Search PubMed⌕ Search

Biomedical subjects

L R Schad

Publications and source records attributed to L R Schad.

At least 19 recordsLinked to original sources

[Perfusion measurement using the T2* contrast media dynamics in neuro-oncology. Physical basics and clinical applications].

Perfusion imaging in the central nervous system (CNS) is mostly performed using the first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) MRI. The first-pass of a contrast bolus in brain tissue is monitored by a series of T2*-weighted MR images. The susceptibility effect of the paramagnetic contrast agent leads to a signal loss that can be converted, using the principles of the indicator dilution theory, into an increase of the contrast agent concentration. From these data, parameter maps of cerebral blood volume (CBV) and flow (CBF) can be derived. Regional CBF and CBV values can be obtained by region-of-interest analysis. This review article describes physical basics of DSC MRI and summarizes the literature of DSC MRI in neurooncological issues.Studies, all with relatively limited patient numbers, report that DSC MRI is useful in the preoperative diagnosis of gliomas, CNS-lymphomas, and solitary metastases, as well as in the differentiation of these neoplastic lesions from infections and tumor-like manifestations of demyelinating disease. Additionally, DSC MRI is suitable for determining glioma grade and regions of active tumor growth which should be the target of stereotactic biopsy. After therapy, DSC MRI helps better assessing the tumor response to therapy, residual tumor after therapy, and possible treatment failure and therapy-related complications, such as radiation necrosis. The preliminary results show that DSC MRI is a diagnostic tool depicting regional variations in microvasculature of normal and diseased brains.

Algorithms↗

[Noninvasive measurement of relative cerebral blood flow with the blood bolus MRI arterial spin labeling: basic physics and clinical applications].

Knowledge of tumor blood flow is important for diagnosis and follow-up of brain tumors after therapy, especially to discriminate necrosis from tumor recurrence after radiation or chemotherapy. Meanwhile, perfusion and diffusion MRI, besides MR-angiography, are state of the art in stroke imaging. Until now, perfusion imaging was mostly performed using the first-pass dynamic susceptibility-weighted contrast-enhanced (DSC) MRI. The MRI-based arterial spin labeling technique (ASL) is a novel approach for measuring relative cerebral blood flow (rCBF) without using extrinsic contrast agents, by labeling spins of flowing arterial blood as intrinsic contrast agent. This article describes physical basics of ASL and shows clinical examples in neuroimaging such as in meningeoma, glioblastoma, oligodendroglioma, and cerebral ischemia, using the Q2TIPS ASL technique. Gray matter is clearly visible, while the observed white matter signal obtained by Q2TIPS is only slightly higher than background noise. Venous blood causes artefacts in the sagittal sinus and other large superficial veins in the subarachnoid space. Meningeoma and glioblastoma show elevated rCBF, whereas oligodendroglioma and cerebral ischemia have reduced rCBF values. Arterial-spin-labeling techniques are noninvasive tools for measuring rCBF within 5 min, using a standard MRI scanner.

Blood Flow Velocity↗

[Monitoring of irradiated brain metastases using MR perfusion imaging and 1H MR spectroscopy].

PURPOSE: In follow-up examinations of irradiated brain metastases conventional contrast-enhanced morphological MR imaging is often unable to distinguish between transient radiation effects, radionecrosis,and tumor recurrence. To evaluate changes of relative cerebral blood flow (rCBF) in irradiated brain metastases arterial spin-labeling techniques (ASL) were applied and compared to the outcome of (1)H MR spectroscopy and spectroscopic imaging ((1)H MRS, SI). PATIENTS AND METHODS: In 2 patients follow-up examinations of irradiated brain metastases were performed on a 1.5-T tomograph (average single dose: 20 Gy/80% isodose). Relative CBF values of gray matter (GM), white matter (WM),and metastases (Met) were measured by means of the ASL techniques ITS-FAIR and Q2TIPS. (1)H MRS was performed with PRESS 1500/135. RESULTS: In both patients with initially hyperperfused metastases (Met/GM >1) the reduction of rCBF after stereotactic radiosurgery indicated response to treatment--even if the contrast-enhancing region increased--while increasing rCBF values indicated tumor progression. The findings were confirmed by (1)H MRS, SI and subsequent follow-up. CONCLUSION: The ASL techniques ITS-FAIR and Q2TIPS are able to monitor changes of rCBF in irradiated brain metastases. The two cases imply a possible role for ASL-MR perfusion imaging and (1)H MR spectroscopy in differentiating radiation effects from tumor progression.

