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Sample records for breath-hold cine imaging

  1. Usefulness of breath-hold cardiac cine MR imaging with a middle field MRI system

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    Matsumura, Kentaro; Sato, Kiyoto; Aono, Masaki; Inoshita, Kenji; Utsumi, Naoko [Kagawa Inoshita Hospital, Ohnohara (Japan)

    1999-07-01

    To assess the accuracy of contrast-enhanced, single breath-hold cine MR imaging in calculating left ventricular volume and ejection fraction, we compared MR measurements with those obtained by using cine ventriculography in 60 patients. Fast cine MR images were acquired with a middle field MR system (0.5 T). A breath-hold single slice multi-phase fast gradient-echo (Fast Card) sequence was used to obtain fast cine MR images with the following parameters; TR of 16 ms, TE of 3 ms, flip angle of 30 degree, matrix elements of 256 x 128, view per segment of 6, field of view of 350 x 260 mm and one excitation. Left ventricular end-diastolic volume and ejection fraction obtained with contrast-enhanced Fast Card correlated well with those obtained with cine ventriculography (end-diastolic volume, y=1.00x+14.0, r=0.904, p<0.001; ejection fraction, y=0.961x+2.8, r=0.936, p<0.001). Our results show that contrast enhanced breath-hold cardiac cine MR imaging on horizontal long-axis view using a middle field MR system is an accurate method for evaluating left ventricular volume and ejection fraction. (author)

  2. Single breath-hold magnetic resonance cine imaging for fast assessment of global and regional left ventricular function in clinical routine

    International Nuclear Information System (INIS)

    To evaluate a TGRAPPA (temporal parallel acquisition technique)-accelerated, single breath-hold multi-slice cine imaging approach for the assessment of left ventricular (LV) function. One hundred eleven patients were examined at 1.5 T. Cine imaging was performed with single-slice breath-hold acquisitions in short-axis orientation using a SSFP (TR 2.63 ms, TE 1.12 ms, FA 72 ) sequence and a TGRAPPA SSFP (TR 2.66 ms, TE 1.11 ms, FA 72 , AF 3) sequence, which covered the entire LV in multiple short-axis slices during a single breath-hold. End-diastolic (EDV), end-systolic (ESV), stroke volumes (SV), ejection fraction (EF), muscle mass (MM) and regional wall motion were assessed for both data sets. Single breath-hold imaging was feasible in 108 patients. Excellent correlations were observed for all volumetric parameters derived from both data sets (all r > 0.97). While EDV and ESV showed marginally lower values for single breath-hold imaging (EDV: -1.6 ± 7.9 ml; ESV: -1.8 ± 6.0 ml, p < 0.05), no differences were observed for SV, EF, MM and regional wall motion assessment. Single breath-hold imaging required significant shorter acquisition times (28 ± 6 s vs. 335 ± 87 s). TGRAPPA-accelerated multi-slice SSPF imaging allows for fast and accurate assessment of regional and global LV function within a single breath-hold. (orig.)

  3. Single breath-hold real-time cine MR imaging: improved temporal resolution using generalized autocalibrating partially parallel acquisition (GRAPPA) algorithm

    International Nuclear Information System (INIS)

    The purpose of this study was to test parallel imaging techniques for improvement of temporal resolution in multislice single breath-hold real-time cine steady-state free precession (SSFP) in comparison with standard segmented single-slice SSFP techniques. Eighteen subjects were examined on a 1.5-T scanner using a multislice real-time cine SSFP technique using the GRAPPA algorithm. Global left ventricular parameters (EDV, ESV, SV, EF) were evaluated and results compared with a standard segmented single-slice SSFP technique. Results for EDV (r=0.93), ESV (r=0.99), SV (r=0.83), and EF (r=0.99) of real-time multislice SSFP imaging showed a high correlation with results of segmented SSFP acquisitions. Systematic differences between both techniques were statistically non-significant. Single breath-hold multislice techniques using GRAPPA allow for improvement of temporal resolution and for accurate assessment of global left ventricular functional parameters. (orig.)

  4. Clinical application of automatic extraction of left ventricular contours. Evaluation of left ventricular volumes by contrast-enhanced breath-hold ultrafast cine MR imaging

    International Nuclear Information System (INIS)

    To assess the validity of automatic extraction of left ventricular inner contours based on contrast-enhanced ultrafast cine-MR images, phantom (n=15) and clinical (n=60) studies were performed. In phantom study, left ventricular volumes obtained by biplane modified Simpson's method based on automatic extraction of left ventricular inner contour was significantly correlated to phantom's volumes(r=0.991). Contrast-enhanced breath-hold ultrafast cine MR imaging was shown to provide accurate cardiac images with high success rate (89% in horizontal long axis section and 88% in vertical long axis section) in clinical study. However, the extraction of left ventricular inner contour depends on operator's manual tracing and the time required for data analysis is longer. The automatic extraction time of left ventricular inner contour was 4 second/frame, on the other hand conventional manual tracing time was 60-90 second/frame. Comparison with left ventricular volumes showed a high correlation between contrast-enhanced ultrafast cine MR imaging (monoplane area-length's and biplane modified Simpson's methods based on automatic extraction of left ventricle) and digital subtraction left ventriculography (biplane area-length's method). (author)

  5. Blood flow measurement of portal vein with fast cine phase contrast MR imaging under breath-holding

    International Nuclear Information System (INIS)

    Flow measurements of the right portal vein were performed in seven healthy volunteers with the segmented k-space fast gradient-echo phase-contrast (fcard-PC) sequence under breath-holding. The mean velocity and the flow rate of the right portal vein at maximal expiration, 14.3±4.4 cm/sec and 457±218 ml/min, were significantly greater (p<0.01) than those at maximal inspiration: 11.8±3.8 cm/sec (mean±SD) and 364±191 ml/min, respectively. Fcard-PC enabled flow measurements to be obtained under breath-holding. Using this technique, we demonstrated portal venous flow changes according to respiratory phase. (author)

  6. Blood flow measurement of portal vein with fast cine phase contrast MR imaging under breath-holding

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    Inaba, Fumitaka; Murakami, Takamichi; Sakurai, Kosuke; Tsuda, Kyo; Kim, Tonsoku; Tanaka, Hisashi; Kashiwagi, Nobuo; Nakamura, Hironobu [Osaka Univ. (Japan). Faculty of Medicine; Harada, Koshi

    1996-03-01

    Flow measurements of the right portal vein were performed in seven healthy volunteers with the segmented k-space fast gradient-echo phase-contrast (fcard-PC) sequence under breath-holding. The mean velocity and the flow rate of the right portal vein at maximal expiration, 14.3{+-}4.4 cm/sec and 457{+-}218 ml/min, were significantly greater (p<0.01) than those at maximal inspiration: 11.8{+-}3.8 cm/sec (mean{+-}SD) and 364{+-}191 ml/min, respectively. Fcard-PC enabled flow measurements to be obtained under breath-holding. Using this technique, we demonstrated portal venous flow changes according to respiratory phase. (author).

  7. Evaluation of left ventricular function with breath-hold MR imaging

    International Nuclear Information System (INIS)

    Objective: To investigate the value of breath-hold cine MR imaging in the evaluation of left ventricular function. Methods: Eighteen healthy volunteers and 36 patients with cardiac diseases were studied with breath-hold cine MR imaging, then left ventricular volumes and masses were measured, and the measurements were compared with those of conventional cine MR imaging and echocardiography. Results: (1) The measurements of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) with breath-hold cine MR imaging technique were closely correlated with those obtained by conventional cine MR imaging and echocardiography. There was no statistically significant difference among the measurements of the three methods (P > 0.05). The correlation coefficients were 0.52-0.96. (2) The correlation coefficient of left ventricular mass (EDM and ESM) among three methods were lower than those of left ventricular volume, and there was statistically significant difference in ESM between MRI and echocardiography (P < 0.05). Conclusion: Breath-hold cine MR imaging is an useful method for evaluating the left ventricular function because of non-ghosting artifacts and short imaging time

  8. 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

    International Nuclear Information System (INIS)

    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.)

  9. Attenuation correction of emission PET images with average CT: Interpolation from breath-hold CT

    International Nuclear Information System (INIS)

    Misregistration resulting from the difference of temporal resolution in PET and CT scans occur frequently in PET/CT imaging, which causes distortion in tumor quantification in PET. Respiration cine average CT (CACT) for PET attenuation correction has been reported to improve the misalignment effectively by several papers. However, the radiation dose to the patient from a four-dimensional CT scan is relatively high. In this study, we propose a method to interpolate respiratory CT images over a respiratory cycle from inhalation and exhalation breath-hold CT images, and use the average CT from the generated CT set for PET attenuation correction. The radiation dose to the patient is reduced using this method. Six cancer patients of various lesion sites underwent routine free-breath helical CT (HCT), respiration CACT, interpolated average CT (IACT), and 18F-FDG PET. Deformable image registration was used to interpolate the middle phases of a respiratory cycle based on the end-inspiration and end-expiration breath-hold CT scans. The average CT image was calculated from the eight interpolated CT image sets of middle respiratory phases and the two original inspiration and expiration CT images. Then the PET images were reconstructed by these three methods for attenuation correction using HCT, CACT, and IACT. Misalignment of PET image using either CACT or IACT for attenuation correction in PET/CT was improved. The difference in standard uptake value (SUV) from tumor in PET images was most significant between the use of HCT and CACT, while the least significant between the use of CACT and IACT. Besides the similar improvement in tumor quantification compared to the use of CACT, using IACT for PET attenuation correction reduces the radiation dose to the patient.

  10. Attenuation correction of emission PET images with average CT: Interpolation from breath-hold CT

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    Huang, Tzung-Chi [Department of Biomedical Imaging and Radiological Science, China Medical University, Taiwan (China); Zhang, Geoffrey [Department of Radiation Oncology, Moffitt Cancer Center, FL (United States); Chen, Chih-Hao [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Yang, Bang-Hung [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Wu, Nien-Yun [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Wang, Shyh-Jen, E-mail: jwshyh@vghtpe.gov.tw [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Wu, Tung-Hsin, E-mail: tung@ym.edu.tw [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China)

    2011-05-15

    Misregistration resulting from the difference of temporal resolution in PET and CT scans occur frequently in PET/CT imaging, which causes distortion in tumor quantification in PET. Respiration cine average CT (CACT) for PET attenuation correction has been reported to improve the misalignment effectively by several papers. However, the radiation dose to the patient from a four-dimensional CT scan is relatively high. In this study, we propose a method to interpolate respiratory CT images over a respiratory cycle from inhalation and exhalation breath-hold CT images, and use the average CT from the generated CT set for PET attenuation correction. The radiation dose to the patient is reduced using this method. Six cancer patients of various lesion sites underwent routine free-breath helical CT (HCT), respiration CACT, interpolated average CT (IACT), and 18F-FDG PET. Deformable image registration was used to interpolate the middle phases of a respiratory cycle based on the end-inspiration and end-expiration breath-hold CT scans. The average CT image was calculated from the eight interpolated CT image sets of middle respiratory phases and the two original inspiration and expiration CT images. Then the PET images were reconstructed by these three methods for attenuation correction using HCT, CACT, and IACT. Misalignment of PET image using either CACT or IACT for attenuation correction in PET/CT was improved. The difference in standard uptake value (SUV) from tumor in PET images was most significant between the use of HCT and CACT, while the least significant between the use of CACT and IACT. Besides the similar improvement in tumor quantification compared to the use of CACT, using IACT for PET attenuation correction reduces the radiation dose to the patient.

  11. Attenuation correction of emission PET images with average CT: Interpolation from breath-hold CT

    Science.gov (United States)

    Huang, Tzung-Chi; Zhang, Geoffrey; Chen, Chih-Hao; Yang, Bang-Hung; Wu, Nien-Yun; Wang, Shyh-Jen; Wu, Tung-Hsin

    2011-05-01

    Misregistration resulting from the difference of temporal resolution in PET and CT scans occur frequently in PET/CT imaging, which causes distortion in tumor quantification in PET. Respiration cine average CT (CACT) for PET attenuation correction has been reported to improve the misalignment effectively by several papers. However, the radiation dose to the patient from a four-dimensional CT scan is relatively high. In this study, we propose a method to interpolate respiratory CT images over a respiratory cycle from inhalation and exhalation breath-hold CT images, and use the average CT from the generated CT set for PET attenuation correction. The radiation dose to the patient is reduced using this method. Six cancer patients of various lesion sites underwent routine free-breath helical CT (HCT), respiration CACT, interpolated average CT (IACT), and 18F-FDG PET. Deformable image registration was used to interpolate the middle phases of a respiratory cycle based on the end-inspiration and end-expiration breath-hold CT scans. The average CT image was calculated from the eight interpolated CT image sets of middle respiratory phases and the two original inspiration and expiration CT images. Then the PET images were reconstructed by these three methods for attenuation correction using HCT, CACT, and IACT. Misalignment of PET image using either CACT or IACT for attenuation correction in PET/CT was improved. The difference in standard uptake value (SUV) from tumor in PET images was most significant between the use of HCT and CACT, while the least significant between the use of CACT and IACT. Besides the similar improvement in tumor quantification compared to the use of CACT, using IACT for PET attenuation correction reduces the radiation dose to the patient.

  12. Effect of Breath Holding on Spleen Volume Measured by Magnetic Resonance Imaging

    OpenAIRE

    Inoue, Yusuke; Nakajima, Ai; Mizukami, Shinya; Hata, Hirofumi

    2013-01-01

    Objective Ultrasonographic studies have demonstrated transient reduction in spleen volume in relation to apnea diving. We measured spleen volume under various respiratory conditions by MR imaging to accurately determine the influence of ordinary breath holding on spleen volumetry. Materials and Methods Twelve healthy adult volunteers were examined. Contiguous MR images of the spleen were acquired during free breathing and during respiratory manipulations, including breath holding at the end o...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Whole-heart cine MRI in a single breath-hold. A compressed sensing accelerated 3D acquisition technique for assessment of cardiac function

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to perform functional MR imaging of the whole heart in a single breath-hold using an undersampled 3 D trajectory for data acquisition in combination with compressed sensing for image reconstruction. Materials and Methods: Measurements were performed using an SSFP sequence on a 3 T whole-body system equipped with a 32-channel body array coil. A 3 D radial stack-of-stars sampling scheme was utilized enabling efficient undersampling of the k-space and thereby accelerating data acquisition. Compressed sensing was applied for the reconstruction of the missing data. A validation study was performed based on a fully sampled dataset acquired by standard Cartesian cine imaging of 2 D slices on a healthy volunteer. The results were investigated with regard to systematic errors and resolution losses possibly introduced by the developed reconstruction. Subsequently, the proposed technique was applied for in-vivo functional cardiac imaging of the whole heart in a single breath-hold of 27 s. The developed technique was tested on three healthy volunteers to examine its reproducibility. Results: By means of the results of the simulation (temporal resolution: 47 ms, spatial resolution: 1.4 x 1.4 x 8 mm, 3 D image matrix: 208 x 208 x 10), an overall acceleration factor of 10 has been found where the compressed sensing reconstructed image series shows only very low systematic errors and a slight in-plane resolution loss of 15 %. The results of the in-vivo study (temporal resolution: 40.5 ms, spatial resolution: 2.1 x 2.1 x 8 mm, 3 D image matrix: 224 x 224 x 12) performed with an acceleration factor of 10.7 confirm the overall good image quality of the presented technique for undersampled acquisitions. Conclusion: The combination of 3 D radial data acquisition and model-based compressed sensing reconstruction allows high acceleration factors enabling cardiac functional imaging of the whole heart within only one breath-hold. The image quality in the

  15. Whole-heart cine MRI in a single breath-hold. A compressed sensing accelerated 3D acquisition technique for assessment of cardiac function

    Energy Technology Data Exchange (ETDEWEB)

    Wech, T.; Koestler, H. [Wuerzburg Univ. (Germany). Inst. of Radiology; Wuerzburg Univ. (Germany). Comprehensive Heart Failure Center; Pickl, W.; Tran-Gia, J.; Ritter, C.; Hahn, D. [Wuerzburg Univ. (Germany). Inst. of Radiology; Beer, M. [Wuerzburg Univ. (Germany). Inst. of Radiology; Graz Univ. (Austria). University Hospital Radiology

    2014-01-15

    Purpose: The aim of this study was to perform functional MR imaging of the whole heart in a single breath-hold using an undersampled 3 D trajectory for data acquisition in combination with compressed sensing for image reconstruction. Materials and Methods: Measurements were performed using an SSFP sequence on a 3 T whole-body system equipped with a 32-channel body array coil. A 3 D radial stack-of-stars sampling scheme was utilized enabling efficient undersampling of the k-space and thereby accelerating data acquisition. Compressed sensing was applied for the reconstruction of the missing data. A validation study was performed based on a fully sampled dataset acquired by standard Cartesian cine imaging of 2 D slices on a healthy volunteer. The results were investigated with regard to systematic errors and resolution losses possibly introduced by the developed reconstruction. Subsequently, the proposed technique was applied for in-vivo functional cardiac imaging of the whole heart in a single breath-hold of 27 s. The developed technique was tested on three healthy volunteers to examine its reproducibility. Results: By means of the results of the simulation (temporal resolution: 47 ms, spatial resolution: 1.4 x 1.4 x 8 mm, 3 D image matrix: 208 x 208 x 10), an overall acceleration factor of 10 has been found where the compressed sensing reconstructed image series shows only very low systematic errors and a slight in-plane resolution loss of 15 %. The results of the in-vivo study (temporal resolution: 40.5 ms, spatial resolution: 2.1 x 2.1 x 8 mm, 3 D image matrix: 224 x 224 x 12) performed with an acceleration factor of 10.7 confirm the overall good image quality of the presented technique for undersampled acquisitions. Conclusion: The combination of 3 D radial data acquisition and model-based compressed sensing reconstruction allows high acceleration factors enabling cardiac functional imaging of the whole heart within only one breath-hold. The image quality in the

  16. Effect of Breath Holding on Spleen Volume Measured by Magnetic Resonance Imaging.

    Directory of Open Access Journals (Sweden)

    Yusuke Inoue

    Full Text Available Ultrasonographic studies have demonstrated transient reduction in spleen volume in relation to apnea diving. We measured spleen volume under various respiratory conditions by MR imaging to accurately determine the influence of ordinary breath holding on spleen volumetry.Twelve healthy adult volunteers were examined. Contiguous MR images of the spleen were acquired during free breathing and during respiratory manipulations, including breath holding at the end of normal expiration, breath holding at deep inspiration, and the valsalva maneuver, and spleen volume was measured from each image set based on the sum-of-areas method. Acquisition during free breathing was performed with respiratory triggering. The duration of each respiratory manipulation was 30 s, and five sets of MR images were acquired serially during each manipulation.Baseline spleen volume before respiratory manipulation was 173.0 ± 79.7 mL, and the coefficient of variance for two baseline measures was 1.4% ± 1.6%, suggesting excellent repeatability. Spleen volume decreased significantly just after the commencement of respiratory manipulation, remained constant during the manipulation, and returned to the control value 2 min after the cessation of the manipulation, irrespective of manipulation type. The percentages of volume reduction were 10.2% ± 2.9%, 10.2% ± 3.5%, and 13.3% ± 5.7% during expiration breath holding, deep-inspiration breath holding, and the valsalva maneuver, respectively, and these values did not differ significantly.Spleen volume is reduced during short breath-hold apnea in healthy adults. Physiological responses of the spleen to respiratory manipulations should be considered in the measurement and interpretation of spleen volume.

  17. Breath-hold T2-weighted MR imaging of the liver

    International Nuclear Information System (INIS)

    T2-weighted sequences are important for liver studies at high field strength; however, long imaging times prolong total study time and often cause image degradation from breathing artifacts and patients motion. This paper compares four techniques that create images with T2/T2* information with a breath hold. The following breath-hold sequences were compared: FLASH, PSIF, turbo-FLASH, and spin-echo (T2-weighted RASE with variable flip angle), with reference to the regular T2-weighted SE sequence in 10 healthy volunteers. Imaging was conducted at 1.0 and 1.5-T. Images were evaluated quantitatively for liver signal-to-noise ratios (S/Ns) and spleen-liver signal difference-to-noise ratios (SD/N) and qualitatively for the presence of artifacts and image quality

  18. Diagnosis of small hepatic nodular lesion determined by magnetic resonance imaging (MRI) under breath holding

    International Nuclear Information System (INIS)

    We examined fast MRI under breath holding in patients with small hepatic nodular lesion. MR imagings were obtained with Fast Spin Echo (FSE) which was T1-weighted image and T2-weighted image and Fast Multiplanar Spoiled GRASS (FMPSPGR) which was dynamic study. Sixty-four of 78 (74%) patients with small hepatocellular carcinoma (HCC) were detected by FSE sequence. Nine of 16 (56%), nine of 26 (37%) and 29 of 29 (100%) patients with adenomatous hyperplasia, large regenerative nodule and cavernous hemangioma were detected by FSE sequence, respectively. Fifty-seven (74%) HCC lesions and 28 (97%) adenomatous hypoplasia lesions were diagnosed by FMPSPGR sequence, respectively. Fast MRI (FSE and FMPSPGR) with breath holding provides diagnostically useful small nodular lesion of the liver. (author)

  19. Quantification of missing and overlapping data in multiple breath hold abdominal imaging

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) of the abdomen is often performed in multiple breath holds which are designed to contiguously cover the region of interest. This technique may result in a failure to image all the appropriate area, and the extent of this failure is difficult to appreciate on a set of 2D slices. With reference to three patient cases, we present a method to quantify the extent of this problem and suggest a solution. First, we manually delineate the region of interest on a single breath hold fast spoiled gradient echo (FSPGR) sequence. Subsequently, we align images acquired in separate breath holds to this reference volume. A coloured 3D presentation makes the extent of unimaged and repeatedly imaged areas clearly visible to the clinician. The alignment also helps radiologists to accurately determine the location of individual slices. The described method can easily be automated and is ideally implemented at the scanner console, ensuring the availability of contiguously sampled datasets to radiologists with minimum user interaction from the radiographer. Such datasets enable the deployment of robust 3D analysis algorithms

  20. Evaluation of left ventricular function in healthy volunteers with non breath-hold cine MRI%非屏气法电影MRI测量健康志愿者左心室功能

    Institute of Scientific and Technical Information of China (English)

    王荣品; 梁长虹; 黄美萍; 邓奇平; 刘辉; 徐莉

    2011-01-01

    Objectives:To study the values of non breath-hold multiphase acquisition cine MRI sequence during cardiac cycle in the evaluation of the left ventricular function.and to investigate the feasibility of this method in evaluating the cardiac function for patients with incompatible breath-hold. Methods:Fast imaging employing steady state acquisition (FIESTA) sequence of cine MRI with and without breath-hold were performed in 15 healthy volunteers. The results of the function parameters of left ventricle,including end-diastolic volume (EDV),end-systolic volume (ESV), ejection fraction (EF),mean myocardial mass (MM),cardiac output (CO) and the corresponding parameters standardized by body surface area with non breath-hold sequence were collected and calculated. Paired samples t test were performed to assess the significant differences of the two methods. Results:No statistical differences were found between the results of the function parameters of left ventricle measured with non breath-hold multiphase acquisition sequence and with breath-hold multiphase acquisition sequence (all P>0. 05). Conclusion:The function parameters of left ventricle were proved to be reliable with multi-phase acquisition cine MRI sequence without breath-hold. Therefore,it is feasible to evaluate the cardiac function by using this method for patients with incompatible breath-hold.%目的:评估非屏气多时相采集电影MRl测量左心室功能的价值,探讨非屏气法电影MRI用于不能配合屏气患者心功能检查的可行性。方法:采用非屏气法和多次屏气法快速稳态平衡进动(FIESTA)序列电影MRI对15例健康志愿者左心室功能进行测量分析,采用配对样本t检验分析两种方法测量的心功能指标的差异,包括舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、平均心肌质量(MM)、心输出量(CO)及相应的体表面积标准化指标。结果:非屏气法和多次屏气法电影MRI测量左心室各项

  1. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, L; Quirk, S; Smith, WL [The University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Yeung, R; Phan, T [The University of Calgary, Calgary, AB (Canada); Hudson, A [Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients.

  2. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    International Nuclear Information System (INIS)

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

    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

  5. Influences of prolonged apnea and oxygen inhalation on pulmonary hemodynamics during breath holding: Quantitative assessment by velocity-encoded MR imaging with SENSE technique

    Energy Technology Data Exchange (ETDEWEB)

    Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan)], E-mail: aznogami@med.kobe-u.ac.jp; Ohno, Yoshiharu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Higashino, Takanori [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Department of Radiology, Tenri Hospital, Tenri, Nara (Japan); Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Yoshikawa, Takeshi [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Department of Radiology, Konan Hospital, Kobe, Hyogo (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Kawamitsu, Hideaki [Division of Radiology, Kobe University Hospital, Kobe, Hyogo (Japan); Fujii, Masahiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Radiology, Kobe University Hospital, Kobe, Hyogo (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan)

    2007-12-15

    Purpose: The purpose of our study was to assess the influence of prolonged apnea and administration of oxygen on pulmonary hemodynamics during breath holding (BH) by using velocity-encoded MR imaging combined with the SENSE technique (velocity MRI). Materials and methods: Ten healthy male volunteers underwent velocity MRI during BH with and without O{sub 2} inhalation. All velocity MRI data sets were obtained continuously with the 2D cine phase-contrast method during a single BH period. The data were then divided into three BH time phases as follows: first, second and third. To evaluate the influence of prolonged apnea on hemodynamics, stroke volume (SV) and maximal change in flow rate during ejection (MCFR) of second and third phases were statistically compared with those of first phase by using the ANOVA followed by Turkey's HSD multiple comparison test. To assess the influence of O{sub 2} on hemodynamics, SV and MCFR with or without O{sub 2} were compared by the paired t-test. To assess the measuring agreement of hemodynamic indices during prolonged breath holding, Bland-Altman's analysis was performed. Results: Prolonged apnea had no significant influence on SV and MCFR regardless of administration of O{sub 2} (p > 0.05). Mean MCFR for all phases was significantly lower with administration of O{sub 2} than without (p < 0.05). The limits of agreement for MCFR with O{sub 2} were smaller than without. Conclusion: O{sub 2} inhalation modulated maximal change in flow rate during ejection, and did not influence stroke volume during breath holding. Influence of O{sub 2} inhalation should be considered for MR measurements of pulmonary hemodynamics during breath holding.

  6. Newly found pulmonary pathophysiology from automated breath-hold perfusion-SPECT-CT fusion image

    International Nuclear Information System (INIS)

    Pulmonary perfusion single photon emission computed tomography (SPECT)-CT fusion image largely contributes to objective and detailed correlation between lung morphologic and perfusion impairment in various lung diseases. However, traditional perfusion SPECT obtained during rest breathing usually shows a significant mis-registration on fusion image with conventional CT obtained during deep-inspiratory phase. There are also other adverse effects caused by respiratory lung motion such as blurring or smearing of small perfusion defects. To resolve these disadvantages of traditional perfusion SPECT, an innovative method of deep-inspiratory breath-hold (DIBrH) SPECT scan is developed in the Nuclear Medicine Institute of Yamaguchi University Hospital. This review article briefly describes the new findings of pulmonary pathophysiology which has been reveled by detailed lung morphologic-perfusion correlation on automated reliable DIBrH perfusion SPECT-CT fusion image. (author)

  7. MR evaluation of coronary stents with navigator echo and breath-hold cine gradient-echo techniques

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate coronary artery stents with MR. Thirty-eight patients underwent MR imaging 48.1±6.6 days (range 38-60 days) after placement of 47 coronary stents of 11 different types, using navigator echo (NE) and cine gradient-echo (GE) techniques. For both sequences the low signal artifact was used to localize the stent, whereas the flow-related high signal before and distal to the stent was considered as a patency sign. Exercise electrocardiographic test (EET) had been performed 1-7 days before MR. No adverse event with possible relation to the MR examination was observed. All the stents were recognized as signal void with GE, and all but one with NE. Of the 2 patients with positive EET, the first one, with a stent on the left anterior descending coronary artery, presented low signal distal to the stent at both MR sequences, suggesting dysfunction [60% stenosis at conventional coronary angiography (CCA)]; the second one, with two sequential stents on the right coronary artery, presented lack of signal distal to the stents at both MR sequences, suggesting occlusion (97% stenosis at CCA). For the 44 remaining stents in 36 patients with negative EET, MR high signal before and distal to the stent suggested patency at both sequences. MR seems to be a safe and promising technique for non-invasive evaluation of coronary stents. (orig.)

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

    OpenAIRE

    Wielopolski, Piotr; Gaa, J; Wielopolski, D.R.; 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, three-dimensional MRCP images were obtained and volume rendered. In 15 (100%) healthy subjects and 13 (93%) patients, clear depiction of biliary, hepatic, and pancreatic ducts (with lumen diameter of at least 2 mm) was possible with good s...

  9. Incorporating breath holding and image guidance in the adjuvant gastric cancer radiotherapy: a dosimetric study

    International Nuclear Information System (INIS)

    The respiratory related target motion and setup error will lead to a large margin in the gastric radiotherapy. The purpose of this study is to investigate the dosimetric benefit and the possibility of incorporating the breath-hold (BH) technique with online image-guided radiotherapy in the adjuvant gastric cancer radiotherapy. Setup errors and target motions of 22 post-operative gastric cancer patients with surgical clips were analyzed. Clips movement was recorded using the digital fluoroscopics and the probability distribution functions (pdf) of the target motions were created for both the free breathing (FB) and BH treatment. For dosimetric comparisons, two intensity-modulated radiotherapy (IMRT) treatment plans, i.e. the free breathing treatment plan (IMRTFB) and the image-guided BH treatment plan (IMRTIGBH) using the same beam parameters were performed among 6 randomly selected patients. Different margins for FB and BH plans were derived. The plan dose map was convoluted with various pdfs of the setup errors and the target motions. Target coverage and dose to organs at risk were compared and the dose-escalation probability was assessed. The mean setup errors were 1.2 mm in the superior-inferior (SI), 0.0 mm in the left-right (LR), and 1.4 mm in the anterior-posterior (AP) directions. The mean target motion for the free breathing (vs. BH) was 11.1 mm (vs. 2.2 mm), 1.9 mm (vs. 1.1 mm), and 5.5 mm (vs. 1.7 mm) in the SI, LR, and AP direction, respectively. The target coverage was comparable for all the original plans. IMRTIGBH showed lower dose to the liver compared with IMRTFB (p = 0.01) but no significant difference in the kidneys. Convolved IMRTIGBH showed better sparing in kidneys (p < 0.01) and similar in liver (p = 0.08). Combining BH technique with online image guided IMRT can minimize the organ motion and improve the setup accuracy. The dosimetric comparison showed the dose could be escalated to 54 Gy without increasing the critical organs toxicities

  10. Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

    International Nuclear Information System (INIS)

    The aim of this study was to assess the ability of real-time breath-hold-triggered myocardial perfusion imaging (MPI) using a novel cadmium-zinc-telluride (CZT) gamma camera to discriminate artefacts from true perfusion defects. A group of 40 patients underwent a 1-day 99mTc-tetrofosmin pharmacological stress/rest imaging protocol on a conventional dual detector SPECT gamma camera with and without attenuation correction (AC), immediately followed by scanning on an ultrafast CZT camera with and without real-time breath-hold triggering (instead of AC) by intermittent scanning confined to breath-hold at deep inspiration (using list mode acquisition). We studied the use of breath-hold triggering on the CZT camera and its ability to discriminate artefacts from true perfusion defects using AC SPECT MPI as the reference standard. Myocardial tracer uptake (percent of maximum) from CZT was compared to AC SPECT MPI by intraclass correlation and by calculating Bland-Altman limits of agreement. AC of SPECT MPI identified 19 apparent perfusion defects as artefacts. Of these, 13 were correctly identified and 4 were partially unmasked (decrease in extent and/or severity) by breath-hold triggering of the CZT scan. All perfusion defects verified by SPECT MPI with AC were appropriately documented by CZT with and without breath-hold triggering. This was supported by the quantitative analysis, as the correlation (r) of myocardial tracer uptake between CZT and AC SPECT improved significantly from 0.81 to 0.90 (p<0.001) when applying breath-hold triggering. Similarly, Bland-Altman limits of agreement were narrower for CZT scans with breath-hold triggering. This novel CZT camera allows real-time breath-hold triggering as a potential alternative to AC to assist in the discrimination of artefacts from true perfusion defects. (orig.)

  11. Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

    Energy Technology Data Exchange (ETDEWEB)

    Buechel, Ronny R.; Pazhenkottil, Aju P.; Herzog, Bernhard A.; Husmann, Lars; Nkoulou, Rene N.; Burger, Irene A.; Valenta, Ines; Wyss, Christophe A.; Ghadri, Jelena R. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University of Zurich, Zurich Center for Integrative Human Physiology (ZIHP), Zurich (Switzerland)

    2010-10-15

    The aim of this study was to assess the ability of real-time breath-hold-triggered myocardial perfusion imaging (MPI) using a novel cadmium-zinc-telluride (CZT) gamma camera to discriminate artefacts from true perfusion defects. A group of 40 patients underwent a 1-day {sup 99m}Tc-tetrofosmin pharmacological stress/rest imaging protocol on a conventional dual detector SPECT gamma camera with and without attenuation correction (AC), immediately followed by scanning on an ultrafast CZT camera with and without real-time breath-hold triggering (instead of AC) by intermittent scanning confined to breath-hold at deep inspiration (using list mode acquisition). We studied the use of breath-hold triggering on the CZT camera and its ability to discriminate artefacts from true perfusion defects using AC SPECT MPI as the reference standard. Myocardial tracer uptake (percent of maximum) from CZT was compared to AC SPECT MPI by intraclass correlation and by calculating Bland-Altman limits of agreement. AC of SPECT MPI identified 19 apparent perfusion defects as artefacts. Of these, 13 were correctly identified and 4 were partially unmasked (decrease in extent and/or severity) by breath-hold triggering of the CZT scan. All perfusion defects verified by SPECT MPI with AC were appropriately documented by CZT with and without breath-hold triggering. This was supported by the quantitative analysis, as the correlation (r) of myocardial tracer uptake between CZT and AC SPECT improved significantly from 0.81 to 0.90 (p<0.001) when applying breath-hold triggering. Similarly, Bland-Altman limits of agreement were narrower for CZT scans with breath-hold triggering. This novel CZT camera allows real-time breath-hold triggering as a potential alternative to AC to assist in the discrimination of artefacts from true perfusion defects. (orig.)

  12. Single Breath-Hold Physiotherapy Technique: Effective tool for T2* magnetic resonance imaging in young patients with thalassaemia major

    OpenAIRE

    Mevada, Surekha T.; Najma Al-Mahruqi; Ismail El-Beshlawi; Mohamed El-Shinawy; Mathew Zachariah; Al-Rawas, Abdul H.; Shahina Daar; Yasser Wali

    2016-01-01

    Magnetic resonance imaging using T2* (MRI T2*) is a highly sensitive and non-invasive technique for the detection of tissue iron load. Although the single breath-hold multi-echo T2* technique has been available at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, since 2006, it could not be performed on younger patients due to their inability to hold their breath after expiration. This study was carried out between May 2007 and May 2015 and assessed 50 SQUH thalassaemic patients age...

  13. Digital cine-imaging

    International Nuclear Information System (INIS)

    Digitization of fluoroscopic images has been developed for the digital cine imaging system as a result of the computer technology, television technology, and popularization of interventional radiology. Present digital cine imaging system is able to offer images similar to cine film because of the higher operatability and better image quality with the development of interventional radiology. As a result, its higher usefulness for catheter diagnosis examination except for interventional radiology was reported, and the possibility of having filmless cine is close to becoming a reality. However several problems have been pointed out, such as spatial resolution, time resolution, storage and exchangeability of data, disconsolidated viewing functions, etc. Anyhow, digital cine imaging system has some unresolved points and lots the needs to be discussed. The tendency of digitization is the passage of the time and we have to promote a study for more useful digital cine imaging system in team medical treatment which centers on the patients. (author)

  14. Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases

    International Nuclear Information System (INIS)

    Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of >80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control

  15. Single Breath-Hold Physiotherapy Technique: Effective tool for T2* magnetic resonance imaging in young patients with thalassaemia major.

    Science.gov (United States)

    Mevada, Surekha T; Al-Mahruqi, Najma; El-Beshlawi, Ismail; El-Shinawy, Mohamed; Zachariah, Mathew; Al-Rawas, Abdul H; Daar, Shahina; Wali, Yasser

    2016-02-01

    Magnetic resonance imaging using T2* (MRI T2*) is a highly sensitive and non-invasive technique for the detection of tissue iron load. Although the single breath-hold multi-echo T2* technique has been available at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, since 2006, it could not be performed on younger patients due to their inability to hold their breath after expiration. This study was carried out between May 2007 and May 2015 and assessed 50 SQUH thalassaemic patients aged 7-17 years old. Seven of these patients underwent baseline and one-year follow-up MRI T2* scans before receiving physiotherapy training. Subsequently, all patients were trained by a physiotherapist to hold their breath for approximately 15-20 seconds at the end of expiration before undergoing baseline and one-year follow-up MRI T2* scans. Failure rates for the pre- and post-training groups were 6.0% and 42.8%, respectively. These results indicate that the training of thalassaemic patients in breath-hold techniques is beneficial and increases rates of compliance for MRI T2* scans. PMID:26909218

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

    International Nuclear Information System (INIS)

    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: R2=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.

  17. 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; Kellman, Peter

    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...

  18. Optimising diffusion-weighted MR imaging for demonstrating pancreatic cancer: a comparison of respiratory-triggered, free-breathing and breath-hold techniques

    International Nuclear Information System (INIS)

    To compare respiratory-triggered, free-breathing, and breath-hold DWI techniques regarding (1) image quality, and (2) signal intensity (SI) and ADC measurements in pancreatic ductal adenocarcinoma (PDAC). Fifteen patients with histopathologically proven PDAC underwent DWI prospectively at 1.5 T (b = 0, 50, 300, 600 and 1,000 s/mm2) with the three techniques. Two radiologists, independently and blindly, assigned total image quality scores [sum of rating diffusion images (lesion detection, anatomy, presence of artefacts) and ADC maps (lesion characterisation, overall image quality)] per technique and ranked them. The lesion SI, signal-to-noise ratio, mean ADC and coefficient of variation (CV) were compared. Total image quality scores for respiratory-triggered, free-breathing and breath-hold techniques were 17.9, 16.5 and 17.1 respectively (respiratory-triggered was significantly higher than free-breathing but not breath-hold). The respiratory-triggered technique had a significantly higher ranking. Lesion SI on all b-values and signal-to-noise ratio on b300 and b600 were significantly higher for the respiratory-triggered technique. For respiratory-triggered, free-breathing and breath-hold techniques the mean ADCs were 1.201, 1.132 and 1.253 x 10-3 mm2/s, and mean CVs were 8.9, 10.8 and 14.1 % respectively (respiratory-triggered and free-breathing techniques had a significantly lower mean CV than the breath-hold technique). In both analyses, respiratory-triggered DWI showed superiority and seems the optimal DWI technique for demonstrating PDAC. (orig.)

  19. Optimising diffusion-weighted MR imaging for demonstrating pancreatic cancer: a comparison of respiratory-triggered, free-breathing and breath-hold techniques

    Energy Technology Data Exchange (ETDEWEB)

    Kartalis, Nikolaos; Loizou, Louiza; Edsborg, Nick; Albiin, Nils [Karolinska University Hospital, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm (Sweden); Segersvaerd, Ralf [Karolinska University Hospital, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm (Sweden)

    2012-10-15

    To compare respiratory-triggered, free-breathing, and breath-hold DWI techniques regarding (1) image quality, and (2) signal intensity (SI) and ADC measurements in pancreatic ductal adenocarcinoma (PDAC). Fifteen patients with histopathologically proven PDAC underwent DWI prospectively at 1.5 T (b = 0, 50, 300, 600 and 1,000 s/mm{sup 2}) with the three techniques. Two radiologists, independently and blindly, assigned total image quality scores [sum of rating diffusion images (lesion detection, anatomy, presence of artefacts) and ADC maps (lesion characterisation, overall image quality)] per technique and ranked them. The lesion SI, signal-to-noise ratio, mean ADC and coefficient of variation (CV) were compared. Total image quality scores for respiratory-triggered, free-breathing and breath-hold techniques were 17.9, 16.5 and 17.1 respectively (respiratory-triggered was significantly higher than free-breathing but not breath-hold). The respiratory-triggered technique had a significantly higher ranking. Lesion SI on all b-values and signal-to-noise ratio on b300 and b600 were significantly higher for the respiratory-triggered technique. For respiratory-triggered, free-breathing and breath-hold techniques the mean ADCs were 1.201, 1.132 and 1.253 x 10{sup -3} mm{sup 2}/s, and mean CVs were 8.9, 10.8 and 14.1 % respectively (respiratory-triggered and free-breathing techniques had a significantly lower mean CV than the breath-hold technique). In both analyses, respiratory-triggered DWI showed superiority and seems the optimal DWI technique for demonstrating PDAC. (orig.)

  20. Hypofractionated image-guided breath-hold SABR (Stereotactic Ablative Body Radiotherapy) of liver metastases – clinical results

    International Nuclear Information System (INIS)

    Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive therapy option for inoperable liver oligometastases. Outcome and toxicity were retrospectively evaluated in a single-institution patient cohort who had undergone ultrasound-guided breath-hold SABR. 19 patients with liver metastases of various primary tumors consecutively treated with SABR (image-guidance with stereotactic ultrasound in combination with computer-controlled breath-hold) were analysed regarding overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC), acute and late toxicity. PTV (planning target volume)-size was 108 ± 109cm3 (median 67.4 cm3). BED2 (Biologically effective dose in 2 Gy fraction) was 83.3 ± 26.2 Gy (median 78 Gy). Median follow-up and median OS were 12 months. Actuarial 2-year-OS-rate was 31%. Median PFS was 4 months, actuarial 1-year-PFS-rate was 20%. Site of first progression was predominantly distant. Regression of irradiated lesions was observed in 84% (median time to detection of regression was 2 months). Actuarial 6-month-LC-rate was 92%, 1- and 2-years-LC-rate 57%, respectively. BED2 influenced LC. When a cut-off of BED2 = 78 Gy was used, the higher BED2 values resulted in improved local control with a statistical trend to significance (p = 0.0999). Larger PTV-sizes, inversely correlated with applied dose, resulted in lower local control, also with a trend to significance (p-value = 0.08) when a volume cut-off of 67 cm3 was used. No local relapse was observed at PTV-sizes < 67 cm3 and BED2 > 78 Gy. No acute clinical toxicity > °2 was observed. Late toxicity was also ≤ °2 with the exception of one gastrointestinal bleeding-episode 1 year post-SABR. A statistically significant elevation in the acute phase was observed for alkaline-phosphatase; in the chronic phase for alkaline-phosphatase, bilirubine, cholinesterase and C-reactive protein. A trend to statistically significant correlation of local progression was observed

  1. Comparative study of fast T 2-weighted images using respiratory triggered, breath-hold, fat suppression and phased array multi coil for liver evaluation by magnetic resonance imaging

    International Nuclear Information System (INIS)

    The objective of this study was to compare both qualitatively and quantitatively six T 2-weighted turbo spin-echo sequences varying the respiratory compensation technique, associating or not fat tissue suppression and using different types of coils. We performed a prospective study of 71 consecutive patients that were submitted to MRI of the liver using a 1.5 T magnet. The six following pulse sequences were used: fat-suppressed respiratory triggered with conventional body coil; breath-hold fat-suppressed with conventional body coil; non-suppressed respiratory triggered with conventional body coil; breath-hold non fat-suppressed with conventional body coil; fat-suppressed respiratory triggered with phased-array multi coil; breath-hold fat-suppressed with phased-array multi coil. Images were analyzed quantitatively by measuring the signal-to-noise ratios and qualitatively by evaluating the sharpness of hepatic contours, visibility of intrahepatic vessels and other segmental landmarks, and the presence of artifacts. Results: the qualitative analysis showed that the mean values obtained with the six sequences were 7.8, 4.6, 7.9, 5.2, 6.7 and 4.6 respectively. The respiratory-triggered sequences were better than the breath-hold sequences in both qualitative and quantitative analysis (p < 0.001). No significant differences in the values of signal-to-noise ratios and in overall image quality were found between the sequences with and without fat suppression (p . 0.05). The sequences using the body coil were similar in terms of image quality (p . 0.05) and better regarding signal-to-noise ratios than those obtained with the phased=array multi coil (p ,0.001). Our qualitative and quantitative results suggest that the best MRI sequences for the valuation of the liver are the sequences with respiratory triggering using a conventional body coil, with or without fat suppression. (author)

  2. SU-E-J-223: A BOLD Contrast Imaging Sequence to Evaluate Oxygenation Changes Due to Breath Holding for Breast Radiotherapy: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Adamson, J; Chang, Z; Cai, J; Palta, M; Horton, J; Yin, F; Blitzblau, R [Duke University Medical Center, Durham, NC (United States)

    2015-06-15

    Purpose: To develop a robust MRI sequence to measure BOLD breath hold induced contrast in context of breast radiotherapy. Methods: Two sequences were selected from prior studies as candidates to measure BOLD contrast attributable to breath holding within the breast: (1) T2* based Gradient Echo EPI (TR/TE = 500/41ms, flip angle = 60°), and (2) T2 based Single Shot Fast Spin Echo (SSFSE) (TR/TE = 3000/60ms). We enrolled ten women post-lumpectomy for breast cancer who were undergoing treatment planning for whole breast radiotherapy. Each session utilized a 1.5T GE MRI and 4 channel breast coil with the subject immobilized prone on a custom board. For each sequence, 1–3 planes of the lumpectomy breast were imaged continuously during a background measurement (1min) and intermittent breath holds (20–40s per breath hold, 3–5 holds per sequence). BOLD contrast was quantified as correlation of changes in per-pixel intensity with the breath hold schedule convolved with a hemodynamic response function. Subtle motion was corrected using a deformable registration algorithm. Correlation with breath-holding was considered significant if p<0.001. Results: The percentage of the breast ROI with positive BOLD contrast measured by the two sequences were in agreement with a correlation coefficient of R=0.72 (p=0.02). While both sequences demonstrated areas with strong BOLD response, the response was more systematic throughout the breast for the SSFSE (T2) sequence (% breast with response in the same direction: 51.2%±0.7% for T2* vs. 68.1%±16% for T2). In addition, the T2 sequence was less prone to magnetic susceptibility artifacts, especially in presence of seroma, and provided a more robust image with little distortion or artifacts. Conclusion: A T2 SSFSE sequence shows promise for measuring BOLD contrast in the context of breast radiotherapy utilizing a breath hold technique. Further study in a larger patient cohort is warranted to better refine this novel technique.

  3. SU-E-J-223: A BOLD Contrast Imaging Sequence to Evaluate Oxygenation Changes Due to Breath Holding for Breast Radiotherapy: A Pilot Study

    International Nuclear Information System (INIS)

    Purpose: To develop a robust MRI sequence to measure BOLD breath hold induced contrast in context of breast radiotherapy. Methods: Two sequences were selected from prior studies as candidates to measure BOLD contrast attributable to breath holding within the breast: (1) T2* based Gradient Echo EPI (TR/TE = 500/41ms, flip angle = 60°), and (2) T2 based Single Shot Fast Spin Echo (SSFSE) (TR/TE = 3000/60ms). We enrolled ten women post-lumpectomy for breast cancer who were undergoing treatment planning for whole breast radiotherapy. Each session utilized a 1.5T GE MRI and 4 channel breast coil with the subject immobilized prone on a custom board. For each sequence, 1–3 planes of the lumpectomy breast were imaged continuously during a background measurement (1min) and intermittent breath holds (20–40s per breath hold, 3–5 holds per sequence). BOLD contrast was quantified as correlation of changes in per-pixel intensity with the breath hold schedule convolved with a hemodynamic response function. Subtle motion was corrected using a deformable registration algorithm. Correlation with breath-holding was considered significant if p<0.001. Results: The percentage of the breast ROI with positive BOLD contrast measured by the two sequences were in agreement with a correlation coefficient of R=0.72 (p=0.02). While both sequences demonstrated areas with strong BOLD response, the response was more systematic throughout the breast for the SSFSE (T2) sequence (% breast with response in the same direction: 51.2%±0.7% for T2* vs. 68.1%±16% for T2). In addition, the T2 sequence was less prone to magnetic susceptibility artifacts, especially in presence of seroma, and provided a more robust image with little distortion or artifacts. Conclusion: A T2 SSFSE sequence shows promise for measuring BOLD contrast in the context of breast radiotherapy utilizing a breath hold technique. Further study in a larger patient cohort is warranted to better refine this novel technique

  4. Single Breath-Hold Physiotherapy Technique; Effective tool for T2* magnetic resonance imaging in young patients with thalassaemia major

    Directory of Open Access Journals (Sweden)

    Surekha T. Mevada

    2016-02-01

    Full Text Available Magnetic resonance imaging using T2* (MRI T2* is a highly sensitive and non-invasive technique for the detection of tissue iron load. Although the single breath-hold multi-echo T2* technique has been available at the Sultan Qaboos University Hospital (SQUH, Muscat, Oman, since 2006, it could not be performed on younger patients due to their inability to hold their breath after expiration. This study was carried out between May 2007 and May 2015 and assessed 50 SQUH thalassaemic patients aged 7‒17 years old. Seven of these patients underwent baseline and one-year follow-up MRI T2* scans before receiving physiotherapy training. Subsequently, all patients were trained by a physiotherapist to hold their breath for approximately 15‒20 seconds at the end of expiration before undergoing baseline and one-year follow-up MRI T2* scans. Failure rates for the pre- and post-training groups were 6.0% and 42.8%, respectively. These results indicate that the training of thalassaemic patients in breathhold techniques is beneficial and increases rates of compliance for MRI T2* scans.

  5. A Voluntary Breath-Hold Treatment Technique for the Left Breast With Unfavorable Cardiac Anatomy Using Surface Imaging

    International Nuclear Information System (INIS)

    Purpose: Breath-hold (BH) treatments can be used to reduce cardiac dose for patients with left-sided breast cancer and unfavorable cardiac anatomy. A surface imaging technique was developed for accurate patient setup and reproducible real-time BH positioning. Methods and Materials: Three-dimensional surface images were obtained for 20 patients. Surface imaging was used to correct the daily setup for each patient. Initial setup data were recorded for 443 fractions and were analyzed to assess random and systematic errors. Real time monitoring was used to verify surface placement during BH. The radiation beam was not turned on if the BH position difference was greater than 5 mm. Real-time surface data were analyzed for 2398 BHs and 363 treatment fractions. The mean and maximum differences were calculated. The percentage of BHs greater than tolerance was calculated. Results: The mean shifts for initial patient setup were 2.0 mm, 1.2 mm, and 0.3 mm in the vertical, longitudinal, and lateral directions, respectively. The mean 3-dimensional vector shift was 7.8 mm. Random and systematic errors were less than 4 mm. Real-time surface monitoring data indicated that 22% of the BHs were outside the 5-mm tolerance (range, 7%-41%), and there was a correlation with breast volume. The mean difference between the treated and reference BH positions was 2 mm in each direction. For out-of-tolerance BHs, the average difference in the BH position was 6.3 mm, and the average maximum difference was 8.8 mm. Conclusions: Daily real-time surface imaging ensures accurate and reproducible positioning for BH treatment of left-sided breast cancer patients with unfavorable cardiac anatomy.

