Patient Navigation Expands and Evolves, Nurses Assume Many Roles

    Cancer.gov

    It can be difficult to access care in our labyrinthine health care system. Oncology nurses are joining the ranks of patient navigators—a diverse group of people who help patients at all stages of cancer care, from screening and diagnosis to treatment and survivorship.

  9. Survival of Patients Older Than 60 Years With Kidneys Transplanted From Spanish Expanded Criteria Donors Versus Patients Continued on Hemodialysis

    Microsoft Academic Search

    J. Martín Navarro; M. Ortega; M. J. Gutiérrez; F. García Martín; J. M. Alcázar; J. M. Morales; A. Andrés; M. Praga

    2009-01-01

    A retrospective study was performed in patients >60 years of age who had initiated hemodialysis (HD) at our hospital between 2000 and 2005 (n = 211). Of these, 47 were placed on the kidney transplantation waiting list and 164 were excluded and continued on HD. Cadaveric transplantation was performed in 31 patients using an expanded criteria donor organ (TR), while

  10. Imaging the Expanding Shell of SN 2011dh

    E-print Network

    de Witt, A; Kamble, A; Soderberg, A M; Brunthaler, A; Zauderer, B; Bartel, N; Rupen, M P

    2015-01-01

    We report on third epoch VLBI observations of the radio-bright supernova SN 2011dh located in the nearby galaxy (7.8 Mpc) M51. The observations took place at $t=453$ d after the explosion and at a frequency of 8.4 GHz. We obtained a fairly well resolved image of the shell of SN 2011dh, making it one of only six recent supernovae for which resolved images of the ejecta are available. By fitting a spherical shell model directly to the visibility measurements we determine the angular radius of SN 2011dh's radio emission to be $636 \\pm 29$ $\\mu$as . At a distance of 7.8 Mpc, this angular radius corresponds to a linear radius of $(7.4 \\pm 0.3) \\times 10^{16}$ cm and an average expansion velocity since the explosion of $18900^{+2800}_{-2400}$ kms$^{-1}$. We also calculated more precise radius measurements for the earlier VLBI observations and we show that all the measured values of the radius of the emission region, up to $t=453$ d, are still almost perfectly consistent with those derived from fitting synchrotron s...

  11. Autosomal recessive spastic ataxia of Charlevoix Saguenay (ARSACS): expanding the genetic, clinical and imaging spectrum

    PubMed Central

    2013-01-01

    Background Mutations in SACS, leading to autosomal-recessive spastic ataxia of Charlevoix-Saguenay (ARSACS), have been identified as a frequent cause of recessive early-onset ataxia around the world. Here we aimed to enlarge the spectrum of SACS mutations outside Quebec, to establish the pathogenicity of novel variants, and to expand the clinical and imaging phenotype. Methods Sequencing of SACS in 22 patients with unexplained early-onset ataxia, assessment of novel SACS variants in 3.500 European control chromosomes and extensive phenotypic investigations of all SACS carriers. Results We identified 11 index patients harbouring 17 novel SACS variants. 9/11 patients harboured two variants of at least probable pathogenicity which were not observed in controls and, in case of missense mutations, were located in highly conserved domains. These 9 patients accounted for at least 11% (9/83) in our series of unexplained early onset ataxia subjects. While most patients (7/9) showed the classical ARSACS triad, the presenting phenotype reached from pure neuropathy (leading to the initial diagnosis of Charcot-Marie-Tooth disease) in one subject to the absence of any signs of neuropathy in another. In contrast to its name “spastic ataxia”, neither spasticity (absent in 2/9=22%) nor extensor plantar response (absent in 3/9=33%) nor cerebellar ataxia (absent in 1/9=11%) were obligate features. Autonomic features included urine urge incontinence and erectile dysfunction. Apart from the well-established MRI finding of pontine hypointensities, all patients (100%) showed hyperintensities of the lateral pons merging into the (thickened) middle cerebellar peduncles. In addition, 63% exhibited bilateral parietal cerebral atrophy, and 63% a short circumscribed thinning of the posterior midbody of the corpus callosum. In 2 further patients with differences in important clinical features, VUS class 3 variants (c.1373C>T [p.Thr458Ile] and c.2983 G>T [p.Val995Phe]) were identified. These variants were, however, also observed in controls, thus questioning their pathogenic relevance. Conclusions We here demonstrate that each feature of the classical ARSACS triad (cerebellar ataxia, spasticity and peripheral neuropathy) might be missing in ARSACS. Nevertheless, characteristic MRI features – which also extend to supratentorial regions and involve the cerebral cortex – will help to establish the diagnosis in most cases. PMID:23497566

  12. Reconfigurable Mesh Algorithms for Image Shrinking, Expanding, Clustering, and Template Matching

    Microsoft Academic Search

    Jing-fu Fu Jenq; Sartaj Sahni

    1991-01-01

    Parallel reconfigurable mesh algorithms are developed for the following image processing prob- lems: shrinking, expanding, clustering, and template matching. Our N×N reconfigurable mesh algorithm for the q-step shrinking and expansion of a binary image takes O (1) time. One pass of the clustering algorithm for N patterns and K centers can be done in O (MK + KlogN), O (KlogNM

  13. Meta-analysis of comparison between self-expandable and balloon-expandable valves for patients having transcatheter aortic valve implantation.

    PubMed

    Moretti, Claudio; D'Ascenzo, Fabrizio; Mennuni, Marco; Taha, Salma; Brambilla, Nedy; Nijhoff, Freek; Fraccaro, Chiara; Barbanti, Marco; Tamburino, Corrado; Tarantini, Giuseppe; Rossi, Marco L; Presbitero, Patrizia; Napodanno, Massimo; Stella, Pieter; Bedogni, Francesco; Omedè, Pierluigi; Conrotto, Federico; Montefusco, Antonio; Giordana, Francesca; Biondi Zoccai, Giuseppe; Agostoni, Piefrancesco; D'Amico, Maurizio; Rinaldi, Mauro; Marra, Sebastiano; Gaita, Fiorenzo

    2015-06-15

    Two different devices, 1 self-expanding and 1 balloon-expandable, have been developed for patients who underwent transcatheter aortic valve implantation with contrasting data about efficacy and safety. Pubmed, Medline, and Google Scholar were systematically searched for studies of these different devices, with data derived from randomized controlled trial or registries with multivariate analysis. All-cause death at 30 days and at follow-up were the primary end points, whereas postprocedural moderate or severe aortic regurgitation (AR), stroke, major vascular complications, bleedings, and pacemaker implantation the secondary ones. Six studies with 957 self-expanding and 947 balloon-expandable valves were included: 1 randomized controlled trial and 5 observational studies. At 30 days follow-up, rates of death did not differ between self-expanding and balloon-expandable valves (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.47 to 1.17), whereas balloon expandable reduced rates of moderate or severe AR (OR 0.51, 95% CI 0.27 to 0.99) and of pacemaker implantation (OR 0.28, 95% CI 0.17 to 0.47). After a follow-up of 360 days (300 to 390), rates of all-cause death did not differ between the 2 groups. In conclusion, risks of moderate or severe AR and pacemaker implantation were lower with the balloon-expandable devices without an impact on 30 days and midterm mortality. PMID:25890630

  14. Photon beam dose distributions for patients with implanted temporary tissue expanders

    NASA Astrophysics Data System (ADS)

    Asena, A.; Kairn, T.; Crowe, S. B.; Trapp, J. V.

    2015-01-01

    This study examines the effects of temporary tissue expanders (TTEs) on the dose distributions of photon beams in breast cancer radiotherapy treatments. EBT2 radiochromic film and ion chamber measurements were taken to quantify the attenuation and backscatter effects of the inhomogeneity. Results illustrate that the internal magnetic port present in a tissue expander causes a dose reduction of approximately 25% in photon tangent fields immediately downstream of the implant. It was also shown that the silicone elastomer shell of the tissue expander reduced the dose to the target volume by as much as 8%. This work demonstrates the importance for an accurately modelled high-density implant in the treatment planning system for post-mastectomy breast cancer patients.

  15. Phase-preserving beam expander for biomedical X-ray imaging.

    PubMed

    Martinson, Mercedes; Samadi, Nazanin; Bassey, Bassey; Gomez, Ariel; Chapman, Dean

    2015-05-01

    The BioMedical Imaging and Therapy beamlines at the Canadian Light Source are used by many researchers to capture phase-based imaging data. These experiments have so far been limited by the small vertical beam size, requiring vertical scanning of biological samples in order to image their full vertical extent. Previous work has been carried out to develop a bent Laue beam-expanding monochromator for use at these beamlines. However, the first attempts exhibited significant distortion in the diffraction plane, increasing the beam divergence and eliminating the usefulness of the monochromator for phase-related imaging techniques. Recent work has been carried out to more carefully match the polychromatic and geometric focal lengths in a so-called `magic condition' that preserves the divergence of the beam and enables full-field phase-based imaging techniques. The new experimental parameters, namely asymmetry and Bragg angles, were evaluated by analysing knife-edge and in-line phase images to determine the effect on beam divergence in both vertical and horizontal directions, using the flat Bragg double-crystal monochromator at the beamline as a baseline. The results show that by using the magic condition, the difference between the two monochromator types is less than 10% in the diffraction plane. Phase fringes visible in test images of a biological sample demonstrate that this difference is small enough to enable in-line phase imaging, despite operating at a sub-optimal energy for the wafer and asymmetry angle that was used. PMID:25931100

  16. Dosimetry around metallic ports in tissue expanders in patients receiving postmastectomy radiation therapy: an ex vivo evaluation

    SciTech Connect

    Moni, Janaki; Graves-Ditman, Maria; Cederna, Paul; Griffith, Kent; Krueger, Editha A.; Fraass, Benedick A.; Pierce, Lori J

    2004-03-31

    Postmastectomy breast reconstruction can be accomplished utilizing tissue expanders and implants. However, in patients who require postoperative radiotherapy, the complication rate with tissue expander/implant reconstruction can exceed 50%. One potential cause of this high complication rate may be the metallic port in the tissue expander producing altered dosimetry in the region of the metallic device. The purpose of this study was to quantify the radiation dose distribution in the vicinity of the metallic port and determine its potential contribution to this extremely high complication rate. The absolute dosimetric effect of the tissue expander's metallic port was quantified using film and thermoluminescent dosimetry (TLD) studies with a single beam incident on a metallic port extracted from an expander. TLD measurements were performed at 11 reproducible positions on an intact expander irradiated with tangential fields. A computed tomography (CT)-based treatment plan without inhomogeneity corrections was used to derive expected doses for all TLD positions. Multiple irradiation experiments were performed for all TLD data. Confidence intervals for the dose at TLD sites with the metallic port in place were compared to the expected dose at the site without the metallic port. Film studies did not reveal a significant component of scatter around the metallic port. TLD studies of the extracted metallic port revealed highest doses within the casing of the metallic port and no consistent increased dose at the surface of the expander. No excess dose due to the metallic port in the expander was noted with the phantom TLD data. Based upon these results, it does not appear that the metallic port in tissue expanders significantly contributes to the high complication rate experienced in patients undergoing tissue expander breast reconstruction and receiving radiation therapy. Strategies designed to reduce the breast reconstruction complication rate in this clinical setting will need to focus on factors other than adjusting the dosimetry around the tissue expander metallic port.

  17. Interactive 3-D Patient-Image Registration

    Microsoft Academic Search

    Charles A. Pelizzari; K. K. Tan; David N. Levin; George T. Y. Chen; J. Balter

    1991-01-01

    A method has been developed which allows accurate registration of 3D image data sets of the head, such as CT or MRI, with with the anatomy of the actual patient. Once registration is accomplished, the patient and image spaces may be interactively explored, and any point or volume of interest in either space instantly transformed to the other. This paper

  18. Use of two expanded-criteria-donor renal allografts in a single patient.

    PubMed

    Sanchez, Edmund Q; Fischbach, Bernard V; Narasimhan, Gomathy; Chinnakotla, Srinath; Nikitin, Dmitriy; Khan, Tariq; Randall, Henry B; McKenna, Gregory J; Ruiz, Richard; Goldstein, Robert M; Klintmalm, Göran B; Levy, Marlon F

    2007-07-01

    The disparity between the number of available renal donors and the number of patients on the transplant waiting list has prompted the use of expanded-criteria-donor (ECD) renal allografts to expand the donor pool. ECD allografts have shown good results in appropriately selected recipients, yet a number of renal allografts are still discarded. The use of dual renal transplantation may lower the discard rate. Additionally, the use of perfusion systems may improve acute tubular necrosis rates with these allografts. We report a successful case of a dual transplant with ECD allografts using a perfusion system. The biopsy appearance and the pump characteristics were suboptimal for these kidneys, making them unsuitable for single transplantation; however, the pair of transplanted kidneys provided increased nephron mass and functioned well. We recommend that ECD kidneys that are individually nontransplantable be evaluated for potential dual renal transplantation. Biopsy criteria and perfusion data guidelines must be developed to improve the success rates with ECD dual renal allografts. Finally, recipient selection is of utmost importance. PMID:17637877

  19. Expanding imaging capabilities for microfluidics: applicability of darkfield internal reflection illumination (DIRI) to observations in microfluidics.

    PubMed

    Kawano, Yoshihiro; Otsuka, Chino; Sanzo, James; Higgins, Christopher; Nirei, Tatsuo; Schilling, Tobias; Ishikawa, Takuji

    2015-01-01

    Microfluidics is used increasingly for engineering and biomedical applications due to recent advances in microfabrication technologies. Visualization of bubbles, tracer particles, and cells in a microfluidic device is important for designing a device and analyzing results. However, with conventional methods, it is difficult to observe the channel geometry and such particles simultaneously. To overcome this limitation, we developed a Darkfield Internal Reflection Illumination (DIRI) system that improved the drawbacks of a conventional darkfield illuminator. This study was performed to investigate its utility in the field of microfluidics. The results showed that the developed system could clearly visualize both microbubbles and the channel wall by utilizing brightfield and DIRI illumination simultaneously. The methodology is useful not only for static phenomena, such as clogging, but also for dynamic phenomena, such as the detection of bubbles flowing in a channel. The system was also applied to simultaneous fluorescence and DIRI imaging. Fluorescent tracer beads and channel walls were observed clearly, which may be an advantage for future microparticle image velocimetry (?PIV) analysis, especially near a wall. Two types of cell stained with different colors, and the channel wall, can be recognized using the combined confocal and DIRI system. Whole-slide imaging was also conducted successfully using this system. The tiling function significantly expands the observing area of microfluidics. The developed system will be useful for a wide variety of engineering and biomedical applications for the growing field of microfluidics. PMID:25748425

  20. Immunophenotypic and functional characterization of ex vivo expanded natural killer cells for clinical use in acute lymphoblastic leukemia patients.

    PubMed

    Peragine, Nadia; Torelli, Giovanni F; Mariglia, Paola; Pauselli, Simona; Vitale, Antonella; Guarini, Anna; Foà, Robin

    2015-02-01

    The management of acute lymphoblastic leukemia (ALL) patients has witnessed profound changes in recent years. Nonetheless, most patients tend to relapse, underlining the need for new therapeutic approaches. The anti-leukemic potential of natural killer (NK) cells has over the years raised considerable interest. In this study, we developed an efficient method for the expansion and activation of NK cells isolated from healthy donors and ALL patients for clinical use. NK cell products were derived from peripheral blood mononuclear cells of 35 healthy donors and 4 B-lineage ALL by immunomagnetic CD3 T cell depletion followed by CD56 cell enrichment. Isolated NK cells were expanded and stimulated in serum-free medium supplemented with irradiated autologous feeder cells and autologous plasma in the presence of clinical grade interleukin (IL)-2 and IL-15 for 14 days. Healthy donor NK cells expanded on average 34.9 ± 10.4 fold and were represented, after expansion, by a highly pure population of CD3(-)CD56(+) cells showing a significant upregulation of natural cytotoxicity receptors, activating receptors and maturation markers. These expanded effectors showed cytolytic activity against K562 cells and, most importantly, against primary adult B-lineage ALL blasts. NK cells could be efficiently isolated and expanded-on average 39.5 ± 20.3 fold-also from primary B-lineage ALL samples of patients in complete remission. The expanded NK cells from these patients showed a significantly increased expression of the NKG2D- and DNAM1-activating receptors and were cytotoxic against K562 cells. These data provide the basis for developing new immunotherapeutic strategies for the management of ALL patients. PMID:25341808

  1. Estimating patient dielectric losses in NMR imagers.

    PubMed

    Redpath, T W; Hutchison, J M

    1984-01-01

    Dielectric losses in the patient may impair radiofrequency receiver coil sensitivity, and transmitter coil efficiency, in nuclear magnetic resonance (NMR) imagers. The frequency dependence of this loss mechanism is derived. Patient losses in a solenoidal head coil used for imaging heads were simulated by a cylindrical saline phantom. The frequency dependence of the loss introduced by the phantom can indicate whether dielectric losses in the patient will be significant compared to eddy current losses. The detuning caused by the phantom is used to calculate an upper limit for the distributed stray capacitance between coil and patient. Given the approximate conductivity of the patient, an upper limit for the dielectric loss can be estimated. Some methods of reducing patient dielectric losses are suggested. PMID:6530932

  2. Antigen specificity of clonally expanded and receptor edited cerebrospinal fluid B cells from patients with relapsing remitting MS

    Microsoft Academic Search

    Doris Lambracht-Washington; Kevin C. O'Connor; Elizabeth M. Cameron; Andrea Jowdry; E. Sally Ward; Elliot Frohman; Michael K. Racke; Nancy L. Monson

    2007-01-01

    We re-engineered the immunoglobulin rearrangements from clonally expanded CSF B cells of three Multiple Sclerosis patients as Fab fragments, and used three methods to test for their antigen (Ag) specificity. Nine out of ten Fab fragments were reactive to Myelin Basic Protein (MBP). The one Fab that did not react to MBP was a product of receptor editing. Two of

  3. Technical aspects of unilateral dual kidney transplantation from expanded criteria donors: experience of 100 patients.

    PubMed

    Ekser, B; Furian, L; Broggiato, A; Silvestre, C; Pierobon, E S; Baldan, N; Rigotti, P

    2010-09-01

    One option for using organs from donors with a suboptimal nephron mass, e.g. expanded criteria donors (ECD) kidneys, is dual kidney transplantation (DKT). In adult recipients, DKT can be carried out by several techniques, but the unilateral placement of both kidneys (UDKT) offers the advantages of single surgical access and shorter operating time. One hundred UDKT were performed using kidneys from ECD donors with a mean age of 72 years (Group 1). The technique consists of transplanting both kidneys extraperitoneally in the same iliac fossa. The results were compared with a cohort of single kidney transplants (SKT) performed with the same selection criteria in the same study period (Group 2, n = 73). Ninety-five percent of UDKTs were positioned in the right iliac fossa, lengthening the right renal vein with an inferior vena cava patch. In 69% of cases, all anastomoses were to the external iliac vessels end-to-side. Surgical complications were comparable in both groups. At 3-year follow-up, patient and graft survival rates were 95.6 and 90.9% in Group 1, respectively. UDKT can be carried out with comparable surgical complication rates as SKT, leaving the contralateral iliac fossa untouched and giving elderly recipients a better chance of receiving a transplant, with optimal results up to 3-years follow-up. PMID:20636454

  4. Imaging evaluation of patients with spinal deformity.

    PubMed

    Gundry, C R; Heithoff, K B

    1994-04-01

    CT myelography and MRI provide the best means of preoperatively assessing patients with spinal deformities. Owing to its noninvasive nature and its superior soft-tissue contrast, MRI represents the single best modality in the evaluation of a patient with any deformity. MRI allows complete preoperative surgical planning and obviates the need for any additional studies. Screening of the entire cord in a patient with a deformity is best accomplished with sagittal and coronal (as needed) T1W images. These images allow assessment of the cord for compression, tethering, syrinx, enlargement, and Arnold-Chiari malformation. Evaluation of cord compression at the apex of a curve is the single most important consideration other than the diagnosis of intrinsic cord abnormality. Subsequent sagittal or axial T2W images may be helpful if specific abnormalities are noted on T1W screening images. Coronal images are particularly helpful in patients with prominent curves or in those with vertebral anomalies. Additionally, coronal images may be useful in assessing patients with suspected diastematomyelia. Advances in hardware and software design have resulted in marked improvements in the ability to satisfactorily image all aspects of patients with spinal deformities. New phased array coils allow rapid imaging of larger portions of the spine. For instance, a complete MRI of the spine can be performed in a child in the same length of time that would have been necessary for a single lumbar examination when MRI was in it's infancy. The use of fast spin-echo imaging also permits more rapid acquisition times. CT myelography remains useful for those patients who cannot undergo MRI or for those with specific abnormalities such as multilevel central spinal stenosis when dynamic information obtained during the myelogram might be helpful. CT myelography represents the only means of assessing the central spinal canal of patients with metallic instrumentation in place. With the exception of these limited applications, MRI has replaced CT myelography as the imaging study of choice in the evaluation and examination of patients with spinal deformities. PMID:8159399

  5. Efficacy of ex vivo activated and expanded natural killer cells and T lymphocytes for colorectal cancer patients.

    PubMed

    Subramani, Baskar; Pullai, Chithra Ramanathan; Krishnan, Kohila; Sugadan, Sheela Devi; Deng, Xuewen; Hiroshi, Terunuma; Ratnavelu, Kananathan

    2014-07-01

    Immune cell-based therapies using natural killer (NK) cells and cytotoxic T cells are under constant scrutiny, with the aim to design an effective and reduced-toxicity therapy, which will benefit patients via improved quality of life and improved prognosis. Four patients with stage IV colon cancer were administered 1, 3, 5 and 6 effector cell intravenous infusions, respectively. Peripheral blood was collected from the patients and the ex vivo activation and expansion of NK and T cells was performed in Good Manufacturing Practice-certified clean rooms for ~12-15 days. Immunophenotypic analysis of the peripheral blood mononuclear cells (PBMCs) and expanded NK and T cells was conducted using flow cytometry and the patients were followed up. On average, 4.8×10(7) initial PBMCs and 2.7×10(9) total expanded cells were obtained. The intravenous infusions of the expanded cells were not accompanied by adverse reactions. Improved prognosis, reflected by a considerable decrease in the cancer markers, accompanied by an improved quality of life in the patients were observed. In conclusion, potential strategies are currently under development for the large-scale production of effectors cells; therefore, autologous immune enhancement therapy (AIET) may be considered as a viable approach to cancer treatment. PMID:24944796

  6. Efficacy of ex vivo activated and expanded natural killer cells and T lymphocytes for colorectal cancer patients

    PubMed Central

    SUBRAMANI, BASKAR; PULLAI, CHITHRA RAMANATHAN; KRISHNAN, KOHILA; SUGADAN, SHEELA DEVI; DENG, XUEWEN; HIROSHI, TERUNUMA; RATNAVELU, KANANATHAN

    2014-01-01

    Immune cell-based therapies using natural killer (NK) cells and cytotoxic T cells are under constant scrutiny, with the aim to design an effective and reduced-toxicity therapy, which will benefit patients via improved quality of life and improved prognosis. Four patients with stage IV colon cancer were administered 1, 3, 5 and 6 effector cell intravenous infusions, respectively. Peripheral blood was collected from the patients and the ex vivo activation and expansion of NK and T cells was performed in Good Manufacturing Practice-certified clean rooms for ~12–15 days. Immunophenotypic analysis of the peripheral blood mononuclear cells (PBMCs) and expanded NK and T cells was conducted using flow cytometry and the patients were followed up. On average, 4.8×107 initial PBMCs and 2.7×109 total expanded cells were obtained. The intravenous infusions of the expanded cells were not accompanied by adverse reactions. Improved prognosis, reflected by a considerable decrease in the cancer markers, accompanied by an improved quality of life in the patients were observed. In conclusion, potential strategies are currently under development for the large-scale production of effectors cells; therefore, autologous immune enhancement therapy (AIET) may be considered as a viable approach to cancer treatment. PMID:24944796

  7. Ex Vivo Expanded Natural Killer Cells Demonstrate Robust Proliferation In Vivo In High-Risk Relapsed Multiple Myeloma Patients

    PubMed Central

    Szmania, Susann; Lapteva, Natalia; Garg, Tarun; Greenway, Amy; Lingo, Joshuah; Nair, Bijay; Stone, Katie; Woods, Emily; Khan, Junaid; Stivers, Justin; Panozzo, Susan; Campana, Dario; Bellamy, William T.; Robbins, Molly; Epstein, Joshua; Yaccoby, Shmuel; Waheed, Sarah; Gee, Adrian; Cottler-Fox, Michele; Rooney, Cliona; Barlogie, Bart; van Rhee, Frits

    2015-01-01

    Highly activated/expanded natural killer (NK) cells can be generated via stimulation with the HLA-deficient cell line K562 genetically modified to express 41BB-ligand and membrane-bound interleukin (IL)15. We tested the safety, persistence and activity of expanded NK cells generated from myeloma patients (auto-NK) or haplo-identical family donors (allo-NK) in heavily pretreated patients with high-risk relapsing myeloma. The preparative regimen comprised bortezomib only or bortezomib and immunosuppression with cyclophosphamide, dexamethasone and fludarabine. NK cells were shipped overnight either cryopreserved or fresh. In 8 patients, up to 1×108 NK cells/kg were infused on day 0 and followed by daily administrations of IL2. Significant in vivo expansion was observed only in the 5 patients receiving fresh products, peaking at or near day 7, with the highest NK cell counts in 2 subjects who received cells produced in a high concentration of IL2 (500 units/mL). Seven days after infusion, donor NK cells comprised > 90% of circulating leukocytes in fresh allo-NK cell recipients, and cytolytic activity against allogeneic myeloma targets was retained in vitro. Among the 7 evaluable patients, there were no serious adverse events that could be related to NK cell infusion. One patient had a partial response and in another the tempo of disease progression decreased; neither patient required further therapy for 6 months. In the 5 remaining patients, disease progression was not affected by NK cell infusion. In conclusion, infusion of large numbers of expanded NK cells was feasible and safe; infusing fresh cells was critical to their expansion in vivo. PMID:25415285

  8. Initial experience with the use of an expandable titanium cage as a vertebral body replacement in patients with tumors of the spinal column: a report of 95 patients

    Microsoft Academic Search

    Ashwin Viswanathan; Muhammad M. Abd-El-Barr; Egon Doppenberg; Dima Suki; Ziya Gokaslan; Ehud Mendel; Ganesh Rao; Laurence D. Rhines

    Objective  Vertebral body resection to treat spine tumors necessitates reconstruction to maintain spinal stability. The durability of\\u000a reconstruction may be a challenge in cancer patients as treatment with chemotherapy and\\/or radiation coupled with poor nutritional\\u000a status may compromise bone quality. We present a series of patients who underwent implantation of an expandable titanium cage\\u000a (ETC) for reconstruction after vertebral body resection

  9. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease

    Microsoft Academic Search

    Patrick W. Serruys; Peter de Jaegere; Ferdinand Kiemeneij; C. M. Miguel; Wolfgang Rutsch; Guy Heyndrickx; Hakan Emanuelsson; Jean Marco; Victor Legrand; Pierre Materne; Jorge Belardi; Ulrich Sigwart; Antonio Colombo; Jean Jacques Goy; Paul van den Heuvel; Juan Delcan; Marie-angele Morel

    1994-01-01

    BACKGROUND. Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. METHODS. A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned

  10. Antigen Specificity of Clonally Expanded and Receptor Edited Cerebrospinal Fluid B cells from Patients with Relapsing Remitting MS

    PubMed Central

    Lambracht-Washington, Doris; O’Connor, Kevin C.; Cameron, Elizabeth; Jowdry, Andrea; Ward, E. Sally; Frohman, Elliot; Racke, Michael K.; Monson, Nancy L.

    2009-01-01

    We re-engineered the immunoglobulin rearrangements from clonally expanded CSF B cells of three Multiple Sclerosis patients as Fab fragments, and used three methods to test for their Ag-specificity. Nine out of ten Fab fragments were reactive to Myelin Basic Protein (MBP). The one Fab that did not react to MBP was a product of receptor editing. Two of the nine MBP-reactive Fabs were also reactive to GFAP and CNPase, indicating that these clones were polyreactive. Targeting the mechanisms that allows these self-reactive B cells to reside in the CSF of MS patients may prove to be a potent immunotherapeutic strategy. PMID:17451814

  11. Body image concerns of breast augmentation patients.

    PubMed

    Sarwer, David B; LaRossa, Don; Bartlett, Scott P; Low, David W; Bucky, Louis P; Whitaker, Linton A

    2003-07-01

    This study investigated the body image concerns of women who sought cosmetic breast augmentation. Thirty breast augmentation candidates completed several measures of body image before their initial surgical consultation. Thirty physically similar women who were not interested in breast augmentation were recruited from the medical center and university community and also completed the measures. Breast augmentation candidates, as compared with women not seeking augmentation, reported greater dissatisfaction with their breasts. Augmentation candidates rated their ideal breast size, as well as the breast size preferred by women, as significantly larger than did controls. In addition, women interested in breast augmentation reported greater investment in their appearance, greater distress about their appearance in a variety of situations, and more frequent teasing about their appearance. Finally, breast augmentation candidates also reported more frequent use of psychotherapy in the year before the operation as compared with women not seeking augmentation. These results replicate and extend previous studies of body image in cosmetic surgery patients. PMID:12832880

  12. Radionuclide myocardial perfusion imaging for the evaluation of patients with known or suspected coronary artery disease in the era of multimodality cardiovascular imaging.

    PubMed

    Taqueti, Viviany R; Di Carli, Marcelo F

    2015-01-01

    Over the last several decades, radionuclide myocardial perfusion imaging (MPI) with single photon emission tomography and positron emission tomography has been a mainstay for the evaluation of patients with known or suspected coronary artery disease (CAD). More recently, technical advances in separate and complementary imaging modalities including coronary computed tomography angiography, computed tomography perfusion, cardiac magnetic resonance imaging, and contrast stress echocardiography have expanded the toolbox of diagnostic testing for cardiac patients. While the growth of available technologies has heralded an exciting era of multimodality cardiovascular imaging, coordinated and dispassionate utilization of these techniques is needed to implement the right test for the right patient at the right time, a promise of "precision medicine." In this article, we review the maturing role of MPI in the current era of multimodality cardiovascular imaging, particularly in the context of recent advances in myocardial blood flow quantitation, and as applied to the evaluation of patients with known or suspected CAD. PMID:25770849

  13. Expanding applications, accuracy, and interpretation of laser speckle contrast imaging of cerebral blood flow.

    PubMed

    Kazmi, S M Shams; Richards, Lisa M; Schrandt, Christian J; Davis, Mitchell A; Dunn, Andrew K

    2015-07-01

    Laser speckle contrast imaging (LSCI) provides a rapid characterization of cortical flow dynamics for functional monitoring of the microcirculation. The technique stems from interactions of laser light with moving particles. These interactions encode the encountered Doppler phenomena within a random interference pattern imaged in widefield, known as laser speckle. Studies of neurovascular function and coupling with LSCI have benefited from the real-time characterization of functional dynamics in the laboratory setting through quantification of perfusion dynamics. While the technique has largely been relegated to acute small animal imaging, its scalability is being assessed and characterized for both chronic and clinical neurovascular imaging. PMID:25944593

  14. Towards online patient imaging during helical radiotherapy.

    PubMed

    Yu, L; Poole, C M; Lancaster, C M; Sylvander, S R

    2015-03-01

    Exit-detector data from helical radiation therapy have been studied extensively for delivery verification and dose reconstruction. Since the same radiation source is used for both imaging and treatment, this work investigates the possibility of utilising exit-detector raw data for imaging purposes. This gives rise to potential clinical applications such as retrospective daily setup verification and inter-fractional setup error detection. The exit-detector raw data were acquired and independently analysed using Python programming language. The raw data were extracted from the treatment machine's onboard computer, and converted into 2D array files. The contours of objects (phantom or patient) were acquired by applying a logarithmic function to the ratio of two sinograms, one with the object in the beam and one without. The setup variation between any two treatment deliveries can be detected by applying the same function to their corresponding exit-detector sinograms. The contour of the object was well defined by the secondary radiation from the treatment beam and validated with the imaging beam, although no internal structures were discernible due to the interference from the primary radiation. The sensitivity of the setup variation detection was down to 2 mm, which was mainly limited by the resolution of the exit-detector itself. The exit-detector data from treatment procedures contain valuable photon exit fluence maps which can be utilised for contour definition and verification of patient alignment without reconstruction. PMID:25636244

  15. Sexual Abuse Images in Cyberspace: Expanding the Ecology of the Child

    ERIC Educational Resources Information Center

    Martin, Jennifer; Alaggia, Ramona

    2013-01-01

    Cyberspace has added a new dimension to the ecology of children made the subjects of sexual abuse images distributed online. These images cannot be permanently removed and can continue to circulate in cyberspace forever. A review of the current literature suggests that helping professionals are not consistently aware of or do not probe…

  16. Diagnostic imaging of the acutely injured patient

    SciTech Connect

    Berquist, T.H.

    1985-01-01

    This book provides an analysis of pathophysiologic concepts of trauma and reviews the effectiveness of the available imaging modalities in acute trauma of various organ system. Topics covered are chest injuries; abdominal trauma; fractures of long bones; the foot and ankle; the knee; hand and wrist; the elbow; the shoulder; the pelvis hips; the spine; the skull and facial trauma and the clinical assessment of multiple injuries patients. Comparative evaluation of diagnostic techniques of radiography is discussed. Normal anatomy and bone fractures along with soft-tissue injuries are described.

  17. Expanded palette of Nano-lanterns for real-time multicolor luminescence imaging.

    PubMed

    Takai, Akira; Nakano, Masahiro; Saito, Kenta; Haruno, Remi; Watanabe, Tomonobu M; Ohyanagi, Tatsuya; Jin, Takashi; Okada, Yasushi; Nagai, Takeharu

    2015-04-01

    Fluorescence live imaging has become an essential methodology in modern cell biology. However, fluorescence requires excitation light, which can sometimes cause potential problems, such as autofluorescence, phototoxicity, and photobleaching. Furthermore, combined with recent optogenetic tools, the light illumination can trigger their unintended activation. Because luminescence imaging does not require excitation light, it is a good candidate as an alternative imaging modality to circumvent these problems. The application of luminescence imaging, however, has been limited by the two drawbacks of existing luminescent protein probes, such as luciferases: namely, low brightness and poor color variants. Here, we report the development of bright cyan and orange luminescent proteins by extending our previous development of the bright yellowish-green luminescent protein Nano-lantern. The color change and the enhancement of brightness were both achieved by bioluminescence resonance energy transfer (BRET) from enhanced Renilla luciferase to a fluorescent protein. The brightness of these cyan and orange Nano-lanterns was ?20 times brighter than wild-type Renilla luciferase, which allowed us to perform multicolor live imaging of intracellular submicron structures. The rapid dynamics of endosomes and peroxisomes were visualized at around 1-s temporal resolution, and the slow dynamics of focal adhesions were continuously imaged for longer than a few hours without photobleaching or photodamage. In addition, we extended the application of these multicolor Nano-lanterns to simultaneous monitoring of multiple gene expression or Ca(2+) dynamics in different cellular compartments in a single cell. PMID:25831507

  18. Nurse-led action research project for expanding nurses’ role in patient education in Iran: Process, structure, and outcomes

    PubMed Central

    Khorasani, Parvaneh; Rassouli, Maryam; Parvizy, Soroor; Zagheri-Tafreshi, Mansoureh; Nasr-Esfahani, Mahmood

    2015-01-01

    Background: Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses’ role in patient education in Iran. Materials and Methods: This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. Results: A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a “core research support team,” “two steering committees,” and community representatives of clients and professionals as “feedback groups.” A seven-stage process, named the “Nurse Educators: Al-Zahra Role Expansion Action Research” (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. Conclusions: A nurse-led ad hoc structure with academic–clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses’ educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.

  19. A clinical and pharmacokinetic study of the combination of etravirine plus raltegravir in HIV patients with expanded intolerance or resistance

    PubMed Central

    Bañón, Sara; Moreno, Ana; Quereda, Carmen; Gomez, Cristina; Diaz de Santiago, Alberto; Perez-Elías, María J; Moreno, Santiago; Luis Casado, Jose

    2014-01-01

    Introduction The combination of etravirine (ETR) plus raltegravir (RAL) could be an option for HIV patients with resistance, intolerance or important interactions with other drugs. However, there are few data on the efficacy, safety and pharmacokinetics of this dual therapy, taking into account the effect of HCV co-infection or the possible induction of ETR in the drug metabolism of RAL. Material and Methods Cohort study of HIV patients initiating ETR plus RAL as dual therapy. Plasma trough levels of RAL were measured by LC/MS after at least one month on therapy. Results A total of 25 patients have been included in this combination since 2009. Mean age was 46 years, 72% were male, and 20 patients (80%) had HCV co-infection (seven patients with fibrosis 3–4). Median nadir CD4+ count was 109 (60–209), and 21 patients had an HIV RNA level below 50 copies/mL. Median time on previous therapy was 473 months (IQR, 395–570), and reasons for this dual therapy was toxicity/intolerance in 19, and interactions in nine (two chemotherapy, three DAAs, two methadone, two other). After a median follow up of 722 days (473–1088: 53.3 patients-year), there were no cases of blips or virological failure. Six patients (24%) discontinued therapy after more than 1.5 year on therapy, in four cases due to lost follow up and in two due to simplification after finishing the reason for interaction. There were no cases of liver toxicity, and only two patients increased slightly transaminases values (grade 1 and 2). Total cholesterol and triglycerides levels decrease significantly after initiation (TC, from 182 to 165 at one year; p=0.01; TG from 185 to 143 mg/dL; p=0.01). CT/HDL ratio decreases from 4.35 to 4.28 after six months. Geometric mean plasma trough level of RAL was 166 ng/mL (IQR, 40–249) and only one patient (6%) was below the in vitro IC50 of the wild type. Conclusions The combination of ETR plus RAL as dual therapy is effective and safe in patients with expanded intolerance or interactions. There are no significant pharmacokinetic interactions between both drugs. PMID:25397548

  20. [Anesthetic management for a patient with chronic expanding hematoma of the thorax associated with respiratory failure].

    PubMed

    Kurotaki, Kenji; Yoshida, Akiko; Ito, Yosuke; Nagaya, Kei

    2015-01-01

    Chronic expanding hematoma (CEH) of the thorax is an intractable disease which induces long-standing growing hematoma after tuberculosis or thoracic surgery. It causes respiratory failure and heart failure by compressing the mediastinum. A 68-year-old man with a history of tuberculosis during childhood had suffered from progressive exertional dyspnea for 20 years. Because a huge hematoma occupying whole right thoracic cavity compressed the heart and the trachea to the left, he was scheduled for extrapleural pneumonectomy. Bronchial arterial embolization was performed preoperatively to prevent hemoptysis and reduce intraoperative blood loss. There was no problem in the airway management using a double lumen endotracheal tube. However, severe hypotension and a decrease in cardiac index were observed due to excessive bleeding, leading to total blood loss of 11,000 g. In addition, surgical manipulation caused abrupt severe hypotension. Monitoring of arterial pressure-based cardiac output and deep body temperature was useful for the hemodynamic management during the operation. The successful postoperative course resulted in remarkable improvement of Huge-Jones dyspnea criteria from IV to II. In the anesthetic management of CEH precautions should be taken against the excessive intraoperative bleeding and abrupt hemodynamic changes. PMID:25868208

  1. Designing the Expanded Programme on Immunisation (EPI) as a service: Prioritising patients over administrative logic.

    PubMed

    McKnight, Jacob; Holt, Douglas B

    2014-01-01

    Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural consumer research to conduct an ethnographic study of vaccination delivery in Jimma Zone, Ethiopia - one such region. We find that Western public health sector policies are dominated by an administrative logic. Critical failures in delivery are produced by a system that obfuscates the on-the-ground problems that mothers face in trying to vaccinate their children, while instead prioritising administrative processes. Our ethnographic analysis of 83 mothers who had not vaccinated their children reveals key barriers to vaccination from a 'customer' perspective. While mothers value vaccination, it is a 'low involvement' good compared to the acute daily needs of a subsistence life. The costs imposed by poor service - such as uncaring staff with class hostilities, unpredictable and missed schedules and long waits - are too much and so they forego the service. Our service design framework illuminates specific service problems from the mother's perspective and points towards simple service innovations that could improve vaccination rates in regions that have poor uptake. PMID:25363481

  2. Sexual abuse images in cyberspace: expanding the ecology of the child.

    PubMed

    Martin, Jennifer; Alaggia, Ramona

    2013-01-01

    Cyberspace has added a new dimension to the ecology of children made the subjects of sexual abuse images distributed online. These images cannot be permanently removed and can continue to circulate in cyberspace forever. A review of the current literature suggests that helping professionals are not consistently aware of or do not probe possibilities of online sexual victimization in the investigation, assessment, and treatment of child sexual abuse. Nor is this issue adequately addressed in their education and training. There are gaps in the literature regarding how to identify and provide treatment for these children. New assessment and treatment targets are needed to enhance existing practice approaches. A contemporary ecological model that incorporates an explicit consideration of the cybersystem is provided as a starting point for practitioners to be aware of the possibility that images of child sexual abuse were recorded and distributed online. PMID:23682766

  3. Exit pupil expander: image quality performance enhancements and environmental testing results

    Microsoft Academic Search

    Karlton D. Powell; Peggy A. Lopez; Amjad Malik

    2003-01-01

    The numerical aperture of the light emanating from display pixels in a given display system determines the exit pupil size. In retinal scanning displays, the exit pupil is defined by the scanner optics, creating a rastered, projected image at an intermediate plane, typically resulting in an exit pupil approximately the size of an eye\\

  4. Investigation of the Near-Field Acoustic and Flow Properties of Imperfectly Expanded Supersonic Jets using Particle Image Velocimetry

    NASA Astrophysics Data System (ADS)

    Gutmark, Ephraim; Munday, David; Liu, Junhui; Kailasanath, K.

    2008-11-01

    The flow fields of imperfectly Expanded Supersonic Jets from conical CD nozzles are investigated by Particle Image Velocimetry. This nozzle geometry represents the exhaust nozzles on high-performance military engines. The results are compared with shadowgraph to bring out the details of the highly accelerated regions where seed particles may lag behind the flow, viz. the shocks and Prandtl-Meyer fans. Nozzles with three area ratios are examined over a wide range of under- and over-expanded conditions as well as the design conditions for each nozzle. It is found that this type of nozzle is not shock free at the design condition due to the sharp change of the geometry in the throat area. Both near-field and far-field acoustic measurements are presented. Flow-field and near-field acoustic measurements are compared with Numerical simulations in the accompanying presentation by Liu, Kailasanath and Ramamurti. The distributions of the centerline static pressure and noise spectra are in good agreement with the corresponding experimental data.

  5. Mesenchymal stromal cells from patients with acute myeloid leukemia have altered capacity to expand differentiated hematopoietic progenitors.

    PubMed

    Chandran, Priya; Le, Yevgeniya; Li, Yuhua; Sabloff, Mitchell; Mehic, Jelica; Rosu-Myles, Michael; Allan, David S

    2015-04-01

    The bone marrow microenvironment may be permissive to the emergence and progression of acute myeloid leukemia (AML). Studying interactions between the microenvironment and leukemia cells should provide new insight for therapeutic advances. Mesenchymal stromal cells (MSCs) are central to the maintenance of the hematopoietic niche. Here we compared the functions and gene expression patterns of MSCs derived from bone marrow aspirates of healthy donors and patients with AML. MSCs expanded from AML patients had heterogeneous morphology and displayed a wide range of proliferation capacity compared to MSCs from healthy controls. The ability of AML-MSCs to support the expansion of committed hematopoietic progenitors from umbilical cord blood-derived CD34+ cells may be impaired while the expression of genes associated with maintaining hematopoietic quiescence appeared to be increased in AML-MSCs compared to healthy donors. These results highlight important potential differences in the biologic profile of MSCs from AML patients compared to healthy donors that may contribute to the emergence or progression of leukemia. PMID:25703353

  6. Rapid scanning catheterscope for expanded forward-view volumetric imaging with optical coherence tomography.

    PubMed

    Lurie, Kristen L; Gurjarpadhye, Abhijit A; Seibel, Eric J; Ellerbee, Audrey K

    2015-07-01

    We demonstrate a novel catheterscope, based on scanning fiber endoscopy, for volumetric imaging with optical coherence tomography (OCT), which possesses a high resonance frequency (>2??kHz) and a small outer diameter (OD) (1.07 mm). Our design is the fastest volumetric-scanning, forward-viewing catheterscope for OCT, and the scanning package has the smallest OD of any such OCT package published to date. Using a proof-of-operation catheterscope with commercial lenses, we demonstrate high-quality in vivo and ex vivo volumetric imaging and extend the 1.1 mm diameter field of view more than 200-fold by mosaicking. Due to its small OD, short rigid tip length, and fast scan rate, this scope is the leading candidate design to enable early detection and staging of bladder cancer during flexible white light cystoscopy. PMID:26125393

  7. Imaging informatics for consumer health: towards a radiology patient portal

    PubMed Central

    Arnold, Corey W; McNamara, Mary; El-Saden, Suzie; Chen, Shawn; Taira, Ricky K; Bui, Alex A T

    2013-01-01

    Objective With the increased routine use of advanced imaging in clinical diagnosis and treatment, it has become imperative to provide patients with a means to view and understand their imaging studies. We illustrate the feasibility of a patient portal that automatically structures and integrates radiology reports with corresponding imaging studies according to several information orientations tailored for the layperson. Methods The imaging patient portal is composed of an image processing module for the creation of a timeline that illustrates the progression of disease, a natural language processing module to extract salient concepts from radiology reports (73% accuracy, F1 score of 0.67), and an interactive user interface navigable by an imaging findings list. The portal was developed as a Java-based web application and is demonstrated for patients with brain cancer. Results and discussion The system was exhibited at an international radiology conference to solicit feedback from a diverse group of healthcare professionals. There was wide support for educating patients about their imaging studies, and an appreciation for the informatics tools used to simplify images and reports for consumer interpretation. Primary concerns included the possibility of patients misunderstanding their results, as well as worries regarding accidental improper disclosure of medical information. Conclusions Radiologic imaging composes a significant amount of the evidence used to make diagnostic and treatment decisions, yet there are few tools for explaining this information to patients. The proposed radiology patient portal provides a framework for organizing radiologic results into several information orientations to support patient education. PMID:23739614

  8. Geodetic Imaging: Expanding the Boundaries of Geodesy in the 21st Century

    NASA Astrophysics Data System (ADS)

    Fernandez Diaz, J. C.; Carter, W. E.; Shrestha, R. L.; Glennie, C. L.

    2013-12-01

    High resolution (sub-meter) geodetic images covering tens to thousands of square kilometers have extended the boundaries of geodesy into related areas of the earth sciences, such as geomorphology and geodynamics, during the past decade, to archaeological exploration and site mapping during the past few years, and are now poised to transform studies of flora and fauna in the more remote regions of the world. Geodetic images produced from airborne laser scanning (ALS), a.k.a. airborne light detection and ranging (LiDAR) have proven transformative to the modern practice of geomorphology where researchers have used decimeter resolution digital elevation models (DEMs) to determine the spatial frequencies of evenly spaced features in terrain, and developed models and mathematical equations to explain how the terrain evolved to its present state and how it is expected to change in the future (Perron et al., 2009). In geodynamics researchers have used ';before' and ';after' geodetic images of the terrain near earthquakes, such as the 2010 El Mayor-Cucapah Earthquake, to quantify surface displacements and suggest models to explain the observed deformations (Oskin et. al., 2012). In archaeology, the ability of ALS to produce ';bare earth' DEMs of terrain covered with dense vegetation, including even tropical rain forests, has revolutionized the study of archaeology in highly forested areas, finding ancient structures and human modifications of landscapes not discovered by archaeologists working at sites for decades (Chase et al., 2011 & Evans et al., 2013), and finding previously unknown ruins in areas that ground exploration has not been able to penetrate since the arrival of the conquistadors in the new world in the 17th century (Carter et al., 2012). The improved spatial resolution and ability of the third generation ALS units to obtain high resolution bare earth DEMs and canopy models in areas covered in dense forests, brush, and even shallow water (steams, lakes, and coastal waters) is just beginning to attract the attention of researchers studying such plant life as marsh vegetation and sea grasses, and the habitats of animals as diverse as fish, migratory birds, and lions (Vierling et al., 2008). From thousands and thousands of survey markers covering large regions of the earth common to geodesy a half century ago, the focus of some geodesist has changed to billions and billions of points covering landscapes, which are enabling them to redefine and extend the limits of geodesy in the 21st century. References: Carter, W. E. et al., (2012), 'Geodetic Imaging: A New Tool for Mesoamerican Archaeology,' Eos, Trans. American Geophysical Union, Vol. 93, No. 42, pages 413-415. Chase, A. F. et al., (2010) 'Airborne LiDAR, archaeology, and the ancient Maya landscape at Caracol, Belize,' Journal Of Archaeological Science, vol. 38, no. 2, p. 387-398. Evans, D. H. et al., (2013), 'Uncovering archaeological landscapes at Angkor using lidar.' PNAS. Oskin, M. E. et al., (2012), 'Near-Field Deformation from the El Mayor-Cucapah Earthquake Revealed by Differential LIDAR,' Science. Vol. 335 no.6069, pp. 702-705. Perron, J. Taylor, et al (2009), 'Formation of evenly spaced ridges and valleys,' Nature, Vol. 460/23. Vierling, K. T. et al., (2008),'Lidar: shedding new light on habitat characterization and modeling,' Front Ecol Environ 2008, 6(2): 90-98.

  9. Megapixel imaging camera for expanded H{sup {minus}} beam measurements

    SciTech Connect

    Simmons, J.E.; Lillberg, J.W.; McKee, R.J.; Slice, R.W.; Torrez, J.H. [Los Alamos National Lab., NM (United States); McCurnin, T.W.; Sanchez, P.G. [EG and G Energy Measurements, Inc., Los Alamos, NM (United States). Los Alamos Operations

    1994-02-01

    A charge coupled device (CCD) imaging camera system has been developed as part of the Ground Test Accelerator project at the Los Alamos National Laboratory to measure the properties of a large diameter, neutral particle beam. The camera is designed to operate in the accelerator vacuum system for extended periods of time. It would normally be cooled to reduce dark current. The CCD contains 1024 {times} 1024 pixels with pixel size of 19 {times} 19 {mu}m{sup 2} and with four phase parallel clocking and two phase serial clocking. The serial clock rate is 2.5{times}10{sup 5} pixels per second. Clock sequence and timing are controlled by an external logic-word generator. The DC bias voltages are likewise located externally. The camera contains circuitry to generate the analog clocks for the CCD and also contains the output video signal amplifier. Reset switching noise is removed by an external signal processor that employs delay elements to provide noise suppression by the method of double-correlated sampling. The video signal is digitized to 12 bits in an analog to digital converter (ADC) module controlled by a central processor module. Both modules are located in a VME-type computer crate that communicates via ethernet with a separate workstation where overall control is exercised and image processing occurs. Under cooled conditions the camera shows good linearity with dynamic range of 2000 and with dark noise fluctuations of about {plus_minus}1/2 ADC count. Full well capacity is about 5{times}10{sup 5} electron charges.

  10. The Self-Expanding Symetis Acurate Does Not Increase Cerebral Microembolic Load When Compared to the Balloon-Expandable Edwards Sapien Prosthesis: A Transcranial Doppler Study in Patients Undergoing Transapical Aortic Valve Implantation

    PubMed Central

    Erdoes, Gabor; Huber, Christoph; Basciani, Reto; Stortecky, Stefan; Windecker, Stephan; Wenaweser, Peter; Carrel, Thierry; Eberle, Balthasar

    2014-01-01

    Objectives The aim of this study was to quantify potential differences in count, frequency and pattern of high-intensity transient signals (HITS) during transapical transcatheter aortic valve implantation (TA-TAVI), by comparing the Symetis Acurate TA (SA) with the balloon-expandable Edwards Sapien XT (ES) system. Background Recently, the Symetis Acurate TA revalving system has been introduced for TA-TAVI. The Symetis Acurate TA aortic bioprosthesis is self-expanding and is deployed by a specific two-step implantation technique. Whether this novel method increases the load of intraprocedural emboli, detected by transcranial Doppler ultrasound (TCD) as HITS, or not is not clear. Methods Twenty-two patients (n?=?11 in each study arm, median logistic EuroScore 20%, median STS score 7%) displayed continuous TCD signals of good quality throughout the entire TA-TAVI procedure and were included in the final analysis. Data are presented as median with interquartile ranges. Results No significant differences were detected in total procedural or interval-related HITS load (SA: 303 [200; 594], ES: 499 [285; 941]; p?=?0.16). With both devices, HITS peaked during prosthesis deployment (PD), whereas significantly fewer HITS occurred during instrumentation (SA: p?=?0.002; ES: <0.001) or post-implantation PI (SA: p?=?0.007; ES: <0.001). PD-associated HITS amounted to almost half of the total HITS load. One patient suffered new disabling stroke at 30 days. Thirty-day mortality amounted to 13.6% (3 of 22 patients). Conclusions Simplified transapical delivery using the self-expanding SA device does not increase HITS, despite of a two-step deployment technique with more interactions with the native aortic valve, when compared to the balloon-expandable ES valve. The similarity in HITS count, frequency and pattern with the two systems suggests a common mechanism for the release of cerebral microemboli. PMID:25289688

  11. Multidetector CT imaging features of solid pseudopapillary tumours of the pancreas in male patients: distinctive imaging features with female patients

    PubMed Central

    Park, M J; Kim, J K; Kim, Y C; Park, M-S; Yu, J-S; Kim, Y B; Lee, D

    2014-01-01

    Objective: To describe multidetector CT imaging features of solid pseudopapillary tumours (SPTs) in male patients and to compare these imaging features with those found in female patients. Methods: The institutional review board approved this retrospective study. We included the CT images of 72 patients (M:F?=?12:60; mean age, 35.0 years) diagnosed with SPT by histology. CT images were reviewed on the following: location of the tumour, maximal diameter, shape, margin and the fraction of the tumour composition. Statistical differences in CT imaging features were analysed. Results: Male patients with SPTs were significantly older than female patients (42.4 years vs 33.4 years, p?=?0.0408) and the mean size of the SPTs in male patients was larger (6.3?cm vs 4.6?cm, p?=?0.0413) than that of SPTs in female patients. Lobulated shape of the SPTs was most frequent in male patients, whereas oval shape was most frequent in female patients (p?=?0.0133). SPTs in male patients tended to have a solid component (p?=?0.0434). Progressive enhancement in the solid portion of the tumour was seen in 9 (81.8%) of 11 SPTs in male patients and in 30 (79.0%) of 38 SPTs in female patients on multiphasic CT. Conclusion: The imaging features of SPTs in male patients usually appeared as a somewhat large-sized solid mass with a lobulated margin and progressive enhancement. These imaging features may help to differentiate SPTs from other pancreatic tumours for their proper management. Advances in knowledge: SPTs in male patients appear as somewhat large-sized solid masses with lobulated margins, and this form occurs more frequently in older male patients than in female patients. PMID:24472726

  12. Modeling Cardiovascular Anatomy from Patient-Specific Imaging Data

    E-print Network

    Texas at Austin, University of

    Modeling Cardiovascular Anatomy from Patient-Specific Imaging Data Chandrajit Bajaj1 and Samrat Introduction The importance of modern imaging techniques for capturing detailed struc- tural information of a biological system cannot be understated. Unfortunately images do not reveal the "full functional story

  13. Preprocedural Imaging for Patients with Atrial Fibrillation and Heart Failure

    PubMed Central

    Thai, Wai-ee; Wai, Bryan; Truong, Quynh A.

    2012-01-01

    Various electrophysiological procedures and device implantation has been shown to improve morbidity and mortality in patients with atrial fibrillation (AF) and patients with heart failure (HF). Non-invasive cardiac imaging is used extensively in the pre-procedural patient selection and for procedural guidance. In this review, we will discuss the application of pre-procedural cardiac imaging in patients with AF prior to pulmonary vein and left atrial ablation as well as insertion of left atrial occluder device. We also discuss the role of non-invasive cardiac imaging in the selection of appropriate HF patients for device therapy as well as their use in guiding implantation of biventricular pacemaker for cardiac resynchronization therapy by assessing left ventricular ejection fraction, coronary venous anatomy, mechanical dyssynchrony and myocardial scar. We describe new research associated with pre-procedural imaging in these patient cohorts. PMID:22828754

  14. Comparison of balloon-expandable versus self-expandable valves for transcatheter aortic valve implantation in patients with low-gradient severe aortic stenosis and preserved left ventricular ejection fraction.

    PubMed

    Covolo, Elisa; Saia, Francesco; Napodano, Massimo; Frigo, Anna Chiara; Agostoni, Pierfrancesco; Mojoli, Marco; Fraccaro, Chiara; Ciuca, Cristina; Presbitero, Patrizia; Moretti, Claudio; D'Ascenzo, Fabrizio; Tarantini, Giuseppe

    2015-03-15

    A relevant proportion of patients, classified as severe aortic stenosis on the basis of valve area ?1 cm(2), have a mean transvalvular gradient ?40 mm Hg, despite a preserved left ventricular ejection fraction (LGSAS). We assessed the clinical and hemodynamic impact of transcatheter aortic valve implantation in patients with symptomatic LGSAS at high risk for surgery or inoperable, according to the type of percutaneous valve implanted. Ninety-five patients received an Edwards SAPIEN valve (Edwards Lifesciences, Irvine, California) and 51 received a Medtronic CoreValve (Medtronic, Inc., Minneapolis, Minnesota). The hemodynamic performance of the 2 valves was similar in term of final transvalvular gradients (10 mm Hg, p = 0.069). Early mortality rate was 7% and was not different between the 2 valves (p = 0.73). During follow-up, cardiovascular mortality rate was similar between groups, and valve type was not a predictor of outcome (p = 0.72). Estimated survival by Kaplan-Meier at 2 years was 70%. At multivariate analysis, life-threatening or major bleeding, postprocedural aortic insufficiency, and acute kidney injury were the major predictors of an adverse outcome. In patients with LGSAS treated by transcatheter aortic valve implantation, the use of balloon-expandable versus self-expandable valves resulted in similar hemodynamic, early, and long-term clinical outcomes. PMID:25620039

  15. Coma Patient Monitoring System Using Image Processing

    NASA Astrophysics Data System (ADS)

    Sankalp, Meenu

    2011-12-01

    COMA PATIENT MONITORING SYSTEM provides high quality healthcare services in the near future. To provide more convenient and comprehensive medical monitoring in big hospitals since it is tough job for medical personnel to monitor each patient for 24 hours.. The latest development in patient monitoring system can be used in Intensive Care Unit (ICU), Critical Care Unit (CCU), and Emergency Rooms of hospital. During treatment, the patient monitor is continuously monitoring the coma patient to transmit the important information. Also in the emergency cases, doctor are able to monitor patient condition efficiently to reduce time consumption, thus it provides more effective healthcare system. So due to importance of patient monitoring system, the continuous monitoring of the coma patient can be simplified. This paper investigates about the effects seen in the patient using "Coma Patient Monitoring System" which is a very advanced product related to physical changes in body movement of the patient and gives Warning in form of alarm and display on the LCD in less than one second time. It also passes a sms to a person sitting at the distant place if there exists any movement in any body part of the patient. The model for the system uses Keil software for the software implementation of the developed system.

  16. Impact of sirolimus-eluting stents on outcome in diabetic patients: A SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable stent in the treatment of patients with de novo coronary artery lesions) substudy

    Microsoft Academic Search

    Issam Moussa; Martin B. Leon; Donald S. Baim

    2004-01-01

    Background—Randomized clinical trials have shown that a sirolimus-eluting stent significantly reduces restenosis after percutaneous coronary revascularization. Diabetic patients are known to have a higher risk of restenosis compared with nondiabetic patients. The purpose of this analysis was to determine the impact of sirolimus-eluting stents on outcomes of diabetic compared with nondiabetic patients. Methods and Results—The SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable

  17. Body Image Screening for Cancer Patients Undergoing Reconstructive Surgery

    PubMed Central

    Fingeret, Michelle Cororve; Nipomnick, Summer; Guindani, Michele; Baumann, Donald; Hanasono, Matthew; Crosby, Melissa

    2014-01-01

    Objectives Body image is a critical issue for cancer patients undergoing reconstructive surgery, as they can experience disfigurement and functional impairment. Distress related to appearance changes can lead to various psychosocial difficulties, and patients are often reluctant to discuss these issues with their healthcare team. Our goals were to design and evaluate a screening tool to aid providers in identifying patients who may benefit from referral for specialized psychosocial care to treat body image concerns. Methods We designed a brief 4-item instrument and administered it at a single time point to cancer patients who were undergoing reconstructive treatment. We used simple and multinomial regression models to evaluate whether survey responses, demographic, or clinical variables predicted interest and enrollment in counseling. Results Over 95% of the sample (n = 248) endorsed some concerns, preoccupation, or avoidance due to appearance changes. Approximately one-third of patients were interested in obtaining counseling or additional information to assist with body image distress. Each survey item significantly predicted interest and enrollment in counseling. Concern about future appearance changes was the single best predictor of counseling enrollment. Sex, age, and cancer type were not predictive of counseling interest or enrollment. Conclusions We present initial data supporting use of the Body Image Screener for Cancer Reconstruction. Our findings suggest benefits of administering this tool to patients presenting for reconstructive surgery. It is argued that screening and treatment for body image distress should be provided to this patient population at the earliest possible time point. PMID:25066586

  18. Methodological problems of body image research in anorexia nervosa patients.

    PubMed

    Meermann, R; Vandereycken, W; Napierski, C

    1986-01-01

    The significance of the disturbed body image as a psychopathological phenomenon in anorexia nervosa patients is quite evident to clinicians. It appears to be difficult, however, to assess this disturbance in a more objective way. The studies on body image perception discussed here make use of objective psychometric methods of measurement: image marking procedure, visual size estimation apparatus, distorting photograph technique, and video distortion. The following methodological problems are discussed: reliability, validity, experimental situation, and selection of subjects. Experimental data are presented on 52 anorectic patients as well as 210 control subjects, studied with three different perceptual tasks. PMID:3962691

  19. Are tactile acuity and clinical symptoms related to differences in perceived body image in patients with chronic nonspecific lower back pain?

    PubMed

    Nishigami, Tomohiko; Mibu, Akira; Osumi, Michihiro; Son, Kouki; Yamamoto, Shyogo; Kajiwara, Saori; Tanaka, Katsuyoshi; Matsuya, Ayako; Tanabe, Akihito

    2015-02-01

    Clinically, perceived image of the lower back and the two-point discrimination (TPD) test are used as markers for evaluating alterations of cortical reorganization. The purpose of the present study was to examine whether TPD and selected clinical findings are different in subgroups of individuals with chronic nonspecific lower back pain (CNLBP) based on body image drawings. Forty-two patients with CNLBP and seventeen healthy individuals were recruited. Perceived body image, TPD and clinical profiles was measured. Of the patients with CNLBP, 42.8% had a normal perceived body image, 28.5% an expanded image, and 28.5% a shrunken image. The TPD distance threshold was significantly larger for the expanded subgroup (13.3 ± 6.8 mm) compared with the control (5.5 ± 3.8 mm; Difference, 7.8; 95%CI, 1.83 to 13.66; p < 0.05) and normal subgroups (4.5 ± 5.5 mm; Difference, 8.8; 95%CI, 2.90 to 14.59; p < 0.05). No significant differences in pain intensity, duration of pain, Roland Morris Disability Questionnaire (RDQ), and Pain Catastrophizing Scale (PCS) scores were found between three body image subgroups. Our results suggest that TPD is increased in patients who report an expanded perceived image of the lower back compared with healthy individuals and patients who report a normal image. The effectiveness of new rehabilitation techniques may be evaluated by assessing perceived image of the lower back and TPD values for patients with CNLBP before and after treatment. PMID:25081221

  20. Expanding the clinical spectrum of the 16p11.2 chromosomal rearrangements: three patients with syringomyelia

    PubMed Central

    Schaaf, Christian P; Goin-Kochel, Robin P; Nowell, Kerri P; Hunter, Jill V; Aleck, Kirk A; Cox, Sarah; Patel, Ankita; Bacino, Carlos A; Shinawi, Marwan

    2011-01-01

    16p11.2 rearrangements are associated with developmental delay, cognitive impairment, autism spectrum disorder, behavioral problems (especially attention-deficit hyperactivity disorder), seizures, obesity, dysmorphic features, and abnormal head size. In addition, congenital anomalies and abnormal brain findings were frequently observed in patients with these rearrangements. We identified and performed a detailed microarray, phenotypic, and radiological characterization of three new patients with 16p11.2 rearrangements: two deletion patients and one patient with the reciprocal duplication. All patients have a heterozygous loss (deletion) or gain (duplication) corresponding to chromosomal coordinates (chr16: 29?528?190–30?107?184) with a minimal size of 579?kb. The deletion patients had language delay and learning disabilities and one met criteria for pervasive developmental disorder not otherwise specified. The duplication patient received a diagnosis of autism and had academic deficits and behavioral problems. The patients with deletion had long cervicothoracic syringomyelia and the duplication patient had long thoracolumbar syringomyelia. The syringomyelia in one patient with deletion was associated with Chiari malformation. Our findings highlight the broad spectrum of clinical and neurological manifestations in patients with 16p11.2 rearrangements. Our observation suggests that genes (or a single gene) within the implicated interval have significant roles in the pathogenesis of syringomyelia. A more comprehensive and systematic research is warranted to study the frequency and spectrum of malformations in the central nervous system in these patients. PMID:20959866

  1. Quantitative diffusion weighted imaging measures in patients with multiple sclerosis

    Microsoft Academic Search

    Eleonora Tavazzi; Michael G. Dwyer; Bianca Weinstock-Guttman; Jordan Lema; Stefano Bastianello; Roberto Bergamaschi; Vittorio Cosi; Ralph H. B. Benedict; Frederick E. Munschauer; Robert Zivadinov

    2007-01-01

    Diffusion-weighted imaging (DWI) has been proposed as a sensitive measure of disease severity capable of detecting subtle changes in gray matter and white matter brain compartments in patients with multiple sclerosis (MS). However, DWI has been applied to the study of MS clinical subtypes in only a few studies. The objective of this study was to demonstrate the validity of

  2. Patient dose and image quality from mega-voltage cone beam computed tomography imaging

    SciTech Connect

    Gayou, Olivier; Parda, David S.; Johnson, Mark; Miften, Moyed [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania 15212 (United States)

    2007-02-15

    The evolution of ever more conformal radiation delivery techniques makes the subject of accurate localization of increasing importance in radiotherapy. Several systems can be utilized including kilo-voltage and mega-voltage cone-beam computed tomography (MV-CBCT), CT on rail or helical tomography. One of the attractive aspects of mega-voltage cone-beam CT is that it uses the therapy beam along with an electronic portal imaging device to image the patient prior to the delivery of treatment. However, the use of a photon beam energy in the mega-voltage range for volumetric imaging degrades the image quality and increases the patient radiation dose. To optimize image quality and patient dose in MV-CBCT imaging procedures, a series of dose measurements in cylindrical and anthropomorphic phantoms using an ionization chamber, radiographic films, and thermoluminescent dosimeters was performed. Furthermore, the dependence of the contrast to noise ratio and spatial resolution of the image upon the dose delivered for a 20-cm-diam cylindrical phantom was evaluated. Depending on the anatomical site and patient thickness, we found that the minimum dose deposited in the irradiated volume was 5-9 cGy and the maximum dose was between 9 and 17 cGy for our clinical MV-CBCT imaging protocols. Results also demonstrated that for high contrast areas such as bony anatomy, low doses are sufficient for image registration and visualization of the three-dimensional boundaries between soft tissue and bony structures. However, as the difference in tissue density decreased, the dose required to identify soft tissue boundaries increased. Finally, the dose delivered by MV-CBCT was simulated using a treatment planning system (TPS), thereby allowing the incorporation of MV-CBCT dose in the treatment planning process. The TPS-calculated doses agreed well with measurements for a wide range of imaging protocols.

  3. Imaging of cardiovascular risk in patients with Turner's syndrome.

    PubMed

    Marin, A; Weir-McCall, J R; Webb, D J; van Beek, E J R; Mirsadraee, S

    2015-08-01

    Turner's syndrome is a disorder defined by an absent or structurally abnormal second X chromosome and affects around 1 in 2000 newborn females. The standardised mortality ratio in Turner's syndrome is around three-times higher than in the general female population, mainly as a result of cardiovascular disorders. Most striking is the early age at which Turner's syndrome patients develop the life-threatening complications of cardiovascular disorders compared to the general population. The cardiovascular risk stratification in Turner's syndrome is challenging and imaging is not systematically used. The aim of this article is to review cardiovascular risks in this group of patients and discuss a systematic imaging approach for early identification of cardiovascular disorders in these patients. PMID:25917542

  4. Noninvasive Bioluminescent Imaging Demonstrates Long-Term Multilineage Engraftment of Ex Vivo-Expanded CD34-Selected Umbilical Cord Blood Cells

    PubMed Central

    Steiner, David; Gelovani, Juri; Savoldo, Barbara; Robinson, Simon N.; Decker, William K.; Brouard, Nathalie; Najjar, Amer; Xing, Dongxia; Yang, Hong; Li, Sufang; Marini, Frank; Zweidler-McKay, Patrick A.; Bollard, Catherine M.; Shpall, Elizabeth J.; Dotti, Gianpietro; Simmons, Paul J.

