Search PubMed⌕ Search

Biomedical subjects

E Moser

Publications and source records attributed to E Moser.

At least 109 records · Page 6Linked to original sources
PubMed1997

Magnetoencephalography may help to improve functional MRI brain mapping.

The validity of functional magnetic resonance imaging (FMRI) brain maps with respect to the sites of neuronal activation is still unknown. One source of localization error may be pixels with large signal amplitudes, since such pixels may be expected to overlie large vessels, running remote from the centre of neuronal activation. In this study, magnetoencephalography was used to determine the centre of neuronal activation in a simple finger tapping task. The localization accuracy of conventional FMRI depending on FMRI signal enhancement was investigated relative to the magnetoencephalography reference. The results show a deterioration of FMRI localization with increasing signal amplitude related to increased contributions from large vessels. We conclude that FMRI data analysis should exclude large signal amplitudes and that magnetoencephalography may help to improve FMRI brain mapping results in a multimethod approach.

Adult↗
PubMed1997

PET and SPECT in whiplash syndrome: a new approach to a forgotten brain?

Whiplash associated disorders are a medicolegally controversial condition becoming increasingly worrisome in the western world. This study was designed to evaluate perfusion and glucose metabolism in whiplash brain. Using Tc-99m-bicisate (ECD) single photon emission computed tomography (SPECT) and F-18-fluorodeoxyglucose (FDG) PET, six clinically and neuropsychologically controlled patients (patient group) with whiplash syndrome and 12 normal controls (control group) were investigated. Standardised elliptical regions of interest (ROIs) were determined in three adjacent transaxial slices in the frontal, parietal, temporal, and parieto-occipital cortex, cerebellum, brain stem, basal ganglia, and thalamus. For PET, the glucose metabolic index (GMI; =ROI uptake/global uptake at the level of the basal ganglia) and, for SPECT, the perfusion index (PI; =ROI/global) were calculated. In the patient group there was significant hypometabolism and hypoperfusion in the parieto-occipital regions (on the right (R) and left (L) side) compared with the control group: PET data: GMI parieto-occipital R: control 1.066 (0.081) (mean (SD)), patient 0.946 (0.065); P=0.0092, Mann Whitney. GMI parieto-occipital L: control 1.034 (0.051), patient 0.922 (0.073); p=0.0067. SPECT data: PI parieto-occipital R: control 1.262 (0.066), patient 1.102 (0.063); P=0.0039. PI parieto-occipital L: control 1.226 (0.095), patient 1.098 (0.075); P=0.0273. In some patients there was hypometabolism (>2 SD of control) in regions other than the parieto-occipital region. It is hypothesised that parieto-occipital hypometabolism may be caused by activation ofnociceptive afferent nerves from the upper cervical spine.

Adolescent↗
PubMed1997

Comparative diagnostic accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma.

PURPOSE: To compare the diagnostic accuracy of magnetic resonance imaging (MRI) and immunoscintigraphy (IS) for detection of bone marrow infiltration in malignant lymphoma. PATIENTS AND METHODS: In 32 patients with Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL), MRI of the axial skeleton and whole-body IS using technetium-99m (99mTc)-labeled monoclonal antibodies were reviewed and compared with iliac crest biopsies. Criterion for marrow infiltration was a positive biopsy or concordant positive results of MRI and IS. RESULTS: In 16 patients (50%), MRI, IS, and iliac crest biopsies were negative for marrow infiltration. Iliac crest biopsy showed infiltration in only four patients (13%). Infiltration was missed in two of 32 patients with IS and in one patient with MRI. In one additional patient, MRI was false-positive because of pelvic hematopoietic hyperplasia. A subset of nine patients (28%) with negative biopsies had bone marrow involvement according to MRI and IS with identical location and pattern of infiltration. In eight of these nine patients, diagnostic imaging indicated marrow involvement only in noncrest marrow. Subsequent biopsy confirmed infiltration in five patients. The clinical course suggested true-positive imaging results in the remaining four patients. Two patients (6%) remained equivocal. Overall concordance of MRI and IS for marrow infiltration was 88% (28 of 32 patients). CONCLUSION: Diagnostic imaging is essential for optimal staging in malignant lymphoma, as blind biopsies appear to have low sensitivity for bone marrow infiltration because of frequent involvement in noncrest marrow. both imaging modalities show a high rate of detection of bone marrow infiltration.

