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  • Germany  (17)
  • COMPUTED-TOMOGRAPHY  (11)
  • RESOLUTION  (6)
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  • 1
    Keywords: measurement ; tumor ; Germany ; LUNG ; CT ; IMAGES ; DISEASE ; NEW-YORK ; TUMORS ; PATIENT ; REDUCTION ; CONTRAST ; MRI ; CYCLE ; SEQUENCE ; NO ; DIFFERENCE ; REGION ; LOCALIZATION ; LENGTH ; COMPUTED-TOMOGRAPHY ; CURVES ; 3-DIMENSIONAL RECONSTRUCTION ; MOTION ; HEALTHY ; ORIENTATION ; LOCATION ; dynamic MRI ; ADULT ; ADULTS ; STRENGTH ; TRUEFISP ; HEALTHY-VOLUNTEERS ; PULMONARY-FUNCTION ; HEART-FAILURE ; EXPIRATION ; LUNG-VOLUMES ; breathing cycle ; diaphragmatic function
    Abstract: The purpose of this study was to assess diaphragmatic length and shortening during the breathing cycle in healthy volunteers and patients with a lung tumor using dynamic MRI (dMRI). In 15 healthy volunteers and 28 patients with a solitary lung tumor, diaphragmatic motion and length were measured during the breathing cycle using a trueFISP sequence (three images per second in the coronal and sagittal plane). Time-distance curves and maximal length reduction (= shortening) of the diaphragm were calculated. The influence of tumor localization on diaphragmatic shortening was examined. In healthy volunteers maximal diaphragmatic shortening was 30% in the coronal and 34% in the sagittal orientation, with no difference between both hemithoraces. Tumors of the upper and middle lung region did not affect diaphragmatic shortening. In contrast, tumors of the lower lung region changed shortening significantly (P〈0.05). In hemithoraces with a tumor in the lower region, shortening was 18% in the coronal and 19% in the sagittal plane. The ratio of diaphragmatic length change from inspiration to expiration changed significantly from healthy subjects (inspiration length &MGT; expiratory length, P〈0.05) to patients with a tumor in the lower lung region (inspiratory length = expiratory length). dMRI is a simple, non-invasive method to evaluate diaphragmatic motion and shortening in volunteers and patients during the breathing cycle. Tumors of the lower lung region have a significant influence on shortening of the diaphragm
    Type of Publication: Journal article published
    PubMed ID: 15127220
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  • 2
    Keywords: measurement ; CANCER ; radiotherapy ; tumor ; Germany ; LUNG ; IMAGES ; lung cancer ; LUNG-CANCER ; TISSUE ; TUMORS ; PATIENT ; MRI ; CYCLE ; SEQUENCE ; STAGE ; RADIATION-THERAPY ; MOBILITY ; REGION ; REGIONS ; WALL ; CURVES ; MOTION ; FUTURE ; LINEAR-ACCELERATOR ; LOCATION ; dynamic MRI ; TRUEFISP ; PULMONARY-FUNCTION ; EXTERNAL-BEAM RADIOTHERAPY ; breathing cycle ; CT SCANS ; DIAPHRAGM ; HEALTHY-SUBJECTS ; lung MRL radiotherapy ; tumor diameter
    Abstract: Background and purpose: To assess the influence of tumor diameter on tumor mobility and motion of the tumor bearing hemithorax during the whole breathing cycle in patients with stage I non-small-cell lung cancer (NSCLC) using dynamic MRI. Patients and methods: Breathing cycles of thirty-nine patients with solitary NSCLCs were examined using a trueFISP sequence (three images per second). Patients were divided into three groups according to the maximal tumor diameter in the transverse plane ( 〈3, 3-5 and 〉5 cm). Continuous time-distance curves and deep inspiratory and expiratory positions of the chest wall, the diaphragm and the tumor were measured in three planes. Motion of tumor-bearing and corresponding contralateral non-tumor bearing regions was compared. Results: Patients with a tumor 〉3 cm showed a significantly lower diaphragmatic motion of the tumor bearing compared with the non-tumor bearing hemithorax in the craniocaudal (CC) directions (tumors 3-5 cm: 23.4 +/- 1.2 vs 21.1 +/- 1.5 cm (P 〈0.05); tumors 〉5 cm: 23.4 +/- 1.2 vs 20.1 +/- 1.6 cm (P 〈0.01). Tumors 〉5 cm in the lower lung region showed a significantly lower mobility compared with tumors 〈3 cm (1.8 +/- 1.0 vs 3.8 +/- 0.7 cm, P 〈0.01) in the CC directions. Conclusions: Dynamic MRI is a simple non-invasive method to differentiate mobility of tumors with different diameters and its influence on the surrounding tissue. Tumor diameter has a significant influence on tumor mobility and this might be taken into account in future radiotherapy planning, (C) 2004 Elsevier Ireland Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 15588881