    2012-01-01

    The use of umbilical cord blood (UCB) grafts for hematopoietic stem cell transplantation (HSCT) is a promising technique that permits a degree of human leukocyte antigen mismatch between the graft and the host without the concomitant higher rate of graft-versus-host disease that would be observed between an adult marrow graft and a mismatched host. A disadvantage to the use of UCB for HSCT is that immune reconstitution may be significantly delayed because of the low stem cell dose available in the graft. Ex vivo expansion of UCB CD34 cells would provide a greater number of stem cells; however, there are persistent concerns that ex vivo-expanded CD34 cells may lose pluripotency and the ability to contribute meaningfully to long-term engraftment. To address this issue, we transduced CD34-selected UCB cells with a lentiviral construct expressing luciferase, and determined homing and engraftment patterns in vivo by noninvasive bioluminescent imaging in sublethally irradiated NOD/SCID/IL-2R??/? (NSG) mice. Graft contribution to multilineage commitment was also confirmed by analysis of primary and secondary transplants by flow cytometry and immunohistochemistry. Our results demonstrate that, other than a mild delay at the onset of engraftment, there were no significant differences in lineage repopulation or in long-term or secondary engraftment between culture-expanded and unexpanded UCB CD34-selected cells. The results suggest that multipotent stem cells can be expanded ex vivo and can contribute meaningfully to long-term hematopoietic engraftment. PMID:19544439

  5. Body Image Disturbance in Acromegaly Patients Compared to Nonfunctioning Pituitary Adenoma Patients and Controls

    PubMed Central

    Conaglen, Helen M.; de Jong, Dennis; Crawford, Veronica; Elston, Marianne S.; Conaglen, John V.

    2015-01-01

    Purpose. Excess growth hormone secretion in adults results in acromegaly, a condition in which multiple physical changes occur including bony and soft tissue overgrowth. Over time these changes can markedly alter a person's appearance. The aim of this study was to compare body image disturbance in patients with acromegaly to those with nonfunctioning pituitary adenomas (NFAs) and controls and assess the impact of obesity in these groups. Methods. A cross-sectional survey including quality of life, body image disturbance, anxiety and depression measures, growth hormone, and BMI measurement was carried out. Results. The groups did not differ with respect to body image disturbance. However separate analysis of obese participants demonstrated relationships between mood scales, body image disturbance, and pain issues, particularly for acromegaly patients. Conclusions. While the primary hypothesis that acromegaly might be associated with body image disturbance was not borne out, we have shown that obesity together with acromegaly and NFA can be associated with body image issues, suggesting that BMI rather than primary diagnosis might better indicate whether patients might experience body image disturbance problems. PMID:26078758

  6. Patient-Centered Imaging: Shared Decision Making for Cardiac Imaging Procedures with Exposure to Ionizing Radiation

    PubMed Central

    Einstein, Andrew J.; Berman, Daniel S.; Min, James K.; Hendel, Robert C.; Gerber, Thomas C.; Carr, J. Jeffrey; Cerqueira, Manuel D.; Cullom, S. James; DeKemp, Robert; Dickert, Neal; Dorbala, Sharmila; Garcia, Ernest V.; Gibbons, Raymond J.; Halliburton, Sandra S.; Hausleiter, Jörg; Heller, Gary V.; Jerome, Scott; Lesser, John R.; Fazel, Reza; Raff, Gilbert L.; Tilkemeier, Peter; Williams, Kim A.; Shaw, Leslee J.

    2014-01-01

    Objective To identify key components of a radiation accountability framework fostering patient-centered imaging and shared decision-making in cardiac imaging. Background An NIH-NHLBI/NCI-sponsored symposium was held in November 2012 to address these issues. Methods Symposium participants, working in three tracks, identified key components of a framework to target critical radiation safety issues for the patient, the laboratory, and the larger population of patients with known or suspected cardiovascular disease. Results Use of ionizing radiation during an imaging procedure should be disclosed to all patients by the ordering provider at the time of ordering, and reinforced by the performing provider team. An imaging protocol with effective dose ?3mSv is considered very low risk, not warranting extensive discussion or written consent. However, a protocol effective dose <20mSv was proposed as a level requiring particular attention in terms of shared decision-making and either formal discussion or written informed consent. Laboratory reporting of radiation dosimetry is a critical component of creating a quality laboratory fostering a patient-centered environment with transparent procedural methodology. Efforts should be directed to avoiding testing involving radiation, in patients with inappropriate indications. Standardized reporting and diagnostic reference levels for computed tomography and nuclear cardiology are important for the goal of public reporting of laboratory radiation dose levels in conjunction with diagnostic performance. Conclusions The development of cardiac imaging technologies revolutionized cardiology practice by allowing routine, noninvasive assessment of myocardial perfusion and anatomy. It is now incumbent upon the imaging community to create an accountability framework to safely drive appropriate imaging utilization. PMID:24530677

  7. Novel point mutations in survival motor neuron 1 gene expand the spectrum of phenotypes observed in spinal muscular atrophy patients.

    PubMed

    J?drzejowska, Maria; Gos, Monika; Zimowski, Janusz G; Kostera-Pruszczyk, Anna; Ryniewicz, Barbara; Hausmanowa-Petrusewicz, Irena

    2014-07-01

    The aim of our study was to identify point mutations in a group of 606 patients diagnosed for spinal muscular atrophy with excluded biallelic loss of the SMN1 gene. Point missense mutations or small deletions in the SMN1 gene were ultimately identified in 18 patients. Six patients were found to have small deletions, the c.429_435del mutation in 3 cases, the c.431delC mutation in 2 and c.722delC in one. Those mutations, not described previously, were characteristic of patients presenting a severe phenotype. The most frequent missense mutation - p.Thr274Ile, was identified in 9 patients presenting a rather mild phenotype. Three other missense mutations, i.e., p.Ser230Leu, p.Ala111Gly and p.Pro244Leu, were identified in a further 3 SMA3 patients. Mutation p.Pro244Leu, not described so far, was identified in a patient with a mild form of SMA and more distal distribution of muscle weakness. Our results suggest a specific point mutation spectrum in the Polish population. The existence of small deletions not identified thus far could suggest a possible founder effect. In patients with preserved one SMN1 allele without common exon 7 deletion, presenting a mild form of SMA, a special consideration should be given to the p.Thr274Ile mutation. PMID:24844453

  8. HIGH-RESOLUTION EXPANDED VERY LARGE ARRAY IMAGE OF DIMETHYL ETHER (CH{sub 3}){sub 2}O IN ORION-KL

    SciTech Connect

    Favre, C. [Department of Physics and Astronomy, University of Arhus, Ny Munkegade 120, DK-8000 Arhus C (Denmark); Wootten, H. A.; Remijan, A. J. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903-2475 (United States); Brouillet, N.; Despois, D.; Baudry, A. [Universite de Bordeaux, OASU, 2 rue de l'Observatoire, BP 89, 33271 Floirac Cedex (France); Wilson, T. L., E-mail: favre@phys.au.dk, E-mail: brouillet@obs.u-bordeaux1.fr, E-mail: despois@obs.u-bordeaux1.fr, E-mail: baudry@obs.u-bordeaux1.fr, E-mail: awootten@nrao.edu, E-mail: aremijan@nrao.edu, E-mail: tom.wilson@nrl.navy.mil [Naval Research Laboratory, Code 7210, Washington, DC 20375 (United States)

    2011-09-20

    We report the first subarcsecond (0.''65 x 0.''51) image of the dimethyl ether molecule, (CH{sub 3}){sub 2}O, toward the Orion Kleinmann-Low nebula. The observations were carried at 43.4 GHz with the Expanded Very Large Array (EVLA). The distribution of the lower energy transition 6{sub 1,5}-6{sub 0,6}, EE (E {sub u} = 21 K) mapped in this study is in excellent agreement with the published dimethyl ether emission maps imaged with a lower resolution. The main emission peaks are observed toward the Compact Ridge and Hot Core southwest components, at the northern parts of the Compact Ridge and in an intermediate position between the Compact Ridge and the Hot Core. A notable result is that the distribution of dimethyl ether is very similar to that of another important larger O-bearing species, the methyl formate (HCOOCH{sub 3}), imaged at a lower resolution. Our study shows that higher spectral resolution (WIDAR correlator) and increased spectral coverage provided by the EVLA offer new possibilities for imaging complex molecular species. The sensitivity improvement and the other EVLA improvements make this instrument well suited for high sensitivity, high angular resolution, and molecular line imaging.

  9. Chronic expanding hematoma in the retroperitoneal space: a case report

    PubMed Central

    2013-01-01

    Background Chronic expanding hematoma is a rare condition that develops after surgery, trauma, or injury. It can also develop at any location in the body in the absence of trauma. Clinical findings and various diagnostic imaging modalities can aid in the differential diagnosis of this condition. In general, hematomas are naturally reabsorbed and rarely cause serious problems. However, hematomas that develop slowly without a history of trauma, surgery, or bleeding disorders could be difficult to differentiate from soft tissue neoplasms. In the present case, we describe a patient, without any history or physical evidence of trauma, who exhibited a large chronic expanding hematoma in the retroperitoneal space that resulted in hydronephrosis because of the pressure exerted on the left ureter. Case presentation A 69-year-old man presented to our hospital with a swollen lesion in the left flank. A mass, 19 cm in diameter, was detected in the retroperitoneal space by computed tomography. We suspected the presence of a chronic expanding hematoma, soft tissue tumor, or left renal artery aneurysm. Surgical treatment was performed. However, postoperative histopathological examination indicated that the mass was a nonmalignant chronic expanding hematoma. No recurrence was observed during a 2-year follow-up period. Conclusion In patients without a history of trauma who present slowly growing masses, the differential diagnosis should include chronic expanding hematoma in addition to cysts and soft tissue tumors. Moreover, the use of magnetic resonance imaging and computed tomography is essential to differentiate between chronic expanding hematoma and soft tissue tumors. PMID:24237992

  10. Does a continuous local anaesthetic pain treatment after immediate tissue expander reconstruction in breast carcinoma patients more efficiently reduce acute postoperative pain - a prospective randomised study

    PubMed Central

    2014-01-01

    Background Immediate breast reconstruction with an expander is a reasonable option for properly selected patients. After reconstruction, patients have severe postoperative pain, which responds poorly to opioids. Our aim was to evaluate if continuous wound infusion of a local anaesthetic into the surgical wound reduces postoperative pain, consumption of opioids and incidence of chronic pain compared to standard intravenous piritramide after primary breast reconstruction in breast carcinoma patients. Methods Altogether, 60 patients were enrolled in our study; one half in the group with wound infusion of a local anaesthetic, and the other half in the standard (piritramide) group. Parameters measured included: pain intensity (visual analogue scale), drug requirements, alertness, hospitalisation, side-effects and late complications. A p-value of?expander breast reconstruction, wound infusion of a local anaesthetic significantly reduces acute pain and enables reduced opioid consumption, resulting in less postoperative sedation and reduced need for antiemetic drugs. Wound infusion of a local anaesthetic reduces chronic pain. PMID:24433317

  11. Brain magnetic resonance imaging in patients with Cowden syndrome.

    PubMed

    Lok, Catherine; Viseux, Valérie; Avril, Marie Françoise; Richard, Marie Aleth; Gondry-Jouet, Catherine; Deramond, Hervé; Desfossez-Tribout, Caroline; Courtade, Sandrine; Delaunay, Michèle; Piette, Fréderic; Legars, Daniel; Dreno, Brigitte; Saïag, Philippe; Longy, Michel; Lorette, Gérard; Laroche, Liliane; Caux, Fréderic

    2005-03-01

    Cowden syndrome (CS) is a rare autosomal dominant genodermatosis, characterized by multiple hamartomas, particularly of the skin, associated with high frequencies of breast, thyroid, and genitourinary malignancies. Although Lhermitte-Duclos disease (LDD) or dysplastic gangliocytoma of the cerebellum, a slowly progressive unilateral tumor, is a major criterion of CS, its frequency in patients with CS is unknown. Other cerebral abnormalities, especially meningioma and vascular malformations, have also been described, albeit rarely, in these patients. The aim of the current study was to use cerebral magnetic resonance imaging (MRI) to evaluate LDD frequency and to investigate other brain abnormalities in CS patients recruited by dermatologists. A multicenter study was conducted in 8 hospital dermatology departments between January 2000 and December 2003. Twenty patients with CS were included; specific cerebral MRI abnormalities were found in 35% (7/20) of them. Cerebral MRI revealed LDD in 3 patients, a meningioma in 1, and numerous vascular malformations in 6 patients. Five patients had venous angiomas (3 associated with LDD) and 2 patients had cavernous angiomas (1 associated with LDD and a venous angioma). The discovery of asymptomatic LDD in 3 patients and a cavernous angioma in another prompted us to perform neurologic examinations regularly and MRI to estimate the size and the extension of the tumor, and to assess the need for surgery. CS similarities with Bannayan-Riley-Ruvalcaba (BRR) are discussed because some patients could also have the BRR phenotype (for example, genital lentigines, macrocephaly, multiple lipomas) and because BRR seems to have more central nervous system vascular anomalies. Because CS signs can involve numerous systems, all physicians who might encounter this disease should be aware of its neurologic manifestations. Our findings confirm the contribution of brain MRI to detecting asymptomatic LDD, vascular malformations, and meningiomas in patients with CS. PMID:15758842

  12. MR imaging in patients with intracranial aneurysm clips.

    PubMed

    Becker, R L; Norfray, J F; Teitelbaum, G P; Bradley, W G; Jacobs, J B; Wacaser, L; Rieman, R L

    1988-09-01

    Four patients with intracranial aneurysm clips made from a variety of alloys were studied without incidence by MR imaging at field strengths ranging from 0.35 to 0.6 T. Knowledge of the type of alloy used in the manufacturing of an aneurysm clip is important in determining whether the clip will or will not deflect in a magnetic field. Ferromagnetic clips show deflection and torque in a magnetic field and have the potential to dislodge from the aneurysm. Nonferromagnetic or weakly ferromagnetic aneurysm clips such as the Sugita (Elgiloy), Yasargil (316 LVM stainless steel), Heifetz (Elgiloy), Yasargil (Phynox), and Vari-Angle McFadden (MP35N) do not deflect or deflect weakly in the magnetic field and therefore would not be expected to dislodge during MR. The option of imaging many patients with intracranial aneurysm clips with MR extends the usefulness of the technique to a previously excluded population. PMID:3140632

  13. The factor structure of the brief psychiatric rating scale (expanded version) in a sample of forensic psychiatric patients.

    PubMed

    van Beek, Janneke; Vuijk, Pieter Jelle; Harte, Joke M; Smit, Bettine L; Nijman, Henk; Scherder, Erik J A

    2015-06-01

    Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale-Extended (BPRS-E) is a widely used scale for assessing psychiatric symptoms, with a stable factor structure over various patient groups. For the first time, its usefulness for forensic psychiatric patients was studied by means of an exploratory factor analysis on 302 patients in a penitentiary psychiatric center. A five-factor solution fitted the data best and showed large overlap with previous research done in both in- and outpatient populations with schizophrenia and mixed diagnoses. Around 45% of the patients did not fully comply. Items relying most on self-report caused the most non-adherence, possibly because of difficulty with verbalizing distress. These items loaded on the factors psychosis and affect. The BPRS-E is a suitable instrument for forensic use. Future research and clinical practice should focus on alignment with forensic patients to improve measurement, understanding, and eventually therapeutic interventions. PMID:24709831

  14. Estimated Radiation Exposure from Medical Imaging in Hemodialysis Patients

    PubMed Central

    De Mauri, Andreana; Chiarinotti, Doriana; Matheoud, Roberta; Carriero, Alessandro; De Leo, Martino

    2011-01-01

    Radiation exposure accompanying medical imaging associates with cancer risk. Patients with recurrent or chronic diseases may be especially at risk, because they may undergo more of these procedures. The aim of this study was to assess the individual cumulative effective doses (CEDs), which quantify radiation from medical imaging procedures, in a cohort of 106 hemodialysis patients during a median follow-up of 3 years. We retrospectively calculated individual radiation exposures by collecting the number and type of radiologic procedures from hospital records. We also estimated organ doses for computed tomography procedures. The mean and median annual CEDs were 21.9 and 11.7 mSv per patient-year, respectively. The mean and median total CEDs per patient during the study period were 57.7 and 27.3 mSv, respectively. By radiation dose group, we classified 22 patients as low (<3 mSv/yr), 51 as moderate (3 to <20 mSv/yr), 22 as high (20 to <50 mSv/yr), and 11 as very high (?50 mSv/yr). Seventeen patients had a total CED >100 mSv, a value associated with a substantial increase in risk for cancer- mortality. Of the total CED,s 76% was a result of CT scanning. The annual CED significantly associated with age and transplant waitlist status. In summary, this study shows that a significant fraction of surviving hemodialysis patients during a 3-year period receives estimated radiation doses that may put them at an increased risk for cancer. PMID:21355057

  15. Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea.

    PubMed

    Kim, Sujin; Kwon, Soonman

    2015-08-01

    To increase financial protection for catastrophic illness, South Korean government expanded the National Health Insurance (NHI) benefit coverage for cancer patients in September 2005. This paper investigated whether the policy has reduced inequality in catastrophic payments, defined as annual out-of-pocket (OOP) health payments exceeding 10% annual income, across different income groups. This study used the NHI claims data from 2002 to 2004 and 2006 to 2010. Triple difference estimator was employed to compare cancer patients as a treatment group with those with liver and cardio-cerebrovascular diseases as control groups and the low-income with the high-income groups. While catastrophic payments decreased in cancer patients compared with those of two diseases, they appeared to decrease more in the high-income than the low-income group. Considering that increased health care utilization and poor economic capacity may lead to a smaller reduction in catastrophic payments for the low-income than the high-income patients, the government needs to consider additional policy measures to increase financial protection for the poor. PMID:26123883

  16. Expanding multimodal microscopy by high spectral resolution coherent anti-Stokes Raman scattering imaging for clinical disease diagnostics.

    PubMed

    Meyer, Tobias; Chemnitz, Mario; Baumgartl, Martin; Gottschall, Thomas; Pascher, Torbjörn; Matthäus, Christian; Romeike, Bernd F M; Brehm, Bernhard R; Limpert, Jens; Tünnermann, Andreas; Schmitt, Michael; Dietzek, Benjamin; Popp, Jürgen

    2013-07-16

    Over the past years fast label-free nonlinear imaging modalities providing molecular contrast of endogenous disease markers with subcellular spatial resolution have been emerged. However, applications of these imaging modalities in clinical settings are still at the very beginning. This is because single nonlinear imaging modalities such as second-harmonic generation (SHG) and two-photon excited fluorescence (TPEF) have only limited value for diagnosing diseases due to the small number of endogenous markers. Coherent anti-Stokes Raman scattering (CARS) microscopy on the other hand can potentially be added to SHG and TPEF to visualize a much broader range of marker molecules. However, CARS requires a second synchronized laser source and the detection of a certain wavenumber range of the vibrational spectrum to differentiate multiple molecules, which results in increased experimental complexity and often inefficient excitation of SHG and TPEF signals. Here we report the application of a novel near-infrared (NIR) fiber laser of 1 MHz repetition rate, 65 ps pulse duration, and 1 cm(-1) spectral resolution to realize an efficient but experimentally simple SGH/TPEF/multiplex CARS multimodal imaging approach for a label-free characterization of composition of complex tissue samples. This is demonstrated for arterial tissue specimens demonstrating differentiation of elastic fibers, triglycerides, collagen, myelin, cellular cytoplasm, and lipid droplets by analyzing the CARS spectra within the C-H stretching region only. A novel image analysis approach for multispectral CARS data based on colocalization allows correlating spectrally distinct pixels to morphologic structures. Transfer of this highly precise but compact and simple to use imaging approach into clinical settings is expected in the near future. PMID:23781826

  17. Depression in adults with congenital heart disease-public health challenge in a rapidly expanding new patient population

    PubMed Central

    Pauliks, Linda B

    2013-01-01

    There is a growing population of adults with congenital heart disease (CHD) due to improved survival beyond childhood. It has been suggested that adults with CHD may be at increased risk for mental health problems, particularly depression. The reported incidence of depression in CHD varies from 9% to 30%. This review examines the evidence for a higher depression rate in CHD vs general population. Possible explanations are offered from a variety of disease models, ranging from brain injury to the psychoanalytical approach. Risk factors for an abnormal emotional adjustment and depression include early exposure to stress from illness and medical interventions in infancy, separation from the parents during hospitalizations and brain organic syndromes. Later in life, patients often have to cope with physical limitations. Recent improvements in care may be protective. Current patients may benefit from an earlier age at first surgical intervention, fewer reoperations and inclusion to the mainstream schooling, among other factors. At this point, there is little systematic knowledge about evidence-based therapeutic interventions for depression in adults with CHD. Health care providers of patients with CHD should be aware of mental health challenges and may take a more proactive approach to identifying patients at risk for depression. PMID:23802047

  18. The Expanding Role of Mitral Valve Repair in Triple Valve Operations: Contemporary North American Outcomes in 8,021 Patients

    PubMed Central

    Suri, Rakesh M.; Thourani, Vinod H.; Englum, Brian R.; Rankin, J. Scott; Badhwar, Vinay; Svensson, Lars G.; Ailawadi, Gorav; Mack, Michael J.; He, Max; Brennan, J. Matthew; Schaff, Hartzell V.; Gammie, James S.

    2015-01-01

    Background Although the operative risk of multivalve operations has historically been high, current outcomes are poorly understood. We sought to evaluate factors influencing contemporary results of triple-valve operations using The Society of Thoracic Surgeons Adult Cardiac Surgery Database. Methods Among patients undergoing combined mitral, aortic, and tricuspid valve (triple- valve) operations between 1993 and 2011, aortic valve repair patients were excluded and those having aortic valve replacement were analyzed according to whether they underwent repair vs replacement of the mitral valve (MV) and tricuspid valve (TV). Temporal trends in operative death and clinical outcomes were examined using unadjusted and adjusted analyses. Results A total of 8,021 triple-valve patients were studied. The median (25th percentile, 75th percentile) age was 67 years (59, 77 years), 4,809 (60%) were women, 4,488 (56%) had New York Heart Association class III to IV symptoms, and the mean (25th percentile, 75th percentile) ejection fraction was 50% (40%, 60%). MV repair was performed in 2,728 (34%) patients overall and increased over time from 13% (1993 to 1997) to 41% (2008 to 2011). TV repair was performed in 7,512 (94%) patients overall and increased over time from 86% (1993 to 1997) to 96% (2008 to 2011). Unadjusted operative mortality decreased from 17% in 1993 to 9% in 2011. Adjusted odds ratios (95% confidence intervals) of operative mortality were lower in those having MV repair (0.72 [0.61 to 0.85]), TV repair (0.64 [0.50 to 0.83]), and MV D TV repair (0.46 [0.34 to 0.63]) compared with those having replacements. Unadjusted and adjusted odds of stroke were similar between groups and not significant for all. Conclusions This large series demonstrates that surgical results of triple-valve operations have continued to improve during the past 18 years. MV and TV repair were associated with improvements in early survival. Although further study is required to understand late outcomes, these data suggest that broader efforts to perform MV repair instead of replacement in this high-risk patient population appear warranted. PMID:24680034

  19. Different Imaging Strategies in Patients With Possible Basilar Artery Occlusion

    PubMed Central

    Beyer, Sebastian E.; Hunink, Myriam G.; Schöberl, Florian; von Baumgarten, Louisa; Petersen, Steffen E.; Dichgans, Martin; Janssen, Hendrik; Ertl-Wagner, Birgit; Reiser, Maximilian F.

    2015-01-01

    Background and Purpose— This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion. Methods— A Markov decision analytic model was used to evaluate long-term outcomes resulting from strategies using computed tomographic angiography (CTA), magnetic resonance imaging, nonenhanced CT, or duplex ultrasound with intravenous (IV) thrombolysis being administered after positive findings. The analysis was performed from the societal perspective based on US recommendations. Input parameters were derived from the literature. Costs were obtained from United States costing sources and published literature. Outcomes were lifetime costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and net monetary benefits, with a willingness-to-pay threshold of $80 000 per QALY. The strategy with the highest net monetary benefit was considered the most cost-effective. Extensive deterministic and probabilistic sensitivity analyses were performed to explore the effect of varying parameter values. Results— In the reference case analysis, CTA dominated all other imaging strategies. CTA yielded 0.02 QALYs more than magnetic resonance imaging and 0.04 QALYs more than duplex ultrasound followed by CTA. At a willingness-to-pay threshold of $80 000 per QALY, CTA yielded the highest net monetary benefits. The probability that CTA is cost-effective was 96% at a willingness-to-pay threshold of $80 000/QALY. Sensitivity analyses showed that duplex ultrasound was cost-effective only for a prior probability of ?0.02 and that these results were only minimally influenced by duplex ultrasound sensitivity and specificity. Nonenhanced CT and magnetic resonance imaging never became the most cost-effective strategy. Conclusions— Our results suggest that CTA in patients with possible basilar artery occlusion is cost-effective. PMID:26022634

  20. Instability of the expanded (CTG){sub n} repeats in the myotonin protein kinase gene in cultured lymphoblastoid cell lines from patients with myotonic dystrophy

    SciTech Connect

    Ashizawa, Tetsuo; Patel, B.J.; Monckton, D.G. [Baylor College of Medicine, Houston, TX (United States)] [and other] [Baylor College of Medicine, Houston, TX (United States); and other

    1996-08-15

    The mutation associated with myotonic dystrophy (DM) is the expansion of an unstable trinucleotide repeat, (CTG){sub n}, in the 3{prime}-untranslated region of the myotonin protein kinase gene. Although expanded repeats show both germline and somatic instability, the mechanisms of the instability are poorly understood. To establish a model system in which somatic instability of the DM repeat could be studied in more detail, we established lymphoblastoid cell lines (LBCL) from DM patients. Analysis of the DNA from DM LBCL using Southern blotting showed that the (CTG). repeats were apparently stable up to 29 passages in culture. To study infrequent repeat size mutations that are undetectable due to the size heterogeneity, we established LBCL of single-cell origins by cloning using multiple steps of limiting dilution. After expansion to approximately 10{sup 6} cells (equivalent to approximately 20 cell cycles), the DNAs of these cell lines were analyzed by the small pool PCR technique using primers flanking the (CTG), repeat region. Two types of mutations of the expanded (CTG){sub n} repeat alleles were detected: (1) frequent mutations that show small changes of the (CTG){sub n} repeat size, resulting in alleles in a normal distribution around the progenitor allele, and (2) relatively rare mutations with large changes of the (CTG){sub n} repeat size, with a bias toward contraction. The former may represent the mechanism responsible for the so matic heterogeneity of the (CTG), repeat size observe in blood cells of DM patients. This in vitro experimental system will be useful for further studies on mechanisms involved in the regulation of the somatic stability of the (CTG). repeats in DM. 24 refs., 4 figs.

  1. Magnetization Transfer Imaging of Suicidal Patients with Major Depressive Disorder

    PubMed Central

    Chen, Ziqi; Zhang, Huawei; Jia, Zhiyun; Zhong, Jingjie; Huang, Xiaoqi; Du, Mingying; Chen, Lizhou; Kuang, Weihong; Sweeney, John A.; Gong, Qiyong

    2015-01-01

    Magnetization transfer imaging (MTI) provides a quantitative measure of the macromolecular structural integrity of brain tissue, as represented by magnetization transfer ratio (MTR). In this study, we utilized MTI to identify biophysical alterations in MDD patients with a history of suicide attempts relative to MDD patients without such history. The participants were 36 medication-free MDD patients, with (N = 17) and without (N = 19) a history of a suicide attempt, and 28 healthy controls matched for age and gender. Whole brain voxel-based analysis was used to compare MTR across three groups and to analyze correlations with symptom severity and illness duration. We identified decreased MTR in left inferior parietal lobule and right superior parietal lobule in suicide attempters relative to both non-attempters and controls. Non-attempters also showed significantly reduced MTR in left inferior parietal lobule relative to controls, as well as an MTR reduction in left cerebellum. These abnormalities were not correlated with symptom severity or illness duration. Depressed patients with a history of suicide attempt showed bilateral abnormalities in parietal cortex compared to nonsuicidal depressed patients and healthy controls. Parietal lobe abnormalities might cause attentional dysfunction and impaired decision making to increase risk for suicidal behavior in MDD. PMID:25853872

  2. Cerebella segmentation on MR images of pediatric patients with medulloblastoma

    NASA Astrophysics Data System (ADS)

    Shan, Zu Y.; Ji, Qing; Glass, John; Gajjar, Amar; Reddick, Wilburn E.

    2005-04-01

    In this study, an automated method has been developed to identify the cerebellum from T1-weighted MR brain images of patients with medulloblastoma. A new objective function that is similar to Gibbs free energy in classic physics was defined; and the brain structure delineation was viewed as a process of minimizing Gibbs free energy. We used a rigid-body registration and an active contour (snake) method to minimize the Gibbs free energy in this study. The method was applied to 20 patient data sets to generate cerebellum images and volumetric results. The generated cerebellum images were compared with two manually drawn results. Strong correlations were found between the automatically and manually generated volumetric results, the correlation coefficients with each of manual results were 0.971 and 0.974, respectively. The average Jaccard similarities with each of two manual results were 0.89 and 0.88, respectively. The average Kappa indexes with each of two manual results were 0.94 and 0.93, respectively. These results showed this method was both robust and accurate for cerebellum segmentation. The method may be applied to various research and clinical investigation in which cerebellum segmentation and quantitative MR measurement of cerebellum are needed.

  3. Patient Specific Tumor Growth Prediction Using Multimodal Images

    PubMed Central

    Liu, Yixun; Sadowski, Samira M.; Weisbrod, Allison B.; Kebebew, Electron; Summers, Ronald M.; Yao, Jianhua

    2014-01-01

    Personalized tumor growth model is valuable in tumor staging and therapy planning. In this paper, we present a patient specific tumor growth model based on longitudinal multimodal imaging data including dual-phase CT and FDG-PET. The proposed Reaction-Advection-Diffusion model is capable of integrating cancerous cell proliferation, infiltration, metabolic rate and extracellular matrix biomechanical response. To bridge the model with multimodal imaging data, we introduce intracellular volume fraction (ICVF) measured from dual-phase CT and Standardized Uptake Value (SUV) measured from FDG-PET into the model. The patient specific model parameters are estimated by fitting the model to the observation, which leads to an inverse problem formalized as a coupled Partial Differential Equations (PDE)-constrained optimization problem. The optimality system is derived and solved by the Finite Difference Method. The model was evaluated by comparing the predicted tumors with the observed tumors in terms of average surface distance (ASD), root mean square difference (RMSD) of the ICVF map, average ICVF difference (AICVFD) of tumor surface and tumor relative volume difference (RVD) on six patients with pathologically confirmed pancreatic neuroendocrine tumors. The ASD between the predicted tumor and the reference tumor was 2.4±0.5 mm, the RMSD was 4.3±0.4%, the AICVFD was 2.6±0.6%, and the RVD was 7.7±1.3%. PMID:24607911

  4. Surgical transposition of the ovaries: Imaging findings in 14 patients

    SciTech Connect

    Kier, R.; Chambers, S.K. (Yale Univ. School of Medicine, New Haven, CT (USA))

    1989-11-01

    Pelvic radiation therapy for cervical or vaginal cancer often leads to ovarian failure. To remove the ovaries from the radiation portal and preserve their function, they can be transposed to the lateral abdomen. Serial imaging studies in 14 patients who had undergone ovarian transposition (five bilateral, nine unilateral) were reviewed. Images obtained included 32 CT scans, 20 sonograms, and one MR image. Most transposed ovaries were located along the paracolic gutters near the iliac crests, creating an extrinsic mass effect on adjacent bowel. Detection of surgical clips on the ovary on CT scans allowed confident recognition of all 19 transposed ovaries. Cysts in the transposed ovaries, noted on most imaging studies, did not correlate with complications of pain or hormonal dysfunction. In one case, a large physiologic cyst in a transposed ovary distorted the cecum and was mistaken for a mucocele of the appendix. In another case, a large ovarian cyst was thought to be tumor recurrence or a lymphocele. These findings indicate that although the transposed ovaries can be recognized on CT scans by the surgical clips attached to the ovaries, the appearance of the ovary does not predict reliably the development of complications.

  5. Magnetic resonance imaging seems safe in patients with intracoronary stents.

    PubMed

    Schroeder, A P; Houlind, K; Pedersen, E M; Thuesen, L; Nielsen, T T; Egeblad, H

    2000-01-01

    We elucidated whether exposure to cardiac magnetic resonance imaging (MRI) of patients with implanted intracoronary stents is associated with increased risk of stent-thrombosis, stent-restenosis, or other cardiovascular complications. Forty-seven patients admitted with acute myocardial infarction (AMI) were studied. Twenty-three were included in a serial cardiac MRI study, using 1.5-T scanners with standard gradient systems. The remaining patients were control subjects who were matched for age and gender with the MRI group. All patient had intracoronary stents implanted in connection with primary angioplastic treatment (PTCA) of AMI (n = 21), secondary PTCA procedures due to recurrent angina (n = 22), or both (n = 4). In the MRI group (n = 23, aged 58 +/- 10 yr), MRI was carried out one to five times in each patient a median of 166 days (range, 1-501) after stent implantation. The control group comprised 24 patients, ages 59 +/- 11 yr. The incidences of stent-thrombosis, stent-restenosis, and other cardiovascular complications did not differ statistically significantly between the two groups. In the MRI group, stent-related thrombosis (n = 1) or restenosis (n = 7) was observed in eight cases a median of 102 days (range, 7-547) after MR examination and a median of 318 days (range, 138-713) after stent implantation, compared with nine cases in the control group (thrombosis, n = 1; restenosis, n = 8) observed a median of 147 days (range, 1-267) after stent implantation. No acute thromboembolic or other complication occurred in immediate connection with MRI. The follow-up time was 21.3 +/- 4.5 months. This small study shows no evidence of an MRI-related risk of stent-restenosis or other cardiovascular complications, not even if cardiac MRI is performed early after stent implantation. PMID:11545106

  6. Silent radiological imaging time in patients with brain metastasis.

    PubMed

    Mystakidou, Kyriaki; Boviatsis, Efstathios J; Kouyialis, Andreas T; Voumvourakis, Konstantinos; Kouloulias, Vassilios; Kouvaris, John; Vlahos, Lambros

    2004-09-01

    Cerebral metastasis is a common finding in patients with systemic carcinoma and is an indication for progress of the disease. When brain metastases occur, they lead to a considerable decrease in both survival and the quality of life, in patients who otherwise might be functional. Furthermore, the location, size and number of such lesions, play a decisive role in management and prognosis. Even though early diagnosis and treatment is curative in rare cases, it may lead to a useful remission of the central nervous system (CNS) symptoms, enhance the patient's quality of life and prolong survival. The radiological exams established in the diagnosis of this condition, include computed tomography (CT) scan or magnetic resonance imaging (MRI). In cases of "micrometastatic" disease though, these exams may be pronounced as normal. This retrospective study was performed in patients with advanced systemic disease, who presented with neurological findings of intracranial mass lesion, in the absence of radiological evidence. Early-occurring symptoms were evaluated in accordance to location of the primary disease and follow-up with repetitive MRI scans was performed, in an attempt to confirm the diagnosis and facilitate prompt and appropriate treatment. PMID:15297004

  7. Functional imaging of radiation liver injury in a liver metastasis patient: imaging and pathologic correlation

    PubMed Central

    Chapman, Tobias R.; Kumarapeli, Asangi R.; Nyflot, Matthew J.; Bowen, Stephen R.; Yeung, Raymond S.; Vesselle, Hubert J.; Yeh, Matthew M.

    2015-01-01

    Background Radiation therapy (RT) is increasingly being utilized as a treatment modality for the treatment of primary and metastatic liver malignancies. Accurate assessment of liver function and prediction of radiation induced liver disease (RILD) remains a challenge with conventional laboratory tests and imaging. Imaging-pathology correlation of hepatic injury after RT has been described with computer tomography (CT) imaging that depicts perfusion changes. However, these imaging changes may not directly characterize the functional capacity of the liver. Case presentation This case report describes a patient that received preoperative chemoradiation and surgical resection for a liver metastasis from endometrial cancer. Sulfur colloid (SC) single photon emission computed tomography (SPECT/CT) was obtained post-chemoradiation and prior to surgery. Imaging-pathology correlation between radiation changes depicted on functional imaging using SC SPECT/CT and corresponding histopathology is described. Discussion Quantitative SC SPECT/CT may allow non-invasive assessment of global and spatial liver function before treatment and enable personalized treatment approaches for liver-directed therapies.

  8. Protecting patient privacy against unauthorized release of medical images in a group communication environment

    E-print Network

    Poovendran, Radha

    Protecting patient privacy against unauthorized release of medical images in a group communication identify and study an important patient privacy protection problem related to medical images. Following' medical records, efforts have been devoted to guaranteeing the confidentiality of data and medical images

  9. Visual search performance of patients with vision impairment: effect of JPEG image enhancement

    E-print Network

    Peli, Eli

    Visual search performance of patients with vision impairment: effect of JPEG image enhancement Gang & Peli E. Visual search performance of patients with vision impairment: effect of JPEG image enhancement, image enhancement, low vision rehabilitation, visual search Correspondence: Gang Luo E-mail address

  10. A Multidimensional Analysis of Body Image Concerns Among Newly Diagnosed Patients with Oral Cavity Cancer

    PubMed Central

    Fingeret, Michelle Cororve; Vidrine, Damon J.; Reece, Gregory P.; Gillenwater, Ann M.; Gritz, Ellen R.

    2009-01-01

    Background Body image is a critical psychosocial issue for patients facing treatment for oral cancer yet there is limited research conducted in this area. This study utilizes a multidimensional approach to body image assessment and evaluates relationships between body image, demographic, health, and psychosocial variables. Methods Newly diagnosed patients with oral cancer completed self-report questionnaires and a structured clinical interview. Results Most participants identified current and/or future body image concerns primarily related to impending surgery. Adequate psychometric properties were demonstrated on a range of body image measures. Depression was the strongest and most consistent predictor of body image outcomes. Conclusions Preliminary evidence supports the importance of evaluating body image concerns in oral cancer patients prior to surgical intervention. Our findings have implications for developing validated body image tools and can be used to guide psychosocial interventions targeting body image disturbance. PMID:19626634

  11. Logging roads rapidly expanding in Congo rainforest Logging roads rapidly expanding in Congo rainforest

    E-print Network

    Logging roads rapidly expanding in Congo rainforest Logging roads rapidly expanding in Congo rainforest mongabay.com June 7, 2007 Logging roads are rapidly expanding in the Congo rainforest, report satellite images of 4 million square miles of Central African rainforest acquired between 1976 and 2003

  12. Efficient derivation and inducible differentiation of expandable skeletal myogenic cells from human ES and patient-specific iPS cells.

    PubMed

    Maffioletti, Sara M; Gerli, Mattia F M; Ragazzi, Martina; Dastidar, Sumitava; Benedetti, Sara; Loperfido, Mariana; VandenDriessche, Thierry; Chuah, Marinee K; Tedesco, Francesco Saverio

    2015-07-01

    Skeletal muscle is the most abundant human tissue; therefore, an unlimited availability of myogenic cells has applications in regenerative medicine and drug development. Here we detail a protocol to derive myogenic cells from human embryonic stem (ES) and induced pluripotent stem (iPS) cells, and we also provide evidence for its extension to human iPS cells cultured without feeder cells. The procedure, which does not require the generation of embryoid bodies or prospective cell isolation, entails four stages with different culture densities, media and surface coating. Pluripotent stem cells are disaggregated to single cells and then differentiated into expandable cells resembling human mesoangioblasts. Subsequently, transient Myod1 induction efficiently drives myogenic differentiation into multinucleated myotubes. Cells derived from patients with muscular dystrophy and differentiated using this protocol have been genetically corrected, and they were proven to have therapeutic potential in dystrophic mice. Thus, this platform has been demonstrated to be amenable to gene and cell therapy, and it could be extended to muscle tissue engineering and disease modeling. PMID:26042384

  13. Correlation of PET Images of Metabolism, Proliferation and Hypoxia to Characterize Tumor Phenotype in Patients with Cancer of the Oropharynx

    PubMed Central

    Nyflot, Matthew J; Harari, Paul M; Yip, Stephen; Perlman, Scott B; Jeraj, Robert

    2012-01-01

    Spatial organization of tumor phenotype is of great interest to radiotherapy target definition and outcome prediction. We characterized tumor phenotype in patients with cancers of the oropharynx through voxel-based correlation of PET images of metabolism, proliferation, and hypoxia. Methods Patients with oropharyngeal cancer received 18F-fluorodeoxyglucose (FDG) PET/CT, 18F-fluorothymidine (FLT) PET/CT, and 61Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) PET/CT. Images were co-registered and standardized uptake values (SUV) were calculated for all modalities. Voxel-based correlation was evaluated with Pearson’s correlation coefficient in tumor regions. Additionally, sensitivity studies were performed to quantify the effects of image segmentation, registration, noise, and segmentation on R. Results On average, FDG PET and FLT PET images were most highly correlated (RFDG:FLT=0.76, range 0.53–0.85), while Cu-ATSM PET showed greater heterogeneity in correlation to other tracers (RFDG:Cu-ATSM=0.64, range 0.51–0.79; RFLT:Cu-ATSM=0.61, range 0.21–0.80). Of the tested parameters, correlation was most sensitive to image registration. Misregistration of one voxel lead to ?RFDG=0.25, ?RFLT=0.39, and ?RCu-ATSM=0.27. Image noise and reconstruction also had quantitative effects on correlation. No significant quantitative differences were found between GTV, expanded GTV, or CTV regions. Conclusions Voxel-based correlation represents a first step into understanding spatial organization of tumor phenotype. These results have implications for radiotherapy target definition and provide a framework to test outcome prediction based on pretherapy distribution of phenotype. PMID:23068711

  14. 89Zr-huJ591 immuno-PET imaging in patients with advanced metastatic prostate cancer

    PubMed Central

    O’Donoghue, Joseph A.; Beylergil, Volkan; Lyashchenko, Serge; Ruan, Shutian; Solomon, Stephen B.; Durack, Jeremy C.; Carrasquillo, Jorge A.; Lefkowitz, Robert A.; Gonen, Mithat; Lewis, Jason S.; Holland, Jason P.; Cheal, Sarah M.; Reuter, Victor E.; Osborne, Joseph R.; Loda, Massimo F.; Smith-Jones, Peter M.; Weber, Wolfgang A.; Bander, Neil H.; Scher, Howard I.; Morris, Michael J.; Larson, Steven M.

    2015-01-01

    Purpose Given the bone tropism of prostate cancer, conventional imaging modalities poorly identify or quantify metastatic disease. 89Zr-huJ591 positron emission tomography (PET) imaging was performed in patients with metastatic prostate cancer to analyze and validate this as an imaging biomarker for metastatic disease. The purpose of this initial study was to assess safety, biodistribution, normal organ dosimetry, and optimal imaging time post-injection for lesion detection. Methods Ten patients with metastatic prostate cancer received 5 mCi of 89Zr-huJ591. Four whole-body scans with multiple whole-body count rate measurements and serum activity concentration measurements were obtained in all patients. Biodistribution, clearance, and lesion uptake by 89Zr-huJ591 immuno-PET imaging was analyzed and dosimetry was estimated using MIRD techniques. Initial assessment of lesion targeting of 89Zr-huJ591 was done. Optimal time for imaging post-injection was determined. Results The dose was well tolerated with mild chills and rigors seen in two patients. The clearance of 89Zr-huJ591 from serum was bi-exponential with biological half-lives of 7 ± 4.5 h (range 1.1–14 h) and 62 ± 13 h (range 51–89 h) for initial rapid and later slow phase. Whole-body biological clearance was 219 ± 48 h (range 153–317 h). The mean whole-body and liver residence time was 78.7 and 25.6 h, respectively. Dosimetric estimates to critical organs included liver 7.7 ± 1.5 cGy/mCi, renal cortex 3.5 ± 0.4 cGy/mCi, and bone marrow 1.2 ± 0.2 cGy/mCi. Optimal time for patient imaging after injection was 7 ± 1 days. Lesion targeting of bone or soft tissue was seen in all patients. Biopsies were performed in 8 patients for a total 12 lesions, all of which were histologically confirmed as metastatic prostate cancer. One biopsy-proven lesion was not positive on 89Zr-huJ591, while the remaining 11 lesions were 89Zr-huJ591 positive. Two biopsy-positive nodal lesions were noted only on 89Zr-huJ591 study, while the conventional imaging modality was negative. Conclusion 89Zr-huJ591 PET imaging of prostate-specific membrane antigen expression is safe and shows good localization of disease in prostate cancer patients. Liver is the critical organ for dosimetry, and 7 ± 1 days is the optimal imaging time. A larger study is underway to determine lesion detection in an expanded cohort of patients with metastatic prostate cancer. PMID:25143071

  15. Patient-controlled sharing of medical imaging data across unaffiliated healthcare organizations

    PubMed Central

    Ahn, David K; Unde, Bhagyashree; Gage, H Donald; Carr, J Jeffrey

    2013-01-01

    Background Current image sharing is carried out by manual transportation of CDs by patients or organization-coordinated sharing networks. The former places a significant burden on patients and providers. The latter faces challenges to patient privacy. Objective To allow healthcare providers efficient access to medical imaging data acquired at other unaffiliated healthcare facilities while ensuring strong protection of patient privacy and minimizing burden on patients, providers, and the information technology infrastructure. Methods An image sharing framework is described that involves patients as an integral part of, and with full control of, the image sharing process. Central to this framework is the Patient Controlled Access-key REgistry (PCARE) which manages the access keys issued by image source facilities. When digitally signed by patients, the access keys are used by any requesting facility to retrieve the associated imaging data from the source facility. A centralized patient portal, called a PCARE patient control portal, allows patients to manage all the access keys in PCARE. Results A prototype of the PCARE framework has been developed by extending open-source technology. The results for feasibility, performance, and user assessments are encouraging and demonstrate the benefits of patient-controlled image sharing. Discussion The PCARE framework is effective in many important clinical cases of image sharing and can be used to integrate organization-coordinated sharing networks. The same framework can also be used to realize a longitudinal virtual electronic health record. Conclusion The PCARE framework allows prior imaging data to be shared among unaffiliated healthcare facilities while protecting patient privacy with minimal burden on patients, providers, and infrastructure. A prototype has been implemented to demonstrate the feasibility and benefits of this approach. PMID:22886546

  16. Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research

    PubMed Central

    Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.

    2013-01-01

    Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

  17. Treatment of acutely ruptured wide-necked intracranial aneurysms using self-expanding stent

    PubMed Central

    Li, Hui; Guan, Jinqun; Liu, Jianfeng; Hou, Kai; Zhao, Di; Wu, Guobiao; Xu, Lifeng; Liu, Linlin

    2015-01-01

    Objectives: To evaluate the effectiveness and safety of self-expanding stent in treatment of acutely ruptured wide-necked intracranial aneurysms in the acute stage. Method: Treatment of 38 patients with self-expanding stent was retrospectively analyzed. Results: From January 2009 to May 2014, a total of 38 patients with 44 acutely ruptured wide-necked intracranial aneurysms were embolized with self-expanding stents at our center. Immediate post-operative imaging demonstrated that the aneurysms were densely packed in 17 patients, subtotally embolized in 2 patients, and subtotally embolized with residual aneurysm necks in 19 patients. At discharge, the patients were assessed for prognosis and the results revealed nerve dysfunction in 3 patients (7.9%), coma in 6 patients (15.8%), hospital death in 1 case (2.6%). Twenty-eight (73.7%) patients were asymptomatic at discharge. Ten of the 38 patients were followed up by angiography for a period of 3.7 months on average, which showed complete occlusion in 9 patients (90%), remnant aneurysm necks in 1 patient (10%), and no recanalization was observed in all the followed-up patients. Stent related complications also were recorded. Conclusion: Stent-assisted coiling is effective in treating acutely ruptured wide-necked intracranial aneurysms. Angiographic investigation and clinical follow-up is needed for evaluation of long-term clinical outcomes. PMID:25785122

  18. High-Cost Imaging in Elderly Patients with Stage IV Cancer

    PubMed Central

    2012-01-01

    Background Medicare expenditures for high-cost diagnostic imaging have risen faster than those for total cancer care and have been targeted for potential cost reduction. We sought to determine recent and long-term patterns in high-cost diagnostic imaging use among elderly (aged ?65 years) patients with stage IV cancer. Methods We identified claims within the Surveillance, Epidemiology, and End Results (SEER)-Medicare database with computed tomography, magnetic resonance imaging, positron emission tomography, and nuclear medicine scans between January 1994 and December 2009 for patients diagnosed with stage IV breast, colorectal, lung, or prostate cancer between January 1995 and December 2006 (N = 100 594 patients). The proportion of these patients imaged and rate of imaging per-patient per-month of survival were calculated for each phase of care in patients diagnosed between January 2002 and December 2006 (N = 55 253 patients). Logistic regression was used to estimate trends in imaging use in stage IV patients diagnosed between January 1995 and December 2006, which were compared with trends in imaging use in early-stage (stages I and II) patients with the same tumor types during the same period (N = 192 429 patients). Results Among the stage IV patients diagnosed between January 2002 and December 2006, 95.9% underwent a high-cost diagnostic imaging procedure, with a mean number of 9.79 (SD = 9.77) scans per patient and 1.38 (SD = 1.24) scans per-patient per-month of survival. After the diagnostic phase, 75.3% were scanned again; 34.3% of patients were scanned in the last month of life. Between January 1995 and December 2006, the proportion of stage IV cancer patients imaged increased (relative increase = 4.6%, 95% confidence interval [CI] = 3.7% to 5.6%), and the proportion of early-stage cancer patients imaged decreased (relative decrease = ?2.5%, 95% CI = ?3.2% to ?1.9%). Conclusions Diagnostic imaging is used frequently in patients with stage IV disease, and its use increased more rapidly over the decade of study than that in patients with early-stage disease. PMID:22851271

  19. Combined Fourier amplitude and phase imaging in patients with coronary artery disease.

    PubMed

    Alcan, K E; Robeson, W; Graham, M C; Palestro, C; Oliver, F H; Benua, R S

    1984-12-01

    Fourier amplitude and phase image analysis were evaluated in 66 patients. Thirty patients served as a control group and 36 had coronary artery disease (CAD). Each patient in our control group had a rest and exercise radionuclide cineangiogram (RNCA) study (60 total). The amplitude and phase images for controls were uniform. No statistically significant difference in the histogram distribution of amplitude or phase occurred between rest and exercise. Twenty-five patients with CAD had a prior myocardial infarction (MI). Fourier analysis, when compared to the left ventricular ejection fraction (LVEF) and visual cine wall motion analysis, improved the sensitivity of the rest RNCA study to detect CAD from 68% to 92%. Regional Fourier amplitude and phase image analysis demonstrated an 85% sensitivity in localizing regions of previous infarction. Thirteen of 25 patients with prior MI and an additional 11 patients with recent onset of angina but no previous infarction, had exercise RNCA studies. When compared to cardiac catheterization data, regional Fourier amplitude and phase image analysis demonstrated sensitivities of 87% and 80%, respectively, in correctly identifying clinically significant major coronary artery involvement in these two subsets of patients. Fourier amplitude and phase image analysis were also able to distinguish normals from patients with previous MI, and patients with CAD but no prior infarction. All comparisons were statistically significant. We conclude that the semiquantitative image analysis of Fourier amplitude and phase data increases the clinical utility of the RNCA study in patients with CAD. PMID:6096069

  20. Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT

    Microsoft Academic Search

    G. A. Santa Cruz; J. Bertotti; J. Marín; S. J. González; S. Gossio; D. Alvarez; B. M. C. Roth; P. Menéndez; M. D. Pereira; M. Albero; L. Cubau; P. Orellano; S. J. Liberman

    2009-01-01

    We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal and abnormal physiologic response of the nervous and vascular systems, as well as the

  1. Turkish hysterectomy and mastectomy patients - depression, body image, sexual problems and spouse relationships.

    PubMed

    Keskin, Gulseren; Gumus, Aysun Babacan

    2011-01-01

    The aim of this study was to compare hysterectomy and mastectomy patients in terms of depression, body image, sexual problems and spouse relations. The study group comprised 94 patients being treated in Ege University Radiation Oncology Clinic, Tulay Aktas Oncology Hospital, Izmir Aegean Obstetrics and Gynecology Training and Research Hospital for breast and gynecological cancer (42 patients underwent mastectomy, 52 patient underwent hysterectomy). Five scales were used in the study: Sociodemographic Data Form, Beck Depression Scale, Body Image Scale, Dyadic Adjustment Scale, Golombok Rust Sexual Functions Scale. Mastectomy patients were more depressive than hysterectomy patients (t = 2.78, p < 0.01). Body image levels of the patients were bad but there was no significant difference between the two patient groups (p > 0.05). Hysterectomy patients had more problems in terms of vaginismus (t = 2.32, p < 0.05), avoidance of sexual intercourse (t = 2.31, p < 0.05), communication (t = 2.06, p < 0.05), and frequency of sexual intercourse than mastectomy patients (t = 2.10, p < 0.05). As compared with compliance levels between patients and spouses; hysterectomy patients had more problems related to expression of emotions than mastectomy patients (t = 2.12, p < 0.05). In conclusion, body image was negative, mastectomy was associated with more depression and hysterectomy with greater sexual problems and difficulties with spouse relationships. PMID:21545207

  2. Anti-leukemia effect of ex vivo expanded DNT cells from AML patients: a potential novel autologous T-cell adoptive immunotherapy

    Microsoft Academic Search

    S Merims; X Li; B Joe; P Dokouhaki; M Han; R W Childs; Z-Y Wang; V Gupta; M D Minden; L Zhang

    2011-01-01

    CD3+CD56?, CD4 and CD8 double negative T (DNT) cells comprise 1–3% of peripheral blood (PB) mononuclear cells. Their role in tumor immunity remains largely unknown due to their limited numbers and lack of effective methods to expand them. Here we developed a novel protocol by which DNT cells can be expanded ex vivo to therapeutic levels in 2 weeks from

  3. [Chronic expanding hematoma of the soleus: a case report].

    PubMed

    Pichon, H; Pittet Barbier, L; Pasquier, B; Cartier, J; Saragaglia, D

    2006-11-01

    Trauma-induced hematomas of the limbs usually resorb without sequelae. In certain circumstances which are not fully understood, the hematoma may expand progressively, eventually leading to the development of a tumor-like mass in the soft tissues. We report the case of a chronic expanding hematoma observed in the right soleus muscle of a 75-year-old man. The mass grew +9 cm compared with the other side over a period of two to three years with no notion of recent trauma. Surgical biopsy disclosed a thick capsule containing "chocolate pus". Pathology and cytology examination led to the diagnosis of pseudo-tumor calcinosis subsequent to a hematoma which the patient had developed 34 years earlier when as a mountain guide he had experienced a tear of the soleus muscle. Local care required complete resection of the soleus muscle. The patient was able to resume activities without pain. Well described in the literature, encapsulated hematoma of the limbs is not well known in France. This case illustrated the potentially long latency period (34 years in our patient). Pathologically similar to tumor calcinosis, chronic expanding hematoma should be entertained as a possible diagnosis in a patient with a longstanding mass and a history of past trauma. The differential diagnosis with sarcoma is established by magnetic resonance imaging which reveals a peripheral low intensity signal on T1 and T2 sequences. PMID:17124458

  4. An international expanded-access programme of everolimus: Addressing safety and efficacy in patients with metastatic renal cell carcinoma who progress after initial vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy

    Microsoft Academic Search

    Viktor Grünwald; Pierre I. Karakiewicz; Sevil E. Bavbek; Kurt Miller; Jean-Pascal Machiels; Se-Hoon Lee; James Larkin; Petri Bono; Sun Young Rha; Daniel Castellano; Christian U. Blank; Jennifer J. Knox; Robert Hawkins; Oezlem Anak; Marianne Rosamilia; Jocelyn Booth; Nicoletta Pirotta; István Bodrogi

    Background and objectivesThe RECORD-1 trial established the clinical benefit of everolimus in patients with metastatic renal cell carcinoma (mRCC) after failure of initial vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFr-TKI) therapy. The REACT (RAD001 Expanded Access Clinical Trial in RCC) study was initiated to address an unmet medical need by providing everolimus prior to commercial availability, and also to

  5. Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: a report of seven cases.

    PubMed

    Su, K P; Hsu, C Y; Hsieh, S C; Shen, W W

    2001-04-01

    Delusions associated with cerebrovascular diseases have been sporadically reported. Although both psychiatrists and neurologists attempted to link delusions with anatomical locations of the brain lesion, comorbid psychiatric and neurological disorders make the interpretation of delusions difficult. The purpose of the present paper is to report the clinical features and magnetic resonance imaging (MRI) characteristics in patients with delusional disorder due to diffuse cerebrovascular diseases, and to redefine the concept of 'vascular delusion'. The clinical features and MRI findings were reviewed retrospectively in a series of seven patients with 'delusional disorder due to cerebrovascular disease' as defined in Diagnostic and Statistical Manual of Mental Disorders (DSMIV). The average age of onset is 64. No patient had a prior personal or family history of major psychiatric illness. The illness is presented as acute, subacute or stepwise course. Hypertension was present in all patients. Two had diabetes mellitus, and one had atrial fibrillation. Three had clinical evidence of previous cerebrovascular attacks, only one showed minor neurological deficits. Three had diffuse cortical slow wave in electroencephalogram. No patient had significant cognitive impairment but had multiple cortical and subcortical cerebrovascular lesions in MRI, with white-matter lesions (WML) in bilateral frontal areas. Delusional disorder due to diffuse cerebrovascular change is characterized by late-onset, stepwise course, and comorbid medical and neurological diseases. The results of vascular changes in the present study did not establish a cause-effect relationship and should be considered as multifactorial in pathogenesis. The findings suggested the hypothesis of neural circuit theory. Further studies in larger numbers of patients and newer neuroimaging techniques are needed to expand the knowledge learned from these findings. PMID:11285090

  6. Need for routine delayed radionuclide hepatobiliary imaging in patients with intercurrent disease

    SciTech Connect

    Drane, W.E.; Nelp, W.B.; Rudd, T.G.

    1984-06-01

    A retrospective review was made of all radionuclide hepatobiliary studies performed in a major trauma center over a 27-month period and correlated with the patients' clinical course. In a population of 42 patients (27 of whom were on total parenteral nutrition (TPN)) who had severe intercurrent illness (primarily trauma), and an additional 18 patients who had hepatocellular dysfunction, hepatobiliary imaging confirmed a patent cystic duct in 43 of 60 patients (72%). Of 17 patients who had nonvisualization of the gallbladder, four had surgically proved acute cholecystitis. The presence of gallstones, wall thickening, or sludge on sonograms did not correlate with cystic duct patency, and was not specific for acute cholecystitis. Though gallbladder function is compromised in the population with severe intercurrent disease, radionuclide hepatobiliary imaging is still valuable; it can confirm a patent systic duct in at least 72% of patients if routine imaging is continued for up to 24 hours.

  7. [Image fusion methods for the repositioning of the patient in radiotherapy].

    PubMed

    Troccaz, J; Vassal, P; Giraud, J Y; le Verre, C; Artignan, X; Bolla, M

    2000-11-01

    Conformal radiotherapy requires the accurate and reproducible setup of the patient for each fraction delivery. Megavoltage imaging could enable this. This requires the development of image processing and data fusion algorithms. We describe an automated method based on the use of mutual information for registration. Such a method does not require any preliminary segmentation of the images. This method has been extensively tested on phantom as well as on some patient data. The obtained results demonstrated that this automated method for 2D/2D registration is rapid, accurate and robust even in the case of blurred images for small treatment fields. PMID:11194962

  8. Diffusion-Weighted MR Imaging of Cholesteatoma in Pediatric and Adult Patients Who Have Undergone Middle Ear Surgery

    Microsoft Academic Search

    Gustav Carus

    OBJECTIVE. The aim of this prospective study was to determine the role of diffusion- weighted MR imaging combined with conventional MR imaging for the detection of residual or recurrent cholesteatoma in patients who have undergone middle ear surgery. SUBJECTS AND METHODS. Twenty-two patients who had undergone resection of cholesteatoma were referred for MR imaging. MR imaging (1.5 T) was performed

  9. The expandable mammary implant.

    PubMed

    Becker, H

    1987-04-01

    An expandable saline-gel implant having a detachable injection dome is described. The implant functions initially as a tissue expander. Once the correct size has been obtained, the injection dome is removed, leaving the implant in position. PMID:3823256

  10. Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation

    SciTech Connect

    Camp, A.D.; Garvin, P.J.; Hoff, J.; Marsh, J.; Byers, S.L.; Chaitman, B.R. (St. Louis Univ. School of Medicine, MO (USA))

    1990-06-15

    Patients with diabetes and end-stage renal failure are known to have a high risk for cardiac morbidity and mortality associated with renal transplantation. The most efficient method to determine preoperative cardiac risk has not been established. To determine the effectiveness of intravenous dipyridamole thallium imaging in predicting cardiac events, 40 diabetic renal transplant candidates were studied preoperatively in a prospective trial. The study group consisted of 40 patients whose average age was 42 years (range 27 to 64); 34 (85%) were hypertensive and 21 (53%) were cigarette smokers. Cardiac history included chest pain in 6 patients and prior myocardial infarction in 3 patients. Dipyridamole thallium imaging showed reversible defects in 9 patients, fixed defects in 8 patients and normal scans in 23 patients. Dipyridamole thallium imaging was performed using 0.56 mg/kg of dipyridamole infused intravenously over 4 minutes. Cardiac events occurred only in patients with reversible thallium defects, of which there were 6. Of these 6 patients, 3 had cardiac events before transplantation and 3 had them in the early postoperative phase (within 6 weeks of surgery). Of 21 patients who underwent renal transplantation, 3 had cardiac events within 6 weeks of transplantation. The average duration of follow-up was 11 months (range 1 to 21). Thus, dipyridamole thallium imaging is an effective method of identifying renal transplant candidates likely to develop cardiac complications. Routine coronary angiography may not be necessary to screen all renal transplant candidates for coronary artery disease before surgery.

  11. Patient-blaming and representation of risk factors in breast cancer images.

    PubMed

    Andsager, J L; Hust, S J; Powers, A

    2000-01-01

    Media coverage of some cancers in the past often equated cancer with a death sentence. Breast cancer coverage in 1990s magazines, however, has become less fatalistic, more frequent, and discusses a broader range of issues than before. This study examined whether the visual images accompanying magazine articles about breast cancer have also evolved. We used Goffman's (1976) rituals of subordination to measure patient-blaming and subordinating, disempowering images. We also analyzed race/ethnicity, body type, and age of females in the images to gauge whether these demographic risk factors were represented in a random sample of images from nine magazines over a 30-year period. Magazines analyzed represented three genres-women's magazines, fashion/beauty, and general news. Findings suggest that patient-blaming images have decreased in some categories and women portrayed are slightly more representative of risk factors of age and race/ethnicity. Magazine images tended to reinforce stereotyped portrayals of femininity to the detriment of cancer patients. Fashion/beauty magazines, aimed at younger women, were most likely to portray breast cancer images in stereotyped, patient-blaming ways, with the least representative images of risk factors. The social construction of feminine beauty seems to overpower accuracy in creating these images. PMID:11289686

  12. The need for routine delayed radionuclide hepatobiliary imaging in patients with intercurrent disease

    SciTech Connect

    Drane, W.E.; Nelp, W.B.; Rudd, T.G.

    1984-06-01

    A retrospective review was made of all radionuclide hepatobiliary studies performed in a major trauma center over a 27-month period and correlated with the patients' clinical course. In a population of 42 patients (27 of whom were on total parenteral nutrition (TPN)) who had severe intercurrent illness (primarily trauma), and an additional 18 patients who had hepatocellular dysfunction, hepatobiliary imaging confirmed a patent cystic duct in 43 of 60 patients (72%). Fourteen of these 43 patients (33%) had gallbladder visualization at later than one hour after radiotracer administration, and seven of these 14 required imaging from four to 24 hours. Of 17 patients who had nonvisualization of the gallbladder, four had surgically proved acute cholecystitis. Images of nine of the remaining 13 patients with gallbladder nonvisualization were not obtained for 24 hours. The presence of gallstones, wall thickening, or sludge on sonograms did not correlate with cystic duct patency, and was not specific for acute cholecystitis. Though gallbladder function is compromised in the population with severe intercurrent disease, radionuclide hepatobiliary imaging is still valuable; it can confirm a patent cystic duct in at least 72% of patients if routine imaging is continued for up to 24 hours.

  13. Image-to-patient registration by natural anatomical surfaces of the head

    Microsoft Academic Search

    Rüdiger Marmulla; Joachim Mühling; Georg Eggers

    2007-01-01

    The use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts.\\u000a \\u000a During the preparation of image guided surgery, automated markerless patient-to-image registration based on anatomical surfaces\\u000a allows a significant reduction of preoperative effort and of the radiation dose the patient is exposed to. Placement and measurement\\u000a of radio-opaque fiducial markers becomes unnecessary. The usability of

  14. Coping and self-image in patients with symptoms attributed to indoor environment.

    PubMed

    Edvardsson, B; Bergdahl, J; Eriksson, N; Stenberg, B

    2013-01-01

    This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure. PMID:23566321

  15. Solitary fibrous tumors in the extremities: imaging findings for six patients.

    PubMed

    Hyodo, Ryota; Komada, Tomohiro; Takada, Akira; Kawai, Hisashi; Ito, Shinji; Nishida, Yoshihiro; Naganawa, Shinji

    2015-02-01

    The purpose of this study was to describe the magnetic resonance imaging (MRI) and computed tomography (CT) findings for solitary fibrous tumors (SFTs) in the extremities in correlation with histopathological findings. Between 2006 and 2013, 6 consecutive patients with SFT in an extremity were studied with MRI (6 patients) and CT (4 patients). Diffusion-weighted images were also performed in 3 patients and dynamic contrast-enhanced CT in 2 patients. All 6 tumors were diagnosed after surgical excision, and the pre-surgical imaging findings were correlated with the histopathological findings. As a result, all 6 patients were female, and each had a clearly palpable, well-circumscribed, round or oval mass adjacent to fascia in an extremity, of less than 10 cm maximum diameter in 5 patients. On MRI, the tumors were iso-intense with muscle on T1-weighted image, and appeared heterogeneous and high-intensity on T2-weighted image. After injection of a contrast agent, the tumors demonstrated strong enhancement. A vascular pedicle was detected in 4 patients with tumors having a maximum diameter more than 5 cm. Diffusion-weighted images demonstrated high signal intensities, and apparent diffusion coefficient values were iso to high compared to muscle (from 1.41-2.10×10(-3) mm(2)/s). All the tumors were benign histopathologically and clinically. In 1 patient, the imaging appearance revealed underlying histopathological components, including fibrous-rich, cellular-rich, and myxoid change areas. In conclusion, a SFT in an extremity comprises a well-circumscribed mass adjacent to fascia having a fibrous-dominant area, strong contrast enhancement, and a vascular pedicle. PMID:25797981

  16. SOLITARY FIBROUS TUMORS IN THE EXTREMITIES: IMAGING FINDINGS FOR SIX PATIENTS

    PubMed Central

    HYODO, RYOTA; KOMADA, TOMOHIRO; TAKADA, AKIRA; KAWAI, HISASHI; ITO, SHINJI; NISHIDA, YOSHIHIRO; NAGANAWA, SHINJI

    2015-01-01

    ABSTRACT The purpose of this study was to describe the magnetic resonance imaging (MRI) and computed tomography (CT) findings for solitary fibrous tumors (SFTs) in the extremities in correlation with histopathological findings. Between 2006 and 2013, 6 consecutive patients with SFT in an extremity were studied with MRI (6 patients) and CT (4 patients). Diffusion-weighted images were also performed in 3 patients and dynamic contrast-enhanced CT in 2 patients. All 6 tumors were diagnosed after surgical excision, and the pre-surgical imaging findings were correlated with the histopathological findings. As a result, all 6 patients were female, and each had a clearly palpable, well-circumscribed, round or oval mass adjacent to fascia in an extremity, of less than 10 cm maximum diameter in 5 patients. On MRI, the tumors were iso-intense with muscle on T1-weighted image, and appeared heterogeneous and high-intensity on T2-weighted image. After injection of a contrast agent, the tumors demonstrated strong enhancement. A vascular pedicle was detected in 4 patients with tumors having a maximum diameter more than 5 cm. Diffusion-weighted images demonstrated high signal intensities, and apparent diffusion coefficient values were iso to high compared to muscle (from 1.41–2.10×10–3 mm2/s). All the tumors were benign histopathologically and clinically. In 1 patient, the imaging appearance revealed underlying histopathological components, including fibrous-rich, cellular-rich, and myxoid change areas. In conclusion, a SFT in an extremity comprises a well-circumscribed mass adjacent to fascia having a fibrous-dominant area, strong contrast enhancement, and a vascular pedicle. PMID:25797981

  17. Fundus autofluorescence in patients with macular holes imaged with a laser scanning ophthalmoscope

    Microsoft Academic Search

    Andrea von Rückmann; Fredrick W Fitzke; Zdenek J Gregor

    1998-01-01

    AIMTo demonstrate the usefulness of a recently developed technique of imaging fundus autofluorescence and to compare it with the results of fluorescein angiography in the diagnosis and staging of macular holes.METHODSThe intensity and distribution of fundus autofluorescence was studied in 51 patients with idiopathic macular holes and pseudoholes using a confocal laser scanning ophthalmoscope (cLSO) and the images were compared

  18. Evaluation of the effects of patient arm attenuation in SPECT cardiac perfusion imaging

    Microsoft Academic Search

    Dershan Lou; Michael A. King; Tin-Su Pan; Weishi Xia

    1996-01-01

    It was hypothesized that the use of attenuation correction could compensate for degradation in the uniformity of apparent localization of imaging agents seen in cardiac walls when patients are imaged with arms at their sides. Noise-free simulations of the digital MCAT phantom were employed to investigate this hypothesis. Four variations in camera size and collimation scheme were investigated. We observed

  19. Development of A Novel Image Guidance Alternative for Patient Localization using Topographic Images for TomoTherapy

    NASA Astrophysics Data System (ADS)

    Qi, X. Sharon; White, Benjamin; Low, Daniel A.

    2014-03-01

    To develop a faster and lower dose topogram based image registration for TomoTherapy as an alternative image guidance tool to volumetric megavoltage computed tomography (MVCT). Topogram procedures were performed for an anthropomorphic thorax phantom on a TomoTherapy HD unit (Accuray Inc., Sunnyvale, CA) using couch speeds from 1-4 cm/s and gantry angles of 0 and 90 degrees, other scanning parameters are: 1 mm imaging jaw, compression factor of 1, 30 seconds scanning duration with all multileaf collimators (MLCs) open. The raw exit detector data was exported after each scan. The topogram was reconstructed from a fan beam source for TomoTherapy beam and detector geometry at a SSD of 85 cm. A reference image, so called Digitally Reconstructed Topogram (DRT) was created by integrating the trajectories through the kVCT simulation with the topogram geometry. Image registration was performed by visually aligning the bony structure in topogram to the DRT. Image resolution was determined by the radius of curvature for the detector array, source to axis distance, source to detector distance, detector spacing, and number of detectors. The localization errors were 1.5, 2.5 mm in medio-lateral and anterior-posterior direction, larger errors in cranial-caudal direction was observed for faster couch speeds (i.e., >=3cm/s). The topographic imaging time was 30 sec (versus 3-5 minutes for MVCT thorax scan) with imaging dose less than 1% of MVCT scan. Topograms with appropriate couch speed provide reliable patient localization images while significantly reducing pre-treatment imaging time. Topogram can be used as an alternative and/or additional patient alignment tool to MVCT on TomoTherapy.

