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Sample records for breath-hold cine imaging

  1. Single-breath-hold 3-D CINE imaging of the left ventricle using Cartesian sampling.

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    Wetzl, Jens; Schmidt, Michaela; Pontana, François; Longère, Benjamin; Lugauer, Felix; Maier, Andreas; Hornegger, Joachim; Forman, Christoph

    2018-02-01

    Our objectives were to evaluate a single-breath-hold approach for Cartesian 3-D CINE imaging of the left ventricle with a nearly isotropic resolution of [Formula: see text] and a breath-hold duration of [Formula: see text]19 s against a standard stack of 2-D CINE slices acquired in multiple breath-holds. Validation is performed with data sets from ten healthy volunteers. A Cartesian sampling pattern based on the spiral phyllotaxis and a compressed sensing reconstruction method are proposed to allow 3-D CINE imaging with high acceleration factors. The fully integrated reconstruction uses multiple graphics processing units to speed up the reconstruction. The 2-D CINE and 3-D CINE are compared based on ventricular function parameters, contrast-to-noise ratio and edge sharpness measurements. Visual comparisons of corresponding short-axis slices of 2-D and 3-D CINE show an excellent match, while 3-D CINE also allows reformatting to other orientations. Ventricular function parameters do not significantly differ from values based on 2-D CINE imaging. Reconstruction times are below 4 min. We demonstrate single-breath-hold 3-D CINE imaging in volunteers and three example patient cases, which features fast reconstruction and allows reformatting to arbitrary orientations.

  2. Assessment of voluntary deep inspiration breath-hold with CINE imaging for breast radiotherapy.

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    Estoesta, Reuben Patrick; Attwood, Lani; Naehrig, Diana; Claridge-Mackonis, Elizabeth; Odgers, David; Martin, Darren; Pham, Melissa; Toohey, Joanne; Carroll, Susan

    2017-10-01

    Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery. Weekly CINE images were retrospectively assessed for 20 left-sided breast cancer patients receiving RT in vDIBH, and compared with CINE images of 20 patients treated in FB. The intra-beam motion was assessed and the distance from the beam central axis (CA) to the internal chest wall (ICW) was measured on each CINE image. These were then compared to the planned distance on digitally reconstructed radiograph (DRR). The maximum intra-beam motion for any one patient measurement was 0.30 cm for vDIBH and 0.20 cm for FB. The mean difference between the distance from the CA to ICW on DRR and the equivalent distance on CINE imaging (as treated) was 0.28 cm (SD 0.17) for vDIBH patients and 0.25 cm (SD 0.14) for FB patients (P = 0.458). The measured values were comparable for patients undergoing RT in vDIBH, and for those in FB. This quality assessment showed that using in-room lasers and skin tattoos to independently monitor breath-hold in vDIBH as detected by 'on-treatment' CINE imaging is safe and effective. © 2017 The Royal Australian and New Zealand College of Radiologists.

  3. Evaluation of a motion artifacts removal approach on breath-hold cine-magnetic resonance images of hypertrophic cardiomyopathy subjects

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    Betancur, Julián.; Simon, Antoine; Schnell, Frédéric; Donal, Erwan; Hernández, Alfredo; Garreau, Mireille

    2013-11-01

    The acquisition of ECG-gated cine magnetic resonance images of the heart is routinely performed in apnea in order to suppress the motion artifacts caused by breathing. However, many factors including the 2D nature of the acquisition and the use of di erent beats to acquire the multiple-view cine images, cause this kind of artifacts to appear. This paper presents the qualitative evaluation of a method aiming to remove motion artifacts in multipleview cine images acquired on patients with hypertrophic cardiomyopathy diagnosis. The approach uses iconic registration to reduce for in-plane artifacts in long-axis-view image stacks and in-plane and out-of-plane motion artifacts in sort-axis-view image stack. Four similarity measures were evaluated: the normalized correlation, the normalized mutual information, the sum of absolute voxel di erences and the Slomka metric proposed by Slomka et al. The qualitative evaluation assessed the misalignment of di erent anatomical structures of the left ventricle as follows: the misalignment of the interventricular septum and the lateral wall for short-axis-view acquisitions and the misalignment between the short-axis-view image and long-axis-view images. Results showed the correction using the normalized correlation as the most appropriated with an 80% of success.

  4. Compressed sensing real-time cine cardiovascular magnetic resonance: accurate assessment of left ventricular function in a single-breath-hold.

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    Kido, Tomoyuki; Kido, Teruhito; Nakamura, Masashi; Watanabe, Kouki; Schmidt, Michaela; Forman, Christoph; Mochizuki, Teruhito

    2016-08-24

    Cardiovascular cine magnetic resonance (CMR) accelerated by compressed sensing (CS) is used to assess left ventricular (LV) function. However, it is difficult for prospective CS cine CMR to capture the complete end-diastolic phase, which can lead to underestimation of the end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), compared to retrospective standard cine CMR. This prospective study aimed to evaluate the diagnostic quality and accuracy of single-breath-hold full cardiac cycle CS cine CMR, acquired over two heart beats, to quantify LV volume in comparison to multi-breath-hold standard cine CMR. Eighty-one participants underwent standard segmented breath-hold cine and CS real-time cine CMR examinations to obtain a stack of eight contiguous short-axis images with same high spatial (1.7 × 1.7 mm(2)) and temporal resolution (41 ms). Two radiologists independently performed qualitative analysis of image quality (score, 1 [i.e., "nondiagnostic"] to 5 [i.e., "excellent"]) and quantitative analysis of the LV volume measurements. The total examination time was 113 ± 7 s for standard cine CMR and 24 ± 4 s for CS cine CMR (p cine image quality was slightly lower than standard cine (4.8 ± 0.5 for standard vs. 4.4 ± 0.5 for CS; p cine were above 4 (i.e., good). No significant differences existed between standard and CS cine MR for all quantitative LV measurements. The mean differences with 95 % confidence interval (CI), based on Bland-Altman analysis, were 1.3 mL (95 % CI, -14.6 - 17.2) for LV end-diastolic volume, 0.2 mL (95 % CI, -9.8 to10.3) for LV end-systolic volume, 1.1 mL (95 % CI, -10.5 to 12.7) for LV stroke volume, 1.0 g (95 % CI, -11.2 to 13.3) for LV mass, and 0.4 % (95 % CI, -4.8 - 5.6) for LV ejection fraction. The interobserver and intraobserver variability for CS cine MR ranged from -4.8 - 1.6 % and from -7.3 - 9.3 %, respectively, with slopes of the regressions ranging 0.88-1.0 and 0

  5. Single breath hold 3D cardiac cine MRI using kat-ARC: preliminary results at 1.5T.

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    Jeong, Daniel; Schiebler, Mark L; Lai, Peng; Wang, Kang; Vigen, Karl K; François, Christopher J

    2015-04-01

    Validation of a new single breath-hold, three-dimensional, cine balanced steady-state free precession (3D cine bSSFP) cardiac magnetic resonance (CMR) sequence for left ventricular function. CMR examinations were performed on fifteen patients and three healthy volunteers on a clinical 1.5T scanner using a two-dimensional (2D) cine balanced SSFP CMR sequence (2D cine bSSFP) followed by an investigational 3D cine bSSFP pulse sequence acquired within a single breath hold. Left ventricular end diastolic volume (LVEDV), end systolic volume (LVESV), ejection fraction (LVEF), and myocardial mass were independently segmented on a workstation by two experienced radiologists. Blood pool to myocardial contrast was evaluated in consensus using a Likert scale. Bland-Altman analysis was used to compare these quantitative and nominal measurements for the two sequences. The average acquisition time was significantly shorter for the 3D cine bSSFP than for 2D cine bSSFP (0.36 ± 0.03 vs. 8.5 ± 2.3 min) p = 0.0002. Bland-Altman analyses [bias and (limits of agreement)] of the data derived from these two methods revealed that the LVEF 0.9% (-4.7, 6.4), LVEDV 4.9 ml (-23.0, 32.8), LVESV -0.2 ml (-22.4, 21.9), and myocardial mass -0.4 g (-23.8, 23.0) were not significantly different. There was excellent intraclass correlation for intra-observer variability (0.981, 0.989, 0.997, 0.985) and inter-observer variability (0.903, 0.954, 0.970, 0.842) for LVEF, LVEDV, LVESV, and myocardial mass respectively. 3D cine bSSFP allows for accurate single breath-hold volumetric cine CMR which enables substantial improvements in scanner time efficiency without sacrificing diagnostic accuracy.

  6. Comparison of left and right ventricular ejection and filling parameters by fast cine MR imaging in breath-hold technique: clinical study of 42 patients with cardiomyopathy and coronary heart disease; Vergleich links- und rechtsventrikulaerer Auswurf- und Fuellungsparameter des Herzens mittels Cine MRT in Atemanhaltetechnik: klinische Studie an 42 Patienten mit Kardiomyopathie und koronarer Herzerkrankung

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    Rominger, M.B.; Bachmann, G.F.; Geuer, M.; Puzik, M.; Rau, W.S. [Giessen Univ. (Germany). Diagnostische Radiologie; Ricken, W.W. [Kerckhoff-Klinik GmbH, Bad Nauheim (Germany). Abt. Kardiologie

    1999-06-01

    Purpose: Quantification of left and right ventricular filling and ejection of localized and diffuse heart diseases with fast cine MR imaging in breath-hold technique. Methods: 42 patients (14 idiopathic dilated cardiomyopathies (DCM), 13 hypertrophic cardiomyopathies (HCM) and 15 coronary artery diseases (CAD)) and 10 healthy volunteers were examined. Time-volume-curves of three left ventricular and one right ventricular slices were evaluated and peak ejection and filling rates (PER, PFR end-diastolic volume (EDV)/s) time to PER and PFR (TPER, TPFR ms) and time of end-systole (TSYS in % RR-intervall) were calculated. Results: There were significant regional and left-/right-sided differences of the filling and ejection of both ventricles within and between the different groups. In DCM the left ventricular PFR was reduced (DCM 3.1 EDV/s; volunteers 4.9 EDV/s) and Z-SYS prolonged (DCM 50.1%; volunteers 35.4%). In CAD there were localized decreased filling rates in comparison to the normal volunteer group (left ventricle: basal: 2.9 and 6.3 EDV/s, apical: 4.4 and 6.3 EDV/s; right ventricle: 3.6 and 5.7 EDV/s). HCM typically showed an isovolumetric lengthening of the endsystole. Conclusions: Cardiac MR imaging in breath-hold technique is suitable for measuring contraction and relaxation disturbances of localized and diffuse heart diseases by means of ejection and filling volume indices. (orig.) [Deutsch] Ziel: Quantifizierung der links- und rechtsventrikulaeren Fuellung und des Auswurfs bei umschriebenen und diffusen Herzerkrankungen mittels schneller Cine MR Bildgebung in Atemanhaltetechnik. Methoden: Untersucht wurden 42 Patienten (14 dilatative Kardiomyopathien (DCM), 13 hypertrophe obstruktive Kardiomyopathien (HCM) und 15 koronare Herzerkrankungen (KHK)) und 10 Probanden. Von drei linksventrikulaeren und einer rechtsventrikulaeren Einzelschicht wurden Zeit-Volumen-Kurven erstellt, aus denen die maximale Auswurf- und Fuellrate (MAR) (MFR eddiastolisches Volumen (EDV

  7. Comparison of breath-hold T1-weighted MR sequences for imaging of the liver.

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    Semelka, R C; Willms, A B; Brown, M A; Brown, E D; Finn, J P

    1994-01-01

    Three rapid T1-weighted gradient-echo techniques for imaging of the liver were compared: fast low-angle shot (FLASH) and section-selective (SSTF) and non-section-selective (NSTF) inversion-recovery TurboFLASH. Ten healthy volunteers were imaged at 1.5 T, with breath-hold images acquired in the transaxial and coronal planes and non-breath-hold images in the transaxial plane. Breath-hold images were evaluated quantitatively and qualitatively, and non-breath-hold images were evaluated qualitatively. FLASH images had significantly higher (P FLASH images than on NSTF and SSTF images. With breath hold, FLASH images were rated as having the highest quality in the axial plane, followed by NSTF and SSTF images. In the coronal plane, NSTF images were rated as having the highest quality. For images acquired during patient respiration, NSTF images had the highest quality and showed the least degradation. The results suggest that FLASH images have the highest SD/N and S/N for liver imaging and have the highest quality in the axial plane. In patients who cannot suspend respiration. NSTF images may be least affected by breathing artifact and provide reasonable image quality.

  8. Magnetic Resonance Imaging in Breath-Hold Divers with Cerebral Decompression Sickness

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    Ryu Matsuo

    2014-01-01

    Full Text Available The mechanism of cerebral decompression sickness (DCS is still unclear. We report 2 cases of breath-hold divers with cerebral DCS in whom magnetic resonance imaging (MRI demonstrated distinctive characteristics. One case presented right hemiparesthesia, diplopia, and gait disturbance after breath-hold diving into the sea at a depth of 20 m. Brain MRI with fluid-attenuated inversion recovery (FLAIR sequence revealed multiple hyperintense lesions in the right frontal lobe, bilateral thalamus, pons, and right cerebellar hemisphere. The second case presented visual and gait disturbance after repetitive breath-hold diving into the sea. FLAIR imaging showed hyperintense areas in the bilateral occipito-parietal lobes. In both cases, diffusion-weighted imaging and apparent diffusion coefficient mapping revealed hyperintense areas in the lesions identified by FLAIR. Moreover, follow-up MRI showed attenuation of the FLAIR signal abnormalities. These findings are suggestive of transient hyperpermeability in the microvasculature as a possible cause of cerebral DCS.

  9. Breath-hold MR cholangiopancreatography with three-dimensional, segmented, echo-planar imaging and volume rendering

    NARCIS (Netherlands)

    P.A. Wielopolski (Piotr); J. Gaa; D.R. Wielopolski; M. Oudkerk (Matthijs)

    1999-01-01

    textabstractEnd-expiration, 21-second breath-hold, three-dimensional magnetic resonance (MR) cholangiopancreatography (MRCP) was developed with segmented echo-planar imaging. In 15 healthy subjects and 14 randomly selected patients undergoing liver studies,

  10. Automated daily breath hold stability measurements by real-time imaging in radiotherapy of breast cancer

    NARCIS (Netherlands)

    De Boer, Hans C J; Van Den Bongard, Desirée J G; van Asselen, B

    2016-01-01

    Background and purpose Breath hold is increasingly used for cardiac sparing in left-sided breast cancer irradiation. We have developed a fast automated method to verify breath hold stability in each treatment fraction. Material and methods We evaluated 504 patients treated with breath hold. Moderate

  11. Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

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    Suga, K.; Yasuhiko, K. (Dept. of Radiology, St. Hill Hospital, Ube, Yamaguchi (Japan)); Iwanaga, H.; Tokuda, O.; Matsunaga, N. (Dept. of Radiology, Yamaguchi Univ. School of Medicine, Ube, Yamaguchi (Japan))

    2009-01-15

    Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

  12. Breath holding spell

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    ... this page: //medlineplus.gov/ency/article/000967.htm Breath holding spell To use the sharing features on this page, please enable JavaScript. Some children have breath holding spells. This is an involuntary stop in breathing that ...

  13. Breath-Holding Spells

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    ... Staying Safe Videos for Educators Search English Español Breath-Holding Spells KidsHealth / For Parents / Breath-Holding Spells What's in ... Spells Print en español Espasmos de sollozo About Breath-Holding Spells Many of us have heard stories about stubborn ...

  14. Imaging of ventilation with dual-energy CT during breath hold after single vital-capacity inspiration of stable xenon.

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    Honda, Norinari; Osada, Hisato; Watanabe, Wataru; Nakayama, Mitsuo; Nishimura, Keiichiro; Krauss, Bernhard; Otani, Katharina

    2012-01-01

    To assess single-breath-hold technique for ventilation mapping by using dual-energy computed tomography (CT) in phantom experiments and volunteers. Institutional review board approved this study, and written informed consent was obtained from all volunteers. A rubber bag filled with a mixture of xenon (0%-35.4%) and oxygen was scanned with dual-source dual-energy CT (80 kV and 140 kV with tin [Sn] filter [Sn/140 kV] and 100 kV and Sn/140 kV). A cylinder containing six tubes of identical sizes with different apertures was ventilated once with a mixture of 35% xenon and 65% oxygen and was scanned in dual-energy mode (80 kV and Sn/140 kV). Xenon-enhanced images were derived by using three-material decomposition technique. Four volunteers were scanned twice in dual-energy mode (80 kV and Sn/140 kV) during breath hold after a single vital-capacity inspiration of air (nonenhanced) and of 35% xenon. Xenon-enhanced images were obtained by using two methods: three-material decomposition and subtraction of nonenhanced from xenon-enhanced images. Regression analysis with t and F tests was applied to the data of the rubber bag scans, with the significance level set at .05. Mean pixel values of gas in the bag were linearly related to xenon concentration for all x-ray tube voltages (r(2) = 1.00, P lungs of healthy volunteers, with higher pixel values in the trachea and lower pixel values in the bullae. Xenon-enhanced images calculated by using three-material decomposition had better image quality on visual comparison than those calculated by using subtraction. Xenon-enhanced dual-energy CT with the single-breath-hold technique could depict ventilation in phantoms and in four volunteers. © RSNA, 2011.

  15. Registration-based regional lung mechanical analysis: retrospectively reconstructed dynamic imaging versus static breath-hold image acquisition

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    Ding, Kai; Cao, Kunlin; Christensen, Gary E.; Hoffman, Eric A.; Reinhardt, Joseph M.

    2009-02-01

    The lungs undergo expansion and contraction during the respiratory cycle. Since many disease or injury conditions are associated with the biomechanical or material property changes that can alter lung function, there is a great interest in measuring regional lung ventilation and regional mechanical changes. We describe a technique that uses multiple respiratory-gated CT images and non-rigid 3D image registration to make local estimates of lung tissue expansion. The degree of regional lung expansion is measured using the Jacobian (a function of local partial derivatives) of the registration displacement field. We compare the ventral-dorsal patterns of lung expansion estimated in both retrospectively reconstructed dynamic scans and static breath-hold scans to a xenon CT based measure of specific ventilation and a semi-automatic reference standard in four anesthetized sheep studied in the supine orientation. The regional lung expansion estimated by 3D image registration of images acquired at 50% and 75% phase points of the inspiratory portion of the respiratory cycle and 20 cm H2O and 25 cm H2O airway pressures gave the best match between the average Jacobian and the xenon CT specific ventilation respectively (linear regression, average r2 = 0.85 and r2 = 0.84). The registration accuracy assessed by 200 semi-automatically matched landmarks in both the dynamic and static scans show landmark error on the order of 2 mm.

  16. Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla.

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    Edelman, Robert R; Giri, S; Pursnani, A; Botelho, M P F; Li, W; Koktzoglou, I

    2015-11-23

    Coronary magnetic resonance angiography (MRA) is usually obtained with a free-breathing navigator-gated 3D acquisition. Our aim was to develop an alternative breath-hold approach that would allow the coronary arteries to be evaluated in a much shorter time and without risk of degradation by respiratory motion artifacts. For this purpose, we implemented a breath-hold, non-contrast-enhanced, quiescent-interval slice-selective (QISS) 2D technique. Sequence performance was compared at 1.5 and 3 Tesla using both radial and Cartesian k-space trajectories. The left coronary circulation was imaged in six healthy subjects and two patients with coronary artery disease. Breath-hold QISS was compared with T2-prepared 2D balanced steady-state free-precession (bSSFP) and free-breathing, navigator-gated 3D bSSFP. Approximately 10 2.1-mm thick slices were acquired in a single ~20-s breath-hold using two-shot QISS. QISS contrast-to-noise ratio (CNR) was 1.5-fold higher at 3 Tesla than at 1.5 Tesla. Cartesian QISS provided the best coronary-to-myocardium CNR, whereas radial QISS provided the sharpest coronary images. QISS image quality exceeded that of free-breathing 3D coronary MRA with few artifacts at either field strength. Compared with T2-prepared 2D bSSFP, multi-slice capability was not restricted by the specific absorption rate at 3 Tesla and pericardial fluid signal was better suppressed. In addition to depicting the coronary arteries, QISS could image intra-cardiac structures, pericardium, and the aortic root in arbitrary slice orientations. Breath-hold QISS is a simple, versatile, and time-efficient method for coronary MRA that provides excellent image quality at both 1.5 and 3 Tesla. Image quality exceeded that of free-breathing, navigator-gated 3D MRA in a much shorter scan time. QISS also allowed rapid multi-slice bright-blood, diastolic phase imaging of the heart, which may have complementary value to multi-phase cine imaging. We conclude that, with further clinical

  17. Accuracy Evaluation of a 3-Dimensional Surface Imaging System for Guidance in Deep-Inspiration Breath-Hold Radiation Therapy

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    Alderliesten, Tanja; Sonke, Jan-Jakob; Betgen, Anja; Honnef, Joeri; Vliet-Vroegindeweij, Corine van [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Remeijer, Peter, E-mail: p.remeijer@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2013-02-01

    Purpose: To investigate the applicability of 3-dimensional (3D) surface imaging for image guidance in deep-inspiration breath-hold radiation therapy (DIBH-RT) for patients with left-sided breast cancer. For this purpose, setup data based on captured 3D surfaces was compared with setup data based on cone beam computed tomography (CBCT). Methods and Materials: Twenty patients treated with DIBH-RT after breast-conserving surgery (BCS) were included. Before the start of treatment, each patient underwent a breath-hold CT scan for planning purposes. During treatment, dose delivery was preceded by setup verification using CBCT of the left breast. 3D surfaces were captured by a surface imaging system concurrently with the CBCT scan. Retrospectively, surface registrations were performed for CBCT to CT and for a captured 3D surface to CT. The resulting setup errors were compared with linear regression analysis. For the differences between setup errors, group mean, systematic error, random error, and 95% limits of agreement were calculated. Furthermore, receiver operating characteristic (ROC) analysis was performed. Results: Good correlation between setup errors was found: R{sup 2}=0.70, 0.90, 0.82 in left-right, craniocaudal, and anterior-posterior directions, respectively. Systematic errors were {<=}0.17 cm in all directions. Random errors were {<=}0.15 cm. The limits of agreement were -0.34-0.48, -0.42-0.39, and -0.52-0.23 cm in left-right, craniocaudal, and anterior-posterior directions, respectively. ROC analysis showed that a threshold between 0.4 and 0.8 cm corresponds to promising true positive rates (0.78-0.95) and false positive rates (0.12-0.28). Conclusions: The results support the application of 3D surface imaging for image guidance in DIBH-RT after BCS.

  18. Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

    2016-01-01

    OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...... quality. Advances in knowledge: DIBH RT has dosimetric advantages over FB; this work demonstrates an additional benefit of DIBH in terms of registration accuracy because of improved image quality....

  19. Rapid acquisition of helium-3 and proton three-dimensional image sets of the human lung in a single breath-hold using compressed sensing.

    Science.gov (United States)

    Qing, Kun; Altes, Talissa A; Tustison, Nicholas J; Feng, Xue; Chen, Xiao; Mata, Jaime F; Miller, G Wilson; de Lange, Eduard E; Tobias, William A; Cates, Gordon D; Brookeman, James R; Mugler, John P

    2015-10-01

    To develop and validate a method for acquiring helium-3 ((3) He) and proton ((1) H) three-dimensional (3D) image sets of the human lung with isotropic spatial resolution within a 10-s breath-hold by using compressed sensing (CS) acceleration, and to assess the fidelity of undersampled images compared with fully sampled images. The undersampling scheme for CS acceleration was optimized and tested using (3) He ventilation data. Rapid 3D acquisition of both (3) He and (1) H data during one breath-hold was then implemented, based on a balanced steady-state free-precession pulse sequence, by random undersampling of k-space with reconstruction by means of minimizing the L1 norm and total variance. CS-reconstruction fidelity was evaluated quantitatively by comparing fully sampled and retrospectively undersampled image sets. Helium-3 and (1) H 3D image sets of the lung with isotropic 3.9-mm resolution were acquired during a single breath-hold in 12 s and 8 s using acceleration factors of 2 and 3, respectively. Comparison of fully sampled and retrospectively undersampled (3) He and (1) H images yielded mean absolute errors 0.9. By randomly undersampling k-space and using CS reconstruction, high-quality (3) He and (1) H 3D image sets with isotropic 3.9-mm resolution can be acquired within an 8-s breath-hold. © 2014 Wiley Periodicals, Inc.

  20. Estimation of heart-position variability in 3D-surface-image-guided deep-inspiration breath-hold radiation therapy for left-sided breast cancer

    NARCIS (Netherlands)

    Alderliesten, Tanja; Betgen, Anja; Elkhuizen, Paula H. M.; van Vliet-Vroegindeweij, Corine; Remeijer, Peter

    2013-01-01

    To investigate the heart position variability in deep-inspiration breath-hold (DIBH) radiation therapy (RT) for breast cancer when 3D surface imaging would be used for monitoring the BH depth during treatment delivery. For this purpose, surface setup data were compared with heart setup data. Twenty

  1. Retrospective Reconstruction of High Temporal Resolution Cine Images from Real-Time MRI using Iterative Motion Correction

    DEFF Research Database (Denmark)

    Hansen, Michael Schacht; Sørensen, Thomas Sangild; Arai, Andrew

    2012-01-01

    Cardiac function has traditionally been evaluated using breath-hold cine acquisitions. However, there is a great need for free breathing techniques in patients who have difficulty in holding their breath. Real-time cardiac MRI is a valuable alternative to the traditional breath-hold imaging...... approach, but the real-time images are often inferior in spatial and temporal resolution. This article presents a general method for reconstruction of high spatial and temporal resolution cine images from a real-time acquisition acquired over multiple cardiac cycles. The method combines parallel imaging...... and motion correction based on nonrigid registration and can be applied to arbitrary k-space trajectories. The method is demonstrated with real-time Cartesian imaging and Golden Angle radial acquisitions, and the motion-corrected acquisitions are compared with raw real-time images and breath-hold cine...

  2. Automated registration of sequential breath-hold dynamic contrast-enhanced MR images: a comparison of three techniques.

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    Rajaraman, Sivaramakrishnan; Rodriguez, Jeffrey J; Graff, Christian; Altbach, Maria I; Dragovich, Tomislav; Sirlin, Claude B; Korn, Ronald L; Raghunand, Natarajan

    2011-06-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is increasingly in use as an investigational biomarker of response in cancer clinical studies. Proper registration of images acquired at different time points is essential for deriving diagnostic information from quantitative pharmacokinetic analysis of these data. Motion artifacts in the presence of time-varying intensity due to contrast enhancement make this registration problem challenging. DCE-MRI of chest and abdominal lesions is typically performed during sequential breath-holds, which introduces misregistration due to inconsistent diaphragm positions and also places constraints on temporal resolution vis-à-vis free-breathing. In this work, we have employed a computer-generated DCE-MRI phantom to compare the performance of two published methods, Progressive Principal Component Registration and Pharmacokinetic Model-Driven Registration, with Sequential Elastic Registration (SER) to register adjacent time-sample images using a published general-purpose elastic registration algorithm. In all three methods, a 3D rigid-body registration scheme with a mutual information similarity measure was used as a preprocessing step. The DCE-MRI phantom images were mathematically deformed to simulate misregistration, which was corrected using the three schemes. All three schemes were comparably successful in registering large regions of interest (ROIs) such as muscle, liver, and spleen. SER was superior in retaining tumor volume and shape, and in registering smaller but important ROIs such as tumor core and tumor rim. The performance of SER on clinical DCE-MRI data sets is also presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Diagnosing lung nodules on oncologic MR/PET imaging: Comparison of fast T1-weighted sequences and influence of image acquisition in inspiration and expiration breath-hold

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    Schwenzer, Nina F.; Seith, Ferdinand; Gatidis, Sergios; Brendle, Cornelia; Schmidt, Holger; Pfannenberg, Christina A; LaFougère, Christian; Nikolaou, Konstantin; Schraml, Christina [University Hospital of Tuebingen, Tuebingen (Germany)

    2016-09-15

    First, to investigate the diagnostic performance of fast T1-weighted sequences for lung nodule evaluation in oncologic magnetic resonance (MR)/positron emission tomography (PET). Second, to evaluate the influence of image acquisition in inspiration and expiration breath-hold on diagnostic performance. The study was approved by the local Institutional Review Board. PET/CT and MR/PET of 44 cancer patients were evaluated by 2 readers. PET/CT included lung computed tomography (CT) scans in inspiration and expiration (CTin, CTex). MR/PET included Dixon sequence for attenuation correction and fast T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences (volume interpolated breath-hold examination acquired in inspiration [VIBEin], volume interpolated breath-hold examination acquired in expiration [VIBEex]). Diagnostic performance was analyzed for lesion-, lobe-, and size-dependence. Diagnostic confidence was evaluated (4-point Likert-scale; 1 = high). Jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. Seventy-six pulmonary lesions were evaluated. Lesion-based detection rates were: CTex, 77.6%; VIBEin, 53.3%; VIBEex, 51.3%; and Dixon, 22.4%. Lobe-based detection rates were: CTex, 89.6%; VIBEin, 58.3%; VIBEex, 60.4%; and Dixon, 31.3%. In contrast to CT, inspiration versus expiration did not alter diagnostic performance in VIBE sequences. Diagnostic confidence was best for VIBEin and CTex and decreased in VIBEex and Dixon (1.2 ± 0.6; 1.2 ± 0.7; 1.5 ± 0.9; 1.7 ± 1.1, respectively). The JAFROC figure-of-merit of Dixon was significantly lower. All patients with malignant lesions were identified by CTex, VIBEin, and VIBEex, while 3 patients were false-negative in Dixon. Fast T1-weighted VIBE sequences allow for identification of patients with malignant pulmonary lesions. The Dixon sequence is not recommended for lung nodule evaluation in oncologic MR/PET patients. In contrast to CT, inspiration versus

  4. Diagnosing Lung Nodules on Oncologic MR/PET Imaging: Comparison of Fast T1-Weighted Sequences and Influence of Image Acquisition in Inspiration and Expiration Breath-Hold

    Energy Technology Data Exchange (ETDEWEB)

    Schwenzer, Nina F.; Seith, Ferdinand; Gatidis, Sergios [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076 (Germany); Brendle, Cornelia [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076 (Germany); Department of Diagnostic and Interventional Neuroradiology, University Hospital of Tuebingen, Tuebingen 72076 (Germany); Schmidt, Holger; Pfannenberg, Christina A. [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076 (Germany); Fougère, Christian la [Department of Nuclear Medicine, University Hospital of Tuebingen, Tuebingen 72076 (Germany); Nikolaou, Konstantin; Schraml, Christina [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen 72076 (Germany)

    2016-11-01

    First, to investigate the diagnostic performance of fast T1-weighted sequences for lung nodule evaluation in oncologic magnetic resonance (MR)/positron emission tomography (PET). Second, to evaluate the influence of image acquisition in inspiration and expiration breath-hold on diagnostic performance. The study was approved by the local Institutional Review Board. PET/CT and MR/PET of 44 cancer patients were evaluated by 2 readers. PET/CT included lung computed tomography (CT) scans in inspiration and expiration (CTin, CTex). MR/PET included Dixon sequence for attenuation correction and fast T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences (volume interpolated breath-hold examination acquired in inspiration [VIBEin], volume interpolated breath-hold examination acquired in expiration [VIBEex]). Diagnostic performance was analyzed for lesion-, lobe-, and size-dependence. Diagnostic confidence was evaluated (4-point Likert-scale; 1 = high). Jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. Seventy-six pulmonary lesions were evaluated. Lesion-based detection rates were: CTex, 77.6%; VIBEin, 53.3%; VIBEex, 51.3%; and Dixon, 22.4%. Lobe-based detection rates were: CTex, 89.6%; VIBEin, 58.3%; VIBEex, 60.4%; and Dixon, 31.3%. In contrast to CT, inspiration versus expiration did not alter diagnostic performance in VIBE sequences. Diagnostic confidence was best for VIBEin and CTex and decreased in VIBEex and Dixon (1.2 ± 0.6; 1.2 ± 0.7; 1.5 ± 0.9; 1.7 ± 1.1, respectively). The JAFROC figure-of-merit of Dixon was significantly lower. All patients with malignant lesions were identified by CTex, VIBEin, and VIBEex, while 3 patients were false-negative in Dixon. Fast T1-weighted VIBE sequences allow for identification of patients with malignant pulmonary lesions. The Dixon sequence is not recommended for lung nodule evaluation in oncologic MR/PET patients. In contrast to CT, inspiration versus

  5. Simultaneous multislice imaging for native myocardial T1mapping: Improved spatial coverage in a single breath-hold.

    Science.gov (United States)

    Weingärtner, Sebastian; Moeller, Steen; Schmitter, Sebastian; Auerbach, Edward; Kellman, Peter; Shenoy, Chetan; Akçakaya, Mehmet

    2017-08-01

    To develop a saturation recovery myocardial T 1 mapping method for the simultaneous multislice acquisition of three slices. Saturation pulse-prepared heart rate independent inversion recovery (SAPPHIRE) T 1 mapping was implemented with simultaneous multislice imaging using FLASH readouts for faster coverage of the myocardium. Controlled aliasing in parallel imaging (CAIPI) was used to achieve minimal noise amplification in three slices. Multiband reconstruction was performed using three linear reconstruction methods: Slice- and in-plane GRAPPA, CG-SENSE, and Tikhonov-regularized CG-SENSE. Accuracy, spatial variability, and interslice leakage were compared with single-band T 1 mapping in a phantom and in six healthy subjects. Multiband phantom T 1 times showed good agreement with single-band T 1 mapping for all three reconstruction methods (normalized root mean square error spatial variability compared with single-band imaging was lowest for GRAPPA (1.29-fold), with higher penalties for Tikhonov-regularized CG-SENSE (1.47-fold) and CG-SENSE (1.52-fold). In vivo multiband T 1 times showed no significant difference compared with single-band (T 1 time ± intersegmental variability: single-band, 1580 ± 119 ms; GRAPPA, 1572 ± 145 ms; CG-SENSE, 1579 ± 159 ms; Tikhonov, 1586 ± 150 ms [analysis of variance; P = 0.86]). Interslice leakage was smallest for GRAPPA (5.4%) and higher for CG-SENSE (6.2%) and Tikhonov-regularized CG-SENSE (7.9%). Multiband accelerated myocardial T 1 mapping demonstrated the potential for single-breath-hold T 1 quantification in 16 American Heart Association segments over three slices. A 1.2- to 1.4-fold higher in vivo spatial variability was observed, where GRAPPA-based reconstruction showed the highest homogeneity and the least interslice leakage. Magn Reson Med 78:462-471, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  6. Compressed sensing single-breath-hold CMR for fast quantification of LV function, volumes, and mass.

    Science.gov (United States)

    Vincenti, Gabriella; Monney, Pierre; Chaptinel, Jérôme; Rutz, Tobias; Coppo, Simone; Zenge, Michael O; Schmidt, Michaela; Nadar, Mariappan S; Piccini, Davide; Chèvre, Pascal; Stuber, Matthias; Schwitter, Juerg

    2014-09-01

    The purpose of this study was to compare a novel compressed sensing (CS)-based single-breath-hold multislice magnetic resonance cine technique with the standard multi-breath-hold technique for the assessment of left ventricular (LV) volumes and function. Cardiac magnetic resonance is generally accepted as the gold standard for LV volume and function assessment. LV function is 1 of the most important cardiac parameters for diagnosis and the monitoring of treatment effects. Recently, CS techniques have emerged as a means to accelerate data acquisition. The prototype CS cine sequence acquires 3 long-axis and 4 short-axis cine loops in 1 single breath-hold (temporal/spatial resolution: 30 ms/1.5 × 1.5 mm(2); acceleration factor 11.0) to measure left ventricular ejection fraction (LVEF(CS)) as well as LV volumes and LV mass using LV model-based 4D software. For comparison, a conventional stack of multi-breath-hold cine images was acquired (temporal/spatial resolution 40 ms/1.2 × 1.6 mm(2)). As a reference for the left ventricular stroke volume (LVSV), aortic flow was measured by phase-contrast acquisition. In 94% of the 33 participants (12 volunteers: mean age 33 ± 7 years; 21 patients: mean age 63 ± 13 years with different LV pathologies), the image quality of the CS acquisitions was excellent. LVEF(CS) and LVEF(standard) were similar (48.5 ± 15.9% vs. 49.8 ± 15.8%; p = 0.11; r = 0.96; slope 0.97; p < 0.00001). Agreement of LVSV(CS) with aortic flow was superior to that of LVSV(standard) (overestimation vs. aortic flow: 5.6 ± 6.5 ml vs. 16.2 ± 11.7 ml, respectively; p = 0.012) with less variability (r = 0.91; p < 0.00001 for the CS technique vs. r = 0.71; p < 0.01 for the standard technique). The intraobserver and interobserver agreement for all CS parameters was good (slopes 0.93 to 1.06; r = 0.90 to 0.99). The results demonstrated the feasibility of applying the CS strategy to evaluate LV function and volumes with high accuracy in patients. The single-breath-hold

  7. Evaluation of pancreatic cancer by multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Xiuzhong, E-mail: yao.xiuzhong@zs-hospital.sh.cn [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Zeng, Mengsu, E-mail: zengmengsu@gmail.com [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Wang, He, E-mail: herry258@hotmail.com [Global Applied Science Laboratory of GE Healthcare, No. 1, Huatuo Road, Zhangjiang Hi-tech Park, Pudong District, Shanghai 201203 (China); Sun, Fei, E-mail: fei.sun@med.ge.com [Global Applied Science Laboratory of GE Healthcare, No. 1, Huatuo Road, Zhangjiang Hi-tech Park, Pudong District, Shanghai 201203 (China); Rao, Shengxiang, E-mail: rao.shengxiang@zs-hospital.sh.cn [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Ji, Yuan, E-mail: Ji.yuan@zs-hospital.sh.cn [Department of Pathology, Zhongshan Hospital of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China)

    2012-08-15

    Objective: To investigate the microcirculation in pancreatic cancer by pharmacokinetic analysis of multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T. Materials and methods: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging was performed in 40 healthy volunteers and 40 patients with pancreatic cancer proven by histopathology using an axial three-dimensions fat-saturated T1-weighted spoiled-gradient echo sequence at 3.0 T. A two compartment model with T1 correction was used to quantify the transfer constant, the rate constant of backflux from the extravascular extracellular space to the plasma and the extravascular extracellular space fractional volume in pancreatic cancer, obstructive pancreatitis distal to the malignant tumor, adjacent pancreatic tissue proximal to the tumor and normal pancreas. All parameters were statistically analyzed. Results: Statistical differences were noticed in both the transfer constant (p = 0.000075) and the rate constant of backflux (p = 0.006) among different tissues. Both the transfer constant and the rate constant of backflux in pancreatic cancer were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). Both the transfer constant and the rate constant of backflux in obstructive pancreatitis were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). The extravascular extracellular space fractional volume in pancreatic cancer was statistically lager than that in normal pancreas (p = 0.002). Conclusion: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging offers a useful technique to evaluate the microenvironment in pancreatic cancer at 3.0 T. Compared to normal pancreas, pancreatic cancer has lower transfer constant, rate constant of backflux and larger extravascular extracellular space fractional volume.

  8. Optimal MR pulse sequences for hepatic hemangiomas : comparison of T2-weighted turbo-spin-echo, T2-weighted breath-hold turbo-spin-echo, and T1-weighted FLASH dynamic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Wen Chao; Choi, Byung Ihn; Han, Joon Koo; Kim, Tae Kyoung; Cho, Soon Gu [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-03-01

    To optimize MR imaging pulse sequences in the imaging of hepatic hemangioma and to evaluate on dynamic MR imaging the enhancing characteristics of the lesions. Twenty patients with 35 hemangiomas were studied by using Turbo-spin-echo (TSE) sequence (T2-weighted, T2- and heavily T2-weighted breath-hold) and T1-weighted FLASH imaging acquired before, immediately on, and 1, 3 and 5 minutes after injection of a bolus of Gd-DTPA (0.1mmol/kg). Phased-array multicoil was employed. Images were quantitatively analyzed for lesion-to-liver signal difference to noise ratios (SD/Ns), and lesion-to-liver signal ratios (H/Ls), and qualitatively analyzed for lesion conspicuity. The enhancing characteristics of the hemangiomas were described by measuring the change of signal intensity as a curve in T1-weighted FLASH dynamic imaging. For T2-weighted images, breath-hold T2-weighted TSE had a slightly higher SD/N than other pulse sequences, but there was no statistical difference in three fast pulse sequences (p=0.211). For lesion conspicuity, heavily T2-weighted breath-hold TSE images was superior to T2-weighted breath-hold or non-breath-hold TSE (H/L, 5.75, 3.81, 2.87, respectively, p<0.05). T2-weighted breath-hold TSE imaging was more effective than T2-weighted TSE imaging in removing lesion blurring or lack of sharpness, and there was a 12-fold decrease in acquisition time (20sec versus 245 sec). T1-weighted FLASH dynamic images of normal liver showed peak enhancement at less than 1 minute, and of hemangioma at more than 3 minutes;the degree of enhancement for hemangioma decreased after a 3 minute delay. T2-weighed breath-hold TSE imaging and Gd-DTPA enhanced FLASH dynamic imaging with 5 minutes delay are sufficient for imaging hepatic hemangiomas.

  9. Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent

    Science.gov (United States)

    2012-01-01

    Background Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). Methods LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18–25 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, Bland–Altman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. Conclusions A single-breath-hold 3D-whole-heart cine SSFP sequence in combination

  10. Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent

    Directory of Open Access Journals (Sweden)

    Makowski Marcus R

    2012-07-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR is the current gold standard for the assessment of left ventricular (LV function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP. Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP. Methods LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18–25 s after Gadopentetate dimeglumine (GdD, day 1 and Gadofosveset trisodium (GdT, day 2 administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE. CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR, blood to myocardium contrast (BMC, image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. Results All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p vs. 23.7 and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71, compared to 3D-SSFP with GdD. Conclusions A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. Trial registration The study was approved by the local

  11. Blue breath holding is benign.

    Science.gov (United States)

    Stephenson, J B

    1991-01-01

    In their recent publication in this journal, Southall et al described typical cyanotic breath holding spells, both in otherwise healthy children and in those with brainstem lesions and other malformations. Their suggestions regarding possible autonomic disturbances may require further study, but they have adduced no scientific evidence to contradict the accepted view that in the intact child blue breath holding spells are benign. Those families in which an infant suffers an 'apparently life threatening event' deserve immense understanding and help, and it behoves investigators to exercise extreme care and self criticism in the presentation of new knowledge which may bear upon their management and their morale. PMID:2001115

  12. Detection of hepatocellular carcinoma: comparison of ferumoxides-enhanced and gadolinium-enhanced dynamic three-dimensional volume interpolated breath-hold MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyosung; Kim, Youngkon; Kim, Chongsoo [Chonbuk National University Medical School, Department of Diagnostic Radiology, Chon-ju (Korea); Lee, Jeongmin [Seoul National University Hospital, Department of Radiology, Seoul (Korea); Lee, Younghwan [Wonkwang University School of Medicine, Department of Diagnostic Radiology, Iksan (Korea)

    2005-01-01

    The purpose was to compare the diagnostic accuracy of ferumoxides-enhanced MR imaging and gadolinium-enhanced dynamic MR imaging using three-dimensional (3D) volume interpolated breath-hold examination (VIBE) for the detection of hepatocellular carcinoma (HCC). Forty-nine patients with 61 HCCs, who underwent ferumoxides-enhanced and gadolinium-enhanced dynamic MR imaging, were included prospectively in this study. Ferumoxides-enhanced MR imaging was performed 24 h after completion of the dynamic study using 3D-VIBE. Three radiologists independently interpreted the images. The diagnostic accuracy was evaluated using the receiver-operating characteristic method, and the sensitivity of each imaging technique was compared using McNemar's test. The mean diagnostic accuracy of dynamic MR imaging (Az=0.95) was higher than that of ferumoxides-enhanced MR imaging (Az=0.90), but failed to reach a statistical significance (P=0.057). The mean sensitivity of dynamic MR imaging (90.7%) was significantly superior to that of ferumoxides-enhanced MR imaging (80.9%, P=0.03). Furthermore, for lesions smaller than 15 mm, the mean sensitivity of dynamic MR imaging was significantly higher than that of ferumoxides-enhanced MR imaging (85.2% vs. 69.2%, P<0.05). Dynamic MR imaging showed a trend toward better diagnostic accuracy for than ferumoxides-enhanced MR imaging for the detection of HCCs. (orig.)

  13. [Evaluation of optimal parameters for non-contrast-enhanced non-breath-holding pulmonary artery MRA using 3D-FSE imaging with variable flip angle echo trains].

    Science.gov (United States)

    Kubo, Hitoshi; Kobata, Takuya; Otsuka, Hideki; Harada, Masafumi

    2014-11-01

    The aim of this study was to find the optimal acquisition parameters of non-contrast-enhanced non-breath-holding pulmonary artery MRA using 3D-FSE imaging with variable flip angle echo trains. The 3D-FSE imaging method with variable flip angle echo trains (CUBE) was employed in this study. Pulmonary artery MRA was performed in five healthy volunteers using a 1.5 tesla (T) and a 3 T clinical scanner with multi-channel torso coils. The institutional review boards approved the study, and informed consent was obtained from all subjects. Prior to the CUBE studies, ECG-gated single-shot FSE scans were performed to determine the timing of systole and diastole. After that, CUBE scans with systolic timing and three adjusted (early, middle and delayed) diastolic timings using both ECG and respiratory gating were performed and subtracted images between systolic and diastolic images were calculated. Subtracted intensities of both lung parenchyma and pulmonary arteries were evaluated using the region of interest (ROI) function. Maximum intensity projection (MIP) images with six different scan parameters (three timings and two static magnetic fields) were processed for evaluation by the ranking method with visual assessment. Three observers each scored all six images and a statistical analysis based on the variation of ratings was performed. The subtracted intensities of pulmonary arteries and lung parenchyma with middle diastolic timing were higher than that with both early and delayed systolic timing. The same tendency was shown in both 1.5 T and 3 T images. Though the subtracted intensity of 3 T was higher than that of 1.5 T, the contrast ratio between lung parenchyma and pulmonary artery of 1.5 T was higher than that of 3 T. The MIP image using the 1.5 T scanner with middle diastolic timing obtained the best score by the visual assessment using the ranking methods. The middle diastolic timing using the 1.5 T scanner provides the best non-contrast-enhanced non-breath-holding

  14. Free-breathing whole-heart 3D cine magnetic resonance imaging with prospective respiratory motion compensation.

    Science.gov (United States)

    Moghari, Mehdi H; Barthur, Ashita; Amaral, Maria E; Geva, Tal; Powell, Andrew J

    2017-12-08

    To develop and validate a new prospective respiratory motion compensation algorithm for free-breathing whole-heart 3D cine steady-state free precession (SSFP) imaging. In a 3D cine SSFP sequence, 4 excitations per cardiac cycle are re-purposed to prospectively track heart position. Specifically, their 1D image is reconstructed and routed into the scanner's standard diaphragmatic navigator processing system. If all 4 signals are in end-expiration, cine image data from the entire cardiac cycle is accepted for image reconstruction. Prospective validation was carried out in patients (N = 17) by comparing in each a conventional breath-hold 2D cine ventricular short-axis stack and a free-breathing whole-heart 3D cine data set. All 3D cine SSFP acquisitions were successful and the mean scan time was 5.9 ± 2.7 min. Left and right ventricular end-diastolic, end-systolic, and stroke volumes by 3D cine SSFP were all larger than those from 2D cine SSFP. This bias was cine images had a lower ventricular blood-to-myocardium contrast ratio, contrast-to-noise ratio, mass, and subjective quality score. The novel prospective respiratory motion compensation method for 3D cine SSFP imaging was robust and efficient and yielded slightly larger ventricular volumes and lower mass compared to breath-hold 2D cine imaging. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  15. SU-E-J-55: End-To-End Effectiveness Analysis of 3D Surface Image Guided Voluntary Breath-Holding Radiotherapy for Left Breast

    Energy Technology Data Exchange (ETDEWEB)

    Lin, M; Feigenberg, S [University of Maryland School of Medicine, Baltimore, MD (United States)

    2015-06-15

    Purpose To evaluate the effectiveness of using 3D-surface-image to guide breath-holding (BH) left-side breast treatment. Methods Two 3D surface image guided BH procedures were implemented and evaluated: normal-BH, taking BH at a comfortable level, and deep-inspiration-breath-holding (DIBH). A total of 20 patients (10 Normal-BH and 10 DIBH) were recruited. Patients received a BH evaluation using a commercialized 3D-surface- tracking-system (VisionRT, London, UK) to quantify the reproducibility of BH positions prior to CT scan. Tangential 3D/IMRT plans were conducted. Patients were initially setup under free-breathing (FB) condition using the FB surface obtained from the untaged CT to ensure a correct patient position. Patients were then guided to reach the planned BH position using the BH surface obtained from the BH CT. Action-levels were set at each phase of treatment process based on the information provided by the 3D-surface-tracking-system for proper interventions (eliminate/re-setup/ re-coaching). We reviewed the frequency of interventions to evaluate its effectiveness. The FB-CBCT and port-film were utilized to evaluate the accuracy of 3D-surface-guided setups. Results 25% of BH candidates with BH positioning uncertainty > 2mm are eliminated prior to CT scan. For >90% of fractions, based on the setup deltas from3D-surface-trackingsystem, adjustments of patient setup are needed after the initial-setup using laser. 3D-surface-guided-setup accuracy is comparable as CBCT. For the BH guidance, frequency of interventions (a re-coaching/re-setup) is 40%(Normal-BH)/91%(DIBH) of treatments for the first 5-fractions and then drops to 16%(Normal-BH)/46%(DIBH). The necessity of re-setup is highly patient-specific for Normal-BH but highly random among patients for DIBH. Overall, a −0.8±2.4 mm accuracy of the anterior pericardial shadow position was achieved. Conclusion 3D-surface-image technology provides effective intervention to the treatment process and ensures

  16. Magnitude of shift of tumor position as a function of moderated deep inspiration breath-hold: An analysis of pooled data of lung patients with active breath control in image-guided radiotherapy

    Directory of Open Access Journals (Sweden)

    Muralidhar K

    2008-01-01

    Full Text Available The purpose of this study was to evaluate the reproducibility and magnitude of shift of tumor position by using active breathing control and iView-GT for patients with lung cancer with moderate deep-inspiration breath-hold (mDIBH technique. Eight patients with 10 lung tumors were studied. CT scans were performed in the breath-holding phase. Moderate deep-inspiration breath-hold under spirometer-based monitoring system was used. Few important bony anatomic details were delineated by the radiation oncologist. To evaluate the interbreath-hold reproducibility of the tumor position, we compared the digital reconstruction radiographs (DRRs from planning system with the DRRs from the iView-GT in the machine room. We measured the shift in x, y, and z directions. The reproducibility was defined as the difference between the bony landmarks from the DRR of the planning system and those from the DRR of the iView-GT. The maximum shift of the tumor position was 3.2 mm, 3.0 mm, and 2.9 mm in the longitudinal, lateral, and vertical directions. In conclusion, the moderated deep-inspiration breath-hold method using a spirometer is feasible, with relatively good reproducibility of the tumor position for image-guided radiotherapy in lung cancers.

  17. Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy

    Science.gov (United States)

    Cerviño, Laura I.; Gupta, Sonia; Rose, Mary A.; Yashar, Catheryn; Jiang, Steve B.

    2009-11-01

    Late cardiac complications may arise after left-breast radiation therapy. Deep-inspiration breath hold (DIBH) allows reduction of the irradiated heart volume at the same time as it reduces tumor bed motion and increases lung sparing. In the present study, we have evaluated the improvement in reproducibility and stability of the DIBH for left-breast-cancer treatment when visual coaching is provided with the aid of 3D video surface imaging and video goggles. Five left-breast-cancer patients and fifteen healthy volunteers were asked to perform a series of DIBHs without and with visual coaching. Reproducibility and stability of DIBH were measured for each individual with and without visual coaching. The average reproducibility and stability changed from 2.1 mm and 1.5 mm, respectively, without visual feedback to 0.5 mm and 0.7 mm with visual feedback, showing a significant statistical difference (p 2 mm) in reproducibility and stability were observed in 35% and 15% of the subjects, respectively. The average chest wall excursion of the DIBH with respect to the free breathing preceding the DIBH was found to be 11.3 mm. The reproducibility and stability of the DIBH improve significantly from the visual coaching provided to the patient, especially in those patients with poor reproducibility and stability.

  18. Highly-Accelerated Real-Time Cardiac Cine MRI Using k-t SPARSE-SENSE

    Science.gov (United States)

    Feng, Li; Srichai, Monvadi B.; Lim, Ruth P.; Harrison, Alexis; King, Wilson; Adluru, Ganesh; Dibella, Edward VR.; Sodickson, Daniel K.; Otazo, Ricardo; Kim, Daniel

    2012-01-01

    For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution (~2.5mm × 2.5mm) and temporal resolution (~40ms), to produce high-quality real-time cine MR images that could be applied clinically for wall motion assessment and measurement of left ventricular (LV) function. In this work, we present an 8-fold accelerated real-time cardiac cine MRI pulse sequence using a combination of compressed sensing and parallel imaging (k-t SPARSE-SENSE). Compared with reference, breath-hold cine MRI, our 8-fold accelerated real-time cine MRI produced significantly worse qualitative grades (1–5 scale), but its image quality and temporal fidelity scores were above 3.0 (adequate) and artifacts and noise scores were below 3.0 (moderate), suggesting that acceptable diagnostic image quality can be achieved. Additionally, both 8-fold accelerated real-time cine and breath-hold cine MRI yielded comparable LV function measurements, with coefficient of variation cine MRI with k-t SPARSE-SENSE is a promising modality for rapid imaging of myocardial function. PMID:22887290

  19. Highly accelerated real-time cardiac cine MRI using k-t SPARSE-SENSE.

    Science.gov (United States)

    Feng, Li; Srichai, Monvadi B; Lim, Ruth P; Harrison, Alexis; King, Wilson; Adluru, Ganesh; Dibella, Edward V R; Sodickson, Daniel K; Otazo, Ricardo; Kim, Daniel

    2013-07-01

    For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution (∼2.5 × 2.5 mm(2)) and temporal resolution (∼40 ms), to produce high-quality real-time cine MR images that could be applied clinically for wall motion assessment and measurement of left ventricular function. In this work, we present an eightfold accelerated real-time cardiac cine MRI pulse sequence using a combination of compressed sensing and parallel imaging (k-t SPARSE-SENSE). Compared with reference, breath-hold cine MRI, our eightfold accelerated real-time cine MRI produced significantly worse qualitative grades (1-5 scale), but its image quality and temporal fidelity scores were above 3.0 (adequate) and artifacts and noise scores were below 3.0 (moderate), suggesting that acceptable diagnostic image quality can be achieved. Additionally, both eightfold accelerated real-time cine and breath-hold cine MRI yielded comparable left ventricular function measurements, with coefficient of variation cine MRI with k-t SPARSE-SENSE is a promising modality for rapid imaging of myocardial function. Copyright © 2012 Wiley Periodicals, Inc.

  20. Setup error and motion during deep inspiration breath-hold breast radiotherapy measured with continuous portal imaging

    DEFF Research Database (Denmark)

    Lutz, Christina Maria; Poulsen, Per Rugaard; Fledelius, Walther

    2016-01-01

    ). At every third treatment fraction, continuous portal images were acquired. The time-resolved chest wall position during treatment was compared with the planned position to determine the inter-fraction setup errors and the intra-fraction motion of the chest wall. RESULTS: The DIBH compliance was 95% during...... both recruitment periods. A tendency of smaller inter-fraction setup errors and intra-fraction motion was observed for group 2 (medial marker block position). However, apart from a significantly reduced inter-field random shift (σ = 1.7 mm vs. σ = 0.9 mm, p = 0.005), no statistically significant...... differences between the groups were found. In a combined analysis, the group mean inter-fraction setup error was M = - 0.1 mm, with random and systematic errors of σ = 1.7 mm and Σ = 1.4 mm. The group mean inter-field shift was M = 0.0 (σ = 1.3 mm and Σ = 1.1 mm) and the group mean standard deviation...

  1. Motion-Corrected Real-Time Cine Magnetic Resonance Imaging of the Heart: Initial Clinical Experience.

    Science.gov (United States)

    Rahsepar, Amir Ali; Saybasili, Haris; Ghasemiesfe, Ahmadreza; Dolan, Ryan S; Shehata, Monda L; Botelho, Marcos P; Markl, Michael; Spottiswoode, Bruce; Collins, Jeremy D; Carr, James C

    2018-01-01

    Free-breathing real-time (RT) imaging can be used in patients with difficulty in breath-holding; however, RT cine imaging typically experiences poor image quality compared with segmented cine imaging because of low resolution. Here, we validate a novel unsupervised motion-corrected (MOCO) reconstruction technique for free-breathing RT cardiac images, called MOCO-RT. Motion-corrected RT uses elastic image registration to generate a single heartbeat of high-quality data from a free-breathing RT acquisition. Segmented balanced steady-state free precession (bSSFP) cine images and free-breathing RT images (Cartesian, TGRAPPA factor 4) were acquired with the same spatial/temporal resolution in 40 patients using clinical 1.5 T magnetic resonance scanners. The respiratory cycle was estimated using the reconstructed RT images, and nonrigid unsupervised motion correction was applied to eliminate breathing motion. Conventional segmented RT and MOCO-RT single-heartbeat cine images were analyzed to evaluate left ventricular (LV) function and volume measurements. Two radiologists scored images for overall image quality, artifact, noise, and wall motion abnormalities. Intraclass correlation coefficient was used to assess the reliability of MOCO-RT measurement. Intraclass correlation coefficient showed excellent reliability (intraclass correlation coefficient ≥ 0.95) of MOCO-RT with segmented cine in measuring LV function, mass, and volume. Comparison of the qualitative ratings indicated comparable image quality for MOCO-RT (4.80 ± 0.35) with segmented cine (4.45 ± 0.88, P = 0.215) and significantly higher than conventional RT techniques (3.51 ± 0.41, P cine (1.51 ± 0.90, P = 0.088 and 1.23 ± 0.45, P = 0.182) were not different. Wall motion abnormality ratings were comparable among different techniques (P = 0.96). The MOCO-RT technique can be used to process conventional free-breathing RT cine images and provides comparable quantitative assessment of LV function and volume

  2. Three-dimensional cardiac cine imaging using the kat ARC acceleration: Initial experience in clinical adult patients at 3T.

    Science.gov (United States)

    Okuda, Shigeo; Yamada, Yoshitake; Tanimoto, Akihiro; Fujita, Jun; Sano, Motoaki; Fukuda, Keiichi; Kuribayashi, Sachio; Jinzaki, Masahiro; Nozaki, Atsushi; Lai, Peng

    2015-09-01

    Three-dimensional cardiac cine imaging has demonstrated promising clinical 1.5-Tesla results; however, its application to 3T scanners has been limited because of the higher sensitivity to off-resonance artifacts. The aim of this study was to apply 3D cardiac cine imaging during a single breath hold in clinical patients on a 3T scanner using the kat ARC (k- and adaptive-t auto-calibrating reconstruction for Cartesian sampling) technique and to evaluate the interchangeability between 2D and 3D cine imaging for cardiac functional analysis and detection of abnormalities in regional wall motion. Following institutional review board approval, we obtained 2D cine images with an acceleration factor of two during multiple breath holds and 3D cine images with a net scan acceleration factor of 7.7 during a single breath hold in 20 patients using a 3T unit. Two readers independently evaluated the wall motion of the left ventricle (LV) using a 5-point scale, and the consistency in the detection of regional wall motion abnormality between 2D and 3D cine was analyzed by Cohen's kappa test. The LV volume was calculated at end-diastole and end-systole (LVEDV, LVESV); the ejection fraction (LVEF) and myocardial weight (LVmass) were also calculated. The relationship between functional parameters calculated for 2D and 3D cine images was analyzed using Pearson's correlation analysis. The bias and 95% limit of agreement (LA) were calculated using Bland-Altman plots. In addition, a qualitative evaluation of image quality was performed with regard to the myocardium-blood contrast, noise level and boundary definition. Despite slight degradation in image quality for 3D cine, excellent agreement was obtained for the detection of wall motion abnormalities between 2D and 3D cine images (κ=0.84 and 0.94 for each reader). Excellent correlations between the two imaging methods were shown for the evaluation of functional parameters (r>0.97). Slight differences in LVEDV, LVESV, LVEF and LVmass

  3. Cardiac cine parallel imaging on a 0.7T open system.

    Science.gov (United States)

    Takizawa, Masahiro; Goto, Tomohiro; Mochizuki, Hiroyuki; Nonaka, Masayuki; Nagai, Shizuka; Takeuchi, Hiroyuki; Taniguchi, Yo; Ochi, Hisaaki; Takahashi, Tetsuhiko

    2004-04-01

    Parallel imaging can be applied to cardiac imaging with a cylindrical MRI (magnetic resonance imaging) apparatus. Studies of open MRI, however, are few. This study sought to achieve cardiac cine parallel imaging (or RAPID, for "rapid acquisition through parallel imaging design") with an open 0.7T MRI apparatus. Imaging time was shortened in all slice directions with the use of a dedicated four-channel RF receiving coil comprising solenoid coils and butterfly coils. Coil shape was designed through an RF-coil simulation that considered biological load. The auto-calibration of a 0.7T open MRI apparatus incorporated a modified image-domain reconstruction algorithm. Cine images were obtained with a BASG, or balanced SARGE (steady-state acquisition with rewound gradient echo), sequence. Image quality was evaluated with cylindrical phantoms and five healthy volunteers. Multi-slice phantom images showed no visible artifacts. Cine images taken under breath-hold with an acceleration factor of two were evaluated carefully. With auto-calibration, the images revealed no visible unfolded artifacts or motion artifacts. RAPID thus improved the acquisition speed, time resolution, and spatial resolution of short-axis, long-axis, and four-chamber images. The use of a dedicated RF coil enabled cardiac cine RAPID to be performed with an open MRI apparatus.

  4. Audiovisual biofeedback guided breath-hold improves lung tumor position reproducibility and volume consistency

    Directory of Open Access Journals (Sweden)

    Danny Lee, PhD

    2017-07-01

    Conclusions: This study demonstrated that audiovisual biofeedback can be used to improve the reproducibility and consistency of breath-hold lung tumor position and volume, respectively. These results may provide a pathway to achieve more accurate lung cancer radiation treatment in addition to improving various medical imaging and treatments by using breath-hold procedures.

  5. Brain damage in commercial breath-hold divers.

    Directory of Open Access Journals (Sweden)

    Kiyotaka Kohshi

    Full Text Available Acute decompression illness (DCI involving the brain (Cerebral DCI is one of the most serious forms of diving-related injuries which may leave residual brain damage. Cerebral DCI occurs in compressed air and in breath-hold divers, likewise. We conducted this study to investigate whether long-term breath-hold divers who may be exposed to repeated symptomatic and asymptomatic brain injuries, show brain damage on magnetic resonance imaging (MRI.Our study subjects were 12 commercial breath-hold divers (Ama with long histories of diving work in a district of Japan. We obtained information on their diving practices and the presence or absence of medical problems, especially DCI events. All participants were examined with MRI to determine the prevalence of brain lesions.Out of 12 Ama divers (mean age: 54.9±5.1 years, four had histories of cerebral DCI events, and 11 divers demonstrated ischemic lesions of the brain on MRI studies. The lesions were situated in the cortical and/or subcortical area (9 cases, white matters (4 cases, the basal ganglia (4 cases, and the thalamus (1 case. Subdural fluid collections were seen in 2 cases.These results suggest that commercial breath-hold divers are at a risk of clinical or subclinical brain injury which may affect the long-term neuropsychological health of divers.

  6. Breath-holding spells in infants.

    Science.gov (United States)

    Goldman, Ran D

    2015-02-01

    I have children in my clinic who experience seizurelike episodes in which they cry and hold their breath to the point of cyanosis and loss of consciousness. Their examination or investigation findings are normal and referral to a pediatric specialist results in no further investigation. Are breath-holding spells common, and what type of investigation is needed? A breath-holding spell is a benign paroxysmal nonepileptic disorder occurring in healthy children 6 to 48 months of age. The episodes start with a provocation such as emotional upset or minor injury, and might progress to breath holding, cyanosis, and syncope. The episodes are extremely frightening to watch but have benign consequences. Once a clinical diagnosis is made, it is recommended to conduct an electrocardiogram and to rule out anemia, but no further investigation or referral is warranted. Copyright© the College of Family Physicians of Canada.

  7. Oxidative stress in breath-hold divers after repetitive dives

    OpenAIRE

    Theunissen, S; Sponsiello, N; Rozloznik, M; Germonpre, P.; Guerrero, F.; Cialoni, D; Balestra, C.

    2013-01-01

    Introduction: Hyperoxia causes oxidative stress. Breath-hold diving is associated with transient hyperoxia followed by hypoxia and a build-up of carbon dioxide (CO2), chest-wall compression and significant haemodynamic changes. This study analyses variations in plasma oxidative stress markers after a series of repetitive breath-hold dives.Methods: Thirteen breath-hold divers were asked to perform repetitive breath-hold dives to 20 metres’ depth to a cumulative breath-hold time of approximatel...

  8. Qualitative assessment of contrast-enhanced magnetic resonance angiography using breath-hold and non-breath-hold techniques in the portal venous system

    Science.gov (United States)

    Goo, Eun-Hoe; Kim, Sun-Ju; Dong, Kyung-Rae; Kim, Kwang-Choul; Chung, Woon-Kwan

    2016-09-01

    The purpose of this study is to evaluate the image quality in delineation of the portal venous systems with two different methods, breath-hold and non-breath-hold by using the 3D FLASH sequence. We used a 1.5 T system to obtain magnetic resonance(MR)images. Arterial and portal phase 3D FLASH images were obtained with breath-hold after a bolus injection of GD-DOTA. The detection of PVS on the MR angiograms was classified into three grades. First, the angiograms of the breath-hold method showed well the portal vein, the splenic vein and the superior mesenteric vein systems in 13 of 15 patients (86%) and the inferior mesenteric vein system in 6 of 15 patients (40%), Second, MR angiograms of the non-breath-hold method demonstrated the PVS and the SMV in 12 of 15 patients (80%) and the IMV in 5 of 15 patients (33%). Our study showed contrast-enhanced 3D FLASH MR angiography, together with the breath-hold technique, may provide reliable and accurate information on the portal venous system.

  9. Improving the detectability of focal liver lesions on T2-weighted MR images: ultrafast breath-hold or respiratory-triggered thin-section MRI?

    Science.gov (United States)

    Pauleit, D; Textor, J; Bachmann, R; Conrad, R; Flacke, S; Kreft, B; Schild, H

    2001-08-01

    The purpose of this study was to determine whether a respiratory-triggered (RT) T2-weighted turbo spin-echo (TSE) sequence with thin section can improve the detectability of focal liver lesions compared to a breath-hold (BH) T2-weighted TSE sequence. In 25 patients an RT TSE with 8-mm sections (8-TSE RT) and 5-mm sections (5-TSE RT) and a BH TSE sequence with 8-mm sections (8-TSE BH) were performed. Forty-one focal liver lesions (mean: 1.8 +/- 1.2 cm; 14 lesions 1 cm) were evaluated. The 5-TSE RT was significantly better in lesion detection compared to the 8-TSE BH sequence for all sizes of lesions (40/41 vs. 33/41; P = 0.014). For lesions >1 cm no relevant differences in the detection rate of the sequences were found (8-TSE RT, 26/27; 5-TSE RT, 26/27; 8-TSE BH, 25/27), for lesions < or =1 cm the 5-TSE RT provided significantly better sensitivity than the 8-TSE BH (14/14 vs. 8/14, P = 0.015). The results of this study suggest that lesion detection could be significantly improved by using an RT TSE sequence with thin sections compared with a BH TSE sequence. Copyright 2001 Wiley-Liss, Inc.

  10. The Physics of Breath-Hold Diving.

    Science.gov (United States)

    Aguilella, Vicente; Aguilella-Arzo, Marcelo

    1996-01-01

    Analyzes physical features of breath-hold diving. Considers the diver's descent and the initial surface dive and presents examples that show the diver's buoyancy equilibrium varying with depth, the driving force supplied by finning, and the effect of friction between the water and the diver. (Author/JRH)

  11. Rapid 3D imaging of the lower airway by MRI in patients with congenital heart disease: A retrospective comparison of delayed volume interpolated breath-hold examination (VIBE) to turbo spin echo (TSE).

    Science.gov (United States)

    Goot, Benjamin H; Patel, Sonali; Fonseca, Brian

    2017-01-01

    When imaging the lower airway by MRI, the traditional technique turbo spin echo (TSE) results in high quality 2D images, however planning and acquisition times are lengthy. An alternative, delayed volume interpolated breath-holds examination (VIBE), is a 3D gradient echo technique that produces high spatial resolution imaging of the airway in one breath-hold. The objective of this study is to retrospectively evaluate the accuracy of lower airway measurements obtained by delayed VIBE when compared to TSE. Patients with congenital heart disease who underwent a cardiac MRI (CMR) that included a delayed VIBE sequence from 5/2008 to 9/2013 were included. Standard TSE imaging was performed and delayed VIBE was acquired 5 min after gadolinium contrast administration. Airway measurements were made on both sequences by two observers in a blinded fashion to the other observer and other technique. Intraclass correlations (ICC) were calculated to assess for agreement between both techniques and the observers. 29 studies met inclusion criteria with a mean patient age of 8.8 years (2 months to 63 years) and mean patient weight of 30.2 kg (3.5-110). All delayed VIBE and TSE sequences were found to be of diagnostic quality. Mean acquisition time was shorter for the delayed VIBE (13.1 seconds) than TSE (949.9 seconds). Overall there was very good agreement between the delayed VIBE and TSE measurements for both observers (ICC 0.78-0.94) with the exception of the distal right bronchus (ICC 0.67) The interobserver agreement was also excellent for both TSE (ICC 0.78-0.96) and VIBE (ICC 0.85-0.96). Delayed VIBE is rapid and at least as accurate as the alternative TSE imaging for assessment of the lower airway by MRI across a wide spectrum of patients. © 2016 Wiley Periodicals, Inc.

  12. Automatically gated image-guided breath-hold IMRT is a fast, precise, and dosimetrically robust treatment for lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Simeonova-Chergou, Anna; Jahnke, Anika; Siebenlist, Kerstin; Stieler, Florian; Mai, Sabine; Boda-Heggemann, Judit; Wenz, Frederik; Lohr, Frank; Jahnke, Lennart [University Medical Center Mannheim, University of Heidelberg, Department of Radiotherapy and Oncology, Mannheim (Germany)

    2016-03-15

    High-dose radiotherapy of lung cancer is challenging. Tumors may move by up to 2 cm in craniocaudal and anteroposterior directions as a function of breathing cycle. Tumor displacement increases with treatment time, which consequentially increases the treatment uncertainty. This study analyzed whether automatically gated cone-beam-CT (CBCT)-controlled intensity modulated fast deep inspiration breath hold (DIBH) stereotactic body radiation therapy (SBRT) in flattening filter free (FFF) technique and normofractionated lung DIBH intensity-modulated radiotherapy (IMRT)/volumetric-modulated arc therapy (VMAT) treatments delivered with a flattening filter can be applied with sufficient accuracy within a clinically acceptable timeslot. Plans of 34 patients with lung tumors were analyzed. Of these patients, 17 received computer-controlled fast DIBH SBRT with a dose of 60 Gy (5 fractions of 12 Gy or 12 fractions of 5 Gy) in an FFF VMAT technique (FFF-SBRT) every other day and 17 received conventional VMAT with a flattening filter (conv-VMAT) and 2-Gy daily fractional doses (cumulative dose 50-70 Gy). FFF-SBRT plans required more monitor units (MU) than conv-VMAT plans (2956.6 ± 885.3 MU for 12 Gy/fraction and 1148.7 ± 289.2 MU for 5 Gy/fraction vs. 608.4 ± 157.5 MU for 2 Gy/fraction). Total treatment and net beam-on times were shorter for FFF-SBRT plans than conv-VMAT plans (268.0 ± 74.4 s vs. 330.2 ± 93.6 s and 85.8 ± 25.3 s vs. 117.2 ± 29.6 s, respectively). Total slot time was 13.0 min for FFF-SBRT and 14.0 min for conv-VMAT. All modalities could be delivered accurately despite multiple beam-on/-off cycles and were robust against multiple interruptions. Automatically gated CBCT-controlled fast DIBH SBRT in VMAT FFF technique and normofractionated lung DIBH VMAT can be applied with a low number of breath-holds in a short timeslot, with excellent dosimetric accuracy. In clinical routine, these approaches combine optimally reduced lung tissue irradiation with maximal

  13. Kidney motion during free breathing and breath hold for MR-guided radiotherapy.

    Science.gov (United States)

    Stam, Mette K; van Vulpen, Marco; Barendrecht, Maurits M; Zonnenberg, Bernard A; Intven, Martijn; Crijns, Sjoerd P M; Lagendijk, Jan J W; Raaymakers, Bas W

    2013-04-07

    Current treatments for renal cell carcinoma have a high complication rate due to the invasiveness of the treatment. With the MRI-linac it may be possible to treat renal tumours non-invasively with high-precision radiotherapy. This is expected to reduce complications. To deliver a static dose distribution, radiation gating will be used. In this study the reproducibility and efficiency of free breathing gating and a breath hold treatment of the kidney was investigated. For 15 patients with a renal lesion the kidney motion during 2 min of free breathing and 10 consecutive expiration breath holds was studied with 2D cine MRI. The variability in kidney expiration position and treatment efficiency for gating windows of 1 to 20 mm was measured for both breathing patterns. Additionally the time trend in free breathing and the variation in expiration breath hold kidney position with baseline shift correction was determined. In 80% of the patients the variation in expiration position during free breathing is smaller than 2 mm. No clinically relevant time trends were detected. The variation in expiration breath hold is for all patients larger than the free breathing expiration variation. Gating on free breathing is, for gating windows of 1 to 5 mm more efficient than breath hold without baseline correction. When applying a baseline correction to the breath hold it increases the treatment efficiency. The kidney position is more reproducible in expiration free breathing than non-guided expiration breath hold. For small gating windows it is also more time efficient. Since free breathing also seems more comfortable for the patients it is the preferred breathing pattern for MRI-Linac treatments of the kidney.