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  • 3
    Keywords: BLOOD ; Germany ; LUNG ; PERFUSION ; imaging ; QUANTIFICATION ; VOLUME ; TIME ; BLOOD-FLOW ; blood flow ; FLOW ; HIGH-RESOLUTION MEASUREMENT ; MRI ; TRACER BOLUS PASSAGES ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; AGE ; PARAMETERS ; SCINTIGRAPHY ; CONTRAST-ENHANCED MRI ; magnetic resonance imaging (MRI) ; QUANTITATIVE-ANALYSIS ; HEALTHY ; LUNG PERFUSION ; TRANSIT-TIME ; HEALTHY-VOLUNTEERS ; ARTERIAL ; INFLATION ; contrast-enhanced
    Abstract: Rationale and Objectives: The effect of breathholding on pulmonary perfusion remains largely unknown. The aim of this study was to assess the effect of inspiratory and expiratory breathhold on pulmonary perfusion using quantitative pulmonary perfusion magnetic resonance imaging (MRI). Methods and Results: Nine healthy volunteers (median age, 28 years; range, 20-45 years) were examined with contrast-enhanced time-resolved 3-dimensional pulmonary perfusion MRI (FLASH 313, TR/TE: 1.9/0.8 ms; flip angle: 40degrees; GRAPPA) during end-inspiratory and expiratory breathholds. The perfusion parameters pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated using the indicator dilution theory. As a reference method, end-inspiratory and expiratory phase-contrast (PC) MRI of the pulmonary arterial blood flow (PABF) was performed. Results: There was a statistically significant increase of the PBF (Delta = 182 mL/100mL/min), PBV (Delta = 12 mL/100 mL), and PABF (Delta = 0.5 L/min) between inspiratory and expiratory breathhold measurements (P 〈 0.0001). Also, the MTT was significantly shorter (Delta = -0.5 sec) at expiratory breathhold (P = 0.03). Inspiratory PBF and PBV showed a moderate correlation (r = 0.72 and 0.61, P less than or equal to0.008) with inspiratory PABF. Conclusion: Pulmonary perfusion during breathhold depends on the inspiratory level. Higher perfusion is observed at expiratory breathhold
    Type of Publication: Journal article published
    PubMed ID: 15654250
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  • 4
    Keywords: CANCER ; COMPUTED-TOMOGRAPHY ; HELICAL CT ; MANAGEMENT ; GUIDELINES ; IMAGE QUALITY ; CHEST CT ; STATEMENT ; SCREENING TRIAL ; LOW-DOSE CT
    Abstract: OBJECTIVES: To evaluate the influence of exposure parameters and raw-data based iterative reconstruction (IR) on the measurement variability of computer-aided nodule volumetry on chest multidetector computed tomography (MDCT). MATERIALS AND METHODS: N=7 porcine lung explants were inflated in a dedicated ex vivo phantom and prepared with n=162 artificial nodules. MDCT was performed eight consecutive times (combinations of 120 and 80 kV with 120, 60, 30 and 12 mAs), and reconstructed with filtered back projection (FBP) and IR. Nodule volume and diameter were measured semi-automatically with dedicated software. The absolute percentage measurement error (APE) was computed in relation to the 120 kV 120 mAs acquisition. Noise was recorded for each nodule in every dataset. RESULTS: Mean nodule volume and diameter were 0.32 +/- 0.15 ml and 12.0 +/- 2.6mm, respectively. Although IR reduced noise by 24.9% on average compared to FBP (p〈0.007), APE with IR was equal to or slightly higher than with FBP. Mean APE for volume increased significantly below a volume computed tomography dose index (CTDI) of 1.0 mGy: for 120 kV 12 mAs APE was 3.8 +/- 6.2% (FBP) vs. 4.0 +/- 5.2% (IR) (p〈0.007); for 80 kV 12 mAs APE was 8.0 +/- 13.0% vs. 9.3 +/- 15.8% (n.s.), respectively. Correlating APE with image noise revealed that at identical noise APE was higher with IR than with FBP (p〈0.05). CONCLUSIONS: Computer-aided volumetry is robust in a wide range of exposure settings, and reproducibility is reduced at a CTDI below 1.0 mGy only, but the error rate remains clinically irrelevant. Noise reduction by IR is not detrimental for measurement error in the setting of semi-automatic nodule volumetry on chest MDCT.
