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Biomedical subjects

G Brix

Publications and source records attributed to G Brix.

At least 127 records · Page 7Linked to original sources

Selective 19F MR imaging of 5-fluorouracil and alpha-fluoro-beta-alanine.

A 19F MR chemical shift imaging (CSI) technique is presented which enables selective imaging of the antineoplastic drug 5-fluorouracil (5-FU) and its major catabolite alpha-fluoro-beta-alanine (FBAL). The CSI sequence employs a chemical shift selective (CHESS) saturation pulse to suppress either the 5-FU or the FBAL resonance before the other component of the two-line 19F MR spectrum is measured. Because the transmitter frequency can always be set to the Larmor frequency of the 19F resonance to be imaged, this approach yields 5-FU and FBAL MR images free of chemical shift artifacts in read-out and slice-selection direction. In phantom experiments, selective 5-FU and FBAL images with a spatial resolution of 15 x 15 x 20 mm3 (4.5 ml) were obtained in 30 min from a model solution, whose drug and catabolite concentrations were similar to those estimated in the liver of tumor patients undergoing IV chemotherapy with 5-FU. The drug-specific MR imaging technique developed is, therefore, well-suited for the direct and noninvasive monitoring of the up-take and trapping of 5-FU in liver tumors in vivo.

Artifacts↗

[Bone marrow involvement in Hodgkin's disease: MR tomography and chemical-shift imaging].

The ranking of magnetic resonance imaging (MRI) and chemical shift imaging (CSI) of the bone marrow was assessed in 30 patients in the initial staging of Hodgkin's disease or in the restaging after relapse. The results were compared with other staging procedures, especially trephine biopsies. Pathologic findings were divided into diffuse and focal lesions resulting in a better differentiation between malignant infiltrations and unspecific marrow reactions that are common in Hodgkin's disease. Diffuse changes were unspecific, a diffuse marrow infiltration could not be established in 7 patients. Focal lesions proved to be infiltrations in 6 of 7 patients; only in one case an unspecific marrow reaction was found on histology. CSI showed a pathological increase of the relative water signal in focal and diffuse marrow changes, and made no individual diagnostic contribution.

Adolescent↗

Recurrent rectal cancer: diagnosis with dynamic MR imaging.

PURPOSE: To evaluate whether dynamic magnetic resonance (MR) imaging can increase the diagnostic accuracy in suspected local recurrence of rectal carcinoma. MATERIALS AND METHODS: Eighteen patients (seven men, 11 women, aged 26-78 years) with 19 suspect lesions were examined. T1-weighted (pre- and postcontrast) and T2-weighted spin-echo images were read by three observers. Computed tissue-specific enhancement parameters were obtained and displayed on gray-scale images (pharmacokinetic mapping). RESULTS: Reading of the spin-echo images yielded a sensitivity of 91%-100% (confidence interval, 67%, 100%), a specificity of 29%-43% (12%, 67%), and an accuracy of 71%-75% (48%, 91%). Analysis of the MR data showed greater (P = .0038) and faster (P = .0018) enhancement of malignant lesions (n = 12) compared with benign lesions (n = 7). CONCLUSION: Pharmacokinetic mapping of dynamic MR imaging data allows in vivo insight into tissue physiopathology, helping differentiate benign from malignant pelvic lesions in rectal cancer.

Adult↗

Correction of spatial distortion in magnetic resonance angiography for radiosurgical treatment planning of cerebral arteriovenous malformations.

A treatment planning system based on magnetic resonance (MR) angiographic imaging data for the radiosurgery of inoperable cerebral arteriovenous malformations is reported. MR angiography was performed using a three-dimensional (3D) velocity-compensated fast imaging with steady-state precession (FISP) sequence. Depending on the individual MR system, inhomogeneities and nonlinearities induced by eddy currents during the pulse sequence can distort the images and produce spurious displacements of the stereotactic coordinates in both the x-y plane and the z axis. If necessary, these errors in position can be assessed by means of two phantoms placed within the stereotactic guidance system--a "2D-phantom" displaying "pincushion" distortion in the image, and a "3D-phantom" displaying displacement, warp, and tilt of the image plane itself. The pincushion distortion can be "corrected" (reducing displacements from 2-3 mm to 1 mm) by calculations based on modeling the distortion as a fourth order 2D polynomial. Displacement, warp, and tilt of the image plane may be corrected by adjustment of the gradient shimming currents. After correction, the accuracy of the geometric information is limited only by the pixel resolution of the image (= 1 mm). Precise definition of the target volume could be performed by the therapist either directly in the MR images or in calculated projection MR angiograms obtained by a maximum intensity projection algorithm. MR angiography provides a sensitive, noninvasive 3D method for defining target volume and critical structures, and for calculating precise dose distributions for radiosurgery of cerebral arteriovenous malformations.

