Search PubMed⌕ Search

Biomedical subjects

A H Karantanas

Publications and source records attributed to A H Karantanas.

At least 37 records · Page 2Linked to original sources

Electron density of tissues and breast cancer radiotherapy: a quantitative CT study.

PURPOSE: To obtain more accurate data on the electron density of tissues to be used in the treatment planning of breast cancer patients. METHODS AND MATERIALS: Single kVp quantitative computed tomography was applied in 70 women, 20 to 77 years old, to study the electron density of the breast, the thoracic wall close and parallel to the breast, and the lung parenchyma. RESULTS: The electron density of the entire breast decreases with increasing age in premenopausal women and remains practically constant in postmenopausal women (8% less than that of water). No difference was found in the electron densities of the right and left breast. The electron density of the lung parenchyma in proximity to the breast is lower than the density in the entire lung parenchyma. CONCLUSIONS: Whenever no accurate data is available on individual patients, the electron density values to be used in treatment planning for breast and thoracic wall have to take into account both age and menstrual status. The regional differences in electron density of the lung also have to be considered.

Adult↗

Dimensions of the lumbar spinal canal: variations and correlations with somatometric parameters using CT.

The aim of this study was to investigate the correlation of vertebral dimensions with somatometric parameters in patients without clinical symptoms and radiological signs of central lumbar spinal stenosis. One hundred patients presenting with low back pain or sciatica were studied with CT. In each of the L3, L4 and L5 vertebra three slices were taken with the following measurements: 1. Slice through the intervertebral disc: (a) spinal canal area; (b) interarticular diameter; (c) interligamentous diameter. 2. Slice below the vertebral arcus: (a) dural sac area; (b) vertebral body area. 3. Pediculolaminar level: (a) anteroposterior diameter and interpedicular diameter of the spinal canal; (b) spinal canal area; (c) width of the lateral recesses. The Jones-Thomson index was also estimated. The results of the present study showed that there is a statistically significant correlation of height, weight and age with various vertebral indices. The conventional, widely accepted, anteroposterior diameter of 11.5 mm of the lumbar spinal canal is independent of somatometric parameters, and it is the only constant measurement for the estimation of lumbar spinal stenosis with a single value. The present study suggests that there are variations of the dimensions of the lumbar spinal canal and correlations with height, weight and age of the patient.

Adult↗

Amount and composition of bone minerals in chronic liver disease.

Alterations in bone mineral are a common complication of chronic liver disease. The aim of the current study was to assess bone mineral status in patients with chronic liver disease not treated with corticosteroids and to investigate any possible correlation with the histological stage of liver disease. Bone mineral status in 27 patient with chronic active hepatitis, and 17 with active cirrhosis was compared to that of matched controls. Partial body neutron activation analysis was applied for measuring hand bone phosphorus, single-photon absorptiometry for measuring forearm bone mineral content, and dual-energy x-ray absorptiometry for measuring spinal bone mineral density. These noninvasive measurements were supplemented with data obtained by high resolution radiography and biochemistry. Decreased metacarpal cortical thickness was found in five patients, all in the cirrhotic group. In addition, both mean intact parathyroid hormone and 25-hydroxyvitamin D levels were reduced in this group of patients. The mean values of the quantities assessed by the in vivo techniques in patients in the early stages of the hepatic disease did not differ statistically from those of matched normal controls. On the contrary, these quantities were reduced by 9% in the patients at the late stages relative to controls. In conclusion, only the late stages of liver disease are associated with an increased risk of fractures.

Absorptiometry, Photon↗

Software upgrading in a CT scanner. Influence on quantitative CT.

PURPOSE: In an attempt to improve field uniformity and CT number stability, the software in a CT scanner was replaced with a new version. The purpose of the present study was to investigate the influence of the software upgrading on density measurements. MATERIAL AND METHODS: The upgrading influence was investigated by means of a torso phantom (European spinal). The phantom simulates a torso which contains 3 vertebrae of different densities. RESULTS: Despite the use of a reference standard under the phantom, the software change resulted in: a) improved short-term precision; b) increased density values at 80 and 100 kVp, decreased at 130 kVp; and c) increased influence of the kVp on the values. CONCLUSION: The results of the present study suggest that conversion factors have to be used in density values for reference populations as well as in the values of patients undergoing follow-up studies.