  14. Assessment of Left Ventricular Function and Mass on Free-Breathing Compressed Sensing Real-Time Cine Imaging.

    Science.gov (United States)

    Kido, Tomoyuki; Kido, Teruhito; Nakamura, Masashi; Watanabe, Kouki; Schmidt, Michaela; Forman, Christoph; Mochizuki, Teruhito

    2017-09-25

    Compressed sensing (CS) cine magnetic resonance imaging (MRI) has the advantage of being inherently insensitive to respiratory motion. This study compared the accuracy of free-breathing (FB) CS and breath-hold (BH) standard cine MRI for left ventricular (LV) volume assessment.Methods and Results:Sixty-three patients underwent cine MRI with both techniques. Both types of images were acquired in stacks of 8 short-axis slices (temporal/spatial resolution, 41 ms/1.7×1.7×6 mm 3 ) and compared for ejection fraction, end-diastolic and systolic volumes, stroke volume, and LV mass. Both BH standard and FB CS cine MRI provided acceptable image quality for LV volumetric analysis (score ≥3) in all patients (4.7±0.5 and 3.7±0.5, respectively; Pcine MRI (median, IQR: BH standard, 83.8 mL, 64.7-102.7 mL; FB CS, 79.0 mL, 66.0-101.0 mL; P=0.0006). The total acquisition times for BH standard and FB CS cine MRI were 113±7 s and 24±4 s, respectively (Pcine MRI is a clinically useful alternative to BH standard cine MRI in patients with impaired BH capacity.

  15. Cine MR imaging in valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tsunehiko; Yamada, Naoaki; Itoh, Akira; Miyatake, Kunio

    1989-01-01

    Cine MR Imaging was carried out using FLASH (fast low angle shot) which employes TE of 16 msec and TR of 30/similar to/40 msec. Regurgitant jet was visible as discrete area of low signal intensity extending from the incompetent valve into the respective cardiac chamber. In 20 patients with mitral regurgitation, the correlation of the length and area of mitral jet by cine MR and color doppler mapping was 0.74 and 0.71, respectively. Cine MR imaging is a promising modality for detection and quantification of valvular heart disease.

  16. Free-Breathing 3D Imaging of Right Ventricular Structure and Function Using Respiratory and Cardiac Self-Gated Cine MRI

    Directory of Open Access Journals (Sweden)

    Yanchun Zhu

    2015-01-01

    Full Text Available Providing a movie of the beating heart in a single prescribed plane, cine MRI has been widely used in clinical cardiac diagnosis, especially in the left ventricle (LV. Right ventricular (RV morphology and function are also important for the diagnosis of cardiopulmonary diseases and serve as predictors for the long term outcome. The purpose of this study is to develop a self-gated free-breathing 3D imaging method for RV quantification and to evaluate its performance by comparing it with breath-hold 2D cine imaging in 7 healthy volunteers. Compared with 2D, the 3D RV functional measurements show a reduction of RV end-diastole volume (RVEDV by 10%, increase of RV end-systole volume (RVESV by 1.8%, reduction of RV systole volume (RVSV by 21%, and reduction of RV ejection fraction (RVEF by 12%. High correlations between the two techniques were found (RVEDV: 0.94; RVESV: 0.85; RVSV: 0.95; and RVEF: 0.89. Compared with 2D, the 3D image quality measurements show a small reduction in blood SNR, myocardium-blood CNR, myocardium contrast, and image sharpness. In conclusion, the proposed self-gated free-breathing 3D cardiac cine imaging technique provides comparable image quality and correlated functional measurements to those acquired with the multiple breath-hold 2D technique in RV.

  17. Evaluation of highly accelerated real-time cardiac cine MRI in tachycardia.

    Science.gov (United States)

    Bassett, Elwin C; Kholmovski, Eugene G; Wilson, Brent D; DiBella, Edward V R; Dosdall, Derek J; Ranjan, Ravi; McGann, Christopher J; Kim, Daniel

    2014-02-01

    Electrocardiogram (ECG)-gated breath-hold cine MRI is considered to be the gold standard test for the assessment of cardiac function. However, it may fail in patients with arrhythmia, impaired breath-hold capacity and poor ECG gating. Although ungated real-time cine MRI may mitigate these problems, commercially available real-time cine MRI pulse sequences using parallel imaging typically yield relatively poor spatiotemporal resolution because of their low image acquisition efficiency. As an extension of our previous work, the purpose of this study was to evaluate the diagnostic quality and accuracy of eight-fold-accelerated real-time cine MRI with compressed sensing (CS) for the quantification of cardiac function in tachycardia, where it is challenging for real-time cine MRI to provide sufficient spatiotemporal resolution. We evaluated the performances of eight-fold-accelerated cine MRI with CS, three-fold-accelerated real-time cine MRI with temporal generalized autocalibrating partially parallel acquisitions (TGRAPPA) and ECG-gated breath-hold cine MRI in 21 large animals with tachycardia (mean heart rate, 104 beats per minute) at 3T. For each cine MRI method, two expert readers evaluated the diagnostic quality in four categories (image quality, temporal fidelity of wall motion, artifacts and apparent noise) using a Likert scale (1-5, worst to best). One reader evaluated the left ventricular functional parameters. The diagnostic quality scores were significantly different between the three cine pulse sequences, except for the artifact level between CS and TGRAPPA real-time cine MRI. Both ECG-gated breath-hold cine MRI and eight-fold accelerated real-time cine MRI yielded all four scores of ≥ 3.0 (acceptable), whereas three-fold-accelerated real-time cine MRI yielded all scores below 3.0, except for artifact (3.0). The left ventricular ejection fraction (LVEF) measurements agreed better between ECG-gated cine MRI and eight-fold-accelerated real-time cine MRI

  18. Comparison of multi-echo dixon methods with volume interpolated breath-hold gradient magnetic resonance imaging in fat-signal fraction quantification of paravaertebral muscle

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Yeon Hwa; Kim, Hak Sun; Lee, Young Han [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

    2015-10-15

    To assess whether multi-echo Dixon magnetic resonance (MR) imaging with simultaneous T2{sup *} estimation and correction yields more accurate fat-signal fraction (FF) measurement of the lumbar paravertebral muscles, in comparison with non-T2{sup *}-corrected two-echo Dixon or T2{sup *}-corrected three-echo Dixon, using the FF measurements from single-voxel MR spectroscopy as the reference standard. Sixty patients with low back pain underwent MR imaging with a 1.5T scanner. FF mapping images automatically obtained using T2{sup *}-corrected Dixon technique with two (non-T2{sup *}-corrected), three, and six echoes, were compared with images from single-voxel MR spectroscopy at the paravertebral muscles on levels L4 through L5. FFs were measured directly by two radiologists, who independently drew the region of interest on the mapping images from the three sequences. A total of 117 spectroscopic measurements were performed either bilaterally (57 of 60 subjects) or unilaterally (3 of 60 subjects). The mean spectroscopic FF was 14.3 ± 11.7% (range, 1.9-63.7%). Interobserver agreement was excellent between the two radiologists. Lin's concordance correlation between the spectroscopic findings and all the imaging-based FFs were statistically significant (p < 0.001). FFs obtained from the T2*-corrected six-echo Dixon sequences showed a significantly better concordance with the spectroscopic data, with its concordance correlation coefficient being 0.99 and 0.98 (p < 0.001), as compared with two- or three-echo methods. T2{sup *}-corrected six-echo Dixon sequence would be a better option than two- or three-echo methods for noninvasive quantification of lumbar muscle fat quantification.

  19. Prospective intraindividual comparison between respiratory-triggered balanced steady-state free precession and breath-hold gradient-echo and time-of-flight magnetic resonance imaging for assessment of portal and hepatic veins

    Energy Technology Data Exchange (ETDEWEB)

    Willmann, Juergen K.; Goepfert, Kerstin; Lutz, Amelie M.; Marincek, Borut; Weishaupt, Dominik [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Nanz, Daniel [University Hospital Zurich, Department of Medical Radiology, Zurich (Switzerland); McCormack, Lucas; Petrowsky, Henrik [University Hospital Zurich, Department of Visceral and Transplantation Surgery, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Hervo, Patrice [GE Healthcare, Buc Cedex (France)

    2007-01-15

    The purpose of this study was to compare respiratory-triggered balanced steady-state free precession (bSSFP) with breath-hold contrast-enhanced dynamic two-dimensional (2D) gradient-echo (GRE) and time-of-flight (TOF) magnetic resonance imaging (MRI) for portal and hepatic vein visualization and assessment of portal and hepatic venous variants. Sixty patients with liver disease underwent nonenhanced bSSFP and contrast-enhanced GRE, bSSFP, and TOF imaging. Contrast-to-noise ratios (CNRs) for portal and hepatic veins were measured. Two readers rated the quality of portal and hepatic vein visualization on a 5-point Likert scale. The diagnostic performance of each MRI series in the detection of portal and hepatic venous variants was assessed in 40/60 patients who also underwent contrast-enhanced multidetector-row computed tomography (MDCT). CNRs for portal and hepatic veins were highest on contrast-enhanced bSSFP images. Image quality of portal and hepatic veins was rated higher for nonenhanced bSSFP than for contrast-enhanced GRE (p<0.03) and TOF (p<0.003) and higher for contrast-enhanced than for nonenhanced bSSFP (p<0.003). Compared with MDCT, portal and hepatic venous variants were identified with an accuracy of 99% on bSSFP images, with an excellent interobserver agreement ({kappa}=0.97). Compared with MDCT, presence of surgically important portal and hepatic venous anatomical variants can be predicted with high accuracy on bSSFP images. (orig.)

  20. Sports-related lung injury during breath-hold diving.

    Science.gov (United States)

    Mijacika, Tanja; Dujic, Zeljko

    2016-12-01

    The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage. Copyright ©ERS 2016.

  1. A pacemaker for asystole in breath-holding spells

    Science.gov (United States)

    Legge, Leah M; Kantoch, Michal J; Seshia, Shashi S; Soni, Reeni

    2002-01-01

    Two cases of young children with frequent severe breath-holding spells complicated by prolonged asystole and seizures are reported. A ventricular pacemaker was implanted in each child, and both have subsequently remained free of syncope, although they continue to exhibit breath-holding behaviour. PMID:20046299

  2. Oxidative stress in breath-hold divers after repetitive dives.

    Science.gov (United States)

    Theunissen, Sigrid; Sponsiello, Nicola; Rozloznik, Miroslav; Germonpré, Peter; Guerrero, François; Cialoni, Danilo; Balestra, Constantino

    2013-06-01

    Hyperoxia causes oxidative stress. Breath-hold diving is associated with transient hyperoxia followed by hypoxia and a build-up of carbon dioxide (CO₂), chest-wall compression and significant haemodynamic changes. This study analyses variations in plasma oxidative stress markers after a series of repetitive breath-hold dives. Thirteen breath-hold divers were asked to perform repetitive breath-hold dives to 20 metres' depth to a cumulative breath-hold time of approximately 20 minutes over an hour in the open sea. Plasma nitric oxide (NO), peroxinitrites (ONOO⁻) and thiols (R-SH) were measured before and after the dive sequence. Circulating NO significantly increased after successive breath-hold dives (169.1 ± 58.26% of pre-dive values; P = 0.0002). Peroxinitrites doubled after the dives (207.2 ± 78.31% of pre-dive values; P = 0.0012). Thiols were significantly reduced (69.88 ± 19.23% of pre-dive values; P = 0.0002). NO may be produced by physical effort during breath-hold diving. Physical exercise, the transient hyperoxia followed by hypoxia and CO₂ accumulation would all contribute to the increased levels of superoxide anions (O₂²⁻). Since interaction of O₂²⁻ with NO forms ONOO⁻, this reaction is favoured and the production of thiol groups is reduced. Oxidative stress is, thus, present in breath-hold diving.

  3. Novel Findings in Breath-Holding Spells

    Science.gov (United States)

    Azab, Seham F.A.; Siam, Ahmed G.; Saleh, Safaa H.; Elshafei, Mona M.; Elsaeed, Wafaa F.; Arafa, Mohamed A.; Bendary, Eman A.; Farag, Elsayed M.; Basset, Maha A.A.; Ismail, Sanaa M.; Elazouni, Osama M.A.

    2015-01-01

    Abstract The mechanism of breath-holding spells (BHS) is not fully understood and most probably multifactorial; so, this study was designed to clarify the pathophysiology of BHS through assessing some laboratory parameters and electrocardiographic (ECG) changes which might be contributing to the occurrence of the attacks. Another aim of the study was to evaluate the differences in the pathophysiology between pallid and cyanotic types of BHS. This was a prospective study performed in Zagazig University Hospitals. Seventy-six children diagnosed with BHS were included as follows: 32 children with cyanotic BHS, 14 children with pallid BHS, and 30 healthy children as a control group. All children were subjected to the following: full history taking, clinical examination, and laboratory work up in the form of CBC, serum iron, ferritin, and zinc levels. Twenty-four hours ambulatory ECG (Holter) recording was also performed. No significant statistical difference was found between cyanotic and pallid groups regarding family history of BHS, severity, and precipitating factors of the attacks. Frequent runs of respiratory sinus arrhythmia (RSA) during 24 hours ECG were significantly higher in children with BHS; the frequency of RSA was significantly correlated with the frequency (severity) of the attacks. Low serum ferritin was significantly associated with BHS groups but not correlated with the severity of the attacks. Autonomic dysregulation evidenced by frequent RSA is considered to be an important cause of BHS in children and is correlated with the frequency of the attacks. Low serum ferritin is additional factor in the pathophysiology. Both pallid and cyanotic BHS are suggested to be types of the same disease sharing the same pathophysiology. PMID:26181556

  4. SU-F-J-22: Lung VolumeVariability Assessed by Bh-CBCT in 3D Surface Image Guided Deep InspirationBreath Hold (DIBH) Radiotherapy for Left-Sided Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, A; Stanley, D; Papanikolaou, N; Crownover, R [University of Texas Health Science Center San Antonio, San Antonio, TX (United States)

    2016-06-15

    Purpose: With the increasing use of DIBH techniques for left-sided breast cancer, 3D surface-image guided DIBH techniques have improved patient setup and facilitated DIBH radiation delivery. However, quantification of the daily separation between the heart and left breast still presents a challenge. One method of assuring separation is to ensure consistent left lung filling. With this in mind, the aim of this study is to retrospectively quantify left lung volume from weekly breath hold-CBCTs (bh-CBCT) of left-sided breast patients treated using a 3D surface imaging system. Methods: Ten patients (n=10) previously treated to the left breast using the C-Rad CatalystHD system (C-RAD AG, Uppsala Sweden) were evaluated. Patients were positioned with CatalystHD and with bh-CBCT. bh-CBCTs were acquired at the validation date, first day of treatment and at subsequent weekly intervals. Total treatment courses spanned from 3 to 5 weeks. bh-CBCT images were exported to VelocityAI and the left lung volume was segmented. Volumes were recorded and analyzed. Results: A total of 41 bh-CBCTs were contoured in VelocityAI for the 10 patients. The mean left lung volume for all patients was 1657±295cc based on validation bh-CBCT. With the subsequent lung volumes normalized to the validation lung volume, the mean relative ratios for all patients were 1.02±0.11, 0.97±0.14, 0.98±0.11, 1.02±0.01, and 0.96±0.02 for week 1, 2, 3, 4, and 5, respectively. Overall, the mean left lung volume change was ≤4.0% over a 5-week course; however left lung volume variations of up to 28% were noted in a select patient. Conclusion: With the use of the C-RAD CatalystHD system, the mean lung volume variability over a 5-week course of DIBH treatments was ≤4.0%. By minimizing left lung volume variability, heart to left breast separation maybe more consistently maintained. AN Gutierrez has a research grant from C-RAD AG.

  5. Fetal cardiac cine imaging using highly accelerated dynamic MRI with retrospective motion correction and outlier rejection.

    Science.gov (United States)

    van Amerom, Joshua F P; Lloyd, David F A; Price, Anthony N; Kuklisova Murgasova, Maria; Aljabar, Paul; Malik, Shaihan J; Lohezic, Maelene; Rutherford, Mary A; Pushparajah, Kuberan; Razavi, Reza; Hajnal, Joseph V

    2018-01-01

    Development of a MRI acquisition and reconstruction strategy to depict fetal cardiac anatomy in the presence of maternal and fetal motion. The proposed strategy involves i) acquisition and reconstruction of highly accelerated dynamic MRI, followed by image-based ii) cardiac synchronization, iii) motion correction, iv) outlier rejection, and finally v) cardiac cine reconstruction. Postprocessing entirely was automated, aside from a user-defined region of interest delineating the fetal heart. The method was evaluated in 30 mid- to late gestational age singleton pregnancies scanned without maternal breath-hold. The combination of complementary acquisition/reconstruction and correction/rejection steps in the pipeline served to improve the quality of the reconstructed 2D cine images, resulting in increased visibility of small, dynamic anatomical features. Artifact-free cine images successfully were produced in 36 of 39 acquired data sets; prolonged general fetal movements precluded processing of the remaining three data sets. The proposed method shows promise as a motion-tolerant framework to enable further detail in MRI studies of the fetal heart and great vessels. Processing data in image-space allowed for spatial and temporal operations to be applied to the fetal heart in isolation, separate from extraneous changes elsewhere in the field of view. Magn Reson Med 79:327-338, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

  6. Brain metabolite values in children with breath-holding spells

    Directory of Open Access Journals (Sweden)

    Calik M

    2017-06-01

    Full Text Available Mustafa Calik,1 Dilek Sen Dokumaci,2 Suna Sarikaya,3 Mahmut Demir,4 Ilhan Isik,5 Halil Kazanasmaz,4 Cemil Kaya,4 Hasan Kandemir6 1Department of Pediatric Neurology, 2Department of Radiology, 3Department of Neurology, 4Department of Pediatrics, Harran University School of Medicine, 5Department of Pediatric Neurology, Eyyubiye Training and Research Hospital, 6Department of Child and Adolescent Psychiatry, Harran University School of Medicine, Sanliurfa, Turkey Abstract: Breath-holding spells are benign, paroxysmal events with apnea and postural tone changes after a crying episode in infants. The objective of this study was to investigate the pathologies in brain metabolite values in the absence of seizure in children with breath-holding spells by using magnetic resonance spectroscopy (MRS. Brain MRS examination was performed on 18 children with breath-holding spells and 13 neurologically normal children who were included as the control group. There was no significant difference in terms of N-acetyl aspartate (NAA, choline (Cho, creatine (Cr, and myoinositol (mI levels and also in terms of NAA/Cr, Cho/Cr, and mI/Cr ratios between the patients and the control group (all P>0.05. Our study suggested that there is no permanent neuronal damage in patients with breath-holding spells. This result confirms the previous studies, which reported no permanent neuronal damage in patients with breath-holding spells. Keywords: brain metabolite, children, breath holding, magnetic resonance spectroscopy 

  7. Lung volume reproducibility under ABC control and self-sustained breath-holding.

    Science.gov (United States)

    Kaza, Evangelia; Dunlop, Alex; Panek, Rafal; Collins, David J; Orton, Matthew; Symonds-Tayler, Richard; McQuaid, Dualta; Scurr, Erica; Hansen, Vibeke; Leach, Martin O

    2017-03-01

    An Active Breathing Coordinator (ABC) can be employed to induce breath-holds during CT imaging and radiotherapy of lung, breast and liver cancer, and recently during lung cancer MRI. The apparatus measures and controls respiratory volume, hence subject lung volume reproducibility is its principal measure of effectiveness. To assess ABC control quality, the intra-session reproducibility of ABC-induced lung volumes was evaluated and compared with that reached by applying the clinical standard of operator-guided self-sustained breath-holds on healthy volunteers during MRI. Inter-session reproducibility was investigated by repeating ABC-controlled breath-holds on a second visit. Additionally, lung volume agreement with ABC devices used with different imaging modalities in the same institution (MR, CT), or for a breast trial treatment, was assessed. Lung volumes were derived from three-dimensional (3D) T1-weighted MRI datasets by three observers employing semiautomatic lung delineation on a radiotherapy treatment planning system. Inter-observer variability was less than 6% of the delineated lung volumes. Lung volume agreement between the different conditions over all subjects was investigated using descriptive statistics. The ABC equipment dedicated for MR application exhibited good intra-session and inter-session lung volume reproducibility (1.8% and 3% lung volume variability on average, respectively). MR-assessed lung volumes were similar using different ABC equipment dedicated to MR, CT, or breast radiotherapy. Overall, lung volumes controlled by the same or different ABC devices agreed better than with self-controlled breath-holds, as suggested by the average ABC variation of 1.8% of the measured lung volumes (99 mL), compared to the 4.1% (226 mL) variability observed on average with self-sustained breath-holding. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in

  8. Effect of iron supplementation in children with breath holding spells.

    Science.gov (United States)

    Jain, Rahul; Omanakuttan, Divin; Singh, Amitabh; Jajoo, Mamta

    2017-08-01

    The aim of this study was to analyse the effect of iron supplementation in children with breath holding spells, irrespective of their iron status and study the factors associated with the response. This was a prospective interventional study. Study population comprised of patients aged 6-36 months, attending a paediatric outpatient department with recurrent episodes (more than three in last 4 weeks) of breath holding spells. Children with loss of consciousness or convulsive movements associated with breath holding spells were considered as severe. After baseline investigations, all enrolled patients were given elemental iron at the dose of 3 mg/kg/day as a single daily dose. Four weekly follow-ups were done until 3 months after initiation of the intervention. At 12 weeks, investigations were repeated and outcome assessed for remission or decrease in severity of breath holding episodes. A total of 100 children with breath holding spells received iron supplementation. Almost 73% of children showed complete response, with another 23% showing greater than 50% reduction in frequency. Frequency of spells at diagnosis and intolerance to oral iron were significantly associated with poor response to iron supplementation. Other factors such as age at onset, age at presentation, severity of spells, anaemia and serum iron parameters had no significant association with the response. Of the 27 children without iron deficiency (serum ferritin ≥ 30 µg/L), 77.7% responded completely to iron supplementation, similar to the iron-deficient group. Iron supplementation is effective in the management of breath holding spells. Non-anaemic and iron-replete children with breath holding spells also respond well to iron supplementation. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  9. Cine-MR imaging of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Allmann, K.H.; Uhl, M.; Gufler, H.; Kotter, E.; Langer, M. [Univ. Hospital, Freiburg (Germany). Dept. of Diagnostic Radiology; Biebow, N.; Hauer, M.P.; Reichelt, A. [Univ. Hospital, Freiburg (Germany). Dept. of Orthopedic Surgery

    1997-11-01

    Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement. Material and Methods: The cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. The examinations were videotaped and evaluated later. Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. And we were able to objectively assess distances between the osseous structures during dynamic movement. Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. The method may provide an early diagnosis in the subacromial impingement syndrome. (orig.).

  10. Accelerated cardiac cine MRI using locally low rank and finite difference constraints.

    Science.gov (United States)

    Miao, Xin; Lingala, Sajan Goud; Guo, Yi; Jao, Terrence; Usman, Muhammad; Prieto, Claudia; Nayak, Krishna S

    2016-07-01

    To evaluate the potential value of combining multiple constraints for highly accelerated cardiac cine MRI. A locally low rank (LLR) constraint and a temporal finite difference (FD) constraint were combined to reconstruct cardiac cine data from highly undersampled measurements. Retrospectively undersampled 2D Cartesian reconstructions were quantitatively evaluated against fully-sampled data using normalized root mean square error, structural similarity index (SSIM) and high frequency error norm (HFEN). This method was also applied to 2D golden-angle radial real-time imaging to facilitate single breath-hold whole-heart cine (12 short-axis slices, 9-13s single breath hold). Reconstruction was compared against state-of-the-art constrained reconstruction methods: LLR, FD, and k-t SLR. At 10 to 60 spokes/frame, LLR+FD better preserved fine structures and depicted myocardial motion with reduced spatio-temporal blurring in comparison to existing methods. LLR yielded higher SSIM ranking than FD; FD had higher HFEN ranking than LLR. LLR+FD combined the complimentary advantages of the two, and ranked the highest in all metrics for all retrospective undersampled cases. Single breath-hold multi-slice cardiac cine with prospective undersampling was enabled with in-plane spatio-temporal resolutions of 2×2mm(2) and 40ms. Highly accelerated cardiac cine is enabled by the combination of 2D undersampling and the synergistic use of LLR and FD constraints. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. TH-C-12A-11: Target Correlation of a 3D Surface Surrogate for Left Breast Irradiation Using the Respiratory-Gated Deep-Inspiration Breath-Hold Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rong, Y; Walston, S [A Quick, Ohio State University, Columbus, OH (United States)

    2014-06-15

    Purpose: To evaluate the use of 3D optical surface imaging as a new surrogate for respiratory motion gated deep-inspiration breath-hold (DIBH) technique for left breast cancer patients. Methods: Patients with left-sided breast cancer after lumpectomy or mastectomy were selected as candidates for DIBH technique for their external beam radiation therapy. Treatment plans were created on both free breathing (FB) and DIBH CTs to determine whether DIBH was beneficial in reducing heart doses. The Real-time Position Management (RPM) system was used to acquire patient's breathing trace during DIBH CT acquisition and treatment delivery. The reference 3D surface models from FB and DIBH CTs were generated and transferred to the “AlignRT” system for patient positioning and real-time treatment monitoring. MV Cine images were acquired for each beam as quality assurance for intra-fractional position verification. The chest wall excursions measured on these images were used to define the actual target position during treatment, and to investigate the accuracy and reproducibility of RPM and AlignRT. Results: Reduction in heart dose can be achieved for left-sided breast patients using DIBH. Results showed that RPM has poor correlation with target position, as determined by the MV Cine imaging. This indicates that RPM may not be an adequate surrogate in defining the breath-hold level when used alone. Alternatively, the AlignRT surface imaging demonstrated a better correlation with the actual CW excursion during DIBH. Both the vertical and magnitude real-time deltas (RTDs) reported by AlignRT can be used as the gating parameter, with a recommend threshold of ±3 mm and 5 mm, respectively. Conclusion: 3D optical surface imaging serves as a superior target surrogate for the left breast treatment when compared to RPM. Working together with the realtime MV Cine imaging, they ensure accurate patient setup and dose delivery, while minimizing the imaging dose to patients.

  12. Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon

    Science.gov (United States)

    Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

    2017-01-01

    Abstract Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results. Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon–oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images. Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects. Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images

  13. 3D late gadolinium enhancement in a single prolonged breath-hold using supplemental oxygenation and hyperventilation.

    Science.gov (United States)

    Roujol, Sébastien; Basha, Tamer A; Akçakaya, Mehmet; Foppa, Murilo; Chan, Raymond H; Kissinger, Kraig V; Goddu, Beth; Berg, Sophie; Manning, Warren J; Nezafat, Reza

    2014-09-01

    To evaluate the feasibility of three-dimensional (3D) single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. Breath-hold metrics [breath-hold duration, diaphragmatic/LV position drift, and maximum variation of R wave to R wave (RR) interval] without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real-time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (field of view = 320 × 320 × 100 mm(3) , resolution = 1.6 × 1.6 × 5.0 mm(3) , acceleration rate of 4) and a free-breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semiquantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. Supplemental oxygenation and hyperventilation increased the breath-hold duration (35 ± 11 s to 58 ± 21 s; P  0.01). LGE images were of similar quality when compared with free-breathing acquisitions, but with reduced total scan time (85 ± 22 s to 35 ± 6 s; P hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV. Copyright © 2013 Wiley Periodicals, Inc.

  14. Brain metabolite values in children with breath-holding spells.

    Science.gov (United States)

    Calik, Mustafa; Sen Dokumaci, Dilek; Sarikaya, Suna; Demir, Mahmut; Isik, Ilhan; Kazanasmaz, Halil; Kaya, Cemil; Kandemir, Hasan

    2017-01-01

    Breath-holding spells are benign, paroxysmal events with apnea and postural tone changes after a crying episode in infants. The objective of this study was to investigate the pathologies in brain metabolite values in the absence of seizure in children with breath-holding spells by using magnetic resonance spectroscopy (MRS). Brain MRS examination was performed on 18 children with breath-holding spells and 13 neurologically normal children who were included as the control group. There was no significant difference in terms of N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), and myoinositol (mI) levels and also in terms of NAA/Cr, Cho/Cr, and mI/Cr ratios between the patients and the control group (all P>0.05). Our study suggested that there is no permanent neuronal damage in patients with breath-holding spells. This result confirms the previous studies, which reported no permanent neuronal damage in patients with breath-holding spells.

  15. T2-weighted MR imaging of liver lesions: a prospective evaluation comparing turbo spin-echo, breath-hold turbo spin-echo and half-Fourier turbo spin-echo (HASTE) sequences; Estudio de lesiones hepaticas con imagenes de resonancia magnetica potenciadas en T2: evaluacion prospectiva comparando secuencias turbo eco del espin, turbo eco del espin con respiracion sostenida y half-Fourier turbo eco del espin (HASTE)

    Energy Technology Data Exchange (ETDEWEB)

    Martin, J.; Villajos, M.; Oses, M. J.; Veintemillas, M.; Rue, M.; Puig, J.; Sentis, M. [Fundacion Parc Tauli. Sabadell (Spain)

    2000-07-01

    To compare turbo spin-echo (TSE), breath-hold TSE and half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences quantitatively and qualitatively in T2-weighted images of liver lesions. The authors evaluated prospectively 89 liver lesions in 73 patients using a 1.0-T magnetic resonance system to compare TSE, breath-hold TSE and HASTE sequences. The quantitative parameters were: lesion-to-liver contrast and lesion-to-liver contrast-to-noise ratio. The qualitative analysis was performed by two observers in consensus who examined four parameters: respiratory artifacts, lesion edge definition, intrahepatic vessel definition and image quality. Repeated measures analysis of variance was utilized to compare the quantitative variables and Friedman's nonparametric test for the qualitative parameters. In quantitative terms, the lesion-to-liver contrast was similar in TSE and breath-hold TSE sequences (2.45{+-}1.44 versus 2.60{+-}1.66), both of which were significantly better than the HASTE sequence (1.12{+-}0.72; p<0.001). The lesion-to-liver contrast-to-noise ratio was significantly higher in the TSE sequence (62.60{+-}46.40 versus 40.22{+-}25.35 versus 50.90{+-}32.10 for TSE, breath-hold TSE and HASTE sequences, respectively; p<0.001). In the qualitative comparisons, the HASTE sequence was significantly better than the TSE and breath-hold TSE sequences (p<0.001) in terms of artifacts and definition of lesion edge and intrahepatic vessels. Image quality was also significantly greater in the HASTE sequence (p<0.001). In quantitative terms, the TSE sequence is better than the breath-hold TSE and HASTE sequences, but there are no movement artifacts in the HASTE sequence, which is also significantly superior to TSE and breath-hold TSE sequences in qualitative terms and, thus, can be employed for T2-weighted images in liver studies. (Author) 17 refs.

  16. Assessment of both serum S-100B protein and neuropeptide-Y levels in childhood breath-holding spells.

    Science.gov (United States)

    Calik, Mustafa; Ciftci, Ahmet; Sarikaya, Suna; Kocaturk, Ozcan; Abuhandan, Mahmut; Taskin, Abdullah; Kandemir, Hasan; Yoldas, Tahır Kurtulus; Aksoy, Nurten

    2015-06-01

    Breath-holding spells are common paroxysmal events in children. Although the spells have a benign prognosis in the long term, they may be complicated by loss of consciousness, tonic-clonic movements, and occasionally seizures. Hence, this study aimed to measure the levels of serum S-100B proteins and neuropeptide-Y in the blood of children who experience breath-holding spells. The study groups consisted of 45 patients (13 females, 32 males) with breath-holding spells and a control group of 32 healthy individuals (12 females, 20 males). The serum S-100B levels were measured using commercially available ELISA kits. The neuropeptide-Y levels in the serum were measured with RayBio® Human/Mouse/Rat Neuropeptide Y ELISA kits. The mean serum S-100B protein level of the breath-holding spells group was 56.38 ± 13.26 pg/mL, and of the control group, 48.53 ± 16.77 pg/mL. The mean neuropeptide-Y level was 62.29 ± 13.89 pg/mL in the breath-holding spells group and 58.24 ± 12.30 pg/mL in the control group. There were significant differences between the groups with respect to serum S-100B protein levels (p = 0.025), while there was no statistically significant difference in neuropeptide-Y levels between the breath-holding spells group and the control group (p = 0.192). The findings of this study suggest that frequent and lengthy breath-holding may lead to the development of neuronal metabolic dysfunction or neuronal damage which is most likely related to hypoxia. In light of these findings, future studies should be conducted using biochemical and radiological imaging techniques to support these results. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Contrast-enhanced specific absorption rate-efficient 3D cardiac cine with respiratory-triggered radiofrequency gating.

    Science.gov (United States)

    Henningsson, Markus; Chan, Raymond H; Goddu, Beth; Goepfert, Lois A; Razavi, Reza; Botnar, Rene M; Schaeffter, Tobias; Nezafat, Reza

    2013-04-01

    To investigate the use of radiofrequency (RF) gating in conjunction with a paramagnetic contrast agent to reduce the specific absorption rate (SAR) and increase the blood-myocardium contrast in balanced steady-state free precession (bSSFP) 3D cardiac cine. RF gating was implemented by synchronizing the RF-excitation with an external respiratory sensor (bellows), which could additionally be used for respiratory gating. For reference, respiratory-gated 3D cine images were acquired without RF gating. Free-breathing 3D cine images were acquired in eight healthy subjects before and after contrast injection (Gd-BOPTA) and compared to breath-hold 2D cine. RF-gated 3D cine reduced the SAR by nearly 40% without introducing significant artifacts while providing left ventricle (LV) measurements similar to those obtained with 2D cine. The contrast-to-noise ratio (CNR) was significantly higher for 3D cine compared to 2D cine, both before and after contrast injection; however, no statistically significant CNR increase was observed for the postcontrast 3D cine compared to the precontrast acquisitions. Respiratory-triggered RF gating significantly reduces SAR in 3D cine acquisitions, which may enable a more widespread clinical use of 3D cine. Furthermore, CNR of 3D bSSFP cine is higher than of 2D and administration of Gd-BOPTA does not improve the CNR of 3D cine. Copyright © 2012 Wiley Periodicals, Inc.

  18. Ultrasound lung "comets" increase after breath-hold diving.

    Science.gov (United States)

    Lambrechts, Kate; Germonpré, Peter; Charbel, Brian; Cialoni, Danilo; Musimu, Patrick; Sponsiello, Nicola; Marroni, Alessandro; Pastouret, Frédéric; Balestra, Costantino

    2011-04-01

    The purpose of the study was to analyze the ultrasound lung comets (ULCs) variation, which are a sign of extra-vascular lung water. Forty-two healthy individuals performed breath-hold diving in different conditions: dynamic surface apnea; deep variable-weight apnea and shallow, face immersed without effort (static maximal and non-maximal). The number of ULCs was evaluated by means of an ultrasound scan of the chest, before and after breath-hold diving sessions. The ULC score increased significantly from baseline after dynamic surface apnea (p = 0.0068), after deep breath-hold sessions (p = 0.0018), and after static maximal apnea (p = 0.031). There was no statistically significant difference between the average increase of ULC scores after dynamic surface apnea and deep breath-hold diving. We, therefore, postulate that extravascular lung water accumulation may be due to other factors than (deep) immersion alone, because it occurs during dynamic surface apnea as well. Three mechanisms may be responsible for this. First, the immersion-induced hydrostatic pressure gradient applied on the body causes a shift of peripheral venous blood towards the thorax. Second, the blood pooling effect found during the diving response Redistributes blood to the pulmonary vascular bed. Third, it is possible that the intense involuntary diaphragmatic contractions occurring during the "struggle phase" of the breath-hold can also produce a blood shift from the pulmonary capillaries to the pulmonary alveoli. A combination of these factors may explain the observed increase in ULC scores in deep, shallow maximal and shallow dynamic apneas, whereas shallow non-maximal apneas seem to be not "ULC provoking".

  19. Prevalence of acute respiratory symptoms in breath-hold divers.

    Science.gov (United States)

    Cialoni, Danilo; Sponsiello, Nicola; Marabotti, Claudio; Marroni, Alessandro; Pieri, Massimo; Maggiorelli, Fabrizio; Tonerini, Michele; Frammartino, Brunella

    2012-01-01

    After repetitive deep dives, breath-hold divers are often affected by a syndrome characterized by typical symptoms such as cough, sensation of chest constriction, blood-striated expectorate (hemoptysis) and, rarely, an overt acute pulmonary edema syndrome, often together with various degrees of dyspnea. The aim of this work is an epidemiological investigation to evaluate the prevalence of acute respiratory symptoms (ARS) in breath-hold divers (BHDs) in practicing breath-hold diving. A retrospective investigation has been performed using specific questionnaires completed by a selected sample of free-divers (212 breath-hold diving instructors--194 male, 18 female; mean age 34 +/- 6.91 years); affiliated with Apnea Academy, (International School for Education and Research of Free-Diving). We also investigated possible risk factors for post-dive acute respiratory symptoms. Furthermore, the authors report that a severe case of acute pulmonary edema occurred to a healthy and experienced breath-hold diving instructor. We reported detailed CT scan and follow-up CT scans three days later, with another scan reported 10 days later as well. A total of 56 subjects (26.4%) reported previous events such as cough, thoracic constraint, hemoptysis, associated with various degrees of dyspnea as confirmation of pulmonary involvement. Forty-five of them (82%) reported signs of true hemoptysis and a high degrees of dyspnea. A CT scan revealed the presence of patchy bilateral lung opacities at the level of superior and parahilar zones; follow-up CT scans three days later and 10 days later are also reported. Our data show that this is a common condition among experienced BHDs. In our opinion, this is particularly interesting for the free-diving community.

  20. Real-time cardiac magnetic resonance cine imaging with sparse sampling and iterative reconstruction for left-ventricular measures: Comparison with gold-standard segmented steady-state free precession.

    Science.gov (United States)

    Camargo, Gabriel C; Erthal, Fernanda; Sabioni, Leticia; Penna, Filipe; Strecker, Ralph; Schmidt, Michaela; Zenge, Michael O; Lima, Ronaldo de S L; Gottlieb, Ilan

    2017-05-01

    Segmented cine imaging with a steady-state free-precession sequence (Cine-SSFP) is currently the gold standard technique for measuring ventricular volumes and mass, but due to multi breath-hold (BH) requirements, it is prone to misalignment of consecutive slices, time consuming and dependent on respiratory capacity. Real-time cine avoids those limitations, but poor spatial and temporal resolution of conventional sequences has prevented its routine application. We sought to examine the accuracy and feasibility of a newly developed real-time sequence with aggressive under-sampling of k-space using sparse sampling and iterative reconstruction (Cine-RT). Stacks of short-axis cines were acquired covering both ventricles in a 1.5T system using gold standard Cine-SSFP and Cine-RT. Acquisition parameters for Cine-SSFP were: acquisition matrix of 224×196, temporal resolution of 39ms, retrospective gating, with an average of 8 heartbeats per slice and 1-2 slices/BH. For Cine-RT: acquisition matrix of 224×196, sparse sampling net acceleration factor of 11.3, temporal resolution of 41ms, prospective gating, real-time acquisition of 1 heart-beat/slice and all slices in one BH. LV contours were drawn at end diastole and systole to derive LV volumes and mass. Forty-one consecutive patients (15 male; 41±17years) in sinus rhythm were successfully included. All images from Cine-SSFP and Cine-RT were considered to have excellent quality. Cine-RT-derived LV volumes and mass were slightly underestimated but strongly correlated with gold standard Cine-SSFP. Inter- and intra-observer analysis presented similar results between both sequences. Cine-RT featuring sparse sampling and iterative reconstruction can achieve spatial and temporal resolution equivalent to Cine-SSFP, providing excellent image quality, with similar precision measurements and highly correlated and only slightly underestimated volume and mass values. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Feasibility of Pencil Beam Scanned Intensity Modulated Proton Therapy in Breath-hold for Locally Advanced Non-Small Cell Lung Cancer

    DEFF Research Database (Denmark)

    Gorgisyan, Jenny; Munck Af Rosenschold, Per; Perrin, Rosalind

    2017-01-01

    with image guided photon radiation therapy were included in the present simulation study. In addition to a planning breath-hold computed tomography (CT) scan before the treatment start, a median of 6 (range 3-9) breath-hold CT scans per patient were acquired prospectively throughout the radiation therapy......) in terms of the percentage of voxels with 3-mm or more undershoot on repeat CT scans. The dose to the organs at risk was similar for the planned and simulated dose distributions. Three or fewer breath-holds per field would be required for 12 of the 15 patients, which was clinically feasible. CONCLUSIONS...

  2. Motion Correction using Coil Arrays (MOCCA) for Free-Breathing Cardiac Cine MRI

    Science.gov (United States)

    Hu, Peng; Hong, Susie; Moghari, Mehdi H.; Goddu, Beth; Goepfert, Lois; Kissinger, Kraig V.; Hauser, Thomas H.; Manning, Warren J; Nezafat, Reza

    2014-01-01

    In this study, we present a motion compensation technique based on coil arrays (MOCCA) and evaluate its application in free-breathing respiratory self-gated cine MRI. MOCCA takes advantages of the fact that motion-induced changes in k-space signal are modulated by individual coil sensitivity profiles. In the proposed implementation of MOCCA self-gating for free-breathing cine MRI, the k-space center line is acquired at the beginning of each k-space segment for each cardiac cycle with 4 repetitions. For each k-space segment, the k-space center line acquired immediately before was used to select one of the 4 acquired repetitions to be included in the final self-gated cine image by calculating the cross-correlation between the k-space center line with a reference line. The proposed method was tested on a cohort of healthy adult subjects for subjective image quality and objective blood-myocardium border sharpness. The method was also tested on a cohort of patients to compare the left and right ventricular volumes and ejection fraction measurements with that of standard breath-hold cine MRI. Our data indicate that the proposed MOCCA method provides significantly improved image quality and sharpness compared to free-breathing cine without respiratory self-gating, and provides similar volume measurements compared with breath-hold cine MRI. PMID:21773986

  3. Target position uncertainty during visually guided deep-inspiration breath-hold radiotherapy in locally advanced lung cancer

    DEFF Research Database (Denmark)

    Rydhog, Jonas Scherman; de Blanck, Steen Riisgaard; Josipovic, Mirjana

    2017-01-01

    Purpose: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath hold (DISH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients.Methods: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course...... of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm.Results: A mean...... small in visually guided breath-hold radiotherapy of NSCLC. Target motion could be substantially reduced, but not eliminated, using visually guided DIBH. (C) 2017 Elsevier B.V. All rights reserved....

  4. Differentiation of recently infarcted myocardium from chronic myocardial scar: the value of contrast-enhanced SSFP-based cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyoung Ah; Seo, Joon Beom; Do, Kyoung Hyun; Heo, Jeong Nam; Lee, Young Kyung; Song, Jae Woo; Lee, Jin Seong; Song, Koun Sik; Lim, Tae Hwan [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2006-03-15

    The purpose of this study is to demonstrate whether the signal intensity (SI) of myocardial infarction (MI) on contrast enhanced (CE)-cine MRI is useful for differentiating recently infarcted myocardium from chronic scar. This study included 24 patients with acute MI (36-84) years, mean age: 57) and 19 patients with chronic MI (44-80) years, mean age: 64). The diagnosis of acute MI was based on the presence of typical symptoms, i.e. elevation of the cardiac enzymes and the absence of any remote infarction history. The diagnosis of chronic MI was based on a history of MI or coronary artery disease of more than one month duration and on the absence of any recent MI within the previous six months. Retrospectively, the ECG-gated breath-hold cine imaging was performed in the short axis plane using a segmented, balanced, turbo-field, echo-pulse sequence two minutes after the administration of Gd-DTPA at a dose of 0.2 mmol/kg body weight. Delayed contrast-enhanced MRI (DCE MRI) in the same plane was performed 10 to 15 minutes after contrast administration, and this was served as the gold standard of reference. The SI of the infarcted myocardium on the CE-cine MRI was compared with that of the normal myocardium on the same image. The area of abnormal SI on the CE-cine MRI was compared with the area of hyper enhancement on the DCE MRI. The area of high SI on the CE-cine MRI was detected in 23 of 24 patients with acute MI (10 with homogenous high SI, 13 high SI with subendocardial low SI, and one with iso SI). The area of high SI on the CE- cine MRI was larger than that seen on the DCE MRI ({rho} < 0.05). In contrast, the areas of chronic MI were seen as iso-SI with thin subendocardial low SI on the CE-cine MR in all the chronic MI patients. The presence of high SI on both the CE-cine MRI and the DCE MRI is more sensitive (95.8%) for determining the age of a MI than the presence of myocardial thinning (66.7%). The study showed the different SI patterns between recently

  5. Temperamental traits of breath holding children: A case control study

    Science.gov (United States)

    Subbarayan, A.; Ganesan, B.; Anbumani; Jayanthini

    2008-01-01

    Background: Clinical observation and few anecdotal reports suggest that the children with breath holding spells (BHS) have certain temperamental traits, which predispose them to behave in certain way. They seem to have low frustration tolerance, which leads to adamant behavior. Vigorous crying, through various mechanisms, precipitates BHS. Materials and Methods: We assessed the temperamental traits of 30 children with BHS and compared them with 30 normal children after matching for age, sex, and socioeconomic status. Temperament was measured using ‘Temperament measurement Schedule’. Results: The data were analyzed using Mann-Whitney U test. The following temperamental traits, threshold of responsiveness (Pbreath holders. Conclusions: Significantly differing temperamental traits in breath holders suggests that these could influence the behavioral pattern exhibited by them. Breath holding spells can act as an easy marker for difficult temperamental traits, which gives an early opportunity to shape their difficult behavior. PMID:19742234

  6. P Wave Dispersion in Children with Breath-holding Spells

    OpenAIRE

    Tahsin Gider; Bülent Koca; Mustafa Çalık; Ali Yıldırım; Savaş Demirpençe

    2016-01-01

    Objective: A breath-holding spell (BHS) is a clinical feature frequently seen in infancy and early childhood and generally bringing children to pediatric cardiology outpatient clinics with the suspicion of cardiac disease. In this study, P wave dispersion (PWD), which is a marker of regional differences in atrial depolarization in electrocardiography and has been demonstrated to be beneficial in defining the risk of supraventricular tachycardia in various patient groups, was studied in childr...

  7. Evaluation of QT Dispersion in Children with Breath Holding Spells.

    Science.gov (United States)

    Movahedian, Amir Hosein; Heidarzadeh Arani, Marzieh; Motaharizad, Davood; Mousavi, Gholam Abbas; Mosayebi, Ziba

    2016-01-01

    Breath holding spells (BHS) are common involuntary reflexes in infancy and early childhood. Differential diagnosis should embrace Long QT Syndrome (LQTS) and paroxysmal abnormalities of rhythm. The aim of this study was to compare QT dispersion (QTd) in children with breath holding spells and normal controls. QT dispersion and Corrected QT(QTc) dispersion were measured in 12 lead surface electrocardiograms in 56 patients with BHS and compared with healthy children of the same age referred to the clinic for regular checkup visits. The most common type of BHS was cyanotic (83.9%). Seven patients (12.5%) had pallid and two patients (3.5%) had mixed spells. There was a history of breath holding spells in 33.9% of the children. QT dispersion was 61.6± 22.5 and 47.1±18.8 ms in patient and control groups, respectively. QTc dispersion (QTcd) was 104 ± 29.6 and 71.9 ±18.2 ms, respectively. There was a significant difference between patient and control groups in terms of QTd and QTcd (P<0.001). QTd and QTcd were increased in children with BHS. Therefore, the evaluation of EKG for early diagnosis of rhythm abnormalities seems reasonable in these children.

  8. Compressed sensing cine imaging with high spatial or high temporal resolution for analysis of left ventricular function.

    Science.gov (United States)

    Goebel, Juliane; Nensa, Felix; Schemuth, Haemi P; Maderwald, Stefan; Gratz, Marcel; Quick, Harald H; Schlosser, Thomas; Nassenstein, Kai

    2016-08-01

    To assess two compressed sensing cine magnetic resonance imaging (MRI) sequences with high spatial or high temporal resolution in comparison to a reference steady-state free precession cine (SSFP) sequence for reliable quantification of left ventricular (LV) volumes. LV short axis stacks of two compressed sensing breath-hold cine sequences with high spatial resolution (SPARSE-SENSE HS: temporal resolution: 40 msec, in-plane resolution: 1.0 × 1.0 mm(2) ) and high temporal resolution (SPARSE-SENSE HT: temporal resolution: 11 msec, in-plane resolution: 1.7 × 1.7 mm(2) ) and of a reference cine SSFP sequence (standard SSFP: temporal resolution: 40 msec, in-plane resolution: 1.7 × 1.7 mm(2) ) were acquired in 16 healthy volunteers on a 1.5T MR system. LV parameters were analyzed semiautomatically twice by one reader and once by a second reader. The volumetric agreement between sequences was analyzed using paired t-test, Bland-Altman plots, and Passing-Bablock regression. Small differences were observed between standard SSFP and SPARSE-SENSE HS for stroke volume (SV; -7 ± 11 ml; P = 0.024), ejection fraction (EF; -2 ± 3%; P = 0.019), and myocardial mass (9 ± 9 g; P = 0.001), but not for end-diastolic volume (EDV; P = 0.079) and end-systolic volume (ESV; P = 0.266). No significant differences were observed between standard SSFP and SPARSE-SENSE HT regarding EDV (P = 0.956), SV (P = 0.088), and EF (P = 0.103), but for ESV (3 ± 5 ml; P = 0.039) and myocardial mass (8 ± 10 ml; P = 0.007). Bland-Altman analysis showed good agreement between the sequences (maximum bias ≤ -8%). Two compressed sensing cine sequences, one with high spatial resolution and one with high temporal resolution, showed good agreement with standard SSFP for LV volume assessment. J. Magn. Reson. Imaging 2016;44:366-374. © 2016 Wiley Periodicals, Inc.

  9. Technical Note: Measurement of common carotid artery lumen dynamics using black-blood MR cine imaging.

    Science.gov (United States)

    Dai, Erpeng; Dong, Li; Zhang, Zhe; Li, Lyu; Zhang, Hui; Zhao, Xihai; Wang, Jinnan; Yuan, Chun; Guo, Hua

    2017-03-01

    To demonstrate the feasibility of measuring the common carotid artery (CCA) lumen dynamics using a black-blood cine (BB-cine) imaging method. Motion-sensitized driven-equilibrium (MSDE) prepared spoiled gradient sequence was used for the BB-cine imaging. CCAs of eleven healthy volunteers were studied using this method. Lumen dynamics, including lumen area evolution waveforms and distension values, were measured and evaluated by comparing this method with bright-blood cine (BrB-cine) imaging. Compared with the BrB-cine images, flow artifacts were effectively suppressed in the BB-cine images. BrB-cine images generally show larger lumen areas than BB-cine images. The lumen area waveforms and distension measurements from BB-cine imaging showed smaller variances among different subjects than BrB-cine imaging. The proposed BB-cine imaging technique can suppress the flow artifacts effectively and reduce the partial volume effects from the vessel wall. This might allow more accurate lumen dynamics measurements than traditional BrB-cine imaging, which may further be valuable for investigating biomechanical and functional properties of the cardiovascular system. © 2017 American Association of Physicists in Medicine.

  10. Increased oxidant status in children with breath-holding spells.

    Science.gov (United States)

    Calik, Mustafa; Abuhandan, Mahmut; Aycicek, Ali; Taskin, Abdullah; Selek, Sahabettin; Iscan, Akin

    2013-06-01

    Breath-holding spells (BHS) are the most common form of non-epileptic paroxysmal events in infancy. The pathophysiology of BHS is not fully understood. Iron-deficiency anemia (IDA) may be a factor contributing to breath-holding spells. Although numerous reports have shown that elevated oxidative stress is implicated in the pathophysiology of neurodegenerative diseases and neurological conditions, such as epileptic seizures, brain damage, and neurotrauma, there are no data regarding the role of oxidative stress in the development of BHS. This study aimed to investigate oxidative stress in children with BHS. This case-control study was conducted at the Department of Pediatric Neurology, Harran University School of Medicine, Sanliurfa, in Turkey. Blood samples from 31 patients (14 females, 17 males) with BHS which were taken at least 24 h after the BHS attack, and a control group of 35 healthy individuals (13 females, 22 males) were used for the measurement of the plasma total antioxidant capacity, total oxidant status, and oxidative stress index, hemoglobin concentration, serum iron, transferrin saturation and serum ferritin levels. The plasma total antioxidant capacity values were markedly lower and total oxidant status and oxidative stress index values in the BHS group were significantly higher than that in the controls (P ≤ 0.01). Our data suggest that the value of oxidative stress was significantly higher in patients with BHS than in the controls. Conditions associated with increased oxidative stress such as IDA may be a risk factor for the development of BHS.

  11. [Breath-hold diving--an increasing adventure sport with medical risks].

    Science.gov (United States)

    Lindholm, Peter; Gennser, Mikael

    2004-02-26

    Breath-hold diving as a recreational and competitive sports activity is on the increase. In this review physiological limitations and medical risks associated with breath-hold diving are discussed. Specific topics include hypoxia, ascent blackout, hyperventilation, squeeze or barotrauma of descent including effects on the pulmonary system, glossopharyngeal breathing, and decompression illness. It is also concluded that the health requirements for competitive breath-hold diving should follow essentially the same standards as used for SCUBA-diving.

  12. EFFECTS OF ORAL IRON SUPPLEMENT ON BREATH-HOLDING SPELLS IN CHILDREN

    OpenAIRE

    S.H. TONEKABONI; S. ALAVI; F. MAHVELATI; Z. TABASI

    2006-01-01

    Objectives:Breath holding spells are one of the most frequent and important diagnostic challenges in pediatrics. The aim of this study, conducted on pediatric patients referring to the pediatric neurology clinic in Hormozgan province, was to evaluate therapeutic effects of iron on breath holding spellsMaterials and Methods:35 children (19 males and 16 females), aged between 3 to 60 months, with a history of breath-holding spells, were included in the trial. To obtain all relevant data a speci...

  13. Fundamental Tongue Motions for Trumpet Playing: A Study Using Cine Magnetic Resonance Imaging (Cine MRI).

    Science.gov (United States)

    Furuhashi, Hiroko; Chikui, Toru; Inadomi, Daisuke; Shiraishi, Tomoko; Yoshiura, Kazunori

    2017-12-01

    Though the motions of structures outside the mouth in trumpet performance have been reported, the dynamics of intraoral structures remain unelucidated. This study explored the tongue's movement in trumpet playing using cine magnetic resonance imaging (cine MRI) and demonstrated the effects of intraoral anatomical structures on changes in pitch and dynamics. Cine MRI was applied to 18 trumpet players, who were divided into two groups (7 beginner, 11 advanced) based on their ability to play a certain high note. They were instructed to play a custom-made MRI-compatible simulated trumpet. Pitch-change tasks and dynamics-change tasks were assigned. The positions of the anatomical points and intraoral areas were identified on outlined images, and the changes associated with each task were evaluated. A forward and upward projection of the tongue was observed in the production of higher pitches, and there were no significant differences in all areas. In louder dynamics, a backward and downward bending of the tongue occurred, the tongue area became smaller (pcine MRI that certain tongue movements were associated with each task. Tongue protrusion in the production of higher pitch and bending in louder dynamics can be rationalized using acoustics theory and the movements of anatomical structures. These findings seem to be consistent regardless of the player's proficiency.

  14. The Ins and Outs of Breath Holding: Simple Demonstrations of Complex Respiratory Physiology

    Science.gov (United States)

    Skow, Rachel J.; Day, Trevor A.; Fuller, Jonathan E.; Bruce, Christina D.; Steinback, Craig D.

    2015-01-01

    The physiology of breath holding is complex, and voluntary breath-hold duration is affected by many factors, including practice, psychology, respiratory chemoreflexes, and lung stretch. In this activity, we outline a number of simple laboratory activities or classroom demonstrations that illustrate the complexity of the integrative physiology…

  15. Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

    Science.gov (United States)

    Bartlett, Frederick R.; Colgan, Ruth M.; Donovan, Ellen M.; Carr, Karen; Landeg, Steven; Clements, Nicola; McNair, Helen A.; Locke, Imogen; Evans, Philip M.; Haviland, Joanne S.; Yarnold, John R.; Kirby, Anna M.

    2014-01-01

    Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breath-holding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery. PMID:25046661

  16. Genetic predisposition to breath-hold diving-induced hemoptysis: Preliminary study.

    OpenAIRE

    Cialoni, Danilo; Marabotti, Claudio C; Sponsiello, Nicola; Pieri, Massimo; Balestra, Costantino; Lucchini, Vittorio V; Marroni, Alessandro

    2015-01-01

    Breath-hold diving-induced hemoptysis (BH-DIH) has been reported in about 25% breath-hold divers (BHD) and is characterized by dyspnea, coughing, hemoptysis and chest pain. We investigated whether eNOS G894T, eNOS T786C and ACE insertion/deletion I/D genetic variants, are possible BH-DIH risk factors.

  17. Cine magnetic resonance imaging of ocular motility.

    Science.gov (United States)

    Cadera, W; Viirre, E; Karlik, S

    1992-01-01

    We describe a technique of generation of a cine motion picture of ocular movements in a patient with Duane Type II exotropia. With the magnetic resonance scanning unit, multiple scans can be sequenced to give a graphic animation to the eyes as targets are fixated across the visual field. With this technique, we were able to clearly view the contractility of the extraocular muscles and note the changes in pulling directions of the muscles in this patient. The restriction of movement due to the cocontraction of the horizontal rectus muscles was readily apparent.

  18. Successful treatment of pallid breath-holding spells with fluoxetine.

    Science.gov (United States)

    Walsh, Mark; Knilans, Timothy K; Anderson, Jeffrey B; Czosek, Richard J

    2012-09-01

    Pallid breath-holding (PBH) is a childhood condition that presents with recurrent syncope. Although typically benign, severe cases can lead to asystole and anoxic seizures. Previous studies have advocated pacemaker placement to abbreviate symptoms. This was a retrospective study of patients treated with fluoxetine for PBH spells. Clinical response, side effects and avoidance of pacemaker implantation were reviewed in six patients (12-60 months) treated with fluoxetine for PBH. Patients were referred because of concern of arrhythmia and failed medical treatment strategies. Two patients had previously implanted loop recorders, 5 patients had documented episodes of asystole, and 2 patients had generalized seizures. Fluoxetine resulted in alleviation of syncope in 5 of 6 patients. Time to symptomatic improvement symptoms ranged from 2 days to 1 month (median, 2 weeks). Median duration of treatment with fluoxetine was 12 months (12-24 months). One patient demonstrated no improvement and had a pacemaker implanted. There were no reported side effects to fluoxetine. Fluoxetine can be used to treat childhood PBH spells and may obviate the need for permanent pacing in a significant subset of this population. Considering its safe side-effect profile it is a worthwhile first-line agent to treat this disorder.

  19. Cyanotic breath-holding spell: a life-threatening complication after radical resection of a cervicomedullary ganglioglioma.

    Science.gov (United States)

    Fujisawa, Hironori; Yoshida, Yuya; Niida, Yo; Hasegawa, Mitsuhiro; Yamashita, Junkoh

    2005-01-01

    Cyanotic breath-holding spell is a benign and self-limiting disease of young children but occasionally associated with sudden, unexpected death. The authors report a rare case in a 2-year-old girl with a severe form that started after radical resection of a cervicomedullary ganglioglioma. She was admitted to our hospital because of delayed and unstable gait. Since magnetic resonance imaging showed a cervicomedullary tumor, she underwent a radical resection and histology showed the tumor to be a ganglioglioma. Postoperatively, the function of the lower cranial nerves and cerebellum deteriorated and hemiparesis on the left became apparent, but she returned to the preoperative state in a few months. In addition, mild sleep apnea (Ondine curse) and severe cyanotic breath-holding spells occurred. The former responded to medication but the latter failed and continued several times per day with a rapid onset and progression of hypoxemia, loss of consciousness, sweating and opisthotonos. Five months after the operation, the patient returned home with a portable oxygen saturation monitor equipped with an alarm. This case indicates that cyanotic breath-holding spell, as well as sleep apnea, is critical during the early postoperative period. This is the first report observing that such spells may occur as a complication of radical resection of a cervicomedullary tumor. Copyright (c) 2005 S. Karger AG, Basel.

  20. Detection of diminished response to cold pressor test in smokers: assessment using phase-contrast cine magnetic resonance imaging of the coronary sinus.

    Science.gov (United States)

    Kato, Shingo; Kitagawa, Kakuya; Yoon, Yeonyee E; Nakajima, Hiroshi; Nagata, Motonori; Takase, Shinichi; Nakamori, Shiro; Ito, Masaaki; Sakuma, Hajime

    2014-04-01

    The purposes of this study were to evaluate the reproducibility for measuring the cold pressor test (CPT)-induced myocardial blood flow (MBF) alteration using phase-contrast (PC) cine MRI, and to determine if this approach could detect altered MBF response to CPT in smokers. After obtaining informed consent, ten healthy male non-smokers (mean age: 28±5 years) and ten age-matched male smokers (smoking duration ≥5 years, mean age: 28±3 years) were examined in this institutional review board approved study. Breath-hold PC cine MR images of the coronary sinus were obtained with a 3T MR imager with 32 channel coils at rest and during a CPT performed after immersing one foot in ice water. MBF was calculated as coronary sinus flow divided by the left ventricular (LV) mass which was given as a total LV myocardial volume measured on cine MRI multiplied by the specific gravity (1.05 g/mL). In non-smokers, MBF was 0.86±0.25 mL/min/g at rest, with a significant increase to 1.20±0.36 mL/min/g seen during CPT (percentage change of MBF (∆MBF (%)); 39.2%±14.4%, pcine MRI can be used to reproducibly quantify MBF response to CPT and to detect impaired flow response in smokers. This MR approach may be useful for monitoring the sequential change of coronary blood flow in various potentially pathologic conditions and for investigating its relationship with cardiovascular risk. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Free-breathing steady-state free precession cine cardiac magnetic resonance with respiratory navigator gating.

    Science.gov (United States)

    Moghari, Mehdi H; Komarlu, Rukmini; Annese, David; Geva, Tal; Powell, Andrew J

    2015-04-01

    To develop and validate a respiratory motion compensation method for free-breathing cardiac cine imaging. A free-breathing navigator-gated cine steady-state free precession acquisition (Cine-Nav) was developed which preserves the equilibrium state of the net magnetization vector, maintains the high spatial and temporal resolutions of standard breath-hold (BH) acquisition, and images entire cardiac cycle. Cine image data is accepted only from cardiac cycles occurring entirely during end-expiration. Prospective validation was performed in 10 patients by obtaining in each three complete ventricular image stacks with different respiratory motion compensation approaches: (1) BH, (2) free-breathing with 3 signal averages (3AVG), and (3) free-breathing with Cine-Nav. The subjective image quality score (1 = worst, 4 = best) for Cine-Nav (3.8 ± 0.4) was significantly better than for 3AVG (2.2 ± 0.5, P = 0.002), and similar to BH (4.0 ± 0.0, P = 0.13). The blood-to-myocardium contrast ratio for Cine-Nav (6.3 ± 1.5) was similar to BH (5.9 ± 1.6, P = 0.52) and to 3AVG (5.6 ± 2.5, P = 0.43). There were no significant differences between Cine-Nav and BH for the ventricular volumes and mass. In contrast, there were significant differences between 3AVG and BH in all of these measurements but right ventricular mass. Free-breathing cine imaging with Cine-Nav yielded comparable image quality and ventricular measurements to BH, and was superior to 3AVG. © 2014 Wiley Periodicals, Inc.

  2. The assessment of the breath hold and the free breath methods about the blood flow evaluation by using phase contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho [Dept. of Radiology, Konkuk Medical center, Seoul (Korea, Republic of)

    2016-06-15

    Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/ velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were 96.17±19.12 ml/sec, 17.04±4.12 cm/sec respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of 72.31±13.27 ml and 12.32±3.85. On the other hand, the average 2NEX blood flow and mean flow velocity is 101.90±24.09, 16.84±4.32, 3NEX 103.06±25.49, 16.88±4.19 did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were 76.68±19.72 ml/s, and 22.23±4.8, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

  3. SU-F-BRB-03: Quantifying Patient Motion During Deep-Inspiration Breath-Hold Using the ABC System with Simultaneous Surface Photogrammetry

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, Y; Rahimi, A; Sawant, A [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Active breathing control (ABC) has been used to reduce treatment margin due to respiratory organ motion by enforcing temporary breath-holds. However, in practice, even if the ABC device indicates constant lung volume during breath-hold, the patient may still exhibit minor chest motion. Consequently, therapists are given a false sense of security that the patient is immobilized. This study aims at quantifying such motion during ABC breath-holds by monitoring the patient chest motion using a surface photogrammetry system, VisionRT. Methods: A female patient with breast cancer was selected to evaluate chest motion during ABC breath-holds. During the entire course of treatment, the patient’s chest surface was monitored by a surface photogrammetry system, VisionRT. Specifically, a user-defined region-of-interest (ROI) on the chest surface was selected for the system to track at a rate of ∼3Hz. The surface motion was estimated by rigid image registration between the current ROI image captured and a reference image. The translational and rotational displacements computed were saved in a log file. Results: A total of 20 fractions of radiation treatment were monitored by VisionRT. After removing noisy data, we obtained chest motion of 79 breath-hold sessions. Mean chest motion in AP direction during breath-holds is 1.31mm with 0.62mm standard deviation. Of the 79 sessions, the patient exhibited motion ranging from 0–1 mm (30 sessions), 1–2 mm (37 sessions), 2–3 mm (11 sessions) and >3 mm (1 session). Conclusion: Contrary to popular assumptions, the patient is not completely still during ABC breath-hold sessions. In this particular case studied, the patient exhibited chest motion over 2mm in 14 out of 79 breath-holds. Underestimating treatment margin for radiation therapy with ABC could reduce treatment effectiveness due to geometric miss or overdose of critical organs. The senior author receives research funding from NIH, VisionRT, Varian Medical Systems

  4. Automatic contour propagation in cine cardiac magnetic resonance images.

    Science.gov (United States)

    Hautvast, Gilion; Lobregt, Steven; Breeuwer, Marcel; Gerritsen, Frans

    2006-11-01

    We have developed a method for automatic contour propagation in cine cardiac magnetic resonance images. The method consists of a new active contour model that tries to maintain a constant contour environment by matching gray values in profiles perpendicular to the contour. Consequently, the contours should maintain a constant position with respect to neighboring anatomical structures, such that the resulting contours reflect the preferences of the user. This is particularly important in cine cardiac magnetic resonance images because local image features do not describe the desired contours near the papillary muscle. The accuracy of the propagation result is influenced by several parameters. Because the optimal setting of these parameters is application dependent, we describe how to use full factorial experiments to optimize the parameter setting. We have applied our method to cine cardiac magnetic resonance image sequences from the long axis two-chamber view, the long axis four-chamber view, and the short axis view. We performed our optimization procedure for each contour in each view. Next, we performed an extensive clinical validation of our method on 69 short axis data sets and 38 long axis data sets. In the optimal parameter setting, our propagation method proved to be fast, robust, and accurate. The resulting cardiac contours are positioned within the interobserver ranges of manual segmentation. Consequently, the resulting contours can be used to accurately determine physiological parameters such as stroke volume and ejection fraction.

  5. SU-E-J-236: Audiovisual Biofeedback Improves Breath-Hold Lung Tumor Position Reproducibility Measured with 4D MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D; Pollock, S; Keall, P [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, NSW (Australia); Greer, P [School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW (Australia); Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW (Australia); Lapuz, C; Ludbrook, J [Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW (Australia); Kim, T [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, NSW (Australia); Department of Radiation Oncology, University of Virginia Health System, Charlottesville, VA (United States)

    2015-06-15

    Purpose: Audiovisual biofeedback breath-hold (AVBH) was employed to reproduce tumor position on inhale and exhale breath-holds for 4D tumor information. We hypothesize that lung tumor position will be more consistent using AVBH compared with conventional breath-hold (CBH). Methods: Lung tumor positions were determined for seven lung cancer patients (age: 25 – 74) during to two separate 3T MRI sessions. A breathhold training session was performed prior to the MRI sessions to allow patients to become comfortable with AVBH and their exhale and inhale target positions. CBH and AVBH 4D image datasets were obtained in the first MRI session (pre-treatment) and the second MRI session (midtreatment) within six weeks of the first session. Audio-instruction (MRI: Siemens Skyra) in CBH and verbal-instruction (radiographer) in AVBH were used. A radiation oncologist contoured the lung tumor using Eclipse (Varian Medical Systems); tumor position was quantified as the centroid of the contoured tumor after rigid registration based on vertebral anatomy across two MRI sessions. CBH and AVBH were compared in terms of the reproducibility assessed via (1) the difference between the two exhale positions for the two sessions and the two inhale positions for the sessions. (2) The difference in amplitude (exhale to inhale) between the two sessions. Results: Compared to CBH, AVBH improved the reproducibility of two exhale (or inhale) lung tumor positions relative to each other by 33%, from 6.4±5.3 mm to 4.3±3.0 mm (p=0.005). Compared to CBH, AVBH improved the reproducibility of exhale and inhale amplitude by 66%, from 5.6±5.9 mm to 1.9±1.4 mm (p=0.005). Conclusions: This study demonstrated that audiovisual biofeedback can be utilized for improving the reproducibility of breath-hold lung tumor position. These results are advantageous towards achieving more accurate emerging radiation treatment planning methods, in addition to imaging and treatment modalities utilizing breath-hold

  6. Cine magnetic resonance imaging of left ventricular volumes

    Energy Technology Data Exchange (ETDEWEB)

    Niwa, Koichiro; Uchishiba, Mika; Aotsuka, Hiroyuki; Matsuo, Kozo; Fujiwara, Tadashi (Chiba Children' s Hospital (Japan))

    1992-02-01

    Cine magnetic resonance imaging (MRI) of 27 patients with various heart diseases has been undertaken. The children ranged from 11 months to 16 years old (average age: 6.8 years), so as to assess the MRI capability to evaluate the left ventricular volumes, which were previously calculated by angiography. ECG-gated MRI was performed by spin echo and gradient refocused imaging techniques at 0.5 tesla. Ventricular volumes were determined using a single slice comparable with the right anterior oblique projection of the ventriculogram. Comparison of the left ventricular end-diastolic and end-systolic volume yielded a high correlation between MRI (y) and ventriculography (x) (y=0.83x + 4.1, r=0.98 and y=0.88x - 1.74, r=0.98, respectively). It is concluded that the cine MRI provides an accurate non-invasive means for quantification of left ventricular volumes. (author).

  7. Breath Holding Spells in Children with Long QT Syndrome.

    Science.gov (United States)

    Robinson, Jeffrey A; Bos, J Martijn; Etheridge, Susan P; Ackerman, Michael J

    2015-01-01

    Long QT syndrome (LQTS) is a genetic heart rhythm disorder that may present with syncope, seizures, or sudden cardiac death. Breath holding spells (BHS) occur in 5% of all children and have been noted in children with LQTS anecdotally. The purpose of this study was to determine the frequency of BHS in children diagnosed with LQTS at ≤5 years of age. A retrospective review was performed to identify children diagnosed with LQTS who were ≤5 years old at initial presentation to our LQTS clinic from August 1999 to November 2013. The mean length of follow-up was 6.4 ± 2.8 years. The electronic medical records were reviewed for clinical presentation of BHS, as well as LQTS-associated symptoms, diagnostic tests, and treatment. The study cohort consisted of 115 children with LQTS (58% male; median age at diagnosis, 11 months [range, birth to 5 years]; mean corrected QT interval (QTc), 478 ± 60 milliseconds). At presentation, 80% of patients were asymptomatic. Genetic testing revealed type 1 LQTS (LQT1) in 48%. Overall, 5 of 115 patients (4.3%) had BHS (2 of 5 [40%] male, mean QTc: 492 ± 14 milliseconds, 4 [80%] with family history of LQTS). BHS were the presenting symptom in 1 of 23 symptomatic patients (4.3%). All BHS occurred in patients with LQT1 (P = .02). Although BHS among children with LQTS are relatively rare and occur at similar frequency as the general population, they can be the presenting symptom for a heart rhythm disorder. Careful attention to BHS is important to distinguish an innocent BHS from a potential LQTS-triggered cardiac event so that proper treatment is initiated. © 2015 Wiley Periodicals, Inc.

