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E Moser

Publications and source records attributed to E Moser.

At least 55 records · Page 3Linked to original sources

Co-registration of EEG and MRI data using matching of spline interpolated and MRI-segmented reconstructions of the scalp surface.

Accurate co-registration of MRI and EEG data is indispensable for the correct interpretation of EEG maps or source localizations in relation to brain anatomy derived from MRI. In this study, a method for the co-registration of EEG and MRI data is presented. The method consists of an iterative matching of EEG-electrode based reconstructions of the scalp surface to scalp-segmented MRIs. EEG-electrode based surface reconstruction is achieved via spline interpolation of individually digitized 3D-electrode coordinates. In contrast to other approaches, neither fiducial determination nor any additional provisions (such as bite bars, other co-registration devices or head shape digitization) are required, and co-registration errors associated with inaccurate fiducial determination are avoided. The accuracy of the method was estimated by calculating the root-mean-square (RMS) deviation of spline interpolated and MRI-segmented surface reconstructions in 20 subjects. In addition, the distance between co-registered and genuine electrode coordinates was assessed via a simulation study, in which surface reconstruction was based on virtual electrodes determined on the scalp surface of a high-resolution MRI data set. The mean RMS deviation of surface reconstructions was 2.43 mm, and the maximal distance between any two matched surface points was 5.06 mm. The simulated co-registration revealed a mean deviation of genuine and co-registered electrode coordinates of 0.61 mm. It is concluded that surface matching using spline interpolated reconstructions of scalp surfaces is a precise and highly practicable method to co-register EEG and MRI data.

Adult↗

High-resolution polymer gel dosimetry by parameter selective MR-microimaging on a whole body scanner at 3T.

High dose variations across small spatial distances, as present in brachytherapeutic applications or radiosurgery and especially gamma-knife therapy, are difficult to quantify by standard dosimetry. We demonstrate the possibility to obtain planar spatial resolutions for dose imaging at pixel sizes below 200 microm within multislice parameter selective MR imaging on polymer gels. The sensitivity of the transversal and longitudinal relaxation time as well as diffusivity on dose is shown. High spatial resolution is achieved by parameter selective microimaging of polymer gels on a high-field (3 T) whole-body MR system equipped with a dedicated strong gradient system and a small probe head matched to the sample size. In addition to the spin-spin relaxation rate R2 = 1/T2 we investigate the sensitivity of the longitudinal relaxation rate R1 = 1/T1 and the diffusivity Dapp in acrylic polymer gels on irradiation up to dose levels of about 20 Gy. Dose images are obtained after calibration of the corresponding MR parameters by known dose levels of gamma irradiation. Also the MR-parameter T1 may be used for dose imaging. The impact of all of the three parameters T1, T2, and diffusivity on obtained signal intensities in irradiated regions has to be taken into account in nonoptimized pulse sequences. Further, very high spatial resolution imposes several restrictions on the evaluation of R2, which have to be considered for quantitative dosimetry. These restrictions are discussed in detail. We also demonstrate the importance of such a high spatial resolution in case of a set of differently sized gamma-knife stereotactic irradiation schemes. Gel dosimetry based on MR parameter selective microimaging represents a potent alternative for the detection of dose distributions characterized by steep dose gradients, typical in brachytherapeutic and radiosurgical applications.

Calibration↗

Metastatic lymph nodes in patients with cervical cancer: detection with MR imaging and FDG PET.

PURPOSE: To compare the diagnostic accuracy of magnetic resonance (MR) imaging with that of positron emission tomography (PET) with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) for detecting metastatic lymph nodes in patients with cervical cancer. MATERIALS AND METHODS: Before radical hysterectomy and pelvic lymphadenectomy in 35 patients with International Federation of Gynecology and Obstetrics stage IB or II cervical cancer, abdominal FDG-PET and MR imaging were performed. Malignancy criteria were a lymph node diameter of 1 cm or more at MR imaging and a focally increased FDG uptake at PET. The findings of FDG-PET and MR imaging were compared with histologic findings. RESULTS: Histologic examination revealed pN0-stage cancer in 24 patients and pN1-stage cancer in 11 patients. On a patient basis, node staging resulted in sensitivities of 0.91 with FDG-PET and 0.73 with MR imaging and specificities of 1.00 with FDG-PET and 0.83 with MR imaging. The positive predictive value (PPV) of FDG-PET was 1.00 and that of MR imaging, 0.67 (not significant). The metastatic involvement of lymph node sites was identified at FDG-PET with a PPV of 0.90; at MR imaging, 0.64 (P <.05, Fisher exact test). CONCLUSION: Metabolic imaging with FDG-PET is an alternative to morphologic MR imaging for detecting metastatic lymph nodes in patients with cervical cancer.