  20. Abnormal brain magnetic resonance imaging in two patients with Smith-Magenis syndrome.

    PubMed

    Maya, Idit; Vinkler, Chana; Konen, Osnat; Kornreich, Liora; Steinberg, Tamar; Yeshaya, Josepha; Latarowski, Victoria; Shohat, Mordechai; Lev, Dorit; Baris, Hagit N

    2014-08-01

    Smith-Magenis syndrome (SMS) is a clinically recognizable contiguous gene syndrome ascribed to an interstitial deletion in chromosome 17p11.2. Seventy percent of SMS patients have a common deletion interval spanning 3.5 megabases (Mb). Clinical features of SMS include characteristic mild dysmorphic features, ocular anomalies, short stature, brachydactyly, and hypotonia. SMS patients have a unique neurobehavioral phenotype that includes intellectual disability, self-injurious behavior and severe sleep disturbance. Little has been reported in the medical literature about anatomical brain anomalies in patients with SMS. Here we describe two patients with SMS caused by the common deletion in 17p11.2 diagnosed using chromosomal microarray (CMA). Both patients had a typical clinical presentation and abnormal brain magnetic resonance imaging (MRI) findings. One patient had subependymal periventricular gray matter heterotopia, and the second had a thin corpus callosum, a thin brain stem and hypoplasia of the cerebellar vermis. This report discusses the possible abnormal MRI images in SMS and reviews the literature on brain malformations in SMS. Finally, although structural brain malformations in SMS patients are not a common feature, we suggest baseline routine brain imaging in patients with SMS in particular, and in patients with chromosomal microdeletion/microduplication syndromes in general. Structural brain malformations in these patients may affect the decision-making process regarding their management. PMID:24788350

  1. Silent radiological imaging time in patients with brain metastasis

    Microsoft Academic Search

    Kyriaki Mystakidou; Efstathios J Boviatsis; Andreas T Kouyialis; Konstantinos Voumvourakis; Vassilios Kouloulias; John Kouvaris; Lambros Vlahos

    2004-01-01

    Cerebral metastasis is a common finding in patients with systemic carcinoma and is an indication for progress of the disease. When brain metastases occur, they lead to a considerable decrease in both survival and the quality of life, in patients who otherwise might be functional. Furthermore, the location, size and number of such lesions, play a decisive role in management

  2. Prognostic value of exercise thallium-201 imaging in patients presenting for evaluation of chest pain

    Microsoft Academic Search

    Kenneth A. Brown; Charles A. Boucher; Robert D. Okada; Timothy E. Guiney; John B. Newell; H. William Strauss; Gerald M. Pohost

    1983-01-01

    Accurate prognostic information is important in determining optimal management of patients presenting for evaluation of chest pain. In this study, the ability of exercise thallium-201 myocardial imaging to predict future cardiac events (cardiovascular death or nonfatal myocardial infarction) was correlated with clinical, coronary and left ventricular angiographic and exercise electrocardiographic data in 139 consecutive, nonsurgically managed patients followed-up over a

  3. Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope

    Microsoft Academic Search

    J N Kirkpatrick; A Manivannan; A K Gupta; J Hipwell; J V Forrester; P F Sharp

    1995-01-01

    AIMS--An investigation was carried out to compare the image quality of the ocular fundus obtained clinically, photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelengths in patients with significant cataract. METHODS--Nineteen patients admitted for routine cataract extraction were examined clinically by two independent observers to ascertain cataract type and clarity of fundus view with an indirect

  4. Thoracolumbar fracture in blunt trauma patients: guidelines for diagnosis and imaging

    Microsoft Academic Search

    Jeremy M. Hsu; Tony Joseph; Andrew M. Ellis

    2003-01-01

    Objective: The aim of the study was to determine a clinical diagnostic pathway for the imaging of the thoracolumbar spine in blunt trauma patients.Method: A literature review was undertaken to determine the factors important in the detection of thoracolumbar injury and also to produce a trial protocol, which could be tested retrospectively. Two hundred patients admitted between 1998 and 2000

  5. Endoscopic sinus surgery with magnetic resonance imaging guidance: Initial patient experience

    Microsoft Academic Search

    MARVIN P. FRIED; GEORGE TOPULOS; LIANGGE HSU; HEYAM JALAHEJ; HARSHA GOPAL; ARTHUR LAURETANO; PAUL R. MORRISON; FERENC A. JOLESZ

    1998-01-01

    We report the first endoscopic surgeries performed with patients under general anesthesia using intraoperative guidance with MRI. The procedures were experimental and intended to test (1) the unusual working environment of a unique new “open-configuration” MRI unit for head and neck surgery, and (2) real-time image guidance. Twelve patients underwent endoscopic sinus surgery while under general anesthesia in a new

  6. Expanding Eligibility for Outpatient Treatment of Deep Venous Thrombosis and Pulmonary Embolism With Low-Molecular-Weight Heparin A Comparison of Patient Self-Injection With Homecare Injection

    Microsoft Academic Search

    Philip S. Wells; Michael J. Kovacs; Janis Bormanis; Melissa A. Forgie; Donna Goudie; Bev Morrow; Judy Kovacs

    1998-01-01

    Background: The outpatient treatment of patients with deep vein thrombosis and pulmonary embolism using low- molecular-weight heparin has the potential to reduce health care costs, but it is unclear if most patients with deep vein thrombosis and pulmonary embolism can be treated as out- patients. In the published studies, more than 50% of pa- tients were excluded from outpatient treatment

  7. Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy

    Microsoft Academic Search

    Mohammad K. Islam; Thomas G. Purdie; Bernhard D. Norrlinger; Hamideh Alasti; Douglas J. Moseley; Michael B. Sharpe; Jeffrey H. Siewerdsen; David A. Jaffray

    2006-01-01

    Kilovoltage cone-beam computerized tomography (kV-CBCT) systems integrated into the gantry of linear accelerators can be used to acquire high-resolution volumetric images of the patient in the treatment position. Using on-line software and hardware, patient position can be determined accurately with a high degree of precision and, subsequently, set-up parameters can be adjusted to deliver the intended treatment. While the patient

  8. Multimode C-arm fluoroscopy, tomosynthesis, and cone-beam CT for image-guided interventions: from proof of principle to patient protocols

    NASA Astrophysics Data System (ADS)

    Siewerdsen, J. H.; Daly, M. J.; Bachar, G.; Moseley, D. J.; Bootsma, G.; Brock, K. K.; Ansell, S.; Wilson, G. A.; Chhabra, S.; Jaffray, D. A.; Irish, J. C.

    2007-03-01

    High-performance intraoperative imaging is essential to an ever-expanding scope of therapeutic procedures ranging from tumor surgery to interventional radiology. The need for precise visualization of bony and soft-tissue structures with minimal obstruction to the therapy setup presents challenges and opportunities in the development of novel imaging technologies specifically for image-guided procedures. Over the past ~5 years, a mobile C-arm has been modified in collaboration with Siemens Medical Solutions for 3D imaging. Based upon a Siemens PowerMobil, the device includes: a flat-panel detector (Varian PaxScan 4030CB); a motorized orbit; a system for geometric calibration; integration with real-time tracking and navigation (NDI Polaris); and a computer control system for multi-mode fluoroscopy, tomosynthesis, and cone-beam CT. Investigation of 3D imaging performance (noise-equivalent quanta), image quality (human observer studies), and image artifacts (scatter, truncation, and cone-beam artifacts) has driven the development of imaging techniques appropriate to a host of image-guided interventions. Multi-mode functionality presents a valuable spectrum of acquisition techniques: i.) fluoroscopy for real-time 2D guidance; ii.) limited-angle tomosynthesis for fast 3D imaging (e.g., ~10 sec acquisition of coronal slices containing the surgical target); and iii.) fully 3D cone-beam CT (e.g., ~30-60 sec acquisition providing bony and soft-tissue visualization across the field of view). Phantom and cadaver studies clearly indicate the potential for improved surgical performance - up to a factor of 2 increase in challenging surgical target excisions. The C-arm system is currently being deployed in patient protocols ranging from brachytherapy to chest, breast, spine, and head and neck surgery.

  9. Nasolacrimal system aeration on computed tomographic imaging: effects of patient positioning and scan orientation

    PubMed Central

    Czyz, Craig N; Bacon, Thomas S; Stacey, Andrew W; Cahill, Eva N; Costin, Bryan R; Karanfilov, Boris I; Cahill, Kenneth V

    2015-01-01

    Purpose To determine the impact of patient positioning and scan orientation on the appearance of air in the nasolacrimal drainage system on computed tomography (CT) imaging, and the repeatability of the observations. Methods This was a retrospective analysis of CT images for 92 patients. Results Air was found to be present more fully in the upright-position group as compared with the supine-position group. Comparing axial and coronal scan orientation, no difference in aeration was found, except for the nasolacrimal duct in the upright-position group. Conclusion Patient position should be accounted for in diagnostic conclusions and treatment decisions based on CT. PMID:25792799

  10. A Phase I study of AT-101 with Cisplatin and Etoposide in patients with advanced solid tumors with an Expanded Cohort in Extensive-Stage Small Cell Lung Cancer

    PubMed Central

    Schelman, William R.; Mohammed, Tabraiz A.; Traynor, Anne M.; Kolesar, Jill M.; Marnocha, Rebecca M.; Eickhoff, Jens; Keppen, Michael; Alberti, Dona B.; Wilding, George; Takebe, Naoko; Liu, Glenn

    2013-01-01

    Background A phase I, dose-escalation study of AT-101 with cisplatin and etoposide was conducted to determine the maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D), safety and pharmacokinetics in patients with advanced solid tumors, with an expanded cohort in patients with extensive-stage small cell lung cancer (ES-SCLC) to assess preliminary activity. Methods In the dose escalation portion, increasing doses of AT-101 were administered orally BID on days 1–3 along with cisplatin on day 1 and etoposide on days 1–3 of a 21 day cycle. At the RP2D, an additional 7 patients with untreated ES-SCLC were enrolled. Results Twenty patients were enrolled in the dose-escalation cohort, and 7 patients with ES-SCLC were enrolled in the expanded cohort. The MTD/RP2D was established at AT-101 40 mg BID days 1–3 with cisplatin 60 mg/m2 and etoposide 120 mg/m2 on day 1 of a 21 day cycle with pegfilgrastim support. Two DLTs of neutropenic fever were seen at dose level 1. After the addition of pegfilgrastim, no additional DLTs were observed. Grade 3/4 treatment-related toxicities included: diarrhea, increased AST, neutropenia, hypophosphatemia, hyponatremia, myocardial infarction and pulmonary embolism. No apparent PK interactions were observed between the agents. Preliminary activity was observed with PRs in patients with ES-SCLC, high-grade neuroendocrine tumor, esophageal cancer and NSCLC. Conclusions AT-101 with cisplatin and etoposide is well tolerated with growth factor support. Anti-tumor activity was observed in a variety of cancers including ES-SCLC, supporting further investigation with BH-3 mimetics in combination with standard chemotherapy for ES-SCLC. PMID:23860642

  11. Developing image-based electronic patient records for collaborative medical applications

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Sun, Jianyong; Yong, Yuanyuan; Chen, Xiaomeng; Yu, Fenghai; Zhang, Xiaoyan; Lian, Ping; Sun, Kun; Huang, H. K.

    2004-04-01

    We developed a Web-based system to interactively display image-based electronic patient records (EPR) for intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). We have successfully used this system two times for the teleconsultation on Severe acute respiratory syndrome (SARS) in Shanghai Xinhua Hospital and Shanghai Infection Hospital. During the consultation, both the physicians in infection control area and the experts outside the control area could interactively study, manipulate and navigate the EPR of the SARS patients to make more precise diagnosis on images with this system assisting. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications.

  12. DRR and portal image registration for automatic patient positioning in radiotherapy treatment.

    PubMed

    Bastida-Jumilla, Ma Consuelo; Larrey-Ruiz, Jorge; Verdú-Monedero, Rafael; Morales-Sánchez, Juan; Sancho-Gómez, José-Luis

    2011-12-01

    Image processing turns out to be essential in the planning and verification of radiotherapy treatments. Before applying a radiotherapy treatment, a dosimetry planning must be performed. Usually, the planning is done by means of an X-ray volumetric analysis using computerized tomography, where the area to be radiated is marked out. During the treatment phase, it is necessary to place the patient under the particle accelerator exactly as considered in the dosimetry stage. Coarse alignment is achieved using fiduciary markers placed over the patient's skin as external references. Later, fine alignment is provided by comparing a digitally reconstructed radiography (DRR) from the planning stage and a portal image captured by the accelerator in the treatment stage. The preprocessing of DRR and portal images, as well as the minimization of the non-shared information between both kinds of images, is mandatory for the correct operation of the image registration algorithm. With this purpose, mathematical morphology and image processing techniques have been used. The present work describes a fully automatic method to calculate more accurately the necessary displacement of the couch to place the patient exactly at the planned position. The proposed method to achieve the correct positioning of the patient is based on advanced image registration techniques. Preliminary results show a perfect match with the displacement estimated by the physician. PMID:21455811

  13. Surface imaging for patient setup and monitoring for breast radiotherapy

    E-print Network

    Book, Lynn Novella

    2007-01-01

    Approximately one in eight women will get breast cancer at some point in their lives. A promising new treatment is partial breast irradiation, in which multiple radiation beams cross at the tumor site within the patient. ...

  14. Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

    PubMed Central

    Guimaraes, Marcos Duarte; Hochhegger, Bruno; Santos, Marcel Koenigkam; Santana, Pablo Rydz Pinheiro; Sousa, Arthur Soares; Souza, Luciana Soares; Marchiori, Edson

    2015-01-01

    Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias. PMID:25798006

  15. Modeling Cardiovascular Anatomy from Patient-Specific Imaging

    NASA Astrophysics Data System (ADS)

    Bajaj, Chandrajit; Goswami, Samrat

    The importance of modern imaging techniques for capturing detailed structural information of a biological system cannot be understated. Unfortunately images do not reveal the "full functional story" and a spatially realistic computer model is often necessary for a comprehensive understanding of the complicated structural and physiological properties of the biological system's entities under investigation [1]. Deeper insights into structure-to-function relationships of different entities is achieved via finite element simulations of the modeled biomedical process. A 3D (three dimensional) finite element meshed computer model of the biological system is therefore a first step to perform such simulations.

  16. Perianal Sepsis in Hematologic Malignancy: MR Imaging Appearances and Distinction from Cryptoglandular Infection in Immunocompetent Patients.

    PubMed

    Plumb, Andrew A; Halligan, Steve; Bhatnagar, Gauraang; Taylor, Stuart A

    2015-07-01

    Purpose To use magnetic resonance (MR) imaging to document the appearance of perianal infection in patients with a hematologic malignancy (HM) compared with that in immunocompetent control patients. Materials and Methods After an ethical waiver was obtained, 38 patients with an HM were matched by age and sex to 38 control patients with no history of immunocompromise or Crohn disease. Both groups had undergone MR imaging for perianal symptoms and/or systemic sepsis. Two radiologists who were blinded to the diagnosis independently reviewed the MR images and recorded the size and distribution of abscesses and/or fistula tracts, the extent of perianal edema, and the likely diagnosis. Groups were compared by using the Mann-Whitney-Wilcoxon, ?(2), or Fisher exact test. Receiver operating characteristic (ROC) curves were constructed to estimate the ability of MR imaging to help distinguish patients with an HM from control patients. Results Patients with an HM had significantly greater perianal edema than did control patients (mean arc angle of anal canal involved, 220° vs 60°; P < .001). However, they had significantly lower rates of fistula (15 [39.5%] vs 35 [92.1%] of 38; P < .001). Abscesses were similar in frequency (10 [26.3%] vs 17 [44.7%] of 38; P = .15) and were unrelated to the degree of neutropenia (P = .71) or the use of chemotherapy (P = .10). Surgical treatment was rarely required in patients with an HM, either during the acute illness (four [10.5%] of 38) or thereafter (three [7.9%] of 38). MR imaging had an excellent ability to help discriminate patients with HM from immunocompetent patients (areas under the ROC curve, 0.91 and 0.97). Conclusion Perianal infection in patients with an HM is more likely to cause diffuse perianal edema and is less likely to cause fistulas than in immunocompetent patients. MR imaging can help distinguish patients with an HM from those without immunocompromise. (©) RSNA, 2015 Online supplemental material is available for this article. PMID:25759970

  17. Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

    PubMed

    Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

    2014-01-01

    Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care. PMID:25180648

  18. High-Resolution Imaging of Patients with Bietti Crystalline Dystrophy with CYP4V2 Mutation

    PubMed Central

    Gocho, Kiyoko; Kameya, Shuhei; Akeo, Keiichiro; Kikuchi, Sachiko; Usui, Ayumi; Yamaki, Kunihiko; Hayashi, Takaaki; Tsuneoka, Hiroshi; Mizota, Atsushi; Takahashi, Hiroshi

    2014-01-01

    The purpose of this study was to determine the retinal morphology of eyes with Bietti crystalline dystrophy (BCD) associated with a CYP4V2 mutation using high-resolution imaging techniques. Three subjects with BCD underwent detailed ophthalmic examinations. High-resolution fundus images were obtained with an adaptive optics (AO) fundus camera. A common homozygous mutation was detected in the three patients. Funduscopic examination of the three patients revealed the presence of crystalline deposits in the retina, and all of the crystalline deposits were also detected in the infrared (IR) images. The crystals observed in the IR images were seen as bright reflective plaques located on the RPE layer in the SD-OCT images. The clusters of hyperreflective signals in the AO images corresponded to the crystals in the IR images. High-magnification AO images revealed that the clusters of hyperreflective signals consisted of circular spots that are similar to the signals of cone photoreceptors. Most of these circular spots were detected in healthy areas in the FAF images. There is a possibility that circular spots observed by AO are residual cone photoreceptors located over the crystals. PMID:25276414

  19. Dose reduction and image quality optimizations in CT of pediatric and adult patients: phantom studies

    NASA Astrophysics Data System (ADS)

    Jeon, P.-H.; Lee, C.-L.; Kim, D.-H.; Lee, Y.-J.; Jeon, S.-S.; Kim, H.-J.

    2014-03-01

    Multi-detector computed tomography (MDCT) can be used to easily and rapidly perform numerous acquisitions, possibly leading to a marked increase in the radiation dose to individual patients. Technical options dedicated to automatically adjusting the acquisition parameters according to the patient's size are of specific interest in pediatric radiology. A constant tube potential reduction can be achieved for adults and children, while maintaining a constant detector energy fluence. To evaluate radiation dose, the weighted CT dose index (CTDIw) was calculated based on the CT dose index (CTDI) measured using an ion chamber, and image noise and image contrast were measured from a scanned image to evaluate image quality. The dose-weighted contrast-to-noise ratio (CNRD) was calculated from the radiation dose, image noise, and image contrast measured from a scanned image. The noise derivative (ND) is a quality index for dose efficiency. X-ray spectra with tube voltages ranging from 80 to 140 kVp were used to compute the average photon energy. Image contrast and the corresponding contrast-to-noise ratio (CNR) were determined for lesions of soft tissue, muscle, bone, and iodine relative to a uniform water background, as the iodine contrast increases at lower energy (i.e., k-edge of iodine is 33 keV closer to the beam energy) using mixed water-iodine contrast normalization (water 0, iodine 25, 100, 200, and 1000 HU, respectively). The proposed values correspond to high quality images and can be reduced if only high-contrast organs are assessed. The potential benefit of lowering the tube voltage is an improved CNRD, resulting in a lower radiation dose and optimization of image quality. Adjusting the tube potential in abdominal CT would be useful in current pediatric radiography, where the choice of X-ray techniques generally takes into account the size of the patient as well as the need to balance the conflicting requirements of diagnostic image quality and radiation dose optimization.

  20. Wide-field imaging and OCT vs clinical evaluation of patients referred from diabetic retinopathy screening

    PubMed Central

    Manjunath, V; Papastavrou, V; Steel, D H W; Menon, G; Taylor, R; Peto, T; Talks, J

    2015-01-01

    Purpose Compare wide-field Optomap imaging and optical coherence tomography (OCT) with clinical examination in diabetic retinopathy (DR). Methods Patients referred from Diabetic Eye Screening Programmes to three centres underwent dilated ophthalmoscopy and were assigned a DR grade. Wide-field colour imaging and OCT were then examined by the same clinician at that visit and a combined grade was assigned. Independent graders later reviewed the images and assigned an imaging-only grade. These three grades (clinical, combined, and imaging) were compared. The method that detected the highest grade of retinopathy, including neovascularisation, was determined. Results Two thousand and forty eyes of 1023 patients were assessed. Wide-field imaging compared with clinical examination had a sensitivity and specificity of 73% and 96%, respectively, for detecting proliferative DR, 84% and 69% for sight-threatening DR, and 64% and 90% for diabetic macular oedema. Imaging alone found 35 more eyes with new vessels (19% of eyes with new vessels) and the combined grade found 14 more eyes than clinical examination alone. Conclusions Assessment of wide-field images and OCT alone detected more eyes with higher grades of DR compared with clinical examination alone or when combined with imaging in a clinical setting. The sensitivity was not higher as the techniques were not the same, with imaging alone being more sensitive. Wide-field imaging with OCT could be used to assess referrals from DR screening to determine management, to enhance the quality of assessment in clinics, and to follow-up patients whose DR is above the screening referral threshold but does not actually require treatment. PMID:25592127

  1. Video surveillance of epilepsy patients using color image processing.

    PubMed

    Bager, Gitte; Vilic, Kenan; Vilic, Adnan; Alving, Jørgen; Wolf, Peter; Sams, Thomas; Sorensen, Helge B D

    2014-01-01

    This paper introduces a method for tracking patients under video surveillance based on a color marker system. The patients are not restricted in their movements, which requires a tracking system that can overcome non-ideal scenes e.g. occlusions, very fast movements, lighting issues and other moving objects. The suggested marker system consists of twelve unique markers that are located at each joint. By using a color marker system, each marker (if visible) can be found in every frame disregarding the possibility that it was occluded in the previous frame, compared to other tracking systems. PMID:25571054

  2. Initial Clinical Experience Performing Patient Treatment Verification With an Electronic Portal Imaging Device Transit Dosimeter

    SciTech Connect

    Berry, Sean L., E-mail: BerryS@MSKCC.org [Department of Applied Physics and Applied Mathematics, Columbia University, New York, New York (United States); Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Polvorosa, Cynthia; Cheng, Simon; Deutsch, Israel; Chao, K. S. Clifford; Wuu, Cheng-Shie [Department of Radiation Oncology, Columbia University, New York, New York (United States)

    2014-01-01

    Purpose: To prospectively evaluate a 2-dimensional transit dosimetry algorithm's performance on a patient population and to analyze the issues that would arise in a widespread clinical adoption of transit electronic portal imaging device (EPID) dosimetry. Methods and Materials: Eleven patients were enrolled on the protocol; 9 completed and were analyzed. Pretreatment intensity modulated radiation therapy (IMRT) patient-specific quality assurance was performed using a stringent local 3%, 3-mm ? criterion to verify that the planned fluence had been appropriately transferred to and delivered by the linear accelerator. Transit dosimetric EPID images were then acquired during treatment and compared offline with predicted transit images using a global 5%, 3-mm ? criterion. Results: There were 288 transit images analyzed. The overall ? pass rate was 89.1% ± 9.8% (average ± 1 SD). For the subset of images for which the linear accelerator couch did not interfere with the measurement, the ? pass rate was 95.7% ± 2.4%. A case study is presented in which the transit dosimetry algorithm was able to identify that a lung patient's bilateral pleural effusion had resolved in the time between the planning CT scan and the treatment. Conclusions: The EPID transit dosimetry algorithm under consideration, previously described and verified in a phantom study, is feasible for use in treatment delivery verification for real patients. Two-dimensional EPID transit dosimetry can play an important role in indicating when a treatment delivery is inconsistent with the original plan.

  3. White matter abnormalities revealed by diffusion tensor imaging in non-demented and demented HIV+ patients

    PubMed Central

    Chen, Yasheng; An, Hongyu; Zhu, Hongtu; Stone, Taylor; Smith, J. Keith; Hall, Colin; Bullitt, Elizabeth; Shen, Dinggang; Lin, Weili

    2015-01-01

    HIV associated dementia (HAD) is the most advanced stage of central nervous system disease caused by HIV infection. Previous studies have demonstrated that patients with HAD exhibit greater cerebral and basal ganglia atrophy than non-demented HIV+ (HND) patients. However, the extent to which white matter is affected in HAD patients compared to HND patients remains elusive. This study is designed to address the potential white matter abnormalities through the utilization of diffusion tensor imaging (DTI) in both HND and HAD patients. DTI and T1-weighted images were acquired from 18 healthy controls, 21 HND and 8 HAD patients. T1 image-based registration was performed to 1) parcellate the whole brain white matter into major white matter regions, including frontal, parietal, temporal and occipital white matter, corpus callosum and internal capsule for statistical comparisons of the mean DTI values, and 2) warp all DTI parametric images towards the common template space for voxel-based analysis. The statistical comparisons were performed with four DTI parameters including fractional anisotropy (FA), mean (MD), axial (AD), and radial (RD) diffusivities. With Whitney U tests on the mean DTI values, both HND and HAD demonstrated significant differences from the healthy control in multiple white matter regions. In addition, HAD patients exhibited significantly elevated MD and RD in the parietal white matter when compared to HND patients. In the voxel-based analysis, widespread abnormal regions were identified for both HND and HAD patients, although a much larger abnormal volume was observed in HAD patients for all four DTI parameters. Furthermore, both region of interest (ROI) based and voxel-based analyses revealed that RD was affected to a much greater extent than AD by HIV infection, which may suggest that demyelination is the prominent disease progression in white matter. PMID:19376246

  4. An optically stimulated luminescence dosimeter for measuring patient exposure from imaging guidance procedures.

    PubMed

    Ding, George X; Malcolm, Arnold W

    2013-09-01

    There is a growing interest in patient exposure resulting from an x-ray imaging procedure used in image-guided radiation therapy. This study explores a feasibility to use a commercially available optically stimulated luminescence (OSL) dosimeter, nanoDot, for estimating imaging radiation exposure to patients. The kilovoltage x-ray sources used for kV-cone-beam CT (CBCT) imaging acquisition procedures were from a Varian on-board imager (OBI) image system. An ionization chamber was used to determine the energy response of nanoDot dosimeters. The chamber calibration factors for x-ray beam quality specified by half-value layer were obtained from an Accredited Dosimetry Calibration Laboratory. The Monte Carlo calculated dose distributions were used to validate the dose distributions measured by using the nanoDot dosimeters in phantom and in vivo. The range of the energy correction factors for the nanoDot as a function of photon energy and bow-tie filters was found to be 0.88-1.13 for different kVp and bow-tie filters. Measurement uncertainties of nanoDot were approximately 2-4% after applying the energy correction factors. The tests of nanoDot placed on a RANDO phantom and on patient's skin showed consistent results. The nanoDot is suitable dosimeter for in vivo dosimetry due to its small size and manageable energy dependence. The dosimeter placed on a patient's skin has potential to serve as an experimental method to monitor and to estimate patient exposure resulting from a kilovoltage x-ray imaging procedure. Due to its large variation in energy response, nanoDot is not suitable to measure radiation doses resulting from mixed beams of megavoltage therapeutic and kilovoltage imaging radiations. PMID:23920245

  5. An optically stimulated luminescence dosimeter for measuring patient exposure from imaging guidance procedures

    NASA Astrophysics Data System (ADS)

    Ding, George X.; Malcolm, Arnold W.

    2013-09-01

    There is a growing interest in patient exposure resulting from an x-ray imaging procedure used in image-guided radiation therapy. This study explores a feasibility to use a commercially available optically stimulated luminescence (OSL) dosimeter, nanoDot, for estimating imaging radiation exposure to patients. The kilovoltage x-ray sources used for kV-cone-beam CT (CBCT) imaging acquisition procedures were from a Varian on-board imager (OBI) image system. An ionization chamber was used to determine the energy response of nanoDot dosimeters. The chamber calibration factors for x-ray beam quality specified by half-value layer were obtained from an Accredited Dosimetry Calibration Laboratory. The Monte Carlo calculated dose distributions were used to validate the dose distributions measured by using the nanoDot dosimeters in phantom and in vivo. The range of the energy correction factors for the nanoDot as a function of photon energy and bow-tie filters was found to be 0.88-1.13 for different kVp and bow-tie filters. Measurement uncertainties of nanoDot were approximately 2-4% after applying the energy correction factors. The tests of nanoDot placed on a RANDO phantom and on patient's skin showed consistent results. The nanoDot is suitable dosimeter for in vivo dosimetry due to its small size and manageable energy dependence. The dosimeter placed on a patient's skin has potential to serve as an experimental method to monitor and to estimate patient exposure resulting from a kilovoltage x-ray imaging procedure. Due to its large variation in energy response, nanoDot is not suitable to measure radiation doses resulting from mixed beams of megavoltage therapeutic and kilovoltage imaging radiations.

  6. Investigation of eating disorders in cancer patients and its relevance with body image

    PubMed Central

    Hossein, Seyyed Abbas; Bahrami, Masoud; Mohamadirizi, Shahla; Paknaad, Zamzam

    2015-01-01

    Background: Eating disorder is one of the most common health problems with clinical and psychological consequences, which can affect body image in cancer patients. Similar studies in this area for checking the status of this disorder and its relevance with body image in patients with cancer are limited. Therefore, this study was designed with the aim of determination of eating disorders in patients with cancer and their relevance with body image. Materials and Methods: The research was a cross-correlation study. It was carried out in Sayed-Al-Shohada Hospital affiliated to the Isfahan University of Medical Sciences in 2013. Two hundred and ten patients with cancer were selected and were asked tocomplete the demographic and disease characteristics questionnaire, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and eating disorders questionnaire. SPSS statistical software, version 14 was used for statistical analysis’-Test, analysis of variance (ANOVA), and Pearson correlation coefficient were used for analyzing the obtained data. Results: The mean values of age, body mass index (BMI), and duration of illness were 48.2 ± 13.20 years, 24.6 ± 4.6kg/m2, and 25.64 ± 21.24months, respectively. Most patients were married (87%), without university education (96%), unemployed (67%), and with incomes below their requirement (52%). Most patients were diagnosed with breast cancer (36.5%). They received chemotherapy as the main treatment (56.2%). In addition, mean ± SD of eating disorders and body image were 12.84 ± 4.7 and184.40 ± 43.68, respectively. Also, 49.7% of patients with cancer had an eating disorder. Among these, 29% had experiences of anorexia and 20.7% had bulimia. There was a significant negative correlation between the score of body image and eating disorders (r = ?0.47, P = 0.01). Conclusions: Findings of this study showed that most patients with cancer had experienced symptoms of eating disorders. This may lead to a negative impact on the body image in these patients and may be the cause of further psychological and physical changes in these patients. The findings of this study can assist the healthcare team to pay more attention to eating disorders and body image in patients with cancer and also in considering the relationship of these issues in their evaluations.

  7. Longitudinal evaluation of patients with oral potentially malignant disorders using optical imaging and spectroscopy

    NASA Astrophysics Data System (ADS)

    Schwarz, Richard A.; Pierce, Mark C.; Mondrik, Sharon; Gao, Wen; Quinn, Mary K.; Bhattar, Vijayashree; Williams, Michelle D.; Vigneswaran, Nadarajah; Gillenwater, Ann M.; Richards-Kortum, Rebecca

    2012-02-01

    Dysplastic and cancerous alterations in oral tissue can be detected noninvasively in vivo using optical techniques including autofluorescence imaging, high-resolution imaging, and spectroscopy. Interim results are presented from a longitudinal study in which optical imaging and spectroscopy were used to evaluate the progression of lesions over time in patients at high risk for development of oral cancer. Over 100 patients with oral potentially malignant disorders have been enrolled in the study to date. Areas of concern in the oral cavity are measured using widefield autofluorescence imaging and depth-sensitive optical spectroscopy during successive clinical visits. Autofluorescence intensity patterns and autofluorescence spectra are tracked over time and correlated with clinical observations. Patients whose lesions progress and who undergo surgery are also measured in the operating room immediately prior to surgery using autofluorescence imaging and spectroscopy, with the addition of intraoperative high-resolution imaging to characterize nuclear size, nuclear crowding, and tissue architecture at selected sites. Optical measurements are compared to histopathology results from biopsies and surgical specimens collected from the measured sites. Autofluorescence imaging and spectroscopy measurements are continued during post-surgery followup visits. We examined correlations between clinical impression and optical classification over time with an average followup period of 4 months. The data collected to date suggest that multimodal optical techniques may aid in noninvasive monitoring of the progression of oral premalignant lesions, biopsy site selection, and accurate delineation of lesion extent during surgery.

  8. IMAGE-GUIDED EVALUATION AND MONITORING OF TREATMENT RESPONSE IN PATIENTS WITH DRY EYE DISEASE

    PubMed Central

    Hamrah, Pedram

    2014-01-01

    Dry eye disease (DED) is one of the most common ocular disorders worldwide. The pathophysiological mechanisms involved in the development of DED are not well understood and thus treating DED has been a significant challenge for ophthalmologists. Most of the currently available diagnostic tests demonstrate low correlation to patient symptoms and have low reproducibility. Recently, sophisticated in vivo imaging modalities have become available for patient care, namely, in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT). These emerging modalities are powerful and non-invasive, allowing real-time visualization of cellular and anatomical structures of the cornea and ocular surface. Here we discuss how, by providing both qualitative and quantitative assessment, these techniques can be used to demonstrate early subclinical disease, grade layer-by-layer severity, and allow monitoring of disease severity by cellular alterations. Imaging-guided stratification of patients may also be possible in conjunction with clinical examination methods. Visualization of subclinical changes and stratification of patients in vivo, allows objective image-guided evaluation of tailored treatment response based on cellular morphological alterations specific to each patient. This image-guided approach to DED may ultimately improve patient outcomes and allow studying the efficacy of novel therapies in clinical trials. PMID:24696045

  9. Receptor revision and atypical mutational characteristics in clonally expanded B cells from the cerebrospinal fluid of recently diagnosed multiple sclerosis patients

    Microsoft Academic Search

    Nancy L. Monson; Hans-Peter Brezinschek; Ruth I. Brezinschek; Angela Mobley; Gwen K. Vaughan; Elliot M. Frohman; Michael K. Racke; Peter E. Lipsky

    2005-01-01

    Purpose: to determine whether cerebrospinal fluid (CSF) B cells exhibit clonal expansion in patients recently diagnosed with multiple sclerosis (MS). CSF B cell clonal expansion was detected early in the disease process. Evidence of receptor revision was present in at least one MS patient who had been recently diagnosed with MS. Targeting of mutations to RGYW\\/WRCY motifs within CDRs was

  10. Schistosomal myelopathy in childhood: findings of magnetic resonance imaging in 26 patients.

    PubMed

    Henriques-Souza, Adélia Maria de Miranda; Valença, Marcelo Moraes

    2011-12-01

    We describe magnetic resonance image findings of 26 children (16 boys; average age, 9.4 years) with schistosomal myelopathy. All children lived in Pernambuco State, Brazil, an area of endemic mansoni schistosomiasis. Imaging abnormalities were identified in 92.3% of the children. The most frequent findings included: (1) enlargement of the spinal cord at the thoracic level, usually below T(8), in 23/24 (96%) patients; (2) hypointense signals in T(1)-weighted imaging; (3) hyperintense signals in T(2) imaging; and (4) heterogeneous enhancement with gadolinium. Although enlargement was evident at the thoracic level, abnormal signals frequently extended to the lower cervical level, or inferiorly to the lumbar and sacral cord. Magnetic resonance imaging of the spinal cord can play a strong role in the investigation of children with schistosomal myelopathy. Although imaging abnormalities are not specific, their presence strengthens presumptive diagnoses, to expedite treatment and avoid invasive procedures. PMID:22114998

  11. Multiplane transesophageal echocardiography: a basic oblique plane patient imaging sequence.

    PubMed

    Griffin, M; Rafferty, T

    1998-01-01

    We have previously reported a standardized 10-step sequence of monoplane (transverse plane) transesophageal two-dimensional echocardiographic views and a standardized 7-step vertical plane examination, both suitable for expeditious intraoperative use by the beginning practitioner. A multiplane transesophageal examination involves transverse plane views, vertical plane views and the remaining "in-between" oblique plane views. This report describes a sequence of specific oblique views to be used as a framework for the completion of a multiplane transesophageal examination. Each of these steps is illustrated with a two-dimensional echocardiographic image, a matching diagram and a schematic representation of the corresponding axis of interrogation. This description of oblique plane imaging, therefore, completes the components of a multiplane transesophageal examination. PMID:10604783

  12. Imaging of Microglia in Patients with Neurodegenerative Disorders

    PubMed Central

    Politis, Marios; Su, Paul; Piccini, Paola

    2012-01-01

    Microglia constitute the main immune defense in the central nervous system. In response to neuronal injury, microglia become activated, acquire phagocytic properties, and release a wide range of pro-inflammatory mediators that are essential for the annihilation of the neuronal insult. Although the role of microglial activation in acute neuronal damage is well defined, the pathophysiological processes underlying destructive or protective role to neurons following chronic exposure to microglial activation is still a subject of debate. It is likely that chronic exposure induces detrimental effects by promoting neuronal death through the release of neurotoxic factors. Positron emission tomography (PET) imaging with the use of translocator protein (TSPO) radioligands provides an in vivo tool for tracking the progression and severity of neuroinflammation in neurodegenerative disease. TSPO expression is correlated to the extent of microglial activation and the measurement of TSPO uptake in vivo with PET is a useful indicator of active disease. Although understanding of the interaction between radioligands and TSPO is not completely clear, there is a wide interest in application of TSPO imaging in neurodegenerative disease. In this article, we aim to review the applications of in vivo microglia imaging in neurodegenerative disorders such as Parkinson’s disease, Huntington’s disease, Dementias, and Multiple Sclerosis. PMID:22661951

  13. Visual search performance of patients with vision impairment: Effect of JPEG image enhancement

    PubMed Central

    Luo, Gang; Satgunam, PremNandhini; Peli, Eli

    2012-01-01

    Purpose To measure natural image search performance in patients with central vision impairment. To evaluate the performance effect for a JPEG based image enhancement technique using the visual search task. Method 150 JPEG images were presented on a touch screen monitor in either an enhanced or original version to 19 patients (visual acuity 0.4 to 1.2 logMAR, 6/15 to 6/90, 20/50 to 20/300) and 7 normally sighted controls (visual acuity ?0.12 to 0.1 logMAR, 6/4.5 to 6/7.5, 20/15 to 20/25). Each image fell into one of three categories: faces, indoors, and collections. The enhancement was realized by moderately boosting a mid-range spatial frequency band in the discrete cosine transform (DCT) coefficients of the image luminance component. Participants pointed to an object in a picture that matched a given target displayed at the upper-left corner of the monitor. Search performance was quantified by the percentage of correct responses, the median search time of correct responses, and an “integrated performance” measure – the area under the curve of cumulative correct response rate over search time. Results Patients were able to perform the search tasks but their performance was substantially worse than the controls. Search performances for the 3 image categories were significantly different (p?0.001) for all the participants, with searching for faces being the most difficult. When search time and correct response were analyzed separately, the effect of enhancement led to increase in one measure but decrease in another for many patients. Using the integrated performance, it was found that search performance declined with decrease in acuity (p=0.005). An improvement with enhancement was found mainly for the patients whose acuity ranged from 0.4 to 0.8 logMAR (6/15 to 6/38, 20/50 to 20/125). Enhancement conferred a small but significant improvement in integrated performance for indoor and collection images (p=0.025) in the patients. Conclusion Search performance for natural images can be measured in patients with impaired vision to evaluate the effect of image enhancement. Patients with moderate vision loss might benefit from the moderate level of enhancement used here. PMID:22540926

  14. Development of a Fast and Highly Efficient Gas Ionization Chamber For Patient Imaging and Dosimetry in Radiation Therapy

    E-print Network

    Hinderler, R; Keller, H; Mackie, T R

    2003-01-01

    In radiation therapy of cancer, more accurate delivery techniques spur the need for improved patient imaging during treatment. To this purpose, the megavoltage radiation protocol that is used for treatment is also used for imaging.

  15. Development of Fast and Highly Efficient Gas Ionization Chamber For Patient Imaging and Dosimetry in Radiation Therapy

    SciTech Connect

    R. Hinderler; H. Keller; T.R. Mackie; M.L. Corradini

    2003-09-08

    In radiation therapy of cancer, more accurate delivery techniques spur the need for improved patient imaging during treatment. To this purpose, the megavoltage radiation protocol that is used for treatment is also used for imaging.

  16. Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas

    SciTech Connect

    Pollock, Bruce E. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, MN (United States) and Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)]. E-mail: pollock.bruce@mayo.edu; Stafford, Scott L. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)

    2005-08-01

    Introduction: The purpose of this study was to evaluate the efficacy and safety of stereotactic radiosurgery as primary management for patients with imaging defined cavernous sinus meningiomas. Methods: Between 1992 and 2001, 49 patients had radiosurgery for dural-based masses of the cavernous sinus presumed to be meningiomas. The mean patient age was 55.5 years. The mean tumor volume was 10.2 mL; the mean tumor margin dose was 15.9 Gy. The mean follow-up was 58 months (range, 16-144 months). Results: No tumor enlarged after radiosurgery. Twelve of 38 patients (26%) with preexisting diplopia or facial numbness/pain had improvement in cranial nerve function. Five patients (10%) had new (n = 3) or worsened (n = 2) trigeminal dysfunction; 2 of these patients (4%) underwent surgery at 20 and 25 months after radiosurgery despite no evidence of tumor progression. Neither patient improved after partial tumor resection. One patient (2%) developed an oculomotor nerve injury. One patient (2%) had an ischemic stroke related to occlusion of the cavernous segment of the internal carotid artery. Event-free survival was 98%, 85%, and 80% at 1, 3, and 7 years after radiosurgery, respectively. Univariate analysis of patient and dosimetric factors found no analyzed factor correlated with postradiosurgical morbidity. Conclusions: Radiosurgery was an effective primary management strategy for patients with an imaging defined cavernous sinus meningioma. Except in situations of symptomatic mass effect, unusual clinical presentation, or atypical imaging features, surgery to confirm the histologic diagnosis is unlikely to provide clinical benefit.

  17. Correction for patient and organ movement in SPECT: application to exercise thallium-201 cardiac imaging

    SciTech Connect

    Geckle, W.J.; Frank, T.L.; Links, J.M.; Becker, L.C.

    1988-04-01

    We describe a technique for correction of artifacts in exercise /sup 201/Tl single photon emission computed tomography (SPECT) images arising from abrupt or gradual translational movement of the heart during acquisition. The procedure involves the tracking of the center of the heart in serial projection images using an algorithm which we call diverging squares. Each projection image is then realigned in the x-y plane so that the heart center conforms to the projected position of a fixed point in space. The shifted projections are reconstructed using the normal filtered backprojection algorithm. In validation studies, the motion correction procedure successfully eliminated movement artifacts in a heart phantom. Image quality was also improved in over one-half of 36 exercise thallium patient studies. The corrected images had smoother and more continuous left ventricular walls, greater clarity of the left ventricular cavity, and reduced streak artifacts. Rest injected or redistribution images, however, were often made worse, due to reduced heart to liver activity ratios and poor tracking of the heart center. Analysis of curves of heart position versus projection angle suggests that translation of the heart is common during imaging after exercise, and results from both abrupt patient movements, and a gradual upward shift of the heart. Our motion correction technique appears to represent a promising new approach for elimination of movement artifacts and enhancement of resolution in exercise /sup 201/Tl cardiac SPECT images.

  18. Imaging Modalities in Focal Therapy: Patient Selection, Treatment Guidance and Follow-up

    PubMed Central

    Muller, BG; van den Bos, W; Pinto, PA; de la Rosette, JJMCH

    2014-01-01

    Purpose of review Focal therapy for prostate cancer is emerging as a management option between active surveillance and radical treatments. In this article we present two of the most important imaging modalities in focal therapy, multiparametric MRI and Ultrasonography. We review recent advances within these two platforms. Recent findings State-of-the-art imaging in all phases of focal therapy is essential for treatment safety. In patient selection, treatment guidance and follow-up, different aspects of imaging are important. mpMRI is an imaging technology with high imaging resolution and contrast. This makes it an excellent technology for patient selection and treatment planning and follow-up. Ultrasound has the unique property of real time image acquisition. This makes it an excellent technology for real time treatment guidance. There are multiple novelties in these two platforms that have increased the accuracy considerably. Examples in ultrasound are: CEUS, elastography, shear-wave elastography and histoscanning. In mpMRI these advantages consist of multiple sequences combined to one image and MR thermometry. Summary Standardization of mpTRUS and mpMRI is of paramount importance. For targeted treatment and follow-up, a good negative predictive value of the test is important. There is much to gain both of these developing fields and imaging accuracy of the two platforms is comparable. Standardization in conduct and interpretation, 3D reconstruction and fusion of the two platforms can make focal therapy for prostate cancer standard of care. PMID:24637316

  19. Imaging of the small bowel: Crohn’s disease in paediatric patients

    PubMed Central

    Casciani, Emanuele; De Vincentiis, Chiara; Polettini, Elisabetta; Masselli, Gabriele; Di Nardo, Giovanni; Civitelli, Fortunata; Cucchiara, Salvatore; Gualdi, Gian Franco

    2014-01-01

    In more than 20% of all patients, the Crohn’s disease presents before the age of 18years. The diagnosis and management of Crohn’s disease in children has changed dramatically over the last decade, mainly due to increased awareness, availability of newer diagnostic modalities such as magnetic resonance imaging (MRI) and newer, more powerful treatments such as biologics. Imaging of the small bowel is needed for diagnosis, management, follow-up and also evaluation of the disease in terms of location, extent, activity and complications. We review all the methods (barium examinations, ultrasonography, computed tomography, MR, and computed tomography- positron emission tomography) commonly used for imaging the small bowel in paediatric patients with Crohn’s disease analyzing the advantages and disadvantages of each modality, with particular emphasis on MR imaging. PMID:24976933

  20. Comprehensive Non-contrast CT Imaging of the Vulnerable Patient

    Microsoft Academic Search

    Damini Dey; Ioannis A. Kakadiaris; Matthew J. Budoff; Morteza Naghavi; Daniel S. Berman

    \\u000a Atherosclerotic cardiovascular disease is the leading cause of death in developed countries. Every year, one million people\\u000a in the US experience a heart attack or sudden cardiac death. A large percentage of these patients have no prior symptoms of\\u000a any kind but suffer from silent heart disease, which may cause a heart attack at any time. Currently, there is no

  1. Optimal steel thickness combined with computed radiography for portal imaging of nasopharyngeal cancer patients

    SciTech Connect

    Wu Shixiu; Jin Xiance; Xie Congying; Cao Guoquan [Radiation Oncology Department of the 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000 (China); Radiography Department of the 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000 (China)

    2005-10-15

    The poor image quality of conventional metal screen-film portal imaging system has long been of concern, and various methods have been investigated in an attempt to enhance the quality of portal images. Computed radiography (CR) used in combination with a steel plate displays image enhancement. The optimal thickness of the steel plate had been studied by measuring the modulation transfer function (MTF) characteristics. Portal images of nasopharyngeal carcinoma patients were taken by both a conventional metal screen-film system and this optimal steel and CR plate combination system. Compared with a conventional metal screen-film system, the CR-metal screen system achieves a much higher image contrast. The measured modulation transfer function (MTF) of the CR combination is greater than conventional film-screen portal imaging systems and also results in superior image performance, as demonstrated by receiver operator characteristic (ROC) analysis. This optimal combination steel CR plate portal imaging system is capable of producing high contrast portal images conveniently.

  2. FDG-PET for Evaluation of Recurrent Lymph Node Metastases in Patients with Surgically Resected Breast Cancer: Adding Spot Images to Whole Body Images

    Microsoft Academic Search

    Tsuneo Tamaki; Akihiro Naito; Masami Nisbio; Katsuhiko Kawahara

    2004-01-01

    Background  To evaluate the role of18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), spot images were added to whole-body FDG-PET images in a patient\\u000a with suspected lymph node recurrence of breast cancer.\\u000a \\u000a \\u000a \\u000a Methods  FDG-PET spot images were obtained of 44 patients who had undergone surgical resection of breast cancer as were whole-body\\u000a FDG-PET images. A total of 33 lesions in 19 patients (mean age, 59

  3. Electronic decision protocols for ART patient triaging to expand access to HIV treatment in South Africa: A cross sectional study for development and validation

    PubMed Central

    MITCHELL, Marc; HEDT, Bethany L.; ESHUN-WILSON, Ingrid; FRASER, Hamish; JOHN, Melanie-Anne; MENEZES, Colin; GROBUSCH, Martin P.; JACKSON, Jonathan; TALJAARD, Jantjie; LESH, Neal

    2012-01-01

    Background The shortage of doctors and nurses, along with future expansion into rural clinics, will require that the majority of clinic visits by HIV infected patients on antiretroviral therapy (ART) are managed by non-doctors. The goal of this study was to develop and evaluate a screening protocol to determine which patients needed a full clinical assessment and which patients were stable enough to receive their medications without a doctor’s consultation. For this study, we developed an electronic, handheld tool to guide non-physician counselors through screening questions. Methods Patients visiting two ART clinics in South Africa for routine follow-up visits between March 2007 – April 2008 were included in our study. Each patient was screened by non-physician counselors using the handheld device and then received a full clinical assessment. Clinicians’ report on whether full clinical assessment had been necessary was used as the gold standard for determining “required referral”. Observations were randomly divided into two datasets – 989 for developing a referral protocol and 200 for validating protocol performance. Results A third of patients had at least one physical complaint, and 16% had five or more physical complaints. 38% of patients required referral for full clinical assessment. We identify a subset of questions which are 87% sensitive and 47% specific for recommended patient referral. Conclusions The final screening protocol is highly sensitive and could reduce burden on ART clinicians by 30%. The uptake and acceptance of the handheld tool to support implementation of the protocol was high. Further examination of the data reveals several important questions to include in future referral algorithms to improve sensitivity and specificity. Based on these results, we identify a refined algorithm to explore in future evaluations. PMID:22178295

  4. Assessment of patient selection criteria for quantitative imaging with respiratory-gated positron emission tomography

    PubMed Central

    Bowen, Stephen R.; Pierce, Larry A.; Alessio, Adam M.; Liu, Chi; Wollenweber, Scott D.; Stearns, Charles W.; Kinahan, Paul E.

    2014-01-01

    Abstract. The objective of this investigation was to propose techniques for determining which patients are likely to benefit from quantitative respiratory-gated imaging by correlating respiratory patterns to changes in positron emission tomography (PET) metrics. Twenty-six lung and liver cancer patients underwent PET/computed tomography exams with recorded chest/abdominal displacements. Static and adaptive amplitude-gated [F18]fluoro-D-glucose (FDG) PET images were generated from list-mode acquisitions. Patients were grouped by respiratory pattern, lesion location, or degree of lesion attachment to anatomical structures. Respiratory pattern metrics were calculated during time intervals corresponding to PET field of views over lesions of interest. FDG PET images were quantified by lesion maximum standardized uptake value (SUVmax). Relative changes in SUVmax between static and gated PET images were tested for association to respiratory pattern metrics. Lower lung lesions and liver lesions had significantly higher changes in SUVmax than upper lung lesions (14 versus 3%, p<0.0001). Correlation was highest (0.42±0.10, r2=0.59, p<0.003) between changes in SUVmax and nonstandard respiratory pattern metrics. Lesion location had a significant impact on changes in PET quantification due to respiratory gating. Respiratory pattern metrics were correlated to changes in SUVmax, though sample size limited statistical power. Validation in larger cohorts may enable selection of patients prior to acquisition who would benefit from respiratory-gated PET imaging.

  5. Functionalized expanded porphyrins

    DOEpatents

    Sessler, Jonathan L; Pantos, Patricia J

    2013-11-12

    Disclosed are functionalized expanded porphyrins that can be used as spectrometric sensors for high-valent actinide cations. The disclosed functionalized expanded porphyrins have the advantage over unfunctionalized systems in that they can be immobilized via covalent attachment to a solid support comprising an inorganic or organic polymer or other common substrates. Substrates comprising the disclosed functionalized expanded porphyrins are also disclosed. Further, disclosed are methods of making the disclosed compounds (immobilized and free), methods of using them as sensors to detect high valent actinides, devices that comprise the disclosed compounds, and kits.

  6. Patient-reported complications from fiducial marker implantation for prostate image-guided radiotherapy

    PubMed Central

    Gill, S; Li, J; Thomas, J; Bressel, M; Thursky, K; Styles, C; Tai, K H; Duchesne, G M; Foroudi, F

    2012-01-01

    Objectives To report on complications from transrectal ultrasound-guided insertion of fiducial markers for prostate image-guided radiotherapy. Methods 234 patients who underwent transrectal fiducial marker insertion for prostate cancer image-guided radiotherapy were assessed retrospectively by questionnaire with regard to the duration and severity of eight symptoms experienced following the procedure. Pain during the implantation procedure was assessed according to the Wong–Baker faces pain scale. Results Of 234 patients, 32% had at least one new symptom after the procedure. The commonest new symptom following the procedure was urinary frequency affecting 16% of patients who had not been troubled by frequency beforehand. Haematuria, rectal bleeding, dysuria and haematospermia affected 9–13% of patients, mostly at Grade 1 or 2. Pain, obstruction, and fever and shivers affected 3–4% of patients. Grade 3 rectal bleeding, haematuria, fever and shivers, and urinary frequency affected 0.5–1.5% of patients. Only one patient had a Grade 4 complication (i.e. fever and shivers). Overall, 9% of patients had symptoms lasting more than 2 weeks. The commonest symptoms that lasted more than 2 weeks were frequency, dysuria, obstructive symptoms and rectal bleeding. Mean pain score during the procedure was 1.1 (range 0–5). Conclusion Transrectal ultrasound-guided fiducial marker insertion for image-guided radiotherapy is well tolerated in the majority of prostate cancer patients. Most symptoms were Grade 1 or 2 in severity. Symptoms in the majority of patients last under 2 weeks. The most serious complication was sepsis in our study. PMID:22253345

  7. SU-E-J-204: Radiation Dose to Patients Resulting From Image Guidance Procedures and AAPM TG-180 Update

    SciTech Connect

    Ding, G [Vanderbilt University, Nashville, TN (United States); Alaei, P [UniversityMinnesota, Minneapolis, MN (United States)

    2014-06-01

    Purpose: Image-guided radiation therapy (IGRT) is the new paradigm for patient positioning and target localization in radiotherapy. Daily imaging procedures add additional dose to the patient's treatment volume and normal tissues and may expose the organs at risk to unaccounted doses. This presentation is to update the progress of AAPM TG-180 which aims to provide strategies to quantify and account the dose from both MV and kV imaging in patient treatment planning. Methods: Our current knowledge on image guidance dose is presented. A summary of doses from image guidance procedures delivered to patients in relationship with therapeutic doses is given. Different techniques in reducing the image guidance dose are summarized. Typical organ doses resulting from different image acquisition procedures used in IGRT are tabulated. Results: Many techniques to reduce the imaging doses are available in clinical applications. There are large variations between dose to bone and dose to soft tissues for x-rays at kilovoltage energy range. Methods for clinical implementation of accounting for the imaging dose from an imaging procedure are available. Beam data from imaging systems can be generated by combining Monte Carlo simulations and experimental measurements for commissioning imaging beams in the treatment planning. Conclusion: The current treatment planning systems are not yet equipped to perform patient specific dose calculations resulting from kV imaging procedures. The imaging dose from current kV image devices has been significantly reduced and is generally much less than that resulting from MV. Because the magnitude of kV imaging dose is significantly low and the variation between patients is modest, it is feasible to estimate dose based on imaging producers or protocols using tabulated values which provides an alternative to accomplish the task of accounting and reporting imaging doses.

  8. Efficacy of MR Imaging in Patients Suspected of Having Morton's Neuroma

    Microsoft Academic Search

    Marco Zanet; Thomas Ledermann; Hans Zollinger; Juerg Hodler

    OBJECTIVE. The purpose of our study was to evaluate the role of MR imaging in patients with suspected Morton's neuroma and to assessthe value of various MR sequences in this diagnosis. MATERIALS AND METHODS. Thirty-two consecutive patients with suspected Mor- ton's neuroma were studied using a 1.O-T MR scanner. Axial TI - and T2-weighted spin-echo, short inversion time inversion recovery,

  9. Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation

    Microsoft Academic Search

    R. Galm; M. Fröhling; M. Rittmeister; E. Schmitt

    1998-01-01

    A dysfunction of a joint is defined as a reversible functional restriction of motion presenting with hypomobility according\\u000a to manual medicine terminology. The aim of our study was to evaluate the frequency and significance of sacroiliac joint (SIJ)\\u000a dysfunction in patients with low back pain and sciatica and imaging-proven disc herniation. We examined the SIJs of 150 patients\\u000a with low

  10. Image-to-patient-registration by the natural anatomical surfaces of the auricle, mandible, and maxilla

    Microsoft Academic Search

    Rüdiger Marmulla; Joachim Mühling; Tim Lüth; Georg Eggers; Stefan Hassfeld

    2004-01-01

    A new developed navigation system, named SSN++, was evaluated for automated and markerless patient registration. The purpose of this system is to reduce radiation load and logistical input prior to computer-assisted surgery, as it is not necessary to place and measure reference markers. The method of image-to-patient-registration is based on natural anatomical surfaces such as the surfaces of the auricle,

  11. Construction of realistic liver phantoms from patient images using 3D printer and its application in CT image quality assessment

    NASA Astrophysics Data System (ADS)

    Leng, Shuai; Yu, Lifeng; Vrieze, Thomas; Kuhlmann, Joel; Chen, Baiyu; McCollough, Cynthia H.

    2015-03-01

    The purpose of this study is to use 3D printing techniques to construct a realistic liver phantom with heterogeneous background and anatomic structures from patient CT images, and to use the phantom to assess image quality with filtered back-projection and iterative reconstruction algorithms. Patient CT images were segmented into liver tissues, contrast-enhanced vessels, and liver lesions using commercial software, based on which stereolithography (STL) files were created and sent to a commercial 3D printer. A 3D liver phantom was printed after assigning different printing materials to each object to simulate appropriate attenuation of each segmented object. As high opacity materials are not available for the printer, we printed hollow vessels and filled them with iodine solutions of adjusted concentration to represent enhance levels in contrast-enhanced liver scans. The printed phantom was then placed in a 35×26 cm oblong-shaped water phantom and scanned repeatedly at 4 dose levels. Images were reconstructed using standard filtered back-projection and an iterative reconstruction algorithm with 3 different strength settings. Heterogeneous liver background were observed from the CT images and the difference in CT numbers between lesions and background were representative for low contrast lesions in liver CT studies. CT numbers in vessels filled with iodine solutions represented the enhancement of liver arteries and veins. Images were run through a Channelized Hotelling model observer with Garbor channels and ROC analysis was performed. The AUC values showed performance improvement using the iterative reconstruction algorithm and the amount of improvement increased with strength setting.

  12. Magnetic Resonance Imaging in Multiple Sclerosis – Patients' Experiences, Information Interests and Responses to an Education Programme

    PubMed Central

    Brand, Judith; Köpke, Sascha; Kasper, Jürgen; Rahn, Anne; Backhus, Imke; Poettgen, Jana; Stellmann, Jan-Patrick; Siemonsen, Susanne; Heesen, Christoph

    2014-01-01

    Background Magnetic resonance imaging (MRI) is a key diagnostic and monitoring tool in multiple sclerosis (MS) management. However, many scientific uncertainties, especially concerning correlates to impairment and prognosis remain. Little is known about MS patients' experiences, knowledge, attitudes, and unmet information needs concerning MRI. Methods We performed qualitative interviews (n?=?5) and a survey (n?=?104) with MS patients regarding MRI patient information, and basic MRI knowledge. Based on these findings an interactive training program of 2 hours was developed and piloted in n?=?26 patients. Results Interview analyses showed that patients often feel lost in the MRI scanner and left alone with MRI results and images while 90% of patients in the survey expressed a high interest in MRI education. Knowledge on MRI issues was fair with some important knowledge gaps. Major information interests were relevance of lesions as well as the prognostic and diagnostic value of MRI results. The education program was highly appreciated and resulted in a substantial knowledge increase. Patients reported that, based on the program, they felt more competent to engage in encounters with their physicians. Conclusion This work strongly supports the further development of an evidence-based MRI education program for MS patients to enhance participation in health-care. PMID:25415501

  13. Follow-up study using iodine-131 metaiodobenzylguanidine imaging in a patient with neuroblastoma

    SciTech Connect

    Ikekubo, K.; Habuchi, Y.; Jeong, S.; Yamaguchi, H.; Saiki, Y.; Ito, H.; Hino, M.; Higa, T.

    1986-11-01

    A new radiopharmaceutical, I-131 metaiodobenzylguanidine (I-131 MIBG) was used to determine the location and to follow-up tumors in a 13-month-old girl with neuroblastoma. I-131 MIBG imaging revealed both a primary abdominal tumor and a distant metastatic orbital tumor. Follow-up study with I-131 MIBG imaging demonstrated significant resolution of tumors after external radiotherapy and chemotherapy. I-131 MIBG imaging is a simple, safe, and specific method of determining the location of tumors and also is clinically useful in the evaluation and management of patients with neuroblastoma.

  14. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography. [Dogs; patients

    SciTech Connect

    Frick, M.P.; O'Leary, J.F.; Salomonowitz, E.; Stoltenberg, E.; Hutton, S.; Gedgaudas, E.

    1984-01-01

    A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

  15. Deformable image registration for geometrical evaluation of DIBH radiotherapy treatment of lung cancer patients

    NASA Astrophysics Data System (ADS)

    Ottosson, W.; Lykkegaard Andersen, J. A.; Borrisova, S.; Mellemgaard, A.; Behrens, C. F.

    2014-03-01

    Respiration and anatomical variation during radiotherapy (RT) of lung cancer yield dosimetric uncertainties of the delivered dose, possibly affecting the clinical outcome if not corrected for. Adaptive radiotherapy (ART), based on deformable image registration (DIR) and Deep-Inspiration-Breath-Hold (DIBH) gating can potentially improve the accuracy of RT. Purpose: The objective was to investigate the performance of contour propagation on repeated CT and Cone Beam CT (CBCT) images in DIBH compared to images acquired in free breathing (FB), using a recently released DIR software. Method: Three locally advanced non-small cell lung cancer patients were included, each with a planning-, midterm- and final CT (pCT, mCT, fCT) and 7 CBCTs acquired weekly and on the same day as the mCT and fCT. All imaging were performed in both FB and DIBH, using Varian RPM system for respiratory tracking. Delineations of anatomical structures were performed on each image set. The CT images were retrospective rigidly and deformable registered to all obtained images using the Varian Smart Adapt v. 11.0. The registered images were analysed for volume change and Dice Similarity Coefficient (DSC). Result: Geometrical similarities were found between propagated and manually delineated structures, with a slightly favour of FB imaging. Special notice should be taken to registrations where image artefacts or low tissue contrast are present. Conclusion: This study does not support the hypothesis that DIBH images perform better image registration than FB images. However DIR is a feasible tool for ART of lung cancer.

  16. Body image of patients with burns sequellae: evaluation through the critical incident technique.

    PubMed

    Bergamasco, E C; Rossi, L A; da C G Amancio, A; de Carvalho, E C

    2002-02-01

    The present investigation is a descriptive study, with a retrospective, ex-post facto, design. The objectives of this study were to characterize the body image changes in patients with burn sequellae, through the critical incident technique and to identify and categorize critical incidents, comparing them to the characteristics defined by the Taxonomy of the North American Nursing Diagnoses Association (NANDA) for the body image disturbance nursing diagnosis. Thirty-five patients were interviewed. Two types of critical incidents were identified: 'facing the mirror'--the moment the patient looks at himself/herself and notices the changes in his/her body, and 'facing other people'--the moment the patient becomes aware that he/she calls the attention of others. Associated with the perceptions of changes in their bodies, the patients reported feelings of fear (19), rebellion (18) and shame (12). They also presented coping mechanisms of denial (12), rationalization (7), minimization (7) and repression (2). NANDA's body image disturbance diagnosis was identified in all patients. PMID:11834329

  17. Expanded Access Investigational (Test)

    E-print Network

    Puglisi, Joseph

    investigational drugs, biologics and devices requires IRB approval and must follow FDA regulations circumstances regarding expanded access at Stanford Stanford University Research Compliance Office For more information contact: Food and Drug Administration 186618663004374 or 13017968240 www.fda

  18. The expandable network disk

    E-print Network

    Muthitacharoen, Athicha, 1976-

    2008-01-01

    This thesis presents a virtual disk cluster called END, the Expandable Network Disk. END aggregates storage on a cluster of servers into a single virtual disk. END's main goals are to offer good performance during normal ...

  19. Opportunities Are Expanding.

    ERIC Educational Resources Information Center

    Featherman, David L.

    1979-01-01

    Americans today enjoy at least as much opportunity for socioeconomic mobility as they did in earlier periods of this century. For some, especially Blacks in the labor force, opportunities have expanded, even though large inequalities in opportunity exist. (Author)

  20. A quantitative evaluation of damage in normal appearing white matter in patients with multiple sclerosis using diffusion tensor MR imaging at 3 T.

    PubMed

    Gratsias, Georgios; Kapsalaki, Eftychia; Kogia, Styliani; Dardiotis, Efthimios; Tsimourtou, Vaia; Lavdas, Eleftherios; Kousi, Evanthia; Pelekanou, Aimilia; Hadjigeorgiou, Georgios M; Fezoulidis, Ioannis

    2015-06-01

    The white matter (WM) of the brain is damaged in multiple sclerosis (MS), even in areas that appear normal on standard MR imaging. The purpose of our study is to evaluate the damage of normal appearing white matter (NAWM) in patients with MS. In our study, 84 MS patients and 42 healthy adults underwent a routine brain MRI, including also diffusion tensor imaging (DTI). All studies were performed on a 3 T MRI scanner. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained. The DTI parameters of NAWM were correlated with expanded disability status scales (EDSS) scores. Our results showed statistically significant differences in FA and ADC values between MS plaques and the symmetrical NAWM, as also between NAWM and the respective white matter in controls. The ADC values of the NAWM correlated with the EDSS scores. The present study demonstrated damage of the NAWM in MS patients, using DTI in 3.0 T. DTI may be used in the detection of subtle damage of the white matter. PMID:25073775

  1. Prevalence of microdeletion 22q11 in patients with hypernasal speech due to velopharyngeal insufficiency: Expanded phenotype and clinical comparison to nondeletion

    SciTech Connect

    Siegel-Bartelt, J.; Cytrynbaum, C.; Witzel, M.A.; Teshima, I.E. [Univ. of Toronto, Ontario (Canada)

    1994-09-01

    Microdeletion 22q11.2 has been reported as a frequent ethiology of both velocardiofacial (VCF) and DiGeorge syndromes. We have studied the prevalence of microdeletion 22q11 in a group of patients ascertained through a Speech and Language clinic presenting with (1) velopharyngeal insufficiency (VPI) and (2) difficultly in school. Growth parameters were measured, and facies were scored for features of VCF. Microdeletions were detected at locus D22S75 by FISH with probe N25 (Oncor), and at 22q11.2 with high resolution banding analysis (HRB). One child with typical VCF facies was considered to have a deletion at 22q11 with HRB, but is not deleted with N25, indicating that N25 may not detect all deletion patients. An additional 8/30 children tested to date were deleted with the N25 probe. Heart defects were present in only 2/8 deletion patients: VSD/ASD and PS/AS. One N25 deletion patient was atypica; he has a tall, lanky habitus (height = 90%), and facies not characteristic of CVF. As expected, there is a trend to lower head size, smaller ear size, and more typical facies in deletion patients; however, four of the nondeletion patients also had a clinical diagnosis of VCF. Medially displaced carotid arteries were present in both groups, which is therefore not a diagnostic feature of microdeletion 22q11. Our findings indicate that the microdeletion 22q11 is frequent (26% in this series) in a population with VPI, even when not selected for typical facies. We believe this series supports the view that microdeletion 22q11 has a broader clinical phenotype than previously recognized.

