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G Brix

Publications and source records attributed to G Brix.

At least 19 recordsLinked to original sources

[Comparison of methods for quantifying contrast enhancement exemplified by dynamic MRI mammography].

AIM: Aim of this study was to demonstrate and compare different quantification techniques to assess contrast enhancement in dynamic MRI studies. The diagnostic potential of dynamic MRI studies is increasingly appreciated and already used in different organ systems. METHOD: A patient population of 314 histologically verified breast lesions (138 malignant, 176 benign) were evaluated using a high temporal resolved dynamic sequence. Different quantification techniques such as the use of a cutoff line, time dependent and pharmacokinetic assessment were comparatively evaluated. RESULTS: Time dependent quantification methods revealed higher diagnostic potential which was further improved by in vivo normalization of the contrast availability in the vascular system. Significant differences in the enhancement characteristics were determined between malignant and benign as well within the different histological entities. CONCLUSION: Time dependent quantification methods enable an angiogenic characterization of lesions to improve diagnostic interpretation as well as monitoring during therapy. They are also the basis for automated, color-coded visualization of dynamic studies.

Breast↗

[Quantification and visualization of oxygen partial pressure in vivo by 19F NMR imaging of perfluorocarbons].

Due to the high solubility of molecular oxygen in perfluorocabons (PFC), this class of fluorinated compounds has gained wide-spread interest for its biomedical application as temporary blood substitutes and as radiosensitizers. Since the observation that the NMR spin-lattice relaxation times (T1) of some 19F PFC resonances are sensitive to oxygen tension (pO2), this paramagnetic effect has been used to non-invasively probe pO2 in vivo. In this study, combined 19F/1H NMR image data of Copenhagen rats after PFC application were evaluated with the software package MATLAB. The analysis of the 19F NMR data resulted in image matrices with calculated T1 values in each pixel. By using a calibration curve, the corresponding pO2 values were computed. Color overlays of pO2 contour lines on T1-weighted 1H images show a good anatomical-functional correspondence.

Animals↗

[Assessment of radiation exposure caused by transmission scans in SPECT: an anthropomorphic dosimetry study].

Transmission measurements are performed in SPECT to correct for attenuation of the gamma quanta in the body. In this study, we measured the additional radiation dose caused by transmission scans using a field of collimated 153Gd rod sources. Two measurement series were performed with a anthropomorphic phantom and thermoluminescence dosimeters. For a typical SPECT study, we found a mean dose rate of 2.2 +/- 0.8 micro Sievert per hour (range: 1.2-3.9 micro Sievert per hour). For a measurement time of 20 min, this corresponds to a mean equivalent patient radiation dose of 0.73 micro Sievert. Thus, the radiation exposure caused by transmission scans can be neglected compared to the radiopharmaceutical dose and may not be considered as a limiting factor for the clinical application of attenuation correction in SPECT.

Gadolinium↗

[Assessment of radiation exposure caused by transmission scans in SPECT: an anthropomorphic dosimetry study].

Transmission measurements are performed in SPECT to correct for attenuation of the gamma quanta in the body. In this study, we measured the additional radiation dose caused by transmission scans using a field of collimated 153Gd rod sources. Two measurement series were performed with an anthropomorphic phantom and thermoluminescence dosimeters. For a typical SPECT study, we found a mean dose rate of 2.2 +/- 0.8 micro Sievert per hour (range: 1.2-3.9 micro Sievert per hour). For a measurement time of 20 min, this corresponds to a mean equivalent patient radiation dose of 0.73 micro Sievert. Thus, the radiation exposure caused by transmission scans can be neglected compared to the radiopharmaceutical dose and may not be considered as a limiting factor for the clinical application of attenuation correction in SPECT.

Gadolinium↗

[Recovery coefficients for the quantification of the arterial input functions from dynamic PET measurements: experimental and theoretical determination].