Humans↗

[MR tomographic studies of the cerebral circulation: the methodological principles and initial clinical experiences with T2*-weighted gradient-echo sequences and CM administration as a bolus].

Paramagnetic contrast agents produce local magnetic field inhomogeneity when they pass through the cerebrovascular system. This effect can be monitored with T2*-weighted gradient echo images, which show transient signal loss, while a bolus of GdDTPA is passing through the brain tissue. This signal loss is correlated to the local cerebral tissue perfusion and the local cerebral blood volume. In a prospective study 10 volunteers and 14 patients with cerebral infarcts and brain tumours were examined. After bolus application of GdDTPA a dynamic series of rapid T2*-weighted gradient echo images were recorded, and the local dynamics of contrast flow in brain tissue was examined. From the series of images, local changes in signal intensity were calculated pixel by pixel and presented as parameter images. By this method, infarcted areas and brain tumours can be distinguished from normal tissue by their contrast flow dynamics. The abnormal contrast dynamics depend on changes in local tissue perfusion and alterations in local blood volume. The separation of the influence of both parameters however is still an unsolved problem.

Adolescent↗

[MR tomography of the bone marrow in malignant systemic diseases. Diagnosis and therapeutic follow-up control].

This paper presents a short survey of the current status of bone marrow diagnosis in systemic neoplastic disease by means of MR imaging. The different patterns of bone marrow infiltration from lymphomas and leukaemias are presented and the differential diagnoses are discussed. Apart from the primary diagnosis the relevance of conventional MRI and chemical shift imaging for therapy follow up and after-care is discussed.

Bone Marrow↗

[Bone marrow changes following radiotherapy. Results of MR tomography].

Magnetic resonance imaging (MRI) offers a new approach in the morphologic evaluation of the bone marrow. Physiologic and pathologic changes can be assessed with very high sensitivity. Radiotherapy induces acute depletion of the hematopoietic bone marrow, resulting in fatty degeneration. With MRI it is possible to evaluate the changes during irradiation and it also discloses the long-term fatty degeneration after radiotherapy. The irradiated bone marrow mostly exhibits a homogeneous hyperintense pattern on T1-weighted images. This allows clear recognition of the former target volumes. Our quantitative studies based on chemical shift imaging data reveal a lack of recovery of hematopoiesis after radiotherapy with 30 Gy or more. These results are independent of patients' age and of the interval after radiotherapy.

Adipose Tissue↗

[MR tomography and MR angiography--a new method for the planning of the irradiation of large abdominal fields].

Subdiaphragmatic radiation therapy in malignant lymphoma requires complete irradiation of retroperitoneal lymph nodes, spleen and splenic pedicle and optimal shielding of radiosensitive structures. The aim of our study was to develop a new method for individual field definition by using MR tomography and MR angiography. In 38 patients with malignant lymphoma coronal MR tomograms and MR angiograms of the abdominal vessels were obtained and superimposed by a specially created computer program. By using a Subtraskop the MRT/MRA superposition was geometrically projected onto the simulation film in correct scale. The target volume could individually be defined and was compared to standard treatment planning according to the definition by Abbatucci. In all patients an exact irradiation of the spleen, the splenic pedicle and prominent lymphatic masses was possible. Furthermore, this resulted in a 32% reduction of treated kidney volume in the average of patients. Noninvasiveness, acceptable costs and high accuracy support the application of this new method in clinical routine.

Abdomen↗

Fast and precise T1 imaging using a TOMROP sequence.

Proton spin-lattice (T1) relaxation time images were computed from a data set of 32 gradient-echo images acquired with a fast TOMROP (T One by Multiple Read Out Pulses) sequence using a standard whole-body MR imager operating at 64 MHz. The data acquisition and analysis method which permits accurate pixel-by-pixel estimation of T1 relaxation times is described. As an example, the T1 parameter image of a human brain is shown demonstrating an excellent image quality. For white and gray brain matter, the measured longitudinal relaxation processes are adequately described by a single-component least-squares fit, while more than one proton component has to be considered for fatty tissue. A quantitative analysis yielded T1 values of 547 +/- 36 msec and 944 +/- 73 msec for white and gray matter, respectively.