Aged↗

Comparison of TSE, TGSE, and CPMG measurement techniques for MR polymer gel dosimetry.

A radiation dose distribution that optimally conforms to the target volume is of major interest for stereotactic radiotherapy. For this purpose treatment plans have to be verified experimentally before transferring to the patient. The requirements regarding dose accuracy and spatial resolution can be fulfilled with tissue equivalent polymer gel dosimeters which offer the possibility to visualize 3D dose distributions. Herewith, dosimetry can be performed by the spin-spin relaxation rate R2 which varies with the absorbed dose. In this work, different MR measurement techniques were evaluated: The standard Carr-Purcell-Meiboom-Gill (CPMG) method, a modified Turbo-Spin-Echo (TSE) sequence, and a modified Turbo-Gradient-Spin-Echo (TGSE) sequence. Experiments were performed both with a homogeneous water phantom and an irradiated polymer gel. The results show that TGSE and especially TSE are suited well for MR polymer gel dosimetry: The acquisition time of both techniques can be reduced in comparison to CPMG by a factor of 5. The accuracy of dose determination for doses between 2 Gy and 13 Gy lies between 5.6% and 2.0% (TSE), 9.0% and 3.2% (TGSE), and 7.9% and 2.7% (CPMG). These investigations show that especially TSE can be handled as a substitute or at least an alternative to CPMG for the verification of treatment plans in stereotactic radiotherapy.

Gels↗

[Structural cerebral changes in subjects with mild cognitive impairment].

The aim of the present study was to investigate the morphological changes in subjects with mild cognitive impairment (MCI) revealed by quantitative magnetic resonance imaging (MRI). Twenty-one subjects with cognitive impairment and 22 healthy controls were compared with 12 patients suffering from mild Alzheimer's disease (AD). The volumes of the following brain structures were assessed: total intracranial compartment, cerebrospinal fluid compartment, whole brain, and medial temporal substructures (hippocampus and parahippocampal gyrus). Subjects with mild cognitive impairment showed a significantly reduced volume of the right parahippocampal gyrus over healthy controls. Volumes of the other regions and structures did not differ between the MCI group and controls. The volumetric and neuropsychological findings of the present study support the hypothesis that mild cognitive impairment - at least in some of the affected individuals - can be seen as a preclinical stage of AD and that atrophy of the parahippocampal gyrus might be useful as an early marker of AD.

Aged↗

23Na-MRI of the human heart using a 3D radial projection technique.

Sodium MRI has the potential to differentiate viable and non-viable infarcted myocardium. The accurate quantification of the total sodium content requires imaging techniques with ultra short echo times below 0.5 ms. We present a 3D-radial projection technique which allows the acquisition of ECG-triggered sodium images of the human heart with echo times of 0.4 ms. A 3D-data set of the heart of a volunteer was acquired within less than 18 min on a clinical scanner (1.5 T), achieving a SNR of 10 in the myocardium with an isotropic resolution of 10 mm. This technique provides a tool for clinical studies of ischemic heart diseases.

Electrocardiography↗

Reducing oblique flow effects in interleaved EPI with a centric reordering technique.

Segmented interleaved echo planar imaging offers a fast and efficient approach to magnetic resonance angiography. Unfortunately, this technique is particularly sensitive to oblique flow in the imaging plane. In this work, a mathematical analysis of oblique flow effects for several types of k-space coverage is presented. The conventional linear acquisition scheme, an alternating centric and a nonalternating centric encoding scheme are compared with respect to their flow properties. It is shown both by simulations and imaging experiments that artifacts from oblique in-plane flow are effectively reduced by both centric reordered phase-encoding schemes. The nonalternating centric acquisition scheme is preferred to the alternating centric scheme due to the smoother phase error transition in k-space in the presence of obliquely-angled flow. Magn Reson Med 45:623-629, 2001.

Artifacts↗

Arterial spin labeling in combination with a look-locker sampling strategy: inflow turbo-sampling EPI-FAIR (ITS-FAIR).