  6. Reduction of respiratory effects on lung PET imaging with respiratory-gated acquisition associated with breath-hold CT

    International Nuclear Information System (INIS)

    Respiratory motion causes a spread of lesion uptake over a larger area in Positron Emission Tomography (PET) images for moving structures. When CT images are used for attenuation correction of emission data, this motion may alter the quantization of PET images. We present the clinical results of a respiratory-gated PET processing 'CT-based' method, which aims to improve PET-CT co registration by using an additional breath-hold CT (B.H.-CT). The CT-based protocol consisted in a 10-min List Mode respiratory-gated PET acquisition, followed by an end-expiration B.H.-CT acquisition. During these two examinations, the respiratory signal was recorded continuously. Eleven pulmonary lesions were studied. Patients underwent both a standard clinical PET protocol (free breathing) and the CT-based protocol. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions centroids on PET and CT images. SUVmax (Standardized Uptake Value) and volume variations were also investigated. The CT-based method showed a significant reduction (p = 0.049) of centroid distances (mean relative change versus standard method: 49%). We also noted a higher SUVmax (mean change: 39%). Lesion volumes were significantly lower (p = 0.026) in CT-based PET volumes (mean change: 43%) compared with standard ones. The CT-based method improves PET-CT co registration of pulmonary lesions. This protocol should lead to more accurate attenuation correction and thus improve S.U.V. measurement

  7. Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

    OpenAIRE

    Buechel, R R; Pazhenkottil, A P; Herzog, B A; Husmann, L; Nkoulou, R N; Burger, I A; Valenta, I; Wyss, C A; Ghadri, J R; Kaufmann, P A

    2010-01-01

    PURPOSE: The aim of this study was to assess the ability of real-time breath-hold-triggered myocardial perfusion imaging (MPI) using a novel cadmium-zinc-telluride (CZT) gamma camera to discriminate artefacts from true perfusion defects. METHODS: A group of 40 patients underwent a 1-day (99m)Tc-tetrofosmin pharmacological stress/rest imaging protocol on a conventional dual detector SPECT gamma camera with and without attenuation correction (AC), immediately followed by scanning on an ultrafas...

  8. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation

    NARCIS (Netherlands)

    Osman, S.O.; Hol, S.; Poortmans, P.M.P.; Essers, M.

    2014-01-01

    PURPOSE: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. MATERIALS AND METHODS: For 13 patients, four treatment co

  9. Hilar cholangiocarcinoma: preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence

    Institute of Scientific and Technical Information of China (English)

    YIN Long-lin; SONG Bin; XU Juan; LI Ying-chun

    2007-01-01

    Background Early detection and accurate staging are crucial for planning treatment and improving survival rate of hilar cholangiocarcinomas. This study investigated the diagnostic value of a three dimensional, spoiled gradient echo,T1-weighted magnetic resonance (MR) imaging sequence (3D volumetric interpolated breath-hold examination, 3D-VIBE) in the preoperative evaluation of hilar cholangiocarcinoma.Methods Thirty-one patients with surgically and histologically confirmed hilar cholangiocarcinomas underwent preoperative MR imaging examination. Unenhanced two-dimensional T1- and T2-weighted images, 2D MR cholangiopancreatographs (MRCP), gadolinium enhanced 3D-VIBE images in the early arterial, late arterial and portal venous phases followed by 2D T1-weighted images in the equilibrium phase were acquired. Images from 3D-VIBE, 2D T1-weighted enhanced sequences and 2D MRCP were interpreted by two abdominal radiologists through consensus reading in blind manner, focussing on the assessment of the morphological type, the longitudinal extent of tumor infiltration in the bile ducts and the involvement of neighbouring blood vessels. The accuracy of 3D-VIBE and 2D T1-weighted enhanced sequences in assessing the tumor resectability was compared.Results All the 31 tumors were directly displayed and accurately classified on 3D-VIBE images whereas 8 periductal infiltrating tumors (8/31, 25.8%) were not depicted on 2D T1-weighted enhanced images. Using the Bismuth Corlette classification, 3D-VIBE was closer to MRCP in delineating the intraductal extent of tumor infiltration than 2D T1-weighted enhanced (28/31, 90.3%; 10/31,32.3%; χ2=22.0, P<0.05). Involvement of the hepatic artery, the portal venous trunk and their branches was shown more frequently on 3D VIBE than 2D T1-weighted enhanced images. The positive predictive value and accuracy of 3D-VIBE (84.2%; 90.3%) for assessing tumor resectability were higher than those of 2D T1-weighted enhanced images (64.0%; 71.0%, all P

  10. [An Examination of Variable Image Positions in the Aortic Valve Blood Flow Using Phase Contrast MRI: Effect of Breath-holding Methods in Healthy Volunteers].

    Science.gov (United States)

    Nakagawa, Kenichi; Morimoto, Noriyoshi; Fukushima, Sachi

    2015-12-01

    Phase contrast MRI (PC-MRI) is a useful tool for evaluating valvular pathology. In addition, PC-MRI can provide a noninvasive assessment of blood flow in an arbitrary cross section. However, the blood flow measurement with breath-hold or free breath PC-MRI may be different from each other because of intrathoracic pressure changing and variable image position. The aim of this study was to find both the optimal breath-hold technique and the image position. Quantitative flow images were acquired in four planes (ascending aorta: Ao, sino-tubular junction: STJ, valsalva sinus: valsalva, left ventricular outflow tract: LVOT), in healthy subjects (n=10). The study protocol was divided into two parts: (1) stroke volume (SV) measured in each slice positions by using inspiration, expiration, and navigation method during normal breathing and (2) SV measured at each breath-hold techniques in the Ao, STJ, valsalva, and LVOT. As a result, (1) SV of the respective measurement positions were not significant by using inspiration, expiration, and navigation method and (2) LVOT SV was significantly lower than Ao, STJ, and valsalva. PMID:26685835

  11. Evaluation of image quality and patient safety: paired inspiratory and expiratory MDCT assessment of tracheobronchomalacia in paediatric patients under general anaesthesia with breath-hold technique

    International Nuclear Information System (INIS)

    The purpose of our investigation was to evaluate image quality and patient safety in infants and young children who required general anaesthesia with breath-hold technique for paired inspiratory and expiratory multidetector CT (MDCT) assessment of tracheobronchomalacia (TBM). Our hospital's institutional review board approved the review of radiological and clinical data of a consecutive series of 20 paediatric patients who underwent MDCT under general anaesthesia with breath-hold technique for evaluation of TBM from May 2006 to December 2008. For each MDCT study, two fellowship-trained paediatric radiologists reviewed the inspiratory and expiratory MDCT images in an independent, randomised and blinded fashion for the presence of motion artefact at three anatomic levels (upper, middle and lower central airways). The clinical history and anaesthesia outcome, including the occurrence of any adverse events during or following the MDCT examinations until discharge, were also reviewed and recorded. The study population consisted of 20 infants and young children (13 boys/seven girls, mean age 1.7 ± 1.4 years, age range 11 days to 4 years). The imaging quality of all 20 MDCT studies was diagnostic with no motion artefact in 16 studies (80%) and minimal motion artefact in the remaining four studies (20%). Minor adverse events occurred in three patients (15%) that included one patient (5%) with a brief (<60 s) oxygen desaturation during MDCT study, which resolved with oxygen, and two patients (5%) with either a brief (<60 s) oxygen desaturation (n = 1, 5%) or cough (n = 1, 5%) during recovery period, which were completely resolved with oxygen and dexamethasone, respectively. Diagnostic quality paired inspiratory and expiratory MDCT imaging with breath-hold technique can be safely performed in infants and young children under general anaesthesia for evaluation of TBM.

  12. 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.

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

    International Nuclear Information System (INIS)

    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.

  14. The Value of In-Phase and Opposed-Phase T1-Weighted Breath-Hold FLASH Sequences for Hepatic Imaging

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The value of the combined in-phase (IP) and opposed-phase (OP) T1-weighted (T1-W) breath-hold FLASH sequences for hepatic imaging, especially for fat content, was evaluated. Noncontrast-enhanced IP and OP T1-W GRE breath-hold images were obtained in 76 patients refereed for abdominal MRI at 1. 5T. 76 patients were divided into three groups for analysis: (1) liver without mass (n=8); (2) liver with hepatoma (n= 34); (3) liver with haemangioma or cyst (n= 34). Liver/spleen and liver/lesion signal-to-noise (SNR) and contrast-to-noise ratio (CNR) were assessed for lesion detection. Images between IP and OP sequences were compared quantitatively. The results showed that there was not statistically significant difference in liver/spleen and liver/lesion SNR between IP and OP sequences. In the patients with fatty infiltration, the OP sequences yielded substantially lower values for liver/spleen and liver/lesion SNR than those of the IP sequences. Furthermore, OP imaging showed fatty infiltration in 14 cases and demonstrated hyperintense peritumor rim in 4 cases. In 14 cases of fatty infiltration, many lesions were identified using IP images. The use of IP and OP GRE sequences provides complementary diagnostic information for hepatic lesions and fat content. Focal hepatic lesions may be obscured in the setting of fatty infiltration if only OP sequences are employed. A complete assessment of the liver with MR should include both IP and OP imaging.

  15. 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

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

    OpenAIRE

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

    2016-01-01

    Background 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 card...

  17. In vivo micro-CT imaging of the murine lung via a computer controlled intermittent iso-pressure breath hold (IIBH) technique

    Science.gov (United States)

    Namati, Eman; Chon, Deokiee; Thiesse, Jacqueline; McLennan, Geoffrey; Sieren, Jered; Ross, Alan; Hoffman, Eric A.

    2006-03-01

    Micro-CT, a technique for imaging small objects at high resolution using micro focused x-rays, is becoming widely available for small animal imaging. With the growing number of mouse models of pulmonary pathology, there is great interest in following disease progression and evaluating the alteration in longitudinal studies. Along with the high resolution associated with micro CT comes increased scanning times, and hence minimization of motion artifacts is required. We propose a new technique for imaging mouse lungs in vivo by inducing an intermittent iso-pressure breath hold (IIBH) with a fixed level of positive airway pressure during image acquisition, to decrease motion artifacts and increase image resolution and quality. Mechanical ventilation of the respiratory system for such a setup consists of three phases, 1) tidal breathing (hyperventilated), 2) a breath hold during a fixed level of applied positive airway pressure, 3) periodic deep sighs. Image acquisition is triggered over the stable segment of the IIBH period. Comparison of images acquired from the same mouse lung using three imaging techniques (normal breathing / no gating, normal breathing with gating at End Inspiration (EI) and finally the IIBH technique) demonstrated substantial improvements in resolution and quality when using the IIBH gating. Using IIBH triggering the total image acquisition time increased from 15 minutes to 35 minutes, although total x-ray exposure time and hence animal dosage remains the same. This technique is an important step in providing high quality lung imaging of the mouse in vivo, and will provide a good foundation for future longitudinal studies.

  18. Three-dimensional gadolinium-enhanced magnetic resonance breath-hold FLASH imaging in the diagnosis and staging of renal cell carcinoma

    International Nuclear Information System (INIS)

    Renal cell carcinoma accounts for 2% of all reported cancers. Its apparent incidence is increasing due to the more widespread use of cross-sectional imaging and as a result, tumours are being detected at an earlier stage. It is hoped that this improvement in early detection will result in a significant increase in survival rates. Radiological diagnosis and staging have a critical role in triaging patients' -treatment. Although computed tomography (CT) and ultrasound are well established in the evaluation of renal cell carcinoma, magnetic resonance (MR) techniques are still rapidly developing. In our institution breath-hold three-dimensional (3D) gadolinium-enhanced fast low-angled single shot (FLASH) spoiled gradient-echo sequence imaging has become an integral part of staging for renal cell carcinoma. In this article, we review our experience of the use of this emerging technique in the diagnosis and staging of renal cancer

  19. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation

    International Nuclear Information System (INIS)

    Purpose: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. Materials and methods: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42.56 Gy in 16 fractions. For 10 additional patients, 3D-CRT and VMAT in vmDIBH only were also compared. Results: Dose conformity, PTV coverage, ipsilateral and total lung doses were significantly better for VMAT plans compared to 3D-CRT. Mean heart dose (Dmean,heart) reduction in 3D-CRT(vmDIBH) was between 0.9 and 8.6 Gy, depending on initial Dmean,heart (in 3D-CRT(FB) plans). VMAT(vmDIBH) reduced the Dmean,heart further when Dmean,heart was still >3.2 Gy in 3D-CRT(vmDIBH). Mean contralateral breast dose was higher for VMAT plans (2.7 Gy) compared to 3DCRT plans (0.7 Gy). Conclusions: VMAT and 3D-CRT(vmDIBH) significantly reduced heart dose for patients treated with locoregional RT of left-sided breast cancer. When Dmean,heart exceeded 3.2 Gy in 3D-CRT(vmDIBH) plans, VMAT(vmDIBH) resulted in a cumulative heart dose reduction. VMAT also provided better target coverage and reduced ipsilateral lung dose, at the expense of a small increase in the dose to the contralateral breast

  20. Breath-hold CT attenuation correction for quantitative cardiac SPECT

    OpenAIRE

    Koshino, Kazuhiro; Fukushima, Kazuhito; Fukumoto, Masaji; Sasaki, Kazunari; Moriguchi, Tetsuaki; Hori, Yuki; Zeniya, Tsutomu; Nishimura, Yoshihiro; Kiso, Keisuke; Iida, Hidehiro

    2012-01-01

    Background Attenuation correction of a single photon emission computed tomography (SPECT) image is possible using computed tomography (CT)-based attenuation maps with hybrid SPECT/CT. CT attenuation maps acquired during breath holding can be misaligned with SPECT, generating artifacts in the reconstructed images. The purpose of this study was to investigate the effects of respiratory phase during breath-hold CT acquisition on attenuation correction of cardiac SPECT imaging. Methods A series o...

  1. MRCP using breath-hold HASTE sequence : comparison of maximum intensity projection image with single slice acquisition image

    International Nuclear Information System (INIS)

    To compare the usefulness of single-slice acquisition imaging and conventional maximum intensity projection imaging, as employed in magnetic resonance cholangiopancreatography (MRCP) using the Half-Fourier Acquisition Single Shot Turbo Spin-Echo(HASTE) sequence. Five healthy volunteers underwent MRCP using the HASTE sequence on a 1.5T MR unit. Two data acquisition techniques were used:1) single slice acquisition, with 20mm slice thickness (imaging time, 2sec), 2) multi-slice acquisition, with 5mm slice thickness(imaging time, 19sec), followed by maximum intensity projection reconstruction. Two radiologists independently evaluated the MRCP images obtained using these two techniques;based on the depiction by each of ten anatomic structures, their quality was graded as excellent(3 points), good(2 points), fair(1 point) or poor(0). Mean scores were totalled, and to compare the quality of the two techniques, these scores were compared. Data was statistically analyzed using the paired student t-test. There was no difference in bile duct image quality between the two techniques. The pancreatic duct was more conspicuous on single-slice (mean score, 1.94) than on maximum intensity projection imaging (mean score, 0.7). The sum of the mean scores of single-slice imaging was 18.75, and that of maximum intensity projection imaging was 14.7 (p=0.42);the general difference between the two techniques was thus statistically insignificant. Compared with maximum intensity projection imaging, single-slice imaging had a distinct advantage:acquisition time was short (within 2sec), thus motion artifacts could be avoided, and there was no need for post-processing. There is a close and direct connection between the avoidance of motion artifact and short acquisition time, but lack of need for post-processing is independent. On single-slice images, the pancreatic duct was more conspicuous than on maximum intensity projection images. The former can therefore be used with patients who

  2. Evaluation of target and cardiac position during visually monitored deep inspiration breath-hold for breast radiotherapy.

    Science.gov (United States)

    Conroy, Leigh; Yeung, Rosanna; Watt, Elizabeth; Quirk, Sarah; Long, Karen; Hudson, Alana; Phan, Tien; Smith, Wendy L

    2016-01-01

    A low-resource visually monitored deep inspiration breath-hold (VM-DIBH) technique was successfully implemented in our clinic to reduce cardiac dose in left-sided breast radiotherapy. In this study, we retrospectively characterized the chest wall and heart positioning accuracy of VM-DIBH using cine portal images from 42 patients. Central chest wall position from field edge and in-field maximum heart distance (MHD) were manually measured on cine images and compared to the planned positions based on the digitally reconstructed radiographs (DRRs). An in-house program was designed to measure left anterior descending artery (LAD) and chest wall separation on the planning DIBH CT scan with respect to breath-hold level (BHL) during simulation to determine a minimum BHL for VM-DIBH eligibility. Systematic and random setup uncertainties of 3.0 mm and 2.6 mm, respectively, were found for VM-DIBH treatment from the chest wall measurements. Intrabeam breath-hold stability was found to be good, with over 96% of delivered fields within 3 mm. Average treatment MHD was significantly larger for those patients where some of the heart was planned in the field compared to patients whose heart was completely shielded in the plan (p < 0.001). No evidence for a minimum BHL was found, suggesting that all patients who can tolerate DIBH may yield a benefit from it. PMID:27455494

  3. High resolution T2 weighted liver MR imaging using functional residual capacity breath-hold with a 1.0-Tesla scanner

    International Nuclear Information System (INIS)

    Purpose: During acquisition of rapid high resolution (HR) T2 weighted (T2W) liver magnetic resonance (MR) images using a 1.0-Tesla (T) scanner, the liver is segmented into odd and even sections that are acquired at two different times using the multi-breath-hold (MBH) strategy. Misalignment between the two breath-hold (B-H) images may result in the occurrence of a blind area and a decrease in diagnostic accuracy. Here, a functional residual capacity (FRC) B-H method was developed to overcome this problem. Material and methods: Twenty-five volunteers were enrolled. The sagittal images were reconstructed from whole liver transverse images. When the B-H phases are different, misalignment may occur in the craniocaudal and anterior-posterior (AP) directions. In this study, misalignments of the abdominal wall were measured in the AP direction. The misalignment was compared between four B-H phases, maximum inspiration (MI), maximum expiration (ME), voluntary expiration (VE) and FRC using one-way repeated measures ANOVA. Differences between groups were compared using the t-test for multi-group comparisons. In addition, qualitative analysis of misalignment was performed between VE and FRC in 52 clinical patients and the χ2 test was performed. Results: The misalignment widths of FRC, ME, MI and VE B-Hs were 2.7 ± 3.8, 6.4 ± 7.4, 9.1 ± 8.4 and 6.0 ± 6.7 mm, respectively. Misalignment of the liver position using FRC was significantly smaller than for the other B-H methods (p < 0.05). Significant differences between the VE B-H and FRC B-H were also observed in the qualitative analysis (p < 0.05). Conclusion: The liver positions obtained when using FRC B-H were significantly more reproducible than when using the other B-H methods. The FRC B-H method resulted in a reduction in the blind area and an extension of the diagnostic area to the whole liver.

  4. High resolution T2 weighted liver MR imaging using functional residual capacity breath-hold with a 1.0-Tesla scanner

    Energy Technology Data Exchange (ETDEWEB)

    Tabuchi, Akihiko [Graduate School of Health Sciences, Okayama University, Okayama (Japan); Kawasaki Medical School, Kawasaki Hospital, 2-1-80 Nakasange, Okayama City, Okayama 700-8505 (Japan)], E-mail: a-tab@po1.oninet.ne.jp; Katsuda, Toshizo [Faculty of Health Care Sciences, Himeji Dokkyo University, Hyogo (Japan); Gotanda, Rumi; Gotanda, Tatsuhiro [Graduate School of Health Sciences, Okayama University, Okayama (Japan); Mitani, Masahiko [Kawasaki Medical School, Kawasaki Hospital, 2-1-80 Nakasange, Okayama City, Okayama 700-8505 (Japan); Takeda, Yoshihiro [Graduate School of Health Sciences, Okayama University, Okayama (Japan)

    2009-11-15

    Purpose: During acquisition of rapid high resolution (HR) T2 weighted (T2W) liver magnetic resonance (MR) images using a 1.0-Tesla (T) scanner, the liver is segmented into odd and even sections that are acquired at two different times using the multi-breath-hold (MBH) strategy. Misalignment between the two breath-hold (B-H) images may result in the occurrence of a blind area and a decrease in diagnostic accuracy. Here, a functional residual capacity (FRC) B-H method was developed to overcome this problem. Material and methods: Twenty-five volunteers were enrolled. The sagittal images were reconstructed from whole liver transverse images. When the B-H phases are different, misalignment may occur in the craniocaudal and anterior-posterior (AP) directions. In this study, misalignments of the abdominal wall were measured in the AP direction. The misalignment was compared between four B-H phases, maximum inspiration (MI), maximum expiration (ME), voluntary expiration (VE) and FRC using one-way repeated measures ANOVA. Differences between groups were compared using the t-test for multi-group comparisons. In addition, qualitative analysis of misalignment was performed between VE and FRC in 52 clinical patients and the {chi}{sup 2} test was performed. Results: The misalignment widths of FRC, ME, MI and VE B-Hs were 2.7 {+-} 3.8, 6.4 {+-} 7.4, 9.1 {+-} 8.4 and 6.0 {+-} 6.7 mm, respectively. Misalignment of the liver position using FRC was significantly smaller than for the other B-H methods (p < 0.05). Significant differences between the VE B-H and FRC B-H were also observed in the qualitative analysis (p < 0.05). Conclusion: The liver positions obtained when using FRC B-H were significantly more reproducible than when using the other B-H methods. The FRC B-H method resulted in a reduction in the blind area and an extension of the diagnostic area to the whole liver.

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

    International Nuclear Information System (INIS)

    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

  6. 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

  7. Anatomy, variants, and pathologies of the superior glenohumeral ligament: Magnetic resonance imaging with three-dimensional volumetric interpolated breath-hold examination sequence and conventional magnetic resonance arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Ogul, Hayri; Karaca, Leyla; Emre, Cahit; Pirimoglu, Berhan; Tuncer, Kutsi; Topai, Murat; Okur, Aylin; Kantarci, Mecit [Medical Faculty, Ataturk University, Erzurum (Turkmenistan)

    2014-08-15

    The purpose of this review was to demonstrate magnetic resonance (MR) arthrography findings of anatomy, variants, and pathologic conditions of the superior glenohumeral ligament (SGHL). This review also demonstrates the applicability of a new MR arthrography sequence in the anterosuperior portion of the glenohumeral joint. The SGHL is a very important anatomical structure in the rotator interval that is responsible for stabilizing the long head of the biceps tendon. Therefore, a torn SGHL can result in pain and instability. Observation of the SGHL is difficult when using conventional MR imaging, because the ligament may be poorly visualized. Shoulder MR arthrography is the most accurately established imaging technique for identifying pathologies of the SGHL and associated structures. The use of three dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences produces thinner image slices and enables a higher in-plane resolution than conventional MR arthrography sequences. Therefore, shoulder MR arthrography using 3D VIBE sequences may contribute to evaluating of the smaller intraarticular structures such as the SGHL.

  8. Anatomy, variants, and pathologies of the superior glenohumeral ligament: Magnetic resonance imaging with three-dimensional volumetric interpolated breath-hold examination sequence and conventional magnetic resonance arthrography

    International Nuclear Information System (INIS)

    The purpose of this review was to demonstrate magnetic resonance (MR) arthrography findings of anatomy, variants, and pathologic conditions of the superior glenohumeral ligament (SGHL). This review also demonstrates the applicability of a new MR arthrography sequence in the anterosuperior portion of the glenohumeral joint. The SGHL is a very important anatomical structure in the rotator interval that is responsible for stabilizing the long head of the biceps tendon. Therefore, a torn SGHL can result in pain and instability. Observation of the SGHL is difficult when using conventional MR imaging, because the ligament may be poorly visualized. Shoulder MR arthrography is the most accurately established imaging technique for identifying pathologies of the SGHL and associated structures. The use of three dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences produces thinner image slices and enables a higher in-plane resolution than conventional MR arthrography sequences. Therefore, shoulder MR arthrography using 3D VIBE sequences may contribute to evaluating of the smaller intraarticular structures such as the SGHL.

  9. 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

    International Nuclear Information System (INIS)

    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

  10. 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.

  11. Three-dimensional dynamic MR imaging with a volumetric interpolated breath-hold examination for solitary pulmonary lesions. Correlation of contrast enhancement pattern with pathological features

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the clinical feasibility of dynamic MR imaging of solitary pulmonary lesions (SPLs) using a fat-suppressed three-dimensional gradient-echo technique with a volumetric interpolated breath-hold examination (VIBE). Correlation between the enhancement pattern and the histological characteristics of the nodules was also assessed. Dynamic 3D-VIBE was performed in 16 patients with pathologically proven SPLs. Each lesion was analyzed for its internal enhancement pattern, dynamic enhancement pattern, and peripheral enhancement (PE). A heterogeneous pattern of internal enhancement was well correlated with histological observation of necrosis, cystic changes, and variously sized air spaces. The washout pattern was seen in the medullary parts of the nodules with little fibrous stroma. The progressive pattern was seen at foci of collapse in the alveolar structure, central scars, and prominent fibrosis. PE was also seen in 6 malignant lesions (43%), and was well correlated with the medullary growth of adenocarcinoma and marginal fibrosis with lymphocytic infiltration of squamous cell carcinoma. The presence of PE was statistically significantly related with tumor size (p<0.05). Dynamic 3D-VIBE allows assessment of the histological characteristics of SPLs. It is also thought that this technique may be a promising method for differentiation between benign and malignant lesions. (author)

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

    International Nuclear Information System (INIS)

    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.

  13. 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.

  14. Contrast-enhanced three-dimensional MR imaging using a volumetric interpolated breath-hold examination (VIBE): clinical utility in the evaluation of renal tumors

    International Nuclear Information System (INIS)

    To compare, in terms of technical feasibility, image quality and clinical efficacy, contrast-enhanced three-dimensional (3D) MR imaging using volumetric interpolated breath-hold examination (VIBE) with two-dimensional gradient-echo MR imaging for the evaluation of renal messes. Twenty-three patients with 25 renal masses underwent dynamic MR imaging using a 1.5-T MR system and the 3D VIBE, 2D fast low angle shot (FLASH), and combined fat saturation techniques after the injection of 20 ml of Gd-DTPA. We compared postcontrast 2D FLASH and 3D VIBE images with precontrast 2D FLASH images. For quantitative analysis, the signal-to-noise and lesion to kidney contrast-to-noise ratio of the images were calculated using the three different techniques. For qualitative analysis, two experienced radiologists analyzed the images in terms of artifacts, lesion conspicuity and delineation, and general image quality. Delineation of the anatomy of renal vasculature and pelvocalyceal systems on reconstructed 3D VIBE MIP images was also assessed. Quantitative analysis showed that the SNR of a renal mass was slightly higher at postcontrast 2D FLASG than at 3D VIBE imaging, and the SNR of renal cortex was higher at 3D VIBE than at postcontrast 2D FLASF imaging. The differences were, though, statistically insignificant (p>0.05). The CNR of al renal mass was, however, significantly higher at 3D VIBE than at 2D FLASH imaging (p<0.05). Qualitative analysis showed that general image quality was best at postcontrast 3D VIBE, followed by 2D FLASH and precontrast 2D FLASH imaging, and image artifacts were worst at post-contrast 2D FLASH image (p<0.05). In terms of lesion conspicuity and delineation, 3D VIBE gave the best results and postcontrast images were better than precontrast (p<0.05). Reconstructed angiographic and urographic images using the VIBE technique provided information about the anatomy of the renal vasculature and pelvocalyceal system. 3D VIBE MR imaging offers comparable or

  15. Contrast-enhanced three-dimensional MR imaging using a volumetric interpolated breath-hold examination (VIBE): clinical utility in the evaluation of renal tumors

    International Nuclear Information System (INIS)

    To compare, in terms of technical feasibility, image quality and clinical efficacy, contrast-enhanced three-dimensional (3D) MR imaging using volumetric interpolated breath-hold examination (VIBE) with two-dimensional gradient-echo MR imaging for the evaluation of renal masses. Twenty-three patients with 25 renal masses underwent dynamic MR imaging using a 1.5-T MR system and the 3D VIBE, 2D fast low angle shot (FLASH), and combined fat saturation techniques after the injection of 20 ml of Gd-DTPA. We compared postcontrast 2D FLASH and 3D VIBE images with precontrast 2D FLASH images. For quantitative analysis, the signal-to-noise and lesion to kidney contrast-to-noise ratio of the images were calculated using the three different techniques. For qualitative analysis, two experienced radiologists analyzed the images in terms of artifacts, lesion conspicuity and delineation, and general image quality. Delineation of the anatomy of renal vasculature and pelvocalyceal system on reconstructed 3D VIBE MIP images was also assessed. Quantitative analysis showed that the SNR of a renal mass was slightly higher at postcontrast 2D FLASH than at 3D VIBE imaging, and the SNR of renal cortex was higher at 3D VIBE than at postcontrast 2D FLASH imaging. The differences were, though, statistically insignificant (p>0.05). The CNR of a renal mass was, however, significantly higher at 3D VIBE than at 2D FLASH imaging (p<0.05). Qualitative analysis showed that general image quality was best at postcontrast 3D VIBE, followed by 2D FLASH and precontrast 2D FLASH imaging, and image artifacts were worst at post-contrast 2D FLASH image (p<0.05). In terms of lesion conspicuity and delineation, 3D VIBE gave the best results and postcontrast images were better than precontrast (p<0.05). Reconstructed angiographic and urographic images using the VIBE technique provided information about the anatomy of the renal vasculature and pelvocalyceal system. 3D VIBE MR imaging offers comparable or

  16. Assessment of anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema with breath-hold SPECT-CT fusion images

    International Nuclear Information System (INIS)

    Anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema was assessed on deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images. Subjects were 38 patients with pulmonary emphysema and 11 non-smoker controls, who successfully underwent DIBrH and non-BrH perfusion SPECT using a dual-headed SPECT system during the period between January 2004 and June 2006. DIBrH SPECT was three-dimensionally co-registered with DIBrH CT to comprehend the relationship between lung perfusion defects and CT low attenuation areas (LAA). By comparing the appearance of lung perfusion on DIBrH with non-BrH SPECT, the correlation with the rate constant for the alveolar-capillary transfer of carbon monoxide (DLCO/VA) was compared between perfusion abnormalities on these SPECTs and LAA on CT. DIBrH SPECT provided fairly uniform perfusion in controls, but significantly enhanced perfusion heterogeneity when compared with non-BrH SPECT in pulmonary emphysema patients (P<0.001). The reliable DIBrH SPECT-CT fusion images confirmed more extended perfusion defects than LAA on CT in majority (73%) of patients. Perfusion abnormalities on DIBrH SPECT were more closely correlated with DLCO/VA than LAA on CT (P<0.05). DIBrH SPECT identifies affected lungs with perfusion abnormality better than does non-BrH SPECT in pulmonary emphysema. DIBrH SPECT-CT fusion images are useful for more accurately localizing affected lungs than morphologic CT alone in this disease. (author)

  17. Preliminary Investigation of Respiratory Self-Gating for Free-Breathing Segmented Cine MRI

    OpenAIRE

    Larson, Andrew C.; Kellman, Peter; Arai, Andrew; Hirsch, Glenn A.; Mcveigh, Elliot,; Li, Debiao; Simonetti, Orlando P.

    2005-01-01

    Segmented cine MRI generally requires breath-holding, which can be problematic for many patients. Navigator echo techniques, particularly successful for free-breathing coronary MRA, are incompatible with the acquisition strategies and SSFP pulse sequences commonly used for cine MRI. The purpose of this work is to introduce a new self-gating technique deriving respiratory gating information directly from the raw imaging data acquired for segmented cine MRI. The respiratory self-gating techniqu...

  18. Advantage of using deep inspiration breath hold with active breathing control and image-guided radiation therapy for patients treated with lung cancers

    Directory of Open Access Journals (Sweden)

    KR Muralidhar

    2015-01-01

    Full Text Available Purpose: The aim of this study was to evaluate the irradiated volume and doses to the target, heart, left lung, right lung and spinal cord, the number of segments and treatment time by using moderated deep inspiration breath hold (mDIBH with active breathing control (ABC and image-guided radiotherapy (IGRT for patients treated with lung cancers.Methods: The suitability of this technique for lung patient treated with ABC was investigated and the solutions to achieve better treatments were discussed. Eleven lung cancer patients (3 left-sided and 8 right sided lesions with stages I-III underwent standard free breath (FB and ABC computed tomography (CT scans in the treatment supine position. This can be achieved by applying respiratory manoeuvres, such as mDIBH, during which the threshold volume utilized is defined as 75-80% of the maximum aspiratory capacity. Five to seven, 6-MV photon beams with optimized gantry angles were designed according to the tumor location to conform to the PTV while sparing as much heart, spinal cord, and contra lateral lung as possible. For eleven patients, treatment planning using mDIBH CT data with intensity modulated radiation therapy (IMRT was then reoptimized on the free breathing data set for comparison. The studied parameters of the plans for each patient were evaluated based on the average of the minimum, mean, and maximum difference in dose, the range of difference, and the p-value using two-tailed paired t test assuming equal variance.Results: The average volume of the planning target volume (PTV in 11 patients increased to 1.32% in ABC compared to FB. The average volume of heart in 11 patients decreased to 2.9% in ABC compared to free breathing IMRT. In the case of lungs, the volume increased to 27.5% and 25.85% for left and right lungs, respectively. The range of mean difference in dose to the PTV in 11 patients was -54 cGy to 230 cGy with ABC technique when compared with free breathing. The range of mean

  19. Decompression sickness following breath-hold diving.

    Science.gov (United States)

    Schipke, J D; Gams, E; Kallweit, Oliver

    2006-01-01

    Despite convincing evidence of a relationship between breath-hold diving and decompression sickness (DCS), the causal connection is only slowly being accepted. Only the more recent textbooks have acknowledged the risks of repetitive breath-hold diving. We compare four groups of breath-hold divers: (1) Japanese and Korean amas and other divers from the Pacific area, (2) instructors at naval training facilities, (3) spear fishers, and (4) free-dive athletes. While the number of amas is likely decreasing, and Scandinavian Navy training facilities recorded only a few accidents, the number of spear fishers suffering accidents is on the rise, in particular during championships or using scooters. Finally, national and international associations (e.g., International Association of Free Drives [IAFD] or Association Internationale pour Le Developpment De L'Apnee [AIDA]) promote free-diving championships including deep diving categories such as constant weight, variable weight, and no limit. A number of free-diving athletes, training for or participating in competitions, are increasingly accident prone as the world record is presently set at a depth of 171 m. This review presents data found after searching Medline and ISI Web of Science and using appropriate Internet search engines (e.g., Google). We report some 90 cases in which DCS occurred after repetitive breath-hold dives. Even today, the risk of suffering from DCS after repetitive breath-hold diving is often not acknowledged. We strongly suggest that breath-hold divers and their advisors and physicians be made aware of the possibility of DCS and of the appropriate therapeutic measures to be taken when DCS is suspected. Because the risk of suffering from DCS increases depending on depth, bottom time, rate of ascent, and duration of surface intervals, some approaches to assess the risks are presented. Regrettably, none of these approaches is widely accepted. We propose therefore the development of easily manageable

  20. Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

    International Nuclear Information System (INIS)

    In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3±0.2 l/min in controls vs 1.0±0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0±0.2 l/min in controls vs 0.9±0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5±0.2 l/min in controls vs 1.1±0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6±8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5±4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8±9.4% vs +5.9±11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly physiologic conditions

  1. Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

    Energy Technology Data Exchange (ETDEWEB)

    Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu [Saiseikai Wakakusa Hospital, Yakohama (Japan)

    1999-07-01

    In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3{+-}0.2 l/min in controls vs 1.0{+-}0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0{+-}0.2 l/min in controls vs 0.9{+-}0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5{+-}0.2 l/min in controls vs 1.1{+-}0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6{+-}8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5{+-}4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8{+-}9.4% vs +5.9{+-}11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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. (paper)

  4. 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.

    2013-04-01

    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.

  5. 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

  6. Novel Findings in Breath-Holding Spells

    OpenAIRE

    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 U...

  7. Radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC) for dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI of the liver: advantages over Cartesian VIBE in the arterial phase

    International Nuclear Information System (INIS)

    To compare radial volumetric imaging breath-hold examination with k-space weighted image contrast reconstruction (r-VIBE-KWIC) to Cartesian VIBE (c-VIBE) in arterial phase dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (DCE-MRI) of the liver. We reviewed 53 consecutive DCE-MRI studies performed on a 3-T unit using c-VIBE and 53 consecutive cases performed using r-VIBE-KWIC with full-frame image subset (r-VIBEfull) and sub-frame image subsets (r-VIBEsub; temporal resolution, 2.5-3 s). All arterial phase images were scored by two readers on: (1) contrast-enhancement ratio (CER) in the abdominal aorta; (2) scan timing; (3) artefacts; (4) visualisation of the common, right, and left hepatic arteries. Mean abdominal aortic CERs for c-VIBE, r-VIBEfull, and r-VIBEsub were 3.2, 4.3 and 6.5, respectively. There were significant differences between each group (P full and r-VIBEsub in all factors except for visualisation of the common hepatic artery (P sub was not significantly different from that for r-VIBEfull. Radial VIBE-KWIC provides higher image quality than c-VIBE, and r-VIBEsub features high temporal resolution without image degradation in arterial phase DCE-MRI. circle Radial VIBE-KWIC minimised artefact and produced high-quality and high-temporal-resolution images. circle Maximum abdominal aortic enhancement was observed on sub-frame images of r-VIBE-KWIC. (orig.)

  8. Determination of the optimal matching position for setup images and minimal setup margins in adjuvant radiotherapy of breast and lymph nodes treated in voluntary deep inhalation breath-hold

    International Nuclear Information System (INIS)

    Adjuvant radiotherapy (RT) of left-sided breast cancer is increasingly performed in voluntary deep inspiration breath-hold (vDIBH). The aim of this study was to estimate the reproducibility of breath-hold level (BHL) and to find optimal bony landmarks for matching of orthogonal setup images to minimise setup margins. 1067 sets of images with an orthogonal setup and tangential field from 67 patients were retrospectively analysed. Residual position errors were determined in the tangential treatment field images for different matches of the setup images. Variation of patient posture and BHL were analysed for position errors of the vertebrae, clavicula, ribs and sternum in the setup and tangential field images. The BHL was controlled with a Varian RPM® system. Setup margins were calculated using the van Herk’s formula. Patients who underwent lymph node irradiation were also investigated. For the breast alone, the midway compromise of the ribs and sternum was the best general choice for matching of the setup images. The required margins were 6.5 mm and 5.3 mm in superior-inferior (SI) and lateral/anterior-posterior (LAT/AP) directions, respectively. With the individually optimised image matching position also including the vertebrae, slightly smaller margins of 6.0 mm and 4.8 mm were achieved, respectively. With the individually optimised match, margins of 7.5 mm and 10.8 mm should be used in LAT and SI directions, respectively, for the lymph node regions. These margins were considered too large. The reproducibility of the BHL was within 5 mm in the AP direction for 75% of patients. The smallest setup margins were obtained when the matching position of the setup images was individually optimised for each patient. Optimal match for the breast alone is not optimal for the lymph node region, and, therefore, a threshold of 5 mm was introduced for residual position errors of the sternum, upper vertebrae, clavicula and chest wall to retain minimal setup margins of 5 mm

  9. Cine MR imaging in mitral valve prolapse

    International Nuclear Information System (INIS)

    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)

  10. Double-oblique cine cardiac MR imaging

    International Nuclear Information System (INIS)

    A study has been performed analyzing the contrast between the blood pool and myocardium on double oblique long- and short-axis cine MR images using gradient echo fast imaging with steady precession and fast low-angle shot sequences. Inflow of unsaturated spins dominates the contrast behavior of short-axis images. With long-axis imaging, suboptimal contrast is seen in peak systole and early diastole due to partial saturation of spins in the imaging section and anatomic considerations at small ventricular volumes. The effects of echo time, flip angle, motion compensation, and spatial presaturation on the contrast between the blood pool and myocardium are discussed

  11. The effectiveness of breath-holding to stabilize lung and pancreas tumors during radiosurgery

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effect of breath-holding on the short-term reproducibility and long-term variability of tumor position during image-guided radiosurgery. Method: Thirteen patients have undergone single-fraction radiosurgery treatments during which the tumor was repeatedly imaged radiographically to observe its position. The imaging data were used to monitor the efficacy of breath-holding and to periodically readjust the alignment of the treatment beam with the tumor. These measurements have allowed the effects of breathing, heartbeat, patient movement, and instrumental uncertainties to be separately identified in the record of tumor position. Results: During inspiration breath-holding, the lung tumor position was reproducible to within 1 mm, on average, in the direction of maximum displacement during regular breathing, and to within 1.8 mm in three dimensions overall. The pancreas tumor position in three dimensions was reproducible to within 2.5 mm on average. Some patients showed a slow, steady drift of tumor position during the extended sequence of breath-holds, which was compensated by periodic retargeting of the treatment beam. Conclusion: Breath-holding can allow the reduction of tumor motion dosimetry margins to 2 mm or less for lung cancer treatments, provided that the treatment system can detect and adapt to long-term variations in the mean tumor position during a lengthy treatment fraction

  12. The effect of acetazolamide on breath holding at high altitude.

    OpenAIRE

    Morrissey, S. C.; Keohane, K.; Coote, J.H.

    1987-01-01

    The effect of altitude and acetazolamide on breath holding was studied in 20 individuals. Breath holding time was reduced progressively during ascent. There was an additional reduction in the acetazolamide group at low but not at high altitude. The initial difference between the two groups may have been related to a lower CSF pH when on acetazolamide. At high altitude the finding of similar breath holding times in the two groups may have been due to acclimatization in the placebo group.

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

    International Nuclear Information System (INIS)

    To assess whether multi-echo Dixon magnetic resonance (MR) imaging with simultaneous T2* estimation and correction yields more accurate fat-signal fraction (FF) measurement of the lumbar paravertebral muscles, in comparison with non-T2*-corrected two-echo Dixon or T2*-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*-corrected Dixon technique with two (non-T2*-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*-corrected six-echo Dixon sequence would be a better option than two- or three-echo methods for noninvasive quantification of lumbar muscle fat quantification

  14. 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.

  15. Comparative study of fast T 2-weighted images using respiratory triggered, breath-hold, fat suppression and phased array multi coil for liver evaluation by magnetic resonance imaging; Estudo comparativo das sequencias rapidas ponderadas em T2, utilizando-se sincronizacao respiratoria, apneia, supressao de gordura, bobina de corpo e bobina de sinergia para a avaliacao do figado pela ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Abbehusen, Cristiane L.; D' Ippolito, Giuseppe; Palacio, Glaucia A.S.; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina (EPM). Dept. de Diagnostico por Imagem]. E-mail: cabbehusen@hotmail.com

    2003-10-01

    The objective of this study was to compare both qualitatively and quantitatively six T 2-weighted turbo spin-echo sequences varying the respiratory compensation technique, associating or not fat tissue suppression and using different types of coils. We performed a prospective study of 71 consecutive patients that were submitted to MRI of the liver using a 1.5 T magnet. The six following pulse sequences were used: fat-suppressed respiratory triggered with conventional body coil; breath-hold fat-suppressed with conventional body coil; non-suppressed respiratory triggered with conventional body coil; breath-hold non fat-suppressed with conventional body coil; fat-suppressed respiratory triggered with phased-array multi coil; breath-hold fat-suppressed with phased-array multi coil. Images were analyzed quantitatively by measuring the signal-to-noise ratios and qualitatively by evaluating the sharpness of hepatic contours, visibility of intrahepatic vessels and other segmental landmarks, and the presence of artifacts. Results: the qualitative analysis showed that the mean values obtained with the six sequences were 7.8, 4.6, 7.9, 5.2, 6.7 and 4.6 respectively. The respiratory-triggered sequences were better than the breath-hold sequences in both qualitative and quantitative analysis (p < 0.001). No significant differences in the values of signal-to-noise ratios and in overall image quality were found between the sequences with and without fat suppression (p . 0.05). The sequences using the body coil were similar in terms of image quality (p . 0.05) and better regarding signal-to-noise ratios than those obtained with the phased=array multi coil (p ,0.001). Our qualitative and quantitative results suggest that the best MRI sequences for the valuation of the liver are the sequences with respiratory triggering using a conventional body coil, with or without fat suppression. (author)

  16. CAIPIRINHA-Dixon-TWIST (CDT)-volume-interpolated breath-hold examination (VIBE) for dynamic liver imaging: Comparison of gadoterate meglumine, gadobutrol and gadoxetic acid

    International Nuclear Information System (INIS)

    Highlights: • We examined the influence of different clinically used contrast agents on the image quality of a new sequence called CDT-VIBE for dynamic MRI of the liver. • CDT-VIBE is a robust sequence for clinical routine as it provides good image quality regardless of the utilized contrast agent. • In average, more than 3 hepatic arterial dominant phases are acquired with the CDT-VIBE sequence regardless of the contrast agent. - Abstract: Purpose: CAIPIRINHA-Dixon-TWIST (CDT)-VIBE is a robust method for abdominal magnetic resonance imaging providing both high spatial and high temporal resolution. The purpose of this study was to examine the influence of different gadolinium based contrast agents (GBCA) on image quality (IQ) with CDT-VIBE. Materials and methods: In this IRB-approved, retrospective, inter-individual comparison study, 86 patients scanned at 3T were included. Within 28 s, 14 high-resolution 3D datasets were acquired using CDT-VIBE. 37 patients received 0.1 mmol/kg gadoterate meglumine, 28 patients 0.1 mmol/kg gadobutrol, and 19 patients 0.1 mL/kg gadoxetic acid. Two blinded, board-certified radiologists assessed the image quality on a 5 point scale, as well as the number of hepatic arterial dominant (HAD) phases. Results: Regardless of the GBCA utilized, CDT-VIBE resulted in good IQ in terms of best IQ achieved among all 14 datasets (gadobutrol 4.3, gadoterate meglumine 3.9, gadoxetic acid 3.7). With respect to worst IQ, the three groups showed statistically significant differences with gadobutrol receiving the highest rating (3.6) and gadoxetic acid the lowest (2.4) (gadoterate meglumine 3.0; 0.0014 < p < 0.0485). No statistically significant differences were found in the mean number of acquired HAD phases (gadobutrol 3.4, gadoterate meglumine 3.9, gadoxetic acid 3.1; 0.18 < p < 0.57). Conclusion: Different gadolinium-based contrast agents can be utilized for dynamic liver imaging with CDT-VIBE resulting in good image quality

  17. CAIPIRINHA-Dixon-TWIST (CDT)-volume-interpolated breath-hold examination (VIBE) for dynamic liver imaging: Comparison of gadoterate meglumine, gadobutrol and gadoxetic acid

    Energy Technology Data Exchange (ETDEWEB)

    Budjan, Johannes, E-mail: Johannes.Budjan@umm.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim—Heidelberg University, Mannheim (Germany); Ong, Melissa; Riffel, Philipp [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim—Heidelberg University, Mannheim (Germany); Morelli, John N. [Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Michaely, Henrik J.; Schoenberg, Stefan O.; Haneder, Stefan [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim—Heidelberg University, Mannheim (Germany)

    2014-11-15

    Highlights: • We examined the influence of different clinically used contrast agents on the image quality of a new sequence called CDT-VIBE for dynamic MRI of the liver. • CDT-VIBE is a robust sequence for clinical routine as it provides good image quality regardless of the utilized contrast agent. • In average, more than 3 hepatic arterial dominant phases are acquired with the CDT-VIBE sequence regardless of the contrast agent. - Abstract: Purpose: CAIPIRINHA-Dixon-TWIST (CDT)-VIBE is a robust method for abdominal magnetic resonance imaging providing both high spatial and high temporal resolution. The purpose of this study was to examine the influence of different gadolinium based contrast agents (GBCA) on image quality (IQ) with CDT-VIBE. Materials and methods: In this IRB-approved, retrospective, inter-individual comparison study, 86 patients scanned at 3T were included. Within 28 s, 14 high-resolution 3D datasets were acquired using CDT-VIBE. 37 patients received 0.1 mmol/kg gadoterate meglumine, 28 patients 0.1 mmol/kg gadobutrol, and 19 patients 0.1 mL/kg gadoxetic acid. Two blinded, board-certified radiologists assessed the image quality on a 5 point scale, as well as the number of hepatic arterial dominant (HAD) phases. Results: Regardless of the GBCA utilized, CDT-VIBE resulted in good IQ in terms of best IQ achieved among all 14 datasets (gadobutrol 4.3, gadoterate meglumine 3.9, gadoxetic acid 3.7). With respect to worst IQ, the three groups showed statistically significant differences with gadobutrol receiving the highest rating (3.6) and gadoxetic acid the lowest (2.4) (gadoterate meglumine 3.0; 0.0014 < p < 0.0485). No statistically significant differences were found in the mean number of acquired HAD phases (gadobutrol 3.4, gadoterate meglumine 3.9, gadoxetic acid 3.1; 0.18 < p < 0.57). Conclusion: Different gadolinium-based contrast agents can be utilized for dynamic liver imaging with CDT-VIBE resulting in good image quality.

  18. Cine-MR imaging of the shoulder

    International Nuclear Information System (INIS)

    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.)

  19. Morphologic and functional assessment of vascular abnormalities of the pulmonary vasculature by breath-hold MR techniques

    International Nuclear Information System (INIS)

    Purpose: To evaluate breath-hold MR techniques for morphologic and functional assessment of vascular abnormalities of the pulmonary vasculature. Patients and Methods: 13 patients aged 11 to 60 years with different vascular abnormalities of the pulmonary vasculature (5 patients with 16 arteriovenous malformations, 8 patients with partial anomalous pulmonary venous return) underwent MR imaging at 1.5 T. For morphological assessment, a contrast-enhanced 3D MR angiography (ce-MRA) was performed after a timing run. Segmented cine- and velocity-encoded GRE sequences were used for delineation of associated cardiac septal defects and for determination of systemic left-to-right or intrapulmonary shunt volumes. Selective intra arterial digital subtraction angiography, cardiac catheterization, and the intraoperative situs served as reference standards. Results: Ce-MRA allowed for detection of all vascular abnormalities and for anatomic characterization of 14/16 arteriovenous malformations. Flow measurements in the feeding arteries allowed for determination of intrapulmonary shunt volumes in 4/5 patients. Flow measurements performed in the pulmonary arteries and the ascending aorta enabled determination of systemic left-to-right shunting in patients with anomalous pulmonary venous return. Cine-sequences clearly depicted associated cardiac septal defects. Conclusion: Breathhold MR techniques allow for morphological and functional characterization of vascular anomalies of the pulmonary vasculature. Therefore, they are the non-invasive method of choice for planning further treatment. (orig.)

  20. Acute effects of cannabis on breath-holding duration.

    Science.gov (United States)

    Farris, Samantha G; Metrik, Jane

    2016-08-01

    Distress intolerance (an individual's perceived or actual inability to tolerate distressing psychological or physiological states) is associated with cannabis use. It is unknown whether a biobehavioral index of distress intolerance, breath-holding duration, is acutely influenced (increased or decreased) by cannabis. Such information may further inform understanding of the expression of psychological or physiological distress postcannabis use. This within-subjects study examined whether smoked marijuana with 2.7%-3.0% delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed duration of breath holding. Participants (n = 88; 65.9% male) were nontreatment-seeking frequent cannabis users who smoked placebo or active THC cigarette on two separate study days and completed a breath-holding task postsmoking. Controlling for baseline breath-holding duration and participant sex, THC produced significantly shorter breath-holding durations relative to placebo. There was a significant interaction of drug administration × frequency of cannabis use, such that THC decreased breath-holding time among less frequent but not among more frequent users. Findings indicate that cannabis may exacerbate distress intolerance (via shorter breath-holding durations). As compared to less frequent cannabis users, frequent users display tolerance to cannabis' acute effects including increased ability to tolerate respiratory distress when holding breath. Objective measures of distress intolerance are sensitive to contextual factors such as acute drug intoxication, and may inform the link between cannabis use and the expression of psychological distress. (PsycINFO Database Record PMID:27454678

  1. 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

  2. Breath-hold times in patients undergoing radiological examinations. Comparison of expiration and inspiration with and without hyperventilation

    International Nuclear Information System (INIS)

    Background. Breath-holding is necessary for imaging studies of the thorax and abdomen using computed tomography, magnetic resonance imaging or ultrasound examinations. The purpose of this study was to compare the breath-hold times in expiration and inspiration and to evaluate the effects of hyperventilation. Patients and methods. Thirty patients and 19 healthy volunteers participated in this study after informed consent was obtained in all. The breath-hold times were measured in expiration and inspiration before and after hyperventilation. Results. The mean breath-hold times in expiration (patients: 24±9 sec, volunteers: 27±7 sec) were significantly shorter than those in inspiration (patients: 41±20 sec, p<0.001; volunteers: 62±18 sec, p<0.001). Additional hyperventilation resulted in a significant increase (range: 40-60%, p≤0.005) of the mean breathhold times either in expiration and in inspiration and for both patients and volunteers. Conclusions. Although breath-holding in expiration is recommended for various imaging studies particularly of the thorax and of the abdomen, suspending respiration in inspiration enables the patient a considerable longer breath-hold time. (author)

  3. Radiotherapy of lung cancer: the inspiration breath hold with a spirometric monitoring

    International Nuclear Information System (INIS)

    A CT acquisition during a free breathing examination generates images of poor quality. It creates an uncertainty on the reconstructed gross tumour volume and dose distribution. The aim of this study is to test the feasibility of a breath hold method applied in all preparation and treatment days. Five patients received a thoracic radiotherapy with the benefit of this procedure. The breathing of the patient was measured with a spirometer. The patient was coached to reproduce a constant level of breath-hold in a deep inspiration. Video glasses helped the patients to fix the breath-hold at the reference level. The patients followed the coaching during preparation and treatment, without any difficulty. The better quality of the CT reconstructed images resulted in an easier contouring. No movements of the gross tumour volume lead to a better coverage. The deep breath hold decreased the volume of irradiated lung. This method improves the reproducibility of the thoracic irradiation. The decrease of irradiated lung volume offers prospects in dose escalation and intensity modulation radiotherapy. (authors)

  4. Detection of viable myocardium by low dose of dobutamine cine MR imaging in miniswine

    Institute of Scientific and Technical Information of China (English)

    陆敏杰; 赵世华; 韦云青; 王诚; 蒋世良; 黄连军; 张岩; 牟峰; 孟亮; 阮英峁

    2003-01-01

    Objective To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for myocardial viability. Methods Ten male miniswines underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using ameroid constrictor. More than one month later, left ventriculography and coronary angiography were performed again, followed by cine-MRI at rest and during stress with incremental dose of dobutamine 5-20 μg·kg-1·min-1. Traditional and/or breath-hold cine-MRI were used to evaluate regional left ventricular wall motion, corresponding to basal, midventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated.The miniswines were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) delineated myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results One pig died, one pig suffered from aneurysm and another showed no negative findings. The other seven pigs were found with hypokinetic (n=4) or akinetic (n=3) myocardial regions related to stenosed LCX. Their mean WMSI at rest for the lateral and posteroinferior walls (ischemic regions) of the left ventricle was 2.27±0.32, as compared with 1.00±0.00 (P0.05). The pathologic examination showed viable myocardium at the ischemic regions. ConclusionLow-dose dobutamine (5μg·kg-1·min-1) recovers hypokinetic or akinetic myocardial regions, and dobutamine stress MRI can be used to detect myocardial viability.