  2. In Vivo Imaging Enables High Resolution Preclinical Trials on Patients’ Leukemia Cells Growing in Mice

    PubMed Central

    Terziyska, Nadia; Alves, Catarina Castro; Groiss, Volker; Schneider, Katja; Farkasova, Katarina; Ogris, Manfred; Wagner, Ernst; Ehrhardt, Harald; Brentjens, Renier J.; zur Stadt, Udo; Horstmann, Martin; Quintanilla-Martinez, Leticia; Jeremias, Irmela

    2012-01-01

    Background Xenograft mouse models represent helpful tools for preclinical studies on human tumors. For modeling the complexity of the human disease, primary tumor cells are by far superior to established cell lines. As qualified exemplary model, patients’ acute lymphoblastic leukemia cells reliably engraft in mice inducing orthotopic disseminated leukemia closely resembling the disease in men. Unfortunately, disease monitoring of acute lymphoblastic leukemia in mice is hampered by lack of a suitable readout parameter. Design and Methods Patients’ acute lymphoblastic leukemia cells were lentivirally transduced to express the membrane-bound form of Gaussia luciferase. In vivo imaging was established in individual patients’ leukemias and extensively validated. Results Bioluminescence in vivo imaging enabled reliable and continuous follow-up of individual mice. Light emission strictly correlated to post mortem quantification of leukemic burden and revealed a logarithmic, time and cell number dependent growth pattern. Imaging conveniently quantified frequencies of leukemia initiating cells in limiting dilution transplantation assays. Upon detecting a single leukemia cell within more than 10,000 bone marrow cells, imaging enabled monitoring minimal residual disease, time to tumor re-growth and relapse. Imaging quantified therapy effects precisely and with low variances, discriminating treatment failure from partial and complete responses. Conclusions For the first time, we characterized in detail how in vivo imaging reforms preclinical studies on patient-derived tumors upon increasing monitoring resolution. In the future, in vivo imaging will enable performing precise preclinical studies on a broad range of highly demanding clinical challenges, such as treatment failure, resistance in leukemia initiating cells, minimal residual disease and relapse. PMID:23300782

  3. A retrospective analysis of negative diffusion-weighted image results in patients with acute cerebral infarction

    PubMed Central

    Zuo, Lian; Zhang, Yue; Xu, Xiahong; Li, Ying; Bao, Huan; Hao, Junjie; Wang, Xin; Li, Gang

    2015-01-01

    We aimed to investigate the clinicoradiologic determinants of negative diffusion-weighted image (DWI) results in patients with acute cerebral infarction (ACI). The medical records were reviewed of ACI patients. Patients were divided to the DWI positive and negative group. Positive DWI was used as independent variable and patients' clinicoradiologic factors were used as co-variables for multivariate logistic regression analysis. 349 patients received initial cerebral MRI within 72?hours of admission. Lacunar infarction was most common (42.1%) followed by posterior circulation infarction (30.1%) and partial anterior circulation infarction (18.1%). The majority of the patients (72.2%) had an NIHSS score of less than 5 at admission. 316 patients (90.54%) were positive on initial DWI. Patients with smoking, initial SBP ? 140 or DBP ? 90?mmHg, initial fasting plasma glucose (FPG) ?7.0?mmol/L, initial MRI from onset of disease >1?d and anterior circulation infarction were liable to show positive DWI. Furthermore, DWI negative patients had significantly lower NIHSS scores (IQR 0,1,2) than DWI positive patients (IQR 1,2,4) (P = 0.000) at two weeks post onset of acute cerebral infarction. In conclusion, multiple clinicoradiologic factors are associated with negative and positive DWI and further delineation of these factors is required in future prospective studies. PMID:25777182

  4. Balloon-expandable stent repair of severe coarctation of aorta

    Microsoft Academic Search

    José Suárez de Lezo; Manuel Pan; Miguel Romero; Alfonso Medina; José Segura; Djordje Pavlovic; Carlos Martinez; Ignacio Tejero; Juan Perez Navero; Francisco Torres; Mercedes Lafuente; Enrique Hernández; Francisco Melián; Manuel Concha

    1995-01-01

    Experimental studies have shown that stents implanted at the aorta become incorporated within the aortic wall and can be further expanded in growing animals. This study evaluates the feasibility and immediate results of balloon-expandable stent implantation in 10 patients with severe coarctation of aorta. The ages of the patients ranged from 1 month to 43 years; 1 was an infant,

  5. Maraviroc Observational Study: The Impact of Expanded Resistance Testing and Clinical Considerations for Antiretroviral Regimen Selection in Treatment-Experienced Patients

    PubMed Central

    Wilkins, Sara-Anne; Tamhane, Ashutosh; Nevin, Christa R.; Mugavero, Michael J.; Raper, James L.; Napolitano, Laura A.; Saag, Michael S.

    2013-01-01

    Abstract Maraviroc (MVC) use has trailed that of other post-2006 antiretroviral therapy (ART) options for treatment-experienced patients. We explored the impact of free tropism testing on MVC utilization in our cohort and explored barriers to MVC utilization. The Maraviroc Outcomes Study (MOS) is an investigator-initiated industry-sponsored trial where consecutive ART-experienced patients receiving routine care with viral loads ?1,000 copies/ml, and whose provider requested resistance testing and received standardized resistance testing (SRT; phenotype, genotype, coreceptor/tropism). Sociodemographic, clinical, and ART characteristics of those receiving SRT were compared to a historical cohort (HC). Subsequently, providers were surveyed regarding factors influencing selection of salvage ART therapy. The HC (n=165) had resistance testing 7/08–9/09, while prospective SRT (n=83) patients were enrolled 9/09–8/10. In the HC, 92% had genotypes, 2% had tropism assays, and 62% (n=102) changed ART after resistance testing (raltegravir 37%, etravirine 25%, darunavir 24%, MVC 1%). In the SRT cohort, 57% (n=48) changed regimens after standardized resistance testing (darunavir 48%, raltegravir 40%, and etravirine 19%). CCR5-tropic virus was identified in 43% of the SRT group, and MVC was used in 10% [or 20% of R5 tropic patients who underwent a subsequent regimen change (n=25)], a statistically significant (p=0.01) increase in utilization. The factors most strongly influencing utilization were unique patient circumstances (60%), clinical experience (55%), and potential side effects (40%). The addition of routine tropism testing to genotypic/phenotypic testing was associated with increased MVC utilization, raising the possibility that tropism testing may present a barrier to MVC use; however, additional barriers exist, and merit further evaluation. PMID:22881368

  6. Towards Mobile Augmented Reality for On-Patient Visualization of Medical Images

    E-print Network

    Jaehne, Bernd

    . M. Franz1 , M. Fangerau, M. Schmidt2 , A. Seitel1 , S. Mersmann1 , T. Kilgus1 , A. Groch1 , K. Yung1Towards Mobile Augmented Reality for On-Patient Visualization of Medical Images L. Maier-Hein1 , A , T. dos Santos1 , and H.-P. Meinzer1 1 German Cancer Research Center, Div. of Medical and Biological

  7. Hypointense and Hyperintense Lesions on Magnetic Resonance Imaging in Secondary-Progressive MS Patients

    Microsoft Academic Search

    H.-P. Adams; S. Wagner; D. F. Sobel; L. S. Slivka; J. C. Sipe; J. S. Romine; E. Beutler; J. A. Koziol

    1999-01-01

    Cranial magnetic resonance imaging (MRI) is widely used to monitor disease activity in clinical trials in multiple sclerosis (MS). The purpose of this study is to examine lesion burden as determined from hypointense regions on postcontrast T1-weighted scans (or black holes), and lesion burden on conventional T2-weighted scans, from a cohort of secondary progressive MS patients who participated in a

  8. Localized right ventricular structural abnormalities in patients with idiopathic ventricular fibrillation: Magnetic resonance imaging study

    Microsoft Academic Search

    Yuichi Sato; Kaori Kato; Makoto Hashimoto; Haruhiko Akiyama; Naoya Matsumoto; Hidehito Takase; Kazuya Ogawa; Tatsuo Sakamaki; Hiroshi Yagi; Katsuo Kanmatsuse

    1996-01-01

    Summary Lethal arrhythmias, including ventricular tachycardia and ventricular fibrillation, may occur in the absence of apparent morphological abnormalities. However, a recent study using magnetic resonance imaging (MRI) has suggested that localized, minor structural abnormalities of the right ventricle are responsible for right ventricular outflow tract ventricular tachycardia in a number of patients. We demonstrated regional wall thinning and systolic dyskinesia

  9. Thallium-201 imaging in a patient with mid-ventricular hypertrophic obstructive cardiomyopathy

    SciTech Connect

    Wakasugi, S.; Shibata, N.; Kobayashi, T.; Fudemoto, Y.; Hasegawa, Y.; Nakano, S.

    1988-10-01

    Findings specific to mid-ventricular hypertrophic obstructive cardiomyopathy were obtained in a patient by means of /sup 201/Tl planar myocardial scintigraphy. Namely, a myocardial band-like image dividing the left ventricle into two chambers was clearly shown. This was identified as hypertrophic muscle with sphincter-like muscular stenosis at the mid portion of the left ventricle.

  10. Patient perspectives and preferences for communication of medical imaging risks in a cancer care setting.

    PubMed

    Thornton, Raymond H; Dauer, Lawrence T; Shuk, Elyse; Bylund, Carma L; Banerjee, Smita C; Maloney, Erin; Fox, Lindsey B; Beattie, Christopher M; Hricak, Hedvig; Hay, Jennifer

    2015-05-01

    Purpose To identify opportunities for improving patient-centered communication about diagnostic imaging tests that involve the use of radiation in a cancer care setting. Materials and Methods Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Patient knowledge, information sources, and communication preferences were assessed in six focus groups during 2012. The groups consisted of patients undergoing treatment for metastatic colorectal carcinoma, women treated within the past 6 months for early-stage breast carcinoma, men undergoing surveillance after testicular cancer treatment, parents of patients treated for stage I-III neuroblastoma, patients in a thoracic oncology survivorship program, and participants in a lung cancer screening program. A multidisciplinary research team performed thematic content analysis of focus group transcripts. High-level findings were summarized during consensus conferences. Results Although they were aware of the long-term risk of cancer from exposure to ionizing radiation, most participants reported that their health care provider did not initiate discussion about benefits and risks of radiation from imaging tests. Most patients obtained information by means of self-directed internet searches. Participants expressed gratitude for tests ("That CT saved my daughter's life," "I'd rather have the radiation dosage than being opened up"), yet they expressed concern about having to initiate discussions ("If you don't ask, nobody is going to tell you anything") and the desire to be offered information concerning the rationale for ordering specific imaging examinations, intervals for follow-up imaging, and testing alternatives. Participants believed that such information should be available routinely and that conversation with their personal physician or endorsed, readily available reference materials were ideal methods for information exchange. Understanding imaging radiation risks and active participation in decision making about imaging were especially important to cancer survivors. Conclusion A substantial gap exists between patient expectations and current practices for providing information about medical imaging tests that involve the use of radiation. (©) RSNA, 2015 Online supplemental material is available for this article. PMID:25803490

  11. Brain Magnetic Resonance Imaging Findings in Young Patients with Hepatosplenic Schistosomiasis Mansoni without Overt Symptoms

    PubMed Central

    Manzella, Adonis; Borba-Filho, Paulo; Brandt, Carlos T.; Oliveira, Keyla

    2012-01-01

    The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9–25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.5-T system that included multiplanar pre-contrast and post-contrast sequences, and reports were completed by two radiologists after a consensus review. Twenty (58.8%) patients had MRI signal changes that were believed to be related to schistosomiasis mansoni. Twelve of the 20 patients had small focal hyperintensities on T2WI in the cerebral white matter, and eight patients had symmetric hyperintense basal ganglia on T1WI. There was a high frequency of brain MRI signal abnormalities in this series. Although not specific, these findings may be related to schistosomiasis. PMID:22665605

  12. Comparison of setup error using different reference images: a phantom and lung cancer patients study

    SciTech Connect

    Jiang Bo [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Dai Jianrong, E-mail: jiangbo122@126.com [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Zhang Ye; Zhang Ke; Men Kuo; Zhou Zongmei; Liang Jun; Wang Lvhua [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China)

    2012-04-01

    The purpose of this study was to compare setup errors obtained with kilovoltage cone-beam computed tomography (CBCT) and 2 different kinds of reference images, free-breathing 3D localization CT images (FB-CT) and the average images of 4-D localization CT images (AVG-CT) for phantom and lung cancer patients. This study also explored the correlation between the difference of translational setup errors and the gross tumor volume (GTV) motion. A respiratory phantom and 14 patients were enrolled in this study. For phantom and each patient, 3D helical CT and 4D CT images were acquired, and AVG-CT images were generated from the 4D CT. The setup errors were determined based on the image registration between the CBCT and the 2 different reference images, respectively. The data for both translational and rotational setup errors were analyzed and compared. The GTV centroid movement as well as its correlation with the translational setup error differences was also evaluated. In the phantom study, the AVG-CT method was more accurate than the FB-CT method. For patients, the translational setup errors based on FB-CT were significantly larger than those from AVG-CT in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions (p < 0.05). Translational setup errors differed by >1 mm in 32.6% and >2 mm in 12.9% of CBCT scans. The rotational setup errors from FB-CT were significantly different from those from AVG-CT in the LR and AP directions (p < 0.05). The correlation coefficient of the translational setup error differences and the GTV centroid movement in the LR, SI, and AP directions was 0.515 (p = 0.060), 0.902 (p < 0.001), and 0.510 (p = 0.062), respectively. For lung cancer patients, respiration may affect the on-line target position location. AVG-CT provides different reference information than FB-CT. The difference in SI direction caused by the 2 methods increases with the GTV movement. Therefore, AVG-CT should be the prefered choice of reference images.

  13. Malignant lymphoma of the breast in a male patient: ultrasound imaging features.

    PubMed

    Ikeda, Tatsuhiko; Bando, Hiroko; Iguchi, Akiko; Tanaka, Yuko; Tohno, Eriko; Hara, Hisato

    2015-03-01

    Non-Hodgkin lymphoma (NHL) of the breast is a rare disease. Herein, we report a rare case of secondary involvement of the breast by NHL in a male patient and the ultrasound imaging findings. A 70-year-old man noticed an induration of the subareolar region of the right breast. He had been diagnosed as having mantle cell lymphoma 5 years before and treated with several series of chemoradiotherapy. On supine examination, palpation revealed bilateral breast enlargement, but detection of a lump was difficult. Ultrasonography showed a hypoechoic non-mass image-forming lesion in the subareolar region of the right breast. The final pathological diagnosis was recurrence of mantle cell lymphoma in the right breast. The diagnosis of malignant lymphoma of the breast by imaging modalities is difficult because there are no specific features. Breast lymphoma should be included with gynecomastia and breast cancer in the differential diagnosis of male patients with breast enlargement. PMID:22396322

  14. Correlation between clinical symptoms and magnetic resonance imaging findings in patients with temporomandibular joint internal derangement

    PubMed Central

    Jung, Young-Wook; Park, Sung-Hoon; On, Sung-Woon

    2015-01-01

    Objectives The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID. PMID:26131429

  15. Correlations between multiple sclerosis functional composite, expanded disability status scale and health-related quality of life during and after treatment of relapses in patients with multiple sclerosis

    Microsoft Academic Search

    Serkan Ozakbas; Inanc Cagiran; Burcu Ormeci; Egemen Idiman

    2004-01-01

    The measurement of the clinical manifestations of multiple sclerosis (MS) is difficult. In the present study, we examined the changes in measurement of functions during and after pulse methylprednisolon (MP) treatment of MS exacerbations using the MSFC and EDSS. Correlation between multiple sclerosis quality of life (MSQoL)-54, EDSS and MSFC were studied. Thirty-six clinically definite MS patients were included in

  16. Image-Guided Radiotherapy for Cardiac Sparing in Patients with Left-Sided Breast Cancer

    PubMed Central

    Lemanski, Claire; Thariat, Juliette; Ampil, Federico L.; Bose, Satya; Vock, Jacqueline; Davis, Rick; Chi, Alexander; Dutta, Suresh; Woods, William; Desai, Anand; Godinez, Juan; Karlsson, Ulf; Mills, Melissa; Nguyen, Nam Phong; Vinh-Hung, Vincent

    2014-01-01

    Patients with left-sided breast cancer are at risk of cardiac toxicity because of cardiac irradiation during radiotherapy with the conventional 3-dimensional conformal radiotherapy technique. In addition, many patients may receive chemotherapy prior to radiation, which may damage the myocardium and may increase the potential for late cardiac complications. New radiotherapy techniques such as intensity-modulated radiotherapy (IMRT) may decrease the risk of cardiac toxicity because of the steep dose gradient limiting the volume of the heart irradiated to a high dose. Image-guided radiotherapy (IGRT) is a new technique of IMRT delivery with daily imaging, which may further reduce excessive cardiac irradiation. Preliminary results of IGRT for cardiac sparing in patients with left-sided breast cancer are promising and need to be investigated in future prospective clinical studies. PMID:25295227

  17. Patient-Specific Volume Conductor Modeling for Non-Invasive Imaging of Cardiac Electrophysiology

    PubMed Central

    Pfeifer, B; Hanser, F; Seger, M; Fischer, G; Modre-Osprian, R; Tilg, B

    2008-01-01

    We propose a general workflow to numerically estimate the spread of electrical excitation in the patients’ hearts. To this end, a semi-automatic segmentation pipeline for extracting the volume conductor model of structurally normal hearts is presented. The cardiac electrical source imaging technique aims to provide information about the spread of electrical excitation in order to assist the cardiologist in developing strategies for the treatment of cardiac arrhythmias. The volume conductor models of eight patients were extracted from cine-gated short-axis magnetic resonance imaging (MRI) data. The non-invasive estimation of electrical excitation was compared with the CARTO™ maps. The development of a volume conductor modeling pipeline for constructing a patient-specific volume conductor model in a fast and accurate way is one essential step to make the technique clinically applicable. PMID:19415133

  18. Imaging of the pulmonary hilum: a prospective comparative study in patients with lung cancer

    SciTech Connect

    Glazer, G.M.; Gross, B.H.; Aisen, A.M.; Quint, L.E.; Francis, I.R.; Orringer, M.B.

    1985-08-01

    Using magnetic resonance imaging (MRI), dynamic computed tomography (CT), and 55/sup 0/ posterior oblique tomography, the authors prospectively evaluated the pulmonary hilum in 35 patients with lung cancer; 19 of these patients had surficial excision of ipsilateral hilar lymph nodes and formed the study group. Their results showed no significant differences between the three imaging methods in overall accuracy of hilar for diagnosing hilar metastasis, whereas oblique tomography had fair sensitivity and specificity. The calculated magnetic relaxation times, T1 and T2, were not useful in distinguishing between benign and malignant enlarged hilar nodes. The authors conclude that accurate staging of the pulmonary hilum in patients with lung cancer is not currently possible using MRI, CT, or oblique tomography.

  19. What Has Diffusion Imaging in Animals Told Us about Diffusion Imaging in Patients with Ischaemic Stroke?

    Microsoft Academic Search

    Carly S. Rivers; Joanna M. Wardlaw

    2005-01-01

    Background and Purpose: In acute ischaemic stroke, the amount (and type) of cellular damage underlying diffusion-weighted imaging (DWI) lesion appearances is unclear.We summarized all information from experimental studies of DWI in focal ischaemia models. Methods: We systematically reviewed all published studies of DWI in focal ischaemic stroke models. We extracted key experimental details to determine correlations between histological features and

  20. Population of 100 realistic, patient-based computerized breast phantoms for multi-modality imaging research

    NASA Astrophysics Data System (ADS)

    Segars, W. Paul; Veress, Alexander I.; Wells, Jered R.; Sturgeon, Gregory M.; Kiarashi, Nooshin; Lo, Joseph Y.; Samei, Ehsan; Dobbins, James T.

    2014-03-01

    Breast imaging is an important area of research with many new techniques being investigated to further reduce the morbidity and mortality of breast cancer through early detection. Computerized phantoms can provide an essential tool to quantitatively compare new imaging systems and techniques. Current phantoms, however, lack sufficient realism in depicting the complex 3D anatomy of the breast. In this work, we created one-hundred realistic and detailed 3D computational breast phantoms based on high-resolution CT datasets from normal patients. We also developed a finiteelement application to simulate different compression states of the breast, making the phantoms applicable to multimodality imaging research. The breast phantoms and tools developed in this work were packaged into user-friendly software applications to distribute for breast imaging research.

  1. Indium-111 chloride imaging in patients with suspected abscesses: concise communication

    SciTech Connect

    Sayle, B.A.; Balachandran, S.; Rogers, C.A.

    1983-12-01

    Two hundred and fifty-eight patients with clinically suspected inflammatory processes were studied. Seventy-two images were categorized as true positive; 211 as true negative. There were nine false-positive studies, four of which were due to activity in beds of excised organs. There were six false-negative studies, four of which were due to walled-off abscesses found either at surgery or biopsy. The sensitivity was 92%, the specificity 95%, and the accuracy 94%. This study shows that indium-111 chloride imaging provides a reliable way to locate inflammatory processes and overcomes the disadvantages of other imaging agents, for example gastrointestinal activity or the demonstration of healing surgical wounds with gallium-67, and the false-positive images due to cystic fibrosis and other respiratory diseases, or accessory spleens as seen with In-111-labeled white cells.

  2. A contextual based double watermarking of PET images by patient ID and ECG signal.

    PubMed

    Nambakhsh, Mohammad-Saleh; Ahmadian, Alireza; Zaidi, Habib

    2011-12-01

    This paper presents a novel digital watermarking framework using electrocardiograph (ECG) and demographic text data as double watermarks. It protects patient medical information and prevents mismatching diagnostic information. The watermarks are embedded in selected texture regions of a PET image using multi-resolution wavelet decomposition. Experimental results show that modifications in these locations are visually imperceptible. The robustness of the watermarks is verified through measurement of peak signal to noise ratio (PSNR), cross-correlation (CC%), structural similarity measure (SSIM) and universal image quality index (UIQI). Their robustness is also computed using pixel-based metrics and human visual system metrics. Additionally, beta factor (?) as an edge preservation measure is used for degradation evaluation of the image boundaries throughout the watermarked PET image. Assessment of the extracted watermarks shows watermarking robustness to common attacks such as embedded zero-tree wavelet (EZW) compression and median filtering. PMID:20934773

  3. Tomographic and planar radionuclide imaging in patients suspected meniscal injury: Arthroscopic correlation

    SciTech Connect

    Fajman, W.A.; Diehl, M.; Dunaway, E.; Stephenson, R.; Eisner, R.; Riggins, R.S.; Berger, H.J.

    1985-05-01

    In patients (pts) with knee pain which may be related to meniscal tears, clinical judgment is used to determine whether medical management or arthroscopy is indicated. Based on the assumption that meniscal injury will result in adjacent changes in Tc-99m MDP bone images, studies using both planar and tomographic techniques were performed in 12 pts referred for arthroscopy. Planar imaging was performed in the anterior, posterior, and posterior medial and lateral oblique positions of the symptomatic knee. Single photon emission computed tomography was performed using a 64 view 360/sup 0/ acquisition of both knees. In this series, both imaging techniques were accurate in identifying abnormality, but analysis of transaxial tomographic data showed greater contrast and facilitated localization because of the better spatial orientation provided by this method. Thus, tomographic bone imaging appears valuable in defining areas of localized abnormality in the knees of pts with meniscal injury.

  4. Noninvasive electrocardiographic imaging of cardiac resynchronization therapy in patients with heart failure.

    PubMed

    Rudy, Yoram

    2006-10-01

    Cardiac resynchronization therapy (CRT) using biventricular (BiV) pacing has been developed to restore synchrony and improve cardiac performance in patients with heart failure. It has been clinically beneficial in 65% to 70% of patients. Being an electrical (pacing) approach, detailed electrical information during CRT is critical in understanding its mechanism and clinical outcome. However, electrical data from patients have been limited because of the requirement for invasive mapping. Electrocardiographic imaging provides the necessary tool to noninvasively obtain this information. We applied electrocardiographic imaging to 8 patients undergoing CRT during their native rhythm and various (single-ventricular and BiV) pacing modes with the following observations: (1) native rhythm activation was heterogeneous with latest activation in lateral left ventricular (LV) base (3 of 6 patients) or in anterolateral, midlateral, or inferior LV; (2) when accompanied by fusion, LV pacing was as effective as BiV; (3) right ventricular pacing was not effective for resynchronization; (4) efficacy of CRT depended strongly on patient-specific electrophysiologic substrate. PMID:16950331

  5. What Does PET Imaging Add to Conventional Staging of Head and Neck Cancer Patients?

    SciTech Connect

    Pohar, Surjeet [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States) and Department of Radiation Oncology, Eastern Virginia Medical School, Norfolk, VA (United States)]. E-mail: poharss@evms.edu; Brown, Robert B.S. [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States); Newman, Nancy [Department of Medicine, SUNY Upstate Medical University, Syracuse, NY (United States); Koniarczyk, Michael [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States); Hsu, Jack [Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY (United States); Feiglin, David [Department of Radiology, SUNY Upstate Medical University, Syracuse, NY (United States)

    2007-06-01

    Purpose: To determine the value of PET scans in the staging of patients with head and neck carcinoma. Methods and Materials: The charts of 25 patients who underwent neck dissection, computed tomography (CT) scan, and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as part of their initial work-up for a head and neck squamous cell cancer between 2000-2003 were reviewed. All patients underwent clinical examination, triple endoscopy, and chest radiograph as part of their clinical staging, adhering to American Joint Commission for Cancer criteria. In addition to the clinical nodal (N) stage, PET findings were incorporated to determine a second type of N staging: clinical N + PET stage. The number of neck sides and nodal levels involved on CT or PET and on pathologic examination were recorded. Results: The sensitivity and specificity for detection of nodal disease were similar for CT and FDG-PET. Positive and negative likelihood ratios were similar for both diagnostic tests. None of our 25 patients had unsuspected distant disease detected by PET. Conclusion: The addition of PET imaging did not improve diagnostic accuracy in our patients compared with CT. PET scanning did not alter clinical management in any of the patients.

  6. Is preoperative high-resolution magnetic resonance imaging accurate in predicting neurovascular compression in patients with trigeminal neuralgia?

    Microsoft Academic Search

    Ludwig Benes; Kiyoshi Shiratori; Mariana Gurschi; Ulrich Sure; Wuttipong Tirakotai; Boris Krischek; Helmut Bertalanffy

    2005-01-01

    High-resolution magnetic resonance imaging (HR-MRI) using three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) and double-dose contrast-enhanced three-dimensional fast spoiled gradient echo (3D-FSPGR) sequences is considered to be a useful tool in detecting neurovascular compression in patients with trigeminal neuralgia. The purpose of this study was to analyze the accuracy and preoperative diagnostic value of these high-resolution imaging techniques in patients

  7. Infrared Thermal Imaging in Patients with Medial Collateral Ligament Injury of the Knee - A Retrospective Study

    PubMed Central

    Yang, HyunJung; Park, HaeIn; Lim, Chungsan; Park, SangKyun; Lee, KwangHo

    2014-01-01

    Objectives: Digital infrared thermographic imaging (DITI) has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient’s with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient’s who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient’s knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient’s were composed of 14 women (70%) and 6 men (30%), with a mean age of 62.15 ± 15.71 (mean ± standard deviation (SD)) years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05). The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury. PMID:25780719

  8. Dipyridamole thallium imaging may not be a reliable screening test for coronary artery disease in patients undergoing vascular surgery

    SciTech Connect

    Marwick, T.H.; Underwood, D.A. (Cleveland Clinic Foundation, OH (USA))

    1990-01-01

    Dipyridamole thallium imaging has been proposed for cardiac risk stratification in patients undergoing peripheral vascular surgery. The purpose of this study was to define the benefit of this investigation in routine preoperative evaluation of these patients. The outcome of 86 patients undergoing vascular surgery procedures was examined in light of preoperative clinical assessment and dipyridamole SPECT thallium imaging (DST). Fifty-one patients (59%) were considered at high risk on clinical grounds, and 22 patients (26%) had perfusion defects. Ten patients suffered a perioperative coronary event, including unstable angina, myocardial infarction, or cardiac death. Seven of the patients with such events were among the 51 clinically high-risk subjects (14%). Three perioperative events occurred in the group of 19 patients with positive DST images who underwent surgery (16%), but the DST test failed to identify 7 patients who suffered coronary events. The frequency of abnormal thallium imaging was similar to the prevalence of angiographically significant coronary disease reported previously at this center, but considerably less than the rate of abnormal thallium imaging in past studies of vascular surgery patients. The application of the test to a low to moderate risk population is probably responsible for its lower predictive accuracy for coronary events. DST is not an ideal routine noninvasive technique for risk stratification in patients undergoing vascular surgery.

  9. Advanced MRI and PET imaging for assessment of treatment response in patients with gliomas.

    PubMed

    Dhermain, Frederic G; Hau, Peter; Lanfermann, Heinrich; Jacobs, Andreas H; van den Bent, Martin J

    2010-09-01

    Imaging techniques are important for accurate diagnosis and follow-up of patients with gliomas. T1-weighted MRI, with or without gadolinium, is the gold standard method. However, this technique only reflects biological activity of the tumour indirectly by detecting the breakdown of the blood-brain barrier. Therefore, especially for low-grade glioma or after treatment, T1-weighted MRI enhanced with gadolinium has substantial limitations. Development of more advanced imaging methods to improve outcomes for individual patients is needed. New imaging methods based on MRI and PET can be employed in various stages of disease to target the biological activity of the tumour cells (eg, increased uptake of aminoacids or nucleoside analogues), the changes in diffusivity through the interstitial space (diffusion-weighted MRI), the tumour-induced neovascularisation (perfusion-weighted MRI or contrast-enhanced MRI, or increased uptake of aminoacids in endothelial wall), and the changes in concentrations of metabolites (magnetic resonance spectroscopy). These techniques have advantages and disadvantages, and should be used in conjunction to best help individual patients. Advanced imaging techniques need to be validated in clinical trials to ensure standardisation and evidence-based implementation in routine clinical practice. PMID:20705518

  10. Imaging Plaques to Predict and Better Manage Patients with Acute Coronary Events

    PubMed Central

    Garcia-Garcia, Hector M.; Jang, Ik-Kyung; Serruys, Patrick W.; Kovacic, Jason C.; Narula, Jagat; Fayad, Zahi A.

    2014-01-01

    Culprit lesions of patients who have had an acute coronary syndrome commonly are ruptured coronary plaques with superimposed thrombus. The precursor of such lesions is an inflamed thin-capped fibroatheroma. These plaques can be imaged by means of invasive techniques such as intravascular ultrasound (and derived techniques), optical coherence tomography and near-infrared spectroscopy. Very often these patients exhibit similar (multiple) plaques beyond the culprit lesion. These remote plaques can be assessed non invasively by computed tomography angiography and magnetic resonance imaging and also using invasive imaging. The detection of these remote plaques is not only feasible, but also in natural history studies have been associated with clinical coronary events. Different systemic pharmacological treatments have been studied (mostly statins) with modest success and therefore newer approaches are being tested. Local treatment for such lesions is in its infancy and larger, prospective and randomized trials are needed. This review will describe the pathological and imaging findings in culprit lesions of patients with acute coronary syndrome and as well as the assessment of remote plaques. In addition, the pharmacological and local treatment options will be reviewed. PMID:24902974

  11. Cognitive Impairment and Brain Imaging Characteristics of Patients with Congenital Cataracts, Facial Dysmorphism, Neuropathy Syndrome

    PubMed Central

    Chamova, Teodora; Zlatareva, Dora; Raycheva, Margarita; Bichev, Stoyan; Kalaydjieva, Luba; Tournev, Ivailo

    2015-01-01

    Congenital cataracts, facial dysmorphism, neuropathy (CCFDN) syndrome is a complex autosomal recessive multisystem disorder. The aim of the current study is to evaluate the degree of cognitive impairment in a cohort of 22 CCFDN patients and its correlation with patients' age, motor disability, ataxia, and neuroimaging changes. Twenty-two patients with genetically confirmed diagnosis of CCFDN underwent a detailed neurological examination. Verbal and nonverbal intelligence, memory, executive functions, and verbal fluency w?re assessed in all the patients aged 4 to 47 years. Brain magnetic resonance imaging was performed in 20 affected patients. Eighteen affected were classified as having mild intellectual deficit, whereas 4 had borderline intelligence. In all psychometric tests, evaluating different cognitive domains, CCFDN patients had statistically significant lower scores when compared to the healthy control group. All cognitive domains seemed equally affected. The main abnormalities on brain MRI found in 19/20 patients included diffuse cerebral atrophy, enlargement of the lateral ventricles, and focal lesions in the subcortical white matter, different in number and size, consistent with demyelination more pronounced in the older CCFDN patients. The correlation analysis of the structural brain changes and the cognitive impairment found a statistically significant correlation only between the impairment of short-term verbal memory and the MRI changes.

  12. Radiation risks associated with serial imaging in colorectal cancer patients: Should we worry?

    PubMed Central

    Oh, Jeong Suk; Koea, Jonathan B

    2014-01-01

    To provide an overview of the radiation related cancer risk associated with multiple computed tomographic scans required for follow up in colorectal cancer patients. A literature search of the PubMed and Cochrane Library databases was carried out and limited to the last 10 years from December 2012. Inclusion criteria were studies where computed tomographic scans or radiation from other medical imaging modalities were used and the risks associated with ionizing radiation reported. Thirty-six studies were included for appraisal with no randomized controlled trials. Thirty-four of the thirty-six studies showed a positive association between medical imaging radiation and increased risk of cancer. The radiation dose absorbed and cancer risk was greater in children and young adults than in older patients. Most studies included in the review used a linear, no-threshold model to calculate cancer risks and this may not be applicable at low radiation doses. Many studies are retrospective and ensuring complete follow up on thousands of patients is difficult. There was a minor increased risk of cancer from ionizing radiation in medical imaging studies. The radiation risks of low dose exposure (< 50 milli-Sieverts) are uncertain. A clinically justified scan in the context of colorectal cancer is likely to provide more benefits than harm but current guidelines for patient follow up will need to be revised to accommodate a more aggressive approach to treating metastatic disease. PMID:24415862

  13. Leg edema quantification for heart failure patients via 3D imaging.

    PubMed

    Hayn, Dieter; Fruhwald, Friedrich; Riedel, Arthur; Falgenhauer, Markus; Schreier, Günter

    2013-01-01

    Heart failure is a common cardiac disease in elderly patients. After discharge, approximately 50% of all patients are readmitted to a hospital within six months. Recent studies show that home monitoring of heart failure patients can reduce the number of readmissions. Still, a large number of false positive alarms as well as underdiagnoses in other cases require more accurate alarm generation algorithms. New low-cost sensors for leg edema detection could be the missing link to help home monitoring to its breakthrough. We evaluated a 3D camera-based measurement setup in order to geometrically detect and quantify leg edemas. 3D images of legs were taken and geometric parameters were extracted semi-automatically from the images. Intra-subject variability for five healthy subjects was evaluated. Thereafter, correlation of 3D parameters with body weight and leg circumference was assessed during a clinical study at the Medical University of Graz. Strong correlation was found in between both reference values and instep height, while correlation in between curvature of the lower leg and references was very low. We conclude that 3D imaging might be a useful and cost-effective extension of home monitoring for heart failure patients, though further (prospective) studies are needed. PMID:23948874

  14. Determining patient 6-degrees-of-freedom motion from stereo infrared cameras during supine medical imaging

    NASA Astrophysics Data System (ADS)

    Beach, Richard D.; Feng, Bing; Shazeeb, Mohammed S.; King, Michael A.

    2006-03-01

    Patient motion during SPECT acquisition causes inconsistent projection data and reconstruction artifacts which can significantly affect the diagnostic accuracy of SPECT. The tracking of motion by infrared monitoring spherical reflectors (markers) on the patient's surface can provide 6-Degrees-of-Freedom (6-DOF) motion information capable of providing clinically robust correction. Object rigid-body motion can be described by 3 translational DOF and 3 rotational DOF. Polaris marker position information obtained by stereo infrared cameras requires algorithmic processing to correctly record the tracked markers, and to calibrate and map Polaris co-ordinate data into the SPECT co-ordinate system. Marker data then requires processing to determine the rotational and translational 6-DOF motion to ultimately be used for SPECT image corrections. This processing utilizes an algorithm involving least-squares fitting, to each other, of two 3-D point sets using singular value decomposition (SVD) resulting in the rotation matrix and translation of the rigid body centroid. We have demonstrated the ability to monitor 12 clinical patients as well as 7 markers on 2 elastic belts worn by a volunteer while intentionally moving, and determined the 3 axis Euclidian rotation angles and centroid translations. An anthropomorphic phantom with Tc-99m added to the heart, liver, and body was simultaneously SPECT imaged and motion tracked using 4 rigidly mounted markers. The determined rotation matrix and translation information was used to correct the image resulting in virtually identical "no motion" and "corrected" images. We plan to initiate routine 6-DOF tracking of patient motion during SPECT imaging in the future.

  15. Multimodality imaging in a depressed patient with violent behavior and temporal lobe seizures.

    PubMed

    Poprawski, T J; Pluzyczka, A N; Park, Y; Chennamchetty, V N; Halaris, A; Crayton, J W; Konopka, L M

    2007-07-01

    Patients suffering from epilepsy commonly experience behavioral symptoms. Behavioral manifestations are especially prevalent in patients with seizures originating in the limbic system. This case report illustrates how an objective, multimodality work-up can guide the clinician in the diagnosis and the treatment of a patient with a complex presentation. After the discontinuation of some medications, the patient underwent a multimodality work-up that consisted of MRI, SPECT, and conventional and quantitative EEG (LORETA). In this case, the functional imaging studies showed a convergence of findings across the three modalities: MRI, SPECT and qEEG. Because of these findings, we supported more aggressive treatment of the seizure disorder. Ultimately this treatment resulted in resolution of the aggression and the depression. In summary, when applied routinely, a comprehensive, systematic, diagnostic approach will minimize treatment false starts and failures, may reduce costs, and also, potentially decrease the severity and the duration of symptoms. PMID:17844949

  16. Liver stiffness measurements by means of supersonic shear imaging in patients without known liver pathology.

    PubMed

    Sirli, Roxana; Bota, Simona; Sporea, Ioan; Jurchis, Ana; Popescu, Alina; Gradinaru-Tasc?u, Oana; Szilaski, Milana

    2013-08-01

    We used supersonic shear imaging to determine the liver stiffness (LS) values of 82 patients without known liver pathology and studied the factors that influence these measurements. Five LS measurements were made in each subject, and the median value, expressed in kilopascals, was calculated. Reliable LS measurements were obtained in 84.5% of patients. Higher body mass index and older age were associated with failure to obtain reliable measurements. The mean value of LS measurements determined by SSI in our cohort of patients without known liver pathology was 6 ± 1.4 kPa. The mean LS measurements determined by SSI for men were significantly higher than those for women; body mass index did not significantly influence SSI measurements. Thus, 6 kPa is the mean SSI value in patients without known liver pathology, with higher values being obtained in men. PMID:23743106

  17. Myocardial perfusion defect on thallium-201 imaging in patients with chronic obstructive pulmonary disease

    SciTech Connect

    Mehrotra, P.P.; Weaver, Y.J.; Higginbotham, E.A.

    1983-08-01

    Six patients with angina pectoris had reversible perfusion defects on stress and redistribution thallium imaging. Three patients had a positive electrocardiographic response to exercise. No significant coronary artery lesions were seen on coronary arteriography in any of the six patients. All had mild to moderate hypoxemia at rest and physiologic evidence of chronic obstructive pulmonary disease as defined by the decrease in the ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1/FVC X 100) or decrease in the forced midexpiratory flow rate (FEF25-75), or both. None had clinical findings suggestive of any of the reported causes of positive thallium scans in patients with normal coronary arteriograms. Cellular dysfunction produced by hypoxemia affecting the uptake of thallium seems to be the most likely mechanism of this abnormality.

  18. Nuclear Overhauser Enhancement Mediated Chemical Exchange Saturation Transfer Imaging at 7 Tesla in Glioblastoma Patients

    PubMed Central

    Paech, Daniel; Zaiss, Moritz; Meissner, Jan-Eric; Windschuh, Johannes; Wiestler, Benedikt; Bachert, Peter; Neumann, Jan Oliver; Kickingereder, Philipp; Schlemmer, Heinz-Peter; Wick, Wolfgang; Nagel, Armin Michael; Heiland, Sabine; Ladd, Mark Edward; Bendszus, Martin; Radbruch, Alexander

    2014-01-01

    Background and Purpose Nuclear Overhauser Enhancement (NOE) mediated chemical exchange saturation transfer (CEST) is a novel magnetic resonance imaging (MRI) technique on the basis of saturation transfer between exchanging protons of tissue proteins and bulk water. The purpose of this study was to evaluate and compare the information provided by three dimensional NOE mediated CEST at 7 Tesla (7T) and standard MRI in glioblastoma patients. Patients and Methods Twelve patients with newly diagnosed histologically proven glioblastoma were enrolled in this prospective ethics committee–approved study. NOE mediated CEST contrast was acquired with a modified three-dimensional gradient-echo sequence and asymmetry analysis was conducted at 3.3ppm (B1?=?0.7 µT) to calculate the magnetization transfer ratio asymmetry (MTRasym). Contrast enhanced T1 (CE-T1) and T2-weighted images were acquired at 3T and used for data co-registration and comparison. Results Mean NOE mediated CEST signal based on MTRasym values over all patients was significantly increased (p<0.001) in CE-T1 tumor (?1.99±1.22%), tumor necrosis (?1.36±1.30%) and peritumoral CEST hyperintensities (PTCH) within T2 edema margins (?3.56±1.24%) compared to contralateral normal appearing white matter (?8.38±1.19%). In CE-T1 tumor (p?=?0.015) and tumor necrosis (p<0.001) mean MTRasym values were significantly higher than in PTCH. Extent of the surrounding tumor hyperintensity was smaller in eight out of 12 patients on CEST than on T2-weighted images, while four displayed at equal size. In all patients, isolated high intensity regions (0.40±2.21%) displayed on CEST within the CE-T1 tumor that were not discernible on CE-T1 or T2-weighted images. Conclusion NOE mediated CEST Imaging at 7T provides additional information on the structure of peritumoral hyperintensities in glioblastoma and displays isolated high intensity regions within the CE-T1 tumor that cannot be acquired on CE-T1 or T2-weighted images. Further research is needed to determine the origin of NOE mediated CEST and possible clinical applications such as therapy assessment or biopsy planning. PMID:25111650

  19. Value of a 24-hour image (four-phase bone scan) in assessing osteomyelitis in patients with peripheral vascular disease

    SciTech Connect

    Alazraki, N.; Dries, D.; Datz, F.; Lawrence, P.; Greenberg, E.; Taylor, A. Jr.

    1985-07-01

    The delayed images of the four-phase /sup 99m/Tc phosphonate bone scan are compared with the delayed images of the three-phase study in patients with diabetes mellitus and/or peripheral vascular disease and suspected osteomyelitis. Three-phase bone imaging includes an immediate postinjection radionuclide angiogram, a blood-pool image, and delayed static images to 7 hr. The four-phase study adds a 24-hr static image. The scan is positive for osteomyelitis if images show progressively increasing lesion to background activity ratios over time. The results of analyzing 21 three- and four-phase bone scans in 17 patients were correlated with clinical course, cultures, and/or x-rays, gallium scans, and CT scans. The accuracy of four-phase bone imaging for diagnosing osteomyelitis was 85%; for three phase, 80%. Sensitivity for four phase was 80%; specificity was 87%. Sensitivity for three phase was 100%; specificity was 73%.

  20. Magnetic resonance imaging of a small vessel hepatic hemangioma in a cirrhotic patient with histopathologic correlation.

    PubMed

    Lewis, Sara; Aljarallah, Badr; Trivedi, Anshu; Thung, Swan N

    2015-01-01

    The authors report and discuss a rare case of a small vessel hepatic hemangioma in a 59-year-old patient with liver cirrhosis, which was pre-procedurally characterized as indeterminate due to atypical magnetic resonance imaging (MRI) features. This manuscript reviews the MRI features with pathologic correlation, emphasizes the importance of accurate characterization of liver lesions, and discusses the role of biopsy. We believe this is the first reported case of a small vessel hemangioma in liver cirrhosis with imaging and histopathologic correlation. PMID:25748474

  1. Using patient-specific phantoms to evaluate deformable image registration algorithms for adaptive radiation therapy.

    PubMed

    Stanley, Nick; Glide-Hurst, Carri; Kim, Jinkoo; Adams, Jeffrey; Li, Shunshan; Wen, Ning; Chetty, Indrin J; Zhong, Hualiang

    2013-01-01

    The quality of adaptive treatment planning depends on the accuracy of its underlying deformable image registration (DIR). The purpose of this study is to evaluate the performance of two DIR algorithms, B-spline-based deformable multipass (DMP) and deformable demons (Demons), implemented in a commercial software package. Evaluations were conducted using both computational and physical deformable phantoms. Based on a finite element method (FEM), a total of 11 computational models were developed from a set of CT images acquired from four lung and one prostate cancer patients. FEM generated displacement vector fields (DVF) were used to construct the lung and prostate image phantoms. Based on a fast-Fourier transform technique, image noise power spectrum was incorporated into the prostate image phantoms to create simulated CBCT images. The FEM-DVF served as a gold standard for verification of the two registration algorithms performed on these phantoms. The registration algorithms were also evaluated at the homologous points quantified in the CT images of a physical lung phantom. The results indicated that the mean errors of the DMP algorithm were in the range of 1.0 ~ 3.1 mm for the computational phantoms and 1.9 mm for the physical lung phantom. For the computational prostate phantoms, the corresponding mean error was 1.0-1.9 mm in the prostate, 1.9-2.4mm in the rectum, and 1.8-2.1 mm over the entire patient body. Sinusoidal errors induced by B-spline interpolations were observed in all the displacement profiles of the DMP registrations. Regions of large displacements were observed to have more registration errors. Patient-specific FEM models have been developed to evaluate the DIR algorithms implemented in the commercial software package. It has been found that the accuracy of these algorithms is patient dependent and related to various factors including tissue deformation magnitudes and image intensity gradients across the regions of interest. This may suggest that DIR algorithms need to be verified for each registration instance when implementing adaptive radiation therapy. PMID:24257278

  2. Image-enhanced endoscopy is critical in the surveillance of patients with colonic IBD.

    PubMed

    Subramanian, Venkataraman; Bisschops, Raf

    2014-07-01

    Cancer risk in patients with inflammatory bowel disease (IBD) involving the colon is high and increases with time. The quality and efficacy of colonoscopic surveillance is variable. Chromoendoscopy with targeted biopsies is superior to standard white light endoscopy with random biopsies. Although commonly practiced, the technique of random colonic biopsies has poor yield for dysplasia and has little clinical consequence. Studies have shown a limited role for electronic-based image-enhanced endoscopy, including narrow band imaging, in detecting IBD dysplasia. Efforts should focus on the dissemination of the technique of chromoendoscopy in routine clinical practice through training and quality metrics. PMID:24975530

  3. EXPANDED BED BIOLOGICAL TREATMENT

    EPA Science Inventory

    A three-year pilot-scale research investigation at the EPA Lebanon Pilot Plant was conducted to evaluate the feasibility of a unique biological secondary treatment process, designated the Expanded Bed Biological Treatment Process (EBBT). The EBBT process is a three-phase (oxygen/...

  4. NIUST AUVs - Expanding possibilities

    Microsoft Academic Search

    A. Diercks; V. L. Asper; M. Woolsey; J. L. Williams; F. Cantelas; R. Camilli; P. Rona; V. Guida; L. Macelloni

    2010-01-01

    The National Institute of Undersea Science and Technology (NIUST)'s Underwater Vehicle Technology Center (UVTC) expanded their operational capabilities by acquiring a SeaBED class AUV in early 2009. This vehicle dubbed, Mola Mola after the Ocean Sunfish, is a superb addition to the UVTC, as it adds photographic capabilities at very slow moving speeds to the centers repertoire. The vehicle is

  5. Expanded Roles for HRD.

    ERIC Educational Resources Information Center

    1998

    This document contains three papers from a symposium on expanded roles for human resource development (HRD). "The Roles of Consultants in Gainsharing Firms: Empirical Results" (Eunsang Cho, Gary N. McLean) reports findings that consultants are moderately involved at the separation, preparation, evaluation, and design stages and have low…

  6. Expand Your Hiring Horizons.

    ERIC Educational Resources Information Center

    Leske, Lucy Apthorp; Archer-Martin, Nancy

    1999-01-01

    To succeed in recruiting development officers, colleges and universities must use more aggressive methods to reach alumni, people with ties to the campus, and local business people; expand their selection criteria, perhaps including candidates with little or no experience; streamline the hiring process; and train new professionals. (MSE)

  7. Expanding the Literary Canon

    ERIC Educational Resources Information Center

    Horwedel, Dina

    2007-01-01

    For most college students, literature courses began in high school and consisted almost entirely of the classics of America and Western Europe. English professor Norma E. Cantu says the emergence of Hispanic literature and its growing popularity on college campuses around the country--and the world--is proof that American literature is expanding

  8. EXPANDING READERSHIP DIGITAL REPOSITORIES

    E-print Network

    Argerami, Martin

    EXPANDING READERSHIP THROUGH DIGITAL REPOSITORIES #12;Online archives of universities, colleges to search every item they hold. NEW COmPUTATIONAL RESEARCH TECHNIqUES Digital repositories open the door are available to whoever needs them, whenever needed. LONG-TERm PRESERvATION Digital repositories are managed

  9. Feasibility of monitoring patient motion with opposed stereo infrared cameras during supine medical imaging

    NASA Astrophysics Data System (ADS)

    Beach, Richard D.; McNamara, Joseph E.; Terlecki, George; King, Michael A.

    2006-10-01

    Patient motion during single photon emission computed tomographic (SPECT) acquisition causes inconsistent projection data and reconstruction artifacts which can significantly affect diagnostic accuracy. We have investigated use of the Polaris stereo infrared motion-tracking system to track 6-Degrees-of-Freedom (6-DOF) motion of spherical reflectors (markers) on stretchy bands about the patient's chest and abdomen during cardiac SPECT imaging. The marker position information, obtained by opposed stereo infrared-camera systems, requires processing to correctly record tracked markers, and map Polaris co-ordinate data into the SPECT co-ordinate system. One stereo camera views the markers from the patient's head direction, and the other from the patient's foot direction. The need for opposed cameras is to overcome anatomical and geometrical limitations which sometimes prevent all markers from being seen by a single stereo camera. Both sets of marker data are required to compute rotational and translational 6-DOF motion of the patient which ultimately will be used for SPECT patient-motion corrections. The processing utilizes an algorithm involving least-squares fitting, to each other, of two 3-D point sets using singular value decomposition (SVD) resulting in the rotation matrix and translation of the rigid body centroid. We have previously demonstrated the ability to monitor multiple markers for twelve patients viewing from the foot end, and employed a neural network to separate the periodic respiratory motion component of marker motion from aperiodic body motion. We plan to initiate routine 6-DOF tracking of patient motion during SPECT imaging in the future, and are herein evaluating the feasibility of employing opposed stereo cameras.

  10. Clinical Implications of Sulcal Enhancement on Postcontrast Fluid Attenuated Inversion Recovery Images in Patients with Acute Stroke Symptoms

    PubMed Central

    Lee, Hyukjoon; Lee, Kyung Mi; Kim, Jae Hyoung; Bae, Yun Jung; Choi, Byoung Se; Jung, Cheolkyu

    2015-01-01

    Objective Hyperintense acute reperfusion marker (HARM) without diffusion abnormalities is occasionally found in patients with an acute stroke. This study was to determine the prevalence and clinical implications of HARM without diffusion abnormalities. Materials and Methods There was a retrospective review of magnetic resonance images 578 patients with acute strokes and identified those who did not have acute infarction lesions, as mapped by diffusion-weighted imaging (DWI). These patients were classified into an imaging-negative stroke and HARM without diffusion abnormalities groups, based on the DWI findings and postcontrast fluid attenuated inversion recovery images. The National Institutes of Health Stroke Scale (NIHSS) scores at admission, 1 day, and 7 days after the event, as well as clinical data and risk factors, were compared between the imaging-negative stroke and HARM without diffusion abnormalities groups. Results Seventy-seven acute stroke patients without any DWI abnormalities were found. There were 63 patients with an imaging-negative stroke (accounting for 10.9% of 578) and 13 patients with HARM without diffusion abnormalities (accounting for 2.4% of 578). The NIHSS scores at admission were higher in HARM without diffusion abnormalities group than in the imaging-negative stroke group (median, 4.5 vs. 1.0; p < 0.001), but the scores at 7 days after the event were not significantly different between the two groups (median, 0 vs. 0; p = 1). The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001). Conclusion Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke. PMID:26175592

  11. Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients

    PubMed Central

    Shah, Ravi V.; Heydari, Bobak; Coelho-Filho, Otavio; Abbasi, Siddique A.; Feng, Jiazhuo H.; Neilan, Tomas G.; Francis, Sanjeev; Blankstein, Ron; Steigner, Michael; Jerosch-Herold, Michael; Kwong, Raymond Y.

    2014-01-01

    Objectives This study sought to determine feasibility and prognostic performance of stress cardiac magnetic resonance (CMR) in obese patients (body mass index [BMI] ?30 kg/m2). Background Current stress imaging methods remain limited in obese patients. Given the impact of the obesity epidemic on cardiovascular disease, alternative methods to effectively risk stratify obese patients are needed. Methods Consecutive patients with a BMI ?30 kg/m2 referred for vasodilating stress CMR were followed for major adverse cardiovascular events (MACE), defined as cardiac death or nonfatal myocardial infarction. Univariable and multivariable Cox regressions for MACE were performed to determine the prognostic association of inducible ischemia or late gadolinium enhancement (LGE) by CMR beyond traditional clinical risk indexes. Results Of 285 obese patients, 272 (95%) completed the CMR protocol, and among these, 255 (94%) achieved diagnostic imaging quality. Mean BMI was 35.4 ± 4.8 kg/m2, with a maximum weight of 200 kg. Reasons for failure to complete CMR included claustrophobia (n = 4), intolerance to stress agent (n = 4), poor gating (n = 4), and declining participation (n = 1). Sedation was required in 19 patients (7%; 2 patients with intravenous sedation). Sixteen patients required scanning by a 70-cm-bore system (6%). Patients without inducible ischemia or LGE experienced a substantially lower annual rate of MACE (0.3% vs. 6.3% for those with ischemia and 6.7% for those with ischemia and LGE). Median follow-up of the cohort was 2.1 years. In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, inducible ischemia (hazard ratio 7.5; 95% confidence interval: 2.0 to 28.0; p = 0.002) remained independently associated with MACE. When patients with early coronary revascularization (within 90 days of CMR) were censored on the day of revascularization, both presence of inducible ischemia and ischemia extent per segment maintained a strong association with MACE. Conclusions Stress CMR is feasible and effective in prognosticating obese patients, with a very low negative event rate in patients without ischemia or infarction. PMID:24726254

  12. Functional brain imaging in 14 patients with dissociative amnesia reveals right inferolateral prefrontal hypometabolism.

    PubMed

    Brand, Matthias; Eggers, Carsten; Reinhold, Nadine; Fujiwara, Esther; Kessler, Josef; Heiss, Wolf-Dieter; Markowitsch, Hans J

    2009-10-30

    Dissociative amnesia is a condition usually characterized by severely impaired retrograde memory functioning in the absence of structural brain damage. Recent case studies nevertheless found functional brain changes in patients suffering from autobiographical-episodic memory loss in the cause of dissociative amnesia. Functional changes were demonstrated in both resting state and memory retrieval conditions. In addition, some but not all cases also showed other neuropsychological impairments beyond retrograde memory deficits. However, there is no group study available that examined potential functional brain abnormalities and accompanying neuropsychological deteriorations in larger samples of patients with dissociative retrograde amnesia. We report functional imaging and neuropsychological data acquired in 14 patients with dissociative amnesia following stressful or traumatic events. All patients suffered from autobiographical memory loss. In addition, approximately half of the patients had deficits in anterograde memory and executive functioning. Accompanying functional brain changes were measured by [18F]fluorodeoxyglucose positron emission tomography (FDG-PET). Regional glucose utilization of the patients was compared with that of 19 healthy subjects, matched for age and gender. We found significantly decreased glucose utilization in the right inferolateral prefrontal cortex in the patients. Hypometabolism in this brain region, known to be involved in retrieval of autobiographical memories and self-referential processing, may be a functional brain correlate of dissociative amnesia. PMID:19783409

  13. Predictive value of longitudinal whole-body magnetic resonance imaging in patients with smoldering multiple myeloma.

    PubMed

    Merz, M; Hielscher, T; Wagner, B; Sauer, S; Shah, S; Raab, M S; Jauch, A; Neben, K; Hose, D; Egerer, G; Weber, M A; Delorme, S; Goldschmidt, H; Hillengass, J

    2014-09-01

    Previous studies demonstrated the relevance of focal lesions (FL) in whole-body magnetic resonance imaging (wb-MRI) at the initial workup of patients with smoldering multiple myeloma (SMM). The aim of this study was to assess the effects of longitudinal wb-MRIs on progression into multiple myeloma (MM). Sixty-three patients with SMM were analyzed who received at least two wb-MRIs for follow-up before progression into MM. Radiological progressive disease (MRI-PD) was defined as detection of new FL or increase in diameter of existing FL and a novel or progressive diffuse infiltration. Radiological stable disease (MRI-SD) was defined by no change compared with the prior MRI. Patients were followed-up every 3-6 months, including a serological and clinical evaluation. One Hundred and eighty-two wb-MRIs were analyzed. MRI-PD occurred in 31 patients (49%), and 25 (40%) patients developed MM. MRI-PD was highly significantly associated with progression into MM, regardless of findings at the initial MRI. In multivariate analysis, MRI-PD remained a risk factor, independent of relevant baseline parameters like serum monoclonal protein or ?95% aberrant plasma cells in the bone marrow. Patients with MRI-SD had no higher risk of progression, even when FL were present at the initial MRI. Therefore, MRI is suitable for the follow-up of patients with SMM. PMID:24535407

  14. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

    NASA Astrophysics Data System (ADS)

    Hernández, M. R.; Dies, P.; Gamboa-deBuen, I.; Rickards, J.; Ruiz, C.

    2008-08-01

    Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de México "Dr. Federico Gómez." We measured the entrance surface air kerma (KP) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.

  15. Nuclear Imaging of a Pregnant Patient: Should We Perform Nuclear Medicine Procedures During Pregnancy?

    PubMed Central

    Bural, Gonca G.; Laymon, Charles M.; Mountz, James M.

    2012-01-01

    Although it is extremely rare, nuclear imaging of a pregnant woman presents a unique challenge to the nuclear medicine physician because of the high concern for radiation risk to the embryo or the fetus. This challenge has been exacerbated due to recent heightened public concern of medical procedures involving radiation. This awareness also has been emphasized to the referring physicians to the extent that the risks of most nuclear medicine scans are overstressed relative to the benefit. Radionuclide procedures are reluctantly ordered by clinicians in pregnant patients, because of the malpractice fear or because of uncertainty regarding fetal radiation dose. However, when used appropriately, the benefits of nuclear imaging procedures usually outweigh the minimal risks associated with small amount of radiation even in pregnant patients. Conflict of interest:None declared. PMID:23487481

  16. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

    SciTech Connect

    Hernandez, M. R.; Gamboa-deBuen, I. [Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, A.P. 70-543, Mexico 04510 DF (Mexico); Dies, P. [Hospital Infantil de Mexico 'Dr. Federico Gomez', Dr.Marquez 162, Mexico 06720 DF (Mexico); Rickards, J.; Ruiz, C. [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, A.P. 20-364, Mexico 01000 DF (Mexico)

    2008-08-11

    Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico 'Dr. Federico Gomez.' We measured the entrance surface air kerma (K{sub P}) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.

  17. Expandable Metallic Stent Treatment for Malignant Colorectal Strictures

    SciTech Connect

    Mishima, Kazuya; Sawada, Satoshi; Tanigawa, Noboru; Okuda, Yoshikazu [Department of Radiology, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-01 (Japan); Kobayashi, Masami [Department of Radiology, Tottori University Hospital, 36-1 Nishimachi, Yonago 683 (Japan); Koyama, Tsukasa [Department of Radiology, Yohka Hospital, 1878-1 Yohka, Hyougo 667 (Japan)

    1999-03-15

    Four patients were treated by placement of an expandable metallic stent (two Gianturco Z-stents, two Ultraflex stents) for malignant colorectal strictures. All four patients were able to defecate after stent placement. Stent migration was recognized in one patient. Two patients suffered from tenesmus after stent placement.

  18. Segmenting CT prostate images using population and patient-specific statistics for radiotherapy

    SciTech Connect

    Feng, Qianjin; Foskey, Mark; Chen Wufan; Shen Dinggang [Biomedical Engineering College, South Medical University, Guangzhou (China) and Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27510 (United States); Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Biomedical Engineering College, South Medical University, Guangzhou 510510 (China); Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27510 (United States)

    2010-08-15

    Purpose: In the segmentation of sequential treatment-time CT prostate images acquired in image-guided radiotherapy, accurately capturing the intrapatient variation of the patient under therapy is more important than capturing interpatient variation. However, using the traditional deformable-model-based segmentation methods, it is difficult to capture intrapatient variation when the number of samples from the same patient is limited. This article presents a new deformable model, designed specifically for segmenting sequential CT images of the prostate, which leverages both population and patient-specific statistics to accurately capture the intrapatient variation of the patient under therapy. Methods: The novelty of the proposed method is twofold: First, a weighted combination of gradient and probability distribution function (PDF) features is used to build the appearance model to guide model deformation. The strengths of each feature type are emphasized by dynamically adjusting the weight between the profile-based gradient features and the local-region-based PDF features during the optimization process. An additional novel aspect of the gradient-based features is that, to alleviate the effect of feature inconsistency in the regions of gas and bone adjacent to the prostate, the optimal profile length at each landmark is calculated by statistically investigating the intensity profile in the training set. The resulting gradient-PDF combined feature produces more accurate and robust segmentations than general gradient features. Second, an online learning mechanism is used to build shape and appearance statistics for accurately capturing intrapatient variation. Results: The performance of the proposed method was evaluated on 306 images of the 24 patients. Compared to traditional gradient features, the proposed gradient-PDF combination features brought 5.2% increment in the success ratio of segmentation (from 94.1% to 99.3%). To evaluate the effectiveness of online learning mechanism, the authors carried out a comparison between partial online update strategy and full online update strategy. Using the full online update strategy, the mean DSC was improved from 86.6% to 89.3% with 2.8% gain. On the basis of full online update strategy, the manual modification before online update strategy was introduced and tested, the best performance was obtained; here, the mean DSC and the mean ASD achieved 92.4% and 1.47 mm, respectively. Conclusions: The proposed prostate segmentation method provided accurate and robust segmentation results for CT images even under the situation where the samples of patient under radiotherapy were limited. A conclusion that the proposed method is suitable for clinical application can be drawn.

  19. Landmarking and segmentation of computed tomographic images of pediatric patients with neuroblastoma

    Microsoft Academic Search

    Rangaraj M. Rangayyan; Shantanu Banik; Graham S. Boag

    2009-01-01

    Objectives  Segmentation and landmarking of computed tomographic (CT) images of pediatric patients are important and useful in computer-aided\\u000a diagnosis, treatment planning, and objective analysis of normal as well as pathological regions. Identification and segmentation\\u000a of organs and tissues in the presence of tumors is difficult. Automatic segmentation of the primary tumor mass in neuroblastoma\\u000a could facilitate reproducible and objective analysis of

  20. Cerebral Aneurysms: A Patient-Specific and Image-Based Management Pipeline

    Microsoft Academic Search

    M. C. Villa-Uriol; I. Larrabide; J. M. Pozo; M. Kim; M. Craene; O. Camara; C. Zhang; A. J. Geers; H. Bogunovi?; H. Morales; A. F. Frangi

    \\u000a This work presents an image- and biomechanics-based data processing pipeline able to build patient-specific models of cerebral\\u000a aneurysms. The pipeline also contemplates the virtual modeling and release of endovascular devices such as stents and coils.\\u000a As a result of the morphological, morphodynamic, hemodynamic and structural analyses, a set of complex descriptors relevant\\u000a for aneurysm’s diagnosis and prognosis is derived. On

  1. Noninvasive imaging of pancreatic islet inflammation in type 1A diabetes patients

    PubMed Central

    Gaglia, Jason L.; Guimaraes, Alexander R.; Harisinghani, Mukesh; Turvey, Stuart E.; Jackson, Richard; Benoist, Christophe; Mathis, Diane; Weissleder, Ralph

    2010-01-01

    Type 1A diabetes (T1D) is an autoimmune disease characterized by leukocyte infiltration of the pancreatic islets of Langerhans. A major impediment to advances in understanding, preventing, and curing T1D has been the inability to “see” the disease initiate, progress, or regress, especially during the occult phase. Here, we report the development of a noninvasive method to visualize T1D at the target organ level in patients with active insulitis. Specifically, we visualized islet inflammation, manifest by microvascular changes and monocyte/macrophage recruitment and activation, using magnetic resonance imaging of magnetic nanoparticles (MNPs). As a proof of principle for this approach, imaging of infused ferumoxtran-10 nanoparticles permitted effective visualization of the pancreas and distinction of recent-onset diabetes patients from nondiabetic controls. The observation that MNPs accumulate in the pancreas of T1D patients opens the door to exploiting this noninvasive imaging method to follow T1D progression and monitoring the ability of immunomodulatory agents to clear insulitis. PMID:21123946

  2. Diffusion tensor imaging and white matter abnormalities in patients with disorders of consciousness

    PubMed Central

    Cavaliere, Carlo; Aiello, Marco; Di Perri, Carol; Fernandez-Espejo, Davinia; Owen, Adrian M.; Soddu, Andrea

    2015-01-01

    Progress in neuroimaging has yielded new powerful tools which, potentially, can be applied to clinical populations, improve the diagnosis of neurological disorders and predict outcome. At present, the diagnosis of consciousness disorders is limited to subjective assessment and objective measurements of behavior, with an emerging role for neuroimaging techniques. In this review we focus on white matter alterations measured using Diffusion Tensor Imaging on patients with consciousness disorders, examining the most common diffusion imaging acquisition protocols and considering the main issues related to diffusion imaging analyses. We conclude by considering some of the remaining challenges to overcome, the existing knowledge gaps and the potential role of neuroimaging in understanding the pathogenesis and clinical features of disorders of consciousness. PMID:25610388

  3. Elemental bio-imaging of calcium phosphate crystal deposits in knee samples from arthritic patients

    PubMed Central

    Austin, Christine; Hare, Dominic; Rozelle, Andrew L.; Robinson, William H.; Grimm, Rudolf

    2012-01-01

    Laser ablation inductively coupled plasma mass spectrometry (LA ICP-MS) was employed to image deposits of calcium phosphate based crystals in knee cartilage and synovial fluid from arthritic patients. A reaction/collision cell containing hydrogen minimised plasma interferences on calcium and also improved the image quality without significant sensitivity reduction. Areas of high calcium and phosphorus intensities consistent with crystal deposits were observed for both the cartilage and synovial fluid samples. These areas were also characterised by high magnesium and strontium intensities. Distribution patterns of other elements such as copper and sulfur did not correlate with the crystal deposits. Filtered and non-filtered solutions of calcium phosphate crystals grown in synthetic synovial fluid were also imaged as further evidence of crystal deposits. The crystal deposits were detected in the unfiltered solution, and were absent from the filtered solutions. PMID:21305107

  4. Patient dosimetry for 90Y selective internal radiation treatment based on 90Y PET imaging.

    PubMed

    Ng, Sherry C; Lee, Victor H; Law, Martin W; Liu, Rico K; Ma, Vivian W; Tso, Wai Kuen; Leung, To Wai

    2013-01-01

    Until recently, the radiation dose to patients undergoing the 90Y selective internal radiation treatment (SIRT) procedure is determined by applying the partition model to 99mTc MAA pretreatment scan. There can be great uncertainty in radiation dose calculated from this approach and we presented a method to compute the 3D dose distributions resulting from 90Y SIRT based on 90Y positron emission tomography (PET) imaging. Five 90Y SIRT treatments were retrospectively analyzed. After 90Y SIRT, patients had 90Y PET/CT imaging within 6 hours of the procedure. To obtain the 3D dose distribution of the patients, their respective 90Y PET images were convolved with a Monte Carlo generated voxel dose kernel. The sensitivity of the PET/CT scanner for 90Y was determined through phantom studies. The 3D dose distributions were then presented in DICOM RT dose format. By applying the linear quadratic model to the dose data, we derived the biologically effective dose and dose equivalent to 2 Gy/fraction delivery, taking into account the spatial and temporal dose rate variations specific for SIRT. Based on this data, we intend to infer tumor control probability and risk of radiation induced liver injury from SIRT by comparison with established dose limits. For the five cases, the mean dose to target ranged from 51.7 ± 28.6 Gy to 163 ± 53.7 Gy. Due to the inhomogeneous nature of the dose distribution, the GTVs were not covered adequately, leading to very low values of tumor control probability. The mean dose to the normal liver ranged from 21.4 ± 30.7 to 36.7 ± 25.9 Gy. According to QUANTEC recommendation, a patient with primary liver cancer and a patient with metastatic liver cancer has more than 5% risk of radiotherapy-induced liver disease (RILD). PMID:24036875

  5. Prior CT imaging history for patients who undergo PAN CT for acute traumatic injury

    PubMed Central

    Kenter, Jeremy; Blow, Osbert; Krall, Scott P.; Gest, Albert; Smith, Cynthia

    2015-01-01

    Objective. A single PAN scan may provide more radiation to a patient than is felt to be safe within a one-year period. Our objective was to determine how many patients admitted to the trauma service following a PAN scan had prior CT imaging within our six-hospital system. Methods. We performed a secondary analysis of a prospectively collected trauma registry. The study was based at a level-two trauma center and five affiliated hospitals, which comprise 70.6% of all Emergency Department visits within a twelve county region of southern Texas. Electronic medical records were reviewed dating from the point of trauma evaluation back to December 5, 2005 to determine evidence of prior CT imaging. Results. There were 867 patients were admitted to the trauma service between January 1, 2012 and December 31, 2012. 460 (53%) received a PAN scan and were included in the study group. The mean age of the study group was 37.7 ± 1.54 years old, 24.8% were female, and the mean ISS score was 13.4 ± 1.07. The most common mechanism of injury was motor vehicle collision (47%). 65 (14%; 95% CI [11–18]%) of the patients had at least one prior CT. The most common prior studies performed were: CT head (29%; 19–42%), CT Face (29%; 19–42%) and CT Abdomen and Pelvis (18%; 11–30%). Conclusion. Within our trauma registry, 14% of patients had prior CT imaging within our hospital system before their traumatic event and PAN scan. PMID:26056616

  6. Simultaneous Bilateral Magnetic Resonance Imaging of the Femoral Arteries in Peripheral Arterial Disease Patients

    PubMed Central

    Brown, Ryan; Karmonik, Christof; Brunner, Gerd; Lumsden, Alan; Ballantyne, Christie; Johnson, Shawna; Wang, Yi; Morrisett, Joel

    2013-01-01

    Purpose To image the femoral arteries in peripheral arterial disease (PAD) patients using a bilateral receive coil. Materials and Methods An eight-channel surface coil array for bilateral MRI of the femoral arteries at 3T was constructed and evaluated. Results The bilateral array enabled imaging of a 25-cm segment of the superficial femoral arteries (SFA) from the profunda to the popliteal. The array provided improved the signal-to-noise ratio (SNR) at the periphery and similar SNR in the middle of a phantom compared to three other commercially available coils (4-channel torso, quadrature head, whole body). Multicontrast bilateral images of the in vivo SFA with 1 mm inplane resolution made it possible to directly compare lesions in the index SFA to the corresponding anatomical site in the contralateral vessel without repositioning the patient or coil. A set of bilateral time-of-flight, T1-weighted, T2-weighted, and proton density-weighted images was acquired in a clinically acceptable exam time of ?45 minutes. Conclusion The developed bilateral coil is well suited for monitoring dimensional changes in atherosclerotic lesions of the SFA. PMID:21598344

  7. Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy

    PubMed Central

    Price, Liam D; Au, Stephanie; Chong, N Victor

    2015-01-01

    Purpose To compare diabetic retinopathy (DR) severity grading between Optomap ultrawide field scanning laser ophthalmoscope (UWFSLO) 200° images and an Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field view. Methods Optomap UWFSLO images (total: 266) were retrospectively selected for evidence of DR from a database of eye clinic attendees. The Optomap UWFSLO images were graded for DR severity by two masked assessors. An ETDRS seven-field mask was overlaid on the Optomap UWFSLO images, and the DR grade was assessed for the region inside the mask. Any interassessor discrepancies were adjudicated by a senior retinal specialist. Kappa agreement levels were used for statistical analysis. Results Fifty images (19%) (P<0.001) were assigned a higher DR level in the Optomap UWFSLO view compared to the ETDRS seven-field view, which resulted in 40 images (15%) (P<0.001) receiving a higher DR severity grade. DR severity grades in the ETDRS seven-field view compared with the Optomap UWFSLO view were identical in 85% (226) of the images and within one severity level in 100% (266) of the images. Agreement between the two views was substantial: unweighted ? was 0.74±0.04 (95% confidence interval: 0.67–0.81) and weighted ? was 0.80±0.03 (95% confidence interval: 0.74–0.86). Conclusion Compared to the ETDRS seven-field view, a significant minority of patients are diagnosed with more severe DR when using the Optomap UWFSLO view. The clinical significance of additional peripheral lesions requires evaluation in future prospective studies using large cohorts. PMID:25848202

  8. A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup.

    PubMed

    Bert, Christoph; Metheany, Katherine G; Doppke, Karen; Chen, George T Y

    2005-09-01

    External beam irradiation requires precise positioning of the target relative to the treatment planning coordinate system. A three-dimensional (3D) surface imaging system for patient positioning has recently been installed in one of our linear accelerator (linac) rooms. The device utilizes close-range photogrammetry to generate a 3D model of the patient's surface. This geometric model can be made to look like a digital camera image if wrapped with a gray-level image (texture mapping) that shows surface coloration. The system is calibrated to the linac coordinate system and has been designed as a patient setup device. To reproduce patient position in fractionated radiotherapy, the daily patient surface model is registered to a previously recorded reference surface. Using surface registration, the system calculates the rigid-body transformation that minimizes the distance between the treatment and the reference surface models in a region-of-interest (ROI). This transformation is expressed as a set of new couch coordinates at which the patient position best matches with the reference data. If respiratory motion is a concern, the surface can be obtained with a gated acquisition at a specified phase of the respiratory cycle. To analyze the accuracy of the system, we performed several experiments with phantoms to assess stability, alignment accuracy, precision of the gating function, and surface topology. The reproducibility of surface measurements was tested for periods up to 57 h. Each recorded frame was registered to the reference surface to calculate the required couch adjustment. The system stability over this time period was better than 0.5 mm. To measure the accuracy of the system to detect and quantify patient shift relative to a reference image, we compared the shift detected by the surface imaging system with known couch transitions in a phantom study. The maximum standard deviation was 0.75 mm for the three translational degrees of freedom, and less than 0.1 degrees for each rotation. Surface model precision was tested against computed tomography (CT)-derived surface topology. The root-mean-square rms of the distance between the surfaces was 0.65 mm, excluding regions where beam hardening caused artifacts in the CT data. Measurements were made to test the gated acquisition mode. The time-dependent amplitude was measured with the surface imaging system and an established respiratory gating system based on infrared (IR)-marker detection. The measured motion trajectories from both systems were compared to the known trajectory of the stage. The standard deviations of the amplitude differences to the motor trajectory were 0.04 and 0.15 mm for the IR-marker system and the 3D surface imaging system, respectively. A limitation of the surface-imaging device is the frame rate of 6.5 Hz, because rapid changes of the motion trajectory cannot be detected. In conclusion, the system is accurate and sufficiently stable to be used in the clinic. The errors computed when comparing the surface model with CT geometry were submillimeter, and deviations in the alignment and gating-signal tests were of the same magnitude. PMID:16266088

  9. A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup

    SciTech Connect

    Bert, Christoph; Metheany, Katherine G.; Doppke, Karen; Chen, George T.Y. [Biophysics, Gesellschaft fuer Schwerionenforschung, Planckstrasse 1, 64291 Darmstadt (Germany); Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

    2005-09-15

    External beam irradiation requires precise positioning of the target relative to the treatment planning coordinate system. A three-dimensional (3D) surface imaging system for patient positioning has recently been installed in one of our linear accelerator (linac) rooms. The device utilizes close-range photogrammetry to generate a 3D model of the patient's surface. This geometric model can be made to look like a digital camera image if wrapped with a gray-level image (texture mapping) that shows surface coloration. The system is calibrated to the linac coordinate system and has been designed as a patient setup device. To reproduce patient position in fractionated radiotherapy, the daily patient surface model is registered to a previously recorded reference surface. Using surface registration, the system calculates the rigid-body transformation that minimizes the distance between the treatment and the reference surface models in a region-of-interest (ROI). This transformation is expressed as a set of new couch coordinates at which the patient position best matches with the reference data. If respiratory motion is a concern, the surface can be obtained with a gated acquisition at a specified phase of the respiratory cycle. To analyze the accuracy of the system, we performed several experiments with phantoms to assess stability, alignment accuracy, precision of the gating function, and surface topology. The reproducibility of surface measurements was tested for periods up to 57 h. Each recorded frame was registered to the reference surface to calculate the required couch adjustment. The system stability over this time period was better than 0.5 mm. To measure the accuracy of the system to detect and quantify patient shift relative to a reference image, we compared the shift detected by the surface imaging system with known couch transitions in a phantom study. The maximum standard deviation was 0.75 mm for the three translational degrees of freedom, and less than 0.1 deg. for each rotation. Surface model precision was tested against computed tomography (CT)-derived surface topology. The root-mean-square rms of the distance between the surfaces was 0.65 mm, excluding regions where beam hardening caused artifacts in the CT data. Measurements were made to test the gated acquisition mode. The time-dependent amplitude was measured with the surface imaging system and an established respiratory gating system based on infrared (IR)-marker detection. The measured motion trajectories from both systems were compared to the known trajectory of the stage. The standard deviations of the amplitude differences to the motor trajectory were 0.04 and 0.15 mm for the IR-marker system and the 3D surface imaging system, respectively. A limitation of the surface-imaging device is the frame rate of 6.5 Hz, because rapid changes of the motion trajectory cannot be detected. In conclusion, the system is accurate and sufficiently stable to be used in the clinic. The errors computed when comparing the surface model with CT geometry were submillimeter, and deviations in the alignment and gating-signal tests were of the same magnitude.