Adult↗

Whole-body 18F dopa PET for detection of gastrointestinal carcinoid tumors.

PURPOSE: To evaluate fluorine 18 (18F) dopa positron emission tomography (PET) in comparison with established imaging procedures in gastrointestinal carcinoid tumors. MATERIALS AND METHODS: After evaluation of the normal distribution of 18F dopa, 17 patients with histologically confirmed tumors were examined with 18F dopa PET. Results of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) PET, somatostatin-receptor scintigraphy, and morphologic imaging (computed tomography and/or magnetic resonance imaging) were available for all patients. Results of the procedures were evaluated by two radiologists and two nuclear medicine specialists, whose consensus based on all available histologic, imaging, and follow-up findings was used as the reference standard. RESULTS: Ninety-two tumors were diagnosed: eight primary tumors, 47 lymph node metastases, and 37 organ metastases. 18F dopa PET led to 60 true-positive findings (seven primary tumors, 41 lymph node metastases, 12 organ metastases); FDG PET, 27 (two primary tumors, 14 lymph node metastases, 11 organ metastases); somatostatin-receptor scintigraphy, 52 (four primary tumors, 27 lymph node metastases, 21 organ metastases); and morphologic imaging, 67 (two primary tumors, 29 lymph node metastases, 36 organ metastases). This resulted in the following overall sensitivities: 18F dopa PET, 65% (60 of 92); FDG PET, 29% (27 of 92); somatostatin-receptor scintigraphy, 57% (52 of 92); morphologic procedures, 73% (67 of 92). Although the morphologic procedures were most sensitive for organ metastases, 18F dopa PET enabled best localization of primary tumors and lymph node staging. CONCLUSION: 18F dopa PET is a promising procedure and useful supplement to morphologic methods in diagnostic imaging of gastrointestinal carcinoid tumors.

Adult↗

Spatial distribution of prostate cancers undetected on initial needle biopsies.

OBJECTIVES: The spatial distribution of cancer foci of prostate carcinomas with negative initial biopsies was compared to that of prostate carcinomas with positive initial biopsies to detect areas in which carcinomas were more frequently located when the initial biopsy was negative. METHODS: Twenty patients with prostate cancer and a negative initial biopsy trial were detected among 218 patients with preceding systematic biopsies (9.2%) in our hospital. Analysis of the prostatectomy specimens regarding cancer distribution, multifocality, tumour size, Gleason score, and stage was performed using pathohistological techniques and three-dimensional computer reconstruction. RESULTS: Prostatectomy specimens with negative initial biopsies showed more frequently cancer foci in apical (p<0.0001) and dorsal (p<0.02) prostatic compartments, higher incidence of multifocality (p<0.01), and smaller size of carcinoma foci (p<0.00003) compared to carcinomas in 81 stage-matched prostatectomy specimens with positive initial biopsies. Comparing both groups, no significant differences were noted in Gleason score of preoperative biopsies and prostatectomies, prostate weight, prostate-specific antigen (PSA) level, digital rectal examination, and patients age. CONCLUSIONS: Missing the cancer in clinically significant prostate carcinomas by current systematic biopsy techniques may also be due to an apico-dorsal cancer location, particularly in combination with multifocality and small size of carcinoma foci in large prostates. In case of reasonable clinical suspicion of prostate cancer and negative initial biopsy, an early repeat biopsy with special emphasis on the apico-dorsal peripheral zone should be envisaged.

Biopsy, Needle↗

Increased metabolic activity in the thymus gland studied with 18F-FDG PET: age dependency and frequency after chemotherapy.