Arterial spin labeling (ASL) permits quantification of tissue perfusion without the use of MR contrast agents. With standard ASL techniques such as flow-sensitive alternating inversion recovery (FAIR) the signal from arterial blood is measured at a fixed inversion delay after magnetic labeling. As no image information is sampled during this delay, FAIR measurements are inefficient and time-consuming. In this work the FAIR preparation was combined with a Look-Locker acquisition to sample not one but a series of images after each labeling pulse. This new method allows monitoring of the temporal dynamics of blood inflow. To quantify perfusion, a theoretical model for the signal dynamics during the Look-Locker readout was developed and applied. Also, the imaging parameters of the new ITS-FAIR technique were optimized using an expression for the variance of the calculated perfusion. For the given scanner hardware the parameters were: temporal resolution 100 ms, 23 images, flip-angle 25.4 degrees. In a normal volunteer experiment with these parameters an average perfusion value of 48.2 +/- 12.1 ml/100 g/min was measured in the brain. With the ability to obtain ITS-FAIR time series with high temporal resolution arterial transit times in the range of -138 - 1054 ms were measured, where nonphysical negative values were found in voxels containing large vessels.

Adult↗

[Event-related functional magnetic resonance imaging of cerebral pain processing].

Neurofunctional magnetic resonance imaging (fMRI) offers the possibility to map cerebral activity non-invasively. The development of event-related techniques during the past years allows to study brain processes with high spatial and temporal resolution. Based on these techniques, EPI- and FLASH sequences were developed in this study, to investigate cerebral processing of experimental thermal pain stimulation. Phasic and tonic stimulation paradigms were developed with an MR-compatible contact thermode. Functional mapping of pain-relevant areas was performed with these paradigms, as well as a specification of the temporal characteristics of the activation. Further, a randomized paradigm with several stimulus intensities could differentiate graded functional responses, dependent on stimulus intensity in specific "regions-of-interest". In this design, randomizing the stimulus order reduced habituation effects, while continuous subjective magnitude estimation of the stimuli kept attention of subjects maximal.

Brain↗

Separation of arteries and veins in 3D MR angiography using correlation analysis.

Multiphase contrast-enhanced 3D MR angiography (MRA) data sets allow the separate visualization of the arterial and venous pulmonary vasculature. However, due to short arterial-to-venous bolus transit times in the lung, the generation of pure venograms without arterial overlay is difficult. To suppress arterial signal in venograms, early arterial phase data are typically subtracted from peak venous phase images. In this study, a correlation algorithm is used to postprocess the multiphase 3D MRA data sets. The cross-correlation between a measured arterial or venous reference function and the local signal-time course is computed which highlights image locations with a similar signal-time curve as the reference function and suppresses constant signal. Conventional maximum intensity projections (MIP) are generated from the arterial and venous correlation maps. In a study with five volunteers, an increase in SNR by a factor of 2.1 (1.8) of arterial (venous) correlation MIP images over subtraction MIP images was observed.

Contrast Media↗

Prospective acquisition correction for head motion with image-based tracking for real-time fMRI.

In functional magnetic resonance imaging (fMRI) head motion can corrupt the signal changes induced by brain activation. This paper describes a novel technique called Prospective Acquisition CorrEction (PACE) for reducing motion-induced effects on magnetization history. Full three-dimensional rigid body estimation of head movement is obtained by image-based motion detection to a high level of accuracy. Adjustment of slice position and orientation, as well as regridding of residual volume to volume motion, is performed in real-time during data acquisition. Phantom experiments demonstrate a high level of consistency (translation < 40 microm; rotation < 0.05 degrees ) for detected motion parameters. In vivo experiments were carried out and they showed a significant decrease of variance between successively acquired datasets compared to retrospective correction algorithms.

Algorithms↗

An amplitude optimized single-shot hybrid QUEST technique.