Absorptiometry, Photon↗

Quantitative computed tomography for spinal bone mineral measurements in chronic renal failure.

The aim of this study was to assess non-invasively the status of spinal trabecular bone in patients with chronic renal failure and the influence of the disease stage. Single energy quantitative computed tomography (CT) was used in 89 patients with chronic renal failure to measure spinal trabecular bone equivalent density. 23 patients were independent of dialysis and 66 were receiving long-term haemodialysis. Spinal trabecular bone density of the patients was compared with locally determined normal ranges. Although trabecular bone mineral density (BMD) was lower (9% on average) in the patients who were not dependent on dialysis compared with the predicted mean normal values (BMDp) for age- and sex-matched normal subjects, the difference was not statistically significant. A statistically significant reduction was found in patients on dialysis (BMD/BMDp 0.75 +/- 0.16, Z-score -1.3). Osteosclerosis was found in 11 patients and they were excluded from the study. Longitudinal measurements in 42 patients on dialysis without osteosclerosis showed a 2.9% mean reduction in BMD/BMDp over a period of 8 months. All but one of the 16 haemodialysis patients with osteopenic spinal fractures had trabecular BMD values lower than the fracture threshold determined by our technique. In conclusion, end-stage chronic renal failure was associated with reduction in the spinal trabecular bone density.

Adult↗

Benign postpartum pleural effusion.

The conditions of labour appear to favour the development of pleural effusion. The frequency of postpartum pleural effusion was investigated in this study using thoracic ultrasonography. Thirty one postpartum and 22 healthy nonpregnant women of the same age-group were examined, both supine and seated, via an intercostal approach. Seven of the 31 (23%) postpartum women had pleural effusion within 1-24 h of normal delivery. None of the nonpregnant women had pleural effusion. No correlation was found between postpartum pleural effusion and age, weight-gain during pregnancy, duration of labour, use of intravenous fluid, or oxytocin administration. Pleural effusion seems to be a common finding postpartum, but of no clinical significance.

Adult↗

Bone mineral status after renal transplantation. Assessment by noninvasive techniques.

RATIONALE AND OBJECTIVES: Bone mineral status in recipients of renal grafts is related to preexisting renal osteodystrophy and immunosuppressive treatment. The authors assessed bone mineral status after renal transplantation. METHODS: Bone mineral status of 20 male graft recipients was evaluated using the following noninvasive techniques: 1) neutron activation analysis, to measure hand bone phosphorus (HBP); 2) single photon absorptiometry, to measure forearm bone mineral content (BMC); and 3) single energy spectrum quantitative computed tomography, to measure spinal trabecular bone equivalent density (TBED). RESULTS: The mean (+/- SD, P) HBP, BMC, and TBED were found to be respectively, 4.8% (+/- 8.3%, P = .02), 6.6% (+/- 14.6%, P = .07) and 52% (+/- 8.5%, P < .001) lower than that measured in matched normal controls. Renal graft recipients demonstrated mean HBP and BMC decrements that were similar to those observed in matched patients on extrarenal dialysis, although the decrement in TBED was significantly greater in the graft recipients (P < .001). Repeated measurements performed during a 3-year period showed no statistically significant changes. CONCLUSIONS: Renal transplantation was associated with minor degree of osteopenia in the primarily cortical bone tissue. We speculate that the remarkably low TBED values in graft recipients does not reflect a mean 52% decrement of spinal bone minerals, but rather may be attributed in part to the deposition of adipose tissue in the spine as a result of corticosteroid treatment.

Absorptiometry, Photon↗

Quantitative computed tomography for bone mineral measurement: technical aspects, dosimetry, normal data and clinical applications.

