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W Semmler

Publications and source records attributed to W Semmler.

103 records · Page 6Linked to original sources

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↗

Synthesis, characterization, and biological properties of cyanine-labeled somatostatin analogues as receptor-targeted fluorescent probes.

We present the synthesis and characterization of the somatostatin receptor-specific peptide H(2)N-(D-Phe)-cyclo[Cys-Phe-(D-Trp)-Lys-Thr-Cys]-Thr-OH, which is labeled with a carboxylated indodicarbo- and an indotricarbocyanine dye at the N-terminal amino group. The preparation was performed by automated solid-phase synthesis, with subsequent attachment of the cyanine dye and cleavage of the entire conjugate from the resin. The compounds display high molar absorbance and fluorescence quantum yields typical for cyanine dyes and are thus suitable receptor-targeted contrast agents for molecular optical imaging. The ability of these agents to target the somatostatin receptor was demonstrated by flow cytometry in vitro, in which the indotricarbocyanine conjugate led to elevated cell-associated fluorescence on somatostatin receptor-expressing tumor cells. In contrast, the corresponding linearized derivative of the sequence H(2)N-(D-Phe)-Met-Phe-(D-Trp)-Lys-Thr-Met-Thr-OH produced only minimal cell fluorescence, hence confirming the specificity of the cyclic somatostatin analogue. Intracellular localization could be visualized by near-infrared (NIR) fluorescence microscopy. In conclusion, receptor-specific peptides are promising tools for designing site-directed optical contrast agents for use in molecular optical imaging.

Animals↗

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↗

Systemic bone marrow disorders: characterization with proton chemical shift imaging.

In a prospective clinical study, 26 patients (22 with malignant lymphoma and 4 with myelofibrosis) and 9 healthy volunteers were examined by conventional magnetic resonance and proton chemical shift imaging (CSI; modified Dixon method). On the basis of the CSI data, a quantitative evaluation of the relative fat and water signal fractions in regions of interest of the femur, pelvis, and spine was performed. In 16 of 17 patients with biopsy-proven bone marrow disorders, CSI revealed a significant reduction in the fat fraction of the bone marrow relative to that of normal volunteers. The visual assessment could detect only 14 of the 17 pathological cases.

Bone Marrow↗

Proton chemical shift imaging of bone marrow for monitoring therapy in leukemia.

In three patients with different forms of leukemia, follow-up examinations before, during, and after chemotherapy and bone marrow transplantation were performed by proton chemical shift imaging (1H-CSI). The relative fat and water fractions were computed in representative regions of the marrow in the femur, pelvis, and lumbar spine. On serial examinations the fat fractions increased over time, in agreement with the responses to therapy proven by bone marrow biopsies from the iliac crest. These preliminary results suggest a role for magnetic resonance and CSI in the monitoring of therapy in leukemia and systemic neoplastic diseases.

Acute Disease↗

Clinical applications of MR angiography in intrathoracic masses.

This is a prospective evaluation of the use of MR angiography (MRA) at 1.5 T in the assessment of intrathoracic masses. Two-dimensional (2D) MRA was obtained sequentially by means of a fast low angle shot (FLASH) technique (repetition time 30 ms, echo time 10 ms, flip angle 30 degrees) one slice per breath-holding. An automated control procedure and instantaneous image reconstruction permitted constant monitoring of the image quality and tailoring of the timing of the scans to each patient's breathing capacity; MRA was successfully completed in all patients. Two-dimensional FLASH angiography was postprocessed into three-dimensional (3D) MR angiography (projections) by a maximum-intensity-projection algorithm; a 3D spatial impression of the MRA was achieved by obtaining 3D MRAs from different viewing angles and by viewing these in a cine-loop. Superimposition of vessels was avoided by creating angiograms of interest of a specific anatomic region. Fifteen patients with malignant or benign intrathoracic tumor were evaluated; their MR findings were correlated with chest radiography, conventional angiography, bolus enhanced CT, and/or perfusion scintigraphy. Magnetic resonance angiography revealed stenosis, distortion, and displacement of vessels by tumors as well as distal perfusion defects caused by proximal tumors. The MRA findings were readily accepted by our clinical colleagues and incorporated into their surgical planning. We believe MRA to be a promising complement to MR imaging in the assessment of intrathoracic masses.

Adult↗

Pharmacokinetic parameters in CNS Gd-DTPA enhanced MR imaging.

Dynamic MR imaging can be used to study tissue perfusion and vascular permeability. In the present article a procedure for dynamic MR is presented, which (a) accurately resolves the fast kinetics of tissue response during and after intravenous infusion of the paramagnetic contrast medium Gd-DTPA and (b) yields a linear relationship between the measured MR signal and the Gd-DTPA concentration in the tissue. According to these features, the measured signal-time curves can be analyzed within the framework of pharmacokinetic modeling. Tissue response has been parameterized using a linear two-compartment open model, with only negligible effects of the peripheral compartment on the central compartment. The three model parameters were fitted to the signal-time data pixel by pixel, based on a set of 64 rapid SE images (SE 100/10 ms, image scan time 13 s, interscan intervals 11 s). This makes it possible to construct parameter images, whereby structures become visible that cannot be distinguished in conventional Gd-DTPA enhanced MR. As a clinical example, the approach is discussed in a case of glioblastoma.

Brain Neoplasms↗

MRI and MRA in treatment planning of subdiaphragmatic radiation therapy.