  5. Impact of breath holding on cardiovascular respiratory and cerebrovascular health.

    Science.gov (United States)

    Dujic, Zeljko; Breskovic, Toni

    2012-06-01

    Human underwater breath-hold diving is a fascinating example of applied environmental physiology. In combination with swimming, it is one of the most popular forms of summer outdoor physical activities. It is performed by a variety of individuals ranging from elite breath-hold divers, underwater hockey and rugby players, synchronized and sprint swimmers, spear fishermen, sponge harvesters and up to recreational swimmers. Very few data currently exist concerning the influence of regular breath holding on possible health risks such as cerebrovascular, cardiovascular and respiratory diseases. A literature search of the PubMed electronic search engine using keywords 'breath-hold diving' and 'apnoea diving' was performed. This review focuses on recent advances in knowledge regarding possibly harmful physiological changes and/or potential health risks associated with breath-hold diving. Available evidence indicates that deep breath-hold dives can be very dangerous and can cause serious acute health problems such a collapse of the lungs, barotrauma at descent and ascent, pulmonary oedema and alveolar haemorrhage, cardiac arrest, blackouts, nitrogen narcosis, decompression sickness and death. Moreover, even shallow apnoea dives, which are far more frequent, can present a significant health risk. The state of affairs is disturbing as athletes, as well as recreational individuals, practice voluntary apnoea on a regular basis. Long-term health risks of frequent maximal breath holds are at present unknown, but should be addressed in future research. Clearly, further studies are needed to better understand the mechanisms related to the possible development or worsening of different clinical disorders in recreational or competitive breath holding and to determine the potential changes in training/competition regimens in order to prevent these adverse events. PMID:22574634

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

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. Evaluation of left ventricular volume curve by Gd-DTPA enhanced ultrafast cine MR imaging. Clinical application of automatic extraction left ventricular contours on long axis views

    International Nuclear Information System (INIS)

    Contrast-enhanced breath-hold ultrafast cine MR imaging was shown to provide accurate cardiac images with higher success rate (89% in horizontal long axis view and 88% in vertical long axis view). However, the data analysis method still depends on operator's manual tracing of left ventricular (LV) contours which cannot exclude subjectivity, so not only the operator's contributions but also the data analysis results' reproducibility problems remains. We propose an automatic extraction method of LV contours on cine MR images, which needs only 3 manually inputted points at the 1st cardiac frame and require no manual operation for another frames. The automatic LV edge extraction time was 4 second/frame by this method, on the other hand, conventional manual tracing time was 60-90 second/frame. Comparison with LV volumes showed a high correlation (r=0.953 in EDVI, r=0.962 in ESVI) between manual and automatic tracing of LV contours on horizontal long axis view. We have developed an automatic extraction method of LV contours on long axis view in contrast-enhanced ultrafast cine MR images. This is an accurate highly reproducible method of evaluating LV volumetry and volume curve. (author)

  9. 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.

  10. Clinical evaluation of digital cine imaging on coronary angiography

    International Nuclear Information System (INIS)

    Digital cine angio system was developed a few years ago and is used widely for cardiac examinations. However, the image quality of digital imaging in clinical examinations is seldom evaluated. We have attempted to evaluate the digital imaging in D.C.I. First, each segment of coronary arteries that is exposed in routine projection angle were visually evaluated. Second, regarding the appearance of the coronary arteries on the diaphragm we compared digital imaging with cine film. As a result, the image quality of the coronary arteries except for segments 7 to 10 (classified by A.H.A.) was evaluated as being good. Regarding the appearance of coronary arteries on a diaphragm, digital imaging was evaluated higher than cine film. In this report, the advantages of digital imaging in coronary angiography were studied. (author)

  11. Assessment of reproducibility and stability of different breath-hold maneuvres by dynamic MRI: comparison between healthy adults and patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    To assess the stability and reproducibility of different breath-hold levels in healthy volunteers and patients using dynamic MRI (dMRI). In ten healthy volunteers and ten patients with pulmonary hypertension (PH) and normal lung function craniocaudal intrathoracic distances (CCD) were measured during inspiratory and expiratory breath-hold (15 s) (in healthy volunteers additionally at a self-chosen mid-inspiratory breath-hold) using dMRI (trueFISP, three images/s). To evaluate stability and intraobserver reproducibility of the different breath-hold levels, CCDs, time-distance curves, confidence intervals (CIs), Mann-Witney U test and regression equations were calculated. In healthy volunteers there was a substantial decrease of the CCD during the inspiratory breath-hold in contrast to the expiratory breath-hold. The CI at inspiration was 2.84±1.28 in the right and 2.1±0.68 in the left hemithorax. At expiration the CI was 2.54±1.18 and 2.8±1.48. Patients were significantly less able to hold their breath at inspiration than controls (P<0.05). In patients CI was 4.53±4.06 and 3.46±2.21 at inspiration and 4.45±4.23 and 4.76±3.73 at expiration. Intraobserver variability showed no significant differences either in patients or in healthy subjects. Reproducibility was significantly lower at a self-chosen breath-hold level of the healthy volunteers. DMRI is able to differentiate stability and reproducibility of different breath-hold levels. Expiratory breath-hold proved to be more stable than inspiratory breath-hold in healthy volunteers and patients. (orig.)

  12. Assessment of reproducibility and stability of different breath-hold maneuvres by dynamic MRI: comparison between healthy adults and patients with pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Plathow, Christian [German Cancer Research Center Heidelberg, Department of Radiology, Heidelberg (Germany); Eberhard-Karls-University Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); Ley, Sebastian; Zaporozhan, Julia; Puderbach, Michael; Eichinger, Monika; Zuna, Ivan; Kauczor, Hans-Ulrich [German Cancer Research Center Heidelberg, Department of Radiology, Heidelberg (Germany); Schoebinger, Max; Meinzer, Hans-Peter [German Cancer Research Center Heidelberg, Department of Medical and Biological Informatics, Heidelberg (Germany); Gruenig, Ekkehard [University of Heidelberg, Department of Internal Medicine III, Heidelberg (Germany)

    2006-01-01

    To assess the stability and reproducibility of different breath-hold levels in healthy volunteers and patients using dynamic MRI (dMRI). In ten healthy volunteers and ten patients with pulmonary hypertension (PH) and normal lung function craniocaudal intrathoracic distances (CCD) were measured during inspiratory and expiratory breath-hold (15 s) (in healthy volunteers additionally at a self-chosen mid-inspiratory breath-hold) using dMRI (trueFISP, three images/s). To evaluate stability and intraobserver reproducibility of the different breath-hold levels, CCDs, time-distance curves, confidence intervals (CIs), Mann-Witney U test and regression equations were calculated. In healthy volunteers there was a substantial decrease of the CCD during the inspiratory breath-hold in contrast to the expiratory breath-hold. The CI at inspiration was 2.84{+-}1.28 in the right and 2.1{+-}0.68 in the left hemithorax. At expiration the CI was 2.54{+-}1.18 and 2.8{+-}1.48. Patients were significantly less able to hold their breath at inspiration than controls (P<0.05). In patients CI was 4.53{+-}4.06 and 3.46{+-}2.21 at inspiration and 4.45{+-}4.23 and 4.76{+-}3.73 at expiration. Intraobserver variability showed no significant differences either in patients or in healthy subjects. Reproducibility was significantly lower at a self-chosen breath-hold level of the healthy volunteers. DMRI is able to differentiate stability and reproducibility of different breath-hold levels. Expiratory breath-hold proved to be more stable than inspiratory breath-hold in healthy volunteers and patients. (orig.)

  13. Cine spatial modulation of magnetization imaging of heart wall motion

    International Nuclear Information System (INIS)

    Cardiac-synchronized spatial modulation of magnetization (SPAMM) produces tagging stripes that move with the heart wall on MR images. Retrospectively gated rapid gradient-echo imaging (cine) permits the use of shorter imaging times than conventional spin-echo imaging but poses the problem of synchronizing the tagging with the heart cycle. The cardiac trigger permits production of SPAMM tags very close in time to the onset of systole, although there may be some residual jitter in the timing. A side benefit of cine SPAMM imaging is prolonged persistence of the tagging stripes, permitting evaluation of motion through more phases of the heart cycle

  14. Evaluation of aortic regurgitation using cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (MRI) was used to assess aortic regurgitation (AR) in 13 patients with valvular disease and 3 normal subjects, and the results were compared to color Doppler flow mapping findings. AR produced a signal void in the left ventricle during the diastolic phase in all patients by MRI. There were no false positive or negative results compared with echocardiographic findings. Visual grading of cine MRI gave results similar to color flow Doppler echocardiography (88%). The distance and the area of aortic regurgitation using MRI correlated well with color Doppler flow mapping (r=0.82 and 0.88). However, measurements of distance and area by color flow Doppler tended to be larger than those by cine MRI. With current techniques echocardiography may overestimate the severity of AR as compared with cine MRI. In addition, MRI gives clinically useful information in patients in whom transthoracic Doppler echocardiography is not adequate. (author)

  15. A comparison of the physiological responses to underwater arm cranking and breath holding between synchronized swimmers and breath holding untrained women.

    Science.gov (United States)

    Alentejano, Teresa C; Bell, Gordon J; Marshall, Dru

    2012-05-01

    Exercise and breath holding in the water such as that performed in the sport of synchronized swimming may evoke the physiological consequences of the diving response. The purpose of this study was to investigate the physiological responses of breath holding during underwater arm cranking in synchronized swimmers who are trained in breath holding and compare these responses to untrained women. Each participant performed 6 breath holding periods in the water (2 × 10s, 2 × 20s and 2 × 25s) with 2 minutes of normal breathing in between, in either an ascending or descending order while performing arm crank exercise. The intensity of arm crank exercise was set below the individual ventilatory threshold. Both synchronized swimmers and controls were matched on sitting height and then randomly divided into 2 groups: one group started breath holding with the longest (25s) breath holding periods while the other group began breath holding with the shortest (10s) breath holding periods. The synchronized swimmers experienced a significant decrease in heart rate while breath holding for 20 and 25s but the changes in heart rate for the control group was not consistent between subgroups. Full recovery from breath holding was identified for minute ventilation after 25s of recovery from breath holding for all groups. Results suggest synchronized swimmers exhibited a better adaptation to breath holding while exercising underwater. PMID:23487567

  16. Reproducibility of diaphragm position assessed with a voluntary breath-holding device

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the reproducibility of diaphragm position in our new breath-holding radiotherapy for abdominal tumors using image-guided radiation therapy (IGRT) and a voluntary breath-holding device, Abches. Patients treated with abdominal tumors using IGRT with Abches were enrolled. Twenty patients without dementia or severe lung disease were analyzed. Each fraction of all patients was set up with kV cone-beam CT with reference to the vertebral bodies. Before daily treatment, electronic portal imaging device (EPID) images of the diaphragm at breath-holding exhale phase were acquired. The difference in the diaphragm position relative to the vertebral body was analyzed by comparing EPID images and the digitally reconstructed radiograph of the planning CT. We evaluated the reproducibility of two axes: superior-inferior (S-I) and right-left (R-L) with the EPID measurements. The 443 irradiation data sets were analyzed. The interfractional reproducibility of the diaphragm relative to vertebral bodies was 1.7±1.4 mm in the S-I and 1.4±1.2 mm in the R-L direction. This technique has good interfractional reproducibility and visibility of the diaphragm during irradiation. Its use is feasible in the routine clinical setting and irradiation. (author)

  17. The physiology and pathophysiology of human breath-hold diving.

    Science.gov (United States)

    Lindholm, Peter; Lundgren, Claes E G

    2009-01-01

    This is a brief overview of physiological reactions, limitations, and pathophysiological mechanisms associated with human breath-hold diving. Breath-hold duration and ability to withstand compression at depth are the two main challenges that have been overcome to an amazing degree as evidenced by the current world records in breath-hold duration at 10:12 min and depth of 214 m. The quest for even further performance enhancements continues among competitive breath-hold divers, even if absolute physiological limits are being approached as indicated by findings of pulmonary edema and alveolar hemorrhage postdive. However, a remarkable, and so far poorly understood, variation in individual disposition for such problems exists. Mortality connected with breath-hold diving is primarily concentrated to less well-trained recreational divers and competitive spearfishermen who fall victim to hypoxia. Particularly vulnerable are probably also individuals with preexisting cardiac problems and possibly, essentially healthy divers who may have suffered severe alternobaric vertigo as a complication to inadequate pressure equilibration of the middle ears. The specific topics discussed include the diving response and its expression by the cardiovascular system, which exhibits hypertension, bradycardia, oxygen conservation, arrhythmias, and contraction of the spleen. The respiratory system is challenged by compression of the lungs with barotrauma of descent, intrapulmonary hemorrhage, edema, and the effects of glossopharyngeal insufflation and exsufflation. Various mechanisms associated with hypoxia and loss of consciousness are discussed, including hyperventilation, ascent blackout, fasting, and excessive postexercise O(2) consumption. The potential for high nitrogen pressure in the lungs to cause decompression sickness and N(2) narcosis is also illuminated. PMID:18974367

  18. Cine magnetic resonance imaging in congenital heart disease

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (MRI) was performed in 33 patients aged 19 days to 18 years (mean 5.1 years), who had congenital heart disease comfirmed at echocardiography or angiography. Prior to cine MRI, gated MRI with spin echo (SE) sequence was perfomed to evaluate cardiac structure. Cine MRI was demonstrated by fast low fip angle shot imaging technique with a 30 deg flip angle, 15 msec echo time, 30∼40 msec pulse repetition time, and 128X128 acquisition matrix. Abnormalities of cardiac structure were extremely well defined in all patients. Intracardiac and intravasucular blood flow were visualized with high signal intensity area, whereas ventricular filling flow and left to right shunt flow through ventricular septal defect and atrial septal defect were visualized with low signal intensity area. However, in the patients who had severe congestive heart failure or respiratory arrhythmia, the good recording of cine MRI was not obtained because of artifacts. Gated MRI with SE sequence provides excellent visualization of fine structures, and cine MRI can provide high spatial resolution imaging of flow dynamic in a variety of congenital heart disease, noninvasively. (author)

  19. Magnetic resonance (MR) cine imaging of the human heart

    Energy Technology Data Exchange (ETDEWEB)

    Waterton, J.C. (Imperial Chemical Industries Ltd., Macclesfield (UK). Pharmaceuticals Div.); Jenkins, J.P.R.; Zhu, X.P.; Love, H.G.; Isherwood, I.; Rowlands, D.J. (Manchester Univ. (UK))

    1985-08-01

    A novel approach has been developed for MR cine imaging of the human heart by a modified ECG-gated 2DFT method. A pulse sequence has been devised to minimise the effects of saturation which can be anticipated in sequences that require rapid pulsing. Five frames are produced at the same anatomical level at predetermined intervals during the cardiac cycle. The total time taken to achieve this data is 8 minutes. Additional frames can be interleaved by repeating the sequence with an ECG-gated delay. The anatomical sections, which can be in any orthogonal plane, are then displayed as a cine loop. Cine display in the coronal plane has been used to examine 10 volunteers and 12 patients. In addition to the morphological feature displayed in single slice ECG-gated imaging, areas of dyskinesia can be detected and subjective estimates have been made of left ventricular function.

  20. Cine MR imaging-current use in cardiac diagnosis

    International Nuclear Information System (INIS)

    This paper reviews the current status of cine MR imaging of the heart with special attention to the assessment of cardiac function. Cine MR provides tomographic sectional images with clear distinction between myocardium and flowing blood, and allows accurate volumetry of the cardiac chambers at specific points of the cardiac cycle. From these volume measurements parameters for the cardiac function, such as stroke volumem, ejection fraction, regurgitant fraction and shunt volum are calculated. While determination of chamber volumes can be done using any imaging plane, regional wall motion and wall thickening are evaluated with the short axis images. These images are readily obtained by orienting the slice selective gradient perpendicular to the long axis of the left ventricle. Left ventricular meridional wall stress is also calculated from cine MR images and noninvasive measurements of peak- and end-systolic pressure. Wall stress is an indicator of myocardial function in response to after load and can be used for monitoring patients with myocardial disease, regurgitant valvular disease and hypertension, and might be used to quantitatively assess the response of these diseases to therapy. Diseases causing hypertrophy of the ventricles, such as valvular stenosis, systemic or pulmonary hypertension and hypertrophic cardiomyopathy, can be monitored with cine MR by measuring the myocardial mass. A signal void from high velocity jets is caused by regurgitant or stenotic valvular lesion as well as flow across ventricular or atrial septal defects. Measurement of the dimension of the signal void have been correlated with the severity of regurgitation and can be used for semi-quantitation of these lesions. Due to the inherent contrast between blood and myocardium, high temporal resolution, and acquisition of tomographic images encompassing the entire heart, cine MR can serve as a comprehensive cardiac imaging modality that provides quantitative evaluation of anatomy and

  1. Clinical and Laboratory Findings of Patients with Breath Holding Spells

    Directory of Open Access Journals (Sweden)

    Özlem Özdemir

    2009-09-01

    Full Text Available Aim: The aim of this prospective study was to evaluate the clinical characteristics; physical findings, cardiological, hematological and neurological problems; treatment approaches; and the prognosis of children with breath holding spells.Materials and Method: Seventhy patients were included in this study. All patients were evaluated with detailed history and physical examination. Complete blood count, serum iron and iron binding capacity were studied; cardiological (telecardiography, electrocardiography, if necessary echocardiography and event recorder and neurological investigations (electroencephalography were done during the admission. Patients with iron deficiency anemia and iron deficiency were treated with ferrous sulphate orally. In patients with normal hematological values, no medication was used. After a two-month treatment period patients underwent control hematological evaluation. Frequency of the spells, age of disappearance of spells (defined as 6 months without spells, disappearance ratios between the three groups were compared. Results: The percentage of cyanotic, palloric and mixt type of breath holding spells of 70 patients included in the study were 67.1, 14.3 and 18.6, respectively. It was determined that psychogenic factors played a role in 77.1% of our patients. There were iron deficiency anemia in 39 (55.7%, iron deficiency in 12 (17.2% and normal hematological parameters in 19 (27.1% of 70 patients. The QTc values were normal in all of them. EEG’s were normal in 56 (80%, dysrhythmic in 11 (15.7% and pathologic in (4.3%. There was a positive family history of breath holding spells in 44.3% of those with breath holding spells. Conclusion: We determined that there was a correlation between the iron levels and the frequency of spells. The lower the iron levels the higher the frequency of spells. There was a dramatic decrease of 92% in spells with low doses of iron supplementation especially in the anemic group. (Journal of

  2. Clinical and Laboratory Findings of Patients with Breath Holding Spells

    OpenAIRE

    Özlem Özdemir; Serpil Çalışkan Can; Evren Semizel; Mehmet S. Okan

    2009-01-01

    Aim: The aim of this prospective study was to evaluate the clinical characteristics; physical findings, cardiological, hematological and neurological problems; treatment approaches; and the prognosis of children with breath holding spells.Materials and Method: Seventhy patients were included in this study. All patients were evaluated with detailed history and physical examination. Complete blood count, serum iron and iron binding capacity were studied; cardiological (telecardiography, electro...

  3. A Comparison of the Physiological Responses to Underwater Arm Cranking and Breath Holding Between Synchronized Swimmers and Breath Holding Untrained Women

    OpenAIRE

    Alentejano, Teresa C.; Bell, Gordon J; Marshall, Dru

    2012-01-01

    Exercise and breath holding in the water such as that performed in the sport of synchronized swimming may evoke the physiological consequences of the diving response. The purpose of this study was to investigate the physiological responses of breath holding during underwater arm cranking in synchronized swimmers who are trained in breath holding and compare these responses to untrained women. Each participant performed 6 breath holding periods in the water (2 × 10s, 2 × 20s and 2 × 25s) with ...

  4. Image processing in cine-scintigraphy. Organization of the CINE 200 system

    International Nuclear Information System (INIS)

    The CINE 200 system, although using a small computer to reduce costs, is shown to be a highly efficient instrument for the processing of scintigraphic images. This was achieved by creating an acquisition and display system branched directly onto the memory, reducing the processing times by the writing of fast micro-programmes, and cutting down the place occupied by the programmes in the live memory by a good organization of these programmes. This internal organization of the system, the insertion and role of the programmes, the data organization and the working procedure are described briefly

  5. Evaluation of mitral regurgitation by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Valvular regurgitation can be detected as a region of signal loss ('flow void') by cardiac cine magnetic resonance (MR) imaging. Cine MR images of 36 patients with mitral regurgitation caused by mitral valve prolapse (MVP) and non-MVP were evaluated and compared with color Doppler flow images. The direction, distance, area and timing of flow void were detected in all patients in several different planes at mitral level with a 0.5 Tesla superconducting magnet by an ECG-gated fast field echo technique. In 23 of the 36 patients contiguous multiple transaxial images were also obtained to calculate the volumes of flow void and the left atrium. The direction of flow void tended to deviate to the opposite side within the left atrium in MVP. The frame showing maximal area of flow void was demonstrated in mid-systole in 24 of the 36 patients (67%). The distance, area and volume of flow void were concordant with the grade from color Doppler flow images. The volumes of flow void and the left atrium correlated (n=19, r=0.74, p<0.05) in MVP. In conclusion, cine MR images in several different planes or contiguous multiple slices are useful in determining spatial orientation and the extent and timing of mitral regurgitation noninvasively. Furthermore, calculation of the volume of flow void enables the assessment of the semiquantitation of mitral regurgitation. (author)

  6. Energy cost and optimisation in breath-hold diving.

    Science.gov (United States)

    Trassinelli, M

    2016-05-01

    We present a new model for calculating locomotion costs in breath-hold divers. Starting from basic mechanics principles, we calculate the work that the diver must provide through propulsion to counterbalance the action of drag, the buoyant force and weight during immersion. Compared to those in previous studies, the model presented here accurately analyses breath-hold divers which alternate active swimming with prolonged glides during the dive (as is the case in mammals). The energy cost of the dive is strongly dependent on these prolonged gliding phases. Here we investigate the length and impacts on energy cost of these glides with respect to the diver characteristics, and compare them with those observed in different breath-hold diving species. Taking into account the basal metabolic rate and chemical energy to propulsion transformation efficiency, we calculate optimal swim velocity and the corresponding total energy cost (including metabolic rate) and compare them with observations. Energy cost is minimised when the diver passes through neutral buoyancy conditions during the dive. This generally implies the presence of prolonged gliding phases in both ascent and descent, where the buoyancy (varying with depth) is best used against the drag, reducing energy cost. This is in agreement with past results (Miller et al., 2012; Sato et al., 2013) where, when the buoyant force is considered constant during the dive, the energy cost was minimised for neutral buoyancy. In particular, our model confirms the good physical adaption of dolphins for diving, compared to other breath-hold diving species which are mostly positively buoyant (penguins for example). The presence of prolonged glides implies a non-trivial dependency of optimal speed on maximal depth of the dive. This extends previous findings (Sato et al., 2010; Watanabe et al., 2011) which found no dependency of optimal speed on dive depth for particular conditions. The energy cost of the dive can be further

  7. BREATH-HOLDING SPELLS: AN ANALYSIS OF 43 CASES

    Directory of Open Access Journals (Sweden)

    M.R. Ashrafi

    2006-10-01

    Full Text Available Objective:Breath holding spells, very often misinterpreted as epileptic seizures,are most common in children aged 6 months to 6 years of age. Inthis investigation, we sought to prospectively document the naturalhistory of breath holding spells (BHS among children with cyanotic,pallid and mixed type BHS referred for neurological consultation.Materials & Methods:This was a cross-sectional study in which a total of 43 children (23boys, 20 girls with BHS, admitted to the out patient clinic of theChildren's Hospital Medical Center, between Sept 1998 and June1999, were enrolled. A structured interview was under taken at thetime of initial consultation to confirm BHS and its type, associatedphenomenon, family history, sex and age at initiation of spells.Laboratory, electroencephalographic and electrocardiographic testswere done.Results:Patients were between 1.7 and 42.8 months (mean age 18.4 months.In 76.8% of cases, BHS began during the first 12 months of age.Anger and pain were the most common triggering factors (65.1 %.A positive family history of BHS was identified in 51% and parentalconsanguinity was found in 30% of cases. The spells were cyanoticin 79.1% (34 children. 78% of cases were iron deficient and 53%of cases had iron deficiency anemia.Conclusion:The results of this study emphasize the role of genetic factors in BHS;measurement of hemoglobin and serum ferritin is recommended allsuch cases

  8. Clinical Efficacy of Piracetam on Breath Holding Spells in Children

    Directory of Open Access Journals (Sweden)

    F. Ashrafzadeh

    2004-07-01

    Full Text Available Breath holding spells (BHS is a type of syncope in children , most commonly encontered in the early years of life. Although these athacks don't damage the brain , if these are frequent or prolonged cause , parents frighten , so physician should intervent. In this study we evaluated clinical efficacy of piracetam on B.H.S of children in Mashhad Ghaem Hospital during 2001-2002.In this double blind placebo control study , piracetam or placebo on a randomized basis was administered to children with 40 mg/kg/day in 2 divided doses for 2 months. From the 41 children that were enrolled , 21 cases received piracetam and 20 cases received placebo. Parents denoted the numbers of spells two months before and two months after taking drug. Control of breath holding spells were observed in 90.5% of patients in the group taking piracetam as compared with 40% in the group taking placebo (P = 0.002. Of the all patients 10 cases had iron deficiency anemia so they had taken elemental Fe too. The side effects were the same in these two groups. The results of this study indicated that piracetam was efficient for the treatment of children with B.H.S without greater incidence adverse effects than placebo.

  9. 自由呼吸扩散加权成像与屏气扩散加权成像在肾脏病变方面的对比研究%Free-Breathing Versus Breath-Hold Diffusion-Weighted MRI of Renal Lesions: Comparison of Image Quality and Apparent Diffusion Coefficient Values

    Institute of Scientific and Technical Information of China (English)

    王海屹; 王佳; 叶慧义; 张旭; 王殿军; 郭爱桃; 钟燕; 王鑫坤

    2011-01-01

    目的 比较肾脏病变自由呼吸扩散加权成像与屏气扩散加权成像在表观弥散系数(ADC)值及图像质量方面的异同.资料与方法 本研究纳入41例经病理结果或临床随访证实患有肾脏疾病的患者.所有患者均在1.5T磁共振扫描仪上进行自由呼吸扩散加权成像及屏气扩散加权成像.两种成像序列方面的参数除激励次数(NEX)之外均相同.两组图像的信噪比(SNR)、对比噪声比(CNR)及相对病变对比度的比较通过Wilcoxon检验进行统计学分析.两组肾实质ADC值及病变ADC值的一致性通过Pearson相关分析及信度分析方法进行分析.结果 自由呼吸扩散加权成像图像的SNR及CNR都显著高于屏气扩散加权成像图像(P<0.01).但两组图像的病变相对对比度差异无统计学意义(P=0.459).两种扩散加权成像方法计算出的肾脏病变ADC值表现出良好的一致性(Pearson相关系数为0.888;信度分析中校正的a系数为0.949,组内相关系数为0.901).两组肾实质ADC值之间亦表现出良好的一致性(Pearson相关系数为0.871;信度分析中校正的a系数为0.931,组内相关系数为0.931).结论 自由呼吸扩散加权成像适用于肾脏病变的评价,特别适用于屏气困难的患者,而且ADC值与屏气扩散加权成像一致性良好.%Purpose To compare free-breathing and breath-hold diffusion-weighted MRI of renal lesions and to assess the coincidence of the apparent diffusion coefficient (ADC) values between the two sequences. Materials and Methods 41 patients were enrolled into this study with 41 renal masses (median diameter, 4.0cm) confirmed by pathology results or follow-up. All patients underwent both free-breathing and breath-hold diffusion-weighted MR imaging (DWI) at a 1.5 T MR system. Both sequences had identical imaging parameters except for signal averages, which were 8 in free-breathing and 2 in breath-hold sequences. Signal-to-noise ratio (SNR) of the kidney

  10. Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer

    OpenAIRE

    Bruzzaniti, Vicente; Abate, Armando; Pinnarò, Paola; D’Andrea, Marco; Infusino, Erminia; Landoni, Valeria; Soriani, Antonella; Giordano, Carolina; Ferraro, Anna Maria; Strigari, Lidia

    2013-01-01

    Background To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB). Methods Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose...

  11. Pneumomediastinum is induced during glossopharyngeal insufflation in breath-hold divers.

    OpenAIRE

    2010-01-01

    In breath-hold diving as in ordinary scuba diving, there are reported incidents of serious neurological symptoms, mimicking cerebral insults. The etiology for the symptoms in breath-hold diving is uncertain. It has been speculated that it may be due to decompression sickness, provided that there is enough nitrogen in tissue to cause supersaturation. However, as far as we are aware of, such venous gas bubbles have not been demonstrated. Neurological symptoms during breath-hold diving may also ...

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

    OpenAIRE

    S.H. TONEKABONI MD; S. Alavi MD; F. Mahvelati MD; Z. TABASI MD

    2009-01-01

    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. The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping

    OpenAIRE

    Babu-Narayan Sonya V; Johansson Bengt; Kilner Philip J

    2009-01-01

    Abstract Background Pulmonary regurgitation is a common and clinically important residual lesion after repair of tetralogy of Fallot. Cardiovascular magnetic resonance (CMR) phase contrast velocity mapping is widely used for measurement of pulmonary regurgitant fraction. Breath-hold acquisitions, usually acquired during held expiration, are more convenient than the non-breath-hold approach, but we hypothesized that breath-holding might affect the amount of pulmonary regurgitation. Methods For...

  14. Breath-hold times in patients undergoing radiological examinations: comparison of expiration and inspiration with and without hyperventilation: primerjava časov po izdihu in po vdihu z ali brez hiperventilacije: Zadrževanje diha pri bolnikih, ki so radiološko preiskovani:

    OpenAIRE

    Groell, Reinhard; Schaffler, Gottfried J; Schloffer, Stephan

    2001-01-01

    Background: Breath-holding is necessary for imaging studies of the thorax and abdomen using computed tomography, magnetic resonance imaging or ultrasound examinations. The purpose of this study was to compare the breath-hold times in expiration and inspiration and to evaluate the effects of hyperventilation.Patients and methods. Thirty patients and 19 healthy volunteers participated in this study after informed consent was obtained in all. The breath-hold times were measured in expiration and...

  15. Longitudinal study of a mouse model of chronic pulmonary inflammation using breath hold gated micro-CT

    International Nuclear Information System (INIS)

    To evaluate the feasibility of using automatic quantitative analysis of breath hold gated micro-CT images to detect and monitor disease in a mouse model of chronic pulmonary inflammation, and to compare image-based measurements with pulmonary function tests and histomorphometry. Forty-nine A/J mice were used, divided into control and inflammation groups. Chronic inflammation was induced by silica aspiration. Fourteen animals were imaged at baseline, and 4, 14, and 34 weeks after silica aspiration, using micro-CT synchronized with ventilator-induced breath holds. Lung input impedance was measured as well using forced oscillation techniques. Five additional animals from each group were killed after micro-CT for comparison with histomorphometry. At all time points, micro-CT measurements show statistically significant differences between the two groups, while first differences in functional test parameters appear at 14 weeks. Micro-CT measurements correlate well with histomorphometry and discriminate diseased and healthy groups better than functional tests. Longitudinal studies using breath hold gated micro-CT are feasible on the silica-induced model of chronic pulmonary inflammation, and automatic measurements from micro-CT images correlate well with histomorphometry, being more sensitive than functional tests to detect lung damage in this model. (orig.)

  16. Contrast-enhanced 3D MR angiography of the chest and abdomen with breath-holding using phase reordering

    International Nuclear Information System (INIS)

    This report presents the feasibility of phase-reordered contrast-enhanced three-dimensional MR angiography in 32 consecutive patients with vascular abnormalities in the chest and abdomen. To suppress motion artifacts due to respiratory corruption, a phase-reordering technique was introduced so that the low frequency components of the phase data were obtained first during the imaging period. Image quality and degree of motion suppression were assessed by four radiologists independently without information on breath-holding time. Abnormalities were detected in 30 cases (93.8%), and their extent was correctly assessed in 28 cases (87.5%). More confident assessment was possible in abnormalities of the pulmonary vessels and thoracic aorta than in those of the abdominal aorta and portal venous system. With phase reordering, more than 20 seconds of breath-holding ensured image quality sufficient to correctly assess the vascular abnormalities. While this technique is easy and requires only single breath-holding, it can provide excellent MRA without slice-to-slice spatial misregistration. (author)

  17. Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer

    International Nuclear Information System (INIS)

    To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P < 0.05), except in the CC direction post-treatment. However, no significant correlation was detected between the relative tumor position, the total treatment time and the tumor reproducibility (P > 0.05). Using ABC for single-breath-hold CBCT guidance is an

  18. 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)

  19. 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…

  20. 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

  1. Reduction of respiratory effects on lung PET imaging with respiratory-gated acquisition associated with breath-hold CT; Reduction des effets de la respiration en imagerie TEP pulmonaire par une acquisition synchronisee a la respiration associee a une TDM en apnee

    Energy Technology Data Exchange (ETDEWEB)

    Morvan, J.; El Esper, I.; Saidi, L.; Moullart, V.; Daouk, J.; Fin, L.; Bailly, P.; Meyer, M.E. [Hopital Sud, CHU d' Amiens, Service de Medecine Nucleaire et de Traitement de l' Image Medicale, 80 - Amiens (France)

    2007-12-15

    Respiratory motion causes a spread of lesion uptake over a larger area in Positron Emission Tomography (PET) images for moving structures. When CT images are used for attenuation correction of emission data, this motion may alter the quantization of PET images. We present the clinical results of a respiratory-gated PET processing 'CT-based' method, which aims to improve PET-CT co registration by using an additional breath-hold CT (B.H.-CT). The CT-based protocol consisted in a 10-min List Mode respiratory-gated PET acquisition, followed by an end-expiration B.H.-CT acquisition. During these two examinations, the respiratory signal was recorded continuously. Eleven pulmonary lesions were studied. Patients underwent both a standard clinical PET protocol (free breathing) and the CT-based protocol. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions centroids on PET and CT images. SUV{sub max} (Standardized Uptake Value) and volume variations were also investigated. The CT-based method showed a significant reduction (p = 0.049) of centroid distances (mean relative change versus standard method: 49%). We also noted a higher SUV{sub max} (mean change: 39%). Lesion volumes were significantly lower (p = 0.026) in CT-based PET volumes (mean change: 43%) compared with standard ones. The CT-based method improves PET-CT co registration of pulmonary lesions. This protocol should lead to more accurate attenuation correction and thus improve S.U.V. measurement.

  2. Improving intra-fractional target position accuracy using a 3D surface surrogate for left breast irradiation using the respiratory-gated deep-inspiration breath-hold technique.

    Directory of Open Access Journals (Sweden)

    Yi Rong

    Full Text Available PURPOSE: To evaluate the use of 3D optical surface imaging as a surrogate for respiratory gated deep-inspiration breath-hold (DIBH for left breast irradiation. MATERIAL AND METHODS: Patients with left-sided breast cancer treated with lumpectomy or mastectomy were selected as candidates for DIBH treatment for their external beam radiation therapy. Treatment plans were created on both free breathing (FB and DIBH computed tomography (CT simulation scans to determine dosimetric benefits from DIBH. 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 CT scans were generated and transferred to the "AlignRT" system for patient positioning and real-time treatment monitoring. MV Cine images were acquired during treatment 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 using DIBH for left breast/chest wall radiation. RPM was shown to have inferior correlation with the actual target position, as determined by the MV Cine imaging. Therefore, RPM alone may not be an adequate surrogate in defining the breath-hold level. Alternatively, the AlignRT surface imaging demonstrated a superior correlation with the actual target positioning during DIBH. Both the vertical and magnitude real-time deltas (RTDs reported by AlignRT can be used as the gating parameter, with a recommended threshold of ±3 mm and 5 mm, respectively. CONCLUSION: The RPM system alone may not be sufficient for the required level of accuracy in left-sided breast/CW DIBH treatments. The 3D surface imaging can be used to ensure patient setup and monitor inter- and intra- fractional motions

  3. Role of cerebral blood flow in extreme breath holding

    Directory of Open Access Journals (Sweden)

    Bain Anthony R.

    2016-01-01

    Full Text Available The role of cerebral blood flow (CBF on a maximal breath-hold (BH in ultra-elite divers was examined. Divers (n = 7 performed one control BH, and one BH following oral administration of the non-selective cyclooxygenase inhibitor indomethacin (1.2 mg/kg. Arterial blood gases and CBF were measured prior to (baseline, and at BH termination. Compared to control, indomethacin reduced baseline CBF and cerebral delivery of oxygen (CDO2 by about 26% (p < 0.01. Indomethacin reduced maximal BH time from 339 ± 51 to 319 ± 57 seconds (p = 0.04. In both conditions, the CDO2 remained unchanged from baseline to the termination of apnea. At BH termination, arterial oxygen tension was higher following oral administration of indomethacin compared to control (4.05 ± 0.45 vs. 3.44 ± 0.32 kPa. The absolute increase in CBF from baseline to the termination of apnea was lower with indomethacin (p = 0.01. These findings indicate that the impact of CBF on maximal BH time is likely attributable to its influence on cerebral H+ washout, and therefore central chemoreceptive drive to breathe, rather than to CDO2.

  4. 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. PMID:26528793

  5. Phase-gated cine cardiovascular MR imaging without electrocardiography

    International Nuclear Information System (INIS)

    Cine cardiovascular MR imaging remains dependent on adequate electrocardiographic (ECG) recordings, often in the setting of arrhythmia, decreased R waves, and/or artifactual waves. The authors employed a gating strategy based on phase changes from cardiac motion (phase gating). With incorporation of an additional section or echo for monitoring such motion-related phase changes during constant phase encoding, imaging and timing data were obtained simultaneously. Following noise filtering, a search algorithm located regular phase perturbations in the timing data related to cardiac cycles. The resulting artificial ECG signals were then used in a standard retrospective gating scheme. This strategy has been used to study acquired and congenital cardiovascular abnormalities. The phase-gated images have resembled those from prospective and retrospective ECG-referenced strategies

  6. 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

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

    International Nuclear Information System (INIS)

    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

  8. 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

  9. MR cholangiopancreatography: prospective comparison of a breath-hold 2D projection technique with diagnostic ERCP

    Energy Technology Data Exchange (ETDEWEB)

    Lomas, D.J.; Bearcroft, P.W.P.; Gimson, A.E. [University Department of Radiology, Addenbrooke Hospital, Cambridge (United Kingdom)

    1999-09-01

    The aim of this study was to compare prospectively a breath-hold projection magnetic resonance cholangiopancreatography (MRCP) technique with diagnostic endoscopic retrograde cholangiopancreatography (ERCP). Seventy-six patients with suspected strictures or choledocholithiasis were referred for MRCP and subsequent ERCP examination, which were performed within 4 h of each other. The MRCP technique was performed using fat-suppressed rapid acquisition with relaxation enhancement (RARE) projection images obtained in standardised planes with additional targeted projections as required by the supervising radiologist. Two radiologists (in consensus) assessed the MRCP results prospectively and independently for the presence of bile duct calculi, strictures, non-specific biliary dilatation and pancreatic duct dilatation, and recorded a single primary diagnosis. The ERCP was assessed prospectively and independently by a single endoscopist and used as a gold standard for comparison with MRCP. Diagnostic agreement was assessed by the Kappa statistic. The MRCP technique failed in two patients and ERCP in five. In the remaining 69 referrals ERCP demonstrated normal findings in 23 cases, strictures in 19 cases, choledocholithiasis in 9 cases, non-specific biliary dilatation in 14 cases and chronic pancreatitis in 4 cases. The MRCP technique correctly demonstrated 22 of 23 normal cases, 19 strictures with one false positive (sensitivity 100 %, specificity 98 %), all 9 cases of choledocholithiasis with two false positives (sensitivity 100 %, specificity 97 %), 12 of 14 cases of non-specific biliary dilatation and only 1 of 4 cases of chronic pancreatitis. There was overall good agreement for diagnosis based on a kappa value of 0.88. Breath-hold projection MRCP can provide non-invasively comparable diagnostic information to diagnostic ERCP for suspected choledocholithiasis and biliary strictures and may allow more selective use of therapeutic ERCP. (orig.) With 6 figs., 1 tab., 20

  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. High-pitch coronary CT angiography in dual-source CT during free breathing vs. breath holding in patients with low heart rates

    International Nuclear Information System (INIS)

    Background: Coronary CT angiography (CCTA) is usually performed during breath holding to reduce motion artifacts caused by respiration. However, some patients are not able to follow the breathing commands adequately due to deafness, hearing impairment, agitation or pulmonary diseases. The aim of this study was to evaluate the potential of high-pitch CCTA in free breathing patients when compared to breath holding patients. Methods: In this study we evaluated 40 patients (20 free breathing and 20 breath holding patients) with a heart rate of 60 bpm or below referred for CCTA who were examined on a 2nd generation dual-source CT system. Image quality of each coronary artery segment was rated using a 4-point grading scale (1: non diagnostic–4: excellent). Results: Mean heart rate during image acquisition was 52 ±5 bpm in both groups. There was no significant difference in mean image quality, slightly favoring image acquisition during breath holding (mean image quality score 3.76 ± 0.32 in breath holding patients vs. 3.61 ± 0.45 in free breathing patients; p = 0.411). Due to a smaller amount of injected contrast medium, there was a trend for signal intensity to be slightly lower in free breathing patients, but this was not statistically significant (435 ± 123 HU vs. 473 ± 117 HU; p = 0.648). Conclusion: In patients with a low heart rate who are not able to hold their breath adequately, CCTA can also be acquired during free breathing without substantial loss of image quality when using a high pitch scan mode in 2nd generation dual-source CT

  12. High-pitch coronary CT angiography in dual-source CT during free breathing vs. breath holding in patients with low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Bischoff, Bernhard, E-mail: bernhard.bischoff@med.uni-muenchen.de [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Meinel, Felix G. [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Del Prete, Alessandra [Department of Radiology Magrassi-Lanzara, Second University of Naples, Naples (Italy); Reiser, Maximilian F.; Becker, Hans-Christoph [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany)

    2013-12-01

    Background: Coronary CT angiography (CCTA) is usually performed during breath holding to reduce motion artifacts caused by respiration. However, some patients are not able to follow the breathing commands adequately due to deafness, hearing impairment, agitation or pulmonary diseases. The aim of this study was to evaluate the potential of high-pitch CCTA in free breathing patients when compared to breath holding patients. Methods: In this study we evaluated 40 patients (20 free breathing and 20 breath holding patients) with a heart rate of 60 bpm or below referred for CCTA who were examined on a 2nd generation dual-source CT system. Image quality of each coronary artery segment was rated using a 4-point grading scale (1: non diagnostic–4: excellent). Results: Mean heart rate during image acquisition was 52 ±5 bpm in both groups. There was no significant difference in mean image quality, slightly favoring image acquisition during breath holding (mean image quality score 3.76 ± 0.32 in breath holding patients vs. 3.61 ± 0.45 in free breathing patients; p = 0.411). Due to a smaller amount of injected contrast medium, there was a trend for signal intensity to be slightly lower in free breathing patients, but this was not statistically significant (435 ± 123 HU vs. 473 ± 117 HU; p = 0.648). Conclusion: In patients with a low heart rate who are not able to hold their breath adequately, CCTA can also be acquired during free breathing without substantial loss of image quality when using a high pitch scan mode in 2nd generation dual-source CT.

  13. Cine magnetic resonance imaging for evaluation of cardiac structure and flow dynamics in congenital heart disease

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (Cine MRI) was performed in 20 patients aged 19 days to 13 years (mean 4.0 years), who had congenital heart disease confirmed at echocardiography or angiography. Prior to cine MRI, gated MRI was performed to evaluate for cardiac structure. Cine MRI was demonstrated by fast low fip angle shot imaging technique with a 30deg flip angle, 15 msec echo time, 30-40 msec pulse repetition time, and 128 x 128 acquisition matrix. Abnormalities of cardiac structure were extremely well defined in all patients by gated MRI. Intracardiac or intravascular blood flow were visualized in 17 (85%) of 20 patients by cine MRI. Left to right shunt flow through ventricular septal defect, atrial septal defect, and endocardial cushion defect were visualized with low signal intensity area. Low intensity jets flow through the site of re-coarctation of the aorta were also visualized. However, the good recording of cine MRI was not obtained because of artifacts in 3 of 20 patients (15%) who had severe congestive heart failure or respiratory arrhythmia. Gated MRI provides excellent visualization of fine structure, and cine MRI can provide high spatial resolution imaging of flow dynamic in a variety of congenital heart disease, noninvasively. (author)

  14. The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping

    Directory of Open Access Journals (Sweden)

    Babu-Narayan Sonya V

    2009-01-01

    Full Text Available Abstract Background Pulmonary regurgitation is a common and clinically important residual lesion after repair of tetralogy of Fallot. Cardiovascular magnetic resonance (CMR phase contrast velocity mapping is widely used for measurement of pulmonary regurgitant fraction. Breath-hold acquisitions, usually acquired during held expiration, are more convenient than the non-breath-hold approach, but we hypothesized that breath-holding might affect the amount of pulmonary regurgitation. Methods Forty-three adult patients with a previous repair of tetralogy of Fallot and residual pulmonary regurgitation were investigated with CMR. In each, pulmonary regurgitant fraction was measured from velocity maps transecting the pulmonary trunk, acquired during held expiration, held inspiration, by non-breath-hold acquisition, and also from the difference of right and left ventricular stroke volume measurements. Results Pulmonary regurgitant fraction was lower when measured by velocity mapping in held expiration compared with held inspiration, non-breath-hold or stroke volume difference (30.8 vs. 37.0, 35.6, 35.4%, p = 0.00017, 0.0035, 0.026. The regurgitant volume was lower in held expiration than in held inspiration (41.9 vs. 48.3, p = 0.0018. Pulmonary forward flow volume was larger during held expiration than during non-breath-hold (132 vs. 124 ml, p = 0.0024. Conclusion Pulmonary regurgitant fraction was significantly lower in held expiration compared with held inspiration, free breathing and stroke volume difference. Altered airway pressure could be a contributory factor. This information is relevant if breath-hold acquisition is to be substituted for non-breath-hold in the investigation of patients with a view to re-intervention.

  15. CT scans of the hypopharynx and larynx during inspiration, expiration, breath holding and phonation

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Naoko; Anno, Hirofumi; Ito, Tsuyoshi; Ohashi, Ichiro; Takahashi, Masaki; Koga, Sukehiko; Iwata, Sigenobu; Ikuta, Katsumi

    1988-11-01

    CT scans of the hypopharynx and larynx during inspiration, expiration, breath holding and phonation of the letter E were performed on seven volunteers. Two mm contiguous scans were obtained to span the glottis and supraglottic area. The vocal cords were shown in the paramedian or median position on breath holding and phonation. The ditails of the arytenoid cartilages were better visualized with thin slices. The laryngeal ventricles were demonstrable on phonation scans.

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

    OpenAIRE

    Cristiane Diniz; Tiago Farias; Mayane Pereira; Caio Pires; Luciana Gonçalves; Patrícia Coertjens; Marcelo Coertjens

    2014-01-01

    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 ...

  17. CT scans of the hypopharynx and larynx during inspiration, expiration, breath holding and phonation

    International Nuclear Information System (INIS)

    CT scans of the hypopharynx and larynx during inspiration, expiration, breath holding and phonation of the letter E were performed on seven volunteers. Two mm contiguous scans were obtained to span the glottis and supraglottic area. The vocal cords were shown in the paramedian or median position on breath holding and phonation. The ditails of the arytenoid cartilages were better visualized with thin slices. The laryngeal ventricles were demonstrable on phonation scans. (author)

  18. Cine magnetic resonance imaging in hypertrophic cardiomyopathy. Evaluation of left ventricular wall thickness and systolic function

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (MRI) was performed on 21 patients with hypertrophic cardiomyopathy and left ventricular (LV) regional systolic function was quantitatively evaluated. The visual evaluation of hypertrophic regions and the motion patterns of their walls on cine MR images was possible in most cases. However, this evaluation was subjective and a quantitative analysis was difficult. Septal and posterior wall thickness measured on cine MRI correlated well with those obtained by ultrasound cardiogram (UCG). There was also a good correlation between % thickness of LV wall and its thickness at end diastolic phase. Comparison of % thickness between normal subjects and hypertrophic cardiomyopathies showed a tendency of it being less at the region of more severe hypertrophic change. We conclude that cine MRI is a useful means to analyse the anatomical feature and functional change in hypertrophic cardiomyopathy. (author)

  19. Lack of Correlation Between External Fiducial Positions and Internal Tumor Positions During Breath-Hold CT

    International Nuclear Information System (INIS)

    Purpose: For thoracic tumors, if four-dimensional computed tomography (4DCT) is unavailable, the internal margin can be estimated by use of breath-hold (BH) CT scans acquired at end inspiration (EI) and end expiration (EE). By use of external surrogates for tumor position, BH accuracy is estimated by minimizing the difference between respiratory extrema BH and mean equivalent-phase free breathing (FB) positions. We tested the assumption that an external surrogate for BH accuracy correlates with internal tumor positional accuracy during BH CT. Methods and Materials: In 16 lung cancer patients, 4DCT images, as well as BH CT images at EI and EE, were acquired. Absolute differences between BH and mean equivalent-phase (FB) positions were calculated for both external fiducials and gross tumor volume (GTV) centroids as metrics of external and internal BH accuracy, respectively, and the results were correlated. Results: At EI, the absolute difference between mean FB and BH fiducial displacement correlated poorly with the absolute difference between FB and BH GTV centroid positions on CT images (R2 = 0.11). Similarly, at EE, the absolute difference between mean FB and BH fiducial displacements correlated poorly with the absolute difference between FB and BH GTV centroid positions on CT images (R2 = 0.18). Conclusions: External surrogates for tumor position are not an accurate metric of BH accuracy for lung cancer patients. This implies that care should be taken when using such an approach because an incorrect internal margin could be generated.