  10. Discovering the Expanding Universe

    NASA Astrophysics Data System (ADS)

    Nussbaumer, Harry; Bieri, Lydia; Sandage, Foreword by Allan

    2009-03-01

    Acknowledgments; Foreword; 1. Introduction; 2. Cosmological concepts at the end of the Middle Ages; 3. Nebulae as a new astronomical phenomenon; 4. On the construction of the Heavens; 5. Island universes turn into astronomical facts: a universe of galaxies; 6. The early cosmology of Einstein and de Sitter; 7. The dynamical universe of Friedmann; 8. Redshifts: how to reconcile Slipher and de Sitter?; 9. Lemaître discovers the expanding universe; 10. Hubble's contribution of 1929; 11. The breakthrough for the expanding universe; 12. Hubble's anger about de Sitter; 13. Robertson and Tolman join the game; 14. The Einstein-de Sitter universe; 15. Are Sun and Earth older than the universe?; 16. In search of alternative tracks; 17. The seed for the Big Bang; 18. Summary and Postscript; Appendix; References; Index.

  11. Expandable LED array interconnect

    DOEpatents

    Yuan, Thomas Cheng-Hsin; Keller, Bernd

    2011-03-01

    A light emitting device that can function as an array element in an expandable array of such devices. The light emitting device comprises a substrate that has a top surface and a plurality of edges. Input and output terminals are mounted to the top surface of the substrate. Both terminals comprise a plurality of contact pads disposed proximate to the edges of the substrate, allowing for easy access to both terminals from multiple edges of the substrate. A lighting element is mounted to the top surface of the substrate. The lighting element is connected between the input and output terminals. The contact pads provide multiple access points to the terminals which allow for greater flexibility in design when the devices are used as array elements in an expandable array.

  12. Grazing incidence beam expander

    SciTech Connect

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  13. SU-E-T-387: Achieving Optimal Patient Setup Imaging and Treatment Workflow Configurations in Multi-Room Proton Centers

    SciTech Connect

    Zhang, H; Prado, K; Langen, K; Yi, B; Mehta, M; Regine, W; D'Souza, W [University of Maryland School of Medicine, Baltimore, MD (United States)

    2014-06-01

    Purpose: To simulate patient flow in proton treatment center under uncertainty and to explore the feasibility of treatment preparation rooms to improve patient throughput and cyclotron utilization. Methods: Three center layout scenarios were modeled: (S1: In-Tx room imaging) patient setup and imaging (planar/volumetric) performed in treatment room, (S2: Patient setup in preparation room) each treatment room was assigned with preparation room(s) that was equipped with lasers only for patient setup and gross patient alignment, and (S3: Patient setup and imaging in preparation room) preparation room(s) was equipped with laser and volumetric imaging for patient setup, gross and fine patient alignment. A 'snap' imaging was performed in treatment room. For each scenario, the number of treatment rooms and the number of preparation rooms serving each treatment room were varied. We examined our results (average of 100 16-hour (two shifts) working days) by evaluating patient throughput and cyclotron utilization. Results: When the number of treatment rooms increased ([from, to]) [1, 5], daily patient throughput increased [32, 161], [29, 184] and [27, 184] and cyclotron utilization increased [13%, 85%], [12%, 98%], and [11%, 98%] for scenarios S1, S2 and S3 respectively. However, both measures plateaued after 4 rooms. With the preparation rooms, the throughput and the cyclotron utilization increased by 14% and 15%, respectively. Three preparation rooms were optimal to serve 1-3 treatment rooms and two preparation rooms were optimal to serve 4 or 5 treatment rooms. Conclusion: Patient preparation rooms for patient setup may increase throughput and decrease the need for additional treatment rooms (cost effective). Optimal number of preparation rooms serving each gantry room varies as a function of treatment rooms and patient setup scenarios. A 5th treatment room may not be justified by throughput or utilization.

  14. The Expanding Place Value

    NSDL National Science Digital Library

    Erin Thomson

    2005-01-01

    This collection of three lesson plans is designed to provide students with practice understanding place value (0 to 999), using standard and word form to represent numbers, and using expanded form to represent place value. Each lesson plan provides activities that will help build student understanding of the concepts and practice to help reinforce the skill. Thirteen resource sheets are included and can be used with these lessons or as independent activities.

  15. Motor co-activation in siblings of patients with juvenile myoclonic epilepsy: an imaging endophenotype?

    PubMed Central

    Wandschneider, Britta; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J.; Duncan, John S.

    2014-01-01

    Juvenile myoclonic epilepsy is a heritable idiopathic generalized epilepsy syndrome, characterized by myoclonic jerks and frequently triggered by cognitive effort. Impairment of frontal lobe cognitive functions has been reported in patients with juvenile myoclonic epilepsy and their unaffected siblings. In a recent functional magnetic resonance imaging study we reported abnormal co-activation of the motor cortex and increased functional connectivity between the motor system and prefrontal cognitive networks during a working memory paradigm, providing an underlying mechanism for cognitively triggered jerks. In this study, we used the same task in 15 unaffected siblings (10 female; age range 18–65 years, median 40) of 11 of those patients with juvenile myoclonic epilepsy (six female; age range 22–54 years, median 35) and compared functional magnetic resonance imaging activations with 20 age- and gender-matched healthy control subjects (12 female; age range 23–46 years, median 30.5). Unaffected siblings showed abnormal primary motor cortex and supplementary motor area co-activation with increasing cognitive load, as well as increased task-related functional connectivity between motor and prefrontal cognitive networks, with a similar pattern to patients (P < 0.001 uncorrected; 20-voxel threshold extent). This finding in unaffected siblings suggests that altered motor system activation and functional connectivity is not medication- or seizure-related, but represents a potential underlying mechanism for impairment of frontal lobe functions in both patients and siblings, and so constitutes an endophenotype of juvenile myoclonic epilepsy. PMID:25001494

  16. Body Image Disturbances Have Impact on the Sexual Problems in Chinese Systemic Lupus Erythematosus Patients

    PubMed Central

    Shen, Biyu; He, Yan; Chen, Haoyang; Zhao, Chunmei; Zhu, Li; Gao, Yingying; Ren, Yunli; Wang, Xueqing; Liu, Jingwei

    2015-01-01

    SLE might affect all aspects of life including sexual functioning; previous study found that body image disturbance (BID) was the most powerful predictors of impaired partner relationships and sexual function. The current study investigated the relationship among disease parameters, quality of life, the psychological status, BID, and sexual problems in Chinese patients with SLE. A self-report survey design was administered to 168 SLE patients and 210 healthy individuals. Our results showed that 86 (55.1%) SLE patients reported impaired relationships with a sexual partner or partners, and 100 (64.1%) patients reported impaired sexual function which were significantly higher than the control group (31.6%, 35.7%, rep.). Age, marital status, depression, and BIDQ were the most powerful predictors of impaired partner relationships, while BIDQ3 and education, disease activity, and depression were the most significant causes of impaired sexual function. The study for first time reported Chinese SLE patients had sexual problems and BID was associated with sexual problems. So, early detection and interventions might not only rehabilitate the patients and their loved ones, but also improve overall health outcomes and reduce the direct and indirect costs of their medical care.

  17. Differences in body image between anorexics and in-vitro-fertilization patients - a study with Body Grid

    PubMed Central

    Borkenhagen, Ada; Klapp, Burghard F.; Schoeneich, Frank; Brähler, Elmar

    2005-01-01

    Objectives: The purpose of the investigation was to explore the body image disturbance of anorexics and in-vitro-fertilization patients (IvF-patients) with Body Grid and Body Identity Plot. Methods: The paper reports on an empirical study conducted with 32 anorexic patients and 30 IvF-patients. The structure of the body image was derived from the Body Grid, an idiographic approach following the Role Repertory Grid developed by George A. Kelly [17]. The representation of the body image and the degree of body-acceptance is represented graphically. Results: By the Body Grid and Body Identity Plot measures we were able to identify important differences in body image between anorexics and IvF-patients. Conclusion: The tendencies of dissociation in the body image of anorexics which we found must be seen in the sense of a specific body image disturbance which differs significantly from the body-experience profile of IvF-patients. With the grid approach it was possible to elicit the inner structure of body image and determine the acceptance of the body and integration of single body parts. PMID:19742059

  18. Quality of life for our patients: how media images and messages: influence their perceptions.

    PubMed

    Carr, Ellen R

    2008-02-01

    Media messages and images shape patients' perceptions about quality of life (QOL) through various "old" media-literature, film, television, and music-and so-called "new" media-the Internet, e-mail, blogs, and cell phones. In this article, the author provides a brief overview of QOL from the academic perspectives of nursing, psychology, behavioral medicine, multicultural studies, and consumer marketing. Selected theories about mass communication are discussed, as well as new technologies and their impact on QOL in our society. Examples of media messages about QOL and the QOL experience reported by patients with cancer include an excerpt from the Canadian Broadcasting Corporation radio interview with author Carol Shields, the 60 Minutes television interview focusing on Elizabeth Edwards (wife of presidential candidate John Edwards), and an excerpt from the 1994 filmThe Shawshank Redemption. Nurses are challenged to think about how they and their patients develop their perceptions about QOL through the media. PMID:18258574

  19. Muscle Quantitative MR Imaging and Clustering Analysis in Patients with Facioscapulohumeral Muscular Dystrophy Type 1

    PubMed Central

    Lareau-Trudel, Emilie; Le Troter, Arnaud; Ghattas, Badih; Pouget, Jean; Attarian, Shahram; Bendahan, David; Salort-Campana, Emmanuelle

    2015-01-01

    Background Facioscapulohumeral muscular dystrophy type 1 (FSHD1) is the third most common inherited muscular dystrophy. Considering the highly variable clinical expression and the slow disease progression, sensitive outcome measures would be of interest. Methods and Findings Using muscle MRI, we assessed muscular fatty infiltration in the lower limbs of 35 FSHD1 patients and 22 healthy volunteers by two methods: a quantitative imaging (qMRI) combined with a dedicated automated segmentation method performed on both thighs and a standard T1-weighted four-point visual scale (visual score) on thighs and legs. Each patient had a clinical evaluation including manual muscular testing, Clinical Severity Score (CSS) scale and MFM scale. The intramuscular fat fraction measured using qMRI in the thighs was significantly higher in patients (21.9 ± 20.4%) than in volunteers (3.6 ± 2.8%) (p<0.001). In patients, the intramuscular fat fraction was significantly correlated with the muscular fatty infiltration in the thighs evaluated by the mean visual score (p<0.001). However, we observed a ceiling effect of the visual score for patients with a severe fatty infiltration clearly indicating the larger accuracy of the qMRI approach. Mean intramuscular fat fraction was significantly correlated with CSS scale (p?0.01) and was inversely correlated with MMT score, MFM subscore D1 (p?0.01) further illustrating the sensitivity of the qMRI approach. Overall, a clustering analysis disclosed three different imaging patterns of muscle involvement for the thighs and the legs which could be related to different stages of the disease and put forth muscles which could be of interest for a subtle investigation of the disease progression and/or the efficiency of any therapeutic strategy. Conclusion The qMRI provides a sensitive measurement of fat fraction which should also be of high interest to assess disease progression and any therapeutic strategy in FSHD1 patients. PMID:26181385

  20. Images created in a model eye during simulated cataract surgery can be the basis for images perceived by patients during cataract surgery

    PubMed Central

    Inoue, M; Uchida, A; Shinoda, K; Taira, Y; Noda, T; Ohnuma, K; Bissen-Miyajima, H; Hirakata, A

    2014-01-01

    Purpose To evaluate the images created in a model eye during simulated cataract surgery. Patients and methods This study was conducted as a laboratory investigation and interventional case series. An artificial opaque lens, a clear intraocular lens (IOL), or an irrigation/aspiration (I/A) tip was inserted into the ‘anterior chamber' of a model eye with the frosted posterior surface corresponding to the retina. Video images were recorded of the posterior surface of the model eye from the rear during simulated cataract surgery. The video clips were shown to 20 patients before cataract surgery, and the similarity of their visual perceptions to these images was evaluated postoperatively. Results The images of the moving lens fragments and I/A tip and the insertion of the IOL were seen from the rear. The image through the opaque lens and the IOL without moving objects was the light of the surgical microscope from the rear. However, when the microscope light was turned off after IOL insertion, the images of the microscope and operating room were observed by the room illumination from the rear. Seventy percent of the patients answered that the visual perceptions of moving lens fragments were similar to the video clips and 55% reported similarity with the IOL insertion. Eighty percent of the patients recommended that patients watch the video clip before their scheduled cataract surgery. Conclusions The patients' visual perceptions during cataract surgery can be reproduced in the model eye. Watching the video images preoperatively may help relax the patients during surgery. PMID:24788007

  1. Factors affecting patient compliance in the acute setting: an analysis of 20,000 imaging reports.

    PubMed

    Shuaib, Waqas; Vijayasarathi, Arvind; Johnson, Jamlik-Omari; Salastekar, Ninad; He, Qing; Maddu, Kiran Kumar; Khosa, Faisal

    2014-08-01

    The aim of this study was to identify the risk factors associated with noncompliance of recommendations made by emergency radiologists. Between March 2012 and August 2012, our team retrospectively reviewed 20,000 consecutive emergency department (ED) patients receiving imaging to assess how often emergency radiologists made recommendations, how often they were followed, and what factors were associated with noncompliance. Faculty (Radiology or Emergency Medicine) were considered senior if they had been practicing for >5 years post residency/fellowship training. Faculty practicing <5 years were considered junior physicians. The following data was extracted from the electronic medical records and the hospital information system: recommendation in imaging report, age, gender, race (Caucasian, African-American, and others), insurance status, primary care contact, distance from the hospital to patient residence, and primary language. Recommendations were categorized as follows: (1) immediate follow-up, (2) follow-up 1-4 weeks, (3) follow-up 1-3 months, (4) follow-up 4-6 months, (5) follow-up 7-12 months, and (6) clinical/laboratory follow-up recommendations irrespective of time. We identified 1,650 recommendations (1,650/20,000 = 8.25 %). Using a one-to-one logistic regression analysis, the following factors were significant (P < 0.05) when evaluating noncompliance: increasing age, no primary care physician, lack of insurance, primary language other than English, increased distance from hospital, and extended follow-up interval. Noncompliance with recommended additional imaging (RAI) is multifactorial. Primary and/or referring physicians should take notice of the aforementioned compliance trends and mitigating factors, adopt systematic safety measures and create interdepartmental dialogue with radiology to ensure compliance, and counsel and educate patients about the importance of imaging recommendations. PMID:24615661

  2. Utility of traditional circulating and imaging-based cardiac biomarkers in patients with predialysis CKD.

    PubMed

    Colbert, Gates; Jain, Nishank; de Lemos, James A; Hedayati, S Susan

    2015-03-01

    Cardiac biomarkers, such as cardiac troponin T (cTnT), brain natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-pro-BNP), are commonly used to diagnose acute coronary syndrome and congestive heart failure exacerbation in symptomatic patients. Levels of these biomarkers are frequently chronically elevated in asymptomatic patients with ESRD who are receiving maintenance dialysis. Other imaging biomarkers commonly encountered in nephrologists' clinical practice, such as coronary artery calcium measured by computed tomography, left ventricular hypertrophy, and carotid intima-media thickness, are also frequently abnormal in asymptomatic patients with ESRD. This article critically reviews the limited observational data on associations between cTnT, BNP, NT-pro-BNP, coronary artery calcium, left ventricular hypertrophy, and carotid intima-media thickness with cardiovascular events and death in non-dialysis-dependent patients with CKD. Although sufficient evidence suggests that these biomarkers may be used for prognostication, the diagnostic utility of cTnT, BNP, and NT-pro-BNP remain challenging in patients with CKD. Decreased renal clearance may affect the plasma levels of these biomarkers, and upper reference limits were originally derived in patients without CKD. Until better data are available, higher cutoffs, or a rise in level compared with previous values, have been proposed to help distinguish acute myocardial infarction from chronic elevations of cTnT in symptomatic patients with CKD. Additionally, it is not known whether these biomarkers are modifiable and amenable to interventions that could change hard clinical outcomes in patients with CKD not yet undergoing long-term dialysis. PMID:25403922

  3. Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system

    PubMed Central

    Sharma, Reena; Sharma, Sunil Dutt; Pawar, Shramika; Chaubey, Ajay; Kantharia, S.; Babu, D. A. R.

    2015-01-01

    The screen-film system is replaced by computed radiography system for recording the images of the patients during X-ray radiography examinations. The change in imaging system requires the re-establishment of the institutional diagnostic reference levels (DRLs) for different types of X-ray examinations conducted at the hospital. For this purpose, patient specific parameters [age, height, weight, body mass index (BMI), object to image distance (OID)] and machine specific parameters (kVp, mAs, distance and field sizes) of 1875 patients during 21 different types of X-ray examinations were recorded for estimating the entrance skin dose (ESD). The ESD for each of these patients were estimated using measured X-ray beam output and the standard value of the back scatter factor. Five number summary was calculated for all the data for their presentation in the Box-Whisker plot, which provides the statistical distribution of the data. The data collected indicates that majorly performed examinations are cervical spine AP, Chest PA and Knee Lat with percentage contributions of 16.05, 16 and 8.27% respectively. The lowest contribution comes from Hip Lat which is about 1.01%. The ratio of measured ESD (maximum to minimum) for these examinations is found to be highest for the cervical spine AP with a value of 50 followed by Thoracic spine AP of 32.36. The ESD ratio for Chest PA, Knee Lat and Lumbar Spine AP are 30.75, 30.4 and 30.2 respectively. The lowest ESD ratio is for Hip Lat which is 2.68. The third quartile values of ESDs are established as the institutional DRLs. The ESD values obtained for 21 different X-ray projections are either comparable or lesser than the reported national/international values.

  4. Magnetic Resonance Imaging of the Ear for Patient-Specific Reconstructive Surgery

    PubMed Central

    Nimeskern, Luc; Feldmann, Eva-Maria; Kuo, Willy; Schwarz, Silke; Goldberg-Bockhorn, Eva; Dürr, Susanne; Müller, Ralph; Rotter, Nicole; Stok, Kathryn S.

    2014-01-01

    Introduction Like a fingerprint, ear shape is a unique personal feature that should be reconstructed with a high fidelity during reconstructive surgery. Ear cartilage tissue engineering (TE) advantageously offers the possibility to use novel 3D manufacturing techniques to reconstruct the ear, thus allowing for a detailed auricular shape. However it also requires detailed patient-specific images of the 3D cartilage structures of the patient’s intact contralateral ear (if available). Therefore the aim of this study was to develop and evaluate an imaging strategy for acquiring patient-specific ear cartilage shape, with sufficient precision and accuracy for use in a clinical setting. Methods and Materials Magnetic resonance imaging (MRI) was performed on 14 volunteer and six cadaveric auricles and manually segmented. Reproducibility of cartilage volume (Cg.V), surface (Cg.S) and thickness (Cg.Th) was assessed, to determine whether raters could repeatedly define the same volume of interest. Additionally, six cadaveric auricles were harvested, scanned and segmented using the same procedure, then dissected and scanned using high resolution micro-CT. Correlation between MR and micro-CT measurements was assessed to determine accuracy. Results Good inter- and intra-rater reproducibility was observed (precision errors <4% for Cg.S and <9% for Cg.V and Cg.Th). Intraclass correlations were good for Cg.V and Cg.S (>0.82), but low for Cg.Th (<0.23) due to similar average Cg.Th between patients. However Pearson’s coefficients showed that the ability to detect local cartilage shape variations is unaffected. Good correlation between clinical MRI and micro-CT (r>0.95) demonstrated high accuracy. Discussion and Conclusion This study demonstrated that precision and accuracy of the proposed method was high enough to detect patient-specific variation in ear cartilage geometry. The present study provides a clinical strategy to access the necessary information required for the production of 3D ear scaffolds for TE purposes, including detailed patient-specific shape. Furthermore, the protocol is applicable in daily clinical practice with existing infrastructure. PMID:25144306

  5. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients

    Microsoft Academic Search

    T. Ichikawa; H. Haradome; J. Hachiya; T. Nitatori; T. Araki

    1999-01-01

    Background: To determine the potential ability of diffusion-weighted magnetic resonance (MR) imaging with single-shot echo-planar imaging\\u000a (DW imaging) in the upper abdomen by apparent diffusion coefficient (ADC) and signal:intensity ratio (SIR) measurements.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: DW imaging was performed in 61 clinical patients. ADCs in the liver, pancreas, spleen, kidney, and different pathological\\u000a conditions were calculated. Spleen-to-liver SIR and segmental intensity difference

  6. Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy

    SciTech Connect

    Schiffner, Daniel C. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Gottschalk, Alexander R. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States) and Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States)]. E-mail: gottschalk@radonc17.ucsf.edu; Lometti, Michael M.S. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Aubin, Michele M.Sc.E.E. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Pouliot, Jean [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Speight, Joycelyn [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Hsu, I.-Chow [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Shinohara, Katsuto [Department of Urology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States)

    2007-02-01

    Purpose: The aim of this study was to measure interfraction prostate bed motion, setup error, and total positioning error in 10 consecutive patients undergoing postprostatectomy radiotherapy. Methods and Materials: Daily image-guided target localization and alignment using electronic portal imaging of gold seed fiducials implanted into the prostate bed under transrectal ultrasound guidance was used in 10 patients undergoing adjuvant or salvage radiotherapy after prostatectomy. Prostate bed motion, setup error, and total positioning error were measured by analysis of gold seed fiducial location on the daily electronic portal images compared with the digitally reconstructed radiographs from the treatment-planning CT. Results: Mean ({+-} standard deviation) prostate bed motion was 0.3 {+-} 0.9 mm, 0.4 {+-} 2.4 mm, and -1.1 {+-} 2.1 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) axes, respectively. Mean set-up error was 0.1 {+-} 4.5 mm, 1.1 {+-} 3.9 mm, and -0.2 {+-} 5.1 mm in the LR, SI, and AP axes, respectively. Mean total positioning error was 0.2 {+-} 4.5 mm, 1.2 {+-} 5.1 mm, and -0.3 {+-} 4.5 mm in the LR, SI, and AP axes, respectively. Total positioning errors >5 mm occurred in 14.1%, 38.7%, and 28.2% of all fractions in the LR, SI, and AP axes, respectively. There was no significant migration of the gold marker seeds. Conclusions: This study validates the use of daily image-guided target localization and alignment using electronic portal imaging of implanted gold seed fiducials as a valuable method to correct for interfraction target motion and to improve precision in the delivery of postprostatectomy radiotherapy.

  7. Molecular Imaging in Cancer

    NASA Astrophysics Data System (ADS)

    Weissleder, Ralph

    2006-05-01

    Medical imaging technologies have undergone explosive growth over the past few decades and now play a central role in clinical oncology. But the truly transformative power of imaging in the clinical management of cancer patients lies ahead. Today, imaging is at a crossroads, with molecularly targeted imaging agents expected to broadly expand the capabilities of conventional anatomical imaging methods. Molecular imaging will allow clinicians to not only see where a tumor is located in the body, but also to visualize the expression and activity of specific molecules (e.g., proteases and protein kinases) and biological processes (e.g., apoptosis, angiogenesis, and metastasis) that influence tumor behavior and/or response to therapy. This information is expected to have a major impact on cancer detection, individualized treatment, and drug development, as well as our understanding of how cancer arises.

  8. Chest imaging features of patients afflicted with Influenza A (H1N1) in a Malaysian tertiary referral centre

    PubMed Central

    Bux, SI; Mohd. Ramli, N; Ahmad Sarji, S; Kamarulzaman, A

    2010-01-01

    This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis. PMID:21611071

  9. Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come?

    PubMed

    Nordbeck, Peter; Ertl, Georg; Ritter, Oliver

    2015-06-21

    Magnetic resonance imaging (MRI) has long been regarded a general contraindication in patients with cardiovascular implanted electronic devices such as cardiac pacemakers or cardioverter defibrillators (ICDs) due to the risk of severe complications and even deaths caused by interactions of the magnetic resonance (MR) surrounding and the electric devices. Over the last decade, a better understanding of the underlying mechanisms responsible for such potentially life-threatening complications as well as technical advances have allowed an increasing number of pacemaker and ICD patients to safely undergo MRI. This review lists the key findings from basic research and clinical trials over the last 20 years, and discusses the impact on current day clinical practice. With 'MR-conditional' devices being the new standard of care, MRI in pacemaker and ICD patients has been adopted to clinical routine today. However, specific precautions and specifications of these devices should be carefully followed if possible, to avoid patient risks which might appear with new MR technology and further increasing indications and patient numbers. PMID:25796053

  10. Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come?

    PubMed Central

    Nordbeck, Peter; Ertl, Georg; Ritter, Oliver

    2015-01-01

    Magnetic resonance imaging (MRI) has long been regarded a general contraindication in patients with cardiovascular implanted electronic devices such as cardiac pacemakers or cardioverter defibrillators (ICDs) due to the risk of severe complications and even deaths caused by interactions of the magnetic resonance (MR) surrounding and the electric devices. Over the last decade, a better understanding of the underlying mechanisms responsible for such potentially life-threatening complications as well as technical advances have allowed an increasing number of pacemaker and ICD patients to safely undergo MRI. This review lists the key findings from basic research and clinical trials over the last 20 years, and discusses the impact on current day clinical practice. With ‘MR-conditional’ devices being the new standard of care, MRI in pacemaker and ICD patients has been adopted to clinical routine today. However, specific precautions and specifications of these devices should be carefully followed if possible, to avoid patient risks which might appear with new MR technology and further increasing indications and patient numbers. PMID:25796053

  11. Image-Guided Hypofractionated Radiotherapy in Low-Risk Prostate Cancer Patients

    PubMed Central

    Valeriani, Maurizio; Carnevale, Alessia; Bonome, Paolo; Montalto, Adelaide; Nicosia, Luca; Osti, Mattia F.; De Sanctis, Vitaliana; Minniti, Giuseppe; Maurizi Enrici, Riccardo

    2014-01-01

    Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT) in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT). Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60?Gy delivered in 20 fractions. Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI) and genitourinary (GU) toxicity rates were 11.9% and 40.7%, respectively. Grade 1?GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ?2 late toxicities were recorded. Acute grade 2-3?GU toxicity resulted significantly lower (P = 0.04) in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2?GU toxicity was significantly higher (P < 0.001) for HFRT patients. Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT. PMID:24864248

  12. The Potential Impact of Functional Imaging on Decision Making and Outcome in Patients Undergoing Surgical Revascularization.

    PubMed

    Plass, Andre; Goetti, Robert P; Emmert, Maximilian Y; Caliskan, Etem; Stolzmann, Paul; Wieser, Monika; Donati, Olivio; Alkadhi, Hatem; Falk, Volkmar

    2015-06-01

    Objective?Coronary angiography (CA) remains the standard for preoperative planning for surgical revascularization. However, besides anatomical imaging, current guidelines recommend additional functional imaging before a therapy decision is made. We assess the impact of functional imaging on the strategy of coronary artery bypass grafting (CABG) with particular regards on postoperative patency and myocardial perfusion. Methods?After CA, 55 patients (47 males/8 females; age: 65.1?±?9.5 years) underwent perfusion cardiovascular magnetic resonance (CMR) and dual-source computed tomography (DSCT) before isolated CABG (n?=?31), CABG and concomitant valve surgery (valve?+?CABG; n?=?10) and isolated valve surgery (n?=?14; control). DSCT was used for analysis of significant stenosis, CMR for myocardial-perfusion to discriminate between: no ischemia (normal), ischemia, or scar. The results, unknown to the surgeons, were compared with CA and related to the location and number of distal anastomoses. Nineteen CABG patients underwent follow-up CMR and DSCT (FU: 13?±?3 months) to compare the preop findings with the postop outcomes. Results?Thirty-nine patients either received CABG alone (n?=?31) or a combined procedure (n?=?10) with a total of 116 distal anastomoses. DSCT was compared with CA regarding accuracy of coronary stenosis and showed 91% sensitivity, 88% specificity, and negative/positive predictive values of 89/90%. In total, 880 myocardial segments (n?=?55, 16 segments/patient) were assessed by CMR. In 17% (149/880) of segments ischemia and in 8% (74/880) scar tissue was found. Interestingly, 14% (16/116) of bypass-anastomoses were placed on non-ischemic myocardium and 3% (4/116) on scar tissue. In a subgroup of 19 patients 304 segments were evaluated. Thirty-nine percent (88/304) of all segments showed ischemia preoperatively, while 94% (83/88) of these ischemic segments did not show any ischemia postoperatively. In regard to performed anastomoses, 79% of all grafts (49/62) were optimally placed, whereas 21% (13/62) were either placed into non-ischemic myocardium or scar tissue, including 10% occluded grafts (6/62). Conclusion?In the whole cohort analysis, 17% of grafts were placed in regions with either no ischemia or scar tissue. The subgroup analysis revealed that 94% of all ischemic segments were successfully revascularized after CABG. Thus, functional imaging could be a promising tool in preoperative planning of revascularization strategy. Avoidance of extensive and unnecessary grafting could further optimize outcomes after CABG. PMID:25463355

  13. Anterior Segment Optical Coherence Tomography: Assisted Topographic Corneal Epithelial Thickness Distribution Imaging of a Keratoconus Patient

    PubMed Central

    Kanellopoulos, A. John; Asimellis, George

    2013-01-01

    Purpose To evaluate safety, efficacy and ease of measurement of epithelial thickness in a keratoconic patient based on anterior segment optical coherence tomography (AS-OCT). Methods A 25-year-old male patient, previously diagnosed with keratoconus, with highly asymmetric manifestation among the two eyes, was subjected to AS-OCT corneal epithelial imaging. We investigated epithelial thickness and epithelial topographic thickness distribution. Results Mean epithelial thickness was 51.97 ± 0.70 for the less affected right eye (OD), and 55.65 ± 1.22 for the more affected left eye (OS). Topographic epithelial thickness variability for the OD was 1.53 ± 0.21 ?m, while for the OS it was 9.80 ± 0.41 ?m. Conclusions This case further supports our previous findings with high-frequency ultrasound measurements of the increase in overall epithelial thickness in keratoconic eyes in comparison with normal eyes. AS-OCT further offers ease of use and possibly higher predictability of measurement. This case report, based on AS-OCT imaging, verifies increased overall epithelial thickness in keratoconic eyes, as introduced by a previous study [Kanellopoulos et al.: Clin Ophthalmol 2012;6:789–800], based on high-frequency scanning ultrasound biomicroscopy imaging. PMID:23687500

  14. Transit Dosimetry for Patient Treatment Verification with an Electronic Portal Imaging Device

    NASA Astrophysics Data System (ADS)

    Berry, Sean L.

    The complex and individualized photon fluence patterns constructed during intensity modulated radiation therapy (IMRT) treatment planning must be verified before they are delivered to the patient. There is a compelling argument for additional verification throughout the course of treatment due to the possibility of data corruption, unintentional modification of the plan parameters, changes in patient anatomy, errors in patient alignment, and even mistakes in identifying the correct patient for treatment. Amorphous silicon (aSi) Electronic Portal Imaging Devices (EPIDs) can be utilized for IMRT verification. The goal of this thesis is to implement EPID transit dosimetry, measurement of the dose at a plane behind the patient during their treatment, within the clinical process. In order to achieve this goal, a number of the EPID's dosimetric shortcomings were studied and subsequently resolved. Portal dose images (PDIs) acquired with an aSi EPID suffer from artifacts related to radiation backscattered asymmetrically from the EPID support structure. This backscatter signal varies as a function of field size (FS) and location on the EPID. Its presence can affect pixel values in the measured PDI by up to 3.6%. Two methods to correct for this artifact are offered: discrete FS specific correction matrices and a single generalized equation. The dosimetric comparison between the measured and predicted through-air dose images for 49 IMRT treatment fields was significantly improved (p << .001) after the application of these FS specific backscatter corrections. The formulation of a transit dosimetry algorithm followed the establishment of the backscatter correction and a confirmation of the EPID's positional stability with linac gantry rotation. A detailed characterization of the attenuation, scatter, and EPID response behind an object in the beam's path is necessary to predict transit PDIs. In order to validate the algorithm's performance, 49 IMRT fields were delivered to a number of homogeneous and heterogeneous slab phantoms. A total of 33 IMRT fields were delivered to an anthropomorphic phantom. On average, 98.1% of the pixels in the dosimetric comparison between the measured and predicted transit dose images passed a 3%/3mm gamma analysis. Further validation of the transit dosimetry algorithm was performed on nine human subjects under an institutional review board (IRB) approved protocol. The algorithm was shown to be feasible for patient treatment verification. Comparison between measured and predicted transit dose images resulted in an average of 89.1% of pixels passing a 5%/3mm gamma analysis. A case study illustrated the important role that EPID transit dosimetry can play in indicating when a treatment delivery is inconsistent with the original plan. The impact of transit dosimetry on the clinical workflow for these nine patients was analyzed to identify improvements that could be made to the procedure in order to ease widespread clinical implementation. EPID transit dosimetry is a worthwhile treatment verification technique that strikes a balance between effectiveness and efficiency. This work, which focused on the removal of backscattered radiation artifacts, verification of the EPID's stability with gantry rotation, and the formulation and validation of a transit dosimetry algorithm, has improved the EPID's dosimetric performance. Future research aimed at online transit verification would maximize the benefit of transit dosimetry and greatly improve patient safety.

  15. Automated Optic Disc Detection in Retinal Images of Patients with Diabetic Retinopathy and Risk of Macular Edema

    Microsoft Academic Search

    Arturo Aquino; Manuel Emilio Geg; Diego Mar ´ in

    In this paper, a new automated methodology to detect the optic disc (OD) automatically in retinal images from patients with risk of being affected by Diabetic Retinopathy (DR) and Macular Edema (ME) is presented. The detection procedure comprises two independent methodologies. On one hand, a location methodology obtains a pixel that belongs to the OD using image contrast analysis and

  16. In vivo molecular imaging of chemokine receptor CXCR4 expression in patients with advanced multiple myeloma.

    PubMed

    Philipp-Abbrederis, Kathrin; Herrmann, Ken; Knop, Stefan; Schottelius, Margret; Eiber, Matthias; Lückerath, Katharina; Pietschmann, Elke; Habringer, Stefan; Gerngroß, Carlos; Franke, Katharina; Rudelius, Martina; Schirbel, Andreas; Lapa, Constantin; Schwamborn, Kristina; Steidle, Sabine; Hartmann, Elena; Rosenwald, Andreas; Kropf, Saskia; Beer, Ambros J; Peschel, Christian; Einsele, Hermann; Buck, Andreas K; Schwaiger, Markus; Götze, Katharina; Wester, Hans-Jürgen; Keller, Ulrich

    2015-04-01

    CXCR4 is a G-protein-coupled receptor that mediates recruitment of blood cells toward its ligand SDF-1. In cancer, high CXCR4 expression is frequently associated with tumor dissemination and poor prognosis. We evaluated the novel CXCR4 probe [(68)Ga]Pentixafor for in vivo mapping of CXCR4 expression density in mice xenografted with human CXCR4-positive MM cell lines and patients with advanced MM by means of positron emission tomography (PET). [(68)Ga]Pentixafor PET provided images with excellent specificity and contrast. In 10 of 14 patients with advanced MM [(68)Ga]Pentixafor PET/CT scans revealed MM manifestations, whereas only nine of 14 standard [(18)F]fluorodeoxyglucose PET/CT scans were rated visually positive. Assessment of blood counts and standard CD34(+) flow cytometry did not reveal significant blood count changes associated with tracer application. Based on these highly encouraging data on clinical PET imaging of CXCR4 expression in a cohort of MM patients, we conclude that [(68)Ga]Pentixafor PET opens a broad field for clinical investigations on CXCR4 expression and for CXCR4-directed therapeutic approaches in MM and other diseases. PMID:25736399

  17. In vivo molecular imaging of chemokine receptor CXCR4 expression in patients with advanced multiple myeloma

    PubMed Central

    Philipp-Abbrederis, Kathrin; Herrmann, Ken; Knop, Stefan; Schottelius, Margret; Eiber, Matthias; Lückerath, Katharina; Pietschmann, Elke; Habringer, Stefan; Gerngroß, Carlos; Franke, Katharina; Rudelius, Martina; Schirbel, Andreas; Lapa, Constantin; Schwamborn, Kristina; Steidle, Sabine; Hartmann, Elena; Rosenwald, Andreas; Kropf, Saskia; Beer, Ambros J; Peschel, Christian; Einsele, Hermann; Buck, Andreas K; Schwaiger, Markus; Götze, Katharina; Wester, Hans-Jürgen; Keller, Ulrich

    2015-01-01

    CXCR4 is a G-protein-coupled receptor that mediates recruitment of blood cells toward its ligand SDF-1. In cancer, high CXCR4 expression is frequently associated with tumor dissemination and poor prognosis. We evaluated the novel CXCR4 probe [68Ga]Pentixafor for in vivo mapping of CXCR4 expression density in mice xenografted with human CXCR4-positive MM cell lines and patients with advanced MM by means of positron emission tomography (PET). [68Ga]Pentixafor PET provided images with excellent specificity and contrast. In 10 of 14 patients with advanced MM [68Ga]Pentixafor PET/CT scans revealed MM manifestations, whereas only nine of 14 standard [18F]fluorodeoxyglucose PET/CT scans were rated visually positive. Assessment of blood counts and standard CD34+ flow cytometry did not reveal significant blood count changes associated with tracer application. Based on these highly encouraging data on clinical PET imaging of CXCR4 expression in a cohort of MM patients, we conclude that [68Ga]Pentixafor PET opens a broad field for clinical investigations on CXCR4 expression and for CXCR4-directed therapeutic approaches in MM and other diseases. PMID:25736399

  18. A Simple Technique to Deflate a Tissue Expander

    PubMed Central

    Dalton, Edward

    2014-01-01

    Summary: Removal of an intact, inflated tissue expander can result in uncontrolled spillage of expander contents on the drapes, surgeons, staff, or patient. The technique described has been used for the past 4 years to eliminate these spillage concerns. It is simple and inexpensive using common disposable supplies found in any operating room. An irrigating syringe is modified by cutting away its 2 flanges. The bulb is removed and suction is applied to the syringe tip. The expander is punctured with a scalpel while the puncture hole is covered by the syringe opening. The applied suction aspirates the contents thereby deflating the expander. Uncontrolled content spillage and spray are eliminated. PMID:25289324

  19. Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy

    PubMed Central

    von Oertzen, J; Urbach, H; Jungbluth, S; Kurthen, M; Reuber, M; Fernandez, G; Elger, C

    2002-01-01

    Objectives: Patients with intractable epilepsy may benefit from epilepsy surgery especially if they have a radiologically demonstrable cerebral lesion. Dedicated magnetic resonance imaging (MRI) protocols as performed at epilepsy surgery centres can detect epileptogenic abnormalities with great sensitivity and specificity. However, many patients with epilepsy are investigated with standard MRI sequences by radiologist outside epilepsy centres ("non-experts"). This study was undertaken to compare standard MRI and epilepsy specific MRI findings in patients with focal epilepsy. Methods: Comparison of results of standard MRI reported by "non-expert" radiologists, standard MRI evaluated by epilepsy "expert" radiologists, and epilepsy specific MRI read by "expert" radiologists in 123 consecutive patients undergoing epilepsy surgery evaluation between 1996 and 1999. Validation of radiological findings by correlation with postoperative histological examination. Results: Sensitivity of "non-expert" reports of standard MRI reports for focal lesions was 39%, of "expert" reports of standard MRI 50%, and of epilepsy dedicated MRI 91%. Dedicated MRI showed focal lesions in 85% of patients with "non-lesional" standard MRI. The technical quality of standard MRI improved during the study period, but "non-expert" reporting did not. In particular, hippocampal sclerosis was missed in 86% of cases. Neuropathological diagnoses (n=90) were predicted correctly in 22% of "non-expert" standard MRI reports but by 89% of dedicated MRI reports. Conclusions: Standard MRI failed to detect 57% of focal epileptogenic lesions. Patients without MRI lesion are less likely to be considered candidates for epilepsy surgery. Patients with refractory epilepsy should be referred to an MRI unit with epileptological experience at an early point. PMID:12438463

  20. Effect of clozapine on white matter integrity in patients with schizophrenia: a diffusion tensor imaging study.

    PubMed

    Ozcelik-Eroglu, Elcin; Ertugrul, Aygun; Oguz, Kader Karli; Has, Arzu Ceylan; Karahan, Sevilay; Yazici, Mumin Kazim

    2014-09-30

    Several diffusion tensor imaging (DTI) studies have reported disturbed white matter integrity in various brain regions in patients with schizophrenia, whereas only a few studied the effect of antipsychotics on DTI measures. The aim of this study was to investigate the effect of 12 weeks of clozapine treatment on DTI findings in patients with schizophrenia, and to compare the findings with those in unaffected controls. The study included 16 patients with schizophrenia who were assessed with the Positive and Negative Syndrome Scale, a neurocognitive test battery, and DTI at baseline and 12 weeks after the initiation of clozapine treatment. Eight unaffected controls were assessed once with the neurocognitive test battery and DTI. Voxel-wise analysis of DTI data was performed via tract-based spatial statistics (TBSS). Compared with the control group, the patient group exhibited lower fractional anisotropy (FA) in 16 brain regions, including the bilateral superior longitudinal fasciculi, inferior fronto-occipital fasciculi, superior and inferior parietal lobules, cingulate bundles, cerebellum, middle cerebellar peduncles, and left inferior longitudinal fasciculus, whereas the patients had higher FA in six regions, including the right parahippocampus, left anterior thalamic radiation, and right posterior limb of the internal capsule before clozapine treatment. After 12 weeks of treatment with clozapine, white matter FA was increased in widespread brain regions. In two of the regions where FA had initially been lower in patients compared with controls (left inferior fronto-occipital fasciculus and superior parietal lobule), clozapine appeared to increase FA. An improvement in semantic fluency was correlated with the increase in FA value in the left inferior fronto-occipital fasciculus. An increase in FA following 12 weeks of treatment with clozapine suggests that this treatment alters white matter microstructural integrity in patients with schizophrenia previously treated with typical and/or atypical antipsychotics and, in some locations, reverses a previous deficit. PMID:25012780

  1. Diffusion tensor imaging of patients with proteolipid protein 1 gene mutations.

    PubMed

    Laukka, Jeremy J; Makki, Malek I; Lafleur, Tori; Stanley, Jeffrey; Kamholz, John; Garbern, James Y

    2014-12-01

    Pelizaeus-Merzbacher disease (PMD) is an X-linked disorder of the central nervous system (CNS) caused by a wide variety of mutations affecting proteolipid protein 1 (PLP1). We assessed the effects of PLP1 mutations on water diffusion in CNS white matter by using diffusion tensor imaging. Twelve patients with different PLP1 point mutations encompassing a range of clinical phenotypes were analyzed, and the results were compared with a group of 12 age-matched controls. The parallel (?// ), perpendicular (?? ), and apparent diffusion coefficients (ADC) and fractional anisotropy were measured in both limbs of the internal capsule, the genu and splenium of corpus callosum, the base of the pons, and the cerebral peduncles. The mean ADC and ?? in the PMD patient group were both significantly increased in all selected structures, except for the base of the pons, compared with controls. PMD patients with the most severe disease, however, had a significant increase of both ?// and ?? . In contrast, more mildly affected patients had much smaller changes in ?// and ?? . These data suggest that myelin, the structure responsible in part for the ?? barrier, is the major site of disease pathogenesis in this heterogeneous group of patients. Axons, in contrast, the structures mainly responsible for ?// , are much less affected, except within the subgroup of patients with the most severe disease. Clinical disability in patients with PLP1 point mutation is thus likely determined by the extent of pathological involvement of both myelin and axons, with alterations of both structures causing the most severe disease. © 2014 Wiley Periodicals, Inc. PMID:25156430

  2. Multi-observation PET image analysis for patient follow-up quantitation and therapy assessment

    PubMed Central

    David, Simon; Visvikis, Dimitris; Roux, Christian; Hatt, Mathieu

    2011-01-01

    In Positron Emission Tomography (PET) imaging, an early therapeutic response is usually characterized by variations of semi-quantitative parameters restricted to maximum SUV measured in PET scans during the treatment. Such measurements do not reflect overall tumour volume and radiotracer uptake variations. The proposed approach is based on multi-observation image analysis for merging several PET acquisitions to assess tumour metabolic volume and uptake variations. The fusion algorithm is based on iterative estimation using stochastic expectation maximization (SEM) algorithm. The proposed method was applied to simulated and clinical follow-up PET images. We compared the multi-observation fusion performance to threshold-based methods, proposed for the assessment of the therapeutic response based on functional volumes. On simulated datasets, the adaptive threshold applied independently on both images led to higher errors than the ASEM fusion and on the clinical datasets, it failed to provide coherent measurements for four patients out of seven due to aberrant delineations. The ASEM method demonstrated improved and more robust estimation of the evaluation leading to more pertinent measurements. Future work will consist in extending the methodology and applying it to clinical multi-tracers datasets in order to evaluate its potential impact on the biological tumour volume definition for radiotherapy applications. PMID:21846937

  3. Multi-observation PET image analysis for patient follow-up quantitation and therapy assessment

    NASA Astrophysics Data System (ADS)

    David, S.; Visvikis, D.; Roux, C.; Hatt, M.

    2011-09-01

    In positron emission tomography (PET) imaging, an early therapeutic response is usually characterized by variations of semi-quantitative parameters restricted to maximum SUV measured in PET scans during the treatment. Such measurements do not reflect overall tumor volume and radiotracer uptake variations. The proposed approach is based on multi-observation image analysis for merging several PET acquisitions to assess tumor metabolic volume and uptake variations. The fusion algorithm is based on iterative estimation using a stochastic expectation maximization (SEM) algorithm. The proposed method was applied to simulated and clinical follow-up PET images. We compared the multi-observation fusion performance to threshold-based methods, proposed for the assessment of the therapeutic response based on functional volumes. On simulated datasets the adaptive threshold applied independently on both images led to higher errors than the ASEM fusion and on clinical datasets it failed to provide coherent measurements for four patients out of seven due to aberrant delineations. The ASEM method demonstrated improved and more robust estimation of the evaluation leading to more pertinent measurements. Future work will consist in extending the methodology and applying it to clinical multi-tracer datasets in order to evaluate its potential impact on the biological tumor volume definition for radiotherapy applications.

  4. PRACTICAL PARALLEL IMAGING COMPRESSED SENSING MRI: SUMMARY OF TWO YEARS OF EXPERIENCE IN ACCELERATING BODY MRI OF PEDIATRIC PATIENTS.

    E-print Network

    Lustig, Michael 'Miki'

    IN ACCELERATING BODY MRI OF PEDIATRIC PATIENTS. SS Vasanawala2 MJ Murphy 1 MT Alley2 P Lai3 K Keutzer1 JM Pauly4 M- ing of pediatric patients. It is a joint-effort by teams from UC Berkeley, Stanford University and GE approach: 1-SPIRiT, an iterative autocalibrat- ing parallel imaging reconstruction that enforces both data

  5. Value of Acute Rest Sestamibi Perfusion Imaging for Evaluation of Patients Admitted to the Emergency Department With Chest Pain

    Microsoft Academic Search

    Michael C Kontos; Robert L Jesse; Kristin L Schmidt; Joseph P Ornato; James L Tatum

    1997-01-01

    Objectives. This study sought to determine the ability of early perfusion imaging using technetium-99m sestamibi to predict adverse cardiac outcomes in patients who present to the emergency department with possible cardiac ischemia and nondiagnostic electrocardiograms (ECGs).Background. Evaluation of patients presenting to the emergency department with possible acute coronary syndromes and nondiagnostic ECGs is problematic. Accurate risk stratification is necessary to

  6. Whole Brain Imaging of HIV-Infected Patients: Quantitative Analysis of Magnetization Transfer Ratio Histogram and Fractional Brain Volume

    Microsoft Academic Search

    Yulin Ge; Dennis L. Kolson; James S. Babb; Lois J. Mannon; Robert I. Grossman

    2003-01-01

    BACKGROUND AND PURPOSE: Magnetization transfer ratio (MTR) histogram analysis and volumetric MR imaging are sensitive tools with which to quantify the tissue destructive effects in patients with white matter or neurodegenerative disease. Our purpose was to deter- mine whether whole brain MTR and fractional brain parenchyma volume measurements are altered in HIV-1-infected patients who are neurologically symptomatic and in those

  7. Cardiac Memory in WPW Patients : Noninvasive Imaging of Activation and Repolarization Before and After Catheter Ablation

    PubMed Central

    Ghosh, Subham; Rhee, Edward K; Avari, Jennifer N; Woodard, Pamela K.; Rudy, Yoram

    2009-01-01

    Background Cardiac memory refers to change in ventricular repolarization induced by, and persisting for minutes to months after cessation of a period of altered ventricular activation (e.g. due to pacing or pre-excitation in Wolff-Parkinson-White [WPW] patients). Electrocardiographic imaging (ECGI) is a novel imaging modality for noninvasive electro-anatomic mapping of epicardial activation and repolarization. Methods and Results Fourteen pediatric WPW patients, in absence of any other congenital disease, were imaged with ECGI a day before, and 45 mins, 1 week and 1 month after successful catheter ablation. ECGI determined pre-excitation sites were consistent with sites of successful ablation in all cases to within one hour arc of each atrio-ventricular (AV) annulus. In the pre-excited rhythm, activation-recovery interval (ARI) was the longest (349±6 ms) in the area of pre-excitation leading to high average base-to-apex ARI dispersion (ARId) of 95±9 ms (normal is about 40 ms). The ARId remained the same 45 minutes post-ablation, though the activation sequence was restored to normal. ARId was still high (79±9 ms) one week later and returned to normal (45±6 ms) one month post-ablation. Conclusions The study demonstrates that ECGI can noninvasively localize ventricular insertion sites of accessory pathways and evaluate its outcome to guide ablation in pediatric WPW patients. WPW is associated with high ARId in the pre-excited rhythm which persists after ablation and gradually returns to normal over a period of one month, demonstrating the presence of cardiac memory. The one-month time course is consistent with transcriptional reprogramming and remodeling of ion-channels. PMID:18697818

  8. Image-Based Modeling and Precision Medicine: Patient-Specific Carotid and Coronary Plaque Assessment and Predictions

    PubMed Central

    Yang, Chun; Zheng, Jie; Canton, Gador; Bach, Richard; Hatsukami, Thomas S.; Wang, Liang; Yang, Deshan; Billiar, Kristen L.; Yuan, Chun

    2013-01-01

    Atherosclerotic plaques may rupture without warning and cause acute cardiovascular events such as heart attack and stroke. Current clinical screening tools are insufficient to identify those patients with risks early and prevent the adverse events from happening. Medical imaging and image-based modeling have made considerable progress in recent years in identifying plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies. The key steps and factors in image-based models for human carotid and coronary plaques were illustrated, as well as grand challenges facing the researchers in the field to develop more accurate screening tools. PMID:23362245

  9. Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy

    SciTech Connect

    Islam, Mohammad K.; Purdie, Thomas G.; Norrlinger, Bernhard D.; Alasti, Hamideh; Moseley, Douglas J.; Sharpe, Michael B.; Siewerdsen, Jeffrey H.; Jaffray, David A. [Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation, University of Toronto, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Toronto (Canada); Ontario Cancer Institute Princess Margaret Hospital and Department of Medical Biophysics, University of Toronto, Toronto (Canada); Department of Radiation Physics and Ontario Cancer Institute, Princess Margaret Hospital and Department of Radiation Oncology and Department of Medical Biophysics, University of Toronto, Toronto (Canada)

    2006-06-15

    Kilovoltage cone-beam computerized tomography (kV-CBCT) systems integrated into the gantry of linear accelerators can be used to acquire high-resolution volumetric images of the patient in the treatment position. Using on-line software and hardware, patient position can be determined accurately with a high degree of precision and, subsequently, set-up parameters can be adjusted to deliver the intended treatment. While the patient dose due to a single volumetric imaging acquisition is small compared to the therapy dose, repeated and daily image guidance procedures can lead to substantial dose to normal tissue. The dosimetric properties of a clinical CBCT system have been studied on an Elekta linear accelerator (Synergy[reg] RP, XVI system) and additional measurements performed on a laboratory system with identical geometry. Dose measurements were performed with an ion chamber and MOSFET detectors at the center, periphery, and surface of 30 and 16-cm-diam cylindrical shaped water phantoms, as a function of x-ray energy and longitudinal field-of-view (FOV) settings of 5,10,15, and 26 cm. The measurements were performed for full 360 deg.CBCT acquisition as well as for half-rotation scans for 120 kVp beams using the 30-cm-diam phantom. The dose at the center and surface of the body phantom were determined to be 1.6 and 2.3 cGy for a typical imaging protocol, using full rotation scan, with a technique setting of 120 kVp and 660 mAs. The results of our measurements have been presented in terms of a dose conversion factor f{sub CBCT}, expressed in cGy/R. These factors depend on beam quality and phantom size as well as on scan geometry and can be utilized to estimate dose for any arbitrary mAs setting and reference exposure rate of the x-ray tube at standard distance. The results demonstrate the opportunity to manipulate the scanning parameters to reduce the dose to the patient by employing lower energy (kVp) beams, smaller FOV, or by using half-rotation scan.

  10. Clinical Usefulness of Novel Serum and Imaging Biomarkers in Risk Stratification of Patients with Stable Angina

    PubMed Central

    Ikonomidis, Ignatios; Tsantes, Argirios

    2014-01-01

    Inflammatory mediators appear to be the most intriguing yet confusing subject, regarding the management of patients with acute coronary syndromes (ACS). The current inflammatory concept of atherosclerotic coronary artery disease (CAD) led many investigators to concentrate on systemic markers of inflammation, as well as imaging techniques, which may be helpful in risk stratification and prognosis assessment for cardiovascular events. In this review, we try to depict many of the recently studied markers regarding stable angina (SA), their clinical usefulness, and possible future applications in the field. PMID:25045198

  11. Four-Dimensional Magnetic Resonance Imaging Using Axial Body Area as Respiratory Surrogate: Initial Patient Results

    PubMed Central

    Yang, Juan; Cai, Jing; Wang, Hongjun; Chang, Zheng; Czito, Brian G.; Bashir, Mustafa R.; Yin, Fang-Fang

    2014-01-01

    Purpose To evaluate the feasibility of a retrospective binning technique for 4-dimensional magnetic resonance imaging (4D-MRI) using body area (BA) as a respiratory surrogate. Methods and Materials Seven patients with hepatocellular carcinoma (4 of 7) or liver metastases (3 of 7) were enrolled in an institutional review board-approved prospective study. All patients were simulated with both computed tomography (CT) and MRI to acquire 3-dimensinal and 4D images for treatment planning. Multiple-slice multiple-phase cine-MR images were acquired in the axial plane for 4D-MRI reconstruction. Image acquisition time per slice was set to 10-15 seconds. Single-slice 2-dimensinal cine-MR images were also acquired across the center of the tumor in orthogonal planes. Tumor motion trajectories from 4D-MRI, cine-MRI, and 4D-CT were analyzed in the superior–inferior (SI), anterior–posterior (AP), and medial–lateral (ML) directions, respectively. Their correlation coefficients (CC) and differences in tumor motion amplitude were determined. Tumor-to-liver contrast-to-noise ratio (CNR) was measured and compared between 4D-CT, 4D-MRI, and conventional T2-weighted fast spin echo MRI. Results The means (±standard deviations) of CC comparing 4D-MRI with cine-MRI were 0.97 ± 0.03, 0.97 ± 0.02, and 0.99 ± 0.04 in SI, AP, and ML directions, respectively. The mean differences were 0.61 ± 0.17 mm, 0.32 ± 0.17 mm, and 0.14 ± 0.06 mm in SI, AP, and ML directions, respectively. The means of CC comparing 4D-MRI and 4D-CT were 0.95 ± 0.02, 0.94 ± 0.02, and 0.96 ± 0.02 in SI, AP, and ML directions, respectively. The mean differences were 0.74 ± 0.02 mm, 0.33 ± 0.13 mm, and 0.18 ± 0.07 mm in SI, AP, and ML directions, respectively. The mean tumor-to-tissue CNRs were 2.94 ± 1.51, 19.44 ± 14.63, and 39.47 ± 20.81 in 4D-CT, 4D-MRI, and T2-weighted MRI, respectively. Conclusions The preliminary evaluation of our 4D-MRI technique results in oncologic patients demonstrates its potential usefulness to accurately measure tumor respiratory motion with improved tumor CNR compared with 4D-CT. PMID:24444759

  12. Analysis using histograms of muscle CT images in patients with Duchenne muscular dystrophy.

    PubMed

    Nakayama, Takahiro; Kuru, Satoshi; Kawai, Mitsuru

    2013-01-01

    We showed that the shape of the thigh CT value histogram, which was reflecting muscle and fat, changed with the disease progression in a patient with Duchenne muscular dystrophy, and this shape of the histogram will employ a new analytical method. CT images of the middle part of the thigh were acquired in a patient with Duchenne muscular dystrophy once a year from 6 to 11 years of age. Regions apparently corresponding to subcutaneous fat, bone and bone marrow were manually excluded, and the CT values were calculated to prepare histograms. His motor disability was also evaluated employing Vignos functional rating scale. A single peak was noted in the muscle CT value range in the histogram at the youngest age. The muscle-to-fat ratio in muscle decreased with the worsening of his disease disability level and the peak of the histogram shifted from the muscle to the fat CT value. PMID:23729708

  13. Analysis using histograms of muscle CT images in patients with Duchenne muscular dystrophy

    PubMed Central

    Nakayama, Takahiro; Kuru, Satoshi; Kawai, Mitsuru

    2013-01-01

    We showed that the shape of the thigh CT value histogram, which was reflecting muscle and fat, changed with the disease progression in a patient with Duchenne muscular dystrophy, and this shape of the histogram will employ a new analytical method. CT images of the middle part of the thigh were acquired in a patient with Duchenne muscular dystrophy once a year from 6 to 11?years of age. Regions apparently corresponding to subcutaneous fat, bone and bone marrow were manually excluded, and the CT values were calculated to prepare histograms. His motor disability was also evaluated employing Vignos functional rating scale. A single peak was noted in the muscle CT value range in the histogram at the youngest age. The muscle-to-fat ratio in muscle decreased with the worsening of his disease disability level and the peak of the histogram shifted from the muscle to the fat CT value. PMID:23729708

  14. Posterior Fossa Neurenteric Cysts Can Expand Rapidly: Case Report

    PubMed Central

    Priamo, Francesco A.I.; Jimenez, Elpidio D.; Benardete, Ethan A.

    2011-01-01

    Neurenteric cysts are considered congenital lesions that may slowly expand over time. Although more commonly found in the spinal canal, they may be found intracranially, particularly in the posterior fossa. Here, we present an unusual case of a large, rapidly expanding histologically confirmed posterior fossa neurenteric cyst in a 53-year-old woman, who presented with quadriparesis. Computed tomography imaging done ~1.5 years before admission failed to demonstrate any obvious abnormality; however, the lesion had grown to 4 cm in maximal dimension at presentation with significant mass effect. The lesion was resected microsurgically using a retrosigmoid approach. The patient improved postoperatively and was neurologically intact at last follow-up. We could find no other documented case of marked, rapid expansion of a neurenteric cyst in the literature. We conclude that, although neurenteric cysts are thought to be congenital, they can undergo rapid expansion even in adults. The mechanism of expansion is unknown but may involve increased secretion, hemorrhage, or inflammation. We discuss the surgical management and review the literature in view of this surprising finding. PMID:23984213

  15. Visualization of Coronary Wall Atherosclerosis in Asymptomatic Subjects and Patients with Coronary Artery Disease Using Magnetic Resonance Imaging

    Microsoft Academic Search

    Suzanne C. Gerretsen; M. Eline Kooi; Alfons G. Kessels; Simon Schalla; Marcus Katoh; Rob J. van der Geest; Warren J. Manning; Johannes Waltenberger; Jos M. A. van Engelshoven; Rene M. Botnar; Tim Leiner

    2010-01-01

    BackgroundMagnetic resonance imaging (MRI) is sensitive to early atherosclerotic changes such as positive remodeling in patients with coronary artery disease (CAD). We assessed prevalence, quality, and extent of coronary atherosclerosis in a group of healthy subjects compared to patients with confirmed CAD.MethodologyTwenty-two patients with confirmed CAD (15M, 7F, mean age 60.4±10.4 years) and 26 healthy subjects without history of CAD

  16. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation. Lessons learned by use of magnetic resonance imaging

    Microsoft Academic Search

    Ritsushi Kato; Lars Lickfett; Glenn Meininger

    2003-01-01

    Background—This study sought to define the technique and results of magnetic resonance imaging (MRI) of pulmonary vein (PV) anatomy before and after catheter ablation of atrial fibrillation (AF). Methods and Results—Twenty-eight patients with AF underwent ablation. Patients underwent gadolinium-enhanced MRI before and 6 weeks after their procedures. A control group of 27 patients also underwent MRI. Variant PV anatomy was

  17. Electrical stimulation and treadmill gait in tetraplegic patients: assessment of its effects on the knee with magnetic resonance imaging

    Microsoft Academic Search

    F P Ferro; H J N González; D M Ferreira; A Cliquet

    2008-01-01

    Study design:Evaluation of knees of tetraplegic patients who have been walking for several months with the aid of a system that involves neuromuscular stimulation, treadmill and a harness support device.Objectives:To investigate if the training program could cause knee injury to tetraplegic patients.Setting:Hospital das Clinicas – UNICAMP. Campinas-SP, Brazil.Methods:Nine patients were evaluated. Clinical exam and magnetic resonance images (MRIs) were used

  18. The Role of Imaging in Patient Selection, Preoperative Planning, and Postoperative Monitoring in Human Upper Extremity Allotransplantation

    PubMed Central

    Roth, Eira S.; Buck, David G.; Gorantla, Vijay S.; Losee, Joseph E.; Foust, Daniel E.; Britton, Cynthia A.

    2014-01-01

    Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications. PMID:24800056

  19. The role of imaging in patient selection, preoperative planning, and postoperative monitoring in human upper extremity allotransplantation.