  8. Nitric oxide-related endothelial changes in breath-hold and scuba divers.

    Science.gov (United States)

    Theunissen, S; Guerrero, F; Sponsiello, N; Cialoni, D; Pieri, M; Germonpré, P; Obeid, G; Tillmans, F; Papadopoulou, V; Hemelryck, W; Marroni, A; De Bels, D; Balestra, C

    2013-01-01

    Scuba and breath-hold divers are compared to investigate whether endothelial response changes are similar despite different exposure(s) to hyperoxia. 14 divers (nine scuba and five breath-holding) performed either one scuba dive (25m/25 minutes) or successive breath-hold dives at a depth of 20 meters, adding up to 25 minutes of immersion time in a diving pool. Flow-mediated dilation (FMD) was measured using echography. Peripheral post-occlusion reactive hyperemia (PORH) was assessed by digital plethysmography and plasmatic nitric oxide (NO) concentration using a nitrate/nitrite colorimetric assay kit. The FMD decreased in both groups. PORH was reduced in scuba divers but increased in breath-hold divers. No difference in circulating NO was observed for the scuba group. Opposingly, an increase in circulating NO was observed for the breath-hold group. Some cardiovascular effects can be explained by interaction between NO and superoxide anion during both types of diving ending to less NO availability and reducing FMD. The increased circulating NO in the breath-hold group can be caused by physical exercise. The opposite effects found between FMD and PORH in the breath-hold group can be assimilated to a greater responsiveness to circulating NO in small arteries than in large arteries.

  9. Respiratory sinus arrhythmia in children with severe cyanotic and pallid breath-holding spells.

    Science.gov (United States)

    DiMario, F J; Bauer, L; Baxter, D

    1998-09-01

    In this study we investigated centrally mediated parasympathetic regulation of modulated cardiac vagal tone among children with severe cyanotic and pallid breath-holding spells by examining respiratory sinus arrhythmia. Respiratory sinus arrhythmia was evaluated in 41 children; 17 subjects with cyanotic breath-holding spells (6 boys, 11 girls; mean age 37.1 months), 7 subjects with pallid breath-holding spells (2 boys, 5 girls; mean age 33.0 months), and 17 controls (8 boys, 9 girls; mean age 41.2 months). Subjects had recurrent (more than 3) severe breath-holding spells. Each subject's electrocardiogram was recorded in a quiet room and digitized by an 80386 personal computer during five 1-minute periods. R-R intervals within each 1-minute period were converted to heart rate in 120 successive 0.5-second intervals. The resultant heart rate time series was converted to its underlying frequency composition by a fast Fourier transform and averaged across minutes. Respiratory sinus arrhythmia was defined as the variability in the time series over a frequency range (0.096 Hz to 0.48 Hz) corresponding to a range of respiratory rates from 6 to 30 breaths per minute. ANCOVA adjusting for age and sex was conducted with the subject group as the independent measure. There were no significant differences between subjects with cyanotic breath-holding spells and controls. Pallid breath-holding spell subjects had a marked difference in respiratory sinus arrhythmia from either controls or subjects with cyanotic breath-holding spells, demonstrating less variability in respiratory sinus arrhythmia (P breath-holding spells, caused by a primary central parasympathetic disturbance distinct from the dysregulation found in cyanotic breath-holding spells.

  10. Hemoptysis Due to Breath-Hold Diving Following Chemotherapy and Lung Irradiation

    OpenAIRE

    Gutsche, Markus; Kuschner, Ware G.

    2012-01-01

    Breath-hold diving, also known as free-diving, describes the practice of intentional immersion under water without an external supply of oxygen. Pulmonary hemorrhage with hemoptysis has been reported as a complication of immersion and breath-hold diving in young healthy athletes. We report the case of a 60-year-old man with a history of radiation and chemotherapy for breast carcinoma, who developed the abrupt onset of hemoptysis in the setting of swimming and breath-hold diving. A computed to...

  11. Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon

    OpenAIRE

    Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

    2017-01-01

    Abstract Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pu...

  12. Two-dimensional sonographic cine imaging improves confidence in the initial evaluation of the fetal heart.

    Science.gov (United States)

    Poole, Patricia Sims; Chung, Romy; Lacoursiere, Yvette; Palmieri, Carolina Rossi; Hull, Andrew; Engelkemier, Dawn; Rochelle, Michele; Trivedi, Neha; Pretorius, Dolores H

    2013-06-01

    Initial screening sonography of the fetal heart with static images is often inadequate, resulting in repeated imaging or failure to detect abnormalities. We hypothesized that the addition of short cine clips would reduce the need for repeated imaging. Two-dimensional (2D) static sonograms and short 2D cine clips of the 4-chamber view and left and right ventricular outflow tracts were obtained from 342 patients with gestational ages of greater than 16 weeks. A diagnostic radiologist and a perinatologist retrospectively reviewed the static and cine images independently and graded them as normal, abnormal, or suboptimal. A statistically significant increase in the number of structures called normal was seen when 2D cine clips were added to static imaging for both observers (P cine images versus 61.9% with static images alone, whereas the perinatologist recorded 68.1% as normal versus 58.8%, respectively. The radiologist called 77.8% of structures normal with cine images only versus 61.9% with static images only (P cine images alone (38.9%) versus static images alone (58.8%). The use of cine loops alone resulted in no significant increase in the ability to clear the heart as normal. The maternal body mass index was inversely associated with the ability to clear structures when 2D cine images were added to static images (P cine clips to standard 2D static imaging of the fetal heart significantly improves the number of structures cleared as normal. Two-dimensional cine clips are easily obtained, add little time to a study, and require minimal archival space.

  13. Retrospectively gated cardiac cine imaging with temporal and spatial acceleration.

    Science.gov (United States)

    Madore, Bruno; Hoge, W Scott; Chao, Tzu-Cheng; Zientara, Gary P; Chu, Renxin

    2011-05-01

    Parallel imaging methods are routinely used to accelerate the image acquisition process in cardiac cine imaging. The addition of a temporal acceleration method, whereby k-space is sampled differently for different time frames, has been shown in prior work to improve image quality as compared to parallel imaging by itself. However, such temporal acceleration strategies prove difficult to combine with retrospectively gated cine imaging. The only currently published method to feature such combination, by Hansen et al. [Magn Reson Med 55 (2006) 85-91] tends to be associated with prohibitively long reconstruction times. The goal of the present work was to develop a retrospectively gated cardiac cine method that features both parallel imaging and temporal acceleration, capable of achieving significant acceleration factors on commonly available hardware and associated with reconstruction times short enough for practical use in a clinical context. Seven cardiac patients and a healthy volunteer were recruited and imaged, with acceleration factors of 3.5 or 4.5, using an eight-channel product cardiac array on a 1.5-T system. The prescribed FOV value proved slightly too small in three patients, and one of the patients had a bigemini condition. Despite these additional challenges, good-quality results were obtained for all slices and all patients, with a reconstruction time of 0.98±0.07 s per frame, or about 20 s for a 20-frame slice, using a single processor on a single PC. As compared to using parallel imaging by itself, the addition of a temporal acceleration strategy provided much resistance to artifacts. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Diverse presentation of breath holding spells: two case reports with literature review.

    Science.gov (United States)

    Rathore, Geetanjali; Larsen, Paul; Fernandez, Cristina; Parakh, Manish

    2013-01-01

    Breath holding spells are a common and dramatic form of syncope and anoxic seizure in infancy. They are usually triggered by an emotional stimuli or minor trauma. Based on the color change, they are classified into 3 types, cyanotic, pallid, and mixed. Pallid breath holding spells result from exaggerated, vagally-mediated cardiac inhibition, whereas the more common, cyanotic breathholding spells are of more complex pathogenesis which is not completely understood. A detailed and accurate history is the mainstay of diagnosis. An EKG should be strongly considered to rule out long QT syndrome. Spontaneous resolution of breath-holding spells is usually seen, without any adverse developmental and intellectual sequelae. Rare cases of status epilepticus, prolonged asystole, and sudden death have been reported. Reassurance and education is the mainstay of therapy. Occasionally, pharmacologic intervention with iron, piracetam; atropine may be of benefit. Here we present 2 cases, one of each, pallid and cyanotic breath holding spells.

  15. Diverse Presentation of Breath Holding Spells: Two Case Reports with Literature Review

    Science.gov (United States)

    Rathore, Geetanjali; Larsen, Paul; Fernandez, Cristina; Parakh, Manish

    2013-01-01

    Breath holding spells are a common and dramatic form of syncope and anoxic seizure in infancy. They are usually triggered by an emotional stimuli or minor trauma. Based on the color change, they are classified into 3 types, cyanotic, pallid, and mixed. Pallid breath holding spells result from exaggerated, vagally-mediated cardiac inhibition, whereas the more common, cyanotic breathholding spells are of more complex pathogenesis which is not completely understood. A detailed and accurate history is the mainstay of diagnosis. An EKG should be strongly considered to rule out long QT syndrome. Spontaneous resolution of breath-holding spells is usually seen, without any adverse developmental and intellectual sequelae. Rare cases of status epilepticus, prolonged asystole, and sudden death have been reported. Reassurance and education is the mainstay of therapy. Occasionally, pharmacologic intervention with iron, piracetam; atropine may be of benefit. Here we present 2 cases, one of each, pallid and cyanotic breath holding spells. PMID:24191206

  16. Selenium and antioxidant levels decreased in blood of children with breath-holding spells.

    Science.gov (United States)

    Saad, Khaled; Farghaly, Hikma S; Badry, Reda; Othman, Hisham A K

    2014-10-01

    We hypothesize that the imbalance between oxidant and antioxidant systems might be involved in the pathophysiology of breath-holding spells. The aim of this study is to evaluate the oxidant-antioxidant status in children with breath-holding spells compared to healthy children. In a case control study, 67 children with breath-holding spells were compared with 60 healthy children. Malondialdehyde values of the patients were significantly higher than those in control. Levels of selenium, glutathione peroxidase, and superoxide dismutase of the patient group are significantly lower than those in control. The present study gives helpful data about oxidant-antioxidant systems alterations in breath-holding spells in such a large patient group. These data give support to the hypothesis of the imbalance between oxidant and antioxidant systems, and selenium deficiency might be involved in the pathophysiology of breath-holding spells, suggesting the role of this system dysregulation in breath-holding spells. © The Author(s) 2014.

  17. Case report of successful treatment of pallid breath-holding spells with glycopyrrolate.

    Science.gov (United States)

    Williams, Jason; Cain, Nicole

    2015-05-01

    Breath-holding spells are a common childhood disorder that typically present before 12 months of age. Whereas most cases are benign, some patients have very severe cases associated with bradycardia that can progress from asystole to syncope and seizures. Treatment studies have implicated the use of several therapies, such as oral iron, fluoxetine, and pacemaker implantation. This is a retrospective study of patients treated with glycopyrrolate for pallid breath-holding spells. Clinical data from 4 patients referred to pediatric cardiology who saw therapeutic benefit from treatment using glycopyrrolate were reviewed to evaluate for clinical response to the drug. Two twin patients, whose symptoms began at 5 months of age, experienced a decrease in breath-holding frequency after 1 month. A patient diagnosed at 7 months of age experienced a decrease in frequency of spells. A patient diagnosed at 10 months of age reported cessation of syncope shortly after initiation of glycopyrrolate and complete resolution of breath-holding spells during prolonged treatment. This case study of 4 patients with pallid breath-holding offers evidence that glycopyrrolate may be beneficial in treating breath-holding spells and has a safer side-effect profile than pacemaker implantation. Copyright © 2015 by the American Academy of Pediatrics.

  18. Cardiac repolarization changes in the children with breath-holding spells.

    Science.gov (United States)

    Amoozgar, Hamid; Saleh, Fazl; Farhani, Nahal; Rafiei, Mohammad; Inaloo, Soroor; Asadipooya, Ali-Akbar

    2013-12-01

    Breath-holding spells are known as benign attacks, frequencies of which decrease by the development of the autonomic nervous system. The present study aims to compare the electrocardiographic repolarization in children with breath-holding spells. In this study, QT dispersion, QTc dispersion, T peak to T end dispersion, and P wave dispersion of the twelve-lead surface electrocardiography of fifty children who had breath-holding spells were measured and compared with normal children from April 2011 to August 2012. Forty-four (88%) patients had cyanotic spells, while 6 (12%) had pallid spells. QTc dispersion was increased in the patients with breath-holding spells (148.2±33.1) compared to the healthy children (132±27.3) and the difference was statically significant (P = 0.01). Meanwhile, no statistically significant differences were observed between the patients and the control subjects regarding the other parameters (P > 0.05). QTc dispersion was significantly increased in the patients with breath-holding spells compared to normal children and this is a sign of cardiac repolarization abnormality as well as the increased risk of cardiac arrhythmia in patients with breath-holding spells.

  19. Autonomic nervous system functions in children with breath-holding spells and effects of iron deficiency.

    Science.gov (United States)

    Kolkiran, Abdülkerim; Tutar, Ercan; Atalay, Semra; Deda, Gülhis; Cin, Sükrü

    2005-09-01

    To analyse the activity of the autonomic nervous system during breath-holding spells, we assessed the ECG changes, including ventricular repolarization parameters before and during the spell. We also analysed the effects of iron deficiency on these ECG parameters. The study group consisted of 37 children with breath-holding spells (30 cyanotic, 7 pallid) (mean age+/-SD: 12.9+/-10.8 mo). Twenty-six healthy children (mean age+/-SD: 14.4+/-8.6 mo) served as a control group. All patients and controls had standard 12-lead simultaneous surface ECG. All patients had ECG recordings during at least one severe breath-holding spell obtained by "event recorder". Traces obtained by "event recorder" were analysed in terms of mean heart rate and the frequency and duration of asystole during the spell. Respiratory sinus arrhythmia on standard ECGs and asystole frequency during spells were higher in patients with pallid breath-holding spells. Patients with iron deficiency had a lower frequency of respiratory sinus arrhythmia and prolonged asystole time during the spell. There was no difference in terms of ventricular repolarization parameters (QT/QTc intervals and QT/QTc dispersions) between patients and controls and between patient subgroups (cyanotic versus pallid). These results confirmed the presence of autonomic dysregulation in children with breath-holding spells. Iron deficiency may have an impact on this autonomic dysregulation. Ventricular repolarization was unaffected in patients with breath-holding spells.

  20. A Technique for Generating Volumetric Cine-Magnetic Resonance Imaging.

    Science.gov (United States)

    Harris, Wendy; Ren, Lei; Cai, Jing; Zhang, You; Chang, Zheng; Yin, Fang-Fang

    2016-06-01

    The purpose of this study was to develop a techique to generate on-board volumetric cine-magnetic resonance imaging (VC-MRI) using patient prior images, motion modeling, and on-board 2-dimensional cine MRI. One phase of a 4-dimensional MRI acquired during patient simulation is used as patient prior images. Three major respiratory deformation patterns of the patient are extracted from 4-dimensional MRI based on principal-component analysis. The on-board VC-MRI at any instant is considered as a deformation of the prior MRI. The deformation field is represented as a linear combination of the 3 major deformation patterns. The coefficients of the deformation patterns are solved by the data fidelity constraint using the acquired on-board single 2-dimensional cine MRI. The method was evaluated using both digital extended-cardiac torso (XCAT) simulation of lung cancer patients and MRI data from 4 real liver cancer patients. The accuracy of the estimated VC-MRI was quantitatively evaluated using volume-percent-difference (VPD), center-of-mass-shift (COMS), and target tracking errors. Effects of acquisition orientation, region-of-interest (ROI) selection, patient breathing pattern change, and noise on the estimation accuracy were also evaluated. Image subtraction of ground-truth with estimated on-board VC-MRI shows fewer differences than image subtraction of ground-truth with prior image. Agreement between normalized profiles in the estimated and ground-truth VC-MRI was achieved with less than 6% error for both XCAT and patient data. Among all XCAT scenarios, the VPD between ground-truth and estimated lesion volumes was, on average, 8.43 ± 1.52% and the COMS was, on average, 0.93 ± 0.58 mm across all time steps for estimation based on the ROI region in the sagittal cine images. Matching to ROI in the sagittal view achieved better accuracy when there was substantial breathing pattern change. The technique was robust against noise levels up to SNR = 20. For

  1. A Technique for Generating Volumetric Cine-Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Wendy [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Ren, Lei, E-mail: lei.ren@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Zhang, You [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Chang, Zheng; Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2016-06-01

    Purpose: The purpose of this study was to develop a techique to generate on-board volumetric cine-magnetic resonance imaging (VC-MRI) using patient prior images, motion modeling, and on-board 2-dimensional cine MRI. Methods and Materials: One phase of a 4-dimensional MRI acquired during patient simulation is used as patient prior images. Three major respiratory deformation patterns of the patient are extracted from 4-dimensional MRI based on principal-component analysis. The on-board VC-MRI at any instant is considered as a deformation of the prior MRI. The deformation field is represented as a linear combination of the 3 major deformation patterns. The coefficients of the deformation patterns are solved by the data fidelity constraint using the acquired on-board single 2-dimensional cine MRI. The method was evaluated using both digital extended-cardiac torso (XCAT) simulation of lung cancer patients and MRI data from 4 real liver cancer patients. The accuracy of the estimated VC-MRI was quantitatively evaluated using volume-percent-difference (VPD), center-of-mass-shift (COMS), and target tracking errors. Effects of acquisition orientation, region-of-interest (ROI) selection, patient breathing pattern change, and noise on the estimation accuracy were also evaluated. Results: Image subtraction of ground-truth with estimated on-board VC-MRI shows fewer differences than image subtraction of ground-truth with prior image. Agreement between normalized profiles in the estimated and ground-truth VC-MRI was achieved with less than 6% error for both XCAT and patient data. Among all XCAT scenarios, the VPD between ground-truth and estimated lesion volumes was, on average, 8.43 ± 1.52% and the COMS was, on average, 0.93 ± 0.58 mm across all time steps for estimation based on the ROI region in the sagittal cine images. Matching to ROI in the sagittal view achieved better accuracy when there was substantial breathing pattern change. The technique was robust against

  2. Self-gated cardiac cine imaging using phase information.

    Science.gov (United States)

    Seo, Hyunseok; Kim, Dongchan; Oh, Changheun; Park, HyunWook

    2017-03-01

    To obtain multiphase cardiac cine images with high resolution, a novel self-gating method for both cardiac and respiratory motions is proposed. The proposed method uses the phase of projection data obtained from a separate axial slice to measure cardiac and respiratory motion, after the acquisition of every k-space line in the image plane. Cardiac motion is estimated from the phase of the projection data passing through the aorta, which is amplified by superior-inferior directional bipolar gradients, whereas respiratory motion is estimated from the phase of the left-right directional projection data of the abdomen. To verify the proposed self-gating method, a simulation and in vivo steady state free precession cardiac imaging were performed. The proposed method provides high resolution multiphase cardiac cine images. Using the proposed self-gating method, the phase variation of the projection data offers information about cardiac and respiratory motions that is equivalent to external gating devices. The proposed method can capture time-resolved cardiac and respiratory motion from the phase information of the projection data. Because the projection data is obtained from a separate gating slice, the self-gating signals are not affected by imaging planes. Magn Reson Med 77:1216-1222, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  3. Organ perfusion during voluntary pulmonary hyperinflation; a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Kristensen, Kasper Kyhl; Drvis, Ivan; Barak, Otto

    2016-01-01

    . Myocardial, pulmonary, skeletal muscle, kidney, and liver perfusion were evaluated by magnetic resonance imaging in 10 elite breath-hold divers at rest and during moderate GPI. Cardiac chamber volumes, stroke volume, and thus CO were determined from cardiac short-axis cine images. Organ volumes were assessed...... from gradient echo sequences, and organ perfusion was evaluated from first-pass images after gadolinium injection. During GPI, lung volume increased by 5.2 ± 1.5 liters (mean ± SD; P

  4. Usefulness of true FISP cine MR imaging in patients with poor cardiac function

    Energy Technology Data Exchange (ETDEWEB)

    Sakuma, Toshiharu; Yamada, Naoaki; Motooka, Makoto; Enomoto, Naoyuki; Maeshima, Isamu; Matsuda, Kazuhide; Urayama, Shinichi; Ikeo, Miki [National Cardiovascular Center, Suita, Osaka (Japan)

    2002-01-01

    This study was done to assess the value of True FISP cine in patients with poor cardiac function. True FISP cine and FLASH cine imaging were performed on a 1.5 T machine. Both short axis and horizontal long axis imaging sections were used. The imaging sections used a Matrix (120 x 128), FOV (24 x 32 cm), and had a slice thickness of 8 mm. The imaging time for True FISP cine was 8 heart beats and 17 heart beats for FLASH cine. The contrast-to-noise ratio between the blood and myocardium (CNR) was measured at enddiastole and endsystole. The subjects in the study were 10 healty volunteers (average age 26.5{+-}3.2 years) and 12 patients with hypofunction (average age 53.9{+-}13.2 years). In the volunteers, the CNR of the short axis imaging was similar in both True FISP (24.6{+-}3.7) and FLASH (23.4{+-}5.9). In the patients with poor cardiac function however, the CNR of True FISP was larger than FLASH in both the short and long axis. In the short axis (22.7{+-}6.1 vs. 17.9{+-}5.3, P<0.01) and in the long axis (17.4{+-}4.3 vs. 9.3{+-}4.0, P<0.01). We conclude that True FISP cine has a higher contrast in a shorter imaging time than FLASH cine. True FISP cine is especially useful in patients with poor cardiac function. (author)

  5. Whole-heart magnetic resonance coronary angiography with multiple breath-holds and automatic breathing-level tracking

    Science.gov (United States)

    Kuhara, Shigehide; Ninomiya, Ayako; Okada, Tomohisa; Kanao, Shotaro; Kamae, Toshikazu; Togashi, Kaori

    2010-05-01

    Whole-heart (WH) magnetic resonance coronary angiography (MRCA) studies are usually performed during free breathing while monitoring the position of the diaphragm with real-time motion correction. However, this results in a long scan time and the patient's breathing pattern may change, causing the study to be aborted. Alternatively, WH MRCA can be performed with multiple breath-holds (mBH). However, one problem in the mBH method is that patients cannot hold their breath at the same position every time, leading to image degradation. We have developed a new WH MRCA imaging method that employs both the mBH method and automatic breathing-level tracking to permit automatic tracking of the changes in breathing or breath-hold levels. Evaluation of its effects on WH MRCA image quality showed that this method can provide high-quality images within a shorter scan time. This proposed method is expected to be very useful in clinical WH MRCA studies.

  6. Risk of Neurological Insult in Competitive Deep Breath-Hold Diving.

    Science.gov (United States)

    Tetzlaff, Kay; Schöppenthau, Holger; Schipke, Jochen D

    2017-02-01

    It has been widely believed that tissue nitrogen uptake from the lungs during breath-hold diving would be insufficient to cause decompression stress in humans. With competitive free diving, however, diving depths have been ever increasing over the past decades. A case is presented of a competitive free-diving athlete who suffered stroke-like symptoms after surfacing from his last dive of a series of 3 deep breath-hold dives. A literature and Web search was performed to screen for similar cases of subjects with serious neurological symptoms after deep breath-hold dives. A previously healthy 31-y-old athlete experienced right-sided motor weakness and difficulty speaking immediately after surfacing from a breathhold dive to a depth of 100 m. He had performed 2 preceding breath-hold dives to that depth with surface intervals of only 15 min. The presentation of symptoms and neuroimaging findings supported a clinical diagnosis of stroke. Three more cases of neurological insults were retrieved by literature and Web search; in all cases the athletes presented with stroke-like symptoms after single breath-hold dives of depths exceeding 100 m. Two of these cases only had a short delay to recompression treatment and completely recovered from the insult. This report highlights the possibility of neurological insult, eg, stroke, due to cerebral arterial gas embolism as a consequence of decompression stress after deep breath-hold dives. Thus, stroke as a clinical presentation of cerebral arterial gas embolism should be considered another risk of extreme breath-hold diving.

  7. Comparison of transient severe motion in gadoxetate disodium and gadopentetate dimeglumine-enhanced MRI: effect of modified breath-holding method.

    Science.gov (United States)

    Song, Ji Soo; Choi, Eun Jung; Park, Eun Hae; Lee, Ju-Hyung

    2017-10-06

    To compare the occurrence of transient severe motion (TSM) between gadoxetate disodium- and gadopentetate dimeglumine-enhanced MRI and between gadoxetate disodium-enhanced MRI scans obtained with and without the application of a modified breath-holding technique. We reviewed 80 patients who underwent two magnetic resonance examinations (gadoxetate disodium-enhanced MRI and gadopentetate dimeglumine-enhanced MRI) with the application of a modified breath-holding technique (dual group). This group was compared with 100 patients who underwent gadoxetate disodium-enhanced MRI without the application of the modified breath-holding technique (single group). Patient risk factors and motion scores (1 [none] to 5 [non-diagnostic]) for each dynamic-phase imaging were analysed. In the dual group, mean motion scores did not differ significantly between gadoxetate disodium- and gadopentetate dimeglumine-enhanced MRI (p=0.096-0.807) in any phase. However, in all phases except the late dynamic phase, mean motion scores of the dual group were significantly lower than those in the single group. TSM incidence did not differ significantly between gadoxetate disodium- and gadopentetate dimeglumine-enhanced MRI in the dual group (3.8% vs. 1.3%, p=0.620). With proper application of the modified breath-holding technique, TSM occurrence with gadoxetate disodium-enhanced MRI was comparable to that associated with gadopentetate dimeglumine-enhanced MRI. • The modified breath-holding method significantly reduced the incidence of TSM. • Gadoxetate disodium and gadopentetate dimeglumine showed comparable motion scores. • TSM incidence was comparable between gadoxetate disodium- and gadopentetate dimeglumine-enhanced MRI.

  8. Evaluation of deep inspiration breath-hold lung treatment plans with Monte Carlo dose calculation.

    Science.gov (United States)

    Yorke, Ellen D; Wang, Lu; Rosenzweig, Kenneth E; Mah, Dennis; Paoli, Jean-Baptiste; Chui, Chen-Shou

    2002-07-15

    To evaluate dosimetry of deep inspiration breath-hold (DIBH) relative to free breathing (FB) for three-dimensional conformal radiation therapy of lung cancer with 6-MV photons and Monte Carlo (MC) dose calculations. Static three-dimensional conformal radiation therapy, 6-MV plans, based on DIBH and FB CT images for five non-small-cell lung cancer patients, were generated on a clinical treatment planning system with equivalent path length tissue inhomogeneity correction. Margins of gross to planning target volume were not reduced for DIBH plans. Cord and lung toxicity determined the maximum treatment dose for each plan. Dose distributions were recalculated for the same beams with an MC dose calculation algorithm and electron density distributions derived from the CT images. MC calculations showed decreased target coverage relative to treatment-planning system predictions. Lateral disequilibrium caused more degradation of target coverage for DIBH than for FB (approximately 4% worse than expected for FB vs. 8% for DIBH). However, with DIBH higher treatment doses could be delivered without violating normal tissue constraints, resulting in higher total doses to gross target volume and to >99% of planning target volume. If DIBH enables prescription dose increases exceeding 10%, MC calculations indicate that, despite lateral disequilibrium, higher doses will be delivered to medium-to-large, partly mediastinal gross target volumes, providing that 6-MV photons are used and margins are not reduced.

  9. Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon: Results of a preliminary study.

    Science.gov (United States)

    Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

    2017-01-01

    Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results.Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon-oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images.Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects.Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected

  10. Hemoptysis due to breath-hold diving following chemotherapy and lung irradiation.

    Science.gov (United States)

    Gutsche, Markus; Kuschner, Ware G

    2012-08-01

    Breath-hold diving, also known as free-diving, describes the practice of intentional immersion under water without an external supply of oxygen. Pulmonary hemorrhage with hemoptysis has been reported as a complication of immersion and breath-hold diving in young healthy athletes. We report the case of a 60-year-old man with a history of radiation and chemotherapy for breast carcinoma, who developed the abrupt onset of hemoptysis in the setting of swimming and breath-hold diving. A computed tomography (CT) scan of the chest demonstrated an area of ground glass opacification, suggestive of pulmonary hemorrhage, superimposed on a background of reticular opacities within the prior radiation field. A follow-up CT scan of the chest, obtained 2 months after presentation, demonstrated resolution of the ground glass opacification, but persistence of fibrotic features attributable to prior radiation therapy. We postulate that prior irradiation of the chest resulted in lung injury and fibrosis which, in turn, rendered the affected region of the lung susceptible to "stress failure," due to an increase in the transcapillary pressure gradient arising from immersion and breath-hold diving. Patients with a history of lung injury resulting from chest irradiation should be cautioned about pulmonary hemorrhage and hemoptysis as a potential complication of swimming and breath-hold diving.

  11. Nonrigid registration method to assess reproducibility of breath-holding with ABC in lung cancer.

    Science.gov (United States)

    Sarrut, David; Boldea, Vlad; Ayadi, Myriam; Badel, Jean-Noël; Ginestet, Chantal; Clippe, Sébastien; Carrie, Christian

    2005-02-01

    To study the interfraction reproducibility of breath-holding using active breath control (ABC), and to develop computerized tools to evaluate three-dimensional (3D) intrathoracic motion in each patient. Since June 2002, 11 patients with non-small-cell lung cancer enrolled in a Phase II trial have undergone four CT scans: one during free-breathing (reference) and three using ABC. Patients left the room between breath-hold scans. The patient's breath was held at the same predefined phase of the breathing cycle (about 70% of the vital capacity) using the ABC device, then patients received 3D-conformal radiotherapy. Automated computerized tools for breath-hold CT scans were developed to analyze lung and tumor interfraction residual motions with 3D nonrigid registration. All patients but one were safely treated with ABC for 7 weeks. For 6 patients, the lung volume differences were 300 cm(3) and displacements >10 mm, probably owing to atelectasia and emphysema. One patient was excluded, and two others had incomplete data sets. Breath-holding with ABC was effective in 6 patients, and discrepancies were clinically accountable in 2. The proposed 3D nonrigid registration method allows for personalized evaluation of breath-holding reproducibility with ABC. It will be used to adapt the patient-specific internal margins.

  12. Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients.

    Science.gov (United States)

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra; Lever, Sandra; de Bruijne, Marleen; Morana, Giovanni; Muzzio, Pier Carlo; Lequin, Maarten H; Tiddens, Harm A W M

    2014-01-01

    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard for diagnosing TBM; however it has major disadvantages, such as general anaesthesia. Cine computed tomography (CT) is a noninvasive alternative used to diagnose TBM, but its use in children is restricted by ionising radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine magnetic resonance imaging (MRI) as an alternative to cine-CT in a retrospective study. 12 children with a mean age (range) of 12 years (7-17 years), suspected of having TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a three-dimensional spoiled gradient echo sequence. Three-dimensional dynamic scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter >50% at end-expiration in the static and dynamic scans. The success rate of the cine-MRI protocol was 92%. Cine-MRI was compared with bronchoscopy or chest CT in seven subjects. TBM was diagnosed by cine-MRI in seven (58%) out of 12 children and was confirmed by bronchoscopy or CT. In four patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans. Spirometer controlled cine-MRI is a promising technique to assess TBM in children and has the potential to replace bronchoscopy.

  13. SU-E-T-177: Clinical Experience with Spirometer Guided Breath Hold Lung SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H; Manning, M; Sintay, B; Maurer, J; Hayes, L; Wiant, D [Cone Health Cancer Center, Greensboro, NC (United States)

    2015-06-15

    Purpose: Tumor motion in lung SBRT is typically managed by creating an internal target volume (ITV) based on 4D-CT information. Another option, which may reduce lung dose and imaging artifact, is to use a breath hold (BH) during simulation and delivery. Here we evaluate the reproducibility of tumor position at repeated BH using a newly released spirometry system. Methods: Three patients underwent multiple BH CT’s at simulation. All patients underwent a BH cone beam CT (CBCT) prior to each treatment. All image sets were registered to a patient’s first simulation CT based on local bony anatomy. The gross tumor volume (GTV), and the diaphragm or the apex of the lung were contoured on the first image set and expanded in 1 mm increments until the GTVs and diaphragms on all image sets were included inside an expanded structure. The GTV and diaphragm margins necessary to encompass the structures were recorded. Results: The first patient underwent 2 BH CT’s and fluoroscopy at simulation, the remaining patients underwent 3 BH CT’s at simulation. In all cases the GTV’s remained within 1 mm expansions and the diaphragms remained within 2 mm expansions on repeat scans. Each patient underwent 3 daily BH CBCT’s. In all cases the GTV’s remained within a 2 mm expansions, and the diaphragms (or lung apex in one case) remained within 2 mm expansions at daily BH imaging. Conclusions: These case studies demonstrate spirometry as an effective tool for limiting tumor motion (and imaging artifact) and facilitating reproducible tumor positioning over multiple set-ups and BH’s. This work was partially supported by Qfix.

  14. Cardiac cine imaging at 3 Tesla: initial experience with a 32-element body-array coil.

    Science.gov (United States)

    Fenchel, Michael; Deshpande, Vibhas S; Nael, Kambiz; Finn, J Paul; Miller, Stephan; Ruehm, Stefan; Laub, Gerhard

    2006-08-01

    We sought to assess the feasibility of cardiac cine imaging and evaluate image quality at 3 T using a body-array coil with 32 coil elements. Eight healthy volunteers (3 men; median age 29 years) were examined on a 3-T magnetic resonance scanner (Magnetom Trio, Siemens Medical Solutions) using a 32-element phased-array coil (prototype from In vivo Corp.). Gradient-recalled-echo (GRE) cine (GRAPPAx3), GRE cine with tagging lines, steady-state-free-precession (SSFP) cine (GRAPPAx3 and x4), and SSFP cine(TSENSEx4 andx6) images were acquired in short-axis and 4-chamber view. Reference images with identical scan parameters were acquired using the total-imaging-matrix (Tim) coil system with a total of 12 coil elements. Images were assessed by 2 observers in a consensus reading with regard to image quality, noise and presence of artifacts. Furthermore, signal-to-noise values were determined in phantom measurements. In phantom measurements signal-to-noise values were increased by 115-155% for the various cine sequences using the 32-element coil. Scoring of image quality yielded statistically significant increased image quality with the SSFP-GRAPPAx4, SSFP-TSENSEx4, and SSFP-TSENSEx6 sequence using the 32-element coil (P coil (P coil is feasible in healthy volunteers. Using a large number of coil elements with a favorable sensitivity profile supports faster image acquisition, with high diagnostic image quality even for high parallel imaging factors.

  15. The Utilization of an Insertable Cardiac Monitor in a Child With Pallid Breath-Holding Spells.

    Science.gov (United States)

    Tejman-Yarden, Shai; Ben-Zeev, Bruria; Goldshmit, Yuval; Sarquella-Brugada, Georgia; Cicurel, Assi; Katz, Uriel; Mishali, David; Glikson, Michael

    2016-11-01

    Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal. Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes. This finding led to a pacemaker implantation. Subsequently, her breath-holding spells completely resolved. This child illustrates the ability of the insertable cardiac monitor to help and diagnose arrhythmias in children with unresolved clinical findings. The ability to implant it with a minimal scar makes it ideal for uncooperative individuals with relative few and unexpected episodes that are hard to diagnose. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cine-MR imaging of valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Jin; Kim, Woo Sung; Park, Hyun Wuk; Cho, Zang Hee [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    1989-04-15

    Cine-MR imaging was done in 2 normal persons and 9 patients of valvular heart disease with 2.0 T superconducting MR system (Spectro-2000; GoldStar, Korea). The MRI was undertaken using gradient echo technique with small flip angle. Repetition time (TR) was 34 msec, and echo time (TE), 18 msec. In most cases, 20 to 30 frames could be obtained during one cardiac cycle. With normal heart, high signal intensity was identified in the blood filled cardiac chambers. Transient signal void was observed near tricuspid, mitral and aortic valves due to the turbulences induced by valve opening or closure. In 6 cases of mitral valvular disease, mitral valve was identified in all cases. The valvular motion was limited revealing doming toward cardiac apex during diastole. Signal void was evident in pansystolic phase of left ventricle in all cases. Evidence of combined aortic or tricuspid valve disease were also demonstrated, revealing signal void in the corresponding cardiac chambers. Cine-MRI seemed to be not only a good non-invasive diagnostic modality for the valvular heart disease, but also an accurate modality for cardiac functional evaluation.

  17. Facial immersion in cold water enhances cerebral blood velocity during breath-hold exercise in humans

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Pott, Frank C; Secher, Niels H

    2009-01-01

    perfusion evaluated as the middle cerebral artery mean flow velocity (MCA V(mean)) during exercise in nine male subjects. At rest, a breath hold of maximum duration increased the arterial carbon dioxide tension (Pa(CO(2))) from 4.2 to 6.7 kPa and MCA V(mean) from 37 to 103 cm/s (mean; approximately 178%; P...... 180-W exercise (from 47 to 53 cm/s), and this increment became larger with facial immersion (76 cm/s, approximately 62%; P change. These results indicate that a breath hold diverts blood toward the brain with a >100% increase in MCA V(mean), largely...

  18. Improved workflow for quantification of left ventricular volumes and mass using free-breathing motion corrected cine imaging.

    Science.gov (United States)

    Cross, Russell; Olivieri, Laura; O'Brien, Kendall; Kellman, Peter; Xue, Hui; Hansen, Michael

    2016-02-25

    Traditional cine imaging for cardiac functional assessment requires breath-holding, which can be problematic in some situations. Free-breathing techniques have relied on multiple averages or real-time imaging, producing images that can be spatially and/or temporally blurred. To overcome this, methods have been developed to acquire real-time images over multiple cardiac cycles, which are subsequently motion corrected and reformatted to yield a single image series displaying one cardiac cycle with high temporal and spatial resolution. Application of these algorithms has required significant additional reconstruction time. The use of distributed computing was recently proposed as a way to improve clinical workflow with such algorithms. In this study, we have deployed a distributed computing version of motion corrected re-binning reconstruction for free-breathing evaluation of cardiac function. Twenty five patients and 25 volunteers underwent cardiovascular magnetic resonance (CMR) for evaluation of left ventricular end-systolic volume (ESV), end-diastolic volume (EDV), and end-diastolic mass. Measurements using motion corrected re-binning were compared to those using breath-held SSFP and to free-breathing SSFP with multiple averages, and were performed by two independent observers. Pearson correlation coefficients and Bland-Altman plots tested agreement across techniques. Concordance correlation coefficient and Bland-Altman analysis tested inter-observer variability. Total scan plus reconstruction times were tested for significant differences using paired t-test. Measured volumes and mass obtained by motion corrected re-binning and by averaged free-breathing SSFP compared favorably to those obtained by breath-held SSFP (r = 0.9863/0.9813 for EDV, 0.9550/0.9685 for ESV, 0.9952/0.9771 for mass). Inter-observer variability was good with concordance correlation coefficients between observers across all acquisition types suggesting substantial agreement. Both motion

  19. SU-C-19A-01: A Simple Deep Inspiration Breath Hold System

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, B; Kaznowski, L; Blackburn, J; Chu, K [Marquette General Hospital, Marquette, MI (United States); Duelge, J; Baldwin, B; Valenti, M; Hunsader, A [Dickinson County Healthcare System, Iron Mountain, MI (United States)

    2014-06-15

    Purpose: Deep Inspiration Breath Hold (DIBH) Radiation therapy for left sided breast can reduce dose to the lungs and heart. The purpose of this work is to illustrate how to implement a simple method of DIBH for simulation and treatment using equipment readily available in most radiation oncology clinics. Methods: For simulation and treatment, a foam block is placed on the patient's abdomen or chest and a horizontal laser mounted on a movable slide is aimed at the center of the foam block. After a coaching session the block is marked at the average free breathing position and average DIBH position. The position of block relative to laser can be seen by the patient via prism glasses as well as the radiation therapists via a video camera system. Simulation CT scans and treatment delivery are performed under DIBH conditions. Imaging and treatment are performed by manually turning the beam on once the patient has achieved DIBH after being given verbal instructions. Results: Manually triggered imaging was used daily to verify DIBH reproducibility for all patients treated using this system. Sets of before and during port images were used to ensure patient position was appropriate for treatment. Results of the laser on block method were compared to a sister facility using surface mapping techniques for DIBH and the two methods were found to have clinically equivalent reproducibility. Conclusion: The laser and block system was found to be simple to implement and robust during patient treatment. This system can be created from readily available materials at low cost and provides adequate feedback to patient and therapists. During treatment images document the reproducibility of setup and give confidence to clinicians that this method is reproducible from day to day.

  20. Dobutamine cine magnetic resonance imaging after myocardial infarction; Cine Risonanza Magnetica con dobutamina dopo infarto del miocardio

    Energy Technology Data Exchange (ETDEWEB)

    Giovagnoni, A.; Ligabue, G.; Romagnoli, R. [Modena Univ., Modena (Italy). Scienze Radiologiche, Dipt. di Medicina Interna; Reggio Emilia Univ., Reggio Emilia (Italy). Cattedra di Cardiologia; Rossi, R.; Muia, N.; Modena, M.G. [Modena Univ., Modena (Italy). Dipt. di Scienze Mediche, Oncologiche e Radiologiche; Reggio Emilia Univ. (Italy). Dipt. di Scienze Mediche, Oncologiche e Radiologiche

    1999-12-01

    Dobutamine Cine MRI is a new diagnostic imaging technique in the pretreatment (revascularization) assessment of myocardial infarction patients. In this issue are reported the result of a comparative study of the diagnostic yield of dobutamine Cine MRI with that of stress echocardiography in the assessment of viable myocardium. A new method for analysis of Cine MR images, employing digital subtraction, aimed at decreasing subjectivity in the quantitative assessment of myocardial wall thickening. Twenty-six patients (21 men and 5 women) with a history of myocardial infarction who were scheduled for revascularization were submitted to stress echocardiography and dobutamine Cine MRI to evaluate contractile recovery of the segments considered akinetic or hypo kinetic at baseline echocardiography. Dobutamine was administered in growing doses (5, 10, 15{gamma}/kg/min). 16 segments of the left ventricle in each patient were considered. In the 416 segments studied, it was found that 307 normo kinetic, 64 scarred and 45 viable segments with stress echocardiography, versus 302 normo kinetic, 83 scarred and 31 viable segments with dobutamine MRI. Three months after revascularization 15 patients were examined to check contractile recovery of the segments considered as viable. Echocardiography had 79% sensitivity and 97% specificity, while Cine MRI had 96% and 86%, respectively. In patients with anteroseptal wall myocardial infarction stress echocardiography had 75% sensitivity and 97% specificity. Echocardiography permits to distinguish viable myocardium and scarred myocardial tissue with good sensitivity and specificity, but Cine MRI performs better. Cine MRI has much higher sensitivity than stress echocardiography and thus makes the technique of choice to evaluate viable myocardium in these sites. The digital subtraction technique is as accurate as manual measurements, but reduces the error rate and permits quicker evaluation, particularly in subendocardial thickening

  1. MO-FG-BRA-09: Towards an Optimal Breath-Holding Procedure for Radiotherapy: Differences in Organ Motion During Inhalation and Exhalation Breath-Holds

    Energy Technology Data Exchange (ETDEWEB)

    Lens, E; Gurney-Champion, O; Horst, A van der; Tekelenburg, D; Kesteren, Z van; Tienhoven, G van; Nederveen, A; Bel, A [Academic Medical Center, Amsterdam, Noord-Holland (Netherlands); Parkes, M [University of Birmingham, Birmingham, West Midlands (United Kingdom)

    2016-06-15

    Purpose: Breath-holding (BH) is often used to reduce organ motion during radiotherapy. The aim of this study was to determine the differences in pancreatic and diaphragmatic motion during BH between inhalation and exhalation BHs with variable lung volumes and to investigate whether motion increases/decreases during BH. Methods: Sixteen healthy volunteers were asked to perform four different 60-second BHs, from fully inflated to fully deflated lungs (i.e. lung volumes of: 100%, ∼70%, ∼30% and 0% of inspiratory capacity) three times (total of 192 BHs). During each BH, we obtained single-slice (coronal) magnetic-resonance scans with spatial resolution 0.93×0.93×8.0 mm3 and temporal resolution 0.6 s. We used 2-dimensional image correlation to obtain the motion of pancreatic head and diaphragm during BH. Motion magnitude in inferior-superior direction was obtained by determining the maximum displacement during BH. Results: Pancreatic and diaphragmatic drifts occurred during BH and were mostly in the superior direction. We observed significantly smaller pancreatic and diaphragmatic motion magnitudes in inferior-superior direction during exhalation BHs (BH{sub 30%} and BH{sub 0%}) compared to inhalation BHs (BH{sub 100%} and BH{sub 70%}). The mean motion magnitudes of the pancreatic head were 7.0, 6.5, 4.4 and 4.2 mm during BH{sub 100%}, BH{sub 70%}, BH{sub 30%} and BH{sub 0%}, respectively, and mean BH durations were 59.9, 59.1, 59.0 and 52.7 s. For the diaphragm, mean motion magnitudes were 9.8, 9.0, 5.6 and 4.3 mm, respectively. When considering 30-second BHs, as often used in the clinic, the motion was most pronounced during the first 10 s and excluding these from the analysis (yielding an effective BH period of 20 s) significantly reduced (P≤0.002) organ motion. Conclusion: Organ motion was significantly smaller during exhalation BHs compared to inhalation BHs. Also, motion was largest at the start of BH. Hence, waiting for 10 s may significantly decrease

  2. Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability

    Energy Technology Data Exchange (ETDEWEB)

    Heussel, C.P.; Schreiber, W.; Thelen, M.; Kauczor, H.U. [Dept. of Radiology, Johannes Gutenberg Univ., Mainz (Germany); Hafner, B. [Dept. of Ear-Nose-Throat Surgery, Johannes Gutenberg Univ., Mainz (Germany); Lill, J. [Dept. of Pneumology, Johannes Gutenberg Univ., Mainz (Germany)

    2001-06-01

    In tracheo- and bronchomalacia, localisation and determination of collapse is necessary for planning of surgical procedure. We compared inspiratory and expiratory spiral CT, cine CT, bronchoscopy, exemplary cine MR, and evaluated the clinical relevance. Twenty-nine patients (2 follow-ups; mean age 61 years, age range 27-85 years) with suspected or verified tracheal stenosis or collapse (post-tracheotomy: n=17; neoplasm: n=5; other: n=7) underwent paired breath-hold inspiratory and expiratory spiral CT. Forty-five additional cine CT were performed at 1-4 levels (mean 1.5) during continuous respiration (increment 100 ms) to clarify respiratory collapse. The tracheal cross-sectional diameters of both techniques were calculated. Comparison with bronchoscopy, follow-up, and influence upon therapy were evaluated retrospectively. Exemplary comparison with cine MR (8 frames/s) was done in 3 cases. In addition to bronchoscopy, further information concerning localisation, extent, collapse, stability of the tracheal wall, distal portions of the stenosis and extraluminal compressions were obtained. A significantly higher degree and more pathological collapses (>50%) were seen using cine CT (38%) compared with paired spiral CT (13%; degree: p<0.0001; number: p<0.001). The findings changed the further therapeutic procedure in 16 of 29 patients. Further stenoses were excluded and bronchoscopy was verified in another 13 of 29. Temporal resolution of cine CT and cine MR is sufficient; however, spatial resolution of cine MR is inferior. Paired inspiratory and expiratory spiral CT localises tracheal stenoses and demonstrates relevant extraluminal compression. Significantly improved evaluation of respiratory collapse and further information of localised tracheal instability is obtained by cine CT. Cine MR promises more functional information especially due to free choice of imaging plane. (orig.)

  3. Effect of breath holding on cerebrovascular hemodynamics in normal pregnancy and preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Zeeman, Gerda G.; Belfort, Michael A.

    2015-01-01

    Preeclampsia (PE) is associated with endothelial dysfunction and impaired autonomic function, which is hypothesized to cause cerebral hemodynamic abnormalities. Our aim was to test this hypothesis by estimating the difference in the cerebrovascular response to breath holding (BH; known to cause

  4. Effects of eye rubbing and breath holding on corneal biomechanical properties and intraocular pressure.

    Science.gov (United States)

    Liu, Wan-Cherng; Lee, Shui-Mei; Graham, Andrew D; Lin, Meng C

    2011-08-01

    To determine whether corneal biomechanical properties and intraocular pressure (IOP) are affected by eye rubbing and breath holding. Corneal hysteresis, corneal resistance factor, corneal compensated IOP (IOPcc), and Goldmann equivalent IOP (IOPg) were measured on both eyes of 40 subjects. Measurements were taken at baseline before eye rubbing (ER(0)) and before breath holding (BH(0)), immediately after 2 episodes of eye rubbing (ER(1) and ER(2)), and during 2 episodes of breath holding (BH(1) and BH(2)). Corneal hysteresis, corneal resistance factor, and IOPg were significantly lower after ER(1) compared with ER(0) and were significantly lower after ER(2) compared with ER(1). In contrast, IOPcc did not decrease significantly. There were no significant differences among BH(0), BH(1), and BH(2) in any of the 4 outcomes. Eye rubbing should be avoided before measurements of corneal biomechanical properties and IOPg. In contrast, breath holding during measurements is not likely to cause a significant change in IOPg and IOPcc or corneal biomechanical properties.

  5. Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring.

    Science.gov (United States)

    Yilmaz, Osman; Ciftel, Murat; Ozturk, Kezban; Kilic, Omer; Kahveci, Hasan; Laloğlu, Fuat; Ceylan, Ozben

    2015-02-01

    Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells. We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells - 56 cyanotic type and 12 pallid type - and 39 healthy controls. Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups. Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes.

  6. Release of erythropoietin and neuron-specific enolase after breath holding in competing free divers

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Jattu, T; Nielsen, Henrik

    2015-01-01

    Free diving is associated with extreme hypoxia. This study evaluated the combined effect of maximal static breath holding and underwater swimming on plasma biomarkers of tissue hypoxemia: erythropoietin, neuron-specific enolase and S100B, C-reactive protein, pro-atrial natriuretic peptide...

  7. Myocardial strain assessment by cine cardiac magnetic resonance imaging using non-rigid registration.

    Science.gov (United States)

    Tsadok, Yossi; Friedman, Zvi; Haluska, Brian A; Hoffmann, Rainer; Adam, Dan

    2016-05-01

    To evaluate a novel post-processing method for assessment of longitudinal mid-myocardial strain in standard cine cardiac magnetic resonance (CMR) imaging sequences. Cine CMR imaging and tagged cardiac magnetic resonance imaging (TMRI) were performed in 15 patients with acute myocardial infarction (AMI) and 15 healthy volunteers served as control group. A second group of 37 post-AMI patients underwent both cine CMR and late gadolinium enhancement (LGE) CMR exams. Speckle tracking echocardiography (STE) was performed in 36 of these patients. Cine CMR, TMRI and STE were analyzed to obtain longitudinal strain. LGE-CMR datasets were analyzed to evaluate scar extent. Comparison of peak systolic strain (PSS) measured from CMR and TMRI yielded a strong correlation (r=0.86, pcine CMR data. The method was found to be highly correlated with strain measurements obtained by TMRI and STE. This tool allows accurate discrimination between different transmurality states of myocardial infarction. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Comparison of LV mass and volume measurements derived from electron beam tomography using cine imaging and angiographic imaging.

    Science.gov (United States)

    Mao, Songshou; Takasu, Junichiro; Child, Janis; Carson, Sivi; Oudiz, Ronald; Budoff, Matthew J

    2003-10-01

    To estimate the variation of left ventricular (LV) mass and volume measurement with cine and angiography by electron beam tomography (EBT). Sixty-three consecutive patients (41 men, 22 women; age range 46-91) referred for cardiac imaging for clinical indications underwent cine and coronary artery electron beam angiography (EBA) studies on the same day. The cine images consisted of 144 images (12 slices/level x 12 levels), taken 12 frames/s for a full cardiac cycle. The EBA images consisted of 50-70 slices triggered at end-systole, with an acquisition time of 100 ms/slice. Slice thickness was 8 mm for the cine images and 1.5 mm for the EBA images. A total volume of 120-180 ml of nonionic contrast was used for each subject. The LV mass (myocardial tissue volume), LV cavity volume and total LV volume (tissue + cavity) measurements were completed using the software from the EBT computer console (G.E., S. San Francisco, CA). The LV mass, cavity volume and total LV volumes at end-systole were 124.11 g, 45.66 and 163.86 ml when derived from the cine images and 130.74 g, 41.31 and 165.82 ml when derived from the EBA images. There were no significant differences between the cine and EBA-derived measurements, however the EBA-derived measurements showed slightly larger LV mass (mean 6.63 g), smaller cavity volume (mean -4.35 ml) and larger total LV volume (mean 1.96 ml, all p > 0.05) than did the cine-derived measurements. Based on case-by-case observations, these differences appear to be related to the higher spatial resolution of the thinner EBA images which allows better discrimination between papillary and trabecular muscle and LV. This leads to slightly smaller cavity size estimations and greater LV mass measurements. There was significant correlation between cine and EBA-derived measurements. Formulas were developed for relating the measurements made from the two modalities as follows: For LV mass: EBA value = 0.91 x cine value + 17.09, R = 0.95, p cine value - 6.91, R

  9. Breathing adapted radiotherapy for breast cancer: comparison of free breathing gating with the breath-hold technique

    DEFF Research Database (Denmark)

    Korreman, Stine Sofia; Pedersen, Anders N; Nøttrup, Trine Jakobi

    2005-01-01

    , and to compare this respiratory technique with voluntary breath-hold. PATIENTS AND METHODS: 17 patients were CT-scanned during non-coached breathing manoeuvre including free breathing (FB), end-inspiration gating (IG), end-expiration gating (EG), deep inspiration breath-hold (DIBH) and end-expiration breath...

  10. Breathing adapted radiotherapy for reduction of cardiac exposure using deep inspiration breath-hold technique

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Joo; Jung, Joo Young; Woong, Cho; Suh, Tae Suk [Dept. of Biomedical Engineering, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, Jae Hong [Dept. of Radiation Oncology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2012-11-15

    Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation-induced pneumonitis. Also, several studies have demonstrated the dose to heart and artery, especially the dose to left anterior descending (LAD) coronary artery were maximized for left-sided breast cancer patient and could cause the subsequent risk causing more severe myocardial infarction than the other coronary artery. Several effective treatment techniques for breast cancer patient have been reported that partial breast irradiation technique for early stage breast cancer patient an alternative to whole breast irradiation, is a beam delivery method that uses a limited range of treatment volume to minimize Organ At Risks (OARs) and Computed Tomography (CT) images from several breathing control technique during treatment time could reduce the delivered dose to heart, lung. Particularly, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart, lung. The present study demonstrates that cardiac dose during left-sided breast treatment can be reduced by applying DIBH breathing control technique. Also, RHC could help assess the risk of radiation induced cardiac dose, toxicity.

  11. The Role of Cine Flow Magnetic Resonance Imaging in Patients with Chiari 0 Malformation.

    Science.gov (United States)

    Ozsoy, Kerem Mazhar; Oktay, Kadir; Cetinalp, Nuri Eralp; Gezercan, Yurdal; Erman, Tahsin

    2016-12-14

    The aim of this study was to define the role of phase-contrast cine magnetic resonance imaging in deciding the therapeutic strategy and underlying pathophysiology resulting in syrinx formation in patients with Chiari type 0 malformation. Seven patients admitted to our clinic with diagnosis of Chiari 0 malformations during the period January 2005 to July 2016 were enrolled in the study. All patients underwent a detailed preoperative neurological examination. The entire neuroaxis magnetic resonance imaging and phase-contrast cine magnetic resonance imaging was obtained preoperatively and postoperatively. Seven patients (5 female and 2 male) cover the inclusion criteria of the Chiari type 0. All of the patients with Chiari type 0 malformation had absent cine flow at the craniovertebral junction except two patients. All these five patients underwent surgical interventions; suboccipital decompression and duraplasty. All of them showed both clinical and imaging improvements postoperatively. Cine flow magnetic resonance imaging appears to be a useful tool in the management of patients with Chiari 0 malformations. There was a good correlation between the clinical presentation and cine flow preoperatively, and between clinical improvement and cine flow postoperatively.

  12. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dueck, Jenny, E-mail: jenny.dueck@psi.ch [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Knopf, Antje-Christin [Joint Department of Physics at the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London (United Kingdom); Lomax, Antony [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Physics, ETH Zürich, Zürich (Switzerland); Albertini, Francesca [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); Persson, Gitte F. [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Josipovic, Mirjana [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Aznar, Marianne [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen (Denmark); Weber, Damien C. [Center for Proton Therapy, Paul Scherrer Institut, Villigen PSI (Switzerland); University of Zürich, Zürich (Switzerland); Munck af Rosenschöld, Per [Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark)

    2016-05-01

    Purpose: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delivery uncertainties resulting from interfractional motion. Methods and Materials: Data from 15 patients with peripheral lung tumors previously treated with stereotactic radiation therapy were included in this study. The patients had 1 computed tomographic (CT) scan in voluntary breath-hold acquired before treatment and 3 scans during the treatment course. PBS proton treatment plans with 2 fields (2F) and 3 fields (3F), respectively, were calculated based on the planning CT scan and subsequently recalculated on the 3 repeated CT scans. Recalculated plans were considered robust if the V{sub 95%} (volume receiving ≥95% of the prescribed dose) of the gross target volume (GTV) was within 5% of what was expected from the planning CT data throughout the simulated treatment. Results: A total of 14/15 simulated treatments for both 2F and 3F met the robustness criteria. Reduced V{sub 95%} was associated with baseline shifts (2F, P=.056; 3F, P=.008) and tumor size (2F, P=.025; 3F, P=.025). Smaller tumors with large baseline shifts were also at risk for reduced V{sub 95%} (interaction term baseline/size: 2F, P=.005; 3F, P=.002). Conclusions: The breath-hold approach is a realistic clinical option for treating lung tumors with PBS proton therapy. Potential risk factors for reduced V{sub 95%} are small targets in combination with large baseline shifts. On the basis of these results, the baseline shift of the tumor should be monitored (eg, through image guided therapy), and appropriate measures should be taken accordingly. The intrafractional motion needs to be investigated to confirm that the breath-hold approach is robust.

  13. Application of phase-contrast cine magnetic resonance imaging in endoscopic aqueductoplasty.

    Science.gov (United States)

    Chen, Guoqiang; Zheng, Jiaping; Xiao, Qing; Liu, Yunsheng

    2013-06-01

    The aim of this study was to evaluate the application of phase-contrast cine magnetic resonance imaging (MRI) in endoscopic aqueductoplasty (EA) for patients with obstructive hydrocephalus. The clinical diagnosis of hydrocephalus caused by aqueduct obstruction in 23 patients was confirmed by phase-contrast cine MRI examination. The patients were treated with EA and MRI was repeated during the follow-up. The cerebrospinal fluid (CSF) flow velocity in the aqueduct was measured to determine whether the aqueduct was obstructed. The results of phase-contrast cine MRI examinations indicated that there was no CSF flow in the aqueduct for all patients prior to surgery. Aqueductoplasty was successfully performed in all patients. The results of phase-contrast cine MRI examinations performed a week after surgery demonstrated an average CSF flow velocity of 4.74±1.77 cm/sec. During the follow-up, intracranial hypertension recurred in two patients in whom CSF flow was not observed in the aqueduct by the phase-contrast cine MRI scan. Aqueduct re-occlusion was revealed by an endoscopic exploration. By measuring the CSF flow velocity, phase-contrast cine MRI accurately identifies aqueduct obstruction. Cine MRI is a nontraumatic, simple and reliable method for determining whether the aqueduct is successfully opened following aqueductoplasty.

  14. Cine viability magnetic resonance imaging of the heart without increased scan time.

    Science.gov (United States)

    Hassanein, Azza S; Khalifa, Ayman M; Ibrahim, El-Sayed H

    2016-02-01

    Cardiac magnetic resonance imaging (MRI) provides information about myocardial morphology, function, and viability from cine, tagged, and late gadolinium enhancement (LGE) images, respectively. While the cine and tagged images are acquired in a time-resolved fashion, the LGE images are acquired at a single timeframe. The purpose of this work is to develop a method for generating cine LGE images without additional scan time. The motion field is extracted from the tagged images, and is then used to guide the deformation of the infarcted region from the acquired LGE image at the acquired timeframe to any other timeframe. Major techniques for motion estimation, including harmonic phase (HARP) and optical flow analysis, are tested in this work for motion estimation. The proposed method is tested on numerical phantom and images from four human subjects. The generated cine LGE images showed both viability and wall motion information in the same set of images without additional scan time or image misregistration problems. The band-pass optical flow analysis resulted in the most accurate motion estimation compared to other methods, especially HARP, which fails to track points at the myocardial boundary. Infarct transmurality from the generated images showed good agreement with myocardial strain, and wall thickening showed good agreement with that measured from conventional cine images. In conclusion, the developed technique allows for generating cine LGE images that enable simultaneous display of wall motion and viability information. The generated images could be useful for estimating myocardial contractility reserve and for treatment prognosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approach.

    Science.gov (United States)

    Vardoulis, Orestis; Monney, Pierre; Bermano, Amit; Vaxman, Amir; Gotsman, Craig; Schwitter, Janine; Stuber, Matthias; Stergiopulos, Nikolaos; Schwitter, Juerg

    2015-06-11

    Left atrial (LA) dilatation is associated with a large variety of cardiac diseases. Current cardiovascular magnetic resonance (CMR) strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration. To develop a time-efficient single breath-hold 3D CMR acquisition and reconstruction method to precisely measure LA volumes and function. A highly accelerated compressed-sensing multi-slice cine sequence (CS-cineCMR) was combined with a non-model-based 3D reconstruction method to measure LA volumes with high temporal and spatial resolution during a single breath-hold. This approach was validated in LA phantoms of different shapes and applied in 3 patients. In addition, the influence of slice orientations on accuracy was evaluated in the LA phantoms for the new approach in comparison with a conventional model-based biplane area-length reconstruction. As a reference in patients, a self-navigated high-resolution whole-heart 3D dataset (3D-HR-CMR) was acquired during mid-diastole to yield accurate LA volumes. Phantom studies. LA volumes were accurately measured by CS-cineCMR with a mean difference of -4.73 ± 1.75 ml (-8.67 ± 3.54%, r2 = 0.94). For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms. Long-axis "aligned" vs "not aligned" with the phantom long-axis yielded similar differences vs the reference volume (-4.87 ± 1.73 ml vs. -4.45 ± 1.97 ml, p = 0.67) and short-axis "perpendicular" vs. "not-perpendicular" with the LA long-axis (-4.72 ± 1.66 ml vs. -4.75 ± 2.13 ml; p = 0.98). The conventional bi-plane area-length method was susceptible for slice orientations (p = 0.0085 for the interaction of "slice orientation" and "reconstruction technique", 2-way ANOVA for repeated measures). To use the 3D-HR-CMR as the reference for LA volumes

  16. Review of deep inspiration breath-hold techniques for the treatment of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Latty, Drew, E-mail: drew.latty@health.nsw.gov.au [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Stuart, Kirsty E [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Wang, Wei [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Sydney, New South Wales (Australia); Nepean Cancer Care Centre, Sydney, New South Wales (Australia); Ahern, Verity [Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales (Australia)

    2015-03-15

    Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.

  17. Facial immersion in cold water enhances cerebral blood velocity during breath-hold exercise in humans

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Pott, Frank C; Secher, Niels H

    2009-01-01

    180-W exercise (from 47 to 53 cm/s), and this increment became larger with facial immersion (76 cm/s, approximately 62%; P brain with a >100% increase in MCA V(mean), largely...... perfusion evaluated as the middle cerebral artery mean flow velocity (MCA V(mean)) during exercise in nine male subjects. At rest, a breath hold of maximum duration increased the arterial carbon dioxide tension (Pa(CO(2))) from 4.2 to 6.7 kPa and MCA V(mean) from 37 to 103 cm/s (mean; approximately 178%; P...... exercise, a breath hold increased Pa(CO(2)) from 5.9 to 8.2 kPa (P

  18. Cine MR imaging of uterine peristalsis in patients with endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Aki; Togashi, Kaori; Koyama, Takashi; Fujimoto, Ryota [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Nishino, Mizuki [Beth Israel Deaconess Medical Center, Department of Radiology, Kyoto (Japan); Miyake, Kanae; Hayakawa, Katsumi [Kyoto City Hospital, Department of Radiology, Kyoto (Japan); Iwasaku, Kazuhiro [Kyoto City Hospital, Department of Obstetrics and Gynecology, Kyoto (Japan); Fujii, Shingo [Kyoto University, Department of Gynecology and Obstetrics, Kyoto (Japan)

    2007-07-15

    Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12 x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport. (orig.)

  19. Can multi-slice or navigator-gated R2* MRI replace single-slice breath-hold acquisition for hepatic iron quantification?

    Energy Technology Data Exchange (ETDEWEB)

    Loeffler, Ralf B.; McCarville, M.B.; Song, Ruitian; Hillenbrand, Claudia M. [St. Jude Children' s Research Hospital, Diagnostic Imaging, Memphis, TN (United States); Wagstaff, Anne W. [St. Jude Children' s Research Hospital, Diagnostic Imaging, Memphis, TN (United States); Rhodes College, Memphis, TN (United States); University of Alabama at Birmingham School of Medicine, Birmingham, AL (United States); Smeltzer, Matthew P. [St. Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); University of Memphis, Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, Memphis, TN (United States); Krafft, Axel J. [St. Jude Children' s Research Hospital, Diagnostic Imaging, Memphis, TN (United States); University Hospital Center Freiburg, Department of Radiology, Freiburg (Germany); Hankins, Jane S. [St. Jude Children' s Research Hospital, Department of Hematology, Memphis, TN (United States)

    2017-01-15

    Liver R2* values calculated from multi-gradient echo (mGRE) magnetic resonance images (MRI) are strongly correlated with hepatic iron concentration (HIC) as shown in several independently derived biopsy calibration studies. These calibrations were established for axial single-slice breath-hold imaging at the location of the portal vein. Scanning in multi-slice mode makes the exam more efficient, since whole-liver coverage can be achieved with two breath-holds and the optimal slice can be selected afterward. Navigator echoes remove the need for breath-holds and allow use in sedated patients. To evaluate if the existing biopsy calibrations can be applied to multi-slice and navigator-controlled mGRE imaging in children with hepatic iron overload, by testing if there is a bias-free correlation between single-slice R2* and multi-slice or multi-slice navigator controlled R2*. This study included MRI data from 71 patients with transfusional iron overload, who received an MRI exam to estimate HIC using gradient echo sequences. Patient scans contained 2 or 3 of the following imaging methods used for analysis: single-slice images (n = 71), multi-slice images (n = 69) and navigator-controlled images (n = 17). Small and large blood corrected region of interests were selected on axial images of the liver to obtain R2* values for all data sets. Bland-Altman and linear regression analysis were used to compare R2* values from single-slice images to those of multi-slice images and navigator-controlled images. Bland-Altman analysis showed that all imaging method comparisons were strongly associated with each other and had high correlation coefficients (0.98 ≤ r ≤ 1.00) with P-values ≤0.0001. Linear regression yielded slopes that were close to 1. We found that navigator-gated or breath-held multi-slice R2* MRI for HIC determination measures R2* values comparable to the biopsy-validated single-slice, single breath-hold scan. We conclude that these three R2* methods can be

  20. Panic disorder in a breath-holding challenge test: a simple tool for a better diagnosis

    Directory of Open Access Journals (Sweden)

    Nardi Antonio E.

    2003-01-01

    Full Text Available OBJECTIVE: Our aim was to observe if anxiety disorder patients - DSM-IV - respond in a similar way to the induction of panic attacks by a breath-holding challenge test. METHOD: We randomly selected 29 panic disorder (PD patients, 27 social anxiety disorder (SAD patients, 21 generalized anxiety disorder (GAD patients. They were induced to breath-hold for as long as possible four times with two-minute interval between them. Anxiety scales were applied before and after the test. RESULTS: A total of 44.8% (n=13 PD patients, 14.8% (n=4 SAD patients, 9.5% (n=2 GAD patients had a panic attack after the test (c²= 21.44, df= 2, p=0.001. There was no heart rate or anxiety levels difference among the groups before and after the test. CONCLUSION: In this breath-holding challenge test the panic disorder patients were more sensitive than other anxiety disorder patients.

  1. Subacute and Chronic Left Ventricular Myocardial Scar: Accuracy of Texture Analysis on Nonenhanced Cine MR Images.

    Science.gov (United States)

    Baessler, Bettina; Mannil, Manoj; Oebel, Sabrina; Maintz, David; Alkadhi, Hatem; Manka, Robert

    2018-01-01

    Purpose To test whether texture analysis (TA) allows for the diagnosis of subacute and chronic myocardial infarction (MI) on noncontrast material-enhanced cine cardiac magnetic resonance (MR) images. Materials and Methods In this retrospective, institutional review board-approved study, 120 patients who underwent cardiac MR imaging and showed large transmural (volume of enhancement on late gadolinium enhancement [LGE] images >20%, n = 72) or small (enhanced volume ≤20%, n = 48) subacute or chronic ischemic scars were included. Sixty patients with normal cardiac MR imaging findings served as control subjects. Regions of interest for TA encompassing the left ventricle were drawn by two blinded, independent readers on cine images in end systole by using a freely available software package. Stepwise dimension reduction and texture feature selection based on reproducibility, machine learning, and correlation analyses were performed for selecting features, enabling the diagnosis of MI on nonenhanced cine MR images by using LGE imaging as the standard of reference. Results Five independent texture features allowed for differentiation between ischemic scar and normal myocardium on cine MR images in both subgroups: Teta1, Perc.01, Variance, WavEnHH.s-3, and S(5,5)SumEntrp (in patients with large MI: all P values cine MR images, with an area under the curve of 0.93 and 0.92, respectively. Conclusion This proof-of-concept study indicates that TA of nonenhanced cine MR images allows for the diagnosis of subacute and chronic MI with high accuracy. © RSNA, 2017 Online supplemental material is available for this article.

  2. Interfractional Dose Variations in Intensity-Modulated Radiotherapy With Breath-Hold for Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Mitsuhiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shibuya, Keiko, E-mail: kei@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Nakamura, Akira [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Shiinoki, Takehiro [Department of Nuclear Engineering, Kyoto University Graduate School of Engineering, Kyoto (Japan); Matsuo, Yukinori [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan); Nakata, Manabu [Clinical Radiology Service Division, Kyoto University Hospital, Kyoto (Japan); Sawada, Akira; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan)

    2012-04-01

    Purpose: To investigate the interfractional dose variations for intensity-modulated radiotherapy (RT) combined with breath-hold (BH) at end-exhalation (EE) for pancreatic cancer. Methods and Materials: A total of 10 consecutive patients with pancreatic cancer were enrolled. Each patient was fixed in the supine position on an individualized vacuum pillow with both arms raised. Computed tomography (CT) scans were performed before RT, and three additional scans were performed during the course of chemoradiotherapy using a conventional RT technique. The CT data were acquired under EE-BH conditions (BH-CT) using a visual feedback technique. The intensity-modulated RT plan, which used five 15-MV coplanar ports, was designed on the initial BH-CT set with a prescription dose of 39 Gy at 2.6 Gy/fraction. After rigid image registration between the initial and subsequent BH-CT scans, the dose distributions were recalculated on the subsequent BH-CT images under the same conditions as in planning. Changes in the dose-volume metrics of the gross tumor volume (GTV), clinical target volume (CTV = GTV + 5 mm), stomach, and duodenum were evaluated. Results: For the GTV and clinical target volume (CTV), the 95th percentile of the interfractional variations in the maximal dose, mean dose, dose covering 95% volume of the region of structure, and percentage of the volume covered by the 90% isodose line were within {+-}3%. Although the volume covered by the 39 Gy isodose line for the stomach and duodenum did not exceed 0.1 mL at planning, the volume covered by the 39 Gy isodose line for these structures was up to 11.4 cm{sup 3} and 1.8 cm{sup 3}, respectively. Conclusions: Despite variations in the gastrointestinal state and abdominal wall position at EE, the GTV and CTV were mostly ensured at the planned dose, with the exception of 1 patient. Compared with the duodenum, large variations in the stomach volume receiving high-dose radiation were observed, which might be beyond the

  3. Whole-brain vascular reactivity measured by fMRI using hyperventilation and breath-holding tasks: efficacy of 3D prospective acquisition correction (3D-PACE) for head motion

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, Shinji; Koshikawa, Tokiko; Fukatsu, Hiroshi; Ishigaki, Takeo [Department of Radiology, Nagoya University School of Medicine, 65 Tsurumai-cho, Shouwa-ku, 466-8550, Nagoya (Japan); Maruyama, Katsuya; Takizawa, Osamu [Siemens-Asahi Medical Technologies Ltd, Tokyo (Japan)

    2004-08-01

    Functional MR imaging (fMRI) study using hyperventilation and breath-holding task has been reported to be one of the non-invasive methods to examine whole-brain vascular reactivity. The purpose of this study was to evaluate the efficacy of a method for 3D prospective detection and correction of head motion (3D-PACE) in a study of whole-brain vascular reactivity using hyperventilation and breath-holding tasks. Eight healthy volunteers were scanned using an fMRI protocol of hyperventilation and breath-holding task blocks at 3 T in separate runs with and without 3D-PACE. In two subjects, two more runs with and without 3D-PACE were repeated. The mean total number of activated voxels {+-} standard deviation was 26,405.3{+-}1,822.2 in the run with 3D-PACE and 17,329.9{+-}2,766.3 in the run without 3D-PACE (P<0.05), although there is some intersubject variation regarding the effect of 3D-PACE. In the two subjects whose performed two more runs, the number of activated voxels were smaller in the run without 3D-PACE than even in the run with 3D-PACE performed later. We conclude that 3D-PACE is beneficial for fMRI studies of whole-brain vascular reactivity induced by hyperventilation and breath-holding. (orig.)