Rapid MR imaging techniques either deposit high amounts of radio frequency power or require powerful gradient systems with high slew rates, which might not be available on conventional scanners. QUEST provides a fast imaging method with scan times of the order of hundreds of milliseconds and avoids these problems at the cost of low signal-to-noise ratios (SNR). In this work, QUEST was optimized with regard to image quality and measuring time. With the use of a Hybrid QUEST technique, that refocuses the image echoes several times, a spatial resolution of 1.9 mm x 1.6 mm x 5 mm was achieved. By acquiring both the necessary correction data and the image information in a single echo train, the Hybrid QUEST technique was implemented as a true single-shot measurement with a total scan time of 190 ms. Optimization of the excitation flip angles and the amplitude and phase correction methods for image reconstruction resulted in an improved SNR of 53.7 in the white matter of the human head for a 10 mm slice thickness at 1.5 T. In contrast to echo planar imaging techniques, no image distortions were observed with Hybrid QUEST in anatomic regions with many tissue interfaces.

Brain↗

Estimation of aortic compliance using magnetic resonance pulse wave velocity measurement.

A method for compliance estimation employing magnetic resonance pulse wave velocity measurement is presented. Time-resolved flow waves are recorded at several positions along the vessel using a phase contrast sequence, and pulse wave velocity is calculated from the delay of the wave onsets. Using retrospective cardiac gating in combination with an optically decoupled electrocardiogram acquisition, a high temporal resolution of 3 ms can be achieved. A phantom set-up for the simulation of pulsatile flow in a compliant vessel is described. In the phantom, relative errors of pulse wave velocity estimation were found to be about 15%, whereas in a volunteer, larger errors were found that might be caused by vessel branches. Results of pulse wave velocity estimation agree with direct aortic distension measurements which rely on a peripheral estimate of aortic pressure and are therefore less accurate. Studies in 12 volunteers show values of pulse wave velocity consistent with the literature; in particular the well-known increase in pulse wave velocity with age was observed. Preliminary results show that the method can be applied to aortic aneurysms.

Adult↗

Three-dimensional BANG gel dosimetry in conformal carbon ion radiotherapy.

In this study we applied BANG polymer-gel dosimetry using magnetic resonance imaging (MRI) to densely ionizing radiation such as carbon ion beams. BANG polymer gels were irradiated with a quadratic field of monoenergetic 12C ions at different beam energies in the range of 135 MeV u(-1) to 410 MeV u(-1). They were irradiated at the radiotherapy facility of the GSI, Darmstadt, Germany. Our object was to examine the saturation effect for densely ionizing radiation that occurs at high values of linear energy transfer (LET). The examination yielded the first effectiveness values that will be discussed in the following sections. A solid sphere and a hollow sphere were both irradiated with a horizontal pencil beam from the raster scanning facility at energies of 268 MeV u(-1) (solid sphere) and 304 MeV u(-1) (hollow sphere) respectively. MR dosimetry measurements were compared with data from a planning system. As far as quality is concerned, there is good agreement between the measured dose distributions of both samples and the dose maps from the planning software. The measured MR signals cannot be converted into absolute dose, since the relative efficiency is still unknown for mixed radiation fields of primary carbon ions and it is known only to a limited extent for nuclear fragments with different energies from highly energetic photon radiation. Model calculations are in progress in order to facilitate conversions of measured MR signals into dose.

Acrylamides↗

Topography of callosal atrophy reflects distribution of regional cerebral volume reduction in Alzheimer's disease.

It has been suggested that regional corpus callosum atrophy in Alzheimer's disease (AD) may serve as an in vivo index of neuronal loss in the neocortex. In this study total and regional size of the corpus callosum was evaluated with respect to the volumes of the frontal, temporal, and parietal lobes in 38 patients with AD (NINCDS-ADRDA criteria) using quantitative magnetic resonance imaging. Twenty healthy subjects matched for age and gender served as a control group. All quantitative measurements were performed by manual tracing using personal computer-based software. Both total size and the five measured regional subsections were significantly smaller in AD when compared to the control subjects. The severity of dementia was significantly correlated with the size of the middle sections of the corpus callosum (rostral body and midbody). Within the AD group, the rostral body of the corpus callosum was significantly correlated with the frontal lobe volumes, the midbody was correlated with the temporal lobe volumes, and size of the splenium was correlated with the parietal lobe volumes. We conclude that callosal atrophy in AD reflects the severity and pattern of cortical neuronal damage. Correlations between regional callosal atrophy and severity of dementia indicate that interhemispheric cortico-cortical disconnection may contribute to the dementia syndrome.

Aged↗