AIM: For kinetic modelling of dynamic PET data, the arterial input function can be determined directly from the PET scans if a large artery is visualized on the images. It was the purpose of this study to experimentally and theoretically determine recovery coefficients for cylinders as a function of the diameter and level of background activity. METHODS: The measurements were performed using a phantom with seven cylinder inserts (Ø = 5-46 mm). The cylinders were filled with an aqueous 68Ga solution while the main chamber was filled with a 18F solution in order to obtain a varying concentration ratio between the cylinders and the background due to the different isotope half lives. After iterative image reconstruction, the activity concentrations were measured in the center of the cylinders and the recovery coefficients were calculated as a function of the diameter and the background activity. Based on the imaging properties of the PET system, we also developed a model for the quantitative assessment of recovery coefficients. RESULTS: The functional dependence of the measured recovery data from the cylinder diameter and the concentration ratio is well described by our model. For dynamic PET measurements, the recovery correction must take into account the decreasing concentration ratio between the blood vessel and the surrounding tissue. Under the realized measurement and data analysis conditions, a recovery correction is required for vessels with a diameter of up to 25 mm. CONCLUSIONS: Based on the experimentally verified model, the activity concentration in large arteries can be calculated from the measured activity concentration in the blood vessel and the background activity. The presented approach offers the possibility to determine the arterial input function for pharmacokinetic PET studies non-invasively from large arteries (especially the aorta).

Humans↗

Tumor microcirculation evaluated by dynamic magnetic resonance imaging predicts therapy outcome for primary rectal carcinoma.

Contrast enhanced dynamic studies of malignant tumors performed by computed tomography or magnetic resonance imaging (MRI) are increasingly applied to characterize tumor microcirculation for the prediction of therapy outcome. The aim of our study was to correlate perfusion index (PI) values determined in primary rectal carcinoma before chemoradiation with therapy outcome. In 17 patients with clinically staged T3 primary rectal carcinoma, dynamic MRI was performed before the onset of therapy using an ultrafast T1-mapping sequence. On the basis of the acquired data sets, PI values were calculated on a pixel-by-pixel basis. To characterize the heterogeneity of tumor microcirculation, relative cumulative frequency histograms of PI values within the tumors were computed. Subsequent resection of the tumors allowed correlating PI with histopathological classification. In 12 of 17 patients, T-downstaging as a response to therapy was found, whereas in the remaining 5 patients no therapy response was observed after chemoradiation. A statistically significant difference between both groups was found for the mean PI (P < 0.001; 8.5+/-1.7 ml/min/100 g versus 11.4+/-0.7 ml/min/100 g). Analyzing the cumulative frequency histograms for both groups revealed an optimal discrimination for a P1 value of 12.6 ml/min/100 g. The fraction of pixels in the tumor with PI values larger than 12.6 ml/min/100 g was significantly different (P < 0.001) between therapy-responding (3+/-3.6%) and therapy-nonresponding tumors (21+/-4.3%). The results indicate either a reduced supply of nutrients as well as chemotherapeutic agents attributable to increased shunt flow or highly aggressive tumor cell clusters characterized by increased angiogenic activity. Noninvasive PI measurements by dynamic MRI in rectal carcinoma before therapy seem to be of predictive value for therapy outcome in patients scheduled for preoperative chemoradiation.

Adenocarcinoma↗

Dynamic contrast-enhanced MRI using Gd-DTPA: interindividual variability of the arterial input function and consequences for the assessment of kinetics in tumors.

Gd-DTPA kinetics in arterial blood was investigated by dynamic MRI in 47 patients with malignant and benign mammary tumors. Signal enhancement was monitored for 10 min after the beginning of a 1-min infusion of 0.1 mmol/kg Gd-DTPA. Kinetics in blood was biexponential with median half-lives of 21 sec and 11.1 min, respectively. Peak signal enhancement and the area under the signal enhancement-time curve varied 2.5- and 3.7-fold between patients. The shortest mean residence time in one of up to three tumor compartments, MRT*, was estimated using either the individual (reference) or a mean population (surrogate) arterial input function (AIF). MRT* (reference estimate) was 1.0 (0-1.5), 1.9 (1.5-2.3), and 2.5 (2.3-2.8) min in carcinomas, fibroadenomas, and mastopathies, respectively (median and interquartile distance). Surrogate estimates were unbiased but differed from the reference estimates 1.5-fold or more in 23% of cases. AIFs should be monitored individually if accurate estimates of individual MRT* are desired.

Breast Neoplasms↗

Apoptosis and changes in glucose transport early after treatment of Morris hepatoma with gemcitabine.