Brain↗

[MR-tomographic quantification of infiltrative bone marrow changes and therapeutic follow-up of patients with hairy cell leukemia].

The effect of treatment on bone marrow infiltration in hairy cell leukaemia was followed by means of MRT in five patients. A semi-quantitative method has been developed in order to judge the effect of treatment. The results correlate well with the findings on iliac crest biopsies. The method could partly replace the invasive iliac crest biopsies, which are used for therapy monitoring.

Bone Marrow↗

Evaluation of proton density by magnetic resonance imaging: phantom experiments and analysis of multiple component proton transverse relaxation.

The quantitative evaluation of proton density by magnetic resonance imaging (MRI) is limited as a result of non-uniformities in the intensity distribution of the images and by the fact that only part of the protons of the tissue contribute to the image signal. This study was undertaken to estimate the accuracy of proton density measurements using a standard whole-body MR imager operating at 1.5 T. First, phantom experiments were performed to examine the possibility of an intensity correction. For the test phantom the systematical errors in the computed proton densities were reduced from 5 to 1% after correction. Secondly, proton transverse relaxation curves of biological tissues were measured in vitro on an MR spectrometer. A multi-exponential analysis of the data shows that for spin-echo times TE greater than 10 ms in total between 10 and 30% of the protons of the tissue do not contribute to the image signal. In all tissues a proton component with a free induction decay (FID) time T2* less than 32 microseconds was observed. In the time range TE greater than 10 ms two proton components can be distinguished in muscle and fatty tissue. Finally, it will be shown that a pixel-orientated two-exponential analysis of spin-echo images leads to a much more homogeneous density image than one-exponential computation, since tissue-specific biexponentiality and partial volume effects are taken into account. As a conclusion, the hydrogen density of biological tissues can be evaluated at best with an overall error of 10% from MR images for TE greater than 10 ms. This accuracy is insufficient for a pixel-orientated neutron therapy planning.

Adipose Tissue↗

[Bone marrow changes in Hodgkin's disease: MR tomography and chemical shift imaging].

A patient with Hodgkin's disease, who had received various forms of treatment, was examined by MR tomography and scintigraphy; the results are discussed together with the findings of the bone marrow biopsy. A spectroscopic imaging technique (modified Dixon method) and quantitative evaluation of the fat and water components of the RF signal provide new diagnostic information that may improve the differential diagnosis. Serial examinations following supra-lethal therapy and bone marrow transplantation have been able to show changes in the bone marrow and these could be evaluated quantitatively.

Adult↗

Fatty replacement of bone marrow after radiation therapy for Hodgkin disease: quantification with chemical shift imaging.

The authors studied the long-term fatty replacement of bone marrow in 23 patients who had received radiation therapy for Hodgkin disease, with T1-weighted magnetic resonance imaging and quantitative chemical shift imaging. T1-weighted images revealed a mostly homogeneous high-signal-intensity pattern, in contrast to the hypointense pattern of nonirradiated marrow. The degree of fatty replacement was objectively assessed with chemical shift imaging, comparing patients to age-matched healthy volunteers. The authors found an increase in relative fat signal of 37% in the thoracic spine and 34% in the lumbar spine. The relative fat signal of nonirradiated pelvic and femoral marrow was decreased by 8%, indicating marrow reconversion. No radiation dose dependence was found in the range from 25 to 50 Gy. No signs of marrow regeneration were observed 15-126 months after radiation therapy. With chemical shift imaging, the degree of long-term radiogenic fatty replacement of the bone marrow can be quantified, confirming the lack of regeneration after radiation therapy for Hodgkin disease.

Adult↗

Pharmacokinetic MRI for assessment of malignant glioma response to stereotactic radiotherapy: initial results.