Adolescent↗
PubMed1997

Immunoscintigraphy with anti-225.28S for ocular melanoma--a comparison with histology and immunohistochemistry.

AIM: The purpose of this prospective study was to evaluate the value of immunoscintigraphy (ISG) with anti-225.28S in clinically suspected ocular melanoma. METHODS: For this purpose standardized ISG was performed in 36 patients using both planar acquisition and emission computed tomography (ECT). Ocular melanoma was present in 31 patients. In 21 patients therapy was enucleation of the eye. These specimens were evaluated by histology and immunohistochemistry in 11 of 21 patients. RESULTS: Regarding the clinical diagnosis, ISG was positive only in 15 of 31 patients with ocular melanoma, regarding histology in 11 of 21 and regarding immunohistochemistry in 5 of 6 patients with a positive immunoreaction 5 patients showed no immunoreactivity, their ISG was negative. CONCLUSION: Thus a good correlation between ISG and immunohistochemistry was observed. However ISG using the cutaneous melanoma antibody 225.28S cannot be recommended for the diagnostic work-up of an ocular melanoma considering the poor immunoreactivity.

Adult↗
PubMed1997

[Radioiodine therapy of Basedow's disease--is there a therapeutic standard?].

This review article will come to a positive answer to the question entitled. The good experiences within more than 50 years were able to define commonly accepted standards concerning the following items: therapeutic aim, indications, contraindications, pretreatment, dose concept, assessment of radioactivity, follow-up. The broad consensus among experts when to apply medical treatment, surgery or radioiodine in this special disease was one of the reasons that the nuclear medicine treatment is accepted more and more. By this, the patients have to wait for many months to become treated on an in-patient basis, as it is mandatory in Germany. In the current health care scene it is absolutely unrealistic to demand an increasing number of radioiodine beds. Facing this fact the guidelines of applying radioiodine which are extremely restrictive in Germany have to be modified as proposed by the National Commission on Radiation Protection.

Contraindications↗
PubMed1997

[Double isotope albumin flux measurement: diagnosis and therapeutic monitoring of acute lung injury].

PURPOSE: Acute Lung Injury (ALI) is a clinical condition which is associated with a high lethality. It is characterized by an increased pulmonary capillary permeability and non-cardiogenic pulmonary edema. This study was designed to answer the question whether double isotope albumin-flux measurement is a useful tool both for diagnosis of increased pulmonary capillary permeability and for monitoring therapeutic interventions (nitric oxide (NO) inhalation). METHOD: In 12 patients with clinical signs of ALI, transvascular albumin-flux was measured by a double radioisotope technique before, during and after NO inhalation. 99mTc labeled albumin and 51Cr labeled autologous erythrocytes were used as tracer. The radioactivity of both radiopharmaceuticals was measured externally over the right lung by a radiation probe and simultaneously in arterial blood. For quantification of transvascular albumin-flux Normalized Index (NI) and Normalized Slope Index (NSI) were calculated. Furthermore, pulmonal vascular pressures and other physiological parameters were recorded. RESULTS: All 12 patients showed markedly increased NSI before inhalation of NO. NSI decreased from 0.0074 +/- 0.0046 min-1 without nitric oxide to -0.0051 +/- 0.0041 min-1 during nitric oxide and increased to 0.0046 +/- 0.0111 min-1 after nitric oxide. The decrease of the NSI correlated well with decrease of venous pulmonary resistance during inhalation of NO. CONCLUSION: Inhalation of NO reduces transvascular albumin-flux in patients with ALI. Double isotope albumin-flux measurement enables diagnosis of increased capillary permeability as well as monitoring therapeutic interventions.