Apoptosis has been described as an energy-consuming process. This combined in vivo/in vitro study investigated the effects of the antineoplastic agent gemcitabine on tumour metabolism and on the induction of apoptosis. Dynamic positron emission tomography (PET) measurements of fluorine-18 fluorodeoxyglucose (FDG) uptake were done in rats bearing Morris hepatoma prior to and after therapy with 90 mg gemcitabine/kg b.w. Furthermore, thymidine (TdR) incorporation into the DNA of these tumours was determined. In vitro measurements of FDG and TdR uptake were performed immediately and 24 h after the end of gemcitabine treatment, and the amount of apoptotic cells was determined using the TUNEL reaction. In vivo an increase in FDG transport and phosphorylation occurred early after gemcitabine treatment, although TdR incorporation into the DNA of the tumours declined. In vitro, an enhanced glucose transport, an increase in TdR uptake in the cytoplasm and a decrease in TdR incorporation in the nucleic acid fraction early after treatment occurred. Inhibition of glucose transport caused an increase in the amount of apoptotic cells. The increase in glucose uptake and TdR metabolism early after therapy is interpreted as a stress reaction of the tumour cells, protecting the cells from apoptosis during this early period after exposure to cytotoxic drugs like gemcitabine.

3-O-Methylglucose↗

Comparison of pharmacokinetic MRI and [18F] fluorodeoxyglucose PET in the diagnosis of breast cancer: initial experience.

It was the aim of this methodology-oriented clinical pilot study to compare the potential of dynamic MRI and 2-[18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) for the detection and characterization of breast cancer. Fourteen women with suspicious breast lesions were examined. The MRI data were acquired with a turbo fast low-angle shot sequence and analyzed using a pharmacokinetic model. Emission data were detected in the sensitive 3D modus, iteratively reconstructed, and superimposed onto corresponding transmission images. In the 14 patients, 13 breast masses with a suspicious contrast enhancement and FDG uptake were detected. For these lesions, no statistically significant correlation between evaluated MR and PET parameters was found. Of the 9 histologically confirmed carcinomas, 8 were correctly characterized with MRI and PET. Two inflammatory lesions were concordantly classified as cancer. Moreover, dynamic MRI yielded another false-positive finding. In 6 patients, PET detected occult lymph node and/or distant metastases. Although both functional imaging techniques provide independent tissue information, the results concerning the diagnosis of primary breast lesions were almost identical. An advantage of PET, however, is its ability to localize lymph node involvement and distant metastases as an integral part of the examination.

Adult↗

Classification of signal-time curves from dynamic MR mammography by neural networks.

The aim of this study was to test the performance of artificial neural networks for the classification of signal-time curves obtained from breast masses by dynamic MRI. Signal-time courses from 105 parenchyma, 162 malignant, and 102 benign tissue regions were examined. The latter two groups were histopathologically verified. Four neural networks corresponding to different temporal resolutions of the signal-time curves were tested. The resolution ranges from 28 measurements with a temporal spacing of 23s to just 3 measurements taken 1.8, 3, and 10 minutes after contrast medium administration. Discrimination between malignant and benign lesions is best if 28 measurement points are used (sensitivity: 84%, specificity: 81%). The use of three measurement points results in 78% sensitivity and 76% specificity. These results correspond to values obtained by human experts who visually evaluated signal-time curves without considering additional morphologic information. All examined networks yielded poor results for the subclassification of the benign lesions into fibroadenomas and benign proliferative changes. Neural networks can computationally fast distinguish between malignant and benign lesions even when only a few post-contrast measurements are made. More precise specification of the type of the benign lesion will require incorporation of additional morphological or pharmacokinetic information.

Adult↗

MR monitoring of focused ultrasound surgery in a breast tissue model in vivo.

The objective of this study was to investigate MRI methods for monitoring focused ultrasound surgery (FUS) of breast tumors. To this end, the mammary glands of sheep were used as tissue model. The tissue was treated in vivo with numerous single sonications which covered extended target volumes by employing a scanning technique. The ultrasound focus position was controlled by online temperature mapping based on the temperature dependence of the relaxation time T(1). This approach proved to be reliable and offers thus an alternative to proton resonance frequency methods, whose application is hampered in fatty tissues. FUS-induced tissue changes were visible on T(2)- as well as on pre- and post-contrast T(1)-weighted images. According to our initial experience, noninvasive MRI-guided FUS of breast tumors is feasible.

Adipose Tissue↗

Sampling and evaluation of specific absorption rates during patient examinations performed on 1.5-Tesla MR systems.