    Type of Publication: Journal article published
    PubMed ID: 23727376
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  • 5
    Keywords: QUANTIFICATION ; COMPUTED-TOMOGRAPHY ; OBSTRUCTIVE PULMONARY-DISEASE ; SMOKERS ; multidetector CT ; SEX-DIFFERENCES ; SHORT-TERM ; COPD ; VOLUME-REDUCTION SURGERY ; AIR-FLOW OBSTRUCTION
    Abstract: Purpose: The change of emphysema distribution with increasing COPD severity is not yet assessed. Especially, involvement of the upper aspect of the lower lobe is unknown. The primary aim was to quantitatively determine regional distribution of emphysema in anatomically (lung lobes) and non-anatomically defined lung regions (upper/lower lung halves as well as core and rind regions) in a cohort covering equally all COPD severity stages using CT. Material and Methods: Basically 100 CT data sets were quantitatively evaluated for regional distribution of emphysema. Emphysema characteristics (emphysema index, mean lung density and 15th percentile of the attenuation values of lung voxels) were compared (t-test) in: upper lobes vs. upper halves, lower lobes vs. lower halves, core vs. rind region. Results: In patients with 〈= GOLD II, a significantly higher emphysema burden was found in the upper lobes as compared to upper halves. In subjects with GOLD III/IV the differences were not significant for all emphysema characteristics. A high difference between lobes and halves in subjects with 〈= GOLD II was found, in contrast to low difference in higher GOLD stages. Conclusions: Lobar segmentation provides improved characterization of cranio-caudal emphysema distribution compared to a non-anatomic approach in subjects up to GOLD stage II.
    Type of Publication: Journal article published
    PubMed ID: 25230093
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  • 6
    Keywords: BLOOD ; Germany ; LUNG ; QUANTIFICATION ; TIME ; BLOOD-FLOW ; blood flow ; FLOW ; MRI ; PATTERNS ; PARAMETERS ; HYPERTENSION ; BLOOD-FLOW MEASUREMENTS ; BREATH-HOLD ; ENCODED CINE MRI ; HEMODYNAMICS ; RE ; HEALTHY-VOLUNTEERS ; phase-contrast MRI ; pulmonary circulation ; systemic circulation ; VENTRICULAR STROKE VOLUME
    Abstract: OBJECTIVE. The purpose of this study was to use phase-contrast MRI to evaluate the influence of various breathing maneuvers on the hemodynamics of the pulmonary and systemic arterial circulation. SUBJECTS AND METHODS. Twenty-five volunteers were examined with phase-contrast MRI. Flow measurements were acquired in the aorta, pulmonary trunk, and left and right pulmonary arteries during deep, large-volume inspiratory breath-hold, expiratory breath-hold, and smooth respiration (no breath-hold). Parameters assessed were peak velocity, blood flow, velocity gradient, and acceleration time. RESULTS. Pulmonary blood flow and peak velocity were significantly reduced during inspiratory breath-hold and expiratory breath-hold compared with no breath-hold (p 〈 0.01). Pulmonary velocity gradient in inspiratory breath-hold was significantly (p:! 0.01) lower than in expiratory breath-hold and no breath-hold. There was no difference in velocity gradient between expiratory breath-hold and no breath-hold. Peak velocity in the aorta was lowest with no breath-hold. Velocity gradient was highest in expiratory breath-hold, and no breath-hold had the smallest SD. Acceleration time in the pulmonary trunk showed no difference between inspiratory breath-hold, expiratory breath-hold, and no breath-hold. Blood flow distribution to the left (45-47%) and to the right (53-55%) lung was not influenced by breathing maneuver. CONCLUSION. Measurements during smooth respiration showed the smallest SD. Therefore, no-breath-hold measurements should be considered for assessment of hemodynamics in clinical practice
    Type of Publication: Journal article published
    PubMed ID: 16861549
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  • 7
