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  • FUNCTION TESTS  (4)
  • 1
    Keywords: DISEASE ; SURGERY ; SCINTIGRAPHY ; FUNCTION TESTS ; ARTERY ; HYPERTENSION ; COPD ; QUANTITATIVE COMPUTED-TOMOGRAPHY ; LUNG-VOLUME-REDUCTION ; CT EVALUATION
    Abstract: PURPOSE: Distinct morphological emphysema phenotypes were assessed by CT to show characteristic perfusion defect patterns. MATERIAL/METHODS: Forty-one patients with severe emphysema (GOLD III/IV) underwent three-dimensional high resolution computed tomography (3D-HRCT) and contrast-enhanced magnetic resonance (MR) perfusion. 3D-HRCT data was visually analyzed for emphysema phenotyping and quantification by consensus of three experts in chest-radiology. The predominant phenotype per segment was categorized as normal, centrilobular, panlobular or paraseptal. Segmental lung perfusion was visually analyzed using six patterns of pulmonary perfusion (1-normal; 2-mild homogeneous reduction in perfusion; 3-heterogeneous perfusion without focal defects; 4-heterogeneous perfusion with focal defects; 5-heterogeneous absence of perfusion; 6-homogeneous absence of perfusion), with the extent of the defect given as a percentage. RESULTS: 730 segments were evaluated. CT categorized 566 (78%) as centrilobular, 159 (22%) as panlobular and 5 (〈1%) as paraseptal with no normals. Scores with regards to MR perfusion patterns were: 1-0; 2-0; 3-28 (4%); 4-425 (58%); 5-169 (23%); 6-108 (15%). The predominant perfusion pattern matched as follows: 70 % centrilobular emphysema - heterogeneous perfusion with focal defects (score 4); 42% panlobular--homogeneous absence of perfusion (score 5); and 43% panlobular--heterogeneous absence of perfusion (score 6). CONCLUSION: MR pulmonary perfusion patterns correlate with the CT phenotype at a segmental level in patients with severe emphysema. KEY POINTS: * MR perfusion patterns correlate with the CT phenotype in emphysema. * Reduction of MR perfusion is associated with loss of lung parenchyma on CT * Centrilobular emphysema shows heterogeneous perfusion reduction while panlobular emphysema shows loss of perfusion.
    Type of Publication: Journal article published
    PubMed ID: 25163898
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  • 2
    Keywords: tumor ; COMBINATION ; evaluation ; Germany ; THERAPY ; CT ; FOLLOW-UP ; imaging ; VOLUME ; DISEASE ; NEW-YORK ; validation ; NUCLEAR-MEDICINE ; PATIENT ; MRI ; SEQUENCE ; SEQUENCES ; chemotherapy ; VARIABILITY ; FUNCTION TESTS ; MOTION ; nuclear medicine ; mesothelioma ; PLEURAL MESOTHELIOMA ; dynamic MRI ; radiology ; malignant pleural mesothelioma ; THERAPIES ; IMAGING TECHNIQUES ; WEIGHT ; breathing cycle ; NUCLEAR ; CRITERIA ; technique ; USA ; correlation ; MEDICINE ; comparison ; KAPPA ; VALUES ; INTEROBSERVER ; RECIST ; RECIST CRITERIA ; MPM ; tumour volumetry
    Abstract: To evaluate and compare early therapy response according to RECIST (response evaluation criteria in solid tumours) and modified RECIST criteria using MRI techniques in patients with malignant pleural mesothelioma (MPM) in comparison with CT. Fifty patients with MPM (32 male/18 female) were included in this study. Early therapy response was evaluated after 9 weeks [three of six chemotherapy (CHT)] cycles. Additionally patients were examined before chemotherapy, 4 weeks after early therapy response evaluation and after six cycles to evaluate diagnostic follow-up. RECIST and modified RECIST criteria were applied using CT and MRI (HASTE, VIBE, T2-TSE sequences). In MRI additionally a volumetric approach measuring tumour weight (overall segmented tumour volume) was applied. Additionally vital capacity (VC) was measured for correlation. Image interpretation was performed by three independent readers independently and in consensus. The 'gold standard' was follow-up examination. Twenty-eight patients showed partial response, 12 patients stable disease and 10 patients progressive disease at early therapy response evaluation. In the follow-up these results remained. For MRI, in 46 cases patients were identically classified using RECIST and modified RECIST criteria. Modified RECIST criteria were identically classified as gold standards in all cases, whereas using RECIST criteria in four cases there was a mismatch (partial response vs. stable disease). Modified