Radiotherapy treatment planning needs optimum definition of target volume in its relative position to normal tissue. The aim of our study was to achieve individual field definition in subdiaphragmatic radiotherapy by visualization of the target volume using fast, breath-held MRI and MR angiography. A modified rapid acquisition SE technique (SE 150/10) was used to obtain a coronal image within a 14 s breath-holding period, displaying kidneys, spleen, and lumbar spine on one slice. Coronal MR angiography acquisition in breath-hold technique was performed using a sequential FLASH-2D sequence (FLASH-2D 30/10/30 degrees). For reconstruction of the MR angiogram in coronal view, we used a maximum intensity projection algorithm. A computer program superimposed the MR angiogram onto the MR image. Correct magnification of the superposition image allowed direct projection onto the simulation film. Problems of distortion and different projection techniques were taken into account and quantified by phantom measurements. The localization error measured in a reference plane was less than 5 mm within a radius of 140 mm. Fourteen cases of Hodgkin disease and non-Hodgkin lymphomas were treated employing the novel technique. By superposition of the MR image and the MR angiogram, demarcation of vascular architecture from parenchymatous organs was achieved. Projection of the MR superposition onto the simulation film yielded accurate and convenient field definition using noninvasive imaging techniques.

Abdomen↗

3D TOF MR angiography of cerebral arteriovenous malformations after radiosurgery.

To investigate the potential of three-dimensional time-of-flight MR angiography (MRA) to complement SE imaging, 18 patients with intracerebral arteriovenous malformations were prospectively followed after undergoing radiosurgery. Vessel occlusion after stereotaxic single high dose radiotherapy develops slowly. The MRA detected signs of nidus obliteration earlier and with a higher sensitivity than did SE imaging. Six months after radiosurgery, MRA showed a reduction of the nidus flow signals in nine patients and after 1 year it showed reduction in 15 of the 18 patients. As shown by MRA, the loss of flow signals was related to a reduction of the nidus size in 4 patients after 6 months and in 11 after 1 year. The SE imaging revealed a reduction of the nidus size in only two patients after 6 months and in eight after 1 year. The signal intensity of the feeding arteries was reduced in nine patients and that of the draining veins was reduced in six. The T2-weighted images exhibited white matter lesions in eight patients after 1 year. For complete follow-up, SE imaging should be performed together with MRA.

Adolescent↗

Heat response of HT29 cells depends strongly on perfusion--a 31P NMR spectroscopy, HPLC and cell survival analysis.

A model system of perfused human colon adenocarcinoma cells (HT29) encapsulated in alginate was used to examine metabolic response to heat therapy with 31P NMR spectroscopy, HPLC and cell survival analysis. The presented data show, that perfused (medium flow during hyperthermia) and non-perfused (no medium flow during hyperthermia) cells are very difficult in their sensitivity to hyperthermia. Under equivalent experimental conditions with respect to medium pH, oxygen and nutrient concentration, encapsulated perfused HT 29 cells display a significantly lower thermal sensitivity than non-perfused cells. This reduced sensitivity of perfused cells is characterized by an increased cell survival and relative ATP concentration, and reduced drop of the NTP/Pi ratio in the long-term follow up towards zero. The relative ATP concentration determined by HPLC after hyperthermia is correlated with the clonogenic survival fraction. There is a direct relationship, depending on the specific experimental conditions (perfused, non-perfused). For perfused cells only a slight dependency of survival and relative ATP concentration on heat dose is observed. In consequence, the correlation between survival and relative ATP concentration is weak, described by log(SFperf) = 0.7*[ATP-12.4, R2 = 0.79, p < 0.04. For non-perfused cells the correlation is stronger resulting in a relationship of log(SFno perf) = 0.6*[ATP]-9.0, R2 = 0.98, p < 0.0002. Altogether, the presented data suggest that the relative ATP concentration measured by HPLC after hyperthermia might be predictive for cell survival. On the other hand, a dependence between cell survival and long-term changes of NTP/Pi has been found. The results confirm the importance of tumour perfusion for hyperthermia-induced metabolic changes and cytotoxicity and therefore, for the therapeutic outcome.

Adenosine Triphosphate↗

Dose administration of gadolinium-DTPA in MR imaging of intracranial tumors.

Eleven patients with intracranial tumors were investigated with MR imaging at different dose levels of gadolinium-DTPA to determine a safe and effective dose for imaging intracranial tumors. The patients were divided into two groups. Baseline spin-echo images were obtained with a repetition time of 800 msec and an echo time of 35 msec, and a total of 0.1 mmol of gadolinium-DTPA/kg (six patients) or 0.2 mmol gadolinium-DTPA/kg (five patients) was injected according to a fractionated incremental dose regime (0.025, 0.025, and 0.05 mmol/kg and 0.05, 0.05, and 0.1 mmol/kg, respectively). Postcontrast MR was performed after each injection. In group 1 the best visualization was achieved after the third injection in four cases. In one glioblastoma and in a pituitary adenoma tumor margins were well defined at lower dose levels. In group 2, with five patients, the total dose of 0.2 mmol of gadolinium-DTPA/kg (0.05, 0.05, and 0.1) significantly improved tumor visualization after the third injection in only one patient with multiple metastases. No short-term side effects were encountered. In a range of parameters measured in both serum and whole blood, slight transient elevation of serum iron levels was the only appreciable change. As a result of our investigation we conclude that 0.1 mmol of gadolinium-DTPA/kg is a safe and suitable dose for brain-tumor imaging. In selected cases of 0.2 mmol/kg may increase the diagnostic yield.

Adenoma↗