Adult↗
PubMed1997

Proton NMR relaxation times of human blood samples at 1.5 T and implications for functional MRI.

To further investigate the dependency of fMRI signal changes on echo time TE, we measured T2 and T2* values, obtained from human blood samples at various oxygenation levels and used them in a simple model to calculated signal enhancement in fMRI. In addition, the longitudinal relaxation time T1 of human blood was determined for reference. All measurements were performed at 23 degrees C to reduce blood cell metabolism during the measurement procedure. At 23 degrees C T1 values of 1434 +/- 48 ms for arterial human blood were obtained after correcting for hematocrit content, as hematocrit values ranged fro 28% to 34% only. The T2 relaxation times obtained are 181 +/- 23 ms for venous and 254 +/- 26 ms for arterial human blood, T2* relaxation times corrected for inhomogeneities of the static magnetic field (B0) are 42 +/- 2.8 ms and 254 +/- 32 ms, respectively. Furthermore, absolute and relative signal changes in fMRI experiments are calculated. The results from these model calculations reveal that contrast in fMRI can be optimised by choosing an appropriate echo time.

Adult↗
PubMed1996

[Therapy of hepatocellular carcinoma].

The therapeutic modalities in patients with hepatocellular carcinoma (HCC) depend on the number, size and location of the lesions as well as the stage of the underlying liver disease and the physical condition of the patient. In patients with small and solitary lesions, resection, liver transplantation and in some cases percutaneous ethanol injection (PEI) can be curative. In more advanced stages of the disease with larger or multiple lesions, PEI and/or transarterial chemotherapy with or without embolization (TACE or TAC) can slow the progression of the disease. In disseminated disease, a radiotherapeutic approach can be taken in selected cases. The therapeutic strategy in patients with HCCs should be individualized, frequently involving a combination of therapeutic modalities. In contrast to the earlier dismal prognosis, for most HCC patients there is today a therapeutic strategy that results in prolongation of life and in some cases even cure.

Antineoplastic Agents↗
PubMed1996

An update on diagnostic methods in the investigation of diseases of the thyroid.

Iodine deficiency and iodine-deficiency disorders continue to be problems in several parts of Europe, requiring further improvements in the techniques employed in thyroid diagnosis, and particularly in the early diagnosis and risk assessment of autonomously functioning thyroid tissue. For the latter purpose, scintigraphy with technetium-99m pertechnetate under exogenous or endogenous thyroid-stimulating hormone (TSH) suppression provides the best results. Significant methodological improvements in laboratory tests have resulted from the application of new luminescent techniques and gene technology to thyroid function tests. Especially TSH measurement using second- or third-generation assays ensures diagnostic accuracy, so that the thyrotropin-releasing hormone (TRH) test is now almost always unnecessary. The differentiation of blocking and stimulating TSH receptor antibodies is relevant when discrepant results are obtained with respect to thyroid function. Determination of glycosaminoglycans in urine may become a helpful tool in the follow-up of endocrine ophthalmopathy. Some new imaging agents have recently been applied in the scintigraphy of thyroid diseases, such as octreotide, or in thyroid diagnosis, such as fluorodeoxyglucose. Both improve the detectability of metastases of thyroid cancer, especially if the radioiodine scan is negative.

Biopsy, Needle↗
PubMed1996

Improved estimation of tissue hydration and bound water fraction in rat liver tissue.