  4. Breath-holding spells may be associated with maturational delay in myelination of brain stem.

    Science.gov (United States)

    Vurucu, Sebahattin; Karaoglu, Abdulbaki; Paksu, Sukru M; Oz, Oguzhan; Yaman, Halil; Gulgun, Mustafa; Babacan, Oguzhan; Unay, Bulent; Akin, Ridvan

    2014-02-01

    To evaluate possible contribution of maturational delay of brain stem in the etiology of breath-holding spells in children using brain stem auditory evoked potentials. The study group included children who experienced breath-holding spells. The control group consisted of healthy age- and sex-matched children. Age, gender, type and frequency of spell, hemoglobin, and ferritin levels in study group and brain stem auditory evoked potentials results in both groups were recorded. Study group was statistically compared with control group for brain stem auditory evoked potentials. The mean age of study and control groups was 26.3 ± 14.6 and 28.9 ± 13.9 months, respectively. The III-V and I-V interpeak latencies were significantly prolonged in the study group compared with the control group (2.07 ± 0.2 milliseconds; 1.92 ± 0.13 milliseconds and 4.00 ± 0.27 milliseconds; 3.83 ± 0.19 milliseconds; P = 0.009 and P = 0.03, respectively). At the same time, III-V and I-V interpeak latencies of patients without anemia in the study group compared with those of control group were significantly prolonged (2.09 ± 0.24 milliseconds; 1.92 ± 0.13 milliseconds and 4.04 ± 0.28 milliseconds; 3.83 ± 0.19 milliseconds; P = 0.007 and P = 0.01, respectively). Our results consider that maturational delay in myelination of brain stem may have a role in the etiology of breath-holding spells in children.

  5. Chronic adaptations of lung function in breath-hold diving fishermen

    Directory of Open Access Journals (Sweden)

    Cristiane Diniz

    2014-04-01

    Full Text Available Objectives: The aim of this study was to verify and analyze the existence of chronic adaptations of lung function in freediving fishermen whose occupation is artisanal fishing. Material and Methods: This was a cross-sectional study involving 11 breath-hold diving fishermen and 10 non-breath-hold diving fishermen (control from the village of Bitupitá in the municipality of Barroquinha (Ceará - Brazil. Anthropometric measurements, chest and abdominal circumferences as well as spirometric and respiratory muscle strength tests were conducted according to the specifications of the American Thoracic Society/European Respiratory Society (ATS/ERS. In order to compare the measured values versus the predicted values, Student t test was used in the case of parametric test and Wilcoxon test in the case of nonparametric test. To compare the inter-group means Student t test was used for parametric test and Mann-Whitney test for the nonparametric one. The level of significance was set at α = 5%. Results: The forced vital capacity (FVC (4.9±0.6 l vs. 4.3±0.4 l and forced expiratory volume in 1 s (FEV1 (4.0±0.5 l vs. 3.6±0.3 l were, respectively, higher in the group of divers compared to the control group (p ≤ 0.05. Furthermore, in the group of free divers, the measured FVC, FEV1 and FEV1/FVC ratios were significantly greater than the predicted ones. No differences were found between the measured respiratory pressures. Conclusions: These results indicate that breath-hold diving seems to produce chronic adaptations of the respiratory system, resulting in elevated lung volumes with no airway obstruction.

  6. Accelerated two-dimensional cine DENSE cardiovascular magnetic resonance using compressed sensing and parallel imaging.

    Science.gov (United States)

    Chen, Xiao; Yang, Yang; Cai, Xiaoying; Auger, Daniel A; Meyer, Craig H; Salerno, Michael; Epstein, Frederick H

    2016-06-14

    Cine Displacement Encoding with Stimulated Echoes (DENSE) provides accurate quantitative imaging of cardiac mechanics with rapid displacement and strain analysis; however, image acquisition times are relatively long. Compressed sensing (CS) with parallel imaging (PI) can generally provide high-quality images recovered from data sampled below the Nyquist rate. The purposes of the present study were to develop CS-PI-accelerated acquisition and reconstruction methods for cine DENSE, to assess their accuracy for cardiac imaging using retrospective undersampling, and to demonstrate their feasibility for prospectively-accelerated 2D cine DENSE imaging in a single breathhold. An accelerated cine DENSE sequence with variable-density spiral k-space sampling and golden angle rotations through time was implemented. A CS method, Block LOw-rank Sparsity with Motion-guidance (BLOSM), was combined with sensitivity encoding (SENSE) for the reconstruction of under-sampled multi-coil spiral data. Seven healthy volunteers and 7 patients underwent 2D cine DENSE imaging with fully-sampled acquisitions (14-26 heartbeats in duration) and with prospectively rate-2 and rate-4 accelerated acquisitions (14 and 8 heartbeats in duration). Retrospectively- and prospectively-accelerated data were reconstructed using BLOSM-SENSE and SENSE. Image quality of retrospectively-undersampled data was quantified using the relative root mean square error (rRMSE). Myocardial displacement and circumferential strain were computed for functional assessment, and linear correlation and Bland-Altman analyses were used to compare accelerated acquisitions to fully-sampled reference datasets. For retrospectively-undersampled data, BLOSM-SENSE provided similar or lower rRMSE at rate-2 and lower rRMSE at rate-4 acceleration compared to SENSE (p cine DENSE provided good image quality and expected values of displacement and strain. BLOSM-SENSE-accelerated spiral cine DENSE imaging with 2D displacement encoding can be

  7. Detection of venous gas emboli after repetitive breath-hold dives: case report

    OpenAIRE

    Cialoni, D; Pieri, M; Giunchi, G.; Sponsiello, N; Lanzone, MA; Torcello, L; Boaretto, G; Marroni, A.

    2016-01-01

    Introduction: Neurological symptoms after breath-hold (BH) diving are often referred to as “Taravana” and considered a form of decompression sickness. However, the presence of “high” gas embolism after BH diving has never been clearly shown. This study showed high bubble formation after BH diving. Materials and methods: We performed transthoracic echocardiography on a 53-year-old male spearfishing diver (180 cm; 80 kg; BMI 24.7) 15 minutes before diving and at 15-minute intervals for 90 m...

  8. Automatic segmentation of left ventricle in cardiac cine MRI images based on deep learning

    Science.gov (United States)

    Zhou, Tian; Icke, Ilknur; Dogdas, Belma; Parimal, Sarayu; Sampath, Smita; Forbes, Joseph; Bagchi, Ansuman; Chin, Chih-Liang; Chen, Antong

    2017-02-01

    In developing treatment of cardiovascular diseases, short axis cine MRI has been used as a standard technique for understanding the global structural and functional characteristics of the heart, e.g. ventricle dimensions, stroke volume and ejection fraction. To conduct an accurate assessment, heart structures need to be segmented from the cine MRI images with high precision, which could be a laborious task when performed manually. Herein a fully automatic framework is proposed for the segmentation of the left ventricle from the slices of short axis cine MRI scans of porcine subjects using a deep learning approach. For training the deep learning models, which generally requires a large set of data, a public database of human cine MRI scans is used. Experiments on the 3150 cine slices of 7 porcine subjects have shown that when comparing the automatic and manual segmentations the mean slice-wise Dice coefficient is about 0.930, the point-to-curve error is 1.07 mm, and the mean slice-wise Hausdorff distance is around 3.70 mm, which demonstrates the accuracy and robustness of the proposed inter-species translational approach.

  9. Strain analysis in CRT candidates using the novel segment length in cine (SLICE) post-processing technique on standard CMR cine images.

    Science.gov (United States)

    Zweerink, Alwin; Allaart, Cornelis P; Kuijer, Joost P A; Wu, LiNa; Beek, Aernout M; van de Ven, Peter M; Meine, Mathias; Croisille, Pierre; Clarysse, Patrick; van Rossum, Albert C; Nijveldt, Robin

    2017-12-01

    Although myocardial strain analysis is a potential tool to improve patient selection for cardiac resynchronization therapy (CRT), there is currently no validated clinical approach to derive segmental strains. We evaluated the novel segment length in cine (SLICE) technique to derive segmental strains from standard cardiovascular MR (CMR) cine images in CRT candidates. Twenty-seven patients with left bundle branch block underwent CMR examination including cine imaging and myocardial tagging (CMR-TAG). SLICE was performed by measuring segment length between anatomical landmarks throughout all phases on short-axis cines. This measure of frame-to-frame segment length change was compared to CMR-TAG circumferential strain measurements. Subsequently, conventional markers of CRT response were calculated. Segmental strains showed good to excellent agreement between SLICE and CMR-TAG (septum strain, intraclass correlation coefficient (ICC) 0.76; lateral wall strain, ICC 0.66). Conventional markers of CRT response also showed close agreement between both methods (ICC 0.61-0.78). Reproducibility of SLICE was excellent for intra-observer testing (all ICC ≥0.76) and good for interobserver testing (all ICC ≥0.61). The novel SLICE post-processing technique on standard CMR cine images offers both accurate and robust segmental strain measures compared to the 'gold standard' CMR-TAG technique, and has the advantage of being widely available. • Myocardial strain analysis could potentially improve patient selection for CRT. • Currently a well validated clinical approach to derive segmental strains is lacking. • The novel SLICE technique derives segmental strains from standard CMR cine images. • SLICE-derived strain markers of CRT response showed close agreement with CMR-TAG. • Future studies will focus on the prognostic value of SLICE in CRT candidates.

  10. Manifold learning based ECG-free free-breathing cardiac CINE MRI.

    Science.gov (United States)

    Usman, Muhammad; Atkinson, David; Kolbitsch, Christoph; Schaeffter, Tobias; Prieto, Claudia

    2015-06-01

    To present and validate a manifold learning (ML)-based method that can estimate both cardiac and respiratory navigator signals from electrocardiogram (ECG)-free free-breathing cardiac magnetic resonance imaging (MRI) data to achieve self-gated retrospective CINE reconstruction. In this work the use of the ML method is demonstrated for 2D cardiac CINE to achieve both cardiac and respiratory self-gating without the need of an external navigator or ECG signal. This is achieved by sequentially applying ML to two sets of retrospectively reconstructed real-time images with differing temporal resolutions. A 1D cardiac signal is estimated by applying ML to high temporal resolution real-time images reconstructed from the acquired data. Using the estimated cardiac signal, a 1D respiratory signal was obtained by applying the ML method to low temporal resolution images reconstructed from the same acquired data for each cardiac cycle. Data were acquired in five volunteers with a 2D golden angle radial trajectory in a balanced steady-state free precession (b-SSFP) acquisition. The accuracy of the estimated cardiac signal was calculated as the standard deviation of the temporal difference between the estimated signal and the recorded ECG. The correlation between the estimated respiratory signal and standard pencil beam navigator signal was evaluated. Gated CINE reconstructions (20 cardiac phases per cycle, temporal resolution ∼30 msec) using the estimated cardiac and respiratory signals were qualitatively compared against conventional ECG-gated breath-hold CINE acquisitions. Accurate cardiac signals were estimated with the proposed method, with an error standard deviation in comparison to ECG lower than 20 msec. Respiratory signals estimated with the proposed method achieved a mean cross-correlation of 94% with respect to standard pencil beam navigator signals. Good quality visual scores of 2.80 ± 0.45 (scores from 0, bad, to 4, excellent quality) were observed for the

  11. [Assessment of influence of breath holding and hyperventilation on human postural stability with spectral analysis of stabilographic signal].

    Science.gov (United States)

    Malakhov, M V; Makarenkova, E A; Mel'nikov, A A; Vikulov, A D

    2014-01-01

    The influence of breath holding and voluntary hyperventilation on the classic stabilometric parameters and the frequency characteristic of stabilographic signal were studied. We measured the stabilometric parameters on the force platform ("Ritm", Russia) on the healthy volunteers (n = 107) during quiet breath, voluntary hyperventilation (20 seconds) and maximal inspiratory breath holding (20 seconds). Respiratory frequency, respiratory amplitude and ventilation were estimated with strain gauge. We found that antero-posterior and medio-lateral sway amplitude and velocity as well as sway surface at breath-holding and at quiet breathing were the same, so breath holding didn't influence the postural stability. However the spectral parameters shifted to the high frequency range due to alteration of the respiratory muscles contractions during breath-holding versus quiet breath. Voluntary hyperventilation caused significant increase of all stabilographic indices that implied an impairment of postural stability, which was due to the increase of respiration frequency and amplitude. We also found that the spectral indices moved toward the high-frequency range with more pronounced degree of this shift versus breath holding. Besides, amplitudes of spectral peaks also increased. Perhaps such change of spectral indices was due to distortion of proprioceptive information because of increased excitability of nerve fibers during hyperventilation. Maximal inspiration breath holding causes strain of the postural control mechanisms that is reflected as elevation of postural sway frequency with no postural stability changes. Hyperventilation leads to the most prominent strain of balance function and decrease of steadiness that is manifested as increase of center of pressure oscillations amplitude and frequency.

  12. Analysis of 3-D Tongue Motion from Tagged and Cine Magnetic Resonance Images

    Science.gov (United States)

    Xing, Fangxu; Woo, Jonghye; Lee, Junghoon; Murano, Emi Z.; Stone, Maureen; Prince, Jerry L.

    2016-01-01

    Purpose: Measuring tongue deformation and internal muscle motion during speech has been a challenging task because the tongue deforms in 3 dimensions, contains interdigitated muscles, and is largely hidden within the vocal tract. In this article, a new method is proposed to analyze tagged and cine magnetic resonance images of the tongue during…

  13. Functional imaging of murine hearts using accelerated self-gated UTE cine MRI

    NARCIS (Netherlands)

    Motaal, Abdallah G.; Noorman, Nils; de Graaf, Wolter L.; Hoerr, Verena; Florack, Luc M. J.; Nicolay, Klaas; Strijkers, Gustav J.

    2015-01-01

    We introduce a fast protocol for ultra-short echo time (UTE) Cine magnetic resonance imaging (MRI) of the beating murine heart. The sequence involves a self-gated UTE with golden-angle radial acquisition and compressed sensing reconstruction. The self-gated acquisition is performed asynchronously

  14. Presumed Arterial Gas Embolism After Breath-Hold Diving in Shallow Water.

    Science.gov (United States)

    Harmsen, Stefani; Schramm, Dirk; Karenfort, Michael; Christaras, Andreas; Euler, Michael; Mayatepek, Ertan; Tibussek, Daniel

    2015-09-01

    Dive-related injuries are relatively common, but almost exclusively occur in recreational or scuba diving. We report 2 children with acute central nervous system complications after breath-hold diving. A 12-year-old boy presented with unilateral leg weakness and paresthesia after diving beneath the water surface for a distance of ∼25 m. After ascent, he suddenly felt extreme thoracic pain that resolved spontaneously. Neurologic examination revealed right leg weakness and sensory deficits with a sensory level at T5. Spinal MRI revealed a nonenhancing T2-hyperintense lesion in the central cord at the level of T1/T2 suggesting a spinal cord edema. A few weeks later, a 13-year-old girl was admitted with acute dizziness, personality changes, confusion, and headache. Thirty minutes before, she had practiced diving beneath the water surface for a distance of ∼25 m. After stepping out, she felt sudden severe thoracic pain and lost consciousness. Shortly later she reported headache and vertigo, and numbness of the complete left side of her body. Neurologic examination revealed reduced sensibility to all modalities, a positive Romberg test, and vertigo. Cerebral MRI revealed no pathologic findings. Both children experienced a strikingly similar clinical course. The chronology of events strongly suggests that both patients were suffering from arterial gas embolism. This condition has been reported for the first time to occur in children after breath-hold diving beneath the water surface without glossopharyngeal insufflation. Copyright © 2015 by the American Academy of Pediatrics.

  15. Effects of piracetam on pediatric breath holding spells: a randomized double blind controlled trial.

    Science.gov (United States)

    Abbaskhanian, Ali; Ehteshami, Sara; Sajjadi, Sadegh; Rezai, Mohammad Sadegh

    2012-01-01

    Breath holding spells (BHS) are common paroxysmal non-epileptic events in the pediatric population which are very stressfull despite their harmless nature. There has been no specific treatment found for the spells yet. The aim of this study was to evaluate the efficacy of piracetam (2-oxo-l-pyrrolidine) on these children. In this randomized double blind clinical trial study, 150 children with severe BHS referred to our pediatric outpatient service were enrolled from August 2011 to July 2012. The patients were randomized into two equal groups. One received 40mg/kg/day piracetam and the other group received placebo, twice daily. Patients were followed monthly for three months. The number of attacks/month before and after treatment were documented. Of the enrolled patients, 86 were boys. The mean age of the patients was 17 months (range, 6 to 24 months). In the piracetam group, 1 month after treatment an 81% response to treatment was found. In the placebo group, none of the patients had complete remission and 7% of the cases had partial remission. Overall, control of breath-holding spells was observed in 91% of the patients in the group taking piracetam as compared with 16% in the group taking placebo at the end of the study. There was no significant difference detected between the groups regarding the prevalence of drug side effects. A significant difference was detected between piracetam and placebo in prevention and controlling BHS. Piracetam (40mg/kg/day) had a good effect on our patients.

  16. An Atypical Case of Taravana Syndrome in a Breath-Hold Underwater Fishing Champion: A Case Report

    Directory of Open Access Journals (Sweden)

    Andrea Cortegiani

    2013-01-01

    Full Text Available Dysbaric accidents are usually referred to compressed air-supplied diving. Nonetheless, some cases of decompression illness are known to have occurred among breath-hold (BH divers also, and they are reported in the medical literature. A male BH diver (57 years old, underwater fishing champion, presented neurological disorders as dizziness, sensory numbness, blurred vision, and left frontoparietal pain after many dives to a 30–35 meters sea water depth with short surface intervals. Symptoms spontaneously regressed and the patient came back home. The following morning, pain and neurological impairment occurred again and the diver went by himself to the hospital where he had a generalized tonic-clonic seizure and lost consciousness. A magnetic resonance imaging of the brain disclofsed a cortical T1-weighted hypointense area in the temporal region corresponding to infarction with partial hemorrhage. An early hyperbaric oxygen therapy led to prompt resolution of neurological findings. All clinical and imaging characteristics were referable to the Taravana diving syndrome, induced by repetitive prolonged deep BH dives. The reappearance of neurological signs after an uncommon 21-hour symptom-free interval may suggest an atypical case of Taravana syndrome.

  17. Functional imaging of murine hearts using accelerated self-gated UTE cine MRI.

    Science.gov (United States)

    Motaal, Abdallah G; Noorman, Nils; de Graaf, Wolter L; Hoerr, Verena; Florack, Luc M J; Nicolay, Klaas; Strijkers, Gustav J

    2015-01-01

    We introduce a fast protocol for ultra-short echo time (UTE) Cine magnetic resonance imaging (MRI) of the beating murine heart. The sequence involves a self-gated UTE with golden-angle radial acquisition and compressed sensing reconstruction. The self-gated acquisition is performed asynchronously with the heartbeat, resulting in a randomly undersampled kt-space that facilitates compressed sensing reconstruction. The sequence was tested in 4 healthy rats and 4 rats with chronic myocardial infarction, approximately 2 months after surgery. As a control, a non-accelerated self-gated multi-slice FLASH sequence with an echo time (TE) of 2.76 ms, 4.5 signal averages, a matrix of 192 × 192, and an acquisition time of 2 min 34 s per slice was used to obtain Cine MRI with 15 frames per heartbeat. Non-accelerated UTE MRI was performed with TE = 0.29 ms, a reconstruction matrix of 192 × 192, and an acquisition time of 3 min 47 s per slice for 3.5 averages. Accelerated imaging with 2×, 4× and 5× undersampled kt-space data was performed with 1 min, 30 and 15 s acquisitions, respectively. UTE Cine images up to 5× undersampled kt-space data could be successfully reconstructed using a compressed sensing algorithm. In contrast to the FLASH Cine images, flow artifacts in the UTE images were nearly absent due to the short echo time, simplifying segmentation of the left ventricular (LV) lumen. LV functional parameters derived from the control and the accelerated Cine movies were statistically identical.

  18. Real-time SPARSE-SENSE cardiac cine MR imaging: optimization of image reconstruction and sequence validation.

    Science.gov (United States)

    Goebel, Juliane; Nensa, Felix; Bomas, Bettina; Schemuth, Haemi P; Maderwald, Stefan; Gratz, Marcel; Quick, Harald H; Schlosser, Thomas; Nassenstein, Kai

    2016-12-01

    Improved real-time cardiac magnetic resonance (CMR) sequences have currently been introduced, but so far only limited practical experience exists. This study aimed at image reconstruction optimization and clinical validation of a new highly accelerated real-time cine SPARSE-SENSE sequence. Left ventricular (LV) short-axis stacks of a real-time free-breathing SPARSE-SENSE sequence with high spatiotemporal resolution and of a standard segmented cine SSFP sequence were acquired at 1.5 T in 11 volunteers and 15 patients. To determine the optimal iterations, all volunteers' SPARSE-SENSE images were reconstructed using 10-200 iterations, and contrast ratios, image entropies, and reconstruction times were assessed. Subsequently, the patients' SPARSE-SENSE images were reconstructed with the clinically optimal iterations. LV volumetric values were evaluated and compared between both sequences. Sufficient image quality and acceptable reconstruction times were achieved when using 80 iterations. Bland-Altman plots and Passing-Bablok regression showed good agreement for all volumetric parameters. 80 iterations are recommended for iterative SPARSE-SENSE image reconstruction in clinical routine. Real-time cine SPARSE-SENSE yielded comparable volumetric results as the current standard SSFP sequence. Due to its intrinsic low image acquisition times, real-time cine SPARSE-SENSE imaging with iterative image reconstruction seems to be an attractive alternative for LV function analysis. • A highly accelerated real-time CMR sequence using SPARSE-SENSE was evaluated. • SPARSE-SENSE allows free breathing in real-time cardiac cine imaging. • For clinically optimal SPARSE-SENSE image reconstruction, 80 iterations are recommended. • Real-time SPARSE-SENSE imaging yielded comparable volumetric results as the reference SSFP sequence. • The fast SPARSE-SENSE sequence is an attractive alternative to standard SSFP sequences.

  19. Algebraic Reconstruction Technique (ART) for parallel imaging reconstruction of undersampled radial data: Application to cardiac cine

    Science.gov (United States)

    Li, Shu; Chan, Cheong; Stockmann, Jason P.; Tagare, Hemant; Adluru, Ganesh; Tam, Leo K.; Galiana, Gigi; Constable, R. Todd; Kozerke, Sebastian; Peters, Dana C.

    2014-01-01

    Purpose To investigate algebraic reconstruction technique (ART) for parallel imaging reconstruction of radial data, applied to accelerated cardiac cine. Methods A GPU-accelerated ART reconstruction was implemented and applied to simulations, point spread functions (PSF) and in twelve subjects imaged with radial cardiac cine acquisitions. Cine images were reconstructed with radial ART at multiple undersampling levels (192 Nr x Np = 96 to 16). Images were qualitatively and quantitatively analyzed for sharpness and artifacts, and compared to filtered back-projection (FBP), and conjugate gradient SENSE (CG SENSE). Results Radial ART provided reduced artifacts and mainly preserved spatial resolution, for both simulations and in vivo data. Artifacts were qualitatively and quantitatively less with ART than FBP using 48, 32, and 24 Np, although FBP provided quantitatively sharper images at undersampling levels of 48-24 Np (all pART was comparable to CG SENSE. GPU-acceleration increased ART reconstruction speed 15-fold, with little impact on the images. Conclusion GPU-accelerated ART is an alternative approach to image reconstruction for parallel radial MR imaging, providing reduced artifacts while mainly maintaining sharpness compared to FBP, as shown by its first application in cardiac studies. PMID:24753213

  20. Accuracy and effectiveness of self-gating signals in free-breathing three-dimensional cardiac cine magnetic resonance imaging

    Science.gov (United States)

    Li, Shuo; Wang, Lei; Zhu, Yan-Chun; Yang, Jie; Xie, Yao-Qin; Fu, Nan; Wang, Yi; Gao, Song

    2016-12-01

    Conventional multiple breath-hold two-dimensional (2D) balanced steady-state free precession (SSFP) presents many difficulties in cardiac cine magnetic resonance imaging (MRI). Recently, a self-gated free-breathing three-dimensional (3D) SSFP technique has been proposed as an alternative in many studies. However, the accuracy and effectiveness of self-gating signals have been barely studied before. Since self-gating signals are crucially important in image reconstruction, a systematic study of self-gating signals and comparison with external monitored signals are needed. Previously developed self-gated free-breathing 3D SSFP techniques are used on twenty-eight healthy volunteers. Both electrocardiographic (ECG) and respiratory bellow signals are also acquired during the scan as external signals. Self-gating signal and external signal are compared by trigger and gating window. Gating window is proposed to evaluate the accuracy and effectiveness of respiratory self-gating signal. Relative deviation of the trigger and root-mean-square-deviation of the cycle duration are calculated. A two-tailed paired t-test is used to identify the difference between self-gating and external signals. A Wilcoxon signed rank test is used to identify the difference between peak and valley self-gating triggers. The results demonstrate an excellent correlation (P = 0, R > 0.99) between self-gating and external triggers. Wilcoxon signed rank test shows that there is no significant difference between peak and valley self-gating triggers for both cardiac (H = 0, P > 0.10) and respiratory (H = 0, P > 0.44) motions. The difference between self-gating and externally monitored signals is not significant (two-tailed paired-sample t-test: H = 0, P > 0.90). The self-gating signals could demonstrate cardiac and respiratory motion accurately and effectively as ECG and respiratory bellow. The difference between the two methods is not significant and can be explained. Furthermore, few ECG trigger errors

  1. High spatial and temporal resolution retrospective cine cardiovascular magnetic resonance from shortened free breathing real-time acquisitions.

    Science.gov (United States)

    Xue, Hui; Kellman, Peter; Larocca, Gina; Arai, Andrew E; Hansen, Michael S

    2013-11-14

    Cine cardiovascular magnetic resonance (CMR) is challenging in patients who cannot perform repeated breath holds. Real-time, free-breathing acquisition is an alternative, but image quality is typically inferior. There is a clinical need for techniques that achieve similar image quality to the segmented cine using a free breathing acquisition. Previously, high quality retrospectively gated cine images have been reconstructed from real-time acquisitions using parallel imaging and motion correction. These methods had limited clinical applicability due to lengthy acquisitions and volumetric measurements obtained with such methods have not previously been evaluated systematically. This study introduces a new retrospective reconstruction scheme for real-time cine imaging which aims to shorten the required acquisition. A real-time acquisition of 16-20s per acquired slice was inputted into a retrospective cine reconstruction algorithm, which employed non-rigid registration to remove respiratory motion and SPIRiT non-linear reconstruction with temporal regularization to fill in missing data. The algorithm was used to reconstruct cine loops with high spatial (1.3-1.8 × 1.8-2.1 mm²) and temporal resolution (retrospectively gated, 30 cardiac phases, temporal resolution 34.3 ± 9.1 ms). Validation was performed in 15 healthy volunteers using two different acquisition resolutions (256 × 144/192 × 128 matrix sizes). For each subject, 9 to 12 short axis and 3 long axis slices were imaged with both segmented and real-time acquisitions. The retrospectively reconstructed real-time cine images were compared to a traditional segmented breath-held acquisition in terms of image quality scores. Image quality scoring was performed by two experts using a scale between 1 and 5 (poor to good). For every subject, LAX and three SAX slices were selected and reviewed in the random order. The reviewers were blinded to the reconstruction approach and acquisition protocols and

  2. Anxiety sensitivity and breath-holding duration in relation to PTSD symptom severity among trauma exposed adults.

    Science.gov (United States)

    Berenz, Erin C; Vujanovic, Anka A; Coffey, Scott F; Zvolensky, Michael J

    2012-01-01

    The present investigation examined the main and interactive effects of anxiety sensitivity and behavioral distress tolerance, indexed using the breath-holding task, in relation to PTSD symptom severity among trauma-exposed adults. Participants were 88 adults (63.6% women; M(age)=22.9, SD=9.1, range=18-62), recruited from the community, who met DSM-IV-TR PTSD Criterion A for lifetime trauma exposure. Covariates included number of potentially traumatic events, nonclinical panic attack history, and participant sex. Anxiety sensitivity was significantly incrementally associated with PTSD total symptom severity, as well as Avoidance and Hyperarousal symptom severity (p'sseverity (p's>.05). However, breath-holding duration emerged as a significant moderator of the association between anxiety sensitivity and PTSD Avoidance symptom severity, such that lower breath-holding duration exacerbated the effect of heightened anxiety sensitivity with regard to PTSD Avoidance symptom severity. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. [The use of Pantogam syrup in treating small children's breath holding spells].

    Science.gov (United States)

    Polskaya, A V; Chutko, L S; Jakovenko, E V

    To study the efficacy of pantogam syrup 10% (hopantenic acid) in the treatment of breath-holding spells (BHS). Sixty children, aged from 2 to 4 years, with BHS were studied. The evaluation of clinical manifestations and anxiety level was performed. Results of neurophysiological examination (long-term video-EEG-monitoring) were analyzed. Children were divided into 2 groups: main, in which the patients received pantogam syrup, and control group, in which only psychological methods were used. The results of the clinical and neurophysiological studies performed after the treatment, showed the clinical improvement in 73.3% of patients of the main group compared with similar data from the children in the control group (16.7%). The anxiety level significantly decreased after the neuroprotective therapy. A comparative analysis of electroencephalographic indicators demonstrated a significant (рchildren with BHS.

  4. Computer tomography guided lung biopsy using interactive breath-hold control

    DEFF Research Database (Denmark)

    Ashraf, Haseem; Krag-Andersen, Shella; Naqibullah, Matiullah

    2017-01-01

    BACKGROUND: Interactive breath-hold control (IBC) may improve the accuracy and decrease the complication rate of computed tomography (CT)-guided lung biopsy, but this presumption has not been proven in a randomized study. METHODS: Patients admitted for CT-guided lung biopsy were randomized...... to biopsy either with (N=201) or without (N=206) IBC. Biopsy accuracy, procedure time, radiation, and complications were compared in the two groups. Predictors for pneumothorax were analyzed. RESULTS: Procedures performed with the use of IBC (N=130) did not show higher biopsy accuracy (P=0.979) but were...... associated with a higher risk of pneumothorax (P=0.022) compared to procedures without the use of IBC (N=171). Overall, 50% of the biopsies were malignant, 13% were benign, and 33% were inconclusive (4% missing). Long needle time (P=0.037) and small nodule size (P=0.001) were predictors of pneumothorax...

  5. Laughter is not always funny: breath-holding spells in familial dysautonomia.

    Science.gov (United States)

    Maayan, Channa; Katz, Eliot; Begin, Michal; Yuvchev, Ivelin; Kharasch, Virginia S

    2015-02-01

    Familial dysautonomia (FD) is a genetic disease characterized by primary autonomic dysfunction including parasympathetic hypersensitivity. Breath-holding spells (BHS) are believed to be caused by autonomic dysregulation mediated via the vagus nerve and increased in patients with a family history of BHS. Details and understanding of its pathophysiology are lacking. In this retrospective study of patients with FD, the incidence of BHS was higher at 53.3%, compared with previous studies in normal children. Laughter as a precipitating factor for BHS has not been previously reported in FD and occurred in 10% of patients in this study. Lower lung volumes, chronic lung disease, chronic CO2 retention, and inadequate autonomic compensation occur in those with FD leading to a higher incidence and severity of BHS when crying or laughing. Thus, FD may be a good model for understanding manifestations of the autonomic nervous system dysfunction and contribute to our knowledge of BHS mechanisms. © The Author(s) 2014.

  6. Effects of Piracetam on Pediatric Breath Holding Spells: A Randomized Double Blind Controlled Trial

    Science.gov (United States)

    ABBASKHANIAN, Ali; EHTESHAMI, Sara; SAJJADI, Sadegh; REZAI, Mohammad Sadegh

    2012-01-01

    Objective Breath holding spells (BHS) are common paroxysmal non-epileptic events in the pediatric population which are very stressfull despite their harmless nature. There has been no specific treatment found for the spells yet. The aim of this study was to evaluate the efficacy of piracetam (2-oxo-l-pyrrolidine) on these children. Materials & Methods In this randomized double blind clinical trial study, 150 children with severe BHS referred to our pediatric outpatient service were enrolled from August 2011 to July 2012. The patients were randomized into two equal groups. One received 40mg/kg/day piracetam and the other group received placebo, twice daily. Patients were followed monthly for three months. The number of attacks/month before and after treatment were documented. Results Of the enrolled patients, 86 were boys. The mean age of the patients was 17 months (range, 6 to 24 months). In the piracetam group, 1 month after treatment an 81% response to treatment was found. In the placebo group, none of the patients had complete remission and 7% of the cases had partial remission. Overall, control of breath-holding spells was observed in 91% of the patients in the group taking piracetam as compared with 16% in the group taking placebo at the end of the study. There was no significant difference detected between the groups regarding the prevalence of drug side effects. Conclusion A significant difference was detected between piracetam and placebo in prevention and controlling BHS. Piracetam (40mg/kg/day) had a good effect on our patients. PMID:24665274

  7. Effect of cardiogenic gas mixing on arterial O2 and CO2 tensions during breath holding.

    Science.gov (United States)

    Kelly, S M; Brancatisano, A P; Engel, L A

    1987-04-01

    To examine the effect of cardiogenic gas mixing on gas exchange we measured arterial tension of O2 (PaO2) and arterial tension of CO2 (PaCO2) during 3- to 5-min breath holds (BH) before and after infusing 50 ml of saline into the pericardial space (PCF) of seven anesthetized, paralyzed, mechanically ventilated dogs. During BH the ventilator was disconnected and a bias flow of 50% O2 at 4-5 l/min was delivered through the side ports of a small catheter whose tip was positioned 1 cm cephalad of the carina. Paired runs, alternately with and without PCF, were performed in triplicate in each dog. Initial PaO2 was similar for control runs [81 +/- 3 mmHg (SE)] and PCF runs (78 +/- 3 mmHg; P greater than 0.1). After 3-min BH, PaO2 in PCF runs (33 +/- 3 mmHg) was less than that in control runs (58 +/- 4 mmHg) (P less than 0.001). In contrast, the pattern of PaCO2 during BH did not differ with PCF. After 3-min BH, PaCO2 was 49 +/- 3 mmHg with PCF and 49 +/- 2 mmHg in the control runs (P greater than 0.7). In two dogs, repeated 50-ml reductions in lung volume, produced by rib cage compression, did not alter the time course of PaO2 during BH. Although cardiac output decreased slightly with PCF, hemodynamic changes due to PCF were unlikely to account for the observed fall in PaO2. Our results indicate a substantial effect of cardiogenic gas mixing on O2 uptake when tracheal gas is O2 enriched during breath holding.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Evaluation of a reproducible breath hold technique for\\ud the SABR treatment of lower lobe lung tumours

    OpenAIRE

    Barrett, Sarah; Taylor, Amy; Rock, Luke

    2017-01-01

    Aim\\ud Deep inspiration breath hold (DIBH) is a method of motion management used in\\ud stereotactic ablative body radiotherapy (SABR) for lung tumours. An external gating\\ud block marker can be used as a tumour motion surrogate, however, inter-fraction gross\\ud target volume (GTV) displacement within DIBH occurs. This study measured this\\ud displacement during a reproducible breath hold regime. Additionally, factors such as\\ud position of the gating block marker were analysed.\\ud Methods and ...

  9. SU-F-T-644: Reproducibility of Target Position Using Moderate Voluntary Breath- Hold During Liver Stereotactic Ablative Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Cui, G; Trakul, N; Chang, E; Shiu, A [University Southern California, Los Angeles, CA (United States)

    2016-06-15

    Purpose: To evaluate the reproducibility of target position using moderate voluntary breath-hold during liver stereotactic ablative radiotherapy (SABR). Methods: Two patients who underwent liver SABR on a Varian TrueBeam STx linac were used for this study. Fiducial markers were placed in and around the target in the liver as surrogates for the target position and motion. GTVs were contoured by assessing tumor extent on contrast enhanced CT. The PTV was created from the GTV by adding 2 mm margins to account for the residual motion during breath-holds. A portable biofeedback system was used to facilitate the breath-hold to a reproducible position. The Varian RPM system was used for gating the linac. Proceeding each treatment, orthogonal kV pairs were taken, and alignment to nearby bony anatomy was performed. Then the breath-hold CBCT was acquired to align the fiducial markers. On-line fluoroscopy was used to fine-tune the breath-hold gating thresholds to correlate with the positions of the fiducial markers. The inter-fraction reproducibility of the target was evaluated by the offsets of the daily breath-hold CBCTs from the paired kV matches as a direct measure of the target position relative to the bony anatomy. The intra-fraction reproducibility of the target position was assessed by the gated window of the RPM marker block for each fraction. Results: The absolute mean offsets between the CBCT and paired kV matches in the vertical, longitudinal, and lateral directions were 0.06 cm, 0.10 cm, and 0.06 cm for patient 1, and 0.37 cm, 0.62 cm, and 0.09 cm for patient 2. The gated window of the RPM marker block for the breath-hold for each fraction was within 0.63 ± 0.16 cm and 0.59 ± 0.12 cm for patients 1 and 2, respectively. Conclusion: Moderate voluntary breath-hold showed good inter- and intra-fraction reproducibility of target position during liver SABR.

  10. Imaging Three-Dimensional Myocardial Mechanics Using Navigator-gated Volumetric Spiral Cine DENSE MRI

    Science.gov (United States)

    Zhong, Xiaodong; Spottiswoode, Bruce S.; Meyer, Craig H.; Kramer, Christopher M.; Epstein, Frederick H.

    2010-01-01

    A navigator-gated 3D spiral cine displacement encoding with stimulated echoes (DENSE) pulse sequence for imaging 3D myocardial mechanics was developed. In addition, previously-described 2D post-processing algorithms including phase unwrapping, tissue tracking, and strain tensor calculation for the left ventricle (LV) were extended to 3D. These 3D methods were evaluated in 5 healthy volunteers, using 2D cine DENSE and historical 3D myocardial tagging as reference standards. With an average scan time of 20.5 ± 5.7 minutes, 3D data sets with a matrix size of 128 × 128 × 22, voxel size of 2.8 × 2.8 × 5.0 mm3, and temporal resolution of 32 ms were obtained with displacement encoding in three orthogonal directions. Mean values for end-systolic mid-ventricular mid-wall radial, circumferential, and longitudinal strain were 0.33 ± 0.10, −0.17 ± 0.02, and −0.16 ± 0.02, respectively. Transmural strain gradients were detected in the radial and circumferential directions, reflecting high spatial resolution. Good agreement by linear correlation and Bland-Altman analysis was achieved when comparing normal strains measured by 2D and 3D cine DENSE. Also, the 3D strains, twist, and torsion results obtained by 3D cine DENSE were in good agreement with historical values measured by 3D myocardial tagging. PMID:20574967

  11. Cine MR imaging in mitral valve prolapse; Study on mitral regurgitation and left atrial volume

    Energy Technology Data Exchange (ETDEWEB)

    Kumai, Toshihiko (Chiba Univ. (Japan). School of Medicine)

    1993-02-01

    This study was undertaken to assess the ability of cine MR imaging to evaluate the direction, timing, and severity of mitral regurgitation in patients with mitral valve prolapse (MVP). The population of this study was 33 patients with MVP diagnosed by two-dimensional echocardiography and 10 patients with rheumatic mitral valve disease (MSR) for comparison. 7 patients with MVP and 5 with MSR had atrial fibrillation and/or history of congestive heart failure as complications. Mitral regurgitation was graded for severity by color Doppler flow imaging in all patients. Direction and size of systolic flow void in the left atrium were analyzed by contiguous multilevel cine MR images and the maximum volumes of flow void and left atrium were measured. Although flow void was found at the center of the left atrium in most of MSR, it was often directed along the postero-caudal atrial wall in anterior leaflet prolapse and along the anterocranial atrial wall in posterior leaflet prolapse. In MVP, the maximum volume of flow void was often seen in late systole. The maximum volume of flow void and that of left atrium were significantly larger in patients with atrial fibrillation and/or history of congestive heart failure. The length and volume of flow void were increased with clinical severity and degree of regurgitation determined by color Doppler flow imaging. Thus cine MR imaging provides a useful means for detection and semiquantitative evaluation of mitral regurgitation in subjects with MVP. (author).

  12. Right ventricular volume and mass determined by cine magnetic resonance imaging in HIV patients with possible right ventricular dysfunction

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette; Gerstoft, Jan

    2006-01-01

    Impaired right ventricular (RV) function has been reported to occur in patients with HIV when studied by echocardiography. However, for accurate evaluation of RV function and morphology, first-pass radionuclide ventriculography (RNV) and cine magnetic resonance imaging (cine-MRI) are methods...... ventricular ejection fraction (RVEF). To do so, we screened patients with RNV and performed an additional cine-MRI in those with reduced RVEF determined by RNV. Ninety patients with HIV were included. To evaluate the MRI measures exactly we included 18 age- and gender-matched healthy volunteers to establish...

  13. Evaluation of motion measurement using cine MRI for image guided stereotactic body radiotherapy on a new phantom platform

    Science.gov (United States)

    Cai, Jing; Wang, Ziheng; Yin, Fang-Fang

    2011-01-01

    The objective of this study is to investigate accuracy of motion tracking of cine magnetic resonance imaging (MRI) for image-guided stereotactic body radiotherapy. A phantom platform was developed in this work to fulfill the goal. The motion phantom consisted of a platform, a solid thread, a motor and a control system that can simulate motion in various modes. To validate its reproducibility, the phantom platform was setup three times and imaged with fluoroscopy using an electronic portal imaging device (EPID) for the same motion profile. After the validation test, the phantom platform was evaluated using cine MRI at 2.5 frames/second on a 1.5T GE scanner using five different artificial profiles and five patient profiles. The above profiles were again measured with EPID fluoroscopy and used as references. Discrepancies between measured profiles from cine MRI and EPID were quantified using root-mean-square (RMS) and standard deviation (SD). Pearson’s product moment correlational analysis was used to test correlation. The standard deviation for the reproducibility test was 0.28 mm. The discrepancies (RMS) between all profiles measured by cine MRI and EPID fluoroscopy ranged from 0.30 to 0.49 mm for artificial profiles and ranged from 0.75 to 0.91 mm for five patient profiles. The cine MRI sequence could precisely track phantom motion and the proposed motion phantom was feasible to evaluate cine MRI accuracy. PMID:29296304

  14. Impact of beam angle choice on pencil beam scanning breath-hold proton therapy for lung lesions

    DEFF Research Database (Denmark)

    Gorgisyan, Jenny; Perrin, Rosalind; Lomax, Antony J

    2017-01-01

    INTRODUCTION: The breath-hold technique inter alia has been suggested to mitigate the detrimental effect of motion on pencil beam scanned (PBS) proton therapy dose distributions. The aim of this study was to evaluate the robustness of incident proton beam angles to day-to-day anatomical variation...

  15. Accelerated three-dimensional cine phase contrast imaging using randomly undersampled echo planar imaging with compressed sensing reconstruction.

    Science.gov (United States)

    Basha, Tamer A; Akçakaya, Mehmet; Goddu, Beth; Berg, Sophie; Nezafat, Reza

    2015-01-01

    The aim of this study was to implement and evaluate an accelerated three-dimensional (3D) cine phase contrast MRI sequence by combining a randomly sampled 3D k-space acquisition sequence with an echo planar imaging (EPI) readout. An accelerated 3D cine phase contrast MRI sequence was implemented by combining EPI readout with randomly undersampled 3D k-space data suitable for compressed sensing (CS) reconstruction. The undersampled data were then reconstructed using low-dimensional structural self-learning and thresholding (LOST). 3D phase contrast MRI was acquired in 11 healthy adults using an overall acceleration of 7 (EPI factor of 3 and CS rate of 3). For comparison, a single two-dimensional (2D) cine phase contrast scan was also performed with sensitivity encoding (SENSE) rate 2 and approximately at the level of the pulmonary artery bifurcation. The stroke volume and mean velocity in both the ascending and descending aorta were measured and compared between two sequences using Bland-Altman plots. An average scan time of 3 min and 30 s, corresponding to an acceleration rate of 7, was achieved for 3D cine phase contrast scan with one direction flow encoding, voxel size of 2 × 2 × 3 mm(3) , foot-head coverage of 6 cm and temporal resolution of 30 ms. The mean velocity and stroke volume in both the ascending and descending aorta were statistically equivalent between the proposed 3D sequence and the standard 2D cine phase contrast sequence. The combination of EPI with a randomly undersampled 3D k-space sampling sequence using LOST reconstruction allows a seven-fold reduction in scan time of 3D cine phase contrast MRI without compromising blood flow quantification. Copyright © 2014 John Wiley & Sons, Ltd.

  16. β1-Blockade increases maximal apnea duration in elite breath-hold divers.

    Science.gov (United States)

    Hoiland, Ryan L; Ainslie, Philip N; Bain, Anthony R; MacLeod, David B; Stembridge, Mike; Drvis, Ivan; Madden, Dennis; Barak, Otto; MacLeod, Douglas M; Dujic, Zeljko

    2017-04-01

    We hypothesized that the cardioselective β1-adrenoreceptor antagonist esmolol would improve maximal apnea duration in elite breath-hold divers. In elite national-level divers (n = 9), maximal apneas were performed in a randomized and counterbalanced order while receiving either iv esmolol (150 μg·kg-1·min-1) or volume-matched saline (placebo). During apnea, heart rate (ECG), beat-by-beat blood pressure, stroke volume (SV), cardiac output (CO), and total peripheral resistance (TPR) were measured (finger photoplethysmography). Myocardial oxygen consumption (MV̇o2) was estimated from rate pressure product. Cerebral blood flow through the internal carotid (ICA) and vertebral arteries (VA) was assessed using Duplex ultrasound. Apnea duration improved in the esmolol trial when compared with placebo (356 ± 57 vs. 323 ± 61 s, P oxyhemoglobin saturation (71.8 ± 10.3 vs. 74.9 ± 9.5%, P = 0.10). The HR response to apnea was reduced by esmolol at 10-30% of apnea duration, whereas MAP was unaffected. Esmolol reduced SV (main effect, P < 0.05) and CO (main effect; P < 0.05) and increased TPR (main effect, P < 0.05) throughout apnea. Esmolol also reduced MV̇o2 throughout apnea (main effect, P < 0.05). Cerebral blood flow through the ICA and VA was unchanged by esmolol at baseline and the last 30 s of apnea; however, global cerebral blood flow was reduced in the esmolol trial at end-apnea (P < 0.05). Our findings demonstrate that, in elite breath-hold divers, apnea breakpoint is improved by β1-blockade, likely owing to an improved total body oxygen sparring through increased centralization of blood volume (↑TPR) and reduced MV̇o2NEW & NOTEWORTHY The governing bodies for international apnea competition, the Association Internationale pour le Développment de l'Apnée and La Confédération Mondaile des Activités Subaquatiques, have banned the use of β-blockers based on anecdotal reports that they improve apnea duration. Using a randomized placebo-controlled trial

  17. Genetic predisposition to breath-hold diving-induced hemoptysis: Preliminary study.

    Science.gov (United States)

    Cialoni, Danilo; Marabotti, Claudio; Sponsiello, Nicola; Pieri, Massimo; Balestra, Costantino; Lucchini, Vittorio; Marroni, Alessandro

    2015-01-01

    Breath-hold diving-induced hemoptysis (BH-DIH) has been reported in about 25% breath-hold divers (BHD) and is characterized by dyspnea, coughing, hemoptysis and chest pain. We investigated whether eNOS G894T, eNOS T786C and ACE insertion/deletion I/D genetic variants, are possible BH-DIH risk factors. 108 experienced healthy instructor BHDs with the same minimum requirements (102 male, six female; mean age 43.90 ± 7.49) were studied. We looked for different eNOS G894T, eNOS T786C and ACE insertion/ deletion genetic variants between BH-DIH-positive and BH-DIH-negative subjects to identify the variants most frequently associated with BH-DIH. At least one BH-DIH episode was reported by 22.2% of subjects, while 77.7% never reported BH-DIH. The majority of BH-DIH-positive subjects showed eNOS G894T (p = 0.001) and eNOS-T786C (p = 0.001) genotype "TT" (high-risk profile). Prevalence of BH-DIH was higher in subjects with eNOS G894T TT genotype (50%) than in subjects with GT (9.5%, p < 0.001) and GG (24%, (p = 0.0002) genotype (low-risk profile). Similar results were observed for eNOS T786C: BH-DIH prevalence was higher in the TT genotype (41.2%) group than in the CT (15.4%, p < 0.001) and CC genotype (9.1%, p < 0.001) groups. BH-DIH prevalence was significantly higher in subjects showing ACE ID genotype (34.5%) than II (0%, p < 0.001) and DD (10.5%, p = 0.0002). Of the ACE "II" genotype group, 100% never developed BH-DIH. eNOS-G894T, eNOS-T786C and ACE influence NO availability and regulation of peripheral vascular tone and blood flow. Different genetic variants of eNOS-G894T, eNOS-T786C and ACE appear significantly related to the probability to develop BH-DIH (p < 0.001).

  18. SU-E-J-33: Cardiac Movement in Deep Inspiration Breath-Hold for Left-Breast Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, M; Lee, S; Suh, T [Department of Biomedical Engineering, Research Institute of Biomedical Engineering, Catholic University of Korea, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: The present study was designed to investigate the displacement of heart using Deep Inspiration Breath Hold (DIBH) CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Methods: Treatment planning was performed on the computed tomography (CT) datasets of 20 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ≥ 95% of the prescribed dose and that the volume inside the CTV receiving > 107% of the prescribed dose should be minimized. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. Results: The maximum and minimum left-right (LR) displacements of heart were 8.9 mm and 3 mm, respectively. The heart moved > 4 mm in the LR direction in 17 of the 20 patients. The distances between the heart and left breast ranged from 8.02–17.68 mm (mean, 12.23 mm) and 7.85–12.98 mm (mean, 8.97 mm) with DIBH CT and FB CT, respectively. The maximum doses to the heart were 3115 cGy and 4652 cGy for the DIBH and FB CT dataset, respectively. Conclusion: The present study has demonstrated that the DIBH technique could help to reduce the risk of radiation dose-induced cardiac toxicity by using movement of cardiac; away from radiation field. The DIBH technique could be used in an actual treatment room for a few minutes and could effectively reduce the cardiac dose when used with a sub-device or image acquisition standard to maintain consistent respiratory motion.

  19. Whole heart cine MR imaging of pulmonary veins in patients with congenital heart disease. Comparison with Spin Echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mitsui, Hideaki [Yamagata City Hospital Saiseikan (Japan); Saito, Haruo; Ishibashi, Tadashi; Takahashi, Shoki; Zuguchi, Masayuki; Yamada, Shogo

    2002-01-01

    We evaluated the accuracy of Whole Heart Cine (WHC) magnetic resonance (MR) imaging in the depiction of pulmonary veins (PVs) in patients with congenital heart disease (CHD) compared to that of spin echo (SE) MR imaging. Among our 35 patients, 4 patients had anomalous PV return. Detectability of four PVs on each MR examination images were evaluated. MR imaging is an effective modality for the clarification of PVs, and WHC MR imaging is more useful in delineating PV anomalies than SE MR imaging. (author)

  20. Cyanotic breath-holding spells in children respond to adenotonsillectomy for sleep-disordered breathing.

    Science.gov (United States)

    Guilleminault, Christian; Huang, Yu-Shu; Chan, Allison; Hagen, Chad C

    2007-12-01

    Children with breath-holding (BH) spells may demonstrate sleep-disordered breathing (SDB) during polysomnography. We studied five young children with cyanotic spells retrospectively and found both SDB and a response to adenotonsillectomy. We therefore proceeded with a prospective investigation of treatment for SDB in children with comorbid cyanotic spells. Nineteen children with cyanotic BH spells were identified and enrolled in the prospective study. Parents chose either treatment or observation. Fourteen children underwent complete SDB evaluation and treatment trials while five selected observation only (control group). Sleep and sleep-surgery specialist evaluation and polysomnography revealed the presence of a narrow upper-airway and an abnormal respiratory disturbance index in all 14 children. Nasal CPAP was not successful, but adenotonsillectomy performed near 14 months of age eliminated SDB. BH spells were eliminated 1 month after surgery, while they persisted to the end of the study (24 months of age) in the control group. In conclusion, the presence of cyanotic BH should prompt investigation and polysomnography for possible SDB. Independent treatment of SDB may hasten resolution of BH spells in these cases.

  1. Long-term prognosis for children with breath-holding spells.

    Science.gov (United States)

    Olsen, Anne Lise; Mathiasen, Rene; Rasmussen, Niels Henrik; Knudsen, Finn Ursin

    2010-11-01

    The aim of this study was to investigate the long-term prognosis for children with severe breath-holding spells (BHS). The study was a retrospective cohort study. Data from the medical records of all patients with severe BHS admitted during a ten-year period were recorded and a questionnaire was sent to the families. A matched group of adolescents with febrile convulsions served as controls (n = 289). A total of 85 out of 115 families (73.9%) responded. The mean age of the included patients was 20.5 years. Among first-degree relatives 21.5% had BHS and 14.6% had epilepsy. The peak age for severe BHS was 16 months. The children had a total of 1-25 attacks. All electrocardiogram (ECG) recordings were normal. One patient died of asystolia at the age of 20 years, ECG two weeks previously showed a WPW-block. Twenty-six (30.6%, p spells. Twenty-five (29.4%) had concentration problems. The grades achieved by BHD children at the final school exam did not differ from the mean values achieved by all children in the area. In this study on the long-term prognosis of children with BHS, we found a predisposition to fainting spells as expected. We also found that 29.4% of children with BHS had concentration problems. Further follow-up studies are needed to confirm this trend.

  2. Breath-holding spells occur disproportionately more often in children with transient erythroblastopenia.

    Science.gov (United States)

    Hellström Schmidt, Sanna; Tedgård, Ulf; Pronk, Cornelis J H

    2016-09-01

    This study aimed to evaluate the concomitant occurrence and possible association of breath-holding spells (BHS) and transient erythroblastopenia of childhood (TEC). This population-based cohort study, carried out in Southern Sweden from 2004 to 2014, included patients with BHS and/or anaemia, including TEC. The subjects were evaluated for the presence of all three conditions and the diagnostic workups, disease characteristics and outcome were analysed. We studied 443 470 children under the age of 10 years during 2004-2014. The total cohort included 321 patients (0.07%) with BHS and 366 patients with a selection of anaemia diagnoses, including 41 with TEC. We found that nine (2.5%) of the 366 patients with anaemia diagnoses also had BHS and that five (12.2%) of the 41 patients with TEC also had BHS. Treatment for anaemia resolved BHS in a number of patients. Our population-based analysis revealed an overrepresentation of BHS among children with TEC, and we identified five patients with concomitant TEC and BHS. We found that correcting anaemia was an effective means of ameliorating potentially debilitating BHS and that the presence of concomitant BHS and TEC was more common than previously assumed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. Breath holding endurance: stability over time and relationship with self-assessed persistence

    Directory of Open Access Journals (Sweden)

    Daisy G.Y. Thompson-Lake

    2017-09-01

    Full Text Available Breath holding (BH endurance has been suggested as a measure of the distress tolerance that could predict the outcome of attempts to implement behavior changes, such as stopping smoking or illicit substance use. It is not known however, to what degree BH endurance is a variable trait that may vary depending on situational context, or a stable state characteristic. We measured BH in two groups of participants at baseline and 22 and 89 days (N = 62 and N = 41 post-baseline and in a third group at multiple times points across a 5-week period (N = 44. Participants also filled out a questionnaire created to assess their perceived persistence compared to peers. Correlations were found between baseline and final BH measures (r’s > 0.67, p’s < 0.0001 at all time points. When groups were combined, regardless of time point, Spearman’s rank correlation showed a strong positive correlation (rs = 0.66, p < 0.0001. Self-assessed persistence was not related to BH endurance. This study provides evidence of the stability of BH across time when tested under the same conditions in young adults. Further research is needed to clarify whether BH is linked to behavioral outcomes.

  4. The value of neurologic and cardiologic assessment in breath holding spells.

    Science.gov (United States)

    Yilmaz, Unsal; Doksoz, Onder; Celik, Tanju; Akinci, Gulcin; Mese, Timur; Sevim Yilmaz, Tuba

    2014-01-01

    Objective : To evaluate the value of neurologic and cardiologic assessment and also the frequency of iron deficiency anemia in children with Breath Holding Spells (BHS). Methods : The hospital charts of patients diagnosed with BHS between 2011 and 2013 were reviewed retrospectively. Results : A total of 165 children (90 boys, 75 girls) with BHS comprised the study group. A matched group of 200 children with febrile convulsions served as controls. Among the first-degree relatives, 13.3% had BHS, 1.8% had febrile convulsions and 12.1% had epilepsy. The spells were cyanotic in 140 (84.8%) children and pallid or mixed in the remainder. BNS type was simple in 46.7% of patients and complicated in the remainder. Eighteen patients had abnormalities in electroencephalography, however only one patient was diagnosed with epilepsy. Sixty nine (47.9%) patients were found to have iron deficiency anemia. Conclusion : Referral of children with clinically definite BHS to pediatric neurology or pediatric cardiology clinics and performance of echocardiography and EEG investigations for exclusion of heart disease or epilepsy appear unnecessary. However, performance of an electrocardiogram to search for prolonged QT syndrome should be considered although no patient in our series had any cardiologic abnormalities.

  5. Measurement of ventricular volumes by cine magnetic resonance imaging in complex congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Niwa, Koichiro; Uchishiba, Mika; Aotsuka, Hiroyuki; Tateno, Shigeru; Tobita, Kimimasa; Hamada, Hiromichi; Matsuo, Kozo; Fujiwara, Tadashi [Chiba Children`s Hospital (Japan)

    1995-01-01

    Along with the remarkable improvement in surgical results for complex congenital heart disease (CCHD) in recent years, it has become increasingly important for pediatric cardiologist and cardiovascular surgeons to evaluate ventricular volumes in CCHD accurately to develop a proper strategy for treating these patients. However, the validity of geometric formulas to derive volumes in various morphological types of abnormal ventricles like those in CCHD has been problematic. This study assessed the validity and usefulness of cine magnetic resonance imaging (MRI) for measuring right and left ventricular volumes using Simpson`s rule in children with CCHD. Twenty-eight patients with CCHD (group A), children ranging in age from 4 months to 8 years (average 2.4 years) and 10 patients with morphologically normal ventricles (control; group B), ranging in age from 1 to 6 years (average 2.7 years) were evaluated. Cine MRI was performed by the GRASS methods (gradient recalled acquisition in steady state) at 0.5 T. The whole heart was encompassed by contiguous 7 or 10 mm transverse section. Ventricular volumes were calculated by adding luminal areas determined in each section at end-diastole and end-systole (EDV and ESV). Cine MRI findings of the right and left ventricular volumes were compared with those on ventriculogram. All cine MRI studies were considered diagnostic. Comparison of the RVEDV, RVESV, LVEDV and LVESV in both groups yielded a good correlation between cine MRI (Y) and ventriculography (X): RVEDV; Y=0.98X-0.49, r=0.98, RVESV; Y=0.89X+2.2, r=0.95, LVEDV; Y=0.97X+0.59, r=0.97, LVESV; Y=0.91X+0.56, r=0.95, Group B: RVEDV; Y=0.87X+4.9, r=0.93, RVESV; Y=0.91X+1.7, r=0.90, LVEDV; Y=1.1X-3.0, r=0.97, LVESV; Y=0.91X+0.6, r=0.93. These findigns indicate that cine MRI provides a suitable non-invasive means of quantifying right ventricular volume and left ventricular volumes in children with CCHD. (author).

  6. The advantage of deep-inspiration breath-hold and cone-beam CT based soft-tissue registration for locally advanced lung cancer radiotherapy

    DEFF Research Database (Denmark)

    Ottosson, Wiviann; Rahma, Fatma; Sjöström, David

    2016-01-01

    Background and purpose: Three cone-beam computed tomography (CBCT) registration strategies combined with deep-inspiration breath-hold (DIBH) and free-breathing (FB) were explored, in terms of obtaining the smallest planning target volume (PTV). Material and methods: CBCT images were acquired pre...... were calculated. Results: For the spine, the smallest residual misalignments were observed in FB, independently of registration method. For GTV-T and GTV-N, soft-tissue registrations were superior to bony registration, independently of FB or DIBH. Compared to FB, PTV-Totals were during DIBH reduced...... uncertainties compared to FB, DIBH resulted in smaller PTV-Totals for all registration methods. Soft-tissue registrations were superior to bony registration, independently of FB and DIBH. During DIBH, undesirable arching of the back was identified. Daily CBCT pre-treatment target verification is advised....

  7. Easy Diagnosis of Aortic Invasion in Patients with Lung Cancer Using Cine Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Hidetaka Uramoto

    2015-07-01

    Full Text Available Selecting the proper treatment strategy for locally advanced lung cancer, such as T4 tumors, is difficult. Therefore, obtaining an accurate diagnosis of T4 tumors is required. It can be difficult to determine whether the tumor invades adjacent structures. We describe the case of a patient easily diagnosed to be without aortic invasion using cine magnetic resonance imaging (MRI. We herein report the case of an 80-year-old male who presented a lung tumor. The transbronchial lung washing cytology findings were consistent with those of adenocarcinoma. In addition, the computed tomography findings indicated suspected aortic invasion of the lung tumor, as the mass girdled the descending aorta beyond 120° adjoining at a length of 10 cm. However, cine MRI display clearly demonstrated a clear area of isolation between the aorta and lung tissue based on differences in the heart rhythm from the patient's respiratory movements. Therefore, the lesion was clinically diagnosed as a stage IIB (T3N0M0 tumor. Radiation was administered due to the patient's advanced age and comorbidities such as chronic obstructive pulmonary disease. He remains alive without disease progression 6 months after the therapy. Our findings, therefore, indicate the usefulness of easily diagnosing the absence of aortic invasion in patients with lung cancer using cine MRI without the need for a special software program.

  8. Synchronization and Registration of Cine Magnetic Resonance and Dynamic Computed Tomography Images of the Heart.

    Science.gov (United States)

    Betancur, Julian; Simon, Antoine; Langella, Bernard; Leclercq, Christophe; Hernandez, Alfredo; Garreau, Mireille

    2016-09-01

    The synchronization and registration of dynamic computed tomography (CT) and magnetic resonance images (MRI) of the heart is required to perform a combined analysis of their complementary information. We propose a novel method that synchronizes and registers intrapatient dynamic CT and cine-MRI short axis view (SAX). For the synchronization step, a normalized cross-correlation curve is computed from each image sequence to describe the global cardiac dynamics. The time axes of these curves are then warped using an adapted dynamic time warping (DTW) procedure. The adaptation constrains the time deformation to obtain a coherent warping function. The registration step then computes the rigid transformation that maximizes the multiimage normalized mutual information of DTW-synchronized images. The DTW synchronization and the multiimage registration were evaluated using dynamic CT and cine-SAX acquisitions from nine patients undergoing cardiac resynchronization therapy. The distance between the end-systolic phases after DTW was used to evaluate the synchronization. Mean errors, expressed as a percentage of the RR-intervals, were 3.9% and 3.7% after adapted DTW synchronization against 10.8% and 11.3% after linear synchronization, for dynamic CT and cine-SAX, respectively. This suggests that the adapted DTW synchronization leads to a coherent warping of cardiac dynamics. The multiimage registration was evaluated using fiducial points. Compared to a monoimage and a two-image registration, the multiimage registration of DTW-synchronized images obtained the lowest mean fiducial error showing that the use of dynamic voxel intensity information improves the registration.

  9. Cine magnetic resonance imaging with single-shot fast spin echo for evaluation of dysphagia and aspiration.

    Science.gov (United States)

    Hartl, Dana M; Kolb, Frédéric; Bretagne, Evelyne; Marandas, Patrick; Sigal, Robert

    2006-07-01

    The aim of this study was to determine the feasibility of and interest in evaluation of swallowing using dynamic magnetic resonance imaging (cine-MRI) in patients with dysphagia and aspiration caused by an abnormal pharyngeal phase of swallow. A cohort of six patients previously treated for head and neck cancer with persistent dysphagia and/or aspiration were evaluated an average of 47 months after treatment. The morphology and mobility of the oral, oropharyngeal, and laryngeal structures were analyzed using cine-MRI using single-shot fast spin echo technology. The qualitative observations were compared with a clinical fiberoptic swallowing evaluation. Swallowing physiology was analyzable for dry (saliva) swallow in all patients. MRI was well-tolerated by all six patients and no clinical aspiration occurred during the MRI. In five of six cases, further information on the cause of dysphagia was obtained using cine-MRI compared with the clinical evaluation alone. In the remaining case, cine-MRI confirmed the clinical evaluation. Cine-MRI using the dry swallow technique is feasible and without risk in patients with clinical aspiration. Cine-MRI is complementary to clinical evaluation of swallowing in patients with an abnormal pharyngeal phase of swallowing resulting from treatment of cancer.

  10. Standardized cine-loop documentation in abdominal ultrasound facilitates offline image interpretation.

    Science.gov (United States)

    Dormagen, Johann Baptist; Gaarder, Mario; Drolsum, Anders

    2015-01-01

    One of the main disadvantages of conventional ultrasound is its operator dependency, which might impede the reproducibility of the sonographic findings. A new approach with cine-loops and standardized scan protocols can overcome this drawback. To compare abdominal ultrasound findings of immediate bedside reading by performing radiologist with offline reading by a non-performing radiologist, using standardized cine-loop sequences. Over a 6-month period, three radiologists performed 140 dynamic ultrasound organ-based examinations in 43 consecutive outpatients. Examination protocols were standardized and included predefined probe position and sequences of short cine-loops of the liver, gallbladder, pancreas, kidneys, and urine bladder, covering the organs completely in two planes. After bedside examinations, the studies were reviewed and read out immediately by the performing radiologist. Image quality was registered from 1 (no diagnostic value) to 5 (excellent cine-loop quality). Offline reading was performed blinded by a radiologist who had not performed the examination. Bedside and offline reading were compared with each other and with consensus results. In 140 examinations, consensus reading revealed 21 cases with renal disorders, 17 cases with liver and bile pathology, and four cases with bladder pathology. Overall inter-observer agreement was 0.73 (95% CI 0.61-0.91), with lowest agreement for findings of the urine bladder (0.36) and highest agreement in liver examinations (0.90). Disagreements between the two readings were seen in nine kidneys, three bladder examinations, one pancreas and bile system examinations each, and in one liver, giving a total number of mismatches of 11%. Nearly all cases of mismatch were of minor clinical significance. The median image quality was 3 (range, 2-5) with most examinations deemed a quality of 3. Compared to consensus reading, overall accuracy was 96% for bedside reading and 94% for offline reading. Standardized cine

  11. UNDERWATER STROKE KINEMATICS DURING BREATHING AND BREATH-HOLDING FRONT CRAWL SWIMMING

    Directory of Open Access Journals (Sweden)

    Nickos Vezos

    2007-03-01

    Full Text Available The aim of the present study was to determine the effects of breathing on the three - dimensional underwater stroke kinematics of front crawl swimming. Ten female competitive freestyle swimmers participated in the study. Each subject swam a number of front crawl trials of 25 m at a constant speed under breathing and breath-holding conditions. The underwater motion of each subject's right arm was filmed using two S-VHS cameras, operating at 60 Hz, which were positioned behind two underwater viewing windows. The spatial coordinates of selected points were calculated using the DLT procedure with 30 control points and after the digital filtering of the raw data with a cut-off frequency of 6 Hz, the hand's linear displacements and velocities were calculated. The results revealed that breathing caused significantly increases in the stroke duration (t9 = 2.764; p < 0.05, the backward hand displacement relative to the water (t9 = 2.471; p<0.05 and the lateral displacement of the hand in the X - axis during the downsweep (t9 = 2.638; p < 0.05. On the contrary, the peak backward hand velocity during the insweep (t9 = 2.368; p < 0.05 and the displacement of the hand during the push phase (t9 = -2.297; p < 0.05 were greatly reduced when breathing was involved. From the above, it was concluded that breathing action in front crawl swimming caused significant modifications in both the basic stroke parameters and the overall motor pattern were, possibly due to body roll during breathing

  12. Frequency of coeliac disease in children with breath-holding spells.

    Science.gov (United States)

    Işikay, Sedat; Hızlı, Şamil

    2014-11-01

    Iron deficiency anaemia (IDA), which is reported very commonly among patients with breath holding spells (BHS), is the most common presentation of coeliac disease (CD). In that aspect, IDA may be a common pathway linking these two diseases. The aim of this study was to evaluate the frequency of CD in patients with BHS. We studied 348 children with BHS, and 470 age- and sex-matched controls with no known disease. Serological screening for CD was performed in all patients by searching for serum tissue transglutaminase immunoglobulin A. The first group consisted of 348 children with BHS (231 males, 117 females; mean age 2.23 ± 1.84 years), and the second group consisted of 470 healthy children (284 males, 186 females; mean age 2.11 ± 1.98 years). A total of 300 (86.2%) patients had cyanotic type of BHS only, 27 (7.8%) had pallid type of BHS only and 21 (6%) had mixed type of BHS. The prevalence of IDA was statistically significantly higher in BHS patients compared with controls. Tissue transglutaminase immunoglobulin A was not detected as positive in any patients in either group; therefore, endoscopic and histopathological examinations were not performed. Our report is the first to describe the frequency of tissue transglutaminase immunoglobulin A positivity in patients with BHS. There was no evidence of a relationship between CD and BHS, but IDA seems to be an important risk factor in the development of BHS. Therefore, serological screening for CD in patients with BHS does not seem to be necessary. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  13. Novel Findings in Breath-Holding Spells: A Cross-Sectional Study.

    Science.gov (United States)

    Azab, Seham F A; Siam, Ahmed G; Saleh, Safaa H; Elshafei, Mona M; Elsaeed, Wafaa F; Arafa, Mohamed A; Bendary, Eman A; Farag, Elsayed M; Basset, Maha A A; Ismail, Sanaa M; Elazouni, Osama M A

    2015-07-01

    The mechanism of breath-holding spells (BHS) is not fully understood and most probably multifactorial; so, this study was designed to clarify the pathophysiology of BHS through assessing some laboratory parameters and electrocardiographic (ECG) changes which might be contributing to the occurrence of the attacks. Another aim of the study was to evaluate the differences in the pathophysiology between pallid and cyanotic types of BHS. This was a prospective study performed in Zagazig University Hospitals. Seventy-six children diagnosed with BHS were included as follows: 32 children with cyanotic BHS, 14 children with pallid BHS, and 30 healthy children as a control group. All children were subjected to the following: full history taking, clinical examination, and laboratory work up in the form of CBC, serum iron, ferritin, and zinc levels. Twenty-four hours ambulatory ECG (Holter) recording was also performed. No significant statistical difference was found between cyanotic and pallid groups regarding family history of BHS, severity, and precipitating factors of the attacks. Frequent runs of respiratory sinus arrhythmia (RSA) during 24  hours ECG were significantly higher in children with BHS; the frequency of RSA was significantly correlated with the frequency (severity) of the attacks. Low serum ferritin was significantly associated with BHS groups but not correlated with the severity of the attacks. Autonomic dysregulation evidenced by frequent RSA is considered to be an important cause of BHS in children and is correlated with the frequency of the attacks. Low serum ferritin is additional factor in the pathophysiology. Both pallid and cyanotic BHS are suggested to be types of the same disease sharing the same pathophysiology.