    Keywords: Germany ; LUNG ; imaging ; SYSTEM ; SYSTEMS ; VOLUME ; SAMPLE ; COMPONENTS ; ACCURACY ; MR ; magnetic resonance ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; DIFFERENCE ; AGE ; COMPONENT ; PARAMETERS ; COMPUTED-TOMOGRAPHY ; BODY ; MR imaging ; dynamic magnetic resonance imaging ; BODIES ; CAPACITY ; OBSTRUCTION ; PULMONARY-FUNCTION TESTS ; development ; DIAPHRAGM ; HEALTHY-SUBJECTS ; CYSTIC-FIBROSIS ; SPIROMETRY ; INTERVAL ; analysis ; function ; LUNG-VOLUME ; female ; Male ; AGREEMENT ; RESONANCE ; body posture ; lung function tests ; magnetic resonance-compatible-spirometry ; nonsmokers ; pulmonary mechanics
    Abstract: The aim of this study was to assess the feasibility and accuracy of a novel magnetic resonance-compatible (MRc)-spirometer. The influence of body posture, magnetic resonance (MR)-setting and image acquisition on lung function was evaluated. Dynamic MR imaging (dMRI) was compared with simultaneously measured lung function. The development of the MRc-spirometer was based on a commercial spirometer and evaluated by flow-generator measurements and forced expiratory manoeuvres in 34 healthy nonsmokers (17 females and 17 males, mean age 32.9 yrs). Mean differences between forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were calculated and a sample paired t-test and Bland-Altman plots were generated. A total of I I subjects underwent different subsequent MRc-spirometric measurements to assess the influence of the components of the MR system on lung function. The mean (95% confidence interval) difference of FEV1 and FVC between the two systems was 0.004 (-0.04-0.04) L and 0.018 (-0.05-0.09) L, respectively. In the subgroup analysis, an influence of the MR-system on FEV1 was found. FEV1 correlated well with the dMRI measurement of the apico-diaphragmatic distance-change after the first second of forced expiration (r=0.72). In conclusion, magnetic resonance-compatible-spirometry is feasible, reliable and safe. The magnetic resonance-setting only has a small influence on simultaneously measured forced expiratory volume in one second. Dynamic magnetic resonance imaging measurements correlate well with simultaneously acquired lung function parameters
    Type of Publication: Journal article published
    PubMed ID: 17715166
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  • 8
    Keywords: Germany ; LUNG ; PERFUSION ; THERAPY ; CT ; FOLLOW-UP ; imaging ; VENTILATION ; DISEASE ; EXPOSURE ; LONG-TERM ; POPULATION ; radiation ; prognosis ; FLOW ; MRI ; PROGRESSION ; MUTATION ; GAS ; MUTATIONS ; FREQUENT ; CHILDREN ; HYPERPOLARIZED HE-3 ; MR imaging ; review ; monitoring ; CHEST-X-RAY ; HUMAN LUNG ; cystic fibrosis ; CHILD ; proton MRI ; INTERVENTIONS ; MODALITY ; Follow up
    Abstract: Cystic fibrosis (CF) lung disease is caused by mutations in the CFTR-gene and remains one of the most frequent lethal inherited diseases in the Caucasian population. Given the progress in CF therapy and the consecutive improvement in prognosis, monitoring of disease progression and effectiveness of therapeutic interventions with repeated imaging of the CF lung plays an increasingly important role. So far, the chest radiograph has been the most widely used imaging modality to monitor morphological changes in the CF lung. CT is the gold standard for assessment of morphological changes of airways and lung parenchyma. Considering the necessity of life-long repeated imaging studies, the cumulative radiation doses reached with CT is problematic for CF patients. A sensitive, non-invasive and quantitative technique without radiation exposure is warranted for monitoring of disease activity. In previous studies, MRI proved to be comparable to CT regarding the detection of morphological changes in the CF lung without using ionising radiation. Furthermore, MRI was shown to be superior to CT regarding assessment of functional changes of the lung. This review presents the typical morphological and functional MR imaging findings with respect to MR-based follow-up of CF lung disease. MRI offers a variety of techniques for morphological and functional imaging of the CF lung. Using this radiation free technique short- and long-term follow-up studies are possible enabling an individualised guidance of the therapy
    Type of Publication: Journal article published
    PubMed ID: 20432002
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  • 9
    Keywords: PERFUSION ; CT ; COMPUTED-TOMOGRAPHY ; REGIONAL VENTILATION