  20. Effects of Incentive Spirometry on Respiratory Motion in Healthy Subjects Using Cine Breathing Magnetic Resonance Imaging

    OpenAIRE

    Kotani, Toshiaki; Akazawa, Tsutomu; Sakuma, Tsuyoshi; Nagaya, Shigeyuki; Sonoda, Masaru; Tanaka, Yuji; Katogi, Takehide; Nemoto, Tetsuharu; Minami, Shohei

    2015-01-01

    Objective To investigate the effectiveness of incentive spirometry on respiratory motion in healthy subjects using cine breathing magnetic resonance imaging (MRI). Methods Ten non-smoking healthy subjects without any history of respiratory disease were studied. Subjects were asked to perform pulmonary training using incentive spirometry every day for two weeks. To assess the effectiveness of this training, pulmonary function tests and cine breathing MRI were performed before starting pulmonar...

  1. A hybrid breath hold and continued respiration-triggered technique for time-resolved 3D MRI perfusion studies in lung cancer

    International Nuclear Information System (INIS)

    Assessment of lung cancer perfusion is impaired by respiratory motion. Imaging times for contrast agent wash-out studies often exceed breath hold capabilities, and respiration triggering reduces temporal resolution. Temporally resolved volume acquisition of entire tumors is required to assess heterogeneity. Therefore, we developed and evaluated an MR measurement technique that exceeds a single breath hold, and provides a variable temporal resolution during acquisition while suspending breath-dependent motion. 20 patients with suspected lung cancer were subjected to perfusion studies using a spoiled 3D gradient echo sequence after bolus injection of 0.07 mmol/kg body weight of Gd-DTPA. 10 acquisitions in expiratory breath hold were followed by 50 navigator-triggered acquisitions under free breathing. Post-processing allowed for co-registration of the 3D data sets. An ROI-based visualization of the signal-time curves was performed. In all cases motion-suspended, time-resolved volume data sets (40 x 33 x 10 cm3, voxel size: 2.1 x 2.1 x 5.0 mm3) were generated with a variable, initially high temporal resolution (2.25 sec) that was synchronized with the breath pattern and covered up to 8(1)/(2) min. In 7 / 20 cases a remaining offset could be reduced by rigid co-registration. The tumors showed fast wash-in, followed by rapid signal decay (8 / 20) or a plateau. The feasibility of a perfusion study with hybrid breath hold and navigator-triggered time-resolved 3D MRI which combines high initial temporal resolution during breath hold with a long wash-out period under free breathing was demonstrated. (orig.)

  2. Evaluation of valvular regurgitation by cine magnetic resonance imaging (0.5 T)

    International Nuclear Information System (INIS)

    The usefulness of cine magnetic resonance imaging (MRI) as a method for the quantification of valvular regurgitation was studied. Cine MRI (0.5 T) was performed by using gradient echo technique in 29 patients with various valvular regurgitation (13 mitral regurgitation, 9 aortic regurgitation, 7 tricuspid regurgitation) and the data were compared with those by Doppler color-flow mapping. A distance of signal loss in cine MRI was compared with that of regurgitant jet in Doppler color-flow mapping. A good correlation between the two methods was noted in each valvular disease (r = 0.989 in mitral regurgitation, r = 0.908 in aortic regurgitation and r = 0.985 in tricuspid regurgitation). Cine MRI, even if 0.5 T, is a useful method of noninvasive quantificaiton of valvular regurgitation. (author)

  3. Evaluation of an interactive breath-hold control system in CT-guided lung biopsy

    International Nuclear Information System (INIS)

    Purpose: In this study we assessed the effect of an interactive breath-hold control system on procedure time and technical success in transthoracic CT-guided lung biopsies. Materials and Methods: in 36 patients (4 female, 32 male, mean age 65 years; range 33 - 88) with a pulmonary nodule, we performed CT-guided biopsy using a 18G Tru-cut needle (Cardinal Health, Dublin, UK) in a 64 row dual-source CT scanner (Somatom Definition, Siemens, Forchheim, Germany) using intermittent imaging of the needle. In half of the patients (2 female, 16 male, mean age 67 years), an interactive breathhold control system (IBC) (Mayo Clinic Medical Devices, USA) was applied. No additional device was used in the control group. Results: the biopsy was visually successful in all patients. The diameter of the target lesion was comparable in both groups (IBC: 30 ± 19 mm; control: 28 ± 15 mm). The number of imaging steps was significantly smaller (p < 0.05) and the intervention time was significantly shorter (p < 0.05) in the IBC group (IBC: 9 ± 5 steps 17 ± 10 min; control: 13 ± 5 steps 26 ± 12 min). Conclusion: application of the IBC unit reduced the intervention time and radiation exposure in CT-guided Tru-cut biopsy of pulmonary nodules. (orig.)

  4. Evaluation of atrial, ventricular and atrioventricular septal defects by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cine magnetic resonance imaging (MRI) was performed on 20 patients (mean age: 5.3±4.4 years) with atrial, ventricular, or atrioventricular septal defects for evaluation of cardiac structure and blood flow. Prior to cine MRI, electrocardiographycally gated MRI using multislice scquisition was performed on all patients to localize optimal slice location. Cine-MRI was obtained with a 30 deg flip angle, 15 msec echo time, and 30 msec pulse repetition time, on a 256 x 256 or 128 x 128 acquisition matrix. Abnormalities of cardiac structure were well defined in all patients by gated cardiac imaging. In 18 of the 20 patients, cine-MRI was able to detect shunt flow, visualized as a low intensity signal in comparison with the surrounding blood flow. Cine-MRI can provide not only accurate anatomy of cardiac structures but functional assessment of the cardiac chamber, wall topology and flow relations. Cine-MRI will become an important noninvasive technique for assessment of anatomy and physiology in congenital heart disease. (author)

  5. SU-E-J-234: Application of a Breathing Motion Model to ViewRay Cine MR Images

    International Nuclear Information System (INIS)

    Purpose: A respiratory motion model previously used to generate breathing-gated CT images was used with cine MR images. Accuracy and predictive ability of the in-plane models were evaluated. Methods: Sagittalplane cine MR images of a patient undergoing treatment on a ViewRay MRI/radiotherapy system were acquired before and during treatment. Images were acquired at 4 frames/second with 3.5 × 3.5 mm resolution and a slice thickness of 5 mm. The first cine frame was deformably registered to following frames. Superior/inferior component of the tumor centroid position was used as a breathing surrogate. Deformation vectors and surrogate measurements were used to determine motion model parameters. Model error was evaluated and subsequent treatment cines were predicted from breathing surrogate data. A simulated CT cine was created by generating breathing-gated volumetric images at 0.25 second intervals along the measured breathing trace, selecting a sagittal slice and downsampling to the resolution of the MR cines. A motion model was built using the first half of the simulated cine data. Model accuracy and error in predicting the remaining frames of the cine were evaluated. Results: Mean difference between model predicted and deformably registered lung tissue positions for the 28 second preview MR cine acquired before treatment was 0.81 +/− 0.30 mm. The model was used to predict two minutes of the subsequent treatment cine with a mean accuracy of 1.59 +/− 0.63 mm. Conclusion: Inplane motion models were built using MR cine images and evaluated for accuracy and ability to predict future respiratory motion from breathing surrogate measurements. Examination of long term predictive ability is ongoing. The technique was applied to simulated CT cines for further validation, and the authors are currently investigating use of in-plane models to update pre-existing volumetric motion models used for generation of breathing-gated CT planning images

  6. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  8. Breath-hold two-dimensional MR angiography of coronary arteries. Comparison with conventional coronary angiography in ten cases

    International Nuclear Information System (INIS)

    Purpose: To assess the diagnostic value of two-dimensional coronary magnetic resonance (MR) angiography in patients evaluated for ischemic heart disease. Materials and methods: Ten patients who underwent selective cardiac catheterization with coronary MR angiography were evaluated with two-dimensional coronary MR angiography. Coronary MR angiography was performed with breath-hold fat-suppressed ECG-gated Turbo-FLASH with K-space segmentation using a 1.5 T imager. Results: The left main coronary artery, proximal left anterior descending artery, circumflex artery and right coronary artery were demonstrated in all cases. Continuous segments (mean) of left anterior descending, circumflex and right coronary arteries visualized on MRA were 6.72 +- 3.16 cm, 3.67 +- 4.81 cm and 7.93 +- 3.12 cm respectively. The overall sensitivity for detection of hemodynamically significant coronary artery lesion (≥50%) was 62.5% respectively. Conclusion: Breath-hold two-dimensional coronary MR angiography was useful in showing relatively long segments of the main coronary arteries and also has potential in depicting hemodynamically significant coronary artery lesions

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

    OpenAIRE

    Nardi Antonio E.; Nascimento Isabella; Valença Alexandre M; Lopes Fabiana L.; Mezzasalma Marco A; Zin Walter A.

    2003-01-01

    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 to...

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

    OpenAIRE

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

    2012-01-01

    How to cite this article:Abbaskhanian A, Ehteshami S, Sajjadi S, Rezai MS. Effects of Piracetam on Pediatric Breath Holding Spells: A Randomized Double Blind Controlled Trial. Iran J Child Neurol Autumn 2012; 6(4): 9-15. Abstarct:Objective Breath holding spells (BHS) are common paroxysmal non-epileptic eventsin the pediatric population which are very stressfull despite their harmlessnature. There has been no specific treatment found for the spells yet. The aimof this study was to evaluate the...

  11. Effect of Dyspnea Induced by Breath-holding on Maximal Muscular Strength of Patients with COPD

    OpenAIRE

    Shingai, Kazuya; Kanezaki, Masashi

    2014-01-01

    [Purpose] The purpose of the present study was to clarify the effect of dyspnea induced by breath-holding on maximum muscular strength of patients with COPD. [Subjects] This study recruited 14 COPD subjects via public posting. [Methods] Dyspnea was assessed by the modified Borg scale. The subject asked to stop breathing at end-expiration and to hold their breath with a nose clip for as long as possible. Both total breath-holding time and threshold time of dyspnea were measured with a chronogr...

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

    International Nuclear Information System (INIS)

    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

  13. 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.

  14. Total Removal of Unwanted Harmonic Peaks (TruHARP) MRI for Single Breath-Hold High-Resolution Myocardial Motion and Strain Quantification

    OpenAIRE

    Agarwal, Harsh K.; Prince, Jerry L.; Abd-Elmoniem, Khaled Z.

    2010-01-01

    Current MRI methods for myocardial motion and strain quantification have limited resolution because of Fourier space spectral peak interference. Methods have been proposed to remove this interference in order to improve resolution; however, these methods are clinically impractical due to the prolonged imaging times. In this paper, we propose total removal of unwanted harmonic peaks (TruHARP); a myocardial motion and strain quantification methodology that uses a novel single breath-hold MR ima...

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

    Directory of Open Access Journals (Sweden)

    Ali ABBASKHANIAN

    2013-01-01

    Full Text Available How to cite this article:Abbaskhanian A, Ehteshami S, Sajjadi S, Rezai MS. Effects of Piracetam on Pediatric Breath Holding Spells: A Randomized Double Blind Controlled Trial. Iran J Child Neurol Autumn 2012; 6(4: 9-15. Abstarct:Objective Breath holding spells (BHS are common paroxysmal non-epileptic eventsin the pediatric population which are very stressfull despite their harmlessnature. There has been no specific treatment found for the spells yet. The aimof this study was to evaluate the efficacy of piracetam (2-oxo-l-pyrrolidineon these children.Materials & MethodsIn this randomized double blind clinical trial study, 150 children with severe BHS referred to our pediatric outpatient service were enrolled from August2011 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 numberof attacks/month before and after treatment were documented.ResultsOf the enrolled patients, 86 were boys. The mean age of the patients was17 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 partialremission. 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 wasd nosignificant difference detected between the groups regarding the prevalenceof drug side effects.ConclusionA significant difference was detected between piracetam and placebo in prevention and controlling BHS. Piracetam (40mg/kg/day had a good effecton our patients. ReferencesDi Mario FJ Jr. Prospective study of children with cyanotic and pallid breath-holding spells. Pediatrics. 2001 Feb;107(2:265-9.Kotagal P, Costa M, Wyllie E, Wolgamuth B. Paroxysmal non epileptic

  16. PET/CT-guided percutaneous liver mass biopsies and ablations: Targeting accuracy of a single 20 s breath-hold PET acquisition

    International Nuclear Information System (INIS)

    Aim: To determine whether a single 20 s breath-hold positron-emission tomography (PET) acquisition obtained during combined PET/computed tomography (CT)-guided percutaneous liver biopsy or ablation procedures has the potential to target 2-[18F]-fluoro-2-deoxy-D-glucose (FDG)-avid liver masses as accurately as up to 180 s breath-hold PET acquisitions. Materials and methods: This retrospective study included 10 adult patients with 13 liver masses who underwent FDG PET/CT-guided percutaneous biopsies (n = 5) or ablations (n = 5). PET was acquired as nine sequential 20 s, monitored, same-level breath-hold frames and CT was acquired in one monitored breath-hold. Twenty, 40, 60, and 180 s PET datasets were reconstructed. Two blinded readers marked tumour centres on randomized PET and CT datasets. Three-dimensional spatial localization differences between PET datasets and either 180 s PET or CT were analysed using multiple regression analyses. Statistical tests were two-sided and p < 0.05 was considered significant. Results: Targeting differences between 20 s PET and 180 s PET ranged from 0.7–20.3 mm (mean 5.3 ± 4.4 mm; median 4.3) and were not statistically different from 40 or 60 s PET (p = 0.74 and 0.91, respectively). Targeting differences between 20 s PET and CT ranged from 1.4–36 mm (mean 9.6 ± 7.1 mm; median 8.2 mm) and were not statistically different from 40, 60, or 180 s PET (p = 0.84, 0.77, and 0.35, respectively). Conclusion: Single 20 s breath-hold PET acquisitions from PET/CT-guided percutaneous liver procedures have the potential to target FDG-avid liver masses with equivalent accuracy to 180 s summed, breath-hold PET acquisitions and may facilitate strategies that improve image registration and shorten procedure times

  17. Effect of repetitive end-inspiration breath holding on very short-term heart rate variability in healthy humans

    International Nuclear Information System (INIS)

    Very short-term heart rate variability (HRV) is thought to reflect dynamic changes in autonomic nervous activity, which is helpful in understanding the role of autonomic nervous function (ANF) in the mechanisms underlying apnea-induced cardiac arrhythmias. The goal of this study was to investigate the effect of repetitive end-inspiration breath holding on very short-term HRV. A total of 32 young healthy participants took part in the experiments. Three trials were performed, each involving seven repetitive end-inspiration breath holding and a 30 s recovery period between breath holding. Durations of breath holding in the three trials were 1:2:3. The study first evaluated the effect of analyzed data lengths on the stability of HRV indices and determined three HRV indices suitable for very short-term analysis. The results showed that in most cases, during breath holding, the square root of the mean squared differences of successive normal RR intervals (rMSSD) was significantly lower, but normalized units of the power in the low frequency band ranging from 0.04 to 0.15 Hz (nLF) and LF/high frequency (HF) were significantly higher than those during corresponding durations under the normal breathing conditions. On the contrary, during recovery after breath holding, rMSSD was significantly higher but nLF and LF/HF were lower than normal. Moreover, the durations of breath holding had no significant influence on the variations of LF/HF. In addition, as participants repeated the breath holding, HRV indices varied non-linearly. HRV changes may indicate sympathetic activation during breath holding and parasympathetic activation during recovery after breath holding. In conjunction with the existing physiological interpretation based on changes in heart rate, the results may imply that breath holding leads to both cardiac sympathetic and parasympathetic activation simultaneously, which may be a possible pathogenic factor of apnea-induced arrhythmias. (paper)

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

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte Bjørnsen Fredberg; Dueck, Jenny;

    2016-01-01

    BACKGROUND AND PURPOSE: Deep inspiration breath hold (DIBH) increases lung volume and can potentially reduce treatment-related toxicity in locally advanced lung cancer. We estimated geometric uncertainties in visually guided voluntary DIBH and derived the appropriate treatment margins for differe...

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

    Directory of Open Access Journals (Sweden)

    S.H. TONEKABONI MD

    2009-05-01

    Full Text Available 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 specifically designed questionnaire requiring information on sex, age, age of onset of spells, type of spells, frequency of attacks before and after treatment with oral iron supplement, and determinants of body iron stores was completed for all the patients, based on the mother's statements. The patients were treated by an oral iron preparation for three months.Results:The age of onset of spells ranged between 6 to 24 months. The cyanotic type of spell was detected in 31 children, the pallid type in 3, and the mixed type in one child. There were 14 children with iron deficiency anemia and 20 children with reduced iron stores. Just one child had a normal iron profile. Complete therapeutic response was documented in 24 children, good response in 9, and poor response in one and in one child no change in frequency of spells was seen.Conclusion:Although no significant therapeutic difference was seen in the different response groups, it seems that iron supplement may play an important role in reducing breath holding spells in children.Keywords:Iron, Breath holding spell, children, Iron deficiency Anemia

  20. Treatment of Chronic Breath-Holding in an Adult with Severe Mental Retardation: A Clinical Case Study

    Science.gov (United States)

    Reed, Derek D.; Martens, Brian K.

    2008-01-01

    We describe a clinical case study surrounding the behavioral assessment and operant treatment of, an adult with severe mental retardation who engaged in chronic breath-holding. In this clinical case, previous neurological and medical testing had ruled out biological bases for the individual's breath-holding. A functional behavioral assessment…

  1. 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…

  2. Evaluation of esophageal peristalsis in patients with esophageal tumors. Initial experience with cine MR imaging

    International Nuclear Information System (INIS)

    We evaluated esophageal peristalsis in patients with esophageal tumors by cine MR using steady-state free precession (SSFP) sequence and correlated the alteration of the esophageal peristalsis with clinical symptoms and tumor stages. Thirteen patients with pathologically proven esophageal tumors, including 12 esophageal cancers and one submucosal leiomyoma, underwent cine MRI using true fast imaging with steady precession (trueFISP) sequence, which is one SSFP sequence, after contrast-enhanced MR scanning for clinical purposes. A total of 120 serial images were obtained within 60 s through the plane along the long axis of the esophagus while patients chewed gum. The serial trueFISP images were evaluated for the presence, frequency, speed of progression, and passage of peristalsis through the tumor. The data from cine MRI were compared with clinical symptoms and tumor stages. Peristalsis was clearly identified in all patients. Seven patients with complete interruption of peristalsis had dysphagia; one with partially impaired peristalsis could intake solid foods with discomfort; and two with partially impaired peristalsis and three with preserved peristalsis remained asymptomatic. Patients with complete or partial interruption of peristalsis had Stage T3 or T4 esophageal cancer. In conclusion, trueFISP cine MR imaging enables direct visualization of esophageal peristalsis in relation to esophageal tumors. Complete interruption of peristalsis causes dysphagia, whereas partial interruption of and preserved peristalsis usually do not cause digestive problems. Interruption of peristalsis may indicate impaired muscle function caused by invasion of advanced esophageal cancers. (author)

  3. Effects of breath holding CT scan during mid-expiration on PET/CT

    International Nuclear Information System (INIS)

    Objective: To study the effects of breath holding during mid-expiration of CT scan on PET/CT and SUV of lung. Methods: From September 2010 to December 2010, 200 patients including 120 males and 80 females (23-87 (55.01± 11.60) years), who underwent 18F-FDG PET/CT studies were included. Patients were randomly divided into 2 groups using random number table. In breath holding (BH) group (52 males, 48 females, age ranging from 29-83 (55.43±10.38) years), all underwent PET/CT studies with BH CT during mid-expiration.In free breath (FB) group (68 males, 32 females, age ranging from 23-87 (55.68± 12.72) years), all underwent PET/CT studies with FB CT. PET/CT images were analyzed by 1 senior technologist and 2 nuclear physicians. Analysis was carried out for the special registration of PET and CT, SUV of lung tissue on the bottom of lung and respiratory motion artifacts of lung on CT scanning. The diaphragmatic dome showed on the same layer of PET and CT was considered as well-registration between CT and PET. Two-sample t test, χ2 test and one-way analysis of variance were used to analyze data. Results: In BH group, 28% (28/100) of expiratory motion artifacts was observed, which was significantly lower than that of FB group (96%, 96/100; χ2=98.132, P<0.01). In BH group, 40% (80/200) was considered well-registration between CT and PET, which was significantly higher than that of FB group (30%, 60/200; χ2=4.396, P<0.05). There were 3 types of registration between CT and PET: location of diaphragm on CT higher than that on PET, matching between PET and CT, location of diaphragm on PET higher than that on CT. SUV in low lung tissue of these different types were increased one by one, with more significant difference found in BH group (SUVmax: 0.73±0.28, 1.00±0.29, 1.60±0.68; SUVmean: 0.59±0.23, 0.81±0.22, 1.33±0.34; F=21.93, 24.57, both P<0.01) than those in FB group (SUVmax: 0.84±0.36, 1.08±0.27, 1.16±0.24; SUVmean: 0.69±0.29, 0.85±0.20, 0.94±0.24; F=7.23, 6

  4. Experience with MR cholangiopancreatography with use of a fast inversion recovery sequence during a single breath-hold period

    Energy Technology Data Exchange (ETDEWEB)

    Shiono, Takahiro [Dokkyo Univ., Saitama (Japan). Koshigaya Hospital

    1997-11-01

    The purpose of this study was to evaluate the single breath-hold fast inversion recovery sequence (FIR) for depicting the biliary tract. A prospective study was performed in 40 patients with suspected diseases in the biliary tract. MRCP (magnetic resonance cholangiopancreatography) including cholecystograms of diagnostic quality was carried out in 35 patients. Impacted common duct stones were able to be distinguished from malignancies because of their characteristic shapes of obstruction in four of five cases. FIR with thick slices can provide a shorter acquisition time and fewer artifacts with better signal to noise ratio and contrast to noise ratio than MIP images obtained by means of gradient echo methods. MRCP with FIR was a useful adjunctive tool for non-invasive evaluation of patients with obstructive jaundice. (author)

  5. In vivo proton MRS of normal pancreas metabolites during breath-holding and free-breathing

    Energy Technology Data Exchange (ETDEWEB)

    Su, T.-H. [Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing (China); Jin, E.-H., E-mail: erhujin1@hotmail.com [Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing (China); Shen, H. [GE China Company Ltd, Healthcare, General Electric Company, Beijing (China); Zhang, Y.; He, W. [Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing (China)

    2012-07-15

    Aim: To characterize normal pancreas metabolites using in vivo proton magnetic resonance spectroscopy ({sup 1}H MRS) at 3 T under conditions of breath-holding and free-breathing. Materials and methods: The pancreases of 32 healthy volunteers were examined using {sup 1}H MRS during breath-holding and free-breathing acquisitions in a single-voxel point-resolved selective spectroscopy sequence (PRESS) technique using a 3 T MRI system. Resonances were compared between paired spectra of the two breathing modes. Furthermore, correlations between lipid (Lip) content and age, body-mass index (BMI), as well as choline (Cho) peak visibility of the normal pancreas were analysed during breath-holding. Results: Twenty-nine pairs of spectra were successfully obtained showing three major resonances, Lip, Cho, cholesterol and the unsaturated parts of the olefinic region of fatty acids (Chol + Unsat). Breath-hold spectra were generally better, with higher signal-to-noise ratios (SNR; Z=-2.646, p = 0.008) and Cho peak visible status (Z=-2.449, p = 0.014). Correlations were significant between spectra acquired by the two breathing modes, especially for Lip height, Lip area, and the area of other peaks at 1.9-4.1 ppm. However, the Lip resonance was significantly different between the spectra of the two breathing modes (p < 0.05). In the breath-holding spectra, there were significant positive correlations between Lip peak height, area, and age (r = 0.491 and 0.521, p = 0.007 and 0.004), but not between Lip peak area and BMI. There was no statistical difference in Cho resonances between males and females. The Lip peak height and area were significantly higher in the Cho peak invisible group than in the Cho peak visible group (t = 2.661 and 2.353, p = 0.030 and 0.043). Conclusion: In vivo{sup 1}H MRS of the normal pancreas at 3 T is technically feasible and can characterize several metabolites. {sup 1}H MRS during breath-holding acquisition is superior to that during free

  6. An insulin based model to explain changes and interactions in human breath-holding.

    Science.gov (United States)

    Dangmann, Rosita

    2015-06-01

    Until now oxygen was thought to be the leading factor of hypoxic conditions. Whereas now it appears that insulin is the key regulator of hypoxic conditions. Insulin seems to regulate the redox state of the organism and to determine the breakpoint of human breath-holding. This new hypoxia-insulin hypotheses might have major clinical relevance. Besides the clinical relevance, this hypothesis could explain, for the first time, why the training of the diaphragm, among other factors, results in an increase in breath-holding performance. Elite freedivers/apnea divers are able to reach static breath-holding times to over 6 min. Untrained persons exhibit an unpleasant feeling after more or less a minute. Breath-holding is stopped at the breakpoint. The partial oxygen pressure as well as the carbon dioxide pressure failed to directly influence the breakpoint in earlier studies. The factors that contribute to the breakpoint are still under debate. Under hypoxic conditions the organism needs more glucose, because it changes from the oxygen consuming pentose phosphate (36 ATP/glucose molecule) to the anaerobic glycolytic pathway (2ATP/glucose molecule). Hence insulin, as it promotes the absorption of glucose, is set in the center of interest regarding hypoxic conditions. This paper provides an insulin based model that could explain the changes and interactions in human breath-holding. The correlation between hypoxia and reactive oxygen species (ROS) and their influence on the sympathetic nerve system and hypoxia-inducible factor 1 alpha (HIF-1α) is dealt with. It reviews as well the direct interrelation of HIF-1α and insulin. The depression of insulin secretion through the vagus nerve activation via inspiration is discussed. Furthermore the paper describes the action of insulin on the carotid bodies and the diaphragm and therefore a possible role in respiration pattern. Freedivers that go over the breakpoint of breath-holding could exhibit seizures and thus the effect of

  7. Clinical usefulness of cardiac cine magnetic resonance imaging in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    We studied the clinical usefulness of cine mode magnetic resonance (MR) imaging in patients with atrial fibrillation (AF) from aspects of image quality and cardiac function. The signal-to-noise (S/N) ratio in the myocardium was significantly (p<0.05) lower in patients with AF than those with normal sinus rhythm. Two radiologists who did not know any patient's information evaluated the image quality visually by marking method on a scale of 12 points. There was no difference of image quality between the two groups. The standard deviation of R-R interval was significantly (r=-0.92, p<0.001) correlated with the S/N ratio in myocardium. Consequently, it was not favorable to estimate visually cardiac cine MR image in patients with AF, when standard deviation of R-R interval was large. The left ventricular (LV) end diastolic, end systolic and stroke volumes and ejection fraction were closely (r=0.82∼0.95, p<0.05∼0.001) correlated between MR imaging and M-mode echocardiography, respectively. The ability to detect left side valvular regurgitation was almost equal in both MR imaging and color Doppler echocardiography. This result was coincided to previous papers in patients with normal sinus rhythm. In conclusion, cine mode MR imaging was also useful to analyze cardiac function and detect valvular regurgitation in patients with AF. (author)

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

    International Nuclear Information System (INIS)

    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

  9. 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.

  10. Efficacy of 'breath holding at ease' during CT pulmonary angiography in the improvement of contrast enhancement in pulmonary arteries

    International Nuclear Information System (INIS)

    The aim of this study is to assess whether breath-hold at ease by patients during the CT pulmonary angiography (CTPA) will improve contrast enhancement in pulmonary arteries. Retrospective review was conducted on 51 consecutive CTPA studies undertaken in the traditional method of patients taking deep inspiration and breath-hold immediately prior to scanning, and subsequently 75 consecutive CTPA studies with patients breathing-holding at ease immediately prior to and during the scanning. Attenuation values in pulmonary arteries of different anatomical levels in both groups were measured in Hounsfield unit (HU). Results were compared between the two groups. The mean attenuation value in pulmonary arteries including pulmonary trunk, main and proximal pulmonary arteries calculated in HU in the 'deep inspiration and breath-hold' group was 327 HU (95% confidence interval: 315 to 339 HU). The mean attenuation value in pulmonary arteries in the 'breath hold at ease' group was calculated to be 390 HU (95% confidence interval: 381 to 399 HU); that is, an overall 17.95% increase (P-value<0.0001) in attenuation value in this group. By asking patients to breath-hold at ease instead of taking deep inspiration and breath hold prior to CTPA scan can effectively improve contrast enhancement in pulmonary arteries, therefore producing a higher-quality CT pulmonary angiography scan.

  11. EFFECTS OF AQUA AEROBICS AND FLOOR AEROBICS ON BREATH HOLDING TIME AMONG SCHOOL GIRLS

    OpenAIRE

    P.V. Shelvam; S. Arunadevi

    2013-01-01

    The purpose of the study was to find out the effects of aqua aerobics and floor aerobics on breath holding time among school girls. To achieve this purpose of the study, ninety school girls were selected as subjects who were studied Cornation Higher Secondary School, Sivakasi. The selected subjects were aged between 15 to 17 years. The selected subjects were randomly divided into three groups of 30 subjects each group. Group one acted as experimental group I and group two acted as experimenta...

  12. 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.

  13. Multi-center transferability of a breath-hold T2 technique for myocardial iron assessment

    Directory of Open Access Journals (Sweden)

    Chan Godfrey CF

    2008-02-01

    Full Text Available Abstract Background Cardiac iron overload is the leading cause of death in thalassemia major and is usually assessed using myocardial T2* measurements. Recently a cardiovascular magnetic resonance (CMR breath-hold T2 sequence has been developed as a possible alternative. This cardiac T2 technique has good interstudy reproducibility, but its transferability to different centres has not yet been investigated. Methods and Results The breath-hold black blood spin echo T2 sequence was installed and validated on 1.5T Siemens MR scanners at 4 different centres across the world. Using this sequence, 5–10 thalassemia patients from each centre were scanned twice locally within a week for local interstudy reproducibility (n = 34 and all were rescanned within one month at the standardization centre in London (intersite reproducibility. The local interstudy reproducibility (coefficient of variance and mean difference were 4.4% and -0.06 ms. The intersite reproducibility and mean difference between scanners were 5.2% and -0.07 ms. Conclusion The breath-hold myocardial T2 technique is transferable between Siemens scanners with good intersite and local interstudy reproducibility. This technique may have value in the diagnosis and management of patients with iron overload conditions such as thalassemia.

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

    Directory of Open Access Journals (Sweden)

    S.H. TONEKABONI

    2006-06-01

    Full Text Available Objectives:Breath holding spells are one of the most frequent and importantdiagnostic challenges in pediatrics. The aim of this study, conductedon pediatric patients referring to the pediatric neurology clinic inHormozgan province, was to evaluate therapeutic effects of iron onbreath 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. Toobtain all relevant data a specifically designed questionnaire requiringinformation on sex, age, age of onset of spells, type of spells, frequencyof attacks before and after treatment with oral iron supplement, anddeterminants of body iron stores was completed for all the patients,based on the mother’s statements. The patients were treated by anoral iron preparation for three months.Results:The age of onset of spells ranged between 6 to 24 months. Thecyanotic type of spell was detected in 31 children, the pallid type in3, and the mixed type in one child. There were 14 children with irondeficiency anemia and 20 children with reduced iron stores. Just onechild had a normal iron profile. Complete therapeutic response wasdocumented in 24 children, good response in 9, and poor responsein one and in one child no change in frequency of spells was seen.Conclusion:Although no significant therapeutic difference was seen in the differentresponse groups, it seems that iron supplement may play an importantrole in reducing breath holding spells in children.

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

    International Nuclear Information System (INIS)

    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 cm3 and 1.8 cm3, 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 negligible

  16. 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

  17. 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).

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

    International Nuclear Information System (INIS)

    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 for a translation of 39.9 mm. We have demonstrated how interleaved acquired, orthogonal cine-MRI planes can be used for online tracking of soft-tissue target volumes. (paper)

  19. Cardiac Motion During Deep-Inspiration Breath-Hold: Implications for Breast Cancer Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Many patients with left-sided breast cancer receive adjuvant radiotherapy during deep-inspiration breath hold (DIBH) to minimize radiation exposure to the heart. We measured the displacement of the left anterior descending artery (LAD) and heart owing to cardiac motion during DIBH, relative to the standard tangential fields for left breast cancer radiotherapy. Methods and Materials: A total of 20 patients who had undergone computed tomography-based coronary angiography with retrospective electrocardiographic gating were randomly selected for the present study. The patients underwent scanning during DIBH to control the influence of respiration on cardiac motion. Standard medial and lateral tangential fields were placed, and the LADs were contoured on the systolic- and diastolic-phase computed tomography data sets by the clinicians. Displacement of the LAD during cardiac contractions was calculated in three directions: toward the posterior edge of the treatment fields, left–right, and anteroposterior. Displacement of the entire heart was measured on the maximal and minimal intensity projection computed tomography images. Results: The mean displacement of the LAD from cardiac contraction without the influence of respiration for 20 patients was 2.3 mm (range, 0.7–3.8) toward the posterior edge of the treatment fields, 2.6 mm (range, 1.0–6.8) in the left–right direction, and 2.3 mm (range, 0.6–6.5) in the anteroposterior direction. At least 30% of the LAD volume was displaced >5 mm in any direction in 2 patients (10%), and 5 mm in 10 patients (50%). The extent of displacement of the heart periphery during cardiac motion was negligible near the treatment fields. Conclusions: Displacement of the heart periphery near the treatment fields was negligible during DIBH; however, displacement of the LAD from cardiac contraction varied substantially between and within patients. We recommend maintaining ≥5 mm of distance between the LAD and the field edge for

  20. Fourier modeling of the BOLD response to a breath-hold task: Optimization and reproducibility.

    Science.gov (United States)

    Pinto, Joana; Jorge, João; Sousa, Inês; Vilela, Pedro; Figueiredo, Patrícia

    2016-07-15

    Cerebrovascular reactivity (CVR) reflects the capacity of blood vessels to adjust their caliber in order to maintain a steady supply of brain perfusion, and it may provide a sensitive disease biomarker. Measurement of the blood oxygen level dependent (BOLD) response to a hypercapnia-inducing breath-hold (BH) task has been frequently used to map CVR noninvasively using functional magnetic resonance imaging (fMRI). However, the best modeling approach for the accurate quantification of CVR maps remains an open issue. Here, we compare and optimize Fourier models of the BOLD response to a BH task with a preparatory inspiration, and assess the test-retest reproducibility of the associated CVR measurements, in a group of 10 healthy volunteers studied over two fMRI sessions. Linear combinations of sine-cosine pairs at the BH task frequency and its successive harmonics were added sequentially in a nested models approach, and were compared in terms of the adjusted coefficient of determination and corresponding variance explained (VE) of the BOLD signal, as well as the number of voxels exhibiting significant BOLD responses, the estimated CVR values, and their test-retest reproducibility. The brain average VE increased significantly with the Fourier model order, up to the 3rd order. However, the number of responsive voxels increased significantly only up to the 2nd order, and started to decrease from the 3rd order onwards. Moreover, no significant relative underestimation of CVR values was observed beyond the 2nd order. Hence, the 2nd order model was concluded to be the optimal choice for the studied paradigm. This model also yielded the best test-retest reproducibility results, with intra-subject coefficients of variation of 12 and 16% and an intra-class correlation coefficient of 0.74. In conclusion, our results indicate that a Fourier series set consisting of a sine-cosine pair at the BH task frequency and its two harmonics is a suitable model for BOLD-fMRI CVR measurements

  1. Pneumomediastinum or lung damage in breath-hold divers from different mechanisms: a report of three cases.

    Science.gov (United States)

    Toklu, Akin Savaş; Erelel, Mustafa; Arslan, Abdullah

    2013-12-01

    Normally pulmonary over-inflation is not an issue during breath-hold diving, in contrast to lung squeeze. Compared with compressed air diving, pulmonary barotrauma is rare in breath-hold diving. Several mechanisms can lead to an increase in intrathoracic pressure in breath-hold diving that may cause alveolar rupture. Here we report three cases of pulmonary barotrauma in breath-hold diving. Using high-resolution chest tomography, bullous damage in Case 1, and pneumomediastinum in Cases 2 and 3 were detected. Transient neurological symptoms in Cases 1 and 2 suggested cerebral arterial gas embolism. The mechanisms that caused intrapulmonary overpressure were, respectively, lung packing ('buccal pumping'), considerable effort and straining at depth, and breathing compressed air at depth and ascending without exhaling. All three cases recovered without specific treatment such as recompression. PMID:24510331

  2. Short breath-hold MR cholangio-pancreatography on 0.5T MR unit using fast asymmetric spin echo sequence

    Energy Technology Data Exchange (ETDEWEB)

    Hanaoka, Hideto; Ichikawa, Tomoaki; Katase, Shichiro; Hachiya, Junichi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Kobayashi, Kuninori; Matsumoto, Naomoto

    1996-04-01

    Fast asymmetric spin echo (FastASE) sequence and short breath-hold technique were employed to achieve the high resolution images on magnetic resonance cholangiopancreatography (MRCP) at a 0.5T MR unit. Short breath hold MRCP with the multi-slice maximum intensity projection technique (MIP MRCP) and the single slice technique (single slice MRCP) were performed in 22 cases: 3 chronic pancreatitis, 8 CBD and/or GB stones and 11 normal cases. Visual score, interobserver agreement and depiction rate of each ductal portion were obtained from the image evaluation by 2 diagnostic radiologists and used as parameters to evaluate the difference of image quality between MIP and single slice MRCP. Image quality between echo times (TEs) of 120 and 250ms on single slice MRCP were evaluated by the contrast to noise ratio (CNR) and the lesion liver signal intensity ratio (SIR). Single slice MRCP was superior to MIP MRCP in the comparison of visual score and depiction rate. There were good interobserver agreement in MIP and single slice MRCP with exception of the head portion of pancreatic duct on MIP MRCP and the intrahepatic bile duct and the tail portion of pancreatic duct on single slice MRCP. By comparing the CNR and the SIR between TEs of 120 and 250 ms on single slice MRCP, the CNR and the SIR showed significantly higher values (P<0.01) for TEs of 250 than 120 ms. These results suggested that short breath-hold single slice MRCP with FastASE sequence might better demonstrate the biliary system and the pancreatic duct at 0.5T MR unit. (author)

  3. Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0–3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 ± 3 mm inferior, 1 ± 2 mm right, and 1 ± 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

  4. Cine magnetic resonance imaging, computed tomography and ultrasonography in the evaluation of chest wall invasion of lung cancer

    International Nuclear Information System (INIS)

    To assess the usefulness of cine-magnetic resonance imaging (cine-MRI) in the evaluation of chest wall invasion, we compared the results of cine-MRI with those of computed tomography (CT) and ultrasonography (US). Eleven patients were examined who had no pain and who were difficult to diagnose by routine examinations. MRI was performed with a Magnetom SP/4000, 1.5T unit (Siemens, Germany). For cine imaging, continuous turbo-FLUSH (ultra fast low angle shot) images were obtained at an orthogonal section to the chest wall during slow deep breathing. A CT scan was performed using a TCT 900S or Super Helix (Toshiba, Japan) at 1 cm intervals, with section thicknesses of 1 cm throughout the entire chest. US was performed with a model SSA-270A (Toshiba, Japan) with 7.5-MHz linear array scanners (PLF-705S; Toshiba, Japan). Sensitivity, specificity and accuracy were 67%, 75% and 73% for cine MRI, 67%, 63% and 64% for CT, 33%, 75% and 64% for US, respectively. These results indicate that cine MRI is potentially useful for the diagnosis of chest wall invasion of lung cancer. (author)

  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. Measurement of left ventricular volume by biplane cine magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Ichida, Fukiko; Hamamichi, Yuuji; Hashimoto, Ikuo; Tsubata, Shinichi; Miyazaki, Ayumi; Okada, Toshio; Murakami, Arata; Futatsuya, Ryuusuke (Toyama Medical and Pharmaceutical Univ. (Japan))

    1993-09-01

    To determine the ability of cine magnetic resonance imaging (MRI) to assess left ventricular (LV) volumes, we studied 20 children (age 4 months to 10 years) with various heart disease, validated by comparison with biplane LV angiography. Previous MRI studies to assess LV volumes have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, an imaging approach using biplane cine MRI and planes aligned with the true cardiac axes (the intrinsic long and short axis) of the LV was developed in views comparable with biplane LV angiography. In all patients, LV volumes were calculated by a Simpson's rule algorithm, both in MRI and LV angiography. MRI determined LV volumes were slightly underestimated but correlated reasonably well with angiographic values (LVEDV: Y=0.88X + 1.58, R=0.98, LVESV: Y=0.72X + 1.02, R=0.98). Especially, even in the patients who have abnormal left ventricular geometry such as Tetralogy of Fallot, MRI determined LV volumes correlated well with angiographic values. It is concluded that biplane cine MRI, using the intrinsic LV long and short axis planes, permits noninvasive assessment of LV volumes in views comparable to standard angiographic projections and appears practical for clinical use in childhood heart disease, because the scan and analysis time are relatively short. (author).

  7. Measurement of left ventricular volume by biplane cine magnetic resonance imaging in children

    International Nuclear Information System (INIS)

    To determine the ability of cine magnetic resonance imaging (MRI) to assess left ventricular (LV) volumes, we studied 20 children (age 4 months to 10 years) with various heart disease, validated by comparison with biplane LV angiography. Previous MRI studies to assess LV volumes have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, an imaging approach using biplane cine MRI and planes aligned with the true cardiac axes (the intrinsic long and short axis) of the LV was developed in views comparable with biplane LV angiography. In all patients, LV volumes were calculated by a Simpson's rule algorithm, both in MRI and LV angiography. MRI determined LV volumes were slightly underestimated but correlated reasonably well with angiographic values (LVEDV: Y=0.88X + 1.58, R=0.98, LVESV: Y=0.72X + 1.02, R=0.98). Especially, even in the patients who have abnormal left ventricular geometry such as Tetralogy of Fallot, MRI determined LV volumes correlated well with angiographic values. It is concluded that biplane cine MRI, using the intrinsic LV long and short axis planes, permits noninvasive assessment of LV volumes in views comparable to standard angiographic projections and appears practical for clinical use in childhood heart disease, because the scan and analysis time are relatively short. (author)

  8. Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer

    International Nuclear Information System (INIS)

    Purpose: The goal of this paper is to describe our initial experience with the deep inspiration breath-hold (DIBH) technique in conformal treatment of non-small-cell lung cancer with particular emphasis on the technical aspects required for implementation. Methods and Materials: In the DIBH technique, the patient is verbally coached through a modified slow vital capacity maneuver and brought to a reproducible deep inspiration breath-hold level. The goal is to immobilize the tumor and to expand normal lung out of the high-dose region. A physicist or therapist monitors and records patient breathing during simulation, verification, and treatment using a spirometer with a custom computer interface. Examination of internal anatomy during fluoroscopy over multiple breath holds establishes the reproducibility of the DIBH maneuver for each patient. A reference free-breathing CT scan and DIBH planning scan are obtained. To provide an estimate of tumor motion during normal tidal breathing, additional scan sets are obtained at end inspiration and end expiration. These are also used to set the spirometer action levels for treatment. Patient lung inflation is independently verified over the course of treatment by comparing the distance from the isocenter to the diaphragm measured from the DIBH digitally reconstructed radiographs to the distance measured on the portal films. Patient breathing traces obtained during treatment were examined retrospectively to assess the reproducibility of the technique. Results: Data from the first 7 patients, encompassing over 250 treatments, were analyzed. The inferred displacement of the centroid of gross tumor volume from its position in the planning scan, as calculated from the spirometer records in over 350 breath holds was 0.02 ± 0.14 cm (mean and standard deviation). These data are consistent with the displacements of the diaphragm (-0.1 ± 0.4 cm; range, from -1.2 to 1.1 cm) relative to the isocenter, as measured on the (92) portal films

  9. Optimization of parameter settings in cine-MR imaging for diagnosis of swallowing.

    Science.gov (United States)

    Ohkubo, Mai; Higaki, Takuo; Nishikawa, Keiichi; Otonari-Yamamoto, Mika; Sugiyama, Tetsuya; Ishida, Ryo; Wako, Mamoru; Sano, Tsukasa

    2014-01-01

    Videofluorography is frequently used to evaluate swallowing and is considered the "gold standard" among imaging modalities. This modality, however, has several disadvantages, including radiation exposure and limitations in the detection of soft tissues. Conversely, magnetic resonance imaging (MRI) offers excellent contrast resolution in soft tissue without radiation exposure. A major drawback of MRI in evaluating swallowing, however, is that temporal resolution is poor. The aim of this study was to investigate a new cine-MRI modality. Imaging parameters were optimized and the efficacy of this new technique is discussed. Three techniques for speeding up MRI were combined: true fast imaging with steady state precession, generalized auto-calibrating partially parallel acquisition, and key-hole imaging. The effects of the receiver coils used, receiving bandwidth, slice thickness, and flip angle on each image were determined. The optimal imaging parameters obtained comprised a reduction factor of 2, receiving bandwidth of 1,000 Hz/pixel (repetition time of 151.7 milliseconds and echo time of 1.4 milliseconds), flip angle of 50°, and slice thickness of 6 mm. Neck and spine coils were used. Under these conditions, the new cine-MR imaging technique investigated showed a temporal resolution of 0.1 sec/slice (10 frames/sec). Even with optimized parameter settings, this technique did not allow a true temporal resolution of 30 frames/sec by a large margin. Motion artifacts persisted. Further study is needed on how to speed up this technique. PMID:25212558

  10. [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. PMID:25272773

  11. Quantification of mechanical ventricular dyssynchrony. Direct comparison of velocity-encoded and cine magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Muellerleile, K. [Univ. Medical Center Hamburg-Eppendorf (Germany). Center for Cardiology and Cardiovascular Surgery; Baholli, L. [Klinikum Dortmund (DE). Schwerpunkte Kardiologie (Herz- und Kreislauferkrankungen) und Internistische Intensivmedizin; Groth, M. [Univ. Medical Center Hamburg-Eppendorf (DE). Dept. of Diagnostic and Interventional Radiology] (and others)

    2011-06-15

    Purpose: The preoperative assessment of mechanical dyssynchrony can help to improve patient selection in candidates for cardiac resynchronization therapy (CRT). The present study compared the performance of velocity-encoded (VENC) MRI to cine-magnetic resonance imaging (MRI) for quantifying mechanical ventricular dyssynchrony. Materials and Methods: VENC-MRI and cine-MRI were performed in 20 patients with heart failure NYHA class III and reduced ejection fraction (median: 24 %, interquartile range: 18 - 28 %) before CRT device implantation. The interventricular mechanical delay (IVMD) was assessed by VENC-MRI as the temporal difference between the onset of aortic and pulmonary flow. Intraventricular dyssynchrony was quantified by cine-MRI, using the standard deviation of time to maximal wall thickening in sixteen left ventricular segments (SDt-16). The response to CRT was assessed in a six-month follow-up. Results: 14 patients (70 %) clinically responded to CRT. A similar accuracy was found to predict the response to CRT by measurements of the IVMD and SDt-16 (75 vs. 70 %; p = ns). The time needed for data analysis was significantly shorter for the IVMD at 1.69 min (interquartile range: 1.66 - 1.88 min) compared to 9.63 min (interquartile range: 8.92 - 11.63 min) for the SDt-16 (p < 0.0001). Conclusion: Measurements of the IVMD by VENC-MRI and the SDt-16 by cine-MRI provide a similar accuracy to identify clinical responders to CRT. However, data analysis of the IVMD is significantly less time-consuming compared to data analysis of the SDt-16. (orig.)

  12. Spontaneous pneumomediastinum in an 11-year-old boy after a shallow breath-hold dive.

    Science.gov (United States)

    Laitila, Maija; Eskola, Vesa

    2013-12-01

    Spontaneous pneumomediastinum is caused by pulmonary barotrauma due to transiently increased intra-alveolar and intra-bronchial pressure. The most frequent triggers of spontaneous pneumomediastinum in children are asthma and manoeuvres creating forced expiration. It has been rarely associated with breath-hold diving. Chest pain and dyspnoea are the main symptoms, and the diagnosis can be confirmed by chest X-ray. The treatment of choice is oxygen, analgesics and monitoring the patient. The recurrence rate is low. The main differential diagnoses of spontaneous pneumomediastinum are oesophageal perforation and pericarditis. We report a case of an 11-year-old boy with no substantial medical history, who tried to breath-hold in shallow water for as long as possible. After diving, he felt dyspnoea and chest pain. Chest X-ray revealed pneumomediastinum and subcutaneous emphysema. The patient was admitted to the PICU for observation and was discharged after two days' follow up. Spontaneous pneumomediastinum in children may be more common than thus far acknowledged. It requires a high index of suspicion and should be considered in all children with acute chest pain. PMID:24510332

  13. 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. PMID:26260715

  14. Reproducibility of deep inspiration breath hold for prone left-sided whole breast irradiation

    International Nuclear Information System (INIS)

    Investigating reproducibility and instability of deep inspiration breath hold (DIBH) in the prone position to reduce heart dose for left-sided whole breast irradiation. Thirty patients were included and underwent 2 prone DIBH CT-scans during simulation. Overlap indices were calculated for the ipsilateral breast, heart and lungs to evaluate the anatomical reproducibility of the DIBH maneuver. The breathing motion of 21 patients treated with prone DIBH were registered using magnetic probes. These breathing curves were investigated to gain data on intra-fraction reproducibility and instability of the different DIBH cycles during treatment. Overlap index was 0.98 for the ipsilateral breast and 0.96 for heart and both lungs between the 2 prone DIBH-scans. The magnetic sensors reported population amplitudes of 2.8 ± 1.3 mm for shallow breathing and 11.7 ± 4.7 mm for DIBH, an intra-fraction standard deviation of 1.0 ± 0.4 mm for DIBH, an intra-breath hold instability of 1.0 ± 0.6 mm and a treatment time of 300 ± 69 s. Prone DIBH can be accurately clinically implemented with acceptable reproducibility and instability

  15. Barotraumatic orbital emphysema of rhinogenic origin in a breath-hold diver: a case report.

    Science.gov (United States)

    Bolognini, A; Delehaye, E; Cau, M; Cosso, L

    2008-01-01

    Orbital emphysema is a well-recognized complication of fractures involving the orbit. Commonly, it occurs when high pressure develops in nasal cavity as during nose blowing, coughing or Valsalva's maneuver and usually occurs in the subcutaneous tissues. We report the case of a young breath-hold diver who developed spontaneous, non compressive orbital emphysema during underwater fishing, with a maximal depth of 25-30 meters in the Sardinian sea. He was otherwise healthy, without previous cranio-facial trauma and nasosinusal diseases or surgery were not present in the history. When he was referred to our attention the patient presented right eyelid ptosis but diplopia and vision impairment were absent. Computer tomography scans showed subcutaneous air in the right upper eyelid and around the eyeball, particularly near the orbit's roof but optic nerve area, intraconal, was free of air. A dehiscence in lamina papyracea was evident. In our opinion, this has been the point of air entry into the orbit. A supportive therapy was advised and two weeks later the emphysema was recovered completely and the subject was symptoms free. The literature has been revised and to our knowledge no previous cases of barotraumatic orbital emphysema, in a breath-hold diver, are referred. PMID:18619111

  16. 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

    The diving response is initiated by apnea and facial immersion in cold water and includes, besides bradycardia, peripheral vasoconstriction, while cerebral perfusion may be enhanced. This study evaluated whether facial immersion in 10 degrees C water has an independent influence on cerebral...... <0.001). Similarly, during 100-W exercise, a breath hold increased Pa(CO(2)) from 5.9 to 8.2 kPa (P <0.001) and MCA V(mean) from 55 to 113 cm/s ( approximately 105%), and facial immersion further increased MCA V(mean) to 122 cm/s ( approximately 88%; both P <0.001). MCA V(mean) also increased during...... 180-W exercise (from 47 to 53 cm/s), and this increment became larger with facial immersion (76 cm/s, approximately 62%; P <0.001), although Pa(CO(2)) did not significantly change. These results indicate that a breath hold diverts blood toward the brain with a >100% increase in MCA V(mean), largely...