  14. Pacemaker in complicated and refractory breath-holding spells: when to think about it?

    Science.gov (United States)

    Sartori, Stefano; Nosadini, Margherita; Leoni, Loira; de Palma, Luca; Toldo, Irene; Milanesi, Ornella; Cerutti, Alessia; Suppiej, Agnese

    2015-01-01

    Breath-holding spells (BHS) are benign non-epileptic paroxysmal events of infancy, rarely occurring with high frequency and complicated by prolonged syncope, convulsions and even status epilepticus. In these cases response to medical treatment is often unsatisfactory. Pacemaker implantation is a possible therapeutic option, but its indications, efficacy and complications have not been clarified yet. To report a new case of BHS treated with pacemaker and to review its indications and efficacy in patients with severe BHS. We extensively searched the literature in PubMed on cardiac pacing in patients with BHS and we described a new case. A previously healthy boy presented at the age of 4 months with frequent BHS inconstantly associated to prolonged syncope and post-anoxic non-epileptic and epileptic seizures. Parental reassurance, iron supplementation and piracetam were ineffective. After cardiac pacing at the age of 16 months, BHS and their complications disappeared. We identified 47 patients with BHS treated with pacemaker in the literature. Based on the available data, in all patients asystole or marked bradycardia were documented during BHS or stimulating maneuvers; syncope complicated BHS in 100% of cases and post-anoxic convulsions in 78.3%. Medical treatment before pacing, when administered, was ineffective or poorly tolerated. After pacing, BHS complications disappeared in 86.4% of cases, and decreased in 13.6%. Technical problems with the device were reported in 25.7% of patients and mild medical complications in 11.4%. Pacemaker could be reasonably considered in subjects with frequent and severe BHS, poor response to medications, and demonstration of cardioinhibition during spells. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  15. Breath holding spells: point prevalence and associated factors among Turkish children.

    Science.gov (United States)

    Carman, Kursat Bora; Ekici, Arzu; Yimenicioglu, Sevgi; Arslantas, Didem; Yakut, Ayten

    2013-06-01

    Breath holding spells (BHS) are known as paroxysmal non-epileptic disorder. There are two subtypes of BHS: cyanotic and the pallid. BHS have been reported to occur in 0.1-4.6% of children in Western countries. Although it is easy to diagnose in its typical form, the data on prevalence of BHS are insufficient in developing countries. This study was performed in Turkey's Eskisehir province. A total of 1000 randomly selected 0-6-year-old children were invited to family health centers. A specific questionnaire was given to parents. Children who had a history BHS were referred to the hospital to for investigation of medical history and neurological examinations. A total of 933 children participated and were included in analysis. Thirty-four children (3.6%) had had BHS. Children's birthweight, parent consanguinity and mothers' education status significantly affected the frequency of BHS. Increase in birth sequence decreases the risk of BHS 0.65-fold. Fathers' education status also affected the prevalence of BHS, with the risk of BHS being 0.39-fold less if the father had completed high school or some higher education. And, as the age of the fathers increased, the risk that their children would have BHS was 1.14-fold higher. Although the calculated prevalence rate was compatible with previous studies, positive family history for BHS, birth sequence, parents' education status and fathers' age were identified as risk factors associated with BHS. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  16. Prospective study of children with cyanotic and pallid breath-holding spells.

    Science.gov (United States)

    DiMario, F J

    2001-02-01

    In this investigation, we sought to prospectively document the natural history of severe breath-holding spells (BHS) among children with both cyanotic and pallid BHS who were referred for neurologic consultation. Prospective cohort study. A structured interview was undertaken at the time of initial consultation and at subsequent 1-year intervals regarding type of BHS, frequency of spells, associated phenomenon, sequelae, family history, and age at termination of spells. A total of 95 children (48 boys, 47 girls) with BHS were identified and followed over a 9-year interval. There were no significant differences between genders. Median onset age was between 6 and 12 months old with 15% presenting younger than 6 months. A median frequency of spells was weekly with 30% experiencing 1 or more spells per day. The median age at peak frequency was between 12 and 18 months old with a range extending from 6 months to 4 years of age. Of the patients whose BHS had remitted for >12 months' time (n = 67), the last spell occurred at a median age of 37 to 42 months. Of those children whose BHS were still occurring, the oldest age at time of latest spell was at 7 years old. Hypoxic convulsions were associated with BHS in

  17. Treatment of cyanotic breath-holding spells with oral theophylline in a 10-year-old boy.

    Science.gov (United States)

    Garg, Meenal; Goraya, Jatinder S

    2015-06-01

    Cyanotic breath-holding spells are generally benign and resolve spontaneously by 4 to 5 years of age. Treatment with iron and other drugs has been employed in selected cases with very frequent and severe episodes. We describe a 10-year-old boy with recent-onset cyanotic breath-holding spells that were activity limiting. He was unable to participate in physical activities with his peers as any argument or emotional upset provoked these spells. Treatment with oral iron and piracetam was ineffective. However, treatment with oral theophylline produced dramatic amelioration of symptoms, and he was once again able to participate in play activities with his peers. We believe that general central nervous system stimulant and respirogenic effects of theophylline were instrumental in control of symptoms in our child. © The Author(s) 2014.

  18. Self-gated golden angle spiral cine MRI for coronary endothelial function assessment.

    Science.gov (United States)

    Bonanno, Gabriele; Hays, Allison G; Weiss, Robert G; Schär, Michael

    2017-12-27

    Depressed coronary endothelial function (CEF) is a marker for atherosclerotic disease, an independent predictor of cardiovascular events, and can be quantified non-invasively with ECG-triggered spiral cine MRI combined with isometric handgrip exercise (IHE). However, MRI-CEF measures can be hindered by faulty ECG-triggering, leading to prolonged breath-holds and degraded image quality. Here, a self-gated golden angle spiral method (SG-GA) is proposed to eliminate the need for ECG during cine MRI. SG-GA was tested against retrospectively ECG-gated golden angle spiral MRI (ECG-GA) and gold-standard ECG-triggered spiral cine MRI (ECG-STD) in 10 healthy volunteers. CEF data were obtained from cross-sectional images of the proximal right and left coronary arteries in a 3T scanner. Self-gating heart rates were compared to those from simultaneous ECG-gating. Coronary vessel sharpness and cross-sectional area (CSA) change with IHE were compared among the 3 methods. Self-gating precision, accuracy, and correlation-coefficient were 7.7 ± 0.5 ms, 9.1 ± 0.7 ms, and 0.93 ± 0.01, respectively (mean ± standard error). Vessel sharpness by SG-GA was equal or higher than ECG-STD (rest: 63.0 ± 1.7% vs. 61.3 ± 1.3%; exercise: 62.6 ± 1.3% vs. 56.7 ± 1.6%, P cine MRI method even when ECG is faulty or not available. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  19. Three-dimensional MRI-linac intra-fraction guidance using multiple orthogonal cine-MRI planes

    DEFF Research Database (Denmark)

    Bjerre, Troels; Crijns, Sjoerd; Rosenschöld, Per Munck af

    2013-01-01

    The introduction of integrated MRI-radiation therapy systems will offer live intra-fraction imaging. We propose a feasible low-latency multi-plane MRI-linac guidance strategy. In this work we demonstrate how interleaved acquired, orthogonal cine-MRI planes can be used for low-latency tracking...... of the 3D trajectory of a soft-tissue target structure. The proposed strategy relies on acquiring a pre-treatment 3D breath-hold scan, extracting a 3D target template and performing template matching between this 3D template and pairs of orthogonal 2D cine-MRI planes intersecting the target motion path....... For a 60 s free-breathing series of orthogonal cine-MRI planes, we demonstrate that the method was capable of accurately tracking the respiration related 3D motion of the left kidney. Quantitative evaluation of the method using a dataset designed for this purpose revealed a translational error of 1.15 mm...

  20. Accuracy of Dose Delivery in Multiple Breath-Hold Segmented Volumetric Modulated Arc Therapy: A Static Phantom Study

    Directory of Open Access Journals (Sweden)

    Kimiya Noto

    2014-01-01

    Full Text Available Purpose. Accuracy of dose delivery in multiple breath-hold segmented volumetric modulated arc therapy (VMAT was evaluated in comparison to noninterrupted VMAT using a static phantom. Material and Methods. Five VMAT plans were evaluated. A Synergy linear accelerator (Elekta AB, Stockholm, Sweden was employed. A VMAT delivery sequence was divided into multiple segments according to each of the predefined breath-hold periods (10, 15, 20, 30, and 40 seconds. The segmented VMAT delivery was compared to noninterrupted VMAT delivery in terms of the isocenter dose and pass rates of a dose difference of 1% with a dose threshold of 10% of the maximum dose on a central coronal plane using a two-dimensional dosimeter, MatriXX Evolution (IBA Dosimetry, Schwarzenbruck, Germany. Results. Means of the isocenter dose differences were 0.5%, 0.2%, 0.2%, 0.0%, and 0.0% for the beam-on-times between interrupts of 10, 15, 20, 30, and 40 seconds, respectively. Means of the pass rates were 85%, 99.9%, 100%, 100%, and 100% in the same order as the above. Conclusion. Our static phantom study indicated that the multiple breath-hold segmented VMAT maintains stable and accurate dose delivery when the beam-on-time between interrupts is 15 seconds or greater.

  1. Real-time automatic fiducial marker tracking in low contrast cine-MV images.

    Science.gov (United States)

    Lin, Wei-Yang; Lin, Shu-Fang; Yang, Sheng-Chang; Liou, Shu-Cheng; Nath, Ravinder; Liu, Wu

    2013-01-01

    To develop a real-time automatic method for tracking implanted radiographic markers in low-contrast cine-MV patient images used in image-guided radiation therapy (IGRT). Intrafraction motion tracking using radiotherapy beam-line MV images have gained some attention recently in IGRT because no additional imaging dose is introduced. However, MV images have much lower contrast than kV images, therefore a robust and automatic algorithm for marker detection in MV images is a prerequisite. Previous marker detection methods are all based on template matching or its derivatives. Template matching needs to match object shape that changes significantly for different implantation and projection angle. While these methods require a large number of templates to cover various situations, they are often forced to use a smaller number of templates to reduce the computation load because their methods all require exhaustive search in the region of interest. The authors solve this problem by synergetic use of modern but well-tested computer vision and artificial intelligence techniques; specifically the authors detect implanted markers utilizing discriminant analysis for initialization and use mean-shift feature space analysis for sequential tracking. This novel approach avoids exhaustive search by exploiting the temporal correlation between consecutive frames and makes it possible to perform more sophisticated detection at the beginning to improve the accuracy, followed by ultrafast sequential tracking after the initialization. The method was evaluated and validated using 1149 cine-MV images from two prostate IGRT patients and compared with manual marker detection results from six researchers. The average of the manual detection results is considered as the ground truth for comparisons. The average root-mean-square errors of our real-time automatic tracking method from the ground truth are 1.9 and 2.1 pixels for the two patients (0.26 mm/pixel). The standard deviations of the

  2. Cine Magnetic Resonance Imaging of the Small Bowel: Comparison of Different Oral Contrast Media

    Energy Technology Data Exchange (ETDEWEB)

    Asbach, P.; Breitwieser, C.; Diederichs, G.; Eisele, S.; Kivelitz, D.; Taupitz, M.; Zeitz, M.; Hamm, B.; Klessen, C. [Charite - Universitatsmedizin Berlin, Charite Campus Mitte, Berlin (Germany). Dept. of Radiology

    2006-11-15

    Purpose: To evaluate several substances regarding small bowel distension and contrast on balanced steady-state free precession (bSSFP) cine magnetic resonance (MR) images. Material and Methods: Luminal contrast was evaluated in 24 volunteers after oral application of two different contrast agent groups leading to either bright lumen (pineapple, blueberry juice) or dark lumen (tap water, orange juice) on T1-weighted images. Bowel distension was evaluated in 30 patients ingesting either methylcellulose or mannitol solution for limiting intestinal absorption. Fifteen patients with duodeno-jejunal intubation served as the control. Quantitative evaluation included measurement of luminal signal intensities and diameters of four bowel segments, qualitative evaluation assessed luminal contrast and distension on a five-point scale. Results: Quantitative and qualitative evaluation of the four contrast agents revealed no significant differences regarding luminal contrast on bSSFP images. Quantitative evaluation revealed significantly lower (P<0.05) small bowel distension for three out of four segments (qualitative evaluation: two out of four segments) for methylcellulose in comparison to the control. Mannitol was found to be equal to the control. Conclusion: Oral ingestion of tap water or orange juice in combination with mannitol is recommended for cine MR imaging of the small bowel regarding luminal contrast and small bowel distension on bSSFP sequences.

  3. Fully automated segmentation of left ventricle using dual dynamic programming in cardiac cine MR images

    Science.gov (United States)

    Jiang, Luan; Ling, Shan; Li, Qiang

    2016-03-01

    Cardiovascular diseases are becoming a leading cause of death all over the world. The cardiac function could be evaluated by global and regional parameters of left ventricle (LV) of the heart. The purpose of this study is to develop and evaluate a fully automated scheme for segmentation of LV in short axis cardiac cine MR images. Our fully automated method consists of three major steps, i.e., LV localization, LV segmentation at end-diastolic phase, and LV segmentation propagation to the other phases. First, the maximum intensity projection image along the time phases of the midventricular slice, located at the center of the image, was calculated to locate the region of interest of LV. Based on the mean intensity of the roughly segmented blood pool in the midventricular slice at each phase, end-diastolic (ED) and end-systolic (ES) phases were determined. Second, the endocardial and epicardial boundaries of LV of each slice at ED phase were synchronously delineated by use of a dual dynamic programming technique. The external costs of the endocardial and epicardial boundaries were defined with the gradient values obtained from the original and enhanced images, respectively. Finally, with the advantages of the continuity of the boundaries of LV across adjacent phases, we propagated the LV segmentation from the ED phase to the other phases by use of dual dynamic programming technique. The preliminary results on 9 clinical cardiac cine MR cases show that the proposed method can obtain accurate segmentation of LV based on subjective evaluation.

  4. Texture analysis of cardiac cine magnetic resonance imaging to detect non-viable segments in patients with chronic myocardial infarction.

    Science.gov (United States)

    Larroza, Andrés; López-Lereu, María P; Monmeneu, José V; Gavara, Jose; Chorro, Francisco J; Bodí, Vicente; Moratal, David

    2018-02-01

    To investigate the ability of texture analysis to differentiate between infarcted non-viable, viable, and remote segments on cardiac cine magnetic resonance imaging (MRI). This retrospective study included 50 patients suffering chronic myocardial infarction. The data was randomly split into training (30 patients) and testing (20 patients) sets. The left ventricular myocardium was segmented according to the 17-segment model in both cine and late gadolinium enhancement (LGE) MRI. Infarcted myocardium regions were identified on LGE in short-axis views. Non-viable segments were identified as those showing LGE ≥ 50%, and viable segments those showing 0 cine images. A support vector machine (SVM) classifier was trained with different combination of texture features to obtain a model that provided optimal classification performance. The best classification on testing set was achieved with local binary patterns features using a 2D + t approach, in which the features are computed by including information of the time dimension available in cine sequences. The best overall area under the receiver operating characteristic curve (AUC) were: 0.849, sensitivity of 92% to detect non-viable segments, 72% to detect viable segments, and 85% to detect remote segments. Non-viable segments can be detected on cine MRI using texture analysis and this may be used as hypothesis for future research aiming to detect the infarcted myocardium by means of a gadolinium-free approach. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Effect of complete denture wearing on deglutition time: a cine-magnetic resonance imaging study.

    Science.gov (United States)

    Gokce, H S; Gokce, S M; Akin, E; Bulakbasi, N; Akyol, M

    2012-03-01

    Purpose of the study was to evaluate the effect of complete denture wearing on deglutition time (DT), hyoid bone and larynx movements in edentulous patients with real-time balanced turbo field echo cine-magnetic resonance imaging. Subjects were examined by cine-magnetic resonance imaging in supine position during swallowing water. Two sets of images for 23 edentulous (with/without wearing complete dentures) and one for 23 dentulous patients were obtained. Radiographic outputs representing three consecutive deglutition stages (oral, pharyngeal and oesophageal) were provided to perform measurements. Deglutition time significantly increased when edentulous patients wore their dentures (mean 0·75 s increased to 1·17 s), whereas dentulous patients' DT was about 0·91 s (P ≤ 0.05). The duration of deglutition is crucial because prolonged pharyngeal transit times increases the risk of aspiration. Within the limitations of the study, complete denture wearing could increase the shortened DT of the edentulous patients. © 2011 Blackwell Publishing Ltd.

  6. Free breathing whole-heart 3D CINE MRI with self-gated Cartesian trajectory.

    Science.gov (United States)

    Usman, M; Ruijsink, B; Nazir, M S; Cruz, G; Prieto, C

    2017-05-01

    To present a method that uses a novel free-running self-gated acquisition to achieve isotropic resolution in whole heart 3D Cartesian cardiac CINE MRI. 3D cardiac CINE MRI using navigator gating results in long acquisition times. Recently, several frameworks based on self-gated non-Cartesian trajectories have been proposed to accelerate this acquisition. However, non-Cartesian reconstructions are computationally expensive due to gridding, particularly in 3D. In this work, we propose a novel highly efficient self-gated Cartesian approach for 3D cardiac CINE MRI. Acquisition is performed using CArtesian trajectory with Spiral PRofile ordering and Tiny golden angle step for eddy current reduction (so called here CASPR-Tiger). Data is acquired continuously under free breathing (retrospective ECG gating, no preparation pulses interruption) for 4-5min and 4D whole-heart volumes (3D+cardiac phases) with isotropic spatial resolution are reconstructed from all available data using a soft gating technique combined with temporal total variation (TV) constrained iterative SENSE reconstruction. For data acquired on eight healthy subjects and three patients, the reconstructed images using the proposed method had good contrast and spatio-temporal variations, correctly recovering diastolic and systolic cardiac phases. Non-significant differences (P>0.05) were observed in cardiac functional measurements obtained with proposed 3D approach and gold standard 2D multi-slice breath-hold acquisition. The proposed approach enables isotropic 3D whole heart Cartesian cardiac CINE MRI in 4 to 5min free breathing acquisition. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Spirometer-controlled cine magnetic resonance imaging to diagnose tracheobronchomalacia in pediatric patients

    DEFF Research Database (Denmark)

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra

    2014-01-01

    -MRI was compared with bronchoscopy or chest-CT in 7 subjects. TBM was diagnosed by cine-MRI in 7 out of 12 children (58%) and was confirmed by bronchoscopy or CT. In 4 patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans.Spirometer-controlled cine-MRI is a promising technique...

  8. Single-Breath-Hold Whole-heart Unenhanced Coronary MRA Using Multi-shot Gradient Echo EPI at 3T: Comparison with Free-breathing Turbo-field-echo Coronary MRA on Healthy Volunteers.

    Science.gov (United States)

    Iyama, Yuji; Nakaura, Takeshi; Nagayama, Yasunori; Oda, Seitaro; Utsunomiya, Daisuke; Kidoh, Masafumi; Yuki, Hideaki; Hirata, Kenichiro; Namimoto, Tomohiro; Kitajima, Mika; Morita, Kosuke; Funama, Yoshinori; Takemura, Atsushi; Okuaki, Tomoyuki; Yamashita, Yasuyuki

    2017-06-26

    We investigated the feasibility of single breath hold unenhanced coronary magnetic resonance angiography (MRA) using multi-shot gradient echo planar imaging (MSG-EPI) on a 3T-scanner. Fourteen volunteers underwent single breath hold coronary MRA with a MSG-EPI and free-breathing turbo field echo (TFE) coronary MRA at 3T. The acquisition time, signal to noise ratio (SNR), and the contrast of the sequences were compared with the paired t-test. Readers evaluated the image contrast, noise, sharpness, artifacts, and the overall image quality. The acquisition time was 88.1% shorter for MSG-EPI than TFE (24.7 ± 2.5 vs 206.4 ± 23.1 sec, P EPI than TFE scans (P EPI and TFE scans (1.8 ± 0.3 vs 1.9 ± 0.3, P = 0.24). There was no significant difference in image contrast, image sharpness, and overall image quality between two scan techniques. The score of image noise and artifact were significantly higher on MSG-EPI than TFE scans (P EPI sequence is a promising technique for shortening the scan time and for preserving the image quality of unenhanced whole heart coronary MRA on a 3T scanner.

  9. Measuring vascular reactivity with resting-state blood oxygenation level-dependent (BOLD) signal fluctuations: A potential alternative to the breath-holding challenge?

    National Research Council Canada - National Science Library

    Jahanian, Hesamoddin; Christen, Thomas; Moseley, Michael E; Pajewski, Nicholas M; Wright, Clinton B; Tamura, Manjula K; Zaharchuk, Greg

    2017-01-01

    Measurement of the ability of blood vessels to dilate and constrict, known as vascular reactivity, is often performed with breath-holding tasks that transiently raise arterial blood carbon dioxide (PaCO2) levels...

  10. Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Buhmann-Kirchhoff, Sonja; Reiser, Maximilian; Lienemann, Andreas [University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Munich (Germany); Lang, Reinhold; Steitz, Heinrich O.; Jauch, Karl W. [University Hospital Munich-Grosshadern, Department of Surgery, Munich (Germany); Kirchhoff, Chlodwig [University Hospital Munich-Innenstadt, Department of Surgery, Munich (Germany)

    2008-06-15

    The purpose of this study was to evaluate the presence and localization of intraabdominal adhesions using functional cine magnetic resonance imaging (MRI) and to correlate the MR findings with intraoperative results. In a retrospective study, patients who had undergone previous abdominal surgery with suspected intraabdominal adhesions were examined. A true fast imaging with steady state precession sequence in transverse/sagittal orientation was used for a section-by-section dynamic depiction of visceral slide on a 1.5-Tesla system. After MRI, all patients underwent anew surgery. A nine-segment abdominal map was used to document the location and type of the adhesions. The intraoperative results were taken as standard of reference. Ninety patients were enrolled. During surgery 71 adhesions were detected, MRI depicted 68 intraabdominal adhesions. The most common type of adhesion in MRI was found between the anterior abdominal wall and small bowel loops (n = 22, 32.5%) and between small bowel loops and pelvic organs (n = 14, 20.6%). Comparing MRI with the intraoperative findings, sensitivity varied between 31 and 75% with a varying specificity between 65 and 92% in the different segments leading to an overall MRI accuracy of 89%. Functional cine MRI proved to be a useful examination technique for the identification of intraabdominal adhesions in patients with acute or chronic pain and corresponding clinical findings providing accurate results. However, no differentiation for symptomatic versus asymptomatic adhesions is possible. (orig.)

  11. Dynamic study of the medial and lateral recti capsulopalpebral fasciae using cine mode magnetic resonance imaging.

    Science.gov (United States)

    Kakizaki, Hirohiko; Selva, Dinesh; Leibovitch, Igal

    2010-02-01

    To assess the dynamic features of the medial rectus capsulopalpebral fascia (mrCPF) and the lateral rectus CPF (lrCPF) during horizontal eye movements using cine mode magnetic resonance imaging (MRI). Observational case series. Ten patients (9 males and 1 female; age range, 8-75 years; mean age, 41.1 years) diagnosed with a unilateral orbital blowout fracture (medial wall, floor, or both) and having a normal contralateral orbit. Cine mode MRI was used to examine the role of the mrCPF and the lrCPF in relation to the eyelid and horizontal recti muscles during horizontal eye movements. To assess the dynamic features of the mrCPF and the lrCPF. In medial gaze, the medial part of the eyelid moves posteromedially, in synchronicity with medial rectus muscle contraction, mediated by the mrCPF. The lateral part of the eyelid moves anteromedially, in synchronicity with lateral rectus muscle relaxation, mediated by the lrCPF. In lateral gaze, the lateral part of the eyelid moves posterolaterally, in synchronicity with the lateral rectus muscle contraction, mediated by the lrCPF. The medial part of the eyelid moves anterolaterally, in synchronicity with medial rectus muscle relaxation, mediated by the mrCPF. These findings were demonstrated in all 10 patients. Cine mode MRI was used to demonstrate the dynamic roles of the mrCPF and the lrCPF in mediating eyelid position with the corresponding horizontal recti muscles. This study may allow a better understanding of the importance of these anatomic structures and may reduce functional and cosmetic complications during common oculoplastic and strabismus surgeries. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Evaluation of cardiac dyssynchrony with longitudinal strain analysis in 4-chamber cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kawakubo, Masateru, E-mail: masateru@med.kyushu-u.ac.jp [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Kumazawa, Seiji, E-mail: s_kmzw@hs.med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Chishaki, Akiko S., E-mail: chishaki@hs.med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Mukai, Yasushi, E-mail: y_mukai@cardiol.med.kyushu-u.ac.jp [Department of Cardiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Nakamura, Yasuhiko, E-mail: yas-nkmr@r-tec.med.kyushu-u.ac.jp [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Morishita, Junji, E-mail: junjim@med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan)

    2013-12-01

    Purpose: We investigated the clinical performance of evaluation of cardiac mechanical dyssynchrony with longitudinal strain analysis using four-chamber (4CH) cine magnetic resonance imaging (MRI). Materials and methods: We retrospectively enrolled 73 chronic heart failure patients (41 men, 32 women; mean age, 57 years, NYHA 2, 3, and 4) who underwent a cardiac MRI in the present study. The left ventricular dyssynchrony (LVD) and interventricular dyssynchrony (IVD) indices were calculated by longitudinal strain analysis using 4CH cine MRI. The LVD and IVD indices were compared by the Wilcoxon rank-sum test between the patients with indication for cardiac resynchronization therapy (CRT) (n = 13) and without indication for CRT (n = 60), with LGE (n = 40) and without LGE (n = 27), the CRT responders (n = 8) and non-responders (n = 6), respectively. Results: LVD in the patients with indication for CRT were significantly longer than those without indication for CRT (LVD: 92 ± 65 vs. 28 ± 40 ms, P < .01). LVD and IVD were significantly longer in the patients with LGE than those without LGE (LVD: 54 ± 58 vs. 21 ± 30 ms, P < .01 and IVD: 51 ± 39 vs. 23 ± 34 ms, P < .01). LVD and IVD in the CRT responders were significantly longer than the CRT non-responders (LVD: 126 ± 55 vs. 62 ± 55 ms, P < .01 and IVD: 96 ± 39 vs. 52 ± 40 ms, P < .05). Conclusion: Longitudinal strain analysis with 4CH cine MRI could be useful for clinical examination in the evaluation of cardiac mechanical dyssynchrony.

  13. Does smoking abstinence influence distress tolerance? An experimental study comparing the response to a breath-holding test of smokers under tobacco withdrawal and under nicotine replacement therapy.

    Science.gov (United States)

    Cosci, Fiammetta; Anna Aldi, Giulia; Nardi, Antonio Egidio

    2015-09-30

    Distress tolerance has been operationalized as task persistence in stressful behavioral laboratory tasks. According to the distress tolerance perspective, how an individual responds to discomfort/distress predicts early smoking lapses. This theory seems weakly supported by experimental studies since they are limited in number, show inconsistent results, do not include control conditions. We tested the response to a stressful task in smokers under abstinence and under no abstinence to verify if tobacco abstinence reduces task persistence, thus distress tolerance. A placebo-controlled, double-blind, randomized, cross-over design was used. Twenty smokers underwent a breath holding test after the administration of nicotine on one test day and a placebo on another test day. Physiological and psychological variables were assessed at baseline and directly before and after each challenge. Abstinence induced a statistically significant shorter breath holding duration relative to the nicotine condition. No different response to the breath holding test was observed when nicotine and placebo conditions were compared. No response to the breath holding test was found when pre- and post-test values of heart rate, blood pressure, Visual Analogue Scale for fear or discomfort were compared. In brief, tobacco abstinence reduces breath holding duration but breath holding test does not influence discomfort. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Comparative assessment of liver tumor motion using cine-magnetic resonance imaging versus 4-dimensional computed tomography.

    Science.gov (United States)

    Fernandes, Annemarie T; Apisarnthanarax, Smith; Yin, Lingshu; Zou, Wei; Rosen, Mark; Plastaras, John P; Ben-Josef, Edgar; Metz, James M; Teo, Boon-Keng

    2015-04-01

    To compare the extent of tumor motion between 4-dimensional CT (4DCT) and cine-MRI in patients with hepatic tumors treated with radiation therapy. Patients with liver tumors who underwent 4DCT and 2-dimensional biplanar cine-MRI scans during simulation were retrospectively reviewed to determine the extent of target motion in the superior-inferior, anterior-posterior, and lateral directions. Cine-MRI was performed over 5 minutes. Tumor motion from MRI was determined by tracking the centroid of the gross tumor volume using deformable image registration. Motion estimates from 4DCT were performed by evaluation of the fiducial, residual contrast (or liver contour) positions in each CT phase. Sixteen patients with hepatocellular carcinoma (n=11), cholangiocarcinoma (n=3), and liver metastasis (n=2) were reviewed. Cine-MRI motion was larger than 4DCT for the superior-inferior direction in 50% of patients by a median of 3.0 mm (range, 1.5-7 mm), the anterior-posterior direction in 44% of patients by a median of 2.5 mm (range, 1-5.5 mm), and laterally in 63% of patients by a median of 1.1 mm (range, 0.2-4.5 mm). Cine-MRI frequently detects larger differences in hepatic intrafraction tumor motion when compared with 4DCT most notably in the superior-inferior direction, and may be useful when assessing the need for or treating without respiratory management, particularly in patients with unreliable 4DCT imaging. Margins wider than the internal target volume as defined by 4DCT were required to encompass nearly all the motion detected by cine-MRI for some of the patients in this study. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A four-dimensional motion field atlas of the tongue from tagged and cine magnetic resonance imaging

    Science.gov (United States)

    Xing, Fangxu; Prince, Jerry L.; Stone, Maureen; Wedeen, Van J.; El Fakhri, Georges; Woo, Jonghye

    2017-02-01

    Representation of human tongue motion using three-dimensional vector fields over time can be used to better understand tongue function during speech, swallowing, and other lingual behaviors. To characterize the inter-subject variability of the tongue's shape and motion of a population carrying out one of these functions it is desirable to build a statistical model of the four-dimensional (4D) tongue. In this paper, we propose a method to construct a spatio-temporal atlas of tongue motion using magnetic resonance (MR) images acquired from fourteen healthy human subjects. First, cine MR images revealing the anatomical features of the tongue are used to construct a 4D intensity image atlas. Second, tagged MR images acquired to capture internal motion are used to compute a dense motion field at each time frame using a phase-based motion tracking method. Third, motion fields from each subject are pulled back to the cine atlas space using the deformation fields computed during the cine atlas construction. Finally, a spatio-temporal motion field atlas is created to show a sequence of mean motion fields and their inter-subject variation. The quality of the atlas was evaluated by deforming cine images in the atlas space. Comparison between deformed and original cine images showed high correspondence. The proposed method provides a quantitative representation to observe the commonality and variability of the tongue motion field for the first time, and shows potential in evaluation of common properties such as strains and other tensors based on motion fields.

  16. Right-sided cardiac function in healthy volunteers measured by first-pass radionuclide ventriculography and gated blood-pool SPECT: comparison with cine MRI

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette; Hesse, Birger

    2005-01-01

    and breath-hold cine MRI performed according to standard protocols. RESULTS: Normal ranges for RV ejection fraction (RVEF) defined as mean +/- 2SD were 0.49-0.72, 0.44-0.66 and 0.40-0.69 when measured by MRI, FP and GBPS respectively. Bland-Altman analysis showed a mean difference (bias) between MRI and FP...

  17. Four-dimensional dose reconstruction through in vivo phase matching of cine images of electronic portal imaging device.

    Science.gov (United States)

    Yoon, Jihyung; Jung, Jae Won; Kim, Jong Oh; Yi, Byong Yong; Yeo, Inhwan

    2016-07-01

    A method is proposed to reconstruct a four-dimensional (4D) dose distribution using phase matching of measured cine images to precalculated images of electronic portal imaging device (EPID). (1) A phantom, designed to simulate a tumor in lung (a polystyrene block with a 3 cm diameter embedded in cork), was placed on a sinusoidally moving platform with an amplitude of 1 cm and a period of 4 s. Ten-phase 4D computed tomography (CT) images of the phantom were acquired. A planning target volume (PTV) was created by adding a margin of 1 cm around the internal target volume of the tumor. (2) Three beams were designed, which included a static beam, a theoretical dynamic beam, and a planning-optimized dynamic beam (PODB). While the theoretical beam was made by manually programming a simplistic sliding leaf motion, the planning-optimized beam was obtained from treatment planning. From the three beams, three-dimensional (3D) doses on the phantom were calculated; 4D dose was calculated by means of the ten phase images (integrated over phases afterward); serving as "reference" images, phase-specific EPID dose images under the lung phantom were also calculated for each of the ten phases. (3) Cine EPID images were acquired while the beams were irradiated to the moving phantom. (4) Each cine image was phase-matched to a phase-specific CT image at which common irradiation occurred by intercomparing the cine image with the reference images. (5) Each cine image was used to reconstruct dose in the phase-matched CT image, and the reconstructed doses were summed over all phases. (6) The summation was compared with forwardly calculated 4D and 3D dose distributions. Accounting for realistic situations, intratreatment breathing irregularity was simulated by assuming an amplitude of 0.5 cm for the phantom during a portion of breathing trace in which the phase matching could not be performed. Intertreatment breathing irregularity between the time of treatment and the time of planning CT was

  18. Clinical features of panic patients sensitive to hyperventilation or breath-holding methods for inducing panic attacks

    Directory of Open Access Journals (Sweden)

    A.E. Nardi

    2004-02-01

    Full Text Available Our aim was to compare the clinical features of panic disorder (PD patients sensitive to hyperventilation or breath-holding methods of inducing panic attacks. Eighty-five PD patients were submitted to both a hyperventilation challenge test and a breath-holding test. They were asked to hyperventilate (30 breaths/min for 4 min and a week later to hold their breath for as long as possible, four times with a 2-min interval. Anxiety scales were applied before and after the tests. We selected the patients who responded with a panic attack to just one of the tests, i.e., those who had a panic attack after hyperventilating (HPA, N = 24, 16 females, 8 males, mean age ± SD = 38.5 ± 12.7 years and those who had a panic attack after breath holding (BHPA, N = 20, 11 females, 9 males, mean age ± SD = 42.1 ± 10.6 years. Both groups had similar (chi² = 1.28, d.f. = 1, P = 0.672 respiratory symptoms (fear of dying, chest/pain disconfort, shortness of breath, paresthesias, and feelings of choking during a panic attack. The criteria of Briggs et al. [British Journal of Psychiatry, 1993; 163: 201-209] for respiratory PD subtype were fulfilled by 18 (75.0% HPA patients and by 14 (70.0% BHPA patients. The HPA group had a later onset of the disease compared to BHPA patients (37.9 ± 11.0 vs 21.3 ± 12.9 years old, Mann-Whitney, P < 0.001, and had a higher family prevalence of PD (70.8 vs 25.0%, chi² = 19.65, d.f. = 1, P = 0.041. Our data suggest that these two groups - HPA and BHPA patients - may be specific subtypes of PD.

  19. Moderate correlation between breath-holding and CO(2) inhalation/hyperventilation methods for transcranial doppler evaluation of cerebral vasoreactivity.

    Science.gov (United States)

    Haussen, Diogo C; Katsnelson, Michael; Rodriguez, Abiezer; Campo, Nelly; Campo-Bustillo, Iszet; Romano, Jose G; Koch, Sebastian

    2012-01-01

    Both CO(2) inhalation followed by hyperventilation and breath-holding have been utilized to measure cerebral vasomotor reactivity (VMR) but their correlation has been poorly studied and understood. A retrospective study was conducted in 143 subjects (62.6 ± 15.8 years old, 64% men) with transcranial Doppler ultrasonography measurement of mean flow velocity (MFV) at baseline, after 30 seconds of breath-holding, and after CO(2) inhalation followed by hyperventilation, in the left and right middle cerebral artery. Breath-holding index (BHI) was calculated as the percentage of MFV increase from baseline per second of apnea. CO(2) inhalation/hyperventilation index (CO(2) /HV) was calculated as the percentage of MFV difference between CO(2) inhalation and hyperventilation. There were 75 carotid arteries with >70% stenosis or occlusion, and 18 middle cerebral arteries with >50% stenosis or occlusion. The mean BHI was 0.93 ± 0.7 and 0.89 ± 0.6, whereas the mean CO(2) /HV was 61 ± 26% and 60 ± 26%, respectively, on the right and left sides. The correlation between BHI and CO(2) /HV was moderate on the right (r = 0.33; p < 0.01) and left sides (r = 0.38; p < 0.01). Multivariate linear regression analysis indicated that age (p = 0.01) and history of stroke (p = 0.007) were associated independently with an impaired VMR on the right as measured by CO(2) /HV. No predictors for impaired VMR by CO(2) /HV on the left and by BHI on either side were found. CO(2) /HV and BHI are only moderately correlated. Further studies are necessary to determine which method more accurately predicts clinical morbidity. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 2012; Published online in Wiley Online Library. Copyright © 2012 Wiley Periodicals, Inc.

  20. “Lung packing” in breath hold-diving: An impressive case of pulmo–cardiac interaction

    Directory of Open Access Journals (Sweden)

    Jochen D. Schipke

    2015-01-01

    Full Text Available There is a complex interaction between the heart and the lungs. We report on a healthy female who performs breath hold diving at a high, international level. In order to optimize pressure equalization during diving and to increase oxygen available, apneists employed a special breathing maneuver, so called “lung packing”. Based on cardiac MRI we could demonstrate impressive effects of this maneuver on left ventricular geometry and hemodynamics. Beyond the fact, that our findings support the concept of pulmonary –cardiac interrelationship, it should be emphasized, that the reported, extreme breathing maneuver could have detrimental consequences due to reduction of stroke volume and cardiac output.

  1. Breath-holding spells: Prevalence and risk factors in under 6-year old children at south of Tehran

    OpenAIRE

    P. Tootoonchi

    2001-01-01

    To determine breath- holding spells (BHS) prevalence and risk factors in under 6- year- old children, we interviewed mothers of 400 children in a cross- sectional study in 5 health centers at south of Tehran in autumn 1999. 33 children (8.25%) had history of BHS (Male: 19, Female: 14 25 cases were between 2-4 years old (mean: 40±17 months). Seventy percent of cases (23) had onset of attacks after 6 months of age (mean: 10 monthis) and the commonest frequency was one spell per month...

  2. Study of breath-holding spell and its triggering factors in Children’s Hospital Medical Center

    OpenAIRE

    Ashrafi MR

    2000-01-01

    To evaluate breath-holding spell (BHS) and its triggering factors, 47 children with BHS admitted to the out patients clinic of Children's hospital medical center, between Sept 1998-June 1999, were included in this prospective study. Diagnosis of BHS was made for cases by medical history, pediatric physical examination, EEG, ECG and lab findings. 4 cases were excluded from study because of paroxysmal epileptic discharges at their EEGs. Of 43 cases having BHS (M:F: 1.15:1), 74.4% were less...

  3. Computerized method for measurement of displacement vectors of target positions on EPID cine images in stereotactic radiotherapy

    Science.gov (United States)

    Arimura, Hidetaka; Anai, Shigeo; Yoshidome, Satoshi; Nakamura, Katsumasa; Shioyama, Yoshiyuki; Nomoto, Satoshi; Honda, Hiroshi; Onizuka, Yoshihiko; Terashima, Hiromi

    2007-03-01

    The purpose of this study was to develop a computerized method for measurement of displacement vectors of target position on electronic portal imaging device (EPID) cine images in a treatment without implanted markers. Our proposed method was based on a template matching technique with cross-correlation coefficient between a reference portal (RP) image and each consecutive portal (CP) image acquired by the EPID. EPID images with 512×384 pixels (pixel size:0.56 mm) were acquired in a cine mode at a sampling rate of 0.5 frame/sec by using an energy of 4, 6, or 10MV on linear accelerators. The displacement vector of the target on each cine image was determined from the position in which took the maximum cross-correlation value between the RP image and each CP image. We applied our method to EPID cine images of a lung phantom with a tumor model simulating respiratory motion, and 5 cases with a non-small cell lung cancer and one case of metastasis. For validation of our proposed method, displacement vectors of a target position calculated by our method were compared with those determined manually by two radiation oncologists. As a result, for lung phantom images, target displacements by our method correlated well with those by the oncologists (r=0.972 - 0.994). Correlation values for 4 cases ranged from 0.854 to 0.991, but the values for the other two cases were 0.609 and 0.644. This preliminary result suggested that our method may be useful for monitoring of displacement vectors of target positions without implanted markers in stereotactic radiotherapy.

  4. Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

    2005-01-01

    Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

  5. Detection and correction for EPID and gantry sag during arc delivery using cine EPID imaging.

    Science.gov (United States)

    Rowshanfarzad, Pejman; Sabet, Mahsheed; O'Connor, Daryl J; McCowan, Peter M; McCurdy, Boyd M C; Greer, Peter B

    2012-02-01

    Electronic portal imaging devices (EPIDs) have been studied and used for pretreatment and in-vivo dosimetry applications for many years. The application of EPIDs for dosimetry in arc treatments requires accurate characterization of the mechanical sag of the EPID and gantry during rotation. Several studies have investigated the effects of gravity on the sag of these systems but each have limitations. In this study, an easy experiment setup and accurate algorithm have been introduced to characterize and correct for the effect of EPID and gantry sag during arc delivery. Three metallic ball bearings were used as markers in the beam: two of them fixed to the gantry head and the third positioned at the isocenter. EPID images were acquired during a 360° gantry rotation in cine imaging mode. The markers were tracked in EPID images and a robust in-house developed MATLAB code was used to analyse the images and find the EPID sag in three directions as well as the EPID + gantry sag by comparison to the reference gantry zero image. The algorithm results were then tested against independent methods. The method was applied to compare the effect in clockwise and counter clockwise gantry rotations and different source-to-detector distances (SDDs). The results were monitored for one linear accelerator over a course of 15 months and six other linear-accelerators from two treatment centers were also investigated using this method. The generalized shift patterns were derived from the data and used in an image registration algorithm to correct for the effect of the mechanical sag in the system. The Gamma evaluation (3%, 3 mm) technique was used to investigate the improvement in alignment of cine EPID images of a fixed field, by comparing both individual images and the sum of images in a series with the reference gantry zero image. The mechanical sag during gantry rotation was dependent on the gantry angle and was larger in the in-plane direction, although the patterns were not

  6. Cine and tagged cardiovascular magnetic resonance imaging in normal rat at 1.5 T: a rest and stress study

    Directory of Open Access Journals (Sweden)

    Lepetit-Coiffé Matthieu

    2008-11-01

    Full Text Available Abstract Background The purpose of this study was to measure regional contractile function in the normal rat using cardiac cine and tagged cardiovascular magnetic resonance (CMR during incremental low doses of dobutamine and at rest. Methods Five rats were investigated for invasive left ventricle pressure measurements and five additional rats were imaged on a clinical 1.5 T MR system using a cine sequence (11–20 phases per cycle, 0.28/0.28/2 mm and a C-SPAMM tag sequence (18–25 phases per cycle, 0.63/1.79/3 mm, tag spacing 1.25 mm. For each slice, wall thickening (WT and circumferential strains (CS were calculated at rest and at stress (2.5, 5 and 10 μg/min/kg of dobutamine. Results Good cine and tagged images were obtained in all the rats even at higher heart rate (300–440 bpm. Ejection fraction and left ventricular (LV end-systolic volume showed significant changes after each dobutamine perfusion dose (p Conclusion Robust cardiac cine and tagging CMR measurements can be obtained in the rat under incremental dobutamine stress using a clinical 1.5 T MR scanner.

  7. Interpretation of cardiac wall motion from cine-MRI combined with parametric imaging based on the Hilbert transform.

    Science.gov (United States)

    Benameur, Narjes; Caiani, Enrico Gianluca; Arous, Younes; Abdallah, Nejmeddine Ben; Kraiem, Tarek

    2017-08-01

    The aim of this study was to test and validate the clinical impact of parametric amplitude images obtained using the Hilbert transform on the regional interpretation of cardiac wall motion abnormalities from cine-MR images by non-expert radiologists compared with expert consensus. Cine-MRI short-axis images obtained in 20 patients (10 with myocardial infarction, 5 with myocarditis and 5 with normal function) were processed to compute a parametric amplitude image for each using the Hilbert transform. Two expert radiologists blindly reviewed the cine-MR images to define a gold standard for wall motion interpretation for each left ventricular sector. Two non-expert radiologists reviewed and graded the same images without and in combination with parametric images. Grades assigned to each segment in the two separate sessions were compared with the gold standard. According to expert interpretation, 264/320 (82.5%) segments were classified as normal and 56/320 (17.5%) were considered abnormal. The accuracy of the non-expert radiologists' grades compared to the gold standard was significantly improved by adding parametric images (from 87.2 to 94.6%) together with sensitivity (from 64.29 to 84.4%) and specificity (from 92 to 96.9%), also resulting in reduced interobserver variability (from 12.8 to 5.6%). The use of parametric amplitude images based on the Hilbert transform in conjunction with cine-MRI was shown to be a promising technique for improvement of the detection of left ventricular wall motion abnormalities in less expert radiologists.

  8. Double-blind, placebo-controlled trial on the effect of piracetam on breath-holding spells.

    Science.gov (United States)

    Sawires, Happy; Botrous, Osama

    2012-07-01

    Breath-holding spells (BHS) are apparently frightening events occurring in otherwise healthy children.The aim of this study was to evaluate the efficacy of piracetam in the treatment of breath-holding spells. Forty patients with BHS (who were classified into two groups)were involved in a double-blinded placebo-controlled prospective study. Piracetam was given to group A while group B received placebo. Patients were followed monthly for a total period of 4 months. The numbers of attacks/month before and monthly after treatment were documented, and the overall number of attacks/month after treatment was calculated in both groups. The median number of attacks/month before treatment in the two groups was 5.5 and 5,respectively, while after the first month of treatment, it was 2 and 5, respectively. The median overall number of attacks/month after treatment in both groups was 1 and 5, respectively.There was a significant decline of number of attacks after piracetam treatment compared to placebo (p valuespells in children.

  9. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt.

    Science.gov (United States)

    Sadek, Abdelrahim Abdrabou; Mohamed, Montaser Mohamed; Sharaf, El-Zahraa El-Said Ahmed; Magdy, Rofaida Mohamed; Allam, Ahmed Ahmed

    2016-04-01

    Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country.

  10. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

    Science.gov (United States)

    Sadek, Abdelrahim Abdrabou; Mohamed, Montaser Mohamed; Sharaf, El-Zahraa El-Said Ahmed; Magdy, Rofaida Mohamed; Allam, Ahmed Ahmed

    2016-01-01

    Introduction Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. Methods An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). Results During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. Conclusion BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country. PMID:27279996

  11. Assessment of atrial diastolic function in patients with hypertrophic cardiomyopathy by cine magnetic resonance imaging.

    Science.gov (United States)

    Grassedonio, Emanuele; Todiere, Giancarlo; La Grutta, Ludovico; Toia, Patrizia; Gentile, Giovanni D; Galia, Massimo; Midiri, Federico; Pepe, Alessia; Midiri, Massimo; Aquaro, Giovanni Donato

    2015-08-01

    This study was conducted to assess the role of atrial function by cardiac magnetic resonance (CMR) for the evaluation of diastolic physiology in patients with hypertrophic cardiomyopathy (HCM) compared to healthy controls. We enrolled 23 consecutive patients affected by HCM and 43 healthy subjects as age-matched control cases (CC). CMR was performed through acquisition of cine steady-state free precession sequences using a 1.5-T scanner. Image postprocessing was carried out using Tracking Tool software. Atrial volumes were significantly higher in patients with HCM compared to CC: maximum atrial volume (p = 0.007) and minimum atrial volume (p = 0.01). A statistically significant difference was also observed in atrial ejection fraction in patients with HCM (p study demonstrated that in HCM patients with early diastolic dysfunction the parameters of left atrial function assessed by CMR are impaired before the ventricular diastolic indexes such as the early peak filling rate and the active peak filling rate.

  12. Quantitative evaluation of left ventricular regional wall motion by cardiac cine magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hiroshi; Okamura, Masahiro; Kondo, Takeshi (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan)) (and others)

    1991-04-01

    The purpose of this study is to evaluate quantitatively the left ventricular (LV) regional wall motion abnormalities by cardiac cine magnetic resonance imaging (MRI) with the on-line wall motion analysis software that is developed by us. Eighteen patients with various heart diseases were studied by field echo cardiac cine MRI (TR/TE/flip angle = 50/22/30deg) with chain oblique technique. The LV of the right anterior oblique (RAO) left ventriculography (LVG) and vertical long-axis MRI was divided into 5 segments corresponding to those specified by the American Heart Association (AHA), respectively. The area contraction ratio of all segments using LVG and MRI showed significant (p<0.001) positive correlation (r=0.748). As for each segment evaluated independently, correlation was significant (p<0.001) and positive for segments 1 to 3 (r=0.809 in segment 1, r=0.886 in segment 2, and r=0.806 in segment 3). On the other hand, strong correlation was not seen in segment 4 (r=0.712, p<0.001), nor in segment 5 (r=0.698, p<0.002). This was because, due to the absence of respiratory gating, movement of the diaphragm hindered clear delineation of the inferior wall in some cases. In conclusion, the newly developed on-line software permits outlining of LV vertical long-axis images at the end diastole and the end systole, and readily provides quantitative analysis of the LV wall motion. We believe that this method will prove to be useful clinically. (author).

  13. Relationship between coronary flow reserve evaluated by phase-contrast cine cardiovascular magnetic resonance and serum eicosapentaenoic acid

    Science.gov (United States)

    2013-01-01

    Background Long-term intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) is associated with a low risk for cardiovascular disease. Phase-contrast cine cardiovascular magnetic resonance (PC cine CMR) can assess coronary flow reserve (CFR). The present study investigates the relationship between CFR evaluated by PC cine CMR and the serum EPA. Methods We studied 127 patients (male, 116 (91%); mean age, 72.2 ± 7.4 years) with known or suspected coronary artery disease (CAD). X-ray coronary angiography revealed no significant coronary arterial stenoses (defined as luminal diameter reduction ≥50% on quantitative coronary angiogram (QCA) analysis) in all study participants. Breath-hold PC cine CMR images of the coronary sinus (CS) were acquired to assess blood flow of the CS both at rest and during adenosine triphosphate (ATP) infusion. We calculated CFR as CS blood flow during ATP infusion divided by that at rest. Patients were allocated to groups according to whether they had high (n = 64, EPA ≥ 75.8 μg/mL) or low (n = 63, EPA  2.5, which is the previously reported lower limit of normal flow reserve without obstructive CAD. Multivariate analysis revealed that EPA is an independent predictor of CFR > 2.5 (odds ratio, 1.01; 95% confidence interval, 1.00 – 1.02, p = 0.008). Conclusions The serum EPA is significantly correlated with CFR in CAD patients without significant coronary artery stenosis. PMID:24359564

  14. SU-F-T-254: Dose Volume Histogram (DVH) Analysis of Breath Hold Vs Free Breathing Techniques for Esophageal Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Badkul, R; Doke, K; Pokhrel, D; Aguilera, N; Lominska, C [University of Kansas Medical Center, Kansas City, KS (United States)

    2016-06-15

    Purpose: Lung and heart doses and associated toxicity are of concern in radiotherapy for esophageal cancer. This study evaluates the dosimetry of deep-inspiration-breath-hold (DIBH) technique as compared to freebreathing( FB) using 3D-conformal treatment(3D-CRT) of esophageal cancer. Methods: Eight patients were planned with FB and DIBH CT scans. DIBH scans were acquired using Varian RPM system. FB and DIBH CTs were contoured per RTOG-1010 to create the planning target volume(PTV) as well as organs at risk volumes(OAR). Two sets of gross target volumes(GTV) with 5cm length were contoured for each patient: proximal at the level of the carina and distal at the level of gastroesophageal junction and were enlarged with appropriate margin to generate Clinical Target Volume and PTV. 3D-CRT plans were created on Eclipse planning system for 45Gy to cover 95% of PTV in 25 fractions for both proximal and distal tumors on FB and DIBH scans. For distal tumors celiac nodes were covered electively. DVH parameters for lung and heart OARs were generated and analyzed. Results: All DIBH DVH parameters were normalized to FB plan values. Average of heart-mean and heart-V40 was 0.70 and 0.66 for proximal lesions. For distal lesions ratios were 1.21 and 2.22 respectively. For DIBH total lung volume increased by 2.43 times versus FB scan. Average of lung-mean, V30, V20, V10, V5 are 0.82, 0.92, 0.76, 0.77 and 0.79 for proximal lesions and 1.17,0.66,0.87,0.93 and 1.03 for distal lesions. Heart doses were lower for breath-hold proximal lesions but higher for distal lesions as compared to free-breathing plans. Lung doses were lower for both proximal and distal breath-hold lesions except mean lung dose and V5 for distal lesions. Conclusion: This study showed improvement of OAR doses for esophageal lesions at mid-thoracic level utilizing DIBH vs FB technique but did not show consistent OAR sparing with DIBH for distal lesions.

  15. Validation of highly accelerated real-time cardiac cine MRI with radial k-space sampling and compressed sensing in patients at 1.5T and 3T.

    Science.gov (United States)

    Haji-Valizadeh, Hassan; Rahsepar, Amir A; Collins, Jeremy D; Bassett, Elwin; Isakova, Tamara; Block, Tobias; Adluru, Ganesh; DiBella, Edward V R; Lee, Daniel C; Carr, James C; Kim, Daniel

    2017-09-17

    To validate an optimal 12-fold accelerated real-time cine MRI pulse sequence with radial k-space sampling and compressed sensing (CS) in patients at 1.5T and 3T. We used two strategies to reduce image artifacts arising from gradient delays and eddy currents in radial k-space sampling with balanced steady-state free precession readout. We validated this pulse sequence against a standard breath-hold cine sequence in two patient cohorts: a myocardial infarction (n = 16) group at 1.5T and chronic kidney disease group (n = 18) at 3T. Two readers independently performed visual analysis of 68 cine sets in four categories (myocardial definition, temporal fidelity, artifact, noise) on a 5-point Likert scale (1 = nondiagnostic, 2 = poor, 3 = adequate or moderate, 4 = good, 5 = excellent). Another reader calculated left ventricular (LV) functional parameters, including ejection fraction. Compared with standard cine, real-time cine produced nonsignificantly different visually assessed scores, except for the following categories: 1) temporal fidelity scores were significantly lower (P = 0.013) for real-time cine at both field strengths, 2) artifacts scores were significantly higher (P = 0.013) for real-time cine at both field strengths, and 3) noise scores were significantly (P = 0.013) higher for real-time cine at 1.5T. Standard and real-time cine pulse sequences produced LV functional parameters that were in good agreement (e.g., absolute mean difference in ejection fraction cine MRI pulse sequence using radial k-space sampling and CS produces good to excellent visual scores and relatively accurate LV functional parameters in patients at 1.5T and 3T. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  16. Evaluation of ventricular dysfunction using semi-automatic longitudinal strain analysis of four-chamber cine MR imaging.

    Science.gov (United States)

    Kawakubo, Masateru; Nagao, Michinobu; Kumazawa, Seiji; Yamasaki, Yuzo; Chishaki, Akiko S; Nakamura, Yasuhiko; Honda, Hiroshi; Morishita, Junji

    2016-02-01

    The aim of this study was to evaluate ventricular dysfunction using the longitudinal strain analysis in 4-chamber (4CH) cine MR imaging, and to investigate the agreement between the semi-automatic and manual measurements in the analysis. Fifty-two consecutive patients with ischemic, or non-ischemic cardiomyopathy and repaired tetralogy of Fallot who underwent cardiac MR examination incorporating cine MR imaging were retrospectively enrolled. The LV and RV longitudinal strain values were obtained by semi-automatically and manually. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff of the minimum longitudinal strain value for the detection of patients with cardiac dysfunction. The correlations between manual and semi-automatic measurements for LV and RV walls were analyzed by Pearson coefficient analysis. ROC analysis demonstrated the optimal cut-off of the minimum longitudinal strain values (εL_min) for diagnoses the LV and RV dysfunction at a high accuracy (LV εL_min = -7.8 %: area under the curve, 0.89; sensitivity, 83 %; specificity, 91 %, RV εL_min = -15.7 %: area under the curve, 0.82; sensitivity, 92 %; specificity, 68 %). Excellent correlations between manual and semi-automatic measurements for LV and RV free wall were observed (LV, r = 0.97, p cine MR imaging can evaluate LV and RV dysfunction with simply and easy measurements. The strain analysis could have extensive application in cardiac imaging for various clinical cases.

  17. Breath-holding spells: Prevalence and risk factors in under 6-year old children at south of Tehran

    Directory of Open Access Journals (Sweden)

    P. Tootoonchi

    2001-05-01

    Full Text Available To determine breath- holding spells (BHS prevalence and risk factors in under 6- year- old children, we interviewed mothers of 400 children in a cross- sectional study in 5 health centers at south of Tehran in autumn 1999. 33 children (8.25% had history of BHS (Male: 19, Female: 14 25 cases were between 2-4 years old (mean: 40±17 months. Seventy percent of cases (23 had onset of attacks after 6 months of age (mean: 10 monthis and the commonest frequency was one spell per month (78.79%. Painful experience and falling and striking the head wee the common triggering factors (79% and 76% respectively and there was significant association between BHS and history of fallin and severe striking of the head. There was no significant associations between BHS and sex, birth weight, birth order, delivery method, type of labor initiating and duration of labor.

  18. Extracorporeal cardiopulmonary resuscitation for breath-holding spells followed by cardiac arrest due to left main coronary artery stenosis.

    Science.gov (United States)

    Ozyilmaz, Isa; Altin, Husnu Fırat; Yildiz, Okan; Erek, Ersin; Ergul, Yakup; Guzeltas, Alper

    2015-06-01

    Non-syndromic congenital supravalvular aortic stenosis (SVAS) leads to ventricular hypertrophy and increased oxygen consumption, and when combined with other factors reduces coronary blood flow, potentially resulting in myocardial ischemia and sudden cardiac death. While the anatomic obstruction of coronary circulation is as common in non-syndromic SVAS as in Williams syndrome, it often remains unacknowledged. Extracorporeal membrane oxygenation (ECMO) is an elective procedure that can be used to support patients with cardiac arrest during diagnosis as a way to reduce cardiopulmonary load in preparation for surgery or further treatment. In this report, we describe the rare case of an infant with severe SVAS and mild valvular pulmonary and left main coronary artery stenosis, as well as breath-holding spells. After multiple cardiac arrests, the infant underwent diagnostic catheter angiography on ECMO and had the pathology surgically corrected. © 2015 Japan Pediatric Society.

  19. A novel profile/view ordering with a non-convex star shutter for high-resolution 3D volumetric T1 mapping under multiple breath-holds.

    Science.gov (United States)

    Wang, Sui-Cheng; Patel, Amit R; Tanaka, Akiko; Wang, Hui; Ota, Takeyoshi; Lang, Roberto M; Carroll, Timothy J; Kawaji, Keigo

    2017-06-01

    To examine a novel non-convex star ordering/shutter for reducing the number of breath-holds in cardiac three-dimensional (3D) T1 Mapping MRI with multiple breath-holds. A novel ordering, Non-Convex Star (NCS) was designed to acquire 3D volumes in a modified look-locker inversion recovery (MOLLI) T1 mapping sequence to provide more spatial resolution and coverage in fewer breath-holds. The proposed 3D-MOLLI approach using NCS was first validated in two phantoms using artifact power (AP) measurement against the fully sampled phantom. This was followed by an in vivo study in seven swine, in which the T1 values of the left ventricular (LV) myocardium divided into the American Heart Association (AHA) 16-segment model was compared against the reference multislice two-dimensional (2D) clinical reference and 3D volume without NCS breath-hold reduction. NCS breath-hold reduction yielded less AP compared with the matched SENSE accelerated phantom volume (P T1 values from 3D in vivo volumes with/without NCS were comparable in all AHA segments (P = NS), whereas 3D-NCS yielded significantly higher T1 values than 2D at midslice of the LV myocardium in each AHA segment (P T1 mapping acquisition requiring fewer breath-holds. Magn Reson Med 77:2215-2224, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  20. Three-dimensional echo-planar cine imaging of cerebral blood supply using arterial spin labeling.

    Science.gov (United States)

    Shrestha, Manoj; Mildner, Toralf; Schlumm, Torsten; Robertson, Scott Haile; Möller, Harald

    2016-12-01

    Echo-planar imaging (EPI) with CYlindrical Center-out spatiaL Encoding (EPICYCLE) is introduced as a novel hybrid three-dimensional (3D) EPI technique. Its suitability for the tracking of a short bolus created by pseudo-continuous arterial spin labeling (pCASL) through the cerebral vasculature is demonstrated. EPICYCLE acquires two-dimensional planes of k-space along center-out trajectories. These "spokes" are rotated from shot to shot about a common axis to encode a k-space cylinder. To track a bolus of labeled blood, the same subset of evenly distributed spokes is acquired in a cine fashion after a short period of pCASL. This process is repeated for all subsets to fill the whole 3D k-space of each time frame. The passage of short pCASL boluses through the vasculature of a 3D imaging slab was successfully imaged using EPICYCLE. By choosing suitable sequence parameters, the impact of slab excitation on the bolus shape could be minimized. Parametric maps of signal amplitude, transit time, and bolus width reflected typical features of blood transport in large vessels. The EPICYCLE technique was successfully applied to track a short bolus of labeled arterial blood during its passage through the cerebral vasculature.

  1. Heart position variability during voluntary moderate deep inspiration breath-hold radiotherapy for breast cancer determined by repeat CBCT scans.

    Science.gov (United States)

    van Haaren, Paul; Claassen-Janssen, Fiere; van de Sande, Ingrid; Boersma, Liesbeth; van der Sangen, Maurice; Hurkmans, Coen

    2017-08-01

    Voluntary moderate deep inspiration breath hold (vmDIBH) in left-sided breast cancer radiotherapy reduces cardiac dose. The aim of this study was to investigate heart position variability in vmDIBH using CBCT and to compare this variability with differences in heart position between vmDIBH and free breathing (FB). For 50 patients initial heart position with respect to the field edge (HP-FE) was measured on a vmDIBH planning CT scan. Breath-hold was monitored using an in-house developed vertical plastic stick. On pre-treatment CBCT scans, heart position variability with respect to the field edge (ΔHP-FE) was measured, reflecting heart position variability when using an offline correction protocol. After registering the CBCT scan to the planning CT, heart position variability with respect to the chest wall (ΔHP-CW) was measured, reflecting heart position variability when using an online correction protocol. As a control group, vmDIBH and FB computed tomography (CT) scans were acquired for 30 patients and registering both scans on the chest wall. For 34 out of 50 patients, the average HP-FE and HP-CW increased over the treatment course in comparison to the planning CT. Averaged over all patients and all treatment fractions, the ΔHP-FE and the ΔHP-CW was 0.8±4.2mm (range -9.4-+10.6mm) and 1.0±4.4mm (range -8.3-+10.4mm) respectively. The average gain in heart to chest wall distance was 11.8±4.6mm when using vmDIBH instead of FB. In conclusion, substantial variability in heart position using vmDIBH was observed during the treatment course. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  2. Left ventricular volume measurements with free breathing respiratory self-gated 3-dimensional golden angle radial whole-heart cine imaging - Feasibility and reproducibility.

    Science.gov (United States)

    Holst, Karen; Ugander, Martin; Sigfridsson, Andreas

    2017-11-01

    To develop and evaluate a free breathing respiratory self-gated isotropic resolution technique for left ventricular (LV) volume measurements. A 3D radial trajectory with double golden-angle ordering was used for free-running data acquisition during free breathing in 9 healthy volunteers. A respiratory self-gating signal was extracted from the center of k-space and used with the electrocardiogram to bin all data into 3 respiratory and 25 cardiac phases. 3D image volumes were reconstructed and the LV endocardial border was segmented. LV volume measurements and reproducibility from 3D free breathing cine were compared to conventional 2D breath-held cine. No difference was found between 3D free breathing cine and 2D breath-held cine with regards to LV ejection fraction, stroke volume, end-systolic volume and end-diastolic volume (Pcine and 2D breath-held cine (Pcine and conventional 2D breath-held cine showed similar values and test-retest repeatability for LV volumes in healthy volunteers. 3D free breathing cine enabled retrospective sorting and arbitrary angulation of isotropic data, and could correctly measure LV volumes during free breathing acquisition. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Do anticholinergic agents suppress uterine peristalsis and sporadic myometrial contractions at cine MR imaging?

    Science.gov (United States)

    Nakai, Asako; Togashi, Kaori; Kosaka, Kenzo; Kido, Aki; Kataoka, Masako; Koyama, Takashi; Fujii, Shingo

    2008-02-01

    To prospectively evaluate anticholinergic drug effects on uterine peristalsis and sporadic myometrial contractions, as well as on intestinal motion, with cine magnetic resonance (MR) imaging. This prospective study was approved by the institutional review board; informed consent was obtained from all participants. Twenty-one women (mean age, 29.3 years +/- 4.0 [standard deviation]) underwent MR imaging during the follicular through periovulatory phases (cycle days 5-26). Before and after injection of an anticholinergic agent, 60 serial half-Fourier rapid acquisition with relaxation enhancement MR images were obtained within 2 minutes in the midsagittal uterine plane. Evaluations were performed independently and separately in random order by two radiologists who were blinded to whether an anticholingeric agent had been administered. Uterine peristalsis was evaluated for frequency (paired t test), predominant direction (McNemar test), degree of endometrial movement, wave conduction in the junctional zone (JZ), and wave conduction toward the outer myometrium (Wilcoxon signed rank test). Degree of sporadic contractions in the outer myometrium and intestinal motion were also evaluated (Wilcoxon signed rank test). On postinjection images, uterine peristalsis decreased in frequency from 4.57 waves per 2 minutes +/- 1.62 to 3.52 waves per 2 minutes +/- 1.59, which is a 23% (95% confidence interval: 8.7%, 37.2%) average reduction (P = .003). There was no significant difference in actual predominant uterine peristalsis direction between pre- and postinjection images (P > .99). Although there were trends toward reduction of the degree of endometrial movement and of wave conduction in the JZ and toward the outer myometrium, these were not significant. The degree of sporadic myometrial contractions (P = .001) and intestinal motion (P contractions and uterine peristalsis, in addition to intestinal motion, all of which may contribute to improved quality of conventional uterine MR

  4. Geometric uncertainties in voluntary deep inspiration breath hold radiotherapy for locally advanced lung cancer

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, G F; Dueck, Jenny

    2016-01-01

    DIBH radiotherapy is highly reproducible provided an image-guidance strategy with tumour registration is performed. If the primary tumour is separated from the mediastinal lymph nodes, inter-fractional differential motion remains a challenge and margins must be adapted to reflect the image registration...

  5. Deep Inspiration Breath Hold [(18)F]FDG PET-CT on 4-rings scanners in evaluating lung lesions: evidences from a phantom and a clinical study.

    Science.gov (United States)

    Caobelli, Federico; Puta, Erinda; Kaiser, Stefano Ren; Massetti, Valentina; Andreoli, Michela; Mostarda, Angelica; Soffientini, Alberto; Pizzocaro, Claudio; Guerra, Ugo Paolo

    2014-01-01

    To investigate the clinical feasibility of a Deep Inspiration Breath Hold (DIBH) (18)F-FDG PET-CT acquisition in apnea and compare the results obtained between these acts of acquisition in apnea and in Free Breathing in the evaluation of lung lesions. A pre-clinical phantom study was performed to evaluate the shortest simulated DIBH time according to the minimum detectable lesion that can be detected by our ultrasound scanner. This study was conducted by changing acquisition time and sphere-to-background activity ratio values and by using radioactivity densities similar to those generally found in clinical examinations. In the clinical study, 25 patients with pulmonary lesions underwent a standard whole body (18)F-FDG PET-CT scan in free breathing followed by a 20s single thorax acquisition PET/CT in DIBH acquisition. The phantom study indicated that a 20-s acquisition time provides an accurate evaluation of smallest sphere shaped lesions. In the clinical study, PET-CT scans obtained in DIBH studies showed a significant reduction of misalignment between the PET and CT scan images and an increase of SUVmax compared to free breathing acquisitions. A correlation between the %BH-index and lesion displacement between PET and CT images in FB acquisition was demonstrated, significantly higher for lesions with a displacement>8mm. The single 20s acquisition of DIBH PET-CT is a feasible technique for lung lesion detection in the clinical setting. It only requires a minor increase in examination time without special patient training. 20s DIBH scan provided a more precise measurement of SUVmax, especially for lesions in the lower lung lobes which usually show greater displacement between PET and CT scan images in FB acquisition. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  6. Right ventricular volume and mass determined by cine magnetic resonance imaging in HIV patients with possible right ventricular dysfunction

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette; Gerstoft, Jan

    2006-01-01

    Impaired right ventricular (RV) function has been reported to occur in patients with HIV when studied by echocardiography. However, for accurate evaluation of RV function and morphology, first-pass radionuclide ventriculography (RNV) and cine magnetic resonance imaging (cine-MRI) are methods...... of choice. Studies of RV involvement in patients with HIV are of interest since pulmonary hypertension is a known serious complication of HIV recognized with increasing frequency. The aim of the present study was to characterize cardiac function and geometry in patients with HIV and reduced right.......47-0.55 with 3 below the lower 95% reference limit according to the control group (lower reference limit: 0.49). None of the 6 patients with HIV had dilated right ventricle and only 1 had a marginally increased right ventricular mass index of 43 g/m(2) (reference:

  7. Feasibility of free-breathing dynamic contrast-enhanced MRI of gastric cancer using a golden-angle radial stack-of-stars VIBE sequence: comparison with the conventional contrast-enhanced breath-hold 3D VIBE sequence.

    Science.gov (United States)

    Li, Huan-Huan; Zhu, Hui; Yue, Lei; Fu, Yi; Grimm, Robert; Stemmer, Alto; Fu, Cai-Xia; Peng, Wei-Jun

    2017-12-19

    To investigate the feasibility and diagnostic value of free-breathing, radial, stack-of-stars three-dimensional (3D) gradient echo (GRE) sequence ("golden angle") on dynamic contrast-enhanced (DCE) MRI of gastric cancer. Forty-three gastric cancer patients were divided into cooperative and uncooperative groups. Respiratory fluctuation was observed using an abdominal respiratory gating sensor. Those who breath-held for more than 15 s were placed in the cooperative group and the remainder in the uncooperative group. The 3-T MRI scanning protocol included 3D GRE and conventional breath-hold VIBE (volume-interpolated breath-hold examination) sequences, comparing images quantitatively and qualitatively. DCE-MRI parameters from VIBE images of normal gastric wall and malignant lesions were compared. For uncooperative patients, 3D GRE scored higher qualitatively, and had higher SNRs (signal-to-noise ratios) and CNRs (contrast-to-noise ratios) than conventional VIBE quantitatively. Though 3D GRE images scored lower in qualitative parameters compared with conventional VIBE for cooperative patients, it provided images with fewer artefacts. DCE parameters differed significantly between normal gastric wall and lesions, with higher Ve (extracellular volume) and lower Kep (reflux constant) in gastric cancer. The free-breathing, golden-angle, radial stack-of-stars 3D GRE technique is feasible for DCE-MRI of gastric cancer. Dynamic enhanced images can be used for quantitative analysis of this malignancy. • Golden-angle radial stack-of-stars VIBE aids gastric cancer MRI diagnosis. • The 3D GRE technique is suitable for patients unable to suspend respiration. • Method scored higher in the qualitative evaluation for uncooperative patients. • The technique produced images with fewer artefacts than conventional VIBE sequence. • Dynamic enhanced images can be used for quantitative analysis of gastric cancer.

  8. Automatic marker detection and 3D position reconstruction using cine EPID images for SBRT verification.

    Science.gov (United States)

    Park, Sang-June; Ionascu, Dan; Hacker, Fred; Mamon, Harvey; Berbeco, Ross

    2009-10-01

    In previous studies, an electronic portal imaging device (EPID) in cine mode was used for validating respiratory gating and stereotactic body radiation therapy (SBRT) by tracking implanted fiducials. The manual marker tracking methods that were used were time and labor intensive, limiting the utility of the validation. The authors have developed an automatic algorithm to quickly and accurately extract the markers in EPID images and reconstruct their 3D positions. Studies have been performed with gold fiducials placed in solid water and dynamic thorax phantoms. In addition, the authors have examined the cases of five patients being treated under an SBRT protocol for hepatic metastases. For each case, a sequence of images was created by collecting the exit radiation using the EPID. The markers were detected and recognized using an image processing algorithm based on the Laplacian of Gaussian function. To reduce false marker detection, a marker registration technique was applied using image intensity as well as the geometric spatial transformations between the reference marker positions produced from the projection of 3D CT images and the estimated marker positions. An average marker position in 3D was reconstructed by backprojecting, towards the source, the position of each marker on the 2D image plane. From the static phantom study, spatial accuracies of study, using only the Laplacian of the Gaussian algorithm, the marker detection success rate was 88.8%. However, adding a marker registration technique which utilizes prior CT information, the detection success rate was increased to 100%. From the SBRT patient study, intrafractional tumor motion (3.1-11.3 mm) in the SI direction was measured using the 2D images. The interfractional patient setup errors (0.1-12.7 mm) in the SI, AP, and LR directions were obtained from the average marker locations reconstructed in 3D and compared to the reference planning CT image. The authors have developed an automatic algorithm to

  9. Monte Carlo calculations support organ sparing in Deep-Inspiration Breath-Hold intensity-modulated radiotherapy for locally advanced lung cancer

    DEFF Research Database (Denmark)

    Ottosson, Wiviann; Sibolt, Patrik; Larsen, Christina

    2015-01-01

    Background and purpose: Studies indicate that Deep-Inspiration Breath-Hold (DIBH) is advantageous over Free-Breathing (FB) for locally advanced lung cancer radiotherapy. However, these studies were based on simplified dose calculation algorithms, potentially critical due to the heterogeneous nature...