A single KVp quantitative CT (QCT) technique was used for measuring the spinal trabecular bone density. The trabecular bone equivalent density (TBED) was expressed as the density of a K2HPO4 solution that exhibits a linear attenuation coefficient identical to that of trabecular bone. A field non-uniformity correcting factor was obtained from experiments on phantoms. The effective equivalent dose of the whole examination (four sections and a scout view) is 370 muSv. The in vivo short-term precision (reproducibility coefficient of variation) ranges from 1.4% to 4.1% depending on the TBED values of the normal subjects. The TBED was measured in 206 normal Greeks aged 30-69 years. Average TBED decreased with increasing age for both sexes. Analysis considering separately each vertebra showed a tendency to a caudal spinal TBED reduction. No correlation was found between the TBED values and the body habitus, milk consumption, smoking habits in men, and number of full-term pregnancies. A significant difference (p less than 0.01) was found between the TBED values of the normals and those of 50 women suffering from post-menopausal osteoporosis, 37 alcoholic men, and 12 gastrectomized men (Billroth II). Quantitative CT has been established as a method of measuring TBED in health and disease, and the results from this study confirm these applications.

Adult↗

Limitations of quantitative CT in corticosteroid induced osteopenia.

Single energy spectrum quantitative CT (SES-QCT) was applied for the assessment of the trabecular bone mineral status in patients under long-term corticosteroid treatment. Seventeen renal graft recipients (RGR) and 12 patients receiving corticosteroid treatment for collagen disease were studied. A reduction of about 40% in the spinal trabecular bone density relative to matched controls was found, associated with the corticosteroid administration. Repeated measurements showed significant reduction in density 4 months after transplantation, and an increase in density after graft rejection. Radiologic or clinical evidence of osteopenia in the spine was not found. Other noninvasive techniques, applied in the upper extremities of the RGR, showed only minor bone reduction compared to controls. The findings of the present study suggest that adipose tissue deposition in the spinal trabeculae can introduce errors in the measurements. Therefore, SES-QCT should not be applied during corticosteroid therapy.

Adult↗

Can treatment with methotrexate influence the radiological progression of rheumatoid arthritis?

We have recently reported that methotrexate (MTX) is an effective treatment of patients with refractory rheumatoid arthritis (RA) to second line medication. We showed that 54% of our patients continued having clinical benefit after 24 months therapy with MTX. In this study we evaluated pairs of hand radiographs from 35 patients taken before and after 24 months treatment. We used a scale scoring similar to Larsen's standard radiographs with minor modifications. No significant changes were observed in the overall scoring of the radiographs before (14.84 +/- 13.05) and after treatment (18.77 +/- 15.60) (p greater than 0.5). Of these 35 patients, 23 had a clinical remission and 12 had a good response. Twenty patients have shown a stabilization of erosions in radiographs while 15 showed a deterioration. No correlation was found between clinical response and radiological changes. We conclude that MTX does not appear to be a disease modifying agent, but may inhibit joint damage progression.

Arthritis, Rheumatoid↗

T2-weighted magnetic resonance imaging of the liver: comparison of fat-suppressed GRASE with conventional spin echo, fat-suppressed turbo spin echo, and gradient echo at 1.0 T.

BACKGROUND: Fat-suppressed T2-weighted gradient and spin echo (GRASE) magnetic resonance imaging in the liver was compared with three other sequences: conventional spin echo (SE), fat-suppressed and respiratory-triggered turbo SE (TSE), and fast field echo (FFE). METHODS: All sequences were applied in 48 prospective patients. Quantitative and qualitative analyses were performed. Biopsy or clinical follow-up established the final diagnosis of the lesions. RESULTS: GRASE showed the second best contrast-to-noise ratio, the second best artifact level, the same lesion detectability as TSE, and very short acquisition time. GRASE and TSE had the highest sensitivity, specificity, and accuracy. CONCLUSION: Fat-suppressed GRASE offers a fast and accurate method for imaging the liver.

Adult↗

Echinococcus of the pulmonary artery: CT, MRI and MRA findings.

The location of echinococcal cysts inside pulmonary artery is extremely rare. The cause is usually rupture of intracardiac cysts. We report a case of a 67-year-old patient with known lung hydatid disease whose main clinical presentation was dyspnea. The patient did not have any surgery in the past. The importance of the present case lies in the demonstration of the MR angiographic findings.

Aged↗