  17. Verification of the linac isocenter for stereotactic radiosurgery using cine-EPID imaging and arc delivery

    International Nuclear Information System (INIS)

    Purpose:Verification of the mechanical isocenter position is required as part of comprehensive quality assurance programs for stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments. Several techniques have been proposed for this purpose but each of them has certain drawbacks. In this paper, a new efficient and more comprehensive method using cine-EPID images has been introduced for automatic verification of the isocenter with sufficient accuracy for stereotactic applications. Methods: Using a circular collimator fixed to the gantry head to define the field, EPID images of a Winston-Lutz phantom were acquired in cine-imaging mode during 360 deg. gantry rotations. A robust matlab code was developed to analyze the data by finding the center of the field and the center of the ball bearing shadow in each image with sub-pixel accuracy. The distance between these two centers was determined for every image. The method was evaluated by comparison to results of a mechanical pointer and also by detection of a manual shift applied to the phantom position. The repeatability and reproducibility of the method were tested and it was also applied to detect couch and collimator wobble during rotation. Results:The accuracy of the algorithm was 0.03 ± 0.02 mm. The repeatability was less than 3 μm and the reproducibility was less than 86 μm. The time elapsed for the analysis of more than 100 cine images of Varian aS1000 and aS500 EPIDs were ∼65 and 20 s, respectively. Processing of images taken in integrated mode took 0.1 s. The output of the analysis software is printable and shows the isocenter shifts as a function of angle in both in-plane and cross-plane directions. It gives warning messages where the shifts exceed the criteria for SRS/SRT and provides useful data for the necessary adjustments in the system including bearing system and/or room lasers. Conclusions: The comprehensive method introduced in this study uses cine-images, is highly accurate, fast, and independent

  18. 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)

  19. Development of automatic extraction method of left ventricular contours on long axis view MR cine images

    International Nuclear Information System (INIS)

    In the MRI cardiac function analysis, left ventricular volume curves and diagnosis parameters are obtained by extracting the left ventricular cavities as regions of interest (ROI) from long axis view MR cine images. The ROI extractions had to be done by manual operations, because automatization of the extraction is difficult. A long axis view left ventricular contour consists of a cardiac wall part and an aortic valve part. The above mentioned difficulty is due to the decline of contrast on the cardiac wall part, and the disappearance of edge on the aortic valve part. In this paper, we report a new automatic extraction method for long axis view MR cine images, which needs only 3 manually indicated points on the 1st image to extract all the contours from the total sequence of images. At first, candidate points of a contour are detected by edge detection. Then, selecting the best matched combination of candidate points by Dynamic Programming, the cardiac wall part is automatically extracted. The aortic valve part is manually extracted for the 1st image by indicating both the end points, and is automatically extracted for the rest of the images, by utilizing the aortic valve motion characteristics throughout a cardiac cycle. (author)

  20. Breath holding duration as a measure of distress tolerance: examining its relation to measures of executive control

    Directory of Open Access Journals (Sweden)

    Stefan eSütterlin

    2013-07-01

    Full Text Available Recent research considers distress (intolerance as an essential component in the development of various forms of psychopathology. A behavioral task frequently used to assess distress tolerance is the breath holding task. Although breath holding time (BHT has been associated with behavioral outcomes related to inhibitory control (e.g., smoking cessation, the relationship among breath holding and direct measures of executive control has not yet been thoroughly examined. The present study aims to investigate the relationship between a series of executive function tasks and breath holding duration. Furthermore, we assessed the BHT-task’s test-retest reliability in a one-year follow-up. 113 students completed an initial BHT assessment, 58 of which also completed a series of executive function tasks (the Wisconsin Card Sorting Test, the Parametric Go/No-Go task and the N-back memory updating task. A subsample of these students (N = 34 repeated the breath holding task in a second session one year later. Test-retest reliability of the BHT-task over a one year period was high (r = .67, p

  1. 3D Tongue Motion from Tagged and Cine MR Images

    OpenAIRE

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

    2013-01-01

    Understanding the deformation of the tongue during human speech is important for head and neck surgeons and speech and language scientists. Tagged magnetic resonance (MR) imaging can be used to image 2D motion, and data from multiple image planes can be combined via post-processing to yield estimates of 3D motion. However, lacking boundary information, this approach su ers from inaccurate estimates near the tongue surface. This paper describes a method that combines two sources of information...

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

    International Nuclear Information System (INIS)

    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. 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.

  4. 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

    BACKGROUND AND PURPOSE: Adjuvant radiotherapy after breast-conserving surgery for breast cancer implies a risk of late cardiac and pulmonary toxicity. This is the first study to evaluate cardiopulmonary dose sparing of breathing adapted radiotherapy (BART) using free breathing gating, 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......-hold (EBH). The Varian Real-time Position Management system (RPM) was used to monitor respiratory movement and to gate the scanner. For each breathing phase, a population based internal margin (IM) was estimated based on average chest wall excursion, and incorporated into an individually optimised three...

  5. Clinical advantages of three dimensional cine cardiac images

    International Nuclear Information System (INIS)

    We evaluated clinical advantages and the quantitativeness of computerized three-dimensional (3D) cinematic images of a human heart, which were produced with a set of magnetic resonance (MR) images by using the computer graphic technique. Many contiguous, multi-location and multi-phase short axis images were obtained with the ECG gated conventional and fast cardiac imaging sequences in normal volunteers and selected patients with myocardial infarction, hypertrophic cardiomyopathy, dilated cardiomyopathy and left ventricular dysfunction. Judging by visual impressions of the computerized 3D cinematic cardiac images, we could easily understand and evaluate the myocardial motions or the anatomic and volumetric changes of a heart according to the cardiac phases. These images were especially useful to compare the wall motion, the left ventricular ejection-fraction (LVEF), or other cardiac functions and conditions between before and after therapeutic procedures such as percutaneous transluminal coronary angioplasty for patients with myocardial infarction. A good correlation between the LVEF calculated from a set of computerized 3D cinematic images and the ultra sound examinations were found. The results of our study showed that computerized 3D cinematic cardiac images were clinically useful to understand the myocardial motions qualitatively and to evaluate cardiac functions such as the LVEF quantitatively. (author)

  6. Application of cine cardiac MR imaging in normal subjects and patients with valvular, coronary artery, and aortic disease

    International Nuclear Information System (INIS)

    Cine MR imaging was performed on 15 normal subjects and 27 patients with cardiac disease. In normal subjects, high signal intensity of flowing blood contrasted with that of the myocardium. In 16 patients with valvular regurgitation, signal void jet due to turbulence was visualized across the diseased valves. In three IHSS patients, thickened LV myocardium, mitral regurgitant jets, and systolic LV outflow jets were noted. Five patients with myocardial infarction (MI) showed thinning and/or hypokinesis of MI regions. In three patients with Marfan syndrome, aortic dilatation, insufficiency, and flap (one pt) were identified. Cine MR imaging is potentially useful for evaluation of a variety of cardiac diseases

  7. A case of spinal epidural haematoma during breath-hold diving.

    Science.gov (United States)

    Tremolizzo, Lucio; Patassini, Mirko; Malpieri, Massimo; Ferrarese, Carlo; Appollonio, Ildebrando

    2012-06-01

    Spinal epidural haematoma (SEH) is a rare condition usually the result of bleeding of the epidural venous plexus that might present with acute spinal cord compression. It is often due to traumatic events, but 'spontaneous' cases have been described, usually related to different predisposing conditions, such as coagulopathies. A 47-year-old male presented with severe frontal headache and intense cervical pain which developed during a protracted breath-hold spearfishing session. A cervical spine MRI performed 12 days after symptom onset showed a small epidural blood collection on the left side of the spinal canal, at the C7-T1 level. One week later, blood was no longer present and the asymptomatic patient was discharged. Protracted minor trauma (neck flexion) and repeated Valsalva manoeuvres might have played a role in the genesis of this event. The role of decompression sickness is discussed as well. PMID:22828819

  8. Hemoptysis and pneumomediastinum after breath-hold diving in shallow water: a case report.

    Science.gov (United States)

    Henckes, A; Arvieux, J; Cochard, G; Jézéquel, P; Arvieux, C C

    2011-01-01

    We report the case of a healthy 21-year-old woman who performed iterative breath-hold dives in relatively cold water, not exceeding depths of 5 meters but with "empty lungs." At the end of a dive, after experiencing an intense involuntary diaphragmatic contraction underwater, she presented hemoptysis followed by chest pain and cough. Chest radiography and computed tomography were performed 24 hours later, confirming the diagnosis of pneumomediastinum. The clinical course was benign: However, chest pain and effort dyspnea lasted for a few weeks. The pathophysiology of this accident may be explained by a combination of mechanisms involved in several clinical entities, namely pulmonary edema of immersion, pulmonary barotrauma and spontaneous pneumomediastinum. PMID:21721355

  9. Iron supplementation reduces the frequency and severity of breath-holding attacks in non-anaemic children

    Directory of Open Access Journals (Sweden)

    Anthony Zehetner

    2011-11-01

    Full Text Available Iron supplementation reduces the frequency and severity of breath-holding attacks (BHAs, particularly in children with iron deficiency. The issue of iron supplementation is less clear for Westernized children with BHAs who present to an outpatient community clinic and are not iron-deficient. This is the first reported case series of iron-replete children with frequent and disabling breath-holding attacks who have responded to a course of oral iron supplementation. This intervention is safe, improves quality of life for both child and carer, and is significantly cost-effective in terms of health resource utilization.

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

    OpenAIRE

    A.E. Nardi; A.M. Valença; F.L. Lopes; Nascimento, I.; M.A. Mezzasalma; W.A. Zin

    2004-01-01

    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...

  11. Reproducibility of organ position using voluntary breath-hold method with spirometer for extracranial stereotactic radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate in healthy volunteers the reproducibility of organ position using a voluntary breath-hold method with a spirometer and the feasibility of this method for extracranial stereotactic radiotherapy in a clinical setting. Methods and materials: For this study, 5 healthy volunteers were enrolled. After training sessions, they held their breath at the end-inspiration and the end-expiration phase under spirometer-based monitoring. Computed tomography (CT) scans were performed twice at each respiratory phase, with a 10-min interval, on 2 separate days. The total number of CT scans was four at each respiratory phase. After CT volume data were transferred to a three-dimensional treatment-planning system, digitally reconstructed radiographs (DRRs) were calculated for anterior-posterior and left-right beams. Verification was performed with DRRs relative to the diaphragm position, bony landmarks, and the isocenter in each healthy volunteer at each respiratory phase. To evaluate intrafraction reproducibility, we measured the distance between diaphragm position and bony landmarks. To evaluate interfraction reproducibility, we measured the distance between diaphragm position and the isocenter. Reproducibility and setup error were defined as the average value of the differences between each DRR with regard to the first DRR. Results: Intrafraction reproducibility of the caudal-cranial direction was 4.0 ± 3.5 mm at the end-inspiration phase and 2.2 ± 2.0 mm at the end-expiration phase. Interfraction reproducibility of the caudal-cranial direction was 5.1 ± 4.8 mm at the end-inspiration phase and 2.1 ± 1.8 mm at the end-expiration phase. The end-expiration phase was more stable than the end-inspiration phase. Conclusions: The voluntary breath-hold method with a spirometer is feasible, with relatively good reproducibility. We are encouraged about the use of this technique clinically for extracranial stereotactic radiotherapy

  12. Breath-hold monitoring and visual feedback for radiotherapy using a charge-coupled device camera and a head-mounted display. System development and feasibility

    International Nuclear Information System (INIS)

    The aim of this study was to present the technical aspects of the breath-hold technique with respiratory monitoring and visual feedback and to evaluate the feasibility of this system in healthy volunteers. To monitor respiration, the vertical position of the fiducial marker placed on the patient's abdomen was tracked by a machine vision system with a charge-coupled device camera. A monocular head-mounted display was used to provide the patient with visual feedback about the breathing trace. Five healthy male volunteers were enrolled in this study. They held their breath at the end-inspiration and the end-expiration phases. They performed five repetitions of the same type of 15-s breath-holds with and without a head-mounted display, respectively. A standard deviation of five mean positions of the fiducial marker during a 15-s breath-hold in each breath-hold type was used as the reproducibility value of breath-hold. All five volunteers well tolerated the breath-hold maneuver. For the inspiration breath-hold, the standard deviations with and without visual feedback were 1.74 mm and 0.84 mm, respectively (P=0.20). For the expiration breath-hold, the standard deviations with and without visual feedback were 0.63 mm and 0.96 mm, respectively (P=0.025). Our newly developed system might help the patient achieve improved breath-hold reproducibility. (author)

  13. [Research of Left Ventricle Function Analysis Using Real-time Cardiac Magnetic Resonance Imaging].

    Science.gov (United States)

    Yang, Fan; He, Yan; Zhang, Jie; Wu, Yin

    2015-12-01

    Real-time free breathing cardiac cine imaging is a reproducible method with shorter acquisition time and without breath-hold for cardiac magnetic resonance imaging. However, the detection of end-diastole and end-systole frames of real-time free breathing cardiac cine imaging for left ventricle function analysis is commonly completed by visual identification, which is time-consuming and laborious. In order to save processing time, we propose a method for semi-automatic identification of end-diastole and end-systole frames. The method fits respiratory motion signal and acquires the expiration phase, end-diastole and end-systole frames by cross correlation coefficient. The procedure successfully worked on ten healthy volunteers and validated by the analysis of left ventricle function compared to the standard breath-hold steady-state free precession cardiac cine imaging without any significant statistical differences. The results demonstrated that the present method could correctly detect end-diastole and end-systole frames. In the future, this technique may be used for rapid left ventricle function analysis in clinic. PMID:27079101

  14. Initial clinical results for breath-hold CT-based processing of respiratory-gated PET acquisitions

    Energy Technology Data Exchange (ETDEWEB)

    Fin, Loic; Daouk, Joel; Morvan, Julie; Esper, Isabelle El; Saidi, Lazhar; Meyer, Marc-Etienne [Amiens University Hospital, Nuclear Medicine Department, Amiens (France); Bailly, Pascal [Amiens University Hospital, Nuclear Medicine Department, Amiens (France); CHU d' Amiens, Service de Medecine Nucleaire, unite TEP, Hopital Sud, Amiens cedex (France)

    2008-11-15

    Respiratory motion causes uptake in positron emission tomography (PET) images of chest structures to spread out and misregister with the CT images. This misregistration can alter the attenuation correction and thus the quantisation of PET images. In this paper, we present the first clinical results for a respiratory-gated PET (RG-PET) processing method based on a single breath-hold CT (BH-CT) acquisition, which seeks to improve diagnostic accuracy via better PET-to-CT co-registration. We refer to this method as ''CT-based'' RG-PET processing. Thirteen lesions were studied. Patients underwent a standard clinical PET protocol and then the CT-based protocol, which consists of a 10-min List Mode RG-PET acquisition, followed by a shallow end-expiration BH-CT. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions' centroids on PET and CT images. SUV{sub MAX} and volume variations were also investigated. The CT-based method showed significantly lower (p=0.027) centroid distances (mean change relative to the clinical method =-49%; range =-100% to 0%). This led to higher SUV{sub MAX} (mean change =+33%; range =-4% to 69%). Lesion volumes were significantly lower (p=0.022) in CT-based PET volumes (mean change =-39%: range =-74% to -1%) compared with clinical ones. A CT-based RG-PET processing method can be implemented in clinical practice with a small increase in radiation exposure. It improves PET-CT co-registration of lung lesions and should lead to more accurate attenuation correction and thus SUV measurement. (orig.)

  15. Initial clinical results for breath-hold CT-based processing of respiratory-gated PET acquisitions

    International Nuclear Information System (INIS)

    Respiratory motion causes uptake in positron emission tomography (PET) images of chest structures to spread out and misregister with the CT images. This misregistration can alter the attenuation correction and thus the quantisation of PET images. In this paper, we present the first clinical results for a respiratory-gated PET (RG-PET) processing method based on a single breath-hold CT (BH-CT) acquisition, which seeks to improve diagnostic accuracy via better PET-to-CT co-registration. We refer to this method as ''CT-based'' RG-PET processing. Thirteen lesions were studied. Patients underwent a standard clinical PET protocol and then the CT-based protocol, which consists of a 10-min List Mode RG-PET acquisition, followed by a shallow end-expiration BH-CT. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions' centroids on PET and CT images. SUVMAX and volume variations were also investigated. The CT-based method showed significantly lower (p=0.027) centroid distances (mean change relative to the clinical method =-49%; range =-100% to 0%). This led to higher SUVMAX (mean change =+33%; range =-4% to 69%). Lesion volumes were significantly lower (p=0.022) in CT-based PET volumes (mean change =-39%: range =-74% to -1%) compared with clinical ones. A CT-based RG-PET processing method can be implemented in clinical practice with a small increase in radiation exposure. It improves PET-CT co-registration of lung lesions and should lead to more accurate attenuation correction and thus SUV measurement. (orig.)

  16. 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.

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

    International Nuclear Information System (INIS)

    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

  18. Constrained detection of left ventricular boundaries from Cine CT images of human hearts

    International Nuclear Information System (INIS)

    Detection of the left ventricular (LV) endocardial (inner) and epicardial (outer) boundaries in cardiac images, provided by fast computer tomography (Cine CT), magnetic resonance (MR), or ultrasound (echocardiography), is essential for the quantitative analysis of cardiac function. Manual tracing of the boundaries, which is presently used for subsequent analysis and diagnostics, is time consuming; this seriously limits the three-dimensional (3-D) spatial reconstruction of the LV shape and the clinical interpretation and utilization of the dynamical nature of the cardiac data. The automatic detection of the LV boundaries is difficult due to background noise, poor contrast, and often-unclear differentiation of the tissue characteristics of the ventricles, papillary muscles, and surrounding tissues. The new approach to the automatic ventricular boundary detection employs set-theoretic techniques, and is based on incorporating a priori knowledge of the heart geometry, its brightness, spatial structure, and temporal dynamics into the boundaries detection algorithm. Available knowledge is interpreted as constraint sets in the functional space and the consistent boundaries are considered to belong to the intersection of all the introduced sets, thus satisfying the a priori information. A novel algorithm is also suggested for the simultaneous detection of the endocardial and epicardial boundaries of the LV. The procedure is demonstrated using Cine CT images of the human heart

  19. 3D tongue motion from tagged and cine MR images.

    Science.gov (United States)

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

    2013-01-01

    Understanding the deformation of the tongue during human speech is important for head and neck surgeons and speech and language scientists. Tagged magnetic resonance (MR) imaging can be used to image 2D motion, and data from multiple image planes can be combined via post-processing to yield estimates of 3D motion. However, lacking boundary information, this approach suffers from inaccurate estimates near the tongue surface. This paper describes a method that combines two sources of information to yield improved estimation of 3D tongue motion. The method uses the harmonic phase (HARP) algorithm to extract motion from tags and diffeomorphic demons to provide surface deformation. It then uses an incompressible deformation estimation algorithm to incorporate both sources of displacement information to form an estimate of the 3D whole tongue motion. Experimental results show that use of combined information improves motion estimation near the tongue surface, a problem that has previously been reported as problematic in HARP analysis, while preserving accurate internal motion estimates. Results on both normal and abnormal tongue motions are shown. PMID:24505742

  20. 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...

  1. 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; Hesse, Birger; Petersen, Claus Leth

    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...... 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...

  2. Mind-body relationships in elite apnea divers during breath holding: a study of autonomic responses to acute hypoxemia

    OpenAIRE

    Laurino, Marco; Menicucci, Danilo; Mastorci, Francesca; Allegrini, Paolo; Piarulli, Andrea; Scilingo, Enzo P.; Bedini, Remo; Pingitore, Alessandro; Passera, Mirko; L'Abbate, Antonio; Gemignani, Angelo

    2012-01-01

    The mental control of ventilation with all associated phenomena, from relaxation to modulation of emotions, from cardiovascular to metabolic adaptations, constitutes a psychophysiological condition characterizing voluntary breath-holding (BH). BH induces several autonomic responses, involving both autonomic cardiovascular and cutaneous pathways, whose characterization is the main aim of this study. Electrocardiogram and skin conductance (SC) recordings were collected from 14 elite divers duri...

  3. A size-based emphysema severity index: robust to the breath-hold-level variations and correlated with clinical parameters

    Science.gov (United States)

    Hwang, Jeongeun; Lee, Minho; Lee, Sang Min; Oh, Sang Young; Oh, Yeon-Mok; Kim, Namkug; Seo, Joon Beom

    2016-01-01

    Objective To determine the power-law exponents (D) of emphysema hole-size distributions as a competent emphysema index. Robustness to extreme breath-hold-level variations and correlations with clinical parameters for chronic obstructive pulmonary disease (COPD) were investigated and compared to a conventional emphysema index (EI%). Patients and methods A total of 100 patients with COPD (97 males and three females of mean age 67±7.9 years) underwent multidetector row computed tomography scanning at full inspiration and full expiration. The diameters of the emphysematous holes were estimated and quantified with a fully automated algorithm. Power-law exponents (D) of emphysematous hole-size distribution were evaluated. Results The diameters followed a power-law distribution in all cases, suggesting the scale-free nature of emphysema. D of inspiratory and expiratory computed tomography of patients showed intraclass correlation coefficients >0.8, indicating statistically absolute agreement of different breath-hold levels. By contrast, the EI% failed to agree. Bland–Altman analysis also revealed the superior robustness of D to EI%. D also significantly correlated with clinical parameters such as airflow limitation, diffusion capacity, exercise capacity, and quality of life. Conclusion The D of emphysematous hole-size distribution is robust to breath-hold-level variations and sensitive to the severity of emphysema. This measurement may help rule out the confounding effects of variations in breath-hold levels. PMID:27536095

  4. [Value of cine magnetic resonance imaging in the diagnosis and quantification of valvular regurgitation. Comparison with angiography and Doppler echocardiography].

    Science.gov (United States)

    Germain, P; Baruthio, J; Roul, G; Mossard, J M; Bareiss, P; Wecker, D; Chambron, J; Sacrez, A

    1989-10-01

    Thirty-three patients presenting with regurgitation of the mitral valve (19 cases), tricuspid valve (14 cases) or aortic valve (11 cases) documented by angiography (n = 20) and/or doppler-echocardiography (n = 28) were examined by cine-MRI in order to test this method in valvular regurgitation. Sixteen ECG-synchronized cine-MRI images were acquired by the GRASS technique every 40 ms on appropriate projections, with a resistive 0.28 Tesla Bruker magnet. The semiology of normal and pathological blood flow images at cine-MRI is described. Valvular regurgitations present as "signal void" jets the chronology and spatial extension of which depend on the severity of the lesion. The differential diagnosis with physiological flows is discussed. The diagnostic sensitivity of the method was 29/29 when compared with angiography and 29/33 when compared with doppler-echocardiography (2 cases of 1/4 mitral regurgitation and 2 cases 1/4 tricuspid regurgitation were not visible at cine-MRI). The specificity of this method, as can be judged from 104 patients explored, also seems to be satisfactory. The severity of regurgitation was graded from 1 to 4 with the three methods, on the basis of strict criteria. The differences in grade evaluation exceeded +/- 1 point in only one case of mitral regurgitation which was greatly underestimated by the doppler method as compared with angiography and cine-MRI. Thus, cine-MRI is a reliable method to evaluate valvular regurgitations and their severity. It solves the practical problem raised by non-echogenic patients when catheterization is to be postponed or avoided. PMID:2512868

  5. Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration

    International Nuclear Information System (INIS)

    Purpose:To examine the dosimetric benefit of self-gated radiotherapy at deep-inspiration breath hold (DIBH) in the treatment of patients with non-small-cell lung cancer (NSCLC). The relative contributions of tumor immobilization at breath hold (BH) and increased lung volume at deep inspiration (DI) in sparing high-dose lung irradiation (≥20 Gy) were examined. Methods and Materials:Ten consecutive patients undergoing radiotherapy for Stage I-IIIB NSCLC who met the screening criteria were entered on this study. Patients were instructed to BH at DI without the use of external monitors or breath-holding devices (self-gating). Computed tomography (CT) scans of the thorax were performed during free breathing (FB) and DIBH. Fluoroscopy screened for reproducible tumor position throughout DIBH, and determined the maximum superior-inferior (SI) tumor motion during both FB and DIBH. Margins used to define the planning target volume (PTV) from the clinical target volume included 1 cm for setup error and organ motion, plus an additional SI margin for tumor motion, as determined from fluoroscopy. Three conformal treatment plans were then generated for each patient, one from the FB scan with FB PTV margins, a second from the DIBH scan with FB PTV margins, and a third from the DIBH scan with DIBH PTV margins. The percent of total lung volume receiving ≥20 Gy (using a prescription dose of 70.9 Gy to isocenter) was determined for each plan. Results:Self-gating at DIBH was possible for 8 of the 10 patients; 2 patients were excluded, because they were not able to perform a reproducible DIBH. For these 8 patients, the median BH time was 23 (range, 19-52) s. The mean percent of total lung volume receiving ≥20 Gy under FB conditions (FB scan with FB PTV margins) was 12.8%. With increased lung volume alone (DIBH scan with FB PTV margins), this was reduced to 11.0%, tending toward a significant decrease in lung irradiation over FB (p=0.086). With both increased lung volume and tumor

  6. The effect of climbing Mount Everest on spleen contraction and increase in hemoglobin concentration during breath holding and exercise.

    Science.gov (United States)

    Engan, Harald K; Lodin-Sundström, Angelica; Schagatay, Fanny; Schagatay, Erika

    2014-04-01

    Release of stored red blood cells resulting from spleen contraction improves human performance in various hypoxic situations. This study determined spleen volume resulting from two contraction-evoking stimuli: breath holding and exercise before and after altitude acclimatization during a Mount Everest ascent (8848 m). Eight climbers performed the following protocol before and after the climb: 5 min ambient air respiration at 1370 m during rest, 20 min oxygen respiration, 20 min ambient air respiration at 1370 m, three maximal-effort breath holds spaced by 2 min, 10 min ambient air respiration, 5 min of cycling at 100 W, and finally 10 min ambient air respiration. We measured spleen volume by ultrasound and capillary hemoglobin (HB) concentration after each exposure, and heart rate (HR) and arterial oxygen saturation (Sao2) continuously. Mean (SD) baseline spleen volume was unchanged at 213 (101) mL before and 206 (52) mL after the climb. Before the climb, spleen volume was reduced to 184 (83) mL after three breath holds, and after the climb three breath holds resulted in a spleen volume of 132 (26) mL (p=0.032). After exercise, the preclimb spleen volume was 186 (89) mL vs. 112 (389) mL) after the climb (p=0.003). Breath hold duration and cardiovascular responses were unchanged after the climb. We concluded that spleen contraction may be enhanced by altitude acclimatization, probably reflecting both the acclimatization to chronic hypoxic exposure and acute hypoxia during physical work. PMID:24673535

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

    International Nuclear Information System (INIS)

    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

  8. The impact of cine EPID image acquisition frame rate on markerless soft-tissue tracking

    Energy Technology Data Exchange (ETDEWEB)

    Yip, Stephen, E-mail: syip@lroc.harvard.edu; Rottmann, Joerg; Berbeco, Ross [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States)

    2014-06-15

    Purpose: Although reduction of the cine electronic portal imaging device (EPID) acquisition frame rate through multiple frame averaging may reduce hardware memory burden and decrease image noise, it can hinder the continuity of soft-tissue motion leading to poor autotracking results. The impact of motion blurring and image noise on the tracking performance was investigated. Methods: Phantom and patient images were acquired at a frame rate of 12.87 Hz with an amorphous silicon portal imager (AS1000, Varian Medical Systems, Palo Alto, CA). The maximum frame rate of 12.87 Hz is imposed by the EPID. Low frame rate images were obtained by continuous frame averaging. A previously validated tracking algorithm was employed for autotracking. The difference between the programmed and autotracked positions of a Las Vegas phantom moving in the superior-inferior direction defined the tracking error (δ). Motion blurring was assessed by measuring the area change of the circle with the greatest depth. Additionally, lung tumors on 1747 frames acquired at 11 field angles from four radiotherapy patients are manually and automatically tracked with varying frame averaging. δ was defined by the position difference of the two tracking methods. Image noise was defined as the standard deviation of the background intensity. Motion blurring and image noise are correlated with δ using Pearson correlation coefficient (R). Results: For both phantom and patient studies, the autotracking errors increased at frame rates lower than 4.29 Hz. Above 4.29 Hz, changes in errors were negligible withδ < 1.60 mm. Motion blurring and image noise were observed to increase and decrease with frame averaging, respectively. Motion blurring and tracking errors were significantly correlated for the phantom (R = 0.94) and patient studies (R = 0.72). Moderate to poor correlation was found between image noise and tracking error with R −0.58 and −0.19 for both studies, respectively. Conclusions: Cine EPID

  9. SU-E-T-326: The Oxygen Saturation (SO2) and Breath-Holding Time Variation Applied Active Breathing Control (ABC)

    International Nuclear Information System (INIS)

    Purpose: To study the oxygen saturation (SO2) and breath-holding time variation applied active breathing control (ABC) in radiotherapy of tumor. Methods: 24 volunteers were involved in our trials, and they all did breath-holding motion assisted by ELEKTA Active Breathing Coordinator 2.0 for 10 times respectively. And the patient monitor was used to observe the oxygen saturation (SO2) variation. The variation of SO2, and length of breath-holding time and the time for recovering to the initial value of SO2 were recorded and analyzed. Results: (1) The volunteers were divided into two groups according to the SO2 variation in breath-holding: A group, 14 cases whose SO2 reduction were more than 2% (initial value was 97% to 99%, while termination value was 91% to 96%); B group, 10 cases were less than 2% in breath-holding without inhaling oxygen. (2) The interfraction breath holding time varied from 8 to 20s for A group compared to the first breath-holding time, and for B group varied from 4 to 14s. (3) The breathing holding time of B group prolonged mean 8s, compared to A group. (4) The time for restoring to the initial value of SO2 was from 10s to 30s. And the breath-holding time shortened obviously for patients whose SO2 did not recover to normal. Conclusion: It is very obvious that the SO2 reduction in breath-holding associated with ABC for partial people. It is necessary to check the SO2 variation in breath training, and enough time should be given to recover SO2

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

    International Nuclear Information System (INIS)

    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

  11. 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.

  12. 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, and...... troponin T. Venous blood samples were obtained from 17 competing free divers before and 3 h after sessions of static apnea and underwater swimming. The heart was evaluated by echocardiography. Static apnea for 293 ± 78 s (mean ± SD) and subsequent 88 ± 21 m underwater swimming increased plasma...... = 0.549), and troponin T (P = 0.125) remained unchanged and, as assessed by echocardiography, the heart was not affected. In competitive free divers, bouts of static and dynamic apnea increase plasma erythropoietin and neuron-specific enolase, suggesting that renal and neural tissue, rather than the...

  13. Cardiorespiratory adaptation to breath-holding in air: Analysis via a cardiopulmonary simulation model.

    Science.gov (United States)

    Albanese, Antonio; Limei Cheng; Ursino, Mauro; Chbat, Nicolas W

    2015-08-01

    Apnea via breath-holding (BH) in air induces cardiorespiratory adaptation that involves the activation of several reflex mechanisms and their complex interactions. Hence, the effects of BH in air on cardiorespiratory function can become hardly predictable and difficult to be interpreted. Particularly, the effect on heart rate is not yet completely understood because of the contradicting results of different physiological studies. In this paper we apply our previously developed cardiopulmonary model (CP Model) to a scenario of BH with a twofold intent: (1) further validating the CP Model via comparison against experimental data; (2) gaining insights into the physiological reasoning for such contradicting experimental results. Model predictions agreed with published experimental animal and human data and indicated that heart rate increases during BH in air. Changes in the balance between sympathetic and vagal effects on heart rate within the model proved to be effective in inverting directions of the heart rate changes during BH. Hence, the model suggests that intra-subject differences in such sympatho-vagal balance may be one of the reasons for the contradicting experimental results. PMID:26738098

  14. Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

    International Nuclear Information System (INIS)

    Background and purpose: Cardiac disease has been related to heart dose after left-sided breast radiotherapy. This trial evaluates the heart sparing ability and feasibility of deep inspiration breath hold (DIBH) in the prone position for left-sided whole breast irradiation (WBI). Materials and methods: Twelve patients underwent CT-simulation in supine shallow breathing (SB), supine DIBH, prone SB and prone DIBH. A validation cohort of 38 patients received prone SB and prone DIBH CT-scans; the last 30 patients were accepted for prone DIBH treatment. WBI was planned with a prescription dose of 40.05 Gy. Results: DIBH was able to reduce (p < 0.001) heart dose in both positions, with results for prone DIBH at least as favorable as for supine DIBH. Mean heart dose was lowered from 2.2 Gy for prone SB to 1.3 Gy for prone DIBH (p < 0.001), while preserving the lung sparing ability of prone positioning. Moreover prone DIBH nearly consistently reduced mean heart dose to less then 2 Gy, regardless of breast volume. All patients were able to perform the simulation procedure, 28/30 patients were treated with prone DIBH. Conclusions: This trial demonstrates the ability and feasibility of prone DIBH to acquire optimal heart and lung sparing for left-sided WBI

  15. 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.

  16. Automated method for estimation of displacement of target position on EPID cine images without implanted markers in stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to develop a computerized method for measuring displacement vectors at a target position on electronic portal imaging device (EPID) cine images in treatment without implanted markers in stereotactic body radiotherapy. Our method was based on a template matching technique with cross-correlation coefficient between the reference portal (RP) image and each consecutive portal (CP) image acquired by EPID. EPID images with 512 x 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 10 MV on two linear accelerators. The displacement vector of the target on each cine image was determined from the position at maximum cross-correlation coefficient between the RP image and 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, displacements of a target position calculated by our method were compared with those obtained manually by two radiation oncologists. As a result, for lung phantom images, target displacements by our method relatively correlated well with those by the oncologists (r=0.972-0.994). Correlation values for 4 cases ranged from 0.854 to 0.948, while the values for the other 2 cases were 0.609 and 0.644. This preliminary result suggested that our method may be useful for monitoring displacements of target positions without implanted markers in stereotactic body radiotherapy. (author)

  17. A trial to reduce cardiac motion artifact on HR-CT images of the lung with the use of subsecond scan and special cine reconstruction algorithm

    International Nuclear Information System (INIS)

    We describe our trial to reduce cardiac motion artifacts on HR-CT images caused by cardiac pulsation by combining use of subsecond CT (scan time 0.8 s) and a special cine reconstruction algorithm (cine reconstruction algorithm with 180-degree helical interpolation). Eleven to 51 HR-CT images were reconstructed with the special cine reconstruction algorithm at the pitch of 0.1 (0.08 s) from the data obtained by two to six contigious rotation scans at the same level. Images with the fewest cardiac motion artifacts were selected for evaluation. These images were compared with those reconstructed with a conventional cine reconstruction algorithm and step-by-step scan. In spite of its increased radiation exposure, technical complexity and slight degradation of spatial resolution, our method was useful in reducing cardiac motion artifacts on HR-CT images in regions adjacent to the heart. (author)

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

    International Nuclear Information System (INIS)

    Purpose: 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. Methods: 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 deg. 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. Results: The mechanical sag during gantry rotation was dependent on the gantry angle and was larger in the in-plane direction, although

  19. 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...... of the lung region. Using detailed Monte-Carlo (MC) calculations, a comparative study of DIBH vs. FB was therefore designed. Material and methods: Eighteen locally advanced lung cancer patients underwent FB and DIBH CT imaging and treatment planning with the Anisotropic-Analytical-Algorithm (AAA......) for intensity-modulated-radio therapy or volumetric-modulated-arc-therapy using 66 Gy in 33 fractions. All plans were re-calculated with MC. Results: Relative to FB, the total lung volume increased 86.8% in DIBH, while the gross tumor volume decreased 14.8%. MC revealed equally under- and over...

  20. High-resolution cine MRI with TGRAPPA for fast assessment of left ventricular function at 3 Tesla

    International Nuclear Information System (INIS)

    Purpose: To implement and evaluate the accuracy of multislice dual-breath hold cine MR for analysis of global systolic and diastolic left ventricular function at 3 T. Materials and methods: 25 patients referred to cardiac MR underwent cine imaging at 3 T (MAGNETOM Verio) using prospective triggered SSFP (TR 3.1 ms; TE 1.4 ms; FA 60°). Analysis of LV function was performed using a standard non-accelerated single-slice approach (STD) with multiple breath-holds and an accelerated multi-slice technique (TGRAPPA; R = 4) encompassing the ventricles with 5 slices/breath-hold. Parameters of spatial and temporal resolution were kept identical (pixel: 1.9 × 2.5 mm2; temporal resolution: 47 ms). Data of both acquisition techniques were analyzed by two readers using semiautomatic algorithms (syngoARGUS) with respect to EDV, ESV, EF, myocardial mass (MM), peak filling rate (PFR) and peak ejection rate (PER) including assessment of interobserver agreement. Results: Volumetric results of the TGRAPPA approach did not show significant differences to the STD approach for left ventricular ejection fraction (62.3 ± 10.6 vs. 61.0 ± 8.4, P = 0.2), end-diastolic volume (135.8 ± 47.5 vs. 130.8 ± 46.4, P = 0.07), endsystolic volume (53.0 ± 29.7 vs. 53.1 ± 32.7, P = 0.99) and myocardial mass (114.2 ± 32.5 vs. 114.6 ± 30.6, P = 0.9). Moreover, a comparison of peak ejection rate (601.3 ± 190.2 vs. 590.8 ± 218.2, P = 0.8) and peak filling rate (535.1 ± 191.2 vs. 535.4 ± 210.7, P = 0.99) did not reveal significant differences between the two groups. Limits in interobserver agreement were low for all systolic and diastolic parameters in both groups (P ≥ 0.05). Total acquisition time for STD was 273 ± 124 s and 34 ± 5 s for TGRAPPA (P ≤ 0.001). Evaluation time for standard and multislice approach was equal (10.8 ± 1.4 vs. 9.8 ± 2.1 min; P = 0.08)

  1. High-resolution cine MRI with TGRAPPA for fast assessment of left ventricular function at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Theisen, Daniel, E-mail: daniel.theisen@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Sandner, Torleif A., E-mail: torleif.sandner@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Bamberg, Fabian, E-mail: fabian.bamberg@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Bauner, Kerstin U., E-mail: kerstin.bauner@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwab, Felix, E-mail: felix.schwab@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwarz, Florian, E-mail: florian.schwarz@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Arnoldi, Elisabeth, E-mail: elisabeth.arnoldi@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Reiser, Maximilian F., E-mail: maximilian.reiser@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Wintersperger, Bernd J., E-mail: bernd.wintersperger@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Department of Medical Imaging, University of Toronto, Toronto, Ontario (Canada)

    2013-05-15

    Purpose: To implement and evaluate the accuracy of multislice dual-breath hold cine MR for analysis of global systolic and diastolic left ventricular function at 3 T. Materials and methods: 25 patients referred to cardiac MR underwent cine imaging at 3 T (MAGNETOM Verio) using prospective triggered SSFP (TR 3.1 ms; TE 1.4 ms; FA 60°). Analysis of LV function was performed using a standard non-accelerated single-slice approach (STD) with multiple breath-holds and an accelerated multi-slice technique (TGRAPPA; R = 4) encompassing the ventricles with 5 slices/breath-hold. Parameters of spatial and temporal resolution were kept identical (pixel: 1.9 × 2.5 mm{sup 2}; temporal resolution: 47 ms). Data of both acquisition techniques were analyzed by two readers using semiautomatic algorithms (syngoARGUS) with respect to EDV, ESV, EF, myocardial mass (MM), peak filling rate (PFR) and peak ejection rate (PER) including assessment of interobserver agreement. Results: Volumetric results of the TGRAPPA approach did not show significant differences to the STD approach for left ventricular ejection fraction (62.3 ± 10.6 vs. 61.0 ± 8.4, P = 0.2), end-diastolic volume (135.8 ± 47.5 vs. 130.8 ± 46.4, P = 0.07), endsystolic volume (53.0 ± 29.7 vs. 53.1 ± 32.7, P = 0.99) and myocardial mass (114.2 ± 32.5 vs. 114.6 ± 30.6, P = 0.9). Moreover, a comparison of peak ejection rate (601.3 ± 190.2 vs. 590.8 ± 218.2, P = 0.8) and peak filling rate (535.1 ± 191.2 vs. 535.4 ± 210.7, P = 0.99) did not reveal significant differences between the two groups. Limits in interobserver agreement were low for all systolic and diastolic parameters in both groups (P ≥ 0.05). Total acquisition time for STD was 273 ± 124 s and 34 ± 5 s for TGRAPPA (P ≤ 0.001). Evaluation time for standard and multislice approach was equal (10.8 ± 1.4 vs. 9.8 ± 2.1 min; P = 0.08)

  2. Quantitative measurement of normal and hydrocephalic cerebrospinal fluid flow using phase contrast cine MR imaging

    International Nuclear Information System (INIS)

    Measurements of the cerebrospinal fluid (CSF) flow using phase contrast cine magnetic resonance (MR) imaging were performed on a phantom, 12 normal subjects and 20 patients with normal pressure hydrocephalus (NPH). The phantom study demonstrated the applicability of phase contrast in quantitative measurement of the slow flow. The CSF flows of the normal subjects showed a consistent pattern with a to-and-fro movement of the flow in the anterior subarachnoid space at the C2/3 level, and they were dependent on the cardiac cycle in all subjects. However, the patients with NPH showed variable patterns of the CSF pulsatile flow and these patterns could be divided into four types according to velocity and amplitude. The amplitudes of each type were as follows: type 0 (n=1), 87.6 mm; type I (n=2), 58.2 mm (mean); type II (n=6), 48.0±5.0 mm (mean±SEM); and type III (n=11), 19.9±1.8 mm (mean±SEM). The decrease of the amplitudes correlated to a worsening of the clinical symptoms. After the shunting operation, the amplitude of to-and-fro movement of the CSF increased again in the patients with NPH who improved clinically. Some of the type III cases were reclassified type II, I and 0 and also one of the type II cases changed type I after the shunting operation. We conclude that the phase contrast cine MR imaging is a practically and clinically applicable technique for the quantitative measurement of the CSF flow. (author)

  3. 3D cine magnetic resonance imaging of rat lung ARDS using gradient-modulated SWIFT with retrospective respiratory gating

    Science.gov (United States)

    Kobayashi, Naoharu; Lei, Jianxun; Utecht, Lynn; Garwood, Michael; Ingbar, David H.; Bhargava, Maneesh

    2015-03-01

    SWeep Imaging with Fourier Transformation (SWIFT) with gradient modulation and DC navigator retrospective gating is introduced as a 3D cine magnetic resonance imaging (MRI) method for the lung. In anesthetized normal rats, the quasi-simultaneous excitation and acquisition in SWIFT enabled extremely high sensitivity to the fast-decaying parenchymal signals (TE=~4 μs), which are invisible with conventional MRI techniques. Respiratory motion information was extracted from DC navigator signals and the SWIFT data were reconstructed to 3D cine images with 16 respiratory phases. To test this technique's capabilities, rats exposed to > 95% O2 for 60 hours for induction of acute respiratory distress syndrome (ARDS), were imaged and compared with normal rat lungs (N=7 and 5 for ARDS and normal groups, respectively). SWIFT images showed lung tissue density differences along the gravity direction. In the cine SWIFT images, a parenchymal signal drop at the inhalation phase was consistently observed for both normal and ARDS rats due to lung inflation (i.e. decrease of the proton density), but the drop was less for ARDS rats. Depending on the respiratory phase and lung region, the lungs from the ARDS rats showed 1-24% higher parenchymal signal intensities relative to the normal rat lungs, likely due to accumulated extravascular water (EVLW). Those results demonstrate that SWIFT has high enough sensitivity for detecting the lung proton density changes due to gravity, different phases of respiration and accumulation of EVLW in the rat ARDS lungs.

  4. 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

    covering the thorax using a 3D SPGR sequence. 3D-Dynamic-scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter greater than 50% at end-expiration in the static and dynamic scans.The success rate of the cine-MRI protocol was 92%. Cine-MRI...... restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration...... 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...

  5. Deep inspiration breath hold technique reduces heart dose from radiotherapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Adjuvant left breast radiotherapy (ALBR) for breast cancer can result in significant radiation dose to the heart. Current evidence suggests a dose–response relationship between the risk of cardiac morbidity and radiation dose to cardiac volumes. This study explores the potential benefit of utilising a deep inspiration breath hold (DIBH) technique to reduce cardiac doses. Thirty patients with left-sided breast cancer underwent CT-simulation scans in free breathing (FB) and DIBH. Treatment plans were generated using a hybrid intensity-modulated radiation therapy technique with simultaneous integrated boost. A dosimetric comparison was made between the two techniques for the heart, left anterior descending coronary artery (LAD), left lung and contralateral breast. Compared with FB, DIBH resulted in a significant reduction in heart V30 (7.1 vs. 2.4%, P < 0.0001), mean heart dose (6.9 vs. 3.9 Gy, P < 0.001), maximum LAD planning risk volume (PRV) dose, (51.6 vs. 45.6 Gy, P = 0.0032) and the mean LAD PRV dose (31.7 vs. 21.9 Gy, P < 0.001). No significant difference was noted for lung V20, mean lung dose or mean dose to the contralateral breast. The DIBH plans demonstrated significantly larger total lung volumes (1126 vs. 2051 cc, P < 0.0001), smaller maximum heart depth (2.08 vs. 1.17 cm, P < 0.0001) and irradiated heart volume (36.9 vs. 12.1 cc, P < 0.0001). DIBH resulted in a significant reduction in radiation dose to the heart and LAD compared with an FB technique for ALBR. Ongoing research is required to determine optimal cardiac dose constraints and methods of predicting which patients will derive the most benefit from a DIBH technique.

  6. 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. PMID:26181556

  7. 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

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

    International Nuclear Information System (INIS)

    Purpose. Accuracy of dose delivery in multiple breath-hold segmented volumetric modulated arc therapy (VMAT) was evaluated in comparison to non interrupted 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 non interrupted 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

  9. The deep inspiration breath-hold technique in the treatment of inoperable non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: Conventional radiotherapeutic techniques are associated with lung toxicity that limits the treatment dose. Motion of the tumor during treatment requires the use of large safety margins that affect the feasibility of treatment. To address the control of tumor motion and decrease the volume of normal lung irradiated, we investigated the use of three-dimensional conformal radiation therapy (3D-CRT) in conjunction with the deep inspiration breath-hold (DIBH) technique. Methods and Materials: In the DIBH technique, the patient is initially maintained at quiet tidal breathing, followed by a deep inspiration, a deep expiration, a second deep inspiration, and breath-hold. At this point the patient is at approximately 100% vital capacity, and simulation, verification, and treatment take place during this phase of breath-holding. Results: Seven patients have received a total of 164 treatment sessions and have tolerated the technique well. The estimated normal tissue complication probabilities decreased in all patients at their prescribed dose when compared to free breathing. The dose to which patients could be treated with DIBH increased on average from 69.4 Gy to 87.9 Gy, without increasing the risk of toxicity Conclusions: The DIBH technique provides an advantage to conventional free-breathing treatment by decreasing lung density, reducing normal safety margins, and enabling more accurate treatment. These improvements contribute to the effective exclusion of normal lung tissue from the high-dose region and permit the use of higher treatment doses without increased risks of toxicity

  10. An initial study on the estimation of time-varying volumetric treatment images and 3D tumor localization from single MV cine EPID images

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Pankaj, E-mail: pankaj.mishra@varian.com; Mak, Raymond H.; Rottmann, Joerg; Bryant, Jonathan H.; Williams, Christopher L.; Berbeco, Ross I.; Lewis, John H. [Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Li, Ruijiang [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305 (United States)

    2014-08-15

    Purpose: In this work the authors develop and investigate the feasibility of a method to estimate time-varying volumetric images from individual MV cine electronic portal image device (EPID) images. Methods: The authors adopt a two-step approach to time-varying volumetric image estimation from a single cine EPID image. In the first step, a patient-specific motion model is constructed from 4DCT. In the second step, parameters in the motion model are tuned according to the information in the EPID image. The patient-specific motion model is based on a compact representation of lung motion represented in displacement vector fields (DVFs). DVFs are calculated through deformable image registration (DIR) of a reference 4DCT phase image (typically peak-exhale) to a set of 4DCT images corresponding to different phases of a breathing cycle. The salient characteristics in the DVFs are captured in a compact representation through principal component analysis (PCA). PCA decouples the spatial and temporal components of the DVFs. Spatial information is represented in eigenvectors and the temporal information is represented by eigen-coefficients. To generate a new volumetric image, the eigen-coefficients are updated via cost function optimization based on digitally reconstructed radiographs and projection images. The updated eigen-coefficients are then multiplied with the eigenvectors to obtain updated DVFs that, in turn, give the volumetric image corresponding to the cine EPID image. Results: The algorithm was tested on (1) Eight digital eXtended CArdiac-Torso phantom datasets based on different irregular patient breathing patterns and (2) patient cine EPID images acquired during SBRT treatments. The root-mean-squared tumor localization error is (0.73 ± 0.63 mm) for the XCAT data and (0.90 ± 0.65 mm) for the patient data. Conclusions: The authors introduced a novel method of estimating volumetric time-varying images from single cine EPID images and a PCA-based lung motion model

  11. Dosimetric investigation of breath-hold intensity-modulated radiotherapy for pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Mitsuhiro; Kishimoto, Shun; Iwamura, Kohei; Shiinoki, Takehiro; Nakamura, Akira; Matsuo, Yukinori; Shibuya, Keiko; Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto 606-8507 (Japan); Department of Radiological Technology, Faculty of Medical Science, Kyoto College of Medical Science, Nantan, Kyoto 622-0041 (Japan); Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto 606-8507 (Japan)

    2012-01-15

    Purpose: To experimentally investigate the effects of variations in respiratory motion during breath-holding (BH) at end-exhalation (EE) on intensity-modulated radiotherapy (BH-IMRT) dose distribution using a motor-driven base, films, and an ionization chamber. Methods: Measurements were performed on a linear accelerator, which has a 120-leaf independently moving multileaf collimator with 5-mm leaf width at the isocenter for the 20-cm central field. Polystyrene phantoms with dimensions of 40 x 40 x 10 cm were set on a motor-driven base. All gantry angles of seven IMRT plans (a total of 35 fields) were changed to zero, and doses were then delivered to a film placed at a depth of 4 cm and an ionization chamber at a depth of 5 cm in the phantom with a dose rate of 600 MU/min under the following conditions: pulsation from the abdominal aorta and baseline drift with speeds of 0.2 mm/s (BD{sub 0.2mm/s}) and 0.4 mm/s (BD{sub 0.4mm/s}). As a reference for comparison, doses were also delivered to the chamber and film under stationary conditions. Results: In chamber measurements, means {+-} standard deviations of the dose deviations between stationary and moving conditions were -0.52% {+-} 1.03% (range: -3.41-1.05%), -0.07% {+-} 1.21% (range: -1.88-4.31%), and 0.03% {+-} 1.70% (range: -2.70-6.41%) for pulsation, BD{sub 0.2mm/s}, and BD{sub 0.4mm/s}, respectively. The {gamma} passing rate ranged from 99.5% to 100.0%, even with the criterion of 2%/1 mm for pulsation pattern. In the case of BD{sub 0.4mm/s}, the {gamma} passing rate for four of 35 fields (11.4%) did not reach 90% with a criterion of 3%/3 mm. The differences in {gamma} passing rate between BD{sub 0.2mm/s} and BD{sub 0.4mm/s} were statistically significant for each criterion. Taking {gamma} passing rates of > 90% as acceptable with a criterion of 3%/3 mm, large differences were observed in the {gamma} passing rate between the baseline drift of {<=}5 mm and that of >5 mm (minimum {gamma} passing rate: 92.0% vs 82

  12. Performance of simultaneous cardiac-respiratory self-gated three-dimensional MR imaging of the heart: initial experience.