  10. Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Min, Lingfeng; Xu, Xingxiang [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Song, Yong [Jinling Hospital, Nanjing University School of Medical, Nanjing 210002, Jiangsu (China); Issahar, Ben-Dov [Pulmonary Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Wu, Jingtao; Zhang, Le; Huang, Qian [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Chen, Mingxiang, E-mail: chenmx1129@126.com [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China)

    2013-01-15

    Purpose: To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. Materials and methods: Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique. Results: A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver. Conclusion: Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study.

  11. Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approach

    NARCIS (Netherlands)

    Vardoulis, Orestis; Monney, Pierre; Bermano, Amit; Vaxman, A.|info:eu-repo/dai/nl/413533662; Gotsman, Craig; Schwitter, Janine; Stuber, Matthias; Stergiopulos, Nikolaos; Schwitter, Juerg

    2015-01-01

    Background: Left atrial (LA) dilatation is associated with a large variety of cardiac diseases. Current cardiovascular magnetic resonance (CMR) strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration. Aim:

  12. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    NARCIS (Netherlands)

    Dueck, Jenny; Knopf, Antje-Christin; Lomax, Antony; Albertini, Francesca; Persson, Gitte F; Josipovic, Mirjana; Aznar, Marianne C.; Weber, Damien C.; Munck af Rosenschöld, Per

    2016-01-01

    PURPOSE: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delivery

  13. Robustness of the Voluntary Breath-Hold Approach for the Treatment of Peripheral Lung Tumors Using Hypofractionated Pencil Beam Scanning Proton Therapy

    DEFF Research Database (Denmark)

    Dueck, Jenny; Knopf, Antje-Christin; Lomax, Antony

    2016-01-01

    PURPOSE: The safe clinical implementation of pencil beam scanning (PBS) proton therapy for lung tumors is complicated by the delivery uncertainties caused by breathing motion. The purpose of this feasibility study was to investigate whether a voluntary breath-hold technique could limit the delive...

  14. Detection of myocardial viability by low-dose dobutamine Cine MR imaging.

    Science.gov (United States)

    Sandstede, J J; Bertsch, G; Beer, M; Kenn, W; Werner, E; Pabst, T; Lipke, C; Kretschmer, S; Neubauer, S; Hahn, D

    1999-12-01

    The purpose of this work was to test the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for predicting recovery of regional myocardial contractility after revascularization. Cardiac wall motion abnormalities are due to either non-viable and/or scarred, or viable, but hibernating, myocardial tissue. Dobutamine stress leads to increased systolic wall thickening only in viable myocardium. Twenty-five patients with akinetic or dyskinetic myocardial regions were examined with a Cine FLASH-2D sequence at rest and during dobutamine stress (10 microg/kg/min). Patients were re-examined at rest 3, and in case of persisting wall motion defects, 6 months after revascularization. Criterion of viability was increasing end-systolic wall thickening during stress and/or at follow-up. Akinetic regions related either to the LAD (n = 19) or to the RCA (n = 6) were judged viable if > or = 50% of the affected segments improved. MR studies were completed in all subjects without arrhythmia or need for early terminations due to symptoms. Sensitivity, specificity, and positive predictive value for the prediction of myocardial viability were 61%, 90%, and 87% for the segment-related analysis, and 76%, 100%, and 100% for the patient-related analysis based on coronary artery distribution, respectively. Dobutamine stress MRI allows to predict global functional recovery of akinetic myocardial regions after revascularization with a high positive predictive value and high specificity.

  15. SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T; Yue, N; Jabbour, S; Zhang, M [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components that were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy

  16. Influence of Spatial Resolution in Three-dimensional Cine Phase Contrast Magnetic Resonance Imaging on the Accuracy of Hemodynamic Analysis.

    Science.gov (United States)

    Fukuyama, Atsushi; Isoda, Haruo; Morita, Kento; Mori, Marika; Watanabe, Tomoya; Ishiguro, Kenta; Komori, Yoshiaki; Kosugi, Takafumi

    2017-10-10

    We aim to elucidate the effect of spatial resolution of three-dimensional cine phase contrast magnetic resonance (3D cine PC MR) imaging on the accuracy of the blood flow analysis, and examine the optimal setting for spatial resolution using flow phantoms. The flow phantom has five types of acrylic pipes that represent human blood vessels (inner diameters: 15, 12, 9, 6, and 3 mm). The pipes were fixed with 1% agarose containing 0.025 mol/L gadolinium contrast agent. A blood-mimicking fluid with human blood property values was circulated through the pipes at a steady flow. Magnetic resonance (MR) images (three-directional phase images with speed information and magnitude images for information of shape) were acquired using the 3-Tesla MR system and receiving coil. Temporal changes in spatially-averaged velocity and maximum velocity were calculated using hemodynamic analysis software. We calculated the error rates of the flow velocities based on the volume flow rates measured with a flowmeter and examined measurement accuracy. When the acrylic pipe was the size of the thoracicoabdominal or cervical artery and the ratio of pixel size for the pipe was set at 30% or lower, spatially-averaged velocity measurements were highly accurate. When the pixel size ratio was set at 10% or lower, maximum velocity could be measured with high accuracy. It was difficult to accurately measure maximum velocity of the 3-mm pipe, which was the size of an intracranial major artery, but the error for spatially-averaged velocity was 20% or less. Flow velocity measurement accuracy of 3D cine PC MR imaging for pipes with inner sizes equivalent to vessels in the cervical and thoracicoabdominal arteries is good. The flow velocity accuracy for the pipe with a 3-mm-diameter that is equivalent to major intracranial arteries is poor for maximum velocity, but it is relatively good for spatially-averaged velocity.

  17. Impact of low signal intensity assessed by cine magnetic resonance imaging on detection of poorly viable myocardium in patients with prior myocardial infarction.

    Science.gov (United States)

    Ota, Shingo; Tanimoto, Takashi; Orii, Makoto; Hirata, Kumiko; Shiono, Yasutsugu; Shimamura, Kunihiro; Matsuo, Yoshiki; Yamano, Takashi; Ino, Yasushi; Kitabata, Hironori; Yamaguchi, Tomoyuki; Kubo, Takashi; Tanaka, Atsushi; Imanishi, Toshio; Akasaka, Takashi

    2015-05-13

    Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been established as a modality to detect myocardial infarction (MI). However, the use of gadolinium contrast is limited in patients with advanced renal dysfunction. Although the signal intensity (SI) of infarct area assessed by cine MRI is low in some patients with prior MI, the prevalence and clinical significance of low SI has not been evaluated. The aim of this study was to evaluate how low SI assessed by cine MRI may relate to the myocardial viability in patients with prior MI. Fifty patients with prior MI underwent both cine MRI and LGE-MRI. The left ventricle was divided into 17 segments. The presence of low SI and the wall motion score (WMS) of each segment were assessed by cine MRI. The transmural extent of infarction was evaluated by LGE-MRI. LGE was detected in 329 of all 850 segments (39%). The low SI assessed by cine MRI was detected in 105 of 329 segments with LGE (32%). All segments with low SI had LGE. Of all 329 segments with LGE, the segments with low SI showed greater transmural extent of infarction (78 [72 - 84] % versus 53 [38 - 72] %, P cine MRI may be effective for detecting poorly viable myocardium in patients with prior MI.

  18. Computerized method for estimation of the location of a lung tumor on EPID cine images without implanted markers in stereotactic body radiotherapy

    Science.gov (United States)

    Arimura, H.; Egashira, Y.; Shioyama, Y.; Nakamura, K.; Yoshidome, S.; Anai, S.; Nomoto, S.; Honda, H.; Toyofuku, F.; Higashida, Y.; Onizuka, Y.; Terashima, H.

    2009-02-01

    The purpose of this study was to develop a computerized method for estimation of the location of a lung tumor in cine images on an electronic portal imaging device (EPID) without implanted markers during stereotactic body radiotherapy (SBRT). Each tumor region was segmented in the first EPID cine image, i.e., reference portal image, based on a multiple-gray level thresholding technique and a region growing technique, and then the image including the tumor region was cropped as a 'tumor template' image. The tumor location was determined as the position in which the tumor template image took the maximum cross-correlation value within each consecutive portal image, which was acquired in cine mode on the EPID in treatment. EPID images with 512 × 384 pixels (pixel size: 0.56 mm) were acquired at a sampling rate of 0.5 frame s-1 by using energies of 4, 6 or 10 MV on linear accelerators. We applied our proposed method to EPID cine images (226 frames) of 12 clinical cases (ages: 51-83, mean: 72) with a non-small cell lung cancer. As a result, the average location error between tumor points obtained by our method and the manual method was 1.47 ± 0.60 mm. This preliminary study suggests that our method based on the tumor template matching technique might be feasible for tracking the location of a lung tumor without implanted markers in SBRT.

  19. Monitoring tumor motion with on-line mega-voltage cone-beam computed tomography imaging in a cine mode

    Energy Technology Data Exchange (ETDEWEB)

    Reitz, Bodo [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Gayou, Olivier [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Parda, David S [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Miften, Moyed [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States)

    2008-02-21

    Accurate daily patient localization is becoming increasingly important in external-beam radiotherapy (RT). Mega-voltage cone-beam computed tomography (MV-CBCT) utilizing a therapy beam and an on-board electronic portal imager can be used to localize tumor volumes and verify the patient's position prior to treatment. MV-CBCT produces a static volumetric image and therefore can only account for inter-fractional changes. In this work, the feasibility of using the MV-CBCT raw data as a fluoroscopic series of portal images to monitor tumor changes due to e.g. respiratory motion was investigated. A method was developed to read and convert the CB raw data into a cine. To improve the contrast-to-noise ratio on the MV-CB projection data, image post-processing with filtering techniques was investigated. Volumes of interest from the planning CT were projected onto the MV-cine. Because of the small exposure and the varying thickness of the patient depending on the projection angle, soft-tissue contrast was limited. Tumor visibility as a function of tumor size and projection angle was studied. The method was well suited in the upper chest, where motion of the tumor as well as of the diaphragm could be clearly seen. In the cases of patients with non-small cell lung cancer with medium or large tumor masses, we verified that the tumor mass was always located within the PTV despite respiratory motion. However for small tumors the method is less applicable, because the visibility of those targets becomes marginal. Evaluation of motion in non-superior-inferior directions might also be limited for small tumor masses. Viewing MV-CBCT data in a cine mode adds to the utility of MV-CBCT for verification of tumor motion and for deriving individualized treatment margins.

  20. Monitoring tumor motion with on-line mega-voltage cone-beam computed tomography imaging in a cine mode

    Science.gov (United States)

    Reitz, Bodo; Gayou, Olivier; Parda, David S.; Miften, Moyed

    2008-02-01

    Accurate daily patient localization is becoming increasingly important in external-beam radiotherapy (RT). Mega-voltage cone-beam computed tomography (MV-CBCT) utilizing a therapy beam and an on-board electronic portal imager can be used to localize tumor volumes and verify the patient's position prior to treatment. MV-CBCT produces a static volumetric image and therefore can only account for inter-fractional changes. In this work, the feasibility of using the MV-CBCT raw data as a fluoroscopic series of portal images to monitor tumor changes due to e.g. respiratory motion was investigated. A method was developed to read and convert the CB raw data into a cine. To improve the contrast-to-noise ratio on the MV-CB projection data, image post-processing with filtering techniques was investigated. Volumes of interest from the planning CT were projected onto the MV-cine. Because of the small exposure and the varying thickness of the patient depending on the projection angle, soft-tissue contrast was limited. Tumor visibility as a function of tumor size and projection angle was studied. The method was well suited in the upper chest, where motion of the tumor as well as of the diaphragm could be clearly seen. In the cases of patients with non-small cell lung cancer with medium or large tumor masses, we verified that the tumor mass was always located within the PTV despite respiratory motion. However for small tumors the method is less applicable, because the visibility of those targets becomes marginal. Evaluation of motion in non-superior-inferior directions might also be limited for small tumor masses. Viewing MV-CBCT data in a cine mode adds to the utility of MV-CBCT for verification of tumor motion and for deriving individualized treatment margins.

  1. Parental attitude, depression, anxiety in mothers, family functioning and breath-holding spells: A case control study.

    Science.gov (United States)

    Eliacik, Kayi; Bolat, Nurullah; Kanik, Ali; Sargin, Enis; Selkie, Ellen; Korkmaz, Nurhan; Baydan, Figen; Akar, Ebru; Sarioglu, Berrak

    2016-05-01

    This study aimed to identify differences in the antenatal stressful life events, parenting style, family functioning, depression and anxiety of mothers who have children with breath-holding spells (BHS) compared with controls. This case control study divided 66 children into a group of children with BHS and a control group, with the children's ages ranging between 6 months and 5 years of age. This study explored underlying anxiety and depression in mothers as well as functioning of their families. Socio-demographical data and stressful life events that the mother experienced during pregnancy were analysed. In order to evaluate the effects of family structure, depression and anxiety in mothers on BHS in children, the Family Assessment Device, and both the Parental Attitude Research Instrument and the Beck Depression Inventory as well as the State-Trait Anxiety Inventory were used to assess both groups. Exposure to stressful life events during pregnancy (P anxiety (P anxiety, depression, prenatal stressful events and poor family functioning in mothers who have children with BHS is significantly higher than controls. An evaluation of these problems may be beneficial in the management of BHS. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Efficacy of a Brief Psychoeducational Intervention for Mothers of Children with Breath-Holding Spells: A Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Bolat, Nurullah; Eliacik, Kayi; Sargin, Enis; Kanik, Ali; Baydan, Figen; Sarioglu, Berrak

    2016-08-01

    Objective Mothers of individuals with breath-holding spells (BHS) suffer more often from anxiety and experience more stressors in their everyday life. The purpose of this study was to examine the efficacy of psychoeducational intervention in reducing BHS and coping with these spells. Participants and Methods Mothers who have children with BHS were randomly assigned to one of the two groups: an intervention group receiving psychoeducational therapy in addition to the routine follow-up (n = 31) and a control group who did not receive psychoeducation in their routine follow-up (n = 28). The data collected at the beginning of the study and at the end of 3rd and 6th months about the frequency of the spells per month, maternal anxiety, and depression levels and mothers' perceived self-knowledge about coping BHS of both groups were compared. Results Mothers in psychoeducation group, compared with controls, improved significantly on state anxiety, depression, perceived anticipation anxiety level for BHS of their children and self-knowledge about coping with the spells. Conclusion The intervention program had a positive effect on anxiety-depression levels of the mothers and the frequency of BHS among the children. The possible link between emotional and autonomic dysregulation in children with BHS and maternal mental health were discussed. Georg Thieme Verlag KG Stuttgart · New York.

  3. The evaluation of physiological and biochemical parameters and the autonomic nervous systems of children with breath-holding spells.

    Science.gov (United States)

    Arslan, Huseyin; Torun, Emel; Akkan, Julide Canan U; Guler, Serhat; Bayraktar, Suleyman

    2014-08-01

    The aim of this study was to investigate the physiological and biochemical parameters of children who are experiencing breath-holding spells (BHS) and to compare the function of their autonomic nervous systems with those of healthy children. A total of 30 children (age range, 6 months-5 years) admitted for BHS were included in the study. The control group consisted of 30 age-matched and gender-matched healthy children. Each participant underwent a detailed physical examination as well as a laboratory evaluation. Echocardiography, electrocardiography (ECG), and electroencephalography were performed in the study group. The pilocarpine eye test was administered to each participant to detect autonomic dysfunction.  No statistically significant differences were found between the groups for mean age, gender, and anthropometric measurements, nor for the biochemical parameters, including hemoglobin concentration, hematocrit, serum iron, transferrin saturation, ferritin, vitamin D, and vitamin B12 levels (p = 0.05). Compared with the control group, the study group showed significantly abnormal hypersensitivity of pupils after instillation of pilocarpine into their eyes (p = 0.01).  Autonomic dysfunction existed in the children with BHS, but no correlation was found between BHS and deficiencies of iron, vitamin D, or vitamin B12. Georg Thieme Verlag KG Stuttgart · New York.

  4. Study of breath-holding spell and its triggering factors in Children’s Hospital Medical Center

    Directory of Open Access Journals (Sweden)

    Ashrafi MR

    2000-06-01

    Full Text Available To evaluate breath-holding spell (BHS and its triggering factors, 47 children with BHS admitted to the out patients clinic of Children's hospital medical center, between Sept 1998-June 1999, were included in this prospective study. Diagnosis of BHS was made for cases by medical history, pediatric physical examination, EEG, ECG and lab findings. 4 cases were excluded from study because of paroxysmal epileptic discharges at their EEGs. Of 43 cases having BHS (M:F: 1.15:1, 74.4% were less there 24 months of age (Mean age 18.4 mo. 77% of patients had onset of BHS within 12 months of age. Family history of BHS in first degree relatives were found in 51% of patients. Parent consanguinity were found in 30% of cases. The commonest type of BHS were cyanotic (79.1%. Pallid (11.6% and mixed (9.3% were other types. Pain and anger were the commonest triggering factors. 78% of cases were iron deficient and 53% of cases had iron deficiency anemia.

  5. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  6. Influence of longitudinal position on the evolution of steady-state signal in cardiac cine balanced steady-state free precession imaging.

    Science.gov (United States)

    Spear, Tyler J; Stromp, Tori A; Leung, Steve W; Vandsburger, Moriel H

    2017-11-01

    Emerging quantitative cardiac magnetic resonance imaging (CMRI) techniques use cine balanced steady-state free precession (bSSFP) to measure myocardial signal intensity and probe underlying physiological parameters. This correlation assumes that steady-state is maintained uniformly throughout the heart in space and time. To determine the effects of longitudinal cardiac motion and initial slice position on signal deviation in cine bSSFP imaging by comparing two-dimensional (2D) and three-dimensional (3D) acquisitions. Nine healthy volunteers completed cardiac MRI on a 1.5-T scanner. Short axis images were taken at six slice locations using both 2D and 3D cine bSSFP. 3D acquisitions spanned two slices above and below selected slice locations. Changes in myocardial signal intensity were measured across the cardiac cycle and compared to longitudinal shortening. For 2D cine bSSFP, 46% ± 9% of all frames and 84% ± 13% of end-diastolic frames remained within 10% of initial signal intensity. For 3D cine bSSFP the proportions increased to 87% ± 8% and 97% ± 5%. There was no correlation between longitudinal shortening and peak changes in myocardial signal. The initial slice position significantly impacted peak changes in signal intensity for 2D sequences ( P  cine bSSFP that is only restored at the center of a 3D excitation volume. During diastole, a transient steady-state is established similar to that achieved with 3D cine bSSFP regardless of slice location.

  7. SU-C-202-07: Protocol and Hardware for Improved Flood Field Calibration of TrueBeam FFF Cine Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Adamson, J; Faught, A; Yin, F [Duke University Medical Center, Durham, NC (United States)

    2016-06-15

    Purpose: Flattening filter free photon energies are commonly used for high dose treatments such as SBRT, where localization accuracy is essential. Often, MV cine imaging may be employed to verify correct localization. TrueBeam Electronic Portal Imaging Devices (EPIDs) equipped with the 40×30cm{sup 2} Image Detection Unit (IDU) are prone to image saturation at the image center especially for higher dose rates. While saturation often does not occur for cine imaging during treatment because the beam is attenuated by the patient, the flood field calibration is affected when the standard calibration procedure is followed. Here we describe the hardware and protocol to achieve improved image quality for this model of TrueBeam EPID. Methods: A stainless steel filter of uniform thickness was designed to have sufficient attenuation to avoid panel saturation for both 6XFFF and 10XFFF at the maximum dose rates (1400 MU/min & 2400 MU/min, respectively). The cine imaging flood field calibration was then acquired with the filter in place for the FFF energies under the standard calibration geometry (SDD=150cm). Image quality during MV cine was assessed with & without the modified flood field calibration using a low contrast resolution phantom and an anthropomorphic phantom. Results: When the flood field is acquired using the standard procedure (no filter in place), a pixel gain artifact is clearly present in the image center (r=3cm for 10XFFF at 2400 MU/min) which appears similar to and may be mis-attributed to panel saturation in the subject image. The artifact obscured all low contrast inserts at the image center and was also visible on the anthropomorphic phantom. Using the filter for flood field calibration eliminated the artifact. Conclusion: Use of a modified flood field calibration procedure improves image quality for cine MV imaging with TrueBeams equipped with the 40×30cm{sup 2} IDU.

  8. Less increase of CT-based calcium scores of the coronary arteries. Effect three years after breast-conserving radiotherapy using breath-hold

    Energy Technology Data Exchange (ETDEWEB)

    Mast, M.E.; Kempen-Harteveld, M.L. van; Petoukhova, A.L. [Centre West, Radiotherapy, The Hague (Netherlands); Heijenbrok, M.W. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Scholten, A.N. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands); Wolterbeek, R. [Leiden University Medical Centre, Department of Medical Statistics and Bioinformatics, Leiden (Netherlands); Schreur, J.H.M. [Medical Center Haaglanden, Department of Cardiology, The Hague (Netherlands); Struikmans, H. [Centre West, Radiotherapy, The Hague (Netherlands); Leiden University Medical Centre, Department of Clinical Oncology, Leiden (Netherlands)

    2016-10-15

    The aim of this prospective longitudinal study was to compare coronary artery calcium (CAC) scores determined before the start of whole breast irradiation with those determined 3 years afterwards. Changes in CAC scores were analysed in 99 breast cancer patients. Three groups were compared: patients receiving left- and right-sided radiotherapy, and those receiving left-sided radiotherapy with breath-hold. We analysed overall CAC scores and left anterior descending (LAD) and right coronary artery (RCA) CAC scores. Between the three groups, changes of the value of the LAD minus the RCA CAC scores of each individual patient were also compared. Three years after breath-hold-based whole breast irradiation, a less pronounced increase of CAC scores was noted. Furthermore, LAD minus RCA scores in patients treated for left-sided breast cancer without breath-hold were higher when compared to LAD minus RCA scores of patients with right-sided breast cancers and those with left-sided breast cancer treated with breath-hold. Breath-hold in breast-conserving radiotherapy leads to a less pronounced increase of CT-based CAC scores. Therefore, breath-hold probably prevents the development of radiation-induced coronary artery disease. However, the sample size of this study is limited and the follow-up period relatively short. (orig.) [German] Das Ziel dieser prospektiven Langzeitstudie war der Vergleich der Coronary-Artery-Calcium-(CAC-)Werte vor Beginn der Brustbestrahlung mit den Werten nach 3 Jahren. Aenderungen der CAC-Werte wurden bei 99 Brustkrebspatienten analysiert. Drei Gruppen wurden untersucht: Patienten nach links- und rechtsseitiger Strahlentherapie sowie mit Bestrahlung unter Atemanhalt. Wir analysierten die Gesamt-CAC-Werte sowie die CAC-Werte der vorderen linken absteigenden (''left anterior descending'', LAD) und der rechten Koronararterie (''right coronary artery'', RCA). Zwischen den drei Gruppen wurden auch die Veraenderungen

  9. Spirometer-controlled Cine-Magnetic Resonance Imaging for Diagnosis of Tracheobronchomalacia in Pediatric Patients

    NARCIS (Netherlands)

    Ciet, P.; Wielopolski, P.; Manniesing, R.; Lever, S.; Bruijne, M. de; Morana, G.; Muzzio, P.C.; Lequin, M.H.; Tiddens, H.A.W.M.

    2014-01-01

    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children is

  10. Improved quality of life after treatment of prolonged asystole during breath holding spells with a cardiac pacemaker.

    Science.gov (United States)

    Kolterer, Bruno; Gebauer, Roman Antonin; Janousek, Jan; Dähnert, Ingo; Riede, Frank Thomas; Paech, Christian

    2015-01-01

    To validate the physical and psychological effectiveness of cardiac pacing in pediatric patients with breath-holding spells (BHS) and prolonged asystole. The records and clinical data of all the patients with BHS who presented to our center in the period of 2001-2013 were reviewed. All patients who received cardiac pacemaker implantation for prolonged asystole during BHS were included. In addition, the parents were asked to fill out a standardized quality of life (QOL) questionnaire. Seven patients were identified. The mean onset of symptoms was 7 month (1-12 months) of age, documented asystole was 12-21 seconds, and a permanent cardiac pacemaker device was implanted at a mean age of 23 months (8 months-3.9 years). No pacemaker related adverse events were recorded. Follow up showed immediate resolution from spells in four cases (4/7). Two patients (2/7) showed significant reduction of frequency and severity of spells, with complete elimination of loss of consciousness (LOC). One patient (1/7) with an additional neurologic disorder continued to have minor pallid BHS and eventually switched from pallid to cyanotic spells without further detection of bradycardia or asystole in holter examination. QOL questionnaire revealed significant reduction in subjective stress levels of patients (P = 0.012) and parents (P = 0.007) after pacemaker implantation. Cardiac pacing using appropriate pacemaker settings seems effective in the prevention of LOC and reduction of the frequency of BHS. Our results imply a reduction of subjective stress levels of patients and parents as well as an increased quality of everyday life. After all, randomized controlled trials of the influence of cardiac pacemaker implantation on subjective stress levels in patients with BHS are needed.

  11. Mechanical indentation improves cerebral blood oxygenation signal quality of functional near-infrared spectroscopy (fNIRS) during breath holding

    Science.gov (United States)

    Vogt, William C.; Romero, Edwin; LaConte, Stephen M.; Rylander, Christopher G.

    2013-03-01

    Functional near-infrared spectroscopy (fNIRS) is a well-known technique for non-invasively measuring cerebral blood oxygenation, and many studies have demonstrated that fNIRS signals can be related to cognitive function. However, the fNIRS signal is attenuated by the skin, while scalp blood content has been reported to influence cerebral oxygenation measurements. Mechanical indentation has been shown to increase light transmission through soft tissues by causing interstitial water and blood flow away from the compressed region. To study the effects of indentation on fNIRS, a commercial fNIRS system with 16 emitter/detector pairs was used to measure cerebral blood oxygenation at 2 Hz. This device used diffuse reflectance at 730 nm and 850 nm to calculate deoxy- and oxy-hemoglobin concentrations. A borosilicate glass hemisphere was epoxied over each sensor to function as both an indenter and a lens. After placing the indenter/sensor assembly on the forehead, a pair of plastic bands was placed on top of the fNIRS headband and strapped to the head to provide uniform pressure and tightened to approx. 15 N per strap. Cerebral blood oxygenation was recorded during a breath holding regime (15 second hold, 15 second rest, 6 cycles) in 4 human subjects both with and without the indenter array. Results showed that indentation increased raw signal intensity by 85 +/- 35%, and that indentation increased amplitude of hemoglobin changes during breath cycles by 313% +/- 105%. These results suggest that indentation improves sensing of cerebral blood oxygenation, and may potentially enable sensing of deeper brain tissues.

  12. Investigation of dose homogeneity for loose helical tomotherapy delivery in the context of breath-hold radiation therapy

    Science.gov (United States)

    Kim, Bryan; Kron, Tomas; Battista, Jerry; Van Dyk, Jake

    2005-05-01

    Loose helical delivery is a potential solution to account for respiration-driven tumour motion in helical tomotherapy (HT). In this approach, a treatment is divided into a set of interlaced 'loose' helices commencing at different gantry angles. Each loose helix covers the entire target length in one gantry rotation during a single breath-hold. The dosimetric characteristics of loose helical delivery were investigated by delivering a 6 MV photon beam in a HT-like manner. Multiple scenarios of conventional 'tight' HT and loose helical deliveries were modelled in treatment planning software, and carried out experimentally with Kodak EDR2 film. The advantage of loose helical delivery lies in its ability to produce a more homogeneous dose distribution by eliminating the 'thread' effect—an inherent characteristic of HT, which results in dose modulations away from the axis of gantry rotation. However, loose helical delivery was also subjected to undesirable dose modulations in the direction of couch motion (termed 'beating' effect), when the ratio between the number of beam projections per gantry rotation (n) and pitch factor (p) was a non-integer. The magnitude of dose modulations decreased with an increasing n/p ratio. The results suggest that for the current HT unit (n = 51), dose modulations could be kept under 5% by selecting a pitch factor smaller than 7. A pitch factor of this magnitude should be able to treat a target up to 30 cm in length. Loose helical delivery should increase the total session time only by a factor of 2, while the planning time should stay the same since the total number of beam projections remains unchanged. Considering its dosimetric advantage and clinical practicality, loose helical delivery is a promising solution for the future HT treatments of respiration-driven targets.

  13. Minimizing Late Effects for Patients With Mediastinal Hodgkin Lymphoma: Deep Inspiration Breath-Hold, IMRT, or Both?

    Energy Technology Data Exchange (ETDEWEB)

    Aznar, Marianne C., E-mail: marianne.camille.aznar@regionh.dk [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Faculty of Sciences, Niels Bohr Institute, and Faculty of Health Sciences, University of Copenhagen, Copenhagen (Denmark); Maraldo, Maja V.; Schut, Deborah A. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Lundemann, Michael [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Faculty of Sciences, Niels Bohr Institute, and Faculty of Health Sciences, University of Copenhagen, Copenhagen (Denmark); Brodin, N Patrik [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Institute of Onco-Physics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Vogelius, Ivan R. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Berthelsen, Anne K. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Specht, Lena; Petersen, Peter M. [Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

    2015-05-01

    Purpose: Hodgkin lymphoma (HL) survivors have an increased risk of cardiovascular disease (CD), lung cancer, and breast cancer. We investigated the risk for the development of CD and secondary lung, breast, and thyroid cancer after radiation therapy (RT) delivered with deep inspiration breath-hold (DIBH) compared with free-breathing (FB) using 3-dimensional conformal RT (3DCRT) and intensity modulated RT (IMRT). The aim of this study was to determine which treatment modality best reduced the combined risk of life-threatening late effects in patients with mediastinal HL. Methods and Materials: Twenty-two patients with early-stage mediastinal HL were eligible for the study. Treatment plans were calculated with both 3DCRT and IMRT on both DIBH and FB planning computed tomographic scans. We reported the estimated dose to the heart, lung, female breasts, and thyroid and calculated the estimated life years lost attributable to CD and to lung, breast, and thyroid cancer. Results: DIBH lowered the estimated dose to heart and lung regardless of delivery technique (P<.001). There was no significant difference between IMRT-FB and 3DCRT-DIBH in mean heart dose, heart V20Gy, and lung V20Gy. The mean breast dose was increased with IMRT regardless of breathing technique. Life years lost was lowest with DIBH and highest with FB. Conclusions: In this cohort, 3DCRT-DIBH resulted in lower estimated doses and lower lifetime excess risks than did IMRT-FB. Combining IMRT and DIBH could be beneficial for a subgroup of patients.

  14. Improved quality of life after treatment of prolonged asystole during breath holding spells with a cardiac pacemaker

    Science.gov (United States)

    Kolterer, Bruno; Gebauer, Roman Antonin; Janousek, Jan; Dähnert, Ingo; Riede, Frank Thomas; Paech, Christian

    2015-01-01

    Objectives: To validate the physical and psychological effectiveness of cardiac pacing in pediatric patients with breath-holding spells (BHS) and prolonged asystole. Materials and Methods: The records and clinical data of all the patients with BHS who presented to our center in the period of 2001–2013 were reviewed. All patients who received cardiac pacemaker implantation for prolonged asystole during BHS were included. In addition, the parents were asked to fill out a standardized quality of life (QOL) questionnaire. Results: Seven patients were identified. The mean onset of symptoms was 7 month (1–12 months) of age, documented asystole was 12–21 seconds, and a permanent cardiac pacemaker device was implanted at a mean age of 23 months (8 months–3.9 years). No pacemaker related adverse events were recorded. Follow up showed immediate resolution from spells in four cases (4/7). Two patients (2/7) showed significant reduction of frequency and severity of spells, with complete elimination of loss of consciousness (LOC). One patient (1/7) with an additional neurologic disorder continued to have minor pallid BHS and eventually switched from pallid to cyanotic spells without further detection of bradycardia or asystole in holter examination. QOL questionnaire revealed significant reduction in subjective stress levels of patients (P = 0.012) and parents (P = 0.007) after pacemaker implantation. Conclusion: Cardiac pacing using appropriate pacemaker settings seems effective in the prevention of LOC and reduction of the frequency of BHS. Our results imply a reduction of subjective stress levels of patients and parents as well as an increased quality of everyday life. After all, randomized controlled trials of the influence of cardiac pacemaker implantation on subjective stress levels in patients with BHS are needed. PMID:26085761

  15. Changes in Respiratory Parameters and Fin-Swimming Performance Following a 16-Week Training Period with Intermittent Breath Holding.

    Science.gov (United States)

    Stavrou, Vasileios; Toubekis, Argyris G; Karetsi, Eleni

    2015-12-22

    The purpose of this study was to examine the effects of training with intermittent breath holding (IBH) on respiratory parameters, arterial oxygen saturation (SpO2) and performance. Twenty-eight fin-swimming athletes were randomly divided into two groups and followed the same training for 16 weeks. About 40% of the distance of each session was performed with self-selected breathing frequency (SBF group) or IBH (IBH group). Performance time of 50 and 400 m at maximum intensity was recorded and forced expired volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and SpO2 were measured before and after the 50 m test at baseline and post-training. Post-training, the respiratory parameters were increased in the IBH but remained unchanged in the SBF group (FEV1: 17 ±15% vs. -1 ±11%; FVC: 22 ±13% vs. 1 ±10%; PEF: 9 ±14% vs. -4 ±15%; p<0.05). Pre compared to post-training SpO2 was unchanged at baseline and decreased post-training following the 50 m test in both groups (p<0.05). The reduction was higher in the IBH compared to the SBF group (p<0.05). Performance in the 50 and 400 m tests improved in both groups, however, the improvement was greater in the IBH compared to the SBF group in both 50 and 400 m tests (p<0.05). The use of IBH is likely to enhance the load on the respiratory muscles, thus, contributing to improvement of the respiratory parameters. Decreased SpO2 after IBH is likely due to adaptation to hypoventilation. IBH favours performance improvement at 50 and 400 m fin-swimming.

  16. Changes in Respiratory Parameters and Fin-Swimming Performance Following a 16-Week Training Period with Intermittent Breath Holding

    Directory of Open Access Journals (Sweden)

    Stavrou Vasileios

    2015-12-01

    Full Text Available The purpose of this study was to examine the effects of training with intermittent breath holding (IBH on respiratory parameters, arterial oxygen saturation (SpO2 and performance. Twenty-eight fin-swimming athletes were randomly divided into two groups and followed the same training for 16 weeks. About 40% of the distance of each session was performed with self-selected breathing frequency (SBF group or IBH (IBH group. Performance time of 50 and 400 m at maximum intensity was recorded and forced expired volume in 1 s (FEV1, forced vital capacity (FVC, peak expiratory flow (PEF and SpO2 were measured before and after the 50 m test at baseline and post-training. Posttraining, the respiratory parameters were increased in the IBH but remained unchanged in the SBF group (FEV1: 17 ±15% vs. -1 ±11%; FVC: 22 ±13% vs. 1 ±10%; PEF: 9 ±14% vs. -4 ±15%; p<0.05. Pre compared to post-training SpO2 was unchanged at baseline and decreased post-training following the 50 m test in both groups (p<0.05. The reduction was higher in the IBH compared to the SBF group (p<0.05. Performance in the 50 and 400 m tests improved in both groups, however, the improvement was greater in the IBH compared to the SBF group in both 50 and 400 m tests (p<0.05. The use of IBH is likely to enhance the load on the respiratory muscles, thus, contributing to improvement of the respiratory parameters. Decreased SpO2 after IBH is likely due to adaptation to hypoventilation. IBH favours performance improvement at 50 and 400 m fin-swimming.

  17. Non-contrast-enhanced 3D MR portography within a breath-hold using compressed sensing acceleration: A prospective noninferiority study.

    Science.gov (United States)

    Ono, Ayako; Arizono, Shigeki; Fujimoto, Koji; Akasaka, Thai; Yamashita, Rikiya; Furuta, Akihiro; Isoda, Hiroyoshi; Togashi, Kaori

    2017-11-01

    To evaluate images of non-contrast-enhanced 3D MR portography within a breath-hold (BH) using compressed sensing (CS) compared to standard respiratory-triggered (RT) sequences. Fifty-nine healthy volunteers underwent MR portography using two sequences of balanced steady-state free-precession (bSSFP) with time-spatial labeling inversion pulses (Time-SLIP): BH bSSFP-CS and RT bSSFP. Two radiologists independently scored the diagnostic acceptability to delineate the portal branches (MPV: main portal vein; RPV: right portal vein; LPV: left portal vein; RPPV: right posterior portal vein; and P4 and P8: portal branch of segment 4 and segment 8, respectively) and the overall image quality on a four-point scale. We assessed noninferiority of BH bSSFP-CS to RT bSSFP. For quantitative analysis, vessel-to-liver contrast (Cv-l) was calculated in MPV, RPV and LPV. BH bSSFP sequence was successfully performed with a 30-second acquisition time. The diagnostic acceptability scores of BH bSSFP-CS compared with RT bSSFP were statistically noninferior: MPV (95% CI for score difference of Reader 1 and Reader 2, respectively: [-0.16, 0.06], [-0.05, 0.02]), RPV ([-0.00, 0.11], [-0.01, 0.08]), LPV ([-0.03, 0.10], [-0.10, 0.03]), RPPV ([-0.03, 0.10], [-0.05, 0.05]), P4 ([-0.13, 0.34], [-0.28, 0.21]) and P8 ([-0.21, 0.11], [-0.25, -0.02]). However, the overall image quality of BH bSSFP-CS did not show noninferiority ([-0.61, -0.24], [-0.54, -0.17]). Cv-l values were significantly lower in BH bSSFP-CS (P<0.001). CS enabled non-contrast-enhanced 3D bSSFP MR portography to be performed within a BH while maintaining noninferior diagnostic acceptability compared to standard RT bSSFP MR portography. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Decompression sickness in breath-hold diving, and its probable connection to the growth and dissolution of small arterial gas emboli.

    Science.gov (United States)

    Goldman, Saul; Solano-Altamirano, J M

    2015-04-01

    We solved the Laplace equation for the radius of an arterial gas embolism (AGE), during and after breath-hold diving. We used a simple three-region diffusion model for the AGE, and applied our results to two types of breath-hold dives: single, very deep competitive-level dives and repetitive shallower breath-hold dives similar to those carried out by indigenous commercial pearl divers in the South Pacific. Because of the effect of surface tension, AGEs tend to dissolve in arterial blood when arteries remote from supersaturated tissue. However if, before fully dissolving, they reach the capillary beds that perfuse the brain and the inner ear, they may become inflated with inert gas that is transferred into them from these contiguous temporarily supersaturated tissues. By using simple kinetic models of cerebral and inner ear tissue, the nitrogen tissue partial pressures during and after the dive(s) were determined. These were used to theoretically calculate AGE growth and dissolution curves for AGEs lodged in capillaries of the brain and inner ear. From these curves it was found that both cerebral and inner ear decompression sickness are expected to occur occasionally in single competitive-level dives. It was also determined from these curves that for the commercial repetitive dives considered, the duration of the surface interval (the time interval separating individual repetitive dives from one another) was a key determinant, as to whether inner ear and/or cerebral decompression sickness arose. Our predictions both for single competitive-level and repetitive commercial breath-hold diving were consistent with what is known about the incidence of cerebral and inner ear decompression sickness in these forms of diving. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Strain analysis in CRT candidates using the novel segment length in cine (SLICE) post-processing technique on standard CMR cine images

    NARCIS (Netherlands)

    Zweerink, A.; Allaart, C.P.; Kuijer, J.P.A.; Wu, L.; Beek, A.M.; Ven, P.M. van de; Meine, M.; Croisille, P.; Clarysse, P.; Rossum, A.C. van; Nijveldt, R.

    2017-01-01

    OBJECTIVES: Although myocardial strain analysis is a potential tool to improve patient selection for cardiac resynchronization therapy (CRT), there is currently no validated clinical approach to derive segmental strains. We evaluated the novel segment length in cine (SLICE) technique to derive

  20. Retrospective cine 3He ventilation imaging under spontaneous breathing conditions: a non-invasive protocol for small-animal lung function imaging.

    Science.gov (United States)

    Stupar, Vasile; Canet-Soulas, Emmanuelle; Gaillard, Sophie; Alsaid, Hasan; Beckmann, Nicolau; Crémillieux, Yannick

    2007-04-01

    A non-invasive and free-breathing hyperpolarized (HP) (3)He imaging protocol for small animals was implemented and validated on rats for lung function imaging. Animals were allowed to breathe a mixture of air and (3)He from a mask and a gas reservoir fitted to their heads. Radial imaging sequences were used, and MRI signal intensity changes were monitored for retrospective cine image reconstruction. The ventilation cycle of the animals was imaged with a 100 ms temporal resolution. The sliding window imaging technique was applied to reconstruct 5 ms time-shifted image series covering the complete breathing cycle. Image series were processed to extract quantitative ventilation parameters such as the gas arrival time. The reproducibility and the non-invasiveness of this ventilation imaging protocol were evaluated by multiple acquisitions on the same animals. c 2006 John Wiley & Sons, Ltd.

  1. Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2D-cine phase-contrast magnetic resonance imaging.

    Science.gov (United States)

    Gouya, Hervé; Grabar, Sophie; Vignaux, Olivier; Saade, Anastasia; Pol, Stanislas; Legmann, Paul; Sogni, Philippe

    2016-07-01

    To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis. Sixty-nine patients with cirrhosis were prospectively included. All patients underwent HVPG measurements, upper gastrointestinal endoscopy and 2D-cine PC MRI measurements of azygos, portal and aortic blood flow. Univariate and multivariate regression analyses were used to evaluate the correlation between the blood flow and HVPG. The performance of 2D-cine PC MRI to diagnose severe portal hypertension (HVPG ≥ 16 mmHg) was determined by receiver operating characteristic curve (ROC) analysis, and area under the curves (AUC) were compared. Azygos and aortic flow values were associated with HVPG in univariate linear regression model. Azygos flow (p cine PC MRI is a promising technique to evaluate significant portal hypertension in patients with cirrhosis. • Noninvasive HVPG assessment can be performed with MRI azygos flow. • Azygos MRI flow is an easy-to-measure marker to detect significant portal hypertension. • MRI flow is more specific that varice grade to detect portal hypertension.

  2. Impact of Surgical Evaluation of Additional Cine Magnetic Resonance Imaging for Advanced Thymoma with Infiltration of Adjacent Structures: The Thoracic Surgeon's View.

    Science.gov (United States)

    Ried, Michael; Hnevkovsky, Stefanie; Neu, Reiner; von Süßkind-Schwendi, Marietta; Götz, Andrea; Hamer, Okka W; Schalke, Berthold; Hofmann, Hans-Stefan

    2017-04-01

    Background  Preoperative radiological assessment is important for clarification of surgical operability for advanced thymic tumors. Objective was to determine the feasibility of magnetic resonance imaging (MRI) with cine sequences for evaluation of cardiovascular tumor invasion. Patients and Methods  This prospective study included patients with advanced thymoma, who underwent surgical resection. All patients received preoperative computed tomography (CT) scan and cine MRI. Results  Tumor infiltration was surgically confirmed in the pericardium ( n  = 12), myocardium ( n  = 1), superior caval vein (SCV; n  = 3), and aorta ( n  = 2). A macroscopic complete resection was possible in 10 patients, whereas 2 patients with aortic or myocardial tumor invasion had R2 resection. The positive predictive value (PPV) was 50% for cine MRI compared with 0% for CT scan regarding myocardial tumor infiltration. The PPV for tumor infiltration of the aorta was 50%, with a higher sensitivity for the CT scan (100 vs. 50%). Infiltration of the SCV could be detected slightly better with cine MRI (PPV 75 vs. 66.7%). Conclusion  Cine MRI seems to improve the accuracy of preoperative staging of advanced thymoma regarding infiltration of cardiovascular structures and supports the surgical approach. Georg Thieme Verlag KG Stuttgart · New York.

  3. SU-E-T-361: Clinical Benefit of Automatic Beam Gating Mixed with Breath Hold in Radiation Therapy of Left Breast

    Energy Technology Data Exchange (ETDEWEB)

    Wu, J; Hill, G; Spiegel, J [Swedish Cancer Institute, Issaquah, Washington (United States); Ye, J [Swedish Cancer Institute, Edmond, Washington (United States); Mehta, V [Swedish Cancer Institute, Seattle, WA (United States)

    2014-06-01

    Purpose: To investigate the clinical and dosimetric benefits of automatic gating of left breast mixed with breath-hold technique. Methods: Two Active Breathing Control systems, ABC2.0 and ABC3.0, were used during simulation and treatment delivery. The two systems are different such that ABC2.0 is a breath-hold system without beam control capability, while ABC3.0 has capability in both breath-hold and beam gating. At simulation, each patient was scanned twice: one with free breathing (FB) and one with breath hold through ABC. Treatment plan was generated on the CT with ABC. The same plan was also recalculated on the CT with FB. These two plans were compared to assess plan quality. For treatments with ABC2.0, beams with MU > 55 were manually split into multiple subfields. All subfields were identical and shared the total MU. For treatment with ABC3.0, beam splitting was unnecessary. Instead, treatment was delivered in gating mode mixed with breath-hold technique. Treatment delivery efficiency using the two systems was compared. Results: The prescribed dose was 50.4Gy at 1.8Gy/fraction. The maximum heart dose averaged over 10 patients was 46.0±2.5Gy and 24.5±12.2Gy for treatments with FB and with ABC respectively. The corresponding heart V10 was 13.2±3.6% and 1.0±1.6% respectively. The averaged MUs were 99.8±7.5 for LMT, 99.2±9.4 for LLT. For treatment with ABC2.0, normally the original beam was split into 2 subfields. The averaged total time to delivery all beams was 4.3±0.4min for treatments with ABC2.0 and 3.3±0.6min for treatments with ABC3.0 in gating mode. Conclusion: Treatment with ABC tremendously reduced heart dose. Compared to treatments with ABC2.0, gating with ABC3.0 reduced the total treatment time by 23%. Use of ABC3.0 improved the delivery efficiency, and eliminated the possibility of mistreatments. The latter may happen with ABC2.0 where beam is not terminated when breath signal falls outside of the treatment window.

  4. Self-gated CINE MRI for combined contrast-enhanced imaging and wall-stiffness measurements of murine aortic atherosclerotic lesions

    NARCIS (Netherlands)

    den Adel, Brigit; van der Graaf, Linda M.; Strijkers, Gustav J.; Lamb, Hildo J.; Poelmann, Robert E.; van der Weerd, Louise

    2013-01-01

    High-resolution contrast-enhanced imaging of the murine atherosclerotic vessel wall is difficult due to unpredictable flow artifacts, motion of the thin artery wall and problems with flow suppression in the presence of a circulating contrast agent. We applied a 2D-FLASH retrospective-gated CINE MRI

  5. Fast cine-magnetic resonance imaging point tracking for prostate cancer radiation therapy planning

    Science.gov (United States)

    Dowling, J.; Dang, K.; Fox, Chris D.; Chandra, S.; Gill, Suki; Kron, T.; Pham, D.; Foroudi, F.

    2014-03-01

    The analysis of intra-fraction organ motion is important for improving the precision of radiation therapy treatment delivery. One method to quantify this motion is for one or more observers to manually identify anatomic points of interest (POIs) on each slice of a cine-MRI sequence. However this is labour intensive and inter- and intra- observer variation can introduce uncertainty. In this paper a fast method for non-rigid registration based point tracking in cine-MRI sagittal and coronal series is described which identifies POIs in 0.98 seconds per sagittal slice and 1.35 seconds per coronal slice. The manual and automatic points were highly correlated (r>0.99, pmanual verification.

  6. A novel diagnostic aid for intra-abdominal adhesion detection in cine-MR imaging: Pilot study and initial diagnostic impressions.

    Science.gov (United States)

    Randall, David; Joosten, Frank; ten Broek, Richard; Gillott, Richard; Bardhan, Karna Dev; Strik, Chema; Prins, Wiesje; van Goor, Harry; Fenner, John

    2017-07-14

    A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices. The technique produces a 'sheargram' which depicts the amount of sliding which has occurred over 1-3 respiratory cycles. A retrospective cohort of 52 patients, scanned for suspected adhesions, made 281 cine-MRI sagittal slices available for processing. The resulting sheargrams were reported by two operators and compared to expert clinical judgement of the cine-MRI scans. The sheargram matched clinical judgement in 84% of all sagittal slices and 93-96% of positive adhesions were identified on the sheargram. The sheargram displayed a slight skew towards sensitivity over specificity, with a high positive adhesion detection rate but at the expense of false positives. Good correlation between sheargram and absence/presence of inferred adhesions indicates quantification of sliding motion has potential to aid adhesion detection in cine-MRI. Advances in Knowledge: This is the first attempt to clinically evaluate a novel image processing technique quantifying the sliding motion of the abdominal contents against the abdominal wall. The results of this pilot study reveal its potential as a diagnostic aid for detection of abdominal adhesions.

  7. SU-C-210-04: Considerable Pancreatic Tumor Motion During Breath-Hold Measured Using Intratumoral Fiducials On Fluoroscopic Movies

    Energy Technology Data Exchange (ETDEWEB)

    Lens, E; Horst, A van der; Versteijne, E; Tienhoven, G van; Bel, A [Academic Medical Center, Amsterdam (Netherlands)

    2015-06-15

    Purpose: Using a breath hold (BH) technique during radiotherapy of pancreatic tumors is expected to reduce intra-fractional motion. The aim of this study was to evaluate the tumor motion during BH. Methods: In this pilot study, we included 8 consecutive pancreatic cancer patients. All had 2– 4 intratumoral gold fiducials. Patients were asked to perform 3 consecutive 30-second end-inhale BHs on day 5, 10 and 15 of their three-week treatment. During BH, airflow through a mouthpiece was measured using a spirometer. Any inadvertent flow of air during BH was monitored for all patients. We measured tumor motion on lateral fluoroscopic movies (57 in total) made during BH. In each movie the fiducials as a group were tracked over time in superior-inferior (SI) and anterior-posterior (AP) direction using 2-D image correlation between consecutive frames. We determined for each patient the range of intra-BH motion over all movies; we also determined the absolute means and standard deviations (SDs) for the entire patient group. Additionally, we investigated the relation between inadvertent airflow during BH and the intra-BH motion. Results: We found intra-BH tumor motion of up to 12.5 mm (range, 1.0–12.5 mm) in SI direction and up to 8.0 mm (range, 1.0–8.0 mm) in AP direction. The absolute mean motion over the patient population was 4.7 (SD: 3.0) mm and 2.8 (SD: 1.2) mm in the SI and AP direction, respectively. Patients were able to perform stable consecutive BHs; during only 20% of the movies we found very small airflows (≤ 65 ml). These were mostly stepwise in nature and could not explain the continuous tumor motions we observed. Conclusion: We found substantial (up to 12.5 mm) pancreatic tumor motion during BHs. We found minimal inadvertent airflow, seen only during a minority of BHs, and this did not explain the obtained results. This work was supported by the foundation Bergh in het Zadel through the Dutch Cancer Society (KWF Kankerbestrijding) project No. UVA 2011-5271.

  8. SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dueck, J [Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Perrin, R [Paul Scherrer Institut, Villigen PSI (Switzerland); Persson, G F; Engelholm, S A [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Lomax, A [Paul Scherrer Institut, Villigen PSI (Switzerland); Department of Physics, ETH, Zürich (Switzerland); Josipovic, M; Rosenschöld, AF [Department of Oncology, Rigshospitalet, Copenhagen (Denmark); Niels Bohr Institute, University of Copenhagen, Copenhagen (Denmark); Weber, D C [Paul Scherrer Institut, Villigen PSI (Switzerland); University of Zürich, Zürich (Switzerland); Munck, P

    2016-06-15

    Purpose: The breath-hold (BH) technique has been suggested to mitigate motion and reduce target coverage degradation due to motion effects. The aim of this study was to investigate the effect of inter-BH residual motion on the dose distribution for pencil beam scanned (PBS) proton therapy of locally-advanced lung cancer patients. Methods: A dataset of visually-guided BH CT scans was acquired (10 scans per patient) taken from five lung cancer patients: three intra-fractionally repeated CT scans on treatment days 2,16 and 31, in addition to the day 0 planning CT scan. Three field intensity-modulated proton therapy (IMPT) plans were constructed on the planning CT scan. Dose delivery on fraction 2, 16 and 31 were simulated on the three consecutive CT scans, assuming BH duration of 20s and soft tissue match. The dose was accumulated in the planning CT using deformable image registration, and scaled to simulate the full treatment of 66Gy(RBE) in 33 fractions. Results: The mean dose to the lungs and heart, and maximum dose to the spinal cord and esophagus were within 1% of the planned dose. The CTV V95% decreased and the inhomogeneity (D5%–D95%) increased on average 4.1% (0.4–12.2%) and 5.8% (2.2–13.4%), respectively, over the five patient cases. Conclusion: The results showed that the BH technique seems to spare the OARs in spite of inter-BH residual motion. However, small degradation of target coverage occurred for all patients, with 3/5 patients having a decrease in V95% ≤1%. For the remaining two patients, where V95% decreased up to 12%, the cause could be related to treatment related anatomical changes and, as in photon therapy, plan adaptation may be necessary to ensure target coverage. This study showed that BH could be a potential treatment option to reliably mitigate motion for the treatment of locally-advanced lung cancer using PBS proton therapy.

  9. Clinical feasibility of 3D-QALAS - Single breath-hold 3D myocardial T1- and T2-mapping.

    Science.gov (United States)

    Kvernby, Sofia; Warntjes, Marcel; Engvall, Jan; Carlhäll, Carl-Johan; Ebbers, Tino

    2017-05-01

    To investigate the in-vivo precision and clinical feasibility of 3D-QALAS - a novel method for simultaneous three-dimensional myocardial T1- and T2-mapping. Ten healthy subjects and 23 patients with different cardiac pathologies underwent cardiovascular 3T MRI examinations including 3D-QALAS, MOLLI and T2-GraSE acquisitions. Precision was investigated in the healthy subjects between independent scans, between dependent scans and as standard deviation of consecutive scans. Clinical feasibility of 3D-QALAS was investigated for native and contrast enhanced myocardium in patients. Data were analyzed using mean value and 95% confidence interval, Pearson correlation, Paired t-tests, intraclass correlation and Bland-Altman analysis. Average myocardial relaxation time values and SD from eight repeated acquisitions within the group of healthy subjects were 1178±18.5ms (1.6%) for T1 with 3D-QALAS, 52.7±1.2ms (2.3%) for T2 with 3D-QALAS, 1145±10.0ms (0.9%) for T1 with MOLLI and 49.2±0.8ms (1.6%) for T2 with GraSE. Myocardial T1 and T2 relaxation times obtained with 3D-QALAS correlated very well with reference methods; MOLLI for T1 (r=0.994) and T2-GraSE for T2 (r=0.818) in the 23 patients. Average native/post-contrast myocardial T1 values from the patients were 1166.2ms/411.8ms for 3D-QALAS and 1174.4ms/438.9ms for MOLLI. Average native myocardial T2 values from the patients were 53.2ms for 3D-QALAS and 54.4ms for T2-GraSE. Repeated independent and dependent scans together with the intra-scan repeatability, demonstrated all a very good precision for the 3D-QALAS method in healthy volunteers. This study shows that 3D T1 and T2 mapping in the left ventricle is feasible in one breath hold for patients with different cardiac pathologies using 3D-QALAS. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Development and clinical evaluation of automatic fiducial detection for tumor tracking in cine megavoltage images during volumetric modulated arc therapy

    Energy Technology Data Exchange (ETDEWEB)

    Azcona, Juan Diego [Department of Radiation Oncology, Stanford University, Stanford, California 94305 and Department of Oncology, Division of Radiation Physics, Clinica Universidad de Navarra, Pamplona, Navarra 31008 (Spain); Li Ruijiang; Mok, Edward; Hancock, Steven; Xing Lei [Department of Radiation Oncology, Stanford University, Stanford, California 94305 (United States)

    2013-03-15

    Purpose: Real-time tracking of implanted fiducials in cine megavoltage (MV) imaging during volumetric modulated arc therapy (VMAT) delivery is complicated due to the inherent low contrast of MV images and potential blockage of dynamic leaves configurations. The purpose of this work is to develop a clinically practical autodetection algorithm for motion management during VMAT. Methods: The expected field-specific segments and the planned fiducial position from the Eclipse (Varian Medical Systems, Palo Alto, CA) treatment planning system were projected onto the MV images. The fiducials were enhanced by applying a Laplacian of Gaussian filter in the spatial domain for each image, with a blob-shaped object as the impulse response. The search of implanted fiducials was then performed on a region of interest centered on the projection of the fiducial when it was within an open field including the case when it was close to the field edge or partially occluded by the leaves. A universal template formula was proposed for template matching and normalized cross correlation was employed for its simplicity and computational efficiency. The search region for every image was adaptively updated through a prediction model that employed the 3D position of the fiducial estimated from the localized positions in previous images. This prediction model allowed the actual fiducial position to be tracked dynamically and was used to initialize the search region. The artifacts caused by electronic interference during the acquisition were effectively removed. A score map was computed by combining both morphological information and image intensity. The pixel location with the highest score was selected as the detected fiducial position. The sets of cine MV images taken during treatment were analyzed with in-house developed software written in MATLAB (The Mathworks, Inc., Natick, MA). Five prostate patients were analyzed to assess the algorithm performance by measuring their positioning

  11. Breath-hold [68Ga]DOTA-TOC PET/CT in neuroendocrine tumors: detection of additional lesions and effects on quantitative parameters.

    Science.gov (United States)

    Zirnsak, Mariana; Bärwolf, Robert; Freesmeyer, Martin

    2016-11-08

    Respiratory motion during PET/CT acquisition generates artifacts in the form of breath-related blurring, which influences the lesion detectability and diagnostic accuracy. The goal of this study was to verify whether breath-hold [68Ga]DOTA-TOC PET/CT (bhPET) allows detection of additional foci compared to free-breathing PET/CT (fbPET), and to assess the impact of breath-holding on standard uptake values (SUV) and isocontoured volume (Vic40) in patients with neuroendocrine tumors (NET). Patients with NET (n=39) were included in this study. BhPET and fbPET characteristics of 96 lesions were compared, and correlated with standard contrast-enhanced (ce) CT and MRI for lesion verification. Quantitative parameters SUV (max and mean) and Vic40 were assessed for both methods and evaluated by linear regression and Spearman's correlation. The impact of lesion size, localization and time interval between investigations was also analyzed. bhPET identified one additional metastasis not seen at fbPET but visible at ceMRI. Another additional bhPET focus did not have a morphological correlate. At bhPET, the SUVmax and SUVmean proved significantly higher and the Vic40 significantly lower than at fbPET. Lesion size, localization and time intervals did not impact significantly on SUV or Vic40. Currently, routine use of breath-hold [68Ga]DOTA-TOC PET/CT cannot be recommended as only one additional lesion was identified. Therefore, bhPET has currently no indication in patients with NET. If technical improvements regarding PET/CT scanner sensitivity are available, bhPET should be reevaluated in the future.

  12. Breath-hold and free-breathing F-18-FDG-PET/CT in malignant melanoma-detection of additional tumoral foci and effects on quantitative parameters.

    Science.gov (United States)

    Bärwolf, Robert; Zirnsak, Mariana; Freesmeyer, Martin

    2017-01-01

    During PET/CT acquisition, respiratory motion generates artifacts in the form of breath-related blurring, which may impair lesion detectability and diagnostic accuracy. This observational study was undertaken to verify whether breath-hold F-18-FDG-PET/CT (bhPET) detects additional foci compared to free-breathing PET/CT (fbPET) in cases of malignant melanoma, and to assess the impact of breath-holding on standard uptake values (SUV) and metabolic isocontoured volume (mVic40).Thirty-four patients with melanoma were examined. BhPET and fbPET findings of 117 lesions were compared and correlated with standard contrast-enhanced (ce) CT and MRI for lesion verification. Quantitative parameters (SUVmax, SUVmean, and mVic40) were assessed for both methods and evaluated by linear regression and Spearman correlation. The impact of lesion size and time interval between investigations was analyzed.In 1 patient, a CT-confirmed liver metastasis was seen only on bhPET but not on fbPET. At bhPET, SUVmax, and SUVmean proved significantly higher and mVic40 significantly lower than at fbPET. The positive effect on SUVmax and SUVmean was more pronounced in smaller lesions, whereas the time interval between bhPET and fbPET did not influence SUV or mVic40.In our patient cohort, bhPET yielded significantly higher SUV and provided improved volumetric lesion definition, particularly of smaller lesions. Also one additional liver lesion was identified. Breath-hold PET/CT is technically feasible, and may become clinically useful when fine quantitative evaluations are needed.

  13. Quantitative assessment of left ventricular mechanical dyssynchrony using cine cardiovascular magnetic resonance imaging: Inter-study reproducibility

    Directory of Open Access Journals (Sweden)

    Johannes T Kowallick

    2017-05-01

    Full Text Available Objectives To determine the inter-study reproducibility of left ventricular (LV mechanical dyssynchrony measures based on standard cardiovascular magnetic resonance (CMR cine images. Design Steady-state free precession (SSFP LV short-axis stacks and three long-axes were acquired on the same day at three time points. Circumferential strain systolic dyssynchrony indexes (SDI, area-SDI as well as circumferential and radial uniformity ratio estimates (CURE and RURE, respectively were derived from CMR myocardial feature-tracking (CMR-FT based on the tracking of three SSFP short-axis planes. Furthermore, 4D-LV-analysis based on SSFP short-axis stacks and longitudinal planes was performed to quantify 4D-volume-SDI. Setting A single-centre London teaching hospital. Participants 16 healthy volunteers. Main outcome measures Inter-study reproducibility between the repeated exams. Results CURE and RURE as well as 4D-volume-SDI showed good inter-study reproducibility (coefficient of variation [CoV] 6.4%–12.9%. Circumferential strain and area-SDI showed higher variability between the repeated measurements (CoV 24.9%–37.5%. Uniformity ratio estimates showed the lowest inter-study variability (CoV 6.4%–8.5%. Conclusions Derivation of LV mechanical dyssynchrony measures from standard cine images is feasible using CMR-FT and 4D-LV-analysis tools. Uniformity ratio estimates and 4D-volume-SDI showed good inter-study reproducibility. Their clinical value should next be explored in patients who potentially benefit from cardiac resynchronization therapy.

  14. Four-dimensional real-time cine images of wrist joint kinematics using dual source CT with minimal time increment scanning.

    Science.gov (United States)

    Choi, Yoon Seong; Lee, Young Han; Kim, Sungjun; Cho, Hee Woo; Song, Ho-Taek; Suh, Jin-Suck

    2013-07-01

    To validate the feasibility of real time kinematography with four-dimensional (4D) dynamic functional wrist joint imaging using dual source CT. Two healthy volunteers performed radioulnar deviation and pronation- supination wrist motions for 10 s and 4 s per cycle in a dual source CT scanner. Scan and reconstruction protocols were set to optimize temporal resolution. Cine images of the reconstructed carpal bone of the moving wrist were recorded. The quality of the images and radiation dosage were evaluated. The 4D cine images obtained during 4 s and 10 s of radioulnar motion showed a smooth stream of movement with good quality and little noise or artifact. Images from the pronation-supination motion showed noise with a masked surface contour. The temporal resolution was optimized at 0.28 s. Using dual source CT, 4D cine images of in vivo kinematics of wrist joint movement were obtained and found to have a shorter scan time, improved temporal resolution and lower radiation dosages compared with those previously reported.

  15. Free-breathing imaging of the heart using 2D cine-GRICS (generalized reconstruction by inversion of coupled systems) with assessment of ventricular volumes and function.

    Science.gov (United States)

    Vuissoz, Pierre-André; Odille, Freddy; Fernandez, Brice; Lohezic, Maelene; Benhadid, Adnane; Mandry, Damien; Felblinger, Jacques

    2012-02-01

    To assess cardiac function by means of a novel free-breathing cardiac magnetic resonance imaging (MRI) strategy. A stack of ungated 2D steady-state free precession (SSFP) slices was acquired during free breathing and reconstructed as cardiac cine imaging based on the generalized reconstruction by inversion of coupled systems (GRICS). A motion-compensated sliding window approach allows reconstructing cine movies with most motion artifacts cancelled. The proposed reconstruction uses prior knowledge from respiratory belts and electrocardiogram recordings and features a piecewise linear model that relates the electrocardiogram signal to cardiac displacements. The free-breathing protocol was validated in six subjects against a standard breath-held protocol. Image sharpness, as assessed by the image gradient entropy, was comparable to that of breath-held images and significantly better than in uncorrected images. Volumetric parameters of cardiac function in the left ventricle (LV) and right ventricle (RV) were similar, including end-systolic volumes, end-diastolic volumes and mass, stroke volumes, and ejection fractions (with differences of 3% ± 2.4 in the LV and 2.9% ± 4.4 in the RV). The duration of the free-breathing protocol was nearly the same as the breath-held protocol. Free-breathing cine-GRICS enables accurate assessment of volumetric parameters of cardiac function with efficient correction of motion. Copyright © 2011 Wiley Periodicals, Inc.

  16. Analysis of Cerebrospinal Fluid Flow in the Aqueduct using Cine Phase-Contrast Imaging : Efficacy of a New Technique to Correct the Maxwell Term Phase Errors and Fourier Analysis

    OpenAIRE

    Suzuki, Takayuki

    2002-01-01

    Cerebrospinal fluid (CSF) flow through the aqueduct was studied using cine phase-contrast (Cine-PC) imaging. To increase the precision of velocity measurements, the author employed 'opposite directional flow-encoding (ODFE) technique' which could eliminate the influence of the Maxwell term phase errors on ROI analyses of velocity images. Various experiments using a flow-phantom proved that the ODFE technique could estimate low flow rates (around 7 ml/min) with great accuracy (absolute percent...

  17. Differentiation between acute and chronic myocardial infarction by means of texture analysis of late gadolinium enhancement and cine cardiac magnetic resonance imaging.

    Science.gov (United States)

    Larroza, Andrés; Materka, Andrzej; López-Lereu, María P; Monmeneu, José V; Bodí, Vicente; Moratal, David

    2017-07-01

    The purpose of this study was to differentiate acute from chronic myocardial infarction using machine learning techniques and texture features extracted from cardiac magnetic resonance imaging (MRI). The study group comprised 22 cases with acute myocardial infarction (AMI) and 22 cases with chronic myocardial infarction (CMI). Cine and late gadolinium enhancement (LGE) MRI were analyzed independently to differentiate AMI from CMI. A total of 279 texture features were extracted from predefined regions of interest (ROIs): the infarcted area on LGE MRI, and the entire myocardium on cine MRI. Classification performance was evaluated by a nested cross-validation approach combining a feature selection technique with three predictive models: random forest, support vector machine (SVM) with Gaussian Kernel, and SVM with polynomial kernel. The polynomial SVM yielded the best classification performance. Receiver operating characteristic curves provided area-under-the-curve (AUC) (mean±standard deviation) of 0.86±0.06 on LGE MRI using 72 features; AMI sensitivity=0.81±0.08 and specificity=0.84±0.09. On cine MRI, AUC=0.82±0.06 using 75 features; AMI sensitivity=0.79±0.10 and specificity=0.80±0.10. We concluded that texture analysis can be used for differentiation of AMI from CMI on cardiac LGE MRI, and also on standard cine sequences in which the infarction is visually imperceptible in most cases. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Long-term operative failure of endoscopic third ventriculostomy in pediatric patients: the role of cine phase-contrast MR imaging.

    Science.gov (United States)

    Faggin, Roberto; Calderone, Milena; Denaro, Luca; Meneghini, Luisa; d'Avella, Domenico

    2011-04-01

    Although a rarely reported occurrence, late failure of endoscopic third ventriculostomy (ETV) may occur in children as a result of a variety of factors. Delay in recognition of symptoms can lead to harmful deterioration in the patient's condition. The authors undertook this study to assess the capacity of cine phase-contrast MR imaging to identify late failure in asymptomatic pediatric patients treated with ETV for hydrocephalus. This study was a retrospective evaluation of cases involving patients who underwent ETV between January 1, 1999, and December 31, 2008, at the pediatric neurological surgery service of the University of Padua. Before 2004, patients were routinely followed up with cine MR imaging at 3, 6, and 12 months after ETV. In 2004, a protocol of annual cine MR follow-up was instituted as a result of a case of fatal late failure. The authors evaluated all cases of late failure identified through cine MR imaging and performed a statistical analysis to investigate the relationship between ETV failure and several variables, including the cause of hydrocephalus for which ETV was originally indicated. In a series of 84 patients (age range 6 days-16 years), 17 patients had early ETV failure. Of the remaining 67 patients, 5 (7%) were found to have no CSF flow through the fenestration and recurrent ventriculomegaly when assessed with cine MR imaging at 1, 2, 3, 4, and 7 years after ETV. The patient in whom ETV failure was identified 1 year postoperatively had Dandy-Walker malformation. The patients in whom ETV failure was identified 2, 3, and 4 years postoperatively all had undergone ETV for treatment of postinfective hydrocephalus. The patient in whom ETV failure was identified 7 years postoperatively had a cystic arachnopathy in the fourth ventricle after cerebellar astrocytoma removal. Patients who undergo ETV for infective hydrocephalus and Dandy-Walker malformation should receive long-term follow-up, because late closure of the stoma may occur

  19. Exploratory analysis of nonlinear coupling between EEG global field power and end-tidal carbon dioxide in free breathing and breath-hold tasks.

    Science.gov (United States)

    Morelli, Maria Sole; Valenza, Gaetano; Greco, Alberto; Giannoni, Alberto; Passino, Claudio; Emdin, Michele; Scilingo, Enzo Pasquale; Vanello, Nicola

    2016-08-01

    Brain activations underlying control of breathing are not completely known. Furthermore, the coupling between neural and respiratory dynamics is usually estimated through linear correlation measures, thus totally disregarding possible underlying nonlinear interactions. To overcome these limitations, in this preliminary study we propose a nonlinear coupling analysis of simultaneous recordings of electroencephalographic (EEG) and respiratory signals at rest and after variation of carbon dioxide (CO2) level. Specifically, a CO2 increase was induced by a voluntary breath hold task. EEG global field power (GFP) in different frequency bands and end-tidal CO2 (PETCO2) were estimated in both conditions. The maximum information coefficient (MIC) and MIC-ρ2 (where ρ represents the Pearson's correlation coefficient) between the two signals were calculated to identify generic associations (i.e. linear and nonlinear correlations) and nonlinear correlations, respectively. With respect to a free breathing state, our results suggest that a breath hold state is characterized by an increased coupling between respiration activity and specific EEG oscillations, mainly involving linear and nonlinear interactions in the delta band (1-4 Hz), and prevalent nonlinear interactions in the alpha band (8-13 Hz).

  20. [Changes in P-wave, T-wave, and ST segment amplitude in 12 lead electrocardiogram in children with breath holding spell].

    Science.gov (United States)

    Zhang, Wenhua; Wang, Cheng; Zou, Runmei; Liu, Liping; Wu, Lijia; Luo, Xuemei; Li, Fang; Liao, Donglei; Cai, Hong

    2016-06-28

    To explore the change of the amplitude of P wave, T wave and ST segment of 12 lead electrocardiogram (ECG) in children with breath holding spell.
 A total of 29 children (24 males and 5 females) with breath holding spell in Second Xiangya Hospital, Central South University were enrolled for this study from October, 2009 to September, 2015. Their ages ranged from 3 months to 6 years, with an average of 1.82±1.27 years old. The control group consisted of 30 age-matched and gender-matched healthy children. All subjects were underwent electrocardiography by the SR-1000A comprehensive automatic electrocardiograph analyzer, and the changes of the ECG parameters were compared between the two groups.
 Compared with the control group, the amplitude of P-wave of V5 lead was decreased [(44.10±23.98) vs (58.30±21.19) μV, Pbreath holding spell have autonomic nerve dysfunction. The amplitude of ST segment changes is sensitive.