UNLABELLED: This study was designed to evaluate the age dependency of 18F-FDG uptake in the thymus and the frequency of PET confirmation of thymus hyperplasia after chemotherapy in cancer patients. METHODS: Whole-body FDG PET recordings of 168 patients were retrospectively examined for a retrosternal lesion in the anterior mediastinum that was attributable to the thymus. The patients were assigned to the following four groups: children with malignant lesions before the first therapy (group Ia; n = 15; mean age +/- SD, 11.9 +/- 3.7 y), children with malignant disease after chemotherapy (group Ib; n = 12; mean age, 10.3 +/- 5.0 y), adults with histologically confirmed malignant lymphoma before the first therapy (group IIa; n = 37; mean age, 43.9 +/- 16.7 y), and adult lymphoma patients 3 wk to 4 mo after chemotherapy (group IIb; n = 104; mean age, 40.9 +/- 14.6 y). RESULTS: Increased FDG accumulation in the thymus was seen in 11 patients (73%) of group Ia and 9 patients (75%) of group Ib. Thymus hyperplasia was found in 5 patients (5%) of group IIb. The eldest of these 5 patients was 25 y old. No increased FDG accumulation in the thymus was observed in any of the group IIa patients. In cases of visible FDG uptake in the thymus, standardized uptake values did not exceed 4. CONCLUSION: FDG accumulation in the thymus is a common finding in children and can occasionally be observed in young adults after chemotherapy. Knowledge of the characteristics of a typical retrosternal lesion in conjunction with the clinical history allows avoidance of diagnostic uncertainty and unnecessary procedures.

Adolescent↗

Radioisotope albumin flux measurement of microvascular lung permeability: an independent parameter in acute respiratory failure?

AIM: To evaluate the extent to which single measurements of microvascular lung permeability may be relevant as an additional parameter in a heterogenous clinical patient collective with Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS). METHODS: In 36 patients with pneumonia (13), non pneumogenic sepsis (9) or trauma (14) meeting the consensus conference criteria of ALI or ARDS double-isotope protein flux measurements (51Cr erythrocytes as intravascular tracer, Tc-99m human albumin as diffusible tracer) of microvascular lung permeability were performed using the Normalized Slope Index (NSI). The examination was to determine whether there is a relationship between the clinical diagnosis of ALI/ARDS, impaired permeability and clinical parameters, that is the underlying disease, oxygenation, duration of mechanical ventilation and mean pulmonary-artery pressure (PAP). RESULTS: At the time of study, 25 patients presented with increased permeability (NSI > 1 x 10(-3) min-1) indicating on exudative stage of disease, and 11 patients with normal permeability. The permeability impairment correlated with the underlying disease (p > 0.05). With respect to survival, there was a negative correlation to PAP (p < 0.01). Apart from that no correlations between the individual parameters were found. Especially no correlation was found between permeability impairment and oxygenation, duration of disease or PAP. CONCLUSION: In ALI and ARDS, pulmonary capillary permeability is a diagnostic parameter which is independent from clinical variables. Permeability measurement makes a stage classification (exudative versus non exudative phase) of ALI/ARDS possible based on a measurable pathophysiological correlate.

Adult↗

[Clinical PET activities in European and Asia-Oceanian countries].

Clinical diagnosis using positron emission tomography (PET) requires high costs. Therefore, sociomedical evaluation is very important for spread of clinical PET. In this report, sociomedical situation in European and Asia-Oceanian countries, especially concerning transportation of 18F-FDG and reimbursement of medical costs for clinical PET indications, is reported. It seems that UK, Germany and Belgium are the most advanced in clinical PET in Europe. In these countries, many PET investigations are reimbursed though systems are different among the countries. In UK, both public and private insurance gives authorization for clinical PET to some extent. In Germany, private health insurance companies give authorization but public insurance has not. In Belgium, private health insurance does not exist and public insurance gives authorization for clinical PET. Other European countries seem to be in transitional stages. Transportation of 18F-FDG has been already started in almost every country in Europe and Asia-Oceania. In Japan, neither transportation of FDG nor full reimbursement of clinical PET has not started yet and this situation seems to be exceptional. To promote clinical PET in Japan, there is the need of at least establishing a list of clinical indications for PET investigations and establishing commercial-based 18F-FDG supplying system. They could be regarded as a kind of infrastructure for spread of clinical PET.

Asia↗

Multivoxel 3D proton spectroscopy in the brain at 1.5 versus 3.0 T: signal-to-noise ratio and resolution comparison.