    Science.gov (United States)

    Manka, Robert; Buehrer, Martin; Boesiger, Peter; Fleck, Eckart; Kozerke, Sebastian

    2010-06-01

    This study was approved by the local institutional ethics committee, and informed consent was obtained from all volunteers and patients. The objective of the present study was to assess the performance of high-spatial-resolution three-dimensional prospective cardiac-respiratory self-gated (CRSG) magnetic resonance (MR) imaging for determining left ventricular (LV) volumes and mass, as well as right ventricular (RV) volumes, in comparison with standard electrocardiography (ECG)-triggered, two-dimensional multisection, multiple-breath-hold cine imaging. The self-gated method derives cardiac triggering and respiratory gating information prospectively on the basis of additional MR imaging signals acquired in every repetition time and, thereby, eliminates the need for ECG triggering and multiple-breath-hold procedures. Data were acquired in 15 healthy volunteers (mean age, 27.2 years +/- 7.2 [standard deviation]) and 11 patients (mean age, 60.7 years +/- 11.3). The bias between the self-gating and the reference imaging techniques was minimal for all LV and RV parameters (mean values: LV end-diastolic volume, 2.0 mL; LV end-systolic volume, 0.6 mL; RV end-diastolic volume, 2.2 mL; and RV end-systolic volume, 0.8 mL). Prospective CRSG is a valuable alternative to ECG-triggered, multisection, multiple-breath-hold cine imaging of the heart and holds considerable promise for simplifying functional imaging of the heart, particularly in patients who are unable to hold their breath for a long period and patients who show ECG signal disturbances. PMID:20501728

  13. Cine magnetic resonance imaging study of blood flow and wall motion of the aortic arch

    International Nuclear Information System (INIS)

    The aortic arch has 3D distortions in the transverse arch in the axial view, and we previously reported that this distortion is a risk factor in the pathogenesis of arch aneurysms. In this study, we evaluated blood flow and movement of the aortic arch. In 10 healthy young volunteers, ECG-gated cine magnetic resonance imaging was carried out in the axial plane of the transverse arch, the coronal plane of the ascending arch, and the long axial plane along the entire arch. Left anterolateral movements around the midpoint of the transverse arch in the systolic phase were observed in all of the men (6.3±1.59 mm) and women (4.8±0.73 mm). A jet flow was detected in the systolic phase along the right side of the aortic wall. At the top of the plane, this jet flow turned to the left in a clockwise rotation in the anterior view. In the long axial plane, a turbulent flow in the systolic phase was observed distal to the left subclavian arterial orifice in 6 of the 7 cases. In conclusion, this turbulent flow and left anterolateral wall motion of the transverse arch are due to anatomical three-dimensional distortion of the transverse arch. We propose that these phenomena may be important risk factors in the pathogenesis of arch aneurysms. (author)

  14. 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.

  15. “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.

  16. A segmented K-space velocity mapping protocol for quantification of renal artery blood flow during breath-holding

    DEFF Research Database (Denmark)

    Thomsen, C; Cortsen, M; Söndergaard, L;

    1995-01-01

    segmented k-space technique, in which the entire data acquisition can be made within a breath-hold by the sampling of several phase-encoding lines within a small time window during each heart cycle. The aim of this study was to investigate the performance of a segmented k-space velocity mapping protocol for...... renal artery flow determination. The protocol uses 16 phase-encoding lines per heart beat during 16 heart cycles and gives a temporal velocity resolution of 160 msec. Comparison with a conventional ECG-triggered velocity mapping protocol was made in phantoms as well as in volunteers. In our study, both...

  17. Reproducibility of small animal cine and scar cardiac magnetic resonance imaging using a clinical 3.0 tesla system

    OpenAIRE

    Manka, Robert; Jahnke, Cosima; Hucko, Thomas; Dietrich, Thore; Gebker, Rolf; Schnackenburg, Bernhard; Graf, Kristof; Paetsch, Ingo

    2013-01-01

    Background To evaluate the inter-study, inter-reader and intra-reader reproducibility of cardiac cine and scar imaging in rats using a clinical 3.0 Tesla magnetic resonance (MR) system. Methods Thirty-three adult rats (Sprague–Dawley) were imaged 24 hours after surgical occlusion of the left anterior descending coronary artery using a 3.0 Tesla clinical MR scanner (Philips Healthcare, Best, The Netherlands) equipped with a dedicated 70 mm solenoid receive-only coil. Left-ventricular (LV) volu...

  18. The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To determine whether voluntary deep-inspiratory breath-hold (vDIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABCDIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods: Following surgery for early breast cancer, patients underwent planning-CT scans in vDIBH and ABCDIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (Σ) and random errors (σ) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test. Results: Twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived Σ were ⩽1.8 mm (vDIBH) and ⩽2.0 mm (ABCDIBH) and σ ⩽2.5 mm (vDIBH) and ⩽2.2 mm (ABCDIBH) (all p non-significant). CBCT-derived Σ were ⩽3.9 mm (vDIBH) and ⩽4.9 mm (ABCDIBH) and σ ⩽ 4.1 mm (vDIBH) and ⩽ 3.8 mm (ABCDIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred vDIBH (p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for vDIBH (p = 0.02, p = 0.04, respectively). Conclusions: vDIBH and ABCDIBH are comparable in terms of positional reproducibility and normal tissue sparing. vDIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABCDIBH

  19. Left-sided breast cancer radiotherapy with and without breath-hold: Does IMRT reduce the cardiac dose even further?

    International Nuclear Information System (INIS)

    Purpose: In radiotherapy for left-sided breast cancer, Active Breathing Control enables a decrease of cardiac and Left Anterior Descending (LAD) coronary artery dose. We compared 3D-Conformal (3D-CRT) to Intensity Modulated Radiotherapy (IMRT) treatment plans based on free-breathing (FB) and breath-hold (BH). We investigated whether IMRT enables an additional decrease of cardiac dose in radiotherapy plans with and without BH. Methods and materials: Twenty patients referred for whole breast irradiation were included. The whole breast, heart and LAD-region were contoured. Four treatment plans were generated: FB3D-CRT; FBIMRT; BH3D-CRT; BHIMRT. Several doses were obtained from Dose Volume Histograms and compared. Results were compared statistically using the Wilcoxin Signed Rank Test. For heart and LAD-region, a significant dose reduction was found in BH (p < 0.01). For both BH and FB, a significant dose reduction was found using IMRT (p < 0.01). By using IMRT an average reduction of 5% was noted in the LAD-region for the volume receiving 20 Gy. In 5 cases, the LAD-region remained situated in the vicinity of the radiation portals even in BH. Nevertheless, with IMRT the LAD dose was reduced in these cases. Conclusion: IMRT results in a significant additional decrease of dose in the heart and LAD-region in both breath-hold and free-breathing

  20. Fast Determination of Flip Angle and T1 in Hyperpolarized Gas MRI During a Single Breath-Hold

    Science.gov (United States)

    Zhong, Jianping; Ruan, Weiwei; Han, Yeqing; Sun, Xianping; Ye, Chaohui; Zhou, Xin

    2016-05-01

    MRI of hyperpolarized media, such as 129Xe and 3He, shows great potential for clinical applications. The optimal use of the available spin polarization requires accurate flip angle calibrations and T1 measurements. Traditional flip angle calibration methods are time-consuming and suffer from polarization losses during T1 relaxation. In this paper, we propose a method to simultaneously calibrate flip angles and measure T1 in vivo during a breath-hold time of less than 4 seconds. We demonstrate the accuracy, robustness and repeatability of this method and contrast it with traditional methods. By measuring the T1 of hyperpolarized gas, the oxygen pressure in vivo can be calibrated during the same breath hold. The results of the calibration have been applied in variable flip angle (VFA) scheme to obtain a stable steady-state transverse magnetization. Coupled with this method, the ultra-short TE (UTE) and constant VFA (CVFA) schemes are expected to give rise to new applications of hyperpolarized media.

  1. 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.

  2. Use of expiratory CT pulmonary angiography to reduce inspiration and breath-hold associated artefact: Contrast dynamics and implications for scan protocol

    International Nuclear Information System (INIS)

    Aim: To investigate the effects of scanning in expiration during computed tomography pulmonary angiography (CTPA). Materials and methods: One hundred and eighty-one consecutive expiratory CTPA examinations were compared with 145 inspiratory CTPA examinations performed using a standardized protocol through assessment of attenuation seen in the cardiac chambers, pulmonary artery (PA), and ascending aorta. Results: Expiratory scans showed greater attenuation at the pulmonary trunk, right PA, left PA, lobar and segmental PAs (p < 0.05). Expiratory scans showed a lower incidence of transient contrast medium interruption (p < 0.001) and generalized unsatisfactory PA opacification (p < 0.05). Scans with generalized low PA attenuation had lower attenuation in the right ventricle, left heart, and ascending aorta (p < 0.001) suggesting that contrast medium delivery or dilution prior to contrast medium entry into the PA is responsible. Expiratory scans showed lower quality scores (p < 0.001) for depiction of lung parenchyma. Conclusion: Expiratory scanning could be used as an optimal protocol for dedicated PA imaging. However, it suffers from inferior parenchymal imaging and should probably be reserved for failed inspiratory breath-hold CTPA.

  3. Use of expiratory CT pulmonary angiography to reduce inspiration and breath-hold associated artefact: Contrast dynamics and implications for scan protocol

    Energy Technology Data Exchange (ETDEWEB)

    Mortimer, A.M., E-mail: alex_mortimer@hotmail.com [Department of Radiology, Bristol Royal Infirmary, Bristol (United Kingdom); Singh, R.K.; Hughes, J.; Greenwood, R.; Hamilton, M.C.K. [Department of Radiology, Bristol Royal Infirmary, Bristol (United Kingdom)

    2011-12-15

    Aim: To investigate the effects of scanning in expiration during computed tomography pulmonary angiography (CTPA). Materials and methods: One hundred and eighty-one consecutive expiratory CTPA examinations were compared with 145 inspiratory CTPA examinations performed using a standardized protocol through assessment of attenuation seen in the cardiac chambers, pulmonary artery (PA), and ascending aorta. Results: Expiratory scans showed greater attenuation at the pulmonary trunk, right PA, left PA, lobar and segmental PAs (p < 0.05). Expiratory scans showed a lower incidence of transient contrast medium interruption (p < 0.001) and generalized unsatisfactory PA opacification (p < 0.05). Scans with generalized low PA attenuation had lower attenuation in the right ventricle, left heart, and ascending aorta (p < 0.001) suggesting that contrast medium delivery or dilution prior to contrast medium entry into the PA is responsible. Expiratory scans showed lower quality scores (p < 0.001) for depiction of lung parenchyma. Conclusion: Expiratory scanning could be used as an optimal protocol for dedicated PA imaging. However, it suffers from inferior parenchymal imaging and should probably be reserved for failed inspiratory breath-hold CTPA.

  4. Quantification of lung tumor rotation with automated landmark extraction using orthogonal cine MRI images

    Science.gov (United States)

    Paganelli, Chiara; Lee, Danny; Greer, Peter B.; Baroni, Guido; Riboldi, Marco; Keall, Paul

    2015-09-01

    The quantification of tumor motion in sites affected by respiratory motion is of primary importance to improve treatment accuracy. To account for motion, different studies analyzed the translational component only, without focusing on the rotational component, which was quantified in a few studies on the prostate with implanted markers. The aim of our study was to propose a tool able to quantify lung tumor rotation without the use of internal markers, thus providing accurate motion detection close to critical structures such as the heart or liver. Specifically, we propose the use of an automatic feature extraction method in combination with the acquisition of fast orthogonal cine MRI images of nine lung patients. As a preliminary test, we evaluated the performance of the feature extraction method by applying it on regions of interest around (i) the diaphragm and (ii) the tumor and comparing the estimated motion with that obtained by (i) the extraction of the diaphragm profile and (ii) the segmentation of the tumor, respectively. The results confirmed the capability of the proposed method in quantifying tumor motion. Then, a point-based rigid registration was applied to the extracted tumor features between all frames to account for rotation. The median lung rotation values were  -0.6   ±   2.3° and  -1.5   ±   2.7° in the sagittal and coronal planes respectively, confirming the need to account for tumor rotation along with translation to improve radiotherapy treatment.

  5. Quantification of lung tumor rotation with automated landmark extraction using orthogonal cine MRI images

    International Nuclear Information System (INIS)

    The quantification of tumor motion in sites affected by respiratory motion is of primary importance to improve treatment accuracy. To account for motion, different studies analyzed the translational component only, without focusing on the rotational component, which was quantified in a few studies on the prostate with implanted markers. The aim of our study was to propose a tool able to quantify lung tumor rotation without the use of internal markers, thus providing accurate motion detection close to critical structures such as the heart or liver. Specifically, we propose the use of an automatic feature extraction method in combination with the acquisition of fast orthogonal cine MRI images of nine lung patients. As a preliminary test, we evaluated the performance of the feature extraction method by applying it on regions of interest around (i) the diaphragm and (ii) the tumor and comparing the estimated motion with that obtained by (i) the extraction of the diaphragm profile and (ii) the segmentation of the tumor, respectively. The results confirmed the capability of the proposed method in quantifying tumor motion. Then, a point-based rigid registration was applied to the extracted tumor features between all frames to account for rotation. The median lung rotation values were  −0.6   ±   2.3° and  −1.5   ±   2.7° in the sagittal and coronal planes respectively, confirming the need to account for tumor rotation along with translation to improve radiotherapy treatment. (paper)

  6. 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 re

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

    International Nuclear Information System (INIS)

    Background and purpose: Adjuvant radiotherapy after breast-conserving surgery for breast cancer implies a risk of late cardiac and pulmonary toxicity. This is the first study to evaluate cardiopulmonary dose sparing of breathing adapted radiotherapy (BART) using free breathing gating, 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-hold (EBH). The Varian Real-time Position Management system (RPMTM) was used to monitor respiratory movement and to gate the scanner. For each breathing phase, a population based internal margin (IM) was estimated based on average chest wall excursion, and incorporated into an individually optimised three-field mono-isocentric wide tangential photon field treatment plan for each scan. The target included the remaining breast, internal mammary nodes and periclavicular nodes. Results: The mean anteroposterior chest wall excursion during FB was 2.5 mm. For IG and EG, the mean excursions within gating windows were 1.1 and 0.7 mm, respectively, whereas for DIBH and EBH the excursions were 4.1 and 2.6 mm, respectively. For patients with left-sided cancer, the median heart volume receiving more than 50% of the prescription dose was reduced from 19.2% for FB to 2.8% for IG and 1.9% for DIBH, and the median left anterior descending (LAD) coronary artery volume was reduced from 88.9% to 22.4% for IG and 3.6% for DIBH. Simultaneously, the median ipsilateral relative lung volume irradiated to >50% of the prescribed target dose for both right- and left-sided cancers was reduced from 45.6% for FB to 29.5% for IG and 27.7% for DIBH. For EBH and EG, both the irradiated heart, LAD and lung volumes increased compared to FB. Conclusions: This is the first study to demonstrate the dosimetric benefits

  8. Availability of using diaphragm matching in stereotactic body radiotherapy (SBRT) at the time in breath-holding SBRT for liver cancer

    International Nuclear Information System (INIS)

    Liver image guided radiation therapy (IGRT) based on bone matching risks generating serious target positioning errors for reasons of lack of reproducibility of expiration breath hold. We therefore investigated the feasibility of 3D image matching between planning CT images and pretreatment cone-beam computed tomography (CBCT) images based on diaphragm surface matching. 27 liver stereotactic body radiotherapy (SBRT) cases in whom trancecatheter arterial chemoembolization (TACE) had been performed in advance of radiotherapy were manually image-matched based on contrast, Lipiodol used in the TACE as the marker of the tumor, and the relative coordinates of the isocenter obtained by contrast matching, defined as the reference coordinate. The target positioning difference between diaphragm matching and bone matching were evaluated by using relative coordinates of the isocenter from the reference obtained for each matching technique. The target positioning error using diaphragm matching and bone matching was 1.31±0.83 and 3.10±2.80 mm in the cranial-caudal (C-C) direction, 1.04±0.95 and 1.62±1.02 mm in the anterior-posterior (A-P) direction, and 0.93±1.19 and 1.12±0.94 mm in the left-right (L-R) direction, respectively. The positioning error due to diaphragm matching was significantly smaller than for bone matching in the C-C direction (p<0.05). IGRT based on diaphragm matching has potential as an alternative image matching technique for the positioning of liver patients. (author)

  9. SU-E-J-211: Design and Study of In-House Software Based Respiratory Motion Monitoring, Controlling and Breath-Hold Device for Gated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shanmugam, Senthilkumar [Madurai Medical College ' Govt. Rajaji Hospital, Madurai (India)

    2014-06-01

    Purpose: The purpose of this present work was to fabricate an in-house software based respiratory monitoring, controlling and breath-hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy. Methods: The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle, to control, breath-hold and analyze the respiratory movement using indigenously developed software. Results: Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment. Conclusion: An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation

  10. SU-E-J-211: Design and Study of In-House Software Based Respiratory Motion Monitoring, Controlling and Breath-Hold Device for Gated Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this present work was to fabricate an in-house software based respiratory monitoring, controlling and breath-hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy. Methods: The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle, to control, breath-hold and analyze the respiratory movement using indigenously developed software. Results: Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment. Conclusion: An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation

  11. Utility of cine MR urography of the urinary tract and comparison with static MR urography

    International Nuclear Information System (INIS)

    MR urography using heavily T2-weighted images can depict the urinary tract without the need for contrast medium. However, this technique has potential problems with regard to evaluating the non-dilated ureter. We compared the efficacy of cine MR urography (C-MRU) with static MR urography (S-MRU). Twenty-two patients with suspected upper urinary tract disease underwent C-MRU. The final clinical diagnosis was compared with the diagnosis made using S-MRU and C-MRU, respectively. The sequence used was single-shot fast spin echo with a slice thickness of 50 mm, field of view (FOV) of 45 cm, and 256 x 256 matrix. MR urography was obtained sequentially by 6 to 10 repetitions of single-shot scans with intermittent breath holding. S-MRU was used in the initial phase of this sequence, while C-MRU was used for the entire sequence. A final diagnosis was made based on existence of stenosis, rate of certainty of existence of stenosis, etiology of stenosis. No statistically significant difference was observed between S-MRU and C-MRU, except in certainty of existence of stenosis, where C-MRU (average rate: 2.82±0.39) was significantly superior to S-MRU (2.41±0.73). C-MRU can improve the certainty of existence of urinary stenosis, and may be useful in excluding suspected stenoses in normal or undilated ureters. (author)

  12. Breathing adapted radiotherapy of breast cancer: reduction of cardiac and pulmonary doses using voluntary inspiration breath-hold

    DEFF Research Database (Denmark)

    Pedersen, Anders N; Korreman, Stine; Nyström, Håkan;

    2004-01-01

    volume (CTV) of the breast and ipsilateral internal mammary nodes, and an anterior supraclavicular field. RESULTS: Breath-hold was well accepted by the patients, with a median duration of 24 s for both EBH and DIBH. The mean anterioposterior chest wall excursions were 2.5, 2.6 and 4.1 mm during FB, EBH...... and DIBH, respectively. During EBH, the mean front chest wall position was 2.7 mm posterior to its mid-FB position, and during DIBH 12.6 mm anterior to its mid-FB position. For right-sided tumours, the median ipsilateral relative lung volume receiving >50% of the prescribed CTV dose was 39, 49 and 32...

  13. A COMPARATIVE STUDY OF PEAK EXPIRATORY FLOW RATE & BREATH HOLDING TIME IN NORMAL & ‘OM’ MEDITATORS

    Directory of Open Access Journals (Sweden)

    Gayatri

    2013-06-01

    Full Text Available ABSTRACT: BACKGROUND: ‘ Om’ is the name or symbol of God (Ishwara, Brahman . Either chanting or thinking about ‘Om’ is anecdotall y reported to cause a quite mental state, an d improve the all round performance of the bra in and body. OBJECTIVES: The study design aimed to find the effect of ‘OM meditation’ on Peak expiratory flow rate (PEFR & breath holding time (BHT, among Non-targeted thinkin g (control & Dhyana (‘Om’ meditation groups. METHODS: Source of DATA: 30 healthy male MBBS students (in the age g roup of 18- 20 years of Adichunchanagiri Institute of Med ical Sciences, B.G. Nagara, studying 1 st year MBBS, were included in the study. The group was divided equally into two sub-groups on a random basis (each sub-group consisting 15 st udents. Each of these sub-groups was made to get familiarized with the procedure.

  14. 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.

  15. Clinical Feasibility of Using an EPID in cine Mode for Image-Guided Verification of Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To introduce a novel method for monitoring tumor location during stereotactic body radiotherapy (SBRT) while the treatment beam is on by using a conventional electronic portal imaging device (EPID). Methods and Materials: In our clinic, selected patients were treated under a phase I institutional review board-approved SBRT protocol for limited hepatic metastases from solid tumors. Before treatment planning multiple gold fiducial markers were implanted on the periphery of the tumor. During treatment the EPID was used in cine mode to collect the exit radiation and produce a sequence of images for each field. An in-house program was developed for calculating the location of the fiducials and their relative distance to the planned locations. Results: Three case studies illustrate the utility of the technique. Patient A exhibited a systematic shift of 4 mm during one of the treatment beams. Patient B showed an inferior drift of the target of approximately 1 cm from the time of setup to the end of the fraction. Patient C had a poor setup on the first day of treatment that was quantified and accounted for on subsequent treatment days. Conclusions: Target localization throughout each treatment beam can be quickly assessed with the presented technique. Treatment monitoring with an EPID in cine mode is shown to be a clinically feasible and useful tool

  16. Detection of viable myocardium by low dose dobutamine cine MRI: experimental study in pigs

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MR) for myocardial viability. Methods: Mini swine (n = 10) underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using aneroid constrictor. More than 1 month later left ventriculography and coronary angiography were performed again, followed by cine-MR at rest and during stress with incremental dose of dobutamine 5-20 μg · kg-1 · min-1. Traditional and/or breath-hold cine-MR were used to evaluate regional left ventricular wall motion, corresponding to basal, mid ventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated. Mini swine were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) assessed myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results: One pig died, 1 pig suffered from aneurysm and another 1 showed negative findings. The other 7 pigs were found with hypokinetic (n=4) or akinetic (n = 3) myocardial regions related to stenosed LCX, their mean WMSI at rest for the lateral and postero-inferior walls (ischemic regions) of the left ventricle was 2.27 +- 0.32 compared with 1.00 +- 0.00 (x2 = 106.27, P 2 = 20.57, P -1·min-1. However, the mean WMSI at the dose of dobutamine 10 and 20 μg·kg-1·min-1 was 1.70 +- 0.76, 1.75 +- 0.83, respectively, compared with the mean WSCI at rest (x2=3.25 versus 2.33, P > 0.05). The pathologic examination showed viable myocardium at the ischemic regions. Conclusion: Low dose dobutamine (5 μg·kg-1·min-1) can recover hypokinetic or akinetic myocardial regions, Dobutamine stress MR can detect myocardial viability

  17. SU-E-J-140: Availability of Using Diaphragm Matching in Stereotactic Body Radiotherapy (SBRT) at the Time in Breath-Holding SBRT for Liver Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kawahara, D; Tsuda, S. [Course of Medical and Dental Sciences, Graduate School of Biomedical ' Health Sciences, Hiroshima University (Japan); Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital Health (Japan); Ozawa, S; Ohno, Y.; Kimura, T.; Nagata, Y. [Department of Radiation Oncology, Institute of Biomedical ' Health Science, Hiroshima University (Japan); Nakashima, T.; Aita, M.; Ochi, Y.; Okumura, T.; Masuda, H. [Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital Health (Japan)

    2014-06-01

    Purpose: IGRT based on the bone matching may produce a larger target positioning error in terms of the reproducibility of the expiration breath hold. Therefore, the feasibility of the 3D image matching between planning CT image and pretreatment CBCT image based on the diaphragm matching was investigated. Methods: In fifteen-nine liver SBRT cases, Lipiodol, uptake after TACE was outlined as the marker of the tumor. The relative coordinate of the isocenter obtained by the contrast matching was defined as the reference coordinate. The target positioning difference between diaphragm matching and bone matching were evaluated by the relative coordinate of the isocenter from the reference coordinate obtained by each matching technique. In addition, we evaluated PTV margins by van Herk setup margin formula. Results: The target positioning error by the diaphragm matching and the bone matching was 1.31±0.83 and 3.10±2.80 mm in the cranial-caudal(C-C) direction, 1.04±0.95 and 1.62±1.02 mm in the anterior-posterior(A-P) direction, 0.93±1.19 and 1.12±0.94 mm in the left-right(L-R) direction, respectively. The positioning error by the diaphragm matching was significantly smaller than the bone matching in the C-C direction (p<0.05). The setup margin of diaphragm matching and bone matching that we had calculated based on van Herk margin formula was 4.5mm and 6.2mm(C-C), and 3.6mm and 6.3mm(A-P), and 2.6mm and 4.5mm(L-R), respectively. Conclusion: IGRT based on a diaphragm matching could be one alternative image matching technique for the positioning of the patients with liver tumor.

  18. SU-E-J-140: Availability of Using Diaphragm Matching in Stereotactic Body Radiotherapy (SBRT) at the Time in Breath-Holding SBRT for Liver Cancer

    International Nuclear Information System (INIS)

    Purpose: IGRT based on the bone matching may produce a larger target positioning error in terms of the reproducibility of the expiration breath hold. Therefore, the feasibility of the 3D image matching between planning CT image and pretreatment CBCT image based on the diaphragm matching was investigated. Methods: In fifteen-nine liver SBRT cases, Lipiodol, uptake after TACE was outlined as the marker of the tumor. The relative coordinate of the isocenter obtained by the contrast matching was defined as the reference coordinate. The target positioning difference between diaphragm matching and bone matching were evaluated by the relative coordinate of the isocenter from the reference coordinate obtained by each matching technique. In addition, we evaluated PTV margins by van Herk setup margin formula. Results: The target positioning error by the diaphragm matching and the bone matching was 1.31±0.83 and 3.10±2.80 mm in the cranial-caudal(C-C) direction, 1.04±0.95 and 1.62±1.02 mm in the anterior-posterior(A-P) direction, 0.93±1.19 and 1.12±0.94 mm in the left-right(L-R) direction, respectively. The positioning error by the diaphragm matching was significantly smaller than the bone matching in the C-C direction (p<0.05). The setup margin of diaphragm matching and bone matching that we had calculated based on van Herk margin formula was 4.5mm and 6.2mm(C-C), and 3.6mm and 6.3mm(A-P), and 2.6mm and 4.5mm(L-R), respectively. Conclusion: IGRT based on a diaphragm matching could be one alternative image matching technique for the positioning of the patients with liver tumor

  19. Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition. Detectability for pulmonary lesions compared with respiratory-gated PET/CT

    International Nuclear Information System (INIS)

    Deep-inspiration breath-hold (DIBH) positron emission tomography (PET)/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used. (author)

  20. Cardiac MRI: evaluation of phonocardiogram-gated cine imaging for the assessment of global und regional left ventricular function in clinical routine

    Energy Technology Data Exchange (ETDEWEB)

    Nassenstein, Kai; Schlosser, Thomas [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Orzada, Stephan [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); Haering, Lars; Czylwik, Andreas [University Duisburg-Essen, Department of Communication Systems, Duisburg (Germany); Zenge, Michael; Mueller, Edgar [Siemens Healthcare, Erlangen (Germany); Eberle, Holger; Bruder, Oliver [Elisabeth Hospital Essen, Department of Cardiology and Angiology, Essen (Germany); Ladd, Mark E.; Maderwald, Stefan [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2012-03-15

    To validate a phonocardiogram (PCG)-gated cine imaging approach for the assessment of left ventricular (LV) function. In this prospective study, cine MR imaging of the LV was performed twice in 79 patients by using retrospectively PCG- and retrospectively ECG-gated cine SSFP sequences at 1.5 T. End-diastolic volumes (EDV), end-systolic volumes (ESV), stroke volumes (SV), ejection fraction (EF), muscle mass (MM), as well as regional wall motion were assessed. Subgroup analyses were performed for patients with valvular defects and for patients with dysrhythmia. PCG-gated imaging was feasible in 75 (95%) patients, ECG-gating in all patients. Excellent correlations were observed for all volumetric parameters (r > 0.98 for all variables analysed). No significant differences were observed for EDV (-0.24 {+-} 3.14 mL, P = 0.5133), ESV (-0.04 {+-} 2.36 mL, P = 0.8951), SV (-0.20 {+-} 3.41 mL, P = 0.6083), EF (-0.16 {+-} 1.98%, P = 0.4910), or MM (0.31 {+-} 4.2 g, P = 0.7067) for the entire study cohort, nor for either of the subgroups. PCG- and ECG-gated cine imaging revealed similar results for regional wall motion analyses (115 vs. 119 segments with wall motion abnormalities, P = 0.3652). The present study demonstrates that PCG-gated cine imaging enables accurate assessment of global and regional LV function in the vast majority of patients in clinical routine. (orig.)

  1. Cardiac MRI: evaluation of phonocardiogram-gated cine imaging for the assessment of global und regional left ventricular function in clinical routine

    International Nuclear Information System (INIS)

    To validate a phonocardiogram (PCG)-gated cine imaging approach for the assessment of left ventricular (LV) function. In this prospective study, cine MR imaging of the LV was performed twice in 79 patients by using retrospectively PCG- and retrospectively ECG-gated cine SSFP sequences at 1.5 T. End-diastolic volumes (EDV), end-systolic volumes (ESV), stroke volumes (SV), ejection fraction (EF), muscle mass (MM), as well as regional wall motion were assessed. Subgroup analyses were performed for patients with valvular defects and for patients with dysrhythmia. PCG-gated imaging was feasible in 75 (95%) patients, ECG-gating in all patients. Excellent correlations were observed for all volumetric parameters (r > 0.98 for all variables analysed). No significant differences were observed for EDV (-0.24 ± 3.14 mL, P = 0.5133), ESV (-0.04 ± 2.36 mL, P = 0.8951), SV (-0.20 ± 3.41 mL, P = 0.6083), EF (-0.16 ± 1.98%, P = 0.4910), or MM (0.31 ± 4.2 g, P = 0.7067) for the entire study cohort, nor for either of the subgroups. PCG- and ECG-gated cine imaging revealed similar results for regional wall motion analyses (115 vs. 119 segments with wall motion abnormalities, P = 0.3652). The present study demonstrates that PCG-gated cine imaging enables accurate assessment of global and regional LV function in the vast majority of patients in clinical routine. (orig.)

  2. Fast Measurement of Intracardiac Pressure Differences With 2D Breath-Hold Phase-Contrast MRI

    OpenAIRE

    Thompson, Richard B; Mcveigh, Elliot R.

    2003-01-01

    Intracardiovascular blood pressure differences can be derived from velocity images acquired with phase-contrast (PC) MRI by evaluating the Navier-Stokes equations. Pressure differences within a slice of interest can be calculated using only the in-plane velocity components from that slice. This rapid exam is proposed as an alternative to the lengthy 3D velocity imaging exams. Despite their good spatial coverage, the 3D exams are prone to artifacts and errors from respiratory motion and insuff...

  3. 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...

  4. 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.

  5. NOTE: Dosimetric evaluation of inspiration and expiration breath-hold for intensity-modulated radiotherapy planning of non-small cell lung cancer

    Science.gov (United States)

    Tahir, Bilal A.; Bragg, Christopher M.; Lawless, Sarah E.; Hatton, Matthew Q. F.; Ireland, Rob H.

    2010-04-01

    The purpose of this study was to compare target coverage and lung tissue sparing between inspiration and expiration breath-hold intensity-modulated radiotherapy (IMRT) plans for patients with non-small cell lung cancer (NSCLC). In a prospective study, seven NSCLC patients gave written consent to undergo both moderate deep inspiration and end-expiration breath-hold computed tomography (CT), which were used to generate five-field IMRT plans. Dose was calculated with a scatter and an inhomogeneity correction algorithm. The percentage of the planning target volume (PTV) receiving 90% of the prescription dose (PTV90), the volume of total lung receiving >= 10 Gy (V10) and >= 20 Gy (V20) and the mean lung dose (MLD) were compared by the Student's paired t-test. Compared with the expiration plans, the mean ± SD reductions for V10, V20 and MLD on the inspiration plans were 4.0 ± 3.7% (p = 0.031), 2.5 ± 2.3% (p = 0.028) and 1.1 ± 0.7 Gy (p = 0.007), respectively. Conversely, a mean difference of 1.1 ± 1.1% (p = 0.044) in PTV90 was demonstrated in favour of expiration. When using IMRT, inspiration breath-hold can reduce the dose to normal lung tissue while expiration breath-hold can improve the target coverage. The improved lung sparing at inspiration may outweigh the modest improvements in target coverage at expiration.

  6. Incorrect performance of the breath hold method in the old underestimates cerebrovascular reactivity and goes unnoticed without concomitant blood pressure and end-tidal CO(2) registration

    NARCIS (Netherlands)

    Beek, A. van; Wit, H.M. de; Olde Rikkert, M.G.M.; Claassen, J.A.H.R.

    2011-01-01

    BACKGROUND AND PURPOSE: The breath hold maneuver is a convenient and frequently used method to assess cerebrovascular reactivity (CR). This study aimed to assess feasibility and reproducibility of this method in healthy older persons. METHODS: Twenty-five healthy volunteers, aged 75 (SD 4) years, pe

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

    International Nuclear Information System (INIS)

    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

  8. The UK HeartSpare Study (Stage IB): Randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery

    International Nuclear Information System (INIS)

    Purpose: To compare mean heart and left anterior descending coronary artery (LAD) doses (NTDmean) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques. Materials and methods: Following surgery for early breast cancer, patients with estimated breast volumes >750 cm3 underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1–7, before switching techniques for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTDmean between techniques. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. Results: 34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTDmean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p < 0.001) and 2.9 and 7.8 (p < 0.001). Clip-based CBCT errors for VBH and prone respectively were ⩽3.0 mm and ⩽6.5 mm (Σ) and ⩽3.5 mm and ⩽5.4 mm (σ). Conclusions: In larger-breasted women, supine VBH provided superior cardiac sparing and reproducibility than a free-breathing prone position

  9. 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

  10. Development and clinical evaluation of automatic fiducial detection for tumor tracking in cine megavoltage images during volumetric modulated arc therapy

    International Nuclear Information System (INIS)

    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. SU-E-J-112: The Impact of Cine EPID Image Acquisition Frame Rate On Markerless Soft-Tissue Tracking

    Energy Technology Data Exchange (ETDEWEB)

    Yip, S; Rottmann, J; Berbeco, R [Brigham and Women' s Hospital, Boston, MA (United States)

    2014-06-01

    Purpose: Although reduction of the cine EPID acquisition frame rate through multiple frame averaging may reduce hardware memory burden and decrease image noise, it can hinder the continuity of soft-tissue motion leading to poor auto-tracking results. The impact of motion blurring and image noise on the tracking performance was investigated. Methods: Phantom and patient images were acquired at a frame rate of 12.87Hz on an AS1000 portal imager. Low frame rate images were obtained by continuous frame averaging. A previously validated tracking algorithm was employed for auto-tracking. The difference between the programmed and auto-tracked positions of a Las Vegas phantom moving in the superior-inferior direction defined the tracking error (δ). Motion blurring was assessed by measuring the area change of the circle with the greatest depth. Additionally, lung tumors on 1747 frames acquired at eleven field angles from four radiotherapy patients are manually and automatically tracked with varying frame averaging. δ was defined by the position difference of the two tracking methods. Image noise was defined as the standard deviation of the background intensity. Motion blurring and image noise were correlated with δ using Pearson correlation coefficient (R). Results: For both phantom and patient studies, the auto-tracking errors increased at frame rates lower than 4.29Hz. Above 4.29Hz, changes in errors were negligible with δ<1.60mm. Motion blurring and image noise were observed to increase and decrease with frame averaging, respectively. Motion blurring and tracking errors were significantly correlated for the phantom (R=0.94) and patient studies (R=0.72). Moderate to poor correlation was found between image noise and tracking error with R -0.58 and -0.19 for both studies, respectively. Conclusion: An image acquisition frame rate of at least 4.29Hz is recommended for cine EPID tracking. Motion blurring in images with frame rates below 4.39Hz can substantially reduce the

  12. SU-E-J-112: The Impact of Cine EPID Image Acquisition Frame Rate On Markerless Soft-Tissue Tracking

    International Nuclear Information System (INIS)

    Purpose: Although reduction of the cine EPID acquisition frame rate through multiple frame averaging may reduce hardware memory burden and decrease image noise, it can hinder the continuity of soft-tissue motion leading to poor auto-tracking results. The impact of motion blurring and image noise on the tracking performance was investigated. Methods: Phantom and patient images were acquired at a frame rate of 12.87Hz on an AS1000 portal imager. Low frame rate images were obtained by continuous frame averaging. A previously validated tracking algorithm was employed for auto-tracking. The difference between the programmed and auto-tracked positions of a Las Vegas phantom moving in the superior-inferior direction defined the tracking error (δ). Motion blurring was assessed by measuring the area change of the circle with the greatest depth. Additionally, lung tumors on 1747 frames acquired at eleven field angles from four radiotherapy patients are manually and automatically tracked with varying frame averaging. δ was defined by the position difference of the two tracking methods. Image noise was defined as the standard deviation of the background intensity. Motion blurring and image noise were correlated with δ using Pearson correlation coefficient (R). Results: For both phantom and patient studies, the auto-tracking errors increased at frame rates lower than 4.29Hz. Above 4.29Hz, changes in errors were negligible with δ<1.60mm. Motion blurring and image noise were observed to increase and decrease with frame averaging, respectively. Motion blurring and tracking errors were significantly correlated for the phantom (R=0.94) and patient studies (R=0.72). Moderate to poor correlation was found between image noise and tracking error with R -0.58 and -0.19 for both studies, respectively. Conclusion: An image acquisition frame rate of at least 4.29Hz is recommended for cine EPID tracking. Motion blurring in images with frame rates below 4.39Hz can substantially reduce the

  13. Measurement of left ventricular dimensions with contrast-enhanced three-dimensional cine imaging facilitated by k-t SENSE

    Directory of Open Access Journals (Sweden)

    Greenwood John P

    2008-05-01

    Full Text Available Abstract Aim To compare three-dimensional (3D k-t sensitivity encoded (k-t SENSE cine cardiovascular magnetic resonance (CMR, before and after contrast administration, against standard 2D imaging for the assessment of left ventricular volumes and mass. Method Twenty-six subjects (14 volunteers, 12 patients underwent multiple breathhold 2D balanced turbo-field echo cine CMR in addition to k-t SENSE accelerated 3D imaging (acceleration factor 5; 5× k-t SENSE, performed before and after administration of a high-relaxivity gadolinium-based contrast agent (Gadobutrolum. k-t acceleration factors of 7 and 10 were also assessed in six volunteers. Left ventricular end diastolic volume (EDV, end systolic volume (ESV, mass, and ejection fraction (EF were calculated for each method. Results There was at least moderate agreement between the EDV, ESV, mass and EF calculated by 2D and 3D 5× k-t SENSE methods before contrast (concordance coefficients 0.92, 0.95, 0.97, 0.92, respectively. Agreement improved following contrast (concordance coefficients 0.97, 0.99, 0.98, 0.93, respectively. The 3D method underestimated all parameters compared to 2D (mean bias pre-contrast 6.1 ml, 0.6 ml, 3.5 g, 2.0% respectively. 3D image quality scores were significantly poorer than 2D, showing a non-significant trend to improvement following contrast administration. Parameters derived with k-t acceleration factors of 7 and 10 showed poorer agreement with 2D values. Conclusion Left ventricular volumes and mass are reliably assessed using 3D 5× k-t SENSE accelerated CMR. Contrast administration further improves agreement between 5× k-t SENSE and 2D-derived measurements. k-t acceleration factors greater than 5, though feasible, produce poorer agreement with 2D values.

  14. Implementation of Feedback-Guided Voluntary Breath-Hold Gating for Cone Beam CT-Based Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To analyze tumor position reproducibility of feedback-guided voluntary deep inspiration breath-hold (FGBH) gating for cone beam computed tomography (CBCT)-based stereotactic body radiotherapy (SBRT). Methods and materials: Thirteen early-stage lung cancer patients eligible for SBRT with tumor motion of >1cm were evaluated for FGBH-gated treatment. Multiple FGBH CTs were acquired at simulation, and single FGBH CBCTs were also acquired prior to each treatment. Simulation CTs and treatment CBCTs were analyzed to quantify reproducibility of tumor positions during FGBH. Benefits of FGBH gating compared to treatment during free breathing, as well treatment with gating at exhalation, were examined for lung sparing, motion margins, and reproducibility of gross tumor volume (GTV) position relative to nonmoving anatomy. Results: FGBH increased total lung volumes by 1.5 times compared to free breathing, resulting in a proportional drop in total lung volume receiving 10 Gy or more. Intra- and inter-FGBH reproducibility of GTV centroid positions at simulation were 1.0 ± 0.5 mm, 1.3 ± 1.0 mm, and 0.6 ± 0.4 mm in the anterior-posterior (AP), superior-inferior (SI), and left-right lateral (LR) directions, respectively, compared to more than 1 cm of tumor motion at free breathing. During treatment, inter-FGBH reproducibility of the GTV centroid with respect to bony anatomy was 1.2 ± 0.7 mm, 1.5 ± 0.8 mm, and 1.0 ± 0.4 mm in the AP, SI, and LR directions. In addition, the quality of CBCTs was improved due to elimination of motion artifacts, making this technique attractive for poorly visualized tumors, even with small motion. Conclusions: The extent of tumor motion at normal respiration does not influence the reproducibility of the tumor position under breath hold conditions. FGBH-gated SBRT with CBCT can improve the reproducibility of GTV centroids, reduce required margins, and minimize dose to normal tissues in the treatment of mobile tumors.

  15. Application of the Karhunen-Loeve transform temporal image filter to reduce noise in real-time cardiac cine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ding Yu; Raman, Subha V; Simonetti, Orlando P [Davis Heart and Lung Research Institute, Ohio Sate University, Columbus, OH, 43210 (United States); Chung, Y-C [Siemens Medical Solutions, Inc., Columbus, OH, 43210 (United States)], E-mail: yu.ding@osumc.edu

    2009-06-21

    Real-time dynamic magnetic resonance imaging (MRI) typically sacrifices the signal-to-noise ratio (SNR) to achieve higher spatial and temporal resolution. Spatial and/or temporal filtering (e.g., low-pass filtering or averaging) of dynamic images improves the SNR at the expense of edge sharpness. We describe the application of a temporal filter for dynamic MR image series based on the Karhunen-Loeve transform (KLT) to remove random noise without blurring stationary or moving edges and requiring no training data. In this paper, we present several properties of this filter and their effects on filter performance, and propose an automatic way to find the filter cutoff based on the autocorrelation of the eigenimages. Numerical simulation and in vivo real-time cardiac cine MR image series spanning multiple cardiac cycles acquired using multi-channel sensitivity-encoded MRI, i.e., parallel imaging, are used to validate and demonstrate these properties. We found that in this application, the noise standard deviation was reduced to 42% of the original with no apparent image blurring by using the proposed filter cutoff. Greater noise reduction can be achieved by increasing the length of the image series. This advantage of KLT filtering provides flexibility in the form of another scan parameter to trade for SNR.

  16. Application of the Karhunen-Loeve transform temporal image filter to reduce noise in real-time cardiac cine MRI.

    Science.gov (United States)

    Ding, Yu; Chung, Yiu-Cho; Raman, Subha V; Simonetti, Orlando P

    2009-06-21

    Real-time dynamic magnetic resonance imaging (MRI) typically sacrifices the signal-to-noise ratio (SNR) to achieve higher spatial and temporal resolution. Spatial and/or temporal filtering (e.g., low-pass filtering or averaging) of dynamic images improves the SNR at the expense of edge sharpness. We describe the application of a temporal filter for dynamic MR image series based on the Karhunen-Loeve transform (KLT) to remove random noise without blurring stationary or moving edges and requiring no training data. In this paper, we present several properties of this filter and their effects on filter performance, and propose an automatic way to find the filter cutoff based on the autocorrelation of the eigenimages. Numerical simulation and in vivo real-time cardiac cine MR image series spanning multiple cardiac cycles acquired using multi-channel sensitivity-encoded MRI, i.e., parallel imaging, are used to validate and demonstrate these properties. We found that in this application, the noise standard deviation was reduced to 42% of the original with no apparent image blurring by using the proposed filter cutoff. Greater noise reduction can be achieved by increasing the length of the image series. This advantage of KLT filtering provides flexibility in the form of another scan parameter to trade for SNR. PMID:19491455

  17. Application of the Karhunen-Loeve transform temporal image filter to reduce noise in real-time cardiac cine MRI

    International Nuclear Information System (INIS)

    Real-time dynamic magnetic resonance imaging (MRI) typically sacrifices the signal-to-noise ratio (SNR) to achieve higher spatial and temporal resolution. Spatial and/or temporal filtering (e.g., low-pass filtering or averaging) of dynamic images improves the SNR at the expense of edge sharpness. We describe the application of a temporal filter for dynamic MR image series based on the Karhunen-Loeve transform (KLT) to remove random noise without blurring stationary or moving edges and requiring no training data. In this paper, we present several properties of this filter and their effects on filter performance, and propose an automatic way to find the filter cutoff based on the autocorrelation of the eigenimages. Numerical simulation and in vivo real-time cardiac cine MR image series spanning multiple cardiac cycles acquired using multi-channel sensitivity-encoded MRI, i.e., parallel imaging, are used to validate and demonstrate these properties. We found that in this application, the noise standard deviation was reduced to 42% of the original with no apparent image blurring by using the proposed filter cutoff. Greater noise reduction can be achieved by increasing the length of the image series. This advantage of KLT filtering provides flexibility in the form of another scan parameter to trade for SNR.

  18. Development and evaluation of a semiautomatic segmentation method for the estimation of LV parameters on cine MR images

    Science.gov (United States)

    Mazonakis, Michalis; Grinias, Elias; Pagonidis, Konstantin; Tziritas, George; Damilakis, John

    2010-02-01

    The purpose of this study was to develop and evaluate a semiautomatic method for left ventricular (LV) segmentation on cine MR images and subsequent estimation of cardiac parameters. The study group comprised cardiac MR examinations of 18 consecutive patients with known or suspected coronary artery disease. The new method allowed the automatic detection of the LV endocardial and epicardial boundaries on each short-axis cine MR image using a Bayesian flooding segmentation algorithm and weighted least-squares B-splines minimization. Manual editing of the automatic contours could be performed for unsatisfactory segmentation results. The end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and LV mass estimated by the new method were compared with the reference values obtained by manually tracing the LV cavity borders. The reproducibility of the new method was determined using data from two independent observers. The mean number of endocardial and epicardial outlines not requiring any manual adjustment was more than 80% and 76% of the total contour number per study, respectively. The mean segmentation time including the required manual corrections was 2.3 ± 0.7 min per patient. LV volumes estimated by the semiautomatic method were significantly lower than those by manual tracing (P 0.05). LV indices estimated by the two methods were well correlated (r >= 0.80). The mean difference between manual and semiautomatic method for estimating EDV, ESV, EF and LV mass was 6.1 ± 7.2 ml, 3.0 ± 5.2 ml, -0.6 ± 4.3% and -6.2 ± 12.2 g, respectively. The intraobserver and interobserver variability associated with the semiautomatic determination of LV indices was 0.5-1.2% and 0.8-3.9%, respectively. The estimation of LV parameters with the new semiautomatic segmentation method is technically feasible, highly reproducible and time effective.

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

    International Nuclear Information System (INIS)

    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

  20. 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.

  1. Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients

    International Nuclear Information System (INIS)

    Background and purpose: This study aims at evaluating the effect of deep-inspiration breath hold (DIBH) on target coverage and dose to organs at risk in a large series of breast cancer patients. Materials and methods: Clinical dose plans for 319 breast cancer patients were evaluated: 144 left-sided patients treated with DIBH and 175 free-breathing (FB) patients (83 left-sided and 92 right-sided). All patients received whole breast irradiation with tangential fields, based on a forward-planned intensity-modulated radiation therapy (IMRT) technique. Dose to heart, ipsi-lateral lung and ipsi-lateral breast were assessed and median values compared between patient groups. Results: Comparing group median values, DIBH plans show large reductions of dose to the heart compared with left-sided FB plans; V20Gy (relative volume receiving ⩾20 Gy) for the heart is reduced from 7.8% to 2.3% (−70%, p < 0.0001), V40Gy from 3.4% to 0.3% (−91%, p < 0.0001) and mean dose from 5.2 to 2.7 Gy (−48%, p < 0.0001). Lung dose also shows a small reduction in V20Gy (p < 0.04), while median target coverage is slightly improved (p = 0.0002). Conclusions: In a large series of clinical patients we find that implementation of DIBH in daily clinical practice results in reduced irradiation of heart and lung, without compromising target coverage

  2. Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation

    International Nuclear Information System (INIS)

    Purpose/Objective: This study evaluates the dosimetric benefits and feasibility of a deep inspiration breath-hold (DIBH) technique in the treatment of lung tumors. The technique has two distinct features--deep inspiration, which reduces lung density, and breath-hold, which immobilizes lung tumors, thereby allowing for reduced margins. Both of these properties can potentially reduce the amount of normal lung tissue in the high-dose region, thus reducing morbidity and improving the possibility of dose escalation. Methods and Materials: Five patients treated for non-small cell lung carcinoma (Stage IIA-IIIB) received computed tomography (CT) scans under 4 respiration conditions: free-breathing, DIBH, shallow inspiration breath-hold, and shallow expiration breath-hold. The free-breathing and DIBH scans were used to generate 3-dimensional conformal treatment plans for comparison, while the shallow inspiration and expiration scans determined the extent of tumor motion under free-breathing conditions. To acquire the breath-hold scans, the patients are brought to reproducible respiration levels using spirometry, and for DIBH, modified slow vital capacity maneuvers. Planning target volumes (PTVs) for free-breathing plans included a margin for setup error (0.75 cm) plus a margin equal to the extent of tumor motion due to respiration (1-2 cm). Planning target volumes for DIBH plans included the same margin for setup error, with a reduced margin for residual uncertainty in tumor position (0.2-0.5 cm) as determined from repeat fluoroscopic movies. To simulate the effects of respiration-gated treatments and estimate the role of target immobilization alone (i.e., without the benefit of reduced lung density), a third plan is generated from the free-breathing scan using a PTV with the same margins as for DIBH plans. Results: The treatment plan comparison suggests that, on average, the DIBH technique can reduce the volume of lung receiving more than 25 Gy by 30% compared to free

  3. Evaluation of methods for MR imaging of human right ventricular heart volumes and mass

    International Nuclear Information System (INIS)

    Purpose: To assess the utility of two different imaging directions in the evaluation of human right ventricular (RV) heart volumes and mass with MR imaging; to compare breath-hold vs. non-breath-hold imaging in volume analysis; and to compare turbo inversion recovery imaging (TIR) with gradient echo imaging in RV mass measurement. Material and Methods: We examined 12 healthy volunteers (age 27-59 years). Breath-hold gradient echo MR imaging was performed in two imaging planes: 1) perpendicular to the RV inflow tract (RVIT view), and 2) in the transaxial view (TA view). The imaging was repeated in the TA view while the subjects were breathing freely. To analyze RV mass using TIR images, the RV was again imaged at end-diastole using the two views. The RV end-diastolic cavity (RVEDV) and muscle volume as well as end-systolic cavity volume (RVESV) were determined with the method of discs. All measurements were done blindly twice to assess repeatability of image analysis. To assess reproducibility of the measurements, 6 of the subjects were imaged twice at an interval of 5-9 weeks. Results: RVEDV averaged 133.2 ml, RVESV 61.5 ml and the RVmass 46.2 g in the RVIT view and 119.9 ml, 56.9 ml and 38.3 g in the TA view, respectively. The volumes obtained with breath-holding were slightly but not significantly smaller than the volumes obtained during normal breathing. There were no marked differences in the RV muscle mass obtained with gradient echo imaging compared to TIR imaging in either views. Repeatability of volume analysis was better in TA than RVIT view: the mean differences were 0.7±4.0 ml and 5.4±14.0 ml in end-diastole and 1.6±3.1 ml and 1.5±13.9 ml in end-systole, respectively. Repeatability of mass analysis was good in both TIR and cine images in the RVIT view but slightly better in TIR images: 0.5±2.4 g compared to 0.8±2.9 g in cine images. Reproducibility of imaging was good, mean differences for RVEDV and RVESV were 1.0±4.8 ml and 0.8±2.8 ml

  4. Evaluation of methods for MR imaging of human right ventricular heart volumes and mass

    Energy Technology Data Exchange (ETDEWEB)

    Jauhiainen, T.; Jaervinen, V.M.; Hekali, P.E. [Helsinki Univ. Central Hospital (Finland). Dept. of Diagnostic Radiology

    2002-11-01

    Purpose: To assess the utility of two different imaging directions in the evaluation of human right ventricular (RV) heart volumes and mass with MR imaging; to compare breath-hold vs. non-breath-hold imaging in volume analysis; and to compare turbo inversion recovery imaging (TIR) with gradient echo imaging in RV mass measurement. Material and Methods: We examined 12 healthy volunteers (age 27-59 years). Breath-hold gradient echo MR imaging was performed in two imaging planes: 1) perpendicular to the RV inflow tract (RVIT view), and 2) in the transaxial view (TA view). The imaging was repeated in the TA view while the subjects were breathing freely. To analyze RV mass using TIR images, the RV was again imaged at end-diastole using the two views. The RV end-diastolic cavity (RVEDV) and muscle volume as well as end-systolic cavity volume (RVESV) were determined with the method of discs. All measurements were done blindly twice to assess repeatability of image analysis. To assess reproducibility of the measurements, 6 of the subjects were imaged twice at an interval of 5-9 weeks. Results: RVEDV averaged 133.2 ml, RVESV 61.5 ml and the RVmass 46.2 g in the RVIT view and 119.9 ml, 56.9 ml and 38.3 g in the TA view, respectively. The volumes obtained with breath-holding were slightly but not significantly smaller than the volumes obtained during normal breathing. There were no marked differences in the RV muscle mass obtained with gradient echo imaging compared to TIR imaging in either views. Repeatability of volume analysis was better in TA than RVIT view: the mean differences were 0.7{+-}4.0 ml and 5.4{+-}14.0 ml in end-diastole and 1.6{+-}3.1 ml and 1.5{+-}13.9 ml in end-systole, respectively. Repeatability of mass analysis was good in both TIR and cine images in the RVIT view but slightly better in TIR images: 0.5{+-}2.4 g compared to 0.8{+-}2.9 g in cine images. Reproducibility of imaging was good, mean differences for RVEDV and RVESV were 1.0{+-}4.8 ml and 0

  5. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gerretsen, S.C.; Versluis, B.; Bekkers, S.C.A.M. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Leiner, T. [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands)], E-mail: leiner@rad.unimaas.nl

    2008-01-15

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 {+-} 3.1 vs. 3.0 T: 50.7 {+-} 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 {+-} 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 {+-} 0.3), and lowest for non-enhanced 3.0 T (1.7 {+-} 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T.