Based on recent improvements in the field, biexponential data from fresh rat liver and monoexponential data from cold storage experiments allow quantification of three distinct relaxation components in liver tissue: bound water (4.2%, R1 = 12.0 +/- 1.7 s-1, R2 = 440 +/- 180 s-1); structured water (59%, R1 approximately 3.3 +/- 0.07 s-1, R2 approximately 24.9 +/- 1.1 s-1); and free water (approximately 37%, R1 = R2 approximately 0.4 s-1). However, only the relaxation rates of the structured water component change with water content: R1A (s-1) = 6.53* Ms/Mw - 0.77 (r2 = 0.911); R2A (s-1) = 71.15 * Ms/Mw - 3.09 (r2 = 0.956), respectively. This suggests a slow exchange between bound and structured water in liver cells.

Animals↗
PubMed1996

Reproducibility and postprocessing of gradient-echo functional MRI to improve localization of brain activity in the human visual cortex.

High reproducibility of human FMRI studies is imperative for potential clinical applications of this new method for mapping human brain functions. So far, published data are not comparable quantitatively (even at the same field strength) as differences in sequence design and parameters as well as statistical methods applied to enhance function related image contrast, in particular, to extract the size of the "activated areas," are manifold. We present a study on reproducibility of gradient-echo FMRI in the human visual cortex using the different threshold strategies for correlation analysis that shows that, (a) applying adaptive correlation thresholds results in higher reproducibility compared to a fixed (0.5) threshold; (b) highly reproducible data can be obtained on a clinical 1.5 T MRI system, at least for repeated single subject studies (i.e., standard deviation of 2-30% for signal enhancement in 72-94% of the studies and 5-50% for activated area size in 63-88% of the studies, respectively, depending on threshold strategies); however, depending also on subject cooperation; (c) reproducibility across groups (alpha = const.) is worse, i.e., standard deviations are within 33-45% for signal enhancement and 41-74% for activated area size, respectively; (d) SNR is maximum at about 30 degrees flip angle, suggesting significant contributions from T1-effects for larger flip angles. Various technical, methodological, and physiological factors are influencing variability of signal enhancement and apparently activated area size, which should be taken into account if interpreting FMRI data quantitatively.

Adult↗
PubMed1996

Cellular correlates to spatial learning in the rat hippocampus.

Learning through exploration gives increased synaptic field potentials in the perforant path/dentate synapses, largely due to an activity-dependent brain temperature increase. After temperature compensation, spatial learning was associated with small, but significant, STP-like changes of the field potential lasting 20-30 min. A group of spatially trained adult rats showed faster spatial learning and about 10% higher basal dendritic spine density (LY-filled) compared to two control groups. With unchanged dendritic length and branching pattern, the results suggest the formation of new synapses.

Animals↗
PubMed1996

Quantification of intensity variations in functional MR images using rotated principal components.

In functional MRI (fMRI), the changes in cerebral haemodynamics related to stimulated neural brain activity are measured using standard clinical MR equipment. Small intensity variations in fMRI data have to be detected and distinguished from non-neural effects by careful image analysis. Based on multivariate statistics we describe an algorithm involving oblique rotation of the most significant principal components for an estimation of the temporal and spatial distribution of the stimulated neural activity over the whole image matrix. This algorithm takes advantage of strong local signal variations. A mathematical phantom was designed to generate simulated data for the evaluation of the method. In simulation experiments, the potential of the method to quantify small intensity changes, especially when processing data sets containing multiple sources of signal variations, was demonstrated. In vivo fMRI data collected in both visual and motor stimulation experiments were analysed, showing a proper location of the activated cortical regions within well known neural centres and an accurate extraction of the activation time profile. The suggested method yields accurate absolute quantification of in vivo brain activity without the need of extensive prior knowledge and user interaction.

Algorithms↗
PubMed1996

Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study.