It was the purpose of present study, to evaluate a large number of exposure-time courses measured during patient examinations in clinical routine in relation to the current IEC standard and the draft version of the revised standard and, moreover, to investigate whether there is a correlation between the subjective heat perception of the patients during the MR examination and the intensity of RF power deposition. To this end, radiofrequency exposure to 591 patients undergoing MR examinations performed on 1.5-Tesla MR systems was monitored in five clinics and evaluated in accordance with both IEC standards. For each of the 7902 sequences applied, whole body and partial body SARs were estimated on the basis of a simple patient model. Following the examinations, 149 patients were willing to provide information in a questionnaire regarding their body weight and their subjective heat perception during the examination. Although patient masses entered into the MR system were in some cases too high, reliable masses could be estimated by the SAR monitor. In relation to our data, the revision of the IEC standard results in a tightening of the restrictions, but still more than 96% of the examinations did not exceed the SAR limits recommended for the normal operating mode. For the exposure conditions examined, no statistically significant correlation was found between the subjective heat perception of the patients and the intensity of power deposition. Taking advantage of the possibility to compute running SAR averages, MR sequences can be employed in clinical practice for which SAR levels exceed the defined IEC limits, if the acquisition time is short in relation to the averaging period and energy deposition has been low previous to the applied high-power sequence.

Female↗

[understanding and radiation hygiene assessment of solar UV exposure in Germany].

In order to monitor the natural ultraviolet (UV) radiation and to assess it from the point of view of radiation hygiene, the Federal Office for Radiation Protection (BfS) and the Federal Environmental Agency (UBA) have built up a common network for UV monitoring. Since 1993, the ground-level solar UV radiation has been measured at four sites in Germany every 6 minutes, with spectroradiometers in the wavelength range between 290 and 400 nm. Because erythema (sunborn) is of special interest in terms of radiation hygiene, the erythemal weighted irradiance was used as a measure for the biological effect of UV exposure. For this purpose, the measured spectral irradiance was multiplied by the relative erythemal weighting function, and the resulting function integrated from 290 to 400 nm. In the summer months of June and July 1999, the erythemal irradiance exceeded regularly the value of 175 mW/m2 in the south of Germany. In the north, values of not less than 160 mW/m2 were measured during this period. These values correspond to an UV index of more than 7 or 6, respectively--a high exposure regarding to the classification of the German Radiation Protection Commission (SSK), for which (absolute) sun protection is recommend. Between 1995 and 1999, the four sites were characterized by a small increase of the ground-level UV exposure of approx. 10%. Nevertheless, in consideration of the manifold factors affecting the acquired data, the measuring period of 5 years is still insufficient to demonstrate an ozone-dependent effect.

Erythema↗

Quantification of [(18)F]FDG uptake in the normal liver using dynamic PET: impact and modeling of the dual hepatic blood supply.

UNLABELLED: For quantification of hepatic [(18)F]FDG uptake, the dual blood supply to the liver must be considered. In contrast to the arterial input, however, the portal venous blood supply to the liver cannot be monitored directly by PET because of the inaccessibility of the portal vein on PET scans. In this study, we investigated whether the dual hepatic input can be predicted from the measurable arterial input. Moreover, we assessed the effect of different input models on the rate constants of the standard 3-compartment model describing regional uptake of FDG. METHODS: Dynamic FDG PET scanning was performed on 5 foxhounds. Activity concentrations in blood from the aorta and the portal vein were measured simultaneously using external circuits. After image reconstruction, time--activity courses were determined from the aorta and the liver. The venous input was approximated by convolving the arterial input with a notional system function describing the dispersion of the arterial input on its way through the gastrointestinal tract. On the basis of these data, 5 different hepatic input models, which pertain to a single-input as well as a dual-input scenario, were statistically compared with regard to the adequacy of the model fits to liver data and to differences in the estimated rate constants. RESULTS: Portal venous input to the liver could be approximated by convolving the arterial input function with a system function. From this function, a mean transit time of 25 s was computed for FDG to pass through the gastrointestinal tract. According to the statistical analysis, dual-input models were superior to their single-input counterparts. However, differences in the rate constants estimated for the 5 input models were in the same order as interindividual variations within the different model groups. For the dephosphorylation rate constant, a consistent value of 0.05 +/- 0.01 min(-1) was found. CONCLUSION: Dual-input models proved to be superior to single-input models with respect to the adequacy of FDG model fits to normal liver data. However, the hepatic blood supply may be approximated by the arterial input function as well, especially for the evaluation of liver lesions mainly fed by the hepatic artery.