  6. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

    International Nuclear Information System (INIS)

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 ± 3.1 vs. 3.0 T: 50.7 ± 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 ± 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 ± 0.3), and lowest for non-enhanced 3.0 T (1.7 ± 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T

  7. Comparison of 16 slice multi-detector computed tomography and breath hold 3D magnetic resonance angiography in the detection of coronary stenosis

    Institute of Scientific and Technical Information of China (English)

    Xin LIU; Zulong CAI; Youquan CAI; Shaohong ZHAO; Ningyu AN; Yuangui GAO

    2006-01-01

    Objective To compare 16-slice multi-detector spiral computed tomography (MDCT) and breathhold 3D magnetic resonance (MR) coronary angiography in the visualization of coronary arteries and the accuracy of detecting significant (> 50%) coronary stenoses in patients with suspected coronary artery disease. Methods Forty patients were examined by 16-slice CT (GE, Lightspeedl6)and MR (GE,Twinspeed) within 3 days; 31 of them underwent conventional coronary angiography (CAG) within 2 weeks after CT and MR scan. CT was performed with 16× 1.25 mm detector collimation, 0.5 s rotation time and images were reconstructed at 60%-75% of the cardiac cycle. MR was performed with breath hold 3D FIESTA (TR4.0 ms, TE1.7 ms, flip angle 65, slice thickness 3 mm, FOV 280 mm, matrix 256× 192). Mean heart rate was 63 ± 5.8 bpm and β-blocker was used in 24 patients. MR and CT image quality was evaluated in 9 coronary segments (RCA1, RCA2, RCA3, LM, LAD1, LAD2, LAD3, LCX1, LCX2) using a four-point grading scale.Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for detection of significant stenosis using CAG as the gold standard. Results 16-slice CT showed higher image quality in most coronary segments except RCA2.Forty-three segments were diagnosed as significant stenosis by CAG, 36 and 27 of these were correctly detected by CT and MR respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of 16-slice CT and MR for detecting significant stenosis were 83 %, 84 %, 49 %, 97 % and 63 %, 90 %, 55 %, 93 %, respectively. Conclusion Sixteen-slice CT showed higher image quality in most coronary segments excepted for middle RCA. 16-slice CT had higher sensitivity than MR for detection of coronary significant stenosis, whereas MR had higher specificity than CT. Both CT and MR showed high negative predictive value,which is useful for excluding coronary stenosis in symptomatic patients.

  8. Dosimetric study of SIB-IMRT versus SIB-3DCRT for breast cancer with breath-hold gated technique

    Directory of Open Access Journals (Sweden)

    Suresh Moorthy

    2013-10-01

    , integral dose, and treatment time. With the use of breath-hold gated technique in IMRT, it can further improve the target coverage and reduction of doses to the heart, lung, and LAD. SIB technique could reduce the overall treatment duration by about one week.----------------------------------Cite this article as:Moorthy S, Sakr H, Hasan S, Samuel J, Al-Janahi S, Murthy N. Dosimetric study of SIB-IMRT versus SIB-3DCRT for breast cancer with breath-hold gated technique. Int J Cancer Ther Oncol 2013;1(1:010110. DOI: http://dx.doi.org/10.14319/ijcto.0101.10

  9. Minimizing Late Effects for Patients With Mediastinal Hodgkin Lymphoma: Deep Inspiration Breath-Hold, IMRT, or Both?

    International Nuclear Information System (INIS)

    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

  10. Involved-node radiotherapy combined with deep-inspiration breath-hold technique in patients with Hodgkin lymphoma

    International Nuclear Information System (INIS)

    Purpose. - To assess the clinical outcome of the involved-node radiotherapy (INRT) concept with the use of deep-inspiration breath-hold (DIBH) technique in patients with localized supra-diaphragmatic Hodgkin lymphoma. Patients and methods. - All were patients with stage I-II Hodgkin lymphoma and they were treated with chemotherapy prior to irradiation. Radiation treatments were delivered using the involved-node radiotherapy concept according to the European Organization for Research and Treatment of Cancer Guidelines and a spirometer dedicated to DIBH radiotherapy was used for every patient. Results. - Twenty-seven patients with Hodgkin lymphoma (26 patients with primary Hodgkin lymphoma, one with refractory disease), treated from November 2004 to October 2010, were retrospectively analysed. The median age was 27 years (range 16 to 54). Seventeen (63%) patients had stage I-IIA and 10 (37%) had stage I-IIB disease. All patients received two to six cycles of adriamycin, bleomycin, vinblastine and dacarbazine. The median radiation dose to patients was 30,6 Gy (range: 19,8-40). Protection of various organs at risk was satisfactory. Median follow-up, 3-year progression-free and 3-year overall survival were 38 months (range: 7-70), 96% (95% CI: 79-99%) and 95% (95% CI: 75-99%), respectively. Recurrence occurred in one patient (mediastinal in-field relapse). There was one grade 3 acute toxicity (transient pneumonitis). Conclusions. - Our results suggest that patients with localized Hodgkin lymphoma can be safely and efficiently treated using deep-inspiration breath technique and the involved-node radiotherapy concept. Longer follow-up is needed to assess late toxicity, especially for the heart and the coronary arteries. (authors)

  11. The deep inspiration breath hold technique using Abches reduces cardiac dose in patients undergoing left-sided breast irradiation

    International Nuclear Information System (INIS)

    We explored whether the deep inspiration breath hold (DIBH) technique using Abches during left-sided breast irradiation was effective for minimizing the amount of radiation to the heart and lung compared to free breathing (FB). Between February and July 2012, a total of 25 patients with left-sided breast cancer underwent two computed tomography scans each with the DIBH using Abches and using FB after breast-conserving surgery. The scans were retrospectively replanned using standardized criteria for the purpose of this study. The DIBH plans for each patient were compared with FB plans using dosimetric parameters. All patients were successfully treated with the DIBH technique using Abches. Significant differences were found between the DIBH and FB plans for mean heart dose (2.52 vs. 4.53 Gy), heart V30 (16.48 vs. 45.13 cm3), V20 (21.35 vs. 54.55 cm3), mean left anterior descending coronary artery (LAD) dose (16.01 vs. 26.26 Gy, all p 3 of the LAD (41.65 vs. 47.27 Gy, p = 0.017). The mean left lung dose (7.53 vs. 8.03 Gy, p = 0.073) and lung V20 (14.63% vs. 15.72%, p 0.060) of DIBH using Abches were not different significantly compared with FB. We report that the use of a DIBH technique using Abches in breathing adapted radiotherapy for left-sided breast cancer is easily feasible in daily practice and significantly reduces the radiation doses to the heart and LAD, therefore potentially reducing cardiac risk.

  12. 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.

  13. Evaluation of Vasomotor Reactivity by Transcranial Doppler Sonography: Age and Sex Related Differences in Breath Holding Index in Iranian Population

    Directory of Open Access Journals (Sweden)

    SA Mousavi

    2005-03-01

    Full Text Available Background: The assessment of cerebral vasoreactivity can provide information regarding the reserve capacity of cerebral circulation. Reduction of this property has been found in association with situations predisposing one toward cerebrovascular disease. In this study, we defined the vasoreactivity of brain vesseles according to age and sex of the patients. Methods: In this descriptive study, 289 healthy subjects (without hypertension, diabetes mellitus, obesity, smoking, CHF, CHD, were admitted from January 2004 to June 2004. The population was divided to four groups, according to age and sex (women and men more and less than 30. After determination of each patient’s flow velocity of middle cerebral artery (MCA by mean of a transcranial doppler instrument (TCD, before and after 30s apnea, breath holding index (BHI was calculated. Data was analyzed, using SPSS software. Results: BHI was significantly higher in women than men (0.918±0.40 versus 0.637±0.22; P<0.001. BHI was significantly lower in older (age > 30 women (0.812±0.31 than in younger ( ≤ 30 years women (0.995±0.44; P<0.001 but there was no significant difference between older (age > 30 men (0.62±0.23 and younger ( ≤ 30 years men (0.65±0.20; P > 0.05. Conclusion: The average of BHI was lower in men than in women in total and in all age subgroups. BHI was relatively constant in all age subgroups in men but there was significant decline in BHI by increasing age in women. So despite of many physiologic changes related to aging, vasomotor reactivity remains relatively constant in men but decreases in women. Findings of our study suggest that changes of cerebrovascular vasomotor reactivity in healthy subjects may be related to aging, but they are probably mainly influenced by sex. Keywords: vasomotor reactivity, BHI, TCD

  14. 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.

  15. Mind-body relationships in elite apnea divers during breath holding: a study of autonomic responses to acute hypoxemia

    Directory of Open Access Journals (Sweden)

    Marco eLaurino

    2012-03-01

    Full Text Available The mental control of ventilation with all associated phenomena,from relaxation to modulation of emotions, from cardiovascular tometabolic adaptations, constitutes a psychophysiological conditioncharacterizing voluntary breath holding (BH. BH induces severalautonomic responses, involving both autonomic cardiovascular andcutaneous pathways, whose characterization is the main aim ofthis study. Electrocardiogram and skin conductance (SC recordingswere collected from 14 elite divers during three conditions: freebreathing (FB, normoxic phase of BH (NPBH and hypoxic phaseof BH (HPBH. Thus, we compared a set of features describing signaldynamics between the three experimental conditions: from heart ratevariability features (in time and frequency domains and by usingnonlinear methods to rate and shape of spontaneous SC responses.The main result of the study rises by applying a Factor Analysis tothe subset of features significantly changed in the two BH phases.Indeed, the Factor Analysis allowed to uncover the structure of latentfactors which modeled the autonomic response: a factor describingthe autonomic balance, one the information increase rate, and alatter the central nervous system driver. The BH did not disrupt theFB factorial structure, and only few features moved among factors.Factor Analysis indicates that during BH i only the SC described theemotional output, ii the sympathetic tone on heart did not change, iiithe dynamics of interbeats intervals showed an increase of long rangecorrelation that anticipates the HPBH, followed by a drop to a randombehavior. In conclusion, data show that the autonomic control onheart rate and skin conductance are differentially modulated duringBH, which could be related to a more pronounced effect on emotionalcontrol induced by the mental training to BH.

  16. Dosimetric evaluation of inspiration and expiration breath-hold for intensity-modulated radiotherapy planning of non-small cell lung cancer

    International Nuclear Information System (INIS)

    The purpose of this study was to compare target coverage and lung tissue sparing between inspiration and expiration breath-hold intensity-modulated radiotherapy (IMRT) plans for patients with non-small cell lung cancer (NSCLC). In a prospective study, seven NSCLC patients gave written consent to undergo both moderate deep inspiration and end-expiration breath-hold computed tomography (CT), which were used to generate five-field IMRT plans. Dose was calculated with a scatter and an inhomogeneity correction algorithm. The percentage of the planning target volume (PTV) receiving 90% of the prescription dose (PTV90), the volume of total lung receiving ≥ 10 Gy (V10) and ≥ 20 Gy (V20) and the mean lung dose (MLD) were compared by the Student's paired t-test. Compared with the expiration plans, the mean ± SD reductions for V10, V20 and MLD on the inspiration plans were 4.0 ± 3.7% (p = 0.031), 2.5 ± 2.3% (p = 0.028) and 1.1 ± 0.7 Gy (p = 0.007), respectively. Conversely, a mean difference of 1.1 ± 1.1% (p = 0.044) in PTV90 was demonstrated in favour of expiration. When using IMRT, inspiration breath-hold can reduce the dose to normal lung tissue while expiration breath-hold can improve the target coverage. The improved lung sparing at inspiration may outweigh the modest improvements in target coverage at expiration. (note)

  17. Dosimetric evaluation of inspiration and expiration breath-hold for intensity-modulated radiotherapy planning of non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tahir, Bilal A; Bragg, Christopher M [Department of Radiotherapy Physics, Weston Park Hospital, Sheffield Teaching Hospitals NHS Trust (United Kingdom); Lawless, Sarah E; Hatton, Matthew Q F; Ireland, Rob H [Academic Unit of Clinical Oncology, University of Sheffield, Sheffield (United Kingdom)], E-mail: r.ireland@sheffield.ac.uk

    2010-04-21

    The purpose of this study was to compare target coverage and lung tissue sparing between inspiration and expiration breath-hold intensity-modulated radiotherapy (IMRT) plans for patients with non-small cell lung cancer (NSCLC). In a prospective study, seven NSCLC patients gave written consent to undergo both moderate deep inspiration and end-expiration breath-hold computed tomography (CT), which were used to generate five-field IMRT plans. Dose was calculated with a scatter and an inhomogeneity correction algorithm. The percentage of the planning target volume (PTV) receiving 90% of the prescription dose (PTV{sub 90}), the volume of total lung receiving {>=} 10 Gy (V{sub 10}) and {>=} 20 Gy (V{sub 20}) and the mean lung dose (MLD) were compared by the Student's paired t-test. Compared with the expiration plans, the mean {+-} SD reductions for V{sub 10}, V{sub 20} and MLD on the inspiration plans were 4.0 {+-} 3.7% (p = 0.031), 2.5 {+-} 2.3% (p = 0.028) and 1.1 {+-} 0.7 Gy (p = 0.007), respectively. Conversely, a mean difference of 1.1 {+-} 1.1% (p = 0.044) in PTV{sub 90} was demonstrated in favour of expiration. When using IMRT, inspiration breath-hold can reduce the dose to normal lung tissue while expiration breath-hold can improve the target coverage. The improved lung sparing at inspiration may outweigh the modest improvements in target coverage at expiration. (note)

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

    Science.gov (United States)

    Kyhl, Kasper; Drvis, Ivan; Barak, Otto; Mijacika, Tanja; Engstrøm, Thomas; Secher, Niels H; Dujic, Zeljko; Buca, Ante; Madsen, Per Lav

    2016-02-01

    Pulmonary hyperinflation is used by competitive breath-hold divers and is accomplished by glossopharyngeal insufflation (GPI), which is known to compress the heart and pulmonary vessels, increasing sympathetic activity and lowering cardiac output (CO) without known consequence for organ perfusion. 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 hyperinflation by GPI, CO and organ perfusion, including the myocardium, as well as perfusion of skeletal muscles, are reduced, and yet perfusion of the liver is maintained. Liver perfusion seems to be prioritized when CO decreases during GPI. PMID:26589331

  19. Differences in the definition of internal target volumes using slow CT alone or in combination with thin-slice CT under breath-holding conditions during the planning of stereotactic radiotherapy for lung cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate how the delineations of the internal target volume (ITV) made from 'slow' CT alter with reference to 'thin-slice' CT. Materials and methods: Thin-slice CT images taken under breath-holding conditions and slow CT images taken under shallow-breathing conditions (8 s/image) of 11 lung cancers were used for this study. Five radiation oncologists delineated ITV of the 11 lesions using slow CT images (ITV1), and then redefined them with reference to thin-slice CT images (ITV2). SD-images (standard deviation image) were created for all patients from ITV images in order to visualize the regional variation of the ITVs. Results: The mean value of ITV2 was smaller than that initially defined by ITV1. There was no significant change in ITV1 and ITV2 between operators with regard to standard deviation in volume. There was a significant difference in the distribution of the ratio of ITV1 to ITV2 obtained on thin-slice CTs between cases with and without ground glass opacity. In cases without ground glass opacity there was a tendency for ITV2 to have a smaller volume than ITV1. Conclusions: Combined use of slow CT and thin-slice CT in delineation of ITV contours appeared to be useful in making adjustments for obscured tumor images caused by respiratory movement

  20. SU-E-T-361: Clinical Benefit of Automatic Beam Gating Mixed with Breath Hold in Radiation Therapy of Left Breast

    International Nuclear Information System (INIS)

    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

  1. Reproducibility of small animal cine and scar cardiac magnetic resonance imaging using a clinical 3.0 tesla system

    International Nuclear Information System (INIS)

    To evaluate the inter-study, inter-reader and intra-reader reproducibility of cardiac cine and scar imaging in rats using a clinical 3.0 Tesla magnetic resonance (MR) system. Thirty-three adult rats (Sprague–Dawley) were imaged 24 hours after surgical occlusion of the left anterior descending coronary artery using a 3.0 Tesla clinical MR scanner (Philips Healthcare, Best, The Netherlands) equipped with a dedicated 70 mm solenoid receive-only coil. Left-ventricular (LV) volumes, mass, ejection fraction and amount of myocardial scar tissue were measured. Intra-and inter-observer reproducibility was assessed in all animals. In addition, repeat MR exams were performed in 6 randomly chosen rats within 24 hours to assess inter-study reproducibility. The MR imaging protocol was successfully completed in 32 (97%) animals. Bland-Altman analysis demonstrated high intra-reader reproducibility (mean bias%: LV end-diastolic volume (LVEDV), -1.7%; LV end-systolic volume (LVESV), -2.2%; LV ejection fraction (LVEF), 1.0%; LV mass, -2.7%; and scar mass, -1.2%) and high inter-reader reproducibility (mean bias%: LVEDV, 3.3%; LVESV, 6.2%; LVEF, -4.8%; LV mass, -1.9%; and scar mass, -1.8%). In addition, a high inter-study reproducibility was found (mean bias%: LVEDV, 0.1%; LVESV, -1.8%; LVEF, 1.0%; LV mass, -4.6%; and scar mass, -6.2%). Cardiac MR imaging of rats yielded highly reproducible measurements of cardiac volumes/function and myocardial infarct size on a clinical 3.0 Tesla MR scanner system. Consequently, more widely available high field clinical MR scanners can be employed for small animal imaging of the heart e.g. when aiming at serial assessments during therapeutic intervention studies

  2. SU-C-210-04: Considerable Pancreatic Tumor Motion During Breath-Hold Measured Using Intratumoral Fiducials On Fluoroscopic Movies

    International Nuclear Information System (INIS)

    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

  3. 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.

  4. Postoperative irradiation of thymomas: intensity-modulated radiotherapy or deep-inspiration breath-hold? Dosimetric investigation; Irradiation postoperatoire des thymomes: radiotherapie avec modulation d'intensite ou en inspiration profonde bloquee? etude dosimetrique

    Energy Technology Data Exchange (ETDEWEB)

    Paumier, A.; Azoury, F.; Bretel, J.J.; Le Pechoux, C. [Departement de radiotherapie, institut Gustave-Roussy, 94 - Villejuif (France); Beaudre, A.; Brahim, J.; Ferreira, I.; Lefkopoulos, D. [Unite de physique, institut Gustave-Roussy, 94 - Villejuif (France); Besse, B. [Departement de medecine, institut Gustave-Roussy, 94 - Villejuif (France); Dartevelle, P. [Departement de chirurgie, centre chirurgical Marie-Lannelongue, 92 - Le Plessis-Robinson (France)

    2010-10-15

    The authors report an investigation which aimed at assessing the protection of organs at risk whether conformational radiotherapy with or without intensity modulation is delivered with free breathing or with deep-inspiration breath-hold. Four treatment plans have been computed for eight patients: conventional conformational radiotherapy with free breathing or with deep-inspiration breath-hold, intensity-modulated conformational radiotherapy or IMRT with free breathing or with deep-inspiration breath-hold. They compared the mean dose received by the organs at risk: lungs, heart, anterior intraventricular coronary artery, right coronary artery, circumflex coronary artery, oesophagus, and the whole body. A variance analysis has been performed on dosimetric data. It appears that intensity modulation allows the doses delivered to organs at risk to be reduced in the case of postoperative irradiation of thymomas. The breath-hold technique has no real interest for these patients. Short communication

  5. In-vivo quantification of wall motion in cerebral aneurysms from 2D cine phase contrast magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Karmonik, C. [The Methodist Hospital Research Inst., Houston (United States); Diaz, O.; Klucznik, R. [The Methodist Hospital, Houston (United States); Grossman, R. [The Methodist Hospital, Houston (United States). Neurosurgery

    2010-02-15

    Purpose: The quantification of wall motion in cerebral aneurysms is of interest for the assessment of aneurysmal rupture risk, for providing boundary conditions for computational simulations and as a validation tool for theoretical models. Materials and Methods: 2D cine phase contrast magnetic resonance imaging (2D pcMRI) in combination with quantitative magnetic resonance angiography (QMRA) was evaluated for measuring wall motion in 7 intracranial aneurysms. In each aneurysm, 2 (in one case 3) cross sections, oriented approximately perpendicular to each other, were measured. Results: The maximum aneurysmal wall distention ranged from 0.16 mm to 1.6 mm (mean 0.67 mm), the maximum aneurysmal wall contraction was -1.91 mm to -0.34 mm (mean 0.94 mm), and the average wall displacement ranged from 0.04 mm to 0.31 mm (mean 0.15 mm). Statistically significant correlations between average wall displacement and the shape of inflow curves (p-value < 0.05) were found in 7 of 15 cross sections; statistically significant correlations between the displacement of the luminal boundary center point and the shape of inflow curves (p-value < 0.05) were found in 6 of 15 cross sections. Conclusion: 2D pcMRI in combination with QMRA is capable of visualizing and quantifying wall motion in cerebral aneurysms. However, application of this technique is currently restricted by its limited spatial resolution. (orig.)

  6. In-vivo quantification of wall motion in cerebral aneurysms from 2D cine phase contrast magnetic resonance images

    International Nuclear Information System (INIS)

    Purpose: The quantification of wall motion in cerebral aneurysms is of interest for the assessment of aneurysmal rupture risk, for providing boundary conditions for computational simulations and as a validation tool for theoretical models. Materials and Methods: 2D cine phase contrast magnetic resonance imaging (2D pcMRI) in combination with quantitative magnetic resonance angiography (QMRA) was evaluated for measuring wall motion in 7 intracranial aneurysms. In each aneurysm, 2 (in one case 3) cross sections, oriented approximately perpendicular to each other, were measured. Results: The maximum aneurysmal wall distention ranged from 0.16 mm to 1.6 mm (mean 0.67 mm), the maximum aneurysmal wall contraction was -1.91 mm to -0.34 mm (mean 0.94 mm), and the average wall displacement ranged from 0.04 mm to 0.31 mm (mean 0.15 mm). Statistically significant correlations between average wall displacement and the shape of inflow curves (p-value < 0.05) were found in 7 of 15 cross sections; statistically significant correlations between the displacement of the luminal boundary center point and the shape of inflow curves (p-value < 0.05) were found in 6 of 15 cross sections. Conclusion: 2D pcMRI in combination with QMRA is capable of visualizing and quantifying wall motion in cerebral aneurysms. However, application of this technique is currently restricted by its limited spatial resolution. (orig.)

  7. 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’&...

  8. 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...

  9. Automated classification of LV regional wall motion based on spatio-temporal profiles from cardiac cine magnetic resonance imaging

    Science.gov (United States)

    Mantilla, Juan; Garreau, Mireille; Bellanger, Jean-Jacques; Paredes, José Luis

    2013-11-01

    Assessment of the cardiac Left Ventricle (LV) wall motion is generally based on visual inspection or quantitative analysis of 2D+t sequences acquired in short-axis cardiac cine-Magnetic Resonance Imaging (MRI). Most often, cardiac dynamic is globally analized from two particular phases of the cardiac cycle. In this paper, we propose an automated method to classify regional wall motion in LV function based on spatio-temporal pro les and Support Vector Machines (SVM). This approach allows to obtain a binary classi cation between normal and abnormal motion, without the need of pre-processing and by exploiting all the images of the cardiac cycle. In each short- axis MRI slice level (basal, median, and apical), the spatio-temporal pro les are extracted from the selection of a subset of diametrical lines crossing opposites LV segments. Initialized at end-diastole phase, the pro les are concatenated with their corresponding projections into the succesive temporal phases of the cardiac cycle. These pro les are associated to di erent types of information that derive from the image (gray levels), Fourier, Wavelet or Curvelet domains. The approach has been tested on a set of 14 abnormal and 6 healthy patients by using a leave-one-out cross validation and two kernel functions for SVM classi er. The best classi cation performance is yielded by using four-level db4 wavelet transform and SVM with a linear kernel. At each slice level the results provided a classi cation rate of 87.14% in apical level, 95.48% in median level and 93.65% in basal level.

  10. 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...

  11. Monitoring ABC-assisted deep inspiration breath hold for left-sided breast radiotherapy with an optical tracking system

    Energy Technology Data Exchange (ETDEWEB)

    Mittauer, Kathryn E. [Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, Florida 32610 and J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32610 (United States); Deraniyagala, Rohan; Li, Jonathan G.; Lu, Bo; Liu, Chihray; Samant, Sanjiv S.; Lightsey, Judith L.; Yan, Guanghua, E-mail: yangua@shands.ufl.edu [Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, Florida 32610 (United States)

    2015-01-15

    Purpose: Recent knowledge on the effects of cardiac toxicity warrants greater precision for left-sided breast radiotherapy. Different breath-hold (BH) maneuvers (abdominal vs thoracic breathing) can lead to chest wall positional variations, even though the patient’s tidal volume remains consistent. This study aims to investigate the feasibility of using optical tracking for real-time quality control of active breathing coordinator (ABC)-assisted deep inspiration BH (DIBH). Methods: An in-house optical tracking system (OTS) was used to monitor ABC-assisted DIBH. The stability and localization accuracy of the OTS were assessed with a ball-bearing phantom. Seven patients with left-sided breast cancer were included. A free-breathing (FB) computed tomography (CT) scan and an ABC-assisted BH CT scan were acquired for each patient. The OTS tracked an infrared (IR) marker affixed over the patient’s xiphoid process to measure the positional variation of each individual BH. Using the BH within which the CT scan was performed as the reference, the authors quantified intra- and interfraction BH variations for each patient. To estimate the dosimetric impact of BH variations, the authors studied the positional correlation between the marker and the left breast using the FB CT and BH CT scans. The positional variations of 860 BHs as measured by the OTS were retrospectively incorporated into the original treatment plans to evaluate their dosimetric impact on breast and cardiac organs [heart and left anterior descending (LAD) artery]. Results: The stability and localization accuracy of the OTS was within 0.2 mm along each direction. The mean intrafraction variation among treatment BHs was less than 2.8 mm in all directions. Up to 12.6 mm anteroposterior undershoot, where the patient’s chest wall displacement of a BH is less than that of a reference BH, was observed with averages of 4.4, 3.6, and 0.1 mm in the anteroposterior, craniocaudal, and mediolateral directions

  12. Monitoring ABC-assisted deep inspiration breath hold for left-sided breast radiotherapy with an optical tracking system

    International Nuclear Information System (INIS)

    Purpose: Recent knowledge on the effects of cardiac toxicity warrants greater precision for left-sided breast radiotherapy. Different breath-hold (BH) maneuvers (abdominal vs thoracic breathing) can lead to chest wall positional variations, even though the patient’s tidal volume remains consistent. This study aims to investigate the feasibility of using optical tracking for real-time quality control of active breathing coordinator (ABC)-assisted deep inspiration BH (DIBH). Methods: An in-house optical tracking system (OTS) was used to monitor ABC-assisted DIBH. The stability and localization accuracy of the OTS were assessed with a ball-bearing phantom. Seven patients with left-sided breast cancer were included. A free-breathing (FB) computed tomography (CT) scan and an ABC-assisted BH CT scan were acquired for each patient. The OTS tracked an infrared (IR) marker affixed over the patient’s xiphoid process to measure the positional variation of each individual BH. Using the BH within which the CT scan was performed as the reference, the authors quantified intra- and interfraction BH variations for each patient. To estimate the dosimetric impact of BH variations, the authors studied the positional correlation between the marker and the left breast using the FB CT and BH CT scans. The positional variations of 860 BHs as measured by the OTS were retrospectively incorporated into the original treatment plans to evaluate their dosimetric impact on breast and cardiac organs [heart and left anterior descending (LAD) artery]. Results: The stability and localization accuracy of the OTS was within 0.2 mm along each direction. The mean intrafraction variation among treatment BHs was less than 2.8 mm in all directions. Up to 12.6 mm anteroposterior undershoot, where the patient’s chest wall displacement of a BH is less than that of a reference BH, was observed with averages of 4.4, 3.6, and 0.1 mm in the anteroposterior, craniocaudal, and mediolateral directions

  13. SU-C-BRF-01: Correlation of DIBH Breath Hold Amplitude with Dosimetric Sparing of Heart and Left Anterior Descending Artery in Left Breast Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: A 7.4% increase in major coronary events per 1 Gy increase in mean heart dose has been reported from the population-based analysis of radiation-induced cardiac toxicity following treatment of left sided breast cancer. Deep inhalation breath-hold (DIBH) is clinically utilized to reduce radiation dose to heart and left anterior descending artery (LAD). We investigated the correlation of dose sparing in heart and LAD with internal DIBH amplitude to develop a quantitative predictive model for expected dose to heart and LAD based on internal breath hold amplitude. Methods: A treatment planning study (Prescription Dose = 50 Gy) was performed on 50 left breast cancer patients underwent DIBH whole breast radiotherapy. Two CT datasets, free breathing (FB) and DIBH, were utilized for treatment planning and for determination of the internal anatomy DIBH amplitude (difference between sternum position at FB and DIBH). The heart and LAD dose between FB and DIBH plans was compared and dose to the heart and LAD as a function of breath hold amplitude was determined. Results: Average DIBH amplitude using internal anatomy was 13.9±4.2 mm. The DIBH amplitude-mean dose reduction correlation is 20%/5mm (0.3 Gy/5mm) for the heart and 18%/5mm (1.1 Gy/5mm) for LAD. The correlation with max dose reduction is 12%/5mm (3.8 Gy/5mm) for the heart and 16%/5mm (3.2 Gy/5mm) for LAD. We found that average dose reductions to LAD from 6.0±6.5 Gy to 2.0±1.6 Gy with DIBH (4.0 Gy reduction: -67%, p < 0.001) and average dose reduction to the heart from 1.3±0.7 Gy to 0.7±0.2 Gy with DIBH (0.6 Gy reduction: -46%, p < 0.001). That suggests using DIBH may reduce the risk of the major coronary event for left sided breast cancer patients. Conclusion: The correlation between breath hold amplitude and dosimetric sparing suggests that dose sparing linearly increases with internal DIBH amplitude

  14. Optimization of 'involved-node' radiotherapy with the help of the deep-inspiration breath-hold technique in supra-diaphragmatic Hodgkin disease

    International Nuclear Information System (INIS)

    The authors report a retrospective study aimed at the assessment of conformational radiotherapy optimized with deep-inspiration-breath-hold in an 'involved-node' irradiation of a localized supra-diaphragmatic Hodgkin disease. All patients of different ages and suffering from the Hodgkin disease at different stages had chemotherapy before radiotherapy. The treated volumes have been determined according to the 'involved-node' radiotherapy concept. Prescribed doses, doses received by the heart, coronaries and lungs, survival probability over three years are discussed. The concept appears to be efficient and not much toxic. Short communication

  15. 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. PMID:26179244

  16. Does the use of additional X-ray beam filtration during cine acquisition reduce clinical image quality and effective dose in cardiac interventional imaging?

    International Nuclear Information System (INIS)

    The impact of spectral filtration in digital ('cine') acquisition was investigated using a flat panel cardiac interventional X-ray imaging system. A 0.1-mm copper (Cu) and 1.0-mm aluminium (Al) filter added to the standard acquisition mode created the filtered mode for comparison. Image sequences of 35 patients were acquired, a double-blind subjective image quality assessment was completed and dose-area product (DAP) rates were calculated. Entrance surface dose (ESD) and effective dose (E) rates were determined for 20- and 30-cm phantoms. Phantom ESD fell by 28 and 41 % and E by 1 and 0.7 %, for the 20- and 30-cm phantoms, respectively, when using the filtration. Patient DAP rates fell by 43 % with no statistically significant difference in clinical image quality. Adding 0.1-mm Cu and 1.0-mm Al filtration in acquisition substantially reduces patient ESD and DAP, with no significant change in E or clinical image quality. (authors)

  17. Flow velocity and volume measurement of superior and inferior mesenteric artery with cine phase contrast magnetic resonance imaging

    International Nuclear Information System (INIS)

    The flow velocity and volume of the superior and inferior mesenteric arteries (SMA, IMA) were measured with cine phase contrast magnetic resonance (MR) imaging in five healthy volunteers. Each volunteer was first measured in a fasting state, and then one, two, and three hours after a meal. The average SMA flow volume of the volunteers was 230.3±46.8 ml/min (mean±standard error) during the fasting state, and 714.7±207.7 ml/min, 339.2±85.7 ml/min, and 263.8±21.0 ml/min, respectively, at one, two, and three hours postmeal. The increase at one hour postmeal was statistically significant (p<0.05). The corresponding flow measurements in the IMA were 63.1±11.2 ml/min, 67.6±11.2 ml/min, 57.9±8.6 ml/min, and 53.2±6.8 ml/min. These values do not represent a statistically significant flow volume change in the IMA. In all volunteers, the SMA volumetric flow increased the most one hour after the food challenge (72-400% relative to baseline). Diastolic velocity in the SMA increased significantly one hour postmeal, but systolic velocity did not change significantly. The IMA did not demonstrate a significant change in either systolic or diastolic velocity. The difference between the SMA and IMA in the way of reacting against the food challenge is thought to represent the difference between the requirements of small and large intestine for blood supply after the food challenge. These data demonstrate the possibility of this modality for the assessment of conditions such as chronic mesenteric ischemia. (author)

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

    OpenAIRE

    Yanchun Zhu; Jing Liu; Jonathan Weinsaft; Pascal Spincemaille; Nguyen, Thanh D.; Prince, Martin R.; Shanglian Bao; Yaoqin Xie; Yi Wang

    2015-01-01

    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 brea...

  19. Accuracy of Routine Treatment Planning 4-Dimensional and Deep-Inspiration Breath-Hold Computed Tomography Delineation of the Left Anterior Descending Artery in Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To assess the feasibility of radiation therapy treatment planning 4-dimensional computed tomography (4DCT) and deep-inspiration breath-hold (DIBH) CT to accurately contour the left anterior descending artery (LAD), a primary indicator of radiation-induced cardiac toxicity for patients undergoing radiation therapy. Methods and Materials: Ten subjects were prospectively imaged with a cardiac-gated MRI protocol to determine cardiac motion effects, including the displacement of a region of interest comprising the LAD. A series of planar views were obtained and resampled to create a 3-dimensional (3D) volume. A 3D optical flow deformable image registration algorithm determined tissue displacement during the cardiac cycle. The measured motion was then used as a spatial boundary to characterize motion blurring of the radiologist-delineated LAD structure for a cohort of 10 consecutive patients enrolled prospectively on a breast study including 4DCT and DIBH scans. Coronary motion–induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD structure despite the presence of motion blurring. The 4DCT maximum inhalation and exhalation respiratory phases were coregistered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the region of interest was 0.7 ± 0.1 mm (left–right [LR]), 1.3 ± 0.6 mm (superior–inferior [SI]), and 0.6 ± 0.2 mm (anterior–posterior [AP]) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4% ± 4.5% for the DIBH. The LAD volume overestimation had the dosimetric impact of decreasing the reported mean LAD dose by 23% ± 9% on average in the DIBH. During tidal respiration the average relative LAD contour increase was 69.3% ± 5.9% and 67.9% ± 4.6% for inhalation and exhalation respiratory phases, respectively. The average 90th

  20. Accuracy of Routine Treatment Planning 4-Dimensional and Deep-Inspiration Breath-Hold Computed Tomography Delineation of the Left Anterior Descending Artery in Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    White, Benjamin M., E-mail: benjamin.white@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Vennarini, Sabina [L' Unità Operativa di Protonterapia, Azienda Provinciale per i Servizi Sanitari, Trento (Italy); Lin, Lilie; Freedman, Gary [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Santhanam, Anand; Low, Daniel A. [Department of Radiation Oncology, University of California, Los Angeles, California (United States); Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2015-03-15

    Purpose: To assess the feasibility of radiation therapy treatment planning 4-dimensional computed tomography (4DCT) and deep-inspiration breath-hold (DIBH) CT to accurately contour the left anterior descending artery (LAD), a primary indicator of radiation-induced cardiac toxicity for patients undergoing radiation therapy. Methods and Materials: Ten subjects were prospectively imaged with a cardiac-gated MRI protocol to determine cardiac motion effects, including the displacement of a region of interest comprising the LAD. A series of planar views were obtained and resampled to create a 3-dimensional (3D) volume. A 3D optical flow deformable image registration algorithm determined tissue displacement during the cardiac cycle. The measured motion was then used as a spatial boundary to characterize motion blurring of the radiologist-delineated LAD structure for a cohort of 10 consecutive patients enrolled prospectively on a breast study including 4DCT and DIBH scans. Coronary motion–induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD structure despite the presence of motion blurring. The 4DCT maximum inhalation and exhalation respiratory phases were coregistered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the region of interest was 0.7 ± 0.1 mm (left–right [LR]), 1.3 ± 0.6 mm (superior–inferior [SI]), and 0.6 ± 0.2 mm (anterior–posterior [AP]) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4% ± 4.5% for the DIBH. The LAD volume overestimation had the dosimetric impact of decreasing the reported mean LAD dose by 23% ± 9% on average in the DIBH. During tidal respiration the average relative LAD contour increase was 69.3% ± 5.9% and 67.9% ± 4.6% for inhalation and exhalation respiratory phases, respectively. The average 90th

  1. Prospective feasibility study of chest X-ray vs. thoracic MRI in breath-hold technique at an open low-field scanner

    International Nuclear Information System (INIS)

    Purpose: MR investigations using a breath-hold sequence at an open low-field MR had to be compared to chest X-rays in patients with a wide spectrum of cardio-thoracic pathologies. Material and Methods: 114 patients and three volunteers who actually received a chest X-ray due to different indications underwent triplanar breath-hold (17-20 s) True-FISP sequence using a 0.2 T low-field MR (Siemens Magnetom Open, TR/TE/α: 7.3/3.5/80 , SD: 10 mm, Pixel: 2.18 x 1.41 mm) a mean of 5.1 (±8.2) days later. Results: Signal-to-noise ratio as basics for pattern recognition was 3.2 in nodule, 5.0 in infiltration, and 12.0 in effusion, and therefore True-FISP is usable for the detection of these findings. MRI demonstrated nodules (89% vs. 57%), infiltration (81% vs. 71%), pleural effusions (86% vs. 75%), pericardial effusions (100% vs. 21%) and pulmonary congestion (90% vs. 80%) clearly more frequently compared to chest X-ray. Discussion: MRI of the lung has been implemented successfully at an open low-field MR system. Diagnostic safety and accuracy are at least comparable to those of chest X-ray. The lack of superimposition led to a major improvement in the detection of pericardial effusions and nodules, and an increase in identification of infiltration, pleural effusion, and pulmonary congestion. (orig.)

  2. Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T

    International Nuclear Information System (INIS)

    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: ESVVCG = (56 ± 17) ml, EDVVCG = (151 ± 32) ml, LVMVCG = (97 ± 27) g, SVVCG = (94 ± 19) ml, EFVCG = (63 ± 5)% cf. ESVACT = (56 ± 18) ml, EDVACT = (147 ± 36) ml, LVMACT = (102 ± 29) g, SVACT = (91 ± 22) ml, EFACT = (62 ± 6)%; 3.0 T: ESVVCG = (55 ± 21) ml, EDVVCG = (151 ± 32) ml, LVMVCG = (101 ± 27) g, SVVCG = (96 ± 15) ml, EFVCG = (65 ± 7)% cf. ESVACT = (54 ± 20) ml, EDVACT = (146 ± 35) ml, LVMACT = (101 ± 30) g, SVACT = (92 ± 17) ml, EFACT = (64 ± 6)%). ACT's intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical CMR. (orig.)

  3. Trial of quantitative analysis of cardiac function by 3D reconstruction of multislice cine MR images

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Hideki (Okayama Univ. (Japan). Faculty of Education); Sei, Tetsurou; Nakagawa, Tomio; Hiraki, Yoshio

    1994-09-01

    Non-invasive techniques for measuring the dynamic behavior of the left ventricle (LV) can be invaluable tool in the diagnosis of the heart disease. In this paper we present methods for quantitative analysis of cardiac function using a compact magnetic resonance image processing system. A 256 x 256 magnetic resonance transaxial image of the left ventricle in a normal case is obtained. After gray level thresholding and region segmentation, the boundary of the left ventricular chamber is extracted. Then, the boundaries of the left ventricular chamber are displayed three-dimensionally by using the Z-buffer algorithm. Thus, LV volume and ejection fraction are calculated. Here, the value of LV ejection fraction is 60%. These results agree reasonably well with the corresponding data obtained by the echocardiography. (author).

  4. Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

    International Nuclear Information System (INIS)

    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

  5. 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

  6. 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; Larsen, Christina; Behrens, Claus F.

    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...... 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 to be...... 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...

  7. Development of picture and voice gated intermittent irradiation system connected without linear accelerator for voluntary breath-hold synchronized with respiration

    International Nuclear Information System (INIS)

    In patients with lung cancer of the lower lobes and liver cancer, treatment volume including respiratory motion is an important therapeutic problem. We developed a voluntary breath-hold system using pictures and voice messages so as to reduce the excessive safety margin that covers respiratory motion. The system consists of two sets of monitor and speaker, and a computer and software for control without direct connection to a linear accelerator. When the patient repeatedly holds his or her breath in response to a picture and voice message, irradiation is manually performed and then proceeds intermittently. Although safety problems remain to be solved because of off-line, synchronized irradiation with our system is simple, inexpensive, and could be widely used. It also would be expected to reduce the tumor target volume around the diaphragm. (author)

  8. Automatic generation of endocardial surface meshes with 1-to-1 correspondence from cine-MR images

    Science.gov (United States)

    Su, Yi; Teo, S.-K.; Lim, C. W.; Zhong, L.; Tan, R. S.

    2015-03-01

    In this work, we develop an automatic method to generate a set of 4D 1-to-1 corresponding surface meshes of the left ventricle (LV) endocardial surface which are motion registered over the whole cardiac cycle. These 4D meshes have 1- to-1 point correspondence over the entire set, and is suitable for advanced computational processing, such as shape analysis, motion analysis and finite element modelling. The inputs to the method are the set of 3D LV endocardial surface meshes of the different frames/phases of the cardiac cycle. Each of these meshes is reconstructed independently from border-delineated MR images and they have no correspondence in terms of number of vertices/points and mesh connectivity. To generate point correspondence, the first frame of the LV mesh model is used as a template to be matched to the shape of the meshes in the subsequent phases. There are two stages in the mesh correspondence process: (1) a coarse matching phase, and (2) a fine matching phase. In the coarse matching phase, an initial rough matching between the template and the target is achieved using a radial basis function (RBF) morphing process. The feature points on the template and target meshes are automatically identified using a 16-segment nomenclature of the LV. In the fine matching phase, a progressive mesh projection process is used to conform the rough estimate to fit the exact shape of the target. In addition, an optimization-based smoothing process is used to achieve superior mesh quality and continuous point motion.

  9. Differentiation between focal malignant marrow-replacing lesions and benign red marrow deposition of the spine with T2{sup *}-corrected fat-signal fraction map using a three -echo volume interpolated breath-hold gradient echo dixon sequence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Pyo; Kim, Sung Jun; Chung, Tae Sub; Yoo, Yeon Hwa; Yoon, Choon Sik [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kanneengiesser, Stephan [MR Applications Development, Siemens AG, Healthcare Sector, Erlangen (Germany); Paek, Moon Young [Siemens Ltd., Seoul (Korea, Republic of); Song, Ho Taek; Lee, Young Han; Suh, Jin Suck [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    To assess the feasibility of T2{sup *}-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{sup *}-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.

  10. Comparison of 3D two-point Dixon and standard 2D dual-echo breath-hold sequences for detection and quantification of fat content in renal angiomyolipoma

    International Nuclear Information System (INIS)

    Purpose: To assess the utility of a 3D two-point Dixon sequence with water–fat decomposition for quantification of fat content of renal angiomyolipoma (AML). Methods: 84 patients underwent renal MRI including 2D in-and-opposed-phase (IP and OP) sequence and 3D two-point Dixon sequence that generates four image sets [IP, OP, water-only (WO), and fat-only (FO)] within one breath-hold. Two radiologists reviewed 2D and 3D images during separate sessions to identify fat-containing renal masses measuring at least 1 cm. For identified lesions subsequently confirmed to represent AML, ROIs were placed at matching locations on 2D and 3D images and used to calculate 2D and 3D SIindex [(SIIP − SIOP)/SIIP] and 3D fat fraction (FF) [SIFO/(SIFO + SIWO)]. 2D and 3D SIindex were compared with 3D FF using Pearson correlation coefficients. Results: 41 AMLs were identified in 6 patients. While all were identified using the 3D sequence, 39 were identified using the 2D sequence, with the remaining 2 AMLs retrospectively visible on 2D images but measuring under 1 cm. Among 32 AMLs with a 3D FF of over 50%, both 2D and 3D SIindex showed a statistically significant inverse correlation with 3D FF (2D SIindex: r = −0.63, p = 0.0010; 3D SIindex: r = −0.97, p index, is not limited by ambiguity of water or fat dominance. This may assist clinical management of AML given evidence that fat content predicts embolization response.

  11. Whole-heart coronary MR angiography under a single breath-hold: A comparative study with respiratory-gated acquisition using a multi-element phased-array coil

    International Nuclear Information System (INIS)

    Aim: To compare visualization using whole-heart coronary magnetic resonance angiography (CMRA) acquired during a single breath-hold (BH) with that using conventional respiratory-gated (RG) CMRA. Materials and methods: The CMRAs of 14 healthy subjects under either BH or RG conditions were studied using a 1.5 T system equipped with a whole-body phased-array coil and 16-channel receivers. The BH examination was accelerated using parallel imaging (PI) by factors of 2.5 and 2 in the phase and section directions, respectively. For the RG examination, a PI factor of 2 was used only in the phase direction. The visualization quality of 15 coronary segments using each condition was evaluated with a five-point scale (0-4). Differences between two conditions were compared at segments with an average score greater than 2 in RG-CMRA. Results: The average examination time for BH and RG acquisition scans was 34 s and 11 min 31 s, respectively. Ten segments (segments 1-3, 5-9, 11, and 13) had average scores higher than 2 in RG-CMRA. Of these, BH-CMRA had significantly lower scores than RG-CMRA at six segments (segments 1, 5-8, and 11) after correction for multiple comparisons (p < 0.005). However, in BH-CMRA, proximal segments (segments 1-2, 5-7, and 11) showed average scores over 2, indicating marginally acceptable image quality. Conclusion: Compared with the relatively limited degree of image degradation with RG-CMRA, the present data suggest that BH-CMRA would be useful for screening and as an adjunct to RG-CMRA that is occasionally incomplete.

  12. A quantitative study of CSF pulsatile flow in normal pressure hydrocephalus; An analysis of flow patterns before and after a shunting procedure using cine MR phase imaging

    Energy Technology Data Exchange (ETDEWEB)

    Katayama, Shinji; Makabe, Tetsuo; Itoh, Takahiko (Okayama Univ. (Japan). School of Medicine) (and others)

    1992-06-01

    In the previous report, we described the visualization and quantitative analysis of a normal CSF pulsatile flow using cine MR phase imaging. In the present study, CSF flow velocities were measured in patients with normal pressure hydrocephalus (NPH) before and after a shunting procedure. All of the healthy subjects showed a similar flow pattern in the time-velocity flow profiles (TVFP). However, patients with NPH showed a variable pattern of TVFP and could be divided into the following four types: Type 0: the CSF flow pattern was similar to that of the healthy subjects. Type I: the caudal peak flow was delayed more than 190 msec on TVFP. Type II: the caudal peak flow was not apparent, but the CSF flow through the aqueduct was remarkable on phase images. Type III: the amplitude of TVFP was very small, and no CSF flow through the aqueduct was identified. The patients with Type III TVFP showed significantly lower NPH scores. The lumbar CSF pressures tended to be high in the patients with Type III TVFP, but nevertheless failed to reach a statistically significant level. The amplitude of TVFP increased in the patients who improved clinically after the shunting procedure. Some of the Type III patients changed into Type II, I, and 0; also, one of the Type II patients changed into a Type I patients after the shunting procedure. We conclude that cine MR phase imaging is useful for analyzing the CSF flow of the patients with NPH before and after the shunting procedure as well as for evaluating shunt patency. (author).

  13. Physiological Uptake of 18F-Fluorodeoxyglucose in Uterine Endometrium and Myometrium: Correlation with Uterine Motility Evaluated by Cine Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    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

  14. 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.)

  15. Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation

    International Nuclear Information System (INIS)

    Purpose/Objective: Lung tumors are subject to movement due to respiratory motion. Conventionally, a margin is applied to the clinical target volume (CTV) to account for this and other treatment uncertainties. The purpose of this study is to evaluate the dosimetric benefits of a deep inspiration breath-hold (DIBH) technique which has two distinct features - deep inspiration which reduces lung density and breath-hold which immobilizes lung tumors. Both properties can potentially reduce the mass of normal lung tissue in the high dose region, thus improving the possibility of dose escalation. Methods and Materials: To study the efficacy of the DIBH technique, CT scans are acquired for each patient under 4 respiration conditions: free-breathing; DIBH; shallow inspiration breath-hold; shallow expiration breath-hold. The free-breathing and DIBH scans are used to generate treatment plans for comparison of standard and DIBH techniques, while the shallow inspiration and expiration scans provide information on the maximum extent of tumor motion under free-breathing conditions. To acquire the breath-hold scans, the patients are brought to reproducible respiration levels using spirometry and slow vital capacity maneuvers. For the treatment plan comparison free-breathing and DIBH planning target volumes (PTVs) are constructed consisting of the CTV plus a margin for setup error and lung tumor motion. For both plans the margin for setup error is the same while the margin for lung tumor motion differs. The margin for organ motion in free-breathing is determined by the maximum tumor excursions in the shallow inspiration and expiration CT scans. For the DIBH, tumor motion is reduced to the extent to which DIBH can be maintained and the margin for any residual tumor motion is determined from repeat fluoroscopic movies, acquired with the patient monitored using spirometry. Three-dimensional treatment plans, generated using apertures based on the free-breathing and DIBH PTVs, are

  16. Small bowel imaging of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Emanuele; Casciani; Chiara; De; Vincentiis; Gianfranco; Gualdi

    2015-01-01

    The study of the small bowel(SB) has always beenchallenging both for clinicians and radiologist. It is a long and tortuous tube that can be affected by various pathologies whose signs and symptoms are usually non specific and can mimic other acute abdominal disorders. For these reasons, imaging plays a central role in the diagnosis of the different pathological conditions that can occur. They are important also in the management and follow up of chronic diseases. We expose and evaluate all the radiological methods that are now available for the study of the SB with particular emphasis on the technological improvement of cross-sectional imaging, such as computed tomography(CT) and magnetic resonance imaging(MRI). These techniques have, infact, highly improved in terms of execution times(fast acquisitions images), patients discomfort and radiation dose, for CT, with consequent reduced biological risks. Moreover, the new post-processing options with multiplanar reconstruction and isotropic images have made significant changes in the evaluation of the exams. Especially MRI scans have been improved by the advent of new sequences, such as diffusion weighted imaging and cine-MRI, parallel imaging and breath-hold sequences and can provide excellent soft-tissue contrast without the use of ionizing radiations.

