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Biomedical subjects

M Giessing

Publications and source records attributed to M Giessing.

30 records · Page 2Linked to original sources

[The staging of bladder tumors in MRT: the value of the intravesical application of an iron oxide-containing contrast medium in combination with high-resolution T2-weighted imaging].

AIM: To investigate superparamagnetic iron oxide (SPIO) particles as intravesically applied contrast material in combination with high-resolution T2-weighted MR imaging for the diagnostic assessment of urinary bladder tumors. METHODS: A prospective study was performed in 40 patients with suspected urinary bladder tumors who underwent MR imaging with a body phased-array coil at 1.5 T. Prior to imaging, a SPIO-containing solution (179.2 mg Fe/l) was instilled into the bladder. All patients were examined with T2-weighted, half-fourier acquired single shot turbo spin echo sequences and T1-weighted fast low angle shot sequences in 3 planes as well as a T2-weighted turbo spin echo sequence (TSE) using a 512 matrix. An additional gadolinium-enhanced dynamic study was performed in 33 patients. All patients underwent transurethral resection of the bladder or cystectomy. RESULTS: The combination of intravesically applied SPIO particles and a high-resolution T2-weighted TSE sequence depicted intravesical tumors as small as 4 mm. A reliable identification of the different layers of the bladder wall was possible in 5 cases only. The T2-weighted TSE sequence allowed the correct determination of the depth of infiltration in 29 of 36 patients with urothelial cancer by assessing the inner and outer boundary of the urinary bladder wall. This sequence had a diagnostic accuracy of 81% compared to 84% for the dynamic study (26/31). CONCLUSION: Even small tumors could be identified with the T2-weighted TSE sequence after intravesical administration of SPIO particles but it was not possible to reliably differentiate the layers of the bladder wall. The results suggest that a dynamic MR imaging study cannot be dispensed with in patients with urinary bladder cancer.

Administration, Intravesical↗

Presence and persistence of HPV infection and p53 mutation in cancer of the cervix uteri and the vulva.

We studied 51 cervical carcinomas, among them 25 squamous-cell carcinomas (SCC) and 26 cervical adenocarcinomas (AdCa), and 40 vulvar SCC for the presence of HPV and mutant p53. HPV was detected by PCR, and p53 alterations by temperature-gradient gel electrophoresis/direct sequencing and immunohistochemistry. HPV, mostly type 16/18, was found in 80.4% of the cervical tumors (92.0% of the SCC and 69.2% of the AdCa), but in only 27.5% of vulvar carcinomas. In contrast, p53 mutations were found in 7.8% and 52.5% of cervical and vulvar tumors respectively. Mutant p53 occurred in pre-invasive vulvar lesions, indicating that this oncogenic factor is involved early in carcinogenesis. Further analysis of recurrent/metastatic lesions of 9 cervical and 14 vulvar tumors also showed remarkable differences: in cervical cancer, HPV was persistent, and p53 mutations absent, whereas in vulvar tumors, HPV was mostly absent or not persistent, and the p53 mutation rate was very high (78.6%). These observations suggest that HPV persistence is an important event for the evolution and maintenance of cervical cancer, whereas for vulvar cancers p53 mutation and not HPV activity is a central oncogenic event.

Adenocarcinoma↗