BACKGROUND AND PURPOSE: The new 3.0-T imagers theoretically yield double the signal-to-noise ratio (SNR) and spectral resolution of 1.5-T instruments. To assess the possible improvements for multivoxel 3D proton MR spectroscopy (1H-MRS) in the human brain, we compared the SNR and spectral resolution performance with both field strengths. METHODS: Three-dimensional 1H-MRS was performed in four 21-29-year-old subjects at 1.5 and 3.0 T. In each, a volume of interest of 9 x 9 x 3 cm was obtained within a field of view of 16 x 16 x 3 cm that was partitioned into four (0.75-cm-thick) 16 x 16-voxel sections, yielding 324 (0.75-cm3) signal voxels per examination. RESULTS: In an acquisition protocol of approximately 27 min, average voxel SNRs increased 23-46% at 3.0 versus 1.5 T in the same brain regions of the same subjects. SNRs for N-acetylaspartate, creatine, and choline, respectively, were as follows: 15.3 +/- 4, 8.2 +/- 2.2, and 8.0 +/- 2.0 at 1.5 T and 22.4 +/- 7.0, 10.1 +/- 3.5, and 10.1 +/- 3.6 at 3.0 T. Spectral resolution (metabolite linewidths) were 3.5 +/- 0.5 Hz at 1.5 T versus 6.1 +/- 1.5 Hz at 3.0 T in approximately 900 voxels. Spectral baselines were noticeably flatter at 3.0 T. CONCLUSION: Expected gains in SNR and spectral resolution were not fully realized in a realistic experiment because of intrinsic and controllable factors. However, the 23-46% improvements obtained enable more reliable peak-area estimation and an 1H-MRS acquisition approximately 50% shorter at 3.0 versus 1.5 T.

Adult↗

[Assessment of left ventricular function and volume by myocardial perfusion scintigraphy--comparison of two algorithms].

AIM: Left ventricular volume and function can be computed from gated SPECT myocardial perfusion imaging using Emory Cardiac Toolbox (ECT) or Gated SPECT Quantification (GS-Quant). The aim of this study was to compare both programs with respect to their practical application, stability and precision on heart-models as well as in clinical use. METHODS: The volumes of five cardiac models were calculated by ECT and GS-Quant. 48 patients (13 female, 35 male) underwent a one day stress-rest protocol and gated SPECT. From these 96 gated SPECT images, left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ECT and GS-Quant. For 42 patients LVEF was also determined by echocardiography. RESULTS: For the cardiac models the computed volumes showed high correlation with the model-volumes as well as high correlation between ECT and GS-Quant (r > or = 0.99). Both programs underestimated the volume by approximately 20-30% independent of the ventricle-size. Calculating LVEF, EDV and ESV, GS-Quant and ECT correlated well to each other and to the LVEF estimated by echocardiography (r > or = 0.86). LVEF values determined with ECT were about 10% higher than values determined with GS-Quant or echocardiography. The incorrect surfaces calculated by the automatic algorithm of GS-Quant for three examinations could not be corrected manually. 34 of the ECT studies were optimized by the operator. CONCLUSION: GS-Quant and ECT are two reliable programs in estimating LVEF. Both seem to underestimate the cardiac volume. In practical application GS-Quant was faster and easier to use. ECT allows the user to define the contour of the ventricle and thus is less susceptible to artifacts.

Algorithms↗

Improvement of presurgical patient evaluation by generation of functional magnetic resonance risk maps.

Recent functional magnetic resonance imaging (FMRI) replication studies show a high variability of active voxels within subjects and across runs - a potentially harmful situation for clinical applications. We tried to reduce these uncertainties inherent in current presurgical FMRI. For this, a new high quality head fixation device was used to detect reliably activated voxels over repeated measurements. In addition high correlation thresholds were applied to define the areas with highest probability of activation. The results show a focussing of such functional high risk areas to only a few voxels which localized close to intraoperative cortical stimulation. The generation of such FMRI risk maps may improve validity of clinical localization and facilitate the development of currently missing standards for maximized but still safe tumor resection.

Adult↗

Very short echo time proton MR spectroscopy of human brain with a standard transmit/receive surface coil.

A method for localized proton spectroscopy of the human brain is proposed which can be used with a standard transmit/receive planar surface coil producing an inhomogeneous RF field. Water suppression is accomplished by a train of full passage adiabatic pulses with optimized frequencies and delays, which account for variation in the water resonance frequency and the spin-lattice relaxation time. The robust method requires minimal pulse calibration and provides high-quality spectra even at very short echo times and in the absence of outer volume saturation and, therefore, is well suited for clinical in vivo spectroscopy. Performance of the method is demonstrated on a test object and on MR spectra from the human brain at 3 T.

Adult↗

[New developments in diagnosis of coronary heart disease--3D fusion image].