The purpose of this study was to assess the value of dynamic, contrast-enhanced MRI in patients with malignant glioma (a) to predict before stereotactic radiotherapy local tumor control, (b) to investigate temporal changes in tumor microcirculation after stereotactic radiotherapy, and (c) to analyze whether malignant glioma response may be predicted earlier by alterations in the tissue pharmacokinetics rather than in terms of tumor volume. Ninety MRI studies were performed of 18 patients with malignant glioma before and 6, 18, 26, 52, and 72 weeks after the end of stereotactic radiotherapy. The signal time courses of the contrast-enhanced tumors were analyzed using a pharmacokinetic two-compartment model that calculates for the parameter A, reflecting the degree of MRI signal enhancement [no units] and the exchange rate constant k21 [min(-1)]. Before radiotherapy, the amplitude A was significantly (P < .05) lower in patients with subsequent local tumor control (n = 8; mean A = .34 +/- .15) compared to patients without subsequent local tumor control (n = 10; mean A = .94 +/- .71). In the local tumor control group, early after stereotactic radiotherapy (at 6-18 weeks), there was a significant (P < .05) time-dependent decrease in the parameter k21, whereas there was still no alteration in the tumor volume. A low amplitude A before radiotherapy, combined with an early drop of k21 after stereotactic radiotherapy, reliably characterized the group of patients with subsequent tumor volume decrease. Our preliminary results suggest that two contrast-enhanced dynamic MR studies, one before and one early after stereotactic radiotherapy, offer important information on local tumor control within the first 6 to 18 weeks after stereotactic radiotherapy. Moreover, this response may be evidenced before tumor volume changes and provides a therapeutic window to broaden treatment options and to improve treatment outcome.

Brain↗

1H-spectroscopic imaging using a modified Dixon method.

Inhomogeneities of the static magnetic field and the different susceptibilities of the various types of tissue are a serious problem for all imaging methods of spectral separation of fat and water. In the Dixon method this problem is solved by using the absolute values of the image signals for the separation. In image regions where the fat signal is greater than the water signal, however, this results in an incorrect assignment of the computed solutions. A modified Dixon method was developed to easily carry out the spectral separation completely over the entire image by interactively building up a phase correction matrix after the data acquisition. The spectral delineation of the fat tissue finds an interesting application in the treatment planning with fast neutrons in accounting for the increase in dose.

Adipose Tissue↗

Two-exponential analysis of spin-spin proton relaxation times in MR imaging using surface coils.

Proton relaxation time measurements were performed on a standard whole body MR imager operating at 1.5 T using a conventional surface coil of the manufacturer. A combined CP/CPMG multiecho, multislice sequence was used for the T1 and T2 relaxation time measurements. Two repetition times of 2000 ms (30 echoes) and 600 ms (2 echoes) with 180 degrees-pulse intervals of 2 tau = 22 ms were interleaved in this sequence. A two-exponential T2 analysis of each pixel of the spin-echo images was computed in a case of an acoustic neurinoma. The two-exponential images show a "short" component (T2S) due to white and gray matter and a "long" component (T2S) due to the cerebrospinal fluid. In the fatty tissue two components with T2S = 35 +/- 3 ms and T2L = 164 +/- 7 ms were measured. Comparing with Gd-DTPA imaging the relaxation time images show a clear differentiation of vital tumor tissue and cerebrospinal fluid.

Equipment Design↗

Multiexponential proton spin-spin relaxation in MR imaging of human brain tumors.

In vivo measurements of proton relaxation processes in human brain tumors have been performed by magnetic resonance (MR) imaging using a whole-body superconductive MR scanner, operating at 1.5 T. The T1 and T2 relaxation time measurements were based on a combined Carr-Purcell/Carr-Purcell-Meiboom-Gill sequence with two interleaved repetition times and 32 echoes. First, comparative measurements in the imager and with the spectrometer of relaxation times were performed on phantoms containing fluids of different T1 and T2 to evaluate accuracy. A maximum deviation of approximately 10% was found. Multislicing with a gap width of one slice thickness influenced the accuracy of T1 relaxation measurement. A gap width of at least two times the slice thickness was necessary for reliable determination of T1. No influence on T2 values was observed by multislicing. Second, in human head imaging the multiexponential behavior of the T2 decay curves has been analyzed in each pixel, where the mean square deviation has been used as a criterion to discriminate between mono- and biexponential behavior. Mean values of monoexponential T1 and multiexponential T2 relaxation data for white matter, gray matter, CSF, edema, and tumor were sampled in 12 patients with brain tumors. T2 showed monoexponential behavior in white and gray matter, whereas CSF, edema, and tumor showed distinct biexponentiality. The biexponential analysis generally yields "fast" and "slow" components with T2f = 80 +/- 17 ms and T2s = 2,030 +/- 210 ms for CSF (partial volume effect), T2f = 104 +/- 25 ms and T2s = 677 +/- 152 ms for edematous tissues, T2f = 97 +/- 19 ms and T2s = 756 +/- 99 ms for tumor tissues, respectively. Using a stepwise discriminant analysis by forward selection, the two best discriminating parameters of the multiexponential relaxation analysis for each pair of classification groups have been selected. For the discrimination of edematous and tumor tissues a retrospective overall accuracy of 94% has been found.

Brain↗