  1. Verification of respiratory-gated radiotherapy with new real-time tumour-tracking radiotherapy system using cine EPID images and a log file

    Science.gov (United States)

    Shiinoki, Takehiro; Hanazawa, Hideki; Yuasa, Yuki; Fujimoto, Koya; Uehara, Takuya; Shibuya, Keiko

    2017-02-01

    A combined system comprising the TrueBeam linear accelerator and a new real-time tumour-tracking radiotherapy system, SyncTraX, was installed at our institution. The objectives of this study are to develop a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine electronic portal image device (EPID) images and a log file and to verify this treatment in clinical cases. Respiratory-gated radiotherapy was performed using TrueBeam and the SyncTraX system. Cine EPID images and a log file were acquired for a phantom and three patients during the course of the treatment. Digitally reconstructed radiographs (DRRs) were created for each treatment beam using a planning CT set. The cine EPID images, log file, and DRRs were analysed using a developed software. For the phantom case, the accuracy of the proposed method was evaluated to verify the respiratory-gated radiotherapy. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker used as an internal surrogate were calculated to evaluate the gating accuracy and set-up uncertainty in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions. The proposed method achieved high accuracy for the phantom verification. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker were  ⩽3 mm and  ±3 mm in the SI, AP, and LR directions. We proposed a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine EPID images and a log file and showed that this treatment is performed with high accuracy in clinical cases. This work was partly presented at the 58th Annual meeting of American Association of Physicists in Medicine.

  2. Verification of respiratory-gated radiotherapy with new real-time tumour-tracking radiotherapy system using cine EPID images and a log file.

    Science.gov (United States)

    Shiinoki, Takehiro; Hanazawa, Hideki; Yuasa, Yuki; Fujimoto, Koya; Uehara, Takuya; Shibuya, Keiko

    2017-02-21

    A combined system comprising the TrueBeam linear accelerator and a new real-time tumour-tracking radiotherapy system, SyncTraX, was installed at our institution. The objectives of this study are to develop a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine electronic portal image device (EPID) images and a log file and to verify this treatment in clinical cases. Respiratory-gated radiotherapy was performed using TrueBeam and the SyncTraX system. Cine EPID images and a log file were acquired for a phantom and three patients during the course of the treatment. Digitally reconstructed radiographs (DRRs) were created for each treatment beam using a planning CT set. The cine EPID images, log file, and DRRs were analysed using a developed software. For the phantom case, the accuracy of the proposed method was evaluated to verify the respiratory-gated radiotherapy. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker used as an internal surrogate were calculated to evaluate the gating accuracy and set-up uncertainty in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions. The proposed method achieved high accuracy for the phantom verification. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker were  ⩽3 mm and  ±3 mm in the SI, AP, and LR directions. We proposed a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine EPID images and a log file and showed that this treatment is performed with high accuracy in clinical cases.

  3. Planning target volume assessment in lung tumors during 3D conformal radiotherapy by means of an aSi electronic portal imaging device in cine mode.

    Science.gov (United States)

    Caivano, R; Clemente, S; Fiorentino, A; Chiumento, C; Pedicini, P; Califano, G; Cozzolino, M; Fusco, V

    2013-08-01

    The major uncertainties in treating lung cancer are the repositioning errors and respiratory lung tumor motion. Typically, margins are added to the clinical target volume (CTV) to obtain a planning target volume (PTV) allowing the accommodation of such uncertainties. We want to test a new technique to assess the adequacy of the chosen PTV using an aSi electronic portal imaging device (EPID). Four patients affected by lung cancer and treated by radical 3D conformal radiotherapy (3DRT) were studied. During treatment the EPID was used in cine mode acquisition: acquired images were used to the aim. Treatment monitoring with an EPID in cine mode is shown to be a clinically feasible and useful tool.

  4. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... to remain perfectly still and follow breath-holding instructions while the images are being recorded. If you ... Please type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone ...

  5. The Effect of Inhalation Volume and Breath-Hold Duration on the Retention of Nicotine and Solanesol in the Human Respiratory Tract and on Subsequent Plasma Nicotine Concentrations During Cigarette Smoking

    Directory of Open Access Journals (Sweden)

    Armitage AK

    2014-12-01

    Full Text Available The influence of inhalation depth and breath-hold duration on the retention of nicotine and solanesol in the human respiratory tract and on nicotine uptake was studied in ten cigarette smokers. In a first series of experiments, the subjects took seven puffs from a 10 mg ‘tar’ yield, test cigarette and a fixed volume of air (0, 75, 250, 500 or 1000 mL, as required by the protocol was inhaled after each puff in order to give a controlled ‘depth’ of inhalation. The inhalation was drawn from a bag containing the required volume of air. Following a 2 s breath-hold, subjects exhaled normally, with the first exhalation after each puff passing through a single acidified filter pad for collection of the non-retained nicotine and solanesol. Blood samples were taken before and at intervals during and after smoking for the sessions with 0, 75 and 500 mL inhalation volumes for determination of plasma nicotine and carboxyhaemoglobin levels. Another series of experiments was conducted with a fixed inhalation volume (500 mL and two further breath-hold durations (0 and 10 s in addition to 2 s from above. Nicotine and solanesol retentions were measured for each breath-hold condition. The amounts of nicotine retained within the respiratory system, expressed as a percentage of the amount taken into the mouth, were consistently higher than the corresponding values for solanesol in all five inhalation conditions (0-1000 mL, 2 s breath-hold. Nicotine retention increased from 46.5% at zero inhalation to 99.5% at 1000 mL inhalation (2 s breath-hold and from 98.0% at zero breath-hold to 99.9% at 10 s breath-hold (500 mL inhalation. Solanesol retention increased from 34.2% at zero inhalation volume to 71.9% at 1000 mL inhalation (2 s breath-hold and from 51.8% at zero breath-hold to 87.6% at 10 s breath-hold (500 mL inhalation. Plasma nicotine decreased from pre-smoking levels after zero inhalation indicating that the nicotine retained within the mouth was poorly

  6. Noise properties for three weighted Feldkamp algorithms using a 256-detecotor row CT-scanner: case study for hepatic volumetric cine imaging.

    Science.gov (United States)

    Mori, Shinichiro; Endo, Masahiro; Obata, Takayuki; Kishimoto, Riwa; Kato, Hirotoshi; Kandatsu, Susumu; Tsujii, Hirohiko; Tanada, Shuji

    2006-08-01

    In cone-beam geometry, image quality may be degraded or artifacts may occur if the cone angle is substantially wide. This is because a cone-beam scan along a circular orbit does not collect the complete set of data required to make an exact reconstruction of all volumetric data. To increase temporal resolution and thus image quality in cone-beam geometry, Silver proposed the new half-scan algorithm (NHS-FDK), which extends Parker's weighting function (HS-FDK) by utilizing a larger range up to 2pi. Here, we evaluated these algorithms for hepatic contrast-enhanced CT in cine scan mode using a 256-detector row CT. The full-scan (FS-FDK) images show uniform distribution of the image noise and CT-number uniformity. Image noise and CT-number uniformity with HS-FDK and NHS-FDK images follow the initial projection angle. HS-FDK images therefore have more changeable higher intensity (brighter) and a lower intensity (darker) areas than respective FS-FDK and NHS-FDK images. We concluded that, considering the trade-off between image quality and temporal resolution, the NHS-FDK algorithm is useful in volumetric cine imaging for the abdomen.

  7. 2D XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration

    Science.gov (United States)

    Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon

    2017-01-01

    Object Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMR). We evaluated whether a free-breathing (FB) radial imaging CCMR sequence with compressed sensing reconstruction (eXtra-Dimension (e.g. cardiac and respiratory phases) Golden-angle RAdial Sparse Parallel, or XD-GRASP) could provide better image quality than a conventional Cartesian breath-held (BH) sequence, in an unselected population of patients undergoing clinical CCMR. Material and Methods 101 patients who underwent BH and FB imaging in a mid-ventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a 5-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastole (ED) and end-systole (ES) left-ventricular areas were also measured and compared for both BH and FB images. Results Image quality was generally better with the BH cines (overall quality grade BH vs FB: 4 vs 2.9, pcine in general, it provided improved image quality in the subgroup of patients presenting respiratory motion-induced artifacts on breath-held images. PMID:29067539

  8. Relationship between Class III malocclusion and hyoid bone displacement during swallowing: a cine-magnetic resonance imaging study.

    Science.gov (United States)

    Gokce, Sila Mermut; Gokce, Hasan Suat; Gorgulu, Serkan; Karacay, Seniz; Akca, Eralp; Olmez, Huseyin

    2012-08-01

    The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage. At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity. Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing.

  9. Effect of Maximal Apnoea Easy-Going and Struggle Phases on Subarachnoid Width and Pial Artery Pulsation in Elite Breath-Hold Divers.

    Directory of Open Access Journals (Sweden)

    Pawel J Winklewski

    Full Text Available The aim of the study was to assess changes in subarachnoid space width (sas-TQ, the marker of intracranial pressure (ICP, pial artery pulsation (cc-TQ and cardiac contribution to blood pressure (BP, cerebral blood flow velocity (CBFV and cc-TQ oscillations throughout the maximal breath hold in elite apnoea divers. Non-invasive assessment of sas-TQ and cc-TQ became possible due to recently developed method based on infrared radiation, called near-infrared transillumination/backscattering sounding (NIR-T/BSS.The experimental group consisted of seven breath-hold divers (six men. During testing, each participant performed a single maximal end-inspiratory breath hold. Apnoea consisted of the easy-going and struggle phases (characterised by involuntary breathing movements (IBMs. Heart rate (HR was determined using a standard ECG. BP was assessed using the photoplethysmography method. SaO2 was monitored continuously with pulse oximetry. A pneumatic chest belt was used to register thoracic and abdominal movements. Cerebral blood flow velocity (CBFV was estimated by a 2-MHz transcranial Doppler ultrasonic probe. sas-TQ and cc-TQ were measured using NIR-T/BSS. Wavelet transform analysis was performed to assess cardiac contribution to BP, CBFV and cc-TQ oscillations.Mean BP and CBFV increased compared to baseline at the end of the easy phase and were further augmented by IBMs. cc-TQ increased compared to baseline at the end of the easy phase and remained stable during the IBMs. HR did not change significantly throughout the apnoea, although a trend toward a decrease during the easy phase and recovery during the IBMs was visible. Amplitudes of BP, CBFV and cc-TQ were augmented. sas-TQ and SaO2 decreased at the easy phase of apnoea and further decreased during the IBMs.Apnoea increases intracranial pressure and pial artery pulsation. Pial artery pulsation seems to be stabilised by the IBMs. Cardiac contribution to BP, CBFV and cc-TQ oscillations does not

  10. Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

    Science.gov (United States)

    Kim, Taeho; Kim, Siyong; Park, Yang-Kyun; Youn, Kaylin K.; Keall, Paul; Lee, Rena

    2014-11-01

    A dual quasi-breath-hold (DQBH) technique is proposed for respiratory motion management (a hybrid technique combining breathing-guidance with breath-hold task in the middle). The aim of this study is to test a hypothesis that the DQBH biofeedback system improves both the capability of motion management and delivery efficiency. Fifteen healthy human subjects were recruited for two respiratory motion measurements (free breathing and DQBH biofeedback breathing for 15 min). In this study, the DQBH biofeedback system utilized the abdominal position obtained using an real-time position management (RPM) system (Varian Medical Systems, Palo Alto, USA) to audio-visually guide a human subject for 4 s breath-hold at EOI and 90% EOE (EOE90%) to improve delivery efficiency. We investigated the residual respiratory motion and the delivery efficiency (duty-cycle) of abdominal displacement within the gating window. The improvement of the abdominal motion reproducibility was evaluated in terms of cycle-to-cycle displacement variability, respiratory period and baseline drift. The DQBH biofeedback system improved the abdominal motion management capability compared to that with free breathing. With a phase based gating (mean ± std: 55  ±  5%), the averaged root mean square error (RMSE) of the abdominal displacement in the dual-gating windows decreased from 2.26 mm of free breathing to 1.16 mm of DQBH biofeedback (p-value = 0.007). The averaged RMSE of abdominal displacement over the entire respiratory cycles reduced from 2.23 mm of free breathing to 1.39 mm of DQBH biofeedback breathing in the dual-gating windows (p-value = 0.028). The averaged baseline drift dropped from 0.9 mm min-1 with free breathing to 0.09 mm min-1 with DQBH biofeedback (p-value = 0.048). The averaged duty-cycle with an 1 mm width of displacement bound increased from 15% of free breathing to 26% of DQBH biofeedback (p-value = 0.003). The study demonstrated that the DQBH biofeedback

  11. Free-breathing black-blood CINE fast-spin echo imaging for measuring abdominal aortic wall distensibility: a feasibility study

    Science.gov (United States)

    Lin, Jyh-Miin; Patterson, Andrew J.; Chao, Tzu-Cheng; Zhu, Chengcheng; Chang, Hing-Chiu; Mendes, Jason; Chung, Hsiao-Wen; Gillard, Jonathan H.; Graves, Martin J.

    2017-05-01

    The paper reports a free-breathing black-blood CINE fast-spin echo (FSE) technique for measuring abdominal aortic wall motion. The free-breathing CINE FSE includes the following MR techniques: (1) variable-density sampling with fast iterative reconstruction; (2) inner-volume imaging; and (3) a blood-suppression preparation pulse. The proposed technique was evaluated in eight healthy subjects. The inner-volume imaging significantly reduced the intraluminal artifacts of respiratory motion (p  =  0.015). The quantitative measurements were a diameter of 16.3  ±  2.8 mm and wall distensibility of 2.0  ±  0.4 mm (12.5  ±  3.4%) and 0.7  ±  0.3 mm (4.1  ±  1.0%) for the anterior and posterior walls, respectively. The cyclic cross-sectional distensibility was 35  ±  15% greater in the systolic phase than in the diastolic phase. In conclusion, we developed a feasible CINE FSE method to measure the motion of the abdominal aortic wall, which will enable clinical scientists to study the elasticity of the abdominal aorta.

  12. Adaptation requirements due to anatomical changes in free-breathing and deep-inspiration breath-hold for standard and dose-escalated radiotherapy of lung cancer patients

    DEFF Research Database (Denmark)

    Sibolt, Patrik; Ottosson, Wiviann; Sjöström, David

    2015-01-01

    Background. Radiotherapy of lung cancer patients is subject to uncertainties related to heterogeneities, anatomical changes and breathing motion. Use of deep-inspiration breath-hold (DIBH) can reduce the treated volume, potentially enabling dose-escalated (DE) treatments. This study was designed...... to investigate the need for adaptation due to anatomical changes, for both standard (ST) and DE plans in free-breathing (FB) and DIBH. Material and methods. The effect of tumor shrinkage (TS), pleural effusion (PE) and atelectasis was investigated for patients and for a CIRS thorax phantom. Sixteen patients were...... and had no effect for DIBH. Conclusion. Phantom simulations provided potential adaptation action levels for PE and TS. For the more complex patient geometry, individual assessment of the dosimetric impact is recommended for both ST and DE plans in DIBH as well as in FB. However, DIBH was found...

  13. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

    Science.gov (United States)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-09-22

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean irradiation.

  14. SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Depauw, N; Patel, S; MacDonald, S; Lu, H [Massachusetts General Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: Deep inspiration breath-hold techniques (DIBH) have been shown to carry significant dosimetric advantages in conventional radiotherapy of left-sided breast cancer. The purpose of this study is to evaluate the use of DIBH techniques for post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Method: Ten PMRT patients, with or without breast implant, underwent two helical CT scans: one with free breathing and the other with deep inspiration breath-hold. A prescription of 50.4 Gy(RBE) to the whole chest wall and lymphatics (axillary, supraclavicular, and intramammary nodes) was considered. PBS plans were generated for each patient’s CT scan using Astroid, an in-house treatment planning system, with the institution conventional clinical PMRT parameters; that is, using a single en-face field with a spot size varying from 8 mm to 14 mm as a function of energy. Similar optimization parameters were used in both plans in order to ensure appropriate comparison. Results: Regardless of the technique (free breathing or DIBH), the generated plans were well within clinical acceptability. DIBH allowed for higher target coverage with better sparing of the cardiac structures. The lung doses were also slightly improved. While the use of DIBH techniques might be of interest, it is technically challenging as it would require a fast PBS delivery, as well as the synchronization of the beam delivery with a gating system, both of which are not currently available at the institution. Conclusion: DIBH techniques display some dosimetric advantages over free breathing treatment for PBS PMRT patients, which warrants further investigation. Plans will also be generated with smaller spot sizes (2.5 mm to 5.5 mm and 5 mm to 9 mm), corresponding to new generation machines, in order to further quantify the dosimetric advantages of DIBH as a function of spot size.

  15. An investigation of gantry angle data accuracy for cine-mode EPID images acquired during arc IMRT.

    Science.gov (United States)

    McCowan, Peter M; Rickey, Daniel W; Rowshanfarzad, Pejman; Greer, Peter B; Ansbacher, William; McCurdy, Boyd M

    2014-01-06

    EPID images acquired in cine mode during arc therapy have inaccurate gantry angles recorded in their image headers. In this work, methods were developed to assess the accuracy of the gantry potentiometer for linear accelerators. As well, assessments of the accuracy of other, more accessible, sources of gantry angle information (i.e., treatment log files, analysis of EPID image headers) were investigated. The methods used in this study are generally applicable to any linear accelerator unit, and have been demonstrated here with Clinac/Trilogy systems. Gantry angle data were simultaneously acquired using three methods: i) a direct gantry potentiometer measurement, ii) an incremental rotary encoder, and iii) a custom-made radiographic gantry-angle phantom which produced unique wire intersections as a function of gantry angle. All methods were compared to gantry angle data from the EPID image header and the linac MLC DynaLog file. The encoder and gantry-angle phantom were used to validate the accuracy of the linac's potentiometer. The EPID image header gantry angles and the DynaLog file gantry angles were compared to the potentiometer. The encoder and gantry-angle phantom mean angle differences with the potentiometer were 0.13° ± 0.14° and 0.10°± 0.30°, respectively. The EPID image header angles analyzed in this study were within ± 1° of the potentiometer angles only 35% of the time. In some cases, EPID image header gantry angles disagreed by as much as 3° with the potentiometer. A time delay in frame acquisition was determined using the continuous acquisition mode of the EPID. After correcting for this time delay, 75% of the header angles, on average, were within ± 1° of the true gantry angle, compared to an average of only 35% without the correction. Applying a boxcar smoothing filter to the corrected gantry angles further improved the accuracy of the header-derived gantry angles to within ± 1° for almost all images (99.4%). An angle accuracy of 0.11°

  16. Differentiation between focal malignant marrow-replacing lesions and benign red marrow deposition of the spine with T2*-corrected fat-signal fraction map using a three-echo volume interpolated breath-hold gradient echo Dixon sequence.

    Science.gov (United States)

    Kim, Yong Pyo; Kannengiesser, Stephan; Paek, Mun-Young; Kim, Sungjun; Chung, Tae-Sub; Yoo, Yeon Hwa; Yoon, Choon-Sik; Song, Ho-Taek; Lee, Young Han; Suh, Jin-Suck

    2014-01-01

    To assess the feasibility of T2*-corrected fat-signal fraction (FF) map by using the three-echo volume interpolated breath-hold gradient echo (VIBE) Dixon sequence to differentiate between malignant marrow-replacing lesions and benign red marrow deposition of vertebrae. We assessed 32 lesions from 32 patients who underwent magnetic resonance imaging after being referred for assessment of a known or possible vertebral marrow abnormality. The lesions were divided into 21 malignant marrow-replacing lesions and 11 benign red marrow depositions. Three sequences for the parameter measurements were obtained by using a 1.5-T MR imaging scanner as follows: three-echo VIBE Dixon sequence for FF; conventional T1-weighted imaging for the lesion-disc ratio (LDR); pre- and post-gadolinium enhanced fat-suppressed T1-weighted images for the contrast-enhancement ratio (CER). A region of interest was drawn for each lesion for parameter measurements. The areas under the curve (AUC) of the parameters and their sensitivities and specificities at the most ideal cutoff values from receiver operating characteristic curve analysis were obtained. AUC, sensitivity, and specificity were respectively compared between FF and CER. The AUCs of FF, LDR, and CER were 0.96, 0.80, and 0.72, respectively. In the comparison of diagnostic performance between the FF and CER, the FF showed a significantly larger AUC as compared to the CER (p = 0.030), although the difference of sensitivity (p = 0.157) and specificity (p = 0.157) were not significant. Fat-signal fraction measurement using T2*-corrected three-echo VIBE Dixon sequence is feasible and has a more accurate diagnostic performance, than the CER, in distinguishing benign red marrow deposition from malignant bone marrow-replacing lesions.

  17. Two-dimensional XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration.

    Science.gov (United States)

    Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon

    2017-10-24

    Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMRI). We evaluated whether a free-breathing (FB) radial imaging CCMRI sequence with compressed sensing reconstruction [extradimensional (e.g. cardiac and respiratory phases) golden-angle radial sparse parallel, or XD-GRASP] could provide better image quality than a conventional Cartesian breath-held (BH) sequence in an unselected population of patients undergoing clinical CCMRI. One hundred one patients who underwent BH and FB imaging in a midventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a five-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastolic and end-systolic left ventricular areas were also measured and compared for both BH and FB images. Image quality was generally better with the BH cines (overall quality grade for BH vs FB images 4 vs 2.9, p images regarding end-diastolic or end-systolic areas (p = 0.35 and p = 0.12). Eighteen of the 101 patients had poor BH image quality (grade 1 or 2). In this subgroup, the quality of the FB images was better (p = 0.0032), as was the SNR grade (p = 0.003), but there were no significant differences regarding noise and sharpness (p = 0.45 and p = 0.47). Although FB XD-GRASP CCMRI was visually inferior to conventional BH CCMRI in general, it provided improved image quality in the subgroup of patients with respiratory-motion-induced artifacts on BH images.

  18. SU-F-J-151: Evaluation of a Magnetic Resonance Image Gated Radiotherapy System Using a Motion Phantom and Radiochromic Film

    Energy Technology Data Exchange (ETDEWEB)

    Lamb, J; Ginn, J; O’Connell, D; Thomas, D; Agazaryan, N; Cao, M; Yang, Y; Low, D [UCLA, Los Angeles, CA (United States)

    2016-06-15

    Purpose: Magnetic resonance image (MRI) guided radiotherapy enables gating directly on target position for soft-tissue targets in the lung and abdomen. We present a dosimetric evaluation of a commercially-available FDA-approved MRI-guided radiotherapy system’s gating performance using a MRI-compatible respiratory motion phantom and radiochromic film. Methods: The MRI-compatible phantom was capable of one-dimensional motion. The phantom consisted of a target rod containing high-contrast target inserts which moved inside a body structure containing background contrast material. The target rod was equipped with a radiochromic film insert. Treatment plans were generated for a 3 cm diameter spherical target, and delivered to the phantom at rest and in motion with and without gating. Both sinusoidal and actual tumor trajectories (two free-breathing trajectories and one repeated-breath hold) were used. Gamma comparison at 5%/3mm was used to measure fidelity to the static target dose distribution. Results: Without gating, gamma pass rates were 24–47% depending on motion trajectory. Using our clinical standard of repeated breath holds and a gating window of 3 mm with 10% of the target allowed outside the gating boundary, the gamma pass rate was 99.6%. Relaxing the gating window to 5 mm resulted in gamma pass rate of 98.6% with repeated breath holds. For all motion trajectories gated with 3 mm margin and 10% allowed out, gamma pass rates were between 64–100% (mean:87.5%). For a 5 mm margin and 10% allowed out, gamma pass rates were between 57–98% (mean: 82.49%), significantly lower than for 3 mm by paired t-test (p=0.01). Conclusion: We validated the performance of respiratory gating based on real-time cine MRI images with the only FDA-approved MRI-guided radiotherapy system. Our results suggest that repeated breath hold gating should be used when possible for best accuracy. A 3 mm gating margin is statistically significantly more accurate than a 5 mm gating margin.

  19. Initial effects of the tongue crib on tongue movements during deglutition: a Cine-Magnetic resonance imaging study.

    Science.gov (United States)

    Sayin, M Ozgür; Akin, Erol; Karaçay, Seniz; Bulakbaşi, Nail

    2006-05-01

    The objective of this study was to investigate the initial effects of a tongue crib on tongue movements during deglutition by using real time balanced turbo field echo (B-TFE) Cine-MR imaging. A total of 21 patients were evaluated in this study. The open-bite group (OBG) consisted of 11 patients (seven girls, four boys) who had a mean age of 11.09 +/- 2.02 years and a mean overbite of -5.14 +/- 1.83 mm. These patients were evaluated initially (T1) and while wearing a tongue crib (T2). A total of 10 patients (five girls, five boys) with a mean age of 14.5 +/- 2.6 years and with a mean overbite of 1.6 +/- 0.5 mm served as controls (CG), and only initial records were obtained from these patients. T2 was compared with T1 and CG. T1 was also compared with CG. We evaluated deglutition during three stages matching oral (1), pharyngeal (2), and esophageal (3) stages. Our results indicated that the tongue's tip positioned more posteriorly when the crib was in place (T2) compared with both T1 and CG; the anterior portion of the tongue's dorsum was at a lower position in T2 compared with both T1 and CG at stage 3; the midportion of the tongue's dorsum was at a lower position in T2 than in T1 and CG at stages 1 and 2. To compensate for the posterior position of the tongue's tip (caused by the tongue crib), adaptive changes occurred in the anterior and midportions of the dorsum of the tongue.

  20. Cine-Club

    CERN Multimedia

    Cine-Club

    2013-01-01

    The CERN CineClub is a meeting point every Thursday for anyone who wants to discover, discuss, and appreciate cinema with people who are truly interested in the art of the moving image. In the actual context where downloading became easier than cooking an egg, one might wonder why bother when it can be watched on any computer. Well, cinema is not an individual activity. What the CineClub offers is a big screen with good quality image and sound. It also offers a careful selection, for allowing people to (re-)discover new and forgotten authors. Finally, it offers the opportunity for meeting people sharing a common interest. So come every Thursday, and see by yourself that watching films can actually be a real party! Every Thursday at 20 h 00 Council Chamber, 503/1-001 Programme June 2013 Science Fiction Cycle “Imagination is more important than knowledge. For knowledge is limited, whereas imagination embraces the entire world, stimulating progress, giving birth to evolution.” 6th June 2...

  1. SU-G-JeP4-01: An Assessment of a Microsoft Kinect V2 Sensor for Voluntary Breath-Hold Monitoring in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Edmunds, D; Donovan, E [The Royal Marsden NHS Foundation Trust, Sutton, London (United Kingdom)

    2016-06-15

    Purpose: To determine whether the Microsoft Kinect Version 2 (Kinect v2), a commercial off-the-shelf (COTS) depth sensors designed for entertainment purposes, were robust to the radiotherapy treatment environment and could be suitable for monitoring of voluntary breath-hold compliance. This could complement current visual monitoring techniques, and be useful for heart sparing left breast radiotherapy. Methods: In-house software to control Kinect v2 sensors, and capture output information, was developed using the free Microsoft software development kit, and the Cinder creative coding C++ library. Each sensor was used with a 12m USB 3.0 active cable. A solid water block was used as the object. The depth accuracy and precision of the sensors was evaluated by comparing Kinect reported distance to the object with a precision laser measurement across a distance range of 0.6m to 2.0 m. The object was positioned on a high-precision programmable motion platform and moved in two programmed motion patterns and Kinect reported distance logged. Robustness to the radiation environment was tested by repeating all measurements with a linear accelerator operating over a range of pulse repetition frequencies (6Hz to 400Hz) and dose rates 50 to 1500 monitor units (MU) per minute. Results: The complex, consistent relationship between true and measured distance was unaffected by the radiation environment, as was the ability to detect motion. Sensor precision was < 1 mm and the accuracy between 1.3 mm and 1.8 mm when a distance correction was applied. Both motion patterns were tracked successfully with a root mean squared error (RMSE) of 1.4 and 1.1 mm respectively. Conclusion: Kinect v2 sensors are capable of tracking pre-programmed motion patterns with an accuracy <2 mm and appear robust to the radiotherapy treatment environment. A clinical trial using Kinect v2 sensor for monitoring voluntary breath hold has ethical approval and is open to recruitment. The authors are supported by a

  2. How to perform and interpret cine MR enterography.

    Science.gov (United States)

    Wnorowski, Amelia M; Guglielmo, Flavius F; Mitchell, Donald G

    2015-11-01

    Magnetic resonance (MR) enterography has become a fundamental tool for small bowel evaluation. Multiphasic cine imaging is a useful component of MR enterography evaluation because it provides functional information about bowel motility. Cine MR enterography can be used to evaluate for strictures and adhesions. Bowel motility evaluation has been shown to increase pathologic lesion detection in Crohn's disease and has been incorporated into disease activity scoring systems. Currently, cine MR enterography remains underutilized. The purpose of this article is to outline how to perform and interpret cine MR enterography. The authors describe how to perform a multiphasic balanced steady state free precession sequence using different MR systems and give practical advice on how to display and interpret the cine sequence. Sample cases illustrate how the cine sequence complements standard MR enterography evaluation with T2 -weighted, contrast-enhanced T1 -weighted, and diffusion-weighted imaging. © 2015 Wiley Periodicals, Inc.

  3. SIFT-based dense pixel tracking on 0.35 T cine-MR images acquired during image-guided radiation therapy with application to gating optimization

    Energy Technology Data Exchange (ETDEWEB)

    Mazur, Thomas R., E-mail: tmazur@radonc.wustl.edu, E-mail: hli@radonc.wustl.edu; Fischer-Valuck, Benjamin W.; Wang, Yuhe; Yang, Deshan; Mutic, Sasa; Li, H. Harold, E-mail: tmazur@radonc.wustl.edu, E-mail: hli@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, Missouri 63110 (United States)

    2016-01-15

    Purpose: To first demonstrate the viability of applying an image processing technique for tracking regions on low-contrast cine-MR images acquired during image-guided radiation therapy, and then outline a scheme that uses tracking data for optimizing gating results in a patient-specific manner. Methods: A first-generation MR-IGRT system—treating patients since January 2014—integrates a 0.35 T MR scanner into an annular gantry consisting of three independent Co-60 sources. Obtaining adequate frame rates for capturing relevant patient motion across large fields-of-view currently requires coarse in-plane spatial resolution. This study initially (1) investigate the feasibility of rapidly tracking dense pixel correspondences across single, sagittal plane images (with both moderate signal-to-noise and spatial resolution) using a matching objective for highly descriptive vectors called scale-invariant feature transform (SIFT) descriptors associated to all pixels that describe intensity gradients in local regions around each pixel. To more accurately track features, (2) harmonic analysis was then applied to all pixel trajectories within a region-of-interest across a short training period. In particular, the procedure adjusts the motion of outlying trajectories whose relative spectral power within a frequency bandwidth consistent with respiration (or another form of periodic motion) does not exceed a threshold value that is manually specified following the training period. To evaluate the tracking reliability after applying this correction, conventional metrics—including Dice similarity coefficients (DSCs), mean tracking errors (MTEs), and Hausdorff distances (HD)—were used to compare target segmentations obtained via tracking to manually delineated segmentations. Upon confirming the viability of this descriptor-based procedure for reliably tracking features, the study (3) outlines a scheme for optimizing gating parameters—including relative target position and a

  4. CINE CLUB

    CERN Multimedia

    Ciné Club

    2009-01-01

    Main Auditorium CERN jeudi 17 décembre 2009 à 18 h 15 à l’Amphithéâtre principal du CERN (bâtiment 500)   Comme chaque année avant Noël, le CineClub du CERN est heureux d’inviter petits et grands à une projection gratuite du film   LE MONDE DE NEMO (FINDING NEMO) (USA, 2003, Andrew Stanton and Lee Unkrich)   Dans les eaux tropicales de la Grande Barrière de corail, un poisson-clown du nom de Marin mène une existence paisible avec son fils unique, Nemo. Redoutant l’océan et ses risques imprévisibles, il fait de son mieux pour protéger son fils. Comme tous les petits poissons de son âge, celui-ci rêve pourtant d’explorer les mystérieux récifs. Lorsque Nemo disparaît, Marin devient malgré lui le héros d’une qu&a...

  5. Cine club

    CERN Multimedia

    Ciné club

    2010-01-01

    Monday 13 December 2010 at 18:30 / Lundi 13 Décembre 2010 à 18:30 CERN Main Auditorium / Amphithéâtre Principal Comme chaque année avant Noël, le CINE-CLUB du CERN est heureux d’inviter petits et grands à une projection gratuite du film.   Ponyo sur la falaise (Japon, 2008, Hayao Miyazaki) Le petit Sosuke vit avec sa mère sur une haute falaise surplombant la mer. Un beau jour, il découvre sur la plage caillouteuse Ponyo, une petite fille poisson. Ponyo est si fascinée par Sosuke et le monde terrestre que son désir le plus cher est de devenir un être humain. Mais Fujimoto, son magicien de père, n’est pas du tout d’accord avec cette idée et il la force à regagner les profondeurs de l’océan. Bien décidée à revoir Sosuke, Ponyo s’&...

  6. A dosimetric analysis of cardiac dose with or without active breath coordinator moderate deep inspiratory breath hold in left sided breast cancer radiotherapy.

    Science.gov (United States)

    Kunheri, Beena; Kotne, Sanketh; Nair, Sneha S; Makuny, Dinesh

    2017-01-01

    Cardiac toxicity is a major concern for left breast tangential field irradiation. The left ventricle and left anterior descending (LAD) artery are suggested to be radiosensitive and radiation to these structures leads to late lethal cardiotoxicity. Moderate deep inspiration breath hold (mDIBH) during radiation treatment delivery helps in reducing the cardiac dose. This study compares dosimetric parameters of heart with and without active breath coordinator (ABC) mDIBH during tangential field breast cancer radiation. This is a dosimetric comparative study. Forty-five consecutive patients with left-sided breast cancer who underwent breast-conserving surgery and adjuvant tangential field and radiotherapy with ABC mDIBH between November 2013 and September 2015 in our center were analyzed in this study. The ABC device was used for respiratory control and patients who could hold their breath for 20-30 s were considered for radiation with ABC mDIBH. Simulation scans of both free breathing (FB) and ABC mDIBH were done. Tangent field treatment plans with a dose prescription of 40 Gy/15 Fr were generated for each patient, in both scans. Target coverage, dose to the heart, LAD, and the left lung were documented with dose-volume histograms. Statistical Package for the Social Sciences, version 20 software, was used for analysis and the level of significance was set at P cardiac dose and hence can be considered as a promising tool for cardiac sparing.

  7. Early report: Comparison of breath-hold MR excretory urography, Doppler ultrasound and isotope renography in evaluation of symptomatic hydronephrosis in pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, J.A.; Tomlinson, A.J.; Weston, M.J.; Lloyd, S.N

    2000-06-01

    AIM: To compare assessment by MR excretory urography (MREU), Doppler ultrasound and isotope renography of women with symptomatic hydronephrosis in pregnancy and to define its cause. MATERIALS AND METHODS: Eleven women at 19-34 weeks of gestation were studied prospectively with gadolinium-enhanced breath-hold gradient echo MREU and transabdominal Doppler ultrasound compared with a 'gold standard' of isotope renography employing frusemide challenge. All studies were performed within 24 h, were reported independently in a blinded fashion and employed clearly defined criteria. Obstetric and infant outcomes were obtained. RESULTS: There were no adverse reactions to gadolinium administration in pregnancy and no adverse obstetric or infant outcomes. Three of the 11 women were unable to tolerate the complete MREU protocol. Ultrasound indices could not be used to predict ureteric obstruction as shown by isotope renography. MREU agreed with renographic findings in five of the six cases with obstruction and in two without obstruction. MREU directly demonstrated hydronephrosis to result from extrinsic compression of the ureter between the gravid uterus and iliopsoas muscle. CONCLUSION: MR excretory urography is a promising technique which affords equivalent functional and additional anatomical information to isotope renography. It is more accurate than Doppler ultrasound in the assessment of ureteric obstruction in pregnancy. Spencer, J. A. (2000)

  8. Quantitative assessment of irradiated lung volume and lung mass in breast cancer patients treated with tangential fields in combination with deep inspiration breath hold (DIBH)

    Energy Technology Data Exchange (ETDEWEB)

    Kapp, Karin Sigrid [Univ. Clinic of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Zurl, Brigitte; Stranzl, Heidi; Winkler, Peter

    2010-03-15

    Purpose: Comparison of the amount of irradiated lung tissue volume and mass in patients with breast cancer treated with an optimized tangential-field technique with and without a deep inspiration breath-hold (DIBH) technique and its impact on the normal-tissue complication probability (NTCP). Material and Methods: Computed tomography datasets of 60 patients in normal breathing (NB) and subsequently in DIBH were compared. With a Real-Time Position Management Respiratory Gating System (RPM), anteroposterior movement of the chest wall was monitored and a lower and upper threshold were defined. Ipsilateral lung and a restricted tangential region of the lung were delineated and the mean and maximum doses calculated. Irradiated lung tissue mass was computed based on density values. NTCP for lung was calculated using a modified Lyman-Kutcher-Burman (LKB) model. Results: Mean dose to the ipsilateral lung in DIBH versus NB was significantly reduced by 15%. Mean lung mass calculation in the restricted area receiving {<=} 20 Gy (M{sub 20}) was reduced by 17% in DIBH but associated with an increase in volume. NTCP showed an improvement in DIBH of 20%. The correlation of individual breathing amplitude with NTCP proved to be independent. Conclusion: The delineation of a restricted area provides the lung mass calculation in patients treated with tangential fields. DIBH reduces ipsilateral lung dose by inflation so that less tissue remains in the irradiated region and its efficiency is supported by a decrease of NTCP. (orig.)

  9. Effects of nicotine withdrawal on panic-like response to breath holding: a placebo-controlled, double-blind, crossover patch study.

    Science.gov (United States)

    Cosci, Fiammetta; Bertoli, Giuly; Abrams, Kenneth

    2013-12-01

    Cigarette smoking may increase the likelihood of developing panic disorder. Periods of nicotine withdrawal, in particular, may promote panic in individuals high in anxiety sensitivity. We examined the importance of nicotine withdrawal in the occurrence of smoking and panic. We utilized a placebo-controlled, double-blind, randomized, crossover design. Fifty smokers underwent a breath-holding (BH) challenge after the transdermal administration of nicotine on one test day and a placebo on another test day. Physiological and psychological variables were assessed at baseline as well as directly before and after the challenges. Nicotine abstinence induced a decrease in heart rate and systolic blood pressure (BP) before the BH procedure (heart rate: 78.80 ± 11.43 under nicotine, 70.88 ± 10.83 under placebo; systolic BP: 124.90 ± 11.34 under nicotine, 121.18 ± 13.44 under placebo) and shorter BH duration relative to the nicotine patch condition. Nicotine abstinence did not, though, increase fear reactivity to the challenge. The findings for heart rate and BP are consistent with the stimulant properties of nicotine. The reduced capacity to maintain apnea under placebo might be due to carbon dioxide (CO2 ) hypersensitivity during periods of nicotine abstinence. The negative findings regarding fear reactivity might be due to BH being a relatively weak anxiogen. Future researchers are encouraged to employ CO2 -inhalation procedures to study the relationship between nicotine withdrawal and panic. © 2013 Wiley Periodicals, Inc.

  10. Reproducible deep-inspiration breath-hold irradiation with forward intensity-modulated radiotherapy for left-sided breast cancer significantly reduces cardiac radiation exposure compared to inverse intensity-modulated radiotherapy.

    Science.gov (United States)

    Bolukbasi, Yasemin; Saglam, Yucel; Selek, Ugur; Topkan, Erkan; Kataria, Anglina; Unal, Zeynep; Alpan, Vildan

    2014-01-01

    To investigate the objective utility of our clinical routine of reproducible deep-inspiration breath-hold irradiation for left-sided breast cancer patients on reducing cardiac exposure. Free-breathing and reproducible deep-inspiration breath-hold scans were evaluated for our 10 consecutive left-sided breast cancer patients treated with reproducible deep-inspiration breath-hold. The study was based on the adjuvant dose of 50 Gy in 25 fractions of 2 Gy/fraction. Both inverse and forward intensity-modulated radiotherapy plans were generated for each computed tomography dataset. Reproducible deep-inspiration breath-hold plans with forward intensity-modulated radiotherapy significantly spared the heart and left anterior descending artery compared to generated free-breathing plans based on mean doses - free-breathing vs reproducible deep-inspiration breath-hold, left ventricle (296.1 vs 94.5 cGy, P = 0.005), right ventricle (158.3 vs 59.2 cGy, P = 0.005), left anterior descending artery (171.1 vs 78.1 cGy, P = 0.005), and whole heart (173.9 vs 66 cGy, P = 0.005), heart V20 (2.2% vs 0%, P = 0.007) and heart V10 (4.2% vs 0.3%, P = 0.007) - whereas they revealed no additional burden on the ipsilateral lung. Reproducible deep-inspiration breath-hold and free-breathing plans with inverse intensity-modulated radiotherapy provided similar organ at risk sparing by reducing the mean doses to the left ventricle, left anterior descending artery, heart, V10-V20 of the heart and right ventricle. However, forward intensity-modulated radiotherapy showed significant reduction in doses to the left ventricle, left anterior descending artery, heart, right ventricle, and contralateral breast (mean dose, 248.9 to 12.3 cGy, P = 0.005). The mean doses for free-breathing vs reproducible deep-inspiration breath-hold of the proximal left anterior descending artery were 1.78 vs 1.08 Gy and of the distal left anterior descending artery were 8.11 vs 3.89 Gy, whereas mean distances to the 50 Gy

  11. Evaluation of manual and automatic segmentation of the mouse heart from CINE MR images

    NARCIS (Netherlands)

    Heijman, Edwin; Aben, Jean-Paul; Penners, Cindy; Niessen, Petra; Guillaume, René; van Eys, Guillaume; Nicolay, Klaas; Strijkers, Gustav J.

    2008-01-01

    To compare global functional parameters determined from a stack of cinematographic MR images of mouse heart by a manual segmentation and an automatic segmentation algorithm. The manual and automatic segmentation results of 22 mouse hearts were compared. The automatic segmentation was based on

  12. Vortex Flow in the Right Atrium Surrogates Supraventricular Arrhythmia and Thrombus After Atriopulmonary Connection-Type Fontan Operation: Vortex Flow Analysis Using Conventional Cine Magnetic Resonance Imaging.

    Science.gov (United States)

    Shiina, Yumi; Inai, Kei; Takahashi, Tatsunori; Shimomiya, Yamato; Ishizaki, Umiko; Fukushima, Kenji; Nagao, Michinobu

    2017-11-02

    We developed a novel imaging technique, designated as vortex flow (VF) mapping, which presents a vortex flow visually on conventional two-dimensional (2D) cine MRI. Using it, we assessed circumferential VF patterns and influences on RA thrombus and supraventricular tachycardia (SVT) in AP connection-type Fontan circulation. Retrospectively, we enrolled 27 consecutive patients (25.1 ± 9.2 years) and 7 age-matched controls who underwent cardiac MRI. Conventional cine images acquired using a 1.5-Tesla scanner were scanned for axial and coronal cross section of the RA. We developed "vortex flow mapping" to demonstrate the ratio of the circumferential voxel movement at each phase to the total movement throughout a cardiac cycle towards the RA center. The maximum ratio was used as a magnitude of vortex flow (MVF%) in RA cine imaging. We also measured percentages of strong and weak VF areas (VFA%). Furthermore, in 10 out of 27, we compared VF between previous CMR (3.8 ± 1.5 years ago) and latest CMR. Of the patients, 15 had cardiovascular complications (Group A); 12 did not (Group B). A transaxial image showed that strong VFA% in Group A was significantly smaller than that in Group B or controls. A coronal view revealed that strong VFA% was also smaller, and weak VFA% was larger in Group A than in Group B or controls (P < 0.05, and P < 0.05). Maximum MVF% in Group A was significantly smaller than in other groups (P < 0.001). Univariate logistic analyses revealed weak VFA% on a coronal image, and serum total bilirubin level as factors affecting cardiovascular complications (Odds ratio 1.14 and 66.1, 95% CI 1.004-1.30 and 1.59-2755.6, P values < 0.05 and < 0.05, respectively). Compared to the previous CMR, smaller maximum VMF%, smaller strong VFA%, and larger weak VFA% were identified in the latest CMR. Circumferentially weak VFA% on a coronal image can be one surrogate marker of SVT and thrombus in AP connection-type Fontan circulation. This simple VF

  13. Cine CT for Attenuation Correction in Cardiac PET/CT

    Science.gov (United States)

    Alessio, Adam M.; Kohlmyer, Steve; Branch, Kelley; Chen, Grace; Caldwell, James; Kinahan, Paul

    2008-01-01

    In dual-modality PET/CT systems, the CT scan provides the attenuation map for PET attenuation correction. The current clinical practice of obtaining a single helical CT scan provides only a snapshot of the respiratory cycle, whereas PET occurs over multiple respiratory cycles. Misalignment of the attenuation map and emission image because of respiratory motion causes errors in the attenuation correction factors and artifacts in the attenuation-corrected PET image. To rectify this problem, we evaluated the use of cine CT, which acquires multiple low-dose CT images during a respiratory cycle. We evaluated the average and the intensity-maximum image of cine CT for cardiac PET attenuation correction. Methods Cine CT data and cardiac PET data were acquired from a cardiac phantom and from multiple patient studies. The conventional helical CT, cine CT, and PET data of an axially translating phantom were evaluated with and without respiratory motion. For the patient studies, we acquired 2 cine CT studies for each PET acquisition in a rest–stress 13N-ammonia protocol. Three readers visually evaluated the alignment of 74 attenuation image sets versus the corresponding emission image and determined whether the alignment provided acceptable or unacceptable attenuation-corrected PET images. Results In the phantom study, the attenuation correction from helical CT caused a major artifactual defect in the lateral wall on the PET image. The attenuation correction from the average and from the intensity-maximum cine CT images reduced the defect by 20% and 60%, respectively. In the patient studies, 77% of the cases using the average of the cine CT images had acceptable alignment and 88% of the cases using the intensity maximum of the cine CT images had acceptable alignment. Conclusion Cine CT offers an alternative to helical CT for compensating for respiratory motion in the attenuation correction of cardiac PET studies. Phantom studies suggest that the average and the intensity

  14. A 4D ultrasound real-time tracking system for external beam radiotherapy of upper abdominal lesions under breath-hold

    Energy Technology Data Exchange (ETDEWEB)

    Sihono, Dwi Seno Kuncoro; Vogel, Lena; Thoelking, Johannes; Wenz, Frederik; Boda-Heggemann, Judit; Wertz, Hansjoerg [University of Heidelberg, Department of Radiation Oncology, University Medical Center Mannheim, Mannheim (Germany); Weiss, Christel [University of Heidelberg, Department of Biomathematics and Medical Statistics, University Medical Center Mannheim, Mannheim (Germany); Lohr, Frank [University of Heidelberg, Department of Radiation Oncology, University Medical Center Mannheim, Mannheim (Germany); Az. Ospedaliero-Universitaria di Modena, Struttura Complessa di Radioterapia, Dipartimento di Oncologia, Modena (Italy)

    2017-03-15

    To evaluate a novel four-dimensional (4D) ultrasound (US) tracking system for external beam radiotherapy of upper abdominal lesions under computer-controlled deep-inspiration breath-hold (DIBH). The tracking accuracy of the research 4D US system was evaluated using two motion phantoms programmed with sinusoidal and breathing patterns to simulate free breathing and DIBH. Clinical performance was evaluated with five healthy volunteers. US datasets were acquired in computer-controlled DIBH with varying angular scanning angles. Tracked structures were renal pelvis (spherical structure) and portal/liver vein branches (non-spherical structure). An external marker was attached to the surface of both phantoms and volunteers as a secondary object to be tracked by an infrared camera for comparison. Phantom measurements showed increased accuracy of US tracking with decreasing scanning range/increasing scanning frequency. The probability of lost tracking was higher for small scanning ranges (43.09% for 10 and 13.54% for 20 ).The tracking success rates in healthy volunteers during DIBH were 93.24 and 89.86% for renal pelvis and portal vein branches, respectively. There was a strong correlation between marker motion and US tracking for the majority of analyzed breath-holds: 84.06 and 88.41% of renal pelvis target results and 82.26 and 91.94% of liver vein target results in anteroposterior and superoinferior directions, respectively; Pearson's correlation coefficient was between 0.71 and 0.99. The US system showed a good tracking performance in 4D motion phantoms. The tracking capability of surrogate structures for upper abdominal lesions in DIBH fulfills clinical requirements. Further investigation in a larger cohort of patients is underway. (orig.) [German] Evaluation eines neuen vierdimensionalen (4D) Ultraschall(US)-Tracking-Systems fuer die externe Strahlentherapie von Oberbauchlaesionen unter computergesteuertem tiefem Atemanhalt (DIBH). Die Tracking-Genauigkeit des 4D

  15. Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations.

    Science.gov (United States)

    Thattaliyath, Bijoy D; Forsha, Daniel E; Stewart, Chad; Barker, Piers C A; Campbell, Michael J

    2015-01-01

    The aim of the study was to determine right and left ventricle deformation parameters in patients with transposition of the great arteries who had undergone atrial or arterial switch procedures. Patients with transposition are born with a systemic right ventricle. Historically, the atrial switch operation, in which the right ventricle remains the systemic ventricle, was performed. These patients have increased rates of morbidity and mortality. We used cardiac MRI with Velocity Vector Imaging analysis to characterize and compare ventricular myocardial deformation in patients who had an atrial switch or arterial switch operation. Patients with a history of these procedures, who had a clinically ordered cardiac MRI were included in the study. Consecutive 20 patients (75% male, 28.7 ± 1.8 years) who underwent atrial switch operation and 20 patients (60% male, 17.7 ± 1.9 years) who underwent arterial switch operation were included in the study. Four chamber and short-axis cine images were used to determine longitudinal and circumferential strain and strain rate using Vector Velocity Imaging software. Compared with the arterial switch group, the atrial switch group had decreased right ventricular ejection fraction and increased end-diastolic and end-systolic volumes, and no difference in left ventricular ejection fraction and volumes. The atrial switch group had decreased longitudinal and circumferential strain and strain rate. When compared with normal controls multiple strain parameters in the atrial switch group were reduced. Myocardial deformation analysis of transposition patients reveals a reduction of right ventricular function and decreased longitudinal and circumferential strain parameters in patients with an atrial switch operation compared with those with arterial switch operation. A better understanding of the mechanisms of right ventricle failure in transposition of great arteries may lead to improved therapies and adaptation. © 2015 Wiley Periodicals

  16. SU-F-BRB-02: Towards Quantitative Clinical Decision On Deep Inspiration Breath Hold (DIBH) Or Prone for Left-Sided Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Lin, H; Gao, Y [Rensselaer Polytechnic Institute, Troy, NY (United States); Liu, T [Memorial Sloan Kettering West Harrison, West Harrison, New York (United States); Gelblum, D; Ho, A [Memorial Sloan Lettering Cancer Center, New York City, New York (United States); Powell, S [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Tang, X [Memorial Sloan Kettering Cancer Center, West Harrison, NY (United States); Xu, X [Rensselaer Polytechnic Inst., Troy, NY (United States)

    2015-06-15

    Purpose: To develop quantitative clinical guidelines between supine Deep Inspiratory Breath Hold (DIBH) and prone free breathing treatments for breast patients, we applied 3D deformable phantoms to perform Monte Carlo simulation to predict corresponding Dose to the Organs at Risk (OARs). Methods: The RPI-adult female phantom (two selected cup sizes: A and D) was used to represent the female patient, and it was simulated using the MCNP6 Monte Carlo code. Doses to OARs were investigated for supine DIBH and prone treatments, considering two breast sizes. The fluence maps of the 6-MV opposed tangential fields were exported. In the Monte Carlo simulation, the fluence maps allow each simulated photon particle to be weighed in the final dose calculation. The relative error of all dose calculations was kept below 5% by simulating 3*10{sup 7} photons for each projection. Results: In terms of dosimetric accuracy, the RPI Adult Female phantom with cup size D in DIBH positioning matched with a DIBH treatment plan of the patient. Based on the simulation results, for cup size D phantom, prone positioning reduced the cardiac dose and the dose to other OARs, while cup size A phantom benefits more from DIBH positioning. Comparing simulation results for cup size A and D phantom, dose to OARs was generally higher for the large breast size due to increased scattering arising from a larger portion of the body in the primary beam. The lower dose that was registered for the heart in the large breast phantom in prone positioning was due to the increase of the distance between the heart and the primary beam when the breast was pendulous. Conclusion: Our 3D deformable phantom appears an excellent tool to predict dose to the OARs for the supine DIBH and prone positions, which might help quantitative clinical decisions. Further investigation will be conducted. National Institutes of Health R01EB015478.

  17. Deep inspiration breath-hold technique for left-sided breast cancer: An analysis of predictors for organ-at-risk sparing

    Energy Technology Data Exchange (ETDEWEB)

    Register, Steven; Takita, Cristiane [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Reis, Isildinha; Zhao, Wei [Department of Public Health Sciences, University of Miami, Miami, FL (United States); Amestoy, William [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Wright, Jean, E-mail: jwrigh71@jhmi.edu [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL (United States); Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD (United States)

    2015-04-01

    To identify anatomic and treatment characteristics that correlate with organ-at-risk (OAR) sparing with deep inspiration breath-hold (DIBH) technique to guide patient selection for this technique. Anatomic and treatment characteristics and radiation doses to OARs were compared between free-breathing and DIBH plans. Linear regression analysis was used to identify factors independently predicting for cardiac sparing. We identified 64 patients: 44 with intact breast and 20 postmastectomy. For changes measured directly on treatment planning scans, DIBH plans decreased heart-chest wall length (6.5 vs 5.0 cm, p < 0.001), and increased lung volume (1074.4 vs 1881.3 cm{sup 3}, p < 0.001), and for changes measured after fields are set, they decreased maximum heart depth (1.1 vs 0.3 cm, p < 0.001) and heart volume in field (HVIF) (9.1 vs 0.9 cm{sup 3}, p < 0.001). DIBH reduced the mean heart dose (3.4 vs 1.8 Gy, p < 0.001) and lung V{sub 20} (19.6% vs 15.3%, p < 0.001). Regression analysis found that only change in HVIF independently predicted for cardiac sparing. We identified patients in the bottom quartile of the dosimetric benefits seen with DIBH and categorized the cause of this “minimal benefit.” Overall, 29% of patients satisfied these criteria for minimal benefit with DIBH and the most common cause was favorable baseline anatomy. Only the reduction in HVIF predicted for reductions in mean heart dose; no specific anatomic surrogate for the dosimetric benefits of DIBH technique could be identified. Most patients have significant dosimetric benefit with DIBH, and this technique should be planned and evaluated for all patients receiving left-sided breast/chest wall radiation.

  18. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Zagar, Timothy M., E-mail: zagar@med.unc.edu [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Kaidar-Person, Orit [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Tang, Xiaoli [Memorial Sloan Kettering Cancer Center, West Harrison, New York (United States); Jones, Ellen E.; Matney, Jason; Das, Shiva K.; Green, Rebecca L. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Sheikh, Arif [Department of Radiology, Columbia University, New York, New York (United States); Khandani, Amir H.; McCartney, William H.; Oldan, Jorge Daniel; Wong, Terence Z. [Department of Radiology, University of North Carolina, Chapel Hill, North Carolina (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

    2017-04-01

    Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motion abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.

  19. Purine metabolism in response to hypoxic conditions associated with breath-hold diving and exercise in erythrocytes and plasma from bottlenose dolphins (Tursiops truncatus).

    Science.gov (United States)

    Del Castillo Velasco-Martínez, Iris; Hernández-Camacho, Claudia J; Méndez-Rodríguez, Lía C; Zenteno-Savín, Tania

    2016-01-01

    In mammalian tissues under hypoxic conditions, ATP degradation results in accumulation of purine metabolites. During exercise, muscle energetic demand increases and oxygen consumption can exceed its supply. During breath-hold diving, oxygen supply is reduced and, although oxygen utilization is regulated by bradycardia (low heart rate) and peripheral vasoconstriction, tissues with low blood flow (ischemia) may become hypoxic. The goal of this study was to evaluate potential differences in the circulating levels of purine metabolism components between diving and exercise in bottlenose dolphins (Tursiops truncatus). Blood samples were taken from captive dolphins following a swimming routine (n=8) and after a 2min dive (n=8). Activity of enzymes involved in purine metabolism (hypoxanthine guanine phosphoribosyl transferase (HGPRT), inosine monophosphate deshydrogenase (IMPDH), xanthine oxidase (XO), purine nucleoside phosphorylase (PNP)), and purine metabolite (hypoxanthine (HX), xanthine (X), uric acid (UA), inosine monophosphate (IMP), inosine, nicotinamide adenine dinucleotide (NAD(+)), adenosine, adenosine monophosphate (AMP), adenosine diphosphate (ADP), ATP, guanosine diphosphate (GDP), guanosine triphosphate (GTP)) concentrations were quantified in erythrocyte and plasma samples. Enzymatic activity and purine metabolite concentrations involved in purine synthesis and degradation, were not significantly different between diving and exercise. Plasma adenosine concentration was higher after diving than exercise (p=0.03); this may be related to dive-induced ischemia. In erythrocytes, HGPRT activity was higher after diving than exercise (p=0.007), suggesting an increased capacity for purine recycling and ATP synthesis from IMP in ischemic tissues of bottlenose dolphins during diving. Purine recycling and physiological adaptations may maintain the ATP concentrations in bottlenose dolphins after diving and exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. SU-E-J-32: Calypso(R) and Laser-Based Localization Systems Comparison for Left-Sided Breast Cancer Patients Using Deep Inspiration Breath Hold

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, S [Northwest Medical Physics Center, Lynnwood, WA (United States); Kaurin, D; Sweeney, L [Northwest Medical Physics Center, Lynnwood, WA (United States); Seattle Cancer Care Alliance, Seattle, WA (United States); Kim, J; Fang, L; Tran, A [Seattle Cancer Care Alliance, Seattle, WA (United States); University of Washington Medical Center, Seattle, WA (United States); Holloway, K [Seattle Cancer Care Alliance, Seattle, WA (United States)

    2014-06-01

    Purpose: Our institution uses a manual laser-based system for primary localization and verification during radiation treatment of left-sided breast cancer patients using deep inspiration breath hold (DIBH). This primary system was compared with sternum-placed Calypso(R) beacons (Varian Medical Systems, CA). Only intact breast patients are considered for this analysis. Methods: During computed tomography (CT) simulation, patients have BB and Calypso(R) surface beacons positioned sternally and marked for free-breathing and DIBH CTs. During dosimetry planning, BB longitudinal displacement between free breathing and DIBH CT determines laser mark (BH mark) location. Calypso(R) beacon locations from the DIBH CT are entered at the Tracking Station. During Linac simulation and treatment, patients inhale until the cross-hair and/or lasers coincide with the BH Mark, which can be seen using our high quality cameras (Pelco, CA). Daily Calypso(R) displacement values (difference from the DIBH-CT-based plan) are recorded.The displacement mean and standard deviation was calculated for each patient (77 patients, 1845 sessions). An aggregate mean and standard deviation was calculated weighted by the number of patient fractions.Some patients were shifted based on MV ports. A second data set was calculated with Calypso(R) values corrected by these shifts. Results: Mean displacement values indicate agreement within 1±3mm, with improvement for shifted data (Table). Conclusion: Both unshifted and shifted data sets show the Calypso(R) system coincides with the laser system within 1±3mm, demonstrating either localization/verification system will Resultin similar clinical outcomes. Displacement value uncertainty unilaterally reduces when shifts are taken into account.

  1. Obstructive sleep apnea screening by NIRS imaging

    Science.gov (United States)

    Kashefi, Feraydune; Watenpaugh, Donald E.; Liu, Hanli

    2007-02-01

    This study aimed at determining cerebral hemodynamic parameters in human subjects during breath holding using near infrared spectroscopy (NIRS). Breath holding serves as a method of simulation OSA (Obstructive Sleep Apnea). Data was acquired non-invasively from 40 subjects, twenty OSA sufferers (10 females, 10 males, age 20-70 years), and twenty normal volunteers (10 females, 10 males, age 20-65 years). Measurements were conducted using a LED Imager (LEDI) during breath holding. In comparing OSA subjects with controls during breath holding, a consistent increase or even a decrease in oxy- ([O IIHb]), deoxy- ([HHb]), total hemoglobin ([tHb]) concentrations, and tissue hemoglobin oxygen saturation (SO II) in the regional brain tissue were observed. The LEDI probe consists of 4 sources and 10 detectors serving as 4 sets of 1 source and 4 detectors each. A three wavelength (730, 805, and 850 nm) LED was used and the wavelengths were switched sequentially. The distance between sources and the source-detector separation were 2.5 cm. Data acquisition consisted of three segments, baseline for one minute, followed by a period of breath holding, and then 2 minutes of recovery time. The duration of the breath holding was subject-dependent. Our investigation proves that NIR spectroscopy could be used as a tool for detecting cerebral hemodynamics and also serves as a method of screening patients with OSA.

  2. Physiological Uptake of 18F-Fluorodeoxyglucose in Uterine Endometrium and Myometrium: Correlation with Uterine Motility Evaluated by Cine Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kido, A.; Nishizawa, S.; Okada, H. (Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamakita City, Shizuoka (Japan)); Nakamoto, Y.; Yamamoto, A.; Fujimoto, K.; Togashi, K. Dept. of Diagnostic Radiology, Kyoto Univ. Hospital, Kyoto City, Kyoto (Japan))

    2009-05-15

    Background: Accumulation of 18F-fluorodeoxyglucose (18F-FDG) in the uterine endometrium and uterine motility are dependent on menstrual cycle. However, the relationship between them remains unknown. Purpose: To investigate the relationship between radiometabolic activity of 18F-FDG in the uterus and uterine motility observed by cine magnetic resonance imaging (MRI). Material and Methods: The study population consisted of 65 healthy, fertile women, selected from 229 women who underwent positron emission tomography (PET), computed tomography (CT), and MRI for cancer screening at our facility. They were divided into three groups according to their menstrual cycle phases: menstrual, follicular-periovulatory, and luteal. Regions of interest (ROIs) were placed over the endometrium and myometrium to calculate the standardized uptake value (SUV). Uterine peristalsis and contraction shown by cine MR imaging were evaluated visually, and the correlation between FDG uptake and uterine movements was assessed. Results: After excluding nine patients due to inadequate images, 56 patients (19 follicular-periovulatory, 27 luteal, and 10 menstrual) were analyzed. FDG uptake of the endometrium, frequency of peristalsis, and the presence of sustained contraction varied according to the menstruation cycle, with a tendency toward greater uptake in the menstrual phase, but there was little relationship between the frequency of uterine peristalsis and FDG accumulation in the uterus. Significantly higher FDG accumulation in the endometrium was observed in patients with sustained contractions (3.32+-1.47) than in those without contractions (2.45+-0.66). Conclusion: Our preliminary data suggest that FDG accumulation in the endometrium tends to be higher in patients with uterine contraction, although there was no significant correlation between uterine peristalsis and FDG uptake in the uterine myometrium or endometrium

  3. Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T.

    Science.gov (United States)

    Becker, Meike; Frauenrath, Tobias; Hezel, Fabian; Krombach, Gabriele A; Kremer, Ute; Koppers, Benedikt; Butenweg, Christoph; Goemmel, Andreas; Utting, Jane F; Schulz-Menger, Jeanette; Niendorf, Thoralf

    2010-06-01

    As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to interference from electromagnetic fields (EMF) and to magneto-hydrodynamic (MHD) effects increases and with it the motivation for a CMR triggering alternative. This study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects (n = 14). Quantitative analysis of 2D CINE steady-state free precession (SSFP) images was conducted to compare ACT's performance with vector ECG (VCG). Endocardial border sharpness (EBS) was examined paralleled by quantitative LV function assessment. Unlike VCG, ACT provided signal traces free of interference from EMF or MHD effects. In the case of correct R-wave recognition, VCG-triggered 2D CINE SSFP was immune to cardiac motion effects-even at 3.0 T. However, VCG-triggered 2D SSFP CINE imaging was prone to cardiac motion and EBS degradation if R-wave misregistration occurred. ACT-triggered acquisitions yielded LV parameters (end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular mass (LVM)) comparable with those derived from VCG-triggered acquisitions (1.5 T: ESV(VCG) = (56 +/- 17) ml, EDV(VCG) = (151 +/- 32) ml, LVM(VCG) = (97 +/- 27) g, SV(VCG) = (94 +/- 19) ml, EF(VCG) = (63 +/- 5)% cf. ESV(ACT) = (56 +/- 18) ml, EDV(ACT) = (147 +/- 36) ml, LVM(ACT) = (102 +/- 29) g, SV(ACT) = (91 +/- 22) ml, EF(ACT) = (62 +/- 6)%; 3.0 T: ESV(VCG) = (55 +/- 21) ml, EDV(VCG) = (151 +/- 32) ml, LVM(VCG) = (101 +/- 27) g, SV(VCG) = (96 +/- 15) ml, EF(VCG) = (65 +/- 7)% cf. ESV(ACT) = (54 +/- 20) ml, EDV(ACT) = (146 +/- 35) ml, LVM(ACT) = (101 +/- 30) g, SV(ACT) = (92 +/- 17) ml, EF(ACT) = (64 +/- 6)%). ACT's intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical CMR.

  4. Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Meike [University Hospital, RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Humboldt-University, Experimental and Clinical Research Center (ECRC), Charite Campus Buch, Berlin (Germany); Frauenrath, Tobias; Hezel, Fabian [University Hospital, RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Berlin Ultrahigh Field Facility, Max-Delbrueck Center for Molecular Medicine, Berlin (Germany); Krombach, Gabriele A.; Kremer, Ute; Koppers, Benedikt [University Hospital, RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Butenweg, Christoph; Goemmel, Andreas [Chair of Structural Statics and Dynamics, RWTH Aachen, Aachen (Germany); Utting, Jane F. [MRI, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen (United Kingdom); Schulz-Menger, Jeanette [Humboldt-University, Working Group Cardiovascular MR, Franz-Volhard-Klinik, Department of Cardiology, HELIOS-Klinikum Berlin-Buch and Charite Campus Buch, Berlin (Germany); Niendorf, Thoralf [University Hospital, RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Humboldt-University, Experimental and Clinical Research Center (ECRC), Charite Campus Buch, Berlin (Germany); Berlin Ultrahigh Field Facility, Max-Delbrueck Center for Molecular Medicine, Berlin (Germany)

    2010-06-15

    As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to interference from electromagnetic fields (EMF) and to magneto-hydrodynamic (MHD) effects increases and with it the motivation for a CMR triggering alternative. This study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects (n = 14). Quantitative analysis of 2D CINE steady-state free precession (SSFP) images was conducted to compare ACT's performance with vector ECG (VCG). Endocardial border sharpness (EBS) was examined paralleled by quantitative LV function assessment. Unlike VCG, ACT provided signal traces free of interference from EMF or MHD effects. In the case of correct R-wave recognition, VCG-triggered 2D CINE SSFP was immune to cardiac motion effects - even at 3.0 T. However, VCG-triggered 2D SSFP CINE imaging was prone to cardiac motion and EBS degradation if R-wave misregistration occurred. ACT-triggered acquisitions yielded LV parameters (end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular mass (LVM)) comparable with those derived from VCG-triggered acquisitions (1.5 T: ESV{sub VCG} = (56 {+-} 17) ml, EDV{sub VCG} = (151 {+-} 32) ml, LVM{sub VCG} = (97 {+-} 27) g, SV{sub VCG} = (94 {+-} 19) ml, EF{sub VCG} = (63 {+-} 5)% cf. ESV{sub ACT} = (56 {+-} 18) ml, EDV{sub ACT} = (147 {+-} 36) ml, LVM{sub ACT} = (102 {+-} 29) g, SV{sub ACT} = (91 {+-} 22) ml, EF{sub ACT} = (62 {+-} 6)%; 3.0 T: ESV{sub VCG} = (55 {+-} 21) ml, EDV{sub VCG} = (151 {+-} 32) ml, LVM{sub VCG} = (101 {+-} 27) g, SV{sub VCG} = (96 {+-} 15) ml, EF{sub VCG} = (65 {+-} 7)% cf. ESV{sub ACT} = (54 {+-} 20) ml, EDV{sub ACT} = (146 {+-} 35) ml, LVM{sub ACT} = (101 {+-} 30) g, SV{sub ACT} = (92 {+-} 17) ml, EF{sub ACT} = (64 {+-} 6)%). ACT's intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical CMR. (orig.)

  5. Comparison of cardiac and lung doses for breast cancer patients with free breathing and deep inspiration breath hold technique in 3 dimensional conformal radiotherapy - a dosimetric study

    Science.gov (United States)

    Raj Mani, Karthick; Poudel, Suresh; Maria Das, K. J.

    2017-12-01

    Purpose: To investigate the cardio-pulmonary doses between Deep Inspiration Breath Hold (DIBH) and Free Breathing (FB) technique in left sided breast irradiation. Materials & Methods: DIBH CT and FB CT were acquired for 10 left sided breast patients who underwent whole breast irradiation with or without nodal irradiation. Three fields single isocenter technique were used for patients with node positive patients along with two tangential conformal fields whereas only two tangential fields were used in node negative patients. All the critical structures like lungs, heart, esophagus, thyroid, etc., were delineated in both DIBH and FB scan. Both DIBH and FB scans were fused with the Dicom origin as they were acquired with the same Dicom coordinates. Plans were created in the DIBH scan for a dose range between 50 Gy in 25 fractions. Critical structures doses were recorded from the Dose Volume Histogram for both the DIBH and FB data set for evaluation. Results: The average mean heart dose in DIBH vs FB was 13.18 Gy vs 6.97 Gy, (p = 0.0063) significantly with DIBH as compared to FB technique. The relative reduction in average mean heart dose was 47.12%. The relative V5 reduced by 14.70% (i.e. 34.42% vs 19.72%, p = 0.0080), V10 reduced by 13.83% (i.e. 27.79 % vs 13.96%, p = 0.0073). V20 reduced by 13.19% (i.e. 24.54 % vs 11.35%, p = 0.0069), V30 reduced by 12.38% (i.e. 22.27 % vs 9.89 %, p = 0.0073) significantly with DIBH as compared to FB. The average mean left lung dose reduced marginally by 1.43 Gy (13.73 Gy vs 12.30 Gy, p = 0.4599) but insignificantly with DIBH as compared to FB. Other left lung parameters (V5, V10, V20 and V30) shows marginal decreases in DIBH plans compare to FB plans. Conclusion: DIBH shows a substantial reduction of cardiac doses but slight and insignificant reduction of pulmonary doses as compared with FB technique. Using the simple DIBH technique, we can effectively reduce the cardiac morbidity and at the same time radiation induced lung

  6. Cine-MR imaging aqueductal CSF flow in normal pressure hydrocephalus syndrome before and after CSF shunt

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Arnetoli, G. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Inzitari, D. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Dal Pozzo, G. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Lolli, F. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Caramella, D. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy)); Bartolozzi, C. (Sezione di Radiodiagnostica, Dipt. di Fisiopatologia Clinica, and Dipt. di Scienze Neurologiche, Florence Univ. (Italy))

    1993-11-01

    Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction. (orig.).

  7. Improving left ventricular segmentation in four-dimensional flow MRI using intramodality image registration for cardiac blood flow analysis.

    Science.gov (United States)

    Gupta, Vikas; Bustamante, Mariana; Fredriksson, Alexandru; Carlhäll, Carl-Johan; Ebbers, Tino

    2018-01-01

    Assessment of blood flow in the left ventricle using four-dimensional flow MRI requires accurate left ventricle segmentation that is often hampered by the low contrast between blood and the myocardium. The purpose of this work is to improve left-ventricular segmentation in four-dimensional flow MRI for reliable blood flow analysis. The left ventricle segmentations are first obtained using morphological cine-MRI with better in-plane resolution and contrast, and then aligned to four-dimensional flow MRI data. This alignment is, however, not trivial due to inter-slice misalignment errors caused by patient motion and respiratory drift during breath-hold based cine-MRI acquisition. A robust image registration based framework is proposed to mitigate such errors automatically. Data from 20 subjects, including healthy volunteers and patients, was used to evaluate its geometric accuracy and impact on blood flow analysis. High spatial correspondence was observed between manually and automatically aligned segmentations, and the improvements in alignment compared to uncorrected segmentations were significant (P flow analysis from manual and automatically corrected segmentations did not differ significantly (P > 0.05). Our results demonstrate the efficacy of the proposed approach in improving left-ventricular segmentation in four-dimensional flow MRI, and its potential for reliable blood flow analysis. Magn Reson Med 79:554-560, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  8. Assessment of cerebellar pulsation in dogs with and without Chiari-like malformation and syringomyelia using cardiac-gated cine magnetic resonance imaging.