    PubMed

    Roth, Eira S; Buck, David G; Gorantla, Vijay S; Losee, Joseph E; Foust, Daniel E; Britton, Cynthia A

    2014-01-01

    Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications. PMID:24800056

  20. Diffusion tensor imaging of the cerebellum in patients after heat stroke.

    PubMed

    Li, Jun; Zhang, Xue-Yan; Wang, Bin; Zou, Zhi-Meng; Wang, Pei-Yuan; Xia, Ji-Kai; Li, Hai-Fei

    2015-06-01

    To explore the application value of cerebellar diffusion tensor imaging (DTI) in patients after heat stroke (HS). Eleven patients after HS with a score of 3-9 in Glasgow Coma Scale (GCS) and seven age-matched healthy volunteers were selected to undergo MR examinations during the same hot summer. The MR studies including DTI were performed with a 1.5 T scanner. Fractional anisotropy (FA) values of normal-appearing cerebellar white and gray matter were measured and the differences between the two groups were evaluated with Mann-Whitney U test. The FA value of normal-appearing cerebellar white matter in patients after HS was found to be decreased compared to normal control subjects (652.5 ± 86.1 vs 769.5 ± 58.4, p = 0.025). The FA value of normal-appearing cerebellar gray matter in patients after HS was found to be decreased compared to normal control subjects (158.8 ± 27.9 vs 187.5 ± 15.8, p = 0.040). Neural damage of the cerebellum induced by HS may be effectively evaluated by DTI with the decrease of FA value in normal-appearing cerebellum structures. PMID:25082094

  1. CT and MR Imaging in a Large Series of Patients with Craniofacial Fibrous Dysplasia

    PubMed Central

    Atalar, Mehmet Haydar; Salk, Ismail; Savas, Recep; Uysal, Ismail Onder; Egilmez, Hulusi

    2015-01-01

    Summary Background In this retrospective review of patients with craniofacial fibrous dysplasia (FD), the clinical and radiological findings of CT and MR scan were analyzed. Material/Methods The study material included 32 patients, at 9 to 68 years of age that were directed for differential diagnostics of several disorders in the head. We recorded CT and MRI data related to the lesion number, location, sidedness, appearance, and sex of the cases with craniofacial FD. Results Of 32 patients involved in this study, 17 had monostotic and 15 had polyostotic involvement pattern. Bones most commonly involved by monostotic involvement in females were, in descending order, mandibular, maxillary, and sphenoid bones, while the sphenoid bone was involved the most in males. Leontiasis ossea was observed in 2 patients. Sclerotic and mixed lesion types were more common in both females and males. In T1- and T2-weighted MRI sequences, hypointensity was more common compared to hyperintensity or heterogeneous intensity. The type of enhancement of lesions was found similar after contrast medium administration. Conclusions In the presence of craniofacial FD during CT or MRI imaging of the head, a detailed description of FD lesions may provide an important clinical benefit by increasing radiological experience during the diagnostics of this rare disorder. PMID:26000068

  2. SU-E-J-160: Comparing the Setup Accuracy of Non-Ionizing Patient Localization Systems with CBCT to Reduce Imaging Dose in Prone Breast Treatments

    SciTech Connect

    Chung, E; Yamamoto, T; Mayadev, J; Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States)

    2014-06-01

    Purpose: CBCT is the current gold standard to verify prone breast patient setup. We investigated in a phantom if non-ionizing localization systems can replace ionizing localization systems for prone breast treatments. Methods: An anthropomorphic phantom was positioned on a prone breast board. Electromagnetic transponders were attached on the left chest surface. The CT images of the phantom were imported to the treatment planning system. The isocenter was set to the center of the transponders. The positions of the isocenter and transponders transferred to the transponder tracking system. The posterior phantom surface was contoured and exported to the optical surface tracking system. A CBCT was taken for the initial setup alignment on the treatment machine. Using the electromagnetic and optical localization systems, the deviation of the phantom setup from the original CT images was measured. This was compared with the difference between the original CT and kV-CBCT images. Results: For the electromagnetic localization system, the phantom position deviated from the original CT in 1.5 mm, 0.0 mm and 0.5 mm in the anterior-posterior (AP), superior-inferior (SI) and left-right (LR) directions. For the optical localization system, the phantom position deviated from the original CT in 2.0 mm, ?2.0 mm and 0.1 mm in the AP, SI and LR directions. For the CBCT, the phantom position deviated from the original CT in 4.0 mm, 1.0 mm and ?1.0 mm in the AP, SI and LR directions. The measured values from the non-ionizing localization systems differed from those with the CBCT less than 3.0 mm in all directions. Conclusions: This phantom study showed the feasibility of using a combination of non-ionizing localization systems to achieve a similar setup accuracy as CBCT for prone breast patients. This could potentially eliminate imaging dose. As a next step, we are expanding this study to actual patients. This work has been in part supported by Departmental Research Award RODEPT1-JS001, Department of Radiation Oncology, UC Davis Medical Center.

  3. Mechanically expandable annular seal

    DOEpatents

    Gilmore, Richard F. (Kennewick, WA)

    1983-01-01

    A mechanically expandable annular reusable seal assembly to form an annular hermetic barrier between two stationary, parallel, and planar containment surfaces. A rotatable ring, attached to the first surface, has ring wedges resembling the saw-tooth array of a hole saw. Matching seal wedges are slidably attached to the ring wedges and have their motion restricted to be perpendicular to the second surface. Each seal wedge has a face parallel to the second surface. An annular elastomer seal has a central annular region attached to the seal wedges' parallel faces and has its inner and outer circumferences attached to the first surface. A rotation of the ring extends the elastomer seal's central region perpendicularly towards the second surface to create the fluidtight barrier. A counterrotation removes the barrier.

  4. Expandable Total Humeral Replacement in a Child with Osteosarcoma

    PubMed Central

    Henderson, Eric R.; Gao, Jidi; Groundland, John; Letson, G. Douglas

    2015-01-01

    Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient's success indicates that expandable total humeral replacement is a viable option.

  5. Expandable Total Humeral Replacement in a Child with Osteosarcoma.

    PubMed

    Henderson, Eric R; Gao, Jidi; Groundland, John; Binitie, Odion; Letson, G Douglas

    2015-01-01

    Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient's success indicates that expandable total humeral replacement is a viable option. PMID:26090254

  6. Reliability of tumor volume estimation from MR images in patients with malignant glioma. Results from the American College of Radiology Imaging Network (ACRIN) 6662 Trial

    Microsoft Academic Search

    Birgit B. Ertl-Wagner; Jeffrey D. Blume; Donald Peck; Jayaram K. Udupa; Benjamin Herman; Anthony Levering; Ilona M. Schmalfuss

    2009-01-01

    Reliable assessment of tumor growth in malignant glioma poses a common problem both clinically and when studying novel therapeutic\\u000a agents. We aimed to evaluate two software-systems in their ability to estimate volume change of tumor and\\/or edema on magnetic\\u000a resonance (MR) images of malignant gliomas. Twenty patients with malignant glioma were included from different sites. Serial\\u000a post-operative MR images were

  7. Effect of disease and recovery on functional anatomy in brain tumor patients: insights from functional MRI and diffusion tensor imaging

    PubMed Central

    Abd-El-Barr, Muhammad M; Saleh, Emam; Huang, Raymond Y; Golby, Alexandra J

    2014-01-01

    Patients with brain tumors provide a unique opportunity to understand functional brain plasticity. Using advanced imaging techniques, such as functional MRI and diffusion tensor imaging, we have gained tremendous knowledge of brain tumor behavior, transformation, infiltration and destruction of nearby structures. Using these advanced techniques as an adjunct with more proven techniques, such as direct cortical stimulation, intraoperative navigation and advanced microsurgical techniques, we now are able to better formulate safer resection trajectories, perform larger resections at reduced risk and better counsel patients and their families about possible complications. Brain mapping in patients with brain tumors and other lesions has shown us that the old idea of fixed function of the adult cerebral cortex is not entirely true. Improving care for patients with brain lesions in the future will depend on better understanding of the functional organization and plasticity of the adult brain. Advanced noninvasive brain imaging will undoubtedly play a role in advancing this understanding. PMID:24660024

  8. Imaging the lungs in asthmatic patients by using hyperpolarized helium-3 magnetic resonance: Assessment of response to methacholine and exercise challenge

    Microsoft Academic Search

    Saba Samee; Talissa Altes; Patrick Powers; Eduard E. de Lange; Jack Knight-Scott; Gary Rakes; John P. Mugler III; Jonathan M. Ciambotti; Bennet A. Alford; James R. Brookeman; Thomas A. E. Platts-Mills

    2003-01-01

    Background: Imaging of gas distribution in the lungs of patients with asthma has been restricted because of the lack of a suitable gaseous contrast agent. Hyperpolarized helium-3 (HHe3) provides a new technique for magnetic resonance imaging of lung diseases. Objective: We sought to investigate the use of HHe3 gas to image the lungs of patients with moderate or severe asthma

  9. Magnetic resonance imaging of the temporal bone in patients with Ménière's disease.

    PubMed

    Lorenzi, M C; Bento, R F; Daniel, M M; Leite, C C

    2000-08-01

    Ménière's disease (MD) is still controversial in several aspects. The vestibular aqueduct, the osseous channel that carries the endolymphatic duct and sac, has previously been studied by tomography and computed tomography, with shortening and narrowing of this structure observed. These findings are apparently correlated to the development of the endolymphatic hydrops present in MD and related to its episodic symptoms. In studying the endolymphatic duct, the key structure in the pathology of this disease, magnetic resonance imaging (MRI) studies of the temporal bone were performed in 12 patients with unilateral MD and in 9 bilateral cases; the results were compared with images obtained from 30 normal ears. The endolymphatic duct appeared to be statistically less visible in MD patients, with no difference between symptomatic and asymptomatic ears in the presence of unilateral disease. No relationship was found between visualization of the endolymphatic duct and time of evolution or response to clinical treatment in these cases. The distance from the posterior semicircular canal to the posterior temporal border was found to be bilaterally reduced in MD. The authors conclude that although the demonstration of endolymphatic hydrops "in vivo" is not yet possible by MRI, some features can be observed that can support a clinical hypothesis of MD. PMID:11039871

  10. Assessment of allograft function using diffusion-weighted magnetic resonance imaging in kidney transplant patients.

    PubMed

    Kaul, Anupma; Sharma, Raj Kumar; Gupta, Rakesh Kumar; Lal, Hira; Yadav, Abhishek; Bhadhuria, Dharmendra; Prasad, Narayan; Gupta, Amit

    2014-11-01

    Developing a non-invasive method such as diffusion-weighted magnetic resonance imaging (DWMRI) could be used as a feasible and reproducible modality in the differential diagnosis of allograft dysfunction. We assessed the functional status of the renal allograft by DWMRI and its applicability in assessment of graft dysfunction on all end-stage renal transplant patients who attained normal renal function on the 7th day post-transplantation. Follow-up imaging of the recipient allograft was performed at the end of 90 and 180 days and in case of graft dysfunction. Kidney biopsies were performed to correlate with the corresponding MRI. The apparent diffusion coefficient (ADC) maps of the cortex and medulla were obtained by studying the DWMRI. The ADC values were significantly lower in the medulla compared with the cortex in normal donor kidneys and normally functioning transplanted kidneys, while they decreased significantly when rejection occurred. The reduction in ADC values occurred both in the cortex and in the medulla, and correlated with the degree of rejection on the kidney biopsies. The ADC values increased significantly during the recovery from rejection. We conclude that DWMRI can be beneficial in the diagnosis and follow-up of transplant patients during acute rejection. PMID:25394428

  11. Study and design of beam expander with wide aperture

    NASA Astrophysics Data System (ADS)

    Guo, Ming; Jin, Guangyong; Cai, Jixing; Zhang, Wei; Wei, Zhi

    2014-12-01

    In order to improve the capacity of beam collimation for laser beam expander, it is necessary to design a more reasonable and feasible structure of beam expander system. Laser beam expander is used to compress the laser divergence angle, in order to reduce the energy losing in long distance scanning acquisition system. This paper introduces the working principle and design idea of the laser beam expander, the collimating multiplying power focal length and the collimated magnification formula of expander main, secondary mirror. According to the third-order aberration theory, Considering the spherical aberration, sine difference and divergence angle, the reasonable analysis of optical path, ZEMAX optical design software was used to design large-diameter laser beam expander and analysis and optimize, And given the actual design data and results. Display the maximum optical path difference is +/-0.01? of the main light ray and each light ray. To combination the rear- group objective lens of Galileo and Kepler beam expander, a large-diameter(1.475m) laser beam expander was designed with 0.2m in the diameter, 1/2m in the relative caliber. In the objective lens System, a high-order aspherical was used to the aberration of extra-axial point. we can see that the image quality is close to the diffraction limit from the curves of wavefront. In addition to improve image quality effectively, the system has the characteristics of simple structure, less costly and less design difficulty to compare with the other beam expanding system. And make the output beam's divergence angle smaller, energy density higher, and the beam quality has been greatly improved. The results show that the beam expander is fully meet the design requirements, the use effect is good. Design and research of laser beam expanding system not only improves the quality of the laser beam in the laser system, but also enlarge the application field of laser technology in photoelectric system.

  12. Analysis of diaphragmatic movement before and after pulmonary rehabilitation using fluoroscopy imaging in patients with COPD

    PubMed Central

    Chun, Eun Mi; Han, Soo Jeong; Modi, Hitesh N

    2015-01-01

    Background The diaphragm is the principal inspiratory muscle. The purpose of this study was to assess improvements in diaphragmatic movement before and after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD), using a fluoroscopy-guided chest X-ray. Patients and methods Among 117 patients with COPD receiving pulmonary rehabilitation who underwent the initial fluoroscopy-guided chest X-ray and pulmonary function test, 37 of those patients who underwent both initial and follow-up fluoroscopy and pulmonary function tests were enrolled in this study. After hospital education, participants received pulmonary rehabilitation through regular home-based training for at least 3 months by the same physiatrist. We assessed the changes in diaphragm area with fluoroscopy-guided posteroanterior chest X-rays between pre- and postpulmonary rehabilitation. To minimize radiation hazards for subjects, the exposure time for fluoroscopy to take chest X-rays was limited to less than 5 seconds. Results There were significant improvements (2,022.8±1,548.3 mm2 to 3,010.7±1,495.6 mm2 and 2,382.4±1,475.9 mm2 to 3,315.9±1,883.5 mm2; right side P=0.001 and left side P=0.019, respectively) in diaphragmatic motion area during full inspiration and expiration in both lungs after pulmonary rehabilitation. Pulmonary function tests showed no statistically significant difference between pre- and postpulmonary rehabilitation. Conclusion The study suggests that the strategy to assess diaphragm movement using fluoroscopy is a relatively effective tool for the evaluation of pulmonary rehabilitation in COPD patients in terms of cost and time savings compared with computed tomography or magnetic resonance imaging. PMID:25670895

  13. Three-Dimensional Microwave Breast Imaging: Dispersive Dielectric Properties Estimation using Patient-Specific Basis Functions

    PubMed Central

    Winters, David W.; Shea, Jacob D.; Kosmas, Panagiotis; Van Veen, Barry D.; Hagness, Susan C.

    2009-01-01

    Breast imaging via microwave tomography involves estimating the distribution of dielectric properties within the patient's breast on a discrete mesh. The number of unknowns in the discrete mesh can be very large for three-dimensional imaging, and this results in computational challenges. We propose a new approach where the discrete mesh is replaced with a relatively small number of smooth basis functions. The dimension of the tomography problem is reduced by estimating the coefficients of the basis functions instead of the dielectric properties at each element in the discrete mesh. The basis functions are constructed using knowledge of the location of the breast surface. The number of functions used in the basis can be varied to balance resolution and computational complexity. The reduced dimension of the inverse problem enables application of a computationally efficient, multiple-frequency inverse scattering algorithm in 3-D. The efficacy of the proposed approach is verified using two 3-D anatomically realistic numerical breast phantoms. It is shown for the case of single-frequency microwave tomography that the imaging accuracy is comparable to that obtained when the original discrete mesh is used, despite the reduction of the dimension of the inverse problem. Results are also shown for a multiple-frequency algorithm where it is computationally challenging to use the original discrete mesh. PMID:19211350

  14. Idiopathic pulmonary haemosiderosis: spectrum of thoracic imaging findings in the adult patient.

    PubMed

    Khorashadi, L; Wu, C C; Betancourt, S L; Carter, B W

    2015-05-01

    Idiopathic pulmonary haemosiderosis (IPH) is a rare disease characterized by alveolar capillary haemorrhage resulting in deposition and accumulation of haemosiderin in the lungs. Although its precise pathophysiology remains unclear, several hypotheses have been proposed to explain the aetiology of the disorder, including autoimmune, environmental, allergic, and genetic theories. IPH is typically diagnosed in childhood, usually before the age of 10 years; however, this entity may be encountered in older patients given the greater awareness of the diagnosis, availability and utilization of advanced imaging techniques, and improved treatment and survival. The classic presentation of IPH consists of the triad of haemoptysis, iron-deficiency anaemia, and pulmonary opacities on chest radiography. The diagnosis is usually confirmed via bronchoscopy with bronchoalveolar lavage (BAL), at which time haemosiderin-laden macrophages referred to as siderophages, considered pathognomonic for IPH, may be identified. However, lung biopsy may ultimately be necessary to exclude other disease processes. For children with IPH, the disease course is severe and the prognosis is poor. However, adults generally have a longer disease course with milder symptoms and the prognosis is more favourable. Specific imaging features, although non-specific in isolation, may be identified on thoracic imaging studies, principally chest radiography and CT, depending on the phase of disease (acute or chronic). Recognition of these findings is important to guide appropriate clinical management. PMID:25515792

  15. Transfer patient imaging: a survey of members of the American Society of Emergency Radiology.

    PubMed

    Robinson, Jeffrey D; McNeeley, Michael F

    2012-10-01

    When trauma patients are transferred from outside hospitals, the receiving clinicians often consult their local radiologists for definitive interpretations of outside examinations (IOE). Such requests introduce a host of logistical, medicolegal, and financial concerns related to quality control and resource utilization. We surveyed 701 members of the American Society of Emergency Radiology to elucidate these concerns. We found that the majority of emergency departments still rely on compact disks for conveyance of outside images; hard film and network transfers were minor mechanisms for most respondents. Sixty-nine percent of the respondents indicated that radiologist reports accompany fewer than 25 % of all transferred imaging studies; of the reports that do arrive, most are unverified preliminary reads. There is considerable variability in billing practices and reimbursement patterns for radiologic second opinions; 68 % of the respondents do not know how often their IOEs are reimbursed. Suboptimal communication between community hospitals and referral centers may result in duplicated efforts and inconsistent quality of medical imaging studies. Further investigation into the role of radiology trainees in the handling of outside studies is also highly recommended. PMID:22527362

  16. Prospective Changes in Body Image Dissatisfaction among Adolescent Bariatric Patients: The Importance of Body Size Estimation

    PubMed Central

    Ratcliff, M.B.; Eshleman, K.E.; Reiter-Purtill, J.; Zeller, M.H.

    2011-01-01

    Background Body image dissatisfaction (BID) is pervasive among patients presenting for bariatric surgery but significantly improves post-operatively. These findings are based primarily on studies of adults. Objective The objective of this study was to examine changes in BID among adolescents with extreme obesity from baseline/preoperative to 6 and 12 months following bariatric surgery using body size estimation. Setting Pediatric Medical Center. Methods BID was prospectively assessed among 16 adolescent bariatric patients (Mage=16.3±1.2, MBMI=66.2±12.0, 67% female) using a standard visual/perceptual measure [i.e., Stunkard Figure Rating Scale. Participants identified Current and Ideal body size, with a discrepancy score (Current – Ideal) indicating BID. Body size estimation ratings were compared to attitudinal (i.e., IWQOL-Kids: Body Esteem and Self-Perception Profile for Adolescents: Physical Appearance) body image scores, BMI (kg/m2), and Total weight-related quality of life (WRQOL). Results There was a significant reduction in Current body size (7.9 to 6.4, p<.001) from baseline to 6 months but not from 6 to 12 months. Current body size was related to BMI and %EWL but not attitudinal body image at each time point. Smaller Discrepancy (Current – Ideal) was associated with higher Total WRQOL (r=?0.68), with a trend towards significance for Body Esteem (r=?0.65) at 12 months. Conclusions Adolescents undergoing bariatric surgery experience significantly decreased BID within the first 12 months post-surgery, with the most substantial change between baseline and 6 months. Post-operative WRQOL is more closely associated to body size discrepancy than current body size. PMID:22154271

  17. Magnetic resonance imaging evaluation of calcaneal fat pads in patients with os calcis fractures.

    PubMed

    Levy, A S; Berkowitz, R; Franklin, P; Corbett, M; Whitelaw, G P

    1992-02-01

    Destruction of the calcaneal fat pad has been implicated as a source of chronic pain following fractures of the os calcis. Several investigators postulate that the initial trauma that produces a calcaneal fracture also results in destruction of the U-shaped fibrous septa that maintain the piston-like organization of the fat columns. Fibrosis and loss of the protective cushioning provided by the fat pad may eventually occur. The authors report on the largest series of magnetic resonance images of the calcaneal fat pad in the heels of patients with calcaneal fractures. A prospective consecutive study utilizing magnetic resonance imaging was performed on 22 heels with calcaneal fractures. Ten contralateral heels without calcaneal fracture and the heels of five normal subjects were scanned as controls. No signal changes suggestive of increased fat pad edema, fibrosis, or fatty release were detected. In addition, the vertical septa were well visualized and found to be intact in all cases. The height of the fat pad was measured, with no changes noted as compared with the contralateral heel. In those patients with acute fractures, signal changes suggestive of hematoma were well visualized in the soft tissue surrounding the calcaneus. In two of these cases, there was extension beneath the plantar fascia, but no penetration into the fat columns. Magnetic resonance imaging allows excellent detailed visualization of the calcaneal fat pad and surrounding structures. No evidence is found to support the hypothesis that marked damage to the gross structure of the fat pad occurs at the time of injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1572588

  18. /sup 99m/Tc-pyrophosphate imaging in patients with acute myocardial infarction: Comparison of planar imaging with single-photon tomography with and without blood pool overlay

    SciTech Connect

    Corbett, J.R.; Lewis, M.; Willerson, J.T.; Nicod, P.H.; Huxley, R.L.; Simon, T.; Rude, R.E.; Henderson, E.; Parkey, R.; Rellas, J.S.

    1984-06-01

    To test the hypothesis that single-photon emission computed tomography (SPECT) of /sup 99m/Tc-pyrophosphate (/sup 99m/Tc-PPi) with and without the overlay of tomographic blood pool scintigrams might detect small infarcts not identified by planar imaging, 52 patients were studied 3.2 +/- 2.0(SD) days after hospital admission for suspected acute myocardial infarction. Patients were chosen prospectively for tomographic study primarily, but not exclusively, because planar four-view imaging with /sup 99m/Tc-PPi was either negative or equivocal. SPECT was performed with a commercial rotating detector system immediately after planar imaging on one occasion. Corresponding /sup 99m/Tc-PPi and blood pool sections were mapped into opposite halves of a bichromic color table and displayed as an overlay. Planar images, SPECT and SPECT with blood pool overlay were interpreted separately and in random order without knowledge of clinical data. Seventeen patients had transmural infarcts (four anterior, 13 inferior), 19 had nontransmural infarcts, and 16 patients did not have acute myocardial infarction. The sensitivity of SPECT with blood pool overlay was significantly better than planar imaging for the entire group with myocardial infarction (97% vs 78%; p less than .025); this was primarily due to increased sensitivity in the detection of nontransmural myocardial infarction (95% vs 67%; p less than .05), although in one additional patient inferior transmural myocardial infarction was also detected by the SPECT overlay technique. The specificities of the SPECT overlay technique and planar imaging were not significantly different; however, receiver operating characteristic analysis showed enhanced observer confidence with the tomographic method. SPECT without overlay was intermediate in sensitivity and specificity.

  19. Lesion comparison of multiple sclerosis in hispanic and caucasian patients utilizing an imaging informatics-based eFolder system

    NASA Astrophysics Data System (ADS)

    Ma, Kevin; Fernandez, James; Amezcua, Lilyana; Lerner, Alex; Shiroishi, Mark; Liu, Brent

    2012-02-01

    Multiple sclerosis (MS) is a demyelinating disease in the central nervous system. Genetics have been considered as a leading factor in the prevalence and disease course of MS. We have presented an informatics-based eFolder system for integrating patients' clinical data with MR images and lesion quantification results. The completed eFolder system has been designed and developed in aiding to evaluate disease manifestation differences in Hispanic and Caucasian MS patients. MS lesion data, as shown in MRI, can be extracted by the 3-D automatic lesion detection tool in the eFolder, and data storing and mining tools in eFolder is able to extract and compare data from individual patients. The computer-aided detection (CAD) algorithm has been modified and enhanced to include spatial information as detection criteria. For this study, 36 Caucasian MS patients and 36 matched Hispanic patients have been selected. Most recent MR images of the patients are collected, and images are evaluated both by the CAD tool in the eFolder and radiologists. The results are compared between Caucasian and Hispanic patients and statistically evaluated to see if the two populations have significant difference in lesion presentations. The results can be used to evaluate differences in the two groups of patients and to evaluate the new CAD algorithm's performance with radiologists' contours. Significant findings can further evaluate effectiveness of MS eFolder in MS-related research.

  20. Imaging Findings of Implanted Absorbable Mesh in Patients with Breast Partial Resection

    PubMed Central

    2008-01-01

    Purpose The author presents imaging findings of patients that underwent partial resection of the breast followed by absorbable mesh implantation. Materials and Methods Ultrasonographic (n = 18) and mammographic (n = 11) images of patients that had undergone absorbable mesh implantation after breast partial resection were reviewed retrospectively. Sequential changes of the lesions were analyzed in follow-up ultrasonographic examinations, focusing on the change of the size and pattern of the lesion. The presence of a mass, asymmetry, focal asymmetry, architectural distortion, and calcification were evaluated by mammography. Pathologic findings of the implanted mesh in available cases were analyzed. Results Ultrasonograms revealed a well-encapsulated anechoic lesion with (pattern 1, n = 11) or without (pattern 2, n = 5) internal isoechoic nodular portion, and a hyperechoic mass-like lesion without anechoic portion (pattern 3, n = 2). The mean length of the longest diameter decreased gradually as determined in follow-up examinations (3 months, 6.12 ± 2.599 cm; 6 months, 5.08 ± 2.105 cm; 12 months, 3.26 ± 2.206 cm). In mammograms, a mass (n = 4) was noted at the surgical site and focal asymmetry, overlapping with the postoperative change, was seen in the remaining seven cases. Pathologic findings of two cases revealed foreign body reaction. Conclusion Ultrasonography of the patients that underwent breast partial resection followed by absorbable mesh implantation showed a well-encapsulated cyst at the surgical site that gradually decreased in follow-up examinations. Adjunctive ultrasonography combined with mammography would be recommended in postoperative follow-up examinations. PMID:18306477

  1. Quantitative assessment of synovitis in patients with rheumatoid arthritis using fluorescence optical imaging

    PubMed Central

    2013-01-01

    Introduction To prospectively evaluate quantitative assessment of fluorescence optical imaging (FOI) for differentiation of synovitic from non-synovitic joints in patients suffering from rheumatoid arthritis (RA). Methods FOI of the hands was performed in patients with active RA, and a stratified quantitative fluorescence readout (FLRO) of 3 phases (1-120 s; 121-240 s; 241-360 s) was generated for 5 individual joints of the clinical predominant hand (carpal joint, metacarpophalangeal and proximal interphalangeal joints of digits II & III). To dissect the effect of the overall perfusion of the hand from the perfusion due to synovitis, a fluorescence ratio (FLRA) was additionally calculated, dividing each FLRO by the readout of the eponychium of digit II. The mean FLRO and FLRA were compared between joints with absent vs. present synovitis determined by clinical examination, grayscale, color Doppler ultrasonography, or magnetic resonance imaging (MRI). Results The analysis for 90 individual joints from 18 patients yielded FLRO ranging from 4.4 to 49.0 × 103, and FLRAs ranging from 0.37 to 2.27. Overall, the analyses based on the FLRA revealed a higher discrimination than the analyses related to the FLRO, demonstrating most significant differences in phases 2 and 3. A sensitivity of 26/39 (67%) and a specificity of 31/40 (77%) were calculated for FLRA of phase 3 using a cut-off value of more than 1.2 to detect MRI-confirmed synovitis with FOI. Conclusions FOI has a potential for visualizing synovitis in subjects with RA. For adequate FOI interpretation, quantitative analysis should be based on the novel FLRA calculated for phases 2 and 3. PMID:24432363

  2. The catatonic dilemma expanded

    PubMed Central

    Penland, Heath R; Weder, Natalie; Tampi, Rajesh R

    2006-01-01

    Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes. PMID:16959040

  3. Neuropsychological patterns in magnetic resonance imaging-defined subgroups of patients with degenerative dementia

    PubMed Central

    LISTERUD, JOHN; POWERS, CHIVON; MOORE, PEACHIE; LIBON, DAVID J.; GROSSMAN, MURRAY

    2010-01-01

    We hypothesized that specific neuropsychological deficits were associated with specific patterns of atrophy. A magnetic resonance imaging volumetric study and a neuropsychological protocol were obtained for patients with several frontotemporal lobar dementia phenotypes including a social/dysexecutive (SOC/EXEC, n = 17), progressive nonfluent aphasia (n = 9), semantic dementia (n = 7), corticobasal syndrome (n = 9), and Alzheimer’s disease (n = 21). Blinded to testing results, patients were partitioned according to pattern of predominant cortical atrophy; our partitioning algorithm had been derived using seriation, a hierarchical classification technique. Neuropsychological test scores were regressed versus these atrophy patterns as fixed effects using the covariate total atrophy as marker for disease severity. The results showed the model accounted for substantial variance. Furthermore, the “large-scale networks” associated with each neuropsychological test conformed well to the known literature. For example, bilateral prefrontal cortical atrophy was exclusively associated with SOC/EXEC dysfunction. The neuropsychological principle of “double dissociation” was supported not just by such active associations but also by the “silence” of locations not previously implicated by the literature. We conclude that classifying patients with degenerative dementia by specific pattern of cortical atrophy has the potential to predict individual patterns of cognitive deficits. PMID:19402932

  4. Plasma aldosterone and left ventricular diastolic function in treatment-naïve patients with hypertension: tissue-Doppler imaging study.

    PubMed

    Catena, Cristiana; Verheyen, Nicolas; Pilz, Stefan; Kraigher-Krainer, Elisabeth; Tomaschitz, Andreas; Sechi, Leonardo A; Pieske, Burkert

    2015-06-01

    Aldosterone has hypertrophic and profibrotic effects on the heart. The relationship between plasma aldosterone levels and left ventricular diastolic function in hypertension, however, is unclear. The aim of this study was to examine this relationship in treatment-naïve hypertensive patients free of comorbidities that could affect left ventricular diastolic filling properties. In 115 patients with primary hypertension who were eating a standard diet and 100 matched normotensive controls, we measured plasma aldosterone and active renin levels and performed both conventional echocardiography and tissue-Doppler imaging for assessment of left ventricular diastolic function. Left ventricular hypertrophy was found in 21% of hypertensive patients, and diastolic dysfunction was detected in 20% by conventional echocardiography and in 58% by tissue-Doppler imaging. Patients with left ventricular diastolic dysfunction at tissue-Doppler imaging were older and more frequently men, had greater body mass index, blood pressure, alcohol intake, left ventricular mass index, relative wall thickness, and lower plasma aldosterone levels than patients with preserved diastolic function. Plasma aldosterone correlated directly with left ventricular mass index in addition to age, body mass index, and systolic blood pressure. Plasma aldosterone was also directly related to e' velocity at tissue-Doppler imaging, but this relationship was lost after multivariate adjustment. In conclusion, plasma aldosterone levels are associated with left ventricular hypertrophy but have no independent relationship with left ventricular diastolic properties in hypertensive patients. PMID:25801873

  5. Expand sulfur plant capacity

    SciTech Connect

    Hull, R. [BOC Gases, Murray Hill, NJ (United States); Watson, R. [BOC Gases, Guildford (United Kingdom); Chow, T.K. [Ralph M Parsons Co., Pasadena, CA (United States)] [and others

    1995-09-01

    Interest in oxygen use to expand existing Claus sulfur plants in refineries has been building ever since high oxygen concentrations were successfully used at the Conoco, Lake Charles La., refinery, and the KOA, Kawasaki refinery in Japan. This interest increased recently due to the demand created by numerous refinery hydrotreater projects, driven by more stringent fuel quality and sulfur emission standards, as well as the economic incentive to process low-cost heavy, sour crudes. Various approaches that introduce low oxygen levels have resulted in moderate capacity increases. Oxygen can be added to the air supply stream for concentrations up to 30% oxygen. Beyond the 30% oxygen level, oxygen must be introduced into the reaction furnace through a burner specifically designed to accommodate oxygen, or through a separate oxygen lance. However, higher oxygen concentrations result in higher temperatures, which rapidly approach the furnace refractory design limits. Methods must be employed to mitigate the reaction furnace temperature whenever high oxygen levels are necessary to coincide with significant capacity increases in refinery operations. Three proprietary technologies are in commercial operation that successfully address this issue.

  6. Patient-specific model of brain deformation: application to medical image registration.

    PubMed

    Wittek, Adam; Miller, Karol; Kikinis, Ron; Warfield, Simon K

    2007-01-01

    This contribution presents finite element computation of the deformation field within the brain during craniotomy-induced brain shift. The results were used to illustrate the capabilities of non-linear (i.e. accounting for both geometric and material non-linearities) finite element analysis in non-rigid registration of pre- and intra-operative magnetic resonance images of the brain. We used patient-specific hexahedron-dominant finite element mesh, together with realistic material properties for the brain tissue and appropriate contact conditions at boundaries. The model was loaded by the enforced motion of nodes (i.e. through prescribed motion of a boundary) at the brain surface in the craniotomy area. We suggest using explicit time-integration scheme for discretised equations of motion, as the computational times are much shorter and accuracy, for practical purposes, the same as in the case of implicit integration schemes. Application of the computed deformation field to register (i.e. align) the pre-operative images with the intra-operative ones indicated that the model very accurately predicts the displacements of the tumour and the lateral ventricles even for limited information about the brain surface deformation. The prediction accuracy improves when information about deformation of not only exposed (during craniotomy) but also unexposed parts of the brain surface is used when prescribing loading. However, it appears that the accuracy achieved using information only about the deformation of the exposed surface, that can be determined without intra-operative imaging, is acceptable. The presented results show that non-linear biomechanical models can complement medical image processing techniques when conducting non-rigid registration. Important advantage of such models over the previously used linear ones is that they do not require unrealistic assumptions that brain deformations are infinitesimally small and brain stress-strain relationship is linear. PMID:16678834

  7. Multiphase Contrast-Enhanced Magnetic Resonance Imaging Features of Bacillus Calmette-Guérin-Induced Granulomatous Prostatitis in Five Patients

    PubMed Central

    Kawada, Hiroshi; Goshima, Satoshi; Kondo, Hiroshi; Watanabe, Haruo; Noda, Yoshifumi; Tanahashi, Yukichi; Kawai, Nobuyuki; Hoshi, Hiroaki

    2015-01-01

    Objective To evaluate the multiphase contrast-enhanced magnetic resonance (MR) imaging features of Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis (GP). Materials and Methods Magnetic resonance images obtained from five patients with histopathologically proven BCG-induced GP were retrospectively analyzed for tumor location, size, signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI), apparent diffusion coefficient (ADC) value, and appearance on gadolinium-enhanced multiphase images. MR imaging findings were compared with histopathological findings. Results Bacillus Calmette-Guérin-induced GP (size range, 9-40 mm; mean, 21.2 mm) were identified in the peripheral zone in all patients. The T2WI showed lower signal intensity compared with the normal peripheral zone. The DWIs demonstrated high signal intensity and low ADC values (range, 0.44-0.68 × 10-3 mm2/sec; mean, 0.56 × 10-3 mm2/sec), which corresponded to GP. Gadolinium-enhanced multiphase MR imaging performed in five patients showed early and prolonged ring enhancement in all cases of GP. Granulomatous tissues with central caseation necrosis were identified histologically, which corresponded to ring enhancement and a central low intensity area on gadolinium-enhanced MR imaging. The findings on T2WI, DWI, and gadolinium-enhanced images became gradually obscured with time. Conclusion Bacillus Calmette-Guérin-induced GP demonstrates early and prolonged ring enhancement on gadolinium-enhanced MR imaging which might be a key finding to differentiate it from prostate cancer. PMID:25741196

  8. Predictors of intramedullary lesion expansion rate on MR images of patients with subaxial spinal cord injury.

    PubMed

    Le, Elizabeth; Aarabi, Bizhan; Hersh, David S; Shanmuganathan, Kathirkamanthan; Diaz, Cara; Massetti, Jennifer; Akhtar-Danesh, Noori

    2015-06-01

    OBJECT Studies of preclinical spinal cord injury (SCI) in rodents indicate that expansion of intramedullary lesions (IMLs) seen on MR images may be amenable to neuroprotection. In patients with subaxial SCI and motor-complete American Spinal Injury Association (ASIA) Impairment Scale (AIS) Grade A or B, IML expansion has been shown to be approximately 900 ?m/hour. In this study, the authors investigated IML expansion in a cohort of patients with subaxial SCI and AIS Grade A, B, C, or D. METHODS Seventy-eight patients who had at least 2 MRI scans within 6 days of SCI were enrolled. Data were analyzed by regression analysis. RESULTS In this cohort, the mean age was 45.3 years (SD 18.3 years), 73 patients were injured in a motor vehicle crash, from a fall, or in sport activities, and 77% of them were men. The mean Injury Severity Score (ISS) was 26.7 (SD 16.7), and the AIS grade was A in 23 patients, B in 7, C in 7, and D in 41. The mechanism of injury was distraction in 26 patients, compression in 22, disc/osteophyte complex in 29, and Chance fracture in 1. The mean time between injury onset and the first MRI scan (Interval 1) was 10 hours (SD 8.7 hours), and the mean time to the second MRI scan (Interval 2) was 60 hours (SD 29.6 hours). The mean IML lengths of the first and second MR images were 38.8 mm (SD 20.4 mm) and 51 mm (SD 36.5 mm), respectively. The mean time from the first to the second MRI scan (Interval 3) was 49.9 hours (SD 28.4 hours), and the difference in IML lengths was 12.6 mm (SD 20.7 mm), reflecting an expansion rate of 366 ?m/ hour (SD 710 ?m/hour). IML expansion in patients with AIS Grades A and B was 918 ?m/hour (SD 828 ?m/hour), and for those with AIS Grades C and D, it was 21 ?m/hour (SD 304 ?m/hour). Univariate analysis indicated that AIS Grade A or B versus Grades C or D (p < 0.0001), traction (p= 0.0005), injury morphology (p < 0.005), the surgical approach (p= 0.009), vertebral artery injury (p= 0.02), age (p < 0.05), ISS (p < 0.05), ASIA motor score (p < 0.05), and time to decompression (p < 0.05) were all predictors of lesion expansion. In multiple regression analysis, however, the sole determinant of IML expansion was AIS grade (p < 0.005). CONCLUSIONS After traumatic subaxial cervical spine or spinal cord injury, patients with motor-complete injury (AIS Grade A or B) had a significantly higher rate of IML expansion than those with motor-incomplete injury (AIS Grade C or D). PMID:25746115

  9. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance

    PubMed Central

    2014-01-01

    Background Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). Methods A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. Results The 2-year actuarial likelihood of developing grade?>?= 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p??= 2 GI toxicity compared to IG-IMRT (p?image guidance and margin reduction. PMID:24495815

  10. Intracranial Plaque Enhancement in Patients with Cerebrovascular Events on High-Spatial-Resolution MR Images

    PubMed Central

    Qiao, Ye; Zeiler, Steven R.; Mirbagheri, Saeedeh; Leigh, Richard; Urrutia, Victor; Wityk, Robert

    2014-01-01

    Purpose To characterize intracranial plaque inflammation in vivo by using three-dimensional (3D) high-spatial-resolution contrast material–enhanced black-blood (BB) magnetic resonance (MR) imaging and to investigate the relationship between intracranial plaque inflammation and cerebrovascular ischemic events. Materials and Methods The study was approved by the institutional review board and was HIPAA compliant. Twenty-seven patients (19 men; mean age, 56.8 years ± 12.4 [standard deviation]) with cerebrovascular ischemic events (acute stroke, n = 20; subacute stroke, n = 2; chronic stroke, n = 3; transient ischemic attack, n = 2) underwent 3D time-of-flight MR angiography and contrast-enhanced BB 3-T MR imaging for intracranial atherosclerotic disease. Each identified plaque was classified as either culprit (the only or most stenotic lesion upstream from a stroke), probably culprit (not the most stenotic lesion upstream from a stroke), or nonculprit (not within the vascular territory of a stroke). Plaque contrast enhancement was categorized on BB MR images (grade 0, enhancement less than or equal to that of normal arterial walls seen elsewhere; grade 1, enhancement greater than grade 0 but less than that of the pituitary infundibulum; grade 2, enhancement greater than or equal to that of the pituitary infundibulum), and degree of contrast enhancement was calculated. Associations of the likelihood of being a culprit lesion with both plaque contrast enhancement and plaque thickness were estimated with ordinal logistic regression. Results Seventy-eight plaques were identified in 20 patients with acute stroke (21 [27%] culprit, 12 [15%] probably culprit, and 45 [58%] nonculprit plaques). In these patients, grade 2 contrast enhancement was associated with culprit plaques (odds ratio 34.6; 95% confidence interval: 4.5, 266.5 compared with grade 0) when adjusted for plaque thickness. Grade 0 was observed in only nonculprit plaques. Culprit plaques had a higher degree of contrast enhancement than did nonculprit plaques (25.9% ± 13.4 vs 13.6% ± 12.3, P = .003). Conclusion Contrast enhancement of intracranial atherosclerotic plaque is associated with its likelihood to have caused a recent ischemic event and may serve as a marker of its stability, thereby providing important insight into stroke risk. © RSNA, 2014 Online supplemental material is available for this article. PMID:24475850

  11. Head model and electrical source imaging: A study of 38 epileptic patients?

    PubMed Central

    Birot, Gwénael; Spinelli, Laurent; Vulliémoz, Serge; Mégevand, Pierre; Brunet, Denis; Seeck, Margitta; Michel, Christoph M.

    2014-01-01

    Electrical source imaging (ESI) aims at reconstructing the electrical brain activity from scalp EEG. When applied to interictal epileptiform discharges (IEDs), this technique is of great use for identifying the irritative zone in focal epilepsies. Inaccuracies in the modeling of electro-magnetic field propagation in the head (forward model) may strongly influence ESI and lead to mislocalization of IED generators. However, a systematic study on the influence of the selected head model on the localization precision of IED in a large number of patients with known focus localization has not yet been performed. We here present such a performance evaluation of different head models in a dataset of 38 epileptic patients who have undergone high-density scalp EEG, intracranial EEG and, for the majority, subsequent surgery. We compared ESI accuracy resulting from three head models: a Locally Spherical Model with Anatomical Constraints (LSMAC), a Boundary Element Model (BEM) and a Finite Element Model (FEM). All of them were computed from the individual MRI of the patient and ESI was performed on averaged IED. We found that all head models provided very similar source locations. In patients having a positive post-operative outcome, at least 74% of the source maxima were within the resection. The median distance from the source maximum to the nearest intracranial electrode showing IED was 13.2, 15.6 and 15.6 mm for LSMAC, BEM and FEM, respectively. The study demonstrates that in clinical applications, the use of highly sophisticated and difficult to implement head models is not a crucial factor for an accurate ESI. PMID:25003030

  12. The Artful Universe Expanded

    NASA Astrophysics Data System (ADS)

    Barrow, John D.

    2005-07-01

    Our love of art, writes John Barrow, is the end product of millions of years of evolution. How we react to a beautiful painting or symphony draws upon instincts laid down long before humans existed. Now, in this enhanced edition of the highly popular The Artful Universe , Barrow further explores the close ties between our aesthetic appreciation and the basic nature of the Universe. Barrow argues that the laws of the Universe have imprinted themselves upon our thoughts and actions in subtle and unexpected ways. Why do we like certain types of art or music? What games and puzzles do we find challenging? Why do so many myths and legends have common elements? In this eclectic and entertaining survey, Barrow answers these questions and more as he explains how the landscape of the Universe has influenced the development of philosophy and mythology, and how millions of years of evolutionary history have fashioned our attraction to certain patterns of sound and color. Barrow casts the story of human creativity and thought in a fascinating light, considering such diverse topics as our instinct for language, the origins and uses of color in nature, why we divide time into intervals as we do, the sources of our appreciation of landscape painting, and whether computer-generated fractal art is really art. Drawing on a wide variety of examples, from the theological questions raised by St. Augustine and C.S. Lewis to the relationship between the pure math of Pythagoras and the music of the Beatles, The Artful Universe Expanded covers new ground and enters a wide-ranging debate about the meaning and significance of the links between art and science.

  13. Distribution of Proliferating Bone Marrow in Adult Cancer Patients Determined Using FLT-PET Imaging

    SciTech Connect

    Hayman, James A., E-mail: hayman@umich.ed [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); University of Michigan Health Systems, Ann Arbor, MI (United States); Callahan, Jason W.; Herschtal, Alan [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Everitt, Sarah [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Monash University, Melbourne, VIC (Australia); Binns, David S. [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Hicks, Rod J.; Mac Manus, Michael [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Melbourne University, Melbourne, VIC (Australia)

    2011-03-01

    Purpose: Given that proliferating hematopoietic stem cells are especially radiosensitive, the bone marrow is a potential organ at risk, particularly with the use of concurrent chemotherapy and radiotherapy. Existing data on bone marrow distribution have been determined from the weight and visual appearance of the marrow in cadavers. {sup 18}F-fluoro-L-deoxythymidine concentrates in bone marrow, and we used its intensity on positron emission tomography imaging to quantify the location of the proliferating bone marrow. Methods and Materials: The {sup 18}F-fluoro-L-deoxythymidine positron emission/computed tomography scans performed at the Peter MacCallum Cancer Centre between 2006 and 2009 on adult cancer patients were analyzed. At a minimum, the scans included the mid-skull through the proximal femurs. A software program developed at our institution was used to calculate the percentage of administered activity in 11 separately defined bony regions. Results: The study population consisted of 13 patients, 6 of whom were men. Their median age was 61 years. Of the 13 patients, 9 had lung cancer, 2 had colon cancer, and 1 each had melanoma and leiomyosarcoma; 6 had received previous, but not recent, chemotherapy. The mean percentage of proliferating bone marrow by anatomic site was 2.9% {+-} 2.1% at the skull, 1.9% {+-} 1.2% at the proximal humeri, 2.9% {+-} 1.3% at the sternum, 8.8% {+-} 4.7% at the ribs and clavicles, 3.8% {+-} 0.9% at the scapulas, 4.3% {+-} 1.6% at the cervical spine, 19.9% {+-} 2.6% at the thoracic spine, 16.6% {+-} 2.2% at the lumbar spine, 9.2% {+-} 2.3% at the sacrum, 25.3% {+-} 4.9% at the pelvis, and 4.5% {+-} 2.5% at the proximal femurs. Conclusion: Our modern estimates of bone marrow distribution in actual cancer patients using molecular imaging of the proliferating marrow provide updated data for optimizing normal tissue sparing during external beam radiotherapy planning.

  14. Smaragdyrins: emeralds of expanded porphyrin family.

    PubMed

    Pareek, Yogita; Ravikanth, M; Chandrashekar, T K

    2012-10-16

    Porphyrins are tetrapyrrolic 18 ? electron conjugated macrocycles with wide applications that range from materials to medicine. Expanded porphyrins, synthetic analogues of porphyrins that contain more than 18 ? electrons in the conjugated pathway, have an increased number of pyrroles or other heterocyles or multiple meso-carbon bridges. The expanded porphyrins have attracted tremendous attention because of unique features such as anion binding or transport that are not present in porphyrins. Expanded porphyrins exhibit wide applications that include their use in the coordination of large metal ions, as contrasting agents in magnetic resonance imaging (MRI), as sensitizers for photodynamic therapy (PDT) and as materials for nonlinear optical (NLO) studies. Pentaphyrin 1, sapphyrin 2, and smaragdyrin 3 are expanded porphyrins that include five pyrroles or heterocyclic rings. They differ from each other in the number of bridging carbons and direct bonds that connect the five heterocyclic rings. Sapphyrins were the first stable expanded porphyrins reported in the literature and remain one of the most extensively studied macrocycles. The strategies used to synthesize sapphyrins are well established, and these macrocycles are versatile anion binding agents. They possess rich porphyrin-like coordination chemistry and have been used in diverse applications. This Account reviews developments in smaragdyrin chemistry. Although smaragdyrins were discovered at the same time as sapphyrins, the chemistry of smaragdyrins remained underdeveloped because of synthetic difficulties and their comparative instability. Earlier efforts resulted in the isolation of stable ?-substituted smaragdyrins and meso-aryl isosmaragdyrins. Recently, researchers have synthesized stable meso-aryl smaragdyrins by [3 + 2] oxidative coupling reactions. These results have stimulated renewed research interest in the exploration of these compounds for anion and cation binding, energy transfer, fluorescent sensors, and their NLO properties. Recently reported results on smaragdyrin macrocycles have set the stage for further synthetic studies to produce stable meso-aryl smaragdyrins with different inner cores to study their properties and potential for various applications. PMID:22939582

  15. Experience of Dual Time Point Brain F-18 FDG PET\\/CT Imaging in Patients with Infectious Disease

    Microsoft Academic Search

    Dae-Weung Kim; Chang Guhn Kim; Soon-Ah Park; Sang-Ah Jung

    2010-01-01

    Dual time point FDG PET imaging (DTPI) has been considered helpful for discrimination of benign and malignant disease, and\\u000a staging lymph node status in patients with pulmonary malignancy. However, DTPI for benign disease has been rarely reported,\\u000a and it may show a better description of metabolic status and extent of benign infectious disease than early imaging only.\\u000a The authors report

  16. Impact of total activity variation in 18F-FDG injected with the overall PET image quality in oncology patients

    NASA Astrophysics Data System (ADS)

    Hishar, H.; Fathinul Fikri, A. S.; Salasiah, M.; Noramaliza, M. N.; Abdul Jalil, N.

    2013-05-01

    The preliminary study aims to investigate whether variation on dose activity 18F-FDG will influence the overall PET image quality in oncology patients. This is a retrospective analysis of 10 oncology patients who were injected with an average of 337.40 ± 38.43 MBq of 18F-FDG for PET/CT whole body examination. Patients were divided into 2 groups based on total activity of 18F-FDG injected: less than 333 MBq (302.96±12.65 MBq) (group 1) and more than 333 MBq (371.85±14.00 MBq) (group 2). Multiple Image Projection (MIP) PET images were scored visually by two qualified nuclear radiologists using a two-point scoring scale (poor and excellent). The agreement between radiologists was analysed using kappa measure of agreement (K). The prediction on poor-to-excellent PET image by the total activity of 18F-FDG injected was analysed using a Chi-squared test (x2). A p value of < 0.05 was considered significant. Agreement on PET image scoring was substantial, with a kappa value of 0.737. However, the prediction of the PET image quality by the total activity injected has been found to be insignificant (p > 0.05). Therefore, there is no strong evidence suggest that the dose injected will influence the PET image quality. Hence, it is recommended to use low-dosed of 18F-FDG technique as it also potentially yields a comparable PET image and reduces radiation burden to the patients.

  17. Diagnostic Accuracy of Clinical Assessment, Magnetic Resonance Imaging, Magnetic Resonance Arthrography, and Intra-Articular Injection in Hip Arthroscopy Patients

    Microsoft Academic Search

    J. W. Thomas Byrd; Kay S. Jones

    2004-01-01

    Background: Hip arthroscopy has defined elusive causes of hip pain.Hypothesis\\/Purpose: It is postulated that the reliability of various investigative methods is inconsistent. The purpose of this study is to evaluate the diagnostic accuracy of these methods.Study Design: Retrospective review of prospectively collected data.Methods: Five parameters were assessed in 40 patients: clinical assessment, high-resolution magnetic resonance imaging, magnetic resonance imaging with

  18. Prospective study of computed tomography, ultrasound, and gallium imaging in patients with fever

    SciTech Connect

    McNeil, B.J.; Sanders, R.; Alderson, P.O.; Hessel, S.J.; Finberg, H.; Siegelman, S.S.; Adams, D.F.; Abrams, H.L.

    1981-06-01

    Computed tomography, ultrasound, and /sup 67/Ga-citrate imaging were analyzed prospectively in patients thought to have a focal source of sepsis. They were divided into three groups: (a) postoperative, fever greater than or equal to 38.3/sup 0/C; (b) fever greater than or equal to 38.3/sup 0/C for less than four weeks, unrelated to surgery; and (c) any fever present for more than four weeks. ROC curves showed no significant difference in the ability of the three modalities to differentiate focal from nonfocal sources of sepsis. The authors concluded that all three modalities have a similar ability to detect sepsis and that sensitivity can be increased by using any two of them.

  19. Wavelet transform: capabilities expanded

    NASA Astrophysics Data System (ADS)

    Pokorski, Krzysztof; Patorski, Krzysztof

    2014-07-01

    A review of our recently developed fringe pattern processing techniques utilizing two dimensional continuous wavelet transform is presented. Their development significantly broadens the range of 2D CWT capabilities. Namely they enable analysis of images containing multiple fringe sets and the carrier fringe contrast reversal. The methods are fully automatic and require no user interference. Their validity and robustness are confirmed using simulations. Furthermore, a novel Talbot interferometer setup utilizing binary amplitude checker gratings with its output fringe patterns successfully analyzed utilizing 2D CWT technique is presented.

  20. Evidence of outer retinal changes in glaucoma patients as revealed by ultrahigh-resolution in vivo retinal imaging

    PubMed Central

    Choi, Stacey S; Zawadzki, Robert J; Lim, Michele C; Brandt, James D; Keltner, John L; Doble, Nathan; Werner, John S

    2010-01-01

    Aims It is well established that glaucoma results in a thinning of the inner retina. To investigate whether the outer retina is also involved, ultrahigh-resolution retinal imaging techniques were utilised. Methods Eyes from 10 glaucoma patients (25–78 years old), were imaged using three research-grade instruments: (1) ultrahigh-resolution Fourier-domain optical coherence tomography (UHR-FD-OCT), (2) adaptive optics (AO) UHR-FD-OCT and (3) AO-flood illuminated fundus camera (AO-FC). UHR-FD-OCT and AO-UHR-FD-OCT B-scans were examined for any abnormalities in the retinal layers. On some patients, cone density measurements were made from the AO-FC en face images. Correlations between retinal structure and visual sensitivity were measured by Humphrey visual-field (VF) testing made at the corresponding retinal locations. Results All three in vivo imaging modalities revealed evidence of outer retinal changes along with the expected thinning of the inner retina in glaucomatous eyes with VF loss. AO-UHR-FD-OCT images identified the exact location of structural changes within the cone photoreceptor layer with the AO-FC en face images showing dark areas in the cone mosaic at the same retinal locations with reduced visual sensitivity. Conclusion Losses in cone density along with expected inner retinal changes were demonstrated in well-characterised glaucoma patients with VF loss. PMID:20956277

  1. Pituitary Magnetic Resonance Imaging for Sellar and Parasellar Masses: Ten-Year Experience in 2598 Patients

    PubMed Central

    Famini, Pouyan; Maya, Marcel M.

    2011-01-01

    Context: Sellar and parasellar masses present with overlapping clinical and radiological features ranging from asymptomatic incidental presentations and hormonal effects to compressive local mass effects. Pituitary masses are diagnosed with increased frequency with magnetic resonance imaging (MRI) advancements and availability, but indications and diagnostic outcomes of MRI screening for sellar lesions are not defined. Although pituitary adenomas are the most frequently encountered sellar mass lesions, other etiologies should be considered in the differential diagnosis of a sellar mass. Setting: The study was conducted at a tertiary pituitary center. Patients: This study was a retrospective review of 2598 subjects undergoing at least one pituitary MRI scan from 1999 to 2009. Main Outcome Measure: Prevalence and diagnosis of specific sellar and parasellar masses as screened by pituitary MRI. Results: The most common indications for pituitary imaging, excluding known mass follow-up, were for evaluation of hyperprolactinemia or hypogonadism. A normal pituitary gland was reported in 47% of subjects undergoing pituitary MRI. The most common pituitary adenomas initially identified by MRI included prolactinoma (40%), nonfunctioning adenoma (37%), and GH adenoma (13%). Nonadenomatous sellar masses accounted for 18% of visible lesions, of which the most common were Rathke's cleft cyst (19%), craniopharyngioma (15%), and meningioma (15%). Metastases accounted for 5% of nonpituitary lesions and breast cancer was the most common primary source. Conclusions: Half of all pituitary MRI scans performed in a large patient population yielded no visible lesion. Nonadenomatous pituitary lesions should be considered in the diagnosis of sellar masses observed on MRI, and a high clinical suspicion is required to exclude the presence of a nonfunctioning pituitary adenoma. PMID:21470998

  2. A magnetic resonance imaging-based prognostic scoring system to predict outcome in transplant-eligible patients with multiple myeloma.

    PubMed

    Mai, Elias K; Hielscher, Thomas; Kloth, Jost K; Merz, Maximilian; Shah, Sofia; Raab, Marc S; Hillengass, Michaela; Wagner, Barbara; Jauch, Anna; Hose, Dirk; Weber, Marc-André; Delorme, Stefan; Goldschmidt, Hartmut; Hillengass, Jens

    2015-06-01

    Diffuse and focal bone marrow infiltration patterns detected by magnetic resonance imaging have been shown to be of prognostic significance in all stages of monoclonal plasma cell disorders and have, therefore, been incorporated into the definition of the disease. The aim of this retrospective analysis was to develop a rapidly evaluable prognostic scoring system, incorporating the most significant information acquired from magnetic resonance imaging. Therefore, the impact of bone marrow infiltration patterns on progression-free and overall survival in 161 transplant-eligible myeloma patients was evaluated. Compared to salt and pepper/minimal diffuse infiltration, moderate/severe diffuse infiltration had a negative prognostic impact on both progression-free survival (P<0.001) and overall survival (P=0.003). More than 25 focal lesions on whole-body magnetic resonance imaging or more than seven on axial magnetic resonance imaging were associated with an adverse prognosis (progression-free survival: P=0.001/0.003 and overall survival: P=0.04/0.02). A magnetic resonance imaging-based prognostic scoring system, combining grouped diffuse and focal infiltration patterns, was formulated and is applicable to whole-body as well as axial magnetic resonance imaging. The score identified high-risk patients with median progression-free and overall survival of 23.4 and 55.9 months, respectively (whole-body-based). Multivariate analyses demonstrated that the magnetic resonance imaging-based prognostic score stage III (high-risk) and adverse cytogenetics are independent prognostic factors for both progression-free and overall survival (whole-body-based, progression-free survival: hazard ratio=3.65, P<0.001; overall survival: hazard ratio=5.19, P=0.005). In conclusion, we suggest a magnetic resonance imaging-based prognostic scoring system which is a robust, easy to assess and interpret parameter summarizing significant magnetic resonance imaging findings in transplant-eligible patients with multiple myeloma. PMID:25795721

  3. A magnetic resonance imaging-based prognostic scoring system to predict outcome in transplant-eligible patients with multiple myeloma

    PubMed Central

    Mai, Elias K.; Hielscher, Thomas; Kloth, Jost K.; Merz, Maximilian; Shah, Sofia; Raab, Marc S.; Hillengass, Michaela; Wagner, Barbara; Jauch, Anna; Hose, Dirk; Weber, Marc-André; Delorme, Stefan; Goldschmidt, Hartmut; Hillengass, Jens

    2015-01-01

    Diffuse and focal bone marrow infiltration patterns detected by magnetic resonance imaging have been shown to be of prognostic significance in all stages of monoclonal plasma cell disorders and have, therefore, been incorporated into the definition of the disease. The aim of this retrospective analysis was to develop a rapidly evaluable prognostic scoring system, incorporating the most significant information acquired from magnetic resonance imaging. Therefore, the impact of bone marrow infiltration patterns on progression-free and overall survival in 161 transplant-eligible myeloma patients was evaluated. Compared to salt and pepper/minimal diffuse infiltration, moderate/severe diffuse infiltration had a negative prognostic impact on both progression-free survival (P<0.001) and overall survival (P=0.003). More than 25 focal lesions on whole-body magnetic resonance imaging or more than seven on axial magnetic resonance imaging were associated with an adverse prognosis (progression-free survival: P=0.001/0.003 and overall survival: P=0.04/0.02). A magnetic resonance imaging-based prognostic scoring system, combining grouped diffuse and focal infiltration patterns, was formulated and is applicable to whole-body as well as axial magnetic resonance imaging. The score identified high-risk patients with median progression-free and overall survival of 23.4 and 55.9 months, respectively (whole-body-based). Multivariate analyses demonstrated that the magnetic resonance imaging-based prognostic score stage III (high-risk) and adverse cytogenetics are independent prognostic factors for both progression-free and overall survival (whole-body-based, progression-free survival: hazard ratio=3.65, P<0.001; overall survival: hazard ratio=5.19, P=0.005). In conclusion, we suggest a magnetic resonance imaging-based prognostic scoring system which is a robust, easy to assess and interpret parameter summarizing significant magnetic resonance imaging findings in transplant-eligible patients with multiple myeloma. PMID:25795721

  4. Effect of rare earth filtration on patient exposure, dose reduction, and image quality in oral panoramic radiology

    Microsoft Academic Search

    Donald A. Tyndall; David B. Washburn

    1987-01-01

    Rare earth intensifying screen material (Gd2O2S:Tb) was added to the standard Al filtration of an oral panoramic x-ray unit, resulting in a beam capable of achieving reductions in patient dose without a loss of image quality. The added rare earth filtration technique resulted in patient dose reductions of 21-56%, depending on anatomic sites, when compared to the conventional Al filtration

  5. Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients

    Microsoft Academic Search

    B. Schuknecht; G. Stergiou; K. Graetz

    2008-01-01

    Propagation of odontogenic masticator space abscesses is insufficiently understood. The purpose was to analyse pathways of\\u000a spread in 30 patients with odontogenic masticator space abscess. The imaging findings in 30 patients (CT in 30, MR in 16 patients)\\u000a were retrospectively analysed. CT and MR imaging depicted a masticator space abscess within: medial pterygoid muscle in 13\\u000a patients (43.3%), lateral masseter

  6. [Reversible changes on MR images in a patient with metronidazole-induced encephalopathy].

    PubMed

    Neshige, Shuichiro; Kanaya, Yuhei; Takeshima, Shinichi; Yoshimoto, Takeshi; Tanaka, Akio; Kuriyama, Masaru

    2015-01-01

    A 66-year-old woman was diagnosed with a brain abscess. The abscess was drained by sterotactic catheter insertion. She was administered metronidazole at a dose of 2?g/day. On the 30th day of treatment, she had nausea that gradually progressed. On the 45th day, she developed a disturbance of consciousness and was admitted to our department. She was in stuporous state, and had slight vestibular and cerebellar dysfunctions. Diffusion-weighted and FLAIR brain MR images showed bilateral symmetrical high signals in the splenium of the corpus callosum (SCC), cerebellar dentate nucleus, and inferior colliculus. The apparent diffusion coefficient (ADC) map was reduced in the SCC, but not in the other locations. The peak of lactate on MR spectroscopy was increased in the SCC. The clinical presentation and image changes of the patient were thought to be most consistent with metronidazole toxicity. Metronidazole was discontinued, and her condition improved rapidly. She was discharged 14 days later. The lesions in her cerebellar dentate nucleus and inferior colliculus, suspected to be vasogenic edema, had disappeared 5 to 10 days later, whereas the lesion in the SCC, which gradually diminishing, could still be faintly detected 40 days later, which corresponded to our suspicion of cytotoxic edema. PMID:25786755

  7. SRXRF imaging of a single brain cell from a patient with Parkinson's disease

    SciTech Connect

    Takada, K.; Ektessabi, A. M. [Department of Precision Engineering, Graduate school of Engineering, Kyoto University, Yoshida Honmachi, Sakyo-ku, Kyoto, 606-8501 (Japan); Yoshida, S. [Division of Neurological Disease, Wakayama Medical College, 27-9 Bancho, Wakayama City, 640-8511 (Japan)

    1999-06-10

    Synchrotron radiation X-ray fluorescence spectroscopy (SRXRF) is a potential imaging technique with regard to minimum detection limit, measuring time and being non-destructive on biological samples. These advantages are important for measuring trace elements in biological samples. In this paper, we investigated the distribution of trace elements in the cerebral neurons of the brains of patients with Parkinson's disease (PD), using SRXRF spectroscopy. The cause of PD is unknown but many researchers consider that excessive accumulation of trace metal elements (mainly iron) has strong influence on the generative process of PD. Micro beam imaging (mapping of the elements) with a beam size of 6x8 {mu}m{sup 2}, and the energy of 13.5 keV was carried out in a single neuron. The distribution of trace elements in the neurons was successfully obtained in an area of about 100x100 {mu}m{sup 2}. The same sample was histologically studied with an optical microscope.

  8. Measuring the relative extent of pulmonary infiltrates by hierarchical classification of patient-specific image features

    NASA Astrophysics Data System (ADS)

    Tsevas, S.; Iakovidis, D. K.

    2011-11-01

    Pulmonary infiltrates are common radiological findings indicating the filling of airspaces with fluid, inflammatory exudates, or cells. They are most common in cases of pneumonia, acute respiratory syndrome, atelectasis, pulmonary oedema and haemorrhage, whereas their extent is usually correlated with the extent or the severity of the underlying disease. In this paper we propose a novel pattern recognition framework for the measurement of the extent of pulmonary infiltrates in routine chest radiographs. The proposed framework follows a hierarchical approach to the assessment of image content. It includes the following: (a) sampling of the lung fields; (b) extraction of patient-specific grey-level histogram signatures from each sample; (c) classification of the extracted signatures into classes representing normal lung parenchyma and pulmonary infiltrates; (d) the samples for which the probability of belonging to one of the two classes does not reach an acceptable level are rejected and classified according to their textural content; (e) merging of the classification results of the two classification stages. The proposed framework has been evaluated on real radiographic images with pulmonary infiltrates caused by bacterial infections. The results show that accurate measurements of the infiltration areas can be obtained with respect to each lung field area. The average measurement error rate on the considered dataset reached 9.7% ± 1.0%.

  9. High-Resolution Images of Retinal Structure in Patients with Choroideremia

    PubMed Central

    Syed, Reema; Sundquist, Sanna M.; Ratnam, Kavitha; Zayit-Soudry, Shiri; Zhang, Yuhua; Crawford, J. Brooks; MacDonald, Ian M.; Godara, Pooja; Rha, Jungtae; Carroll, Joseph; Roorda, Austin; Stepien, Kimberly E.; Duncan, Jacque L.

    2013-01-01

    Purpose. To study retinal structure in choroideremia patients and carriers using high-resolution imaging techniques. Methods. Subjects from four families (six female carriers and five affected males) with choroideremia (CHM) were characterized with best-corrected visual acuity (BCVA), kinetic and static perimetry, full-field electroretinography, and fundus autofluorescence (FAF). High-resolution macular images were obtained with adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT). Coding regions of the CHM gene were sequenced. Results. Molecular analysis of the CHM gene identified a deletion of exons 9 to 15 in family A, a splice site mutation at position 79+1 of exon 1 in family B, deletion of exons 6 to 8 in family C, and a substitution at position 106 causing a premature stop in family D. BCVA ranged from 20/16 to 20/63 in carriers and from 20/25 to 5/63 in affected males. FAF showed abnormalities in all subjects. SD-OCT showed outer retinal layer loss, outer retinal tubulations at the margin of outer retinal loss, and inner retinal microcysts. Patchy cone loss was present in two symptomatic carriers. In two affected males, cone mosaics were disrupted with increased cone spacing near the fovea but more normal cone spacing near the edge of atrophy. Conclusions. High-resolution retinal images in CHM carriers and affected males demonstrated RPE and photoreceptor cell degeneration. As both RPE and photoreceptor cells were affected, these cell types may degenerate simultaneously in CHM. These findings provide insight into the effect of CHM mutations on macular retinal structure, with implications for the development of treatments for CHM. (ClinicalTrials.gov number, NCT00254605.) PMID:23299470

  10. Assessment of Optic Nerve Impairment in Patients with Neuromyelitis Optica by MR Diffusion Tensor Imaging

    PubMed Central

    Chen, Zhiye; Lou, Xin; Liu, Mengqi; Huang, Dehui; Wei, Shihui; Yu, Shengyuan; Ma, Lin

    2015-01-01

    Background Diffusion tensor imaging (DTI) has been used for the evaluation of the white matter integrity. In this study, we evaluated optic nerve impairment in patients with neuromyelitis optica (NMO) using DTI. Methodology/Principal Findings Optic nerve DTI were performed on 28 NMO patients and 38 normal controls. Fractional anisotropy (FA) values were measured in the anterior, middle, and posterior parts of the intraorbital optic nerve segment. For the posterior intraorbital optic nerve, FA values of BI (0.20±0.07), MI (0.24±0.16), and NA (0.25±0.14) decreased significantly compared with that of NC (0.43±0.07) (P<0.05), and ROC analysis demonstrated that the area under the curve (AUC) measurements for BI vs. NC, MI vs. NC, NA vs. NC, and NMO (including BI, MI, and NA) vs. NC were 0.99, 0.93, 0.88, and 0.96, respectively. The corresponding diagnostic sensitivities of ROC analysis were 100%, 80%, 80%, and 91%; and the specificities were 93%, 97%, 91%, and 93%. Conclusions/Significance Decreased FA value in the intraorbital optic nerve, especially in the posterior part of the nerve, was demonstrated as a characteristic MR feature for NMO-related optic nerve impairment. PMID:25962183

  11. Biomarkers for identifying first-episode schizophrenia patients using diffusion weighted imaging

    PubMed Central

    Rathi, Yogesh; Malcolm, James; Michailovich, Oleg; Goldstein, Jill; Seidman, Larry; McCarley, Robert W.; Westin, Carl-Fredrik; Shenton, Martha E.

    2011-01-01

    Recent advances in diffusion weighted MR imaging (dMRI) has made it a tool of choice for investigating white matter abnormalities of the brain and central nervous system. In this work, we design a system that detects abnormal features (biomarkers) of first-episode schizophrenia patients and then classifies them using these features. We use two different models of the dMRI data, namely, spherical harmonics and the two-tensor model. The algorithm works by first computing several diffusion measures from each model. An affine-invariant representation of each subject is then computed, thus avoiding the need for registration. This representation is used within a kernel based feature selection algorithm to determine the biomarkers that are statistically different between the two populations. Confirmation of how well these biomarkers identify each population is obtained by using several classifiers such as, k-nearest neighbors, Parzen window classifier, and support vector machines to separate 21 first-episode patients from 20 age-matched normal controls. Classification results using leave-many-out cross-validation scheme are given for each representation. This algorithm is a first step towards early detection of schizophrenia. PMID:20879287

  12. Feasibility study of patient positioning verification in electron beam radiotherapy with an electronic portal imaging device (EPID).