RECIST kappa values showed better interobserver variability compared with RECIST criteria (kappa=0.9-1.0 vs. 0.7-1.0). For CT, in 44 cases patients were identically classified using RECIST and modified RECIST criteria. Modified RECIST criteria were identically classified as in gold standards in 48 out of 50 patients, whereas using RECIST criteria in 6 cases there was a mismatch (partial response vs. stable disease). Modified RECIST kappa values showed better interobserver variability compared with RECIST criteria (kappa=0.9-1.0 vs. 0.6-1.0). Modified RECIST criteria especially in combination with high-resolution MRI is a very accurate and reproducible technique to correctly evaluate early therapy response in MPM
    Type of Publication: Journal article published
    PubMed ID: 18369634
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  • 3
    Keywords: EMPHYSEMA ; QUANTIFICATION ; DISEASE ; MORTALITY ; FUNCTION TESTS ; LUNG-VOLUMES ; STANDARDIZATION ; pirfenidone ; QUANTITATIVE CT INDEXES ; PHYSIOLOGICAL IMPAIRMENT
    Abstract: OBJECTIVES: To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification. METHODS: Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles. RESULTS: In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5 %/year (interquartile: 0 %/y; +11 %/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Delta) in OE and Delta 40th percentile (r=0.69; p〈0.001) as compared to Delta 80th percentile (r=0.58; p〈0.001); closer correlation was found between Delta ground-glass extent and Delta 40th percentile (r=0.66, p〈0.001) as compared to Delta 80th percentile (r=0.47, p=0.002), while the Delta reticulations correlated better with the Delta 80th percentile (r=0.56, p〈0.001) in comparison to Delta 40th percentile (r=0.43, p=0.003). CONCLUSIONS: There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Delta 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Delta 80th percentile might reveal the course of reticular opacities.
    Type of Publication: Journal article published
    PubMed ID: 26110421
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  • 4
    Keywords: Germany ; LUNG ; PERFUSION ; THERAPY ; FOLLOW-UP ; imaging ; VOLUME ; DISEASE ; PATIENT ; MRI ; CYCLE ; magnetic resonance imaging ; MOBILITY ; chemotherapy ; FUNCTION TESTS ; MOTION ; PLEURAL MESOTHELIOMA ; dynamic MRI ; 2D ; breathing cycle ; DIAPHRAGM ; HEALTHY-SUBJECTS ; SPIROMETRY ; volumetry ; LUNG-VOLUME ; therapy monitoring ; 3D volumetry
    Abstract: Purpose: To monitor lung motion in patients with malignant pleural mesothelioma (MPM) before and after chemotherapy (CHT) using 2-dimensional (2D) and 3-dimensional (3D) dynamic MRI (dMRI) in comparison with spirometry. Methods and Materials: Twenty-two patients with MPM were examined before CHT, as well as after 3 and 6 CHT cycles (3 months and 6 months) using 2D dMRI (trueFISP; 3 images/s) and 3D dMRI (FLASH 3D, I slab (52 slices)/s) using parallel imaging in combination with view-sharing technique. Maximum craniocaudal lung dimensions (2D) and lung volumes (3D) were monitored, separated into the tumor-bearing and nontumor-bearing hemithorax. Vital capacity (VC) was measured for comparison using spirometry. Results: Using 2D technique, there was a significant difference between the tumor-bearing and the nontumor-bearing hemithorax before CHT (P 〈 0.01) and after 3 CHT cycles (P 〈 0.05), whereas difference was not significant in the second control. In the tumor-bearing hemithorax, mobility increased significantly from the status before versus after 3 CHT cycles (4.1 +/- 1.1 cm vs. 4.8 +/- 1.4 cm, P 〈 0.05). Using 3D technique, at maximum inspiration, the volume of the tumor-bearing hemithorax was 0.6 +/- 0.4 L and of the nontumor-bearing hemithorax 1.25 +/- 0.4 L before CHT. In the follow-up exams, these volumes changed to 1.05 +/- 0.4 L (P 〈 0.05) and 1.4 +/- 0.5 L, respectively. Using spirometry, there was no significant change in VC (1.9 +/- 0.4 L vs. 2.2 +/- 0.7 L vs. 2.2 +/- 0.9 L). Conclusion: dMRI is capable of monitoring changes in lung, motion and volumetry in patients with MPM not detected by global spirornetry. Thus, dMRI is proposed for use as a further measure of therapy response
    Type of Publication: Journal article published
    PubMed ID: 16625107
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