    Science.gov (United States)

    Driver, C J; Watts, V; Bunck, A C; Van Ham, L M; Volk, H A

    2013-10-01

    Canine Chiari-like malformation (CM) is characterised by herniation of part of the cerebellum through the foramen magnum. In humans with Chiari type I malformation (CM-I), abnormal pulsation of the cerebellum during the cardiac cycle has been documented and is pivotal to theories for the pathogenesis of syringomyelia (SM). In this retrospective study, cardiac-gated cine balanced fast field echo (bFEE) magnetic resonance imaging (MRI) was used to assess pulsation of the brain in dogs and to objectively measure the degree of cerebellar pulsation with the neck in a flexed position. Overall, 17 Cavalier King Charles Spaniels (CKCS) with CM, including eight with SM and nine without SM, were compared with six small breed control dogs. Linear regions of interest were generated for the length of cerebellar herniation from each phase of the cardiac cycle and the degree of cerebellar pulsation was subsequently calculated. Age, bodyweight and angle of neck flexion were also compared. CKCS with CM and SM had significantly greater pulsation of the cerebellum than control dogs (P=0.003) and CKCS with CM only (P=0.031). There was no significant difference in age, bodyweight and angle of neck flexion between the three groups. Cardiac-gated cine bFEE MRI permitted the dynamic visualisation of cerebellar pulsation in dogs. These findings support the current theories regarding the pathogenesis of SM secondary to CM and further highlight the similarities between canine CM and human CM-I. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Música y Cine

    OpenAIRE

    Olarte Martínez, Matilde María

    2008-01-01

    Materiales de clase: Introducción a la Historia de la Música en el Cine; partituras de cine mudo; música clásica y cine; textos sobre música incidental. Se Analiza la música utilizada en cinematografía, y el estudio de sus funciones aplicada a la imagen. Audiciones de música incidental y música preexistente de los principales compositores. la música utilizada en cinematografía, y el estudio de sus funciones aplicada a la imagen. Audiciones de música incidental y música preexistente de los ...

  10. Whole left ventricular functional assessment from two minutes free breathing multi-slice CINE acquisition

    Science.gov (United States)

    Usman, M.; Atkinson, D.; Heathfield, E.; Greil, G.; Schaeffter, T.; Prieto, C.

    2015-04-01

    Two major challenges in cardiovascular MRI are long scan times due to slow MR acquisition and motion artefacts due to respiratory motion. Recently, a Motion Corrected-Compressed Sensing (MC-CS) technique has been proposed for free breathing 2D dynamic cardiac MRI that addresses these challenges by simultaneously accelerating MR acquisition and correcting for any arbitrary motion in a compressed sensing reconstruction. In this work, the MC-CS framework is combined with parallel imaging for further acceleration, and is termed Motion Corrected Sparse SENSE (MC-SS). Validation of the MC-SS framework is demonstrated in eight volunteers and three patients for left ventricular functional assessment and results are compared with the breath-hold acquisitions as reference. A non-significant difference (P > 0.05) was observed in the volumetric functional measurements (end diastolic volume, end systolic volume, ejection fraction) and myocardial border sharpness values obtained with the proposed and gold standard methods. The proposed method achieves whole heart multi-slice coverage in 2 min under free breathing acquisition eliminating the time needed between breath-holds for instructions and recovery. This results in two-fold speed up of the total acquisition time in comparison to the breath-hold acquisition.

  11. Reduction of cardiac and coronary artery doses in irradiation of left-sided breast cancer during inspiration breath hold. A planning study

    Energy Technology Data Exchange (ETDEWEB)

    Schoenecker, S.; Heinz, C.; Soehn, M.; Haimerl, W.; Corradini, S.; Pazos, M.; Belka, C.; Scheithauer, H. [University Hospital of Ludwig-Maximilian-University, Department of Radiation Oncology, Munich (Germany)

    2016-11-15

    The radiation dose received by the heart during adjuvant left-sided breast irradiation plays a crucial role in development of late toxicity. Although the absolute risk of cardiotoxicity can be reduced with modern irradiation techniques, cardiotoxic chemotherapy increases the risk of late damage. Thus, the radiation dose to the heart should be minimized. This study evaluated the influence of different amplitudes of inspiration breath hold (IBH) during simulated left-sided breast irradiation on cardiac doses compared to free breathing (FB). CT data of 11 lung cancer patients were retrospectively used as left-sided pseudo-breast cancer cases. Two CT scans were used, one during IBH and one during FB, and two treatment plans were generated. Relevant heart, lung, and left anterior descending artery (LAD) parameters were derived from dose-volume histograms. The normal tissue complication probabilities (NTCPs) for the heart were calculated based on the relative seriality model. Inspiration depth was quantified using chest volume and diameter, and correlated thereafter to a possible sparing of heart tissue. Mean reduction of heart dose for IBH compared to FB was 40 % (1.65 vs. 0.99 Gy; p = 0.007). Maximum dose to the heart and LAD could be decreased by 33 % (p = 0.011) and 43 % (p = 0.024), respectively. The mean anteroposterior shift was 5 mm (range 0.9-9.5 mm). Significant negative correlations between the relative change in LAD mean dose and the mean thoracic diameter and volume change, as well as with the absolute change in thoracic diameter were seen. The NTCP for cardiac mortality could be decreased by about 78 % (p = 0.017). For left-sided breast cancer patients, cardiac doses can be significantly decreased with tangential irradiation and IBH. (orig.) [German] Die Herzdosisbelastung spielt eine entscheidende Rolle in der Entwicklung einer kardialen Spaettoxizitaet nach der adjuvanten Strahlentherapie von linksseitigem Brustkrebs. Obwohl moderne strahlentherapeutische

  12. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation : Is IMRT more beneficial than VMAT?

    Science.gov (United States)

    Sakka, Mazen; Kunzelmann, Leonie; Metzger, Martin; Grabenbauer, Gerhard G

    2017-10-01

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  13. In vivo breath-hold (1) H MRS simultaneous estimation of liver proton density fat fraction, and T1 and T2 of water and fat, with a multi-TR, multi-TE sequence.

    Science.gov (United States)

    Hamilton, Gavin; Middleton, Michael S; Hooker, Jonathan C; Haufe, William M; Forbang, Nketi I; Allison, Matthew A; Loomba, Rohit; Sirlin, Claude B

    2015-12-01

    To examine the intra-examination repeatability of proton density fat fraction (PDFF) and T1 and T2 of liver water and fat as estimated by a novel multi-repetition time (TR)-echo time (TE) (1) H magnetic resonance spectroscopy (MRS)-stimulated echo acquisition mode (STEAM) sequence that acquires 32 spectra for a range of TRs and TEs in single breath-hold. Sixty-seven subjects undergoing liver MRI examinations at 3T had three multi-TR-TE sequences acquired consecutively in a single session. This sequence was designed to allow accurate estimation of T1 and T2 of both water and fat, as well as PDFF, in a single breath-hold. A standard long-TR, multi-TE sequence was also acquired to allow comparison of estimated PDFF. Regression and interclass correlation (ICC) analyses were performed. There was strong agreement between PDFF estimated by the multi-TR-TE and long-TR, multi-TE sequences (slope 0.997; intercept -0.03; R = 0.997). The multi-TR-TE sequence had high repeatability for estimating PDFF (ICC = 0.999), water T2 (ICC = 0.920), water T1 (ICC = 0.845), and fat T2 (ICC = 0.760), and moderate repeatability for estimating fat T1 (ICC = 0.556). A novel multi-TR-TE sequence can estimate PDFF and water and fat T1 and T2 in a single breath-hold. Refinement may be needed to improve repeatability for fat T1 estimation. © 2015 Wiley Periodicals, Inc.

  14. Medicina y cine o el Cine como Medicina

    OpenAIRE

    Moratal Ibáñez, Laura María

    2006-01-01

    La editorial de este número de la "Revista de Medicina y Cine" trata la relación entre medicina y cine y de el cine como medicina, ya que ha ayudado en ocasiones a curar heridas graves de la sociedad.

  15. Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

    Energy Technology Data Exchange (ETDEWEB)

    McCowan, P. M., E-mail: pmccowan@cancercare.mb.ca [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada and Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); McCurdy, B. M. C. [Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Department of Radiology, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9 (Canada)

    2016-01-15

    Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, less EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose (<20% prescription dose) and high dose regions (>80% prescription dose) was calculated for each frame averaged

  16. Is the Deep Inspiration Breath-Hold Technique Superior to the Free Breathing Technique in Cardiac and Lung Sparing while Treating both Left-Sided Post-Mastectomy Chest Wall and Supraclavicular Regions

    Directory of Open Access Journals (Sweden)

    Anupama Darapu

    2017-01-01

    Full Text Available Aims: To evaluate the efficacy of the deep inspirational breath-hold (DIBH technique and its dosimetric advantages over the free breathing (FB technique in cardiac (heart and left anterior descending artery [LAD] and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. Materials and Methods: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head. All patients had 2 sets of planning CT images (one in FB and another in DIBH with a Biograph TruePoint HD CT scanner in the same setup. DIBH was performed by tracking the respiratory cycles using a Varian Real-Time Position Management system. The target (chest wall and supraclavicular region, organs at risk (OARs; ipsilateral lung, contralateral lung, heart, LAD, and contralateral breast, and other organs of interests were delineated as per the RTOG (Radiation Therapy Oncology Group contouring guidelines. The single-isocenter conformal fields in the field treatment plans were generated with the Eclipse Treatment Planning System (Varian Medical Systems for both FB and DIBH images, and the doses to the target and OARs were compared. The standard fractionation regimen of 50 Gy in 25 fractions over a period of 5 weeks was used for all patients in this study. Results and Discussion: The target coverage parameters (V95, V105, V107, and Dmean were found to be 97.8 ± 0.9, 6.1 ± 3.4, 0.2 ± 0.3, and 101.9 ± 0.5% in the FB plans and 98.1 ± 0.8, 6.1 ± 3.2, 0.2 ± 0.3, and 101.9 ± 0.4% in the DIBH plans, respectively. The plan quality indices (conformity index and homogeneity index also showed 1.3 ± 0.2 and 0.1 for the FB plans and 1.2 ± 0.3 and 0.1 for the DIBH plans, respectively. There was a significant reduction in dose to the heart in the DIBH plans compared to the FB plans, with p values of nearly 0 for the

  17. Comparison of two single-breath-held 3-D acquisitions with multi-breath-held 2-D cine steady-state free precession MRI acquisition in children with single ventricles

    Energy Technology Data Exchange (ETDEWEB)

    Atweh, Lamya A.; Dodd, Nicholas A.; Krishnamurthy, Ramkumar; Chu, Zili D. [Texas Children' s Hospital, EB Singleton Department of Pediatric Radiology, Cardiovascular Imaging, Houston, TX (United States); Pednekar, Amol [Philips Healthcare, Houston, TX (United States); Krishnamurthy, Rajesh [Texas Children' s Hospital, EB Singleton Department of Pediatric Radiology, Cardiovascular Imaging, Houston, TX (United States); Baylor College of Medicine, Department of Radiology, Houston, TX (United States); Baylor College of Medicine, Department of Pediatrics, Houston, TX (United States)

    2016-05-15

    Breath-held two-dimensional balanced steady-state free precession cine acquisition (2-D breath-held SSFP), accelerated with parallel imaging, is the method of choice for evaluating ventricular function due to its superior blood-to-myocardial contrast, edge definition and high intrinsic signal-to-noise ratio throughout the cardiac cycle. The purpose of this study is to qualitatively and quantitatively compare the two different single-breath-hold 3-D cine SSFP acquisitions using 1) multidirectional sensitivity encoding (SENSE) acceleration factors (3-D multiple SENSE SSFP), and 2) k-t broad-use linear acceleration speed-up technique (3-D k-t SSFP) with the conventional 2-D breath-held SSFP in non-sedated asymptomatic volunteers and children with single ventricle congenital heart disease. Our prospective study was performed on 30 non-sedated subjects (9 healthy volunteers and 21 functional single ventricle patients), ages 12.5 +/- 2.8 years. Two-dimensional breath-held SSFP with SENSE acceleration factor of 2, eight-fold accelerated 3-D k-t SSFP, and 3-D multiple SENSE SSFP with total parallel imaging factor of 4 were performed to evaluate ventricular volumes and mass in the short-axis orientation. Image quality scores (blood myocardial contrast, edge definition and interslice alignment) and volumetric analysis (end systolic volume, end diastolic volume and ejection fraction) were performed on the data sets by experienced users. Paired t-test was performed to compare each of the 3-D k-t SSFP and 3-D multiple SENSE SSFP clinical scores against 2-D breath-held SSFP. Bland-Altman analysis was performed on left ventricle (LV) and single ventricle volumetry. Interobserver and intraobserver variability in volumetric measurements were determined using intraclass coefficients. The clinical scores were highest for the 2-D breath-held SSFP images. Between the two 3-D sequences, 3-D multiple SENSE SSFP performed better than 3-D k-t SSFP. Bland-Altman analysis for volumes

  18. Retrospectively-gated CINE (23)Na imaging of the heart at 7.0 Tesla using density-adapted 3D projection reconstruction.

    Science.gov (United States)

    Resetar, Ana; Hoffmann, Stefan H; Graessl, Andreas; Winter, Lukas; Waiczies, Helmar; Ladd, Mark E; Niendorf, Thoralf; Nagel, Armin M

    2015-11-01

    Implementation, evaluation and application of a pulse sequence for retrospectively-gated sodium magnetic resonance imaging of the human heart. Measurements were conducted at a magnetic field strength of 7.0 Tesla. A 3D projection reconstruction technique using a standard (ST) and a golden angle (GA) acquisition scheme for short echo time (23)Na MR was applied. Data were acquired continuously without cardiac triggering using a free breathing regime. Arbitrary phases of the cardiac cycle were reconstructed using synchronization with a physiological trigger signal and different temporal resolutions. Phantom measurements and examinations of healthy subjects were performed to evaluate the performance of the ST and GA acquisition schemes. A signal-to-background ratio (SBR)--that compromises both the signal-to-noise ratio and artifacts--was calculated for benchmarking the GA and ST scheme. In phantom measurements, the measured SBR of the GA acquisition scheme was up to 88% higher versus ST. Undersampling artifacts were reduced in GA compared to the ST sampling scheme. Whole heart coverage sodium images could be reconstructed with a nominal spatial resolution of (6 mm)(3) and a temporal resolution of Δt=0.1 s for covering the entire cardiac cycle. Changes in overall heart volume and myocardial wall thickness throughout the cardiac cycle were clearly visible in the reconstructed images. For the in vivo data and the imaging protocol used, GA provided a mean SBR of 38.0±5.5 while ST provided a mean SBR of 37.2±2.2. Retrospectively-gated CINE (23)Na imaging of the heart at 7.0 T using density-adapted 3D projection reconstruction is feasible. The GA acquisition scheme is superior to the ST acquisition. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Cine MR imaging after myocardial infarction--assessment and follow-up of regional and global left ventricular function.

    Science.gov (United States)

    Sandstede, J J; Lipke, C; Kenn, W; Beer, M; Pabst, T; Hahn, D

    1999-12-01

    Myocardial infarction often leads to regional wall motion defects and in case of large defects to remodeling of the left ventricle. With this study, changes in regional and global myocardial function of 12 patients 3 weeks after myocardial infarction and after revascularization therapy were determined using MRI. Cine MRI was performed at study entry at rest and during low-dose dobutamine stimulation. All patients were re-examined at rest 3 and 6 months after the revascularization, including analysis of wall thickening and of left ventricular end-diastolic volume index (LVEDVI), end-systolic volume index (LVESVI), ejection fraction (LVEF), and mass index. After revascularization. 6 patients with stress-induced improvement of regional wall thickening recovered, 4 patients without improvement did not, but 2 patients without stress-induced improvement of wall thickening also recovered. Concerning global cardiac function, patients with mainly improved regional wall motion also showed a lower LVESVI and a higher LVEF than patients without improvement of regional contractility 6 months after revascularization in comparison to study entry. In conclusion, improvement of global myocardial function after revascularization is higher in patients with improved contractility in the infarcted region. The extent of the response of regions with wall motion defects to dobutamine stress correlates with the actual improvement after revascularization, and, therefore, dobutamine stress MRI may be helpful in selecting patients that will have a higher benefit from a revascularization therapy.

  20. Left ventricular strain and its pattern estimated from cine CMR and validation with DENSE.

    Science.gov (United States)

    Gao, Hao; Allan, Andrew; McComb, Christie; Luo, Xiaoyu; Berry, Colin

    2014-07-07

    Measurement of local strain provides insight into the biomechanical significance of viable myocardium. We attempted to estimate myocardial strain from cine cardiovascular magnetic resonance (CMR) images by using a b-spline deformable image registration method. Three healthy volunteers and 41 patients with either recent or chronic myocardial infarction (MI) were studied at 1.5 Tesla with both cine and DENSE CMR. Regional circumferential and radial left ventricular strains were estimated from cine and DENSE acquisitions. In all healthy volunteers, there was no difference for peak circumferential strain (- 0.18 ± 0.04 versus - 0.18 ± 0.03, p = 0.76) between cine and DENSE CMR, however peak radial strain was overestimated from cine (0.84 ± 0.37 versus 0.49 ± 0.2, p cine were similar to the patterns from DENSE, including the strain evolution related to recovery time and strain patterns related to MI scar extent. Furthermore, cine-derived strain disclosed different strain patterns in MI and non-MI regions, and regions with transmural and non-transmural MI as DENSE. Although there were large variations with radial strain measurements from cine CMR images, useful circumferential strain information can be obtained from routine clinical CMR imaging. Cine strain analysis has potential to improve the diagnostic yield from routine CMR imaging in clinical practice.

  1. Automated Motion Estimation for 2D Cine DENSE MRI

    Science.gov (United States)

    Gilliam, Andrew D.; Epstein, Frederick H.

    2013-01-01

    Cine displacement encoding with stimulated echoes (DENSE) is a magnetic resonance (MR) method that directly encodes tissue displacement into MR phase images. This technique has successfully interrogated many forms of tissue motion, but is most commonly used to evaluate cardiac mechanics. Currently, motion analysis from cine DENSE images requires manually delineated anatomical structures. An automated analysis would improve measurement throughput, simplify data interpretation, and potentially access important physiological information during the MR exam. In this article, we present the first fully automated solution for the estimation of tissue motion and strain from 2D cine DENSE data. Results using both simulated and human cardiac cine DENSE data indicate good agreement between the automated algorithm and the standard semi-manual analysis method. PMID:22575669

  2. La discapacidad en el cine

    OpenAIRE

    Aparicio Sánchez, David

    2015-01-01

    La discapacidad en el cine, es una tesis doctoral que analiza el tratamiento que el cine ofrece de la discapacidad. Se centra en el cine, importante e influyente medio de comunicación de masas, pues es un potente emisor de ideas y mensajes. Esta idea del cine nos parece particularmente interesante, ya que el individuo, mediante el proceso cognitivo de la percepción –ver películas–, crea conceptos que, más tarde, tendrá en cuenta en su relación con la sociedad. Hoy en día, el cine refleja, en ...

  3. Evaluation of flow volume and flow patterns in the patent false lumen of chronic aortic dissections using velocity-encoded cine magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Toshihisa; Watanabe, Shigeru; Sakurada, Hideki; Ono, Katsuhiro; Urano, Miharu; Hijikata, Yasuyoshi; Saito, Isao; Masuda, Yoshiaki [Chiba Univ. (Japan). School of Medicine

    2000-10-01

    In 21 patients with chronic aortic dissections and proven patent false lumens, the flow volume and flow patterns in the patent false lumens was evaluated using velocity-encoded cine magnetic resonance imaging (VENC-MRI) and the relationship between the flow characteristics and aortic enlargement was retrospectively examined. Flow patterns in the false lumen were divided into 3 groups: pattern A with primarily antegrade flow (n=6), pattern R with primarily retrograde flow (n=3), and pattern B with bidirectional flow (n=12). In group A, the rate of flow volume in the false lumen compared to the total flow volume in true and false lumens (%TFV) and the average rate of enlargement of the maximum diameter of the dissected aorta per year ({delta}D) were significantly greater than in groups R and B (%TFV: 74.1{+-}0.07 vs 15.2{+-}0.03 vs 11.8{+-}0.04, p<0.01; {delta}D: 3.62{+-}0.82 vs 0 vs 0.58{+-}0.15 mm/year, p<0.05, respectively). There was a significant correlation between %TFV and {delta}D (r=0.79, p<0.0001). Evaluation of flow volume and flow patterns in the patent false lumen using VENC-MRI may be useful for predicting enlargement of the dissected aorta. (author)

  4. Real-time balanced turbo field echo cine-magnetic resonance imaging evaluation of tongue movements during deglutition in subjects with anterior open bite.

    Science.gov (United States)

    Akin, Erol; Sayin, Mehmet Ozgür; Karaçay, Seniz; Bulakbaşi, Nail

    2006-01-01

    The aim of this study was to evaluate tongue movements in subjects with anterior dental open bites during deglutition by using real-time balanced turbo field echo cine-magnetic resonance imaging. The study included 28 subjects. Two groups were formed according to the presence of anterior open bite (at least 2 mm). The open-bite group (OBG) consisted of 18 patients (14 girls, 4 boys) with a mean age of 14.5 +/- 2.7 years. The control group (CG) consisted of 10 patients (5 girls, 5 boys) with a mean age of 14.5 +/- 2.6 years. We evaluated deglutition during 3 stages: oral (stage 1), pharyngeal (stage 2), and esophageal stage (3). Results indicated that (1) in the OBG, from stage 2 to stage 3, the anterior portion of the tongue dorsum was elevated [corrected] whereas its midportion was lowered [corrected]; (2) in the CG, its posterior portion was lowered [corrected] from stage 2 to stage 3; (3) in the CG, the tongue tip was positioned more posteriorly [corrected] at stage 2 than at stage 1; (4) in the OBG, the tongue tip moved more anteriorly in all stages of deglutition than in the CG. Compensatory tongue functions occur in patients with anterior dental open bites. Dynamic MRI is a promising tool for evaluating swallowing patterns in these patients.

  5. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation. Is IMRT more beneficial than VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Sakka, Mazen; Grabenbauer, Gerhard G. [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany); Friedrich-Alexander University of Erlangen-Nuernberg, Faculty of Medicine, Erlangen (Germany); Kunzelmann, Leonie; Metzger, Martin [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany)

    2017-10-15

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  6. Quantitative T2 mapping after reperfusion therapy in patients with acute myocardial infarction: A comparison with late gadolinium enhancement and cine MR imaging.

    Science.gov (United States)

    Park, Chul Hwan; Choi, Eui-Young; Yoon, Young Won; Kwon, Hyuck Moon; Hong, Bum Kee; Lee, Byoung Kwon; Min, Pil-Ki; Greiser, Andreas; Paek, Mun Young; Hwang, Sung Ho; Kim, Tae Hoon

    2015-12-01

    This study evaluates myocardial edema by quantitative T2 mapping in patients with acute myocardial infarction (AMI) and compares the lateral extent of myocardial edema with those of infarcted and dysfunctional myocardium. Cardiac magnetic resonance images (MRIs) of 31 patients (M:F=29:2, mean age: 52.5±10.8years) with AMI were reviewed. On cine-MRI, all short axis images of the left ventricle (LV) were divided into 60 sectors. The regional wall motion of each sector was calculated as follows: systolic wall thickening (SWT, %)=[(LV wall thicknessES-LV wall thicknessED)/LV wall thicknessED]*100. Dysfunctional myocardium was defined as sectors with decreased SWT lower than 40%. On LGE-images, myocardial infarction was defined as an area of hyper-enhancement more than 5 SDs from the remote myocardium. On T2 map, myocardial edema was defined as an area in which T2 values were at least 2 SDs higher than those from remote myocardium. The lateral extents of infarcted myocardium, myocardial edema, and dysfunctional myocardium were calculated as the percentage of central angles ((central angle of the involved myocardium/360)*100 (%)) and then compared. The lateral extent of myocardial edema was slightly larger than that of infarcted myocardium (37.4±13.3% vs. 35±12.9%, pinfarcted myocardium or myocardial edema (pmyocardial edema beyond the infarcted myocardium might be narrow, but the dysfunctional myocardium could be significantly larger than myocardial edema, suggesting stunned myocardium without edema. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Memoria y Cine

    OpenAIRE

    Getino, Octavio

    2006-01-01

    El cine argentino conserva como puntos básicos de referencia las obras de portavoces de la memoria y de la historia popular. Obras no sólo de fecha reciente, sino también aquellas que nacen con la propia industria cinematográfica. Este artículo, cuyas reflexiones –según coincidimos con su autor– conservan vigencia, apareció por primera vez en México, en 1984, en Notas sobre cine argentino y latinoamericano, una publicación que reunió diversos aportes sobre la cinematografía nacional y lati...

  8. Cine y discapacidad

    OpenAIRE

    Collado Vázquez, Susana

    2017-01-01

    ISSN En junio de 2013 un grupo de profesores del Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física desarrollamos la primera Jornada de Cine y Discapacidad en la Facultad de Ciencias de la Salud de la Universidad Rey Juan Carlos, y debido a su gran acogida por parte de profesores y alumnos, en noviembre de ese mismo año celebramos una segunda edición. A esta iniciativa le dimos continuidad con una III Jornada de Cine y Discapacidad que se celebró el 24 de o...

  9. Hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery: assessment using magnetic resonance imaging.

    Science.gov (United States)

    Petzina, Rainer; Ugander, Martin; Gustafsson, Lotta; Engblom, Henrik; Sjögren, Johan; Hetzer, Roland; Ingemansson, Richard; Arheden, Håkan; Malmsjö, Malin

    2007-05-01

    The hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery are debated. The aim of the present study was to quantify cardiac output and left ventricular chamber volumes after vacuum-assisted closure using magnetic resonance imaging, which is known to be the most accurate method for quantifying these measures. Six pigs had median sternotomy followed by vacuum-assisted closure treatment in the presence and absence of a paraffin gauze interface dressing. Cardiac output and stroke volume were examined using magnetic resonance imaging flow quantification (breath-hold and real-time). Chamber volumes were assessed using cine magnetic resonance imaging. Cardiac output and stroke volume decreased immediately after application of negative pressures of 75, 125, and 175 mm Hg (13% +/- 1% decrease in cardiac output). Interposition of 4 layers of paraffin gauze dressing over the heart during vacuum-assisted closure therapy resulted in a smaller decrease in cardiac output (8% +/- 1%). Vacuum-assisted closure therapy results in an immediate decrease in cardiac output, although to a lesser extent than shown previously. Covering the heart with a wound interface dressing lessens the hemodynamic effects of vacuum-assisted closure.

  10. El cine posmoderno

    Directory of Open Access Journals (Sweden)

    Edel Cadena Vargas

    2015-05-01

    Full Text Available En el presente trabajo se trata de dar respuesta a las siguientes preguntas: ¿cuál es el origen del cine posmoderno?, ¿cuáles son los factores que permiten su creación?, ¿a qué sentimiento responde?

  11. Efeito do broncodilatador no tempo de apneia voluntária máxima em pacientes com distúrbios ventilatórios obstrutivos Bronchodilator effect on maximal breath-hold time in patients with obstructive lung disease

    Directory of Open Access Journals (Sweden)

    Raqueli Biscayno Viecili

    2011-12-01

    Full Text Available OBJETIVO: Identificar o papel do broncodilatador no tempo de apneia voluntária máxima em pacientes com distúrbios ventilatórios obstrutivos (DVOs. MÉTODOS: Estudo caso-controle incluindo pacientes com DVOs e grupo controle. Foram realizadas espirometrias antes e após o uso de broncodilatador, assim como testes de apneia respiratória, utilizando-se um microprocessador eletrônico e um pneumotacógrafo como transdutor de fluxo. As curvas de fluxo respiratório foram exibidas em tempo real em um computador portátil, e os tempos de apneia voluntária inspiratória e expiratória máximos (TAVIM e TAVEM, respectivamente foram determinados a partir do sinal adquirido. RESULTADOS: Um total de 35 pacientes com DVOs e 16 controles foram incluídos no estudo. O TAVIM sem o uso de broncodilatador foi significativamente menor no grupo DVO que no grupo controle (22,27 ± 11,81 s vs. 31,45 ± 15,73; p = 0,025, mas essa diferença não foi significativa após o uso de broncodilatador (24,94 ± 12,89 s vs. 31,67 ± 17,53 s. Os valores de TAVEM foram significativamente menores no grupo DVO que no grupo controle antes (16,88 ± 6,58 s vs. 22,09 ± 7,95 s; p = 0,017 e após o uso de broncodilatador (21,22 ± 9,37 s vs. 28,53 ± 12,46 s; p = 0,024. CONCLUSÕES: Estes resultados fornecem uma evidência adicional da utilidade clínica do teste de apneia na avaliação da função pulmonar e do papel do broncodilatador nesse teste.OBJECTIVE: To identify the role of bronchodilators in the maximal breath-hold time in patients with obstructive lung disease (OLD. METHODS: We conducted a case-control study including patients with OLD and a control group. Spirometric tests were performed prior to and after the use of a bronchodilator, as were breath-hold tests, using an electronic microprocessor and a pneumotachograph as a flow transducer. Respiratory flow curves were displayed in real time on a portable computer. The maximal breath-hold times at end

  12. Accuracy of contrast-enhanced cine-MR sequences in the assessment of left ventricular function: comparison with precontrast cine-MR sequences. Results of a bicentric study

    Energy Technology Data Exchange (ETDEWEB)

    Lasalarie, Jean-Christophe; Carre, Christophe [Centre Hospitalier Sud Reunion, Department of Radiology, Saint-Pierre (France); Serfaty, Jean-Michel; Schouman-Claeys, Elisabeth; Laissy, Jean-Pierre [Hopital Bichat AP-HP, Department of Radiology, Paris Cedex 18 (France); Messika-Zeitoun, David [Hopital Bichat, Department of Cardiology, Paris Cedex 18 (France); Jeannot, Christophe [Centre Hospitalier Sud Reunion, Department of Cardiology, Saint-Pierre (France)

    2007-11-15

    The accuracy of contrast-enhanced cine magnetic resonance (cine-MR) imaging to determine left ventricular function was assessed by comparison with the established noncontrast cine-MR sequences. Contrast-enhanced balanced steady-state free precession (cine-SSFP) sequences were compared with precontrast cine-SSFP sequences in the assessment of left ventricular contractile function in 30 consecutive patients with various cardiac diseases. Five to eight short-axis image sections were obtained in each patient. Quantitative data were analyzed using a paired t-test and linear regression analysis. Qualitative assessment of images was made following a 16-segment analysis. There was no significant difference between the two sequences in regional wall motion, end-diastolic volumes (EDV) and end-systolic volumes (ESV), stroke volume, left ventricular mass, as well as left ventricular ejection fraction (LVEF), despite slight delayed subendocardial enhancement in ten patients with myocardial infarction. All the values studied above were closely correlated between both cine-SSFP sequences (Spearman r=0.85-0.97, P<0.0001 for all comparisons). Contrast-enhanced cine-SSFP sequences can be used as a similar diagnostic tool as precontrast cine-MR sequences in the assessment of left ventricular contractile function. (orig.)

  13. [Study on cine view of relative enhancement ratio map in O2-enhanced MRI].

    Science.gov (United States)

    Fujii, Keita; Watanabe, Yasushi; Hanaoka, Shouhei; Motoyoshi, Kouichi; Goto, Masami; Amemiya, Shiori; Ino, Kenji; Akahane, Masaaki; Yano, Keiichi; Ohtomo, Kuni

    2014-11-01

    Magnetic resonance imaging (MRI) enables the evaluation of organ structure and function. Oxygen-enhanced MRI (O2-enhanced MRI) is a method for evaluating the pulmonary ventilation function using oxygen as a contrast agent. We created the Cine View of Relative Enhancement Ratio Map (Cine RER map) in O2-enhanced MRI to easily observe the contrast effect for clinical use. Relative enhancement ratio (RER) was determined as the pixel values of the Cine RER map. Moreover, six healthy volunteers underwent O2-enhanced MRI to determine the appropriate scale width of the Cine RER map. We calculated each RER and set 0 to 1.27 as the scale width of the Cine RER map based on the results. The Cine RER map made it possible to observe the contrast effect over time and thus is a convenient tool for evaluating the pulmonary ventilation function in O2-enhanced MRI.

  14. Improved attenuation correction for respiratory gated PET/CT with extended-duration cine CT: a simulation study

    Science.gov (United States)

    Zhang, Ruoqiao; Alessio, Adam M.; Pierce, Larry A.; Byrd, Darrin W.; Lee, Tzu-Cheng; De Man, Bruno; Kinahan, Paul E.

    2017-03-01

    Due to the wide variability of intra-patient respiratory motion patterns, traditional short-duration cine CT used in respiratory gated PET/CT may be insufficient to match the PET scan data, resulting in suboptimal attenuation correction that eventually compromises the PET quantitative accuracy. Thus, extending the duration of cine CT can be beneficial to address this data mismatch issue. In this work, we propose to use a long-duration cine CT for respiratory gated PET/CT, whose cine acquisition time is ten times longer than a traditional short-duration cine CT. We compare the proposed long-duration cine CT with the traditional short-duration cine CT through numerous phantom simulations with 11 respiratory traces measured during patient PET/CT scans. Experimental results show that, the long-duration cine CT reduces the motion mismatch between PET and CT by 41% and improves the overall reconstruction accuracy by 42% on average, as compared to the traditional short-duration cine CT. The long-duration cine CT also reduces artifacts in PET images caused by misalignment and mismatch between adjacent slices in phase-gated CT images. The improvement in motion matching between PET and CT by extending the cine duration depends on the patient, with potentially greater benefits for patients with irregular breathing patterns or larger diaphragm movements.

  15. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  16. Novel Super-Resolution Approach to Time-Resolved Volumetric 4-Dimensional Magnetic Resonance Imaging With High Spatiotemporal Resolution for Multi-Breathing Cycle Motion Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Li, Guang, E-mail: lig2@mskcc.org [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Wei, Jie [Department of Computer Science, City College of New York, New York, New York (United States); Kadbi, Mo [Philips Healthcare, MR Therapy Cleveland, Ohio (United States); Moody, Jason; Sun, August; Zhang, Shirong; Markova, Svetlana; Zakian, Kristen; Hunt, Margie; Deasy, Joseph O. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2017-06-01

    Purpose: To develop and evaluate a super-resolution approach to reconstruct time-resolved 4-dimensional magnetic resonance imaging (TR-4DMRI) with a high spatiotemporal resolution for multi-breathing cycle motion assessment. Methods and Materials: A super-resolution approach was developed to combine fast 3-dimensional (3D) cine MRI with low resolution during free breathing (FB) and high-resolution 3D static MRI during breath hold (BH) using deformable image registration. A T1-weighted, turbo field echo sequence, coronal 3D cine acquisition, partial Fourier approximation, and SENSitivity Encoding parallel acceleration were used. The same MRI pulse sequence, field of view, and acceleration techniques were applied in both FB and BH acquisitions; the intensity-based Demons deformable image registration method was used. Under an institutional review board–approved protocol, 7 volunteers were studied with 3D cine FB scan (voxel size: 5 × 5 × 5 mm{sup 3}) at 2 Hz for 40 seconds and a 3D static BH scan (2 × 2 × 2 mm{sup 3}). To examine the image fidelity of 3D cine and super-resolution TR-4DMRI, a mobile gel phantom with multi-internal targets was scanned at 3 speeds and compared with the 3D static image. Image similarity among 3D cine, 4DMRI, and 3D static was evaluated visually using difference image and quantitatively using voxel intensity correlation and Dice index (phantom only). Multi-breathing-cycle waveforms were extracted and compared in both phantom and volunteer images using the 3D cine as the references. Results: Mild imaging artifacts were found in the 3D cine and TR-4DMRI of the mobile gel phantom with a Dice index of >0.95. Among 7 volunteers, the super-resolution TR-4DMRI yielded high voxel-intensity correlation (0.92 ± 0.05) and low voxel-intensity difference (<0.05). The detected motion differences between TR-4DMRI and 3D cine were −0.2 ± 0.5 mm (phantom) and −0.2 ± 1.9 mm (diaphragms). Conclusion: Super-resolution TR-4

  17. MR imaging of the heart in patients after myocardial infarction: effect of increasing intersection gap on measurements of left ventricular volume, ejection fraction, and wall thickness.

    Science.gov (United States)

    Cottin, Y; Touzery, C; Guy, F; Lalande, A; Ressencourt, O; Roy, S; Walker, P M; Louis, P; Brunotte, F; Wolf, J E

    1999-11-01

    To determine the extent to which the number of planes imaged at magnetic resonance (MR) imaging could be reduced without modifying the calculated volume and thickness of the left ventricle. Sixty-one patients were examined after a myocardial infarction. The whole left ventricle was imaged by using 5-mm contiguous breath-hold cine MR short-axis sections with no gap (SAng) (two-dimensional fast low-angle shot sequence, 9/4.8 [repetition time msec/echo time msec]). The effect of omitting one section in two (short-axis sections with 5-mm gap [SA5 mm]) or two sections in three (short-axis sections with 10-mm gap [SA10 mm]) was studied. In the comparison of SA5 mm or SA10 mm with respect to the reference SAng, the standard error of the estimate (SEE) for the diastolic volume did not exceed the 6.1% interobserver SEE, and the SEE for the ejection fraction remained lower than the 3% interobserver SEE. The measured wall thickness was not affected. In addition, six simple geometric models were compared with SAng and yielded an SEE of 9.5%-28.1% for the diastolic volume and 3.8%-13.3% for the ejection fraction. In the study of left ventricles with heterogeneous contractility, short-axis imaging is more accurate than geometric modeling and permits wall thickness measurements when an intersection gap of 5 or 10 mm is used.

  18. Simultaneous static and cine nonenhanced MR angiography using radial sampling and highly constrained back projection reconstruction.

    Science.gov (United States)

    Koktzoglou, Ioannis; Mistretta, Charles A; Giri, Shivraman; Dunkle, Eugene E; Amin, Parag; Edelman, Robert R

    2014-10-01

    To describe a pulse sequence for simultaneous static and cine nonenhanced magnetic resonance angiography (NEMRA) of the peripheral arteries. The peripheral arteries of 10 volunteers and 6 patients with peripheral arterial disease (PAD) were imaged with the proposed cine NEMRA sequence on a 1.5 Tesla (T) system. The impact of multi-shot imaging and highly constrained back projection (HYPR) reconstruction was examined. The propagation rate of signal along the length of the arterial tree in the cine nonenhanced MR angiograms was quantified. The cine NEMRA sequence simultaneously provided a static MR angiogram showing vascular anatomy as well as a cine display of arterial pulse wave propagation along the entire length of the peripheral arteries. Multi-shot cine NEMRA improved temporal resolution and reduced image artifacts. HYPR reconstruction improved image quality when temporal reconstruction footprints shorter than 100 ms were used (P cine NEMRA was slower in patients with PAD than in volunteers. Simultaneous static and cine NEMRA of the peripheral arteries is feasible. Multi-shot acquisition and HYPR reconstruction can be used to improve arterial conspicuity and temporal resolution. Copyright © 2013 Wiley Periodicals, Inc.

  19. Cine e identidades virtuales

    Directory of Open Access Journals (Sweden)

    Labrador Ben, Julia María

    2006-12-01

    Full Text Available The subject is the ability the cinema has performed - since its very begining - as a creation instrument of national and transnational identities. In the first place, it covers Spanish cinema since 1938 and right after the end of the Spanish Civil War, II World War Italian-German cinema, Eisenstein’s, Leni Riefenstahl’s, Griffth’s and Ford’s cinema, the role American war and science fiction productions played, as well as the comedies dealing with the divided Berlin subject. The role of computers and video-games and the new cinema positionings that forecast the end of what is real, is studied through films such as Tron, The Lawnmower Man, Johnny Mnemonic, Ghost in the shell, Simone o Matrix.Se estudia la capacidad del cine desde sus orígenes como instrumento de generación de identidades nacionales y transnacionales. Se realiza, en primer lugar, un recorrido por el cine español desde 1938 y tras el final de la guerra civil, el cine italo-alemán de la II Guerra Mundial, el cine de Eisenstein, Leni Riefenstahl, Griffth y Ford, y el papel que jugaron las producciones norteamericanas bélicas y de ciencia ficción, así como las comedias sobre el Berlín dividido. El papel de los ordenadores y los videojuegos, y los nuevos planteamientos cinematográficos que pronostican el final de lo real se estudia a través de películas como Tron, El cortador de césped, Johnny Mnemonic, Ghost in the shell, Simone o Matrix.

  20. Cine MRI: a new approach to the diagnosis of scapholunate dissociation

    Energy Technology Data Exchange (ETDEWEB)

    Langner, I.; Eisenschenk, A. [University Medicine Greifswald, Division of Hand Surgery and Functional Microsurgery, Department of Trauma and Reconstructive Surgery, Greifswald (Germany); Fischer, S.; Langner, S. [University Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2015-08-15

    To evaluate the feasibility of cine MRI for the detection of scapholunate dissociation (SLD) and to compare the sensitivity and specificity of cine MRI with those of cineradiography and arthroscopy. To evaluate feasibility, healthy subjects underwent cine MRI of the wrist. To evaluate sensitivity and specificity, patients with clinically suspected scapholunate ligament (SLL) injury after trauma to the wrist were prospectively included and underwent radiographic examination, cineradiography, and cine MRI. In 25 out of 38 patients, subsequent arthroscopy was performed. Results of cineradiography and cine MRI correlated with those of arthroscopy. Cine MRI was of diagnostic quality in all healthy subjects and patients with good interrater agreement. There was excellent correlation between cineradiography and cine MRI. Scapholunate distance differed significantly between healthy subjects and patients with scapholunate dissociation (p < 0.001), but not between imaging modalities in the patient group. Cine MRI had 85 % sensitivity and 90 % specificity for the detection of SLD. Cine MRI of the wrist is a fast and reliable technique for the detection of SLD with diagnostic accuracy comparable to cineradiography. It can be easily implemented as a routine clinical MRI examination, facilitating diagnostic workup of patients with suspected SLD while avoiding radiation exposure. (orig.)

  1. The Cine Club de Lima

    Directory of Open Access Journals (Sweden)

    Ricardo Bedoya

    2009-10-01

    Full Text Available Cine Club de Lima was the most important cinematography culture spreading institution of the fifties. It was also the precursor of other movie clubs of following decades, which would bring together important Peruvian intellectuals from every art form, who would together promote cultural entertainment. This piece describes ”Cine Club Lima” origins and dissolution, while taking into account its programs.

  2. SU-F-T-136: Breath Hold Lung Phantom Study in Using CT Density Versus Relative Stopping Power Ratio for Proton Pencil Beam Scanning System

    Energy Technology Data Exchange (ETDEWEB)

    Syh, J; Wu, H; Rosen, L [Willis-Knighton Medical Center, Shreveport, LA (United States)

    2016-06-15

    Purpose: To evaluate mass density effects of CT conversion table and its variation in current treatment planning system of spot scanning proton beam using an IROC proton lung phantom for this study. Methods: A proton lung phantom study was acquired to Imaging and Radiation Oncology Core Houston (IROC) Quality Assurance Center. Inside the lung phantom, GAF Chromic films and couples of thermal luminescent dosimeter (TLD) capsules embedded in specified PTV and adjacent structures to monitor delivered dosage and 3D dose distribution profiles. Various material such as cork (Lung), blue water (heart), Techron HPV (ribs) and organic material of balsa wood and cork as dosimetry inserts within phantom of solid water (soft tissue). Relative stopping power (RLSP) values were provided. Our treatment planning system (TPS) doesn’t require SP instead relative density was converted relative to water. However lung phantom was irradiated by planning with density override and the results were compared with IROC measurements. The second attempt was conducted without density override and compared with IROC’s. Results: The higher passing rate of imaging and measurement results of the lung phantom irradiation met the criteria by IROC without density override. The film at coronal plane was found to be shift due to inclined cylinder insertion. The converted CT density worked as expected to correlate relative stopping power. Conclusion: The proton lung phantom provided by IROC is a useful tool to qualify our commissioned proton pencil beam delivery with TPS within reliable confidence. The relative mass stopping power ratios of materials were converted from the relative physical density relative to water and the results were satisfied.

  3. Cine-teatro-cine: los vasos comunicantes en Edgar Neville

    OpenAIRE

    Rodríguez Sánchez, María Ángeles; Torres Nebrera, Gregorio

    2005-01-01

    Edgar Neville desempeñó un importante papel en el cine y el teatro de su tiempo. Como dramaturgo escribió numerosas comedias de éxito, algunas tan famosas como La vida en un hilo y El baile. Tales títulos fueron también guiones de dos de sus mejores películas. Este artículo trata de examinar las relaciones entre cine y teatro a través de los dos ejemplos citados, que son auténticos experimentos de "vasos comunicantes" entre el teatro y el cine de Edgar Neville.

  4. Kinematic analysis of the knee joint by cine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Inouye, Tamon; Kose, Katsumi

    1989-08-01

    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author).

  5. Intramyocardial strain estimation from cardiac cine MRI.

    Science.gov (United States)

    Elnakib, Ahmed; Beache, Garth M; Gimel'farb, Georgy; El-Baz, Ayman

    2015-08-01

    Functional strain is one of the important clinical indicators for the quantification of heart performance and the early detection of cardiovascular diseases, and functional strain parameters are used to aid therapeutic decisions and follow-up evaluations after cardiac surgery. A comprehensive framework for deriving functional strain parameters at the endocardium, epicardium, and mid-wall of the left ventricle (LV) from conventional cine MRI data was developed and tested. Cine data were collected using short TR-/TE-balanced steady-state free precession acquisitions on a 1.5T Siemens Espree scanner. The LV wall borders are segmented using a level set-based deformable model guided by a stochastic force derived from a second-order Markov-Gibbs random field model that accounts for the object shape and appearance features. Then, the mid-wall of the segmented LV is determined based on estimating the centerline between the endocardium and epicardium of the LV. Finally, a geometrical Laplace-based method is proposed to track corresponding points on successive myocardial contours throughout the cardiac cycle in order to characterize the strain evolutions. The method was tested using simulated phantom images with predefined point locations of the LV wall throughout the cardiac cycle. The method was tested on 30 in vivo datasets to evaluate the feasibility of the proposed framework to index functional strain parameters. The cine MRI-based model agreed with the ground truth for functional metrics to within 0.30 % for indexing the peak systolic strain change and 0.29 % (per unit time) for indexing systolic and diastolic strain rates. The method was feasible for in vivo extraction of functional strain parameters. Strain indexes of the endocardium, mid-wall, and epicardium can be derived from routine cine images using automated techniques, thereby improving the utility of cine MRI data for characterization of myocardial function. Unlike traditional texture-based tracking, the

  6. CineGlob

    CERN Multimedia

    CineGlob

    2014-01-01

    CERN will be hosting the next CineGlobe International Film Festival from March 18 to 23 at the Globe of Science and Innovation with the theme “Beyond the Frontier”, This 4th edition will see 66 short films “inspired by science” in competition, including fiction films as well as documentaries. From Tuesday the 18th to Friday the 21st, special lunch sessions are organized from 12:30 to 13:30. Food will be available for purchase at the tent “Café Cinéma” next to the Globe. Special evenings While the short film screenings are the heart of the festival, every year CineGlobe also organizes compelling special events every night, from feature films to special musical performances: Tuesday 18th: The Swiss premiere of the acclaimed documentary film Particle Fever. Presented by BBC Storyville with Fabiola Gianotti and director Mark Levinson in attendance; Wednesday 19th: The result of the “Story Matter” Hacka...

  7. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study

    NARCIS (Netherlands)

    Kreeft, Anne Marijn; Rasch, Coen R. N.; Muller, Sara H.; Pameijer, Frank A.; Hallo, Eeke; Balm, Alfons J. M.

    2012-01-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures.

  8. Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy.

    Science.gov (United States)

    Werys, Konrad; Petryka-Mazurkiewicz, Joanna; Błaszczyk, Łukasz; Miśko, Jolanta; Śpiewak, Mateusz; Małek, Łukasz A; Mazurkiewicz, Łukasz; Miłosz-Wieczorek, Barbara; Marczak, Magdalena; Kubik, Agata; Dąbrowska, Agnieszka; Piątkowska-Janko, Ewa; Sawionek, Błażej; Wijesurendra, Rohan; Piechnik, Stefan K; Bogorodzki, Piotr

    2016-12-01

    To investigate whether magnetic resonance imaging (MRI) cine-derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT). Patients scheduled for CRT (n = 52) underwent preprocedure MRI including cine and tMRI acquisitions. Segmental strain curves were calculated for both cine and tMRI to produce a range of standard indices for direct comparison between modalities. We also proposed and evaluated a novel index of "dyscontractility," which detects the presence of focal areas with paradoxically positive circumferential strain. Across conventional strain indices, there was only moderate-to-poor (R = 0.3-0.6) correlation between modalities; eight cine-derived indices showed statistically significant (P cine images (cine dyscontractility index, "CDI") was the single best predictor of clinical response to CRT (area under the curve AUC = 0.81, P Cine-derived strain indices offer potentially new information compared to tMRI. Specifically, the novel CDI is most strongly linked to response to cardiac resynchronization therapy in a contemporary patient cohort. It utilizes readily available MRI data, is relatively straightforward to process, and compares favorably with any conventional tagging index. J. Magn. Reson. Imaging 2016;44:1483-1492. © 2016 International Society for Magnetic Resonance in Medicine.

  9. Magnetic resonance imaging of athlete's heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Zandrino, F.; Sardanelli, F. [Dept. of Experimental Medicine, Section of Diagnostic Imaging and Radiotherapy, University of Genoa School of Medicine (Italy); Molinari, G.; Masperone, M.A. [Dept. of Cardiology, University of Genoa School of Medicine (Italy); Smeraldi, A.; Odaglia, G. [Dept. of Sports Medicine, University of Genoa School of Medicine (Italy)

    2000-02-01

    To evaluate left ventricular myocardial mass and function as well as ostial coronary artery cross-sectional area in endurance athletes, an athlete group of 12 highly trained rowers and a control group of 12 sedentary healthy subjects underwent MR examination. An ECG-gated breath-hold cine gradient-echo sequence was used to calculate myocardial mass, end-diastolic and end-systolic volumes, stroke volume, and cardiac output, all related to body surface area, as well as ejection fraction. A 3D fat-saturated ECG- and respiratory-triggered navigator echo sequence was used to evaluate coronary arteries: left main (LM), left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA). Cross-sectional area was calculated and divided for body surface area. Myocardial mass was found significantly larger in athlete group than in control group (p = 0.0078), the same being for end-diastolic volume (p = 0.0078), stroke volume (p = 0.0055), LM (p = 0.0066) and LAD (p = 0.0129). No significant difference was found for all the remaining parameters. Significant correlation with myocardial mass was found for LM (p < 0.001) and LAD (p = 0.0340), not for LCx and RCA. Magnetic resonance imaging is a useful tool in evaluating the myocardial hypertrophy and function of athlete's heart. Magnetic resonance angiography is a valuable noninvasive method to visualize the correlated cross-sectional area increase of the left coronary artery system. (orig.)

  10. Left-sided breast cancer loco-regional radiotherapy with deep inspiration breath-hold: Does volumetric-modulated arc radiotherapy reduce heart dose further compared with tangential intensity-modulated radiotherapy?

    Science.gov (United States)

    Pham, Trang T; Ward, Rachel; Latty, Drew; Owen, Catherine; Gebski, Val; Chojnowski, Jacek; Kelly, Christopher; Ahern, Verity; Tiver, Kenneth; Stuart, Kirsty; Wang, Wei

    2016-08-01

    Left-sided breast cancer radiotherapy has been associated with an increase in cardiac mortality. This study investigated the potential heart-sparing effect of volumetric-modulated arc radiotherapy (VMAT). We compared VMAT to tangential intensity-modulated radiotherapy (t-IMRT) in the loco-regional treatment of left-sided breast cancer, including internal mammary nodal irradiation, based on deep inspiration breath-hold (DIBH) and free-breathing (FB). Radiotherapy for 15 patients was re-planned. Four plans were compared: t-IMRT-DIBH; VMAT-DIBH; t-IMRT-FB; VMAT-FB. Prescribed dose was 50 Gy in 25 fractions. T-IMRT plans were generated using tangentially orientated fields. VMAT plans were generated using two partial arcs (average arc 190°). Mean heart dose (MHD) was 5 ± 2.4 Gy, 5.7 ± 1.4 Gy, 9.7 ± 3.3 Gy and 8.1 ± 2.0 Gy for t-IMRT-DIBH, VMAT-DIBH, IMRT-FB and VMAT-FB respectively. The difference in MHD between IMRT-DIBH and VMAT-DIBH was not significant (P = 0.14). VMAT-DIBH significantly spared the volume of heart irradiated to doses of 20 Gy and above (p 6.3 Gy with t-IMRT-DIBH, the use of VMAT-DIBH resulted in a benefit in reducing the MHD. © 2016 The Royal Australian and New Zealand College of Radiologists.

  11. CINE: Comet INfrared Excitation

    Science.gov (United States)

    de Val-Borro, Miguel; Cordiner, Martin A.; Milam, Stefanie N.; Charnley, Steven B.

    2017-08-01

    CINE calculates infrared pumping efficiencies that can be applied to the most common molecules found in cometary comae such as water, hydrogen cyanide or methanol. One of the main mechanisms for molecular excitation in comets is the fluorescence by the solar radiation followed by radiative decay to the ground vibrational state. This command-line tool calculates the effective pumping rates for rotational levels in the ground vibrational state scaled by the heliocentric distance of the comet. Fluorescence coefficients are useful for modeling rotational emission lines observed in cometary spectra at sub-millimeter wavelengths. Combined with computational methods to solve the radiative transfer equations based, e.g., on the Monte Carlo algorithm, this model can retrieve production rates and rotational temperatures from the observed emission spectrum.

  12. Cine-Club

    CERN Document Server

    Cine-Club

    2011-01-01

    Thursday 10 November 2011 at 20:30 CERN Council Chamber The Counterfeiters / Die Fälscher By: Stefan Ruzowitzky (Germany/Austria, 2007) 98 min With: Karl Markovics, August Diel, Devid Striesow The Counterfeiters is the true story of the largest counterfeiting operation in history, set up by the Nazis in 1936. Master counterfeiter Salomon ‘Sally’ Sorowitsch, a Jew without morals, is arrested and sent to Mauthausen concentration camp, where he weasels through by offering his ‘artistic’ services. After transfer to Sachsenhausen he’s given an official alternative: taking ‘artistic’ charge of a cons teams assigned to produce perfect forgeries of allied banknotes for the Third Reich. Survivor Sally accepts, but conscience matters among the team prove no less dangerous then a sadistic jailer, which only the CO may keep in check. Original version German; English subtitles Entrance: 2 CHF Projection from DVD http://cine...

  13. Functional imaging of the lung using a gaseous contrast agent: {sup 3}Helium-magnetic resonance imaging; Funktionelle Bildgebung der Lunge mit gasfoermigem Kontrastmittel: {sup 3}Helium-Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Gast, K.K.; Heussel, C.P. [Klinik mit Poliklinik fuer Radiologie, Klinikum der Johannes Gutenberg-Univ., Mainz (Germany); Schreiber, W.G. [AG Medizinische Physik, Klinik mit Poliklinik fuer Radiologie, Klinikum der Johannes Gutenberg-Univ., Mainz (Germany); Kauczor, H.U. [Deutsches Krebsforschungszentrum (DKFZ), Heidelberg (Germany)

    2005-05-01

    Current imaging methods of the lung concentrate on morphology as well as on the depiction of the pulmonary parenchyma. The need of an advanced and more subtle imaging technology compared to conventional radiography is met by computed topograhy as the method of choice. Nevertheless, computed tomography yields very limited functional information. This is to be derived from arterial blood gas analysis, spirometry and body plethysmography. These methods, however, lack the scope for regional allocation of any pathology. Magnetic resonance imaging of the lung has been advanced by the use of hyperpolarised {sup 3}Helium as an inhaled gaseous contrast agent. The inhalation of the gas provides functional data by distribution, diffusion and relaxation of its hyperpolarised state. Because anatomical landmarks of the lung can be visualised as well, functional information can be linked with regional information. Furthermore, the method provides high spatial and temporal resolution and lacks the potential side-effects of ionising radiation. Four different modalities have been established: 1. Spin density imaging studies the distribution of gas, normally after a single inhalation of contrast gas in inspiratory breath hold. 2. Dynamic cine imaging studies the distribution of gas with respect to regional time constants of pulmonary gas inflow. 3. Diffusion weighted imaging can exhibit the presence and severity of pulmonary airspace enlargement, as in pulmonary emphysema. 4. Oxygen sensitive imaging displays intrapulmonary oxygen partial pressure and its distribution. Currently, the method is limited by comparably high costs and limited availability. As there have been recent developments which might bring this modality closer to clinical use, this review article will comprise the methodology as well as the current state of the art and standard of knowledge of magnetic resonance imaging of the lung using hyperpolarised {sup 3}Helium. (orig.)

  14. Self-gated fat-suppressed cardiac cine MRI.

    Science.gov (United States)

    Ingle, R Reeve; Santos, Juan M; Overall, William R; McConnell, Michael V; Hu, Bob S; Nishimura, Dwight G

    2015-05-01

    To develop a self-gated alternating repetition time balanced steady-state free precession (ATR-SSFP) pulse sequence for fat-suppressed cardiac cine imaging. Cardiac gating is computed retrospectively using acquired magnetic resonance self-gating data, enabling cine imaging without the need for electrocardiogram (ECG) gating. Modification of the slice-select rephasing gradients of an ATR-SSFP sequence enables the acquisition of a one-dimensional self-gating readout during the unused short repetition time (TR). Self-gating readouts are acquired during every TR of segmented, breath-held cardiac scans. A template-matching algorithm is designed to compute cardiac trigger points from the self-gating signals, and these trigger points are used for retrospective cine reconstruction. The proposed approach is compared with ECG-gated ATR-SSFP and balanced steady-state free precession in 10 volunteers and five patients. The difference of ECG and self-gating trigger times has a variability of 13 ± 11 ms (mean ± SD). Qualitative reviewer scoring and ranking indicate no statistically significant differences (P > 0.05) between self-gated and ECG-gated ATR-SSFP images. Quantitative blood-myocardial border sharpness is not significantly different among self-gated ATR-SSFP ( 0.61±0.15 mm -1), ECG-gated ATR-SSFP ( 0.61±0.15 mm -1), or conventional ECG-gated balanced steady-state free precession cine MRI ( 0.59±0.15 mm -1). The proposed self-gated ATR-SSFP sequence enables fat-suppressed cardiac cine imaging at 1.5 T without the need for ECG gating and without decreasing the imaging efficiency of ATR-SSFP. © 2014 Wiley Periodicals, Inc.

  15. Left Ventricle: Fully Automated Segmentation Based on Spatiotemporal Continuity and Myocardium Information in Cine Cardiac Magnetic Resonance Imaging (LV-FAST

    Directory of Open Access Journals (Sweden)

    Lijia Wang

    2015-01-01

    Full Text Available CMR quantification of LV chamber volumes typically and manually defines the basal-most LV, which adds processing time and user-dependence. This study developed an LV segmentation method that is fully automated based on the spatiotemporal continuity of the LV (LV-FAST. An iteratively decreasing threshold region growing approach was used first from the midventricle to the apex, until the LV area and shape discontinued, and then from midventricle to the base, until less than 50% of the myocardium circumference was observable. Region growth was constrained by LV spatiotemporal continuity to improve robustness of apical and basal segmentations. The LV-FAST method was compared with manual tracing on cardiac cine MRI data of 45 consecutive patients. Of the 45 patients, LV-FAST and manual selection identified the same apical slices at both ED and ES and the same basal slices at both ED and ES in 38, 38, 38, and 41 cases, respectively, and their measurements agreed within -1.6±8.7 mL, -1.4±7.8 mL, and 1.0±5.8% for EDV, ESV, and EF, respectively. LV-FAST allowed LV volume-time course quantitatively measured within 3 seconds on a standard desktop computer, which is fast and accurate for processing the cine volumetric cardiac MRI data, and enables LV filling course quantification over the cardiac cycle.

  16. Discursos subversivos en el cine no hablado

    Directory of Open Access Journals (Sweden)

    Rodríguez Fernández, M.ª del Carmen

    2012-12-01

    Full Text Available “Subversive discourses in silent films” aims to analyse the gender transgression that emerges in certain movies of the silent period. These being silent films, their meaning can only be understood from the content of the images. Directors of the silent period were aware of the importance of images and of their power to put across their views to spectators. The field of filmmaking was new but it was not ungendered, and women filmmakers knew that their films were the vehicle to make spectators aware of their feminist positions. Le matelas alcoolique, La souriante Mme. Beudet and Dora Films of America Shorts are examples of this privilege since, although they belong to two periods of silent film history and have different aims, the directors and the films selected are good examples to be revisited with a gender perspective.

    “Discursos subversivos en el cine no hablado” se propone analizar las transgresiones de género que aparecen en algunas películas del cine mudo. Por sus características al tratarse de un cine no hablado, lo que sugieren algunas imágenes es fundamental para entender los significados de las películas. Las directoras de aquella época eran conocedoras de la importancia de las imágenes y del poder que les confería la cámara para expresar sus reivindicaciones al público espectador. El campo de la cinematografía era nuevo, pero tenía género y las directoras sabían que sus películas eran el vehículo para dar a conocer su articulación como feministas. Le matelas alcoolique, La souriante Mme. Beudet y Dora Films of America Shorts son ejemplos de este privilegio puesto que, aunque las películas de esta muestra pertenezcan a dos etapas del cine mudo y de que sus propósitos fueran diferentes, las directoras y las películas seleccionadas son ejemplos merecedores de una revisión con perspectiva de género.

  17. Comparison of fluoro and cine coronary angiography: balancing acceptable outcomes with a reduction in radiation dose.

    Science.gov (United States)

    Olcay, Ayhan; Guler, Ekrem; Karaca, Ibrahim Oguz; Omaygenc, Mehmet Onur; Kizilirmak, Filiz; Olgun, Erkam; Yenipinar, Esra; Cakmak, Huseyin Altug; Duman, Dursun

    2015-04-01

    Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques. We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision. Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 ± 53542.71 mGy•cm² vs 11349.2 ± 8796.46 mGy•cm²; Pcine group vs the LFH group (3.87 ± 5.08 minutes vs 1.66 ± 1.51 minutes; Pcine group vs the LFH group (112.07 ± 43.79 cc vs 88.15 ± 23.84 cc; Pcine and LFH angiography groups (0.66680 ± 0.19309 vs 0.54193 ± 0.31046; P=.20). Radiation doses, contrast use, and fluoroscopy times are lower in fluoroscopic LFH angiography vs cine angiography. Interclass variability of visual stenosis estimation between three operators was not different between cine and LFH groups. Fluoroscopic LFH images conventionally have inferior diagnostic quality when compared with cine coronary angiography, but with new angiographic systems with improved LFH image quality, these images may be adequate for diagnostic coronary angiography.

  18. SU-F-T-263: Dosimetric Characteristics of the Cine Acquisition Mode of An A-Si EPID

    Energy Technology Data Exchange (ETDEWEB)

    Bawazeer, O; Deb, P [RMIT University, Melbourne, VIC (Australia); Sarasanandarajah, S [Peter MacCallum Cancer Institute, Melbourne, Victoria (Australia); Herath, S; Kron, T [Peter MacCallum Cancer Institute, Melbourne, VIC (Australia)

    2016-06-15

    Purpose: To investigate the dosimetric characteristics of Varian a-Si-500 electronic portal imaging device (EPID) operated in cine mode particularly considering linearity with delivered dose, dose rate, field size, phantom thickness, MLC speed and common IMRT fields. Methods: The EPID that attached to a Varian Clinac 21iX linear accelerator, was irradiated with 6 and 18 MV using 600 MU/min. Image acquisition is controlled by the IAS3 software, Trigger delay was 6 ms, BeamOnDelay and FrameStartDelay were zero. Different frame rates were utilized. Cine mode response was calculated using MATLAB as summation of mean pixel values in a region of interest of the acquired images. The performance of cine mode was compared to integrated mode and dose measurements in water using CC13 ionization chamber. Results: Figure1 illustrates that cine mode has nonlinear response for small MU, when delivering 10 MU was about 0.5 and 0.64 for 6 and 18 MV respectively. This is because the missing acquired images that were calculated around four images missing in each delivery. With the increase MU the response became linear and comparable with integrated mode and ionization chamber within 2%. Figure 2 shows that cine mode has comparable response with integrated mode and ionization chamber within 2% with changing dose rate for 10 MU delivered. This indicates that the dose rate change has no effect on nonlinearity of cine mode response. Except nonlinearity, cine mode is well matched to integrated mode response within 2% for field size, phantom thickness, MLC speed dependences. Conclusion: Cine mode has similar dosimetric characteristics to integrated mode with open and IMRT fields, and the main limitation with cine mode is missing images. Therefore, the calibration of EPID images with this mode should be run with large MU, and when IMRT verification field has low MU, the correction for missing images are required.

  19. Cine-Club

    CERN Multimedia

    Cine-Club

    2011-01-01

    Lundi 12 décembre 2011 à 18:30 Salle du Conseil Comme chaque année avant Noël, le CINE-CLUB du CERN est heureux d’inviter petits et grands à une projection gratuite du film : Ponyo sur la falaise (Japon, 2008, Hayao Miyazaki) Le petit Sosuke vit avec sa mère sur une haute falaise surplombant la mer. Un beau jour, il découvre sur la plage caillouteuse Ponyo, une petite fille poisson. Ponyo est si fascinée par Sosuke et le monde terrestre que son désir le plus cher est de devenir un être humain. Mais Fujimoto, son magicien de père, n’est pas du tout d’accord avec cette idée et il la force à regagner les profondeurs de l’océan. Bien décidée à revoir Sosuke, Ponyo s’échappe de sa prison sous-marine, mais ce faisant elle déclenche une immense catastroph...

  20. Cine-Club

    CERN Multimedia

    CineClub

    2014-01-01

      On the occasion of CERN’s 60th anniversary the CERN CineClub will be showing films from all CERN member states Thursday 10 April 2014 at 20:00 CERN Council Chamber   The Bothersome Man     Directed by Jens Lien (Norway, 2006) 95 minutes   Forty-year-old Andreas arrives in a strange city with no memory of how he got there. He is presented with a job, an apartment-even a beautiful girlfriend. But before long, Andreas notices that something is wrong. The people around him seem cut off from any real emotion, and communicate only in superficialities. All this seems to be governed by a shadowy group of technicians, the ominous Caretakers’, who make sure the city runs smoothly. When they find Andreas is not adjusting to his new life, they keep an increasing watch over his activities...”The Bothersome Man” is a fantastic fable, a parable for modern society’s consumerism and obsession with ap...

  1. Movimientos migratorios y cine

    Directory of Open Access Journals (Sweden)

    Manuel Galiano León

    2009-12-01

    Full Text Available Nuestro artículo se ha centrado en el estudio de las películas de mayor distribución comercial para ver cómo éstas han representado el tema de la migración y qué reflexiones sugieren. En general, creemos que el reconocimiento por parte del cine de este fenómeno es positivo y que indudablemente constituye una fuente esencial para comprender las realidades migratorias distinguiendo discursos diversos y explicitando intenciones y hechos que intentan ocultarse u olvidarse.__________________ABSTRACT:Our article focuses on the study of the most commercial movies to check the way they present the subject of immigration and which kind of reflections they suggest. In general, we believe that the recognition of the migration phenomena in the cinema world is positive and it is actually an esential source to understand the reality of migration, being able to recognize different discourses and showing intentions and facts which are hidden or forgotten.  

  2. CERN CINE CLUB

    CERN Multimedia

    CERN CINE CLUB

    2010-01-01

    CERN CINE CLUB Thursday 24 June 2010 at 20:30 / Jeudi 24 Juin 2010 à 20:30 CERN Main Auditorium / Amphithéâtre Principal   The Raggedy Rawney By/de : Bob Hoskins (UK, 1988) - 104 min With/avec: Dexter Fletcher, Bob Hoskins, David Hill, Zoe Nathanson, Zoe Wanamaker Bob Hoskins makes his directorial debut with this lyrical, mystical fable about the strength of family and the transcendence of love. When a young military recruit named Tom goes AWOL after his first taste of battle, he must disguise himself with face paint and women’s clothing to avoid being captured by his vengeful commanding officer. He is instead discovered and taken in by Darky, the leader of an eccentric group of traveling gypsies, who thinks he is a «rawney», a half-mad, half-magical woman who brings good fortune. But when Tom begins a love affair with Darky’s daughter, he sets off a chain reaction of events that will soon put all of their lives in grave ...

  3. Cine Club - Special Event

    CERN Document Server

    Cine Club

    2017-01-01

    Special event on Thursday 4 May 2017 at 18:30 CERN Council Chamber In collaboration with the CERN Running Club and the Women In Technology initiative, the CERN CineClub is happy to announce the screening of the film Free to Run Directed by Pierre Morath Switzerland, 2016, 99 minutes Today, all anybody needs to run is the determination and a pair of the right shoes. But just fifty years ago, running was viewed almost exclusively as the domain of elite male athletes who competed on tracks. With insight and propulsive energy, director Pierre Morath traces running's rise to the 1960s, examining how the liberation movements and newfound sense of personal freedom that defined the era took the sport out of the stadiums and onto the streets, and how legends like Steve Prefontaine, Fred Lebow, and Kathrine Switzer redefined running as a populist phenomenon. Original version French; English subtitles. http://freetorun.ch/ Come along to watch the film and learn more about the history of popular races and amat...

  4. Feasibility of vocal fold abduction and adduction assessment using cine-MRI.

    Science.gov (United States)

    Baki, Marina Mat; Menys, Alex; Atkinson, David; Bassett, Paul; Morley, Simon; Beale, Timothy; Sandhu, Guri; Naduvilethil, Georgekutty; Stevenson, Nicola; Birchall, Martin A; Punwani, Shonit

    2017-02-01

    Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) METHODS: Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. • Cine-MRI is used to assess vocal folds (VFs) mobility: abduction and adduction. • New quantitative metrics are derived from VF position and abduction potential. • Cine-MRI able to depict the difference between normal and abnormal VF mobility. • Cine-MRI derived quantitative metrics have good repeatability.

  5. Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin's lymphoma. Comparison of ILROG IS-RT and the GHSG IF-RT

    Energy Technology Data Exchange (ETDEWEB)

    Kriz, Jan; Spickermann, Max; Lehrich, Philipp; Reinartz, Gabriele; Eich, Hans; Haverkamp, Uwe [University of Muenster, Department of Radiation Oncology, Muenster (Germany); Schmidberger, Heinz [University Mainz, Department of Radiation Oncology, Mainz (Germany)

    2015-09-15

    The present study addresses the role of intensity-modulated radiotherapy (IMRT) in contrast to standard RT (APPA) for patients with Hodgkin's lymphoma (HL) with a focus on deep inspiration breath-hold (DIBH) technique and a comparison between the International Lymphoma Radiation Oncology Group (ILROG) Involved Site Radiotherapy (IS-RT) versus the German Hodgkin Study Group (GHSG) Involved Field Radiotherapy (IF-RT). APPA treatment and 2 IMRT plans were compared for 11 patients with HL. Furthermore, treatment with DIBH versus free breathing (FB) and two different treatment volumes, i.e. IF-RT versus IS-RT, were compared. IMRT was planned as a sliding-window technique with 5 and 7 beam angles. For each patient 12 different treatment plans were calculated (132 plans). Following organs at risk (OAR) were analysed: lung, heart, spinal cord, oesophagus, female breast and skin. Comparisons of the different values with regard to dose-volume histograms (DVH), conformity and homogeneity indices were made. IS-RT reduces treatment volumes. With respect to the planning target volume (PTV), IMRT achieves better conformity but the same homogeneity. Regarding the D{sub mean} for the lung, IMRT shows increased doses, while RT in DIBH reduces doses. The IMRT shows improved values for D{sub max} concerning the spinal cord, whereas the APPA shows an improved D{sub mean} of the lung and the female breast. IS-RT reduces treatment volumes. Intensity-modulated radiotherapy shows advantages in the conformity. Treatment in DIBH also reduces the dose applied to the lungs and the heart. (orig.) [German] Ziel dieser Auswertung ist es, die konventionelle APPA-Feldanordnung mit der Intensitaetsmodulierten Radiotherapie (IMRT) bei Patienten mit Hodgkin-Lymphom (HL) zu vergleichen. Ein besonderer Fokus liegt hierbei auf der Bestrahlung in tiefer Inspiration und Atemanhaltetechnik (DIBH). Des Weiteren wurde die ''Involved-site''-Radiotherapie (IS-RT) der International

  6. Imaging of lung ventilation and respiratory dynamics in a single ventilation cycle using hyperpolarized He-3 MRI.

    Science.gov (United States)

    Holmes, James H; Korosec, Frank R; Du, Jiang; O'Halloran, Rafael L; Sorkness, Ronald L; Grist, Thomas M; Kuhlman, Janet E; Fain, Sean B

    2007-09-01

    To image respiratory dynamics and three-dimensional (3D) ventilation during inhalation, breath-hold, and exhalation for evaluation of obstructive lung disease using a single dose of hyperpolarized (HP) He-3 during MRI. A single 2D-3D projections inside Z encoding (PRIZE)-2D acquisition was pe