    PubMed

    Ramm, U; Köhn, J; Rodriguez Dominguez, R; Licher, J; Koch, N; Kara, E; Scherf, C; Rödel, C; Weiß, C

    2014-03-01

    The purpose of this study is to demonstrate the feasibility of verification and documentation in electron beam radiotherapy using the photon contamination detected with an electronic portal imaging device. For investigation of electron beam verification with an EPID, the portal images are acquired irradiating two different tissue equivalent phantoms at different electron energies. Measurements were performed on an Elekta SL 25 linear accelerator with an amorphous-Si electronic portal imaging device (EPID: iViewGT, Elekta Oncology Systems, Crawley, UK). As a measure of EPID image quality contrast (CR) and signal-to-noise ratio (SNR) are determined. For characterisation of the imaging of the EPID RW3 slabs and a Gammex 467 phantom with different material inserts are used. With increasing electron energy the intensity of photon contamination increases, yielding an increasing signal-to-noise ratio, but images are showing a decreasing contrast. As the signal-to-noise ratio saturates with increasing dose a minimum of 50 MUs is recommended. Even image quality depends on electron energy and diameter of the patient, the acquired results are mostly sufficient to assess the accuracy of beam positioning. In general, the online EPID acquisition has been demonstrated to be an effective electron beam verification and documentation method. The results are showing that this procedure can be recommended to be routinely and reliably done in patient treatment with electron beams. PMID:23850512

  13. Cardiac Imaging System

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Although not available to all patients with narrowed arteries, balloon angioplasty has expanded dramatically since its introduction with an estimated further growth to 562,000 procedures in the U.S. alone by 1992. Growth has fueled demand for higher quality imaging systems that allow the cardiologist to be more accurate and increase the chances of a successful procedure. A major advance is the Digital Cardiac Imaging (DCI) System designed by Philips Medical Systems International, Best, The Netherlands and marketed in the U.S. by Philips Medical Systems North America Company. The key benefit is significantly improved real-time imaging and the ability to employ image enhancement techniques to bring out added details. Using a cordless control unit, the cardiologist can manipulate images to make immediate assessment, compare live x-ray and roadmap images by placing them side-by-side on monitor screens, or compare pre-procedure and post procedure conditions. The Philips DCI improves the cardiologist's precision by expanding the information available to him.

  14. Magnetic Resonance Imaging (MRI) Evaluation of Developmental Delay in Pediatric Patients

    PubMed Central

    Syed, Naziya P.; Murthy, G.S.N.; Nori, Madhavi; Abkari, Anand; Pooja, B.K.; Venkateswarlu, J.

    2015-01-01

    Introduction: Developmental delay is defined as significant delay in one or more developmental domains. Magnetic Resonance Imaging (MRI) is the best modality to investigate such patients. Evaluation of a child with developmental delay is important not only because it allows early diagnosis and treatment but also helpful for parental counseling regarding the outcome of their child and to identify any possible risk of recurrence in the siblings. Thus this study was undertaken to evaluate the developmental delay in Indian children which will help the clinicians in providing an estimation of the child’s ultimate developmental potential and organize specific treatment requirement and also relieve parental apprehension. Aims and Objectives: To study the prevalence of normal and abnormal MRI in pediatric patients presenting with developmental delay and further categorize the abnormal MRI based on its morphological features. Materials and Methods: It is a prospective, observational & descriptive study of MRI Brain in 81 paediatric patients (46 Males and 35 Females), aged between three months to 12 years; presenting with developmental delay in Deccan College of Medical Sciences, Hyderabad; over a period of three years (Sept 2011 to Sept 2014). MRI brain was done on 1.5T Siemens Magnetom Essenza & 0.35T Magnetom C with appropriate sequences and planes after making the child sleep/sedated/ anesthetized. Various anatomical structures like Ventricles, Corpus callosum, etc were systematically assessed. The MRI findings were divided into various aetiological subgroups. Results: Normal MRI findings were seen in 32% cases and 68% had abnormal findings of which the proportion of Traumatic/ Neurovascular Diseases, Congenital & Developmental, Metabolic and Degenerative, neoplastic and non specific were 31%, 17%, 10%, 2.5% and 7.5% respectively. The ventricles and white matter mainly the corpus callosum were the most commonly affected anatomical structures. The diagnostic yield was found to be 68% and higher yield was seen in patients presenting with developmental delay plus. Conclusion: The clinical diagnosis of developmental delay should not be the end point, but rather a springboard for an effective search for causal factors. MRI is the best investigation with a high yield in such patients. PMID:25738057

  15. Does bicarbonate prevent contrast-induced nephropathy in cardiovascular patients undergoing contrast imaging?

    PubMed Central

    Dabare, Dilan; Banihani, Mohammed; Gibbs, Paul; Grewal, Perbinder

    2013-01-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether administering sodium bicarbonate (NaHCO3) prevents contrast-induced nephropathy (CIN) in cardiovascular patients undergoing contrast imaging. In total, 266 papers were found using the reported search, 16 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. CIN is thought to occur as a result of ischaemic or oxidative injury to the kidney. It is postulated that NaHCO3attenuates this renal damage by alkanizing renal tubular fluid thus reducing the generation of contrast-induced free radicals, which damage the kidney. Of the 16 trials, 15 recruited patients with various degrees of renal dysfunction at baseline. The benefit of using NaHCO3 was demonstrated at all stages of chronic kidney disease. Apart from four studies, 12 studies used low toxicity, low-osmolar contrast. Merten et al. published the first trial of NaHCO3 vs (saline) NaCl in preventing CIN, demonstrated a significantly lower rate in the NaHCO3 group and advocated its widespread use. Subsequent trials using the same regimen have collaborated these results. However, more recently, Gomes et al. concluded that NaHCO3 is not superior to saline-based hydration. Similarly, Brar et al. randomized 323 patients with moderate-to-severe renal insufficiency to receive either an NaHCO3 or an NaCl infusion and observed no difference in CIN rates. Two studies investigated the effects of rapid urine alkanization with bolus injections of NaHCO3 prior to contrast and found significant reductions in CIN rates compared with NaCl-treated groups. One study observed that NaCl is superior to NaHCO3, while all other studies showed a beneficial effect or no difference between NaCl- and NaHCO3-based hydration. The most recent meta-analysis by Jang et al. incorporated 3609 patients across 19 trials and concluded that NaHCO3-based hydration regimens are superior to NaCl-based ones. Based on this review, the authors recommend NaHCO3 alongside an NaCl hydration regimen. The exact regimen will depend on the context within which contrast is being administered and needs further evaluation. PMID:23996732

  16. Clinical and Muscle Imaging Findings in 14 Mainland Chinese Patients with Oculopharyngodistal Myopathy

    PubMed Central

    Zhao, Juan; Liu, Jing; Xiao, Jiangxi; Du, Jing; Que, Chengli; Shi, Xin; Liang, Wei; Sun, Weiping; Zhang, Wei; Lv, He; Yuan, Yun; Wang, Zhaoxia

    2015-01-01

    Oculopharyngodistal myopathy (OPDM) is an extremely rare, adult-onset hereditary muscular disease characterized by progressive external ocular, pharyngeal, and distal muscle weakness and myopathological rimmed vacuole changes. The causative gene is currently unknown; therefore, diagnosis of OPDM is based on clinical and histopathological features and genetic exclusion of similar conditions. Moreover, variable manifestations of this disorder are reported in terms of muscle involvement and severity. We present the clinical profile and magnetic resonance imaging (MRI) changes of lower limb muscles in 14 mainland Chinese patients with OPDM, emphasizing the role of muscle MRI in disease identification and differential diagnosis. The patients came from 10 unrelated families and presented with progressive external ocular, laryngopharyngeal, facial, distal limb muscle weakness that had been present since early adulthood. Serum creatine kinase was mildly to moderately elevated. Electromyography revealed myogenic changes with inconsistent myotonic discharge. The respiratory function test revealed subclinical respiratory muscle involvement. Myopathological findings showed rimmed vacuoles with varying degrees of muscular dystrophic changes. All known genes responsible for distal and myofibrillar myopathies, vacuolar myopathies, and muscular dystrophies were excluded by PCR or targeted next-generation sequencing. Muscle MRI revealed that the distal lower legs had more severe fatty replacement than the thigh muscles. Serious involvement of the soleus and long head of the biceps femoris was observed in all patients, whereas the popliteus, gracilis and short head of biceps femoris were almost completely spared, even in advanced stages. Not only does our study widen the spectrum of OPDM in China, but it also demonstrates that OPDM has a specific pattern of muscle involvement that may provide valuable information for its differential diagnosis and show further evidence supporting the conclusion that OPDM is a unique disease phenotype. PMID:26039504

  17. A modified VMAT adaptive radiotherapy for nasopharyngeal cancer patients based on CT-CT image fusion

    PubMed Central

    2013-01-01

    Background To investigate the feasibility and benefits of a modified adaptive radiotherapy (ART) by replanning in the initial CT (iCT) with new contours from a repeat CT (rCT) based on CT-CT image fusion for nasopharyngeal cancer (NPC) patients underwent volumetric modulated arc radiotherapy (VMAT). Materials and methods Nine NPC patients underwent VMAT treatment with a rCT at 23rd fraction were enrolled in this study. Dosimetric differences for replanning VMAT plans in the iCT and in the rCT were compared. Volumetric and dosimetric changes of gross tumor volume (GTV) and organs at risk (OARs) of this modified ART were also investigated. Results No dosimetric differences between replanning in the iCT and in the rCT were observed. The average volume of GTV decreased from 78.83?±?38.42 cm3 in the iCT to 71.44?±?37.46 cm3 in the rCT, but with no significant difference (p?=?0.42).The average volume of the left and right parotid decreased from 19.91?±?4.89 cm3 and 21.58?±?6.16 cm3 in the iCT to 11.80?±?2.79 cm3 and 13.29?±?4.17 cm3 in the rCT (both p?Patients with NPC undergoing VMAT have significant anatomic and dosimetric changes to parotids. Repeat CT as an anatomic changes reference and re-optimization in the iCT based on CT-CT image fusion was accurate enough to identify the volume changes and to ensure safe dose to parotids. PMID:24279414

  18. Characterization of mammographic masses based on level set segmentation with new image features and patient information

    SciTech Connect

    Shi Jiazheng; Sahiner, Berkman; Chan Heangping; Ge Jun; Hadjiiski, Lubomir; Helvie, Mark A.; Nees, Alexis; Wu Yita; Wei Jun; Zhou Chuan; Zhang Yiheng; Cui Jing [Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-0904 (United States)

    2008-01-15

    Computer-aided diagnosis (CAD) for characterization of mammographic masses as malignant or benign has the potential to assist radiologists in reducing the biopsy rate without increasing false negatives. The purpose of this study was to develop an automated method for mammographic mass segmentation and explore new image based features in combination with patient information in order to improve the performance of mass characterization. The authors' previous CAD system, which used the active contour segmentation, and morphological, textural, and spiculation features, has achieved promising results in mass characterization. The new CAD system is based on the level set method and includes two new types of image features related to the presence of microcalcifications with the mass and abruptness of the mass margin, and patient age. A linear discriminant analysis (LDA) classifier with stepwise feature selection was used to merge the extracted features into a classification score. The classification accuracy was evaluated using the area under the receiver operating characteristic curve. The authors' primary data set consisted of 427 biopsy-proven masses (200 malignant and 227 benign) in 909 regions of interest (ROIs) (451 malignant and 458 benign) from multiple mammographic views. Leave-one-case-out resampling was used for training and testing. The new CAD system based on the level set segmentation and the new mammographic feature space achieved a view-based A{sub z} value of 0.83{+-}0.01. The improvement compared to the previous CAD system was statistically significant (p=0.02). When patient age was included in the new CAD system, view-based and case-based A{sub z} values were 0.85{+-}0.01 and 0.87{+-}0.02, respectively. The study also demonstrated the consistency of the newly developed CAD system by evaluating the statistics of the weights of the LDA classifiers in leave-one-case-out classification. Finally, an independent test on the publicly available digital database for screening mammography with 132 benign and 197 malignant ROIs containing masses achieved a view-based A{sub z} value of 0.84{+-}0.02.

  19. Extracapsular extension in prostate cancer: added value of diffusion-weighted MRI in patients with equivocal findings on T2-weighted imaging.

    PubMed

    Woo, Sungmin; Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup

    2015-02-01

    OBJECTIVE. The objective of our study was to evaluate diffusion-weighted imaging (DWI) and T2-weighted imaging for predicting extracapsular extension (ECE) in patients with prostate cancer. MATERIALS AND METHODS. One hundred seventeen patients underwent preoperative 3-T MRI and radical prostatectomy. Two radiologists evaluated ECE with T2-weighted imaging based on the Prostate Imaging Reporting and Data System (PI-RADS). Then, the apparent diffusion coefficient (ADC) of the tumor calculated from two b values (0, 1000 s/mm(2)) was measured. Interreader agreement of T2-weighted imaging scores was assessed with weighted kappa statistics. We compared T2-weighted imaging scores and ADC values between patients with ECE and those without ECE using the unpaired Student t test and evaluated their association with ECE using logistic regression analyses and ROC curves incorporating prostate-specific antigen value, Gleason score, clinical stage, and greatest percentage involved core length. The ADC values were also tested for differences between patients with ECE and those without ECE in subgroups stratified by the T2-weighted imaging criteria shown to have a high specificity for ECE. RESULTS. Fifty (42.7%) patients had ECE. There was substantial agreement for T2-weighted imaging scores (? = 0.613). T2-weighted imaging scores and ADCs were significantly different in patients with ECE and those without ECE (p < 0.001). Multivariate analysis showed that the greatest percentage involved core length, T2-weighted imaging score, and ADC (p < 0.05) were independently predictive of ECE. The AUCs for these variables (range, 0.733-0.770) were not significantly different except for the AUC for clinical stage (0.552). The use of a high specificity (92.5%) setting for ECE divided the patients into the following groups: patients with a T2-weighted imaging score of ? 4 (n = 20) and patients with a T2-weighted imaging score of < 4 (n = 97). In patients with a T2-weighted imaging score of ? 4, the ADC was not significantly different between patients with ECE and those without ECE (p = 0.555). However, among patients with a T2-weighted imaging score of ? 3, the ADC value was significantly lower in patients with ECE (mean ± SD, 0.794 ± 0.116) than in those without ECE (1.027 ± 0.339) (p < 0.001). CONCLUSION. T2-weighted imaging scores and ADCs were independently associated with ECE, and the ADC had incremental value in patients without a high suspicion of ECE on T2-weighted imaging. PMID:25615777

  20. IMAGES, IMAGES, IMAGES

    SciTech Connect

    Marcus, A.

    1980-07-01

    The role of images of information (charts, diagrams, maps, and symbols) for effective presentation of facts and concepts is expanding dramatically because of advances in computer graphics technology, increasingly hetero-lingual, hetero-cultural world target populations of information providers, the urgent need to convey more efficiently vast amounts of information, the broadening population of (non-expert) computer users, the decrease of available time for reading texts and for decision making, and the general level of literacy. A coalition of visual performance experts, human engineering specialists, computer scientists, and graphic designers/artists is required to resolve human factors aspects of images of information. The need for, nature of, and benefits of interdisciplinary effort are discussed. The results of an interdisciplinary collaboration are demonstrated in a product for visualizing complex information about global energy interdependence. An invited panel will respond to the presentation.

  1. Pseudo Wellens T-waves in patients with suspected myocardial infarction: How cardiac magnetic resonance imaging can help the diagnosis

    Microsoft Academic Search

    Chiara Bucciarelli-Ducci; Pablo Denes; Thomas A. Holly; Edwin Wu

    2008-01-01

    Wellens' syndrome is characterized by symmetrically inverted T-waves in the precordial leads suggestive of impending myocardial infarction due to a critical proximal left anterior descending (LAD) stenosis. We describe three unusual cases of patients with such electrocardiographic abnormality in which coronary angiography ruled out the presence of critical coronary stenosis and cardiac magnetic resonance imaging excluded the presence of acute

  2. Increased right ventricular uptake on stress SPECT myocardial perfusion images in a patient with severe coronary artery disease

    Microsoft Academic Search

    John P. Higgins

    2006-01-01

    Severe abnormal myocardial perfusion defects on single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) are often related to obstructive coronary artery disease. However, falsenegative results may be encountered in patients with severe and extensive coronary artery disease if all of the myocardial territories are uniformly affected—so-called balanced ischemia. In these cases other clues to high risk on MPI

  3. Radionuclide angiography and blood pool imaging to assess skin ulcer healing prognosis in patients with peripheral vascular disease

    SciTech Connect

    Alazraki, N.; Lawrence, P.F.; Syverud, J.B.

    1984-01-01

    Several non-invasive diagnostic techniques including segmental limb blood pressures, skin fluoresence, and photo plethysmography, have been evaluated as predictors of skin ulcer healing in patients with peripheral vascular disease, but none are widely used. Using 20mCi of Tc-99m phosphate compounds, four phase bone scans were obtained, including (1) radionuclide angiogram (2) blood pool image (3) 2 hour and 4-6 hour static images and (4) 24 hour static delayed images. The first two phases were used to assess vacularity to the region of distal extremity ulceration; the last two phases evaluated presence or absence of osteomyelitis. Studies were performed in 30 patients with non-healing ulcers of the lower extremities. Perfusion to the regions of ulceration on images was graded as normal, increased, or reduced with respect to the opposite (presumed normal) limb or some other normal reference area. Hypervascular response was interpreted as good prognosis for healing unless osteomyelitis was present. Clinicians followed patients for 14 days to assess limb healing with optimum care. If there was no improvement, angiography and/or surgery (reconstructive surgery, sympathectomy, or amputation) was done. Results showed: sensitivity for predicting ulcer healing was 94%, specificity 89%. Patients who failed to heal their ulcers showed reduced perfusion, no hypervascular response, or osteomyelitis. Microcirculatory adequacy for ulcer healing appear predictable by this technique.

  4. Determination of physiological cross-section area of patient-specific masticatory muscles with three-dimensional medical imaging analysis

    Microsoft Academic Search

    Linping Zhao; P. K. Patel; G. E. O. Widera; G. F. Harris

    2002-01-01

    The physiological cross-section area (PCSA) of the masticatory muscles of an adolescent patient were determined based upon the clinical relevant computer tomography (CT) data. A procedure was developed by means of three-dimensional medical image analysis. The resultant PCSA values are in consistent with available knowledge in the literature.

  5. Vertical left ventricular angulation assessed by thallium 201 myocardial perfusion imaging in patients with mitral valve prolapse

    SciTech Connect

    Arora, R.R.; Horowitz, S.F.; Machac, J.; Goldman, M.E.

    1986-01-01

    Mitral valve prolapse has been associated with septal to aortic root angle abnormalities determined by echocardiography. Thallium 201 imaging in the anterior view permits visualization of the left ventricular long axis. In the present study, the vertical angle was defined as the angle formed by the long axis of the left ventricle and a horizontal line. The vertical angle was determined in 25 patients who had 201 TL stress testing and M-mode echocardiography. Group I (11 patients) had mitral valve prolapse and group II (14 patients) did not have mitral valve prolapse. The vertical angle and ultrasound were read blinded to each other. Height, weight, and body surface area were compared for the two groups, and receiver operator curve analysis performed. Vertical angle measured by TL 201 was significantly more vertical in patients with mitral valve prolapse. Receiver operator curve analysis showed that an angle of greater than 30 degrees successfully identified 9/11 patients with mitral valve prolapse, with a sensitivity of 82% and a specificity of 79%. There were no significant differences in height, weight, or body surface area between the two groups. Thus, patients with mitral valve prolapse have more vertically positioned hearts than patients without mitral valve prolapse, independent of body habitus. The different appearance of a vertically oriented heart may contribute to false-positive readings of TL 201 images.

  6. Colour Doppler Imaging of Ophthalmic Artery and Central Retinal Artery in Glaucoma Patients with and without Diabetes Mellitus

    PubMed Central

    Kumar, M. Ashok; Selvasundari, S.; Prakash, M. L.

    2014-01-01

    Purpose: To assess the ocular blood flow in Diabetic and non-Diabetic Primary Open Angle Glaucoma (POAG) patients. Design: Prospective comparitive study. Material and Methods: A total 100 eyes of 50 POAG patients was included in the study and divided into two groups, Group 1 (25 POAG patients without Diabetes mellitus) and Group 2 (25 POAG patients with Diabetes mellitus). Colour Doppler Imaging (CDI) of Ophthalmic artery and Central retinal artery were studied and peak systolic velocity (V max), End diastolic velocity (V min) and Resistivity Index (RI) were assessed. Results: Ocular blood flow in Group 2 showed a reduction in V max, V min and increased RI compared to Group I with a statistically significant reduction in the central retinal artery flow (V max (p=0.01), V min (p=0.07) and RI (p=0.03). Conclusion: CDI showed a significant reduction in the ocular blood flow of POAG patients with Diabetes mellitus. PMID:24959497

  7. Acute Radiation Effects on Cardiac Function Detected by Strain Rate Imaging in Breast Cancer Patients

    SciTech Connect

    Erven, Katrien, E-mail: Katrien.erven@uzleuven.b [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium); Jurcut, Ruxandra [Department of Cardiology, Institute of Emergency for Cardiovascular Diseases, UMF Carol Davila, Bucharest (Romania); Weltens, Caroline [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium); Giusca, Sorin [Department of Cardiology, Institute of Emergency for Cardiovascular Diseases, UMF Carol Davila, Bucharest (Romania); Ector, Joris [Department of Cardiology, University Hospital Gasthuisberg, Leuven (Belgium); Wildiers, Hans [Department of Medical Oncology, University Hospital Gasthuisberg, Leuven (Belgium); Van den Bogaert, Walter [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium); Voigt, Jens-Uwe [Department of Cardiology, University Hospital Gasthuisberg, Leuven (Belgium)

    2011-04-01

    Purpose: To investigate the occurrence of early radiation-induced changes in regional cardiac function using strain rate imaging (SRI) by tissue Doppler echocardiography. Methods and Materials: We included 20 left-sided and 10 right-sided breast cancer patients receiving radiotherapy (RT) to the breast or chest wall. Standard echocardiography and SRI were performed before RT (baseline), immediately after RT (post-RT), and at 2 months follow-up (FUP) after RT. Regional strain (S) and strain rate (SR) values were obtained from all 18 left ventricular (LV) segments. Data were compared to the regional radiation dose. Results: A reduction in S was observed post-RT and at FUP in left-sided patients (S{sub post-RT}: -17.6 {+-} 1.5%, and S{sub FUP}: -17.4 {+-} 2.3%, vs. S{sub baseline}: -19.5 {+-} 2.1%, p < 0.001) but not in right-sided patients. Within the left-sided patient group, S and SR were significantly reduced after RT in apical LV segments (S{sub post-RT}: -15.3 {+-} 2.5%, and S{sub FUP}: -14.3 {+-} 3.7%, vs. S{sub baseline}: -19.3 {+-} 3.0%, p < 0.01; and SR{sub post-RT}: -1.06 {+-} 0.15 s {sup -1}, and SR{sub FUP}: -1.16 {+-} 0.28 s {sup -1}, vs. SR{sub baseline}: -1.29 {+-} 0.27s {sup -1}, p = 0.01), but not in mid- or basal segments. Furthermore, we observed that segments exposed to more than 3 Gy showed a significant decrease in S after RT (S{sub post-RT}: -16.1 {+-} 1.6%, and S{sub FUP}: -15.8 {+-} 3.4%, vs. S{sub baseline}: -18.9 {+-} 2.6%, p < 0.001). This could not be observed in segments receiving less than 3 Gy. Conclusions: SRI shows a dose-related regional decrease in myocardial function after RT. It might be a useful tool in the evaluation of modern RT techniques, with respect to cardiac toxicity.

  8. Metastases to the Pancreas: Computed Tomography Imaging Spectrum and Clinical Features: A Retrospective Study of 18 Patients With 36 Metastases.

    PubMed

    Shi, Hong-Yuan; Zhao, Xue-Song; Miao, Fei

    2015-06-01

    The aim of this study is to identify the key computed tomography (CT) imaging findings and clinical characteristics of pancreatic metastases for its differential diagnosis. CT images and clinical features of 18 patients with 36 histopathologically proven pancreatic metastases were retrospectively reviewed. The primary malignancy included non-small cell lung cancer (NSCLC) (n?=?7), gastrointestinal carcinoma (n?=?5), renal cell carcinoma (RCC) (n?=?3), osteosarcoma (n?=?1), cardiac sarcomas (n?=?1), and neuroendocrine ethmoid sinus carcinoma (n?=?1). Pancreatic metastases were metachronous in 12 patients (ranging from 4 to 72 months). Tumor markers were elevated for 8 patients, of which 7 patients had NSCLC and gastrointestinal carcinoma, and 1 patient had osteosarcoma. Metastases from NSCLC and gastrointestinal carcinoma frequently presented as small well-circumscribed lesions, with homogeneous or rim enhancement, and or local pancreatic infiltration instead of focal mass, mimicking local pancreatitis. Neuroendocrine ethmoid sinus carcinoma affecting the pancreas also exhibited local pancreatic infiltration. Metastases from RCC and cardiac sarcomas had typical characteristics of hypervascular lesions. Osteosarcoma metastasizing to pancreas had special manifestation, that is, cystic lesion with thick wall and calcification.Although pancreatic metastases have a broad spectrum of CT appearances, lesions from some types of primary tumors exhibited characteristic imaging features, which, in combination with oncological history, will contribute to correct diagnosis. PMID:26061312

  9. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    SciTech Connect

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  10. Body image in idiopathic scoliosis: a comparison study of psychometric properties between four patient-reported outcome instruments

    PubMed Central

    2014-01-01

    Background Four patient-reported outcome (PRO) instruments are commonly used to assess body image in idiopathic scoliosis (IS): the Quality of Life Profile for Spinal Deformities (QLPSD), SRS-22 Self-Image scale, Spinal Appearance Questionnaire (SAQ), and Trunk Appearance Perception Scale (TAPS). The aim of this study is to compare the psychometric properties of these instruments in patients with IS and report the translational/cultural adaptation of the SAQ to Spanish. Methods The four instruments in a Spanish version were administered to 80 patients with IS aged 10 to 40 years old. The sample was stratified according to scoliosis magnitude (less and more than 45º). Analysis was also conducted for age groups. The psychometric properties studied included convergent and divergent construct validity, as well as internal consistency. Convergent validity was evaluated by correlation analysis between the self-image instruments and Cobb angle. Divergent validity was assessed with correlation analysis between PRO scores and SRS-22 dimensions scores such as Function, Pain and Mental Health. Results In the overall sample, each of the PRO instruments demonstrated high internal consistency (QLPSD Body Image, ??=?0.80; SRS-22 Self Image, ??=?0.78; SAQ, ??=?0.89; TAPS, ??=?0.87), also both for younger and adult patients subgroups. Correlation with curve magnitude was significant for each of the four scales. However, the correlation was higher for the pictorial scales (SAQ Appearance r?=?0.61, TAPS r?=?- 0.62) than for the textual scales (QLPSD-bi r?=?0.36, SRS-22 Self-Image scale r?=?- 0.41). In the younger group, correlation between Cobb angle and textual scales (QLPSD-bi and SRS-22 Self-Image Scale) was not significant. Body Image scales showed significant correlations with SRS-22 Pain, Function and Mental Health dimensions. Conclusions All four instruments tested have good psychometric properties. Pictorial scales (SAQ Appearance and TAPS) correlated better with the radiological magnitude of the curve and this correlation is independent of age. Unexpectedly, all four scales demonstrated significant correlations with non-body image dimensions and the divergent hypothesis was not confirmed. Globally, pictorial scales showed slightly better construct validity to test body image perception than textual scales. PMID:24894714

  11. Images

    Cancer.gov

    Home News and Events Multimedia Library Images Images:  Cancer Biology Image: Cell with DNA 72 DPI | 300 DPIDrawing depicting DNA molecule unwinding from a chromosome inside the nucleus of a cell. NHGRI >> View All Cancer Pathology/Imaging Image: Female

  12. Flavors in an expanding plasma

    E-print Network

    Johannes Große; Romuald A. Janik; Piotr Surówka

    2008-02-05

    We consider the effect of an expanding plasma on probe matter by determining time-dependent D7 embeddings in the holographic dual of an expanding viscous plasma. We calculate the chiral condensate and meson spectra including contributions of viscosity. The chiral condensate essentially confirms the expectation from the static black hole. For the meson spectra we propose a scheme that is in agreement with the adiabatic approximation. New contributions arise for the vector mesons at the order of the viscosity terms.

  13. Image Guided Hypofractionated 3-Dimensional Radiation Therapy in Patients With Inoperable Advanced Stage Non-Small Cell Lung Cancer

    SciTech Connect

    Osti, Mattia Falchetto [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy)] [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy); Agolli, Linda, E-mail: lindaagolli@yahoo.it [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy)] [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy); Valeriani, Maurizio; Falco, Teresa; Bracci, Stefano; De Sanctis, Vitaliana; Enrici, Riccardo Maurizi [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy)] [Institute of Radiation Oncology, La Sapienza University, Sant'Andrea Hospital, Rome (Italy)

    2013-03-01

    Purpose: Hypofractionated radiation therapy (HypoRT) can potentially improve local control with a higher biological effect and shorter overall treatment time. Response, local control, toxicity rates, and survival rates were evaluated in patients affected by inoperable advanced stage non-small cell lung cancer (NSCLC) who received HypoRT. Methods and Materials: Thirty patients with advanced NSCLC were enrolled; 27% had stage IIIA, 50% had stage IIIB, and 23% had stage IV disease. All patients underwent HypoRT with a prescribed total dose of 60 Gy in 20 fractions of 3 Gy each. Radiation treatment was delivered using an image guided radiation therapy technique to verify correct position. Toxicities were graded according to Radiation Therapy Oncology Group morbidity score. Survival rates were estimated using the Kaplan-Meier method. Results: The median follow-up was 13 months (range, 4-56 months). All patients completed radiation therapy and received the total dose of 60 Gy to the primary tumor and positive lymph nodes. The overall response rate after radiation therapy was 83% (3 patients with complete response and 22 patients with partial response). The 2-year overall survival and progression-free survival rates were 38.1% and 36%, respectively. Locoregional recurrence/persistence occurred in 11 (37%) patients. Distant metastasis occurred in 17 (57%) patients. Acute toxicities occurred consisting of grade 1 to 2 hematological toxicity in 5 patients (17%) and grade 3 in 1 patient; grade 1 to 2 esophagitis in 12 patients (40%) and grade 3 in 1 patient; and grade 1 to 2 pneumonitis in 6 patients (20%) and grade 3 in 2 patients (7%). Thirty-three percent of patients developed grade 1 to 2 late toxicities. Only 3 patients developed grade 3 late adverse effects: esophagitis in 1 patient and pneumonitis in 2 patients. Conclusions: Hypofractionated curative radiation therapy is a feasible and well-tolerated treatment for patients with locally advanced NSCLC. Randomized studies are needed to compare HypoRT to conventional treatment.

  14. When does Subliminal Affective Image Priming Influence the Ability of Schizophrenic Patients to Perceive Face Emotions?

    PubMed Central

    Vaina, Lucia M.; Rana, Kunjan D.; Cotos, Ionela; Li-Yang, Chen; Huang, Melissa A.; Podea, Delia

    2014-01-01

    Background Deficits in face emotion perception are among the most pervasive aspects of schizophrenia impairments which strongly affects interpersonal communication and social skills. Material/Methods Schizophrenic patients (PSZ) and healthy control subjects (HCS) performed 2 psychophysical tasks. One, the SAFFIMAP test, was designed to determine the impact of subliminally presented affective or neutral images on the accuracy of face-expression (angry or neutral) perception. In the second test, FEP, subjects saw pictures of face-expression and were asked to rate them as angry, happy, or neutral. The following clinical scales were used to determine the acute symptoms in PSZ: Positive and Negative Syndrome (PANSS), Young Mania Rating (YMRS), Hamilton Depression (HAM-D), and Hamilton Anxiety (HAM-A). Results On the SAFFIMAP test, different from the HCS group, the PSZ group tended to categorize the neutral expression of test faces as angry and their response to the test-face expression was not influenced by the affective content of the primes. In PSZ, the PANSS-positive score was significantly correlated with correct perception of angry faces for aggressive or pleasant primes. YMRS scores were strongly correlated with PSZ’s tendency to recognize angry face expressions when the prime was a pleasant or a neutral image. The HAM-D score was positively correlated with categorizing the test-faces as neutral, regardless of the affective content of the prime or of the test-face expression (angry or neutral). Conclusions Despite its exploratory nature, this study provides the first evidence that conscious perception and categorization of facial emotions (neutral or angry) in PSZ is directly affected by their positive or negative symptoms of the disease as defined by their individual scores on the clinical diagnostic scales. PMID:25537115

  15. Intravenous administration of auto serum-expanded autologous mesenchymal stem cells in stroke

    PubMed Central

    Houkin, Kiyohiro; Matsunaga, Takuya; Niitsu, Yoshiro; Ishiai, Sumio; Onodera, Rie; Waxman, Stephen G.; Kocsis, Jeffery D.

    2011-01-01

    Transplantation of human mesenchymal stem cells has been shown to reduce infarct size and improve functional outcome in animal models of stroke. Here, we report a study designed to assess feasibility and safety of transplantation of autologous human mesenchymal stem cells expanded in autologous human serum in stroke patients. We report an unblinded study on 12 patients with ischaemic grey matter, white matter and mixed lesions, in contrast to a prior study on autologous mesenchymal stem cells expanded in foetal calf serum that focused on grey matter lesions. Cells cultured in human serum expanded more rapidly than in foetal calf serum, reducing cell preparation time and risk of transmissible disorders such as bovine spongiform encephalomyelitis. Autologous mesenchymal stem cells were delivered intravenously 36–133 days post-stroke. All patients had magnetic resonance angiography to identify vascular lesions, and magnetic resonance imaging prior to cell infusion and at intervals up to 1 year after. Magnetic resonance perfusion-imaging and 3D-tractography were carried out in some patients. Neurological status was scored using the National Institutes of Health Stroke Scale and modified Rankin scores. We did not observe any central nervous system tumours, abnormal cell growths or neurological deterioration, and there was no evidence for venous thromboembolism, systemic malignancy or systemic infection in any of the patients following stem cell infusion. The median daily rate of National Institutes of Health Stroke Scale change was 0.36 during the first week post-infusion, compared with a median daily rate of change of 0.04 from the first day of testing to immediately before infusion. Daily rates of change in National Institutes of Health Stroke Scale scores during longer post-infusion intervals that more closely matched the interval between initial scoring and cell infusion also showed an increase following cell infusion. Mean lesion volume as assessed by magnetic resonance imaging was reduced by >20% at 1 week post-cell infusion. While we would emphasize that the current study was unblinded, did not assess overall function or relative functional importance of different types of deficits, and does not exclude placebo effects or a contribution of recovery as a result of the natural history of stroke, our observations provide evidence supporting the feasibility and safety of delivery of a relatively large dose of autologous mesenchymal human stem cells, cultured in autologous human serum, into human subjects with stroke and support the need for additional blinded, placebo-controlled studies on autologous mesenchymal human stem cell infusion in stroke. PMID:21493695

  16. Pilot study of PET imaging of 124I-iodoazomycin galactopyranoside (IAZGP), a putative hypoxia imaging agent, in patients with colorectal cancer and head and neck cancer

    PubMed Central

    2013-01-01

    Background Hypoxia within solid tumors confers radiation resistance and a poorer prognosis. 124I-iodoazomycin galactopyranoside (124I-IAZGP) has shown promise as a hypoxia radiotracer in animal models. We performed a clinical study to evaluate the safety, biodistribution, and imaging characteristics of 124I-IAZGP in patients with advanced colorectal cancer and head and neck cancer using serial positron emission tomography (PET) imaging. Methods Ten patients underwent serial whole-torso (head/neck to pelvis) PET imaging together with multiple whole-body counts and blood sampling. These data were used to generate absorbed dose estimates to normal tissues for 124I-IAZGP. Tumors were scored as either positive or negative for 124I-IAZGP uptake. Results There were no clinical toxicities or adverse effects associated with 124I-IAZGP administration. Clearance from the whole body and blood was rapid, primarily via the urinary tract, with no focal uptake in any parenchymal organ. The tissues receiving the highest absorbed doses were the mucosal walls of the urinary bladder and the intestinal tract, in particular the lower large intestine. All 124I-IAZGP PET scans were interpreted as negative for tumor uptake. Conclusions It is safe to administer 124I-IAZGP to human subjects. However, there was insufficient tumor uptake to support a clinical role for 124I-IAZGP PET in colorectal cancer and head and neck cancer patients. Trial registration ClinicalTrials.gov NCT00588276 PMID:23731770

  17. Definitions and outlook targeting x-ray exposure of patients in diagnostic imaging

    NASA Astrophysics Data System (ADS)

    Regulla, Dieter F.

    2011-03-01

    Computer tomography (CT) is vital and currently irreplaceable in diagnostic radiology. But CT operates with ionizing radiation which may cause cancer or non-cancer diseases in humans. The degree of radiation impact depends on the dose administered by an investigation. And this is the core issue: Even CT exams executed lege artis, administer doses to patients which by magnitude are far beyond the level of hitherto known doses of conventional film-screen techniques. Patients undergoing one or multiple CT examinations, digital angiographies or interventions will be exposed to effective doses between roughly several mSv and several 100 mSv depending on type and frequency of the diagnostic investigations. From the radiation protection point of view, there is therefore the worldwide problem of formulating firm rules for the control of these high-dose investigations, as dose limits can not be established for reasons of the medical benefit. This makes the difference compared with radiation protection for occupationally exposed persons. What remains is "software", namely "justification" and "optimization". Justification requires balancing the interests between the health benefit and the potential harm of an exam which has to be responsibly executed by the physician himself; therefore the radiologists' associations are in the duty to prepare practicable rules for justification. Optimization again needs a cooperative solution, and that is the establishment of reference doses for diagnostic examinations, to be checked by the technical service of the producers' companies. Experts and authorities have been aware of the high-dose dilemma in diagnostic imaging since long. It is time for the reflection of active solutions and their implementation into practice.

  18. Follow up by colour Doppler imaging of 102 patients with retinal vein occlusion over 1 year

    PubMed Central

    Arséne, S; Giraudeau, B; Le Lez, M-L; Pisella, P J; Pourcelot, L; Tranquart, F

    2002-01-01

    Background/aim: Retinal vein occlusion (RVO) is one of the most frequent ocular vascular diseases and leads to severe vision impairment. Colour Doppler imaging (CDI) is the first method which allows distinct evaluation of arterial and venous velocities in RVO. CDI is valuable for diagnosis of RVO and shows the effects of isovolaemic haemodilution. Patients with RVO were monitored by CDI for 1 year in order to clarify venous and arterial involvement in the pathogenesis of this disease. Methods: Patients with RVO were monitored prospectively for 1 year with clinical examinations, fluorescein angiography, and CDI every 3 months. 102 adults referred for RVO for less than 2 months were enrolled. Unaffected eyes were used as control. The maximum systolic and diastolic flow velocities and the resistance index (RI) were measured in the central retinal artery (CRA) and the maximum and minimum blood flow velocities in the central retinal vein (CRV). Results: During the year of observation, branch retinal vein occlusion (BRVO), ischaemic central retinal vein occlusion (CRVO), and non-ischaemic CRVO had a distinct pattern of venous velocity changes. BRVO had a similar profile to that observed in controls. Venous velocities were continuously lower in central forms, with the lowest values in ischaemic occlusion. In contrast, a brief decrease in arterial diastolic velocity was observed in ischaemic CRVO at presentation, correlated with arteriovenous passage time on fluorescein angiography, but with rapid normalisation. Conclusions: CDI findings were correlated with the type of RVO at all times during follow up. CDI showed persistent impairment of central venous velocity in CRVO whereas there was a fast initial values recovery of the arterial velocity. These results using CDI show strong evidence of a primary venous mechanism in RVO. PMID:12386080

  19. Clinical relevance and practical implications of trials of perfusion and angiographic imaging in patients with acute ischaemic stroke: a multicentre cohort imaging study

    PubMed Central

    Wardlaw, Joanna M; Muir, Keith W; Macleod, Mary-Joan; Weir, Christopher; McVerry, Ferghal; Carpenter, Trevor; Shuler, Kirsten; Thomas, Ralph; Acheampong, Paul; Dani, Krishna; Murray, Alison

    2013-01-01

    Background In randomised trials testing treatments for acute ischaemic stroke, imaging markers of tissue reperfusion and arterial recanalisation may provide early response indicators. Objective To determine the predictive value of structural, perfusion and angiographic imaging for early and late clinical outcomes and assess practicalities in three comprehensive stroke centres. Methods We recruited patients with potentially disabling stroke in three stroke centres, performed magnetic resonance (MR) or CT, including perfusion and angiography imaging, within 6?h, at 72?h and 1?month after stroke. We assessed the National Institutes of Health Stroke Scale (NIHSS) score serially and functional outcome at 3?months, tested associations between clinical variables and structural imaging, several perfusion parameters and angiography. Results Among 83 patients, median age 71 (maximum 89), median NIHSS 7 (range 1–30), 38 (46%) received alteplase, 41 (49%) had died or were dependent at 3?months. Most baseline imaging was CT (76%); follow-up was MR (79%) despite both being available acutely. At presentation, perfusion lesion size varied considerably between parameters (p<0.0001); 40 (48%) had arterial occlusion. Arterial occlusion and baseline perfusion lesion extent were both associated with baseline NIHSS (p<0.0001). Recanalisation by 72?h was associated with 1?month NIHSS (p=0.0007) and 3?month functional outcome (p=0.048), whereas tissue reperfusion, using even the best perfusion parameter, was not (p=0.11, p=0.08, respectively). Conclusion Early recanalisation on angiography appeared to predict clinical outcome more directly than did tissue reperfusion. Acute assessment with CT and follow-up with MR was practical and feasible, did not preclude image analysis, and would enhance trial recruitment and generalisability of results. PMID:23644501

  20. Neuromelanin Magnetic Resonance Imaging Reveals Increased Dopaminergic Neuron Activity in the Substantia Nigra of Patients with Schizophrenia

    PubMed Central

    Watanabe, Yoshiyuki; Tanaka, Hisashi; Tsukabe, Akio; Kunitomi, Yuki; Nishizawa, Mitsuo; Hashimoto, Ryota; Yamamori, Hidenaga; Fujimoto, Michiko; Fukunaga, Masaki; Tomiyama, Noriyuki

    2014-01-01

    Purpose The dopamine hypothesis suggests that excessive dopamine release results in the symptoms of schizophrenia. The purpose of this study was to elucidate the dopaminergic and noradrenergic neurons using 3-T neuromelanin magnetic resonance imaging (MRI) in patients with schizophrenia and healthy control subjects. Methods We prospectively examined 52 patients with schizophrenia (M: F?=?27?25, mean age, 35 years) and age- and sex-matched healthy controls. Using a 3T MRI unit, we obtained oblique T1-weighted axial images perpendicular to the brainstem. We measured the signal intensity and area for the substantia nigra (SNc), midbrain tegmentum, locus ceruleus (LC), and pons. We then calculated the contrast ratios (CR) for the SNc (CRSN) and LC (CRLC), which were compared between patients and healthy controls using unpaired t-tests. Results The SNc and LC were readily identified in both patients and healthy controls as areas with high signal intensities in the posterior part of the cerebral peduncle and in the upper pontine tegmentum. The CRSN values in patients were significantly higher than those in healthy controls (10.89±2.37 vs. 9.6±2.36, p<0.01). We observed no difference in the CRLC values between the patients and healthy controls (14.21±3.5 vs. 13.44±3.37, p?=?0.25). Furthermore, there was no difference in area of the SNc and LC between schizophrenia patients and controls. Conclusions Neuromelanin MRI might reveal increased signal intensity in the SNc of patients with schizophrenia. Our results indicate the presence of excessive dopamine products in the SNc of these patients. PMID:25111500

  1. A multimedia Electronic Patient Record (ePR) system for Image-Assisted Minimally Invasive Spinal Surgery

    PubMed Central

    Documet, Jorge; Le, Anh; Liu, Brent; Chiu, John; Huang, HK

    2009-01-01

    Purpose This paper presents the concept of bridging the gap between diagnostic images and image-assisted surgical treatment through the development of a one-stop multimedia electronic patient record (ePR) system that manages and distributes the real-time multimodality imaging and informatics data that assists the surgeon during all clinical phases of the operation from planning Intra-Op to post-care follow-up. We present the concept of this multimedia ePR for surgery by first focusing on Image-Assisted Minimally Invasive Spinal Surgery as a clinical application. Methods Three clinical Phases of Minimally Invasive Spinal Surgery workflow in Pre-Op, Intra-Op, and Post Op are discussed. The ePR architecture was developed based on the three-phased workflow, which includes the Pre-Op, Intra-Op, and Post-Op modules and four components comprising of the input integration unit, fault-tolerant gateway server, fault-tolerant ePR server, and the visualization and display. A prototype was built and deployed to a Minimally Invasive Spinal Surgery clinical site with user training and support for daily use. Summary A step-by step approach was introduced to develop a multi-media ePR system for Imaging-Assisted Minimally Invasive Spinal Surgery that includes images, clinical forms, waveforms, and textual data for planning the surgery, two real-time imaging techniques (digital fluoroscopic, DF) and endoscope video images (Endo), and more than half a dozen live vital signs of the patient during surgery. Clinical implementation experiences and challenges were also discussed. PMID:20033507

  2. Use of integrated SPECT/CT imaging for tumor dosimetry in I-131 radioimmunotherapy: a pilot patient study.

    PubMed

    Dewaraja, Yuni K; Wilderman, Scott J; Koral, Kenneth F; Kaminski, Mark S; Avram, Anca M

    2009-08-01

    Integrated systems combining functional (single-photon emission computed tomography; SPECT) imaging with anatomic (computed tomography; CT) imaging have the potential to greatly improve the accuracy of dose estimation in radionuclide therapy. In this article, we present the methodology for highly patient-specific tumor dosimetry by utilizing such a system and apply it to a pilot study of 4 follicular lymphoma patients treated with I-131 tositumomab. SPECT quantification included three-dimensional ordered-subset expectation-maximization reconstruction and CT-defined tumor outlines at each time point. SPECT/CT images from multiple time points were coupled to a Monte Carlo algorithm to calculate a mean tumor dose that incorporated measured changes in tumor volume. The tumor shrinkage, defined as the difference between volumes drawn on the first and last CT scan (a typical time period of 15 days) was in the range 5%-49%. The therapy-delivered mean tumor-absorbed dose was in the range 146-334 cGy. For comparison, the therapy dose was also calculated by assuming a static volume from the initial CT and was found to underestimate this dose by up to 47%. The agreement between tracer-predicted and therapy-delivered tumor-absorbed dose was in the range 7%-21%. In summary, malignant lymphomas can have dramatic tumor regression within days of treatment, and advanced imaging methods allow for a highly patient-specific tumor-dosimetry calculation that accounts for this regression. PMID:19694576

  3. Use of Integrated SPECT/CT Imaging for Tumor Dosimetry in I-131 Radioimmunotherapy: A Pilot Patient Study

    PubMed Central

    Wilderman, Scott J.; Koral, Kenneth F.; Kaminski, Mark S.; Avram, Anca M.

    2009-01-01

    Abstract Integrated systems combining functional (single-photon emission computed tomography; SPECT) imaging with anatomic (computed tomography; CT) imaging have the potential to greatly improve the accuracy of dose estimation in radionuclide therapy. In this article, we present the methodology for highly patient-specific tumor dosimetry by utilizing such a system and apply it to a pilot study of 4 follicular lymphoma patients treated with I-131 tositumomab. SPECT quantification included three-dimensional ordered-subset expectation-maximization reconstruction and CT-defined tumor outlines at each time point. SPECT/CT images from multiple time points were coupled to a Monte Carlo algorithm to calculate a mean tumor dose that incorporated measured changes in tumor volume. The tumor shrinkage, defined as the difference between volumes drawn on the first and last CT scan (a typical time period of 15 days) was in the range 5%–49%. The therapy-delivered mean tumor-absorbed dose was in the range 146–334?cGy. For comparison, the therapy dose was also calculated by assuming a static volume from the initial CT and was found to underestimate this dose by up to 47%. The agreement between tracer-predicted and therapy-delivered tumor-absorbed dose was in the range 7%–21%. In summary, malignant lymphomas can have dramatic tumor regression within days of treatment, and advanced imaging methods allow for a highly patient-specific tumor-dosimetry calculation that accounts for this regression. PMID:19694576

  4. Dosimetric evaluation for exposure of patient to a z-gradient coil in magnetic resonance imaging

    SciTech Connect

    Lu Mai [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences, University of Lisbon, 1749-016 Lisbon (Portugal); Ueno, Shoogo [Department of Applied Quantum Physics, Graduate School of Engineering, Kyushu University, Fukuoka, 812-8581 (Japan)

    2011-04-01

    In magnetic resonance imaging, time-varied gradient magnetic fields may stimulate nerves and muscles by inducing electric fields and currents in patients, which may potentially cause health problems. In this paper, a realistic z-gradient coil was numerically designed and the exposure level in a 3D real human man model was calculated by using the impedance method. It was found that the z-gradient coil produces a magnetic flux density (B-field) with two regions of good homogeneity along the coil length, separated by a very weak B-field in the middle of the coil. The spatially averaged B-field is 281 times greater than that of the International Commission on Non-Ionizing Radiation Protection's (ICNIRP) reference level. The 1-cm{sup 2}-averaged induced current density in the central nervous system is 87 times greater than that of the ICNIRP's basic restriction. The maximum current density in all of the body tissues is above the nerve stimulation threshold.

  5. Dosimetric evaluation for exposure of patient to a z-gradient coil in magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    Lu, Mai; Ueno, Shoogo

    2011-04-01

    In magnetic resonance imaging, time-varied gradient magnetic fields may stimulate nerves and muscles by inducing electric fields and currents in patients, which may potentially cause health problems. In this paper, a realistic z-gradient coil was numerically designed and the exposure level in a 3D real human man model was calculated by using the impedance method. It was found that the z-gradient coil produces a magnetic flux density (B-field) with two regions of good homogeneity along the coil length, separated by a very weak B-field in the middle of the coil. The spatially averaged B-field is 281 times greater than that of the International Commission on Non-Ionizing Radiation Protection's (ICNIRP) reference level. The 1-cm2-averaged induced current density in the central nervous system is 87 times greater than that of the ICNIRP's basic restriction. The maximum current density in all of the body tissues is above the nerve stimulation threshold.

  6. A prospective study of computed tomography, ultrasound, and gallium imaging in patients with fever

    SciTech Connect

    McNeil, B.J.; Sanders, R.; Alderson, P.O.; Hessel, S.J.; Finberg, H.; Siegelman, S.S.; Adams, D.F.; Abrams, H.L.

    1981-06-01

    Computed tomography, ultrasound, and /sup 67/Ga-citrate imaging were analyzed prospectively in patients thought to have a focal source of sepsis. They were divided into three groups: (a) postoperative, fever greater than or equal to 38.3 degrees C; (b) fever greater than or equal to 38.3 degrees C for less than four weeks, unrelated to surgery; and (c) any fever present for more than four weeks. ROC curves showed no significant difference in the ability of the three modalities to differentiate focal from nonfocal sources of sepsis. If any two examinations were used and either study was abnormal, the sensitivity increased from about 60% to nearly 90% while the false-positive rate increased from about 15% to 25%. When focal disease was diagnosed only if two examinations were abnormal, the false-positive ratio dropped to nearly zero but the sensitivity fell to below 40%. The authors concluded tha all three modalities have a similar ability to detect sepsis and that sensitivity can be increased by using any two of them.

  7. Phase I Study of Nintedanib Incorporating Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Patients With Advanced Solid Tumors

    PubMed Central

    Taylor, N. Jane; Attard, Gerhardt; Pacey, Simon; Nathan, Paul D.; de Bono, Johann S.; Temple, Graham; Bell, Susan; Stefanic, Martin; Stopfer, Peter; Tang, Adrian; Koh, Dow-Mu; Collins, David J.; d’Arcy, James; Padhani, Anwar R.; Leach, Martin O.; Judson, Ian R.; Rustin, Gordon J.

    2015-01-01

    Background. This open-label phase I dose-escalation study investigated the safety, efficacy, pharmacokinetics (PK), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) effects of the oral angiokinase inhibitor nintedanib in patients with advanced solid tumors. Methods. Nintedanib was administered once daily continuously, starting at 100 mg and later amended to allow evaluation of 250 mg b.i.d. The primary endpoint was maximum tolerated dose (MTD). DCE-MRI studies were performed at baseline and on days 2 and 28. Results. Fifty-one patients received nintedanib 100–450 mg once daily (n = 40) or 250 mg b.i.d. (n = 11). Asymptomatic reversible liver enzyme elevations (grade 3) were dose limiting in 2 of 5 patients at 450 mg once daily. At 250 mg b.i.d., 2 of 11 patients experienced dose-limiting toxicity (grade 3 liver enzyme elevation and gastrointestinal symptoms). Common toxicities included fatigue, diarrhea, nausea, vomiting, and abdominal pain (mainly grade ?2). Among 45 patients, 22 (49%) achieved stable disease; 7 remained on treatment for >6 months. DCE-MRI of target lesions revealed effects in some patients at 200 and ?400 mg once daily. Conclusion. Nintedanib is well tolerated by patients with advanced solid malignancies, with MTD defined as 250 mg b.i.d., and can induce changes in DCE-MRI. Disease stabilization >6 months was observed in 7 of 51 patients. PMID:25795637

  8. Convergent Evidence from Multimodal Imaging Reveals Amygdala Abnormalities in Schizophrenic Patients and Their First-Degree Relatives

    PubMed Central

    Tian, Lin; Meng, Chun; Yan, Hao; Zhao, Qiang; Liu, Qi; Yan, Jun; Han, Yonghua; Yuan, Huishu; Wang, Lifang; Yue, Weihua; Zhang, Yanbo; Li, Xinmin; Zhu, Chaozhe; He, Yong; Zhang, Dai

    2011-01-01

    Background Shared neuropathological features between schizophrenic patients and their first-degree relatives have potential as indicators of genetic vulnerability to schizophrenia. We sought to explore genetic influences on brain morphology and function in schizophrenic patients and their relatives. Methods Using a multimodal imaging strategy, we studied 33 schizophrenic patients, 55 of their unaffected parents, 30 healthy controls for patients, and 29 healthy controls for parents with voxel-based morphometry of structural MRI scans and functional connectivity analysis of resting-state functional MRI data. Results Schizophrenic patients showed widespread gray matter reductions in the bilateral frontal cortices, bilateral insulae, bilateral occipital cortices, left amygdala and right thalamus, whereas their parents showed more localized reductions in the left amygdala, left thalamus and right orbitofrontal cortex. Patients and their parents shared gray matter loss in the left amygdala. Further investigation of the resting-state functional connectivity of the amygdala in the patients showed abnormal functional connectivity with the bilateral orbitofrontal cortices, bilateral precunei, bilateral dorsolateral frontal cortices and right insula. Their parents showed slightly less, but similar changes in the pattern in the amygdala connectivity. Co-occurrences of abnormal connectivity of the left amygdala with the left orbitofrontal cortex, right dorsolateral frontal cortex and right precuneus were observed in schizophrenic patients and their parents. Conclusions Our findings suggest a potential genetic influence on structural and functional abnormalities of the amygdala in schizophrenia. Such information could help future efforts to identify the endophenotypes that characterize the complex disorder of schizophrenia. PMID:22174900

  9. High-resolution en face images of microcystic macular edema in patients with autosomal dominant optic atrophy.

    PubMed

    Gocho, Kiyoko; Kikuchi, Sachiko; Kabuto, Takenori; Kameya, Shuhei; Shinoda, Kei; Mizota, Atsushi; Yamaki, Kunihiko; Takahashi, Hiroshi

    2013-01-01

    The purpose of this study was to investigate the characteristics of microcystic macular edema (MME) determined from the en face images obtained by an adaptive optics (AO) fundus camera in patients with autosomal dominant optic atrophy (ADOA) and to try to determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL by using the advantage of AO. Six patients from 4 families with ADOA underwent detailed ophthalmic examinations including spectral domain optical coherence tomography (SD-OCT). Mutational screening of all coding and flanking intron sequences of the OPA1 gene was performed by DNA sequencing. SD-OCT showed a severe reduction in the retinal nerve fiber layer (RNFL) thickness in all patients. A new splicing defect and two new frameshift mutations with premature termination of the Opa1 protein were identified in three families. A reported nonsense mutation was identified in one family. SD-OCT of one patient showed MME in the inner nuclear layer (INL) of the retina. AO images showed microcysts in the en face images of the INL. Our data indicate that AO is a useful method to identify MME in neurodegenerative diseases and may also help determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL. PMID:24369534

  10. High-Resolution En Face Images of Microcystic Macular Edema in Patients with Autosomal Dominant Optic Atrophy

    PubMed Central

    Kikuchi, Sachiko; Kabuto, Takenori; Mizota, Atsushi; Yamaki, Kunihiko; Takahashi, Hiroshi

    2013-01-01

    The purpose of this study was to investigate the characteristics of microcystic macular edema (MME) determined from the en face images obtained by an adaptive optics (AO) fundus camera in patients with autosomal dominant optic atrophy (ADOA) and to try to determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL by using the advantage of AO. Six patients from 4 families with ADOA underwent detailed ophthalmic examinations including spectral domain optical coherence tomography (SD-OCT). Mutational screening of all coding and flanking intron sequences of the OPA1 gene was performed by DNA sequencing. SD-OCT showed a severe reduction in the retinal nerve fiber layer (RNFL) thickness in all patients. A new splicing defect and two new frameshift mutations with premature termination of the Opa1 protein were identified in three families. A reported nonsense mutation was identified in one family. SD-OCT of one patient showed MME in the inner nuclear layer (INL) of the retina. AO images showed microcysts in the en face images of the INL. Our data indicate that AO is a useful method to identify MME in neurodegenerative diseases and may also help determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL. PMID:24369534

  11. Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

    SciTech Connect

    Pawlowski, Jason M. [Vanderbilt-Ingram Cancer Center, Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Department of Physics and Astronomy, Vanderbilt University College of Art and Sciences, B-902, TVC, 1301 Medical Center Drive, Nashville, Tennessee (United States); Yang, Eddy S.; Malcolm, Arnold W. [Vanderbilt-Ingram Cancer Center, Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Coffey, Charles W. [Vanderbilt-Ingram Cancer Center, Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Department of Physics and Astronomy, Vanderbilt University College of Art and Sciences, B-902, TVC, 1301 Medical Center Drive, Nashville, Tennessee (United States); Ding, George X., E-mail: george.ding@vanderbilt.ed [Vanderbilt-Ingram Cancer Center, Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee (United States); Department of Physics and Astronomy, Vanderbilt University College of Art and Sciences, B-902, TVC, 1301 Medical Center Drive, Nashville, Tennessee (United States)

    2010-03-01

    Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

  12. Computerised tomography vs magnetic resonance imaging for modeling of patient-specific instrumentation in total knee arthroplasty

    PubMed Central

    Stirling, Paul; Valsalan Mannambeth, Rejith; Soler, Agustin; Batta, Vineet; Malhotra, Rajeev Kumar; Kalairajah, Yegappan

    2015-01-01

    AIM: To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation (PSI) surgery. METHODS: The MEDLINE and EMBASE medical literature databases were searched, from January 1990 to December 2013, to identify relevant studies. The data from several clinical studies was assimilated to allow appreciation and comparison of the accuracy of each modality. The overall accuracy of each modality was calculated as proportion of outliers > 3% in the coronal plane of both computerised tomography (CT) or magnetic resonance imaging (MRI). RESULTS: Seven clinical studies matched our inclusion criteria for comparison and were included in our study for statistical analysis. Three of these reported series using MRI and four with CT. Overall percentage of outliers > 3% in patients with CT-based PSI systems was 12.5% vs 16.9% for MRI-based systems. These results were not statistically significant. CONCLUSION: Although many studies have been undertaken to determine the ideal pre-operative imaging modality, conclusions remain speculative in the absence of long term data. Ultimately, information regarding accuracy of CT and MRI will be the main determining factor. Increased accuracy of pre-operative imaging could result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging and revision surgery. PMID:25793170

  13. Combined PET/MR imaging using (68)Ga-DOTATOC for radiotherapy treatment planning in meningioma patients.

    PubMed

    Thorwarth, Daniela; Müller, Arndt-Christian; Pfannenberg, Christina; Beyer, Thomas

    2013-01-01

    Hybrid imaging is beneficial for improved medical diagnosis and therapy planning today. Hybrid imaging describes the prospective correlation of two or more complementary sets of imaging information, such as functional and anatomical image volumes. Correlation can be performed through physically combined imaging modalities, such as PET/CT, SPECT/CT, or PET/MR. Here we present first results from employing fully integrated PET/MR tomography for intensity-modulated radiotherapy (IMRT) treatment planning in patients with meningioma using [(68)Ga]-DOTATOC as the biomarker of choice. Combined PET/MR offers higher soft tissue contrast and the ability to add functional information to the plain combination of MR-based anatomy and PET-based metabolic and molecular information. Furthermore, fully integrated PET/MR employs novel PET technology that is neither available in PET-only nor PET/CT systems. Despite the current lack of broad clinical evidence, integrated PET/MR may become particularly important and clinically useful for improved, individualized RT therapy planning for brain lesions. In particular, logistical and diagnostic benefits of integrated PET/MR-based treatment planning over treatment planning based on PET/CT data may be expected in meningioma patients. PMID:22918773

  14. Creation of gastric conduit free-graft with intraoperative perfusion imaging during pancreaticoduodenectomy in a patient post esophagectomy

    PubMed Central

    Pagkratis, Spyridon; Virvilis, Dimitrios; Phillips, Brett T.; Bao, Philip Q.; Khan, Sami U.; Ganz, Jason C.; Watkins, Kevin T.

    2015-01-01

    As surgery becomes more successful for complicated malignancies, patients survive longer and can unfortunately develop subsequent malignancies. Surgical resection in these settings can be treacherous and manipulations of the patient’s anatomy need to be closely considered before embarking on major operations. We report a case of a patient who survived esophageal resection for locally advanced esophageal cancer only to develop a new pancreatic head malignancy. Careful upfront planning allowed for a successful resection with an uncomplicated recovery. She underwent open pancreaticoduodenectomy, and to maintain perfusion to the gastric conduit a microvascular anastomosis of the gastroepiploic pedicle was performed to the middle colic vessels. Intraoperative fluorescent imaging was used to evaluate the anastomosis as well as gastric and duodenal perfusion during the case. PMID:25723746

  15. Imaging polarimetry in patients with neovascular age-related macular degeneration

    PubMed Central

    Elsner, Ann E.; Weber, Anke; Cheney, Michael C.; VanNasdale, Dean A.; Miura, Masahiro

    2007-01-01

    Imaging polarimetry was used to examine different components of neovascular membranes in age-related macular degeneration. Retinal images were acquired with a scanning laser polarimeter. An innovative pseudo-color scale, based on cardinal directions of color, displayed two types of image information: relative phases and magnitudes of birefringence. Membranes had relative phase changes that did not correspond to anatomical structures in reflectance images. Further, membrane borders in depolarized light images had significantly higher contrasts than those in reflectance images. The retinal birefringence in neovascular membranes indicates optical activity consistent with molecular changes rather than merely geometrical changes. PMID:17429494

  16. Patient Alignment Estimation in Six Degrees of Freedom Using a CT-scan and a Single X-ray Image

    NASA Astrophysics Data System (ADS)

    Selby, B. P.; Sakas, G.; Walter, S.; Groch, W.-D.; Stilla, U.

    Particle beam treatment allows accurate dose delivery onto carcinogen tissue. The reachable accuracy is limited by patient alignment errors relative to the beam source. Errors can be corrected manually or by automatic comparison of two X-ray images to a CT-scan but correction mostly does not cover all degrees of freedom (DoF). In this contribution we present a solution that makes use of one X-ray image and computes full 6 DoF alignment correction by gray value based comparison to a CT. By using regions of interest, we are able to increase performance and reliability.

  17. Expanding the phenotype of GMPPB mutations.

    PubMed

    Cabrera-Serrano, Macarena; Ghaoui, Roula; Ravenscroft, Gianina; Johnsen, Russell D; Davis, Mark R; Corbett, Alastair; Reddel, Stephen; Sue, Carolyn M; Liang, Christina; Waddell, Leigh B; Kaur, Simranpreet; Lek, Monkol; North, Kathryn N; MacArthur, Daniel G; Lamont, Phillipa J; Clarke, Nigel F; Laing, Nigel G

    2015-04-01

    Dystroglycanopathies are a heterogeneous group of diseases with a broad phenotypic spectrum ranging from severe disorders with congenital muscle weakness, eye and brain structural abnormalities and intellectual delay to adult-onset limb-girdle muscular dystrophies without mental retardation. Most frequently the disease onset is congenital or during childhood. The exception is FKRP mutations, in which adult onset is a common presentation. Here we report eight patients from five non-consanguineous families where next generation sequencing identified mutations in the GMPPB gene. Six patients presented as an adult or adolescent-onset limb-girdle muscular dystrophy, one presented with isolated episodes of rhabdomyolysis, and one as a congenital muscular dystrophy. This report expands the phenotypic spectrum of GMPPB mutations to include limb-girdle muscular dystrophies with adult onset with or without intellectual disability, or isolated rhabdomyolysis. PMID:25681410

  18. Denial and Self-Image in Stroke, Lung Cancer, and Heart Disease Patients

    ERIC Educational Resources Information Center

    Levine, Jacob; Zigler, Edward

    1975-01-01

    Stroke, lung cancer, and heart disease patients were found to employ denial, as indicated by the relatively small difference between their real and ideal selves before and after the onset of illness. The greatest amount of denial was found for stroke patients. Cancer patients displayed more denial than did heart patients. (Author)

  19. Megavoltage Computed Tomography Image Guidance With Helical Tomotherapy in Patients With Vertebral Tumors: Analysis of Factors Influencing Interobserver Variability

    SciTech Connect

    Levegruen, Sabine, E-mail: sabine.levegruen@uni-due.de [Department of Radiotherapy, University Hospital Essen, Essen (Germany)] [Department of Radiotherapy, University Hospital Essen, Essen (Germany); Poettgen, Christoph; Abu Jawad, Jehad; Berkovic, Katharina; Hepp, Rodrigo; Stuschke, Martin [Department of Radiotherapy, University Hospital Essen, Essen (Germany)] [Department of Radiotherapy, University Hospital Essen, Essen (Germany)

    2013-02-01

    Purpose: To evaluate megavoltage computed tomography (MVCT)-based image guidance with helical tomotherapy in patients with vertebral tumors by analyzing factors influencing interobserver variability, considered as quality criterion of image guidance. Methods and Materials: Five radiation oncologists retrospectively registered 103 MVCTs in 10 patients to planning kilovoltage CTs by rigid transformations in 4 df. Interobserver variabilities were quantified using the standard deviations (SDs) of the distributions of the correction vector components about the observers' fraction mean. To assess intraobserver variabilities, registrations were repeated after {>=}4 weeks. Residual deviations after setup correction due to uncorrectable rotational errors and elastic deformations were determined at 3 craniocaudal target positions. To differentiate observer-related variations in minimizing these residual deviations across the 3-dimensional MVCT from image resolution effects, 2-dimensional registrations were performed in 30 single transverse and sagittal MVCT slices. Axial and longitudinal MVCT image resolutions were quantified. For comparison, image resolution of kilovoltage cone-beam CTs (CBCTs) and interobserver variability in registrations of 43 CBCTs were determined. Results: Axial MVCT image resolution is 3.9 lp/cm. Longitudinal MVCT resolution amounts to 6.3 mm, assessed as full-width at half-maximum of thin objects in MVCTs with finest pitch. Longitudinal CBCT resolution is better (full-width at half-maximum, 2.5 mm for CBCTs with 1-mm slices). In MVCT registrations, interobserver variability in the craniocaudal direction (SD 1.23 mm) is significantly larger than in the lateral and ventrodorsal directions (SD 0.84 and 0.91 mm, respectively) and significantly larger compared with CBCT alignments (SD 1.04 mm). Intraobserver variabilities are significantly smaller than corresponding interobserver variabilities (variance ratio [VR] 1.8-3.1). Compared with 3-dimensional registrations, 2-dimensional registrations have significantly smaller interobserver variability in the lateral and ventrodorsal directions (VR 3.8 and 2.8, respectively) but not in the craniocaudal direction (VR 0.75). Conclusion: Tomotherapy image guidance precision is affected by image resolution and residual deviations after setup correction. Eliminating the effect of residual deviations yields small interobserver variabilities with submillimeter precision in the axial plane. In contrast, interobserver variability in the craniocaudal direction is dominated by the poorer longitudinal MVCT image resolution. Residual deviations after image guidance exist and need to be considered when dose gradients ultimately achievable with image guided radiation therapy techniques are analyzed.

  20. Accuracy of a commercial optical 3D surface imaging system for realignment of patients for radiotherapy of the thorax

    NASA Astrophysics Data System (ADS)

    Schöffel, Philipp J.; Harms, Wolfgang; Sroka-Perez, Gabriele; Schlegel, Wolfgang; Karger, Christian P.

    2007-07-01

    Accurate and reproducible patient setup is a prerequisite to fractionated radiotherapy. To evaluate the applicability and technical performance of a commercial 3D surface imaging system for repositioning of breast cancer patients, measurements were performed in a rigid anthropomorphic phantom as well as in healthy volunteers. The camera system records a respiration-gated surface model of the imaged object, which may be registered to a previously recorded reference model. A transformation is provided, which may be applied to the treatment couch to correct the setup of the patient. The system showed a high stability and detected pre-defined shifts of phantoms and healthy volunteers with an accuracy of 0.40 ± 0.26 mm and 1.02 ± 0.51 mm, respectively (spatial deviation between pre-defined shift and suggested correction). The accuracy of the suggested rotational correction around the vertical axis was always better than 0.3° in phantom measurements and 0.8° in volunteers, respectively. Comparison of the suggested setup correction with that detected by a second and independently operated marker-based optical system provided consistent results. The results demonstrate that the camera system provides highly accurate setup corrections in a phantom and healthy volunteers. The most efficient use of the system for improving the setup accuracy in breast cancer patients has to be investigated in routine patient treatments.

  1. Task-based measures of image quality and their relation to radiation dose and patient risk

    NASA Astrophysics Data System (ADS)

    Barrett, Harrison H.; Myers, Kyle J.; Hoeschen, Christoph; Kupinski, Matthew A.; Little, Mark P.