  17. Age- and gender-specific differences in left and right ventricular cardiac function and mass determined by cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    We examined possible age- and gender-specific differences in the function and mass of left (LV) and right (RV) ventricles in 36 healthy volunteers using cine gradient-recalled echo magnetic resonance imaging. Subjects were divided into four groups (nine men and nine women in each): men aged under 45 years (32 ± 7), women aged under 45 (27 ± 6), men aged over 45 (59 ± 8), and women aged over 45 (57 ± 9). Functional analysis of cardiac volume and mass and of LV wall motion was performed by manual segmentation of the endocardial and epicardial borders of the end-diastolic and end-systolic frame; both absolute and normalized (per square meter body surface area) values were evaluated. With age there was a significant decrease in both absolute and normalized LV and RV chamber volumes (EDV, ESV), while LV and RV masses remained unchanged. Gender-specific differences were found in cardiac mass and volume (for men and women, respectively: LV mass, 155 ± 18 and 110 ± 16 g; LV EDV, 118 ± 27 and 96 ± 21 ml; LV ESV, 40 ± 13 and 29 ± 9 ml; RV mass, 52 ± 10 and 39 ± 5 g; RV EDV, 131 ± 28 and 100 ± 23 ml; RV ESV, 53 ± 17 and 33 ± 15 ml). Normalization to body surface area eliminated differences in LV volumes but not those in LV mass, RV mass, or RV function. Functional parameters such as cardiac output and LV ejection fraction showed nonsignificant or only slight differences and were thus largely independent of age and gender. Intra- and interobserver variability ranged between 1.4 % and 5.9 % for all parameters. Cine magnetic resonance imaging thus shows age- and gender-specific differences in cardiac function, and therefore the evaluation of cardiac function in patients should consider age- and gender-matched normative values. (orig.)

  18. 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.).

  19. Cine-MR imaging aqueductal CSF flow in normal pressure hydrocephalus syndrome before and after CSF shunt

    International Nuclear Information System (INIS)

    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.)

  20. Improved abdominal MRI in non-breath-holding children using a radial k-space sampling technique

    International Nuclear Information System (INIS)

    Radial k-space sampling techniques have been shown to reduce motion artifacts in adult abdominal MRI. To compare a T2-weighted radial k-space sampling MRI pulse sequence (BLADE) with standard respiratory-triggered T2-weighted turbo spin echo (TSE) in pediatric abdominal imaging. Axial BLADE and respiratory-triggered turbo spin echo sequences were performed without fat suppression in 32 abdominal MR examinations in children. We retrospectively assessed overall image quality, the presence of respiratory, peristaltic and radial artifact, and lesion conspicuity. We evaluated signal uniformity of each sequence. BLADE showed improved overall image quality (3.35 ± 0.85 vs. 2.59 ± 0.59, P < 0.001), reduced respiratory motion artifact (0.51 ± 0.56 vs. 1.89 ± 0.68, P < 0.001), and improved lesion conspicuity (3.54 ± 0.88 vs. 2.92 ± 0.77, P = 0.006) compared to respiratory triggering turbo spin-echo (TSE) sequences. The bowel motion artifact scores were similar for both sequences (1.65 ± 0.77 vs. 1.79 ± 0.74, P = 0.691). BLADE introduced a radial artifact that was not observed on the respiratory triggering-TSE images (1.10 ± 0.85 vs. 0, P < 0.001). BLADE was associated with diminished signal variation compared with respiratory triggering-TSE in the liver, spleen and air (P < 0.001). The radial k-space sampling technique improved the quality and reduced respiratory motion artifacts in young children compared with conventional respiratory-triggered turbo spin-echo sequences. (orig.)

  1. Improved abdominal MRI in non-breath-holding children using a radial k-space sampling technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Hyuk; Choi, Young Hun; Cheon, Jung Eun; Lee, So Mi; Cho, Hyun Hae; Kim, Woo Sun; Kim, In One [Seoul National University Children' s Hospital, Department of Radiology, Seoul (Korea, Republic of); Shin, Su Mi [SMG-SNU Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2015-06-15

    Radial k-space sampling techniques have been shown to reduce motion artifacts in adult abdominal MRI. To compare a T2-weighted radial k-space sampling MRI pulse sequence (BLADE) with standard respiratory-triggered T2-weighted turbo spin echo (TSE) in pediatric abdominal imaging. Axial BLADE and respiratory-triggered turbo spin echo sequences were performed without fat suppression in 32 abdominal MR examinations in children. We retrospectively assessed overall image quality, the presence of respiratory, peristaltic and radial artifact, and lesion conspicuity. We evaluated signal uniformity of each sequence. BLADE showed improved overall image quality (3.35 ± 0.85 vs. 2.59 ± 0.59, P < 0.001), reduced respiratory motion artifact (0.51 ± 0.56 vs. 1.89 ± 0.68, P < 0.001), and improved lesion conspicuity (3.54 ± 0.88 vs. 2.92 ± 0.77, P = 0.006) compared to respiratory triggering turbo spin-echo (TSE) sequences. The bowel motion artifact scores were similar for both sequences (1.65 ± 0.77 vs. 1.79 ± 0.74, P = 0.691). BLADE introduced a radial artifact that was not observed on the respiratory triggering-TSE images (1.10 ± 0.85 vs. 0, P < 0.001). BLADE was associated with diminished signal variation compared with respiratory triggering-TSE in the liver, spleen and air (P < 0.001). The radial k-space sampling technique improved the quality and reduced respiratory motion artifacts in young children compared with conventional respiratory-triggered turbo spin-echo sequences. (orig.)

  2. Accuracy of gated cine-images for differentiating fixed defects from attenuation artifacts in Tc-99m tetrofosmin myocardial SPECT: comparison with visual grading, projection views and ejection fractions

    International Nuclear Information System (INIS)

    The differentiation of attenuation artifacts from true lesions is important in the interpretation of myocardial perfusion imaging. We investigated the degree of increased accuracy which gated cine-images provide over conventional methods of visual grading, reviewing projection views and left ventricular ejection fraction (LVEF) measurements in this regard. Eighty three patients (M: 65, F: 18; mean age, 58.2 ± 9.0) with equivocal fixed defects in stress-rest myocardial SPECT using Tc-99m tetrofosmin were included. Two independent observers graded confidence levels for true lesion over attenuation artifacts with a 5 point scaling system after sequentially reviewing tomographic images, projection images and gated cine-images. LVEF was measured by gated SPECT. The fixed defects were proved to be true lesions in 23 cases while 42 cases were due to attenuation artifact, and 18 cases with the undetermined final diagnosis were excluded. There were no significant differences in age, body weight and LVEF between the two groups. Receiver operator characteristics (ROC) curve analysis showed that LVEF measurements did not improve diagnostic accuracy while gated-cine images provided additional accuracy over visual (p=0.126 for observer A; p=0.0002 for observer B) or visual plus projection view assessment (p=0.278 for observer A; p=0.019 in observer B). Moreover, although there was significant inter-observer variance for accuracy with visual assessment alone (p=0.005), the gated cine-images provided the highest accuracy and lowest inter-observer variance (p=0.821). In conclusion, gated SPECT improves the accuracy of differentiating attenuation artifacts from true lesions compared to conventional mehod. It also enahnces the objectively of assessment by reducing inter-observer variability

  3. 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.)

  4. Early report: Comparison of breath-hold MR excretory urography, Doppler ultrasound and isotope renography in evaluation of symptomatic hydronephrosis in pregnancy

    International Nuclear Information System (INIS)

    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)

  5. 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)

  6. Development and pre-clinical evaluation of a real time monitoring and feedback system for deep inspiration breath hold for stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Full text: Background. Respiration can cause tumour movements in the thoracic region up to 3 cm. Currently, there are several approaches under development and/or evaluation to minimize the internal margin which is generally applied to account for motion effects. One approach is the deep inspiration breath hold (DIBH) technique to immobilize the target and to deliver a beam during breath hold. Such an approach has the additional advantage of an increased lung volume with decreased lung density. However, the application of respiration-controlled delivery in stereotactic body radiotherapy (SBRT) still remains a challenge and the treatment for the optimal therapeutic benefit (TCP/NTCP) is still under evaluation. technique Material and methods The BrainLAB ExacTrac system was used to monitor deep inspiration for patients immobilized in a stereotactic bodyframe. As in the standard procedure for patient positioning using ExacTrac, several markers are placed on the patient's skin, preferably close to the target position and on the sternum. During training sessions the dominant direction of marker movement was determined. Using an in-house developed interface, online information about respiration movements of the thorax (determined form ExacTrac marker) was displayed. Additionally, a patient feedback system was developed to visualize the respiration cycle to the patient and thus to utilize his/her ability for cooperation. The feedback system was tested with 35 patients undergoing SBRT. In a multislice CT study, the underlying hypothesis that targets can be immobilized with high accuracy with a DIBH maneuver and that ExacTrac marker can be used as surrogate was verified for 16 patients. The DIBH reproducibility and stability were determined from multislice CT studies with multiple (4-5) DIBH maneuvers and from various training sessions with patients. In a subsequent treatment planning study, 13 patients with lung lesion undergoing SBRT treatment underwent additional multi

  7. Breath-holding gadolinium-enhanced three-dimensional MR angiography in the evaluation of patients with vascular reconstruction

    International Nuclear Information System (INIS)

    Breath-bolding gadolinium-enhanced three-dimensional MR angiography (MRA) was performed in 20 patients with vascular reconstruction (arterial reconstruction in 18 and venous reconstruction in 2) after administration of 0.1 mmol/kg gadopentetate dimeglumine. A 3D fast gradient echo sequence was employed for MRA. Comparison was made with angiography in 10 patients and with CT in 12 patients. In all patients, the patency of artificial grafts could be assessed on MRA. On the other hand, angiography failed to visualization of an artificial grafts in one of ten cases, the case with venous reconstruction. Postprocessing images of maximum intensity projection allowed evaluation of the anastomotic region from any direction. There were two limitations in MRA; it overestimated the stenosis compared with the results of angiography, and it did not clearly show fluid collection around the artificial grafts. However, MRA has another advantage in that it is applicable to the patients with renal failure or iodine allergy. We concluded MRA has great possibilities in evaluation of artificial grafts if the examiner pays attention to these minor limitations. (author)

  8. Reliability and reproducibility of quantitative assessment of left ventricular function and volumes with 3-slice segmentation of cine steady-state free precession short axis images

    International Nuclear Information System (INIS)

    Highlights: • Quantitative LV assessment in CMR requires contour tracing of multiple SA images. • Conventional multi-slice method for LV assessment is tedious and time-consuming. • 3-slice segmentation is comparable to multi-slice method in determining LVEF. • 3-slice method is reliable and reproducible in determining LV volumes and mass. • 3-slice method reduces post-processing time compared to multi-slice method. - Abstract: Objectives: Quantitative assessment of left ventricular (LV) functional parameters in cardiac MR requires time-consuming contour tracing across multiple short axis images. This study assesses global LV functional parameters using 3-slice segmentation on steady state free precision (SSFP) cine short axis images and compares the results with conventional multi-slice segmentation of LV. Methods: Data were collected from 61 patients who underwent cardiac MRI for various clinical indications. Semi-automated cardiac MR software was used to trace LV contours both at multiple slices from base to apex as well as just 3 slices (base, mid, and apical) by two readers. Left ventricular ejection fraction (LVEF), LV volumes, and LV mass were calculated using both methods. Results: Bland–Altman plot revealed narrow limits of agreement (−4.4% to 5.1%) between LVEF obtained by the two methods. Bland–Altman analysis showed slightly wider limits of agreement between end-diastolic volumes (−5.0 to 12.0%; −3.9 to 8.5 ml/m2), end-systolic volumes (−10.9 to 14.7%; −4.1 to 6.5 ml/m2), and LV mass (−5.2 to 12.7%; −4.8 to 10.2 g/m2) obtained by the two methods. There was a small mean difference between LV volumes and LV mass obtained using multi-slice and 3-slice segmentation. No statistically significant difference existed between the LV parameters obtained by the two readers using 3-slice segmentation (p > 0.05). Multi-slice assessment required approximately 15 min per study while 3-slice assessment required less than 5 min. Conclusions: 3

  9. Reliability and reproducibility of quantitative assessment of left ventricular function and volumes with 3-slice segmentation of cine steady-state free precession short axis images

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Christopher, E-mail: cnguye38@uci.edu [School of Medicine, University of California, Irvine, Orange, CA (United States); Kuoy, Edward, E-mail: ekuoy@uci.edu [School of Medicine, University of California, Irvine, Orange, CA (United States); Ruehm, Stefan, E-mail: sruehm@mednet.ucla.edu [Diagnostic Cardiovascular Imaging, University of California, Los Angeles (United States); Krishnam, Mayil, E-mail: mskrishn@uci.edu [Cardiovascular and Thoracic Imaging, Radiological Sciences, University of California, Irvine, Orange, CA (United States)

    2015-07-15

    Highlights: • Quantitative LV assessment in CMR requires contour tracing of multiple SA images. • Conventional multi-slice method for LV assessment is tedious and time-consuming. • 3-slice segmentation is comparable to multi-slice method in determining LVEF. • 3-slice method is reliable and reproducible in determining LV volumes and mass. • 3-slice method reduces post-processing time compared to multi-slice method. - Abstract: Objectives: Quantitative assessment of left ventricular (LV) functional parameters in cardiac MR requires time-consuming contour tracing across multiple short axis images. This study assesses global LV functional parameters using 3-slice segmentation on steady state free precision (SSFP) cine short axis images and compares the results with conventional multi-slice segmentation of LV. Methods: Data were collected from 61 patients who underwent cardiac MRI for various clinical indications. Semi-automated cardiac MR software was used to trace LV contours both at multiple slices from base to apex as well as just 3 slices (base, mid, and apical) by two readers. Left ventricular ejection fraction (LVEF), LV volumes, and LV mass were calculated using both methods. Results: Bland–Altman plot revealed narrow limits of agreement (−4.4% to 5.1%) between LVEF obtained by the two methods. Bland–Altman analysis showed slightly wider limits of agreement between end-diastolic volumes (−5.0 to 12.0%; −3.9 to 8.5 ml/m{sup 2}), end-systolic volumes (−10.9 to 14.7%; −4.1 to 6.5 ml/m{sup 2}), and LV mass (−5.2 to 12.7%; −4.8 to 10.2 g/m{sup 2}) obtained by the two methods. There was a small mean difference between LV volumes and LV mass obtained using multi-slice and 3-slice segmentation. No statistically significant difference existed between the LV parameters obtained by the two readers using 3-slice segmentation (p > 0.05). Multi-slice assessment required approximately 15 min per study while 3-slice assessment required less than 5

  10. Cine MRI of hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Cine MRI was performed using 1.5T or 0.5T MR units in eleven patients with hypertrophic cardiomyopathy. Septal and posterior wall thickness measured by cine MRI correlated well with those obtained by ultrasonographic cardiogram. In hypertrophic obstructive cardiomyopathy, cine MRI demonstrated the site and nature of obstructive change in left ventricle. Cine MRI also showed flow void due to mitral regurgitation successfully. We considered cine MRI is useful means to evaluate the anatomical and functional findings in hypertrophic cardiomyopathy. (author)

  11. 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

    2014-07-01

    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 < 0.01). In the patient study, the peak strain patterns predicted by 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.

  12. Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study

    International Nuclear Information System (INIS)

    To estimate the risk of radiation induced second cancers after radiotherapy using deep-inspiration breath-hold (DI) technique with three-dimensional conformal (3DCRT) and volumetric arc therapy (VMAT) for patients with Hodgkin’s lymphoma (HL). Early-stage HL with mediastinal and supraclavicular involvement was studied using an Alderson phantom. A whole body CT was performed and all tissues were delineated. The clinical target volumes and planning target volumes (PTV) were determined according to the German Hodgkin study group guidelines. Free-breathing (FB) technique and DI technique were simulated by different safety margins for the PTV definition. In both cases, 30 Gy in 15 fractions was prescribed. Second cancer risk was estimated for various tissues with a second cancer model including fractionation. When compared with FB-3DCRT, estimated relative life time attributable risk (LAR) of cancer induction after DI-3DCRT was 0.86, 0.76, 0.94 and 0.92 for breast, lung, esophagus and stomach, respectively. With DI-VMAT, the corresponding values were 2.05, 1.29, 1.01, 0.93, respectively. For breast cancer, the LAR observed with DI-VMAT was not substantially distinguishable from the LAR computed for mantle RT with an administered dose of 40 Gy. This study suggests that DI may reduce the LAR of secondary cancers of all OARs and may be a valuable technique when using 3DCRT. Conversely, VMAT may increase substantially the LAR and should be cautiously implemented in clinical practice

  13. Deep inspiration breath-hold technique for left-sided breast cancer: An analysis of predictors for organ-at-risk sparing

    International Nuclear Information System (INIS)

    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 cm3, 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 cm3, p < 0.001). DIBH reduced the mean heart dose (3.4 vs 1.8 Gy, p < 0.001) and lung V20 (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

  14. Dosimetric Benefits of Intensity-Modulated Radiotherapy Combined With the Deep-Inspiration Breath-Hold Technique in Patients With Mediastinal Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Purpose: To assess the additional benefits of using the deep-inspiration breath-hold (DIBH) technique with intensity-modulated radiotherapy (IMRT) in terms of the protection of organs at risk for patients with mediastinal Hodgkin’s disease. Methods and Materials: Patients with early-stage Hodgkin’s lymphoma with mediastinal involvement were entered into the study. Two simulation computed tomography scans were performed for each patient: one using the free-breathing (FB) technique and the other using the DIBH technique with a dedicated spirometer. The clinical target volume, planning target volume (PTV), and organs at risk were determined on both computed tomography scans according to the guidelines of the European Organization for Research and Treatment of Cancer. In both cases, 30 Gy in 15 fractions was prescribed. The dosimetric parameters retrieved for the statistical analysis were PTV coverage, mean heart dose, mean coronary artery dose, mean lung dose, and lung V20. Results: There were no significant differences in PTV coverage between the two techniques (FB vs. DIBH). The mean doses delivered to the coronary arteries, heart, and lungs were significantly reduced by 15% to 20% using DIBH compared with FB, and the lung V20 was reduced by almost one third. The dose reduction to organs at risk was greater for masses in the upper part of the mediastinum. IMRT with DIBH was partially implemented in 1 patient. This combination will be extended to other patients in the near future. Conclusions: Radiation exposure of the coronary arteries, heart, and lungs in patients with mediastinal Hodgkin’s lymphoma was greatly reduced using DIBH with IMRT. The greatest benefit was obtained for tumors in the upper part of the mediastinum. The possibility of a wider use in clinical practice is currently under investigation in our department.

  15. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

    International Nuclear Information System (INIS)

    Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

  16. 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.

  17. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    International Nuclear Information System (INIS)

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm3 (D2 cm 3), volume receiving ≥ 5 Gy (V5), 10 Gy (V10), 15 Gy (V15) and 20 Gy (V20). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D2 cm 3 was less than 42 Gy in DIBH. In FB the heart D2 cm 3 was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.)

  18. Dosimetric Benefits of Intensity-Modulated Radiotherapy Combined With the Deep-Inspiration Breath-Hold Technique in Patients With Mediastinal Hodgkin's Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Paumier, Amaury, E-mail: amaury.paumier@igr.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Ghalibafian, Mithra; Gilmore, Jennifer [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Beaudre, Anne [Physics Unit, Institut Gustave Roussy, Villejuif (France); Blanchard, Pierre; El Nemr, Mohammed; Azoury, Farez; Al Hamokles, Hweej [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Lefkopoulos, Dimitri [Physics Unit, Institut Gustave Roussy, Villejuif (France); Girinsky, Theodore [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France)

    2012-03-15

    Purpose: To assess the additional benefits of using the deep-inspiration breath-hold (DIBH) technique with intensity-modulated radiotherapy (IMRT) in terms of the protection of organs at risk for patients with mediastinal Hodgkin's disease. Methods and Materials: Patients with early-stage Hodgkin's lymphoma with mediastinal involvement were entered into the study. Two simulation computed tomography scans were performed for each patient: one using the free-breathing (FB) technique and the other using the DIBH technique with a dedicated spirometer. The clinical target volume, planning target volume (PTV), and organs at risk were determined on both computed tomography scans according to the guidelines of the European Organization for Research and Treatment of Cancer. In both cases, 30 Gy in 15 fractions was prescribed. The dosimetric parameters retrieved for the statistical analysis were PTV coverage, mean heart dose, mean coronary artery dose, mean lung dose, and lung V20. Results: There were no significant differences in PTV coverage between the two techniques (FB vs. DIBH). The mean doses delivered to the coronary arteries, heart, and lungs were significantly reduced by 15% to 20% using DIBH compared with FB, and the lung V20 was reduced by almost one third. The dose reduction to organs at risk was greater for masses in the upper part of the mediastinum. IMRT with DIBH was partially implemented in 1 patient. This combination will be extended to other patients in the near future. Conclusions: Radiation exposure of the coronary arteries, heart, and lungs in patients with mediastinal Hodgkin's lymphoma was greatly reduced using DIBH with IMRT. The greatest benefit was obtained for tumors in the upper part of the mediastinum. The possibility of a wider use in clinical practice is currently under investigation in our department.

  19. 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.

  20. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

    Energy Technology Data Exchange (ETDEWEB)

    Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar (Dept. of Radiotherapy, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: vijo@sus.no

    2011-01-15

    Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

  1. SU-E-J-32: Calypso(R) and Laser-Based Localization Systems Comparison for Left-Sided Breast Cancer Patients Using Deep Inspiration Breath Hold

    International Nuclear Information System (INIS)

    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

  2. A comparative analysis of 3D conformal deep inspiratory–breath hold and free-breathing intensity-modulated radiation therapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Patients undergoing radiation for left-sided breast cancer have increased rates of coronary artery disease. Free-breathing intensity-modulated radiation therapy (FB-IMRT) and 3-dimensional conformal deep inspiratory–breath hold (3D-DIBH) reduce cardiac irradiation. The purpose of this study is to compare the dose to organs at risk in FB-IMRT vs 3D-DIBH for patients with left-sided breast cancer. Ten patients with left-sided breast cancer had 2 computed tomography scans: free breathing and voluntary DIBH. Optimization of the IMRT plan was performed on the free-breathing scan using 6 noncoplanar tangential beams. The 3D-DIBH plan was optimized on the DIBH scan and used standard tangents. Mean volumes of the heart, the left anterior descending coronary artery (LAD), the total lung, and the right breast receiving 5% to 95% (5% increments) of the prescription dose were calculated. Mean volumes of the heart and the LAD were lower (p<0.05) in 3D-DIBH for volumes receiving 5% to 80% of the prescription dose for the heart and 5% for the LAD. Mean dose to the LAD and heart were lower in 3D-DIBH (p≤0.01). Mean volumes of the total lung were lower in FB-IMRT for dose levels 20% to 75% (p<0.05), but mean dose was not different. Mean volumes of the right breast were not different for any dose; however, mean dose was lower for 3D-DIBH (p = 0.04). 3D-DIBH is an alternative approach to FB-IMRT that provides a clinically equivalent treatment for patients with left-sided breast cancer while sparing organs at risk with increased ease of implementation

  3. 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. PMID:26506131

  4. Deep-inspiration breath-hold PET/CT versus free breathing PET/CT and respiratory gating PET for reference. Evaluation in 95 patients with lung cancer

    International Nuclear Information System (INIS)

    The objective of this study was to define the factors that correlate with differences in maximum standardized uptake value (SUVmax) in deep-inspiration breath-hold (DIBH) and free breathing (FB) positron emission tomography (PET)/CT admixed with respiratory gating (RG) PET for reference. Patients (n=95) with pulmonary lesions were evaluated at one facility over 33 months. After undergoing whole-body PET/CT, a RG PET and FB PET/CT scans were obtained, followed by a DIBH PET/CT scan. All scans were recorded using a list-mode dynamic collection method with respiratory gating. The RG PET was reconstructed using phase gating without attenuation correction; the FB PET was reconstructed from the RG PET sinogram datasets with attenuation correction. Respiratory motion distance, breathing cycle speed, and waveform of RG PET were recorded. The SUVmax of FB PET/CT and DIBH PET/CT were recorded: the percent difference in SUVmax between the FB and DIBH scans was defined as the %BH-index. The %BH-index was significantly higher for lesions in the lower lung area than in the upper lung area. Respiratory motion distance was significantly higher in the lower lung area than in the upper lung area. A significant relationship was observed between the %BH-index and respiratory motion distance. Waveforms without steady end-expiration tended to show a high %BH-index. Significant inverse relationships were observed between %BH-index and cycle speed, and between respiratory motion distance and cycle speed. Decrease in SUVmax of FB PET/CT was due to tumor size, distribution of lower lung, long respiratory movement at slow breathing cycle speeds, and respiratory waveforms without steady end-expiration. (author)

  5. Reproducibility of The Abdominal and Chest Wall Position by Voluntary Breath-Hold Technique Using a Laser-Based Monitoring and Visual Feedback System

    International Nuclear Information System (INIS)

    Purpose: The voluntary breath-hold (BH) technique is a simple method to control the respiration-related motion of a tumor during irradiation. However, the abdominal and chest wall position may not be accurately reproduced using the BH technique. The purpose of this study was to examine whether visual feedback can reduce the fluctuation in wall motion during BH using a new respiratory monitoring device. Methods and Materials: We developed a laser-based BH monitoring and visual feedback system. For this study, five healthy volunteers were enrolled. The volunteers, practicing abdominal breathing, performed shallow end-expiration BH (SEBH), shallow end-inspiration BH (SIBH), and deep end-inspiration BH (DIBH) with or without visual feedback. The abdominal and chest wall positions were measured at 80-ms intervals during BHs. Results: The fluctuation in the chest wall position was smaller than that of the abdominal wall position. The reproducibility of the wall position was improved by visual feedback. With a monitoring device, visual feedback reduced the mean deviation of the abdominal wall from 2.1 ± 1.3 mm to 1.5 ± 0.5 mm, 2.5 ± 1.9 mm to 1.1 ± 0.4 mm, and 6.6 ± 2.4 mm to 2.6 ± 1.4 mm in SEBH, SIBH, and DIBH, respectively. Conclusions: Volunteers can perform the BH maneuver in a highly reproducible fashion when informed about the position of the wall, although in the case of DIBH, the deviation in the wall position remained substantial

  6. 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?

  7. Evaluation of flow volume and flow patterns in the patent false lumen of chronic aortic dissections using velocity-encoded cine magnetic resonance imaging

    International Nuclear Information System (INIS)

    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 (ΔD) 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; ΔD: 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 ΔD (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)

  8. 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)

  9. 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

  10. SU-D-18A-06: Variation of Controlled Breath Hold From CT Simulation to Treatment and Its Dosimetric Impact for Left-Sided Breast Radiotherapy with a Real-Time Optical Tracking System

    International Nuclear Information System (INIS)

    Purpose: Different breath-hold (BH) maneuvers (abdominal breathing vs. chest breathing) during CT simulation and treatment can lead to chest wall positional variation. The purpose of this study is to quantify the variation of active breathing control (ABC)-assisted BH and estimate its dosimetric impact for left-sided whole-breast radiotherapy with a real-time optical tracking system (OTS). Methods: Seven breast cancer patients were included. An in-house OTS tracked an infrared (IR) marker affixed over the xiphoid process of the patient at CT simulation and throughout the treatment course to measure BH variations. Correlation between the IR marker and the breast was studied for dosimetric purposes. The positional variations of 860 BHs were retrospectively incorporated into treatment plans to assess their dosimetric impact on breast and cardiac organs (heart and left anterior descending artery [LAD]). Results: The mean intrafraction variations were 2.8 mm, 2.7 mm, and 1.6 mm in the anteroposterior (AP), craniocaudal (CC), and mediolateral (ML) directions, respectively. Mean stability in any direction was within 1.5 mm. A general trend of BH undershoot at treatment relative to CT simulation was observed with an average of 4.4 mm, 3.6 mm, and 0.1 mm in the AP, CC, and ML directions, respectively. Undershoot up to 12.6 mm was observed for individual patients. The difference between the planned and delivered dose to breast targets was negligible. The average planned/delivered mean heart doses, mean LAD doses, and max LAD doses were 1.4/2.1, 7.4/15.7, and 18.6/31.0 Gy, respectively. Conclusion: Systematic undershoot was observed in ABC-assisted BHs from CT simulation to treatment. Its dosimetric impact on breast coverage was minimized with image guidance, but the benefits of cardiac organ sparing were degraded. A real-time tracking system can be used in junction with the ABC device to improve BH reproducibility

  11. Gadolinium-enhanced three-dimensional breath-hold MR angiography of the thoracic aorta; Angiografia con Risonanza Magnetica tridimensionale nell'apnea con infusione rapida di mezzo di contrasto paramagnetico nello studio dell'aorta toracica

    Energy Technology Data Exchange (ETDEWEB)

    Di Cesare, E.; Giordano, A.V.; Cerone, G.; Splendiani, A.; Michelini, O; Masciocchi, C. [L' Aquila Univ., L' Aquila (Italy). Ist. di Radiologia

    1999-11-01

    In this paper it is investigated the diagnostic accuracy of gadolinium-enhanced 3D MRA in the assessment of thoracic aortic diseases. Thirty-eight patients with diagnosed or suspected conditions of thoracic aorta were examined with contrast-enhanced MRA. All the examinations were performed with a 1.5 T superconductive magnet acquiring breath-hold 3D fast Gradient-Echo (GE) sequences (TR=5.9 ms; TE=1.2 ms; FA=45 degrees; FOV=48 cm; thickness=2-2.5 mm; locs=30-32; TA=22-24s; MA=512) on the coronal plane. The contrast agent was injected bolus after a bolus-test to evaluate circulation time. In the experts opinion contrast-enhanced three dimensional MR angiography should be the screening technique of choice in the evaluation of thoracic aorta thanks to its low invasiveness, short acquisition time, large field of view and morphologica resolution ECG gating is not needed. Limitations are found in the study of wall and periaortic region which are better evaluated with conventional MR imaging. [Italian] Scopo di questo lavoro e' stato verificare le potenzialita' della tecnica di angiografia con Risonanza Magnetica tridimensionale (angio-RM tridimensionale) nell'apnea con bolo di mdc paramagnetico nello studio delle malattie dell'aorta toracica. Sono stati sottoposti ad angio-RM con mdc trentotto pazienti con diagnosi o sospetta malattia dell'aorta toracica. E' stato utilizzato un magnete superconduttivo operante a 1,5 tesla (GE) impiegando una sequenza 3D Fast Gradient-Echo (TR=5,9 ms; TE=1,2 ms; FA=45 degrees; FOV=48 cm; thickness=2-2.5 mm; locs=30-32; TA=22-24s; matrice=512) acquista in apnea sul piano coronale. Il mdc e' stato somministrato a bolo con ritardo calcolato sulla base del bolo-test che ha sempre preceduto l'acquisizione volumetrica. La valutazione con angio-RM tridimensionale con bolo di mdc rappresenta a nostro avviso la tecnica di scelta nello studio dell'aorta toracica in ragione della scarsa invasivita

  12. SU-E-T-426: Dose Delivery Accuracy in Breast Field Junction for Free Breath and Deep Inspiration Breath Hold Techniques

    International Nuclear Information System (INIS)

    Purpose: The purpose of this work was to verify the accuracy of the dose distribution along the field junction in a half beam irradiation technique for breast cancer patients receiving radiation to the breast or chest wall (CW) and the supraclavicular LN region for both free breathing and deep inspiration breath hold (DIBH) technique. Methods: We performed in vivo measurements for nine breast cancer patients receiving radiation to the breast/CW and to the supraclavicular LN region. Six patients were treated to the left breast/CW using DIBH technique and three patients were treated to the right breast/CW in free breath. We used five microMOSFET dosimeters: three located along the field junction, one located 1 cm above the junction and the fifth microMOSFET located 1 cm below the junction. We performed consecutive measurements over several days for each patient and compared the measurements to the TPS calculation (Eclipse, Varian™). Results: The calculated and measured doses along the junction were 0.97±0.08 Gy and 1.02±0.14 Gy, respectively. Above the junction calculated and measured doses were 0.91±0.08 Gy and 0.98±0.09 Gy respectively, and below the junction calculated and measured doses were 1.70±0.15 Gy and 1.61±0.09 Gy, respectively. All differences were not statistically significant. When comparing calculated and measured doses for DIBH patients only, there was still no statistically significant difference between values for all dosimeter locations. Analysis was done using the Mann-Whitney Rank-Sum Test. Conclusion: We found excellent correlation between calculated doses from the TPS and measured skin doses at the junction of several half beam fields. Even for the DIBH technique, where there is more potential for variance due to depth of breath, there is no over or underdose along the field junction. This correlation validates the TPS, as well an accurate, reproducible patient setup

  13. Motion-compensated compressed sensing for dynamic imaging

    Science.gov (United States)

    Sundaresan, Rajagopalan; Kim, Yookyung; Nadar, Mariappan S.; Bilgin, Ali

    2010-08-01

    The recently introduced Compressed Sensing (CS) theory explains how sparse or compressible signals can be reconstructed from far fewer samples than what was previously believed possible. The CS theory has attracted significant attention for applications such as Magnetic Resonance Imaging (MRI) where long acquisition times have been problematic. This is especially true for dynamic MRI applications where high spatio-temporal resolution is needed. For example, in cardiac cine MRI, it is desirable to acquire the whole cardiac volume within a single breath-hold in order to avoid artifacts due to respiratory motion. Conventional MRI techniques do not allow reconstruction of high resolution image sequences from such limited amount of data. Vaswani et al. recently proposed an extension of the CS framework to problems with partially known support (i.e. sparsity pattern). In their work, the problem of recursive reconstruction of time sequences of sparse signals was considered. Under the assumption that the support of the signal changes slowly over time, they proposed using the support of the previous frame as the "known" part of the support for the current frame. While this approach works well for image sequences with little or no motion, motion causes significant change in support between adjacent frames. In this paper, we illustrate how motion estimation and compensation techniques can be used to reconstruct more accurate estimates of support for image sequences with substantial motion (such as cardiac MRI). Experimental results using phantoms as well as real MRI data sets illustrate the improved performance of the proposed technique.

  14. 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.

  15. Postoperative cine-MRI for patients with cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Honjo, Yasuomi [Okayama Univ. (Japan). School of Medicine

    1995-07-01

    The usefulness of cine-MRI using motion pictures was studied on 75 patients with postoperative cervical myelopathy, and morphology of cervical spine and cervical cord, postoperative MRI, and postoperative outcome were investigated. T1-weighted images by SE method and T2-weighted images by gradient field echo were obtained. Cine-MR images were classified into 5 according to the site of cerebrospinal fluid flow void and its degree (anterior type, 21; anteroposterior type, 30; posterior type, 7; incomplete block type, 15; complete block type, 2), and relationship between clinical features were studied. This method enabled dynamic noninvasive evaluation of spinal cord compression by cerebrospinal fluid flow. (S.Y.).

  16. 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.)

  17. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hepp, Rodrigo; Ammerpohl, Mark; Morgenstern, Christina; Erichsen, Patricia [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Nielinger, Lisa [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Hochschule Hamm-Lippstadt, Lippstadt (Germany); Abdallah, Abdallah [Evangelische Kliniken Gelsenkirchen, Klinik fuer Senologie, Gelsenkirchen (Germany); Galalae, Razvan [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Christian-Albrechts-Universitaet zu Kiel, Medizinische Fakultaet, Kiel (Germany)

    2015-09-15

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm{sup 3} (D{sub 2} {sub cm} {sup 3}), volume receiving ≥ 5 Gy (V{sub 5}), 10 Gy (V{sub 10}), 15 Gy (V{sub 15}) and 20 Gy (V{sub 20}). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D{sub 2} {sub cm} {sup 3} was less than 42 Gy in DIBH. In FB the heart D{sub 2} {sub cm} {sup 3} was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.) [German] Die adjuvante Strahlentherapie nach brusterhaltener Operation (BCS) bei Brustkrebs (BC) ist eine seit langem anerkannte Behandlungsform. Das postradiogene Risiko einer kardialen Ischaemie steigt linear ohne erkennbaren Schwellenwert mit der mittleren Herzdosis. Die Bestrahlung der linken Brust in tiefer Inspiration unter Anhalten der

  18. Cine y Modernismo

    OpenAIRE

    González García, María; Caro Valverde, María Teresa

    2008-01-01

    Unidad Didáctica de Innovación Educativa de proyección semiótica interdisciplinar entre Cine y Literatura aplicada al nivel de Cuarto Curso de Educación Secundaria Obligatoria, de acuerdo con las disposiciones legales de la LOE. Sus actividades de aprendizaje siguen una metodología de iniciación a la investigación para el desarrollo del aprendizaje en competencias comunicativas. Unidad Didáctica de Lengua castellana y Literatura para el nivel educativo de Cuarto Curso de Educación Secundar...

  19. Cine-CT of the mediastinum in pediatric patients

    International Nuclear Information System (INIS)

    Eighty-three cine-CT examinations of the mediastinum were performed in children. Lesions imaged include neoplastic, inflammatory, and vascular abnormalities. The 50-msec scan time allowed superb visualization of the heart and airway, minimized motion artifact, allowed examinations to be done with little or no sedation, and permitted optimal opacification of all vascular structures with as little as 0.5 ml/kg of intravenous contrast agent. Scanning time for a 20-section examination is 10 sec. The radiation dose for an equivalent examination is approximately one-tenth that of conventional CT. Cine-CT is an excellent imaging modality for examining the mediastinum in children

  20. 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...

  1. Kinematic analysis of the knee joint by cine MRI

    International Nuclear Information System (INIS)

    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)

  2. An experimental animal model of chronic myocardial hibernation: comparative study of cine-MR, myocardial single photon emission computed tomography and pathology

    International Nuclear Information System (INIS)

    Objective: To establish the chronic low-flow myocardial hibernation animal model in pigs, and to assess the diagnostic value for myocardial hibernation by using various imaging methods. Methods: A total of 13 miniswine (30-40 kg) were used. All animals underwent general anesthesia and orotracheal intubation while the animals were mechanically ventilated. Under sterile conditions, left ventriculography and coronary angiography were performed by introduction of catheter into the right femoral artery. Further, a left anterolateral thoracotomy was performed in the third intercostal space. The proximal LCX was dissected free to allow placement of an ameroid constrictor. More than 1 month later, left ventriculography and coronary angiography were performed again, followed by cine-MRI at rest and during stress with low-dose of dobutamine (5μg·kg-1·min-1), respectively. Traditional and/or breath-hold cine-MRI were used to evaluate regional left ventricular wall motion, corresponding to basal, midventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated. At the same time 99mTc-MIBI myocardial SPECT was performed at rest and during nitroglycerin administration, respectively. All animals were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) staining was used to assess the myocardial infarction. Electron microscopy was used to identify myocardial cellular changes characteristic of hibernating myocardium. Results: Three pigs died during surgery or within two weeks after surgery. One pig died of anesthesia during SPECT examination, 1 pig suffered from aneurysm, and another one pig showed negative findings. The other 7 pigs were found with hypokinetic (n=4) or akinetic (n=3) myocardial regions related to stenosed LCX (70%-99%). Resting cine-MRI demonstrated decreased regional motion of the lateral and posteroinferior walls (ischemic regions) of the left ventricle (n=7), compared with the nonischemic

  3. Cine-Club

    CERN Multimedia

    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...

  4. Examination of swallowing disorders using Digital Cine-Radiography (DCR)

    International Nuclear Information System (INIS)

    Twenty-seven patients with different swallowing disorders were studied by employing Digital Cine-Radiography (DCR) for rapid imaging of the pharynx with a temporal resolution of up to 50 frames per second and a maximum spatial resolution of 0.8 per/mm. To facilitate therapy planning, the DCR study can be transferred to the oto-rhino-laryngologist via videotape. DCR is capable to substitute analog cine or videotechniques in the pre- and postoperative examination of patients with swallowing disorders. (orig.)

  5. Functional imaging of the lung using a gaseous contrast agent: 3Helium-magnetic resonance imaging

    International Nuclear Information System (INIS)

    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 3Helium 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 3Helium. (orig.)

  6. Cine CT technique for dynamic airway studies

    International Nuclear Information System (INIS)

    The advent of cine CT scanning with its 50-msec data acquisition time promises a much wider range of dynamic CT studies. The authors describe a method for dynamic evaluation of the extrathoracic airway, which they believe has considerable potential application in nonfixed upper-airway disease, such as sleep apnea and stridor of unknown cause. Conventional CT is limited in such studies by long data acquisition time and can be used to study only prolonged maneuvers such as phonation. Fluoroscopy and digital subtraction studies are limited by relatively high radiation dose and inability to image all wall motions simultaneously

  7. 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

  8. Cine phase contrast angiography of normal and diseased peripheral arteries. Preliminary results

    International Nuclear Information System (INIS)

    Cine phase contrast angiography (PCA) is a modified MR phase contrast sequence that acquires up to 22 coronal phase images per mean cardiac cycle. The ability of the sequence to visualise local haemodynamics was investigated in 7 normal volunteers and 9 patients with flow disturbances of the peripheral arteries using a 1.5 T imager. Functional flow information provided by coronal cine PCA was correlated with quantitative data obtained by MR flow measurements and vessel morphology confirmed by conventional angiograms. Due to the yet suboptimal image quality, an aortic dissection and 1 of 4 aneurysms could not be depicted morphologically. The temporal pattern of arterial perfusion in cine PCA corresponded with flow velocity versus time data provided by quantitative MR flow measurements. Accuracy and time resolution of cine PCA was thus sufficient to provide functional information on the severity of occlusive vascular disease. (orig.)

  9. 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.

  10. Cine-Club

    CERN Document Server

    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...

  11. 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 ...

  12. 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.  

  13. 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...

  14. 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.

  15. Analysis of blowout fractures using cine mode MRI

    International Nuclear Information System (INIS)

    By observing conventional CT and MRI images, it is difficult to distinguish extension failure from adhesion, bone fracture or damage to the extraocular muscle, any one of which may be the direct cause of the eye movement disturbance accompanying blowout fracture. We therefore carried out dynamic analysis of eye movement disturbance using a cine mode MRI. We put seven fixation points in the gantry of the MRI and filmed eye movement disturbances by the gradient echo method, using a surface coil and holding the vision on each fixation point. We also video recorded the CRT monitor of the MRI to obtain dynamic MRI images. The subjects comprised 5 cases (7-23 years old). In 4 cases, we started orthoptic treatment, saccadic eye movement training, convergence training and fusional amplitude training after surgery, with only orthoptic treatment in the 5 th case. In all cases, fusion area improvement was recognized during training. In 2 cases examined by cine mode MRI before and after surgery, we observed improved eye movement after training, the effectiveness of which was thereby proven. Also, using cine mode MRI we were able to determine the character of incarcerated tissue and the cause of eye movement disturbance. We conclude that it blowout fracture, cine mode MRI may be useful in selecting treatment and observing its effectiveness. (author)

  16. High resolution MR imaging of the fetal heart with cardiac triggering: a feasibility study in the sheep fetus

    International Nuclear Information System (INIS)

    The aim of this study was to perform fetal cardiac magnetic resonance imaging (MRI) with triggering of the fetal heart beat in utero in a sheep model. All experimental protocols were reviewed and the usage of ewes and fetuses was approved by the local animal protection authorities. Images of the hearts of six pregnant ewes were obtained by using a 1.5-T MR system (Philips Medical Systems, Best, Netherlands). The fetuses were chronically instrumented with a carotid catheter to measure the fetal heart frequency for the cardiac triggering. Pulse wave triggered, breath-hold cine-MRI with steady-state free precession (SSFP) was achieved in short axis, two-, four- and three-chamber views. The left ventricular volume and thus the function were measured from the short axis. The fetal heart frequencies ranged between 130 and 160 bpm. The mitral, tricuspid, aortic, and pulmonary valves could be clearly observed. The foramen ovale could be visualized. Myocardial contraction was shown in cine sequences. The average blood volume at the end systole was 3.4±0.2 ml (± SD). The average volume at end diastole was 5.2±0.2 ml; thus the stroke volumes of the left ventricle in the systole were between 1.7 and 1.9 ml with ejection fractions of 38.6% and 39%, respectively. The pulse wave triggered cardiac MRI of the fetal heart allowed evaluation of anatomical structures and functional information. This feasibility study demonstrates the applicability of MRI for future evaluation of fetuses with complex congenital heart defects, once a noninvasive method has been developed to perform fetal cardiac triggering. (orig.)

  17. High resolution MR imaging of the fetal heart with cardiac triggering: a feasibility study in the sheep fetus.

    Science.gov (United States)

    Yamamura, Jin; Schnackenburg, Bernhard; Kooijmann, Hendrik; Frisch, Michael; Hecher, Kurt; Adam, Gerhard; Wedegärtner, Ulrike

    2009-10-01

    The aim of this study was to perform fetal cardiac magnetic resonance imaging (MRI) with triggering of the fetal heart beat in utero in a sheep model. All experimental protocols were reviewed and the usage of ewes and fetuses was approved by the local animal protection authorities. Images of the hearts of six pregnant ewes were obtained by using a 1.5-T MR system (Philips Medical Systems, Best, Netherlands). The fetuses were chronically instrumented with a carotid catheter to measure the fetal heart frequency for the cardiac triggering. Pulse wave triggered, breath-hold cine-MRI with steady-state free precession (SSFP) was achieved in short axis, two-, four- and three-chamber views. The left ventricular volume and thus the function were measured from the short axis. The fetal heart frequencies ranged between 130 and 160 bpm. The mitral, tricuspid, aortic, and pulmonary valves could be clearly observed. The foramen ovale could be visualized. Myocardial contraction was shown in cine sequences. The average blood volume at the end systole was 3.4 + or - 0.2 ml (+ or - SD). The average volume at end diastole was 5.2 + or - 0.2 ml; thus the stroke volumes of the left ventricle in the systole were between 1.7 and 1.9 ml with ejection fractions of 38.6% and 39%, respectively. The pulse wave triggered cardiac MRI of the fetal heart allowed evaluation of anatomical structures and functional information. This feasibility study demonstrates the applicability of MRI for future evaluation of fetuses with complex congenital heart defects, once a noninvasive method has been developed to perform fetal cardiac triggering. PMID:19430796

  18. Cine y estudios de género: Imagen, representación e ideología. Notas para un abordaje crítico Cinema and gender studies: Image, representation and ideology. Notes for a critical approach

    Directory of Open Access Journals (Sweden)

    Paula Laguarda

    2006-12-01

    Full Text Available El cine, en tanto productor de imágenes, representaciones, significados e ideologías, aparece como un terreno óptimo para el rastreo del modo en que se han construido las subjetividades, desde la popularización de esta técnica en las primeras décadas del siglo XX hasta la actualidad. En este sentido ofrece a los estudios de género una fuente de primer orden para el análisis de las representaciones socialmente dominantes acerca de lo femenino y lo masculino y las características asignadas a cada uno; así como la interacción de la categoría de género con otras como clase, etnicidad, nación, domesticidad, educación, ejercicio de la sexualidad y edad. En el artículo se abordan críticamente las principales líneas teóricas que han vinculado cine y feminismo y las posibilidades que éste ofrece a los estudios de género, al permitir la indagación simultánea sobre aspectos textuales (discursivos, narrativos y recursos propios del lenguaje cinematográfico y contextuales (al considerar al cine a la vez como industria cultural y manifestación de la cultura popular.Cinema, as a producer of images, representations, meanings and ideologies, seems to be an optimum territory for tracing the way in which subjectivities had been constructed, sinces the popularization of this technique on the early decades of XX century to the present day. In this sense, cinema provides gender studies with a source of prime order to analyse socially dominant representations about female and male, and the characteristics assigned to each other; such as the interaction between gender category and other like class, ethnicity, nation, domesticity, education, sexuality and age. This article approaches critically to the main theoretical lines that had conected cinema and feminism, and to the possibilities it offers to gender studies, by allowing simultaneous research on textual aspects (discoursive, narrative elements and resources of cinematographic language and

  19. Magnetic resonance imaging of athlete's heart: myocardial mass, left ventricular function, and cross-sectional area of the coronary arteries

    International Nuclear Information System (INIS)

    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.)

  20. Clinical evaluation of X-ray voxel Monte Carlo versus pencil beam-based dose calculation in stereotactic body radiotherapy of lung cancer under normal and deep inspiration breath hold.

    Science.gov (United States)

    Landoni, V; Borzì, G R; Strolin, S; Bruzzaniti, V; Soriani, A; D'Alessio, D; Ambesi, F; Di Grazia, A M; Strigari, L

    2015-06-01

    The purpose of this study is to evaluate the differences between dose distributions calculated with the pencil beam (PB) and X-ray voxel Monte Carlo (MC) algorithms for patients with lung cancer using intensity-modulated radiotherapy (IMRT) or HybridArc techniques. The 2 algorithms were compared in terms of dose-volume histograms, under normal and deep inspiration breath hold, and in terms of the tumor control probability (TCP). The dependence of the differences in tumor volume and location was investigated. Dosimetric validation was performed using Gafchromic EBT3 (International Specialty Products, ISP, Wayne, NJ). Forty-five Computed Tomography (CT) data sets were used for this study; 40 Gy at 8 Gy/fraction was prescribed with 5 noncoplanar 6-MV IMRT beams or 3 to 4 dynamic conformal arcs with 3 to 5 IMRT beams distributed per arc. The plans were first calculated with PB and then recalculated with MC. The difference between the mean tumor doses was approximately 10% ± 4%; these differences were even larger under deep inspiration breath hold. Differences between the mean tumor dose correlated with tumor volume and path length of the beams. The TCP values changed from 99.87% ± 0.24% to 96.78% ± 4.81% for both PB- and MC-calculated plans (P = .009). When a fraction of hypoxic cells was considered, the mean TCP values changed from 76.01% ± 5.83% to 34.78% ± 18.06% for the differently calculated plans (P < .0001). When the plans were renormalized to the same mean dose at the tumor, the mean TCP for oxic cells was 99.05% ± 1.59% and for hypoxic cells was 60.20% ± 9.53%. This study confirms that the MC algorithm adequately accounts for inhomogeneities. The inclusion of the MC in the process of IMRT optimization could represent a further step in the complex problem of determining the optimal treatment plan. PMID:25223324

  1. Manually respiratory-triggered single-shot fast spin-echo: a non-breath-hold T2-weighted method for liver lesion detection

    International Nuclear Information System (INIS)

    To determine whether manual respiratory triggering of a T2-weighted single-shot fast spin-echo sequence (M-SSFSE) improves detection and characterization of liver lesions compared with conventional breath-held single-shot fast spin-echo (C-SSFSE) technique. M-SSFSE is performed by manually triggering a series of single-slice acquisitions through the liver at end of expiration. There were 171 hepatic lesions in 49 patients. Images were random zed and reviewed by 3 radiologists. Lesions were characterized as hemangiomas, cystic or solid. Dynamic gadolinium-enhanced sequences were used as the reference standard. Contrast-to-noise ratios (CNR) were calculated for all le ions that measured 1 cm or more. M-SSFSE was more sensitive than C-SSFSE in the detection of liver lesions (48%-58% v. 37%-46%, p < 0.001). There were no significant differences in the specificity of lesion detection be ween the 2 sequences. Artifacts were significantly less severe for M-SSFSE compared with C-SSFSE (p = 0.001). The CNR was significantly higher for all liver lesions on M-SSFSE compared with C-SSFSE (p < 0.001). M-SSFSE significantly improved hepatic lesion detection and, in particular, improved characterization of solid liver lesions and hemangiomas compared with C-S SSFSE imaging. (author)

  2. Manually respiratory-triggered single-shot fast spin-echo: a non-breath-hold T{sub 2}-weighted method for liver lesion detection

    Energy Technology Data Exchange (ETDEWEB)

    O' Riordan, E. [Univ. of Western Ontario, Dept. of Diagnostic Imaging and Nuclear Medicine, London Health Care Sciences, London, Ontario (Canada); Haider, M.A.; O' Malley, M.E.; Khalili, K.; Ibach, K.; Lockwood, G.A.; Bahadorani, B. [Univ.