Algorithms↗

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: decrease in regional cerebral blood volume in hyperintense subcortical lesions inversely correlates with disability and cognitive performance.

BACKGROUND AND PURPOSE: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an arteriopathic syndrome related to a genetic defect on chromosome 19. Characteristic changes in CADASIL can be observed onT2-weighted MR images in the subcortical white matter. The purpose of this study was to measure changes of regional cerebral blood volume (rCBV) with dynamic contrast-enhanced MR imaging and to correlate the changes to disability and cognitive performance. METHODS: We obtained rCBV measurements of 24 individuals with proven CADASIL on a 1.5-T MR imaging unit. A susceptibility-weighted MR imaging sequence was used for bolus tracking. Principles of the indicator dilution theory were applied to estimate values of absolute rCBV (mL/100 g). Disability was determined by using the Rankin scale, and overall cognitive performance was assessed by using the Mini-Mental State Examination. RESULTS: The mean rCBV in the subcortical white matter that was hyperintense on the T2-weighted images (2.7 +/- 0.8 mL/100 g) was significantly lower than the rCBV in the white matter that appeared normal on the T2-weighted images (4.4 +/- 1.3 mL/100 g) (P <.05). The mean rCBV in the gray matter was within the normal range (8.3 +/- 1.7 mL/100 g). Both cognitive impairment and disability negatively correlated with rCBV in the subcortical white matter that was hyperintense (P <.05) but not with rCBV in the normal appearing white matter. rCBV did not correlate with age. CONCLUSION: rCBV measured in the hyperintense subcortical white matter in individuals with CADASIL was decreased and inversely correlated with disability and cognitive impairment.

Adult↗

[Application of radioactive substances in nuclear medicine research: current trends and radiation exposure of study subjects].

AIM: Analysis of the application of radioactive substances in research in the field of nuclear medicine in human beings and of the resulting radiation exposure to study subjects. METHODS: Assessment of applications for approval submitted in accordance with Paragraph 41 of the Radiation Protection Ordinance, evaluated by the Federal Office for Radiation Protection together with the Federal Institute for Pharmaceuticals and Medical Products, within the period from 1997 to 1999. RESULTS: The focus of the studies on the diagnostic application of radioactive substances in medicine evaluated has, since 1998, shifted from oncological to neurological and psychological aspects, while, at the same time, the number of PET studies increased constantly. The proportion of healthy study subjects included in the diagnostic studies increased from 7 to 22%. The number of therapeutic applications of radioactive substances has, since 1997, undergone a three-fold increase, and in the process of this, the focus of attention lay within the area of radioimmuno-therapy and endovascular brachytherapy. The effective dose was, among up to 49% of the investigated healthy study subjects higher than 5 mSv, and among up to 6% of these subjects was at levels of over 20 mSv. Up to 22% of the patients received, within the scope of diagnostic studies, an effective dose of between 20 and 50 mSv. An exceeding of the 50 mSv limit occurred among up to 3% of the patients. CONCLUSIONS: In spite of the increasing numbers of PET applications, conventional nuclear medicine has maintained its importance in the field of medical research. Further developments in the areas of radiochemistry and molecular biology led to an increase in the importance of radio-immuno therapy. The evaluation of new radiopharmaceuticals and the extension of basic biomedical research, resulted in an increase in the proportion of healthy study subjects included in the studies. The radiation exposure among subjects resulting directly from the studies showed, for the period of evaluation, an overall trend towards reduction.

Humans↗

Elastic matching of dynamic MR mammographic images.

Dynamic magnetic resonance imaging (MRI) carried out with paramagnetic contrast media has been proven to increase sensitivity and specificity in the detection of breast cancer. Due to movements of the patients and changes in the shape of the breasts during the measurement period, a coregistration (matching) of the acquired data volumes is necessary to obtain higher accuracy for the localization of lesions. In this study, an algorithm for the elastic matching of dynamic MRI volume data is presented. The approach includes automatic feature extraction along with the analysis of corresponding features between the data sets. The matching is actually slice-oriented, even though information on displacement vectors in adjacent slices is taken into account. An extension of the procedure to fully three-dimensionally (3D) matching is straight forward. Up until now, the approach has been applied to 20 dynamic MRI studies. The matching time for two image data sets with 256 x 256 x 15 voxels each was about 4 min using a PC (Pentium Pro, 200MHz).

Algorithms↗