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  • PERFUSION  (4)
  • 1
    Keywords: measurement ; ANGIOGENESIS ; Germany ; PERFUSION ; CLASSIFICATION ; CT ; imaging ; INFORMATION ; QUANTIFICATION ; liver ; TISSUE ; TUMORS ; computed tomography ; PATIENT ; BLOOD-FLOW ; INDEX ; primary ; INJECTION ; SIGNAL ; LESIONS ; PATTERNS ; DIFFERENCE ; metastases ; US ; tomography ; COMPUTED-TOMOGRAPHY ; LIVER METASTASES ; POWER DOPPLER SONOGRAPHY ; VASCULARIZATION ; contrast-enhanced ultrasound,liver metastases,arterial perfusion,low-MI imaging,SonoVue ; MICROBUBBLE CONTRAST ; SHU 508A
    Abstract: Rationale and Objectives: We investigated whether observing the arterial vascularization of liver metastases by contrast-enhanced ultrasound with low mechanical index (low-MI) imaging offers additional diagnostic information for the characterization of the liver lesions.Methods: Twenty nine patients with untreated liver metastases of different primaries were examined. Measurements were performed using a low frame rate, low-MI pulse inversion technique after injection of 2.4 mL SonoVue. The relative maximum signal intensity of the liver lesions related to the normal liver tissue was quantified. Ultrasound findings were compared with contrast-enhanced, dual-phase computed tomography (CT) using a pattern-based classification scheme.Results: Compared with contrast-enhanced CT, this modality better detects arterial perfusion. Metastases, even those usually considered hypovascularized, often showed homogeneous enhancement (66%) and higher arterial vascularization than normal liver tissue. CT did not show a comparable vascularization pattern (P 〈 0.001) or any similarly early signal intensity (P 〈 0.001).Conclusions: Contrast-enhanced CT may not be able to visualize short-lasting but large differences of the arterial perfusion of liver metastases, as does contrast-enhanced low-MI ultrasound. This offers new methods for their characterization and for monitoring of therapeutic effects
    Type of Publication: Journal article published
    PubMed ID: 15021325
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  • 2
    Keywords: CANCER ; tumor ; carcinoma ; Germany ; LUNG ; PERFUSION ; THERAPY ; CT ; DENSITY ; LUNG-CANCER ; NEW-YORK ; TUMORS ; PATIENT ; CONTRAST ; INJECTION ; treatment ; DIFFERENCE ; REGION ; REGIONS ; LOCALIZATION ; PARAMETERS ; tomography ; CARCINOMAS ; COMPUTED-TOMOGRAPHY ; PET ; lung neoplasms ; PULMONARY ; DYNAMIC CT ; X-ray computed
    Abstract: Advanced bronchial carcinomas by means of perfusion and peak enhancement using dynamic contrast-enhanced multislice CT are characterized. Twenty-four patients with advanced bronchial carcinoma were examined. During breathhold, after injection of a contrast-medium (CM), 25 scans were performed (I scan/s) at a fixed table position. Density-time curves were evaluated from regions of interest of the whole tumor and high- and low-enhancing tumor areas. Perfusion and peak enhancement were calculated using the maximum-slope method of Miles and compared with size, localization (central or peripheral) and histology. Perfusion of large tumors (〉50 cm(3)) averaged over both the whole tumor (P=0.001) and the highest enhancing area (P=0.003) was significantly lower than that of smaller ones. Independent of size, central carcinomas had a significantly (P=0.04) lower perfusion (mean 27.9 ml/min/100 g) than peripheral ones (mean 66.5 ml/min/100 9). In contrast, peak enhancement of central and peripheral carcinomas was not significantly different. Between non-small-cell lung cancers and small-cell lung cancers, no significant differences were observed in both parameters. In seven tumors, density increase after CM administration started earlier than in the aorta, indicating considerable blood supply from pulmonary vessels. Tumor perfusion was dependent on tumor size and localization, but not on histology. Furthermore, perfusion CT disclosed blood supply from both pulmonary and/or bronchial vessels in some tumors
    Type of Publication: Journal article published
    PubMed ID: 15029450
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  • 3
    Keywords: tumor ; AGENTS ; BLOOD ; Germany ; IN-VIVO ; MODEL ; PERFUSION ; THERAPY ; VIVO ; imaging ; QUANTIFICATION ; VOLUME ; liver ; TISSUE ; TIME ; BLOOD-FLOW ; INDEX ; CONTRAST ; blood flow ; CONTRAST AGENT ; FLOW ; INJECTION ; BIOLOGY ; metastases ; US ; PARAMETERS ; tomography ; KINETICS ; LIVER METASTASES ; CONTRAST AGENTS ; POWER DOPPLER SONOGRAPHY ; INDUCED DESTRUCTION ; AGENT ; TRANSIT-TIME ; DESTRUCTION ; REAL-TIME ; tissue viability ; OCT ; ENHANCED SONOGRAPHY ; HEPATIC METASTASES ; HEPATIC PERFUSION ; low-MI ultrasound ; MATHEMATICAL-MODEL ; quantification of perfusion ; replenishment kinetics ; TUMOR PERFUSION ; ultrasound contrast agent
    Abstract: Low-MI (mechanical index) ultrasound allows real-time observation of replenishment kinetics after destruction ("flash") of ultrasound contrast agents (USCA). We developed an examination protocol and a mathematical model to quantify perfusion of liver tissue and hepatic metastases. Using a modified multivessel model, we attempted a consistent, physiological description of microbubble replenishment in liver tissue. Perfusion parameters were calculated, separately for the arterial and portal venous phase of liver perfusion, using an i.v. bolus injection of 2 x 2.4 mL SonoVue(R). The model was evaluated for 10 examinations of liver metastases using flash/low-MI imaging. In contrast to the established, exponential model, the new model consistently describes the sigmoid replenishment of USCA measured in vivo, using flash/low-MI imaging. Parameters for blood volume, blood velocity and blood flow in liver tissue and metastases can be calculated during the arterial and the portal venous phase after a CA bolus injection. The median arterial perfusion in the examined liver metastases was more than 2.5 times higher than in normal liver tissue, whereas the median perfusion during the portal venous phase was more than five times higher in the liver tissue than that in metastases. Microbubble replenishment measured with flash/low-MI US techniques can be consistently analyzed using the multivessel model, even after a bolus injection of USCA. This allows for the quantification of perfusion of liver tissue and hepatic metastases and provides promising parameters of tissue viability and tumor characterization. (C) 2004 World Federation for Ultrasound in Medicine Biology
    Type of Publication: Journal article published
    PubMed ID: 15582235
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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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