    Abstract: Purpose: To compare unenhanced lung ventilation-weighted (VW) and perfusion-weighted (QW) imaging based on Fourier decomposition (FD) magnetic resonance (MR) imaging with the clinical reference standard single photon emission computed tomography (SPECT)/computed tomography (CT) in an animal experiment. Materials and Methods: The study was approved by the local animal care committee. Lung ventilation and perfusion was assessed in seven anesthetized pigs by using a 1.5-T MR imager and SPECT/CT. For time-resolved FD MR imaging, sets of lung images were acquired by using an untriggered two-dimensional balanced steady-state free precession sequence (repetition time, 1.9 msec; echo time, 0.8 msec; acquisition time per image, 118 msec; acquisition rate, 3.33 images per second; flip angle, 75 degrees; section thickness, 12 mm; matrix, 128 x 128). Breathing displacement was corrected with nonrigid image registration. Parenchymal signal intensity was analyzed pixelwise with FD to separate periodic changes of proton density induced by respiration and periodic changes of blood flow. Spectral lines representing respiratory and cardiac frequencies were integrated to calculate VW and QW images. Ventilation and perfusion SPECT was performed after inhalation of dispersed technetium 99m ((99m)Tc) and injection of (99m)Tc-labeled macroaggregated albumin. FD MR imaging and SPECT data were independently analyzed by two physicians in consensus. A regional statistical analysis of homogeneity and pathologic signal changes was performed. Results: Images acquired in healthy animals by using FD MR imaging and SPECT showed a homogeneous distribution of VW and QW imaging and pulmonary ventilation and perfusion, respectively. The gravitation-dependent signal distribution of ventilation and perfusion in all animals was similarly observed at FD MR imaging and SPECT. Incidental ventilation and perfusion defects were identically visualized by using both modalities. Conclusion: This animal experiment demonstrated qualitative agreement in the assessment of regional lung ventilation and perfusion between contrast media-free and radiation-free FD MR imaging and conventional SPECT/CT.
    Type of Publication: Journal article published
    PubMed ID: 21586678
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  • 10
    Keywords: DIAGNOSIS ; SYSTEMS ; TIME ; REPRODUCIBILITY ; COMPUTED-TOMOGRAPHY ; THIN-SECTION CT ; magnetic resonance imaging (MRI) ; CHILDREN ; ADULTS ; cystic fibrosis ; Lung disease ; Scoring system
    Abstract: Magnetic resonance imaging (MRI) gains increasing importance in the assessment of cystic fibrosis (CF) lung disease. The aim of this study was to develop a morpho-functional MR-scoring-system and to evaluate its intra- and inter-observer reproducibility and clinical practicability to monitor CF lung disease over a broad severity range from infancy to adulthood. 35 CF patients with broad age range (mean 15.3years; range 0.5-42) were examined by morphological and functional MRI. Lobe based analysis was performed for parameters bronchiectasis/bronchial-wall-thickening, mucus plugging, abscesses/sacculations, consolidations, special findings and perfusion defects. The maximum global score was 72. Two experienced radiologists scored the images at two time points (interval 10weeks). Upper and lower limits of agreement, concordance correlation coefficients (CCC), total deviation index and coverage probability were calculated for global, morphology, function, component and lobar scores. Global scores ranged from 6 to 47. Intra- and inter-reader agreement for global scores were good (CCC: 0.98 (R1), 0.94 (R2), 0.97 (R1/R2)) and were comparable between high and low scores. Our results indicate that the proposed morpho-functional MR-scoring-system is reproducible and applicable for semi-quantitative evaluation of a large spectrum of CF lung disease severity. This scoring-system can be applied for the routine assessment of CF lung disease and maybe as endpoint for clinical trials.
    Type of Publication: Journal article published
    PubMed ID: 21429685
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