The interpretation of three-dimensional (3D) structures of the coronary tree and the myocardium by a clinician demands a subjective visual integration of two-dimensional (2D) images of cardiac diagnostic procedures like coronary angiography and myocardial scintigraphy. Although in the conventional analysis of 2D display scintigraphic myocardial perfusion segments are arbitrarily assigned to three major coronary artery systems, the standard myocardial perfusion distribution territories correspond with the individual pathologic-anatomic coronary tree in only 50-60% of the patients. Hence, the mental integration of both 2D images of coronary angiography and myocardial scintigraphy does not necessarily allow an accurate assignment of particular myocardial perfusion regions to the corresponding vessels. For an objective assignment of each vessel segment of the coronary tree to the corresponding myocardial regions, we have developed a 3D "fusion image" technique and applied it to patients with coronary artery disease. Cause-and-effect relationships may be more obvious with 3D data fusion and may enable an easier comparison of anatomy and physiology. Preliminary results demonstrate that our newly developed 3D fusion image is useful for accurate assignment of coronary vessel segments to the corresponding myocardial perfusion regions and suggest that it may allow the clinician a comprehensive and accurate assessment of the patient's myocardial status.

Coronary Angiography↗

Spatial resolution in echo planar imaging: shifting the acquisition window in k-space.

Single-shot echo planar imaging (EPI) is one of the most suitable techniques for very fast image acquisition, especially in functional MRI. In standard EPI schemes the k-space center is sampled in the middle of the acquisition train. This leads to longer echo times for higher spatial resolutions, as well as reduced signal intensity and signal-to-noise ratio. Therefore, echo shifting to lower echo times is often used. After a brief overview on the theoretical background of various point-spread-functions (PSF) computational simulations are presented, which quantify the modulation amplitude of a binary test object sampled with either standard, zero-filled or shifted k-space acquisition. The results suggest that echo-shifting with zero-filling is not advantageous, not even with small matrix sizes, and that echo-shifting with additional acquisition of outer k-space lines decreases the modulation amplitude only slightly. Simulations were also performed on noise-corrupted test objects, indicating that the use of the echo-shifted scheme causes resolution loss of up to 30% compared to the standard scheme for a 128 by 128 pixel matrix at a noise level of 20%. Finally, in vivo experiments using different echo shifts are presented and the characteristics of signal and noise with varying TE are quantified.

Echo-Planar Imaging↗

Wavelet domain de-noising of time-courses in MR image sequences.

Magnetic resonance images acquired with high temporal resolution often exhibit large noise artifacts, which arise from physiological sources as well as from the acquisition hardware. These artifacts can be detrimental to the quality and interpretation of the time-course data in functional MRI studies. A class of wavelet-domain de-noising algorithms estimates the underlying, noise-free signal by thresholding (or 'shrinking') the wavelet coefficients, assuming the underlying temporal noise of each pixel is uncorrelated and Gaussian. A Wiener-type shrinkage algorithm is developed in this paper, for de-noising either complex- or magnitude-valued image data sequences. Using the de-correlation properties of the wavelet transform, as elucidated by Johnstone and Silverman, the assumption of i.i.d. Gaussian noise can be abandoned, opening up the possibility of removing colored noise. Both wavelet- and wavelet-packet based algorithms are developed, and the Wiener method is compared to the traditional Hard and Soft wavelet thresholding methods of Donoho and Johnstone. The methods are applied to two types of data sets. In the first, an artificial set of complex-valued images was constructed, in which each pixel has a simulated bimodal time-course. Gaussian noise was added to each of the real and imaginary channels, and the noise removed from the complex image sequence as well as the magnitude image sequence (where the noise is Rician). The bias and variance between the original and restored paradigms was estimated for each method. It was found that the Wiener method gives better balance in bias and variance than either Hard or Soft methods. Furthermore, de-noising magnitude data provides comparable accuracy of the restored images to that obtained from de-noising complex data. In the second data set, an actual in vivo complex image sequence containing unknown physiological and instrumental noise was used. The same bimodal paradigm as in the first data set was added to pixels in a small localized region of interest. For the paradigm investigated here, the smooth Daubechies wavelets provide better de-noising characteristics than the discontinuous Haar wavelets. Also, it was found that wavelet packet de-noising offers no significant improvement over the computationally more efficient wavelet de-noising methods. For the in vivo data, it is desirable that the groups of "activated" time-courses are homogeneous. It was found that the internal homogeneity of the group of time-courses increases when de-noising is applied. This suggests using de-noising as a pre-processing tool for both exploratory and inferential data analysis methods in fMRI.

Journal Article↗