    2015-01-01

    The theory of task-based assessment of image quality is reviewed in the context of imaging with ionizing radiation, and objective figures of merit (FOMs) for image quality are summarized. The variation of the FOMs with the task, the observer and especially with the mean number of photons recorded in the image is discussed. Then various standard methods for specifying radiation dose are reviewed and related to the mean number of photons in the image and hence to image quality. Current knowledge of the relation between local radiation dose and the risk of various adverse effects is summarized, and some graphical depictions of the tradeoffs between image quality and risk are introduced. Then various dose-reduction strategies are discussed in terms of their effect on task-based measures of image quality.

  2. Infant Processing of Depth Information in Expanding Dot Patterns.

    ERIC Educational Resources Information Center

    Ball, William A.

    A looming paradigm was used to determine what depth information infants process in addition to that provided by the expansion of a single, closed contour of an object. A total of 18 male and 15 female infants aged 22-48 days watched a film in which the circular elements and inter-element spaces of the projected image alternately expanded and…

  3. Epitrochlear and axillary lymph node visualization on FDG-PET/CT imaging in a patient with rheumatoid arthritis.

    PubMed

    Ozcan Kara, P; Kaya, B; Kara Gedik, G; Sari, O

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the field of view and showed elevated FDG uptake. In this case report, we report benign axillary and epitrochlear tracer uptake on FDG-PET/CT scan in a patient with a history of rheumatoid arthritis. PMID:20570414

  4. EXPANDING THE USE OF EXPANDED POLYSTYRENE (EPS) GEOFOAM IN PRACTICE

    Microsoft Academic Search

    John S. Horvath

    2005-01-01

    Most geotechnical and structural engineers are now aware of the well established and proven use of expanded polystyrene (EPS) geofoam as a lightweight fill material. However much less well known and utilized to date in practice are the many other functional applications of EPS geofoam, most of which cannot be provided by any other geosynthetic product. Therefore greater use of

  5. Intraventricular cerebrospinal fluid temperature analysis using MR diffusion-weighted imaging thermometry in Parkinson's disease patients, multiple system atrophy patients, and healthy subjects

    PubMed Central

    Sumida, Kaoru; Sato, Noriko; Ota, Miho; Sakai, Koji; Nippashi, Yasumasa; Sone, Daichi; Yokoyama, Kota; Ito, Kimiteru; Maikusa, Norihide; Imabayashi, Etsuko; Matsuda, Hiroshi; Yamada, Kei; Murata, Miho; Kunimatsu, Akira; Ohtomo, Kuni

    2015-01-01

    Purpose We examined the temperature of the intraventricular cerebrospinal fluid (Tv) in patients with Parkinson's disease (PD) and those with multiple system atrophy (MSA) in comparison with healthy subjects, and we examined normal changes in this temperature with aging. Methods Tv was estimated by magnetic resonance (MR) diffusion-weighted imaging (DWI) thermometry in 36 PD patients (19 males, 17 females), 34 MSA patients (17 males, 17 females), 64 age-matched controls (27 men, 37 women), and 114 all-age adult controls (47 men, 67 women; 28–89 years old). The volume of lateral ventricles was also estimated using FreeSurfer in all subjects. Tv and ventricular volume data were compared among the PD and MSA patients and age-matched controls. We also evaluated the relationship between Tv and age in the 114 all-age controls, controlling for ventricular volume. Men and women were analyzed separately. Results The male PD and MSA patients had significantly higher Tv values compared to the male controls, with no significant difference in ventricular volume among them. There was no significant difference in Tv between the female patients and controls. In the all-age male controls, there was a significant negative correlation between Tv and age controlling for ventricular volume, and this was not observed in the women. Conclusion DWI thermometry is a useful and easy method for demonstrating an altered intracranial environment in male patients and healthy controls, but not in females. DWI thermometry can thus be used to help to explore the pathophysiology of Parkinsonian syndromes and to differentiate individuals affected by neurodegenerative disease with autonomic dysfunction from those without it. PMID:26085965

  6. Fractal Dimension Analysis of MDCT Images for Quantifying the Morphological Changes of the Pulmonary Artery Tree in Patients with Pulmonary Hypertension

    PubMed Central

    Haitao, Sun; Ning, Li; Lijun, Guo; Fei, Gao

    2011-01-01

    Objective The aim of this study was to use fractal dimension (FD) analysis on multidetector CT (MDCT) images for quantifying the morphological changes of the pulmonary artery tree in patients with pulmonary hypertension (PH). Materials and Methods Fourteen patients with PH and 17 patients without PH as controls were studied. All of the patients underwent contrast-enhanced helical CT and transthoracic echocardiography. The pulmonary artery trees were generated using post-processing software, and the FD and projected image area of the pulmonary artery trees were determined with ImageJ software in a personal computer. The FD, the projected image area and the pulmonary artery pressure (PAP) were statistically evaluated in the two groups. Results The FD, the projected image area and the PAP of the patients with PH were higher than those values of the patients without PH (p < 0.05, t-test). There was a high correlation of FD with the PAP (r = 0.82, p < 0.05, partial correlation analysis). There was a moderate correlation of FD with the projected image area (r = 0.49, p < 0.05, partial correlation analysis). There was a correlation of the PAP with the projected image area (r = 0.65, p < 0.05, Pearson correlation analysis). Conclusion The FD of the pulmonary arteries in the PH patients was significantly higher than that of the controls. There is a high correlation of FD with the PAP. PMID:21603288

  7. Evaluation of overall setup accuracy and adequate setup margins in pelvic image-guided radiotherapy: Comparison of the male and female patients

    SciTech Connect

    Laaksomaa, Marko, E-mail: marko.laaksomaa@pshp.fi [Department of Oncology, Tampere University Hospital (TAUH), Tampere (Finland); Kapanen, Mika [Department of Oncology, Tampere University Hospital (TAUH), Tampere (Finland); Department of Medical Physics, Tampere University Hospital (TAUH), Tampere (Finland); Tulijoki, Tapio [Department of Oncology, Tampere University Hospital (TAUH), Tampere (Finland); Peltola, Seppo; Hyödynmaa, Simo [Department of Oncology, Tampere University Hospital (TAUH), Tampere (Finland); Department of Medical Physics, Tampere University Hospital (TAUH), Tampere (Finland); Kellokumpu-Lehtinen, Pirkko-Liisa [Department of Oncology, Tampere University Hospital (TAUH), Tampere (Finland)

    2014-04-01

    We evaluated adequate setup margins for the radiotherapy (RT) of pelvic tumors based on overall position errors of bony landmarks. We also estimated the difference in setup accuracy between the male and female patients. Finally, we compared the patient rotation for 2 immobilization devices. The study cohort included consecutive 64 male and 64 female patients. Altogether, 1794 orthogonal setup images were analyzed. Observer-related deviation in image matching and the effect of patient rotation were explicitly determined. Overall systematic and random errors were calculated in 3 orthogonal directions. Anisotropic setup margins were evaluated based on residual errors after weekly image guidance. The van Herk formula was used to calculate the margins. Overall, 100 patients were immobilized with a house-made device. The patient rotation was compared against 28 patients immobilized with CIVCO's Kneefix and Feetfix. We found that the usually applied isotropic setup margin of 8 mm covered all the uncertainties related to patient setup for most RT treatments of the pelvis. However, margins of even 10.3 mm were needed for the female patients with very large pelvic target volumes centered either in the symphysis or in the sacrum containing both of these structures. This was because the effect of rotation (p ? 0.02) and the observer variation in image matching (p ? 0.04) were significantly larger for the female patients than for the male patients. Even with daily image guidance, the required margins remained larger for the women. Patient rotations were largest about the lateral axes. The difference between the required margins was only 1 mm for the 2 immobilization devices. The largest component of overall systematic position error came from patient rotation. This emphasizes the need for rotation correction. Overall, larger position errors and setup margins were observed for the female patients with pelvic cancer than for the male patients.

  8. Patient-specific dosimetry of conventional and intensity modulated radiation therapy using a novel full Monte Carlo phase space reconstruction method from electronic portal images

    NASA Astrophysics Data System (ADS)

    Jarry, Geneviève; Verhaegen, Frank

    2007-04-01

    Electronic portal imagers have promising dosimetric applications in external beam radiation therapy. In this study a patient dose computation algorithm based on Monte Carlo (MC) simulations and on portal images is developed and validated. The patient exit fluence from primary photons is obtained from the portal image after correction for scattered radiation. The scattered radiation at the portal imager and the spectral energy distribution of the primary photons are estimated from MC simulations at the treatment planning stage. The patient exit fluence and the spectral energy distribution of the primary photons are then used to ray-trace the photons from the portal image towards the source through the CT geometry of the patient. Photon weights which reflect the probability of a photon being transmitted are computed during this step. A dedicated MC code is used to transport back these photons from the source through the patient CT geometry to obtain patient dose. Only Compton interactions are considered. This code also produces a reconstructed portal image which is used as a verification tool to ensure that the dose reconstruction is reliable. The dose reconstruction algorithm is compared against MC dose calculation (MCDC) predictions and against measurements in phantom. The reconstructed absolute absorbed doses and the MCDC predictions in homogeneous and heterogeneous phantoms agree within 3% for simple open fields. Comparison with film-measured relative dose distributions for IMRT fields yields agreement within 3 mm, 5%. This novel dose reconstruction algorithm allows for daily patient-specific dosimetry and verification of patient movement.

  9. Patient-specific dosimetry of conventional and intensity modulated radiation therapy using a novel full Monte Carlo phase space reconstruction method from electronic portal images.

    PubMed

    Jarry, Geneviève; Verhaegen, Frank

    2007-04-21

    Electronic portal imagers have promising dosimetric applications in external beam radiation therapy. In this study a patient dose computation algorithm based on Monte Carlo (MC) simulations and on portal images is developed and validated. The patient exit fluence from primary photons is obtained from the portal image after correction for scattered radiation. The scattered radiation at the portal imager and the spectral energy distribution of the primary photons are estimated from MC simulations at the treatment planning stage. The patient exit fluence and the spectral energy distribution of the primary photons are then used to ray-trace the photons from the portal image towards the source through the CT geometry of the patient. Photon weights which reflect the probability of a photon being transmitted are computed during this step. A dedicated MC code is used to transport back these photons from the source through the patient CT geometry to obtain patient dose. Only Compton interactions are considered. This code also produces a reconstructed portal image which is used as a verification tool to ensure that the dose reconstruction is reliable. The dose reconstruction algorithm is compared against MC dose calculation (MCDC) predictions and against measurements in phantom. The reconstructed absolute absorbed doses and the MCDC predictions in homogeneous and heterogeneous phantoms agree within 3% for simple open fields. Comparison with film-measured relative dose distributions for IMRT fields yields agreement within 3 mm, 5%. This novel dose reconstruction algorithm allows for daily patient-specific dosimetry and verification of patient movement. PMID:17404469

  10. Office-based laryngeal imaging in awake patients with swept-source optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Yu, Lingfeng; Liu, Gangjun; Guo, Shuguang; Wong, Brian J. F.; Chen, Zhongping

    2009-02-01

    Optical coherence tomography (OCT) is an evolving noninvasive imaging modality and has been used to image the human larynx during surgical endoscopy. The design of a long GRIN lens based probe capable of capturing images of the human larynx by use of a swept-source OCT during a typical office-based laryngoscopy examination is presented. An optical-ballast-based 4F optical relay system is proposed to realize variable working distance with a constant optical delay. In vivo OCT imaging of the human larynx is demonstrated with 40 fame/second. Office-based OCT is a promising imaging modality to study the larynx.

  11. A reference skeletal dosimetry model for an adult male radionuclide therapy patient based on three-dimensional imaging and paired-image radiation transport

    NASA Astrophysics Data System (ADS)

    Shah, Amish P.

    The need for improved patient-specificity of skeletal dose estimates is widely recognized in radionuclide therapy. Current clinical models for marrow dose are based on skeletal mass estimates from a variety of sources and linear chord-length distributions that do not account for particle escape into cortical bone. To predict marrow dose, these clinical models use a scheme that requires separate calculations of cumulated activity and radionuclide S values. Selection of an appropriate S value is generally limited to one of only three sources, all of which use as input the trabecular microstructure of an individual measured 25 years ago, and the tissue mass derived from different individuals measured 75 years ago. Our study proposed a new modeling approach to marrow dosimetry---the Paired Image Radiation Transport (PIRT) model---that properly accounts for both the trabecular microstructure and the cortical macrostructure of each skeletal site in a reference male radionuclide patient. The PIRT model, as applied within EGSnrc, requires two sets of input geometry: (1) an infinite voxel array of segmented microimages of the spongiosa acquired via microCT; and (2) a segmented ex-vivo CT image of the bone site macrostructure defining both the spongiosa (marrow, endosteum, and trabeculae) and the cortical bone cortex. Our study also proposed revising reference skeletal dosimetry models for the adult male cancer patient. Skeletal site-specific radionuclide S values were obtained for a 66-year-old male reference patient. The derivation for total skeletal S values were unique in that the necessary skeletal mass and electron dosimetry calculations were formulated from the same source bone site over the entire skeleton. We conclude that paired-image radiation-transport techniques provide an adoptable method by which the intricate, anisotropic trabecular microstructure of the skeletal site; and the physical size and shape of the bone can be handled together, for improved compilation of reference radionuclide S values. We also conclude that this comprehensive model for the adult male cancer patient should be implemented for use in patient-specific calculations for radionuclide dosimetry of the skeleton.

  12. Epitrochlear and axillary lymph node visualization on FDG-PET\\/CT imaging in a patient with rheumatoid arthritis

    Microsoft Academic Search

    P. Ozcan Kara; B. Kaya; G. Kara Gedik; O. Sari

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET\\/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET\\/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the

  13. Beyond Patient Reported Pain: Perfusion Magnetic Resonance Imaging Demonstrates Reproducible Cerebral Representation of Ongoing Post-Surgical Pain

    Microsoft Academic Search

    Matthew A. Howard; Kristina Krause; Nadine Khawaja; Nathalie Massat; Fernando Zelaya; Gunter Schumann; John P. Huggins; William Vennart; Steven C. R. Williams; Tara F. Renton; Bernhard Baune

    2011-01-01

    Development of treatments for acute and chronic pain conditions remains a challenge, with an unmet need for improved sensitivity and reproducibility in measuring pain in patients. Here we used pulsed-continuous arterial spin-labelling [pCASL], a relatively novel perfusion magnetic-resonance imaging technique, in conjunction with a commonly-used post-surgical model, to measure changes in regional cerebral blood flow [rCBF] associated with the experience

  14. Brain Magnetic Resonance Imaging White-Matter Lesions and Cerebrospinal Fluid Findings in Patients with Acute Intermittent Porphyria

    Microsoft Academic Search

    Ingemar Bylesjö; Ole-Lars Brekke; Jan Prytz; Trine Skjeflo; Rolf Salvesen

    2004-01-01

    Background: Case reports display similaritiesbetween multiple sclerosis and acute intermittent porphyria (AIP). This study examines whether patients with AIP in general demonstrate white-matter lesions on brain magnetic resonance imaging (MRI) and\\/or abnormalities in plasma and\\/or cerebrospinal fluid (CSF) when examined outside attacks. We looked particularly for the presence of oligoclonal bands (OB) of immunoglobulin (Ig) in liquor. Methods:Eight AIP gene

  15. Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T

    PubMed Central

    Jia, Zhiyun; Wang, Yuqing; Huang, Xiaoqi; Kuang, Weihong; Wu, Qizhu; Lui, Su; Sweeney, John A.; Gong, Qiyong

    2014-01-01

    Background The neurobiology of suicide is largely unknown. Studies of white matter tracts in patients with a history of suicidal behaviour have shown alteration in the left anterior limb of the internal capsule (ALIC). Our aim was to determine whether particular target fields of fibre projections through the ALIC are affected in depressed patients who recently attempted suicide. Methods We studied patients with major depressive disorder (MDD) with and without a history of suicide attempts and healthy controls using diffusion tensor imaging (DTI) and deterministic tractography to generate fibre tract maps for each participant. Tract voxels were coded as being unique to the left ALIC. We compared the mean percentage of fibres projecting to relevant brain regions in the 3 groups using analysis of covariance. Results We included 63 patients with MDD (23 with and 40 without a history of suicide attempts) and 46 controls in our study. Both groups of depressed patients had reduced fibre projections through the ALIC to the left medial frontal cortex, orbitofrontal cortex and thalamus. Those with a history of suicide attempts had greater abnormalities than those without suicide attempts in the left orbitofrontal cortex and thalamus. Limitations Diffusion tensor imaging deterministic tracking is unable to distinguish between afferent and efferent pathways, limiting our ability to distinguish the directionality of altered fibre tracts. Conclusion Frontothalamic loops passing through the ALIC are abnormal in patients with depression and significantly more abnormal in depressed patients with a history of suicide attempts than in those without a history of suicide attempts. Abnormal projections to the orbitofrontal cortex and thalamus may disrupt affective and cognitive functions to confer a heightened vulnerability for suicidal behaviour. PMID:24119793

  16. Molecular Imaging Radiotherapy: Theranostics for Personalized Patient Management of Neuroendocrine Tumors (NETs)

    PubMed Central

    Öberg, Kjell

    2012-01-01

    Neuroendocrine tumors (NETs) possess unique features including expression of peptide hormone receptors as well as the capacity to concentrate and take up precursor forms of amines and peptides making hormones that are stored in secretory granules within the tumor cells (APUD). The expression of somatostatin receptors on tumor cells have been widely explored during the last two decades starting with 111In-DTPA-Octreotide as an imaging agent followed by 68Ga-DOTATOC/TATE positron emission tomography scanning. The new generation of treatment includes 90Yttrium-DOTATOC/DOTATATE as well as 177Lutetium-DOTATOC/DOTATATE/DOTANOC treatment of various subtypes of NETs. The objective response rate by these types of PRRT is in the range of 30-45% objective responses with 5-10% grade 3/4 toxicity mainly hematologic and renal toxicity. The APUD mechanism is another unique feature of NETs which have generated an interest over the last two decades to develop specific tracers including 11C-5HTP, 18F-DOPA and 11C-hydroxyefedrin. These radioactive tracers have been developed in centres with specific interest in NETs and are not available everywhere. 111In-DTPA-Octreotide is still the working horse in diagnosis and staging of metastatic NETs, but will in the future be replaced by 68Ga-DOTATOC/DOTATATE PET/CT scanning which provide higher sensitivity and specificity and is also more convenient for the patient because it is a one-stop-procedure. Both 90Yttrium-DOTATOC/DOTATATE as well as 177Lutetium-DOTATOC/DOTATATE are important new therapies for malignant metastatic NETs. However, the precise role in the treatment algorithm has to be determined in forthcoming randomized trials. PMID:22768025

  17. Investigation of four-dimensional computed tomography-based pulmonary ventilation imaging in patients with emphysematous lung regions

    NASA Astrophysics Data System (ADS)

    Yamamoto, Tokihiro; Kabus, Sven; Klinder, Tobias; Lorenz, Cristian; von Berg, Jens; Blaffert, Thomas; Loo, Billy W., Jr.; Keall, Paul J.

    2011-04-01

    A pulmonary ventilation imaging technique based on four-dimensional (4D) computed tomography (CT) has advantages over existing techniques. However, physiologically accurate 4D-CT ventilation imaging has not been achieved in patients. The purpose of this study was to evaluate 4D-CT ventilation imaging by correlating ventilation with emphysema. Emphysematous lung regions are less ventilated and can be used as surrogates for low ventilation. We tested the hypothesis: 4D-CT ventilation in emphysematous lung regions is significantly lower than in non-emphysematous regions. Four-dimensional CT ventilation images were created for 12 patients with emphysematous lung regions as observed on CT, using a total of four combinations of two deformable image registration (DIR) algorithms: surface-based (DIRsur) and volumetric (DIRvol), and two metrics: Hounsfield unit (HU) change (VHU) and Jacobian determinant of deformation (VJac), yielding four ventilation image sets per patient. Emphysematous lung regions were detected by density masking. We tested our hypothesis using the one-tailed t-test. Visually, different DIR algorithms and metrics yielded spatially variant 4D-CT ventilation images. The mean ventilation values in emphysematous lung regions were consistently lower than in non-emphysematous regions for all the combinations of DIR algorithms and metrics. VHU resulted in statistically significant differences for both DIRsur (0.14 ± 0.14 versus 0.29 ± 0.16, p = 0.01) and DIRvol (0.13 ± 0.13 versus 0.27 ± 0.15, p < 0.01). However, VJac resulted in non-significant differences for both DIRsur (0.15 ± 0.07 versus 0.17 ± 0.08, p = 0.20) and DIRvol (0.17 ± 0.08 versus 0.19 ± 0.09, p = 0.30). This study demonstrated the strong correlation between the HU-based 4D-CT ventilation and emphysema, which indicates the potential for HU-based 4D-CT ventilation imaging to achieve high physiologic accuracy. A further study is needed to confirm these results.

  18. Correlation of Computed Tomography Imaging Features With Pain Response in Patients With Spine Metastases After Radiation Therapy

    SciTech Connect

    Mitera, Gunita, E-mail: Gunita.Mitera@Sunnybrook.ca [Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Probyn, Linda [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Ford, Michael [Department of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Donovan, Andrea; Rubenstein, Joel [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Finkelstein, Joel [Department of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Christakis, Monique [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Zhang, Liying; Campos, Sarah; Culleton, Shaelyn; Nguyen, Janet; Sahgal, Arjun; Barnes, Elizabeth; Tsao, May; Danjoux, Cyril; Holden, Lori [Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Yee, Albert [Department of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Khan, Luluel; Chow, Edward [Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2011-11-01

    Purpose: To correlate computed tomography (CT) imaging features of spinal metastases with pain relief after radiotherapy (RT). Methods and Materials: Thirty-three patients receiving computed tomography (CT)-simulated RT for spinal metastases in an outpatient palliative RT clinic from January 2007 to October 2008 were retrospectively reviewed. Forty spinal metastases were evaluated. Pain response was rated using the International Bone Metastases Consensus Working Party endpoints. Three musculoskeletal radiologists and two orthopaedic surgeons evaluated CT features, including osseous and soft tissue tumor extent, presence of a pathologic fracture, severity of vertebral height loss, and presence of kyphosis. Results: The mean patient age was 69 years; 24 were men and 9 were women. The mean worst pain score was 7/10, and the mean total daily oral morphine equivalent was 77.3 mg. Treatment doses included 8 Gy in one fraction (22/33), 20 Gy in five fractions (10/33), and 20 Gy in eight fractions (1/33). The CT imaging appearance of spinal metastases included vertebral body involvement (40/40), pedicle involvement (23/40), and lamina involvement (18/40). Soft tissue component (10/40) and nerve root compression (9/40) were less common. Pathologic fractures existed in 11/40 lesions, with resultant vertebral body height loss in 10/40 and kyphosis in 2/40 lesions. At months 1, 2, and 3 after RT, 18%, 69%, and 70% of patients experienced pain relief. Pain response was observed with various CT imaging features. Conclusions: Pain response after RT did not differ in patients with and without pathologic fracture, kyphosis, or any other CT features related to extent of tumor involvement. All patients with painful spinal metastases may benefit from palliative RT.

  19. Cingulum correlates of cognitive functions in patients with mild cognitive impairment and early Alzheimer's disease: a diffusion spectrum imaging study.

    PubMed

    Lin, Yi-Cheng; Shih, Yao-Chia; Tseng, Wen-Yih I; Chu, Yu-Hsiu; Wu, Meng-Tien; Chen, Ta-Fu; Tang, Pei-Fang; Chiu, Ming-Jang

    2014-05-01

    Diffusion spectrum imaging (DSI) of MRI can detect neural fiber tract changes. We investigated integrity of cingulum bundle (CB) in patients with mild cognitive impairment (MCI) and early Alzheimer's disease (EAD) using DSI tractography and explored its relationship with cognitive functions. We recruited 8 patients with MCI, 9 with EAD and 15 healthy controls (HC). All subjects received a battery of neuropsychological tests to access their executive, memory and language functions. We used a 3.0-tesla MRI scanner to obtain T1- and T2-weighted images for anatomy and used a pulsed gradient twice-refocused spin-echo diffusion echo-planar imaging sequence to acquire DSI. Patients with EAD performed significantly poorer than the HC on most tests in executive and memory functions. Significantly smaller general fractional anisotropy (GFA) values were found in the posterior and inferior segments of left CB and of the anterior segment of right CB of the EAD compared with those of the HC. Spearman's correlation on the patient groups showed that GFA values of the posterior segment of the left CB were significantly negatively associated with the time used to complete Color Trails Test Part II and positively correlated with performance of the logical memory and visual reproduction. GFA values of inferior segment of bilateral CB were positively associated with the performance of visual recognition. DSI tractography demonstrates significant preferential degeneration of the CB on the left side in patients with EAD. The location-specific degeneration is associated with corresponding declines in both executive and memory functions. PMID:24414091

  20. Teleteach Expanded Delivery System: Evaluation.

    ERIC Educational Resources Information Center

    Christopher, G. Ronald; Milam, Alvin L.

    In order to meet the demand for Air Force Institute of Technology (AFIT) professional continuing education (PCE) courses within the School of Systems and Logistics and the School of Engineering, the Teleteach Expanded Delivery System (TEDS) for instruction of Air Force personnel at remote locations was developed and evaluated. TEDS uses a device…

  1. Expanded Plain TEX Steven Smith

    E-print Network

    Mintmire, John W.

    Expanded Plain TEX Sept 2004 2.8.4 Karl Berry Steven Smith #12;This manual documents the Eplain Berry. Steven Smith wrote the documentation for the commutative diagram macros. (He also wrote the macros.) Some additions/corrections by Adam Lewenberg. Permission is granted to make and distribute

  2. The Expanding World Information Economy.

    ERIC Educational Resources Information Center

    Nesterov, Pyotr V.

    1991-01-01

    Three articles analyze the following aspects of the world information economy: (1) the role of the Soviet Union's information system--VINITI--in the implementation of the State STI (Scientific and Technical Information) system; (2) Britain's information policies; and (3) Europe's expanding market for information technology. (MAB)

  3. Expanding the Universe of Education.

    ERIC Educational Resources Information Center

    Parsons, Elizabeth

    1996-01-01

    Definitions of "education" and "rural" are debunked and expanded. The three major tasks of rural education are educating people to understand their own needs, the unavoidable changes that will transform rural Australia within their lifetimes, and the range of technologies that can enhance their well-being. Presents a strategy for educating…

  4. ERBU, Expanding Rubber Band Universe

    E-print Network

    Soares, Domingos

    2015-01-01

    I put forward a simple unidimensional mechanical analogue of the three-dimensional universe models of modern relativistic cosmology. The main goal of the proposal is the appropriate appreciation of the intrinsic relationship between Hubble's law and the homogeneity of expanding relativistic models.

  5. Entropy of expanding QCD matter

    E-print Network

    Tamas S Biro; Jozsef Zimanyi

    2007-04-13

    Using the lattice QCD equation of state for an isentropically expanding fireball we follow the evolution of the effective number of particles in an ideal gas pV/T. This number reduces roughly to its third around the crossover temperature, which helps to circumvent the entropy obstacle inherent in quark coalescence models of the hadronization.

  6. The Expanding Marketplace for Applied Geophysics

    NASA Astrophysics Data System (ADS)

    Carlson, N.; Sirles, P.

    2012-12-01

    While the image of geophysics for the proverbial "layman" often seems limited to volcanoes and earthquakes, and to the geoscientist this image enlarges to include oil or minerals exploration and whole earth studies, there has been a steady increase in the application of geophysics into the realm of "daily life", such as real estate deals, highway infrastructure, and flood protection. This expansion of applications can be attributed to the improved economics from advances in equipment and interpretation. Traditional geophysical methods that at one time often only fit within the budgets of oil, gas, and minerals exploration programs can now be economically applied to much smaller scale needs like contaminant mapping, landfill delineation, and levee investigations. A real-world, economic example of this expanding marketplace is our company, which began very small and was aimed almost exclusively at the minerals exploration market. Most of our growth has been in the last 10 years, when we have expanded to five offices and a staff with almost 40 geoscientist degrees (21 in geophysics); much of this growth has been in the non-oil, non-minerals arenas. While much of our work still includes minerals exploration, other projects this year include wind-farm foundation studies, cavity detection above underground nuclear tests, landfill studies, acid mine drainage problems, and leaks in evaporation ponds. A methodology example of this expanding market is the induced polarization (IP) survey, once primarily used for minerals exploration, particularly large porphyry copper deposits, but now efficient enough to also use in environmental studies. The IP method has been particularly useful in delineating and characterizing old, poorly documented landfills, and recent research suggests it may also be useful in monitoring the accelerated biodegradation processes used in some cases to rehabilitate the sites. Compared to temperature monitoring systems, IP may be more useful in providing a better image of the subsurface to locate areas that are not being properly decomposed due to poor fluid flow or inefficient air circulation.Raw IP data in traditional pseudosection format, prior to modeling, showing the change in IP effects after four years of accelerated biodegradation of an old, buried, municipal solid waste landfill. Posted values are chargeability in milliseconds.

  7. An experimental reciprocating expander for cryocooler application

    Microsoft Academic Search

    M. Minta; J. L. Smith Jr.

    1985-01-01

    An experimental reciprocating expander was designed with features appropriate for cryocooler cycles. The expander has a displacer piston, simple valves, and a hydraulic\\/pneumatic stroking mechanism. The expander has a valve in head configuration with the valves extending out the bottom of the vacuum enclosure while the piston extends out the top. The expander was tested using a CTI 1400 liquefier

  8. Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate

    SciTech Connect

    Lyons, K.P.; Milne, N.; Karlsberg, R.P.; Olson, H.G.; Kuperus, J.

    1987-07-01

    Technetium-99m 2,3-dimercaptosuccinic acid (Tc-99m DMSA) has been used successfully for imaging acute myocardial infarction in a canine model. The application in humans, however, has not been previously reported. In order to determine the feasibility of using this agent in clinical studies and to compare the agent to technetium-99m pyrophosphate (Tc-99m PPi), ten patients with proven myocardial infarction were studied. While imaging of transmural infarctions in humans was achieved using Tc-99m DMSA, scores for the Tc-99m DMSA images (1.8 +/- 0.96) were not as high as for Tc-99m PPi (2.5 +/- 0.45) (P less than 0.05). Discordance among four independent interpreters was greater for images obtained with Tc-99m DMSA. The superiority of Tc-99m PPi was evident whether images were obtained early (within 24 hours) or late (within five days). Although DMSA images were not obscured by rib uptake, they were less sensitive (63%) than Tc-99m PPi (97%). A potential advantage of Tc-99m DMSA in imaging acute myocardial infarction is that radiotracer concentration in the infarct occurs primarily in the early postinfarction period. The longer postinfarction that Tc-99m DMSA imaging was attempted, the lower the concentration of radiotracer. Thus, Tc-99m DMSA would not be expected to have the same persistence pattern as Tc-99m PPi into the remote postinfarction period. The persistent positivity of Tc-99m PPi has made it difficult to diagnose reinfarction.

  9. [Imaging protocols for the management of respiratory motions in the treatment planning of early stage lung cancer patients].

    PubMed

    Pócza, Tamás; Pesznyák, Csilla; Lövey, József; Bajcsay, András; Szilágyi, András; Almády, Balázs; Major, Tibor; Polgár, Csaba

    2015-06-01

    The aim of our work is to present the imaging techniques used at the National Institute of Oncology for taking into consideration the breathing motion at radiation therapy treatment planning. Internationally recommended imaging techniques, such as 4D CT, respiratory gating and ITV (Internal Target Volume) definition were examined. The different imaging techniques were analysed regarding the delivered dose during imaging, the required time to adapt the technique, and the necessary equipment. The differences in size of PTVs (Planning Target Volume) due to diverse volume defining methods were compared in 5 cases. For 4D CT breath monitoring is crucial, which requires special equipment. To decrease the relatively high exposure of 4D CT it is possible to scan only a few predefined breathing phases. The possible positions of the tumour can be well approximated with CT scans taken in the inhale maximum, the exhale maximum and in intermediate phase. The intermediate phase can be exchanged with an ordinary CT image set, and the extreme phase CT images can be ensured by given verbal instructions for the patient. This way special gating equipment is not required. Based on these 3 breathing phases an ITV can be defined. Using this ITV definition method the margin between the CTV (Clinical Target Volume) and the PTV can be reduced by 1 cm. Using this imaging protocol PTV can be reduced by 30%. A further 10% PTV reduction can be achieved with respiratory gating. In the routine clinical practice respiratory motion management with a 3-phase CT-imaging protocol the PTV for early-stage lung cancer can be significantly reduced without the use of 4D CT and/or respiratory gating. For special, high precision treatment techniques 4D CT is recommended. PMID:26035161

  10. MR Imaging in Patients with Suspected Liver Metastases: Value of Liver-Specific Contrast Agent Gadoxetic Acid

    PubMed Central

    Lee, Kyung Hee; Park, Ji Hoon; Kim, Jung Hoon; Park, Hee Sun; Yu, Mi Hye; Yoon, Jeong-Hee; Han, Joon Koo; Choi, Byung Ihn

    2013-01-01

    Objective To compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance (MR) imaging with that of triple-phase multidetector-row computed tomography (MDCT) in the detection of liver metastasis. Materials and Methods Our institutional review board approved this retrospective study and waived informed consent. The study population consisted of 51 patients with hepatic metastases and 62 patients with benign hepatic lesions, who underwent triple-phase MDCT and gadoxetic acid-enhanced MRI within one month. Two radiologists independently and randomly reviewed MDCT and MRI images regarding the presence and probability of liver metastasis. In order to determine additional value of hepatobiliary-phase (HBP), the dynamic-MRI set alone and combined dynamic-and-HBP set were evaluated, respectively. The standard of reference was a combination of pathology diagnosis and follow-up imaging. For each reader, diagnostic accuracy was compared using the jackknife alternative free-response receiver-operating-characteristic (JAFROC). Results For both readers, average JAFROC figure-of-merit (FOM) was significantly higher on the MR image sets than on the MDCT images: average FOM was 0.582 on the MDCT, 0.788 on the dynamic-MRI set and 0.847 on the combined HBP set, respectively (p < 0.0001). The differences were more prominent for small (? 1 cm) lesions: average FOM values were 0.433 on MDCT, 0.711 on the dynamic-MRI set and 0.828 on the combined HBP set, respectively (p < 0.0001). Sensitivity increased significantly with the addition of HBP in gadoxetic acid-enhanced MR imaging (p < 0.0001). Conclusion Gadoxetic acid-enhanced MRI shows a better performance than triple-phase MDCT for the detection of hepatic metastasis, especially for small (? 1 cm) lesions. PMID:24265564

  11. Impact of dopamine transporter single photon emission computed tomography imaging using I-123 ioflupane on diagnoses of patients with parkinsonian syndromes

    Microsoft Academic Search

    C. Bairactaris; N. Demakopoulos; G. Tripsianis; C. Sioka; D. Farmakiotis; K. Vadikolias; I. Heliopoulos; P. Georgoulias; I. Tsougos; I. Papanastasiou; C. Piperidou

    2009-01-01

    To assess the impact of I-123 ioflupane single photon emission computed tomography (SPECT) imaging on classifying patients with striatal dopaminergic deficits. Sixty-one patients with an initial diagnosis of parkinsonism or uncertain tremor disorder were screened and followed-up for one year. All patients were re-examined by two neurologists at our centre and were classified as having neurodegenerative or non-neurodegenerative disorders. Patients

  12. Do Patients With Juvenile Idiopathic Arthritis in Clinical Remission Have Evidence of Persistent Inflammation on 3T Magnetic Resonance Imaging?

    PubMed Central

    BROWN, AMANDA; HIRSCH, RAPHAEL; LAOR, TAL; HANNON, MICHAEL J.; LEVESQUE, MARC C.; STARZ, TERENCE; FRANCIS, KIMBERLY; KWOH, C. KENT

    2013-01-01

    Objective Up to 90% of adults with rheumatoid arthritis (RA) in clinical remission have persistent synovitis and/or bone marrow lesions (BMLs) on magnetic resonance imaging (MRI). MRI findings in patients with juvenile idiopathic arthritis (JIA) in clinical remission have not been described. We utilized 3T MRI with contrast enhancement to examine JIA patients with hand and/or wrist involvement who were in clinical remission and compared them with a cohort of adult RA patients. Methods In total, 11 JIA patients and 10 RA patients with arthritis involving the hands and/or wrists were identified by their primary rheumatologist as being in physician-defined clinical remission, having no signs or symptoms of active arthritis and no medication changes for at least 6 months. A study rheumatologist performed a joint evaluation for tenderness, swelling, and limitation of motion, and study participants self-reported tender joint counts. The participants underwent MRI with intravenous contrast enhancement of 1 hand and wrist with a history of prior symptoms. A pediatric musculoskeletal radiologist blinded to the clinical data scored the MRIs for synovitis, tenosynovitis, and/or BMLs. Results Sixty-three percent of the JIA cohort and 70% of the RA cohort had MRI findings of synovitis, BMLs, and/or tenosynovitis. All pediatric patients with MRI abnormalities had normal physician tender and swollen joint counts. The patients’ self-report of painful joint counts did not predict MRI abnormalities. Conclusion Over one-half of the patients in clinical remission had MRI evidence of persistent inflammation, defined as the presence of synovitis, tenosynovitis, or BMLs. A substantial portion of patients with JIA may have subclinical disease despite clinical remission. PMID:22740386

  13. Mutual-information-based image to patient re-registration using intraoperative ultrasound in image-guided neurosurgery

    PubMed Central

    Ji, Songbai; Wu, Ziji; Hartov, Alex; Roberts, David W.; Paulsen, Keith D.

    2008-01-01

    An image-based re-registration scheme has been developed and evaluated that uses fiducial registration as a starting point to maximize the normalized mutual information (nMI) between intraoperative ultrasound (iUS) and preoperative magnetic resonance images (pMR). We show that this scheme significantly (p?0.001) reduces tumor boundary misalignment between iUS pre-durotomy and pMR from an average of 2.5 mm to 1.0 mm in six resection surgeries. The corrected tumor alignment before dural opening provides a more accurate reference for assessing subsequent intraoperative tumor displacement, which is important for brain shift compensation as surgery progresses. In addition, we report the translational and rotational capture ranges necessary for successful convergence of the nMI registration technique (5.9 mm and 5.2 deg, respectively). The proposed scheme is automatic, sufficiently robust, and computationally efficient (<2 min), and holds promise for routine clinical use in the operating room during image-guided neurosurgical procedures. PMID:18975707

  14. Effect of beta blockade on single photon emission computed tomographic (SPECT) thallium-201 images in patients with coronary disease

    SciTech Connect

    Narahara, K.A.; Thompson, C.J.; Hazen, J.F.; Brizendine, M.; Mena, I.

    1989-05-01

    We evaluated the effect of beta blockers on thallium-201 (Tl-201) single photon emission computed tomographic (SPECT) imaging in 12 patients with coronary disease using an automated computer algorithm. Maximal exercise heart rate and blood pressure were reduced and exercise time was increased with beta blockers. Estimated stress defect size decreased from 47 +/- 36.3 gm during placebo treatment to 32 +/- 27.1 gm during beta blocker therapy (-32%; p less than 0.01). The placebo treatment redistribution defect was estimated to be 28 +/- 29.8 gm. It fell to 15 +/- 23.3 gm with beta blockade (-46%; p less than 0.005). All patients had a stress Tl-201 defect during placebo treatment and eight had redistribution defects consistent with residual scar. During beta blocker therapy, 2 of 12 patients had normal stress-redistribution studies and only five patients had redistribution defects. Beta blockade can reduce exercise and redistribution Tl-201 SPECT defect size significantly while simultaneously increasing exercise time and reducing angina. Beta blockers may unmask or may eliminate evidence of redistribution. Tl-201 SPECT imaging may be useful in defining the reduction in ischemia produced by cardiac drugs.

  15. Exposing medical students to expanding populations.

    PubMed

    Lindenthal, J J; DeLisa, J A; Heinrich, G F; Calderón Gerstein, W S

    2015-01-01

    Physicians are required to advocate for and counsel patients based on the best science and the interests of the individual while avoiding discrimination, ensuring equal access to health and mental services. Nonetheless, the communication gap between physician and patients has long been observed. To this end, the Institute for the Public Understanding of Health and Medicine of the Rutgers University New Jersey Medical School has expanded its efforts. This report describes two new programs: a legacy lecture series for medical students and an international "experience", in Huancayo, Peru, for medical students and faculty. The MiniMed outreach program, now in its ninth year and first described in this journal in 2012, was designed to empower the powerless to communicate more effectively with clinicians, thus improving both the effectiveness of the physician-patient relationship and health care outcomes. The approach of the two new programs and their effects on patients, particularly the underserved, and medical students and faculty, are outlined in the following article. PMID:25834472

  16. Expanding the Oral Hygiene Curriculum in a Nursing Program.

    ERIC Educational Resources Information Center

    Briggs, Susan; Griego, Elizabeth

    A program was implemented to expand the curriculum materials within the Licensed Practical Nursing (LPN) Program at Clark County Community College (CCCC) which relate to oral hygiene care for the hospital patient. The instructional materials included a video tape and a written instructional packet which were researched, prepared, and presented by…

  17. A novel algorithm for the reconstruction of an entrance beam fluence from treatment exit patient portal dosimetry images

    NASA Astrophysics Data System (ADS)

    Sperling, Nicholas Niven

    The problem of determining the in vivo dosimetry for patients undergoing radiation treatment has been an area of interest since the development of the field. Most methods which have found clinical acceptance work by use of a proxy dosimeter, e.g.: glass rods, using radiophotoluminescence; thermoluminescent dosimeters (TLD), typically CaF or LiF; Metal Oxide Silicon Field Effect Transistor (MOSFET) dosimeters, using threshold voltage shift; Optically Stimulated Luminescent Dosimeters (OSLD), composed of Carbon doped Aluminum Dioxide crystals; RadioChromic film, using leuko-dye polymers; Silicon Diode dosimeters, typically p-type; and ion chambers. More recent methods employ Electronic Portal Image Devices (EPID), or dosimeter arrays, for entrance or exit beam fluence determination. The difficulty with the proxy in vivo dosimetery methods is the requirement that they be placed at the particular location where the dose is to be determined. This precludes measurements across the entire patient volume. These methods are best suited where the dose at a particular location is required. The more recent methods of in vivo dosimetry make use of detector arrays and reconstruction techniques to determine dose throughout the patient volume. One method uses an array of ion chambers located upstream of the patient. This requires a special hardware device and places an additional attenuator in the beam path, which may not be desirable. A final approach is to use the existing EPID, which is part of most modern linear accelerators, to image the patient using the treatment beam. Methods exist to deconvolve the detector function of the EPID using a series of weighted exponentials. Additionally, this method has been extended to determine in vivo dosimetry. The method developed here employs the use of EPID images and an iterative deconvolution algorithm to reconstruct the impinging primary beam fluence on the patient. This primary fluence may then be employed to determine dose through the entire patient volume. The method requires patient specific information, including a CT for deconvolution/dose reconstruction. With the large-scale adoption of Cone Beam CT (CBCT) systems on modern linear accelerators, a treatment time CT is readily available for use in this deconvolution and in dose representation.

  18. Myocardial iron overload assessment by T2* magnetic resonance imaging in adult transfusion dependent patients with acquired anemias.

    PubMed

    Di Tucci, Anna Angela; Matta, Gildo; Deplano, Simona; Gabbas, Attilio; Depau, Cristina; Derudas, Daniele; Caocci, Giovanni; Agus, Annalisa; Angelucci, Emanuele

    2008-09-01

    Only limited data are available regarding myocardial iron overload in adult patients with transfusion dependent acquired anemias. To address this topic using MRI T2* we studied 27 consecutive chronic transfusion dependent patients with acquired anemias: (22 myelodysplastic syndrome, 5 primary myelofibrosis). Cardiac MRI T2* values obtained ranged from 5.6 to 58.7 (median value 39.8) milliseconds. Of the 24 analyzable patients, cardiac T2* correlated with transfusion burden (p=0.0002). No patient who had received less than 290 mL/kg of packed red blood cells (101 units=20 grams of iron) had a pathological cardiac T2* value (< 20 ms). All patients who had received at least 24 PRBC units showed MRI T2* detectable hepatic iron (liver T2* value patients with severe hepatic iron overload (T2* <1.4 ms) showed cardiac T2* value indicative of dangerous myocardial iron deposition. Serum ferritin was not significantly correlated with cardiac T2* (p=0.24). Gradient echo T2* magnetic resonance imaging provides a rapid and reproducible method for detecting myocardial iron overload which developed after a heavy transfusion burden equal to or greater than 290 mL/kg of packed red blood cell units. PMID:18603557

  19. An optimization based on simulation approach to the patient admission scheduling problem: diagnostic imaging department case study.

    PubMed

    Granja, Conceição; Almada-Lobo, Bernardo; Janela, Filipe; Seabra, João; Mendes, Adélio

    2014-02-01

    The growing influx of patients in healthcare providers is the result of an aging population and emerging self-consciousness about health. In order to guarantee the welfare of all the healthcare stakeholders, it is mandatory to implement methodologies that optimize the healthcare providers' efficiency while increasing patient throughput and reducing patient's total waiting time. This paper presents a case study of a conventional radiology workflow analysis in a Portuguese healthcare provider. Modeling tools were applied to define the existing workflow. Re-engineered workflows were analyzed using the developed simulation tool. The integration of modeling and simulation tools allowed the identification of system bottlenecks. The new workflow of an imaging department entails a reduction of 41 % of the total completion time. PMID:23917864

  20. Effect of rare earth filtration on patient exposure, dose reduction, and image quality in oral panoramic radiology

    SciTech Connect

    Tyndall, D.A.; Washburn, D.B.

    1987-01-01

    Rare earth intensifying screen material (Gd2O2S:Tb) was added to the standard Al filtration of an oral panoramic x-ray unit, resulting in a beam capable of achieving reductions in patient dose without a loss of image quality. The added rare earth filtration technique resulted in patient dose reductions of 21-56%, depending on anatomic sites, when compared to the conventional Al filtration technique. Films generated from both techniques were measured densitometrically and evaluated by a panel of practicing clinicians. Diagnostically significant differences were minimal. The results indicate that use of rare earth filters in oral panoramic radiography is an effective means of reducing exposures of dental patients to ionizing radiation.

  1. Implementation and evaluation of Google Glass for visualizing real-time image and patient data in the primary care office

    NASA Astrophysics Data System (ADS)

    Monroy, Guillermo L.; Shemonski, Nathan D.; Shelton, Ryan L.; Nolan, Ryan M.; Boppart, Stephen A.

    2014-02-01

    Primary care physicians must conduct a staggering number of comprehensive physical exams and medical record reviews, resulting in demanding daily schedules. Few commercial technologies have been marketed towards the primary care market, which has stifled improvements in disease screening and detection, work flow, and records management, taking time away from interactions with patients. In efforts to improve the quality of care in primary care medicine, we integrated our handheld primary care optical imaging system with Google Glass©, a commercial heads-up display (HUD). The integration of a HUD allows the physician to focus on the patient during the medical history review and during the patient exam, resulting in potential improvements to the quality of care and efficient access to real-time data for display and analysis.

  2. The Expanded Owens Valley Solar Array

    NASA Astrophysics Data System (ADS)

    Gary, Dale E.; Hurford, G. J.; Nita, G. M.; White, S. M.; Tun, S. D.; Fleishman, G. D.; McTiernan, J. M.

    2011-05-01

    The Expanded Owens Valley Solar Array (EOVSA) is now under construction near Big Pine, CA as a solar-dedicated microwave imaging array operating in the frequency range 1-18 GHz. The solar science to be addressed focuses on the 3D structure of the solar corona (magnetic field, temperature and density), on the sudden release of energy and subsequent particle acceleration, transport and heating, and on space weather phenomena. The project will support the scientific community by providing open data access and software tools for analysis of the data, to exploit synergies with on-going solar research in other wavelengths. The New Jersey Institute of Technology (NJIT) is expanding OVSA from its previous complement of 7 antennas to a total of 15 by adding 8 new antennas, and will reinvest in the existing infrastructure by replacing the existing control systems, signal transmission, and signal processing with modern, far more capable and reliable systems based on new technology developed for the Frequency Agile Solar Radiotelescope (FASR). The project will be completed in time to provide solar-dedicated observations during the upcoming solar maximum in 2013 and beyond. We provide an update on current status and our preparations for exploiting the data through modeling and data analysis tools. This research is supported by NSF grants AST-0908344, and AGS-0961867 and NASA grant NNX10AF27G to New Jersey Institute of Technology.

  3. Value of thallium-201 imaging in detecting adverse cardiac events after myocardial infarction and thrombolysis: a follow up of 100 consecutive patients.

    PubMed Central

    Basu, S.; Senior, R.; Dore, C.; Lahiri, A.

    1996-01-01

    OBJECTIVE: To determine the prognostic role of thallium-201 imaging compared with that of exercise electrocardiography in patients with acute myocardial infarction treated by thrombolysis. DESIGN: Patients who remained free of adverse cardiac events six weeks after myocardial infarction had stress and rest 201TI imaging and exercise electrocardiography and were followed up for 8-32 months. Adverse cardiac events (death, reinfarction, unstable angina, and congestive heart failure) were documented. SETTING: Large district general hospital, Middlesex. SUBJECTS: 100 consecutive male and female patients who were stable six weeks after thrombolysis for myocardial infarction. MAIN OUTCOME MEASURES: Prediction of occurrence of adverse cardiac events after myocardial infarction by exercise cardiography and 201TI myocardial perfusion imaging. RESULTS: Reversible ischaemia on 201TI imaging predicted adverse cardiac events in 33 out of 37 patients with such events during follow up (hazard ratio 8.1 (95% confidence interval 2.7 to 23.8), P < 0.001). Exercise electrocardiography showed reversible ischaemia in 33 patients, of whom 13 had subsequent events, and failed to predict events in 24 patients (hazard ratio 1.1 (0.56 to 2.2), P = 0.8). CONCLUSION: 201TI imaging is a sensitive predictor of subsequent adverse cardiac events in patients who have received thrombolysis after acute myocardial infarction, whereas exercise electrocardiography fails to predict outcome. Images Fig 1 PMID:8870569

  4. Assessment of ?-zone peripapillary atrophy by optical coherence tomography and scanning laser ophthalmoscopy imaging in glaucoma patients

    PubMed Central

    Seidensticker, Florian; Reznicek, Lukas; Mann, Thomas; Hübert, Irene; Kampik, Anselm; Ulbig, Michael; Hirneiss, Christoph; Neubauer, Aljoscha S; Kernt, Marcus

    2014-01-01

    Purpose To assess ?-zone peripapillary atrophy (?-PPA) using spectral domain optical coherence tomography (SD-OCT), scanning laser ophthalmoscopy (SLO), and fundus auto-fluorescence (FAF) imaging in patients with primary open-angle glaucoma with advanced glaucomatous visual field defects. Methods A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma were included in this study. All study participants underwent a full ophthalmic examination followed by SD-OCT, wide-field SLO, and FAF imaging of the optic nerve head and the peripapillary region. Results Eighty-four glaucomatous eyes were included in our prospective study. Correlation analyses for horizontally and vertically obtained ?-PPA for all three imaging modalities (color SLO, FAF, and SD-OCT) revealed highest correlations between FAF and color SLO (Pearson correlation coefficient: 0.904 [P<0.001] for horizontal ?-PPA and 0.786 [P<0.001] for vertical ?-PPA). Bland–Altman plotting revealed highest agreements between color SLO and FAF, with ?2.1 pixels ±1.96 standard deviation (SD) for horizontal ?-PPA, SD: 10.5 pixels and 2.4 pixels ±1.96 SD for vertical ?-PPA. Conclusion ?-PPA can be assessed using en-face SLO and cross-sectional SD-OCT imaging. Correlation analyses revealed highest correlations between color SLO and FAF imaging, while correlations between SLO and SD-OCT were weak. A more precise structural definition of ?-PPA is needed. PMID:25061270

  5. A comparison of dipyridamole-thallium imaging and exercise testing in the prediction of postoperative cardiac complications in patients requiring arterial reconstruction

    SciTech Connect

    McPhail, N.V.; Ruddy, T.D.; Calvin, J.E.; Davies, R.A.; Barber, G.G.

    1989-07-01

    The individual and combined predictive values of dipyridamole-thallium imaging and exercise testing were compared in a prospective study of 70 patients who had abdominal aortic aneurysms or aortoiliac occlusive disease that required surgical repair. All patients were evaluated clinically by the same cardiologist and had exercise stress testing and dipyridamole-thallium imaging before admission for surgery. Ten patients were excluded from the study because they had evidence of severe ischemia when tested (ST segment depression greater than 2 mm on exercise testing, severe multivessel disease on thallium imaging). The remaining 60 patients were operated on (abdominal aortic aneurysm repair, 40; aortobifemoral repair, 17; femorofemoral graft, 3). The test results were withheld from the surgeon, anesthetist, and cardiologist before surgery. A total of 22 patients experienced major cardiac complications postoperatively (acute pulmonary edema, 17; acute myocardial infarction, 5; cardiac death, 2). Thallium imaging showed myocardial ischemia in 31/60 patients. Exercise testing was positive (greater than or equal to 1 mm ST segment depression) in 10/60 patients. Dipyridamole-thallium imaging with a high sensitivity and reasonable specificity is the initial test of choice. Exercise testing is a poor screening test because of its low sensitivity. The combination of the two tests gives the highest positive predictive value and the greatest likelihood ratio. Thus patients assessed initially and found to have positive thallium scan results may be further stratified by exercise testing.

  6. SU-E-T-248: Near Real-Time Analysis of Radiation Delivery and Imaging, Accuracy to Ensure Patient Safety

    SciTech Connect

    Wijesooriya, K; Seitter, K; Desai, V; Read, P; Larner, J [University of Virginia Health Systems, Charlottesville, VA (United States)

    2014-06-01

    Purpose: To develop and optimize an effective software method for comparing planned to delivered control point machine parameters for all VARIAN TrueBeam treatments so as to permit (1) assessment of a large patient pool throughout their treatment course to quantify treatment technique specific systematic and random uncertainty of observables, (2) quantify the site specific daily imaging shifts required for target alignment, and (3) define tolerance levels for mechanical parameters and imaging parameters based on statistical analysis data gathered, and the dosimetric impact of variations. Methods: Treatment and imaging log files were directly compared to plan parameters for Eclipse and Pinnacle planned treatments via 3D, IMRT, control point, RapidArc, and electrons. Each control point from all beams/arcs (7984) for all fractions (1940) of all patients treated over six months were analyzed. At each control point gantry angle, collimator angle, couch angle, jaw positions, MLC positions, MU were compared. Additionally per-treatment isocenter shifts were calculated. Results were analyzed as a whole in treatment type subsets: IMRT, 3D, RapidArc; and in treatment site subsets: brain, chest/mediastinum, esophagus, H and N, lung, pelvis, prostate. Results: Daily imaging isocenter shifts from initial external tattoo alignment were dependent on the treatment site with < 0.5 cm translational shifts for H and N, Brain, and lung SBRT, while pelvis, esophagus shifts were ?1 cm. Mechanical delivery parameters were within tolerance levels for all sub-beams. The largest variations were for RapidArc plans: gantry angle 0.11±0.12,collimator angle 0.00±0.00, jaw positions 0.48±0.26, MLC leaf positions 0.66±0.08, MU 0.14±0.34. Conclusion: Per-control point validation reveals deviations between planned and delivered parameters. If used in a near real-time error checking system, patient safety can be improved by equipping the treatment delivery system with additional forcing functions which by-pass human error avenues.

  7. Magnetic Resonance Image Intensity Ratio, A Normalized Measure to Enable Inter-Patient Comparability of Left Atrial Fibrosis

    PubMed Central

    Khurram, Irfan M.; Beinart, Roy; Zipunnikov, Vadim; Dewire, Jane; Yarmohammadi, Hirad; Sasaki, Takeshi; Spragg, David D.; Marine, Joseph E.; Berger, Ronald D.; Halperin, Henry R.; Calkins, Hugh; Zimmerman, Stefan L.; Nazarian, Saman

    2014-01-01

    Background The measurement of late gadolinium enhanced MRI (LGE-MRI) intensity in arbitrary units (au), limits the objectivity of thresholds for focal scar detection and inter-patient comparisons of scar burden. Objective We sought to develop and validate a normalized measure, the image intensity ratio (IIR), for assessment of left atrial (LA) scar on LGE-MRI. Methods ECG- and respiratory-gated 1.5 Tesla LGE-MRI was performed in 75 patients (75% male, 62±8 years) prior to atrial fibrillation (AF) ablation. The local IIR was defined as LA myocardial signal intensity for each of 20 sectors on contiguous axial image planes divided by the mean LA blood pool image intensity. Intra-cardiac point-by-point sampled electro-anatomical map (EAM) points were co-registered with corresponding image sectors. Results The average bipolar voltage for all 8,153 EAM points was 0.9±1.1 mV. In a mixed effects model accounting for within patient clustering, and adjusting for age, LA volume and mass, body mass index, gender, CHA2DS2-VASc score, AF type, history of previous ablations, and contrast delay time, each unit increase in local IIR was associated with 91.3% decrease in bipolar LA voltage (P<0.001). Local IIR thresholds of >0.97 and >1.61 corresponded to bipolar voltage <0.5 mV and <0.1 mV, respectively. Conclusion Normalization of LGE-MRI intensity by the mean blood pool intensity results in a metric that is closely associated with intra-cardiac voltage as a surrogate of atrial fibrosis. PMID:24096166

  8. Risk stratification by regadenoson stress magnetic resonance imaging in patients with known or suspected coronary artery disease.

    PubMed

    Abbasi, Siddique A; Heydari, Bobak; Shah, Ravi V; Murthy, Venkatesh L; Zhang, Ying Yi; Blankstein, Ron; Steigner, Michael; Jerosch-Herold, Michael; Kwong, Raymond Y

    2014-10-15

    The aim of this study was to investigate the association between major adverse cardiovascular events (MACEs) and inducible ischemia on regadenoson cardiac magnetic resonance (CMR) myocardial perfusion imaging (MPI) performed at 3.0 T. Regadenoson stress CMR MPI is increasingly used to assess patients with suspected ischemia; however, its value in patient prognostication and risk reclassification is only emerging. A total of 346 patients with suspected ischemia who were referred for regadenoson CMR were studied. The prognostic association of presence of inducible ischemia by CMR with MACEs was determined. In addition, we assessed the extent of net reclassification improvement by CMR beyond a clinical risk model. There were 52 MACEs during a median follow-up period of 1.9 years. Patients with inducible ischemia were fourfold more likely to experience MACEs (hazard ratio, 4.14, 95% confidence interval 2.37 to 7.24, p <0.0001). In the best overall model, presence of inducible ischemia conferred a 2.6-fold increased hazard for MACEs adjusted to known clinical risk markers (adjusted hazard ratio 2.59, 95% confidence interval 1.30 to 5.18, p = 0.0069). Patients with no inducible ischemia experienced a low rate of cardiac death and myocardial infarction (0.6% per patient-year), whereas those with inducible ischemia had an annual event rate of 3.2%. Net reclassification improvement across risk categories (low <5%, intermediate 5% to 10%, and high >10%) by CMR was 0.29 (95% confidence interval 0.15 to 0.44), and continuous net reclassification improvement was 0.58. In conclusion, in patients with clinical suspicion of myocardial ischemia, regadenoson stress CMR MPI provides robust risk stratification. CMR MPI negative for ischemia was associated with a very low annual rate of hard cardiac events. In addition, CMR MPI provides effective risk reclassification in a substantial proportion of patients. PMID:25173444

  9. Volumic patient-specific reconstruction of muscular system based on a reduced dataset of medical images

    Microsoft Academic Search

    E. Jolivet; E. Daguet; V. Pomero; D. Bonneau; J. D. Laredo; W. Skalli

    2008-01-01

    Three-dimensional mechanical modelling of muscles is essential for various biomechanical applications and clinical evaluation, but it requires a tedious manual processing of numerous images. A muscle reconstruction method is presented based on a reduced set of images to generate an approximate parametric object from basic dimensions of muscle contours. A regular volumic mesh is constructed based on this parametric object.

  10. [Perfusion and diffusion-weighted MR imaging in the early staging and the follow-up of patients with lung cancer].

    PubMed

    Khalil, A; Thomassin-Naggara, I; Gounant, V; Nedelcu, N; Marsault, C; Carette, M-F

    2009-02-01

    Tissue characterization is a major and ultimate goal of imaging, whether morphological (Computed Tomography, Magnetic Resonance Imaging) or metabolic (PET-FDG-[18F]). Functional imaging, using the MRI, began several years ago with the perfusion of lung nodules and very recently with diffusion-weighted imaging applied to the lung cancer. The authors review the interest and the place of diffusion-weighted and perfusion MR imaging in the diagnosis, early staging and follow-up of patients with lung cancer. PMID:19306784

  11. Helical screw expander evaluation project

    NASA Technical Reports Server (NTRS)

    Mckay, R.

    1982-01-01

    A one MW helical rotary screw expander power system for electric power generation from geothermal brine was evaluated. The technology explored in the testing is simple, potentially very efficient, and ideally suited to wellhead installations in moderate to high enthalpy, liquid dominated field. A functional one MW geothermal electric power plant that featured a helical screw expander was produced and then tested with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing, operation on two-phase geothermal fluids. The Project also produced a computer equipped data system, an instrumentation and control van, and a 1000 kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  12. Helical screw expander evaluation project

    NASA Astrophysics Data System (ADS)

    McKay, R.

    1982-03-01

    A one MW helical rotary screw expander power system for electric power generation from geothermal brine was evaluated. The technology explored in the testing is simple, potentially very efficient, and ideally suited to wellhead installations in moderate to high enthalpy, liquid dominated field. A functional one MW geothermal electric power plant that featured a helical screw expander was produced and then tested with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing, operation on two-phase geothermal fluids. The Project also produced a computer equipped data system, an instrumentation and control van, and a 1000 kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  13. Accuracy of Image Coregistration of Pulmonary Lesions in Patients with Non-Small Cell Lung Cancer Using an Integrated PET\\/CT System

    Microsoft Academic Search

    Gerhard W. Goerres; Ehab Kamel; Burkhardt Seifert; Cyrill Burger; Alfred Buck; Thomas F. Hany; Gustav K. von Schulthess

    The purpose of this study was to evaluate the accuracy of image coregistration of PET and CT (PET\\/CT) images in patients with lung lesions and the influence of the breathing protocol during CT. Methods: Seventy-five patients with a solitary and well-circum- scribed pulmonary lesion (non-small cell lung cancer; size, 10-30 mm) underwent PET\\/CT on a combined scanner. CT was acquired

  14. Association of right-to-left shunt with frontal white matter lesions in T2-weighted MR imaging of stroke patients

    Microsoft Academic Search

    Jian-Ren Liu; Björn-Moritz Plötz; Axel Rohr; Robert Stingele; Olav Jansen; Karsten Alfke

    2009-01-01

    Introduction  Cardiac right-to-left shunt (RLS), mainly due to patent foramen ovale (PFO), is a risk factor for paradoxical embolism and\\u000a stroke. Results of studies about brain lesions in diffusion-weighted imaging (DWI) in PFO patients were controversial. DWI\\u000a only detects acute ischemic lesions. We assessed the hypothesis that, in T2-weighted magnetic resonance imaging (T2WI) of\\u000a stroke patients, RLS is associated with a

  15. Stress myocardial imaging in patients with mitral valve prolapse: evidence of a perfusion abnormality

    SciTech Connect

    Butman, S.; Chandraratna, P.A.; Milne, N.; Olson, H.; Lyons, K.; Aronow, W.S.

    1982-01-01

    Twenty-four patients with mitral valve prolapse underwent cardiac catheterization, exercise testing, and exercise /sup 201/T1 scintigraphy. Of 10 patients with coronary artery disease, six had abnormal scintigrams. Two of these six had exercise-induced reversible defects, two had defects that persisted during redistribution, and two had both reversible and persistent defects. Of 14 patients with normal coronary arteries, five had negative scintigrams. Of the remaining nine patients, two had exercise-induced defects, and seven (50%) had defects involving the inferior or posterior wall that persisted during redistribution. Possible mechanisms for this latter finding are discussed. In contrast to previous reports, exercise /sup 201/T1 scintigraphy was not entirely successful in identifying patients with coronary artery disease in our patients with mitral valve prolapse.

  16. Decreased activation of the lateral geniculate nucleus in a patient with anisometropic amblyopia demonstrated by functional magnetic resonance imaging.

    PubMed

    Miki, Atsushi; Liu, Grant T; Goldsmith, Zachariah G; Liu, Chia-Shang J; Haselgrove, John C

    2003-01-01

    Although postmortem morphological changes in the lateral geniculate nucleus (LGN) have been reported in human amblyopia, LGN function during monocular viewing by amblyopic eyes has not been documented in humans. We used functional magnetic resonance imaging (fMRI) to study monocular visual activation of the LGN in a patient with anisometropic amblyopia. Four normal subjects, a patient with optic neuritis and a patient with anisometropic amblyopia were studied with fMRI at 1.5 T during monocular checkerboard stimulation. Activated areas in the LGN and visual cortex were identified after data processing (motion correction and spatial normalization) with SPM99. In the 4 normal subjects, comparable activation of the LGN and visual cortex was obtained by stimulation of either the right or left eye. In the patient with unilateral optic neuritis, activation of the LGN and visual cortex was markedly decreased when the affected eye was stimulated. Similarly, decreased activation of the LGN as well as the visual cortex by the affected eye was demonstrated in the patient with anisometropic amblyopia. Our preliminary results suggest that activation of the LGN is diminished during monocular viewing by affected eyes in anisometropic amblyopia. fMRI appears to be a feasible method to study LGN activity in human amblyopia. PMID:12913328

  17. The key role of the radiologist in the management of polytrauma patients: indications for MDCT imaging in emergency radiology.

    PubMed

    Schueller, Gerd; Scaglione, Mariano; Linsenmaier, Ulrich; Schueller-Weidekamm, Claudia; Andreoli, Chiara; De Vargas Macciucca, Marina; Gualdi, Gianfranco

    2015-07-01

    Trauma causes greater losses of life years and it is the most common cause of death for people under the age of 45. Time is one of the most relevant factors for the survival of injured patients, particularly the time elapsed from trauma until the resuscitation procedures. As a member of the trauma team, the radiologist contributes to the rapid diagnosis of traumatic disorders, with appropriate imaging modalities. Based on the evidence, the most appropriate diagnostic tool for severe/multiple trauma is computed tomography (CT). With the advent of multidetector CT (MDCT), radiologists are able to more effectively characterize life-threatening traumatic disorders within a few seconds in stable or stabilized patients. Considering the diagnostic potential of MDCT, conventional radiographs could be virtually abandoned in the diagnostic algorithms for adult polytraumatized patients. The radiologist helps to facilitate triage and to assess the optimal individual treatment for polytrauma patients, thus contributing to the improvement of patient outcomes. In this article, the indications for MDCT in the polytrauma setting are discussed. PMID:25634793

  18. Investigation of new flow modifying endovascular image-guided interventional (EIGI) techniques in patient-specific aneurysm phantoms (PSAPs) using optical imaging

    NASA Astrophysics Data System (ADS)

    Sherman, J. R.; Rangwala, H. S.; Ionita, C. N.; Dohatcu, A. C.; Lee, J. W.; Bednarek, D. R.; Hoffmann, K. R.; Rudin, S.

    2008-03-01

    Effective minimally invasive treatment of cerebral bifurcation aneurysms is challenging due to the complex and remote vessel morphology. An evaluation of endovascular treatment in a phantom involving image-guided deployment of new asymmetric stents consisting of polyurethane patches placed to modify blood flow into the aneurysm is reported. The 3D lumen-geometry of a patient-specific basilar-artery bifurcation aneurysm was derived from a segmented computed-tomography dataset. This was used in a stereolithographic rapid-prototyping process to generate a mold which was then used to create any number of exact wax models. These models in turn were used in a lost-wax technique to create transparent elastomer patient-specific aneurysm phantoms (PSAP) for evaluating the effectiveness of asymmetric-stent deployment for flow modification. Flow was studied by recording real-time digitized video images of optical dye in the PSAP and its feeding vessel. For two asymmetric stent placements: through the basilar into the right-posterior communicating artery (RPCA) and through the basilar into the left-posterior communicating artery (LPCA), the greatest deviation of flow streamlines away from the aneurysm occurred for the RPCA stent deployment. Flow was also substantially affected by variations of inflow angle into the basilar artery, resulting in alternations in washout times as derived from time-density curves. Evaluation of flow in the PSAPs with real-time optical imaging can be used to determine new EIGI effectiveness and to validate computational-fluid-dynamic calculations for EIGI-treatment planning.

  19. Investigation of new flow modifying endovascular image-guided interventional (EIGI) techniques in patient-specific aneurysm phantoms (PSAPs) using optical imaging

    PubMed Central

    Sherman, JR; Rangwala, HS; Ionita, CN; Dohatcu, AC; Lee, JW; Bednarek, DR; Hoffmann, KR; Rudin, S

    2008-01-01

    Effective minimally invasive treatment of cerebral bifurcation aneurysms is challenging due to the complex and remote vessel morphology. An evaluation of endovascular treatment in a phantom involving image-guided deployment of new asymmetric stents consisting of polyurethane patches placed to modify blood flow into the aneurysm is reported. The 3D lumen-geometry of a patient-specific basilar-artery bifurcation aneurysm was derived from a segmented computed-tomography dataset. This was used in a stereolithographic rapid-prototyping process to generate a mold which was then used to create any number of exact wax models. These models in turn were used in a lost-wax technique to create transparent elastomer patient-specific aneurysm phantoms (PSAP) for evaluating the effectiveness of asymmetric-stent deployment for flow modification. Flow was studied by recording real-time digitized video images of optical dye in the PSAP and its feeding vessel. For two asymmetric stent placements: through the basilar into the right-posterior communicating artery (RPCA) and through the basilar into the left-posterior communicating artery (LPCA), the greatest deviation of flow streamlines away from the aneurysm occurred for the RPCA stent deployment. Flow was also substantially affected by variations of inflow angle into the basilar artery, resulting in alternations in washout times as derived from time-density curves. Evaluation of flow in the PSAPs with real-time optical imaging can be used to determine new EIGI effectiveness and to validate computational-fluid-dynamic calculations for EIGI-treatment planning. PMID:18946513

  20. Images

    Microsoft A