The authors represent a cooperative group of 15 institutions that examined the feasibility of using metabolic features observed in vivo with 1H-magnetic resonance (MR) spectroscopy to characterize brain tumors of the glial type. The institutions provided blinded, centralized MR spectroscopy data processing long with independent central review of MR spectroscopy voxel placement, composition and contamination by brain, histopathological typing using current World Health Organization criteria, and clinical data. Proton 1H-MR spectroscopy was performed using a spin-echo technique to obtain spectra from 8-cc voxels in the tumor and when feasible in the contralateral brain. Eighty-six cases were assessable, 41 of which had contralateral brain spectra. Glial tumors had significantly elevated intensities of choline signals, decreased intensities of creatine signals, and decreased intensities of N-acetylaspartate compared to brain. Choline signal intensities were highest in astrocytomas and anaplastic astrocytomas, and creatine signal intensities were lowest in glioblastomas. However, whether expressed relative to brain or as intratumoral ratios, these metabolic characteristics exhibited large variations within each subtype of glial tumor. The resulting overlaps precluded diagnostic accuracy in the distinction of low-and high-grade tumors. Although the extent of contamination of the 1H-MR spectroscopy voxel by brain had a marked effect on metabolite concentrations and ratios, selection of cases with minimal contamination did not reduce these overlaps. Thus, each type and grade of tumor is a metabolically hetero-geneous group. Lactate occurred infrequently and in all grades. Mobile lipids, on the other hand, occurred in 41% of high-grade tumors with higher mean amounts found in glioblastomas. This result, coupled with the recent demonstration that intratumoral mobile lipids correlate with microscopic tumor cell necrosis, leads to the hypothesis that mobile lipids observed in vivo in 1H-MR spectroscopy may correlate independently with prognosis of individual patients.

Adolescent↗
PubMed1996

PET imaging of recurrent medullary thyroid cancer.

Medullary carcinoma of the thyroid gland is a rare tumor. Its prognosis is mainly linked to surgery, because there is no valid alternative therapy to improve patients outcome. In this report, we discuss the recurrence of such a tumor in a 64-year-old female, focusing on magnetic resonance imaging and position emission tomography evaluation of this tumor.

3-Iodobenzylguanidine↗
PubMed1996

[Clinical value of positron emission tomography (PET) in oncologic questions: results of an interdisciplinary consensus conference. Schirmerreschaft der Deutschen Gesellschaft for Nuklearmedizin].

AIM: The purpose of the present paper is to assess clinical value of PET in oncology on the basis of published studies. METHODS: Clinical value of PET in oncology was evaluated by a panel of recognized experts in the framework of an interdisciplinary consensus conference. On the basis of PET studies, well documented in the international literature, the value of PET for solving clinical questions was classified according to the following categories (classes 1a, 1b, 2a, 2b, 3): "appropriate" (1a), "mostly acceptable" (1b), "helpful" (2a), "value as yet unknown" (2b), "useless" (3). RESULTS: 2-fluorodeoxyglucose (FDG) acts as the radiopharmaceutical of choice for PET in clinical oncology. PET is indicated (1a) for diagnosing relapse in high grade glioma (FDG) or low grade glioma (C-11 methionine or F-18 fluorotyrosine), differential diagnosis of solitary peripheral pulmonary nodules in high risk patients and for diagnosis of pancreatic carcinoma. PET may be clinically used (1b): In "low-grade" glioma, search for unknown primary in head and neck tumors, suspicion of relapse in non-small cell bronchial carcinoma (NSCBC) and colorectal carcinoma, lymphnode staging in NSCBC, pancreatic carcinoma, muscle invasive bladder carcinoma and testicular cancer. Staging of Hodgkin's disease (HD, stage I/II vs III), early therapy control in patients with a residual mass or suspicion of relapse in HD and in high grade NHL, lymph node staging and search for distant metastases in malignant melanoma (Breslow > 1.5 mm), search for lymph node or distant metastases in differentiated thyroid cancer with elevated hTG and a negative radioiodide whole body scan. Many further indications are emerging, but are not yet sufficiently well documented in the literature. For most indications beside scientific studies, an individual cost benefit utility evaluation by the responsible physician is recommended. CONCLUSION: Metabolic imaging of PET provides for many principle advantages compared to conventional anatomically based cross sectional imaging. For routine use in oncology a detailed assessment of specific efficiency of PET is indicated.

Female↗